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Where is the Horror?

By: Magnus Ekervik | Mon, Jun 7, 2004
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In recent weeks I as many other financial writers have noticed the extreme M3 expansion by the FED. The size of expansion is what would follow after a catastrophic event that could threaten the financial system like the WTC attacks or the failure of LTCM. What kind of horror forces the FED to hyper inflate M3? I believe this is the most important question at the moment.

Some writers try to explain that the FED is hyper inflating to counteract the underlying forces of global deflation. I agree that deflationary forces are like a wet blanket over the global economy. However we have had deflationary forces in the economy due to overinvestment/overcapacity since at least 2000. I am not satisfied with such a general explanation to this last month sudden super growth in M3. I think there is a more specific reason for the FED's action!

OK, what kind of horror has got the FED spooked? They must know something since they are acting before the event has become public. I think the FED has told us about the horror they now expect/experience several times the last two years. Here are some clues for you! Alan Greenspan touched the issue in Feb 2002 and warned us again in Feb 2004. William Poole president of the St Louis FED made a publicized in depth analysis on the "problem" in May 2004.

I will soon reveal what I think the FED is scared of. But first lets try to see if we can figure out where all the money is going.

To get the enormous amount of new M3 money into the banking system the FED can buy almost any type of debt. Mortgage refinancing has been in a sharp decline since the bond market took a dive in mid March. This money is not likely going to home refinancing.

Has the FED been buying bonds to halt the rise in long term yields? With approximately 45 billion dollar in M3 expansion each week the last month this amount of money would certainly stop a rise in bond yields at least temporary. But the yield on bonds has been going up so I don't think they are intervening in the bond market. Besides the FED is preparing Wall Street for higher short-term rates so a rise in long-term rates would be normal.

Are US corporations borrowing new money to increase production capacity thereby boosting M3? Both new borrowing and investment in production has been in steady decline in corporate America. So where is the money going?

OK, here it is!

I think the FED directly or indirectly via US banks are liquefying the two Government Sponsored Enterprises, Fannie Mae and Freddie Mac. (together FF or GSE from now on)

What on earth would make me think this?

I think FF is in big trouble and a meltdown of the entire US financial system is at risk because of the enormous size of these companies. And the strange/scary thing is Federal Reserve officially shares my opinion!

I will give you some scary highlights and personal comments on the article "GSE's Borrowing Short and Lending Long" published on http://www.stlouisfed.com/ and written by St Louis FED president William Poole.

Mr Poole: "Some crises, such as the one that brought down Enron, are well contained and do not spread to other firms. Others, such as Long Term Capital Management, have wider effects. There is no question but that a crisis affecting either Fannie Mae or Freddie Mac would have widespread effects because these firms are so large. I want to emphasize that, on the basis of information I have, no crisis is at hand in the market for GSE obligations."

ME comment: If there is no crisis at hand why would FED Chairman Greenspan and St Louis FED president Poole address this issue twice in the last 4 months. Why cry wolf if there is no wolf around? This could scare the public and financial markets for no reason. It doesn't make any sense to address this issue unless the FED is afraid of getting the blame for a financial system meltdown that these companies might trigger if faced with a crisis. I think they are trying to shelter themselves from responsibility. Few other companies in the US have benefited more from FED easy money policy than FF. Should the FED be freed from responsibility? Not in my opinion.

Mr Poole: "In my opinion, GSE capital positions are undesirably thin and leave these firms unnecessarily vulnerable to surprise shocks. There is no way to predict what kind of shock might shake market confidence, but the reason a shock could have serious adverse effects is that FF pursue a strategy of borrowing short and lending long, with a thin capital margin."

ME comment: The shock Mr Poole is referring to is rising interest rates. Since mid March the long-term bonds have had a big and swift unexpected rise in yields. Was this a shock to FF?

Mr Poole: "The main point about managing a crisis through this mechanism, with FF obtaining credit from banks and the Federal Reserve providing loans to the banks, is that the enormous scale of FF obligations would strain the banking system. This mechanism might not suffice to handle a major crisis as the banks would insist that FF post collateral. In a crisis, the mortgage market would be severely disrupted and mortgages and mortgage-backed securities would no doubt trade at lower prices, thus impairing the value of the collateral FF could post. The decline in the value of FF assets would strain their capital positions, and lead to fears that either or both Fannie Mae and Freddie Mac might become insolvent."

ME comment: Should a crisis hit, FF would strain the banking system and might become insolvent!

Mr Poole: "Under Section 13(3) of the Federal Reserve Act, Federal Reserve Banks have the authority to discount paper for individuals, partnerships or corporations. Direct lending to the GSEs would have to come under provisions of this part of the Federal Reserve Act. Critical provisions include a finding of unusual and exigent circumstances and an affirmative vote of not less than five members of the Board of Governors. The loans would have to be fully collateralised. There has been no lending under this provision of the Federal Reserve Act since the 1930s. Such lending, were it to be authorized by the Board of Governors, would permit GSEs to redeem maturing obligations and would, therefore, solve part of a crisis problem. However, such loans might not restore liquidity to GSE debt before redemption and would not per se restore normal functioning of the mortgage market. Clearly, Federal Reserve support for the GSEs would help to prevent a broadening crisis, but most likely would be incapable of preventing some considerable disruption."

ME comment: The FED could temporarily milder a crisis but a considerable disruption is unavoidable.

Mr Poole: "Many financial institutions seem not to understand the nature of the issues. It is interesting that GSE obligations trade at much smaller spreads over Treasuries at the short end of the maturity spectrum than at the long end. Investors in short-term obligations apparently believe that they are completely protected from credit risk because they will have enough warning to permit them to exit these obligations by letting them mature in a few months. The problem is that should a crisis occur, it will take hold so quickly that GSE obligations will in a matter of hours, or days, become illiquid. While any one holder of GSE debt can exit, not all holders together can exit at once. The economics of this market are similar to those of banking markets. A scramble to convert all bank deposits into cash cannot succeed in the aggregate because not enough cash exists to effect the conversion. Similarly, a scramble to convert GSE obligations into cash cannot succeed in the aggregate because the underlying mortgage assets cannot be quickly converted to cash."

ME comment: Wow this is my favourite! Should a crisis occur, GSE debt would become illiquid within hours or in best case a couple of days. Holding any GSE debt?

Mr Poole: "I note also that FF have a powerful incentive to grow. They report returns on equity in the neighborhood of 30 percent per year. They are able to achieve these returns by exploiting the implicit federal guarantee of their obligations, which enables them to borrow at near Treasury rates despite their thin capital positions and invest in mortgages at private market rates. Their growth objectives insure that their scale will increase over time, unless they become subject to full private market incentives through convincing federal policies that lead to market recognition that the federal government will not guarantee GSE obligations in a crisis."

ME comment: Should a severe crisis occur the FED will/can not bail out FF.

Conclusion: If the FED is repeatedly warning us about the possible financial systemic risk of Fannie Mae and Freddie Mac I think it is wise to be on full alert for a crisis in these companies. I think they are experiencing a crisis already and the FED is pumping billions of M3 to liquefy these companies. Remember that what you have read above is the official version from the FED. The official version is scary enough, who knows how they talk about this issue behind closed doors. I think a severe shock is about to hit the financial markets in the form of a GSE collapse. A crash like this will throw the US and world economies into recession so fast it will make your head spin. Eventually these events will lead the global economies into a new depression...

Author: Magnus Ekervik

Magnus Ekervik

Magnus Ekervik offers independent research and analysis of macroeconomics to financial corporations and financial newspapers. For more information please contact: ekervik@gmail.com

Copyright © 2004-2009 Magnus Ekervik. All rights reserved.

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SAH Members in the News

Obituary: Cheryl Robertson

by SAH News | Jul 16, 2013

Cheryl Robertson, a highly respected curator, speaker and author in the Arts and Crafts community, passed away over the weekend of July 6th, at her home in Cambridge, Massachusetts. She was 60 years old.

For more than thirty years Cheryl had served in museums as well as at universities, both as a professor and as a curator. As such she organized, prepared and directed the installation of numerous temporary and permanent displays for major exhibitions. Cheryl prided herself in her efforts to help museums revitalize what she liked to call "tired art museum exhibits." In addition, she often assisted private individuals restoring and furnishing historic homes, helped manage small and large single-owner collections, and worked with local historical societies.

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Friday, August 7, 2009

May Co-Authors Text on Moore Teaching Method

Dr. Lee MaySALISBURY, MD---In 1905, mathematician R.L. Moore developed a unique teaching method using no textbooks, no lectures and no conferring.

More than a century later, Dr. E. Lee May (a self-proclaimed “Moore-on”) of Salisbury University’s Mathematics and Computer Science Department, has taught hundreds of students using an adapted version of that method. Now, he’s helping others do the same as a co-author of the Mathematical Association of America’s The Moore Method: A Pathway to Learner-Centered Instruction.

