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Artist Trust, Seattle / 2016 Benefit Art Auction / Call for Artists
- Deadline
For more information visit:
For almost 30 years, Artist Trust has been fueling individual artists in Washington State through unrestricted grants, career training, opportunities and resources. At the 2016 Benefit Art Auction, a celebratory gathering of artists and arts supporters, we will commemorate this tremendous milestone! Proceeds from the auction are directly invested in artists. Donating to the auction is a wonderful way to sustain Artist Trust's mission of service to artists of all disciplines in our community.
In addition to quality visual art, jewelry and craft, we are also accepting proposals for Art Experiences such as trips to art destinations, creative classes, exclusive performances, screenings, or readings, and behind the scenes tours. Thank you for lending your time and talent to Artist Trust!
Eligible media
All Disciplines, Arts-Related, Craft, Dance, Design, Emerging Fields & Cross-Disciplinary, Film/Media Arts, Folk/Traditional Arts, Literary Arts, Multidisciplinary Arts, Music, Performing Arts, Photography, Theater, Visual Arts, Non-Profit Orgs.


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Ranches For Sale In Nevada
Nevada Ranch Land
Big Creek Ranch
Nestled at the base of the Pine Forest Range, north of Winnemucca, the 1275±-acre Big Creek Ranch is comprised of 675± acres irrigated land, which includes 545± acres of alfalfa ground under 2-pivots, and 350± acres water righted land. Bisected by Big Creek, the Ranch is an outdoorsmens paradise presenting abundant wildlif...
Old Yella Dog Ranch
A classic ranch where early wagon trains traveled the historic Applegate-Lassen Emigrant Trail, the 820±-acre Old Yella Dog Ranch offers privacy and ample water with 250± acres of flood irrigated meadows, year round springs and a 5±-acre, spring fed pond. Situated in a spectacular setting on the edge of the Black Rock Dese...
Disaster Peak Cattle Ranch
Located 20 miles west of McDermitt, NV straddling the Nevada Oregon border 3,345 deeded acres surrounded by 55,000 acres, 7,342 AUMs private BLM permit Runs 700+ cows year round or an excellent yearling operation All pastures contiguous, 7 miles of McDermitt Creek runs year round through the ranch Pre 1909 water rights ...
Milky Way Ranchette
Located 1 1/2 hours south of Reno in beautiful, prestigious Smith Valley Unique ranch home, 3 bed, 2 bath with large bonus room, all on 20 acres Attached 3 car garage Great horse property Eight stall barn Well producing 35 GPM...
26 Ranch
A historic cattle ranch, the expansive 26 Ranch (formerly and known to most as 25 Ranch) is situated in northern Nevada and encompasses 126,018± deeded acres spanning across four counties. One of the largest and oldest ranches in the state, 26 Ranch holds many vested and decreed water rights dating back to the 1870s and 188...
Winnemucca Horse Ranch
Beautiful 10 acre park-like setting ranch in Winnemucca, Nevada. Well kept 2,600 sqft home with 3 bedrooms and 2 bathrooms. Property is on level ground and situated adjacent from miles of open range. There are tons of recreational opportunities on and near the property, ranch is currently used for horses....
Shadow Mountain Estate
Shadow Mountain Ranch compound 12.5 exceptional acres Located 22 miles Northeast of Ely, Nevada In beautiful Duck Creek Basin Great hunting and fishing Visible from balcony of your custom home mule deer, elk, large rainbow and brown trout surfacing on the nearby reservoir Wildlife, fish and waterfowl are abundant Pan...
7 H Ranch
Located on the eastern flank of the Ruby Mountains 55 miles southeast of Elko, Nevada, the 7H Ranch is a quality year-round operating ranch steeped in the tradition and heritage of northern Nevada and the Great Basin. The ranch consists of 3,417 deeded acres largely in a single block along Ruby Valley Road. A separate 40-ac...
Schaefer Ranch
Schaefer Ranch, legacy investment property Recreation, livestock, remnants of old stagecoach, abandoned gold mines Just 10 minutes from Eureka, Nevada Several active springs with water rights from springs, dating back to late 1800s Topography high desert meadow, gentle slope to steeper canyons Spectacular rock formatio...
Currant Mountain Ranch
330 acres in Currant, Nevada, one hour from Ely. Property has water rights, some of which date back to the 1880s. An irrigation well was also recently drilled. Ranch has 3 homes, 4 ponds, and lots of tree cover for wildlife. Seller says 25 lb. rainbow trout can be fished from the 4 ponds. ...
Kunz Ranch
The Kunz Ranch- originally priced at $1,400,000 800 deeded acres with five homesteads Located northeast corner of Nevada near Idaho border Property sits in meadowlands of Blizzard Buttes and Merritt Mountain Spectacular panoramic meadow and mountain views Accessed by maintained Forest Service roads except in the winter...
Heritage Mansion & Ranch Estate
The Heritage Ranch Estate is located in Gardnerville, Nevada in the prestigious Carson Valley, just 30 minutes from Lake Tahoe. The approximately 9,625 sq. ft. Brick Mansion along with 240 prime acres is a rare offering of an historic Nevada ranch property. Reminiscent of a southern plantation or a Bar Harbor Maine summer c...
Woodward Ranch - REDUCED
WOODWARD RANCH 1,536 DEEDED ACRES QUINN RIVER VALLEY, HUMBOLDT COUNTY, DENIO NEVADA The Woodward Ranch is one of the few remaining Nevada ranches that have remained family owned for nearly a century. The ranch is located in the Quinn River Valley approx. 120 miles northwest of Winnemucca NV. Just off of Hwy 140. The ranc...
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Re-use of this article is permitted in accordance with the Terms and Conditions set out at http://wileyonlinelibrary.com/onlineopen#OnlineOpen_Terms
Influenza H1N1 (swine flu) vaccination: a safety surveillance feasibility study using self-reporting of serious adverse events and pregnancy outcomes
Article first published online: 5 APR 2012
DOI: 10.1111/j.1365-2125.2011.04142.x
© 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society
British Journal of Clinical Pharmacology
Volume 73, Issue 5, pages 801–811, May 2012
Additional Information
How to Cite
Mackenzie, I. S., MacDonald, T. M., Shakir, S., Dryburgh, M., Mantay, B. J., McDonnell, P. and Layton, D. (2012), Influenza H1N1 (swine flu) vaccination: a safety surveillance feasibility study using self-reporting of serious adverse events and pregnancy outcomes. British Journal of Clinical Pharmacology, 73: 801–811. doi: 10.1111/j.1365-2125.2011.04142.x
Publication History
- Issue published online: 5 APR 2012
- Article first published online: 5 APR 2012
- Accepted manuscript online: 15 NOV 2011 02:08AM EST
- Received; 22 July 2011; Accepted; 26 October 2011; Accepted Article Published Online; 15 November 2011
- Abstract
- Article
- References
- Cited By
- H1N1 vaccination;
- post marketing;
- safety surveillance
• While the new H1N1 vaccines underwent the usual rigorous safety and efficacy testing, concerns remained that there may be unexpected side effects of the vaccines.
• The strategy for H1N1 vaccine pharmacovigilance in the UK consisted of two patient studies by the two vaccine manufacturers, 14 small scale studies supported by the National Institute of Health Research, monitoring by specialist neurologists and the MHRA.
• There were calls to investigate the feasibility of a large-scale prospective active surveillance system for 'near real-time' vaccine safety monitoring that would be complementary to the other aforementioned initiatives.
• This pilot study demonstrated that collecting 'near real-time' reporting of event data from patients who experienced side effects as well as those who reported no problems after swine flu vaccination is feasible.
• The use of information technologies improves patient involvement in research as well as dramatically limiting the cost of the study.
• The online methodology facilitates rapid surveillance in response to urgent safety issues.
During the global H1N1 influenza A (swine flu) pandemic 2009–2010, swine flu vaccines were expeditiously licensed and a mass vaccination programme for high risk groups, including pregnant women, was introduced in the UK. This pilot active safety surveillance study was performed to establish the feasibility of rapidly monitoring the new swine flu vaccines in large patient numbers receiving or offered the vaccination under normal conditions of use within a short time frame.
A cohort design with safety data capture through modern technologies was carried out in Scotland, UK during the winter swine flu vaccination programme 2009–2010 in individuals receiving or offered the swine flu vaccination. The main outcome measures were self-reported serious adverse events (SAEs) and pregnancy outcomes.
The cohort comprised 4066 people; 3754 vaccinated and 312 offered the vaccination but not vaccinated. There were 939 self-reported events (838 different events), 53 judged to fit SAE criteria by the investigators, with nine judged as possibly, probably or definitely vaccine related. None of the seven deaths (six in vaccinees) were judged as vaccine related. One hundred and twenty-eight women reported 130 pregnancies during the study with 117 pregnant at study start. There were reports of four miscarriages in three women and six possible congenital abnormalities in live births.
Overall, no significant safety issues were identified. The methodology and use of modern technologies to collect safety data from large numbers of patients was successful and could be used again in similar safety studies.


