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On What Matters
|Derek Parfit
|Philosophy, ethics
|Oxford University Press
Publication date
|26 May 2011
|Media type
|Hardback book
On What Matters is a two-volume book of moral philosophy by Derek Parfit published in 2011. It is a follow-up to Parfit's 1984 book Reasons and Persons. The dust jacket states that the book is "about reasons, values and morality". The book is introduced by Samuel Scheffler.
On What Matters defends an objective ethical theory and suggests that we have reasons to act that cannot be accounted for by subjective ethical theories. Furthermore, it attempts to present a moral theory that combines three traditional approaches in moral and political philosophy: Kantian deontology, consequentalism, and contractarianism (of the sort advocated by T. M. Scanlon, and from the tradition of Thomas Hobbes, John Locke and John Rawls).[1] According to Parfit, these theories converge rather than disagree, "climbing the same mountain on different sides", in Parfit's metaphor.[2]
Parfit labels his synthesis of these three ethical theories the "Triple Theory":[3]
An act is wrong if and only if, or just when, such acts are disallowed by some principle that is
- one of the principles whose being universal laws would make things go best,
- one of the only principles whose being universal laws everyone could rationally will....
- a principle that no one could reasonably reject.
On Parfit's view, these three criteria (a) represent the best versions of consequentialism, Kantian ethics, and contractarianism respectively, and (b) should generally agree in their recommendations. Both claims have proven controversial.
The manuscript, originally titled Climbing the Mountain, circulated for many years prior to publication, and occasioned a great deal of excitement, including reading groups and a conference prior to publication.[4]
Some of On What Matters is derived from lectures given at the University of California, Berkeley as part of the Tanner Lectures on Human Values in 2002. As part of that series at Berkeley, Parfit's lectures were responded to by Allen W. Wood, T. M. Scanlon and Susan Wolf.[5]
The economist Tyler Cowen has expressed admiration for Parfit's style ("Reading him is an unforgettable and illuminating experience") in On What Matters, but argues:
- I see the biggest and most central part of the book as a failure, possibly wrong but more worryingly "not even wrong" and simply missing the questions defined by where the frontier – choice theory and not just philosophic ethics – has been for some time.[6]
Peter Singer was far more positive, saying that Parfit's arguments "put those who reject objectivism in ethics on the defensive".[7]
Constantine Sandis raises an objection to Parfit's project: the various "theories may well converge on their recommendations, but to think that the actions that follow from them are all that matters is to already presuppose the truth of consequentialism". Sandis jokes that the significance of Parfit's work, despite his scant publication record, should cause us to question the "publish or perish" demands of the Research Excellence Framework, but "whether it will change the way we think about morality remains to be seen".[2]
The sheer length of time Parfit took to produce this magnum opus and the increasing incompatibility of such extended work with the demands of academic life was raised by Nigel Thrift, vice-chancellor of the University of Warwick, in a blog post on the Chronicle of Higher Education website:
- Parfit's life has been able to be intellectually uncompromising because he found the infrastructure – especially All Souls College in Oxford, which does no undergraduate teaching – that allowed it to be. But I wonder how much longer that kind of infrastructure will be available in all but a few universities.[8]
- ^ Mark Schroeder. "On What Matters, Volumes 1 and 2". Notre Dame Philosophical Reviews. University of Notre Dame.
- ^ a b Constantine Sandis (9 June 2011). "Not quite the top of the mountain". Times Higher Educational Supplement.
- ^ Kitcher, Philip (11 January 2012). "The Lure of the Peak". The New Republic. Retrieved 6 April 2012.
- ^ Suikkanen, Jussi (2011). "Parfit's mountain" (PDF) (54): 102–103Issue 54, 3rd Quarter 2011, "Parfit's mountain"
- ^ "2002-2003 Lecture Series". Tanner Lectures on Human Value. University of California, Berkeley. Retrieved 6 April 2012.
- ^ Cowen, Tyler (7 July 2011). "On What Matters, vol. I, review of Derek Parfit". Marginal Revolution. Retrieved 5 April 2012.
- ^ Singer, Peter (13 June 2011). "Does Anything Matter?". Australian Broadcasting Corporation. Retrieved 6 April 2011.
- ^ Thrift, Nigel (21 September 2011). "Derek Parfit and the future of the academic workload". WorldWise. Chronicle of Higher Education. Retrieved 6 April 2012.


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subset: commoncrawl


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Being a Victim of Drunk Driving
Winning a lawsuit after being hit by a drunk driver is fairly easy, but it may be better to file an insurance claim than immediately suing the driver. This is especially important when you live or have been involved in a car accident in a no-fault state.
Alcohol-related accident make insurance claims easier simply because it already shows negligence on the side of the driver/defendant. Every state requires their drivers to carry at least the minimum amount for car insurance. Before filing a lawsuit, ask your injury attorney, such as those from the Hankey Law Office, to talk with the driver's insurance carrier to inform them of your intention to get full compensation for the injuries and damages caused by their client's accident. Because of the evident negligence in the part of their client, they will eventually provide you with a settlement offer for your claim. It is then be up to you and your lawyer to decide whether the amount is enough or fair to your belief.
There are many reasons as to why insurance carriers are ready to settle personal injury claims. One of them is when the client has a record of a DUI or DWI conviction that is also related to a car accident, not connected to yours. Going to trial with a client who has a DUI or DWI conviction will only cost them more money, so settling the case out of court would be a wiser and more cost-efficient option for them.
There are more than a dozen states that follow the "no-fault" law when it comes to car insurance, and in these states your settlement options may be limited. In such instances, you may use your own insurance (through personal injury protection) to cover for your medical expenses and other costs. However, if your injuries and total damages meet the state's description of "serious injuries" you are allowed to file for a personal injury lawsuit or a liability lawsuit against the drunk driver.Read More
Pneumonia: What it is and what you can do about it
Pneumonia is a condition wherein the air sacs in one or both lungs are filled with pus or fluid. This is oftentimes a result of a bacterial, viral, or fungal infection. While healthy individuals usually recover from pneumonia in a few days or weeks, this lung condition can be serious, and may even be fatal, to infants, those with weak immune system, and those who are 65 years old and older.
Signs and symptoms of pneumonia vary depending on its severity. Milder pneumonia may manifest as a flu or cold, only longer. For more serious pneumonia, on the other hand, a person may experience cough with phlegm, and some symptoms of infections, such as difficulty breathing, weakness, fever, sweating, chills, nausea, vomiting, and diarrhea.
There are many causes of pneumonia. Being hospitalized for another illness, for instance, can expose you to pneumonia-causing pathogens. Pneumonia acquired in hospitals is considered severe, because bacteria involved could be resistant to antibiotics. Some pneumonia cases, on the other hand, develop because of aspiration, or inhalation of fluid or food items.
You are also at higher risk of pneumonia if you are living in a community with poor air quality. Pneumonia cases are higher in cities where clean air regulations are more leniently implemented. Unfortunately, some car manufacturers even contribute to the risk by trying to defraud the law. The website of the diesel emissions fraud lawsuit lawyers at the Driscoll Firm says that Volkswagen tried to trick the system by selling cars equipped with special software designed to cheat emissions tests.
If you experience one or more symptoms above, and you think you are at risk of pneumonia, visit your doctor right away for an accurate and prompt pneumonia diagnosis. When left undetected, pneumonia may result in even more serious medical complications, such as abscess in the lungs, pleural effusion (fluid build-up inside the lungs), trouble breathing, and bacteria in the bloodstream.Read More
Visual Driving Distractions
Distracted driving is unfortunately a common phenomenon, part of an everyday lifestyle for many. People eat in their cars, reach for things out of view, divert attention to navigation systems, talk and text on their phones. According to the National Highway Traffic Safety Administration, distracted driving can occur in three different forms, which can also intermingle: visual distraction, cognitive distraction and manual distraction.
Visual distraction involves anything that diverts the driver's attention from the road. Cognitive distractions make the driver's mind wander from the task at hand, and manual distraction is anything that makes the driver remove their hands from the steering wheel. Although this behavior is dangerous for anyone driving, it is particularly hazardous when a truck driver is behind the wheel, and the most common distraction for truck drivers is visual-manual, in the form of using a mobile phone.
Rules of the road are in place to help deter negligent and reckless driving. Truck drivers, in particular, must abide by these rules, as the mere size of their vehicles makes them more dangerous to operate than passenger cars. A study by the Virginia Tech Transportation Institute found that texting while driving was the most dangerous distracted driving behavior truck drivers engaged in, making truck drivers who texted while operating their vehicles nearly 23 times more likely to become involved in a crash or near-crash incident. The Federal Motor Carrier Safety Administration even prohibits cell phone use while operating commercial vehicles, and drivers caught violating this are subject to fines, disqualifications, and even termination.
