Capable, competent; ready for service or action.
(AM-92: dp. 295; 1. 173'8"; b. 23'; dr. 11'7"; s. 17 k.;
cpl. 65; a. 1 3"; cl. Adroit)
Effective (AM-92) was launched 13 June 1942 by Dravo Corp., Pittsburgh, Pa., sponsored by Mrs. B. H. Rhoads; and commissioned 1 October 1942, Lieutenant Commander A. A. Campbell, USNR, in command. She was reclassified PC-1596, 1 June 1944.
Effective sailed from New Orleans 11 November 1942, and called at Key West and Charleston before arriving at Norfolk 8 January 1943. After intensive training she arrived in Bermuda in February. She remained there on patrol and local escort, with occasional escort voyages to ports on the east coast, until 7 July 1944. Sailing from Bermuda she rendezvoused with a convoy boned for the Mediterranean.
On 15 August 1944 PC-1596 saw action in the invasion of southern France. ;he continued to support the operation by escorting convoys among various Mediterranean ports, training and patrol. She departed Oran 27 May 1945 for the east coast and arrived at Jacksonville, Fla., in June. She was decommissioned 9 November 1945, and was transferred to the Maritime Commission for disposal 30 July 1946.
PC-1596 received one battle star for World War II service.
How the Nazis Were Inspired by Jim Crow
In 1935, Nazi Germany passed two radically discriminatory pieces of legislation: the Reich Citizenship Law and the Law for the Protection of German Blood and German Honor. Together, these were known as the Nuremberg Laws, and they laid the legal groundwork for the persecution of Jewish people during the Holocaust and World War II.
When the Nazis set out to legally disenfranchise and discriminate against Jewish citizens, they weren’t just coming up with ideas out of thin air. They closely studied the laws of another country. According to James Q. Whitman, author of Hitler’s American Model, that country was the United States.
𠇊merica in the early 20th century was the leading racist jurisdiction in the world,” says Whitman, who is a professor at Yale Law School. “Nazi lawyers, as a result, were interested in, looked very closely at, [and] were ultimately influenced by American race law.”
In particular, Nazis admired the Jim Crow-era laws that discriminated against Black Americans and segregated them from white Americans, and they debated whether to introduce similar segregation in Germany.
Yet they ultimately decided that it wouldn’t go far enough.
“One of the most striking Nazi views was that Jim Crow was a suitable racist program in the United States because American Blacks were already oppressed and poor,” he says. 𠇋ut then in Germany, by contrast, where the Jews (as the Nazis imagined it) were rich and powerful, it was necessary to take more severe measures.”
Because of this, Nazis were more interested in how the U.S. had designated Native Americans, Filipinos and other groups as non-citizens even though they lived in the U.S. or its territories. These models influenced the citizenship portion of the Nuremberg Laws, which stripped Jewish Germans of their citizenship and classified them as “nationals.”
A copy of the Nazi-issued Nuremberg Laws. (Credit: Fine Art Images/Heritage Images/Getty Images)
But a component of the Jim Crow era that Nazis did think they could translate into Germany were anti-miscegenation laws, which prohibited interracial marriages in 30 of 48 states.
𠇊merica had, by a wide margin, the harshest law of this kind,” Whitman says. “In particular, some of the state laws threatened severe criminal punishment for interracial marriage. That was something radical Nazis were very eager to do in Germany as well.”
The idea of banning Jewish and Aryan marriages presented the Nazis with a dilemma: How would they tell who was Jewish and who was not? After all, race and ethnic categories are socially constructed, and interracial relationships produce offspring who don’t fall neatly into one box.
Again, the Nazis looked to America.
𠇌onnected with these anti-miscegenation laws was a great deal of American jurisprudence on how to classify who belonged to which race,” he says.
Controversial “one-drop” rules stipulated that anyone with any Black ancestry was legally Black and could not marry a white person. Laws also defined what made a person Asian or Native American, in order to prevent these groups from marrying whites (notably, Virginia had a “Pocahontas Exception” for prominent white families who claimed to be descendedਏrom Pocahontas).
The Nuremberg Laws, too, came up with a system of determining who belonged to what group, allowing the Nazis to criminalize marriage and sex between Jewish and Aryan people. Rather than adopting a “one-drop rule,” the Nazis decreed that a Jewish person was anyone who had three or more Jewish grandparents.
