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At this place of employment, I worked shifts ranging from 9 hours to 12 hours throughout the week without legitimate break time. My manager would constantly bully myself and coworkers, and once actually took my keys to keep me there after hours to force me into a talk with him. These talks would occur often and would amount to him intimidating me and breaking me down into accepting any sort of thing I was upset with him for doing (denying breaks, insulting/bullying me, going into my car without permission... the list goes on.) I left the workplace 8 months ago and now I feel like I am emotionally ready to confront him but I need information about the legalities and processes.I was also harassed when trying to call out sick once when I had the flu and was told to get a doctor's note or get in to work immediately. I hadn't called out the day prior and had been vomiting at the end of my shift. To even attempt to stay home while sick was a cause for anxiety as manager would relentlessly try and bully me into coming in using threats and intimidation. He would also take money out of our paychecks for errors in booking customer appointments in a very complex scheduling software. Every aspect of the appointment would be perfect, otherwise he would take a bit of our check away. My own check had less than $50 taken, but a coworker had over $100. He did not make any of us sign anything that said we accept this and brought this practice into effect months after my employment started.
If your paycheck was unlawfully docked, contact the wage and hour division of your state's department of labor.
Definition of Workplace Bullying
Workplace Bullying is repeated, health-harming mistreatment of one or more persons (the targets) by one or more perpetrators s (including nonverbal) which are threatening, humiliating, or intimidating
Work interference — sabotage — which prevents work from getting done
Workplace Bullying...
Is driven by perpetrators' need to control the targeted individual(s).
Is initiated by bullies who choose their targets, timing, location, and methods.
Escalates to involve others who side with the bully, either voluntarily or through coercion.
Undermines legitimate business interests when bullies' personal agendas take precedence over work itself.
Is akin to domestic violence at work, where the abuser is on the payroll.Workplace bullying, like childhood bullying, is the tendency of individuals or groups to use persistent aggressive or unreasonable behavior against a co-worker or subordinate. Workplace bullying can include such tactics as verbal, nonverbal, psychological, physical abuse and humiliation. This type of aggression is particularly difficult because, unlike the typical forms of school bullying, workplace bullies often operate within the established rules and policies of their organization and their society. Bullying in the workplace is in the majority of cases reported as having been perpetrated by management and takes a wide variety of forms. Bullying can be covert or overt but it's always bad.
While there is no single formal definition of workplace bullying, several researchers have endeavoured to define it. Some categorize all harmful boss-behaviour and actions of malintent directed at employees as bullying. Bullying behaviours may be couched in humiliation and hazing rites and iterative programs or protocols framed as being in the best interests of employee development and coaching. Others separate behaviours into different patterns, labeling a subset of those behaviours as bullying, explaining that there are different ways to deal effectively with specific patterns of behaviour. Some workplace bullying is defined as involving an employee's immediate supervisor, manager or boss in conjunction with other employees as complicit, while other workplace bullying is defined as involving only an employee's immediate supervisor, manager or boss.
According to Tracy, Lutgen-Sandvik, and Alberts,[1] researchers associated with the Project for Wellness and Work-Life, workplace bullying is most often "a combination of tactics in which numerous types of hostile communication and behaviour are used" (p. 152).
Gary and Ruth Namie[2] define workplace bullying as "repeated, health-harming mistreatment, verbal abuse, or conduct which is threatening, humiliating, intimidating, or sabotage that interferes with work or some combination of the three."
Pamela Lutgen-Sandvik[3] expands this definition, stating that workplace bullying is "persistent verbal and nonverbal aggression at work, that includes personal attacks, social ostracism, and a multitude of other painful messages and hostile interactions."
