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Saccharin: Avoid This Artificial Sweetener (Made From Coal Tar)
If someone dared you to eat coal tar, would you? Would you happily sip it down or gleefully sprinkle it on your morning cereal?
Probably not. After all, you'd have to be crazy to knowingly consume something as awful sounding as coal tar.
But what if I told you it was sweet? Really sweet. As in 700 times sweeter than sugar. Would that matter?
Before you answer an emphatic "no," consider this. Not only have you likely eaten or drank this mysterious coal-derived sweetener, it graces virtually every table in restaurants across the country.
Who is Consuming Coal Tar…
This sweet mess is saccharin (think Sweet and Low). It was first produced in 1878 by a chemist working on coal tar derivatives at Johns Hopkins University. After working with his compounds all day, he discovered that his hand tasted "sweet."1 Not really sure how it came about that he tasted his hand, but there it is.
Today, saccharin is commonly manufactured by combining anthranilic acid (used among other things as a corrosive agent for metal) with nitrous acid, sulfur dioxide, chlorine, and ammonia. Yes, that's right. Chlorine and ammonia.
In fact, that particular group of chemicals sounds more like a recipe for a household cleaner than a sweetener. And yet, millions upon millions of people consume saccharin every year.
But what most people don't realize is that saccharin has had a rather bumpy road ever since its discovery.
As far back as 1907, the USDA began taking a closer look at saccharin through the Pure Food and Drug Act (a precursor of sorts to the FDA). Mr. Harvey Wiley, the director of the bureau of chemistry for the USDA during that time, felt saccharin should not be used in foods. In fact, he is quoted as saying, "[Saccharin is] a coal tar product totally devoid of food value and extremely injurious to health."2
And the USDA and FDA have flip-flopped virtually ever since. In 1911, they stated that foods with saccharin were "adulterated," then in 1912, said that saccharin wasn't harmful.
In 1948-49, there was much discussion about the dangers of saccharin, but in 1969, an investigation into those claims found little scientific proof to warrant the concerns. Yet, there must have been something because three years later, in 1972, the FDA tried to ban saccharin.3 They failed, of course, which is why saccharin is still available and being consumed by thousands of people every day.
One of the key reasons for the FDA's concerns was that in 1970, researchers learned that saccharin caused bladder cancer in lab rats.4 I'll discuss this a bit more in a moment, but suffice it to say that this created quite a problem for saccharin and the FDA.
See, back in 1958, Congress added a little clause to the Food, Drugs, and Cosmetic Act, mandating that the FDA "prohibits the use of compounds found to induce cancer when ingested by man or animal, or if it is found after tests which are appropriated for the evaluation of the safety of the food additive, to induce cancer in man or animal."5
But, instead of taking it off the market, the FDA simply added a warning to the label of foods containing saccharin stating that it caused bladder cancer in rats.
And the Controversy Continues…
You'd think that would be the end of it, wouldn't you? Cancer causing, necessary warning label, etc. Well, you'd be wrong. Really wrong.
In late 2000, the FDA removed the warning labels after studies showed that the rats have a completely different chemical make up to their urine. And it is this particular combination of high pH, high calcium phosphate, and high protein that interacts with saccharin and damages the bladder walls. And this damage is what leads to increased cancer risk, not the saccharin itself.6,7
And the FDA bought it. In fact, by 2010, saccharin was been taken off nearly every carcinogenic list, from the U.S. Department of Health and Human Services' National Toxicology Program to the EPA's list of hazardous products.
But should it have been?
Big Problems…
Let's start with cancer.
A 1997 report from the Center for the Science in Public Interest felt that it would be "highly imprudent for the National Toxicology Program to delist saccharin." They believed that doing so "would give the public a false sense of security, remove any incentive for further testing, and result in greater exposure to this probable carcinogen in tens of millions of people, including children (indeed, fetuses)."
And with good reason.
As I discussed, there are the rodent studies showing that saccharin caused bladder cancer, not to mention vascular and lung cancer. It also increased the risk of uterine cancer in female mice.8
This was based on several studies, including one from 1978, which found that rats given saccharin developed bladder cancer that was quite aggressive.9 Additionally, rats exposed while in the womb were even more likely to develop cancer than those exposed immediately after birth.
Researchers in that study concluded, "Saccharin is carcinogenic for the urinary bladder in rats and mice, and most likely is carcinogenic in human beings."
But the pro-saccharin people argued that rats and people aren't the same. Agreed.
There in lies the issue. No one is willing to do a double blind, placebo-controlled study with saccharin, as it would be imprudent to knowingly place someone at risk. But there are several case-controlled studies showing a definitive link between saccharin consumption and increased risk of cancer.
First of all, the National Cancer Institute noted a 10 percent increase in the incidence of bladder cancer 1973 and 1994.8 (Remember, the FDA tried to ban saccharin in 1972.)
An analysis of nearly 1,900 cases found that heavy use of artificial sweeteners was associated with increased risk of bladder cancer.10
A second analysis of more than 600 cases also found an increased risk of cancer in Canadian men who consumed either more artificial sweeteners or consumed them for a longer period of time.11
Finally, a British study found that English women who consume more than 10 tablets of artificial sweeteners (mostly saccharin) also had a higher risk of cancer.12
Thanks, but no thanks.
Wait, There's More…
As if cancer weren't bad enough, saccharin has also been tied to a variety of allergic reactions, including headaches, breathing issues, skin rashes, and diarrhea.13 Worst yet, it is still being added to some infant formulas! Give me a break!
And then there's the dieters' and diabetic dilemma. Or perhaps irony is a better word.
A 2008 study from Appetite found "a significant increase of plasma insulin concentration was apparent after stimulation with saccharin."14 And they didn't even ingest the saccharin! They just rinsed their mouth out with it.
As we all know, increased insulin levels is a risk factor for both obesity and diabetes. Probably NOT the side effect dieters and diabetics are going for when they choose a sugar-free product.
Use Your Brain…
So, what do you do? You have a sweetener that is used in hundreds of products in the United States, and is deemed "safe" by the FDA.
But it clearly has documented health risks and concerns, ranging from allergies to cancer to increased insulin levels.
So what do you do? Blindly trust the government and consume away? I say no.
And the reason is pretty simple. Chemicals, chemicals, chemicals.
There is nothing natural about saccharin. Nothing. And there's certainly nothing natural about the side effects it has been proven to cause.
I say, just say no and step away. Far away.
If you must have a bit of sweetness, opt instead for stevia. This herb comes in both powdered and liquid forms and is a great choice to sweeten coffee, oatmeal, or even give mineral water a flavor boost. Best of all, it's chemical- and toxin-free.
And no coal tar in sight.
1Myers, RL and Myers, RL. The 100 most important chemical compounds: a reference guide. 2007. Westport, Conn: Greenwood Press.
2Sugar: A Cautionary Tale.
3Priebem, PM and Kauffman, GB. Making governmental policy under conditions of scientific uncertainty: A century of controversy about saccharin in congress and the laboratory. Minerva 1980;18(4):556–74.
4Price, JM et al. Bladder tumors in rats fed cyclohexylamine or high doses of a mixture of cyclamate and saccharin. Science. 1970 Feb 20;167(921):1131-2.
6Whysner, J and Williams, GM. Saccharin mechanistic data and risk assessment: urine composition, enhanced cell proliferation, and tumor promotion. Pharmacol Ther. 1996;71(1-2):225–52.
7Dybing, E. Development and implementation of the IPCS conceptual framework for evaluating mode of action of chemical carcinogens. Toxicology 2002 Dec;181-182:121–5.
8Saccharin still poses cancer risk, scientists tell federal agency. CSPI press release. October 28, 1997.
9Reuber, MD. Carcinogenicity of saccharin. Environ Health Perspect. 1978 Aug;25:173-200.
10Sturgeon, SR et al. Associations between bladder cancer risk factors and tumor stage and grade at diagnosis. Epidemiology. 1994 Mar;5(2):218-25.
11Howe, GR and Burch, JD. Artificial sweeteners in relation to the epidemiology of bladder cancer. Nutr Cancer. 1981;2(4):213-6.
12Morrison, AS et al. Artificial sweeteners and bladder cancer in Manchester, U.K., and Nagoya, Japan. Br J Cancer. 1982 Mar;45(3):332-6.
13Stewart, D. Risks of Saccharin. eHow. March 31, 2011.
14Just, T et al. Cephalic phase insulin release in healthy humans after taste stimulation? Appetite. 2008 Nov;51(3):622-7.
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Neal Klausner Sophomore Book Awards
The awards are given to students who have achieved the highest GPAs in their class during their first year at Grinnell. Each student is given a cash prize to be used for book purchases at the college bookstore.
Phi Beta Kappa Scholar's Award
The award is customarily given for an outstanding piece of scholarly work completed by a Grinnell student prior to the final semester of the senior year. "Scholarly work" is to be interpreted broadly, to include such accomplishments as a scholarly paper or project completed in connection with a course, an original literary piece, a scientific research project, an essay, or any scholarly endeavor which results in a tangible product.

