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When I use insider trading data to try and find a possible investment candidate, one of the main criteria I use is consensus and clustering (I wrote about this in my book) - I tend to skip over stocks that are seeing both insider buying and selling and focus on those stocks where multiple high-level insiders are all buying around the same time.
And that's the case for this week's Insider stock pick Black Diamond Inc. (NASDAQ:BDE) - it's a small cap stock with an interesting expansion story to tell in a hot sector (outdoor sports). Insiders, both officers of the company and directors on the board, have bought close to $10M in stock in the past month.
My methodology uses insider trading data from Bluetrader. I monitor hundreds of weekly trades, looking for interesting stories that may slip between the cracks and publish these in my weekly (free) insider trading newsletter. When you subscribe, you can get a feel for the methodology I use by downloading a free ebook there, The Harvard Guide to Insider Trading.
Trigger Event
On February 24, 2012, 5 insiders of BDE, including the President of the firm, Peter Metcalf and the Chairman of the Board and Executive Vice Chairman (Warren Kanders and Robert Schiller - these guys are important to the story and I'll come back to them), bought almost $10 million in BDE stock on the open market.
Company Tearsheet
In May of 2010, Warren Kanders and Robert Schiller, two successful businessmen put together what today is known as Black Diamond. Black Diamond, as it appears today, is a funny-tasting sandwich of 3 different companies, combined in May of 2010.
- Clarus Corporation: Used essentially as a public company shell, Schiller and Kanders used the firm, still with $81M in cash and $231M in Net Operating Losses (NOLs, used to offset taxable income) to essentially take public Black Diamond.
- Black Diamond: This is the jewel in the BDE crown with a heritage dating back to 1957. Black Diamond is one of the most globally recognized brands for climbers, mountaineers, and aspirational outdoor enthusiasts. (Website)
- Gregory: Premier technical backpacking and other products, founded in 1977. Kanders and Schiller bought this company in 2008. (Website)
What Does Armor Holdings Have To Do With BDE?
Well, a lot. Warren Kanders and Rob Schiller took Armor and completed in excess of 30 acquisitions over 12 years. In July 2007, AH was bought by BAE Systems for $3.1B.
Armor Holding participated in an industry, after market security fittings for vehicles, that was highly fragmented and showing good secular trends, just like outdoor equipment. Schiller and Kanders have every intention of turning BDE (currently about $180M in market cap) into a multi-billion dollar brand in the outdoor equipment industry.
Snapshot Of Trends In Outdoor Equipment
There is definitely a growing trend, particularly among baby boomers, for travel and outdoor exploration, combined with an increased awareness in health/wellness and environmentalism.
Sales of outdoor products in the U.S. Reached $7.7 billion for the first nine months in 2011, up 6.3% from the same period in 2010.
Black Diamond: The Core Business
Black Diamond has seen double digit top line growth since 1990. Its mission - to design high quality, high performance gear for climbers, mountaineers and skiers- has been driven by a passion and innovation that's driven the firm's financial performance.
The 5 Year Plan For BDE
Msrs Kanders and Schiller have high aspirations for BDE. Given their track record and history at Armor Holdings, investors should expect a mix of organic growth and acquisitions. Lots of them.
Retail expansion: First, the firm is embarking on a mission to increase its retail space at the largest specialty retailers (REI, the firm's largest customer). Using REI as an example, the retailer has increased its own store count by 60% over the past 5 years. So, BDE plans to grow alongside its retail partners to increase is sales floor presence and merchandising initiatives. Acquisitions are a core part of this strategy.
New products: BDE has made it clear that it wants to redefine the categories it enters and will seek out opportunities (like with Gregory backpacks) to create a pipeline of new products in multiple categories. This includes a launch into apparel (expected in Fall 2013). The firm's been gearing up for this push with new hires, experienced pros snatched from leading competitors.
BDE believes there is a $250M long-term opportunity (meaning, by 2020) to create a brand presence in apparel with higher gross margins by using existing relationships with key outdoor retailers.
Go more global: Black Diamond's competitors sell a lot globally and BDE already has a significant chunk of its sales coming from the rest of world (50% outside of US) with rapid growth in Asia. The company plans to extend and broaden its distribution into high-demand markets like Asia.
Acquisition strategy/Building a $500M business: BDE is targeting firms with revenues between $25 and $50 million. Candidates should have similar characteristics to Black Diamond itself: technical products, protected intellectual property, iconic brands/heritages, and strong markets.
With its strategy, BDE believes it can generate over 50% growth organically and use acquisitions to contribute $250M in top line sales by 2015. Remember, Apparel alone is expected to do $250M by 2020, so this is a long-term growth story.
Who's Buying The Stock And Why?
Everyone is buying the stock here - as mentioned previously, the top 5 executives, including the key board members Kanders and Schiller, have bought almost $10M worth of BDE just last week. Schiller and Kanders appear to have about $8M of their own capital sunk into the company so far.
There is a lot of room for growth here - taking a $125M (current) niche retailer more mass market to a $500M+ powerhouse. I'm always wary of a firm that uses M&A so instrumentally to grow - it works for a while and then tends to become a financial mess. There's huge integration risk that these add-on acquisitions don't quite fit.
In fact, the company is on the road, trying to raise money to fund some future acquisitions. If you're going to get in, you might want to wait until that fundraising is over.
But I guess that's not Kanders and Schiller's plan. I think the deal is to sell this thing before then and let the large acquirer sort everything out.
They've done it before with Armor Holdings, can they do it again with Black Diamond? What do you think?
Disclosure: I have no positions in any stocks mentioned, and no plans to initiate any positions within the next 72 hours.
Additional disclosure: This should definitely not be construed as investment advice. I've tried my best to be as faithful to the story as I could, using sound resources to help describe the insider trading activity at leading companies. But you should definitely do your homework — don't base an investment decision off this information.


text: Ken Barlow Alan Bradley Colin Grimshaw Doreen Fenwick Christine Appleby Pages in category "1939 births" The following 5 pages are in this category, out of 5 total. A Christine ApplebyB Ken BarlowAlan BradleyF Doreen FenwickG Colin Grimshaw Retrieved from "http://coronationstreet.wikia.com/wiki/Category:1939_births?oldid=62483" Ad blocker interference detected! Wikia is a free-to-use site that makes money from advertising. We have a modified experience for viewers using ad blockers Wikia is not accessible if you've made further modifications. Remove the custom ad blocker rule(s) and the page will load as expected. Categories: 1939 Births Add category Cancel Save

subset: commoncrawl


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Not every meal can be perfect. Things are going to happen that are beyond our control. However one of my biggest peeves is being moved while in the middle of dining.
The other day a group of five of us were eating. We had run up a decent size bill. When the deserts were to came out they were not brought to us but placed on a table half way down the restaurant next to the band. The manager simply stood there waving us over. No 'please', 'excuse me' or 'would you mind'. No one offered to help us with our coats and bags. And no nothing was compt I was expecting at least a tea out of it. It turns out he simply wanted our table to accommodate a larger group. To me this was totally unacceptable. I won't go back to that place.
Another time mid way through my meal I was asked to change tables to accommodate some people who had come in with a stroller. As there were plenty of other tables I thought that perhaps the restaurant staff could have made a little effort and moved things around instead of just moving me. I was a little irritated but figured why not take the high road.
Is it ever okay to be moved in the middle of a meal? If so should the restaurant make amends?


