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 veryhotthread  Author  Topic: Stuff & Nonsense  (Read 16173 times)
ZETAR
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GREAT SPIRITS ALWAYS ENCOUNTER THE MOST VIOLENT OPPOSITION FROM MEDIOCRE MINDS E=MC2


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xx Re: Stuff & Nonsense
« Reply #11610 on: Oct 23rd, 2014, 07:26am »


Straight-away the ideas flow in upon me, directly from God, and not only do I see distinct themes in my mind's eye, but they are clothed in the right forms, harmonies, and orchestration.

If there is anyone here whom I have not insulted, I beg his pardon.

Johannes Brahms

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« Reply #11611 on: Oct 23rd, 2014, 08:51am »

GOOD MORNING Z AND UFOCASEBOOKERS cheesy


Reuters

Some U.S. hospitals weigh withholding care to Ebola patients

By Julie Steenhuysen and Sharon Begley
CHICAGO/NEW YORK
Wed Oct 22, 2014 7:16pm EDT

(Reuters) - The Ebola crisis is forcing the American healthcare system to consider the previously unthinkable: withholding some medical interventions because they are too dangerous to doctors and nurses and unlikely to help a patient.

U.S. hospitals have over the years come under criticism for undertaking measures that prolong dying rather than improve patients' quality of life.

But the care of the first Ebola patient diagnosed in the United States, who received dialysis and intubation and infected two nurses caring for him, is spurring hospitals and medical associations to develop the first guidelines for what can reasonably be done and what should be withheld.

Officials from at least three hospital systems interviewed by Reuters said they were considering whether to withhold individual procedures or leave it up to individual doctors to determine whether an intervention would be performed.

Ethics experts say they are also fielding more calls from doctors asking what their professional obligations are to patients if healthcare workers could be at risk.

U.S. health officials meanwhile are trying to establish a network of about 20 hospitals nationwide that would be fully equipped to handle all aspects of Ebola care.

Their concern is that poorly trained or poorly equipped hospitals that perform invasive procedures will expose staff to bodily fluids of a patient when they are most infectious. The U.S. Centers for Disease Control and Prevention is working with kidney specialists on clinical guidelines for delivering dialysis to Ebola patients. The recommendations could come as early as this week.

The possibility of withholding care represents a departure from the "do everything" philosophy in most American hospitals and a return to a view that held sway a century ago, when doctors were at greater risk of becoming infected by treating dying patients.

"This is another example of how this 21st century viral threat has pulled us back into the 19th century," said medical historian Dr. Howard Markel of the University of Michigan.

Some ethicists and physicians take issue with the shift.

Because the world has almost no experience treating Ebola patients in state-of-the-art facilities rather than the rudimentary ones in Africa, there are no reliable data on when someone truly is beyond help, whether dialysis can make the difference between life and death, or even whether cardiopulmonary resuscitation (CPR) can be done safely with proper protective equipment and protocols.

Such procedures "may have diminishing effectiveness as the severity of the disease increases, but we simply have no data on that," said Dr. G. Kevin Donovan, director of the bioethics center at Georgetown University.

Donovan said he had received inquiries from fellow physicians about whether hospitals should draw up lists of procedures that would not be performed on an Ebola patient. "To have a blanket refusal to offer these procedures is not ethically acceptable,” he said he told the doctors.

NEW GUIDELINES

Nevertheless, discussions about adopting policies to withhold care in Ebola cases are under way at places like Geisinger Health System, which operates hospitals in Pennsylvania, and Intermountain Healthcare, which runs facilities in Utah, according to their spokesmen.

Dr Nancy Kass, a bioethicist at Johns Hopkins Bloomberg School of Public Health, said healthcare workers should not hesitate to perform a medically necessary procedure so long as they have robust personal protective gear.

So far, only two U.S. hospitals have used kidney dialysis: Texas Health Presbyterian Dallas, which treated Liberian patient Thomas Duncan and where two nurses became infected, and Emory University Hospital in Atlanta, which has treated four Ebola patients at its biocontainment unit without any healthcare workers becoming infected.

Although it is not yet clear how the Dallas nurses became infected, health officials have questioned both the lack of adequate training in the use of protective gear and the decision to perform invasive procedures.

The American Society of Nephrology and CDC are now working on new dialysis guidelines for Ebola patients, whose kidneys often fail. In some cases, dialysis can help a patient get through the worst of the illness until their own immune system can fend off the virus.

Nephrologist Dr. Harold Franch said the new guidelines will consider both whether the procedure is medically necessary and whether the hospital can do it safely.

"Most academic medical centers and many good private tertiary care hospitals will be able to do this," he said. Yet he thinks many hospitals may not offer the service, since “it takes a lot of money and time to train people.”

TREAT, OR FLEE?

