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If you could boil the needs of the trucking equipment parts world down into two words, ease and speed would be the choice, so says Kathy Seegebrecht, vice president-marketing and brand for the Navistar Parts Group. At the end of the day, the demand for easier ways to find and price parts, along with speedier delivery options, are what's driving the wave of digitalization now sweeping the truck equipment parts world.
"Fleets today also have fewer people doing more work, so they are turning to a variety of electronic systems for help with parts, as well as in other areas of their business," says Seegebrecht.
Paul Tuomi, director of parts marketing for Daimler Trucks North America (DTNA), agrees. "The Internet's impact on heavy-duty parts distribution is mostly about speed and accessibility, plus improving effective communication and information exchange," he notes. "Catalogs and parts documentation have moved from the printed page to the web, providing ready information about the whole spectrum of suppliers from the OES [original equipment supplier] to 'offshore' options."
The Internet is also fostering stronger business-to-business connections, Tuomi adds. Businesses can now schedule service work or parts delivery; receive status updates on repair work; and receive "more complete responses" to customer service needs between partners, all at a lower cost and in real-time.
The "digitalization" of the truck parts business is not limited to just the Internet, though, Pete Painter points out. "It involves e-commerce initiatives, or connections through virtual private networks operated via enterprise resource planning systems," explains Painter, vice president-sales & marketing for parts wholesaler FleetPride. "The Internet changed how fleets access part information. Now we have web portals and other systems set up that allow for part ordering, purchasing, and other services. This goes far beyond merely accessing part pricing information."
While the Internet has provided more accessibility and information to fleets, including the ability to electronically connect fleets with their service providers, it still is not the preferred method for purchasing, according to Jim Pennig, vice president-business development for aftermarket parts supplier Vipar Heavy Duty.
"At this point, we don't believe the heavy-duty segment of the business has migrated to a retail online purchasing method," Pennig stresses. "The end purchase is still largely taking place between the fleet and provider, in our case the aftermarket distributor."
One thing the Internet has done is create another line of communication. That means fleets can quickly see whether a part is available from a particular supplier, how much that part will cost, and whether other suppliers might offer a better value. It has not, though, replaced the need for human interaction.
"The Internet, in this respect, has created much more transparency to ultimately benefit customers but nothing further," says Jeff Sass, general marketing manager for Paccar Parts. "Our research indicates that customers prefer to be contacted directly by a sales contact through face-to-face interaction or by telephone, and paper-based communication through direct mail and magazine advertising. Within the last couple of years, we have seen a shift as email has become the preferable way of communication."
Navistar's Seegebrecht believes the big digital shift is closer at hand than many think. "A lot of the trucking parts business today is still conducted over the phone," she explains. "But over the next five years, we believe that will really change as the next generation of fleet managers moves into the business."
The ability for parts suppliers to match the flexible 24/7 schedule of today's fleet manager who is no longer tied to his or her desk is becoming more critical, Seegebrecht says. Whether that information is delivered via computer, smartphone or other mobile device, it needs to be provided quickly on the manager's schedule and with the options necessary, such as pricing OEM parts alongside competitive alternatives.
With knowledge and information comes increasing complexity. Too many choices can bog down the decision-making process; not enough information can slow the process. That's why Tuomi believes the experience and training of parts professionals remains vital to making the correct decisions.
"For all its speed and power, the Internet has not yet replaced the need for distribution networks that provide local product support and local parts inventory," he says. "The need to fix trucks quickly and get them back on the concrete superhighway is even more time-and-place sensitive than the information superhighway can support."
One area that is slowing down due to the Internet is parts distribution. Customers with the ability to search nationwide for just the right part at just the right price are now faced with longer waits for that part to be shipped across the country.
"The Internet has made parts distribution less efficient because customers are searching across the country for parts that they could find near their home base," Paccar Parts' Sass explains. "Rather than go to their local retailer for quality-ensured parts, they order from suppliers all over the world."
That's why, he says, many suppliers like Paccar Parts continue to place a greater importance on developing partnerships. These partnerships can provide peace of mind to fleets through improved customer service, warranty support, and the knowledge that the part purchased is a quality part with a local company that will stand behind it.
"These elements have become vital to our business and are a result of a growing influx of lower quality and untested parts entering today's market by other suppliers," Sass says.
The same arguments for staying local apply to the aftermarket side of the parts business as well.
"Don't overlook the true value of salespersons/sales managers who call on and service the wholesale distributors and original equipment dealers," says Aaron Bickford, marketing director-aftermarket for Meritor Inc. "They are problem-solvers, troubleshooters, and facilitators [ready] to take care of customers. They have massive industry experience and relationships still matter."
Despite the growing use of the Internet to find parts, Bickford still believes distribution centers play a vital role.
"The bottom line to an efficient aftermarket is stocking and sending the needed part to the truck operator who needs it now," he explains. "Until a vehicle can send its own signal that 'I need a brake part or driveline part replaced in the next 100 mi.,' we will need a viable, proactive, quality-focused aftermarket with speedy, on-time delivery, as promised."
From Bickford's perspective, parts suppliers use tools like the Internet as a means to provide faster, quicker services as part of a more sophisticated warehouse management, logistics and freight optimization strategy. As convenient as the Internet has made ordering, the reality is that fleets are still spread out geographically across the U.S. and still require just-in-time inventory delivery, according to Vipar's Pennig.
"It has allowed us to make the process more efficient," Pennig points out. "In our case, using our v-Enterprise e-commerce system, we connect our fleet customers with us and our distributors electronically for everything from placing the initial order to receiving the final invoicing, while reducing the time and resources needed for the process."
Yet he also notes that the Internet and other electronic connections with customers combined with a robust parts distribution network are allowing many fleets to outsource most, if not all, of their parts inventory — freeing up capital resources to fund other aspects of their operation.
This has led to an "inventory reduction" by fleets, according to Brett Fincham, DTNA's fleet parts team manager. During the Great Recession, fleets looking to cut costs began utilizing more web-based inventory management systems to reduce their on-hand inventory "to only those parts most critical to keeping their units up and running," Finchem says. "[Some] even went as far as shifting inventory around their various terminals and shop locations to avoid adding costly inventory at each particular location." Fleets have only recently started increasing their parts inventories, he adds.
Due to the ability to order and receive parts quickly, more fleets are now keeping only parts for routine maintenance and repair, Paccar Part's Sass says. There is also an increase in fleets looking for national programs with standardized pricing, centralized billing, and national parts availability. That is leading to a one-stop shop mentality where a provider must service all makes and all models.
"Fleets would prefer to call a single source, or as few as needed, to cover all their needs rather than having to utilize multiple sources. They want one-stop shopping," explains Vipar's Pennig. "The source that has the strongest relationship with a fleet is the one who has the ability to provide bumper-to-bumper coverage for the fleets' demands."
To take advantage of this trend, Heavy Duty America and Truck Pride Partners merged last year to form HDA Truck Pride, an aftermarket parts distributor. The company's plan is to unify and expand their distribution networks, consolidate product and program offerings while still maintaining the independent aftermarket channel as a viable alternative to dealership networks, notes Don Reimondo, HDA's CEO, in a speech at the Heavy Duty Aftermarket Week conference in Las Vegas earlier this year.
"With a new unified group with the power of 700 locations, all able to service independent repair shops, national fleets, regional fleets, and vocational types of all sizes with the right parts and with a network of over 400 service facilities, we'll have the ultimate in flexibility versus the OE brands," he said.
Meritor's Bickford agrees, suggesting that even the OE dealer community is beginning to move towards all-makes parts to service the modern dealerships, many of which now include multiple brands.
Even as the industry starts focusing on the ease and speed of ordering parts, one factor still garners a considerable amount of attention: price. "We are seeing a lot of pricing pressure from our dealers and their customers, especially as imported products are gaining acceptance as quality has improved and maintenance budgets have been cut," says Dan Haggarty, director of parts marketing for Daimler Trucks North America (DTNA).
Indeed, the economic pressures that continue to dog fleets of all shapes and sizes is one reason OEMs themselves are trying to bring lower-cost products to their parts shelves.
Yet Haggerty notes that extended warranties for parts are only proving marginally popular. "We've also seen other OEMs launch their own brands of 'second-line' parts focused at value customers like second or third owners," he says.
Meritor's Bickford says that parts sourcing can occur from all around the world, so quality materials and workmanship must be present at all times.
"Equal to that is the after-the-sale service support," he stresses. "Truck operators must still ask themselves, Who will stand behind the part? Who can I turn to? What's the engineering-approved use for a particular part? A price is not always the correct answer or solution."


