Lately, the director has been revealing a more philosophical side, often posting cryptic messages on social media

If you are an independent contractor or a self-employed worker in Delaware and want to receive Pandemic Unemployment Assistance (PUA) as detailed in the CARES Act, please review and follow the steps detailed below.   Step 1: Apply for traditional UI benefits. Get started by visiting the website ui.delawareworks.com   Step 2: Receive a denial […]

Halloween is hauntingly around the corner. While it is known for its fun, costumes and candy, Halloween can also be a little scary for parents and pet owners – but it doesn’t have to be! The Delaware Division of Public Health (DPH) offers health and safety tips for a safe and fun celebration this Halloween. “Creep” It Healthy with These Treats Halloween can be a fun and exciting holiday […]

Check here each week to keep up with the latest from John MacArthur's pulpit at Grace Community Church.

brophyc Mon, 12/20/2021 - 14:55

“If you have bitter jealousy and selfish ambition in your heart, do not be arrogant and so lie against the truth” (James 3:14).

A wise person lives for God and others, not for self.

Having characterized spiritual wisdom in the preceding verse, James begins to analyze worldly wisdom in verse 14. Worldly wisdom is not of God. It has no relationship to Him, is not obedient to Him, and has no knowledge of His truth.

What is the motive of someone who lives according to worldly wisdom? “Bitter jealousy and selfish ambition.” The Greek word translated “bitter” also means “harsh” and is used of bitter, undrinkable water. “Bitter jealousy” carries the idea of a harsh, bitter self-centeredness that produces a resentful attitude toward others. People with bitter jealousy live in a world that focuses on themselves. They react in a jealous manner toward anyone who threatens their territory, accomplishments, or reputation. They resent anyone who threatens to crowd their slice of this world. They consider people who differ from them as implacable enemies. And they are bitterly jealous of anyone who is successful.

The Greek term translated “selfish ambition” refers to a personal ambition that creates rivalry, antagonism, or a party spirit. That’s another way of pointing to self. The person who follows human wisdom begins with a “bitter jealousy” that creates an attitude of competition and conflict. Then “selfish ambition” generates a party spirit and bitterness toward others. James is saying that ungodly wisdom is self-centered, and its goal is personal gratification at any cost.

What about you? Are you motivated by jealousy and selfish ambition? Be honest in your evaluation. Take a serious inventory of your heart and ask yourself, Am I serving others instead of fulfilling my own desires at the expense of others?

Suggestions for Prayer

• Ask God to convict you when you put yourself before Him and others.
• Repent of any present situations in which you are doing that very thing.

For Further Study

Read the following verses: Genesis 37:4; 1 Samuel 18:8; Luke 15:25-30; 22:24.

• What was the sin in each example?
• Read and study 1 Corinthians 13:4-7 to learn how the qualities of love are opposite to human wisdom.

From Strength for Today by John MacArthur Copyright © 1997. Used by permission of Crossway Books, a division of Good News Publishers, Wheaton, IL 60187, www.crossway.com.

Additional Resources

• The Study Bible (mobile app)
• Grace to You Sermons (mobile app)
• John MacArthur’s complete sermon archive
• The MacArthur Study Bible
• The complete MacArthur New Testament Commentary series

to write an essay paper about yourself

to write a self concept paper

to make yourself happy and remarkably less disturbable

to write a paper about myself

to write an autobiography essay about yourself

to write an autobiography about yourself

More and more parents are choosing to only have one child. Here’s what the evidence says about how growing up without siblings affects their personality traits and well-being

