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Northridge Hospital Gives Parents Another Option

When Debbie Koslowsky's 6 year old son Alex was too sick to go to school, she would bring him to work to lie on the floor of her office at the West Valley YMCA in Reseda, or she would stay home with him.

Since Northridge Hospital Medical Center opened its Kids Care program for mildly sick children, she has another option, which she has used twice in the past six weeks, when Alex had two cases of strep throat.

"The last time Alex was there, I was wondering if he could also have an ear infection. The doctor checked Alex at no charge, which not only saved me the trouble and the $44 cost of going to the pediatrician after work, but I knew that if he had had a problem, I would have known about it early in the day," said Koslowsky, 38, a physical education director.

The Northridge Kids Care program, open since November, is set up to care for mildly sick children, from 6 weeks to 15 years old, 24 hours a day, at a cost of $3.25 per hour, or $2.75 for hospital employees.

The program, which operates as an outpatient service under Northridge's hospital license, "does not accept children for Kids Care who have chicken pox, lice, measles or high temperatures that are not responding to Tylenol," said Cindy Albright, a registered nurse and coordinator for Kids Care. Parents do not have to call ahead to say they are bringing a child in, but it is encouraged, and pre registration forms that include the child's medical history help speed the 10 minute registration process.

One hospital staff nursing assistant is assigned to care for every four children. Registered nurses oversee the care and give the necessary Hermes bag copy medications, either over the counter drugs or medications already prescribed for the child. Physicians from the hospital's UCLA Family Residency Program examine the children each morning and notify parents if they find medical problems that they think need more evaluation.

The Kids Care facilities, in the pediatric wing on the fifth floor of the hospital, are divided into bag Hermes fake a quiet room, a crafts room and a kitchen. Most children become involved in crafts, directed by a part time child activities coordinator, or take the video route, playing an ever popular Nintendo game or watching TV and videotapes. Some bring their own treasured blankets, backpacks, books, dolls or other toys.

Carrie Reitz, 12, was recently at Kids Care after a night of high fever and an upset stomach. Although Carrie was feeling better, her mother hesitated to let her go to school. The day she was at Kids Care, she played with the other three children there, who were from 1 to 8 years old.

Was it scary to come to a hospital for the day? "No," she said. "I wasn't real sure when I came in. There's a lot of things to do. You can read books, help the little kids color. . . . It's better than home."

Carrie's mother, Beverly, is a teacher at First Lutheran Pre School across the street from the hospital. "Parents who work tend to bring their children to the nursery school even if the children are not 100%," she said. She thinks that the hospital's program provides the added care and reassurance parents need to leave their children to go to work.

Started for Employees

According to Don Adams, administrator of Northridge Hospital, the Kids Care program was started largely to attract and fake Hermes Kelly handbag retain hospital employees. Northridge Hospital and Valley Hospital Medical Center in Van Nuys, both owned by Hospital Corp. of America, employ a total of 1,600 people, Adams said. The center cares for an average of four or five children a day.

Two hermes replica bag Los Angeles hospitals California Medical Center and Orthopaedic Hospital have recently closed their sick child care programs. Another, at Torrance Memorial Medical Center, the model for Northridge's program, is going strong, caring for an average of five to 18 children a day.

Patsy Lane, child care coordinator for the city of Los Angeles, said closure of these programs may be because "it's hard for people to bring an ill child to a place that's relatively unfamiliar. It's a tough concept for parents to bring their children for day care to a health care facility."

Lane said the most successful sick child care programs have been in suburban areas, geographically and administratively connected to the sick child's regular day care or nursery school program. On a sick day, the child doesn't go to an entirely different place, just to a different room or wing at the same school. But she thinks that the license requirements for such programs mildly ill day care children are kept separate from hospital patients, and employees who care for the day care children do not also care for hospitalized children minimize the risks.
Aug 30 '17 · 0 comments
Word Wenches

Years published 164. Novels published 231. Novellas published 74. Range of story dates 9 centuries fake cartier love bracelet (1026 present). AWARDS WON: RWA RITA, RWA Honor Roll, RWA Top 10 Favorite, RT Lifetime Achievement, RT Living Legend, RT Reviewers Choice, Publishers Weekly Starred Reviews, Golden Leaf, Barclay Gold, ABA Notable Book, Historical Novels Review Editors Choice, AAR Best Romance, Smart Bitches Top 10, Kirkus Reviews Top 21, Library Journal Top 5, Publishers Weekly Top 5, Booklist Top 10, Booktopia Top 10, Golden Apple Award for Lifetime Achievement.

Nicola here. Today it is my very great pleasure to welcome Melinda Hammond back to the Word Wench blog. Today, however, we are chatting about her haunting timeslip novel Moonshadows, set in the Georgian period and the present day, originally published by Samhain and now re issued by Melinda herself.

I first read Moonshadows a number of years ago and found it a thought provoking read as well as a beautiful mix of the past and the present. In the interview below, Melinda mentions why she feels the story takes a different slant on the idea of the 18th century rake. The conflict at the heart of the story is strong and heartbreaking and (no spoilers!) tells of the ultimate price of getting what you wish for

Anne here. Since the loss of our beloved Jo, we wenches have been discussing who we would like join us in Word Wench bloggery. Amazingly because often making Word Wench decisions is a bit like trying to herd cats we were unanimous in our first choice. And when we asked her, we were thrilled when she said yes!

Her first blog will be on July 25th, and until then, we keeping her wrapped in mystery.

But here for your intrigue and entertainment is a quiz about her. Not that we tell you who won or what the answer is until the 24th July, but a prize for someone who makes a answer. get a pen and paper and note your answers, then click on the link at the bottom, and see how right you were or weren Then come back and make a guess about who you think the new Word Wench might be.

