Comment on “My Big Fat Fabulous Life” Trots Out Cringe-Inducing Stereotypes by Dagny Kight        
She's a novelty because she's a fat girl who can dance AND she's fat because of a medical condition so she's absolved of responsibility. Throw in the wealthy eccentric parents and you've got a reality show perfect storm! Don't forget the gay sidekick!
          By: Anon2        
While incentives are nice, pay usually comes down to market forces. For those of you on the clinical side you will see medical doctors make a ton of money, but not really contribute very much of anything, beyond adding their credential to a protocol. They mostly regurgitate what they can from MSLs. Then the present clinical data to basic scientists and basic science data to clinical folks (so to each party this MD is looked up to as someone who is filling a knowledge gap). The best incentives for early development folks would be a priority class of stock options/shares. However the VCs usually prevent that from happening.
          Accelerate Live! talk: Health-generating buildings, Marcene Kinney, Angela Mazzi, GBBN Architects        
Architects Marcene Kinney and Angela Mazzi share design hacks pinpointing specific aspects of the built environment that affect behavior, well-being, and performance.

 

During the past 20 years, we’ve witnessed an evolution in building design, from high-performance and energy-efficient buildings, to sustainable and green buildings, and now to spaces that enhance performance and promote wellness and health. 

In this 15-minute talk at BD+C’s Accelerate Live! conference (May 11, 2017, Chicago), Marcene Kinney and Angela Mazzi from Cincinnati-based GBBN Architects talk about their work in behavior change and health-generating design.

Their predictive outcome modeling helps clients make strategic design investments that enhance user and building performance, while minimizing behaviors that can lead to more negative outcomes, such as injuries, poor health, or mistakes.

They also share design hacks pinpointing specific aspects of the built environment that affect behavior, well-being, and performance to help clients get more success out of their spaces.

ABOUT THE SPEAKERS

As Principal and Market Director at GBBN Architects, Marcene Kinney, AIA, LEED AP, leads her team's exploration and focus to do more than merely solve functional architectural problems for clients. Her applied research details fives types of space and their physical attributes that contribute to socialization and gathering patterns within spaces. She has dedicated 17 years exploring how space facilitates social interaction and builds community within the educational environment. Kinney has presented her research-based design work to American Institute of Architecture and Society of College and University Planning audiences and is the recent recipient of an AIA design award for work completed at Northern Kentucky University. Perhaps most important are the satisfaction survey reports by her clients who are reporting increased engagement and retention from their customers.

Angela Mazzi, AIA, ACHA, EDAC, is a Senior Associate and Medical Planner at GBBN Architects, where she focuses on enhancing quality of life through built environments—connecting great design with user needs. Her background in design, business management, and research on socio-cultural contexts provides a unique perspective on how culture is reflected in architecture and user experience. Mazzi serves on the Board of Regents for the American College of Healthcare Architects (ACHA), the Board of AIA Cincinnati, the Advisory Committee for the Institute for Patient-Centered Design, and was an Advisory Board member for Arizona State University's Healthcare Design Program in its initial years. Her research linking wellness to design has been published in many healthcare journals and been presented at both national and international conferences.

FOLLOW GBBN ARCHITECTS

@GBBNArchitects
www.facebook.com/GBBNArchitects


          Full Circle        
I’m happy to report that Gabe and I are both parasite-free after our mid-service medical exams. After a few weeks vacationing in the decadent land of available cheese and hot showers (Europe) with our amazing friends and family who met us halfway around the world to bring me Junior Mints (among other things), we are [...]
          Tropical Disease Bingo!        
Peace Corps Cameroon Tropical Disease Bingo! We’re in Yaounde this week for Mid-Service Medical, during which they give every volunteer a physical and test our bodily fluids to see if we’ve acquired any fun new tropical diseases. To commemorate the occasion of being in Cameroon for a whole year, I made an official Peace Corps Cameroon [...]
          AAC/Medicare Changes        

I was hoping to have written this post last week, so that you might have more time to help out, but life got in the way!  This is a VERY important post, especially to those of you who rely on Medicare to secure AAC devices.  Specifically this is related to patients with ALS, Cerebral Palsy, Muscular Dystrophy, Rett Syndrome,spinal cord injuries, spinal muscular atrophy and other impairments and their ability to retain and receive Speech Generation Devices (SGD).

As of September 1, Medicare will be changing the rules and will not allow patients to receive this devices to "unlock" them.  Thereby, denying individuals the ability to communicate with their families and other individuals via email, text, video chat, etc...  Even though the unlock fee is not paid by Medicare, they will no longer allow individuals to purchase devices that this could be done on.

Medicare has also been denying Eye Gaze devices for those individuals whose only means of access if via an eye gaze system.  Many of these cases have 2 medical professionals certifying the need for an eye gaze system and it is still denied. The backlog of appeals is years long and many patients are being denied the ability to communicate.

Please take a moment and go to this website - Center for Medical Advocacy, fill in your zip code, and the short form that follows to contact your representatives and urge them to sign a petition to stop these rule changes!  It takes just 2-3 minutes.  You only have until August 27, so please do it right away!



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          Unlocking G Suite for Nonprofits: Improve internal workflow and communication        

Whether you have a team of five or 500 a seamless, collaborative workflow is critical in the digital age. Our goal is to make sure that your nonprofit is able to focus on changing the world by using technology to save time -- not waste it. In the digital age though, information sharing can often be complex; your team might not work in the same office, or even the same timezone. Some team members might be in an office with computer access, while others are in the field on mobile devices. Who from your team should be able to access confidential documents?

This brings us to a key question: How do you empower team members to work together towards a common goal, and use technology to enable it?

Great question. We’d like to introduce you to G Suite - (formerly  Google Apps for Work ). G Suite aims to help teams work together in real-time -- no matter where they are in the world.

Today, we’re spotlighting a few nonprofits to share how their teams  are using Google tools and apps to improve workflow and internal communication.

Mercy Beyond Borders - Internal Communication with Sheets & Sites

Mercy Beyond Borders (MBB) is a U.S. nonprofit that aims to forge opportunities for women and girls in extreme poverty to learn, connect, and lead. Utilizing a small office in the U.S. as home base, MBB targets rural areas in Haiti and South Sudan. In both of these areas, cultural norms and poverty prohibit full participation of women. In fact, these areas offer minimal education and opportunities for employment, which often  impedes the development of leadership skills or positions. Mercy Beyond Borders focuses its programs on providing trainings, scholarships, leadership camps, and business loans for women.

To achieve their mission, Mercy Beyond Borders faces the challenge of balancing US-based operations with field work in remote areas like South Sudan and Haiti. Their nonprofit partners range from large organizations to local schools to individuals. So how does Mercy Beyond Borders ensure that all staff, vendors, and partners stay connected and working together in sync?
MBB-trained nurse in South-Sudan village
MBB-trained nurse in South Sudan village. Photo credit: Mercy Beyond Borders

Mercy Beyond Border began using G Suite to streamline its workflow, connecting their team across the globe. Using G Suite, MBB’s team is able to access, share, and collaborate together in real-time. Take a glimpse into how they do it:

  • Track Finances: MBB manages their overseas program budget expenditures in Google Sheets. Using this tool, the domestic office tracks monthly vendor payments in Haiti. This enables the staff to wire more money as needed in order to ensure program success. Additionally, using Sheets enables the team to provide transparency in the organization, clarifying spending and creating a simple overview of total annual expenses. This standardized and collaborative approach to data enables better efficiency and communication between domestic and international offices.

  • Store images: Mercy Beyond Borders regularly takes photos in the field to keep the domestic office up to date on progress and communicate stories to their donors. The team overseas is able to upload the pictures to Google Drive, which allows them to share or retrieve the images at any time.

  • Share Information: It’s imperative that MBB shares frequent updates with the Board of Directors, highlighting current developments, areas for growth, and new opportunities. To keep the Board of Directors apprised of progress, the team created a MBB Board website with Google Sites as a way to provide updates outside of meetings. The site functions as a central hub, where the Board can find all relevant information and resources at their discretion. The website is organized in subsections including internal updates from the Executive Director, background articles on country conditions and descriptions of new partnerships. To take it one step further, MBB also added a comment section for board members to engage in open communication.

“It [G Suite] helps to better connect, engage, and keep Board members up-to-date in between meetings, or  if they are unable to make a meeting (in which case they can view the Meeting Archives page),” said Adrienne Perez.


MyFace - Increasing productivity and improving internal workflow by remote access

Established in 1951, MyFace was founded to address the medical, surgical and psychological needs of those living with facial deformities. The organization offers access to care and treatments --- regardless of the severity of the anomaly, the length of treatment, or the family’s ability to afford care. In America alone, 1 in 650 children is born with an facial cleft. Every year, MyFace helps more than 1,000 patients seek treatment. Of this population, 85% are children, 70% live in poverty, and 95% require long-term care. The costs involved in this are high and verges on insurmountable for low income families. With this in mind, MyFace ensures that all children receive highest quality interdisciplinary and comprehensive reconstructive care by doctors who provide their services pro bono.

As a small nonprofit (their staff of eight including their therapy dog, Bentley), employees are required to perform a variety of different tasks. On any given day, team members might be responsible for website design, grant proposal writing, and marketing strategy. And oftentimes, what one employee starts today is  picked up by another employee tomorrow. Because it’s often all-hands-on-deck, collaboration is particularly key for MyFace.

Our mission of changing faces and transforming lives can be fulfilled with the help of technology from G4NP Carolyn Spector Executive Director MyFace

To address their challenge, MyFace began using Google Drive to centrally store, access, and share information from anywhere at anytime. Drive helped decrease the amount of time that MyFace spends on administrative tasks, like sending documents back and forth or working with out-of-date data or information. Drive’s tools like Docs and Sheets enable the team to collaborate both in and out of office.

MyFace also deals with an overwhelming amount of data and information. The team needs this data to not only be easy to store, retrieve, and share — it needs to be secure, since it contains confidential and personal patient information. G Suite offers that as well, ensuring that all information is kept private and secure. (Want to know more about G Suite security and how safe they really are? Read more about it here).

“Our mission of changing faces and transforming lives can be fulfilled with the help of technology from G4NP because it offers invaluable resources to nonprofits of any size at no cost,” stated Carolyn Spector, Executive Director of MyFace.

MyFace Staff photo
MyFace team. Photo credit: MyFace

Having global teams of different sizes with varying access to technology can make timely communication difficult, if not impossible. While nonprofits like Mercy Beyond Borders and myFace strive to accomplish unique missions, both organizations are passionate about changing the world. And about using the right technology to help. Utilizing tools like G Suite has been key for nonprofits like these in order to improve internal workflow and communications. For Mercy and my Face, making information shared, up-to-date, and secure has been crucial for navigating the Technology Age.

Interested in learning more about the tools available to your nonprofit? Check out our website to see how G4NP can help your nonprofit with real-time, up-to-date communication and data sharing.

//

To see if your nonprofit is eligible to participate, review the Google for Nonprofits eligibility guidelines. Google for Nonprofits offers organizations like yours free access to Google tools like Gmail, Google Calendar, Google Drive, Google Ad Grants, YouTube for Nonprofits and more. These tools can help you reach new donors and volunteers, work more efficiently, and tell your nonprofit’s story. Learn more and enroll here.

Footnote:  Statements are provided by Nonprofits that received free products as part of the Google for Nonprofits program, which offers free products to qualified nonprofits.


          Proenhance patch - Be a better man        



No more worries for you regarding the scale of your penis - it's time for the pure joy! The medical professionals as well as the herbalists support the ProEnhance patch, a system that's designed so that men like you achieve their best male sexual potency.

It is a double system : the convenient and powerful ProEnhance herbal patch plus free unlimited access to the exercise programmes. The patch was developed for simple use and convenient, discreet male potential enhancement that with you everywhere - and is an alternative choice to the common pills or powders. The program for buttressing the sexual endurance is considered the leader, and is far better, safer and more comfy than working with penis pumps or the like.

A patch, where you worry about any serious changes in way of living wants.

Click here to learn more about Proenhance patch



The patch is like a ordinary bandage or a plaster - nobody suspected such a thing! Additionally, here is the best : the patch can be worn in the shower, while participating in sports and during the entire day.

The repeated feedback from the buyers as well as the ideal customer service will guarantees that folks feel in any way impeded by the patch in normal life, not in the shower, sport and all of the daily activities.

For the bulk of folk the results can be seen instantly or within a week with the "fast-acting" ProEnhance patch system and practice.

ProEnhance Patch is developed in order to make a contribution to a better orgasm, better erection, longer-lived encounters. What this suggests is that you thru the use of the ProEnhance patch you will definitely spot the following :
- A supercharged sex drive
- More solid erections that feel to be greater, wider and more total
- Large, impressive ejaculations
- More confidence in the love
- bigger, more content feeling
Some folk get results, while it may take longer for others.

Click here to learn more about Proenhance patch



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Proenhance patch - How can it helps you
Proenhance patch - Truth of Proenhance patch
Proenhance patch - Benefits of Proenhance patch

          Proenhance patch - Be a better man        



No more worries for you regarding the dimensions of your penis - it is time for the pure joy! The medical execs as well as the herbalists support the ProEnhance patch, a system that is designed so that men like you achieve their best male sexual potency.

It is a double system : the convenient and powerful ProEnhance herbal patch plus free unlimited access to the exercise programs. The program for reinforcing the sexual endurance is regarded the leader, and is better, safer and more comfy than working with john thomas pumps or the like.

From the beginning the manufactures of ProEnhance patvh wished to develop a completely new and different patch, a product that men can wear and use without asking questions. A patch, where you worry about any major changes in lifestyle wants. Rather than taking up to three tablets per day, or wear for hours stretching device, you can just take a patch and then replace all a few days, practice with the program when you have the time and you will achieve excellent results.

Click here to learn more about Proenhance patch



The ProEnhance herbal patch is developed to be sitting in the area of the stomach discreetly under your clothing. The patch is like a ordinary bandage or a plaster - no one suspected such a thing! Additionally, here is the best : the patch can be worn in the shower, while participating in sports and during the entire day.

The ProEnhance patch is very flexible and durable and in the product selection, the producers have tested many various patches to make sure that the choice is the best that is available.



ProEnhance Patch is developed to contribute to a better orgasm, better erection, longer-lived encounters. What this means is that you thru the use of the ProEnhance patch you may definitely notice the following :
- Large, electrifying ejaculations
- More confidence in the love
- larger, more comfortable feeling
- It is vital to recognize that the results can vary depending on the person. Some folk see results, while it could take longer for others.

Click here to learn more about Proenhance patch



More quality articles:
Proenhance patch - Truth of Proenhance patch
Proenhance patch - Benefits of Proenhance patch
Proenhance patch - How can it helps you
Proenhance patch - Benefits of Proenhance patch

          Inside Sales (medical device) - Lux Research        
Nashville, TN - Location: Nashville, TNType: Full TimeMin. Experience: Mid Level
The CHALLENGE:

Seeking a hearing solution is a big deal. For most people, it?s a big decision that involves a long period of research and contemplation which can lead to a complicated purchase process that involves
          When your feelings hurt your health        
While your emotions may be invisible to the world's most advanced medical technology, they still impact your health just as much as your flesh-and-blood organs do.
          Too tough to get sick: Why men won't see the doc        

James Chisum, 28, doesn’t drink, doesn’t smoke and doesn’t believe men his age should have yearly medical check-ups. Turns out, he's not the only guy who feels that way. Many American men, such as 28-year-old James Chisum, simply refuse to go to the doctor, ever, either out of male pride, out of white-coat fear or simply out of lifestyle habit.  That mindset could be genetic, experts suggest.



          FDA OKs new drug for advanced prostate cancer        
The Food and Drug Administration said Friday it approved the pill Xtandi for men with advanced prostate cancer that has returned or spread despite major medical intervention.
          Who's your daddy? DNA clinic sparks concerns        
A mobile DNA testing facility that looks more like a motor home than a medical clinic is raising questions about the ramifications of quick and easy tests to determine paternity and other biological connections.
          Suspect in hepatitis C outbreak was fired in Ariz.        

This undated photo provided  by the U.S. Attorney's Office in New Hampshire shows David Kwiatkowski, a former lab technician at Exeter, N.H., Hospital, arrested at a hospital in Massachusetts where he is receiving medical treatment.  Kwiatkowski, originally from Michigan, was charged Thursday, July 19, 2012, with causing a hepatitis C outbreak involving at least 30 patients who were treated at Exeter Hospital's cardiac catheterization lab. (AP Photo/U.S. Attorney's Office)A dozen hospitals in seven states are scrambling to identify people who might have been infected with hepatitis C by a traveling medical technician who was charged a week ago with causing an outbreak in New Hampshire.



          Double arm transplant patient feels new hands        

Gabriel Granados Vergara, 52, received a double arm transplant at the National Institute of Medical Science and Nutrition (INCMN) in Mexico City.A Mexican man whose arms were severely burned by electricity became the first patient in Latin America to receive a double arm transplant, doctors said Thursday.



          No routine PSA tests for men, panel rules        

An expert task force has recommended against routine PSA testing to screen for prostate cancer. That doesn't sit well with Rick Lyke, 51, of Charlotte, N.C., who was diagnosed and treated because of a PSA test -- and figures it saved his life.  He's shown with his daughters, Brhea and Brittany.A top panel of U.S. medical experts has issued a final decision on a long-debated men’s health controversy, concluding that no man of any age should routinely be screened for prostate cancer using the popular PSA test.



          Forty summers ago – July 5, 1977 – grand jury began hearing testimony, piercing, slightly, the ongoing Showalter hit-run cover-up in New London, CT        


Editor’s Note: The Showalter grand jury is noteworthy in that forces for justice – Judge Joseph Dannehy, Special Prosecutor Austin McGuigan and as many as 17 Connecticut State Police detectives – could only knock down some of the walls protecting New London Police, State’s Attorney C. Robert Satti, Asst. State’s Attorney Harold Dean, Judge Angelo Santaniello, former Mayor Harvey Mallove and others who escaped complete discovery. The cover-up continues to this day, highlighted by the suppression and disappearance of the grand jury transcripts.




The foundation for investigative reporting in this case was developed by John Peterson, who was managing editor of The Norwich Bulletin during the grand jury. The grand jury began hearing testimony on July 5, 1977
.








Special Prosecutor McGuigan became Chief State’s Attorney, then was fired after convicting appointees of the governor and many other public officials.

---
Chronology, Grand Juror Report, Follow-up Columns
Via
Law And Justice In Everyday Life, CT Law Tribune


F. Lee Bailey on Law and Justice in Everyday Life and the Showalter case:

This book - which is mainly about public officials, police, judges and lawyers either shaming or shining - is a good read. Many of the stories stand alone, like slices of life. Others will appear early in the book, with follow-up chapters later. The crown jewel, in my view, is his handling of the strange death of Kevin Showalter, who was slammed 50 feet down the road in New London, Connecticut on Christmas Eve 1973 while changing a tire on the traffic side of a parked car. For many years, Andy Thibault dogged a case which public officials seemed determined to let die, despite the presence of a likely suspect. He tells me his mentor, John Peterson, broke the case open and then handed over the torch. Joined by the victim's mother, Lucille, who revealed herself as a determined but delightful woman as the story unfolds, Andy beats up on police, prosecutors, judges and governors until finally there is action. Spurred on by an appointment hastened by Gov. Ella Grasso, Judge Joseph Dannehy conducted one of the most brilliant and thorough investigations I have ever seen. If this book were only about the Showalter case, it would be worth the price.

APPENDIX

THE SHOWALTER CHRONOLOGY – A FOUR YEAR SEARCH FOR JUSTICE


New London, Ct.

1973

December 24

Approximately 11:10 to 11:20 p.m. Kevin B. Showalter is killed. Car leaves scene. Only taillights observed by a neighbor.

There is much confusion. Mr. Showalter had been changing a tire on his companion’s car. His companion Debra Emilyta, was sitting about six feet away from the car on a stone wall.

Ms. Emilyta told police she heard a thud, but did not see the car which struck Mr. Showalter. She said she ran across the road, a well-lit section of Pequot Avenue near Plant Street, before seeing Mr. Showalter’s body.

Mr. Showalter’s body was thrown 22 feet from the believed point of impact, onto a sidewalk near a large tree. The police report prepared that night noted the deceased’s shoes were found 110 feet apart. Part of a leg bone was found 75 feet away.

Michael Buscetto of Mike’s Auto Body gives police body putty, apparently from the car which struck Mr. Showalter. The putty never made it to the police station. Det. Lt. Konstanty T. Bucko later denies its existence.

December 25

Autopsy performed. No trace of alcohol or drugs found. Cause of death listed as lacerated liver and broken neck.

In efforts to console Mrs. Showalter, friends, neighbors, witnesses and officials volunteer information about the accident. She quietly listens for about six weeks, taking it for granted that police are acting on the same information. December 26

New London police begin full-scale search for red car.

1974

February 6

FBI report describes paint particles on Mr. Showalter’s clothing as “racing green” or “forest green” used on 1968 Chrysler products.

February 7

Mrs. Showalter notes she had the impression local police were not actively pursuing the case. She began interviewing those persons who came to her voluntarily and made a written record of her findings.

During the next three weeks, Mrs. Showalter spends much of her time making telephone calls and knocking on doors. She and her youngest son Craig, then 14, visited a number of local auto dealers and garages. She said in most cases they were told police had not made any inquiries of them.

February 28

New London police conduct first interview with Harvey N. Mallove, the downtown merchant and former mayor and city councilor. Mallove stated he drove by Pequot Avenue near Plant Street shortly before 11:15 p.m. on Christmas Eve 1973. Seven people near the accident scene contradict what he said he saw.

April 20

Mrs. Showalter writes to State’s Atty. Edmund J. O’Brien, requesting a one-man grand jury investigation into her son’s death. O’Brien never responds.

On the same day, Atty. Thomas Bishop, representing Mrs. Showalter as the administratix of Mr. Showalter’s estate, asks Atty. Joseph Moukawsher to conduct a coroner’s inquest of the hit-run death.

April 23

Moukawsher agrees to conduct inquest but must confer with New London police before setting date.

June 4

Mrs. Showalter writes to New London Police Chief John J. Crowley, asking for a progress report on the investigation by his force. Crowley neither acknowledges receipt of letter nor responds. Copies of letter were sent to City Manager C. Francis Driscoll, and Abraham Kirshenbaum, then chairman of the City Council’s Public Safety Committee.

June 10

Mrs. Showalter asks Superior Court Judge Angelo Santaniello to call for a grand jury investigation.

June 24

Santaniello notes Moukawsher has agreed to conduct coroner’s inquest. He tells Mrs. Showalter, “If it appears that during any stage of this proceeding that any further intercession is necessary, appropriate action will be taken at that time.”

July 2

Mrs. Showalter writes to City Manager C. Francis Driscoll, asking for a report from his office assessing the police department’s handling of the case. She also asks for a reply to her June 4 letter to Police Chief Crowley.

July 9

Driscoll tells Crowley to prepare a complete report for Mrs. Showalter.

July 10

Bucko completes report on fatal accident.

July 25

Driscoll sends Mrs. Showalter Bucko’s report. The report said Mr. Showalter’s body was in the road, but the ambulance crew which took Mr. Showalter to Lawrence Memorial Hospital said they found him on the sidewalk several feet away. No police officer ever saw the body at the scene since the first officer arrived as the body was being placed in the ambulance.

Bucko says paint particles from a 1968 Plymouth at the U.S. Naval Submarine Base in Groton are similar to those found on Mr. Showalter’s clothing, but the same paint is used on any 1968 Chrysler product.

Bucko also says a piece of metal Mrs. Showalter found near the accident scene is in the detective bureau. When Mrs. Showalter first offered the metal to police, they refused to sign a receipt for it.

August 6

Mrs. Showalter writes to Driscoll regarding Bucko’s report. She lists six pages of comments on allegedly “serious omissions” and “strictly opinion judgments” by Bucko.

Mrs. Showalter also writes to Chief State’s Atty. Joseph Gormley, asking him to send a representative to the coroner’s inquest. She includes copies of correspondence with local officials and Bucko’s report.

August 9

Mrs. Showalter requests a meeting with the City Council’s Public Safety Committee.

August 15

Bucko updates report, at request of city manager Driscoll.

Bucko said of the body location, “the position he (Mr. Showalter) was found in at the scene of the accident, in my opinion, would not help in solving this matter.” Erroneous on the report is the position of the car jack which is shown on the front bumper. The car Mr. Showalter was working on, a Ford Pinto, had to be jacked from the side of the vehicle.

Omitted from the report is the location of a car mat seen to the rear of the car and the spare tire Mr. Showalter never got to put on the car.

August 20

Gormley writes to Mrs. Showalter, telling her the local police investigation “has proceeded smoothly,” and there is “no reason for this office to initiate its own investigation.”

August 28

The Public Safety Committee of the New London City Council meets in closed session for one hour to discuss the hit-run death. Chief Crowley requested the closed session. He said there is evidence that could jeopardize future action.

Mrs. Showalter submitted a 12-page statement for the meeting, but did not attend.

Crowley said the case is not closed and it appears an arrest may be made.

August 31

Mallove submits official statement to New London police.

November, 1974

After being postponed several times, the coroner’s inquest hears testimony from 50 persons. No findings issued.

1975

January 24

A state police detective participating in the federal grand jury probe of the city police department has told one of its patrolmen they identified the driver of the car which struck and killed Mr. Showalter on Christmas Eve, 1973.

“We know who killed the Showalter kid, how come you don’t?” the detective was quoted in The Norwich Bulletin as saying.

March 19-22

The Bulletin, in a four-part series, shows:

- Eyewitnesses and what New London police called “near witnesses” drastically differed in their accounts of the accident.

- Microscopic paint particles found on Mr. Showalter’s clothing on which police based their search may not have been left by the vehicle which struck him.

- Evidence entrusted to police officers at the scene has never been seen since.

- A claim by police that it would cost as much as $1,200 to trace vehicles possible involved in the mishap was declared false by the state Motor Vehicle Department.

The Bulletin, when preparing the series of articles, made repeated efforts to discuss the case with police officials but Lt. K.T. Bucko, who headed the case, on the advice of then Police Chief John Crowley, would not.

April 3 State police conduct an extensive door-to-door inquiry in the Pequot Avenue region. State police have been looking into the case as part of a federal grand jury investigation into alleged corruption within the city force.

July 12

The state of Connecticut offers a $2,000 reward for information leading to the arrest and conviction of the person responsible for the hit-run death of Mr. Showalter. A total of $3,000 is now being offered. Classmates and friends of Mr. Showalter’s have already collected $1,000.

July 21

A community effort by friends and classmates raises the reward to $5,000.

November 8

The transcript of the coroner’s inquest of the hit-run death conducted nearly a year ago has yet to be typed, Coroner Joseph Moukawsher confirms. He said he wants to review the transcript even though he believes his six-day long inquest did not establish any guilt in the case. He said he has not spoken with the court reporter assigned to the case since the early summer.

December 10

Mrs. Showalter writes to State’s Atty. C. Robert Satti, requesting a one-man grand jury investigation. No response.

1976

January 6

Satti refuses to confirm or deny the existence of Mrs. Showalter’s request. Mrs. Showalter has also asked Satti’s office to ascertain the location of recorded tapes made during the coroner’s inquest.

January 9

Mrs. Showalter sends a special delivery letter to Satti asking for a response to the December 10 request. No response.

February 19

In a feature article, also carried statewide by the Associated Press, The Bulletin profiles Mrs. Showalter on page one.

Some public officials regard her as a persistent nuisance, someone to be ignored and sidestepped, but Mrs. Lucille M. Showalter will not breathe easily until they tell her who killed her son, Bulletin reporter Fred Vollono wrote.

“The official comment seems to be there is nothing to it,” Mrs. Showalter said. “It is just the ramblings of a grief-stricken mother. But there are many people who urge me to go on. They say, ‘Lucille, if you stop, then nothing will ever be done.’”

February 23

Mrs. Showalter receives a letter of confession from an inmate at Somers state prison. The inmate said he was plagued by news accounts of the death. Every time he seems to forget the accident, the inmate said, he reads another news story.

April 2

Mrs. Showalter submits a third written request to Satti for a grand-jury probe. No response.

May 6

Common Pleas court Prosecutor Harold Dean quashes the only lead in the two and a half year old investigation, The Norwich Bulletin reports. The lead was the letter of confession written by the inmate at Somers Prison. State police arrested the inmate for harassment of the victim’s mother, Mrs. Showalter, to whom the letter was sent. Dean nolled the case and allowed it to be dismissed despite a prior meeting with state police when the significance of the arrest was discussed.

State police did not believe the letter writer was responsible for the hit-run death, but they thought the letter contained possibly significant information. Dean said he was certain the accused had no knowledge of the case, because he was incarcerated when Mr. Showalter was killed.

August 7 The day following the Bulletin’s report of Dean quashing the lead, Chief State’s Atty. Joseph Gormley says he had “no idea” why the lead “which very well could have led to something,” resulted in a dead end. Two state police officers had met with Gormley to discuss the letter of confession.

August 6

State police list the investigation into the killing of Mr. Showalter as “closed pending further development.” That classification came 31 days after Dean threw the harassment case out of court.

August 30

Mrs. Showalter again asks Superior Court Judge Angelo Santaniello to call for a one-man grand jury probe.

September 1

Mrs. Showalter publicly renews her efforts to have a one-man grand jury reopen the investigation into the hit-run killing of her son. In a statement sent to 22 media outlets, Mrs. Showalter says she made the appeal in an August 30 letter to Superior Court Judge Angelo Santaniello. She says she was asking the judge to “make good on a promise” he made to her in June 1974. Santaniello wrote in a June 24, 1974 letter, Superior Court intercession would be possible if the investigation required it.

Santaniello said, “probably the proper person” to approach would be State’s Atty. C. Robert Satti. But Mrs. Showalter said she is ignoring Satti because he failed to respond to her December 1975 letter asking for the grand jury.

September 23

State’s Atty. C. Robert Satti says he needs another three weeks to review information on the killing of Mr. Showalter before deciding whether the investigation should be reopened or shelved.

Satti says he had hoped to have the matter resolved by today, but the sinking of his 35-foot cabin cruiser two weeks ago, an unexpected report of crimes by New London police, and a new trial forced him behind schedule.

November 23

Mrs. Showalter turns to Governor Ella T. Grasso for help.

“I cannot endure this loss of a beloved son in the midst of a governmental system that appears to neither act nor care,” Mrs. Showalter says in a letter to the governor.

Mrs. Showalter says she is skeptical the New London County State’s Attorney’s review of the case will result in the one-man grand jury she has requested. Satti today said he is still reviewing transcripts of the Coroner’s Inquest and refused further comment.

December 21

Just three days before the third anniversary of the killing of Kevin B. Showalter, the state’s chief court administrator orders the city’s only unsolved hit-and-run case reopened.

John P. Cotter signs an order creating a one-man jury to probe the death, renewing hopes that allegations of police bungling and mishandling of the case will be settled.

“I can’t yet believe it,” says Mrs. Showalter, calling the action a “literal miracle.”

Cotter, a justice on the state Supreme Court, selects retired Superior Court Judge Raymond J. Devlin to head the one-man grand jury.

An attorney representing Mrs. Lucille M. Showalter also files a $600,000 lawsuit against the unnamed person(s) responsible for the killing of her son. Atty. Averum J. Sprecher of East Haddam says the suit is aimed at protecting Mrs. Showalter’s rights.

“The action as I have filed it will definitively preserve her rights when the investigative bodies finally determine who killed the boy,” he said. The suit is aimed at heading off fears the state’s statute of limitations might preclude Mrs. Showalter from pursuing civil action if the killer is found.

December 24

Superior Court Judge Joseph F. Dannehy is ordered to replace State Referee Raymond J. Devlin as the one-man grand juror investigating Mr. Showalter’s death. Chief Court Administrator John P. Cotter says Judge Devlin had asked to be taken off the case because he was too busy with other duties, and would be unable to commute from his New Haven office.

1977

January 4

Austin J. McGuigan, the special prosecutor assigned to the one-man grand jury probing the hit-run death of Mr. Showalter promises to pull “all the stops” in his investigation but says he needs help from the public to succeed.

McGuigan has worked for the state for two years as the top investigator of organized crime. He appeals to anyone with information to call him confidentially.

February 8

State Police Commissioner Edward P. Leonard, as part of a last-resort effort, makes a personal appeal to area residents for information about the killing of Mr. Showalter. In a letter to the people who live near the Pequot Avenue site where Mr. Showalter died, Leonard asks for facts – “No matter how insignificant they may appear” – which might shed light on the car, the driver or the accident scene.

Special Prosecutor McGuigan says police “had no suspects.” However, he says if a suspect is found police believe there is sufficient evidence to tie the person to the case.

April 18

Investigators say they feel confident the Showalter case will be solved.

The new optimism comes after a public appeal netted more than 300 leads, new laboratory analysis of existing evidence, and an accounting of each of the more than 10,000 green Chrysler products registered in Eastern Connecticut when Mr. Showalter was killed.

The new evidence means “there is a significant possibility the vehicle in question was not a green Chrysler,” Special Prosecutor Austin McGuigan says. While the investigators will not say what other color the car might have been, the evidence apparently opens new avenues for the investigation. Previously, other theories on who drove the death car, theories which have had some substantiation, were locked into the green Chrysler theory, police acknowledge.

May 10

State police investigators spend two and a half hours recreating and filming the Pequot Avenue death scene where Mr. Showalter was the victim of the hit and run.

May 18

State police again film and re-create death scene.

June 22

The Bulletin reports that one of the most intensive investigations in state police history, the probe into Mr. Showalter’s hit-run death, will be given to a one-man grand jury July 5 in Windham county Superior Court.

Judge Joseph F. Dannehy, the grand juror, imposes a gag order on all investigators assigned to the case. Special Prosecutor McGuigan and 17 state police detectives had gathered evidence for the grand jury.

June 23

More than 50 persons will be subpoenaed and the scope of the probe will be expanded to include subsequent actions connected with the accident, The Bulletin reports.

June 24

Eleven New London police officers, including the top detective involved in the first of three investigations of the hit-run death, have been subpoenaed, The Bulletin reports.

July 5

The grand jury begins behind closed doors with testimony by New London Det. Lt. Konstanty T. Bucko.

Outside, a television camera crew drips with sweat under the glare of a hot summer sun.

Inside it is quiet and cool – almost like any other day. The state police detectives and reporters talk about golf, baseball and other summertime activities. Because of the gag order imposed by Judge Dannehy, they can’t talk about what is most on their minds, what has brought them all together – the unsolved hit-run death of Kevin B. Showalter.

The session lasts about five hours and also includes testimony by Mrs. Showalter and Debra Emilyta, Mr. Showalter’s companion the night he died.

Ms. Emilyta has been sitting on a wall about 6 feet from Mr. Showalter when he was killed. She told police she only heard the 20-year-old Mitchell College student struck, and did not see the car which struck him.

July 6

Witnesses include Michael Buscetto of Mike’s Arco in New London. What he identified as body putty, apparently from the car that struck and killed Mr. Showalter, has never been seen since police officers placed it in an envelope that night, according to sources.

Ms. Emilyta concludes testimony.

Also testifying are Dr. Robert Weller, members of his family, and a friend, who while returning home from church drove past Mr. Showalter as he was changing the tire. They were among the last persons to see Mr. Showalter alive.

Other witnesses include Mrs. Ruth P. Hendel and Mrs. Charles (Shirley Pope) Alloway, her daughter.

On Christmas Eve, 1973, Mrs. Hendel had just turned away from the window of her home on Pequot Avenue where she had been watching Mr. Showalter work on the Emilyta car. She heard the noise of the car striking Mr. Showalter and turning back quickly she caught a glimpse of the taillights. Her first impression of the fleeing southbound car was that it was bright-colored, possibly red.

Mrs. Hendel continued to watch the accident scene as she telephoned Mrs. Alloway, the wife of a New London police officer.

Arthur Adams of New London, a Mitchell College security guard and former state policeman, also testifies. Aside from Ms. Emilyta and the hit-run driver, Adams may have been one of the last persons to see Mr. Showalter alive.

Adams saw Mr. Showalter working on the car and Ms. Emilyta sitting on the stone wall, swinging her legs. He observed the girl with a coat collar wrapped around her head, in conversation with Mr. Showalter, after the Weller party had driven by.

Adams continued on his rounds towards the Montauk Avenue side of the campus. Sometime after 11 p.m., he saw an ambulance heading for the hospital and two police cars heading down Plant Street.

July 7

Some of the last persons who saw Mr. Showalter alive and one of the first who saw him dead testify.

Six members of the Sitty family, who were celebrating Christmas Eve and occasionally watching Mr. Showalter change a tire from inside a house on Pequot Avenue, tell the grand jury what they knew about the case, Edmond Sitty had brought out a blanket and a corduroy coat to put over Mr. Showalter’s body after he had been struck and killed.

A New London High School classmate of Mr. Showalter, Arthur Petrini, was a passenger in a car that passed the accident scene sometime after Mr. Showalter was killed and before the ambulance and police arrived. He also testified.

July 12

Witnesses included two firemen and a dispatcher, two nurses and an orderly, the New London County Medical Examiner, the first man to officially identify Mr. Showalter, and a woman who lives near the accident scene.

Larry Grimes, a security guard who knew Mr. Showalter from Mitchell College, had made the preliminary identification at Lawrence and Memorial Hospitals, where he also worked. Mrs. Dorothy Bryson of Pequot Avenue, who came upon the accident scene, also testifies.

July 13

New London police officers pack the waiting room of the Windham County Courthouse. Of the 11 who were subpoenaed last month, at least seven are present.

The 11 include Patrolmen Vincent McGrath, Steven Colonis, Thomas P. Bowes Jr., and Cpl. Joseph Chiapponne, all of whom were involved in the initial investigation. With the change of shift, Sgt. Joseph Jullarine, Patrolmen Richard West and Glenn Davis and Det. Sgt. Konstanty T. Bucko joined the probe. Bucko was off duty at the time.

McGrath filed the motor vehicle report of the accident and the sketch on the report was by Bowes. Bucko took photographs of the scene and gathered evidence. His photographs may be the only ones taken. Bucko also went to the hospital and got the victim’s clothing, according to sources.

Colonis, the first officer on the scene, apparently arrived as Mr. Showalter was being placed in the ambulance. He interviewed Ms. Emilyta and took her to the station to file a 13-sentence statement.

There is some confusion of whether Colonis drove an unmarked police car that night. Sources say police made conflicting statements on that question.

July 14

Thomas Wainwright, who played tennis with Kevin Showalter at New London High, saw his lifeless body on a sidewalk on Pequot Avenue before an ambulance or police arrived, and is among those testifying today. Arthur Petrini, who testified last week, was a passenger in Wainwright’s car.

Mr. and Mrs. Donald Wainwright, who were stopped by police after circling the scene in another auto, also testify.

At least seven New London police officers are at the courthouse, but it is not known how many are testifying.

July 19

The grand jury shifts beyond reconstructions by “near witnesses,” as Sgt. Joseph Jullarine, now retired, testifies. He was the squad leader who reportedly conducted “an intensive investigation” for a red car during the 11:30 p.m. to 7:30 a.m. shift on Christmas Day 1973.

July 20

The grand jury investigators spend much of the day alone reviewing physical evidence and testimony. Only three witnesses – New London police who have already appeared during the proceedings – are present.

July 21

Det. Bucko appears for at least the fourth time in the nine days the grand jury has convened. The session begins at 10 a.m. and ends about 5:45 p.m., with his departure.

A nurse’s aide who knelt by Mr. Showalter’s body, feeling for a pulse, also testifies, Sue Costello, who heard the report of an accident as she was leaving Lawrence and Memorial Hospitals in New London from her shift, had arrived on the scene before ambulance personnel and police.

July 26

The scope of the grand jury probe goes beyond Mr. Showlater’s death and runs smack into a crucial area of dispute with the appearance of New London police detective Walter Petchark.

On Christmas Day 1973, with evidence already missing and news of Mr. Showalter’s death on the radio, Petchark reportedly received a call from former mayor Harvey N. Mallove. Mallove later told The Bulletin there was no truth to the report. But he allegedly told Petchark he thought he saw the accident the night before.

Three city police detectives – Bucko, Petchark, and Carmello Fazzina – were present at the inquiry. They were followed by laboratory technicians from the FBI, who lent their expertise in the analysis of headlight glass possibly belonging to the death vehicle.

July 27

The former counsel for the estate of Mr. Showalter testifies. Atty. Thomas Bishop confirms his representation of the estate was severed in June 1974.

Thomas and Donald Wainwright return for further testimony.

July 28

Witnesses include Mrs. S.F. Zimet of Ledyard. Mallove said he was visiting at her home on Christmas Eve 1973, left about 10:45 p.m., and was home in New London about half an hour later.

Mrs. Zimet is accompanied by her attorney, L. Patrick Gray. Gray, like Bishop, is a member of the New London law firm Suissman, Shapiro, Wool, and Brennan.

Other witnesses include New London city Manager C. Francis Driscoll and Elise Mallove, Mallove’s daughter. Miss Mallove was home for her Christmas vacation in 1973.

The grand jury begins a four-week recess. More than 50 persons were called during the first 12 days of the inquiry.

August 30

New London police investigators and a newspaper editor who has followed their unsolved hit-run death case for three years are among the witnesses.

Retired Police Chief John Crowley and Det. Lt. K.T. Bucko, who refused repeated pleas by The Bulletin in March of 1975 to discuss the death of Kevin B. Showalter, gives testimony – as did the paper’s managing editor, John C. Peterson.

Peterson testifies for three hours.

August 31

The attorney who conducted a coroner’s inquest into Mr. Showalter’s death, the results of which have never met public scrutiny, is the first witness today. Atty. Joseph Moukwasher, who heard testimony from 50 witnesses during six days in September and November of 1974, is one of the few persons familiar with the substance of that investigation.

It took more than two years for the transcripts of the hearings to be typed and submitted to State’s Atty. C. Robert Satti.

State Police Sgt. Donald Crouch, who in 1974 and 1975 worked for the federal grand jury investigating alleged corruption in the New London force, also testifies. Other witnesses included Rosemary Benson and Carol James.

September 1

Physical exhibits appear to outnumber witnesses in the 15th day of proceedings. Two state police technicians from the crime lab in Bethany carry satchels concealing evidence into the closed courtroom. One exhibit is a light colored automobile fender, which was dented and streaked.

September 2

Det. Edward Pickett of the New London County State’s Attorney’s office, who helped administer a lie detector test to Ms. Emilyta, testifies. Ms. Emilyta passed the test.

Another detective, private investigator Joe Harris, is also called. A former Waterford police sergeant, he worked on the case for a brief time, on his own.

Other witnesses in a short session include State Police Sgt. Charles Trotter, a principal investigator in the federal grand jury probe of the New London city police.

September 12

Two persons who saw Mr. Showalter on Christmas Eve 1973, hours before he was killed testify.

Ramona Ricci, a coworker of Mr. Showalter’s at a Waterford discotheque, attended one of two parties Mr. Showalter had planned to go to after work that night. Nancy Wicksham, who also testified, had joined friends that holiday evening at the club.

September 18

Mallove says his status as a suspect in the case is “nothing new.” During testimony in a New Jersey courtroom, Connecticut State Police revealed Mallove is a prime suspect in the hit-run case. The testimony concerned refusal by two New Jersey men to comply with a subpoena issued by the one-man grand jury. Trooper Charles Wargat also testified he was told the two men repaired Mallove’s car on Christmas Eve or Christmas Day 1973.

Mallove tells The Bulletin he did not know the men and never had a car repaired at their shop on Reed Street in New London. He says he didn’t kill Mr. Showalter and doesn’t know anything about anybody who did.

September 19

One of the two men who testified with immunity today has said in a published account he has no knowledge of the case and denied any car was repaired in his New London shop on Christmas Eve 1973.

Walter String Jr. made those comments in the New Jersey Courier Post. He and his son, Walter String III, had been ordered to appear today by a New Jersey judge, after refusing to comply with a subpoena.

Among the dozen or so witnesses are New London city police Sgt. Donald Sloan and Cpl. Charles Alloway. They took the first full statement from Ms. Emilyta, five days after the accident.

September 26

Darlene Barnes, a friend of Mr. Showalter who patronized the Waterford discotheque where he worked, is among the witnesses today. Ms. Barnes was also one of the 50 witnesses during the coroner’s inquest of 1974.

October 3

Larry Grimes testifies again. The Mitchell College security guard who made the first identification of Mr. Showalter at Lawrence and Memorial Hospitals, was also at the courthouse on July 12, and Sept. 26.

The grand jury will be in recess until October 17. It has convened 20 times since July 5 and heard about 90 witnesses.

October 11

Judge Dannehy says published reports that Mallove is a prime suspect in the case “couldn’t bother me in the least.”

“They (the newspapers) are free to speculate if they wish,” Dannehy says. “I am not concerned with their claimed right to freedom of expression.

I think that sometimes their attitude is to publish and be damned, but they don’t bother me.”

“Why don’t you wait” for the grand jury report? Dannehy asked.

October 17

The sales manager of a New London auto firm who said he has sold a number of cars to the family of a suspect in the hit-run case testifies.

In 1970, Peter Emmanuel Sr. of New London Motors sold a Lincoln Continental to Harvey N. Mallove, whom state police have identified as a suspect in the Christmas Eve, 1973 death. A compact car was among the other autos the New London firm sold to Mallove.

State police were looking for a green Chrysler product when they first questioned New London motors personnel, Emmanuel said before he testified. But the firm didn’t sell Mallove such a vehicle, which police had believed was the death car, he added.

October 24

The grand jury does not convene today because the investigators were not ready to proceed, Judge Dannehy said. He said he plans to conduct several more sessions before adjourning to write the final report, but did not specify.

November 14

The grand jury meets for its first regular session since October 17 and hears one witness. The witness, Gary Jordan of New London, said he was dating Elise Mallove on Christmas Eve 1973.

Sources say the grand jury conducted at least one special session since October 17, but it was not known who testified.

November 21

State police continue working long and irregular hours probing Mr. Showalter’s death as they re-create the hit-run scene on Pequot Avenue near Plant Street for at least the third time.

November 29

The man whom state police have said they consider a prime suspect in New London’s only unsolved hit-run death has his day in court.

Harvey N. Mallove testifies for about four hours before the secret grand jury probing Mr. Showalter’s death. Atty. Leo J. McNamara accompanies Mallove to the Windham County Courthouse.

Mallove says he was one of a number of persons who drove by the accident scene shortly before or after Mr. Showalter was killed. But a four-part series by The Bulletin in March of 1975 showed Mallove saw a scene that seven other persons said could not have taken place.

Mallove passed the accident scene within a minute or two after an ambulance call was logged. His statement to New London police – dated eight months later – conflicts with accounts of seven persons at the scene or looking out their windows seconds after Mr. Showalter was struck.

Mr. Showalter was struck by a car as he changed a tire on a friend’s parked Ford Pinto, on a well-lit section of Pequot Avenue near Plant Street.

In his statement, Mallove said he saw an automobile parked at an angle in front of the Pinto. None of the seven persons saw any car stopped at the scene immediately after the victim was hit according to the July 10, 1974 report by New London Det. Lt. Konstanty T. Bucko.

Mallove’s vivid description of a middle-aged man talking with a girl near the car also conflicts with statements by the seven persons.

In his statement, Mallove said he assumed the man was a member of the police department. But Bucko claims in the July 10 report that Mallove told him the talking to the girl was “NOT” a policeman.

Bucko’s report also claims Mallove learned on Christmas Day 1974 that “a man had been killed and he remarked to some people that he saw the body.” But Bucko continued to report that after Mallove viewed photographs of the scene he realized what he mistook for a body was a floor mat. In his statement, Mallove said he saw a “flat object which I assumed was a blanket or a mat.”

In his August 31, 1974 statement, Mallove said, “Seeing no trouble, accident, or any evidence of anything out of place…I continued on my way home.”

In the July 10, 1974 report, Bucko claims; “Mr. Mallove stated he was going to stop because he realized there had been an accident.”

Mallove has told The Bulletin that Bucko misquoted him.

December 7

The calling of witnesses ends with Mallove’s second appearance.

The proceedings included a film screening, apparently of the death scene as re-created by state police.

After the 35 minute screening, Special Prosecutor McGuigan and Judge Dannehy questioned Mallove for about 40 minutes. That was the bulk of the afternoon session.

The question of whether indictments should be handed down in New London’s only unsolved hit-run death now rests with Judge Dannehy.

After 24 sessions and more than 100 witnesses, Dannehy said the next step for the grand jury is the final report on who killed Kevin B. Saltwater.

1978

Feb. 17 Report filed.

Feb. 22

Report made public.

  • THE DANNEHY REPORT


  • SHOWALTER COVERUP COLUMNS

    Chapter 1

    Law and Justice in Everyday Life

    Cover-Up In New London

    Hit-And-Run Continues To Mock Justice


    Sept. 4, 2000

    If Connecticut Chief State’s Attorney John Bailey wants to bring closure to cold cases, here’s one from New London that should top the list: The Showalter hit-and-run cover-up is a dark chapter in Connecticut history, a tale more appropriate for a Third World country.

    And yet, only one thing bothers former New London County State’s Attorney C. Robert Satti about the Showalter case: that it was investigated at all.

    Satti, now retired, made the point again and again, most recently this year. Satti’s complaint, made during the wake of the late state police Detective George Ryalls, was that Ryalls’ obituary mentioned the suspect the prosecutor refused to pursue in the Showalter probe.

    Kevin B. Showalter, a 20-year-old Mitchell College student, was killed at 11:12 p.m. on Christmas Eve 1973. He was changing a tire on a well-lit section of Pequot Avenue on the New London shoreline when he was struck and killed. His girlfriend, sitting only 6 feet away on a stone wall, claims she saw nothing.

    Auto body putty from the death car disappeared after a tow truck driver gave it to New London police. The evidence file that was supposed to contain the putty was stuffed with bathroom tiles. The file that was supposed to contain headlight glass from the death car instead contained glass from three different headlights. State police and others suspected that, in order to throw legitimate investigators off the trail, the late young man's clothing was pounded on a different-colored car than the one that killed him.

    The victim's mother, Lucille M. Showalter, tried to get a grand jury investigation of the cover-up. She was rebuffed repeatedly by the presiding judge, Angelo Santaniello who, it later became clear, was best friends with the leading suspect. Santaniello then referred Showalter to prosecutor Satti, who happened to be his former law partner. Satti refused to acknowledge registered letters from Mrs. Showalter pleading for a grand jury probe.

    Satti did finally meet with Mrs. Showalter in 1978, after Judge Joseph Dannehy of Willimantic, acting as a one-man grand jury, named former New London Mayor Harvey N. Mallove as the probable driver of the hit-run vehicle. Satti called the three-hour meeting, in which he repeatedly told Mrs. Showalter that there never should have been a grand jury investigation under Dannehy.

    Mallove held a good hand; he had the best legal muscle in New London County on his side. New London police would not question him for more than seven months, and then only in a perfunctory manner. They would say they inspected his cars, but they did not. Significantly, Mallove’s Lincoln had been repaired, but it wasn’t until state police took over the case four years after the accident that the fender was finally seized.

    Santaniello would arrange for a coroner’s inquest and put his niece in charge of typing the transcript. Only after two years of intense public pressure would the transcript be typed. But the inquest never issued a finding.

    Santaniello tipped off Mallove that he was a suspect. The judge was also aware of what local police knew about the case. Mrs. Showalter memorialized the admissions in tape-recorded telephone conversations.

    “I did talk to Harvey,” Santaniello told Mrs. Showalter on Oct. 17, 1975, “and I said, `You’re suspected.’ As a matter of fact, at that time a police officer came to him on the same day or the next day, and told him you were making accusations about him and that he was a prime suspect.” The day before, Mallove told Mrs. Showalter, “Judge Santaniello is of the opinion that you fingered me.”

    It was not until 1977 that state police, who took over the case at the behest of former Gov. Ella Grasso, formally named Mallove a suspect. Next week, I'll propose a means to solve the Showalter cover-up.

    Showalter Cover-Up Is New London's Shame

    Sept. 11, 2000

    New London, where I grew up and began working in the 1960s and ‘70s, was a dirty little city with character.

    It had a restaurant called the Hygienic that was everything but. There were at least a couple bars where the cops couldn't do anything, except maybe a little business.

    The top pimp in town never went to jail until he was about 60 and a certain court official retired.

    New London will always be the city that tried to cover up the Christmas Eve 1973 hit-and-run death of Kevin B. Showalter. It's been doing a pretty good job for nearly 27 years, but the onion is beginning to peel.

    The local daily newspaper admitted -- in its official history published this year -- that it did a shoddy job on the Showalter case. Specifically, The Day admitted its failure to explore the relationship between a former mayor and a top judge, and their influence on the course of the criminal investigation. That’s a beginning.

    Political and police corruption goes back a couple generations in New London. By the 1970s, New London police were widely known to be involved in the selling of women, dope and refrigerators, among other things. A federal grand jury took note. But as with the Showalter case, there were these little problems with the evidence.

    A jewelry store owner and former city mayor multi-millionaire Harvey Mallove was the prime suspect in the hit-and-run death of Showalter, a student at Mitchell College. Showalter’s date that night, Christmas Eve 1973, said she saw nothing from her vantage point six feet away, sitting on a stone wall under a streetlight on a residential street as a young man changed the tire of her car.

    Harvey was everybody’s pal. He would take kids to the Super Bowl, then, down the road, get them jobs as cops. He was friends with bums in the street and bums in high political office. He was wired. The standing joke among reporters became: Harvey's a great guy to have a beer with, just don't change your tire if he's driving by.

    “I didn't kill the kid in any way, shape or form,” Harvey told me many times. As mayor, Harvey helped hire a few police chiefs. His best friend was the administrative judge for the county; that was the judge who controlled the early stages of the investigation, specifically a coroner’s inquest that never issued a finding.

    State police followed up a report that Mallove’s best friend, County Administrative Judge Angelo G. Santaniello, was with Mallove on Christmas Eve 1973. Santaniello reportedly was No. 11 on a guest list for a party at the home of his political mentor, the late state Sen. Peter Mariani. The Mariani party was one of two Mallove attended that night.

    Santaniello told reporters he never went out on Christmas Eve.

    Another state judge, Joseph F. Dannehy, conducted two grand jury investigations. In 1978, Dannehy named Mallove as the probable driver of the hit-run vehicle, but said evidence that might have ensured conviction was either mishandled or destroyed.

    Mallove died a few years ago with this legacy. Others still have time to come clean and tell the truth about the cover-up. Mrs. Showalter tried unsuccessfully to have Satti, Santaniello and others prosecuted for hindrance of prosecution (CGS Section 53a-166) warning of impending discovery, providing means of avoiding discovery, preventing discovery by deception. Because a conspiracy to hinder prosecution is an ongoing crime, those with information could tell Chief State's Attorney John Bailey, who has begun an initiative to solve some of the state's cold homicide cases.

    Isn’t it time? No one kept the system honest when it counted, though some tried. Most stood by as the system that was supposed to protect the victim and his family betrayed them all.

    Where is the conscience of the community?

    Cold Case On Ice Forever

    Nov. 6, 2000

    One way to deflect attention from a suspect is to get investigators involved in meaningless, time-consuming tasks. Another way is to create a bogus suspect who is then exposed as such, causing a belief that the case is just too hazy to pursue.

    Both of these devices were used repeatedly in the cover-up of the Showalter hit-run case in New London. Whether this was happenstance, indifference, incompetence or malfeasance, the result was the same. The system failed.

    And now, it seems, the truth will remain buried forever.

    Judge Joseph F. Dannehy, the grand juror who investigated the case, wrote in his finding of fact: “After December 25, 1973, the New London Police Department did virtually nothing to solve the hit-run death of Kevin B. Showalter.” The accident occurred the night before.

    Local police and court officials, however, were pro-active in another sense. Their actions served to protect the assailant.

    For example, New London police claimed it would cost as much as $1,200 to trace vehicles using data from the state Motor Vehicle Department. The motor vehicle department declared there was no such charge.

    Nevertheless, New London police spent their time hand-sorting local motor vehicle cards. They looked for a green Chrysler. That was likely a false lead; state police said paint particles found on the victim's clothing did not come from the car that killed him.

    Former Mayor Harvey Mallove began meeting informally with police and court officials as early as Dec. 25, 1973. Mallove wanted to know what the police knew.

    The only lead after two and a half years was quashed by then New London Common Pleas Court Prosecutor Harold Dean in May 1976. The lead was a letter of confession written by a Somers prison inmate to the victim’s mother, Lucille Showalter.

    “I told Harold how important that was to me,” Mallove, the prime suspect, confided to an associate. He also acknowledged discussing the purported confession with his best friend, the presiding judge for the county, Angelo Santaniello.

    The author of the letter was known to be connected with “fences,” or purveyors of stolen goods in the New London area. State police arrested him for harassment of Mrs. Showalter. Two state troopers met with Dean for an hour. They told him the letter contained possibly significant information. State police also believed they could connect the dots in New London between the letter writer and the powers-that-be. Did he owe some favors? Was he paid? Police knew the author had no liability for the accident; he was actually in Florida at the time of the hit-run.

