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When the clock strikes twelve on December 31st, people all over the world cheer and wish each other a very Happy New Year. For some, this event is no more than a change of a calendar. For others, the New Year symbolizes the beginning of a better tomorrow. So, if you look forward to a good year ahead, spread happiness with these wonderful New Year wishes.

Irish toast
In the New Year, may your right hand always be stretched out in friendship, never in want.

Minnie L. Haskins
And I said to the man who stood at the gate of the year: Give me a light that I may tread safely into the unknown. And he replied: Go out into the darkness and put your hand into the hand of God. That shall be to you better than light, and safer than a known way.

Movie: "When Harry Met Sally", Harry Burns
And I love that you are the last person I want to talk to before I go to sleep at night. And it's not because I'm lonely, and it's not because it's New Year's Eve. I came here tonight because when you realize you want to spend the rest of your life with somebody, you want the rest of your life to start as soon as possible.

Edith Lovejoy Pierce
We will open the book. Its pages are blank. We are going to put words on them ourselves. The book is called "Opportunity" and its first chapter is New Year's Day.

Charles Dickens
A merry Christmas to everybody! A happy New Year to the world!

Sydney Smith
Resolve to make at least one person happy every day, and then in ten years you may have made three thousand, six hundred and fifty persons happy, or brightened a small town by your contribution to the fund of general enjoyment.

Anonymous
Your Merry Christmas may depend on what others do for you. But your Happy New Year depends on what you do for others.

William Makepeace Thackeray
Certain corpuscles, denominated Christmas Books, with the ostensible intention of swelling the tide of exhilaration, or other expansive emotions, incident upon the exodus of the old and the inauguration of the New Year.

Aisha Elderwyn
Every new year people make resolutions to change aspects of themselves they believe are negative. A majority of people revert back to how they were before and feel like failures. This year I challenge you to a new resolution. I challenge you to just be yourself.

F. M. Knowles, A Cheerful Year Book
He who breaks a resolution is a weakling; He who makes one is a fool.

G. K. Chesterton
The object of a new year is not that we should have a new year. It is that we should have a new soul.

John Greenleaf Whittier
We meet today
To thank Thee for the era done,
And Thee for the opening one

T. S. Eliot
For last year's words belong to last year's language and next year's words await another voice. And to make an end is to make a beginning.

Emily Miller
Then sing, young hearts that are full of cheer,
With never a thought of sorrow;
The old goes out, but the glad young year
Comes merrily in tomorrow

Martin Luther
Glory to God in highest heaven,
Who unto man His Son hath given;
While angels sing with tender mirth,
A glad new year to all the earth

Walter Scott
Each age has deemed the new born year
The fittest time for festal cheer

Benjamin Franklin
Be always at war with your vices, at peace with your neighbors, and let each New Year find you a better man.

Edgar A. Guest
A happy New Year! Grant that I
May bring no tear to any eye
When this New Year in time shall end
Let it be said I've played the friend,
Have lived and loved and labored here,
And made of it a happy year.

William Arthur Ward
This bright new year is given me
To live each day with zest
To daily grow and try to be
My highest and my best!

Ella Wheeler Wilcox
What can be said in New Year rhymes,
That's not been said a thousand times?
The new years come, the old years go,
We know we dream, we dream we know.
We rise up laughing with the light,
We lie down weeping with the night.
We hug the world until it stings,
We curse it then and sigh for wings.
We live, we love, we woo, we wed,
We wreathe our prides, we sheet our dead.
We laugh, we weep, we hope, we fear,
And that's the burden of a year.

Charles Lamb
Of all sound of all bells, the most solemn and touching is the peal which rings out the Old Year.
 
 
I want to personally take this opportunity to wish all of our current and future clients a very happy Thanksgiving holiday, and thought it appropriate to look back at its history.

Thanksgiving at Plymouth


In September 1620, a small ship called the Mayflower left Plymouth, England, carrying 102 passengers—an assortment of religious separatists seeking a new home where they could freely practice their faith and other individuals lured by the promise of prosperity and land ownership in the New World. After a treacherous and uncomfortable crossing that lasted 66 days, they dropped anchor near the tip of Cape Cod, far north of their intended destination at the mouth of the Hudson River. One month later, the Mayflower crossed Massachusetts Bay, where the Pilgrims, as they are now commonly known, began the work of establishing a village at Plymouth.

