An HIV treatment strategy that greatly expands the use of antiretroviral medication may provide a roadmap to an AIDS-free generation, but scientists launching clinical studies may have trouble running the kinds of tests that would find that out.HIV researchers are grappling with an ethical conundrum on the horizon even as they design and launch studies to test whether “treatment as prevention” can dramatically slash HIV transmission rates in the general population.Treatment as prevention initiates the use of powerful antiretroviral drugs as soon after HIV infection as possible, a significant change from earlier treatment guidelines that recommended drug treatment beginning when numbers of a key immune system cell, called a CD4 T-cell, fall to less than 350 cells per cubic millimeter of blood. A healthy person’s CD4 cell count is between 500 and 1,200 cells per cubic millimeter.Ethical concerns arose last June, when the World Health Organization (WHO) changed its recommended treatment guidelines so that everyone with a CD4 cell count of 500 or less would get antiretroviral drugs. WHO guidelines influence many nations as they set their own treatment guidelines.Though the change was applauded by those who believe earlier treatment is better both for the individual patient and, because it reduces transmission, for the broader society, it jumps ahead of the scientific evidence and threatens to gut the statistical power of studies under way or being planned to answer the question of effectiveness definitively.That’s because scientific studies rely on the difference between control groups for whom nothing has changed and test groups receiving a new drug regimen to understand whether the drug regimen is working. If countries adopt WHO’s recommendations and widely initiate antiretroviral drug treatment among those whose CD4 count dips below 500, statistical differences between the groups would be harder to detect.To counterbalance the change statistically, researchers would have to double the size of the study or greatly increase its length, either of which would also greatly increase the costs involved. Other strategies, such as keeping controls on a lesser drug regimen than on the broader society, are ethically risky.A group of HIV researchers and medical ethicists gathered Friday at the Harvard School of Public Health (HSPH) to investigate the issue and discuss ways to maintain the studies’ scientific validity that would pass ethical muster.The session, “Trials of HIV Treatment as Prevention: Ethics and Science,” was sponsored by the HSPH Department of Global Health and Population and moderated by Megan Murray, professor of global health and social medicine at Harvard Medical School (HMS) and of epidemiology at HSPH. Other participants were Till Bärnighausen, associate professor of global health; Max Essex, Lasker Professor of Health Sciences; Deenan Pillay of the Wellcome Trust Africa Centre for Health and Population in South Africa; Velephi Okello of the Swaziland National AIDS Programme; Dan Wikler, Mary B. Saltonstall Professor of Population Ethics at HSPH; and Nir Eyal, associate professor of global health and social medicine.The participants immediately ruled out providing study controls that would offer less care than would be widely available in society. Similarly, the participants said it would be wrong to stop the entire society from moving to the new standard solely for the sake of scientific study.But they also ruled out just abandoning the studies. Wikler said the treatment as prevention strategy is promising enough that it is “absolutely crucial” that evidence be gathered to support or refute its potential.If the treatment is found to be effective, scientific evidence will be essential to secure the additional funding that a worldwide change to the new standard would require. But a chance to finally “lick the epidemic” once and for all would be persuasive, Wikler said.Some believe that possibility exists. Treatment as prevention was cited by former Secretary of State Hillary Clinton as a key element in a strategy to create an AIDS-free generation, and the strategy has proven effective in more limited populations. Among pregnant or nursing mothers, antiretroviral treatment has greatly reduced the transmission of HIV to infants and nursing toddlers. The strategy also has been used successfully among “discordant” couples, where only one partner has HIV. In many of those cases, antiretroviral treatment has kept viral loads low enough to prevent infection of the HIV-negative partner.Despite those encouraging examples, whether the treatment will work in the general population remains an open question, scientists said. Essex, who is conducting a trial in 30 communities in Botswana, where he has long maintained a partnership with the government, said little is known about how people in the general community will behave. For example, if adherence to the drug regimen drops, that could foster development of drug-resistant HIV, and such strains could begin circulating. Studies in Botswana, South Africa, and Swaziland are designed to answer that and other questions.If the study host nations adopt the new WHO guidelines, one ethical way to maintain a study would be to coordinate with government adoption of the new policy, since such rollouts are often phased in over time, Wikler said. That would require coordination between researchers and government officials. But if the government were to randomize phase-in of the new treatment nationwide, rather than in phases, the researchers could draw study controls from the groups known not to be receiving the new treatment.So far, Swaziland has announced that it will adopt the new standard, but South Africa and Botswana have both indicated they are sticking to the 350 CD4 cell count standard for now, minimizing the ethical quandary in those nations.“If you could prove that treatment as prevention could not only improve people’s health but lick the epidemic … you could say you see the light at the end of the tunnel,” Wikler said.