    Dean nolled and dismissed the case without telling the troopers or Mallove. Soon thereafter, state police listed the killing of Showalter as “closed pending further development.” Upon learning of Dean's action, Chief State's Attorney Joseph Gormley remarked he had “no idea” why the lead, “which very well could have led to something,” resulted in a dead end. The case would remain closed for six months, until Gov. Ella Grasso brought the matter to Justice John Cotter.

    Was there criminal activity connected with the Showalter cover-up? It appears we will never know for certain. Dannehy named Mallove as the probable driver, noting that evidence which might have ensured conviction was destroyed. The Chief State’s Attorney’s Office reviewed aspects of the case this fall after a series of columns appeared in The Law Tribune. However, the statute of limitations for the most likely potential charge, conspiracy to hinder prosecution of motor vehicle misconduct, has expired. This shameful case, it appears, is destined to stay on ice forever.

    - AND:

    Olympic Gold for Missing Evidence


    November 28, 2005

    Judge Ellen Gordon was in way over her head with what she tried pass off as a ruling in Day Publishing v. State's Attorney.

    Clueless Gordon was handed a hot one, a case no one has ever wanted in the so-called New London Judicial District. Every single time this case has come to court, begging for justice, The Robes, the prosecutors and their minions have either desecrated their oaths or looked the other way. Clueless Gordon, fairly new to the scene, has managed to join the list of those who are both ostriches and failures.

    The Day newspaper asked Gordon this year to release the grand jury testimony regarding the cover-up of the 1973 hit-run death of Kevin Showalter. Before Gordon probably ever heard of Showalter, five New London County judges recused themselves from a John Doe civil suit against the driver because they were friends with the prime suspect, Harvey Mallove. Mallove -- the late mayor of New London and multimillionaire jeweler who picked police chiefs, planned to run for Congress and starred in the social scene -- was prone to say, "I never killed the kid -- in any way, shape or form."

    It's not like we could expect a New London judge to show guts or brains in this case. Compelling testimony from the first of two grand juries implicated local law enforcement and court officials in a widespread cover-up.

    On Christmas Eve 1973 at 11:12 p.m., as the call came in, a high-ranking New London officer, said, "F--k him, he's dead," and then left to go home. Showalter, a 20-year-old Mitchell College student, lay dead on a well-lit section of Pequot Avenue by the shoreline. His body was thrown 22 feet from the point of impact. His shoes were found 110 feet apart. A leg bone was 75 feet away.

    A tow truck driver gave police auto body putty from the death car. The putty was never seen again. New London police mixed headlight glass from at least three different cars in what they called the evidence file. Replacing the auto body putty was bathroom tile. A local coroner's inquest never issued a finding. State police, who took over the case at the behest of Gov. Ella Grasso, were bewildered and angry when they could not find the transcript of the coroner's inquest. Mallove's best friend -- the presiding judge for the county, Angelo G. Santaniello -- had put his niece in charge of typing that transcript. Santaniello also tipped off Mallove to his status as a suspect.

    Now, Clueless Gordon can't find the 3,000-page transcript of the first grand jury. Does she care? Court clerks allegedly performed a diligent search. Would any reasonable person believe or accept any of this?

    Among the last persons known to possess the grand jury report was the late State's Attorney, C. Robert Satti. Satti, who refused to investigate the case before a special prosecutor was appointed, claimed he returned a copy to the grand juror, then Willimantic Superior Court Judge (later Supreme Court Justice) Joseph Dannehy. Both Dannehy and Satti are dead. Did "Do Nothing Bob" -- Mallove's moniker for Satti -- take it with him? We might as well ask Harvey, also dead, or Kevin.

    Gordon's pathetic decision, dated Nov. 7, went on for about a sentence before its first fatal error. It might sound like a technical error, but it's much, much more than that. She actually said New London police investigated the case.

    Before this, I thought it might take generations to remove the stench from the New London courthouse. Alas, for New London, the stench of this cover-up is forever.


    Find & Open
    the Showalter File

  • Hartford Courant Editorial








  • more COOL JUSTICE








  •           Resistance at Standing Rock: Dispatches from the Front Lines        

    UPDATES:





  • Water Protector Legal Collective Files Suit for Excessive Force against Peaceful Protesters


  • Veterans to Serve as ‘Human Shields’ for Dakota Pipeline Protesters



  • Oceti Sakowin encampment on Oct. 6, 2016. The proper name for the people commonly known as the Sioux is Oceti Sakowin, (Och-et-eeshak-oh-win) meaning Seven Council Fires.








    Story and Photos by John Briggs

    Cool Justice Editor's Note: OK to repost, courtesy of John Briggs and The Cool Justice Report.







    Corporate – Government Alliance Versus the American People

    Native Americans from tribes across the country have gathered on the windswept plains of North Dakota to pray with Mother Earth to keep the Dakota Access Pipeline (DAPL) from pumping 500,000 gallons of oil a day beneath the Missouri River. The natives know the pipeline will most certainly leak or break, as have most U.S. pipelines, fouling the water for the Great Sioux Nation and 18 million non-Natives downstream.

    The standoff -- which began in April -- continues as a new U.S. administration ascends to power with a president-elect who campaigned denying human-caused climate change and threatening the Paris Climate accords. This remains the overriding reality despite a mini walk back by Donald Trump pledging an open mind to The New York Times this week.

    Standing Rock illuminates the brazen alliance that has developed between corporate and government interests. Viewed from the front lines, the law has been turned into a fig leaf for repression and suppression. Only the discipline and spiritual clarity of the water protectors and the native elders has kept people from being killed or seriously injured since April when the movement began.

    The fused police-DAPL force is doing everything it can to incite a violent reaction from the resisters so as to crack down, clear the camps, imprison, or even gun down the natives. More than one commentator has found the atmosphere at Standing Rock similar to what led to the Wounded Knee massacre in 1890 when 300 Sioux were murdered by government troops who mistook their prayerful Ghost Dance for a war dance.

    A great deal is at issue at Standing Rock. The Sioux and their numerous native and non-native allies face a militarized force whose composition tells us something dark about the complex façade that U.S. democracy has become and suggests the proto-fascist zombi lurking beneath. More deeply, Standing Rock also emblemizes a struggle that is taking place at this moment in human history between two distinct modes of human consciousness.

    One mode is the familiar anthropocentric (human-centered) consciousness that the dominant culture most of us were born into favors—a consciousness that assumes reality is a collection of objects to be extracted, owned, and branded. Humans are the focus of this consciousness, meaning that our concerns about climate change focus primarily on the fate of our own species.

    Distinct from this anthropocentric mind-set is a second, ancient and spiritual mode of awareness that understands that the earth and its landscapes are not objects; they are relationships, including the tangle of relationships that gave us birth. This ancient mode of consciousness is potential in everyone, but for most it has been buried beneath the piles of conceptual objects that we have come to believe constitute our reality.

    The Indigenous Peoples gathered at Standing Rock are guided by this ancient, holistic, earth-mind consciousness, and so they understand that humans are not the most valuable living objects on the planet: we are not in control of the planet; it is not our job to manage nature; rather, our sacred task is to work with Mother Earth and other beings as members of Earth’s family. If we don’t, Mother Earth will make us face this spiritual truth one way or another.

    Guided by their ancient, earth-mind awareness, Native Americans have taken up a role as “water protectors.” “Mni Wiconi, Water is Life” is the slogan of the Standing Rock movement.

    Every day scores of Sioux from North Dakota, South Dakota and nearby states, along with Paiute, Shoshoni, Diné, and a sampling of other Natives from the 300 or so tribes whose flags fly at the Standing Rock encampments set out to pipeline construction sites in a convoy to engage in “actions” on the “front lines.”

    There the protectors sing and pray in the face of physical harassment and arrests by heavily armed police fused with a corporate security force.

    DAPL and their overlord company, Energy Transfer Partners, have lavished campaign contributions on politicians in North Dakota and the U.S. Congress so that they could use the state’s eminent domain powers to force purchase of land for the pipeline all across North Dakota, beginning in the Bakken fields in the northwest corner of the state where the fracked crude oil is extracted. Similar eminent domain arrangements were achieved in other states through which the 1,200-mile line traverses before reaching a river port in Illinois. The company promised Congress and the public that the pipeline would carry oil for 100 percent domestic use only, but it is clear from reporting done by the website The Intercept that the oil will be sold on international markets.

  • Though Promised for Domestic Use, Dakota Access Pipeline May Fuel Oil Exports


  • The DAPL line, now virtually complete except for permission from the Army Corps of Engineers to fill in the link that crosses under the Missouri River, passes just north of the Standing Rock Sioux Reservation and Cannon Ball, North Dakota. The DAPL construction runs through sacred burial and archeological grounds that the Lakota people were given free access to by treaties with the U.S. Government in the 19th Century. In mounting their resistance to the pipeline, the Standing Rock Sioux have been turned into “trespassers on their own land.”

    In late August, the tribe’s lawyers filed a stop work petition in federal court detailing areas where sacred sites would be disturbed if construction continued on its planned trajectory. The federal judge routinely forwarded a copy of the filing to DAPL. Over Labor Day weekend, when the company would not have been expected to work, pipeline crews leapfrogged to the disputed sacred and preemptively bulldozed them under. Too late, the judge granted the Sioux an emergency restraining order, but, then in a curious move, allowed construction in some areas where sacred sites have been discovered. DAPL has ignored a request from the Obama administration not to work in buffer areas on either side of the river. No fines have been imposed for intentionally bulldozing the disputed sacred sites.

  • The Legal Case for Blocking the Dakota Access Pipeline


  • Burial ground at center of police confrontations is known historical site


  • In recent live-stream videos from the front lines, DAPL-police snipers can be seen perched on top of a sacred mound called Turtle Island, their high-powered rifle crosshairs trained on the water protectors who are standing in prayer in the frigid lake below.

    North Dakota wants the federal government to pick up the tab for the massive expenditures required to keep the Native Americans under their guns. Alternatively, the CEO of Energy Transfers, Kelcy Warren, has offered to pick up the millions-of-dollars tab.

  • ETP CEO Kelcy Warren Says They Have Offered to Pay Protest Related Expenses


  • Native media have documented that DAPL has already been supplying military-style equipment, drones, armored vehicles, riot gear, water canons, concussion grenades and other armaments. The tax-payer-funded and corporate-sponsored front lines phalanx is led by the Morton County Sheriff’s Department, which has local jurisdiction, reinforced by North Dakota State Troopers, North Dakota National Guard units, sheriffs and police from six nearby states—all interpenetrated by DAPL security (while the FBI lurks in the background). A contingent of Hennepin County, Minnesota, Sheriffs’ Deputies were recalled following protests back home. Residents in the state of Ohio are writing letters and calling legislators to express their distress that their law enforcement has been enlisted into this repressive force.

  • Hennepin Co. sheriff's deputies leave Standing Rock protest


  • Native media’s live stream videos show DAPL security teams in mirror-visor helmets and black ops body armor with no identification, mingling with the police, sometimes directing them when and who to mace or pepper spray. They point out media making video for arrest. The big fossil fuel company evidently has plenty of experience dealing with protestors around the world. In their blank, reflecting visors we can see the soulless Darth Vader face of the government-corporate proto-fascist state the U.S. is becoming.

    Of course, this struggle with the Wasi’chu (Lakota word for the white man, meaning literally “takes too much”) is an old story for Native-Americans. In the 18th and 19th centuries it took the form of the Sioux nations trying to hold back the tsunami of colonizers flooding into their ancestral lands, occupying and despoiling them. The big difference now is that the fire-power of the state (think Custer’s 7th Cavalry or present day militarized police) has been fused with vast profit centers dependent for their existence on plundering the earth in the name of energy-squandering lifestyle survival.

    The provocations the water protectors endure take many forms. There is the psychological pressure of constant surveillance: the heavy police presence on the roads around tribal and reservation lands, the DPLA helicopter and a small plane that circle constantly above the encampments; there is the Bureau of Indian Affairs station set up on a knoll to suck out data from the cell phones of anyone in the area. There is the pepper spraying and tasing of water protectors who are praying. There is the more recent blasting of the protectors with freezing water canons in sub zero weather. There is the constant threat of weapons pointed at them. One twitching trigger finger could set off a slaughter.

    The water protectors are unarmed. The resistance movement does not allow guns in the encampments. One day, at one of the front line actions, an armed man showed up with a pistol and began firing. Possibly he was paid by DAPL to create an incident. The Natives are aware of paid provocateurs or agitators passing through the camps, pulling dirty tricks, looking to start something. Antimedia reported about the man with the gun: “According to an official statement from the tribe, the man fired several shots from his gun before being peacefully apprehended by tribal police. Witnesses at the scene say he pointed his gun at several protesters. The man was clearly trying to provoke violence that could later be used to demonize protesters who have so far remained peaceful.”

    The news site added, “The Morton County Sheriff’s Department circulated a false report claiming the man was shot, presumably by protesters… [As images show], the man was not harmed. The Sheriff’s Department has since retracted that report. Anti-Media’s attempts to obtain clarifying comments from Morton County Sheriffs were ignored.”

  • Dakota Access Caught Infiltrating Protests to Incite Violence, Funding Trolls Online


  • On a hill overlooking Oceti Sakowin, the largest of the Standing Rock encampments, an old army tent houses the field office of the rotating teams of lawyers who come to Standing Rock to help out. They use donations made to the resistance to bail out protectors who have been arrested; they try to negotiate with the police so the protectors can be allowed to pray. The constant arrests on trumped-up charges are an ongoing harassment—people maced or beaten, violently thrown to the ground and zip-tied. Often activists are charged with trespass and “riot” on the Morton County Sheriff’s novel legal theory that if several people are arrested for trespass that must signify that they were engaged in a riot.

    All this naturally requires court time and money to defend, incarceration in usually unpleasant conditions, including dog kennels. (Though the white allies who are arrested seem to get better treatment.)

    Arrests are to be expected as a consequence of civil disobedience. But some arrests are directed at chilling speech. One lawyer who came to Standing Rock from the Oregon-based Civil Liberties Defense Center, an activist defense nonprofit primarily involved in climate protests, https://cldc.org/ told Jordan Chariton of The Young Turks Network that often after the day’s action was over, police would stop the last cars in the caravan. They would then make “snatch and grab” arrests, impounding the cars of people who had come to support the water protectors but had no expectation that they’d be arrested when the action was over and the police told them to leave. They have to pay heavy fines ($900) to get their cars back. She said the arrests and impoundment fines for their cars are unlawful. “The intention with those types of actions is to scare out-of-towners from being comfortable coming to these actions. So they’re trying to chill the rights of others to come and participate in these protests.”

  • Environmental Lawyer Explains Standing Rock Legal Issues




  • The authorities regularly characterize the natives as terrorists, and local radio spreads false rumors of farm animals being slaughtered and stolen, reported vandalism—the kind of thing you would expect from psychologically projected homesteader fears about savage Indians of earlier centuries.

    Yes, Magazine on Oct. 31 reported: “The county sheriff is claiming the water protectors were violent and that police were stopping a riot. But hours of live video feed from people caught in the confrontation showed instead a military-style assault on unarmed people: police beating people with batons, police with assault rifles, chemical mace, guns firing rubber bullets and beanbag rounds, tasers.”

  • Why Police From 7 Different States Invaded a Standing Rock Camp—and Other Questions


  • The UN has sent human rights observers. According to Salon, Nov. 16, 2016: “The U.N. special rapporteur said that American law enforcement officials, private security firms and the North Dakota National Guard have used unjustified force against protesters.

    “ ‘This is a troubling response to people who are taking action to protect natural resources and ancestral territory in the face of profit-seeking activity,’ [Maina] Kiai [U.N. special rapporteur] said in his statement, which was issued by the Office of the U.N. High Commissioner for Human Rights and was endorsed by several other U.N. experts.

  • Native Americans facing excessive force in North Dakota pipeline protests – UN expert


  • “At least 400 activists have been detained and often have been held in ‘inhuman and degrading conditions in detention,’ Kiai added. Some indigenous protesters have said they were treated like animals and even held in dog kennels.

  • Dakota pipeline protesters say they were detained in dog kennels; 268 arrested in week of police crackdown


  • “ ‘Marking people with numbers and detaining them in overcrowded cages, on the bare concrete floor, without being provided with medical care, amounts to inhuman and degrading treatment,’ the U.N. expert said.

    “ ‘The excessive use of State security apparatus to suppress protest against corporate activities that are alleged to violate human rights is wrong,’ he continued, noting that it violates U.N. guidelines on business and human rights.

    “Amnesty International USA, which has repeatedly criticized authorities for not respecting the rights of protesters, issued another statement on Tuesday noting that U.S. authorities had put up roadblocks to prevent journalists and human rights observers from documenting the protests and the official response.”

  • U.N. experts call for halt in Dakota Access pipeline, blast “excessive force” against protesters


  • Living on Earth reporter Sandy Tolan reflected: “You know, at times I felt I was back reporting in the West Bank, and not the Northern Plains…”

  • Standing With the Standing Rock Sioux


  • The Bundy crew was the cowboys, not the Indians

    Compare the government response at Standing Rock with the response occasioned by Ammon Bundy and his gang of armed militants when they occupied Oregon’s Malheur National Wildlife Refuge for over a month in January 2016. Imagine if the Bundy gang had been pepper sprayed, beaten, hit with water cannon, tased. But the Bundy crew were taking over the refuge to proclaim their belief that public lands should be given free to the profit-making private ranching business. In other words, the Bundy crew was the cowboys, not the Indians.

    The mainstream corporate media has largely ignored the stand-off at Standing Rock. Rallies have taken place around the world at places like Tokyo, Stockholm, and Auckland, but the sad truth is many foreigners have heard more about Standing Rock than Americans have. Not surprising. The news editors, working for corporate media conglomerates, choose what they believe we should know and what fits the larger corporate agenda, and so they devote massively more play to Brad Pitt, to the gossipy politics of who’s-on-first, and to whatever the latest glittering consumer thing is than they do to climate change and issues highlighted by the poor and the powerless, like Standing Rock. What coverage that does exist is usually cursory and misleading.

    Fortunately, alternative media have been on the scene and active at Standing Rock. As someone who taught journalism for more nearly 20 years, it has been refreshing for me to see what the alternative press is accomplishing.

    Amy Goodman of the webcast Democracy Now brought the prayer-resistance movement to national attention over the summer. She was arrested and charged with riot in absentia for her live reports of water protectors being set upon by dogs. The charge was later dismissed in court.

    Jordan Chariton of The Young Turks Network has done searching interviews and incisive commentary from the scene.

    But my absolute favorite news source at Standing Rock is Myron Dewey’s Digital Smoke Signals. Dewey does updates every day, which he posts on Facebook. I highly recommend anyone who has a Facebook account to “follow” him. I went to Standing Rock on Oct. 4-11 with two friends and I have since been able to keep up with developments on the ground through Dewey’s Facebook broadcasts. He posts live stream unedited clips that constitute what he calls an ongoing “documentation” of what is happening day-to-day at the movement.

    Here is Dewey at night standing on a hillside next to the Oceti Sakowin encampment. His face appears in the glow of his screen. Then he’s panning and zooming in on a large grassfire as he’s telling us about it. His finger appears in the screen and points out where the fire started. He says the helicopter which constantly circulates over the camp suddenly disappeared 20 minutes before they saw the first flames. He zooms to the area where he and the person he is with first spotted the fire. He says, “It looked like someone using a drip torch.” He says they called 911, but it’s been over an hour and the Morton County Fire Department hasn’t shown up. He tells the people in the camp, his audience, not to worry, though. It looks like the fire was started by DAPL employees to scare them or hurt them. But the Oceti Sakowin is full of Indians who supplement their income by wild-land firefighting, work that also benefits Mother Earth; he mentions that he is himself a “hotshot” firefighter [one of the elite crews]. He and his fellow firefighters can tell by the wind direction that the fire won’t harm the camp.

    Now here’s Dewey on a bright morning walking along the road by Oceti Sakowin. A young man appears on screen, and Dewey asks him who he is and why he’s here. He’s from the Paiute nation. “I’m here to protect the water,” he says. Dewey asks him to sing a Paiute song. The young man closes his eyes and sings.

    In another nighttime broadcast find we ourselves looking through a car windshield, headlights illuminating the highway, centerlines whizzing by. We hear voices talking in the backseat. The car drives on and on. We’re just watching the road. Then ahead is a police roadblock. The police van looms. Dewey gets out with his camera and calls over to the officers, asks them where they’re from, inquires about where the road blocks are, what are the open routes. At one level it’s a mundane exchange between a citizen and police, but you experience the edginess of the situation. More deeply, you feel the riskiness and pathos that is involved any human interaction. Dewey firmly exercises his right to have these protect-and-serve police respond to him civilly; he is cordial and respectful in a way that reinforces to them and to his viewers that he is after all not their enemy but a fellow human being. Dewey asks more questions and the lead officer says he doesn’t want to be filmed; Dewey offers to turn his camera away from them and onto himself. The distant officers disappear from the screen and Dewey’s face fills it. The contact officer walks nearer; we can hear his voice. Dewey can’t resist a joke, though. He asks the officer if he’s sure he doesn’t want to become famous by putting his face on Dewey’s screen? You realize these are just guys doing their job. Dewey understands that, but he also wants to educate them about the water protectors’ mission. He never misses an opportunity to educate his adversary, as well as his own people about the larger dimensions of the Standing Rock resistance. When he gets back in the car, someone in the back seat says “Let’s get out of here; this is enemy territory.” Dewey laughs, turning the car around, “It’s not enemy territory.”

    I believe you learn more about Standing Rock by watching Dewey’s unedited video than you ever could from watching any number of dramatically produced, commercially constricted reports on CNN, complete with the drumb-drumb latest crisis theme music.

    Dewey explains to his viewers that what they’re seeing is a “documentation” that’s not edited. “It’s not scripted. It’s not acted out.”

    After a month of watching Dewey’s daily reports I realize more fully than I ever have before how ghastly and vacuous mainstream news reporting is: a production where facts have been emptied of the humanity of real encounters, replaced by the shallow performances of reporters and news sources, slick, clichéd phrasing, behavior slotted into ready made categories, events analyzed and even predigested. The news about reality comes to us compartmentalized in trays like tasteless microwave dinners. Rarely is the reader or viewer allowed to simply experience the event unfolding through the reporter’s eyes or camera. The stories are crafted and slickly packaged. Their very polish and stimulating presentation sabotages their meaning and replaces it with a meaningless, artificial understanding.

    Note that I am not saying that the news these days is politically biased. Some obviously is, but the left or right bias charge is a serious red herring, a mis-direction. In fact, in mainstream media’s very effort to appear neutral and unbiased means events are chopped up and pieced together to fit the templates of a few hackneyed forms of storytelling: the winner-loser story, the conflict story, the individual overcoming obstacles story, the facing bad choices stories, he-said, she-said stories, scandal stories, hypocrisy stories. You’ve seen them all, repeatedly.

    Most of these templates come plated with a cynicism, skepticism, superiority, or sentimentality that grabs our attention by adding a dash of disgust. The current journalistic manner of telling stories reduces and dismisses the story in a way that sometimes makes the commercials and pop-up ads come as a relief. None of the common journalistic templates or attitude has much to do with real life as it’s lived in the moment. It’s not what people really experience in their lives. Instead, it’s how they’ve been conditioned to wrap up experience afterward in a dramatized way that leaches out the nuance, that leaves out the moment-to-moment uncertainty, or as the Lakota call it, the Wakan, the deep mystery of relationships that permeates every event. And that’s what Dewey’s broadcasts have in abundance. You get to see him interacting with the people who show up on his screen. You get to feel his humanity and the mystery of everyday relationships taking place at Standing Rock that he brings to light. It’s certainly not dramatic or melodramatic. It’s not interesting or stimulating in the usual way. It does seem really important.

    So when Dewey sits in his parked car and does an update video on “10 things to know about DAPL” (Nov. 18, 2016), there’s no editing and no script, meaning that you get to see him thinking through what those top 10 things might be. Some points he makes are incisive and comic, others not so much. But the not-so-much ones can lead you to thinking about gray areas, the imprecise observations we all make. He asks a guy who just got in the car to help out with his list and the guy, William Hawk Birdshead, goes immediately serious on him until Dewey says, “I was trying to keep it light.” So the Birdshead says, “Laughter is good medicine.” Suddenly they’re off. Dewey mimics the shifty-eyed look of the FBI guys lurking around the area and denying they are FBI, the DAPL security characters trying to look all steely and tough. We learn that in the encampments they say that “DAPL dresses up like Ninja Turtles.” You can tell that it’s DAPL undercover because those guys never drive rez cars, which are rusted and dented. Nobody is spared. Dewey describes the water protectors just arriving from California as dudes who’ve “got their animal spirits on… They’re all furred up. They’re coming in all mystical and crystals.” He and his buddy laugh, which Dewey says is laughter “in a good way,” because the whole thing going on at Standing Rock is deadly serious but you need laughter, because that’s good medicine for healing. And healing and praying are about “getting reconnected with the Earth.”

    This points to a major difference between anthropocentric prayer as most of us know it and earth-mind prayer. In the prayer that most people are familiar with, an individual seeks intercession for human needs with a transcendent being. The Native prayer is about healing not getting. The prayer is a community ceremony or song or ritual to maintain or restore the balance between and among beings, both animate and inanimate. Prayer is to all my relatives, all my relations, the birds, the water, the wind, the buffalo, my family, even those who oppose me as enemies. Mitakuye Oyasin is an important Lakota phrase that means “all my relations.” When you’re watching a Dewey update from Standing Rock you’re experiencing Mitakuye Oyasin in action. It’s newscasting as a kind of prayer, in the earth-mind sense. Whether he’s engaging in laughter or educating about the spiritual importance of water, you can see that what he’s getting at is healing relationships. Watching and listening, you get to be part of that healing.

    What Dewey does goes way beyond advocacy journalism.

    Our traveling companion for our visit to Standing Rock, Lakota elder Tiokasin Ghosthorse, also provides a good way to keep up with developments through the interviews he conducts for his weekly syndicated broadcast from WPKN in Bridgeport Conn. and WBAI in New York City. On Oct. 31, 2016, Tiokasin interviewed a young man who was seized on Oct. 27 when a frontline camp was destroyed by police. Trenton Joseph Castillas Bakeberg, in the bloodline of Crazy Horse, was praying in a sweat lodge when the militarized police swept through the camp. They yanked him out of the sweat lodge and arrested him. The young water protector told Tiokasin:

    “I pray that we’ll be able to keep a state of prayer and peace, as we have been… Although there’s some people on our side are more likely to tend toward violence. But there’s also people on our side to stop them. Don’t start a fight. That’s what it’s all about, keeping it peaceful because the elders told us in the beginning that all it takes is one single act of violence, one person attacking a police officer and they’ll unleash the fear on all of us. This wrath that we have with our military overseas, we’re beginning to see it now in the heart of our own country. All for the greed and the corporate interests of this government. They say we’re a democracy but it’s not showing anymore. The people didn’t want this pipeline, but this foreign entity that they call a corporation, Energy Transfers, is saying, we don’t care. We want this money. We need this for economic stability of the country and that somehow trumps the interests of our communities and our nation as a whole….We’re standing up to this corporate machine with prayer and love.”

  • Forcibly removed from prayer at Standing Rock


  • Against a heavily armed, corporatized democracy designed to ensure that only powerful business and political elites rule the land and possess the wealth of its objects, the Native-American people at Standing Rock stand in defense of Mother Earth armed with songs, prayers, and an understanding that Earth’s objects are us, and we are them. They are our relatives. It seems better armament than most of us Wasi’shu possess. Webster defines fascism as “a political system headed by a dictator in which the government controls business and labor and opposition is not permitted.” It’s an incendiary word, and readers might think ill of me for introducing it here. Certainly we are not a fascist state yet. But for the prayer-resistance at Standing Rock, the clear alliance between corporate and government interests to quell their opposition under color of the law has a fascist flavor.

    It should not surprise anyone that the new US president reportedly holds stocks that directly fund the Dakota Access Pipeline and that the DAPL CEO Kelcy Warren gave the Trump campaign a substantial donation.

  • Trump's Personal Investments Ride on Completion of Dakota Access Pipeline


  • This is how the proto-fascism works. Ironically (or perhaps absurdly), Trump may have been elected by people hoping he would somehow counter the tightening grip of multinational corporations on their lives. One might wish for that to happen.

    At a deep level, Standing Rock may suggest that such absurdities as a Trump presidency occur because our mode of consciousness is impaired or inadequate to the situation it has created on our planet at this historical time. Too many of us have gone dead to the natural world we come from. Our obsessive anthropocentric mode of consciousness has reduced nature and reality at large to a bunch of things we have names for—things that feed our greed. Fortunately, many Indigenous people have retained an acute and ancient consciousness that we are those rocks and trees and clouds, and birds and water that we see outside our windows, and that restoring our relationships with them is incumbent on us.

    John Briggs is emeritus distinguished Professor of Writing and Aesthetics from Western Connecticut State University. He was the English Department’s journalism coordinator for 18 years and was one of the founders of Western’s Department of Writing, Linguistics, and Creative Process. He is the author of several well-known books on chaos theory, fractals and creativity. He lives in the hilltown of Granville, Mass., where served as a Selectman for five years and as reserve police officer for 10 years.


    When people at Standing Rock talk about the black snake they mean the pipeline, referring to an old Sioux legend about a black snake that will threaten the end of the world. The Lakota prophet Black Elk said that in the seventh generation, the Sioux tribes would unite to save the world.

    Media covering the Standing Rock resistance movement:

  • Digital Smoke Signals


  • Myron Dewey, Facebook


  • The Antimedia


  • Democracy Now


  • The Intercept


  • The Guardian


  • Censored News


  • Unicorn Riot


  • Living on Earth


  • The Indigenous Environmental Network


  • Status of Standing Rock court claim



  •           Hit-and-Run Chronology, Grand Jury Report & Follow-up Columns, Re; Library Discussion 9-22-16        

    Open
    the Showalter File

  • Hartford Courant Editorial




  • Cool Justice Editor's Note:
    This post is primarily for patrons and guests of the Sprague Public Library, who might participate in a discussion on Thursday at 6:30 p.m. A link to announcements of that event is at the very bottom of this post. Thanks for reading, AT.


    Via
    Law And Justice In Everyday Life


    F. Lee Bailey on Law and Justice in Everyday Life and the Showalter case:

    This book - which is mainly about public officials, police, judges and lawyers either shaming or shining - is a good read. Many of the stories stand alone, like slices of life. Others will appear early in the book, with follow-up chapters later. The crown jewel, in my view, is his handling of the strange death of Kevin Showalter, who was slammed 50 feet down the road in New London, Connecticut on Christmas Eve 1973 while changing a tire on the traffic side of a parked car. For many years, Andy Thibault dogged a case which public officials seemed determined to let die, despite the presence of a likely suspect. He tells me his mentor, John Peterson, broke the case open and then handed over the torch. Joined by the victim's mother, Lucille, who revealed herself as a determined but delightful woman as the story unfolds, Andy beats up on police, prosecutors, judges and governors until finally there is action. Spurred on by an appointment hastened by Gov. Ella Grasso, Judge Joseph Dannehy conducted one of the most brilliant and thorough investigations I have ever seen. If this book were only about the Showalter case, it would be worth the price.

    APPENDIX

    THE SHOWALTER CHRONOLOGY – A FOUR YEAR SEARCH FOR JUSTICE


    New London, Ct.

    1973

    December 24

    Approximately 11:10 to 11:20 p.m. Kevin B. Showalter is killed. Car leaves scene. Only taillights observed by a neighbor.

    There is much confusion. Mr. Showalter had been changing a tire on his companion’s car. His companion Debra Emilyta, was sitting about six feet away from the car on a stone wall.

    Ms. Emilyta told police she heard a thud, but did not see the car which struck Mr. Showalter. She said she ran across the road, a well-lit section of Pequot Avenue near Plant Street, before seeing Mr. Showalter’s body.

    Mr. Showalter’s body was thrown 22 feet from the believed point of impact, onto a sidewalk near a large tree. The police report prepared that night noted the deceased’s shoes were found 110 feet apart. Part of a leg bone was found 75 feet away.

    Michael Buscetto of Mike’s Auto Body gives police body putty, apparently from the car which struck Mr. Showalter. The putty never made it to the police station. Det. Lt. Konstanty T. Bucko later denies its existence.

    December 25

    Autopsy performed. No trace of alcohol or drugs found. Cause of death listed as lacerated liver and broken neck.

    In efforts to console Mrs. Showalter, friends, neighbors, witnesses and officials volunteer information about the accident. She quietly listens for about six weeks, taking it for granted that police are acting on the same information. December 26

    New London police begin full-scale search for red car.

    1974

    February 6

    FBI report describes paint particles on Mr. Showalter’s clothing as “racing green” or “forest green” used on 1968 Chrysler products.

    February 7

    Mrs. Showalter notes she had the impression local police were not actively pursuing the case. She began interviewing those persons who came to her voluntarily and made a written record of her findings.

    During the next three weeks, Mrs. Showalter spends much of her time making telephone calls and knocking on doors. She and her youngest son Craig, then 14, visited a number of local auto dealers and garages. She said in most cases they were told police had not made any inquiries of them.

    February 28

    New London police conduct first interview with Harvey N. Mallove, the downtown merchant and former mayor and city councilor. Mallove stated he drove by Pequot Avenue near Plant Street shortly before 11:15 p.m. on Christmas Eve 1973. Seven people near the accident scene contradict what he said he saw.

    April 20

    Mrs. Showalter writes to State’s Atty. Edmund J. O’Brien, requesting a one-man grand jury investigation into her son’s death. O’Brien never responds.

    On the same day, Atty. Thomas Bishop, representing Mrs. Showalter as the administratix of Mr. Showalter’s estate, asks Atty. Joseph Moukawsher to conduct a coroner’s inquest of the hit-run death.

    April 23

    Moukawsher agrees to conduct inquest but must confer with New London police before setting date.

    June 4

    Mrs. Showalter writes to New London Police Chief John J. Crowley, asking for a progress report on the investigation by his force. Crowley neither acknowledges receipt of letter nor responds. Copies of letter were sent to City Manager C. Francis Driscoll, and Abraham Kirshenbaum, then chairman of the City Council’s Public Safety Committee.

    June 10

    Mrs. Showalter asks Superior Court Judge Angelo Santaniello to call for a grand jury investigation.

    June 24

    Santaniello notes Moukawsher has agreed to conduct coroner’s inquest. He tells Mrs. Showalter, “If it appears that during any stage of this proceeding that any further intercession is necessary, appropriate action will be taken at that time.”

    July 2

    Mrs. Showalter writes to City Manager C. Francis Driscoll, asking for a report from his office assessing the police department’s handling of the case. She also asks for a reply to her June 4 letter to Police Chief Crowley.

    July 9

    Driscoll tells Crowley to prepare a complete report for Mrs. Showalter.

    July 10

    Bucko completes report on fatal accident.

    July 25

    Driscoll sends Mrs. Showalter Bucko’s report. The report said Mr. Showalter’s body was in the road, but the ambulance crew which took Mr. Showalter to Lawrence Memorial Hospital said they found him on the sidewalk several feet away. No police officer ever saw the body at the scene since the first officer arrived as the body was being placed in the ambulance.

    Bucko says paint particles from a 1968 Plymouth at the U.S. Naval Submarine Base in Groton are similar to those found on Mr. Showalter’s clothing, but the same paint is used on any 1968 Chrysler product.

    Bucko also says a piece of metal Mrs. Showalter found near the accident scene is in the detective bureau. When Mrs. Showalter first offered the metal to police, they refused to sign a receipt for it.

    August 6

    Mrs. Showalter writes to Driscoll regarding Bucko’s report. She lists six pages of comments on allegedly “serious omissions” and “strictly opinion judgments” by Bucko.

    Mrs. Showalter also writes to Chief State’s Atty. Joseph Gormley, asking him to send a representative to the coroner’s inquest. She includes copies of correspondence with local officials and Bucko’s report.

    August 9

    Mrs. Showalter requests a meeting with the City Council’s Public Safety Committee.

    August 15

    Bucko updates report, at request of city manager Driscoll.

    Bucko said of the body location, “the position he (Mr. Showalter) was found in at the scene of the accident, in my opinion, would not help in solving this matter.” Erroneous on the report is the position of the car jack which is shown on the front bumper. The car Mr. Showalter was working on, a Ford Pinto, had to be jacked from the side of the vehicle.

    Omitted from the report is the location of a car mat seen to the rear of the car and the spare tire Mr. Showalter never got to put on the car.

    August 20

    Gormley writes to Mrs. Showalter, telling her the local police investigation “has proceeded smoothly,” and there is “no reason for this office to initiate its own investigation.”

    August 28

    The Public Safety Committee of the New London City Council meets in closed session for one hour to discuss the hit-run death. Chief Crowley requested the closed session. He said there is evidence that could jeopardize future action.

    Mrs. Showalter submitted a 12-page statement for the meeting, but did not attend.

    Crowley said the case is not closed and it appears an arrest may be made.

    August 31

    Mallove submits official statement to New London police.

    November, 1974

    After being postponed several times, the coroner’s inquest hears testimony from 50 persons. No findings issued.

    1975

    January 24

    A state police detective participating in the federal grand jury probe of the city police department has told one of its patrolmen they identified the driver of the car which struck and killed Mr. Showalter on Christmas Eve, 1973.

    “We know who killed the Showalter kid, how come you don’t?” the detective was quoted in The Norwich Bulletin as saying.

    March 19-22

    The Bulletin, in a four-part series, shows:

    - Eyewitnesses and what New London police called “near witnesses” drastically differed in their accounts of the accident.

    - Microscopic paint particles found on Mr. Showalter’s clothing on which police based their search may not have been left by the vehicle which struck him.

    - Evidence entrusted to police officers at the scene has never been seen since.

    - A claim by police that it would cost as much as $1,200 to trace vehicles possible involved in the mishap was declared false by the state Motor Vehicle Department.

    The Bulletin, when preparing the series of articles, made repeated efforts to discuss the case with police officials but Lt. K.T. Bucko, who headed the case, on the advice of then Police Chief John Crowley, would not.

    April 3 State police conduct an extensive door-to-door inquiry in the Pequot Avenue region. State police have been looking into the case as part of a federal grand jury investigation into alleged corruption within the city force.

    July 12

    The state of Connecticut offers a $2,000 reward for information leading to the arrest and conviction of the person responsible for the hit-run death of Mr. Showalter. A total of $3,000 is now being offered. Classmates and friends of Mr. Showalter’s have already collected $1,000.

    July 21

    A community effort by friends and classmates raises the reward to $5,000.

    November 8

    The transcript of the coroner’s inquest of the hit-run death conducted nearly a year ago has yet to be typed, Coroner Joseph Moukawsher confirms. He said he wants to review the transcript even though he believes his six-day long inquest did not establish any guilt in the case. He said he has not spoken with the court reporter assigned to the case since the early summer.

    December 10

    Mrs. Showalter writes to State’s Atty. C. Robert Satti, requesting a one-man grand jury investigation. No response.

    1976

    January 6

    Satti refuses to confirm or deny the existence of Mrs. Showalter’s request. Mrs. Showalter has also asked Satti’s office to ascertain the location of recorded tapes made during the coroner’s inquest.

    January 9

    Mrs. Showalter sends a special delivery letter to Satti asking for a response to the December 10 request. No response.

    February 19

    In a feature article, also carried statewide by the Associated Press, The Bulletin profiles Mrs. Showalter on page one.

    Some public officials regard her as a persistent nuisance, someone to be ignored and sidestepped, but Mrs. Lucille M. Showalter will not breathe easily until they tell her who killed her son, Bulletin reporter Fred Vollono wrote.

    “The official comment seems to be there is nothing to it,” Mrs. Showalter said. “It is just the ramblings of a grief-stricken mother. But there are many people who urge me to go on. They say, ‘Lucille, if you stop, then nothing will ever be done.’”

    February 23

    Mrs. Showalter receives a letter of confession from an inmate at Somers state prison. The inmate said he was plagued by news accounts of the death. Every time he seems to forget the accident, the inmate said, he reads another news story.

    April 2

    Mrs. Showalter submits a third written request to Satti for a grand-jury probe. No response.

    May 6

    Common Pleas court Prosecutor Harold Dean quashes the only lead in the two and a half year old investigation, The Norwich Bulletin reports. The lead was the letter of confession written by the inmate at Somers Prison. State police arrested the inmate for harassment of the victim’s mother, Mrs. Showalter, to whom the letter was sent. Dean nolled the case and allowed it to be dismissed despite a prior meeting with state police when the significance of the arrest was discussed.

    State police did not believe the letter writer was responsible for the hit-run death, but they thought the letter contained possibly significant information. Dean said he was certain the accused had no knowledge of the case, because he was incarcerated when Mr. Showalter was killed.

    August 7 The day following the Bulletin’s report of Dean quashing the lead, Chief State’s Atty. Joseph Gormley says he had “no idea” why the lead “which very well could have led to something,” resulted in a dead end. Two state police officers had met with Gormley to discuss the letter of confession.

    August 6

    State police list the investigation into the killing of Mr. Showalter as “closed pending further development.” That classification came 31 days after Dean threw the harassment case out of court.

    August 30

    Mrs. Showalter again asks Superior Court Judge Angelo Santaniello to call for a one-man grand jury probe.

    September 1

    Mrs. Showalter publicly renews her efforts to have a one-man grand jury reopen the investigation into the hit-run killing of her son. In a statement sent to 22 media outlets, Mrs. Showalter says she made the appeal in an August 30 letter to Superior Court Judge Angelo Santaniello. She says she was asking the judge to “make good on a promise” he made to her in June 1974. Santaniello wrote in a June 24, 1974 letter, Superior Court intercession would be possible if the investigation required it.

    Santaniello said, “probably the proper person” to approach would be State’s Atty. C. Robert Satti. But Mrs. Showalter said she is ignoring Satti because he failed to respond to her December 1975 letter asking for the grand jury.

    September 23

    State’s Atty. C. Robert Satti says he needs another three weeks to review information on the killing of Mr. Showalter before deciding whether the investigation should be reopened or shelved.

    Satti says he had hoped to have the matter resolved by today, but the sinking of his 35-foot cabin cruiser two weeks ago, an unexpected report of crimes by New London police, and a new trial forced him behind schedule.

    November 23

    Mrs. Showalter turns to Governor Ella T. Grasso for help.

    “I cannot endure this loss of a beloved son in the midst of a governmental system that appears to neither act nor care,” Mrs. Showalter says in a letter to the governor.

    Mrs. Showalter says she is skeptical the New London County State’s Attorney’s review of the case will result in the one-man grand jury she has requested. Satti today said he is still reviewing transcripts of the Coroner’s Inquest and refused further comment.

    December 21

    Just three days before the third anniversary of the killing of Kevin B. Showalter, the state’s chief court administrator orders the city’s only unsolved hit-and-run case reopened.

    John P. Cotter signs an order creating a one-man jury to probe the death, renewing hopes that allegations of police bungling and mishandling of the case will be settled.

    “I can’t yet believe it,” says Mrs. Showalter, calling the action a “literal miracle.”

    Cotter, a justice on the state Supreme Court, selects retired Superior Court Judge Raymond J. Devlin to head the one-man grand jury.

    An attorney representing Mrs. Lucille M. Showalter also files a $600,000 lawsuit against the unnamed person(s) responsible for the killing of her son. Atty. Averum J. Sprecher of East Haddam says the suit is aimed at protecting Mrs. Showalter’s rights.

    “The action as I have filed it will definitively preserve her rights when the investigative bodies finally determine who killed the boy,” he said. The suit is aimed at heading off fears the state’s statute of limitations might preclude Mrs. Showalter from pursuing civil action if the killer is found.

    December 24

    Superior Court Judge Joseph F. Dannehy is ordered to replace State Referee Raymond J. Devlin as the one-man grand juror investigating Mr. Showalter’s death. Chief Court Administrator John P. Cotter says Judge Devlin had asked to be taken off the case because he was too busy with other duties, and would be unable to commute from his New Haven office.

    1977

    January 4

    Austin J. McGuigan, the special prosecutor assigned to the one-man grand jury probing the hit-run death of Mr. Showalter promises to pull “all the stops” in his investigation but says he needs help from the public to succeed.

    McGuigan has worked for the state for two years as the top investigator of organized crime. He appeals to anyone with information to call him confidentially.

    February 8

    State Police Commissioner Edward P. Leonard, as part of a last-resort effort, makes a personal appeal to area residents for information about the killing of Mr. Showalter. In a letter to the people who live near the Pequot Avenue site where Mr. Showalter died, Leonard asks for facts – “No matter how insignificant they may appear” – which might shed light on the car, the driver or the accident scene.

    Special Prosecutor McGuigan says police “had no suspects.” However, he says if a suspect is found police believe there is sufficient evidence to tie the person to the case.

    April 18

    Investigators say they feel confident the Showalter case will be solved.

    The new optimism comes after a public appeal netted more than 300 leads, new laboratory analysis of existing evidence, and an accounting of each of the more than 10,000 green Chrysler products registered in Eastern Connecticut when Mr. Showalter was killed.

    The new evidence means “there is a significant possibility the vehicle in question was not a green Chrysler,” Special Prosecutor Austin McGuigan says. While the investigators will not say what other color the car might have been, the evidence apparently opens new avenues for the investigation. Previously, other theories on who drove the death car, theories which have had some substantiation, were locked into the green Chrysler theory, police acknowledge.

    May 10

    State police investigators spend two and a half hours recreating and filming the Pequot Avenue death scene where Mr. Showalter was the victim of the hit and run.

    May 18

    State police again film and re-create death scene.

    June 22

    The Bulletin reports that one of the most intensive investigations in state police history, the probe into Mr. Showalter’s hit-run death, will be given to a one-man grand jury July 5 in Windham county Superior Court.

    Judge Joseph F. Dannehy, the grand juror, imposes a gag order on all investigators assigned to the case. Special Prosecutor McGuigan and 17 state police detectives had gathered evidence for the grand jury.

    June 23

    More than 50 persons will be subpoenaed and the scope of the probe will be expanded to include subsequent actions connected with the accident, The Bulletin reports.

    June 24

    Eleven New London police officers, including the top detective involved in the first of three investigations of the hit-run death, have been subpoenaed, The Bulletin reports.

    July 5

    The grand jury begins behind closed doors with testimony by New London Det. Lt. Konstanty T. Bucko.

    Outside, a television camera crew drips with sweat under the glare of a hot summer sun.

    Inside it is quiet and cool – almost like any other day. The state police detectives and reporters talk about golf, baseball and other summertime activities. Because of the gag order imposed by Judge Dannehy, they can’t talk about what is most on their minds, what has brought them all together – the unsolved hit-run death of Kevin B. Showalter.

    The session lasts about five hours and also includes testimony by Mrs. Showalter and Debra Emilyta, Mr. Showalter’s companion the night he died.

    Ms. Emilyta has been sitting on a wall about 6 feet from Mr. Showalter when he was killed. She told police she only heard the 20-year-old Mitchell College student struck, and did not see the car which struck him.

    July 6

    Witnesses include Michael Buscetto of Mike’s Arco in New London. What he identified as body putty, apparently from the car that struck and killed Mr. Showalter, has never been seen since police officers placed it in an envelope that night, according to sources.

    Ms. Emilyta concludes testimony.

    Also testifying are Dr. Robert Weller, members of his family, and a friend, who while returning home from church drove past Mr. Showalter as he was changing the tire. They were among the last persons to see Mr. Showalter alive.

    Other witnesses include Mrs. Ruth P. Hendel and Mrs. Charles (Shirley Pope) Alloway, her daughter.

    On Christmas Eve, 1973, Mrs. Hendel had just turned away from the window of her home on Pequot Avenue where she had been watching Mr. Showalter work on the Emilyta car. She heard the noise of the car striking Mr. Showalter and turning back quickly she caught a glimpse of the taillights. Her first impression of the fleeing southbound car was that it was bright-colored, possibly red.

    Mrs. Hendel continued to watch the accident scene as she telephoned Mrs. Alloway, the wife of a New London police officer.

    Arthur Adams of New London, a Mitchell College security guard and former state policeman, also testifies. Aside from Ms. Emilyta and the hit-run driver, Adams may have been one of the last persons to see Mr. Showalter alive.

    Adams saw Mr. Showalter working on the car and Ms. Emilyta sitting on the stone wall, swinging her legs. He observed the girl with a coat collar wrapped around her head, in conversation with Mr. Showalter, after the Weller party had driven by.

    Adams continued on his rounds towards the Montauk Avenue side of the campus. Sometime after 11 p.m., he saw an ambulance heading for the hospital and two police cars heading down Plant Street.

    July 7

    Some of the last persons who saw Mr. Showalter alive and one of the first who saw him dead testify.

    Six members of the Sitty family, who were celebrating Christmas Eve and occasionally watching Mr. Showalter change a tire from inside a house on Pequot Avenue, tell the grand jury what they knew about the case, Edmond Sitty had brought out a blanket and a corduroy coat to put over Mr. Showalter’s body after he had been struck and killed.

    A New London High School classmate of Mr. Showalter, Arthur Petrini, was a passenger in a car that passed the accident scene sometime after Mr. Showalter was killed and before the ambulance and police arrived. He also testified.

    July 12

    Witnesses included two firemen and a dispatcher, two nurses and an orderly, the New London County Medical Examiner, the first man to officially identify Mr. Showalter, and a woman who lives near the accident scene.

    Larry Grimes, a security guard who knew Mr. Showalter from Mitchell College, had made the preliminary identification at Lawrence and Memorial Hospitals, where he also worked. Mrs. Dorothy Bryson of Pequot Avenue, who came upon the accident scene, also testifies.

    July 13

    New London police officers pack the waiting room of the Windham County Courthouse. Of the 11 who were subpoenaed last month, at least seven are present.

    The 11 include Patrolmen Vincent McGrath, Steven Colonis, Thomas P. Bowes Jr., and Cpl. Joseph Chiapponne, all of whom were involved in the initial investigation. With the change of shift, Sgt. Joseph Jullarine, Patrolmen Richard West and Glenn Davis and Det. Sgt. Konstanty T. Bucko joined the probe. Bucko was off duty at the time.

    McGrath filed the motor vehicle report of the accident and the sketch on the report was by Bowes. Bucko took photographs of the scene and gathered evidence. His photographs may be the only ones taken. Bucko also went to the hospital and got the victim’s clothing, according to sources.

    Colonis, the first officer on the scene, apparently arrived as Mr. Showalter was being placed in the ambulance. He interviewed Ms. Emilyta and took her to the station to file a 13-sentence statement.

    There is some confusion of whether Colonis drove an unmarked police car that night. Sources say police made conflicting statements on that question.

    July 14

    Thomas Wainwright, who played tennis with Kevin Showalter at New London High, saw his lifeless body on a sidewalk on Pequot Avenue before an ambulance or police arrived, and is among those testifying today. Arthur Petrini, who testified last week, was a passenger in Wainwright’s car.

    Mr. and Mrs. Donald Wainwright, who were stopped by police after circling the scene in another auto, also testify.

    At least seven New London police officers are at the courthouse, but it is not known how many are testifying.

    July 19

    The grand jury shifts beyond reconstructions by “near witnesses,” as Sgt. Joseph Jullarine, now retired, testifies. He was the squad leader who reportedly conducted “an intensive investigation” for a red car during the 11:30 p.m. to 7:30 a.m. shift on Christmas Day 1973.

    July 20

    The grand jury investigators spend much of the day alone reviewing physical evidence and testimony. Only three witnesses – New London police who have already appeared during the proceedings – are present.

    July 21

    Det. Bucko appears for at least the fourth time in the nine days the grand jury has convened. The session begins at 10 a.m. and ends about 5:45 p.m., with his departure.

    A nurse’s aide who knelt by Mr. Showalter’s body, feeling for a pulse, also testifies, Sue Costello, who heard the report of an accident as she was leaving Lawrence and Memorial Hospitals in New London from her shift, had arrived on the scene before ambulance personnel and police.

    July 26

    The scope of the grand jury probe goes beyond Mr. Showlater’s death and runs smack into a crucial area of dispute with the appearance of New London police detective Walter Petchark.

    On Christmas Day 1973, with evidence already missing and news of Mr. Showalter’s death on the radio, Petchark reportedly received a call from former mayor Harvey N. Mallove. Mallove later told The Bulletin there was no truth to the report. But he allegedly told Petchark he thought he saw the accident the night before.

    Three city police detectives – Bucko, Petchark, and Carmello Fazzina – were present at the inquiry. They were followed by laboratory technicians from the FBI, who lent their expertise in the analysis of headlight glass possibly belonging to the death vehicle.

    July 27

    The former counsel for the estate of Mr. Showalter testifies. Atty. Thomas Bishop confirms his representation of the estate was severed in June 1974.

    Thomas and Donald Wainwright return for further testimony.

    July 28

    Witnesses include Mrs. S.F. Zimet of Ledyard. Mallove said he was visiting at her home on Christmas Eve 1973, left about 10:45 p.m., and was home in New London about half an hour later.

    Mrs. Zimet is accompanied by her attorney, L. Patrick Gray. Gray, like Bishop, is a member of the New London law firm Suissman, Shapiro, Wool, and Brennan.

    Other witnesses include New London city Manager C. Francis Driscoll and Elise Mallove, Mallove’s daughter. Miss Mallove was home for her Christmas vacation in 1973.

    The grand jury begins a four-week recess. More than 50 persons were called during the first 12 days of the inquiry.

    August 30

    New London police investigators and a newspaper editor who has followed their unsolved hit-run death case for three years are among the witnesses.

    Retired Police Chief John Crowley and Det. Lt. K.T. Bucko, who refused repeated pleas by The Bulletin in March of 1975 to discuss the death of Kevin B. Showalter, gives testimony – as did the paper’s managing editor, John C. Peterson.

    Peterson testifies for three hours.

    August 31

    The attorney who conducted a coroner’s inquest into Mr. Showalter’s death, the results of which have never met public scrutiny, is the first witness today. Atty. Joseph Moukwasher, who heard testimony from 50 witnesses during six days in September and November of 1974, is one of the few persons familiar with the substance of that investigation.

    It took more than two years for the transcripts of the hearings to be typed and submitted to State’s Atty. C. Robert Satti.

    State Police Sgt. Donald Crouch, who in 1974 and 1975 worked for the federal grand jury investigating alleged corruption in the New London force, also testifies. Other witnesses included Rosemary Benson and Carol James.

    September 1

    Physical exhibits appear to outnumber witnesses in the 15th day of proceedings. Two state police technicians from the crime lab in Bethany carry satchels concealing evidence into the closed courtroom. One exhibit is a light colored automobile fender, which was dented and streaked.

    September 2

    Det. Edward Pickett of the New London County State’s Attorney’s office, who helped administer a lie detector test to Ms. Emilyta, testifies. Ms. Emilyta passed the test.

    Another detective, private investigator Joe Harris, is also called. A former Waterford police sergeant, he worked on the case for a brief time, on his own.

    Other witnesses in a short session include State Police Sgt. Charles Trotter, a principal investigator in the federal grand jury probe of the New London city police.

    September 12

    Two persons who saw Mr. Showalter on Christmas Eve 1973, hours before he was killed testify.

    Ramona Ricci, a coworker of Mr. Showalter’s at a Waterford discotheque, attended one of two parties Mr. Showalter had planned to go to after work that night. Nancy Wicksham, who also testified, had joined friends that holiday evening at the club.

    September 18

    Mallove says his status as a suspect in the case is “nothing new.” During testimony in a New Jersey courtroom, Connecticut State Police revealed Mallove is a prime suspect in the hit-run case. The testimony concerned refusal by two New Jersey men to comply with a subpoena issued by the one-man grand jury. Trooper Charles Wargat also testified he was told the two men repaired Mallove’s car on Christmas Eve or Christmas Day 1973.

    Mallove tells The Bulletin he did not know the men and never had a car repaired at their shop on Reed Street in New London. He says he didn’t kill Mr. Showalter and doesn’t know anything about anybody who did.

    September 19

    One of the two men who testified with immunity today has said in a published account he has no knowledge of the case and denied any car was repaired in his New London shop on Christmas Eve 1973.

    Walter String Jr. made those comments in the New Jersey Courier Post. He and his son, Walter String III, had been ordered to appear today by a New Jersey judge, after refusing to comply with a subpoena.

    Among the dozen or so witnesses are New London city police Sgt. Donald Sloan and Cpl. Charles Alloway. They took the first full statement from Ms. Emilyta, five days after the accident.

    September 26

    Darlene Barnes, a friend of Mr. Showalter who patronized the Waterford discotheque where he worked, is among the witnesses today. Ms. Barnes was also one of the 50 witnesses during the coroner’s inquest of 1974.

    October 3

    Larry Grimes testifies again. The Mitchell College security guard who made the first identification of Mr. Showalter at Lawrence and Memorial Hospitals, was also at the courthouse on July 12, and Sept. 26.

    The grand jury will be in recess until October 17. It has convened 20 times since July 5 and heard about 90 witnesses.

    October 11

    Judge Dannehy says published reports that Mallove is a prime suspect in the case “couldn’t bother me in the least.”