In an effort to provide a more all-encompassing definition, and catch the attention of employers, Catherine Mattice and Karen Garman define workplace bullying as "systematic aggressive communication, manipulation of work, and acts aimed at humiliating or degrading one or more individual that create an unhealthy and unprofessional power imbalance between bully and target(s), result in psychological consequences for targets and co-workers, and cost enormous monetary damage to an organization's bottom line"[4]
Because it can occur in a variety of contexts and forms, it is also useful to define workplace bullying by the key features that these behaviours possess. Bullying is characterized by (Einarsen, 1999; Keashly & Harvey 2004; Lutgen-Sandvik, 2006):
Repetition (occurs regularly)
Duration (is enduring)
The materials available at this web site are for informational purposes only and not for the purpose of providing legal advice. You should contact your attorney to obtain advice with respect to any particular issue or problem. Use of and access to this Web site or any of the e-mail links contained within the site do not create an attorney-client relationship between Howard Roitman, Esq. and the user or browser. The opinions expressed at or through this site are the opinions of the individual author and may not reflect the opinions of the firm or any individual attorney.Ask a similar question
It sounds like there were numerous violations of the Massachusetts wage and hour law (overtime, meal breaks, and deductions). The wage and hour law is enforced by the Massachusetts Attorney General's Office which can be accessed online http://www.mass.gov/ago/doing-business-in-massachusetts/labor-laws-and-public-construction/file-a-wage-complaint.html
The attorney general's office does a good job, but may take some time. There are many employment lawyers here on avvo.com (search for your area) that would be willing to take a case like thin on contingency because the penalties are steep and often include attorney fees. But, don't wait – the statute of limitations is short.
This is not legal advice and is not intended to create an attorney-client relationship. You should speak to an attorney for further information.Ask a similar question
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Description: After Harley Jade quads and hamstrings stretch it was time for Mr. Jones to stretch out that sweet 20 year old pussy of Ms. Jade. Of course with an butt as big as Harley's, doggystyle was the preferred method of fucking.

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Last week in Denver, the Chiefs came out looking like a completely different team. They pounded the run, controlled the clock and abused a Bronco defense that has played extremely well so far this year. The Chiefs were successful running up the middle and to the outside, overpowering Denver's front seven. That was Kansas City's game plan coming in, to beat the Broncos on the ground -- a stark contrast to the opener, where they decided they would try to beat the Bengals through the air. The Chiefs, however, played too conservatively at times, especially when they crossed midfield, and never found the endzone. They settled for two field goals, six points and their sixth straight loss at Invesco Field.
Now they need to find their identity. Are they a run-first, conservative offense or are they a pass-happy offense that is willing to air it out and take chances down the field? Or are they balanced? Nobody really knows. Quarterback Trent Green is out, probably for another few weeks. That means Damon Huard will get coddled into "game management." And that's fine. Maybe that's the best way for the Chiefs to win. It sure looked like it last week in Denver, when they revived "Marty Ball."
But aren't we forgetting something? The Chiefs have a defense now. And that, more than anything, should give the Chiefs hope for the rest of the season.
Like it or not, the future of this team is on defense. Sure, the majority of the salary cap dollars are tied up in offensive stars - Brian Waters, Will Shields, Tony Gonzalez, Green and Johnson - but all of the youth and rising talent is clearly on the other side of the ball. Defensive end Tamba Hali has showed promise with his non-stop motor and his constant, every-down energy. Linebackers Kawika Mitchell and Derrick Johnson are two of the quickest linebackers the Chiefs have had since Derrick Thomas. Kendrell Bell even got into the mix last game, recording six tackles, the most he's had in a game as a Chief.
In the secondary, the Chiefs have a pair of young safeties, Bernard Pollard and Jarrad Page, who are pushing safety Sammy Knight into an early retirement and forcing Greg Wesley to play at a new level. There is competition everywhere on defense, and thus far coordinator Gunther Cunningham is pushing all the right buttons. The best part about all of this is that we haven't seen the best out of the defense. The Chiefs have yet to allow cornerbacks Patrick Surtain and Ty Law do what they do best, which is to play press man-to-man coverage on the outside. Expect that to change in the coming weeks. The Chiefs will start to give their speedy linebackers opportunities to get after the quarterback, because they finally have corners they can put on an island and trust.
The Chiefs no longer have to rely on their offense to score 30 points to win. This team needs to shift toward a ball-control, "Marty Ball"-type offense where they play field position and wear down the opponents. That's not to say they can't take chances, because they can. We learned that last week, and that's the exception.
If the occasional aggressive play call backfires, the Chiefs have a defense that can work damage control. That's the mentality the Chiefs need coming out of the bye week. They need to play to their defense.
For the first time in years, the play of the defense will dictate the offensive playcalling. And for the first time in years, it should be an advantage.
So much for the Chiefs "finding" their identity. It's already there, and it's crystal clear.