Which means, as Whitman notes, “that American racial classification law was much harsher than anything the Nazis themselves were willing to introduce in Germany.”
It should come as no surprise then, that the Nazis weren’t uniformly condemned in the U.S. before the country entered the war. In the early 1930s, American eugenicists welcomed Nazi ideas about racial purity and republished their propaganda. American aviator Charles Lindberghptedਊ swastika medal from the Nazi Party in 1938.
Once the United States entered the war, it took a decidedly anti-Nazi stance. But Black American troops noticed the similarities between the two countries, and confronted them head-on with a 𠇍ouble V Campaign.” Its goal? Victory abroad against the Axis powers𠅊nd victory at home against Jim Crow.
Comparing Efficient , Effective , and Proficient
These three words cover some overlapping territory.
Efficient most often describes what is capable of producing desired results without wasting materials, time, or energy. While the word can be applied to both people and things, it is far more commonly applied to things, such as machines, systems, processes, and organizations. The focus of the word is on how little is wasted or lost while the desired results are produced.
Effective typically describes things—such as policies, treatments, arguments, and techniques—that do what they are intended to do. People can also be described as effective when they accomplish what they set out to accomplish, but the word is far more often applied to things.
Proficient typically describes people, and it often is followed by the preposition at. If you are proficient at something, you are very good at it. You are, in fact, so good at doing it that you are unusually efficient when you do it. One can also be proficient in something, such as a language.
Novartis response to COVID-19
Novartis COVID-19 Response Fund is providing urgently needed support for healthcare workers and communities in more than 50 projects around the world.
Novartis established a $20 million Global Response Fund in mid-March to support communities around the world impacted by the COVID-19 pandemic. The fund aims to support public health initiatives designed to help communities manage the challenges posed by the pandemic, such as programs to strengthen healthcare infrastructure, digital platforms for data collection or dissemination of important public health information, and community health programs.
To learn more about how Novartis is responding to COVID-19, visit novartis.com/coronavirus.
HITECH 2009 and the Breach Notification Rule
HIPAA history continued in 2009 with the introduction of the Health Information Technology for Economic and Clinical Health Act (HITECH). HITECH had the primary goal of compelling healthcare authorities to implement the use of Electronic Health Records (EHRs) and introduced the Meaningful Use incentive program. Stage one of Meaningful Use was rolled out the following year, incentivizing healthcare organizations to maintain the Protected Health Information of patients in electronic format, rather than in paper files.
With the incentive program also came an extension of HIPAA Rules to Business Associates and third-party suppliers to the healthcare industry, and the introduction of the Breach Notification Rule – which stipulated that all breaches of ePHI affecting more than 500 individuals must be reported to the Department of Health and Human Services’ Office for Civil Rights. The criteria for reporting breaches of ePHI were subsequently extended in the Final Omnibus Rule of March 2013.
Constipation is a clinical diagnosis based on symptoms of incomplete elimination of stool, difficulty passing stool, or both. Patients typically experience other symptoms such as hard stools, abdominal bloating, pain, and distention. Constipation may be present with normal stool frequency, defined as at least one stool three times per week, or with daily bowel movements.1 Chronic constipation is characterized by the presence of symptoms for at least three months out of the preceding 12 months.
Primary constipation, or functional constipation, is classified into three subtypes: normal transit constipation, slow transit constipation, and disorders of defecation. Often, more than one subtype occurs simultaneously.4 Normal transit constipation is the most common. Patients report hard stool or difficulty with defecation, but have normal stool frequency.4 Slow transit constipation, caused by abnormal innervation of the bowel or visceral myopathy, leads to increased transit time of stool through the colon with infrequent defecation, bloating, and abdominal discomfort.5 Disorders of defecation can occur in any age group but are particularly common in older patients.6 Defecation may be impaired by decreased smooth muscle contraction in the rectum or the inability to relax the muscles of defecation. In older adults, rectal receptors may have a diminished response to stretching, blunting the urge to defecate despite accumulation of large quantities of stool.
Causes of secondary constipation include medication use, chronic disease processes, and psychosocial issues. A previous article in American Family Physician reviewed the diagnostic approach to chronic constipation in older adults (https://www.aafp.org/afp/2011/0801/p299.html).