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We all know you are in business concern. That is what your name flash is for. When you but try to flog concrete in every email, you will get unsubscribes, and the ones that don't unsubscribe aren't language your emails anyhow. Correction: Give your subscribers useful subject matter in your emails. You can now and again dispatch a guidance to a commodity you individually use or cognise will be serviceable to your readers, but do it meagerly.
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1.Fin tube for power station,fin tube for boiler which is widely
used in Germany now
2.Standard according to DIN17175 DIN239
·Titanium advantage:
It is hard to find more light and corrosion resistant material. Titanium is heat resistant, insensible to temperature changes, pressure resistant and stable in salt, moisture and organic conditions. Titanium alloy is the hardest metal. Titanium tube is required everywhere where it is important be stability to mechanical influences and endurance to aggressive media. Due to high durability, corrosion stability, accumulation of salts and organics on the wall surface titanium alloys keep its qualities and properties.
·Titanium Finned Tube advantage:
Titanium finned tube is an essential construction element in high tech industries due to its unique properties: specific strength, heat and wear resistance, low density and lightness. Titanium is known as "eternal" metal because of corrosion resistance and biological interness.
·Titanium Finned Tube disadvantage
The main disadvantage of titanium finned tube is its high production cost. Actually titanium got its name due to titanic pure state. But despite high production cost and laboriousness this product is widely required.
·Our Advantages:
1, Direct material sourcing from Yunnan titanium and imported
2, More than 2 processing mills to produce the welded titanium tube for us.
3, Strong business cooperation with Bao Steel and Shanghai Minmetals
4, More than usd$50,000,000 annual turnover.
5, Sales of more than 400 MT titanium coil/ strip annually.
·Titanium Finned tube Application:
It is highly demanded in heat exchangers, oil and petroleum production spheres, cooling systems. Titanium and titanium finned tube is used at interior design. Usage of such finned tube is efficient because of its processability, durability and strength in spite of its high price. In many cases finned tube is an irreplaceable element.
·Titanium Finned Tube Production:
Titanium strip can be produced of titanium alloys Gr1, Gr2 with chemical composition in accordance with ASTM B891
*Air cooling unit *Product coolers - gas, Finned Tube chemicals, petrochemicals, oil etc. *Heat exchangers
Titanium Finned Tube Base Tube: welded/seamless titanium tube Per ASTM B891 Gr1/Gr2 better heat transfer coefficient ratio
Spiral Finned Curved Tube Images


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Cataract and Refractive Surgery 1 (OPSC5018)
This unit of study aims to provide candidates with the theoretical and practical foundations of the practise of cataract and refractive surgery. Successful candidates will demonstrate to the examiners that they have a detailed and comprehensive knowledge of corneal refractive surgery. Candidates should be able to: (1) Describe how an excimer laser, femtosecond laser, conductive and thermal keratoplasty work; (2) Describe how PRK, LASIK. Arcuate keratotomy, conductive keratoplasty are performed; (3) Demonstrate knowledge of the theory behind the lasers involved; (4) Describe indications and contraindications for the above procedures; (5) Demonstrate an understanding of the impact of systemic disease on refractive surgery patients; (6) Describe the management of corneal related refractive surgery complications; (7) Describe the treatments for keratoconus; (8) Demonstrate an understanding of the economics of setting up a refractive surgery practice; (9) Discuss lens based approaches to refractive surgery including lens; (10) Extraction and phakic intra ocular lens choices, including the preoperative; (11) Assessment, surgery and postoperative management; (12) Have an understanding of the management of lens based related refractive surgery adverse events; (13) Understand the evidence for and ethical issues related to refractive surgery.
Our courses that offer this unit of study
Further unit of study information
3x2000 word written assignments (90%), and online discussion (10%)
LASIK: Advances, Controversies and Custom, Louis E Probst; Mastering Refractive IOLs: The Art and Science, David F Chang, Slack publishers; The Art of LASIK, Machet, Slade, Probst. 2nd edition Slack Publishers; Step by Step LASIK Surgery, Vajpayee R., Jaypee publishers.
Faculty/department permission required?
Unit of study rules
Additional Information
This unit is only offered in Semester 1.
Study this unit outside a degree
Non-award/non-degree study
If you wish to undertake one or more units of study (subjects) for your own interest but not towards a degree, you may enrol in single units as a non-award student.
Cross-institutional study
If you are from another Australian tertiary institution you may be permitted to underake cross-institutional study in one or more units of study at the University of Sydney.


text:
(53-29) 3rd in the Midwest Division
Team needs: John Starks, Danny Manning and Olden Polynice are key role
players who need to be brought back but are all in the twilight of their careers.
The promising youngster DeShawn Stevenson, the club's future franchise player,
was accused of the statutory rape of a 14-year-old Fresno girl this past month
by and could be unavailable for next season or several more. Greg Ostertag is
a solid backup but not the answer at center, probably not even in combination
with Polynice. Jacque Vaughn may not be re-signed. Everybody in the organization,
including John Stockton and Karl Malone, has lost their patience with the club's
pattern of fine regular season play followed by playoff letdowns being exhibited
on a regular basis. Management is certainly willing to shake things up this
summer if it has to, because it's now or never for this current mix.


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CuteDJ 4.3.4 (Full + Crack)
CuteDJ 4.3.4 CuteDJ 4.3.4 Full Crack offers everything you need for DJ mixing, scratch, remixing, vinyl emulation, and live performance. It's perfect for weddings, parties, clubs, hotels, and even at home! CuteDJ finds songs very fast, lets you mix automatically and manually, play music to...Continue reading »


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Team a pair of black denims and flats with this top. Carry a printed tote to complete the look. You can also team it with a leather shirt skirt and a pair of boots. Carry a sling bag while heading out.
Enter your PIN code to check the delivery time and special services


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We host a variety of general admission parties onboard our party boats, mainly at Christmas and New Year, but sometimes throughout the year too. They are a great way to experience the magic of a London boat party without having to hire the whole boat! Below are details of parties with tickets for sale, click on the flyers for more information.
Please note all our ticket parties are strictly over 21 only.
Ready to book?
Secure your tickets nowBuy Tickets Now
Christmas Parties Info
Need more information on our Christmas ticket parties?Christmas Parties
NYE Ticket Parties
Details of the NYE parties we have on offer this year.NYE Parties


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Stock up on wine a spirits for your event, for provisioning needs, or just to keep on hand for when you are in need. The more you buy, the ore you save.
This shop commonly keep spirits, wines, and beers on hand in addition to energy drinks, sodas, water, cigarettes and drinking accessories.
Aside from Island Wines & Spirits, the shopping opportunities in the vicinity are scarce.
Stop in between the hours of 9:00 a.m. and 8:00 p.m. Monday through Saturday.
Location: Mackey Street, Nassau, New Providence
Phone: 394-0632
Website: http://www.islandwinesandspirits.com
Help us improve! We welcome your corrections and suggestions.


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Coming into the Delaware River event, six anglers had brought a limit to the scales each day they've competed in 2014: Brett Hite, Bill Lowen, Jacob Powroznik, Dean Rojas, Randall Tharp and David Walker. Four of them fell by the wayside on Day 1. Rojas had three bass. Powroznik and Tharp had two each. Walker had only one keeper. That left just Brett Hite and Bill Lowen with a chance to go the full season with a limit every day.
Of course, that changed on Day 2 also. While Lowen brought five to the scales yet again, Hite managed just three bass, leaving "The Turtle" as the only angler with a chance to limit every day of the season.
Apparently, slow and steady really does win this race.


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Some truly shocking and sad news has hit the wire as director David R. Ellis (Snakes on a Plane, Shark Night, Final Destination 2) is no longer with us. Details are scarce at the moment, but read on for what we know as of now.
Deadline reports that Ellis died in Johannesburg, South Africa. The director passed away suddenly early this morning (Los Angeles time). Ellis was just 60 years old, and the cause of death is not yet known. Ellis was in South Africa preparing to direct the film Kite; the director's live-action adaptation of the 1998 Japanese anime was set to reunite Ellis with his Snakes star Samuel L. Jackson.
We here at Dread Central would like to take this time to offer our most sincerest of condolences to David's many friends, his family, and constituents. Rest easy, kind sir, and thanks for all the fun rides.
Got news? Click here to submit it!
Celebrate David's legacy in the comments section below!


