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Revision Express AS and A2 Law Paperback
by Chris Turner, Mary Charman
Part of the Direct to Learner Secondary series
If you're looking for a fast, focussed and effective way to revise for your AS or A2 exams, Revision Express is the answer.
Now fully updated for the new A-levels, Revision Express covers everything you need for success in your exams. Each chapter is broken down into two-page topic sessions, packed with information, top tips and unique features to help you carefully organise your revision and gain vital extra marks. All the information is presented in short, memorable chunks for quick and simple revision and you can check your understanding and progress as you proceed with checkpoint questions. Develop and practice your exam techniques with sample exam-style questions (and answers -- luckily!) and get some inside information as A-level examiners reveal the secrets to getting top grades.
- Format: Paperback
- Pages: 216 pages, Illustrations
- Publisher: Pearson Education Limited
- Publication Date: 21/11/2008
- Category: Law: study & revision guides
Free Home Delivery
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Rahul Dravid and Sachin Tendulkar celebrate the final wicket, Pakistan v India, 1st Test, Multan, 5th day, April 1, 2004 © AFP
India clinch their first Test win in Pakistan © AFP
India, on the verge of their first Test win in Pakistan © Getty Images
No tenners, but a five-for will do just fine © Getty Images
Yousuf Youhana strikes a face-saving 112 after Pakistan follow on © AFP
Let me entertain you: Inzamam-ul-Haq gives the bowlers a hammering © AFP
White flag? What white flag? Yasir Hameed goes down fighting © AFP
Irfan Pathan extracts bounce from the pitch after dismissing another batsman © Getty Images
He's not there but he's watching you ... © AFP
Saqlain Mushtaq sits on the pitch as Sachin Tendulkar and Yuvraj Singh pile on the runs © AFP
At a strike rate of 82, Virender Sehwag gets to 300 with a massive six © Getty Images
Sachin Tendulkar comes to the crease and displays ominous form © Getty Images
Fast bowlers and spinners, both, feel the heat © Getty Images
As the Indians soar, so do the temperatures © Getty Images
Take that! Virender Sehwag gives the ball an almighty tonk © AFP
The ball rockets off Virender Sehwag's bat © AFP
This is it! Rahul Dravid, the stand-in captain, and Inzamam-ul-Haq get ready for the toss © AFP
Players from Pakistan and India train before the first Test © AFP
Anil Kumble lets out an impassioned appeal © AFP
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subset: commoncrawl


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Break, break, break, On thy cold gray stones, O Sea! And I would that my tongue could utter The thoughts that arise in me. O, well for the fisherman's boy, That he shouts with his sister at play! O, well for the sailor lad, That he sings in his boat on the bay! And the stately ships go on To their haven under the hill; But O for the touch of a vanish'd hand, And the sound of a voice that is still! Break, break, break At the foot of thy crags, O Sea! But the tender grace of a day that is dead Will never come back to me.
Provide your analysis, explanation, meaning, interpretation, and comments on the poem Break Break Break here.


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THE WORLD HAS BEEN INVADED BY ALIENS! It's up to a nerdy, lazy high school kid to save it!
3.85 / 5.00 5,607 ViewsLog in to save your medals! Don't have an account? Create one for free!
There is now a walkthrough available, courtesy of the fine writers over at JayIsGames. If you get stuck somewhere, check it out! It actually details the entire game for all of you completionists out there.
- Changed BG's from vector to bitmaps, increasing the game's performance dramatically. Most players should be able to play on HIGH quality now :D
- Tweaks to the Ogre's attack patterns have been added
- Officially, officially fixed the Death/Restart Menu glitch
- Added a drop shadow effect to the mute button and Ogre battle restart button
- New red click-indication arrows have been added to let players know where and when to click on the different action scenes
- Hint arrows added to the intro of the Ogre fight scene
- Music mute on/off toggle has been added
- Restart/Death Menu would sometimes still be visible after restarting already; This bug has been remedied.
- The Ogre's attacks can now be anticipated a bit better in this version... however, he's now much harder to beat. It takes 6 successful attacks to kill the Ogre.
Ok, so everyone seems to keep missing the 4th arrow. That's done intentionally. The 4th arrow is much faster and at a slightly lower location than the first 3 arrows. After you block the 4th arrow, quickly click on the bandit elf to choose his death.
- Boss now has less life and should be less "buggy," but also starts attacking more quickly
- There is now a "restart" button on the Boss stage, just in case of any weird, game-stopping bug occurance. The restart button makes elfmin explode, then brings up the restart menu... pretty entertaining just killing yourself actually lol
- The knife icon now responds to when you've thrown it at the bandit elf
I recommend that people play this game on the 'Medium' (unless you're sure your computer can handle it -- I'd rather everyone fully appreciate the artwork on the High setting, honestly) setting, due to the highly detailed artwork/animations creating lag when the game is played online. You can find the Quality settings in the top left-hand side of the game.
You are Edwin. A normal kid, with a normal life. One day, you're playing video games with your girlfriend and all's good. You're about to beat your favorite game of all time, "The Legend of Hooligan," when suddenly, Lord Gorn (the warlock within the game) reaches into the reality realm and nabs your girlfriend! Oh my, lord, jesus, f**k! ...Panicking, you stupidly throw a wild punch and miss, leaving Lord Gorn with a perfect opportunity to smash your face in. Before you know it, you're laying unconscious, on the floor of your room.
Greetings Newgrounders!
Behold! I bring you.... Elf Story! An epic (yet short) journey into a game realm, heavily inspired by the legend of zelda series.
Elf Story is a point-n-click adventure that's heavy in art/animation. A very simple game to get into, and one that almost everyone can appreciate, I would think.
You'll assume the role of Edwin, who later becomes Elfmin, on a 10-scene quest to try and find your girlfriend while battling off vicious enemies...
Enjoy the beautifully animated kills and death sequences as you journey through the painstakingly detailed backgrounds and scenes. Seriously... too much damn work was put into the art and animations... So, please, enjoy the game.
Also, if you notice any bugs at all, please PM me. Thanks!
You've learned new skills and earned new weapons. You've unlocked achievements and killed many a foe. Though you've reached the end of this chapter, your journey is not over... You must finish what you started.
It has Style, its a good Point and click adventure in the parody of Legend of Zelda.
as far i could hear is that it uses also of sound from other games.
The Graphics are good and the Battles are very good animated.
the only things i didnt liked was the repeating music over and over, it was just to short and the speed of the animations.
all in one, its a great game.
Seems like a good game, except, I crash on the first level. The orb appears and tells me that I haven't explored at all, but I said "Nah, let's go to the next level" and it just stops there with the black boxes on the screen. What a shame. :/
Good game, requires some fine tuning.
Music is okay, but repetitive, gameplay is good, animation is awesome, still some glitches.
I suggest for improvement, you allow for a 'skip scene' and 'replay scene' option. No one wants to do the boring non-skippable intro again.
Change the music after a couple of scenes.
Also, fix it when you face the ogre. If you click his face multiple times, you can glitch yourself to hit the correct timing. Also, the ogre doesn't die, apparently hitting him in the face 20 times isn't enough.
Other than that, great game. got yourself great animation skills there.
i bugged out at the part with the giant in the forest nothing was clicking both the elf and the giant jsut stode there shame too i was loving it up till then
Very nice! Would be better if there was easier way to repeat story parts, without having to restart the game.