The American Brewers Guild Brewing School will be hosting it’s professional brewing class, at Otter Creek Brewing, in Middlebury Vermont, from December 1st to 6th, 2003. The American Brewers Guild, one of only three professional brewing schools in the country, is now headquartered in Salisbury, Vermont. The residential week of the Intensive Brewing Science and Engineering and Craftbrewer’s Apprenticeship Programs will host 20 students and four instructors and is a culmination of 21 weeks of learning. It will include hands on brewing, laboratory analysis and sensory evaluation, ending with a rigorous final examination. The graduation will be held December 6th at 1:00 pm at the Waybury Inn in East Middlebury. Students and brewing instructors will be coming to Middlebury from all over the country, some from as far away as California.The American Brewers Guild, which started in Davis California, has been educating and training professional craft brewers since 1995. Award winning Brewmaster Steve Parkes and his wife Christine McKeever purchased the American Brewers Guild in 1997. Operations were moved to Vermont in 2003 when Mr. Parkes accepted the position as Head Brewer with Otter Creek Brewing and Wolaver’s Organic Ales. For more information on the American Brewers Guild see their website at www.abgbrew.com(link is external).
American Recovery and Reinvestment Act enhancements to U.S. Small Business Administration (SBA) loan programs have led to a major rebound in Vermont of SBA-backed loans for small businesses and greater access to much-needed capital. SBA lending in Vermont dramatically increased in the second quarter of the 2010 fiscal year, Jan. 1, 2010 through March 31, 2010. Compared to the second quarter of FY 2009, the 2010 second quarter increased 169 percent from 35 to 94 7(a) loans, with a dollar volume increase from $6,591million in 2009 to more than $19 million, an increase of 191 percent. (See spread sheet for additional details.) Signed into law on Feb. 17, 2009, the American Recovery & Reinvestment Act (ARRA) provided broad-reaching assistance to small businesses, including an increase in the guarantee on all loans up to 90 percent from 75-85 percent and the elimination of guaranty fees, resulting in substantial savings for small business borrowers. We are encouraged by these results, said SBA Vermont District Director Darcy Carter. With the enhancements provided under the Recovery Act, compared to where we were a year ago, we ve made a significant difference by providing access to capital for many of Vermont s deserving small businesses. As part of the Recovery Act, SBA received $730 million to help small businesses. These funds were exhausted on Nov. 23, 2009, and an additional $125 million was provided by Congress in Dec. 2009. When those funds were exhausted in late Feb. 2010, an additional $60 million was provided. A subsequent extension will allow SBA to continue to waive loan fees and provide higher guarantee levels through April 30, 2010, or until the funds are exhausted. SBA is continuing to work with Congress to provide longer term funding for our primary loan program enhancements, added Carter.For more information on SBA s programs and services, call 802-828-4422 or go to www.sba.gov(link is external). Source: SBA. 4.8.2010 See results Below. 2nd Q 20092nd Q 2010 YTD 2009YTD 2010 2,353,0003,849,00064% 2nd Q 20092nd Q 2010 Number of LoansNumber of Loans% Change $ loans$ loans% change Vermont – 50465-16% $ loans$ loans% change 3594169% First Q 2009First Q 2010 YTD 2009YTD 2010 Vermont – All10,854,00020,048,50085% 16500% Vermont – All499594% 6,591,00019,187,557191% Vermont – 7a8,624,00017,234,500100% First Q 2009First Q 2010 71157% 78184136% 123,0001,035,000741% 85195129% #’sNumber of LoansNumber of Loans% Change VT District Office 15,215,00036,422,057139% 6,714,00020,222,557201% Vermont – 5042,230,0002,814,00026% 36100178% $’s$ loans$ loans% change Number of LoansNumber of Loans% Change Vermont – 7a4390109% 17,568,00040,271,057129%