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October 14, 2015
Jane After Dark: The Wire - season four ends, alliances shift
by Jane Boursaw, posted Jul 26th 2009 6:00PM
Well, well, well. How interesting to see the purchase of the nail gun we saw in the first episode of season four of The Wire come back around to bring everything together. "It's a tomb," says Freamon in "A New Day," and it all makes sense to me. Well, some of it makes sense anyway.
And then there's the teetering decision of whether Freamon will keep getting crap from the higher-ups about going out and looking for Marlo's bodies, using up manpower, and upping the murder rate of the city, or whether they'll do the right thing and actually do their jobs. Oh, the bodies that rolled in.
Jane After Dark: The Wire, season 4 - The kids are not alright
by Jane Boursaw, posted Jul 19th 2009 1:01PM
I'm well into season four of The Wire (just finished "Margin of Error"; read my other Jane After Dark installments), and getting into the guts of the Baltimore political scene and how it's all interwoven with the cops and drug business.
Oh, those kids! It really makes you see how they've gotta be extremely driven to get out of that life, because a lot of the adults are just priming them to continue the drug business into the next generation. Not only their parents -- which is really sad -- but people like Marlo, who has his minions handing out back-to-school cash to build goodwill with the kids. At that rate, those kids don't have a shot of clawing their way out of a life of crime.
It will take me another run-through or two to really fit all the pieces together, but I'm digging how all of the characters have evolved ... or not ...
Jane After Dark: The Wire, season three - Oh, Stringer!
by Jane Boursaw, posted Jul 12th 2009 10:03AM
Well, holy cow. I did not see that coming, although from what you've all said, I was prepared for just about anything to happen on The Wire. Except that!
I feel like season three ended on a high note. Well, sort of ... at least for McNulty, now walking the beat in the Western Division. Even though he's wearing a uniform, which is just weird for him, he's talking and laughing with the residents, and that's really what it's all about. And Rhonda and Cedric are together (oh, that chiseled butt of his!).
Even with all the busts, though, the drug business sails onward, with Marlo moving up in the hierarchy and Dennis' boxing gym virtually deserted, all the kids lured back into the streets. But mostly, season three was all about Episode 11, "Middle Ground"; in particular, a few penultimate scenes...
Jane After Dark: The Wire, season 3 - Stringer wears a suit, Omar gets rash
by Jane Boursaw, posted Jul 5th 2009 2:05PM
After a brief break to watch season four of Weeds last week, Jane After Dark is back with The Wire. I'm half-way into season three, and while there are definitely parts of this show that put me to sleep (ducking and running for cover), it's still a brilliant drama. My teenage son popped in for part of an episode, decided it was too "real," and promptly lost interest.
To help me organize my thoughts, let's take a look at a few characters:
Stringer Bell. I'm really digging Idris Elba dressed up in his fancy suit, running the real estate company, working with government officials, and holding drug meetings using Robert's Rules of Order. It's fascinating that there's this whole hierarchy within the gangs that most of them respect and follow.
Jane After Dark: The Wire - Season two ends, the Sobotka clan crumbles
by Jane Boursaw, posted Jun 20th 2009 3:16PM
As John Howard noted in the comments in last week's Jane After Dark column, I really haven't talked much about Omar yet. I just finished season two of The Wire, and to be honest, most of my thoughts right now revolve around the Sobotka clan.
First of all, how stupid was Ziggy? The guy's always been a live wire, and you could see the bad karma building throughout this season, with him flashing money around, showing off his Italian leather coat, and going a little bonkers with the stolen Mercedes. Things were bound to go bad for him, and they did just that when his deal with Double-G went oh so wrong.
Jane After Dark: The Wire season two - on the waterfront with Amy Ryan
by Jane Boursaw, posted Jun 13th 2009 2:06PM
I'm three episodes into season two of The Wire. I tried watching it online as Usama suggested in last week's Jane After Dark comments (thank you for that awesome site!), but decided to just buy the DVDs, because I stop and start a lot and need easy access to it. So I looked around town and found a fairly reasonably priced season two at FYE. It's new; no one seems to have any used sets, which makes me think - as you all have suggested - that no one ever gets rid of their DVDs of The Wire. They keep them around to watch again and again. I'll probably just buy each season as I work my way through the series.
And speaking of starting and stopping, The Wire does not get any easier to watch while doing something else at the same time. Whenever I try to do that, I end up replaying those parts again, because there's way too many subtleties to be only half-paying attention.
Jane After Dark: I'm still watching The Wire
by Jane Boursaw, posted Jun 7th 2009 3:31PM
I just watched the last episode of season one of The Wire. You guys are right. It's good stuff. Most of season one was pretty slow-going, but things started to kick in during the last few episodes, about the time Greggs got shot.
As in last week's Jane After Dark column, I'm still a bit lost on exactly what's happening, but that doesn't seem to really matter. The characters are so interesting to watch. It's almost like you're watching a documentary about the real thing, rather than a scripted TV show. I took the suggestion of some of you and started watching with the subtitles on. It really does help!
I noticed that Alan Sepinwall is also blogging on The Wire -- and writing a masters thesis on each episode. He even has two different versions -- one for newbies and one for veterans. I'm the anti-Sepinwall, just trying to grasp the storyline and get the basic gist. But I did read his newbie editions and found them helpful.
As in last week's Jane After Dark column, I'm still a bit lost on exactly what's happening, but that doesn't seem to really matter. The characters are so interesting to watch. It's almost like you're watching a documentary about the real thing, rather than a scripted TV show. I took the suggestion of some of you and started watching with the subtitles on. It really does help!
I noticed that Alan Sepinwall is also blogging on The Wire -- and writing a masters thesis on each episode. He even has two different versions -- one for newbies and one for veterans. I'm the anti-Sepinwall, just trying to grasp the storyline and get the basic gist. But I did read his newbie editions and found them helpful.
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Environmental Standards Companies in Ontario
Category: Monitoring & Testing ×
Subcategory: Environmental Standards ×
Industry: Forestry & Wood ×
Location: Canada ×
Location: Ontario ×
based in London, UNITED KINGDOM
Ecometrica is passionate about clear, correct, and meaningful environmental management that helps businesses meet their sustainability challenges, reduce costs, and increase overall performance. We help our clients measure their environmental impacts, from carbon, energy, paper, waste and water management all the way through to full supply chain accounting. We have global ...
Oxford Instruments Industrial Analysis
based in Abingdon, UNITED KINGDOM
Oxford Instruments designs, supplies and supports high-technology tools and systems with a focus on research and industrial applications. Innovation has been the driving force behind Oxford Instruments` growth and success for over 50 years, and its strategy is to effect the successful commercialisation of these ideas by bringing them to market in a timely and ...
SGS - Climate Change Programme
based in Geneva, SWITZERLAND
Our services can help you whether you are eligible for the EU Emission Trading Scheme (ETS), have a Clean Development Mechanism (CDM) project or simply want to report to one of the growing number of voluntary or state-based initiatives. Our climate change program will help facilitate your trade in GHG emissions. By promoting the standardization of verification procedures, ...
Babcock & Wilcox MEGTEC
based in De Pere, WISCONSIN (USA)
Babcock & Wilcox MEGTEC provides environmental compliance solutions that make economic sense. B&W MEGTEC offers a portfolio of proven, high-efficiency technologies including wet electrostatic precipitators, scrubbers and liquid atomization systems for particulate and acid gas control, DeNOx and evaporative gas cooling, regenerative thermal oxidizers (RTOs) for VOC ...
NSF International
based in Ann Arbor, MICHIGAN (USA)
National Sanitation Foundation, we changed our name to NSF International in 1990 as we expanded our services beyond sanitation and into global markets. The letters in our organization`s name do not represent any specific words today.NSF International for the development of public health standards and certification programs that help protect the world's food, water, ...
Weston Solutions, Inc
based in West Chester, PENNSYLVANIA (USA)
Weston Solutions, Inc. (WESTON) delivers integrated environmental, sustainability, property redevelopment, energy, and construction solutions. Dedicated to making a difference in the world, our 1,650 people have been reaching out from 60 offices around the globe responding to our clients` toughest problems for more than 55 years.
Trinity Consultants
based in Dallas, TEXAS (USA)
For over 30 years, Trinity Consultants has assisted industrial facilities nationwide with a myriad of environmental issues. Our regulatory compliance services include air permitting, air dispersion modeling, and compliance auditing. We also provide environmental management services related to compliance management, ISO 14001 compliance, and emissions trading. In addition, ...
Environnement S.A
based in Poissy, FRANCE
Environnement S.A is the leading company in the field of instrumentation for the environment. Ever since its creation in 1978, Environnement S.A has been dedicated to the study, development, manufacture and supply of advanced on-line gas, particulate and water analyzers, using the most recent technologies. Environnement S.A proposes a comprehensive range of continuous ...
SEI Industries Ltd.
based in Delta, BRITISH COLUMBIA (CANADA)
SEI Industries Ltd. is an industrial fabric products manufacturer best known for its invention of the world-famous Bambi Bucket which is used by helicopters to drop water on forest fires. Today, operating from a full-service 48,000 sq. ft. (4,460 sq. m.) manufacturing facility located in Delta, BC, Canada, SEI supplies more than 45 unique products that serve more than 50 ...
Forestry Suppliers, Inc.
based in Jackson, MISSISSIPPI (USA)
When Jim Craig started this company in 1949, packages wrapped for Parcel Post shipment to customers were loaded on a Red Wagon and pulled to a nearby post office. Today, Forestry Suppliers, Inc. is a direct-mail supplier for natural resource professionals worldwide. Our annual catalog features thousands of quality products for the forestry, environmental science, ...
Need help finding the right suppliers?
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text: More from SI Report: Dodgers release pitcher Freddy Garcia Report: Dodgers release pitcher Freddy Garcia Marshawn Lynch sports gold cleats for Super Bowl Marshawn Lynch sports gold cleats for Super Bowl Louisville vs. FIU: Game time, live stream, TV coverage Louisville vs. FIU: Game time, live stream, TV coverage Pittsburgh-area high school football player dies after... Pittsburgh-area high school football player dies after... Close Tweet0 Share0 Comment0 Share0 Share0 Stumble It0 Print0 More SI Wire Caron Butler To Meet With The Clippers For Second Day In A Row by Will Yoder Email Posted: Tue Dec. 6, 2011 Free agent Caron Butler is scheduled to meet with the Los Angeles Clippers for the second time in two days today, according to ESPN Los Angeles."Caron was really happy with the meeting," Butler's agent Raymond Brothers told ESPN Los Angeles. "We were really impressed by (general manager) Neil Olshey and (coach) Vinny Del Negro. I think they've got a good young team that can win. Caron had a really good feeling about it."Butler, who missed a large chunk of last season's championship run by the Dallas Mavericks due to an injury, played one year in Los Angeles for the Lakers in 2004-05. Butler has also already had one meeting with the Chicago Bulls and Dallas Mavericks, and is expected to also meet with the New Jersey Nets, San Antonio Spurs and the Detroit Pistons, according to ESPN.Last season Butler averaged 15 points, 4.1 rebounds, and 1.6 assists per game in just 29 contests for the Mavericks. His best season came in 2007-08 when he averaged 20.3 points, 6.7 rebounds, and 4.9 assists for the Washington Wizards. The Clippers finished fourth in the Pacific Division of the Western Conference last season with a 32-50 record. Promoted Stories Comments


