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Sir I am facing lot of stress, memory loss, tension, less confidence. please tell me how to over common these problems.
My wife is suffering from BIPOLAR AFFECTIVE DISORDER. I want to know more about this disease and also permanent cure or solution at the earliest.
I got irritated and getting angry on others whole day and night .suffering from stress, mental tension. I can not sleep. A severe forehead pain. What to do?
Sir... I have suffer from depression problem my mind has does not work to do any work properly and I do not concentrate our business tell me how I reduce our stress and what meditation I do.
Hello I am 22 year boy I have concentration problem Many times I forget that what was I am reading and mind goes away from the study So what should I do to increase my concentration power.
Binge drinking is a problem that has been noticed nowadays in many teenagers and youngsters. Whether it is at an event or a party, drinking high doses of alcohol in one sitting is known as binge drinking.
Binge Drinking in Women Is Different from Men
Binge drinking for men is the consumption of more than five alcoholic beverages in one sitting. But the case is different for women. For women binge drinking is defined as a woman consuming more than four alcoholic beverages in a single sitting. Also, it has been found in a survey that almost 75% of the binge drinkers are college students. Among these, the ratio of men is much higher than women.
What Leads to Binge Drinking?
- Lack of control: One of the most common reasons is, of course, the lack of control. When such a person comes in contact with alcohol, they tend to over drink because they have no control over their drinking.
- The weekend fun: Secondly, another reason is seen in the case of youngsters between the age of 18 years to 35 years. These are youngsters who have a tendency of meeting friends and going out on weekends after the week's toil. They know that after this weekend they will be able to enjoy their favorite bottle only in the next weekend. Hence, they binge drink.
Results of Binge Drinking
It becomes difficult to check how much alcohol will affect a person, because it depends on various factors, such as height, weight, age and also at times, alcohol tolerance of the person. But of course, there are some common results of binge drinking. Some of such results are:
- Unintended and unprotected sex leading to pregnancy or even STDs (sexually transmitted diseases) in some cases
- Accidents that may lead to severe injuries and even death at times
- Physical or mental assault of others that the person may regret later on.
When Is Help Required?
When the person has a habit of driving after drinking, neglecting family and doing harm to others as well, help is surely needed. Here, short 4-5 sessions with a therapist may help. A regular drinking habit is no doubt a reason to worry. But binge drinking is another reason that can lead to bigger problems and hence, needs to be examined closely too. If you wish to discuss about any specific problem, you can consult a Psychiatrist.
Anxiety is a very normal emotion, which gives rise to feelings of nervousness every now and then. An anxiety disorder is a serious medical condition in which people experience a high degree of distress and mental trauma, which causes difficulties in leading a normal life. People suffering from this medical condition experience high levels of anxiety and nervousness almost all the time. Here are the symptoms that indicate you're suffering from anxiety disorder.
1. Excessive worry - This condition persists if you worry about the day to day activities a bit too much on a regular basis. It is identified when you start taking too much stress about very petty things, which tends to affect you in an adverse manner. A noticeable sign of excessive worry can be too much fatigue.
2. Sleep problems - Problems falling asleep at the right time and problems in maintaining a sound sleep are two signs that indicate you have an anxiety disorder.
3. Irrational fears - This symptom is not generalized; instead, it is specific and subjective in relation to a particular thing or situation. The fears that are experienced under this category are sudden and unexpected in nature and there is no fixed rationale behind these fears.
4. Muscle tension - Muscle discomfort and pain is one of the leading physiological causes of an anxiety disorder. The pain felt is chronic and pervasive, and is very common among people facing situations of anxiety. If you are exposed to constant periods of anxiety, you will experience fatigue, muscle pains and unwillingness to work.
5. Chronic indigestion - Problems related to the digestive system are also a sign of anxiety disorder. In this case, you may face constant digestive problems accompanied by a common disorder called IBS (Irritable Bowel Syndrome). IBS refers to an anxiety situation in the digestive tract, which is characterized by stomach aches, cramping, bloating, gas, constipation, and/or diarrhea.
Apart from the above-mentioned symptoms, other symptoms of an anxiety disorder include stage fright, self- consciousness, panic attacks, memory flashbacks, perfectionism, compulsive behaviors, self- doubt, and such others. If you wish to discuss about any specific problem, you can consult a Psychiatrist.
I can't concentrate on studies and any physical work I do my brain and mind is not under my control if try to concentrate specially in studies my headache starts what should I do now.
Hlw, respected doctors my problem is first related to OCD which is not curing by medicines and second problem is getting thin day by day like a old man I'm living in very depressed for my health. Sometimes once in a week i do masturbate that's cause of my weakness I can't quit masturbate but i do tell me how to become healthier and OCD treatment medicines. THANK YOU.
Fear, anxiety and stress can often lead humans to either escape the situation or fight it by defending themselves. But there are other behaviours that humans turn to when they are under stress. This is not unnatural at all; we all face it at some point in time. What's more, even dogs revert to the four Fs when under stress. Let us find out what are they and also how to deal with them.
- Fight: Fighting back is the natural reaction, which we turn to when we want to defend ourselves. Shouting at someone might give you some confidence for the time being. But again, it is not a permanent solution. We might end up apologising for our behaviour later but do nothing to address the situation that brought about that kind of behaviour.
- Flight: This is the escape mode that we turn to when we want to avoid a certain person or scenario, that might lead to stress. However, it must be remembered that, fleeing stress will help in fixing it temporarily. But since the situation remains unchanged, it will keep happening again and again.
- Freeze: For some people, the shock is so overwhelming that it becomes difficult for them to react at all. They simply freeze. The person goes into the panic mode and fails to move or say anything.
- Fool around: This option seems to be not a very bad idea in times of stress and anxiety depending on exactly what you mean by fooling around. If you can crack a joke at a tensed situation and lighten the mood, it helps immensely. However, if your idea of fooling around is to avoid talking about the situation and instead have fun, talk about other silly things, then it might not be a good idea.
Dealing with stress is not easy, but if you have realised the cause for your stress, your problem is half solved. If it is something you can change, then start working on it. If not, then it is best to let things happen in their own sweet way, while you change your attitude towards it. If you have realised what kind of behaviour your turn to when under stress, it is easier to face the situation. Listen to some of your favourite music, wear clothes that make you feel good and think about the situation and the possible solution later. Don't let stress get to you, face situations, keep calm and be positive!
My son had approached me a couple of months ago and said that he has been unable to concentrate for a while and feels that his ability to remember stuff has decreased. I have noticed that for some while he has lacks energy and finds it hard to perform simple tasks. He has been very unstable emotionally and gets irked very easily and frequently. He gets very angry at himself and even harmed himself after a bad exam. His results were also very below par. He wasn't like this until about 6 months ago. I haven't seen him this sad before. I'm worried about his mental health and request you to recommend to me the next step I should take. I anxiously await your response. Thanking you.
I got too much anxiety thinking about my previous sex encounter. I didn't eat and sleep well for two days. After that I got burning stomach which still persists after that I got very tiny pimple like thing beneath my tongue without any pain or irritation and my lips skin also peeled a little. Is this may be oral herpes? It's bit separated and not itchy or burn. Just am worried since I received oral sex Please help me.
Sir. I am addicted to smoke too much. And Now I am suffering from cold and cough ver much. .so sir what can I do now?
Heel pain is a common problem in the body where the affected person experiences pain radiating from the heel bone. Heel pain usually progresses slowly over time, it is recommended to consult a medical professional, if heel pain turns severe. The pain tends to be most severe after one has been inactive for some time such as after waking up in the morning.
Heel pain is usually caused when tissues present in the bottom of the heel (Plantar fascia) is inflammed. These tissues connect the heel bone with the bones of the feet and acts as a shock absorber. Tears form in these tissues when they are damaged or when they get thicker. These tissues are at an increased risk of wear and tear for those who are over 45 years old. The risks also tend to increase if the person is obese or whose occupation requires standing for lengthy periods of time.
Among other causes of heel pain are heel bone fractures, fat pad atrophy (a condition where a layer of fat present under the heel bone is reduced) and bursitis (inflammation of the fluid filled sacs present around the joints). Peripheral neuropathy is a condition where damage occurs in the peripheral nerves (that transmits signals between the central nervous system and the rest of the body), this can cause pain in the heel.
The symptoms of heel pain include:
- Experiencing pain while jogging or walking
- A feeling of pins pricking the heels after waking up in the morning
- Inability to put weight on the heel
- Painful swelling
- Pain in the heel accompanied by fever
Heel pain can be prevented by taking certain preventive measures such as restricting usage of high heeled shoes without proper support and stretching the heel regularly. Medications such as painkillers are used to treat symptoms of heel pain. Consult a doctor for accurate medicines !!
I have a boyfriend who was lovely and caring before. Now he has changed after 10 months of being together. He used to call me alot but now he never calls and when I call him sometimes he answers, sometimes not. When he answers he is normal and fine. When he do not answer he never calls back. I asked him so many times what happened and all he is saying that he is so busy. I do not know what to do I feel worried and sad and I lost my appetite. What should I do?
At some point I start having panic attacks and I feel my self shaking and trembling, which makes me start crying sometimes. I feel loss of breath. Somethings make me fear a lot. What can I do? Any medications if you can suggest?
My child has a red mole on his forehead since birth it was small n it's big will it disappear or we need to do the surgery but will that harm him or leave any marks on it's face worried for the same as he is 1 years 6 months only.
A panic attack is a sudden fit of anxiety or fear. In this situation, a person's heart starts pounding and they are unable to breathe. Sometimes, they may even feel like throwing up or even dying. It may even make a person withdraw from their daily routine and reach a point of hopelessness. If left untreated, these panic attacks can lead to a panic disorder. These attacks can have more physical symptoms including shaking, nausea, dry mouth, sweating or dizziness.
There are certain medications and treatments to cure this disorder. These include antidepressants and benzodiazepines, which are anti-anxiety medications. Taking them brings rapid relief, however; these are highly addictive and can have certain withdrawal symptoms. To avoid medications, there are certain self-help tips to cope with the problem. These include:
- Avoid smoking, alcohol and caffeine. These are substances that can provoke your panic attacks.
- Learn how to control your breathing while you are experiencing an attack. Deep breathing can relieve the symptoms that come with this disorder. This can help you calm down.
- Practice relaxation techniques such as yoga and meditation. These strengthen the body's ability to respond to situations that can cause anxiety. Not only do they release stress but they also increase the feelings of joy and happiness.
- Try to exercise regularly. It is a natural anxiety reliever. Therefore, one should exercise in any form, for at least thirty minutes a day.
- You should try to get as much sleep as possible. Insufficient amounts of sleep can make the anxiety even worse. Dancing, swimming or cycling can be highly effective.
- Try not to stay alone. Anxiety levels and the chances of a panic attack are high when you are alone. If you feel that you do not have anyone to go to or turn to, try to explore ways to meet and build supportive relationships.
- Go to a therapist or a psychologist to vent out your feelings and anxieties. This can help you by giving you a cathartic release and get over your pent up emotions.
If someone is suffering from a panic disorder, make sure that you do not let it go unnoticed because people who suffer from this condition usually like to keep it to themselves. This smothers them even further and leaves them at a great risk and vulnerability. Those who have this condition should try to seek medical or psychological help in order to feel better.
Panic disorders are very dangerous and unpredictable. These can mess with your work and performance. In order to avoid that, keep noticing the signs and symptoms and reach for the correct type of medical or clinical attention. Ignoring such a condition can hamper your future and lead to a lot of other allied health problems. If you wish to discuss about any specific problem, you can ask a free question.