    “They (the newspapers) are free to speculate if they wish,” Dannehy says. “I am not concerned with their claimed right to freedom of expression.

    I think that sometimes their attitude is to publish and be damned, but they don’t bother me.”

    “Why don’t you wait” for the grand jury report? Dannehy asked.

    October 17

    The sales manager of a New London auto firm who said he has sold a number of cars to the family of a suspect in the hit-run case testifies.

    In 1970, Peter Emmanuel Sr. of New London Motors sold a Lincoln Continental to Harvey N. Mallove, whom state police have identified as a suspect in the Christmas Eve, 1973 death. A compact car was among the other autos the New London firm sold to Mallove.

    State police were looking for a green Chrysler product when they first questioned New London motors personnel, Emmanuel said before he testified. But the firm didn’t sell Mallove such a vehicle, which police had believed was the death car, he added.

    October 24

    The grand jury does not convene today because the investigators were not ready to proceed, Judge Dannehy said. He said he plans to conduct several more sessions before adjourning to write the final report, but did not specify.

    November 14

    The grand jury meets for its first regular session since October 17 and hears one witness. The witness, Gary Jordan of New London, said he was dating Elise Mallove on Christmas Eve 1973.

    Sources say the grand jury conducted at least one special session since October 17, but it was not known who testified.

    November 21

    State police continue working long and irregular hours probing Mr. Showalter’s death as they re-create the hit-run scene on Pequot Avenue near Plant Street for at least the third time.

    November 29

    The man whom state police have said they consider a prime suspect in New London’s only unsolved hit-run death has his day in court.

    Harvey N. Mallove testifies for about four hours before the secret grand jury probing Mr. Showalter’s death. Atty. Leo J. McNamara accompanies Mallove to the Windham County Courthouse.

    Mallove says he was one of a number of persons who drove by the accident scene shortly before or after Mr. Showalter was killed. But a four-part series by The Bulletin in March of 1975 showed Mallove saw a scene that seven other persons said could not have taken place.

    Mallove passed the accident scene within a minute or two after an ambulance call was logged. His statement to New London police – dated eight months later – conflicts with accounts of seven persons at the scene or looking out their windows seconds after Mr. Showalter was struck.

    Mr. Showalter was struck by a car as he changed a tire on a friend’s parked Ford Pinto, on a well-lit section of Pequot Avenue near Plant Street.

    In his statement, Mallove said he saw an automobile parked at an angle in front of the Pinto. None of the seven persons saw any car stopped at the scene immediately after the victim was hit according to the July 10, 1974 report by New London Det. Lt. Konstanty T. Bucko.

    Mallove’s vivid description of a middle-aged man talking with a girl near the car also conflicts with statements by the seven persons.

    In his statement, Mallove said he assumed the man was a member of the police department. But Bucko claims in the July 10 report that Mallove told him the talking to the girl was “NOT” a policeman.

    Bucko’s report also claims Mallove learned on Christmas Day 1974 that “a man had been killed and he remarked to some people that he saw the body.” But Bucko continued to report that after Mallove viewed photographs of the scene he realized what he mistook for a body was a floor mat. In his statement, Mallove said he saw a “flat object which I assumed was a blanket or a mat.”

    In his August 31, 1974 statement, Mallove said, “Seeing no trouble, accident, or any evidence of anything out of place…I continued on my way home.”

    In the July 10, 1974 report, Bucko claims; “Mr. Mallove stated he was going to stop because he realized there had been an accident.”

    Mallove has told The Bulletin that Bucko misquoted him.

    December 7

    The calling of witnesses ends with Mallove’s second appearance.

    The proceedings included a film screening, apparently of the death scene as re-created by state police.

    After the 35 minute screening, Special Prosecutor McGuigan and Judge Dannehy questioned Mallove for about 40 minutes. That was the bulk of the afternoon session.

    The question of whether indictments should be handed down in New London’s only unsolved hit-run death now rests with Judge Dannehy.

    After 24 sessions and more than 100 witnesses, Dannehy said the next step for the grand jury is the final report on who killed Kevin B. Saltwater.

    1978

    Feb. 17 Report filed.

    Feb. 22

    Report made public.

  • THE DANNEHY REPORT


  • SHOWALTER COVERUP COLUMNS

    Chapter 1

    Law and Justice in Everyday Life

    Cover-Up In New London

    Hit-And-Run Continues To Mock Justice


    Sept. 4, 2000

    If Connecticut Chief State’s Attorney John Bailey wants to bring closure to cold cases, here’s one from New London that should top the list: The Showalter hit-and-run cover-up is a dark chapter in Connecticut history, a tale more appropriate for a Third World country.

    And yet, only one thing bothers former New London County State’s Attorney C. Robert Satti about the Showalter case: that it was investigated at all.

    Satti, now retired, made the point again and again, most recently this year. Satti’s complaint, made during the wake of the late state police Detective George Ryalls, was that Ryalls’ obituary mentioned the suspect the prosecutor refused to pursue in the Showalter probe.

    Kevin B. Showalter, a 20-year-old Mitchell College student, was killed at 11:12 p.m. on Christmas Eve 1973. He was changing a tire on a well-lit section of Pequot Avenue on the New London shoreline when he was struck and killed. His girlfriend, sitting only 6 feet away on a stone wall, claims she saw nothing.

    Auto body putty from the death car disappeared after a tow truck driver gave it to New London police. The evidence file that was supposed to contain the putty was stuffed with bathroom tiles. The file that was supposed to contain headlight glass from the death car instead contained glass from three different headlights. State police and others suspected that, in order to throw legitimate investigators off the trail, the late young man's clothing was pounded on a different-colored car than the one that killed him.

    The victim's mother, Lucille M. Showalter, tried to get a grand jury investigation of the cover-up. She was rebuffed repeatedly by the presiding judge, Angelo Santaniello who, it later became clear, was best friends with the leading suspect. Santaniello then referred Showalter to prosecutor Satti, who happened to be his former law partner. Satti refused to acknowledge registered letters from Mrs. Showalter pleading for a grand jury probe.

    Satti did finally meet with Mrs. Showalter in 1978, after Judge Joseph Dannehy of Willimantic, acting as a one-man grand jury, named former New London Mayor Harvey N. Mallove as the probable driver of the hit-run vehicle. Satti called the three-hour meeting, in which he repeatedly told Mrs. Showalter that there never should have been a grand jury investigation under Dannehy.

    Mallove held a good hand; he had the best legal muscle in New London County on his side. New London police would not question him for more than seven months, and then only in a perfunctory manner. They would say they inspected his cars, but they did not. Significantly, Mallove’s Lincoln had been repaired, but it wasn’t until state police took over the case four years after the accident that the fender was finally seized.

    Santaniello would arrange for a coroner’s inquest and put his niece in charge of typing the transcript. Only after two years of intense public pressure would the transcript be typed. But the inquest never issued a finding.

    Santaniello tipped off Mallove that he was a suspect. The judge was also aware of what local police knew about the case. Mrs. Showalter memorialized the admissions in tape-recorded telephone conversations.

    “I did talk to Harvey,” Santaniello told Mrs. Showalter on Oct. 17, 1975, “and I said, `You’re suspected.’ As a matter of fact, at that time a police officer came to him on the same day or the next day, and told him you were making accusations about him and that he was a prime suspect.” The day before, Mallove told Mrs. Showalter, “Judge Santaniello is of the opinion that you fingered me.”

    It was not until 1977 that state police, who took over the case at the behest of former Gov. Ella Grasso, formally named Mallove a suspect. Next week, I'll propose a means to solve the Showalter cover-up.

    Showalter Cover-Up Is New London's Shame

    Sept. 11, 2000

    New London, where I grew up and began working in the 1960s and ‘70s, was a dirty little city with character.

    It had a restaurant called the Hygienic that was everything but. There were at least a couple bars where the cops couldn't do anything, except maybe a little business.

    The top pimp in town never went to jail until he was about 60 and a certain court official retired.

    New London will always be the city that tried to cover up the Christmas Eve 1973 hit-and-run death of Kevin B. Showalter. It's been doing a pretty good job for nearly 27 years, but the onion is beginning to peel.

    The local daily newspaper admitted -- in its official history published this year -- that it did a shoddy job on the Showalter case. Specifically, The Day admitted its failure to explore the relationship between a former mayor and a top judge, and their influence on the course of the criminal investigation. That’s a beginning.

    Political and police corruption goes back a couple generations in New London. By the 1970s, New London police were widely known to be involved in the selling of women, dope and refrigerators, among other things. A federal grand jury took note. But as with the Showalter case, there were these little problems with the evidence.

    A jewelry store owner and former city mayor multi-millionaire Harvey Mallove was the prime suspect in the hit-and-run death of Showalter, a student at Mitchell College. Showalter’s date that night, Christmas Eve 1973, said she saw nothing from her vantage point six feet away, sitting on a stone wall under a streetlight on a residential street as a young man changed the tire of her car.

    Harvey was everybody’s pal. He would take kids to the Super Bowl, then, down the road, get them jobs as cops. He was friends with bums in the street and bums in high political office. He was wired. The standing joke among reporters became: Harvey's a great guy to have a beer with, just don't change your tire if he's driving by.

    “I didn't kill the kid in any way, shape or form,” Harvey told me many times. As mayor, Harvey helped hire a few police chiefs. His best friend was the administrative judge for the county; that was the judge who controlled the early stages of the investigation, specifically a coroner’s inquest that never issued a finding.

    State police followed up a report that Mallove’s best friend, County Administrative Judge Angelo G. Santaniello, was with Mallove on Christmas Eve 1973. Santaniello reportedly was No. 11 on a guest list for a party at the home of his political mentor, the late state Sen. Peter Mariani. The Mariani party was one of two Mallove attended that night.

    Santaniello told reporters he never went out on Christmas Eve.

    Another state judge, Joseph F. Dannehy, conducted two grand jury investigations. In 1978, Dannehy named Mallove as the probable driver of the hit-run vehicle, but said evidence that might have ensured conviction was either mishandled or destroyed.

    Mallove died a few years ago with this legacy. Others still have time to come clean and tell the truth about the cover-up. Mrs. Showalter tried unsuccessfully to have Satti, Santaniello and others prosecuted for hindrance of prosecution (CGS Section 53a-166) warning of impending discovery, providing means of avoiding discovery, preventing discovery by deception. Because a conspiracy to hinder prosecution is an ongoing crime, those with information could tell Chief State's Attorney John Bailey, who has begun an initiative to solve some of the state's cold homicide cases.

    Isn’t it time? No one kept the system honest when it counted, though some tried. Most stood by as the system that was supposed to protect the victim and his family betrayed them all.

    Where is the conscience of the community?

    Cold Case On Ice Forever

    Nov. 6, 2000

    One way to deflect attention from a suspect is to get investigators involved in meaningless, time-consuming tasks. Another way is to create a bogus suspect who is then exposed as such, causing a belief that the case is just too hazy to pursue.

    Both of these devices were used repeatedly in the cover-up of the Showalter hit-run case in New London. Whether this was happenstance, indifference, incompetence or malfeasance, the result was the same. The system failed.

    And now, it seems, the truth will remain buried forever.

    Judge Joseph F. Dannehy, the grand juror who investigated the case, wrote in his finding of fact: “After December 25, 1973, the New London Police Department did virtually nothing to solve the hit-run death of Kevin B. Showalter.” The accident occurred the night before.

    Local police and court officials, however, were pro-active in another sense. Their actions served to protect the assailant.

    For example, New London police claimed it would cost as much as $1,200 to trace vehicles using data from the state Motor Vehicle Department. The motor vehicle department declared there was no such charge.

    Nevertheless, New London police spent their time hand-sorting local motor vehicle cards. They looked for a green Chrysler. That was likely a false lead; state police said paint particles found on the victim's clothing did not come from the car that killed him.

    Former Mayor Harvey Mallove began meeting informally with police and court officials as early as Dec. 25, 1973. Mallove wanted to know what the police knew.

    The only lead after two and a half years was quashed by then New London Common Pleas Court Prosecutor Harold Dean in May 1976. The lead was a letter of confession written by a Somers prison inmate to the victim’s mother, Lucille Showalter.

    “I told Harold how important that was to me,” Mallove, the prime suspect, confided to an associate. He also acknowledged discussing the purported confession with his best friend, the presiding judge for the county, Angelo Santaniello.

    The author of the letter was known to be connected with “fences,” or purveyors of stolen goods in the New London area. State police arrested him for harassment of Mrs. Showalter. Two state troopers met with Dean for an hour. They told him the letter contained possibly significant information. State police also believed they could connect the dots in New London between the letter writer and the powers-that-be. Did he owe some favors? Was he paid? Police knew the author had no liability for the accident; he was actually in Florida at the time of the hit-run.

    Dean nolled and dismissed the case without telling the troopers or Mallove. Soon thereafter, state police listed the killing of Showalter as “closed pending further development.” Upon learning of Dean's action, Chief State's Attorney Joseph Gormley remarked he had “no idea” why the lead, “which very well could have led to something,” resulted in a dead end. The case would remain closed for six months, until Gov. Ella Grasso brought the matter to Justice John Cotter.

    Was there criminal activity connected with the Showalter cover-up? It appears we will never know for certain. Dannehy named Mallove as the probable driver, noting that evidence which might have ensured conviction was destroyed. The Chief State’s Attorney’s Office reviewed aspects of the case this fall after a series of columns appeared in The Law Tribune. However, the statute of limitations for the most likely potential charge, conspiracy to hinder prosecution of motor vehicle misconduct, has expired. This shameful case, it appears, is destined to stay on ice forever.

    - AND:

    Olympic Gold for Missing Evidence


    November 28, 2005

    Judge Ellen Gordon was in way over her head with what she tried pass off as a ruling in Day Publishing v. State's Attorney.

    Clueless Gordon was handed a hot one, a case no one has ever wanted in the so-called New London Judicial District. Every single time this case has come to court, begging for justice, The Robes, the prosecutors and their minions have either desecrated their oaths or looked the other way. Clueless Gordon, fairly new to the scene, has managed to join the list of those who are both ostriches and failures.

    The Day newspaper asked Gordon this year to release the grand jury testimony regarding the cover-up of the 1973 hit-run death of Kevin Showalter. Before Gordon probably ever heard of Showalter, five New London County judges recused themselves from a John Doe civil suit against the driver because they were friends with the prime suspect, Harvey Mallove. Mallove -- the late mayor of New London and multimillionaire jeweler who picked police chiefs, planned to run for Congress and starred in the social scene -- was prone to say, "I never killed the kid -- in any way, shape or form."

    It's not like we could expect a New London judge to show guts or brains in this case. Compelling testimony from the first of two grand juries implicated local law enforcement and court officials in a widespread cover-up.

    On Christmas Eve 1973 at 11:12 p.m., as the call came in, a high-ranking New London officer, said, "F--k him, he's dead," and then left to go home. Showalter, a 20-year-old Mitchell College student, lay dead on a well-lit section of Pequot Avenue by the shoreline. His body was thrown 22 feet from the point of impact. His shoes were found 110 feet apart. A leg bone was 75 feet away.

    A tow truck driver gave police auto body putty from the death car. The putty was never seen again. New London police mixed headlight glass from at least three different cars in what they called the evidence file. Replacing the auto body putty was bathroom tile. A local coroner's inquest never issued a finding. State police, who took over the case at the behest of Gov. Ella Grasso, were bewildered and angry when they could not find the transcript of the coroner's inquest. Mallove's best friend -- the presiding judge for the county, Angelo G. Santaniello -- had put his niece in charge of typing that transcript. Santaniello also tipped off Mallove to his status as a suspect.

    Now, Clueless Gordon can't find the 3,000-page transcript of the first grand jury. Does she care? Court clerks allegedly performed a diligent search. Would any reasonable person believe or accept any of this?

    Among the last persons known to possess the grand jury report was the late State's Attorney, C. Robert Satti. Satti, who refused to investigate the case before a special prosecutor was appointed, claimed he returned a copy to the grand juror, then Willimantic Superior Court Judge (later Supreme Court Justice) Joseph Dannehy. Both Dannehy and Satti are dead. Did "Do Nothing Bob" -- Mallove's moniker for Satti -- take it with him? We might as well ask Harvey, also dead, or Kevin.

    Gordon's pathetic decision, dated Nov. 7, went on for about a sentence before its first fatal error. It might sound like a technical error, but it's much, much more than that. She actually said New London police investigated the case.

    Before this, I thought it might take generations to remove the stench from the New London courthouse. Alas, for New London, the stench of this cover-up is forever.







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  •           NEW: RFK Jr. says ‘recent forensic evidence’ points to two shooters in his father’s assassination         


    Robert F. Kennedy flanked by union organizers Dolores Huerta (left) and Paul Schrade (right). Huerta co-founded what would become the United Farm Workers. Schrade, also a union organizer, was one of five others wounded when RFK was assassinated in 1968.
    - Photo courtesy of Mexican American Legal Defense and Educational Fund


    Cool Justice:
    RFK Jr. points to forensic evidence of second gunman in his father’s assassination
    By Andy Thibault


    Buried on page 271 of Robert F. Kennedy Jr.’s new book on the Skakel murder case in Greenwich is a quick, but telling reference to his father’s assassination.

    As part of my summer reading I highlighted the passage. I had a visceral sense it was important.

    Kennedy family members rarely have spoken publicly about the assassinations of either President John Kennedy or U.S. Sen. Robert Kennedy, much less criticized the official findings. The passage is noteworthy for the simple fact it is memorialized in a book. It is not just a comment in an interview.

    This angle deserves serious attention, and so it wasn’t shoehorned into the column published Aug. 5 on the Greenwich murder case, “COOL JUSTICE: RFK Jr. attacks prosecutors, cops, courts for willful misconduct as he asserts cousin Skakel’s innocence.”

  • Aug. 5 column

  • Some of Kennedy’s claims and his book investigating the murder of 15-year-old Martha Moxley in Greenwich in 1975 have been panned by the state Judicial Department and other authors who chronicled the case. A state Supreme Court ruling on whether Skakel will face a retrial or be sent back to prison is expected this fall. A senior judge ruled in 2013 that Skakel did not receive a fair trial when he was convicted of the Moxley murder in 2002. Skakel was freed on bond after serving 11 years of a sentence of 20 years to life in jail.

    That covers a lot of ground, and the next court decision will be big news. It seems to me the “footnote” on page 271 also is big news.

    Following are two paragraphs from Kennedy’s book, “Framed, Why Michael Skakel Spent Over A Decade In Prison For A Murder He Didn’t Commit,” leading up to the clincher paragraph on the RFK assassination:

    “I sympathize deeply with Dorthy Moxley [Martha’s mother]. I have seen up-close the agony of a mother’s grief over the loss of her child. my mother lost her husband to murder and two of her sons to violent, untimely deaths in the bosom of their youth. I was with her when my father died. I stood beside her 29 years later as my little brother Michael died in her arms.

    “My mother told us that we needed to let go of our impulse for revenge and allow the cycle of violence to end with our family. This, she said, was the lesson of the New Testament, which swapped the savage eye-for-an-eye tribalism of the Old Testament for the ethical mandate that we turn the other cheek. But forgiveness wasn’t just ethics. It was salutary. Revenge and resentments, my mother said, are corrosive. Indulging them is like swallowing poison and hoping someone else will die. By opposing the death penalty for Sirhan, we diluted these poisonous passions.

    “And what if, God forbid, the object of our revenge turns out to be innocent? For several decades, my father’s close friend Paul Schrade [in recent photo, right], who took one of Sirhan’s bullets, has argued that Sirhan Sirhan did not fire the shot that killed my father. Recent forensic evidence supports him. How would we have felt now, if our family had demanded his execution?”

    Like most Americans, I had not paid much attention to the forensic details regarding the RFK murder. What kind of evidence was RFK Jr. referring to? What is the significance of his dropping this tidbit toward the end of a book on another subject?

    Robert F. Kennedy was shot just after midnight on June 5, 1968 in the back and in the back of the head at the Ambassador Hotel in Los Angeles. He had been celebrating his California primary win in his campaign for the Democratic nomination for president. Kennedy had become a vigorous opponent of the Vietnam War and an advocate for civil rights, unions and racial justice. His death came just two months after the murder of Rev. Martin Luther King Jr.

    The renowned forensic pathologist and medical school professor, Dr. Cyril Wecht, assisted Los Angeles Chief Medical Examiner Dr. Thomas Noguchi in efforts to secure the Kennedy body and perform the autopsy. I reached out to Wecht this week to talk about the new Kennedy statement and the evidence cited by Paul Schrade and others.

    Regarding Robert Kennedy Jr.’s statement in the new book, Wecht commented: “I think it’s commendable. I wish he had done it sooner.”


    Letter presented this year to California parole officials by Paul Schrade


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  •           Healing Plants         
    Garrigue - Teucrium creticus

    Although I never intentionally created my perfume with aromatherapy mindset, I found them to be very healing throughout the years. Partially because of the creative process itself - the bringing together of contrasting and conflicting elements that represent such aspects within my psyche. And partially because I actually felt the plants' healing energy through wearing the perfumes:
    Grounding, soothing, reviving, reminiscent of the places and people I missed and longed for, helped me get through many rough patches and heartbreaks that permeated the majority of my years on this earth.

    While moving my vast collection of fragrant materials, I realized that at my fingertips I have an entire pharmacopeia. This is also true for some of my fragrances. A few weeks ago I started the day with intense sense of grief and feeling very heavy hearted and anxious. I had to fill orders that morning, and make samples of Ayalitta. I dabbed some on and no less than fifteen minutes later I noticed that I am feeling more grounded and that the anxious hole opening at the pit of my stomach started to close... It could be partially explained by power of association and past experiences wearing this scent while being in a similar state of mind and finding it soothing. Also, I think another big part has to do with the actual plants in it and their healing powers, namely sage (both Spanish and Clary), rose, jasmine, neroli and patchouli.

    Part of my moving back to my home village was for reconnecting with nature and Mother Earth in a more immediate, hands-on manner. I wanted to not only smell the spirit of the plants that I love and cherish, but also experience them int heir living state. I wanted to see how they grow and turn the brown soil and sunlight they absorb into myriads of different colours, shapes, flavours, scents and therapeutic properties.

    Behind my home is a mountain, and on it grow wild many fragrant and medicinal plants. It's awe-inspiring how many remedies are gifted to us by Mother Nature. If we only listen and learn her secrets, we have the potential to heal gently and find cure for many of our physical and emotional pains and misalignments. Plants are such benevolent creatures, I am now beginning to understand on a more immediate level why so many tales and myths about plants associate them with a spiritual being, such as an angel, nymph or even a god or a goddess.

    The properties and aromas of the plants here fascinate me. They feel familiar (and in fact I know many of them since forever) - yet I keep meeting new plants that are either highly fragrant or medical; and those that I do know keep surprising me with new uses and therapeutic potential that I never knew existed.

    For example: I came across a very ambery-spicy-herbaceous-smelling herb that has quite resinous leaves., growing in rather rocky areas up on the mountains here. I could not ID it because it never had flowers when I saw it. I tried brewing it into teas (even though you probably shouldn't consume something you haven't even identified yet!), tincturing it, and also drying the leaves, which I want to incorporate into incense. Just yesterday I saw someone post about it and was able to immediately recognize it - Chiliadenus iphionoides (כתילה חריפה)Turns out it has not only a delicious aroma but also many uses for diseases in respiratory system, as well as the heart, digestive system, skin conditions, wounds, fever, overall weakness and joint inflammation.

    Teucrium (Germander) is another new discovery for me - for both its fragrance and myriads of medicinal uses. And also I am going to dedicate an entire post to the various thymes and oreganos that grow here, which aside from their well known culinary significance in regional and international cuisine - are also extremely valuable medicinally; and I'm also warming up to their fragrance per se (a rare occurrence in perfumery, really). Vitex agnus-castus (שיח-אברהם מצוי) always eluded me with its fragrance, and now I'm also discovering its healing properties, especially for women's health.  And last but not least - I discovered that clary sage is actually a wild plant here as well, and was gifted two tiny plants from Neta Fink who visited my studio last week. I am feeling very inspired to study these plants - both old friends and new ones - explore properties and work them into new applicable products that would be both fragrant and healing.
              Elysium Artwork        
    We've finally been cleared to show some of the work we produced for Elysium! 
    So here are some of my favourite designs from the thousands we at Weta created.

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              Index of courses from Lemberg (L'viv) University Medical School: Alexandra Klaudia Melnyk (nee Alexandra Klaudia Yezerska)        
    Index of courses from Lemberg (L'viv) University Medical School: Alexandra Klaudia Melnyk (nee Alexandra Klaudia Yezerska) This item comes from a region where place names vary historically and politically. We have used the Getty Thesaurus of Geographic Names (TGN) as a source for controlled place names. (http://www.getty.edu/research/conducting_research/vocabularies/tgn/); Index of courses from the Lemberg (L'viv) University Medical School attended by Alexandra Klaudia Melnyk (nee Alexandra Klaudia Yezerska) in her first year. The document issued in Lemberg (L'viv) and dated 1944.; Lemberg
              Certificate of attendance from Lemberg University Medical School: Alexandra Klaudia Melnyk (nee Alexandra Klaudia Yezerska)        
    Certificate of attendance from Lemberg University Medical School: Alexandra Klaudia Melnyk (nee Alexandra Klaudia Yezerska) Lemberg (L'viv) University This item comes from a region where place names vary historically and politically. We have used the Getty Thesaurus of Geographic Names (TGN) as a source for controlled place names. (http://www.getty.edu/research/conducting_research/vocabularies/tgn/); Certificate of attendance from Lemberg University Medical School of Alexandra Klaudia Melnyk (nee Alexandra Klaudia Yezerska). The document issued in Lemberg, Poland and dated 1944.; Lemberg, Poland
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              Frustration With Medical Marijuana Delays        
    Last year, supporters of marijuana use for health purposes cheered when a bill became law. They’ve since been frustrated, however, over the timeframe of...
              Online Ads Promise To Help Residents Get Medical Marijuana Cards That Don't Exist Yet        
    Now that New Hampshire has a law allowing for the use of medicinal marijuana, it might not surprise you to find advertisements about how people can...
               6.0.5         
    updated on 22-12-2013 CDT - The program "Medical certificate" is intended for automation of filling medical specialist...
               6.0.5         
    updated on 22-12-2013 CDT - The program "Medical certificate" is intended for automation of filling medical specialist...
              US company to offer microchip implants to employees        
    07/26/2017

    Over the past few years, the security industry has begun to embrace many new technologies—robotics, the cloud, biometrics, for example—but one company here in the U.S., Three Square Market, is pushing the boundaries of RFID technology by offering to implant tiny RFID chips—the size of a grain of rice—into its employees’ hands between the thumb and forefinger.

    The chip would allow employees to not only buy snacks in the break room but also have their hands function as a mobile key to gain access to the building and other doors, which makes me think of the possible applications/ramifications within security.

    Implanting chips in employee’s hands is already being done in Sweden, where an organization named Epicenter is having success with an increasing number of employees there opting to get the implant. Here in the U.S., Three Square Market says it has approximately 50 employees who are interested in getting the implant, and unlike in Sweden, the company is paying for the $300 procedure for its employees. Three Square Market partnered with a Swedish firm, BioHax International, to make the chip and is planning to sell the technology to other companies.

    "Eventually, this technology will become standardized, allowing you to use this as your passport, public transit, all purchasing opportunities, etc.," chief executive Todd Westby wrote in a blog post announcing the program, noting that there is even potential for storing medical/health information, and for use as payment at other RFID terminals.

    But one has to wonder what security vulnerabilities this could create, especially in protecting the data on that chip from being hacked, stolen and/or compromised, etc. Not to mention, the “creepy” factor here, as mass adoption of microchip implants is dubious, at best.

    Maybe some day, like in the year 2112, but in the short term, I do think there is good fodder here for a futuristic sci-fi movie.
     


              Certified Medical Assistant Training Education And Certification For CMA        
    If you have been thinking about getting certified medical assistant training, you can get the necessary education at many different schools. There is a demand for trained health-care professionals, and especially for certified ones. The need for certified medical assistants (CMA) continues to grow each year. Things are changing within the medical field. Where at […]
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    Welcome to WordPress.com. This is your first post. Edit or delete it and start blogging!
              Tubal Ligation        

    The post Tubal Ligation appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Skin Lightening – Whitening        

    The post Skin Lightening – Whitening appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Artificial Insemination – AI        

    The post Artificial Insemination – AI appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Hair Loss Treatment        

    The post Hair Loss Treatment appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Tattoo Removal        

    The post Tattoo Removal appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Birthmark Removal        

    The post Birthmark Removal appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Acne Scar Removal        

    The post Acne Scar Removal appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Mole Removal        

    The post Mole Removal appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Scar Removal        

    The post Scar Removal appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Skin Cancer        

    The post Skin Cancer appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Arthroscopy        

    The post Arthroscopy appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Elbow Replacement        

    Elbow Replacement is surgery to replace the elbow joint with Artificial Joint parts (prosthetics). The procedure is similar to Hip and Knee Replacements. The Elbow Joint connects two bones: The humerus in the upper arm The ulna in the lower arm (forearm) Why the Procedure is Performed Elbow Replacement Surgery is usually done if the elbow […]

    The post Elbow Replacement appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Yoga        

    Yoga is a holistic way of life that integrates all elements of ancient knowledge of Yoga, to make a prayerful discipline uniting the body, mind, and soul. Along with the series of simple, yet effective yoga postures and breathing techniques, a greater emphasis is placed on the inner experience of meditation, for the well-being of […]

    The post Yoga appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Ayurveda        

    Sprouted in the pristine land of India some 5000 years ago, Ayurveda, the science of life and longevity, is the oldest healthcare system in the world and it combines the profound thoughts of medicine and philosophy. Since then Ayurveda has stood for the wholesome physical, the mental and spiritual growth of humanity around the world. […]

    The post Ayurveda appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Laser Hair Removal        

    The post Laser Hair Removal appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Dermatology        

    The post Dermatology appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Pain Management        

    Pain management (also called pain medicine or algiatry) is a branch of medicine employing an interdisciplinary approach for easing the suffering and improving the quality of life of those living with pain. The typical pain management team includes medical practitioners, pharmacists, clinical psychologists, physiotherapists, occupational therapists, physician assistants, nurse practitioners, and clinical nurse specialists. Types […]

    The post Pain Management appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Vertigo        

    Vertigo is a sensation of spinning. If you have these dizzy spells, you might feel like you are spinning or that the world around you is spinning. Causes of Vertigo An inner ear problem often causes vertigo. Some of the most common causes include: BPPV. These initials stand for benign paroxysmal positional vertigo. BPPV occurs […]

    The post Vertigo appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Hearing Surgery – Stapedectomy & Otosclerosis        

    A Stapedectomy (Hearing Surgery) is ear surgery that can be done to treat hearing loss caused by a problem called otosclerosis. Otosclerosis causes a buildup of bone around the stapes (stirrup bone). The buildup of bone keeps the stapes from moving normally, resulting in a hearing loss called conductive hearing loss. The surgery is done […]

    The post Hearing Surgery – Stapedectomy & Otosclerosis appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Sleep Apnea        

    Sleep Apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound. Sleep […]

    The post Sleep Apnea appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Voice Feminization Surgery        

    Voice Feminization Surgery (VFS) is changing one’s voice to a higher voice tone. It is for the patients who have experienced abnormal hormone functions that were affected by a urogenital syndrome or androphobia, or through the side effect of the hormone treatment for aplastic anemia. However, Voice Feminization Surgery (VFS) is mainly performed to the […]

    The post Voice Feminization Surgery appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Canalith Repositioning Procedure        

    The Canalith Repositioning Procedure is also known as the “Epley maneuver.” BPPV occurs as a result of displaced otoconia, which are small crystals of calcium carbonate (also referred to as “otoliths” or “canaliths”) that are normally attached to the otolithic membrane in the utricle of the inner ear. Because of trauma, infection, or even simple […]

    The post Canalith Repositioning Procedure appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Ear Tubes – Myringotomy        

    Myringotomy (Ear Tubes) is a surgical procedure in which a small incision is made in the eardrum (the Tympanic Membrane), usually in both ears. It is also called Myringocentesis, Tympanostomy, Tympanostomy, or Paracentesis of the tympanic membrane. Fluid in the middle ear can be drawn out through the incision. Myringotomy (Ear Tubes) or Tympanostomy Tubes, […]

    The post Ear Tubes – Myringotomy appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Tympanoplasty        

    Tympanoplasty, also called eardrum repair, refers to surgery performed to reconstruct a perforated tympanic membrane (eardrum) or the small bones of the middle ear. Eardrum perforation may result from chronic infection or, less commonly, from trauma to the eardrum. Purpose The tympanic membrane of the ear is a three-layer structure. The outer and inner layers […]

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              Sinus Surgery – Sinusitis        

    Allergies that affect the nose, such as hay fever and indoor allergies, can cause the nasal membranes to swell, and the passages to the sinuses — hollow spaces within the bones around the nose — to become blocked. Mucus, which typically drains from the sinuses to the nose, can’t drain. Sinus Surgery (Sinusitis) involves the […]

    The post Sinus Surgery – Sinusitis appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Balloon Sinuplasty        

    Balloon Sinuplasty (BSP) is a breakthrough sinus surgery procedure performed by ENT doctors that open sinus passages to relieve sinus pain and sinus pressure associated with chronic sinusitis. Medical therapy and Functional Endoscopic Sinus Surgery (FESS) are two very common techniques used for patients suffering from sinus infections. Advantages of Balloon Sinuplasty Balloon Sinuplasty is […]

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              Aplastic Anemia        

    Idiopathic aplastic anemia is a condition where your bone marrow stops making new blood cells. This condition is not that uncommon and can be fatal if left untreated. Aplastic anemia is caused by damage to the bone marrow which can be due to viruses, some drugs, and radiation exposure. Some scientists think that this may […]

    The post Aplastic Anemia appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Thalassemia        

    Thalassemia is a blood disorder passed down through families (inherited) in which the body makes an abnormal form of hemoglobin (protein in red blood cells that carries oxygen). The disorder results in excessive destruction of red blood cells, which leads to anemia. Anemia is a disorder in which your body doesn’t have normal enough, healthy red […]

    The post Thalassemia appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Sickle-Cell Anaemia        

    The sickle-cell disease also known as sickle-cell anemia is a hereditary blood disorder caused by an abnormality in the oxygen-carrying protein hemoglobin found in red blood cells. Sickle-Cell disease leads to a propensity for the cells to assume an abnormal, rigid, sickle-like shape under certain circumstances. Sickle-cell disease is associated with some acute and chronic health […]

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              Stem Cell Therapy        

    Stem-cell therapy is the use of stem cells to treat or prevent a disease or condition. Bone marrow transplant is the most widely used stem-cell therapy, but some therapies derived from umbilical cord blood are also in use. Research is underway to develop various sources for stem cells and to apply stem-cell treatments for neurodegenerative […]

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              Laparoscopic Surgery        

    Laparoscopic surgery or minimally invasive surgery is a procedure which uses a special surgical instrument called a laparoscope to look inside your tummy (abdomen) or to perform certain operations. A laparoscope is like a thin telescope with a light source. It is used to light up and magnify the structures inside the abdomen. A laparoscope is […]

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              Tubal Ligation Reversal        

    The post Tubal Ligation Reversal appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Circumcision        

    Male circumcision is the surgical removal of the foreskin (prepuce) from the human penis. In the most common procedure, the foreskin is opened and then separated from the glans after inspection. The circumcision device (if used) is placed, and then the foreskin is removed. Circumcision is the standard procedure for: Phimosis: a narrowing of the foreskin, […]

    The post Circumcision appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Cochlear Implant        

    The post Cochlear Implant appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              ENT – Ear, Nose & Throat        

    The post ENT – Ear, Nose & Throat appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Hernia        

    A Hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the intestines may break through a weakened area in the abdominal wall. Hernias are most common in the abdomen, but they can also appear in the upper thigh, belly button, and groin areas. […]

    The post Hernia appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Kidney Stone        

    Kidney Stones or Renal Calculi are solid masses made of crystals. Kidney Stones or Renal Calculi usually originate in your kidneys but can develop anywhere along your urinary tract. The urinary tract includes the kidneys, ureters, bladder, and urethra. The kidney acts as a filter for blood, removing waste products from the body and making […]

    The post Kidney Stone appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Intracytoplasmic sperm injection – ICSI        

    The post Intracytoplasmic sperm injection – ICSI appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Intrauterine Insemination – IUI        

    The post Intrauterine Insemination – IUI appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Forum        

    The post Forum appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Blog        

    The post Blog appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Left Ventricular Reconstructive        

    The post Left Ventricular Reconstructive appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Left Ventricular Assist Device        

    The post Left Ventricular Assist Device appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Cervix Cancer        

    The post Cervix Cancer appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Uterus – Endometrial Cancer        

    Endometrial or Uterus or Womb cancer starts in the endometrium or Uterus or Womb, the inner lining of the uterus (womb). About the Uterus (Womb) and Endometrium The uterus is a hollow organ, which is normally about the size and shape of a medium-sized pear. The uterus is where a fetus grows and develops when a […]

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              Ovarian Cancer        

    The post Ovarian Cancer appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Australia        

    The post Australia appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Angioplasty        

    The post Angioplasty appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Cardiothoracic Surgery        

    The post Cardiothoracic Surgery appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Thyroid Cancer        

    The post Thyroid Cancer appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Atrial Septal Defect – ASD        

    The post Atrial Septal Defect – ASD appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              USA to India        

    It is now possible to undergo high quality medical care procedures, treatments, and after-care, along with a vacation in one of the most serene and exotic tropical locations in the world – India. From guiding you on the right choice of world class hospitals and doctors, helping you with travel arrangements, world-class accommodations, visa acquirements, […]

    The post USA to India appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Iraq to India        

    Help for Iraqis seeking medical treatment/procedure in India. “Can I get quality medical treatment in India?” “How do I get connected with the right Doctors?” “What are the medical visa procedures?” The questions you face can seem as numerous as the sources of advice offering answers. Mirage Healthcare provides good advice, practical travel information, and […]

    The post Iraq to India appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Nigeria to India        

    Help for Nigerians seeking medical treatment/procedure in India “Can I get quality medical treatment in India?” “How do I get connected with the right Doctors?” “What are the medical visa procedures?” The questions you face can seem as numerous as the sources of advice offering answers. Mirage Healthcare provides good advice, practical travel information, and […]

    The post Nigeria to India appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Medical Tourism        

    Medical tourism is a growing sector in India. India’s medical tourism sector is expected to experience an annual growth rate of 30%, making it a $2 billion industry by 2015. As medical treatment costs in the developed world balloon – with the United States leading the way – more and more Westerners are finding the […]

    The post Medical Tourism appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Cosmetic Dentistry        

    We have an excellent team of cosmetic dentists here in Mirage; all of whom have been in practice for many years and each of which has an interest in a specific area of cosmetic dentistry. At Mirage we have designed the cosmetic dental treatment in such a way that you take back the beautiful smile […]

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              Chemical Peel        

    The post Chemical Peel appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Surrogacy        

    The post Surrogacy appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              In Vitro Fertilization – IVF        

    The post In Vitro Fertilization – IVF appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Duodenal Switch        

    The post Duodenal Switch appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Cervical Microforaminotomy        

    Navigated posterior cervical microforamitomy (PCM) is a promising minimally invasive technique for treating radiculopathy caused by lateral disc herniations and foraminal stenosis. The aim of this paper is to describe the surgical technique and clinical results of minimally invasive posterior cervical microforaminotomy (PCM) assisted by an O-arm-based navigation system for the treatment of unilateral radiculopathy […]

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              Add Your Clinic        

    The post Add Your Clinic appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Pediatric Dentistry        

    Braces and Aligners straighten the teeth, making it easier for the patient to bite, chew and speak. Braces can correct misaligned teeth, prevent speech problems; improve chewing capacity. Traditional braces are available in ceramic or metal, with silver or colored modules (the small pieces that hold the wires in place on the teeth) Self-ligating braces […]

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              Oral & Maxillofacial Surgery        

    Simple & Surgical Extractions A dental extraction (also referred to as exodontia) is the removal of a tooth from the mouth. Extractions are performed for a wide variety of reasons, including tooth decay that has destroyed enough tooth structure to render the tooth non-restorable. Extractions of impacted or problematic wisdom teeth are routinely performed, as are extractions of […]

    The post Oral & Maxillofacial Surgery appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Orthodontics Braces & Aligners        

    The branch of dentistry deals with the aligning, straightening of curved misaligned teeth to its natural and best for providing beautiful smile best to function also. Invisible – since the aligners are transparent most people won’t even notice them, and so nobody will know that you are straightening your teeth. So you will be able to […]

    The post Orthodontics Braces & Aligners appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Bridges, Crowns & Dentures        

    A bridge is a set of artificial teeth that replaces two or more adjacent missing teeth, using the natural teeth on both sides of the gap to anchor the artificial teeth in place. Crowns are made of ceramic, metal or porcelain fused to metal. They cover teeth to restore them to their normal shape and […]

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              Fillings & Root Canal Treatment        

    A Filling is a material that fills the opening that’s left after a decayed portion of a tooth has been removed. Fillings fall into three categories: amalgam, composite and GIC. Amalgam Fillings use an alloy (mixture) of mercury and other metals (such as silver, copper or tin) that is carved and contoured after placement in […]

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              Implants Dentistry        

    An implant is a prosthetic solution that replaces a missing tooth. It offers the most realistic, long-lasting solution for the restoration of functionality and your smile. Made of titanium, it is placed in the jaw, and a crown is placed on top, providing the appearance of a natural tooth. It offers greater stability and durability […]

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              Pigmentation        

    The post Pigmentation appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Skin Care Treatment        

    The post Skin Care Treatment appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Voluma        

    Juvéderm VOLUMA™ XC, Voluma Filler The Woodlands, TX is a new filler designed specifically for the cheeks. Rivela Plastic Surgery has been pleased to be the first to provide the newly released Voluma. Instead of just treating signs of aging around the mouth, Voluma, add volume for the mid-face, correcting the problem and not the […]

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              Radiesse        

    Radiesse is a safe, FDA approved dermal filler that restores a natural, long lasting, youthful look. This convenient treatment can restore facial volume as well as correct smile lines, Nasolabial folds and wrinkles around the nose and mouth. Radiesse is made of unique calcium-based microspheres suspended in a natural gel that is injected into the skin […]

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              Sculptra        

    Sculptra®Aesthetic is a new facial injectable treatment indicated for the correction of shallow to deep nasolabial fold (smile lines) contour deficiencies and other facial wrinkles, which are treated with the appropriate injection technique in healthy people. It works gradually to replace collagen that is lost during the aging process. Most injectables can fill these wrinkles, […]

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              Juvederm        

    The post Juvederm appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Botox        

    The post Botox appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Artefill        

    The post Artefill appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Injectable- Fillers        

    The post Injectable- Fillers appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Vaginal Rejuvenation        

    The post Vaginal Rejuvenation appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Buttock Lift – Gluteoplasty        

    The post Buttock Lift – Gluteoplasty appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Brazilian Butt Lift – Butt Implants – Buttock Augmentation        

    The post Brazilian Butt Lift – Butt Implants – Buttock Augmentation appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Body Implants – Modification        

    The post Body Implants – Modification appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Lower Body Lift – Belt Lipectomy        

    The post Lower Body Lift – Belt Lipectomy appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Thigh Lift – Thighplasty        

    The post Thigh Lift – Thighplasty appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Arm Lift – Brachyplasty        

    The post Arm Lift – Brachyplasty appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Invasive Facial Rejuvenation        

    The post Invasive Facial Rejuvenation appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Hand Rejuvenation        

    The post Hand Rejuvenation appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Body Rejuvenation        

    The post Body Rejuvenation appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Smile Rejuvenation        

    The post Smile Rejuvenation appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Anti Aging        

    The post Anti Aging appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Mommy Makeover        

    The post Mommy Makeover appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              United Kingdom        

    The post United Kingdom appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              India        

    The post India appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Phalloplasty        

    Phalloplasty surgery is a surgical penile augmentation to enhance the length, girth, and the glands of the penis. Candidates for Phalloplasty are: Men who have a birth defect or have had an injury that removed the penis Women who have transitioned into men–commonly known as a transgendered female-to-male Men who want to enhance their penis […]

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              Urology & Andrology        

    A Urologist is a Medical Specialist who has specialized knowledge and skill regarding problems of the male and female urinary tract and the male reproductive organs Urology Specialties Pediatric Urology Urologic oncology Renal transplantation Male infertility Urinary tract stones Female urology Neurourology Erectile dysfunction (ED, impotence) Andrology Andrology is a medical discipline dealing with men’s […]

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              Fibroid Removal – Myomectomy        

    The post Fibroid Removal – Myomectomy appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Upload Medical Reports        

    At Mirage Healthcare our focus is on tailoring our medical retreat packages to the specific needs of our clients. We pride ourselves on ensuring a rewarding outcome through a unique service model: providing high-quality, affordable health care services abroad coupled with a world-class escape after that. Whats App: “Treatment Name” to +919711586419 Delhi Office: +919711586419 […]

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              Talk to Doctor        

    At Mirage Healthcare our focus is on tailoring our medical retreat packages to the specific needs of our clients. We pride ourselves on ensuring a rewarding outcome through a unique service model: providing high-quality, affordable health care services abroad coupled with a world-class escape after that. Whats App: “Treatment Name” to +919711586419 Delhi Office: +919711586419 […]

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              Uterus Removal – Hysterectomy        

    The post Uterus Removal – Hysterectomy appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Gynaecologic laparoscopy        

    The post Gynaecologic laparoscopy appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Obstetrics & Gynaecology        

    The post Obstetrics & Gynaecology appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Colon Cancer        

    The colon is the last part of the digestive system in most vertebrates. It extracts water and salt from solid wastes before they are eliminated from the body and is the site Unlike the small intestine; the colon does not play a major role in the absorption of foods and nutrients. However, the colon does […]

    The post Colon Cancer appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Bone Cancer        

    The post Bone Cancer appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Coronary Artery Bypass Grafting        

    The post Coronary Artery Bypass Grafting appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Valve Replacement        

    The post Valve Replacement appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Cardiac Transplant        

    The post Cardiac Transplant appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Liver Transplant        

    The post Liver Transplant appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Liposuction        

    The post Liposuction appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Body Contouring        

    Surgical body contouring following major weight loss. It Removes excess sagging fat and skin while improving the shape of the underlying support tissue. The result is a more normal appearance with smoother contours. Dramatic weight loss has many benefits. But after weight reduction surgery, or any substantial amount of weight loss, the skin and tissues […]

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              Gynecomastia – Male Breast Reduction        

    The post Gynecomastia – Male Breast Reduction appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Breast Lift        

    A breast lift, also known as Mastopexy, is a surgical procedure to uplift the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour. A woman’s breasts often change over time, losing their youthful shape and firmness. These changes and loss of skin elasticity can result from […]

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              Breast Reconstruction        

    The post Breast Reconstruction appeared first on Medical Treatment, Medical Treatment centre, Medical healthcare Centre.


              Breast Reduction        

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              Breast Augmentation        

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              Tummy Tuck – Abdominoplasty        

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              Hair Transplant        

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              Nerve Grafts        

    Nerve Grafts are used when a patient has a nerve injury resulting in complete loss of muscle function or sensation. A nerve grafting is a surgical technique in which a segment of unrelated nerve is used to replace or bridge an injured portion of the nerve. The donor’s nerve serves as a “track” along which […]

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              Minimally Invasive Knee Replacement        

    Minimally invasive knee replacement is the surgical procedure similar to traditional Knee Replacement, and It requires less cutting of the tissue surrounding the knee. The artificial implants used are the same as those used for traditional knee replacement. However, specially designed surgical instruments are used to prepare the femur and tibia and to place the implants […]

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              Spinal Cord Injury        

    The spinal cord is a collection of nerves that travels from the bottom of the brain down your back. 31 pairs of nerves leave the spinal cord and go to your arms, legs, chest and abdomen. These nerves allow your brain to give commands to your muscles and cause movements of your arms and legs. […]

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              Spina Bifida        

    Spina Bifida is a type of birth defect called a neural tube defect. Spina Bifida occurs when the bones of the spine (vertebrae) don’t form properly around part of the baby’s spinal cord. Spina bifida can be mild or severe. The key early priorities for treating myelomeningocele or Spina Bifida are to prevent infection from developing in […]

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              Lumbar Spinal Stenosis        

    The lumbar spine is made up of five vertebral bodies in the lower back, where the spine curves inward toward the abdomen. It starts about five or six inches below the shoulder blades, and connects with the thoracic spine at the top and extends downward to the sacral spine. These nerves transmit sensations from the […]

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              Cervical Spine Disorders        

    The cervical spine is the most flexible anatomic region in the axial skeleton. Distinct segments of the cervical spine give us the ability to perform complex neck motions like head turning or tilting and to carry weight or absorb impact while protecting the delicate spinal cord and nerve roots that pass through the cervical vertebra. […]

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              Breast Surgery        

    Dissatisfaction with breast size and shape is not only a cosmetic concern but may lead to physical symptoms. While breast augmentation leads to enhanced self-image, breast reduction, and lifts. It results in relief of symptoms of back and shoulder pain, improvement of posture and comfort. In men, male breast reduction reduces Gynecomastia, enlarged male breasts, […]

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              Dermabrasion        

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              Lip Augmentation        

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              Earlobe Repair        

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              Chin Liposuction        

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              Brow Lift – Forehead lift        

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              Fat Transfer – Fat Grafting        

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              Facial Implants        

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              Cheek Augmentation        

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              Rhinoplasty – Nose Surgery        

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              Neck lift        

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              Lip Reduction        

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              Ear Surgery        

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              Chin Augmentation        

    A Chin Augmentation or Mentoplasty is a surgical approach for reshaping or beautifying the size of the chin. It can be done by both ways, either by inserting an implant or by moving or reshaping bone. Chin Augmentation Procedure Following are the details of the method Chin Implants Surgery The Surgeon uses general anesthesia or […]

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              Eyelid Surgery – Blepharoplasty        

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              Facelift        

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              Face Surgery        

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              Contact Us        

    At Mirage Healthcare our focus is on tailoring our medical retreat packages to the specific needs of our clients. We pride ourselves on ensuring a rewarding outcome through a unique service model: providing high-quality, affordable health care services abroad coupled with a world-class escape after that. WhatsApp: “Treatment Name” to +919711586419 Delhi Office: +919711586419 Email: […]

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              Gastric Band – Lap Band        

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              Gastric Sleeve        

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              Gastric Bypass        

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              Gastric Balloon        

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              Shoulder Replacement        

    Shoulder Replacement or shoulder arthroplasty is a surgical procedure for relieving severe pain from arthritis of the shoulder and replaced it with artificial parts. Treatment In the early stage, shoulder pain is managed with physical therapy and non-steroidal anti-inflammatory (NSAID) drugs. Surgery is considered if pain worsens. There are two primary methods for shoulder replacement […]

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              Knee Replacement        

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              Knee Arthroscopy        

    Knee Arthroscopy is a technique used to diagnose and treat problems in the knee Joint. During the procedure, your surgeon will make a very small incision and insert a tiny camera — called an arthroscope — into your knee. It allows them to view the inside of the joint on a screen. Arthroscopy diagnoses several […]

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              Hip Replacement        

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              Hallux Valgus-Bunions        

    Even though Bunions are a common foot deformity, there are misconceptions about them. Many people may unnecessarily suffer the pain of bunions for years before seeking treatment. What is a Bunion? A bunion (also referred to as hallux valgus or hallux abducto valgus) is often described as a bump on the side of the big […]

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              Cervical Discectomy        

    Anterior cervical discectomy and fusion (ACDF) are a surgery to remove a herniated or degenerative disc in the neck area of the spine. The incision is made in the front of the spine through the throat area. After the disc is removed, a bone graft is inserted to fuse together the bones above and below […]

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              Carpal Tunnel        

    The Carpal Tunnel is a narrow, tunnel-like structure in the wrist. The bottom and sides of this tunnel are formed by wrist (carpal) bones. The top of the tunnel is covered by a strong band of connective tissue called the transverse carpal ligament. The median nerve travels from the forearm into the hand through this […]

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              Anterior Cruciate Ligament        

    The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments in the human knee. The anterior cruciate ligament is one of the four main ligaments of the knee, and the ACL provides 85% of the restraining force to anterior tibial displacement at 30 degrees and 90 degrees of knee flexion. Surgery for […]

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              Ankle Joint Replacement        

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              Ankle Fusion        

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              Lung Cancer        

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              Breast Cancer        

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              Brain Tumor        

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              Bone Marrow Transplant        

    A Bone Marrow Transplant is a procedure to replace destroyed or damaged unhealthy bone marrow with healthy bone marrow stem cells. Bone Marrow is the soft, fatty tissue inside your bones. The Bone Marrow produces blood cells. Stem Cells are immature cells in the Bone Marrow that give rise to all of your different blood […]

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              Bladder Cancer        

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              Bariatric Surgery – Weight Loss Surgery        

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              Spine Surgery Treatment        

    If you’ve struggled with back pain for any length of time, you may be wondering if spine surgery is your only treatment option. Sometimes, surgery is the only treatment. However, there’s good news. The vast majority of back problems can be remedied with non-surgical treatments—often referred to as non-surgical or conservative therapies. Aging, improper body […]

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              Orthopedic & Joint Replacement        

    The most common reason that people go see an orthopedic doctor is for the treatment of a broken bone, though arthritis treatment and management of carpal tunnel and rotator cuff injuries are also considered somewhat “standard.” Theses sorts of doctors routinely perform arthroscopies, which are minimally invasive procedures to explores hip, shoulder, or knee damage. […]

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              Kidney Transplant        

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              Cardiac – Heart Surgery        

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              General Surgery        

    Adhesioloysis Appendectomy – Laparoscopic/Open Colonoscopy Colostomy Reversal Colposcopy ERCP – Endoscopic Retrograde GallBladder Surgery Open/Laparoscopic Gallstone Removal From Common Bile Duct Gastrectomy Hemorrhoids Removal Hiatal Hernia Surgery (Laparoscopic) Hydrocelectomy Hysterectomy Incisional Hernia Surgery – Laparoscopic/Open Inguinal Hernia Repair – Laparoscopic/Open Kidney Stone Kidney Transplant (With Donor) Laparoroscopic Surgery For Endometriosis Laparoscopic Anti-Reflux Surgery Laparoscopic Nephrectomy […]

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              Infertility Treatment        

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              Dental Treatment        

    Bridges Crowns Dental Bone Graft Dental Implants Dentures Gum Surgery Implants (Titanium) Inlays (Porcelain) Root Canal Sinus Elevation Surgical Extractions Teeth Bleaching Teeth Whitening (Laser) Tooth Extraction Veneers White Bonded Composite Fillings Zirconium Implant

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              Plastic & Reconstructive – Cosmetic Surgery        

    Cosmetic Surgery In The Era of Beauty It is the most wide-spread form of plastic surgery and is associated with voluntary and optional surgical or non-surgical practices (e.g.: Botox, laser hair removal) that are intended to improve appearance, boost self-confidence, correct unaesthetic features, forms, sizes or conceal the signs of aging. In case of cosmetic […]

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              Cancer – Oncology        

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              Hospitals / Clinics        

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              Treatment        

    Cancer / Oncology Treatments Oncology is the medical study of cancer including its diagnosis, prevention, and therapy, which usually comprises three types of treatment: surgery, radiotherapy, and chemotherapy, with the follow-up care Plastic & Reconstructive / Cosmetic Surgery It is the most wide-spread form of plastic surgery and is associated with voluntary and optional surgical […]

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              About Us        

    At Mirage Healthcare our focus is on tailoring our medical retreat packages to the specific needs of our clients. We pride ourselves on ensuring a rewarding outcome through a unique service mode. Providing high-quality, affordable health care services abroad coupled with a world-class escape after that. We are a team of experienced service industry consultants […]

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              Hand Therapy Massage        
    Special Recommend information on A H1N1 (swine flu)
    As it is known to all, currently we human being are all faced with a big enemy-A/H1N1 flu (swine flu) which has been threatening our life. Now the situation is worsening. As health and medical to AH1N1organ, we shoulder more responsibility to handle outbreak of this emergency.

    In TCM, A/H1N1 belongs to epidemic febrile disease of TCM which is the same as human avian influenza and SARS and similar to A/H1N1 flu syndrome differentiation and treatment of TCM prevention and cure. It is advocated “dispelling wind, reducing fever and dissipating dampness in clinical.

    TCM center will provide latest Special Report Globally on the A/H1N1 flu; and you still can find the Symptoms and Prevention about A/H1N1 flu ; further more, TCM prevention for swine flu provides latest global news; Chinese medicine prevention for A/H1N1 flu ; Chinese herbal medicine and so on.Although there are many therapeutic methods used for hand therapy, only the most common are discussed in this chapter. They include massage, acupuncture, hand bath, qigong and several miscellaneous methods including holding herbs, pressing and kneading the border of second metacarpal bone, arm swinging and other exercises.

