Sample size calculation in cross-sectional studies

Shocking Victory for Proponents of Alternative Medicine

Sickle cell disease SCD is an inheritable hemoglobinopathy characterized by polymerization of hemoglobin S in red blood cells resulting in chronic hemolytic anemia, vaso-occlusive painful crisis, and multiorgan damage. At what point does their blindness pass from being depraved indifference to active participation in a universal crime? For some, palatable foods have palliative properties and can be viewed as a form of self medication. But in the previous studies the values are mentioned in mean, now how to calculate sample size, because we need values in percentage to calculate sample size. Date of most recent search of the Group's Haemoglobinopathies Trials Register:


International Conferences

All new products related to such potential health benefits will naturally need to be scrutinized through thorough environmental and food safety risk assessments.

An analysis of risks and effects of food production practices using modern methods of biotechnology needs to reflect on all developments in the area, based on knowledge of modern biology and keeping in mind that the definition of modern biotechnology is often not very standardized.

Integrated pest management IPM needs to be seen in the light of modern biotechnology because of the use of advanced bio-technological methods: Definitions of IPM cover a range of approaches: Suitable pest control methods should be used in an integrated manner and pesticides should be used on an "as needed basis" only, and as a last resort component of an IPM strategy.

In such a strategy, the effects of pesticides on human health, the environment, sustainability of the agricultural system and the economy should be carefully considered.

According to FAO, IPM programmes are designed to generate independence and increased profits for farmers, and savings on foreign imports for governments. IPM enables farmers to make informed decisions to manage their crops. Sometimes also organic farming is discussed as a modern technology for food production, where farmers adhering to this idea are aiming for similar objectives like IPM but more clearly pronounce the ideas of integrity, self determination and co evolution.

Principles of the environmental risk assessment, ERA: In many national regulations the elements of the ERA for GM food organisms include the biological and molecular characterizations of the genetic insert, the nature and environmental context of the recipient organism, the significance of new traits of the GMO for the environment, and information on the geographical and ecological characteristics of the environment in which the introduction will take place.

The risk assessment focuses especially on potential consequences on the stability and diversity of ecosystems, including putative invasiveness, vertical or horizontal gene flow, other ecological impacts, effects on biodiversity and the impact of presence of GM material in other products.

Internationally the concept of familiarity was developed also in the concept of environmental safety of transgenic plants. Familiarity can also be used to indicate appropriate management practices including whether standard agricultural practices are adequate or whether other management practices are needed to manage the risk OECD, Currently the Cartagena Protocol on Biosafety to the Convention on Biological Diversity is the only international regulatory instrument which deals specifically with the potential adverse effects of genetically modified organisms known as Living Modified Organisms LMOs under the Protocol on the environment.

The Biosafety Protocol covers transboundary movements of any genetically modified foods that meet the definition of LMO. The Protocol establishes a harmonized set of international rules and procedures designed to ensure that countries are provided with the relevant information, through the information exchange system called "Biosafety Clearing-House".

This Internet-based information system enables countries to make informed decisions before agreeing to the import of LMOs. It also ensures that LMO shipments are accompanied by appropriate identification documentation.

Furthermore, the scope of its consideration of human health issues is limited, given that its primary focus is biodiversity, in line with the scope of the Convention itself. Potential unintended effects of GMOs on non target organisms, ecosystems and Biodiversity: Potential risks for the environment include unintended effects on non target organisms, ecosystems and biodiversity. Insect resistant GM crops have been developed by expression of a variety of insecticidal toxins from the bacterium Bacillus thuringiensis Bt.

Detrimental effect on beneficial insects or a faster induction of resistant insects depending on the specific characteristics of the Bt proteins, expression in pollen and areas of cultivation have been considered in the environmental risk assessment ERA of a number of insect protected GM crops. These questions are considered an issue for monitoring strategies and improved pest resistance management, which inherently can affect food safety in the longer term.

Under certain agro-ecological situations, such as a high weed pressure, the use of herbicide tolerant crops has resulted in a reduction in quantity of the herbicides used, in other cases no herbicide reductions or even the need of increased herbicide uses have been reported.

Out-crossing of transgenes has been reported from fields of commercially grown GM plants including oilseed rape and sugar beet, and has been demonstrated in experimental releases for a number of crops including rice and maize.

Out-crossing could result in an undesired transfer of genes such as herbicide resistance genes to non-target crops or weeds creating new weed management problems. The consequences of out-crossing can be expected in regions where a GM crop has a sympatric distribution and synchronized flowering period, that is highly compatible with a weedy or wild relative species as demonstrated e.

The possibility that certain genetically engineered fish and other animals may escape, reproduce in the natural environment and introduce recombinant genes into wild populations is a concern of a report of a recent US Academy of Science study [46]. Genetically engineered insects, shellfish, fish and other animals that can easily escape, are highly mobile and form feral populations easily, are of concern, especially if they are more successful at reproduction than their natural counterparts.

For example, it is possible that transgenic salmon with genes engineered to accelerate growth released into the natural environment could compete more successfully for food and mates than wild salmon, thus endangering wild populations. The use of sterile all-female genetically engineered fish could reduce interbreeding between native populations and farmed populations, a current problem with the use of non-engineered fish in ocean net-pen farming.

Sterility eliminates the potential for spread of transgenes in the environment, but does not eliminate all potential for ecological harm. Monosex triploidy is the best existing method for sterilizing fish and shellfish, although robust triploidy verification procedures are essential. Gene transfer between bacteria belonging to different species, genera or even families has been demonstrated in soil and other systems.

Such gene transfer goes on between ordinary microorganisms in all ecosystems, and has also been demonstrated from GM microorganisms to other microorganisms, e.

The transfer of antibiotic genes to microorganisms present in foods and of clinical importance is an unwanted event relative to food safety, while the very low frequency of such transfer most probably leads to very low levels of concern.

Only a limited number of releases of GM microorganisms e. Pseudomonas and Rhizobia have been permitted mainly to explore the spread and the fate of microorganisms in nature. In some cases released GM bacterial populations have been found to persist in the soil for years. Regional specificity in safety assessments: Contradictory findings as relates benefits or disadvantages for the same GM crop may reflect different agro-ecological conditions in different regions. For example, the use of herbicide resistant crops and the consequent herbicide use could potentially be detrimental in a small sized agricultural area, which has extensive crop rotation and low levels of pest pressure.

However, the moderate herbicide use related to these GM plants could be beneficial in other agricultural situations where it might represent a decrease in herbicide use. Presently, no conclusive evidence on environmental advantages or costs can be generalized from the use of GM crops.

Consequences may vary significantly between different GM traits, crop types and different local conditions including ecological and agro-ecological characteristics. In , the UK government asked an independent consortium of researchers to investigate how growing genetically modified GM crops might affect the abundance and diversity of farmland wildlife compared with growing conventional varieties of the same crops.

The researchers stress that the differences they found do not arise just because the crops have been genetically modified.

They arise because these GM crops give farmers new options for weed control where they use different herbicides and apply them differently. Monitoring of human health and environmental safety: In the future specific GM organisms may gain approvals for widespread production where the approval may not always include the possibility to enter them also in the human food supply.

Examples could be plants or animals used for drug production. In such situations, it will be important to consider whether or not to apply post-market monitoring for unexpected environmental spread of the GM animals or animals and their transgenes in the event that these would pose food safety hazards. A prerequisite for any kind of monitoring are tools to identity or trace GMOs or products derived from GMOs in the environment or food-chain.

Detection techniques such as PCR are in place in a number of countries to monitor the presence of GMOs in foodstuffs, to enable the enforcement of GM labelling requirements and for the monitoring of effects on the environment.

Attempts to standardize analytical methods for tracing GMOs have been initiated e. The need to assess indirect effects of the use of GMOs in food production has been emphasized by many countries. For example, the production of chemicals or enzymes from contained GM micro-organisms e. A further example of beneficial human environmental outcomes of the use of GM crops is the reduction in the use, environmental contamination and human exposure to pesticides demonstrated in some areas.

This has been demonstrated especially through the use of pesticide resistant Bt cotton, which has been shown to decrease pesticide poisoning in farm workers [51]. Out-crossing of GM plants with conventional crops or wild relatives, as well as the contamination of conventional crops with GM material, can have an indirect effect on food safety and food security by contamination of genetic resources [52].

The Codex guidelines for the safety assessment of GM foods include the analysis of potential unintended effects, where effects on the environment may result in unintended, indirect effects on human health.

Crop breeding strategies are highly dependent upon preservation of diversity of crops and wild relatives. Many methods of conventional and modern biotechnology can interfere with diversity of organisms which have relevance for further breeding. In crops these methods can often concentrate on the further improvement of few elite lines only. The majority of locally adapted land races e. Also the system for the protection of intellectual property rights interferes with crop diversity.