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Hot Links! And the Advanced Word on Lindsay Lohan in 'Liz and Dick' Is…
Plus: A holiday gift guide for the 'Downton Abbey' fans in your life, how to get P!NK's AMAs makeup look, and more!
-Lucia Peters
How's this for a headline?: "Meet Julie Daubigny, the Lady Duelist Who Dug Up a Dead Nun and Set Her on Fire (With Bonus Topless Photos)." We'll let this one speak for itself. (But it's really interesting! We promise!). (TheGloss)
What's the advanced word on Lindsay Lohan's performance in Liz & Dick? Well… it's not exactly flattering, but it IS absolutely hilarious. More here! (The Frisky)
Still looking for the perfect pair of heels to wear on Thanksgiving? Find some inspiration here. All heels, report to our closets IMMEDIATELY! (The Berry)
If the eyes are the windows to the soul, then you'd better play yours up for all they're worth! This quiz will help you figure out the best colors and application techniques for you. Eye makeup advice tailored specifically to you? Yes please! (YouBeauty)
What do you do when you see your high school classmates at your hometown bar while you're home for the holidays? Attempt to pick them up, of course. Try these 10 pickup lines on for size and see how they work! (HowAboutWe)
We don't know about you, but we're totally obsessed with Downton Abbey. Good thing there's a holiday gift guide just for gals like us! Antique hand mirrors, Lady Sybil paper dolls, and more ahead! (TresSugar)
P!NK's AMAs makeup look was gorgeous—paired down, but glowing and incredibly glamorous. Here's how to recreate it yourself! (BeautyBloggingJunkie)
Could this be the new Andrej Pejic? Meet Casey Legler, a woman working as a male model! (TheGloss)
There are many reasons why we love Rachel Bilson. The O.C. is one of them (guilty pleasure!). Her fabulous sense of style is another. Let's take a look at her 10 best looks, shall we? (The Frisky)

subset: commoncrawl


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Bookmark this site
"Recent sneak previews of the spectacular new courses have appeared on the LIVEWIRE website and other social media outlets, and the player response has been overwhelmingly positive", said Scott Morrison, VP of Marketing at IT. "The Golden Tee audience is thriving, and they can't wait for the latest version of their favorite game to hit the streets."
Like previous years, Incredible Technologies is again offering the popular "AwesomeDraw" incentive promotion. Operators who preorder course updates for all of their online games in a single order before September 23 qualify for the random drawing. Prizes include brand-new Showpiece games, full game kits, transfer cabinets, and a host of other valuable prizes.
"Ordering updates early has so many advantages," said Don Pesceone, VP of Sales at IT. "With a simple phone call and no money down, you save a spot in the first shipment, spread out your payments over a full year with no interest, and have a great chance at winning some awesome prizes. It's that easy!"
AwesomeDraw 2014 ends Sept. 23, with the drawing for prizes around Oct. 7. The first shipment is expected to ship around the last week of September. Operators are encouraged to call their IT sales rep or the IT Sales Hotline at (855) 803-1621 for more information.
Golden Tee LIVE 2014 course previews can be viewed at http://livewire.itsgames.com/news/11052-see-golden-tee-2014-in-action.
Additional information on Golden Tee 2014 can be found on the LIVEWIRE at goldentee.com.


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Sam Smith Gives Details on Heartbreak That Inspired Album
Photo: Getty Images
By Kathleen Perricone
Sam Smith released his highly-anticipated debut album, In the Lonely Hour, this week!
And the "Stay With Me" singer called in to On Air with Ryan Seacrest on Thursday morning to talk about the songs on it and his inspiration.
"Every single song is revealing, I said way too much," he says. "I've had this realization the other week when I was driving around London [and] there's pictures of my face everywhere with the word Lonely underneath. I kind of realized I'e really really opened myself up on this record."
But just because Sam included the word "lonely" in the title, it doesn't have to mean sad.
"A year ago, I was wallowing in it and I felt really sorry for myself," explains Sam. "And then I wrote the record and I realized, I'm 22 and I've got a long time to get into relationships. I don't have to take it too seriously. There's lonely moments, but I'm now in control of them."
Much of In the Lonely Hour was inspired by a guy who did not share the same feelings for Sam that he had for him. So does the guy in question have any idea?
"I told the guy," he says. "But the record is not about one person. It's about loads of different people who I've fallen in love with, who haven't loved me back. And it just so happens that something happened last year … I'm very thankful it happened because the record got written."
As for Sam's idols in musics, he explains he really only listens to female singers, except for a few males, like Stevie Wonder.
Growing up, "I was listening to Whitney Houston, Chaka Khan, Joni Mitchell, Aretha Franklin, and still to this day, most of the people on my iPod are females, which is odd," he says. "Maybe I can just relate to the music better."
Sam's duet with Mary J. Blige on "Stay With Me" has made his hit even bigger than it already was. "Not only is she obviously a legend, but she's the kindest woman ever," he gushes. "I love her. I want to spend all my time with her every day. She's so sweet."
Download In the Lonely Hour on iTunes now!


