Roberta M Roy on Nuclear Survival

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Sunday, April 13, 2014

Anna in HIPAA-land or Through the Peeking Glass

One day Anna Banana was walking through the primeval forest when out of the bushes jumped a monkey and bit her on her rump.

"Ouch," cried Anna. "Why did you do that? I didn't do anything to you!"

"No," said the monkey, "but some things are the way they are and as it is I happen to like bananas."

"Well, why did you have to pick me to attack?"

"It wasn't an attack. I was just letting you know you looked good. Also there were no other bananas in the area to satisfy my hunger."

"Oh, banana peels! I'm so embarrassed! What will my mother think?"

"Just forget about it! After all I only took a little bite!"

"Oh, you monkeys are all the same. Play. Play. Play. When are you going to grow up and get serious?"

And with that, Anna Banana turned on her heel and took off down the road thinking maybe she had better wash off where the monkey had taken the chunk out of her.

At supper she decided to eat standing.

"Why don't you sit down, dear?" asked Momma Banana.

Now Anna couldn't tell a fib to her mom so she said she had a small laceration on her backside.

"Laceration?' queried her mom. "But how?"

And so in good time Anna had to relate all the details of her encounter with the monkey which worried her mother because she was afraid that if the monkey had bit her in the daytime that perhaps it was rabid. So Momma Banana took Anna Banana to the doctor for some medicine but the doctor said she should have brought her immediately so he might have given her some of his RPA, the full name of which was Rabies Prevention Activator. But now it was too late so the next best thing to do would be to determine if the little monkey had rabies and if that could not be determined they would just start Anna on the full rabies treatment which in and of itself was painful and could have side effects.

‘Okay," said Momma Banana, "let's go Anna. We need to find that little monkey and have him tested."

"Well," said Anna, "I really don't know him except to tell you he has three orange rings around his tail and one of his ears is purple so he should be pretty easy to locate."

So Anna Banana and her mom went down the path of the forest primeval, querying the animals they met along the way in the hopes that one of them might be familiar with a small monkey with three orange rings around his tail and a purple ear.

They asked the skunk, who wiggled her nose and said it sounded like a good kind of monkey to avoid. And no, she had never seen it.

They asked the owl, who blinked his lids slowly closed and when he opened them again suggested they search around among the wild violets as if it had been he and he had a purple ear, it would be there that he would hide.

"But monkeys live in trees, you know, Mr. Owl. I don't think he would want to hide among the violets and especially so because our violet patch is not even near the banana grove."

They asked the squirrel who did have some recollection of having seen an animal with a purple ear, but as the rodent had not seen its tail, it could not be sure it was even a monkey.

Disheartened and numb, the two were just about to give up the search for the purple-eared monkey as impossible when an orange-striped tail swooped across the landscape in front of them, hitting Anna in the face, thereafter only to be followed by another much larger and longer tail with similar stripes that moved with somewhat greater care following the smaller one as it made its way through the air above the path between two trees that arched above Anna and her mom.

"Hey, there," Momma Banana yelled to the larger of the two monkeys. "We need to talk. Please talk to us."

"Well, it's coconut season and we've had enough bananas. What do you want?"

"Please come down."

So the daddy monkey came down and as nicely as was possible he said he'd like to help, but it was a very busy time, and he had many important chores to do.

"Yes," said Momma Banana. "But we are important, too. And we need to know if your little boy monkey has rabies."

"Rabies! Imagine that! Of course not! Why would my little monkey have rabies?"

"Well, I don't know. But I have to ask."

"Well, ask if you like for as it turns out, it's none of your business!"

"I think it is," parried Momma Banana. "After all, your little monkey bit my daughter, Anna Banana, and I need to know if she has been exposed to rabies.

‘Not to worry. I told you my son is happy and healthy. No rabies in that quarter. And anyhow, bananas can't catch rabies."

‘But I don't know that, and Anna's physician would like your child to be tested."

"Tested? What for? Didn't I tell you he was healthy?"

"Yes, but rabies takes a while to develop. He could be a carrier."

"Never! And besides, that kind of little monkey information is protected under HIPAA and even if I had him tested there would be no reason for me to tell you the results."

"It's criminal!" cried Momma Banana. "Your son bit my daughter! I am going to call the police and press charges! Then we'll see!"

