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Transfer Pricing: methodologies: Mutual Agreement Procedure: SP1/11: arbitration stage
Statement of Practice 1/11: arbitration stage
The Arbitration Convention obviously provides for arbitration in certain circumstances, but the OECD Convention and Commentary thereon also contemplates the inclusion of arbitration provisions within tax treaties. The UK is now beginning to incorporate provision for arbitration in some of its tax treaties.
It will be necessary in every case to have regard to the relevant tax treaty, but generally for treaties with an arbitration provision, where a person has presented a case and the competent authorities are unable to reach an agreement to resolve that case within two years from the presentation, the person can request that any unresolved issues be submitted to arbitration.
The relevant provision in the OECD Convention precludes the availability of arbitration where a decision on these issues has already been rendered by a court or administrative tribunal of either treaty partner state. However, where possible the UK will seek when agreeing treaties to have terms more favourable to the taxpayer included in the treaty.
Unless a person directly affected by the case does not accept the mutual agreement that implements the arbitration decision, it shall be binding and shall be implemented notwithstanding any time limit in the domestic law of either treaty partner state.
The competent authorities will decide the mode of application of the arbitration provision. This will include matters such as the form of the request for arbitration, the information that must have been provided to both competent authorities when the case for MAP was presented, terms of reference and the selection of arbitrators.
For MAP cases within the Arbitration Convention, Article 7(1) provides that if the competent authorities fail to reach an agreement that eliminates double taxation within two years from the date on which the case was first submitted they shall set up an advisory commission to deliver its opinion on the matter. Article 7(4) provides that the competent authorities may, with the agreement of the associated enterprises concerned, waive the two year time limit. Where the UK competent authority considers that continuation of the MAP is likely to result in earlier resolution of a case than referral to an advisory commission, it will assume the tacit agreement of the other competent authorities and the associated enterprises to waiving of the time limit. MAP will therefore proceed accordingly.
The associated enterprises, of course, retain the right to invoke the two year time limit when it expires. If the enterprises, or the other competent authority, notify the UK competent authority of their wish to invoke the time limit, the UK will cooperate fully in establishing an advisory commission. Similarly, when the UK competent authority does not consider that MAP will result in earlier resolution of the case, it will ask the other competent authority to cooperate in setting up an advisory commission.
The two-year time limit before a case proceeds to the second stage may also be extended where the case is still under appeal through domestic procedures in one of the treaty partner states.
The submission of a case to the advisory commission does not prevent a Contracting State from initiating or continuing judicial proceedings or proceedings for administrative penalties in relation to the same matters (Article 7(2)).
Article 7(3) provides that, where the domestic law of a Contracting State does not permit the competent authorities of that State to derogate from the decisions of their judicial bodies, the second stage will not commence until the time provided for appeal has expired without an appeal having been made, or the taxpayer has withdrawn the appeal or settled it by agreement. This might effectively present the taxpayer with a choice between pursuit under the domestic appeals process or arbitration. Although the UK has previously decided to apply Article 7(3) it no longer sees the need to do so. For the purposes of the Arbitration Convention the UK will be prepared to consider reference of a case to an advisory commission notwithstanding a prior decision within the UK judicial process.
The UK will adopt a similar approach where arbitration is provided for under its treaties unless the relevant treaty prevents it.
The advisory commission, constituted in accordance with Article 9 of the Arbitration Convention and before which the taxpayer may appear (Article 10(2)), must deliver within six months a decision which will eliminate the double taxation (Article 11). The competent authorities must then act within six months in accordance with the decision, unless they agree to eliminate the double taxation by some other means (Article 12).
Article 8 of the Arbitration Convention provides that the competent authority of a Contracting State is not obliged to initiate either of the two stages, MAP or advisory commission, where one of the enterprises involved is liable to a serious penalty. The UK has declared that it will interpret the term 'serious penalty' as comprising criminal sanctions and administrative sanctions in respect of the fraudulent or negligent delivery of incorrect accounts, claims or returns for tax purposes.
The UK's domestic provisions on penalties for inaccuracies were revised in Finance Act 2007, replacing the terms 'fraudulent' or 'negligent' with 'deliberate' or 'careless'. In the light of its experience since 1990 the UK will, in practice, only exercise its discretion under Article 8 in cases involving the imposition of penalties for deliberate inaccuracy. In considering whether to proceed under the Arbitration Convention the UK will take into account the facts and circumstances which have led to the taxpayer becoming liable to such a sanction. There is no provision equivalent to Article 8 of the Arbitration Convention affecting MAP or arbitration in the OECD Model on which the UK seeks to base its tax treaties.
The UK and other EU Member States subscribe to the "Code of Conduct for the effective administration of the Arbitration Convention" (90/436/EEC and revised by 2009/C 322/01). The Code provides that the two years period from the presentation of the taxpayer's case to the time at which arbitration can be invoked is started when the competent authorities receive certain information from the taxpayer. This includes identification of the enterprise concerned, details of the relevant facts and circumstances of the case, identification of the relevant tax periods, copies of any assessments, tax audit reports or similar giving rise to double taxation, details of any appeals and litigation initiated by the enterprise or other parties to the relevant transactions, an explanation of why the principles of the Convention are considered not to have been observed. The enterprise must also undertake to respond completely and quickly to requests by the competent authority for further information.
Although the Arbitration Convention is regularly invoked, it has generally been possible for States to arrive at agreement under MAP without proceeding to the secondary stage of the advisory commission. Enquiries about the provisions, or about presenting a case, should be addressed to the people named at the end of this statement.


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Technology Product Evalution Essay, Research Paper
Introduction I am looking at the dishwasher as I am very knowledgeable on it. I have a number of good ideas on how to improve the washer. I am also interested in electrical devices such as this. Also my father manages a company which deals with such appliances. Description This dishwasher is mahogany brown in colour. It fully integrates with our fitted kitchen. On the face of the dishwasher is a drop-down door containing a mahogany panel. On the top part of the front panel is the function knob and 3 function buttons. I have explained how these operate on the opposite side of the picture. Inside the washer, it is mostly water powered with the exception of the heating elements. There are 2 stacking racks inside with a cutlery basket situated in the centre of the bottom rack. There are 2 spraying arms which are powered by water pressure. There is a sound dampening layer of material below the lid of the washer. The dishwasher is 954mm in height and 600mm x 500mm top surface area. The is a 150mm gap between the washer and the floor. It is supported by a block of kitchen integrated wood. Justification I have chosen this product because: 1) A dishwasher is almost a necessity in today's society due to the high standard of living. 2) I know a substantial amount of information on the product to give a fairly accurate evaluation. 3) The product is used regularly by a lot of people. 4) I have a number of ideas on how to improve the product. 5) My Father manages a company which is a branch of Electrolux the, largest domestic appliance company in the world. Operational Controls of Dishwasher Eight different settings: A, B, C, E, D, F, G, H, I. This selects the program of the wash. Door handle: this is a spring controlled door. The handle is pulled to open the door. The door then automatically locks itself when the door is pushed closed. There is an electronic safety device which turns the dishwasher off when the door is opened. Three switches: operate the functions of the dishwasher. The 1st switches the dishwasher on/off, the second chooses the drying temperature of the dishes and the third selects a lower wash temperature. Control Knob: this selects the cycle of wash you would like to use as above. Factors For Specification 1. I chose ergonomics as a dishwasher has so many different cycles and modes and a detailed control system would be very complicated. The door should be easy to open as many spring-switch doors can slip maybe causing accidents. 2. I chose materials because it is extremely important to what the machine is constructed of. E.g. Cast iron would be unsuitable for the interior of the dishwasher. Another example would be a metallic substance to insulate electrical and water operated areas of the machine. This would be extremely unsuitable. Materials are very important. 3. Safety is probably one of the most important factors in the construction of a dishwasher, Using water and electrical powered mechanisms together can be extremely dangerous. Also a dishwasher has many sharp edges etc. Safety is an important factor to consider. 4. Appearance is important mostly for the pleasing of the customer/buyer. It would be important in the marketing stage. It is important that the washer goes well with kitchen furnishings. 5. Cost is important because it must meet the price band that customers expect to pay. It is also vitally important in the marketing stage of the product. Specification ŸShould be attractive to the eye. Also should integrate well with kitchen furnishings. Written instructions should be clear and concise. ŸShould be safe to use. Water and electrical sections should be safely divided. No sharp edges should be left uncovered. Small areas in which fingers , could be caught should be safely guarded. ŸMetallic, rustproof material should be used for the interior of the machine to withstand extreme thermal and aquatic conditions. ŸExterior should be made of an electrically insulating material such as plastic. Wooden cover on door for mahogany effect. There should also be a sound proofing material surrounding the machine to reduce noise pollution. ŸDoor should open easily with little force required. The operation switches and knobs should be easy to understand. Instructions and cycle instructions should be basic and direct. Cost is also important, it needs to reflect the product's features and be within a price band that is accessible to most people. Questionnaire No. surveyed 1. Do you think that the dishwasher is fairly easy to use? 1. 2. 3. Yes No2. Do you think that the washer is an attractive colour? 1. 2. 3. Yes No 3. Do you believe that the washer integrates well with the 1. 2. 3. Kitchen? Yes No 4. Do you believe the machine to be safe? 1. 2. 3. Yes No 5. Do you think that the machine does its job well? 1. 2. 3. Yes No 6. Do you believe the product has enough user features? 1. 2. 3. Yes No 7. Is the product easy to carry out general maintenance on 1. 2. 3. I.e. clean filters etc.? Yes No 8. Are the stacking arrangements of the baskets adequate for 1. 2. 3. the average household? Yes No 9. Does the purchase price of this dishwasher reflect the overall 1. 2. 3. quality and features of the product? Yes No Evaluation Materials: The interior tub is made of high grade stainless steel suitable for extreme aquatic and thermal conditions. The exterior is made of heat resistant polyvinyl chloride with the outer casing consisting of rust treated steel as condensation can form on surface of washer. There is also a sound dampening material on machine to reduce noise pollution. All materials are well suited to job. Safety: The machine has been in the household for 8 years and has not caused an accident in its working life. No electrical components are exposed to metal or damp areas however there is a slot in the door where a lot of wire is run through. Buttons can sometimes catch the skin and nip. All sharp areas are covered but there are areas where fingers could get caught. Over heat thermostats are installed to switch off heaters when water reaches 75oC. All metal parts are earthed and there is a 13 amp fuse in pug top. The spring switch in the door can be stiff and slips which may cause serious accidents. Ergonomics: This machine is quite easy to use, but some symbols can be confusing. The machine has a counter balance door for easy opening and an 'easy grip' control knob for easier operation. The interior of the machine includes an 'easy lift' upper basket. Door tends to stick at times. Also the symbols on the knob often wear off with time and use. Appearance: It is fairly dark and dull. It integrates well with the mahogany kitchen as a wood panel door has been fitted. It also has a brown control panel which adds to its unattractiveness. The control panel is easily cleaned however. Modification 1. I would modify the door mechanism. It can be quite stiff at times and needs to be adjusted to loosen spring slightly as I have mentioned in the evaluation. 2. I would also modify the timer knob of the washer as sometimes it is difficult to know what cycle the dishwasher is in because the letters wear off. 3. The appearance I think needs to be improved as the machine is fairly dull and dreary. It needs brightened up. Wash progression L.E.D.'s would brighten up the control panel and be a source of information for the user. 4. I would also route the main wiring harness up the back of the dishwasher instead of its current position via the door. This would prevent wires breaking due to fatigue caused by the door opening and closing over the course of its working life.
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subset: commoncrawl