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2000 Dodge Dakota • 100,000 miles
Hi, a co-worker of mine has a 2000 dodge dakota 3.9 litre engine, the engine will not warm up or blow heat, the guage just moves off the first line, he has replaced 3 thermostat's a new heater core and just recently a new water pump, other than using c4 to finish the job, what do you think could be the problem, thx Greg
March 17, 2013.
March 17, 2013.
The only thing that comes to mind where I have seen this happen after what you have already done to the truck is the ambient temperature being so cold that the car does not even heat up. Were talking -25 to -35 degrees outside. Even with a block heater and cardboard over the radiator they struggle VERY much to warm up.
The radiator cooling fan being continually on could also cause this situation.
When i start my truck i hear and ticking noise and it does NOT go away after it warms up or it does not go away at all. When i accelerate the ticking noise gets faster and when im ...
5 answers • 2010 Chevrolet Suburban • 143,000 miles
I am replacing my engine in my 2003 Hyundai Tiburon. It is a 4 cylinder vehicle, but all the engines I am able to find are 6 cylinder engines. Is it possible to replace a the 4 cylinder...
1 answer • 2003 Hyundai Tiburon • 132,000 miles
If i took out my 91 toyota carolla engine what other cars would it be compatible with?
4 answers • 1991 Toyota Corolla
1990 Toyota Camry mileage: 150,000. 1. The oil warning light is on. 2. There are four quarts of oil in the car. 3. The oil filter is dry. 4. The engine sounds rough. 5. There is noise ...
3 answers • 1990 Toyota Camry • 150,000 miles


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Animal prints are EVERYWHERE!! No, this is nothing new but I just feel like I have seen more animal hide inspired looks that ever before. What do you think??
(photo from COCOCOZY)
Another view of the room.
Just one wild chair adds some edge.
(photo from Bromeliad)
The shape of this sofa is so beautiful and the leopard print gives it some sass!
(photo from Design Crisis)
Just a touch of zebra in a white bathroom. Love! Try High Fashion Home's Curved Zebra Bench.
(photo from Dust Jacket)
Dalmatian inspired wallpaper!! Cute!
(photo from Little Green Notebook)
Tiger print rug!
(photo from HGTV)
Leopard print stairs?!
(photo from Indulgy)


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Gift cards > | Order by 7pm for next working day delivery > | FREE Click and Collect at over 100 UK stores >
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Product info
Give Merida some time off for a pampering with the Disney Princess Merida Colourful Curls Doll With Hair Gel.
Merida's arrow satchel is actually a secret storage of glittery blue hair gel to match her beautiful blue eyes. Untwist the arrows to reveal the hair wand to sweep through her curls.
There are also three gem hair clips to finish Merida's new look. You can even pop the clips in your own hair!
Suitable for fans aged three and above.
Rated 4.9 out of 5 by 9 reviewers.
Rated 5 out of 5 by magnoli9 Merinda the best Got this for my daughter and she loved it. Very pretty doll and it was perfect for her. 26 March 2015
Rated 5 out of 5 by Richard01 Great Purchase This Merida doll was a great purchase at a good price. I had put the regular Merida doll in my cart when this option popped up on the side. My daughter age seven went wild because it comes with a bow and arrow set. She loves to play with her new doll. 30 November 2014
Rated 5 out of 5 by Kayla1 DAUGHTER LOVES IT!!! My daughter is 3 and loves this doll!!! She wants to play with it all day! 22 November 2014
Rated 5 out of 5 by yavoral the great presfor Merida-Lovers For those who likes this cartoon it's the best present. Good quality. It will become your best toy. 24 May 2014
Rated 5 out of 5 by spoiledangelbaby2001 Merida!!! Ever since my daughter saw Brave she has asked for a Merida doll, so I bought this one for her for her birthday. She thinks that she is great. I only gave her 4 stars for appearance as I think she should have a different dress on. This is not the dress most little girls will be expecting her to wear. I also only gave her 4 stars for age appropriateness as the hair gel is a bit messy and should be only used under adult supervision. But otherwise a very good doll. 25 February 2014
- Age
- 3 years +
- Height
- 28.0 cm
- Width
- 13.0 cm
- Depth
- 3.5 cm
- Weight
- 0.25 kg
- Manufacturer
- Mattel
- Manufacturer Number
- Our Product Number
- 518059
- Safety Information


