Tue, Oct 27th, 2015 11:00 by capnasty NEWS

According to YouBetrayedUs.org, Facebook has been working behind the scenes to obtain legal immunity for giving users' private data to government as part of the Cybersecurity Information Sharing Act of 2015 (CISA). Here is everything you need to know about the controversial bill. Among some of the concerns, CISA would allow the US to arrest foreign nationals "even if the crimes they commit are against other foreigners," and are being committed in a foreign country.

Proponents argue CISA is needed because most of the U.S. network infrastructure, and most of the sensitive information stored on computer servers, lies in private hands. Hence, the companies that own those networks and servers should be able to freely share threat information, and that the federal government should be involved because it can coordinate threat response across the Internet.

Opponents counter that CISA gives too much immunity to corporations, does not properly protect the private information of individuals, paves the way for misuse of personal data and could justify mass surveillance.

You may also be interested in:

"The ultimate goal of the NSA is total population control"
"It’s increasingly hard to opt-out of online tracking."
"Encode your message into something innocent looking."
How To Protect Your Privacy from Facebook's New Search Tool


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15 - Fidelity - second part

«Soy lo más parecido que queda a ella, soy lo más parecido que queda a ella»1.

"I''m what''s left that''s most like her. I''m what''s left that''s most like her."2.

In 1816, during the Romantic period, Wilhelm von Humboldt, language philosopher and linguist, translated Sophocles and Aeschylus. In his preface to his translation of Agamemnon, to our good fortune, he decided to express himself not only on the translation strategy he adopted in the peculiar text presented, but more generally about translation itself. We will present some of his ideas here on the notion of "fidelity" in translation.
  The first aspect he deals with concerns details of style and expression. It is well known that one of the features universally most observed in translations consists of explicitating implicit details, rationalizing the intuitions left to the reader''s estrum. It seems that often the translator feels she is guardian not only of linguistic but also mental interpretation of the text, deciding therefore - sometimes without realizing that she wasn''t asked to do so - to clarify the gray areas of the text.
  This trend has style/expression consequences as well. There are expressive peculiarities of an author, but also more generally typical of a culture, and the translator, both as a rational choice, and out of technical difficulty, can decide to try and reproduce peculiarities or blunt them transforming them into more standard expressions. Humboldt holds that a translator moved by the best fidelity intentions cannot always actually be faithful: because sometimes her idiosyncratic interpretation of the author''s details can be less faithful to the original than a trivial standardization:

It can even be argued that the more a translation strives toward fidelity, the more it ultimately deviates from the original, for in attempting to imitate refined nuances and avoid simple generalities it can, in fact, only provide new and different nuances3.

It is very interesting that here the notion of "fidelity" criticized is the one of "imitation". At first glance who could maintain that an imitator is not faithful? But an imitator, just for his blind prosecution of the copy, just for his presumption he necessarily is capable of fidelity, just traces the frame''s margin. He doesn''t realize that in that way it is the blind faith in the possibility to imitate that generates a ''betrayal''.
  Humboldt, nonetheless, is not an enemy of faithful translations. On the contrary, Humboldt is favorable. But fidelity must address the "true character" of the prototext, a sort of dominant ante litteram. And to Humboldt the dominant seems the very strangeness, the foreignness. What interests in a foreign text''s translation into one''s own culture is its identity as something foreign or different, and Humboldt invites us to pay particular attention to such a diversity as an element that, alone, can enrich one''s own, national culture.

If, however, translation is to give the language and spirit of a nation that which it does not possess or possesses in another form, then the first requirement is always fidelity. This fidelity must direct itself to the true character of the original and not rely on the incidentals, just as in general every good translation should grow out of a simple and modest love of the original and the study that this love implies-and to which the translation always returns.

Until now Humboldt, even two centuries later, appears to be a pro prototext-adequacy extremist, as compared to receiving-culture-reader acceptability. And maybe the less scientific aspect, describable with less precision, of his theory lies in his very attempt to limit this propensity of his, in stating that - as we could say - even fidelity has its limitations:

From our point of view, given that at the moment we seek indications for the scientific path toward the solution of problems of fidelity in translation, there is a passage from Humboldt''s theory that results more of a stumbling block than a signpost:

As a scientific criterion, the reader''s instinct is really not enough. But here Humboldt goes on in his preaching against acceptability and the obliteration of the other''s identity. These considerations on the own/stranger dynamics predate by more than a century and a half - in a still embryonic and not yet recognizable form - the theories of Bakhtìn and Lotman. Even if they did not explicitly name translation, but, more generally, relations between cultures.

As example of "unfaithfulness" and impermeability to the alien element, Humboldt uses just the kind of translation popular in France we quoted in the previous unit, the belles infidèles:

The great advantage, when it is a translator who speaks about translation, is that she also knows the practical aspects of what she says, that she puts her own work on the line. Here Humboldt tries to say in concrete terms how he tried to apply his view of fidelity to his translation from the Greek:

In my own work, I have tried to approach the simplicity and fidelity just described. With each new revision, I have strived to remove more of what was not plainly stated in the text. The inability to attain the peculiar beauty of the original easily entices one to embellish it with foreign decoration, which as a rule simply produces a false coloring and a different tone. I have tried to guard against un-Germanness and obscurity, but in the latter respect one should not make unjust requirements that might preclude gaining other, higher assets. A translation cannot and should not be a commentary. It should not contain ambiguities caused by insufficient understanding of the language and awkward formulations; however, where the original only intimates without clearly expressing, where it allows itself metaphors whose correlation is hard to grasp, where it leaves out intermediate ideas, the translator commits an injustice if he arbitrarily introduces a clarity that misrepresents the character of the text.

Two centuries later, these words are still very useful in referring to the many translators still convinced that "fidelity" means a systematic disambiguation.
  One of the more recent pronouncements as to fidelity comes from George Steiner, who doesn''t refute the notion, but "translates" it in other terms. "Fidelity is not literalism or any technical device for rendering ''spirit''. The whole formulation, as we have found it again and again in discussions of translation, is hopelessly vague"4.
  The only way in which a translator can be faithful, in Steiner''s opinion, is to be fair in the hermeneutic process. In my opinion, fidelity is an equally vague notion as the "spirit" of the Romantic theorists like Humboldt. But Steiner''s idea takes us further in this direction:

The translator, the exegetist, the reader is faithful to his text, makes his response responsible, only when he endeavors to restore the balance of forces, of integral presence, which his appropriative comprehension has disrupted. Fidelity is ethical, but also, in the full sense, economic. By virtue of tact, and tact intensified is a moral vision, the translator-interpreter creates a condition of significant exchange5.

Steiner indicates a path that is swift, full of obstacles. Valéry says fidelity limited to the meaning is a treason. Fidelity is, maybe, a utopian concept.

Bibliographical references

HUMBOLDT W. von Einleitung zur Agamemnon -Übersetzung, 1816.

STEINER G. After Babel. Aspects of Language and Translation, 3rd edition, Oxford-New York, Oxford University Press, 1998 (1975), ISBN 0-19-288093-4.

1 Marías 2000, p. 220.
2 Marías 2001, p. 177.
3 Humboldt 1816.
4 Steiner 1998, p. 318.
5 Steiner 1998, p. 318.


Endangered Species Recovery Program

photo or drawing of species

bald eagle
Haliaeetus leucocephalus

U.S.A. Threatened and California Endangered; proposed for U.S.A. delisting

The bald eagle is a majestic raptor that was adopted as the United States' national emblem in 1782. The white head and tail and the large dark brown body and wings are the features that distinguish adult bald eagles from other raptors. The adults also have yellow eyes, cere (base of beak, including nostrils), bill, legs, and feet with black claws. However, it is not until the birds are 4 or 5 years old that they fully attain this distinctive plumage. There are at least five different plumages that apparently correspond with age; Juvenile, Basic I, Basic II, Basic III, and Adult; however, the literature varies in regards to the ages associated with these plumages. As seen in flight, the head and tail of an adult bald eagle project from the body at equal lengths; while on a non-adult, the head projects more than one-half the length of the tail. When seen from head on, the extended wings of this species are held level with the body.

Non-adult plumage is similar to that of the golden eagle (Aquila chrysaetos), primarily dark brown with variable amounts of white mottling. However, on the undersides of the wing, non-adult bald eagles have white patches where the wings meet the body (often referred to as wing pits, or axillars) with white diagonal lines extending outward from there. White mottling occurs on their upperparts as well, all to varying degrees. Their tails vary from darkish- to dirty-white, with dark edges and tips.

Bald eagles are usually associated with a source of permanent water, such as reservoirs, lakes, and free-flowing rivers, with abundant fish and nearby sites for perching, roosting, and, in season, nesting. These sites include snags or other open perches, such as broken-topped trees and rocks near the water. Their primary prey is fish, especially salmon, but they will also eat small mammals, various water birds, such as waterfowl, and carrion. In the winter, provided the roosting sites and food are abundant, the eagles will roost in groups, particularly in conifer stands or along rivers with migrating salmon. During salmon runs in Alaska, up to 4,000 eagles have been known to congregate along the Chiklat River.

The bald eagle searches for prey from a soaring flight or from a perch, then swoops down and grabs its prey. These eagles are known to wade in shallow water to pursue fish with their bill or talons. Bald eagles tend to cooperatively hunt, particularly when pursuing lagomorphs, such as cottontails and black-tailed hares; they will try and flush them out by using short flights back and forth across the vegetation, or by watching from a perch and waiting for the prey to appear. Occasionally, bald eagles visit flooded fields, pouncing on the small mammals displaced by the water. Piracy of prey from other species is a common foraging tactic of immature bald eagles.

The breeding season for bald eagles begins in February and lasts through July, with pairs establishing long-term bonds. They breed in open areas along coasts, rivers, and large lakes, usually away from human disturbances. In California, a study showed that approximately 87% of their nest sites were within 1 mile (1.6 km) of water.

