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Sunday, November 30, 2008

Looking good in a recession

From the Globe and Mail:
It's September and retailers are already feeling the pinch of sluggish consumer spending, but not here in a wealthy enclave in north Toronto. Shoppers Drug Mart Corp. is opening one of its biggest, glitziest new outlets and it doesn't look much like a drugstore, with its high ceilings, large windows and bright ambience.

Glass shelves filled with fancy bottles of cosmetics and fragrances greet consumers at the entrance. Organic foods and Nintendo portable consoles are among the products further inside. Customers could pick up $435 facial creams, pose for passport photos and even drop off their prescriptions (it is, after all, still a drugstore).

Under the direction of former chief executive officer Glenn Murphy, Shoppers transformed itself into a Canadian retail powerhouse. Its expansion has been dramatic, growing to more than 1,100 stores from about 800 in 2001. These were the best of times, and they continued under the leadership of Jurgen Schreiber, who became CEO in early 2007. Shoppers has been continually evolving, branching out into high-end beauty products, groceries and seasonal gifts to the point where it is more like a neighbourhood mini-department store. Throw in a burgeoning array of high-margin private labels, a loyalty card that is the envy of retailers across the country and a near doubling of profit in the past five years and it's not hard to make a case it is the most successful retail chain in the country.

But all that was during good times for the broader economy. Now that the tide is turning, it's up to Mr. Schreiber to keep up the momentum. ...more

Prescription drug program under review

From the Fredericton (NB) Daily Gleaner:
The feds need to chip in to improve access to drugs for those with a serious illness, says New Brunswick's health minister.

Four health charities met with Mike Murphy recently to urge him to introduce a catastrophic drug program for New Brunswick that would provide better coverage for people battling serious illnesses such as cancer, diabetes and arthritis.

Provincial chapters of the Canadian Cancer Society, Heart and Stroke Foundation, Kidney Foundation of Canada and the Canadian Diabetes Association reminded Murphy that New Brunswick is one of only two provinces without a catastrophic drug program.

Murphy said he's hoping to change the way the drug program determines who's eligible for provincial coverage.

"This review will focus on providing drug coverage based on the ability to pay rather than on age or disease, which is now the case with the existing prescription drug program," he said.

"We will complete this review within the next year and we'll then know what is doable and at what cost."

Murphy said he met with health ministers from across the country two months ago and a big part of their discussion was devoted to the National Pharmaceuticals Strategy. ...more

Pharmacy wins green award

From the Sudbury (ont.) Star:
A Greater Sudbury pharmacy manager has come up with a winning prescription.

Jenny-Lyn Faught, the frontshop manager of Health Care Pharmacy Pharmasave on Lasalle Boulevard, was named Outstanding Frontshop Manager or Staff in the 2008 Commitment to Care & Service Awards -- a national awards program hosted by Pharmacy Practice and Drugstore Canada, Canada's leading pharmacy magazines.

Faught has significantly boosted staff morale and performance since being promoted to the position four years ago, according to a testimonial letter submitted by Julie Lajeunesse, the pharmacy's regional operations manager.

To enter the awards competition, Faught collected 15 testimonials and also wrote a 750-word essay. She beat out dozens of people for the honour.

As frontshop manager, Faught oversees coaching and development of all staff. She also manages merchandising, team-leading and team-building, as well as design and revision of policies and procedures.

An avid environmentalist, Faught is proud of her store's recent attempts to become greener, including introducing biodegradable plastic bags earlier this year and staff creating a raincoat out of the old traditional plastic bags which will be up for auction. ...more

Taking Canadians 'where no one else has gone'

From the Globe and Mail:
Last summer, when Jurgen Schreiber reviewed his latest batch of consumer research reports, one item in particular grabbed his attention: For the first time, just about as many consumers thought about Shoppers Drug Mart Corp. for beauty products as they did for its pharmacy.

The finding was the catalyst for Mr. Schreiber, chief executive officer of Shoppers, to decide to expand even further into high-end makeup and fragrances.

Shoppers had already built a network of in-store beauty boutiques stocked with some high-end (and high-margin) brands. Now Mr. Schreiber wanted more.

This month, Shoppers launched its first Murale store, a standalone upscale beauty and spa retailer with 200 brands such as Bobbi Brown, Chanel and Estée Lauder - more than 16 times more labels as in a Shoppers beauty boutique. Prices range from $1,060 for a jar of Natura Bisse skin cream from Spain to $12 for eye shadows.

While Mr. Schreiber didn't plan for the launch to come in an economic downturn, he's resigned to the fact - and not letting it deter his plans. ...more

Thursday, November 27, 2008

Druggists afraid of squeeze on payments

From the Toronto Star:
Brampton pharmacist Ben Shenouda says it costs $10 on average to fill a prescription in Ontario, but the provincial government pays him just $7 for the seniors, welfare recipients and others who qualify for provincial drug coverage.

The owner of an independent pharmacy, Shenouda says he makes up the shortfall by using some of the "professional allowances" he receives from generic drug makers for stocking their products.

Ontario pharmacists fear those payments are under attack, as the government eyes the millions of dollars they received in allowances from generic drug makers. Under Ontario law, pharmacies are supposed to use the allowances to improve patient care, providing such things as flu and diabetes clinics.

This week, the federal consumer watchdog released a report that said Canadian taxpayers, consumers and businesses could save up to $800 million a year if the generic drug industry were more competitive. The Competition Bureau concluded the market would improve if pharmacists passed on the allowances they get from generic drug makers to customers – something the bureau says rarely happens. ...more

Whitehorse pharmacy to stop selling cigarettes

From CBC News:
Yukon smokers are about to lose a popular supplier of cigarettes: the new owner of a prominent Whitehorse pharmacy says she'll be phasing out all tobacco sales by the end of this year.

Since taking over the Shoppers Drug Mart location on Main Street earlier in November, pharmacist and owner Tracey Keefer said she has been planning to get rid of cigarettes, which are currently for sale there.

"I don't think pharmacies should be selling cigarettes, if you're trying to promote healthiness," Keefer told CBC News, adding that tobacco sales are already banned from pharmacies in some other parts of Canada.

"We don't sell alcohol, we don't sell other … street drugs or anything here, so we're going to get rid of the cigarettes," she added. ...more

Wednesday, November 26, 2008

Pharmacists shouldn't prescribe smoking drugs: critics

From the Globe and Mail:
Smokers looking to kick the habit might chew nicotine gum or wear a patch sold over the counter in drug stores across Canada to give them an extra boost. But should they also be able to bypass the doctor and head to the drugstore if they're looking for something stronger?

A growing number of pharmacists across Canada think they should - and the idea is drawing sharp criticism from some drug-safety experts.

A few dozen Alberta pharmacists are currently authorized to write prescriptions for Zyban and Champix, the brand names of two common smoking-cessation drugs.

An advisory council to Ontario's health ministry is recommending that pharmacists in the province also be allowed to write prescriptions for smoking-cessation drugs. The recommendation is contained in a broader report that supports expanding the power of pharmacists to prescribe drugs for minor ailments, as well as to alter prescriptions or change dosages.

While Ontario's Health Professions Regulatory Advisory Council admits that nicotine addiction is not a "minor ailment," it says pharmacists in the province should be able to write prescriptions for stop-smoking drugs as a way to improve access for those who want to quit. ...more

Selling generic drugs in more competitive market could save millions: study

From the Canadian Press:
A more competitive generic drug market could save Canada's health-care system $800 million a year, the Competition Bureau says in a study released Tuesday.

Some of this money could be used to maintain or improve drug plans, reduce premiums or directly fund some pharmacist services, competition commissioner Sheridan Scott said in a Toronto speech.

"Progress is being made to get generic drugs at lower prices," Scott told the Economic Club in Toronto.

"We expect this amount (of savings) will climb significantly over the next three years, as some of the blockbuster brand-name drugs that came on to the market in the 1990s lose their patent protection and generic equivalents appear on the market."

The study, entitled Benefiting from Generic Drug Competition in Canada: The Way Forward, estimates the potential savings at more than $1 billion in coming years if changes are made to how generic drugs are paid for.

"Obtaining these savings, however, requires changes to allow the price Canadians pay for generic drugs to be based on the competitive price of the drug," Scott said. ...more

Vancouver pharmacy closed over methadone kickback claims

From the National Post:
A Downtown Eastside pharmacy has been told to close its doors amid allegations it provided cash kickbacks to addicts filling methadone prescriptions.

The AYC Pharmacy on East Hastings has had its licence suspended and was ordered to close indefinitely after an investigation by the College of Pharmacists, according to CBC News. The pharmacy must close by Dec. 1, but will operate on shortened hours until then so customers can find another place to fill prescriptions.

The college said the closure was a result of "medicine-management" issues involving patient safety, according to CBC.

The pharmacy is also being investigated by the Ministry of Health over allegations that it provided drug addicts with cash inducements to fill methadone prescriptions. Methadone is sometimes prescribed to drug users as an alternative to heroin.

B.C. pharmacies are paid $8.60 each time they dispense a drug. If pharmacies dispense methadone and supervise the patient as they take it, they receive an additional $7.70. ...more

Pharmacists' care drops blood pressure: study

From the Edmonton Journal:
Patients with high blood pressure who received enhanced care from pharmacists saw their blood pressure go down more than patients who received normal care from their pharmacists and family doctors, a new study has found.

The drop reduces a patient's risk for stroke by 30 per cent and risk of heart attack by 23 per cent, as long as the patient maintains the lowered blood pressure long-term, said Dr. Ross Tsuyuki, a pharmacist and the senior author of a paper published Monday in the journal, Archives of Internal Medicine.

"That's what we were really excited about -- a 30-per-cent reduction in stroke is quite a bit," Tsuyuki said.

He enlisted the help of pharmacists in 14 Medicine Shoppe pharmacies in urban Edmonton, Mill Woods, Sherwood Park and Spruce Grove, who identified 227 diabetic patients whose blood pressure was above the recommended 130/80 millimetres of mercury for diabetics. High blood pressure is anything above 140/90. ...more

Pharmacists eye greater responsibilities

From the Midland (Ont.) Mirror:
Ontario pharmacists could soon be able to fill and write prescriptions for minor sicknesses without a doctor’s order, recommends a report released Nov. 18 by the provincial health ministry.

