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This week negotiators in Springfield are trying to save the school reform bill. The teachers unions want lawmakers to un-do what the Chicago Teachers Union calls "last minute trickery" on the bill passed unanimously by the State Senate last month.
Illinois unions are reluctant partners in reforms they've fought for decades in part because their colleagues in neighboring states have already lost the battles.
Teachers fought in vain in Wisconsin. Despite huge rallies, Gov. Scott Walker got his plan to strip collective bargaining rights from most public employees. The battle isn't over though. Teachers unions promise to try and block the law with a quote "tsunami of litigation."
And last week, Indiana Gov. Mitch Daniels signed a new law enacting sweeping reform.
By comparison, the reform bill in Springfield seems pretty mild. The CTU said on Monday "we don't like it," but she insisted that the union is still on board -- if -- lawmakers change the language they snuck in at the eleventh hour.
Their issue is with what's on page 107 of the 111 page reform bill. It lays out what happens if the teachers union and the school board cannot agree on some core issues:
If there is an impasse, it does not go to a third party for mediation -- teachers can agree, or they strike. The state education labor relations board has no jurisdiction.
But the really hot button issue may be the last line, which makes these changes "declarative of existing law" -- ie, retroactive. That might derail the union's lawsuit going foward right now over the nearly 1.300 teachers laid off last year.


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Editor's note: Do you need something to smile about? Every day, WND selects the best joke offered up by readers and contributors to its Laughlines forum and brings it to you as the WND Joke of the Day. Here is today's offering:
"How was your blind date?" a college student asked her roommate.
"Terrible!" the roommate answered. "He showed up in a 1974 Corvette."
"Wow! That's a very expensive car. What's so bad about that?"
"He's the original owner."

subset: commoncrawl


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Most Valley locations will reach or slightly exceed the 100-degree mark Sunday through Tuesday.
The "average" first 100° day in the Valley is May 2nd.
A strong high pressure system will build into the region for some of the warmest afternoons of the year.
Highs in Phoenix could remain in the triple digits through Tuesday, with the hottest weather on Monday, when highs could hit 102 degrees, meteorologists said.
A weather system will pass north of us by midweek, knocking temperatures back into the low/mid 90s. The only other effect from this system will be an increase in wind.
Gusts up to 30 mph will be common, mainly across the higher terrain of south-central Arizona Tuesday afternoon.
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Categories > Books > Harry Potter > Unknown Memories
Chapter 56 Reviews
Learning the horrible truth of what the future holds Harry begins his quest to become the perfect wizard and change the future of death and destruction he's foreseen. Not realizing what the consequ...
As they were walking out of Ollivander's Katie's mum cast a water repelling charm on them to prevent another mishap, causing Alexia to start complaining. She loved to run around, and the rain gave her a perfect excuse.
Lunch at Florean's was as delicious as ever though Harry barely noticed as he spent most his time talking with Katie and learning about her family. They'd been really surprised yesterday when Alexia received her acceptance letter to Hogwarts, as none of them thought she'd ever done magic. Her father was a Muggle and, while Katie showed signs of magic early on, Alexia hadn't.
"Harry dear, you're looking much healthier than before. Did you come for more robes?" Madam Malkin asked coming over to him.
Harry started. After finishing their sundaes Harry and Katie began talking about Oliver Wood's chance of being picked up by a Professional Quidditch team, and possible replacements for Gryffindor's Keeper. He was enjoying the conversation and didn't even realize that they left the ice cream parlor until Madam Malkin began talking to him.
"That school robe does look a bit short on you. I do hope you don't mind but I threw away those wet clothes from before. Even resized there was just nothing to be done with them."
She raised his arms and turned him around, nodding at what she saw. "Your dress robes will have to be large by a few centimeters and then charmed to keep a perfect fit as you grow. It'll be more expensive but otherwise the robe won't look perfect when you need it for Hogwarts. Boys your age never seem to stop growing." Noticing the stain on Harry's robe she added, "Or eating for that matter."
Katie laughed at Madam Malkin's comment and told her that they'd just come Fortescue's, where Harry had eaten two sundaes.
"Hey, I was hungry! I didn't have breakfast and ran several kilometers this morning." Harry claimed, trying to defend himself.
"Of course you did," teased Katie. "And here's your reward for having run so far." She added, offering him a small tart.
Harry, having been in the magical world for 3 years, was wary of accepting it.
Katie noticed his apprehension. "Go ahead." She said, looking completely innocent. "I haven't visited Gambol and Japes yet. We only just got to Diagon Alley remember?"
Only somewhat reluctantly Harry accepted the sweet and took a bite. Unfortunately he saw Katie smile the moment he bit the tart and mentally groaned. He didn't like the look of that smile.
The feeling was proved correct when only his entire body began to feeling tingly and he noticed fuzz growing on his hands and arms. Within a minute his entire body was covered with in light brown fur about an inch long.
"Well, it looks like we'll need to wait to pick out a dress robe for you dear. I don't think I have any material that would match your fur." Madam Malkin said in a conversational tone, as if discussing the weather.
Katie and her sister both started laughing at her comment and even Katie's mum had a smile on her face.
"Come along Alexia dear," Mrs. Bell said as she took Cephia by the shoulder, leading her towards the fitting room. "We'll do your robes first."
"Sorry, I couldn't help it! Fred and George made them and owl'd me a few to test. It's a Wolf-Berry Tart, in honor of Professor Lupin." Katie gave Harry a sympathetic smile and added, "They've gotten me more times than I can count so you're in good company."
Harry laughed a bit himself. Typical for the twins. Most of Hogwarts knew better than to accept anything from them because of their reputation, so it only made sense that they start using their friends to help now.
"Wolf-Berry Tarts huh? I'll have to talk to them sometime." Harry commented while looking at the fur on his arms. "This might be able to pass for centaur fur, but it's nothing like real werewolf fur."
"You've seen a real werewolf?" Katie gasped. "It was Professor Lupin wasn't it? I heard a rumor that a student was nearly attacked but I didn't believe it! What happened?"
"And a Centaur? Where did you ever meet a Centaur, I thought they hated magical folk and stayed away from us. People even say that if it wasn't for Dumbledore, they'd try to attack Hogwarts."
At this he had to say something, a Centaur had saved his life and he wouldn't let anyone talk about them like that. So he told her a short version of his detention in The Forbidden Forest and how Firenze saved his life.
Katie was amazed at the end, apparently even Fred and George had never gone very far into The Forbidden Forest.
Harry thought this was actually smart of them, and to make sure Katie wouldn't be interested in going in the forest anytime soon, told her about Aragog and the other Acromantula in the forest.
Alexia finished with her robes before Harry could end his story and then it was their turn to be fitted.
"I wonder what we'll need dress robes for this year?"
Katie's question startled Harry as he'd been reliving his adventure in the Forest, and not particularly paying much attention to anything else.
"Dress Robes?" Harry asked, confused by what she meant.
"Boys." Katie sighed while rolling her eyes. "Madam Malkin talked about the dress robes you'll need for Hogwarts this year when we came in. We never needed them before though, and Alexia's letter didn't mention any."
Madam Malkin came in as Katie was talking about the possible reasons for the dress robes and told her that Hogwarts would be having a formal ball this year. After that the two of them began talking about the dance, Harry quickly tuned them out.
Ollivander was busy with a customer, a sixth or seventh year boy he remembered seeing around Hogwarts. So he went to the backroom and found that his books were already laid out on the table waiting for him and groaned to himself. He should have known Ollivander wouldn't let him slack on the morning's lesson.
Three days later he finished taking the Elixir and would not longer need to come into the shop everyday. Harry was surprised by just how unwelcome the news was to him. Thankfully Ollivander said he'd still need to come back to continue his lessons and take a few more potions, just not every day like he had been.
The last two weeks had been extremely busy for him, going to London and back everyday, reading and studying in the morning, and then practical lessons in the afternoon. While he sometimes complained to himself about the reading assignments, or about listening to Ollivander talk about the Wizarding World's traditions, he'd not only become used to it, but actually enjoyed it.