"It's not criminal. My son is but a boy!" And away swung the two tails and six orange stripes and with them the evidence needed to prove there was or was not rabies in the air as the two monkeys with the purple ears swung out in search of coconuts.

As it happened, down the trail of the Forest Primeval there happened a Red Fox, Esq. And being one of the foxier lawyers around he immediately smelled the possibility of a suit. So he idly commented on how surprised he was to see a top banana like Anna Banana's Momma yelling at monkeys and asked if there was anything he could do.

So Momma Banana explained about how Mr. Purple Ear had refused to have his son tested to rule out rabies and how now Anna Banana was going to have all those awful shots and side effects . . . and who knew if the treatment really was effective. And Red Fox, Esq., smelled a wrangle with HIPPA and quickly excused himself saying he was late to a hearing and that perhaps the place that Mamma Banana needed to start was in Family Court.

"Family Court!" thought Mamma Banana! "They might as well start the treatments now. Even if it were to work, by the time the case had been heard, negotiated and settled, the window for preventative treatment would have closed and being the sane Momma Banana that I am, I am certainly not about to lose time with that route.

So Momma Banana took Anna Banana to the pediatrician who said he was reluctant to treat Anna without documentation to her having been exposed to rabies and that what Momma Banana had to do was to find a way to get Mr. Purple Ear to have his son tested and to sign a release for the results to be shared with Momma and Anna Banana.

So to the coconut grove went Anna and her Momma. They called and asked and looked and searched. But as neither of them could climb trees, locating the purple-eared monkeys proved to be quite a challenge. And just as they were about to give up, crashing down through the limbs above and landing square in front of them in the Forest Primeval came the red-eared boy monkey with the three orange rings around his tail. And he fell with such a thump it stunned him and it took him a bit to shake himself alert and ready himself to swing again among the trees. So down from above came his dad to whom Momma Banana expressed her concern. "Would he be all right?" she asked. "Is there anything Anna and I might do to help?"

The dad looked at Momma Banana as if she were out of her tree. But on closer look he determined she was quite sincere in her concern, which took him back a bit, but not so much as to nail him to the spot. So he grabbed his son by his four-fingered hand, pulled him up over his shoulder, and scampered up the nearest tree without so much as a look backward as he went.

"Momma," said Anna. "You forgot to ask him about getting his son tested."

"Oh, Anna, I'm so sorry. I was so taken aback but the state of his son, and everything happened so fast, I never thought of it."

So Anna Banana began to cry. "Oh, Momma, I'm afraid. I don't want the rabies, but my friend's brother had to take RPA and his liver went to pieces and he hasn't been well since. Except of course, he didn't die even though he had been bitten by a rabid dog."
So Momma Banana took Anna Banana and they went to the Banana City Police who told her that the Forest Primeval was out of their jurisdiction so they should try the Sheriff's Department, which they did. And there a very nice Deputy Sheriff explained that when Sheriff's are bitten they immediately get the one time preventative dose from the Forest Primeval Hospital . . . and if they miss the 48 hour window for that and the perp is a child and the parents' will not sign for him or her to be tested, then they just tough it out and get the full RPA treatment and pray it works. But . . . he was so nice . . . usually if we talk to the parents and explain the gravity of the situation they agree to have their child tested and to sign a release for us to learn the results and as most of the kids are find, all's well that ends well.

So Anna and Momma Banana hung around in the coconut grove for several days and whenever they caught sight of a purple ear or three orange stripes in the limbs above, they called up to ask how Lil' Purple Ear was doing and when was his daddy going to have him tested for rabies and sign the release and share the results with Momma Banana and Anna so they, too, could sleep the night . . . and Anna would not have to go through all of the terrible treatment for naught but the callous attitude and pride of Mr. Purple Ear.

And low and behold, on the seventh day, down came both Lil' and Mr. Purple Ear and it was arranged that Lil' Purple Ear be tested and when Mr. Purple Ear determined his son did not have rabies he was so elated, he just about ran to tell Momma Banana . . . as really no one else gave much of a hoot about it . . . and he even agreed to sign a release so Momma Banana could show the results to Anna's doctor and Anna . . . thanks to the generous advice of the Deputy Sheriff and the loving and caring heart of Mr. Purple Ear and the cooperation of Lil' Purple Ear in being tested, did not have to be treated after all!