There is growing scientific and public concern about a rapid decline of diversity, e. On the other hand modern methods of biotechnology can be beneficial for enabling diversity in scenarios where possibilities of conventional breeding are difficult because of sterility and pests, e.

Historically, plant genetic resources were freely provided by developing countries to gene-banks world-wide. Now international policy attaches importance to national ownership of such resources.

An important aspect for the future potential of agricultural research is access to genetic resources for researchers on terms that recognize the contributions made by farmers to the conservation and sustainable utilization of these resources. The International Treaty on Plant Genetic Resources adopted at a conference by the Food and Agriculture Organization in November , provides the legal framework for dealing with the resources on which food security and sustainable agriculture depend.

The Treaty gives a directive on the conservation and sustainable use of plant genetic resources for food and agriculture making provision for the fair and equitable sharing of the benefits arising out of their use, in harmony with the United Nations Convention on Biological Diversity CBD. The Treaty also addresses farmers' rights. The Treaty establishes a Multilateral System of Facilitated Access and Benefit-sharing MLS for key crops, emphasizing the interdependency of countries in terms of plant genetic resources for food and agriculture.

The developing countries rich in genetic resources are encouraged to place germplasm in the MLS. The users of the material will sign a Material Transfer Agreement, incorporating the conditions for access and benefit sharing through a fund established under the Treaty.

In return, the owners of the genetic resources would get a share of the benefits arising from their use and development in the way of information, technology transfer and capacity building.

Agency for International Development reported that between and the year the world lost 22 percent of its high-potential agricultural land. That's , square miles, an area equal in size to Alaska. The loss is alarming because, as population pressures mount, agricultural production will have to expand onto medium- and low-potential lands that are not only less productive but also more fragile and susceptible to degradation.

Soil is degraded mainly through deforestation, agricultural activities, overgrazing, and overexploitation. Biophysical manifestations include erosion and loss of moisture-holding capacity.

But more important, and more complex, are the social and economic aspects. Indeed, some view land degradation as a socioeconomic rather than biophysical problem. For example, population growth increases demand for land on which to grow crops, which often leads to deforestation, shorter fallow periods, and continuous cropping.

Short-sighted economic policies often make the problem worse by encouraging farmers to clear new land for cultivation rather than to protect land already under cultivation.

Insecure land tenure arrangements discourage farmers from making long-term investments needed for resource conservation. The Impacts of trade liberalization: The implementation or reform of agricultural and trade policy creates a complicated set of environmental effects - some negative, some positive, and in some cases linked to food safety issues. The effect of freer agricultural trade on environmental quality depends on a number of factors, such as the mix of post-reform commodities, level of output, changes in production inputs, land use, technical change, and the capacity of the natural resource base to assimilate production impacts.

The additional effect of such changes related to food safety will in many cases relate to the existence of food safety systems and experience related to the new or increase food commodity production. Freer trade improves market access for goods previously governed by quantity restrictions such as quotas and other non-tariff barriers and aligns domestic prices closer to world prices.

Resource reallocation occurs as prices adjust to market conditions and reflect the availability of resources such as arable land, labour, and other farming inputs. As prices change, farmers respond by altering their crop mix and their input use, buying or selling land, and investing in new machinery.

In addition, trade and health considerations are intimately connected. The use of international standards for traded food, focusing on food safety, but in the future also most likely on environmental issues, will have the potential to improve not only internationally traded food but also local food, and thereby the health of local consumers.

This in turn would then favour both health and social and economic development - a true win-win situation. This Facility will hopefully provide the means for developing countries to strengthen their systems to comply with international standards to the benefit of both exported and locally consumed food.

International agreements related to nature and food production are summarized in a report from FAO on ethical issues in food and agriculture. They include the value of food, the value of enhanced well-being, the value of human health, the value of natural resources, and the value of nature, whereas the Convention on Biological Diversity recognizes that nature itself is to be valued for what it is.

The summary of these objectives shows that all principle arguments usually discussed in a risk benefit evaluation of food biotechnology, especially enhanced productivity for increased food production, equity, health and nature protection, interfere with each other, thus requiring a high level of ethical consideration. There is international agreement that risk assessment, risk management and risk communication are central elements in the management of possibly emerging risks of new technologies for food production where risk assessment needs to be done based on "sound science".

But discussions on the use of precaution by some countries referred to as the precautionary principle and the need to respect legitimate factors other than the scientific assessment of risk have turned out to be controversial [60].

Science and Ethics Rome, The experts agreed that risk assessment is based on science, but scientific evidence and analysis cannot always provide immediate answers to questions posed. Much scientific evidence is tentative, as the established processes of science include checking and re checking outcomes in order to obtain the required level of confidence.

Decisions usually are defended as based on "science," and sometimes on economic costs and benefits as well, which offer seemingly objective, verifiable evidence that the policy choice is "correct. The emphasis on science and the exclusion of ethical argument as the basis for decisions may polarize the scientific debate. A cross sectoral group of scientists, NGOs and industry formulated the safety first approach asking for interactive negotiation between research, industry, government and consumers to formulate safety standards.

These standards would make safety a criterion in discussions on developments from the beginning and not at the end before product notification and include post market monitoring, training and stewardship. Products produced with different methods of modern biotechnology are already produced for local or international markets. Crops, animals or microorganism have been improved according to agricultural objectives where these organisms may display specific characteristics in regard to safety or usefulness in different agro- ecological, socio-economic or cultural areas.

A globalized market for food production will most likely trade products of these organisms internationally and the safety measures of the Biosafety Protocol will be of importance in risk prevention. However, possibilities of the protocol are restricted to transboundary movements of LMOs and direct effects on diversity. Furthermore, sufficient technical capacities for coherent analysis may be difficult to achieve in many developing countries and the need for coordinated local as well as international information exchange on complex parameters will require sophisticated technical and scientific capacities.

The capacity of the Codex Alimentarius Commission to continue its work on internationally agreed principles and guidelines for a food safety risk analysis framework will be key to a truly global development in this area of integrating the different areas of assessment of new agricultural technologies and ensuring that human health considerations will remain at the core. This will ultimately need measures for capacity building in some countries as well as the intensive engagement of international bodies in coordinated monitoring activities, data collection and data analysis.

An engaged cooperation of international organizations, especially UN-bodies will be essential for a successful and equitable development in this direction. The malicious contamination of food for political, financial and other purposes is a real and current threat, and deliberate contamination of food at one location could have global public health implications. Member States of WHO have expressed concern that chemical, biological or radionuclear agents might be introduced into food and other media to deliberately to harm civilian populations and have requested the Organization to provide tools and support to increase their capacity to respond.

In response, WHO has prepared various guidelines, including guidance to prevent and respond to intentional contamination of food. While all food safety emergencies, including intentional and unintentional incidents, may be managed by the existing food safety infrastructure, sensible preventive measures coupled with basic preparedness are needed to address threats posed by deliberate contamination.

Countries should integrate consideration of acts of food sabotage into existing programmes for assuring the safety of their food supplies. Strengthening of food safety infrastructure will serve to increase countries' capacity to reduce the burden of all food-borne illness caused by chemical and microbial agents and to respond to all contamination incidents.

Improved linkages with existing communicable disease control systems will also ensure that surveillance, preparedness and response systems include the necessary metrics to identify food-borne outbreaks in a timely manner and provide relevant information to facilitate an effective and rapid response.

In order to respond effectively and rapidly, countries require alert, preparedness and response systems to public health threats from actual or threatened intentional contamination of the food supply. Coordination with WHO, FAO and other international and regional organizations regarding incidents involving intentional contamination should be considered as an integral part of strengthening of national systems to respond to all food safety emergencies.

Threats from criminals and other anti-social groups who target the safety of the food supply are already a reality. During the past two decades, WHO Member States have expressed increasing concern about the possibility that chemical and biological agents and radionuclear materials might deliberately be used to harm civilian populations. In recent years, the health ministries of several countries have increased their state of alert for intentional malevolent use of agents that may be spread through air, water or food.

In , the World Health Assembly in recognizing these threats against civilian populations, requested WHO to provide tools and support to countries in strengthening their national systems to respond to the deliberate use of biological, chemical or radionuclear agents [65].

It also requested WHO to continue to issue international guidance and technical information on recommended public health measures to deal with potential incidents. All countries must have basic systems to prevent or deter deliberate contamination of their food supplies and, if an incident occurs, to respond rapidly to minimize potential health, economic and other adverse effects of such contamination.

However, specific countermeasures should be seen as only one aspect of a broader, comprehensive food safety programme, in national and global contexts. The WHO Global Food Safety Strategy [67] comprises a preventive approach to food safety, with increased surveillance and more rapid response to outbreaks of food-borne illness and chemical contamination incidents.

This approach could substantially expand the abilities of countries to protect the safety of their food supplies against natural and accidental threats, while providing a framework for addressing intentional contamination of food.