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There are new laws regulating the breeding and selling of dogs and cats. These changes are designed to weed out unscrupulous breeders from the industry.
The most important changes to the law are:
Who has to register?
How to register?
New breeding standards and guidelines
Sale of dogs and cats

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European expertise helps to view the Sun in a new way
European experts have played an integral role in developing and building the instruments on NASA's STEREO spacecraft. This exciting new solar mission will allow scientists to build on the work of the ESA/NASA SOlar and Heliospheric Observatory (SOHO) mission.
The STEREO mission consists of a pair of spacecraft that will separate after launch and move apart. This will allow them to look at the Sun simultaneously from different angles.
STEREO's mission is focused on the study of extraordinary solar events known as Coronal Mass Ejections (CMEs). "A CME is a part of the solar atmosphere that has been blown off by a huge explosion. The CMEs are the link between the Sun and space weather," says Richard Marsden of ESA, and a co-investigator on STEREO's IMPACT instrument.
Space weather affects the Earth by producing the colourful aurorae. It can also be a hazard to satellites, in some cases destroying them by causing electrical short circuits. SOHO, a multi-faceted solar observatory that revolutionised our understanding of the Sun, began the detailed study of CMEs using an instrument called LASCO.
STEREO will build on the work of SOHO by tracking CMEs from the surface of the Sun to their impact with the Earth. In addition, having two viewpoints with STEREO allows scientists to construct quasi-three dimensional images known as stereoscopic images. "Even with two viewpoints, you won't get the full story. If you want a full three-dimensional reconstruction of a structure, you need as many viewpoints as possible," says Marsden.
That's where SOHO comes in. The 11-year-old spacecraft will provide a third viewpoint that scientists can integrate with the STEREO data in order to gain an even more complete picture of the structure of each individual CME.
At the heart of STEREO lie four scientific instrument packages; all have been designed and built with European participation. The Sun Earth Connection Coronal and Heliospheric Investigation (SECCHI) is a suite of instruments that will chart the evolution of solar eruptions.
The STEREO/WAVES (SWAVES) instrument will track radio disturbances from the Sun to the orbit of Earth. Dr. J-L Bougeret, Observatoire de Paris-Meudon, is the principal investigator of this instrument.
The In-situ Measurements of Particles And CME Transients (IMPACT) experiment will sample energetic particles released by the Sun and monitor changes in the magnetic field of space caused by the solar disturbances. Parts of IMPACT were built at ESA's European Science and Technology Research Centre (ESTEC) in The Netherlands.
The PLAsma and SupraThermal Ion Composition (PLASTIC) experiment will provide key measurements of the particles that make up CMEs, looking for differences between these and the electrically charged gas that the Sun emits all the time.
At ESA, Marsden is now working on the design of a new mission, called Solar Orbiter. Planned for launch around 2015, this spacecraft will travel closer to the Sun than any previous mission, giving scientists their first really close up look at the solar surface and the poles of the Sun.


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Traveling to Latham, New York, but aren't sure where to stay? Close to Albany International Airport, Latham is a convenient home base for visiting nearby Albany, Troy, or the University of Albany. This small town is close to freeways and the average price for a hotel room is around $90 per night. Hotels in Latham mainly cater to budget travelers. Popular choices include Comfort Inn; Cocca's Inn and Suites Route 7 Latham; and the Century House, an Ascend Hotel Collection Member.
If you're headed to Albany on a budget, consider staying in nearby Latham. The town is just a 15-minute drive north of central Albany, and the average price for a budget hotel is an affordable $60. For standard no-frills accommodation, try Latham Inn. For a low nightly rate, you'll get a basic room with private bathroom and complimentary toiletries. Another affordable option in Latham is Super 8 Latham/Albany Troy Area. Close to I-87, it's a popular choice with business travelers and offers recently updated rooms with flat screen televisions.
As long as you book your hotel in Latham more than a few weeks in advance, you won't have to pay much more for a weekend stay. Budget travelers will still find plenty of options for less than $100 per night. The Travelodge Inn and Suites Latham, for instance, has rooms available for less than $70 on Friday and Saturday nights. Other hotels in Latham with cheap weekend rates include the Super 8 Latham/Albany Troy Area and Cocca's Inn and Suites - Route 9.
With Albany International Airport nearby, there are lots of different airport hotels in Latham available for an average of $100 per night. The cheapest is Days Inn Airport and Conference Center, while the popular Latham airport hotel is the Residence Inn Albany Airport. Rooms at this beautifully updated hotel feature free wired and wireless Internet, as well as full-sized kitchens, making them ideal for medium and long-term stays.
© 2019 Hipmunk® and Concur® Hipmunk® are trademarks of Hipmunk, Inc. and Concur Technologies, Inc.
© 2019 Hipmunk® and Concur® Hipmunk® are trademarks of Hipmunk, Inc. and Concur Technologies, Inc.


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Drain Cleaning in Buena, NJ
Keep the pipes clean and the water moving smoothly by investing in regular drain cleaning services in Buena, NJ. Over time, debris can build up and lead to slow drains and problems with bacteria, but this is less of a concern when you work with Mr. Rooter Plumbing of South Jersey. We use proven techniques and powerful tools to eliminate the junk in your drains and keep the lines running smoothly.
We have convenient appointments available that fit your schedule, or you can call us 24 hours a day for emergency services. Residents throughout the area appreciate our proficiency at clearing away grease, oil, and mineral buildup. As a customer, you would benefit from our:
- Courteous and respectful service
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Our drain cleaning services are available in Buena and the surrounding areas, so give us a call today. We'll take care of your drain pipes so that you won't have to worry about untimely backups or the inconvenience of slow drains. We're focused on customer satisfaction at Mr. Rooter Plumbing of South Jersey, and we're looking forward to assisting you. Give us a call.


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Please come and join us for the Fifth Annual Macedonian Ilinden festival featuring the tasty flavors of Macedonia, the music, the dancing and more, including items such as the traditional Macedonian kebobs, , Lukajnci - homemade sausage, Selsko country meat, and delicious homemade baklava & other sweets.
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Would you like the space in your home or office to have a particular appearance and personality? You are not the type of person that enjoys traditional art too much? Well, with the help of Scandinavian prints, you will be able to decorate indoor spaces in a unique manner. Choose to be creative, to personalise spaces according to your preferences and style, making them look like no other. Why Scandinavian prints may be the best choice when it comes to decorations? Perhaps their versatility and simplicity, while still being able to transmit a message, makes this type of art so suitable for so many people that are looking from something apart to create a space of their own.
How to decorate your spaces with Scandinavian prints? The first step would be to choose posters and prints that resonate best with the space and with your personality. Whether you like a subtle message or an abstract picture, these prints and posters will be able to deliver the exact look you need. You can find all prints here, easy and convenient. They are perfect for ultra-modern offices in the heart of the city, for apartments that are designed to have a futuristic appearance, or, if chosen well, even as decorations for traditional and rustic spaces, as a reminder of the times in which we live.
You are not sure what to look for yet? Find your favourite poster here, which will transmit the precise message and feeling you are looking to get. Of course, don't expect for everyone to see what you are seeing in a particular poster, this aspect being the best part of Scandinavian prints. Without being too complicated or sophisticated, these modern art pieces manage to stir the imagination of people in all sorts of ways, each of us receiving a particular message by looking at them. Are you a fan of banksy art? That's just perfect, because you can check out these popular banksy arts and see which one will suit your artistic taste.
No one says that the traditional oil and canvas painting are not beautiful, because they still are. But, artworks like the Scandinavian prints appeared from the desire of people to decorate their spaces with something else. Abstract designs and pictures ended up being appreciated a lot, because they complete a space without too much effort and you don't need to be an art critic to understand them. They are closer to the majority of people, from the point of view of artistic approach, because they depict images connected with real life situations. You didn't find anything suitable for decorating your home or office yet?


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Diving Suits
Hard to find nowadays: a genuine late fifties / early sixties 'Calypso' wetsuit. The rubber is in great shape, this suit spent the last 30+ years on a manequin doll as past of a private collection of diving equipment in a cool and dark basement in France. One of the socks / shoes has a hole where the metal pin of the manequin dolls baseplate went through and one leg has a repair. This suit is a very early one, it dates from before the so called 'shark-skin' rubber. Sizes: flat on the floor as shown at the photo's: from the top of the jacket to the bottom, the slip with buttons included measures 108 cm. The bottom the the front of the jacket (not the slip) is 44 cm wide. The trousers are 97 cm long and the waist is 38 cm. Condition: see photo's. A great suit to display an early Spirotechnique SCUBA set on. Price €220 plus shipping
Vintage La Spirotechnique 'Calypso' Wetsuit