    I. Hand Therapy Massage
    In hand therapy massage, stimulation is applied by hand to the regular and extra acupoints or reflective points and reflective areas closely related to various internal organs and tissues in the body. Particular maneuvers are employed to adjust their function, treat diseases, improve life quality, and maintain health. The basic maneuvers of massage include pressing, digitpressing, kneading, pushing, pinching, twisting, rotating, pulling, rubbing, and grinding methods.

    1. Pressing maneuver:
    A vertical pressure is applied by the tip or pad of thumb at the acupoints, reflective areas, and reflective points (Fig. 18).
    Indications: The pressing maneuver is usually applied at the acupoints on a flat area (such as thenar and hypothenar prominence) combined with a kneading maneuver to prevent and treat various chronic diseases and pains and maintain health.
    Principle of manipulation: The thumb should be firmly applied on the skin to produce a steady and persistent pressure in a small area. The pressure should be gradually increased in intensity, and not suddenly applied with a violent action. The frequency and intensity of pressure should be even.

    2. Digit-pressing maneuver:
    A pressure is applied at the acupoints of the hand by the tip of thumb or middle finger; or by the lateral border of tip of little finger supported by thumb and ring finger; or by the knuckle of proximal interphalangeal joint of index finger (Fig. ! 9).
    Indications: The digit-pressing maneuver is usually applied with a heavy pressure at acupoints in a fissure between bones, or in a limited area to treat acute or painful diseases.
    Principle of manipulation: Compared with the pressing maneuver, this maneuver can produce a stronger stimulation in a smaller area. The pressure should be applied at an accurate location without any sliding movement. The intensity of pressure may vary over a wide range.

    3. Kneading maneuver:
    The pad of thumb or middle finger is placed at the acupoint of the hand to receive treatment, and the forearm is actively swung to and fro with the elbow as a fulcrum and the wrist, palm, and finger as a transmitter to produce a gentle rotating and kneading movement to the acupoint with the pad of finger ( Fig. 20).
    Indications: The kneading maneuver is usually applied at acupoints situated superficially over a broad area to produce an adjusting and toning effect for treatment of chronic, deficient, and wasting diseases as well as for maintenance of health and relief of local swelling and pain.
    Principle of manipulation: The pressure applied by the kneading maneuver should be gentle and the movement of finger, hand and arm should be coordinated, rhythmic, and persistent for a longer period of time.

    4. Pushing maneuver:
    The single or multiple finger(s), root of palm, thenar or hypothenar prominence is used to produce an unidirectional linear pushing movement over certain parts of the hand (Fig. 21).
    Indications: The pushing maneuver is usually applied along the longitudinal direction of the hand or over various sides of the fingers, and it may be followed by a rubbing maneuver to maintain health and treat chronic diseases, pain, and soreness due to soft tissue strain or diseases caused by deficiency and cold.
    Principle of manipulation: To apply the pushing maneuver, the pushing force must be steady and strong enough, with the finger or palm placed firm on the skin of the hand. The pushing speed should be slow and even. The direction of the pushing maneuver is along the bones of the hand, and the force of the pushing maneuver may be freely adjusted, but it should be maintained at a fixed depth.

    5. Pinching maneuver:
    The free border or radial corner of the thumb nail or free border of the nails of other fingers is used to apply a vertical, heavy stimulation to the hand acupoints; or the free border of the thumb nail and the free border of the nails of other fingers are used to pinch the acupoint from both sides (Fig. 22).
    Indications: The pinching maneuver is usually applied between metacarpal bones or between metacarpophalangeal joints together with pressing, kneading, and twisting maneuvers (or alternately applied) to treat acute or painful diseases, epilepsy, and neurasthenia.
    Principle of manipulation: This is a maneuver designed to produce a heavy and deep stimulation and response. After the heavy and deep pinching manipulation is held for half a minute, gentle pressing and kneading maneuvers should follow for half a minute to relieve the discomfort produced by the pinching maneuver. This manipulation is repeated a second time. The pinching maneuver may be applied for a shorter duration and with a quicker rhythm. The nail must be steadily applied at the acupoint without any sliding movement to avoid causing injury to the skin.

    6. Twisting maneuver:
    The pads of thumb and index finger are used to hold and twist the injured finger back and forth to promote blood circulation through collaterals and stop pain (Fig. 23).

    More information from TCM and health: Hand Therapy Massage
              Hand Therapy Using Hand Bath        
    Special Recommend information on A H1N1 (swine flu)
    As it is known to all, currently we human being are all faced with a big enemy-A/H1N1 flu (swine flu) which has been threatening our life. Now the situation is worsening. As health and medical to AH1N1organ, we shoulder more responsibility to handle outbreak of this emergency.

    In TCM, A/H1N1 belongs to epidemic febrile disease of TCM which is the same as human avian influenza and SARS and similar to A/H1N1 flu syndrome differentiation and treatment of TCM prevention and cure. It is advocated “dispelling wind, reducing fever and dissipating dampness in clinical.

    TCM center will provide latest Special Report Globally on the A/H1N1 flu; and you still can find the Symptoms and Prevention about A/H1N1 flu ; further more, TCM prevention for swine flu provides latest global news; Chinese medicine prevention for A/H1N1 flu ; Chinese herbal medicine and so on.


    Hand bath is a steaming and washing therapy. The hot steam from an herbal decoction is used to heat the hands which are then soaked in the warm decoction after it gradually cools down. Diseases can be cured by the hot stimulation applied to the meridians and acupoints of the hand and by the gradual absorption of herbs through the skin.

    1. Origin and classification of steaming and washing therapy:

    Steaming and washing therapy originated in ancient times. Among 52 ancient herbal therapy recipes unearthed from the Han Dynasty Mawangdui Tomb, eight were used for steaming and washing therapy. This indicates that steaming and washing therapy has been used by Chinese people to treat diseases for at least 2,000 years. This therapy is also mentioned in classical medical books of the Han (206 B. C.-220) and Jin (265-420) dynasties. During the Tang Dynasty (618-907), this method was used to treat carbuncles, cellulitis, skin rashes, dermatitis, frostbite, hand and foot diseases, and gynecological and eye disorders. In the Kin (1115-1234) and Yuan (1271-1368) dynasties this method was classified as an essential medical therapy. In the Qing Dynasty ( 1644-1911 ), Wu Shangxian, a famous physician of traditional Chinese medicine, divided this therapy into smoking, steaming, shower, sitz bath, and hot ironing. It is a folk treatment used by common people to treat acute sprains, bone injuries, and contusions with a good therapeutic results.
    Steaming and washing therapy can be classified as general and local. Local treatment includes steaming and washing therapy for the hand, foot, and eye, and sitz baths. Hand bath is steaming and washing therapy for the hand.

    2. Function and characteristics of hand bath:

    As demonstrated by the experiments of modern medicine. steaming and washing therapy with hot and moist air can promote the absorption of herbs through the skin, dilate the skin's small blood vessels, promote the circulation of blood and lymph, enhance the phagocytic functions of the reticuloendothelial system, increase the permeability of cellular membranes, and promote metabolism by stimulating the sensitive sensory nerves scattered along the skin. The effective components of herbs used in steaming and washing therapy can directly kill the pathogenic germs on the skin. According to the theory of traditional medicine, the meridians of the hand are closely related to the organs and meridians of the entire body. Therefore, this therapy can clear stagnation in meridians, adjust bodily deficiency and excess, and promote circulation of qi and blood.
    The hand bath is simple, cheap, and easy to learn and practice, with numerous indications and good therapeutic effects, and without any harmful side effects. It is most useful for patients proscribed from taking drugs.

    3. Methods of manipulation:

    1) The proper recipe is selected according to the diseases and the basin, towel and sheets are prepared in use.
    2) The hot decoction of herbs is poured into the basin and the hands and arms are put over the basin. Cover the arms and basin with a sheet to reserve the hot air from quickly escaping away. Some boiled water may be added to the basin to maintain the temperature. After the decoction is cooled down to an adequate temperature, the hands may be soaked and washed in the decoction.
    3) After steaming and bathing, the hands should be dried with a towel and protected from attack of wind and coldness.
    4) The steaming and washing therapy may last for 20-30 minutes, twice a day.

    4. Precautions:

    I) The water used to boil the herbs should be adequate to prepare a decoction of the proper concentration. Aromatic and volatile herbs should be boiled for only 10-15 minutes; and roots, stems and herbs in large clumps should be boiled for 30
    minutes.
    2) The temperature of the decoction for bathing and soaking the hands should be monitored to avoid burning the skin.
    3) These decoctions are not for oral administration.

    More information from TCM and health: Hand Therapy Using Hand Bath
              Hand Therapy Using Hand Qigong        
    Special Recommend information on A H1N1 (swine flu)
    As it is known to all, currently we human being are all faced with a big enemy-A/H1N1 flu (swine flu) which has been threatening our life. Now the situation is worsening. As health and medical to AH1N1organ, we shoulder more responsibility to handle outbreak of this emergency.

    In TCM, A/H1N1 belongs to epidemic febrile disease of TCM which is the same as human avian influenza and SARS and similar to A/H1N1 flu syndrome differentiation and treatment of TCM prevention and cure. It is advocated “dispelling wind, reducing fever and dissipating dampness in clinical.

    TCM center will provide latest Special Report Globally on the A/H1N1 flu; and you still can find the Symptoms and Prevention about A/H1N1 flu ; further more, TCM prevention for swine flu provides latest global news; Chinese medicine prevention for A/H1N1 flu ; Chinese herbal medicine and so on.
    Hand qigong is employed as physical exercises of the hand or the entire body induced by the hand, and is usually accompanied by breathing and mental exercises for treating diseases.

    1. Origin and classification of hand qigong

    Hand qigong is a branch of medical qigong for treatment of diseases and has a long developing history. There were an introduction and case reports mentioned in the medical literature of the Sui (581-618), Tang, Ming (1368-1644), and Qing dynasties.

    Hand qigong can be divided into two types: The pure physical exercise of the hand for treating diseases of the internal organs, and exercises of the entire body induced by the hand with breathing and mental exercises to adjust meridians, qi, and blood throughout the body.

    2. Function and characteristics of hand qigong

    The hand is closely connected to tissues and organs of the entire body through meridians, and there are many sensitive and effective acupoints, such as Hegu (L1 4), Laogong (PC 8) and Shaoshang (LU 11 ) on the hand. Therefore, the physical exercises of the hand and physical exercises of the body induced by the hand with breathing and mental exercises can adjust qi, breath and mental activity, promote circulation of qi and blood through meridians, adjust deficiency and excess in internal organs, and balance yin and yang throughout the body.

    This exercise is simple, practical, easy to learn, and can be practiced by people of all ages at any time and place. It is effective for treating many diseases, especially chronic diseases, without harmful side effects.

    3. Precautions:

    Before doing qigong exercises the practitioner should get rid of mental distractions, maintain a calm mental state, assume a proper posture, and develop a slow and even breath. Then, various types of special hand exercises or physical exercises of the entire body may begin.
    Practical methods of qigong exercises will be discussed in the treatment of different diseases included in the following chapter.

    More information from TCM and health: Hand Therapy Using Hand Qigong
              Hand Therapy Using Miscellaneous Methods        
    Special Recommend information on A H1N1 (swine flu)
    As it is known to all, currently we human being are all faced with a big enemy-A/H1N1 flu (swine flu) which has been threatening our life. Now the situation is worsening. As health and medical organ, we shoulder more responsibility to handle outbreak of this emergency.

    In TCM, A/H1N1 belongs to epidemic febrile disease of TCM which is the same as human avian influenza and SARS and similar to A/H1N1 flu syndrome differentiation and treatment of TCM prevention and cure. It is advocated “dispelling wind, reducing fever and dissipating dampness in clinical.

    TCM center will provide latest Special Report Globally on the A/H1N1 flu; and you still can find the Symptoms and Prevention about A/H1N1 flu ; further more, TCM prevention for swine flu provides latest global news; Chinese medicine prevention for A/H1N1 flu ; Chinese herbal medicine and so on.

    Besides massage, acupuncture, hand bath, and hand qigong, there are some other therapies applied to or near the hand including holding herbs, pressing and kneading maneuvers applied along the second metacarpal bone, swinging arms, and playing bracelet or ball with the hand.
    1. Holding herb therapy
    As an external treatment herbs, properly selected according to the nature of the disease, are held in the hand as a treatment for various ailments.
    This is an ancient therapy. Herbs that induce sweating and promote digestion are best absorbed through the skin of a hot and moist palm to stimulate the meridians and acupoints of the hand.
    Herbs for particular diseases come in a variety of shapes and patterns such as pills or powders, easy to hold in the hand. Fresh raw herbs are also produced for therapeutic use. Before holding the herbs, the hands should be soaked in hot water for a while. The herbs are then held in the hand until a slight sweating is induced. The herbs should be wrapped in gauze and secured to the palm by bandage for babies and young children.
    This method is used to treat common colds, headache, facial palsy, and indigestion in children.
    Corrosive or allergenic herbs should not be used, and it is contraindicated for patients with ulcers or wounds of the palm.
    2. Pressing and kneading therapy beside the second metacarpal bone
    The pressing and kneading maneuvers are applied at the points on the radial side of the second metacarpal bone for treating various diseases.
    The location, indications, and principles for selecting points have been discussed in Acupuncture for Hand Therapy.
    The pressing and kneading maneuvers are chiefly applied in an area around Hegu (LI 4) acupoint. The Hegu acupoint is an important point used to control pain all over the body and is especially effective for stopping pain of the head and face and in the chest, abdomen, and upper and lower limbs.
    The patient is asked to relax the hand muscles and make a hollow fist with the radial side facing upward. The physician holds the patient's fist by one hand and applies pressure with some kneading movement at a frequency of 150 per minute at Hegu acupoint with the thumb of the other hand to produce a sore, distending, heavy, and numb sensation for three minutes.
    The point should be correctly located; the pressure should be vertically applied to a deep layer, and should be gentle to avoid damaging the skin.


    3. Swinging arm exercise
    This exercise was developed and taught by Mr. Tian Ruifang in Shanghai, 1961. It is a physical exercise, simple and easy to learn and practice and effective for treating certain chronic diseases.
    l) Preparation: Before starting the exercise, the practitioner should be rid of all mental distractions, calm the mind, and fully relax every part of the body and remain this way for 3-5 minutes.
    2) Posture:
    (1) The feet are separated to a distance the width of the shoulders to maintain a natural stance, with the head and body kept erect, the knees naturally and slightly flexed, and the arms freely dangling down (Fig. 34).
    (2) The neck is relaxed, the chin is held slightly backward and the vortex of the head, Baihui (GV 20) acupoint (at midpoint between bilateral tips of ear auricle), is intentionally raised upward.
    (3) The pectoralis major muscles are relaxed and the shoulders are slightly drawn forward to draw in the chest and straighten the back and to produce a counteraction against the intentional upward ascent of the vortex of the head. The qi may move
    downward to Dantian when the chest is drawn in; and the qi may diffuse all over the abdomen when the abdomen is relaxed. After the clear qi is moved upward and the dirty qi is moved downward, a result of "deficiency in upper part and excessiveness in lower part of body" can occur.
    (4) The shoulders are relaxed and sagging to draw in the chest and move the qi downward to Dantian. Otherwise, the qi may move upward, if the shoulders are shrugged.
    (5) The thigh, leg, and foot are all relaxed.
    (6) The muscles all over the body are relaxed with a smiling face and a generally comfortable demeanor.
    (7) The tongue should be naturally flat in the mouth. The mouth and teeth should be lightly closed, because the mouth and tongue may become dry if the mouth is opened; and the practitioner cannot relax the body if the mouth is tightly closed and the teeth gnashed.
    3) Method of performance:
    (1) Both naturally extended arms are moved forward with the shoulder joints as a fulcrum, the fingers are naturally and comfortably extended, the palms are slightly concave and facing forward, and the thumbs are slightly flexed and pointing downward. The hands are moved forward and upward, but not beyond the umbilicus (Fig. 35).
    (2) The shoulders are relaxed and the arms swing freely backward to the initial position, but not beyond the buttocks, with the shape of the palms unchanged (Fig. 36). The forward and backward movement of the arms are continuously repeated.
    (3) The arms are moved back and forth by the relaxed shoulders. The shoulders should not be shrugged and the arms always move parallel. The arms are moved forward by a force conducted from the shoulder and then freely swung backward by gravity, as a repeated movement with arms alternately kept tense and relaxed.
    (4) The palms are slightly concave and the fingers are slightly flexed and separated, because the full extension of tight fingers may interfere with meridians and the free circulation of internal qi.
    (5) The arms should be naturally extended throughout the back and forth movement and the elbows should not be flexed to move the forearms alone.
    (6) The feet are flat on the ground. With increased experience, the practitioner may keep a stance with the toes firmly holding the ground.
    (7) The swinging arm exercise should be carried with the body relaxed, quiet, and natural.
    4) Repetitions, speed, and silent counting:
    More information from
    TCM and health
              COMMON ACUPOINTS FOR HAND THERAPY        
    Special Recommend information on A H1N1 (swine flu)
    As it is known to all, currently we human being are all faced with a big enemy-A/H1N1 flu (swine flu) which has been threatening our life. Now the situation is worsening. As health and medical organ, we shoulder more responsibility to handle outbreak of this emergency.

    In TCM, A/H1N1 belongs to epidemic febrile disease of TCM which is the same as human avian influenza and SARS and similar to A/H1N1 flu syndrome differentiation and treatment of TCM prevention and cure. It is advocated “dispelling wind, reducing fever and dissipating dampness in clinical.

    TCM center will provide latest Special Report Globally on the A/H1N1 flu; and you still can find the Symptoms and Prevention about A/H1N1 flu ; further more, TCM prevention for swine flu provides latest global news; Chinese medicine prevention for A/H1N1 flu ; Chinese herbal medicine and so on.

    The acupoints for hand therapy include the regular and extra acupoints on the hand. The acupoints on the forearm are also used in hand therapy because they are exposed and convenient to locate for application of acupuncture (the acupoints marked with an asterisk (*) are located on the hand).

    1. Chize (LU 5, on hand Taiyin lung meridian) Location: With elbow slightly flexed, it is on the cubital crease and on the radial border of tendon of brachial biceps muscle (Fig. 1). Function: To suppress adverse ascent of lung qi, tone lung yin, and moisten the lung. Indications: Cough, asthma, hemoptysis, sore throat, chest distension, acute mastitis, arm and elbow pain, vomiting, and diarrhea. Acupuncture: Vertical insertion of needle for 1.6 cm, or bleeding therapy with three-edged needle; and moxibustion is permissible.

    2. Kongzui (LU 6, on hand Taiyin lung meridian) Location: With arm extended and palm supine, it is on the connecting line between Chize (LU 5) and Taiyuan (LU 9) and 23.3 cm from Taiyuan (Fig. 1). Function: To suppress adverse ascent of lung qi, clear blood heat, and stop bleeding. Indications: Cough, asthma, hemoptysis, sore throat, aphonia, hemorrhoids, and arm and elbow pain. Acupuncture: Vertical insertion of needle for 1.6-3.3 cm; and moxibustion is permissible.

    3. Lieque (LU 7, on hand Taiyin lung meridian) Location: It is proximal to radial styloid process and 5 cm proximal to carpal crease (Fig. 1). Function: To expel pathogen from lungs and adjust Renmai (conceptional vessel). Indications: Cough, asthma, sore throat, hemiplegia, deviation of mouth and eye, migraine, stiff neck, toothache, and hotness in palm. Acupuncture: Oblique insertion of needle toward elbow for 0.7 cm; and moxibustion is permissible.

    4. Jingqu (LU 8, on hand Taiyin lung meridian) Location: With palm supine, it is 3.3 cm proximal to carpal crease and in a depression between radial styloid process and radial artery (Fig. 1). Function: To control cough and asthma and adjust breath. Indications: Cough, asthma, sore throat, pain and distension in chest, and hotness in palm. Acupuncture: Vertical insertion of needle for 1 cm; and moxibustion is permissible.

    5. Taiyuan* (LU 9, on hand Taiyin lung meridian) Location: With palm supine, it is on carpal crease and in a depression on the radial side of radial artery (Fig. 2). Function: To control cough, resolve phlegm, improve body resistance, and expel pathogens. Indications: Cough, asthma, hemoptysis, pain and distension of chest, sore throat, vomiting, abdominal distension, irregular pulse, and hand and wrist pain. Acupuncture: Vertical insertion of needle for l cm; and moxibustion is permissible.

    6. Yuji* (LU 10, on hand Taiyin lung meridian) Location: With palm supine, it is proximal to the first metacarpophalangeal joint, at the midpoint of metacarpal bone and on the dorsopalmar boundary (Fig. 2). Function: To clear heat in lungs, relieve stagnation in throat, and clear heat in blood. Indications: Cough, hemoptysis, sore throat, elbow spasm, and hotness in palm. Acupuncture: Vertical insertion of needle for 1.6-3.3 cm; and moxibustion is permissible.

    7. Shaoshang* (LU 11, on hand Taiyin lung meridian). Location: On the radial side of thumb and 0.3 cm from corner of nail (Fig. 2). Function: To clear heat, open sense organ orifices, restore yang, revive critical patients, relieve stagnation in throat, and control convulsion. Indications: Cough, asthma, sore throat, madness, epilepsy, stroke with coma, febrile diseases, and convulsion in children. Acupuncture: Horizontal insertion of needle toward wrist for 0.6 cm or bleeding therapy with three-edged needle; and moxibustion is permissible.

    8. Shangyang* (LI 1, hand Yangming large intestine meridian) Location: On the radial side of index finger and 0.3 cm from the corner of nail (Fig. 3). Function: To clear heat, resolve swelling, open sense organ orifices, and refresh the mind. Indications: Sore throat, swelling of jaw, toothache, deafness, tinnitus, cough, asthma, stroke with coma, and shoulder pain. Acupuncture: Upward oblique insertion of needle for 0.6 cm or bleeding therapy with three-edged needle; and moxibustion is permissible.

    9. Erjian* (LI 2, on hand Yangming large intestine meridian) Location: With hand slightly clenched, it is on the radial side of second metacarpophalangeal joint and distal to it, and on the dorsopalmar boundary of hand (Fig. 3). Function: To clear heat and resolve swelling. Indications: Sore throat, swelling of jaw, nasal bleeding, toothache, eye pain, deviation of mouth and eye, body heat, and shoulder pain. Acupuncture: Vertical insertion of needle for 0.6 cm; and moxibustion is permissible.

    10. Sanjian* (LI 3, on hand Yangming large intestine meridian) Location: With hand slightly clenched, it is on the radial side of index finger and proximal to second metacarpophalangeal joint and capitulum of second metacarpal bone (Fig. 3). Function: To clear heat, resolve swelling, relieve fullness, and stop diarrhea. Acupuncture: Vertical insertion of needle for 1 cm; and moxibustion is permissible.

    11. Hegu* (LI 4, on hand Yangming large intestine meridian) Location: Between the first and second metacarpal bone and at the midpoint of second metacarpal bone (Fig. 3). Function: To clear heat, treat exterior syndrome, and improve vision and hearing. Indications: Headache, dizziness, toothache, eye pain, sore throat, swelling of face, deviation of mouth and eye, diseases of nose and ear, fever, hemiplegia, finger spasms, arm pain, amenorr hea, late delivery of baby, skin rashes, and diseases ofstomach and intestines. Acupuncture: Vertical insertion of needle for 1.6-3.3 cm; and moxibustion is permissible.

    12. Yangxi* (LI 5, on hand Yangming large intestine meridian) Location: On the radial side of dorsum of wrist and in a depression between tendons of long and short extensor muscles of thumb (Fig. 3). Function: To clear heat, tranquilize the mind, improve vision, and remove stagnation in throat. Indications: Headache, sore throat, red eyes, deafness, tinnitus, toothache, arm and wrist pain, epilepsy, and madness. Acupuncture: Vertical insertion of needle for 1.3 cm; and moxibustion is permissible.

    13. Pianli (LI 6, on hand Yangming large intestine meridian) Location: On the connecting line between Yangxi (LI 5) and Quchi (LI 11) acupoints and 10 cm from Yangxi (Fig. 4). Function: To improve vision and hearing. Indications: Nasal bleeding, red eyes, tinnitus, deafness, deviation of mouth and eye, sore throat, edema and pain in shoulder, arm, elbow, and wrist. Acupuncture: Oblique insertion of needle for 1 cm; and moxibustion is permissible.

    14. Wenliu (LI 7, on hand Yangming large intestine meridian) Location: On the connecting line between Yangxi (El 5) and Quchi (L 11) acupoints and 16.6 cm from Yangxi (Fig. 4). Function: To clear heat, resolve swelling, tranquillize the mind, anti promote transportation in organs. Indications: Headache, facial swelling, nose bleed, sore throat, pain in shoulder and back, epilepsy, and madness. Acupuncture: Vertical insertion of needle for 1.6 cm; and moxibustion is permissible.

    15. Xialian (LI 8, on hand Yangming large intestine meridian) Location: On the connecting line between Yangxi (LI 5) and Quchi (LI 11) acupoints and 1.3 cm from Quchi (Fig. 4). Functi,on: To adjust qi and promote transportation in organs. Indications: Headache, dizziness, abdominal pain, acute mastitis, and pain in elbow and arm. Acupuncture: Vertical insertion of needle for 1.6 cm; and moxibustion is permissible.

    16. Shanglian (LI 9, on hand Yangming large intestine meridian) Location: On the connecting line between Yangxi (LI 5) and Ouchi (LI 11) acupoints and 10 cm from Quchi (Fig. 4). Function: To adjust qi and promote transportation in organs. Indications: Headache, pain in shoulder and arm, abdominal pain, diarrhea, and hemiplegia. Acupuncture: Vertical insertion of needle for 1.6-3.3 cm; and moxibustion is permissible.

    17. Shonsanli (LI 10, on hand Yangming large intestine meridian) Location: On the connecting line between Yangxi (LI 5) and Quchi (LI 11) acupoints and 6.7 cm from Quchi (Fig. 4). Function: To clear heat, improve vision, adjust qi, and promote transportation in organs. Indications: Abdominal distension, diarrhea, eye diseases, toothache, hemiplegia, and hand, arm, and elbow pain. Acupuncture: Vertical insertion of needle for i.6-3.3 cm; and moxibustion is permissible.

    18. Quchi (LI 11, on hand Yangming large intestine meridian) Location: With elbow flexed, it is in a depression on the radial end of cubital crease (Fig. 4). Function: To expel wind pathogen, control itching, clear heat, and resolve swelling. Indications: Febrile diseases, sore throat, toothache, eye pain, skin rashes, skin sores, scabies, diseases of stomach and intestine, epilepsy, madness, disturbance of menstruation, paralysis of upper limb, and shoulder and arm pain. Acupuncture: Vertical insertion of needle for 3.3-5 cm; and moxibustion is permissible.

    19. Shaohai (HT 3, on hand Shaoyin heart meridian) Location: With elbow flexed, it is in a depression on the ulnar end of cubital crease (Fig. 5). Function: To tranquilize the mind. Indications: Heart pain, epilepsy, madness, tuberculosis of cervical lymph nodes, hand tremors and spasms, and pain in armpit. Acupuncture: Vertical insertion of needle for 1.6-3.3 cm; and moxibustion is permissible.

    20. Lingdao (HT 4, on hand Shaoyin heart meridian) Location: With hand supine, it is on the radial border of ulnar flexor muscle of wrist and 5 cm proximal to carpal crease (Fig. 5). Function: To expand chest and adjust qi. Indications: Heart pain and palpitations, dizziness, vertigo, unreasonable crying and laughing, stiff tongue, aphasia, and wrist and arm spasms. Acupuncture: Vertical insertion of needle for 1 cm; and moxibustion is permissible.

    21. Tongli (HT 5, on hand Shaoyin heart meridian) Location: With hand supine, it is on the radial border of ulnar flexor muscle of wrist and 3.3 cm proximal to carpal crease (Fig. 5). Function: To tranquilize the mind, tone yin, and clear heart heat. Indications: Heart palpitations, stiff tongue, aphasia, profuse uterine bleeding, headache, vertigo, and pain on medial and posterior side of shoulder, elbow, and arm. Acupuncture: Vertical insertion of needle for 1 cm; and moxibustion is permissible.

    22. Yinxi (HT 6, on hand Shaoyin heart meridian) Location: With hand supine, it is on the radial border of ulnar flexor muscle of wrist and 1.6 cm proximal to carpal crease (Fig. 5). Function: To tranquilize the mind and clear heat in the blood. Indications: Heart pain and palpitations, night sweating, aphasia, and hematemesis. Acupuncture: Vertical insertion of needle for 1 cm; and moxibustion is permissible.

    23. Shenmen* (HT 7, on hand Shaoyin heart meridian) Location: On the carpal crease and on the radial border of ulnar flexor muscle of wrist (Fig. 6). Function: To improve the body's resistance, expel pathogens, and tranquilize the mind. Indications: Heart pain and palpitations, insomnia, poor memory, unreasonable crying and laughing, epilepsy, madness, headache, vertigo, and hotness in palm. Acupuncture: Vertical insertion of needle for 1 cm; and moxibustion is permissible.
              Hand Therapy Indications, Characteristics, and Precautions        

    Special Recommend information on A H1N1 (swine flu)
    As it is known to all, currently we human being are all faced with a big enemy-A/H1N1 flu (swine flu) which has been threatening our life. Now the situation is worsening. As health and medical organ, we shoulder more responsibility to handle outbreak of this emergency.

    In TCM, A/H1N1 belongs to epidemic febrile disease of TCM which is the same as human avian influenza and SARS and similar to A/H1N1 flu syndrome differentiation and treatment of TCM prevention and cure. It is advocated “dispelling wind, reducing fever and dissipating dampness in clinical.

    TCM center will provide latest Special Report Globally on the A/H1N1 flu; and you still can find the Symptoms and Prevention about A/H1N1 flu ; further more, TCM prevention for swine flu provides latest global news; Chinese medicine prevention for A/H1N1 flu ; Chinese herbal medicine and so on.


    1. Indications: 1) Painful diseases: Neurotic headache, trigeminal neuralgia, toothache, angina pectoris, chest pain, intercostal neuralgia, neuralgia sciatica, and abdominal pain. 2) Chronic diseases: Bronchitis, peptic stomach ulcer, chronic gastroenteritis, diarrhea, diabetes mellitus, rheumatism, soft tissue injury, chronic nephritis, hemiplegia, arthritis, and muscular strain of the waist. 3) Functional diseases: Irregular menstruation, dysmenorrhea, functional disturbance of vegetative nervous system, intestinal paralysis, and stomach spasms. 4) Neurological diseases: Neurasthenia, spasm of facial muscles, facial palsy, and neurotic deafness. 5) Inflammatory diseases: Tonsillitis, pharyngitis, stomatitis, rhinitis, bronchitis, periarthritis of shoulder, cholecystitis, nephritis, and arthritis. 6) Acute diseases: High fever with convulsions, acute angina pectoris, acute attack of epilepsy, acute larygopharyngitis, acute conjunctivitis, and acute gastritis.

    2. Characteristics: 1) Holistic principles in the treatment of disease are followed. This includes treating internal diseases with external therapy and treating general diseases with local therapy. 2) Hand therapy is a simple treatment with numerous indications, including common internal diseases, surgical problems, and gynaecological, pediatric, and ENT disorders. 3) This treatment is cheap, convenient and safe. 4) It can be used to treat diseases as well as improve the health of normal people. 5) It can be done by the patients themselves for early diagnosis and treatment. 6) It can produce good therapeutic results without harmful side effect. 7) The techniques of hand therapy can be widely popularized for broad application.

    3. Precautions: 1) Care must be taken in treating pregnant women at early and later stages of pregnancy. 2) It must be used with care in potential surgical conditions such as acute appendicitis with indication of surgical intervention. 3) Hand therapy is prohibited for patients with necrotic, infectious, or pyogenic skin lesions of the hand.


              Can a Prelitigation Screening Panel’s Findings Be Used As Medical Malpractice Evidence in Maine?        

    In the recent Maine Supreme Court case of Estate of Nickerson v. Carter, a man’s wife appealed from a judgment in favor of a doctor and a primary care facility after a jury found that the doctor was negligent, but that his negligence was not the legal cause of the man’s death. The estate argued […]

    The post Can a Prelitigation Screening Panel’s Findings Be Used As Medical Malpractice Evidence in Maine? appeared first on Maine Personal Injury Lawyers Blog.


              Apology Letters in Maine Medical Malpractice Suits        

    If you are hurt by a professional’s negligence, you may be wondering what evidentiary rules apply to the professional’s apologies or expressions of sympathy. Can they be used to prove that the professional was negligent? In the recent Maine appellate case Strout v. Central Maine Medical Center, the Maine Supreme Court considered the effect of […]

    The post Apology Letters in Maine Medical Malpractice Suits appeared first on Maine Personal Injury Lawyers Blog.


              How I found my brother - Part 1        

    I said I would tell you about how we found our brother and here it is - true to my word. How my brother found us (Part 2) will follow soon.
    =======================================================

    One Friday evening in February 2013, my OH and I were on our way to Kettering to meet up with my brothers. We were stopping at the eldest brother's to pick him up and then go on to the the youngest brother's for a drink and a catch up. My mum and eldest brother had moved to Kettering from London in 1999, and my youngest brother moved to Kettering in 2006. My mum died in 2009 and my dad died, aged only 47, in 1980.

    When we got to the eldest brother's house he told me that someone had come to the door earlier in the day; spoken to him and had left him a card. He said the person - a man - said that he used to work with my mum. This immediately rang alarm bells because I knew my mum had for most of her working life, worked predominantly with women.

    When I read the card (I still have it), I literally went weak at the knees and had to sit down, but I knew at once that what it said was inescapably true. On 13th February, 1953; thirteen months before I was born in March 1954, and before my mum married my dad; my mum gave birth to a baby boy whom she called 'Julian Jerome Flynn' - (her maiden name was Flynn). She gave birth to Julian in St. Pelagia's Home for Penitent Girls (I kid you not) which was  in Highgate, North London. It's since been demolished and is now a gated development.

    All three of us were very close to our mum. We all loved her deeply. She was our rock, we knew she loved us unconditionally and she was always there for us. She was great fun to be with; we loved her company and spending time with her. Yet, none of us knew about this other brother. On that night I could only feel shock at the not knowing as we set off to the younger brother's house.
    Image result for St Pelagias Home for Penitent Girls image
     St. Pelagia's Home
    LOST HOSPITALS OF LONDON

    St Pelagia's Home
    St Joseph's Maternity Home
    34 Highgate West Hill, N6 6NJ
    Medical dates:

    Medical character:
    1889 - 1972

    Maternity
    St Pelagia's Home for Destitute Girls at No. 25 Bickerton Road in Upper Holloway was founded in 1889 by the Roman Catholic order of the Sisters Servants of the Sacred Hearts of Jesus and Mary.It provided  accommodation for unmarried mothers and their first-born babies, who were allowed to enter the Home when the child was a fortnight old.
    The girls were admitted free of charge on condition that they contributed to the earning power of the Home by working in its laundry.
    The Home later occupied the neighouring house at No. 27 Bickerton Road.

    In 1934 it moved to West Hill Place, a large house on Highgate West Hill, where it re-opened in 1936 after the Convent of Sacred Hearts had been built adjoining the original mansion.

    In March 1948 Mayfield, an adjoining 2-storey Victorian house, was bought and equipped as an antenatal and maternity home.  It had 18 beds and was named St Joseph's Maternity Home.

    The Labour Ward was on the first floor, while the ground floor contained 6 antenatal beds, and 12 postnatal beds in 3- or 5-bedded wards, with 12 cots for the babies.  An isolation room was added later.

    The patients, who stayed for an average of 12 weeks,  were cared for by three nurses.

    The LCC paid a guinea (21 shillings - £1.05) a weeks to the Home for expectant mothers and 25 shillings (£1.25) for mothers and babies (this was later increased to £2 10s (£2.50) a week).

    In 1954 the Homes had 70 beds for mothers and their babies.  Both properties had extensive gardens of 2 acres, but the buildings were in much need of repair, with damaged ceilings in St Joseph's and a leaking flat roof.

    The Homes closed in 1972.


    Present status (February 2009)
    The Homes and the convent were demolished in 1970.  Their site now contains Hill Court and the West Hill Park estate.



    Source: Google (for both photos)

    This is an article about St. Pelagia's from the Telegraph. http://www.telegraph.co.uk/news/uknews/10932969/Convent-that-forced-young-mothers-to-give-up-their-babies.html

    It is certainly worth reading although I don't believe my mum was forced to give Julian up by the nuns, but it would have been extremely difficult to have kept him. One, it would have got back to her parents in Ireland and the shame of having an unmarried daughter with a child could have led to ostracism by their community. Secondly,  in England there wasn't much in the way of good affordable childcare in the 1950s and mum would have to have worked to support herself and her child. There was a lot of stigma and shame attached to being an unmarried mother at that time.

    When we got to the youngest brother's house I told him get himself a glass of wine and sit down as we had some news for him! We spent the rest of the night on the computer trying to find out more information. The one thing we did know was that our dad wasn't Julian's dad. 

    I rang Ireland and spoke to two of our surviving aunts - my mother's sister's - they were totally unaware of Julian. One of the aunt's told me they had only been made aware of my existence (and my mum's marriage) when my mum turned up in Ireland with me aged 11 months! I was left  with my grandparent's and my aunt's, who were only young teenagers at the time, for about 3 months whilst she returned to England and work - of which more later.

    Our searches on the computer kept taking us to an agent who represented Brian May (of Queen) and eventually brought us to a picture of someone called 'Julian Littman. This person looked exactly like one of our first cousins; the eldest son of my mum's older and closest sister, Aunty Betty.  Unfortunately, this aunt had died in the late 1980s.

    The card that had been left had telephone contact numbers on it and we agreed that in the morning I would call the numbers. I didn't sleep a wink that night and got up really early to search on my own computer for any information. This is what I found:






    The bill prevents the government from rationing private health care and actions that interfere in the doctor-patient relationship, the congressman contends. It also would prevent the federal government from regulating the hiring practices of organizations that provide health care, such as hospitals and clinics.





    The bill protects the rights of patients to buy health insurance, or make any other arrangements to pay for their own health care. Several foreign countries and several current health care reform proposals substantially restrict this right, according to the bill.





    Additionally, the proposed bill would give Americans who get care under government health programs, such as Medicare, the ability to obtain health care outside the program.





    In the U.S., if a Medicare-participating doctor accepts payment for a service that would otherwise be covered under Medicare, the doctor is suspended from participating in the federal health program for the elderly for two years, according to the bill.





    "This substantially restricts the ability of Medicare patients to pay on their own if Medicare decides they are ineligible for a particular service normally covered by the program," according to the bill. "Not many doctors are willing to take that penalty, so this substantially (if indirectly) restricts the right of seniors and the disabled to access the health care of their choice."





    With Congress preparing to debate health care reform this summer, the men warned legislation allowing government involvement in health care decisions could have "dire consequences." They cite other public health programs in Canada and Britain as examples of how government involvement compromises quality.





    Long waits for care elsewhere





    In a news release, the men cited a 2008 Commonwealth Fund International survey that found most Canadians and British adults waited longer than four weeks to see a medical specialist compared with only 26 percent of Americans.





    They also cited long waits for care, based on a Heritage Foundation study that found 43 percent of Canadian patients and 15 percent of British patients received hip replacements within six months, compared with more than 90 percent of American senior citizens.





    About 30 percent of Canadians' health care is paid for through the private sector, according to the Organisation for Economic Co-operation and Development, a group of 30 countries that meets regularly to discuss global issues and make economic and social policies.





    The private payments are mostly for services not covered or partially covered by Canada's health program, such as prescription drugs and dentistry, according to the OECD.





    About 65 percent of Canadians have some form of supplementary private health insurance and many receive it through their employers.





    Canada spends less of its gross domestic product on health care (10.4 percent, versus 16 percent in the U.S.) and performs better on two commonly cited health outcome measures - the infant mortality rate and life expectancy.





    A 2007 National Bureau of Economic Research report found the U.S. experienced a higher incidence of chronic health conditions than Canada, but Americans had somewhat better access to treatment for the conditions. Also, a significantly higher percentage of U.S. residents were screened for major forms of cancer.





    The need to ration health care resources in Canada is the reason most Canadians cited for unmet medical needs, where in the U.S., more than half of those surveyed cited health care costs as the reason for unmet needs, the agency found.


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              No Peanuts for Your Peanut        

    Youngsters are developing peanut allergies earlier because of exposures in babyhood

    Food for Thought

    Peanuts are a protein-rich snack food packing plenty of vitamins and trace nutrients. However, these legumes can elicit potentially life-threatening immune reactions within the one in 100 American adults who are allergic to them. Rates of peanut allergy are even higher among children. And the really disturbing news: A new study finds that the age at which this common food allergy first shows up is falling.

    Today, peanut allergy typically emerges in early toddlerhood, a team of Duke University researchers reports in the December Pediatrics. "That's almost a year earlier than what we knew, scientifically, a decade ago, "explains A. Wesley Burks, a pediatric allergist who coauthored the new study.

    Although children outgrow many allergies, peanut allergy is not typically one of them. Among people who develop immune reactions to this food, 80 percent retain their allergy for life.

    The new study began, Burks says, after Duke immunologists noticed that they were encountering younger patients with peanut allergy. To investigate, the researchers pulled entry records and medical charts for all 140 young patients who had come in with the allergy since 1988. Poring over the records confirmed a fall in age at first diagnosis throughout this period—one that proved more dramatic than expected, Burks told Science News Online.

    Nationally, the rate of food allergy appears to be increasing, according to a 2006 report of a National Institutes of Health expert panel. The most striking increase, it noted, has been for peanut allergy, which is also the most common food sensitivity. Because some allergies can be avoided by delaying a child's initial introduction to certain foods, in 2000 the American Academy of Pediatrics recommended that parents "consider" keeping peanuts, tree nuts, fish and shellfish out of the diet of kids under age 3.

    Burks acknowledges that most parents aren't aware of this recommendation. On the other hand, most peanut allergy shows up in children that had already exhibited allergic reactions to other foods—typically eggs or milk. Many affected children also had skin sensitivities as infants, such as eczema or atopic dermatitis, and a parent or sibling with allergies, although not necessarily to food.

    Against that background, you would think parents of the most vulnerable kids would be especially careful about introducing peanuts into the diet. And they might well have been. Indeed, Burks suspects that most initial introductions to peanuts in his young patients were inadvertent. Either a child encountered items that contained unlabeled traces of peanuts—perhaps a jelly bean, certain flavorings used in medicines, or any of several baby lotions (see Unexpected Sources of Peanut Allergy). Or perhaps the kids encountered peanut allergen in the air when others were eating, handling, or cooking foods that contained the legume.

    But for now, Burks' team has no firm leads on why peanut allergies are showing up earlier. The Duke group and others will be probing that in the next few years.

    Homing in on the problem

    Children with peanut allergy in the new study showed the expected history of vulnerability. For instance, four in five had parents or a sib with some form of allergy. Four in five children also had personally experienced atopic dermatitis, two in every three suffered from asthma, and more than half had allergies that triggered runny noses. Moreover, blood tests from two-thirds of the youngsters turned up antibodies highlighting sensitivity to other foods, typically eggs or tree-nuts.

    Half of the young patients were born between 1988 and 1999, the rest between 2000 and 2005. The average age of their peanut allergy's onset was significantly different between the two groups—roughly 29 months old for the pre-2000 birth group, versus 15 months for children born since 2000. Within the first group, half of the children developed peanut allergy by 21 months of age; for children born since 2000, half developed their allergy by the time they were 14 months old.

    In hopes of teasing out factors that contributed to the trend of earlier allergies, Burks' group is participating in a Food Allergy Research Consortium that has been given $17 million to study food allergies—especially to peanuts. One facet of the 5-year program, which is sponsored by NIAID, is investigating the use of shots to desensitize people with peanut allergy. In addition, some 400 infants with milk and egg allergies will be studied for signs of immunological differences that distinguish those who outgrow their allergies from those who retain them lifelong.

    Currently, some 30,000 people a year are hospitalized for food allergy in the United States, and 200 die during an allergic episode. One concern, Burks notes, is that children who develop peanut allergy earlier than in the past might face a lower-than-usual chance of outgrowing their life-threatening affliction—one that requires constant vigilance.

    Such an allergy can even crimp one's social life. Consider the poor teenage girl whose lips swelled up after being kissed by her boyfriend (see A Rash of Kisses). Hours earlier, the boy had eaten peanuts, to which the girl was allergic.


    If you would like to comment on this Food for Thought, please see the blog version.

    Citations

    American Academy of Pediatrics

    141 Northwest Point Boulevard

    Elk Grove Village, IL 60007

    Web site: [Go to]

    A. Wesley Burks

    Division of Pediatric Allergy and Immunology

    Duke University Medical Center

    DUMC 2644

    Durham, NC 27710

    National Institutes of Health

    National Institute of Allergy and Infectious Diseases

    Office of Communications and Government Relations

    6610 Rockledge Drive, MSC 6612

    Bethesda, MD 20892-6612

    Web site: [Go to]
    Further Reading

    Helmuth, L. 1999. Allergy vaccine may take fear out of nuts. Science News 155(April 3):213. Available at [Go to].

    Long, A. 2002. The nuts and bolts of peanut allergy. New England Journal of Medicine 346(April 25):1320-1322. Extract available at [Go to].

    Raloff, J. 2003. Unexpected sources of peanut allergy. Science News Online (March 15). Available at [Go to].

    ______. 2002. A rash of kisses. Science News 162(July 20):40. Available at [Go to].

    ______. 1998. The mango that thought it was poison ivy. Science News Online (Aug. 8). Available at [Go to].

    ______. 1997. A whiff, a sniff—then asthma. Science News Online (Feb. 1). Available at [Go to].

    ______. 1996. Peanut allergy found common and increasing. Science News 150(Sept. 7):150. Available at [Go to].

    _____. 1996. Family allergies? Keep nuts away from kids. Science News 149(May 4):279. Available at [Go to].

    Seppa, N. 2003. Tough nut is cracked: Antibody treatment stifles peanut reactions. Science News 163(March 15):163. Available at [Go to].

              Canadians Advocate Boosting Vitamin D in Pregnancy        

    A Canadian medical society recommends pregnant women and nursing moms boost their intake of vitamin D dramatically

    Food for Thought

    Canadian pediatricians certainly aren't shirking controversy when it comes to a vitamin guideline they've developed for pregnant women and nursing moms. They're asking these women to boost their intake of vitamin D dramatically—to 10 times the daily doses advocated by most health organizations in the States. This new prescription is aimed at combating rickets—leg deformations caused by soft bones—in youngsters who get too little of the sunshine vitamin.

    Vitamin D helps build strong bones by helping the body absorb calcium. Getting pregnant and nursing women to take more of the vitamin ensures that plenty will reach developing children.

    In the past, most people had little trouble getting enough vitamin D—they just went outdoors where ultraviolet rays from the sun trigger chemical reactions in skin to make this vital nutrient. However, some people always had trouble making enough. Canadian kids at highest risk of vitamin deficits generally live in First Nations and Inuit communities. With sun-filtering pigments in their skin, and living at high latitudes, they must glean most of their vitamin D from the diet—generally a poor source—not the sun.

    Most North American women—including those in the United States—eat diets delivering only about 100 international units, or IU, of vitamin D daily, according to the Institute of Medicine (IOM), in Washington, D.C. That is half of what IOM recommends and a mere 5 percent of what Canadian pediatricians are now advocating for new and soon-to-be moms.

    Although IOM's dietary recommendations are for the United States, the Canadian health establishment has tended to rubber stamp them. In this case, though, Canada's health agency took the unusual tack of signing off on a Canadian Paediatric Society proposal to boost the recommended intake by women who are pregnant or breast feeding to 2,000 IU per day. This new guideline appears in a consensus statement published in September by the society in its journal, Paediatrics & Child Health.

    Soon the society will begin sending its new guideline to every provincial, territorial, and aboriginal health department across Canada, notes Marie Adèle Davis, the group's executive director. The goal, she told Science News Online, is to make sure all public health officials learn about it—not just pediatricians.

    The higher recommendation equals the amount that IOM has designated as the safe upper limit for vitamin D's daily consumption. Most nutritionists don't really consider that value is a true ceiling for safe intake—especially since sunbathing on a bright summer day can generate 10,000 to 20,000 IU in the body without harm. Still, for political and legal reasons, most organizations shy away from advocating intakes near what IOM has flagged as a potential maximum for safe consumption.

    Now a number of researchers suspect that intakes by pregnant and lactating women much below 2,000 IU per day could actually prove unsafe for child health.

    Reinhold Vieth of the University of Toronto explained why, recently, to officials with Health Canada, a counterpart to the U.S. Food and Drug Administration. To prevent rickets, he argued, a baby needs 400 IU of vitamin D per day. And in many parts of Canada, he said, nursing women may require several thousand IU of vitamin D per day to get 400 IU into their breast milk. Vieth had been recruited by the Canadian Paediatric Society to help defend its proposed guideline to government officials.

    U.S. physicians won't quibble over the 400 IU figure for babies and young children, notes pediatrician Frank R. Greer, chair of the American Academy of Pediatrics' (AAP) committee on nutrition. Although the 1997 IOM report says 200 IU of vitamin D per day should be sufficient for anyone under 50—including children—few researchers buy that. "Everybody feels that we should be taking more than 200 IU," says Greer, of the University of Wisconsin–Madison.

    Unlike the Canadian Paediatric Society, though, "We [at AAP] don't really have any influence on what pregnant and lactating women take," Greer says. "However, I can say that AAP's committee on nutrition has recommended to the board that we go back to [recommending] 400 IU for all children." That's the amount in a teaspoon of cod liver oil—the vitamin D supplement of choice throughout the early 20th century. Greer expects his committee's recommendation to be approved by AAP's board, perhaps within the next month.

    Optimal needs vary

    For most of the past century, nutrient guidelines have been set to prevent gross deficiencies—shortfalls that could cause disease. Those recommendations tended to represent minimally adequate intakes. Over the past decade, however, considerable debate has surrounded what vitamin D consumption levels would be optimal versus merely adequate.

    The controversy has been fueled by a steady stream of studies that have emerged since the IOM set its vitamin D guidelines. Nearly all demonstrate substantial health benefits from relatively high intakes of vitamin D—amounts well in excess of what most individuals now get. Moreover, those benefits extend well beyond protecting bone. More vitamin D seems to diminish the risk of cancer, diabetes, autoimmune disorders, muscle loss, viral infections—even gum disease.

    Researchers gauge vitamin D sufficiency on the basis of 25-hydroxy vitamin D (25-HD). This is not the form of the vitamin that is consumed—nor the hormonal form that the body actually uses—but an intermediary. To achieve optimal concentrations of 25-HD, growing numbers of nutrition and health scientists suggest, most of us would need intakes of 800 to 4,000 IU per day (see Vitamin D: What's Enough?).

    How much vitamin D someone needs can vary widely, largely depending on the amount of skin that gets exposed to the sun each day—and for how long. Further complicating the picture, some skin is heavily pigmented, filtering sunlight out. Many people cover up with clothes or sunblock when they go outdoors. Still others live at high latitudes—as Canadians do—where little ultraviolet radiation makes it through the atmosphere during much of the year.

    Even for women in the southern United States, however, "we've found that lactating women need about 6,000 IU a day to transfer enough vitamin D into their milk to supply adequate amounts to a nursing infant," says Bruce W. Hollis of the Medical University of South Carolina in Charleston.

    Nor are nursing moms the only individuals who may need relatively large doses of the vitamin. Hollis' research has shown that black women may sometimes need 4,000 IU a day for months at a time to compensate for little time outdoors, heavy skin pigmentation, and/or obesity—a factor that appears to diminish the body's ability to use vitamin D efficiently (see Understanding Vitamin D Deficiency).

    Another reason for moms' supplementation?

    In March, researchers at Harvard Medical School reported evidence that ample vitamin D diminishes the chance a child will develop asthma, a scourge who's incidence has been rising, especially in black and low-income communities (see Childhood Vitamin D—A New Benefit?). Recently, an additional putative benefit has emerged for pregnant women and their developing babies.

    A study linked elevated risk of preeclampsia—high blood pressure that develops in some women during the last half of pregnancy—with low intakes of vitamin D. This condition, which can lead to miscarriage and even the death of the mother—ordinarily develops in some three to seven percent of first pregnancies.

    Pittsburgh researchers enrolled 1,198 women who were pregnant for the first time and measured their blood concentrations of vitamin D within the first 22 weeks of gestation. Subsequently, 59 women developed preeclampsia. Blood values from all but four were compared to a similar group of recruits who maintained normal blood pressure throughout their pregnancies.

    The higher a woman's blood concentrations of 25-HD, the lower her chance of developing preeclampsia—and that risk fell steadily and "strikingly" with increasing vitamin D values, Lisa M. Bodnar of the University of Pittsburgh and her colleagues found.

    Moreover, babies whose moms had developed preeclampsia were far more likely to have low vitamin-D values than were children whose moms had maintained normal blood pressure. "These differences were found in our population despite widespread prenatal/multivitamin use in the 3 months before delivery," Bodnar's group reports in the September Journal of Clinical Endocrinology and Metabolism.

    Black women face far higher risks of developing this hypertensive syndrome. Overall, black women are also far likelier than other ethnic or racial groups to have low blood levels of vitamin D. Against this backdrop, Bodnar's group says, "our data linking vitamin D deficiency and preeclampsia risk raises the intriguing possibility that vitamin D may contribute to racial disparities in this [syndrome]."

    "The story of deficiency begins with vitamin D itself and its primary mode of synthesis, which is from sunlight," argue Adekunle Dawodu of the University of Cincinnati and Carol L. Wagner of the Medical University of South Carolina in Charleston. In a commentary in the September Archives of Disease in Childhood, they report a resurgence of rickets around the world, not only in children at high latitudes, but also in the Arab world and Asia where culture or excessive temperatures may keep women and children indoors or covered up.

    A shift from vitamin-D sufficiency to widespread deficiency has occurred rapidly—mostly throughout a half-century. The reason for it is clear, Dawodu and Wagner say: "insufficient sun exposure and inadequate corrective vitamin-D supplementation." They conclude, much as the Canadian Paediatric Society just has, that dosing moms during pregnancy and lactation "would achieve the double effect of preventing vitamin-D deficiency in both mothers and children." But unlike the Canadian society, they note that doses considerably higher than 2,000 IU may be necessary for some individuals and communities.

    As a goal, achieving population-wide vitamin D sufficiency "may be one of the more important preventative public health initiatives," conclude Dawodu and Wagner.


    If you would like to comment on this Food for Thought, please see the blog version.

    Citations

    American Academy of Pediatrics

    141 Northwest Point Boulevard

    Elk Grove Village, IL 60007-1098


    Lisa M. Bodnar

    Department of Epidemiology

    University of Pittsburgh Graduate School of Public Health

    A742 Crabtree Hall

    130 DeSoto Street

    Pittsburgh, PA 15261


    John J. Cannell

    Psychiatry Department

    Atascadero State Hospital

    10333 El Camino Real

    Atascadero, CA 93423

    Marie Adèle Davis

    Canadian Paediatric Society

    2305 St. Laurent Boulevard

    Ottawa, Ont. K1G 4J8

    Canada

    Frank R. Greer

    Department of Pediatrics

    University of Wisconsin, Madison

    Madison, WI 53792

    Bruce W. Hollis

    Department of Pediatrics

    Medical University of South Carolina

    P.O. Box 250917

    171 Ashley Avenue, Room BM326

    Charleston, SC 29425


    Reinhold Vieth

    Pathology and Laboratory Medicine

    Mount Sinai Hospital

    600 University Avenue

    Toronto, ON M5G 1X5

    Canada
    Further Reading

    Cannell, J.J. In press. Autism and vitamin D. Medical Hypotheses. Abstract available at [Go to].

    Dijkstra, S.H., et al. 2007. High prevalence of vitamin D deficiency in newborn infants of high-risk mothers. Archives of Disease in Childhood 92(September):750-753. Available at [Go to].

    Moore, C.E., M.M. Murphy, and M.F. Holick. 2005. Vitamin D intakes by children and adults in the United States differ among ethnic groups. Journal of Nutrition 135(October):2478-2485. Available at [Go to].

    Raloff, J. 2007. Childhood vitamin D—A new benefit? Science News Online (May 19). Available at [Go to].

    ______. 2007. Childhood vitamin D—A dark side? Science News Online (May 12). Available at [Go to].

    ______. 2006. The antibiotic vitamin. Science News 170(Nov. 11):312-317. Available at [Go to].

    ______. 2005. Breathing easier with vitamin D. Science News Online (Dec. 17). Available at [Go to].

    ______. 2005. Vitamin D boosts calcium potency. Science News Online (Nov. 12). Available at [Go to].

    ______. 2005. Understanding vitamin D deficiency. Science News Online (April 30). Available at [Go to].

    ______. 2004. Vitamin D: What's enough? Science News 166(Oct. 16):248-249. Available at [Go to].

    ______. 2004. Vitamin boost. Science News 166(Oct. 9):232-233. Available at [Go to].

    ______. 2004. Should foods be fortified even more? Science News Online (Sept. 11). Available at [Go to].

    ______. 2000. Calcium may become a dieter's best friend. Science News 157(April 29):277. Available at [Go to].

    Williams, A.F. 2007. Vitamin D in pregnancy: An old problem still to be solved? Archives of Disease in Childhood 92(September):740-741. Available at [Go to].