subset: commoncrawl


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Caring For Multiple Generations of Family Members Has Created A New "Sandwich Generation"
We are all fortunate to be living in a time when medical marvels occur every day. These marvels can save our youngest children and also our oldest adults.
People are surviving strokes, heart attack and disease in record numbers. And while this is most often a blessing, it has created a large new group in our society that is responsible for caring for multiple generations of family members at the same time. This group is often referred to as "The Sandwich Generation."
There are three general "sandwiches" on the menu of caregivers who are part of "The Sandwich Generation," according to an article in Stroke Connection Magazine. Those groups can be characterized as:
- The Traditional Sandwich: These caregivers are sandwiched between aging parents who need care or help and their own children.
- The Club Sandwich: These caregivers are generally in their 50's or 60's, sandwiched between aging parents, adult children and grandchildren. Those in their 30's and 40's with young children, aging parents and grandparents also fit this category.
- Open-Faced Sandwich: These caregivers comprise all others involved in eldercare.
Even under the best of circumstances, taking on the responsibility of managing a multi-generational family is a tremendous undertaking. The stress can affect marriages, careers, finances — almost all aspects of our lives.
So how do we handle this? Experts at the University of Nebraska (Lincoln) suggest successful sandwich-life living requires negotiation among each generation's needs, including your own. This may be accomplished by considering some of these "solutions":
- Clarify the House Rules: In cases of multi-generational living in the same home, schedules and clearly defined responsibilities can help. Make sure that those living under your roof understand that your values are those by which all are expected to abide.
- Weekly Family Meetings: Even if multiple generations are not living under the same roof, weekly meetings involving all local family working together to care for a multi-generational family can be beneficial in helping with problem-solving and providing encouragement.
- Prepare a Long-Range Financial Plan: Detailed plans and record-keeping give a better sense of control which will, in turn, decrease stress.
- Utilize Community Programs and Services: Use the Internet and/or contact your local and state agency on aging to find out what resources may be available in your community.
- Agree on a Target Date for Departure of Young Adults: Have a plan in place indicating when young adults are expected to leave home and begin living independently. Even if the plan has to change, there will be parameters established from which to work.
- Respect One Another's Privacy: All generations need to have some aspect of their lives that is their own. Personal boundaries and personal space must be defined and respected.
- Take Care of Your Own Family, Your Marriage, and especially, Take Care of Yourself: If stress and feelings of being overwhelmed are allowed to cause you to "burn out," you end up doing a great disservice to yourself and your family. High degrees of stress make people less effective and less efficient. Remember to utilize all of your family and community resources to get the help you may need.
For more information on this topic, please consider investigating the following resources:
- The National Family Caregivers Alliance at 1-800-896-3650 or www.nfcacares.org
- American Stroke Association at 1-888-4-STROKE or www.strokeassociation.org
- Centre County Office of Aging at 1-800-479-0050
- Your healthcare and therapeutic services providers
Elana K. Thompson, MS, CCC-SLP, is a speech-language pathologist at Mount Nittany Medical Center.


