Monday, February 28, 2011

Vitamin D production from UV radiation: The effects of total cholesterol and skin pigmentation

Our body naturally produces as much as 10,000 IU of vitamin D based on a few minutes of sun exposure when the sun is high. Getting that much vitamin D from dietary sources is very difficult, even after “fortification”.

The above refers to pre-sunburn exposure. Sunburn is not associated with increased vitamin D production; it is associated with skin damage and cancer.

Solar ultraviolet (UV) radiation is generally divided into two main types: UVB (wavelength: 280–320 nm) and UVA (320–400 nm). Vitamin D is produced primarily based on UVB radiation. Nevertheless, UVA is much more abundant, amounting to about 90 percent of the sun’s UV radiation.

UVA seems to cause the most skin damage, although there is some debate on this. If this is correct, one would expect skin pigmentation to be our body’s defense primarily against UVA radiation, not UVB radiation. If so, one’s ability to produce vitamin D based on UVB should not go down significantly as one’s skin becomes darker.

Also, vitamin D and cholesterol seem to be closely linked. Some argue that one is produced based on the other; others that they have the same precursor substance(s). Whatever the case may be, if vitamin D and cholesterol are indeed closely linked, one would expect low cholesterol levels to be associated with low vitamin D production based on sunlight.

Bogh et al. (2010) recently published a very interesting study. The link to the study was provided by Ted Hutchinson in the comments sections of a previous post on vitamin D. (Thanks Ted!) The study was published in a refereed journal with a solid reputation, the Journal of Investigative Dermatology.

The study by Bogh et al. (2010) is particularly interesting because it investigates a few issues on which there is a lot of speculation. Among the issues investigated are the effects of total cholesterol and skin pigmentation on the production of vitamin D from UVB radiation.

The figure below depicts the relationship between total cholesterol and vitamin D production based on UVB radiation. Vitamin D production is referred to as “delta 25(OH)D”. The univariate correlation is a fairly high and significant 0.51.

25(OH)D is the abbreviation for calcidiol, a prehormone that is produced in the liver based on vitamin D3 (cholecalciferol), and then converted in the kidneys into calcitriol, which is usually abbreviated as 1,25-(OH)2D3. The latter is the active form of vitamin D.

The table below shows 9 columns; the most relevant ones are the last pair at the right. They are the delta 25(OH)D levels for individuals with dark and fair skin after exposure to the same amount of UVB radiation. The difference in vitamin D production between the two groups is statistically indistinguishable from zero.

So there you have it. According to this study, low total cholesterol seems to be associated with impaired ability to produce vitamin D from UVB radiation. And skin pigmentation appears to have little  effect on the amount of vitamin D produced.

I hope that there will be more research in the future investigating this study’s claims, as the study has a few weaknesses. For example, if you take a look at the second pair of columns from the right on the table above, you’ll notice that the baseline 25(OH)D is lower for individuals with dark skin. The difference was just short of being significant at the 0.05 level.

What is the problem with that? Well, one of the findings of the study was that lower baseline 25(OH)D levels were significantly associated with higher delta 25(OH)D levels. Still, the baseline difference does not seem to be large enough to fully explain the lack of difference in delta 25(OH)D levels for individuals with dark and fair skin.

A widely cited dermatology researcher, Antony Young, published an invited commentary on this study in the same journal issue (Young, 2010). The commentary points out some weaknesses in the study, but is generally favorable. The weaknesses include the use of small sub-samples.

Bogh, M.K.B., Schmedes, A.V., Philipsen, P.A., Thieden, E., & Wulf, H.C. (2010). Vitamin D production after UVB exposure depends on baseline vitamin D and total cholesterol but not on skin pigmentation. Journal of Investigative Dermatology, 130(2), 546–553.

Young, A.R. (2010). Some light on the photobiology of vitamin D. Journal of Investigative Dermatology, 130(2), 346–348.

Monday, February 21, 2011

The China Study II: Wheat, dietary fat, and mortality

In this post on the China Study II data we have seen that wheat apparently displaces dietary fat a lot, primarily fat from animal sources. We have also seen in that post that wheat is strongly and positively associated with mortality in both the 35-69 and 70-79 age ranges, whereas dietary fat is strongly and negatively associated with mortality in those ranges.

This opens the door for the hypothesis that wheat increased mortality in the China Study II sample mainly by displacing dietary fat, and not necessarily by being a primary cause of health problems. In fact, given the strong displacement effect discussed in the previous post, I thought that this hypothesis was quite compelling. I was partly wrong, as you’ll see below.

A counterintuitive hypothesis no doubt, given that wheat is unlikely to have been part of the diet of our Paleolithic ancestors, and thus the modern human digestive tract may be maladapted to it. Moreover, wheat’s main protein (gluten) is implicated in celiac disease, and wheat contains plant toxins such as wheat germ agglutinin.

Still, we cannot completely ignore this hypothesis because: (a) the data points in its general direction; and (b) wheat-based foods are found in way more than trivial amounts in the diets of populations that have relatively high longevity, such as the French.

Testing the hypothesis essentially amounts to testing the significance of two mediating effects; of fat as a mediator of the effects of wheat on mortality, in both the 35-69 and 70-79 age ranges. There are two main approaches for doing this. One is the classic test discussed by Baron & Kenny (1986). The other is the modern test discussed by Preacher & Hayes (2004), and extended by Hayes & Preacher (2010) for nonlinear relationships.

I tested the meditating effects using both approaches, including the nonlinear variation. I used the software WarpPLS for this; the results below are from WarpPLS outputs. Other analyses of the China Study data using WarpPLS can be found here (calorie restriction and longevity), and here (wheat, rice, and cardiovascular disease). For yet other studies, click here.

The graphs below show the path coefficients and chance probabilities of two models. The one at the top-left suggests that wheat flour consumption seems to be associated with a statistically significant increase in mortality in the 70-79 age range (beta=0.23; P=0.04). The effect in the 35-69 age range is almost statistically significant (beta=0.22; P=0.09); the likelihood that it is due to chance is 9 percent (this is the meaning of the P=0.09=9/100=9%).

The graph at the bottom-right suggests that the variable “FatCal”, which is the percentage of calories coming from dietary fat, is indeed a significant mediator of the relationships above between wheat and mortality, in both ranges. But “FatCal” is only a partial mediator.

The reason why “FatCal” is not a “perfect” mediator is that the direct effects of wheat on mortality in both ranges are still relatively strong after “FatCal” is added to the model (i.e., controlled for). In fact, the effects of wheat on mortality don’t change that much with the introduction of the variable “FatCal”.

This analysis suggests that, in the China Study II sample, one of wheat’s main sins might indeed have been to displace dietary fat from animal sources. Wheat consumption is strongly and negatively associated with dietary fat (beta=-0.37; P<0.01), and dietary fat is relatively strongly and negatively associated with mortality in both ranges (more in the 70-79 age range).

Why is dietary fat more protective in the 70-79 than in the 35-69 age range, with the latter effect only being significant at the P=0.10 level (a 10 percent chance probability)? My interpretation is that, as with almost any dietary habit, it takes years for a chronically low fat diet to lead to problems. See graph below; fat was not a huge contributor to the total calorie intake in this sample.

The analysis suggests that wheat also caused problems via other paths. What are them? We can’t say for sure based on this dataset. Perhaps the paths involve lectins and/or gluten. One way or another, the relationship is complex. As you can see from the graph below, the relationship between wheat consumption and mortality is nonlinear for the 70-79 age range, most likely due to confounding factors. The effect size is small for the 35-69 age range, even though it looks linear or quasi-linear in that range.

As you might recall from this post, rice does NOT displace dietary fat, and it seems to be associated with increased longevity. Carbohydrate content per se does not appear to be the problem here. Both rice and wheat foods are rich in them, and have a high glycemic index. Wheat products tend to have a higher glycemic load though.

And why is dietary fat so important as to be significantly associated with increased longevity? This is not a trivial question, because if too much of that fat is stored as body fat it will actually decrease longevity. Dietary fat is very calorie-dense, and can be easily stored as body fat.

Dietary fat is important for various reasons, and probably some that we don’t know about yet. It leads to the formation of body fat, which is not only found in adipocytes or used only as a store of energy. Fat is a key component of a number of important tissues, including 60 percent of our brain. Since fat in the human body undergoes constant turnover, more in some areas than others, lack of dietary fat may compromise the proper functioning of various organs.

Without dietary fat, the very important fat-soluble vitamins (A, D, E and K) cannot be properly absorbed. Taking these vitamins in supplemental form will not work if you don’t consume fat as well. A very low fat diet is almost by definition a diet deficient in fat-soluble vitamins, even if those vitamins are consumed in large amounts via supplements.

Moreover, animals store fat-soluble vitamins in their body fat (as well as in organs), so we get these vitamins in one of their most natural and potent forms when we consume animal fat. Consuming copious amounts of olive and/or coconut oil will not have just the same effect.

Preacher, K.J., & Hayes, A.F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36 (4), 717-731.

Hayes, A. F., & Preacher, K. J. (2010). Quantifying and testing indirect effects in simple mediation models when the constituent paths are nonlinear. Multivariate Behavioral Research, 45(4), 627-660.