              Troubling Meaty 'Estrogen'        

    High temperature cooking can imbue meats with a chemical that acts like a hormone

    Food for Thought

    Women take note. Researchers find that a chemical that forms in overcooked meat, especially charred portions, is a potent mimic of estrogen, the primary female sex hormone. That's anything but appetizing, since studies have linked a higher lifetime cumulative exposure to estrogen in women with an elevated risk of breast cancer.

    Indeed, the new finding offers a "biologically plausible" explanation for why diets rich in red meats might elevate breast-cancer risk, notes Nigel J. Gooderham of Imperial College London.

    At the very high temperatures reached during frying and charbroiling, natural constituents of meats can undergo chemical reactions that generate carcinogens known as heterocyclic amines (see Carcinogens in the Diet). Because these compounds all have very long, unwieldy chemical monikers, most scientists refer to them by their abbreviations, such as IQ, MeIQ, MeIQx, and PhIP.

    Of the nearly two dozen different heterocyclic amines that can form, PhIP dominates. It sometimes accumulates in amounts 10 to 50 times higher than that of any other member of this toxic chemical family, Gooderham says. Moreover, he adds, although heterocyclic amines normally cause liver tumors in exposed animals, PhIP is different: "It causes breast cancer in female rats, prostate cancer in male rats, and colon cancer in both." These are the same cancers that in people are associated with eating a lot of cooked meats.

    However, the means by which such foods might induce cancer has remained somewhat elusive. So, building on his team's earlier work, Gooderham decided to probe what the heterocyclic amine did in rat pituitary cells. These cells make prolactin—another female sex hormone—but only when triggered by the presence of estrogen. Prolactin, like estrogen, fuels the growth of many breast cancers.

    In their new test-tube study, Gooderham and coauthor Saundra N. Lauber show that upon exposure to PhIP, pituitary cells not only make progesterone, but also secrete it. If these cells do the same thing when they're part of the body, those secretions would circulate to other organs—including the breast.

    But "what was startling," Gooderham told Science News Online, is that it took just trace quantities of the heterocyclic amine to spur prolactin production. "PhIP was incredibly potent," he says, able to trigger progesterone production at concentrations comparable to what might be found circulating in the blood of people who had eaten a couple of well-done burgers.

    The toxicologist cautions that there's a big gap between observing an effect in isolated cells growing in a test-tube and showing that the same holds true in people.

    However, even if PhIP does operate similarly in people, he says that's no reason to give up grilled meat. Certain cooking techniques, such as flipping hamburgers frequently, can limit the formation of heterocyclic amines. Moreover, earlier work by the Imperial College team showed that dining on certain members of the mustard family appear to detoxify much of the PhIP that might have inadvertently been consumed as part of a meal.

    The human link

    Three recent epidemiological studies support concerns about the consumption of grilled meats.

    In the first, Harvard Medical School researchers compared the diets of more than 90,000 premenopausal U.S. nurses. Over a 12-year period, 1,021 of the relatively young women developed invasive breast cancers. The more red meat a woman ate, the higher was her risk of developing invasive breast cancer, Eunyoung Cho and her colleagues reported in the Archives of Internal Medicine last November. The increased risk was restricted, however, only to those types of breast cancers that are fueled by estrogen or progesterone.

    Overall, women who ate the most red meat—typically 1.5 servings or more per day—faced nearly double the invasive breast-cancer risk of those eating little red meat each week.

    Related findings emerged in the April 10 British Journal of Cancer. There, researchers at the University of Leeds reported data from a long-running study of more than 35,000 women in the United Kingdom who ranged in age from roughly 35 to 70. Regardless of the volunteers' age, Janet E. Cade's team found, those who consumed the most meat had the highest risk of breast cancer.

    Shortly thereafter, Susan E. Steck of the University of South Carolina's school of public health and her colleagues linked meat consumption yet again with increased cancer risk, but only in the older segment of the women they investigated. By comparing the diets of 1,500 women with breast cancer to those of 1,550 cancerfree women, the scientists showed that postmenopausal women consuming the most grilled, barbecued, and smoked meats faced the highest breast-cancer risk.

    These data support accumulating evidence that a penchant for well-done meats can hike a woman's breast-cancer risk, Steck and her colleagues concluded in the May Epidemiology.

    PhIP fighters

    Such findings have been percolating out of the epidemiology community for years. Nearly a decade ago, for instance, National Cancer Institute scientists reported finding that women who consistently ate their meat very well done—with a crispy, blackened crust—faced a substantially elevated breast-cancer risk when compared to those who routinely ate rare- or medium-cooked meats.

    However, even well-done meats without char can contain heterocyclic amines, chemical analyses by others later showed. The compounds' presence appears to correlate best with how meat is cooked, not merely with how brown its interior ended up (SN: 11/28/98, p. 341).

    At high temperatures, the simple sugar glucose, together with creatinine—a muscle-breakdown product, and additional free amino acids, can all interact within beef, chicken, and other meats to form heterocyclic amines. In contrast, low-temperature cooking or a quick searing may generate none of the carcinogens.

    Because there's no way to tell visually, by taste, or by smell whether PhIP and its toxic kin lace cooked meat, food chemists have been lobbying commercial and home chefs to reduce the heat they use to cook meats—or to turn meats frequently to keep the surfaces closest to the heat source from getting too hot.

    The significance of this was driven home to Gooderham several years ago when just such tactics spoiled an experiment he was launching to test whether Brussels sprouts and broccoli could help detoxify PhIP. "I bought 30 kilograms of prime Aberdeen angus lean beef," he recalls. "Then we ground it up and I gave it to a professional cook to turn into burgers and cook." Professional cooks tend to move meats around quite a bit, he found. The result: His expensive, chef-prepared meat contained almost no PhIP.

    In the end, he says, "I sacked the cook, bought another 30 kilos of meat and prepared the burgers myself. It was a costly lesson."

    Once restarted, however, that study yielded encouraging data.

    One way the body detoxifies and sheds toxic chemicals is to link them to what amounts to a sugar molecule. Consumption of certain members of the mustard (Brassica) family, such as broccoli and Brussels sprouts (both members of the B. oleracea species)—can encourage this process. So Gooderham's team fed 250 grams (roughly half a pound) each of broccoli and Brussels sprouts each day to 20 men for almost 2 weeks. On the 12th day, the men each got a cooked-meat meal containing 4.9 micrograms of PhIP.

    Compared to similar trial periods when their diets had been Brassica-free, the volunteers excreted up to 40 percent more PhIP in urine, the researchers reported in Carcinogenesis.

    Experimental data suggest that two brews may also help detoxify heterocyclic amines. In test-tube studies, white tea largely prevented DNA damage from the heterocyclic amine IQ (SN: 4/15/00, p. 251), and in mice, extracts of beer tackled MeIQx and Trp-P-2 (see Beer's Well Done Benefit).

    The best strategy of all, most toxicologists say, is to prevent formation of heterocyclic amines in the first place. In addition to frequently turning meat on the grill or fry pan, partially cooking meats in a microwave prior to grilling will limit the toxic chemicals' formation. So will mixing in a little potato starch to ground beef before grilling (see How Carbs Can Make Burgers Safer) or marinating meats with a heavily sugared oil-and-vinegar sauce (SN: 4/24/99, p. 264).


    If you would like to comment on this Food for Thought, please see the blog version.

    Citations

    Janet E. Cade

    UK Women's Cohort Study

    Centre for Epidemiology and Biostatistics

    30/32 Hyde Terrace

    The University of Leeds

    Leeds LS2 9LN

    United Kingdom


    Eunyoung Cho

    Channing Laboratory

    Department of Medicine

    Harvard Medical School

    181 Longwood Avenue

    Boston, MA 02115

    Nigel J. Gooderham

    Biomolecular Medicine

    Imperial College London

    Sir Alexander Fleming Building

    London SW7 2AZ

    United Kingdom

    Susan Elizabeth Steck

    Department of Epidemiology and Biostatistics

    Statewide Cancer Prevention and Control Program

    Arnold School of Public Health

    University of South Carolina

    2221 Devine Street, Room 231

    Columbia, SC 29208
    Further Reading

    Raloff, J. 2007. Concerns over genistein, part II—Beyond the heart. Science News Online (July 7). Available at [Go to].

    ______. 2007. Concerns over genistein, part I—The heart of the issue. Science News Online (June 16). Available at [Go to].

    ______. 2006. Pesticides mimic estrogen in shellfish. Science News 170(Dec. 16):397. Available to subscribers at [Go to].

    ______. 2006. No-stick chemicals can mimic estrogen. Science News 170(Dec. 2):366. Available to subscribers at [Go to].

    ______. 2006. Meat poses exaggerated cancer risk for some people. Science News Online (March 25). Available at [Go to].

    ______. 2005. Beer's well done benefit. Science News Online (March 5). Available at [Go to].

    ______. 2005. Carcinogens in the diet. Science News Online (Feb. 19). Available at [Go to].

    ______. 2004. How carbs can make burgers safer. Science News Online (Dec. 4). Available at [Go to].

    ______. 2004. Uranium, the newest 'hormone'. Science News 166(Nov. 13):318. Available to subscribers at [Go to].

    ______. 2001. Fire retardant catfish? Science News Online (Dec. 8). Available at [Go to].

    ______. 1999. Well-done research. Science News 155(April 24):264-266. Available at [Go to].

    ______. 1998. Very hot grills may inflame cancer risks. Science News 154(Nov. 28):341. Available at [Go to].

    ______. 1996. Another meaty link to cancer. Science News 149(June 8):365. Available at [Go to].

    ______. 1996. 'Estrogen' pairings can increase potency. Science News 149(June 8):356. Available at [Go to].

    ______. 1995. Beyond estrogens: Why unmasking hormone-mimicking pollutants proves so challenging. Science News 148(July 15):44. Available at [Go to].

    ______. 1994. Meaty carcinogens: A risk to the cook? Science News 146(Aug. 13):103.

    ______. 1994. Not so hot hot dogs? Science News 145(April 23):264-269.

    ______. 1994. How cooked meat may inflame the heart. Science News 145(March 12):165.

    ______. 1994. The gender benders. Science News 145(Jan. 8):24. Available at [Go to].

    Smith-Roe, S.L., et al. 2006. Induction of aberrant crypt foci in DNA mismatch repair-deficient mice by the food-borne carcinogen 2-amino-1-methyl-6-phenylimidazo [4,5-b] pyridine (PhIP). Cancer Letters. 244(Nov. 28):79-85. Abstract available at [Go to].

    ______. 2006. Mlh1-dependent responses to 2-amino-1-methyl-6-phenylimidazo [4,5-b] pyridine (PhIP), a food-borne carcinogen. (Abstract # 514). Toxicologist 90(March):105.

    ______. 2006. Mlh1-dependent suppression of specific mutations induced in vivo by the food-borne carcinogen 2-amino-1-methyl-6-phenylimidazo [4,5-b] pyridine (PhIP). Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis 594(Feb. 22):101-112. Abstract available at [Go to].

              Diminishing Obesity's Risks        

    Mouse data suggest that, properly managed, obesity can be benign.

    Food for Thought

    Health-care professionals typically refer to an extremely heavy person as being morbidly obese. The term reinforces the idea that the individual is at high risk of diabetes, fatty-liver disease, and heart attacks. Researchers who have been working with mice now report that certain chronic diseases don't have to be consequences of obesity.

    The team accomplished the disconnect by tricking the animals' bodies into storing all their excess fat within their fat cells, or adipocytes.

    That's not what the bodies of rodents—or people—typically do. Initially, excess lipids—fat—are stored in these cells, making up what's called adipose tissue or simply body fat. These deposits lie primarily in the breasts, belly, and thighs. However, once adipocytes fill up, new storage sites take up the overflow. Those new depots usually develop in muscle and the liver.

    Of those two depots, the liver is more dangerous when it becomes fatty. Straightforwardly named, fatty liver disease can arise and lead eventually to hepatitis, cirrhosis, and death.

    A drop in the hormone called adiponectin is the body's signal to store fat outside adipose tissue. Sometimes referred to as the starvation hormone, adiponectin normally remains high in lean animals. With obesity, however, blood concentrations of the molecule fall.

    Philipp E. Scherer of the University of Texas Southwestern Medical Center and his colleagues reasoned that keeping adiponectin concentrations high might fool the body into making extra adipocytes instead of sending surplus fat to muscles and the liver.

    The team has now investigated the hypothesis in a strain of mice that make copious adiponectin regardless of how fat they become. In the Sept. 4 Journal of Clinical Investigation, the researchers report that as the novel mice mature, they become unbelievably huge. Indeed, muses Scherer, these are "the fattest mice ever reported," with fat comprising 60 percent or more of their body weight.

    As hoped for, the mice deposit all their excess fat in adipose tissue. Also in sharp contrast to other obese mice, the high-adiponectin animals develop no signs of diabetes. They also avoid a metabolic disorder known as syndrome X, which puts animals, including people, at high risk of heart disease (SN: 4/8/2000, p. 236).

    So, although these barely mobile, blubbery mounds of flesh look like wrecks, they don't appear to be at high risk for several chronic diseases associated with obesity, Scherer told Science News Online. Actually, he says, from the preliminary data, the mice "appear perfectly healthy."

    He suspects that there's a lesson in this for investigators of human-obesity treatments. Drugs exist that raise adiponectin values in even overweight individuals. Most, like pioglitazone (Actos) and rosiglitazone (Avandia), are prescribed to treat diabetes. However, data suggest these drugs also reduce the buildup of fat in the liver.

    Unfortunately, diminishing health risks in morbidly obese people may require far more than just supersizing their treatment with the diabetes drugs—especially since data reported earlier this year linked rosiglitazone with an increased risk of heart attack (SN: 6/23/07, p. 397).

    Fat signals

    Tissues throughout the body communicate on a regular basis via signaling hormones. Adiponectin is one of those messengers released by adipocytes to inform the rest of the body about how full the fat cells are. If they aren't full, Scherer explains, the cells pour out copious adiponectin. The body then responds by directing its fat into those cells for storage. As adipocytes fill with lipids, they turn down the adiponectin signal, telling the body that it's time to find new fat depots.

    Adipocytes release several other messengers, among them leptin. As lipids swell the adipocytes, the cells crank up production of this hormone. Once released into the bloodstream, leptin circulates to the brain, where it offers a status report on how full the fat cells are. If leptin signals that there's plenty of fat on hand, a healthy body not only experiences satiety but also reduces its food intake and burns more calories.

    At some point, a spontaneous mutation in mice led to a strain of animals that lacked the ability to make leptin. The resulting rodents, always hungry and primed to store—not burn—any excess energy consumed, inevitably become obese. Scherer's group worked with this strain and engineered it also to make extra adiponectin. The new mice typically produce about twice as much adiponectin as a normal, svelte rodent does. This excess is comparable to what can occur when people take certain diabetes-controlling drugs.

    In the new study, the researchers compared normal, lean, leptin-producing mice with leptinfree, obese ones and the new leptinfree-but-high-adiponectin animals. By adulthood, the new mice far surpassed the girth of the original obese line. But instead of having high blood sugar and insulin concentrations—characteristics of the original obese animals that mimic type-2 diabetes symptoms—the new megafatties exhibited normal insulin and blood-sugar values. In fact, Scherer says, the engineered animals had about the same insulin characteristics as healthy, lean mice.

    "That was a real surprise," he concedes—"that the [new] mice could get so fat and yet remain very healthy, metabolically speaking."

    One solution: More fat cells

    Most people are like obese mice, chronically taking in more calories than they burn, Scherer says.

    Lipid buildup in the liver is "really the driving force for insulin resistance," a metabolic change that precedes the development of diabetes, notes Scherer When this develops, the body makes normal amounts of insulin, but finds itself increasingly unable to use it. The end result: Too little insulin is used to move energy into cells, leaving high concentrations of sugar in the blood.

    The new study with high-adiponectin mice shows that "if you can overcome this block of overexpansion of adipose tissue, there is no need for excess calories to deposit as fat in the liver," Scherer says. Instead, fat can accumulate where it does the least damage, "in the professional fat-storage cell, the adipocyte."

    But Scherer doesn't want to say that excess calories are benign when they wind up in fat cells. Bulging adipocytes send out a number of inflammatory compounds (SN: 2/28/04, p. 139). It's not yet clear how important a role these compounds may play in chronic disease, but some have been linked to diabetes. Moreover, extra weight may strain an animal's joints and even its heart. So, it's premature to give a clean bill of health to mice whose physiques rival that of Jabba the Hutt.

    Still, Scherer argues, "from a qualitative point of view, these [new] mice are relatively healthy." Indeed, he says, what happens in the animals' tissues may explain why some very obese people are able to retain good insulin sensitivity and dodge the diabetes bullet.

    People who develop diabetes as adults tend to put all of their fat into a few big, inflammation-prone fat cells. However, some people's bodies employ a different strategy, Scherer says. They pack relatively small quantities of fat into an ever-proliferating number of fat cells, ones that never seem to undergo stress-induced inflammation. This approach is triggered by a "local overexpression of adiponectin in adipocytes." That, in turn, switches on production of a key signaling molecule—PPAR-gamma—that serves as a master switch "governing how many fat cells we have," he explains.

    "None of this is an endorsement for obesity," Scherer cautions. "But it shows that if you can expand your fat stores in a healthy way to keep up with your caloric intake, this will improve insulin sensitivity."

    Overall, he argues, "the best strategy is to eat less and exercise more. But for the many of us who continue to take in more calories than we burn, it would be better to expand our fat-cell numbers than to store excess lipids in other tissues. That's our take-home message."


    If you would like to comment on this Food for Thought, please see the blog version.

    Citations

    Philipp E. Scherer

    Touchstone Center for Diabetes Research

    Department of Internal Medicine

    University of Texas Southwestern Medical Center

    5323 Harry Hines Boulevard

    Dallas, TX 75390-9077
    Further Reading

    Dormandy, J.A., et al. 2005. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): A randomised controlled trial. Lancet 366(Oct. 8):1279-1289. Abstract available at [Go to].

    Harder, B. 2007. Fixes for fatty liver. Science News 171(March 3):136-137. Available at [Go to].

    Pawlak, D.B., et al. 2001. High glycemic index starch promotes hypersecretion of insulin and higher body fat in rats without affecting insulin sensitivity. Journal of Nutrition 131(January):99-104. Available at [Go to].

    Psaty, B.M., and C.D. Furberg. 2007. Rosiglitazone and cardiovascular risk. New England Journal of Medicine 356(June 14):2522-2524. Available at [Go to].

    Raloff, J. 2007. Fattening carbs—Some promote obesity and worse. Science News Online (Sept. 29). Available at [Go to].

    ______. 2007. Infectious foie gras? Science News Online (June 30). Available at [Go to].

    ______. 2007. Super-size mice—Fast food hurts rodents. Science News Online (June 9). Available at [Go to].

    ______. 2004. Inflammatory fat. Science News 165(Feb. 28):139-140. Available at [Go to].

    ______. 2000. The new GI tracts. Science News 157(April 8):236-238. Available at [Go to].

    Seppa, N. 2007. Diabetes drug might hike heart risk. Science News 171(June 23):397. Available at [Go to].

              Fattening Carbs—Some Promote Obesity and Worse        

    Food for Thought

    Nutritionists call them carbohydrates. To most of us, they're simply sugars and starches. And although the fructose in soft drinks and the refined flour in white bread taste quite different, "nutritionally and metabolically they're the same as table sugar," explains endocrinologist David S. Ludwig. That's because the body digests all carbohydrate-rich foods into glucose, or blood sugar.

    However, all carbs don't break down at the same rate. The body digests those in many whole-grain products quite slowly. Others become converted to glucose almost immediately.

    Rapidly digested carbs aren't healthy for people with diabetes and others watching their blood sugar. A new study by Ludwig and his colleagues at Children's Hospital Boston suggests that such carbs are also problematic for people looking to shed body fat. Indeed, the findings indicate that consumption of the wrong carbs can spur the development of body fat, even with no gain in weight.

    In the study, mice that chowed down on a type of rapidly digestible starch didn't gain any more weight than did animals eating a starch that digests slowly. But the first group did accumulate lots of excess fat. The data indicate that something about rapidly digesting carbs signaled the body to convert more of a meal's energy into body fat, into fatty lipids that circulate in blood, and into deposits of fat throughout the liver.

    Ludwig considers the observed effect on the animals' livers the most troubling one. Fatty-liver disease has traditionally been regarded as the first stage of damage from alcoholism that can progress to hepatitis, cirrhosis, and death. But researchers in recent years have discerned the beginnings of an epidemic of fatty-liver disease unrelated to alcoholism but correlated strongly with being overweight. Recent data suggest that as much as one-third of children and even a higher proportion of adults have the condition. Ludwig told Science News Online that he suspects that "up to half of the [U.S.] population" now has fatty-liver disease.

    The question has been what's fueling this epidemic. Because the disease so often accompanies obesity, many researchers have suspected that high-fat diets and junk foods are responsible. Ludwig's group had another idea.

    In recent years, the mushrooming incidence of obesity in the United States has led to a push to get people to lower their intakes of fat. However, reducing fat consumption almost always translates into increasing the intake of carbs (see Counting Carbs). Moreover, the carbs most people reach for first are the refined—easy to digest—types found in white flour, white rice, pasta, and potatoes.

    Ludwig's team decided to see whether a diet rich in a similar carb promotes fat buildup. They used a proportion of carbs that people on a low-fat diet might eat and compared its effects with that of a diet equal in all respects except that its carbs were mainly a slowly digested starch.

    In the September Obesity, the researchers show that animals eating rapidly digested carbs accumulated more fat throughout their bodies—including their livers—than did animals eating primarily the slow-to-digest starch.

    Says Ludwig, "This is the first study in which a single dietary factor—varied within normal ranges—affected whether the liver remained normal or accumulated seriously elevated levels of fat."

    Recipe for pudge

    In the new study, Ludwig's team fed 18 recently weaned mice food pellets containing 13 percent fat, 19 percent protein, and 68 percent carbohydrates from corn starch. Half the animals got pellets containing the starch called amylopectin, which is made up of a string of glucose molecules that the gut easily degrades into sugar. The remaining mice ate pellets containing some amylopectin but mostly the starch called amylose. That type of corn starch resists breakdown in the gut.

    All the animals ate and drank as much as they wanted for 25 weeks. Throughout the study, the researchers charted weight gain, body fat, fecal excretion of starch, and blood concentrations of glucose and insulin. At the end, the researchers killed the animals and measured their livers' fat contents.

    Weight gain didn't differ between the two groups of animals, suggesting that the mice found the diets comparably palatable. However, the animals' bodies responded differently to the two food-pellet recipes. Mice dining on amylopectin-enriched chow became twice as fat as those eating the slower-digested amylose recipe. Mice eating this starch grew a little longer in body, so they looked leaner that the "roly-poly" mice eating easily digested starch, Ludwig says. The latter mice "felt squishy," whereas the slow-digested-starch eaters felt firm, he adds.

    Although blood sugar concentrations didn't differ between the two groups, mice on the amylopectin-rich food developed higher insulin values after a meal. The body uses the hormone to shepherd energy into its cells. Higher blood insulin after a meal, Ludwig explains, indicates that an animal needs more insulin to fully use the food it's eaten. Needing more of the hormone can be a first sign of insulin resistance and impending diabetes.

    Ludwig notes, "Insulin is a powerful anabolic hormone, meaning it promotes the storage of fat. In fact, that's arguably one of [the hormone's] main roles." One of the first places newly made insulin ends up is in the liver, where it can trigger the localized creation and stockpiling of fat.

    Although the rodents' livers weighed the same whether they ate fast- or slow-digested starch, fat made up 12 percent of the liver in mice fed the amylopectin-rich diet. That's double the fat content of livers in animals that had eaten the slow-digested starch. For perspective, Ludwig notes, people whose livers contain 10 percent fat are considered to be suffering from "advanced" nonalcoholic fatty-liver disease.

    What about people?

    This isn't the first study to indicate that foods that rapidly break down to glucose in the body—characterized as having a "high glycemic index" (see The New GI Tracts)—can fuel nonalcoholic fatty-liver disease. For instance, last year Silvia Valtueña of the University of Parma in Italy and her colleagues reported findings from a study of 247 apparently healthy men and women. The volunteers' diets were evaluated and given a glycemic-index (GI) rating.

    Low GI foods included corn, dairy products, and fruit. High GI fare included bread, pizza, and baked snacks. The volunteers were grouped into four categories based on the ascending GI rankings of their diets.

    Participants with the highest-GI diets were twice as likely to have undiagnosed fatty-liver disease as were other study participants. People in the highest group were also far likelier to be insulin resistant, the researcher reported in the July 2006 American Journal of Clinical Nutrition.

    In an editorial accompanying the Valtueña report, David J.A. Jenkins and his colleagues at the University of Toronto argued that the "implication of this study is that a low-GI diet, or selection of lower-GI rather than higher-GI foods, may benefit persons with nonalcoholic fatty liver." Indeed, the commenters suggested, it might be possible for doctors to treat nonalcoholic fatty liver by lowering the glycemic index of an individuals' diets.

    That's what Ludwig's group is now investigating: "We hope to enroll 46 kids to a diet for 6 months," he says. The 8- to 17-year-olds and their parents will receive dietary counseling. Half of the recruits will be assigned to a low-fat diet. The rest will receive counseling to lower the glycemic index of their diets. The general guidelines for a low-GI diet call for substituting whole-grain foods for ones made from highly processed cereal fibers and reducing refined sugars in favor of sweet fruits.

    "Conceptually," Ludwig says, "fatty liver should be reversible—we've seen it anecdotally in practice many times, such as when someone loses weight or changes the quality of their diet."


    If you would like to comment on this Food for Thought, please see the blog version.

    Citations

    David J.A. Jenkins

    Clinical Nutrition and Risk Factor Modification Center

    St. Michael's Hospital

    61 Queen Street, East

    Toronto, ON M5C 3E2

    Canada


    David S. Ludwig

    Children's Hospital Boston

    Department of Medicine

    333 Longwood Avenue

    Boston, MA 02115


    Silvia Valtueña

    Department of Internal Medicine and Biomedical Sciences

    University of Parma

    43100 Parma

    Italy
    Further Reading

    Pawlak, D.B., et al. 2001. High glycemic index starch promotes hypersecretion of insulin and higher body fat in rats without affecting insulin sensitivity. Journal of Nutrition 131(January):99-104. Available at [Go to].

    Raloff, J. 2007. Super-size mice—Fast food hurts rodents. Science News Online (June 9). Available at [Go to].

    ______. 2004. Counting carbs. Science News 166(July 17):40-42. Available at [Go to].

    ______. 2004. Coming soon—Spud lite. Science News Online (June 19). Available at [Go to].

    ______. 2000. The new GI tracts. Science News 157(April 8):236-238. Available at [Go to].

    Sloth, I., et al. 2004. No difference in body weight decrease between a low-glycemic-index and a high-glycemic-index diet but reduced LDL cholesterol after 10-wk ad libitum intake of the low-glycemic-index diet. American Journal of Clinical Nutrition 80(Aug. 1):337-347. Available at [Go to].

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              The Art of Lovin' Animals --- Featured Group of Artists Inspired by Their Beloved Pets.        
    "Enilde And Our Children" Oil on Panel 42" x 60"
    Painting by Luke Van Hook, 2003
    Painting and Photograph copyright by Luke and Ginger E. Van Hook, 2004
    Courtesy of the Van Hook Collection

    The Art of Lovin' Animals
    Features a group of artists inspired,
    motivated or influenced by their beloved pets
    and appear in this blog in the following order:

    Joshua Elias, Simone Gad, Betty Glass, David Newsom,
    Monrovia Association of Fine Arts supporters
    (KidsArt Studio, PaintNPlay Art Studios, Tyson & Tillman Skate Dogs)
    Family Dog and Cat Hospital in Monrovia, California (displays animal artwork).
    Ginger Van Hook, Luke Van Hook,
    Alex in Welderland, Elena Wolek, and Zareh.

    Additionally as part of the "Art of Lovin' Animals"
    there is a special book and movie review of
    John Grogan's book "Marley and Me", and the recent hit movie
    starring Jennifer Aniston and Owen Wilson


    Written by Enilde G. Van Hook with special thanks to all participating artists!


    Do you remember your first pet? I do. I even have a picture of how much bigger my cats’ paws were than my two feet put together at the age of three. My mother, tells me I had a yellow duck, a small dog and a large yellow tabby cat that owned me as a child.
    These three pets were protective, possessive and they were my first companions as I ventured out, for the first time, into my wild back yard of dirt and weeds. I was born in Rosario Argentina and to me now as an adult, my backyard is still my world. I live in Los Angeles, California but the romance of the Argentinean Pampas is not lost on me. From the pictures of my past, I gathered that my Belgian Grandfather, Francisco, ran a plant nursery in Buenos Aires and that my father, Luis, grew up to be an inventor in America. But the most unique connection I have to my past is my relationship with animals. I’ve had a pet at almost every age as I grew up. The importance of this type of companionship has not been explored enough in the art world, at least, this is my opinion. This is the reason I am blogging about the subject of the art and inspiration of lovin’ pets. I hope to instigate discussion, if not compassion. I hope to motivate an artistic response to my thoughts as well. You may have a completely different experience, so I personally encourage you to post your comments after you read this entry.
    This is what I asked myself for the subject of the essay for Ginger's Art Journal. What is the relationship of animals and pets to the art world? How involved are animals throughout the art strata? How much inspiration is gathered from the love of a pet? Can that even be measured? Does the love of a pet inspire political causes? Activism? How does one explain the pangs of loneliness from the loss of a pet? Does the death of a pet make an artist create more art? Does the gift of a new life of a pet inspire hope and renewal in artists? How do artists express their love and affection for the four-legged critters of our earth? How do animals, pets, pet trees, pet rocks or pets of any kind affect the process of making art?
    There are a number of artists that I have followed for a period of time to investigate the questions that will make up this entry. Studying the work of a number of local artists from the Los Angeles and surrounding areas that work with pets in their art practice, I will present some of their unique stories with photos. The artists, in alphabetical order, include Joshua Elias, Simone Gad, Betty Glass, David Newsom, Ginger Van Hook and Luke Van Hook, Alexandra from Alex in Welderland, Lena Wolek and Zareh. Additionally, the art of lovin’ animals has made a seamless transition from the literary art into the film arts so I will discuss one of my favorite books by John Grogan named “Marley and Me” as it compares to its latest movie version of “Marley and Me” starring Jennifer Aniston and Owen Wilson which opened in December for Christmas Day.
    The method selected to choose these artists was random. I began my animal photographic study in 2006. Through my daily practice of studying the arts, I have come across people who were “in my back yard” and came to connect with me in a special way. I didn’t set out to write a story about animals. I merely went about my daily routine of photographing people and artwork that caught my “eye” because I was at the right place at the right time. Believing that the universe has a special plan for me, I allowed this story to evolve of its own volition. What I discovered both surprised me and opened me up. What I mean by this is that I was surprised to discover that artists who had pets had a great deal in common with other artists who had pets. Most people know and understand the history that reveals how the Egyptians revered cats and how the dog is considered “man’s best friend”. While it was common to have general conversations about how great it was to have pets and create pet portraits, I rarely came across artists that spoke to the deeper underlying significance in the arts about this specifically. While doing this research, I came across the most extreme case of worshiping our pets. The act of cloning has been in the news ever since the cloning of “Dolly” the sheep, but did you know that now there is a company that has launched itself into a commercial venture to clone man’s best friend? I discovered this and lots more so enjoy the new year in 2009 with a renewed commitment to your beloved pet. This is an ongoing story so don’t feel left out if your best friend isn’t included in this entry. I’m still reviewing artwork and pet portraits,
    feel free to send me an email about your animal story and I’ll include it in the followup stories!

    *********************************************************************************

    JOSHUA ELIAS
    Fine Arts Painter

    Joshua Elias, Exhibition, DCA Fine Arts
    Santa Monica, California
    Photo copyright Ginger Van Hook, 2007
    Winston and Lucille read art literature on the couch and
    wait for Joshua Elias to become inspired to feed them.
    Photo copyright Ginger Van Hook, 2008
    Paintings by Joshua Elias
    Art in the making at the Brewery Artist Colony
    Los Angeles, California, 2008
    Studio visit by Ginger Van Hook
    Photo copyright Ginger Van Hook
    Artist brushes belonging to Joshua Elias
    The instruments by which Joshua Elias creates the canvas of weather and inspiration.
    Photo copyright Ginger Van Hook, 2008
    DCA Fine Arts Gallery, Joshua Elias with Mathew Heller and his girlfriend
    Photo copyright Ginger Van Hook 2007
    Joshua Elias, Exhibition at DCA Fine Arts Gallery
    Santa Monica, California
    Photo copyright Ginger Van Hook, 2007
    Joshua Elias with his cats Winston and Lucille
    in his studio at the Brewery Arts Complex in Los Angeles, California
    Photo copyright Ginger Van Hook, 2008

    Joshua Elias
    Artist Statement

    Art has become about large quantities of Resin, masquerading as Content. The focus has been on Process, confusing it with Content. Enough. I wish to focus on Content. Story and Vibration lead the way for me to paint.

    I work in oil because of the depth and movement that it allows for me, as a medium. I focus on Landscapes that are rearranged. Traveling spirits act as guides, to the movement of a particular painting. The influence of Moorish architecture and its many doorways offers and allows entryways into paintings.

    At present we are in a period of Time where there seems to be long standing fights over Space, Time Religion, Money, Ideology, and Relationships. Enough. The one thing we do all share is Weather. Through the action of Creating our own environment, our own personal Weather, the Repositioning of Weather can illuminate and allow for more Creation to happen, more of a Life Force to shine and to take shape.

    ï¿_ Joshua Elias

    Courtesy of the DCA website
    *************************************************************************************************************************



    SIMONE GAD
    Fine Arts Painter, Collage Artist, Actor and Performer
    Simone Gad, Artist, Solo Show, L2Kontemporary Gallery
    February 2008 Chinatown, Los Angeles, California,
    Photograph by Ginger Van Hook, copyright 2008


    Selfportrait with Max and Bella/Autoportrait avec Max et Bella
    Private collection, photo courtesy of Simone Gad, Artist, copyright 2005
    Gad/Rin-Tin-Tin Collection Long Beach Museum of Art
    Courtesy Simone Gad, Artist, copyright 2005


    Picture Holocaust Clowns - Pinups 127, Gad and Poodle
    Courtesy Simone Gad, Artist, copyright 2005

    Selfportrait with Cat and Jesus
    Private collection, Courtesy of Simone Gad, Artist, copyright 2005

    Hommage a Ma Mere 2005 Painting Collage
    Copyright and Collection- Simone Gad
    Courtesy Simone Gad-Artist
    Photograph by Antonio Garcia





    Autoportrait avec Kashmir, painting collage 2005/06
    Courtesy Simone Gad- Artist and L2Kontemporary Gallery
    Chinatown, Los Angeles, California. Copyright Simone Gad


    Portrait of Bella, the Brindle cat, acting secretary for Artist, Simone Gad
    Los Angeles, California, Artist studio visit
    Photograph by Ginger Van Hook, copyright 2008



    Bella the Brindle Cat, (on the Marilyn and JFK Installation)
    Photo copyright and courtesy of
    Jesse Bonderman and Simone Gad,

    Bella, the Brindle Cat #2 (Marilyn Installation)
    Photo courtesy of Jessie Bonderman and Simone Gad


    Portrait of Simone Gad, Artist with companion, Bella.
    Los Angeles, California, Artist studio visit
    Photograph by Ginger Van Hook, copyright 2008

    Portrait of Bella
    The Brindle cat, Artist assistant, model
    and loyal companion to Simone Gad.
    Los Angeles, California, Artist studio visit
    Photograph by Ginger Van Hook, copyright 2008

    Max and Bella pose for pictures in the window of Simone Gad's artist studio
    Los Angeles, California
    Photograph by Ginger Van Hook, copyright 2008

    Simone Gad poses with one of her paintings of Chinatown
    during her solo show at L2Kontemporary Gallery
    Chinatown, Los Angeles, California
    Photograph by Ginger Van Hook, copyright 2008



    Enilde Van Hook writer's notes: I met Simone Gad at an exhibition of her work in Chinatown in the spring of 2008. The L2Kontemporary Gallery is a unique gallery located at 990 N. Hill Street #205 in Downtown Los Angeles (90012), California. I received an email from ArtScene, a wonderful source of local Art Events that is produced by the staff of Coagula Art Journal. Special thanks to Michael Salerno and Mat Gleason, because somewhere in the announcement, I read that Simone Gad was a Belgium-born artist and this led me to want to meet her to talk about the art in Belgium, where my grandfather had been born. Once I attended her exhibit and got a chance to meet Simone, I realized there was a distinct cultural connection we had through our reverence to the animals. She used images of her cats to make intriguing and poignant self-portraits and insightful photographic collages.
    I have followed Simone Gad’s work into 2009 and you will enjoy visiting her site through the L2Kontemporary Gallery located in Chinatown in Los Angeles: Follow these links to get to know a renaissance artist, a versatile film and TV actress, a woman of many talents and an artist who has a great deal of compassion to show for her animal friends: visit the online gallery site at http://www.l2kontemporary.com to view her solo show at L2k for Feb 08 plus her updated resume which may be viewed at saatchigallery.org by writing in her name or wooloo.org by writing in Simone Gad’s name.
    Special thanks to the L2Kontemporary Gallery for cooperating with my interview! (www.L2Kontemporary.com and L2Kontemporary@sbcglobal.net and phone: 323-225-1288)

    Simone Gad
    Artist Statement and Biography: 2009

    I've been showing in museums and galleries for 40 years-am a 6 times grants recipient, including a CRA Grant 1986, the Woman's Building 1985/6, New Orleans Contemporary Museum of Art 1984, the Gottlieb Foundation-NYC/Painting Medical Emergency Grant, Change Inc-Robert Rauschenberg Foundation Grant-both in 2002 for painting and medical emergency, and Artist Fellowship Foundation Grant in 2007-NYC. I am included in the Archives of the National Portrait Gallery/Smithsonian-Washington, DC, and will also be included in the Lyn Kienholz Encyclopedia of Los Angeles Artists who have shown between 1944 and 1979. In Los Angeles, I am represented by L2kontemporary Gallery-Chinatown, Jack Fischer Gallery in San Francisco, and am showing in Spain. I am also in the traveling museum exhibition-Your Documents Please thru 2010 in Japan/Europe/Mexico curated by Daniel Georges of Brooklyn, NY. I was born in Brussels, Belgium to holocaust survivor parents, from Poland. We came to the US in the early 1950's and settled in Boyle Heights/E.L.A, after arriving at Ellis Island. My mother got me into show-biz at the age of 4 upon our immigration. I grew up in the entertainment field as a young actress-have been working professionally in film, tv, commercials and theatre ever since. Have always had a dual career-.visual/performance artist and actor. George Herms and Wallace Berman were my first mentors. Al Hansen was my mentor from 1972 to 1995 when he passed away in Koln, Germany.

    My cats Max and Bella Bettina Kashmir are my inspiration for many of my painting collages-have been so for many years. I've always been inspired by my cats and dogs that I've had since I arrived to this country from War torn Europe. My father got me my first dog-Teddy Queeny when I was a child living on Folsom Street-We had just returned from a movie on Brooklyn Avenue when we saw the puppies on our way home. I was allowed to have one-and I was so happy. But my mother hated animals and wouldn't let me keep my pet with me in my bedroom and it cried all night. I was heartbroken when I got home from Nursery School the following day and found that my dog was gone. My mom told me she had sent it to New Jersey to live with my Tante Sally. I wasn't allowed to have any animals after that. Years later I visited my aunt and asked her if she had taken care of my Teddy Queeny and she told me she never did-she never got the dog-didn't know what I was talking about. I realized that my mother had lied to me and had possibly killed my beloved doggie. I had moved to Topanga Canyon for a while in the late 1960's-that's where I got to know Wallace Berman and George Herms. I was given a miniature sheppard-who I named Lady. She was my constant companion and I adored her. She was run over by a couple of friends who were staying with me one night. I found her bleeding from her mouth by the driveway. She died in my arms and I could feel her spirit leave her body. We buried her the next morning. I was devastated for years. A friend of mine gave me a dash-hound and I took it home to be with me when I left Topanga and stayed with my parents for a while. I named her Wiggle Butts because she had this habit of wiggling her behind when she walked. I was not allowed to keep her-once again-so I called a friend and had her drive from The Canyon to pick Wiggles up and take care of her for me. When I left my parents and got an apartment, I got a cat-Nathaniel-my very first cat-who was with me for 15 years until he passed away. It was then that I started to incorporate animal objects into my collages-in the mid 1970's.

    copyright Simone Gad 2009

    http://www.l2kontemporary.com to view Simone Gad’s solo show at L2k for Feb 08 plus her updated resume-you may also get it on saatchigallery.org by writing in her name or wooloo.org by writing in Simone Gad’s name-

    ************************************************************************************


    BETTY GLASS

    Focus One Gallery in Monrovia, California. Sponsored by M.A.F.A.,
    the Monrovia Association of Fine Arts and Focus One Community Credit Union.
    Photo by Ginger Van Hook, copyright 2006

    Betty Glass celebrates Christmas with Lulu at home in 2008.
    Lulu, wearing her new holiday sweater,
    pokes her nose into the gift bag
    to see if she likes what Santa has brought her.
    Photo copyright and courtesy of Betty Glass and James Glass.
    Turtle Painting, Watercolor Artwork by Betty Glass reminiscent of her pet turtles.
    Photo copyright and courtesy of Betty and James Glass.
    Trojan Horses, Watercolor painting by Artist, Betty Glass
    Photo copyright and courtesy of Betty and James Glass.
    Hummy, Watercolor Painting by Artist, Betty Glass.
    Photo copyright and courtesy of Betty and James Glass.

    Yankee and Sugar, Watercolor Painting by Artist, Betty Glass
    memorializing the life of her beloved friends.
    Photo copyright and courtesy of Betty and James Glass.

    Yankee (5-17-80 --- 4-20-94)
    the larger white and orange Brittany on the right,
    and Sugar (7-20-90 --- 12-24-04)
    the smaller Brittany on the left.
    "Beloved Friends and Forever in our hearts!"
    Loyal Friends, Inspiration and Companions
    to Artist, Betty Glass and her family.
    (Special thanks to husband, James Glass
    for his technical computer assistance
    with digital photography formating of Betty Glass Artwork.)
    Photo copyright and courtesy of Betty and James Glass


    Enilde Van Hook, Writer's Notes:
    I met Betty Glass through the Monrovia Association of Fine arts in 2006. We were showing together at the Focus One Gallery on Huntington Drive in Monrovia, California. When Betty came into the gallery, she was toting her adorable poodle named Lulu. I was charmed immediately and I just had to have a photo of this beautiful female pooch with a twinkle in her eye and the gumption to come into an art gallery where only humans gathered. This little poodle had no clue there was any difference between her and her owner, and she acted like she was looking at the art just like everyone else. At the time, I considered this a very cultured poodle and I told Betty so. Betty giggled and let me take her snapshot with Lulu and then we did not see each other again until we had another show together, also at Focus One Gallery two years later in December of 2008. When I saw Betty this time, I saw the connection of her artwork and the love of her animals come through her work and later, she agreed to participate in the interview for my blog. You may enjoy Betty Glass's artwork by visiting her website at www.bhglassart.com

    Betty H. Glass
    Artist Statement about Animal Art

    Through art we communicate our feelings and thoughts.
    Our art reflects what experiences in life have influenced us.
    I have had a lifetime of pets
    ranging from goldfish, parakeets, and turtles and, of course,
    the loyal dog—always your friend even when the sky seems to be falling.
    I am still sketching and painting animals, birds, and fish.
    The softness of their fur, the texture of their feathers and fins,
    the variations of color are very appealing to me,
    because color is part of my artistic signature.
    Sometimes they are presented in a realistic fashion.

    Other times I use animals in a more stylized way—
    using their shapes as patterns, semi-abstracting them and their background.
    For example, my painting Trojan Horses shows flattened stylized figures of horses.
    Hopefully artistically pleasing and calling to mind ancient Greece.

    In reply to We ned both...

    We do need to have a variety of information on this board. Some people really need to have the cheerleaders in their corner to give them the courage to fight this damn disease. It's easy for a newbie to be overwhelmed by the technical nature of some posts, so it's nice to have others on here that can communicate to us commoners. Some of us want to know the details and facts of this disease so they can make informed decisions and challenge their medical staff to see if they are the right people to help them fight this using all of the latest tools in their arsenal. There has always been something for everyone here, and the members are constantly evolving. Their desire to get answers and information keeps growing. The information that once satisfied their needs will become inadequate and they will seek more indepth information from the likes of Neil, TW, etc. I'm thankful for everyone on this site. From the cheerleaders to those who are able to be logical and tell it like it is.

    BLKJAK

    P.S. I guess my post helped to generate some activity on this board! :)


              Ace & Tate by OS & OOS, Eindhoven – Netherlands        

    OS & OOS dismissed bland carpets and tiles reminiscent of medical examination rooms in favour of raw concrete in line with Eindhoven’s historical architecture style.
              Solomon Durrett (Derrett) b. 1800 m. Martha "Jershua" Smith b. 1815        
    I am looking for information on Solomon Durrett b. 1800 in Virginia. He came to Texas before Texas was a republic or a state. He married Martha "Jershua" Smith b. 1815 in Tennessee

    Children of Solomon Durrett and Martha J Smith:

    All of Solomon’ sons were Texas State Troopers when the war broke out their Regiment was transferred to the Confederate States of America.
    1. Rice W. Durrett b. abt 1835 served as a 2nd Lt. in Darnell's Regiment along with his brothers. Rice never married

    2. Thomas C Durrett b. abt 1837 Tennessee

    3. William H Durrett (may have died at the beginning of the Civil War)

    4. Richard H. Durrett married Susan Callahan Cole daughter of John Pope Cole and Susan Hulda Caroline Leonard;

    5. Sarah Durrett married John W. Kincaid no further information on this family.

    6. Mary [Jerusha] Durrett m. Robert A Hawkins (who died in the Civil War in 1862)

    7. Virginia Victoria Durrett born in Texas married James Milton Thorp.

    I have the obituaries for Victoria Thorp and Mary [Jerusha] Durrett Hawkins who never married after her husband’s death in 1862. Robert Hawkins died during the from Re-mitten fever during the Civil War; he died at the field hospital at Fort Galveston, Texas.

    Solomon owned land in Parker County, Texas from 1837 to 1871. I have his land patent records; Solomon and his sons Rice W., Thomas C, William H and Richard H Durrett (Derrett). They are all listed on the Tax Rolls for Parker County from 1846 to 1874.

    In 1871, Solomon is no longer on tax records in Parker county his daughter Mary Hawkins is his agent.

    Solomon's will was lost in a fire in Parker County; Martha his wife moved to Dallas after the sale of the property. Rice W and Thomas C Derrett ran things. Rice drops off the tax roll about 1874. Did he die? Thomas is his agent. What became of him?

    Martha moved to Dallas, Texas were her daughters lived. She died in Dallas, Texas in 1885 leaving a will. In her will, Martha J Smith Durrett named her children and grandchildren. One is my husband's father-in-law Charles Albert Durrett b. 1871 married Cora Missouri Ellen Sanders.

    Solomon’s son Rice W Durrett lost his arm during the civil war according to Military records. He was discharged for medical reasons in Atlantic GA.

    Thomas C. Durrett collects a pension from 1900 to 1904; he was living in Lisbon, Dallas, Texas. Where did Thomas go? Records show he moved to Alabama but where in Alabama?

    Richard Haines Durrett - In a letter to the Adjunct General dated in 1863, Richard, states there was Indian trouble and he asked for leave and it was not granted; so he left to get his family to safety. After they were safe, he returned to his regiment. He was then court marshaled at Fort Galveston, Texas for desertion. He asks to be returned to an Artillery regiment. In 1865, Richard is returned to the active duty and he does serve with an Artillery Regiment until the end of the war.

    After the war, he returns home and marries about 1866 in Parker, Texas Susan Callahan Cole daughter of John Pope (Jack) Cole and Susan Hulda Leonard. The Coles also owned land in Dallas and in Parker County. Are Richard and Susan's marriage license in Parker County or Dallas?

    Any help would be appreciated.

    I can be emailed at jmdgenealogy AT yahoo.com

    Thank you for your help.
    Joy Durrett
    2nd Great-Granddaughter of Solomon and Martha J Smith Durrett and John Pope (Jack) Cole

              ECU ALUMNUS CHRIS BUCHANAN NOW DEPUTY DIRECTOR OF INDIAN HEALTH SERVICES FOR U.S. PUBLIC HEATH SERVICE        
    Chris Buchanan

    Chris Buchanan, East Central University alumnus and a member of the Commissioned Corps of the United States Public Health Service (USPHS), was recently promoted to the flag-officer rank of Rear Admiral and appointed Deputy Director of Indian Health Services.

    Buchanan also recently served six months as acting director.

    As a senior ranking officer, flag officers exemplify the core values for which commissioned officers of the U.S. Public Health Service are held in high esteem, according to Dr. Patrick Bohan, ECU Environmental Health Sciences professor and Retired Captain of the USPHS.

    “Flag officers provide executive-level leadership within the department and the agencies which they serve,” Bohan said. “Our flag officers also carry the title of Assistant Surgeon General and, as such, we rely on them to support special initiatives and exhibit the highest caliber of public health leadership.”

    Buchanan, a native of Konawa, joins fellow ECU alumnus Rear Admiral Kevin D. Meeks as a high-ranking official within the USPHS. Meeks is acting deputy director of field operations for the Indian Health Service, an agency within the Department of Health and Human Services and the principal federal health care advocate and provider of health services for American Indians and Alaska natives.

    ECU has provided more environmental health officers to the Commissioned Corps of the U.S. Public Health Service than any other institution in the country, according to Bohan. The Environmental Health Science program at ECU is one of 31 accredited undergraduate programs throughout the United States.

    “The Environmental Health Science program provided an interdisciplinary foundation that prepared me for my career in Indian Health Service,” Buchanan said. “Environmental health graduates of the program are problem solvers. We use this type of approach to develop skill sets

    that help to constructively review environmental and public health issues and come up with solutions. I have and continue to use these skills in my role as the deputy director of IHS.”

    Buchanan credits the late Dr. Mickey Rowe, former chair and professor of the ECU Environmental Health Science Department, with setting the stage for his career.

    “Dr. Rowe was a force of nature. He left a lasting impact on me personally and professionally,” said Buchanan. “His expectations were high for all his students and former students. He made it clear upon graduation that you would be representing the ECU Environmental Health Program and your environmental health decisions will have an impact on public health. His expectation was nothing short of being the best both academically and in your profession.”

     As deputy director Buchanan, an enrolled member of the Seminole Nation of Oklahoma, leads and oversees IHS operations to ensure delivery of quality comprehensive health services. He ensures that IHS provides for the full participation of tribes in programs and services and helps to establish and track the goals and metrics through which the IHS U.S.-federal-government-operated, or direct service, health care program improves outcomes.

    Buchanan ensures IHS services are integrated across all levels of the agency and engaged with other Operating Divisions of the Department of Health and Human Services and external partners, including states and national organizations.

    He previously served in 2016 as the acting area director for the IHS Great Plains Area, with administrative responsibility for 19 service units serving 130,000 people and 17 tribes through seven hospitals, 10 health centers and two urban Indian health programs, overseeing a complex health care program during a period of change. Previously, Buchanan has served as director of the IHS Office of Direct Services and Contracting Tribes.

    As an environmental health officer in the U.S. Public Health Service Commissioned Corps with more than 20 years of active duty, Buchanan began his IHS career in 1993, serving in various environmental health positions in the Phoenix, Albuquerque and Oklahoma City areas, including serving as the administrative officer for Lawton Indian Hospital and the chief executive officer for Haskell Health Center. In 2010, he was administrative officer of clinical services for the Chickasaw Nation’s Division of Health in Ada.

    Along with serving on several national IHS workgroups and being deployed to several natural disaster events, Buchanan has received numerous professional awards, including one for National Council of Chief Executive Officer’s Rookie of the Year. He earned a bachelor of environmental health science degree from ECU and a public health degree in health policy and administration from the University of North Carolina in Chapel Hill.

    Buchanan has seen Indian Health Service improve over the years, evolving in a similar manner as the traditional healthcare delivery model to a more value-based healthcare delivery system.

    “The IHS sees these changes through the administration of a nationwide health care delivery program that is responsible for providing preventative, curative and community health care for approximately 2.2 American Indians and Alaska natives in hospitals, clinics and other settings throughout the United States,” Buchanan said. “An example of this evolution includes emerging technologies such as telemedicine. By utilizing these healthcare technologies, IHS will continue to improve the populations we serve.”

    Telemedicine is the diagnosis and treatment of patients in remote areas using medical information such as x-rays or television pictures, transmitted over long distances, particularly satellite.