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It looks like any other sea slug, aside from its bright green hue. But the Elysia chlorotica is far from ordinary: it is both a plant and an animal, according to biologists, who have been studying the species for two decades.
Not only does E. chlorotica turn sunlight into energy — something only plants can do — it also appears to have swiped this ability from the algae it consumes.
Native to the salt marshes of New England and Canada, these sea slugs use contraband chlorophyll-producing genes and cell parts called chloroplasts from algae to carry out photosynthesis, says Sidney Pierce, a biologist at the University of South Florida in Tampa.
That genetic material has since been passed down to the next generation, eliminating the need to consume algae for energy.
However, the baby slugs can't carry out photosynthesis until they've stolen their own chloroplasts, which they aren't yet able to produce on their own, from their first and only meal of algae.
"We collect them and we keep them in aquaria for months," Pierce told LiveScience, "As long as we shine a light on them for 12 hours a day, they can survive [without food]."
Pierce and his colleagues used a radioactive tracer to ensure that the slugs are now producing the chlorophyll themselves and not gathering it from algal contamination in the aquaria.
Crustacean biologist Gary Martin of Occidental College in Los Angeles sums it up in one word: "Bizarre".
"Steps in evolution can be more creative than I ever imagined," said Martin.


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BUFFALO, N.Y., March 14 (UPI) -- Colorado's Jamie McGinn forced overtime with 2 seconds left in regulation Wednesday and the Avalanche prevailed 5-4 over Buffalo in a shootout.
McGinn saved Colorado with his second goal of the game in a contest that saw the Avalanche emerge with a win even though goaltender Semyon Varlamov gave up four goals on just 24 shots.
Peter Mueller scored in the second shootout round to give Colorado its third straight victory.
Colorado was one of four teams that began the evening tied for the eighth and final playoff spot in the Western Conference. The Avalanche jumped out of that pack since the other three clubs -- San Jose, Calgary and Los Angeles -- were idle.
Ryan Miller faced 42 shots and made 38 saves in the loss.
The game's first goal, credited to Buffalo's Marcus Foligno, was symbolic of the wild contest in that the puck bounced off his body as he was falling to the ice and then ricocheted off the stick of Colorado's David Jones into his own net.
Jones later made up for that misfortune by scoring with 52 seconds left in the first period to create a 2-2 tie.


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Heather Weisel, a former United States national team rowing and collegiate head coach, begins her third year at the helm of the Old Dominion women's rowing program
Weisel, who has helped build the rowing program from the ground up, saw her Lady Monarchs begin intercollegiate varsity competition last year with her crew registering several impressive results for a first year program. The Lady Monarchs' Frosh/Novice 8 boat won a gold medal at the Knecht Cup and brought home a silver medal from the prestigious Dad Vail Regatta, while the Varsity 4 captured the Grand Final of the Kerr Cup Regatta, earned a bronze medal at the Knecht Cup, and reached the Dad Vail semifinals.
Weisel served as head coach for the men's and women's teams at The College of New Jersey (2005), Worcester Polytechnic Institute (WPI) and Lafayette College (1999-2000). In two stints at WPI (1995-99 and 2000-02), Weisel led her crew to first place finishes at the City Championships in Worcester, the Donahue Cup in Boston and the New England Rowing Championships.
No stranger to international competition, Weisel was a member of the United States Rowing coaching staff that competed in Seville, Spain and Milan, Italy, where her women's double team finished ninth at the FISA World Rowing Championships in September of 2003.
She served as the rowing coach for Old Dominion's men's and women's club team from 1988-1994, guiding the club from six members to 60 during her tenure. She served as an advisor to the ODU club team this past year in addition to her work as a speech language pathologist.
As a competitor at Purdue University, Weisel competed three years for the Boilermakers, winning a gold medal at the 1986 Mid-West Championships.
Weisel is a 1988 graduate of Purdue University, where she earned a Bachelor of Science degree in audio/speech science and a Bachelor of Arts degree in psychology. She holds an MS degree in speech pathology from Old Dominion. She resides in Virginia Beach with her husband Brett and their daughter Caitlyn Joy.