text: Hello internet people! My name is Suze, and I love to doodle, draw, and color, and I love to learn new things. I am an adult coloring page artist and I create digital goodies for people to download and print or use in their digital creations. I have a mild Pinterest addiction, and this blog is where I will share all the cool and interesting things I find, and help my readers to explore and learn cool, fun and new stuff. It's also where I will most likely post lots of pictures of cute kitties that live here. We have adopted a feral cat colony, and I love all the fur babies, so pictures of them will most likely creep in amongst the arty stuff. LOL


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The University of Missouri is a public research university; it is well placed in Colombia, Missouri. It was established in 1839 as the first public institution of higher education west of Mississippi river. It is one of the nation's best universities offering a variety of degree programs. It has other campuses in Rolla, Kansas City, and St Louise. It was ranked 103rd among national universities in the 2016 US news and world report rankings. MU is one of the only six public universities in the US with a medicine school, veterinary medicine, engineering and law all located on one campus.
The MHA degree is designed for students with different educational backgrounds. It gives the student the knowledge and expertise necessary for them to function efficiently as healthcare executives. The curriculum covers areas such as health systems operations, organization theory, information management, health economics, managerial epidemiology, leadership and ethics. The main goal of the graduate program in health services administration is to help the students get ready to take up professional leadership roles in the healthcare administration. It assists students develop applied knowledge in areas like clinical decision making , risk assessment and management, clinical outcome assessment, managing interdisciplinary teams and joint health systems.
If you want to become a senior manager in the developing healthcare field, then you must get a master's degree. The MHA program usually identified using different names in different universities, is a comprehensive degree program which focuses on public policy problems or master health service administration (MHSA) which focuses on business. The well-known areas of mastery include finance, communication and marketing, policy development, outpatient service, informatics and information development.
The residential MHA requires one to have a total of 64 credit hours, which comprises 39 hours of course work, three credits earned for a needed 12-week summer internship. A three credit hour capstone group management program, and nine credit hours of professional electives. It is a requirement that students maintain a minimum 3.0, cumulative MU graduate grade point average to earn the master's degree. The professional elective requirement comprising of three courses, gives the MHA students a chance to concentrate in a particular area of study if they chose. The internship is made in a way that it incorporates the academic knowledge students acquire in their first year of their master's degree with practical applications within the host site. This helps expose students to healthcare management in a real world environment.
The intern should take the opportunity to observe their mentor and also other professionals in the work environment; they must try as much as possible to use the opportunity to discuss their experiences. Some of the core skills to be worked on include: leadership, strategic decision making, project management and also team work.
The admission requirements to join the program include undergraduate GPA 3.0 during the last 60 hours of the undergraduate study, a minimum of a baccalaureate degree from an accredited institution. Dead line for entrance is 4th March. The health management and informatics department recruits and accepts qualified applicants regardless of race.


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Differences between an IVA and DMP
This articlecomprises of the informationrelatedto your debt advice, that how should you manage it and what's the best option to choose in case you are facing difficulties in managing your debts. We would take into account the two major debt managing sources available for individual's i.e. Individual voluntary agreement (IVA) and Debt management plan (DMP), we need to understand the differences between them in order to choose the best option for our debt management butat first place we need to understand the terms.
Firstly, An Individual Voluntary Arrangement (IVA) is an agreement between you and your creditors for paying all or a part of debts that you owe. An agreement of regular payment is made on your behalf to an insolvency practitioner, who will divide this money between you and your creditors.
Whereas, a debt management plan (DMP) is again a formal agreement between a debtor and a creditor for addressing the terms of the outstanding debt. It usually refers to a personal finance procedure for individual addressing higher consumer debt.
You need to choose which one is right for you by understanding the differences between the two and your circumstances. Plus there are a lot of misunderstandingsabout IVAs. Individualsusually think that they are on an IVA, when in reality they are not.
Again you should not trust all the material available about IVAs around the web because everything isn't true and you need to put these untruths to rest. Now we are putting together a thorough guide for your help to understand the very basic and obvious differences between an IVA and a debt management plan.
IVA and DMP; 12 Differences
- An Individual voluntary agreement is a formal agreement between you and your creditors whereas a Debt management plan is an informal agreement.
- An IVA is less flexible agreement as compared to that of a DMP. You can vary you payments on an IVA but only up to 15% other than that your request is forwarded to your creditors and they vote and make a decision for you. Whereas in DMP you can make changes within you payments whenever necessary.
- An IVA has a rule that it will stop all the interests and other charges. On the other hand in a DMP there is no such guarantee that this will happen.
- An IVA is guaranteed and do have an end date. Whereas, there is no guaranteed or end date for a DMP.
- In an IVA fees are involved and if you are going for a DMP with a free debt than there aren't any fees for administration involved.
- In a DMP you can choose a third party to deal with its administration or you yourself can do it but in an IVA you need to use a insolvency practitioner which should be licensed.
- If you go on boardwith an IVA your IP will check your financial settings. But a DMP provider would only inquire for the proof of your salary and your debts usually.
- In a DMP there is usually no amount of minimum debt but it would depend on your DMP provider and the conditions of yours. But in an IVA the lower limit is around £15k.
- 75% Creditors in an IVA agreement needs to agree on your proposal where as in DMP they don't need to accept you agreement.
- All creditorswill stop contacting you once it goes ahead. However in a DMP creditors can continue to hunt for you for any kind of extra payments and can follow the usualstandard debt collection procedure which can be stressful.
- Every IVA has public information and this information is entered on to the insolvency register. There is no corresponding for DMPs.
- You repay your debts in full in a DMP whereas in an IVA a certain percentage of your debt if written off.
Now, we have clarified the striking differences and pointed out how different IVAs are from DMPs in true sense. No doubt, both have their own advantages and disadvantages and only you can decide the best solution for yourself according to your situation.


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He wore stress on his face, and burning the candle at both ends was taking its toll. There were deadlines and lists and bottom lines, and the daily grind was sucking the life out of him and his goal. The last thing he needed was more hours in a day.
Yet like him, that is exactly what we think we need once we begin pouring into our goals and dreams. Suddenly important becomes necessary…necessary becomes urgent…urgent becomes consuming. And we are left very quickly spent and burned out. And in our energy depleted state, we question our choices and ponder if anyone will ever really care if we give up anyway, least of all us.
Every goal has a life span, and that life span is determined largely by how we feed our soul along the way. Just as our bodies need fuel, our soul needs to be fed apart from lists and responsibilities and deadlines. What we need is a good "soul feeding."Our soul needs to drink deeply of life in order to give life to our dreams. Click To Tweet
It's a balancing, an aligning that takes place when we cease striving and take time to soak in everything surrounding our existence, for no other reason than to absorb comfort and pleasure and peace.
When I need to feed my soul, I lose myself in the things that make me lose track of time. I sink into people and experiences that bring warmth and refreshment. I linger in all that grounds me and reminds me of how beautiful this life is here and now.
Feeding our soul doesn't have to be extravagant or costly. A soul feeding should be whatever causes us to exhale.
The kind that brings the glimmer back into our weary eyes and makes us throw back our head in laughter.
The kind that replenishes our heart with joy and gratitude and births a renewed perspective.
The kind that makes our soul dance and hope and dream.
Whatever it is, find it and sink into it.
Nothing need be more necessary, more urgent or more consuming until after we have taken time to feed our souls so they are rooted and refreshed. Then inspiration will come without any effort on our part. And motivation will return with a surging.
We won't wish for more hours in a day because we will be more productive with the hours given. The candle will burn longer and brighter.
The journey will be richer, and the goal will be sweeter because we traveled with not only a full heart, but also with a full soul.
What makes you lose track of time?
What brings your soul comfort and joy and warmth?
What makes your soul dance?
Catch up on posts in the 31 Days to Stay Motivated here!