Platform nests of sticks are lined with vegetation and other fine materials and are built in large snags and old growth trees with open branches. The nests are often built in the fork of the tree and range from 3 to 61 meters (10-200 ft) above the ground. Cliff nests vary in size from those with very little nesting materials to those that are massive structures. Some eagles have been known to use the same nest for more than 35 years; occasionally, they may use more than one nest in a season.

A clutch of one to three eggs, usually two, is laid annually. The incubation period lasts between 34 and 36 days with both parents participating. The eggs hatch asynchronously (at different times, usually with an interval of a day or two in between). The young fledge when they are 70 to 98 days of age. The bald eagle first breeds at 4 or 5 years of age.

Populations of bald eagles outside of Alaska have declined because of habitat loss and reproductive failure due to pesticides and heavy metals in their diets. Restrictions placed on certain pesticides have allowed for the comeback of this species in some of its historic range. Industrial development, logging, recreational development, and other human disturbances have caused eagles to abandon nests and remain potential threats to this species.

Bald eagles' breeding range extends from the Alaskan coast down through western Canada (with the exception of southern regions of Alberta and Saskatchewan), eastward through southern Canada and the Great Lakes, then northward to the eastern Canadian coast. Eagles reside (breed and winter) along their coastal habitat in the eastern states, throughout most of Florida, and along the Gulf Coast. In the west, they reside along the western coast from southern Alaska through the Pacific Northwest to Northern California. A few small populations live in Arizona and Colorado.

In the winter, bald eagles can be found throughout most of the United States west of the Mississippi River. During this time, high concentrations of eagles are found along the coast from southern Alaska and western Canada to Washington and along the upper Mississippi River.

Within California, bald eagles are permanent residents in the north and uncommon winter migrants, particularly in the south. Northern California has a large breeding population and approximately half of the winter population is found in the Klamath Basin along the Oregon border. In southern California, the largest concentrations occur near inland waters, including Big Bear Lake, Cachuma Lake, Lake Mathews, Nacimiento Reservoir, San Antonio Reservoir, and along the Colorado River.

In central California, bald eagles nest at Millerton Lake State Recreation Area (formed by Friant Dam, Fresno/Madera counties). In the winter, bald eagles can be found at this lake, along the San Joaquin River downstream of the dam, and along the Tuluomne and Stanislaus rivers, especially near their reservoirs located in the foothills of the Sierra Nevada.

Order FALCONIFORMES, Family ACCIPTRIDAE, Genus Haliaeetus, Species leucocephalus

According to Johnsgard (1990), there are two subspecies: H. l. leucocephalus, which breeds in the southern United States and Baja California; and H. l. alascanus which breeds from the Bering Island across northern North America. The two subspecies intergrade with one another in the central and northern states.

American eagle.

Wheeler, B. K., and W. S. Clark. 1995. A photographic guide to North American raptors. Academic Press, San Diego, CA, 198 pp; Johnsgard, P. A. 1990. Hawk, eagles, and falcons of North America: biology and natural history. Smithsonian Institution Press, Washington, DC, 403 pp; State of California, Dept. Fish and Game. 1990. California's Wildlife, Vol. II: Birds (D.C. Zeiner, W.F. Laudenslayer, Jr., K. Mayer and 1M. White, eds.). The Resources Agency, Sacramento, 407 pp; Ehrlich, P. R., D. S. Dobkin, and D. Wheye. 1988. The birder's handbook: a field guide to the natural history of North American Birds. Simon and Schuster, Inc., NY, 785 pp; Clark, W. S., and B. K. Wheeler. 1987. A field guide to hawks: North America. The Peterson field guide series, Houghton Mifflin Co., Boston, MA, 198 pp.

70-90 cm (27-35 inches)
180-225 cm (71-89 inches)
2.0-6.2 kg (4.4-13.6 pounds)

When seen from head on, the extended wings of a bald eagle are level, in contrast to the golden eagle whose wings are held in a slight dihedral (uplifted angle). The beak and cere of an adult bald eagle are usually the same color (yellow), whereas those of the golden eagle are tri-colored: cere yellow, base of beak grayish, and tip black. On flying golden eagles, the head projects from the body less than one-half the length of the tail.

N. L. Brown

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Waste Management – the 3 ‘R’s

Waste management includes all aspects of the process to manage waste from its manufacture to its ultimate disposal.  The process includes, collection, transport, sorting, treatment and disposal of waste. It also includes such things as monitoring and regulation which applies to both commercial and domestic waste disposal. reduce reuse and recycle Waste management

In general Waste Management refers to all aspects of waste including industrial waste and for raw materials and finished products. The concept of Waste management is designed to reduce negative effects of waste on the environment.

The expression  “3 Rs”  – reduce, reuse and recycle, is intended to classify waste management into three key factors relative to suitability in terms of waste reduction. There are many good reasons to reduce, reuse and recycle. Everything we use consumes resource and potentially must go somewhere once we’re finished with it. Reducing the amount of packaging particularly can have a great impact on environmental damage. Using natural materials can also help.
Reusing product instead of discarding them, finding new potential uses or simply passing them on to others can help save resources and money.
Recycling can be used for most of the items we use on a daily basis. The benefit of recycling can be manifold, including the reuse of materials or even the generation of energy from processes such as. landfill and combustion.

To know more about recycling and how we can help just call or click on our Waste Management page.

Recycling and the Law

Recycling & Waste management London FJL Recycling

With recent changes to recycling laws it is vital that your company recycles as much of the waste it produces as possible.

Waste can be described in several ways. It is defined in the law as “any substance or object which the holder discards or intends or is required to discard” (Waste Framework Directive 2008/98/EC).

Anyone who produces, imports, keeps, stores, transports, treats or disposes of waste must take all reasonable steps to ensure that waste is managed properly. For businesses disposing of waste efficiently is becoming much more important. It is estimated that over half of what goes into our bins can be recycled or composted.

Our Waste Management and Recycling Solutions will offer all the required segregation for you and provide you with a report for your previous months recycling. Our commercial waste and recycling services include food waste, glass waste, dry mixed (cardboard, paper etc) and even general waste (residual waste).

Commercial waste is separated into waste types or streams and each is recycled in a particular way, with varying levels of recycled goods, for example glass can be recycled into high-grade glass for bottles or new glasses etc. But it can also be recycled into eco-sand that is commonly used in the construction industry.

Learn more about Commercial Waste Recycling


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Karnata (kannada) and Anatolian (Altaic) Exchanges

Ancient Anatolia (Turkey) and karnata has Healthy exchange of Ideas and commerce. Both being at the cross roads of Human Immigration, Commerce and Exchanges in their respective regions. Let us see some of the known exchanges.Language Exchanges

Modern Kannada Shows striking similarities to Modern Turkish (Altaic Languages). Many words are common to the two languages. Another Common feature is Agglutination with several suffixes common.

Similarities to Kannada and Turkish Languages
Kannada and Turkish Language Similarities Apart from Grammatical similarities of Agglutination , both the languages share lot of common words both old and modern. A small list of words is given below.

Turkish word

Nearest Kannada equivalent

1) Agla- (Cry)

Alu (Weep, Cry)

2) Agri (Pain)

Uri (Burning sensation)

3) Al- (Take)

Arisu (Pick, Gather)

4) Alçalt- (Reduce)

Allisu (Erase, wipe off)

5) AltÛ (SÛx)

Aaru (Six)

6) (Arka)das (Friend)

Dasa (Follower)

7) AsÛr (Excessive)

Aatra (Hurry, haste)

8) BagÛr- (Shout)

Bayyi (Scold)

9) Bagla- (Tie, bind)

Bagi, bigi (Fasten, tie tightly)

10) Baskan (Chief)

Bhaskar (Popular name )

11) Basar (Success)

Basari (Pregnancy)

12) Ben (I)

Yen (I, old Kannada)

13) Bere (Bruise)

Bare (Burn, bruise)

14) Bir (One)

Bari (Only)

15) Bosal- (Drain)

Bacchalu (Drain)

16) Bögur- (Bello w)

Bogalu (Bar k, bellow)

17) Bölün- (Be divided)

Bolusu (Shave, cut)

18) ÇalÛs (Work)

Kelasa (Work)

19) Dal (Branch)

Dal (Branch)

20) Dillim (Slice)

Thilli (Dilute); Thelu (Thin)

21) Durak (Stop)

Dorku (Last long, ”halt‘ long?)

22) Eki (Sown)

Agi (Dig, an agricultur al operatio n)

23) Genis (Wide)

Genu (Width)

24) GÛda (Food)

Gadad (Heavy meal)

25) GÛrtlak (Throat)

Gilla (Lower chin)

26) Göl (Lake)

Kola (Pond)

27) Gör- (See)

Gur (Stare, ”Guri‘: Aim)

28) Görev (Duty)

Gaurava (Honour)

29) Gübre (Manure)

Gobra (Manure)

30) Gürü ltü (Lo ud no ise)

Guru lu (Rumble)

31) HalÛ (Carpet)

Haasu (Spread on the floor)

32) Hangi (Which)

Henge (How:Interrogative)

33) Hareket (Gesture)

Harke (Vow, religious gesture)

34) Hela (Toilet)

Helu (Excrement)

35) Iç (Inside)

Iche (Outside, this side)

36) Isyan (Revolt)

Asainya (Repellant)

37) Iste (Like)

Ishta (Like, Love)

38) It- (Push)

Idu (Put, Push)

39) Iyi (Good, well)

Haayi (Soothing)

40) Kabuk (Rind, Shell)

Kabbu (Sugar cane)

41) Kalk- (Depart)

Kalach- (Detach, Fall off)

42) Kara (Black)

Kari (Black)

43) Karga (Crow)

Kaage ( Crow)

44) KatÛ (Hard)

Gatti (Hard)

45) Katlan- (Suffer)

Kashta (Difficulty, suffering)

46) Kol (Arm)

Kol (Stick), Tolu (Arm)

47) Kopar- (Break off)

Kopa (anger)

48) Korku (Fea r )

Korgu (Worry)