The chemical agents in question are man-made or natural toxins, and the biological agents referred to are pathogenic microorganisms, including viruses, bacteria and parasites, that may be communicably infectious or non-infectious. Radionuclear agents are defined in this context as radioactive chemicals capable of causing injury when present at unacceptable levels.

This paper covers all foods, including water used in the preparation of food, as well as bottled water. As with all health and safety problems, prevention is usually the most desirable option. Prevention is considered first line of defence against intentional contamination. The key to prevention is awareness of this potential threat and the implementation of basic security and precautionary measures. Working in cooperation with government, the food industry is in the best position to rapidly address such threats throughout the food supply system from production to consumption.

Government food safety authorities may provide necessary guidance and other coordination functions to assist industry, as in the case of product tracing and recall. As production methods and quality programmes are often proprietary, the food industry has both the knowledge and the capacity to reduce the likelihood of deliberate contamination of food, from the raw materials to product distribution.

Governments should support industry in strengthening existing food safety management systems, to include consideration of deliberate contamination. Governments also have a role in promoting preventive food safety, through various voluntary and regulatory mechanisms [68]. It is important to note that a number of the preventive activities described in this paper relate to 'industrialized' food production systems.

Although industrialized production probably also present the most likely targets for intentional contamination, it is very likely that more traditional production systems, including systems with short distribution lines, present problems that need separate consideration.

Food can be contaminated deliberately by chemical, biological or radionuclear agents at any point in the food chain. Food safety management programmes offer opportunities for the prevention, detection and control of food sabotage.

Understanding the relationships between the production system, ingredients, people, utensils, equipment and machinery can help in identifying where critical failures of the system might occur. Methods of sabotage and the extent of a threat might be identified as a part of this analysis and would provide the basis for a risk analysis. Typical food safety management programmes within the food industry, include good agricultural and manufacturing practices and 'hazard analysis and critical control point' HACCP systems.

Newer systems based on a scientific assessment of the risk are now increasingly being used to develop risk reduction options along the food supply continuum from farm to table.

Governments should work closely with industry to incorporate prevention and response to intentional contamination into food safety management programmes. Not all countries have the infrastructure needed to assist industry, especially small and less developed businesses, to apply such programmes throughout the food production, processing and preparation continuum.

Capacity building for such competence is vital for the prevention of both intentional and unintentional contamination of food. The generic actions that may be taken by governments to assist industry in this respect include:. Prevention of intentional contamination does not always require high technology or great expense. Increased awareness of the problem and enhanced vigilance are among the effective measures that can be taken.

Awareness can be heightened by auditing food safety management programmes. In the event of an incident, information from early surveillance could be shared with the food industry to facilitate prompt action to address consumer concerns and contain and mitigate the threat.

The knowledge and capacity to prevent deliberate sabotage of food lies mainly with the food industry and must be applied throughout the food chain. Potential contamination with chemical and biological agents and radionuclear materials and interruption of food supplies need to be considered in the development and review of food safety management programmes, which may vary from rudimentary to well developed.

Opportunities for deliberate contamination of food can be minimized by increasing the security for both people and premises. All segments of the food industry should consider improving security and response plans for their establishments. For example, sources of raw materials and storage facilities and transport systems could be safeguarded; access to all critical areas in production, processing, transport and storage could be controlled and documented to minimize opportunities for contamination.

Regarding personnel, employers could consider screening their staff to ensure that their qualifications and background are compatible with their work and responsibilities.

Sanitation, maintenance and inspection workers, who have access to critical areas, could also be screened from a security perspective. Appropriate mechanisms could be established to allow staff to report suspicious behaviour and activities. While it is impossible to describe all the possible scenarios for food sabotage, WHO has developed basic guidance for the food industry for strengthening food safety management programmes to prevent intentional contamination of food with harmful agents [69].

This guidance offers a range of options that should be considered by industry, taking into account available resources and the perceived threat. Plausible risks need to be considered at every point in the food chain to ensure the safety of the food produced.

A number of useful documents prepared by certain countries [70] , [71] , [72] and industries [73] offer examples and guidance for analysing risks in the production and processing of specific foods.

Not all of these documents will be applicable in their entirety to smaller, developing businesses, but the general principles of assessing vulnerability apply across all businesses and sectors [74] , [75]. While preventive measures are essential, the opportunities for intentional contamination of food are just too numerous to ever be able to completely prevent such incidents.

However, effective and rapid monitoring and surveillance programmes coupled with preparedness planning can do much to respond to such threats. Many governments have, or are developing, food safety infrastructures to ensure that food produced for both domestic consumption and export meets acceptable safety standards. Strengthening national food safety programmes requires that national policies and resources to support the infrastructure are in place and that food legislation, food contamination monitoring laboratories, food inspection, food-borne disease surveillance, education and training are adequate and up to date.

Above all, the possibility of intentional contamination needs to be an integral part of safety considerations. While most of the knowledge and capacity to prevent food safety emergencies lies within the food industry, governments have a lead responsibility for detecting and responding to actual or threatened food contamination incidents as well as other food safety emergencies. In the event of an intentional food safety emergency, the potential consequences to public health, the economy and social or political stability must be managed by an effective, rapid emergency response system, at all levels.

The effectiveness of a response depends to a great extent on preparedness plans that are developed and implemented long before any event occurs. Public health preparedness planning for emergency situations has been considered in some detail in various WHO publications and is therefore not discussed in detail in this document.

The nature of a preparedness and response system is based on an assessment of specific threats of deliberate food contamination and their priorities in relation to other public health problems. The priorities are determined as part of an assessment of vulnerability performed as part of the development of preparedness plans for intentional contamination. Threats could be ranked from high to low, on the basis of their impact on health and their potential social, economic and political consequences.

Vulnerability is assessed on the basis of the prevailing scientific, economic, political and social circumstances of a country, to measure the extent of a threat and to set priorities for resources.

Priorities must be set to ensure that the action taken to deal with the threat is commensurate with the severity of the inherent consequences of the threat. The purpose of an assessment of vulnerability is to identify the properties and potential consequences of deliberate contamination of food by harmful agents, to identify relative priorities and to commit national resources in a proportion consistent with these priorities.

H If the nursing home resident is also a patient of a hospice care program, the nursing home shall communicate and work with the hospice in development and implementation of a coordinated plan of care between the nursing home and hospice. The nursing home shall allow the hospice care program to retain professional management responsibility for directing the implementation of the resident's plan of care related to the resident's terminal illness pursuant and related conditions to Chapter of the Administrative Code as long as the resident is receiving hospice care.

The coordinated plan of care shall:. I The nursing shall ensure that the privacy and dignity of residents is protected when residents are transported to and from bathing facilities, when residents are preparing for bathing, and during resident bathing.

J Upon a resident's transfer, discharge, or death, the nursing home shall make an accounting of all that resident's monies held by the facility. The nursing home shall convey any remaining funds immediately to the resident or within thirty days to the resident's estate unless otherwise directed by law. Prone restraint includes physical or mechanical restraint. B Except as provided in paragraph F of this rule for emergency situations, the nursing home shall not physically or chemically restrain a resident or subject a resident to prolonged isolation except on written order of an attending physician which shall include the date, means of restraint to be used, medical reason for restraint, and duration of restraint.

Such written orders shall be made a part of the resident's record. C Except as provided in this paragraph, and paragraph F of this rule for emergency situations, prior to authorizing the use of a physical or chemical restraint on any resident, the nursing home shall ensure that the attending physician: Determine the least restrictive device that is most appropriate to meet the needs of the resident, taking into consideration any contraindications;. A nursing home may restrain or isolate a resident transferred from another health care facility based on the resident's transfer orders if such orders include restraint use or isolation authorization and the home complies with the provisions of this paragraph within twenty-four hours of the resident's admission or readmission to the home.

D If a physical restraint is ordered, the nursing home shall select the restraint appropriate for the physical build and characteristics of the resident and shall follow the manufacturer's instructions in applying the restraint. The nursing home shall ensure that correct application of the restraint is supervised by a nurse and that the restrained resident is monitored every thirty minutes. The visual monitoring of the restrained resident may be delegated as permitted under state law.

Jackets, sheets, cuffs, belts, or mitts made with unprotected elements of materials such as heavy canvas, leather, or metal shall not be used as restraints. E The attending physician or a staff physician may authorize continued use of physical or chemical restraints for a period not to exceed thirty days and, at the end of this period and any subsequent period, may extend the authorization for an additional period of not more than thirty days.

The use of physical or chemical restraints shall not be continued without a personal examination of the resident and the written authorization of the attending physician stating the reasons for continuing the restraint. F Physical or chemical restraints or isolation may be used in an emergency situation without authorization of, or personal examination by, the attending physician only to protect the resident from injury to self or others.