Background for Anna in HIPAA-Land

The Health Insurance and Accountability Act of 1996 (HIPAA) in protecting the privacy of patients prevents doctors not only from performing tests for Hepatitis B, Hepatitis C, Syphilis, or HIV without permission, it also prevents them from sharing these results without patient permission. And while at first glance this seems wise and reasonable; on second look, should a child bite someone and draw blood and the parents refuse to have the child tested, anyone so bitten and concerned about the possibility of the child inflicting the bite carrying blood borne pathogens may find him or herself in a bit of a corner.
While the injured may be treated within the first forty-eight hours at an adequately equipped hospital emergency room with an HIV prevention drug array, how many so bitten are likely to even know of this option, let along act on it. Then, lacking knowledge of the HIV status of the child that did the biting, the injured person has the option of being monitored for HIV at intervals as recommended by their doctor or to receive a longer HIV preventative treatment that is likely to take its toll on the body and has no guarantee.
As for prevention, detection, and treatment of the other blood borne pathogens listed, should there be questions, and without test results confirmation that the child giving the bite did not carry them, the best place to start is probably with one's own personal doctor, the CDC, or the County Health Department.

Is HIPAA Creating More Problems Than It's Preventing? Neil Chesanow


Medscape Article on Human Bites. Jeffrey Barrett, MD; Chief Editor: Burke A Cunha, MD Medscape Article on Human Bites. Jeffrey Barrett, MD; Chief Editor: Burke A Cunha, MD

8:44 am edt 

Friday, January 10, 2014

Keeping Warm in 2014

National Weather Service Website Headline,  January 5, 2014 ~ Life-Threatening Wind Chill Impacting Northern and Central U.S. While Heavy Snow Develops from Eastern Plains to Great Lakes

As according to the National Weather Service an arctic cold front brings the coldest temperatures in almost two decades with temperatures in the north and central states falling to life-threatening wind chill values as low as 60 degrees below zero, the subject of keeping warm is a constant. And while it is cheering to think that most of us have an answer, there is a good chance someone out there knows something I don't or needs to know something I do. Therefore to polish up on the subject, I talked with others on the question, googled a dozen or more websites related to keeping warm, reviewed some of my own related life experiences, and decided to share some of the heart (and body) warming notions that have surfaced.

Oldies but goodies:

My mom grew up on in the Dutchess County hill country in Poughquag, NY, before it had streetlights. She told stories of children's hands split and bleeding in the cold and of wearing newspaper inside her jacket in winter to break the chill of the wind.

Later in Hopewell Junction, with a horse on the property, I learned that manure was great to prevent freezing by using it to cover pipes too close to the ground surface from freezing. I recall that each winter my grandfather protected the pipes beneath the floor of a window well it.

Then there were the water pipes too close to the cellar window in my parents' house. My dad rigged a light bulb with a reflective aluminum plate behind it so that the warmth that it generated could be directed toward the pipes to prevent their freezing and each year sometime before the winter holidays he put the rig in place with the result that after their first time the pipes never froze again.

However when one of my sisters' kitchen sink pipes froze the other day, she defrosted it with a hair dryer. It took her two hours and she worried she might burst the pipes, but it worked. Now she tells me she is leaving the sink cabinet door open so the room air can circulate around the pipes warming them and plans to purchase and wrap them in insulated tape to alleviate the threat.

And I recall that in a garage I once had that the plumber hooked up a heating tape that needed to be plugged in when below freezing temperatures threatened. That worked well and the pipes froze never froze thereafter.

Knowing the Weather

After four o'clock in our zip code area freezing rain is predicted. I found that out by accident in exploring the National Weather Service website when I put in my zip code to determine how the website works. Seems there will be freezing rain here and to the south in the county but not to the north where my son and his family are located. But my further reading occurred too late! I had already called them and left a message saying it would be best if everyone planned to stay home after four as freezing rain was expected. And I didn't call back to retract it because my thought was that with two cars in the family if they do go out, one or the other of them is likely to come south. Sloppy of me I agree, but I also know they like confirming any of my pronouncements independently so the likelihood of them functioning on misinformation is pretty slim. Which brings me to my next point about keeping warm: You really need to check the weather yourself once or twice a day so that you are prepared to dress appropriately and to travel safely.

