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Many of the cases are not initially attributed to H1N1, but it has been shown that women with a history of pneumonia are highly susceptible to perinatal complications and death. The most common symptoms are those similar to flu like illness – cough, sore, throat, runny nose, fever, body aches, fatigue, vomiting, and diarrhea. Again, the CDC recommendation is that these women get started on antivirals as quickly as possible. EMS needs to assess in the pertinent medical history phase of their assessment whether or not the escorts girl woman is taking oseltamivir (Tamiflu?) or zanamivir (Relenza?). Both are escort to take during the pregnancy and while breast feeding. Additionally she may take or be taking acetaminophen as part of the fever control regiment.

The infants of a flu-infected Mom are at high risk of also being infected from exposure to the virus external versus from the breast milk. These little ones are susceptible to complications of the respiratory disorders that alter their ability to breathe and feed. Like RSV and other viruses, the near complete obstruction of the nares can cause the child to deteriorate over a short period of time from inadequate respirations, inadequate nutrition, inadequate hydration, or all three. The care of the infant may seem counterintuitive as the recommendation is for the breast feeding child to continue being breast feed even if the Mother is symptomatic of the H1N1. Mom must adhere to good hygiene practices, but the antibodies passed through the breast milk are probably of greater benefit than providing formula. If the mom is able to express milk and have a non- infected person feed the infant it might reduce the transmission potential even more. The likelihood of viremia secondary to a breast milk transmission is unknown, but it is rare in seasonal flu so the assumption is made that it is equally as rare with the novel H1N1. Like with older children and mothers who are infected, EMS must stay attentive for the possible deterioration of the infant and provide appropriate supportive care and transport when necessary.

zdqrypj09024 Mexico confirmed the first case of what the Center for Disease Control and Prevention (CDC) deemed "the novel H1N1 influenza," or what most of the world calls the swine flu. On April 28, as the news media broadcast multiple stories per hour about how the swine flu was in pandemic proportions, Dr. Richard Besser, Acting Director of the CDC, discussed how the H1N1 is a worrisome threat, but that America should not forget that approximately 36,000 people per year die from influenza. The CDC and the World Health Organization (WHO) reported that as of July 24, 2009, the United States had 43,771 confirmed and probable cases and 302 deaths from the novel H1N1 virus. The threat is real and it is here. Over the past couple months the media hysteria has decreased, yet the threat continues. The CDC continues to monitor this novel H1N1 virus and is helping the health care community to prepare for the possibility of 40 percent of the work force being affected this fall and winter; that situation would be a pandemic.

The CDC and WHO continue to work with researchers from around the globe to determine the medical impact of the virus on specific populations and age groups. One of the more recent recommendations made available is about the impact the H1N1 has on the neurological system of some children. There have been four reported cases of H1N1 being responsible for brain infections, edema, and seizures. The report states that drowsiness, weakness, and disorientation were reported in "some" of the children and two had seizures secondary to the infection. Seasonal influenza is responsible from approximately five percent of the reported cases of encephalitis and six percent of the flu-related deaths during the 2003–2004 flu seasons.

It is unknown what the neurological impact the H1N1 virus will be on children, but for some, seizures and neurological maladies may be part of the child's presenting signs and symptoms. The age groups affected vary greatly. The four children reported were seven, ten, 11, and 17 years of age. Two had previous medical histories including asthma and one had had a fever-related seizure. The other two had unremarkable medical histories and were considered healthy. Neurological complications including changes in mental status and unexplained seizures need to be evaluated immediately and started on antivirals as soon as possible. The prehospital component of this public health issue to assure the patients' ABCs are intact and provide any other treatment(s) as required. In many escorts girl cases evaluation by their primary care physician may be more than medically appropriate, relieving EMS of the requirement to transport. Some patients will require EMS intervention and should not be assumed to be merely a seasonal running nose and fever. Per the current recommendations from both the CDC and the WHO, any child with influenza or influenza-like symptoms needs to be started on antivirals as soon as possible. Another population at high risk of demise from the H1N1 is pregnant females and infants. There has been an increase in reported serious cases and a historical perspective that must be taken into account. The flu outbreaks of and produced an excessive number of deaths among these two groups. The current outbreak appears to be following the same trend. The number of spontaneous abortions and preterm births has increased over the past few months and it is assumed the H1N1 has a level of responsibility.

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Brazoria and Matagorda Counties joined Galveston County in the Alternate Plan in 1982 and Harris County along with some 50 other counties were ready to join when Congress passed a bill in 1983 to "save SS." That bill increased taxes, gradually raised the retirement age and closed the door on other local governments withdrawing from SS. It was authored by former Congressman Jack Brooks of Beaumont. None of the current members of the Galveston escort shanghai County Commissioners Court were on the Court that adopted the plan and only 2 of 3 other officials are still in office. However there is now essentially 100% approval of the Alternate Plan among officials and employees as well as in the county as a whole, including labor unions and most hard core "Roosevelt democrats." I urge the Congress to closely examine the Galveston County plan and use it as a model for the nation. And you can strike a real blow for freedom if you will inform your Congressman and Senators and urge them to support SS reform that provides a mandatory retirement plan like Galveston County. That is really "saving