View more about liability related to distracted driving truck crashes.Read More
Medical Malpractice and Hospital Mistakes
Humans are susceptible to error. People, after all, make mistakes all the time – and often, these mistakes need to be paid for. After all, people are free to choose their own choices but not the consequences that their choices make. Some mistakes, however, can have more devastating consequences than others. One such circumstance where a mistake can cost gravely is a mistake made by a medical practitioner.
Say, for example, that a neurosurgeon is operating on a patient's brain. Due to a second of negligence, the surgeon slips and the patient is then severely injured and paralyzed for the rest of his life. Another example is that perhaps a patient was not properly notified of the side effects or consequences that certain medication or an experimental procedure may cost. There have even been some instances wherein an attending physician ordered the wrong procedure for the patient due to a wrong diagnosis, thereby costing the patient a lot of damage. Statistically speaking, one out of three cases wherein the medical practitioner made a mistake out of negligence results in a fatality.
The aforementioned instances are possible situations that can be constituted as medical malpractice which is, according to the website of John Michael Bailey Injury Lawyers, a subset of personal injury – which means the victim or the surviving family of the victim is warranted to file for legal action against the guilty party.
These cases are largely circumstantial as the situations are never going to be the same as another. This is why it is necessary to get the aid of lawyers who also have sufficient knowledge of medical jargon and procedures, especially specific medical information regarding the case at hand, in order to properly represent the victim in a court of law. Legal action is necessary so that the expenses that are an inevitable result of the injury need not fall as a burden to the injured party.
If you or someone you know has been a victim of negligence from a medical practitioner, it is recommended that reputable legal help in the form of a personal injury lawyer is sought immediately.Read More
Motorcycle Accidents
Two of the greatest advantages of motorcycles over cars are its capability to easily maneuver through traffic and the much lesser amount of gasoline (thus, cheaper gas expenses) that it requires. Besides these, motorcycles also make running errands much easier and faster.
The only major disadvantage motorcycle riders have compared to drivers, though, is their vulnerability to severe injuries in the event of an accident. This is due to the absence of a frame or body, like in other motor vehicles, which would receive the force of impact. Thus, a fender bender, for instance, which is very common in cars, may only cause minor injuries in drivers; to a motorcycle rider, however, this same accident can already be fatal.
To greatly lessen any chances of sustaining severe injuries, as well as significantly reduce any odds of dying in a crash, the American Motorcycle Association (AMA), the world's largest motorcycling organization, encourages its members to always wear a helmet that complies with the safety standards of the U.S. Department of Transportation. This is because injury to the head has always proven to be the most common cause of death among riders. Other than the helmet, the organization also advocates the use of other protective gears, including gloves, protective jacket and pants, and safe footwear.
Motorcycle experts also share the following points for higher chances of riding safety:
- New riders are encouraged to first complete a basic rider course from professional schools
- Having bright colors on the helmet and protective gears will make you more visible on the road and to other drivers
- Watch out for cars turning left in front of you – a cause of accident at intersections
- Only ride as fast as you can to avoid entering a corner too fast
- Be aware of blind spots and always avoiding riding along the right side of other vehicles, especially trucks. If you find yourself in a blind spot (or no-zone area), keep out of it immediately. One very important driving tip to consider is that you should make sure that you see the other vehicle's driver's eyes from their left side mirror because if you do, then there is no reason why they won't see you to
- When riding in a group, always observe proper group riding etiquette. Never make a sudden stop and always make sure that your eyes and attention are focused on the riders in front of you
- Learn how to use your motorbike's front brake. Though use of front brake may be difficult to master, you should know that it is the your motorcycle's most powerful component, as it is able to change your bike's speed much more quickly than the engine can
- Never ride your motorbike at a speed that may prove hard to control on slippery road
- Never ride near parked vehicles. You never know when a careless driver or passenger may suddenly open the vehicle's door
- Never ever drink and then ride. Time and again, this deadly combination has proven to be the most common cause of motorcycle accidents.
On its website, the Pohl & Berk law firm mentions that, despite the proper care observed by riders, accidents still happen because of the failure of other drivers and parties to act safely.
Victims of motorcycle accidents should be aware of their rights to pursue legal action and seek the compensation that the law allows them to receive from the liable party. Thus, if involved in an accident, it is essential to seek the assistance of motorcycle accident lawyers for a better understand of the law and your legal rights and alternatives.Read More
Legal Options for a Spinal Cord Injury
Sometimes, it is easy to forget just how fragile the human body is. Truly, people are just held together by fragile ligaments, bone, and skin – should any one of these be severely damaged, the effects could be lasting and catastrophic for the rest of the victim's life. One of the most delicate parts of the body is the spinal cord and, even if damaged by the slightest bit, can mean immediate, irreversible consequences. Sadly enough, according to the website of law firm Pohl & Berk LLP, many of spinal cord injuries are a direct result out of the negligence of someone else.
One of the most common consequences of spinal cord injuries is paralysis. But it is not limited to just that as the spinal cord is one of the most imperative parts of the human body, responsible for sensation, strength, and mobility and it is exactly these things that can be affected by an injury of this nature. Spinal cord injuries are almost always impossible to reverse with today's technology and so the damage done is truly irreparable.
If you have been made to suffer a spinal cord injury because of someone's negligence, it is your legal right to hire attorneys in order to file your case, in order to hold the guilty party accountable financially for the harm done. Though it may be true that there is no replacing what one has lost when one has suffered a spinal cord injury, the compensation claimed in recompense is most warranted and can be some measure of comfort with adjusting to this new challenge in life.
Dealing with cases that pertain to medical fields is certain to be a very arduous process with paperwork, evidence, and parties that need to be involved. It is advisable for you to seek legal aid that will ruthlessly pursue justice for your case, in order for you to be given closure with what is certainly a traumatic event. There are options available to you as the law is always on the side of the righteous – all you have to do is take it.Read More


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"Colette is a kind of corsetiere of love. This most French of all French writers tells us how love sometimes binds and keeps a woman from breathing freely or how it may shape and support her and help her to be beautiful . . . One thinks of her as the female voice of Paris . . . It's as if all the house fronts of Paris were cut away and we could see men and women talking, dressing, brooding, loving." Anatole Broyard, The New York Times
"This large collection of her stories allows us to share her exhilaration and to sample the pleasure of her prose . . . no other woman seems to have had as much lived experience to draw upon or as much sexual sophistication . . . The voice of worldly feminine wisdom runs through her stories." Phyllis Rose, The New York Times Book Review
"Like a table spread with the fruit and wine she celebrated in her books: 'Late-ripening cherries, rosy peaches, thin-skinned Marseilles figs, misty hot-house grapes and champagne shuddering in carafes of heavy crystal.' A sumptuous display." Patricia Blake, Time


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Father charged in son's death
Spokane County Sheriff's detectives arrested a father Monday and charged him with providing the drugs that caused the overdose death of his son in June at a Spokane Valley motel.
Detectives raided the home at 1833 W. Mallon Monday morning and arrested 49-year-old Kristopher D. Olson. He was booked on charges of controlled substance homicide and delivery of a controlled substance, sheriff's spokesman Cpl. Dave Reagan said.
The detectives are also seeking Beverly Lynn Flanagan, 44, who investigators believe purchased the drugs that killed 22-year-old Kenneth Olson.
On the morning of June 29, paramedics were called to the Red Top Motel, 7217 E. Trent, where they found Kenneth Olson not breathing from an apparent overdose. They were unable to resuscitate him. Kristopher Olson, the dead man's father, was in the room at the time, Reagan said.
Investigators found a bindle of methamphetamine under Kenneth Olson's body. But it took months to get toxicology results back from the state lab, Reagan said.
"We needed to know what he overdosed on before we could establish how he died," Reagan said. "The predominant drug in his system was methadone."
Detectives later found that the two Olsons had been at a methadone clinic on June 28 and left afterward with Beverly Flanagan.
She drove the two men to Kristopher Olson's bank, where she withdrew a substantial amount of cash, Reagan said.
Flanagan then drove to the home of Denise F. Tipke, 51, at 15005 E. Broadway, and purchased 40 methadone tablets from Tipke for $600. Flanagan then delivered the pills to the Olsons, who were waiting in a fast-food restaurant on North Sullivan, Reagan said.
Kristopher Olson later admitted giving some of the methadone to his son, who died overnight in the motel room.
According to state law, anyone who purchases or provides drugs to someone who then dies from an overdose can be charged with controlled substance homicide, Reagan said.
On July 13, Detective Mike Ricketts executed a search warrant at Tipke's home on East Broadway and seized more than $5,000 in cash, scales, heroin and more than 156 methadone tablets, Reagan said.
Tipke has since been charged by summons with delivery of a controlled substance and two counts of possession of a controlled substance with intent to deliver.
Flanagan, who remains on the loose, has been charged with controlled substance homicide, delivery of a controlled substance within 1,000 feet of a school and conspiracy to deliver a controlled substance, Reagan said.