Use of the physical or chemical restraint or isolation shall not be continued for more than twelve hours after the onset of the emergency without personal examination and authorization by the attending physician. G When isolation or confinement is used, the nursing home shall ensure that: H Members of the nursing home's quality assurance committee, required by rule of the Administrative Code, shall review monthly the use of restraints and isolation and any incidents that resulted from their use, as well as incidents which resulted in the use of restraints or isolation.

The review shall identify any trends, increases, and problems, the need for additional training, consultations or corrective action which shall be discussed and reflected in the minutes of the next quality assurance committee meeting. A Each resident, if the resident so chooses, shall be provided with an individual bed not less than thirty-six inches wide, a clean comfortable flame-resistant mattress and clean pillows, sheets, and covering suitable for the resident's comfort.

A nursing home shall arrange for the provision of at least a double size bed, upon request of a married couple or other consenting adult residents sharing a room in accordance with the nursing home's policy, unless there is an overriding documented medical reason that puts one of the consenting parties at risk of health and safety or there is a risk to other residents.

Mattresses shall be protected with waterproof material unless otherwise ordered by a physician. Roll away beds, cots, double deck beds, stacked bunk beds, hide-a-bed couches, or studio couches shall not be used as beds. All mattresses purchased or obtained by the nursing home, or brought to the nursing home by residents, shall be in safe condition. B Unless otherwise ordered by a physician or other licensed health professional acting with the applicable scope of practice, each resident shall be provided with a bedside table, a bedside light that is sufficient for reading and staff rendering of bedside care, a bureau or equivalent, a waste basket with liners, a comfortable chair, and adequate closet or wardrobe space for the storage of personal clothing in the resident's room.

A nursing home may provide additional storage space for resident belongings elsewhere in the nursing home. Resident rooms shall be designed or equipped to assure full visual privacy for each resident. For the purposes of this paragraph, "full visual privacy" means that the resident has a means of completely withdrawing from public view while occupying their bed through such means as a curtain, moveable screens or private room.

C Each nursing home shall have a call signal system in good working order that, at minimum, provides for the transmission of calls from resident rooms and toilet and bathing facilities. D Supplies such as hypodermic syringes, needles, and lancets shall be discarded after use in accordance with state and federal requirements. Reusable items shall be cleaned and disinfected according to manufacturer's directions and in accordance with applicable state and federal law and regulations.

E All nursing homes shall, at all times, have the supplies and equipment necessary to provide the services and nursing care needed by the type of residents admitted to or residing in the nursing home.

Wheelchairs, gerichairs, quad canes, adaptive eating equipment and utensils, and other assistive devices shall be maintained in good and safe working condition and shall be equipped properly for the specific needs of each resident. F Within areas generally accessible to residents, all disinfectants, pesticides, and poisons shall be kept in a locked area separate from medications and food.

G The nursing home shall provide a safe, clean, comfortable and homelike environment allowing each resident to use personal belongings to the extent possible. Residents may refuse furnishings, equipment and supplies provided by the nursing home.

The nursing home shall allow residents to bring their own furnishings and other personal items into the home to personalize their individual environment if the furnishings and items do not create a health and safety risk, are not medically inadvisable, or infringe upon the rights of other residents. Upon request, the nursing home shall assist the resident in obtaining essential furnishings and supplies. A The nursing home shall provide or obtain routine and emergency medicines, drugs and biologicals for its resident except if prohibited by state or federal law.

The nursing home shall permit residents to use and continue to obtain medicines, drugs and biologicals dispensed to them from a pharmacy of choice provided the medicines, drugs and biologicals meet the standards of this rule. The pharmacist or pharmacy service shall be responsible for maintaining supervision and control of the stocking and dispensing of drugs and biologicals in the home in accordance with state pharmacy rules.

B Medicines and drugs shall be given only to the individual resident for whom they are prescribed, shall be given in accordance with the directions on the prescription or the physician's orders, and shall be recorded on the resident's medication administration record. C Every container of medicine and drugs prescribed for a resident shall be properly and clearly labeled in accordance with applicable state regulations as to the following: D Containers too small to bear a complete prescription label shall be labeled with at least the prescription number and the name of the resident, unless application of this label would impair the functioning of the product, and shall be dispensed in a container bearing a complete prescription label.

E The nursing home shall ensure that all medications and drugs are stored under proper temperature controls and secured against unauthorized access. All medicines and drugs, including those requiring refrigeration, shall be kept in locked storage areas and separate from materials that may contaminate the medicines and drugs such as poisonous substances.

Where a pharmacist is not present twenty-four hours-a-day, keys to locked contingency drug supplies shall be made available to a health care professional licensed under Chapter F Each nursing home shall ensure that the following requirements regarding individual resident's drugs are met: Drugs not so ordered by the prescriber upon transfer or discharge shall be returned to the pharmacy or disposed of in accordance with any applicable state or federal laws, rules and regulations.

G Paragraph F of this rule does not preclude a nursing home from charging a resident for medications and drugs provided to the resident upon discharge for which the resident has not already paid. H Controlled substances shall be ordered, dispensed, administered, and disposed of in accordance with state and federal laws and regulations. I The nursing home shall ensure that the pharmaceutical needs of each resident are met and that the drug regimen of each resident is reviewed and documented at least once a month by a pharmacist.

J The nursing home shall coordinate the ordering of medicines, drugs and biologicals for hospice patients with the appropriate hospice care program. A Each nursing home shall have a kitchen and other food service facilities which are adequate for preparing and serving food for all residents. The nursing home shall develop and implement a policy addressing its method for accommodating religious, ethnic and cultural and personal preferences.

B The nursing home shall store, prepare, distribute and serve food under sanitary conditions and in a manner that protects it against contamination and spoilage in accordance with food service requirements of Chapter of the Administrative Code. C Each nursing home shall provide at least three nourishing, palatable, and appetizing meals daily to all residents at regular hours comparable to normal mealtimes in the community.

The meals shall be varied and meet the nutritional needs of the residents and be capable of providing the dietary referenced intake of the "Food and Nutrition Board" of the "National Academy of Science. There shall be no more than sixteen hours between the evening meal and breakfast. Each nursing home shall offer a nourishing snack, consisting of a choice of beverages and a food item from a basic food group, after the evening meal.

Food substitutes of similar nutritive value shall be offered to residents who refuse the food served and serving size may be adjusted according to resident preference.

The nursing home shall accommodate a resident's preference or medical need to eat at different intervals. D A nursing home may provide any alternate format of meal service that otherwise meets the requirements of this rule, if the residents agree to participate in the meal service and the home: E Each nursing home shall maintain at all times sufficient food supplies for residents.

The home shall maintain at least two days' supply of perishable food items and at least one week's supply of staple food items. The amount of such supplies shall be based on the number of meals that the nursing home provides and the nursing home's census. F Each nursing home shall have planned menus for all meals that are approved by the dietitian required by paragraph K of this rule, for all meals at least one week in advance.

The nursing home shall maintain records for all meals, including therapeutic diets, as served. The meal records shall be kept on file in the nursing home for at least three months after being served and made available to the director upon request. The records shall indicate the date that each meal was served along with any food substitutions from the menu. G Safe, fresh, and palatable drinking water shall be accessible for residents at all times.

H All diets shall be: I The nursing home shall monitor each resident's nutritional intake and make adjustments in accordance with the resident's needs. Notification of any significant unplanned or undesired weight change shall be made to the resident's attending physician and the dietitian required by paragraph K of this rule. J Each nursing home shall employ a dietitian, who may be hired on a full-time, part-time or consultant basis, to plan, direct and implement dietary services that meet the residents' nutritional needs and comply with the requirements of this rule.

If the home does not have the full-time equivalent of a dietitian, the nursing home shall designate a person who meets the qualifications specified in paragraph H of rule of the Administrative Code, to serve as the food service manager. The part-time or consultant dietitian, at a minimum, shall consult monthly, or sooner, if needed, with the food service manager. Each nursing home shall ensure that the dietitian performs the following functions: Trained unlicensed staff, including the dietary manager, may perform routine tasks that: K Tube feedings and parenteral nutrition shall be ordered by a physician or other licensed health professional acting within their scope of practice and administered by the appropriate licensed health professionals in accordance with acceptable standards of practice.

Tube feedings shall not be used for convenience or when in conflict with treatment decisions, or a resident's advance directive, in accordance with applicable provisions of Chapters A Nursing homes shall keep the following records and such other records as the director may require: Such record shall be started immediately upon admission of a resident to the home and shall contain the following: All records, reports, and orders which accompany the resident as required by rule of the Administrative Code.