May includes a sample syllabus in the book, as do his co-authors: Charles A. Coppin and W. Ted Mahavier of Lamar University in Beaumont, TX; and G. Edgar Parker of James Madison University in Harrisonburg, VA. He uses it to show how other faculty may implement a similar structure in their classes.

“I try, for the most part, to restrict my lecturing to a maximum of 20 minutes per period, and, for example, in a calculus course, many periods will be completely taken up with students putting solutions on the board and the class discussing them,” May said, adding that this hands-on approach allows students to better understand the material than hours of lecturing.

He learned to love the Moore method in the 1960s at Emory University, where he was a student of Mahavier’s father and of John W. Neuberger, both of whom were master practitioners of the teaching style.

May has chaired or co-chaired three “Legacy of R.L. Moore” conferences and attended seven out of the 11 held. He has used Moore’s methods throughout his teaching career, which has included stops at Emory, Kennesaw State and Wake Forest universities, as well as SU.

For more information call 410-543-6030 or visit the SU Web site at

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Metal Single Prong Curl Clips
Metal Single Prong Curl Clips

Metal Single Prong Curl Clips

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  • Durable long-lasting metal
  • Strong metal spring

Salon Care Metal Single Prong Curl Clips are durable clips that help hold curls in place. The rounded design allows the clip to glide through hair easily.

Additional Information on recomended and recently viewd prods

Salon Care Metal Single Prong Curl Clips is rated 3.9 out of 5 by 14.
Rated 4 out of 5 by from Good price for 100 count. 1 & 3/4 inch have a nice, strong grip I purchased these clips to make tiny hats and other crafty hair clips to sell in salon and at craft shows. Sally's clips have a slightly stronger grip than the retail store brands. Also the cost for the 100 count box is the best I've found in my search online. This 1 & 3/4 inch works great for my needs. Thanx Sally:)
Date published: 2016-02-02
Rated 5 out of 5 by from Great Product I have ordered these time and time again. They are great for the price. The quality stands up to every day use.
Date published: 2014-07-18
Rated 5 out of 5 by from Pin curls! I use them to create a pin curl or roller set in a vintage style on thick Caucasian hair. They make a roller set or pin curl set last for a whole week. They last for years. Very good quality.
Date published: 2014-04-19
Rated 5 out of 5 by from Awesome Product! These metal single prong clips are the only ones I use in my business to make our hair accessories! They are definitely strong enough to keep even the thickest hair in place and they are great for adding ribbon to and attaching to flowers. Highly recommend.
Date published: 2014-03-17
Rated 4 out of 5 by from Used to love them I still buy these clips because they're such a great value and sometimes I still get the higher quality ones. The packaging is the same, but often I get clips that aren't as strong and don't clip as tight as the ones I used to get. I love the older design, they were much, much higher quality and I wish there was more consistency with this product. I usually purchase about 1300 clips per month and usually about 1/3rd of the boxes in any given batch are the older, superior quality clips, while the majority are the lesser quality clips. With my last order of 2600 clips, they were all the poorer quality and I was disappointed.
Date published: 2011-08-06
Rated 1 out of 5 by from NOT what they used to be! I make hair accessories using single prong clips and used to buy these clips in bulk from Sally online frequently over the past few years. The quality was great and I got a great price using my Sally card and watching for sales. Well, the price is still good but the quality of the clips is not what it used to be. Although packaged the same, the clips themselves are different and the quality of the new clips is VERY POOR compared to the old ones - the springs do not hold as tightly and the prongs don't even line up! This may not be a problem for some people but it is for me - I need QUALITY clips to make quality products for my customers. SUCH a disappointment because now I need to find a new supplier. Bad decision to change the clips, Sally - you just lost a loyal customer.
Date published: 2011-05-14
Rated 5 out of 5 by from Fast Shipping These are great little clips for covering for my bows and clippies, and the shipping is super fast. With all the coupons I could stack and the free shipping plus my sally card, these are the best price I have found
Date published: 2010-12-24
Rated 4 out of 5 by from not as good as in the store The tension is good, but the ones in the store is GREAT!!! Wish they were the same!
Date published: 2010-12-13
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do they sell these in the store? The closest to me is Fox Point wisconsin

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Hello and thank you for your question. Yes, Salon Care Metal Single Prong Curl Clips are sold in-store, please contact your local Sally Beauty for inventory inquires.
Answered by: Sally Staff
Date published: 2016-02-02

How long are these? Thanks.

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Are these clips electrically conductive? What are they made of?

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When your best friend of 20 years, gets married to a British gent in London in the summer time, asks you to be her maid of honor, and announces she is keen to celebrate her hens / bachelorette in Mykonos, Greece…. The excitement is real!

 If you follow me on Insta, you would have seen some of my Mykonos snaps already, but as this was my first time actively organizing a hen’s (for our USA readers, in Australia & the UK we call Bachelorette a ‘hens’) – I wanted to share of what I learnt, should you be throwing your BFF a hens do!

So – grab your bikini & your flower crown – We’re going to Mykonos!

Melanie (the bride & my BFF) has lived in London for seven years, after heading across the pond from Australia. Her & her friend Natalie, have frequented Mykonos every summer together for the past 5 years, so it was a no brainer for her to choose there to celebrate, get a pre wedding tan, and as guests where already flying in internationally, give them the option to see some more of Europe given the hens was only a week before the wedding.

 Luckily for me, the amazing Natalie knows the island well, and therefore she took on the duties of the dinner, bar & beach club bookings for our group of 11.

  I was in charge of  other hens duties…. So what does fall under the ‘other banner’?.... Here is my version.

It could be the Creative Director in me speaking (ok, it definitely is) but as most will create a hashtag for such a celebration (ours was #MykonosMel) I like the concept of also creating a logo or insignia for the event.  This doesn’t have to be professionally done – it could be as simple as something you create in a word.doc with an image you have cut & pasted in & added the Brides name beneath. Mel’s wedding theme is tropical, and as we were going to an Island for the hens, I went with a series of green palm frons (I sourced these from Shutter stock).

I used this across all printed material; Itinerary, welcome notes & tags.

Penis straws, flashing veils & bride-to-be sashes where not going to make an appearance on my watch. So instead of a veil, I contacted the incredible Keahny at MINT + MELON  to create a luxe flower crown for the bride to be & slightly smaller ones for all the bridesmaids & hens guests. I am not throwing shade on the traditional hens props, but my suggestion is know your bride-to-be’s taste, I know Mel would not have been comfortable rocking around Mykonos with a flashing Bride-To-Be sash & veil – So tailor to your brides style.

A destination hen’s celebration is the ultimate, but often not always achievable…so whether you are organizing a destination escape, or simply a weekend away (anything that requires travel or over night stay) I think the touch of a Welcome Gift is a nice thankyou to everyone who took the time & cost to travel… So what was in our welcome gifts…

I created little Hangover Kits that were ‘For the morning after the night before’ – a cute little drawstring bag containing Advil (Panadol), EmergenC (Berocca), Altoids (TicTacs) & Band aids.  There was a gold ‘flash tattoo’ for each guest that said ‘Brides Tribe’, some travel hair products from Original Mineral, a tiny Apple flavored Smirnoff Vodka with a tag attached that said ‘Let’s Get This Party Started!’, some SW Jewels (obvi), a print out of the itinerary from Nat’s bookings, and welcome note, all packaged in an SW wooden box lined with black tissue papar. The flower crowns where added to the top of the box, with a name card attached, that I doubled up to use as place settings on our first night there.

The Bride’s Welcome Gifts where the same as above, but with a few additional luxe items… a White & Lace over swim kaftan, a customized ‘Mrs Rama’ white silk sleep mask + some For Love & Lemons lace side panties, all wrapped in white tissue paper.

While these gifts are a bit of an investment, you might want to plan it out is far advance, and start collecting samples at makeup counters, asking friends or families who work at brands if they have any promo items you could include, or get crafty & make some gifts that will be special (and useful!) to the occasion.

As the gifts were differentiated for the bride & guests with Black & white tissue, I made sure to let all guests know, that one a certain day, they were only allowed to wear black. That went from breakfast, to beach, to beach club, to dinner…. And on that Day, Mel could ONLY wear white…. This not only made for lots of photos, but got Melanie SO many well wishes for other island goers, it was really special! I highly recommend this, and its super easy to do. As we were in a tropical destination, it also included Bikinis – so be sure to be really clear with all guests how far it extends, no guest wants to be the one who thought it would be OK to wear her white cossie that day!

black and white

I sourced a criminal lineup backdrop (available on ETSY) and after a big night out, made everyone stand infront of it, with a pre printed arrest identification card – Sunglasses allowed. The result is below!

