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Keep accurate notes, records and sketches to describe work performed. Place stakes at designated points and drive them into the ground. Operate and maintain equipment that would include a tablet computer, digital camera, survey grade GPS, robotic total stations along with other measuring tools and Personal Protective Equipment.

Work professionally in the field as a representative of JEO and our clients. Communicate effectively, both written and oral, daily, with the project team. Qualifications High school diploma or G. When working outside, ability to stand for long periods, walk over all types of terrain while caring equipment up to 50 pounds.

Must be able to work in inclement weather conditions. Survey Crew Chief. The ideal candidate will have a minimum of three years Crew Chief experience and survey knowledge which includes: boundary surveying construction staking topographic surveying. Senior Survey Technician. The Survey Technician will: Perform field work on civil engineering, construction and general surveying projects, including topographic, ALTA, boundary, Right of Way and As-builts, Flood Elevation Certifications, Lot Surveys Keep accurate notes, records and sketches to describe work performed Place stakes at designated points and drive them into the ground Operate and maintain equipment that would include a tablet computer, digital camera, survey grade GPS, robotic total stations along with other measuring tools Qualifications High school diploma or G.

Drafts complex boundary surveys and property base maps. Process large topographic surveys. Determine earthwork cuts and fills volumes based on existing and proposed topography.

Prepares moderately difficult to difficult topographic and construction drawings. Supports field assignments as required. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before employees of the organization.

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.

Ability to apply concepts of basic algebra and geometry. Fully competent in the office as it pertains to creating construction staking data and processing preliminary topographic surveys. Able to perform required duties independently with little to no assistance. Knowledge of boundary survey procedures, able to interpret surveys, plats and deeds. The ideal candidate will have a minimum of three years Crew Chief experience and survey knowledge which includes: The Professional Land Surveyor will: Perform field work on civil engineering, construction and general surveying projects, including topographic, ALTA boundary, Right of Way and As-builts, Flood Elevation Certificates, Lot Surveys Keep accurate notes, records, and sketches to describe work performed Place stakes at designated points and drive them into the ground Operate and maintain equipment that would include a tablet computer, digital camera, survey grade GPS, robotic total stations along with measuring tools.

Design Technician. Typical Responsibilities: Participates on a team that makes decisions that effectively balance mobility, environmental impacts, property impacts, cost and long-term maintenance. Analyzes challenges, defines successful solution alternatives, and proactively solves problems.

Motivated, friendly, inclusive, and get-it-done attitude. Four years of full-time work experience in design drafting, cartography, photogrammetry, engineering survey, soils survey, land survey, or construction inspection; and b. Right of Way Coordinator. General Duty Statement Under direction, coordinates right-of-way activities, including plan review, permitting, overseeing construction projects and restoration within the city right-of-way of varying size and complexity.

Distinguishing Features of the Class Responsible for conducting field inspections and initiating administrative enforcement actions to ensure compliance with applicable Federal, State and Local Codes and Ordinances pertaining to construction within the public Right-of-Way.

Supervision Received Works under general supervision of the Chief Development Officer, City Engineer, or other designated supervisor with independence in decisions relating to assignments. Assists citizen, contractors, utility companies and internal staff e. Researches and gathers data on deeds and legal descriptions. Reviews and issues right-of-way permits. Makes field determination and notification to the contractor of non-complying work or materials.

Verifies elevation and other measurements necessary to assure that excavations, backfilling, grading, compaction, alignments, slopes, grades, and elevations are proper. Inspects public sidewalks, identifies defects or hazardous conditions, issues notices to repair, and verifies repairs have been made.

Maintains records and prepares detailed daily diaries and inspection reports on pertinent construction activities for all necessary documentation requirements. Develops and maintains records of construction quantities installed by contractors on a daily basis and confirm construction quantities with contractors on a weekly basis.

Performs data entry in associated software systems. Investigates and responds to citizen complaints and responds to questions and comments in a courteous and timely manner.

Testifies in court, on appeals and when civil infractions are prosecuted. Supports continuous improvement initiatives. Ability and willingness to communicate and coordinate project needs with supervisors, surveyors, engineers and other engineering department personnel. Knowledge of construction materials testing methods and requirements. Knowledge of standard specifications governing public works construction and of problems involved with securing adherence by construction forces.

Ability to make decisions regarding construction-related issues. Good interpersonal skills, ability and willingness establish and maintain effective working relationships with employees, contractors, developers, government officials, representatives of various agencies, the general public and others.

Ability to interpret engineering plans and specifications. Ability to create and maintain accurate records and estimates and to prepare reports. Ability to calculate quantities used on construction projects. Ability to learn and assist in the site location and recording of traffic counts, by electronic means. Knowledge of all safety requirements related to the activities of the department i. Ability to determine long range needs and to plan, organize and oversee work for the accomplishment of objectives, with minimal direct supervision.

Ability to supervise the work of others and assess performance. Good knowledge of the geography of the city. Ability to work effectively as a member of a team to achieve goals. Demonstrates proficiency in operating a computer, iPad and modern day office equipment.

Skill in the use of applicable software programs and willingness to learn new technology. Ability to communicate effectively with others, both orally and in writing.

Ability to deal courteously and tactfully with the public to explain pertinent codes, ordinances and rules. Understanding of and respect for the diversity of others including those whose first language may be one other than English.

Integrity, ingenuity, and inventiveness in the performance of assigned tasks. Ability to be dependable and punctual for work. Sufficient sensory observation capabilities which permit the employee to adequately perform inspection duties. Occasionally perform work indoors, sitting or standing at a desk in front of a computer. Sufficient mental capacity which permits sound decision-making, good judgment, calculating routine mathematical equations rapidly and accurately, interpreting and enforcing laws, codes and procedures.

Sufficient manual dexterity which permits the employee to write field notes, draw simple sketches, operate measurement devices, testing equipment, computer, and other technology.

Routinely perform work outdoors, under a variety of weather conditions, with moderate to high noise level, exposure to dirt, noise, fumes and temperature extremes. Sufficient personal mobility and physical reflexes which permits the employee continuously move to visit various job sites throughout the city, frequently stand, walk on various levels of terrain, bend at the waist and knees, stoop, squat, kneel, climb and reach above and below shoulder level to do measuring and testing, lift and carry equipment and materials up to 50 pounds and visit construction projects on-site at various locations.