Sunday, February 13, 2011

The idea that protein leaches calcium from the bones has been around for a while. It is related to the notion that protein, especially from animal foods, increases blood acidity. The body then uses its main reservoir of calcium, the bones, to reduce blood acidity. Chris Masterjohn does not agree with this idea. This post generally supports Chris’s view, and adds a twist to it, related to plant protein consumption.

The “eat-meat-lose-bone” idea has apparently become popular due to the position taken by Loren Cordain on the topic. Dr. Cordain has also made several important and invaluable contributions to our understanding of the diets of our Paleolithic ancestors. He has argued in his book, The Paleo Diet, and elsewhere (see, e.g., here) that to counter the acid load of protein one should eat fruits and vegetables. The latter are believed to have an alkaline load.

As it turns out, this idea appears to be correct only for plant protein. Animal protein seems to be associated with an increase in BMD, at least according to a study by Promislow et al. (2002). The study shows that there is a positive multivariate association between animal protein consumption and BMD; an association that becomes negative when plant protein consumption is considered.

Sunday, February 6, 2011


We’ve all experienced it. The meeting goes well. Everyone nods, smiles, and quickly agrees. There are no objections or even questions to answer. You leave feeling confident that your proposal will be unanimously adopted.

boxing glovesThen you hear about the meeting after the meeting… and the lingering concerns and worries that ‘everyone’ has… and you know that the torpedoes have already been launched and your proposal is sunk.

I call this dynamic ‘dysfunctional politeness.’ It costs organization dearly in terms of dollars, but it also takes an enormous human toll: disappointment, mistrust, frustration, and disengagement.

Each time we choose to be agreeable rather than raising legitimate concerns, offering candid feedback, or telling the truth about our reactions, we hurt both the results and our relationships with others.

The ability to engage in constructive conflict – focused on issues and expressed with respect – is a key hallmark of effective teams. And it makes sense. Openly airing different points of views and passionately testing ideas helps groups:

  • Identify and adjust faulty assumptions,
  • Eliminate or solve problems early, and
  • Bring the broadest and best thinking to decisions.

 “Conflict is what prevents all forms of stagnation and vulnerability from being overtaken by your competition.”
- Steven Berglas, consultant/clinical psychologist at Harvard Medical School

But beyond the business argument for constructive conflict, there’s a human one. It also builds relationships and teamwork. While it might seem counterintuitive, teams that engage in the most heated and intense conflicts are frequently the strongest. They know they can count on each other for absolute candor. They know that once the group makes a decision, everyone will own it and work toward its success. They know that whatever someone has to say will be shared in a forthright way that allows for the back-and-forth required to fully understand and respond to issues or concerns.

 “Tumultuous meetings are of a sign of progress.”
- Patrick Lencioni

Are you and your team not realizing the benefits of constructive conflict? Here are three steps you can take today to start cultivating this critical team competency.

Do a Personal Gut Check

Check your own reaction to conflict and evaluate the effect it has on your team. Your mindset drives your behavior. If differences make you tense, team members will pick up on that. If you rush in to smooth over minor disagreements, others will quickly learn that conflict is not OK… and dysfunctional politeness may creep in.

Set Expectations and Ground Rules

Share what you know about the value of conflict and the role it can play in helping your team achieve excellence. Brainstorm agreements that keep conflict safe. Examples include: focus on issues and ideas but never people; use respectful language always; listen to understand the other point of view fully before speaking.

Model the Conflict You Want to See

Your own behavior is the most powerful leadership tool at your disposal. Others learn far more from what you do than what you say. So model effective conflict daily. Challenge ideas in a respectful and supportive way. Test assumptions with open-ended questions. Demonstrate high-quality listening and the courage to ask questions that stir up productive controversy.

 “All polishing is done by friction.”
- Mary Parker Follett

What do you think…

How is dysfunctional politeness hurting your organization?

What does constructive conflict look like to you… and how do you promote it?

Art:  www.dreamstime.com and Liz Price

Julie Winkle Giulioni
Julie Winkle Giulioni

We can offer effective content available, but if there is no motivation to learn, why bother? http://t.co/SwU5z0JY8N @HalogenSoftware - 2 hours ago
Julie Winkle Giulioni
Julie Winkle Giulioni


Ways to experiment with conferences

Yesterday I wrote about why I think technical conferences underdeliver. Coincidentally, Evan sent me this quote from Seth Godin's blog yesterday:

We've all been offered access to so many tools, so many valuable connections, so many committed people. What an opportunity.

What should we do about it?

If we are collectively spending 6 careers at the SEG Annual Meeting every autumn, as I asserted yesterday, let's put some of that cognitive surplus to work!

I suggest starting to experiment with our conferences. There are so many tools: unconferences, idea jams, hackdays, wikithons, and other participative activities. Anything to break up sitting in the dark watching 16 lectures a day, slamming coffee and cramming posters in between. Anything to get people not just talking and drinking, but working together. What a way to build collaborations, friendships, and trust. Connecting with humans, not business cards.

Unconvinced? consider which of these groups of people looks like they're learning, being productive, and having fun:

This year I've been to some random (for me) conferences — Science Online, Wikimania, and Strata. Here are some engaging, fun, and inspiring things happening in meetings of those communities:

  • Speaker 'office hours' during the breaks so you can find them and ask questions.
  • Self-selected topical discussion tables at lunch.
  • Actual time for actual discussion after talks (no, really!).
  • Cool giveaways: tattoos and stickers, funky notebooks, useful mobile apps, books, scientific toys.
  • A chance to sit down and work with others — hackathons, co-writing, idea jams, and so on.
  • Engaged, relevant, grounded social media presence, not more marketing.
  • An art gallery, including graphics captured during sessions
  • No posters! Those things epitomize the churn of one-way communication.

Come to our experiment!

Clearly there's no shortage of things to try. Converting a session here, a workshop there — it's easy to do something in a sandbox, alongside the traditional. And by 'easy', I mean uncertain, risky and uncomfortable. It will require a new kind of openness. I'm not certain of the outcome, but I am certain that it's worth doing.

On this note, a wonderful thing happened to us recently. We were — and still are — planning an unconference of our own (stay tuned for that). Then, quite unprovoked, Carmen Dumitrescu asked Evan if we'd like to chair a session at the Canada GeoConvention in May. And she invited us to 'do something different'. Perfect timing!

So — mark your calendar! GeoConvention, Calgary, May 2013. Something different.

The photo of the lecture, from the depressing point of view of the speaker, is licensed CC-BY-SA by Flickr user Pierre-Alain Dorange. The one of the unconference is licensed CC-BY-SA-NC by Flickr user aforgrave.

Are conferences failing you too?

I recently asked a big software company executive if big exhibitions are good marketing value. The reply:

It's not a waste of money. It's a colossal waste of money.

So that's a 'no'.

Is there a problem here?

Next week I'll be at the biggest exhibition (and conference) in our sector: the SEG Annual Meeting. Thousands of others will be there, but far more won’t. Clearly it’s not indispensable or unmissable. Indeed, it’s patently missable — I did just fine in my career as a geophysicist without ever going. Last year was my first time.

Is this just the nature of mass market conferences? Is the traditional academic format necessarily unremarkable? Do the technical societies try too hard to be all things to all people, and thereby miss the mark for everyone?

I don't know the answer to any of these questions, I can only speak for myself. I'm getting tired of conferences. Perhaps I've reached some new loop in the meandering of my career, or perhaps I'm just grumpy. But as I've started to whine, I'm finding more and more allies in my conviction that conferences aren't awesome.

What are conferences for?

  • They make lots of money for the technical societies that organize them.
  • A good way to do this is to provide marketing and sales opportunities for the exhibiting vendors.
  • A good way to do this is to attract lots of scientists there, baiting with talks by all the awesomest ones.
  • A good way to do this, apparently, is to hold it in Las Vegas.

But I don't think the conference format is great at any of these things, except possibly the first one. The vendors get prospects (that's what sales folk call people) that are only interested in toys and beer — they might be users, but they aren't really customers. The talks are samey and mostly not memorable (and you can only see 5% of them). Even the socializing is limited by the fact that the conference is gigantic and run on a tight schedule. And don't get me started on Las Vegas.

If we're going to take the trouble of flying 8000 people to Las Vegas, we had better have something remarkable to show for it. Do we? What do we get from this giant conference? By my conservative back-of-the-envelope calculation, we will burn through about 210 person-years of productivity in Las Vegas next week. That's about 6 careers' worth. Six! Are we as a community satisfied that we will produce 6 careers' worth of insight, creativity, and benefit?

You can probably tell that I am not convinced. Tomorrow, I will put away the wrecking ball of bellyaching, and offer some constructive ideas, and a promise. Meanwhile, if you have been to an amazing conference, or can describe one from your imagination, or think I'm just being a grouch — please use the comments below.

Map data ©2012 Google, INEGI, MapLink, Tele Atlas.

News of the month

Knowledge sharing

Agile stuff

N is for Nyquist

In yesterday's post, I covered a few ideas from Fourier analysis for synthesizing and processing information. It serves as a primer for the next letter in our A to Z blog series: N is for Nyquist.