text: OpenJournals firstname.lastname@example.com DELTA® nursing measure: Its development and testing for nursing utility In the specialised nursing field of acute mental illness nurses expressed a need to measure and evaluate their patients' mental-health outcomes both empirically and routinely. The aim was to develop and test a measurement tool, named the DELTA nursing measure, which could be embedded routinely into the nursing process and care plans, enabling the psychiatric nurses to score and evaluate their patients' acute mental-health outcomes. A qualitative, exploratory study design was used to address two sequential objectives. Firstly, qualitative data that described observable behaviours in patients with acute mental illness were collected from psychiatric nurses (n = 5) who were experienced in acute mental healthcare. The data were analysed using inductive content analysis techniques to design and construct the DELTA nursing measure. In the second objective, the nursing utility of the DELTA nursing measure was studied. This was done by training and testing a new team of psychiatric nurses (n = 25) working in a 116-bed acute psychiatric hospital, in the application of the DELTA nursing measure. After 30 months a focus group (n = 6) representing this team was held to explore their perceptions and experiences of the nursing utility of the newly-developed measure. The descriptive data were analysed using deductive content analysis techniques. The outcome of the DELTA nursing measure as a routine nursing measure of acute mental illness provided good results. The nursing-utility characteristics have confirmed positive responses with regard to its acceptance, usefulness and confidence as a worthwhile tool to be used in expediting nursing services in acute mental healthcare. The positive responses to the DELTA nursing measure are noteworthy. It has the potential to add substantial value to the mental health care field in nursing by adding a measurable dimension to patient outcomes, a much needed requirement by patients, multidisciplinary teams and healthcare funders. In die gespesialiseerde verplegingsveld van akute psigiatrie het verpleegkundiges 'n behoefte uitgespreek om roetineweg pasiënte se geestesgesondheidsuitkomste empiries te meet en te evalueer. Die doel van die studie was om 'n meetinstrument, genoemd die 'DELTA nursing measure', te ontwikkel en toets wat ingebed kan word in die verplegingsproses en versorgingsplan en wat psigiatriese verpleegkundiges in staat kan stel om roetine-weg die pasiënte se akute geestesgesondheidsuitkomste te meet en te evalueer. 'n Kwalitatiewe, eksploratiewe studie ontwerp is gebruik om twee opeenvolgende doelwitte aan te spreek. Eerstens is kwalitatiewe data wat observeerbare gedrag in pasiënte met akute geestessiektes beskryf ingesamel van psigiatriese verpleegkundiges (n = 5) wat ervaring het in akute geestesgesondheidsorg. Die data is geanaliseer met induktiewe inhouds analiese tegnieke om die ontwerp en konstruksie van die 'DELTA nursing measure' te bewerkstellig. In die tweede doelwit was die 'DELTA nursing measure' se bruikbaarheid vir verpleging bestudeer. Om dit te doen was 'n nuwe span psigiatriese verpleegkundiges (n = 25) wat werksaam was in 'n 116-bed akute psigiatriese hospitaal opgelei en getoets in die gebruik van die 'DELTA nursing measure'. Na 30 maande is 'n fokusgroep (n = 6) gehou wat verteenwoordigend was van die span om hulle persepsies en ervarings van die nuut-ontwikkelde meetskaal se bruikbaarheid te eksploreer. Beskrywende data is met behulp van deduktiewe inhouds tegnieke geanaliseer. Die uitkoms van die 'DELTA nursing measure' as 'n routine verplegingmeetskaal vir die bepaling van akuutheid in psigiatrie het baie goeie resultate opgelewer. Die bruikbaarheidseienskappe het positiewe response bevestig dat aanvaarding, betroubaarheid en vertroue bereik is en dat dit 'n nuttige instrument is om die verplegingsdiens te bevorder. Die positiewe response op die 'DELTA nursing measure' is merkwaardig. Dit het die potensiaal om 'n betekenisvolle bydrae te lewer tot die psigiatriese verplegingsveld omdat dit 'n meetbare dimensie toevoeg tot pasient uitkomste, 'n hoogs-benodigde vereiste van pasiënte, multidissiplinêre spanne en gesondheidsorgbefondsers. Hendrik J. Loubser1 1South African Database for Functional Medicine, South Africa Judith C. Bruce2 2School of Therapeutic Sciences, University of the Witwatersrand, South Africa Daleen Casteleijn3 3Department of Occupational Therapy, University of the Witwatersrand, South Africa Hendrik Loubser firstname.lastname@example.com PO Box 2356, Houghton 2041, South Africa 69918110.4102/hsag.v18i1.69921 Sept. 201218 July 201317 Sept. 2013Loubser, H.J., Bruce, J.C. & Casteleijn, D., 2013, 'The DELTA® nursing measure: Its development and testing for nursing utility', Health SA Gesondheid 18(1), Art. #699, 9 pages. http://dx.doi.org/10.4102/hsag.v18i1.699 © 2013.The Authors. Licensee: AOSIS OpenJournals. This work is licensed under the Creative Commons Attribution License.Introduction There is an ongoing global search for validated nursing measures regarding the severity of patients' illness in the field of acute mental healthcare. The nursing profession requires a standardised method, similar to the vital signs, to observe, score and record the severity of a patient's mental illness and to monitor it routinely as it changes from day to day. If such a method can be found and data can be collected routinely, empirical information on patient outcomes in acute mental-health care will be available to provide evidence for clinical effectiveness. Scales currently competing to become a routine nursing measure are structured self-report questionnaires such as the Behavioural and Symptoms Identification System (BASIS) designed by Eisen and Dickey in 1996. The BASIS contains 32-items that capture the patient's perspective on relation to self and others, depression and anxiety, daily living and role functioning, impulsive and addictive behaviour and psychosis. However, as a subjective questionnaire it has limited use in a country such as South Africa where levels of illiteracy remain high (Eisen & Dickey 1996:182). Another competing scale that measures mental-health outcomes, according to Meagher et al. (2009:172) is the Health of the Nation Outcomes Scale (HoNOS), widely used in Britain, Australasia, Canada and some European countries. This is a 12-item scale measuring behaviour, impairment, symptoms and social functioning that can be completed by any member of the healthcare team. There seems to be little consensus in the literature to its usefulness as a routine measure and its accuracy with regard to detecting change. In fact, Bebbington et al. (1999:391) and Adams et al. (2000:196) argue against the use of scales such as HoNOS as a standardised routine measure as it has been found to have questionable validity and only a tenuous relationship with patient severity. Furthermore, Lakeman (2004:212) takes a strong nursing perspective in that clinician-rated standardised tools such as the HoNOS have little, if anything, to do with or to offer toward the patients' recovery process, whilst Trauer, Callaly and Herrman (2009:294) report that the HoNOS enjoys limited acceptance by healthcare professionals as being a useful measure. Moreover, Meagher et al. (2009) caution that service needs cannot be judged merely upon a cross-sectional assessment of active symptomatology on admission and discharge as rendered by the HoNOS, but rather require routinely-observed and recorded longitudinal data on patient changes as these occur. A third competitor is the Global Assessment Functioning (GAF) scale that indicates the severity of mental illness. It is used frequently by psychiatrists and other members of the healthcare team and is often referenced in research. It constitutes the fifth axis of the Diagnostic and Statistical Manual of Mental Disorders (DSM), currently undergoing its fifth review (Aas 2011). However, the GAF is not a measure, but rather a clinical classification based on the clinician's judgement of the patient's overall level of function (American Psychiatric Association 1994:199). The literature expresses significant concern about the GAF's subjectivity, its lack of detail in its user guidelines and poor validation ratings (Aas 2010). In an attempt to satisfy these shortfalls, researchers and developers are currently trying to improve, adjust or repair the inadequacies of the GAF (Aas 2011). Even with all these pressures to find a suitable nursing measure, Salvi, Leese and Slade (2005:146) reported little consensus as to which outcome scales to use in mental healthcare, and suggested that meaningful and comprehensive clinical information could only be provided by a combination of existing measures. However, Aas (2010) cautioned that if the numbers of scales are increased, the learning period for managing the scoring method may increase, scoring may become more time consuming and less easy to use and the outcomes analysis of the data may become more complex. Lately, pressure from clinicians is mounting, challenging the randomised control studies of evidence-based practice as being too far removed from the real world of mental healthcare practice. Clinicians are advocating a parallel consideration for practice-based evidence as being more connected to the context of real practice. Furthermore, clinicians rate first-hand knowledge and experience of what works, what needs to be changed and how it may change due to experience of their patient-based outcomes, higher than the prescriptive formularies of academics (Hellerstein 2008; Warroll 2007). Irrespective of the ongoing debate between the preference for evidence-based practice or practice-based evidence, the point of consensus still requires the need for routine measurements of patient progress (APA Presidential Task Force on Evidence-Based Practice 2006:275). Acute mental healthcare settings are also the domain of multidisciplinary teams and the question has been asked if the nursing profession is best suited, placed and skilled to measure patient progress on a routine basis. Meagher et al. (2009:173) reiterated the consensus that a multidisciplinary team is the preferred approach for mental healthcare services to record the complexities of severe mental illness. The continuous contact with patients and proximity of nurses as primary caregivers enable direct observations of changes as they occur. It has been well recorded that this advantage creates a rich intuitive knowledge integral to the nursing practice which Billay et al. (2007:149) emphasise as a legitimate form of nursing skill. In their line of duty, nurses already report their daily observations descriptively with regard to patient severity and progress. All these factors point toward nurses as being the best-skilled health professionals to observe, score and record patient outcomes routinely as changes occur. However, the existing scales as discussed above do not include the nursing profession as users and a literature review revealed no validated nursing framework available to nurses to allow them to observe and measure objectively the severity of patient mental illness. Problem statement Psychiatric nurses are at a disadvantage because they lack the tools to establish empirically the severity of their patients' acute mental illness. Without a valid empirical nursing measure on which to base their nursing evaluation and assessment, the psychiatric nursing process and care plans are vulnerable to contradiction, inconsistency and ambiguity. Furthermore, the psychiatric nursing process currently has no empirical record of patient recovery and no routine longitudinal data on patient outcomes are available to reflect on the impact of nursing performance. Aims and objectives of study This study aims to provide psychiatric nurses with an objective scale to measure the severity of their patients' acute mental illness. Two objectives were identified: To design and develop a nursing measure for psychiatric nurses to observe, score and record their patients' severity of mental illness routinely as they recover by virtue of the acute psychiatric nursing process. To test if the newly-developed nursing measure has nursing utility, namely, to determine whether it is useful and acceptable enough to be embedded into the nursing process and care plans by psychiatric nurses. Definition of key concepts Scale versus measure: In general, the terms 'scale', 'instrument', 'test', 'tool' and 'questionnaire' may all refer to the concept of producing numerical scores to explain a phenomenon at an ordinal level (Bond & Fox 2007). However, none of these terms refer to a 'measure', which identifies a higher level of measurement qualities, namely linear interval characteristics (Stevens 1946). Nursing utility: The utility of an instrument is the degree of conviction that the users have regarding its usefulness in their practice (Toomey, Nicholson & Carswell 1995), taking into consideration application practicalities such as relevance, suitability, feasibility, accuracy, comprehensiveness, credibility, flexibility, value and adaptability (Barbara & Whiteford 2005). The term clinical utility is often used, but for this study the term nursing utility has been used to fit the population being studied.Psychiatric nurse: A category of nurses who obtained a qualification either through a four-year or a post-registration training programme and who is registered with the South African Nursing Council (SANC) as a psychiatric nurse. Countries such as the UK and Canada call this category of nurses mental-health nurses. Mental health, mental illness and psychiatry: Mental health refers to cognitive, emotional and psychological wellbeing in order to function in society and meet the ordinary demands of everyday life. Mental healthcare is the branch of healthcare which provides care to those with impairments in cognitive, emotional or psychological areas. Mental illness is the term used to refer to impairments and dysfunction in areas of mental health. The term psychiatry is also found in literature. This term refers to the field of mental healthcare but seems to be used less in recent literature. The South African Mental Healthcare Act 17 of 2002 (South Africa 2004) uses the term mental healthcare and mental illness and these terms are used in this article. However, there is one exception. The term for nurses who are trained in mental healthcare will be psychiatric nurses as this is the category of nurses stipulated by the South African Nursing Council. Research design and method Research design A qualitative, exploratory and sequential research design was followed to develop a new nursing measure and to test it for nursing utility. This qualitative study strove to understand the actions and processes within the specific context of psychiatric nursing and, explicitly, the interface between the patient and the psychiatric nurse. Exploratory research examines this interface actively as the specific phenomenon of interest rather than observing and reporting (Lobelo 2004:20). Exploratory research often includes the use of a panel of experts. The inclusion of experts in the design, development and testing of instruments have been advocated widely (Bruce, Langley & Tjale 2008:58; Burns & Grove 2005:400; Elo & Kyngäs 2007:108). The input from experts in this study was obtained through unstructured interviews and focus group interviews. The research design was also sequential in nature as the findings of the first objective were used in the second objective. The nursing measure first had to be developed before it could be subjected to the test for nursing utility. The sample The sequential nature of the study necessitated two different samples. The sample for the first objective was a purposive sample of five psychiatric nurses. These nurses have been working as a team for more than four years in an acute psychiatric unit. The researcher was referred to this specific nursing team by the funding organisations when enquiring for a nursing service of excellence. The nurses in this team were valued for their excellence in mental healthcare and were thus viewed as experts by the lead researcher. The team agreed to meet as a group and thereafter made themselves available individually to edit the initial documentation of the newly-developed nursing measure. The sample size was determined by the availability of respondents and data saturation. When using experts in the development of an instrument, a sample of five to 10 participants is suggested (Burns and Grove 2005:407). For the second objective of the study, a second sample of nurses was selected in order to test the newly-developed measure for its nursing utility. None of the nurses of the second sample were acquainted with the first group of nurses who participated in the design and development of the measure. A new sample was selected to control for possible bias from the first group when testing the measure for nursing utility. The participants of the second sample (n = 6) were selected from a population of 25 nurses employed at a 116-bed acute psychiatric facility in South Africa. This facility admits patients who are referred from a 72-hour unit as stipulated in the South African Mental Healthcare Act 17 of 2002 (South Africa 2004). The average length of stay is 23 days. The inclusion criteria stipulated that participants should be registered psychiatric nurses, should have used the DELTA nursing measure for at least six months (implying that they were credentialed in the use of the measure), should have given consent to participate in the focus group and were scheduled for duty on the day of the focus group interviews. The sample consisted of five psychiatric nurses, one with a Master's qualification in psychiatric nursing. The facility's nursing manager was the sixth participant and, although she had no formal psychiatric qualification, her substantial experience in managing nursing services in this specific acute psychiatric facility made her input valuable. Each participant had between seven and 30 months' experience in using the DELTA nursing measure. Data collection and analysis The design and development of the new nursing measure commenced with unstructured individual interviews with the nursing team in order to get an understanding of the behavioural symptoms and signs of patients with acute mental illness that nurses are able to observe and interpret. The lead researcher named the new measure the 'DELTA nursing measure'. The name DELTA refers to the fourth letter in the Greek alphabet and is the fourth in a suite of nursing measures under construction by the researcher. The unstructured interviews with the expert nurses were explorative and open-ended with the objective to explore their perceptions of what constitutes acuity in mental illness and how they would distinguish consistently between the levels of severity of an illness. Since the DELTA nursing measure must ultimately perform as a global nursing instrument of acute mental illness, special emphases were laid on the generalisations of observations; thus observations should be invariant for all diagnostic groups (observations to cover all patients with mental illness). After the five participants gave their input during the unstructured interviews, group sessions were held to discuss the observations collectively. The central questions used during the individual interviews remained: What do you see or observe when you know this patient is critically ill? How does severity present itself? How do you recognise the first signs of improvement? What are the observational behaviour changes that can serve as stepping stones to recovery and how do you distinguish between them? What observations do you experience as improvement and regression? Field notes, flip charts and audio recordings were made during the focus group sessions. The team of expert nurses was also used to assist with the analysis of the raw data. This was achieved in two sessions with the expert team, scheduled at their facility and at their convenience. An inductive content analyses technique was used to reduce volumes of verbal- and printed descriptive material into more manageable data. The experts were asked to identify patterns from the raw data and explain their understanding of the phenomena of severity of mental illness. The inductive approach enabled the researcher to identify key themes in the area of interest by reducing the material to a domain, a set of themes or items and categories. After the first inductive content analysis session, the researcher used the design