Flanagan is white and stands 5-foot-3, 150-pounds with blonde hair and hazel eyes. She also uses the alias Beverly Sundberg. Anyone with information is asked to call 911.
Saving for the future
sponsored According to two 2015 surveys, 62 percent of Americans do not have enough savings to handle an unexpected emergency, much less any long-term plans.


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Upcoming Events
CEA holds a variety of meetings, conferences and workshops for the benefit of its members. We have annual conferences and also hold workshops in your school district if you request it. We also list conferences of interest for educators. Let us know if you would like us to post your conference here.
July Events
Governor's Council on Climate Change (GC3) Stakeholder Events
July 26
5:30 PM - 7:30 PM (refreshments available at 5:00pm)
The primary/central location will be in Hartford, with 9 satellite locations across the state (from Goshen to Groton and from Norwalk to Killingly). Participants at the satellite locations will view the presentation via video link and then engage in facilitated dialogue at the local level.
The GC3 is seeking input from stakeholders as it develops a set of strategies to achieve the state's mandated goal of a 50% reduction in greenhouse gas emissions below 2001 levels by 2050.
Participants in the July stakeholder events will have an opportunity to learn about the initial results of the modeling scenarios, provide feedback to the GC3 members on the priorities incorporated within those scenarios, and engage in local dialogue about some of the policy implications of the initial results: Which activities should be prioritized for early implementation? What criteria should be used in identifying the communities/regions where we should focus limited resources in the short-term?
August/September Events
Treasurer/Membership Workshops
August 23 1:00 PM CEA Headquarters, Hartford September 1 3:30 PM Spa at Norwich Inn, Norwich September 6 3:30 PM Trumbull Marriott, Trumbull September 13 3:30 PM Crystal Peak, Winchester September 15 3:30 PM CEA Headquarters, Hartford
Treasurer/Membership Chairperson workshops will be held in the evening in four locations around the state this September and we are going to once again do an afternoon workshop in August. These workshops will deal with membership processing procedures, special services, and treasurers' responsibilities including dues obligation/transmittal, tax filing obligations, and agency fee issues. We especially encourage new officers and chairpersons to attend, but recommend that all treasurers and membership chairs attend annually to review procedures.
The entire cost of the workshop, meal included, will be fully paid by CEA. Please call (860) 525-5641 and ask for the CEA business office for any questions or concerns.
If you require special accommodations in order to fully participate in this activity please let us know when you register so that we can make special arrangements
Conferences and Workshops
CEA Representative Assembly (RA)
The CEA RA, held each May, is CEA's highest policy-making body. During two days of business, approximately 500 delegates take action to decide Association policies, including adopting amendments to the CEA RA Standing Rules, the CEA Constitution and Bylaws, approving revisions to the CEA Resolutions, and voting on new business items.
NEA Representative Assembly (RA)
The RA is convened every July during the Annual Meeting. The first two days are devoted to discussions, conferences, and exhibits-but the highlight is the Representative Assembly itself. During this important event, delegates debate issues that impact American public education, elect top officers, and set policy for the 3.2 million-member Association.
New Teacher Conference
Our annual New Teacher Conference offers workshops for new teachers, provides networking opportunities with your colleagues and more!
Summer Leadership Conference
Held for two and a half days in August every year. A variety of tracks, electives as well as leadership training are offered to help you and your local become more effective. Contact Mary Behrens for more information.
Retirement Workshops
Understand and Plan Your Retirement! Workshops are held around the state in the Fall and in early Spring . Any CEA member who wishes to begin planning for retirement is encouraged to attend. It is never too early to educate yourself! Contact Robyn Kaplan-Cho for more information.
Treasurer/Membership Workshops
Held around the state in August and September every year. These workshops deal with membership processing procedures, special services, and treasurers' responsibilities.


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NASA, Associated Press
LOS ANGELES — The NASA rover Curiosity has beamed back pictures of bedrock that suggest a fast-moving stream, possibly waist-deep, once flowed on Mars — a find that the mission's chief scientist called exciting.
There have been previous signs that water existed on the red planet long ago, but the images released Thursday showing pebbles rounded off, likely by water, offered the most convincing evidence so far of an ancient streambed.
There was "a vigorous flow on the surface of Mars," said chief scientist John Grotzinger of the California Institute of Technology. "We're really excited about this."
The discovery did not come as a complete surprise. NASA decided to plunk Curiosity down inside Gale Crater near the Martian equator because photos from space suggested the spot possessed a watery past. The six-wheeled rover safely landed Aug. 5 after a nail-biting plunge through the Martian atmosphere.
Present day Mars is a frozen desert with no hint of water on its radiation-scarred surface, but geological studies of rocks by previous missions suggest the planet was warmer and wetter once upon a time.
The latest evidence came from photos that Curiosity took revealing rounded pebbles and gravel — a sign that the rocks were transported long distances by water and smoothed out.
The size of the rocks — ranging from a sand grain to a golf ball — indicates that they could not have been carried by wind, said mission scientist Rebecca Williams of the Planetary Science Institute in Tucson, Ariz.
Though Curiosity did not use its high-tech instruments to drill into the rocks or analyze their chemical makeup, Grotzinger said scientists were sure that water played a role based on just studying the pictures.
It's unclear how long the water persisted on the surface, but it easily could have lasted "thousands to millions of years," said mission scientist Bill Dietrich of the University of California, Berkeley.
Curiosity chanced upon the dried-up streambed while driving to Glenelg, an intriguing spot where three types of terrain meet. Its ultimate destination is Mount Sharp, a mountain rising from the center of crater floor, but it was not expected to travel there until the end of the year.
Finding past water is a first step to determining whether the environment was favorable for microbial life. Scientists generally agree that besides water and an energy source such as the sun, organic carbon is a necessary prerequisite for life.
While an ancient streambed holds promise as a potentially habitable environment, scientists don't think that it preserved the carbon building blocks of life. That's why the rover will continue its trek to the foothills of Mount Sharp where there's a better chance of finding organics.
Alicia Chang can be followed at http://twitter.com/SciWriAlicia
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text:
Kevin Schmidtchen
Berkshire Hathaway
Home Services
1255 Coast Village
Suite 102B
Montecito, CA 93108
Phone or Text
Phone or Text
(805) 689-6877
Market Statistics / Updates
San Roque Real Estate – Santa Barbara 2016 1st Quarter Update
There has been a lot of real estate activity in San Roque here in Santa Barbara in the first several months of 2016. Sales have been very steady with a good amount of new inventory coming on every week. Currently there are: 8 active listings for sale ranging in price from $900,000 to $1.85 million. 15 homes pending sale / under contract ranging in price from $685,000 to $2 million. 22 closed sales since the beginning of the year ranging in price from $700,000 to $1.85 million. Here below are some informative statistics... Continue Reading >
San Roque Real Estate Year End Review 2015 – Santa Barbara
San Roque Year In Review Overall there was a 12.8% increase in the median sold price for San Roque in 2105. The median sold price was $1.1 million. The lowest sale was $725,000 and the highest sale was $1.975 million. San Roque homes sold for an average of $9 more per sqft. than in 2014. The average was $700 per sqft., the lowest sale was at $423 per sqft., and the highest was at $1,141 per sqft. San Roque homes in 2015 were on the market for an average of 17... Continue Reading >
Significant Real Estate Sales On The Mesa – La Vista Del Oceano, La Coronilla, Harbor Hills, Ricardo
So far in 2015, we have once again seen a very steady active real estate market on The Mesa here in Santa Barbara. One big difference compared to the last few years has been the amount of luxury higher end sales that we have been seeing at the "Top of the Mesa", specifically the newer homes all along the La Vista del Oceano corridor. In this area we have pushed the price point of high end Mesa all the way to the $3.5-5 million plus range. 1702 La Vista Del Oceano is a brand new... Continue Reading >
Montecito & Santa Barbara 3rd Quarter 2015 Real Estate Market Statistics Update
Here are some informative real estate market statistics here for 3rd quarter 2015 Montecito and Santa Barbara CA. The images below compares the average sales price for single family homes in both areas over the last 5 years. As you can see, the amount of sales in Montecito has dropped a large amount this last quarter compared to 2014. This has really been the feel for most of the last month. Many agents are commenting on how slow everything has gotten recently in Montecito and the upper end market. For Santa Barbara proper the... Continue Reading >
Lower Eastside Real Estate Market Update – Santa Barbara
In the Lower Eastside area of Santa Barbara, the real estate market has seen a solid amount of activity since the beginning of the year. Many of the homes that have been on the market were also sold within only a few weeks of being marketed. This is simply showing again that the lower end price point here in Santa Barbara continues to be very competitive. Here are some statistics on the overall market for this area: There have been 27 closed sales in this area since the beginning of the year Sale prices... Continue Reading >
Santa Barbara Bel Air Knolls Real Estate Update
Over the last 12 months, the Bel Air Knolls neighborhood here in Santa Barbara has been pretty active with compared to recent past years. Often months can and do go by in this area with only 1 or 2 homes coming on the market. This has not been the case over the last year, as shown below by the following statistics. There are currently 5 homes on the active market. These homes range in value from $970,000 to $1.65 million. There have been 16 closed sales over the last 12 months. Prices range from $875,000 to $1.8 million. There is... Continue Reading >
Santa Barbara The Mesa Area – Real Estate Market Update First 6 Months 2015
The first 6 months of real estate activity on The Mesa here in Santa Barbara continued to simply replicate what we have been seeing over the last 3-4 years. The Mesa is a very desired area to live in here in Santa Barbara and during the springtime, The Mesa really showcases itself with all the wonderful weather, beach walks, strolls along Shoreline Park etc. As far as demand and value, both of these continued on their upward trends here in the first half of 2015. We have now started to see... Continue Reading >


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|Publication number
|Publication type
|Application number
|Publication date
|Apr 13, 1993
|Filing date
|Dec 12, 1990
|Priority date
|Feb 25, 1988
|Fee status
|Also published as
|Publication number
|John E. A. Wickham, Ronald A. Miller
|Original Assignee
|Wickham John E A, Miller Ronald A
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (7), Referenced by (45), Classifications (19), Legal Events (7)
|External Links: USPTO, USPTO Assignment, Espacenet
This application is a continuation-in-part of applicants' earlier filed application Ser. No. 314,179, filed Feb. 22, 1989, now abandoned.
