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"Fujitsu empowered us to get the project completed much faster, meaning we started making savings sooner. Moreover, we know we've got the best combination of technologies in place as the assessment was entirely vendor-agnostic."
Eugen Sartoris Head of IT - Infrastructure, Deutsche Postbank International
When your business is looking after other people's money, you need to be particularly careful about how you spend your own. A bank that can show it prioritizes cost efficiency across its own operations is much more likely to inspire the trust of its customers.
With this in mind, Eugen Sartoris, Head of IT - Infrastructure at Deutsche Postbank International (PBI), had some ambitious plans for one of its most critical assets. "We keep all of our customer data in a series of Oracle databases," he explains. "They're essential to almost every business process, so we need to ensure they're kept on an IT platform that's stable and powerful. The problem was that our SPARC Solaris platform was quite expensive to maintain." He and his team were eager to find an alternative that was more economical, and that ideally offered better performance too.
"It wasn't just the hardware costs that we wanted to reduce," Sartoris continues. "We were spending a lot on licences for our 20 or so Oracle databases, but it was often hard to track how efficiently we were using them. We wanted to know who was using them and in what way, so we could not only avoid over-spending on licences, but also to make sure we weren't using features we weren't entitled to."
With all eyes on cost efficiency throughout this project, the team was pleased to see its efforts justified with significant savings emerging from the outset. "The x86 platform we migrated to was about half the hardware cost that it would have been to move to a newer version of the one we already had," explains Sartoris. "The increased performance of the new platform means we can do more with less, so our need for new licences could be significantly reduced as well."
The performance improvement has made life easier for everyone too. Across the business, projects are now completed up to 10 times faster, helping make every division more productive and able to deliver more accurate and timely services to customers. Sartoris continues: "Batch processing tasks that used to take 50 hours can now be completed in three, meaning the IT team doesn't have to work as much at weekends – for us that's a real bonus. We're also not experiencing any issues with our storage slowing down, which we did previously."
And how about the bank's objective of gaining better control and visibility over its use of its Oracle licences? "Well, we have confidence now that we have the right licencing in place, and we've implemented controls to enforce compliance and block access to unlicenced features," reflects Sartoris. "We know now that if we're required to respond to a licencing audit, we'll be able to quickly prove exactly what we're using."

subset: commoncrawl


text:
Evans Cycles is one of the largest British cycling retailers. They have a large online store as well as one of the biggest chains of bricks and mortar cycling shops.
The original shop was founded in central London by cyclist, Frederick W Evans, and it is suggested that he won an award from the Cyclists' Touring Club for the invention of a device known as the quick release and reversible rear wheel device in 1925. He died in a road accident in 1944 and the business has had several owners since.
Evans have some of their own brands including Hoy Bikes and Pinnacle and they also have exclusive retail arrangements in the UK with Jamis, Fuji and BMC.


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A new puzzle based game has been added to BlackBerry AppWorld lately - the MAKALU.
It's very addictive and fun game, which has... really nice graphics!
The goal is to "flood" the entire screen in as few moves as possible. The game starts from the most top-left block and only one block can be changed at a time. By selecting the blocks, your "flood" area grows.
Sounds familiar? Maybe! But there are seven different themes of blocks (some of them are really, really hard), five sizes of the board, three difficulty modes and you can also select with how many different blocks you want to play it: 6, 7 or 8.
The MAKALU game is available only for 0.99$ and it's really worth of downloading!
What can I say more? Just check it by yourself! :-)
Makalu - BlackBerry App World


text:
Having a mole problem can be highly destructive for your lawn.
There are several methods of mole control on the market: baiting, gassing, repellents and trapping. We carry and offer all the forms, and our technicians are well-versed in each. While you can try and treat the problem on your own, our experts can take the worry off your shoulders, and we offer a warranty on our work. If your mole problem returns within the warranty period, we'll return to re-treat your yard with no problems!
We offer one month mole trapping, or multi-month services based on your needs. Give us a call and get started today!
Mole Pest Control
Having a mole problem can be highly destructive for your lawn.


text:
I recently started getting this really weird problem where a virus seems to pop up as frequently as once a week in my site. It is running on BlogEngine and basically what happens is this:
- A bunch of .PHP files start appearing in my site folders
- It appends an iFrame in my page that links to a page countXX.php, where XX is a random number
Sucuri.net listed the virus as
MW:EXPLOITKIT:BLACKHOLE1, and said it is one of the most common viruses circling the net as of lately. This has more information.
Please does anyone know how I can protect my website against this? It is wasting me a lot of time.