Rather than having to go to a doctor or hospital for every small health issue, pharmacies could become the first stop for prescription extensions, drug adjustments and medication monitoring through pharmacist-ordered lab tests, the Health Professions Regulatory Advisory Council has recommended.

The report also suggests pharmacists be allowed to:
• adjust prescriptions;
• extend some refills;
• order lab tests to ensure medications are working properly;
• teach people how to inject themselves with medications and use blood-testing devices;
• initiate smoking-cessation treatments, including the use of prescription addiction suppressors. ...more

LGH gets high-tech meds dispenser

From the Montreal Gazette:
The Lakeshore General Hospital has a new member on its pharmaceutical team: a semi-automated medication distribution system, much like a high-tech vending machine, designed to not only save money but to reduce human error.

"This machine can package medication individually, without human manipulation. This way, surplus tablets can be reused, representing approximate savings of $150,000 per year," said Pierre Gendreau, head of the Pointe Claire hospital's pharmacy department.

Hospital spokesman Louis-Pascal Cyr said that under the old system, patient prescriptions were prepared by hand for four to six-day periods.

"And if a patient left before those periods were up, we'd have to throw away the leftover medication," he said.

"With the new system, patient medications are prepared in sealed packets on a daily basis," Cyr said. "And that translates into less loss of medication," he said. ...more

Tuesday, November 25, 2008

Cleverer drug buying could save $800M a year, competition czar says

From the Toronto Star:
Canadian taxpayers, consumers and business could save up to $800 million a year if private and public sector plans changed the way they paid for generic drugs, Canada's consumer watchdog says.

Both the private sector and governments could start now using tools that encourage pharmacies to compete more aggressively for their business and ensure they pass on millions in savings they receive from generic drug makers, the competition bureau said.

Such strategies could include using more mail-order pharmacies, shopping around for the lowest drug-dispensing fees and negotiating group rates from preferred pharmacists, federal competition commissioner Sheridan Scott said in prepared notes for a speech to be delivered today.

"We believe Canadians deserve a health system that is safe and effective, but also delivers the maximum possible value to Canadians," Scott said in the notes.

The potential savings from more competitive pricing could climb to over $1 billion a year in coming years as several blockbuster patent drugs lose their patent protection, the federal competition bureau also said in a report issued today. ...more

A new remedy for medicine

From the Ottawa Citizen:
You walk into a drug store to get your prescription renewed. It's a drug you've taken for years and you are seeing medical professionals about its use.

The pharmacist tells you the two-year prescription has expired. You can't get the drugs you need. That's not good.

Getting the prescription renewed means taking time from a general practitioner, or worse, a specialist who is being run off his or her feet by the problems of an aging population. There should be an easier way.

The Health Professions Regulatory Agency Council, an advisory group of seven members of the public who report to the provincial minister, says pharmacists should have the power to write prescriptions for minor health problems without a doctor's permission. And the pharmacy should be allowed to extend prescriptions, order lab tests and adjust drugs, the council said. In theory, this would cut the volume of patients visiting doctors or going to emergency wards. ...more

Pharmacy workers reach deal with Rexall

I realize this article is quite old, but somehow I missed the resolution of this dispute, and thought maybe some of you did as well.

From the Edmonton Journal:
A tentative agreement has been reached between Daryl Katz's Rexall pharmacy group and the union representing 30 specialized pharmacists and pharmacy technicians.

The agreement was hammered out Sunday morning after an all-night marathon bargaining session and helped avert a pending strike set to start this morning. ...more

Pfizer pulls E.U. application to sell Viagra over the counter

Changing Viagra to OTC status has to be years away at least, but wouldn't it be a fascinating counseling challenge for the pharmacist in the local drugstore?

From MarketWatch:
Pfizer said it still thinks that Viagra at a 50-milligram dose is a suitable candidate for non-prescription supply through pharmacists.

But it's withdrawn its application after the European Medicines Agency's Medicinal Products for Human Use said it had some concerns.

"The withdrawal of the application will enable evaluation of further information and additional data that may be required to allow any future assessments under the centralized procedure," Pfizer said. ...more

Cases of asthma in Canada may be overdiagnosed by 30 per cent: study

From the Canadian Press:
Almost a third of adult Canadians diagnosed with asthma and taking medications to treat their wheezing, coughing and shortness of breath may not actually have the allergic respiratory condition at all, researchers say.

In a study of about 500 adults who had previously been told they have asthma, airway-function and other tests showed that about 30 per cent did not in fact have the disease, suggesting that asthma may be significantly overdiagnosed in Canada.

"What we think is happening ... is that if patients come to a physician complaining of shortness of breath or cough or wheeze, oftentimes the physician will assume that the diagnosis is asthma, and based on the patient's history and complaints prescribe medicines to treat asthma," lead investigator Dr. Shawn Aaron said from Ottawa.

"And what they won't do is order the appropriate diagnostic test to confirm asthma."

Aaron, head of respiratory medicine at Ottawa Hospital and the University of Ottawa, said a doctor's suspicion that a patient has asthma should be followed up by confirmatory tests, including spirometry. ...more

Italian-Canadian Citizen of the Year

From the Hamilton Spectator:
Marita Zaffiro doesn't believe in just handing out pills to cure what ails you.

She believes in a community approach to health care, which includes making sure the needs of the multicultural denizens around her downtown pharmacy and across the city are met.

These are some of the reasons why the Hamilton-born pharmacist was named the Italian-Canadian Citizen of the Year by the Hamilton-based Sons of Italy organization on the weekend.

It will add to the long list of accolades Zaffiro has racked up, including being named Distinguished Citizen of the Year by the city of Hamilton in 1998 and one of the country's most influential pharmacists by the Canadian Pharmacists Association last year. ...more

Methadone could help cocaine addicts: study

From the Calgary Herald:
Methadone, a drug used for many years to treat heroin addiction, also appears to work well against cocaine addiction, a new Canadian study suggests.

Psychologist Francesco Leri of the University of Guelph has been making rats addicted to cocaine, and then treating them with methadone.

Most of the rats responded well, he says. They lost their powerful urge for cocaine and, in addition, their brains "re-set" themselves into the same pattern that existed before they first used cocaine.

"It can be done tomorrow with humans, and should be done tomorrow," Leri said.

That's because methadone--unlike some new drug -- already exists as a tested drug, with clear prescription rules and clinical staff trained in giving it out.

"There is an entire system that is already in place for the employment of methadone," that could be used for cocaine addicts, Leri said. ...more

Monday, November 24, 2008

Skip the doctor's office, go right to the drugstore

I shudder when I read the first paragraph of this article. While I am in favour of pharmacist prescribing, we have to remember the difference between prescribing and diagnosing. Pharmacists aren't trained to diagnose most ailments. Our role needs to be the optimizers of drug therapy, but this is after a dignosis is made. I can adjust warfarin dosages at least as capably as a physician, but I can't diagnose any of the conditions that would lead to being on the drug such as a deep vein thrombosis, pulmonary embolism, or atrial fibrillation for example.

From the Globe and Mail:
Should a nasty cold or poison ivy require a trip to the doctor to get a prescription? What about an earache, urinary tract infection or something as serious as a pre-existing heart problem?

Those are the questions many health professionals across Canada are grappling with as more provinces look to grant pharmacists greater power to prescribe drugs.

This week, an advisory council to Ontario's Health Ministry recommended that pharmacists in the province be allowed to write prescriptions for minor conditions, adjust dosages, extend prescriptions and order laboratory tests in some instances.

The move follows developments across the country to expand the role of pharmacists. ...more

Pharmacist Donates Kidney to Customer After Falling in Love

From ABC News:
Some romances build over dinner and flowers. This one blossomed over medication and dialysis.

A pharmacist in Kansas donated her kidney to a customer she fell in love with.

What began as a simple pharmacist-customer relationship turned into much more for Julie Wallace and Justin Lister, who struck up a friendship, then a romance that led to Wallace giving Lister a kidney.

When they met a little more than a year ago, Wallace, 46, was working as a pharmacist and manager at Dillon's grocery store pharmacy in McPherson, Kan., where Lister, 26, was dragging himself in to pick up a cocktail of prescriptions for his kidney disease.

"He kept coming into the pharmacy, getting all kinds of medication and just looking really bad," Wallace told "I told him that if there's anything I can ever do for him to let me know." ...more

Roche ordered to pay $13M to users of acne drug

From the Associated Press:
A jury has ordered drugmaker Roche to pay nearly $13 million to three patients who claim they developed a chronic bowel disorder because of the company's acne drug Accutane.

Roche's U.S. subsidiary Hoffman-La Roche said it would appeal the verdict.

The money, handed down in New Jersey State Superior Court on Thursday, will be split among the three Florida residents, their attorneys said in a statement. All three began using Accutane a decade ago to treat teenage acne. One of the group is expected to soon have his colon surgically removed while the others will require long-term drug therapy, the attorneys said.

The award is the latest stemming from a wave of lawsuits that accuse Roche of downplaying a link between Accutane and inflammatory bowel disease, which afflicts about 1.4 million people in the U.S. and Canada.

Accutane's warning label notes that the drug is "associated with" chronic bowel problems, but the company has argued that there is no direct connection between its drug and the disease. ...more

Indonesian AIDS patients face microchip monitoring

I realize this isn't really a pharmacy story, but it it heath/medical related and extremely troublesome so I thought I'd include it here.

From the Associated Press:
Lawmakers in Indonesia's remote province of Papua have thrown their support behind a controversial bill requiring some HIV/AIDS patients to be implanted with microchips — part of extreme efforts to monitor the disease.

Health workers and rights activists sharply criticized the plan Monday.

But legislator John Manangsang said by implanting small computer chips beneath the skin of "sexually aggressive" patients, authorities would be in a better position to identify, track and ultimately punish those who deliberately infect others with up to six months in jail or a $5,000 fine.