This invention relates to the presentation of patients for surgical and investigative procedures, especially but not solely for renal endoscopic procedures, and is particularly concerned with a wheelchair in which a patient can be sat and subsequently presented in a suitable position for a surgical or investigative procedure. The invention is also concerned with a surgical or investigative work station at which a surgeon may be seated and at which a patient in the wheelchair can be presented for a surgical or investigative procedure.
While many surgical and investigative procedures involving the use of endoscopes inserted through a natural orifice or a percutaneous access site may take only a short time to conduct, a considerable amount of time is taken in removing the patient from a hospital trolley and placing him or her on an operating surface and then reversing this procedure at the end of the surgery or investigation. Indeed, up to 70% of the time may represent patient handling and only 30% is devoted to the surgical or investigative procedure.
According to one aspect of the present invention there is provided a wheelchair comprising
a frame,
wheels on said frame,
a back rest portion mounted on said frame for pivotal movement from a normal upright inclined position to a substantially horizontal position,
a central seat portion pivotable about a horizontal axis located adjacent the lower end of the back rest portion,
two outer seat portions arranged one on each side of said central seat portion,
means pivotally supporting said outer seat portions for movement toward and away from said central seat portion about axes located near the back rest portion,
two foot rests, and
means supporting a foot rest and attaching it to a respective outer seat portion, the wheelchair being disposed such that a patient can be received in the wheelchair in a semi-recumbent position and the back rest portion and seat portions can be tilted to present the back of a patient in a horizontal position with the patient's legs at a higher level than the patient's head, whereafter the central seat portion can be pivoted downwardly and the outer seat portions pivotted outwardly to present the patient in a position for an ano-reno-genito surgical or investigative procedure.
Each outer seat portion and an associated foot rest attached thereto may constitute a leg support portion with the attachment of the foot rest to the seat portion lying at an obtuse angle to the underside of the seat portion.
Because the back rest portion and the foot rest attachment both lie at an obtuse angle to the seat portion, the position of the patient relative to these portions does not substantially alter when the patient is tilted from a normal semi-upright or rest position into the operative position. The obtuse angles which the back rest portion and foot rest attachment make with the seat portion will normally lie within the range of 100� to 140�. It may be desirable to make the back rest portion and foot rest means adjustable relative to the seat portion so that the angles and positions can be adjusted to accommodate patients of different sizes or proportions, but in most cases such adjustment will be unnecessary and a similar effect might be obtained, for instance, by placing a small cushion in the small of the patient's back.
The arrangement and disposition of the wheels, by which the wheelchair is mobile, may take many forms. In one embodiment, a pair of large diameter wheels is mounted on an axle beneath the seat portion so as to constitute a wheeled frame and the wheels may have hand rings whereby the patient can propel the wheelchair. In this case, a stabilizing wheel or wheels is or are provided and may conveniently be arranged on an arm which depends below the back rest portion and can be folded up to the back rest portion when the chair is tilted into the operative position. The arm, in its folded position, may act as a rest or stop holding the back rest portion in the substantially horizontal operative position or a separate rest or stop may be provided. In a preferred embodiment the back rest portion has attached to it a handle by which a hospital porter or nurse can move the wheelchair and this handle may act as a rest or stop for the backrest portion in the operative position.
In another embodiment of the wheelchair, the chair portions are pivotally mounted on a wheeled undercarriage so that the chair can be tilted from the rest position to the operative position. Preferably means are provided for locking the chair in each of these positions.
If the present chair is to be used in ano-reno-uro-genito-endoscopic procedures, it is necessary to present the patient to the surgeon with the legs of the patient wide apart and with a space between them so that the surgeon can approach the patient. To this end the outer seat portions and associated foot rests are pivotally mounted so that when the chair is in or being moved into the operative position the patient's legs can be parted. The wheelchair may be equipped with means for spreading the outer seat portions apart. The means for spreading the supports apart may be manually operated and include a hand lever or hand wheel, or in a more sophisticated embodiment a lever system may be provided for automatically spreading the outer seat ports apart as the wheelchair is moved from the rest position to the operative position. However, in this case it is desirable to have a manual override to prevent undue stress on elderly patients or patients with no or with restricted hip mobility.
Since it is the intention that the present wheelchair will be used to wheel a patient from a ward or waiting area to an operating or investigating station, it is clear that the wheelchair will not be sterile. Nevertheless, it is important that the wheelchair and in particular the chair portion supporting a patient should be made of or covered with materials which are capable of withstanding washing with disinfectants. Preferably, the wheels and framework of the wheelchair are made of aluminum alloys or even stainless steel, and the chair portions are covered with rubber or plastics, which can be washed with disinfectants, even though the patient will normally sit on a washable or disposable cover laid on the chair.
In the use of the chair, a patient is placed on the chair either in a hospital ward, or, if the patient is an ambulant day-patient, in a waiting area, and is then wheeled to an operating station. On arrival at the operating station, the wheelchair is tilted and the patient is presented to the surgeon in the correct position for an endoscopic surgical or investigative procedure to be carried out. At the end of the procedure, the chair is tilted back to the semi-recumbent rest position and wheeled away, whereupon the next patient can be wheeled up to the operating station so that there is no waste of the surgeon's time at the operating station.
It will be appreciated that apart from operations and investigations conducted in the ano-genital area of a patient, similar endoscopic investigations and operations can be conducted at the head and chest of a patient. Of course, in conducting the latter procedures it is not necessary for the patient's legs to be spread apart and in consequence a simpler version of the wheelchair is suitable for such procedures. In an alternative embodiment of the wheelchair, the back rest portion, seat portion and a leg support portion or portions are mounted so that they can lie substantially flush with one another so as to provide a flat surface to receive a patient in a prone position.
As just indicated, the purpose of the wheelchair is to present the patient at an operating station where operative and investigative procedures can be carried out. It is a further and concomitant object of the present invention to provide such an operating station.
Accordingly, a further aspect of the present invention provides an operating station at which operative or investigative procedures can be carried out on a patient, comprising means to accommodate a surgeon in a sitting position, a work table in front of said means, a first work station to one side of said means for receiving sterile instruments and materials for use in an operative or investigative procedure, a second work station to the other side of said means for receiving used instruments and materials, and means for receiving the present wheelchair the work table and work stations being so shaped and located that when the wheelchair indicated above is wheeled up adjacent the station, the region of the patient to be operated on or investigated is presented at said work table.
Thus, when the ano-genital region of a patient is to be operated on or investigated, that region will be presented at the work table and the surgeon will be seated with the patient's legs on each side of him, the work table being appropriately shaped to lie between the two leg supports of the wheelchair.
In order to present the patient at the right height to the surgeon it may be necessary either to use a split-level operating theatre or to sit the surgeon in a well. However, a more convenient arrangement will be to provide a hydraulic or other lift to which the wheelchair can be firmly attached and then raised to the correct height for the appropriate procedure.
With the present operating station and wheelchair, a surgeon sitting at the operating station can carry out a large number of operative or investigative procedures in a fraction of the time normally entailed in such procedures, most of which is represented by the time taken to remove the patient from a hospital trolley to an operating surface and back again.
Thus with the present invention, the surgeons time is more usefully employed, as are expensive hospital resources, with a consequent reduction in hospital waiting lists.