structures proposed by the experts and created a documented first version of the DELTA nursing measure. This was sent to the experts for editing and during the second work session the team provided valuable information for the change, adjustment, modification and refinement of the content of the DELTA nursing measure. This became the second version of the measure. Throughout the analyses, the following four design guidelines were considered: The measure must be useful at the interface between psychiatric nurses and acute mentally-ill patients. The measure must fit the acute psychiatric nursing process and care plans. The measure scores must facilitate a uniform language in communicating acute mental illness. The measure must improve the quality of the acute psychiatric nursing services. The guidelines above were adapted from Smart's (2006:378) multidimensional model of clinical utility to create the transition to the second objective of the study. The experts agreed to implement the second version of the DELTA nursing measure in their facility to test for applicability and preliminary nursing utility. This was done for six months and during this time further minor changes were made, resulting in the formulation of the third version of the DELTA nursing measure. This third version was used to develop a training manual that included testing material to credential future users of the DELTA nursing measure. Data collection and analysis in relation to the second objective of the study were ready to commence after the third version of the DELTA nursing measure was finalised. For this phase of the study, the team of 25 nurses in the 116-bed facility were credentialed in the use of the DELTA nursing measure. Each nurse underwent a six-hour training session and was subjected to a credentialing examination consisting of four case studies. They were given a certificate of competence on achieving an 80% pass mark. Nurses who failed were requested to repeat the test until they obtained at least the 80% pass mark. The nursing team scored all patients admitted into the facility on the DELTA nursing measure over a period of 30 months. Each patient had an admission score, weekly interval scores and a discharge score. During this period, the team recorded 9413 raw scores collected from 1955 patients admitted into the facility. A focus group interview was held, after the 30-month period of using the DELTA nursing measure, with six participating nurses according to the inclusion criteria described above. The four broad questions selected for the focus group interview included the DELTA nursing measure's overall usefulness to the nursing profession; the ease with which it could be embedded into the nursing process as a routine measure; its ability to become a universal language as measure of the severity of acute mental illness; and its potential to improve the quality of nursing care. These four questions related to the four design guidelines used during the second version of the DELTA nursing measure. The analysis thus followed a deductive content-analysis approach (Elo & Kyngäs 2007:111) where existing data were retested in a new context. The responses were then recorded and transcribed. Ethical considerations Prior to data collection, written approval was obtained from the clinical managers of the facilities where the data were collected, the Human Research Ethics Committee (Medical) of the University of the Witwatersrand (Ethical Clearance Certificate number M 10524) as well as the North West Provincial Department of Health. Informed consent was obtained after explaining the purpose and procedure of the study. Nurses were informed regarding what was expected of them, that there were no known harm or risks in the study, that their participation was voluntary and that they could withdraw at any stage without being disadvantaged in any way. Nurses who agreed signed a consent form. Trustworthiness The four criteria of trustworthiness, namely credibility, dependability, confirmability and transferability were followed (Krefting 1991:214). Credibility was achieved by prolonged engagement with the participating nurses during the interviews and during development and testing procedures. The study was also examined by both internal- and external examiners and was published as part of a PhD dissertation (Loubser 2012). Dependability was achieved through a detailed description of the research methodology and peer review, as well as through use of a code-recode process during data analysis. Confirmability was achieved through a detailed description of the research process, unstructured individual and focus group interviews were recorded and field notes were written. Transferability was achieved through the purposeful selection of the sample, as well as through a dense description of the research methodology and results of the study, so that researchers who are interested in conducting similar research should be thoroughly informed. Results First study: Design and development Five latent variables that contributed equally to the severity of acute mental illness emerged from the individual- and group discussions with the five experts. These five variables became the five items of the DELTA nursing measure and were labelled as: acts of reality loss, acts of incongruence, acts of destructiveness, acts of self-absorption and acts of focus loss. Each of these five items embraces its own unique cluster of typical mental-illness terms and the definitions underpinning it (Table 1). For each item, a scale with seven categories (points on the scale) of severity was established (Figure 1). The first category (1 on the scale) represented the most acutely-ill patient with the least functionality and the seventh category (7 on the scale) represented the highest-functioning patient. Decision trees with guiding questions were developed for each item in order to arrive at the relevant category or score on the scale (Loubser 2012:234). Figure 2 is an example of a decision tree for one of the items, namely 'the acts of reality loss'. The DELTA nursing measure thus consists of a domain ('severity of acute psychiatric illness') with five items, each having seven categories of severity as demonstrated in Figure 1. Therefore, when totalling the scores of the DELTA nursing measure, a minimum score of 5 (5 items multiplied by the minimum score of 1) can be achieved in a critically-ill patient and a maximum score of 35 (5 items multiplied by the maximum score of 7) would indicate a normal functioning person. Second Study: Nursing utility The findings below derived from a focus group interview with six nurses responding to the four guiding questions on the nursing utility of the DELTA nursing measure. In an attempt to convey the richness of the data as expressed in the language used by the participants in the group, any direct quotations used must be interpreted as coming from the spokesperson of the group when expressing an experience or opinion. Question 1: Is the DELTA nursing measure useful to the nurses? Overall the nurses reported a 'new mind-set change' toward severity measurement during the nursing assessment and evaluation. For the novice nurse with little or no previous mental healthcare experience, the inclusion of this new vital sign in the nursing process was initially difficult to master, but 'within months' the DELTA nursing measure became 'very easy to use'. Once proficient, the nurses reported new insights in their practice as they found themselves able not only to measure 'if the patient is improving or not improving', but also to evaluate and record 'how much the patient is improving from admission to discharge'. This new nursing insight has empowered them to guide the multidisciplinary team as their nursing statistic became 'a good indicator to see if things start to go wrong for the patient'. As the nurses started to use it routinely, they also found themselves to be 'very successful to further evaluate [sic] deterioration or improvement in patient scores and even adjust treatment according to the scores'. Overall, the nurses reported a useful new vital statistic whereby they found 'it very helpful to be able to evaluate [empirically] if the patient is improving or not improving'. They also felt that the scores of the DELTA nursing measure correlated with their clinical judgement regarding the severity of symptoms. This enhanced their confidence in the scores to the extent that they advocate adjusting treatment and services based on their recordings. (See Table 2) Question 2: Can it be embedded into the nursing process? All responses indicated that the nurses used the DELTA nursing measure routinely during the assessment, diagnosis, implementation and evaluation phases of the nursing process and found it to be 'beneficial to the nursing process'. They provided evidence showing how the DELTA nursing measure 'mind-set' helped their nursing process to focus on the five items in the DELTA nursing measure. 'Previously', they reported, 'it was difficult to interview, but if you know the content of the DELTA nursing measure it makes it now much easier to interview as we now know what to look out for'. Moreover, 'it makes it easier to make a nursing diagnosis and establish the severity of the diagnosis'. The nurses also highlighted four awareness features of the DELTA nursing measure, which have become embedded into the routine nursing process: firstly, the DELTA nursing measure prompted nurses to identify specific symptoms which directed them to the appropriate nursing diagnosis; secondly, the rating of the severity led them to devise and implement appropriate nursing care plans; thirdly, the DELTA nursing measure has the ability to raise warnings on suicidal risks; and, finally, the longitudinal scoring and recording of patient severity are used to advocate for treatment changes at the multidisciplinary team meetings. Question 3: Can the items of the DELTA nursing measure be used as a uniform language? As the DELTA nursing measure becomes embedded into the routine nursing process, changes in the scores become helpful references of communication between nurses and doctors to allow for the discussion of diagnosis and treatment plans. The DELTA nursing measure became the universal language at the multidisciplinary meetings. According to the nurses, the multidisciplinary teams are becoming more reliant on the feedback from the scores on the DELTA nursing measure as the preferred outcome measure to evaluate patient progress or decline. Nurses find it an 'exciting new development' that multidisciplinary teams base their considerations regarding adjustment of treatment plans more on the nursing observations than ever before. Nurses further emphasised their ability to score a patient empirically as a suicide risk and used this score as motivation for management to supply such patients with one-to-one nursing care. Question 4: Does the DELTA nursing measure improve the quality of nursing services? Whilst probing the issue of nursing quality of care, there was consensus that the DELTA nursing measure 'definitely made nurses more aware of their patient's symptoms, needs and severity of illness'. As the DELTA nursing measure became the universal language at the multidisciplinary meetings, nurses became more confident in defending their scores and patient outcomes. There was also a vast improvement in their patient-interaction skills, interviewing skills and their observations of patient behaviours. Being more aware and knowing the patient better also resulted 'in rendering better conditions of care'. Thus, the DELTA nursing measure, being a dedicated nursing measure and producing scores to calculate patient outcomes, not only 'contributes to improving the quality of nursing care', but also contributes to 'improving the nursing skills'. It became evident that nurses regularly discussed the scores of the DELTA nursing measure amongst themselves so as to evaluate their nursing process. A decline in scores indicated a regression that necessitates re-evaluation of nursing interventions and care plans whilst increased scores indicated improvement that may or may not require adjustments to treatment. One nurse described these discussions as an 'exciting experience'. The findings from the focus group interview supported the nursing utility of the DELTA nursing measure as a clinically-useful measure of severity of acute mental illness. No signs of hesitation by the nurses in any of the four questions to express a positive response were noted by the researcher, thus indicating that the DELTA nursing measure was well accepted by the nursing team in this study. Discussion Psychiatric nurses working in acute mental healthcare facilities are at a disadvantage as they lack the measurement tools to track change after intervention. As a result, they are unable to monitor empirically a patient's progress or to implement appropriate care plans. Although a systematic review of interventions delivered by UK mental-health nurses revealed that nurses are able to deliver effective interventions, the authors reported that a limitation of the study was that a precise assessment of outcomes was not possible. The reason for this is the lack of appropriate and valid measurement of outcomes that are sensitive to change and specific to the situations concerned (Curran & Brooker 2007:501). Montgomery, Rose and Carter (2009:32) reviewed the literature to examine the relationship between psychiatric mental-health nursing interventions and patient-focused outcomes. Their most important finding was that there are inconsistent recommendations as to which instruments should be used routinely in practice. The introduction of the DELTA nursing measure into the scope of psychiatric nursing in South Africa generated a new awareness that nurses should focus on observations and measurement of severity of symptoms in acute mentally-ill patients and the implementation of routine outcome measurement. The design and development of the DELTA nursing measure were dependent on the input from expert nurses who contributed to the positive responses toward nursing utility as well as the appropriateness of the content of this measure to the specific context of acute mental illness in South Africa. With no previous training or information given on acute mental healthcare nursing techniques to improve patient outcomes, it is interesting to note that the psychiatric nurses discovered by themselves that they ought to change the focus of their scope of practice from a reactive task-orientated approach to proactive patient advocacy in order to achieve both patient and nurse satisfaction. The availability of empirical DELTA scores has widened the nursing approach from basic task rendering to an all-inclusive nursing approach with an emphasis on patient-focused outcomes. Data for the development of the items were generated from a small sample of psychiatric nurses (n = 5), which might be seen as a limitation of the study. However, the feeling is that the larger the number of experts, the less consensus is reached (Burns & Grove 2005:407). Working with this small number of people in one institution had the advantage that participants could share all their ideas with fewer interruptions in the group. The institution was also rated by a funding organisation as being one of the settings that provided a good service, allowing the authors to assume that the nursing team are experts in their field and thus able to share rich and relevant information. There is a paucity of literature on nursing measures applied routinely for the measurement of the severity of mental illness. This eliminated the possibility to review other measures and to compare items that emerge from this study to previous studies. It seems that nurses working in the mental healthcare field either form part of multidisciplinary outcome measurements such as HoNOS (Brooks 2000:506) or specific research that does not entail routine outcome measurement, for example, the GAF (Skärsäter, Baigi & Haglund 2006:206) and the Brief Psychiatric Rating scale (Myer et al. 2008:147). None of these measures have been developed with nurses and with the focus on acute mental illness. This may limit their credibility amongst nurses and subsequently decrease their motivation to implement such measures routinely. The newly-developed DELTA nursing measure is intended for routine outcome measurement in acute mentally-ill patients, developed with input from psychiatric nurses. There seems to be an optimism that it fits into the nursing process. Limitations The paucity of published work on routine outcome measurement in nursing for patients with mental illness limits comparison with other measures (Curran & Brooker 2007:501; Montgomery et al. 2009:32). Limited publications in routine outcome measurement might not necessarily point to an absence of relevant measures and therefore the authors would welcome feedback on outcome measures for nursing in mental healthcare settings. The sample was selected from one institution and was thus not representative of the entire country. Although quality data were obtained, bigger samples could support relevance and content validity of the items for the DELTA nursing measure. Research is underway to determine the construct validity of the DELTA nursing measure and preliminary results indicate good validity (Loubser 2012:257). These results could be an indication that, in spite of the limited sample of five experts, the items are indeed valid for South African acute mentally-ill patients. Recommendations The findings of this study suggest that the psychiatric nursing process could benefit from a 'mind-set change' (as the sample in this study experienced) to include sustainable procedures to maintain the nursing focus on patient outcomes. This study also revealed that the DELTA nursing measure is an important instrument to facilitate the process of evidence-based practice. Future nursing education may wish to consider including training, testing and credentialing on the use of the DELTA nursing measure for focused nursing-care plans and improved quality in acute mental healthcare. Conclusion The DELTA nursing measure was developed by South African nurses for South African nurses in order to render better care for patients requiring acute mental healthcare. The findings from this study supported the DELTA nursing measure as a well-designed measure that can be used routinely by psychiatric nurses in acute mental healthcare facilities to provide empirical evidence of their patient's severity of mental illness. It has made nurses aware of the value of having empirical patient-based outcomes data embedded into the nursing process. This was manifested explicitly in the ease with which the nurses recognise, observe and recorded the scores of the DELTA nursing measure in their daily routine. Psychiatric nurses in this sample reported positive outcomes such as an improvement in the quality of nursing services and a uniform language to communicate with team members. In this process the nurses also became aware instinctively that they are the advocates of their patients' recovery process and this put them back in control of nursing effectiveness and efficiency. The DELTA nursing measure adds a measurable dimension to patients' mental health outcomes, a much-needed requirement by patients, multidisciplinary teams and healthcare funders. AcknowledgementsThe authors would like to acknowledge the nurses that participated voluntarily in the study, as well as our colleagues from the School of Therapeutic Sciences at the University of Witwatersrand for their support as peer reviewers in the study, most specifically our colleague, Dr Marietha Nel, for her scientific- and language editing. Competing interests The South African Database for Functional Measures (Pty) Ltd provided financial support for this study. Although the SADFM gave written permission to publish this article, and although the copyright of this article vests with the publishers, the patent rights of the DELTA vests within SADFM (RSA patent registration number 2008/09086). Authors' contributions This article was based on the primary research done by H.J.L. 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text: It turns out that with just a slight bit of modification to the way Journey is installed I can ship it in a much smaller box than I normally use. This will save a good bit on shipping expenses in today's high cost energy world. The cost of shipping my normal box to Europe has ballooned to something over $500 with added fuel surcharges. Journey, in this new box, will ship for less than $300.