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Barron Trump becomes the new kid at school
Don't miss stories. Follow Raw Story!
Barron Trump and his mom, first lady Melania Trump, are finally moving from New York City to Washington, D.C., to live with the president. But given the location of his new school, 11-year-old Barron will still be spending a lot of time apart from his father. Melania Trump announced this week that Barron will head to…
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When Denver promoter Brennen Bryarly isn't packing venues on South Broadway, he works the other side of the aisle, making deep house beats as option4.
Now, Bryarly has collaborated with digital heart crushers Rose Quartz on a brand spanking new single, "Love is Lonely." Behind option4's slick production, Rose Quartz layers in searching lyrics about the side effects and symptoms of love. On the whole, the two parties meld to form a dance floor banger without sounding the least bit pretentious.
Related: Interview w/option4
Rose Quartz frontman Ethan Converse laid the hushed vocals using an analog studio 5×8 foot reverb plate during one of the many Denver snowstorms. It evens out to a subgenre of electronic he's dubbed "emo house."
The song is being published by noted Parisian label Kitsuné, which speaks volumes for the level of heat option4 has been laying as of late. Past singles have been released by the likes of Fool's Gold and Nervous.
Listen to "Love is Lonely" by option4 and Rose Quartz below.


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Two Kinds By Amy Tan Essay, Research Paper
"Two Kinds" by Amy Tan
In the short story "Two Kinds," Amy Tan explores the clash of cultures between a first-generation Chinese-American daughter, Jing-mei, and her mother, Suyan, a Chinese immigrant. Suyan is certain that Jing-mei can become a prodigy if she only tries hard enough. At first Jing-mei is eager to try, but she always falls short of her mother's expectations. She decides that the prodigy in her is the girl who would steadfastly refuse to be what she is not. While the mother and daughter reveal their personality through their language, actions, and thoughts, conflict develops between the two women when their cultures and aspirations collide. "Two Kinds" focuses on the theme of conflict between two kinds of women as well as two kinds of daughters.
Jing-mei and her mother are two kinds of women because of their drastically different life experience. Before she come to America, Jing-mei's mother has " lost everything in China: her mother and father, her family home, her first husband, and two daughters, twin baby girls. But she never looked back with regret. Things could get better in so many ways"(1065). As Suyan's past is revealed, I see a clear picture of a determined and strong-willed woman who beats all the odds to establish a better life in America. However, to the American-born daughter, Jing-mei, her mother's past remains as far as where China is. She neither understands nor comprehends what her mother has gone through in China. When her mother insists her to learn playing piano, her hurtful response is, "I wish I'd never been born! I wish I were dead! Like them"(1071), which pushes the conflict between the two to a higher level. Jing-mei does not understand or fully know her mother because she does not know about her tragic past and the pain she still feels from the memory of it. Her upbrings in America inevitably set her far apart from her mother.
In addition to the conflict of two kinds of women, Jing-mei is also struggling between two kinds of daughters. One is whom her mother expects her to be, and the other is whom she wants to be. Her mother keeps telling her that she can be anything she wants to be, and she has great talent. "Only ask you be your best. For you sake"(1068), told by her mother. Jing-mei is pushed to be successful in many different areas such as dance, academics, trivia, and piano. After failing to excel at each task set before her, Jing-mei begins to feel more and more resentment towards her mother. She sees her mother's hopes as expectations, and when she does not live up to these, she feels like a failure. The final incident, when Jing-mei performs a piano piece filled with mistakes at a talent show, makes her believe that her mother is completely ashamed and disappointed with her. She starts to gather her courage to challenge her mother's authority over her. "I'm not going to play anymore. Why should I? I'm not a genius .You want me to be someone that I'm not! I'll never be the kind of daughter you want me to be!"(1068), she responds angrily to her mother's order of practicing piano after she intentionally fails the recital. Her mother shouts back, "Only two kind of daughters, those who are obedient and those who follow their own mind! Only one kind of daughter can live in this house. Obedient daughter!"(1071) Mother's expectation has clashed with daughter's own desire. Both the mother and daughter are struggling with the acceptance to each other as who they are.
While the confrontation is ever increasing between them, they are also struggling within themselves to define their own roles and identities. To some extent, Suyan adopts many American values. She constantly tells her daughter such a typical American belief that one can be " anything you wanted to be in America"(1065). However, to an even larger extent, her values and ways of doing things are completely Chinese. Just like most Chinese mothers, she tries to form her daughter into a "proper Chinese girl" who will obey whatever the mother says. Only until the worst clash occurred between these two after the piano recital, is when Suyan unwillingly realizes that she has to let her daughter be one of the American daughters who "follow their own mind". As a girl grew up in China, I understand this does not come easy to Suyan. In China, the authoritative role of a mother over her daughter is seldom questioned. A good Chinese mother is respected to channel her daughter to be the extension of herself. When the reality forces Suyan to stop forming her daughter into an obedient one, she is, if not giving up, at least giving in part of her roles of being a good Chinese mother.
While Suyan is experiencing the struggling role of being a Chinese mother in America, Jing-mei's journey to find her roles is also uneasy. Her mother's traditional Chinese ways of teaching her to fulfill a typical American dream further deepens her confusion. After many failures she has matured enough to realize that her attempts to become a prodigy and to please her mother may be entertaining fantasies, but they have nothing to do with her own interests. Because she does not care about any of these things, she does not really try to be successful, and therefore, would never accomplish anything great. At the age of nine years old, all she is trying to do is " never be the kind of daughter you (her mother) want me(her) to be" without knowing what kind of daughter she really wants to be.
The conflict that happens between Jing-mei and her mother are commonly seen within those Chinese immigrant families. As a member of the first generation of an immigrant family myself, I certainly can relate to that experience. To many young immigrants like myself, the American culture can be more easily accustomed to than to the older immigrants. However, our deeply rooted Chinese tradition and family values have often confused us in real life. We often walk on the thin line between American and Chinese culture. High expectations are certainly unavoidable from family members and surrounding Chinese community on the achievement and success in academic and professional life. To satisfy both culture's demand and expectation definitely becomes a challenging task. More tolerance and respect seem to keeping us in good balance and fair judgement.
Tolerance and respect are just exactly what Jing-mei lacks toward her mother. She tells herself, "I didn't have to do what my mother said anymore. I wasn't her slave. This wasn't China"(1071). Jing-mei can not stand her mother's expectations because she thinks her mother is too Chinese, but she herself is not. She believes that she is an American with freedom of choice in life. She is determined to oppose her mother, "I won't let her change me, I promise myself. I won't be what I'm not"(1067). Her mother's Chinese expectation has becomes a burden to her. Jing-mei is trying to differentiate herself from her mother in terms of culture background. As a young girl, she does not realize that she can not separate herself from the Chinese heritage. That makes her whom she really is.
In conclusion, it is not morally right or wrong if Jing-mei's mother expects too much from her daughter. Similary, no one can certainly judge right from wrong in Jing-mei's reactions to her mother's expectation. Each one of their particular behaviors just reflects their different background and life experience. Therefore, "Two Kinds", as it means, will be as close as it can be to best describe the conflicts between two kinds of women shaped by their own life experience, and the conflicts between two kinds of daughter cultivated by Chinses culture and American culture.
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Scott Tracey unveiled the cover art for Witch Eyes, which is the first book in his Witch Eyes series. The book is scheduled to be released in 2011. This is a seriously creepy cover. I definitely have to give this one a read.
Synopsis (Product Description):
Braden Michaels wears his sunglasses at night. And at the movies. And in the shower. Raised by his warlock uncle and taught to use magic, he suffers from a deadly curse: the witch eyes. He sees everything that normal eyes filter out: history and memory; love and pain; magic and darkness. The mind, however, was not meant to process so much, and the power is killing him slowly. The only thing saving his sanity are the sunglasses he always wears.
And then the visions reveal a dark threat on the horizon. Braden runs away to Belle Dam, the city where the threat originated, and is immediately swept up into the town's mysterious feud. Two rival magical families have divided the town into a personal chessboard of scheming and machinations, and Braden is their latest pawn. As he tries to avoid their manipulations, and see the truth behind his return to Belle Dam, he has a choice to make. One side, or the other. Ignite the feud, or end it. Sacrifice himself, or someone else. Live, or die.
Previous Books in Series:
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Welcome to the Girls Ask Guys site, or as it's better known: The Place Where Dreams Go To Die. I believe our current membership is at 12, though if we include the filthy pervert who keeps getting kicked out, only to create new accounts, we're at 13.
I am far-and-away the most popular user simply because I'm the ONLY user who isn't a mentally-constipated dullard. If you'll simply review the history of my posts, you'll see the high standards to which I hold myself. Please turn out the lights when you leave.10|10|0
The most popular user is anonymous! I don't know about the rest.10|10|0
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Free trade unions remain in the W. F. T. U.: World Federation of Trade Unions
Paris: World Federation of Trade Unions, 1949. 75p., 5.25x8.25 inches, foreword, worn wraps. Defense against CIO and TUC charges that the predominance of Soviet officeholders on the Executive Committee and General Council means that WFTU demonstrates communist control.
Cat.No: 101797
Price: $20.00
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10 Things to Try When You're Feeling Achy
Have you ever felt old before your time or just achy all over the place? I keep wondering. Is this just getting older? Or is this a problem that can be fixed? And how do you know which is which?
Several of my readers liked the video with the stretching tips for hip pain, so today I'm including a stretching video for heel/foot pain and swelling. This is another nuisance that I deal with that I think is very common.
So I've learned a few things, for those of you on the age-speed-train with me.
#1. For the heart as well as the back: Walking. Just walk everyday. It's good for every single thing about you, so as long as your body allows you to do so, walk.
#2. For the shoulder: I'm ordering this book:
They say that not taking time to do relaxing things can actually cause strained muscles and tendonitis, which my body has in multiple places. Stress could actually be killing us. Who knows? It's worth a shot!
#3. Swollen heels are often caused by tight calf muscles, so my physical therapist gave me this exercise:
#4. CONSTANTLY monitor your posture. Sit and stand as straight as you possibly can.
#5. Do something relaxing. Today I am going shoe shopping and eating lunch BY MYSELF. Some of you may not find that relaxing, but for me it is perfect.
Or maybe I should have JD give me a head rub.
Here's a perfect example of #5, doing something relaxing. JD calmed his cousin ever-so-easily with a little head rub:
#6. Buy bigger shoes. Never wear uncomfortable shoes or high heels.
Did I just post a photo of feet!!?? I'm seriously all girl, so this one is terribly sad for me. I mostly gave up high heels around 5 years ago, and that kept my feet problems at bay for a long time, but that alone is no longer cutting it. Today I'm buying bigger tennis shoes. It's important for shoes to fit.
#7. Become a better friend.
I received my very first get well card in the mail last week, and I can't tell you how much it meant to me. Several people have come up to me at church to tell me that they are praying for me and ask how I'm doing. Wow! How encouraging to know!
I've always said that I have the best friends.
From this, I am learning how to be a better friend. This goes back to that lesson about not over-scheduling yourself too because if we are so busy with all of our own obligations, how can we ever take time to encourage anyone else?
#8. Pray and read your Bible! Allow the Lord to go to the mat for you.
The other week, I was at yet another doctor appointment, for even more medical tests. There was some confusion about my appointment time, which threw off my whole schedule, and getting an appointment with this cardiologist is difficult. My results appointment was for Tuesday, so the tests needed to be done before that, or there would be no results to share.
The receptionist said, "There's no way we can get you in before Tuesday. Well, we could have it done at the hospital, but then that might be hard with billing…."
I was so finished caring, or maybe I cared too much. Either way, I leveled with her, staying as calm as I could, though I'm sure I had tears in my voice. "I have been through so much this year, I do not care. I don't care what you do or when you do it, or how. You just tell me where to be, and I'll be there. I'm going to go sit down in the waiting room." (I still had another test to do.)
I know, I wasn't easy going. I was not breezy. I'm afraid I'm becoming Maxine, way before my time.
OKay. So you're wondering what this story has to do with prayer. Hang with me.
I sat back down in the waiting room, and I prayed, "Lord, I'm so done dealing with this! I don't even want to go to any more of these stupid appointments, but Lord, if you could just help me. You fix it. I can't. I give up."
It didn't take long for the desk girl to reappear. "April?"
I slowly walked back to the desk.
"You can come tomorrow. Anytime you want."
Prayer, people. I'm telling you. Prayer.
"Can I come at 4:00?"
"Great! Thanks!"
#9. Hang out with people who make you laugh.
Laughter is healing.
#10. Get more sleep.
…because that's my answer to everything..