In seismology, the goal is to propagate a broadband impulse into the subsurface, and measure the reflected wavetrain that returns from the series of rock boundaries. A question that concerns the seismic experiment is: What sample rate should I choose to adequately capture the information from all the sinusoids that comprise the waveform? Sampling is the capturing of discrete data points from the continuous analog signal — a necessary step in recording digital data. Oversample it, using too high a sample rate, and you might run out of disk space. Undersample it and your recording will suffer from aliasing.

What is aliasing?

Alaising is a phenomenon observed when the sample interval is not sufficiently brief to capture the higher range of frequencies in a signal. In order to avoid aliasing, each constituent frequency has to be sampled at least two times per wavelength. So the term Nyquist frequency is defined as half of the sampling frequency of a digital recording system. Nyquist has to be higher than all of the frequencies in the observed signal to allow perfect recontstruction of the signal from the samples.

Above Nyquist, the signal frequencies are not sampled twice per wavelength, and will experience a folding about Nyquist to low frequencies. So not obeying Nyquist gives a double blow, not only does it fail to record all the frequencies, the frequencies that you leave out actually destroy part of the frequencies you do record. Can you see this happening in the seismic reflection trace shown below? You may need to traverse back and forth between the time domain and frequency domain representation of this signal.

Seismic data is usually acquired with either a 4 millisecond sample interval (250 Hz sample rate) if you are offshore, or 2 millisecond sample interval (500 Hz) if you are on land. A recording system with a 250 Hz sample rate has a Nyquist frequency of 125 Hz. So information coming in above 150 Hz will wrap around or fold to 100 Hz, and so on.

It's important to note that the sampling rate of the recording system has nothing to do the native frequencies being observed. It turns out that most seismic acquisition systems are safe with Nyquist at 125 Hz, because seismic sources such as Vibroseis and dynamite don't send high frequencies very far; the earth filters and attenuates them out before they arrive at the receiver.

Space alias

Aliasing can happen in space, as well as in time. When the pixels in this image are larger than half the width of the bricks, we see these beautiful curved artifacts. In this case, the aliasing patterns are created by the very subtle perspective warping of the curved bricks across a regularly sampled grid of pixels. It creates a powerful illusion, a wonderful distortion of reality. The observations were not sampled at a high enough rate to adequately capture the nature of reality. Watch for this kind of thing on seismic records and sections. Spatial alaising.

Click for the full demonstration (or adjust your screen resolution).You may also have seen this dizzying illusion of an accelerating wheel that suddenly appears to change direction after it rotates faster than the sample rate of the video frames captured. The classic example is the wagon whel effect in old Western movies.

Aliasing is just one phenomenon to worry about when transmitting and processing geophysical signals. After-the-fact tricks like anti-aliasing filters are sometimes employed, but if you really care about recovering all the information that the earth is spitting out at you, you probably need to oversample. At least two times for the shortest wavelengths.

Hooray for Fourier!

The theory of truth is a series of truisms - J.L Austin

The mathematical notion that any periodic function, no matter how jagged or irregular, can be represented as a sum of sines — called a Fourier series — is one of the most extraordinarily useful ideas ever. Ever! It is responsible for the theory of transmitting and recovering information, and yes, is ubiquitious in geophysics. Strikingly, any signal can be decomposed into an ensemble of sine waves. They are two different representations of the same object, two equal representations of the same information. Fourier analysis is this act of sending waves through a mathematical prism, breaking up a function into the frequencies that compose it.

To build an arbitrary signal, the trick is to mulitply each of the sines by a coefficient (to change thier amplitude) and to shift them so that they either add together or cancel (changing the phase). From the respective coefficients and phases of the composite sinusoids, one can reconstruct the original curve: no information is lost in translating from one state to the other.

So the wiggle trace we plot of the seismic waveform has bits of information partitioned across each of its individual sinusoids. The more frequencies it has, the more information carrying capacity it has. Think of it as being able to paint with a full color palette. The degree of richess or range is known as bandwidth. In making this example, I was surprised how few sine waves (only ten) it took to make a signal that actually looks like a bonafide seismic trace.

In 52 Things You Should Know About Geophysics, Mostafa Nagizadeh wrote an essay on the magic of Fourier; it's applications for geophysics data analysis. And he should know. In tomorrow's post, I will elaborate on the practical and economical issues we encounter making discrete measurements of continuous (analog) phenomena.


No, thanks

Frequently Asked Questions about Certification

What is certification?

Certification has, as its primary purpose, the increased protection of the public by providing an objective measurement of standardized current knowledge recognized and respected within and outside the field of infection prevention and control.

Infection Preventionists (IPs) can demonstrate a mastery of this knowledge by taking and passing a comprehensive examination developed by APIC's independent credentialing arm, the Certification Board of Infection Control & Epidemiology (CBIC). IPs who are certified are authorized and encouraged to use the internationally recognized initials CIC after their names and in their titles.

Initial certification is good for five years after which successful completion of recertification exams extend certification at five-year intervals.

Why is certification important?

Certification represents an IP's and an institution's commitment to continual improvement of infection prevention and control functions and their contribution to healthcare and patient safety. The mission of CBIC is to protect the public through the development, administration, and promotion of an accredited certification in infection prevention and control. Safety of the public is essential to CBIC.

As an IP, certification reaffirms that through your study and hard work, you have an internationally recognized level of knowledge in the IC field. It gives you a sense of professional accomplishment.

It also signals to your employer and your colleagues that you are committed to professional growth in the field of infection prevention/control by keeping your knowledge and skills current to better your organization's IC function and its success.This recognition can be a factor in increasing your professional credibility. Data also show that the Joint Commission recognizes the professionalism of people with the CIC credential.

Is certification well established and well recognized?

The impetus for certification in IC started in 1977 because of the efforts of the New England Chapter of the Association for Practitioners in Infection Control (APIC). The chapter funded the initial project and it quickly caught on nationally.

The APIC Board of Directors formed a committee in 1978 to establish goals and methods and in 1980, the Board approved education standards for certification. Later that year, the APIC Certification Association (APICCA) was formed. The following year, the APIC Certification Committee and APICCA worked together to develop an independent certification board, contract with a professional testing company, conduct the first job analysis of infection control practice, determine eligibility criteria and develop a recertification plan.

In 1982, APICCA changed its name to the Certification Board of Infection Control (CBIC). The organization is now called the Certification Board for Infection Control & Epidemiology (still CBIC) to reflect current practice, which encompasses applied epidemiology.

The National Commission for Certifying Agencies (NCCA) accredits CBIC’s certification program, which signifies that CBIC has met the highest national voluntary standards for private certification. CBIC periodically conducts job analyses to assure that certification measures current practices and knowledge required for infection prevention and control and applied epidemiology.

How does the Association for Professionals in Infection Control and Epidemiology,

Inc. (APIC) and the Infection Prevention and Control (IPAC Canada/PCI Canada)

 encourage certification?

APIC encourages all its members to become certified and continue qualifying for the CIC® credential by recertifying at the appropriate times. In reality, certification is a part of APIC's education program as it fosters continuing upgrading of IPs knowledge of infection prevention and control and epidemiology. APIC looks upon its members who earn the CIC® credential as having reached a significant milestone in their IP careers. Certification is an important step in an IP's potential to contribute to increased overall patient safety. A goal of 100% certification of qualified members is desired by APIC. IPAC Canada/PCI Canada is a national, multidisciplinary professional association for those engaged in the prevention and control of infections. IPAC Canada/PCI Canada is committed to the wellness and safety of Canadians by promoting best practice in infection prevention and control through education, standards, advocacy and consumer awareness.

Is it still recommended to wait 2 years to sit for the exam?

There is no specific time requirement that defines “sufficient experience”; however we emphasize that this certification examination is geared towards the infection preventionist who has had at least two years of full-time experience in infection prevention and control.

Where can I get the CBIC Candidate Handbook?

The candidate handbook is available for free online here.

What is the cost of the exam?

The cost of the initial exam (the Computer-Based Test or CBT) is $350. If re-certifying by CBT the cost is $325 (within the US) or $350 (to test outside the US). The SARE (Self-Achievement Recertification Exam) is $325.

Why is the SARE not offered for the initial exam?

The SARE is geared toward the advanced infection prevention and control re-certifier (who is, at minimum, a five-year practitioner), so some questions may be more difficult than those on the certification examination, which is geared toward a two-year practitioner. The purpose/goal of the SARE is to demonstrate continued knowledge mastery in the field of infection prevention and control.

Do I have to pay to take the exam if I do not pass the first time?

You are required to pay for each exam. If you do not pass the exam, you will need to wait 90 days before taking the exam again.

How is the CIC exam constructed?

New versions of the examination always exactly match the examination specifications to ensure an appropriate distribution related to the practice of infection prevention, control, and epidemiology.  An item related to every task (or topic) identified by the practice analysis cannot be included on every examination; rather, items are selected to sample the domain of content.  As noted previously, items are unanimously approved prior to pretesting, and they are again unanimously approved by the Test Committee before using the items on a scored portion of the examination.