Mystery Wench Quiz: (and no, that not her below, it Greta Garbo in The Mysterious Lady)

by Mary Jo

Hi, there! Today we are lucky enough to welcome Karen Harper as a return guest. Karen has been writing even longer that I have , and she known for her versatility and superb research. She started out with historical romance and has since branched out into main stream historical, romantic thrillers (including contemporary Amish suspense), and historical mysteries. She isa winner of the Mary Higgins Clark award.

He most certainly was right on about the heroine of The Royal Nanny, Charlotte Bill, the Cockney woman who raised the children of King George V and Queen Mary, the current queen's grandparents.

Two of those six children became kings, and in a way, Charlotte, or 'Lala' as the children dubbed her, saved both of these boys. When she arrived in the royal household of the then Duke and Duchess of York, David (later King Edward VIII and Duke of Windsor) and Bertie (later King George VI) were being abused by their current nanny, who was later committed to an asylum. (Remember The King's Speech flashbacks where Bertie was ignored and starved? And why did the Duke of Windsor gravitate toward abusive, take charge women, including his beloved Wallis?)

Anne here, with Susanna Kearsley and dropping by celebrate our 10th anniversary with us. They also representative of international wenchdom, as Pam is from the UK and Susanna from Canada.

It's a thing about writing: so much of it needs to be done on your own in a room by yourself, shut away from distractions, that it would be easy to feel disconnectedif we didn't have this amazing community.

The first time I best replica cartier love bracelet reviews took my elder son to FanExpo here in in Toronto, he looked across the lines of people standing in their cosplay costumes waiting to get in, and said, "My people!" And I knew exactly how he felt. When I don't have to explain why I'd rather shut myself away with a pile of 18th century newspapers and a big pot of coffee than go to the mall. When I can say I've just surfaced from being in another time, and people understand. It's a wonderful feeling, to be understood.

It's in places like this one, with hosts like the Word Wenches, that we're all able to find one another. We cheer each other, teach each other, share our craft and learn in equal measure; and, as evidenced by this past week, we give each other comfort.

Back when I was gifted with my Honorary Word Wench title, on September 23 of 2009, this group was a mere three years old, and I only knew Nicola. then cartier fake mens ring diamond I've met nearly all of the Wenches, and from sharing an event with Joanna to sharing drinks and laughter with Anne, to having her and Mary Jo come and stand at my shoulder when I won my RITA, the Word Wenches really and truly are "My people". (Susanna first interview with the wenches is here.)

May they continue another ten years, and beyond that.

Susanna Kearsley

Susanna most recent publication is A Desperate Fortune Her website is here.

And now, here Hartshorne:

It is a great honour to be an Honorary Word Wench, especially when I spent so many years writing strictly contemporary romances for Mills Boon as Jessica Hart. But I have always been fascinated by the relationship between the past and the present, and in fact started writing to fund a PhD in medieval history (although I ended up as an early modernist) so my historical leanings have always been there.

Throughout the (very) many years it took me to complete that PhD, the question I was asked most often after 'Have you ever thought about writing a real book?', of course was whether I was going to use my research to write a historical romance. My answer was always 'no': I fretted about authenticity and how I could possibly get modern readers to identify with characters who thought and spoke and acted so differently in the past.
Aug 30 '17 · 0 comments
Pak briefs Hermes bag copy Diplomatic Corps in Islamabad on LoC tension

22:54 21 air raids slow IS advance near Kobane: US military: US led aircraft hammered Islamic State jihadists with 21 bombing raids near Kobane amid signs the strikes had Hermes Kelly bag fake "slowed" the group's advance on the Syrian border town, the American military said.

In one of the heaviest bombardments so far against the Sunni jihadists encircling Kobane yesterday and today, coalition air strikes "destroyed" two IS staging locations, a building, a truck, two vehicles, three compounds and damaged several other targets, it said.

22:53 J flood: General insurers submit status report to High Court: Insurance companies with huge exposure to flood hit J submitted their compliance reports to the Jammu and Kashmir (J High Court today.

"We have submitted our compliance report before the J High Court today in which we gave details of the number of claims we have already settled as well as the amounts paid against those claims so far," United Insurance Chairman and Managing Director Milind Kharat told PTI today without disclosing the total amount his company paid to claimants.

"We need to get Ebola under control in the near term so that it doesn't spread further and become a long term global health crisis that we end up fighting for decades at large scale, like HIV or polio. Mukherjee's 'The Lives Of Others', a sweeping account of life in 1960s Calcutta, is 5/2 favourite to win with bookmakers William Hill, making him the frontrunner for the coveted 50,000 pound prize to be presented by Camilla, Duchess of Cornwall, at a gala ceremony at London's Guildhall.

London based Mukherjee has been selected for his second novel published in May this year. The book is based in his birth place of Kolkata and centres around a dysfunctional Ghosh family in the 1960s and the secrets and rivalries within the family against a backdrop of political activism.

Mukerjee, who studied at Oxford and Cambridge Universities, reviews fiction for the 'Times' and the 'Sunday Telegraph' and his first novel, 'A Life Apart' was a joint winner of the Vodafone Crossword Award in India.

21:44 Bachchan appeals to all to contribute for Kashmir flood relief: Bollywood bag Hermes copy megastar Amitabh Bachchan today called on all the citizens of the country to show their support for Kashmir flood victims. Jammu and Kashmir was hit by heavy floods caused by torrential rains in September, which left at least 200 dead and thousands homeless.

Bachchan, while promoting a charity campaign 'HUM HAIN. Umeed e Kashmir' for the flood victims here, said, "As human beings and as Indians we need to do all that we can help our countrymen in need.

The plight of the people of Jammu and Kashmir has always been a matter of concern and the floods have only made it worse.

"All that we do simply won't be enough to meet the various challenges facing the people, but every drop counts. Hence we call on everyone in our country and from the world community to come forward and provide their support."