Keeping Warm Inside

While pipes are one thing and knowing the weather another, keeping warm in the house can pose another challenge. Some of my favorite suggestions for beating it surfaced in an article about apartment living.  The ones I rely on most myself are to drink something, open the shades and blinds to let the sun in, and clean the house. The first one not only keeps you hydrated and alert, but if you drink something hot it can directly raise your body temperature. As for the effect of sunlight, on some days I have noticed that the difference between rooms that let it in and those that do not as much 5 to 7 degree difference which can be pretty significant if the temperature in the cooler room is 65 and the warmer one is 71. Of course cleaning the house not only improves the circulation, it lifts the spirit . . . one of the reasons I vacuumed and washed floors today.

And if the bottom of a door needs weather stripping to cold air from entering beneath it, a quick fix is a rolled up terry cloth towel stretched across the door's length at the bottom.

Other ways one can actually warm the house without turning up the heat include either baking or doing some stove top cooking. I notice for instance if I make tomato sauce and cook it for a long time on a slow burner, the kitchen warms. It will also warm if I just boil pasta in an open pot. This is because in addition to heating the area around the stove, it also raises the humidity in the air which in turn holds the heat longer.

Keeping Warm Outside

One of the keep warm websites I favored was the wikiHow one on staying warm during winter outdoor activities. Its list was short and definitely tried and true. It included wearing other than cotton materials, layering up, eating for the trip, drinking liquids, and wearing a hat and gloves. My favorite was drinking liquids to compensate for the below freezing air's penchant for drawing the moisture from you which could increase your chance of dehydration. And from what I was told, people in dehydrated states have greater difficulty keeping warm-possibly because of a decrease in level of blood circulation.

A Word on the Homeless

In the ‘Survival Guide to Homelessness' I was reminded of the importance of keeping blankets in your car for use if you breakdown or are caught in the snow. The Guide, by the way, proved to be pretty intense in its recommendations and whereas back a number of years I might not have even considered the need to address the needs of homeless people, now I see it as a serious concern. Who knows? Just possibly one of my readers is among the homeless and just hanging out keeping warm in some warm library reading room or local internet hotspot and hasn't yet heard of the Survival Guide to Homelessness. I know I had not until I started this research. But no matter who you are, dropping by there is definitely informative.

My first introduction to homeless was years ago when my mom told me about the hoboes who traveled the railroads trying to keep warm and safe in box cars and picking up odd jobs in exchange for food wherever the trains pulled over and they could jump out. Later in France I was introduced to the homeless people of Paris, the clochards who were to be seen sleeping on park benches or  . . . I never could understand how . . . on top of the metal grates through which the heat from the Metro rose. Some slept with paper under them to cut the impressions left by the metal rods. Some slept on cardboard. But some seemed to sleep with only their head on their arm, the metal cutting into their body wherever it crossed beneath them.

Now in San Diego alone in 2013 there were 8,879 identified homeless people about half of which were unsheltered and fifteen per cent of whom were veterans.  In NYC the numbers were larger and becoming worse. In 1983 fewer than 15,000 homeless people were sheltered in NYC but by September of 2013, NYC was sheltering an average of 52,351 of its estimated 60,000 homeless people each night among whom 22,136 were children.  And across the nation according to a 2002 federal study about 1.7 million ‘young people every year ‘call the streets home.'  

I recall as a child that my mother brought home a couple of homeless women. One was pregnant, lived with us for a year or so, became employed, and later married the father of her child. My mother said she found her on a street corner . . . whatever that meant. There was also a second who also went to work, became financially stable, married and left to settle down with the man who had become her husband. Together they raised a family on a farm in the Midwest.

But I digress. Or do I? Or are there still young women such as those my mother harbored into health and independence? And are there other homes with doors that need to open in particular against the cold?

On Keeping Hands and Feet Warm (and Dry)

Early on I learned the trick of keeping my feet warm. It lay in keeping them dry. And then when I took up skiing I learned some other bottom-line aspects related to keeping feet warm. I learned that feet had to have room to move and wearing three pairs of socks and immobilizing the toes meant to freeze them. So no tight shoes. And at all costs, look for shoes that breathe. Leather breathes; Patten leather does not which is not good because they hold in moisture. Materials that bind up the moisture from the feet within the shoe cause the socks to become damp and damp feet in cold weather equal cold feet. So remember. Room to move the toes. Shoes that breathe. Dry feet.