Sufficient alertness and considerable mental and visual concentration to ensure attention to detail and accuracy. Occasionally use a respirator. Subject to hazards including a variety of physical conditions such as proximity to moving mechanical parts, moving vehicles, electrical current, working in places of height or close quarters i. Must not pose a direct threat to the health or safety of other individuals in the workplace or citizens encountered during work.

Ability to pass employment physicals including drug testing. Supervisory experience preferred. Survey Instruction Person. Embraces and encourages a culture that thrives on innovative ideas and leading changes that result in effective process and project improvement.

Project schedules are based on hour work weeks. Engineering Technician I. Applications are due by P. July 1, Cedar County is an equal opportunity employer. The county is responsible for the maintenance of nearly bridges and miles of paved, gravel and earth roads. The county averages five construction projects a year which typically involve highway paving, box culverts and bridge projects, most of which are designed and inspected with in-house staff.

Associate degree in Civil Engineering Technology or equivalent experience is required. Applicant must be proficient in AutoCAD. Note that all applications received may be subject to public disclosure. Applicants will be subject to pre-employment drug screening. Class C driver license required and applicant must be insurable.

Specific Qualifications Pre-employment physical and drug test required. Multiple Engineering Technician and Survey Opportunities. Full Time and Intern Technician Opportunities. Building Enclosure Design Professional. Essential Functions: Assist the Building Enclosure Commissioning Providers in reviewing and testing building enclosures in the field.

Record site conditions and observations using written documentation and mobile apps. Work with testing equipment for windows and walls against water intrusion and setting up and observing building pressure testing for tightness of construction. Timely, professional, and accurate production of design documents associated with the delivery of building enclosure design services for new and existing building projects.

Clear communication with other professionals within the building team to understand assigned tasks and work independently to provide roof design and documentation. Adapt to different project delivery methods required by clients and production team members. Qualifications: Candidate should have a basic working knowledge of construction techniques related to architectural principles.

Exhibit the desire and willingness to learn new information through one-on-one training and written resources to develop the knowledge to a be a skilled building enclosure technician. Assist in problem solving and adapting to differing building project types.

Ability to market building enclosure services and interact with clients in a professional manner as a representative of Shive-Hattery. Education: Accredited programs in Building Technology, Construction Management or Architectural Drafting are deemed essential backgrounds for this role. Minimum Physical Requirements: Regular site visits to conduct construction observation under varying climate conditions. Land Surveyor in Training.

As Abaci grows its services and technology, we retain the traditional values that the firm was founded on: We value the resources of our clients and endeavor to complete projects efficiently and under budget.

Application form and job description are available at the Hardin County Engineer’s Office, 16th Street, Eldora, IA , telephone or at www. Hardin County is an equal opportunity employer. Apply Online Questions, contact Bill Thompson, Land Surveyor. Willingness to work outdoors and in adverse weather conditions. Program Instructor – Land Survey Science.

Responsibilities include: develop and teach competency-based curriculum to provide classroom theory and application to prepare students for entry-level positions in their field of study. Minimum of two years of full-time industry experience is required. Three years post-secondary teaching and applied curriculum development experience preferred.

Prior online teaching experience and knowledge of Learning Management Systems preferred. Above average proficiency in project management and processes, and Auto CAD dimensional programs that are relative to current industry standards. Fully functional with Microsoft Office Suite and online communication tools. Post-hire requirement to obtain South Dakota post-secondary teacher credential. Post-hire criminal background check required.

CAD Technician Microstation. Civil Engineering Technician I. Job Details Ingios Geotechnics, Inc. Senior Civil Engineering Technician. Ability to lift and carry 50 pounds. Random drug and alcohol screening. Proposed Start Date Early depending upon applicants’ availability.

Background Check Required. Applications accepted until filled. To apply, send resume to: Andy Eisinger andy teamservices. Two years in related technical school or college; or 2. Minimum Experience years. To apply, send resume to: Brian Foltz bfoltz snyder-associates. CADD Technician. To apply, send resume to: Jason Martin, P.

Duties and Responsibilities: Support an experienced team of project managers, engineers, and other technicians through the production of project exhibits, plans, and other drafting needs. Collaborate with engineers and designers to develop design documents and execute redline markups for transportation related projects.

Compensation will be based on experience and qualifications. We offer competitive benefits and a flexible work environment. HIghway Technician. Current, continuous experience in the state executive branch that includes eighteen months of full-time work as a Highway Technician Associate or Construction Technician Assistant. Prior to starting employment, all persons are required to have a post offer, pre-employment physical verifying the physical ability to perform the duties described.

Within a period of time after hire, as determined by the appointing authority, employees in this class may be required to obtain and maintain Herbicide Applicator certification from the Department of Agriculture and Land Stewardship. Travel, including overnight travel, may be required for positions in this class. Employees must arrange transportation to and from assigned work areas. Within a timeframe determined by the appointing authority, employees in designated positions are required to reside within a defined driving time, during normal conditions, from the assigned work location.

Employees must respond to emergency situations as required. Employees must be able to work up to 16 consecutive hours. Survey Internship. Relocation and housing are not included. We have 24 offices in Minnesota, Iowa, North Dakota, North Carolina, and South Carolina, there are always new challenges and career development opportunities available.

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.

Multiple Engineering Technician and Survey opportunities. As part of a new team, you would: Lead a one or two-person field survey crew to perform a broad scope of survey projects with state-of-the-art Trimble equipment. Oversee the operation and maintenance of survey equipment used on the job site and assist with training others. Prepare field drawings and high-quality notes of each project. Preferred experience basic experience in producing CADD drawings.

Prior use of traditional survey equipment including GNSS devices. Additional Requirements Must be able to work outdoors year around in all weather conditions. Post offer, pre-employment physical. Prior to starting employment, all persons are required to have a post offer pre-employment physical verifying the physical ability to perform the duties described.

To apply, send resume to: Zach Abild zabild northwesterection. To apply, send resume to: Tony Hood TonyH cda-eng. Survey Technician predominately office.