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April 12, 2017 | D&LLast night saw UK dance troupe, Diversity, take to the stage for the first night of their seventh UK tour!
Kick starting night one of the Genesis tour, dance members, including Ashley Banjo, Jordan Banjo and Perri Kiely, debuted their latest body of work in Glasgow. Continuing for nine dates, the guys bring things to a close on April 23rd, at Newcastle's Metro Radio Arena after a headline night at London's o2 arena.
Also making stops at Nottingham, Leeds, Manchester, Brighton, Bournemouth, Cardiff and Birmingham, their motto 'Dream, Believe, Achieve' continues to be at the forefront of everything they do. Delivering more powerful show performances for their audience, this tour acts as the concluding part of their superhero fantasy epic.
Grab your tickets today.
Image Source: The o2


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WildcatReport.com breaks down the game and grades each unit's performance in Northwestern's stunning and historic 33-27 upset of No. 7 Ohio State on Saturday night in Evanston.
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text: MEHSHK LTD has been working since 11/3/2015. The current status of the business is Active MEHSHK LTD located on 274 FIR TREE ROAD, FIR TREE ROAD, EPSOM, UNITED KINGDOM, KT17 3NN Shirazi Kandalchi Hoomin is known as a Secretary of the company. Hospitality Consultant Shirazi Kandalchi Hoomin is known as a Director of the company. Due date of the next annual return is 3/8/2017 12:00:00 AM.


text:
Do you have some people on your list that have a sweet tooth? If so, why not bake them up some sweet treats customized to their own tastes.
If you're feeling like venturing beyond the Christmas cookie, there are other options. Two of our favorites are chocolates and suckers. Soph in particular likes making the chocolates, she actually came up with the idea for the ones we make on her own (you can see them in the picture). We buy Dolci Frutta chocolate to dip fruit in, like strawberries and bananas. Soph thought since it tastes so good, and since she can melt it so easily, why not make pour it into molds and make fancy chocolates. Then she decided we should get some of the white chocolate Dolci Frutta and decorate the chocolates–so we did!
Another fun candy we like to make is suckers. We adapted our larger suckers from a recipe we got from the Barbara Beery, Pink Ponies Cookbook. (which we recently reviewed.)
For ours, we made different shaped molds out of aluminum foil. The Christmas tree was made freehand and the star was made by forming the foil around a star-shaped cookie cutter. The important thing is to keep bottom of the foil mold as contiguous as possible; any cracks or holes will mean leakage. For the stick, you could buy official sucker sticks, but we used skewers that we cut in half and removed the sharp tip. Then we stuck them through the side of the foil and about half way up the middle of the mold to make sure they'd be sufficiently covered by the sucker.
Once the molds were complete, we took some jolly ranchers, put them in a plastic bag and smashed 'em with a hammer. This is fun, but make sure to let the kiddies know that a jolly rancher does not require over-the-head, slamming force to break, a few taps are sufficient to break them into pieces, and that's all that's necessary. We took the broken pieces and placed them in the molds. Our molds were a bit over 1/2 inch high and we filled them to the top.
To melt them into suckers, we placed them in a 350 degree oven for about 6 minutes. Watch them carefully! Once they are melted, promptly remove them and set them some place to cool. If you leave them in too long, they will burn–burnt jolly rancher does not taste good, trust me.
Once they cooled, we removed them from their molds and wrapped them up all cute with treat bags as covers and sparkly ribbon.
If you want to get fancier with your suckers or candies, you can find hard candy molds online, but for those, you pour the hot sucker syrup into the molds which we think is a bit riskier than melting in the oven–especially when the kids are helping.
These are just a couple of sweet treat ideas from the kitchen. If you're not a candy maker, a gift of cookies, brownies or bars would be appreciated by any lover of sweet things. Plus, a gift from the kitchen is just as much fun to make as it is give (and receive!).
Happy family cooking everyone!
Kelly, Alex and Sophia
P.S. Checked out our 2 Kids Cooking Recipes page for all of our holiday recipes


text: Catch the excitement of the UI's other student-athletes — dancers — before they hit the road. Dancers in Company, the University of Iowa Dance Department's touring repertory company, is kicking off its 2008 season with their "home concert" at 8 p.m. Thursday through Saturday, March 6-8, in Space/Place Theatre of UI North Hall. Receipts from the concert help to offset the costs of touring, which is coordinated by the UI Arts Share program. The company will tour Iowa and the Midwest, March through June. In addition, the company will perform an hour of excerpts from the repertory in a free Arts Share Community Concert for families at 3 p.m. Sunday, March 9. [Related news release]