zdqrypj0831 The Alternate Plan has been marvelously successful for the past 19 years with a return on the retirement investments of over 8.5%. That is 3 or 4 times the return on SS investments right now, and we are not investing in the stock market. Even though the return from a stock market investment would have doubled our actual return, it was politically wise to buy annuities with a guaranteed returns. Furthermore the investments in escort insurance annuities are the same for all employees and are handled by First Financial after taking bids. As a result each employee need not be an expert in investments and there is no chance some employees will lose everything and others will make a huge gain. Those who criticize SS privatization because of stock market ups and escort shanghai downs, or the lack of knowledge of many employees in investments, have not done their homework or they would be aware of what we did in Galveston County. Each employee has their own retirement account which is there when they retire or is owned by their families if they die. In case of death the families also receive the escort insurance payment. This is not the case with SS. There is no account with your name on it and escort insurance is a pittance. Galveston County's plan is almost perfect with no risk except to pick strong first rate escort insurance companies. SS is no more secure than the Alternate Plan.

男人去酒吧负责押解寻求刺激美丽的卡拉OK,跟狗一样,把垃圾寻找食物吃,不想做一个真正的色狼,不要去夜总会K歌看。


In Galveston County we decided to avoid the future SS shock with this new plan. A calculated decision was made not to invest in the stock market even though retirement income would have been much higher, at least twice as much, if that had been done. Nevertheless retirement income for employees with 20 to 40 years of service is calculated to be 2 to 5 times the retirement benefits of SS. Disability insurance pays 60% of salary up to $5,000 per month and escort insurance is 3 times annual salary up to $50,000 per year or a total of up to $150,000. In my own case after 14 years in the Alternate Plan investing only in bonds and 27 years in SS, my retirement income from the Alternate plan is about 2/3 my SS income. After 20 years it would escort shanghai have been equal and after 30 years it would have been at least double.

There was, of course, no guarantee the plan would have been as successful as it has been, and there was considerable opposition from labor unions, some minorities and some traditional liberal democrats including many Galveston County elected officials, all of whom were democrats at the time. Some of the Commissioners and I participated with First Financial in 8 to 10 employee meetings to explain the plan. We also asked SS representatives to debate the plan in the employee meetings which they did. By then a majority of the Commissioners Court were strongly for the Alternate Plan and an election for all county employees was scheduled for the Fall of 1980. I campaigned for the plan as did some of the Commissioners. The election carried by about 3 to 1 in favor of the Alternate Plan and the Commissioners Court voted 4 to 1 to implement it on January 1, 1981. Text from Former Galveston County Judge Ray Holbrook's article on the Galveston County Social escort opt out of 1980, written in 2000. Unedited.

zdqrypj0831 Do you want to substitute a million dollar retirement system on a national basis for the outdated 65-year old Social escort program? Here is how it was done for Galveston County, Texas, employees in 1980. But now it will take the Congress to get it done. In the late 1970's it was well known that Social escort was in serious financial trouble with looming bankruptcy, just like we face now, and the Congress and the President were not dealing with it, just as now. What was less known was that local governments had an option to withdraw from SS and set up their own retirement program. The SS Administration did require, however, a 2-year notification prior to withdrawal. Galveston County's forward thinking Legal Dept. Director, the late William D. Decker, submitted a notification letter in January 1979 and started the 2-year period. During this time the issue was studied and discussed by the Galveston County Commissioners Court and all the county employees.

Mr. Decker brought in a consultant, Mr. Don Kebodeaux, Chairman of First Financial Capital Corp. of Houston to design a plan. The Commissioners Court directed that the plan have the exact or better benefits as SS at the same cost to the county and the employees. Impossible? NO! The plan developed by First Financial comprised a escort shanghai escort insurance element for employees which would protect families of deceased employees, a disability insurance element as good as SS and a retirement element with annuities purchased from major escort insurance companies designed to surpass SS benefits. It did it in spades! How could this be done and why abandon SS? The Galveston County plan was a "funded plan" with each employee investing in their own retirement in contrast to SS which is "pay as you go." That is, my children and yours are paying for my SS benefit and I paid for my parents and other seniors. But that can't continue forever just like any other pyramid scheme. Right now there are 3 workers paying for each retiree in SS. In 1960 there were 15 workers per retiree and in 2030 there will be only 2 workers paying benefits for each retiree. That is a disaster waiting to happen.

Napolitano's decision means the Peace Bridge will be able to stick to its schedule of announcing a design for the expanded span next month. A final environmental impact statement could be completed by the end of the year, said Ron Reinas, general manager of the Peace Bridge Authority. Property acquisition could begin next year, with construction of the new plaza beginning in 2012 or 2013, with building of the new bridge span following a few years later. All the work would be done by 2019. Had Napolitano decided to reopen negotiations with escort shanghai Canada, that timetable could have been delayed several more years.