A note of the condition of the resident on admission and subsequent notes as indicated to describe changes in condition, unusual events or accidents. Other individuals rendering services to the resident may enter notes regarding the services they render. A doctor's order sheet upon which orders are recorded and signed by the physician or other licensed health professional acting within the applicable scope of practice, including telephone orders as required by rule of the Administrative Code; a nurse's treatment sheet upon which all treatments or medications are recorded as given, showing what was done or given, the date and hour, and signed by the nurse giving the treatment or medication; or other documentation authenticating who gave the medication or treatment.

A sheet or sheets upon which the doctor, dentist, advanced practice nurse and other licensed health professionals may enter notes concerning changes in diagnosis or condition of the resident. Resident refusal of treatment and services shall also be documented in the progress notes.

All assessments and information required by rule of the Administrative Code. The plan of care required by rule of the Administrative Code. A photograph is only necessary for residents who have been identified as being a elopement risk. The photograph of the resident shall be updated annually. B A record shall be kept showing the name and hours of duty of all persons who work in the home. The nursing home shall maintain each employee's current home address in its personnel file.

C All records and reports required under rules to of the Administrative Code shall be prepared, maintained, filed, and transmitted when required, and shall be made available for inspection at all times when requested by the director or his authorized representative.

The records may be maintained in electronic format, microfilm, or other method that assures a true and accurate copy of the records are available. The operator shall notify the director of the location where the records will be stored. D All records and reports required by Chapter of the Administrative Code shall be maintained and made available in accordance with that chapter.

E Upon the change of operator of a nursing home, the records required to be kept pursuant to this rule shall be transferred to the new operator of the home. A No employee, resident of a nursing home, visitors, or other persons in the nursing home shall be permitted to smoke, carry a lighted cigarette, cigar or pipe or use any spark or flame producing device in any room or area in a nursing home where oxygen is stored or in use.

Approved terminals of a piped oxygen supply does not constitute storage. B "No smoking" signs shall be posted in areas and on doors of rooms where oxygen is stored or in use.

C Except as provided for in paragraph D of this rule, indoor resident smoking shall only be permitted in separately enclosed and separately ventilated designated areas as allowed for in division D of section Nursing homes that allow outdoor resident smoking shall make accommodations for residents during adverse weather conditions.

The nursing home shall take reasonable precautions to ensure the safety of all residents when residents smoke. D The nursing home may establish a smoke-free environment if all residents are notified of the policy prior to admission.

If a nursing home establishes a policy of this nature, the nursing home shall continue to accommodate the needs of smokers living in the home on the effective date of the smoke-free policy by complying with the provisions of paragraph C of this rule. E Ash trays, waste baskets or containers where burnable materials may be placed shall not be made of materials which are flammable, combustible or capable of generating quantities of smoke or toxic gases.

Ash trays and waste baskets and containers where burnable materials may be placed shall be noncombustible or carry a fire resistant "UL" or "FM" rating. F Ash trays shall be provided in all designated resident smoking areas. These ash trays shall be either self-closing or have a cigarette island in the middle and shall not have any cigarette holders located around the outside rim of the tray. A Every building occupied as a nursing home on and in continuous operation since December 22, shall have not less than one room or suitable area which shall be used for no other purposes than dining and recreation by the residents.

Such room or area shall be so located and of such size as to meet the needs of the residents and shall not be used for adult day care participants or residential care facility residents unless the home meets the square footage requirements of paragraph B of this rule. Any building occupied as a nursing home on December 22, that is discontinued for such use, shall, if such use is resumed, comply with paragraph C of this rule.

B Every building erected or converted to use as a nursing home after and in continuous operation since December 22, , and before July 17, , shall have a room or suitable area which shall be used for no other purposes than dining and recreation. The dining and recreation room or area shall have a minimum total area of twenty-five square feet per resident for seventy-five per cent of the nursing home's licensed capacity.

Any building licensed by the state as a nursing home on or after December 22, that is discontinued for such use, shall, if such use is resumed, comply with paragraph C of this rule.

Each nursing home that shares the dining and recreation room or area with participants of an adult day-care program, residents of a residential care facility, or both, shall provide an additional twenty-five square feet per participant, resident, or both, for seventy-five per cent of the total number of adult day-care program participants, the licensed capacity of the residential care facility, or both. C Every building erected or converted to use as a nursing home after July 17, shall have a room or suitable area which shall be used for dining purposes and a separate room or suitable area which shall be used for recreational purposes.

A nursing home may use the dining room or area for recreational purposes when the room or area is not being used for dining. Twenty-five square feet per resident for the nursing home's licensed capacity.

Each nursing home that shares the dining room or area with participants of an adult day-care program, residents of a residential care facility, or both, shall provide an additional twenty-five square feet per participant, resident, or both, for the total number of adult day-care program participants, the licensed capacity of the residential care facility, or both. Twenty-five square feet per resident for seventy-five per cent of the nursing home's licensed capacity.

Each nursing home that shares the recreation room or area with participants of an adult day-care program, residents of a residential care facility, or both, shall provide an additional twenty-five square feet per participant, resident, or both, for seventy-five per cent of the total number of adult day-care program participants, the licensed capacity of the residential care facility, or both.

D Every nursing home shall employ methods and have adequate facilities and supplies for clean and soiled laundry in accordance with prevailing infection control practices. E Bathrooms and toilet rooms shall conform to the Ohio building code. F Bathrooms and all fixtures therein shall ensure resident privacy and dignity in accordance with paragraph I of rule of the Administrative Code. G Bathrooms, toilet rooms and all the facilities therein shall, at all times, be kept in good repair, in a clean and sanitary condition, free from filth and accumulation of waste, and shall be provided with a supply of toilet tissue.

Each hand washing basin shall be provided with a soap dispenser. Bathrooms and toilet rooms shall be designed or equipped to assure full visual privacy for each resident. H Grab rails and other safety devices such as non-slip surfaces shall be provided and maintained in good repair. I In every building or addition to a building constructed or converted to use as a nursing home on or after October 20, , there shall be one room toilet room directly accessible from each resident sleeping room, except the hand washing basin may be located in either the room containing the toilet or the sleeping room.

No more than two residents may share a toilet room. J For purposes of this rule, "bathroom" means a room or rooms conforming to the Ohio building code containing a group of fixtures consisting of a water closet, lavatory, bathtub or shower, including or excluding a bidet, an emergency floor drain, or both.

A The building or buildings in which a nursing home is located shall be in compliance with the applicable provisions of the Ohio building code and shall have a certificate of use issued by the appropriate building authority. B All plumbing shall be so installed and maintained as to be free of leakage and odors and as to reasonably insure adequate health and safety protection. Plumbing fixtures in nursing homes or additions to nursing homes constructed, erected, altered or relocated after September 10, , and plumbing fixtures in buildings converted into nursing homes after September 10, shall conform to the applicable provisions of the Ohio building code.

C Lavatories, bathing facilities, and shower facilities shall be supplied with hot and cold running water and shall be regulated by approved devices for temperature control. The hot water temperature in areas used by residents shall be a minimum of one hundred five degrees Fahrenheit and not exceed one hundred and twenty degrees Fahrenheit. D The nursing home's water supply shall be adequate in quantity and of suitable chemical and bacteriological quality for drinking, culinary, and cleaning purposes.

The water supply for a nursing home shall be taken from a public supply, if available. If from a source of supply other than a public supply, the water supply shall comply with all applicable local and state regulations regarding the construction, development, installation, alteration, and use of private water systems. E All liquid wastes from nursing homes shall be discharged into a public sanitary sewerage system, if available. Where not available, such wastes shall be discharged into a sewage disposal system that meets all applicable local and state regulations regarding the construction, development, installation, alteration, and use of private household sewage disposal systems.

The nursing home shall properly maintain its sewage disposal system in good, safe working condition. F Heating, cooling, electrical, and other building service equipment shall be maintained in good working and safe condition. G The buildings and grounds shall be maintained in a clean and orderly manner.

H All garbage and other refuse shall be disposed of immediately after production, or shall be stored in leak-proof containers with tight fitting covers until time of disposal, and all wastes shall be disposed of in a satisfactory manner.

I Adequate measures shall be taken to prevent the entrance of insects, rodents, and pests into any building used for a nursing home or part thereof and to prevent their infestation of the premises. J The extermination of insects, rodents, and pests shall be done in such a manner as not to create a fire or health hazard.

K Beginning July 1, , each nursing home shall prohibit the use of overhead paging within the nursing home, except that the nursing home may permit the use of overhead paging for matters of urgent public safety or urgent clinical operations. The nursing home shall develop a written policy regarding its use of overhead paging and make the policy available to staff, residents, and residents' families. A In every building where there is a nursing home, the premises of which were initially licensed by the state as a nursing home prior to December 22, and have been in continuous operation since being initially licensed, every room occupied for sleeping purposes by one person shall have a habitable floor area of not less than eighty square feet and every room occupied for sleeping purposes by more than one person shall have a habitable floor area of not less than eighty square feet per person.