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The iScore Predicts Poor Functional Outcomes Early After Hospitalization for an Acute Ischemic Stroke
Background and Purpose—The iScore is a prediction tool originally developed to estimate the risk of death after hospitalization for an acute ischemic stroke. Our objective was to determine whether the iScore could also predict poor functional outcomes.
Methods—We applied the iScore to patients presenting with an acute ischemic stroke at multiple hospitals in Ontario, Canada, between 2003 and 2008, who had been identified from the Registry of the Canadian Stroke Network regional stroke center database (n=3818) and from an external data set, the Registry of the Canadian Stroke Network Ontario Stroke Audit (n=4635). Patients were excluded if they were included in the sample used to develop and validate the initial iScore. Poor functional outcomes were defined as: (1) death at 30 days or disability at discharge, in which disability was defined as having a modified Rankin Scale 3 to 5; and (2) death at 30 days or institutionalization at discharge.
Results—The prevalence of poor functional outcomes in the Registry of the Canadian Stroke Network and the Ontario Stroke Audit, respectively, were 55.7% and 44.1% for death at 30 days or disability at discharge and 16.9% and 16.2%, respectively, for death at 30 days or institutionalization at discharge. The iScore stratified the risk of poor outcomes in low- and high-risk individuals. Observed versus predicted outcomes showed high correlations: 0.988 and 0.940 for mortality or disability and 0.985 and 0.993 for mortality or institutionalization in the Registry of the Canadian Stroke Network and Ontario Stroke Audit cohorts.
Conclusions—The iScore can be used to estimate the risk of death or a poor functional outcome after an acute ischemic stroke.
Stroke is a devastating disease for patients and their families and a leading cause of adult disability. Up to 85% of patients with stroke experience hemiparesis immediately after stroke, and between 55% and 75% of survivors continue to experience motor deficits, which are associated with diminished quality of life.1,2 The risk of a disabling stroke increases steeply with age, and as the population progressively ages, an increased prevalence of functional impairment among stroke survivors is expected.3,4
Clinicians usually attempt to estimate prognosis after stroke in part to relay this information to the patient and his or her family and in part to assist in treatment decisions. Although a variety of risk prediction tools exist, few have focused on the prediction of disability or other functional outcomes after stroke. For some patients and their families, surviving with a major disability or living in a long-term care facility may be as grave an outcome as dying after stroke.5 As such, the prediction of combined mortality with poor functional outcomes (disability at discharge or discharge to a long-term care facility) early after hospitalization may be useful for patients, their families, and clinicians in guiding supportive care plans, discharge planning, facilitating counseling, or discussions related to end-of-life decisions.
The iScore is a recently developed and validated risk score that can be used to estimate the risk of short- and long-term mortality after an acute ischemic stroke.6 The iScore categorizes patients with ischemic stroke into 5 risk categories, from very low to very high average risk, using clinical parameters and comorbid conditions, which include age, sex, stroke severity, stroke subtype, smoking status, preadmission dependency, and the presence or absence of atrial fibrillation, heart failure, previous myocardial infarction, cancer, renal failure on dialysis, and hyperglycemia on admission.6 Variables associated with death may be similar to those that predict poor functional outcome (eg, disability or institutionalization at discharge) after an ischemic stroke. Our objective was to evaluate the ability of the original iScore to predict 2 clinically relevant functional outcomes in patients admitted with an acute ischemic stroke: (1) death at 30 days or disability at discharge; and (2) death at 30 days or institutionalization at discharge.
We used 2 separate cohorts, each with differing accrual methods, to assist in the validation of the iScore for the 2 new outcomes. The Registry of the Canadian Stroke Network (RCSN) collects data on all consecutive patients seen at 12 regional stroke centers in the province of Ontario, Canada, and on a random sample of patients seen at all hospitals across the province through a periodic Ontario Stroke Audit (OSA).7
The RCSN regional center database collects data by chart abstraction performed during and after admission to the hospital for the index event by trained neurology research nurses using custom software. The audit uses population-based, random sampling to collect data from patients with stroke seen in emergency departments or admitted to the hospital with a diagnosis of stroke in 154 teaching and community-based hospitals across Ontario. Data for the OSA are also collected through patient chart abstraction.7,8 Further details on the OSA can be obtained from the RCSN Report at on the 2008–2009 OSA at www.rcsn.org.
The RCSN has the designation of a "prescribed registry," thereby allowing the collection of patient-level information without consent for the purpose of facilitating the provision of stroke care in Ontario.
Information on poststroke all-cause mortality (including death after hospital discharge) was available through linkages to the Ontario Registered Persons Database (RPDB), which was available through the Institute for Clinical Evaluative Sciences. The RPDB is a population-based administrative database including basic demographic data and date of death, which provides complete follow-up for all residents in the province.
To assess and grade the level of stroke disability at discharge, the modified Rankin Scale was used; moderate to severe disability was defined as modified Rankin Scale ≥3. For all registry participants, the modified Rankin Scale was abstracted from patient charts according to the neurological assessment at discharge. Stroke severity on presentation was captured from the neurological assessment at admission using the Canadian Neurological Scale (CNS), which is a simple and validated scale including the following components: comprehension, level of consciousness, speech, and motor function (face, arm, and leg). Lower scores indicate greater stroke severity.9 Stroke severity was categorized a priori as mild (CNS ≥8), moderate (score of 5–7), or severe (score of 1–4) based on previous studies10,11; a score of 0 was assigned to patients in a coma. Previous studies showed good to excellent interrater reliability for the CNS.12,13 All ischemic stroke subtypes were included in the present study. Ischemic stroke subtype was classified as lacunar, nonlacunar, and undetermined according to the Trial of Org 10172 in Acute Stroke Treatment criteria14 by the study coordinator based on documentation by the treating physician and the investigations recorded in the chart.
Details of the selection of variables for the iScore, data sources, and the creation and conceptualization of the iScore have been published elsewhere.6 The risk scoring system is represented in Table 1.
Eligibility Criteria
We used 2 separate cohorts to evaluate the ability of the iScore to predict each of the composite outcomes. One of our study cohorts included patients aged ≥18 years of age with a primary diagnosis of acute ischemic stroke who were seen in the emergency department or admitted to any of the 12 regional stroke centers in Ontario between July 1, 2003, and June 30, 2008. During the initial derivation of the iScore, the RCSN data set was randomly split into derivation and validation components. To avoid an overestimation of the predictive ability of the iScore on the proposed functional outcomes, patients included in the sample used for the derivation of the iScore were not eligible for the present study. Our second study validation cohort was derived from patients seen at any hospital in the province and captured in the OSA. We included patients aged ≥18 years with a primary diagnosis for acute ischemic stroke and with data collected by the OSA in the fiscal years 2002–2003, 2004–2005, and 2008–2009. We thus used 2 study samples: first, patients with stroke in the RCSN registry who were not included in the derivation of the original iScore; second, patients with stroke in the OSA cohort.
Patients with missing baseline characteristics (eg, CNS score, glucose on admission; n=910), those with transient ischemic attack or hemorrhagic stroke, and those with a significant disability coming from long-term care facilities were excluded (n=221 [5.5%] in the RCSN cohort and n=346 [6.9%] in the OSA).
Outcome Measures
Disability at discharge was defined as a score on the modified Rankin Scale of ≥3. Institutionalization was defined as having discharge disposition to long-term care or a complex continuing care facility.
The main outcomes of interest were 2 composite outcomes defined as: (1) death that occurred within 30 days after the stroke admission or severe disability at discharge (modified Rankin Scale=3–5); and (2) death that occurred within 30 days after the stroke admission or discharge to a long-term care facility or complex continuing care (including palliative care).
Statistical Analysis
Chi-square tests were used to compare categorical variables between RCSN and OSA cohorts; analysis of variance or Kruskal-Wallis tests were used to compare mean and median differences for continuous variables in baseline characteristics. Details of the analytic approach for the creation of the iScore have been published elsewhere.6 Variables included in the iScore used to predict mortality at 30 days included age, sex, stroke severity (as determined by the CNS), stroke subtype (lacunar, nonlacunar, undetermined), preadmission independence, glucose on admission, and presence of atrial fibrillation, congestive heart failure, cancer, or renal failure (on dialysis). The scoring system was additive, and we used quintiles to divide the initial derivation cohort into 5 risk categories.6 To test the performance of the iScore for predicting death or disability, we used the same variables and redefined the outcomes as (1) disability at discharge or death at 30 days; and (2) institutionalization at discharge or death at 30 days.6
A logistic regression model with the iScore predictor variables and the iScore regression coefficients were used to predict the probability of the occurrence of each of the composite outcomes. Model discrimination was assessed by the C-statistics (equivalent to the area under the receiver operating characteristic curve).15 Calibration was assessed using the Hosmer-Lemeshow. However, because Hosmer-Lemeshow test is known to be oversensitive to small deviations from good fit in large samples, we compared predicted versus observed outcome at the risk score level.16 The observed and predicted outcomes were plotted as continuous function of the risk score. Pearson correlation coefficient was used to compare the observed and predicted outcomes at the risk score level. Analyses were conducted using SAS statistical software (Version 9.2; SAS Institute Inc, Cary, NC).
Approvals from the Institutional Review Board of St Michael's Hospital as well of each of the Institutional Review Boards of participating stroke centers and the RCSN Publications Committee were obtained before starting this study.
Overall, there were 3818 eligible patients in the RCSN (who were not involved in the derivation of the original iScore) and 4635 eligible patients in the OSA. Patients in the RCSN were younger, had a higher prevalence of coronary artery disease and smoking, and had more severe strokes compared with patients in the OSA. There were no other significant differences in between the cohorts (Table 2).
Death at 30 days or disability at discharge occurred in 2126 (55.7%) patients in the RCSN regional center cohort and 2043 (44.1%) in the OSA cohort. There were 647 (16.9%) patients dead at 30 days or discharged to long-term care institutions in the RCSN and 751 (16.2%) in the OSA. Death at 30 days occurred in 478 patients (12.5%) in the RCSN and 502 patients (10.8%) in the OSA cohort. Overall, 5.6% (n=212) patients in the RCSN and 6.4% (n=298) patients in the OSA cohort were discharged to a long-term care institution.
Risk Score
The distribution of the iScore in both cohorts (RCSN validation cohort and OSA cohort) was approximately normally distributed with mean scores and SDs of 136.71±39.32 for the RCSN validation cohort and 134.36±33.43 for the OSA cohort. Quintiles of the original iScore were used to divide the cohorts into 5 risk categories. The magnitude of the scores had prognostic implications (Figure 1A–B). There was a graded increase risk for both outcomes and in both cohorts by quintile of risk score. The 30-day risk of mortality or disability at discharge in the RCSN cohort was 27.8% for Quintile 1; 37.3% for Quintile 2; 52.8% for Quintile 3; 80.5% for Quintile 4; and 91.9% for Quintile 5. Similarly, a graded increase in risk occurred with 30-day mortality or institutionalization at discharge. Death at 30 days or institutionalization at discharge for the RCSN cohort was 2.1% for Quintile 1; 4.6% for Quintile 2; 11.0% for Quintile 3; 24.2% for Quintile 4; and 50.9% for Quintile 5. In examining death at 30 days or disability at discharge and death at 30 days or institutionalization at discharge, the results for the OSA cohort resembled the trend of a graded increase (as observed in the RCSN) across each quintile, respectively, beginning in the second quintile. Mean predicted mortality for each quintile is provided in Supplemental Table I (http://stroke.ahajournals.org).
Because these results ignore within-quintile risk gradients, we also plotted the observed and predicted death at 30 days or disability at discharge (Figure 2A) and death at 30 days or institutionalization at discharge (Figure 2B) by narrower risk score ranges, in which each risk score group was defined at 10-point intervals. Figure 2A–B shows a worsening prognosis with higher risk scores in the RCSN cohort.
In addition, we analyzed the predictive ability of the iScore by adding other comorbid conditions to those reported by other simple risk score models (Figure 3A–B).17,18 For example, for a lower risk category (70 years with a moderate stroke), the addition of male sex (10 points), presence of hyperglycemia (>135 mg/dL), and dependency on admission (+15 points each) would double the predicted 30-day mortality or disability at discharge from 34.8% to 67.2% (Figure 3A). Similarly, there is a significant increase in the estimated risk of death at 30 days or institutionalization at discharge from 8.04% (for a 90-year-old woman with a moderate stroke), to 26.1% for a same age man, by adding hyperglycemia and dependency on admission (Figure 3B).
A more impressive increase is observed for higher risk categories. For example, for an 80-year-old patient with severe stroke (+65 points), the addition of stroke subtype (nonlacunar=+30 points) or on dialysis (+35 points) would quadruple the estimated risk of death or institutionalization from 14.8% to 66.4% (not shown in Figure 3).
Discrimination and Calibration of the iScore for the Functional Outcomes
In the RCSN, the C-statistics were 0.830 for 30-day mortality or institutionalization at discharge and 0.787 for 30-day mortality or disability at discharge. There was a diminished discrimination in the OSA (C-statistics 0.743 and 0.679 for each outcome, respectively). The significance level of the Hosmer-Lemeshow test was 0.276 in the RCSN. Due to the diminished calibration in the OSA (Hosmer-Lemeshow test P<0.001 for both composite outcomes), we also plotted risk score observed versus predicted outcomes (Figure 2A for 30-day mortality/disability at discharge and Figure 2B for 30-day mortality/institutionalization at discharge).
The findings of this study suggest that the iScore can be used to identify patients at high risk of death or disability and also death or institutionalization after ischemic stroke. The iScore showed a graded effect: the higher the score, the higher the risk of a poor outcome. Predicted and observed mortalities in the validation cohort were in close agreement across the entire spectrum of risk, and the results were confirmed in an external sample.
Prior studies have been conducted to predict stroke outcomes. In 1 study, both clinical and imaging variables were combined, and the investigators were able to find good discrimination (receiver operating characteristic >0.80) and suboptimal calibration (Hosmer-Lemeshow <0.05) for a devastating outcome at 3 months (a composite outcome was defined as National Institutes of Health Stroke Scale (NIHSS) ≥20 or death, Barthel Index <60 or death, or Glasgow Outcome scale >2). Predictor variables included initial NIHSS score, stroke subtype, history of diabetes or stroke, preadmission status, and infarct volume determined on CT 7 to 10 hours/day poststroke.18 However, the commonly used modified Rankin Scale was not included and a score was not developed.
Other studies have used age and the NIHSS to predict good functional recovery, defined as a Barthel Index >95 at 3 months. The Virtual International Stroke Trials Archive used a simple score to predict functional independence between 1 and 6 months in 5419 patients with an ischemic stroke and found that age and NIHSS score predicted good functional recovery at 3 months with an area under the curve of 0.80. Although there are obvious advantages to having fewer variables in this prediction score, the tool was created as a nomogram, making it difficult in its application, and the main outcome measure estimated good functional outcome using the Barthel Index,17 which is known to perform poorly in determining change in high-functioning individuals.
Furthermore, although previous simple prognostic models have been able to demonstrate good discrimination (C-statistics 0.70–0.80)17,19–21 in determining mortality, they have ignored the importance of discharge disposition (eg, institutionalization) as an outcome, which is useful for prognostic purposes, discharge planning, and rehabilitation course. In addition, some of these models omitted the inclusion of relevant and prevalent conditions—atrial fibrillation, renal failure, cancer, congestive heart failure—which in our study had important influence on stroke outcomes (Figure 3).17,19–21
Our present model was designed to use clinical information that is readily available to clinicians in the early hours of hospital presentation for stroke and is independent of stroke volume, imaging, or specialized laboratory tests. Based on the number of variables required, our iScore has good face validity and greater parsimony than most other predictive risk models.
We demonstrated that the use of simple models only including age and stroke severity may over- or underestimate the risk of poor functional outcomes. For example, the inclusion of additional and relevant clinical information leads to very different estimates of 30-day mortality/disability or institutionalization at discharge (Figure 3) compared with those obtained when only age and stroke severity are used.17,19,20,22
Our study has some limitations that deserve comment. By using a score derived initially for a single outcome, 30-day mortality, it is possible that some prognostically important variables (eg, dementia, socioeconomic status, size and location of the infarcts, interventions) not included in the initial iScore may improve the estimated risks of each of the desired composite outcomes. Social factors influencing institutionalization were not considered in the iScore (eg, lack of spouse, social support). Together, differences in the probability of the occurrence of the composite outcomes and differences in baseline characteristics between the RCSN and OSA and lack of inclusion of other relevant variables may explain the suboptimal calibration in the external data set (OSA). Second, the present study only included hospitalized patients with an acute ischemic stroke; therefore, the findings may not be generalizable to ambulatory patients and those with other stroke types. Third, although several ethnic groups were included in the present study, the majority of patients were whites. As such, the predictive ability of the iScore for the studied outcomes needs to be validated in other ethnic groups. Fourth, similar regional or national factors influencing care may limit the iScore's generalizability in hospitals outside the studied region. Fifth, we defined functional status using only 1 scale, the modified Rankin Scale, which was assessed at patient discharge in the RCSN. Finally, we used the CNS Scale,9 which is analogous to the more widely used NIHSS23 for assessing stroke severity. A recent study24 validated the ability to use the CNS and NIHSS interchangeably. As a result, the following conversion formula can be used: a CNS of 1 to 4=a NIHSS score of 14 to 22 (severe), a CNS of 5 to 7=a NIHSS score of 9 to 13 (moderate), a CNS of ≥8=NIHSS score of ≤8 (mild), and a CNS of 0=an NIHSS score of >22. Thus, the iScore (www.sorcan.ca/iscore) may be used by healthcare providers using either 1 of these scales for neurological assessment.
Notwithstanding these limitations, the strengths of our risk score include that it contains near complete stroke severity ascertainment, long-term follow-up for all cohorts, and only includes individual patient-level variables.
The iScore constitutes an objective tool to stratify and estimate the risk of a poor functional outcome after stroke. An online Web-based tool (www.sorcan.ca/iscore) and iPhone are currently available for practical use to facilitate the estimation of individual patient mortality at 30 days and 1 year, and the composite functional outcomes. This could be used not only to discuss prognosis and support rational decision-making, but also to guide end-of-life care and discharge planning. From the healthcare perspective, the iScore may be used to help policymakers plan resources, which may result in optimized access to stroke care and rehabilitation services.
Sources of Funding
The study was supported by a grant from the Heart and Stroke Foundation of Ontario (HSFO). The Registry of the Canadian Stroke Network is funded by the Canadian Stroke Network and the Ontario Ministry of Health and Long-Term Care. The Institute for Clinical Evaluative Sciences (ICES) is funded by the Ontario Ministry of Health and Long-Term Care (MOHLTC).
G.S. is supported in part by a Clinician–Scientist Award from the Heart and Stroke Foundation of Ontario (HSFO). M.K.K. and P.C.A. are supported in part by a Career Scientist Award from the HSFO. J.V.T. is supported by a Canada Research Chair in health services research and a Career Investigator Award from the HSFO. The opinions, results, and conclusions reported in this article are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred.
The online-only Data Supplement is available at http://stroke.ahajournals.org/lookup/suppl/doi:10.1161/STROKEAHA.111.623116/-/DC1.
- Received April 13, 2011.
- Revision received June 2, 2011.
- Accepted June 17, 2011.
- © 2011 American Heart Association, Inc.
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- The iScore Predicts Poor Functional Outcomes Early After Hospitalization for an Acute Ischemic StrokeGustavo Saposnik, Stavroula Raptis, Moira K. Kapral, Ying Liu, Jack V. Tu, Muhammad Mamdani and Peter C. AustinStroke. 2011;42:3421-3428, originally published November 28, 2011https://doi.org/10.1161/STROKEAHA.111.623116
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- The iScore Predicts Poor Functional Outcomes Early After Hospitalization for an Acute Ischemic StrokeGustavo Saposnik, Stavroula Raptis, Moira K. Kapral, Ying Liu, Jack V. Tu, Muhammad Mamdani and Peter C. AustinStroke. 2011;42:3421-3428, originally published November 28, 2011https://doi.org/10.1161/STROKEAHA.111.623116Permalink:


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And what's not to love? It's the one time of the year where you can give all those make up looks a go that you've eyed up throughout the year and haven't yet been able to try on a regular day without looking nuts. I for one will be going for an extreme contour to echo the skeleton vibes of this dress I picked up in H&M the other day.
Halloween Sequins and Sass
Halloween is almost here again, woohoo!
Every year seasonal events always become a *bigger* thing don't they? And Halloween seems to be the one that no one seems to ever complain about the increasing over-hype. Christmas? 'OMG WHY IS CHRISTMAS IN THE SHOPS ALREADY? Easter? 'OMG EASTER EGGS STRAIGHT AFTER XMAS' ...Everything is a big deal nowadays... Halloween though? Everyone seems to love it more and more every time. People don't even seem to moan about the influx of Halloween themed blog posts beauty blogs tend to do either, score.
I made this spooky little Halloween light using an old vodka bottle and a 'bottle light' from the Gifts For Her section over from my pals at IWOOT. It's pretty nifty and perfect for those old bottles which are too pretty for the bin (like that Blue Sapphire Gin bottle I stupidly threw in the bin, before this light came in to my life). It's actually pretty bright too! The other night when the electric decided to conk out at about 3 in the morning and I needed a pee in the dead of night, it came in rayt handy. So not just great for spooking up bottle but also practical too! I stuck some spider earrings in the cork bit on the top of the light for an extra dose of scary.
I might post some Halloween make up looks, but with the dark nights now in and working till late that might prove impossible before Halloween itself. However, if you head over to Twitter, and search #HQScare you'll see a few bloggers showcasing their spooky looks thanks to HQHair *name dropping work related things, soz*
What are you doing this Halloween?


