All in One

There are two basic steps to getting your site online and registering/reserving a domain name is the first.

A domain name makes up the address of your site and can end in .com, .net, .org, .info, .us, .biz, .tv and more. Throughout this site you will also see the domain name referred to as the "dot com name".

Once you have registered your name, you will select a web host (2nd step). The web host is the guts of any website because this is where you create and publish your pages, build order forms, add functionality and maintain your site.

First, let's focus on selecting the best domain name for your site...

How to Select the Best Domain Name

If being found in the major search engines (Google, Yahoo, etc.) is extremely important to you, I highly recommend you register a name that contains your major keywords instead of your company name.

Think about it. The average surfer searches by subject, not by proper name. So why it may seem cool to have a name like TimothysToolTyme.com, you'll want to choose a name that includes keywords that your target audience would likely use when they search.

So with that in mind, a name like Tool-Tips-for-Beginners.com would be much better than TimothysToolTyme.com. Sure, you can still list your company name on your web pages, but I believe it's more important to make sure the domain name includes your important "search friendly" keywords if you want to receive traffic from all over.

Of course, you can still list your company name on the web site some place, but your domain name will include all the important keywords you'll want to be found with.

Now, as always, there are exceptions...

If you are just creating a website for a local business, getting traffic from all over the web may not be as important to you. This is because your customers will be local and you may want to grow your brand name in a specific area.

If this is the case, it may make more sense to register your company name and create brand awareness locally instead of trying to capitalize on search engine presence.

For example, let's say you have a company called J.W. Reed & Co and you help people get rid of debt, but you're based in Kansas and can only cater to residents in this area.

Since you are only servicing local clients, you may not care if someone in California can find your site in Google since they are not likely to become one of your customers.

In this case, it's not as important to register a name filled with "search optimized" keywords. You may decide to just reserve the company name, JWReedAndCo.com.

NOTE: Keep in mind that the domain name is not the only factor weighed by search engines when deciding your rank.

The content on your web pages and your site's popularity (inbound links from other sites) is very important too. However, it certainly doesn't hurt to make sure your name is optimized for maximum results.

Here are some more tips on choosing the best domain name:

1) Don't register domain names that are too long and have too many syllables if you can help it. Yes, you can register names up to 63 characters long, but that doesn't mean you have to use all 63 characters.

You want your name to be easy to remember. Not everyone will bookmark your page initially so try to think of something that can be easily remembered -- although I realize this may be tricky since a lot of names are taken these days.

2) Use hyphens if your name is more than 3 words long (unless your name includes 3 short words). A name like carbuying.com doesn't really need a hyphen because it's readable the way it is.

However a name like used-car-buying-scams.com looks better than usedcarbuyingscams.com since there are so many words in the name.

3) Protect your name by registering multiple extensions (.net, .org, etc.) This deters people from copying your name. For example, if you own garden-tips-for-us.com you can also register garden-tips-for-us.net and any other extension that's available.

You don't have to build a site on all the domains, but you can reserve the others to keep people (copycats) from registering them.

How to Register a Domain Name

Reserving a domain name is easy and very cost friendly. The big name companies like Register.com and NetworkSolutions.com charge ridiculous prices such as $30-35/year for one domain name, and you get the same service at WebsitePalace.com for much less.

It doesn't matter where you register your domain. Every registrar provides the same services.

You can save a bundle at WebsitePalace.com, and you get a bunch of freebies such as a blog, domain forwarding and a free starter page.

Pay per click (PPC) is an advertising model used on search engines, advertising networks, and content websites/blogs, where advertisers only pay when a user actually clicks on an ad to visit the advertiser's website. Advertisers bid on keywords they predict their target market will use as search terms when they are looking for a product or service. When a user types a keyword query matching the advertiser's keyword list, or views a page with relevant content, the advertiser's ad may be shown. These ads are called a "Sponsored link" or "sponsored ads" and appear next to or above the "natural" or organic results on search engine results pages, or anywhere a webmaster/blogger chooses on a content page.

Pay per click ads may also appear on content network websites. In this case, ad networks such as Google AdSense and Yahoo! Publisher Network attempt to provide ads that are relevant to the content of the page where they appear, and no search function is involved.