Normally his summers were filled with chores and mind-numbing boredom, but for the last two weeks it'd almost seemed like he was back at his real home, Hogwarts. The early mornings and running reminded him of Quidditch practice, the reading and practical lessons reminded him of his classes, and occasionally using memories of Ron and Hermione in the Pensieve kept him from missing his friends too much.
The most surprising thing was how much Harry had come to enjoy his lessons. Ollivander, while incredibly knowledgeable, was not the best teacher. He was entirely too smart, passed over a lot of the more basic information that Harry didn't know, but in his own way he was still more effective than any other teacher.
One of the problems Harry had with classes was that he never saw the point in it. What did learning how to transfigure a porcupine into a pin cushion, or a lot of other rubbish they assigned in class, have to do with anything? So he only tried hard enough to get by.
Ollivander though, explained that these basic lessons were just one of the many steps that you must take in order to learn true magic. His interest in Transfiguration, for example, peeked to the highest it'd been since first year after Ollivander gave several examples of how the basics magic he already knew tied into the more advanced spells.
It made him want to study harder and learn more for himself, not merely do enough to get by in class. He learned a lot in those two weeks for just that reason. While none of it was especially interesting, or powerful, he made far greater progress in those two weeks than any two weeks in school.
Interestingly enough some of the most important things Ollivander taught Harry were not spells, rather they were tips on how to use magic efficiently. Eliminating excess movement and saying, rather than shouting, spells were two of the more important.
He'd been simple amazed to learn that a proper grip and the wand alignment would lessen the amount of magic wasted when casting spells. Why didn't they teach that in class?
Ollivander also told him that a well cared for wand would channel magic more efficiently. Any cracks or imperfections of the wood grain inside the wand would increase the power required to cast a spell while decreasing the spell's power. Ollivander gave him special oil used for polishing wands that would, over time, seep into the wood and repair minor imperfections, keeping the wand in top performance.
Several times over his three years at Hogwarts he'd seen students caring for their wands, but never really thought about why. Now that he realized what it was for he felt stupid. He spent hours at a time keeping his broom in top shape, but never thought to do the same for his wand.
This year he knew he'd spend a lot more time polishing his wand.
"Katie?" He asked, a bit surprised to see her in Ollivander's again.
"Harry! I was hoping you'd be here." Katie said as she walked over to him. "I'm going clothes shopping in London. Interested?"
"I guess." Harry replied, unsure of how to answer. He took time from studying the other day and didn't want Ollivander to be angry at him for leaving all the time. "I could use some Muggle clothes, but I'm supposed to be studying today."
"Considering the despicable clothes you previously wore, you should shop while you have willing help." Ollivander told him from across the room. "This young woman's opinion could be quite invaluable to you, Mr. Potter."
"It won't just be me." Katie added. "Angelina and Alicia will be coming too, and my father and Lee."
"Go Mr. Potter, and do not worry about your studies. I have little doubt that your books will anxiously await your return." Ollivander said, his smile turning in to a full-sized grin.
Harry wasn't sure about spending a whole day shopping but had to admit that spending time with friends sounded like fun. "All right. I need to exchange money in Gringotts first though."
"Don't worry about that." Katie said as Harry opened the door for her automatically. "My dad will buy everything and you can pay him back in Galleons afterwards. It's one of the main reasons why he'll be there today, to avoid the Goblin's fees."
"That was Runes you were studying, but I didn't think you took Runes?"
"I'm not, well not yet anyways. I took Divination with Ron last year but, well, you know the story about her predicting my death every class." He stopped talking for a moment to avoid a pushy group of tourists, then continued. "Anyways, Ollivander had me read through a book on Runes and I was a lot more interested in it than I thought I would be. He'll talk to McGonagall about me switching classes if I can learn the basics during the summer."
"Do you want any help? I still have all my notes and homework from last year, and I'm pretty sure I have most of it for my third year too." Katie told him as they stepped through the brick doorway into The Three Broomsticks.
"That'd be great actually. I was going to ask Hermione for hers but she's not back from vacation yet."
The shopping was not going well for Harry. Going off on his own in the first store seemed like a good idea at the time, the fact that he never shopped before and had no idea what to wear not withstanding.
Thankfully after about fifteen minutes Katie found him and checked out the few pieces of clothing he had managed to pick out. She quickly determined that he would never be allowed off on his own again and enlisted the others to help find clothes for Harry.
While he admitted their choices were far better than his own, it did cause one slight annoyance. While the girls were busy trying clothes on, he was forced to wait until one came out to critique what he was wearing. A few stores later however, Harry found there was one surprising benefit to this arrangement.
While proper dress robes were nice, the girls informed him, Muggle dresses were far more fashionable these days. And so Harry was forced to wait a great deal longer than longer as they tried on dress after dress. Waiting for one of the girls to approve his clothing Harry's mouth dropped open and brain stalled as Katie opened the dressing room door.
This was not because of the outfit Katie was wearing, as Harry barely even noticed her. What did catch his attention was that from this angle he could see Alicia. It was what Alicia was wearing, or more accurately, what she wasn't wearing, that took his breath away. He'd never realized just how large her chest, or how flat and toned her stomach was before. Wizarding robes hid far more than they revealed.
His view only lasted for around 10 seconds. By the time Harry came out of his stupor Katie had fallen silent, an odd look on her face. He knew she was going to ask him something he didn't want to answer, so he quickly mumbled an excuse and disappeared.
Katie paused for a moment after he left, feeling a little giddy. She knew she was decent looking but because of all the time she spent with Alicia and Angelina, who were more than a year older and far more developed, guys tended to look past her to eye them.
Looking down at herself she smiled. It wasn't often that she wore dresses and this one was a bit short for her tastes, but with Harry's reaction... This was the dress she was going to buy, and maybe a few others like it.
A large smile on her face, she went back into the changing room glad Harry came along today. It was only after she was already at Diagon Alley that she decided be kind and invite him. Coming from a half-Muggle family she knew how dull it could be to wear bland robes all the time. If she was honest with herself though, she'd been surprised by how much better he looked minus the horrible clothes and glasses, and wanted complete his new look. At the time she thought the girls in his classes could thank her later, but now...
Alicia and Angelina noticed her bright smile and slightly dazed look immediately and quickly surrounded her, wanting to know what happened.
Harry spent the next couple hours trailing behind the rest of the group or talking with Mr. Bell.
Marcus Bell was a kind looking man with sky-blue eyes and a deep voice, which seemed oddly out of place coming from his skinny frame. Harry learned that Mr. Bell had originally been friends with Cephia, his wife, when they were children, but lost touch with her when she went away to school.
Years later he was helping repair his parent's home and met her again. They became friends and, eventually, married. It wasn't until after they were engaged that she told him about the magical world, though he figured something weird was going on with her long before then.
He admitted that it'd been a shock but they got through it and were married a year later. "The hardest part to get used to," Marcus told him while they were waiting for the girls to finish shopping, "was the Floo. I could handle most the other things, but it took me years to get used to that. Even now I still prefer using a car, or the rail."
As they were shopping Harry noticed the three girls would often glance at him and start whispering amongst themselves. He blushed with embarrassment each time this happened and was grateful that none of them had taken him to task for peeking at Alicia, hoping they wouldn't mention it at all.
Part of him wanted nothing more than to stop shopping and dream about what he saw for those precious seconds. Another part of though wanted to go back to Ollivander's and try to forget that it ever happened. Yeah, /he thought to himself, l/ike that will ever happen.
It wasn't until they returned to the familiar territory of Diagon Alley that he relaxed enough chat freely with them again. The girls still wanted to do a bit more shopping in the Alley and Lee was interested in a pair of hand-grips he had seen at Quality Quidditch Supplies. He enjoyed their friendly banter again but could sense that the girls, Katie in particular, would give a thoughtful glance once in a while.
While they were shopping in Gladrag's that he found out the girls were going to help Oliver Wood prepare for his try-outs. Oliver made it past the first two-cuts and would be competing against Puddlemeare United's first string with their Firebolts. It the mention of the Firebolts that caught his attention. He knew a seeker wouldn't be as helpful as three chasers but he did have his Firebolt, and letting the girls use it against Oliver would help him a lot for his final try-out.