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This recipe is from years ago when I started catering in Atlanta. I made this treat many times for luncheons and brunches. Its light and not too sweet, but is also so satisfying and great with a cup of coffee or tea while relaxing. As you can see in the picture, this coffee cake displays beautifully and your friends and family will think it took so long to make when its actually one of the easiest recipes (this can be our secret). Give this a try and let me know what you think. I love hearing from you! Enjoy.
Nutrition: calories 145.2, fat 4.4 g, carbs 24.5 g, fiber 1.8 g, sugar 6.4 g, sodium 289.4 mg, protein 3.4 g
Light As Air Pear Coffee Cake
Yields 8 slices
- 1 3/4 cups Bisquick Heart Health Smart mix
- 1 16 ounce can pear halves in its own juice or water, drained
- 1/2 cup granulated sugar
- 1 tsp granulated sugar
- 4 tbsp stick butter, unsalted
- 3/4 cup skim milk
- 1/2 cup baby food — pears or applesauce
- 1 1/2 tsp vanilla extract
- 1/4 tsp salt
- 2 1/2 tsp cinnamon
- 1 egg white
- Preheat oven to 375 degrees, spray an 8 inch round pan with cooking spray and set aside until ready to fill.
- On a cutting board, slice the pears into thin slices. Set aside until the end.
- In a large mixing bowl, add all the ingredients except for the pears, 1 tsp of the cinnamon and 1 tsp of the sugar (the rest will be used later) and mix until blended. Make sure you get all the dry mix from the bottom all mixed in, but do not over mix. Let sit 5 minutes on the counter.
- Pour the batter into the prepared pan. Spread evenly. Arrange the pears in a circular pattern on top of the batter. Sprinkle the 1 remaining tsp of cinnamon and 1 tsp sugar over the top of the cake.
- Bake about 30 – 40 minutes until golden brown; until a wooden skewer or toothpick comes out clean or with dry crumbs. While baking, turn the pan around after 15 minutes for even baking.
Serve warm and enjoy this wonderful treat! Just a note, my 6-year-old Josh just made me that potholder (in my picture below) in day camp. He was so proud of it and I was so proud of him and wanted to share it with all of you. So indulge me please. Thanks. Big smiles! 🙂


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In case you missed it, Computing Community Consortium (CCC) Council member Cynthia Dwork, distinguished scientist at Microsoft Research, and her co-authors Vitaly Feldman, research scientist at IBM's Almaden Research Center; Moritz Hardt, research scientist at Google; Toniann Pitassi, professor in the Department of Computer Science at the University of Toronto; Omer Reingold, principle researcher at Samsung Research America; and Aaron Roth, the Raj and Neera Singh Assistant Professor in the Department of Computer and Information Science in the University of Pennsylvania's School of Engineering and Applied Science published an article in Science on The reusable holdout: Preserving validity in adaptive data analysis.
In their paper they
demonstrate a new approach for addressing the challenges of adaptivity based on insights from privacy-preserving data analysis.
Large data sets offer a vast scope for testing already-formulated ideas and new ones, but researchers who attempt to do both on the same data set run the risk of making false discoveries. Based on ideas drawn from differential privacy, Dwork et al. now provides a theoretical solution. Ideas are tested against aggregate information and individual data set components remain confidential.
For more information, please see their paper The reusable holdout: Preserving validity in adaptive data analysis, Aaron Roth's ScienceBlog.com interview, or Cynthia Dwork's interview with Microsoft.


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Join RATS (Membership)
We welcome new members
With your RATS membership you will get discounts on training sessions (windtrainer classes, swim sessions) and RATS events, as well as subsidised social events.
Sign up here with our new online membership form
Membership Fees
Membership runs from 1 October – 30 September annually.
If you have joined RATS since 1 August 2017 you are not required to renew your membership until this time next year.
The membership fees remain as previous years.
Individual $30.00
Family $50.00 (2 adults & any children under the age of 20 that live at the same address)
Youth & Child $20.00
If completing a family membership please enter your family name in the 'Team Name' box before entering the family members.
Life Members
You will be emailed a promo code to use in the new system. Please contact us if you have not received this.
Tribe Membership
RATs membership will not include TriNZ or Multisport NZ membership. If you choose to join TriNZ and/or Multisport NZ, please tick the respective box in the online membership form. Please note that if you wish to receive emails from TriNZ, you must go to the Tribe section of the TriNZ website and register.
We encourage all members who are planning on actively participating in triathlons over the season to join TRIBE (some races are actually cheaper when you are a TRIBE member!!). The revenue from the TRIBE membership goes to supporting our sport.
TRIBE membership for clubbies is $25/ year for Adults and $10 /year for Youth (U16).
For those of you that sign up to TRIBE with through our online system we will will be sending the membership data through to Triathlon NZ on a weekly basis. Triathlon NZ will then send their membership cards out too you the following week, or they will also be available at certain races where you can pick up them up from the Tri NZ community tent (white one).
Please note transaction fees are paid on the TRIBE component of the cost ($1) when selecting a TRIBE membership option.
Joining TRIBE with your Club membership is not possible with the family membership option.
Sign up for a membership online
Sign up here with our new online membership form
Finally if you have any problems using the online system please contact us


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2017 MLB All-Star Game: FanFest promotes baseball at the most basic level – CBSSports.com
MIAMI — One of the highlights of every All-Star Game is FanFest, the fan-centric exposition that trots out ballplayers present and past, new merchandise and interactive exhibits. This year's edition took place at the Miami Beach Convention Center, and as usual you could find a steady stream of former ballplayers' autographing and glad-handing and the full complement of swag tied to this year's Midsummer Classic (including 2017 All-Star Game fidget spinners).
What was cool about this year's model, however, was the particular emphasis on the basic constituents of the game itself …
As you can see, "Hit," "Pitch" and "Catch" lead the way.
Commissioner Rob Manfred is of course tasked with nudging baseball's fan demographic toward the younger side. As has been chronicled in the media ad nauseam, high-consumption baseball fans skew older, and millennials/post-millennials have shown demonstrably less enthusiasm for baseball than have older generations.
What gets lost in the hand-wringing is that there's simply much more competition for leisure time these days, and pretty much every avocational pursuit has seen its "market share" winnowed down. In any context, though, baseball needs to lay the substructure for the future — i.e., that time when baseball's current leading demo begins dying off, or at least sees its purchasing power decline.
To that end, Manfred and MLB have worked toward seeding a love for the game through the very basic and atavistically appealing tasks of throwing, hitting, running and catching. Enthusiasm for these slices of the game, the thinking likely goes, eventually evolves into a love of the way the game itself melds and blends those things in the self-contained unit of the nine-inning game. That thinking — that long-term bet on the constituent elements of the sport — was very apparent at FanFest.
In some ways, the battle for the hearts, minds, and — yes — wallets for future fans begins or at least is advanced in just such a place. That's a breezy way of saying you could have a lot of fun at this place.
For instance, you of course have batting cages and pitching machines and radar-gunned pitching tunnels for those looking to air it out:
Speaking of which …
Keep your eye on "Hazier M," who, despite being classified as a kid, already sits in the low 80s.
Also, fans could avail themselves of the kind of instant feedback that Statcast has popularized. At one station, you could take a couple of swings off the tee and get instant data on bat speed, launch angle and so forth:
We're accustomed to seeing our kids test the pitching radar gun at ballparks, but these hitting measurables are a new thing in the public sphere. It's yet another way to modernize those basic baseball tasks, and nice job by MLB getting them out there at FanFest.
Of course, it wasn't all the usual fare of hitting and pitching. There's also fielding …
You catch the fly ball and hit the cutoff man by putting the ball in the hole that's set up where the relevant infielder would be.
And there's also base-stealing …
Feet first next time, young man.
As well, you had stations in which these skills were scaled down in order to engage even younger fans:
These things are reliably enjoyable, especially for kids, but it's not entirely unlike what you'll see in the family concourse of any number of major-league ballparks.
What set FanFest aside is a couple of virtual-reality flourishes:
There's the Virtual Home Run Derby, again with Statcast-y metrics to add to the experience. And …
Yep, with some assistance from Virtual Buster Posey, you can get a taste of what it's like to play the most grueling position in all of baseball.
Yet again, baseball promotes these slices in an interactive and engaging way. Manfred's talked about how youth baseball players tend to become adult baseball consumers. There's an opportunity for growth in that area, particularly with the safety-related decline of youth tackle football. Providing kids with some positive experiences when it comes to these ingredients of the sport in a way that leverages technology when possible is very much a step toward that.
Oh, and you know what else is a baseball skill? This …
It's important to be able to snare a foul-hit baseball while holding a bundle of life-altering responsibility and/or occasional joy — i.e., a baby. It's a fake baby in this instance, but dry reps get you ready for the real thing.
For the youth athlete — and by extension for those future consumers — baseball can be the most frustrating of sports. Downtime is punctuated by instances of pressurized isolation, and you must necessarily wait until your next time up or the next time a ball is hit to you for your temporary redemption. By focusing on the components of the game and reinforcing the lesson that baseball is a complicated and challenging whole made up of simple and enjoyable parts, you make it reducible.
It's a time-honored way to introduce kids to the game, and MLB is banking on that approach, along with some wireless-age finishes, to bridge generations. That was readily apparent at FanFest.
And, yes, you could also wear and eat stuff.