21:31 Bilawal Bhutto facing threats to life: Sindh govt: Pakistan People's Party chief Bilawal Bhutto Zardari is facing serious threats to his life from an outlawed militant group, a media report said today.

The government of Sindh has ordered law enforcement agencies "to ensure extreme vigilance" and take "special measures" to save Bilawal's life from Jundullah militant group, the Dawn reported.

The provincial government in what was intended as a confidential letter shared intelligence of a plan being made by the banned group to target the PPP chairperson. However, the leaked letter did not state the details regarding the date, time, place and method of the attack.

21:19 Prime Minister Narendra Modi's "man ki baat" address to the nation on October 3 on All India Radio (AIR) was listened by over 66 per cent of the people in six cities of the country. The survey was conducted randomly in Mumbai, Chennai, Ahmadabad, Bangalore, Bhopal and Trivandrum covering 100 listeners in each of these cities, said Director General of AIR F Sheharyar.

"It was found that 66.7 per cent of the people had listened to the PM's speech on AIR and they found it very useful," he said.

The transmission was also carried by several private TV channels and FM radios. Sheharyar also talked about AIR's plans to broadcast programmes which are run on medium wave on FM,l thus giving a new lease of life to the popular programmes aired on medium wave stations.

21:17 HC upholds former MLA Pappu Kalani's conviction in murder case: The Bombay high court today dismissed appeals filed by former Maharashtra MLA Suresh alias Pappu Kalani and three others against a sessions court verdict convicting them in a murder case.

The division bench of justices S C Dharmadhikari and Anil Menon dismissed the appeals, saying the court did not find anything perverse in the verdict convicting them for conspiracy and murder of Ghansham Bhatija. Bhatija was shot dead at Ulhasnagar in neighbouring Thane district on February 27, 1990.

His brother Inder bag Hermes fake Bhatija, who saw his brother being gunned down, was shot dead on April 28, 1990 despite having police protection. According to the police, the murders were fall out of a long standing political and criminal rivalry.

21:10 Actor Pawan Kalyan announces Rs 50 lakh for cyclone relief work: Telugu actor and founder president of Jana Sena Party Pawan Kalyan today announced Rs 50 lakh to the Chief Minister's relief fund for taking up relief operations in the aftermath of cyclone Hudhud in Andhra Pradesh.

"I am deeply anguished by the calamity that has swept through Vizag and North Andhra. The plight of lakhs of people who have been destabilised is unimaginable. My heart aches for them," Pawan Kalyan said in a release here.

"It is in times like these that we should step forward beyond parties and politics and come together as one force to overcome this calamity.

Even as all efforts are being made by the Central and State governments, as an individual I will be handing over Rs 50 lakh towards the CM Relief Fund," he added.

20:53 Statements in a blog are personal opinion which cannot be treated as an evidence, the Delhi High Court today said and dismissed a plea for a CBI probe into allegation by Justice (Rtd) Markandey Katju who had blogged that a former CJI had made "improper compromises" to favour a High Court judge despite adverse IB report against him.
Aug 30 '17 · 0 comments
Q Science and Innovation Minister Paul Goldsmith

It's been two months since Paul Goldsmith filled Steven Joyce's shoes as Science and Innovation Minister. Science reporter Jamie Morton spoke with him about the state of the sector and some of our scientists' big concerns.There are some people who think we can just sit back and benefit from all the scientific advances around the world, but it's important that we contribute as well.We do in Niwa and I'm pretty determined that we continue to build on that and strengthen that and fake hermes leather handbags likewise in environment and in geological things.We live in a place with earthquakes and volcanoes and we have an economy based on pastoral industries, so I'm [also] pretty determined that we build on our real strengths in those areas.What will be your relationship be with how much is a hermes handbag the Prime Minister's chief science advisor, Professor Sir Peter Gluckman?Well, a good close working relationship.I've already had several conversations with him.I've known him for many years, independently, and he's a very good man and a very high quality scientist and a broad thinker.So I'm very fortunate to have a wide range of advice coming in from the MBIE [Ministry of Business, Innovation and Employment] as the fake Hermes bag maintenance lead government agency, but also from Sir Peter, and also from the many, many people involved in the Crown research institutes and universities.But it will be a close relationship.Do you think R is growing at a replica hermes bags outlet fast enough rate, and do you identify with the philosophy of your predecessor, Steven Joyce, that it drives the economy?Like I say, investment in R is absolutely an important part of building a more productive and competitive economy, which is the broader goal that we have.It's not the only thing, of course. Investment, more generally, is fundamental.But certainly, over time, lifting the research intensity of our economy into higher value products is a good thing, and certainly, that's why the Government has substantially increased its investment in R to nearly $1.3 billion a year, this year, and we are aiming to get to $1.6 billion by 2020.
Aug 30 '17 · 0 comments
Phil Taylor wins first round match at Unibet Masters

Phil Taylor's last year on the PDC circuit began with victory over Michael Smith at the Unibet Masters, while Gary Anderson set up a clash with Raymond van Barneveld.

On Friday, Taylor reaffirmed what he had hinted at after his World Championship defeat to 'Barney' in December, that 2017 would be his last year on the circuit, with the 2018 World Championship being his last event.

The Power had admitted during the Worlds that he intended to just play the TV tournaments and the events that his ranking got him into during 2017, but confirmation of his impending retirement means the year will now become something of a farewell tour for the 16 time world champion

With the news out in the open, Taylor romped past Michael Smith, winning eight of the final 10 legs in Milton Keynes to seal a victory that sets up a quarter final date with third seed Peter Wright, who beat Ian White 10 5.