CBIC doesn’t simply add and subtract questions (items) from an existing examination. CBIC maintains a bank of items that have been approved by the Test Committee and been subjected to pretesting.  Using this item bank, Psychometrician and test development staff select draft examination forms with an appropriate distribution related to the practice of infection prevention, control, and epidemiology at a level of difficulty consistent with other examination forms.  In addition to exactly matching a specified number of items in each major content area, test developers simultaneously consider several item selection rules.  One requirement is that the collection of items on each form provides a consistent average p-value, or proportion correct, based on previously collected data on first time candidates.  Matching this target p-value is an important first step in ensuring the comparability of examination forms, which is confirmed through statistical pre-equating of the forms.  These procedures foster fairness and equivalency of test results, ensuring that all candidates have an equal opportunity to achieve a score on the examination that represents their level of knowledge, regardless of the particular form of the examination taken.  When assembling the examinations, the test company and CBIC follow these procedures carefully, to ensure that the various versions of the examinations are as comparable as possible, both from a qualitative and quantitative perspective.

What is the best course of action to prepare for the certification exam?

CBIC highly suggests reviewing the content outline and list of references available in the candidate handbook. CBIC does not endorse any particular method of study or education, a lot of candidates find the APIC Certification Competency Review Course helpful. You can also study from the texts that are used to write the questions for the exam. Finally, many Chapters have study groups through which you can prepare with your peers. To see the CBIC webinar on Preparing for the Exam, please go here.

Does CBIC offer exam study materials?

CBIC does not offer study materials other than the practice exam, which can be purchased by visiting our website hereAPIC offers some study materials, but you will need to contact them directly and their website is

How much time is recommended to prepare for the exam when taking for the

first time?

Preparation depends on the amount of experience in infection prevention, as well as an individual’s learning style.

Are there sample questions available?

There are practice questions in the candidate handbook. CBIC has an online practice exam available for purchase as well.

Is the practice exam a helpful tool?

It is helpful to familiarize yourself with the format of the actual exam.

I am a nurse director in a community health facility and am seeking advice on

meeting qualifications because I am not hospital-based.

Those certified in infection control come from a variety of working environments, so it is important to review the practice requirements stated in the handbook or online to see if those are met in your current position. To see if you are eligible, use our online tool. To find out more information regarding the eligibility requirements, please review our Candidate Handbook here.

How do I find out where the exam is given in my area?

CBIC’s testing company assessment centers located throughout the US and Canada. Additional centers can be found internationally as well. A list of testing locations can be found by visiting Prometric's site here.

On which dates of the year is the exam offered?

There are no set testing dates (i.e. the exam isn’t given twice per year at specified locations). Our testing company has about 150 locations at which they administer the exam by computer. Once you register to take the exam, they will send you an email with available dates and times for you to take the exam at the location nearest you.

Do I receive my score immediately upon completion of the exam?

A score report is generated immediately upon completion for the both the CBT and the SARE exam.

How long after I pass the exam can I start using the CIC® credential?

Once you receive your score report indicating that you have passed the exam, you may begin using the CIC credential after your name and in your title immediately, but it takes approximately 4-6 weeks to receive your official certificate from the CBIC Executive Office.

Who can I contact to get a receipt for my exam?

For CBT and SARE receipts contact the CBIC Executive Office at 414.918.9796 or email

How can I get a replacement of my certificate?

To get a replacement certificate printed and mailed to you, please contact us at

If you need a new certificate due to damage during delivery or a misspelling, CBIC will be happy to send you a replacement.

How can I check my certification status?

You can check your certification status on CBIC’s online directory on the website here.

If I move and inform APIC and IPAC Canada/PCI Canada, do they automatically notify

No, you will also need to inform CBIC of any change of address or contact information. You can do so by going to the My Certification tab at and logging in to My Profile. If you need assistance with logging in, please contact

What is the pass rate of the CIC exam?  What is the percentage of correct answers

needed to pass?

In 2013, 58% of those who took the CBT passed the exam. In 2013, 88% of those who took the SARE passed the exam.

When the initial form of an examination is developed following a job analysis, a criterion referenced passing point study is conducted.  Such a study ensures that passing the examination depends on the amount of knowledge displayed, and does not depend on the other candidates taking the examination.  In the passing point study, content experts develop a definition of an individual who should barely be able to pass the examination, sometimes called a minimally competent practitioner or a borderline expert.  Following considerable discussion, training, and practice, the content experts provide a judgment about the difficulty of each item on an examination form for this borderline expert.  The aggregation of these judgments provides an estimate of the number of correct answers that would likely be provided by the borderline expert, and therefore, an estimate of the most appropriate passing point for the examination.  Since examination forms may vary slightly in difficulty, it may not be appropriate to require exactly the same number of correct answers to pass. This is why the passing score may be different for each version of the examination.
To hear additional information please listen to our podcast here.

Last updated: May 20, 2014


Global Semester: World Cultures

The study abroad program aims to balance study of the historical aspects of these societies with a more modern appreciation of cultural and societal differences. We are entering a modern era of globalization where the United States, Europe and Asia will play important and complementary roles.

By reflecting on the historical and cultural traditions that have built these societies, students develop a deeper appreciation of cultural similarities and differences. As the world becomes smaller and we interact more across cultures, the ability to adapt to and bridge these cultural differences becomes an increasingly important skill set.

Now accepting students for

Student Photos


The Forgotten Bouzouki

The Forgotten Bouzouki was formed in 1998 by members of the Greek community of Newfoundland and Labrador. Currently most of its members are local talents who love to play Greek music. Alison Corbett (Baglamas, Violin), Darren Browne (6-string Bouzouki, Baglamas, Mandolin), Dave Panting (8-string Bouzouki, Baglamas, Mandolin, Lute), George Miminis (Vocals, Acoustic Guitar), Heather Write (Violin, Viola), Holly Hogan (Vocals), Matthew Hender (Double Bass), and Simon Miminis (Drum kit, Hand Drums).

The Forgotten Bouzouki performs several genres of Greek music: traditional, island, ballads, folk and Rebetika. The latter is a type of Greek folk music that has been compared to Spanish Flamenco, Portuguese Fado and the American Blues. It speaks to similar subjects and has a similar vibe musically and emotionally, although it involves a more complex variety of rhythms and musical scales.

The Forgotten Bouzouki has been performing regularly at local festivals and venues; the band has been featured on several regional and national CBC radio programs and has always been known for its full orchestration and first-rate musicianship.

In 2010 The Forgotten Bouzouki got a grant from the Newfoundland and Labrador Folk Arts Council to record its first CD, which will be released in late summer, 2011.


Transmission refers to high voltage lines that bring power from generators to substations. From there, the power is stepped down in voltage and distributed to end use customers. Transmission lines usually run in dedicated rights of way and not along public roads.

From time to time, Maine utilities seek permission from the Maine Commission to build high voltage transmission lines. The question to be answered in such cases is whether the lines are "needed". Need usually means that without the line, customers would be exposed to blackouts at certain times of the year. In the some cases, the need is more difficult to quantify, since it is associated with renewable energy (like a wind farm) that would seek to sell to customers throughout New England. In such cases, the need element is usually satisfied by a showing that the generator has all necessary permits and will be built. In such a case, the generator could not deliver power to customers without the transmission line.

By statute, our job in such cases is to represent the "using and consuming" public, i.e. ratepayers as a group. We do not represent the interests of individual ratepayers or their unique concerns. We do, however, understand that transmission lines cause a great deal of upset to many who live near them. Our primary role on behalf of ratepayers is to advocate for the least cost way of providing reliable power. So, we balance cost with reliability. Generally, utilities use existing land rights (easements and fee ownership interests) for new transmission lines. In situations where many individuals live adjacent to these existing utility rights of way, we believe it is appropriate for these rights of way to be used by the utility if they prove the need for the line. It would be much more expensive to require the utility to buy up all the land rights necessary to create a whole new right of way, even though doing so might lessen the impact on those who live next to existing rights of way. Thus, we are very unlikely to become involved in questions about where these lines go.

Individuals may get involved, in several ways. First, people may intervene in the case as a full party. If they do this, they will receive virtually every piece of paper or electronic information filed in the case, including notice of all meetings, technical conferences, hearings and proceedings. In this case, people will have the option to submit substantive testimony about the technical aspects of the proposals, but there is no requirement to do so. Most of the "regular" parties do this through the use of expert witnesses. Short of this, people may request to be an "interested person" in which case you will receive notice of important developments and public hearings. Third, the PUC may hold public witness hearings; in these cases, it is likely that there will be one or more hearings in areas where the proposed line would be built. At these hearings, any person may testify on their views about the case. Finally, people may put their views in writing to the Commission.

A utility seeking permission to build a line must also obtain other permits. For example, the Maine Department of Environmental Protection (DEP) has jurisdiction over the environmental impacts caused by the line. The Public Advocate does not have the authority or expertise to participate in the DEP process.