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Rackit CMRCT-FT-32H Ventit 2-Post Tray
Code: CMRCT-FT-32HPrice:
Shipping Weight: 11.00 pounds
Inside Dimensions: X X
Ventit fan trays create accelerated air-flow throughout a server/equipment cabinet, providing extra ventilation in densely populated enclosed racks.
Available in 1, 2, or 3 row models, Ventit fan trays are designed to accelerate air flow in the back of the cabinet, or in the front, or throughout.
Occupying only 1U rack space (1.75 inch high), Ventit fan trays can be mounted at any desired height inside the cabinet, generating vertical airflow (typically from the bottom to the top) for increased cabinet ventilation and heat dissipation.
Ventit x4V models, designed for 4-post rack-mounting, are depth-adjustable, with adjustable front and rear mounting tabs supporting mounting depth of up to 34-inches.
Ventit 34V, featuring 4-post mounting and one row of fans, allows sliding the row of fans to position the fans either at the front of the cabinet, or at the very back, or anywhere in between.
Ventit 32H typically mounts at the back of the cabinet, generating horizontal airflow, generally used for exhausting air from the enclosed rack through available vents in its rear door.
Use Ventit Controller to control the operation of Ventit fan trays based on internal cabinet temperature.
For pre-emptive temperature management, visit our External Threat Detection (ETD) systems that provide early warnings about insufficient airflow, raising temperatures and other "environmental" threats to your IT infrastructure.
|Related Item(s)
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Odds of Each Hot Trade Rumor Actually Happening Before the DeadlineJuly 26, 2013
Odds of Each Hot Trade Rumor Actually Happening Before the Deadline
With less than a week to go before the trade deadline, contenders are starting to be separated from non-contenders and rumors are starting to get more specific.
With that comes players linked to certain teams more than others. Sometimes, that's where the player ends up. Matt Garza had been linked to the Rangers quite often before he was finally traded there, so it came as no surprise.
Other times, that player is traded to a team that hadn't ever been mentioned in rumors. Francisco Rodriguez was traded to Baltimore after he had been linked to several other interested teams over the previous few days. The Orioles weren't one of them.
Here are five rumors that have been floating around and the odds of each trade actually happening.
Luke Gregerson to the Tigers
It's a pretty good bet that the Tigers will land a relief pitcher by the trade deadline, and Padres setup man Luke Gregerson is on their radar, according to Jon Paul Morosi of Fox Sports.
The 29-year-old Gregerson (2.98 ERA, 13 holds) currently finds himself in a similar situation to Mike Adams, who was also one of the top setup men in the game with another year of team control when the Padres traded him to Texas at the 2011 deadline.
The Rangers' farm system was stacked, though, and they were able to part with two pretty good mid-level pitching prospects—Robbie Erlin and Joe Wieland—without depleting their prospect depth. The Tigers don't have that luxury. They don't have a lot of depth or overall talent in the minors.
If the Padres are expecting a package similar to what they received from Texas for Adams, they probably won't get it from Detroit.
Odds: 20/1
Jake Peavy to the Red Sox
Several teams have their eye on Jake Peavy, considered to be the top starting pitcher on the trade market, and the Red Sox have been mentioned as a possibility on several occasions. And if the Red Sox really want Peavy, they'll probably get him.
That's because they have several high-quality prospects in the upper minors and might even be willing to part with third baseman Will Middlebrooks, whom Scott Merkin of MLB.com says the teams have discussed.
Peter Gammons tweeted earlier today that he's hearing that the White Sox want to acquire pitching for Peavy. That's also good news for the Red Sox, who also have plenty of young starters with front-line potential, including Matt Barnes, Anthony Ranaudo and Allen Webster.
Middlebrooks and either one of the aforementioned pitching prospects could be all it takes for the Sox to acquire the former NL Cy Young winner.
Odds: 2/1
Alexei Ramirez to the Cardinals
A scouting source recently told Mark Gonzales of the Chicago Tribune that the White Sox turned down an offer from the Cardinals that would've landed them top pitching prospect Carlos Martinez for shortstop Alexei Ramirez.
It seemed like a crazy rumor, considering that the White Sox would have to be crazy to turn down that deal for an elite pitching prospect, and Jon Heyman of CBS Sports later tweeted that they hadn't turned down that deal.
Still, Ramirez to the Cardinals makes plenty of sense, since Pete Kozma isn't giving them much with the bat (.583 OPS). Also, although the 31-year-old Ramirez isn't having a great season, he's heating up with a .315 batting average and eight stolen bases since June 10.
It probably wouldn't take a prospect of Martinez's caliber to acquire Ramirez, but the question is whether the Cardinals have enough non-elite minor league talent to get a deal done.
Considering Ramirez is signed through the 2015 season at a reasonable rate ($9.5 million in 2014, $10 million in 2015), the White Sox have the leverage and could probably ask for a lot more than the Cards are willing to offer.
Odds: 12/1
Alex Rios to the Rangers
As of Wednesday, the Rangers and White Sox were discussing an Alex Rios deal, according to T.R. Sullivan of MLB.com. Whether or not Nelson Cruz is hit with a suspension for his alleged involvement in the Biogenesis investigation (subscription required), Texas can use another bat in the middle of the lineup.
With David Murphy having a rough season (.750 OPS), Leonys Martin struggling this month (12-for-56, 4 BB, 18 K) and Lance Berkman possibly out for the season, Rios (.767 OPS, 12 HR, 21 SB) could be perfect in Texas.
Unless the Giants make Hunter Pence available, the trade market for outfielders is thin. The 32-year-old Rios, who is signed through 2014 ($12.5 million) with a $13.5 million club option for 2015, is easily the best option, and the Rangers have one of the best farm systems in baseball. If they want him, I'm certain they'll get him.
Odds: 4/1
Nate Schierholtz to the Pirates
After starting the month in a 2-for-28 slump, Nate Schierholtz was in danger of decreasing his trade value to the point where the Cubs would have no motivation to trade him since he's still under team control for another season.
But he's picked up it again with eight hits in his last 15 at-bats, including three doubles and two homers, to boost his OPS to a healthy .865 with 13 homers on the season.
The Pirates have been keeping close tabs on Schierholtz for quite a while, according to Bruce Levine of ESPN Chicago, and would likely hand him the starting right field job over Travis Snider and Jose Tabata if he was acquired.
If the Bucs still prefer to hang onto their top prospects and keep their payroll at a modest level, then Schierholtz would be the likely choice over pursuing Alex Rios. As long as the Cubs aren't asking for top prospects Jameson Taillon or Gregory Polanco, who both play for Altoona, there's a pretty good chance Schierholtz is in a Pirates unifom by August 1.
Odds: 8/1


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02/07/2012Provided by Citysearch -
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Gym fuses fitness and entertainment with classes that include Cardio Striptease, Firefighter Workout, Cycle Karaoke, African Dance and Disco Yoga.
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Our Membership Plans
At Reebok CrossFit Miami Beach, we have multiple packages to fit all lifestyles and goals. Our vision is to help you become the fittest and healthiest you've ever been. We go above and beyond to get you results!
Get started today and become a member at Reebok CrossFit Miami Beach!
What you get
- Fundamentals Classes
- Unlimited Sessions/Month
- Nutritional Guidance & Support
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- Discounts & Giveaways
Can't Make a Fundamentals Class?
We offer private one-on-one sessions that cover all three days of intro classes in 1 hour. The cost is $150 for the session and will fulfill all your fundamentals requirements. This can be scheduled to best fit your schedule.