Knowledge and skills in CAD and survey software i. What you will be doing: You will have the opportunity to assist our Project Engineers serving our municipal clients in our Spencer area market. You will perform engineering project design and drafting from working sketches and field data, under direct supervision of an engineer or senior technician. Duties include routine testing and construction observation on municipal projects.

Assisting with design and construction phase activities on municipal projects Performing basic design computations, preliminary layout and design, researching and preparing rough drafts of preliminary reports and feasibility studies Assisting with project plans and specifications, preparing cost and quantity take-off estimates Construction observation activities may include performing construction staking, performing construction administration duties such as documenting activities, measuring and testing, providing general oversight, and interacting with contractors, sub-contractors, residents and City staff.

What we are looking for: Associate Degree in Civil Engineering Technology from an accredited institution or equivalent work experience. Must be capable of working in extended outdoor conditions and you must be physically capable of navigating rugged terrain for the purpose of performing the construction observation duties.

You will be reimbursed for business-related travel. Ability to actively listen to others for understanding of their needs and situations; ability to read, speak and write English clearly is required.

This position interacts with City staff, City residents, contractors and sub-contractors. Engineering Technician – Internship. Requirements: Degree Programs : Selected candidates will be enrolled in a Civil Engineering degree program or closely related program from an accredited post-secondary institution. Minimum Cumulative GPA : 2. Desired GPA 3. Job Specifics: Students must have the ability to work in extended outdoor conditions and be physically capable of navigating rugged terrain for the purpose of performing the duties outlined above.

Students must have the ability to read, speak and write English clearly as this position interacts with City staff, City residents, contractors and sub-contractors. Quality Control Technician intern or full time. Position Overview The Quality Control Technician position is responsible for providing inspection, testing services, and documentation of product for plant facilities.

Use accepted methods to inspect, sample, and test product for the purpose of quality control. Monitor and test process functions and materials daily to ensure our products meet or exceed requirements of the appropriate project. Visit job sites, attend meetings and calls to customers promoting value-added products and to collect market and job information.

Follow quality control plans and guidelines as assigned. Maintain laboratory equipment and perform general cleaning of work area. Advise upper management on product development issues arising from product problems identified through technical support calls with customers.

Complete, maintain, and process pertinent paperwork and records. Other duties as assigned per supervisor. Regular and predictable attendance at assigned times is required.

Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Must obtain and maintain DOT certifications required to test materials as required by state regulations.

One year of experience in a related field preferred, or equivalent combination of education and experience. Knowledge of materials, methods, and tools involved concrete projects and can use such tools properly and safely.

Ability to read, write, and accurately perform basic mathematical functions including adding, subtracting, multiplication and division. Ability to effectively communicate verbally and in writing.

Strong analytical and problem-solving skills. Must possess knowledge of Company policies and procedures, including safety. Must consistently produce and efficient, accurate work product. Work Requirements Must be at least 18 years in age or older. Display a professional and courteous attitude to co-workers, supervisors, and the general public at all times. Must pass post-offer employment drug testing, medical exams, and physical agilities testing. Must be willing to travel and work away from home when required.

Must be willing to work nights and weekends when necessary. Physical Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Able to stand, walk, use hands and fingers to manipulate objects or controls, climb or balance, stoop, kneel, crouch, crawl, talk and hear. May require sitting for extended periods of time. Vision abilities with correction include close, distance, peripheral, depth, and the ability to adjust focus.

Able to climb ladders and to work at heights. Able to work extended hours. Able to work in all weather conditions. Able to work in tight quarters. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

The employee may be occasionally exposed to fumes or airborne particles and toxic or caustic chemicals. The employee may be exposed to risk of electrical shock or burn. The noise level in the work environment is usually moderate to loud.

Work schedule is Monday through Friday with weekend and some holiday and evening work required. Benefits Offered Highly competitive base pay. Comprehensive medical, dental, vision, disability, and life insurance programs. Group retirement savings program. Health and wellness programs. Apply Online at www. Applications and resumes must be received no later than March 25, by P. The Engineering intern will assist the engineering department with field inspections related to.

There will be a variety of duties with responsibility for routine or minor projects or for one or more. To apply, send resume to: Chris Bauer, cbauer shive-hattery. Survey Technician. Civil Engineering Technician. Materials Lab Technician. Any construction materials or DOT-related certifications a plus.

Working Conditions Works in office environment. Instead, MDH provides support to providers to help them achieve the goal of statewide interoperability. Table 3. Restoring function to patients with chronic neck and back pain. Interoperability is the ability of two or more systems or components to exchange information and to use the information. In the context of HIE, interoperability is achieved by using standardized terminology and data structure in the various types of clinical data transactions e.

While most of these standards have been developed, adoption and use of these standards is still limited. It was officially incorporated in December as a nonprofit corporation in Minnesota, however, the idea of independent facilities working together was born years earlier. The cost of health care Multiple changes in the health care industry are driving changes in reimbursement as well as patient utilization. Since , the inpatient rate has dropped throughout the U.

The trend is expected to continue throughout the next decade, even in states with loosely managed utilization trends.

Minnesota, considered to be a state with conservative admitting patterns and an overall healthier population,. Another key issue impacting revenue is the shift by payers, starting with Medicare, from quality incentives to penalties. Hospital-acquired infections and readmissions are reducing payment rates for providers. Patients can and should expect high-quality care from providers. The burden for providers is ensuring that there is staff available to interpret the measures, review and report on results, and identify and implement opportunities for improvement.

The challenge is in the delay between the. Out-of-pocket costs for patients have risen dramatically over the past decade as employers have shifted costs to employees in an effort to slow employee benefit costs. Deductible costs for individuals not covered by employer-sponsored health insurance are even higher. Copays and co-insurance add additional patient costs.

Many patients are choosing to delay medical care as a result of their out-of-pocket costs. Regional demographics In addition to reimbursement changes, health systems in northeastern Minnesota are challenged by the demographics in the region. Medicare is the largest payer for all Wilderness Health members and many have a significant number of Medicaid patients also, meaning that contracted rates are much lower than other payer types. Forming the collaborative Given these financial challenges, several hospitals in northeastern Minnesota began discussions several years ago to identify how they could work together in a more cost-effective, efficient manner that would maintain their independence yet still provide their patients with quality health care.