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Health SA Gesondheid (Online)
versión On-line ISSN 2071-9736
versión impresa ISSN 1025-9848
Health SA Gesondheid (Online) vol.19 no.1 Cape Town ene. 2014
Prevention of mother-to-child transmission of HIV data completeness and accuracy assessment in health facilities of the Nkangala district
Motlatso G. MlamboI, IV; Karl PeltzerI, II, III; Annariina KoivuV
IHIV/STIs and TB Research Programme (HAST), Human Sciences Research Council (HSRC), South Africa
IIDepartment of Psychology, University of Limpopo, South Africa
IIIASEAN Institute for Health Development, Mahidol University, Thailand
IVDepartment of Family Medicine, University of the Witwatersrand, South Africa
VINDIGO International Doctorate in Global Health, Trinity College, Ireland
BACKGROUND: Even though significant progress has been made in the roll-out and quality of the prevention of mother-to-child transmission of HIV (PMTCT) services in South Africa, the quality of patient data recording remains a challenge.
OBJECTIVES: To assess PMTCT data completeness and accuracy at primary healthcare level to district level in order to assist with the improvement of the PMTCT data recording.
METHODS: This is a retrospective record review study which involved collecting PMTCT data on indicators which was for the period of August 2009 to January 2010. We conducted baseline facility assessments which included 72 PMTCT sites in one health district, Nkangala. We assessed the data completeness and accuracy of the data values recorded on the seven PMTCT data elements.
RESULTS: Data were only complete for less than a quarter of the time for most of the antenatal indicators (0.5% - 44%) and for the maternity indicators, data were only complete 11% of the time. Data inaccuracy was a result of recording of data values in the District Health Information System (DHIS) which were not within 10% of the data values recorded in the case registers. The results show that data were missing from the case registers, monthly summary sheets and DHIS between 30% and 99% of the time and that data elements had values recorded in the DHIS which were > 10%.
CONCLUSION: There is a need for ongoing training on data recording procedures at all levels. To maintain data quality, healthcare data must be appropriate, organised, timely, available, accurate and complete.
AGTERGROUND: Selfs al is beduidende vordering gemaak met die bekendstelling en die kwaliteit van die voorkoming van moeder-na-kind-oordrag van MIV (PMTCT) dienste in Suid-Afrika, bly die kwaliteit van die pasiëntdataopname 'n uitdaging.
DOELWITTE: Om PMTCT datavolledigheid en akkuraatheid van primêre gesondheidsorg vlak tot distriksvlak te bepaal ten einde te help met die verbetering van die PMTCT data opname.
METODES: Dit is 'n terugwerkende hersieningstudie wat die versameling van PMTCT data op aanwysers vir die tydperk van Augustus 2009 tot Januarie 2010, behels het. Ons het basislyn fasiliteitsramings en/of skattings uitgevoer wat 72 PMTCT webwerwe in een gesondheid distrik, Nkangala, ingesluit het. Ons het data volledigheid en akkuraatheid van datawaardes op die sewe PMTCT data-elemente, beoordeel.
RESULTATE: Data was slegs voltooi vir minder as 'n kwart van die tyd vir die meeste van die voorgeboortesorg aanwysers (0.5% - 44%) en vir die kraamaanwysers, data was slegs volledig vir 11% van die tyd. Onakkuraate data was die resultaat van die opname van datawaardes in die Distrik Gesondheid Inligting System (DHIS) wat nie binne 10% van die datawaardes in die gevalleregisters aangeteken was nie . Die resultate het getoon dat data in die gevalleregisters, maandelikse opsommings en DHIS tussen 30% en 99% van die tyd ontbreek het en dat dataelemente waardes in die DHIS opteken het wat > 10% was.
GEVOLGTREKKING: Daar is 'n behoefte vir voortgesette opleiding ten opsigte van datavasleggingsprosedures op alle vlakke. Om datakwaliteit te handhaaf, moet gesondheidsorgdata gepas, georganiseerd, tydig, beskikbaar, akkuraat en volledig wees.
This study aimed to assess prevention of mother-to-child transmission of HIV (PMTCT) data completeness and data accuracy at the primary healthcare level to district level in order to assist with the improvement of the PMTCT data recording in the Nkangala district of Mpumalanga Province, South Africa. This will be done by assessing the completeness and accuracy of data values recorded in the seven selected national PMTCT data elements. We assessed antenatal, postnatal, maternity and infant PMTCT data elements.
Background and rationale
The data coming from African countries do not reflect accurately the issues affecting this region (Ndira, Rosenberger & Wetter 2008:489; World Health Organization, Regional Office for Africa [WHO/AFRO] 2002). According to WHO / AFRO, the data provided by routine health systems in the African Region are generally not always available for most countries; and even when they are, they are not always comprehensive, complete or up to date (Ndira et al. 2008:489; WHO/AFRO 2002). The information flows around the prevention of mother-to-child transmission (PMTCT) of HIV in South Africa make no exception. In addition to the work done around the data quality issues in the PMTCT area (Mate et al. 2009; Mphatswe et al. 2012:176), studies from South Africa (Jacucci 2005) have raised questions about data quality regarding the South African District Health Information System (DHIS).
The data quality issues should be considered in the context of the South African health system. South Africa has a history of disease- or condition-specific approach, though the health system can be considered comprehensive (Lush et al. 1999:771), with integrated tuberculosis (TB) and HIV programmes, including PMTCT of HIV (Uwimana et al. 2012:658). However, it has been argued (Uwimana et al. 2012:658) that these programmes are not yet integrated fully into the health system functions as outlined in the WHO framework on health systems (WHO 2000) and other conceptual frameworks for integration analysis (Atun et al. 2010:104; Cairncross, Peries & Cutts 1997:20). Hence, the varying quality in collection, reporting and use of data should be discussed with reference to a limited integration of largely vertically-delivered programmes to other health system functions.
Research done in other resource-limited settings has indicated that the quality of data reporting is inconsistent (Freund & Kalumba 1985:137; Kumar 1993:305; Mavimbe, Braa & Bjune 2005:108). Weaknesses that contribute to compromised data quality, as well as suboptimal functioning of the health information system, are shown to stem from data incompleteness and untimely reporting (Chaulagai et al. 2005:375; Kimaro & Twaakyondo 2005:189), poor documentation of services provided within the facilities and overly-onerous reporting requirements (Brown 2007; Makombe et al. 2008:310; Mate et al. 2009). Furthermore, as evidenced by earlier research, the larger the number of data elements to be reported upon, the poorer the quality of the data (Stoops, Williamson & Braa 2003).
Numerous studies have shown that there is a need for improved information systems for monitoring healthcare services that will assist with better service provision (AbouZahr & Boerma 2005:578; Chan et al. 2010; Nash et al. 2009:S58; Rommelmann et al. 2005:569; Shaw 2005:632). A patient register-based system has been utilised to a large extent by South African primary healthcare facilities in order to record patient data and it continues to experience challenges which point to many inaccuracies. Such has been the case in resource-limited settings whereby indicators for monitoring and evaluation are often hand-tallied from paper-based sources and are reported to people at different levels of the programmatic chain (Joint United Nations Programme on HIV/AIDS [UNAIDS] 2008; WHO 2005). Similar to other countries (AbouZahr & Boerma 2005:578), where routine health information systems have been introduced as a way of improving healthcare system performance, South Africa has also introduced a health information system (HIS) which has brought about some improvements in patient data quality sheets (Garrib et al. 2008:549) and data recorded on the DHIS.
Aim of the study
This study aimed to assess the PMTCT data completeness and data accuracy of the primary healthcare level to district level in order to assist with the improvement of the PMTCT data recording in the Nkangala district of Mpumalanga Province, South Africa. This was done by assessing completeness and accuracy of data values recorded in the seven selected national PMTCT data elements. We assessed antenatal, postnatal, maternity and infant PMTCT data elements.
Problem statement
Although improvements have been made in the coverage and quality of PMTCT services in South Africa, the quality of patient data recording remains a challenge, as evidenced by recent research (Mate et al. 2009; Mphatswe et al. 2012:176). The DHIS was introduced as a routine system to track health service delivery in the public health sector of South Africa (Heywood & Rohde 2001) and to support the collection of data that have been used to calculate the indicators by site, subdistrict, district and province. However, several challenges remain which contribute to inconsistent data quality and limited utilisation of available data and information and data flow bottlenecks (Department of Health 2011). On a more detailed level, the challenges also include data recording discrepancies at facility level on case registers and data being recorded on monthly summary.
Therefore, collecting accurate information on the PMTCT data elements would not only strengthen the existing PMTCT services, but would also broaden areas of further intervention as part of comprehensive patient care. To make evidence-based decisions, high-quality data are required at all levels of the healthcare system. At the facility level, the information is used for care delivery and the details about prior events should be recognised and incorporated into current care decisions (Reid & Wagner 2008:987). Furthermore, data collected at facility level can be used to make decisions and improve the quality of healthcare services (Garrib et al. 2008:551-552). Indeed, data analysis is required for advocating, designing, planning and evaluating public health actions (Sanchez, Lloyd-Smith & Getz 2010; WHO 2004) and to inform health policy and resource allocation (WHO 2003). The global interests in the monitoring of development, as illustrated by the Millennium Development Goals (MDGs), generate pressure for quality and timely data in order to demonstrate country progress (Boerma & Stansfield 2007:779).
Research method and design
Study setting
The study was conducted in the Nkangala district (one of the three districts of the Mpumalanga Province) in order to provide technical support and to strengthen PMTCT service implementation at all the subdistricts that fall under its jurisdiction. A similar assessment was conducted in another district (Gert Sibande district) and it also pointed to serious problems with regard to data recording. The study complemented the existing national PMTCT programme and heeds the international call to make women and children a priority in the fight against the epidemic. The PMTCT cascade in the Nkangala district includes antenatal uptake and HIV testing during pregnancy, provision of ART to pregnant women with HIV, safe childbirth practices, safe infant feeding, infant HIV testing and postnatal-care ARV adherence.
This is a retrospective record review study of PMTCT data elements in Nkangala health facilities. The study was conducted between February 2010 and April 2010 and PMTCT data collected on indicators was for the period of August 2009 and January 2010. As part of the PMTCT record review, data for a period of six months (August 2009 - January 2010) were collected from the case registers in the healthcare facilities, using a tool that was developed with data elements for the PMTCT programme. A total of seven PMTCT data elements on antenatal and postnatal care, maternity and infant indicators were assessed.
Sampling criteria
For the baseline assessment, all 80 PMTCT sites in one health district (Nkangala) were identified. Of these 80 sites, four could not be assessed because the PMTCT site manager was unavailable, even after several visits were made to those healthcare facilities. An additional four sites did not agree to provide us with access to assess data recorded in case registers and monthly summary sheets. No facility was excluded from the facility assessments in Nkangala District. Thus, the final sample comprised 72 facilities (53 clinics, 12 community health centers and seven regional and/or district hospitals).
Data collection methods
With regard to the existing data management system, patient data in the Nkangala district healthcare facilities are primarily collected using a paper-based record system. There are a number of registers that are used to collect patient PMTCT-related information, including the PMTCT register, tally sheet register, drug register, PCR register, HIV testing register and CD4 count register. The data flow from the facility to district level involves the collation of patient data from various registers and transferring it to the case registers. Data from case registers are then summarised on the monthly summary sheet, which is then sent to DHIS. Patient data are handwritten and the information is captured on the computer at district level.
In addition, separate books were used to record useful patient information for the clinic which was not necessarily submitted to the district for recording on the DHIS system, since this information was not regarded as providing indicators for PMTCT. Patient records were also not stored at a central site, which means that in preparation for data to be submitted to the district, the site manager had to take all the different registers from different points in order to record data for that particular month. In most of the healthcare facilities, the primary healthcare (PHC) site manager is the one responsible for collating all the information from different registers and sending it to the DHIS, with the exception of few facilities where there are clerks dedicated to do the data recording. For the current study, we asked a professional nurse in charge of the PMTCT programme at each site to provide the researchers with all the registers that had PMTCT data and monthly summary sheets. As part of the staff awareness regarding the effectiveness of the PMTCT programme, most of the healthcare facilities had monthly statistics for the PMTCT indicators displayed (using graphs) on the healthcare facility notice boards. A total of five Human Sciences Research Council (HSRC) researchers reviewed the case registers in each of the 72 facilities.
Assessment of data completeness
Data completeness was defined as the extent to which observed records were filled in with data values (Simba & Mwangu 2005). The data completeness process involved checking the proportion of data values recorded on the seven PMTCT data elements to see if it was reflecting on both the PMTCT registers (case registers and DHIS). A data element was considered complete if a value was recorded on both the case registers the DHIS for each of the six months of the study period. Although there are three levels of data recording (case registers, monthly summary sheet, DHIS) the acceptable limit for data completeness for this study was based on having recorded data values in both case registers and DHIS.
To assess the completeness of the data, we reviewed the seven PMTCT data elements, namely:
Antenatal and postnatal indicators:
1. antenatal care (ANC) clients pre-test counselled for HIV at first visit
2. ANC clients tested positive for HIV at first test (new)
3. HIV-positive ANC clients tested for CD4 count
4. ANC clients initiated on Azidothymidine (AZT) at 28 weeks or later.
Maternity indicators:
5. women receiving Nevirapine (NVP) in labour.
Infant indicators:
6. babies given AZT
7. polymerase chain reaction (PCR) test done on babies born to HIV-positive mothers at six weeks or later,that were reported routinely to the DHIS over a six-month period (August 2009 - January 2010).
In order to ascertain the full completeness level, the selected six months were based on the fact that data were already submitted to the DHIS, so they would not be missing from the case registers. Therefore, this means that if data on the case registers were already submitted to the DHIS using monthly summary sheets, then they are complete. We excluded the following indicators from the analysis because of unavailability of data values recorded on them at the time of the study: NVP given to HIV-positive women at the ANC; babies given NVP, HIV-positive mother; PCR test results given. A data element was considered complete if a value was recorded in the case registers and the DHIS for each of the six months of the study period.