I am an avid iphone photographer. I love to capture & archive most things in my life like one would write a diary, I do so with pictures. Capturing the bride at her most glowing & glamorous provides great lasting memories for her forever. Does she look like a luxe goddess on her sunbed sipping her mojito? Capture that for her! Did you all have a great group dinner with a beautiful toast? Don’t interrupt the toast to take a pic, but after the toast DO have everyone re-raise their glasses & capture a photo of the clicking glasses.  Try to capture as much natural (un-posed) moments as possible – guests chatting or laughing together, one of the best ways to capture is, if you are taking a pic of the bride & a few guests just standing smiling at the camera, after you have captured that, tell everyone to look at the bride & laugh (I know, seems ridiculous, but it makes for a probably what was happening before everyone knew a photo was being taken). I’m sure a beautiful edit of these photos will find their way onto a Facebook album for archive, but you might also want to do the archaic practice of sending the photos to print, and putting them in a album for the bride… A beautiful way to relieve all the fun a few weeks after the celebration.

Obviously as a bridesmaid, your job to ensure the brides experiences as little stress as possible on her special day. The same goes for the hens celebrations. Especially when you are celebrating as a big group, going for dinners / lunches etc, no ones wants to talk about money, its especially not cool to do it in front of the bride. My suggestion is to advise everyone to bring cash (as to not have to bother re splitting amounts on credit cards), and possibly give everyone a heads up as the approx. cost of each organized meal… have them give you the cash pre meal, and if it goes over, start a kitty for after dinner cocktails.

So that’s my hens take-aways! We’re off to London now for the wedding – Can’t wait to show you pics from what I know will be one of the most spectacular weddings!

Congratulations to my beautiful Best Friend! I cannot wait to stand beside you on Sunday! - SWx

Add a Comment 0 Comments | Posted in The Wedding Journal By Samantha Wills

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A 5 star holiday enjoying a lake-side location close to the Atlantic coast

Discover Sandaya Soustons Village 5 Star Campsite in the Nouvelle-Aquitaine region. Located just a stone’s throw from Soustons lake and only 6 km from the Atlantic coast, Sandaya Soustons Village 5 Star Campsite is perfect for enjoying a relaxing holiday in the heart of the Landes forest. Make the most of the many on-site activities available to you on our campsite covering 14 hectares and which includes an aquatic centre with a heated pool, a spa, sports tournaments, evening entertainment and children’s clubs, etc. There is something for everyone at Sandaya Soustons Village 5 Star Campsite.

Open from 01 April 2017 to 24 September 2017

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A new style of eco-friendly holidays

Enjoy holidaying in complete harmony with nature at Sandaya Soustons Village 5 Star Campsite. Surrounded by the Landes pine forest, our campsite on the banks of Soustons lake is perfect for a relaxing eco-holiday with your family. Sandaya Soustons Village 5 Star Campsite has a ‘Clef Verte’ (Green Key) environmental accreditation and offers holiday rentals in modern, low-impact, recyclable accommodation located in pedestrian-only areas and tucked away in 14 hectares of pine forest. By opting for Sandaya Soustons Village Campsite, you are encouraging green practices and are respecting the environment. Experience an alternative style of holiday on our eco-friendly campsite.

A 5 star campsite in the heart of Landes

You will find a 5 star campsite with environmentally-friendly and modern facilities that will delight both adults and children alike. Make the most of a 700 m² aquatic centre with both a heated pool and wave pool, and our on-site spa where you can relax and unwind. Take the time to enjoy the activities on offer in our Soustons Village Campsite: water polo, aquagym, fitness room, pétanque tournaments, shows, etc. Your Sandaya campsite entertainment team will always be there for you. Choose your holiday options and come and discover Landes at Sandaya Soustons Village 5 Star Campsite.

Sandaya Soustons Village 5 Star Campsite offers a variety of services to ensure the comfort and success of your holiday in Landes. Our reception team are there to welcome you and offer advice right from the moment you arrive to ensure that your holiday runs smoothly.

Reception :
Our receptionists are available throughout the year. They will be there to help you when you arrive at Sandaya Soustons Village 5 Star Campsite. The reception is open from 7am to 11pm.
Internet :
There is free WiFi access available in all communal areas on the campsite.
Laundry :
A laundry room with washing machines, tumble dryers and washing powder (1,50€) is available at Sandaya Soustons Village 5 Star Campsite. Tokens (€3) can be collected from grocery.
Clubs for children & teens :
From dawn until dusk, your children and teenagers can take part in numerous activities supervised by our leaders in the 3 campsite clubs or in places suitable for any games they wish to play. There is no question of getting bored whilst on holiday. A health record and vaccination certificates are required for the mini-club (4 to 8 years). The mini-club, Junior club (9 to 12 years) and Teens club (13 to 17 years) are only open during the French school holidays.
Shuttle service to the beach :
There is a free shuttle service taking you straight to the beaches during July and August.

Shops and facilities on site

There are several shops and facilities on site at Sandaya Soustons Village 5 Star Campsite for your convenience and enjoyment whilst on holiday. This means that you do not have to use the car during your stay and so can enjoy your holiday to the full.

Grocery :
There is a grocery store on our campsite. You will be able to find essential everyday items here, as well as newspapers and postcards. Bakery goods and hot and cold snacks such as bread and sweet pastries are also available. It is open from 8 am to 12 am and from 4:45 pm to 7pm during the low season. In the summer season : from 8 am to 12:30 am and from 3:30 pm to 8 pm.
"La Terrasse" restaurant and bar :
"La Terrasse" is located directly opposite the pool and is open every day in summer. The restaurant has a wide choice of traditional Landes dishes for you to enjoy in the dining area itself or to take away. It welcomes you from 11:30 am to midnight out of season; In summer from 10 am to midnight. Finally, after a day at the beach, why not come and cool off with a relaxing cocktail in the bar at ‘La Terrasse’.
Snack :
The snack team welcomes you all season: from 12 am to 1:30pm and from 7:30 pm to 9:30 pm. It proposes to you pizzas, fries, burgers, take-away dishes.
Spa :
There is a spa in Sandaya Soustons Village 5 Star Campsite which includes a hammam, spa bath, sauna and gym. Enjoy relaxing beauty treatments and massages and unwind during your stay in Landes. Come and experience the ‘Too Fruit’ treatments, which are a range especially designed for children from 6 years and over as well as for teenagers. There is also the ‘OMNISENS’ treatment, which will awaken all your senses with its range of natural, paraben-free products. There are plenty of exquisite treatments to enjoy in surroundings that are perfect for relaxing and de-stressing. Open from Monday to Friday from 9:15 am to 12:45 pm and from 3:15 pm to 6:30 pm during the off season, in July and August from 9:15 am to 12:45 pm and from 3:15 pm to 7:30 pm. The appointments are made either by telephone or at the reception of the spa.
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Veterans get ‘stronger hand’ to protect parks, memorial halls

A battle at home over the landmark “Bob Hope Patriotic Hall” in Los Angeles County has ended in a statewide victory for California veterans.

A new law has been signed by Gov. Jerry Brown that guarantees veterans groups will retain the right to use their Memorial Halls and other buildings.

“This bill preserves our state’s commitment to the brave military men and women who have served our country,” Sen. Joel Anderson, R-La Mesa, said in a statement released after the legislation was signed earlier this month.

“Let us uphold the promise we’ve made and make sure our military veterans are always welcome in the facilities dedicated in their honor,” he added.

The issue came to a head when veterans groups were forced out of Patriotic Hall so the county of Los Angeles could undertake a $45 million renovation of the 10-story building starting in 2006.

According to a 2012 Los Angeles Times story, nearly 10 different veterans groups had offices in the building and an entire floor was occupied by the Disable American Veterans organization. The basement space was known as the General Jimmy Doolittle Room, named in honor of the much-decorated WW 11 pilot.

But as the work neared completion, county officials began looking to consolidate space for veterans and use some of the building for other purposes, sparking an outcry.

The issue was later settled, but veterans groups went to Anderson to make sure it would not happen again elsewhere.

The veterans said they have a ”right of return” to memorial halls, parks, recreation centers and other spaces.

Anderson agreed, introducing Senate Bill 725 to protect their rights.

Anderson said the state, acting after WW1, promised veterans that certain buildings and property would be permanently set aside for those who served the nation.

He said the state needs to make sure that those promises are not broken when the veterans groups temporarily leave a facility so that it can be renovated. Originally Patriotic Hall when it opened 88 years ago, it was renamed in 2004 to honor the late comedian Bob Hope, who entertained troops for decades at home and in war zones.

The measure was endorsed by a broad range of groups, including the American Legion, AMVETS, Veterans of Foreign Wars, Vietnam Veterans of America and others.

“It gives them a stronger hand,” said Pete Conaty, who represents a variety of veterans groups in Sacramento.

The legislation sailed through both houses without a single no vote.

Copyright © 2017, The San Diego Union-Tribune


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The Cambrian

October 22, 2013 6:01 PM

Cambria CSD's general manager may get 5 percent raise

A raise for the general manager, the question of whether to lift a landscape watering restriction and the possible purchase of county property are up for discussion by Cambria Community Services District directors Thursday.

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SAT Reading Scores

This is a chart I found this evening on one of my favorite blogs, With SAT reading scores at an all time low, it’s a great time to focus on creative and alternative methods to help teach vocabulary.