The governance structure among the participants varied. All are nonprofits, but some are hospital districts with public boards, some owned nursing homes, and most are critical access hospitals. Many do not employ physicians in their facilities and instead have Federally Qualified Health Centers FQHCs or independent physicians in their communities. The groups that initially joined the collaborative would be considered charter members, with approval rights reserved on any new groups that wanted to join at a later date.

Discussions continue with additional hospitals, clinics, provider groups, and stakeholders such as local counties about how we can work together. All members have agreed to resource commitments, including financial and time, in order to be part of the collaborative.

Each charter member has a seat on the board of directors, regardless of size. Members delegate a senior executive from their organization typically their CEO to serve on the board. Membership agreements and budget allocations were approved for and to launch the organization. Because of the large geographical area and traveling distance. Charter members The charter members of Wilderness Health are located in some of the most rural areas of Minnesota and patients often must travel many miles for access to services.

Seven of the nine charter members are critical access hospitals of 25 beds or less. Six facilities also have long-term care facilities on their campus, many of which are owned by the hospitals themselves.

Cook Hospital Cook, Minn. There are some initiatives that will be addressed during the first years of the collaborative. Emerging evidence in the field of minimally invasive gynecology is helping those who treat endometriosis to better understand the treatment modalities that are effective in managing this enigmatic disease.

Endometriosis affects 6 percent to 10 percent of reproductive aged women and is one of the most common sources of chronic pelvic pain. Endometriosis refers to the presence of viable, estrogen-sensitive endometrial glands and stroma with an associated inflammatory response outside of the uterus.

Several conditions show greater concordance with endometriosis: 21 percent to 47 percent of women presenting with subfertility; 71 percent to 87 percent of those with chronic pelvic pain; and 69 percent of adoles-. Endometriosis also has a strong familial component and first-degree relatives of individuals diagnosed with endometriosis are seven to 10 times more likely to have the disease themselves. Economic burden Endometriosis is a public health issue that bears an important economic burden.

It not only causes pain and infertility, but also has consequences related to medication, health care consumption, work absenteeism, impaired quality of life, and psychosocial factors. Most experts agree that the disease is multifactorial in etiology but distinct pathophysiology is not well understood.

Factors such as retrograde menstruation, metaplastic changes of pleuripotent mesothelial cells, and implantation of cells through hematogenous or lymphatic embolization may play a role in the development of endometriosis.

While most women appear to have some degree of retrograde menstruation, not all women develop endometriosis. Those who have endometriosis may have an inherent immune dysfunction that impairs normal clearance yet promotes disease progression. Treatment Laparoscopy is considered the gold standard for the diagnosis of endometriosis with visual identification of classic endometriosis lesions. Histologic confirmation is helpful because visual identification is associated with a high false positive rate.

Many patients may be erroneously diagnosed with or without endometriosis due to the lack of a biopsy of the peritoneum at the time of surgery to provide histologic proof of the existence of endometrial glands and stroma in the sample.

Medical management of endometriosis involves hormonal suppression of endometriosis with oral contraceptives and GnRH agonist medications. The aim of medical management. These therapies can be effective but symptoms usually reoccur shortly after the medication is discontinued.

Surgical management of endometriosis has largely focused on the destruction or removal of all visible endometriosis lesions. These lesions can take many forms, with the classic presentation being a powder-burn appearance on the surface of the abdominal peritoneum.

Endometriosis lesions can also be red, blue, white, or have a more flattened, scarred appearance. Many providers believe that simple ablation of the superficial endometriosis implants is an adequate surgical treatment for the disease. This is usually accomplished with the use of bipolar or monopolar electrocautery. The lesions are usually burned superficially without exploration and removal of the underlying retroperitoneal tissue.

Evidence suggests that this type of therapy is inadequate and that true excisional surgery is much more effective in alleviating pain due to endometriosis and preventing recurrence of the disease. Most patients have their pain return in less than a year after having ablative, non-excisional surgery. More important, these methods do not allow confirmation of visual diagnosis by a pathologist.

Safety of their application to endometriosis treatment has been questioned. Emerging evidence A recent randomized, controlled trial by Healy, et al. Published in the December issue of the Journal of Minimally Invasive Gynecology JMIG , this study compares the efficacy of these two surgical modalities for a variety of outcomes.

Their previously published, one year follow-up. However, when the same patients were interviewed five years after their surgery some differences emerged. Of those that returned the pain assessment survey after five years, 45 patients had undergone excisional surgery and 42 patients had ablative surgery for endometriosis.

Both modalities in surgical management proved effective in reduction of overall pain including menstrual-related pain and pain with voiding or defecation. The statistically significant difference was revealed in that patients who had undergone excisional surgery had less pain related to dyspareunia and less need for medical therapy after surgery. It is possible that if the response rate of the survey had been higher, more differences may have been found. This study does help us to understand that deep infiltrating disease, which is often the cause of dyspareunia, is better treated with excisional surgery.

Advanced surgery When considering where to refer a patient for management of endometriosis or chronic pelvic pain it is important to understand what patients can expect from their surgeons. Surgeons performing endometriosis resection surgery must be comfortable with complicated pelvic adhesions and dissection of retroperitoneal anatomy.

They must be able to navigate bladder and bowel involvement of endometriosis and resect the diseased tissue from these structures. Endometriosis surgeons should be able to repair any bladder and bowel defects caused during resection surgery and must be able to navigate the challenges of a frozen pelvis.

Gynecologists performing endometriosis surgery must have a close working relationship with like-minded colleagues in the fields of urology, colorectal,. Surgical resection can be planned and completed for even the most challenging of patients. Endometriosis was detected in Additional research reveals that endometriosis is being detected and treated more effectively than ever with advanced laparoscopic surgical technology and the da Vinci surgical robot.

Robotic surgery allows the surgeon to work comfortably, reducing fatigue from standing and bending in a long surgical case. Advanced optics allow visualization in high definition with 10x magnification and 3D and many surgeons believe they can see more disease than they were able to with a traditional laparoscope.