The rules for the hands and the fingers are the same. Keep them dry. And if possible wear mittens or layer gloves. The warmest ski gloves I ever owned were the least beautiful, but I loved them with all my heart for they were invariably warm. They were of leather (which as you recall breathes) and were worn over a pair of wool mittens. This Christmas one of my sisters bought me a pair of cashmere mittens no less! When the bitter cold hit here in the Mid-Hudson Valley, I pulled them on the cashmeres (wool) and over them a pair of cotton driving gloves. Definitely good to go in the cold! Thanks, sis!

My Last Two Bits

The first is common knowledge. The second is up for debate. Here is the first: If you are out and it is cold the first thing always is to keep moving. Anything that increases the circulation from rubbing your hands together to jumping up and down to running the mile will help.

As for the second, it is my absolute favorite ... probably because it is up for debate . . . however it is a belief I had reinforced when I taught at the Vergennes Union High School in Vergennes, VT, and had the chance to observe the students as they arrived to school in dead of winter, jackets open and apparently lightly dressed. Simply stated the maxim is this: For heating comfort, dress with the same weight materials covering all your body and legs.

The belief is based on the assumption that the body has only one heating system with one thermostat. Now although this is not something I have researched beyond casual observation and personal experience, I invite you to experiment with the concept. If you do I think you will find, for instance, that when your upper body is overdressed and your legs hanging out in light jeans, you will freeze. So what I do is to dress overall more heavily or overall more lightly even when its somewhat cols . . . the exception being when the temperature guarantees frostbite on all under-clothed parts in which case the recommendation is seek shelter, call for help if necessary, and stay warm.

Roberta in Po-Town, Keeping Cozy 

10:38 pm est 

Saturday, September 14, 2013

All a Little Wiser . . . But Is It Enough?

It seems so long ago. Life moves so quickly. From shock and fear to shaking oneself to confirm one is still alive to other concerns including the increased study of survival and onward to the establishment of volunteer emergency response teams in every county in the nation. No small feat. And quietly done. And we are stronger now. And wiser.

But twelve years ago with the attack on the Twin Towers we were less wise. It was my painful awareness of my own personal ignorance of what to do in the event of a mass attack . . . or event that was to become  the impetus for me to research and write Jolt: a rural noir. Truly a labor of love. A hand offered to those concerned about nuclear meltdowns. Not to mention a hint to the need to close down Indian Point. And in the interim it has not been until this last year or so that reactors are beginning to be closed.

Just days ago Vermont Yankee became the first nuclear power plant in the USA to close due to, among other things, concerns related to its spewing out nuclear waste into the Connnecticut River.

According to TruthDig Vermont Yankee announcement becomes the fifth shutdown declaration since 2013. When it closes in 2014 it will reduce the number of licensed reactors in the USA from 104 to 99.  Also, according toTruthDig, "As many as seven more proposed U.S. reactors have been canceled since January, turning the much-hyped "nuclear renaissance" into a rapidly rising rout. Upgrades at five other reactors have also been canceled."

Of interest to us in the Hudson Valley of New York State is TruthDig's statement and my own review of the local papers, that the  double-reactor complex at Indian Point "remains under intense political fire as water and other permits there and at the upstate Fitzpatrick reactor are being bitterly contested in Albany."

And . . . I apologize for the over reliance on one source and invite you to research the accuracy of the reporting . . .but due to the warming of the Cape Cod cooling water, TruthDig also stated that the Pilgrim reactor at Plymouth, south of Boston, recently had to reduce power while a reactor on Lake Michigan has been linked to cancer.

Given the above, I'm glad I decided to celebrate our growth in community awareness of how to respond to mass events . . . including meltdowns . . . even if my key original concern, Indian Point Power Plant remains open. 

I can only remain optimistic that it, too, will soon be closing, especially given it is the oldest and most degraded plant in the USA . . . and so close to NYC. Meantime I believe that now is the time for NYS to order the building the cement casings it will need to hold the Indian Point nuclear waste for it is going to take many many years before it becomes degraded enough to be safe. Meantime . . .