"How is it that everyone knows you and calls you Harry?" Katie asked while they were in Esmeralda's Wicces Boutique. "I've been coming here for years and she still calls me little miss Bell, if she even remembers me at all. I could maybe understand Mr. Fortescue, or Noel from Quality Quidditch Supplies, but Esmeralda... You aren't a regular customer here, are you?"
"No! I've never been in here before today." Harry gasped out, shocked she could even suggest that. And seeing no other way out of it, Harry related how Mr. Fortescue nearly started a riot by calling his last name and how the workers in Diagon Alley would call him by his first name now to prevent it from happening again.
The three girls and Lee, being the kind and considerate friends they were, found this hilarious and laughed their arses off. By the time they finally stopped their laughing Harry sure his face looked as red as Ron's hair.
After doing his morning chores and cooking breakfast the next morning Harry had a bit of extra time before meeting Oliver and the girls for Quidditch. Going back to him room he happily picked through his new clothes for an outfit to wear. Yesterday may have embarrassed him a bit, but the results were worth it. Looking at himself in the mirror Harry realized that the girls, and surprisingly Mr. Bell, really did have good taste in clothing. He barely recognized himself anymore.
It still felt weird to be wearing such tight fitting clothes but Katie assured him that this was how they were suppose to fit and, after he became used to the feeling, he'd never want to go back to his old rubbish again. Harry believed her.
The difference between his old pair of trainers, which were held together by magic and tape, and his new pair of running trainers was like night and day. On his way back from shopping he couldn't help but test them and sprinted all the way from the rail station to Wisteria Walk, where he nearly tripped over one of Mrs. Figg's cats. His feet weren't even a little bit sore by the end, it'd been like running on air.
Harry arrived at The Three Broomsticks and found Katie and Angelina already there. After a few minutes of talking Alicia arrived and they all floo'd to the Wizarding Park where Oliver had a pitch reserved.
Looking around Harry was in awe at what he saw. Everywhere he looked there were sprawling grass fields for as far as he could see. Several small children were playing on swings, which seemed to be held up only by magic. In one area older kids were sliding down huge translucent slides, landing with a splash into the huge lake. The lake seemed to defy logic, and gravity. Children swam from the water into the air and then dove, or fell, back into the water again.
The walk to the Quidditch Pitch took about ten or fifteen minutes and the girls told him about the park on the way. It wasn't normally this large, the Ministry had magically expanded it over the last two years for the World Cup. The fields where the cheaper ticket holders, like the girls, would camp out were only about a twenty minute walk from here, next month the whole area would be filled with people.
Arriving at the pitch they found Oliver Wood pacing back and forth talking to himself about Quidditch plays. The four of them only marginally succeeded in stifling their groans. They'd seen Oliver like this many times before and each knew it was going to be a long day.
While there were a few rough spots, he really enjoyed the full day of practice. The moment his feet left the ground the feeling of flying returned; this was where he was meant to be, this was where he belonged.
Harry knew he was the best seeker at Hogwarts, but today he gained a new appreciation for how difficult being a chaser was, and that the three girls did a lot more than just fly. He'd known from the beginnings that they were good and worked perfectly together, but it wasn't until he tried to become a fourth chaser that he truly appreciated their skill.
Harry could easily keep track of the other chasers, even in the fastest and most complex of their plays he always knew where they were, being a seeker did have a few advantages. What he hadn't realized though, was that you needed a lot more than just flying skills to pull the plays off successfully.
Getting the Quaffle exactly where you wanted it while going full speed on a broom was not an easy task. And he'd never even considered that you didn't throw a Quaffle to where a chaser was, but where she would be. They not only knew where the other girls would be, but were somehow able to let the others know where they'd be needed. It was almost like they could communicate to each other without any visible movements, at least none Harry could pick up on.
Perhaps it was male of him, but he always considered the girls as, well, girls. Weaker and more delicate than guys. To learn that all three girls were stronger than him was quite a shock. After several hours of catching and throwing a few kilogram ball around while flying at high speed on broomsticks, he learned first hand just how much strength was required to be a Chaser.
Even with all the chores the Dursley's made him do over the years, he wouldn't have been able to last the whole practice. His only saving grace turned out to be the girls. He didn't want to quit in front of them, to appear weak. So he forced himself to continue, even after his muscles burned and his arm grew numb.
At the end of practice the girls, while looking a bit peaked, seemed to be perfectly fine after a shower. Harry, however, wanted to sleep, right there on the ground. Just to lie down and wake up in the morning. He was sure though that none of them could tell how worn out he felt. If it was one thing he learned from the Dursley's, it was how to wear a mask.
When they were getting ready to leave Oliver surprised him by commenting that if he wasn't such a great seeker he'd make a right good chaser, with practice of course. To Harry this meant a lot, Oliver Wood was not known to give out praise lightly.
Entering his room at the Dursley's he was surprised to see a very serious looking Ollivander standing next to the Pensieve. A feeling of dread came over him, he'd forgotten to remove the memory of Sirius from it this morning.


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text: CUSP: A Framework for Success (Slide Presentation) On the CUSP: Stop BSIThis PowerPoint slide presentation was shown on March 7, 2012 ContentsSlide 1. CUSP: A Framework for SuccessSlide 2. Today's SpeakersSlide 3. Working Together – The PlayersSlide 4. Learning ObjectivesSlide 5. The Michigan CUSP ExperienceSlide 6. It Is Not Just a Simple ChecklistSlide 7. CUSP – The Michigan ExperienceSlide 8. ICU Safety ClimateSlide 9. Culture / Climate and OutcomesSlide 10. ICU Safety ClimateSlide 11. Teamwork Climate & Annual Nurse TurnoverSlide 12. Quote from Man and SupermanSlide 13. The Comprehensive Unit-based Safety ProgramSlide 14. Ideas for Ensuring Patients Receive the Interventions: the 4EsSlide 15. Ensure Patients Reliably Receive EvidenceSlide 16. MeasureSlide 17. What is CUSP?Slide 18. On the CUSP: Stop BSI InterventionSlide 19. Translating Evidence into PracticeSlide 20. Safety Score Card Keystone ICU Safety DashboardSlide 21. Pre CUSP WorkSlide 22. Steps of CUSPSlide 23. Step 1: Science of SafetySlide 24. Step 2: Identify DefectsSlide 25. Prioritize DefectsSlide 26. Step 3: Executive PartnershipSlide 27. Step 4: Learning from MistakesSlide 28. Step 4 cont'd: Identify Most Important Contributing FactorsSlide 29. Step 4 cont'd: Identify Most Effective InterventionsSlide 30. Step 4 cont'd: Evaluate Whether Risks Were ReducedSlide 31. Step 5: Teamwork ToolsSlide 32. Step 5 cont'd: Call ListSlide 33. Step 5 cont'd: Morning BriefingSlide 34. Step 5 cont'd: ShadowingSlide 35. CUSP is a Continuous EffortSlide 36. Action Items -- CUSPSlide 37. Action ItemsSlide 38. ReferencesSlide 39. PhotoSlide 40. CUSP + CAUTI Process and PreventionSlide 41. ObjectivesSlide 42. Science of Safety EducationSlide 43. Project Planning Slide 44. Project Planning Slide 45. Project AwarenessSlide 46. Data CollectionSlide 47. Planning EducationSlide 48. Educate on the EvidenceSlide 49. Developing CAUTI Education Slide 50. CAUTI EducationSlide 51. Urinary Catheter Insertion CompetencySlide 52. Evaluate - Learn from Defects Slide 53. Execute New PlanSlide 54. Other StrategiesSlide 55. Outcome = Culture ChangeSlide 56. Identify Why Defects - CAUTIsSlide 57. Execute New PlansSlide 58. Execute New PlansSlide 59. CUSP - Not a Linear ProcessSlide 60. Polling Questions Slide 1. National Content Webinar CUSP: A Framework for SuccessMarch 7, 2012Return to Contents Slide 2. Today's Speakers Marge Cannon, Medical Officer, CMS.Minet Javellana, Health Insurance Specialist, CMS.Barb Edson, Vice President of Clinical Quality, HRET.Chris George, Director of National Projects, MHA Keystone Center.Chris Goeschel, Director of Strategic Development and Research Initiatives at Armstrong Institute for Patient Safety and Quality, John Hopkins University.Mary