49) Kötü (Bad)

Kett u (Bad, Evil)

50) Kurul- (Be established)

Kuru su (Set/sit down)

51) Kutu (Box)

Kattu (Build, Tie, Package)

52) Kuzu (Young of lamb)

Koosu (Kid, babe)

53) Küçük (Small)

Chikk(a) (Small, Tiny)

54) Narin (Slender)

Naaru (Long and slender fibre)

55) Oku- (Read)

Odu (Read)

56) Orta (Middle)

Ardha (Half)

57) Ögle (Noon)

Hagalu (Day)

58) Ölçu (Measure)

Alte (Measure)

59) Önce (In front)

Munje (Before)

60) Önde (In front)

Munde (In front)

61) Örtü (Cover)

Ho ddu- ( Cover with blanket)

62) Öte (Yonder)

Atta (That side)

63) Payla- (Scold)

Bayyi (Scold)

64) Pibek (Cat, old Altaic)

Bekku (Cat)

65) Salla (Shake)

Alla- (Shake)

66) Satis (Sale)

Setty (Dominant merchant caste)

67) SayrÛ (Ill, Sick)

Saayi (Die)

68) Seda (Sound)

Shabda (Noise)

69) Sevgili ( Darling)

Cheluvi ( Girl)

70) SÛcak (Hot)

Shakha (Warmth)

71) SÛra (Chain)

Sara (Chain, necklace)

72) Tarak (Rake)

Yerka (Harrow)

73) Tepe (Hill)

Tippe (Rubbish heap)

74) TÛrmanmak (Climb)

Tirmana (Conclude, final ruling)

75) Tunç (Bronze)

Kunch (Brass, bronze)

76) Tüm (Whole)

Thumba (Full)

77) Ucuz (Cheap)

Uchita (Free)

78) Uyu- (Sleep)

Uyyale (Swing, Cradle)

79) Uza- (Lengthen)

Udda (Length/long)

80) Ütü (Press)

Ottu (Press)

81) Var- (Arrive)

Bar- (Come, arrive)

82) Vardiya (Shift period)

Vare (Shift, move)

83) Ver- (Give)

Biru (Offer)

84) VÛrÛldan- (Talk incessantly)

Varalu (Grindstone)

85) Vurgu (Stress)

Ooru (Press heavily)

86) Yat- (Lie down)

Yatne (Suffering)

87) Yedi (Seven)

Yelu (Seven)

88) Yemek (Food)

Melk (Chew, cud)

89) Yetki (Capacity)

Yetku (Reach up, also a measure of ability)

90) Yirmi (Twenty)

Ippattu (Twenty)

91) Yudu m (Gu lp)

Gudu m (Gu lp)

92) Yün (Wool)

Unne (Wool)

93) Yüz- (Swim)

Iju (Swim)

Turkish Kannada

(n)in genitive (ina)in genitive identical meaning

li(with) (li)within

ki(off, in) ki(for)

di ,da(locative) da(of)

Typical examples: Istanbulun (Istanbul‘s), Bangalorina (Bangalore‘s); Ankara‘da (in Ankar a), Kalkattada (of Calcutta); the accusative and dative suffixes are also similar and involve vo wel ending s, but with an intervening ”k‘ or ”g‘ in the Kannada case.

One also notes that even when their meanings are not identical, the words may belong to similar classes (e.g)hangi-henge‘ are both interrogatives It is also interesting to note that in many cases, Kannada possesses words of equivalent meaning but deriving from different sources; in these cases one o f the words apparently possesses a specific or occasional sense. Thus, ”give‘ in normal parlance is ”kodu‘,clearly of Dravidian lineage; however, the apparently Altaic ”biru‘ specifically refers to the offering of sesame during the harvest festival. Similarly, ”cut‘ is normally conveyed by ”kattharisu‘, clearly of Indo-European origin; however, the apparently Altaic ”bolusu‘ specifically means ” shave‘. It appears that synonyms of differing origins were accommodated in this manner as the three different linguistic streams merged in Kannada.

Some of these words are found in other Dravidian languges also, but most words seems to be shared between only kannada and Turkish. Many times the closest dravidian word is kannada. (e.g)Gobra and gubre for Fertiliser , sira and sara for chain, Tum and Tumba for full, Bagir and Bayyi for shout or scold etc prove extensive interaction in the past.

The Hittites were the first known people of Indian origin to colonise todays Turkey. They suddenly appeared around 2000BC. They were the first to use Iron in West Asia and Europe and they have superior Iron armour and weapons. They ruled from 1900 – 1000BC. Their Country is called Land of Hatti. Their capital is Hatti or Hattusa and they called themselves Nesite (Kanesili) meaning they are from Nesa (Kanesh city). Their First king was and then Pithana from kussara. His son were Piyusti, Anitta , was the first give compose text. The Other famous kings include Hattusili. Hittites regained their power after a lull with kings like Tudhaliya ,Suppiluliuma , mursili , Arnuwanda, Telepinu, Tahurwaili, Hantili, Zidanta,Ammuna, Huzziya etc.

Bible often refers to Hittites as son of Canaan.

Pharaoh Ramses II often referred to the Hittites as having long hair.

One cannot neglect the similar words to Kannada like Hatti (settlement or village) , Kanes(similar to kannada), Pithana(paithana) and many kings names are sounding similar to kannada names. The Hittites were experts in iron same as kannadigas and they Hatti mines are world famous and of considerable antquity. Are Hittites Kannadigas?

Roman Karnata links

Before first Century AD Monsoon winds used by handful of Indian and Arabs sailors and their use was unknown to the European (Roman and Greek) and Egyptian traders. But when the Romans became aware of the Monsoon winds and opening of Red sea led to huge trade with Romans , many of the southern ports came to be established and sea trade for sometime replaced land trade routes like silk road.

Karnata coast seems to be the most studied coastline at that time. We find The karnataka coast , people, trade items mentioned frequently in foreign literature, such as the Periplus Maris Erythraei. The area was noted for its severe tidal currents, turbulent waves, and rocky sea-beds. Although many ships have attempted to sail outside it in order to prevent shipwrecks, many ships were still drawn inside . As a result of the difficulties, the entrance and departure of ships were dangerous for those who possessed little sea experience. The anchors of the ship would be caught by the waves and quickly cut off, which overturned the ship and ultimately cause a wreck.

Since one must sail against the narrow gulfs of western India, special large boats were used and ship development was demanded. Near the Coastal lines, large ships called trappaga and cotymba helped guide foreign vessels safely to the harbor. These ships were capable of relatively long coastal cruises, and several seals have depicted this type of ship. In each seal, parallel bands were suggested to represent the beams of the ship. In the center of the vessel is a single mast with a tripod base. Apart from the recent explorations, close trade relations as well as the development of ship building were supported by the discovery of several Roman coins. On these coins were depictions of two strongly constructed masted ships. Thus, these depictions of Indian ships, originating from both coins and literature (Pliny and Pluriplus), indicate India’s prowess in seafaring due to the increase in Indo-Roman commerce. In addition, the silver Roman coins discovered in karnataka primarily come from the first, second, and fifth centuries. These Roman coins also suggest that India possessed a stable sea borne trade with Rome during first and second century AD. Land routes, during the time of Augustus, were also used for karnataka embassies to reach Rome.

The discoveries found on karnatak coast strongly indicate that there were strong karnata-Roman trade relations during the first two centuries of the Christian era. The third century A.D, however, was the demise of the Indo-Roman trade. The sea-route between Rome and India was shut down, and as a result, the trading reverted back to the time prior to Roman expansion and exploration that is through landroute(Dakshinapatha).

Karnata and Byzantine Empire
The Loss of Sea Trade resulted in the loss of revenue and Middleman called Persian empire stepping in to demand greater share in trade. So the Eastern Roman Empire based out of Constantinople setupon the task of liberating the Red Sea and reestablished the trade with Karnataka coast for sometime. Direct Trade with Karnata during Byzantine time is very less. Most of the trade took place through Arabs by sea route and persians by land route

Tipu Ottoman links

With the Gulf region firmly under the control of the British, Tipu’s trade relations with the area suffered. He had to soon take some bold steps to revive the commercial relations with the area lest it undermine his position at home. Tipu still perceived the Ottoman empire as strong and hence thought of seeking assistance.

As early as 1784 Tipu had sent an exploratory mission to the Sublime Porte to find out whether an embassy there would be productive. When he was told about the efficacy of having a mission at the Port, Tipu decided to sent a large mission consisting of 900 people on 17 November 1785. The leader of the delegation was Ghulam Ali Khan and included Nurulla Khan, Lutf Ali Khan, Jafar Khan and others. The delegation after a long and difficult sea/land journey via Muscat, Bushire, Basra, Baghdad and other places reached Constantinople on 25 September 1787.

It was only on 5 November 1787 the Ottoman Sultan Salim-III received Tipu’s emissaries with honour and decorated them. The Sultan accorded permission to Tipu to assume the title of an independent monarch and the right to strike coins and to have the khutba read in his name. The envoys were also given for Tipu friendly letters, khillats, a sword and a shield studded with precious stones by the caliph and his grand wazir. With this, one of the major objectives of the mission had been accomplished.

Tipu also sought military assistance from the caliph to put an end to the British menace in India. In order to impress upon the caliph the gravity of the situation and the urgency of his demand, Tipu sought to arouse the religious sentiments of the caliph by highlighting to him the subversive and deceitful manner in which the British had become overlords of large parts of territories which actually belonged to the Mughals.

More significantly in order to make sure his mission would succeed, Tipu also impressed upon the Ottoman Sultan that the British were humiliating the Muslims in India by forcibly converting them to Christianity and changing the mosques to churches.

The Ottoman Sultan found it easy to recognise Tipu as an independent king but found his request for military assistance hard to entertain, because he himself was preoccupied with defending his possessions under challenge from the Russians, Austrians and others. He politely but firmly turned down Tipu’s request for a body of Turkish mercenaries to be sent to Mysore to fight against the British.