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Kurt used to love who he was, once he truly figured himself out. Until one fateful night when everything changed. He now sees himself as damaged, broken goods, not worthy of a relationship. Intimacy is something he believes he'll never find again thanks to the scars; mentally, emotionally, and physically left upon him one night many years ago.
James is the owner of a local wine bar and instantly wants to get to know Kurt on a more personal level after meeting him at an event. Only James's demons come back to haunt him on a regular basis. The past never stays where it's supposed too.
Between Kurt never taking off his shirt, James's past and reputation, along with a few other intense curve balls thrown there way; intimacy seems to be a lost cause.
Purchase: http://amzn.to/2q1B7F3


text:
Table of contents for SQLite
- SQLite – Easy to use, dependable and good to use database for small applications.
- SQLite : Manager for this simple database
- SQLite – simple use in scripts
- Using SQLite to maintain your monthly bills.
For last couple of days I am looking at SQLite, a very footprint, file based Database.
SQLite is a C library that implements an SQL database engine. A large subset of SQL92 is supported. A complete database is stored in a single disk file. The API is designed for convenience and ease of use. Applications that link against SQLite can enjoy the power and flexibility of an SQL database without the administrative hassles of supporting a separate database server. Version 2 and version 3 binaries are named to permit each to be installed on a single host.
There are already some cool tutorials on various blogs about sqlite, so I will just point to them for now.. More to come soon.
1. http://souptonuts.sourceforge.net/readme_sqlite_tutorial.html
2. http://freshmeat.net/articles/sqlite-tutorial
3. http://zetcode.com/databases/sqlitetutorial/
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text:
Buell Recreation is always seeking organized and highly motivated professionals to join our team and represent our company. Whether you are new to the industry or come with many years of experience and knowledge, we welcome you to submit your resume to firstname.lastname@example.com. Please include the position you are interested in on the subject line. Thank you!
Current Openings:
CUSTOMER SERVICE/SALES SUPPORT - PARK & PLAYGROUND PRODUCTS - Portland, Oregon