text:
Page 1
1 Improving Clinical Access and Continuity through Physician Panel Redesign Ritesh Banerjee, Ph.D.1,*, Hari Balasubramanian, Ph.D.2, Brian Denton, Ph.D.3, James Naessens, Sc.D.1, Douglas Wood, M.D1, James Stahl, M.D.4 1Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester MN; 2Department of Mechanical and Industrial Engineering, University of Massachusetts, Amherst MA; 3Department of Industrial and Systems Engineering, North Carolina State University; 4Institute of Technology Assessment, Massachusetts General Hospital. * Dr. Banerjee completed this paper while working at the Mayo Clinic. His current affiliation is Analysis Group, Inc., 111 Huntington Ave., 10th Floor, Boston, MA, 02199 Correspondence to: Hari Balasubramanian Department of Mechanical and Industrial Engineering University of Massachusetts at Amherst 160 Governors Drive Amherst, MA 01003 413.577.3208 (Tel) 413.545.1027 (Fax) Email: firstname.lastname@example.com Running Title: Improving access through panel redesign Key Words: Primary Care Access, Continuity of Care, Systems Engineering
Page 2
2 Word Count: 3391 Number of references: 32 Number of Tables: 3 Number of Figures: 2 Acknowledgement: Authors have no financial disclosures. We would like to thank Liang Wang, Jason Egginton, and Sara Hobbs Kohrt for help with preparing this manuscript.
Page 3
3 Improving Clinical Access and Continuity through Physician Panel Redesign Running Title: Improving access through panel redesign
Page 4
4 ABSTRACT Word Count: 213 Background: Population growth combined with the increasing prevalence of chronic disease due to aging is projected to increase the demand for primary care services in the United States. Objective: To use systems engineering methods to design physician panels that improve access to and continuity of care. Design: We use numerical and simulation techniques to design physician panels based on appointment and capacity data for 2004-2006 from a primary care group practice of 39 physicians with over 20,000 patients at the Mayo Clinic in Rochester, MN. Measures: Patient waiting time and patient/clinician continuity, i.e., the number of times patients redirected to see a provider other than their primary care physician (PCP). Results: Waiting time decreases by 57% [95% CI: 54.5%-59.5%] and continuity increases by 54% [95% CI: 50.8% - 57.2%] in simulations that use the optimal panel design produced by our numerical technique. The new panel design remains more efficient (less waiting, more continuity) than a standard practice up to adding an additional 3500 more patients to the new system. Conclusions:
Page 5
5 Our simulation results indicate that redesigning primary care physician panels using numerical techniques that trade-off access to and continuity of care has the potential to increase the efficiency of primary care practices and may therefore help mitigate the expected shortage of PCPs.
Page 6
6 INTRODUCTION Recent estimates have suggested that the US faces an impending shortage in the number of primary care physicians (PCPs).(1) These projections are based on forecasts of both the needs of an aging population, and the number of PCPs who are likely to be in practice in the near future.(2) An increasing number of Americans have at least one chronic condition.(3) Current projections estimate that, due to an aging population, 25% of Americans will have multiple chronic conditions by 2020.(4) PCPs, typically the first point of contact between patients and the health system, play a particularly important role in the management of chronic health problems, like back pain, asthma, diabetes, hypertension and heart disease. Older patients, who often have multiple chronic ailments, need careful management by a physician who has broad expertise and can spend the time necessary to understand and manage their care. Some authors find a strong positive relationship between primary care and greater utilization of preventive services.(5) More effective use of primary care reduces unnecessary and inappropriate specialist care. Moreover, greater access to primary care reduces mortality-rates and is associated with system-wide positive effects, including a more equitable distribution of health within populations.(5) Insufficient primary care access appears to be rising and has perverse consequences 40% of emergency department visits are reported to take place because patients are not able to access their PCP.(6) From 1997 to 2001, the percentage of people reporting an inability to obtain a timely appointment rose from 23% to 33% and in 2001, 43% of adults reporting an urgent condition were unable to receive care when they wanted. (9) Equally as important as access is continuity of care. Patients who regularly see their own PCPs are 1) more satisfied with their care 2) more likely to take medications
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7 correctly and 3) less likely to be hospitalized.(7-10) Conversely, not seeing your own PCP can have an impact on efficiency and effectiveness of care provided (11) including increasing the number of follow-up appointments.(12) Patients without a regular health care provider also may be at higher risk of injury or adverse outcome.(13) The use of unnecessary invasive diagnostic tests, or studies with risk, increases with physician unfamiliarity with a patient.(14) Mainous et al. (2001) (15) found that roughly only 65% of US patients in their study reported seeing their own PCP when they needed care. Several proposals have been advanced to solve the problem of shortage in access to primary care. Chief among these is payment reform which would reward physicians for the quality rather than the quantity of care they provide (pay-for-performance) (16,17) or payments for care coordination (medical home).(18,19) Some have proposed incentives for patients to choose primary care providers.(22) The method we explore to increase access and continuity of care is to improve the efficiency of physician panels – the set of patients cared for by a physician. While others have proposed management of patient demand, such as implementation of the advanced access paradigm (26), we consider an alternative approach that simultaneously optimizes supply and demand through the restructuring of patient panels. For a more technical discussion of related work, see Balasubramanian, Banerjee et al. (32). How might the design of a physician's panel affect the ―efficiency‖ of a practice? Size alone is not the only important factor. Together, the number of patients in a panel and their disease burden composition determine the panels aggregate demand for health care services. Optimally choosing a size-composition combination will allow a practice to improve the care existing patients receive by reducing wait times for appointments and increasing the frequency at which these patients see their own provider, as well as, allow
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8 new patients to enroll, since good panel design may open up previously unavailable physician capacity. METHODS Baseline data We examined the panels of a primary care group practice at the Mayo Clinic in Rochester, Minnesota. The practice consists of 39 physician panels and covers approximately 20,000 patients living in Olmsted and surrounding counties. Since a period in our model corresponds to one week, we collected weekly appointment and capacity data for each physician from 2004 to 2006. An example of the variation in appointment request rates can be seen in Figure 1 where we plot the distribution of weekly visits for three categories of patients. The three distributions illustrate how differences in appointment request rates can be attributed to gender and age. For our analysis, we divided patients into 14 age categories of five-year increments starting at age 18 and going through age 83. We further divide patients by sex so that we end up with 28 categories in total. We chose this classification for simplicity as suggested by Murray. (20) The 39-physicians in the Mayo (Primary Care Internal Medicine) PCIM practice cover 20,000 patients in Olmsted County in Rochester, MN. After accounting for part-time and other activities (e.g., education and research), the practice group is equivalent to 17 physicians working full time. The average panel size is approximately 1200 patients per physician panel. To obtain panel sizes more representative of the typical practice (~ 2000/provider, see (23)), we used the following method. We increased the total empanelled population to 34,000, while keeping the proportion of people in the different
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9 demographic categories the same. The FTE adjusted panel size thus increased from 1200 per physician to about 2000 per physician on average. Note that the composition of patients in the new panels is unchanged relative to the original panels. We also removed physicians who worked less than a day a week on average from our analysis. In summary, our experimental clinic has 33 physicians who cover 34,000 patients. We use this modified data set to compare the baseline design against the optimal and capacity based designs. Panel outcomes In order to evaluate whether panel design can increase effective capacity, we have developed a model of patient access to a primary care group practice in which the guiding principle is the trade-off between timely access and continuity of care. Thus our model seeks to choose a panel design that balances these two key, but opposing, forces. On the one hand, timely access to care often necessitates a need to see any available physician. This, however sacrifices continuity of care and brings with it the attendant problems described in previous sections. A prudent choice of panel design – the ―optimal panel design‖ – is one that jointly maximizes timely access and continuity of care. While we compare designs based on timely access and continuity, we also report on the utilization of the clinic. Specifically, we report two measures: the number of unfilled slots in any week for the entire clinic, and the number of extra slots (additional capacity) that the clinic needed on a weekly basis to meet demand. Model Description