Throughout that first brutal winter, most of the colonists remained on board the ship, where they suffered from exposure, scurvy and outbreaks of contagious disease. Only half of the Mayflower’s original passengers and crew lived to see their first
New England spring. In March, the remaining settlers moved ashore, where they received an astonishing visit from an Abenaki Indian who greeted them in English. Several days later, he returned with another Native American, Squanto, a member of the Pawtuxet tribe who had been kidnapped by an English sea captain and sold into slavery before escaping to London and returning to his homeland on an exploratory expedition. Squanto taught the Pilgrims, weakened by malnutrition and illness, how to cultivate corn, extract sap from maple trees, catch fish in the rivers and avoid poisonous plants. He also helped the settlers forge an alliance with the Wampanoag, a local tribe, which would endure for more than 50 years and tragically remains one of the sole examples of harmony between European colonists and Native Americans.


In November 1621, after the Pilgrims’ first corn harvest proved successful, Governor William Bradford organized a celebratory feast and invited a group of the fledgling colony’s Native American allies, including the Wampanoag chief Massasoit. Now remembered as American’s “first Thanksgiving”—although the Pilgrims themselves may not have used the term at the time—the festival lasted for three days. While no record exists of the historic banquet’s exact menu, the Pilgrim chronicler Edward Winslow wrote in his journal that Governor Bradford sent four men on a “fowling” mission in preparation for the event, and that the Wampanoag guests arrived bearing five deer. Historians have suggested that many of the dishes were likely prepared using traditional Native American spices and cooking methods. Because the Pilgrims had no oven and the Mayflower’s sugar supply had dwindled by the fall of 1621, the meal did not feature pies, cakes or other desserts, which have become a hallmark of contemporary celebrations.

Thanksgiving Becomes an Official Holiday

Pilgrims held their second Thanksgiving celebration in 1623 to mark the end of a long drought that had threatened the year’s harvest and prompted Governor Bradford to call for a religious fast. Days of fasting and thanksgiving on an annual or occasional basis became common practice in other New England settlements as well. During the American Revolution, the Continental Congress designated one or more days of thanksgiving a year, and in 1789 George Washington issued the first Thanksgiving proclamation by the national government of the United States; in it, he called upon Americans to express their gratitude for the happy conclusion to the country’s war of independence and the successful ratification of the U.S. Constitution. His successors John Adams and James Madison also designated days of thanks during their presidencies.

In 1817,
New York became the first of several states to officially adopt an annual Thanksgiving holiday; each celebrated it on a different day, however, and the American South remained largely unfamiliar with the tradition. In 1827, the noted magazine editor and prolific writer Sarah Josepha Hale—author, among countless other things, of the nursery rhyme “Mary Had a Little Lamb”—launched a campaign to establish Thanksgiving as a national holiday. For 36 years, she published numerous editorials and sent scores of letters to governors, senators, presidents and other politicians. Abraham Lincoln finally heeded her request in 1863, at the height of the Civil War, in a proclamation entreating all Americans to ask God to “commend to his tender care all those who have become widows, orphans, mourners or sufferers in the lamentable civil strife” and to “heal the wounds of the nation.” He scheduled Thanksgiving for the final Thursday in November, and it was celebrated on that day every year until 1939, when Franklin D. Roosevelt moved the holiday up a week in an attempt to spur retail sales during the Great Depression. Roosevelt’s plan, known derisively as “Franksgiving,” was met with passionate opposition, and in 1941 the president reluctantly signed a bill making Thanksgiving the fourth Thursday in November.
 
 
United Health Foundation understands the value of America’s 62 million family caregivers of adults 18 years or older and the critical role they play in our health care system.

According to a recent national family caregiving study, 17 percent of caregivers of adults provide care for a veteran and 11 percent have served in the armed forces themselves. While there are many studies that have probed the needs of the veterans, the United Health Foundation in collaboration with the National Alliance for Caregiving has taken the first in-depth look at the family caregivers of our nation’s veterans.

The study, Caregivers of Veterans – Serving on the Homefront gives voice to caregivers who are caring for veterans across the age spectrum -- from combat eras dating from World War II to the more recent wars in Iraq and Afghanistan. While these caregivers face similar situations as national caregivers, including caring for someone with chronic illness or aging issues, they also have unique challenges such as dealing with physical disabilities and emotional and mental health issues. The study reveals how providing care affects caregivers’ lives, what organizations and information sources have been helpful to them, and what programs and services would support and assist them.