Microwave band issues
For most microwave systems, a completely non-directional isotropic antenna (one which radiates equally and perfectly well in every direction — a physical impossibility) is usually used as a reference antenna. This includes satellite transponders, radar, and other systems which use microwave dishes and reflectors rather than dipole-style antennas. (When referencing the theoretical isotropic antenna, the abbreviation EIRP is used.) Although it is physically impossible to make an isotropic antenna, the assumption makes calculations simpler.
New Class of Antiretrovirals
By the early 1990s, HIV was the No. 1 cause of death among Americans ages 25 to 44. A big problem with a single-drug treatment like AZT is that viruses learn to change, or mutate, so the drugs over time stop working.
In 1995, the FDA approved saquinavir, the first in a different anti-HIV (antiretroviral) drug class called protease inhibitors. Like NRTIs, protease inhibitors stop the virus from copying itself, but at a different stage during the infection.
A year later came yet another class of antiretrovirals, called non-nucleoside reverse transcriptase inhibitor (NNRTI), including nevirapine (Viramune). Similar to AZT, NNRTIs shut down HIV by targeting the enzymes it needs to multiply.
These drugs paved the way to a new era of combination therapy for HIV/AIDS. Doctors began prescribing saquinavir plus AZT or other antiretrovirals. This combination therapy was dubbed highly active antiretroviral therapy (HAART). That approach became the new standard of care for HIV in 1996. HAART greatly lengthened the life span of people with AIDS.
Are Blood Thinners Overused in AFib Patients?
FRIDAY, March 17, 2017 (HealthDay News) -- Many people living with the heart rhythm disorder known as atrial fibrillation may be taking unneeded blood thinners, a new study suggests.
These blood thinners, which include aspirin, Plavix and warfarin, are believed to reduce the risk of stroke that can come with atrial fibrillation. But for many atrial fibrillation patients with a low stroke risk, the medications might actually increase both bleeding and stroke risk, researchers reported.
The way most doctors decide whether a patient needs a blood thinner is by using a simple score called CHADS2, which assigns points to patients based on age and other medical risks. A score of 2 is usually needed to recommend a blood thinner, the researchers explained.
But, "people are realizing that the CHADS2 scores are putting too many people above the threshold -- it's pretty easy to get a 2," explained study author Benjamin Horne, an adjunct assistant professor of biomedical informatics at Intermountain Medical Center Heart Institute in Utah.
For some patients with low CHADS2 scores, the risk of bleeding outweighs the risk of stroke, he added.
"It's better than flipping a coin, but there are many other scores out there that are more predictive," Horne said. "The problem with those scores is that it is difficult and time-consuming to use."
The CHADS2 score breaks down this way: C stands for congestive heart failure, H for high blood pressure, A for age 75 or older, and D for diabetes. S stands for stroke, and the 2 gives an extra point for a previous stroke.
For the study, Horne and his colleagues collected data on nearly 57,000 patients with atrial fibrillation and a CHADS2 score of 0-2. Patients were divided into groups receiving aspirin, Plavix or warfarin or no blood thinner.
At three and five years, the rates of stroke, mini-stroke and major bleeding were higher with any blood thinner, compared with no treatment, the researchers found. The rates of these outcomes were lower among patients taking warfarin than among those taking aspirin or Plavix, the study authors added.
The findings were to be presented Friday at the American College of Cardiology's annual meeting, in Washington, D.C. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.
Horne said that Intermountain has developed a risk score using a blood test that can help doctors make a more precise decision about a patient's risk for stroke. When used along with the CHADS2 score, it might prevent low-risk patients from being put on a blood thinner, he said.
But one heart rhythm expert was less certain.
"We have to take this study with caution," said Dr. Apoor Patel, director of complex ablations in the department of electrophysiology at Northwell Health's Sandra Atlas Bass Heart Hospital in Manhasset, N.Y.
It's controversial whether patients with low CHADS2 scores should take blood thinners, Patel said. "It's something we struggle with every day in clinical practice," he said.
Stroke risk varies among patients, even those with a CHAD score of just 1, he said.
"I wouldn't use this one study alone to change practice. When you have a patient with a low CHADS2 score, you have to make a decision about the pros and cons of anticoagulation [blood thinners], and you have to take into account risk factors that aren't in the score," Patel said.
Conditions not in the score that can make people more prone to stroke include kidney dysfunction, obesity, smoking and alcohol use, and many others, Patel said.
"When you are faced with a patient with a low CHADS2 score, you have to make a decision patient by patient," he said. "You have to take into account not just a patient's score, but a patient's preferences, as well as risk factors not in the score."