Delumba and colleagues reported a Additionally, advanced robotic technology such as Firefly uses integrated fluorescence imaging capability, which provides real-time, image-guided identification of key anatomical landmarks using near-infrared technology. This technology, which has been used since the s for angiography and hemodynamic monitoring, is now finding an application in minimally invasive gynecology.

Firefly takes advantage of the highly vascular nature of endometriosis and helps surgeons identify areas of neovascularization, which is common in this disease. Leaders in endometriosis resection feel that this technology may ultimately help surgeons see more endometriosis and obtain better surgical margins for resection.

While this technology remains. Conclusion Endometriosis is a common disease in women of childbearing age. This disease can be difficult and challenging to manage for health care pro-. With recent advances in minimally invasive surgery and surgical technology, the management of endometriosis is becoming better understood.

As minimally invasive surgeons continue to move the management of endometriosis forward, we are hopeful to see a reduction in the long-term consequences of this disease. Referring physicians should seek out those providers who are comfortable with management of all presentations of endometriosis. A collaborative effort is needed to continue to move this effort forward. He specializes in minimally invasive surgery with a focus on managing uterine fibroids, endometriosis, and pelvic organ prolapse.

Quality Transcription located in Minnesota maintains a professional office environment, thus the confidentiality of your work is strictly maintained. We provide medical transcription services on a contract or overload basis. Our equipment is state of the art with 24 hour dictation lines and nationwide accessibility. We are experts in our field. We deliver on time. We have experienced staff. We monitor the quality of our work. We provide services tailored to your needs and will do whatever it takes to get the job done.

Quality Transcription, Inc. The National Institutes of Health NIH and the Food and Drug Administration FDA are just two organizations that will work to develop the resources necessary to attain these objectives: 1 more and better treatments for cancer, 2 creation of a voluntary national research cohort, 3 commitment to protecting privacy, 4 regulatory modernization, and 5 public-private partnerships. At the center of precision medicine is pharmacogenetics.

What is pharmacogenetics? Different patients can show dramatically different responses to the same medication. Physicians and patients are often left waiting to see if a new medication works and if it is safe. For example, patients lacking glucosephosphate dehydrogenase G6PD activity are more prone to increased side effects from a number of medications. What other genetic. Watch your patients smile! Customize your interior design with familiar but unique art that will comfort and delight all ages.

Seuss dealers. We have many pieces in stock and are pleased to offer them to the health care industry. Louis Park, MN The ultimate goal is to use genetic information to tailor drug therapy that is safe and effective. It is also being used to discover new targets for drug therapy. Pharmacogenetics generally refers to a relatively small number of genetic markers, while pharmacogenomics usually refers to a set of markers spanning the entire genome.

Individual enzyme testing The FDA maintains a list of approved drugs with pharmacogenomic information on their labeling. Labeling does not translate directly to genetic testing, however.

As of Aug. Some of these drugs include the commonly prescribed celecoxib, codeine, glipizide, metoprolol, and warfarin. Classical pharmacokinetics can describe drug absorption or uptake, metabolic activation or deactivation, and elimination. These pharmacokinetic properties are determined by enzymatic activity that itself is determined by genetic sequence. Variation in sequences in genes active in any pharmacokinetic process can alter the activity and side effects of a drug.

Predicting how genetic variation will affect pharmacokinetics in any one individual is the promise of pharmacogenomics. Most medications are subjected to a variety of metabolic enzymes that alter the drug. If a drug is metabolized quickly, it may be eliminated before reaching effective levels. One large family of drug metabolizing enzymes is known as cytochrome P Variations in toxicity and activity of a large number of medications are influenced by variations in genes coding for P enzymes.

Tamoxifen is an example of a commonly used medication that is metabolized by a cytochrome P enzyme. One of the P enzymes is responsible for converting tamoxifen into a more active form.

Genetic polymorphisms variations that are more common than 5 percent in the general population within this particular P gene can be responsible for less tamoxifen activation. Whether people with the less active P enzyme have different breast cancer outcomes is currently under investigation.

Warfarin is another drug that is metabolized by P enzymes. Clinical genetic tests are available to determine if an individual is likely to inactivate warfarin quickly or slowly, and may aid in initial dosing decisions. Since clotting times are measured so frequently with international normalized ratios INRs , the genetic test is rarely used clinically and there is no universal agreement as to its cost effectiveness.

Genetic variations in genes leading to altered drug metabolism are fairly rare in the general population. Therefore, testing individual enzyme activities would lead to a large number of negative tests. The inefficiency of this approach has limited routine enzymatic testing. Genetic testing An alternative to individual enzyme tests is genetic testing. The gene coding for important enzymes in drug metabolism can be sequenced to determine if a person is likely to have.

The appeal of this approach is the increasing efficiency in sequencing genes. The human genome consists of 3,,, base pairs. This large investment initiated a wave of innovation leading to a dramatic drop in the price of DNA sequencing. This technologic revolution makes testing the genes of interest more cost efficient than testing enzyme activity.

Some companies have offered DNA sequencing services directly to the public. The genes sequenced include those responsible for some genetic disorders as well as genes involved in drug metabolism. One company that offers these sequencing services, 23andMe, was required to stop in November by the FDA. The issue that forced the suspension is whether DNA sequencing is a medical test subject to FDA control or simply a source of personal information not subject to FDA regulation.

The case with 23andMe is still ongoing and shows how rapidly this technology is changing. This case also highlights the novelty of genetic information and underscores the need for new approaches to manage genetic data. It prohibits health insurance and employment discrimination based on genetic information. However, as the 23andMe case highlights, several aspects of regulation are still evolving.

Sequencing the entire genome The efficiency of DNA sequencing continues to accelerate. From a pharmacogenetic standpoint, this is a major development and means that instead of specialized tests. The normal DNA sequence and cancer DNA sequence from the same individual can be compared to find unique genetic changes in the cancer.

These genetic differences may serve as. The hope of personalized medicine is to use this personal sequence information to increase the specificity and effectiveness of disease prevention and treatment. Pleitropy Pleiotropy is another challenge for clinical translation of genetic discoveries. Pleiotropy is the influence of a gene on more than one outcome. The genetic changes seen in cancer are very diverse and incompletely understood.