Assessment of data accuracy
Data accuracy was defined as the extent of variation between actual and recorded figures in the PMTCT registers (Simba & Mwangu 2005 ). Assessment of data accuracy involved comparing data values recorded in the DHIS with data values obtained from the individual facility case registers (Mphatswe et al. 2012:176). Using the data elements, patient counts were done by the researcher and a professional nurse for the months that were being assessed (August 2009 - January 2010). We considered a data element to be accurate if the value of the data recorded in the DHIS system was within 10% of the value recorded in the case registers. The 10% accuracy cut-off point was based on previous studies regarding data accuracy levels (Garrib et al. 2008:549; Mate et al. 2009), although for the current study the 10% was calculated by comparing values in the case registers and the DHIS instead of focusing on DHIS data values only. In cases where data were missing from either the case registers or DHIS, we excluded these from the accuracy analysis of the data (Mate et al. 2009).
Data analysis
Data obtained from the primary healthcare facilities and the DHIS were entered using the Software Package for the Social Sciences (SPSS) program, version 20 (released 2011, IBM Corp, Armonk, NY). Descriptive statistics were used to calculate the frequencies for the data recorded on each of the seven PMTCT data elements assessed. Data were analysed according to data completeness and data accuracy. Data analysis was stratified by type of facility for the ANC and maternity indicators. For instance, when analysing data on ANC indicators, we excluded the hospitals and, when analysing maternity indicators, we excluded the clinics from the analysis. The degree of accuracy between data reported in the DHIS and data obtained from individual facility registers was based on a 10% threshold.
Ethical considerations
Ethics approval was obtained from the HSRC ethics committee (Protocol REC 5/11/06/08) and the Mpumalanga Department of Health approved the study. Prior to facility visits, appointments were made with the district coordinator, who in turn liaised with the HIV/AIDS, STIs and TB (HAST) coordinators for all six subdistricts about the HSRC visit to the facilities. The HAST coordinators informed the PHC site managers of the various clinics about the PMTCT baseline assessment. Before conducting the study, the site managers or PMTCT nurses were given background information about the study for purposes of enhancing their understanding about the study and they were also requested to provide informed consent. The district information manager was also asked to provide DHIS data for the period of August 2009 -January 2010. The PMTCT record review took a minimum of two to three hours per site, depending on the ease of access to the records. The nature of the study was emphasised, making sure that the site managers understood that the study was not about their personal evaluation, but was rather an assessment of the PMTCT programme at large.
Data completeness
We assessed the seven PMTCT indicators and found that data completeness varied from one indicator to another. The results show that the data were only complete less than 25% of the time for most of the ANC indicators (with percentages of completeness ranging between 0.5% - 44%) and for the hospitals, data were completed only 11% of the time. The data incompleteness was due to missing values in either the case registers or the DHIS. Of the seven data elements, the best-reported data elements, showing maximum completeness, were: 'ANC clients tested positive for HIV at first test (new)' (n = 171; 44%) and 'ANC clients pre-test counselled for HIV at first visit' (n = 158; 40.5%). The data elements with very minimal completeness were: 'babies given AZT' (n = 2; 0.5%) and 'PCR done on babies born to HIV-positive mothers at six weeks or later' (n = 11; 2.8%). Therefore, data were only completed between 0.5% and 44%, as is reflected in Figure 1.
Data completeness by month
The results show varying data completeness pattern of data recorded by month. The data element showing the highest data completeness was for the month of November 2009, on 'ANC clients tested positive for HIV at first test (new)' (n = 36; 55.4%), followed by 'ANC clients pre-test counselled for HIV at first visit' (n = 29; 44.6%), with the peak of data completeness being for the months of August andSeptember 2009. The data element on 'babies given AZT' was only recorded for two months, namely, August and September 2009. For this data element, the values recorded in the DHIS for the period of October 2009 - January 2010 were > 10% (Table 1).
Missing data
The results show that data were missing from case registers, monthly summary sheets and the DHIS between 30% and 99% of the time (Figure 2). The data elements with the highest missing data were: 'babies given AZT' (n = 389; 99%)', 'PCR done on babies born to HIV-positive mothers at six weeks or later' (n = 379; 97.1%) and 'ANC clients initiated on AZT at 28 weeks or later' (n = 329; 84.3%).
Data accuracy and inaccuracy
The results show that there were data elements which had accurate data values falling within 10% accuracy. The data accuracy in this case ranged from 0.5% to 44%. There were also data elements that showed values with > 10% deviation and these ranged from 0.5% to 17% (Figure 3). The data elements with more accurate data values were: 'ANC clients tested positive for HIV at first test (new)' (n = 171; 44%), followed by 'ANC clients pre-test counselled for HIV at first visit' (n = 158; 40.5%). The three data elements showing > 10% value recorded in the DHIS as compared to original source were: 'ANC clients pre-test counselled for HIV at first visit (n = 66; 17%), 'ANC clients tested positive for HIV at first test (new)' (n = 62; 16%) and 'HIV-positive ANC clients tested for CD4 count' (n = 44; 11.2%).
The results revealed that patient data recording in the Nkangala district remains a challenge because of the lack of accurate data recording by the healthcare professionals. We found that the inaccurate data recording stems from the lack of a double-checking system for the data recorded on the monthly summary sheets before they are submitted to the district to be recorded in the DHIS. There are a number of registers that are used to collect patient PMTCT-related information including the PMTCT register, tally sheet register, drug register, PCR register, HIV testing register and CD4 count register. All of these registers cover the information that is recorded on the case registers and that is summarised on the monthly summary sheet which is then sent to DHIS. The results indicate that because of many PMTCT registers, there is non-verification of data that are being transferred from one register to another. When assessing data completeness and accuracy for the seven PMTCT data elements, we found that the best reported data element, showing maximum completeness and accuracy, was 'ANC clients tested positive for HIV at first test (new)'. Furthermore, the results show that, for the hospitals in the study, there was minimal completion of data. Our findings regarding the incompleteness and inaccuracy of the PMTCT data are in accordance to other studies conducted in South Africa (Mate et al. 2009; Mphatswe et al. 2012:176). This is worrying considering that the unreliability of data compromises the efforts to improve the healthcare systems that provide PMTCT interventions (Mate et al. 2009). The current study concurs with findings from other studies (Garrib et al. 2008:549) which found that data validation to ensure data completeness and accuracy was limited.
We also found that the two data elements with minimal completeness were on infant indicators, namely, 'babies given AZT' and 'PCR test done on babies born to HIV-positive mothers at six weeks or later'. The lower data recording of values for the two data elements could be as a result of no service provision during the assessment period (August 2009 - January 2010). Most of the antenatal facilities were not providing AZT or even doing infant PCR testing. If they were providing that service, there was very little recording for the two data elements during our assessment period. However, it is worth noting that most of the healthcare facilities of the Mpumalanga Province are now giving AZT to the infants and they do infant PCR testing at six weeks. The study conducted by Sherman and Lilian (2011) showed improved PCR testing rates from 18.4% in 2008 to 39.3% in 2010. When assessing data completeness by month, the two data elements with the highest completeness were 'ANC clients tested positive for HIV at first test (new)' and 'ANC clients pre-test counselled for HIV at first visit', which do not show any significant difference when all six months' data are combined.
In this study we found that data recording inaccuracy was common at all levels (PHC to district). As with the reason for data incompleteness, data inaccuracy was also as a result of the over-recording of data values in the DHIS (by over 10% when compared with the data values recorded in the case registers and monthly summary sheets). We found that the over-recording of the values on data elements were mainly in the DHIS. Other studies also suggest that even though data are recorded in the DHIS, the quality is not good (Mphatswe et al. 2012:176). In order for patient data to be useful, they must be valid and accurate (WHO 2003). The results for this study show that patient data are clearly not accurate since DHIS data are collected from many sources and thus may not always be reliable. Another worrying factor is that we found that data were missing from case records, monthly spreadsheets and the DHIS, with the highest missing data element being on 'babies given AZT'. In a study conducted in KwaZulu Natal, South Africa, of the total data values that had been collected, they found a mean of 2.5% missing data in the DHIS and healthcare facilities had not provided any explanation for the omission (Garrib et al. 2008:549). This suggests that patient data recording is a weakness which requires immediate intervention in order for the PMTCT service provision to improve significantly. We concur with the findings of other studies which point out that regular audit of health data could improve data recording significantly. A study conducted in South Africa found significant improvements in all key PMTCT indicators after PMTCT intervention, which included conducting a roadshow to orient staff on PMTCT protocol and monthly support visits by a senior experienced professional nurse in order to assess routine programme indicators (Doherty et al. 2009:406).
There is, therefore, a need to perform interventions aimed at improved data recording quality. Other studies have demonstrated that such interventions work in under-resourced countries (Mphatswe et al. 2012:176). After an intervention that included training on data collection, monthly reviews of data and data audits at individual facilities, a study from South Africa found that data completeness in the studied antenatal care clinics improved from 25% (before the intervention) to 63% (after the intervention) and in the study hospitals, from 28% to 86%. The overall data accuracy improved from 35% to 65%. Reviewing data quality and completeness could be done on a monthly basis during monthly district programme review meetings (Mphatswe et al. 2012:176). Other studies in under-resourced countries also reported on interventions that could lead to the improvement of data quality and completeness. For instance, in Kenya, the onsite assessments and feedback on data completeness and validity were used to improve the quality of routine health information. As a result, the number of HIV tests recorded, as well as the number of HIV-positive patients, doubled (Otwombe et al. 2007:315). In some settings, data improvements were linked to clinic visits by supervisors (Huaman et al. 2009:16). Several studies (Berwick 2004:1124; Center for Applied Research on Population and Development 2003) advocated for quality improvement interventions using a data-driven approach to ensure sustainable improvements in health programmes. Other studies indicate that in order to ensure acceptable completeness and accuracy of patient data, ongoing review of monitoring and evaluation (M&E) indicators is required at multiple levels of the healthcare system (site, regional and national levels) (Nash et al. 2009:S58). The WHO recommends the development of ongoing quality assessment plans which involve identifying important aspects of data collection (accuracy, validity, reliability, completeness and timeliness) and obtaining a threshold to determine acceptable error rate (WHO 2003).
It is not sufficient to focus only on interventions that improve data quality. In many countries there remains an inadequate appreciation and use of available information in planning and management of health services (Chaulagai et al. 2005:375). In other words, if the use of the collected PMTCT data elements is limited, it undermines any effort to improve the different aspects of data quality. Moreover, further research may be beneficial with regard to determining whether the local health professionals perceive the current data recording system adequate or to investigate if any perceived deficiencies in the data recording system may contribute to the atmosphere which, in turn, contributes to suboptimal data entry into the DHIS. Kawonga, Blaauw and Fonn (2012) argue that the key drivers of the silo approach are specific reporting requirements linked to ear-marked funding, politically-driven imperatives and mistrust of DHIS capacity. They conclude that the parallel systems that bypass the DHIS represent a missed opportunity to strengthen system-wide M&E capacity. Finally, they recommend the integration of HIV M&E into the health system. M&E functions such as these would mobilise earmarked HIV funding toward improving DHIS capacity so as to produce quality and timely HIV indicators (Kawonga et al. 2012). Hence, it should be explored to what extent the possibly parallel data requirements of the PMTCT programme or by the non-governmental organisations working in PMTCT may contribute to the data quality issues in the DHIS. Although we found a lot of data inaccuracy and incompleteness in our study, we did not provide any interventions because of funding limitations. The study recommendations were made available to the district.
Limitations of the study
Study limitations include that the study was conducted in only one district of the Mpumalanga Province, thus findings cannot be generalised to every district in South Africa. It cannot, therefore, be assumed that similar issues with data incompleteness and inaccuracy are present in other districts.
In this study, we found that patient data recording varies between different PMTCT data elements whereby antenatal indicators seem to be more recorded than maternity and infant indicators. There is a need for ongoing training on data recording at all levels, which support on DHIS is critical for it to function properly.
To maintain data quality, healthcare data must be appropriate, organised, timely, available, accurate and complete (Abdelhak et al. 1996). Data entry checks are also critical for accurate data reporting (WHO 2003). For this reason, having dedicated personnel in each facility would improve data recording quality significantly.
This research has been supported by the President's Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) under the terms of Cooperative Agreement Number U2G/ PS000570. We would like to thank the healthcare providers and information managers in Nkangala District healthcare facilities for allowing us to review PMTCT records. Furthermore, we would like to thank Greg Molefe for capturing data for this study.
Competing interests
The authors declare that they have no financial or personal relationship(s) which may have inappropriately influenced them in writing this article.
Authors' contributions
M.G.M. (Human Sciences Research Council) was the project manager and participated in the conceptualisation and design of the study. She also analysed and interpreted data and developed a draft article. K.P. (Human Sciences Research Council) was the Principal Investigator for the study. He participated in the design of the study, data analysis and interpretation and writing of the article. A.K. (Trinity College) participated in writing the draft for the article by conducting literature review. All authors corrected and approved the article.
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Karl Peltzer
Private Bag X41
Pretoria 0001, South Africa
Received: 20 Aug. 2013
Accepted: 14 Apr. 2014
Published: 21 Aug. 2014