Tipu wanted the Ottoman Sultan to send him a body of troops whose expenses would be borne by him and they would be sent back to Porte at his expense whenever they would be required by the caliph. In the end, the sultan declined to provide any tangible military help to Tipu. It must be repeated that the Ottoman Sultan facing outside threats could not expect help from France due to the turmoil there leading towards revolution. In fact, Britain was busy mediating peace between Turkey and her enemies, Russia and Austria. The Ottoman Sultan, therefore, was in no mood to help Tipu and lose British friendship.

Lastly, Tipu aware of the rich potential of his kingdom especially in the field of agriculture and other items which were in great demand, sought to establish state to state trade ties. The lucrative trade had made Mysore the richest and most prosperous part in the country which the British and the French sought to dominate and control.

Tipu correctly analysed the reasons for the political decline of the Indians, the most important being their indifference to trade, commerce and industry. The Europeans though extensive monopoly of trade had elbowed the Indians out of this field and also controlled and dominated the Indian states.

He urged the members of the delegation to secure trade privileges with the Ottoman empire on a reciprocal basis; he wanted Basra in exchange for Mangalore, that Turkey should help him in establishing various factories in Mysore and by sending technicians specialised in the art of making muskets, guns, glass, chinaware and other military hardware and in return Tipu would send workers required by the caliph. As the English agent from Basra reported: ‘We have reasons to believe that the embassy to the Porte is for the purpose of obtaining firmans to establish factories in the Turkish ‘dominions…’. Manesty, the English agent at Basra, also wrote to the Court of Directors on 5 September 1786:

The Wakils want to obtain Firmans to establish factories in Turkish dominions for selling the productions of his kingdom. We think this is a circumstance very material for he Honourable Court of Directors to be acquainted with, as we apprehend it precludes all hopes of your servants at Tellicherry being able to provide pepper for your homeward ships?

In early 1799 Caliph Salim III addressed a letter to Tipu describing the French invasion of Egypt and Their plan to conquer Arabia, divide it to republics and extirpate Islam.
He further wrote that the French also wanted to conquer India and deprive its people of their religion, life and property. He advised Tipu to refrain from any hostile activities against the English at French instigation, and offered to adjust satisfactorily any cause of complaint that he might have against them.

Tipu replied to the caliph professing devotion to him and agreeing that as the French were on inimical relations with the head of the faithful, all Muslims should renounce friendship with them.
Later on the British made full use of the passages from the caliph’s manifesto and letter to Tipu.

Religious chuvanist

His eagarness to establish links with ottoman empire lead to serious consequences in mysore. In order to Impress Ottoman emperor Tippu approached then Mughal king to secure recommendation. And Mughal king took his pound of Flesh. He asked Tippu to declare persian as the State Language and Islam as State Religion . This led to lot of oposition and agitation and Tippu lost much of popularity by imposing a foreign religion and Language. Further the Mighty Mysore Army was diluted with introduction of rogue muslim mercenaries as commanders whose only aim to plunder people wealth and their conquest consists of destroying temples and converting people enmass to islam by threat and whatever means. The mercenary commanders have their own agenda and cared nothing about welfare of people. Even the Sringeri mutt was not spared. Eventhough Tippu said to have sent a apology letter to mutt, the popularity of Tippu was fast declining. When Tippu sought a platoon from Turkey , it showed the extend of his local popularity decline in Mysore. The once Mighty mysore army has become such a sorry state of affairs that in the end could not even defend the most secure Fort, Srirangapatna. Many local felt that British rule will be less tyranical to Tippu rule.

An apparent sprinkling of Altaic words in a Dravidian language (Kannada). Possible historical significance for South So sale Chandrasekhar, Midd le East Technical University, 06531, Ankara (Turkey)

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Wednesday, 20 February 2013

A Warning to the Curious Editor

It may come as some surprise that my favourite writer of chilling tales did not produce his most famous works in the Victorian period at all, but rather in the Edwardian era. Montague Rhodes James was certainly a Victorian, however, and his tales encapsulate the greatest motifs of his age, and spin them into something extraordinary, which to my mind gave birth to the 'modern' ghost story.

I will revisit M. R. James' work in future blog posts, but for now I want to talk about a new-ish edition of his collected works that I recently acquired. This book is called Curious Warnings, the 150th anniversary edition of James' collected tales.

This is a beautiful book; a real treasure. Chunky, leather bound, with black flocked page edges, nice paper and binding; everything, in fact, that a print nerd like me loves. The editor, Stephen Jones, has taken two unusual steps when compiling this book, which really brings me to my point.

The first thing he's done, and the most welcome, is to make the prose easier to read by the judicious use of typesetting. James' work notoriously includes lengthy extracts of poems, journals, letters, newspaper articles, religious tracts and so on, which can be quite confusing when they're presented as continuous blocks of run-on text. It seems like such an obvious thing to do, that it's surprising no-one's thought of it before. Simply by indenting the extracts and choosing a nice typeface, it suddenly becomes easier for the brain to follow the story (the exception is the story 'Martin's Close', which uses a horrible typewriter font for several pages, but that's just personal taste).

But now comes the nub. Stephen Jones has also edited the language of the book  no cutting of words nor re-ordering of the manuscript  but he has re-punctuated throughout, so that old-fashioned spellings of words like 'to-day' are corrected. In his foreword, he's quite unclear as to exactly how far he's gone. Indeed, without reading two editions side by side, I doubt the layman would notice. (So far I've spotted a considerable number of new paragraph breaks, and some dodgy dialogue punctuation). But for me, loving the past as much as I do, I can't help but think that the work has lost something in translation, a certain charm of its time. The editor says it was purely to make the work 'more accessible to a modern audience', but I don't get that. You'd be no more or less likely to buy this handsome book because you knew there was old-fashioned punctuation within, would you? If you find the language impenetrable, then a few hyphens won't help.

No; as an editor, I accept that language is constantly evolving, but I also believe that words as painted by the masters are sacrosanct. Removing hyphens from M. R. James is only a slightly smaller crime than modernising Shakespeare (it's been done, a lot, but I believe it only serves to create a curio rather than a work of art, as the beats and flow are replaced by another's efforts). I think the language that you choose to write in, even if it's just an older form of our own, should stay as the author intended it. If anyone picked up something of mine to read in 150 years time (I can dream, right), I think I'd be posthumously offended if an editor had taken the red pen to it whilst I lay spinning in my grave (hey, it's 150 years in the future, it'll probably be all txt-speak and that. Dope.)

But still, after all that, I'm glad I own it. It's one of the nicest books in my collection, and the stories within are still my favourite ghost stories ever written. If you've never read M. R. James, then I seriously recommend them in any form. For the traditionalists, try this one (lovely little hardback). Those less fearful of the hidden dangers of toying with ancient manuscripts should give Stephen Jones' edited version a go...


Presidential control only exists in hindsight

New NYT: Obama and the myth of presidential control
[Via Brendan Nyhan]

From my new Upshot column:

One of the most common criticisms of presidents – especially struggling ones during their second term – is that they have lost control of events.

This charge, which has been leveled at chief executives such as Ronald Reagan and George W. Bush, has become a mantra lately in coverage of President Obama, who faces a stalled legislative agenda and crises in Ukraine, Gaza and at the border with Mexico.

What happened? One frequent explanation from pundits and journalists is that Mr. Obama has “little control” and is instead being “driven” or “buffeted” by events.

This notion pervades commentary and debate on the presidency.

I would tend to agree with this. We put too much focus on the President as though he was some sort of monarch. It is not true when things are happening. Hindsight lets us believe the President  was in charge of some things when he often was not.

FDR only got control of WW2 after the Japanese attacked Pearl Harbor. He tried all sorts of things to move us closer to joining the war before but was unable to accomplish our entry simply by himself.

Kennedy succeeded with the Cuban Missile crisis not purely with a direct show of military might (we had plans to wipe out the military bases almost overnight). He was vastly supported by the soft power of Adlai Stevenson’s private presentation and the United Nation’s secret negotiations.

Reagan only needed to say “Tear down this wall”. The people in Germany made it happen, but probably not because Reagan had any direct control. That is the soft power of a President.

It is often the indirect actions, sometimes in secret, of a President, not the ones he takes direct control of, that have the greatest impact.

During an administration, we often bemoan the inability of the President to do anything. But we only seem to recognize what a President “does’” twenty years later.

Few have the ability to see it at the time.


Frank "Grayhawk" Huminski

Frank “Grayhawk” Huminski is a native of south-central New Jersey (not far from Philly) who currently resides near Washington DC. A former theater technician, rental manager, security guard, bouncer, and Tech-support-ninja-monkey, he now makes a living fiddling about with computers for a secret branch of the federal government that resides within the walls of >agency redacted<. Or something like that. Grayhawk has served on the staff of several conventions, and desperately tries to suppress the urge to volunteer again and again and again. His doctors are still trying various pharmaceuticals to help control this.


Explore BrainMass

Internal and External Sourcing Strategies

Write a paper in which you differentiate between internal and external sourcing strategies in service and manufacturing organizations. Address the following:

- What are the advantages and/or disadvantages of global sourcing?
- Assume the position of being in favor of or opposed to outsourcing a product/service within your organization to a foreign country.
- Defend your position with supporting arguments and facts.
- How would your position change if your organization mandated global sourcing?

Solution Preview

The response addresses the queries posted in 1376 words with references.

//Global sourcing is considered to be a beneficial service, which companies are using now a days in their daily operations. While writing this paper, the advantages and disadvantages of global sourcing will be explained. Followed by this, an explanation will be given in the favor of outsourcing a product or service within your organization to a foreign country//

Global Sourcing Advantages and Disadvantages:

On the other hand, the disadvantage of global sourcing is that the management has to be skilled and talented, so that the business can be handled globally. If the managers are not able to handle the business in the best possible manner, it will run down into losses, which will affect its growth in the global market. The cultural environment and framing of government policies affects the outsourcing of the business. So, there is a need that the complexities should be managed properly by the management, so that the cost does not ...