The technical and practical details still need to be hammered out, but the proposed legislation has received full backing from the provincial parliament and, if it gets a majority vote as expected, will be enacted next month, he and others said.

Indonesia is the world's fourth most populous country and has one of Asia's fastest growing HIV rates, with up to 290,000 infections out of 235 million people, fueled mainly by intravenous drug users and prostitution. ...more

When it comes to statins, don't believe the hype

From the Globe and Mail:
The headlines were dramatic and unequivocal:

"Cholesterol drug causes risk of heart attack to plummet" - Fox News.

"Cholesterol-fighting drugs show wider benefit" - The New York Times.

"Cholesterol drug cuts heart risk in healthy patients" - The Wall Street Journal.

The New York Times article summarized the exciting news in a front-page story saying that "millions more people could benefit from taking the cholesterol-lowering drugs known as statins."

That's big medical/business news, because statins are already the bestselling drugs in the world, with sales in excess of $20-billion (U.S.).

Quoting some of the world's top heart researchers, media reports touted the importance of a blood test for C-reactive protein. That's because those benefiting from statins had high levels of CRP (a marker for inflammation) rather than high levels of LDL cholesterol, which is usually the criterion for statin prescription. ...more

Health groups call for better drug coverage

From the Miramichi (NB) Leader:
When Ross Costain moved to New Brunswick from Prince Edward Island in April 2006, he went from having provincial health coverage to none at all.

Now he suddenly found himself paying around $759 per month for insulin and other measures he needs to cope with the Type 1 diabetes both he and his daughter Latisha have.

“That’s a house payment,” he said. “That’s a mortgage.”

As it stands, it’s enough medication and equipment to cover a small end table.

That cost includes testing strips, which Costain uses to test his blood sugar levels four times a day, to determine how much insulin his body needs to be injected at that particular moment.

With Latisha, who was diagnosed last September, it’s more complicated.

“I have to check her sugar very often,” he said.

As well, her blood sugar levels can change quickly, sometimes in as little as the 25 minutes it takes to ride the bus to school. ...more

Thursday, November 20, 2008

Doctors allege intimidation in raising drug warnings, investigation shows

From CBC News:
Two physicians who tried to warn about the high risk of serious side-effects of the Type 2 diabetes drug Avandia allege they were intimidated by the company that sells it, a CBC investigation revealed Wednesday.

Last year, a review published in the New England Journal of Medicine found a 43 per cent higher risk of heart attack among people taking Avandia, or rosiglitazone, compared to a control group, and 64 per cent more likely to die of cardiovascular problems.

Avandia was hailed as a breakthrough for blood-sugar control. It is designed to help sensitize the body to insulin.

Both the U.S. Food and Drug Administration and Health Canada have issued strong warnings as a result of the 2007 study. By that point, researchers were estimating thousands of people taking Avandia had died, given it had been on the market since 1999. In Canada in 2007, doctors had written more than a million prescriptions for Avandia, according to IMS Health Canada, an industry trend watcher.

In 2000, Dr. Mary Money, an internist from Hagerstown, Md., raised one of the earliest alarms about Avandia. Of 33 patients she put on the new drug, 20 went on to develop serious edema, or fluid retention — a symptom of heart failure. ...more

Tuesday, November 18, 2008

Pet owners turning to mood altering meds to help their critters cope

From the Canadian Press:
With her pink tongue flapping out the side of her mouth, Winnie bounds across the living room, scoops up a tennis ball and proudly trots it back to her owner.

For the two-year-old mutt, life doesn't get much better than hanging out with Mandy Novak, a master who dishes out cold hot dogs and occasionally offers up her face for a slurp.

It's alone time that has filled Winnie with dread.

Late last year, the collie-Labrador mix, adopted from a shelter in October 2007, cried and paced nervously if she even sensed Novak was getting ready to leave for work.

When left on her own, Winnie marauded through the house gnawing on everything from wooden staircases to drywall.

"We came home and we found that she had eaten through the basement walls," said Novak, who lives in the Montreal suburb of Pincourt.

An animal behaviourist diagnosed Winnie with canine separation anxiety, and like more and more pet owners, Novak has turned to a mood-altering drug to help her dog cope. ...more

Sunday, November 16, 2008

The sleepless epidemic

From the Globe and Mail:
For years, Stacie Fox feared the night. From the moment she went to bed, sleeplessness taunted her. Just as she began to drift off, it would jerk her awake again. As a result, she waded through her days with aching joints, swollen glands and a leaden heart. “I felt like I was 80,” says the 32-year-old actor from Burlington, Ont. “I felt like the whole world was going to end. My brain was in a fog.”

Using makeup and her acting skills to hide her exhaustion, she tried everything she could think of escape her insomnia. A dairy-free diet. Acupuncture. Massage therapy. Tai chi. Good sleep hygiene (no caffeine or alcohol, no TV in the bedroom). She even went to the Matrix Repatterning Centre in Aurora, Ont., where naturopathic doctors claimed to help “correct the imbalance in soft tissue, organs and bones.”

Her family doctor tested her thyroid, liver and kidneys, her levels of blood sugar and cortisol, the “stress hormone.” The results all came back normal. Then her doctor prescribed sleeping pills.

Imovane, a tiny, bitter blue piece of magic, sent her into a sweet, sustained slumber. Comfort, at last. She slept like a baby.

Many are loath to admit it, but more and more people both in Canada and the United States are fed up with punching the pillow until dawn. Consumption of sleeping pills has increased dramatically in the past five years. Prescriptions for zopiclone, the generic name for Imovane, rose 49 per cent from 2003 to last year, according to industry tracker IMS Health Canada, while those for all sedatives went up 15 per cent. ...more

HPV vaccine can protect men too

Soon girls may not be the only ones getting Gardasil injections.

Merck Frosst is moving ahead with plans to extend the use of its controversial Gardasil vaccine to boys and young men.

The cancer vaccine for women could be just as effective for men, Universite de Montreal professor and microbiologist Francois Coutlee said Thursday in a telephone interview at a scientific meeting in Nice, France.

Coutlee was part of the team reporting early results of a Merck-sponsored study showing that 90 per cent fewer men ages 16 to 26 years old developed genital warts and other lesions after receiving Gardasil, a vaccine that targets four human papillomavirus strains that can lead to cancer.

But HPV isn't just a problem for women, Coutlee said. In men, HPV can lead to genital warts, anal cancer, and penile cancer.

"The study is still ongoing, but we're relieved to know that it is as effective in men as it is in women," said Coutlee, who was involved in recruiting test subjects in Montreal. ...more

Test strips now covered for people with diabetes who use insulin

From the Charlottetown Guardian:
Islanders who use insulin to manage their diabetes will have assistance in covering the cost of their test strips beginning tomorrow, on World Diabetes Day.

Premier Robert Ghiz and Social Services and Seniors Minister Doug Currie announced today that all Islanders who are dependent on insulin will qualify to receive up to 100 test strips per month, with a monthly co-pay of $11.

The announcement affects close to 2,000 of the nearly 8,000 people with diabetes on P.E.I.

"We are extremely pleased to fulfil the promise this government made to insulin-dependent Islanders in the Throne Speech," said Premier Robert Ghiz. "This announcement is a $1.5 million investment in the health of Islanders."

Nineteen hundred people in Prince Edward Island use insulin and check their blood glucose levels using test strips and monitors. The strips are sold for one dollar each, while the monitors are provided at no charge by manufacturers. ...more

Peppermint oil, older drugs help treat IBS: review

From CBC News:
Older treatments for irritable bowel syndrome like peppermint oil safely help ease symptoms and should be used, a review suggests.

IBS is characterized by abdominal pain and discomfort accompanied by changes in bowel function, diarrhea, constipation or a combination of both, typically over months or years.

It is estimated to affect 13 to 20 per cent of Canadians, according to the Canadian Society of Intestinal Research.

In Canada and most western nations, IBS occurs more often in women. It can occur at any age, but often begins in adolescence or early adulthood. ...more

Breakthrough study finds simple blood test may detect heart disease

From the Globe and Mail:
Measuring certain proteins through a simple blood test may make heart disease easier to detect and a lot less deadly, according to a study published online Sunday in the New England Journal of Medicine.

People with healthy LDL-cholesterol levels but elevated levels of high-sensitivity C-reactive proteins experienced a nearly 50-per-cent reduction in the risk of heart attack, stroke, and cardiovascular death with a daily dose of a cholesterol-lowering statin drug, the study found.

The reduction in heart-disease risk among people who appear healthy and lack risk factors such as elevated cholesterol – which describes about half of those who experience heart disease – is such a significant finding that the drug trial was cut short in order to publish the results sooner.

The nearly 18,000 patients followed in the study had normal cholesterol levels and slightly elevated levels of C-reactive proteins – markers of inflammation that are known indicators of atherosclerosis, or blockage of the arteries.

The researchers suspected statin medications such as rosuvastatin would lower the risk of cardiovascular events in such patients, whose LDL-cholesterol levels were below 3.36 millimoles per litre, but were surprised by how well they worked. ...more

Saturday, November 15, 2008

Internet drug peddlers raided in 9 countries

From Reuters:
Authorities in nine countries have raided businesses suspected of supplying medicines illegally over the Internet in an unprecedented global swoop coordinated by Interpol, officials said on Thursday.

The operation, codenamed Pangea, involved dozens of locations in Britain, Germany, Ireland, Israel, New Zealand, Singapore, Switzerland, Canada and the United States.

The raids on Wednesday mark the first time that such action has been taken on an international scale, an Interpol spokeswoman said.

Illicit sales of medicines via the Web are a growing problem, since many of the products are counterfeits of dubious quality and potentially dangerous.

Britain's Medicines and Healthcare products Regulatory Agency, which raided 12 residential and commercial premises in the crackdown, said illegal Internet sales posed a serious risk to public health.

"A medicine bought in this way has no guarantee that it is safe or that it is effective and can in fact be harmful," Danny Lee-Frost, head of operations, said in a statement. ...more

OxyContin maker: Pills seized in C.B. weren’t the real deal

From the Halifax Chronicle Herald:
Representatives of the company that makes the powerful prescription painkiller OxyContin flew to Sydney on Thursday to examine a vast quantity of seized pills that turned out to be knock-offs.