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The most Controversial Topic in Gaming right now Halo 4 vs Black ops 2. Every Body's creating their own experiences, and topics on the matter, some favor halo while others favor cod. See how me and special guest Gallis109 analyze these games in 3 sections giving a conclusion and explain to the FPS community about these Heavy hitting big releases!.
''The most Controversial Topic in Gaming right now Halo 4 vs Black ops 2.''
Really? it's about as controversial as someone playing video games buying a video game.
There is no controversy between H4 and BLOPS2. If I'm correct, people that play Halo on xbox also play Cod. On PS3 COD players couldn't care much for Halo anyway.


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Television has been proudly brandishing its "Golden Era" calling card of late largely on the merits of the many top dramas being produced on prime time and cable over the last few years. It's a rise in quality such that any demarcation line between film stars and TV stars has been wiped away — film actors who may have once shunned the small screen are increasingly embracing television dramas, proclaiming that the most creative stories and interesting characters are to be found there, and TV actors, well, they know a good thing when they've got it.
The Envelope invited five such actors to take part in the Envelope drama panel — Bryan Cranston of "Breaking Bad," Connie Britton of "Nashville," Andrew Lincoln of "The Walking Dead," Elisabeth Moss of "Mad Men" and Kevin Bacon in his first TV series, "The Following." Their conversation took on strong female role models, violence on television and how any of us, really, could be a killer if pushed hard enough.
Here is the transcript of that April 30 conversation at the L.A. Times; it has been edited for length:
WATCH: The Envelope Emmy Roundtable | Drama
Critics say this is the golden age of television. How do you feel about the state of dramatic TV, and what is it like to be a part of that equation?
Elizabeth Moss: I think that it is very much a golden age. And I feel very lucky to be around at this time when there are such incredible roles for women. I feel like I've witnessed the divide between film and television and even theater kind of disintegrate and fall apart. And now that television is—it has such a high caliber and is so good and the scripts are so good ... and it allows for actors to have a lot more freedom, to be able to go to a lot more places and do more interesting things.
Andrew Lincoln: Yeah, I mean, I came [to American television] because of two people that I'm sitting with, two performances that I've watched on AMC, Elizabeth and Brian. You know, [their shows] were the things that put AMC on the radar for me as an actor in England. And I loved "The Wire" and "Sopranos." You just name all of these incredible shows that were going across the globe from this country that made me sit up and just think there's terrific writing; great character-driven stories in American television. And I never thought that I would bag one of them. There's no coincidence that it's attracting such incredible actors because it's all gotta be driven by the writing.
Is it the writing, Kevin?
Kevin Bacon: Yeah, totally. You know, when a writer is on a movie, a lot of times they're kind of persona non grata. You don't want 'em on the set. They get rewritten. And I think that it starts to get frustrating for writers. And on television, they're it. They're the big man on campus. And, and if, if you can have that kind of power and influence to be able to really create something and kinda put your mark on it, it's going to draw the best people. And, you know, from my experience, the call that I made to actually say that I was interested in doing a television show, it was a difficult call for me to make because I came up in a time when that's not where you wanted to go. I left 'The Guiding Light' — Brian was on a soap too. And I was like, "I'm never going back to television." I was kind of a snob about it like, in terms of my own involvement. But at the same time, I was watching these guys and other amazing shows, and I was married to an actress who was on a show. And from the second I made the call [to consider TV], I mean, within two weeks, I had read three of the best scripts that I had read ever. It was kind of a no-brainer. I was sorta like, "Schmuck, what took you so long?"
Bryan Cranston: Did you think that, at the time, that it would be like, a career killer if you went into television from starring in movies?
Bacon: I did. I mean, it was just, it was a leftover feeling, you know. Some habits they die hard. But, you know, like I said, the second I sort of threw my hat in the ring, first off, I felt a great sense of excitement and of relief. And it was really based on just these characters that were options to play, just like great characters that I just hadn't gotten—or I wasn't seeing that many opportunities in movies.
Connie Britton: I also think that there is a freedom in television. You really have an arc of time to create, there's a freedom to be courageous for our writers. They can push themselves and think outside the box of what they would normally think about writing if they're just writing a film, you know? Film is very finite. And so with television, there's a freedom to meander a little bit and to explore characters a little bit and to delve into something that maybe you wouldn't have the guts to do because you only have this hour and a half time period to cover. So there's something to me that's exciting about TV for that reason.
You started "Breaking Bad" when TV drama was getting good, and now it's great. So you've really seen an evolution in the last several years.
Cranston: Yeah, I had the same thought that Andy had. When I was offered the role in "Breaking Bad," Rob Sorcher at AMC—he's not there anymore, but he was developing it. And he said, "Well, don't say anything." Because I was concerned that such a beautiful pilot script, you want to take care of it, you know, because it can be fragile. You can take a wonderful piece of material and just ruin it. So I told my agency I'd like to talk to AMC because they were the movie channel. And so are they going to dive in and support this? And I got into that conversation. He said, "Wait a second. Let me send you a show that we're doing. It hasn't aired yet, but it's called "Mad Men." Let me send it to you, the pilot, and then we'll talk." It comes. I pop it in. I watch it. And I went, "Oh, my god. This is an incredible storytelling." That's the foundation, no matter what medium you're in. But I think especially for now, there's a golden age of television because I think people really got smart about this and realized that the material should dictate the medium, not the other way around. That all of our shows here would not make good movies. You would have to truncate the stories and ditch some really wonderful character development.
PHOTOS: Celebrities by The Times
Britton: Well, in the case of "Friday Night Lights," it was a movie, and I was in the movie playing the same part. And I went to the premier and thought that my character had been made mute, you know, (laughs) because I had so little to say. And part of what was wonderful about being able to do [the series] for all of us and particularly for Pete Berg, who wrote the movie and also the pilot for Friday Night Lights, he wanted very much to give the women, in particular, of that community a voice because he couldn't do that in the film.
We've got two people here who are at different stages of this arena. Kevin, you're opening a door into it, and Bryan, you're getting ready to close the door. I want to ask you specifically—
Bacon: Johnny Come Lately. (laughter)
Overall, what was the experience of being on the show like, and were there any surprises or challenges that you weren't anticipating?
Bacon: I knew a certain amount about it because of having directed a lot of "The Closer" and having spent time and seeing that world and seeing secondhand, you know. My wife [Kyra Sedgwick] would come home, and she had this little tape recorder and she's sitting there all weekend. And then every time I want to do anything with her, she's like, "Sorry. We're running lines." I could see that grind. But I found it really enjoyable. I'll tell you why. Because I stopped and I looked at my life, and in the course of a year, like maybe 5% of my time I've spent acting. Five percent of my time was between "action" and "cut." The rest of it is, you know, promoting something, waiting for lighting setups, traveling, hopefully reading stuff, waiting for the phone to ring. I really like to act, that's really what I like to do. And when you're on a TV show, you act your ass off. Ten pages, you know, in a day as opposed to 10 pages in a month or two months or whatever it is. So even with the pace and with the hours, I get home and I'm exhilarated. I'm sure you would all agree that when you play a character over a period of time, they can throw you into any kinda situation, and you know how your people will react. So you can kind of go with that instinct sort of thing as opposed—
Britton: You want them to throw you in the middle of this.
Bacon: Yeah. Sure you do.
Britton: Like, that's the fun of it is you have all this opportunity to have your character go through all these twists and turns.
Bacon: Yeah. So I found it great. I mean tiring and definitely a very, very in our case dark place to go. There was too much killing and too much dying and too much just, you know, like tragedy for me to be able to turn it on and off like a faucet. So it was a dark place for sure for the months that we were doing it, but at the same time exhilarating.
Speaking of darkness—You have been miraculous in playing one of the darkest and most twisted people ever.
Cranston: Well, I just think he's misunderstood. (laughter)
But it's gotta be, like Kevin said, not the easiest thing to put on the skin of this guy.
Cranston: Actually, there's a little bit of protection that comes when you're doing it in the third or fourth or fifth or sixth seasons. You know, and mostly it's like a talisman. I put on my wallabies and my hat and I shave my head and I grow my goatee out. And I look in the mirror and go, "Oh, yeah, there he is." And you just kind of let it inside. And I did find places because of the fact that the series got dark that I wanted to lighten it up. I wanted to play the practical jokes on people and have fun because that's what we're there for. We want to have fun during the process.
There's really no fun when you're in the middle of a zombie apocalypse. (laughter)
Your show, just right off the bat, was a phenomenon. First of all, what was it like sort of coming from British television to American television and just getting on this fast-moving train?
Lincoln: I was terrified. You know, the first—the pilot episode in the show that I'm in, I'm isolated for a lot of the first part of the story. And so I remained quite alone for a lot of it. But then after a while, you realize it's an ordinary film set, and I knew what all the people did. And then after a while, it became incredibly comfortable. But it was very much about dialect first. I went out early just to, you know, because if you're going to have the honor of leading or being involved in playing an iconic sort of American role, I wanted to get that bit out of the way before the zombies. You know what I mean? So I could focus on killing them.
Lincoln: But it, you know, just to work with extraordinary people like Frank Darabont, I mean, he was the guy that took me onto the plane to do the screen test. And when I read the pilot episode, I realized what they wanted to do with it. I thought this is the most extraordinary way to sort of distill humanity, to tell this story in this extraordinary landscape. But actually all it is, is just about what it is to be human, you know. And the story that really made me want to sort of take the role was not my character. It was Morgan. There's a story about the first human that [Rick] meets is this guy Morgan and his son. And I just got it. I just thought that that was such a bold and brave and unique way of telling this story.
PHOTOS: Hollywood backlot moments
"Mad Men" isn't quite as dark as "The Walking Dead," but what impresses me about your role is that we've seen you grow season by season probably more than any other character on that show.
Moss: I feel very lucky to have that particular female role on the show because of that, because I think that she's had this crazy arc and has grown up so much. Part of that is just by virtue of the fact that she's 20 in Season One, and she's, I don't know, 26 or 27 now, I guess. And I was 23 when we made the pilot, and now I'm 30. So for me, it's been really interesting to go through my own experiences and have that inform Peggy and often experience a crazy kind of mirror situation that happens with Peggy and me.
How do you connect, you're a modern girl, and Peggy's back in the '60s?
Moss: I never thought of it like that. I didn't care that she was a '60s girl. I wanted to play her like me, like a woman of any time because I think that there are things that she experiences and things that all the women on the show experience that we still experience today, maybe in varying degrees. So for me, what I connected to was that she was just a young woman.
Connie, you've been in two amazing shows where you've played strong, independent women. You are considered a role model. What is that position like?
Britton: It's really rewarding and surprising, particularly playing a role in "Friday Night Lights." That was something that I think really impacted the women who saw it. And, you know, looking back on it, it was sort of built for it, I guess. I mean, I was playing a high school counselor and there was a lot there. And I was in this great marriage. And, you know, I have people still, to this day, come up to me and tell me that they want their kid to see the scene where I talk about sex with my daughter. So certainly when "Friday Night Lights" was over, I definitely was almost stunted in a way by having this sense of responsibility that I needed to somehow maintain, you know, this role model or this image that I was putting out into the world. Thankfully, then I went and did "American Horror Story," which kind of just demystified all of that and made it a lot less precious and gave me a good sense of humor about what I'm doing in the world.
You're all with a group of people where each week, you don't know what family member's going to be around the following week. What is that like for you?
Lincoln: Well, it is a bit of an occupational hazard, you know? And I didn't sort of read the small print when I decided to do the job. We've lost so many amazing friends. And it is a family. It does feel like that. You galvanize, and you spend so much of your waking hours with these people. And it is incredibly sad that you have to say goodbye to these brilliant characters first and foremost, you know, and then dear friends that you've made. I lost my wife in this last season, Sarah Wayne Callies, who's the greatest leading lady I've ever had the privilege of working with. [Quickly to Moss and Britton] I'm looking forward to working with you two ladies soon.
Moss: Until us.
Lincoln: Until you guys.
Moss: No offense.
Lincoln: It was heart-wrenching when I got the call from the show runner directly after he made the call to her because it has so many reverberations, not just on me. It's because she's got a young child like we have. Her husband is great friends with my wife. It's not only the ramifications for your character, it's this domino effect with this family that you work with.
That particular scene (when Rick returns to base to discover his wife has died) was heartbreaking and gut wrenching —was there some of that feeling in occupying that scene?
Lincoln: Yeah. I was saying goodbye to a dear friend. I did a long preparation — for two hours — while people were setting up. By preparation, I mean, I listen to music and get myself into a place. I took my contact lenses out because I thought, maybe I will cry in this. And I just wanted to honor her departure as well — and it was the kid that did it for me. I looked at Chandler Rigs, who plays my son, this genius child who's been discovered out of nowhere. And I had said to the director before, "I think this is the moment where you have to see the man that has been so strong, fall. I want to see him drop his gun. I want to see him kneel. The two things that have driven him the whole season, his motives operandi have been driven by two people: His wife and his son. One of his legs has just been taken away." And so we sort of vaguely plotted it. And it was the kid that undid me. He just looked at me and gave confirmation silently that she was gone. And it just went into a different place, you know?
Acting is such a craft. I'm so used to seeing you as Peggy and then you did this miniseries, "Top of the Lake," which was about as far from "Mad Men" as you could get. I mean, this detective who's very haunted and gets involved with some twisted people. Your character was so raw and had to bare herself in every way. What was that experience like?
Moss: It was super fun, getting the chance to fight and run, and scream and cry — and "Mad Men" is so subtle, that's the beauty of it. And it's not easy to do, that kind of acting, by any means, but it's a very specific kind of style. And just to get the chance to use other muscles for me was so awesome. And then the fact that it was obviously Jane [Campion], somebody that, I mean, anyone would want to work with. And she's sort of known for her kind of female performances. I didn't even know if I could do it. And Jane didn't know if I could do it. And then once I kind of half convinced her that I could, then I went through that thing that I'm sure every single person here has gone through, where you're like, "Oh ..., they think that I can do this." And then eventually, scene by scene and day by day, you start building a character.
Playing Hal in "Malcolm in the Middle" and then doing Walter — which character was more challenging for you?
Cranston: Well, I loved both those guys. I think the thing that all actors are really looking for is opportunity. I've just been extremely fortunate to be able to do that on a spectrum that is—one's way over here, and one's way over here. It's just basically different aspects of your own characters that you're exploring. For instance, with Walter White, I said as a joke I think he's misunderstood. But the truth is I think everyone is capable of doing severe damage to themselves or to society or to another human being depending on the condition of that person. Sociologically, this is where I went in working on this guy, finding out how is it possible to start a character as a nebeshy kind of sad sack who got a bad hand dealt to him and cancer and he's got a son who is special needs and he doesn't make enough as a teacher, so he's gotta have a second job. And how does that guy become a killer, an absolute killer? And I think all of us are capable of being that guy if the right buttons were pushed, if the sense of desperation were present. If I knew really well what makes each one of you tick and I got to see what you're afraid of and I started pushing the buttons, all of a sudden, we'd all have those reactions.
For Ryan, it seems like his chance for redemption or opportunities for redemption are far, far off. To occupy that, how is that for you?
Bacon: I was really drawn to the flaws of who he would be, starting with this heart thing, this pacemaker that he has. When I first met with [series creator] Kevin Williamson, he said, "Well, when you were fighting with Joe Carroll, you were stabbed in the back. And so you have a limp." And I said, "So let me just get my head around this. You just had me sign a six-year contract, so I'm gonna be limping for six years?" And he said, "Well, you know, there was this draft where he had this pacemaker." And I said, "That sounds amazing. What does that look like?" And he pulled back his shirt. And I said, "That's it, man." Because it's metaphoric, of course, but it's also—every time he goes into some kind of a physical thing, whether it's a fight or a chase or whatever, there's always this kind of ticking time bomb of losing your life. And to that, we added the vodka. And to that, basically, sadness, you know, and isolation. So, you know, I like that. (laughs)
There's also the issue of violence that's been a hot-button issue. Your show certainly has had that. Every second of your show has it. What is your feeling about the violence on the show and the controversy of some of that?
Bacon: Well, you know, if we're making a scary thriller that's about a serial killer, there's gonna be some violence. I guess the question is violence in the media and should it be part of the discussion? Yeah, it should be. And you can also turn the television off if you have young children. I also feel like it's just a piece of the discussion in terms of violence in our society right now, to 100% blame it on TV shows is moronic.