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ABSTRACTTraining health workers is one of the biggest challenges and cost drivers when introducing a new contraceptive method or service delivery innovation. PATH developed a digital training curriculum for family planning providers who are learning to offer subcutaneous DMPA (DMPA-SC), including through self-injection, as an option among a range of contraceptive methods. The DMPA-SC eLearning course for health workers includes 10 lessons with an emphasis on informed choice counseling and training clients to self-inject. In partnership with Ministries of Health in Senegal and Uganda, the course was rolled out in select areas in 2019–2020, including during the COVID-19 pandemic when physical distancing requirements restricted in-person training. We conducted evaluations in both countries to assess the practical application of this digital training approach for contraceptive introduction. The evaluation consisted of a post-training survey, an observational assessment conducted during post-training supportive supervision, and an estimation of training costs.In both countries, a majority (88.6% in Uganda and 64.3% in Senegal) scored above 80% on a DMPA-SC knowledge test following the training. In Senegal, where there was a comparison group of providers trained in person, those providers scored similar on the post-test to eLearners. Providers in both groups and in both countries felt more prepared to administer DMPA-SC or offer self-injection to clients after receiving a supervision visit (93%–98% of eLearners felt very prepared after supervision as compared to 45%–72% prior). The evaluation results suggest that digital approaches offer a number of benefits, can be cost-effective, and are most optimal when blended with in-person training and/or supportive supervision.

Clinical reports suggest that the most effective strategies for managing opioid use disorder comprise a comprehensive treatment program of both pharmacological and nonpharmacological approaches. However, the conditions under which these combinations are most effective are not well characterized. This study examined whether the presence of an alternative reinforcer could alter the efficacy of Food and Drug Administration–approved opioid antagonist or agonist medications, as well as the nonopioid flumazenil, in decreasing oxycodone choice self-administration in nonhuman primates. Adult squirrel monkeys (n = 7; four females) responded under concurrent second-order fixed-ratio (FR)-3(FR5:S);TO45s schedules of reinforcement for intravenous oxycodone (0.1 mg/kg) or saline on one lever and 30% sweetened condensed milk or water on the other. Doses of naltrexone (0.00032–1.0 mg/kg), nalbuphine (0.32–10 mg/kg), buprenorphine (0.0032–0.032 mg/kg), methadone (0.32–1.0 mg/kg), or flumazenil (1–3.2 mg/kg) were administered intramuscularly prior to oxycodone self-administration sessions that occurred with either milk or water as the alternative. Naltrexone, a μ-opioid receptor antagonist, was >30-fold more potent when milk was available compared with water and abolished oxycodone intake (injections/session) while concomitantly increasing milk deliveries at the highest dose tested. Pretreatment with the low-efficacy μ-agonist nalbuphine was most effective in the presence of milk compared with water, decreasing oxycodone preference to <50% of control values. The higher efficacy μ-agonists, methadone and buprenorphine, and the benzodiazepine antagonist flumazenil did not appreciably alter the reinforcing potency of oxycodone under either condition. These results suggest that antagonist medications used in combination with alternative reinforcers may be an effective strategy to curtail opioid abuse–related behaviors.

SIGNIFICANCE STATEMENT

Clinical treatment programs for opioid use disorder use a combination of pharmacological and nonpharmacological approaches. However, the conditions under which these combinations are most effective have not been fully characterized. This study examined whether the effectiveness of μ-opioid medications to decrease oxycodone self-administration is altered in the presence of an alternative reinforcer. The results suggest that alternative reinforcers enhance the effects of antagonist or low-efficacy partial agonists, suggesting they may be a more effective strategy to curtail opioid use.

PURPOSE

HIV pre-exposure prophylaxis (PrEP) may increase rates of bacterial sexually transmitted infections (STIs) among gay, bisexual, and other men who have sex with men (GBM) through risk compensation (eg, an increase in condomless sex or number of partners); however, longitudinal studies exploring the time-dependent nature of PrEP uptake and bacterial STIs are limited. We used marginal structural models to estimate the effect of PrEP uptake on STI incidence.