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George V paused before a British typewriter in a booth at the British Industries Fair, London. While His Majesty toyed with the idea of striking one of the typewriter's keys, a respectful member of the exhibiting firm enveloped a disquieting bit of information in honeyed words. The King was informed that almost all of the typewriters used by the British Government are of U. S. manufacture.
Conservative British journalists refused to quote the king's rejoinder. They declared that he seemed "intensely annoyed." The irrepressible correspondents of U....
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Mon, 31 January 2011
AM444 is the new collaboration project of Chinese singer ChaCha (chachachina) and Dutch producer Jay.Soul (jay.soul) |
Sun, 23 January 2011
Shout outs today to Polish soul singer, Pinnawela. Even though we haven't spoken yet, I'm already looking forward to it. "Fly Away" comes from the album titled Soulahili. Read all about Pinnawela on her Myspace page at http://www.myspace.com/pinnawelamusic . Be sure to check for us on Facebook and Twitter as we begin our heralded blast. Yep, that is what we do. Enjoy and keep in touch! DJ Come of Age twitter.com/djcomeofage |
Sun, 23 January 2011
I wish I could tell you all about Ernesto, his life, his music, etc. Truth is, this track was sent to me a couple of years ago and since then, I can't find any further info on Ernesto. Always loved this groove and looked forward to a collabo with this artist. Maybe this time around you all can help me. Let's put an APB out on Ernesto and here's to hearing from him soon. Until then my friends, enjoy.... @djcomeofage |
Thu, 20 January 2011
Lee, aka TruSage, is a 22 year old aspiring producer/ songwriter from from Notting Hill in London. Having grown up in a diverse and rich musical environment, TruSage has roots in Soul, Jazz, Classical and Urban music. He has been producing solidly for nearly a year now and is preparing to release his first chillout/ soul EP "Soul Serenity" at the end of Jan 2011. Also stepping into House/ Electro/ Dubstep genres, TruSage is due to release the "Life of Wires EP" early 2011. ***UPDATE*** - Soul Serenity EP has been pushed back to 2011. This is because 2 new tracks will be added! So thank you for your patience and we hope you enjoy the final cut!
Happy New Year! Contact TruSage at: firstname.lastname@example.com |
Wed, 19 January 2011
1. MJ Cole - Sincere |
Wed, 19 January 2011
Hmmmm, whatever became of MN8? Remember the Jodeci remix of "Happy"? If not, this will refresh your memory. Shoutouts to DJ Rav and DJ Bounce, true spinnas who still rep for that "ole" skool type vibe. Peace and love from Omaha. DJ Come of Age |
Tue, 18 January 2011
Does anyone remember the group SEEK? They came out of Atlanta and had that smooth, mellow vibe of soul music that we appreciate? I remember having quite a few conversations with group member Freddie Luster a few years back. This was wayyy before I started podcasting, yeah, back during my days in the "mixtape" game. So what happened to SEEK? Does anyone know or have any leads? If you find them or a point of contact, drop us a line so we can reconnect. In the meantime, listen to "Believe Me" which came from the album "Journey Into Day". CoA twitter.com/djcomeofage |
Sat, 15 January 2011
Wed, 5 January 2011
Song: Babylon Bye Bye Artist: GreenTara Album: Music For A Mixed Nation |
Tue, 4 January 2011
Songs to Live by is a 16-song Power Packed Release by the Square Egg. The CD is Filled with Genre-bending Compositions, Thoughtful Lyrics and Engaging Melodies. It's Certainly Worth the Two Year Wait. Featured Are Collaborations with Big Brooklyn Red, Antonia Jenae, Nicole Henry and Many More. This Full Length Studio Release also features the Production Talents of Aaron "The Franchise" Fishbein and all of the Square Egg Songs that You've Grown to Love Live. Now You Can Own them in their Slicked Up, Polished, Hollywood-state. |


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3/12/2017 » 4/8/201730 Million Steps in 30 Days - National Public Health Week
3/29/2017 » 3/31/20172nd International Zika Conference and Workshop
3/31/2017Public Health Scholar Bowl
4/3/2017 » 4/9/2017APHA National Public Health Week
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SAVE THE DATE! 2016 Annual Influenza Update September 21, 2016
SAVE THE DATE! 2016 Annual Influenza Update
September 21, 2016
Topics to be included:
Influenza Update: Angela Campbell, MD, Medical Officer, Epidemiology and Prevention Branch, Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention
The Relationship between Social Inequities and Influenza Vaccination in New Haven: James Hadler, MD, Epidemiology Consultant to Yale Emerging Infections Programs and the NYC Department of Health and Mental Hygiene
Antiviral Medications: Michael D. Nailor, PharmD, BCPS (AQ-ID), Associate Clinical Professor, School of Pharmacy, University of Connecticut; Clinical Specialist-Infectious Diseases, Director, Infectious Diseases Residency, Hartford Hospital
Eliminating Influenza Vaccination Disparities: Charles Jackson, Outreach Specialist, HMA Cultural Marketing
And, much more!
For more information contact, Michelle Caul at email@example.com
2/14/2017City of Meriden Job Opportunities
1/13/2017SAVE HEALTHCARE RALLY in Hartford Jan 15
1/10/2017Job Posting - Public Health Section Chief (DPH)
Connecticut Public Health Association © 2014.


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Welcome to the lexicon of commercial gym flooring. At RubberFlooringInc gym flooring is our specialty, and we have been supplying high level commercial gyms along with smaller personal training studios with durable, high quality rubber flooring for over 8 years. You will find an comprehensive collection of gym floor rolls, tiles and mats to set the foundation for a flourishing business. We provide the fastest lead times on the market with many flooring options shipping in less than 7 business days, which means you can open your new gym even sooner than you imagined, Our gym flooring options come with lengthy warranties certain to keep your floor standing strong for years to come.


text: The Lone Wolf Alpha II Hang On Treestand is the benchmark by which all other hang on treestands are measured. Lightweight, roomy, deadly quiet, and easy to use. It's no wonder diehard hunters view their ALPHA Hang On treestand as a key to their success season after season. The ALPHA features a convenient self- eveling seat and platform, and accepts the E-Z hang hook accessory, allowing users to preset multiple stand locations for quick, easy hanging.


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So I've been playing in Daily Tournaments the past week to capitalize on the token system after sparingly playing UR on and off over the past year.
I noticed this past week, while playing in Daily Tournaments in the T1 (25 star) room, that just about every deck I played against was a Mono Sentinel deck with the same 8 characters.
It's always Hawk, Copper Cr, Martha, Westwood, Lehane, John, Carmen/Flinch/Melvin, and Morgan/Tobbie. The variety is infinite!
If everyone is trying to get Tokens and is trying to win the Daily Tournament I understand they want the best deck, but 7/10 matches I play are against a Mono Sentinel deck.
I play UR for fun, and enjoy the challenge of playing against a variety of other decks and clans, and don't really care about the outcome of the match, whether I win or lose. But playing against the same deck over and over has gotten REALLY boring and almost annoying at this point. Not because I perform poorly (see below for recent results), but because I play this game to enjoy it and have fun. Playing against the same deck over and over is not fun.
I don't know if we can redo the penalty list or ban characters or what the solution is, but this Mono Sentinel thing is out of hand.
Hello 40Waffles,
Congratulations! You finished 138th in the last Daily Tournament with 414 Battle Points.
Deck: Sekutor, Neloe. Sunder, Ward hg, Archibald, Brianna, Milena, Wyre
What are your thoughts on this Mono Sentinel epidemic?
But yeah playing against the same cards over and over again gets boring
Entered 2 DTs last night. 5/9 matches were against Mono Sentinel
First match of the 2nd DT was mono Sentinel....stopped right there, wasn't dealing with another hour of "fun"
To be Honest,I got used to it,I now use Sentinel too,don't care anymore about the new Penalty list,I really don't.
Elkas, I could go with the classic montra "if you can't beat them, join them" but I would much rather not conform to what seems to be the "main" or "only" way of reaching a top rank in a DT.
I agree, that is probably the best approach to countering mono Sentinel is to do it yourself. But a mono Sentinel vs mono Sentinel match is kinda boring.
I would love to play a variety of decks and try new things out. Or at least rock a legitimate deck with 2 random clans rather than doing the same, boring clan.
To each their own, obviously, it's just unfortunate that you have to play a game a certain way to achieve top results rather than having the opportunity to play the game your way and achieve the same results.
I play a mono Skeelz deck in tourney when i play though.