A broad base of vocabulary helps with all aspects of the verbal section of standardized tests, including analogies, sentence completion and reading comprehension.

The downward trend shown on the chart makes “Cook Your Way Through The S.A.T.” pretty timely (and it’s lots of fun). We hope you consider including the book in your test prep resources.

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2 responses to “SAT Reading Scores

  1. At 53, I can’t wait to get your book so I can test both my culinary and vocabulary skills. As of today, you would no doubt score higher on the SAT than a seasoned adult.

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 Santa Barbara Zoo : Activities to do with kids in Santa Barbara, CA- The Savvy Source

Santa Barbara Zoo

500 Niños Drive
Santa Barbara, CA 93103

(805) 962-6310

Santa Barbara Zoo offers a wide range of animals to visit and guests can spend a half day meandering the grounds.

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    "Adults 13-64 $12, Children 2-12 $10, Seniors 65+ $10, Children under 2 free"

Santa Barbara Zoo: From the Parents

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Home > Shop By Brand > Bedford Downing Glass

Bedford Downing Glass Sealed Etched Boxes

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vol.19 número1Percutaneous placement of peritoneal dialysis catheters in resource-limited developing countries as an alternative to conventional placement methodsPost-treatment surveillance abdominopelvic computed tomography in children with Wilms tumour: Is it worth the risk? índice de autoresíndice de assuntospesquisa de artigos
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SA Journal of Radiology

versão On-line ISSN 2078-6778
versão impressa ISSN 1027-202X

S. Afr. J. radiol. (Online) vol.19 no.1 Cape Town  2015

Pre-interventional assessment and calcification score of the aortic valve and annulus, with multi-detector CT, in transcatheter aortic valve implantation (TAVI) using the Medtronic CoreValve

Antoinette ReindersI; Coert S. de VriesI; G. JoubertII

IDepartment of Clinical Imaging Sciences, University of the Free State, South Africa
IIDepartment of Biostatistics, University of the Free State, South Africa

BACKGROUND: Transcatheter aortic valve implantation (TAVI) provides an acceptable alternative for aortic valve replacement in the elderly, but needs accurate pre-procedural imaging to optimise intervention.
OBJECTIVES: To evaluate an alternative manual aortic valve calcification scoring system with computed tomography, for patients undergoing TAVI. We hypothesise a correlation between the Free State aortic valve calcium computed tomography score (FACTS) scoring system, valve plaque density and procedure-related complications.
METHODS: Twenty patients suitable for TAVI were selected according to standard international guidelines and received multimodality imaging prior to intervention. Images were reviewed by two reviewers who were blinded to each other's scores. Where large inter-individual score variations existed, retraining was done and scores repeated, using a double-blinded method. Matched scores were included in the final analysis. Rosenhek calcification scores were used as a standard of reference.
RESULTS: The study comprised 9 (45%) men and 11 (55%) women, with a median age of 83.5 years. Median EuroSCORE was 15.5. FACTS scores
6 were associated with the presence of a paravalvular leak (p = 0.01). Procedure-related complications (left bundle branch block, repositioning of the valve and anaemia) were seen in patients with plaques measuring 1000 HU (p = 0.07
CONCLUSION: The FACTS score and averaged valve plaque HU showed potential for predicting a paravalvular leak and procedure-related complications, and could be valuable in the future for optimising patient selection for TAVI

Aortic stenosis is a global major debilitating health concern that is associated with high mortality and morbidity in the elderly population. Until recently, the only treatment for such patients was surgical aortic valve replacement, showing reasonable peri-operative results, but excluding a large number of symptomatic patients owing to unacceptably high peri-operative risk as indicated by a European Society of Cardiology score >20% (EuroSCORE) or Society of Thoracic Surgeons (STS) score >10.1

In the above pre-interventional scoring systems, patients are allocated specific numerical values according to comorbid conditions such as hypertension, hypercholesterolaemia and chronic obstructive pulmonary disease. Since the early 1990s, alternative routes for aortic valve replacement have been sought. 1,2,3 Transcatheter aortic valve replacement (TAVI) has emerged as a suitable and clinically better-tolerated alternative to surgical aortic valve replacement in selected patients.1 Results from the PARTNER trial (cohort B) showed an absolute reduction in one-year mortality of 20% with marked and durable improvement in functional status and reduced hospitalisation in patients who had undergone TAVI, compared with those who had been treated medically.1

Because TAVI is carried out in selected high-risk patients, pre-interventional assessment of the cardiac and aorta iliac anatomy is of the utmost importance.4 Trials have shown multi-detector computed tomography (MDCT) emerging as a valid alternative, and is in some institutions preferred to catheter angiography in assessing the aorta and ilio-femoral circulation prior to valve deployment. This trend is of particular importance in planning a percutaneous entry site as well as artificial valve sizing. MDCT is often also used as an adjunct to trans-oesophageal echocardiography in assessing the aortic annulus and valve cusps.4,5 This fast-growing approach has intertwined the interventional cardiologist's and radiologist's expertise, as well as heralded the start of a dedicated 'heart team' for adequate assessment of the suitability of a patient prior to TAVI.

Several MDCT acquisition protocols, including dual energy virtual non-contrast (DEVNC),6 have been suggested and reviewed in quantifying the aortic valve and annulus prior to percutaneous intervention with TAVI. Some authors advocate the Agatston7,8 calcium scoring method, whilst others rely on a 'gestalt' or manual scoring system based on the Rosenhek diagrammatic calcium score9 in an attempt to predict post-procedural outcomes in these high-risk patients. Heinsig8 alluded to the fact that patients with a high Agatston aortic valve calcification burden were more prone to paravalvular leaks (PVL) as well as a subsequent increase in hospital morbidity and one-year mortality post TAVI. He demonstrated this within a study population of 120 patients.7, 8 Although the Agatston aortic valve calcium score (AVCS) and its ability to predict the probability of a post-procedural paravalvular leak have been extensively written about in larger study groups,7,8,9 it has fallen out of favour at some institutions owing to its labour-intensive and time-consuming reconstructions. Manual scoring systems, on the other hand, have failed to accurately predict complications in patients undergoing TAVI as they do not take into consideration the density of the calcified plaque.

The aim of the present study was to describe our local experience with MDCT in evaluating patients with clinically significant aortic stenosis, in preparation for TAVI, specifically proposing an alternative manual system for grading the calcification of the aortic valves annulus as well as the cusps, denoting calcification burden and density with single-source MDCT. We aimed to hypothesise a link between the Free State aortic valve calcium CT score (FACTS) and valve plaque averaged Hounsfield units (AHU), with patient/procedure-related complications. We regarded complications such as paravalvular leak, stroke, death and myocardial infarction as major complications, and complications such as anaemia, left bundle branch block, and repositioning of the valve post/during the procedure as minor complications.

Research method and design

Materials and setting

A total of 20 patients from July 2011 - January 2013 were included. Consent was obtained from the hospital superintendent, prospective patients and the Faculty of Health Sciences Ethics Committee, University of the Free State, prior to the study (ECUFS no. 148/2012). Patients were evaluated by the Department of Cardiology, University of the Free State, and found eligible for TAVI. All fulfilled the criteria for clinically significant aortic stenosis, as determined by standardised inclusion criteria.10 No additional cardiac rhythm stabilising drugs were added to the patients' usual drug regime. Renal function was confirmed to be fit for intravenous contrast administration (Omnipaque 350, GE Healthcare Ireland, Cork, Ireland) prior to imaging. Exclusion criteria for imaging were severely impaired renal function <40 ml/min/1.73 m2 or previous severe adverse reaction to iodinated contrast material, such as anaphalactoid reaction, severe bronchospasm and cardiorespiratory collapse.11 Patients were evaluated by cardiac echocardiography (trans-oesophageal echocardiography (TEE) and trans-thoracic echo (TTE)) prior to and after TAVI at the cardiology interventional suite by dedicated echocardiographers using the Sellers technique as a guideline; see Table 1.

This was a pro- and retrospective, double-blinded, cohort analytical study.

Examinations were done on a single source, dual energy, high definition 64-detector CT scanner (HD750 Discovery, General Electric, Milwaukee). Patients were scanned using one of two standardised CT protocols, dependent on body weight (70 kg, 120 kV, 160 ml 350 Omnipaque; and 70 kg 100 kV 160 ml 350 Omnipaque), with ECG-prospectively gated, single-source energy scan of the chest, including gated cardiac CT and ungated single-source CTA of the abdomen and pelvis. Scan parameters were set with acquisition thickness of 0.625 mm, small field of view of 25 cm, a pitch of 0.16:1 and gantry rotation speed of 0.25 sec. - 0.35 sec., with kV and mAs dependent on body habitus. Scans were done in a craniocaudal direction on 75% of the RR interval. Automated bolus injection was implemented with the region of interest placed over the ascending aorta with scanning of the chest commencing at an attenuation value of 120 HU. Contrast was administered via an automated pump at 5 ml/sec., with a 40 ml saline bolus 'chaser' given after contrast injection.