Unibet Masters First Round Friday's Results Dave Chisnall 5 10 Raymond van Barneveld Peter Taylor 10 6 Michael Smith Gary Anderson 10 3 Benito how much is a hermes handbag van de Pas Peter Wright 10 5 Ian White Saturday's Matches Mensur Suljovic 10 4 Jelle Klaasen James Wade 9 10 Robert Thornton Michael van Gerwen 10 6 Simon Whitlock Adrian Lewis 10 6 Kim Huybrechts

Taylor was delighted with his display and is looking forward to enjoying his final year on the circuit:

"I think I'm more excited now and I've got butterflies, whereas I didn't have that before. Perhaps that will do me good," he said.

Peter Wright will be up next for Taylor (Picture: Lawrence Lustig/PDC)

"This is a brilliant start. copy hermes bags I've got new darts and they were going lovely. I missed a few doubles and I went 4 2 down and clambered back to five each, and then I had a chance and double seven was lovely tonight."

World number two Gary Anderson produced the most impressive performance of the opening night, averaging almost 110 in a 10 3 demolition of Masters debutant Benito van de Pas.

Van de Pas weathered an early barrage from Anderson to land an 11 darter as he stayed in touch at 3 2, but the two time world champion reeled off the next five legs without reply before bettering the Dutchman's 128 fake hermes leather handbags checkout with a 142 finish to wrap up the win.

"I've had two weeks off since the World Championship without throwing a dart and it's worked," said Anderson.

"I've had a break and it's been great. I've enjoyed the couple of weeks back at home but I've got my head back on now and we'll see what happens."

Up next for Anderson is Van Barneveld, who came from 2 0 down to defeat Dave Chisnall 10 5, winning seven straight legs to take charge of the game in mid match.

Raymond van Barneveld also booked his place in the last eight (Picture: Lawrence Lustig/PDC)

"Dave let me in with some missed doubles but I played really well in the middle of the match," said Van Barneveld.

Reigning champion and world champion Michael van Gerwen began with victory over Simon Whitlock and he was joined in the last eight by Robert Thornton, Adrian Lewis and Mensur Suljovic from the evening session's final first round matches.

The tournament concludes with Sunday's replica hermes bags outlet quarter final, semi final and final.

Unibet Masters Quarter Final Draw Sunday Phil Taylor v Peter Wright Gary Anderson v Raymond van Barneveld Robert Thornton v Adrian Lewis Michael van Gerwen v Mensur Suljovic
Aug 30 '17 · 0 comments
Pioglitazone use and risk of bladder cancer

