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160; for today however, let's not even argue against this fabricated disease attention deficit disorder ; or this sensationalistic worry about suicide children are six times more likely to die in automobile accidents ; , but instead let's take a stroll through the known side-effects of one drug which psychiatrists happily prescribe to millions. The equine industry let's blame the Jockey Club ; has arbitrarily set each foal's birthday as January 1 of the year it was born. That means a foal born in October will celebrate its 1 year birthday as a 3 month old, along with the 11 month old foal born in February that same year. In shows and races, the older foal has an obvious advantage. I sure there is a logical explanation for a universal January 1 birthday; however the rationale eludes me. So I called the AQHA for an explanation. They didn't know either but they said if I join the AQHA I would receive a discount on Michelin Tires ; . Likewise, the AApA didn't know; but they recognize each foal's actual birthday they define a weanling as "under 12 months", so you still have an age discrepancies in competition ; . If it just a matter of convenience, why not choose July 1 as the official birthday as they do in the Southern Hemisphere? Or flatter me and designate October 29. That would be a lot more convenient for me and all horse breeders. Breeders want to give their foals every conceivable advantage. The greatest legal ; advantage a foal could have is a birthday on January 1. Unfortunately, it was preordained by God that mares would naturally cycle and foal out during the fair weather between May and October. From roughly November until April most mares stop having heat cycles and enter a period of reproductive hibernation called anestrus. In the spring, as the days get longer and warmer, mares once again go into heat. However, there is a time period of quite variable length called transition when she shows signs of heat but will not ovulate release the egg ; . Once the mare does finally ovulate, she is off to the races with regular heat cycles. Pregnancy in horses lasts approximately 11 months. Therefore, to get a January foal it is necessary to breed the mare in February. Because mares are normally in deep anestrus, breeders must convince the mare that it is May. The only reliable way to achieve this super-natural feat is with artificial lighting at specific intensity. 16 hours of light and 8 hours of darkness each day for about 60 days will bring the mare into transition. If you do the math correctly, to get a February breeding it is necessary to start mares "under lights" in early December. Often, as February rolls around, many breeders will ask me for a "shot" to bring the mare into heat. As I have already stated, the only reliable way to induce a mare to cycle is 2 months of artificial lighting which brings the mare into "transition". Once the mare is in transition, several drug regimens can be used to hasten ovulation release of the egg, for instance, cephalexin.

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Participant: A policyholder or dependent enrolled in the PEIA PPB Plan A or B. PEIA PPB Plan A: The standard PEIA PPB Plan offered to all eligible employees. PEIA PPB Plan B: The lower-cost PEIA PPB Plan offered to all eligible active employees. Plan B offers lower premiums with higher deductibles, higher out-of-pocket maximums, and higher copayments for prescription drugs. The medical coverage is the same as in Plan A. The differences in deductibles, out-of-pocket maximums and drug copayments are noted in the benefit tables in the "Medical Benefits" section and the "Prescription Drug Benefit" section of this book. PEIA PPO: The PEIA PPO is the network of providers from whom PEIA PPB Plan participants can receive care to get the highest level of benefit. This network consists of all WV providers who provide health care services or supplies to any PEIA participant. For services provided outside of the State, several networks are available. Contact Acordia National with questions about out-of-state providers. Plan: The plan of benefits offered by the Public Employees Insurance Agency, including the PEIA PPB Plans, managed care plans and life insurance coverages. Plan Year: A 12-month period beginning July 1 and ending June 30. Policyholder: The employee, retired employee, surviving dependent or COBRA participant in whose name the PEIA provides any health or life insurance coverage. Preauthorization: A voluntary program that allows you to obtain prior approval for a service to assure that it will be covered by the Plan. Preauthorization is handled by Acordia National. Precertification: The required process of reporting any inpatient stay and certain outpatient procedures in advance to obtain approval for the admission or service. Acordia National handles precertification. Pre-existing Condition: A physical or mental condition that had been diagnosed or treated, or for which the patient incurred expenses in the three months prior to becoming covered by the Plan. Preferred Provider Organization PPO ; : A plan that uses a network of providers to provide benefits at the highest benefit level. PPO plans also offer out-of-network benefits with higher member cost-sharing. Premium: The payment required to keep coverage in force. Prior Approval: The required process of obtaining approval from Acordia National for out-of-state or out-of-network care under the PEIA PPB Plan. Prior Authorization: The required process of obtaining authorization from the Rational Drug Therapy Program for coverage for some