Imaging analysis

Images were reviewed weekly by a qualified radiologist and a training fellow at the University of the Free State, Universitas Hospital Complex. Post processing of images took place on an Advantage Workstation 4.5 (General Electric) and analyses were performed using standard software (Reformat, General Electric). Data were loaded into a standard multiplanar reformat package, with image reconstructions in the coronal, sagittal and axial orientation and analysed using a multiplanar oblique tool. The coronal image was used to visualise the left ventricular outflow tract, with placement of the oblique tool in the middle of the ascending aorta, producing a sagittal oblique view. Placement of the oblique tool was in the centre axis of the ascending aorta, producing true axial images in the aortic leaflets and annulus planes, on which the calcification scoring was done. The aortic annulus and valve leaflets calcification burden was scored using a bone window level (WW2000 WL350).

Two views were used with the FACTS scoring of the aortic valve. The first view visualised the entire aortic annulus on the modified true axial views as done by using the multiplanar oblique tool. Outer ring scoring was done on this initial view. The second view visualised the distal ends of the leaflets as they converged; inner ring scoring was done on this view. The aortic annulus was divided into quarters on the first view and scored. One point was given for every calcification/plaque seen on the individual regions as described. The total score added to 16, where each valve had 4 possible sections as well as the annulus, which was also divided into 4 sections (Figure 1).

FACTS, Rosenhek and HU Score

FACTS scores were done individually and each observer blinded to the other's score. These scores were correlated to the Rosenhek diagrammatic calcium valve scoring system (Figure 2). The diagrammatic Rosenhek scoring system is shown in Figure 3.

Patients for whom the observers' FACTS scores showed a difference >15%/2 points were rescored, after retraining, by the same two observers and included in the final data set for statistical analysis. An agreement score was seen as a difference of up to 10%-15%/2 points between observers. Complications were associated with scores where the two observers were in agreement after the final scoring. Eighteen patients' FACTS scores and 16 patients' Rosenhek scores matched in the final analysis.

HUs were done separately to the FACTS scores and calculated on each aortic valve cusp. The largest calcified plaque density was taken on each valve cusp and summed. This figure was divided by a factor of 3 for an average score and grouped to either 1000 HU or <1000 HU as agreed upon between the observers, taking an HU 1000 as denoting calcified bone on routine CT. Correlations between the two observers' AHU scores were measured and 18 scores matched according to category.

All data (original and rescored) were captured and typed into a Microsoft Excel spreadsheet for statistical analysis. Age, race, sex, comorbid factors, grades of dyspnoea, left ventricular outflow fraction (prior and after the procedure) and presence of aortic regurgitation, complications and the presence of a pacemaker prior to and after procedures were included. Complications considered as major were stroke, myocardial infarction, death, paravalvular leak and 'other'. 'Other' included minor complications such as repositioning of the valve, anaemia post procedure and left bundle branch block. Patients' were followed up at 30, 90 and 180 days. No patients died during the follow-up period.

A total of 20 patients (9 men [45%] and 11 women [55%]), who happened to all be white, were enrolled in the study. Only 18 patients' FACTS scores were used in the final analysis. Patient demographics are shown in Table 2.

New York Heart association (NYHA) criteria were recorded prior to and following the procedure, with 35% of patients being NYHA 2, 50% NYHA 3, and 15% NYHA 4 prior to the procedure and showed marginal improvement post TAVI (NYHA 1 (10%), NYHA 2 (70%), and NYHA 3 (20%), but this was not statistically significant (p = 0.41). The median age of the patients was 83.5 years (range 68-95 years), with a EuroSCORE median of 15.5 (range: 5-22).

Sixteen (80%) of the 20 patients had a grade 1 aortic incompetence prior to TAVI, and 17 (85%) had paravalvular leak (PVL) post TAVI, of whom 10 patients had grade 1 PVL, 5 patients had grade 2 PVL, and 1 patient had grade 3 PVL. FACTS scores 6 were significantly associated with the presence of a paravalvular leak (p = 0.01) post TAVI. Grade 1 PVL = mild PVL, Grade 2 PVL = moderate PVL, and Grade 3 PVL = severe PVL. The FACTS scores were similar to the Rosenhek score in this regard, and both major and 'other' complications were seen to arise at a Rosenhek score >2, but were not statistically significant (p = 1.00; 'other' complications p = 0.09). No patient suffered from a myocardial infarction or death during or immediately after the procedure (see Figure 2). Nine patients fell into the 'other' complication category. The totals of complications were similar in both Rosenhek score groups, with both groups having close to the same number of complications in the 'other' category.

The median left ventricular ejection fraction (LVEF) was 56.5% (range 27%-77%) and marginally increased to 61.5% (range 29%-75%) at follow-up. Comorbid conditions (see Figure 4) prior to TAVI were recorded and were as follows: hypertension 80%, diabetes 15%, renal impairment 10%), ischaemic heart disease 35%), hypercholesterolaemia 24%, chronic lung disease 65%, peripheral vascular disease 65%, and congestive cardiac failure 5%.

Four patients received pacemakers; 1 was inserted prior to TAVI and 3 post TAVI. Left bundle branch block is a known complication of the TAVI procedure. All of our patients had degenerative aortic stenosis. An AHU 1000 was associated with 'other complications' amongst which left bundle branch block, anaemia post procedure and repositioning of the valve were seen; this was close to being statistically significant (p = 0.07). A graph of AHU v. complications is shown in Figure 5. AHUs ranged from 795 to 1336.

Only one female patient had a transient ischaemic event, which resolved in 24 hours. She had high FACTS and AHU scores (FACTS = 9 and AHU 1000). Male patients also had a higher incidence and grade of PVL than female patients, which we associated with a plaque density 1000 HU. One patient had a grade 3 PVL that was the result of initial incorrect positioning of the artificial valve, with a grade 1 PVL after repositioning of the Medtronic valve.

Plaques 1000 HU were associated with comorbidities; diabetes was found to be the main comorbid factor in plaque density differences, as seen in Figure 6.

No adverse events were recorded either during or after image acquisition. All TAVI procedures were performed after multidisciplinary discussion, using a transfemoral approach by a dedicated cardiac team, using the self-expandable Medtronic CoreValve.

Statistical analysis

Results were summarised by frequencies and percentages (categorical variables) and means or percentiles (numerical variables, depending on the distribution of the data). Groups were compared using chi-squared, Fisher's exact test or McNemar's test for categorical variables, the Kruskal-Wallis test, or Mann-Whitney test for numerical variables.

Ethical considerations

Benefits and hazards: If an association between plaque burden and density could be drawn to FACTS score 6 and HU 1000, pre-procedural evaluation could be streamlined and post-procedural complications be anticipated and timeously treated.

Recruitment procedures: Patients undergoing pre-interventional imaging were asked to take part in the study. Prospective and retrospective data capturing was done. No monetary compensation was offered to patients for taking part in the study. There was no discrimination against patients who declined participation.

Informed consent: Each patient received an information document, explaining the goal of the study and the imaging procedure involved. Patients were asked to sign this document prior to imaging, if they agreed to participate in the study.

Data protection: Patients' data were captured onto a standardised Excel sheet and numbers allocated to each patient. Only the first observer/researcher had access to patients' names. Confidentiality was maintained in all circumstances.

All TAVI procedures were performed by a dedicated cardiology team with the same two operators, with the standard use of a transfemoral approach. All patients' aortic valves were reviewed, and calcified valve plaques scored by the same two radiology reviewers on the same GE workstation, using a standard double-blinded method.

TAVI is an established percutaneous method for the treatment of critical aortic stenosis1,2,3,4,5,6,7,8,9,10,11,12 in high-risk patients and is relatively new in the South African context.12 The Agatston calcification scoring system5,7,8,10 for aortic valve calcification has been proposed in the past as well as manual valve plaque calcification scoring systems9 with and without the use of computer software, linking complications such as paravalvular leak and long-term patient survival to these scores13,14,15 and proposing better patient selection prior to intervention.

We aimed to introduce an alternative manual scoring system that was easy to implement, took plaque density into account, was not time consuming, and at the same time could predict clinically significant adverse patient outcomes. In our small study sample, we found that a FACTS score 6 was significantly associated with the presence of a paravalvular leak. Literature has shown that paravalvular leak post TAVI is an independent risk factor for longer hospital stay as well as an increased mortality risk factor at one-year follow-up.7 Procedure-related complication was close to statistically significantly associated with average valve plaque densities 1000 HU. Unfortunately, we were not able to differentiate between grades of paravalvular leak in our study, which could be attributed to our attempt to introduce a new manual scoring system and/or that our study population was small. Nevertheless, all the artificial valves were inserted by the same dedicated cardiology team, so the fact that an association between AHU score and complications such as anaemia, left bundle branch block and repositioning of the artificial valve could be shown is, we feel, some achievement.