AbstractObjectiveTo determine whether pioglitazone compared with other antidiabetic drugs is associated with an increased risk of bladder cancer in people with type 2 diabetes.ParticipantsA cohort of 145806 patients newly treated with antidiabetic drugs between 1 January 2000 and 31 July 2013, with follow up until 31 July 2014.Main outcome measuresThe use of pioglitazone was treated as a time varying variable, with use lagged by one year for latency purposes. Cox proportional hazards models were used to estimate adjusted hazard ratios with 95% confidence intervals of incident bladder cancer associated with pioglitazone overall and by both cumulative duration of use and cumulative dose. Similar analyses were conducted for rosiglitazone, a thiazolidinedione not previously associated with an increased risk of bladder cancer.ResultsThe cohort generated 689616 person years of follow up, during which 622 patients were newly diagnosed as having bladder cancer (crude incidence 90.2 per 100000 person years). Compared with other antidiabetic drugs, pioglitazone was associated with an increased risk of bladder cancer (121.0 v 88.9 per 100000 person years; hazard ratio 1.63, 95% confidence interval 1.22 to 2.19). Conversely, rosiglitazone was not associated with an increased risk of bladder cancer (86.2 v 88.9 per 100000 person years; 1.10, 0.83 to 1.47). Duration response and dose response relations brown hermes belt replica were observed for pioglitazone but not for rosiglitazone.ConclusionThe results of this large population based study indicate that pioglitazone is associated with an increased risk of bladder cancer. The absence of an association with rosiglitazone suggests that the increased risk is drug specific and not a class effect.IntroductionPioglitazone, an antidiabetic drug belonging to the thiazolidinedione class, has been shown to improve glycaemic levels in people with type 2 diabetes.1 However, in 2005 the PROactive randomised controlled trial unexpectedly showed an imbalance in the number of cases of bladder cancer with pioglitazone compared with placebo.2 In contrast, this imbalance was never observed in randomised controlled trials of rosiglitazone, the other approved drug belonging to the thiazolidinedione class.1 3The findings of the PROactive trial were subsequently corroborated in some,4 5 6 7 8 9 10 but not all, observational studies.11 12 13 14 15 16 17 18 19 Indeed, in the five year interim analysis of a large observational study using the Kaiser Permanente Northern California database,4 the use of pioglitazone for 24 months or more was associated with an increased risk of bladder cancer (hazard ratio 1.4, 95% confidence interval 1.03 to 2.0). However, in the final analysis of the Kaiser Permanente Northern California study, which used the same cohort4 with follow up extended to 10 years, the use of pioglitazone was no longer significantly associated with an increased risk of bladder cancer in a duration response fashion.20 These null findings are also consistent with those of another large multicohort study.19 The apparent heterogeneity in this literature may be due to methodological limitations, such as the inclusion of prevalent users,5 6 10 11 12 13 14 18 time lag bias,15 immortal time bias,10 14 18 and no consideration of disease latency.8 10 12 17 18Given these discrepant findings, the methodological shortcoming of previous studies examining this association, and the apparent loss of an association in studies with longer follow up,20 additional studies are needed to investigate further the association between pioglitazone and bladder cancer. In a large, population based study we assessed the association between the use of pioglitazone and bladder cancer in people with type Hermes belt replica paris 2 diabetes.MethodsData sourceThis study was conducted using the United Kingdom Clinical Practice Research Datalink (CPRD). The CPRD collects information on anthropometric variables such as body mass index and lifestyle variables such as smoking. Data collected in the CPRD have been previously validated and shown to be of high quality.22 23 Furthermore, cancer diagnoses have been found to be highly consistent with those recorded in the UK national cancer data repository.24Study populationBase cohortWe assembled a base cohort composed of all people newly treated for type 2 diabetes, defined as receiving a first ever prescription for a non insulin antidiabetic drug (metformin, sulfonylureas, prandial glucose regulators, thiazolidinediones, acarbose, dipeptidyl peptidase 4 (DPP 4) inhibitors, glucagon like peptide (GLP 1) agonists, sodium glucose cotransporter 2 (SGLT2) inhibitors) between 1 January 1988 and 31 July 2013. Patients were required to be at least 40 years of age and to have at least one year of CPRD medical history before that first prescription. We excluded patients prescribed insulin any time before their first non insulin antidiabetic prescription (as these may represent those with an advanced form of type 2 diabetes), and patients with a diagnosis of gestational diabetes and polycystic ovary syndrome (as these are other indications for metformin).Study cohortUsing the base cohort, we identified all patients who hermes belt price replica initiated a new antidiabetic drug class on or after 1 January 2000 (the year pioglitazone and rosiglitazone entered the UK market) until 31 July 2013. These patients included those newly treated with an antidiabetic drug class, as well as those who switched to or added on an antidiabetic drug class not previously used in their treatment. Cohort entry was defined by the date of this new prescription. We excluded all patients with a diagnosis of bladder cancer (including malignant, in situ, and benign lesions) at any time before cohort entry, as well as those with less than one year of follow up after cohort entry. The latter was necessary for latency considerations, as short term drug use are unlikely to cause incident bladder cancer.All patients were followed from the year after cohort entry until a first ever diagnosis of bladder cancer (malignant and in situ), or censored on death from any cause, end of registration with the general practice, or end of the study period (31 July 2014), whichever occurred first.Use of thiazolidinedionesIn the models we entered the use of thiazolidinediones as a time varying variable and classified it according to one of the four mutually exclusive categories: pioglitazone use, rosiglitazone use, pioglitazone and rosiglitazone use (mainly switchers), and no thiazolidinedione use. Patients were considered unexposed to thiazolidinediones until the time of the first thiazolidinedione prescription and thereafter considered exposed, after accounting for a one year lag period. This lag period was necessary to take into account a latency time window and to minimise possible detection bias around the time of treatment initiation. This was considered the primary exposure definition.In secondary analyses, we determined whether there was a duration response and dose response relation between pioglitazone and incidence of bladder cancer. The duration response relation was assessed in terms of cumulative duration of use, which was defined, in a time dependent fashion, as the total number of years of use, calculated by summing the durations of all prescriptions received between cohort entry and the time of the event. This variable was then classified using the same categories used in the interim analysis of the Kaiser Permanente Northern California study4: 2 years of use. We also assessed cumulative duration on a continuous scale using a restricted cubic spline model with five knots.25 Dose response was assessed in terms of cumulative dose, which was calculated in a time dependent fashion as the sum of all doses received up until the date of the event. This variable was also categorised using the same cut offs used in previous studies4 5: 10500 mg, 10501 28000 mg, and >28000 mg. We assessed the linear trend for cumulative duration of use and dose by considering these variables as continuous in the models.For comparison purposes we also assessed whether there was a duration response and dose response relation with rosiglitazone, in terms of cumulative duration of use (categorically (2 years) and continuously using restricted cubic spline modelling) and cumulative dose (categorised on the basis of the distribution of use in thirds in the cohort). We also conducted two secondary analyses to assess whether there were duration response and dose response relations with pioglitazone and risk of bladder cancer in terms of cumulative duration of use and cumulative dose (as defined previously). Identical analyses were done for rosiglitazone. For all models we used the model proposed by Fine and Gray to account for competing risks due to death from any cause.27 We examined the Schoenfeld residuals for the time fixed covariates and found no important departures from the proportional hazards assumption.Sensitivity analysesWe conducted nine sensitivity analyses to assess the robustness of our findings. Firstly, given uncertainties related to the latency time window, we repeated the primary analysis with lag periods of zero and two years. Secondly, we repeated the primary analysis after considering a stricter definition for drug use based on receiving at least four prescriptions within a 12 month window. Thirdly, we repeated the analysis after excluding patients with a history of bladder conditions at any time before cohort entry and censoring on a new diagnosis during follow up. Fourthly, we repeated the primary analysis after additionally censoring on a new diagnosis of benign bladder lesions, in situ bladder cancer, liver failure, and heart failure (the last two were also additional exclusion criteria). Indeed, thiazolidinediones are contraindicated or not recommended for the two last conditions, the presence of which may lead to thiazolidinedione discontinuation or may influence treatment decisions. Fifthly, in 2011 several regulatory actions were issued because of the potential association between pioglitazone and bladder cancer.28 We performed a sensitivity analysis censoring follow up to 31 December 2010, as it is possible that patients starting or continuing pioglitazone after that date may have been more carefully screened for bladder cancer. Sixthly, we repeated the primary analysis using multiple imputation for variables with missing values (that is, body mass index, smoking, and haemoglobin A1c).29 30 Seventhly, we additionally adjusted the models for the time dependent use of other antidiabetic drugs (metformin, sulfonylureas, incretin based drugs (GLP 1 analogues or DPP 4 inhibitors), insulin, and other oral hypoglycaemic drugs) during follow up, lagged by one year for latency considerations. Eighthly, to account for potential time dependent confounding during the 14.5 year study period, we repeated the primary analysis using a marginal structural Cox proportional hazards model with inverse probability of treatment and censoring weighting (see the supplementary file for a detailed description of this method). Finally, we assessed the strength of an unmeasured confounder needed to move the estimated hazard ratio to the null using the "rule out" method proposed by Schneeweiss.31Head to head comparison of pioglitazone with rosiglitazoneTo assess further whether an association between pioglitazone and bladder cancer is a drug specific compared with a class effect, we conducted two additional analyses that directly compared pioglitazone with rosiglitazone. In the first approach, we contrasted the use of pioglitazone with the use of rosiglitazone by repeating our primary analysis with the latter as the reference category. In the second approach, we used the study cohort to assemble a subcohort of patients starting pioglitazone or rosiglitazone between 1 January 2000 and 31 July 2013, with follow up until 31 July 2014. As with the primary analysis, all patients were required to have at least one year of follow up after their first prescription for a thiazolidinedione. Consequently, cohort entry was set as the year after the first thiazolidinedione prescription during the study period. All patients were followed until a first ever diagnosis of bladder cancer, or censored on death from any cause, switching to another thiazolidinedione, end of registration with the general practice, or end of the study period, Hermes belts replica paris whichever occurred first. The model was adjusted for high dimensional propensity scores,32 which included the prespecified variables listed previously along with another 500 empirically defined variables measured at the time of the first thiazolidinedione prescription. All analyses were conducted with SAS version 9.4 (SAS Institute, Cary, NC).Patient involvementNo patients were involved in setting the research question or the outcome measure, nor were they involved in developing plans for design or implementation of the study. No patients were asked to advise on interpretation or writing up of results. There are no plans to disseminate the results of the research to study participants or the relevant patient community.ResultsA total of 145806 patients met the study inclusion criteria (see supplementary figure 1). Overall, the cohort was followed for a mean of 4.7 (SD 3.4) years, generating 689616 person years of follow up. Overall, 622 patients received a diagnosis of bladder cancer during follow up, yielding a crude incidence rate of 90.2 (95% confidence interval 83.2 to 97.6) per 100000 person years. Among patients with an event, the median time between cohort entry and an incident diagnosis of bladder cancer was 4.4 (interquartile range 2.5 6.5) years.Table 1 presents the characteristics of the cohort overall and stratified by pioglitazone users versus non thiazolidinedione users at baseline. Compared with non thiazolidinedione users, pioglitazone users were less likely to be obese but more likely to have increased haemoglobin A1c levels, to have undergone urine protein testing before cohort entry, had a longer duration of treated diabetes, and were more likely to have previous bladder conditions. Pioglitazone users were also more likely to have used sulfonylureas and less likely to have received metformin compared with non users of thiazolidinediones. The baseline characteristics of rosiglitazone users are similar and shown in supplementary table 1.Table 1 Baseline characteristics of cohort overall and stratified by users and non users of pioglitazone at cohort entry. Values are numbers (percentages) unless stated otherwiseView this table:View popupView inlineOverall, the use of rosiglitazone was not associated with an increased risk of incident bladder cancer (86.2 v 88.9 per 100000 person years, adjusted hazard ratio 1.10, 95% confidence interval 0.83 to 1.47; see supplementary table 2). Similarly, there was no evidence of a duration response relation in terms of cumulative duration of use when it was classified as a categorical variable (P=0.7 for trend; see supplementary table 2) or when it was considered as a continuous variable (see supplementary figure 2). Finally, there was no evidence of a dose response relation in terms of cumulative dose (P=0.7 for trend; see supplementary table 2).
Aug 30 '17 · 0 comments
ostracised and written off at Manchester United