Jo Skiba, Project Manager QI/Research, Alpena Regional Medical Center.Return to Contents Slide 3. Working Together – The Players Centers for Medicare & Medicaid Services Quality Improvement Organization (CMS QIO).Agency for Health Care Research and Quality (AHRQ).On the CUSP: Stop HAI www.onthecuspstophai.org.CLABSI National Project Team Michigan Health & Hospital Association: Michigan Keystone Center for Patient Safety & Quality (MHA Keystone).Armstrong Institute for Patient Safety and Quality Johns Hopkins University (JHU).Health Research & Educational Trust (HRET), research affiliate of the American Hospital Association.Image: Pieced puzzle in the shape of a square held by a person on each of the four corners.Return to Contents Slide 4. Learning Objectives Understand CUSP impact on safety.List CUSP components.Describe how a hospital implemented CUSP.Return to Contents Slide 5. The Michigan CUSP Experience Chris George, RN MSDirector of National ProjectsMichigan Health & Hospital AssociationKeystone Center for Patient Safety & QualityImage: Logo for "Pure Michigan".Return to Contents Slide 6. It Is Not Just a Simple Checklist Image of the top of two Annals of Medicine articles: one titled The Checklist; the other titled "The art of medicine: Reality check for checklists".Return to Contents Slide 7. CUSP – The Michigan Experience Use of CUSP tied with a technical intervention, such as central line-associated blood stream infection prevention "checklist.""Knowing the difference between adaptive and technical challenges is one of the key tasks of leadership."Ronald A. HeifetzReturn to Contents Slide 8. ICU Safety Climate Image: Bar chart showing the "Effect of CUSP on Safety Climate". Results: Pre vs. Post Intervention. Pre-CUSP (2004) shows that 87% of Safety Climate Score needs improvement, while Post-CUSP (2006) drops to 47%.Return to Contents Slide 9. Culture / Climate and Outcomes Image: Graph titled "No BSI = 5 months or more w/ zero". Underneath the title is a text box which states "The strongest predictor of clinical excellence: Caregivers feel comfortable speaking up if they perceive a problem with patient care".Return to Contents Slide 10. ICU Safety Climate Image: Bar chart showing the "Effect of CUSP on Safety Climate". Results: Pre vs. Post Intervention. Pre-CUSP (2004) shows that 87% of Safety Climate Score needs improvement, while Post-CUSP (2006) drops to 47%.Return to Contents Slide 11. Teamwork Climate & Annual Nurse Turnover Chart showing the percentage of teams reporting positive teamwork climate and annual nurse turnover. The first group is labeled High turnover: 16.6%. The second group is labeled Md turnover: 10.8%; and the third group is labeled Low turnover: 7.9%.Return to Contents Slide 12. Quote from Man and Superman "The reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore all progress depends on the unreasonable man."Man and SupermanGeorge Bernard ShawReturn to Contents Slide 13. The Comprehensive Unit-based Safety Program The Comprehensive Unit-based Safety Program (CUSP): An Intervention to Learn from Mistakes and Improve Safety CultureChris Goeschel, ScD MPA MPS RN FAANDirector, Strategic Development and Research Initiatives at Armstrong Institute for Patient Safety and QualityJohns Hopkins UniversityReturn to Contents Slide 14. Ideas for Ensuring Patients Receive the Interventions: the 4Es Engage: Stories, show baseline data.Educate staff on evidence.Execute: Standardize: Create line cart.Create independent checks: Create BSI checklist.Empower nurses to stop takeoff.Learn from mistakes.Evaluate: Feedback performance.View infections as defects.Return to Contents Slide 15. Ensure Patients Reliably Receive Evidence Senior LeadersTeam LeadersStaffEngageHow does this make the world a better place?EducateWhat do we need to do?ExecuteWhat keeps me from doing it? How can we do it with my resources and culture?EvaluateHow do we know we imrpoved safety?Pronovost: Health Services Research, 2006Return to Contents Slide 16. Measure Measure|Have We Created a Safe Culture? How Do We Know We Learn From Mistakes?|CUSP Comprehensive Unit-based Safety Program|1. Educate staff on science of safety2. Identify defects3. Assign executive to adopt unit4. Learn from one defect per quarter5. Implement teamwork tools|ImproveMeasure|How Often Do We Harm? Are Patient Outcomes Improving?|(TRiP) Translating Evidence Into Practice|1. Summarize the evidence in a checklist2. Identify local barriers to implementation3. Assign executive to adopt unit4. Measure performance5. Ensure all patients get the evidence|ImproveReturn to Contents Slide 17. What is CUSP? Comprehensive Unit-based Safety Program.An intervention to learn from mistakes and improve safety culture.www.onthecuspstophai.orgReturn to Contents Slide 18. On the CUSP: Stop BSI Intervention On the CUSP: Stop BSI Intervention: Comprehensive Unit-based Safety Program (CUSP) Improve or reinforce good cross-disciplinary communication and teamwork.Enhance coordination of care.Address overall patient safety.Work towards healthy unit culture.BSI-Reduction Protocol Best-evidence supplies, organization of supplies.Ensuring all patients receive the best practices.Checklist to ensure consistent application of evidence.Return to Contents Slide 19. Translating Evidence into Practice Image of a chart that shows how to translate evidence into practice: Summarize the evidence, identify local barriers implementation, measure performance, and ensure all patients receive the intervention. The source is from the BMJ 2008 article by Pronovost, Berenholtz and Needham.Return to Contents Slide 20. Safety Score Card Keystone ICU Safety Dashboard 20042006Engage2.8/10000Educate66%95%Execute100s100sHave we created a safe culture? Which areas need improvement? Safety Climate*: Teamwork Climate*: 84%82% 43%42%*CUSP intervention to improve theseReturn to Contents Slide 21. Pre CUSP Work Create a CUSP team: Nurses, physician, support staff, infection preventionist.Assign a team leaderMeasure culture in the unit.Work with hospital quality leader or hospital management to have a senior executive assigned to CUSP team.Return to Contents Slide 22. Steps of CUSP Educate staff on science of safety.Identify defects.Assign executive to adopt unit.Learn from one defect per quarter.Implement teamwork tools.Return to Contents Slide 23. Step 1: Science of Safety Understand system determines performance.Use strategies to improve system performance: Standardize.Create independent checks for key process.Learn from mistakes.Apply strategies to both technical work and teamwork.Recognize teams make wise decisions with diverse and independent input.Return to Contents Slide 24. Step 2: Identify Defects Administer the staff safety assessment and ask staff, "How will the next patient be harmed?"Review error reports, liability claims, sentinel events, or M and M conference.Return to Contents Slide 25. Prioritize Defects List all defects.Discuss with staff what are the three greatest risks and what you should work on first.Return to Contents Slide 26. Step 3: Executive Partnership Executive should become a member of unit team.Executive should meet monthly with unit team.Executive should: Review defects.Ensure unit team has resources to reduce risks.Hold team accountable for improving risks and central line-associated blood steam infection rate.Return to Contents Slide 27. Step 4: Learning from Mistakes What happened?Why did it happen (system lenses)?What could you do to reduce risk?How do you know risk was reduced? Create policy, process, or procedure.Ensure staff know policy.Evaluate if policy is used correctly.Return to Contents Slide 28. Step 4 cont'd: Identify Most Important Contributing Factors Rate each contributing factor: Importance of the problem and contributing factors: In causing the accident.In future accidents.Return to Contents Slide 29. Step 4 cont'd: Identify Most Effective Interventions Rate each intervention: How well the intervention solves the problem or mitigates the contributing factors for the accident.Rate the team belief that the intervention will be implemented and executed as intended.Return to Contents Slide 30. Step 4 cont'd: Evaluate Whether Risks Were Reduced Did you create a policy or procedure?Do staff know about the policy?Are staff using it as intended?Do staff believe risks have been reduced?Return to Contents Slide 31. Step 5: Teamwork Tools Call list.Daily goals.Morning briefing.Shadowing.Culture check up.Return to Contents Slide 32. Step 5 cont'd: Call List Ensure your unit has a process to identify which physician to page or call for each patient.Make sure call list is easily accessible and updated.Return to Contents Slide 33. Step 5 cont'd: Call List Have a morning meeting with charge nurse and unit attending(s) about the unit-level plan for the day.Discuss work for the day: What happened during the evening?Who is being admitted and discharged today?What are potential risks during the day; how can we reduce these risks?Return to Contents Slide 34. Step 5 cont'd: Shadowing Follow another type of clinician doing his or her job for between 2 and 4 hours.Have the shadower discuss with staff what he or she will do differently now that he or she has walked in another person's shoes.Return to Contents Slide 35. CUSP is a Continuous Effort Add science of safety education to orientation.Learn from one defect per quarter; share or post lessons.Implement teamwork tools that best meet the unit's needs Review details in the CUSP manual.Return to Contents Slide 36. Action Items -- CUSP Look over the CUSP manual with team members.Brainstorm potential hazards with team Assess team composition with respect to CUSP elements.Review pre-implementation checklist — where are you?Return to Contents Slide 37. Action Items Review content of Web site at www.onthecuspstophai.org: Toolkits.Slidesets.Manuals.Project Management Checklists: Pre-Implementation Checklist.CEO/Senior Leader Checklist.Infection Preventionist Checklist.Return to Contents Slide 38. References Pronovost P, Weast B, Rosenstein B, et al. Implementing and validating a comprehensive unit-based safety program. J Pat Safety. 