Key Findings from the study include:
  • Overwhelmingly, veterans’ caregivers are women (96 percent) - compared to national caregiving statistics overall which show 65 percent are women
  • Twice as many veterans’ caregivers (30 percent) said they have been caregiving for 10 or more years – compared to the national caregiving statistic where only 15 percent stated the same
  • Three times as many caregivers of veterans reported spending 40 hours a week or more providing care (43 percent) compared to the total number of caregivers nationally (13 percent)
  • Sixty-eight percent of veterans’ caregivers reported their situation as highly stressful compared to 31 percent of caregivers nationally who feel the same
  • 70 percent of caregivers reported that their veteran experiences depression or anxiety, and 60 percent report post traumatic stress disorder (PTSD), compared to only 28 percent of caregivers nationally whose care recipients suffer from mental or emotional health problems.
  • Of the 68 percent who were employed, almost half (47 percent) reported leaving work entirely or taking early retirement compared to national caregiver statistics who reported the same (9 percent)
  • As seen in other caregiving studies, caregivers feel their role is a labor of love; 94 percent of the veterans’ caregivers reported they are “proud to serve”
Note: *National caregiver statistical comparisons are from “Caregiving in the U.S.” (2009, NAC in collaboration with AARP) and they reflect the subset of caregivers who provide care to an adult age 18 or older.
 
 
Patients at five-star rated hospitals had a 72 percent lower risk of dying when compared with patients at one-star-rated hospitals, according to a new independent study by healthcare ratings organization HealthGrades.

Experts say this is an enormous gap that has held steady over the past years even as overall mortality rates have improved.


The "Thirteenth Annual HealthGrades Hospital Quality in America" study analyzed objective mortality and complication rates at all of the nation's 5,000 nonfederal hospitals using 40 million hospitalization records obtained from the Centers for Medicare and Medicaid Services, part of the U.S. Department of Health and Human Services.


The study, the largest of its kind, identified national and state-level trends in hospital care quality and established quality ratings for each hospital, across 26 different procedures and diagnoses. The ratings are now online, allowing individuals to compare their local hospitals.


Looking at overall trends, the HealthGrades study found that hospital mortality rates, on average, have declined by 7.98 percent over the three-year period studied, from 2007 to 2009. Of the 17 mortality-based diagnoses and procedures analyzed, only two bucked the overall trend with increasing mortality rates – gastrointestinal surgeries and coronary intervention procedures.


As part of the study, HealthGrades rated individual hospitals with a one-star, three-star or five-star rating in each of 26 procedures and diagnoses, from bypass surgery to total knee replacements. A one-star rating means that the hospital performed below average, to a statistically significant degree, when compared with the other 5,000 hospitals. A three-star rating means the hospital's performance was average, and a five-star rating means the hospital outperformed the national average to a statistically significant degree.


Five-star rated hospitals had significantly lower risk-adjusted mortality across the three years studied. A typical patient would have a 72.47 percent lower risk of dying in a five-star rated hospital compared to a one-star rated hospital, and a 53.36 percent lower risk of dying by going to five-star rated hospital compared to the U.S. hospital average.


"We are encouraged by the steady improvement in mortality rates among America's hospitals, but there's an unacceptably wide gap that has persisted between the top-performing hospitals and all others in terms of patient outcomes," said Rick May, MD, an author of the study and a vice president with HealthGrades. "For hospital leaders as well as potential patients, it is essential that they understand – and act upon – these findings."


Key findings from the study include:

  • The nation's hospitals unadjusted mortality improved on average 7.98 percent from 2007 through 2009 across the 17 diagnoses and procedures studied.
  • All but two diagnoses and procedures saw reductions in the unadjusted mortality rates. Gastrointestinal surgeries and procedures and coronary interventional procedures were associated with an increase in unadjusted mortality of 8.76 percent and 9.26 percent respectively.
  • The highest unadjusted mortality rates are among sepsis, respiratory failure, and gastrointestinal surgeries and procedures (20.59 percent, 19.45 percent, 10.29 percent, respectively).
  • The most improvement in unadjusted mortality was seen in chronic obstructive pulmonary disease (18.73 percent), bowel obstruction (14.72percent), heart attack (13.68 percent), and stroke (13.50 percent).
  • If all hospitals performed at the level of a five-star rated hospital, 232,442 Medicare lives could potentially have been saved from 2007 through 2009.
  • Approximately 55.91 percent (129,949) of the potentially preventable deaths were associated with just four diagnoses: sepsis (48,809); pneumonia (29,017); respiratory failure (26,361); and heart failure (25,762).
  • On average, one in nine patients developed a hospital-acquired condition, across the nine procedures evaluated for in-hospital complications, from 2007 to 2009.
  • On average, a typical patient would have an 80.40 percent lower risk of developing one or more in-hospital complications by going to a five-star rated hospital compared to a one-star and a 63.64 percent lower risk of developing one or more in-hospital complications by going to a 5-star compared to the U.S. hospital average.
 
 
More than $1.2 trillion spent on healthcare each year is a waste of money. Members of the medical community identify the leading causes.

Down the drain: $1.2 trillion.

That's half of the $2.2 trillion the United States spends on healthcare each year, according to the most recent data from accounting firm PricewaterhouseCoopers' Health Research Institute.

What counts as waste? The report identified 16 different areas in which healthcare dollars are squandered. But in talking to doctors, nurses, hospital groups and patient advocacy groups, six areas totaling nearly $500 billion stood out as issues to be dealt with in the healthcare reform debate.

1. Too Many Tests

Doctors ordering tests or procedures not based on need but concern over liability or increasing their income is the biggest waste of health care dollars, costing the system at least $210 billion a year, according to the report. The problem is called "defensive medicine."

"Sometimes the motivation is to avoid malpractice suits, or to make more money because they are compensated more for doing more," said Dr. Arthur Garson, provost of the University of Virginia and former dean of its medical school. "Many are also convinced that doing more tests is the right thing to do."

"But any money that is spent on a patient that doesn't improve the outcome is a waste," said Garson.

Some conservatives have suggested that capping malpractice awards would help solve the problem.

President Obama doesn't agree; instead, his reform proposal encourages doctors to practice "evidence-based" guidelines as a way to scale back on unnecessary tests.

2. Those Annoying Claim Forms

Inefficient claims processing is the second-biggest area of wasteful expenditure, costing as much as $210 billion annually, the PricewaterhouseCoopers report said.

"We spend a lot of time and money trying to get paid by insurers," said Dr. Terry McGenney, a Kansas City, Mo.-based family physician.

"Every insurance company has its own forms," McGenney said. "Some practices spend 40% of their revenue filling out paperwork that has nothing to do with patient care. So much of this could be automated."

Dr. Jason Dees, a family doctor in a private practice based in New Albany, Miss., said his office often resubmits claims that have been "magically denied."

"That adds to our administrative fees, extends the payment cycle and hurts our cash flow," he said.

Dees also spends a lot of time getting "pre-certification" from insurers to approve higher-priced procedures such as MRIs. "We're already operating on paper-thin margins and this takes times away from our patients," he said.

Susan Pisano, spokeswoman for America's Health Insurance Plans, said "hundreds of billions" of dollars can be saved by standardizing procedures and using technology -- something the White House has mentioned as a key to health care reform.

"For that to happen, we need the technology," she said. "Doctors and hospitals must adopt the technology, and we have to develop rules for exchanging of information between doctors, hospitals and health plans."

Pisano said the industry is launching a pilot program later this year that will allow physicians to communicate with all health plans using a standardized process.

3. Using the ER as a Clinic

More insured and uninsured consumers are getting their primary care in emergency rooms, wasting $14 billion every year in health care spending.

"This is an inappropriate use of the ER," said Dee Swanson, president of the American Academy of Nurse Practitioners. "You don't go to the ER for strep throat."

Since emergency rooms are legally obligated to treat all patients, Swanson said providers ultimately find ways to pass on the cost for treating the uninsured to other patients, such as to those who pay out-of-pocket for their medical care.

Dees also took issue with consumers who don't get primary care for their diabetes or blood pressure on a timely basis, hence finding themselves in the ER.

"Going to the doctor for strep throat would cost $65-$70. In the ER, it's $600 to $800," he said.