Electromagnetic Fields (EMFs)

EMFs are electromagnetic fields, and are potentially emitted by anything that conducts electricity (including appliances in your home). Because transmission lines conduct high voltage electricity, they do emit EMFs. There has been much study of the effects of EMFs on humans (including studies of electric line workers), and to date there is no clear connection with human illness. There is, however, a "suggestion" that EMFs may contribute to childhood leukemia. If you live next to an existing line that will be upgraded, it is likely to lessen any current EMFs since the line will be bigger, dissipating the EMFs, and if the poles are higher, the line will be further away from you.

To learn more, recommend that you start with the following websites:

Transmission lines may or may not affect the value of property that abuts the line. We have seen arguments presented on both sides of these questions. In prior cases, the utilities have asserted that a new transmission line built next to a residence does not in fact negatively affect the value. Homeowners, on the other hand, have maintained that it does. The answer to this question likely depends on the unique circumstances of your particular location.

Finally, the utility may obtain permission from the Commission to take property by eminent domain.

What is Eminent Domain?

Eminent domain refers to the power possessed or delegated by the State to acquire private property for public use. Maine law authorizes utilities to acquire land using the power of eminent domain. The law provides for certain limitations to this right, for example a utility may not acquire land that is within 300 feet of an inhabited dwelling.

How does Eminent Domain Work?

There are several ways by which electric utilities can acquire land they need for building new transmission lines. Typically they approach the property owner and offer to buy the land they need. If the owner agrees, the sale takes place. If the owner does not agree, utilities may be able to take or condemn the property under the power of eminent domain. Typically, utilities only need an easement, but sometimes they seek full title.

How must a property owner be compensated for his or her land?

Under both the Maine and the United States' constitutions, the owner of land that is to be acquired must receive "just compensation" for his or her land. Just compensation means the sum of money that a willing buyer would pay a willing seller in a bargained for sale upon the open market. In some cases, the owner is entitled to additional compensation, for example, when only part of a parcel of land is taken, but the taking of that part makes the remaining part less valuable. For example, if a utility installs a large high voltage transmission line on a portion of the property, the landowner would be entitled to compensation for the loss of value of his or her remaining property as a result of the transmission line's presence.

What happens if the landowner and the company cannot agree on the amount of compensation?

If the landowner and the company cannot agree on the amount of compensation, either party may, within 3 years after the taking, petition the County Commissioners to determine the amount of compensation. Either party may appeal the decision of the Commissioners within 30 days to the Superior Court in the county where the property is located. An appeal from the Superior Court may be made to the Maine Supreme Court.

Must the Public Utilities Commission approve the transmission line before a utility may seek eminent domain approval?

Yes, the Public Utilities Commission must approve the transmission line before a utility may obtain land by eminent domain. Typically, the Commission must find that a "public need for the line exists." This determination often includes a finding by the Commission that there is no reasonable alternative that would better serve the public interest in having access to safe, reliable and economic electric energy. A utility must obtain this approval before it seeks eminent domain approval to take land necessary for the location of that line.

Must the Commission approve the location to be taken by eminent domain?

Yes. Once the Commission finds the line is necessary, it must, in a separate proceeding, approve the exact location of the land to be taken. The landowner has the right to participate in such a proceeding and may appeal the decision to the Maine Supreme Court.

How is property transferred by eminent domain?

Once the utility obtains the approval of the Commission to acquire the land by eminent domain, it must file a detailed description of the property and the names of the owners of the property with the county commissioners of the county where the property is located. The commissioners must note the time of the filing and then will order the utility to record the location of the property in the registry of deeds. Once this occurs, the utility takes the rights and may begin construction on the land. The only issue left for the landowner is compensation.

Is a landowner entitled to refuse the utility employees the right to come on his or her land prior to the land being acquired?

Yes. However it might be in the landowner's interest to allow access in order to help the company determine if that particular location is suitable for siting a transmission line.

Can land in a transmission line's right of way be used for other purposes?

When a utility acquires an easement right for a transmission line the owner can continue to use the land as long as the use does not interfere with the safe operation of the line. Golf courses, hiking trails, crop plantings and cattle pastures are examples of such uses. The landowner does not need permission to use the land as long as the use of the land does not interfere with the line.

This fact sheet is for general information purposes and does not constitute legal advice.


When the New World Order architects at the Council on Foreign Relations prattle about sovereignty, they mean something entirely different from independent nation-states.

The two leading contenders for the U.S. presidency are both members of Skull and Bones, one of the oldest secret societies in America. Why is this not a major election-year issue?

As a presidential hopeful, Senator John Kerry touts his military experience. But 30 years ago he led anti-war protests and marched alongside revolutionary Communists.

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Tuesday, June 28, 2011

Why Mosquitoes

Why mosquitoes?  Of all the amazing and beautiful rain forest animals to study, why would anyone want to work with this lowly, annoying bug that drives us crazy while sitting on porches on summer evenings?  They spread disease, too.  Why would anyone want to mess with that?

True.  Mosquitoes can spread disease. That is itself a reason to study them.  They have been responsible for countless deaths throughout the centuries and, sadly, continue to be responsible for millions today, mainly in the world’s tropical zones.  Malaria alone causes nearly one million deaths each year.

As a student of biology, I have learned through my courses that the world’s “maneaters” and “creepy crawlies” often get a biased treatment from those that may not be so familiar with them.  I hope to change that perspective a little bit.  Yes…even the “lowly” mosquito gets a little love here.

I remember when it surprised me to learn that not all mosquitoes suck blood.  Both males and females feed on plant juices and nectar.  Given that they feed on nectar, they act as pollinators.  Some may not feed at all.  It is the female that takes in blood, and she does this to lay eggs.  Blood provides iron and protein, which allows her to lay a batch of eggs larger than what would otherwise be possible on a diet of nectar alone.  Of course, being a bloodsucker has its drawbacks – Bzzzz…SLAP! –, and many species of mosquito don’t take in blood at all.  The mosquito genus Toxorhynchites includes unusually large mosquito species – none of which suck blood.  Their larvae are actually predatory (unusual for mosquito larvae) and feed on other mosquito larvae, earning them the nickname, “mosquito hawk.”  In fact, this behavior of mosquito larvae-eating has earned them the honor of being introduced into regions where the disease-carrying species, Aedes aegypti, lives.

My project asks two questions: What species are there? Where are they going?  The first part is pretty straightforward, as I collect specimens around CICRA to get an idea of what mosquito diversity is in this area.  So far, much of the diversity information comes from the areas around Iquitos, Peru, a city located in the northeastern section of the country.  Being located in the southeastern portion of the country, CICRA is a good location to sample the diversity at the opposite end.

The “Where are they going?” portion will be tackled at the KU Natural History Museum after the specimens are identified and mounted for examination.  All life forms require certain biological parameters for them to thrive (ie. temperature, rainfall, soil content, etc.) and the regions where these parameters exist can be mapped.  This provides a picture of potential habitats for any species.  We can then track how these parameters change in response to things like climate shifts and urbanization, and therefore the change in a species distribution.  If we know that areas of a wet habitat will become dry in response to climate change, for example, we can track the potential shift in distribution of a species that requires a wet environment.  As portions of the rain forest become urbanized – such as by the construction of the transatlantic highway – it affects the distributions of its inhabitants.  This has additional consequences to human health in the case of disease-carrying mosquitoes, as an increased human presence means more opportunities for infection and for outbreaks to occur.  Such outbreaks of diseases like yellow fever and malaria (mosquito-borne diseases once eradicated from Peru) have sprung up in recent years.  These are reemerging diseases.


ORDR Programs

ORDR Programs

The Office of Rare Diseases Research aims to improve the lives of people with rare diseases by coordinating the following collaborative research efforts.
Bench-to-Bedside Awards

Rare diseases bench-to-bedside medical research projects designed to speed translation of promising laboratory discoveries into new medical treatments.

The Rare Diseases Clinical Research Network

A clinical research network supported by NIH Institutes and Centers and the ORDR.

Global Rare Diseases Patient Registry and Data Repository (GRDR)

Rare Diseases Human Biospecimens/Biorepositories (RD-HuB)

A searchable database of biospecimens collected, stored, and distributed by biorepositories in the United States and around the globe.

Undiagnosed Diseases Program

The Undiagnosed Diseases Program provides answers to patients with mysterious conditions that have long eluded diagnosis and advanced medical knowledge about rare and common diseases.

Locate healthcare providers and researchers who have knowledge of your condition.

Navigate the process of trying to obtain a diagnosis.


Neuroanatomy and Traumatic Brain Injury
The human brain is the most complex, mystifying, and elegant object in the known universe. Our brains are responsible for virtually every aspect of our functioning from controlling hair growth to the origins of the universe. The human brain is truly a remarkable organ. It is estimated that the human brain contains over 100 billion neurons and several times that number in supportive cells. Each neuron, in addition, assesses between 30,000 and 50,000 branches which connect to both itself and other neurons. Thus, in one cubic millimeter of particle tissues there are literally billions of synapses or connection points between neurons. Furthermore, to support this complex system of neuronal connections the vascular system must function at a highly complex level in order to supply oxygenated blood to each of the neuronal cells. Thus, the vascular system in the human brain and the neurons it serves form a complex and interrelated matrix of extremely delicate vessels. The sensitivity and complexity of such a system leaves one to easily comprehend the results of high velocity impact injury to such a delicate system. Any stretching, compression, twisting, or other physical forces to the brain have the potential to negatively impact these delicate, physical structures. And this does not even address the changes which take place at a metabolic or chemical level. As noted by Bigler (2001) in describing the complexity of the human brain and the effects of trauma on that structure, “complex systems achieve complex functions only with efficient, well integrated, and fast recruitment of constituent parts, followed by a rapid response. Anything that disrupts this complex system, even subtly, will render the system less efficient and prone to errors in processing and responding.”