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A collection of some of our most popular pages. Click on a category
to see related links. To jump to a page, just click on the image.
More NICHQ
Newsletter Archive
NICHQ Defined [Video]
2015 Impact Report
Other NICHQ Sites
Use the filters on the left to narrow your search by resource type and/or topic.
In this NICHQ infographic entitled Lost in the System, we take a closer look at how some children who fail their newborn hearing test fail to get follow-up care.
A report that details a framework for improving follow-up for infants who fail newborn hearing screening tests.
A collection of tools and resources for care providers, designed to improve the system of care for all newborns with possible hearing loss. Includes screening communication templates and forms, audiologic diagnostic forms, early intervention (EI) forms, and more.
A collection of newborn hearing screening tools and resources for care providers to share with parents, designed to help parents understand their child's hearing exam and results, and developmental hearing and speech milestones and to provide families with a hearing loss roadmap.
This report focuses on the work of 10 teams from the Collaborate for Healthy Weight project and showcases six strategies for addressing obesity at the community level.
This Policy Opportunities Tool identifies specific strategies that support healthy active living for children and families.
This guide equips healthcare professionals with the tools to effectively connect and partner with local and state organizations involved in advocacy efforts to reverse the childhood obesity epidemic.
This guide teaches community organizations how to engage and partner with healthcare professionals in obesity advocacy work.
The Advocacy Toolbox is designed to assist healthcare professionals to advocate for healthy eating and active living for children and their families.
This guide provides tools and resources for healthcare professionals to plan and support their obesity advocacy work.
This report presents eight stories about healthcare professionals who participated in the Be Our Voice project and used their voices to advocate for policy changes designed to improve the health of children and families.
Advocate for policies that support healthy eating and active living for children and families in your community.
These modules were developed through monthly Technical Assistance Webinars for the Be Our Voice project sites.
The resource specifies the key elements and functions an electronic health record must have to support the effective use of healthy weight plans.
This resource from NICHQ's Childhood Obesity Action Network (COAN) provides implementation guidance for the expert committee recommendations on the assessment, prevention and treatment of child and adolescent overweight and obesity.
The Texas Ten Step Star Achiever Toolkit provides a strong foundation toward understanding and implementing each of the Ten Steps to Successful Breastfeeding.
This group of resources assists hospitals with developing a written breastfeeding policy.
The US Surgeon General's "Call to Action to Support Breastfeeding" outlining steps that can be taken to remove some of the obstacles faced by women who want to breastfeed their babies.
"Breastfeeding Support: Prenatal Care Through the First Year" is an evidence-based clinical practice guideline that outlines assessment and interventions designed to assist health care providers who care for mothers and infants.
The World Health Organization's International Code of Marketing of Breast-Milk Substitutes provides guidelines for the marketing of infant formula and other products used as breast-milk substitutes.
This group of resources assists with informing women about the benefits and management of breastfeeding.
This group of resources assists with helping mothers initiate breastfeeding within an hour of birth.
This group of resources assists with helping mothers know how to breastfeed and maintain lactation.
This group of resources assists with helping mothers learn the benefits of rooming in with their baby.
This group of resources assists with encouraging breastfeeding on demand.
In this NICHQ infographic entitled Mothers Need Breastfeeding Support, we take a closer look at how the healthcare system can make a difference.
In this NICHQ infographic entitled Autism Uncovered, we take a closer look at the lesser-known aspects of autism spectrum disorder.
These resources will help providers identify, diagnose and treat constipation and insomnia in children with autism.
This after visit summary form, created by teams in the Autism Collaborative, is used to streamline the sharing of information between clinicians, parents and other relevant care providers.
An action plan, tips and recipes for children suffering from chronic constipation, a common physical symptom in children with autism spectrum disorder (ASD). - See more at: http://www.nichq.org/childrens-health/autism/resources#sthash.G71G8iN9.dpuf
This group of resources assists with care planning for pediatric patients being seen in a medical home.
This group of resources provides examples of well-visit questionnaires and patient health history forms.
This group of resources provides examples of patient and family communications on a variety of topics.
This group of resources assists with organizing your office operations to support a medical home model.
This group of resources assists with care transitioning for young adults making the transition out of a pediatric medical home to adult care.
Get your care team organized to provide comprehensive and continuous care for patients with this resource, which lets you assign medical home responsibilities to care team members.
Provide seamless care for patients across the many aspects of their lives with the help of a care plan. This resource lets practices pick and choose items to include in a care plan.
The "This Is Me" tool is specially designed to help caregivers get to know patients personally and medically.
Family Health Partners can play an integral role in a practice's transformation into a medical home and in its continuous quality improvement. This guide will help practices determine if they are ready to work with families as improvement partners, how to recruit and work with Family Health Partners and how to evaluate, sustain and improve the Family Health Partners role and relationship.
These Obesity Factsheets were created to provide national, state, and county-based data regarding childhood overweight and obesity prevalence and the environmental and behavioral factors that influence health. They are designed to make relevant population data more readily available to local advocates and decision makers.
Read about key lessons learned around care coordination from the Massachusetts CHIPRA Medical Home Learning Collaborative
Read about the Practice Transformation Facilitator (PTF) model including useful characteristics of PTFs, strategies for overcoming common challenges, and how the PTF model can be used to further the work of practice transformation.
This toolkit is designed to help your pediatric practice build a system for listening to family perspectives and feedback – by creating your own Patient and Family Advisory Council (PFAC). The kit provides step-by-step guidance on how to effectively engage family perspectives in the design of services and to improve overall quality in the delivery of those services.
A report that details a framework for improving the quality of health services received by children and youth with special healthcare needs through the medical home concept.
"Communication Matters: A guide for sharing information about a child's care" offers tips, tools, forms and resources for communication among families and youth, primary care providers, behavioral health providers and schools.
NICHQ's Medical Home Change Package provides change ideas for improving family, youth and child patient experience with primary care. These changes were tested with a diverse group of pediatric practices ranging in type from single site, single specialty practices to community health centers to academic practices.
A report that details a framework for redesigning pediatric residency training programs to improve quality of care for children and youth with special healthcare needs.
This hand-selected group of articles and commentaries are NICHQ's recommended readings for those interested in the medical home model of care.
View the measurement strategy used to track progress in NICHQ's Massachusetts CHIPRA Medical Home project.
In this three-in-one resource, learn the elements that constitute a patient guide, view a sample guide and access a template to create your own.
This toolkit is a source of information and guidance for practices seeking to engage consumers in the quality improvement process of transforming their medical practice into a patient-centered medical home.
The CAN DO Playbook is an interactive online guide that teaches motivated individuals and teams how to apply evidence-based strategies to address obesity prevention in their community by engaging primary care, public health and community leaders in this work.
This curriculum provides everything you need to host and run your own in-person obesity advocacy training.
A toolkit to assist primary care practice teams in providing coordinated, integrated and multidisciplinary services to both prevent obesity and improve care for children who are already overweight or at risk for becoming overweight.
Want to encourage healthy living in your community? This action kit is designed to help spread the lessons learned from the Healthy Weight Collaborative, a two-phase quality improvement initiative to promote healthy weight and health equity. Includes a library of informative videos and presentations from Collaborative action calls and Q&A sessions.
This interactive online advocacy training program teaches healthcare professionals how to advocate for obesity prevention policies that support healthy, active living for children in their communities.
The CDC's Breastfeeding Report Card for 2016 brings together state-by-state information.
Since many medical homes seek NCQA recognition, this tool has been specifically designed to map tested change concepts in NICHQ's Pediatric Medical Home Framework to the 2014 NCQA PCMH standards.
Next Steps is a guide and flip chart for clinicians to aid in conversations with children and adolescents about reducing and managing weight.
An action kit on improving follow-up care for newborns.
This guide provides instruction on how to develop, implement and maintain a community-based, pediatric healthy weight clinic.
The purpose of this model protocol is to provide clinicians, nurses, allied health professionals, community-based organizations and public health agencies with recommendations and strategies to improve care provided to individuals with sickle cell disease and trait.
A guide for health care providers that details strategies and insights for improving the management of pain episodes in emergency departments or day hospitals for both pediatric and adult patients with sickle cell disease.
This group of resources can be used by providers to educate patients about sickle cell disease, sickle cell trait and screening.
This group of resources and tools is most relevant to providers in the acute care or emergency department setting.
This group of resources is useful for patients, providers and representatives of community based organizations who are involved in coordinating care for patients.
This group of resources is useful for providers looking to share information with patients about the benefits and risks of using hydroxyurea.
This toolkit includes educational materials about sickle cell trait and sickle cell disease to help providers counsel individuals and families who have recently been diagnosed.
This group of resources can be used by providers to help educate patients on how to monitor pain crises and responses to medication.
This group of resources can be used by providers who work with adolescents to ensure they have the information they need as they move into adulthood.
These videos, developed by WISCH teams across the country, inform and help people with sickle cell trait and sickle cell disease--and the healthcare providers that care for them.
A report that details recommendations for redesigning clinical delivery and public health programs, broad health policy and the sickle cell disease treatment demonstration program to improve the quality of care for children and adults with sickle cell disease.
This guide includes information and guidance on how to get the most out of family-provider partnership.
One way for pediatric practices to demonstrate patient-centered care is to consider families as experts and invite them to help with evaluating, planning and improving a practice. Informed by their experience as caregivers and consumers, families can provide valuable perspective to the healthcare team during the practice's transformation into a medical home. But how do you know if your practice is ready to recruit these "Family Health Partners?"
Lack of leadership support is one of the most common reasons that a quality improvement project fails. Whether it is executive, administrative or frontline leadership you are trying to convince, we have eight field-tested tips that will enable your leaders to not only support your project, but also advocate for it.
A quality improvement culture is one that seeks to continually improve outcomes. Organizations that reliably do this have four similar qualities.
Advocacy work doesn't have to be difficult or time consuming. A little education and effort can go a long way. Here are five quick steps to becoming an effective health policy advocate.
When it comes to quality improvement, veteran improvement advisor Jane Taylor, EdD, has likely seen it all. For more than two decades, she has been advising teams across the country on how to overcome barriers to system level change and then how to make change stick. NICHQ recently caught up with Taylor to talk about trends in the quality improvement field.
Successful quality improvement efforts aspire to be sustainable: having the new ways of working become the normal ways of working for the team, organization, systems or facility. However, sustainability does not happen automatically; it requires planning and ongoing effort.
If you are a healthcare practitioner, you know many things outside of a doctor's office can negatively affect a patient's health. Patient health can be impeded by issues such as struggles with housing and bills, lack of support for breastfeeding or exercise, or confusion about how to navigate the healthcare system. Building relationships with community organizations can be a huge boon to healthcare practices and their patients.
At NICHQ, we're obsessed with run charts. Why? Because they are easy to construct and interpret and an elegant way to display data that makes performance visually legible. At a quick glance, you can determine whether the changes you make result in improvement, and even further, if those improvements are being sustained.
Finding the right kind and right number of members for your team will make all the difference in the success or failure of your quality improvement work.
Tips and tools on how to engage with patient representatives and apply patient knowledge to your improvement efforts.
Clinically-based improvement teams can benefit from having a physician champion on board. The physician champion plays a crucial role when it comes time to make the case for other physicians to support an improvement idea. How do you find a physician champion? Here are three tips for successful recruitment.
This report outlines NICHQ's policy recommendations for keeping pediatric health at the forefront of the healthcare reform agenda.
A list of helpful cultural competency resources and websites for healthcare professionals, patients, educators and researchers. These tools provide guidance and standards for delivering culturally and linguistically appropriate care to all patients, gathering and collecting data and reducing health disparities.
In this video series, leadership expert Gwen Webber-McLeod, president and CEO of Gwen Inc., offers her advice on the leadership skills needed to effectively tackle any project.
In this video series, leadership expert Gwen Webber-McLeod, president and CEO of Gwen Inc., offers her advice on offers her advice on the collaboration skills necessary to effectively engage partners in your project.
Cultivating extended partners across multiple sectors to take part in your improvement project takes planning, research and much relationship-building. However, finding and recruiting these partners—be it individuals or organizations—is time well spent. The rewards of extended partnerships can be many, especially when having a wide representation of multi-sector partners.
This report discusses the creation of a framework to evaluate contextual factors that affect the outcome of public health initiatives.
Team member turnover is unavoidable. People leave organizations, go on maternity leave or have periods when they downgrade their participation to focus on something else.
Here at NICHQ, we're in the improvement business. That means we help a lot of people experience a great deal of change. Whether imposed or chosen, however, frequent change efforts can sometimes lead to change fatigue.
Top tactics for ensuring leadership commitment to help overcome organizational resistance to change.
This course teaches the fundamentals of quality improvement.
This report documents recommendations developed for using pediatric primary care practices to reinforce positive socioemotional behaviors in primary caregivers of children ages 0 to 3.
Policies for using NICHQ's website and any content contained within.
A listing of all the main pages and sections on this website.


text:
I Vomited Today Tank Top
$ 20.00
I Vomited Today Tank Top
- Hand screen printed in California
- 4.5 oz. - 30 singles
- 100% combed ringspun cotton jersey
Measurements are taken of the front of the shirt. For example, a Men's Small says Chest = 18", which means it measures 18" from left to right of the front of the shirt. The full shirt circumference = 36" (front and back combined).