Police in Cape Breton seized 25,000 oxycodone tablets from a vehicle at a parking lot last week in what is considered the biggest bust of its kind in Atlantic Canada.

Staff Sgt. Paul Jobe said police are now confident the drugs, which have an estimated street value of about $700,000, are not of pharmaceutical grade.

Investigators met with drug-makers Purdue Pharma at police headquarters in Sydney where the company made a presentation on their manufacturing and security systems.

"It’s not the same quality they would produce," said Jobe. "They have a coating they put on their pills, they have a stamp they put on their pills, there’s a (certain) way they produce them."

The U.S.-based pharmaceutical company operates a facility in Pickering, Ont., and is the only maker of the brand OxyContin in Canada. There are eight other manufacturers of its generic form oxycodone, though none deal with the high milligram content found on the pills that were seized. ...more

Union Yes?

From the Indianapolis Star:
With their white coats and six-figure salaries, pharmacists might seem like an unlikely group of card-carrying union members.

But around the country, 15,000 pharmacists, or about 6 percent of the U.S. total, belong to the Steelworkers, Teamsters and other unions, joining ranks with blue- collar workers who smelt aluminum, build tires and drive beer trucks.

Most of the unionized pharmacists work in big industrial markets such as Pittsburgh and Chicago, along with smaller cities, such as Tampa, Fla., and Gary, Ind. No union pharmacists work in Central Indiana, according to the Indiana Pharmacists Alliance, a statewide trade group.

But that could change.

The United Steelworkers union is keeping a close eye on a massive mail-order pharmacy springing up in Boone County. The $150 million distribution center, being built by Medco Health Systems, will cover an area the size of six football fields when it opens next year. It eventually will employ 1,300 people, including hundreds of pharmacists and pharmacy technicians who may need help negotiating contracts and addressing grievances. ...more

Teaching boycott planned

From the Montreal Gazette:
Quebec pharmacists frustrated by a serious staffing shortage held a special meeting yesterday to vote on a series of pressure tactics they promise will not affect patients.

The shortage is expected to worsen, which means patients will suffer, warned Linda Vaillant, executive director of the Association des pharmaciens des établissements de santé du Québec.

"We may not be able to give chemotherapy to patients and we don't want to get there," Vaillant said.

About 1,200 pharmacists work in Quebec hospitals and other health-care establishments. But hospitals need another 200 pharmacists to properly serve patients, Vaillant said.

Hospital pharmacists regularly work 45-hour weeks, often covering 12 days in a row, she said.

"The pharmacist is like the goalie in hockey. He has to make sure to stop the puck, to catch the error, the drug interactions, and adjust the dose. There's potential for increased medical error because of the intensity of the workload," she said. ...more

P.E.I. pharmacists to be able to prescribe

I missed posting some articles while I took a break. I will attempt to catch up over the weekend. This one might have been one of the most interesting in the world of Canadian pharmacy.

From CBC News:
Prince Edward Island pharmacists will soon be given the authority to write prescriptions for their customers.

Changes to provincial legislation allowing pharmacists to renew some prescriptions are expected to be passed next month in the legislature.

Currently, when a prescription runs out and a person doesn't have a refill from the doctor, P.E.I. pharmacists can't do much except provide a few pills to tide the person over. The new legislation will change that.

"This is not prescribing something new; we are not diagnosing anything," Neala Auld, registrar of the P.E.I. Pharmacy Board, told CBC News Thursday.

Allowing pharmacists to renew some prescriptions will be a great convenience for patients, said Auld, particularly those without a family doctor.

"It puts patients in a very difficult position having to get a new prescription and wait maybe two or three hours in outpatients for something that easily could be addressed at the pharmacy level," she said. ...more

Ban diabetes drug Avandia: consumer group to FDA

From CBC News:
The diabetes drug Avandia should be banned over its risks of heart and liver damage, a U.S. consumer group urged.

In a petition filed with the U.S. Food and Drug Administration on Thursday, the group Public Citizen called for the Type 2 diabetes drug, whose generic name is rosiglitazone, to be pulled from the market.

Last week, the American Diabetes Association and a European counterpart unanimously advised doctors against using Avandia in updated treatment guidelines.

"The FDA is in possession of clear, unequivocal evidence that (Avandia) causes a wide variety of toxicities," Public Citizen said in its petition.

"Many of these are life-threatening, such as heart attacks, heart failure (and) liver failure."

In November 2007, GlaxoSmithKline Inc., the manufacturer of rosiglitazone, updated its prescribing information in consultation with Health Canada after a study published in the New England Journal of Medicine reported a 43 per cent higher risk of heart attack for those taking rosiglitazone compared to people taking other diabetes drugs or no diabetes medication at all. ...more

Rare Treatment Is Reported to Cure AIDS Patient

From the New York Times:
Doctors in Berlin are reporting that they cured a man of AIDS by giving him transplanted blood stem cells from a person naturally resistant to the virus.

But while the case has novel medical implications, experts say it will be of little immediate use in treating AIDS. Top American researchers called the treatment unthinkable for the millions infected in Africa and impractical even for insured patients in top research hospitals.

“It’s very nice, and it’s not even surprising,” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. “But it’s just off the table of practicality.”

The patient, a 42-year-old American resident in Germany, also has leukemia, which justified the high risk of a stem-cell transplant. Such transplants require wiping out a patient’s immune system, including bone marrow, with radiation and drugs; 10 to 30 percent of those getting them die.

“Frankly, I’d rather take the medicine,” said Dr. Robert C. Gallo, director of the Institute of Human Virology at the University of Maryland School of Medicine, referring to antiretroviral drugs. ..more

Thursday, November 13, 2008

Statins: the Aspirin of the 21st century?

From CBC News:
They're the best-selling family of drugs of all time, with annual worldwide sales estimated at more than $20 billion. Every year, Canadian doctors write more than 12 million prescriptions for statins, making them the most-prescribed drugs in the country. They're in a class of drugs that has proven very effective at lowering cholesterol levels and reducing the risk of heart attacks.

The possible effectiveness of statins is so great that surprised researchers reported in November 2008 they have stopped a four-year study two years early in order to present their findings as soon as possible on the drugs' benefits to patients.

The study, which followed nearly 18,000 patients from 27 different countries, found the strongest evidence yet that people with high levels of a particular protein are at increased risk of cardiovascular disease. It also found that the risk dropped by nearly half for patients treated with statins.

All the patients had normal levels of cholesterol (LDL-c) and high levels of hs-CRP (high-sensitivity C-reactive protein) — previously suspected, but not confirmed, to be a critical indicator of heart problems — and as such were not receiving any treatment for cardiovascular disease. ...more

Woman blames drug company for contributing to heart attack

From the Waterloo (Ont.) Record:
Trudy Metzger used to call the little white pill she took daily her miracle drug.

The 38-year-old Elmira woman took the drug to relieve the uncomfortable symptoms of irritable bowel syndrome.

Today, she believes the drug, Zelnorm, contributed to the massive heart attack she suffered two years ago at age 36.

"I could have died," Metzger said yesterday.

The mother of five is the representative plaintiff in a $125-million class-action lawsuit against Novartis Pharmaceuticals Canada Inc., the Quebec-based manufacturer of the drug.

None of the allegations in the lawsuit have been proven in court.

Silvie Letendra, spokesperson for Novartis, declined to comment.

"Since this matter is now before the courts, Novartis cannot comment," she said in an e-mail. ...more

C.B. cops make big Oxy bust

From the Halifax Chronicle Herald:
Some 25,000 OxyContin pills were seized in a downtown parking lot Friday night in what the acting chief of Cape Breton Regional Police says could be the biggest bust of the prescription drug in Atlantic Canada.

Plastic baggies filled with the powerful pills lined a table at police headquarters Monday as Staff Sgt. Paul Jobe told reporters about the takedown.

Members of the street crime unit staked out a car in a parking lot along the Esplanade on Friday and moved in when the suspects got out, he said. A small amount of marijuana was also seized.

Christopher John Allingham of Eastern Passage and Todd Douglas Miller of the Montreal area appeared briefly in Sydney provincial court on Monday....more

AIDS vaccine developed in Ont. nears human trials

An experimental vaccine aimed at combating the HIV/AIDS virus has been developed by a researcher at the University of Western Ontario in London and is ready to be put through a key testing phase, the university announced Wednesday.

The vaccine, developed by virologist Dr. Chil-Yong Kang, will now go through toxicology tests to ensure it can safely be injected into humans.

Toxicology trials using animals will begin in a matter of days at a research facility in the United States with results expected in approximately three months, Kang said.

Phase 1 human clinical trials could begin in early spring.

Unlike other vaccines, which have used only a small amount of HIV's genetic material, Kang said his vaccine uses a whole dead HIV-1 virus, a technique Jonas Salk used in the polio vaccine.

"We have engineered a virus in such a way that it can be produced in larger quantities in shorter periods of time and it is also non-pathogenic. In other words, it doesn't cause the disease," Kang said. "We have tested animals and they do respond to the vaccine and we now have to try it in humans."

The vaccine will be tested in individuals who are HIV-positive, but don't yet have AIDS symptoms, Kang said....more

Tuesday, November 11, 2008

Let us renew meds, save cash: N.L. pharmacists

From CBC News:
Pharmacists in Newfoundland and Labrador are asking the provincial government for authority to extend drug prescriptions, on grounds it would improve patient care and save money.

The pharmacists say millions of dollars are being unnecessarily spent because too many patients head to emergency rooms for treatment or prescriptions, when better alternatives could be made available.

Wayne Morris, president of the Newfoundland Council of Community Pharmacy Owners, said he sees about two or three people each day who must either face not taking medications or heading to hospitals for prescriptions.

The consequences, he said, can be serious.

"If somebody's on insulin and can't get it for a week or 10 days, [then] basically what you have to realize is that they are going to end up in hospital," said Morris, who owns a pharmacy in Grand Falls-Windsor. ...more

Telepharmacy service instituted in Barry's Bay hospital

From Barry's Bay (Ont.) This Week:
The shortage of health care professionals across the province has made it difficult for small rural hospitals to offer the services needed. For the past 18 months, for example, St. Francis Memorial Hospital in Barry’s Bay has been trying to find a pharmacist, without luck.