To further expand on this concept let us look at the individual neuro cell. Each cell in the brain has a specified length, width, and breadth and is held in position by other cells. As such, consistent with the physical constraints inherent in any component, the cell has limited elasticity. In other words, as with almost anything, neuro cells are limited in the amount they can be stretched, twisted, rotated, or compressed before there is an associated negative result. And the human brain is subjected to such physical motion damage may be identified using neuroimaging techniques such as computerized tomography (ct), magnetic resonance (mr), single photon emission computed tomography (spect), and magneto encephalography (mag). It is important to remember, however, that the entire brain is affected by such physical forces. Thus, when a legion is identified by any of the above methods it is erroneous to conclude that the brain has been subjected to damage in only that area identified by the imaging study. Thus, damage to the brain is always beyond just the visually identified legion. In essence, brain injuries resulting from traumatic forces are often diffuse in nature rather than specific to localized areas. Differences in brain injury, thus, should be viewed on a continuum ranging from minimal damage to a few selected neurons to progressively greater damage involving more neuronal injury.

Diffuse axonal injury has been described as a term involving injury to the cerebrial white matter of the brain. Neurons are comprised of a cell body, an axon or long trunk, and dendrites or connective branches. DAI identifies injury to the axonal section of the neurons. Three levels of DAI have been identified. Grade 1 represents wide spread non-specific axonal damage without focal abnormalities. Grade 2 incorporates the injuries in grade 1 but also includes focal abnormalities. Grade 3 again assumes levels 1 and 2 and includes brain stem injury. Very mild DAI has been objectively identified on autopsy as a result of a trauma involving as little as 60 seconds recorded loss of consciousness. Onset of DAI occurs anywhere from 6 to 72 hours following injury. And delayed cell death can occur for as long as up to one month post injury. Researchers have suggested that neuronal death can continue to occur for up to 3 years post injury!

The brain has been found to be most vulnerable if it is moved laterally. That is, trauma that occurs from a side impact has been found to result in the greatest degree of wide spread axonal damage.

Three stages of axonal injury have been suggested. In stage 1 a rapidly stretched axon which does not tear can undergo biochemical changes that may be transient. Studies have found that a minimum of a 5% increase in axon length from its resting length is sufficient to produce a transient disruption of the membrane of the neuron. This results in the neuron being unable to fire. Neuronal function may fully return within minutes after such an injury. Stage 2 axonal injury results from a 5 to 10% increase in axonal length resulting in swelling and enlargement of the injured axon resulting in disruption of neuronal functioning. Stage 3 occurs with a 15% or greater stretching and results in a high likelihood of permanent damage. With such a level of injury the neuron is believed to be unable to self-repair. Stage 4 injury in which stretching is in excess of 20% of the resting length produces immediate and irreversible damage.

In addition to neuronal injury as a result of physical forces impacting the human brain, the vascular system can also be compromised given the delicate lattice work of blood vessels supplying the billions of neurons in the brain any injury to the vascular system resulting in damage to that system can have a profound impact on the ability of that system to deliver nutrients to neurons. Swelling and compromised blood flow drop resulting in a reduction of glucose and oxygen delivery below the need the energy demands of the neuronal cells. With such a drop in glucose and oxygen there is a corresponding metabolic response in the neuron. This finding has been demonstrated most readily with SPECT and MAG imaging. The result of reduced glucose and oxygen delivery to neurons results in neuronal death and can be demonstrated by reduced brain volume. Experimental studies of even mild TBI have demonstrated hemorrhagic contusions at the gray-white matter interface.

*** studies have found that mild cases of TBI which include simple concussions, typically do not demonstrate depictable abnormalities using traditional MR imaging techniques. This does not mean, however, that there is an absence of injury to the brain. In fact, a recent series of articles published in the Journal of the American Medical Association demonstrated that concussion can produce mild but persistent neurocognitive deficits despite the absence of complete cell death resulting from such injuries. It is considered that a concussion can result in a disruption in the “efficiency” of the neurofunctioning of the brain. This finding clashes with other researchers who have consistently found in their studies that persistent post-concussion symptomatology is more likely due to psychological rather than neurologic injury. It has been suggested by other researchers, however, that as greater sophistication develops in the area of neuroimaging that argument will be found to be untenable.

In conclusion, the complexity of the human brain cannot be understated and the extent to which that delicate structure can be negatively impacted as a result of trauma should not be minimized. Most confident assessing such injury should involve sophisticated neuroimaging techniques and neuropsychological and comprehensive and sophisticated neuropsychological testing conducted by a well-trained and experienced Neuropsychologist.

ImPACT Concussion Testing

Did you know that children and adolescents suffer over 3 million concussions in the U.S. annually, and that with each successive concussion the risk of serious injury to the brain increases?!! Doing everything you can now to protect your brain is crucial for your future. When you take this test you will have taken the first step in protecting your brain should you suffer a concussion during the next year.

Take the Test!


A series of apparently random dots are printed on a hinged panel. As the visitor slowly raises the panel toward eye level, a word begins to take shape. Projected onto a tilted screen and traced, the word becomes legible only when it is viewed at a shallow angle.


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Video podcast - International migration to and from the UK, year ending September 2013

Released: 27 February 2014

Also in this release

Slide 1

This is a short video looking at patterns of long-term international migration to and from the United Kingdom, presenting the latest provisional estimates for the year ending September 2013.

Slide 2

This first chart shows patterns of immigration (that’s migrants arriving in to the UK for a period of 12 months or more), emigration (that’s migrants leaving the UK for 12 months or more), and net migration (the difference between immigration and emigration).

Immigration rose sharply during the late 1990s and early 2000s, reaching a peak of 596,000 in 2006. The latest provisional estimate showed that 532,000 migrants moved to the UK in the year ending September 2013.

Emigration has remained broadly steady over the last 40 years, albeit with a slight rise in the last 10 years reflecting rising immigration. The latest provisional estimate shows that 320,000 migrants emigrated from the UK in the year ending September 2013.

During the 1980s and early 1990s, net migration was at a relatively low level,  but rose sharply after 1997. Latest provisional estimates show net migration was 212,000 for the year ending September 2013. This was an increase from 154,000 in the previous year. This means that the estimated increase is likely to reflect a real change in migration patterns.

Slide 3

This chart shows how the patterns of migration vary between EU citizens (not including British citizens) and non-EU citizens. Net migration of EU citizens reached a record high of 131,000 in the year ending September 2013, driven by increased levels of immigration and steady emigration.

By contrast net migration of non-EU citizens fell to 141,000 in the year ending September 2013, due to falling immigration alongside steady emigration.

Rising EU net migration and falling non-EU net migration means that these figures are now closer than they have been at any point over the last 30 years.

Slide 4

The two main reasons why migrants come to live in the UK are for work and study. Traditionally work has been the most common reason for migration, although study overtook work between 2009 and 2012. In the year ending September 2013, 218,000 migrants arrived for work compared to 176,000 migrants arriving to study. The other reasons for migration have remained fairly steady.

Slide 5

Let’s look at EU migration in more detail. The latest estimates from the International Passenger Survey show that in the year ending September 2013, 103,000 EU15 citizens, 65,000 EU8 citizens and 24,000 EU2 citizens migrated to the UK. Immigration of EU15 and EU2 citizens have shown a statistically significant increase relative to the previous year, whilst immigration of EU8 citizens has remained relatively steady compared to the previous year. 6 in every 10 migrants from the EU15 arrived for work, compared to 7 in every 10 migrants from the EU8 and the EU2 arriving for work.

Slide 6

Every person who works in the UK requires a National Insurance Number, or NINO for short. The most common overseas nationality whose citizens had the most new NINo numbers allocated to them in 2013 was Poland, followed by Spain and Italy. These nationalities saw a rise in NINo registrations of 39%, 36% and 66% respectively relative to the number of registrations in 2012.

Source: Office for National Statistics

Background notes

Content from the Office for National Statistics.
© Crown Copyright applies unless otherwise stated.


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A wasp is any insect of the order Hymenoptera and suborder Apocrita that is not a bee, sawfly, or an ant. The less familiar suborder Symphyta includes the sawflies and wood wasps, which differ from the Apocrita by having a broad connection between the thorax and abdomen. Also, Symphyta larvae are mostly herbivorous and "caterpillarlike", whereas those of Apocrita are largely predatory or parasitic. Most familiar wasps belong to the Aculeata, a division of the Apocrita whose ovipositors are...