39SHARESShareShareSharePrintMailGooglePinterestDiggRedditStumbleuponDeliciousBufferTumblr,Jeff Kjoller Jeff has extensive experience in branding, art direction and graphic design, having served employers and clients in a creative capacity for more than twenty-five years. After graduating from the University … Web: www.loudthought.biz Details If you’ve launched a new brand you know that there is a lot of work that goes into it. And as a marketing professional, there is nothing more exciting than the initial launch phase. You are excited to finally reveal what you’ve been working so hard on. Your organization’s employees, if you’ve done your job, are excited about the new culture and direction that’s been set forth and your customers are excited because they can feel there’s an exciting shift happening. But what happens after the launch? What happens after the newness wears off?Keeping your brand fresh and up-to-date is a challenge and should be a part of your ongoing marketing strategy.During the brand launch, part of the excitement is in the collaboration and build-up of what’s to come. Maintaining this collective spirit is key in keeping your brand fresh and relevant internally. But what about externally?Always be in launch mode. Don’t think of launching a brand as a one-off event, but rather a long-term relationship that needs nurturing and constant reinvention to thrive. Every interaction you have with your customer is an opportunity to reinforce your brand. Each of these “launches” acts as a vehicle for movement toward your overall brand goal. Use the initial brand launch as simply a starting point in a journey to tell your brand story then keep the momentum going with constant buzz. You need to constantly invest time and resources to actively manage your brand. Customers who can relate to your story are more likely to tell others about you. Remind them what you want them to think about your organization.Constant EvolutionWhen the brand launch is just the beginning you allow room for change along the way. We may think we know how our customers will react, but are we hearing what they have to say? It’s important to keep a tab on customer metrics and allow them to influence the journey. We need to be willing to adapt based on what customers have to say. Keep an eye on your market and be well informed. Responding to your customers’ needs before they realize what they want is just one way to stay relevant and fresh. It’s naïve to think you can keep up with the rapid pace without regular updates.Keeping Your VisionKeeping your brand fresh does not mean altering your vison. Don’t lose sight of what you are trying to achieve. Too many ideas can easily shift a vision. You must stay true to the values that built your brand if you want longevity and the respect of the marketplace. And don’t just keep the vision to yourself. When you let your customers in on your vision, your brand gets a story. It also builds trust because they know where you stand and why.Keep it ConsistentYou can shape how people perceive your organization. Consistency is the key in helping manage these perceptions and, over time, building brand equity. When you are consistent in your message you evoke the same recognition and feeling across all touch points. This is what builds connections with your customers. Consistency can also give you competitive advantage. When you consistently reinforce your position it becomes more difficult for your competitors to come in and take that advantage away.Launching your brand is just the beginning. The real work is in keeping your brand fresh and engaging. Ongoing maintenance and innovation will go a long way in keeping your brand relevant to your customers. Just make sure you listen to them, give them what they need and want and stay true to your vision along the way.
After graduating from Syracuse University College of Law, she provided legal counsel for emergency service agencies, worked as an assistant and senior district attorney and even volunteered as a firefighter for Cortland. Veronica M. Gorman, Esq. has confirmed with 12 News that she will be running under the republican party. Gorman, a solo practitioner currently owns and runs a Binghamton law firm, Gorman Law, PLLC which practices criminal defense and family law. “Family court just seemed like the natural trajectory of what I had done in the DA’s office and in family court and then married well with my position as a Town of Union judge,” says Gorman. “I take pride in my court and how I run my court and this just seems to me like a perfect fit for my time and talents.” (WBNG) — Another candidate has emerged in the race for family court judge. Gorman joins candidates Steve Cornwell and Hollie Levine in the race for Family Judge.