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Acrylic Painting: Step-by-step
By: Carole Massey (author), Wendy Jelbert (author), David Hyde (author)PaperbackIn Stock
This is a practical and inspiring guide for all acrylics enthusiasts, from the beginner to the experienced artist. There is helpful general advice on which materials to choose, and then three high profile artists share their expertise, tips and techniques. Wendy Jelbert explains the basics of painting with acrylics and gives advice on useful techniques and the effects they can create. David Hyde writes on painting landscapes with acrylics, from composing landscapes and choosing colours to creating depth and painting different seasons. Carole Massey shares her flower painting expertise with advice on flower colours, drawing flowers, composing flower paintings and using tone. Finally Wendy Jelbert explores further creative techniques for painting with acrylics and shows how these can be applied in paintings. There are ten easy to follow step-by-step demonstrations with clear photographs and helpful instructions, and many inspirational paintings for readers to admire. This title comprises material from the "Leisure Arts" series: "Painting with Acrylics" (9780855328405); "Landscapes in Acrylics" (9780855320234); "Creative Acrylic Techniques" (9780855328481); "Flowers in Acrylics" (9780855328535).Create a review
About Author
Wendy Jelbert is a teacher and a professional artist who works with pastels, oils, acrylics, inks, and watercolors. She is the author of several books, including "Wendy Jelbert's Line & Wash" and "Wendy Jelbert's Water-Soluble Pencils." Carole Massey is a practicing instructor and an exhibiting artist. She is the author of "Figures in Watercolour," "Flowers in Acrylics," and "Water Soluble Pencils." David Hyde is a self-taught artist and the author of "Landscapes in Acrylics."Contents
Materials6 PAINTING WITH ACRYLICS10 by Wendy Jelbert My palette12 My sketchbook13 Colour mixing14 Playing with acrylics16 Painting skies22 Sunlit Window26 Step-by-step Farmyard36 Step-by-step LANDSCAPES IN ACRYLICS42 by David Hyde Composition44 Colours for landscape48 Creating depth51 Seasons52 Distant Mountains54 Step-by-step Still Water64 Step-by-step Ancient Tree74 Step-by-step FLOWERS IN ACRYLICS80 by Carole Massey Flower colours82 Flower shapes & drawing86 Composition for flowers90 Tone94 Techniques for flowers96 Primulas98 Step-by-step Rose Arch104 Step-by-step Stargazer Lilies112 Step-by-step CREATIVE ACRYLIC TECHNIQUES118 by Wendy Jelbert Creative techniques120 Creating texture122 Applying techniques124 Lilac Blooms126 Step-by-step Seascape136 Step-by-step Index144Product Details
- publication date: 01/09/2009
- Format: Paperback
- Number Of Pages: 144
- weight: 599
Delivery Information
- Saver Delivery: Yes
- 1st Class Delivery: Yes
- Courier Delivery: Yes
- Store Delivery: Yes


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- Japan, which imports more than 60 percent of its food requirements, the highest level among developed countries, wants to become less dependent on overseas grain supplies to protect it from soaring international prices and ensure long-term security of supply, Yuji Sawa, vice minister of Agriculture, Forestry and Fisheries, said in an interview.
- South Africa, the biggest corn producer in Africa, may increase its forecast for this year's crop by 1.7 percent, according to a Bloomberg survey of grain traders.
Long term support for the RTSI Index is 2133, and today we're seeing that line broken. As a leading indicator, this does not auger well for energy prices.
It is global this time, indeed.
The "Trade" here in global equities is that inflation is abating sequentially from its June 2008 peak. Yes, inflation remains elevated, but that's not the point. The point is that once you're reading the July inflation reports, they'll have come down from June.
Jean Claude Trichet and the ECB are going to start to look a lot smarter by the day. They stepped up, raised rates, and quelled inflation… for now.
Hedgeye Statistics
The total percentage of successful long and short trading signals since the inception of Real-Time Alerts in August of 2008.
Central bankers in Asia have been proactively hawkish, fighting the good fight on the inflation front. With commodities correcting this week, they're getting rewarded for their travails. The head of the Philippines central bank came out with explicit comments overnight that he needs to raise rates further. His domestic stock market and currency liked that, and rallied. South Korea's new President has recently done the same. Korean equities traded up another +2% overnight.
Ben Bernanke, I hope you're taking notes.
Does this new team 'get it' that it has to play catch-up in investing in its brands to stimulate growth at a consistent rate? This raises an interesting decision tree for me.
If the answer is 'Yes' then the timing is still too early on CRI, as there is another guide down to come. Perhaps the sheer magnitude of the changes to come take longer than the 6 weeks since the change was announced. I'm in this camp, and can completely see why it should take time to build the plan – especially given that this plan is likely to not include several senior managers at the company (i.e. Casey needs to walk on eggshells while he cans some colleagues).
If the answer is 'No' then this story is back to one where it will rally repeatedly on false starts – only to fundamentally stall due to lack of horsepower to compete. I don't think this is the case, but tonally – it is THE KEY thing to watch out for. If Casey's agenda (regardless of how it is discussed on the call) is about 'tweaks' to the model instead of material changes in strategic direction, then I'm going to eat crow on this story and head for the hills.
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Jan Bekker
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Jan Bekker was a mage and likely the very first nordling to master the magic of the Old races. He subjected the "Force" to his will, thus granting the north a powerful weapon in their many fights to come. He was a member of the Novigradan Union, along with Geoffrey Monck and Giambattista, and an original member of the Chapter of Wizards.


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text: Heel measures approximately 125mm/ 5 inches with a 40mm/ 1.5 inch platform. Espadrille wedges epitomize warm-weather style, and Paloma Berceló's coral suede pair will give wardrobe favorites an instant new-season update. Slip them on to add an easy pop of color to a white shirt and black shorts. Shown here with a Miu Miu shirt, Milly clutch, Erickson Beamon bracelet, Marc Jacobs shorts and a Kenneth Jay Lane necklace.