FIG. 1 is a simplified schematic representation (side view) of a wheelchair in accordance with the invention;
FIG. 2 is a perspective view of a first embodiment of a wheelchair in accordance with the invention;
FIG. 3 is a side view of the wheelchair of FIG. 2 showing the mechanism by which the seat can be swung and locked in different positions;
FIG. 4 is a further perspective view of the wheelchair of FIG. 2 showing how the seat is mounted for pivotal movement on the wheeled frame;
FIG. 5 is a perspective view of the wheeled frame of the wheelchair of FIG. 2;
FIG. 6 is a front view of the wheelchair of FIG. 2, with the seat in position for an investigative or operative procedure;
FIG. 7 is a rear view of the wheelchair of FIG. 2, with the seat in an upright position;
FIG. 8 is a side view of a caster wheel of the wheelchair of FIG. 2;
FIG. 9 is a sectional view of the locking and release means for pivotal movement of the seat of the wheelchair of FIG. 2;
FIG. 10 is a sectional view of the locking and release means for the side portions of the seat of the wheelchair of FIG. 2;
FIG. 11 is a perspective view of a detail of the wheelchair of FIG. 2 for use during an emergency;
FIG. 12 is a diagrammatical plan view of an operating station, and
FIG. 13 shows how the structure of FIG. 9 is used to lower the patient's head during an emergency.
The basic principle of the wheelchair of the present invention will first be described with reference to FIG. 1 which is a diagrammatic representation of a patient in a wheelchair. The wheelchair shown in FIG. 1 comprises a back rest portion 1, a seat portion 2 and two leg supports 3. The back rest portion 1 lies at an obtuse angle of about 130� to the seat portion 2 and the leg supports 3 also lie at an obtuse angle of about 130� to the seat portion. Because of these angles, the patient 4 is presented in the wheelchair in a semi-recumbent and relaxed position. The wheelchair has a pair of large diameter wheels 5 mounted on an axle 6 beneath the seat portion and the wheels may have hand rings whereby the patient can propel the chair, although these will generally be unnecessary. A stabilizing wheel or wheels is or are provided for the wheelchair but not shown in the drawing. A stabilizing wheel may be arranged on an arm which depends below the back rest portion and which can be folded flat against the back rest portion when the chair is tilted into an operative position, or stabilizing wheels may be arranged on an axle mounted below the leg supports 3.
The back rest portion 1 is provided with a handle 7 by means of which a hospital porter or nurse can hold the wheelchair to move it and the handle can act as a rest or stop in the operative position. In addition arm rests 8 for the patient may be provided.
In the use of the wheelchair, the patient is placed in the chair or enters it by himself if ambulant and, after the administration of any necessary pre-operative medication, is wheeled to the location where the endoscopic procedure is to be carried out. The chair is then tipped so that the handle is on the ground, i.e. so that the broken line 9 is the ground. The patient is then presented in an appropriate position for the endoscopic procedure, with his head and back horizontal and his legs raised. The patient's legs can then be moved apart to permit the surgeon to operate.
A practical version of a wheelchair in accordance with the invention will now be described with reference to FIGS. 2 to 9. Although FIG. 2 is a perspective view of the wheelchair, because of the manner in which the wheelchair is constructed, no one view can begin to show all the features of the wheelchair. The wheelchair will therefore be described with reference to several views of the wheelchair which can be clearly related to one another. In each view, several parts of the wheelchair are omitted so as to prevent them from obscuring the view, the omitted parts, however, being shown in another view. Thus, FIG. 3 shows a wheeled frame for the wheelchair, while FIG. 2 shows the seating and patient-receiving parts of the chair in relation to the wheeled frame. FIGS. 4 and 5 show detailed views of the mechanisms by which the seating and patient receiving parts of the chair can be arranged in different configurations and show the relationship of these mechanisms to the wheeled frame. FIGS. 6 to 9 show further details of the wheelchair.
Referring now to FIG. 2, there is shown the seating part of the chair, that is to say, the part for receiving a patient, this part being mounted on a wheeled frame shown in FIG. 3.
The wheelchair comprises a back rest portion 10, the sides 11 of which are rounded outwardly to give side support to a patient. Two arm rests 12 are provided below the sides 11 and are shown in position to receive the arms of a patient sitting in the chair. Each arm rest 12 can be folded to lie flat against a board 13 forming part of a support structure for the back rest portion the arm rests in their folded position lying flush with the lower part of the back rest portion.
The wheelchair also has a seat portion which is divided into a central portion 14 and two side portions 15. The central portion 14 is carried by two arms 114 which are mounted on a rod 115 rotatably mounted in brackets 116 of a support structure to be described, so that the central portion can be swung about the axis of the rod 115 (c.f. FIG. 5). Each of the side portions 15 has an arcuate retaining board 16 to prevent the legs of a patient from slipping outwardly off the seat. Each side portion 15 has a square section bar 17 attached to it and each bar has a foot rest 18 mounted on it so as to be adjustable up and down. The bars 17 will normally extend forward of the seat portion with the foot rests raised above the ground. However, the bars are mounted beneath the side portions 15 so that they can be moved into a position where they extend substantially vertical so that the foot rests can be lowered into contact with the ground to assist the entry of a patient into the wheelchair. The back rest portion 10, the arm rests, the central and side seat portions and the foot supports are padded, where appropriate, and covered with plastics material capable of withstanding being washed with disinfectant. Conveniently, the plastics material may be one which simulates leather.
FIG. 3 shows a wheeled frame for the wheelchair. The frame comprises two substantially D-shaped side members 20 which are joined at the bottom and near the top of the upright portions of the side members by cross-members 21 and 22 and at the bottom by a substantially A-shaped member 23 the apex of which also connects with the lower cross-member 21. At their forward ends the side members 20 have support discs 24 which support stub axles for spoked wheels 25. Outrigger rods 26 attached to the upright portions of the side members 20 carry at their lower ends castor wheels 127 which have foot-operable brake elements 28. Each brake element 28 comprises an upper plate 130 to which is attached a braking block 128 pivoted at 131 in a bracket 27 housing the castor wheel 127. Operation of the brake is by depressing the free end of the upper plate 130 and this causes the braking block 128 to engage the wheel 127 and brake it as shown in FIG. 6. At their uppermost regions, the side members 20 have discs 29 secured thereto and two arms 30 are pivotally mounted on the discs at 129 and hang downwardly. The arms 30 are joined by a member, indicated at 31, which is joined to the support structure for the back rest portion, so that the back rest portion is thereby mounted for swinging movement about an axis joining the pivot points 129 of the arms 30 on the discs 29.
FIG. 4 shows the mechanism by which the chair can be swung and locked in different positions and the mechanisms for enabling the arm rests 12 to be folded and the foot rests to be adjusted. The frames 20 and the member 23 support a cross-beam 32 which has two L-shaped brackets 33 fixed to it in opposition to one another. The brackets define between them a space in the mid-plane of the wheelchair and a quadrant 34 is held securely between the brackets, the quadrant being formed with rectangular recesses 35. The quadrant could also be formed with ratchet teeth.
A wooden support structure for the back rest portion 10 includes two triangular wings 36 which are spaced apart and which are joined at their lower ends by a base board 37 (c.f. FIG. 5). Beneath the base board is a cruciform member 38 one arm 39 of which carries a spring-loaded detent 40 engaging in one of the recesses 35. The detent 40 is held in a T-shaped slot in the arm 39 and has a depending lug 140 received in the stem of the T-shaped slot. The detent 40 is urged into engagement with the quadrant 34 or a recess 35 by a compression spring 141 (c.f. FIG. 7) housed in a recess 139 in the arm 39. A cable connection 41 comprises a sheath 142 held stationary in a block 143 and a wire 144 movable in the sheath by means of a hand lever 42 to which the wire 144 is connected. The hand lever 42 is mounted on a handle 43 by means of which a porter or nurse can move the chair.
By operating the hand lever 42, the wire 144 is moved in the sheath and acts on the lug 140 to retract the detent 40 into the T-shaped slot into the position shown in FIG. 7. This operation moves the detent 40 out of a recess 35 and, in this position, the parts of the chair, comprising the back rest portion 10, the seat portion 14 and 15 and the leg supports 17 and 18, can be swung on the arms 30 and joining member 31 about an axis joining the pivot points 129 until the detent encounters the next recess. Upon release of the hand lever 42, the detent 40 is then urged into the recess 35 by the spring 141 so that the chair will be locked in this position.
As indicated in FIG. 2, the boards 13 are formed with slots 44 and support bars 45 pivotally attached to the undersides of the arm rests 12 pass through the slots where each support bar is held by the engagement of a bayonet slot 46 in the arm 45 and a rod 101 extending across the slot 44. In order to fold the arm rests flat, the bars 45 are lifted to disengage the bayonet slots from engagement with the rods and then the bars 45 are passed through the slots 44 to allow the arm rests to lie flush against the boards.