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Summers in Ireland are short and sweet, two weeks of blazing sun and then back to the rainy images known around the world. On this particular day, the heat was beyond comprehension for this nineteen year old lad, he'd never understood quite why people enjoyed holidays abroad, all he did in a foreign country was burn, peel and go back to a sickly pale. Avoiding the sun was not on the agenda for today, especially since his move to a new apartment in the centre of the city. The move had been a God send as his grandmother required constant help in her twilight years, and the apartment beside her had become vacant.
So with boxes filled to the brim with every belonging he had, Joey bid farewell to his parents who were so proud to see their son take such responsibility. Throwing the last of the boxes into the back of his battered Vauxhall Corsa, its red paint faded in the two-week sun to a fabulous pink, he put the key in his driver's side door. Jumping backwards as a shadow dashed from beneath the car, he stifled a scream. He dropped one of the boxes, slicing along his hand and leaving a rather nasty cut. Nothing serious, but Joey hated blood.
"Feckin' cats!" he roared into the empty cul-de-sac.
Shaking off the scare he opened the door to the car, the blast of heat built up within nearly made him faint, he could not wait for summer to see its conclusion. Adjusting his seat and turning on the ignition he took a deep breath, it was a new adventure, living on his own. A few minutes into the journey he looked to the radio, usually his cringey pop CD would have kicked in by now, blasting out the latest craze amongst twelve year old girls. Joey loved cringey pop, and had no reservations about singing at the top of his lungs with the windows down. He pushed eject, only to be greeted by the familiar, 'NO CD' message on the dash. He couldn't remember changing the CD, or taking it out. He peered around the car, no sign of it.
Pulling over at the side of the road he began to panic, not so much for the CD, but incase his car had been broken into. He scoured the inside of the car for anything else missing, then reluctantly got out and moved to the trunk. His hand quivering he put the key into the lock and opened the back of the car, only to find all his belongings right where they had been. Nothing else was missing. Joey was an only child, there was no little sister to claim the CD, and his parents never had a key to his car.
"I'm being ridiculous," he said to himself.
Clambering back into the car he pushed on, saddened by the loss of his favourite CD, but nothing worth crying over. The trip from home to his new home only took twenty minutes, a comfortable distance for his first time living alone. Then again, he had family right next door, so it felt almost as if he was cheating. The excitement of arriving had put all negative thoughts out of his mind, especially as he spotted another of his new neighbours, Abby. They'd been best friends since they were in nappies, and she'd been the one to tell him about the vacant apartment.
"Took you long enough!" she scolded in her mocking tone. "Get lost as usual?"
"No, you twerp. I had to pull over for a second."
He loved her sense of humour most, it reflected his to a T, as it would growing up with someone. They could have an entire conversation made of unspoken gestures, and well placed eye movements. Their repertoire of inside jokes rivaled the big book of Dad jokes that Joey had gotten his father for Christmas. The two of them hauled what little Joey had brought up to the third floor, tossing it all onto the living room sofas, it was smaller than home, but it was cosy. It went without a hitch, except for Joey who nearly tripped over a rat on the way up the stairs, he screamed so loud the building must of thought a new Soprano singer was moving in.
"Wow, this place is a lot nicer than mine," Abby remarked.
"Isn't it great? Listen, I'm going to make some lunch, wanna hang around?" he said.
"Nah, I gotta head to work buddy! Say hi to your Gran for me!"
And with that, she was gone, but the warm feelings she left in Joey would last all day, Abby was like his sister, and a daughter to Joey's parents. Abby's mother and father didn't speak to her, and her upbringing was spent staying at Joey's home because she'd been locked out of her own. She'd even been taking care of Granny while he organized his accommodation. He needed to pop next door, just to let her know he'd arrived, but the rumbling in his stomach made him remember that he hadn't eaten all day.
"You win, food first, then next door," he chuckled.
Without time to do any decent shopping, Joey was left with two options, a sandwich or a very suspect looking apple. He weighed up the options and felt the jam sandwich was the safer route. Setting out two slices of hard, but workable bread, he began to butter each piece. The kitchen was small, though as it was an apartment for one person, it was perfect. He set the knife down and turned towards the fridge, all that was within was the apple, and the jam. Picking out the sweet, sweet jam he turned and reached for the knife.
"Huh?" he exclaimed.