Global warming is a hoax, invented in 1988

August 1, 2006 — budsimmons

Man-Made Global Warming Hoax

Excerpts reprinted with permission from Tom Gremillion
Tuesday, January 25, 2005

Global warming is a hoax, invented in 1988, that combines old myths including limits to growth, sustainability, the population growth time bomb, the depletion of resources, pollution, anti-Americanism and anti-corporate sentiment and, of all things, fear of an ice age. Those that espoused and supported the old myths have joined forced into a new group called “Environmentalists.”

In 2004, the energy from massive solar flares bombarded the Earth with solar energy. This solar energy caused heating of the Earth’s surface and atmosphere. Most of the energy of the solar flare eruptions dissipated into space. The amounts of energy ejected were massive, much greater than normal. Had the Earth received a full blast of the solar energy from one of the numerous flare eruptions in 2004, the consequences to life on Earth could have been disastrous. The higher than usual amounts of energy that struck the Earth’s atmosphere did have their effects, however, including some heating of the atmosphere.

Then there is the eruption of volcanoes, such as Mt. St. Helens, ejecting dust and ash into the Earth’s atmosphere. The amount of dust and ash in the atmosphere varies the amount of energy that can cause heating or cooling of the Earth’s atmosphere. Volcanoes also eject the kind of compounds that environmentalists call greenhouse gases. A single eruption the size of the Mt. St. Helens eruption released more of these gases, dust and ash into the atmosphere than all such emissions by human activity since the beginning of recorded human history. And there are numerous volcanic eruptions yearly.

Studies have shown that greenhouse gases produced by human activity accounts for around 1 percent of the gases in the atmosphere. The total elimination of human generated greenhouse gases would have a negligible effect on Earth’s global mean atmospheric temperatures. The elimination of all U.S. gasoline powered vehicles would reduce worldwide “greenhouse” emissions by less than 0.2%.” What would be the effect on global mean temperatures? None. Doubling of manmade greenhouse emissions above current levels would increase the global mean temperature by one degree Centigrade, which is within the normal range of temperature swings.

It is the fluctuations of the Earth’s orbit around the sun, volcanic eruptions, the emission of gases by oceans and trees, all natural occurrences, that cause rises and declines in global mean temperatures, i.e., “global warming” and “global cooling,” not human activity.

Is this “global warming, Mars style” and do Martian SUVs, power plants, and industries cause it? Hardly, but the “environmentalists” think so. Some even blame it on us here on Earth.

Global warming IS a hoax. Those claiming that “global warming” is real have an agenda other than saving the planet from human activity


Bournemouth University

Master Computer Games Technology (Full-time, Part-time) - Máster en Tecnología de Videojuegos

Bournemouth University
  • Imparte:
  • Modalidad:
    Presencial en Dorset
  • Precio:
    Unlimited number of Scholarships available for September 2016/January 2017
    Please fill out the enquiry form for more information

    EU £6,250 Non EU £14,500
  • Comienzo:
    Septiembre 2017
  • Lugar:
    Fern Barrow, Poole,
    Dorset (Bournemouth) BH12 5BB
    Reino Unido
  • Duración:
    1 Año
  • Idioma:
    El Curso se imparte en Inglés
  • Titulación:
    Computer Games Technology MSc (Full-time, Part-time)
  • Otras Convocatorias:

    In recent years there have been significant developments in the philosophies, methods and tools for planning, implementing and producing computer games. The MSc in Computer Games Technology at Bournemouth University is designed to provide the relevant industry with expert personnel who understand the technical tools and techniques required by the gaming development sector.

    The topics covered will provide you with an in-depth knowledge in a number key areas of games technology and production. You will be working on advanced skills for different parts of the games development pipeline such as

    games programming
    level design
    3D modelling
    artificial intelligence
    and the use of physics in games, intellectual property issues and others. The course takes into account the radical changes in the gaming industry and its platforms, covering PC/console to tablets, mobile and smart phones with all the new challenges and opportunities they bring.

    Students having completed a BSc with a minimum of a 2:1 in computer science, electronics or a related technical discipline.
    Practitioners and professionals already employed in the industry looking for additonal theortical and practical knowledge.

    This course aims to provide you with the ability to plan, implement and produce computer games using modern methods and tools. If you have a first degree in computer science or a similar technical degree, and want to get into gaming, then this is the course for you!

    Year 1 / Level M
    Game Development
    The aim of this unit is to develop your skills in computer games and computer graphics modelling development. In this unit there is a particular emphasis on the underlying technical theory and software needed for developing computer games and computer game assets and/or content for deployment on today’s real-world entertainment systems.

    Intellectual Property in the Digital Economy
    You will gain an understanding of the principles of intellectual property law (such as copyright, trade marks, confidentiality and related e-commerce regulation) and how this has become indispensable for professionals aiming for a career in the digital economy. This unit will provide you with a thorough grounding and critical appreciation of legal sources, regulatory environment and strategic impact on business decisions.

    Research Methods
    You will use key research skills in areas such as literature reviews, critical analysis of research findings, project proposals, planning, experiment design and analysis and dissemination. This unit will adequately prepare you for writing a project proposal and for conducting and disseminating the Masters project.

    Individual Masters Project
    Using real life problems you will use your knowledge gained from the programme, research findings and industrial experiences to produce an independently conducted piece of work. The project may be linked to the research being undertaken within School of Design , Engineering & Computing research centres.

    This project will develop your knowledge of philosophy, methodologies and techniques of research. It will provide an opportunity to critically investigate and report on a particular issue in depth. This project will enable you to engage in complex issues and present an analytically rigorous and well argued case.

    Advanced Games Programming
    To produce professionals with knowledge and skills in computer graphics and games programming with a particular emphasis on the underlying technical theory and programming paradigms needed for developing computer game programs.

    Mathematics for Games
    The aim of this unit is to produce professionals with knowledge and skills in mathematics for computer games, the unit will place particular emphasis on the fundamental mathematics required to underpin computer graphics and game physics.

    Game Physics and AI
    Introduce the concepts and techniques required to incorporate physical behaviour in game entities and to endow those entities with artificial intelligence capabilities to achieve realistic and challenging game play. Commencing with a review of the fundamentals of physics and AI, the unit will then develop the necessary coding techniques to enable inclusion of physics and AI in a range of game genres.

    Salidas profesionales

    After the completion of this Masters you will have an advanced skillset in diverse areas of the games development pipeline and be capable of being employed in the gaming sector in job roles such as technical artist, level designer, 3D modeller, character animator, producer, graphics programmer, AI programmer and physics programmer to name but a few.

    ¡Infórmate ahora sin compromiso!

    Cursos Relacionados

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Article Text

American-Indian diabetes mortality in the Great Plains Region 2002–2010
  1. Allyson Kelley1,
  2. Jennifer Giroux2,
  3. Mark Schulz1,
  4. Bob Aronson3,
  5. Debra Wallace1,
  6. Ronny Bell4,
  7. Sharon Morrison1
  1. 1Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
  2. 2Department of Public Health Education, Great Plains Tribal Chairman's Health Board, USA
  3. 3Department of Public Health Education, Taylor University, USA
  4. 4Department of Nursing, Wake Forest University, USA
  1. Correspondence to Dr Allyson Kelley; A_kelle2{at}

Objective To compare American-Indian and Caucasian mortality rates from diabetes among tribal Contract Health Service Delivery Areas (CHSDAs) in the Great Plains Region (GPR) and describe the disparities observed.

Research design and methods Mortality data from the National Center for Vital Statistics and Seer*STAT were used to identify diabetes as the underlying cause of death for each decedent in the GPR from 2002 to 2010. Mortality data were abstracted and aggregated for American-Indians and Caucasians for 25 reservation CHSDAs in the GPR. Rate ratios (RR) with 95% CIs were used and SEER*Stat V.8.0.4 software calculated age-adjusted diabetes mortality rates.

Results Age-adjusted mortality rates for American-Indians were significantly higher than those for Caucasians during the 8-year period. In the GPR, American-Indians were 3.44 times more likely to die from diabetes than Caucasians. South Dakota had the highest RR (5.47 times that of Caucasians), and Iowa had the lowest RR, (1.1). Reservation CHSDA RR ranged from 1.78 to 10.25.

Conclusions American-Indians in the GPR have higher diabetes mortality rates than Caucasians in the GPR. Mortality rates among American-Indians persist despite special programs and initiatives aimed at reducing diabetes in these populations. Effective and immediate efforts are needed to address premature diabetes mortality among American-Indians in the GPR.

Statistics from

Key messages

  • American-Indians are 3.44 times more likely to die from diabetes than Caucasians living in the same geographic areas, despite extensive efforts to address these disparities. American-Indians living in South Dakota have the highest mortality rates from diabetes in the Great Plains Region and the reasons for this are not clear.

  • Existing diabetes mortality data are available and programs such as SEER*Stat are a useful tool for hard to reach populations, such as American-Indians where small population size and a lack of tribal-specific data are common barriers.

  • Future research between universities and tribes should use tribal partnerships and consortia. This will help ensure researchers use methods that are appropriate for the population and culture while recognizing the unique tribal and geographic variation as they relate to diabetes mortality.

Deaths from diabetes have increased significantly in the past two decades, impacting every state, age group, sex, and racial and ethnic group in the USA.1 However, some regions and populations carry a disproportionate burden of diabetes. Diabetes was the fourth leading cause of death among American-Indians (AIs) and Alaska Natives (ANs) between 1999 and 2010 and the seventh leading cause of death in the US population.2 Diabetes was the second leading cause of death for AIs in North Dakota, South Dakota, Iowa, and Nebraska in 2010;3 however, these rates may be 15–25% higher because death certificates often under-report diabetes as the underlying cause of death.4 To address mortality differences, public health officials, tribes, and policymakers must first document tribal-specific disparities. However, this task is often difficult to complete due to the lack of tribal-specific data, small populations, and confidentiality issues. In addition, there is a lack of substantial data and poor surveillance infrastructure in tribal communities. No known published study has examined mortality rate differences in diabetes among AIs and Caucasians residing in the same reservation areas in the Great Plains Region (GPR), (Montana, Wyoming, South Dakota, North Dakota, Iowa, and Nebraska).