text:
First things first, how adorbs is my front porch? I just need a few more pumpkins.
Ah fall. There are pumpkins everywhere, the leaves are falling, the sunsets are unmatched and there's a chill in the air, in other parts of the country, not Spring Hill, TN. No wonder Thanksgiving is in the fall because how can you not feel thankful with all this beauty surrounding us!
And yay for fall clothes! I love to layer so I'm excited to pull my sweaters out of the guest room closet! Oh and I love everything plaid or flannel. So imagine my joy when I found this black and white buffalo check poncho for $14!
Naturally it made my short list of fall favorites...
1. Buffalo Check Poncho: Walmart (!) can you believe that?!
2. Hot Cinnamon Spice Tea: I actually have to go to the Woodhouse Day Spa to buy this stuff but when I remember to, I get it on amazon. If you've never experience this tea, you must order it now! It's heaven in a cup.
3. Blush: This shade of blush is a makeup bag staple in my opinion. It's Blushbaby by MAC and its absolutely gorgeous.
4. Black Flats: I love boots as much as the next gal but there's nothing better than a good pair of flats to throw on when you're running out the door. I love these Tory Burch Minnie Travel Flats, they are so comfortable! You may have noticed that I was wearing the Revas in photo before but after wearing those for a couple of days, I realized that they were the most uncomfortable shoes in the world. I had blisters!! Luckily, Nordstrom has excellent customer service and had heard my very same sad song about the Reva flats and exchanged them for their comfortable sister shoe, the Minnie!
What are your fall favorites? Comment below!
Happy Fall Y'all!


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UK Wellness Week 2018: Finding the Courage to Live Well
LEXINGTON, Ky. (July 12, 2018) — The University of Kentucky is celebrating its inaugural Wellness Week July 16-20. Each day, university faculty and staff will have opportunities to participate in free events related to nutrition, physical activity, and personal health and well-being.
Among the activities offered are daily yoga classes, healthy snacking, chances to relax and release stress with adoptable dogs from the Lexington Humane Society, and a university-wide step challenge to reach a collective goal of 150 million steps (three times around the equator).
The certified exercise specialists at MoveWell at Export Street, the university's employee-dedicated fitness center, will hold an open house with tours of the facility as well as information on group fitness classes and personalized training. The registered dietitians at EatWell will also offer both online and in-person information sessions focusing on the health goals most important to you, enjoying meals incorporating all the food groups, and celebrating your successes.
The keynote address, "The Courage to Live Well," will be delivered by one of UK's certified professional health coaches and wellness specialists, Amy Rodquist-Kodet, noon to 1 p.m. Tuesday, July 17, at the Gatton Student Center's Worsham Cinema. She will share insights about research-backed steps you can take for greater well-being.
The event, hosted by Human Resources Health and Wellness, is part of an ongoing effort by the university to invest in and support the success of the UK community through healthy and positive work-life integration. The Health and Wellness team comprises registered dietitians, certified exercise specialists and certified health coaches dedicated to providing individual and group support to employees daily.
For more information and to sign up for events during 2018 Wellness Week, visit https://ukhr.uky.edu/livewell/wellness_week.
UK is the University for Kentucky. At UK, we are educating more students, treating more patients with complex illnesses and conducting more research and service than at any time in our 150-year history. To read more about the UK story and how you can support continued investment in your university and the Commonwealth, go to: uky.edu/uk4ky. #uk4ky #seeblue