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|This article uses material from the Long Time No See: Jiraiya Returns! article on the Naruto wiki at Wikia and is licensed under the Creative Commons Attribution-Share Alike License.
|Long Time No See: Jiraiya Returns!
Aiyashibaraku! Ero-sennin Tōjō!
|Episode Chronology
|Adopted From
|Air Date
October 8, 2003
September 30, 2006
|Theme Music
|Opening Song
|Ending Song
|Episode Guide
← Ebisu Returns: Naruto's Toughest Training Yet!
The Summoning Jutsu: Wisdom of the Toad Sage! →
Long Time No See: Jiraiya Returns! (あいやしばらく!エロ仙人登場!, Aiyashibaraku! Ero-sennin Tōjō!) is episode 53 of the original Naruto anime.
Ebisu is unconscious following Jiraiya's attack. Naruto attempts to wake him up using One Thousand Years of Death to no avail. Naruto then demands to know the identity of the odd attacker. Jiraiya introduces himself as the Toad Sage and the author of the Icha Icha novels. Naruto, recognising them as the same books Kakashi always reads, accurately concludes that Jiraiya's 'data gathering' was merely peeking in on the women's bath and angrily calls Jiraiya the 'Pervy Sage' instead. Naruto accuses Jiraiya of interrupting his training and tells him to take responsibly for his actions. Jiraiya refuses and leaves with Naruto chasing after him.
Naruto catches up with Jiraiya as the latter is being rejected and slapped by a woman. In response to Naruto's incessant pestering, Jiraiya traps the boy in a large jar and escapes again. Once outside of town, Jiraiya sits watching the clouds and dreams of sexy women. Naruto finds the Sage once again, and again Jiraiya attempts to lose him, this time with a Transformation Technique. The ploy fails, and Jiraiya seemingly acquiesces. He tells Naruto that before he will help him, Naruto must first bring him some ripe and curvy fruit. Naruto misses the insinuation entirely and rushes to buy Jiraiya some actual fruit. Meanwhile, Jiraiya spots a couple of cute girls and follows them back into town.
Jiraiya is making some headway impressing the two girls when Naruto arrives with a ripe and curvy watermelon ruining the Sage's chances. Jiraiya explains that what he actually needs is a babe for inspiration, so Naruto transforms using his Sexy Technique. Jiraiya is thoroughly impressed and tells Naruto he will train him, provided he remain in that form. Naruto returns to his original form disappointed, and Jiraiya proclaims himself a super pervert.
Jiraiya admits he was kidding, and under his supervision, Naruto resumes his water-walking practice. When he fails to stand on the water and falls in, Jiraiya laughs, and Naruto takes off his wet clothes in frustration. Jiraiya sees Naruto's Eight Trigrams Seal and recognises it as the work of the Fourth Hokage to seal the Nine Tails within Naruto. He also notices the additional Five Elements Seal that is preventing Naruto from efficiently controlling his two chakras. Jiraiya thinks the second seal must have been done by Orochimaru, and he removes the seal using the Five Elements Unseal. With this impediment removed, Naruto happily walks (and jumps) across the water.
Watching the ecstatic Naruto, Jiraiya thinks that it is time to teach the boy how to harness the Nine Tail's chakra. But before that, Jiraiya insists that they stop training for the day and head to the hot springs for a bath. Later that night, while Naruto sleeps, Jiraiya apologises to Ebisu for stealing his student. Ebisu agrees it is for the best and tell Jiraiya that, as a member of the Sannin, Jiraiya is one of the few people who can stop Orochimaru.
Characters In Order of Appearance
Jutsu used
Tools used
- Naruto's efforts to track down Jiraiya are unique to the anime.


text: Library Services The Banner Arizona Libraries support the patient care, research and education mission of Banner Health by providing knowledge-based information resources and services to assist in clinical and administrative decision-making. Health professionals throughout Banner may access information services at any Banner facility by phone, fax, email, or in person. The Banner Arizona Libraries make a variety of traditional and electronic resources available to Banner Employees on site and by providing access to the databases of the Arizona Health Information Network (AZHIN), among others. Affiliated health professionals may search these databases. Please contact your Banner Arizona library about password and access information. Searches of the literature: Library staff will perform online database searches for you and provide training in the use of online databases, especially those available to Banner staff via the Digital Library. Call any Banner Arizona Library to request a search. Microcomputer Learning Lab: Each library has at least one microcomputer workstation provided for health professionals to search the literatures or check e-mail. The lab at BGSMC has 14 microcomputers connected to the Internet and loaded with selected software to assist with creating presentations. The lab also provides scanners and CD+DVD burners. Contact Frank Wallace for assistance. Frank is at (602) 839-2979. The Family Learning Centers: Each Banner Arizona facility provides specialized educational materials (books, pamphlets, media, periodicals) for people who wish to learn more about managing their own health and illness. Contact any Banner Arizona library for more information about this service and resource. Books and journals circulation: Each library maintains a collection of books, journals, A-V materials and other types of information provided to meet the information needs of that facility, and to aid efficient resource sharing across the system. Interlibrary borrowing: Materials not owned by Banner Arizona Libraries may be borrowed from other libraries for your use. Contact the library at your facility. Electronic Article Delivery: Banner Staff can now receive an electronic version of an article at their desktop through our document delivery service. The articles are better print quality, in color and so very convenient. To use this service or for more information call Tamra Miller - (602) 839-2384. CME Coordination: Each library is involved in the assessment of need for and delivery of educational programs designed for Banner medical staff. For more information please contact: Gloria Mawson - (480) 835-3756 Suzanne Johnston - (602) 839-5183


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Report: Police investigating Justin Bieber's Brazil graffiti
Listen to Justin Bieber on iHeartRadio
Justin Bieber is getting a lesson in Brazilian law.
According to "TMZ," the pop star is being investigated by local police after being caught spray painting graffiti on a building in Rio de Janeiro. Sources are saying the Biebs was unaware that graffiti was illegal in the country, and claims he was advised by locals that spray painting on the already-graffitied walls was acceptable.
The gossip site says that the defacing of buildings in Brazil is in fact illegal, and punishable by up a year in jail, which means be could be facing arrest.
While the incident in Rio was caught by paparazzi, the singer himself took to Instagram with his graffiti work in Columbia last week.
Photo Credit FameFly.net


text:
Bookmark this site
NEWMARKET, ON, Canada -- Beaver Machine Corp. will be offering new color options for its popular Round Beaver and Northern Beaver bulk venders. The new color sets will debut in the spring, Vending Times has learned.
The bulk vending machine manufacturer will offer its RB and NB venders in tropical teal and sunset orange. The smaller RB vending machine will also be available in bright pink. Beaver said the new colors were suggested by bulk vending operators.
"The release of these fun, new, eye-catching colors is part of Beaver's continued 50-year commitment of responding to our customers' needs," said Beaver's Heidi Schwarzli.
Founded in 1963 as Machine-O-Matic, Beaver manufactures bulk venders, coin mechanisms and equipment stands. Call (800) 265-6772 for more information.


text:
Quill Brand® Print & Copy Paper; 8-1/2" x 11", 94 Bright, 20LB, 500 sheets
- Sheet Dimension: 8.5" x 11" (US letter)
- Paper Weight (lbs.): 20
- Brightness: 94
- 94 bright white paper
- 20-lb. weight
- 8-1/2x11"; letter size
- 500 sheets per ream, 10 reams per case
- Bright white paper provides better contrast and presentation
- Features ColorLok® Technology for bolder blacks and vivid colors with inkjet printing
- Works great in your laser or inkjet printer
- Acid free for archival quality
- Made in USA
Quill Brand Print & Copy Paper Provides the Perfect Canvas
Make copies and print documents on Quill Brand print and copy paper. The crisp white background provides contrast and makes text look sharp.
Featuring 500 sheets per ream, these 10 reams of Quill Brand print and copy paper provide you with 5,000 sheets of paper, covering your office's printing and copying needs for a significant amount of time. ColorLock technology optimizes the attraction between the paper and the ink, creating bold blacks and vivid colors on every sheet.
Long Lasting Paper
Each sheet of Quill Brand print and copy paper is acid free, promising it can stand the test of time without yellowing or aging. This archival quality paper is ideal for printing images and documents you want to save.
Compatible with inkjet and laser prints, this paper provides you with the flexibility you need in an office full of different equipment. Its white color and letter size are perfect for the gamut of everyday office printing and copying.
|Paper Weight (lbs.) : 20
|Sheet Dimension : 8.5" x 11" (US letter)
|Brightness : 94
|Reams per Case : 1-Ream
|Paper Color : White
|Paper Brightness : 94
|True Color : White
|Brand : Quill Brand
|Quill Plus : Yes
|Weight : 5.00 lbs. per Ream