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Ottawa, ON, Canada < change city >
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June, 2010 in Ottawa
Ceremony: Knox Presbyterian Church
Reception: National Arts Centre - Fountain Room
- Cakes/Candies Vendor: Kakes by Judy
- Invitations Vendor: Shutterfly
- Florist: Bloomfield's
- Videographer: B & M Video
- Invitations Vendor: The Papery
- Wedding Fashion Vendor: Saratina Bridal Boutique
- Ceremony: Knox Presbyterian Church
- Attractions: Canada Science and Technology Museum
- Reception: National Arts Centre - Fountain Room
- Attractions: Canadian Aviation Museum
- Hotels: Cartier Place Suite Hotel
- Attractions: Canadian Museum of Civilization
- Hotels: Holiday Inn Hotel & Suites
- Attractions: Canadian Museum of Nature
- Hotels: Hotel Indigo
- Attractions: Canadian War Museum
- Hotels: Lord Elgin Hotel
- Attractions: National Gallery Of Canada
- Hotels: Chateau Laurier
- Attractions: Ottawa Dragon Boat Race Festival
- Hotels: Ottawa Jail Hostel
- Attractions: Parliament Hill
- Attractions: Bytown Museum
- Attractions: Rideau Centre
- Attractions: ByWard Market
- Attractions: Sparks Street Mall
Cakes/Candies Vendor:
Kakes by Judy
Ottawa, Ontario, Canada"Judy did an excellent job on our wedding cake. My husband and I don't have a car, and Judy was nice enough to come by our apartment after she was done setting up for another wedding nearby. We weren't sure what we wanted, and needed to compromise, but Judy guided us and gave us a beautiful and delicious cake. Very reasonably priced, and will set up at the venue. She also provided a cake box so we could save the top layer."
101 Fourth AvenueOttawa, ON, Canada
+1 613-230-6434
"Bloomfield's did an amazing job on my bouquet and our centrepieces. I did not want a round bouquet that is so popular now, and Virginia and her staff did an excellent job on my cascading bouquet. The centrepieces were lovely. They are a delight to work with."
Invitations Vendor:
The Papery
850 Bank StOttawa, ON K1S 3W1, Canada
+1 613-230-1313
"The Papery is a lovely stationary and card shop in the Glebe. They have 3 huge books of wedding invitation templates to choose from. The printer is in Stratford, so you once the final proof is approved, you will have your invitations by the next week. Call ahead of time because you may have to make an appointment."
Invitations Vendor:
Carolina Beach, NC, USA"Shutterfly allows you to custom make any paper product, including thank you notes, invitations, photo albums, etc. They are based out of the US, so shipping can take a week or two and adds some cost, but the end results are worth it. I used them for my wedding thank you notes, and have made several photo albums in the past."
B & M Video
1297 Perez CresentOttawa, ON, Canada
"Mike from B & M did a great job on our wedding video. He was very nice to deal with via email before the wedding and on the day-of. Other than capturing the event, my favourite part of the video is the little interviews with our family and friends. He did a great job on the editing, and the short 3-minute video is great to show to friends and colleagues. The quality of the sound and image is excellent. Very reasonably priced, and a few options for how much you want filmed."
Wedding Fashion Vendor:
Saratina Bridal Boutique
422 Speers RdOakville, ON L6K 2G2, Canada
"Saratina's was a wonderful experience. I was getting exasperated with my dress search after trying on 40+ dresses at dozens of stores. Saratina has a great selection, but not overwhelming for very reasonable prices. I wanted a silk gown, and I found one for under $1000. Their seamstress did an amazing job, and was very reasonably priced. They were very nice about accommodating my request for one-day alteration, since I live in Ottawa and was in town to visit my family. Would recommend to any bride who wants a beautiful gown."
Knox Presbyterian Church
227 Elgin StreetOttawa, ON
"Gorgeous large church with a wonderful organ. It was a pleasure putting the ceremony together with Rev. Gemmell and the organist played some songs for us so we could choose which ones we wanted. There is a lovely courtyard that you can take photos in and greet your guests after the ceremony."
National Arts Centre - Fountain Room
53 Elgin StOttawa, ON
"Our wedding reception at the National Arts Centre (NAC) was fabulous. We chose to get married in a church nearby, but you can have your ceremony there too. For being right downtown it is very reasonably priced. The room rental fee may seem steep at first, but it includes everything (linens, flatware, tealights) and there is no cake cutting fee! We wanted an all-day breakfast for dinner, and they accommodated our request happily, along with serving mimosas. The Fountain Room was a perfect size for our 100-person wedding, and having the terrace overlooking the canal on a warm summer night made the day even more perfect. The other review mentions some negative things, but we weren't kicked out until 2, and alcohol was flowing until 1. I can't give it 5 stars since the venue wasn't perfect. During the last speech we could hear the music from the room beside ours, which was a bit distracting. But once our music started (on the dancefloor at the other side of the room) we never heard it again. Communications via email were sometimes a bit unclear, but there is only one contact person, which is nice, and she is great. The evening of our wedding there was a festival at the park across the street so Elgin street was closed, which isn't the NAC's fault, but something to be aware of. Overall, a great experience, and I would recommend the NAC to anyone."


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Stang.racrRegistered Member |
Last Activity: 04-18-2014 12:53 PM
About Me
- About Stang.racr
- ME Local
- Mississippi
- Biography
- my name is daniel turnage and i live in foxworth mississippi, my current stable is a 91 coupe with a h,c,i and a small shot. my dd is a axleback only slow ol 3valve that gets 24-26 mpg lol. i love mustangs, drag racing, drinking a beer everyonce in a while, playing with my spawn of satin childern, and shooting guns
- Occupation
- Crane op
- Interests
- Girls, mustangs, and girls driving mustangs!!
- Gender
- Male
- having a fine car that is slow is like having a hot girlfriend that won't put out!


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Saudi therapist releases helpful video on wife-beating
From MailOnline
A Saudi family therapist has released a video on the 'correct way' for Muslims to 'discipline their wives' - but advised doing so using a toothpick or handkerchief.
Khaled Al-Saqaby released the footage earlier this year and admitted on camera it was a 'thorny' issue, adding: 'Allah willing, we will cross this bridge safely'.
Mr Al-Saqaby urges men not to physically abuse their wives but pursue three courses of action should they need 'discipline' - first talk to them, then 'forsake them in bed' and finally beat them.
He said wives 'undoubtedly' caused problems because many 'want to live a life of equality with their husbands', which is a 'very grave problem'.
Sitting in an unknown woodland location, he explains why men may need to discipline their wives but outlines how to do it safely and according to Islam.
In the video, he says: 'I am aware that this issue is a thorny one which contains many hazards, but Allah willing we will cross this bridge safely.
'I believe the problem arises when husbands do not understand how to deal with disobedience. Some women disobey their husbands and make mistakes with them, and their husbands think this is due to inadequate treatment [of disobedience].'
He added: 'The first step is to remind her of your rights and of her duties according to Allah. Then comes the second step - forsaking her in bed.
'Here some husbands make mistakes which might exacerbate the problem.'
He said: 'As a woman once told me, this is the most ingenious way to discipline a wife. If the husband leaves the room it is easier for her than if he remains but turns his back to her or if he sleeps on the floor or vice versa.'
Finally comes physical action, although Mr Al-Saqaby stresses it should not be a way for a husband to 'vent one's anger'.
He said: 'Women have to understand the aim is to discipline. The necessary Islamic conditions for beating must be met.
'The beating should not be performed with a rod, nor should it be a headband, or a sharp object which, I am sad to say, some husbands use.
'It should be done with something like the sewak tooth-cleaning twig or with a handkerchief, because the goal is to merely make the wife feel that she was wrong in the way she treated her husband.'
Mr Al-Saqaby adds there are some situations where a wife may hit her husband because of the 'faulty upbringing of some husbands' who may have seen their fathers hit their wives and be 'imitating their behaviour'.
But he added women seeking equality with their husbands was one of the main reasons for a husband's need to discipline them.
He said: 'This is a very grave problem. In addition, sometimes a woman makes a mistake that may lead her husband to beat her.
'I'm sad to say there are some women who say "Go ahead. If you are a real man, beat me." She provokes them.'
The video was recorded in February but was released this week via the Washington DC-based Middle East Media Research Institute.