The latter issue is specious because the guns imported for criminal use into New York are invariably carried by individuals who don’t and can’t get a permit in any state. The straw purchasers are in violation of federal laws before they resell the firearms to the felon who transports them to New York. The people who might enter New York with permitted handguns, however, are almost never felons and all objective studies on the subject demonstrate that these permit holders commit less crime than any other segment of the adult population.Even were this wasn’t the case, Article 6, Section 2 of our Constitution reads: “The citizens of each state shall be entitled to all the privileges and immunities of citizens of the several states.” Section 2 was further clarified by the XIV amendment: “No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States.”These two portions of the Constitution have been found by the courts to require all states to honor driver’s licenses and marriage licenses issued in state X, even though state law bars the licensee from receiving such a license in state Y. Should the Senate fail to approve this legislation, the above demonstrates that, though it may require a review by the Supreme Court, that court will ultimately require that handgun permits, like marriage licenses, must be honored by all the states. That decision might be preferable to the pending legislation because it would also require New York City, Chicago and Washington, D.C., to honor permits from other jurisdictions.Art HenningsonScotiaMore from The Daily Gazette:EDITORIAL: Beware of voter intimidationSchenectady teens accused of Scotia auto theft, chase; Ended in Clifton Park crash, Saratoga Sheriff…EDITORIAL: Find a way to get family members into nursing homesFoss: Should main downtown branch of the Schenectady County Public Library reopen?EDITORIAL: Thruway tax unfair to working motorists Categories: Letters to the Editor, Opinion Earlier in December, The Gazette railed against the bill which passed in Congress requiring the states to honor handgun permits issued by other states.The opinion alluded to varying standards for permit issuance and the fact that many of the firearms used by criminals were from other states.
The postponement came only days after Liga 2 kicked off on Saturday. Liga 1, meanwhile, had just entered its third week of competition since the start of the season on Feb. 29.“We also postponed futsal competition, the women’s soccer league and the training camp for the Under-19 national team. For the U-16 national team, we cut short their training programs and have already sent the players and officials back to their homes,” Iriawan said.The PSSI is now designing a mitigation plan and assessing how the outbreak might affect the future of the league following the two-week suspension.It is also ready to assist the LIB in discussing the global pandemic with a number of international leagues, especially those in Southeast Asia. Amid growing concern over the coronavirus disease (COVID-19), which has infected more than 160,000 people globally, major sports leagues in Indonesia have suspended competition, following in the footsteps of international leagues across all sports.The Soccer Association of Indonesia (PSSI) and the country’s soccer league operator, PT Liga Indonesia Baru (LIB), have postponed all competition in their top two leagues, Liga 1 and Liga 2, for the next two weeks as they prioritize the safety of players, officials and spectators. The decision was made in their extraordinary meeting on Monday night.“After coordinating with the youth and sports minister, the LIB and [the PSSI’s] executive committee, we have decided to suspend competition for at least two weeks while waiting for the latest updates on COVID-19,” PSSI chairman Mochamad Iriawan said in a statement. Topics : Well aware of the financial losses the soccer clubs are likely to suffer as a result of the pause on competition, the PSSI promised to help the LIB in calculating the losses of each member club.