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Being an Olympic athlete and having his picture plastered on posters would probably fill most 22-year-olds with a healthy dose of confidence, if not arrogance.
But Diego Estrada, a distance runner who will be competing for Mexico at this summer's Olympic Games in London, maintains a sense of humility and perspective, thanks to his deep Catholic faith.
"Catholicism and Christianity is a big part of my daily life. I wake up with prayer. I go to bed with prayer. Before a race, I pray. All around, it's a big part of my life," Estrada said in a recent phone interview.
"I was born to Catholic parents in Mexico. We're very Catholic. From day one, attending Mass, being Catholic was important," he said.
Estrada, a four-time All-American student athlete at Northern Arizona University, will run the 10,000 meters for Mexico.
"Once they left their home country, it was no return. They risked it all. Something I'll never forget is that it was my parents' dream for their children to have a higher education, a better life and not to do any manual labor," said Estrada, who became a permanent U.S. resident in 2000 and a citizen in November 2011.
Estrada said he had wanted to represent his adopted country in the Olympics, but added that he had been given false information about not being eligible to run in this year's U.S. Olympic trials.
"I have two countries, and I love them both very much. Emotionally, they're both really special to me, but going to the Olympics and representing Mexico is something I think my parents can relate to more. I feel going to the Olympics is more of a gift for my parents — as a way of thanking them for the sacrifices they made for me when I was a kid," Estrada said.
The Catholic faith has been extremely important for Estrada ever since his parents baptized him in their hometown in Michoacán, Mexico. A few months later, the family — he has four siblings — immigrated to Salinas, Calif., where he received his first Communion at age 11.
Shortly after arriving on Northern Arizona University's campus in Flagstaff, Estrada met a missionary from the Fellowship of Catholic University Students who helped him form a Bible study for other track athletes and students.
Father Matthew Lowry, the Catholic chaplain at Northern Arizona University, remembered urging Estrada to join a Bible study.
"He said, 'Father, I don't want to be in one. I want to lead one,'" Father Lowry said.
"That showed he's a natural leader. God gave him that gift."
Estrada's weekly Bible study meets Wednesday nights at his apartment.
"We open up with prayer; then we start with a reading. We'll read a chapter or two from the Gospel; then we reflect. We try to connect the teachings of the Bible to things we can relate to as athletes, like perseverance, having faith and keeping going. We share our thoughts, and then we close with prayer," Estrada said.
Strength in Faith
The Bible study and fellowship also serves as a needed respite from his intense training regimen.
"For me, I'm 24/7 busy. I'm either training, eating or sleeping. For me, the Bible study on Wednesdays is a mental break to refocus and give some time to God and humble myself," Estrada said.
"It's a way of finding motivation, tranquility and peace of mind being around fellow Christians and Catholic students. It's just helped solidify my foundation," said Estrada, who wears a Miraculous Medal.
He also has a devotion to Our Lady of Guadalupe. "Being Mexican, we have a strong place for her in our hearts. When we're in trouble, she's our route to Jesus, you can say," Estrada added.
Father Lowry said he has seen the impact of Estrada's faith life on him and his teammates.
"I've noticed more track team members coming to Mass," Father Lowry said, adding that Estrada would often make an appointment for confession before going out of town for a track meet.
"Diego lives the faith, and he's not afraid to talk about it. It's his faith that helps him stay grounded and keep perspective. He still has a sense of gratitude for everything he has."
"You meet him, and you would never know that he's a world-class runner," Father Lowry added.
Estrada's accomplishments at Northern Arizona since 2009 testify to his God-given running abilities: four All-American awards, at least four Big Sky individual titles and conference records in the 3,000- and 5,000-meter races.
At Alisa High School, Estrada was a two-time California regional champion and a three-time state qualifier in cross country. Northern Arizona cross country coach Eric Heins, who is also the university's track and field director, recruited Estrada.
"The way he ran, he looked very effective. I thought he had something," said Heins, who saw Estrada mature from a "gung ho" freshmen who ran too hard in practices to a seasoned athlete who learned to properly train and pace himself.
"One of the strengths he's developed is that he's extremely strong. He can get onto a good pace and push through some pain. He's able to handle an enormous amount of pain. That may be his biggest strength," Heins said.
Whenever pain or some other obstacle presents itself, Estrada said he reflects on one of his favorite Scripture verses.
"Matthew 17:20 tells us that if you have faith the size of a mustard seed, you can move mountains. So whenever I think I can't do something, I always go to that Bible verse, and I get some strength from that," Estrada said.
Sharing the Faith
Heins added that Estrada's work ethic is "second to none."
"He's willing to do what it takes to push himself. I was overwhelmed with joy for the kid when he qualified for the Olympics. I almost started shedding a tear. It's something he worked so hard for the past four years," said Heins, who will travel to London to support Estrada in person.
Estrada said he began running his freshman year of high school. He waved away questions about when he realized that he had world-class ability.
"I never thought about having a special talent. It was just something growing up and having a desire to win races. It was just going out there and running. I've never gone out and thought, I'm talented. It's not something that goes through my mind," Estrada said.
Father Lowry said he believes Estrada's faith prevents him from thinking too much about himself.
"He's humble, down-to-earth and loves his family," Father Lowry said.
Estrada is majoring in secondary education and plans to be a teacher and track and field coach. He has also not ruled out becoming a Focus missionary, though his current training schedule precludes that for now.
"I try to be a missionary in my own way," he said.
Father Lowry noted that Estrada will soon have the opportunity to share his faith with many Olympic athletes in London.
"He'll be meeting and influencing athletes from across the world," Father Lowry said. "I'm very happy for him. It couldn't have happened to a better guy."
Brian Fraga writes from El Paso, Texas.