While many companies exist in this space, Google AdWords, Yahoo! Search Marketing, and Microsoft adCenter are the largest network operators as of 2007. Minimum prices per click, often referred to as Costs Per Click (CPC), vary depending on the search engine, with some as low at $0.01. Very popular search terms can cost much more on popular engines. Arguably this advertising model may be open to abuse through click fraud, although Google and other search engines have implemented automated systems to guard against this.^[1]

Categories

PPC engines can be categorized into two major categories "Keyword" or sponsored match and "Content Match". Sponsored match displays your listing on the search engine itself whereas content match features ads on publisher sites and in newsletters and emails. ^[2]

There are other types of PPC engines that deal with Products and/or services. Search engine companies may fall into more than one category. More models are continually evolving. Pay per click programs do not generate any revenue solely from traffic for sites that display the ads. Revenue is generated only when a user clicks on the ad itself.

Keyword PPCs

Advertisers using these bid on "keywords", which can be words or phrases, and can include product model numbers. When a user searches for a particular word or phrase, the list of advertiser links appears in order of the amount bid. Keywords, also referred to as search terms, are the very heart of pay per click advertising. The terms are guarded as highly valued trade secrets by the advertisers, and many firms offer software or services to help advertisers develop keyword strategies. Content Match, will distribute the keyword ad to the search engine's partner sites and/or publishers that have distribution agreements with the search engine company.

As of 2007, notable PPC Keyword search engines include: Google AdWords, Yahoo! Search Marketing, Microsoft adCenter, Ask, LookSmart, Miva, Yandex and Baidu.

Online Comparison Shopping Engines

"Product" engines let advertisers provide "feeds" of their product databases and when users search for a product, the links to the different advertisers for that particular product appear, giving more prominence to advertisers who pay more, but letting the user sort by price to see the lowest priced product and then click on it to buy. These engines are also called Product comparison engines or Price comparison engines.

Some Online Comparison Shopping engines such as Shopping.com use a PPC model and have a defined rate card. ^[3] whereas others such as Google Product Search, part of Google Base (previously known as Froogle) do not charge any type of fee for the listing but still require an active product feed to function.^[4]

Noteworthy PPC Product search engines include: Shopzilla, NexTag, and Shopping.com.

Service PPCs

"Service" engines let advertisers provide feeds of their service databases and when users search for a service offering links to advertisers for that particular service appear, giving prominence to advertisers who pay more, but letting users sort their results by price or other methods. Some Product PPCs have expanded into the service space while other service engines operate in specific verticals.

Noteworthy PPC services include NexTag, SideStep, and TripAdvisor.

[edit] Pay per call

Similar to pay per click, pay per call is a business model for ad listings in search engines and directories that allows publishers to charge local advertisers on a per-call basis for each lead (call) they generate. The term "pay per call" is sometimes confused with "click to call"[1]. Click-to-call, along with call tracking, is a technology that enables the “pay-per-call” business model.

Pay-per-call is not just restricted to local advertisers. Many of the pay-per-call search engines allows advertisers with a national presence to create ads with local telephone numbers.

According to the Kelsey Group, the pay-per-phone-call market is expected to reach US$3.7 billion by 2010.

Pay per delivery (PPD)

A variation on pay per click used in email marketing, whereby email marketing campaigns are charged only on the basis of successfully delivered emails.

Unintentional weight loss

It has been suggested that healthy weight loss be merged into this article or section. (Discuss)

A significant loss of total body weight is a serious, chronic illness. Substantial, unintentional weight loss is a symptom of acute or chronic illness, especially if other evidence is present.

Weight loss, for example, accompanied by early satiety, bilious vomiting of partially undigested food, postprandial epigastric pain and eructation may indicate Superior Mesenteric Artery Syndrome^[1]. Weight loss accompanied by insatiable thirst and hunger and fatigue may indicate diabetes mellitus, a chronic disease characterized by an abnormal accumulation of carbohydrates in the bloodstream due to insufficient production of insulin, a hormone produced in the pancreas that, when secreted into the bloodstream, permits cellular metabolism and utilization of glucose.

Poor management of type 1 diabetes mellitus, also known as insulin-dependent diabetes mellitus (IDDM), leads to an excessive amount of glucose and an insufficient amount of insulin in the bloodstream. This triggers the release of triglycerides from adipose (fat) tissue and catabolism (breakdown) of amino acids in muscle tissue. This results in a loss of both fat and lean mass, leading to a significant reduction in total body weight. Note that untreated type 1 diabetes mellitus will usually not produce weight loss, as these patients get acutely ill before they would have had time to lose weight.