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10 In essence, the panel design problem is an allocation problem: given a set of health categories, and a number of physician panels in a group practice, how many patients from each category should be assigned to each panel? Consider a simple example with three patient categories and three physician panels as shown in Figure 2. The three categories have a total of 220, 370 and 450 patients, respectively, while each physician can see a maximum of 35 patients in one week. Demand from each category for the week is assumed to be 10% of category size. The number of patients from each category assigned to each physician's panel is indicated on the arrows in the figure. The dashed lines indicate redirection of flow for the single-week model. Redirection means that patients have to see another provider since their PCP is unavailable. The panel design in this example is not optimal; however, if the number of patients assigned from category 3 to panels 1, 2 and 3 is changed to 20, 12 and 13, respectively, all patients would see their own PCP. With an additional week, redirections could either be to the same provider in the next week (implying waiting 1 week for an appointment) or to a different provider in the same week. These are shown using solid arrows in the figure. The model's complexity significantly increases when there are multiple weeks, the number of appointment requests for each panel is a random variable, and physicians have a different capacity in each week due to vacations or other commitments. In some panel designs, physicians may have unfilled slots in one week and an over-full calendar in another, which will adversely affect patient waiting time and continuity of care. Physician and staff morale and satisfaction may also suffer. Optimizing the composition and size of panels thus becomes important. Model Instantiation
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11 To find the optimal panel design, we formulate the model as a Stochastic Linear Program,(21) which we solve using numerical techniques. Such methods are an important methodological area within the field of systems engineering, and have been applied to many problems in other service industries including the design of financial portfolios, design of transportation systems, and airline management. (22) The computed optimal panel design is evaluated over 52 weeks using discrete event simulation which allows us to calculate summary statistics like average waiting time and the number of redirections to other providers. The simulation works in the following manner: physicians start with an empty calendar in the first time period, which in our case is one week. In each week, patients make appointment requests that are satisfied on a first-come-first-served basis; if a request was made in an earlier week, it is filled first, and ties between requests in the same week are broken arbitrarily. When a physician's calendar in a week is full, patients can either choose to wait for a future week to see their own provider, or they can see another physician in the same week (provided capacity is available). If capacity is not available, extra slots are added to accommodate these patients. A fraction of patients chooses not to wait additional weeks. In our model, we assume 40% of patients decide to see other physicians in the same period. We base this estimate on the rate observed at the primary care practice at Mayo Clinic. A fraction of patients (50% in this case) who are redirected to other physicians are subsequently asked to follow-up with their own PCP. This feature captures the idea that seeing another physician generates additional follow-up appointments. (23) In the discrete event simulation model, we sample randomly from historical visit data for each of the demographic categories from 2004-2006. However, in order to factor
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12 in seasonality, for any given week we restrict our sampling within an eight week window around that week (four weeks on either side). Each physician has a weekly schedule that we use to determine weekly capacity. The results we present are averages of 50 replications of the simulation for each design. Model Assumptions Our model is based on the following assumptions: 1. We divide patients into categories based on age and sex. 2. There are multiple time periods . 3. Physician capacity is fixed in a time period but may vary between time periods. Assumption 1 is a simple way to categorize patients. We discuss alternative methods below. Assumption 3 says that physician capacity is taken as given and is not a decision variable in our model. This can also be modified to account for additions to staff or changes in how a practice is managed. Panel Strategies The above information can be used to create panels that generate a relatively stable appointment request rate which would allow practice managers to better plan their staffing needs to optimize continuity while meeting expected demand for appointments. One strategy is to populate each panel with patients from categories that generate appointment request rates which are negatively correlated with each other. In a context where there are two categories of patients, this means that when the request rate from one group is high, the request rate from the other group tends to be low and vice versa. When there are many groups, this is equivalent to choosing the panel composition such that the
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13 total variation in request rates is minimized given an expected level of requests. This principle was first proposed by Markowitz (1952) (24) in the context of designing a diversified portfolio of assets. Our results indicate this concept can be applied to the design of physician panels to maximize timely access to, and continuity of, care. We compare the results from our optimal panel design arrived at through our numerically solved Stochastic Linear Program with two other designs, also using discrete event simulation. The first, which we call the baseline design, is the design currently used by the PCIM practice. The baseline design allows a comparison of the optimal design with current practice, and helps benchmark the improvements in timely access and continuity that can be expected if the practice were to reallocate its patients optimally. We also compare the optimal design with a simpler and easier to implement rule of thumb that we call capacity-based panel design. We construct these panels as follows: we tabulate each physician's average share of the total average weekly capacity of the group practice. So, if physician A sees patients on average for 40 hours a week out of a total of 200 hours of patient-time by the group, her share is 20%. We use this proportion to calculate her share of each category of patients, that is, physician A is assigned 20% of each category. Thus, the capacity-based design is an intuitive allocation that allows us to evaluate the performance of a practice in which panels are balanced based on average physician capacity. Case Study: Adding New Patients to the Practice Our age-sex categorization reveals that in this particular primary care practice, younger adults of both sexes tend to ask for appointments less often. What would happen to the access metrics if we increased the number of patients from these categories? As the
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14 demand for primary care doctors increases in the United States, practices are routinely faced with decisions regarding whether to empanel new patients. In panels that had young patients, we increased the number of such patients by 25% which corresponded to 3500 more patients in the system. We analyze how the different panel designs perform under this scenario. RESULTS Baseline Design As displayed in Table 1, based on the actual assignment of patients to PCPs, the mean waiting time was 0.81 weeks and there were on average 400 redirections to other physicians per week . Capacity-based Design The bottom row in Table 1 shows that the capacity-based design produces an average waiting time of 0.42 weeks and 218 redirections to other physicians per week. Note that this design is 49% better in wait time and 46% better in the number of weekly redirections relative to the baseline. Optimal Design Table 1 shows that the optimal design reduces wait time by 57% [95% CI: 54.5%-59.5%] and the number of weekly redirections by 54% [95% CI: 51.8% - 56.2%]. Clinic Utilization
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15 Table 2 shows the average number of unfilled slots (unused capacity) and the additional or extra slots the clinic had to create to meet urgent requests. Note that in any given week, if one of the measures is positive, the other has to be zero. The numbers in the table are averages of the two measures over 52 weeks. The optimal design and capacity-based design require fewer extra slots to be created on average. However, they also have a higher number of unfilled slots on average per week. Increasing Panel Size Results are shown in Table 3. Waiting times and redirections increase under both the current and optimal designs. In sensitivity analysis the optimal design does better on both metrics with 2000 additional patients than the current design without additional patients. Our simulation suggests that this finding remains valid with up to 2500 additional low-request patients in the system. Moreover, fewer numbers of high-request patients, or some combination of the two, could also be added to the system. DISCUSSION Optimizing panel structure leads to reductions in wait times and maximizes continuity. A closer look at the model results reveals that the stochastic linear program algorithm better matches physician capacity with historical demand from each category of patients. Thus, physicians who have less patient-time on their schedule are given proportionally fewer patients from categories that tend to request more appointments and vice versa. The capacity-based design also performs quite well relative to the base-case for the same reason: physician capacities under this method are well matched with appointment demand.
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Tramble, 5-foot-8, 175 pounds, will be a key piece in Tecumseh's push for the playoffs. He has rushed for nearly 1,000 yards this season behind strong offensive line play, and he adds a running threat to go with the throwing ability of 6-foot-5 senior quarterback Colton Owen.
"We stress that we need to run and throw, and we've been able to accomplish that this season, especially the last two weeks," George said. "Julian has been a big part of that. He's a young man that in four years has never missed a practice, a kid you can always count on. He plays defensive back for us, too, and makes an impact on that side of the ball as well.
"We've just got to take care of business. The last two weeks, we've done what we needed to do, so we've got to stay focused and keep that up."