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Derek Contemporary Multi Gray Color Wood Bedroom Set: Queen Panel Headboard, Dresser, Mirror, 2 Night Stands, Chest
Product Details
What do you get when you mix a simply striking linear profile with a complex, multi-tonal finish? The marvelously different Derekson collection, Loaded with interesting texture, the plank-style headboard combines three unique finishes?€?from neutral matte to replicated grain inspired by driftwood?€?for cool, contemporary style with a twist. Four adjustable headboard heights provide for a custom look. Mattress and foundation/box spring available, sold separately. Rustic butcher block finish over replicated pine grain with authentic touch. Cases feature a framed front and pilasters. Bed features a thick and heavy design. Contemporary handles in an antiqued gunmetal finish. Side roller glides for smooth operating drawers. Drawer interiors finished with a replicated linen design. Slim USB charger located on the back of the night stand tops.
- Set include Twin Panel Headboard, Dresser, Mirror, 2 Night Stands, Chest. Made of engineered wood, Butcher block finish over replicated pine wood grain, Four ??" bolts are needed to attach headboard to existing bed frame, Bolt length depends on thickness of your bed frame, Mattress and foundation/box spring available, sold separately.
- Muted distressed finish over replicated pine grain; Metal drawer pulls in antiqued gunmetal finish. Drawers offer a soft-closing motion. Multi-tone finish over replicated wood grain creates a muted layering effect.
- Smooth-gliding drawers with replicated linen interior on all drawers, nighstand features USB charging station. The Mirco Nighstand also feature a Plank-style effect adding a modern yet rustic tone.
- Item Dims: Headboard: 63"W x 5"D x 49"H. Night Stand: 22"W x 16"D x 25"H. Mirror: 59"W x 16"D x 37"H. Assembled dresser: 58.75" W x 15.75" D x 67.25" H. Drawer interior (6): 24.5" W x 13" D x 6.5" H. Assembled queen bed: 62.5" W x 90.25" D x 48.5" H.
- Important: Delivery appointment and Signature required. Standard Curbside Delivery Included. Upgrade Inside Delivery Service Upon Request. Photo may slightly different from actual item in terms of color due to the lighting during photo shooting or the monitor's display