METHODS

We analyzed data from the iCruise study, an online longitudinal study of 535 Ontarian GBM from July 2017 to April 2018, to estimate the effects of PrEP uptake on incidence of self-reported bacterial STIs (chlamydia, gonorrhea, and syphilis) collected with 12 weekly diaries. The incidence rate was calculated as the number of infections per 100 person-months, with evaluation of the STIs overall and individually. We used marginal structural models to account for time-varying confounding and quantitative bias analysis to evaluate the sensitivity of estimates to nondifferential outcome misclassification.

RESULTS

Participating GBM were followed up for a total of 1,623.5 person-months. Overall, 70 participants (13.1%) took PrEP during the study period. Relative to no uptake, PrEP uptake was associated with an increased incidence rate of gonorrhea (incidence rate ratio = 4.00; 95% CI, 1.67-9.58), but not of chlamydia or syphilis, and not of any bacterial STI overall. Accounting for misclassification, the median incidence rate ratio for gonorrhea was 2.36 (95% simulation interval, 1.08-5.06).

CONCLUSIONS

We observed an increased incidence rate of gonorrhea associated with PrEP uptake among Ontarian GBM that was robust to misclassification. Although our findings support current guidelines for integrating gonorrhea screening with PrEP services, additional research should consider the long-term impact of PrEP among this population.

Annals Early Access article

Surprisingly little attention has been given to the impact of selfing on speciation, even though selfing reduces gene flow between populations and affects other key population genetics parameters. Here we review recent theoretical work and compile empirical data from crossing experiments and genomic and phylogenetic studies to assess the effect of mating systems on the speciation process. In accordance with theoretical predictions, we find that accumulation of hybrid incompatibilities seems to be accelerated in selfers, but there is so far limited empirical support for a predicted bias toward underdominant loci. Phylogenetic evidence is scarce and contradictory, including studies suggesting that selfing either promotes or hampers speciation rate. Further studies are therefore required, which in addition to measures of reproductive barrier strength and selfing rate should routinely include estimates of demographic history and genetic divergence as a proxy for divergence time.

Chris gets ready for his favorite part of FFXIV, the benchmark. Kelley complains about her hotel bed while waiting for a tow truck. Josh is force feeding his army desserts. Meanwhile...wait...Robert...wake up, Robert!

The post RPG Cast – Episode 720: “Self Checkout Bouncers” appeared first on RPGamer.

On heritage, identity, and what it means and looks like to be a practicing artist today.

The post Interview: Tschabalala Self appeared first on Fact Magazine.

The largest and most ambitious Martian drone yet could carry kilograms of scientific equipment over great distances and set itself down on the Red Planet unassisted

A judge recused himself Tuesday from presiding over Arizona's fake electors case after an email surfaced in which he told fellow judges to speak out against attacks on Democratic Vice President Kamala Harris' campaign for the presidency.

The ongoing saga of the BlackCat/AlphV ransomware gang continues, with a news report that the crew has shut down its servers after a controversial hack of an American healthcare services provider. Bleeping Computer says the gang’s data leak blog shut on Friday and the sites it uses to negotiate ransom payments closed today. This comes […]

The post Is the BlackCat/AlphV ransomware gang self-destructing? first appeared on ITBusiness.ca.

On “The Alex Marlow Show” on Tuesday, Breitbart Editor-in-Chief and host Alex Marlow mocked Ivy League schools like Yale for degrading themselves with things like Yale’s Beyoncé course. Marlow said, “Yale University’s going to offer a Beyoncé makes history course in 2025. So, that’s what they’re doing. We’re just kicking butt and taking names and then they’re — they’ve got a new Beyoncé course over at Yale. Do the Ivy Leagues know that they degrade themselves and debase themselves? I love it. Because, as people have been pointing out, there’s no surer sign of people moving to the left than…when they go to college. That’s where it’s at. That is the fountain of leftism in our society…the universities. … And, not to mention, they infect our cities.” “The Alex Marlow Show,” hosted by Breitbart Editor-in-Chief Alex Marlow, is a weekday podcast produced by Breitbart News and Salem Podcast Network. You can subscribe to the podcast on YouTube, Rumble, Apple Podcasts, and Spotify. Follow Breitbart.tv on Twitter @BreitbartVideo

The post Alex Marlow: Yale Embarrasses Itself with Woke ‘Beyonce Makes History’ Course appeared first on Breitbart.