Any building licensed by the state as a nursing home prior to December 22, that is discontinued for such use shall, if such use is resumed, comply with paragraph B of this rule. B In every building or addition to a building, erected or converted to use or initially licensed as a home after December 22, , every room occupied for sleeping purposes by one person shall have a habitable floor area of not less than one hundred square feet and every room occupied for sleeping purposes by more than one person shall have a habitable floor area of not less than eighty square feet per person.

In every building occupied as a nursing home on December 22, , every room added for sleeping purposes shall comply with this paragraph. C Except as provided for in paragraph D of this rule, no room, ward, section, or similar division used for sleeping purposes by residents shall be occupied by more than four residents. Any building licensed by the state as a nursing home on or after December 22, that is discontinued for such use, shall, if such use is resumed, comply with paragraph D of this rule.

D In every building or addition to a building, erected or converted to use or initially licensed as a home on or after July 17, , every room occupied for sleeping purposes by residents shall be occupied by no more than two residents and shall be designed to assure full visual privacy, as defined in paragraph B of rule of the Administrative Code, for each resident.

B Each nursing home shall maintain the temperature within the temperature range and the humidity in resident areas at a safe and comfortable level. C Residents in rooms containing separate heating and cooling systems who are capable of controlling them may maintain the temperature of their rooms at any level they desire except the nursing home shall take appropriate intervention if a resident's desired temperature level adversely affects or has potential for adversely affecting the health and safety of the resident or the health, safety and comfort of any other resident sharing the resident room.

D Each nursing home in consultation with its medical director, shall develop written policies and procedures for responding to temperatures in resident areas that are outside the temperature range as defined in paragraph A of this rule. The policies and procedures shall be signed by the medical director and shall include at least the following: I may as well go back and post my opinion there too.

What you can do to stop the New World Order ; http: When the money is fraudulent, the people have a moral right to create their own.

There is no valid contract with any of these legalised loan sharks, so in reality you owe nothing. Ask them for proof of such an agreement. No such proof can exist, so neither does the debt. Here in the UK we have sites like www. The international jew imposes the same laws on all jew-infested countries, so what you find in one country will usually apply in another but not always, so be careful. There is no cavalry. We came to this world to solve the jew problem ourselves.

Btw, anyone making actual plans should use encryption. These devils plan to KILL us. Linux also gives you the option to try before you install. Either they lack citations from primary historical documents or the sources lack proper intellectual pedigrees.

Not trying to be snobbish about that, just being realistic about what can be sourced into a critical historical analysis. I am actually in touch with some of the Financial Times writers he quotes.

Nothing more, nothing less. Selling off pieces of America to a foreign government so that government can plant a sovereign city inside our country that is not subject to our laws amounts to treason. Thanks to the trillions of dollars that the Chinese have made flooding our shores with cheap products, China is now in a position of tremendous economic power.

So what is China going to do with all of that money? Basically it would be a slice of communist China dropped right into the middle of the United States. The most successful Special Economic Zone in China, Shenzhen, has developed from a small village into a city with a population over 10 million within 20 years. India has also played a significant role in the founding and establishment of Special Economic Zones.

It has the largest outsourcing industry in Asia. So, if China gets its way in Idaho, we will have sections of America belonging to a communist foreign government whose residents and the corporations that employ them do not have to abide by our national laws.

Sovereign immunity, or crown immunity, is a type of immunity that in common law jurisdictions traces its origins from early English law. Generally speaking it is the doctrine that the sovereign or state cannot commit a legal wrong and is immune from civil suit or criminal prosecution… Wikipedia. In the recent past, I tried to explain our enslavement by the Jews to Paul Craig Roberts, and he played the anti-Semitism card on me, by emailing me back that he very recently had lunch at his homes with a couple of Jews.

In fact, the SEZs proposed for attracting Chinese manufacturing cap-spend are simply duty-free import zones with a stripped-down customs infrastructure. But your linked article wants to suggest an erosion of sovereignty via diplomatic immunities arising from privileged trade, when the real erosion of sovereignty is more insidious.

Political immunities in a SEZ would imply a conservative approach to classical Westphalian sovereignty. The version proposed actually does erode U.

Pop Culture updates are not news. Big Jew wins because it further dilutes AmeriKwan culture and fractures society even further making it easier to drive in the wedge.

Both of these are rights already enjoyed by domestic U. Should I trust the Chinese? Just saying that the SEZ is a structure which actually promotes robust sovereignty, given that it reinforces 17th century territorial-integrity definitions. One argument I can see based on what you said is that the Commie influence at home presents ordinary Americans with the claim that ascendant China is a model for us to learn from, first politico-economically, then via race dilution.

These are scary prospects indeed. Though I think Boise is a big Taiwanese outpost already, right from semiconductors?

Supposedly those are the good Chinese. But with high-tech and now Sinomach heavy equipment, Idaho is sure going to be growing some yellow potatoes.

They keep it strictly Chinese! I hope that Brother Nathanael will explore it further. It represents a very real threat, in my opinion. Louis Susman, a Chicago investment banker with no diplomatic background was appointed American ambassador to London in July In an executive order issued by Mr Obama as he took office, it was stated that appointees should sign forms saying that they were not hired because of political affiliations or contributions.

Then you will work for the Jew as a slave and he will use the profits to persecute Christians, because he does not want to pay for that either. Confronting the TSA —————————————————————————————————————————————————. Based on all available intel, the American dollar and the US economy will default and crash in What this means is that the US economy has been purposely bankrupted.

In other words, the Titanic has hit an iceberg and is going down fast. However, it now means deferred martial law as America spirals ever downward and falls into a period of disintegration and eventual collapse. Enter the TSA and the American police state. Illegal spy cameras are now recording and tracking people everywhere on buses, in recreation centers, in supermarkets, in post offices, in airports etc.

Street intersection cameras all funded by the US Department of Homeland Security are now instantly tracking your license plates and your movements in nearly every major metropolitan area in the USA.

Marcus Wolf, former director of the East German STASI was, in fact, hired by the US intelligence establishment years ago to design a fascist police state control grid to control and enslave the American people.

What we are witnessing today is the fruition of his plans. In other words, the Dillon Dam security checkpoint, the surveillance camera control grid and the TSA grope-down goons soon to expand into our supermarkets, sports stadiums and shopping malls have all been set up to control YOU, the American people. Welcome to the new 4th Reich in America. All of this is occurring simultaneously with international efforts to instigate World War 3 in the Middle East wars always provide good cover for prefabricated, draconian domestic civil unrest, breakdown and upheaval.

Synergy is probably the best word to describe how rapid change in domestic and international affairs will progress as time and frequency unfolds and accelerates in Whether YOU continue to acquiesce to TSA grope-downs at our airports, for example, or stand up, confront and defend your rights to dignity, privacy and decency… one thing is for sure, the fight against tyranny and the war for freedom is now on.

Here is the link from Keep in mind that China has for many years advocated deceitful and covert warfare against its enemies. This is their Modus Operandi. The central issue of this survey appears to be whether one should shoot at women, children and prisoners of war, but its real significance goes far beyond that.

We wanted to know: Will they be for or against it? As everybody knows, according to the views propagated by the Western scholars, humanity as a whole originated from one single mother in Africa. However, according to the research conducted by most Chinese scholars, the Chinese are different from other races on earth. We did not originate in Africa. Instead, we originated independently in the land of China.

Therefore, we can rightfully assert that we are the product of cultural roots of more than a million years, civilization and progress of more than ten thousand years, an ancient nation of five thousand years, and a single Chinese entity of two thousand years. We all know that on account of our national superiority, during the thriving and prosperous Tang Dynasty our civilization was at the peak of the world.

Later on, because of our complacency, narrow-mindedness, and the self-enclosure of our own country, we were surpassed by Western civilization, and the centre of the world shifted to the West. Will the centre of the world civilization shift back to China? Therefore, if we refer to the 19th Century as the British Century and the 20th century as the American Century, then the 21st Century will be the Chinese Century! Wild applause fills the auditorium. As a result, we have a longer history, more people, and larger land area.

On this basis, our ancestors left us with the two most essential heritages, which are atheism and great unity. It was Confucius, the founder of our Chinese culture, who gave us these heritages. That is why the Chinese race has been able to prosper for so long. This is our advantage. The reason that the United States remains today is that it has never seen war on its mainland. Once its enemies aim at the mainland, the enemies would have already reached Washington before its congress finishes debating and authorizes the president to declare war.

If we let theology from the West into China and empty us from the inside, if we let all Chinese people listen to God and follow God, who will obediently listen to us and follow us? This is the biggest focus of the revitalization of the Chinese race.

In my last speech, I said that the fight over basic living resources including land and ocean is the source of the vast majority of wars in history. This may change in the information age, but not fundamentally. In addition, economic development in the last twenty-plus years had a negative impact, and climates are rapidly changing for the worse.