Persons with diabetes often experience comorbidities such as heart disease, stroke, and kidney failure. Many patients with diabetes experience increased mortality from pneumonia and influenza.4 AIs experience more comorbidities and more severe complications from diabetes that lead to premature mortality. A recent study in South Dakota compared AI adults with diabetes and the US adult population with diabetes and found a higher prevalence of hypertension, cerebrovascular disease, lower extremity amputations, mental health disorders, and liver disease among the AI adults.5

Often, AIs experience additional risk factors for diabetes complications than other racial and ethnic groups. AIs over the age of 25 years are less likely to have a college degree or high school diploma and 77% of them have a high school diploma compared with 91% of Caucasians.6 AIs report higher rates of smoking, obesity, and unhealthy diets, all of which increase the risk of diabetes and death from diabetes.7 ,8 AIs also report significantly lower income than Caucasians. In 2010, the median income for AIs in the USA was $39 664 compared with $67 892 for Caucasians.9 Low income is linked with persistent poverty conditions. Lower income and persistent poverty are associated with higher mortality from all causes in the general US population.10 ,11

AI communities experience segregation, oppression, and discrimination, often linked to colonization,12 ,13 and these factors may contribute to differences in diabetes mortality and inequalities in health outcomes across tribal nations. As a racial minority, AIs may experience racial oppressions that contribute to health differences.14 AIs may experience more discrimination from healthcare providers than Caucasians15 and this may influence how they seek care, prevent or manage diabetes, and cope with complications from diabetes. Healthcare service and delivery for AIs are often described by geographic region.

In the GPR, AIs represent a relatively small percent of the population as a racial minority. However, AIs are an important group to study because of mounting evidence that they experience extreme health disparities and premature mortality.16–18 Similarly, in the USA, racial and ethnic minorities have poorer health than Caucasians19–21 and report higher mortality from diabetes.

The purpose of this study was to document diabetes mortality among AIs and Caucasians in the GPR and describe the differences observed. One unique contribution of this study is the use of a tribally recommended approach for calculating reservation-specific mortality rates.

Research design and methods

Description of study area

The GPR as defined for the study encompasses 6 states and 25 tribal Contract Health Service Delivery Area (CHSDA) regions: Montana, Wyoming, North Dakota, South Dakota, Nebraska, and Iowa. This does not include Minnesota or Wisconsin, which are sometimes defined as part of the GPR, because the Great Plains Tribal Chairman's Health Board and the Montana Wyoming Tribal Leaders Council were partners in this study, and they do not serve tribes in the Minnesota or Wisconsin areas. Combined, the GPR includes 6 states, 390 counties, and 7 641 494 persons, of whom 74.6% were Caucasian and 4.17% were AI.22 This study focuses on 78.8% of the population who are AI alone or Caucasian alone. Other populations in the GPR include Hispanic/Latino, Asian Pacific Islander, African-American, Native Hawaiian, and two or more races; however, the predominant racial classification in Montana, South Dakota, and North Dakota is Caucasian alone and AI alone. This study focused on these groups and observed differences.

American Indians

AIs and ANs are tribal groups in the USA and therefore are not truly ethnic minorities. The 2010 census reported that 5.2 million people identified their race as AI/AN alone or in addition to another racial category. Of these, 2.9 million identified themselves as AI/AN alone and 2.3 million people as AI/AN in combination with another race. The AI/AN population has increased 39% since 2000.6 The Bureau of Indian Affairs recognizes 566 different tribal groups and of these, 25 reservations are located in the GPR.23 In this study, AI refers to the indigenous peoples of the GPR. Few ANs reside in this region. AIs in this study were identified in the data based on death certificates.

Reservation CHSDA regions

CHSDA regions are comprised of counties located on or bordering federally recognized tribal lands (eg, §42 CFR 136.22). Approximately 57% of the AI population resides in 624 tribal CHSDA counties throughout the USA.24 In the GPR, 110 of the counties have CHSDA status. Within these CHSDA areas, health services are provided from public or private medical or hospital facilities at the expense of the Indian Health Service if funding is available. CHSDA counties are often used by researchers and federal programs to identify AI populations and subsequent county-based mortality rates by racial classification (AI vs Caucasian). For example, the Surveillance, Epidemiology, and End Results (SEER) program uses CHSDA status to classify segments of the US population by county, race, region, and disease-specific mortality.25 Reservation CHSDA regions have higher AI populations and often report less misclassification of AI status when compared with non-CHSDA counties.3 ,24 However, the use of reservation CHSDA counties must be approached with caution because tribes do not always feel that federally designated reservation CHSDA regions accurately represent their tribe(s) and tribal members (Giroux, personal communication, January 13, 2013). In this study, the researcher consulted with two tribal health boards in the GPR, the Northern Plains Tribal Epidemiology Center and the Montana Wyoming Tribal Leaders Council, to determine which counties should be included in tribal-specific analyses. For example, some tribes in the GPR prefer that reservation counties are used instead of CHSDA counties.3 Also, reservation CHSDA counties may overlap and therefore tribal-specific mortality rates must be interpreted with caution. Of the 118 counties included in the GPR, 20 overlap and are shared by more than one reservation CHSDA region. In this study, diabetes mortality data are based on 110 CHSDA counties and 8 additional reservation counties. Combined, this area makes up 25 reservation CHSDA regions.

The reservations and counties linked to tribes in the current study were identified and defined based on previous work with tribal leaders in the area3 and county designations from the 2000 US Census. Reservation CHSDA region data were used because tribal registries are not available in these areas, and reservation CHSDAs provide the most comprehensive area to measure of mortality between AIs and Caucasians in the GPR. In order to calculate reservation CHSDA region diabetes mortality rate ratios (RR) between AIs and Caucasians living in the same county, this study combined multiple counties that make up reservation CHSDAs. Tribes and reservations were designated based on federal recognition and the counties that made up reservation boundaries.3 ,23

SEER*Stat data were used to examine diabetes as the underlying cause of death by AI versus Caucasian status from 2002 to 2010. Multiyear data were aggregated from 2002 to 2010 to limit potential instability of county rates, as suggested by a previous research report.24 The National Center for Vital Statistics National Statistics System in the USA provides coverage of deaths within the GPR by county and includes county of residence, race/ethnicity, and underlying cause of death for each decedent by year. Only individuals who self-reported one race, AI (or AN), were counted as decedents in the numerator. Population characteristics from the US Census Bureau's Population Estimates Program incorporate intercensal populations by year, county, race, sex, and age. Population characteristics were used to calcualte rates and only individuals who self-report as exclusively AI (or AN) were included in the denominator and very few ANs (<0.01%) reside in this geographic area. Deaths coded according to the International Classification of Diseases, 10th Revision (ICD-10) standards and only underlying causes of death “Diabetes Mellitus” (ICD-10: E10-E14) were used to calculate mortality rates from the SEER 2002–2010 US mortality registry.25

Diabetes mortality rates were expressed per 100 000 persons and age-adjusted to eliminate the effect of differences in age composition among AIs and Caucasians. SEER*Stat 8.0.4 software calculated age-adjusted diabetes mortality rates using the 2000 US standard population.25 Data were suppressed by SEER when <10 deaths occurred during the time period of interest. Mortality rates between AI and Caucasian populations were compared by RR with 95% CIs.

The age-adjusted diabetes mortality rates among AIs residing in reservation CHSDA areas were significantly higher at 71 per 100 000 than among Caucasians residing in the same areas at 20.6 per 100 000. In the GPR, this mortality RR is 3.44 times higher among AIs than among the Caucasians. This is significantly higher than the US mortality rate for AI/ANs of 20.5 per 100 000.25 Table 1 shows differences in mortality rates by state in the GPR, with South Dakota having the highest mortality RR of any state in the region. The mortality rates among AIs were significantly higher than Caucasians for all states in the GPR with the exception of Iowa.

Table 1

2002–2010 Diabetes mortality RR by state in the Great Plains Region

There was a variation in mortality rates from diabetes by reservation CHSDA region. The Confederated Salish and Kootenai tribes of Montana had the lowest RR, 1.78 times higher for AIs than Caucasians in the same reservation CHSDA counties, while the Sac and Fox tribes of Iowa had the highest RR, 10.25 times higher for AIs than Caucasians in the same reservation CHSDA counties. This was surprising based on the state-specific RR in table 1, where Iowa had the lowest RR (1.1) between AIs and Caucasians aggregated at the state level. However, the mortality rate for the Sac and Fox tribes of Iowa includes only those CHSDA counties within or bordering the reservation. AIs living off the reservation experience lower diabetes mortality than those living on the reservation. The Omaha tribe of Nebraska had the highest rate, 181.9 per 100 000 population, followed by the Sac and Fox tribes of Iowa. South Dakota had more reservations with rates higher than North Dakota, Montana, or Wyoming (see table 2).

Table 2

Mortality rates* and RR by tribal CHSDA regions

There was substantial variation between AIs and Caucasians in the same geographies. There was also variation between tribes and by geographies. For example, two tribes in Montana shared one county; however, one tribe's diabetes mortality RR was 5.91 compared with the other tribe's RR of 3.84. Both tribes reported higher RRs than the overall RR for Montana of 3.36; however, one tribe was significantly higher than both. In South Dakota, two tribes shared one county and their mortality RR were 5.3 and 5.8. These rates were similar to the South Dakota state ratio of 5.47.

AIs experience higher mortality from diabetes than Caucasians living in the same geographic areas, in this case reservation CHSDAs and specific states. This may be related to several risk factors and conditions described in previous reports, including low income, low education, obesity, smoking, genetic predisposition, westernization, loss of traditional foods, barriers to seeking treatment, discrimination, severe complications related to diabetes, high rates of cardiovascular disease and other comorbidities, cultural differences in diabetes based on how it is perceived and treated, and others.26–30 These individual risk factors may be magnified in certain AI populations and geographies where diabetes mortality rates are the highest.