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Question: One of the major benefits of e mail is that it
One of the major benefits of e-mail is that it makes it possible to communicate rapidly without getting a busy signal or no answer, two major criticisms of telephone calls. But does e-mail succeed in helping solve the problems people have trying to run computer software? A study polled the opinions of consumers who had tried to use e-mail to obtain help by posting a message online to their PC manufacturer or authorized representative. Results are shown in the following table.
a. Solve using the p-value approach.
b. Solve using the classical approach.
View Solution:
As marketing manager for a large PC manufacturer, you decide to conduct a survey of your customers comparing your e-mail records against the published results. To ensure a fair comparison, you elect to use the same questionnaire and examine returns from 500 customers who attempted to use e-mail to get help from your technical support staff. The results follow:
Does the distribution of responses differ from the distribution obtained from the published survey? Test at the 0.01 level of significance.
a. Solve using the p-value approach.
b. Solve using the classical approach.
View Solution:
Answer to relevant QuestionsNursing Magazine reported results of a survey of more than 1800 nurses across the country concerning job satisfaction and retention. Nurses from magnet hospitals (hospitals that successfully attract and retain nurses) ...To demonstrate/explore the effect increased sample size has on the calculated chi-square value, let's consider the Skittles candies in Exercise 11.16 and sample some larger bags of the candy. a. Suppose we purchase a ...Identify these values from Table 11. 7: a. C2 b. R1 c. n d. E2,3 A survey of employees at an insurance firm concerned worker–supervisor relationships. One statement for evaluation was, "I am not sure what my supervisor expects." The results of the survey are presented in the ...Using the notation seen in Exercise 11.4, name and find the critical values of x2.
Post your question


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I work with students in this age group. I would also like to hear other opinions on this. I did have a foreign student referred to me for this issue. I was in no way willing to have him apply...Mar 27, '14
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I am a LPN so teaching is not in the cards for me. I had to quit my job as an agency nurse 2 years ago. I was seizure free for a year and tried to return to nursing but whenever I was asked why I...Apr 9, '11
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I am a minority and I am going to tell you now that I am tired of the weak people, who represent my culture, crying about how unfair life is. I was educated in the Newark, NJ school system and did...Feb 4, '11
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When I was in school the smokers weren't even allowed to smoke when they were in uniform. It didn't bother me since I didn't smoke but we had a lot of unhappy people.Dec 26, '10
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I remember when I was in school a fellow nursing student felt the need to tell me that she was cheating off of another student. I told her that I didn't want to hear about it again. She told me again...Dec 19, '10
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A lot of people on this site ask questions about meds and their safety. I didn't didn't find anything absurd about her question.Aug 5, '10
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Since I can't figure out for the life of me where you are asking for medical advice I will bite. No, I have never worked for a weight-loss clinic and I do hope that someone on here does respond and...Aug 5, '10
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I renewed via internet and they mailed me a paper license.Aug 3, '10
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The residents can call them whatever they want. I had one who called it his "banana hammock". Do any of you feel that I should call it that since that is what he calls it? No? Well then the whole...Aug 2, '10
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My son and his friends try to "friend" as many people on fb as possible. I know that these are not people they are really close to because when I ask he will tell me "oh, that's just a kid in my...Aug 2, '10
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I would try to encourage this person because I think that is the right thing to do. I would encourage her right out the door. As a previous poster wrote you should be so wonderful as to bring in help...Aug 1, '10
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What do you mean by "choose not to use it"?Jun 12, '10
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I think the OP said that the patient stated she had papers for the dog. If she has papers, no matter what anyone feels, nothing can be done. I have epilepsy and have met a few people with service...May 29, '10
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I have tried so hard to stay out of this but I have to say that my husband has gotten so used to my laziness with shaving my legs that he considers it foreplay when I shave them.May 21, '10
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I would ask for a longer orientation. I have had ones that short but never in the beginning. Please speak up if you do not feel comfortable after the 3 nights. I think nights are a great shift for...May 8, '10
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I worked at a camp last summer and the problem I saw was that the counselors were too young. They would use food as a punishment and if a camper did not behave they would withhold canteen (when they...May 2, '10
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The OP made a poor choice and it is not a choice most of us would have made. I don't think this is a "new grad" issue but I think it is a "maturity issue". This was completely immature and it doesn't...Apr 21, '10
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Okay, I am really bad at laundry (ask my husband and son) but if the colors do happen to get onto the whites can't you just bleach the whites?Apr 18, '10
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Mad-Mary if that was in reference to what I posted what I meant was that when peoples names had "nurse" in it they were nurses. Now they can be CNAs or students and that can be misleading. I in no...Apr 18, '10
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I think you are right and I am afraid that at times I am very guilty of this. I really am glad you posted this and I really am going to try to keep this in mind when I post. I do tend to say things...Apr 18, '10
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When I joined I noticed that I got a lot of responses (good and bad) from other nurses. Now I have to look to see where it is coming from because it may be a student or non-nurse. I ignore it because...Apr 18, '10
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August 08, 2009
I'm envious of the lives of NFL players in many ways. Being forced to allow some cruel, veteran jackal to have his way with my head, however, is not one of them.
In particular, I feel for #61, Greg Isdaner. Travis Bright, the gentleman with the "unicorn puff" got no bargain, either, as his new style is ridiculous and embarrassing. But Isdaner, the rookie free agent out of West Virginia, not only got ridiculous and embarrassing, but old, too.
This is the sprightly, youthful look Isdaner showed up with:
And again, this is today's carnage.
And he didn't make the video, but here's what they did to poor Pat McQuistan(notes):
Michael Floyd Is In Football For The Long Haul
Posted Jul 2 2012
HBO Real Sports: Holley Mangold
Posted Jul 3 2012
Rams' rookie class, cheerleaders head to Joplin to help rebuilding efforts
Posted Jun 21 2012
Edited By Doug Farrar
Edited By 'Duk
Edited By Kelly Dwyer
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Regina Coeli Child Development Center's annual general membership meeting is set for 6 p.m. Wednesday at the center, 22476 U.S. 190, Robert.
Residents are invited to attend the meeting, at which members of the board of directors will be elected.
RCCDC operates Head Start and Early Head Start programs for children and families in Covington, Lacombe, Slidell, Bogalusa, Franklinton, Greensburg, Springfield, Walker, Hammond, Independence, Roseland, Robert, Amite and on the campus at Southeastern Louisiana University.


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This hotel is located in the Kusadasi city centre and overlooks the marina and Pigeon Island. The beach is only 500m away. It has the quality and comfort of a 4 star hotel. The lobby is lightly but comfortably decorated with a nice bar where guests can sit relax and enjoy the pleasant atmosphere.
Rates and conditions are valid for uk passport holders only
Rooms Description:
Bathroom air conditioning telephone satellite TV hair dryer music minibar andor mini refrigerator balcony and some with great sea views also overlooking Kusadasi harbour.
Facilities and Services:
24hour front desk 24hour room service 24hour security Air conditioning ATMCash machine Baby sitting Bookstore Check cashing policy Cocktail lounge Coffee shop Coin operated laundry Concierge desk Conference facilities Currency exchange Doctor on call Door man Elevators Exercise gym Free parking Free transportation Game room Accessible facilities Housekeeping daily Ice machine Jacuzzi LaundryValet service Massage services Outdoor parking Outdoor pool Photocopy center Playground Pool Poolside snack bar Restaurant Room service Safe deposit box Sauna Security Shoe shine stand Wakeup service Wheel chair access Multilingual staff Banquet facilities Bell staffporter Direct dial telephone 220 AC Room service limited menu Public area air conditioned Complimenary newspaper in lobby Complimenary shoeshine Evening reception Front desk Halal food available Telephone jack adaptor available Buffet breakfast Communal bar area Loungesbars Breakfast served in restaurant Dinner served in restaurant High speed internet access for laptop in public areas Wireless internet connection in public areas Phone services Children play area Early checkin Nonsmoking rooms generic Late checkout available Internet services Hair dryer Toilet Handicap rooms High speed internet access High speed wireless Private bath or shower Fire safety compliant Welcome drink Printing services available