The $787 billion stimulus bill signed passed by President Obama earlier this year includes allocates $1 billion for a wellness and prevention fund, including $300 million for immunizations and $650 million for prevention programs to combat the rapid growth in chronic diseases such as obesity and diabetes.

4. Medical "Oops"

Medical errors are costing the industry $17 billion a year in wasted expenses, something that makes patient advocacy groups irate.

"Do we have a good health IT system in place to prevent this?" asked Kim Bailey, senior health policy analyst with consumer advocacy group Families USA.

Bailey suggested that processes such as computerized order entry for drugs and use of electronic health records (EHR) could help ensure that patients get the correct dosage of medications in hospitals.

The stimulus bill calls for the government to take a leading role in developing standards by 2010 to facilitate the adoption of health information exchanges across the system, including patient electronic health records by 2014.

Obama has repeatedly said that the use of technology in the health sector will help boost savings, enhance the coordination of care and reduce medical errors and unnecessary procedures.

5. Going Back to the Hospital

Bailey suggested that processes such as computerized order entry for drugs and use of electronic health records (EHR) could help ensure that patients get the correct dosage of medications in hospitals. Discharging patients too soon is a "huge waste of money," said Swanson.

"This happens a lot with elderly patients who are discharged prematurely because of insurance, bed unavailability or ageism," she said.

Many times, patients also don't follow instructions for care after discharge. "So complications arise and they are readmitted in a week," Swanson said.

PricewaterhouseCoopers estimates the cost of preventable hospital readmissions at $25 billion annually.

Among the reform plans, one proposal being considered is for Medicare to potentially penalize hospitals who readmit patients within 30 days of discharge.

6. You Forgot to Wash Your Hands!

Those ubiquitous dispensers of hand sanitizer are in hospitals for a reason: PricewaterhouseCoopers estimates that about $3 billion is wasted every year as a result of infections acquired during hospital stays.

"The general belief is that hospitals are getting much better in managing this than they have in the past," said Richard Clarke, CEO of Healthcare Financial Management Association, whose members include hospitals and managed care organizations.

Something as simple as hand-washing often can reduce the problem.

"Sometimes doctors are the most difficult people to convince to do this," said Clarke. "The challenge here is that patients sometimes come in with infections which then spread in the hospital."

The stimulus bill signed by Obama earlier this year includes $50 million for reducing healthcare-associated infections.

Other areas of waste identified in the PricewaterhouseCoopers report included up to $493 billion related to risky behavior such as smoking, obesity and alcohol abuse, $21 billion in staffing turnover, $4 billion in prescriptions written on paper, and $1 billion in the over-prescribing of antibiotics. 
 
 
The following article is reprinted with the permission of Quest Protein Bars, a member of the BAC Medical Marketing affiliate program.

Mankind is truly amazing. We have managed to progress on an almost continual basis for thousands of years. We’ve vanquished many terrible diseases that have plagued us for years totally eliminating polio, for example. We’ve sent a man to the moon and back and each generation has a higher standard of living than the one that came before it.

But there is one huge blind spot in our knowledge the arena of nutrition. Much of what is considered to be correct in nutrition, both by the mainstream and current scientific thinking is not only wrong but actually backwards.

Evidence of that is the fact that despite billions of dollars spent in research and studies in nutrition, this generation is the first that can expect a DECLINE in both it’s health and longevity compared to the generation before it. If any other science be it aerospace, chemistry or physics started producing results that were worse than they produced in the past, people would immediately begin to question everything in an attempt to figure out where they had gone wrong.

But in nutritional “science” that doesn’t happen. Instead, nutritionists and researchers involved in the nutrition field continue to promote a diet that clearly has a lot of holes in it namely that we should be eating a diet that is mostly made up of whole grains, fruits and vegetables while minimizing our consumption of proteins and fats.

The prestigious New England Journal of Medicine published in March of 2005 that due to the increase in childhood obesity, this current generation could expect to live as much as 5 years less than their parents and with poorer health to boot. Some researchers feel that even this number is too conservative and that the impact on health and longevity will be much worse. You can read more about it here: http://www.nytimes.com/obese.html

In any case, all one has to do it go to any mall in America or just about anywhere else and take a look around. It’s clear that the only way obesity can be growing at the rate that it has is because the recommended food pyramid isn’t just a little bit off the mark it’s totally upside down.