2005; 1(1):33-40.Pronovost P, Berenholtz S, Dorman T, et al. Improving communication in the ICU using daily goals. J Crit Care. 2003; 18(2):71-75.Pronovost PJ, Weast B, Bishop K, et al. Senior executive adopt-a-work unit: A model for safety improvement. Jt Comm J Qual Saf. 2004; 30(2):59-68.Thompson DA, Holzmueller CG, Cafeo CL, et al. A morning briefing: Setting the stage for a clinically and operationally good day. Jt Comm J Qual and Saf. 2005; 31(8):476-479.Return to Contents Slide 39. Photo Image: Black and white photo of a young child playing in the sand.Return to Contents Slide 40. CUSP + CAUTI Process and Prevention Mary Jo Skiba, RN BSNProject Manager QI/ResearchImage of various medical equipment, including an IV bag..Return to Contents Slide 41. Objectives Apply CUSP interventions to CAUTI project.Remove barriers/identify steps to successful.CAUTI project initiation Use CUSP to maintain success.Return to Contents Slide 42. Science of Safety Education Education done prior to CAUTI.Safety survey to identify at-risk departments.Mandatory science of safety training.Return to Contents Slide 43. Project Planning CAUTI Team.Policies.Awareness campaign.Data collection plan.Project start date.Education Plan for follow-up.Images to the right of the text include a photo of stick figures circled around a light bulb and a photo of a construction site with many large cranes.Return to Contents Slide 44. Project Planning Establish and engage CAUTI team members: Involve frontline staff – Respect the wisdom.Have a physician champion Include charge nurses/staff development.Engage an executive leader.Identify defects: Review baseline data – CAUTI rateBrainstorm safety concerns.Determine the scope of your initial project.Policy - Urinary catheterization: Review, revise, consolidate.Use policy in toolkit.Don't re-create the wheel.Return to Contents Slide 45. Project Awareness Hospital newsletter.Fliers.Screen savers.Image: Flyer example by KEYSTONE HAI titled "Bladder Bundle Project": Preventing Catheter-Associated Urinary Tract Infections.Return to Contents Slide 46. Data Collection Data collectors.Data forms – Add qualifiers specific to your hospital.Ensure understanding of project requirements.5 days week – Monday through Friday (not weekends).Data entry with Web-based program.Indications: Acute urinary retention or obstruction = 1.Perioperative use in selected surgeries = 2.Perineal and sacral wounds in incontinent patients = 3.Hospice/comfort/palliative care = 4.Required immobilization for trauma or surgery = 5.Chronic indwelling urinary catheter on admittion = 6.Accurate measurement of urinary output in the critically ill patients = 7.Not Indicated Urinary Catheters Reasons: Urine output monitoring OUTSIDE intensive care = 8.Incontinence without a sacral or perineal pressure sore = 9.Prolonged postoperative use = 10.Others = 11 (include those transferred from intensive care, morbid obesity, immobility, confusion of dementia, and patient request).Return to Contents Slide 47. Planning Education Identify Defects -- Plan Ahead to Prevent RoadblocksNursing: Who will be trained?Who will train?How will we train?When will we train?How will we do makeups?How much ongoing training or re-training needed?Physicians Who will train?How will we train?When will we train?Return to Contents Slide 48. Educate on the Evidence Didactic: CAUTI face-to-face inservice.All nursing/aide.Guideline for prevention of CAUTI.Physician CME.Department meetings.Demonstration of insertion competency.Return to Contents Slide 49. Developing CAUTI Education Don't re-create the wheel.Use other hospitals' PowerPoint slides.Multiple CAUTI toolkits.Update/revise to fit.Return to Contents Slide 50. CAUTI Education Trained the trainers.Engaged frontline staff.Image: Flyer that explains how catheter-related infections can occur.Return to Contents Slide 51. Urinary Catheter Insertion Competency Traveling mannequin.100 percent of aides and all nurse frequent inserters (ED, OR, WHU, IP rehab, ICU).Read policy.Take quiz.Perform procedure.Instant remediation and repeat demonstration.Return to Contents Slide 52. Evaluate - Learn from Defects 167 Competencies.Average 15 min/staff member.41 aides, 126 nurses.Improper cleaning: 26Improper gloving: 24Contaminated field: 45Didn't know needleless cath port for specimens 30Return to Contents Slide 53. Execute New Plan Improvement plan for competency.Require field competency all aides within 2 months, supervised by RNs.Newly hired aides trained by RNs.Yearly aide hands-on demo of competency.Return to Contents Slide 54. Other Strategies Caths flagged with date of insertion.Secured to legs.Specimen collection for culture: Don't use first urine drained from catheter ED patients.Prior to collection, change catheter unless known change within 7 days Inpatients.If catheter in for 7 days must change prior to specimen collection.Perineal hygiene prior to cath."John Door" educational posters.Return to Contents Slide 55. Outcome = Culture Change Image: Graph showing that at the start of the initiative there were 3.25 CAUTI's/month and by the end there were 1.7 CAUTI's/month.Return to Contents Slide 56. Identify Why Defects - (Increased)CAUTIs Cath competency plan not followed.Focus was on EMR implementation.Daily cath patrol not consistent.Prevalence rates up.Image: Bar graph showing "No Indicated Reason for Catheter" nearly doubling from 30 to 60 from January 2009 to July 2010.Return to Contents Slide 57. Execute New Plans Annual competency aide and ED/OR nurses.Imbedded competency orientation/annual skill evaluations.Agenda item every leadership/staff meeting.Charge nurse daily cath patrol.Feedback monthly staff and physicians.Return to Contents Slide 58. Execute New Plans Build cath necessity into EMR.Consider decrease size standard cath - #16 to 14.ED data capture of cath necessity.Return to Contents Slide 59. CUSP - Not a Linear Process "You might have to fight the battle more than once in order to win it." (Margaret Thatcher)Don't worry alone. CUSP is a team sport."Shoot for the moon. Even if you miss, you'll land among the stars." (Les Brown)firstname.lastname@example.com to Contents Slide 60. Polling Questions Have you ever heard of the Comprehensive Unit-based Safety Program (CUSP) before? I have never heard of CUSP I have heard of CUSP, but have not implemented it I have heard of CUSP, but have not successfully implemented it.Have implemented CUSP successfully and actively using it in my unit.My senior executive regularly attends safety meetings on my unit, and can identify the top three safety issues that our safety team is currently working on: Very rarely attends and is out of touch with our unit safety issues.Intermittently attends, and is somewhat aware of our unit safety issues.Attends whenever possible, and is aware of our unit's top three safety issues.By ensuring that your senior executive is a part of your safety team, meeting monthly with your unit team, and holding your unit team accountable for improving risks surrounding a hospital inquired condition, my unit will be successfully utilizing the executive partnership component of CUSP? No, not at all.Not sure.Yes, those are the main elements of the executive partnership component of CUSP.Return to Contents Current as of March 2012 Internet Citation: CUSP: A Framework for Success (Slide Presentation): On the CUSP: Stop BSI. March 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/cusptoolkit/contentcalls/framework-slides/frameworkslides.html


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Top 10: Modular Shelving Systems
Modern & Modular. Everyone needs storage in small spaces. Whether it's used for displaying our precious collections or hiding all our clutter. Or maybe both! For this Top Ten we've gathered some old favorites and exciting, newer options. (You've got to love the Bouroullec brothers!)...