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if your last Google search was anywhere around "Best Female Pocket Knife," then you're at right place.
We were receiving complaints for not featuring knives that females can use, so we are live with this article. Hopefully you find a good knife for you.
Actually If we see there isn't any major difference between men & women pocket knives. The only thing that discriminates between a female and male knife is "Looks." Anyways, today we are going to review best female pocket knife.
These knives are not intended to be the 'master-of-all-trades.' Anyhow there's always a better knife for specialized tasks like slicing tomatoes, carving tent pegs from a fallen branch or skinning a deer but most of us want a single "do-everything" knife that stays with us throughout the day.
Best Female Pocket Knife - Detailed Female Pocket Knife Reviews
Spyderco is one of the best brands out there in the knives' industry. They have been making extremely useful knives for their customers since the very beginning.
Spyderco Tenacious is an automatic opening knife in the range of 40$. It has a good length that makes it a best EDC knife under 50$. They've few models that can make it to the best folding knife.
General Dimension & Blade: Spyderco Tenacious plan edge is made in the USA. The length of knife is 197 mm (7.8 inches) when completely open and 113 mm (4.5 inches) when closed. The blade is constructed with 8CR13MOV steel which is stainless steel.
Though this steel is not excellent but still it is a medium range steel and holds the edge very strongly. It's sufficient blade thickness along the flat grind and wide chord design give this blade added durability. The jimping on this blade is best, and thumb sits perfectly on the ramp, and it holds your finger in place.
Handle & Ergonomics: The handle is constructed of top quality material G-10 that makes it best ever handle to grab in the palm. Since the handle is constructed of the G-10 material, you can't complain about the grip at all.
It sticks to the hand that helps you to complete your tasks without any trouble. The knife has a smooth, rough texture that won't dig up your skin or chew up your pants when you put it in your pocket, and honestly, it feels very "amazing."
- Pros: Extremely affordable. Great balance. Nice G-10 handles. Excellent quality at this price point.
- Cons: Blade steel a little soft. Minor amount of side blade play.
Overall: The knife is made in the USA. Furthermore, handle and ergonomics are simply amazing. Also, the design of the knife is dope. It's an excellent female knife under 50$
2. Kershaw Pink Chive
Kershaw cryo is among the best folding knives. We have listed them in top folding pocket knife brands. Kershaw knives are affordable and engaging with the vast collection of styles. Kershaw Cryo knife is excellent for everyday carry (EDC) and classy enough for the formal occasions.
The blade comes in two color and pink suits best to the females.
General Dimension & Blade: The blade length: 1.9 in. (4.9 cm)-Closed length: 2.9 in. (7.3 cm)-Overall length: 4.8 in. (9.9 cm)-Weight: 1.5 oz. The blade is consist of 420HC stainless-steel. And, The blade itself looks very elegant. It has an inner curve in cutting side that gives it a sexy shape.
The Frame lock equipped blade holds its edge beautifully. Blade flicks out of the handle pretty quickly. The blade was very sharp out of the box when arrived. You can take it along you anywhere. You can keep this beauty in the purse or you can use it's clip to keep it in the pocket.
Handle: The handle is consist of 6061-T6 anodized aluminum with Bead-blasted finish-Handle. Handle has been polished to perfect mirror appeal.
Handle feels pretty good in the hand and makes good grip in the hand. Handle size is excellent, not so big not so short. It's a potentially best female pocket knife.
- Pros: Extremely Sharp Blade. Excellent Speedsafe opening mechanism, and good ergonomics.
- Cons: Small in size. Edge retention with 420HC steel isn't great.
if you need something discreet and stylish, then you can't go wrong with the Kershaw Chive. It certainly looks inconspicuous, but it's incredibly useful for many applications. If you're looking for stylish and reasonable price pocket knife, then you can definitely go with it.
3. Kershaw Ken Onion Blur Knife
The best thing about ken models is their opening mechanism which makes their knives fit in many categories. Either you are hiking, camping, backpacking, or just going to a friend's wedding, Ken model's knives will serve you well.
General Dimension & Balde: The overall length of blade is 7.88 inches. It weighs 3.9 oz that means it pretty light. The blade of this knife is constructed of Sandvik 14C28N Steel with Tungsten DLC black coating.
It's built quality is outstanding, opens quickly and easily, and quality of the steel is adequate, the blade shape is very attractive. Blade strength is excellent. It Arrives sharp, stays sharp, and cuts with comfort.
It has speed safe opening mechanism which makes it outstanding. The spring-assist opener has an astonishing deployment speed, flipping the blade open in a fraction of a second with comfort.
Handle & Ergonomics: The handle is construed of 6061-T6 anodized aluminum with Trac-Tec inserts. If you look at the handle, you'll see the roughness design in added to the handle to make it rough that eventually makes it grippy in the handle.
And, if you're knife lover you know it always feels pleasant & comfortable to hold knives with such ergonomics. The handle is available in a variety of colors too, including the olive drab model as well as desert sand, red, and black. So, if you want a sexy design, then you should definitely look forward to it.
- Pros: Sharp, and looks great, Speedsafe opening is good, worth all the money
- Cons: Not a great locking mechanism, and awkward thumb stud.
If we look, other knives with same features and opening speed, including automatics like Microtech and ProTech, will cost three times as much. Hence, this knife is a good choice and definitely makes it to the best folding knife under 60$.
But, the clip is little tighter than we thought, so you've to careful while tucking the knife with clip & while tucking it off. Best female pocket knife for 80$
4. Benchmade 940 Osborne
The Benchmade 940 is an Osborne Design Knife featuring ultra smooth one hand opening and the Axis Lock system for easy opening/closing and a sure fire locking system. Benchmade is also along the top knife brands.
Blade & General Dimensions: The blade length: 4.1 Inch (10.4 cm); Closed length: 5.2 Inch (13.2 cm); Overall length: 9.3 Inch (23.6 cm). The blade on the 940 is constructed with s30v premium stainless steel, one of the best steels available.
It sharpens relatively easily and holds an edge exceptionally well and after few weeks of dull usage, Benchmade 940 still sharps enough to cut with. There is an official logo on the blade and believe us it looks elegant.
Handle: Handle comes with green anodized aluminum handle with stainless-steel liner.The handle looks elegant and its green color will make you in love with the knife. The handle is thin & makes a good grip in the hand.
The blade is all the way attached deep down with handle that makes the whole knife a strong. Though there are nuts on the handle but it doesn't mess with the handle.
- Pros: Roboust lock up, sharp blade, sturdy, and elegant
- Cons: Costly (but not really)
It's an elegenat looking knife. The blade itself is very robust & isn't it? Benchmade made service is superior that gives it an extra edge. The blade is razor-sharp and the handle is super grippy and comfortable to hold.So, if you're looking for your
under 200$, then this knife is for you only. We highly recommend this knife if you're looking for regular EDC knife.
Final Words: So, these are the best female pocket knives. These knives are really elegant in looks and good in performance. The razor sharp blades and grippy handles make these knives best for a woman, and kitchen work.
All knives have some pros and cons according to their performance. The one with higher price has it's own perks, but according to us all these knives are good enough enough if you want to use it as an EDC & kitchen knife.
Wrapping Up!
We hope you found your best female pocket knife. So, if you liked the article, then make sure you share it with your friends on social media platforms. And, if you've any doubt then comment down below, we will solve the query as soon as possible.


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Callaway Corvette
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- Item Category: Transportation and Vehicles
- Source: eBay
- Sold Date: Jun 05, 2007
- Channel: Auction House
Callaway Twin Turbo Corvette brochure, 4 page foldout with color photo insert. Provided to authorized dealers. Perfect, like new condition. Printed 1990. S&H $2.65.