The knife had vanished, he looked round him, then onto the ground. Confused he stared at the bread, had he just imagined buttering it? Nope. There it was, butter on each slice, and even an imprint on the counter where the buttery cutlery had touched down.
"I am losing my mind," Joey whispered, worry carried in his tone.
Stepping out of the kitchen he looked into it, to see if he missed anything. Without any clues he simply took another knife out of the drawer and spread the jam, convincing himself that he'd put it back in the drawer, his mind ignoring the butter mark on the counter top. Quickly finishing the tasty morsel he grabbed his new set of keys and went next door, his Grandmother as usual was watching some god awful soap. There's always the stereotype of the Irish granny having no room for anything on her mantelpiece, because Jesus and Mary have already gotten the best seats. It was definitely true for Granny McCann, who had every table, cabinet and even windowsill covered in knickknacks. Usually Jesus or Mary but occasionally magnets from foreign countries or the occasional genuinely beautiful piece of china.
"Alright Gran?" Joey beamed, leaning down to her level.
Smiling the old lady pushed herself out of her comfortable position, and turned the television off.
"Awk darlin', did you come up to see me? Sit yourself down. Do you want a cup of tea? Or a sandwich? You look like one of those there kids off the tv, the African ones. So thin!"
Rolling his eyes are her incredibly offensive language Joey could only laugh, she was a product of her generation, but had a heart of gold. Unlike Joey who had grown up in a city, Granny McCann came from a small village near the west coast, where her superstitious, and very religious upbringing had made her some kind of wise woman in his eyes. She'd often tell him stories of the Banshee who would wail when someone was to die, or how to stop leprechauns stealing your change, by always keeping an iron coin in your wallet. Joey had grown up on these stories, but naturally only pretended to believe, for her sake.
"I'm alright Gran," he replied. "I had a sandwich next door, that's me all moved in. So if you ever need anything, you just throw your shoe at the wall, mm?"
"I'm not damaging the good wall! You'll just have to get the psychic sense my boy!"
The two shared a laugh as Joey reclined on the sofa, staring over at all the little figurines scattered around the place. His favourite was a small man in a bowler hat who had fallen in a puddle, the man's expression of sheer sadness oddly made Joey feel better. He stared intently at the table where it sat, only to sit up and take a closer look.
"Gran?" he spoke up.
"Yes, love?"
"Where is the puddle man?" His eyes widened.
"The who?" Now even Granny was leaning forward, trying to look.
"The man who'd fallen in a puddle. I think it was Charlie Chaplin."
"Oh, those go missing all the time. Never worry."
"All the time? Gran, is someone stealing from you?"
Suddenly Joey got incredibly angry, he'd been suspicious of the meals on wheels service that had been looking after her dinners, and if they'd been helping themselves, there'd be hell to pay.
"Nonsense, it's just the Goid making their mischief," she said, as if it was the most rational answer in the world.
"The who? This isn't some fairytale Gran, if people are stealing from you-"
"Stealing? They don't steal child, they take. Goid, it means theft in our true tongue, but you wouldn't know anything about that. You kids don't care about our mother tongue, not when you have your text speak."
Eager not to lose the subject, Joey pressed on.
"Tell me about them." He could sense that like his childhood, a new mythological epic was about to spew from his grandmother's lips.
"The Goid are fairy folk, you see, before man started to tax one and other, the Fairy Queen decided she was owed something from everyone in her realm. So, she sent out her Goid to take something from everyone, every so often. But when mankind got too powerful the Fairy Queen could not rule over them. The Goid lost their purpose, and instead of only taking something every now and then, they'd pillage people! If you were picked on by a Goid, you'd be marked for life. Until they stole everything you ever had."
Joey raised his eyebrow, looking towards the empty spot on the table.
"So you're marked eh? Aren't you worried?"
"Nonsense, Goid are harmless as long as they don't know you know they are there. Never look at a Goid my boy, they're small, but they're still fairy folk. And they'll send you packing before you can beg for mercy. I've collected little tidbits my entire life, little keepsakes, 'cause I'd rather they took them, than me."
Joey nodded slowly, in utter shock he was believing what was coming out of this lady's mouth, he snapped back to reality, making a mental note to always be here while the meals on wheels people were.
"I have to head back next door Gran, gotta unpack and get an early night, but I'll stop by tomorrow and we'll have a good dinner, just the two of us, sound alright?"