2005-09-09 09:51:50

The Bombyliids are a large family of flies with hundreds of genera. Their life cycles are not well known. Adults generally feed on nectar and pollen, thus are pollinators of flowers. They superficially resemble bees, thus are commonly called bee flies, and this may offer the adults some protection from predators. The larval stage are predators or parasitoids of other insect eggs and larvae. The adult females usually deposit eggs in the vicinity of possible hosts, quite often in the burrows...

2005-09-09 09:43:40

The bumblebee is a flying insect of the genus Bombus in the family Apidae and a relative of the common honeybee. The bumblebee feeds on nectar and gathers pollen to feed its young. They are beneficial to humans and the plant world alike, and tend to be larger than other members of the bee family. Most bumblebee species are gentle. From this comes their original name: "Humblebee". Bumblebees are social insects that are known for their black and yellow striped bodies, a commonality among the...

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Word of the Day


Jack and the Great Cliff

Jack a young lemming living in the tundra wants to explore the world. Being at the top of every predators menu, he is limited to his immediate surroundings. He accidentally befriends a falcon named Thor that helps Jack discover a sinister secret kept among the elders of his clan. Together they embark on an adventure to save the lives of his fellow lemmings. More

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Reblogged from miquiztli-mazatl  90 notes

The 3rd and 4th logs were notched and set into place.

The notching is done with a log scribe, axe, and gouge. They are concave to produce a tightly fitting edge that both sheds water and tightens over time. Each notch looks like a unique hand carved bowl…


In the Beginning We MisunderstoodMost books dealing with the proper interpretation of Genesis 1 attempt to do one of two things: show how Genesis 1 cannot be reconciled with modern science, or show how Genesis 1 can be reconciled with modern science.  Some try to show that Genesis presents us with a young universe, while others try to show that Genesis presents us with an old universe.  Either way, it is presumed that Genesis 1 intends to present us with a scientific description of how God created (order, duration, etc.).

In their new book, In the Beginning…We Misunderstood: Interpreting Genesis 1 in Its Original Context, coauthors Johnny Miller and John Soden argue that this presumption is false, and concordism is a misguided hermeneutical approach to Genesis 1.  Discussions over the meaning of Genesis should not be driven by scientific questions, but by literary questions.  Our interpretation of Genesis should not be determined by our views about science, but by the text itself.  Why even think that God meant to provide a scientific description of creation?  The most important question to ask is what Moses meant when he wrote the creation account, how his readers would have understood it, and what practical impact it would have for them given their unique historical situation.  How did it prepare them for the theology and religious practices they were familiar with in Egypt, as well as those they would encounter in Canaan?

Glass SlipperIf we are honest with ourselves, all of us want the Bible to support our existing beliefs and practices.  We want it to support the teachings of the religious tradition we were raised in, or are currently part of.  We want it to affirm that which we think is morally right, and condemn that which we think is morally wrong.  There is always a danger, then, that we will engage in hermeneutical and logical gymnastics to ensure that we can walk away from the Bible without having to change our beliefs and practices.

I often ask myself, Would I interpret this passage in this way if I had been raised in a different tradition?  Would I think X is wrong or Y is right if I was Presbyterian rather than Pentecostal?  Are my reasons for interpreting the Bible as I do good enough to rationally compel others to adopt my position, or just good enough to for me to feel justified in my present beliefs?  Would I adopt my position if I were an outsider, listening to the same arguments?  If not, why not?

While I fully understand the desire to avoid change and theological conflict with one’s religious community, truth should always be our first priority.  If good hermeneutics and sound reason cause us to walk away from the Bible confirmed in our present beliefs, then great.  But if good hermeneutics and sound reason require us to change our beliefs and/or practices, then so be it.  Truth is more valuable than tradition.

Portions of 1 John 4:1-6 are often cited in discussions of spiritual warfare.  John’s admonition to “test the spirits to see whether they are from God” (1 Jn 4:1) is cited as evidence that we need to exercise spiritual discernment to distinguish between angelic and demonic spirits, or even good and bad human spirits.  And then there is 1 John 4:4b: “Greater is he who is in you than he who is in the world.”  This Scripture is typically quoted in the context of overcoming the Devil.  But are these passages being interpreted correctly?  Are they referring to spiritual warfare?  To find out, let’s look at the context:

A key word in this passage is “spirit.”  Many presume that when John talks about “test[ing] the spirits,” he is referring to angelic and demonic beings.  It’s clear, however, that John uses “spirit” in several ways in this passage.  And in verse one he uses “spirit” to refer to human teachers, not angels and demons.  This is evidenced by his juxtaposition of “spirits” with “false prophets” who “have gone out into the world.”

Philippians 4:13 reads “I can do all things through Christ who strengthens me.”  This is taken by many to mean they can do anything they set their mind to through Christ’s strength.

NT scholar Ben Witherington argues that this is a misreading of the text.  He notes that the Greek does not say “do.” The only verb in the Greek is “ischuo” which means “to be able, strong, healthy, valid, powerful.”  A literal rendering of the verse is “I am able all things in Him who empowers me.”  Read literally, it doesn’t make any sense.  Able to what?  The helping verb is missing, and can only be supplied by the surrounding context.  So what is the context of Paul’s statement?

In verses 10-12 Paul wrote: “I rejoiced in the Lord greatly that now at length you have revived your concern for me. You were indeed concerned for me, but you had no opportunity. [11] Not that I am speaking of being in need, for I have learned in whatever situation I am to be content. [12] I know how to be brought low, and I know how to abound. In any and every circumstance, I have learned the secret of facing plenty and hunger, abundance and need.” (ESV).

Paul had learned to be content in any state he found himself in.  He learned to endure both the good and the bad through Christ’s empowerment.  A better translation of Phil 4:13 then would be, “I am able [to be content in] all things in Him who empowers me” or “I am able [to endure] all things in Him who empowers me.”  This verse affirms our ability to persevere through the good and the bad by trusting in Christ, not our ability to accomplish any feat we want.

If you are a Christian theologian or teacher, or just a serious student of Scripture, you will engage in word studies.  This can be a very fruitful enterprise in exegesis, and yet there are so many ways it can go badly.  In his book, Biblical Words and Their Meaning: An Introduction to Lexical Semantics, Moises Silva addresses the subject of lexical semantics.  He discusses the proper study of words, and common fallacies to avoid.  This book is a must read for exegetes.  Here are just some of the gems I have gleaned from Silva:

  • Language and concepts are not necessarily correlated.  For example, just because Hebrew lacks a future tense does not mean Hebrew-speakers lack a concept of the future.  All talk of the “Hebrew mind” versus the “Greek mind,” based on linguistic differences, is simply fallacious.  Linguistics cannot tell us about  a person’s worldview and mental categories.
  • Etymological studies and cognate languages are of limited value to exegesis.  The history of a word’s meaning may be of interest if you are a historian, but it is of little value if you want to know what that word means in the Biblical text you are studying.  To determine the meaning of a word used in the Biblical text, we must determine what it meant in the author’s day (synchronic meaning), not its origin and evolution (diachronic meaning). (more…)

What do you think of the pericope of the rich man and Lazarus in Luke 16?  Do you think it is a parable or a historical event?  Why?

Jesus’ words here have been interpreted by many to mean vocalized prayers in public settings should be avoided.  The only acceptable form of prayer in a public setting is silent prayer.  Is this what Jesus meant?  No, as Biblical examples of prayer make clear.

The first thing to observe is that Jesus went on to instruct the disciples how they should pray.  He told them they should say, “Our Father, who is in heaven…” (6:9)  Jesus’ use of the plural possessive implies that this prayer would be prayed aloud in a community setting.  There would be no need for a single person praying alone, or a single person praying silently in a group to use “our.”  In both cases “my Father” would be more appropriate.

Christians are often accused of being judgmental by non-Christians—and sometimes, even by fellow-Christians.  Indeed, it’s not uncommon to even hear non-Christians quote Jesus’ words in Matthew 7:1 against Christians: “Judge not, lest you be judged.” (even if they’ve never read a page from the Bible in their life!)  I am persuaded that both the church and the culture at large have failed to understand the Biblical teaching on judgmentalism.  Before I explain, let’s look at a few more Biblical passages often cited in support of non-judgmentalism:

1 Cor 5:12-13 For what have I to do with judging outsiders? Is it not those inside the church whom you are to judge? 13 God judges those outside. “Purge the evil person from among you.” (ESV) [talking about executing punishment]

The Bible begins with one of the most famous proclamations of all time: “In the beginning God created the heavens and the earth” (Genesis 1:1).  Theologians have historically understood “in the beginning” to refer to the very beginning of time itself.  It was the boundary between timeless eternity and temporality.

Fast forward to the first century A.D.  John opens his gospel about Jesus Christ with these words: “In the beginning was the Word, and the Word was with God, and the Word was God. 2 He was in the beginning with God. 3 All things were made through him, and without him was not any thing made that was made.”  The resemblance to Genesis is unmistakable.  Both Moses and John begin their work with “in the beginning,” and both speak of the creative word of God.