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Former U.S. President Bill Clinton got a standing ovation from the A-list Hollywood stars when he surprisingly appeared to present an award at the Golden Globes on Sunday night.
The 42nd president was on hand to introduce Steven Spielberg's Civil War film, "Lincoln," which was up for best drama. The movie, starring Daniel Day-Lewis, follows Abraham Lincoln's final months in office as he tries to abolish slavery.
"A tough fight to push a bill through a bitterly divided House of Representatives. Winning it required the president to make a lot of unsavory deal that had nothing to do with the big issue. I wouldn't know anything about that," said Clinton.
"President Lincoln's struggle to abolish slavery reminds us that enduring progress is forged in a cauldron of both principle and compromise," he continued. "This brilliant film shows us how he did it, and gives us hope that we can do it again."
As the former president left the stage, Amy Poehler, co-host of the ceremony quipped: "Wow! What an exciting special guest! That was HillaryClinton's husband! That was exciting."
Watch the entire clip in the video above.


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Introducing 3MT® at Memorial
1st place winner:Meagan McCardle
Runner up:Brittany Palm Flawd
People's choice: Brittany Palm Flawd
Three Minute Thesis (3MT®) is a research communication competition developed in 2008 by The University of Queensland (UQ) in Australia. Research students have three minutes to present a compelling oration on their thesis and its significance. 3MT is not an exercise in trivialising or 'dumbing-down' research, but challenges students to consolidate their ideas and research discoveries so they can be presented concisely to a non-specialist audience.
The School of Graduate Studies held its fourth annual 3MT competition as part of the MUNdays events on Monday, October 17, 2016.
Watch competitors videos here.
3MT® resources on this website have been generously provided by The University of Queensland (UQ), Australia.


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Due Diligence
In the UK, solicitors working on mergers and acquisitions, management buy outs/buy ins, and other corporate finance transactions have to undertake due diligence as a core part of their workload, yet practical guidance for lawyers is difficult to come by. Due Diligence: A Practical Guide meets this need by providing a step-by-step manual of the complete due diligence process from start to finish. It brings together simple transactional guidance with trouble shooting, potential pitfalls, points of concern, and precedents to provide everything that the company and commercial lawyer needs in a single handbook. This is complemented with helpful practice notes with tips and traps highlighted. The know-how is supplemented with a wealth of fully annotated UK precedents, including team sheets, questionnaires, and reports. All of these are included on the accompanying CD-ROM, allowing them to be placed directly on client files, and giving users a ready-made practice toolkit. This second edition reflects changes in UK legislation and explores in depth some common issues that can derail a transaction if not explored fully in the due diligence process, such as: employee liabilities * environmental concerns * data protection and the release of information * anti-corruption and the impact of the Bribery Act 2010 * pensions and underfunding * software businesses and intellectual property issues * culture and ethos. In addition, the book explores how due diligence can inform post-acquisition integration and how ongoing business health-checks enable the business to maximize performance and minimize risk.
296 pages
Publication Date: 3/27/2013
Format: Cloth & CD-ROM


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project manager
Mr ChristopherGatherum
5 Brookside Burbage,LE102TG, UK.Home 00-44-01455-440548
Mobil Number 07788947548 CONSTRUCTION ENGINEER TRAINED IN THE UK I AM LOOKING FOR A POSITION IN AFRICA,.ASIA,.HAVE 25 YEARS WORKING IN THIS INDUSTRY FROM HIGH RISES ,ROADWAYS TO BRIDGES,JETTYS,SHOPING CENTRES,AND DRAINAGE WORK,HOUSES,FACTORYS, POWER ETC.
I HAVE WORKED IN THE UK,HAITI,NIGERIA, ZAMBIA,ZIMBABWE,SOUTH AFRICA,.IRAQ. Email
An outstanding and dedicated qualified Engineer (Bsc), with a variety of skills in the construction Industry, power projects, all round the world.