Bastian Schweinsteiger did not even have a peg in the first team dressing room at Manchester United's training ground three months ago, yet, this weekend he will be given one at Wembley for the EFL Cup Final against Southampton.

It has been a story of perseverance and stubbornness, but should Schweinsteiger pick up a League Cup winner's medal, he will give it a happy ending.

One of the most decorated footballers of his generation has been insulted, ostracised, tossed aside and written off, yet Schweinsteiger refused to give up at Manchester United.

When Jose Mourinho sneered at his first team prospects last summer, in an attempt to provoke him into handing in a transfer request, the German smiled and promised to be ready if he changed his mind. Few imitation hermes belt on sale would have had the stomach for that fight or the self control not to argue, but a player with 112 international caps did.

Mourinho was adamant he would not change his mind. He even went so far, back in August, to claim he would rather play someone from the youth team, with no Premier League experience, than a 32 year old who had won eight domestic league titles and a Champions League at Bayern Munich.

Schweinsteiger was too slow, too ponderous to play for him. The decision to sign a player of his age, in decline, even one who had just captained Germany to a World Cup triumph, was a horrendous mistake by his predecessor Louis van Gaal.

However, Mourinho did not just drop Schweinsteiger, he humiliated him. He was turfed out of the first team dressing room at Carrington, forced to train away from his team mates, either alone or with the Academy players.

It was deliberately brutal. Mourinho wanted Schweinsteiger to leave and he did not care how harsh he had to be to make that happen.

The Portuguese also had no time for people who questioned his decision either. He ignored criticism from Schweinsteiger's previous club, Bayern Munich, where chairman Karl Heinz Rummenigge and former manager Otmar Hitzfeld accused him of abusing one of Germany's most famous names.

"One or two players are going to think long and hard in future about whether they want to go to such a club [like United],"said Rummenigge

Hitzfeld went even further."It's a lack of respect for a worthy player," he said. "It's a method which is strange to me. Schweinsteiger is a key player, a world champion, a personality, while at the same time he has an exceptional attitude."

The player's brother, Tobias, vented his frustration on Twitter, also accusing United of treating his sibling with"no respect."

The club, though, backed Mourinho and when the accounts were released in September last year, they showed Schweinsteiger was a6.7m asset that had been written off. They effectively did not care if he played again, retired, quit or left on a free transfer in January. His United career was over.

Schweinsteiger, though, did not complain. He did not retaliate, miss training sessions or refuse to do anything. He patiently and diligently broke his manager down. Mourinho, albeit begrudgingly, began to admire his belligerence.