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Check out our Career Guide for career exploration strategies, resume and cover letter guidelines, interview preparation advice, and our various resources. Consider following our 4-year Bridge to your Future plan. Take a moment to look over the key skills that employers look for in hiring, in our Professionalism Manual and Workbook.
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Look at our Career Guide for resume and cover letter examples and how to write them effectively. The sample resumes present suggested formats describing your education, work and volunteer experience and the cover letters examples will emphasize how to stress how your specific skills match the job description. Meet with a Career Counselor to review your resume and/or cover letter. To schedule an appointment, call 508-626-4625 or stop in room 412 in the McCarthy Center. Please refer to the list of helpful resources below!
Review our Career Guide for interview preparation strategies. Schedule an appointment with a Career Counselor. Prior to a job interview you can practice answering typical interview questions by scheduling a mock interview with a career counselor. You also will receive advice on how to make a good first impression with employers including guidance on proper interview attire, good body language and how to avoid common interview mistakes. The interview is truly the "make or break" moment. This is your opportunity to stand out from the competition. Interviews allow you to prove how you provide value to the organization plus you learn if the organization is a good fit for you. Please refer to the list of helpful resources below!
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In addition to meeting with a career counselor in the CSER office, please consider practicing for interviews on these two free practice sites:
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My Interview Simulator, this free program is designed to simulate a mock interview. Before you go to an actual job interview, one should practice and rehearse potential questions that can be asked. This will lead to a successful interview.
- Be Prepared for Phone Interviews. Employers often use the phone interview to save time and quickly screen potential candidates during the first phase of the interviewing process. As a job seeker, you want to be prepared as if it was an in-person interview.
- Anticipate questions. You can probably anticipate 90% of all questions that will be asked. For starters, tell me about yourself. What do you know about our organization? Why do you want to work for our organization? What interests you about the position? Behavior-based questions are very popular with employers so you want to use the Situation-Task-Action-Result (STAR) approach to give very detailed answers stressing your specific skills and past experiences. The career counselors can help you identify your unique abilities to describe during an interview.
- Dress for the part. You don't have to purchase an expensive suit, but you should have a suit. Wear minimal jewelry and use minimal amounts of perfume/aftershave (if possible, avoid altogether).
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- Follow-up after the interview. Sending a "thank you" has become a lost art. Whether it's by email, a handwritten note or a typed letter, thank everyone you meet for their time and consideration. Too many people don't send a thank note so you'll be remembered for following up professionally.
Dressing For Your Interview
The Framingham State University Suitable Solutions fund offers support for students who, because of financial hardships, are not able to purchase professional interview attire. The goal of the Suitable Solutions Program is to enable eligible students an opportunity to receive a "clothing stipend" of $50 in order to acquire professional attire for internship opportunities and job interviews. Please refer to the list of helpful resources below!
There are different possibilities and options and our goal is to help you reach your goal. We strive to always be supportive in helping you navigate your career search. Contact us to meet with a career counselor to discuss your career planning questions.
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A.Word.A.Day |
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Oct 3, 2014
This week's themeWords borrowed from Yiddish This week's words luftmensch pisher ganef macher kibitzer Art: Giovanni Garinei
This week's comments AWADmail 640 Next week's theme Words to describe people A.Word.A.Day
with Anu Gargkibitzer PRONUNCIATION:
noun: An onlooker who offers unwanted advice or criticism, for example at a card game.
From Yiddish kibitsen, from German kiebitzen (to look on at cards), from
Kiebitz (busybody, literally pewit or lapwing, a bird with a bad
reputation as a meddler). Earliest documented use: 1927.
"Don't listen to the Internet kibitzers. Arthur Chu is playing the game right." Ken Jennings; Arthur Chu Is Playing Jeopardy! the Right Way; Slate (New York); Feb 10, 2014. See more usage examples of kibitzer in Vocabulary.com's dictionary. A THOUGHT FOR TODAY:
As societies grow decadent, the language grows decadent, too. Words are used to disguise, not to illuminate, action: you liberate a city by destroying it. Words are to confuse, so that at election time people will solemnly vote against their own interests. -Gore Vidal, author (1925-2012)
© 1994-2017 Wordsmith


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Still not sure about your plan? Check out these things to do in Doha or create your trip with Doha trip planner.