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NEW YORK (AP) — ABC will add a new drama from "Scandal" and "Grey's Anatomy" powerhouse producer Shonda Rhimes to its schedule in the fall, giving her ownership of Thursday night on a network that's lagging behind its competitors among advertiser-favored young adults.
Rhimes' "How to Get Away With Murder," a legal thriller starring Viola Davis, is among 12 new series that will occupy an ABC schedule that's heavy on crime dramas and rich in ethnic diversity. Rhimes is "one of the greatest voices on television," ABC Entertainment Group President Paul Lee said Tuesday before the network presented its new schedule to advertisers.
"Grey's Anatomy" will move to 8 p.m. Thursday, followed by "Scandal" at 9 p.m. "How to Get Away With Murder" will close out the evening at 10 p.m. That will bolster what has been a weak 8 p.m. slot for ABC and give the new drama a strong launching pad, Lee said.
"Scandal" will air opposite NBC's hit series "The Blacklist" later in the new season, but Lee said he's confident his series will stand up to the challenge, especially as viewers adept at time-shifting have allowed dueling series to both perform well.
Medical soap opera "Grey's Anatomy" can be racy, but Lee said it will have appropriate content for the first hour of prime time, traditionally home for more family-friendly programming.
ABC and its heavily female audience ranks third in viewership this season behind CBS and NBC, but is fourth among the 18-to-49-year-old demographic it cares most about. The network, known for its multi-ethnic casts, is adding shows focused primarily on non-white characters or with minority creators — something often missing from major broadcast networks.
The new sitcoms include "Black-ish," starring Anthony Anderson and Tracee Ellis Ross as a suburban family trying to embrace their African-American identity, and "Fresh off the Boat," about an immigrant Chinese family pursuing the American dream in the 1990s and based on chef Eddie Huang's memoir with the same title.
"Cristela," another comedy, is about an ambitious law student (Cristela Alonzo) at odds with her traditional Mexican-American family.
Laurence Fishburne, who plays dad to Anderson's character in "Black-ish," called the sitcom "authentic and relevant" during an appearance at ABC's presentation.
He also used humor to sell the show to advertisers, saying if they like Michael Jackson or Michael Jordan or listened to Motown, "you might be a little blackish."
John Ridley, Oscar-winning writer of "12 Years a Slave" created the gritty "American Crime," a drama about a murder with racial overtones that features former "Desperate Housewives" star Felicity Huffman.
ABC hits "Modern Family" and "Scandal" have benefited from their inclusivity, Lee said.
"America has changed," he said. "We see that in the election cycle and we see that in everything."
Other new dramas include "Secrets and Lies," starring Ryan Phillipe as a murder suspect trying to prove his innocence, and "Forever," with Ioan Gruffudd as a New York City medical examiner with a secret: He's immortal.
The mystery in "Secrets and Lies" will wrap in one season, with new stories planned for future seasons, Lee said.
On the genre front, "Marvel's Agent Carter," starring Hayley Atwell, will air midseason between runs of "Marvel's Agents of S.H.I.E.L.D."
ABC canceled "Trophy Wife," ''Mixology," ''The Neighbors," ''Suburgatory," ''Super Fun Night," ''Killer Women," ''Lucky 7," ''Betrayal," ''Back in the Game" and "Once Upon a Time in Wonderland."
Other ABC series to debut next season:
"The Whispers," an alien invasion story with Steven Spielberg as an executive producer.
"Galavant," a musical fairytale.
"Manhattan Love Story," a comedy that exposes the unfiltered thoughts of men and women.
"Selfie," a comedy about a woman with 263,000 online followers and no real friends.
NEW YORK (AP) — ABC will add a new drama from "Scandal" and "Grey's Anatomy" powerhouse producer Shonda Rhimes to its schedule in the fall, giving her ownership of Thursday night on a network that's lagging behind its competitors among advertiser-favored young adults.


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Kiev has accused Moscow of seeking to trigger a "third world war" as military tensions soared in east Ukraine and US President Barack Obama led a diplomatic charge against Russia.
A rocket-propelled grenade blew up a Ukrainian military helicopter sitting on the tarmac at a base near the eastern town of Kramatorsk, officials in Kiev said. The pilot escaped but was wounded. Smoke spewed in the sky over the nearby rebel-held town.
The brazen attack by the insurgents came amid an army offensive to dislodge pro-Kremlin gunmen who are holding a string of eastern towns.
Kiev announced on Friday that its forces were seeking to "blockade" rebels inside another flashpoint town, Slavyansk, to prevent militant reinforcements arriving.
On Thursday, Ukrainian armoured vehicles and commandos had made a brief but dramatic incursion into Slavyansk, killing one 22-year-old insurgent.
Russia responded by ordering its troops massed on Ukraine's border to launch a new military exercise.
The developments prompted German Chancellor Angela Merkel to call Russian President Vladimir Putin to voice "great concern" over the situation and to urge implementation of a Geneva accord signed a week ago that was meant to defuse tensions.
Merkel's spokesman Steffen Seibert also warned of fresh sanctions against Russia, telling reporters in Berlin: "Sanctions are already in place ... you have to face the facts - in case nothing changes - it is important to be prepared for more."
Ramping up the Cold War-style rhetoric, Ukrainian Prime Minister Arseniy Yatsenyuk accused Russia of trying to spark a global conflict.
"The world hasn't forgotten the Second World War and Russia wants to start a third world war," he said.
"Russia's support for the terrorists in Ukraine constitutes an international crime and we call on the international community to unite against the Russian aggression."
US Secretary of State John Kerry said the Kremlin was making an "expensive mistake" by meddling in Ukraine, stressing that further Western sanctions on Moscow were poised to be unveiled.
Moscow, Kerry said, was trying to "actively sabotage the democratic process through gross external intimidation", described the latest Russian drills as "threatening".
"Let me be clear: if Russia continues in this direction, it will not just be a grave mistake, it will be an expensive mistake," he said.
Obama, on a visit to South Korea, said he would be consulting with key EU leaders later Friday.
Russia Foreign Minister Sergei Lavrov hit back by charging that Washington was "smearing" Moscow and claimed the United States wanted to "seize" Ukraine for its own "geopolitical ambitions and not the interests of the Ukrainian people".
Lavrov also complained that during private talks with his US, British and French counterparts he had come under pressure to call back Russian agents from Ukraine's east.
Ukraine's acting President Oleksandr Turchynov has vowed to push on with the "anti-terrorist" offensive to put down the rebellion in the east.
"We will not back down from the terrorist threat," Turchynov said in a televised address Thursday.
While Obama has ruled out sending US or NATO forces into Ukraine, Washington has begun deploying 600 US troops to boost NATO's defences in nearby eastern European states.
France also said it was sending four fighter jets to join NATO air patrols over the Baltic states.
The rocketing tensions sent oil prices up for a second day Friday and stocks in Asia lower.
Russia, which supplies gas to Ukraine and to many EU countries, has said it can weather US sanctions, but warned they would trigger a tit-for-tat cycle which no-one would win.
The United States and the European Union have already targeted Putin's inner circle with visa and asset freezes and imposed sanctions on a key Russian bank.
Further punishment, though, has raised fears among some EU states that diminished Russian gas supplies could undermine a fragile European economic recovery.
Gas supply cuts, though, would also hurt Russia's economy, which is forecast to go into recession this year.