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Kulula Flights To JohannesburgBook Kulula flights to Johannesburg
Being one of the most popular routes in South Africa, Kulula Airlines are able to offer some really great Kulula specials on flights to Johannesburg. We have scanned more than 15 million Kulula flights to give you some of the cheapest in South Africa.
Cheapest Kulula Flights To Johannesburg – One-way
|Departure Date
|Airline Logo
|Kulula Flights To Johannesburg From Durban
|22 Nov
|Kulula Flights To Johannesburg From George
|11 Jun
|Kulula Flights To Johannesburg From Cape Town
|26 Feb
|Kulula Flights To Johannesburg From Cape Town
|29 Feb
Cheapest Kulula Flights To Johannesburg – Return
|Departure Date
|Airline Logo
|Kulula Flights To Johannesburg From George
|11 Jun
|Kulula Flights To Johannesburg From Cape Town
|26 Feb
Popular Kulula Flights To Johannesburg
|Kulula Flights from Durban to Johannesburg
|from R490.00
|Kulula Flights from Cape Town to Johannesburg
|from R679.00
|Kulula Flights from East London to Johannesburg
|from R579.00
|Kulula Flights from George to Johannesburg
|from R999.00
Though by far the majority of visitors to the city are business travellers who are heading over to the City of Gold for conferences and business meetings, there's still more than enough to satisfy the most eager tourist who is looking to sample some of the life in Africa's largest commercial centre. There are shopping areas a-plenty, and a plethora of cultural events taking place throughout the entire year.
Those who are journeying from Cape Town, Durban, or George, making use of Kulula flights to Johannesburg, can choose from several daily scheduled flights that are bound for Johannesburg and offer the most competitive of airfares together with superior customer service during the short flights that connect the three major cities within South Africa.
For international travellers, O.R. Tambo International Airport, located just outside the city boundaries, makes for the busiest airport in all of Africa. Flights arrive from all six continents worldwide on a daily basis.
Not only is Johannesburg Africa's busiest city, but it's also regarded as South Africa's economic heart, and is the largest city by populace within South Africa. It's the provincial capital of Gauteng. There are many Kulula flights to Johannesburg daily and, by comparing, each and every airline, we are able to offer you the cheapest Kulula Airlines flights to Johannesburg.
There are a host of commercial opportunities for business travellers within the city, and those who prefer to travel for leisure purposes get to savour the fast-paced lifestyle that is widely recognized as being part of Johannesburg's make-up.
In order to cater to the sheer number of visitors who head over to the commercial hub of the city, there are various Kulula flights offered daily to Johannesburg from various cities within South Africa, including Cape Town, Durban, and George.
For the first-time visitor, they'll notice the sheer size and scale of this extensive, fast-paced metropolis. Along with highways that travel on for mile after mile in every direction, as well as numerous urban and suburban areas which surround the central business district, everyone is catered to with respect to accommodation needs and activities, irrespective of budget and type of traveller.


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Well, have I got news for you! And where on earth to start? I'll do this quickly…
So, work was just not good and I was exhausted so I took 2 weeks holiday to 'recuperate'. Day one I got a mini table top dishwasher from ebay, it was a disaster, myself and kitchen flooded twice, once with the waste pipe water, dishwasher wouldn't drain properly, turned out Mat hadn't removed stopper from waste pipe connection so that solved that one.
By day three I had adopted five degus from a foster home in Twickenham, I went to visit them then we took them home a couple days later, they are all settled in fine and are the most fascinating animals. The bunnies even seem impressed!
By the Saturday Mat and I were lucky enough to be at one of the BBC Proms concerts where we saw a fascinating array of world music based on the TV series the Human Planet and was even lucky enough to hear a Tchaikovsky number played by a recycled orchestra – some of the instruments included an old metal fold up bed symbol, a lorry wheel drum, a coat hanger violin string, toilet plumbing trumpets and trombones and the list continues. It was like nothing I have ever seen or experienced before or ever will again, absolutely breathtaking. That was also the same Saturday that Amy Winehouse died, we heard the news from my sister as we parked for the concert, I had to take ten minutes to process it. A very sad loss of a life, as is any young death.
Anyway, that brought us to Sunday where my oven decided to pack up right in the middle of cooking a roast dinner for Mat and I. So Monday was finding a cheap oven as pay day was still what seemed like years away. I did find a very reasonable one and also purchased a 'whatever happens' cover on it! The first two uses were not great but not quite disastrous, it just took forever to heat up and I had cakes overcooked on the outside but raw in the middle. But I think I have the trick now and cakes since have been as perfect as my last oven (which I dearly miss), I heat it to maximum temperature and then turn it down as I start mixing the batter etc.
Anyway….then by Wednesday, still in my second week of holiday, I quit my job. My job that is more than just a job and where I work with a team which were like a family, really. I wont go in to details now but lets just say its a release and sad but necessary. I'm continuing to work for the 'cause' of street children and am lucky to have had something else totally related to what I have just walked out of and totally what my heart and soul is in, to walk straight in to. That is a major piece of original research for which I am assisting in preparations at this stage. And f course I start university in less than 2 months so that chapter is looming!
By the Thursday I had bought home 2 baby girl bunnies that I saw in the pet shop, fell in love with and couldn't bare to leave behind at the 'zoo'. I buy animals from pet shops only to free them, I have to battle with myself not to buy the lot but then I'd have to give them my flat and go and live in the pet shop as I have no room and then I couldn't look after them! But seriously, can you imagine if you went and picked children and babies in that way? Well, in some places that is the case sadly…Anyway, on a happier note they are lovely, called Bambi (but I keep calling her Bam Bam) and Butterfly. Since Bae and Billy had a brotherly fall out and refuse to forgive each other for dominating the hay I thought they could have a girly to be their friend forever! Lets just hope its all smooth introductions now! The babies are still in with me and separated for ow though until they grow up a little bit and get less timid and also until Billy is neutered and healed which he is going in for on Thursday.
Here's some piccies of Bae bunny looking cute!
Friday I drove down to Sussex to visit a very dear old lady who is very much like my nan, the journey was long as there was lots of traffic but it was a very lovely day and lovely to see Kathleen.
Saturday Mat and I set off on our bikes to find some wild fruit, we found apples, damsons and blackberries which I turned in to jams which I will post as soon as possible. What wasn't so great is that I found a sick baby wild bunny who we tried our best to save but he very sadly didn't make it.
And now here I am, 5.30 am writing this blog post after an extremely sleepless night! I think I need a good old baking sesh!
Blueberry muffins, just a classic, and lord, there is thousands of recipes out there, and I've tried a few, but these my friends are THE blueberry muffins. These are what I want out of my oven. They are just perfect, soft but not too cakey, perfectly sweet and fruity, well risen and with the perfect muffin tops. You have to try them!
- 2 1/2 cups plain/all purpose flour
- 1 Tbsp baking powder
- 1/2 teaspoon baking soda
- 1/2 teaspoon salt
- heaped 1/2 teaspoon cinnamon
- 2 egg replacements
- 1 cup vegan yoghurt
- 1 cup caster sugar
- 8 Tbsp warm melted vegan margarine (1 stick)
- 1 teaspoon vanilla and 1 tsp soya milk
- 6 oz fresh or frozen blueberries
1 Position rack in center of oven. Preheat oven to 200°c/400°F. Grease a standard 12 muffin tin plus a 6 hole tin (or use the same tin if you don't have an extra one and make the muffins in batches) or line with paper muffin cases.
2 Whisk together the flour, baking powder, baking soda, cinnamon and salt in a large bowl.
3 In a separate bowl, whisk together egg replacer, yoghurt, milk, sugar, margarine and vanilla.
4 Add the wet mixture to the dry mixture and mix together with a few light strokes, just until the dry ingredients are moistened. Add the berries and gently fold through. Do not overmix! Overmixing will cause the muffins to be dense, not fluffy. The batter should not be smooth.
5 Divide the batter evenly among the muffin cups. Bake until a toothpick inserted into the middle of 1 or 2 of the muffins comes out clean, 17-20 minutes (or longer). Let cool for 2 to 3 minutes before removing from the pan. If not serving hot, let cool on a rack.
Serve as soon as possible, preferably within a few hours of baking but freeze really well.
Makes about 18 muffins.
Adapted from Simply Recipes' Blackberry Muffins


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Effective committee are the backbone for Young Life in each local area. In more than 700 communities across the US and around the world thousands and thousands of adults meet once every momth in small groups to help the ministry of Young Life in that area. They are often unseen and unknown by most of the students that they serve, but the committee is the foundation for successful outreach ministry in the local high schools.
Currently, in the Beaufort area we have one committee serving both Beaufort and Battery Creek High School. This committee is esential in our ministry with high school students. Our goal is to reach out to many more of the 3,000 high school students in Beaufort and to see their lives transformed forever.
If you are interested in serving on an adult committee please contact us! We look forward to serving alongside of you as we reach high school students in the Beaufort area.
The committee is made up of adults and parents from all different backgrounds & careers, living all throughout the Beaufort Community.
Young Life Beaufort | PO Box 1885 Beaufort, SC 29901-1885
Phone: (843) 781-6507


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Canon: OF THE SERVICES OF THE CHURCH
Chapter: C33 SERVICES
Lawful Services
1 In ministering in the congregation no Clergyman of this Church may use any other Services but such as are appointed in the Book of Common Prayer, nor may he use these Services in any other manner than is prescribed in the said Book, except so far as alterations and abridgements of, and additions to, the Services of the Church are made or allowed in this Church by the Provincial Synod, or are allowed exceptionally by the Bishop.
Lawful Ministers
2 No person shall be permitted to officiate in sacred things in any congregation of this Church, except under the authority of the Bishop of the Diocese. Provided that any person who shall have satisfied the Incumbent or Churchwardens (in the absence of the Incumbent) that he is a Clergyman of this Church, or of some other Church of the Anglican Communion, may be permitted by him or by them (in his absence) to officiate in the congregation for one Sunday, but for no more than one without the permission of the Bishop, except he be a Chaplain to the Forces, who will be considered as one of the Clergy of the Diocese, except he be inhibited by the Bishop.
3 Any clergyman of this Church may, with the permission of the Bishop of the Diocese, unite in the Administration of the Sacraments, or in the conduct of Divine Service, with other ministers not appointed to minister in this Church.
4 No Hymn or Collection of Hymns shall be hereafter introduced into the Public Services of any congregation of this Province without the consent of the Bishop of the Diocese.
Special Services
All Public Fasts and Thanksgivings enjoined by authority shall in this Province be religiously observed, and every Bishop shall give directions to the Clergy of his Diocese as to the form of Prayer which they are to use on such occasions.