Myriad of additional scientific considerations are applicable to weight loss, including but not limited to: physiological and exercise sciences, nutrition science, behavioral sciences, and other sciences.

One area involves the science of bioenergetics including biochemical and physiological energy production and utilization systems, that is frequently evidence of diabetes, and ketone bodies, acetone particles occurring in body fluids and tissues involved in acidosis, also known as ketosis, somewhat common in severe diabetes.

In addition to weight loss due to a reduction in fat and lean mass, illnesses such as diabetes, certain medications, lack of fluid intake and other factors can trigger fluid loss. And fluid loss in addition to a reduction in fat and lean mass exacerbates the risk for cachexia.

Infections such as HIV may alter metabolism, leading to weight loss.^[2]

Hormonal disruptions, such as an overactive thyroid (hyperthyroidism) , may also exhibit as weight loss.^[3]

Intentional weight loss

Weight loss may refer to the loss of total body mass in an effort to improve fitness, health, and/or appearance.

Therapeutic weight loss, in individuals who are overweight, can decrease the likelihood of developing diseases such as diabetes.^[4] Overweight and obese individuals face a greater risk of health conditions such as type 2 diabetes, heart disease, high blood pressure, stroke, osteoarthritis^[5] and certain types of cancer. For healthy weight loss, a physician should be consulted to develop a weight loss plan that is tailored to the individual.

Weight loss occurs when an individual is in a state of negative energy balance. When the human body is spending more energy in work and heat than it is gaining from food or other nutritional supplements, it will catabolise stored reserves of fat or muscle.

Although weight loss may involve loss of fat, muscle or fluid, weight loss for the purposes of maintaining health should aim to lose fat while conserving muscle and fluid.^{[citation needed]}

It is not uncommon for people who are already at a medically healthy weight to intentionally lose weight. In some cases it is with the goal of improving athletic performance or to meet weight classifications in a sport. In other cases, the goal is to attain a more attractively shaped body. Being underweight is associated with health risks. Health problems can include difficulty fighting off infection, osteoporosis, decreased muscle strength, trouble regulating body temperature and even increased risk of death.^[6]

Physical Activity

Aerobic exercise

Anaerobic exercise

Strength training

Dieting

Carbohydrate restriction

Protein restriction

Fat restriction

Combination restriction

Therapeutic weight loss techniques

Main article: Bariatrics

The least intrusive weight loss methods, and those most often recommended by physicians, are adjustments to eating patterns and increased physical exercise. Usually, health professionals will recommend that their overweight patients combine a reduction of the caloric content of the diet with an increase in physical activity.^[7]

Other methods of losing weight include use of drugs and supplements that decrease appetite, block fat absorption, or reduce stomach volume. Surgery is another method. Bariatric surgery artificially reduces the size of the stomach, limiting the intake of food energy. Some of these treatments may have serious side-effects.

"Crash Dieting"

A crash diet (also known as "fasting") is where a person willfully restricts themselves of all nourishment (except water) for more than 12 hours. The desired result is to have the body burn fat for energy with the goal of losing a significant amount of weight in a short time. Crash dieting is not the same as flexible intermittent fasting, where dieters fast for 2 days each week and calories are cycled. Generally the weight lost in a crash diet returns when normal eating resumes.

Weight loss industry

In the developed world, there is a substantial market for products which promise to make weight loss easier, quicker, cheaper, more reliable, or less painful. These include books, CDs, cremes, lotions, pills, rings and earrings, body wraps, body belts and other materials, fitness centers, personal coaches, weight loss groups and food products and supplements. US residents in 1992 spent an estimated $30 billion a year on all types of diet programs and products, including diet foods and drinks.^[8]

History

Distance education dates back to at least as early as 1728, when "an advertisement in the Boston Gazette...[named] 'Caleb Phillips, Teacher of the new method of Short Hand" was seeking students for lessons to be sent weekly.^[1] Modern distance education has been practiced at least since Isaac Pitman taught shorthand in Great Britain via correspondence in the 1840s.^[2] The development of the postal service in the 19th century lead to the growth of Commercial correspondence colleges with nation-wide reach.