text: The mission of the Environmental Center is to establish, develop, and support cross-disciplinary education and research related to the environment. The Center fosters programs for students, faculty, and staff to pursue environmental activities through academics, research, and extracurricular activities. Also, the Center conducts and supports campus infrastructural projects involving sustainability and the campus's natural environment. The Center develops connections and collaborations among university entities and between the university and the region.


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The Comedy Studio
"The Comedy Studio...has cemented its reputation as the area's top laugh lab. It's also earned a solid reputation among industry heavyweights as a "must-visit" club for anyone seeking cutting-edge performers or writers for future television projects. The Comedy Studio--no better breeding ground around."
-Dean Johnson, Boston Herald, December 2001


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SAMJ: South African Medical Journal
versión On-line ISSN 2078-5135
versión impresa ISSN 0256-9574
SAMJ, S. Afr. med. j. vol.101 no.4 Pretoria abr. 2011
Indemnity hikes - suck it up or risk serious money?
Just when doctors were heaving a sigh of relief at not having to cast around for a solid indemnifier with the track record and reserves of the briefly government-threatened Medical Protection Society (MPS),1 a hefty subscription hike kicks in, reports Chris Bateman.2
Unavoidable, says the MPS, given local patient claims, litigators becoming smarter, fast-evolving (and expensive) medical technology and growing patient awareness, which boosted the cost of reported local negligence claims by 132% over the past 2 years. Paediatricians who recently moved into the neonatology field suffer most - with a 182% subscription hike, pushing them to R26 230 per annum, the result of a spike in payouts for catastrophic injuries in their bailiwick. Yet obstetricians and spinal surgeons won't exactly be happy either; they face 43.9% and 65.2% increases, which take their annual subs to a hefty R187 830 and R174 700, respectively.
The bigger hikes reflect the increase in the cost of compensation awards made to young children harmed by negligent treatment, and specifically the heavy cost of funding lifetime care packages. If this is thought outrageous, consider the patient who last year won R17 million for catastrophic damage following a spinal/neurosurgical procedure.
Race in research
The SAMJ author guidelines advise that 'Work that is based on or contains reference to ethnic classification must indicate the rationale for this.' Although authors may provide a rationale, it is sometimes far from clear that such classification is appropriate. Anton van Niekerk investigated race as a variable in research ethics.3
Race as a variable in research needs rational and democratic deliberation, as its admissibility can seldom be settled by alleged 'hard scientific facts'. Deliberation may be defined in terms of outcomes: 'the endogenous change of preferences resulting from communication'. Secondly, the democratic process of deliberation is public. Thirdly, deliberation occurs in a group that agrees to the procedural assumptions of the process. Decision-making ought to be the outcome of a transformation of views, rather than simply the aggregation (and possible misrepresentation) of preferences.
The structure and context of a research ethics committee support our efforts to overcome prejudice and to engage in superior rational argument. Deliberation about a controversial notion such as race is arduous, and will probably remain inconclusive. Our challenge is to make it manageable and no longer feared or concealed. If continued deliberation cannot achieve that, nothing short of violence will.
Hope for cryptococcal meningitis
Adult meningitis in areas of high HIV prevalence in southern Africa is most commonly caused by Cryptococcus neoformans.
Lessells and colleagues4 report on cryptococcal meningitis (CM) at Hlabisa Hospital, a district hospital in rural northern KwaZulu-Natal. They investigated outcomes 2 years after an episode of cryptococcal meningitis. Inpatient mortality was high (40.5%) and was significantly associated with a reduced level of consciousness and absence of headache. They conclude that long-term outcomes of CM are poor in routine practice and that interventions to strengthen linkage to HIV treatment and care and continuation of secondary fluconazole prophylaxis are critical.
A case is made for routine cryptococcal antigen screening for HIV-infected patients with low CD4+ T-lymphocyte counts by Jarvis and colleagues.5 They note that CM is a major cause of death among HIV-infected individuals. Even with optimal treatment in study settings, 10-week mortality rates are between 24% and 37%. The incidence of CM should fall with the scale-up of antiretroviral treatment (ART) programmes as CM primarily infects patients with low CD4 T-cell counts.
Fortunately nearly all patients at risk of developing CM during ART can be identified on entry into ART programmes by screening for sub-clinical infection using cheap, simple and highly sensitive cryptococcal antigen (CRAG) blood tests. Evidence for the utility of CRAG screening to identify patients at risk of CM is compelling, but key questions remain of how best to implement a screening policy and how to manage the asymptomatic CRAG-positive patients identified.
Jarvis and Meintjes6 note that, despite the poor outcomes of CM reported, a series of straightforward steps could markedly improve outcomes, even with the available treatment options, including a low threshold for suspecting CM, having amphotericin B available to all clinicians treating such patients, and other established clinical interventions.
HIV-associated tuberculosis and provider-initiated HIV testing
The traditional model for HIV testing is that of voluntary counselling and testing (in which the decision to test is left with the patient). Lawn and colleagues7 sought to determine the impact of the introduction of provider-initiated HIV testing in TB clinics at a community-based clinic in Cape Town.
They found that the introduction of provider-initiated HIV testing by the TB control programme was temporally associated with a major increase in referrals of patients with HIV-associated TB to this service, a progressive decline in referral delay, improvements in baseline CD4 cell counts, and fewer recurrent TB episodes. Such trends are likely to be associated with improved survival, and these data strongly support this HIV testing strategy.
Rift Valley fever - an occupational hazard
Rift Valley fever (RVF) is a viral zoonosis endemic to Africa that re-emerged in South Africa in 2008, and Archer and colleagues8 investigated the effects on cattle farmers and farm workers, and the staff and students of a veterinary school.
They conclude that the epizootic highlights the need for renewed vaccination of ruminants against RVF in South Africa. The defined occupational group should also be considered as a primary target for future immunisation against RVF once human vaccines become available.
1. Bateman C. Clumsy patient-friendly regulations could strip 25 000 doctors of cover. S Afr Med J 2010;100:696-700. [ Links ]
2. Bateman C. Medical negligence pay-outs soar by 132% - subs follow. S Afr Med J 2010;101:216-218. [ Links ]
3. Van Niekerk AA. Deliberating about race as a variable in biomedical research. S Afr Med J 2011;101:248-250. [ Links ]
4. Lessells RJ, Mutevedzi PC, Heller T, Newell M-L. Poor long-term outcomes for cryptococcal meningitis in rural South Africa. S Afr Med J 2011;101:251-252. [ Links ]
5. Jarvis JN, Harrison HS, Govender N, et al. Routine cryptococcal antigen screening for HIV-infected patients with low CD4+ T-lymphocyte counts - time to implement in South Africa? S Afr Med J 2011;101:232-234. [ Links ]
6. Jarvis J, Meintjes G. Cryptococcal meningitis - a neglected killer. S Afr Med J 2011;101:244-245. [ Links ]
7. Lawn SD, Fraenzel A, Kranzer K, Caldwell J, Bekker L-G, Wood R. Provider-initiated HIV testing increases access of patients with HIV-associated tuberculosis to antiretroviral treatment. S Afr Med J 2011;101:258-262. [ Links ]
8. Archer BN, Weyer J, Paweska J, et al. Outbreak of Rift Valley fever affecting veterinarians and farmers in South Africa. S Afr Med J 2011;101:263-266. [ Links ]