“Several other countries have made stern decisions to halt their soccer competitions. Malaysia and Thailand have postponed their soccer leagues. Similar measures were also taken in China, Japan and South Korea,” PSSI deputy chief and LIB director Cucu Somantri said.President Joko “Jokowi” Widodo has repeatedly called for people to limit movement and adhere to social distancing recommendations to prevent the spread of the virus in the country, where there were at least 172 confirmed cases as of Tuesday.The Indonesian Volleyball Association (PBVSI) relocated all remaining matches of the national volleyball league, Proliga, from various places in Java to Sentul in Bogor, West Java, to minimize risks.This includes matches that were supposed to be held in Central Java’s Surakarta, where the local administration declared an extraordinary occurrence (KLB) status following the death of a COVID-19 patient in the region last week.Plans remain in place for Proliga competition to run according to schedule throughout April. All future matches would be staged without spectators, Proliga director Hanny Surkatty said in a statement on Monday.The Indonesian Basketball League (IBL) was the first league to halt competition. It announced the decision on Friday, only hours before a meeting hosted by the Youth and Sports Ministry to discuss the impact of COVID-19 with sports associations and sports league operators.The meeting failed to produce a solution on whether to postpone or cancel all competition nationwide, with Minister Zainudin Amali leaving the decision to the discretion of each association. The ministry would instead design a protocol on how to handle the spread of COVID-19 in the sporting world.The ministry’s head of international sports achievements, Yayan Rubaeni, said that the protocol was still being drafted as of Tuesday.Badminton players returning from international sporting events, including the recently concluded All England tournament, will be isolated upon arrival in Indonesia, according to the Indonesian Badminton Association (PBSI).All England champions Praveen Jordan and Melati Daeva Oktavianti are among the 24 athletes, coaches and officials who are required to self-quarantine at the PBSI’s training center in Cipayung, East Jakarta, for 14 days after returning from Birmingham, the United Kingdom.These athletes may only leave Cipayung for emergency purposes after obtaining permits from their coaches and the association’s doctors.PBSI secretary-general Achmad Budiharto said they would be provided with a special training program designed for their quarantine.
McDermott bent on rejection Undeterred by recent rejection, the UK-based subsea engineering company Subsea 7 on Wednesday reaffirmed its interest in acquiring the Houston-based McDermott, which, once again, refused the offer. To remind, McDermott recently rejected an unsolicited, non-binding proposal made by Subsea 7 to acquire its entire issued share capital.Subsea 7 had proposed to acquire McDermott common stock for $7 per share, payable entirely in cash or up to 50% in Subsea 7 stock and the balance in cash, to which McDermott reacted by saying the offer significantly undervalued the company and was not an attractive alternative to the proposed $6 billion worth combination with CB&I.According to the New York Times, the value of the unsolicited offer by Subsea 7 was around $2 billion.Commenting on Subsea 7’s first attempt, Institutional Shareholder Services (ISS), a proxy advisory firm which previously endorsed McDermott-CB&I merger, said on Tuesday, April 24 that Subsea 7’s offer “appears opportunistic in light of McDermott’s trading range in recent months.”The firm also added that the offer did not seem to represent a superior alternative to an accretive transaction with CB&I.Reaffirming its proposal on Wednesday, Subsea 7 reiterated that it is subject to the termination of McDermott’s pending transaction with CB&I.“Subsea 7 is open to considering amending its proposal if it can discover additional value through discussions with the McDermott management team,” the company said.Jean Cahuzac, Subsea 7’s CEO stated that “A combination with McDermott is supported by compelling industrial logic. We would welcome the opportunity to engage with McDermott’s board of directors and management to discuss our proposal and the substantial upside opportunity represented by ongoing participation in the equity, with a view to achieving a combination that would be in the best interests of our respective shareholders.”McDermott’s proposed merger with CB&I is still in progress with completion date set for May, following a special meeting of shareholders and their approval as well as closure of other relevant conditions. The new combined company intends to retain the name McDermott as well as David Dickson as its CEO. In a statement issued later on Wednesday, McDermott reiterated its rejection of Subsea 7’s unsolicited proposal.McDermott added it is fully committed to completing the transformational combination with CB&I. The company said its board believes the combination with CB&I is in the best interest of McDermott and its stockholders, and has recommended that McDermott stockholders support the transaction.Offshore Energy Today Staff