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We would like to welcome Vladimir Fomin into our membership and Imagekind's print-on-demand marketplace.
Vladimir Fomin can use this personal profile to post their bio, resume or statement. It's an ideal space to post a show calendar, make announcements, add links and inspire Imagekind wall art shoppers to purchase Vladimir Fomin's fine art prints.
If you want to return to Vladimir Fomin's Imagekind profile, just save this link: http://VladimirFomin.imagekind.com


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Don't have an account with us yet? Please set up an account to place order or obtain customer services.
GLP-1 (7-37) is an incretin hormone that causes glucose dependent release of insulin by pancreatic beta cells. It is the cleavage product of proglucagon. Both GLP-1 (7-36) and GLP-1 (7-37) play roles in gastric motility (gastric emptying), on the suppression of plasma glucagon levels (glucose production) and possibly on the promotion of satiety and stimulation of glucose disposal in peripheral tissues independent of the actions of insulin. Although GLP-1 (7-37) is bioactive, it is available in lesser amounts than GLP-1 (7-36) and is not amidated.
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Full TitleA Pilot Study of Geriatric-Specific Interventions for Quality of Life in Elderly Patients with Cancer.
Many people with cancer seek counseling to help ease the emotional burden of the illness and its treatment. Counseling often helps them cope with cancer by giving them a place to express their feelings.
The purpose of this study is to examine whether psychoeducational counseling for older cancer patients undergoing treatment is feasible and worthwhile. Researchers will test this approach as individual counseling over the phone and in a group counseling format. They want to see if this type of counseling helps reduce depressive symptoms, anxiety, perception of loneliness, and isolation.
Participants will complete questionnaires about anxiety, depression, perception of loneliness and social support, and physical/social/emotional/functional well-being. Patients will receive either this Geriatric Intervention or a referral to a social worker age 65 or older, and the two approaches will be compared.
Participants in this study include people with stage I-III breast or prostate cancer who are age 70 or older and who are being treated at Memorial Sloan-Kettering Cancer Center.
For more information about this study, please contact Dr. Andrew Roth at 646-888-0062.


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- This event has passed.
YogaPaddler Lake Paddle Outs
May 1, 2017 @ 3:00 pm - 5:00 pm
|Recurring Event (See all)
An event every week that begins at 3:00 pm on Monday, repeating until October 30, 2017
Enjoy a sight-seeing paddle around Little St. Germain Lake and other Vilas waterways. We try a different waterway every week. Bring your own board (no fee) or try one of ours for only $14/session. There is a lot of beauty so be sure and bring your camera! While drop-ins are always welcome, if there are no registrations, we may cancel the session. Be sure to register or call ahead!