But it has now solved the problem by connecting with Northern Pharmacy Limited (a division of The North West Company), which offers telepharmacy services.

“A small hospital can safely operate a medication storage and distribution system for their patients under the management of a registered nurse,” says Joan Kuiack, Director of Patient Care Services. “However, the addition of a pharmacist offers an enhanced quality of care to our patients.”

A pharmacist has the expertise to look at the whole patient, his or her disease and relate the effectiveness of the medication they are receiving to their progress, she adds.

The hospital first contacted Kevin McDonald, manager of the hospital pharmacy telepharmacy program at Northern Pharmacy, about a year ago, but decided to try to organize a partnership with Renfrew Victoria Hospital for services of a pharmacist. ...more

Pharmacy school nearly ready

From the Waterloo (Ont.) Record:
Dr. Jake Thiessen walks through a muddy parking lot in a busy construction site and steps into a signature building in the city's core -- the University of Waterloo's school of pharmacy.

At King and Victoria streets, the $52-million building is the most visible and tangible sign of progress in the City of Kitchener's long-running campaign to bolster the downtown.

Thiessen is the founding director of the school, and these days he walks around the site with a feeling of exhilaration.

"It is a terrific thing to be part of something from the ground up," he said yesterday during a tour of the building. "I was blessed with the privilege of starting with a blank slate and dreaming of what could be." ...more

Drugged-out seniors a prescription for disaster

From the Toronto Star:
They are the drugged-out generation, and they're not who you think they are.

They're 80. And 85 and 90 and 95 – overmedicated seniors clogging emergency departments, blocking hospital beds and sicker than they have any reason to be.

The Number 1 drug users in North America, outside of patients in long-term care facilities, are women over the age of 65. Twelve per cent are on 10 or more meds, sometimes up to 20 or more drugs; 23 per cent take at least five drugs. In long-term care, seniors are on six to eight medications, on average. Fifteen per cent of seniors admitted to hospital are suffering drug side effects. It's not uncommon to find seniors dizzy and dotty from being prescribed so many drugs.

"You'd fall down, too, if you were on so many drugs," says Dr. William Dalziel, a prominent Ottawa geriatrician.

Typically, overmedicated seniors have been seen by numerous specialists who have prescribed various medications to treat a host of chronic ailments – high blood pressure, hypertension, diabetes, osteoporosis, arthritis, heart disease, cancer – but there hasn't been any oversight by a geriatrician skilled in looking at the big picture and assessing contra-indications and side effects. Ask any doctor with expertise in seniors what their top health concerns are and they all cite overmedication. ...more

Shoppers' new beauty emporium takes on Sephora

From the Ottawa Citizen:
Shoppers Drug Mart Corporation has chosen Ottawa to launch its first high-end, multi-service beauty store in Canada. Murale features a cocktail of services, from a pharmacy that exudes Scandinavian style to a "bar" focusing on beautiful skin and trim eyebrows.

Launched on the weekend at Place d'Orléans Shopping Centre, Murale is the brainchild of Shoppers Drug Mart president and CEO Jurgen Schreiber, who wanted to combine beauty and dermatological products with professional services in a sleek space.

Among its 30 services Murale offers purifying facial and body treatments, and a skin analysis section called Beauty Metrix where a "skin diagnostic tool" measures a customer's skin damage, skin quality and moisture level, while a consultant will suggest topical creams to meet the customer's needs. ...more

Sunday, November 09, 2008

Pharmacists face Rexall lockout

From the Edmonton Sun:
A potential move by Rexall that would see dozens of highly specialized pharmacists locked out could have negative impacts on the patients they serve, some terminally ill, one expert says.

The Health Sciences Association of Alberta, the organization representing the workers, says the pharmacy giant has applied to the Labour Relations Board to lock out pharmacists and pharmacy technicians working at outpatient pharmacies at the U of A and Royal Alexandra hospitals, following a breakdown in contract negotiations.

Elisabeth Ballermann, HSAA president, says pharmacists working for Rexall have historically been paid on par with their counterparts working for the provincial health board.

However, things turned sour when the non-Rexall employees got a significant pay increase, which Rexall is not prepared to match.

"The message was pretty blunt at the bargaining table that Rexall doesn't feel that they're making enough of a profit. They are, in fact, making a profit, they just don't think they're making a big enough profit," Ballermann said, adding the gap will be in the neighbourhood of $8,000 over two years for workers. ...more

Windsor's independent pharmacists caught in drug war crossfire

From the Windsor Star:
The mural of an old-fashioned, small-town apothecary on the window of Steve Gavrilidis's South Windsor pharmacy reflects the personal service he provides inside -- his best, perhaps only, defence against the rapid expansion of competing national drugstore chains.

Like hundreds of independent pharmacists across the province, Gavrilidis finds himself caught in the crossfire of Ontario's drug war -- the battle for market supremacy being waged between Shoppers Drug Mart and upstart Rexall.

"They're chasing each other and nipping at each other's heels, taking away from guys like me," said Gavrilidis. "Everybody wants a piece of the pie and the pie is getting smaller."
The Pharma Health independent pharmacy has found a niche providing the personal touch. Pharmacist Steve Gavrilidis assists customers in the comfort

Like Burger King and McDonald's at the height of the burger wars, the two drugstore chains are rapidly expanding across the province, acquiring independent outlets and opening new stores in each other's shadows. In Goderich earlier this month, Rexall and Shoppers both opened stores in the span of a week.

"Rexall is out to get Shoppers' market share and that's the bottom line," said retired University of Windsor business professor Alfie Morgan. "It's a competitive battle between two giants." ...more

A New Age Of Statins?

From Forbes:
A new study could lead millions more Americans to take cholesterol-lowering drugs and generate billions in sales for AstraZeneca, which funded it. But first comes a furious debate.

The study, called Jupiter, gave either AstraZeneca's Crestor or placebo to 18,000 patients who received bad scores on a little-known blood test for C-reactive protein (CRP) that is thought to measure inflammation in the arteries. Patients who took Crestor were half as likely to have heart attacks, strokes or operations to open clogged arteries as those getting placebo, an effect that ranks among the best results seen with the two-decade old class of cholesterol drugs called statins, of which Crestor is the most potent.

"It takes prevention to a new level because it applies to a whole group of patients who would not get a statin today," says Douglas Weaver, president of the American College of cardiology. In a statement, Elizabeth Nabel, head of the National Heart, Lung and Blood Institute, says adding CRP tests to those for blood pressure and cholesterol "could identify millions more adults for whom treatments with statins appears to lower the risk of heart attack." ..more

Review of QU college by Canadian body complete

I don't exactly understand the reason that Qatar University wants Canadian accreditation. I suspect this is to enhance their credibility. But could it also lead to their students having an easier path to Canadian licensure than other foreign graduates? Are any other foreign universities planning to ask the CCAPP to inspect their programs?

From the Qatar Gulf Times:
Qatar University’s College of Pharmacy has completed a accreditation review conducted by the Canadian Council for Accreditation of Pharmacy Programmes, the agency for accrediting pharmacy schools in Canada.

“We are the first international programme to undergo an accreditation review by CCAPP,” College of Pharmacy dean Peter Jewesson noted, adding that the same standards and guidelines were applied to the college’s programmes as for Canadian programmes.

The accreditation process was conducted from October 19 to 22 only months after the College of Pharmacy was elevated from Pharmacy Programme following the approval of the QU Board of Regents under the chairmanship of HH the Heir Apparent Sheikh Tamim bin Hamad al-Thani. Advance documentation was provided to the agency in July of this year. ...more

Shoppers Drug Mart Q3 profit climbs 15%

From the Financial Post:
Third-quarter profit at Shoppers Drug Mart Corp. climbed 15% as the retailer of cosmetics, vitamins and prescription drugs built out its store network and increased its sales in house-branded goods.

Net income at Canada's largest drug store chain rose to $162.5-million, or 75¢ per share, compared with $141.7-million, or 65¢, in the same period a year ago. Analysts polled by Thomson First call were predicting profit of 75¢.

Sales rose 9.8% to $2.79-billion and same-store sales, a retailing bellwether which looks at sales at stores open at least a year, rose 5%, not including tobacco sales. Prescription same-store sales rose 5.2% and merchandise sales were up 4.8%.

This was the 18th consecutive quarter of increased profit at Shoppers, which increased its retail space by 12.6% in the period.

"No real surprises," said analyst Bob Gibson of Octagon Capital, which was reassuring, he said, given recent turmoil in the more discretionary end of the retailing sector. The analyst said he was considering moving his rating on the shares up to a buy from a hold given its recent decline in share price. Prior to yesterday's close, Shoppers' shares had lost 10% of their value this year. ...more

Downtown Walgreens to focus on HIV/AIDS

I think it's pretty interesting that some of the bigger pharmacy chains are starting to develop niche markets. Typically this has been the domain of independent pharmacies.

From the Indianapolis Star:
Walgreens is reaching out to people with HIV and AIDS by creating a hub store in Downtown Indianapolis to meet their needs.

Staffed with a pharmacist trained to help HIV patients, the store reflects the nationwide drugstore chain's new strategy of providing customized services to those with certain diseases.

"The company is changing from most people's image of Walgreens, where you have four brick walls, Snickers bars and greeting cards and school supplies," said Bruce Hinshaw, health-care market leader for Walgreen Co. for the Indianapolis/ Central Indiana market. "It's always been a health-care company, and I think Walgreens is saying, 'That's our strength. Let's go back to our core strength.' "

In New Castle, this approach has translated into a pharmacy that offers compounding services. Later, Indianapolis could see a store with a specialty in diabetes care, Hinshaw said. Other Walgreens stores around the country specialize in services for those with respiratory problems, tumors or cancer, or rheumatoid arthritis. ...more

Thursday, November 06, 2008

SCOC upholds blood-thinning drug patent

The Supreme Court of Canada blocked the sale of a generic version of a popular blood-thinning drug in a ruling Thursday that reinforced patent protection to encourage brand-name pharmaceutical companies and other businesses to invest time and money into research.