While there are as many opinions as to why people are getting fatter as there are people, I think we can make some very good guesses as to which path will lead us away from obesity and disease and towards health, longevity and enhanced mental and physical performance.

Although not everyone will agree, I personally think it’s very clear that the two of the big three killers: Heart Disease and Diabetes both have some common roots obesity and insulin resistance. Insulin resistance is when our body requires the secretion of higher and higher amounts of insulin in order to clear our bloodstream of carbohydrate. The only thing that has been consistently found among Centenarians (those who live to be over 100 years old) is the fact that they all tend to have excellent insulin sensitivity.

Keeping our bodies sensitive to insulin is very important and one of the best ways to do that is to get and or stay lean. The best way to get and or stay lean is to minimize our carbohydrate intake. That’s really not up for debate. All one has to do is look at bodybuilders the only group of people on the planet that have consistently managed to achieve SUPREMELY low levels of body fat time and time again. They all reduce carbohydrates in order to strip body fat to very low levels and they have done so since the very beginning of the sport. They’ve tried every type of approach (including some very impractical and complex ones) and reduction of carbohydrates is the thing that always produces the best results.

But in today’s world, carbs are everywhere the average American eats 50-60% of their calories from carbohydrates. They taste great and can only be avoided if someone makes a concerted effort to keep them out of their diet. The results that come from eating low carbohydrate foods are truly amazing, however, and worth the effort.
 
 
As President of BAC Medical Marketing, I want to take this opportunity to wish all of our current and future clients, and their families, a very celebratory 4th of July!

Independence Day is a national holiday marked by patriotic displays. Similar to other summer-themed events, Independence Day celebrations often take place outdoors. Independence Day is a federal holiday, so all non-essential federal institutions (like the postal service and federal courts) are closed on that day. Many politicians make it a point on this day to appear at a public event to praise the nation's heritage, laws, history, society, and people.


Families often celebrate Independence Day by hosting or attending a picnic or barbecue and take advantage of the day off and, in some years, long weekend to gather with relatives. Decorations (e.g., streamers, balloons, and clothing) are generally colored red, white, and blue, the colors of the American flag. Parades often are in the morning, while fireworks displays occur in the evening at such places as parks, fairgrounds, or town squares.

Independence Day fireworks are often accompanied by patriotic songs such as the national anthem "The Star-Spangled Banner", "God Bless America", "America the Beautiful", "My Country, 'Tis of Thee", "This Land Is Your Land", "Stars and Stripes Forever", and, regionally, "Yankee Doodle" in northeastern states and "Dixie" in southern states. Some of the lyrics recall images of the Revolutionary War or the War of 1812.

Firework shows are held in many states, and many fireworks are sold for personal use or as an alternative to a public show. Safety concerns have led some states to ban fireworks or limit the sizes and types allowed. Illicit traffic transfers many fireworks from less restrictive states.

A salute of one gun for each state in the United States, called a “salute to the union,” is fired on Independence Day at noon by any capable military base.

In 2009, New York City had the largest fireworks display in the country, with over 22 tons of pyrotechnics exploded. Other major displays are in Chicago on Lake Michigan; in San Diego over Mission Bay; in Boston on the Charles River; in St. Louis on the Mississippi River; and on the National Mall in Washington, D.C. During the annual Windsor-Detroit International Freedom Festival, Detroit, Michigan hosts one of the world's largest fireworks displays, over the Detroit River, to celebrate Independence Day in conjunction with Windsor, Ontario's celebration of Canada Day.

While the official observance always falls on July 4th, participation levels may vary according to which day of the week the 4th falls on. If the holiday falls in the middle of the week, some fireworks displays and celebrations may take place during the weekend for convenience, again, varying by region.
 
 
Ezekiel Emanuel, a bioethicist with the National Institutes of Health and brother of White House Chief of Staff Rahm Emanuel, put into perspective the more than $2 trillion spent on healthcare in the U.S. every year.

"People don't have any idea of what a trillion is," said Emanuel, pointing out that healthcare's steady increase will theoretically consume the entire economy one day.

He gave a shocking math lesson:

How long ago was a million seconds?

Less than two weeks ago.

How long ago was a billion seconds?

About the time when President Richard Nixon resigned from office in 1974.

How long ago was a trillion seconds?

30,000 B.C., which was 15,000 years before the first human stepped foot on North America.