The University of London was the first university to offer distance learning degrees, establishing its External Programme in 1858.^[3] Another pioneering institution was the University of South Africa, which has been offering Correspondence Education courses since 1946. The largest distance education university in the United Kingdom is the Open University founded 1969. In Germany the FernUniversität in Hagen was founded 1974. There are now many similar institutions around the world, often with the name Open University (in English or in the local language), and these are listed below.

Charles Wedemeyer of the University of Wisconsin at Madison is considered the father of modern distance education in America. From 1964-1968 the Carnegie Foundation funded Wedemeyer's Articulated Instructional Media Project (AIM) which brought in a variety of communications technologies aimed at providing learning to an off-campus population. According to Moore's recounting, AIM impressed the British who imported these ideas and used them to create the first Open University, now called United Kingdom Open University (UKOU) to distinguish it from other open universities which have emerged. UKOU was established in the late 1960s and used television and radio as its primary delivery methodologies, thus placing it in the forefront of applying emerging technologies to learning. It is fair to say that all "open universities" use distance education technologies as delivery methodologies.^[4]

There are many private and public, non-profit and for-profit institutions offering courses and degree programs through distance education. Levels of accreditation vary; some institutions offering distance education in the United States have received little outside oversight, and some may be fraudulent diploma mills. In many other jurisdictions, an institution may not use the term "University" without accreditation and authorisation, normally by the national government. Online education is rapidly increasing among mainstream universities in the United States, where online doctoral programs have even developed at prestigious research institutions. ^[5]

In the twentieth century, radio, television, and the Internet have all been used to further distance education. Computers and the Internet have made distance learning distribution easier and faster. ^[6]

In 2006 the Sloan Consortium reported that more than 96 percent of the largest colleges and universities in the United States offered online courses and that almost 3.2 million U.S. students were taking at least one online course during the fall 2005 term. ^[7]

[edit] Technologies Used in Delivery

The types of available technologies used in distance education are divided into two groups: synchronous and asynchronous. Synchronous technology is used in distance education lessons in which learning is occurring in different places but at the same time. Asynchronous technology is used in lessons in which learning is occurring in different places but also at different times.

Types of Synchronous technologies include:
-telephone
-boradcast video
-internet chat (such as AIM)
-videoconferencing
-net meeting

Types of Asynchronous technologies include:
-voice mail/fax
-videocassette
-audiocassette
-internet conferencing
-e-mail
-print materials^[8]

[edit] Types of distance education courses

• Correspondence conducted through regular mail
• Internet conducted either synchronously or asynchronously
• Telecourse/Broadcast, in which content is delivered via radio or television
• CD-ROM, in which the student interacts with computer content stored on a CD-ROM
• PocketPC/Mobile Learning where the student accesses course content stored on a mobile device or through a wireless server

Distance Education has traversed four to five 'generations' of technology in its history. These are print, audio/video broadcasting, audio/video teleconferencing, computer aided instruction, e-learning/ online-learning, computer broadcasting/webcasting etc. Yet the radio remains a very viable form, especially in the developing nations, because of its reach. In India the FM Channel is very popular and is being used by universities, to broadcast educational programs of variety on areas such as teacher education, rural development, programs in agriculture for farmers, science education, creative writing, mass communication, in addition to traditional courses in liberal arts, science and business administration. The increasing popularity of mp3 players, PDAs and Smart Phone has provided an additional medium for the distribution of distance education content, and some professors now allow students to listen or even watch video of a course as a Podcast ^[9]. Some colleges have been working with the U.S. military to distribute entire course content on a PDA to deployed personnel. ^[10]

In at least one instance, an online course has been run entirely in a 3D virtual world through the popular online community Second Life ^[11]. This approach has also been used in conjunction with on-campus class meetings, making the separation between distance and on-campus students increasingly insignificant.

In short then, though a range of technology presupposes a distance education 'inventory' it is technological appropriateness and connectivity, such as computer, or for that matter electrical connectivity that should be considered, when we think of the world as a whole, while fitting in technological applications to distance education.