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The Book Of Hebrews Chapter 3:1-5 (6 of 24) by Harley Howard
This content is part of a series.THE BOOK OF HEBREWS CHAPTER 3:1-5 (6 of 24)
Harley Howard
1 Wherefore, holy brethren, partakers of the heavenly
calling, consider the Apostle and High Priest of our
profession, Christ Jesus;
For reasons already discussed about Christ, then, my
fellow saints, who are sharers of the Heavenly glory
to come, consider the apostle and High Priest of our
profession, Christ Jesus.
CONSIDER CHRIST. Reflect upon and understand Him.
Perceive Him strongly, fix your mind and focus upon
This is the great omission of most of professing
Christianity today. We are so self-focused, we are so
introspect, so concerned about our own flesh and
perceived needs (which are usually wants) that we have
little or no time to focus on Christ. Just listen to
the things that are being said about Him in Christian
circles and compare them to the bible. By doing that
it is absolutely clear that most professing Christians
know nothing of who Jesus is. I hear with careful
perception and I notice not only that things that are
said about Him which are either distorted or have
nothing to do with the scriptures, or worse than that,
the many things that are left out of our speech and
understanding concerning who He is. How man Christians
knew that Jesus was called an apostle? How many people
have passed over the pages of the Old Testament,
finding it boring and stale, yet the ministry of the
High Priest, which the writer of Hebrews calls Christ
to be the greatest of, we are ignorant of.
We are told of a Jesus that forgives my sin, tolerates
my sin, participates in my sin, whose bloody sacrifice
allows me to participate in abominable behavior under
the guise of grace.
This Jesus has little or no power, which is clearly
indicated by the lifestyles of those who profess to
know Him.
This Jesus also seems to be very much a racist,
tolerating different types of bigotry, under the guise
of culture and status.
This ...
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Description: Few jobs in Hollywood are as shrouded in mystery as the role of the producer. What does it take to be a producer, how does one get started, and what on earth does one actually do? In So You Want to Be a Producer Lawrence Turman, the producer of more than forty films, including The Graduate, The River Wild, Short Circuit, and American History X, and Endowed Chair of the famed Peter Stark Producing Program at the University of Southern California, answers these questions and many more. Examining all the nuts and bolts of production, such as raising money and securing permissions, finding a story and developing a script, choosing a director, hiring actors, and marketing your project, So You Want to Be a Producer is a must-have resource packed with insider information and first-hand advice from top Hollywood producers, writers, and directors, offering invaluable help for beginners and professionals alike. Including a comprehensive case study of Turman's film The Graduate, this complete guide to the movie industry's most influential movers and shakers brims with useful tips and contains all the information you need to take your project from idea to the big screen.
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Older cancer patients' information and support needs surrounding treatment: An evaluation through the eyes of patients, relatives and professionals
Providing cancer patients with adequate treatment information is important for patients' health, well-being and satisfaction. Nurses play an important role in patient education. So far, few studies focused on the specific information needs of older cancer patients surrounding chemotherapy treatment. Given the growing incidence of cancer among older individuals, insight in these needs is crucial. This article describes the views of older cancer patients, their relatives and professionals on older patients' specific communication needs regarding chemotherapy treatment.
A qualitative design was used. Five focus group interviews were held with older cancer patients and their partners (two groups) and professionals with a background in nursing, oncology, gerontology and/or patient-provider communication (three groups). In addition, face to face in-depth interviews were conducted with older cancer patients. A total number of 38 patients and relatives participated, with a mean age of 67.6 years. The focus groups and interviews were audio-recorded for subsequent transcription and analysis.
Older people have more difficulties processing and remembering information than younger ones. A trustful environment appears to be a prerequisite for reflection of older patients on the information provided and individualized information is essential to enhance memory of information. However, the results show that both patients and professionals experienced insufficient exploration of the patients' personal situation and individual information needs. Patients also strengthened the importance of sensitive communication, e.g. showing empathy en emotional support, throughout the continuum of cancer care. Moreover, potential areas of improvement were identified, including engaging the patients' relatives and encouraging patients and relatives to ask questions.
Patient education should be more tailored to older cancer patients' individual information and support needs and abilities by exploring the required amount and content of information, treatment goals and expectations. Nurses can establish a trustful environment by showing empathy and emotional support. Recommendations are given to enhance recall of information in older patients; information giving should be more structured by summarizing and repeating the most important, personally relevant information. To adapt to specific information needs, communication training for nurses and the use of aids such as a question prompt sheet could be useful tools.
Cancer is frequently a disease of older individuals, and is the second leading cause of death in the United States for those aged 65 and older
The information needs of cancer patients vary considerably across individuals
The relationship between personal relevance of information provided, tailoring the information to patients' needs, the extent to which information is remembered and patients outcomes has been visualised in Figure
Figure 1
Conceptual model of the relationship between 'patients needs' and 'recall of information' among elderly patients
Conceptual model of the relationship between 'patients needs' and 'recall of information' among elderly patients.
Older individuals' information needs might differ from the needs of younger patients, since their perceptions of cancer and treatment seem to differ from younger patients, as well as their knowledge of the disease
Thus, it is crucial to gain insight in the information and support needs of older individuals, to tailor patient education about cancer treatment according to these needs, enhance recall of information and, ultimately, improve other patient outcomes such as satisfaction, medical compliance, coping with illness and well being.
Numerous studies have evaluated cancer patients' information needs and suggested that the vast majority of cancer patients want as much information as possible whether it is good or bad
This article describes the views of both older cancer patients and professionals, on patients' specific information needs preceding chemotherapy. The study is part of a larger, prospective study that aims to improve patient education for older cancer patients during nursing consultations preceding chemotherapy. To obtain insight in the views of older cancer patients and professionals, the following research questions were addressed:
1. Which differences between older and younger patients should be taken into account by nurses during patient education?
2. What are the information and support needs of older cancer patients facing chemotherapy treatment?
3. How can older cancer patients' recall of information be enhanced by nurses?
The present study employed a qualitative design using five focus group interviews and five face to face interviews. A semi-structured interview, which consisted of open-ended questions, was used to explore the opinions of cancer patients and professionals concerning the specific needs of cancer patients surrounding chemotherapy treatment. The overarching prospective study, including the present study, was approved by The Medical Ethical Committee of the University Medical Centre Utrecht (VOICE 04/184), supplemented by local feasibility statements from the participating hospitals. Eligible patients were sent or given a letter by the hospital nurse, explaining the study aims and demands as well as explaining that anonymity was guaranteed and refusing to participate would not influence their treatment. After a few days, patients were phoned by one of the researchers to answer their existing questions about the study. Patients who agreed to be interviewed were visited at home, except for one patient who preferred to be interviewed at the hospital. They signed written informed consent prior to the interview. Focus group patients came to the research institute, which is located in the centre of the Netherlands. Personal information (e.g. name and address) was securely stored separately from the data collected in the interviews to make sure that the participants were not identifiable.
In general, patient education about chemotherapy treatment in Dutch hospitals is provided by (specialized) oncology nurses. During a consultation which lasts approximately one hour, information is provided about the treatment, side effects and how to deal with side effects. To explain issues concerning chemotherapy treatment, a booklet 'Treatment Guide Chemotherapy'
Five focus group interviews and five one-on-one interviews were conducted with a total number of 38 subjects. Two focus groups consisted of older cancer patients and their partners who had received a treatment like chemotherapy in the past; three focus groups consisted of professionals with a background in oncology, gerontology, nursing care and/or patient-provider communication. For the interviews, older cancer patients (≥ 65 years) were included who had just finished their second chemotherapy treatment to obtain retrospective information about their needs surrounding treatment as well as their experiences regarding the fulfilment of these needs. The focus group patients and their relatives were selected by an advertisement in a magazine (called "Plus Magazine") for older individuals (first patient focus group) and by approaching seven patient associations (second patient focus group). Twelve people (seven patients and five partners) responded to the advertisement. Seven of them (four patients and three partners) attended the meeting. The other five were unable to come due to holidays (n = 2), hospital appointments (n = 2) and illness (n = 1). In addition, there were nine enlistments (eight patients and one partner) of four patient associations: breast cancer foundation (n = 3), prostate cancer foundation (n = 2), lung cancer foundation (n = 2) and multiple myeloma foundation (n = 2). Six of them (five patients and one partner) attended the meeting. Three cancelled due to other engagements (n = 2) and illness (n = 1). Figure
Figure 2
Flow chart of the study
Flow chart of the study.
Interviewees were recruited in four Dutch Hospitals. To be eligible for the interview, patients had to meet the following inclusion criteria: 1) aged 65 years or older, 2) receiving chemotherapy for the first time or for the first time in 5 years, 3) sufficient command of the Dutch language and 4) no history of cognitive deficiencies according to the medical file. A sample of 13 consecutive participants was selected at the time of their second chemotherapy treatment. Of these, five subjects participated in the study.
Table 1
Characteristics of patients and proxies attending the focus groups (n = 18)
Patients focus groups
Patients interviews
Age (SD)
66.67 (5.31)
70.40 (2.79)
66.25 (5.91)
67.61 (4.95)
Education level
Breast cancer
Lung cancer
Ovary cancer
Multiple myeloma
Lymph gland cancer
Colorectal cancer
n patients (number of treatments (
6 (10.67)
5 (2)
7 (1.71)
4 (28.25)
The professionals were selected based on recommendations of stakeholders in these areas. A total number of 20 participants were divided into three professional focus groups, to cover opinions of professionals in different fields of expertise: one group of oncology nurses (n = 6), one group of policymakers and communication trainers (n = 8), and one group of researchers (n = 6). Table