prescription medications under the PEIA PPB Plan. Provider Discount: A previously determined percentage that is deducted from a provider's charge or payment amount and is not billable to the insured when PEIA is the primary payer and the service is provided in West Virginia or by a PPO network provider. Rational Drug Therapy Program RDT ; : The Rational Drug Therapy Program of the WVU School of Pharmacy provides clinical review of requests for drugs that require prior authorization under the PEIA PPB Plan. Reasonable and Customary: The prevailing range of charges and fees charged by providers of similar training and experience, located in the same area, taking into consideration any unusual circumstances of the patient's condition that might require additional time, skill or experience to treat successfully. Secondary Payer: The plan or coverage whose benefits are determined after the primary plan has paid. Order of payment is determined by rules described under "Which Plan Pays First" on page 60. Third Party Administrator TPA ; : A company with which PEIA has contracted to provide services such as customer service, utilization management and claims processing to PEIA PPB Plan participants. Utilization Management: A process by which PEIA controls health care costs. Components of utilization management include preadmission and concurrent review of all inpatient stays, known as precertification; prior review of certain outpatient surgeries and services; and medical case management. Utilization management is handled by Acordia National. Waiver of Premium: If you become disabled before age 60, and while insured, your basic life insurance coverage will continue as long as you are disabled without further payment of premium. To be considered disabled, you must be unable to do any work for pay or profit. Application for a waiver of premium must be provided to PEIA's life insurance carrier within 12 months of your last day worked. 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Niederman MS, Mandell LA, Anzueto A, et al. Guidelines for the management of adults with community-acquired pneumonia: diagnosis, assessment of severity, antimicrobial therapy, and prevention. J Respir Crit Care Med. 2001; 163: 1730-1754. E, Gonzales R. Management of acute bronchitis in healthy adults. Infect Dis Clin North Am. 2004; 18: 919-937; x. 3. National Health Survey 1995. Vital Health Stat. 10, 1998; 199: Sethi S. Infectious etiology of acute exacerbations of chronic bronchitis. Chest. 2000; 117 5 Suppl 2 380S-385S. 5. Grossman RF. Guidelines for the treatment of acute exacerbations of chronic bronchitis. Chest. 1997; 112 6 Suppl ; : 310S-313S. 6. Poole MD, Portugal LG.Treatment of rhinosinusitis in the outpatient setting. J Med. 2005; 118 Suppl 7A: 45S-50S. 7. Bartlett JG, Mundy LM. Community-acquired pneumonia. N Engl J Med. 1995; 333: 1618-1624. Guthrie R. Community-acquired lower respiratory tract infections: etiology and treatment. Chest. 2001; 120: 2021-2034. Sinus and Allergy Health Partnership.Antimicrobial treatment guidelines for acute bacterial sinusitis. Otolaryngol Head Neck Surg. 2004; 130: 1-45. Centers for Disease Control. Defining the public health impact of drugresistant Streptococcus pneumoniae: report of a working group. MMWR Recomm Rep. 1996; 45 RR-1 Suppl ; : 1-20. 11. Bartlett JG, Dowell SF, Mandell LA, et al. Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America. Clin Infect Dis. 2000; 31: 347-382. Hoban DJ, Doern GV, Fluit AC, et al.Worldwide prevalence of antimicrobial resistance in Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in the SENTRY Antimicrobial Surveillance Program, 1997-1999. Clin Infect Dis. 2001; 32 Suppl 2 ; : S81-S93. 13.Thibodeau KP, Viera AJ ypical pathogens and challenges in communityacquired pneumonia--practical therapeutics. Fam Physician. 2004; 69: 1699-1706. Spika JS, Facklam RR, Plikaytis BD, et al; the Pneumococcal Surveillance Working Group. Antimicrobial resistance of Streptococcus pneumoniae in the United States, 1979-1987. J Infect Dis. 1991; 163: 1273-1278. Doern GV, Heilman KP, Huynk HK, et al.Antimicrobial resistance among clinical isolates of Streptococcus pneumoniae in the United States during 19992000, including a comparison of resistance rates since 1994-1995. Antimicrob Agents Chemother. 2001; 45: 1721-1729. Doern GV, Richter SS, Miller A, et al. Antimicrobial resistance among Streptococcus pneumoniae in the United States: have we begun to turn the corner on resistance to certain antimicrobial classes? Clin Infect Dis. 2005; 41: 139-148. Jenkins SG, Farrell DJ, Patel M, Lavin BS.Trends in anti-bacterial resistance among Streptococcus pneumoniae isolated in the USA, 2000-2003: PROTEKT US years 1-3. J Infect. 2005; 51: 355-363. Doern GV, Brown SD.Antimicrobial susceptibility among communityacquired respiratory tract pathogens in the USA: data from PROTEKT US 2000-01. J Infect. 2004; 48: 56-65. Iannini P, Paladino, Schentag. Failures of empiric oral macrolide or betalactam therapy of CAP caused by S. pneumoniae resulting in hospitalization. Presented at the 45th annual Interscience Conference on Antimicrobial Agents and Chemotherapy; Washington, DC; December 16-19, 2005.Abstract LB-6. 20.Vanderkooi OG, Low DE, Green K, et al; Toronto Invasive Bacterial Disease Network: Predicting antimicrobial resistance in invasive pneumococcal infections. Clin Infect Dis. 2005; 40: 1288-1297. Data on file PROTEKT US 2001-2004 ; . Bridgewater, NJ: sanofi-aventis; 2005. 22. Mandell LA, Bartlett JG, Dowell SF, et al. Update of practice guidelines for and acomplia.

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