Each square section bar 17 is formed on its underside with holes 47 (c.f. FIG. 5) and each foot rest 18 has attached to it a locking mechanism 48 which comprises a spring-loaded pin engaging in a hole 47 in the bar 17 and thus locking the foot rest in position. A handle 49 of the locking mechanism can be operated to retract the pin and allow the foot rest to be moved up or down the bar to adjust the foot rest to the required position for a patient.
Beneath each side seat portion 15 is a support structure of bars which extend below the base board of the wooden support structure. One of these bars 50 for each side seat portion carries a hand lever 51 for operating a cable connection comprising a sheath 150 held stationary in a block 151 and a wire 152 movable in the sheath by the hand lever 51, as shown in greater detail in FIG. 8.
Each side seat portion 15 has mounted beneath it a hollow beam 52 within which is a rod 153 acting as a detent. Each rod 153, as shown in FIG. 8, has a pointed end 53 which engages in a toothed quadrant 54, two such quadrants being mounted below the base board.
Each rod 153 is urged by a spring 154, housed in the hollow beam 52, into engagement with the toothed quadrant. However, operation of the hand lever 51 causes the wire 152 to be moved in the sheath 150 so as to pull the rod 153 against the action of the spring 154 so as to retract the pointed end 53 of the rod from engagement with the quadrant 54. This allows the side seat portion 15 and foot rest 18 to be swung from a closed position, as shown in FIG. 2 where the side seat portions 15 abut against the central seat portion 14, to an open position as shown in FIG. 5, and vice versa.
Underneath the central seat portion 14 there is a cruciform member 55 which is pivotally mounted on a central pivot 56 and which has two arms 57 which project beyond the seat portion 14 to engage in U-section brackets 58 on the underneath of the side seat portions 15, so as to prevent pivotal motion of one seat portion 14 or 15 in relation to another seat portion. In order to release the seat portions, the cruciform member is pivoted into the position shown in broken lines. The underneath of the central seat portion is also provided with stops 59 and 60 to limit the movement of the member 55 and with guideways 61 for controlling the movement of the ends of the other two arms.
The square section bars 17, on which the foot rests 18 are mounted, are normally held in the forward position shown in FIG. 4 by the engagement of a recess in a bar 62 in a bolt projecting through the bar 17, the bar 62 being urged into such engagement by a spring 63. By disengaging by hand the bar 62, the bar 17 can be moved into the vertical in FIG. 4 to facilitate entry into the wheelchair as will already described.
In operative procedures carried out under anaesthetic where the patient is in a recumbent position, it would be desirable in an emergency to be able to lower the patient's head below the rest of his body so as to prevent, for example, the patient from swallowing or inhaling his own vomit. Therefore in a modification of the wheelchair a frame comprising two uprights 64 and a cross-beam 65 is pivotally mounted to the rear of the two D-shaped side members 20 as shown in FIG. 9. The frame is normally held in the position shown by a spring 66, one end of which is looped over the cross-beam 65 and the other end of which is looped over a convenient fixed point, such as the cross-bar of the A-shaped member 23. When the wheelchair is in the recumbent or operating position, the back of the back rest portion will rest against the upper ends of the uprights. However, in an emergency an anaesthetist can grab the cross-beam 65 and pull it against the action of the spring 66 thereby pivoting the uprights 64 about their pivotal connections 67 to the members 20 an lowering their upper ends. This allows the back rest portion to pivot to lower the head of the patient and the pivotal movement may be as much as 15�.
In the use of the wheelchair, each of the bars 17 is moved from the position shown in FIG. 4 into a position where it extends substantially vertically by disengaging the recess in the bar 62 from the bolt projecting through the bar 17 so that the bar can swing about a pivot 100 under the influence of gravity. The handle 49 is operated to retract the locking mechanism 48 from engaging in a hole 47 so that the foot rest can be moved down the bar 17 into contact with the ground.
A patient then enters the wheelchair and when he or she is settled, the foot rests are raised to the correct level to accommodate the patient's feet and the bars 17 are moved into their forward positions in which they are locked by engagement of the recesses in the bars 62 with the bolts.
The chair is then wheeled to the operating theatre. The hand lever 42 is operated to move the cable connection 41 which acts on the detent 40 to retract the detent from engagement in the recess 35. The whole seat portion can then be swung by hand about the pivot axes of the arms 30 on the discs 29 until the back rest portion 10 lies substantially horizontal, whereupon the hand lever 42 is released and the detent 40 enters the recess 135 shown in FIG. 4. The bayonet slots 46 are then released from engagement with the rods 101 and the arm rests 12 are folded flush with the back rest portion.
The cruciform member 55 which is pivotally mounted beneath the central seat portion 14 is then swung about its pivot 56 to release the ends of the arms 57 from engagement with the U-section brackets 58 on the underside of the seat portions 15 so that the central seat portion can be lowered by being swung about the axis of the rod 115.
The hand levers 51 are then operated and each lever acts on the cable connection shown in FIG. 8 to withdraw the pointed ends of the rods 53 from the teeth of the quadrants 54 so that the side seat portions can be swung outwardly about pivot joints 104. The patient's legs are thus spread apart and the patient is now presented in the correct position for a surgical or investigative procedure.
At the end of the procedure, the side seat portions 15, bars 17 and foot rests 18 are swung back to their original position, the central seat portion 14 is raised and locked in position, and the chair is then moved to raise the patient from a recumbent position to an upright sitting position, all following the reverse of the procedures just described. The patient is then wheeled away.
It is to be appreciated that many other modifications of the wheelchair and its construction are possible and that alternative mechanisms to those described can be provided for moving or permitting movement of the various parts of the seating arrangement. For example, the wheels 25 could be replaced by castors similar to the castors 27, or the wheelchair could be provided with two separate handles for pushing the chair, with the various hand levers for moving the parts of the seating arrangement and for braking mounted on the handles.
While the wheelchair has been shown as having hand levers for moving or permitting movement of the various parts and mechanisms of the wheelchair, it will be appreciated that the various mechanisms can be electronically controlled and in such a case a panel of push buttons or the like will be placed on the handle or in another convenient location.
As clearly shown in FIG. 2, the back rest portion 10 has at its upper end an integral portion against which a patient's head can rest. In a further modification of the wheelchair, this head rest portion can be movable and pivotable about an horizontal axis, there being means to lock the head rest portion in a pivoted position. This enables a patient's head to be raised or lowered (extended), particularly when the patient is in a prone position.
In addition, in a further modification of the wheelchair it is possible to pivot the whole of the seat portion relative to the back rest portion and to move the bars 17 and foot rests 18 so as to provide a flat surface to receive a patient in a prone position.
As indicated above, the wheelchair is particularly suitable for presenting a patient at an operating station at which an operative or investigative procedure can be carried out endoscopically on a patient. Such an operating station is shown very diagrammatically in FIG. 10 and comprises means 70 for accommodating a surgeon in a sitting position with a work station on each side, one for receiving or holding sterile instruments and materials for use in an operative or investigative procedure and the other 72 for receiving used instruments and materials. A work table 73 is provided in front of the surgeon and there is a wheelchair-receiving region 74 at which is means 75 for accommodating an anaesthetist. The arrangement of the seating means, work table and work stations is such that when the wheelchair is brought up to the operating station, the region of the patient to be operated on or investigated is correctly presented at the work table. To this end it may be necessary to seat the surgeon in a well, or to arrange for the wheelchair to be raised either by wheeling it up a ramp to a level position or by elevating the wheelchair as by means of a hydraulic lift. In each case, means is provided for locking the wheelchair adjacent the work table.
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|U.S. Classification
|5/610, 5/600, 297/337, 280/647, 5/613, 297/423.32, 297/312, 280/657
|International Classification
|Cooperative Classification
|European Classification
|Jun 3, 1993
Owner name: KEYMED (MEDICAL & INDUSTRIAL EQUIPMENT) LIMITED, E
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:WICKHAM, JOHN E. A.;MILLER, RONALD A.;REEL/FRAME:006559/0539;SIGNING DATES FROM 19930311 TO 19930408
|Mar 15, 1994
|Certificate of correction
|Sep 20, 1996
|Fee payment
Year of fee payment: 4
|Oct 4, 2000
|Fee payment
Year of fee payment: 8
|Oct 27, 2004
|Maintenance fee reminder mailed
|Apr 13, 2005
|Lapse for failure to pay maintenance fees
|Jun 7, 2005
|Expired due to failure to pay maintenance fee
Effective date: 20050413


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This hotel provides the basic needs for a business trip, but not much more. The rooms are fine. Comfortable bed, TV, and a decent bathroom. But there is no closet nor a minibar to have fresh water at night. All is a little bit old fashioned, from the decor to the elevators. Even the clock at the entrance looks from a couple of decades ago. The location is great. Within few blocks from the main buildings, the mall, public transportation, and the bars of shepherd street. Given that I didn't choose the hotel, I can't compare prices with others, but for me the final bill seemed to be expensive. Overall, if I have to go back to Calgary, I would look for other options, but if I have to stay there again, it will be ok.