The new text is timed to a new California law against false advertising.

From Juliette Binoche’s ‘A Thousand Times Good Night’ to Clint Eastwood’s ‘The Bridges of Madison County,’ here are some films that used photography as a lens to reveal the inner landscapes of the protagonist

15 years on, Winamp "still lives"—but mismanagement blunted its llama-whipping.

But the public’s economic outlook is still the most straightforward explanation for voters’ rejection of the incumbent party last week.

[Fair Warning: I have generally tried to keep this blog separate from my corporate existence, but am making an exception for two quick posts about the upcoming DIA 2013 Annual Meeting.]

Improving Enrollment in Pediatric Clinical Trials

Logistically, ethically, and emotionally, involving children in medical research is greatly different from the same research in adults. Some of the toughest clinical trials I've worked on, across a number of therapeutic areas, have been pediatric ones. They challenge you to come up with different approaches to introducing and explaining clinical research – approaches that have to work for doctors, kids, and parents simultaneously.

On Thursday June 27, Don Sickler, one of my team members, will be chairing a session titled “Parents as Partners: Engaging Caregivers for Pediatric Trials”. It should be a good session.

Joining Don are 2 people I've had the pleasure of working with in the past. Both of them combine strong knowledge of clinical research with a massive amount of positive energy and enthusiasm (no doubt a big part of what makes them successful).

However, they also differ in one key aspect: what they work on. One of them – Tristen Moors from Hyperion Therapeutics - works on an ultra-rare condition, Urea Cycle Disorder, a disease affecting only a few hundred children every year. On the other hand, Dr. Ann Edmunds is an ENT working in a thriving private practice. I met her because she was consistently the top enroller in a number of trials relating to tympanostomy tube insertion. Surgery to place “t-tubes” is one of the most common and routine outpatients surgeries there is, with an estimated half million kids getting tubes each year.

Each presents a special challenge: for rare conditions, how do you even find enough patients? For routine procedures, how do you convince parents to complicate their (and their children’s) lives by signing up for a multi-visit, multi-procedure trial?

Ann and Tristen have spent a lot of time tackling these issues, and should have some great advice to give.

For more information on the session, here’s Don’s posting on our news blog.

Are we looking at our enrollment data in the right way?

Session Details:

June 25, 1:45PM - 3:15PM

• Session Number: 241
• Room Number: 205B

1. Enrollment Analytics: Moving Beyond the Funnel
Paul Ivsin
VP, Consulting Director
CAHG Clinical Trials

2. Use of Analytics for Operational Planning
Diana Chung, MSc
Associate Director, Clinical Operations
Gilead
3. Using Enrollment Data to Communicate Effectively with Sites
Gretchen Goller, MA
Senior Director, Patient Access and Retention Services
PRA

To mark Breast Cancer Awareness Month, we speak to inspiring Singaporeans about their journey in battling and overcoming cancer.  Warda Ismail gets anxious about things easily, especially when it comes to her health.  So much so that her doctor once told her that she is a "borderline hypochondriac", she shared with AsiaOne in an interview.  For the uninitiated, hypochondria is a condition where a person is excessively and unduly worried about having a serious illness. To keep her mind at ease, the 44-year-old preschool educator has the habit of going for regular medical checkups.  Though she was vigilant, her worst nightmare came true — she was diagnosed with breast cancer on May 8 this year.  And in the midst of her recovery journey, she got more terrible news — her mother, who had been caring for her, was diagnosed with stage-three gall bladder cancer.  Despite the string of unfortunate events, Warda persevered and tried to have a more positive outlook on life and her health. 

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Video james