"Sounds lovely darlin', take some fresh milk with you, I'll never get through it."
So with milk in hand, and a kiss on his Granny's cheek, Joey moved back next door to his new abode. Flicking on the light he gazed towards the pile of boxes, groaning and rummaging through them for his blanket and pillows. He'd deal with the unpacking tomorrow, for now he just needed the sweet embrace of sleep more than anything. Tossing the bedding onto the mattress he picked out his toothbrush and headed into his bathroom, it wasn't dirty, but it wasn't sparkling either. A full scrub down was in order once everything was settled. He started to brush his teeth in the darkness, staring into the mirror, only seeing the illuminated hallway. Peering round he finally saw the cord for the light, tugging on it the place exploded in light, and with a loud long squeal, the light bulb exploded.
For a brief moment, Joey was so sure he saw the lamp on the table in the hallway move, just as the light bulb broke. As if something had been scared, and jumped up. He turned slowly and called into the hall, his mouth still foaming from the brush.
"Abby? Gran? You in here?" he managed, before spitting out the contents of his mouth into the grit stained sink.
With one foot carefully placed before the other, he crept through the small apartment, peering into each room before throwing on the light in an attempt to catch out anyone trying to hide. After a few minutes of this Joey sighed, his exhaustion was getting the best of him, and the humid night wasn't helping either. Double checking the lock on the front door he slunk into bed, pulling the blanket round him, and laying his head on his pillow. His single pillow. He sat bolt upright, scrambling around for the second pillow he'd left on the bed.
"This isn't funny anymore Abby!" He called out into the darkness. "Stop messing with me! Did Gran put you up to this with that Goid shit?"
From the darkness came the quietest grumble, Joey honestly thought it was his stomach. He didn't sleep for quite some time, he just lay on his side, watching the door. The summer days were long, and the nights were extremely short. As the clock on the side table read '04:43', Joey could feel his eyes become heavy. His anxiety had robbed him of a long sleep, but he was determined to get some rest. Leaning back he looked at the ceiling before drifting off to the land of slumber.
Joey awoke to a sharp pain on his hand, he swore loudly into the still dark night, clearly sleep would evade him yet, especially if these bugs had their way. It definitely felt like a bite, he thought to himself. He raised his hand to inspect it and saw the cut he'd given himself earlier was bleeding. Hanging by a thread, was the meagre scab that had grown that day, as if something had tried to pull it off. He began to shake, gazing over towards the clock, for some reassurance that this was the waking world. The clock was gone, as was he noticed, the sheet that was meant to be around him. He leapt out of bed and dashed into the living room, throwing on the lights in blind panic. Nothing happened, squinting through the darkness he saw the light fixture was empty, without a bulb.
He ran at the door, attempting to pull it open, frantically scrambling to find the keys that he'd left sitting on the side table. Screaming at this point, he saw something move in the shadows.
"This isn't funny! Stop it! Stop it!" His screams had to be heard by his neighbours, especially his grandmother. She'd send for help. She had too. From the corner of his eye he saw something dart across the living room, throwing the box of belongings it had sheltered behind all over the floor. Weeping now, uncontrollably, Joey dashed back to the bedroom throwing the door closed and sitting, his arms wrapped around his knees. He would have sat on the bed, had it been there. Everything in the room was bare, then he heard it. The scratching, but not like a cat on a door. The scratching of a screwdriver on screws, he gazed at the handle on the door, one by one, the screws were pushed through and onto the floor. Impossible.
"Help," he managed to whimper.
Abby released her charcoal black hair from its tight bun as she pulled herself up the stairs towards her apartment, that was when she heard the shouting. It was definitely Joey's vocie, she charged up the extra flights, her exhaustion overtaken by adrenaline. His door was locked, she rushed next door into Granny McCann's, using her spare key without a thought. It took her all but a few minutes to find the spare key to Joey's flat, but by the time she entered it was empty. She looked round at the rooms, nothing was left. Not a box, not a scrap of evidence he had ever been there. She felt tears prick in her eyes, someone had hurt her friend and taken his whole life.
She reached into her pocket to call the police, she had to take action. Her hand found only the inside of her pocket, she'd definitely brought her phone, she'd had to use it to buzz into the building. Gazing round for it she could have swore she saw something move out of the corner of her eye.