text:
This supple top-grain leather bag accommodates a 17" laptop and keeps business essentials organized and easily accessible. Four large zippered pockets hold laptop peripherals, cords, and business documents, and a padded cell phone pocket and a zippered compartment on the exterior keep a passport and boarding pass close at hand. The 17" wide interior pocket is lined with durable nylon and has tiered sleeves that keep business cards and credit cards at the ready. The laptop compartment is lined with high-density foam padding, protecting the computer during travel and commutes to work. With adjustable shoulder strap, padded handle, antique-brass hardware, and self-mending zippers. Black. 12" H x 17" W x 7" D. (3 1/2 lbs.)
Lifetime Guarantee
The Organized Traveler's Leather Laptop Bag comes with The Hammacher Schlemmer Lifetime Guarantee. If this product ever disappoints you, for any reason, you may return your Hammacher Schlemmer purchase for exchange, credit, or refund.
Should you have any questions, we are available seven days a week (8:00 am – midnight EST). Please call 1-800-321-1484 to speak with a specialist or email us at email@example.com to receive a response within three business hours or less.
May we recommend:
(based on 8 reviews)
Ratings Distribution
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of respondents would recommend this to a friend.
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Reviewed by 8 customers
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(4 of 4 customers found this review helpful)
Travel Bag
By RL
from WI
This bag is wonderful in the way pockets are organized. My only criticsm is that the leather used is poor quality rather than the "supple top grain" leather stated in the copy.
Bottom Line Yes, I would recommend this to a friend
Was this review helpful? Yes / No
- flag this review
(3 of 3 customers found this review helpful)
Leather Laptop Bag
By Paula
from Charlotte, NC
Bag was beautiful, just not a true black bag. It did not match the other black leather bags that I have bought from Hammacher Schlemmer before.
(2 of 2 customers found this review helpful)
Nice bag
Beautiful bad except it was a very faded black. I was needing a much richer black. It did not match any of my other black leather bags. I really wished it had, its a awesome looking bag.
(1 of 1 customers found this review helpful)
By AL
from HONOLULU HAWAII
Ecellent for a portable office
By ?
from ND
I use it for commuting If I was to go on a trip, I would want extra padding and for it to be wider,
Great Bag
By traveling salesman
from Boston, MA
This bag is comfortable on my shoulder, holds my 17 inch laptop and day organizer, several files, and a special pocket for my cell phone. And it's good looking.
The Organized Traveler's Leather Laptop
By Fran the Sailor
from Port Charotte, FL
This is a beautiful bag. The leather is very nice, soft and supple. The leather should hold up beautifully, unless the usage is very rough. The space for a 17" laptop is ample and the other compartments and pockets are designed very well.
very good buy
By jake
from Fairbanks AK
delivered as promised ,on schedule, I liked very much.wish could afford in brown color . looks glamorous butI feel for mine purpose dark color is more practical .
COPYRIGHT © 2017 HAMMACHER SCHLEMMER & COMPANY, INC. ALL RIGHTS RESERVED. W106147 E. 57th ST • NEW YORK, NY • 10022 • 1-800-_321-1484


text:
Canacona Overview
You can reach Canacona from Mysore by road in about using a cab upon driving using a cab.
Canacona is a city and a municipal council in South Goa district in the state of Goa, India.Canacona or Kankon Taluka includes places such as: Patnem, Chaudi, Poinguinim, Loliye, Agonda and Gaumdongre. he area also boasts some of the state's most outstanding scenery. Set against a backdrop of the Jungle covered Sahyadri Hills (an extension of the Western Ghat Range), a string of pearl white coves and sweeping beaches scoop its indented coastline. If you are looking for car rental Canacona let us know and we will be happy to provide you with best budgeted deals for . Book cabs in Canacona


text:
Short Pages in this Wiki
Short pages are pages that have little content. This listing is sorted by shortest page. Consider adding more content to the pages if necessary.
IPhone Cheats (~392 characters) Main Page (~438 characters)Expand Navigation
We have updated our PRIVACY POLICY and encourage you to read it by clicking here.
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text:
'The move was made to allow Paille time to continue developing in Rochester, Buffalo's American Hockey League affiliate. The Sabres first-round pick in the 2002 draft, Paille had a goal and an assist in six preseason games with Buffalo.'
Sabres demote Paille to minors
October 3, 2006 Submitted by
Via: AP


text:
An Evening with James Franco - SOLD OUT
Live Talks Los Angeles
Sunday, October 20, 2013 at 7:30 PM
Live Talks Los Angeles
invites you to:
An Evening with James Franco
discussing new novel, Actors Annonymous
Sunday, October 20, 2013 7:30pm
(Reception 6:00-7:00pm)
(Doors open for General Admission tickets at 7:00pm)
$20 General Admission
$40 Includes Franco's book + Reserved seat
$36.34 Book Purchase only to be shipped anywhere in the US (includes tax and shipping)
$95 Includes Pre-event reception +Franco's book + Reserved Seats
James Franco is an actor, director, author, and visual artist. His film appearances include Milk, Pineapple Express, Howl, and 127 Hours, which earned him an Academy Award nomination. He is the author A California Childhood and of the story collection Palo Alto, and his writing has been published in Esquire, Vanity Fair, N+1, The Wall Street Journal, and McSweeney's. Franco's art has been exhibited throughout the world including at the Museum of Contemporary Art in Los Angeles, the Museum of Contemporary Art's PS1 in New York, the Clocktower Gallery in New York, and the Peres Projects in Berlin.
In James Franco's debut novel, Actors Anonymous, the actors include a McDonald's drive-thru operator who spends his shift trying on accents; an ex-child star recalling a massive beachside bacchanal; hospital volunteers and Midwestern transplants; a vampire flick starlet who discovers a cryptic book written by a famous actor gone AWOL; and the ghost of River Phoenix. Then there's Franco himself, who prowls backstage, peering out between the lines—before taking the stage with fascinating meditations on his art, along with nightmarish tales of excess. "Hollywood has always been a private club," he writes. "I open the gates. I say welcome. I say, Look inside."
Told in a dizzying array of styles—from lyric essays and disarming testimonials to hilariously rambling text messages and ghostly footnotes—and loosely modeled on Alcoholics Anonymous's Twelve Steps and Twelve Traditions, Actors Anonymous is an intense, wild ride into the dark heart of celebrity.
Ticket sales are final. We recognize that you may not be able to attend an event, so we will happily offer a credit towards a future Live Talks Los Angeles event should you need to cancel.
In order to purchase these tickets in installments, you'll need an Eventbrite account. Log in or sign up for a free account to continue.


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TLS Training Day 1 and Day 2 with Larry Rogowsky and Ryan Ebling
Larry Rogowsky
Saturday, February 16, 2013 at 9:00 AM - Sunday, February 17, 2013 at 5:00 PM (EST)
Who's Going
San Francisco, California
London, United Kingdom
Florence, Italy
Event Details
What is TLS Day 1 & Day 2 Training?
- TLS® trainings are now being offered locally/regionally to make important information about the TLS® Weight Loss Solution lifestyle widely available and affordable.
Day 1:
Who is it for?
- Anyone that wants to learn more about the new TLS® program and anyone who is interested in losing weight
- Guests welcome to attend (Everyone MUST register)
- Cost is $50 per person
Day 1 Agenda Overview
- Why we struggle with weight
- Why the TLS® Weight Loss Solution is better
- - Weight Loss Profile (online/paper )
- - Menu options
- - Why TLS® Supplements work
- - Choosing the right TLS® Supplements
- - TLS® Weight Loss Guide
- - Setting health goals and starting Detox
Navigating TLS® site for weight loss success
- - Dashboard
- - Meal Planner
- - Exercise
- - Alerts, mobile apps and more resources!
12 weeks of lifestyle tips
Question & Answers
Summary of Day 1
Day 2:
Who is it for?
- Anyone that wants to learn how to be effective with sales
- Those who want to be able to effectively discuss TLS and the competition
- Those who would like to be able to effectively expand their team utilizing TLS™ system
- Guests are NOT permitted to attend (you must be a distributor)
- Cost is $50 per-person (MUST attend Day 1 first)
Day 2 Agenda Overview:
- Identifying Market Base and Business Structures
- Knowing the TLS® materials
- - Approaches
- - Presentation
- - Close
- - Invitation Card (healthy night out events)
- Supplement Details (highlighting TLS® products as compard to the competition)
- Marketing Fundamentals
- Social Media Basics
- Marketing Do's and Don'ts (legal)
- Coaching Tips and Coach's Dashboard
Introducing Additional Products to Support Your Clients
- Optimal Health (Omega III, Curcumin, Greens, NutriClean, Digestive Enzymes, etc)
90 Day Action Plan
- Creating Fitness Goals
- Creating Business Goals and Action Plan
- Building an organization
- Coaches Start Up Guide
Questions & Answers
Summary of Day 2
Next steps for TLS Professionals
This Day 1 & Day 2 TLS® training is the first step in becoming a Certified TLS coach. For more information on benefits and requirements to become a CERTIFIED coach please check details on www.marketamericaevents.com.
You must be a MA distributor to attend Day 2. If you are a guest and would like to attend Day 1 only, please contact Larry.
When & Where
Holiday Inn
440 W 57th St
New York,
Saturday, February 16, 2013 at 9:00 AM - Sunday, February 17, 2013 at 5:00 PM (EST)
Add to my calendar
Larry Rogowsky
Larry Rogowsky is a Executive Supervising Coordinator ($15k-$18k) with with Shop.com/Market America and a Certified TLS trainer. In addition, Larry is a Licensed Massage Therapist and Integrative Wellness Coach. He is also a multiple nutraMetrix, TLS and President's Challenge winner and recognized nutraMetrix Consultant of the Year.