Our resources are in very short supply. The environment is severely polluted, especially that of soil, water, and air. Their sky is often blue with white clouds, while our sky is covered with a layer of dark haze. They have few people in the streets, and two or three people can occupy a small residential building; in contrast our streets are always crawling with people, and several people have to share one room.

It said that, due to our following the American style of consumption, our limited resources would no longer support the population and society would collapse once our population reaches 1.

The Ministry of Land Resources is specialized in this issue. Western countries established colonies all around the world, therefore giving themselves an advantage on the issue of living space. To solve this problem, we must lead the Chinese people outside of China, so that they can develop outside of China. First, if the United States is firm in blocking us, it is hard for us to do anything significant to Taiwan and some other countries!

Second, even if we could snatch some land from Taiwan, Vietnam, India, or even Japan, how much more living space can we get? Only countries like the United States, Canada and Australia have the vast land to serve our need for mass colonization. First, this makes it possible for us to have many people migrate there and even establish another Chinaunder the same leadership of the CCP.

It is historical destiny that China and United States will come into unavoidable confrontation on a narrow path and fight. Of course, right now it is not the time to openly break up with them yet. Our reform and opening to the outside world still rely on their capital and technology. We still need America. Therefore, we must do everything we can to promote our relationship with America, learn from America in all aspects and use America as an example to reconstruct our country. Of course we have not been idle; in the past years we have seized the opportunity to master weapons of this kind.

Biological weapons are unprecedented in their ruthlessness, but if the Americans do not die then the Chinese have to die. According to the computations of the author of Yellow Peril, more than half of the Chinese will die, and that figure would be more than million people!

Just after the liberation, our yellow land supported nearly million people, while today the official figure of the population is more than 1. One day, who know how soon it will come, the great collapse will occur any time and more than half of the population will have to go.

But that is the only path that will secure a Chinese century, a century in which the CCP leads the world. We, as revolutionary humanitarians, do not want deaths. The central committee believes, as long as we resolve the United States problem at one blow, our domestic problems will all be readily solved.

Therefore, our military battle preparation appears to aim at Taiwan, but in fact is aimed at the United States, and the preparation is far beyond the scope of attacking aircraft carriers or satellites. Marxism pointed out that violence is the midwife for the birth of the new society. At some point you need to rethink your mindset and worry about your race.

Your multicultural mindset will convince you that the other races can be trusted and you should follow them wherever they take you. You never fight back but rather settle in and vote on Dancing with the Stars. Japanese scientists have found a way to create artificial meat from sewage containing human feces. Somehow this feels like a Vonnegut plotline: Synthesize food from human waste matter. Absurd yes, but Japanese scientists have actually discovered a way to create edible steaks from human feces.

Mitsuyuki Ikeda, a researcher from the Okayama Laboratory, has developed steaks based on proteins from human excrement. Tokyo Sewage approached the scientist because of an overabundance of sewage mud. They asked him to explore the possible uses of the sewage and Ikeda found that the mud contained a great deal of protein because of all the bacteria.

The researchers then extracted those proteins, combined them with a reaction enhancer and put it in an exploder which created the artificial steak. The researchers color the poop meat red with food coloring and enhance the flavor with soy protein. Initial tests have people saying it even tastes like beef. The scientists hope to price it the same as actual meat, but at the moment the excrement steaks are ten to twenty times the price they should be thanks to the cost of research.

Professor Ikeda understands the psychological barriers that need to be surmounted knowing that your food is made from human feces. They hope that once the research is complete, people will be able to overlook that ugly detail in favor of perks like environmental responsibility, cost and the fact that the meat will have fewer calories. The work was published only for Jews some years ago. The work was compiled by the Jewish historian Malcolm H.

All I can say, Vox, about the Chinese is, if they are serious about trying to come here in mass numbers. This RZN report continues the impeccable documentation that Jews enabled by elite internationally usurious Jews run this world system, a world system based on perpetual unforgiveness and hateful domination.

This world system projects the Anti-Christ message that there is no possibility of inclusive forgiveness and hope, certainly no inclusive forgiveness of fraudulent, ruthless, headache-producing, impossible-for-all-to-repay bank debt. Personally, I feel hungry and thirsty for a system based on life-enhancing, Christ-blessed wealth rather than this system based on anxiety-producing, war-mongering, deadly debt. Byron Dale and Dale Soderberg are working to get the Minnesota State Legislature to consider passing a law that would get debt-free, wealth-based money into circulation.

A Representative named Hilte is currently trying to assist them. Their idea involves putting debt-free money directly into the system by creating money that is, issuing debt-free money through the Minnesota-chartered banking system with the specific focus of paying for beneficial transportation infrastructure. In other words, they suggest that the Minnesota government originates money as a debt-free payment for production as it is accomplished. The first day it was raining steadily and at times quite hard.

The police drove by a couple of times and totally ignored me. But one walking policeman wanted to feel his muscle and forced me off. Today, Thursday, I walked through the entire city of Chicago making stops at numerous median strips throughout the city holding high the Cross. I got in many conversations both today and yesterday. My next to the last stop was Union Station as people were walking into the station after work.

I stood in front of the station on both sides and blessed everyone with the Cross. Although I was placed under arrest the last time I did this at Union Station nothing happened this time around with the police. One new feature I noticed about the police in Chicago this time around is that they are now on bicycles armed with tasers. But here again they left me totally free to stand on the median strips. My last stop was once again the major median strip on Michigan and Congress and everybody was taking pictures from the sidewalk and waving to me from the cars.

It was all so good that I tried to stay an extra day here at the Hostel but they are all booked for the weekend. So I head home…. Let me be entirely frank with you. Hardly anyone donates to me any longer. I have been putting out much more money in the last 6 months than what has been coming in.

This is why I must now cut back on the Videos since they cost much money to produce. With all due respect, clearly, you need some more sources than what you provided us here about David Rockefeller.

And the Bilderbergers are not exclusively Jewish. Prince Bernhard of the Netherlands, who was also instrumental in creating the Bilderberg group, was a member of the Nazi Party until , three years prior to his marrying the Dutch Queen Juliana, and had also worked for the German industrial giant, I.

Farben, the maker of Zyklon B, the gas used in concentration camps. The Germanic dynasty of Saxe-Coburg-Gotha http: And no, they are not just figure heads of state. This is a big fat lie. Is the constitutional monarch of sixteen independent sovereign states known as the Commonwealth realms:.

Notice that none of these mostly Northwestern European countries have been seriously affected by the financial crisis, and notice that most of these countries live off of American military might, so they have enough money to pay for their cradle-to-the-grave nanny states. Notice that none of these peoples real true wealth is ever recorded.

What lies in store for Greece, Portugal, Spain, Ireland, Italy, and, in short order, the United States, is the wholesale sell-off of public property to private corporations at bargain basement prices. Total corporate control over every facet of life equals extreme fascism. What is occurring in Greece is a bellwether for what will befall other nations in Europe, as well as the United States, if the bankers get their way.

And in Greece, the people know how generations of investments by the taxpayers are being turned over to vampire capitalists who have the full backing of the International Monetary Fund, European Commission, and the European Central Bank. The European and global bankers have demanded that the Greek government sell off entirely or assume a minority stake in a number of state enterprises and utilities. For example, this year global capitalists are slated to acquire 84 percent of OTE, the Greek telecommunications provider.

In addition, private bankers will assume 66 percent ownership of the Greek Postal Savings Bank; 51 percent of the National Lottery; 60 percent of the Salonika Water Authority; 68 percent of DEPA, the natural gas utility; and 25 percent ownership of the ports of Piraeus and Salonika.

Next year, the capitalist grab for public property increases in intensity with Athens International Airport coming under 79 percent private ownership. The Greek Communist Party has vowed to fight against the acquisition of public property by the private sector. In fact, it is the Communist parties of Europe that have been the most vocal against the power grab by the bankers but their opposition to the privatization moves receives very little attention by the corporate-controlled media.

Massive sell-off lists of public property are now being drawn up by the governments of Portugal, Spain, Italy, and Ireland. One Libyan government official this reporter spoke to in Tripoli, during an intensive NATO bombing assault, opined that the same fate is in store for the Libyan Socialist Jamahiriyah. With the highest standard of living in Africa, Libyans could witness the U.

There was also the case of Marshal of the Soviet Union Kulik, demoted to major-general by Stalin, who had then sent him to prison and announced that he was dead.

After Stalin, Kulik was released from prison and restored to his rank of lieutenant-general. He was promised promotion to Marshal if he could organise the design and production of the first Soviet intercontinental ballistic missile. He succeeded and in he again became a Marshal of the Soviet Union, although no explanation of his return from the dead was ever made public.