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Stoli vodka pledges $300,000 towards programme to develop global LGBT leadership
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Reader comments
You forgot to say Stoli is owned by a company based in Luxembourg and made in Latvia.
That was a well-thought out boycott, Dan!
Although they try to ignore mentioning the fact, Stoli is made using Russian grain, and they even operate farms in Russia's Tambov region. It is DISTILLED in Russia. They state this on their website.
They also then filter it through Russian Birch.
Stoli is far from separate from Russia, they preach about their Russian connections on their site, so the belief that it's "not Russian" when the grain comes from there, and it's distilled there, is ignorant.
Stoli is Russian and proud, the bullsh*t marketing is for people who don't bother to look deeper.
Well, I'm sure Putin really gives a fck that it's put through Russian birch!
Another victory for #teamgay!
So you ignore the other facts and pick out the smallest one. I couldn't give a rats ass if Putin gives a damn, the fact is Stoli is a RUSSIAN product through manufacture and ingredients, and they make a big song and dance about this on their own website. So, to claim that it's not Russian at all is a lie.
It's akin to Apple creating a marketing site telling the story of how minerals are mined in China, the components made in China, the phones assembled and packaged in China – then claiming their product has "nothing to do with China".
A Boycott is against the product, because the product is primarily Russian. There are other options, ones that do not lead to money flowing into Russia. THAT is the purpose of a Boycott.
Thanks for the info, Bloketoys. Despite their generous donation they are still Russian. One hopes they are also exerting pressure within the company as well as trying to appease the US GLBT community.
This shows that boycotts do actually work, just the threat of it against Stoli, whether you agreed with it or not, has encouraged them to act in support of LGBT equality more openly and with financial backing rather than statements.
When a company's profits are going to be hit, they have no choice but to submit to the will of their customers.
The same now needs to be done against Coca Cola and McDonalds.
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We arrived after a 12+ hour drive. This was probably the 5th or 6th motel we attempted to get a room at. The people were nice and they had 1 room left for $100. Beats $459 in El Portal. Room was clean, no mold in the shower, and the place was quiet. It was nothing special but all 7 of us were happy. Kids loved the pool. Never noticed the noisy a/c, then again, I sleep like a rock. Would definitely stay here again.
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text: "If this trend continues, in 20 years nobody but Academy members will even have heard of the Best Picture," Briggs said in a pre-Oscars blog post last year. "On the other hand, if the previous 5 Most Popular pictures are any guide -- Shrek 2, Star Wars: Episode III -- Revenge of the Sith, Pirates of the Caribbean: Dead Man's Chest, Spider-Man 3, The Dark Knight, Avatar -- the Most Popular movie two decades from now will be targeted at audiences who are still attempting to master pasting and scissoring skills." This year's Top 10 grossing films bear that out. Among the witches, transforming robots and dudebros were five other sequels ( Pirates of the Caribbean: On Stranger Tides, Fast Five, Mission: Impossible -- Ghost Protocol, Cars 2 and Sherlock Holmes: A Game of Shadows) and the comic-book prequel Thor. With the exception of the Hangover sequel, The Help and Bridesmaids, much of last year's Top 20 was a CGI blur. It's also exactly what mass-consumption movie audiences wanted to see. "They want make-believe, effects, explosions, sex -- in short, pure distraction," Farr says. "The movies that cater to this group are often fairly mindless and formulaic." They also overwhelmingly tend to be action and adventure movies. Briggs notes that only four Best Picture films have ever fit into that genre: Around the World in 80 Days in 1956, Ben-Hur in 1959, Gladiator in 2000 and The Lord of the Rings: The Return of the King in 2003. Conversely, a full 33% of the top-grossing films during that same span have been in the action genre. If you want to win an Oscar, write a drama. That genre has won roughly 56% of all best-picture Oscars while making up only 27% of the top-grossing films of the Oscar era. Whatever you do, don't make people laugh. Comedies have been named best picture only four times since 1929 and only twice in the past 75 years: Annie Hall in 1977 and Shakespeare in Love in 1998. Considering comedies were 11% of top-grossing films in the past 84 years, the Academy voting panel's a pretty tough room. "The movies that tend to win Oscars are usually slightly higher-brow," Farr says. "They may have high entertainment value, but are also being judged on excellence in story, script, acting and technique." Prev 1 of 3 Next


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Fatigue is found among people who take Dyazide, especially for people who are female, 60+ old , have been taking the drug for 2 - 5 years, also take medication Lipitor, and have Hypertension . We study 8,052 people who have side effects while taking Dyazide from FDA and social media. Among them, 599 have Fatigue. Find out below who they are, when they have Fatigue and more.
Join a support group for people who take Dyazide and have Fatigue >>>
On eHealthMe you can find out what patients like me (same gender, age) reported their drugs and conditions on FDA and social media since 1977. Our tools are free and anonymous. 86 million people have used us. 300+ peer-reviewed medical journals have referenced our original studies. Start now >>>
Dyazide has active ingredients of hydrochlorothiazide; triamterene. It is often used in high blood pressure. (latest outcomes from Dyazide 8,225 users)
Fatigue (feeling of tiredness) has been reported by people with breathing difficulty, pain, weakness, insomnia, high blood pressure (latest reports from 194,978 Fatigue patients).
On Jul, 24, 2016
8,052 people reported to have side effects when taking Dyazide.
Among them, 599 people (7.44%) have Fatigue
* Approximation only. Some reports may have incomplete information.
** Reports from social media are used.
How to use the study: print a copy of the study and bring it to your health teams to ensure drug risks and benefits are fully discussed and understood.
I have had achalasia developing over the last thirty or thirty-five years, now at Stage Three. These last few weeks I can't seem to get past an all-day sensation of being very tired. I eat well, not a lot, and I exercise regularly; I am active. I'm also 74. And yes, I spit up a lot. I am considering a peri-oral esophageal myotomy (spelling--a POEM in any case) rather than a Heller myotomy. It will be done at Johns Hopkins. What do most patients these days consider, or have done?
I am detoxing from dyazide and I am having withdrawal symptoms. The worst is the pain and swelling/numbness in my legs. Any suggestions to help?
COPD recent diagnosis, Sleep Apnea - diagnosed about 8 yrs ago- use CPAP nightly, nasal allergies, recent back injury, 2 rotator cuff surgeries in the last 10 yrs, about 30 lbs. overweight, history of heart palpitations and arrithmias
Are there vitamin deficiencies associated with taking Humalog and Keepra
Have been on Atripla for 2 month. The first 6 weeks had only vivid dreams but no other side effects. Now after 2 month - i start getting really tired, and often need to rest 30 min twice a day.
Dear all & ehealth, Please tell after how many days fatigue goes after stopping minoxidil? Thanks.
i developed these symptomes from last day. i had also chills but ER didnt do anything after waiting 10hrs to see a dr. it has left two pills(Day 10) and i have very very vivid dreams, headache, abit vertigo, blance issue, and slept all day long. i am not taking the last two pills anyway. i am ...
More questions for: Dyazide, Fatigue
I have had achalasia developing over the last thirty or thirty-five years, now at Stage Three. These last few weeks I can't seem to get past an all-day sensation of being very tired. I eat well, not a lot, and I exercise regularly; I am active. I'm also 74. And yes, I spit up a lot. I am ...
Have been on Pradaxa for about 4months after taking xarelto which for me caused mental confusion.Pradaxa appears to cause excessive tiredness which can be a real problem as I Iive alone and do my own house and garden maintenance. Age 68 have AF and COPD Have had 3 hip replacements and use a ...
Hello. I was diagnosed with COPD a month ago. I'm currently taking the spiriva respimate. My breathing seems to be fine, however iam extremely tired since using this inhaler. Any ideas on how to get rid of this awful side affect. It really is interfering with my daily duties. Help please
I started taking this 2 days ago and everytime I take it about a half hour to an hour after I'm extremely tired.
Currently taking 100 mg Imuran at night for auto-immune hepatitis and recently reduced predinsone down to 5mg -- also have Crohn's and sarcoidosis. Suffering from extreme fatigue since diagnosed with AIH and taking Imuran. Dr. wants to increase Imuran for Crohn's. Was on Humira for Crohn's but ...
NOTE: The study is based on active ingredients and brand name. Other drugs that have the same active ingredients (e.g. generic drugs) are NOT considered.
WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.
DISCLAIMER: All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. All information is observation-only, and has not been supported by scientific studies or clinical trials unless otherwise stated. Different individuals may respond to medication in different ways. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. The use of the eHealthMe site and its content is at your own risk.
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Two conservative non-profits have poured $60 million into the presidential race, far outspending the super-PACS.