    -ECU-

    For Immediate Release: 

    Contact: Brian Johnson or Amy Ford

                                    East Central University Communications and Marketing

                                  580-559-5650 or 405-812-1428 (cell)


              Misuse of Novel Synthetic Opioids: A Deadly New Trend        
    image Novel synthetic opioids (NSOs) include various analogs of fentanyl and newly emerging non-fentanyl compounds. Together with illicitly manufactured fentanyl (IMF), these drugs have caused a recent spike in overdose deaths, whereas deaths from prescription opioids have stabilized. NSOs are used as stand-alone products, as adulterants in heroin, or as constituents of counterfeit prescription medications. During 2015 alone, there were 9580 deaths from synthetic opioids other than methadone. Most of these fatalities were associated with IMF rather than diverted pharmaceutical fentanyl. In opioid overdose cases, where the presence of fentanyl analogs was examined, analogs were implicated in 17% of fatalities. Recent data from law enforcement sources show increasing confiscation of acetylfentanyl, butyrylfentanyl, and furanylfentanyl, in addition to non-fentanyl compounds such as U-47700. Since 2013, deaths from NSOs in the United States were 52 for acetylfentanyl, 40 for butyrylfentanyl, 128 for furanylfentanyl, and 46 for U-47700. All of these substances induce a classic opioid toxidrome, which can be reversed with the competitive antagonist naloxone. However, due to the putative high potency of NSOs and their growing prevalence, it is recommended to forgo the 0.4 mg initial dose of naloxone and start with 2 mg. Because NSOs offer enormous profit potential, and there is strong demand for their use, these drugs are being trafficked by organized crime. NSOs present major challenges for medical professionals, law enforcement agencies, and policymakers. Resources must be distributed equitably to enhance harm reduction though public education, medication-assisted therapies, and improved access to naloxone.
              Prescribe to Prevent: Overdose Prevention and Naloxone Rescue Kits for Prescribers and Pharmacists        
    imageIn March of 2015, the United States Department of Health and Human Services identified 3 priority areas to reduce opioid use disorders and overdose, which are as follows: opioid-prescribing practices; expanded use and distribution of naloxone; and expansion of medication-assisted treatment. In this narrative review of overdose prevention and the role of prescribers and pharmacists in distributing naloxone, we address these priority areas and present a clinical scenario within the review involving a pharmacist, a patient with chronic pain and anxiety, and a primary care physician. We also discuss current laws related to naloxone prescribing and dispensing. This review was adapted from the Prescribe to Prevent online continuing medical education module created for prescribers and pharmacists (http://www.opioidprescribing.com/naloxone_module_1-landing ).
              Inpatient Gamma-Hydroxybutyrate Detoxification: A Case Report Describing Day-to-day Therapeutic Management        
    imageBackground: Gamma-hydroxybutyrate (GHB) is a synthetic drug increasingly used by consumers of psychoactive substances. The sought after psychoactive effects of GHB have resulted in an increase in recreational use in Europe. GHB is considered to have a high dependence potential, and abrupt discontinuation after long-term use can result in a severe withdrawal syndrome. Despite a large number of publications related to GHB withdrawal and detoxification, to date, no evidence-based protocol or consensual international therapeutic guidelines are available (over and above the administration of benzodiazepines). We hereby present a day-to-day description of inpatient GHB detoxification management, from admission to discharge. Case Summary: This case report pertains to a 47-year-old patient hospitalized for a severe GHB use disorder. The patient had independently made several unsuccessful attempts to stop GHB use. Following to these failures, the patient was oriented to our addiction department for inpatient detoxification. Withdrawal symptoms appeared 4 hours after the last dose of GHB, and consisted of diaphoresis, coenesthetic hallucinations, tremors, motor instability, tachycardia, and a hypertensive peak. Symptoms were successfully managed with diazepam titration and nonpharmacological treatment. The duration of hospitalization was 13 days. At discharge, detoxification was complete and the patient was engaged in relapse prevention therapy. Three months after discharge, the patient had maintained abstinence. Conclusions: GHB withdrawal, which can be severe, is better prevented or attenuated by daily medical monitoring and adjustment of treatment dosage. Failure of outpatient detoxification should be included in the indication criteria in the guidelines for inpatient detoxification.
              How to Deliver a More Persuasive Message Regarding Addiction as a Medical Disorder        
    Many members of our field are frustrated that the public does not see addiction as a legitimate medical disorder which should be compassionately addressed as a health problem rather than a criminal justice problem. Although some attribute the disconnect to the public's lack of scientific knowledge or attachment to outdated moral views regarding substance use, this commentary suggests that the problem may well be our own messaging. We would be more persuasive if we acknowledged that addiction is different from most medical disorders because of its high negative externalities, and that this understandably makes the public more scared of and angry about addiction than they are about conditions like asthma, type II diabetes, and hypertension. Relatedly, because of the amount of violence and other crimes associated with addiction, we should acknowledge that the public's belief that law enforcement has an important role to play in responding to addiction has a rational basis.
              Nonmedical Prescription Opioid Use for the Self-treatment of Pain in Young Adults: A National Shame        
    Evans et al. (2017) have pointed out how frequently and pervasively nonmedical prescription opioid use is associated with severe pain in young adults, especially young white males. This is a subset of such nonmedical users at tremendous risk of overdose (indeed 1/3 of the study respondents had an overdose event), especially given their concomitant use of benzodiazepines. Avoiding further contributing to the catastrophic rise in overdoses requires access to comprehensive pain care for these young adults. If they were to require opioid therapy, it would have to be in the context of a highly complex and expert variety of such care. If we fail to make it available, we will fail to address the root cause of overdoses for a sizeable subset of nonmedical prescription opioid users.
              â€œMeth Mouth”: An Interdisciplinary Review of a Dental and Psychiatric Condition        
    imageObjective: Chronic methamphetamine (MA) users experience many dental problems, a condition characterized as “meth mouth.” These devastating effects on dentition is the main reason why many seek professional help. Here, we discuss the effects of MA on oral health and advocate for improved collaboration between dentists and mental health providers. We also introduce a dental evaluation tool with the goal of improving the quality of care for this often-marginalized patient population. Methods: A Medline literature search (1985–2016) was conducted with keywords “meth mouth,” “methamphetamine AND oral health”; “methamphetamine AND dental”; “methamphetamine AND dentist.” Results were supplemented by references gleaned from recent reviews, credible online sources, and citations of search returns. Results: MA predisposes users to tooth decay. They are also more likely to have missing dentition with a linear relationship correlating the number of years of use. A constellation of dental symptoms resulting from chronic MA use has been described in literature: gingival inflammation, excessive tooth wear, decreased salivary output, and severe dental caries. With continued use, mucosal lesions may appear on the lips and the gingival tissue may recede. MA can trigger bruxism, resulting in severe wear patterns and even cracked teeth. Conclusions: Users of MA have many unmet medical and mental health needs. An interdisciplinary approach between dentists and mental health providers can improve outcomes. The dental evaluation tool described here can improve the bidirectional collaboration between mental health and dentistry. Dental professionals are in a unique position to identify users and can facilitate referral to substance abuse treatment. Likewise, mental health providers can identify, assess severity, and prompt users for medical and dental attention.
              Medications For Addiction Treatment: Changing Language to Improve Care        
    The term medication-assisted treatment has been widely adopted in reference to the use of opioid agonist therapy. Although it is arguably better than the older terms of replacement or substitution therapy, medication-assisted treatment implies that medications are a corollary to whatever the main part of treatment is. No other medication for other health conditions is referred to this way. It has finally been recognized that to improve care and reduce stigma, we must use medically accurate and person-first language, describing those with the disease of addiction as people with substance use disorder. However, to truly change outcomes, we must also alter the language of treatment.
              Associations Between Physical Pain, Pain Management, and Frequency of Nonmedical Prescription Opioid Use Among Young Adults: A Sex-specific Analysis        
    imageObjectives: We sought to determine sex-specific associations between experiences of physical pain, pain management, and frequency of nonmedical prescription opioid (NMPO) use among young adults. Methods: Among participants enrolled in the Rhode Island Young Adult Prescription Drug Study, we identified associations between physical pain in the past 6 months, pain history, pain management, polysubstance use, and weekly NMPO use. In sex-specific models, independent correlates of weekly NMPO use were identified via modified stepwise Poisson regression. Results: Of 199 participants, the mean age was 24.6, and 65.3% were male. The racial composition was 16.6% black, 60.8% white, and 22.1% mixed or other race. A total of 119 (59.8%) participants reported weekly or greater NMPO use. The majority of male (86.2%) and female (84.1%) participants reported ever experiencing severe pain. A majority of males (72.3%) and females (81.2%) reported that they engaged in NMPO use to treat their physical pain, and one-quarter (26.9%) of males and one-third (36.2%) of females had been denied a prescription from a doctor to treat severe pain. Among males, frequent NMPO use was independently associated with white race (P < 0.001) and reporting greater physical pain (P = 0.002). Among females, older age (P = 0.002) and monthly or greater nonmedical benzodiazepine use (P = 0.001) were independently associated with weekly NMPO use. Conclusions: Among young men in Rhode Island, physical pain may be related to frequent NMPO use. More research is needed to identify sex-specific, pain-related factors that are linked with NMPO use to improve harm reduction and pain management interventions.
              An Argument for Change in Tobacco Treatment Options Guided by the ASAM Criteria for Patient Placement        
    imageTobacco use is a major threat to public health in the United States, and the number one cause of preventable death. Although most smokers try to quit unaided, robust data indicate that pairing behavioral support to US Food Drug Administration-approved cessation medications significantly increase cessation rates. Those who do receive assistance in quitting usually receive very low intensity treatment, regardless of the severity of their dependence or their medical and environmental circumstances. This is in stark contrast to how other substance use disorders are treated, where there are varying levels of care depending on addiction severity and biopsychosocial circumstances. The American Society of Addiction Medicine (ASAM) developed a formal algorithm for assessing substance use disorders and determining the optimal level of care. The ASAM Patient Placement Criteria are regularly used to determine the appropriate level of care for all substance use disorders except tobacco. This paper will review key aspects of the ASAM dimensions of care and placement levels, with emphasis on how they apply to tobacco use and present case examples of typical smokers who would benefit from a higher intensity of tobacco dependence treatment. We also present current barriers to reimbursing healthcare providers for these services. We conclude with a commentary and discussion regarding recommendations for improvements in tobacco dependence treatment care.
              Tobacco Use Disorder Among Patients With Smoking-related Chronic Medical Disease: Association With Comorbid Substance Use Disorders        
    imageIntroduction: Very little is known of the behavioral vulnerabilities of patients diagnosed with smoking-related chronic medical illness who continue to smoke, potentially worsening morbidity and mortality risks. This study explores the association of tobacco use disorder (TUD) among those with smoking-related chronic medical illnesses with other substance use disorders (SUDs) and risk factors. Methods: Among veterans with smoking-related chronic medical illnesses identified from the National Veterans Health Administration administrative records from fiscal year 2012, we compared the characteristics of those with a diagnosis of TUD (International Classification of Diseases, 9th edition code 305.xx; n = 519,918), and those without such a diagnosis (n = 2,691,840). Using multiple logistic regression, we further explored the independent association of factors associated with TUD. Results: SUD prevalence was markedly higher among those with TUD (24.9% vs 5.44%), including alcohol use disorder (20.4% vs 4.3%) and drug use disorder (13.5% vs 2.6%), compared with nonsmokers. On multiple logistic regression analyses, alcohol use disorder (odds ratio [OR] 2.94, 95% confidence interval [CI] 2.90–2.97) and drug use disorder (OR 1.97, 95% CI 1.94–1.99) were independently associated with current TUD diagnosis. Having any single SUD was associated with considerably high odds of having TUD (OR 3.32, 95% CI 3.29–2.36), and having multiple SUDs with even further increased risk (OR 4.09, 95% CI 4.02–4.16). Conclusions: A substantial proportion of people with TUD diagnosis despite concurrent smoking-related medical illnesses are also likely to have other comorbid SUDs, complicating efforts at smoking cessation, and requiring a broader approach than standard nicotine-dependence interventions.
              Alcohol, Cannabis, and Opioid Use Disorders, and Disease Burden in an Integrated Health Care System        
    imageObjectives: We examined prevalence of major medical conditions and extent of disease burden among patients with and without substance use disorders (SUDs) in an integrated health care system serving 3.8 million members. Methods: Medical conditions and SUDs were extracted from electronic health records in 2010. Patients with SUDs (n = 45,461; alcohol, amphetamine, barbiturate, cocaine, hallucinogen, and opioid) and demographically matched patients without SUDs (n = 45,461) were compared on the prevalence of 19 major medical conditions. Disease burden was measured as a function of 10-year mortality risk using the Charlson Comorbidity Index. P-values were adjusted using Hochberg's correction for multiple-inference testing within each medical condition category. Results: The most frequently diagnosed SUDs in 2010 were alcohol (57.6%), cannabis (14.9%), and opioid (12.9%). Patients with these SUDs had higher prevalence of major medical conditions than non-SUD patients (alcohol use disorders, 85.3% vs 55.3%; cannabis use disorders, 41.9% vs 23.0%; and opioid use disorders, 44.9% vs 26.1%; all P < 0.001). Patients with these SUDs also had higher disease burden than non-SUD patients; patients with opioid use disorders (M = 0.48; SE = 1.46) had particularly high disease burden (M = 0.23; SE = 0.09; P < 0.001). Conclusions: Common SUDs, particularly opioid use disorders, are associated with substantial disease burden for privately insured individuals without significant impediments to care. This signals the need to explore the full impact SUDs have on the course and outcome of prevalent conditions and initiate enhanced service engagement strategies to improve disease burden.
              A Survey of ASAM Members’ Knowledge, Attitudes, and Practices in Urine Drug Testing        
    imageObjectives: Urine drug testing (UDT) can play an important role in addiction medicine. Indeed, the American Society of Addiction Medicine (ASAM) recently released a white paper, detailing the history of UDT, emphasizing recent advances in the laboratory and clinical science of UDT, and discussed the potential for broadening clinical utility of UDT. We conducted a survey of ASAM members to better understand their knowledge, attitudes, and practices with regard to UDT. Methods: ASAM leadership along with clinical and laboratory experts developed a large pool of items on knowledge, attitudes, and practices around the use and implementation of UDT. These were condensed and converted to a web-based format. Two mass e-mails were sent for recruitment to the survey, with the first e-mail resulting in an open rate of 37% and the follow-up e-mail having an open rate of 34%. Results: A total of 365 respondents completed the survey, with 51% indicating they were Board Certified in Addiction Medicine/Addiction Psychiatry. Up to 93% of respondents indicated they were waivered to prescribe buprenorphine, and 20% indicated that they were certified as a Medical Review Officer (MRO). A total of 93% felt confident in their ability to interpret the results of UDT, 90% used UDT to monitor both medication and illicit substance use, and 79% either agreed (48%) or strongly agreed (31%) with the statement “it is important to do adulteration testing for aberrant behavior.” Urine drug testing was most likely to be ordered “when a patient is demonstrating problematic behavior” (70%), and for “baseline testing for new patients plus random selection of current patients” (57%). Significance: The survey revealed that UDT is widely used and highly integrated into the assessment and management of people with addictions undergoing treatment by ASAM members. Greater than 94% of respondents use testing to determine adherence, to monitor abstinence, and to detect an early relapse. The majority felt confident in their ability to interpret and use UDT results, and the vast majority had reportedly used it in changing patient management. Education gaps do exist, however, and should be the focus of future education efforts on UDT.
              Medical Chopper Rushes in to Assist injured in France        
    French media reports a truck plowed into a large crowd of people as they enjoyed Bastille Day celebrations in Nice, France. Several dozens of people were killed.
              Adeus, Bafana        
    Olha........ confesso que não fico triste pelo Mandela ter morrido não. Morreu com 95 (!!!) anos, depois de quase 30 desses na prisão, depois de tanta coisa.. e como estou lendo aqui na BBC (http://www.bbc.co.uk/news/world-africa-25249520):

    "He had been receiving intensive medical care at home for a lung infection after spending three months in hospital."

    Nossa, horrível ficar assim. :(

    Outra:

    "Our nation has lost its greatest son," Mr Zuma said.

    Discordo do presidente, diria que ele é um pai pra nação, não um filho. Merece um dia a ser celebrado, como o MLK nos EUA.

    Por último: na minha concepção ele finalmente está descansando. Dever mais que cumprido.

    Recomendo o filme Mandela - Luta pela liberdade
    http://www.imdb.com/title/tt0438859/
    http://www.cineteka.com/index.php?op=Movie&id=002976

    E há também o filme Invictus.
              LIFE BEHIND BARS IN CHANGI PRISON (PART 4)        

    Different type of prisoners

    Special Needs Prisoners
    This are prisoners who have special needs. They are mostly suicidal or mentally disturb. They are placed in cells where the lights are on 24/7. They can be identified with the color shorts with stripes on it

    Young Prisoners
    These are young prisoners who are below 18 or 19 when they were sentenced. They are placed with prisoners around the same age group to prevent them from being influence by hardcore criminals.

    Remand Prisoners
    They are identified with the brown shorts they wear. These people are not yet convicted of the crime they had been accused. They are remanded bcos they cant afford the bail set by the Court or that no no bail was offered for their cases.

    Family Visits
    All prisoners are allow 2 visits per calendar month except Remand Prisoners who are permitted once a week.

    Visits can either be in person by the family or thru Televisit from a number of sites in SG.

    Visit in person. Family members are allow to see the prisoners face to face but are sperated by a glass panel. They chat via intercom phone system.

    Visit thru televisit. The family can go to some Cisco offices located in Jurong, Paya Lebar Toa Payoh or some other places wher ethey offer such facilities. It is like watching TV where the prisoners and family members view and speak to each other thru TV.

    For Televisit, the time limit is 30 mins for face to face visit is 20 mins.

    Family members are allow to give prisoners books/magazines/religious books, etc.

    These materials will be screened and censored by the Prison to prevent any obscene materials or hidden messages to get pas thru to the prisoners.

    Only family members are entitled to such visits. Friends who wish to see the prisoners must get the approval of the Prison Dept before they are allowed to visit. The prisoner must make this request.

    Anyone who had previously been in prison are not allowed to visit any other prisoners unless they are family member as well as get the permission from Prison Dept

    Letters
    All prisoners are permitted to write to anyone they want to. All outgoing and incoming letters are also screened and censored.

    Transfers
    After the initial stay in cluster B, prisoners are transferred to other HU to serve their sentences.

    This could be AWP (Admirality West Prison), this is a min security prison that usually house foreigner prisoners.

    Others are transferred to other HU in CPC. The new cells can house up to 8 prisoners and is twice the size of the previous 4 men cell. (Like the one in 3 Good Men movie). There is usually a mixture of racial here.

    LT and ST HU are seperated. LT prisoners are housed with other LT prisoners. ST prisoners are housed with other ST prisoners.

    All prisoners are eligible to be transferred as and when required for reasons varying from influence, checks, medical, etc

    Pre Release HU
    This HU house those who are about to be release. Usually for those with less than a mth or so. This is the last stop before the prisoner is finally released.

    Why Life is Tough
    Imagine yourself being lockup in a room without a fan, bed, etc. for 23 hrs a day and up to 48 hrs on weekends. If a PH falls on a Fri or a Mon, they can be lock up for up to 72 hrs.

    You will spend time thinking about your family outside for those who are married with kids and those who have GF outside will also think of them often and reflect on one's mistake that lead to his/her imprisonment.

    Some prisoners goes mad bcos of constance thoughts of their loved ones.

    Some prisoners emo alot inside.
    Sleeping on the hard floor for the entired period of your sentence.

    You need to know who not to offend inside and I dont mean the Wardens.

    There is no freedom, you cant walk to the coffeeshop to get the coke you want, you cant walk to the foodcourt to get the Chicken rice you crazed for.

    Everything is controlled and is disciplined. Your movements are also restricted and controlled.

    You need to strip whenever you go for yard.

    You need to sqat down whenever they are transferring you from 1 HU to another.

    What Prisoners do to pass time
    Most will just eat, sleep and TCSS with fellow inmates

    Some were exercise inside the cells.

    Some do reading or studying

    Some innovative prisoners will make board games like scrabble, chess, checkers, etc with material from the magazines and rice as glue.

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              LIFE BEHIND BARS IN CHANGI PRISON (PART 3)        

    <strong>1/3 off for good behaviors</strong>

    All prisoners except for certain type of prisoners which I will elaborate on later in this thread. These prisoners are eligible for 1/3 off their sentrence for good behavior. This means that they only served 2/3 of the sentence imposed by the judge. This is also known as minus PH and weekends to some of you.

    This entitlement is for those who behaves themselves inside the prison while doing their time. Those who fight or misbehave will not be granted the above.

    There are 2 dates on the prisoner's card that is put outside his/her cell. This cardboard card will reflect the prisoners' name, Prison number, medical needs, special care (if any), EDR (Earliest Date of Release - this is the date of release after deducting 1/3 off) and LDR(Late Date of Release - the original date where the prisoner is supposed to be released)

    Those who are sentenced for CT (Corrective Training) are not eligible for this incentive as they are repeated offenders.

    Only those who had been sentenced to more than 14 days in prison are entitled. Last time yardstick was 3 mths.

    <strong>Caning </strong>

    All those who are sentenced to rotan will get a medical checkup before the caning. They must be certified fit by a Doctor. The caning must be done before the prisoner reach 50 yrs old.

    Regardless of how many strokes the Court imposed, all the rotans were be done on the same day unless the prisoner is unfit to carry on during the caning.

    The prisoner is secured to a standing platform where only his butts are exposed. The warden will then pick any of the canes in the room and procceed with the caning.

    As a general rule of the thumb, it is strongly advised that a person should never scream in pain when being cane or you will be the laughing stock of the rest of the prisoners.

    <strong>Home Dentention Schemes </strong>

    This scheme is opened to all prisoners except those on RT or had committed serious crimes or is a foreigner.

    The eligible prisoner has to served at least 50% of his sentence after the 1/3 off scheme for good behavior

    This scheme is where the prisoner is released from prison to serve his/her remaining time at home and is part of the rehabitation of the prisoner. The prisoner's family members like wife/husband/sister/brother/parents must be agreeable to this before the prisoner can go on this scheme

    A device is used and put on the ankle or wrist of the prisoner. A monitoring device is also placed in his/her house. The device linked to Cisco will sound if the tag is out of its monitoring zone in the house during the period of time when the prisoner is supposed to be at home.

    The prisoner is supposed to be at home during a certain set period of time. He/She can only be out of the house when working/studying where prior pernission must be granted by his/her supervisory warden.

    There are strict rules for this scheme
    1) Must be at home during the period of time when he/she is supposed to be
    2) Cannot indulge in vice like gambling, drinking, drugs or smoking
    3) No tampering of the device or monitoring system
    4) Subject to s/check via calls to residential house number or visits
    5) Subject to random urine test

    Any breaches will result in the home scheme being cancelled for the prisoner

    <strong> Courses </strong>

    Educational or skill courses are offered to prisoners to improve their employablities after their release, its also part of the rehabitional programme that the Prison dept undertakes.

    <strong>Yellow Ribbon Project</strong>

    This dept help former inmates to find jobs after their release

    Editor's Note: 

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              Eat Your Heart Out        
    The Eat Your Heart Out Cake Shop (NSFW), with cakes graphically illustrating medical conditions and symptoms of disease, will be open from October 26th-28th at London's Pathology Museum at St Bart's Hospital. A gallery of some of the best cakes on display (nsfw)
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              Wake Forest Baptist Provides Free Back-to-School Guide to Help Keep Student Athletes Healthy        
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              Wake Forest Baptist Welcomes Wilkes Medical Center into Its Health Care Family with a Celebration for Town Leaders and Employees        
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              Head Impact Exposure Increases as Youth Football Players Get Older Bigger        
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              Wake Forest Baptist Opens Integrative Medicine Clinic        
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              Brenner Children’s Hospital Named Lead Agency of the Year by Safe Kids North Carolina        
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              Wake Forest Medical Alumni Association Honors Five Physicians        
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              CEO Julie Ann Freischlag to Serve as Interim Dean of Wake Forest School of Medicine        
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              Intensive Lowering of Blood Pressure Can Reduce Risk of Harm to Heart Muscle        
    A new study by researchers at Wake Forest Baptist Medical Center has shown that aggressive lowering of blood pressure in people with hypertension reduced the risk of left ventricular hypertrophy (LVH). This condition, the enlargement and thickening of the walls of the heart’s main pumping chamber, is the most common complication of high blood pressure and greatly increases the risk of developing cardiovascular disease.   
              Wake Forest Baptist Continues Efforts to Improve Outcomes for Stroke Survivors and their Families        
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              Wake Forest Baptist Fiscal Year 2017 Third Quarter Performance        
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              Wake Forest Baptist Research Shows Positive Outcomes for Kidney Transplants in Children with Intellectual Disabilities        
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              Wilkes Regional Medical Center Chooses New Name for its Future with Wake Forest Baptist        
     Wilkes Regional Medical Center Chooses New Name for its Future with Wake Forest Baptist 
              Dermatologists to Offer Free Skin Cancer Screening        
    Dermatologists with Wake Forest Baptist Medical Center will offer free skin cancer screenings on Thursday, May 18 from 5:30 p.m. until 7:30 p.m. at Medical Plaza – Country Club, located at 4618 Country Club Road in Winston-Salem.
              Reduction of Post -Traumatic Stress Symptoms Associated with Non-invasive Neurotechnology        
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              Temporary Visitor Restrictions to be Lifted at Wake Forest Baptist        
    Effective Tuesday, April 18 at 7 a.m., temporary visitor restrictions in place at Wake Forest Baptist Medical Center, Wake Forest Baptist Health-Lexington Medical Center and Wake Forest Baptist Health-Davie Medical Center will be lifted.
              ATV Related Injuries in Children Remain Large Public Health Problem        
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              Head of National Institute on Drug Abuse to Speak about Opioid Epidemic        
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              Wake Forest Baptist Recognized as a Leader in LGBTQ Health Care Equality by the Human Rights Campaign        
     Wake Forest Baptist Medical Center today was acknowledged for its leadership and commitment to provide quality, equitable and inclusive patient- and family-centered health care to all.  
              Wake Forest Baptist Opens First New Inpatient Hospital in Davie County in 61 Years        
    Wake Forest Baptist Medical Center today announced completion of the 50-bed inpatient wing at Wake Forest Baptist Health - Davie Medical Center.
              A Little Vigorous Exercise May Help Boost Kids Cardiometabolic Health        
    As little as 10 minutes a day of high-intensity physical activity could help some children reduce their risk of developing heart problems and metabolic diseases such as diabetes, according to an international study led by a researcher at Wake Forest Baptist Medical Center.
              Wake Forest Baptist’s AirCare Flight Team Brings Home the Gold Two Years in a Row        
    For the second straight year, four flight paramedics with AirCare Critical Care Transport Services at Wake Forest Baptist Medical Center have won a national competition of professional emergency medical services teams. Roger Horton, NREMT-P, Barry McMillian, NREMT-P, Robert Coleson, NREMT-P, and Justin Bowers, NREMT-P – all of whom are stationed at the AirCare base at the Elkin Municipal Airport in Surry County – placed first in the Journal of Emergency Medical Services (JEMS) 2017 Games Advanced Clinical Competition, held in Salt Lake City at the end of February. The competition attracted 24 teams from across the country and around the world.
              Having Athletic Trainers Could Benefit Youth Football Organizations        
    Youth football organizations can benefit from the presence of a certified athletic trainer at their practices and games, according to an anecdotal report by researchers at Wake Forest Baptist Medical Center.
              Wake Forest Baptist Breaks Ground on Outpatient Surgery Facility in the Village of Clemmons        
    Wake Forest Baptist Medical Center, in partnership with Surgical Care Affiliates (SCA), a leader in the outpatient surgery industry, today broke ground to signal the official start of construction of a 12,500-square-foot outpatient surgery center at Wake Forest Baptist Health Medical Plaza – Clemmons.It will be the first standalone outpatient surgery center in the Village of Clemmons.
              Wake Forest Baptist Fiscal Year 2017 Second Quarter Financial Performance        
    Wake Forest Baptist Medical Center released its second quarter report on operating performance and operating statistics for fiscal year 2017 (FY17) today and reported improvements in key areas primarily driven by volume growth in the clinical enterprise.
              Temporary Visitor Restrictions to be Implemented at Wake Forest Baptist Medical Center        
     To protect the health of patients, their loved ones and the medical staff, at 7 a.m. Friday, Feb. 24, Wake Forest Baptist Medical Center will implement temporary visitor restrictions that will remain in effect through the remainder of the flu season.  
              Wake Forest Baptist Names Julie Ann Freischlag M D Chief Executive Officer        
     Wake Forest Baptist Medical Center today announced Julie Ann Freischlag, (pronounced FRY-shlog), M.D., as its new chief executive officer (CEO). Freischlag joins the medical center on May 1 and succeeds CEO John D. McConnell, M.D., who last year announced that he would transition to a new position at the Medical Center, after leading it since 2008.  
              Kidney Function in Stroke Patients Associated with Short-term Outcomes        
    A routine blood test that measures kidney function can be a valuable predictor of short-term outcomes for stroke patients, according to a study led by a neurologist at Wake Forest Baptist Medical Center.
              Wake Forest Baptist December Awards and Recognitions        
    Wake Forest Baptist December Awards and Recognitions Wake Forest Baptist Anesthesiologist Receives Alumni Award   James Eisenach, M.D. , professor of anesthesiology at Wake Forest Baptist Medical Center , has received the 2016 Mayo Clinic Distinguished Alumni Award (MCDAA). T
              At 54, Medical Student Looks Forward to her Second Career        
     At 54, Medical Student Looks Forward to her Second Career
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              Wake Forest Baptist to Provide Athletic Training Services at All 12 Winston Salem Forsyth County High Schools        
    The Winston-Salem/Forsyth County Board of Education agreed Tuesday to collaborate with Wake Forest Baptist Medical Center to provide certified athletic trainers at public high schools in the Winston-Salem/Forsyth County Schools (WS/FCS) system. The Board has long looked to develop a sports medicine and athletic trainer program for its high schools in an effort to prevent injuries and minimize the risk of injuries to student athletes. To achieve uniformity in programming, care, standards, and protocols provided to student athletes throughout the WS/FCS, the Board saw Wake Forest Baptist as best to provide a certified athletic trainer (ATC) program.
              99.5 WMAG Partners with Brenner Children’s Hospital for Radiothon        
    For the 13th time, 99.5 WMAG will broadcast a two-day radiothon to benefit Brenner Children’s Hospital, part of Wake Forest Baptist Medical Center, on Thursday and Friday, Dec. 1-2. On-air personalities Lora Songster and Gary Nolan will lead the event, which will be broadcast from 7 a.m. to 6 p.m. each day. The funds raised are used to advance patient care at Brenner Children’s. The previous 12 radiothons have raised more than $1 million.
              Wake Forest Baptist Offers Zero-Percent Interest Loan Program to Help Patients Manage Health Care Costs        
    Wake Forest Baptist Medical Center has partnered with Commerce Bank to offer patients interest-free loans for up to $50,000 to help plan for and manage their health care costs over an extended period of time. The interest-free loan program is available to both new patients and existing patients with a current balance. 
              Wake Forest Baptist Fiscal Year 2017 First Quarter Financial Performance        
    Wake Forest Baptist Medical Center released its first quarter report on operating performance and operating statistics for fiscal year 2017 (FY17) today and reported improvements in key areas driven primarily by volume growth in the clinical enterprise.
              Wake Forest Baptist to Start Construction of an Outpatient Surgery Facility in Clemmons        
    Wake Forest Baptist Medical Center, in partnership with Surgical Care Affiliates (SCA), a leader in the outpatient surgery industry, today announced construction of a new outpatient surgery facility at Wake Forest Baptist Health – Medical Plaza Clemmons.
              Petey Atrix and Simone to Teach Wake Forest School of Medicine Students about Treating Pediatric Patients        
    During the Bowman Gray Center’s Opening Day Tour at the new facility, the donor learned of the need and wanted to make a difference in the medical education of future pediatric physicians. Thanks to this donor’s $80,000 donation, the School of Medicine was recently able to buy two pediatric manikins. 
              Brain Volume Predicts Successful Weight Loss in the Elderly        
    If you’re trying to lose weight, what are your chances of success? Your brain may hold the key. Scientists at Wake Forest Baptist Medical Center believe they may have found a way to predict who will be successful in their weight-loss efforts with a quick, non-invasive brain scan. 
              Women Experience Marked Decline in Sexual Function in Months Immediately Before and After Onset of Menopause        
    Women experience a notable decline in sexual function approximately 20 months before and one year after their last menstrual period, and that decrease continues, though at a somewhat slower rate, over the following five years, according to a study led by a researcher at Wake Forest Baptist Medical Center.
              National Foundation Names Wake Forest Baptist a Pancreatic Cancer Center        
    Wake Forest Baptist Medical Center has been designated a Pancreatic Cancer Center by the National Pancreas Foundation (NPF).
              Wake Forest Baptist Research Team Receives $2 Million Award        
    A research team at Wake Forest Baptist Medical Center has been awarded a three-year grant for $2 million by the Patient-Centered Outcomes Research Institute (PCORI) to compare the effectiveness of cognitive-behavior therapy and yoga on anxiety in older adults.
              Wake Forest School of Medicine Transforms How K-12 Students Learn by Offering Problem-Based Learning Training to Teachers        
      The Center of Excellence for Research, Teaching and Learning (CERTL) at Wake Forest School of Medicine, part of Wake Forest Baptist Medical Center, hosted 175 K-12 teachers from 86 schools in 16 Piedmont Triad school districts this week as part of their commitment to providing effective problem-based learning training to educators. The ongoing training provides local teachers with the tools and knowledge to effectively prepare K-12 students for careers in science, technology, engineering and math – commonly known as STEM.  
              Wake Forest Baptist Offers Free Celiac Disease Screenings        
    Medical providers with Wake Forest Baptist Medical Center will offer free blood testing to screen for celiac disease on Saturday, Oct. 22. This event will run from 10 a.m. until 4 p.m. at Wake Forest Baptist Health – Medical Plaza Clemmons, located at 2311 Lewisville-Clemmons Rd. in Clemmons.
              Wake Forest School of Medicine Offers Students First EMS Course in the State to Study Health Disparities        
      In an ongoing effort to better prepare medical students for a career in emergency medicine, Wake Forest School of Medicine, part of Wake Forest Baptist Medical Center is offering an emergency medical services elective course for fourth year students. The School of Medicine is the first medical school in North Carolina and one of only a few nationwide to offer such a program.  
              Wake Forest Medical Alumni Association Honors Three        
     Wake Forest Medical Alumni Association Honors Three
              Acupuncture Reduces Hot Flashes for Half of Women, Study Finds        
    Hot flashes – the bane of existence for many women during menopause – can be reduced in frequency by almost half for about 50 percent of women over eight weeks of treatment, according to scientists at Wake Forest Baptist Medical Center. 
              Wake Forest Baptist Gets Federal Grant for Alzheimer’s Research Center        
    The National Institutes of Health (NIH) has awarded Wake Forest Baptist Medical Center a grant worth an estimated $8.7 million over five years for the establishment of a new center for research into Alzheimer’s disease.  
              Deacon Gallery to Officially Open at Bowman Gray Center for Medical Education        
     Deacon Gallery to Officially Open at Bowman Gray Center for Medical Education
               Learning to prescribe – pharmacists' experiences of supplementary prescribing training in England         
    Cooper, Richard J. and Lymn, Joanne and Anderson, Claire and Avery, Anthony and Bissell, Paul and Guillaume, Louise and Hutchinson, Allen and Murphy, Elizabeth and Ratcliffe, Julie and Ward, Paul (2008) Learning to prescribe – pharmacists' experiences of supplementary prescribing training in England. BMC Medical Education, 8 (57). p. 8. ISSN 1472-6920
              Hijinks        
    “7.5% silver, 8% copper, 15% nickel…” Kilorn reads off his mobiGlas display - his fancy new mining-focused mobiGlas that he was quite proud of. He had been hoping for a greater concentration of silver but decided this would be fine to test out the new mining system he’d bought for his Dragonfly.  He was pretty sure he was going to fly slow as shit once the saddlebags were all filled up… but Kilorn certainly didn’t have the money for a Prospector yet. It’d have to do. Jumping on his forest green Dragonfly, Kilorn fires up the small craft and starts up the small mining drill, focusing on the area scanned by his mobiGlas. Due to this being a very small scale mining operation there wasn’t a ton of operator involvement… Kilorn’s mind wandered.  Where did it wander you might ask?  Well… he was only 19 so naturally his thoughts drifted towards girls.  Or, really, girl.  Norah. Norah is Kilorn’s best friend, partner in crime, and also the gorgeous girl he was crazy about.  Was she aware of that third note?  Not so much. Kilorn drifted away from consciousness briefly while deep in thought about his friend. “Kilo!” He was startled awake by someone shouting his nickname and his Dragonfly being shoved a few feet.  Struggling to get his bearings, he whipped his head around to glare at the perpetrator and his vision was filled with the beautiful mischievous grin of his friend. Norah sat astride her deep purple Dragonfly, sporting a rainbow coloured flight suit and long black hair that flew wildly in the wind as she rode.  Purple leather boots, one of which was fresh off having booted his saddlebag, adorned her feet and served to complete her ensemble. “Race me.  Last one to the ravine pays for dinner tonight.” “Norah… my Dragonfly is covered in mining equipment.” “Excuses.  Your propulsion is tuned and you have more experience.” “Fine.” Kilorn rapidly retracted the mining equipment and took off across the savannah-like terrain, pushing his Dragonfly to the limit. Despite his head start Norah had reacted quickly and was not far behind. They dodged and weaved around rock outcroppings, occasionally losing sight of each other for several seconds. BAM! Norah didn’t even recall the sounds of crunching metal.  She woke up with a pounding headache and good deal of confusion.  Kilo’s concerned face loomed over her. Norah’s ears were ringing… she could tell Kilo was trying to talk to her but she couldn’t hear at first. Finally she understood him and replied, “Kilo… Kilo, I think I’m okay.  Head hurts a bit though.  What… what happened?” A soft look came upon Kilorn’s eyes and he said, “We both came around that cliff at the same time from opposite directions. I don’t think either of us saw it coming.  We hit each other and unfortunately you got the worst of it… thrown from your ride.” Despite the pain and confusion, the look in Kilo’s eyes tugged at her.  It didn’t help when moments later he carefully removed her helmet and gently touched her face. Moments later Kilo leaned in to kiss her and all Norah could do… all she wanted to do really in that moment, was relax and return the affection. Kilorn pulled back and looked a bit guilty and worried. “Norah… I’m sorry.  Probably last thing you need at this moment.  Let’s get you to the medical unit.” “No Kilo, it was nice.  Thank you.  But yeah, my head isn’t feeling great.” Carefully Kilorn helped Norah to her feet and gently placed her on the back of his green Dragonfly.  After helping her get her helmet back on, he climbed on and began nursing his damaged ride back to the settlement. After a few minutes he felt Norah slump over and he stopped quickly, though carefully. “Norah?!” He jumped off and looked at her face closely… she was barely conscious.  Seeing no other alternative, Kilorn repositioned her gently on the front seat of the Dragonfly and then climbed on behind her, wrapping one arm protectively around her and using the other to start and navigate his craft. Kilorn pushed the Dragonfly faster, trying to get back as quickly as he could without crashing again. Despite repeated attempts, calling her name and shaking her lightly, he couldn’t get her to rouse. Spotting the settlement up ahead, Kilorn pushed the craft a bit faster though it groaned a bit in response. Pulling up outside the medical unit, he lifted Norah into his arms and quickly carried her inside. --- Hours later Kilorn had nearly lost his mind with worry. Finally a doctor strode out to see him, “Your friend is doing well…” A huge sigh of relief exploded from his chest. “Norah had some minor head trauma but we were able to take care of the damage.  You can come see her, she’s asking for you.” Wearing a bright smile Kilorn accompanied the doctor to Norah’s room and he rushed to her bedside. “I’m so glad you’re okay Norah!  I was so worried.  How’s your head?” “My head is feeling much better thanks to the doc.  I also need to thank you Kilo, I really appreciate you taking care of me.” “You would do the same for me.  Besides, I want another kiss.” The two shared a bright smile and then Norah chimed in, “Fine.  Once we get my purple beast fixed up we’ll really see who can be first to the ravine.  I win, I get to kiss you.  You win, you get to kiss me.” A deep chuckle was followed by, “Deal!”
              Tic-Talk Tonight: Theodore Felix-Grafton        
    Welcome to the newest edition of Tic-Talk, the transcript that follows is the full interview as conducted by Indira Nooyi with our guest interviewee, Theodore Felix-Grafton, local farmer from Goss I and former captain of the Nightingale. Interview was carried out on the planet Goss I on 2947-03-28. Indira Nooyi(IN): Good evening and welcome to another edition of Tic-Talk, for our traditional viewing audience this will be a bit of a departure from normal as this interview will be pre-recorded for the convenience of our current guest of tonight’s segment. Today I’m on the planet Goss I touring the farming operation of Theodore Felix-Grafton. Thank you for inviting us to your home, we really appreciate the chance to interview you today. Theodore Felix-Grafton(TFG): Well miss, the pleasure is all mine. Not every day a pretty young reporter visits this old man. IN: Well, we are here to highlight your unique story Mr. Felix-Grafton... TFG: No, no miss. Ted. Call me Ted. IN: Very well, Ted. Now your name came to our attention in a very indirect way, the producer of Tic-Talk heard about you from a neighbour of hers who told her a very interesting, wild story. Her neighbour maintains that you saved her life 22 years ago, from the Orion system. The thing that very much intrigued us at Tic-Talk tonight about this story was that, nobody has heard of this or even known about it until this very moment. I would have to say my very first question would be how do you think this managed to stay under the radar for so long? Cause you rescued how many people, Ted? TFG: Well, what I was doing wasn’t precisely sanctioned by the UEE. I was doing it to help people but I wasn’t sure how it would be received by the higher ups, so I asked those I saved to keep it a bit quiet. You know, not a secret to their friends and family but I asked them not to tell the media and such. My crew and I saved 47 people. Took some hits on our way out too… you can see some of the burns on Nightingale’s hull… like that one there. IN: So, these biodome pods you’re showing me now, once was the ship that took you to Orion system to save these 47 people? TFG: Interestingly, no. I couldn’t go in to Orion for this mission with biodome pods strapped to Nightingale… that just wouldn’t do. So Indira... may I call you Indira? IN: Of course, please do. TFG: So Indira, I called upon my dear friend Jack O’Leary who ran a Hope-class Endeavor named Mercy. He lent me his medical and landing bays for this mission. Interestingly these biodome pods have been here since then… I decided to bring Nightingale down here instead of bringing the farm pods back up… in the end. The rest of the buildings you see here are actually her, my ship.  Still protecting me. IN: Still living on, I’m sure she’s a comfort to you. I’m curious to know though why you decided to more or less invade the Orion system, risk discovery and possible death from the Vanduul, to rescue these people. Were they family? Friends? Was there a personal aspect that motivated you to do it? TFG: An old Genesis pilot I met in a freezing shithole of a bar in Oberon… I think the planet is Uriel? Anyway, he mentioned that he had heard from a reliable source that there were still folk stuck in Orion. Indira… two centuries of scraping together a life under constant threat of attack at any moment from the fucking Vanduul. Once I heard about those poor people I had to do something. But I’m not a fool. I checked with every source I could find and it seemed like the rumours had merit… that those people were actually there.  I thought I could help. Might’ve died trying, but what good is this ‘verse without people willing to help those who need it? IN: Very brave venture you undertook. Many of those families have been hiding or existing in Orion for generations now, the progeny of the original groups the UEE left behind when they vacated the system long ago. How did you know they wanted to be rescued or more to the point how did you get in touch with them to let them know you were coming? It otherwise might have been difficult to organize such a rescue. TFG: That’s the thing Indira, I couldn’t. I couldn’t risk the whole thing by broadcasting wide. I thought long and hard about it. If you were living in a place where you could die at any moment, even if it was home, wouldn’t you consider leaving so you and your family could be safe? IN: I would think so, but many of those families have grown accustomed to living stealthily. So, the 47 you rescued I would assume are the people you managed to either persuade to come with you or came of their own volition. Did you meet any Vanduul resistance either entering or leaving the system? TFG: Yeah… I was younger and a bit brash. I was going to Armitage to save people. If I had actually made it there I probably would have got everyone killed. As it turned out, during our pass by the main asteroid belt in Orion we got the luckiest and faintest hit on our sensors. We were a mite jumpy so at first we were sure it was the Vanduul come to tear us apart, but it became obvious after a few moments that it wasn’t anything of the sort. Turns out that a group of survivors from long ago had hidden out in the asteroid belt and eventually constructed a small space station out of several damaged ships and whatever scrap they could find. They had done a good job shielding it from scanners but the rickety thing was malfunctioning at that moment. IN: Sounds like a good bit of luck followed you into the Orion system. So, when you discovered the ‘space station’ did you manage to communicate with them or did you just send someone over to investigate? TFG: Still concerned about transmissions, I decided to just dispatch the ambulances from our bays to make contact. IN: And in doing so you found 47 survivors, and from what I’m hearing you arrived just at the right time before their current habitat started to fall into further disrepair.  Once you managed to dock with the station, you were able to evacuate the station and escape the system unscathed then? TFG: The folks were happy to see us. A bit wary, you understand, but once they knew fellow humans had come to help they were thrilled. They all came back with us. At that point the ship was getting very cozy… we had a total of 63 aboard. That was enough and from their tales it sounded like Armitage was a fool’s errand. Nightingale headed back for the jump point to Caliban but part way there we got the attention of a Vanduul patrol. They gave us a few scars for our efforts, though we ultimately were able to hold them off long enough to get through the jump. Caliban is no picnic either but thankfully we got through to Oberon unscathed. IN: Sounds like quite the adventure, Ted and I’m sure those 47 were unendingly grateful to you. I have one final question for you, after all that… what possessed you to give up a spacefaring life for that of a humble Goss farmer? TFG: They were grateful. They were. I was too though. It was the most exciting, nerve-wracking, and meaningful event of my life. That event grew some of my most cherished friendships. I still keep in contact with many of those folks. Interestingly, I actually married one of the survivors. Her name is Florence. Honestly after that I just felt that my adventuring days were over. It was time to come home, settle down, and do some work on the ground for once. For me at least, when it came down to it, I felt better to belong to a place. We’ve built a good life here, a nice place, don’t you think? IN: Indeed, it’s a very idyllic place to settle down and your story was not only inspiring but also shows that humanity can still do good things. Thank you for your time, Ted. I’m Indira Nooyi and this has been another edition of Tic-Talk, thanks for joining us and see you next week.  
              Centrelink Mandatory Drug Testing: Australian Drug Law Reform Foundation calls on the Australian Government to stop playing games with people's lives        

    In its drive to universally implement the Cashless Debit Card for all welfare recipients, the Abbott Government first targeted remote indigenous communities to ‘trial’ this income management restrict and control scheme. The Turnbull Government then selected certain low-socio economic urban areas for further trials.

    Now the Liberal-Nationals federal government intends to extend the reach of this card even further and from 1 July 2018 intends to impose compulsory drug testing on 5,000 new recipients of unemployment benefits – with all who test positive for alcohol or drugs being immediately placed on restricted and controlled payments regardless of their personal circumstances.

    All those government MPs and senators cushioned by generous salaries and benefits from life’s vagaries have chosen this group because of the illegality of many of the drugs it will test for, as they think that all Australians will blame those with substance abuse problems and feel comfortable with the idea that they should be punished in some way.

    These MPs and senators do not appear to give a toss that in an effort to eventually control the income support payments of all welfare recipients, it will socially profile and discriminate against a specific group of people with little if any positive outcomes flowing from this discrimination.

    Because it is admitted that cutting off access to cash may exacerbate mental health issues, increase homelessness and lead the desperate into crime.

    The Social Services Legislation Amendment (Welfare Reform) Bill 2017 which contains this measure is currently before the federal parliament and, the Senate Community Affairs Legislation Committee is due to report on this bill on 4 August 2017.

    So a call has gone out……….

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    For 30 years, I served as the head of St Vincent's Hospital Alcohol and Drug Service in Sydney.

    I have treated many thousands of patients trying to rebuild their lives in the face of alcohol and drug problems. Many have been victims of sexual abuse, violence from family members, or other devastating trauma – and most are already living on the margins of society.

    That's why I'm stunned by the government's plan to strip people with alcohol and drug problems of income support payments.1

    Thirty years of experience, backed by research from all over the world, tells me that you can't punish people into recovery. In fact, pushing people into poverty only serves to undermine their chance of recovery – and puts lives at risk.

    Over the coming weeks, Parliament will vote on whether to implement mandatory drug testing. Doctors, nurses and allied health workers – determined to protect patients – are speaking out against the changes.


    Prime Minister Turnbull assures us that the proposal to strip people of income support payments is "based on love".2 That's a hard thing to swallow given his government's failure to consult with addiction medicine experts and lack of evidence to support the trials.

    Mandatory drug testing has already been trialled and abandoned in multiple countries around the world. It's a failed policy that violates our professional commitment to do no harm. This government is forcing doctors to make an impossible choice – to break the law or to hurt our patients.

    I've seen with my own eyes how medical treatment of people struggling with severe alcohol and drug problems must be guided by compassionate care and respect for their human rights.

    Call on the government to stop playing political games with people's lives: https://www.getup.org.au/help-not-harm-petition

    Sincerely,

    Dr Alex Wodak

    President, Australian Drug Law Reform Foundation

    References:

    [1] Drug testing welfare recipients is not about love, Malcolm Turnbull, it's about punishment, The Guardian, 11 May 2017

    [2] Federal budget 2017: Turnbull says welfare drug test policy 'based on love', ABC News, 12 May 2017

    GetUp is an independent, not-for-profit community campaigning group. We use new technology to empower Australians to have their say on important national issues. We receive no political party or government funding, and every campaign we run is entirely supported by voluntary donations. If you'd like to contribute to help fund GetUp's work, please donate now! To unsubscribe from GetUp, please click here.

    Our team acknowledges that we meet and work on the land of the Gadigal people of the Eora Nation. We wish to pay respect to their Elders - past, present and future - and acknowledge the important role all Aboriginal and Torres Strait Islander people continue to play within Australia and the GetUp community.

    Authorised by Paul Oosting, Level 14, 338 Pitt Street, Sydney NSW 2000.

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



              I'd pay more tax to see Richard Littlejohn survive on benefits        
    I shouldn't read Richard Littlejohn's weekly diatribe of hate but every now and then I get copied into one of his more repugnant observations on life.

    This week he chimes into the economic debate with "More tax? we'd all be better off on benefits." He roundly condemns Lib Dem plans to make the rich pay more tax. Well, I'm told Littlejohn earns something in the region of £750,000 a year for his column so it's no wonder he's not keen on the idea. I mean not everyone can be as fair minded and benelovant on the issue as Warren Buffett. However, what I find deplorable is his insistance on having a go at the most vulnerable people in our society to make his point.

    His rant about paying more taxes is basically an excuse to have a go at benefit claimants and asylum seekers.

    "We’d all be better off on benefits, except there wouldn’t be anyone left to pay for those benefits. Vince Cable favours a ‘mansion tax’ on homes worth more than £2 million. Will that apply to the Somali asylum seeker who has just taken up residence in a £2 million house in West Hampstead."
    Of course we would Richard. I'd like to see you survive on £67.50 a week. In fact, I'd pay more tax myself to see it happen. Better still, I'd like to see him experience first-hand what it's really like to be an asylum seeker.

    We could put him up in Colnbrook immigration prison where three asylum seekers have died since 2 July or have members of his family detained in Yarl's Wood where one child spend 166 days in detention before her third birthday.

    These are the people who really don't have a voice. It's a shame those that speak the loudest like Littlejohn see them as easy fodder for their bigotry. Maybe it's because he knows they can't talk back.

              Softchoice’s Oakville employees raising funds for ‘Darling’ kids        
    A child draws. Another sings. Another swims. Ordinarily there is nothing remarkable about these activities, unless you are at Darling Home for Kids in Milton, Ontario. You see, Darling Home for Kids is Ontario’s first children’s hospice. Each child has been diagnosed as medically fragile or technology dependent and many who suffer from progressive illness. […]
         

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              Recovery from removal of Morton's Neuroma        





    Recovery!


    I had surgery for removal of Morton’s Neuroma on January 9. It was a pretty painful recovery for the first few days, but nothing like walking around with a tennis ball under my foot prior to surgery. I experienced quite a bit of burning, swelling and immobility. I sat in the recliner with ice on my leg to cool the blood going into my foot and kept my foot raised for the first few days. I took a few pain killers those first few days but then was ok with Advil.

    My surgeon restricted work, driving and activity for the first week. She told me that if I over-did it my foot would let me know. Last Sunday I over-did it.  I went to WalMart before Church and then to my sister’s home to visit her new puppy. My foot burned all night long. I couldn’t imagine having the stitches taken out the next day and going without my surgical shoe.

    Yesterday I drove Troy back to the U of M after his 5 week Winter Break at home. I then drove myself to my surgeon. She removed all of the dressings, pulled out the stitches and told me I could run next week!  I couldn’t believe it. I couldn’t believe that I would be wearing my Inov-8s home. Yup. I slid into the shoe and walked around a bit.  Amazing. She wrote me a medical note for work releasing me of all restrictions, work and otherwise. Woot!

    After I arrived home I told Topaz we’d go for a slow walk.  We walked up and down the driveway a few times. It never felt so great!

    My foot looks ugly and sore..but it is getting better each and every day. Yippee!



              Support the CREATES Act, S. 974 and H.R. 2212        

    On behalf of FreedomWorks’ activist community, I urge you to contact your representative and ask him or her to support the Creating and Restoring Equal Access To Equivalent Samples (CREATES) Act, S. 974 and H.R. 2212. This bill would lower prescription drug prices by crushing illegal, anti-competitive, and monopolistic practices by the biggest pharmaceutical companies.

    Prescription drug prices have soared above general inflation rates for years, a telltale sign of lacking producer competition. Large moneyed pharmaceutical companies abuse a loophole in the FDA Amendments Act of 2007 that allows them to bar potential competitors from entering the market. They do this by refusing to provide drug samples and safety information that new producers need for medical research required in the FDA approval process of generic drugs.

    Without these samples and safety procedures, new producers never earn FDA approval. Meanwhile, existing producers establish monopolies and hike prices.

    This especially harms the emerging market for “biosimilars,” innovative remakes of biologic drugs. Biosimilars are often much cheaper to produce than name-brand biologics, reducing costs for millions of Americans.

    The CREATES Act would grant relief in court for generic and biosimilar competitors seeking FDA approval. This would clear the pathway for new drugs to enter the market, drastically reducing prices through increased competition. The cost savings stemming from this legislation could reach between 15 percent and 50 percent of current prices for impacted drugs.

    Such legislation would reduce both the federal deficit and national debt. Decreasing prescription drug costs would lessen the financial burden on Medicare, saving taxpayers up to $5 billion annually.

    As you know, FreedomWorks fights for free markets and smaller government. The CREATES Act would lead to a freer market, less cronyism, and cheaper medication. For these reasons, I urge you to contact your representative and ask him or her to support the CREATES, S. 974 and H.R. 2212.

    Sincerely,

    Adam Brandon, President, FreedomWorks


              Congress Should Lower Ridiculous Drug Prices by Passing CREATES Act        

    Perpetually increasing prescription drug prices ravage everyday Americans. Specifically, name-brand prices outpace inflation by about 50%, largely due to government-protected market power. A beacon of hope for reducing drug prices are the generic and biosimilar drug industries, which produces existing brand drugs and biologics drugs through distinctly cheaper methods. But big Pharma doesn’t want competition, so it does everything it can to block generic and biosimilar innovation. The CREATES Act, H.R. 2212, solves a loophole commonly abused by big pharmaceutical companies for unlawful market advantages in the emerging generics and biosimilars markets.

    Existing drug companies exploit the Food and Drug Administration’s (FDA’s) Abbreviated New Drug Application (ANDA) requirements for FDA approval of competitive generic and biosimilar products. This is an unlawful tactic to increase market-power. Biosimilars are a type of biologic drug – drugs manufactured from living cells – that mimic both the composition and the function of an existing biologic drug but employ cheaper production processes. Tragically, established producers prevent aspiring competitors from completing ANDA.

    To complete a generic or biosimilar approval process, applicants must acquire sample drugs from existing producers. This allows medical researchers to demonstrate that the functions and properties of the original brand drug and the new generic or biosimilar are, in fact, equivalent. Sadly, many brand companies refuse to provide samples to potential competitors, preventing them from gaining approval. Thus, innovative generics and biosimilars hit the market less frequently, trapping consumers with fewer options and higher prices. While this practice of abusing distribution networks is illegal, there are no enforcement mechanisms preventing it.

    Remember the damnable pharmaceutical executive Martin Shkreli, who raised the price of a biologic AIDS drug Daraprim by over 5000% in one night? One of his profit-protection methods was to deny competitor applicants the samples they need to earn FDA approval. Competing with losers like Shkreli would be easy it if weren’t for this loophole. High school chemistry students reproduced Daraprim for less than $2 a pill compared to Shkreli’s $750.

    A similar monopolistic scam employed by entrenched pharmaceutical companies involves exploiting shared Risk Evaluation and Mitigation Strategy (REMS) procedures. Producers of existing brand drugs are sometimes required by the FDA to establish safety protocols that protect consumers from safety risks. The FDA encourages companies to share, or streamline, their REMS procedures for maximum safety and congruency among user experiences. If a person taking biologic drug X switches to biosimilar drug X, the shared procedure is supposed to ensure that there are no major differences in how this person safely consumes the drug. In a similar fashion to denying samples, big pharma often refuses to share REMS procedures. When a REMS program has previously been required, FDA cannot approve a generic or biosimilar until a shared REMS has been negotiated or the agency has been given sufficient evidence to waive the requirement. This imposes redundant and costly burdens on biosimilar producers, and ultimately delays market entry for far less expensive but equally safe drugs.

    Both of these tactics, refusal to share samples and failure to fairly negotiate shared REMS programs, establish de facto monopolies for original drug producers, but they’re easily fixed by the CREATES Act. Under the CREATES Act, generics and biosimilar manufacturers will be able to seek injunctive relief in court against companies that withhold samples or REMS information. This will improve competition with new generics and biosimilars, reducing prescription drug costs possibly as much as 40%. It will also help sustain Medicare Part D, the national deficit, and debt, by reducing government drug expenses by up to $5 billion per year.

    Congress should end illegal monopolies and help Americans afford their medications by passing the CREATES Act, all without increasing the size of government.


              Casa de Sănătate Timiş, mesaj important pentru timişeni, înainte de sărbătorile de iarnă        
    Vi se face rău în timpul sărbătorilor de iarnă? Nu trebuie să vă panicaÅ£i, asta pentru că spitalele din întreg judeÅ£ul vă vor acorda îngrijiri medicale de urgenţă, de Crăciun sau de Revelion. Casa JudeÅ£eană de Asigurări de Sănătate Timiş a transmis un comunicat de presă prin intermediul căruia îi informează pe asiguraÅ£i, dar şi […]
              Honest Belief About Employee’s FMLA Abuse Enough to Defeat Retaliation Claim        
    Employee abuse of intermittent FMLA leave is a common employer complaint.   An example of intermittent leave is when an employee occasionally has to take off work because of an ongoing or chronic medical condition.    What happens if the employer suspects the employee uses FMLA covered leave to miss work for non-covered reasons, but does not...… Continue Reading
              When the "best" price isn't always the best thing.         

    We have all heard "you get what you pay for" and all the other similar cliches when it comes to purchasing a good or service. We have all also privately desired to obtain that good or service at the lowest price possible.

    This is being a "smart" or "savvy" shopper. Right? Well...not always. You see some business's have very little "wiggle" room and some none at all. Commercial carriage is a good example.

    Very few if any that remain in the business for long are doing it because it is highly profitiable. It's just a business where that simply isn't possible. Its a high cost/low return business, and there is no way around that. Its a labor of love not fat bank accounts.

    Which is why I caution you against hiring the "cheapest" carriage service in your area. You see...you just can't provide feed, vet, farrier, hay, grooming supplies, dental care, etc for carriage horses and at the same time play cut rate with the prices you charge.

    You just can't. See...not too many businesses have employees that are on room/board/meals & full medical 365 days a year for very part time employment. Not only that its usually not just one of those employees its usually two per carriage operated. You know...just in case one is sick, lame, or can't work for whatever reason. 

    So...its more of a "THEY get what you pay for" and I mean that quite literally. The horses are the "they"and the price you pay directly affects the quality of the care they get. Its the difference between a company that can afford to call the vet when needed, and one that put's up a Go Fund Me page in hopes that a sympathetic public might pay that bill for them. (usually not) 

    Also worth noting is when you look you will notice that the "bargain bin" carriage services are cutting lots of corners. Look at the first photo of a horses obviously wearing tack that does not fit and undoubtably belongs to one of their far larger horses. Or the second photo that clearly depicts that it can be third world bad for the horse belonging to the outfit that is operating on a razors edge. Compare them to the last photo of a proper first class turn out. 