Throughout the history of medicine some doctors have declined to treat infectious patients or fled epidemics, said Michigan's Markel. Greek physician and philosopher Galen fled Rome during the bubonic plague 1,800 years ago, doctors deserted European cities stricken by the Black Death of the Middle Ages, and some health workers refused to treat HIV/AIDS patients in the 1980s.

"The idea that a doctor would stick to his post to the last during an epidemic, that's not part of the Hippocratic Oath," Markel said. "If you feel your life is at risk you don't have to stay and provide care."

At University of Chicago Medicine, questions of taking last-ditch measures were discussed early in the hospital's Ebola planning, said Dr. Emily Landon, a bioethicist and epidemiologist.

Decisions about offering services such as dialysis or inserting a breathing tube are made in advance by the hospital's care team in consultation with patients. But if a doctor on the team feels in the moment that she cannot provide the service, another may step in and do the procedure.

Landon views dialysis as a "no brainer" for Ebola patients, and believes the risks are fairly low to the well-trained nursing staff who have volunteered for the hospital's isolation ward.

But putting in a breathing tube and putting them on a ventilator is more controversial.

"We have very little experience with that except for Mr Duncan, who didn't do well," she said. The hospital plans to consult with patients before the need arises and plans to insert a breathing tube at the earliest sign that it might be needed.

CPR, which is performed when a patient's breathing or heart stops, also poses risks. It can involve chest compressions, inserting breathing tubes and other invasive procedures.

If a patient goes into cardiac or respiratory arrest, a team would have to don protective gear. Rushing could leave them without proper protection, but a delay could make the procedure ineffective.

That represents too great a risk for caregivers for what could be "a futile act," said Dr. Joseph Fins, chief of medical ethics at Weill Cornell Medical College in New York City.


(Editing by Michele Gershberg and Ross Colvin)

http://www.reuters.com/article/2014/10/22/us-health-ebola-usa-interventions-idUSKCN0IB2OM20141022

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« Reply #11612 on: Oct 23rd, 2014, 08:58am »

Scientific American

U.S. Suspends Risky Disease Research

The government will cease funding "gain-of-function" studies that make viruses more dangerous

October 23, 2014
By Sara Reardon and Nature magazine

The US government surprised many researchers on October 17 when it announced that it will temporarily stop funding new research that makes certain viruses more deadly or transmissible. The White House Office of Science and Technology Policy is also asking researchers who conduct such ‘gain-of-function’ experiments on influenza, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) to stop their work until a risk assessment is completed — leaving many unsure of how to proceed.

“I think it’s really excellent news,” says Marc Lipsitch, an epidemiologist at the Harvard School of Public Health in Boston, Massachusetts, who has long called for more oversight for gain-of-function research. “I think it’s common sense to deliberate before you act.”

Critics of such work argue that it is unnecessarily dangerous and risks accidentally releasing viruses with pandemic potential — such as an engineered H5N1 influenza virus that easily spreads between ferrets breathing the same air. In 2012, such concerns prompted a global group of flu researchers to halt gain-of-function experiments for a year (see Nature http://doi.org/wgx; 2012). The debate reignited in July, after a series of lab accidents involving mishandled pathogens at the US Centers for Disease Control and Prevention in Atlanta, Georgia.

The White House’s abrupt move seems to be a response to renewed lobbying by gain-of-function critics who wanted such work suspended and others who sought to evaluate its risks and benefits without disrupting existing research.

Arturo Casadevall, a microbiologist at the Albert Einstein College of Medicine in New York City, calls the plan “a knee-jerk reaction”. “There is really no evidence that these experiments are in fact such high risk,” he says. “A lot of them are being done by very respectable labs, with lots of precautions in place.”

Some researchers are confused by the moratorium’s wording. Viruses are always mutating, and Casadevall says that it is difficult to determine how much mutation deliberately created by scientists might be “reasonably anticipated” to make a virus more dangerous — the point at which the White House states research must stop. The government says that this point will be determined for individual grants in discussions between funding officers and researchers.

One of the most prominent laboratories conducting gain-of-function studies is run by Yoshihiro Kawaoka, a flu researcher at the University of Wisconsin–Madison. In 2012, Kawaoka published a controversial paper reporting airborne transmission of engineered H5N1 flu between ferrets. He has since created an H1N1 flu virus using genes similar to those from the 1918 pandemic strain, to show how such a dangerous flu could emerge. The engineered H1N1 was transmissible in mammals and much more harmful than the natural strain.

Kawaoka says that he plans to comply with the White House directive to halt current research once he understands which of his projects it affects. “I hope that the issues can be discussed openly and constructively so that important research will not be delayed indefinitely,” he says.

But it seems that the freeze could be lengthy. The White House says that it will wait for recommendations from the US National Science Advisory Board for Biosecurity (NSABB) and the National Research Council before deciding whether and how to lift the ban. The groups are expected to finish their work within a year. As Nature went to press, the NSABB was set to convene on October 22, its first meeting in two years. Lipsitch, who will speak at the event, says that he will advocate for the development of an objective risk-assessment tool to evaluate individual research projects. In particular, he says, decision-makers should consider whether a gain-of-function study makes a contribution to a public-health goal, such as the prevention and treatment of flu, that could justify both the risk and the use of money that could be spent on safer research.