We used the Rosenhek score as a reference standard, although in hindsight the two scoring systems are inherently different in that the FACTS and AHU scores offer quantification as well as qualification of the calcified plaques versus the first-mentioned score that only relies on a 'gestalt' or quantification of the calcification burden of the aortic valves, excluding the aortic annulus. Our score included the aortic annulus which, we postulate, could play a role in the pathology of paravalvular leaks post TAVI in our population. A possible reason for this could be the limited pliability of the aortic annulus with bulky calcified plaque. The Rosenhek score could also not differentiate between specific complications (e.g. stroke v. PVL) in our small study population but was, however, associated with no complications if the score was <2, when compared with the FACTS score; and, interestingly, the Rosenhek scores were seen to match in 80% of cases between the two observers, in the final statistical analysis. The LVEF and NYHA only marginally improved after TAVI procedure and were found to be statistically unrelated to either the FACTS or AHU scores. Pacemaker insertion could also be linked to high AHU scores, although this was not statistically significant and is a known complication of the Medtronic CoreValve.13

In our study population, complications were minimal, which could be due to the small study size or because the TAVIs were done meticulously by a qualified cardiac team. Moderate inter-individual variations were seen with the FACTS scores initially but, after retraining, the differences were markedly less. One explanation for the variation could be the relative inexperience of both observers with a new scoring system or because of the lack of experience in calcification scoring. Only two observers scored in this article. Maybe a larger number of observers could have improved the results. The FACTS and AHU scores were looked at individually and could have been incorporated into a single scoring system.

We recommend the incorporation of the AHU with the FACTS score in future for a uniform score, giving a specific numeral value to a specific HU density as well as a larger sample size. Individual scoring of the annulus versus the cusp calcification could also be considered for future studies.

The FACTS and AHU scores are easy to implement, not labour intensive or time consuming, and show promise in providing important added information for patients undergoing pre-interventional assessment for the TAVI procedure, especially in determining the risk of paravalvular leak, left bundle branch block, repositioning of the artificial aortic valve and anaemia. A larger study sample is necessary to confirm these preliminary findings.

The authors thank Dr W. Harmse, diagnostic radiologist and current fellow in Interventional Radiology, Alberta Health Services, Foothills Medical Centre; Professor S. Brown, Department of Paediatric Cardiology, University of the Free State; Professor H. Theron, Head of Department Cardiology, Universitas Academic Hospital, University of the Free State; and Mrs C. Swanepoel, Chief Radiographer Computed Tomography, Department of Clinical Imaging Sciences, University of the Free State, for their invaluable contribution to the completion and publication of the study.

Competing interests

The authors declare that they have no financial or personal relationships which may have inappropriately influenced them in writing this article.

Authors' contributions

A.R. (University of the Free State) protocol and study design, first blinded observer, writing and planning of the article draft and final version, main corresponding author. C.S.d.V. (University of the Free State) second blinded observer, study coordinator, protocol and final article draft reviewer. Professor G.J. (University of the Free State) is thanked for reviewing the statistics and protocols and for her invaluable input in the final draft of this article.

1. Webb J, Rodes-Cabau J, Fremes S, et al. Transcatheter aortic valve implantation: A Canadian Cardiovascular Society position statement. Can J Cardiol. 2012;28: 520-528.        [ Links ]

2. Anderson HR, Knudsen LL, Hasenkam JM. Transluminal implantation of artificial heart valves: Description of new expandable aortic valve and initial results with implantation by catheter technique in closed chest pigs. Eur Heart J. 1992;13: 704-708.         [ Links ]

3. Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis. Circulation. 2002;106: 3006-3008.        [ Links ]

4. Tamborini G, Fusini L, Gripari P, et al. Feasibility and accuracy of 3DTEE versus CT for the evaluation of aorticvalve annulus to left main ostium distance before transcatheter aortic valve implantation. JACC Cardiovasc Imaging. 2012;5: 579-588.        [ Links ]

5. Rixe J, Schuhbaeck A, Liebetrau C, et al. Multi-detector computed tomography is equivalent to trans-oesophagal echocardiography for the assessment of the aortic annulus before transcatheter aortic valve implantation. Eur Radiol. 2012;22: 2662-2669.        [ Links ]

6. Mahoney R, Pavitt CW, Gordon D, et al. Clinical validation of dual-source dual-energy computed tomography for coronary and valve imaging in patients undergoing trans-catheter aortic valve implantation. Clin Radiol. 2014;69: 786-794.        [ Links ]

7. Haensig M, Lehmkuhl L, Rastan AJ, et al. Aortic valve calcium scoring is a predictor of significant paravalvular aortic insufficiency in transapical-aortic valve implantation. Eur J Cardiothorac Surg. 2012;41:1234-1241.        [ Links ]

8. Haensig M, Rastan JA. Aortic valve calcium load before TAVI: Is it important? Ann Cardiothorac Surg. 2012;1:160-164.        [ Links ]

9. Willman JK, Weishaupt D, Lachat M, et al. Electrocardiographically gated multi-detector row CT for asessment of valvular morphology and calcification in aortic stenosis. Radiology. 2002;225:120-128.        [ Links ]

10. Leipsic J, Gurvitch R, LaBounty TM, et al. Multidetector computed tomography in transcatheter aortic valve implanation. JACC. 2011;4:416-419.        [ Links ]

11. Blanke P, Euringer W, Baumann T, et al. Combined assessment of aortic root anatomy and aortoiliac vasculature with dual-source CT as a screening tool in patients evaluated for transcatheter aortic valve replacement. Am J Roentgenol. 2010;195:872-881.        [ Links ]

12. Weich H, Mabin T, Van Wyk J, et al. First experience with the Edward SAPIEN transcatheter aortic valve implantation (TAVI). Data from the Western Cape, South Africa. SA Heart J. 2012;9:6-13.         [ Links ]

13. Leber AW, Kasel M, Ischinger T, et al. Aortic valve calcium score as a predictor for outcome after TAVI using the Corevalve revalving system. Int J Cardiol. 2011;166:652-657.        [ Links ]

14. Feuchtner GM, Muller S, Grander W, et al. Aortic valve calcification as quantified with multislice computed tomography predicts short-term clinical outcome in patients with asymptomatic aortic stenosis. J Heart Valve Dis. 2006;15:494-498.         [ Links ]

15. Delgado V, Ng ACT, van de Veire N, et al. Transcatheter aortic valve implantation: Role of multidetector row computed tomography to evaluate prosthesis positioning and deployment in relation to valve function. Eur Heart J. 2010;31:1114-1123.        [ Links ]

Antoinette Reinders
1 Logeman Street
Universitas 9301, Bloemfontein, South Africa

Received: 03 Dec. 2014
Accepted: 12 Feb. 2015
Published: 04 June 2015

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Australian Nurses Who Spread Anti-Vaccination Messages Will Now Face Prosecution

21 OCT 2016

Australian nurses and midwives who promote anti-vaccination to patients and the public will now be subject to prosecution, the Nursing and Midwifery Board of Australia has announced.

The tough new stance on anti-science statements comes in response to reports of a "small number" of practitioners who have been promoting anti-vaccination statements on social media.

"Midwives and nurses are highly regarded and trusted members of society, and people take their advice very seriously," Hannah Dahlen, a professor of midwifery at the University of Western Sydney and the spokeswoman for the Australian College of Midwives, told The Guardian.

"I agree that they have a very serious obligation to provide the best available evidence, and it is of course concerning that some are taking to social media in order to express a position not backed by science."

According to new regulations, all reports of anti-vaccination statements will now be investigated.

If the nurse or midwife is deemed to have breached their professional obligation to promote scientifically backed health advice, they could face having their ability to practise medicine restricted.

Serious cases will be referred to an industry tribunal, where harsher penalties such as having their registration suspended or cancelled could apply.

"The board is taking this opportunity to make its expectations about providing advice on vaccinations clear to registered nurses, enrolled nurses and midwives," the organisation said in a statement.

"The board expects all registered nurses, enrolled nurses and midwives to use the best available evidence in making practice decisions."

The harsher stance on anti-vaccination messaging follows Australia’s recently enforced "No Jab, No Pay" law, which came into effect on 1 January 2016.

The policy states that you can "conscientiously object" to immunising your kid based on philosophical, religious, or "I read things on the Internet" reasons, but doing so means the government can withhold family payments worth up to $15,000 every year.

Families receiving the Australian government's Child Care Benefit, Child Care Rebate, and the Family Tax Benefit (FTB) were given three months to get their kids' immunisations up to date to ensure that their payments would continue.

Now, 10 months later, Australia’s vaccination rates are at an all-time high, with Australian Medical Association president, Michael Gannon, reporting that 6,000 children whose parents were previously registered as conscientious objectors to vaccination were now fully immunised.

And according to a report released back in August, the immunisation rate for one- and five-year-olds has now reached 93 percent for the first time in the country’s history - up from around 90 percent.

"Vaccination rates had fallen to such a historically low level, that we were seeing the re-emergence of diseases that we had been free of for years," Social Services Minister, Christian Porter, told Matthew Doran at ABC News.