The court unanimously dismissed generic drug-maker Apotex's bid to quash a Canadian patent for best-seller Plavix, which expires in 2012.

The ruling settles an intellectual property dispute over the validity of secondary patents that give drug companies protection, not only for their original inventions, but for an entire family of possible chemical compounds that encourage scientists to go back to the laboratory to improve a product. ...more

Testosterone patch may put pleasure back in post-menopause sex

From the Globe and Mail:
The male sex hormone testosterone may help restore sexual pleasure in some post-menopausal women, much as erectile dysfunction drugs have given some men back their sex lives, according to research published today in the New England Journal of Medicine.

In an international study of 814 women who were not using estrogen therapy, those who received 300 milligrams of testosterone a day via a patch on the stomach for a year reported an increase of about one-and-a-half more satisfying sexual episodes a month, when corrected for a placebo effect.

Lead researcher Susan Davis says she conducted the study to determine whether testosterone was a suitable alternative for menopausal women who have stopped taking estrogen therapy because of studies linking it to health risks, including breast cancer.

The study, a two-year double-blind clinical trial of women from Canada, the United States, Australia, the United Kingdom and Sweden who reported enjoying sex only 50 per cent of time, was financed by Procter and Gamble Pharmaceuticals, the makers of a testosterone patch currently available in Europe. ...more


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Pak former interior minister rubbishes Headley’s testimony

Karachi, Feb 10 (ANI): Pakistan’s former interior minister Rehman Malik has rubbished the testimony of 26/11 Mumbai terror attacks convict David Coleman Headley about his alleged part in conducting the deadly massacre in November 2008.

According to The Express Tribune, Rehman Malik accused India of trying to defame Pakistan by concocting confessions out of Headley.

Rehman said that they have the details about who paid tickets, who funded him and how he recruited non-state actors from Pakistan for the attacks.

In his revelation during the deposition yesterday, Headley said that Pakistan’s spy agency ISI provides financial, moral as well as military support to terror outfits like the LeT, Jaish-e-Mohammad and Hizbul Mujahideen.

Headley said that he was asked by the ISI to recruit Indian army men to spy for them.

On the first day of the deposition, he revealed the sequence of events and planning behind the 26/11 Mumbai terror attacks.

Headley, one of the main conspirators in the 26/11 Mumbai terror attacks, deposed as a witness in the case and admitted that he had come to the city with a false identity at the behest of his colleague and handler Sajid Mir, a Lashkar-e-Taiba (LeT) operative.

Meanwhile, post a technical snag in video-conferencing, David Coleman Headley’s deposition has been adjourned till Thursday. (ANI)

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Turkish forces launch operation in Syria against IS

Ankara, Aug 24 (IANS) Turkish forces and US-led coalition warplanes on Wednesday launched an operation in the Jarablus region of north Syria, the media reported.

Turkish forces dispatched warplanes and artillery during the operation, aiming to clear the borders from the Islamic State militants, halt the new wave of refugees and deliver humanitarian aid to civilians in Jarablus — the last significant town held by the IS near the border between Syria and Turkey, Xinhua news agency reported.

Turkish Foreign Minister Mevlut Cavusoglu said on Tuesday that Turkey would provide all kinds of support for military operations in Jarablus.

Hours before the operation, the Turkish border town of Karkamis was attacked by a series of mortar shells fired from Syria, leading many locals to evacuate.

Earlier on Monday, Cavusoglu said the IS militants must be totally pushed from the Syrian border region, amid reports suggesting that Syrian rebels were preparing to launch an attack to seize Jarablus.

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Arsene Wenger-slider-737500

2013 – 2014 Season – Arsenal Performance Index

Post by Resident Blogger : SimonSEEZ

Transfer business done and dusted, football can return to sanity now or can we? The daily mirror has linked us with Barcelona right back Montoya and a couple of players from Germany. Montoya is running into the last year of his contract at Barcelona, ON A FREE?? and we all know who likes free more than any other don’t we? That’s me again..drifting to transfer talk.

At work I’ve got these monthly sessions where my targets per month are analysed vis a vis the quality of my work, at the end of the year it’s all summed up and divided by 12 to give me my rating for the year which determines if I get promoted, pay rise or errrr  errr  fired? Naaa, we wouldn’t want that now do we? I wonder if Wenger gets these sessions too. With the amount of power he wields what would the mood at the sessions anyway. In any case, I’ve got some Key Performance Index (KPI) for him this season, even made more important as he runs into the last year of his contract.

The league, our bread and butter, there is a reason I start off with it and it has nothing to do with Charity beginning at home. It’s a tough competition and it has only got tougher since the money bags invaded it. Man Utd have all the experience at winning it, Chelsea and Man City can afford to buy it, Spurs, yuck spurs…with their over a hundred million pounds spent this season they look like a poor mans Man City and Liverpool seem to have started off well. Have we used the window well to make our team better? All sins are forgiven once I remember Ozil. Given a choice between the league title and the Champions league, I’ll take the league right now. Can we win the league, it’s a tough call, is it impossible? Definitely not.

Our team looks solid, I tweeted a few hours ago about how our midfield was the best in the league with only Chelseas close to the talent we currently have. I feel our midfield can win us the league if everyone stays fit. We have a pool of talent there and Wenger would have a headache picking a starting midfield. The league is long and hard and he would have to make the best use of the squad to keep us in competition till the very end. This season especially no one is guaranteed dominance, Spurs and Liverpool have strengthened well, Everton with their new acquisitions are not pushovers. This can only mean that a lot of points will be dropped at grounds like these, everyone has dropped points this season already except Liverpool. We have to make the Emirates a fortress; we have lost our fear factor. Remember when we would go to grounds with Bergkamp, Henry, Pires and Ljunberg and teams would set up just to defend out of fear? This team can bring that back. We might not scare teams in Europe but when we go to grounds like Palace, Cardiff, Norwich, Fulham, Southampton etc our fear factor should go before us and this can only be built by constant victories, dominant possession football and quick counter attacks like we did at the Spurs game.  Minimum acceptable position this year should be 2nd.

champions league

Tough group we got in the Champions league, can we get out of the group? I think so. Its important we win all our home games and have one outstanding victory in one away ground. Ten points should be fine for any team in this group to qualify. A detailed Champions league group stage analysis would be up on the blog next week by our resident blogger @theOHbee so watch this space for that. This is a competition we haven’t fared well in since our semi final loss to Utd in 08-09 season. The manager has huge experience in Europe and our seemingly new counter attacking football would suit Europe very well. We have signed a player in Mesut Ozil who has tremendous experience playing in this competition and hopefully will be able to pass this experience across the team. Minimum acceptable position should be a semi-final exit.

The FA cup, I think this competition is the reason the British Media hates us. Wenger has been accused of consistently undervaluing this competition with the teams he fields. He got loads of grief last season also after the loss to Blackburn for the same reason, but the players that were fielded to play against Blackburn that Saturday were good enough to beat them and should have.  I believe the problem with this competition is the manager, if Wenger keeps giving the players the aura that he doesn’t rate this competition, it’s the same aura they would take into the pitch when they play. Tell them you rate it, select a team that can win it and we would win it. This is the last trophy we won and I know we are all sick of hearing the jibes about how long we have gone barren but when you remember that the kick that won this cup for us was from Vieras boots you would have an idea of how far behind it is. To win this competition I feel you usually need a maximum of three big performances depending on how the draw works for you. Wigans run to Wembley last season is enough prove of how a lucky draw can get you to the finals. There is no minimum acceptable here, it has to be a clear mandate to win this.

Carling my Darling, oh! Now it’s the boring name The Capital One cup. This competition has over the years been a chance to give the youngstars a feeling of what a real match day is like. Best position recently was runner up in 2010-2011 season when we lost to Birmingham. Ranks extremely high in my worst football days ever which has days like when Chelsha won the champions league. That tops my list! Our loss to Bradford last year has very few adjectives to describe it , that was an extreme low! Players like Serge Gnabry, Zelalem, Niklas Bendtner and Yaya Sanogo know they have their chance to shine here and they better take it. A sprinkling of first team players especially in defence is needed and should we ever get into trouble the big guns have to be unleashed. Minimum acceptable here, WIN !!!

Round Up

  Competition Key Performance Index
1. Premier League 2ND Position
2. Champions League Semi-Final
3. FA  Cup Win
4. Carling Cup Win

Our trophy drought has made almost every competition we partake in a near must win. However we have to be reasonable and realize we can’t achieve all.  You want to know what a trophy would do for Arsenal? Did you see the social media buzz on the signing of just Ozil? Then imagine what would happen if we win something like the league. Cam On The ARSENAL!!!!!

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Reflections on Faith

Dear friends,

In this blog, you will find weekly reflections on life and faith. My hope is that, in some way, they will prove helpful to you in your daily living. May God bless you on the spiritual journey.

Andrew S. Odom

11/20/2016 6:59 PM

The Wonder of Christmas

11/20/2016 6:59 PM
11/20/2016 6:59 PM

This is what the prophet has written, “But you, Bethlehem, are by no means least among the rulers of Judah; for out of you will come a ruler who will shepherd my people Israel. (Matthew 2:6)

Advent is a season for getting ready. It is a time to prepare for what is next, not for what is next from us, but for what is next from God. In this season of preparation, we will be reflecting on the mystery of the whole of the Christmas story. We are going to be walking through the wonder of Christmas.

I have found that when we experience something deeply mysterious or breathtaking in life, we often remember certain objects or moments that stand out as odd. We use physical things to point beyond the moment to the mystery itself. In the birth story of the Messiah, the gospel writers lift up a number of things from the experience. We will focus on four of them: a star, a name, a manger, and a promise. Ordinarily these things would have no particular meaning, but when tied to the story of God becoming flesh, they become powerful markers of a miraculous moment in time.