Second Life has recently become one of the cutting-edge virtual classrooms for major colleges and universities, including Princeton, Rice University, University of Derby (UK), Vassar, the Open University (UK),^[12]. In 2007 Second Life started to be used for foreign language tuition ^[13]. Both Second Life and real life language educators have begun to use the virtual world for language tuition. English (as a foreign language) has gained a presence through several schools, including the British Council, which has focused on the Teen Grid. Spain’s language and cultural institute “Instituto Cervantes” has an island on Second Life. A list of educational projects (including some language schools) in Second Life can be found on the SimTeach site.

[edit] Testing and evaluation

Distance education has had trouble since its conception with the testing of material. The delivery is fairly straightforward, which makes sure it is available to the student and he or she can read it at their leisure. The problem arises when the student is required to complete assignments and testing. Whether quizzes, tests, or examinations; Online courses have had difficulty controlling cheating because of the lack of teacher control. In a classroom situation a teacher can monitor students and visually uphold a level of integrity consistent with an institution's reputation. With distance education the student can be removed from supervision completely. Some schools address integrity issues concerning testing by requiring students to take examinations in a controlled setting.^[14]

Assignments have adapted by becoming larger, longer, and more thorough so as to test for knowledge by forcing the student to research the subject and prove they have done the work. Quizzes are a popular form of testing knowledge and many courses go by the honor system regarding cheating. Even if the student is checking questions in the textbook or online, there may be an enforced time limit or the quiz may be worth so little in the overall mark that it becomes inconsequential. Exams and bigger tests may be harder to regulate. In smaller tests a professor may employ another computer program to keep all other programs from running on the computer reducing the possibility of help from the Internet.

Used in combination with invigilators, a pre-arranged supervisor trusted with over-looking big tests and examinations may be used to increase security. Many Midterms and Final examinations are held at a common location so that professors can supervise directly. Many of these examinations are still on the computer in which case the same program blocking software can be used. When the Internet became a popular medium for distance education many websites were founded offering secure exam software and packages to help professors manage their students more effectively.

1. Careless pay more. An obvious thing to say, huh? Though, you won’t believe the number of people who have a broken or an old car in their garage for months or years and still pay auto insurance premium for that junk. If it is your case – don’t be mad at us to be a little rude. Just take actions – renew your motor policy and do not cover the old vehicle you do not use.

2. Yes, yearly payment figures are large and scary. Yes, it is a bit frustrating to see your account cut by this amount of money. And, Yes, the annual payments are the real money savers in case of car insurance. Despite the fact that monthly fees seem to be more convenient, they happen to be much more expensive in the end. Just think of 12 bank transactions you have to make: each time you will be charged extra money for bank operations. Twelve times you will receive payment notice. Who do you think covers the mail expenses for insurers? Of course their customers, and hence, you. If you are serious about saving on auto insurance – prefer annual payments.

3. You do not have to be a financial analyst, a great economist or master Joda to get an affordable car insurance. All you have to do is to connect your computer to the Internet and spend some time looking for online insurance quotes. These things are really amazing! You enter your zip code and get vehicle insurance quotes from a number of your local providers in 5 seconds. Then you choose the most suitable variant: the cheapest one or the one with the maximum coverage or anything else. Then you may also purchase the policy via internet. Some insurers even give discounts for online customers. Anyway, you can find lots of valuable information in the Internet that will help you find a cheap auto insurance with good coverage.

Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos.^[1] In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and chest cavity), but it may also occur in the peritoneum (the lining of the abdominal cavity) or the pericardium (a sac that surrounds the heart).

Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products. Unlike lung cancer, there is no association between mesothelioma and smoking.^[2]

Signs and symptoms

Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma.

Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.

These symptoms may be caused by mesothelioma or by other, less serious conditions.

Mesothelioma that affects the pleura can cause these signs and symptoms:

• chest wall pain
• pleural effusion, or fluid surrounding the lung
• shortness of breath
• fatigue or anemia
• wheezing, hoarseness, or cough
• blood in the sputum (fluid) coughed up

In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung. The disease may metastasize, or spread, to other parts of the body.

Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:

• abdominal pain
• ascites, or an abnormal buildup of fluid in the abdomen
• a mass in the abdomen
• problems with bowel function
• weight loss

In severe cases of the disease, the following signs and symptoms may be present:

• blood clots in the veins, which may cause thrombophlebitis
• disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs
• jaundice, or yellowing of the eyes and skin
• low blood sugar level
• pleural effusion
• pulmonary emboli, or blood clots in the arteries of the lungs
• severe ascites

A mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs.