"We were facing a situation where the medical community were telling us that 'herd immunity rates', as they call it, need to be 95 percent, and we were just dropping steadily below that."

There is one concern about enforcing punishments for anti-science messaging among healthcare professionals though - it will only force the conversation to go further underground.

"The worry is the confirmation bias that can occur, because people might say: 'There you go, this is proof that you can’t even have an alternative opinion.' It might in fact just give people more fuel for their belief systems," Devlin told The Guardian

Fears aside, this is a very positive step in actively fighting anti-science messaging among healthcare professionals. Hopefully other countries around the world will follow suit.

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Chavez beats the odds to fight another round

Cancer and strong opponent fail to see off populist president who vows to stay on path to socialism, despite growing chorus of discontent

PUBLISHED : Tuesday, 09 October, 2012, 12:00am
UPDATED : Tuesday, 09 October, 2012, 4:44am

Venezuelan President Hugo Chavez shrugged off cancer and a unified opposition to triumph yet again at the ballot box and claim another six-year mandate to pursue his socialist revolution.

Sunday proved a sterner test than previous elections in Chavez's 14-year tenure, but the bombastic anti-American leftist emerged victorious despite health scares, growing discontent and a strong challenge.

With nearly all the votes counted, Chavez had about 54 per cent, compared with almost 45 per cent for his youthful opponent, former Miranda state governor Henrique Capriles.

Addressing thousands of cheering supporters from the balcony of his Miraflores presidential residence, Chavez sang the national anthem and vowed to be a better president.

"Viva Venezuela! Viva the fatherland!" exulted the leftist leader. "The battle was perfect and the victory was perfect. I want to include everybody, including sectors of the opposition," the 58-year-old Chavez, wearing his trademark red shirt, said in a tacit acceptance of the best electoral showing against him yet.

But brandishing the sword of his 19th century idol, independence hero Simon Bolivar, he pledged to press ahead with a socialist revolution that has antagonised opponents at home and abroad.

"Venezuela will continue its march toward the democratic socialism of the 21st century," he said.

In his victory speech, he alluded to his cancer battle. "Today was a memorable day," he said. "I thank God and ask him [for] life and health to keep serving the Venezuelan people."

Chavez's rival, 40-year-old Capriles, was gracious in defeat, saying: "I accept and respect the decision of the people."

But it was a bitter pill for many to swallow. About 200 Capriles supporters, many in tears and disbelief, massed at campaign headquarters.

"I am disappointed, devastated," said Daniela Torrealba, 33. Chavez's victory means six more years of "uncertainty and stagnation", he said.

Election experts said the electronic voting system was reliable, but suspicions had run high that whoever lost would not concede.

Capriles appeared to put those fears to rest, accepting the result in good faith after an earlier call for calm.

"To know how to win, you have to know how to lose," he said at his campaign headquarters. "For me, what the people say is sacred."

The fate of Chavez, a fierce US critic and the leading voice of Latin America's left, was closely watched by communist ally Cuba, which heavily depends on Venezuela's oil, and other regional partners.

"Viva Venezuela, viva the great fatherland, viva the Bolivarian Revolution!" leftist Ecuadoran President Rafael Correa tweeted, in words echoed by Bolivian leader Evo Morales and Argentina's Cristina Fernandez de Kirchner.

In Beijing, the foreign ministry vowed to bring relations between the close economic partners to a "new high".

"President Chavez was re-elected and China congratulates him on that, and wishes Venezuela new achievements in the development of the country under the leadership of President Chavez," ministry spokesman Hong Lei said.

But in Washington, the head of the House Committee on Foreign Affair, Republican Ileana Ros-Lehtinen, accused Chavez of manipulating the result. "Chavez must not be allowed to continue to export his hate and despotism abroad like his fellow dictators in Iran and Cuba" through human rights oppression and suppression of the press," she said.

President Chavez has nationalised major swathes of the nation's economy and more is expected to come. The main ones so far:

  • In 2007, government took a majority stake in four oil projects worth an estimated US$30 billion. Exxon Mobil and ConocoPhillips filed arbitration claims.
  • In 2008, implemented a windfall tax of 50 per cent for prices over US$70 a barrel, and 60 per cent on oil over US$100. Oil reached US$147 that year, but soon slumped.
  • In 2009, seized a major gas injection project belonging to Williams Cos.
  • In 2010, seized 11 oil rigs from US-based Helmerich & Payne.

  • In 2009, nationalised a rice mill of US food giant Cargill.
  • In 2010, nationalised Fertinitro, major producers of nitrogen fertiliser, as well as Agroislena, a major local agricultural supply company.
  • In 2005, seized unproductive farms and land without proper titles and redistributed millions of acres to boost food production.

  • In 2010, took over the mid-sized bank Banco Federal, citing liquidity problems.
  • In 2009, paid US$1 billion for Banco de Venezuela, a division of Spanish bank Grupo Santander.
  • Closed a dozen small banks since November 2009 for operational irregularities. Brokerages have also been closed and some employees jailed.

  • In 2010, ordered the takeover of the local operations of Owens Illinois, the world's largest glass container maker.
  • In 2008 took over the cement sector, targeting Switzerland's Holcim, France's Lafarge and Mexico's Cemex SAB de CV.

  • In 2009 the mining ministry seized Gold Reserve's Brisas project, which sits on one of Latin America's largest gold veins.

  • Paid US$2 billion in 2009 for Argentine-led Ternium's stake in Venezuela's largest steel mill.

  • In 2007, the nation's largest telecommunications company, CANTV, was nationalised after the government bought out the US-based Verizon Communications' 28.5 per cent stake for US$572 million.

  • In 2007, expropriated the assets of US-based AES Corp in Electricidad de Caracas, the nation's largest private power producer. The government paid AES US$740 million for its 82 per cent stake in the company.

  • In 2011, nationalised a local ferry company, Conferry, owned by a wealthy family and that began operating in 1959.


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Mt Tongariro Eruption – update 2

21 November 2012

Mt Tongariro Eruption – update 2

Air New Zealand advises that flights operating to some airports east of Mount Tongariro may be delayed or cancelled as a result of the eruption at Mount Tongariro.

Air New Zealand is working closely with the Civil Aviation Authority, the MetService and other authorities to keep up to date with ash movement and forecasts.

Air New Zealand General Manager Airline Operations and Safety, and Chief Pilot, Captain David Morgan says the airline is working with the relevant authorities to safely make adjustments to flight routes to ensure aircraft remain clear of any ash and keep providing a safe service to the travelling public.

Passengers are advised to check the Air New Zealand website for flight arrivals and departures information which will be constantly updated throughout the day.

© Scoop Media

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Scalpay residents take control of their island

Have your say

Residents on the small Scots island of Scalpay off Harris have voted to take over the running of the island.

The current landlord, English businessman Fred Taylor, had offered inhabitants the Outer Hebridean island as a gift for free.

Residents of Scalpay will take control of the small island. Picture: TSPL

Residents of Scalpay will take control of the small island. Picture: TSPL

After a vote at Scalpay Community Hall on Tuesday it was a clear result in favour of the takeover - with 197 for and just eight against.

Islanders also voted to go into partnership with the North Harris Community Trust – subject to its own £2.2million buyout in 2003 – to run the island, once a busy fishing community.

The island’s population of 320 has almost halved since the 1970s and 80s.

Its primary school closed after the roll fell to four and Paul Finnegan, of Scalpay Community Land Buyout Steering Group, said they already had plans for the building.

He said: “One suggestion that has come forward is using it for business units for small craft workshops.

“We’ve already identified three people who live in Scalpay who are keen to take them on.”

Boosting tourism, developing fisheries and installing wind turbines are also ideas being considered.

Finlay MacRae, secretary of the steering group, said that Scalpay was unlike any of the other community buyouts who had to fight and raise money to buy their land.

He said: “We are unique in that sense.”

The island is officially owned by the Taylor family trust and sole trustee Mr Taylor is also offering to gift land owned by him personally - the glebe park next to Scalpay Lighthouse and the former Ministry of Defence tracking site.

Mr Taylor, who acquired the island following the death of his father, John, owns a house on Scalpay.

Scalpay, which is around 2.5miles long, was joined to neighbouring Harris by a £6.4m bridge in 1997.

There is a community-run shop and consultants investigating the potential of a takeover said the island could become a centre for yachts visiting the Western Isles.

The historic Eilean Glas lighthouse is a major tourist attraction and there is potential to upgrade the footpath to it and create an improved coastal round-island walk.

Background: Communities take advantage of their right to buy land

The Community Right to Buy allows communities with a population of less than 10,000 in Scotland to register an interest in and the opportunity to buy land when it comes up for sale.

In 1993, Assynt Crofters Trust bought North Assynt Estate for £300,000. Four years later, Isle of Eigg Heritage Trust bought Eigg for £1.5 million. In 1998, Abriachan Forest Trust bought the woodland for £152,000. Knoydart Foundation purchased the estate on the peninsula for £750,000 in 1999 and, in 2000, Culag Community Woodland Trust purchased Little Assynt for £244,000. Isle of Gigha Heritage Trust this year celebrated a decade since buying the island for £4m.