However, some genetic changes are seen frequently and have been used to develop specific therapies. One example is Herceptin, also known as trastuzumab. Approximately 20 percent of breast cancers contain an overabundance of the growth factor gene Her2. Excess Her2 leads to excess cell growth. Every patient diagnosed with breast cancer is now tested for the Her2 genetic abnormality and Herceptin is offered only to patients with tumors containing this abnormality. Her2 amplification is also seen in a minority of esophageal cancers.

The benefit of Herceptin for these patients is under investigation. Therapy targeted against the epidermal growth factor receptor EGFR improves the outcome for colorectal cancer patients but only those that do not have mutations in genes acting downstream of EGFR. Testing cancers for mutations in one downstream gene, KRAS, is now standard for patients with colorectal cancer. Several other cancer treatPharmacogenetics to page Another example is CYP2C9, one of the genes that explains warfarin metabolism.

If a clinician orders a CYP2C9 genetic test that is commercially available, they will likely not be told that there are available guidelines for dosing tolbutamide, phenytoin, and a number of other medications based on CYP2C9 genotype. The genetic sequence of cancers There are even greater genetic variations between cancers than genetic differences between individuals. The same revolution in technology that allows rapid DNA sequencing of normal genomes has allowed investigators to determine the genetic sequence of cancers.

This vote was a historic moment in the fight that we are still waging to improve the home care field for both workers and the seniors and people with disabilities that we serve. My story I had over 10 years of experience working in health care when a family I knew experienced a tragic loss.

As a result, I ended up becoming a home care worker for the first time for a young girl named Jayla. I saw a little girl who deserved to be able to spend her time at home, not. Unionizing home health care How both providers and patients benefit By Sumer Spika in an institution. I knew that if I cared for Jayla she could remain at home. Neither seems to be interested in listening to the voters. Per usual, Morse and other members are belittling residents on social media now.

Morse and Gunderson need to be voted out. Heather Gustafson Vadnais Heights. Stacey Stout has been an excellent member of the Mahtomedi School Board.

A strength of Mahtomedi is the engaged community. As an elected board member, Stacey is very engaged in board meetings and asks thoughtprovoking questions. She welcomes input from parents and the community to encourage collaboration and innovation. The case is under investigation. The thief had used false identification to procure the vehicle. After the vehicle was entered into the NCIC, an investigation identified a possible. After both parties were separated, a report was submitted to the county attorney to review possible charges.

The incident has been referred to the city attorney. The driver sped away from deputies and started a pursuit that lasted 16 minutes and covered 23 miles. Deputies stopped chasing when the vehicle began driving in the opposite lane of traffic.

The vehicle later was found unoccupied in St. Deputies on the scene found medication left in the street and placed it into property. The credit card was used unsuccessfully at Target. Manning Avenue N. The driver apologized and said she was reading a message. A resident on Juniper Street and another resident on Park Avenue each reported thefts from their motor vehicles overnight Sept.

The complainant recognized the scam and just wanted it reported. The vehicle was a Chevy, while the computer said the vehicle should have been a.

The driver explained at p. The driver also told deputies he put another license plate on the vehicle so he could drive it. As the driver was almost at his destination, he was told to park the vehicle and walk the rest of the way. Deputies pulled over four additional motorists at that location between Sept.

The sticker was later recovered by the Hastings Police Department. A White Bear Lake man, 34, was reported at a. Neither did he have a permit to carry a fi rearm, which is a misdemeanor violation in Minnesota. He was not arrested, but the case has been referred to the Vadnais Heights city attorney to decide charges.

Any person who carries a weapon Amy Johnson. In addition to incorporating information on the latest youth substance use trends such as vaping, the program is also addressing the specific needs of Gen Z and adding virtual capabilities.

Schools now have the option to host in-person presentations, live virtual presentations or virtual presentations that students can access at any time. Since the Know the Truth program began more than a decade ago, it has seen significant success. Life is all about experiences. Tours are free. The education and community at St. Jude of the Lake Catholic School are priceless. Ask about our VIP program!

At Hugo Dental Care, we are interested in complete dental health. We take a different approach to dentistry that never settles for the status quo; instead, we strive to stay on top of the most advanced technologies and give you, our patients, the best dental care possible. The program utilizes a peer-topeer format, where Know the Truth presenters — often just a few years older than the students — share their personal struggles with substance use.

During the school year, Know the Truth conducted surveys following presentations. In addition to classroom presentations, students are encouraged to seek continued dialogue with the presenters through social media, reaching out to knowthetruthmn on Twitter, and through the text hotline at The health and safety of our patients has always been our priority.

Our team has implemented new systems, which will be evident when you arrive for your appointment. Try our fast and convenient location. Drive in with your recycling and drive out with CASH!! These additional measures, in addition to our regular infection control procedures, makes the dental office one of the safest places you can be. We offer anything from routine cleanings and exams to cosmetic dentistry, Invisalign, dental implants, whitening and more.

We want our patients to discover a better life with great teeth. We are always welcoming new patients. Concentrations in all six wells were below the MDH health risk limit HRL for drinking water of 1 part per billion and are not of health concern. Additional confi rmation sampling is recommended. The source of the 1,4-dioxane is not known, according to the agencies. The chemical was detected in groundwater on Water Gremlin property at concentrations greater than the HRL in December ; however, the distribution of the 1,4-dioxane in private wells makes the source unclear, particularly for wells at the south end of the sampling area.

Additional data collection and analysis is required to better understand the occurrence and movement of 1,4-dioxane. Three of 11 wells had detectable levels at that time, all significantly less than the HRL of 1 ppb. MDH staff also collected samples at the same time from eight homes to verify testing results.

The public health lab reported the same results as the lab used by Water Gremlin. MPCA will determine locations of the next round of residential well sampling. From press release. When: Oct. Exhibition can be viewed during library hours and also online. Contact: northstarwatermedia. When: p. Wednesday-Friday and 11 a. Saturdays and Sundays, through Oct. Last entry at 4 p. Contact: or pinetreeappleorchard. Learn about race options and register online. Contact: or cbo.