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This article does not cite any references or sources. Please help improve this article by adding citations to sources.
Skill ChecksEdit
A skill check takes into account a character's training (skill rank), natural talent (ability modifier and luck (the die roll). It may also take into account his or her race's knack for doing certain things (racial bonus) or what armor he or she is wearing (armor check penalty), or a certain feat the character possesses, among other things. For instance, a character who has the Skill Focus feat related to a certain skill gets a +3 bonus on all checks involving that skill.
To make a skill check, roll 1d20 and add your character's [[skill] modifier for that skill. The skill modifier incorporates the character's ranks in that skill and the ability modifier for that skill's key ability, plus any other miscellaneous modifiers that may apply, including racial bonusesand armor check penaltys. The higher the result, the better. Unlike with attack rolls and saving throws, a natural roll of 20 on the d20 is not an automatic success, and a natural roll of 1 is not an automatic failure.
Difficulty Class:Edit
See Difficulty Class or DC
Untrained Skill Checks:Edit
Generally, if your character attempts to use a skill he or she does not possess, you still make a skill check as normal. The skill modifier doesn't have a skill rank added in because the character has no ranks in the skill. Any other applicable modifiers, such as the modifier for the skill's key ability,are applied to the check.
Many skills can be used only be someone who is trained in them. If you don't have Spellcraft, for example, you just don't know enough about magic even to attempt to identify a spell, regardless of your class, ability scores, or experience level. Skills that cannot be used untrained are indicated in their skill descriptions.
For example, Krusk the [[barbarian's 4 ranks in Climb make his climb check results 4 points higher than they otherwise would be, but even Gimble the bard, with no Climb ranks, can make a Climb check because Climb can be used untrained. Gimble has a skill modifier of -1 (+0 for his strength, -1 for armor), but he can give it a try. However, Gimble's ranks in Use Magic Device let him do something that he otherwise couldn't do at all - namely, use a magic item as if he had a particular spell on his class spell list that he actually doesn't have. Krusk, with no ranks in the skill, can't makke a Use Magic Device check even at the penalty because Use Magic Device can not be used untrained.
Favorable and Unfavorable ConditionsEdit
- Some situations may make a skill easier or harder to use, resulting in a bonus or penalty to the skill modifier for a skill check or a change to the DC of the skill check.
- The chance of success can be altered in four ways to take into account exceptional circumstances.
- 1. Give the skill user a +2 circumstance bonus to represent conditions that improve performance, such as having the perfect tool for the job, getting help from another character (see Combining Skill Attempts), or possessing unusually accurate information.
- 2. Give the skill user a –2 circumstance penalty to represent conditions that hamper performance, such as being forced to use improvised tools or having misleading information.
- 3. Reduce the DC by 2 to represent circumstances that make the task easier, such as having a friendly audience or doing work that can be subpar.
- 4. Increase the DC by 2 to represent circumstances that make the task harder, such as having an uncooperative audience or doing work that must be flawless.
- Conditions that affect your character's ability to perform the skill change the skill modifier. Conditions that modify how well the character has to perform the skill to succeed change the DC. A bonus to the skill modifier and a reduction in the check's DC have the same result: They create a better chance of success. But they represent different circumstances, and sometimes that difference is important.
Time and Skill ChecksEdit
- Using a skill might take a round, take no time, or take several rounds or even longer. Most skill uses are standard actions, move actions, or full-round actions. Types of actions define how long activities take to perform within the framework of a combat round (6 seconds) and how movement is treated with respect to the activity. Some skill checks are instant and represent reactions to an event, or are included as part of an action.
- These skill checks are not actions. Other skill checks represent part of movement.
Practically impossible TasksEdit
Sometimes you want to do something that seems practically impossible. In general, a task considered practically impossible has a DC of 40, 60, or even higher (or it carries a modifier of +20 or more to the DC).
Practically impossible tasks are hard to delineate ahead of time. They're the accomplishments that represent incredible, almost logic-defying skill and luck. Picking a lock by giving it a single, swift kick might entail a +20 modifier to the DC; swimming up a waterfall could require a Swim check against DC 80; and balancing on a fragile tree branch might have a DC of 90. The DM decides what is actually impossible and what is merely practically impossible. Characters with very high skill modifiers are capable of accomplishing incredible, almost unbelievable tasks, just as characters with very high combat bonuses are.
Checks without RollsEdit
- A skill check represents an attempt to accomplish some goal, usually while under some sort of time pressure or distraction. Sometimes, though, a character can use a skill under more favorable conditions and eliminate the luck factor.
Taking 10:Edit
When your character is not being threatened or distracted, you may choose to take 10. Instead of rolling 1d20 for the skill check, calculate your result as if you had rolled a 10. For many routine tasks, taking 10 makes them automatically successful. Distractions or threats (such as combat) make it impossible for a character to take 10. In most cases, taking 10 is purely a safety measure —you know (or expect) that an average roll will succeed but fear that a poor roll might fail, so you elect to settle for the average roll (a 10). Taking 10 is especially useful in situations where a particularly high roll wouldn't help.
Taking 20:Edit
When you have plenty of time (generally 2 minutes for a skill that can normally be checked in 1 round, one full-round action, or one standard action), you are faced with no threats or distractions, and the skill being attempted carries no penalties for failure, you can take 20. In other words, eventually you will get a 20 on 1d20 if you roll enough times. Instead of rolling 1d20 for the skill check, just calculate your result as if you had rolled a 20.
- Taking 20 means you are trying until you get it right, and it assumes that you fail many times before succeeding. Taking 20 takes twenty times as long as making a single check would take.
Combining Skill AttemptsEdit
When more than one character tries the same skill at the same time and for the same purpose, their efforts may overlap.
Individual EventsEdit
Often, several characters attempt some action and each succeeds or fails independently.
For example, Krusk and each of his friends needs to climb a slope if they're all to get to the top. Regardless of Krusk's roll, the other characters need successful checks, too. Every character makes a skill check.
Aid AnotherEdit
You can help another character achieve success on his or her skill check by making the same kind of skill check in a cooperative effort. If you roll a 10 or higher on your check, the character you are helping gets a +2 bonus to his or her check, as per the rule for favorable conditions. (You can't take 10 on a skill check to aid another.) In many cases, a character's help wont be beneficial, or only a limited number of characters can help at once. The DM limits cooperation as he or she sees fit for the given conditions. For instance, if Krusk has been badly wounded and is dying, Jozan can try a Heal check to keep him from loosing more Hit Points. One other character can Help Jozan. If the other character makes a Heal check against a DC 10, then Jozan gets a +2 circumstance bonus on the Heal check he makes to help Krusk. The DM rules that two characters couldn't help Jozan at the same time because a third person would just get in the way.
In cases where the skill restricts who can achieve certain results (such as with Disable Device, Search and Survival), you can't aid another to grant a bonus to a task that your character couldn't achieve alone. For instance, a character who doesn't have the trapfinding class feature can't use Search to help a rogue find a magic trap, since the helper couldn't attempt to find the magic trap on his own.


text:
WATCH: Greatest school snow day announcement EVER
The northeast United States is getting a lot of snow, but a few of the southern states got their fair share of ice too .. even some Vanilla Ice!
Durham Academy in North Carolina announced their snow day with the help of the rapper's hit "Ice Ice Baby." The school's Head of School and Assistant Head of School put their own lyrics to the song. "No school, there's ice, ice, baby." Genius!
Check out the video below!


text: '"When you do lose a guy, you feel for him, but we also do the team a disservice by (moping about it)," goaltender Ryan Miller said yesterday as the team readied for Game 4 at HSBC Arena. "You have to step up for the guy. You tell yourself 'he went out and gave it his all, so he would expect the same from us.' We don't get down when we lose a guy. We don't look at our team as having just one dimension."'


text:
The new Starz drama "Da Vinci's Demons'' might turn out to be a decent series, although you'd never know if from the debut a confusing mess more notable for the full-frontal nudity than the plot. But Episode 2 of this series that casts Leonardo Da Vinci as a genius/action hero is more coherent and considerably more promising.
Watch • 11 p.m. Friday, Starz The Week Ahead
This new series is gorgeous to look at but the narrative is iffy.
Watch • 7, 9 and 11 p.m. Monday, Syfy
Who killed J.R.? We find out in the season's final two episodes.
Watch • 7 and 8 p.m. Monday, TNT
Who Gets the Last Laugh?
Celebrities play mean-spirited practical jokes on regular folks. This is funny?
Watch • 8 p.m. Tuesday, TBS
Deadliest Catch
A new season begins with two new boats.
Watch • 10 p.m. Tuesday, Discovery
Rachel auditions for "Funny Girl."
Watch • 8 p.m. Thursday, Channel 13 This Weekend
Minnesota at Utah
Watch • 7 p.m. Friday, ROOT
Spartacus: War of the Damned
Spartacus and the rebels fight one last battle against the Romans in the series finale.
Watch • 10 p.m. Friday, Starz
Real Salt Lake at Vancouver
Watch • 2 p.m. Saturday, Channel 4
Masters Tournament
Second, third and final rounds
Watch • 1 p.m. Friday, ESPN; 1 p.m. Saturday and noon Sunday, Channel 2
Louis C.K.: Oh My God
Stand-up comedy.
Watch • 8 p.m. Saturday, HBO
Selina sees the midterms as a chance to expand her role in the season premiere.
Watch • 11 p.m. Sunday, HBO


text:
World Crude Oil Prices
World Crude Oil Prices
World Crude Oil Prices (weekly data, not seasonally adjusted)
The world price of crude oil is the most important factor influencing domestic motor fuel prices, since oil imports make up more than half of the U.S. oil supply. Motor fuel prices, in turn, directly affect the cost of transportation. Increases in transportation costs caused by higher world crude oil prices are pure additional costs in the sense that U.S. citizens do not generally benefit.
|World Crude Oil
|Price (dollars per barrel)
|Dollars per barrel percent change from the previous week
SOURCE: U.S. Department of Energy, Energy Information Administration, Crude Oil Watch, as of September 14, 2001, available at: http://www.eia.doe.gov/pub/oil_gas/petroleum/data_publications/crude_watch/current/pdf/crude.pdf