• Ronan & Erwan Bouroullec's Self System for Vitra.
• Deiter Rams' Vitsoe 606 Universal Modular Shelving.
• Jasper Morrison's Oak Table Modules for Cappellini.
• Tetrad from Brave Space.
• Time to come out of the closet? elfa.
• Anna Castelli Ferrieris' Componibili Storage Units for Kartell.
• Peter Marigold's Make/Shift.
• IKEA's standard IVAR Shelves
• Doron Lachish's Cubits and Cubitec for Design Within Reach...
We left most IKEA products off of this list beacuase while modular in theory, they rarely stand up to disassembly and reinterpretation.
Personally, we use Cubitec and Componibili.
Additionaly, Topdeq has a few options but nothing that blew us away. While we'd love to include Philippe Nigro's Sans Titre, it appears to be just a prototype. We're fully expecting MUJI to make this list in the Accessible category when they open their first U.S. flagship store!
5 Comments
AS4 shelving from Atlas Industries. Just lovely, it will be my first purchase when I win the lottery.
Any thoughts on smartfurniture.com? I've got a modular shelving set that I purchased from them a couple of years ago and it's great! You design your system using their graphics package on the website, where you drag and drop components to get exactly what you want. They then figure out how many connectors you need, and then you buy it. Easy! Also, they offer shelves which are shallower depth than most others I found, which was exactly what I was looking for.
The Cubitec is a good idea but just too plastic for me. I am looking for modular shelving made out of wood. Preferably I would like to be able to see it before I buy it. The only thing I have seen to date is a product from the Door Store which is $400 for little unit to $700 for a larger one. I am talking about the Stiletto and the Diamond bookcase. Also Pier 1 has a stacking T shelf but again seems overpriced for the size. But if I cant find anything else I might break down anyway. I would even be willing to stain unfinished wood if I can find it. Anyone have any ideas where I could find this in the 5 boroughs?
You can always borrow Jasper Morrison's idea (or was it Martha Stewart</A>? and why is this link not working? see below) and use any old benches and footstools and stack for shelving.
Have you seen the new wall system from Get Back Inc? I saw it at the New York Design Center's What's New What's Next show today and it is amazingly versatile. There's a movie about it at www.getbackinc.com


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- Sam Ash Gift Guides
- Hot Deals
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- Bass
- Accessories
- Live Sound
- Keyboards
- Microphones & Wireless
- Recording
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- Books/DVDs
- Band/Orchestra
Vox VT 80 Plus Modeling Tube Guitar Combo Amplifier
Peavey 6505 Plus 112 1x12" Guitar Combo Amp
The Peavey Bandit 112 Guitar Combo Amplifier captures all the vintage tone from a tube amp all within a solid state amp.The Peavey Bandit 112 was first introduced at the NAMM show in 1995 where they set up a blind A/B comparison between their new TransTube amp and a real tube amp. Many professional musicians were shocked to find out that the Bandit 112 was in fact a solid state amp because when compared with the real tube amplifier nobody could tell the difference.
|TransTube Series
|Bandit 112
Reviewed by 2 customers
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Comments about Peavey Bandit 112 Guitar Combo Amplifier:
This is a revision of my previous review titled "Good choice if mostly playing at home".
Recently I made some changes to the instruments I am using this amp with, and discovered a few things which improved my rating of this product a bit. After changing these things, even though I liked my tone, I was getting as much or more hum from the amp as before and it was bothering me so I experimented a bit. What I found was that the problem all along was that I was playing too close to the amp. Now, the product isn't entirely blameless here. In order to do away with the hum, I need to play at least 12 feet away from the amp. Other amps I've used had a much smaller radius of interference. But, for sure some of the problems I noted in my review below were really a result of playing too close to the amp. I'm guessing that might explain the variability of reviews of Bandits, since different players have different setups and some might be playing closer to the amp than others.
But, now that I've figured out how to get rid of that hum, by playing farther away from the amp, I have to say I am liking the this product quite a bit more. Unlike tube amps, you can get some very nice overdrive sounds without having to crank it, and without resorting to pedals. For home use, this really is much more practical than a tube amp.
Most of what I wrote in the original review I still feel is applicable to this product, except I think it was wrong to write that "noise" was a weakness. Once you move far enough away form the amp, it's near silent. I still do think there's a bit of an issue here, because the radius of interference is so wide, more than a lot of other amps out there. But, if you've got enough room to play 12+ feet away from the amp, either on stage or at home, I don't think you need to worry about hum/noise.
Best Uses
Comments about Peavey Bandit 112 Guitar Combo Amplifier:
Solid State Versus Tube
As far as solid state amps go, this one is a decent choice. But, there are some tube amps that are not much more expensive and sound a lot better for blues and classic rock.
The reason I chose solid state is that I wanted a good amp for playing at home at medium-low levels, that sounded better better than a little practice amp, and which I could use for gigging without a PA if needed. The 12 inch speaker is probably the main thing I needed, as opposed to most practice amps with 10 inch speakers that really don't give you a significant bass response. Most tube amps really don't sound so great unless they're turned up loud, which I can rarely do at home (unless they're low wattage and you can mic them up to a PA for your gigs). This solid state amp can sound very nice at low levels, thanks to the T-Dynamics control, which simulates tube saturation and is adjustable so you can simulate a lower wattage or a higher wattage amp. This is especially nice on the Clean channel.
If you are considering this amp when both the 2006 (red stripe) and 2007 (black and chrome) are available, you might be more pleased with the older of the two models since there's more fine control of this T-Dynamics feature on the red stripe model.
Tone - Clean Channel
The clean channel with the vintage voicing sounds great for Blues. With the T-Dynamics turned down (simulating a lower wattage amp) you can get some very warm overdrive even at modest volume. If you have some overwound or otherwise high output pickups, you might like this as your lead channel too.
Tone - Lead Channel
The Lead channel with the vintage voicing sounds okay with the pre-gain below 4 or so. More gain than that and I find it starts sounding really, well, solid state. I never use the modern or high gain voicings, for that same reason, just the vintage voicing.
The switch for Tight/Loose resonance is probably my favorite feature of this amp (along with the T-Dynamics). On Loose, it really creates a big sound, and I love it for playing some dirty blues-rock like Black Keys songs. Anything with a stong bass line where you want some thumping going on.
Multi-Effects Compatibility - The biggest weakness I've found is that I haven't been able to get a decent tone with my Boss multi-effects stompbox. I've tried various combinations of putting effects before the amp, in the effects loop, directly into the power amp, and it's all pretty bad. The sound is very digital, and noisy (hum and buzz). I've used the stompbox with tube amps and I can get a nice sound and a lot less noise. It might depend on the specific of the multi-effects unit (Boss versus Line6 versus Vox), but I think in general this is not a great choice of amp if you regularly play with one of these multi-effects units.
Lack of Master Volume - This amp has direct inputs into the power amp section (Line In, and Effects Return), and the Resonance and T-Dynamics controls are present in the power amp section, but there's no master volume control. This is an issue for me because my multi-effects unit doesn't have a very easy to access master-volume control, and just about the only configuration where the multi-effects sound halfway decent is when they're directly into the power amp. It has a single pedal, but when using that for wah, for example, you can't easily control volume.
Noise - I mostly play with single coil guitars, and this amp is much worse than most tube amps I've played in terms of how much the hum is noticeable as gain is turned up. I've had to get rid of all the compact fluorescents and dimmer switches in my house because with gain above 2 or so, the hum is just too much. I had a Fender Deluxe Reverb tube amp in the same setup at home, and the hum was barely noticeable even at high gain. Not really fair to compare this with a Fender tube amp, but I think the point is that this solid state amp doesn't pair so well with single coil guitars, homes/studios with some rf interference, or noisy effects units.