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Adobe Prelude allows you to jump start your post production process and make very rudimentary rough cuts using sub clips of your footage. If you're out in the field and want to start putting your footage into an ordered sequence, Prelude works great for this. In this course Jason Osder walks you through the easy steps of putting together a very basic rough cut using Adobe Prelude.
To learn more Jason Osder has created a new course called Premiere Pro Guru: Organizing Assets, with Lynda.com
Organization is key to a successful post-production workflow. And you will feel good knowing your footage is organized and logged properly. This course picks up where the end of your shoot leaves off and before editing begins—when you need to import, organize, and log your footage. Jason Osder shows how to import all different types of assets, from stills to soundtracks, and how to sort and annotate your footage in Adobe Premiere Pro. Plus, learn a few tricks involving Bridge and Prelude (like batch renaming) that will cut your logging time in half. He'll walk you through the critical steps of metalogging and organizing your footage even before any editing takes place.
Topics in this course include:
- Using the Media Browser and Metalogging workspace
- Importing from a drive
- Importing bins with a CSV file
- Batch renaming in Bridge
- Logging and pre-editing footage
- Using clip makers
- Working with metadata
You can check out the class here - http://www.lynda.com/Premiere-Pro-tutorials/Rough-cutting-Prelude/149680/154101-4.html


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During this year, I believe I have put in all my effort for the class.
From working with Scratch, HTML, CSS, and Python, I have tried my best to properly understand and I believe I have a firm grasp on all of these programming languages. In regards to all the coding types, I have most enjoyed html, css and python and wish to continue using them.
Overall, the year has been productive for me learning coding and I wish to continue coding in the future. As a learner, I have learned that I like to learn individually with tests along the way. This makes me prepared and know the concepts to learn to succeed in class. I am happy that I know how to be responsible and learn for myself instead of having a teacher or using full online classes. It gives me confidence that I am able to learn on my own.


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Add some Buccaneers spirit to your gameday look with the Tampa Bay Buccaneers Tassel Earrings. These tassel earrings feature a full-color debossed Buccaneers logo as well as red and black tassels. These earrings are also lead and nickel free. Show off your fun Buccaneers side this season with the Tampa Bay Buccaneers Tassel Earrings.
Sign Up for Emails and Save 10% On Your First Order


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They scream at the superficial
not caring what you're all about,
they only want to know your label,
how your binding fits on the shelf.
Though there's a road you wish to tread
you're easier to monitor if locked,
so they take away your freedom
and set you in a box.
Labels are a straightjacket,
self-expression with a zero sum,
and reducing you to less than human
is the label that says, "Unwelcome."
©March 2015, Christina Anne Hawthorne


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We can also provide custom built fuel tanks and tool boxes to meet your specific needs.
Dee Zee Transfer Tanks - A safe and convenient means for transporting non-flammable liquids.Constructed of heavy gauge Brite-Tread aluminum.Radius curve design eliminates key weld pressure points.Tanks feature 3 stability baffles, lockable cap, 3/8" drainage plug, and venting coupler.Tanks are intended for private use (non-commercial).Not designed for use as an auxiliary fuel system.Not for use with gasoline.Does not meet title 49 of the United Stated Federal Registry governing transportation.
Tank size 24" x 24" x 24"
4 Truck-Accessories
600 Fox Ridge Road
Eldridge, IA 52748
Phone 563-285-6003
Fax 563-285-8670


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|You are in: Entertainment: TV and Radio
Thursday, 24 January, 2002, 16:21 GMT
Crossroads faces uncertain future
ITV soap Crossroads could face the axe if ratings do not improve, according to reports.
The show - which returned to the screens after a 13-year absence - will air until September.
A decision will have to be taken in the spring or early summer as to whether it will continue.
The daytime soap was originally commissioned by ITV for one year and will celebrate its first anniversary in March.
ITV has already recommissioned Crossroads from Carlton for shows up until September.
Crossroads was relaunched in a blaze of glory in March 2001, promising a mix of new and old characters, ensuring an audience of 5.5 million in its opening week.
But according to a Crossroads spokesman, ratings dipped and quickly levelled off to its current figure of about 3.5 million across its evening and lunchtime showing.
He added: "At present we have be commissioned up until September and we would like to see the ratings go up in that time so its future is secure."
It first went out five times a week but this was then cut to four to cut down on expenditure.
The same also happened to the original soap, before it was eventually shelved in 1988.
In its heyday Crossroads attracted an audience of 18 million viewers but was both maligned and revered by fans and critics alike for its wooden acting and wobbly sets.
Once a shabby motel, Crossroads was upgraded to a four star hotel complete with executive suites and a health spa.
Its BBC One rival Neighbours draws about 6.3 million viewers over its two daily showings.
But the newest daytime soap Night and Day is struggling to attract viewers despite being billed as a totally new style of soap.
Since its launch in September 2001 it has been averaging audiences of 1.4 million for its teatime edition.
See also:
06 Mar 01 | Entertainment
'Slick' Crossroads a hit with critics
05 Mar 01 | Entertainment
Bad service at new Crossroads
05 Mar 01 | Entertainment
Crossroads makes comeback
05 Mar 01 | Entertainment
A brief history of Crossroads
05 Mar 01 | Entertainment
Crossroads - then and now
Internet links:
The BBC is not responsible for the content of external internet sites
Top TV and Radio stories now:
Links to more TV and Radio stories are at the foot of the page.
Links to more TV and Radio stories
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How to Avoid Toll Roads When Navigating with Apple Maps
No joke: This may actually be my favorite feature of the new version of Apple's mobile operating system. With Apple Maps in iOS 10, users can now specifically indicate that we'd like to avoid toll roads, and…well…I may need a moment to collect myself here, because this has been a long time coming. I'm not saying that I asked Siri to navigate me somewhere under iOS 9 only to have it take me right along a pretty expensive toll road, oh no. That never happened. And that certainly never happened twice. No sir. Um, anyway, here's how to avoid toll roads when navigating with Apple Maps!
To manage how Maps deals with toll roads in iOS 10, head to the Settings app on your iPhone or iPad. From there, select Maps.
From the Maps Settings page, find and tap on Driving & Navigation.
At the top of this page, you'll see two types of roads which Maps can be configured to "avoid" when calculating directions: Tolls and Highways. By default, both options will be disabled. To instruct the Maps app to avoid either one, in our case that's Tolls, just tap the corresponding toggle switch to enable it.
With Maps configured to avoid Tolls, your future driving directions will be updated to do just that, keeping you away from toll roads at the expense of potentially longer routes. Just in case you forget about this option, each set of driving directions will have a small note, as shown in the screenshot below, if "Avoid Tolls" is enabled. This lets you decide on the fly if paying the toll is worth it for a quicker trip.
Finally, it's important to note that when it comes to both tolls and highways, Maps will do its best to avoid these types of roads if possible. There may be some routes in which taking a toll road or highway is necessary, in which case the app will notify you when calculating the directions.
So with Maps in iOS 10, you now have a bit more flexibility to take the routes you prefer, and hopefully save some money, too. Drive safe out there!
Disclaimer: Some pages on this site may include an affiliate link. This does not effect our editorial in any way.


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Changing behavior needs practice! I am passionate about training people and empowering them to access their creative potential - wherever they are, whatever they do.
Train the Trainers
Train the Trainers is a modular workout program that turns you into a Design Thinker. The program is based on the Design Thinking principles and the Toolbox. With the help of both, you will become a motivating facilitator.
Method Deep Dives
Method Deep Dives work like protein shakes in a gym: they are specifically designed nutrition boosters that enable you to work more effectively and reach your goals. You dive deeply into methods and apply them to hand-on tasks.
Here are some examples:
Workshop Design
Become an expert in creating a learning environment and flow that produces tangible results.
Efficient Kick Off Meetings
Become better equipped when working collaboratively and visually towards common goals.
Empathy Methods
Improve your skills by using the 360° field research toolbox.
Cultural Probes
Expand your toolbox with a method that enables long distance, long term, and intimate user research.
Ideation Techniques
Improve your ability to come up with new, inspiring ideas.