Roberta in Po-Town, Remembering

8:45 am edt 

Saturday, August 31, 2013

Therapeutic Crisis Intervention (Cornell University TCI)

An SLP’s Quick Take on TCI: As a speech language pathologist employed in a mixed residential and day student care center, each fall I am required to participate in a recertification program designed to prepare caregivers to offer a consistent, well-researched, dynamic, and caring response to children in crisis—crisis in this instance (my definition) referring to a personal, usually precipitous time of personal emotional crisis and associated behaviors. This required training is called Therapeutic Crisis Intervention or TCI. As a result of its application trained staff learn to use their skills to provide the young person time, space, understanding, and support through crises as they occur. Then following the event, in a Life Space Interview (LSI) the young person is encouraged to learn and use more effective ways to respond to similar situations should they occur in the future.

The TCI Effect: Since the institution of the teaching and application of TCI in residential settings, the need for physical interventions has dropped precipitously. Also, young people are being consistently coached to learn and use new and improved coping skills.

Therapeutic Crisis Intervention: According to the literature,
[1]The Therapeutic Crisis Intervention System Residential Child Care Project development began in the 1980’s at the Family Life Development Center at Cornell University.  Most commonly referred to as TCI, it was designed to assist  [2]organizations in preventing crises from occurring, de-escalating potential crises, managing acute physical behavior, reducing potential and actual injury to young people and staff, teaching young people adaptive coping skills, and developing a learning organization.
Below is a summary drawn from my own study notes of how TCI works. For the real nitty-gritty, however, I suggest you go to the internet or download here a free copy of Crisis Intervention Handbook TCI Manual.

An Invitation: Please peruse my extremely simplified outline and if interested, as suggested above, take the time to read more about Therapeutic Crisis Intervention as I believe that within it there are nuggets of information possibly of value to anyone just going about the business of living and being human.

Roy’s Quick Notes on TCI

During the Crisis

The key concepts as I found them to be during the crisis as described inTCI are five:

  • Self-Awareness

      o The Four Questions
            1. What am I feeling now?
            2. What does the young person feel, need, or want?
            3. How is the environment affecting the young person?
            4. How do I best respond?

  • Crisis Communication/Active Listening

     o    KEY CONCEPT: Meaning to the young person is communicated mostly by Facial Expression (55%) and Tone of Voice (38%) with Words (7%) carrying the least meaningful part of the message

     o    Care providers meantime:

           1. Use Encouraging and Eliciting Techniques
           2. Understanding Responses
           3. Active Listening

  • Behavior Support Techniques relate to the

     o    Environment
           1. Decrease availability of possible causative factors
           2. Remove potential targets or weapons from the environment
           3. Consider need to ontrol heat and loudness levels

     o    Expressions of Care
           1. Caring gesture – hand to shoulder, smile if appropriate
           2. Proximity – move closer or sit down near if appropriate

     o    Verbal Guidance
           1. Prompting
           2. Hurtle Help
           3. Directive Statements
           4. Redirection and Distractions

     o    Time Away in which young person agrees to a need for quiet and a place where such quiet would be available and goes there for a length of time to be determined as the young person begins to calm and can agree he/she is all right to return (Used only if young person has good self-regulating skills)

  • Emotional First Aid

     o    Goals
           1. Co-regulation = Immediate help and support to reduce emotional intensity
           2. Resolve the immediate crisis
           3. Keep the young person in the program or activity

     o    Challenges the Caregiver to
           1. See the incident from the young person’s perspective
           2. Help the child connect his or her feelings and behaviors
           3. Encourage the young person to be responsible for his/her actions


  • Crisis Co-Regulation

     o    Purpose: To support both the Caregiver and the Young Person through the response of
           the Caregiver

     o    What the Caregiver can do:
           1. Use four questions (See Self-Awareness above) and positive self-talk (e.g. I can do
           this. The day is almost over. We got through this before.)
           2. Take a deep breath – Step back/ use protective stance (arms down, finger tips raised),
           Give the situation Time – Sit down if appropriate
           3. Remember the non-verbal message (facial expression, tone of voice, gestures and
           4. SAY: Very little
           5. GIVE: Understanding Responses until such time as young person returns to baseline