This review is based on playing with a copper-shielded Standard Stratocaster with both stock and upgraded (GFS) pickups, straight into the Bandit and on occasion with a BOSS ME-33 in front of or in the effects loop.
The manufacturer's warranty covers guitars, basses, amplifiers, pre-amplifiers, mixers, electronic crossovers and equalizers for two years from date of purchase. An extended warranty is available for three additional years of coverage if a warranty card is completed and returned within 90 days of purchase. The warranty excludes damage from misuse, abuse, and contains other exclusions.


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Northern Ballet Leeds
Thursday, May 26th, 2011
Central Leeds has claim to so many cultural venues and one of those venues is the Northern Ballet. The Northern Ballet is a dance centre that is home to the Northern Ballet Company but also it is a vibrant centre for performing arts and dance classes. Situated in Quarry Hill the Northern Ballet is a popular venue for many of the guests staying at Residence 6 luxury serviced apartments. There is always a varied range of performances – truly something for everyone. (more…)
Category Culture, Music / Tags: Tags: Northern Ballet Leeds, /
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Julie Wendell lives with her 2 sons in Naples, FL. She is an office manager/dispatcher for an A/C company. Her ultimate goal is to be an advocate for Fibromyalgia and Celiac Disease awareness.
Chronic-Illness.org invites you to read Julie Wendell's Fibromyalgia story:
Read the rest of this entry »
Index to Chronic Fatigue Syndrome, CFIDS, Myalgic Encephalomyelitis Sucks t shirt and gift idea design
Whether you refer to it as Chronic Fatigue Syndrome (CFS), Chronic Fatigue Immune Dysfunction Syndrome (CFIDS), or Myalgic Encephalomyelitis (M.E.), the name alone cannot convey the devastation brought about by having to cope with this condition. The "fatigue" in the name refers to much more than just being tired. Those who suffer from this condition experience a fatiguing condition similar to how one feels when you have the flu. Only with the flu, you eventually get better. Imagine dealing with those muscle aches, the weakness, headaches, and other symptoms on a daily basis and you know how someone with CFS feels on a good day.
For more information, see: What is Chronic Fatigue Syndrome?
Or refer to this information:
(Revised) There are lots of diet plans to choose from. Each has its own claims to fame — or at least its promise of a more healthful eating lifestyle. Part of the problems with those diagnosed with syndromes and conditions like Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM) is that not everybody experiences exactly the same symptoms. For example, some with Fibromyalgia have Irritable Bowel Syndrome (IBS); others do not. Therefore, the same as not every treatment plan works for everyone diagnosed with CFS or FM, there isn't a "one size fits all" eating regimen either. Many find they must match their diet with their (for lack of a better word) form of their disease, syndrome, or condition.
Index for CFS/no respect design
When confronted with a Chronic Fatigue Syndrome, CFIDS, or Myalgic Encephalomyelitis (M.E.) diagnosis, it helps to keep abreast of the latest treatments and information. This is especially important because your family and friends may be having difficulty understanding the changes in you — especially when you don't understand those changes yourself.
These sites have Chronic Fatigue Syndrome support newsletters:
Excerpt from:
10 Natural Remedies That Can Save Your Life
by James F. Balch (Doubleday, April 1999)
How do you manage your time when your body seems to be sabotaging your every effort to do so?
Anyone who copes with the turmoil caused by Chronic Fatigue Syndrome, Fibromyalgia, or another disabling conditions for which one of the primary symptoms is devastating fatigue knows how difficult it is to plan your time. It's true: Nobody seems to have enough time at his or her disposal. But most people can predict with a degree of certainty how they'll feel from one minute to the next. Predictability is a key to optimal time management. That's the stuff of which time studies are made — or broken.
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Our society as a whole is very goal-oriented, and when you have a chronic illness like Chronic Fatigue Syndrome or Fibromyalgia you may feel discouraged when you can't accomplish as much as "everyone else" does. Setting goals gives you a way to work toward and measure your accomplishments.
Fibromyalgia — which is also sometimes referred to as Fibromyalgia Syndrome, Fibromyositis, Fibrositis, or Myofascial pain syndrome — is a chronic disorder characterized by tenderness in localized areas of the neck, spine, shoulders, and hips sometimes referred to as tender points or pressure points.
In addition to the tender points, Fibromyalgia is also associated with other body disturbances, including:
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(Written in 2005)
I took the Terry Schiavo issue very personally.
I'm of the opinion that once a judge sentences somebody with one disability to die an agonizing death from starvation and dehydration, it's just a matter of time before that bar is lowered to include another disability and then another….
Welcome to Chronic-Illness.org.
Proceeds from this Web site fund chronic illness and chronic condition awareness and support.
In addition to the chronic illness- and chronic condition-related articles, information, and t-shirt and gift idea designs on this site, Chronic-Illness.org is also the home of the Chronic Illness Realities comic strips.
Pammy is the main character in two comic strips by Pamela Rice Hahn, the first of which is the Writing Woes comic strip. Pammy is a writer who is also disabled because of chronic illness and chronic conditions, so she also appears in the Chronic Illness Realities comic strip.


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Police: Man broke $2,400 signMarch 02,2013BENNINGTON A Farley Drive man was charged with a felony Monday after police said they believed he broke a wooden sign on Elm Street on Feb. 1 that cost nearly $2,400 to replace.
Matthew Bortell, 27, of Bennington, pleaded innocent in Bennington criminal court to a felony count of unlawful mischief resulting in more than $1,000 in damage.
In an affidavit, Officer Thalia Hudson, of the Bennington Police Department, said she was dispatched about 2:45 a.m. Feb. 1 to Elm Street. At the scene, Hudson spoke to a woman who said she had heard the sign for Edwards Investments being broken and saw two men leaving the area.
Hudson said Bortell was spotted on Main Street a short time later. While Bortell admitted to being on Elm Street earlier in the morning with another man, Hudson said he wouldnt give police a last name or address for the other man and denied breaking the sign.
Staff at Edwards Investment gave police an estimate of $2,390.46 to replace the sign.
Bortell has a previous conviction for unlawful mischief resulting in more than $1,000 damage from November 2009.MORE IN This Just InA Rutland judge has denied Christopher Sullivan's motion to exclude an expert's testimony from... Full StoryMayor Christopher Louras endorsed Rutland County State's Attorney candidate Rose Kennedy Monday. Full StoryCaramelized leeks bring flavor to mashed to potatoes. Full Story
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- TOMORROW'S HEADLINES TODAY: Patrick McArdle reports and the theft of an $89,000 shotgun, police release a video of the Monday Castleton robbery, O'Gorman reports a lawsuit by a local man claiming his vehicle unlawfully seized, police leave him in cold.
- RICHARD'S POOR ALMANACK: Giles Corey of Salem, Mass., is pressed to death during the Salem witch trials; on this day in 1952, film comedian Charlie Chaplin, while traveling to England, is denied re-entry into the United States by U.S. attorney general.
- RICHARD'S POOR ALMANACK: Dutch father of microbiology Antonie van Leeuwenhoek discovers the existence of one-celled organisms; in 1967, The Doors are booked to play the Ed Sullivan show; in 1858, freedom fighter Dred Scott dies on this day in St. Louis.
- TOMORROW'S HEADLINES TODAY: No money this year for western rail project, Lola Aiken memorialized in Montpelier, Supreme Court Castleton murder suspect will remain in jail, Shaftbury man fires shots from his AK-47 into neighbor's home.
- RICHARD'S POOR ALMANACK: On this day in 1959, Soviet Premier Nikita S. Khrushchev arrives in U.S. for historic 13-day visit; in 1987, Secretary of State George Shultz and Soviet Foreign Minister Eduard Shevardnadze sign nuclear reduction agreement.


text:
Leon Full Bed:
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Does law matter?: on law and economic growth.
- Michael Faure (ed.)
- Intersentia, 2011
- Find it in Pittcat ›
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The tenant of this scholarship is that the common law would be a more efficient system in promoting economic growth than the civil law.