Beginning this Sunday, let’s dust off our hearts and enter the season with a sense of wonder and surprise. Perhaps more than ever, in a world that feels torn completely in two, now is the time to open ourselves up to the promise God gives birth to in us as the star points the way to the one born in a manger who is given the name above all names, the name of Jesus.

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Beyonce And Blue Ivy Enjoy A Quiet Moment In New Pictures Shared Online

18 October 2013, 09:59

The 'Countdown' singer has shown off some new family pictures to fans online.

Beyonce has shared a number of new snaps with fans online showing her spending some quality time with daughter Blue Ivy.

In one of the new pictures the 'Love On Top' singer is seen sharing a serene moment with one year-old Blue as the pair look out over the ocean.

Beyonce wears a pair of cut-off denim shorts and a bikini top while looking away from the camera at the sea while cradling Blue in her arms.

Check out a picture of the two enjoying a quiet moment below (Credit: Instagram):

The US star also posted a picture of her and Blue playing around together while the pair relaxed in a hammock.

Check out a picture of Beyonce and Blue playing together below (Credit: Tumblr):

Beyonce is widely rumoured to be preparing for the release of a brand new single in December, while her 'The Mrs. Carter Show' world tour hit Australia and New Zealand this week.

Jamie O'Hara & Bianca Gascoigne

Bianca Gascoigne's Opened Up About Those Rumours She's Getting Back With Jamie O'Hara

Leigh-Anne Pinnock joins Snapchat

80+ Of The Best Popstars You Should Have On Snapchat

Capital Metadata - Capital App March 2017

Want To Control The Music On Capital? Now You Can With Our New App - My Capital!


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R&D with Optical Metrology: Integration of ATOS Triple Scan into Target Virtualization, Design Modification, Reverse Engineering and Manufacturing Tight Tolerance Hardware

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The Virtual Targets Center provides weapon system developers, testers, evaluators and trainers with target geometries and simulation model inputs of variable resolution in multi-spectral domains, to answer the life-cycle simulation needs in support of the soldier.

This presentation was given at the Capture 3D Innovation Users Conference in 2014.  To receive a copy of the entire presentation, please fill out the form below or email .

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Tuesday, August 21, 2007

So close, yet so far...

Have you ever solved a Rubik's cube? Some 5 or 6 moves prior to arriving at the solution, it still looks like a mess.

I think--but perhaps this is a thought shared by all cognitive scientists--that we're some 5 or 6 steps towards solving the big problem in Cognitive Science. Like the Rubik's cube, it all looks like a mess now, though we do have huge amounts of knowledge in the neurosciences, linguistics, computer science, philosophy and psychology. However, central organizing principles that may cogently explain how humans can use language, imagine impossible events such as anything beyond one's light cone, play chess or go, have low-level vision and high-level conceptual imagery, or even conceive of something like continental drift or a light cone. How can a brain do so much that's so varied?

A term that many brain scientists usually use is "functional areas", to demarcate that here goes vision, there goes grammar, in that other area we find touch, and so on. This perspective, perhaps, has been a problem on the way to progress. Others may have been the view that the brain is a computer; the empirical dependence on static patterns, the separation between low-level perception and high-level conceptual research, the encapsulation of analogy as a tangential issue, and the lack attention to feedback mechanisms. These are the topics of the PhD seminar starting this week. To some of those we have, I think, a satisfactory solution, as Steve Jobs would say, "available, today".

But to others we have only glimpses and glances of what they look like. If the scientific challenges are met, the technological and business opportunities will be huge. I see the scenery today as in the days of pre-TCP-IP, in which a bunch of guys were daydreaming about a network in which the physical medium would not be important at all, and any point in the network--any point--could be disrupted and the network would not be affected. A basic breakthrough like TCP-IP brings forth hordes of technological advances, and this is the role Cognitive Science may play in the coming decades.

The operating system has been the major platform in the computer industry, at least up until SUN came up with a vision of (pre-web2.0) ideas. Now we're shifting technology to a "new operating system", based not on multi-threading or task scheduling or windowing, but an architecture of community interaction, interoperability between people and computer systems and devices (like your cell phone). Blah blah blah; this is history, right? But what's about to come may be even bigger. Now that we have the whole world connected, and hordes of information available, if a true absolute cognitive technology comes forth, huge sweeping changes will come with it.

I feel that we're in the pre-TCP-IP era of cognitive technology. The net, of course, turbocharges cognitive technology, as it turbocharges globalization, and many other things. But if we suddenly turn this Rubik's cube in the right way for a few more moves, we may just stumble into something really groundbreaking. Discover the missing gaps in our understanding of the mind, and you'll have the ultimate operating system in your hands. I'm betting my career on it; and I plan to do it in all ways: by teaching and writing scientific papers, by programming and designing and striving to see the minute technical details and the big picture, by discussing within the Club of Rome's forums the importance and magnitude of what's happening, by building other, perhaps for-profit, organizations to develop these models, by declaring "friendly war" with Mr. Hawkins, and by having entrepreneurs randomly jumping into my classes to see what they're all about.

Probably I won't touch these untold riches, probably it won't be me who'll turn Rubik's cube the right way, and maybe I won't even live to see this happen, but in any case I'll be glad to help those with enough energy and intelligence to jump into one of the deepest, world-altering, questions of science and technology ever to be found.


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Tuesday, March 31, 2009

America is under hyperinflation

Ok, I am going to stick my neck on the economic scenario after a looong time.

In 1998, Russia had 8 billion US bucks in reserves. Now it has something like 500 billion.

A decade ago, China's reserves were a minute fraction of the what, 2 Trillion, they hold now? Nobody knows what the Arabs really hold. China and Brazil are at all time records of USD reserves.

Instead of thinking about a "housing bubble", why not think about a "manifestation of hyperinflation in house prices"?

There is scarce talk of hyperinflation in the econblogosphere, but to me it is the real basic phenomenon going on here. The USD has become a ponzi scheme, and by definition a ponzi scheme is NOT a ponzi scheme, until it is one.

Of course, the inflation indexes are all fine and dandy. But that's because of other forces. That's because (i) global supply chains have become leaner and meaner; (ii) wal-mart and china and india et al have brought prices and wages down over the last decade.

Needless to mention, while the deficits are gargantuan, the US keeps printing money like there's no tomorrow.

Does anyone expect China to hold 10 Trillion? Or Brazil to hold 1 Trillion?

Hopefully I'm missing something. But if these are all signs of hyperinflation going on right now, a global panic is about to set in.

For your entertainment pleasures after this very cheering post, here's a new iPhone app for you to enjoy the DOW jones. Have a nice day.


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View Full Version : Southern Cali Comps. or Meets.

09-15-2004, 02:19 AM
wats going on guys. i was wondering does anyone know about any car audio competitions in the orange county area? it doesnt have to be a comp it could be a car show or a meeting. thanks alot i would really like to attend 1. just for refrenecne i live next to disney land in anaheim.

09-15-2004, 06:33 PM
we will be having NSPL shows on oct. 2nd @ big papa's grill in moreno valley, and oct10th @the Audio Shop in Whittier for more info e-mail me at [email protected]


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Download PDF for Winter 2015
Agricultural Policy Review home

Ag Supplies for 2015

Chad Hart ( and Lee Schulz (

Markets are the mechanism that balance supply and demand for products. Over the course of the past year, we have discussed the demand patterns for agricultural products in the US and the factors that influence that demand. Now it’s time to look at the other half of the marketplace: agricultural product supplies. During the past couple of years, crop and livestock supplies have been moving in opposite directions. Crop supplies have grown as farmers have brought more land into corn and soybean production and weather conditions allowed record yields. Meanwhile, livestock supplies have shrunk as livestock producers reduced herds to control costs. However, changes are expected as we look forward. Stronger livestock prices have created incentives for increased livestock productions, and weaker crop prices normally spur a reduction in plantings.

Livestock Expansion

Table 1. Cattle Inventory by Class and Calf Crop
Table 1

Starting with cattle, USDA has released the much anticipated inventory of the US cattle herd as of January 1, 2015, and it comes as no surprise that the national cattle herd is on the build. The total number of cattle and calves is 89.8 million head, up 1.4 percent from a year ago. Beef cow numbers are up 2.1 percent. Nearly 5.8 million head of replacement beef heifers are destined to enter the national beef breeding herd, 4.1 percent more than 2014. Table 1 contains a summary of the US and Iowa cattle inventory.

Feeder cattle numbers have also increased from a year ago, although they are still at historically tight levels. The number of cattle on feed is currently 13.09 million, up 0.6 percent from a year ago. Increases in feedlot inventories can be attributed to cattle being fed longer and sold at higher weights as feedlots try to offset the high price they paid for feeder cattle with relatively low cost gain.

Figure 1. Heifers Held for Beef Cow Replacement, January 1, U.S.
Figure 1

Beef cattle heifer retention is on the rise with nearly 4.1 percent more than last year’s inventory, the largest year over year increase since 1994 (Figure 1). This is the fourth year in a row that heifer retention has increased. Perhaps one of the most notable things about the report was that the inventory of beef replacement heifers as a percent of the beef cow herd, at 19.5 percent, was the largest in the history of the data, including the large expansionary phase experienced in the early 1990s. This suggests cattlemen have added youth to their breeding herd, which could even further spur growth in this expansionary phase. The number of beef heifers expected to calve in the coming year is up 7.3 percent. That suggests a rapid expansion of the calf crop.

In short, the beef industry is currently at a hot point in the building of the beef cattle herd. The extraordinary prices paid for feeder calves over the past year has encouraged cow-calf producers to build their herds by both heifer retention and culling fewer mature cows. Heifer retention will continue to have an impact on feeder cattle availability, and the possibility of fewer imports of feeder cattle from Canada and Mexico could temper any chance of relief to tight feeder cattle numbers.

Switching to hogs, USDA’s December Hogs and Pigs report suggested expansion. The breeding herd inventory, at 5.969 million head, was up 3.7 percent compared to one year ago. This is the largest breeding herd inventory since June 2009. Sow utilization was higher than 2013 and approaching the 2008–12 average (49.9 percent). With breeding herd inventories and sow utilization trending higher, many factors indicate expansion in the hog industry.