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Staging of mobility, transfer and walking functions of elderly persons based on the codes of the International Classification of Functioning, Disability and Health
© Okochi et al.; licensee BioMed Central Ltd. 2013
Received: 29 March 2012
Accepted: 8 February 2013
Published: 15 February 2013
The International Classification of Functioning, Disability and Health (ICF) was introduced by the World Health Organization as a common taxonomy to describe the burden of health conditions. This study focuses on the development of a scale for staging basic mobility and walking functions based on the ICF.
Thirty-three ICF codes were selected to test their fit to the Rasch model and their location. Of these ICF items, four were used to develop a Guttman- type scale of "basic mobility" and another four to develop a"walking" scale to stage functional performance in the elderly. The content validity and differential item functioning of the scales were assessed. The participants, chosen at random, were Japanese over 65 years old using the services of public long-term care insurance, and whose functional assessments were used for scale development and scale validation.
There were 1164 elderly persons who were eligible for scale development. To stage the functional performance of elderly persons, two Guttman-type scales of "basic mobility" and "walking" were constructed. The order of item difficulty was validated using 3260 elderly persons. There is no differential item functioning about study location, sex and age-group in the newly developed scales. These results suggested the newly developed scales have content validity.
These scales divided functional performance into five stages according to four ICF codes, making the measurements simple and less time-consuming and enable clear descriptions of elderly functioning level. This was achieved by hierarchically rearranging the ICF items and constructing Guttman-type scales according to item difficulty using the Rasch model. In addition, each functional level might require similar resources and therefore enable standardization of care and rehabilitation. Illustrations facilitate the sharing of patient images among health care providers. By using the ICF as a common taxonomy, these scales could be used internationally as assessment scales in geriatric care settings. However these scales require further validity and reliability studies for international application.
In 2001, the World Health Organization (WHO) approved the International Classification of Functioning, Disability and Health (ICF) to describe functioning in health and health-related contexts. The challenges of implementing the ICF [1] in various fields such as medicine, rehabilitation, long-term care, or social care include the operationalization and quantification of the ICF categories [2]. Unlike the International Classification of Diseases (ICD) [3], also developed by the WHO, to which medical records can serve as an information resource, the ICF measures the problems in an individual's functioning with respect to a health condition. The ICF provides alphanumeric codes that are arranged in a hierarchy for each ICF category or functioning domain. The number of digits in an ICF code represents an increasing level of precision in the categorization or definition for each function in that domain. However, the high number of codes (n = 1434) makes the use of the ICF by health care professionals particularly challenging. Therefore, to facilitate the use of the ICF codes, it is necessary to tailor them to the target population.
As the ICF was developed as a classification system, it requires an additional step for use as a measurement system, i.e., using a qualifier with the ICF code. A user must select an ICF code, followed by measurement using an ICF qualifier. Qualifiers are numeric codes that specify the extent or the magnitude of the disability in that category. The original ICF qualifier is used to record the severity of the problem: no problem; mild; moderate; severe; or complete problem (included in the codes are qualifier 8 (not specified) and qualifier 9 (not applicable)). However, this approach prohibited us from using the ICF for two reasons. First, it was difficult to select relevant ICF codes from the approximately 1434 ICF codes, and if we selected ICF codes for each person, we could not compare the specific function to other persons, because the ICF codes selected for various individuals may not be the same. Second, the reliability of a qualifier for quantification of severity of a disability was not always satisfactory [4, 5].
Therefore, for adaptation of the ICF codes, a priori selection of ICF codes specific to a target population can minimize the burden of selecting numerous ICF codes. In addition, the use of a simpler qualification tool makes the ICF easier to use as a basis for measurement
There have been several studies aimed at tailoring the number of ICF codes [4, 6–9]. ICF codes related to condition-specific ICF items, such as the codes for osteoarthritis and other chronic conditions, were selected in the development of ICF Core Sets [2, 10]. This developmental effort facilitated condition-specific selection of ICF codes, but the ICF codes selected for one chronic condition may not necessarily be adaptable to other chronic conditions. The WHO provided the ICF checklist as a simple version of the ICF; however, the broad and vague definitions of the ICF codes used in the checklist limit its use in a target population such as elderly patients, because some ICF codes do not have high reliability for the intended population [4, 5].
An alternative approach is to create linkage between the ICF and existing measures of activities of daily living (ADLs) and health-related quality of life (HRQOL) [2, 11]. This approach has allowed ICF users to tailor the number of ICF categories to fit specific clinical needs [12, 13]. This approach has qualitatively linked the ICF codes to existing ADL limitation-related scales such as the Functional Independence Measure (FIM) [14]. However, in these cross-linking approaches, the absence of quantitative links limits the use of the ICF for measurement scales.
Some studies have tried to link the existing scale to the ICF codes quantitatively [15–17]. An example of such a linkage has been established between the Typology of the Aged with Illustrations (TAI) and the ICF [18, 19]. The TAI contains four Guttman-type scales for Mobility, Cognitive functioning, Eating, and Toileting. Each scale includes five thresholds that enable staging of the functioning of elderly persons. For example, the following five items are used as thresholds in the TAI mobility scale: threshold 5, "stair climbing"; threshold 4, "walking short distance"; threshold 3, "moving around on a flat floor"; threshold 2, "transferring, maintaining sitting position" and threshold 1, "rolling over on beds". A Guttman scale is composed of a set of binary items with yes or no answers, with similar content, but differing in difficulty. In this case, items are arranged in order of difficulty so that an individual who performs a particular item also performs items of a lower difficulty rank-order. However, it has been shown that some items used in a TAI scale are not in the order of difficulty when they are assessed with the Rasch model [19].
Another approach is the proposed functional staging measurement. In this measurement, sets of items are used to construct scores; which are then converted into hierarchical stages using cut-off scores. Functional staging provides a detailed description of an individual's expected ability within each identified stage, including the types of activities he or she can do. This is achieved by cross-linking Activity Measure for Post-Acute Care (AM-PAC) items to the ICF [5]. However, the items used on the AM-PAC are numerous and are not always linkable to the ICF codes. For example, "Fastening a necklace (clasp) behind your neck" is difficult to code in terms of the ICF.
Therefore, in this study, the authors constructed a Guttman-type scale using the response pattern of the ICF items analyzed by the Rasch model. If we could successfully build such a scale starting from ICF codes, we could obtain a simple scale with a staging property.
where Pi (θ) is the probability that respondents with ability θ will answer item i correctly (or be able to do the task specified by that item i). From this formula, the expected pattern of responses to an item set is determined given that estimated θ and b.
If the items with a binary response pattern fit the Rasch model, they provide a Guttman-like response structure. For this purpose, we used a binary-type response for each ICF item in this study. In the Rasch model, the Guttman response pattern is the most probable response pattern for a person when items are ordered from least difficult to most difficult. Using these characteristics of the Rasch model, we used the item fitted to the Rasch model as a threshold item in the Guttman-type scale. Therefore, selected ICF items are used as the thresholds for the boundaries between categories. Using this property of the Rasch model, we constructed two Guttman-type scales that can be used as a staging tool.
The objective of our study was to construct Guttman-type scales with the ICF codes for use in geriatric care settings. The goal was to be able to use the scales to assign patients to one stage. Staging of the functional levels of patients enhances standardization of care, helps in the planning and development of health services, and allows for communication among health services professionals concerning patients' functional capabilities. Therefore, we decided to construct a new ICF-based staging system, starting from ICF codes, rather than linkage from an extant measure, and to find a link to the ICF. This study departed from measurement of the ICF codes themselves. Using the results, we reconstructed a new measurement tool to stage the functioning of elderly persons.
Item selection and assessment
We selected 19 items related to mobility, walking, and transfer based on a previous study on reliability [4]. The 19 items were then modified into 33 items which specified performance in relation to mobility, walking and transfer. We divided the 33 ICF codes into 12 "basic mobility"-related items, and 21 "walking"-related items according to the meaning of each code. These modified items were labeled differently from the original items compared with the labeling used in the study. For example, the ICF code "Maintaining a standing position (d4154)" was divided into "Maintaining a standing position with assistance (d4154a)" and "Maintaining a standing position without assistance (d4154b)." The modified or specified ICF codes are shown in Additional file 1. All ICF items are attached with illustrations [21].
In this study, we recruited two groups, one for scale development, and another for scale validation. For both groups, elderly persons over 65 years old were recruited. For scale development, Japanese elders from 14 institutions and 14 day care-services under the auspices of long-term care insurance (LTCI) were recruited. Each facility was asked to randomly select 10% of their users. The developmental sample was measured with the 33 ICF items.
For scale validation, data from 182 institutions and 177 day care centers were collected. Each facility randomly selected 10% of their patients for participation in the study. The ICF items selected by the scale development process and the newly constructed Guttmann-type scale were measured in this sample.
Each patient was measured with respect to each ICF item according to performance (whether or not the participants do a task as part of their daily activities) or capacity (whether or not the participants could do the task in a special or "standard" environment setting such as in a rehabilitation room). The performance results were used in this study. We did not use the 0-4 generic qualifier of the ICF. Each item was assessed/rated "yes" or "no" using the binary response options to construct a Guttmann-type scale.
The assessment was based on the observation of the daily activities in a geriatric health facility. For example, in the assessment of maintenance of sitting position, the authors did not specify the duration of maintenance of such activity unless specified otherwise, but if the elderly person was capable of maintaining a sitting position regularly, the assessor checked "yes" to this item.
The assessment was performed by trained health care professionals such as physiotherapists, occupational therapists, nurses, and certified nursing aides, who also had experience in geriatric health assessment. In addition, the health care professionals were given training by the authors on how to make the assessments using each ICF item.
Written consent to participate in this study was obtained from each participant or the participant's proxy family member. The study was approved by the Ethical Review Board of the Japanese Association of Geriatric Health Services Facilities, and is in compliance with the Declaration of Helsinki.
Data analysis