The question arises as to whether John is using “in the beginning” in the same way as Moses.  For Moses it referred to the beginning of time and creation, but that’s how John is using it, then to say the Word was “in the beginning” seems to imply that the Word was not eternal, but a created entity who began to exist concomitantly with the created realm.  Clearly this cannot be the correct interpretation because John 1:1 identifies the Word as being God (whom we know is eternal, and thus existed “prior to” the universe), and John 1:3 identifies the Word as the uncreated creator.  Why, then, would John say the Word was “in the beginning?”  Why not say Jesus was “before the beginning” or “before the ages?”  What is your take on the matter?

There is a doctrine that has circulated within my fellowship for many years called the Shekel and a Half doctrine.  Those espousing to this doctrine claim that in addition to paying tithes on ones income (10%), believers need to pay an additional 5%.  It is often said that the additional 5% is for the upkeep of the church, or to fund a church building program.  Exodus 30:11-16 is appealed to for Biblical support:

The Lord spoke to Moses: 12 “When you take a census of the Israelites according to their number, then each man is to pay a ransom for his life to the Lord when you number them, so that there will be no plague among them when you number them. 13 Everyone who crosses over to those who are numbered is to pay this: a half shekel according to the shekel of the sanctuary (a shekel weighs twenty gerahs). The half shekel is to be an offering to the Lord. 14 Everyone who crosses over to those numbered, from twenty years old and up, is to pay an offering to the Lord. 15 The rich are not to increase it, and the poor are not to pay less than the half shekel when giving the offering of the Lord, to make atonement for your lives. 16 You are to receive the atonement money from the Israelites and give it for the service of the tent of meeting. It will be a memorial for the Israelites before the Lord, to make atonement for your lives.”

I was having a conversation with some coworkers some time ago in regards to same-sex marriage.  They brought up the relationship of homosexuality to the Christian religion, at which point I affirmed that the Bible—and hence Christianity—is opposed to homosexuality.  Immediately I received the “Well, that’s just your interpretation” response.  My response to this charge was to explain the process of exegesis, which took several minutes of my time and got us off the real issue at hand.  In retrospect I thought of a more efficient and tactful response I would like to share with you.

The next time you are discussing some aspect of Biblical teaching with someone, and they give you the “Well, that’s just your interpretation” response, respond by saying something off-the-wall like, “So you are saying I don’t like pickles?!”  A blank and confused stare is sure to follow proceeded by the expected question: “What?!?!”  Explain to them that you have just demonstrated the fundamental principle of interpretation.  Valid interpretation only comes about when the receiver accurately understands the intent of the sender/author.  This is accomplished by correctly employing the use of grammatical and semantic rules, and considering the cultural/historical perspective of the sender.  If the sender’s intent is not properly understood, communication has not occurred and the result is misinterpretation.  If interpretation is rooted in authorial intent only one interpretation can be valid.  As long as the interpreter employs the proper tools they can walk away with the correct interpretation.

The Bible is no different.  There is a correct way and an incorrect way to interpret the Bible.  The same tools and rules we use to correctly interpret our modern conversations and writings apply equally to the Bible.  When those tools and rules are used properly the interpretation we walk away with is sound.  No, it’s not just our interpretation.  It is the meaning inherent within the text itself, discovered (not invented) by the interpreter using the universal rules and tools of language.

Elaine Pagels—famous for her promotion of Gnostic Christianity—was interviewed by David Ian Miller for the April 2, 2007 edition of the San Francisco Chronicle. Pagels was discussing the Gospel of Judas. Miller asked her if this gospel would change the way people observe Easter. Pagels answered in the affirmative. She wrongly asserted that Luke and John give different portrayals of Jesus’ resurrection body (one spiritual, one physical), and then went on to say the following:

And what was important to the authors of Luke and John was not to decide between those stories—the important thing is that we know in some sense that he is alive. That the resurrection happened. And that is affirmed. But one thing we can see in these other texts [such as the Gospel of Judas] is that you don’t have to take the resurrection literally to take it seriously. One can speak about Jesus alive after his death with conviction without necessarily meaning that his physical body got out of the grave.

Yes, we could speak of Jesus being alive after His death without meaning His body got out of the grave, but we could not call it a resurrection. Resurrection, like apple, refers to something specific. It does not refer to any sort of life after death, but in the words of N.T. Wright, life after life after death. In the ancient world the word was always bound up with the return to a bodily existence after a disembodied existence following death. We are not free to redefine words to our own fancy, no matter how much Pagels might wish to do so. If Pagels wants to believe in a spiritual ascension she is free to do so, but she is not free to call it a resurrection, nor is she free to say that those who believe such a thing have satisfied the Biblical requirement to believe in Jesus’ resurrection. You can’t evacuate a term of its meaning, and then assert that any content one might choose in its place satisfies the meaning of the word.

If resurrection can mean whatever one wants it to mean, then why is it important that we affirm it? And what are we even affirming? How about I postulate that Jesus’ resurrection means He survived death only in the memory of His followers? Is that an affirmation of His resurrection? Hardly. “Resurrection” means something.

A spiritual resurrection of Jesus makes no sense. It could not explain the rise of Christianity. If Jesus’ spirit merely survived death, there would be nothing extraordinary about Him. Other people experience the same. What made Jesus extraordinary was that His physical body came back to life, and was subsequently glorified. That is what the early church preached, and that is why Christianity was so scandalous. No pagan would have had a problem with a disembodied spirit ascending to heaven, but they had a big problem with a man returning from the dead, never to taste of death again.

But that’s all icing on the cake. My real focus is on her statement that we can take the Biblical texts seriously without taking them literally. While this is a nice sounding catchphrase that is popular in liberal Christianity, what exactly does this mean, and how does it play itself out in the real world? If the context makes it clear that a text is figurative in nature, then we are taking the text seriously when we understand it in a figurative sense. But when the context gives us every reason to believe the author is presenting something as historical fact, we are not taking the text seriously if we assign it a figurative meaning. When it comes to the gospels, we have every reason to believe that the events recorded are intended as genuine historical events. As such, it is impossible to take them seriously all the while denying their historicity.

Is Pagels prepared to treat other purported historical accounts in this fashion? Can she deny the historicity of slave trade in the early Americas while taking the texts that tell us about this horrendous practice seriously? Of course not! So why treat the Bible any differently? She is free to argue that while the gospels present themselves as genuine history, they are not historical events, but she is not free to deny their historicity all the while claiming to take the texts seriously. It is highly disingenuous.

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3D Construction Instructions

Universal language work instructions

Construction tasks performed on the field are often far from lean. They oblige site managers to deal with setbacks resulting from poorly executed project schedules. They also struggle with inconsistent work quality resulting from differences in the skill sets of the various work teams on site. Moreover, construction workers do not all speak the same language resulting in difficulties communicating instructions to them.

With Optimized Plant Construction 3DEXPERIENCE solution, non-textual, easily understandable 3D instructions can be obtained based on 3D information of the equipment, terrain, and plant facility. Instructions of generic operations can also be easily and quickly created in 3D. Animations of workers’ tasks are then interactively generated. Optimized Plant Construction 3DEXPERIENCE solution delivers virtual animated scenarios to train workers in a 3D life-like manner maximizing comprehension before real-life execution on the field.

Companies generally create instruction manuals in several languages filled with a lot of text and 2D sketches. The documents can, however, be easily transformed into 3D scenarios for any worker. Sensitive specific installation assembly sequences of the erection process can be transmitted to the construction team before actual execution so as to ensure that they do it right the first time.

Key Capabilities and Benefits:

  • Promote first-time-right construction tasks
  • Provide field teams with direct access to instruction procedures and training material.
  • Unambiguous construction instruction
  • Multilingual understanding & learning retention
  • Stakeholders maximized comprehension of project phases


Ma’di, Southern

A language of Uganda

Alternate Names
Southern Ma’di

60,000 (2010 SIL), increasing.

West Nile river bank, Arua District, Madi-Okollo county, extending into Yumbe, Maracha, and Nebbi districts.

Language Maps
Language Status

6a (Vigorous).

Ogoko, Okollo, Rigbo. Reportedly more similar to Lugbara [lgg] than to Ma’di (Moyo) [mhi], which they do not understand. Ogoko and Rigbo dialects are more similar to Lugbara [lgg] than Okollo; intelligibility testing needed. Okollo considered most pure. Southern Ma’di dialects in Rigbo, Ogoko, and Okollo areas, should be considered Lugbara dialects (SIL 1992 Moru-Ma’di Survey Report). Lexical similarity: 85% between Ogoko dialect and Adjumani Ma’di [mhi], 83% between Okollo and Ogoko, 80% between Ogoko and Arua Lugbara, 80% between Ogoko and Moyo Ma’di, 78% between Ogoko and Moyo Ma’di, 76% between Okollo dialect and Arua Lugbara [lgg], 64% between Okollo and Moyo Ma’di, 59% between Okollo and Adjumani Ma’di [mhi] (Boone and Watson 1999).

Language Use

Home, work, markets. All ages. Positive attitudes. Also use English [eng], Lugbara [lgg], Swahili [swh].

Language Development
Taught in primary schools. Poetry.

Unwritten [Qaax].

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