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- Public Notices
The Suwanne Valley Rotary Club hosted the first-ever Tour de Melon on June 2, looking to start a new tradition as an annual kick off one of Chiefland's oldest.
Beginning and ending a few blocks from the Watermelon Festival in downtown Chiefland. The Tour was created in part as a complement to the festival. It attracted participants from as far as Georgia and South Florida, many of whom stayed in Chiefland hotels and got an opportunity to experience the festival.
Over 150 riders and 40 volunteers helped put on the bike ride.
If you currently subscribe or have subscribed in the past to the Chiefland Citizen, then simply find your account number on your mailing label and enter it below.
Click the question mark below to see where your account ID appears on your mailing label.
If you are new to the award winning Chiefland Citizen and wish to get a subscription or simply gain access to our online content then please enter your ZIP code below and continue to setup your account.
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Physicians and Dentists
The California Medical Board is the state agency that licenses medical doctors, investigates complaints and disciplines practitioners who violate the law. The board will refer cases warranting legal action to the Attorney General.
The California Medical Board performs similar functions for those in the affiliated healing arts, including registered dispensing opticians, spectacle lens dispensers, contact lens dispensers, licensed midwives and research psychoanalysts.
For license verification, call (916) 263-2382.
Get more information on the physician-discipline process from the board's website or
call 1-800-633-2322 (toll-free) or (916) 263-2424.
Osteopathic physicians are regulated by the Board of Osteopathic Examiners.
The Board of Dental Examiners licenses and regulates dentists, registered dental assistants and registered dental hygienists. How to File A Complaint Against A Licensee


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Some questions about the ID l
Posted 23 February 2014 - 01:51 PM ( #1 )
1- Is there any shop where I can buy any food to take home? Like rice bowl I mean.
2 - How does the happiness bar works? I mean, apart for the initial yellow bar, you unlock another coloured bars when your tama is very very happy. And you recive a flower sticker. Does those stickers have any uses¿ and the bars¿
3- Where can I adopt a pet¿
4- Can my tama get married whitout connecting to other tamas? I don't have another color tamagotchi and I dunno nobody who have one near of me
Thanks for your atention and please forgive my bad english
Started23 Feb 2014
Last Post27 Feb 2014
Posted 23 February 2014 - 02:02 PM ( #2 )
2.Eat candy or play games or use items to fill the happy bar and the flower stickers are Happy Symbols. When they are an adult, they have favourite foods, items and clothes which you have to buy for them, and there is a topic somewhere with each characters happy symbols. Remember, its only for the Adult/ Friend stage. There are 3 happy symbols and the last is obtained for having your character for at least 48 hours. It will always have an animation if you have the correct item.
3.If your character is an adult, visit the park and you will see Tama-characters and Tama-Pets there. Play with the same pet 3 times and you will be able to take it home. The characters who show up are random and will not always be the one you want to meet, so keep trying. and there is 10 unlockable pets
4. When your character is an Adult and is at least 1 day old i think, they can go to the Matchmaker option on the second page just under the DRESSMAKER. Its better to marry them when you have finished their happy symbols, so they turn into a tamatomo, and the more tamatomos you have, the more destinations and icon banner you achieve.
If you need anymore help just ask
- ichiro.malfoy likes this
Posted 23 February 2014 - 10:38 PM ( #3 )
Posted 26 February 2014 - 04:28 PM ( #4 )
Thank you Hayden, your answer was very helpful. And thank you too furbitchi, I noticed that about vegetables and fruit..I just was wondering if there is any shop where you an buy food to take into the fridge....because when your tama becomes an adult, he doesn`t want rice anymore and you have always to take him to the restaurant
Posted 27 February 2014 - 12:05 AM ( #5 )
Nope, you have to go to the restaurant and feed them there, or what I do I just MAKE them eat rice XD saves monies


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Atelier Versace Spring 2012 Couture
Call it the return of the power woman. Donatella Versace's comeback to the Paris couture schedule was made official today with the first public presentation of her Atelier Versace collection in eight years. If "presentation" sounds like a modest, low-budget affair, forget it: There's nothing very reserved or quiet about building a golden plinth—a towering set of stairs—on which to pose a troop of futuristic glamazons in sparkling lace gowns and starship bodysuits. It was a tableau that might echo the old days of the Alta Moda, when Italian couturiers showed their dresses on the Spanish Steps in Rome, perhaps, or a sci-fi fantasy. The only aspect that was down-to-earth was the fact that the audience stood to watch, some resorting to sitting on the floor.
The silvery siren gowns and gold filigree dresses and biker jackets were worked in combinations of lace, leather, crystalline sugar-granule beading, and rose motifs. Sharp half-moons of gold aluminum, inserted to jut at the hips, or cut into angular slices to emphasize corsets, gave a sense of futuristic drama to sinuous silhouettes calculated to glorify every curve of the Versace rock-goddess body. With the suggestion of peplums, and the underpinnings of shorts showing through sheer segments of lace, the look hit on two trends of the moment, but really, this was a continuation of everything the house has always done. Stepping back into the limelight of couture is a positive step for Donatella—and a fillip to the spirits of this round of shows. Next time, though, she might have to put caution behind her, and have a full-fledged show—why not, when she's come this far?
Learn more about Donatella Versace in Voguepedia.
Learn more about Versace in Voguepedia.


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Child support services are available to both custodial and non-custodial parents. Even if the other parent is living in another state, you can apply for services in Oregon (see Interstate Child Support Cases for more information). Caretakers or relatives who have physical custody of a child may also be entitled to child support services.
The Child Support Program may be able to provide assistance with the following services:
Establishing paternity (who the child's biological father is)
Finding the non-custodial parent
Establishing a child support order or making changes to an existing support order
Coordinating health care coverage for a child
Determining the amount of past due child support
Collecting child support payments
Collecting spousal support payments when spousal support is part of a child support order
To apply for child support services, you can contact your local child support office or fill out the application forms online. You will need to print and send us the completed forms. There is a one-time fee of $1.00 for this service. The fee will be deducted from the first money we collect.
Full Child Support Services - This application is for parents to set-up a new child support order, enforce an existing order, or to modify an existing order.
Before the custodial parent can begin to receive payments, other steps may need to be taken (such as paternity establishment, locating the other parent, etc.). Once you submit this application a child support caseworker will be in contact to help you through any additional steps based on you and your family's needs (see Establish an Order for Child Support, Enforcement, or Modify an Order).
Solicitud de Servicios para Manutención de Hijos
Solicitud para Establecer Paternidad Únicamente
Support for a Child Attending School - If you are a Child Attending School (beyond high school) and you wish to receive child support from your parent(s), visit Child Attending School to apply online.
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Purchase Tickets | Full Schedule
PHILADELPHIA - Single-game tickets, which start as low as $5, are now available for all four 2014 University of Pennsylvania home football games.
Individual and season tickets are availableonline at PennAthletics.com by clicking the links above or by phone at 215-898-6151. Tickets are also available at the ticket office located at Weightman Hall on 235 South 33rd Street. The ticket office is open today from 10 a.m. to 2 p.m. during August, and from 10 a.m. to 5 p.m. starting Monday, August 18.
For those making more than one trip this year to the oldest collegiate football stadium in the nation, season tickets may be a better option. In addition to the discount on tickets, season ticket plan holders will also receive:
* First Opportunity for Parking Passes
* Magnetic Schedule
* Free program at each home game
* Opportunity to buy tickets to away games/events
* Ticket Exchange: Never let a ticket go unused.
Group Ticket Perks (requires minimum of 20 tickets purchased)
* Participate in "High Five Tunnel" on field during team introduction
* Small gift for each group member
* Video board recognition between first and second quarters
* Groups that purchase 50 or more tickets will receive a second gift
In addition, Penn Athletics is offering a special Birthday Party group package which include:
* 10 ticket minimum
* Video board recognition between first and second quarters
* Birthday gift package for the celebrant
* Small gift for each member of the party
The Quakers, entering the final season of legendary head coach Al Bagnoli's tenure, will open the home portion of their 138th season at historic Franklin Field when they host Villanova for a 3 p.m. kickoff on Sept. 27. Penn also hosts Columbia (Oct. 18), Brown (Homecoming - Nov. 1), and Harvard (Nov. 15) in University City this fall.
A complete 2014 football schedule can be found at the link atop this release. See you at Franklin Field!


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WATCH: Alicia Keys gets personal about Swizz, Baby Egypt, and her life
Listen to Alicia Keys on iHeartRadio
In a rare but sweet moment, Alicia Keys takes time out from her busy summer tour to talk to fans about life with Swizz, being a mother to baby Egypt, and being in awe of how much her life has changed and evolved over the years.
In it, she admits that she's so blessed and still surprised every morning by what life has to offer her and by the love that fans show her. It's a truly touching clip that in many ways reminds us of Beyonce's documentary with the fresh-faced, hair-undone honesty.