text: About the author: I am full-time REALTOR® with RE/MAX Solutions in Springfield, MO, and a member of the Greater Springfield Board of REALTORS®. I have helped hundreds of families in the Springfield, Nixa, Republic and Ozark real estate markets, whether buying a home, or selling a home. Visit my website to search for All Springfield MO Area MLS listings. Want to know what our market is like? My website is also an excellent resource for current Springfield MO Area Real Estate Market Reports, as well as current market reports for Ozark, Nixa, Republic, and Rogersville.


text: Back to results Scroll Items 8368 of 13092 Main view Product Details Fashionable clutch, yet slim enough to slip into your favorite purse, Riley is the ideal everyday pouch. Goatskin Leather Top zipper closure Interior slip pocket Personalization available Handcrafted in New York, USA Size: 10" W x 7" H Graphic Image™ hand crafts personal accessories that have set the modern day standard for quality and design. The RILEY CLUTCH BAG crafted in Indigo-Blue Soft Leather by Graphic Image™ Model #59720774 $130.00 This item can be expected to ship by 12/07/2020. Order now by clicking ADD TO CART (below); you are only charged when we actually ship. Or, Click here to be automatically notified when it comes back in stock. Your Price Match is Active Your request for a price of $0.00 for a minimum quantity of has been accepted. You have [time] left to purchase this item for $0.00 Find a Lower Price? We BEAT All Authorized Retailers [?] Brand: Graphic Image® Material: Leather (fine) Display Type: not applicable n/a Color: Blue Approx. Overall Dimensions:10"x7"x3" This item ships in its own box Buy More - Save More * Add this item to your cart for the full details of this promotion. Conditions may apply. SHARE THIS ITEM Share on Facebook View more items Compatible Items Tags - Similar Searches Compatible Items Tags - Similar Searches RILEY CLUTCH Black - $130.00 RILEY CLUTCH Orchid - $130.00 RILEY CLUTCH Orange - $130.00 RILEY CLUTCH Robins-Egg-Blue - $130.00 RILEY CLUTCH Taupe - $130.00 leather Graphic Image Blue