Pig crop variability is an additional factor that influences hog supplies. Both farrowing levels (number of litters) and farrowing performance (pigs saved per litter) determine pig crops. The September-November pigs saved per litter estimate, at 10.23 pigs, was up 0.7 percent compared to a year ago and indicates a return to a more “normal” productivity level. The September-November sows farrowing, at 2.871 million head, was up 3.3 percent. Thus netting a 4.0 percent increase in the September-November pig crop compared to a year ago.

Table 2. USDA NASS Quarterly Hogs and Pigs Report Summary
Table 2

Table 2 provides a summary of the December 1, 2014 hogs and pigs estimates for the United States and Iowa. The US total hogs and pigs inventory, at 66.050 million head, was 2.0 percent above a year ago. The total market hog inventory was up 1.8 percent and the breeding herd inventory was up 3.7 percent. The Iowa total hogs and pigs inventory was 3.5 percent above a year ago. The total market hog inventory was up 3.4 percent and the breeding herd inventory was up 4.1 percent.

Where the cattle expansion seems to have begun in earnest, the hog expansion has been under way for some time and looks to continue through 2015. Farrowing intentions point to a robust expansion, with increasing numbers of hogs reaching market weight in the latter half of 2015. Where growth in the hog sector was limited last year by disease pressures, those pressures have decreased and the hog herd is definitely back on the rise.

Crops May Fail to Contract

Where the livestock sectors are looking to increase supplies, the crop markets are hoping for a little supply reduction. The 2014 crop year was a record breaker. Both the corn and soybean crops set national yield and production records. The corn crop topped 14.2 billion bushels. Meanwhile, the soybean crop nearly reached 4 billion bushels. Those large crops have overwhelmed demand and lowered crop prices to five-year lows.

Typically, when crop prices fall, planted acreage the next year retreats as well. However, much of the chatter in the crop markets this winter has been more about shifting land among crops as opposed to removing land from production. Last year, US producers planted 90.6 million acres to corn and 83.7 million acres to soybeans. Combined, corn and soybeans account for over 170 million acres across the country. The general outlook for 2015 is that the same amount of acres will be planted to corn and soybeans, with some movement from corn to soybeans.

If corn moves down to say 88 million acres, then given USDA’s 2015 trend yield of 167.2 bushels per acre, corn production would approach 13.5 billion bushels. That would be down significantly from 2014, but still one of the largest corn crops the US has ever grown. Some early weather projections for the 2015 growing season suggest yields could be slightly better than trend. If so, that just adds to the projected corn supplies.

While corn may lose some acreage, soybeans will likely gain them. If soybean plantings increase to 86 million acres, then given USDA’s 2015 trend yield of 46 bushels per acre, soybean production would stay around 3.9 billion bushels. With good growing conditions, a 4 billion bushel soybean crop is not out of the question, continuing the potential for massive supplies in the corn and soybean markets.

In summary, the supply outlook across the Iowa agriculture complex is for increasing livestock production and steady to slightly decreasing crop production. These shifts follow from the price movements each sector has experienced over the past year. Livestock profitability has returned, incentivizing herd expansion, and crop profitability has declined substantially, which is beginning to drag on acreage. However, the acreage reduction may not be large enough to improve the market situation quickly.


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Cardinal Capital Management, Inc. (Cardinal Capital) and Astar Capital Management (Astar Capital) are sister companies driven by complementary missions under the same ownership. Together, Cardinal Capital and Astar Capital have acquired, developed, and rehabbed over 8,500 units of multifamily housing with a transaction value exceeding $500 million in assets. Our projects have received numerous local, state, and national awards.

Cardinal Capital Management

Since its establishment in 2004, Cardinal Capital has gained a national reputation as an industry leader in acquiring, developing, financing, and managing multifamily housing. The company's principals, Erich Schwenker and Dan O'Connell, each have over 40 years of real estate investment and management experience. Our development, construction, property management, and real estate asset management divisions achieve high success rates for all of the properties in our portfolio, which include market rate housing, supportive housing for veterans and for persons recovering from mental illness, persons with hearing or vision loss, and homeless people.

We have successfully invested over $140 million in private equity for some of the largest investment entities in the country. Firms such as Boston Capital, Royal Bank of Canada, Richman Group, Redstone, and BMO Harris all trust us for skilled real estate closing, financial management, and property management.

Astar Capital Management

Founded in 2002, Astar Capital serves one client: Wisconsin Housing Preservation Corporation (WHPC), an organization that works to sustain affordable housing in the state of Wisconsin. To date, WHPC and Astar Capital have preserved 7,133 units in 124 projects across Wisconsin. Our method of purchasing both Section 8 and Section 42 properties and rehabbing them with tenants in place allows us to maintain tenants' Section 8 contracts and secure housing for Wisconsin citizens. Astar Capital, working on behalf of WHPC, achieved an "A+" rating for WHPC from Standard & Poor's in December 2013. WHPC is the first social housing provider outside of a public housing provider in the United States to attain an "A+" rating. The S&P rating further validates WHPC's status as a strong enterprise and sound financial institution.

Cardinal Capital and Astar Capital are committed to delivering superior financial and social value to investors, our for-profit and non-profit partners, and the communities in which our projects are located. We value maintaining long standing relationships with all of our clients and actively seek partnerships that result in meaningful projects.


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Dumpster Diving Doesn’t Actually Mean You Must Dive In The Dumpster.

Tips On How To Save A Lot More With Coupons!

With prices rising and budgets shrinking, everyone can use a bit of help. With coupons, you can save more of your hard earned money and stretch your budget further. There are tips below that can help you use coupons whenever you shop and save you money.

Be aware of the specific coupon policies for any store you decide to visit. Do they ever double coupons? Are Internet printed coupons acceptable? What about competitor ads? Knowing the policy will let you know if you can save with the coupons at the store.

You shouldn’t simply use coupons as soon as you obtain them. Provided your coupons don’t expire, it’s a great idea to hold onto them until you can make use of them during a sale on the same items for which they offer savings. This makes the item you desire much cheaper and occasionally almost free!

Always use your coupons when making a grocery list. You will also want to keep your coupons handy so that you can check the item off the list and make sure you have the coupon to go along with it. Keep tabs on what you’re buying, how much of it you’re buying, and which coupons you’re using.

Bring all of your coupons along for the shopping trip, even if you have no plans to use them. You can commonly find in-store-only sale items that are such a great bargain with a coupon, that having the coupons readily available is prudent.

Decide to give yourself some time to find coupons once a week. You’ll be able to work with coupons more efficiently this way. You are always free to clip a particular coupon if you run across a deal. However, utilize one day each week to browse the print coupons and online sites.

Internet forums are a great source for discovering great offers. The Internet has many sites that will put up coupons for you to save money. Forums are great for finding coupons because you can see which ones work from comments of other users. You can also print out these coupons to use in your favorite stores.

Before you cut out any coupons shop for a bit, then cut out the coupons that match what you are buying. You may find that in order to save a lot, you would have to visit many stores instead of just one.

Use the coupons you have in tandem with the sales at your local grocery store. This will help you in maximizing your savings. Most coupons are good for at least 3 months, so save your coupons until the next sale. This can help you to reduce your grocery bill by as much as 90 percent, so it is worth your while.

Many people find coupons confusing, and that is because there is a bit of a learning curve with how to use them best. Once you’ve got it all figured out, you will wonder how you ever got by without them! Start figuring out where to find coupons that you can use to save money.

Awesome Coupon Tips You Need To Check Out

Coupons can help you save large amounts of money, which quickly adds up. Many people underestimate the amount of money they can save with coupons, so they spend more than they need when they shop. You are sure to save money by following the advice found in this article. Keep reading to ensure that you have the same opportunity for serious savings.

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You can find coupons in lots of different places. For example, often the Sunday paper will have coupon flyers. You can find coupons in a wide range of destinations. Check out your Sunday paper, different websites, and even create email alerts for them. When you create an email alert, you will be notified every time new coupons appear online.

Stores are extremely competitive with each other, so use this to your advantage. Coupons that one store takes may be honored by a store that they compete with. This means that you will not have to go from one store to another to save money. You can easily wipe out your coupon savings in wasted time and fuel.

Sign up for an online forum that lists deals. In these forums, you can find many postings on coupons that you can use to save money. Besides connecting you directly to great coupons, these forums will also let you swap information on whether or not a particular coupon is a good bargain or whether or not the coupon / code in question worked.

If you are eager and desperate in your coupon search, take advantage of the coupons that are tossed into the dumpster. Dumpster diving doesn’t actually mean you must dive in the dumpster. Just put on some gloves and rummage through the newspapers to discover some coupons. Many people simply throw coupons away.

Do not spend too much time couponing. It is easy to let the coupon quest take up a big chink of your free time. Look at the time you are spending and the money you are saving to make sure it’s worth it.

In some stores you can double up or even triple up your coupons. If you happen to be a coupon novice, just make a few inquiries about which local stores offer such deals. You can get this information from co-workers, friends, or even family.

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In conclusion, when using coupons properly, you will save tons of money. You can save a lot of money for your family if you use the information in this article so you can apply it to coupon shopping.

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Caregiving Looks Different For Everyone

If you spend any part of your time taking care of your elderly parents, you are a caregiver.  Each family is different, and each family needs to find its own way of balancing needs, talents, and resources.

Some of the different forms caregiving may take include:

  • Checking on your parents to see how they’re managing, running errands for them, and taking them to doctors.
  • Locating people and services to provide additional help in order to allow your parents to remain in their own homes.
  • Finding assisted living and monitoring care.
  • Finding a  skilled nursing facility and monitoring care.
  • Providing care in your own home.

Coaching helps a caregiver:

  • Maintain dignity and respect for your parents.
  • Arrange a safe living situation.
  • Find medical and legal support.
  • Locate community resources.
  • Handle financial issues.
  • Hold honest and sometimes tough conversations with your parents.
  • Coordinate with the rest of your family and ask for help.
  • Cope with situations that change, often rapidly.
  • Set boundaries and maintain a fulfilling life for yourself.
  • Find emotional support and understanding.
  • See opportunities for personal growth and healing.