    I hope you keep this in mind when you are shopping for a carriage service. If the ones that charge the most seem to look the best there are good reasons behind that. When live animals are part of the equation the cheapest around is never the best choice. Paying a fair market price for an any animal industry endevor insures fair treament of the animals. So please...when it comes to carriage services, shop with your eyes, and not with your purse strings.

              In the name of development        
    Teaser: 
    The indigenous community of the Andaman and Nicobar Islands has been systematically alienated from their land by the colonial and post-colonial policies. A new book chronicles the change.
    The forests and the tribal communities of the islands are being decimated. (Source: Wikimedia Commons)

    Pankaj Sekhsaria’s recent book Islands in flux--The Andaman and Nicobar Story is a collection of around 20 years of his writings on the environmental and conservation concerns faced by the indigenous tribal communities of the region. Unlike his previous book, The last wave, a factual fiction adventure story dealing with love, longing and loss, this one is a collection of contemporary developments in the islands. The book is divided into seven parts and several chapters each dealing with the societal and ecological facets of the islands. Issues related to the environment, wildlife conservation and development policies that threaten the island’s indigenous communities have been chronicled by the author who is a long-time member of the NGO, Kalpavriksh.

    Alienation of islanders

    The book begins with the section, Setting the context, in which he writes about the history of the alienation of the island communities living there for over 40,000 years. The author takes a dig at the history writers of the modern democratic Indian state who have left gaping holes in their writings by not sudying the ancient indigenous communities--the Great Andamanese, the Onge, the Jarawa and the Sentinelese. It is here that the author mentions “if the real and complete history of the islands is ever written, the British would not be more than a page and India could only be a paragraph”.

    The indigenous people have been systematically alienated from their resources by the British colonial policies and the post-colonial development-oriented policies of India. The Britishers set up a penal colony in the islands in 1858, the Japanese occupied the islands during the World War II, and during the post colonial period, thousands of settlers from mainland India were brought to the island. Though the islanders put up a fierce fight to defend their territories, the social fabric of the island communities has been violently torn apart and their populations decimated while the settlers outnumbered the original inhabitants. The region is witness to nation building exercises, hinduisation of ‘uncivilized junglees’ and even an attempt to rename the islands. The author calls this as an attempt to “reclaim what was never yours”. No effort has been made by way of scholarship or historical studies to take the islanders’ point of view.

    Forestry is the chief source of revenue in cash in the islands but the system of forestry did not suit the region. The author quotes an official report by the Department of Environment, Government of India that argues that “the forestry system was leading to a preponderance of deciduous elements in the evergreen system that would eventually destroy the whole island ecosystem”. The carrying capacity of the islands has been long exceeded, the author says. Ill-conceived schemes like cattle rearing were introduced for a community that does not consume milk. Tourism is a concern in the islands which have been declared as ‘global biodiversity hotspot’.

    The pristine forests and the people living in the Jarawa tribal reserve that covers half the island is under threat because of the ill conceived Andaman Trunk Road that separates the reserve land from the rest of the island. The Jarawas for whom the forests have been a home for ages have been reduced to begging around the Trunk Road that runs through the reserve. The road has been controversial due to the negative fallouts on the island’s ecology and the indigenous people. The Supreme Court had in 2002 passed an order to close it; the island administration chose to ignore it. Its closure was absolutely critical to protect the Jarawa community, the author says.

    Islands turn colonies

    The author chronicles the colonising of the islands in a chapter of the same name and discusses how the settlers look down upon the indigenous communities. Tension continues between the tribal communities especially the ancient tribal community of Jarawas and the settlers over land rights and there is a lack of political will to ease this even as the population of the Jarawas has been reduced to a few hundreds. “There are opinions that the Jarawas should be assimilated into the modern world, but it is clear that it is exactly this contact with the outside world that is rapidly pushing them towards the brink,” the author states.

    In the chapter, A brief history of logging, Sekhsaria provides an account of the timber operations in the Andamans. He notes how as a part of India’s colonisation scheme, mainlanders were settled here. This was done to strengthen India’s claim over the islands. Incentives were offered to settlers by way of land and royalty free timber. Timber-based industry was promoted and liberal subsidies offered. Forests were exploited to benefit settlers who had little stake in the islands or its natural resources. Timber offered for millions decreased after the 2002 Supreme Court order. The order was in response to a petition by three NGOs to stop logging. The Supreme Court order that banned the cutting of naturally grown trees in the Andamans and Nicobar islands were welcomed by the environmental rights groups. But logging continued within the tribal reserve.

    In the section, Environment, ecology and development, the author stresses the need for evolving sensible conservation policies. The author discusses the consequences of introducing exotic species into the island systems. This has led to irretrievable loss of native species and ecosystems. “The Andaman and Nicobar islands are unsurpassed in their botanical wealth, and the ethnomedical knowledge of the tribals who live here is astounding,” he says.

    In the section, December 2004 and its aftermath, the author discusses the turmoil caused by the tsunami of December 26, 2004 which killed around 3500 people in the fragile Andaman and Nicobar islands, the worst hit area in India. The tectonic activity due to the third deadliest earthquake of the world in the last 100 years caused a significant shift in the islands’ geography with a permanent average uplift of four to six feet while parts of Nicobar islands went significantly under, with the southernmost tip, Indira point on Great Nicobar island going 15 ft down. Apart from dealing with how the tsunami destroyed the island, the section also highlights how the people picked up the pieces and started all over again.

    Leave them alone

    The tsunami waters inundated large areas of the islands causing damage to its coastal and marine ecology. In the aftermath of this turmoil, ecologists have suggested ‘no intervention’ and that ‘leaving areas alone should be the preferred management option’. A disturbing facet of the islands in recent times is its water scarcity. The islands have been facing severe water shortages even during the pre-tsunami period but this got worse after 2004. Fresh water sources got hit by the tsunami.

    Talking about the faulty development planning, the author discusses how the former president late Abdul Kalam in 2005 in the aftermath of the tsunami announced a grandiose vision for the development of the Andamans and Nicobar islands. This included ecologically perilous components like deep sea fishing, exploitation of bamboo, value-added coconut products and tourism.

    A central thread of Sekhsaria’s book has been the neglect and acculturation of the Jarawas, and their losing scuffle with the outsiders. The book presented in a journalistic manner handles the issue very sensitively and the author exhibits a keen understanding of the history of the indigenous people and its ecology.

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              102 synthetic marijuana overdoses in 3 days in 1 county        
    By Shachar Peled and Paul LeBlanc LANCASTER COUNTY, Pa. — One hundred and two people in Lancaster County, Pennsylvania, overdosed on synthetic marijuana in three days, according to C. Robert May, director of Lancaster Emergency Medical Services. None of the overdoses were fatal. “Heroin is normally the issue but in the last week there’s been an overdose of synthetic marijuana,” also known as K2, May told CNN. “The assumption is that heroin is not readily available, so people are turning […]
              Hollywood Medium S02E19 WEB-DL x264-JIVE        
    Season 2, Episode 19 – “Kim Zolciak-Biermann Kroy Biermann Jaleel White Peter Facinelli” Reality star Kim Zolciak-Biermann and her husband Kroy Biermann are left speechless as Tyler delivers shocking medical advice to them from a deceased loved one. In an emotional reading, actor and skeptic Jaleel White is brought to tears when Tyler connects from beyond […]
              Making Sense of MACRA        

    In January 2015, the US Department of Health and Human Services (DHHS) established new goals for Medicare to improve value while controlling costs. The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) will help achieve these goals:

    • Goal 1: by the end of 2016, 30% of Medicare payments are tied to quality or value via alternative payment models (APMs), and 50% by the end of 2018.
    • Goal 2: by the end of 2016, 85% of Medicare fee-for-service (FFS) payments are tied to quality or value, and 90% by the end of 2018.

    Why must we change Medicare reimbursement? As shown in Chart 1, based on DHHS reports, Medicare costs rose sharply from its enactment in the mid-1960s to today, both as a percent of the Gross Domestic Product (GDP) and as a percent of all national health expenditures (NHE). Currently, Medicare is estimated to account for roughly 4% of the GDP, and for over one in five health care dollars. There is also a need to improve the quality of health care services and delivery. Changing Medicare reimbursement is a way to better manage costs while enhancing care quality.

    As discussed in the series of posts on bundled payments, traditional medical billing and payment is volume-based. In other words, the more hip replacements that surgeons perform, the more they can bill for. If the hip replacement procedures are more costly than necessary, the surgeons still get reimbursed. If the patient suffers complications following hip replacement surgery, the added days in the hospital and hospital readmissions are reimbursed. Providers are rewarded for doing more, but not for doing better.

    Increasingly, Medicare and other payers are moving to value-based reimbursement systems that reward providers for improving the quality of care while controlling costs. MACRA changes the incentives for patient care to encourage providers, largely physicians, to become part of this value-based movement. MACRA also ends the Sustainable Growth Rate (SGR) formula used since 1997 for Medicare reimbursement to healthcare providers.

    MIPS and APMs

    MACRA establishes the Quality Payment Program (QPP) with two paths that move providers to value-based reimbursement:

    • The Merit-Based Incentive Payment System (MIPS)
    • Advanced Alternative Payment Models (APMs).

    Healthcare practitioners eligible for Medicare Part B reimbursement will participate in MIPS. For the first two years of MACRA, MIPS eligible clinicians include physicians, dentists, physician assistants and advance practice nurses such as nurse practitioners and certified registered nurse anesthetists. In following years, eligibility may be expanded to other practitioners such as physical or occupational therapists, nurse midwives, clinical social workers and audiologists. Hospitals and other facilities, clinicians with low patient volume or in their first year of Medicare Part B participation, and some clinicians in APMs are excluded from MIPS.

    Under MIPs, the eligible clinician’s Medicare Part B reimbursement is adjusted based on a Composite Performance Score (CPS) that encompasses the categories of quality, resource use, clinical practice improvement activities and advancing care information. The scoring system is complex, and may also be adjusted for factors such as practices located in rural areas. The amount of the adjustment to Part B reimbursement may be positive or negative, beginning at ± 4% in 2019 and increasing to ± 9% by 2022. The adjustments are designed to be more reasonable and predictable than the earlier SGR annual adjustments. Exceptional performers may receive additional reimbursement in the adjustment. These payment adjustments and bonuses begin in 2019.

    APMs include new financing initiatives that increase incentives for high value care, including bundled payment models and Accountable Care Organizations (ACOs). Bundled payment models and ACOs compel providers across a health care episode to work together to deliver high quality care while controlling costs. Physicians, hospitals, rehabilitation centers, home health agencies and other healthcare providers share accountability for their budget as well as their patients, and are rewarded for high-value performance. QPP providers may not need to participate in MIPS if they are part of an advanced APM.

    Nurses in many healthcare settings will see changes to improve coordination and services as a response to MACRA and other value-based reimbursement strategies. My book helps nurses understand fundamental concepts of health care economics and financing, including innovations that tie quality to payment. It is essential that nurses, at the front lines of health care delivery, learn about healthcare finance and its impact on their work and their institutions.

    Susan J. Penner, RN, MN, MPA, DrPH, CNL . Author, Economics and Financial Management for Nurses and Nurse Leaders, 3rd  Edition, 2016, and adjunct faculty at the University of San Francisco School of Nursing and Health Professions.


              Go Directly to IVF - Do Not Pass Go?        
    A new study seems to suggest that couples suffering from infertility should not waste their time or money on less invasive fertility treatments, but instead should con sider going straight to in-vitro fertilization:
    So it makes sense that some researchers are pushing to skip the middle step and go straight to IVF when the first-round effort fails. In a study presented last month at the annual meeting of the American Society of Reproductive Medicine, doctors from Dartmouth Medical School and Boston IVF concluded that women who were fast-tracked to IVF got pregnant three months faster on average, and spent $10,000 less than those who went through the usual preliminaries.
    Considering how many couples I know who tried most or all of the less invasive treatments before finally being successful with IVF, this study would seem to be recommending the exact opposite approach. What's particularly interesting is that I had a conversation with a close friend regarding the halachic parameters of fertility treatments, and her halachic authority was definitely recommending that she and her husband try other treatments before approaching IVF, and seemed to treat IVF as pretty much a last resort (short of treatments such as surrogacy and sperm/egg donors, which can raise more complicated halachic questions). One of the reasons seemed to be a psychological - that the couple should not pull out all the stops treatment-wise, and then be dejected if the holy grail of fertility treatments doesn't show immediate results. While I can understand the motivations behind that, this study would seem to show that such waiting, considering the lower rate of success from the less involved treatments, might be more of a cruel and unusual psychological punishment in and of itself, as the article notes:
    Shorter waits bring welcome psychological relief. One study claimed that women going through infertility treatment were as distressed as women diagnosed with cancer, heart disease, or HIV. Fast-tracking can mean fewer episodes of dashed hopes. That could lead to less depression, anxiety, and stress, which hurts marriages and, some claim, may lower one's chances of conceiving.
    Another reason seemed to be because her Rav was concerned about the supposed higher rates of multiple births with IVF, and the fact that such multiple pregnancies entail a higher risk for both mother and children - however, that IVF does have a higher propensity for multiple births seems to be disproved from the study noted above.
    The first is the potential to prevent higher-order multiple births—triplets, quadruplets, and beyond, which carry a greater risk to the mother's and babies' health. Women who get pregnant from injections with insemination face a 10 percent to 15 percent chance of carrying litters because the drugs can make them release six or more eggs. There's no way to control how many get fertilized. With IVF, by contrast, doctors create embryos in a lab and choose how many to transfer back to the womb, bringing the risk of triplets and beyond down to 2 percent to 4 percent. (The odds of conceiving triplets naturally are between 1 in 6,000 and 1 in 8,100.) That IVF figure is likely to decline further as doctors increasingly transfer fewer embryos.
    So the question is, will the halachic recommendations change as a result of these findings, as the medical recommendation is hopefully going to - if they haven't already? Feel free to chime in with your experience as to whether halachic guidance given to infertile couples jibes with this medical recommendation to fast-track IVF. Though I know a few people who received halachic guidance to wait on IVF until other treatments have been tried, I know of at least one friend, living in Israel, who received a psak to go straight to IVF - but that obviously might have been complicated by her specific situation. So I'd love to hear some weighing in - anecdotal though it might be - on what seems to be the halachic consensus at this moment.

    More on halacha and infertility here, from the indefatigable Chana's excellent notes from a medical ethics conference she attended at YU.
              Scientists to New Moms: Get Your Beauty Sleep (Yeah, right!)        
    On the heels of a study that shows that kids who do not get enough sleep have higher obesity rates, comes this:
    Researchers presented a conundrum to new mothers on Monday, saying that women who want to lose the extra weight gained in pregnancy should try to get more sleep.

    They found that mothers who slept five hours or less a day when their babies were six months old were three times more likely than more rested mothers to have kept on the extra weight at one year.

    "We've known for some time that sleep deprivation is associated with weight gain and obesity in the general population, but this study shows that getting enough sleep — even just two hours more — may be as important as a healthy diet and exercise for new mothers to return to their pre-pregnancy weight," said Erica Gunderson of Kaiser Permanente, which runs hospitals and clinics in California.

    Gunderson and colleagues studied 940 women taking part in a study of prenatal and postnatal health at Harvard Medical School in Boston.

    The women who slept five hours or less a night when their babies were six months old were more likely to have kept on 11 pounds of weight one year after giving birth, they found.

    Women who slept seven hours a night or more lost more weight, they reported in the American Journal of Epidemiology.

    The researchers acknowledged this may pose a dilemma to new mothers, given that infants sleep so fitfully.

    "With the results of this study, new mothers must be wondering, 'How can I get more sleep for both me and my baby?' Our team is working on new studies to answer this important question," said Dr. Matthew Gillman of Harvard Medical School and Harvard Pilgrim Health Care.
    Uh. great. I am SO glad that now that we know being up ALL NIGHT with a screaming baby might be keeping new moms from losing that baby weight may finally have scientists "working on new studies" to get babies and their mothers to sleep more. I mean, it was no problem at all for me to spend the wee hours of countless nights walking back and forth trying to comfort an alternately whimpering and howling baby in my arms - that is, until I found out that this was what might be keeping those pesky pounds from coming off. Because until now, it was perfectly bearable - even enjoyable, right? Thanks for the handy tip, Harvard geniuses! I wonder why getting more sleep didn't occur to me when I was a new mom? Us mothers will be sure to mention it to our colicky babies so that they can take their moms' weight loss needs into account before they make their evening plans!
              Shabbat Gadgets        
    I thought this was interesting:
    Observing Shabbat but have to call your grandmother? Have to have a cup of coffee when you come back from weekend services? The halachic institute for science and technology has just the thing for you.

    A group of engineers at the halachic institute, which specializes in Halacha-friendly technological developments, has come up with several new technological breakthroughs designed to ease the religious public's life, while keeping with all Shabbat-related mitzvahs.

    The gadgets include, among others, a Shabbat air-conditioner, a Shabbat phone and a kosher, Shabbat espresso machine.

    Many of the institute's developments are already in production, both in Israel and abroad, and several have been introduced to the public at a special show arranged by the Manufacturers Association of Israel.

    These devices, said the MAI, have a potential $10 million a year market."We have gadgets that are meant to make life easier, such as the coffee machine and on the other hand, we have things like the Shabbat phone, that could help people in medical need," said Dov Zioni of the halachic institute.

    One of the show's biggest hits was the Shabbat pen, which uses self-dissolving ink that disappears 24 hours after writing. "We're not talking about life and death situations here, when one's need to desecrate Shabbat to save a life goes without saying," added Zioni, "but for all those little grey areas we all encounter in our day-to-day lives."

    "The industry finally realized the financial potential of developing products specifically for the ultra-Orthodox public," Industry, Trade and Labor Minister Eli Yishai, who visited the show and was visibly pleased, told Ynet.

    "We get to develop different technologies, create jobs and observe Shabbat. It's a win-win situation," he added.
    I can't imagine that these products are going to gain much popularity in the ultra-orthodox community, as trade minister Yishai suggests in the article. I just don't see invisible ink pens or Shabbat phones making their way into Charedi homes for regular use on Shabbat and Yom Tov. That said, the gadgets would probably prove very useful in the army, or for hospital or Hatzalah use. Even though, as the article notes, using a phone or a pen isn't an issue in Pikuach Nefesh (life-saving) situations, it would be interesting to see these products in use for situations that are not clearly life-or-death. The products might also hold interest for those who are less observant, and would consider using a non-Shabbat phone or pen on Shabbat. In a case such as that, why not use one specially made to skirt the prohibitions of Shabbat?
              eLearning Simulations        
    Affordable, Dynamic & Custom Interactive Training & Education solutions for any iindustry - Healthcare or Medical Simulation Training, Corporate Training, Technology, Military and General. Contact for FREE CONSULTATAION at mySmartSim's Solutions.
              Electronic Medical Records software programs        
    When your office needs electronic medical records software, then look no further than Medical Charting. Our EMR software will improve the efficiency of your office, and improving satisfaction among your clinic visitors.
              Nov 2012 Daring Cooks' Challenge Brining & Roasting        

    Hello this Audax from Audax Artifex and I'm honoured to be your host this month. I have decided to concentrate on a couple of important cooking techniques that every good cook should have up his or her sleeve. The first technique is brining – which uses a brine (at its simplest, a combination of salt and water usually with some sugar) to infuse flavour and moisture into poultry, red- & white-meat, fish, seafood and most types of nuts and seeds. Brining guarantees moist succulent roast chickens and turkeys, fried steaks, steamed trout, BBQed prawns (shrimps), grilled seafood and toasted nuts and seeds. Brining is simple and only needs a few simple ingredients and really adds an extra dimension to your cooking. I will be providing a couple of different recipes and guidelines on how to brine which can be used with a whole array of meats, poultry, seafood, nuts and seeds.

    Then for the second technique (once you have brined your chosen cut of meat) I want you to roast (or BBQ) it. Again I will be giving you guidelines and rules on how to roast your cut of meat. The roasting guidelines can be used for meat, vegetables, nuts and seeds. For our non-meat eating cooks I want you to use the roasting guidelines to roast a selection of vegetables and/or nuts or seeds to perfection.
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    HOW IT WORKS (from http://www.cooksillustrated.com/images/document/howto/ND01_ISBriningbasics.pdf)

    Soaking in brine improves the taste and the moistness of all fowl (chicken, turkey, goose, duck and guinea fowl), also it works on lean red- and lean white-meats, fish, most seafood and most nuts and seeds. It is simple, cheap and effective and will ensure that your Christmas roast will be the tastiest you have ever made. All you do is brine your cut of meat and then proceed as normal, you will find that the roast is juicy and the skin has a lovely colour. The recipe for all-purpose brine is simple - for each cup (240 ml) of water use 1 tablespoon (18 gm) of table salt this makes a 8% brine solution which can be used for most foods. (This is equivalent to 1 cup of table salt for each gallon (4 litres) of water.)

    Brining works in accordance with two principles, called diffusion and osmosis, these two principles like to keep things in equilibrium (or in stable balance). When brining a fowl for example, there is a greater concentration of salt and sugar outside of the fowl (in the brine) than inside the fowl (in the cells that make up its flesh). The law of diffusion states that the salt and sugar will naturally flow from the area of greater concentration (the brine) to lesser concentration (the cells). There is also a greater concentration of water, so to speak, outside of the fowl than inside. Here, too, the water will naturally flow from the area of greater concentration (the brine) to lesser concentration (the cells). When water moves in this fashion, the process is called osmosis. Once inside the cells, the salt and, to a lesser extent, the sugar causes the cell proteins to unravel, or denature. As the individual proteins unravel, they become more likely to interact with one another. This interaction results in the formation of a sticky matrix that captures and holds moisture. Once exposed to heat, the matrix gels and forms a barrier that keeps much of the water from leaking out as the meat cooks. Thus you have a roast that is both better seasoned and much more moist than when you started.

    HANGING IT OUT TO DRY

    Brining does have one negative effect on poultry: Adding moisture to the skin as well as the flesh which can prevent the skin from crisping when cooked. This can be overcome by air-drying, a technique used in many Chinese recipes for roast duck and chicken. Letting brined chicken and turkey dry uncovered in the refrigerator allows surface moisture to evaporate, making the skin visibly more dry and taut and therefore promoting crispness when cooked. Although this step is optional, if crisp skin is a goal, it’s worth the extra time. For best results, air-dry whole brined birds overnight. Brined chicken parts can be air-dried for several hours. Transfer the brined bird to a heavy-duty cooling rack set over a rimmed baking sheet, pat the bird dry with paper towels, and refrigerate. The rack lifts the bird off the baking sheet, allowing air to circulate freely under the bird. If you are not air-drying your fowl it is best to pat dry the skin with paper towels before roasting in a hot oven.

    Surprisingly, brining has one large positive effect on fish fillets, a quick brine (only 10 mins) greatly improves the appearance of cooked fillets, because the brine reduces the unsightly white layer of albumin that coagulates on the surface during cooking, I highly recommend brining fish fillets when presentation is paramount. 

    ITEMS THAT BENEFIT FROM BRINING
    Lean cuts of meat with mild flavour tend to benefit most from flavour brining also most nuts and seeds can be brined with good affect. These include:

    Chicken: whole, butterflied, or pieces
    Cornish Hens: whole or butterflied
    Turkey: whole, butterflied, or pieces
    Pork: chops, loin, tenderloin, fresh ham
    Seafood: salmon, trout, shrimp
    Beef: use lean pieces of beef
    Nuts and Seeds: Most nuts and seeds are suitable i.e. pumpkin, peanuts, sesame, almonds etc.  

    Fatty meats such as duck, beef, and lamb do not benefit as much from brining (but still can be brined)—they're naturally moist and flavourful. They also tend to be cooked to lower internal temperatures and thus don't lose as much of their natural moisture.

    WHICH SALT TO USE
    Kosher salt (called rock salt outside North America) and table salt are the most common salts used in brining.

    Sea salt can be used for flavour brining, but it tends to be quite expensive. If you have a cheap supply available, go for it; otherwise, stick to kosher salt or table salt.
    Some people say that kosher salt tastes "cleaner" than table salt because it does not contain the anti-caking agents added to table salt. Some people prefer non-iodized table salt over iodized table salt, believing that potassium iodide creates an off-taste. However, these flavour differences melt away when salt is diluted in large quantities of water in a brine. In an article about salt in the September/October 2002 issue of Cook's Illustrated magazine, taste testers felt that "all nine salts tasted pretty much the same" when dissolved in spring water and chicken stock, whether it was 36¢/pound iodized table salt, 66¢/pound kosher salt, or $36/pound Fleur de Sel de Camargue sea salt from France.

    SALT EQUIVALENT MEASURES
    Table salt and kosher salt do not have the same saltiness in a flavour brine when measured by volume—but they do when measured by weight.

    Table salt weighs about 10 ounces (285 grams) per cup, while kosher salt weighs 5-8 ounces (140-225 grams) per cup, depending on the brand. If using kosher salt in a brine, you must use more than a cup to achieve the same salt flavour you would get from a cup of table salt.

    The chart below shows equivalent amounts of table salt and the two most popular brands of kosher salt.

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    Morton Kosher Salt weighs about 7.7 ounces (220 grams) per cup, making it three-fourths as strong as table salt. Diamond Crystal Kosher Salt weighs about 5 ounces (140 grams) per cup, making it half as strong as table salt.
    What if you're using something other than Morton Kosher or Diamond Crystal Kosher salt? Regardless of the type of salt—sea salt, pickling salt, and any other brand of kosher salt—just measure 10 ounces (285 grams) of it on a kitchen scale and you will have the equivalent of 1 cup of table salt.

    HOW LONG TO BRINE
    The length of time meat soaks in a flavour brine depends on the type of meat and its size, as well as the amount of salt used in the brine—the saltier the brine mixture, the shorter the soaking time. Here are common brining times found in recipes:

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    It is possible to end up with meat that's too salty for your taste, so you may want to brine on the low end of the time range to see how it turns out. You can always brine longer next time, but there's no way to salvage a piece of meat that's been brined too long.

    ROASTING TIMES AND TEMPERATURES FOR POULTRY 
    When we roast brined cuts of meat (or whole birds) the procedure firstly is to brown the skin in a hot oven then to lower the temperature so we reduce the moisture loss in the roasted food. It is important to rest (loosely covered in foil) your roast so that the moisture can redistribute itself in the meat, it greatly adds to the final tenderness of the cooked product.

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    For other roasting times for red meat, fish, seafood, nuts and seeds see the additional information at the end of the challenge write-up.

    Recipe Source:  The brine and roast chicken used are traditional recipes used in my family for many generations. The roast vegetable recipe is from my own family cookbook.   

    Blog-checking lines:  Audax of Audax Artifax was our November 2012 Daring Cooks’ host.  Audax has brought us into the world of brining and roasting, where we brined meat and vegetables and roasted them afterwards for a delicious meal!

    Posting Date:  November 14th, 2012

    Download the printable .pdf file HERE


    Note:  Important Information – brining must be done in the refrigerator the salt water will not stop the growth of germs and bacteria. Also brine cannot be reused always discard it after first use.  Make sure that the brine goes into the cavity of large chickens and turkeys when brining.  

    Mandatory Items: If you eat meat you must brine a meat (or seafood) cut and then roast (or BBQ) it. For non-meat eaters please brine some nuts or seeds then roast them or just roast a load of vegetables. I have included an extensive listing of poultry, seafood, nut etc. recipes in the additional information section at the end of the challenge feel free to use any of these recipes. Of course you can use your own favourite recipe if you wish.

    Variations allowed:  Any meat/seafood (or nuts/seeds) can be used for brining. And any vegetable can be used by non-meat eaters. 

    Preparation time:  Generally brining takes from ½ hour to 2 days. Roasting can take up to 2 hours for most pieces of meat, for large poultry 6-7 hours.

    Equipment required:
    non-reactive container for the brine
    roasting pans or trays

    Challenge Recipes
    I have included one all-purpose brine recipe, a roast chicken recipe and a roast vegetable recipe.

    Recipe One – All-Purpose Brine:


    Makes 4 cups of brine enough for about one pound (½ kg) of meat

    This is the brine to use for most cuts of meat and poultry that will be roasted.

    Ingredients
    4 cups (1 litre) of cold water (see note 1)
    ¼ cup (70 gm) table salt or  ½ cup (70 gm) Diamond Crystal Kosher Salt
    optional 2 tablespoons (30 ml) (30 gm/1 oz) sugar (see note 2)
    optional 3-4 peppercorns, a few springs of herbs, a garlic clove or two, a knob of ginger etc. (see note 3)

    Instructions
    1. Heat 1 cup of water to boiling point add the salt and stir until all the salt has totally dissolved.
    2. Place in a non-reactive container (glass, plastic, stainless steel, zip-lock bags etc). Add the remaining water and stir. Make sure that all the salt has dissolved. Wait until the brine has reached room temperature.
    3. Add your cut of meat make sure that the meat is completely submerged (that is totally covered in the salty water) if need be you can weigh down the cut of meat with a clean plate (etc). If using plastic bags make sure that the meat is totally covered in brine and make sure that is bag is locked securely.
    4. Cover the container with plastic wrap to prevent odours contaminating the flavour brine or the brine leaking.
    5. Place the container into the refrigerator for the soaking time suggested by the guidelines above.
    6. If desired you can air-dry your poultry (usually over night) in the refrigerator if you wish to have crispy skin on your bird. It is best to pat dry your brined item (inside and out) with paper towels before cooking.
    7. Cook the brined item as directed by the roasting guidelines above.

    Notes
    1. You can replace all or some of the water with a combination of wine, cider, beer, tea, coffee, fruit juice, most sauces (tomato, soya, BBQ, chilli etc), chicken stock, beef stock or fish stock. Be careful with acidic liquids like wine, cider, fruit juices which can turn your meat to mush if brined too long.
    2. A little sugar can help overcome the saltiness of the brine and helps to give a nice sheen to your piece of meat when roasted. You can use up to ¼ cup of sugar (use the lesser amount (2 tablespoons) for high temperature roasting since the brine can burn at high heats if you use too much sugar). You can use brown sugar or honey or other sweeteners if you wish.
    3. Any combination of spices and herbs can be used to flavour the brine. Garlic powder, onion powder and ginger powder are excellent to use for brining.

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    Recipe Two – Roast Brined Chicken
    Serves four to six people

    Ingredients:
    1 whole chicken (organic is best) about 2 kg (4 ½ pounds)
    Enough brine (see recipe above) to cover the chicken in a large non-reactive container

    Directions:

    1. Brine the whole chicken in the flavoured brine in the refrigerator overnight about 6 hours can be overnight. (Make sure that every part of the chicken is covered in the brine you can weigh the bird down with a clean plate so it is completely submerged.
    2. Discard the brine and dry the skin and inside of the bird with paper towels.
    3. If you desire crispy skin then leave the bird on a rack for several hours or overnight in the refrigerator so the skin can dry.
    4. Preheat oven to moderately hot 220°C/425°F/gas 7.
    5. Roast for 15 minutes.
    6. Reduce oven to moderate 180°C/350°F/gas 4 and roast for a further 12-15 minutes per 450 grams/pound, You can check for done-ness the internal temperature should be 165°F/84°C, or the juices should run clear when you pierce the bird between the leg and thigh.  
    7. Rest for approximately 30 minutes covered loosely in foil.

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    Recipe Three – Roast Vegetables
    Serves six people

    For best results use the largest shallow heavy-weight roasting pan you have and make sure that the vegetable are well spaced out in the pan and only form one layer, use two trays if necessary. A very hot oven 475°F/240°C/gas mark 9 is the key to roasting vegetables. Only toss the vegetables once or twice during cooking. For lighter-weight vegetables such as cabbage, broccoli or cut corn add it to the pan 15 minutes later, so it doesn't get too brown. Greens like kale and mustard greens are done in only 15 minutes. Root vegetables should be cut into cubes of about one-inch (2½ cm). You can add a small amount of apricot fruit spread or honey in the last 10 minutes to enhance the caramelising process. Fresh basil, rosemary and thyme are best when used fresh. Curry, paprika and turmeric are also great. Grated ginger or crushed garlic can also be added.  

    Ingredients:
    1 small butternut squash (pumpkin), cubed
    2 red bell peppers (capsicums), seeded and sliced
    1 orange sweet potato, peeled and cubed OR 3 medium carrots, peeled and sliced lengthways
    3 Yukon Gold (or any baking) potatoes, cubed
    1 red onion, quartered
    optional 1 fat clove of garlic, crushed
    1 tablespoon chopped fresh thyme
    2 tablespoons chopped fresh rosemary
    2 tablespoon olive oil
    1 tablespoon balsamic vinegar or 1 tablespoon lemon juice
    Salt and pepper to taste

    Directions:
    1. Preheat oven to very hot 475°F/240°C/gas mark 9.
    2. In a large bowl, combine the squash, red bell peppers, sweet potato, red onion and Yukon Gold potatoes and the optional garlic if using.
    3. In a small bowl, stir together thyme, rosemary, olive oil, vinegar, salt, and pepper. Toss with vegetables until they are coated. Spread evenly on a large roasting pan.
    4. Roast for 35 to 40 minutes in the preheated oven, stirring one or twice, or until vegetables are cooked through and browned. If using a smaller tray the vegetables will take about 50-60 minutes.

    Roast Vegetables
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    Brined and BBQed “seven-bone” steak (notice the shape of the bone in the steak)
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    Brined and BBQed “wagyu” steak
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    Brined and Roasted Peppered Ribeye Roast
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    Additional Information:  Include links to videos or information that can be of assistance to members.
    Kosher salt versus table salt http://bbq.about.com/od/spicesseasonings/a/aa102007a.htm
    Everything you wanted to know about brining http://www.amazingribs.com/recipes/rubs_pastes_marinades_and_brines/zen_of_brines.html
    Brining Nuts and Seeds http://www.jwright44.com/recipes/BrinedNuts.htm
    How to brine pumpkin seeds http://www.ehow.com/how_8144233_brine-pumpkin-seeds.html
    How a quick brine improves the appearance of fish fillets http://www.cooksillustrated.com/howto/detail.asp?docid=36992
    Dry brining thick steaks (a great article) http://steamykitchen.com/163-how-to-turn-cheap-choice-steaks-into-gucci-prime-steaks.html
    Brining turkey a primer http://bbq.about.com/od/turkey/ss/aa110808a.htm
    Roast chicken ten ways http://culinaryarts.about.com/od/chickenturkeymore/tp/roastchixtenways.htm
    Cooking a turkey (many articles) http://culinaryarts.about.com/od/chickenturkeymore/tp/Cooking-A-Turkey.htm
    To roast a turkey http://culinaryarts.about.com/od/chickenturkeymore/r/Roast-Turkey-Recipe.htm
    Roasting guidelines for red meat roasts http://www.donaldrussell.com/game-technique?ms=tab5 Jamie Oliver's Roast Potato, parsnips and carrot recipe http://www.jamieoliver.com/recipes/vegetarian-recipes/roast-potatoes-parsnips-carrots 
    Jamie Oliver's Perfect Roast Potato recipe http://www.jamieoliver.com/recipes/vegetarian-recipes/perfect-roast-potatoes
    Delia Smith's Roast Potato recipe http://www.deliaonline.com/how-to-cook/fruit-and-vegetables/how-to-roast-potatoes.html
    How to brine fish http://www.ehow.com/how_5963061_brine-fish-before-cooking.html
    Vegetable Roasting Guide http://www.eatingwell.com/healthy_cooking/healthy_cooking_101/shopping_cooking_guides/vegetable_roasting_guide
    How to cook a steak to perfection http://howto.yellow.co.nz/food-drink/cooking-and-baking/how-to-cook-steak/
    How to cook a steak (using American cuts of meat) http://www.marksdailyapple.com/how-to-cook-the-perfect-steak/

    Disclaimer:
    The Daring Kitchen and its members in no way suggest we are medical professionals and therefore are NOT responsible for any error in reporting of “alternate baking/cooking”.  If you have issues with digesting gluten, then it is YOUR responsibility to research the ingredient before using it.  If you have allergies, it is YOUR responsibility to make sure any ingredient in a recipe will not adversely affect you. If you are lactose intolerant, it is YOUR responsibility to make sure any ingredient in a recipe will not adversely affect you. If you are vegetarian or vegan, it is YOUR responsibility to make sure any ingredient in a recipe will not adversely affect you. The responsibility is YOURS regardless of what health issue you’re dealing with. Please consult your physician with any questions before using an ingredient you are not familiar with.  Thank you! :)
              February 2012 Daring Cooks' Challenge: Flipping Fried Patties!!!        
    Hi it is Lisa and Audax and we are hosting this month's Daring Cooks' challenge we have chosen a basic kitchen recipe and a basic cooking technique which can be adapted to suit any ingredient that you have to hand and are beloved by children and adults alike … of course we are talking about patties.
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    Technically patties are flatten discs of ingredients held together by (added) binders (usually eggs, flour or breadcrumbs) usually coated in breadcrumbs (or  flour) then fried (and sometime baked). Burgers, rissoles, croquettes, fritters, and rösti are types of patties as well.

    Irish chef Patrick "Patty" Seedhouse is said to have come up with the original concept and term as we know it today with his first production of burgers utilizing steamed meat pattys - the pattys were "packed and patted down" (and called pattys for short) in order to shape a flattened disc that would enflame with juices once steamed.

    The binding of the ingredients in patties follows a couple of simple recipes (there is some overlap in the categories below)
    Patties – patties are ingredients bound together and shaped as a disc.
    Rissoles and croquettes – use egg with breadcrumbs as the binder, typical usage for 500 grams (1 lb) of filling ingredients is 1 egg with ½ cup of breadcrumbs (sometimes flour, cooked grains, nuts and bran can be used instead of the breadcrumbs). Some meat patties use no added binders in them they rely on the protein strands within the meat to bind the patty together.  Vegetarian and vegan patties may use mashed vegetables, mashed beans, grains, nuts and seeds to bind the patty. Generally croquettes are crumbed (breaded) patties which are  shallow- or deep-fried. Rissoles are not usually crumbed (but can be) and are pan- or shallow-fried. Most rissoles and croquettes can be baked.  (Examples are all-meat patties, hamburgers, meat rissoles, meatloaves, meatballs, tuna fish and rice patties, salmon and potato rissoles, most vegetable patties.)
    Wet Fritters – use flour, eggs and milk as the binder, typical usage for 500 grams (1 lb) of filling ingredients is 2 cups flour, 1 egg with 1 cup of milk and are usually deep-fried and sometimes pan-fried  (examples deep fried apple fritters, potato fritters, some vegetable fritters, hushpuppies)
    Dry Fritters – use eggs and (some) flour as the binder, typical usage for 500 grams  (1 lb) of filling ingredients is 1 to 2 eggs and (usually) some 2 to 8 tablespoons of flour (but sometimes no flour) and are pan- or shallow- fried. (examples most vegetable patties like zucchini fritters, Thai fish cakes, crab cakes, NZ whitebait fritters)
    Röstis – use eggs (sometimes with a little flour) as the binder for the grated potato, carrot and other root vegetables, typical usage for 500 grams (1 lb) of filling ingredients is one egg yolk (potato rösti).

    Sautéing, stir frying, pan frying, shallow frying, and deep frying use different amounts fat to cook the food. Sautéing uses the least amount of oil (a few teaspoons) while deep frying uses (many many cups) the most oil. The oil helps lubricate (sometimes adds flavour) the food being fried so it will not stick to the pan and helps transfer heat to the food being cooked.

    In particular, as a form of cooking patties, pan- and shallow-frying relies on oil of the correct temperature to seal the surface (so retaining moisture) and to heat the interior ingredients (so binding them together) so cooking the patty. The exposed topside of the patty while cooking allows, unlike deep frying, some moisture loss and contact with the pan bottom with the patty creates greater browning on the contact surface that is the crust of the patty is browned and the interior is cooked by pan- and shallow-frying. Because the food is only being cooked on one side while being pan- or shallow-fried, the food must be flipped at least once to totally cook the patty.

    So this month's challenge is to pan- or shallow-fry a patty, so giving us the title for this challenge “flipping fried patties”.

    This challenge will help you understand how to form, what binders to use, and how to fry a patty so that it is cooked to picture perfect perfection.

    Recipe Source:  Audax adapted a number of popular recipes to come up with the challenge patty recipes and Lisa has chosen to share two recipes – California Turkey Burger adapted from Cooking Light Magazine, and French Onion Salisbury Steak adapted from Cuisine at Home magazine.

    Blog-checking lines:  The Daring Cooks’ February 2012 challenge was hosted by Audax & Lis and they chose to present Patties for their ease of construction, ingredients and deliciousness!  We were given several recipes, and learned the different types of binders and cooking methods to produce our own tasty patties!

    Posting Date:  February 14th, 2012

    Download the printable .pdf file HERE



    Notes:
       
    • Binders
    •  
    • Eggs – are found in most patty recipes it acts as a binder, use cold eggs and lightly beat them before using  If you cannot use eggs try this tip  "1/4 cup of silken tofu, blended, or a commercial egg re-placer powder mixed with warm water."
    •  
    • Flour – normal plain (all-purpose) flour is used in most fritter recipes it can be replaced with rice, corn or potato flours (in smaller quantities) in some recipes. If you want some rise in your patties then use self-raising flour or add some baking powder to the flour. 
    •  
    • Breadcrumb Preparation – breadcrumbs are a common ingredient in patties, burgers and fritters they act as a binding agent, ensuring the patty keeps it shape during the cooking process.
    •  
      • Fresh breadcrumbs – these crumbs are made at home with stale bread simply remove the crusts from one- or two-day old bread, break bread into pieces, place pieces in a blender or food processor then blend or process until fine. Store any excess in a plastic bag in the freezer. 1 cup of fresh crumbs = 3 slices of bread.
      •  
      • Packaged breadcrumbs – often called dry breadcrumbs, these are used to make a crisp coating on the burgers, patties and fritters they are easily found in the supermarket, You can make them at home. Place slices of one- or two-day bread on baking trays, bake in the oven on the lowest setting until slices are crisp and pale brown. Cool bread, break pieces in a blender or food processor then blend or process until fine. 1 cup fine dry breadcrumbs = 4 slices of bread.
       
    • Alternate binders – bran (oat, wheat, rice, barley etc) can be used instead of breadcrumbs in most recipes. Tofu (silken) can replace the egg. Also using mashed potato (or sweet potato, carrots, most root vegetables) and/or mashed beans can help bind most patties. Of course chickpea flour and most other flours can be used to help bind patties. Seeds, nuts and grains can help bind a patty especially when the patty has cooled after cooking. These binders are used in vegan recipes.
    •  
    • Moisteners – Mayonnaise and other sauces, pesto and mustard are used in some meat patty recipes mainly for moisture and flavour but they can act as binders as well. For vegetable patties you can use chopped frozen spinach, shredded carrots, shredded zucchini, shredded apple and cooked grains to add extra moisture. Also sour cream and other milk products are used to increase the tenderness of patties.

       
    • Patty Perfection
    •  
    • When making meat patties the higher the fat content of the meat, the more the patties shrink during cooking this is especially true for ground (minced) red meat. Make patties larger than the bun they are to be served on to allow for shrinkage.
    •  
    • For hamburgers keep the fat content to about 20 - 30% (don't use lean meat) this ensures juicy patties when cooked. Also use coarse freshly ground meat (if possible) to make patties, if the mixture is ground too fine the large patties will break apart since the protein strands are too short and are covered in fat and can only bind to nearby ingredients so when the large patty is cooked it will fall apart or be too dense. Compare this behaviour with small amounts of finely ground lean meat (almost a paste) where the protein can adhere to itself (since the protein chains are short, not covered in fat and all the ingredients are nearby) hence forming a small stable patty (lamb kofta, Asian chicken balls, prawn balls).
    •  
    • Patty mixtures should be kept cold as possible when preparing them and kept cold until you  cook them the cold helps bind the ingredients together.
    •  
    • Don't over-mix the ingredients the resultant mixture will be heavy and dense.
    •  
    • For meat patties chop, mince, grate the vegetable ingredients fairly finely, if too coarse the patties will break apart.
    •  
    • Patties made mostly of meat (good quality hamburgers and rissoles) should be seasoned just before the cooking process, if salted too early liquid can be drawn out of the patty.
    •  
    • Make all the patties the same size so they will cook at the same rate. To get even-sized patties, use measuring cups or spoons to measure out your mixture.
    •  
    • For patties use your hands to combine the ingredients with the binders, mix gently until the mixture comes cleanly from the sides of the mixing bowl. Test that the final mixture forms a good patty (take a small amount in your palm and form into a ball it should hold together) before making the whole batch. Add extra liquid or dry binder as needed. Cook the test patty to check for seasoning, add extra if needed then cook the rest of the batch. 
    •  
    • Usually patties should be rested (about an hour) before cooking they “firm” up during this time, a good technique to use if your patty is soft. Always wrap patties they can dry out if left in the fridge uncovered.
    •  
    • Dampen your hands when shaping patties so the mixture won't stick to your fingers.
    •  
    • If making vegetable patties it is best to squeeze the grated/chopped/minced vegetables to remove any excess liquid this is most important for these types of patties.
    •  
    • When making fritters shred your vegetables because it makes long strands that gives a strong lattice for the patties. A food processor  or a box grater is great to use here.
    •  
    • For veggie patties make sure your ingredients are free of extra water. Drain and dry your beans or other ingredients thoroughly before mashing. You can even pat them gently dry with a kitchen cloth or paper towel.
    •  
    • Vegetable patties lack the fat of meat patties so oil the grill when BBQing them so the patty will not stick.
    •  
    • Oil all-meat burgers rather than oiling the barbecue or grill pan – this ensures the burgers don’t stick to the grill allowing them to sear well. If they sear well in the first few minutes of cooking they’ll be golden brown and juicy. To make it easy brush the burgers with a brush dipped in oil or easier still use a spray can of oil.
    •  
    • If you only have very lean ground beef try this tip from the Chicago Tribune newspaper  “To each 1 lb (½ kg) of ground beef add 2 tablespoons of cold water (with added salt and pepper) and 2 crushed ice cubs, form patties.” it really does work.
    •  
    • A panade, or mixture of bread crumbs and milk, will add moisture and tenderness to meat patties when the burgers are cooked well-done.
    •  
    • For vegetable patties it is best to focus on one main ingredient then add some interesting flavour notes to that major taste (examples carrot and caraway patties, beetroot, feta and chickpea fritters etc) this gives a much bolder flavour profile than a patty of mashed “mixed” vegetables which can be bland.
    •  
    • Most vegetable  and meat/vegetable patties just need a light coating of seasoned breadcrumbs. Lightly pat breadcrumbs onto the surface of the patty there is enough moisture and binders on the surface of the patty to bind the breadcrumbs to the patty while it is cooking. You can use wheatgerm, bran flakes, crushed breakfast cereals, nuts and seeds to coat the patty.
    •  
    • Use fine packet breadcrumbs as the coating if you want a fine smooth crust on your patties use coarser fresh breadcrumbs as the coating if you want a rougher crisper crust on your patty.
    •  
    • Flip patties once and only once, over-flipping the patty results in uneven cooking of the interior and allows the juices to escape.
    •  
    • Don't press the patties when they are cooking you'll squeeze out all of the succulent juices.
    •  
    • Rest patties a while before consuming.

       
    • Shaping the patty
    •  
    • Shaping – Shape the patty by pressing a ball of mixture with your clean hands it will form a disc shape which will crack and break up around the edges. What you want to do is press down in the middle and in from the sides, turning the patty  around in your hand until it is even and uniform. It should be a solid disc that is firm. Handle the mixture gently, use a light touch and don’t make them too compacted. Rather than a dense burger, which is difficult to cook well, aim for a loosely formed patty that holds together but is not too compressed.
    •  
    • Depressing the centre – When patties cook, they shrink (especially red meat burgers). As they shrink the edges tend to break apart causing deep cracks to form in the patty. To combat this you want the burger patty to be thinner in the middle than it is around the edges. Slightly depress the center of the patty to push a little extra mixture towards the edges. This will give you an even patty once it is cooked.  

       
    • Shallow- and pan-frying 
    •  
    • Preheat the pan or BBQ.
    •  
    • Generally when shallow-frying patties use enough oil that it comes halfway up the sides of the food. Best for most meat and vegetable patties and where the ingredients in the patty are uncooked.
    •  
    • Generally when pan-frying use enough oil to cover the surface of the pan best for most vegetable patties where all the ingredients are precooked (or cook very quickly) and all-meat rissoles and hamburgers.
    •  
    • Most oils are suitable for shallow- and pan-frying but butter is not it tends to burn. Butter can be used in combination with oil. Low-fat spreads cannot be used to shallow fry as they contain a high proportion of water. Rice bran oil is a great choice since it is almost tasteless and has a very high smoke point of 490°F/254°C. The smoke point is when the oil starts to break down into bitter fatty acids and produces a bluish smoke, Canola (smoke point 400°F/204°C) is also a great choice. Butter has a smoke point of 250–300°F/121–149°C. Olive oil Extra light 468°F/242°C. Olive oil Extra virgin 375°F/191°C. Ghee (Clarified Butter) 485°F/252°C.   
    •  
    • Do not overload the frying pan which allows steam to be trapped near the cooking food which might lead to the patties being steamed instead of fried. If you place too many patties at once into the preheated pan this reduces the heat and the patties will then release juices and begin to stew. Leave some space between each when you place them in the pan.
    •  
    • For most patties preheat the oil or fat until the oil seems to shimmer or a faint haze rises from it, but take care not to let it get so hot it smokes. If the oil is too cool before adding the patties, it will be absorbed by the food making the patty soggy. If the oil is too hot then the crumb coating will burn before the interior ingredients are cooked and/or warmed through. For vegetable and meat/vegetable patties start off cooking in a medium hot skillet and then reduce the heat to medium.  For all-meat patties start off cooking in a very hot skillet and then reduce the heat to hot, as celebrity chef Bobby Flay says that “the perfect [meat] burger should be a contrast in textures, which means a tender, juicy interior and a crusty, slightly charred exterior. This is achieved by cooking the meat [patty] directly over very hot heat, rather than the indirect method preferred for slow barbecues”. All patties should sizzle when they are placed onto the preheated pan.
    •  
    • Cast iron pans are best to fry patties.
    •  
    • When the raw patty hits the hot cooking surface it will stick. And will stay so until the patty crust forms so causing a non-stick surface on the patty at this point you can lift the patty easily without sticking. So wait until the patties (with a gentle shaking of the pan or a light finger-twist of the patty) release themselves naturally from the frying pan surface (maybe a minute or two for meat patties maybe 3-6 minutes for a vegetable patty).  If you try to flip it too early the burger will fall apart. The secret is to wait for the the patty to naturally release itself from the pan surface then flip it over once.
    •  
    • Veggie burgers will firm up significantly as they cool.
    •  
    • Most vegetable patties can be baked in the oven.
    •  
    • Check the temperature of the oil by placing a few breadcrumbs into the pan they should take 30 seconds to brown.
    •  
    • If you need to soak up excess oil place the patties on a rack to drain, do not place onto paper towels since steam will be trapped which can make the patty soggy, if you need to just press off the excess oil with paper towels then place onto a rack.



    Mandatory Items: Make a batch of pan- or shallow-fried (or baked) patties.

    Variations allowed:  Any variation on a patty is allowed. You can use the recipes provided or make your own recipe.

    Preparation time:
    Patties: Preparation time less than 60 minutes. Cooking time less than 20 minutes.

    Equipment required:
    Large mixing bowl
    Large stirring spoon
    Measuring cup
    Frying pan

    Basic Canned Fish and Rice Patties


    Servings: makes about ten ½ cup  patties
    Recipe can be doubled
    adapted from http://www.taste.com.au/recipes/17181/tuna+rissoles

    This is one my favourite patty recipes I make it once a week during the holidays. It is most important that you really mix and mash the patty ingredients well since the slightly mashed rice helps bind the patty together. 

    Ingredients:
    1 can (415 gm/15 oz) pink salmon or tuna or sardines, (not packed in oil) drained well
    1 can (340 gm/13 oz) corn kernels, drained well
    1 bunch spinach, cooked, chopped & squeezed dry or 60 gm/2 oz thawed frozen spinach squeezed dry
    2 cups (300 gm/7 oz) cooked white rice (made from 2/3 cups of uncooked rice)
    1 large egg, lightly beaten
    about 3 tablespoons (20 gm/2/3 oz) fine packet breadcrumbs for binding
    3 tablespoons (45 ml) oil, for frying
    2 spring (green) onions, finely chopped
    1 tablespoon (15 ml) tomato paste or 1 tablespoon (15 ml) hot chilli sauce
    1 tablespoon (15 ml) oyster sauce
    2 tablespoons (30 ml) sweet chilli sauce
    Salt and pepper to taste
    ½ cup (60 gm/2 oz) seasoned fine packet bread crumbs to cover patties

    Directions:
    1) Place all of the ingredients into a large bowl.
    2) Mix and mash using your hands or a strong spoon the ingredients with much force (while slowly adding tablespoons of breadcrumbs to the patty mixture) until the mixture starts to cling to itself about 4 minutes the longer you mix and mash the more compacted the final patty.  Day-old cold rice works best (only needs a tablespoon of breadcrumbs or less) but if the rice is hot or warm you will need more breadcrumbs to bind the mixture. Test the mixture by forming a small ball it should hold together. Cook the test ball adjust the seasoning (salt and pepper) of the mixture to taste.   
    3) Form patties using a ½ cup measuring cup.
    4) Cover in seasoned breadcrumbs.
    5) Use immediately or can be refrigerated covered for a few hours.
    6) Preheat fry pan (cast iron is best) to medium hot add 1½ tablespoons of oil and heat until the oil shimmers place the patties well spaced out onto the fry pan lower heat to medium.
    7) Pan fry for about 3 minutes each side for a thin lightly browned crust about 10 minutes for a darker thicker crisper crust. Wait until the patties can be released from the pan with a shake of the pan or a light turning of the patty using your fingers before flipping over to cook the other side of the patty add the remaining 1½ tablespoons of oil when you flip the patties. Flip only once. You can fry the sides of the patty if you want brown sides on your patty.

    Pictorial Guide
    Some of the ingredients
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    Starting to mix the patty mixture           
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    About ready to be tested
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    The test ball to check if the mixture will hold together
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    Form patties using a ½ cup measuring cup
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    Crumb (bread) the patties                   
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    Cover and refrigerate


    Preheat frying pan add oil wait until the oil shimmers add patties well spaced out onto the pan
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    Wait until the patties can be released by a light shaking of the pan or by finger-turning the patty and then flip the patties over add some extra oil (these were fried for 10 minutes)
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    Enjoy picture perfect patties
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    This patty was pan-fried on my cast iron fry pan notice the shiny very crisp crust as compared to the patty above
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    Zucchini, prosciutto & cheese fritters


    Servings: makes about 8-10 two inch (five cm) fritters
    Recipe can be doubled
    adapted from http://smittenkitchen.com/2011/08/zucchini-fritters/

    This makes a great light lunch or a lovely side dish for dinner. 

    Ingredients:
    500 gm (½ lb) zucchini (two medium)
    1 teaspoon (5 ml) (7 gm) salt
    ½ cup (120 ml) (60 g/2 oz) grated cheese, a strong bitty cheese is best
    5 slices (30 gm/1 oz) prosciutto, cut into small pieces
    ½ cup (120 ml) (70 gm/2½ oz) all-purpose (plain) flour plus ½ teaspoon baking powder, sifted together
    2 large eggs, lightly beaten
    2 spring onions, finely chopped
    1 tablespoon (15 ml) chilli paste
    1 teaspoon (5 ml) (3 gm) black pepper, freshly cracked
    2 tablespoons (30 ml) oil, for frying

    Directions:
       
    • Grate the zucchini with a box grater or food processor. Place into large bowl, add salt, wait 10 minutes.
    •  
    • While waiting for the zucchini, pan fry the prosciutto pieces until cooked. Remove from pan and place prosciutto onto rack this will crisp up the prosciutto when it cools. Paper towels tend to make prosciutto soggy if left on them.
    •  
    • When zucchini is ready wrap in a cloth and squeeze dry with as much force as you can you will get a lot of liquid over ½ cup, discard liquid it will be too salty to use.
    •  
    • Return dried zucchini to bowl add prosciutto, cheese, pepper, sifted flour and baking powder, chilli paste, pepper, a little salt and the lightly beaten eggs.
    •  
    • Mix until combined if the batter is too thick you can add water or milk or another egg, if too wet add some more flour. It should be thick and should not flow when placed onto the frying pan.
    •  
    • Preheat a frying pan (cast iron is best) until medium hot, add 1/3 of the oil wait until it shimmers.
    •  
    • Place dollops of batter (about 2 tablespoons each) onto the fry pan widely spaced out, with the back of a spoon smooth out each dollop to about 2 inches (5 cm) wide, do not make the fritters too thick. You should get three or four fritters in the average-sized fry pan. Lower heat to medium
    •  
    • Fry for 3-4 minutes the first side, flip, then fry the other side about 2-3 minutes until golden brown.  Repeat for the remaining batter. Adding extra oil as needed.
    •  
    • Place cooked fritters into a moderate oven on a baking dish for 10 minutes if you want extra crispy fritters.