Saturday, Oct. House opens at p. Bring a lawn chair. Contact: tickets lakeshoreplayers. Sunday, Oct. Costumes encouraged. Food shelf donations will also be collected. Contact: or gracepeople. All Together Now As our nation looks to reopen, rebound and resurge, our advertising representatives are here to help your business.

Hire us to help get your customers back and your employees ready. Nobody cares more about your success than we do. Nobody delivers a more engaged audience than we do. Our growth online, combined with print, is impressive as more readers turn to us for local news. Design by Metro Creative Graphics, Inc. Thursday, Oct.

Monday, Oct. Contact: lwv-wbla. When: 7 p. Contact: whitebeararts. When and where: p. Friday, Oct. The Red Cross is testing blood, platelet and plas-. Make an appointment in advance. When: Noon-1 p. Contact: treehousehope. VIP; 7 p. Contact: solidgroundmn. When: 9 a. Map of the course available at bit. Contact: gf. When: 11 a. The road will be closed for the duration of the event. All are welcome. Contact: cityofbirchwood. Tuesday, Oct. Class size limited; registration required.

Contact: or WashCoLib. When: 10 a. E-mail to schedule and appointment. Contact: LawLibrary co. When: Programs every half hour, noon to p. Call to register. Contact: The innovative mobile care room ensures program participants have access to a secure, discreet and respectful space, as well as the equipment and supplies needed to address critical care needs.

It might be the only care room like it in the country. Once we got the seed money, it was a vote of confidence for others to grant remaining money. They like to see some skin in the game. The special mobile unit, a converted van purchased from Newtrax, was made possible with seed money from the Greater White Bear Lake Community Foundation.

Dale, Katie and Terri used the van at the capitol rally. The PAI care van is among 72 projects and programs the fund has supported in the last three years. Residents who would like to join in supporting local organizations are encouraged to contribute to the fund.

Contributions can also support a specific field of interest such as the arts, the environment, human services and education. Another project making a positive impact involves Hearts and Hammers. Volunteers for the Roseville-based nonprofit have helped revitalize five homes in White Bear Lake thanks to money from the community foundation.

Hearts and. Hammers assists low-income homeowners with exterior work at no cost so they can safely stay in their affordable home. Executive Director Randi Prebil said two grants awarded by the foundation in and drew their attention to White Bear Lake. COVID put its sensory-friendly project on hold. A production planned months earlier focused on providing access to theater. The show was completely revamped to a virtual online program free to the community. For more information on these grants and how to donate, visit greaterwblfoundation.

Also new to the Community Partners Fund in are grants to offset operating expenses for nonprofits. Bald Eagle Lake is getting cleaner. Thanks to a Clean Water Fund Grant, that trend will continue. The fi lter treats formerly untreated stormwater before it reaches the lake. The system diverts runoff from Ramsey County Ditch 11 RCD11 , removes phosphorus, sediment and other pollutants, and discharges the cleaner water back into the ditch.

The township provided land for the regional water quality project and the watershed district the money to construct, operate and maintain it. The district board budgeted for the project so residents will not see a property tax increase. What they will see is an improvement in water clarity. This is no longer the case, but RCD11 still serves as the outlet for stormwater flows from this area, and for White Bear Lake now that its surface elevation has reached the outlet.

When White Bear Lake is flowing through its outlet, as it did for much of ,. The improvement project has been a long time coming to the Ditch 11 watershed, noted the project manager.

That water went completely untreated. The sand filter project involves Ditch 11, which flows under Hwy. Rustic Roots Winery is located at St. The pair officially bought the farmland last July with the purposes of making it a winery. Last summer was preparation of the land for planting the 11, vines currently in the ground. This winter and summer have been about remodeling what was a residential home into a storefront.

As of now, the business will feature nine varieties of wine — four white, four red and one rose in assorted sweet and dry flavors.

Or one is certainly welcome to bring a blanket and spread out on the property. Hours of operation will be 11 a. Sundays-Wednesdays and 11 a.

For more information, visit rusticroots. Allen and his wife, Annie, met as students at Bethel. They live in White Bear Lake and have four adult children. Thorson has served as chair of the MMA Board of Trustees from to , and as president in , and is a former president of the Minnesota Academy of Family Physicians.

The City Council will interview three finalists to replace him at p. The interviews will be broadcast live on the cable channel and streamed live on Facebook for the community to view. More details can be found at cityofbirchwood. They have been a serious player in the local restaurant scene ever since. Regulars will all recognize the smiling face of Rebecca greeting you from behind the bar when you arrive.

In fact, Rebecca operates a small farm north of White Bear Lake that supplies a lot of the fresh produce the restaurant uses. Many of the staff has been with Ingredients since the beginning, a testament to their passion for the restaurant and its vision. The restaurant has been a loyal supporter of the community over the years with regular participation at the annual Taste of White Bear Lake and other festivals, along with many donations of gourmet dinner parties to.

Before Covid they were doing a very robust lunch trade and their themed Wine Dinners were extremely popular as well.

They recently opened back up for lunch 11 a. The restaurant is open Tuesday thru Sunday at 11 a. Curbside pickup is available from 4 p. Visit ingredientscafe. In , their dream became a reality when they came across the quaint old house for rent on Craigslist wherein the restaurant now operates in the Marina Triangle. Growing up in Roseville and White Bear Lake, Daron was well aware of the need for a higher quality of dining in the area they decided to take the risk.

Nicole and Daron are immensely grateful for their opportunities. We want to stay open for you. Have you supported your favorite restuarant this week? Join the effort to ReGrow White Bear as we cultivate growth, community and awareness to create a vibrant, bright and thriving White Bear Lake area. Written by Ken Galloway Ken has been a hospitality executive and professional chef in the Twin Cities for many years and has been a long-time supporter of the local hospitality scene.

We keep hearing how imperative it is for young adults to get involved in the political process to understand how decisions are made and impact our lives. I have known Elliott Engen for many years and in our discussions, I recognize his firm grasp of policies currently on the books, as well as those within reach. I have encouraged each of them to seek out opportunities to do something meaningful and to do it with passion. I look at Elliott Engen and see a young man doing exactly that. His understanding of our local government, his appreciation of our community and his desire to make improvements best suited to our area is why he has my support.