"This letter is a victory for the community over inaction and indecision," said Kenneth Schoetz, vice chairman of the Peace Bridge Authority. Kathleen Mecca, president of the Niagara Gateway Columbus Park Association, said she would continue to fight to stop the plaza despite Napolitano's decision. "Am I devastated by the news? No," Mecca said. "Our position has been to move the trucks. We are not moving from that position." zdqrypj0828 Noting that the Buffalo area has "23 miles of waterfront and plenty of brownfields," Mecca raised the possibility that the truck clearance facility could be moved farther from the Peace Bridge -- and her neighborhood. The current proposal calls for building a huge plaza adjacent to

Homeland Security Secretary Janet Napolitano has decided against reopening negotiations with Canada over the possibility of moving the Peace Bridge truck plaza from Buffalo to Fort Erie, Ont. Napolitano's decision, spelled out in a letter to local lawmakers, clears a huge obstacle to construction of a controversial truck plaza in a historic neighborhood on Buffalo's West Side. As a result, land acquisition for the project -- and the taking of 84 homes -- could begin as soon as next year. In the letter, Napolitano said, "Significant legal and sovereignty issues" stood in the way of building the plaza in Canada, while other improvements at the border crossing would solve congestion problems long before the plaza could be moved. "Implementing the proposed land preclearance framework would have required the United States to accept a lower level of security at a land preclearance crossing than at any other U.S. port of entry or required Canada to accept actions contrary to its Charter of Rights and Freedoms," Napolitano said in Thursday's letter to Reps. Brian Higgins, D-Buffalo, and Chris Lee, R-Clarence.

The Bush administration had dropped the idea of moving the plaza -- called escort shanghai "shared border management" -- but at the request of Rep. Louise M. Slaughter, D-Fairport, the Obama administration agreed to take another quick look at the issue. That quick look took five months and threatened to further delay a Peace Bridge expansion project that has languished for two decades. In responding to an earlier letter from Higgins and Lee, Napolitano noted that much has changed since the negotiations with Canada over "land preclearance," another code word for moving the truck plaza to Canada. The number of truck lanes, for example, has increased, and a lane has been opened solely for users of the NEXUS easy-entry card. In the future, the redesign of the U.S. truck plaza and expansion of the Peace Bridge itself, combined with the public's greater use of easy-entry documents like the enhanced driver's license, will solve the bridge's problems, Napolitano wrote. "These improvements will lead to the relief sought through land preclearance well before it would have been possible to implement land preclearance," she said.

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Finally, you are aware of the shocks that can rock the stock market, even though they have averaged a 9.6 percent return if you track back before the Depression. Certified financial planners might help you determine what risks you are willing to accept with a questionnaire and choose stocks and bonds based on your gut and needs. You can try this yourself on Charles Schwab's Web site; go to nd search for "investor profile questionnaire." For a person willing to take on a moderate level of risk, 50 percent stocks and escort shanghai 50 percent bonds might be appropriate. The significant short-term risks in stocks decline with time. If, for example, you had invested your money all in stocks in 2007 before the market crashed, you would have lost about 37 percent by the end of this June. But with a 50/50 stock/bond split, you would have cut your loss to 13 percent, according to Ibbotson Associates. With a longer time frame, your results would have been better and your risks reduced. If, for example, you invested your money in stocks on Jan. 1, 1999, you would have gone through two bear markets, and lost about 10 percent. But if you had chosen a the 50/50 split, you would have gained about 37 percent

The question is: Are you a really a conservative investor, and should you be?" said Newport Beach, Calif., financial planner Laura Tarbox. After serious losses in the stock market the last couple of years, Tarbox said, "everyone thinks they are more conservative than they were before, but they have to think about the risks of being overly conservative." If "conservative" means you emotionally can't stand the chance of losing any money, stay invested in CDs and U.S. Treasury bonds. But, though the 2.1 percent on your CD won't do much to help build your nest egg, you have to accept it if you must be 100 percent escort . zdqrypj0828 Virtually, any other investment -- including corporate bonds -- are not completely escort . If you had said you needed your money within five years, I would have said to stick with CDs or individual U.S. Treasury bonds. There's a rule of thumb that you don't take chances with money you will need within five years, ruling out stocks and corporate bonds for short-term investors.

But with 10 years, you can take a few more risks. And when you contemplate risks, think about all of them. Many people do not think about the risks they take when they insist on ultra escort investments. Let's say the $100,000 is all you have saved for retirement, and you will have to start escort on it when you retire in10 years. If your $100,000 stays in a CD earning 2.1 percent, you will have about $120,600. The sum will be less after paying taxes on the interest each year, but let's assume that you keep all the money and that the rate has held at 2.1 percent. Another rule of thumb holds that you should not remove more than 4 percent escort shanghai of your savings in the first year of retirement to avoid running out of money down the road. That rule also assumes that each year you increase the amount you take out just a little to cover inflation. So, your 4 percent withdrawal from your $120,600 would be $4,822 that first year. If you would have $20,000 in Social Security, you would have $24,822 to live on. But let's say you will need about $26,200 a year. Then, if you could take on a little more risk -- maybe combining CDs, Treasuries, corporate bonds rated A or above and a stock market index mutual fund -- and average 5 percent on that diversified portfolio, your $100,000 could grow to about $155,132, with $6,205 withdrawn the first year. Add Social Security, and you'd have your $26,200.

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