He had prodded and poked a World Cup winner, a Germain national icon, to force him to leave, but the player refused to budge.

He repeatedly antagonised him, yet Schweinsteiger would only Hermes belt replica say nice things in response. Mourinho had to accept defeat there is only so many times you can throw stones at a dog before you accept it is going to follow you regardless.

"I don't think he could have done it with anymore class,"said the former United midfielder Owen Hargreaves, who played with the Germany international at Bayern Munich."I think United fans appreciate the way he has conducted himself.

"Football replica Hermes belts france clubs make decisions and sometimes they regret them. I think that is what happened with Bastian.

"With his experience, and you saw it the other day against St Etienne, when he came on and managed the game with ten men for more than 20 minutes, its valuable. He can still do that job better than anyone coming off the bench."

"I've not met anybody in the world of football, players or coaches who did not like Bastie. If you have played with him, if you have spent any time in his company, you love him because he is such a gentleman, such a good person to be around.

"I think he has probably just broken Jose down. Everyone has different views on players, but he is good enough to be a squad player anywhere and I think United have come around to that idea.

"He is the ideal person to have on the bench. He has some handy experience in finals too. If you need to manage a game, keep hold of the ball, he is ideal. That's why he is playing again for Mourinho."

In November, Mourinho, following meetings with the player and his advisors, agreed a peace deal. He allowed Schweinsteiger to return to training with the first team, he even allowed him to play against West Ham in the League Cup soon afterwards.

Even then, most believed Schweinsteiger would leave. His return to training was likened to fattening up a pig for sale at market.

By bringing him back into the fold, Mourinho was probably hoping for an end to the soap opera. If Schweinsteiger looked trim, fit and he had been playing, he would be easier to sell. The rumoured interest from American clubs would be firmed up.

If that was the plan, it did not work and it is unlikely to do so again in the summer. Schweinsteiger has 16 months left on his contract and he intends to spend them in Manchester.

There have been a smattering of first team appearances since November, the most recent in the Europa League win over St Etienne in France when he replaced the injured Michael Carrick.

Schweinsteiger has been given another chance by Mourinho and is determined to take it. And for those who question his place in the squad this weekend, it is worth remembering, the last time fake hermes brown belt whosale he played at Wembley, he won the Champions League with Bayern Munich.
Aug 30 '17 · 0 comments
Put a Floyd Rose on a Stratocaster

The first thing you need to do is take apart the guitar. This is one of the things I love about stratocasters. Screw the neck off, then undo all of the screws in the body. Take everything out. I kept my parts organized by putting them into bags organized by type of screw and what they held in. New screw, new bag. You wont be able to take any of the electronics out unless you want imitiaton hermes bag to re solder them.

Step 3: Measuring the Holes for the Floyd Hermes birkin bags fake Rose

Next you need to measure the holes for the posts. A floyd rose works by leaning on the posts when you push down the wammy bar, so putting these in correctly is very important.

First, you want to measure the diameter of the posts.

Once you measure the holes, you need to drill them. I suggest using a drill press for this because you need to make sure they are perfectly straight. Once you have these, you will need to cut out parts of the pickguard to make room for the posts and the bridge.

Step 5: Putting in the Posts and Testing

Once you have everything cut out, you need to make sure it all fits. If you measured correctly, the posts should be able to slide in, but still be snug, and not move or fall out. Put the bridge in and make sure it is parallel to the direction of the strings. This is very important and will make or break your guitar.

Next you need to put the nut in. Measure the depth of the nut, because that is what really matters in this case. Sand down the neck until it is deep enough that the string slots are just above the line of the neck. There are five holes in the nut piece: three of them, in a row, hold the screws for the locking tuners. The other two, slightly smaller holes, are for the screws that hold the nut to the neck. Carefully drill where the holes are, with a slightly smaller bit than the screws so they are guaranteed to stay in. Then screw it in to make sure that it fits.

Step 7: Putting It Back Together

Do just that: put everything back where it goes! Screw the nut in and set the bridge down. When you put in the springs for the replica hermes handbags outlet bridge, you also need to put strings in to balance it out. To put the strings in, you cut off the ball at the end, slide it between the block in the bridge and the slot, and tighten that screw as far as it will go, and then farther. Then bring them up to the tuning mechanisms and string as normal. Once you get your guitar in tune, slightly lower it, because when you put the locking screws on, it raises the pitch slightly. Then tune your guitar with the bridge screws, not the tuning pegs. This is very important because you will break the strings or move the nut if you tune with the pegs.

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There are many things that could go wrong in this kind of system, but the biggest problem i encountered had to do with the nut. In this case, the hole for the screw was stripped, thus rendering the whole system useless for those two strings. So, instead of buying a whole new nut, i found a slightly longer screw, and put it into the wood under the nut. The only problem with this is that it may interfere with your truss rod, so you need to be very careful about the lenght of the screw. I ended up cutting it to the proper size.

Luckily, I didn have to do any routing. Stratocaster routes and Floyd bridges are usually the same size, so the only woodworking I had to do was for the posts and the nut. As long as your guitar came with a block tremolo, like a Floyd or a Strat, you should be good.

Hello. Thanks for posting this. I been working on making a frankenstrat replica and just got done installing the post holes for it. Now i have a few questions. Did the metal of your locking nut fashion cheap hermes handbags overhang on either side of the nut routing and also when i installed the high e string it played fine when it was open but when i tried to play frets, it would buzz and some of them won change pitch and would go to the pitch of a higher fret. I didn shim my neck so maybe that the prolem but i not sure.

Ok thanks, and thank u for the tutorial before I even saw this tutorial I don know what the Floyd rose was called but now I know and if I ever get a strat or ibanez that will be the first thing I put on

really better to just buy one already factory installed Ibanez sells some great budget guitars with a licenced Floyd on them, as do other brands. look in Musicians friend, Guitar Fetish and Rondo guitar for the best deals.