PittCat: K487.E3 D64 2011


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text:
Creating a Hunger-free Bangladesh
Forty percent of Bangladesh's 150 million people live below the poverty line. The country faces enormous challenges of gender discrimination, high population density, youth unemployment and climate change. And, according to Hunger Project Vice President and Bangladesh Country Director, Prof. Badiul Alam Majumdar in a recent radio interview, "hand outs and foreign aid have created a mindset of dependency."
That's where The Hunger Project (THP) and its capacity-building work make the difference. Badiul shared, "Ours is a homegrown strategy. It's grassroots based, women focused and because of that, it is likely to be sustainable...THP does what is missing: unleashing the human spirit; unleashing leadership." (Listen to the full interview.)
Since 1990, The Hunger Project-Bangladesh has become the largest volunteer organization in the country, and is recognized as a leading voice for the rights of girl children. More than 260,000 volunteer animators and youth leaders are now mobilizing millions of others to take self-reliant actions. They are initiating projects such as education campaigns for safe drinking water and sanitation; forming self-help groups for income-generation; and advocating for an end to violence against women. Check out a video of one such animator in action.
Throughout the month of June, during an awareness-building and fundraising tour throughout the United States, Prof. Majumdar shared with hundreds of people how The Hunger Project difference can be seen throughout the villages of Bangladesh. Volunteer animators are deciding on their own priorities, mobilizing their communities to take action and creating a new future: a self-reliant and hunger-free Bangladesh.
You can join us and take action to create a new future by investing now to train and empower the volunteer animators and youth leaders of Bangladesh.


text:
Teaching Kids to Counter Conflict with Compassion
Meeting each child's needs and instilling good conflict resolution skills are critical parts of the hugely challenging job of parenting.
Conflict between children is a natural part of childhood—but the way in which kids learn to resolve their differences can have lifelong consequences, and both mothers and fathers are vital, say experts, in teaching children how to peacefully interact with each other.
"I very much believe children have the skills to work things out," says Inbal Kashtan, author of Parenting From Your Heart: Sharing the Gifts of Compassion, Connection and Choice. "But most of what they've seen modeled is conflict, not the resolution of conflict."
Kashtan leads workshops for parents in which she encourages them to examine how they mediate arguments between children. "Most parents think they need to decide who's right and who's wrong," she says. "I encourage them to look at their role as a combination of being a supportive connection between children and being a model of how to resolve conflicts peacefully."
When there is an argument among children, Kashtan says, adults should try to discover the unmet needs that are masked by aggressive or confrontational behavior, talking to the children about the emotions behind their actions. Both sides in a quarrel deserve understanding, she says, and conflict resolution is more successful when each child gets an empathetic ear.
"When you start this kind of dialogue, the kids relax. They learn to work it out."
Fathers play a crucial part in teaching their offspring how to settle conflict peacefully, says Armin Brott, author of several books on fatherhood, including Father for Life—A Journey of Joy, Challenge, and Change. He says studies have shown that fathers who are involved in helping with conflict resolution have children who are more empathetic to others and less likely to be bullies or engage in violent behavior.
"It turns out to be true more for fathers even than for mothers to be involved," Brott says. "Maybe that's because when Dad says it, it's not just background noise for kids like it may be when Mom says these things all the time."
Men and women tend to respond differently to friction between youngsters, Brott says, with mothers more concerned about a child's emotional well-being and fathers with a physical conflict. "Dads are more likely to just break it up, send people to opposing corners, and punish someone. Moms tend to want to work it out," he says.
Brott cautions parents not to get caught in "gender traps" when dealing with discord, where "Dad says 'Talk to your mom,' and Mom finally says 'I can't deal with this anymore, go talk to your dad.' Neither is giving the child what he or she needs."
Kashtan advocates seeking to identify children's needs when intervening in a conflict, rather than meting out punishment.
"As parents," she writes in her book, "we have a remarkable opportunity to empower our children with life skills for connecting with others, resolving conflicts and contributing to peace…Our conflicts arise not because we have different needs, but because we have different strategies for how to meet our needs."
By focusing on the needs of each person in a conflict rather than seeking to assign blame, Kashtan says, parents may find themselves moving away from using punishment as the primary method of controlling their children. "This is not permissive parenting," she says. "It is parenting deeply committed to meeting the needs of both parents and children through a focus on connection and mutual respect."
Like Kashtan, Brott believes most aggressive behavior in children is a cry for help, and that older children in particular can be taught to identify each other's needs. "They can say 'Why are you doing this? What do you really want?'"
He emphasizes that many times the children who are bullying others are looking for attention or feeling powerless. And while a physical response to aggression should be a last resort, there may be times when it is necessary.
"In the end," he says, "when you've tried everything else, and there's no adult around, and you're being physically hurt, that's the one time when a physical response is not only appropriate, it's required."
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text:
Integral Transforms With The Homotopy Perturbation Method And Some Applications
AbstractThis paper applies He's homotopy perturbation method to compute a large variety of integral transforms. As illustration, the paper gives special attention to the Esscher transform, the Fourier transform, the Hankel transform, the Mellin transform, the Stieljes transform and some applications.
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Bibliographic InfoPaper provided by HAL in its series Working Papers with number hal-00580023.
Date of creation: 01 Jan 2011
Date of revision:
Handle: RePEc:hal:wpaper:hal-00580023
Note: View the original document on HAL open archive server: http://hal.archives-ouvertes.fr/hal-00580023/en/
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Web page: http://hal.archives-ouvertes.fr/
Related researchKeywords: He's homotopy method; integral transforms; linear equations; Type G and spherical distributions; Random variable.;
This paper has been announced in the following NEP Reports:
- NEP-ALL-2011-04-02 (All new papers)
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- Fotopoulos, Stergios B., 2005. "Type G and spherical distributions on," Statistics & Probability Letters, Elsevier, Elsevier, vol. 72(1), pages 23-32, April.
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Personable Community...Well-Kept Grounds...Near Historical Downtown
PROFESSIONAL MANAGEMENT, LOVELY COMMUNITY...put these two together, and you have an unbeatable combination at Plymouth Heritage. We're a personable community located within walking distance of historical downtown Plymouth and close to schools, shopping and fine dining. Get the most from our apartment homes! At Plymouth Heritage we have everything you need: experienced management team, well-kept grounds, secured entry door and easy access to M-14, I-275 and I-96. Visit us today and make yourself at home.
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-- Robert Preidt
WEDNESDAY, Aug. 24 (HealthDay News) -- Chicks and ducklings from
a mail-order hatchery in Ohio are linked to two salmonella
outbreaks in the United States, the U.S. Centers for Disease
Control and Prevention said Wednesday.
Salmonella Altona has sickened 65 people in 20 states and
Salmonella Johannesburg has sickened 27 people in 15
Interviews with 54 of the people infected with the Altona strain
found that 41 (76 percent) had contact with live poultry (chicks,
chickens, ducklings, ducks, geese and turkeys) before they became
ill, the CDC said.
Interviews with 24 of the people infected with the Johannesburg
variant revealed that 17 (71 percent) of them had contact with live
poultry before they got sick.
Federal, state and local public health and agriculture officials
investigating the outbreaks traced both back to chicks and
ducklings from a single mail-order hatchery in Ohio.
People who touch live poultry or anything in the area where live
poultry live and roam should immediately wash their hands
thoroughly with soap and water, and adults should supervise young
children's handwashing, the CDC advised.
The agency also said that mail-order hatcheries, agricultural
feed stores and others who sell or display chicks, ducklings and
other live poultry should provide consumers with health-related
facts, including information about the risk of salmonella
More information
The CDC has more about the risk of salmonella infection from
live baby poultry.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.


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After suffering a pair of shutout losses on the road in consecutive games, the Rangers returned to Madison Square Garden on April 1st in need of a spark. And Derek Stepan provided just that, scoring just 19 seconds into the Blueshirts contest against the Winnipeg Jets. Sprung behind the defense on a neat pass from Ryan Callahan, Stepan wastes no time rifling a shot past goaltender Ondrej Pavelec---the first of two goals he would score in what turned out to be a crucial 4-2 Rangers victory. This win kick-started the Rangers 10-3-1 month of April.
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