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puppy-blankets.com necesitaba un nuevo diseño de logotipo y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 106 diseños de 19 diseñadores freelance.
Logo and banner needed for new online business that manufactures and sells quilted pet blankets and other dog products (such as pet beds and bandanas).
The company name is "puppy-blankets.com" We are an internet-based business that manufacturers and sells quilted pet blankets. We own three Boston Terriers that will be used as product models on our website (which is still in the development stage). Most of its content will be written as if the dogs are speaking to the customer.
- We would like a logo and banner that incorporates our company name which will be used on our website, in print advertising and on our product label.
- We are looking for a clean, somewhat simple, eye-catching logo that portrays a friendly image.
- We seem to be more drawn to a softer, flowing look instead of hard, sharp edges and fonts.
- Colors and styles will be left up to the creativeness of the designers who enter the contest; however, if there is something that catches our eye, we may ask designers to submit something with specific coloring.
- We would like a logo that prints well in color and in black and white.
- File formats: Vector graphic. jpg, gif, eps, psd, tiff. We need the logo in high resolution for printing purposes and also in one of the most common formats for printing and web layout.
- A few things we would be interested in seeing:1. We like the outline look. A couple of examples are the logos at http://www.sitmeanssit.com and http://www.petparadiseresort.com. Silhouettes are OK too. We are definitely open to other ideas as well.
2. We also liked the logo that was designed on this website for dogzonline.com.au-Australia's Pure Breed Dog Community" (#81) with the dog tongue used in place of the "l" in the word "online." Can be viewed at http://99designs.com/contests/258.
3. An image of a dog enveloped in a blanket would be of interest since the focus of our business is pet blankets.
4. Since our Boston Terriers will be used as product models on the website, it would be neat to see the breed incorporated, but definitely not necessary for inclusion in the design.
5. We don't have a tagline confirmed yet, but would like to see logos with and without taglines. One we are thinking of using is "where sleeping dogs lie."
- No cartoon images or designs that are too detailed or "busy."
- Don't care much for hard, sharp edges and fonts in design.
- Hard to read fonts.
- No three-headed dog logos, unless it can be done in a simple, tasteful outline-type design.
- Photographs
Descubre cómo funciona un concurso de diseño u obtén más información sobre nuestros servicios de diseño de logo.


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General FAQs
What kinds of information do I need to fill out the FAFSA (Free Application for Federal Student Aid)?
You must complete the FAFSA to be considered for financial aid at GCC. You'll need income information from 2 years prior, typically obtained from your Federal Income Tax Return and W-2 wage statements. If you're a dependent student, your parents will also need to supply their income and tax information. You should not send in any tax documents to GCC unless you are specifically asked to do so.
How long does it take to process my FAFSA?
Once the Financial Aid Office receives all your required documentation, it may take up to 6-8 weeks before you receive an award offer. Students are expected to actively review their financial aid status and any outstanding requirements on MyGCC.
How is my bill for tuition and fees paid?
If you've been awarded financial aid, your funds will arrive on campus mid semester and pay toward any unpaid tuition, fee and bookstore charges for the term. Any excess funds are disbursed to you after the mid-semester point. If your bill isn't covered completely by financial aid, you will need to make arrangements with the Bursar's Office, by the bill due date, to pay the balance of the bill.
How are my books and supplies paid?
If you've given the Financial Aid Office permission (by signing the Acknowledgements and Certifications Form) to establish an account in the GCC Bookstore, you will be allowed to use financial aid to help purchase textbooks and supplies. Note that you will only have an account set up if you have excess financial aid after your tuition and fee bill is deducted from your award. If you don't have enough excess aid for books and supplies, you will not have an account open at the Bookstore. If you add or drop classes after your bookstore account is set up, your aid may be adjusted and you could owe a balance. Speak with someone in the financial aid office before adjusting your schedule to find out how this will affect your eligibility.
Why am I still considered a dependent student? I'm 21 years old and haven't lived with my parents for years.
For financial aid purposes, Federal and Massachusetts regulations consider students dependent until they are 24 years old, or are considered independent by marrying, serving in the military, or having dependents. Students may also be independent if they have been wards of the court. Find out more in our publication Are You an Independent Student?
What is Verification?
Verification is a process where a GCC financial aid counselor compares information you provided on your FAFSA with information on tax and income documents. About 3 of every 10 students applying for financial aid at the College are selected for Verification by the Federal Department of Education. If you are selected for Verification, you will be asked to bring in copies of tax and income documents. Learn more about Verification.
What is "Satisfactory Academic Progress" and how does it affect my financial aid?
To be eligible for financial aid, Federal and Massachusetts regulations and official GCC policy require students to be making "Satisfactory Academic Progress." Each semester the Financial Aid Office monitors students' GPA, and also reviews the success of financial aid students in earning credits toward their degrees and certificates. Students also need to earn their degrees within a certain number of attempted credits, usually about 90 credits for an associate degree. If you are not making satisfactory academic progress, you may appeal the status and if successful have your eligibility for financial aid reinstated.
What happens to my financial aid if I drop or withdraw from classes during the semester?
Financial aid is pro-rated for the semester, meaning that aid is earned at a certain rate and not completely provided at the very beginning of the semester. After the 60% point in the semester, all financial aid is considered earned. Generally, earned aid is subtracted from your GCC bill for tuition, fees, and books. If earned aid is less than your bill, you will have to pay the balance.
What happens to my loans if I drop below 6 credits?
Students must be enrolled at least six (6) credit hours to remain eligible to receive loan funds. If you drop below 6 credit hours, your loan will automatically be canceled. You must begin loan repayment with the Department of Education if you drop below 6 credit hours. If you are attending school at least half-time, you may have a set period of time after you graduate, leave school, or drop below 6 credit hours before you must begin repayment. This period of time is called a grace period. Your grace period will be 6 months for the Direct Loan.
What happens to my financial aid if I stop attending classes?
Students who stop attending or participating in classes, without formally withdrawing from GCC, are considered to be withdrawn unofficially. If you stop attending your classes, you are no longer eligible to receive your financial aid for the term. Any financial aid awarded to you but not fully earned by you for the semester must be refunded to the Department of Education.
Students must maintain a G.P.A. of 2.0 at all times. Students who walk away from their class are automatically placed on Unsatisfactory Financial Aid Progress and must complete the Appeal Process.
Is my financial aid limited? How long can I receive financial aid at GCC?
All students are limited in the amount of time during which they can receive financial aid, even those students who are progressing well academically. In order to receive continued financial aid you must be actively completing your degree option. This is called Maximum Time Frame. Maximum Time Frame allows a student to complete his degree within 150% of the degree's total credit requirements. Most degree options at GCC require a total of 60 credit hours. So, this means that a student can attempt no more than 90 credit hours toward his degree. Students are no longer eligible to receive financial aid at GCC after 90 attempted credit hours. Attempted credit hours include all withdrawal credits, including medical withdrawals, all failed or incomplete credits, all transferred credits, and all developmental course work.
I was a student several years ago. I didn't do that well and now I'm re-entering GCC under Fresh-Start. How does my previous academic history affect my financial aid status today?
All previous academic history is counted as credits earned toward a degree, even if the student enters under Fresh Start. Fresh start waives the student's previous academic progress and standing but it does not affect Financial Aid Progress.
I've earned 27 credits at GCC and I've also withdrawn from three 3-credit courses and two 4-credit lab science course. Do withdrawals count toward satisfactory financial aid progress? My GPA is 3.50.
All credits, attempted and earned, are counted toward degree completion. Attempted credit hours include all withdrawal credits, including medical withdrawals, all failed or incomplete credits, all transferred credits, and all developmental course work.
Even with a G.P.A. of 3.50 this student is not making satisfactory financial aid progress. In this example, the student has attempted a total 44 credit hours and earned only 27. Students must maintain a completion rate of 67% or more in order to maintain their good standing. This student's completion rate is only 61%.
I've been at GCC for three years and I've earned 66 credit hours but I haven't completed a degree program yet. I want to change my major, but my new major requires 45 credit hours that I still have to earn. Can I continue to receive financial aid for my new degree option?
Students must complete a degree or certificate within 150% of the required number of credits for that degree or certificate. Most associate degree programs at GCC require 60 credit hours of course completion. Because this student has already earned 66 credit hours without having earned a degree, he may not have enough financial aid eligibility remaining to cover his new change in major. He can only receive financial aid for 24 remaining credit hours.
I intend to apply to the one of the Nursing Programs but I need to complete pre-requisites. How long can I receive financial aid at GCC?
The regulation regarding Maximum Time Frame definitely applies to students earning pre-requisite courses. For example, if you matriculate into the Associates of Liberal Arts Degree – Health Science Option, you must complete all degree requirements within no more than 45 attempted credits before entering either the LPN Certificate Program or Associate of Science Nursing degree program. If you attempted 45 credits and still have pre-requisite courses to complete, you must first complete the Liberal Arts Degree Option before entering either the ADN Degree Program or the LPN Certificate Program.