Do you think you could do this to a standard Gibson or a les Paul?

Better to go to Guitar Fetish. com and buy a Douglas already with a Trem on it. and its only around $400.00, looks great and a great guitar.

I have seen floyd rose bridge kits made for a les paul on ebay. no modification needed, but they arent cheap.

You could, but it would require a lot more machining, including making a space for the bridge, which Gibsons don usually have. I would recommend taking it to a professional for that kind of work. If you really want to do it yourself you would have to go to a machine shop and learn how to use some of the more advanced things there. it get you started in the right direction, if you have any mechanical aptitude whatsoever, you do 10 times better than this post.
Aug 30 '17 · 0 comments
Premier Denis Napthine announces

Asked if he agreed with the Primer Minister's views, Dr Napthine said the election was about "who you can trust to deliver key infrastructure that makes a real difference to the people ofVictoria and that includes East West link, Melbourne Rail Link, the Tullamarine project we're talking about today."

Under the government's latest pledge, the Tullamarine Freeway would be widened betweenMelrose Driveand the Airport, cutting peak travels times by 20 minutes and reducing fatalaties on that road by up to 20 per cent.

The project would add an additional lane imitiaton hermes bag in each direction, complementing an earlier $850 million deal with CityLink operator Transurban to widen the replica hermes handbags outlet road from the West Gate Freeway toMelrose Drive. It would also involve a managed motorway system and a priority queuing system for Skybus access.

If the Coalition is re elected this month, the state will contribute $50 million while the Commonwealth would provide $200 million.

However when asked if he would provide the same amount if Labor was elected given the opposition had also promised a widening of the freeway fake hermes bag Mr Abbott replied: "what we've said is our money is available for these projects, but you can't trust Dan or Daniel Andrews to deliver any of these projects because he would rather put his political interests, his Green preferences, ahead of the welfare of people living in outer metropolitan Melbourne."

"I've said before, the Coalition believes in roads; Labor doesn't. If you support better roads forMelbourne, there's really only one way to go in this coming election."

RACV general manager of public policy, Brian Negus, said the upgraded freeway would remove what had been a "frustrating bottleneck for travellers for many years", especially replica birkin handbags residents living in Melbourne's north west.

Mr Andrews wouldn't be drawn in on the Prime Minster's criticisms.

"I don't believe in, frankly, commenting on Tony Abbott," he said.

"He's completely irrelevant to my plan to put people first. So is Denis Napthine."

Mr Andrews on Saturday took his campaign into the marginal electorate of Yan Yean in support of Labor MP Danielle Green.

"We wouldn't have missed it," Mr Andrews said to Cooper's mother, Cassie Batten, and her partner, Rhett Wallace, as they mingled with hundreds of supporters.

Mr Andrews said Cooper's plight had resonated with him and, over time, the community was slowly understanding the benefits of medical marijuana.

"Cassie and Rhett were planning his funeral and now things are very, very different for them," he said, reiterating how Labor would seek to legalise medical cannabis upon winning the election.

"I'm not talking about everybody being able to access these pharmaceuticals it's what these really are, in these forms. I'm talking about people who have a terminal condition or a life threatening condition."
Aug 30 '17 · 0 comments
old who was on bail on manslaughter charge

20 year old Samir Mokhtar, on bail on fake hermes belt price a manslaughter charge, was shot and killed Monday night in Vancouver. A 20 year old man was found lying on the road on Seaforth Drive near Rupert Street and pronounced dead on the scene. Monday, police received several reports of gunfire on Seaforth Drive near Rupert Street. Officers and paramedics arrived to find 20 year old Samir Mokhtar dead on the side of the road.

Mokhtar was on bail on a manslaughter charge, and replica Hermes belt france the shooting is believed to have been targeted. Police hadn't made any arrests by Tuesday afternoon.

In the 3400 block Seaforth Drive where officers canvassed residents, neighbour Manny Mendes said he initially thought he heard the sound of firecrackers but realized it was three or four gunshots after he heard "really painful" screams.

"It was hermes black belt knockoff a really, really anxious screaming, and it's hard to figure out if it was someone who saw or if it was the person itself," he said.

Mendes said police arrived within a few minutes and secured the area. Another neighbour told Mendes she had seen someone running toward nearby Falaise Park.

On Tuesday a dozen police vehicles surrounded the park as investigators searched for evidence. Police tape blocked traffic from the scene.

Mokhtar was facing charges of manslaughter and accessory after the fact to murder in the shooting death of 20 year old Aladdin Ramadan outside a home in the 2000 block Rosser Avenue in Burnaby on Sept. 24.

Mokhtar fled Canada following the shooting, although he resurfaced in Seattle on Dec. customs officials after getting off a flight from Dubai. A trial date had been set fake hermes black belt for May 2016.

Const. Brian Montague said in an email that police haven't yet determined a motive for the slaying.

"There are theories being developed, but (it) would be inappropriate for me to discuss those at this time," Montague said.

"We are also taking information, witness accounts, video from the area and speaking with other agencies to determine potential suspects, but are not sharing any of that information at this time."

The incident was the second homicide in the area in two days, but police said there is nothing to suggest the two are connected.

Investigators continue to gather evidence after 15 year old Jason Nguyen was killed Sunday. after a family member found Nguyen seriously injured. The teenager was rushed to hospital but did not survive.

The death was initially considered suspicious, but later deemed homicide, and it did not appear to be random, police said.

In the investigation into Mokhtar's death, officers believe several witnesses were in nearby Falaise Park and fled when they heard gunshots.

Anyone with information about either incident is asked to call the Vancouver Police Department's homicide unit at (604) 717 2500 or CrimeStoppers at 1 800 222 8477 (TIPS).
Aug 30 '17 · 0 comments
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