The characteristics of the sample and contrasts between the variables were analyzed using SPSS version 12.0 (IBM Corporation, Armonk, NY, USA). Rasch analysis was performed with RUMM2030 (RUMM Laboratory Pty. Ltd., Duncraig, WA, Australia). The Rasch model was employed to identify item-fitting and redundant items and to identify a hierarchy of mobility items ranked from easiest to hardest. For this analysis, a sample of 300 items was randomly selected from the eligible sample for scale development (n = 1164). If we use the total sample, most of the items appear to not fit the Rasch model because fit statistics are sample size dependent and as the sample here is relatively large. Therefore, all items would be significant and not fit the model unless a smaller random sample is selected [22]. Thus, taking into account the relationship between sample size and significance of mean-square statistics, the authors decided to use the sample size of 300 [23].
The ICF items that showed a low fit to the Rasch model were deleted iteratively until the remaining items reached an acceptable item fit (selection criteria P > 0.05). The iterative process is not shown in this paper. Of the items that showed a closer fit to the Rasch model, four items (out of 12 items) for basic mobility were selected, and four walking-related items (out of 21 items) were selected. A panel of health care professionals, including a physician, nurses, nursing aide, physiotherapist, and occupational therapist, reviewed the items selected after statistical selection of the items. If we had more than four items that fit the Rasch model, then the panel members chose the final item based on its applicability in daily care settings.
Then, two Guttman-type scales namely "basic mobility" and "walking" were constructed using the four ICF items selected for each scale, and illustrations were attached. Using the sample for scale validation, the threshold location of the newly developed scale was tested against the ICF items to see whether the order of the threshold was in order of difficulty for each ICF item. In addition, differential item functioning (DIF) for study location (day care and institution), sex and age-group (under 74 years, 75 to 84 years, 85 to 94 years and over 95 years) was tested for scale validation [24].
Among 1560 potential study candidates from the sample for scale development, 1164 were eligible for this study. A total of 396 participants were excluded due to missing data. Those persons with missing data did not differ significantly in terms of sex, age group and study location, according to the chi-square test. The average age of the candidates in the eligible sample was 84 (SD 8) years, and 222 (19%) of the study subjects were men. Of these, 313 (27%) elderly persons were living at home and assessed while using a day care service. The participants in the remaining sample were institutionalized elderly persons.
Item locations and fit statistics for basic mobility
ICF code | Item related to body movement and body posture | Location | Fitness | p-value |
d4100 | Lying down | −1.53 | 4.87 | 0.09 |
d4103 | Sitting | −0.86 | 3.56 | 0.17 |
d4105 | Bending | −0.16 | 1.40 | 0.50 |
d4106 | Shifting the body's center of gravity | 0.80 | 9.16 | 0.01 |
d415 | Maintaining a body position | −3.29 | 0.82 | 0.66 |
d4153a | Maintaining a sitting position without assistance | −0.33 | 3.33 | 0.19* |
d4154a | Maintaining a standing position with assistance | 1.84 | 3.48 | 0.18 |
d4154b | Maintaining a standing position without assistance | 3.51 | 3.64 | 0.16* |
d420 | Transferring oneself | 0.38 | 22.29 | 0.00 |
d4200 | Transferring oneself while sitting | 0.07 | 3.76 | 0.15* |
d4201 | Transferring oneself while lying | 1.92 | 5.08 | 0.08 |
d4208a | Changing lying position | −2.35 | 1.50 | 0.47* |
Item locations and fit statistics for walking functions
ICF code | Item related to mobility and walking | Location | Fitness | p-value |
d450a | Walking with assistance from a person | −1.93 | 29.66 | 0.00 |
d450b | Walking without assistance | 1.12 | 3.14 | 0.21* |
d4500a | Walking short distances (50 m) | −0.88 | 4.50 | 0.11 |
d4500b | Walking short distances (50 m) on flat floor | −1.50 | 13.92 | 0.00 |
d4502 | Walking on different surfaces | 1.55 | 1.91 | 0.38 |
d4503 | Walking around obstacles | −1.87 | 12.87 | 0.00 |
d4551a | Climbing (climbing upstairs) | 1.64 | 0.52 | 0.77* |
d4551b | Climbing (climbing downstairs) | 1.22 | 2.78 | 0.25 |
d4601a | Moving around within buildings other than home (in nursing home) | −4.23 | 1.44 | 0.49* |
d4601b | Moving around within buildings other than home (not nursing home) | −0.50 | 6.57 | 0.04 |
d4602 | Moving around outside the home and other buildings | 1.36 | 2.82 | 0.24 |
d465a | Moving around using equipment (with cane) | 0.11 | 5.39 | 0.07 |
d465b | Moving around using equipment (with cane and braces) | 1.04 | 3.49 | 0.17 |
d465c | Moving around using equipment (with T-shaped cane) | −0.18 | 3.70 | 0.16 |
d465e | Moving around using equipment (with four-point cane) | 1.30 | 2.27 | 0.32 |
d465f | Moving around using equipment (with walker) | −0.43 | 3.67 | 0.16 |
d465g | Moving around using equipment (with circled-type walker) | 1.55 | 2.05 | 0.36 |
d465h | Moving around using equipment (with wheelchair) | −2.42 | 187.31 | 0.00 |
d465i | Moving around using equipment (with braces) | 0.98 | 4.41 | 0.11 |
d4701 | Using private motorized transportation | −0.96 | 6.93 | 0.03 |
d4702 | Using public motorized transportation | 3.04 | 1.16 | 0.56* |
In the present study, the authors reduced the number of items by constructing Guttman scales in combination with Rasch analysis. An example of a basic mobility scale is shown in Figure 1. This Guttman-type scale is composed of 4 ICF items that were used as thresholds. The levels between the thresholds are labeled, and illustrations have been added to clarify each level. For example, as seen in Figure 1, stage 1 of the basic mobility scale is not being able to change in and out of a lying position independently. If the person is able to change position but does not maintain a sitting position, they are assessed as stage 2.
We tested the characteristics of the newly developed scale using the sample for scale validation. There were 1706 elderly persons using an institutional service (average age, 85 years) and 1554 elderly persons using a day care service (average age, 81 years) from whom we obtained the data for validation. There were more institutionalized elderly persons in the sample for scale validation, but the percentage according to sex did not differ significantly between the two groups. For the age category, the sample for validation was younger (average age, 82 years) compared with the sample for development (average age, 84 years) because the former included more elderly persons in the age group between ages 64 and 75 years.
The ICF-based classification developed in the present study has wide applicability. First, patients can be assigned to one stage in each scale. Staging offers standardization of rehabilitation and care management because patients of the same group in a certain level require a similar amount and type of resources. This was achieved by hierarchically rearranging the ICF items and constructing Guttman-type scales according to item difficulty.
This approach also provides the opportunity to analyze longitudinal changes in an elderly person's functioning. Based on the results shown in Figure 3, the item location of each sample as shown was used to develop this scale. As shown here, patient characteristics are demarcated by ICF codes not only qualitatively, but also quantitatively. The location of each threshold item used to construct staging is arranged in a logit model. If a patient improves from one stage to the next stage, then the amount of improvement can be estimated by the difference between the two items' locations. This means that the user can estimate patients' functioning levels and follow them quantitatively.
Results from our study can also be used to allocate resources, such as for rehabilitation. Figure 3 shows the initial ICF items plotted on the new scale in order of item difficulty. As shown here, the patients within a specific category may or may not be able to perform the tasks represented by the adjacent ICF items. Therefore, these items can be used as proxy targets for rehabilitation.
Some ICF tools, such as ICF Core Sets, have used the ICF codes separately. ICF Core Sets have been developed in the effort to make the utility of the ICF practical and feasible, particularly in clinical settings. Only selected ICF categories that were found to be relevant to a specific health condition, setting, or context are included in a Core Set. Our approach differs from most ICF Core-Set approaches because our method does not select patients by diagnosis. This is because, in sub-acute care settings such as nursing homes or rehabilitation care facilities, as well as in home care settings such as day care, patients are not divided by disease category. Some cross-group difference was analyzed using DIF analysis and no DIF was found between the elderly persons in institutions and day-care facilities, which implies the applicability of this method for both settings. In addition, the scales can be used as a classification system because they have staging properties. By adding illustrations to the scales, a clear image concerning basic mobility and walking can now be obtained for each patient.
Our study does have some limitations. First, the location statistics of two ICF items used as thresholds, namely, 'Going out using public transportation (d4702)' and 'Climbing up stairs (d4551),' were very near each other, which results in weak discriminative power, as shown in Figure 3. This was also evident in the newly developed mobility and walking scale. 'Going out using public transportation' may require not only mobility functioning, but also adequate cognitive and orientation functioning. However, we retained this item in this scale, because for the elderly living at home, this skill is important for staying active in society. Second, we could not use the exact ICF codes because the ICF itself does not provide code definitions applicable or specifically intended for the geriatric setting. Therefore, we had to attach associated words to fit the geriatric care setting such as "Maintain sitting position without assistance" and "Walking without assistance". Third, our study population is Japanese, which could limit the applicability of our findings to other types of patients, settings, geographical locations. Furthermore, our study was conducted in a government long-term care facility, which may impact the use of certain assessment instruments in other populations.
However, the scales we have developed satisfy content validity, because items were selected from a broad spectrum of mobility and walking. In addition, by dividing the items into the categories of basic mobility and walking, and allowing each item to have a closer fit to the Rasch model, the scales are likely to be both measuring a single dimension with different difficulty and satisfying the construct validity. Use of expert opinions to help selecting items for the scale also adds validity. However, further supporting evidence through subsequent studies will need to be considered.
The absence of differential item functioning across institutional and day care users, sex, and age group indicates the cross-group validity of the scale. Therefore, these scales may be ready for use as assessment scales in geriatric care settings. In addition, we can now better understand and manage patient care using functional information based on the ICF. As we used ICF as a basis for our taxonomy, these scales may be used internationally. However, the contextual difference in language across countries should be taken into account for international application.
Furthermore, aspects such as test-retest reliability and both concurrent and predictive validity are also essential elements of outcome measurement. Hence, these would need to be examined in future studies. Using the same methodology, ICF-based staging scales relating other aspects of ADLs, such as eating and toileting, as well as cognitive functioning and social participation, are under development.
We have developed two simple staging scales for basic mobility and walking based on the ICF for elderly persons. Using these scales, patients are assigned to one stage in each scale. This was achieved by hierarchically rearranging the ICF items and constructing Guttman-type scales according to item difficulty using the Rasch model. These scales facilitate objective, simple and clear descriptions of elderly functional levels thereby improving the ability to use as a comparable assessment and staging tool. In addition, each functional level might require similar resources and therefore enable stan-dardization of care and rehabilitation. Illustrations facilitate the sharing of patient images among health care providers. The authors are currently performing additional validity and reliability studies to enable the scale to be used in international geriatric care settings.
We would like to express our appreciation to the JAGHSF for providing research data and making this research possible. This research was supported by the Health Labor Science Research Grant H21-Cyouju-Ippan -005, H24-Chouju-006, and the H20 Geriatric Health Promotion Research Grant from the Japanese Ministry of Health, Labour and Welfare. Part of this research was presented at the 25th Working Conference of Patient Classification System International (PCSI).
Authors' Affiliations
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Pre-publication history
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whichbe commented on the word dippydro
Person who often changes mind. (from Phrontistery)
May 25, 2008