Table 2
Characteristics of professionals attending the focus groups (n = 20)
Area of knowledge
Psychologist-researcher cancer
Researcher Cancer care
Professor Psychiatry of elderly
Researcher Cognition of elderly
Psychologist and expert of educational booklets
Experts of patient-provider
Education adviser and communication trainer
Representative of cancer patient association
Policymaker Care and Elderly (government)
Social worker Cancer Institute
Coordinator Nursing Department
(Oncology) nurses
Oncology nurse (specialist)
Oncology nurse
Nurse-practitioner Oncology
Data collection
An interview schedule was designed to address the study aims. The interview schedule comprised three main sections: 1) differences between older and younger patients; 2) information and support needs and 3) recall of information. Table
Table 3
Interview protocol
Topic list discussed with participants (patients and professionals)
Differences between older and younger patients
a. Are there differences between older and younger patients of which nurses should take account during their patient education?
b. What can nurses do to take these differences in account?
Needs at the beginning of treatment
a. What are the most important educational goals when preparing patients for an invasive treatment like chemotherapy? What are the needs of older patients and their relatives?
b. How can nurses tailor education about chemotherapy to the individual needs and circumstances of older patients and their relatives?
c. Are there any other important aspects to consider during patient education about chemotherapy?
Recall of information
a. Which information is considered most important to remember at the beginning of the treatment?
Extra asked to professionals: Which information should be provided verbally (during consult) and which information can be provided in a written form?
b. What can nurses do to ensure that patients and their relatives will remember relevant information provided?
Data analysis
The focus groups and interviews were audio-recorded for subsequent transcription and analysis. Although qualitative research is very useful in the exploration and description of phenomena, researchers using a qualitative design are more challenged to guarantee validity of the study. To obtain valid results and to overcome the limited perspective of an observer
In the result section, quotes are illustrative and reflect the responses given by the participants. Quotes were selected on basis of the criteria that a quote should illustrate the category of meaning sufficiently, that it adds a new perspective and that the quotes represent the opinions of different participants. The participants are not personally identifiable. Numbers and letters are used to represent: patient in focus group (Pat.foc), patient in the one-on-one interview (Pat.int), relative in focus group (Rel.foc), researcher (Res), expert of patient-provider communication/policy maker (Expert) and (oncology) nurse (Nurse). There were no contradictions within the patient groups and within the professional groups, unless mentioned in the result section.
The results of this study are discussed below. The findings reflect patients', relatives' and professionals' opinions about differences between older and younger patients (research question 1), older patients' need of information and support (research question 2), and remembering information (research question 3). Table
Table 4
Opinions expressed in focus groups and interviews
Patients focus groups
Patients interviews
Professionals focus groups
Differences between older and younger patients
Individual variance, apart from age differences
Older patients have more difficulty processing information
Older patients have more life experience and different expectations about the future
The difference in life expectations has its impact on the decision to undergo a treatment or not
Older patients are more vulnerable (co morbidity) and have more resistance to ask for assistance: they need guidance in asking for and receiving help
Needs of older cancer patients
Concrete information about their disease and treatment
Exploring the patient's personal situation
Exploring information needs of patient and relative
Tailor information to the patient's specific needs and situation
Preferences of timing of providing the information differs among patients
Empathy, support and reassurance, for both patient and relative
Exploring patient's expectations or ideas about chemotherapy treatment
Exploring patient's goals of undergoing treatment
Engage both patient and relative actively in patient education
Encourage patient and relative to ask questions
Communication training for nurses to tailor to patients' needs
Follow-up training, in which learning in practice is the key ingredient.
Enhancing recall of information
Bring a (younger) person
Check: does patient understand the information?
Set priorities and offer information in a structured manner
Spread information over time (piece by piece)
Speak in clear language/avoid jargon
Summarize most important information
Combine different methods of offering information
Use question prompt list
1. Differences between older and younger patients
Two professional groups mentioned that differences between patients are the result of
"Apart from age influences, there is just a lot of variance [between patients ERP]." (Nurse3)
"65 or 85 years old: the actual age doesn't matter." (Res4)
These individual differences were also found in the face to face interviews, as some patients prefer very detailed information, while others prefer little information.
"I want to know everything." (Pat.int3)
"All the information and explanations don't cure. At least, that's my opinion, but every human being is different. I personally don't need it." (Pat.int1)
"I actually don't want to know what the future will bring." (Pat.int5)
Processing information
Despite individual differences, the participants in the patient groups and in one professional group (of experts) agreed that older patients in general have
"Short term memory in older individuals is an important factor [in providing patient education ERP]." (Rel.foc1)
"Yes, you have to read information more often." (Pat.foc2)
"That's obvious, there is a difference in the way the brain functions; cognitive differences." (Expert1)
Life experience and expectations
Both patient and professional groups considered
"And often they already have functional problems, lung diseases for example, so they are more used to being sick." (Nurse1)
"Emotions are different for older people [..]. Young persons shouldn't get ill in any case. When you grow older, you are aware that your chances to get cancer increase." (Pat.foc5)
Consequently, according to both patient groups, interviewees and professional groups, older persons view their future differently from younger persons and are better able to cope with illness than younger ones.
"I think that when you grow older, you're able to handle situations better. When you are 30 years old, you'll have a whole future in front of you. But when you are over 70 years old, the largest part of your life lies behind you. Also, when you are being treated for cancer, the chance that you will die of disease other than cancer grows." (Pat.foc7)
"Well, I'm 75 years old and I don't know how many years there are left." (Pat.int3)
Accepting help from others
Older patients may suffer from co morbidity, which can complicate treatment and influence their view of the disease. However, although more vulnerable, older patients may not ask for help when necessary and often need
"Nurses should realize that [older ERP] patients might need more attention." (Pat.foc5)
"For older individuals, it's difficult to ask for help. That is something I hear very often. [..] Older people frequently say: 'But the children, they are busy working, they don't have the time to help'. So to ask a neighbor for help, they have to overcome their resistance. [..] And you should stimulate them, involve them, for example: 'Your daughter actually appreciates it when you ask for help; they often can do so little to help'. The family is often powerless to do anything, because mum or dad keeps the door closed." (Nurse3)
2. Needs of older cancer patients
Both patient groups, interviewees and professional groups stated that patients in the first place want to receive
"I think the most important goal is to provide information about expected side effects of the treatment." (Expert8)
"The nurse should explain something about possible infections you can get after the chemotherapy treatment." (Pat.foc9)
"The medical [explanation ERP] was most important, off course." (Pat.int1)
Exploring patients' needs and tailoring information
The goal of patient education should further depend on individual preferences. Thus, directly
"It's important to tailor patient education to the patients' personal information needs. That's a basic skill nurses should have." (Pat.foc5)
"Ask them! Just ask them what they need." (Rel.foc1)
According to a patient group and interviewees, nurses pay insufficient attention to the individual patients' information needs.
"My experience is that during patient education, no distinction was made between different patients. For example, we didn't feel like talking about getting in contact with other patients, but the nurse kept talking about this. The conversation was led by the preset ideas the nurse had in mind and she didn't ask us: 'Is it all clear?' or 'What kind of information would you like?'. It was like she had to stick to her mission." (Rel.foc1)
"It was a standard story, at least, that was how I experienced it." (Pat.int5)
"I thought what she did, was merely reading aloud the information. What she 'had to do', like 'I just have to tell you this'. (Pat.int4)
In addition, the interviewees stressed the importance of the nurse exploring the
"They did not ask: 'How's your living condition? Can you amuse yourself?' [..] I think that should be part of it. [..] And maybe they could give advises, like 'you could do this, or that'. You don't hear any of this." (Pat.int4)
"Nothing was asked about my personal situation." (Pat.int5)
Besides the content of information, also the
"Well, that depends strongly on the patients' preference. Some people say they are really upset when they have just heard the diagnosis, the information just don't get in." (Pat.foc7)
"And then this man, the doctor, said: 'Sir [..], you have cancer'. All I could say was: 'O, o, o.....'. The next thirty minutes I was completely stunned. But then the doctor was going to explain the treatment options. These conversations shouldn't follow directly after one another." (Pat.foc8).
"When she told me the diagnose, the nurse said 'you can go home now and come back [..], we can discuss the treatment options then.' I said: 'Actually I wanted to do this yesterday, in other words: it's already too late. I prefer doing it this afternoon'." (Pat.foc6)
Empathy and support
The patient groups and the interviewees stressed the importance of not only tailoring the information to the patients' information needs, but also
"As a nurse, you need to show empathy to make patients feel comfortable. [..] And psychosocial subjects; I think it's strange these are not discussed." (Pat.foc5)
"Every patient is different, the challenge is to give support in the right manner" (Rel.foc3)
"The way in which she offered it was very reassuring. [..] She was all ears and [..] it was just very human." (Pat.int1)
Dispel the patients' fears
Patients mentioned that they experience(d) worries about their health, their treatment and their future. The nurse need to
"They [nurses ERP] need to check what a patient is worried about. They [patients ERP] bring up concerns and worries they want to talk about to return home satisfied." (Pat.foc7)
"They try to reassure you, but that's not easy. [..] I was more relieved [after the consultation ERP]. I knew a little bit more about how it would go." (Pat.int5)
Supporting the patient and his relative is not only important during patient education at the beginning of treatment, but for older patients it is essential to provide continuous support
"Yes, but not just at one single moment. For example, after a few weeks you should create a moment to talk about: 'How are you doing, how did you experience this treatment period, are you able to handle everything..' I consider this important." (Rel.foc4)
"A little chat helps much more than a pill. [..] If I could talk with her, that is much more important than the medical care she has to give. [..] For example: 'How do you feel?' or 'What do you think about this or that?'. That was never asked." (Pat.int3)
Patients' expectations and treatment goals