[edit] Diagnosis

Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).

If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.

If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.

Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by diseased mesothelioma cells. The procedure could diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients.^[3]

[edit] Screening

There is no universally agreed protocol for screening people who have been exposed to asbestos. However some research indicates that the serum osteopontin level might be useful in screening asbestos-exposed people for mesothelioma. The level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening.^[4]

[edit] Staging

Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.

[edit] Pathophysiology

The mesothelium consists of a single layer of flattened to cuboidal cells forming the epithelial lining of the serous cavities of the body including the peritoneal, pericardial and pleural cavities. Deposition of asbestos fibres in the parenchyma of the lung may result in the penetration of the visceral pleura from where the fibre can then be carried to the pleural surface, thus leading to the development of malignant mesothelial plaques. The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibres from the lung are transported to the abdomen and associated organs via the lymphatic system. Additionally, asbestos fibres may be deposited in the gut after ingestion of sputum contaminated with asbestos fibres.

Pleural contamination with asbestos or other mineral fibres has been shown to cause cancer. Long thin asbestos fibers (blue asbestos, amphibole fibers) are more potent carcinogens than "feathery fibers" (chrysotile or white asbestos fibers).^[5] However, there is now evidence that smaller particles may be more dangerous than the larger fibers.[1][2] They remain suspended in the air where they can be inhaled, and may penetrate more easily and deeper into the lungs. "We probably will find out a lot more about the health aspects of asbestos from [the World Trade Center attack], unfortunately," said Dr. Alan Fein, chief of pulmonary and critical-care medicine at North Shore-Long Island Jewish Health System. Dr. Fein has treated several patients for "World Trade Center syndrome" or respiratory ailments from brief exposures of only a day or two near the collapsed buildings.[3]

Mesothelioma development in rats has been demonstrated following intra-pleural inoculation of phosphorylated chrysotile fibres. It has been suggested that in humans, transport of fibres to the pleura is critical to the pathogenesis of mesothelioma. This is supported by the observed recruitment of significant numbers of macrophages and other cells of the immune system to localised lesions of accumulated asbestos fibres in the pleural and peritoneal cavities of rats. These lesions continued to attract and accumulate macrophages as the disease progressed, and cellular changes within the lesion culminated in a morphologically malignant tumour.

Experimental evidence suggests that asbestos acts as a complete carcinogen with the development of mesothelioma occurring in sequential stages of initiation and promotion. The molecular mechanisms underlying the malignant transformation of normal mesothelial cells by asbestos fibres remain unclear despite the demonstration of its oncogenic capabilities. However, complete in vitro transformation of normal human mesothelial cells to malignant phenotype following exposure to asbestos fibres has not yet been achieved. In general, asbestos fibres are thought to act through direct physical interactions with the cells of the mesothelium in conjunction with indirect effects following interaction with inflammatory cells such as macrophages.

Analysis of the interactions between asbestos fibres and DNA has shown that phagocytosed fibres are able to make contact with chromosomes, often adhering to the chromatin fibres or becoming entangled within the chromosome. This contact between the asbestos fibre and the chromosomes or structural proteins of the spindle apparatus can induce complex abnormalities. The most common abnormality is monosomy of chromosome 22. Other frequent abnormalities include structural rearrangement of 1p, 3p, 9p and 6q chromosome arms.

Common gene abnormalities in mesothelioma cell lines include deletion of the tumor suppressor genes:

• Neurofibromatosis type 2 at 22q12
• P16^INK4A
• P14^ARF

Asbestos has also been shown to mediate the entry of foreign DNA into target cells. Incorporation of this foreign DNA may lead to mutations and oncogenesis by several possible mechanisms:

• Inactivation of tumor suppressor genes
• Activation of oncogenes
• Activation of proto-oncogenes due to incorporation of foreign DNA containing a promoter region
• Activation of DNA repair enzymes, which may be prone to error
• Activation of telomerase
• Prevention of apoptosis

Asbestos fibres have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favour the development of mesothelioma. Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences.

Asbestos also may possess immunosuppressive properties. For example, chrysotile fibres have been shown to depress the in vitro proliferation of phytohemagglutinin-stimulated peripheral blood lymphocytes, suppress natural killer cell lysis and significantly reduce lymphokine-activated killer cell viability and recovery. Furthermore, genetic alterations in asbestos-activated macrophages may result in the release of potent mesothelial cell mitogens such as platelet-derived growth factor (PDGF) and transforming growth factor-β (TGF-β) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres.