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11/29/2012 10:16pm, #271
2/07/2013 8:15pm, #272
- Join Date
- Jul 2011
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- Pasadena, CA
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- Judo noob, injured guy.
--This thread is wonderful
I come from an ATA school as well. I have referenced my TKD background a few times in various threads, but I haven't really been around this forum long enough for people to know who I am, so I will tell my story briefly to contribute to the knowledge base.
I took TKD in the early 2000's for about 4 years, earning a Black Belt Recommended (I was surprised no one mentioned the two different ranks within each belt... that might be a regional thing). From other people's stories my club was pretty decent. We mostly did forms but also made time for physical conditioning and medium contact sparring (no face punches). I suspect most of my positive experience comes from the fact that the instructor was an honest, realistic dude. He told us to cross train if we wanted to get better, that boxers would manhandle us, and so forth.
However, testings were always silly. It was memorization of one steps and forms and no-contact sparring (and I always ended up paired with some 8 year old... which as a 6'3" man makes no-contact sparring look even more unimpressive). The only people who were ever failed were people who completely failed to fulfill the "know your form" paradigm.
After leaving (and several years of no martial arts) I eventually ended up at an MMA gym that emphasized no-gi MMA. There I learned that I had no ground game or sub defense. The kickboxing classes there also taught me that I had little to no kickboxing skill beyond a nice left - right - front kick combo that my TKD instructor liked.
Eventually I took up Judo. I learned that I could be taken down at will by anyone who was trained in grappling. I also learned that the friendly Dojo atmosphere of friendship and mutual learning was something that could be found in more practical martial arts.
I think ATA TKD taught me a few things. I did learn to punch and kick hard, and to do some of the more practical spinning kicks pretty well (back - kicks etcs). I credit my instructor actually bothering to emphasize good technique with the teens and adults with doing that. But really, it did not teach my to fight.
Do with that as you will.
12/23/2013 11:08pm, #273
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- Dec 2013
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- Detroit
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--Hi all, I wanted to PM some of the more experienced posters in this thread before I did any posting but if there is any chance to update the FAQ and to answer more I'd like to help where I can. I used to train with shu2jack in Tecumseh back in the day. If he's still lurking around here: Hey Jack, it's been a long time but I hope all is well.
So if you'd like to talk to someone part of the ATA but not a clown like so many of the posters here seem to be, just get a hold of me, I'm not interested in sugarcoating anything and will be frank and honest. Many thanks guys, love the site.
6/21/2014 2:45pm, #274
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- Aug 2002
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--Who cares? ATA is just another McDojang chain.
6/21/2014 3:21pm, #2752
Apparently, you do since you bumped a 6 month old thread.
6/24/2014 4:40pm, #276
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--Oh boy...
I debated on whether or not to bite at a troll, but just in case it wasn't clear in my first post, I was just offering up perspective. No one said anything until now, so I haven't posted since then. I'm not on a crusade to win forum debates to make people think differently about ATA, just to say there are a few (myself included) who do things differently and think we can change it from the inside and make it a part of the larger respectable martial arts community.
So unless you're scheduling a throwdown to put some walk to your talk, come at us with at least a degree of intelligence next time.