    Pictures of process – fresh zucchini, grated zucchini, liquid released from salted and squeezed dry zucchini, ingredients for the fritters, fritter batter and frying the fritters.
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    Cooked fritters
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    California Turkey Burger


    Servings: makes about 10 burgers
    Recipe can be doubled
    adapted from Cooking Light Magazine September 2005:
    http://www.myrecipes.com/recipe/california-burgers-10000001097016/

    Sauce:
    ½ cup (120 ml) ketchup
    1 tablespoon (15 ml) Dijon mustard
    1 tablespoon (15 ml) fat-free mayonnaise

    Patties:
    ½ cup (120 ml) (60 gm/2 oz) finely chopped shallots
    ¼ cup (60 ml) (30 gm/1 oz) dry breadcrumbs
    1 teaspoon (5 ml) (6 gm) salt
    1 teaspoon (5 ml) Worcestershire sauce
    ¼ teaspoon (¾ gm) freshly ground black pepper
    3 garlic cloves, minced
    1¼ lbs (600 gm) ground turkey
    1¼ lbs (600 gm) ground turkey breast
    Cooking spray

    Remaining ingredients:
    10 (2-ounce/60 gm) hamburger buns
    10 red leaf lettuce leaves
    20 bread-and-butter pickles
    10 (1/4-inch thick/5 mm thick) slices red onion, separated into rings
    2 peeled avocados, each cut into 10 slices
    3 cups (750 ml) (60 gm/2 oz) alfalfa sprouts

    Directions:
    1. Prepare the grill to medium-high heat.
    2. To prepare sauce, combine first 3 ingredients; set aside.
    3. To prepare patties, combine shallots and the next 7 ingredients (through turkey breast), mixing well. Divide mixture into 10 equal portions, shaping each into a 1/2-inch-thick (1¼ cm thick) patty. Place patties on grill rack coated with cooking spray; grill 4 minutes on each side or until done.
    4. Spread 1 tablespoon sauce on top half of each bun. Layer bottom half of each bun with 1 lettuce leaf, 1 patty, 2 pickles, 1 onion slice, 2 avocado slices, and about 1/3 cup of sprouts. Cover with top halves of buns.                                                                                                         

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    Yield:  10 servings (serving size: 1 burger) - Nutritional Information – CALORIES 384(29% from fat); FAT 12.4g (sat 2.6g,mono 5.1g,poly 2.8g); PROTEIN 31.4g; CHOLESTEROL 68mg; CALCIUM 94mg; SODIUM 828mg; FIBER 3.9g; IRON 4mg; CARBOHYDRATE 37.5g
    Lisa’s Notes:
    Nutritional information provided above is correct for the recipe as written.  When I make these burgers, the only ingredients I change are using regular mayo, and dill pickles.  My red lettuce of choice is radicchio.  I’ve both grilled and pan fried these burgers and both are delicious.  If you decide to pan fry, you’ll need a little extra fat in the pan – so use about 2 tsp. of extra virgin olive oil, or canola oil before laying your patties on the pan.  Cook for approximately 5 minutes on each side, or until done.  Do not overcook as the patties will dry out and not be as juicy and tasty! :)

    French Onion Salisbury Steak


    Courtesy of Cuisine at Home April 2005 edition
    Makes 4 Steaks; Total Time: 45 Minutes

    Ingredients:
    1 1/4 lb (600 gm) ground chuck 
    1/4 cup (60 ml) (30 gm/1 oz) fresh parsley, minced
    2 tablespoons (30 ml) (⅓ oz/10 gm) scallion (spring onions), minced
    1 teaspoon (5ml) (3 gm) kosher salt or ½ teaspoon (2½ ml) (3 gm) table salt
    1/2 teaspoon (2½ ml) (1½ gm) black pepper
    2 tablespoons (30 ml) (½ oz/18 gm) all-purpose (plain) flour
    2 tablespoons (30 ml) olive oil
    2 cups (240 ml) (140 gm/5 oz) onions, sliced
    1 teaspoon (5 ml) (4 gm) sugar
    1 tablespoon (15 ml) (⅓ oz/10 gm) garlic, minced
    1 tablespoon (15 ml) (½ oz/15 gm) tomato paste
    2 cups (240 ml) beef broth
    1/4 cup (60 ml) dry red wine
    3/4 teaspoon (2 gm) kosher salt or a little less than ½ teaspoon (2 gm) table salt
    1/2 teaspoon  (2½ ml) (1½ gm) dried thyme leaves
    4 teaspoons (20 ml) (⅓ oz/10 gm) fresh parsley, minced
    4 teaspoons (20 ml)  (2/3 oz/20 gm) Parmesan cheese, shredded

    Cheese Toasts
    4 slices French bread or baguette, cut diagonally (1/2" thick) (15 mm thick)
    2 tablespoons (30 ml) (30 ml/1 oz) unsalted butter, softened
    1/2 teaspoon (2½ ml) (2 gm) garlic, minced
    Pinch of paprika
    1/4 cup (60 ml) (30 gm/1 oz) Swiss cheese, grated (I used 4 Italian cheese blend, shredded)
    1 tablespoon (15 ml) (⅓ oz/10 gm) Parmesan cheese, grated

    Directions:
    1. Combine chuck, parsley, scallion, salt and pepper. Divide evenly into 4 portions and shape each into 3/4"-1" (20-25 mm) thick oval patties. Place 2 tablespoons flour in a shallow dish; dredge each patty in flour. Reserve 1 teaspoon flour.
    2. Heat 1 tablespoon oil in a sauté pan over medium-high heat. Add patties and sauté 3 minutes on each side, or until browned. Remove from pan.
    3. Add onions and sugar to pan; sauté 5 minutes. Stir in garlic and tomato paste; sauté 1 minute, or until paste begins to brown. Sprinkle onions with reserved flour; cook 1 minute. Stir in broth and wine, then add the salt and thyme.
    4. Return meat to pan and bring soup to a boil. Reduce heat to medium-low, cover and simmer 20 minutes.
    5. Serve steaks on Cheese Toasts with onion soup ladled over. Garnish with parsley and Parmesan.

    For the Cheese Toasts
    6. Preheat oven to moderately hot 200°/400ºF/gas mark 6.
    7. Place bread on baking sheet.
    8. Combine butter, garlic and paprika and spread on one side of each slice of bread. Combine cheeses and sprinkle evenly over butter. Bake until bread is crisp and cheese is bubbly, 10-15 minutes.

    French Onion Salisbury Steak
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    Potato Rösti


    Servings: makes two large rösti
    adapted from a family recipe

    The classic rösti; cheap, easy and so tasty.

    Ingredients:
    1 kg (2½ lb) potatoes
    1 teaspoon (5 ml) (6 gm) salt
    2 teaspoons (10 ml) (6 gm) black pepper, freshly milled
    1 large egg, lightly beaten
    2 tablespoons (30 ml) (½ oz/15 gm) cornflour (cornstarch) or use all-propose flour
    3 tablespoons (45 ml) oil, for frying

    Directions:
       
    1. Grate lengthwise the peeled potatoes with a box grater or a food processor.
    2.  
    3. Wrap the grated potato in a cloth and squeeze dry, you will get a lot of liquid over ½ cup, discard liquid since it is full of potato starch.
    4.  
    5. Return dried potato to bowl add the egg, cornflour, pepper, and salt.
    6.  
    7. Mix until combined.
    8.  
    9. Preheat a frying pan (cast iron is best) until medium hot, add 2 teaspoons of oil wait until oil shimmers.
    10.  
    11. Place half of mixture into the pan, flatten with a spoon until you get a smooth flat surface. Lower heat to medium.
    12.  
    13. Fry for 8-10 minutes (check at 6 minutes) the first side, flip by sliding the rösti onto a plate then use another plate invert the rösti then slide it back into the pan, then fry the other side about 6-8 minutes until golden brown. Repeat to make another rösti


    Pictures of process – Peel 1 kg spuds, grate lengthwise, squeeze dry, add 1 egg, 2 tablespoons starch, salt and pepper. Pan fry.
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    Pictures of the grated potato before (left) and after (right) squeezing dry. Notice in the left hand pictures the gratings are covered in moisture and starch, while in the right hand pictures the grated potato is dry and doesn't stick together.
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    Pictures of the finished small rösti
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    Pictures of the large rösti
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    Chicken, potato and corn patties
    I had some leftover chicken legs and boiled potatoes from dinner last night so I made up some patties. The patties are made from 1 kilogram of finely grated cold boiled potatoes, 4 chicken legs meat removed and finely chopped, and one can of corn kernels. The binder was one egg and 1/4 cup of self-raising wholewheat flour.

    The crumbed (breaded) patties waiting to be pan fried
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    Patties pan frying
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    The finished patties
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    Meatballs
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    I made meatballs using high quality ground veal and pork (30% fat) I didn't use any binders in the mixture just a little seasoning chilli, garlic and dried mushroom powder.

    The meatballs waiting to be fried
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    Frying the meatballs
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    The finished meatballs
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    Of course I made spaghetti and meatballs for dinner so so delicious
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    Thai Fish Cakes
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    I adore Thai fish cakes but I have never really made them I was surprised how simple it is if you have a very strong food processor. Basically you make a paste from 1/2 kg (1 lb) of white fillet fish (I used catfish (basa) fillets) with 1 egg and 6 tablespoons of flavourings (a combination of 1 Tbsp fish sauce, 1 tsp chilli, 2 Tbsp red curry paste, 1 Tbsp coconut cream, 1 Tbsp chilli crab flakes, 1/2 tsp sugar, 1/2 tsp salt, 1/2 tsp shrimp paste, a few spices), 6 kaffir lime leaves and 2 tablespoons cornflour (cornstarch) with a teaspoon of baking powder, you form small patties (each 2 tablespoons) from the paste and pan fry until cooked. These are just as good as the cafe ones I buy and only cost about 30 cents each instead of $1.90 at the cafe. A good basic recipe for Thai fish cakes is here http://thaifood.about.com/od/thaiseafoodrecipes/r/classicfishcakes.htm I added some extra baking powder and cornflour to the basic recipe since it makes the cakes rise and the interiors are light and fluffy. Super tasty and so cute.

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    Storage & Freezing Instructions/Tips:
    Most rissoles, croquettes and dry fritters keep well for three or four days if covered and kept in the fridge. Uncooked and cooked rissoles and croquettes can be frozen for at least one month.

    Additional Information: 
    An index of Aussie patty recipes http://www.taste.com.au/search-recipes/?q=patties&publication=
    An index of Aussie rissole recipes http://www.taste.com.au/search-recipes/?q=rissoles&publication=
    An index of American patty recipes http://allrecipes.com/Search/Recipes.aspx?WithTerm=patty%20-peppermint%20-dressing&SearchIn=All&SortBy=Relevance&Direction=Descending
    An index of American burger recipes http://busycooks.about.com/cs/easyentrees/a/burgers.htm 
    A great vegetable and chickpea recipe http://www.exclusivelyfood.com.au/2006/06/vegetable-and-chickpea-patties-recipe.html
    A baked vegetable patty recipe http://patternscolorsdesign.wordpress.com/2011/02/20/baked-vegetable-patties/
    Vegetable patty recipes http://www.divinedinnerparty.com/veggie-burger-recipe.html
    Best ever beet(root) and bean patty http://www.thekitchn.com/restaurant-reproduction-bestev-96967
    Ultimate veggie burgers http://ask.metafilter.com/69336/How-to-make-awesome-veggie-burgers
    One of best zucchini fritter recipes http://smittenkitchen.com/2011/08/zucchini-fritters/ 
    Old School Meat rissoles http://www.exclusivelyfood.com.au/2008/07/rissoles-recipe.html
    How to form a patty video http://www.youtube.com/watch?v=iHutN-u6jZc
    Top 12 vegetable patty recipes http://vegetarian.about.com/od/veggieburgerrecipes/tp/bestburgers.htm
    Ultimate Meat Patties Video http://www.chow.com/videos/show/youre-doing-it-all-wrong/55028/how-to-make-a-burger-with-hubert-keller
    Beautiful vegetable fritters so pretty http://helengraves.co.uk/tag/beetroot-feta-and-chickpea-fritters-recipe/   
    Information about veggie patties http://kblog.lunchboxbunch.com/2011/08/veggie-burger-test-kitchen-and-lemon.html  

    Disclaimer:
    The Daring Kitchen and its members in no way suggest we are medical professionals and therefore are NOT responsible for any error in reporting of “alternate baking/cooking”.  If you have issues with digesting gluten, then it is YOUR responsibility to research the ingredient before using it.  If you have allergies, it is YOUR responsibility to make sure any ingredient in a recipe will not adversely affect you. If you are lactose intolerant, it is YOUR responsibility to make sure any ingredient in a recipe will not adversely affect you. If you are vegetarian or vegan, it is YOUR responsibility to make sure any ingredient in a recipe will not adversely affect you. The responsibility is YOURS regardless of what health issue you’re dealing with. Please consult your physician with any questions before using an ingredient you are not familiar with.  Thank you! :)
              January, 2012 Daring Baker Challenge: Back to Basics:Scones (Biscuits)        
    Introduction:  Hi my name is Audax from Audax Artifex (yes this web site). Whenever I visit my sister and her family in S.E. Queensland Australia she always welcomes me with a fresh batch of my favourite baked treat which we devour gleefully with cups of tea while we chat and catch up with the events in our lives.

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    The treat that I'm talking about is the basic scone (also know as baking powder biscuits in North America) my sister really knows how to make them, they are wondrously light with soft sides and a lovely airy crumb – superb with jam and cream. This month I want the Daring Bakers' to share my delight and I invite you to bake a batch of scones to enjoy with friends and family.

    For our North American members I wish to clarify what this challenge is all about and try to avoid any confusions. Scones in North American are nearly always triangular in shape have a slightly crisp crust usually covered in sugar and have a soft interior crumb and sometimes are laced with dried fruit (these baked goods in Australia and England are called “rock cakes” since they are usually made to look like “rocky” cakes not wedges), meanwhile biscuits in North American are a round shaped buttery slightly flaky baked good usually eaten with meals (these items in Australia and England are called “scones” and are eaten with butter and jam usually with cups of tea or coffee as a sweet snack). So this challenge (using the North American name) is to make biscuits. Or using the Australian or English name this challenge is to make scones.

    To further clarify for our North American bakers this month's challenge is to make biscuits (also called baking powder biscuits) if you choose to make your biscuits using buttermilk as the liquid you are making what are known as “Southern” Biscuits which are one of the most famous examples of home cooking in the Southern States of America (that is they are a baking powder biscuit made with buttermilk). In Australia and England “Southern” Biscuits would be called buttermilk scones. So restating the above, the challenge is to make scones (using the Australian/English name) or to make  biscuits (using the North American name). Incidentally if you use cream as your liquid in the challenge recipe the final baked good would be called a cream biscuit in North America or a cream scone in Australia and England.  

    Scones (biscuits) contain only a small number of ingredients they are fast to make, quick to bake, only cost cents per batch and most importantly are super FUN to eat. In England and Australia scones are eaten with jam and butter usually with cups of tea or coffee mostly as a sweet snack, while in North America they are usually eaten with meals as a savoury side.

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    Of course scones (biscuits) have a notorious reputation as being difficult for some people to make  comments like “hockey pucks”, “These made great door-stops ” and the like fill the comment sections of most recipe websites. You see scones (can be said as a rhyme with cone and also can be said as a rhyme with gone) are a type of quick bread that is a white flour dough that is raised using chemical agents usually baking powder and/or baking soda. Basic scones contain flour, raising agent(s), butter (or shortening or lard), salt, and milk (or buttermilk or soured milk or cream). Most recipes just say to “rub the fat into the flour” then combine the dry and wet ingredients until “gathered together” and then “lightly knead” the gathered mixture until a soft dough forms, then “roll or pat” out this dough and then “cut” out rounds and bake them in a hot oven. Well how hard could it really be I thought uh-mm as you can see below my first batch wasn't the greatest success … they didn't raise at all and the texture was barely OK I thought … I was left wondered what I had done wrong …   

    My first attempt at scones (really pretty terrible I thought, no height no tenderness and no flakiness)

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    So after studying many many (288 websites bookmarked) scone/biscuit recipes and the bakers' comments about these recipes and after doing 16 batches! myself I have acquired a lot of information to help you master the techniques involved I hope that at the end of this challenge that you will be able to make a good if not great scone (biscuit).

    After much research and many attempts …  finally some scones (the 14th, 15th and 16th batches) that I wouldn't mind sharing with my sister.

    The Classic Australian scone ring (Aussie Damper) – the crumb is very similar to bread
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    Cheese and chives scones – a “sky-high” light and tender scone flavoured with cheese and chives
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    The classic Southern Biscuit (buttermilk scone) – a superbly flaky scone made with buttermilk and laminated to form distinct layers when baked
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    Fairy Ring
    As I mentioned in the challenge posting in Australia and England scones are usually eaten as a sweet treat (with butter and jam) with cups of tea on that theme while doing my research for this challenge I thought I would do a variation on the sweet side of the scone. Here is one recipe that is suitable for kids and adults when you want something special and sweet yet can be made at a moment's notice.

    In Australia one of the most popular children's party food item is fairy bread. This is a variation of fairy bread called Fairy Ring made with an Aussie Scone (Damper) ring laced with 100s and 1000s then iced (with some icing sugar and a touch of lemon juice made into a sticky paste) then sprinkled with more 100s and 1000s (coloured sprinkles). My 9 year old niece went crazy with delight and literally squealed with glee when I showed her this Fairy Ring and say I made it especially for her.

    Normal (Damper) Scone Ring
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    Fairy Ring straight from the oven
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    Completed Fairy Ring
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    Hot Dog Buns
    Here is a savoury variation, I made hot dog buns using the basic scone recipe. They worked out great I couldn't believe the crumb and they tasted great with the hot dog and relishes and I made them in under 15 minutes (once the oven was hot enough). I was very surprised how well the basic scone dough complimented savoury food.  
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    Touch of Grace Scones
    (Click on the title to go to a great posting about this recipe)
    Here is the answer to dry biscuits this recipe is called "touch of grace" biscuits which uses a few simple techniques to create a super moist crumb. These scones are all about tenderness everything is designed to obtain the softest and most tender crumb possible. These are very different from the normal bread-like scones that Australians like with jam and cream. These would be perfect with a savoury meal. They were so buttery with a soft creamy crumb that literally melts in your mouth, the mouth feel is like clouds. As one reviewer lovingly opined "They're squat little puffs you'll want to grab, steaming, from a basket passed over fried chicken or bacon and eggs". The way I make them is slightly adapted from the original recipe,  I use a lot of very large pieces of butter and all buttermilk with very low gluten cake flour and some resting time in the fridge. Resting the dough after the buttermilk is stirred into the dry ingredients is essential you would never be able to form the soft balls of dough coated in flour that are the "rounds" in this case and keeping everything cold helps the baking process. While baking the large pieces of butter melt into the flour causing large air holes to form in the baked dough and since we use soft flour (6%) which cannot form flaky layers we thus obtain a feather-light creamy tender crumb infused with the maximum amount of butter that the dough can hold.
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    These scones are made entirely from cake flour (6% gluten), I used 1 cup of flour, 2 teaspoons baking powder, 1/2 teaspoon baking soda, 1/4 cup very large-sized butter pieces, about 1/2 cup buttermilk and 1/2 teaspoon sea salt. I rubbed in butter making sure most of the fat/flour where large pea sized pieces. I rested the dough after I mixed in the wet ingredients for 10 minutes until cold, during this time the dough "firms" up making it possible to turn it out in one cohesive dough ball onto a lightly floured board. I formed a rectangle of the soft dough floured the top lightly then I stamped out rounds. You could feel the pieces of butter in the formed round The rounds are very soft but can be picked up and placed into the baking dish. Then I place the baking dish with all the formed rounds back in the fridge for 10 minutes until cold then bake. (This procedure is much easier than the original recipe's method and it gives as good results I think). As you can see the crumb is saturated with butter and has masses of large airy pockets to trap your favourite topping. Absolutely delicious.
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    Raisin Scones
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    I wanted to make one batch of flavoured scones I went with sweet raisins and some molasses in the dough. I rubbed in the butter until it was like fine sand and I used "OO" cake flour about 7% protein and some cornflour (cornstarch), I was very happy with the look of the baked scones and the crumb was very tender very much like bread which is what I wanted. These were very cute looking but to be honest I like plain scones much better.
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    The bread like crumb of the scone so so tasty and soft.
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    As you can see scones (biscuits) are all about technique since the scones pictured above used the same basic recipe. 

    Recipe Source:  The challenge scone (biscuit) recipe has been especially formulated by Audax Artifex after a large amount of research and experimentation. It is designed to help you master the techniques involved in making scones (biscuits) exactly the way you like them. 

    Blog-checking lines: Audax Artifex was our January 2012 Daring Bakers’ host. Aud worked tirelessly to master light and fluffy scones (a/k/a biscuits) to help us create delicious and perfect batches in our own kitchens!

    Posting Date:  January 27, 2012

    Challenge Notes:
    The Ingredients – since scones contain only a small number of ingredients each should be of the highest quality
    Flour – lower gluten (i.e. soft) flours (about 9% or less protein) produce taller and lighter scones than normal plain (all-purpose) flour (about 10%+ protein). But to be honest it wasn't that great a difference so long you sifted the dry ingredients thoroughly at least three times. That is always triple sift the dry ingredients this will ensure that the flour is well aerated and the raising agents are evenly distributed so resulting in light scones. I found that finely milled soft “OO” flour gave the best results but don't worry you can get excellent results with sifted plain (all-purpose) flour. You can use self-raising flour if you wish (remember to leave out the raising agents and salt) in the recipe below it is important to triple sift the self-raising flour as well I like to add about ½ teaspoon of extra fresh baking powder per cup of self-raising flour to ensure a good lift in my scones. In the northern states of America and most of Canada all-purpose flour is generally very hard (high in protein) you can replace for each cup 4 tablespoons of all-purpose flour with cake flour  OR for each cup replace 2 tablespoons of all-purpose flour with cornflour (cornstarch). Or you can let the scones rest (20 mins) in the fridge before baking. 
    Fat – unsalted butter gives the best flavour while lard gives the flakiest texture since it has a much higher melting point than butter so promoting a flaky texture in the final scones. The best compromise is to use a combination of the two in equal measure. I usually use all (unsalted) butter for flavour and health reasons. In most recipes the fat is rubbed into the flour using fingers or a pastry cutter (don't use two knives or forks since it takes too long to cut in the fat using this method). It is best to grate the butter using the coarse side of a box-grater and then freeze it until you need it. Freezing the butter prevents the fat from melting into the flour. The idea is to coat the fat particles with the flour. You are looking for a fat/flour combination that looks like very coarse bread crumbs with a few pieces of butter about the size of peas, the finer you make your fat pieces the more tender the crumb of your final scones. If you want very flaky scones then make the fat pieces large like Lima beans and only lightly coat them in the flour. If your kitchen is very hot you can refrigerate your flour so helping to keep the fat from melting. Don't freeze your flour as this will make it too difficult to rub the fat into the flour. (Typical usage about 1 to 8 tablespoons of fat per cup of flour).
    Chemical raising agents – always use fresh raising agents, baking powder deteriorates within two months once the jar is opened, typical usage 1 to 2 teaspoons per cup. Baking powder nowadays is double action – there is an initial release of gas once the dry and wet ingredients are combined and there is another release of gas from the high heat of the oven. If you are using acidic ingredients (such as buttermilk, soured milk, honey, citrus juice, yoghurt, tomato sauce etc) then use an additional ¼ teaspoon of baking soda per cup of liquid to help neutralise the acid and make the final baked product raise correctly. Baking soda is much stronger (x4) in raising power than baking powder. You can make you own single action baking powder by triple sifting together one part baking soda and two parts cream of tartar store in an airtight container. To check if your double action baking powder is fresh place 1/4 teaspoon in 1/2 cup of water it should bubble a lot, then microwave it for 30 secs it should bubble it again. To check your baking soda place 1/8 teaspoon into 1 tablespoon of vinegar (or lemon juice) it should bubble a lot. 
    Liquid – you can use milk (any sort), buttermilk, soured milk, yoghurt, half-and-half, cream, coconut cream, soda water, even lemon-flavoured soda pop (soft drink) or a combination of these as the liquid in your scones. You can sour regular milk with a tablespoon of cider vinegar or lemon juice for every cup. Just stir it in and let it sit for 10 minutes or so to curdle. Typical usage is 1/3 to 1/2 cup of liquid per cup of flour.
    Salt – a small amount of salt (about ¼ teaspoon per cup of flour)  helps improve the action of the raising agents and enhances the flavour of the scones.

    The Equipment
    Baking pans – use dark coloured heavy weight baking pans as these have the best heat distribution and really give a great raise to your baked goods. Many people like to use cast iron skillets for best results.
    Measuring cups and spoons – try to accurately measure all ingredients especially if this is your first attempt at making scones (biscuits) remember to scoop the ingredient into the measure and level with a knife. If you can weigh the flour using scales even better.
    Scone (biscuit) cutters – use a cutter that is made of sharp thin metal with straight sides and is open at both ends this ensures that the scone will raise straight and evenly and ensures the cut scone is easy to remove from the cutter without compressing the dough. Try to avoid using cutters with wavy sides, thick walled cups, glasses, metal lids, small jars or any cutter with only one opening since it is difficult to remove the cut scones from these without compressing the dough therefore leading to 'tougher' scones. If you cannot get a good cutter you can cut out squares or wedges etc using a sharp knife if you wish.
    Rolling pins – most scone doughs are very soft (and wet) so can be easily patted out using your fingers. For a large amount of dough you can use a rolling pin remember to use light pressure from the centre outwards to form an even thickness of dough ready to be cut into scones. Avoid rolling back and forth over the same area as this can overwork the dough.    

    The Techniques
    Triple sift the dry ingredients – sift your dry ingredients from a height this permits plenty of air to be incorporated into the mixture which allows for maximum lightness in your scones and ensures even distribution of all the raising agents and other ingredients.
    Rubbing in the fat – this is the stage where you can control how tender or flaky your final scone crumb will be. The more you coat your fat with flour and the smaller the particles of the final mixture, the more tender the end product because you’re retarding gluten formation in the flour (unfortunately the price you pay for this tenderness is that the final dough will be soft and might not raise very well since the gluten isn't developed enough to form a stable structure to trap the gases that are released when the dough is baked). Conversely the larger you leave the pieces of fat (the infamous "pea-sized" direction you always see in scone/biscuit recipes), the flakier the final scones will be (that is the gluten in this case is more developed but you might find that the final baked product is dry and the mouth feel of crumb could be too firm i.e. tough). So summarising the tenderness/flakiness of your scone is achieved in this stage by manipulating the size of the fat particles and how much of the flour is used to coat the fat (the more flour used to coat the fat promotes more tenderness while larger fat pieces promote more flakiness).  Either way quickly rub in the grated frozen fat into the dry ingredients using
    1)your finger tips – as you lightly rub and pinch the fat into the flour, lift it up high and let it fall back down into the bowl, this means that air is being incorporated all the time, and air is what makes scones light, continue this until you have the desired sized flour/fat particles in the mixture, or
    2)a cold pastry cutter – begin by rocking the pastry cutter into the fat and flour mixture continue rocking until all the fat is coated in flour and the desired sized flour/fat particles are obtained.
    Moistening and bringing the dough together -  add nearly all of the liquid at once to the rubbed-in dry ingredients.  When mixing the dough (I use a soft plastic spatula, my sister uses a knife), stir with some vigour from the bottom to the top and mix just until the dough is well-moistened and begins to just come together it will be wet (and sticky). And remember the old saying – the wetter the dough the lighter the scones (biscuits)!  
    Handling the dough – as most people know it is important not to overwork the dough but what isn't appreciated is that under-working is almost as common a mistake as overworking. Look at my first attempt (the first photo in this article) at making the challenge recipe it is crumbly and a bit leaden and the crumb isn't flaky at all this is due to under-working the dough and making the flour/fat particles too small, it took me about six batches to understand this and not be afraid to handle the dough so the scone (biscuit) would raise correctly. Under-working causes as many problems as overworking. Overworking leads to tough, dry and heavy scones while under-working leads to crumbly leaden ones. If you are not happy with your baked goods look carefully at your final scones (biscuits) and decide if you have under- or over-worked your dough.
    Kneading or folding/turning the dough – this is the stage where you can control whether or not your scone has distinct layers by 1) only kneading the dough (for no layering effect) or 2) only turning and folding the dough (for a layering effect).  As mentioned above given the same amounts of flour and fat, leaving larger pieces of fat equals more gluten formation and, therefore, flakiness. Leaving smaller pieces of fat equals less gluten formation and, therefore, tenderness. Your dough at this stage of the recipe will be a mixture of different gluten strengths since it is almost impossible to make a totally homogeneous dough at home. The major idea at this stage of the process is to exploit these gluten differences to achieve a desired degree of lamination (layering) in the final baked good. That is at this stage your dough (after you have added the liquid and mixed it until it just holds together), will have different layers of relatively gluten-rich (tougher) dough (the more floury parts of the dough), and layers of relatively gluten-free (tender-er) dough with small pieces of fat (the more fatty parts of the dough). So at this point if we only lightly knead the dough these layers will become less distinct which means the dough will become more homogeneous so producing a more even and more tender crumb when baked. But if at this stage you only fold and turn the dough (as shown below in pictures) over itself, these different layers will remain intact but will get thinner and thinner with each fold and turn, so when the fat melts and the liquid turns to steam in the oven, this steam pushes the tougher layers apart, leading to an overall flakiness and a layering effect in the scone crumb (see picture of the buttermilk biscuit above). So if you want an even more tender crumb just lightly knead (much like you would knead bread but with a very very light touch) the turned-out dough a few times until it looks smooth. If you want to form layers (laminations) in your final baked goods do a few folds and turns until it looks smooth. Always do at least one light knead to make the final dough structurally strong enough to raise and hold its shape whether you are aiming for a smooth tender crumb or a flaky layered crumb.
    Pat or roll out the dough – since most scone (biscuit) doughs are soft (and sticky) it is best to use your fingers to gently pat out the dough once it has been kneaded or folded and turned. Use a very light touch with little pressure while forming the dough rectangle to be cut into rounds for the scones. If you want tall scones then pat out the dough tall, about 3/4 inch to 1 inch (2 cm to 2½ cm) thick is about right.
    Cutting out your scones – use a well-floured scone (biscuit) cutter for each round that you stamp out from the dough. That is dip your cleaned cutter into fresh plain flour before each separate cut. Do not twist the cutter while stamping out the scone, push down firmly until you can feel the board then lift the cutter the round should stay inside the cutter then gently remove it from the cutter  and place the round onto the baking dish. You can use a sharp knife to cut out other shapes if you wish from the dough, also the knife should be floured before each cut as well. 
    Baking your scones – always preheat your oven when baking scones. Place each scone almost touching onto the baking dish this encourages the scones to raise and also keeps the sides soft and moist. If you want crisp sides widely space your scones on the baking dish. Don’t over-bake your scones. Over-baking for even a minute or two will dry your scones out. As soon as the sides begin to turn brown and are set, remove them from the oven. Immediately, place the scones on a wire rack—the hot pan will continue to dry the scones.
    Extra comments about resting the dough – I found in my researches that a number of respected sources mentioned resting the dough in various stages in the recipe. Surprisingly this advice is sound. I found that if you rested the just mixed dough (in the fridge) for 20 minutes there was a huge improvement in the dough's handling qualities and the final scones height, lightness and crumb were outstanding. Also I found that if you rest your patted out dough covered in plastic for 10 minutes in the fridge that the rounds are easier to stamp out and the final baked goods raise higher and have a better crumb. Also you can rest your stamped out rounds in the fridge for a couple of hours without harm so you can make your scones place them into the fridge and then at your leisure bake them later great for dinner parties etc. This is possible because modern baking powder is double action, i.e. there is another release of gas when you bake the rounds in the heat of the oven.

    Troubleshooting  
    Problems with bitter after-taste or dry chalky mouth-feel

    The biggest problem that scone/biscuits can sometimes have is an after-taste (sometimes described as metallic or a salty chemical taste) or the mouthfeel is dry and chalky (i.e. the crumb is tough and doesn't have enough moisture).

    If the problem is the after-taste try these tips
    • use freshly opened raising agents, many people claim old baking powder has a stronger taste
    • look for a single action baking powder (that only uses baking soda and cream of tar tar with a little cornflour) or make your own, since some double action baking powders can have metallic salts in them which some people can taste even in small quantities. Also keep in mind that homemade baking powder works faster and at a lower temperature, so put your recipe together quickly
    • look for a double action baking powder that uses non-metallic ingredients in it, check the ingredients listing on the packet.
    • use less baking powder
    • if you used an acidic liquid (buttermilk etc) and did not use some baking soda with the normal baking powder then some of the acid in the liquid wouldn't have been neutralised so leaving some salts behind causing the salty aftertase, that is make sure you are using the correct combination of agents for the liquids that you use, see the link below for full details about this. 
    • use only baking soda and an acidic liquid (buttermilk) like in the famous Irish Soda bread which very few people complain about having an aftertaste
    • use bakers' ammonium (available from King Arthur's flour) it was one of the most common chemical raising agents in the old days before modern baking powder, it smells like ammonia when baking but the ammonia smell totally dissipates and this chemical leaves nothing behind. I use it a lot in my baking it really gives baked goods that old-fashioned taste that people really can pick up on also it gives cookies extra crispness when baked.   

    See here for a comprehensive posting on baking powder/baking soda and how to use them in recipes.
    See here for the most interesting discussion on the use of baking soda and baking powder

    If the problem is the mouthfeel try these tips
    • try smaller sized scones and bake them quickly in a very hot oven and make the dough wetter since large sized scones using a drier dough baked in a moderate oven will give you a dryer crumb therefore a dry chalky mouthfeel
    • over-handled dough will lead to a dry mouth
    • eat them immediately fresh out of the oven, scones do really suffer (they become dry and tough) when stored for any length of time
    • try using more fat about 1/4 cup+ per cup of flour - more fat gives moister crumb. Also try using all shortening, since shortening contains no water or milk solids it gives a very tender crumb.
    • use this great recipe they are called "a touch of grace" biscuits they are the most tender and moist biscuits (scones) that I have had.
    • some people claim that a very hot oven is best to start the baking process then lower the temperature to moderate to finish baking the scones

    The problem lopsided scones
    About lop-sided scones this is usually caused by uneven cutting out of the scone. Some hints
    1. Clean and flour the scone cutter (by rubbing off any wet dough and then dipping the cutter into fresh flour the entire height of the cutter) every time you stamp out each round. Remember not to twist when you are stamping out the scones. If you are using a knife remember to clean and flour it for each cut.
    2. Try to pat out or roll out the dough as evenly as possible.
    3. Did you sift the dry ingredients three times? (uneven distribution of ingredients can lead to uneven scones).
    4. Try to get the scone out of the cutter by applying gentle even pressure on the entire scone circumference that way you do not compress just one place so making that area less tender so raising less when cooked.
    5. Turn the cut scone upside down onto the baking dish, since this side will be flatter than the patted out top surface.
    6. Only glaze the tops of the scone, a small amount of liquid on the sides will inhibit raise in that area.
    7. Some people like to use a fork and prick some holes in the top of the unbaked scones supposedly this helps the scone raise evenly.
    8. Also some people like to use their thumb and press a small hollow into the top of the scone supposedly this helps the scone raise evenly.
    9. A good article about "making the perfect scone" see here it goes through a lot of the best scone recipes by master bakers.
    10. Try this recipe and its method from Bakers' 911 which seems to make straight-sided scones even from wavy-sided cutters

    How to test baking soda
    1. Place a 1/4 teaspoon of baking soda into a tablespoon of vinegar it should bubble a lot.

    How to test your single action baking powder
    1. Place a teaspoon of baking powder into a cup, add 1/4 cup room temperature water it should bubble a lot.

    How to test your double action baking powder
    1. Place a teaspoon of baking powder into a cup, add 1/4 cup room temperature water it should bubble a lot.
    2. Wait 30 secs and then place your cup into the microwave heat for about 30 secs until about 180F it should bubble again.
    3. If it doesn't then discard and buy a new jar.

    How to test your self-raising flour - add one tablespoon of S.R. flour into some hot water it should bubble a bit. Or try adding some vinegar and see if it bubbles. Usually SR flour is only good for about three months.

    The problem an unreliable oven
    1. Try and use heavy grade dark metal baking dishes which give the best heat distribution.
    2. If your oven heating cycle is unreliable (varies the temperature a lot) lower the temperature to hot 220C (430F), preheat the oven along with a heavy metal baking dish for a good 20 mins then bake the scones on the baking dish which acts as a heat sink helping to bake the scones more evenly. Try to bake smaller sized scones which helps with a constantly varying temperature.
    3. If your oven has hot spots which mine does just rotate the dish at about 3/4 of the total baking time.

    The problem my dairy-free margarine doesn't do a good job of cutting in
    1. Just melt the margarine and add it to the liquid and proceed as normal (this is the best you can do if the margarine is "bad for cutting-in or just bad for scones" in the first place).

    Mandatory Items: You must make one batch of basic scones (i.e. basic biscuits using the North American name). The challenge recipe has been designed to be fast, very cheap and easy to follow so allowing for multiple attempts to be made until you can achieve your desired result. I encourage you to make a couple of batches to see how small changes in technique can obtain vastly different final baked products. I estimate all of my 16 experimental batches cost less than $4 and took about four hours, so please do take this opportunity to explore the possibilities of the different techniques and advice that have been presented here in this challenge. I have included a number of links to the most popular scone (biscuit) recipes (and variations) in a number of countries feel free to use these if you can make a good basic scone (biscuit) already.  

    Variations allowed:  A number of variations (cheese and chives, herb, etc) on the basic challenge recipe are included use them if you wish.  

    Preparation time: Scones: Preparation time less than 10 minutes. Baking time about 10 minutes.

    Equipment required:
    Large mixing bowl
    Baking dish
    Measuring cups and  spoons (optional)
    Flour Sifter (optional)
    Board (optional)
    Scone (biscuit) cutter (optional) or knife (optional)
    Dough scraper (optional)
    Spatula (optional)
    Weighing scale (optional)
    Cooling rack (optional)
    Pastry brush (optional)

    Basic Scones (a.k.a. Basic Biscuits)
    Servings: about eight 2-inch (5 cm) scones or five 3-inch (7½ cm) scones
    Recipe can be doubled

    Ingredients:
    1 cup (240 ml) (140 gm/5 oz) plain (all-purpose) flour
    2 teaspoons (10 ml) (10 gm) (⅓ oz) fresh baking powder
    ¼ teaspoon (1¼ ml) (1½ gm) salt
    2 tablespoons (30 gm/1 oz) frozen grated butter (or a combination of lard and butter)
    approximately ½ cup (120 ml) cold milk
    optional 1 tablespoon milk, for glazing the tops of the scones

    Directions:
    1. Preheat oven to very hot 475°F/240°C/gas mark 9. 
    2. Triple sift the dry ingredients into a large bowl. (If your room temperature is very hot refrigerate the sifted ingredients until cold.)
    3. Rub the frozen grated butter (or combination of fats) into the dry ingredients until it resembles very coarse bread crumbs with some pea-sized pieces if you want flaky scones or until it resembles coarse beach sand if you want tender scones.
    4. Add nearly all of the liquid at once into the rubbed-in flour/fat mixture and mix until it just forms a sticky dough (add the remaining liquid if needed). The wetter the dough the lighter the scones (biscuits) will be!
    5. Turn the dough out onto a lightly floured board, lightly flour the top of the dough. To achieve an even homogeneous crumb to your scones knead very gently about 4 or 5 times (do not press too firmly) the dough until it is smooth. To achieve a layered effect in your scones knead very gently once (do not press too firmly) then fold and turn the kneaded dough about 3 or 4 times until the dough has formed a smooth texture. (Use a floured plastic scraper to help you knead and/or fold and turn the dough if you wish.)
    6. Pat or roll out the dough into a 6 inch by 4 inch rectangle by about ¾ inch thick (15¼ cm by 10 cm by 2 cm thick). Using a well-floured 2-inch (5 cm) scone cutter (biscuit cutter), stamp out without twisting six 2-inch (5 cm) rounds, gently reform the scraps into another ¾ inch (2 cm) layer and cut two more scones (these two scones will not raise as well as the others since the extra handling will slightly toughen the dough).  Or use a well-floured sharp knife to form squares or wedges as you desire.
    7. Place the rounds just touching on a baking dish if you wish to have soft-sided scones or place the rounds spaced widely apart on the baking dish if you wish to have crisp-sided scones. Glaze the tops with milk if you want a golden colour on your scones or lightly flour if you want a more traditional look to your scones.
    8. Bake in the preheated very hot oven for about 10 minutes  (check at 8 minutes since home ovens at these high temperatures are very unreliable) until the scones are well risen and are lightly coloured on the tops. The scones are ready when the sides are set.
    9. Immediately place onto cooling rack to stop the cooking process, serve while still warm.

    Variations on the Basic recipe
    Buttermilk – follow the Basic recipe above but replace the milk with buttermilk, add ¼ teaspoon of baking soda, increase the fat to 4 tablespoons, in Step 3 aim of pea-sized pieces of fat coated in flour, in Step 5 fold and turn the dough, rounds are just touching in the baking dish, glaze with buttermilk.
    Australian Scone Ring (Damper Ring) – follow the Basic recipe above but decrease the fat to 1 tablespoon, in Step 3 aim of fine beach sand sized pieces of fat coated in flour, in Step 5 knead the dough, in Step 7 form seven rounds into a ring shape with the eighth round as the centre, glaze with milk.
    Cream – follow the Basic recipe above but replace the milk with cream, add ¼ teaspoon of baking soda, in Step 3 aim of beach sand sized pieces of fat coated in flour, in Step 5 knead the dough, rounds are just touching in the baking dish, glaze with cream.
    Cheese and Chive – follow the Basic recipe above but add ¼ teaspoon of baking soda, after Step 2 add ½ teaspoon sifted mustard powder, ¼ teaspoon sifted cayenne pepper (optional), ½ cup (60 gm/2 oz) grated cheese and 2 tablespoons finely chopped chives into the sifted ingredients, in Step 3 aim of beach sand sized pieces of fat coated in flour, in Step 5 knead the dough, rounds are widely spaced in the baking dish, sprinkle the rounds with cracked pepper.
    Fresh Herb – follow the Basic recipe above but after Step 3 add 3 tablespoons finely chopped herbs (such as parsley, dill, chives etc).
    Sweet Fruit – follow the Basic recipe above but after Step 3 add ¼ cup (45 gm) dried fruit (e.g. sultanas, raisins, currents, cranberries, cherries etc) and 1 tablespoon (15 gm) sugar.
    Wholemeal –  follow the Basic recipe above but replace half of the plain flour with wholemeal flour.
    Wholemeal and date – follow the Basic recipe above but replace half of the plain flour with wholemeal flour and after Step 3 add ¼ cup (45 gm) chopped dates and 1 tablespoon (15 gm) sugar.     
       
    Pictorial guide to the challenge recipe
    I was at my brother's house and we had a hankering for a baked treat so I decided to make the challenge recipe also I needed some photos of the challenge recipe being made for this posting. My brother isn't a cook, all he had to hand as equipment was concerned was a mixing bowl,a thin walled 20 cm (8 inch) cake tin and a knife, he didn't even have a cup measure only mugs so I improvised.

    As you can see in the collage below I roughly chopped some butter (I eye-balled about 2 tablespoons) and froze it. Then I throw the frozen cubed butter onto one mug of cold self-raising flour I couldn't sift the flour since my brother doesn't own a sifter. Then I proceeded to rub in the butter with my fingers until I got pea-sized fat pieces coated in flour.
    Photobucket

    I added the liquid (½ mug of cold lite-milk) to the rubbed-in fat/flour mixture until I got a sticky dough I turned this out onto a floured board, I lightly floured the top of the sticky dough then I kneaded it once  then I patted it out into a rectangular shape then I proceeded to fold and turn the dough. Notice that you fold 1/3 of the dough over itself then the other 1/3 over that and turn it 90° degrees. Notice the lines on the broad this will help you understand how to do the folding and the turning.
    Photobucket

    I did a couple more folds and turns and used a well-floured knife to cut out squares of prepared dough.
    Photobucket

    Here is a close-up of the finish patted-out dough notice how you can see the fat particles in the dough this is what causes flakiness in the final baked scone.
    Photobucket

    I used the inverted cake tin as my baking dish and baked the scones in a very hot oven for 10 minutes they worked out really well I thought. Notice the nice central lamination in the scone and the great crumb and how well they rose in height.
    Photobucket

    I placed two unbaked scones in the fridge to test whether resting them for 20 minutes helped improve the raise of the final baked product. As you can see the left scone and the middle scone are taller than the right scone which was baked immediately after it was cut out from the dough. So don't worry if you cannot bake the scones straight away they do better with a little resting time. 
    Photobucket

    Videos of my sister making scones (baking powder biscuits) – using a very popular Australian recipe
    (http://www.taste.com.au/recipes/8163/basic+scones) 
    Part 1 – my sister making the scones (baking powder biscuits)
    (http://www.youtube.com/watch?v=ZF9YJiHZ1K0)
    Part 2 – my sister showing off her scones (baking powder biscuits)
    http://www.youtube.com/watch?v=GorStLKSoMo)
    Pictures of my sister's scones
    Photobucket

    Storage & Freezing Instructions/Tips:
    Scones are best eaten warm. Scones (biscuits) are really easy to store – bag the cooked and cooled scones and freeze until needed then reheat in a moderate hot for a few minutes.


    Additional Information: 
    Australia’s most popular scone recipe uses lemon-flavoured soda pop and cream as the liquid
    (http://figjamandlimecordial.com/2010/08/08/lemonade-scones/)
    A great English scone recipe this uses more sugar and fat and has an egg
    (http://www.instructables.com/id/Perfect-English-Scones/)
    Classic Southern Buttermilk Biscuits recipe by Alton Brown
    (http://www.foodnetwork.com/recipes/alton-brown/southern-biscuits-recipe/index.html)
    An index of North American recipes
    (http://allrecipes.com/Recipes/Bread/Biscuits-and-Scones/Biscuits/Top.aspx)
    Another index of North American recipes
    (http://www.breadexperience.com/biscuit-recipes.html)
    Three great Australian recipes
    (http://www.smh.com.au/lifestyle/homestyle/blogs/tried-and-tasted/how-to-bake-the-perfect-scone-20110504-1e7xn.html)
    An index of Irish recipes
    (http://www.littleshamrocks.com/Irish-Bread-Scone-Recipes.html)
    An interesting discussion on “what makes a scone a scone”
    (http://chowhound.chow.com/topics/810928)  
    Videos of Alton Brown making biscuits (scones) with his granny (super cute to watch)
    Episode one ( http://www.youtube.com/watch?v=d3QuQSdjMVE)
    Episode two (http://www.youtube.com/watch?v=Qcz4JQUwY9Q)
    Links to advice about chemical raising agents
    http://www.seriouseats.com/2010/06/what-is-the-difference-between-baking-powder-and-baking-soda-in-pancakes.html
    http://www.kingarthurflour.com/tips/quick-bread-primer.html 

    Disclaimer:
    The Daring Kitchen and its members in no way suggest we are medical professionals and therefore are NOT responsible for any error in reporting of “alternate baking/cooking”.  If you have issues with digesting gluten, then it is YOUR responsibility to research the ingredient before using it.  If you have allergies, it is YOUR responsibility to make sure any ingredient in a recipe will not adversely affect you. If you are lactose intolerant, it is YOUR responsibility to make sure any ingredient in a recipe will not adversely affect you. If you are vegetarian or vegan, it is YOUR responsibility to make sure any ingredient in a recipe will not adversely affect you. The responsibility is YOURS regardless of what health issue you’re dealing with. Please consult your physician with any questions before using an ingredient you are not familiar with.  Thank you! :)[/quote]
              Medical Receptionist (United Kingdom)        
    Job Summary:  Responsible for greeting patients as they enter the clinic. Schedules appointments, collects and enters patient information in practice management system. Collects insurance co-pays, deductibles and self-pay payments. Answers teleph......
              Michigan Cancer Patient Asked to Lift Bandages by Airport TSA        
    BLACK AMERICA WEB SEATTLE (AP) — A Michigan woman dying of leukemia hopes her embarrassing experience at a Seattle airport changes the way the Transportation Security Administration treats travelers with medical conditions. Michelle Dunaj, 34, was making what she expects will be the last trip of her life on Oct. 2 as she departed for […]
              ADMINISTRATIVE SERVICES ASSISTANT - INTERIOR HEALTH AUTHORITY - Slocan, BC        
    Maintains medical/surgical supplies, equipment and CIHS resource material; ADMINISTRATIVE SERVICES ASSISTANT Community :....
    From Interior Health - Fri, 16 Jun 2017 13:26:57 GMT - View all Slocan, BC jobs
              Medical Receptionist        
    FL-Jacksonville, Description: This established office medical practice, with two locations (Jacksonville & Palatka), has been treating the community since 1970. With two practicing physicians (father & son) offering full Podiatric care and foot surgery, this specialty practice prides itself on delivering the best possible patient care. Their commitment is supported by a staff of responsible employees who work toge
              Operation Tonsils        
    Hospitals still give me the creeps, the kind that raise goosebumps on your arms, and that, like many things, can be traced to my childhood.
    Every year for a number of years, since I was small, I had to have tubes put in my ears so they would drain properly. It was a 10-minute procedure. I had this done five times. I always got sick from the anesthetic.
    But the reason I think I'm still afraid of hospitals isn't because of the tubes. Not one of those operations traumatized me nearly as much as the time I got my tonsils out.
    I was 5, and I think the gas mask was the worst of it. They strapped me down to the bed, which was really a cage with sheets, and held the mask over my face as they wheeled me into a room filled with stern faces, alien-bright lights and a lot of cold steel. Now, remember, I was 5, and as far as I knew, they were going to do all kinds of horrible experiments on me, the kind I did to one of my teddy bears a couple months ago, because no one had told me any different. No one explained anything to me, in fact. That book I got explaining the surgery and how I was going to get to eat dump trucks full of ice cream after it was over? LIES. So I fought. Nurses, back then, were all sized to be NFL linebackers, and they were about as mean, and they sat on me and held me down, scowling at my tears. Then they put the mask over my face, again, and a thorny python wrapped a dizzy body around me. 
    "I feel funny!" I screamed, and one of the doctors laughed, which sounded evil at the time, and this horrible blackness swept over my eyes, as if I was being thrown into a pit.
    When I woke up, kicking and hollering, because, remember, I was being tortured when I fell asleep, I cried for Mommy, and one of the linebackers came over, grabbed my legs and strapped my arms to the bars on the side of the bed. Then I noticed my throat felt as if it had been torn out. 
    Then I threw up blood that night.
    Needless to say, when we learned Jayden's tonsils looked to doctors like the size of beach balls - some of the biggest ones he's ever seen, one told us later - I was dreading the day they would have to come out.
    That day was last week.
    Jayden was in tears as I pulled in the garage from an eight-mile run with our new dog. I told him I would meet him there. I needed to shower. I also didn't need him to see me. I would pull it together in the shower, I told myself, and put on a brave face for him. But now wasn't a good time.
    • • • 
    When I walked into his waiting room a half-hour later, he was dressed in blue spaceman scrubs, which looked cozy, and watching Elmo on a TV that came with the bed, which looked like a bed, not a cage with sheets.
    Elmo?
    And yet his emotions were the same as mine 35 years ago.
    "Daddy," he said. "I'm scared."
    Well, I'm glad you can tell them that, I said. It's OK to be scared.
    Three times, a nurse, a doctor and the guy putting Jayden to sleep came in and explained what was going to happen. Apparently medical people have figured out that most kids, just like most adults, do better when they know what's going to happen to them.
    They've also figured out Elmo helps as well.
    Sleepytime Doc came in later, heard that Jayden was nervous, as he told everyone, and said he could give Jayden something for that. Jayden said sure. Doc brought back a cherry-flavored liquid. Jayden gulped it down because, hey, it looked good, and it WAS good, and five minutes later, he was loopy, like he'd had a few too many shots. Jayden, apparently, is a happy drunk.
    The doc wouldn't tell me what it was. I don't blame him. I could make a killing on the street. Give me that before a marathon, and I'm qualifying for Boston.
    Then a nurse came in two minutes later and had Jayden try on the mask. Ah, the dreaded mask, I thought to myself. There's no sugarcoating this. 
    Jayden took a sniff.
    "Yum," he said.
    Yum?
    "Yeah," the nurse said. "The gas smells like Skittles."
    Skittles?
    Are you kidding me?
    I turned to Jayden and used a cliche. I rarely use them. But this time it was appropriate.
    "Jayden," I said, as I hopped off the bed, right before they wheeled him away, "this is not your father's tonsil operation."
    • • •
    They called me in a half-hour later, one of the very few times that Jayden's wanted me over Mommy, and Jayden was in bed with an orange popsicle in his mouth. It was his second one already. He was not strapped down. His nurse didn't look like an NFL linebacker. She looked a little plump, a little cute and very sweet.
    "You'll see some blood on his hands or face. Don't let that worry you," a nurse said.
    "Cool," I said.
    I'm big on battle scars. I always liked to bring home a small gash after climbing a mountain. We called them souvenirs. Besides, there had to be something from this operation that made me squirm.
    After his third popsicle, the nurse told Jayden she could move him to another room. There was a TV in there. He could watch a movie. They had "The Incredibles." She offered him a slushy. Blue.
    "I have a secret recipe," she said.
    Of course she did.
    • • • 
    Lest you think I was hoping my son would suffer, of course I didn't want that. But HOLY COW I couldn't help but feel a little, well, jealous of how much better the experience was. It made me feel proud that our country actually has evolved in some areas. We CAN make improvements on procedures and things other than cell phones. Technology does have a purpose beyond Angry Birds. But it also made me feel old. My operation seemed like from another time, like it was back during World War II or something.
    That was, until we brought him home.
    We've been up every night at least a couple times since that night. The third night, when we moved him back to his room from our bed, he woke up screaming and shaking the pain was so bad. We haven't been up this consistently in the middle of the night since the girls had their first birthday.
    Just the last couple of nights have been better. When he does get up, it's briefly, and after some medicine, he goes back to sleep. He doesn't demand slushees around the clock now. His scabs appear to be healing a bit. But if I ever did get tired of his whining and was tempted to tell him to suck it up a bit, all I had to do was look at the gaping holes in the back of his throat.
    • • •
    Technology has helped us as well as Jayden. We have a ice treats machine that I relentlessly teased my wife for buying a year ago — it seemed to me to be like a salad shooter, an appliance invented just because our basic needs were so met that we think we need something that can fire a radish across the kitchen — that's now, I think, the best thing we've ever bought. It makes one of those slushys in two minutes, and when it's 2:30 a.m. and your boy is hollering from the pain upstairs, it's a lifesaver. I wish they had one for breast milk about five years ago. It would have saved us a lot of sleep.
    He's spent a lot of time on his Nintendo DS. Super Mario, like Coedine, tends to numb the pain.
    I don't remember much beyond the hospital after my tonsil operation, but I do remember that first night. Dad stayed up with me most of the night as I tried to cry my pain and sickness away.
    Despite the cushy parts, this hasn't been easy. We've made about a billion of those slushees now. Jayden is so sensitive that he wants one of us to sit next to him at night at all times, especially when it's time for him to go to bed. He's been nasty and sad and sometimes he's still been our first baby despite the fact that he's 6.
    He needs us now.
    Technology will never replace parenting. At least I hope not. If Jayden doesn't have to go through these rough patches with his own kids I'll be jealous again. Only I'll also be a little sad for him.



              2016 UPSC Examination Question Papers        
    2016 UPSC Examination Question Papers
    Civil Services (Main) Examination, 2016
    Literature Subjects
    Optional Subjects
    Indian Languages (Compulsory)
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    Indian Forest Service (Main) Exam. 2016
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    National Defence Academy & Naval Academy Examination (II) 2016
    Engineering Services Examination , 2016
    Conventional Papers
    Objective Papers
    General
    Civil Services (Preliminary) Examination, 2016
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    Combined Geo-Scientist & Geologist Exam 2016
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    Indian Statistical Service
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    General
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              Coming Soon: Medical Marijuana in New York        
    The new law kicks in soon. What are the new options?
              Tunica Resorts Mississippi        


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              Medical marijuana special guide        
    Dentro do jornal semanal gratuito SF Weekly dessa semana, veio encartado um guia sobre Medical Marijuana.



    Como a maioria que lê esse blog deve saber, que no estado da California a utilização da Maconha para fins medicinais é legalizado, ou seja, se vc tiver o atestado médico alegando que vc possui algum tipo de sintoma que a maconha possa ajudar, vc é apto a utilizar maconha dentro da lei.

    O guia é um compilado de perguntas e respostas sobre o assunto e aqui mostro os highlights da matéria.



    1. A pergunta que mais me chamou atenção foi essa abaixo.