Another aspect in patient education is, according to the professional groups,
"You can try to tailor to the patients' needs by asking: What do you already know? What did the doctor already tell you? What would you like to know more? What are you worried about?" (Res4)
According to the professional groups, the difference in life expectations between older and younger patients can have its impact on
"Maybe they [patients ERP] wanted to be asked that question again. This could be asked by the doctor at a later moment, fine, but the possibility should be there to ask this question." (Expert2)
"The alternative (not undergoing a treatment) is often not even discussed." (Expert3)
"Because older people often think they have no choice." (Res6)
According to the professionals and patients groups, an important aspect in the decision of undergoing the treatment is
"My daughter was pregnant, and when my husband was diagnosed with lung cancer, we immediately said: 'you are going to stay alive', because we wanted to see my grandchild become 20 years old. We absolutely wanted to live for many more years." (Rel.foc4)
"I think it is important to hear what they want to achieve, because that is the drive to undergo the treatment. Some patients explicitly say: 'My daughter is three months pregnant so I want to live at least half a year more." (Nurse3)
Addressing patients' relatives
The patient groups especially stressed the importance of nurses
"It's important that there's support for my wife, she's more ill than I am." (Pat.foc3)
"I would like to have the feeling I can contribute in my own way. At a given moment, a nurse explained to me how I could take care of my husband. That was fantastic." (Rel.foc1)
Communication training for nurses
According to a patient group and interviewees, nurses' skills to tailor information to the patients' specific needs have to be improved.
"An important aspect is that nurses receive good training, including knowledge of the difficulties that may exist in older individuals with processing of information." (Expert7)
"Part of the training should be gaining knowledge about older people, but there are more things that should be taught, for example conversation techniques." (Nurse5)
"But that [showing empathy ERP] is not something everybody has, they should be trained to show empathy, so they can focus on patients' needs." (Rel.foc1)
According to the professional group, for a training to be effective it should be completed by a follow-up, in which learning in practice is the key ingredient.
"I think communication training can only result in changed behaviour if you connect it to a follow-up in which learning and working is indeed connected so that working situations become learning situations [..]." (Expert5)
3. Enhancing recall of information
Bringing a relative
Both patient and professional focus groups mentioned that the patient self can enhance the remembering information by
"Bringing someone helps with listening." (Pat.foc5)
"I thought it was pleasant that I brought my children with me. In this way they knew what was going on" (Pat.int3)
"I think children often ask very relevant questions during the consultation, something the father or mother did not think about. Patients often tell more when somebody they know is present. As a nurse, you receive more complete information, like: 'Well mum, you did not yet tell, that...' (Nurse5)
Check: does patient understand the information?
For the nurse, there are several ways in which to enhance recall of information by older cancer patients. In the first place, it is important that the nurse
"Nurses should ask the patient if there are any questions or if certain things are not clear, both during and after the consultation." (Pat.foc5)
"You should systematically create several moments in which to make sure that everything is clear for the patient." (Res4)
Prioritize and offer information in a structured manner
According to the patient and professional groups, nurses have to set priorities about what to address during patient education. Also, they should offer the information in a structured manner and summarize the most important information.
"Prioritize, summarize and repeat it the next time." (Nurse2)
"The whole structure of the conversation: cluster the information and offer the information step-by-step." (Expert5)
The patient and professional groups mentioned that it is helpful for older patients to
"I would spread the information and check if they remember it. Not too much information at a time." (Res2)
"There should be a possibility for older people to come back another time. Older persons handle emotions in a different manner and they process information more slowly." (Pat.foc5)
Speak in clear language
In the patient group,
"During patient education, they often use technical jargon. They can explain a lot, but in the beginning you're just stunned and nothing gets in. [..] They should explain everything in comprehensible language." (Rel.foc3)
Combine different methods of offering information
The professional group, and one interviewee pointed out that it helps to
"To combine visual information with oral information, if necessary with handouts so family members can write down information." (Nurse3)
"It's to much to comprehend everything that's why it is useful to receive a booklet. At home you read it over." (Pat.int5)
"But this [combining different methods of information ERP] all involves general information. Even more effective is offering personally relevant information, for example what is discussed during the consultation and what is particularly relevant for this specific patient." (Expert3)
Use question list
Finally, both patient and professional groups mentioned the
"The oncology nurse sent me a list with subjects two days before the consultation. This way, I was able to prepare myself. I thought it was pleasant to know what she was going to discuss." (Pat.foc7)
"I think that page in the information folder [e.g. Treatment Guide Chemotherapy ERP] is useful to write down questions to ask the nurse." (Pat.foc3)
"Questions the patient can prepare before the consultation. I think this would yield a profit." (Expert6)
This article describes patients', relatives' and professionals' opinions about older cancer patients' needs preceding cancer treatment, as obtained by five focus group discussions and five one-to-one interviews.
Tailoring patient education to the patients' needs
All participants mentioned a lack of providing older cancer patients with personally relevant information at the moment they consider appropriate. According to the members of the focus groups, the best way to tailor information to older patients needs is asking patients to articulate these needs. These findings are in line with earlier results
The results also show that information needs of older cancer patients as compared to younger patients do not so much differ in the required content of the information, but rather in the way information is given. According to the patient groups, showing empathy and support is an important aspect of patient education. It makes the patient (and relative) feel understood and creates a trustful environment, both during and after the consultation, which is a prerequisite for reflection on the information provided and the decision to undergo treatment. Although showing empathy and support is important in consultations with younger patients too, it could be especially important for older patients and their relatives as the results show that older patients have different life expectations. As a consequence, they might have a different view on the added value of undergoing treatment and perhaps a greater need to deliberate over the decision to undergo the treatment. This finding is in line with earlier research, showing that older cancer patients may be less willing than younger patients to trade increased survival for their quality of live when considering chemotherapy
Enhancing recall of information
Our findings indicate that especially the way in which information is provided to older cancer patients could be improved. All focus groups stated that to enhance memory in older patients, information should be offered in a structured manner in which the most important, personally relevant information should be summarized and repeated. Furthermore, information should be offered step-by-step, to enable patients to let the information sink in, to consider the personal relevance and make him- or herself familiar with it. This is especially important for older patients, as they often are less educated than younger patient and cognitive functions decrease with age
The current study shows that stimulating the patient to bring a (younger) person to the consultation is considered an effective way to express their needs, address specific subjects to discuss and improve remembering. Literature suggests that a supportive accompanying individual may enhance communication when a complicated treatment regimen is being described, if the accompanying individual is present at the patient's request and provides positive support to the patient and accurate information to the health care provider
Interventions to implement in practice
To engage patients in patient education and gain insight in their specific information needs, patient and professional focus groups recommended encouraging patient question asking behaviour in cancer consultations. More specifically, a list with questions about different aspects of the treatment can be given to cancer patients before their initial consultation. Such a list is known in cancer literature as a question prompt sheet (QPS) or question prompt list. Patients can mark the questions on the QPS that they want to discuss during consultations
According to both patients and professionals, communication training for nurses could be useful, especially when addressing specific competencies to provide older patients with tailored patient education. The training should contain knowledge about the information processing and memory in older people, but also teach the essential skills of good communication with older cancer patients, such as exploring the patients' information needs and expectations, responding to cues and concerns, showing empathy and emotional support, paying attention to the patients' relatives and guiding the patient in accepting help from others. Research results show mixed results of the effectiveness of communication training for (oncology) nurses. Some researchers found significant improvement of nurses' skills
Study limitations
The results of this study should be interpreted with care, since only a total number of 38 participants were obtained. In qualitative research, data collection should continue until saturation is achieved, or no new information is uncovered. Usually, three to five group meetings are supposed to be needed to reach this goal
To summarize, this study gives insight in patients', relatives' and professionals' views on patient education for older cancer patients. The results indicate that patient education should be more tailored to older cancer patients' specific needs, by exploring these needs and responding to them during consultation. Showing empathy and support is an important aspect in patient education of older cancer patients, as older patients have different life expectations. In a trustful environment both during and after the consultation, the possibility can be created to reflect on the information provided and the treatment decision, which is not common in the present setting of patient education.
During consultation, using an information booklet (e.g., the 'Treatment Guide Chemotherapy' in the Netherlands
Future (quantitative) studies are needed to compare older cancer patients' needs to younger ones and to explore the extent to which patients' and professionals' opinions are reflected in daily practice and to develop recommendations for further improvements.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
JCMW and JJ designed the study and constructed the interview protocol. ERP and JCMW categorized the data. ERP drafted the manuscript. JCMW and JMB acquired funding. ERP, JCMW, JJ and JMB haven been involved in critically revising the manuscript. All authors have read and approved the final manuscript.
We would like to thank the participating patients, partners and professionals for their commitment to the study. Furthermore, we thank Janneke Noordman and Judith de Groot for their assistance during the focus group interviews. This research project was funded by the Dutch Cancer Society.
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Pre-publication history
The pre-publication history for this paper can be accessed here:


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