North Harris Trust made a £2.2m community buy-out in 2003. Assynt Foundation bought Glencanisp and Drumrunie Estates in 2005 for £2.9m, Stòras Uibhist purchased South Uist Estate in 2006 for £4.5m, and Urras Oighreachd Ghabhsainn bought Galson Estate on Lewis for £1.2m in 2007.

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About Scott Hunter
Black December

FREE short story!

Tweet for a FREE short story! Click link below to access The idea here is that I'll give you a free short story in exchange for you tweeting about it!

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CWA Margery Allingham Short Story Competition

  . . . I had a great evening in Bristol at Crimefest 2016 where the results of the CWA Margery Allingham competition were announced. Nice to see Peter Davison (aka Dr Who – or Dr Daker if anyone remembers… READ MORE

Long Goodbyes is out!

My latest novella, Long Goodbyes is now available. I attempted a video update, with unintentionally comedic results which I’ve left up for you to giggle at. Ah well, must get to grips with the old video software sometime … The… READ MORE

The Irish Detective – Omnibus Edition

DCI Moran - Omnibus Edition

The three novels in the DCI Brendan Moran series are now available in a special Omnibus edition which also includes an exclusive DCI Moran short story.

The short story, renamed 'Safe as Houses' and with a slightly modified ending, was shortlisted for the 2016 Crime Writer's Association (CWA) Margery Allingham Short Story Competition.

Long Goodbyes

Long Goodbyes

1916. Shell-shocked soldier Jack MacLennan and his new wife seek to rebuild their lives in rural Ireland, but although the cottage and its environs seem idyllic, the shadow of Sir William Kenton's dilapidated mansion hangs over the village like a cloud. Why will no one speak of it? And why does it exert such a haunting influence upon Jack? The boundaries between past and present rapidly blur as the young couple find themselves caught up in a series of inexplicable events which lead eventually to heartbreak and murder . . .

Publication: December 2015


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Florida WR talks about FSU camp

Sean Tapley is one of the best wide receiver prospects in the state of Florida this year and Scout caught up with the Jacksonville Raines standout after he took part in Florida State's showcase camp on Saturday.

Sean Tapley is committed to South Carolina but that hasn't stopped him from getting out to various camps and events this summer. On Saturday, he took part in FSU's showcase event.

"We did some 1-on-1's, some 7-on-7's, and things like that," Tapley said. "We didn't run the 40 though. It was fun. They didn't offer me though. They said they gotta talk it over with all the coaches and they'll get back to me and let me know."

Tapley, who has an offer from one of Florida's Big 3 (Miami), was asked for his thoughts on some other camp performers.

"I thought the best QB there was Clint Trickett," he said. "I really like the way he throws it. "At receiver, the one I really liked was Kenny Shaw. He was catching everything. I also liked Andre Davis, the junior."

How about on the defensive side of the ball?

"The corners were alright," he said. "Rashad (Knight) was there and I thought he was the best one."

Next up for Tapley will be trips to a few SEC programs.

"I'm going to Friday Night Lights on Friday and then I'm going up for an unofficial visit to South Carolina on the 1st," he said.

Tapley, who caught 29 passes for 494 yards and four scores last season, claims a 2.8 GPA in the classroom and hasn't reported a test score yet.

-- Junior Highlights

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Signing Day Capsule: Tyler Higby

Houston Kinkaid offensive lineman came back to visit family in Michigan and it led to a commitment after a visit to Michigan State

Tyler Higby – Houston (Texas) Kinkaid Offensive Guard

Height, weight: 6-foot-4, 285 pounds

Commitment Date: July 30, 2014

Why Michigan State: ”With Coach Staten, just the second I walked in the room he seemed high energy and like a really good coach. There was something about him and we really connected right away. He seemed like a really good guy. Same with Coach (Mark) Dantonio. I went in there with my mom and my uncle and one of my friends and we all came out saying he seemed like a great guy. That is how I felt about everyone there.”

The Skinny

Higby was perhaps as surprising as any commit in the class. He came up on a visit while seeing family in Michigan and wound up loving Michigan State and committing.

He was one of three commits from Texas in the class, something unmatched in a long time – if ever. He also had some impressive offers with the likes of LSU in the mix.

Higby, an offensive tackle in high school, figures to be a guard at Michigan State. He is light on his feet despite his size and he uses his upper body well to block. He excels in run blocking, which is one of the things that makes him seem best suited as a guard.

Higby should be lined up for a redshirt.

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Scouting Report - Woody Williams

Cardinal Fans will have to dig deep to find a way to root against former St. Louis Cardinal, Woody Williams in game three of the National League Division Series.

It's may be just a game, but it was business that led to Williams departure from St. Louis.

The Cardinals declined their 2005 option on Woody Williams, last year making him a free agent, and San Diego signed him to a one-year contract for $3.5 million that include some incentives and a 2006 option.

San Diego GM Kevin Towers who had Williams on the Padres' staff from 1999-2001, called trading Williams to the Cardinals "the worst deal I ever made."

Of course Cardinal fans saw the deal that brought Williams to St. Louis in an all together different light. The deal that sent outfielder Ray Lankford, at the time, a shell of his former self and cash to San Diego for Williams was one of the best deals Cardinals' GM, Walt Jocketty ever made.

In his first 11 starts for the Cardinals, Williams went 7-1 with a 2.28 ERA and he was named N.L. Pitcher of the Month in September when he went 4-0 with a 1.13 ERA.

In his second season with the Cardinals in 2002, Williams spent some time on the DL twice with a strained left oblique muscle both times. In spite of his injuries he still finished with a 9-4 record and a 2.53 ERA, and his leadership in the clubhouse was critical in the aftermath of the death of former Cardinal starter Darryl Kile.

In 2003 Williams made a team high 33 starts and won a career high 18 games, finishing with a 18-9 record and a 3.87 ERA. Off to a hot start in 03, Williams was named to the All Star team for the first time and was the first Cardinals since Kent Bottenfield in 1999 (14 wins) to win 12 games before the All Star break.

In his final season with the Cardinals in 04, Williams was 11-8 with a 4.18 ERA. Coming off of off season shoulder surgery, Williams was used very sparingly in spring training and did not reach full strength until about six weeks into the season. Starting slow with a 1-5 record, Williams bounced back to go 10-3 the rest of the way with opponents batting below .239 against him in his final 19 starts.

The fans saw it coming. We saw it coming. Because, it is not just a game, it's a business. The Cardinals for financial reasons declined their 2005 option on Williams. Woody a great teammate and a valuable leader who represents the best in baseball and the best in what it means to be a Cardinal and he was gone, because the bottom line is, while it is a game, it is a business and some days you lose a player like a Woody Williams.

Now it's almost a year later and Woody Williams will be taking the mound at Petco Park in a different uniform, to face our beloved Redbirds. Somehow we will have to find a way, to root against him, at least in this one game.

Game three of the National League Division Series, it's a big game, it could even mean the elimination of the Padres from the playoffs, but big games is nothing new for Williams. He pitched a big game, just last Friday night. In his final outing, Williams pitched three-hit ball over seven innings at Petco Park, to pick up the Padres 81st victory to assure them that at least the Padres wouldn't win the division with a below .500 mark.

Williams is up to the task for game three of the NL Divison series and returning to St. Louis. Williams said "Obviously it will be fun to play in Busch Stadium again" and "hopefully, they know what everyone brings to the table"

What Williams brings to the table is, in the National League playoffs he has a 3-1 record with a 2.81 ERA over five starts, plus he has a 25-8 career record at Busch Stadium with a 2.91 ERA. Fortunately game three will be played in San Diego.

And you wonder why we hated seeing him leave St. Louis?

"I've always loved pitching at Busch," said Williams. "I'd love to pitch there once more before it closes."

Williams finished the season strong, in five of his final seven starts, Williams allowed only one earned run. He is ready for the postseason and the big game as usual.

"I feel like for the last month I've been pitching pretty good" said Williams. "The playoffs are completely different, no doubt about it." With his history in the playoffs, Williams may find himself in the familiar role of in pitching in a major game, with the Padres season on the line.

Williams has an assortment of pitches to get batters out. He has a good cut fastball, which crosses the plate around 89-92 MPH. His cutter is his bread and butter pitch and he has an effective curve ball and a good change up.

His 2005 season record is a little deceptive, he finished the year with a 9-12 record and a 4.85 ERA, but you have to expect him to be better than this record might indicate.

The key to the Cardinals success against Woody, will be to make him throw a lot of pitches. He loses velocity and effectiveness in a hurry and has only gone 7 innings in seven of his 28 starts, this season and did it only twice last season.

He'll give you all he's got while he's out there and that could be just enough for the Padres to come away with a win against St. Louis.

No matter what, it's hard to root against Woody Williams.

The Cardinal Nation Top Stories