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Casualties as Congo and UN forces fight rebels
GOMA, Congo (AP) — Congolese troops came under fire from rebels in the country's volatile east Monday as fighting resumed just outside Goma, a city of nearly 1 million people near the volatile Congolese-Rwandan border, army officials said.
Heavy weapons fire rang out around 4:30 p.m. near the front line just 9 miles (11 kilometers) outside the city.
Hostilities resumed last week after weeks of relative calm, and by Thursday a new United Nations intervention brigade with a stronger mandate than past missions shelled rebel positions for the first time.
Both sides suffered heavy casualties over the weekend, with more than 50 rebels killed and 23 government soldiers dead, according to a doctor near the front line and an army chaplain. Three U.N. peacekeepers were wounded: two South Africans and a Tanzanian, U.N.-backed Radio Okapi reported.
The head of the United Nations mission in Congo, Martin Kobler, visited two hospitals on Sunday and paid his respects to wounded government and U.N. soldiers, hailing them as "heroes fighting to restore peace," Radio Okapi reported.
The Congolese forces have advanced less than a mile (about 2 kilometers) since Wednesday and have yet to achieve their immediate objective — cutting off M23 from a border crossing where the rebel group is believed to get supplies from neighboring Rwanda, say observers.
The Congolese are fighting with the help of a new U.N. intervention brigade, which was created after the M23 rebels invaded and briefly held Goma in November.
The M23 has been pounding Goma from its positions just north of the strategic city, killing civilians in Goma's residential neighborhoods. By Saturday, scores of angry residents took to the streets in protest, claiming that the U.N. had not done enough to protect them. A U.N. car was set on fire, and in the melee two protesters were killed.
Some Goma residents claim the U.N. opened fire on the mob, but the president of Uruguay, Jose Mujica, said in a statement over the weekend that Uruguayan peacekeepers had only fired rubber bullets to control the crowd. Mujica said that it was Congolese police who had used live ammunition.
On Monday, the Congolese government called for an investigation into the deaths of the civilians. Minister of the Interior Richard Muyej told The Associated Press: "We are absolutely in agreement that a joint commission needs to be created" to do that.
Medical services were struggling to cope with the scale of the casualties among government troops and the M23 fighters who launched their rebellion last year and briefly held Goma in November before retreating. Subsequent peace talks in neighboring Uganda have repeatedly stalled.
Dr. Isaac Warwanamiza told The Associated Press he had seen 82 bodies since early Sunday, 23 of whom he claimed were government soldiers, the highest death toll reported since hostilities broke out last week. "I'm overwhelmed by what I've seen: bodies blown apart, arms and feet here and there," he said, speaking by phone from a hospital north of Goma.
Eight of the dead had no uniforms, 23 were government troops and the rest were M23 rebels, the doctor added.
The total of wounded Congolese troops at the military hospital is 720, according to army chaplain Lea Masika.
This is the first time that the Congolese army has been backed by the new U.N. intervention force, which was created in March.
The U.N. brigade was given a mandate to fight the rebels after Goma was seized by the M23 in November. In a humiliating blow to both Congo and the international community, the rebels marched directly past U.N. peacekeepers stationed at the gates of this city. The peacekeepers did nothing to stop them because their mandate at the time was limited to protecting civilians.
The M23 is made up of hundreds of Congolese soldiers, mostly from the Tutsi ethnic group who deserted the national army last year after accusing the government of failing to honor the terms of a deal signed in March 2009. Many of the movement's commanders are veterans of previous rebellions backed by Rwanda, which vigorously denies allegations that it has been supporting and reinforcing the M23.
In Washington, the State Department condemned the actions of the M23, calling on the rebel group to immediately cease hostilities, disarm and disband. The U.S. also suggested that Rwanda is assisting the rebels.
"We urgently call on (Congolese) and Rwandan governments to exercise restraint to prevent military escalation of the conflict or any action that puts civilians at risk," the statement said. "We reiterate our call for Rwanda to cease any and all support to the M23."


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At Countryflags.com you can find all country flags displayed clearly. You can sort the flags alphabetically by name of the country, but also by population and size of the country. Countries can also be clearly displayed by continent. Each flag has a description and it is also indicated which colours are used and what the original proportion of the flag is. It is also stated when a country adopted a flag for the first time, when the current flag was first used and when the last modification was made to the current flag. At Countryflags.com you can find a large collection of images of all the flags of the world. Choose from vector files, images, backgrounds or our extensive collection of icons of each country. The images are of high quality and can be used free of charge for both non-commercial and commercial use.
In addition to the information about the flags of the world you will also find information about all countries. With each flag a map is displayed of the country with the location of the country in the world. Here you will find general information about the countries, such as the population, size, population density, capital, official language, government, currency and time zone. With each flag you can view the neighbouring countries and you can also see what the national flags of the neighbouring countries look like.


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The world's most famous secret agent turns 50 this year and to celebrate a collection of 50 vehicles from the James Bond films has gone on show at the National Motor Museum in England.
ROGER Moore has once again spoken out over James Bond, saying the spy should neither be a gay man or a woman.
Art & Theatre
MUSEUM brings together the largest collection of James Bond movie vehicles in one spot.


