Beekman, Town of and Teamsters Local 456

In the Matter of Fact Finding Between TOWN of BEEKMAN and TEAMSTERS LOCAL 456. Case No. M2009-044. Tia Schneider Denenberg, Fact Finder

Drug Testing From the Arbitrator\u27s Perspective

Much of this nation\u27s industrial policy on drug testing will be fashioned within workplaces which are governed by collective bargaining agreements

Risk marker associations with venous thrombotic events: a cross-sectional analysis.

ObjectiveTo examine the interrelations among, and risk marker associations for, superficial and deep venous events-superficial venous thrombosis (SVT), deep venous thrombosis (DVT) and pulmonary embolism (PE).DesignCross-sectional analysis.SettingSan Diego, California, USA.Participants2404 men and women aged 40-79 years from four ethnic groups: non-Hispanic White, Hispanic, African-American and Asian. The study sample was drawn from current and former staff and employees of the University of California, San Diego and their spouses/significant others.Outcome measuresSuperficial and deep venous events, specifically SVT, DVT, PE and combined deep venous events (DVE) comprising DVT and PE.ResultsSignificant correlates on multivariable analysis were, for SVT: female sex, ethnicity (African-American=protective), lower educational attainment, immobility and family history of varicose veins. For DVT and DVE, significant correlates included: heavy smoking, immobility and family history of DVEs (borderline for DVE). For PE, significant predictors included immobility and, in contrast to DVT, blood pressure (BP, systolic or diastolic). In women, oestrogen use duration for hormone replacement therapy, in all and among oestrogen users, predicted PE and DVE, respectively.ConclusionsThese findings fortify evidence for known risk correlates/predictors for venous disease, such as family history, hormone use and immobility. New risk associations are shown. Striking among these is an association of PE, but not DVT, to elevated BP: we conjecture PE may serve as cause rather than consequence. Future studies should evaluate the temporal direction of this association. Oxidative stress and cell energy compromise are proposed to explain and predict many risk factors, operating through cell-death mediated triggering of coagulation activation

Associations of Perirenal Fat Thickness with Renal and Systemic Calcified Atherosclerosis.

BackgroundWe investigated associations between perirenal fat thickness and atherosclerotic calcification in six different vascular beds.MethodsUsing a community-based cohort (n=3,919), perirenal fat thickness was estimated from computed tomography scans. It was classified as Q1 (the lowest quartile) to Q4 (the highest quartile) in each sex. Calcification in the carotid arteries, coronary arteries, thoracic aorta, abdominal aorta, iliac arteries, and renal arteries was evaluated.ResultsPerirenal fat thickness was associated with older age (P<0.01) and a higher prevalence of obesity, hypertension, and dyslipidemia (P<0.01 for all). Perirenal fat thickness was independently associated with renal arterial calcification even after adjustment for age, sex, body mass index, hypertension, dyslipidemia, smoking history, and family history of heart diseases in first-degree relatives (odds ratio [OR] per quartile of perirenal fat thickness, 1.25; 95% confidence interval [CI], 1.09 to 1.44). Compared to Q1, the odds of renal arterial calcification in Q4 was about two times higher (OR, 2.05; 95% CI, 1.29 to 3.25). After adjustment for renal arterial calcification and atherosclerotic risk factors, the only other vascular bed where perirenal fat thickness showed a significant association with calcification was the abdominal aorta (OR, 1.11; 95% CI, 1.00 to 1.23; P=0.045).ConclusionPerirenal fat thickness was independently associated with vascular calcification in the renal artery and abdominal aorta

Non-ambulatory vision service

Non-ambulatory vision servic

The experience of children and young people in long term foster care

Many children and young people who enter foster care have experienced neglect and/or abuse. They display a very wide range of urgent needs and many record poor outcomes of foster care across various domains. Developmental harm poses significant risk for the emergence of problems across the life course, yet there is evidence that many children can still acquire adaptive coping strategies in the face of adversity. The principal aim of this study was to gain insight into the cultures and patterns of social relations that older children and young people create for themselves in foster care. A secondary aim was to make recommendations that would contribute to the literature concerning placement breakdowns and how these might be avoided. This is a qualitative study that used semi-structured interviews, individually adapted according to the age (nine years to twenty two years) and circumstances of the different children and young people participating in the study. A semi-structured interview style aimed to stay close to the voice of the child, giving space for more extended narrative extracts that presented insights into the child’s world. Analysis paid attention not just to what was said, but also how children and young people narrated their experience. The study was carried out in foster placements since foster care is a form of childhood so the home seemed the right context. A key observation drawn from analysis of interview transcripts was the persistence of feelings of connectedness to family members, sometimes over many years of separation. I examined how children and young people in foster care perceived the material basis of care, for example mealtimes, and show these to be variously organised unintentionally to support or undermine their feelings of belonging in placement. I noted the way the children and young people were supported in their adaptation to foster care by such organisation, or were not. I observed how children and young people in foster care managed information in order to deal with conflicts arising from the relations of local authority care. Attachment theory is drawn on to explain the central importance of family and foster family attachments and I show how people in foster care are affected by separation. The research reveals that foster care provides an important service to many of the children and young people in the study. It also reveals how the institutionalised relations of care are played out in children’s accounts, indicating that the power relations of foster care, although nuanced and situated, affect both what happens to children and how they understand themselves and act. I show that without good enough, long term foster care, children and young people in foster care continue to suffer severe disadvantages and their points of view about their situations are sometimes overlooked, over-ridden or distorted. I draw on the elements of the debate about attachment and resilience across the lifespan to suggest a revision for the role of foster carers. The thesis concludes with some general observations on the methodology and specific findings of the research. I reflect on the great difficulty I encountered in gaining access to children and young people in foster care for the purposes of this study. Firm policy recommendations cannot be made on the basis of small-scale doctoral work such as this, but nevertheless, I indicate the policy and practice relevance of my findings, to include, the centrality of separation and loss for children and young people in foster care