    Following the Crisis

  • The Life Space Interview or LSI

     o    Goals of the LSI:
           1. Clarify events with/for the young person
           2. Repair and restore the relationship with the young person
           3. Teach the young person new coping skills
           4. Return the young person to normal functioning
           5. Reintegrate the young person into the program

     o    LSI Steps – I ESCAPE
            I- Isolate the conversation with the young person so no one other may comment in it
            E - Explore the young person’s point of view
            S - Summarize verbally the young person’s story of the event and feelings expressed
            C - Connect the young person’s feelings to his/her behaviors
            A - Alternative behaviors must be discussed to suggest other, more acceptable ways for
            the young person to respond in the future
            P - Plan or develop one or more new behaviors to be used in similar situations in the
            future/Practice (role play) that new behavior

            E- Enter the young person back into the routine

3:57 pm edt 

Friday, April 5, 2013

Going Green! ALVA the Indie Publisher's Appeal!

At, we are looking for the support of family and friends to help get Carl Waldman's Streetscape: A Jake Soho Mystery on the Barnes and Noble Best Sellers List.

Your support will help promote ALVA's success as a publishing company, boost book sales and provide you with a wonderful opportunity to read a charmingly compelling mystery!!!

For just $9.34, wouldn't it be fun to watch it rise on The B&N Chart knowing you made the difference?

Much appreciated! Robin

1. Go to
2. Search for ALVA Press Inc; then:Click on the Streetscape cover image. To Download a Sample, Buy Now, or send as a gift, just click on the selection of your choice and follow the directions for payment and delivery. Of course, you can always select one of Alva's other amazing book publications like Helmy Kusuma's Mementoes of Mai ($4.24)

9:19 am edt 

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Roberta M. Roy incorporated Alva Press on October 5, 2004. The express purpose of Alva Press, Inc., was to ensure a safe venue for the publication of her works and those with similar focus.  As such, upon the completion of the science fiction novel Jolt: a rural noir, Alva would immediately publish it. Further Alva Press, Inc., would offer a venue for Roy to publish her children's books, including Yell'n'Tell. (At this point Yell'n'Tell needs only design as the watercolor illustrations by Dan Dyen are complete and the text fully edited.  But then there is also Wedding Ready, complete, but in need of an illustrator talented in the art of drawing forest animals. But all that anon.)
Currently, until the soft cover version of Jolt's Library of Congress Number is in, Jolt waits to go to press. Usually the LCN takes but a few days after which will become available in hard cover at $24.95 and Trade paper at $14.95 (plus $5.50 mailing).
Jolt was some five years in the writing; its research took longer. It's scientific basis for nuclear survival has been carefully reviewed by oncologists and experts in the effects of ionizing radiation for accuracy of representation. Jolt is a fast-paced novel that spans two years in the lives of a group of diverse urban, suburban, and rural residents brought together in an imaginary part of the northern United States. There in Locklee, the small town to which those who are forced emigrants flee, they become mutually caught up in the necessities associated with post-nuclear survival.
Check for a more thorough review of Jolt as well as the most recent updates on its publication and availability. And should you be so inclined and care to help defray the last payment of its first printing, a check in the mail to Alva Press for your very own pre-publication autographed copy of Jolt: a rural noir would be a great help.

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Basics to Understanding Nuclear Survival

1)     If you walk out uninjured from a nuclear event, you probably will survive. 
2)     The bywords to survival from a nuclear event are TDS: Time, Distance, Shielding. 
3)     Use  regular soap and water to decontaminate from fallout.Strip and shower or cleanse as best you can. Use bread. 
4)     Nuclear fallout contaminates open water and plants.If there is fallout (ashes),use bottled water and canned goods. 
5)     Babies as well as adults can take Potassium Iodide (KI) to protectthe thyroid against ionizing radiation. 
6)     There is no plume with a nuclear power plant meltdown. 
7)     A large event may seem ‘over there’ if you can’t define its impact.Ionizing radiation is invisible. 
8)     A family needs an escape plan. 
9)     A community can respond as a team to mass events.
10)  After a mass event, a communitymay heal changed but well. 

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Telephone (919) 239-3791 Phone/Fax (845) 454-5200