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10 Restaurants That Started a Food Movement
Some of the most popular foods—like Asian noodles, gastropub fare, sushi, and locally grown produce—were relatively unknown only a generation ago. Here, we recognize, and recommend, some of the restaurants and chefs that changed the food world.
It wasn't long ago that the phrases "local food," "gastropub," "New Nordic," or even "rustic Italian" would have left most Americans scratching their heads in confusion. Now, thanks to pioneering chefs like Alice Waters and Mario Batali, we all know a lot more about where our food comes from and the tradition that informed its preparation. Here, some of the standout restaurants that started it all, plus tips about how to place your order and, in some cases, more affordable offshoot restaurants that still live up to the quality of the original.
Momofuku Ssäm Bar
New York City
Ssäm Bar, one of restaurateur David Chang's empire of 10 Korean-fusion restaurants, opened in 2006, on the heels of Chang's Momofuku Noodle Bar ("Momofuku" is a reference to Momofuku Ando, the inventor of instant noodles). Ssäm, with its cozy communal-seating bar and busy din, soon became an instant fixture and a destination on the NYC dining scene after it ditched its initial "Asian burrito" concept. (Trivia: "Ssäm" means "wrapped" in Korean.) Well-composed dishes like soft, savory steamed pork buns with cucumbers, scallions, and hoisin sauce, and raw seafood, such as the striped bass with plum, cilantro, and green peppercorns, are hallmarks of the menu.
How to order at Ssäm Bar: This menu of small plates is intended for sharing and nibbling. Or, make a quick pit stop by grabbing a seat at the adjoining, newly revamped bar, Booker and Dax, and ordering a drink like the Laurel & Hardy, made with rye, cognac, maraschino, fernet, benedictine, and mole bitters ($15), plus an order of steamed pork buns ($10) or a plate of ham slices straight from farms in Kentucky or Virginia (momofuku.com/restaurants/booker-and-dax) from the limited bar menu. For sheer per-person savings, you can order an entire pork shoulder (the "bo ssäm" meal) for six or more people ($200) or a newer menu item, the whole rotisserie duck for three to six ($140)—each comes equipped with a selection of sides like oysters, in the case of the pork shoulder, or chive pancakes with the duck (momofuku.com).
Copenhagen, Denmark
Winner of the U.K.'s prestigious "Best Restaurant in the World" award three years running, Noma is considered to be the premier destination for "New Nordic" cuisine. Using local ingredients like halibut, roots, and berries and "molecular gastronomy" techniques developed with University of Copenhagen scientists (foams, emulsification, and liquefaction, for example), chef René Redzepi produces inventive dishes like roast filet of muskox and skyr and toasted rye kernels. Redzepi once worked for molecular gastronomy's forefather, chef Ferran Adria, at previous "best restaurant" El Bulli, in Catalonia, which just closed.
Here in the U.S., get your Norse fix from New York City restaurant Acme, whose chef, Mads Refslund, was one of Noma's founders. The menu is divided into four distinct parts: raw, cooked, soil, and sea/land.
How to order at Acme: Choose a few small plates and pass 'em around. Acme recommends that new diners try the country toast with nectarine, brie, carmelized onions, and honey ($12), farmer's eggs with Parmesan and cauliflower ($10), and the pearl barley and clams dish, which is packed with scallops, artichokes, and roasted sunflower broth ($19, acmenyc.com).
Chez Panisse
Berkeley, Calif.
That "slow food" movement that's so trendy right now? Chez Panisse started it all four decades ago. Chef Alice Waters opened Chez Panisse in 1971, with a menu emphasizing locally and organically grown ingredients and sustainable production methods. Her first creations, such as a pate en croute and an almond tart, wowed critics and attracted the attention of culinary luminaries such as Julia Child, and the place has been an institution ever since.
Waters opened Chez Panisse Café, a moderately priced offshoot featuring an open kitchen with a wood-burning oven and charcoal grill, located directly upstairs from the first restaurant, in 1980.
How to order at Chez Panisse Café: Perfect for gastronomers on a budget, the café offers a three-course $29 prix fixe menu that changes daily. One recent lineup: garden lettuce salad; hand-cut fettuccine with sweet corn, zucchini, crème fraîche, and basil; and blenheim apricot sherbet with mulberry gelée and summer berries (chezpanisse.com).


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More Details Released For Broadway Week On Dancing With The Stars
The seven remaining couples on Dancing With The Stars will dance in a Broadway-Themed Group Dance. As we reported to you earlier, Kristin Chenoweth will perform both Monday and Tuesday night. The Cast of Broadway's "Sister Act" will also take to the stage Monday night. Martina McBride will perform Tuesday Night. "Macy's Star of Dance" will also return to the show again Tuesday with a special tribute to Broadway. The "Macy's Stars Of Dance" performance will star Corbin Bleu and be choreographed by Kenny Ortega (3 time Emmy award winner and one of the most sought after choreographers to stars like Barbra Streisand, Michael Jackson, Madonna, Gloria Estefan, Elton John, Rod Stewart, Bette Midler and The Pointer Sisters to name a few.). Also note how Tony Dovolani, Dasha Chesnokova, Chelsie Hightower, and Val Chmerkovskiy will be dancing. According to Mark Ballas' new blog, he will be dancing as well. Below are more details from ABC Medianet. Who's ready? 🙂
"Episode 1306 & 1306A" – The remaining seven couples bring widely entertaining performances to the ballroom floor with explosive dancing and unforgettable songs from some of Broadway's most popular musicals of all time. The night full of show tunes will include a breathtaking performance from Emmy(r) and Tony Award(r) winner Kristin Chenoweth, who is set to perform a medley of "Maybe This Time" from "Cabaret" and "I Could Have Danced All Night" from "My Fair Lady." We also welcome the Broadway cast of "Sister Act," performing a feel-good medley of "Raise Your Voice" and "Sunday Morning Fever." Plus for the first time this season, the seven couples will perform their second dance of the night together in a Broadway-themed group dance to a medley of "Big Spender" from "Sweet Charity" and "Money Money" from "Cabaret," on "Dancing with the Stars," MONDAY, OCTOBER 24 (8:00-10:01 p.m., ET), on the ABC Television Network.
On Tuesday, the entertainment continues with another dazzling performance from Kristin Chenoweth who will perform "Lessons Learned" from her new album, "Some Lessons Learned," accompanied by pro dancers Tony Dovolani and Dasha Chesnokova. Country music entertainer Martina McBride returns to the ballroom with a spectacular performance of "I'm Gonna Love You Through It," the hit single from her new album, "Eleven," accompanied by pro dancers Chelsie Hightower and Val Chmerkovskiy. Also this week, "Macy's Star of Dance" features a special and meaningful piece, a bow to three of the great streets of Broadway, choreographed by Emmy Award-winning choreographer Kenny Ortega and starring actor and recording artist Corbin Bleu, on "Dancing with the Stars the Results Show," TUESDAY, OCTOBER 25 (9:00-10:01 p.m., ET), on the ABC Television Network.


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Everyone has received offers in the mail that are 'too good to be true' mail scams. Unless everyone unites and shuts down these scammers, these businesses will continue to take advantage of people. (especially old people)


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What's the perfect birthday gift for twin sisters who also happen to be in a rock band called The Breeders? If you guessed "A cake shaped like a womb with twin fetuses in it," you are both a little bit sick and correct!
Yesterday rock goddesses Kim Deal and Kelley Deal celebrated their 50th birthday with a fantastic cake created by the elé cake company. As a long-time Pixies fan, this is almost too much awesome for me to handle. Happy birthday, ladies! [Via Laughing Squid, Photos by Chris Glass]