Structured Settlements in the United States

The United States has enacted structured settlement laws and regulations at both the federal and state levels. Federal structured settlement laws include sections of the (federal) Internal Revenue Code. State structured settlement laws include structured settlement protection statutes and periodic payment of judgment statutes. Medicaid and Medicare laws and regulations affect structured settlements. To preserve a claimant’s Medicare and Medicaid benefits, structured settlement payments may be incorporated into “Medicare Set Aside Arrangements” “Special Needs Trusts."

Structured settlements have been endorsed by many of the nation's largest disability rights organizations, including the American Association of People with Disabilities [1] and the National Organization on Disability [2].

[edit] Definitions

The United States definition of “structured settlement” for federal income taxation purposes, found in Internal Revenue Code Section 5891(c)(1), is an "arrangement" that meets the following requirements:

• A structured settlement must be established by:
  • A suit or agreement for periodic payment of damages excludable from gross income under Internal Revenue Code Section 104(a)(2); or
  • An agreement for the periodic payment of compensation under any workers’ compensation law excludable under Internal Revenue Code Section 104(a)(1); and
• The periodic payments must be of the character described in subparagraphs (A) and (B) of Internal Revenue Code Section 130(c)(2) and must be payable by a person who:
  • Is a party to the suit or agreement or to a workers' compensation claim; or
  • By a person who has assumed the liability for such periodic payments under a qualified assignment in accordance with Internal Revenue Code Section 130.

[edit] Legal Structure

The typical structured settlement arises and is structured as follows: An injured party (the claimant) settles a tort suit with the defendant (or its insurance carrier) pursuant to a settlement agreement that provides that, in exchange for the claimant's securing the dismissal of the lawsuit, the defendant (or, more commonly, its insurer) agrees to make a series of periodic payments over time. The insurer, a property/casualty insurance company, thus finds itself with a long-term payment obligation to the claimant. To fund this obligation, the property/casualty insurer generally takes one of two typical approaches: It either purchases an annuity from a life insurance company (an arrangement called a "buy and hold" case) or it assigns (or, more properly, delegates) its periodic payment obligation to a third party which in turn purchases an annuity (which arrangement is called an "assigned case").

In an unassigned case, the property/casualty insurer retains the periodic payment obligation and funds it by purchasing an annuity from a life insurance company, thereby offsetting its obligation with a matching asset. The payment stream purchased under the annuity matches exactly, in timing and amounts, the periodic payments agreed to in the settlement agreement. The property/casualty company owns the annuity and names the claimant as the payee under the annuity, thereby directing the annuity issuer to send payments directly to the claimant. If any of the periodic payments are life-contingent (i.e., the obligation to make a payment is contingent on someone continuing to be alive), then the claimant (or whoever is determined to be the measuring life) is named as the annuitant or measuring life under the annuity.

In an assigned case, the property/casualty company does not wish to retain the long-term periodic payment obligation on its books. Accordingly, the property/casualty insurer transfers the obligation, through a legal device called a qualified assignment, to a third party. The third party, called an assignment company, will require the property/casualty company to pay it an amount sufficient to enable it to buy an annuity that will fund its newly accepted periodic payment obligation. If the claimant consents to the transfer of the periodic payment obligation (either in the settlement agreement or, failing that, in a special form of qualified assignment known as a qualified assignment and release), the defendant and/or its property/casualty company has no further liability to make the periodic payments. This method of substituting the obligor is desirable for property/casualty companies that do not want to retain the periodic payment obligation on their books. Typically, an assignment company is an affiliate of the life insurance company from which the annuity is purchased.

An assignment is said to be "qualified" if it satisfies the criteria set forth in Internal Revenue Code Section 130 [3]. Qualification of the assignment is important to assignment companies because without it the amount they receive to induce them to accept periodic payment obligations would be considered income for federal income tax purposes. If an assignment qualifies under Section 130, however, the amount received is excluded from the income of the assignment company. This provision of the tax code was enacted to encourage assigned cases; without it, assignment companies would owe federal income taxes but would typically have no source from which to make the payments.