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StarbucksJune 27, 2014Coffee Shop • Miami, United States
New pastries are very delicious. Try the chocolate croissant and the spinach square
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New pastries are very delicious. Try the chocolate croissant and the spinach square
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Great for the kids. Free wifi and massage chairs for adults. Go on the weekdays if at all possible. Weekends are crazy.
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Best croquetas in Miami. Also, they now have whole wheat bread.
Bring your own ice. No ice machine. Wtf?
That Stephen P guys being the mayor here sometimes is a joke. This is MY Starbucks! Lol
This place really sucks. They're out of everything and the service is terrible. How can you be out of fish in the keys?


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Amazon to pay $1bn for gaming site Twitch: report
Amazon is buying the videogame platform Twitch for $1 billion, bringing it access to millions of people who watch games being played on the site, The Wall Street Journal reported Monday.
Amazon is buying the videogame platform Twitch for $1 billion, bringing it access to millions of people who watch games being played on the site, The Wall Street Journal reported Monday.
Deep in the hilly grasslands of remote Inner Mongolia, twin smoke stacks rise more than 200 feet into the sky, their steam and sulfur billowing over herds of sheep and cattle. Both day and night, the rumble of this power ...
Google's IPO, a decade ago this week, launched the company on a trajectory that continues to reshape its business and much of the world in its orbit.
New analysis by UNSW suggests that renewable investment is likely to be cheaper and lower risk for Australia, since rising and uncertain gas prices make baseload gas-fired electricity high risk and high cost.
Hachette Book Group defended itself Sunday against accusations of pushing up prices for e-books amid a simmering dispute with online retail giant Amazon.
Zynga said Thursday it wants to perform better, as the social games firm reported losses widened and revenues sank in the past quarter, sending its share price tumbling.
The stock prices of companies that use the same lead underwriter during their equity offerings tend to move together, according to a new study by financial economics experts at Rice University and the University of Alabama.
Rupert Murdoch's 21st Century Fox is abandoning its attempt to take over Time Warner in a proposed deal that would have combined two of the world's biggest media companies.
Consumers can save money on their electricity bills and negotiate better deals by joining forces with similar groups of customers to switch energy suppliers according to new research.
Contrary to widespread media reports, the collapse of several financial firms during the 2008 economic crisis was not triggered by unsettled stock trades, according to new research from the University at Buffalo School of ...


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The Human Centipede II (Full Sequence)
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Quantitative Methods - Statistical Concepts And Market Returns
The term statistics is very broad. In some contexts it is used to refer to specific data. Statistics is also a branch of mathematics, a field of study - essentially the analysis tools and methods that are applied to data. Data, by itself, is nothing more than quantities and numbers. With statistics, data can be transformed into useful information and can be the basis for understanding and making intelligent comparisons and decisions.
- Descriptive Statistics - Descriptive statistics are tools used to summarize and consolidate large masses of numbers and data so that analysts can get their hands around it, understand it and use it. The learning outcomes in this section of the guide (i.e. the statistics section) are focused on descriptive statistics.
- Inferential Statistics - Inferential statistics are tools used to draw larger generalizations from observing a smaller portion of data. In basic terms, descriptive statistics intend to describe. Inferential statistics intend to draw inferences, the process of inferring. We will use inferential statistics in section D. Probability Concepts, later in this chapter.
Population Vs. Sample
A population refers to every member of a group, while a sample is a small subset of the population. Sampling is a method used when the task of observing the entire population is either impossible or impractical. Drawing a sample is intended to produce a smaller group with the same or similar characteristics as the population, which can then be used to learn more about the whole population.
Parameters and Sample Statistics
A parameter is the set of tools and measures used in descriptive statistics. Mean, range and variance are all commonly used parameters that summarize and describe the population. A parameter describes the total population. Determining the precise value of any parameter requires observing every single member of the population. Since this exercise can be impossible or impractical, we use sampling techniques, which draw a sample that (the analyst hopes) represents the population. Quantities taken from a sample to describe its characteristics (e.g. mean, range and variance) are termed sample statistics.
Population ® Parameter Sample ® Sample Statistic
Measurement Scales
Data is measured and assigned to specific points based on a chosen scale. A measurement scale can fall into one of four categories:
- Nominal - This is the weakest level as the only purpose is to categorize data but not rank it in any way. For example, in a database of mutual funds, we can use a nominal scale for assigning a number to identify fund style (e.g. 1 for large-cap value, 2 for large-cap growth, 3 for foreign blend, etc.). Nominal scales don't lend themselves to descriptive tools - in the mutual fund example, we would not report the average fund style as 5.6 with a standard deviation of 3.2. Such descriptions are meaningless for nominal scales.
- Ordinal - This category is considered stronger than nominal as the data is categorized according to some rank that helps describe rankings or differences between the data. Examples of ordinal scales include the mutual fund star rankings (Morningstar 1 through 5 stars), or assigning a fund a rating between 1 and 10 based on its five-year performance and its place within its category (e.g. 1 for the top 10%, 2 for funds between 10% and 20% and so forth). An ordinal scale doesn't always fully describe relative differences - in the example of ranking 1 to 10 by performance, there may be a wide performance gap between 1 and 2, but virtually nothing between 6, 7, and 8.
- Interval - This is a step stronger than the ordinal scale, as the intervals between data points are equal, and data can be added and subtracted together. Temperature is measured on interval scales (Celsius and Fahrenheit), as the difference in temperature between 25 and 30 is the same as the difference between 85 and 90. However, interval scales have no zero point - zero degrees Celsius doesn't indicate no temperature; it's simply the point at which water freezes. Without a zero point, ratios are meaningless - for example, nine degrees is not three times as hot as three degrees.
- Ratio - This category represents the strongest level of measurement, with all the features of interval scales plus the zero point, giving meaning to ratios on the scale. Most measurement scales used by financial analysts are ratios, including time (e.g. days-to-maturity for bonds), money (e.g. earnings per share for a set of companies) and rates of return expressed as a percentage.
Frequency Distribution
A frequency distribution seeks to describe large data sets by doing four things:
(1) establishing a series of intervals as categories,
(2) assigning every data point in the population to one of the categories,
(3) counting the number of observations within each category and
(4) presenting the data with each assigned category, and the frequency of observations in each category.
Frequency distribution is one of the simplest methods employed to describe populations of data and can be used for all four measurement scales - indeed, it is often the best and only way to describe data measured on a nominal, ordinal or interval scale. Frequency distributions are sometimes used for equity index returns over a long history - e.g. the S&P 500 annual or quarterly returns grouped into a series of return intervals.
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The Palaszczuk Government has appointed one of Queensland's most respected businesswomen, Renita Garard as the new Chair of the Port of Townsville.
In a statement released earlier today,
New Jersey Governor Chris Christie on Friday said his transportation commissioner Jamie Fox would step down by the end of the month to return to the private sector after only a year in the position.
The first three of the world's largest and most technologically advanced Ship-to-Shore (STS) container cranes and two rail mounted cranes for the intermodal rail
The Maritime Administration (MARAD) has announced a $900,000 cooperative agreement with Totem Ocean Trailer Express Inc. (TOTE) to further develop knowledge
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MARAD provides funding to further study LNG as marine fuel for containerships
The U.S. Maritime Administration (MARAD) announced it has entered a $900,000 cooperative


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Bibliographic Details
Title: Ulysses. In Two Worlds Monthly, Vol. 1, No. ...
Publisher: Two Worlds
Publication Date: 1927
Binding: Soft cover
A complete set of the eleven separately published issues of Two Worlds Monthly, which reprinted Ulysses in a bowdlerized form, unauthorized by Joyce. Original wrappers, some slight wear to spines but an excellent set, preserved in a full morocco clamshell case. Slocum and Cahoon C68. Bookseller Inventory # 23489
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Did buy AIXM today. Makes equipement that makes LED's. Now that is a growth industry. Intel is in a mature industry. Not going anywhere.
Hey! I own that one also. A neat niche and growing fast. Good call! Sell INTC buy AIXM.
What is aixm?