“There clearly are going to be instances where gain-of-function research is necessary and appropriate, and there are others where the opposite applies,” says Ian Lipkin, a virologist at Columbia University in New York City. The need to understand the ongoing Ebola outbreak in West Africa and control its spread, for instance, emphasizes the importance of infectious-disease research — as well as the regulation of such work, Lipkin says. Although public worry about Ebola being transferred through the air is unfounded, researchers could make a case for the need to determine how the virus could evolve in nature by engineering a more dangerous version in the lab. “I think we should have some sort of guidelines in place before such experiments are even proposed,” says Lipkin. Yet Ebola is not included in the White House’s research-funding ban, and a spokesperson says that there are no plans to include it on the list.

One thing is certain, says Casadevall: the NSABB meeting is certain to see heated debate as scientists from all sides convene. “I hope they have enough room,” he adds.

http://www.scientificamerican.com/article/u-s-suspends-risky-disease-research/

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xx Re: Stuff & Nonsense
« Reply #11613 on: Oct 23rd, 2014, 3:01pm »

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xx Re: Stuff & Nonsense
« Reply #11614 on: Oct 23rd, 2014, 6:04pm »

All you old hippies This one for you ..Luv yas.




this pic has disappeared twice since posted.. cool
« Last Edit: Oct 23rd, 2014, 8:29pm by GForce » User IP Logged

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xx Re: Stuff & Nonsense
« Reply #11615 on: Oct 23rd, 2014, 6:44pm »

REST IN PEACE NATHAN CIRILLO





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xx Re: Stuff & Nonsense
« Reply #11616 on: Oct 23rd, 2014, 6:57pm »

on Oct 23rd, 2014, 6:04pm, Sysconfig wrote:
All you old hippies This one for you ..Luv yas.




Hey Sys

Luv yas back grin

Someone said the Zappa post is showing malware so I'm going to delete that part. No offense meant.

Crystal


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« Reply #11617 on: Oct 23rd, 2014, 6:59pm »

on Oct 23rd, 2014, 6:44pm, Sysconfig wrote:
REST IN PEACE NATHAN CIRILLO







Bless his soul. r.i.p.

Prayers going up for his family and friends.

Crystal


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xx Re: Stuff & Nonsense
« Reply #11618 on: Oct 23rd, 2014, 7:04pm »

on Oct 23rd, 2014, 6:59pm, WingsofCrystal wrote:
Bless his soul. r.i.p.

Prayers going up for his family and friends.

Crystal




THERE GOES MY SON BUT FOR THE GRACE OF GOD..
NATHAN CIRILLO..A NAME A FACE A LIFE A LIGHT
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Sgt. Major of the Deadly,Evil, Reptilian Hunters of America


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xx Re: Stuff & Nonsense
« Reply #11619 on: Oct 23rd, 2014, 7:38pm »

Posted in a Canadian News paper!
RIP

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De Opresso Libre! I Have Been many Men, In Many Times, I Shall Be Again!
\"The real destroyer of the liberties of the people is he who spreads among them bounties, donations and benefits.\"
Plutarch



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« Reply #11620 on: Oct 23rd, 2014, 7:43pm »

This photo of Nathan was taken last week. A young visitor to Ottawa asked him to pose with her.


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« Reply #11621 on: Oct 23rd, 2014, 7:44pm »

on Oct 23rd, 2014, 7:38pm, LoneGunMan wrote:
Posted in a Canadian News paper!
RIP

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That breaks my heart. He was only 24 years old.

Crystal





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xx Re: Stuff & Nonsense
« Reply #11622 on: Oct 23rd, 2014, 8:29pm »

on Oct 23rd, 2014, 6:04pm, Sysconfig wrote:
All you old hippies This one for you ..Luv yas.




this pic has disappeared twice since posted.. cool


Sys_, The photo was reported as containing Malware!!!
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« Reply #11623 on: Oct 23rd, 2014, 8:40pm »

zerohedge it was a screenshot uploaded to photobucket who just completed maintenance yesterday..its not a downloaded pic..
that is very strange Ran Rkill and malware ..iobit the full paid version after..nothing..
shocked
1 vrus low level speci to to google chrome a pup flle delete sptool.dll
j check to see if you have that
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GREAT SPIRITS ALWAYS ENCOUNTER THE MOST VIOLENT OPPOSITION FROM MEDIOCRE MINDS E=MC2


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« Reply #11624 on: Oct 23rd, 2014, 9:18pm »

CRYSTAL,

I AGREE ~ TRAGIC!

PRESENT...ARMS

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WHEN IMAGES SUFFICE!

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SHALOM...Z
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