Here we have a man that official was declared dead. And he is alive. Just how many others who we was told they was dead and live? Nobody ever talks about German prisoners of war, that were taken off probably to Siberia during WW2.

Needless to say, I am sure they all died in a bad way. But that is ok. They were evil Germans and they were white. Somehow civilization flourished for thousands of years with neither one of these absolutist approaches to public goods medieval Holy Land pilgrimages, for example, might have been impossible without the ecosystem of private toll roads created in response.

Much as I resent paying Jew taxes for participating in the financial system, I resent even more these facile suggestions Heeb straw-man arguments that I have only two choices: I try to stay fresh, brother! Feel free to make any puns you like, I always enjoy a round or two of wordplay. Does he do it? A bright note, however: Brother Nathanael is the only person I have yet found on the Internet who is telling the full and entire truth.

He is the man with the inside scoop. The answer is NO! Look at the history of Sephardic Jews just in slavery: Look up their name in the Jewish historian Malcolm H. Do you see the names: There is one little fragment of Scripture which is tremendous but it has a terrible statement in it:. That first, earthly Israel is not now in blessing, nor in life, nor is it in the Divine vocation. It is where the Lord Jesus said it would be if it rejected Him - in outer darkness, where there would be weeping and wailing and gnashing of teeth, and for these many centuries the Wailing Wall in Jerusalem has fulfilled that prophecy!

Though you obviously posted them for a different purpose, your recent links seem quite relevant to our earlier discussion. When asked who the men were, Doctor Dodd refused to name them.

Lucifer is very much alive. You know what all those terms: Guess we have a wee bit of double standard going on in US, huh? It seems that China Arnold right was having a fight with her boyfriend and decided to get back at him by jamming her own 28 day-old tot, Paris, into the microwave, pressing the power button for about 30 seconds and cooking the baby girl from the inside out.

She died the next day in the hospital. They never report on crime blacks do because the PC media mavens want to keep White people oblivious to the very real black horror show going on in all White nations, as well as keeping us from racial awareness and solidarity. Stupid White people thought by electing Obama who is really just as much White or Jewish, as black , might shut up the big-mouthed, militant Negroes and we might see them act a little more civilized.

Like fat, effing, chance. In fact, Negroes all over the country are going criminally bonkers — taking part in flash mob robberies and racially-motivated gang attacks on innocent White people in the street in broad daylight everywhere. Whites are being brutally victimized all over because of their race. One example recently, an elderly White woman, Marthie Grobler, was found dead, stabbed and tortured to death, apparently for hours, by multiple blacks who broke into her home.

This kind of thing happens all the time over there. They have it all planned out. In fact, being a multicultural liberal, is about the most foolish and destructive thing you can be, both for your own kind, as well as for the blacks. They have been working steadily to keep us Whites screwed-up in the head while they use America like a bitch. Absolutely nothing will ever change, in fact, it will keep getting worse and worse until us Whites come together as a race to put a stop to it.

Not only will it help our race out, but blacks too. Yep, think it through. No longer will they think they can get away with murder and mayhem. Think of spoiled little children who need a strong, but wise hand. If us White people will just stop with accusing each other of racism hear that Oxy? All you got to do is talk to everyone you know. No need to shave your head and rush out and join the Nazi party. How appropriate to this article! God Bless You and Thank You!

To the successor of St. So as a birthday present to you, Mr. The light will shine, and in due time, the people will be ready to follow its path. Was this excitement about free electricity all just wishful thinking that science eventually disproved? Spectacular new energy technologies were developed right along with other breakthroughs. Since then, multiple methods for producing vast amounts of energy at extremely low cost have been developed.

None of these technologies have made it to the open consumer market, however. New energy technology is here.

It has been here for decades. Communications technology and the Internet have torn the veil of secrecy off of this remarkable fact. People all over the world are starting to build new energy devices. New energy technology will change everything about the way we live, work and relate to each other. It obsoletes greed and fear for survival. But like all exercises of spiritual faith, we must first manifest generosity and trust in our own lives.

They are all the workers of Satan. The Jacob Rader Marcus Center of the American Jewish Archives is proud to make the latest edition of this classic text available online. First American Jewish Families: This publication is an historical document in its own right, and it is not our intention to alter it in any way.

Students of American Jewish genealogy are encouraged to use this text as a basis for their research. Jews and Muslims Clash; http: And that is exactly what the Jews did to Russia. To conquer the world you must have guns. Every single male Russian was drafted when he turned 18 years. Because the Jews killed all retards. If you were born with only one arm in the Jew-run Soviet, you were killed by the Jews.

So the Jews just killed anyone that was unfit for the military and this is why every single 18 year old male was drafted, because all the unfit was killed when they was born. And do you know what the Jews did to them? The Jews killed all of them on the spot. The generals fare worse.

They are plagued, endlessly, by uncertainty. In one day, in February , Khrushchev sacked generals from the Soviet Army. No Soviet general, and for that matter no Soviet officer or soldier -— no single member of this enormous organisation — has any guarantee that he will be allowed to retain his privileges, his rank or even his life. They may drive him out, like an old dog, at any moment: Can they really enjoy living like this? Why are they silent? An excursion guide once showed me an area in a large Western city which he said was entirely controlled by the Mafia.

Prostitutes, drug-peddlers, shoeblacks, shopkeepers, owners of restaurants, cafes and hotels — all of them controlled, and protected by the Mafia. Once we had emerged, unscathed, from this unhappy district, in our large tourist bus, and felt that we were back in safety,. I put these same questions to our apprehensive guide. Everyone living there had grown up in freedom and democracy; behind them lay centuries of freedom of speech, of the press and of assembly.

Yet, despite these centuries-old traditions, the inhabitants were silent. They had a free press on their side, the population of the entire country, running into many millions, the police, political parties, parliament, the government itself. And yet they said nothing. They made no protest. The society from which I fled is not simply a spacious well-lit prison, providing free medical care and full employment.

The government is the ruling body of the JEW Mafia: Press, television, the judges, the prosecutors—these are not influenced by the JEW Mafia—they are the Mafia. Smart tourist buses pass through our unhappy capital. The drivers and guides belong to the Mafia. I spent thirty years of my life on my knees. Then I got up and ran. Well, there is something which surprises me, too. The aim of all this activity is, quite simply, to bring you to your knees.

Tomorrow it will be too late. As the whole world now lives in more enlightened times, should there be any sort of reparations? And in what form? The Jewish near monopoly of this industry was particularly evident during the days of the Roman Empire, at that time it was mainly White Slaves, but it included other social groups too.

This article about the Jewish role in the White Slave Trade has a very interesting twist connecting it with Auschwitz.

This trade was probably the origin and not religion, bigotry, hate, ignorance etc of European anti-Semitism. The video I provided the link here yesterday has been replaced by something else, cover-up already? Oxy really needs psychiatric help! I hope he gets it! Alex Jones works for the Jews, is married to a descendant of Jews, who is proud to be such, and needs them to promote his computer writings and videos.

He gives out so much disinformation about Hitler, the Germans, and Nazis; and Michael Collins Piper has announced that he will soon do a podbean explaining the Jones phenomenon.

Basically these criminals consolidated their financial power by manipulating 19th century war news. Fast forward to the turn of the 20th century, they controlled every major media format until Thomas Edison invented new ones, then they tried to steal the technology from him!

Fake Civil Rights do we see any in Gaza? Pornography and child pornography. Like Henry Ford said in the early s: And for the English people to read your opinions to become more aware, perhaps more courageous to admit..? You know why I say that. There was this British lady, man it was like talking to a wall. I told her that the garbage from WWII about the lampshades made from Jew skin, and soap from their bones was just a hoax, a prop the Allies used to get the world angry with the Germans.

Even the Holocaust people now admit it was hoax, that it never happened. She went on and on calling me a Naz i you know, the usually stupid Goyim screaming technique: Sound familiar Ox, Henny? Her skull must of been made from Zionist concrete? She was religious also. How many Zionist Jews you know of? Or that own media in England? I even posted this brilliant John Tyndall piece, because I thought they figured Americans are anti-Semitic?

I just got to read it now, been so busy. You know how you spoke of all porn-ers are Jew boyz? This soft porn rag in St. Louis officially went over the cliff. Celebrating the contributions the poofsters have made to society. I know Christianity preaches tolerance but I should would like to break out the terrible swift sword and send some of this garbage to the netherworld. This months dive in to the gutter: To them, it was life. Yeah, well let them pack around the government cheese truck like in New Orleans and watch as they get a bullet in the head like in New Orleans too.

A head shot to at least be humane about it. Then no tears, no remorse, back to business of avoiding being rounded up and put in the camps. Do you understand how your heating or AC system works in your house? You can by Zyklon-B at your local shop. Just ask for a bugspray. A bugspray on can is a simplyfied version of the extremely complicated bugspray Zyklon-B.

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