Possible explanations for increased mortality among AIs in the GPR may be related to the higher prevalence of diabetes in the GPR and the presence of more risk factors associated with diabetes and premature mortality often found in reservation CHSDA areas. For example, the estimated prevalence of diabetes among all residents living in reservation CHSDAs in the GPR is 8.20% compared with 7.46% of non-CHSDAs in the GPR.26 Among reservation CHSDAs in the GPR, 20.73% report limited food access compared with 14.76% of non-CHSDAs.31 Smoking is a behavioral risk factor that contributes to premature mortality and among tribal CHSDAs, the rates are higher, 21.07% compared with 18.40%.32 Poverty is another contributing factor and differences between non-CHSDAs and tribal CHSDAs are pronounced where persistent poverty and persistent child poverty is less than 1% in non-CHSDAs, but 18.35% of tribal CHSDAs experience persistent poverty and 24.77% of tribal CHSDAs have persistent child poverty33 (figure 1).

Figure 1

Characteristics of reservation and non-reservation counties.26–29

To address these differences based on tribe and geography, future studies could examine tribal-specific factors and geographies associated with lower diabetes mortality. This line of research could examine diabetes disparities using a strength-based approach, where tribes with lower mortality rates are involved in assessing the individual-level and population-level characteristics that may be protective against diabetes and subsequent mortality. Examining differences using social determinants of health framework might provide insights into the environment, conditions, and modifiable risk factors associated with diabetes disparities.19 ,34

By documenting mortality rate differences based on state, region, and tribal area, this study underscores the need for effective tribe-specific public health initiatives, policies, and interventions. First, immediate efforts might focus on communicating and describing the extent of disparities with tribal leaders and community members. Knowledge of great documented disparities in diabetes mortality might compel federal funding agencies, community health programs, the Indian Health Service, and families to take action. Second, tribes in the GPR might consider sharing best practices and lessons learned from previous diabetes prevention and interventions. For example, the variation of diabetes mortality in the GPR among AIs shows that some tribes have significantly lower mortality rates than others. Finally, since every tribe has a unique culture, history, language, and geography, differences in diabetes mortality must be addressed through the lens of the tribal population experiencing them, with assistance from public health professionals, policymakers, and tribal leaders.3 ,15 ,17 Higher rates of diabetes mortality among AIs living in reservation CHSDAs may be related to oppression and discrimination.14 ,15 Documenting and understanding risk factors as they relate to diabetes mortality may inform future interventions aimed at alleviating disparities reported in this study.

This study has some limitations and several strengths. Accurately reporting and assessing diabetes mortality in all populations including AIs can be challenging, given that death certificates may be incomplete, inaccurate, or under-report AI status.16 Another challenge with reporting and estimating diabetes deaths stems from the complications and comorbidities associated with diabetes.20 For example, the majority of diabetes-related deaths report the underlying cause of death as cardiovascular disease and a contributing cause of death as diabetes. In this study, only the underlying cause of death as diabetes was examined, and the contributing cause of death was not. These limitations are balanced by several strengths including these: tribally recommended design; the secondary data source used provides an efficient approach to improved understanding about disparities in diabetes mortality by tribe and region. The tribally recommended design used to identify reservation CHSDA regions was shared with the lead author by the Northern Plains Tribal Epidemiology Center, informed by tribal leaders and tribal health directors. Next, the lead author extracted the data and compiled the results. Results were shared with the tribal consortiums as a first step in documenting diabetes disparities. In the coming months, the lead author will present the results of this study to tribes in the GPR while supporting future efforts and programs aimed at eliminating differences in diabetes mortality. Tribes and public health officials agree that documenting disparities to show that they exist is the first of many steps in achieving health equity for all, including AIs.

In summary, this study adds to the literature a clear picture of the geographic and tribal-specific disparities in the GPR that have not been published previously. Researchers, public health professionals, clinicians, community members, and policymakers working in partnership with and in communities must take immediate action through multifaceted strategies to reduce disparities that lead to early mortality among AIs. The time to do this is now. These results are a call to further action to address these severe tribal disparities.

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  • Contributors AK conducted the analysis, wrote the manuscript, and is responsible for the intellectual content. JG, MS, and BA were responsible for the intellectual content and critical review. DW, RB, and SM reviewed and edited the manuscript. AK is the guarantor.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data used for this publication are available through the National Cancer Institute's cancer related databases and Surveillance Epidemiology and End Results program. Tribal-specific methods used to define tribal CHSDA regions are available on request.

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Experiences of an inexperienced hiker

 The path to the highest mountain in Altai  09/9/2011, 06:02
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Experiences of an inexperienced hiker
Photos by Pavel Yukechev

I decided to become a hiker one day before our trip to the mountains. Not a very promising start, I know. However, the ten-day walking route (a phrase I couldn’t fully comprehend at the first time of asking) to the Altai Mountains had already been drawn up, so I had no choice but to keep the promise I made to Pasha in a merciless dive bar. Below is a chaotic description of what the path to Belukha, the most important Altai hiking trail of all time, looks like today.

There aren’t that many ways to get to Belukha, but I’m sure none of them leave people indifferent, seeing as they have to carry a man-sized rucksack for 8 hours a day. The three of us, loaded down, set off from Tungur village, along the Kucherla and Tekelyushka rivers, before heading for the Karatyurek pass. The estimated length of the route is 80km. We have to get back to the city in eleven days time: Pasha has a concert and Mark has a train to catch.

There are still disagreements about the grammatical gender of the word «whisky» in Russian, but this was no obstacle on our camping trip

To my great joy, I managed to quickly — and reasonably competently — pack my bag. Even managed to take charismatic Jack with me, albeit a little, instead of knock-off Armenian brandy. I got some experience in packing from a canoeing holiday in the Leningrad Region in May last year. That first time, I firmly grasped the idea that you shouldn’t go camping with a fork but no bowl!

We met a shepherd on a hill, who showed us the way and mentioned in passing that a bear had scared away his flock, so now he has to wander across the mountain range, looking for his lost sheep with binoculars. He also sighed that there are a lot of Muscovites and foreigners these days, although we didn’t manage to figure out why exactly he’s not happy with this development. On the other hand, I guess I can understand: deserted places should stay that way.

Meanwhile, we got into an argument. To be more precise, I got into an argument with Pasha and Mark. You see, we got properly drenched on the second day. If it was drizzling before that, then for three hours it absolutely poured down and we were faced with a choice: to bravely cover our planned daily mileage or to stay in log cabin with a Russian sauna that miraculously appeared in front of us... I finally managed to tip the scales in my favour with an assertive closing argument: «A wet hiker isn’t a hiker at all», which my fellow travellers agreed with. Before we knew it we were drying our clothes over the stone oven and heating up the steam bath. The next day, the fun was over: we had to tackle an ascent along a mountain river with the seemingly harmless name of Tekelyushka, towards the Karatyurek pass.

In the morning, Anatoly, a well-balanced strongman with a direct gaze and firm hand, encouraged us with some warm parting wishes, while one of his three grandchildren asked where we were going with a smile. We charged Pasha with answering this question, and he described all the details of our route to his six-year-old conversation partner as we repacked our accoutrements. It’s high time to add that Pasha is my cousin, who I hadn’t seen for nearly fifteen years. Though we live in the same city (the time I borrowed his cello for shooting and vanished for another three years after giving it back doesn’t count). So this trip was a very important event for both of us.

The average hiking bag has a volume of 70-90 litres

The track was damp and kept us in top form, as sometimes we had to climb almost vertically. This was more than compensated for by the heavy, sweetish taiga air and incredible heavenly studies, but fundamentally changed my conception of hiking as a sort of meditative retreat. Contemplating with 25 kilograms on your back (a trivial weight for more or less well-prepared hikers and a real challenge for someone as physically unfit as myself) is really hard work.

A four-man tent comfortably accommodates three people.

I came to some conclusions during the first two days of the trip. First of all, under no conditions should you take off your backpack. Otherwise, you have to convince yourself all over again after each rest stop that it is within your powers. Secondly, if you take a collection of short stories by Cortazar with you — even a wafer-thin one — this is evidence of a clear breach of hiking etiquette. And thirdly, no matter which place you choose in the tent or how many fir branches you put down, you still wake up from the grinding sound of your vertebrae demanding an orthopaedist.

The ascent was not easy for us. On the fourth day, in the middle of a mountain pass, we realised that we were incapable of overcoming the ridge (about another six hours climb in total) without serious consequences for ourselves and the following day. Without lengthy debates we pitched our tent next to the glacier, resisting the disturbing gusts of wind that were pulling a solid front of storm clouds towards us. To be honest, this didn’t really fill us with inspiration. The night-time temperature was minus five degrees Celsius.

3060 metres is the height of the Karatyurek pass — a Category 1A climb, according to the hiking classification

The night at almost three thousand metres made a very strange and unforgettable impression on me: as a virgin hiker, that was one of the bravest and most romantic milestones. Now, I finally understood where we were going and why. What Vysotsky (Vladimir, extremely influential Soviet singer-songwriter — Sib.fm comment) was croaking about and why «everything will change when you get there», as hikers on their way back spurred us on. The feeling of being right under the skies didn’t leave me from the moment the sun set until the sip of Jack, carefully poured into the cap before going to sleep, which made the spiritual experiences at least twice as strong.

I made a real effort not miss the dawn, so found the time to go up to some surrounding plateaus to heroically breathe in the thin air and make an attempt to warm up after the bracing night. However, I left my camera in the tent, so consoled myself with some words I’d overheard Brodsky saying: «I prefer to take pictures on my retina».