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CMMG Anti-Jam Charging Handle Assembly for Drop-In 22 Long Rifle Conversions AR-15 Polymer Matte
Product #: 963011 CMMG #: 22BA596 UPC #: 815835010168
- Information
The CMMG Anti-Jam charging handle for drop-in 22 long rifle conversion kits was designed to prevent spent casings from jamming. The charging handle features a much more shallow groove preventing the spent brass from jamming between the charging handle and the bolt. The charging handle features a standard latch and is constructed of black high strength polymer. Technical information :
- Standard Latch
- Black Polymer Construction
- Works with CMMG and Other Drop-In Conversions
Delivery Information
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Product ships from MidwayUSA, separate from any other products on your order due to its size. Products that are Shipped Alone incur separate "Per Order" and "Per Pound" shipping charges.
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Product is restricted by shipping carriers and cannot be shipped to certain locations or via certain shipping methods.
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text: Bet33 Sportsbook addresses slow-pay complaint01.17.2013Bet33 (SBR rating D+) has addressed the payout complaint reported by SBR on January 15th. Bet33 admitted that the player had not been paid in four weeks, depsite being on a payment plan after having his account closed with a $8,614 balance three months ago. No reason was given for the delay. The player is allegedly being paid in full in two transactions this week.


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All Mangas Reader for Mac1.5.4
editor's review
1 comment
All Mangas Reader is a straightforward Google Chrome extension specially designed to help you follow your favorite mangas on a wide variety of websites.
Intuitive Manga monitor
The unobtrusive extension is capable to automatically add mangas to your reading list as you read them on the supported websites. You can display blocks of each manga along with detailed info or view them in a simple and easy-to-read list.
What is more, you can group mangas with the same name on a single line, and take advantage of the calendar icon that helps you view the date when the chapter has been published.
Built-in notifier
From the drop-down menu you can effortlessly access the desired chapter with just a few mouse clicks and enjoy your manga in a new tab. On top of that, All Mangas Reader is capable to notify you when a new chapter is published on one of the followed manga webpages.
Advanced search engine
Switching to the Search Manga tab, allows you to search through all supported websites for the title of a specific manga. You can filter the results by language or by website to speed up the searching process. Once you found it you can quickly add it to your list or open it in a new tab.
Furthermore, All Mangas Reader enables you to organize your mangas in different categories, bookmark your favorite chapters and scans in order to find and access them more quicker and easier. You can even synchronize your reading list across computers and enjoy your mangas at home or at work.
Customizable interface
By accessing All Mangas Reader Options window, you can change the color of the popup window, adjust the refresh and update list time interval, change the size of the window and configure All Mangas Reader to update the chapters list every time you launch Google Chrome.
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One of the United States Navy's smaller training centers highlights how virtual training can save big. The 27-member staff of the Naval Safety & Environmental Training Center provides training to some 10,000 Navy personnel and government civilians around the world in 37 courses each year.
Commander Greg Cook said his command began several years ago to look at virtual training as a way to deliver training to students in some courses, sensing looming budget cuts.
The center rolled out a blended eLearning model in 2011 that it brands "Global Online," and its virtual enrollment has grown from 60 initial students to approximately 800 in five classes in 2013, with plans to expand to more than 2,500 students in fiscal 2014.
The command uses an open source educational tool called Sakai – hosted by the Naval Postgraduate School – for the asynchronous training component and Defense Connect Online for the live sessions with instructors. Students can take their classes from anywhere in the world and view their instructors from any personal mobile device.
Cook said his command conservatively estimates that for each student who participates in virtual training, the command saves $800 to $1,200 in travel costs, plus per diem expenses and recovered productivity. Classes that the center hosts range from one to five days long, but students don't have to expend extra time dealing with travel and may – depending on the rigor of the virtual training – be able to continue their duties.
"It used to be either we travel to 9,500 students per year or they travel to us," Cook said. "I think we need to be looking at this technology and make the most use of it we can. We are doing more robust training in the same amount of time while saving students travel and per diem cost, travel time and lost productivity. We're not pushing virtual as a wholesale training solution, but we are using it strategically where it makes the most sense."
Courses that require physical participation, where a student must try on gear, scale a wall or demonstrate other physical skills, are not applicable to the virtual environment, according to Al Melcher, Learning Standards Officer for the Naval Safety & Environmental Training Center. Those courses are still taught onsite, through the command's mobile training teams offsite, or through video tele-training (VTT) remote sites, though VTT will be defunded later this year, Melcher said.
While some courses will always require hands-on instruction, Cook said many courses work as well or better in the virtual environment than they do in lecture halls.
The command's students are able to interact with an instructor on a daily basis because Global Online requires instructors to commit at least an hour per day of live virtual instruction, addressing a challenge typically inherent in distance learning and sometimes even in college lecture halls: a lack of cognitive learning.
Cook said students are asked to do assignments rather than cycle through the PowerPoint presentations of a nonexistent instructor. Because of the combination of tools available in the virtual environment, they're called upon to retrieve information online, essentially forcing active participation.
"Beyond the cost savings, we're seeing an increase in knowledge transfer, and that's really important," Cook said.
"In this venue, because of the availability of using their own personal devices within their environment, the freedom and choice of students is much greater, the availability of training is greater, and we've found that leveraging these tools together provides a training mechanism that increases over and beyond what traditionally you'd have in a lecture-based classroom environment," Cook added.
There have been some challenges as the center has expanded its virtual training, however. Bandwidth is a problem for some students, especially those who go against the center's preference and train while at sea. "Not all ships have high bandwidth, and the video can get a little choppy," Cook said.
Another challenge is change management, Cook said, noting that some managers are of the mentality that online courses are easy enough to do "after hours." The increased rigor of the Naval Safety & Environmental Training Center's virtual course offerings now has some students telling their bosses the coursework might cut into work time.
"Some students need more time to take their classes," Cook said. "Change isn't always easy."
Yet the change to make virtual training a priority is saving the Navy and taxpayers money, and is a method Cook said many other agencies could try, too.
"We have to use the resources we have as they become scarcer," Cook said. "We're facing cuts and our customers are facing cuts."
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ASS330 - Cyborg Anthropology
Unit details
|2016 unit information
|Enrolment modes:
|Trimester 2: Burwood (Melbourne), Waurn Ponds (Geelong), Cloud (online)
|Credit point(s):
|EFTSL value:
Human Possibilities in the Age of Digital Communication
|Unit chair:
|R Kapferer
|Incompatible with:
|Contact hours:
Campus: 1 x 1 hour Class per week, 1 x 1 hour Seminar per week.
Cloud (online): Learning experiences are via CloudDeakin.
The contemporary revolution in digital information and communication technologies has transformed the worlds of human experience and interaction. Recent social movements and popular uprisings are also increasingly mediated through digital technologies and this has led to ongoing debates concerning the regulation and governance of the Internet. In this unit, students will be introduced to anthropological perspectives that engage these issues. What do new technological discoveries and the interaction of embedded technologies tell us about human beings of today? How are human beings imagined and how is human potential being reconceived in the digital age? What will human beings look like and how will they behave in the future? This course will open up new and exciting ways of thinking about the nature of human being in the context of rapid technological and cultural change, as well asking how human experiences of love, death, culture, gender, identity, community, the body, mind, work and leisure are being transformed in the context of new technologies. Cyborg anthropology is about the world transforming event of modern technological development - it is about the new beings that human beings are becoming.
Class and 0nline exercises 20%
Online quizzes 20%
Essay 40%
Multi-media project 20%
Cloud (online):
Class and 0nline exercises 20%
Online quizzes 20%
Essay 40%
Multi-media project 20%
Unit Fee Information
All Commonwealth Supported Place (CSP), fee paying undergraduate and pre-2016 commencing students
Unit fee information available soon
2016 commencing International and full fee paying postgraduate domestic students
Your units are priced based on the course you are enrolled in. Please refer to the current year's course entry to estimate the unit cost.
You can calculate the cost of each unit by using the following calculation:
Course fee x unit EFTSL value = unit price