We can be cynical and decide that youth is a detriment — but not me. When I meet people like Elliott, I do not believe for a moment that youth is wasted on the young. Elliott has the energy and talent to put words into action, and I trust him with my vote. I am grateful, as I realize these achievements were not for himself alone, but for the good of our community.

Jan Johnson White Bear Lake. One of the refreshing aspects of the Vadnais Heights City Council race is that candidates run without being under the umbrella of a particular political party. Multiple requests to the city for a streetlight to be placed in our neighborhood park due to safety concerns were received and rejected. Thankfully, when Bob began his role with the City Council, he was successful in getting a light installed. As a result, there is a decrease in suspicious activity.

In addition, Bob has enjoyed volunteering for many years to serve on a panel of judges for a local high school scholarship. Please join us in casting your vote for Robert Morse so that he can continue to share his light on the Vadnais Heights City Council.

Dawn Tiefert Vadnais Heights. Why is this happening? Climate change is causing more rain and because of development of all the surrounding land, the water has no place to go. Now these homeowners are looking at a multimilliondollar pumping project to save their homes.

Recognizing the impacts of climate change and focusing now on prevention, mitigation vs. We can all make a difference personally and at the local level. Minnesota has a GreenStep Cities program, a free program that helps cities achieve their sustainability and quality of life goals.

Unfortunately, our current Vadnais Heights City Council has decided not to participate in this program even though our surrounding neighbors have been participating for years White Bear Lake, Arden Hills, Mounds View, Mahtomedi, Shoreview. It is time we have a City Council that makes climate change a priority. There are two candidates running for council who are climate champions: Steve Rogers and Erik Goebel. These two candidates have been endorsed by Northeast Climate Action www.

I urge all Vadnais Heights residents to vote for climate on your ballot this year, up and down the ballot. Judy Lissick Vadnais Heights. It is time for a change, and Birchwood residents have a great opportunity to vote for Mike McKenzie for mayor of Birchwood. We have known Mike for more than 25 years. Mike has the experience and the qualities to serve our community well.

He is sincere and honest, understands management and knows how to apply these qualities to city governance. He will work hard to manage Birchwood efficiently and fairly. It is time for new leadership — leadership that will serve all Birchwood residents equally well. We urge you to vote for Mike McKenzie for mayor of Birchwood — it is time for a change. Judy and Gerry Duffy Birchwood. My neighbors and I are concerned about the rising incidence of vehicles that are speeding excessively on the residential streets of Mahtomedi, including on Old Wildwood Road.

We are concerned for the safety of our children, the residents who live on these roads as well as the neighboring community that use the roads for recreational purposes. The Minnesota state Legislature authorized cities to set their own speed limits on its streets without the authorization of the Minnesota Department of Transportation.

The Legislature changed the definition of a residential roadway, which has the effect of allowing cities to adopt a speed limit of 25 mph without any engineering review. Check first official announcement notice published by Springbrook Nature Center. Now read the Springbrook Nature Center jobs employment notification details. After read this notification your educational profile matching with Springbrook Nature Center Police Officer jobs.

Then you should apply for Springbrook Nature Center Jobs as per details given in next paragraph. Answer: The effective up-and-comer must be coordinated, adaptable, simple and have great agreement, astounding client support and relational aptitudes, and function Springbrook Nature Centerirably with a wide assortment of individuals.

Save my name, email, and website in this browser for the next time I comment. Assists in coordinating survey needs of department through collaboration with project managers and consultants. Performs field inspections and condition surveys.

Maintains supplies for surveying, construction observation and design. Post processes aerial data to provide maps and models. Performs on-site construction inspection for street reconstruction, sanitary sewer, water main and storm sewer projects, as well as other City projects.

Fulfills map requests for Gopher State One calls. Performs other duties as assigned or apparent. Proficient at operating contemporary office equipment and personal computers with a variety of software applications.

Microsoft Office Suite preferred. Experience with GIS programs a plus. Experience in preparation of construction plan sets, graphical renderings, and other technical and graphical exhibits. Knowledge and experience of surveying and use of survey equipment.

Experience with design, construction, and test methods for pavement preservation, pipe lining, utility, and stormwater projects. Associates degree in civil engineering or directly related field.

Related civil design, construction inspection and surveying experience a plus. Ability to use Autodesk programs to create construction documents, plans and figures. Ability to prepare renderings and other drawings to help convey technical information in a graphical manner, including concept level informational plans.

Willingness to try new methods or procedures to achieve specific needs of City staff. Excellent interpersonal and conflict resolution skills. Ability to develop, read, and interpret construction drawings and specifications. Ability to work independently. Ability to work in Minnesota outdoor environments throughout the calendar year. Knowledge of construction surveying and use of survey equipment. Ability to develop, read and interpret construction drawings and specifications.

Ability to provide clear verbal and written communications and directions. Ability to work extended work hours. Ability to effectively communicate, both orally and in writing, have strong positive public relations skills, and to present technical information to a variety of audiences. Ability to work under limited supervision with general autonomy in determining how objectives are achieved.

Considerable analytical ability is needed to select, evaluate and interpret data from several sources. Ability to apply local, state and federal statutes, laws and ordinances relevant to department operations. Ability to have frequent interactions with departments, outside agencies, and the general public on specialized matters requiring detailed or technical responses. After read this notification your educational profile matching with Springbrook Nature Center Engineering Technician I jobs.

Springbrook Nature Center has issued a notification for which post? Springbrook Nature Center has issued notifications for how many posts? How I can apply for this Springbrook Nature Center recruitment? Other Eligibility to Get This Job Answer: The effective up-and-comer must be coordinated, adaptable, simple and have great agreement, astounding client support and relational aptitudes, and function admirably with a wide assortment of individuals. Supervises division staff.

Recommends staff hires, orients and trains. Oversees professional development of staff. Plans, reviews, assigns and evaluates work of staff. Provides coaching, feedback and evaluates staff performance.



Minnesota Physician April by Minnesota Physician Publishing – Issuu.

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