Belukha is the highest point of the Altai Mountains (4,506m), crowning the Katun Range

It was a great day (especially seeing as I was so enthusiastic by that time): we overcame the peak of the mountain pass in the morning and the Akkem Valley opened in front of us, with its breathtaking panoramic view of Belukha’s snow-white faces, the amber ridges of neighbouring mountains and the ice flows creeping towards Akkem Lake. Watching all this as clouds float above and below is an endless joy, especially when the wind dies down and you can hear the sound of the heavens.

Belukha is covered in snow from head to toe and blinds you in the sun. In its immediate proximity you have a feeling of perfect serenity and understand the meaninglessness of timekeeping. I’m even scared to imagine what is experienced by climbers that conquer the peak that the locals know as Uch-Syumer — «Abode of the Gods».

The works of man-mountain Sergei Rakhmaninov would be appropriate background music

So, from now on, our path would mainly wind its way back down. Things were rapidly looking up, seeing as we’d finished off a significant part of our provisions in the first half of the day. Pasha opened up about his jazz band and talked about music more often (for example, I learned that Rakhmaninov’s third concerto is much more interesting than the second as far as critics are concerned). Mark, ignoring his bad knees, went an hour ahead — I got the opportunity to have both a good clean-up in the attics of my mind and sort out the storeroom of accumulated emotional experiences, which I willingly got to work on. By the early evening, we reached our destination on the banks of Akkem Lake, from where we planned to make another four-hour ascent to the Valley of Seven Lakes, a place with a rainbow palette of colours (in good weather conditions, of course), on the following day.

The shores of the lake were dotted with tents: we met organised groups of Norwegian and Swiss tourists, proudly carrying around their crosses on pieces of red cloth, climbers with varying levels of training, athletes, yogis, raw foodists and Sergei, our toned neighbour from Krasnoyarsk who was there with his family and treated us to bread and a piece of smoked fatback bacon (if Sib.fm forks out for another couple of Greta font faces, the phrase «smoked fatback bacon» should be set off in bold, or at least italics).

For the rest of the journey (about two days), I savoured the thought that «I’ve been to the mountains» and considered our adventure complete... That was before we got into the open back of a veteran GAZ-66 pick-up with a broken front wheel, before night fell and before heavy rain started pouring when we began to make our way up to the final pass on a washed-out road. But that’s a completely different story.

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When we got back to Novosibirsk, Pasha held out his hand and asked me: «Well then, will you go back?»

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Ford Motor Pattern Recognition High Wave Candle

Ford Motor pattern-recognition tool provides you with the Pattern Recognition execution environment for running High Wave Candle recognition against Ford Motor. Ford Motor momentum indicators are usually used to generate trading rules based on assumptions that Ford Motor trends in prices tend to continue for long periods.
Investment Horizon     30 Days    Login   to change

The output start index for this execution was ten with a total number of output elements of twelve. The function generated a total of two valid pattern recognition events for the selected time horizon. The High-Wave Candle may signal Ford Motor Co market turn when observed in several bundles.

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Doctor next to Patient in Bed 2

Objective 19: Provide cancer patients with a comprehensive care summary and follow-up plan after completing treatment.

19.1 Promote the use of survivor care plans by health care providers and cancer patients.

19.2 Build existing treatment summary templates into systems of care.

19.3 Establish health care teams to coordinate care.

Cancer patients who have ever been given a written summary of all the cancer treatments received by a doctor, nurse or other health professionali

50.0 %
40.0 %

i. CDC and BRFSS. Chronic disease indicators data, analysis conducted by MDH, 2010.


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Essential Tremor Information

What is Essential Tremor, how is it evaluated and how is it treated?

Aparna Wagle Shukla, M.D., Physician and Research Scientist at the University of Florida Center for Movement Disorders

What is Essential Tremor?

Essential tremor (ET) is the most common movement disorder encountered in expert clinics. Family history is often positive and thus ET is frequently referred to as a benign tremor or familial tremor, though it is not benign. The typical age of onset is either in early 20s and 30s or in the late 60s and 70s. Men and women are affected equally. Tremors in many cases are mild but can cause significant functional limitation of the activities of daily living, such as writing, eating, drinking or dressing.  Essential tremor increases in frequency with age, and is present in more than 1% of individuals 70 years of age or older. Tremors typically worsen with emotional and physical stress. Alcohol is found to alleviate the tremors in some, but not all cases; and the underlying mechanism is not clear.  Although response to alcohol is important for clinical diagnosis, it is not recommended as a treatment. Essential tremor like Parkinson’s disease is now considered a neurodegenerative disease, however the speed of progression is extremely slow and the disease course can sometimes run for many decades. In the later stages of disease, tremors are noted to become more severe, there is a wider distribution and there may be changes in the gait and cognition of the affected individuals.

What is the difference between Essential Tremor and Parkinson Disease tremor?

How is Essential Tremor evaluated?

Essential tremor most commonly affects the arms, tremors are typically asymmetric in the beginning and with advancement, tremors of other regions, notably the head, face, voice, trunk, and legs, are seen either separately, or in combination. There is also a general rule, if prominent tremors are seen in the legs, Parkinson’s disease should be ruled out.

Diagnosis of essential tremor is based on specific criteria observed during the clinical exam. These criteria include the presence of tremors in both hands and forearms engaged in routine daily tasks and absence of any additional neurologic symptoms or signs. A bedside physical exam involves observation of tremors during postural elevation of the arms, on kinetic tasks like drawing an Archimedes spiral (See Figure), line drawing, writing, pouring water into glass and on intentional maneuver such as finger-to nose testing. Tremors occur mainly in the distal hands and are 4 to 12 Hz in frequency, but this can be widely variable.  Tests such as those shown below are ways in which a physician can evaluate and monitor tremor.

ET spirals

Bedside assessment of essential tremor using the Archimedes spiral and the line drawing test

Sometimes during the passive movement of the forearm, a cogwheeling type of resistance is felt by the physicians resulting in a mistaken diagnosis of Parkinson’s Disease. This type of resistance is felt particularly in older individuals. However, in Parkinson’s Disease tremors in the hands are present mainly at rest, tremors are classically but not always pill rolling in character, tremors are unilateral or asymmetric in presentation, tremors in legs are prominent, and there are other pertinent accompanying symptoms such as slowness, lack of dexterity in the hands, stiff muscles, softening of speech, lack of expression on the face, shuffling gait and postural instability. It is possible however to have a resting tremor in essential tremor.

Another important differential diagnosis for essential tremor is enhanced physiologic tremor that is sustained as a result of either an identifiable cause, such as medication or hyperthyroidism; or a cause that is not readily identifiable. Caffeine, cigarettes, and medications such as lithium, prednisone, levothyroxine, beta-adrenergic bronchodilators, valproate, and selective serotonin-reuptake inhibitors commonly result in these enhanced physiologic tremors. Adult-onset idiopathic dystonia, and Wilson’s disease are other conditions on the list that are particularly applicable to younger individuals. Physicians should ask the necessary questions to distinguish these pertinent differential diagnoses.

Although at present there are no validated serologic, radiologic, or pathological markers for diagnosis, major initiatives are actively being explored. Recently an imaging technique known as DaTscan™ (125I-iofluane SPECT), which measures the integrity of the dopamine system in the brain was approved by the FDA, to help distinguish ET from PD.   At University of Florida, Dr. Vaillancourt and colleagues are conducting a major NIH sponsored study to investigate the role of functional MRI (fMRI) and diffusion tensor imaging (DTI) in the diagnosis of essential tremor. These techniques follow well established imaging methods. The functional MRI has an ability to look at the brain activity based on changes in regional blood flow, whereas DTI is used to examine changes in brain connectivity by measuring water diffusion along nerve fiber tracts in the brain. University of Florida also offers a quantitative computerized analysis of tremor that can helps distinguish essential tremor from other types of tremor. This technique is simple, noninvasive, and can be scheduled in the physiology laboratory on an as needed basis.

How is Essential Tremor treated and managed?

At present there is no cure for essential tremor, but tremors can be alleviated with multiple therapies. Mild tremors may not require pharmacological treatments and can be addressed with various non-pharmacological techniques. These techniques include the use of weighted utensils or application of weights to the wrists during daily functional tasks to reduce the amplitude of tremors. These weights are available at stores such as Walmart and Target, or can be ordered online. Another non-pharmacological approach is use of cooling the arms; a technique also used for the control of tremors. All of these techniques can successfully control some of the tremors in although the benefits are short-lasting for some patients. At University of Florida, clinicians routinely schedule essential tremor patients with an occupational therapist for evaluation and demonstration of these techniques.

Propranolol and primidone are the mainstays of medical treatment. Multiple studies have documented the efficacy of propranolol and primidone in the treatment of hand tremors, although these medications have less efficacy for control of tremors located in the head, voice, leg, and trunk.  In the early stages these medications are effective in reducing the amplitude of tremors roughly in the range of 40-50% but over time they may lose efficacy. Sometimes a combination of these two drugs can be tried to facilitate greater synergistic benefits.  The potential benefit of these therapies should be weighed against the possible side effects. Side effects of the medications should always be explained before initiation of therapy. Propranolol is known to result in slowing of the heart rate, fatigue, worsening of diabetes, worsening of mood and exacerbation of asthma. Primidone on the other hand is found to cause worsening of gait, balance, sleepiness and behavioral issues in some individuals. If tremors continue to remain inadequately controlled, a trial of a second-line medication, such as benzodiazepines, gabapentin, topiramate, or botulinum toxin, can also be tried. Finally, for select cases of medication refractory disabling tremors, deep brain stimulation (DBS) of the thalamus is the new standard of care. DBS surgery is now well established and FDA approved. More than 100,000 surgeries have been performed worldwide and several studies have proven its effectiveness in control of essential tremors.  DBS will not stop progression of the tremor and in some cases there may be speech and walking related side effects.  The University of Florida offers each of these therapies through its integrated multidisciplinary program.

In conclusion, essential tremor is a slow progressive disease, has clear well-established guidelines for diagnosis and can be treated by nonpharmacological, pharmacological and surgical approaches.