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Frequently Asked Questions About Celiac Disease 09/30/2015This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc. Subscribe to FREE Celiac.com email alerts What are the major symptoms of celiac disease? Celiac Disease SymptomsWhat testing is available for celiac disease? - list blood tests, endo with biopsy, genetic test and enterolab (not diagnostic) Celiac Disease ScreeningInterpretation of Celiac Disease Blood Test ResultsCan I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful?The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-FreeIs celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic TestingIs there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and DisordersIs there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients)Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients)Gluten-Free Alcoholic BeveragesDistilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free?Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free DietFree recipes: Gluten-Free RecipesWhere can I buy gluten-free stuff? Support this site by shopping at The Celiac.com Store.For Additional Information: Subscribe to: Journal of Gluten Sensitivity
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BasqueMom added a topic in Celiac Disease - Related Disorders & ResearchGluten Free And Dairy Free Diet Brought Total Remission From VitiligoMy 94 year old mother has Alzheimer's. I have cared for her since 2003. She had been diagnosed with vitiligo. She had huge spots on the torso of her body where the pigment had gone away. I had her tested by Enterolab in 2008 because I felt she had gluten and dairy sensitivity. I was correct. The Vitiligo is completely gone and has been for quite some time. I attribute that to her gluten and dairy free diet. This might give other people hope that suffer from Vitiligo.
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BasqueMom added a post in a topic Uveitis, Also Called Arthritis Of The EyeMy daughter has celiac disease and was diagnosed with uveitis. She had been eating gluten free at home but sometimes got gluten when eating out. One of her specialists was so interested in our family history of celiac/gluten intolerance and auto immune diseases that he went on one of the medlines and found an article in French with English heading that said uveitis umproved on a gluten free diet. She went gluten free and he has been astounded at the improvement in her eyesight. So for anyone out there with uveitis, take heart and stick to that gluten free diet.
BasqueMom added a post in a topic Uveitis, Also Called Arthritis Of The Eye
BasqueMom added a post in a topic Celiac And Pancreatic Cancer?I was diagnosed with a mucinous cyst in the tail of my pancreas in 2008. I had surgery and the Dr. removed the tail of my pancreas. Thankfully they found no cancer. I have also been wondering if this had anything to do with me being an undiagnosed celiac for so very many years of my life. I brought up this idea to my gastroenterologist at my last visit. He says pancreatic cancer is or can be genetic. He is the one who diagnosed my cyst as being precancerous by doing an endoscopic ultrasound and biopsy. He takes a very narrow view of celiac disease, as far as I am concerned, and he said that my cyst would not have been caused by gluten consumption. I have never been diagnosed as being a celiac patient by any doctor. I finally did a DNA test several years ago after trying to eat gluten free for some time. I followed the diet carefully and then found out that the flour I was using was brown rice but not gluten free. I inherited the HLA-DQ 4,8 genes. I am assuming the HLA-DQ8 is from my mother's side of the family. She is 90 and we got her tested last year. She is definitely gluten intolerant and carried the HLA-DQ 3,1 (subtype 8,5). They were full blooded Basque and I remember my grandmother being unable to eat much of anything when I was a girl and vomiting often. My grandfather was very short of stature. Interestingly enough the history of pancreatic cancer is on my Dad's side. Assuming that I inherited the DQ8 gene from my mother the other DQ4 gene would have come from him. His mother, my grandmother, was full blooded Italian and the doctor believed that she died of pancreatic cancer. She had sinus problems and had a goiter removed. She died before the days of ultrasound, catscan, etc. From this same Italian side of the family I have lost a third cousin or first cousin twice removed to pancreatic cancer and a second cousin or first cousin once removed who had a cyst in her pancreas like me. All three of my children are gluten intolerant and so far one of my grandchildren. I, of course, do follow the diet which has made a huge difference in the way I feel. I don't understand all the gene issues but am wondering if possibly my Dad carried the gene for celiac also. He always had gastro intestinal issues.
BasqueMom added a post in a topic ScoliosisI am a 66 year old celiac and have scoliosis. I am seeing by the posts that others with celiac also have scoliosis. I have always believed that my scoliosis could be attributed to my celiac disease, and I must not be the only one who believes it. Interesting! No Dr. has ever confirmed the connection but I believe it.


text: I'm 38 weeks and 1 day today. I went to the doctor and he said that i was 50% effaced and 1cm dilated he said my cervix was really soft. I feel stupid asking this at this point but, does this give me any indication on when i can go into labor. I had 2 contractions 9 min apart about 2 hrs ago, well at least i think they were contractions. Please someone give me some light on this.


text: AdChoices Cookie Consent Terms of Use Privacy Policy Hide TOP 10 Top 10 Sports Top 7: Workout DVDs For Men Share Tweet 0 Shares 1. Savage & Serene Cofounder of Aerospace NYC, one of New York's highest-ranked fitness centers, and a former No. 1 middle-weight boxing champion, Michael Olajide takes his fitness seriously. Yet, even if you're not an NYC resident, you can still benefit from Olajide's teachings using Aerospace's latest release, Savage & Serene, a challenging workout with over 3,000 punches that will kick your butt and whip you into shape. Featuring two complimentary workouts, Olajide first leads you through an hour-long professional boxing workout that will have you sweating buckets. A 30-minute, re-energizing stretching session with cofounder Leila Fazel follows. TOP 7 6 5 4 3 2 1 Comments Show Comments More Like This Health Issues 5 Daily Brain Hacks To Keep You Sharp Read More Fitness & Workouts It's Absolutely Crucial To Work Out Your Back - Here's How To Do It Properly Read More Fitness & Workouts Are You Completely Missing Out On This Muscle Group Every Time You're At The Gym? Read More Thrive We Sent An Unsuspecting AskMen Employee To A Mock NFL Combine - This Is What He Learned Read More Fitness & Workouts How To Become An Ironman Read More Top 10 Fitness Want To Get In Shape? Learn These 9 Pull-Ups Read More Around the Web Special Features


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In Spring 2014, Hendrix College installed a new MakerBot Replicator 2 and scanner in the Oathout Technology Center (OTC) inside the Student Life and Technology Center in an effort to inspire new creativity and collaboration.
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Digital Product Management | Marketing Strategy | Writer
Australia - Tests: 8
I am a digital product and marketing development and strategy specialist. Currently creating fast turn around product ideas, process maps and lean canvas models to get your product or communication goal or business case to market for immediate monetisation. Services include ideation, business case support, strategy work, brief and presentation writing, project team support, workflows and systems consultation, workshops and task creation for creative, UI and development, marketing strategy, campaign development, analytics and optimisation. In my previous role at Fairfax I was the Product Owner responsible for the rebuild and redesign of AFR.com (The Australian Financial Review) in Adobe CQ; a adaptive and responsive design that will work on all devices with oversight a team of 30. This agile project consisted of four concurrent scrum teams with all work managed through JIRA.


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Apps: Mickey Mouse: Mash-Up, Tomb Raider, UltraTuner + Yahoo Weather 1.5
Disney's Mickey Mouse: Mash-Up ($4) lets children participate in the "making" of a Mickey Mouse cartoon. Kids can draw a handful of objects that can appear in the short cartoon, which is titled "No Service!" You can then watch your creations appear and interact with them, including scenes in which Mickey and Donald Duck swap clothes, and Mickey has to hide behind objects you've created. Timeless and deliberately silly, the Mash-Up app is good as-is, but could really benefit from additional shorts for kids to play with.
The classic 3-D adventure and shooting game Tomb Raider ($1) from Eidos/Square Enix is now available in the App Store. Interestingly, it's being billed as Tomb Raider I, which suggests that the sequel will be available at some point. The full game from 1996 is included, in addition to two extra "Unfinished Business" chapters included in the 1998 Tomb Raider Gold re-release. Tomb Raider supports iOS game controllers, as well as on-screen input, though the controls remain as dicey as they were decades ago.
UltraTuner ($5) from IK Multimedia is a new instrument tuning app. IK Multimedia claims the app is precise to a level beyond human perception of pitch, and 10 times more accurate than a mechanical strobe tuner. Stage mode lets users tune instruments using a straightforward, simple interface, while studio mode offers wave visualization. In our limited testing, we found the app's results to be impressive.
Yahoo's Yahoo Weather (free) app has updated to version 1.5 with a brand new layout and design for iPad. One of the better-looking weather apps out there, everything has been optimized for the iPad's larger screen, enabling you to see hourly temperature and precipitation forecasts using handy charts. Interactive and transitional animations are also included while viewing the forecasts for multiple cities. iPad users who like Apple's iPhone/iPod touch-only iOS 7 Weather app will find this to be an ideal free tablet alternative.
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