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PREVIEWS: "Daredevil," "Uncanny X-Men," & More Marvel Comics On Sale August 3, 2016
Comic Books
Start Time: 08:00PM End Time: 10:00PM
Joe 'The Towering' Infurnari is a Brooklyn based Canadian cartoonist. He is currently the artist for the smash hit new series, "The BUNKER" with Joshua Hale Fialkov published by Oni Press. Bergen Street Comics be welcoming him to the shop to celebrate the release of the first trade paperback of "The Bunker," as well as the 5th issue!
Bergen Street Comics
470 Bergen Street
Brooklyn, NY 11217
More Info: https://www.facebook.com/events/661555467268413/?ref=notif¬if_t=plan_user_invited
This event was submitted by CBR.
|Follow @cbr


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I am into running, soccer, reading, live music, biking, working out, mountains, skiing, hiking, reading, the beach. I maintain an active lifestyle and I stay in shape; my mate should too.
I want someone who's focused and passionate about life, but who knows not to take themselves too seriously.
Big picture....I'm looking for someone who I can eventually share my life with and vice versa, this is just one outlet through which to meet someone. In the meantime I'm just enjoying life as it comes.
Trying to figure out what's next...I am always evolving and and looking forward to what the next few years have in store.
Movies: I'll watch them now and again, documentaries, 24, breaking bad, comedy.
Music....My Morning Jacket, Delta Spirit, M83, The Black Keys, Plants and Animals, Dawes, Bear in Heaven, Baths, Hot Chip, Gary Clarke Jr., Radiohead, Cloud Nothings, Pearl Jam, Arcade Fire, Yeasayer, Robyn....lots lots lots lots more.
Food: Eat mostly (80%) paleo, I love to cook.
2. Family/Friends
3. Soccer
4. Nature
5. My guitar
6. Traveling
- You are driven, motivated, and want the best from life.
- You possess unicorn qualities.


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It only takes a minute to get started. Fill out our simple sign up form and login to the site.
This step is optional but will seriously increase your chances of having members look at your profile. Write a few sentences about yourself, your pasttimes and upload your best photo.
Utilise our website's state-of-the-art search to uncover members who are up to your requirements. Or just look through listings and uncover members that you find attractive.
Found someone who you're attracted to? Send a letter to them or just a wink and see if anything happens. With a little luck you'll be on your way to locating your soulmate.
And start dating


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For those curious about MMTC, you may wish to note that a few of the better posters on the other board have visited the MMTC offices, met the officers and employees, attended shareholder's meetings and a production roll-out of the MMTC at the IAFP annual convention in Providence, RI. These posters also provided pics of the MMTC booth, literature, and of course the MMTC-1000 machine. They have also documented a shareholder's presentation at the MMTC offices with a video they made and edited at their own expenseWhile I can't swear that posters like SGR, HK, KY, and RM are 100% truthful and forthright, I have seen them make the effort to confirm data regarding MMTC many times and then share that data and the confirmation publicly with others. I assume they have a vested interest in seeing the company move forward, but given the images, videos, and the number of times they have predicted events that transpired later, I tend to listen when they post and I strongly doubt they are fabricating any information for personal gain.SGR has recently stated that being in touch with the CEO, he has learned that the 10-Q will be filed soon, and well before the deadline. Mark the date of this message and see if the filing comes through. If so, we can acknowledge that the A-team on the MMTC board is telling the truth, while the B-team of JH, CM, and BS are just engaged in name calling and back biting.It's easy to confirm the MMTC claims through official sources. Check out this first link for the MMTC presentation at IAFP (scroll down page for pics). The 'Headlines' on the Yahoo page are also useful for seeing the timeline and steps taken by MMTC.http://investorshub.advfn.com/boards/read_msg.aspx?message_id=77786419Then follow these links to see the connection MMTC has with AOAC, NAMSA, and USDA.http://www.aoac.org/testkits/2011_060901_certificate.pdfhttp://ddr.nal.usda.gov/handle/10113/41910http://www.micro-imaging.com/pdf/MITNAMSAFinal%28MicroIdentificationTechnologies%29.pdfhttp://ddr.nal.usda.gov/bitstream/10113/41910/1/IND44365309.pdfhttp://patft.uspto.gov/netacgi/nph-Parser?Sect2=PTO1&Sect2=HITOFF&p=1&u=/netahtml/PTO/search-bool.html&r=1&f=G&l=50&d=PALL&RefSrch=yes&Query=PN/6421121
Sure, but MMTC still sucks.
MMTC sucks so hard its worth more than 2000 posts coming from you.Did you know that Bankie gets 5 times more paid than you for bashing ?I know why...
yes, there really are 2.5 billion shares O/S
now you're just lying:a production roll-out of the MMTC at the IAFP annual convention rocketman, you are the most desperate person i have ever sen on these boards


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GREENSBORO, N.C. — Specialty grocery chain The Fresh Market here will make its debut in New England next year as part of a new waterfront shopping district under construction in Hingham, Mass. The Fresh Market will be among the anchor tenants at The Launch at Hingham Shipyard, a 1.2-million-square-foot mixed-use project scheduled to open next spring, according to Samuel & Associates, the project's Boston-based developer. Fresh Market currently operates 78 stores in 18 states. The Hingham ...
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I just started my first blog http://www.focusonyourphotos.com/blog and connected it to my current Portrait website: http://www.wrenphoto.biz I had never used WordPress and did not venture past using one of the two templates that loaded with it, but was able to do some customizing with my logo and colors. I found it surprisingly easy to use. All of the links on the menu except the home button are links back to my original site and that seemed to work pretty well.
Let me know what you think.
I have much "tweeking" to do but over all I was pretty happy with just a couple hours work.


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Officials demand action on staffing beleaguered Calif. department
Oakland City Council members called on leaders to fully staff the city's department and develop an "action plan" to address low morale
By Will Kane
San Francisco Chronicle
OAKLAND, Calif. — Two influential members of Oakland's City Council demanded Tuesday that Mayor Jean Quan and City Administrator Fred Blackwell fully staff the city's beleaguered Police Department and develop an "action plan" to address low morale among officers.
Quan and Blackwell have not aggressively recruited new police officers or stopped veteran officers from retiring, leaving the city perilously short of officers to respond to 911 calls, said Councilwoman Libby Schaaf and Councilman Noel Gallo. Schaaf is challenging Quan in the mayor's race.
In the current budget, Oakland's City Council set aside enough money to pay for 675 police officers, but as of Tuesday the city employs 649 sworn officers.
The 26-officer gap is infuriating, said Schaaf, a member of the Public Safety Committee.
"Oaklanders need to know that a cop will come when they call, no one has that (belief) yet," Schaaf said. "We need to have every officer we can afford working."
Gallo and Schaaf called on the city to develop an early-warning system to alert staff of a shortage before it becomes a crisis, fund a new police academy, provide a full accounting of the costs to hire new police officers and commission a study to address the high number of Oakland police officers who are retiring or leaving to work in other departments.
"It is really frustrating to see that mounting shortfall develop and nothing be done about it," Gallo said, adding that he has thought the Police Department had been "poorly managed for the last several years."
"Let me make it very plain," Gallo added. "For me, it is really a city administration misuse of our trust."
Quan, in a statement, said hiring more police officers was one of her highest priorities, adding that she had already asked the council to pay for an entire new police academy later this year and fund the early stages of another academy next year.
"I'm glad to know we'll have support for our proposal to fund additional police academies this year and next year, and I look forward to working with the City Council to fund our public safety priorities," Quan said.
"When I took office, the city hadn't held a police academy in two years, and it's taken time to rebuild our economy and restore our recruitment and training programs," Quan said. "The good news is we've turned the corner and we're picking up steam."
Quan pointed to the 47 recruits who graduated from the police academy in April and the 110 cadets who are currently in three different academies and will join the police force in the coming months.
Sean Maher, Quan's spokesman, said the city is also seeing "encouraging signs" in the mayor's efforts to retain long-time officers, including buying new police cars and trying to end mandatory overtime shifts.
Barry Donelan, head of the Oakland Police Officers Association, said city leaders are not giving police officers the "support and resources to do their job, and the frustration shows."
"The department and the city have been doing a good job of hiring police officers to close that gap," Donelan said.
"But what they haven't been doing is a good job of retaining officers."
Copyright 2014 the San Francisco Chronicle
McClatchy-Tribune News Service
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Administrators - the axis in Bermuda's portfolio-pricing triangle
administration in bermuda
The nature of hedge fund administration has changed over the years as technological developments have made it less important where the administrative work for hedge funds is actually done. For locations with a history of expertise and experience in administration, such as Bermuda, this creates particular challenges.The repeal of the '10 Commandments' law (in 1998/99) also had a major impact on Bermuda. Previously, certain SEC and tax guidelines ensured no administration business of hedge funds was...
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7 days in 60 seconds
Repo, MVA and securitisation
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