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Washington : Government Printing Office
|Public Law 86-506
|Colorado River Indian Reservation, Ariz. Calif
|Public Law 86-506
|Leasing of lands.
|Public Law 86-506
|25 U. S. C. 415; 25 U. S. C. 396a.
Page 906
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That, until a determination has been made of the beneficial ownership of the lands on the Colorado River Reservation, Arizona and California, that were set apart by the United States for the Indians of the Colorado River and its tributaries, the Secretary of the Interior is authorized to lease any unassigned lands on the reservation which are located within Arizona and to approve leases made by the holders of assignments heretofore made, for such uses and terms as are authorized by the Act of August 9, 1955 (69 Stat. 539), and by the Act of May 11, 1938 (52 Stat. 347). Income received from such leases of unassigned lands may be expended or advanced by the Secretary for the benefit of the Colorado River Indian tribes and their members. Income received from such leases of assigned lands may be expended or advanced by the Secretary for the benefit of the assignee.
Approved, June 11, 1960.


description: Comb jellies look anything but dangerous. But those pretty, flashing lights can mean death for unwary prey.

is_us_only: false

title: Neon Killers

allowUserEmbed: True

credit: National Geographic

transcript:
What looks like flashing neon is light refracting off of thousands of cilia-tiny, hair-like propellers along comb-like ridges that give the animals their name: comb jellies.
These tiny creatures aren't jellyfish, though they look similar.
One big difference-comb jellies don't grow stingers like jellyfish do...which doesn't mean that they're harmless.
They may look pretty, but appearances, as is usually the case, are deceiving.
They have other, weirder weapons.
In their hunt for plankton, crustaceans and each other, some comb jellies, like this beroe, have evolved a simple approach: a big mouth and a bigger appetite.
It has no brain or specialized senses-only a primitive neural net around the mouth that can detect chemical traces in the water.
When it bumps into something edible, it simply opens wide...very wide.
The beroe zips its mouth shut, holding its prey in place with specialized hooks.
Other comb jellies have a more complicated way of snatching up prey.
Coating the tentacles are specialized adhesive cells that act like glue.
Once trapped, prey are drawn into the gut and digested.
Size is rarely an issue.
Comb jellies attack tiny appetizers...and full-course meals.
The comb jelly snaps its tentacles at the green jellyfish. But it can't drag it in.
The jellyfish counterattacks with the stinging tentacles.
Stingers beat glue.
The jellyfish pulls free and escapes with its life.
The comb jelly flickers through the ocean, unconcerned, and ready for its next opportunity.


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Lady Antebellum on going 'Downtown' ... while being knocked up
Listen to Lady Antebellum on iHeartRadio
(Yahoo!) - Lady Antebellum have been enjoying the spunkiest and sauciest hit of their career with the chart-topping single "Downtown," even as the videos and promotional appearances for it feature Hillary Scott looking ever-so-more pregnant. As the band takes the stage for an exclusive Yahoo! Musicperformance, the average viewer might not notice Scott's expectancy all that much, thanks to the miracles of slimming black.
Still, there is that moment when Scott pleads "I don't know why you don't take me downtown anymore" that you might imagine her partner's response reasonably being, "Um, because your water might break?"
Even with the blessed event being just weeks away — Scott's baby girl, her first, is due in late July — the trio haven't lost a step, and if anything, have been compressing about six months' worth of the usual album promotion into roughly half that time.
"I can probably speak for everybody on our team and say it's easier to promote a record when someone's not pregnant," Scott says. "For sure!"
"Fewer naps in the middle of the day," adds Dave Haywood. It's not clear whether the guitarist is speaking for Scott or himself when it comes to increased narcolepsy, but...
"The pacing has definitely had to be different," says Scott, in the course of promoting Golden, their fourth album. "I mean, we've traveled to the same places that we always do when we promote records. But there's this crazy thing that happens when you're pregnant. Like, when the baby says, 'Mom, I'm tired,' your body just stops and you just kind of start staring through people and not even meaning to. But it's been good. I haven't been sick, which has been really nice. Thankfully, my energy level has been high."
Photo Credit Getty Images


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'"The start wasn't very good," coach Lindy Ruff said. "There's no doubt. That's kind of an obvious statement. If you're going to start games like that, you're going to make it really difficult to win games."'
Slow start stymies Sabres in loss
March 17, 2010 Submitted by
Via: Buffalo News


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I have been looking for SW that enables one to scan sheet music and have the PC play it out via midi or musicXML, but did not find anything in the repo's.
When looking a bit further, I found several windows programs doing this, and also one
linux program (cross platform Win-MAC-Linux in fact), but no deb file to easily install it in linux.
As I use linux for some time now, I was thinking of doing someting back to the community by making a deb package, so I started reading up on how the Java
programming language is structured and how to make a package.
In the new Ubuntu packaging guide, it is adviced to create the package first via Debian, as a lot of distro's are based on Debian, and by Creating the package for Debian, more people will benefit from the package.
So I went over to the Debian dev site and started reading up there.
It struck me however that Debian is not very welcoming for new packagers.
They require you to read up dozens of documents and politely tell you that as long as you don't perfectly know all of these documents, you should not waste their time by asking questions, and that you will be lucky if someone will dedicate
their time to help you out.
To me, this struck me a bit like RTFM and and **** off unless you know all pages by heart.
but I may perhaps be looking in the wrong places ????
As I think this SW would help music students a lot while practicing, I think I would be
a nice addon in a Linux distro though, so I would like to ask an Ubuntu packager
to add this sw to the repo's
Windows alternatives are Photoscore, smartscore, midiscan, and a number of others.
I did not try yet if those work via WINE, but a native linux package for Audiveris
looks much better IMO.
It will be more user friendly to install and avoid possible system infections via windows viruses while running wine
I contacted the developper to report a bug, and at the same time I told him about my packaging plans. He was positive about it, but asked me to wait for the new release that will come out soon, so in the mean time I started reading on deb packaging, but having read the Debian things, I don't feel the urge to proceed with
this so much anymore.
A few years back while browsing throug the ubuntu site, it also seemed to be more
welcoming to new packagers, but at that time I just started using linux and was not ready to give something back to the community yet.
So I someone feels enthousiast about packaging this piece of sw that will help
musicians who at the same time use linux, IMO it would fill a gap in the linux
music SW palette.
Best rgds,


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WATCH: Sting continues Beatles Week on 'Late Show'
Listen to Sting on iHeartRadio
Sting helped put David Letterman's Beatles Week in the fast lane Tuesday night. The rock icon took the stage alongside singer Ivy Levan and Incubus guitarist Mike Einseger to take on the Beatles' classic "Drive My Car."
Sting's performance marked Day Two of a week-long celebration honoring the 50th anniversary of the Fab Four's debut on "The Ed Sullivan Show," which was filmed in the same theater Letterman occupies now.
Beatles Week started Monday with a new rendition of "And I Love Her" from indie duo Broken Bells, and it's set to continue with visits from Lenny Kravitz, the Flaming Lips, and John Lennon's son, Sean Lennon, over the next few days.
Check out Sting's Beatles tribute below!


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'"I'm not worried about it. I'm going to go out and play. The doctors have been great to me. They checked me out and told me everything's fine. I'm obviously going to have to change helmets this year and think about wearing a (face) shield. Other than that, I'm ready to go."'
Concussion healed, Barnes is aching for action
September 13, 2002 Submitted by
Via: Buffalo News


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VHA Optometry Service Internet Website
During the more than a quarter century since its inception, VHA Optometry Service has gradually evolved into providing the majority of primary eye care and low vision rehabilitation services for our Nation's Veterans. Our high quality Optometric Education Programs are affiliated with Accreditation Council on Optometric Education (ACOE) accredited Schools and Colleges of Optometry. Every year there are over 1,250 opportunities for ACOE-accredited Professional Optometric Degree Program doctor of optometry (O.D.) candidates to rotate at VA medical facilities for clinical education and training. Each year about 70% of the 1,400 to 1,500 graduates of the ACOE-accredited Schools and Colleges of Optometry in the United States have performed public health care services at VHA medical facilities to distinguished citizens of the United States, our Nation's Veterans.
Annually, there are over 170 post-graduate VA optometry resident positions available for clinical training and the development of advanced clinical competence. All of these VA post-graduate Optometric Residency Programs are ACOE accredited and affiliated with Schools and Colleges of Optometry. Since 2004, there are three VA Optometric Research Fellowship Program sites to train the next generation of optometric eye and vision care researchers. Of the nearly 700 clinically privileged optometrists in the Veterans Health Administration about 60% have faculty appointments at a School or College of Optometry and are involved in the clinical training and education of future eye doctors. Approximately 10% of VA optometrists have faculty appointments at a School or College of Medicine.
Through funded research grants that are provided by the VHA Research Service, the National Eye Institute of the National Institutes of Health and private sources, many VA optometrists actively participate in low vision rehabilitation as well as basic research and multi-center clinical trials. The results of these research projects have resulted in improved ocular disease prevention and low vision rehabilitation outcomes for the rapidly increasing number of significantly visually impaired and legally blind Veterans. Age-related macular degeneration, glaucoma, diabetic retinopathy and cataracts continue to be leading causes of preventable blindness in the United States.
To complement inpatient Blind Rehabilitation Centers, outpatient low vision rehabilitation clinics and Visual Impairment Center To Optimize Remaining Sight (VICTORS) programs are available. The development of these special clinical programs mirrors the national distribution of VA optometrists. From now to the year 2020, it is estimated that there are over 1,000,000 veterans with significant visual impairment and legal blindness who could benefit from varying levels of low vision and blind rehabilitation services.
Within the Office of Specialty Care Services in the Office of Patient Care Services at VA Central Office, optometry and ophthalmology are equal partners working together to provide the full spectrum of primary, secondary and tertiary eye care services. By utilizing the complementary strengths of both eye care professions, our Nation's Veterans have greatly benefited. This strategic alliance has resulted in the development of national VA/DoD Diabetes Mellitus Clinical Practice Guidelines as well as the VA Teleretinal Imaging Screening Program with the Office of Telehealth Services to improve access and reduce preventable blindness from diabetic retinopathy.
In the future, additional innovative strategies to improve the delivery of high quality eye care services and clinical outcomes will be developed so that we may continue to provide excellence in patient care, education and research to meet the ever-changing needs of the Veterans we serve.