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Tue March 28, 2017 - 7:00 PM
Seattle, WA, 2017
1st Avenue N and 305 Harrison Street
Seattle, WA
Please adhere to the posted ticket limits. Orders found to be in excess may be cancelled without notice. There is a delivery delay in place until March 7, 2017, no tickets will be sent out or printable until after this date....See More


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Hybrid running shorts that are two in one
Free delivery in 2-4 working days with free returns
These running shorts hide a hybrid functionality. Comprising of two layers, the ultra-light, airy outer shorts feature a fully taped, fast-drying woven fabric inside. Two shorts: one handy package.
The shorts outside and short tights within can be worn together or separately. We combine them for long runs or sprints to the beach. Take a plunge in the short tights, then jog home in dry shorts.
The snug and comfortable short tights inside offer a pocket that keeps your phone, keys and cards locked in place – whether running all out or simply walking back home.
The unique duality of these shorts can only be possible with the high-quality and high-tech materials. 4-way stretch Nylon. Tear-proof Italian fabrics. All brought together with our own Swiss Engineering.
++ highly technical 4-way-stretch Nylon/Elastane woven fabric for freedom of movement – lightweight, protective, tear-proof and fast-drying ++ comfortable and elastic Italian fabric for short tights and waistband ++ antibacterial treatment for freshness ++
Run on clouds in On lightweight running gear. It is crafted from advanced materials and applies streamlined function where you need it. Reduced to the max. This means the right balance between protection, breathability and freedom of movement.
This running shorts are very well thought in terms of design and function. For someone like me who's not used in wearing long tights, this running shorts really fits my style. The material of the outer shorts is interesting as apart from being very thin and lightweight, it's also stretches a bit unlike other running shorts I wear.
It sure does sell for a premium price compared to other running shorts in the market, but you definitely get your money's worth!
After these purchase I'm convinced on On's products. I'm about to retire my running shoes next, and will surely start to #runoncloud!
Diese Hose ist wirklich super durchdacht und überzeugt nicht zuletzt von den Materialien und deren Qualität. Auch das Desing kann sich sehen lassen. Wirklich eine sehr funktionale und angenehme Hose.
Top Running Shorts...super comfortable and stylish.
My favourite running Shorts as of today!


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|Silver + White
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|RCA Female jack, current: 0.3A, voltage: DC 50V
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Best Weight Loss Pill In The Market
Weight gain is the major problem for many individuals, but they are not aware about right way to overcome it. For making their task easier, right supplement is available in the market. Phenq is the best supplement available in the market which is used to reduce your weight.
In case you refer phenq reviews then you will come to know about the benefit yielded by this product. This supplement will decrease your hunger so you will consume less amount of food. Once you use this product for several weeks, then you will find noticeable change in your body weight. This product is recommended for both, men and women, who prefer to reduce their weight. Moreover, reducing weight will also reduce your performance; but this is not possible while using this supplement. Your unwanted fat will be transformed to a useful energy with help of this supplement, so your performance will get boosted up. Reduce your weight without spoiling your health. Natural ingredient is used for making this product, so your body won't feel any adverse effect while using this product. You can purchase this product from their home site, since they will provide you free shipping as well as offer quick delivery in time. Other than this, they offer product at discounted price.
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French Cherry Clafouti Pudding - French Cherry Custard Bake
Recipe by French Tart
A delicious and easy traditional French pudding; Clafoutis or Clafouti is basically a custard/pancake batter type pudding which is usually baked with fruit. Most seasonal fruits other than cherries work well - such as apricots, raspberries, blackberries etc. I make it with either fresh cherries or with bottled/tinned cherries. I try to bottle some every year, picked from the cherry trees in the garden and put them in Kirsch or Cognac! Serve with creme fraiche or cream & garnish with a cherry on top with some of the reserved liqueur.
Ingredients Nutrition
- 24 -36 drained cherries, in juice or
- kirsch
- 8 ounces fresh cherries, wiped
CLAFOUTIS CUSTARD or BATTER
- 3 ounces caster sugar
- 3 tablespoons creme fraiche
- 2 ounces unsalted butter, melted
- 1⁄4 pint milk
- 2 medium eggs, beaten
- 3 ounces self-raising flour
- 1⁄2 teaspoon baking powder
- 1⁄2 teaspoon vanilla extract
- extra unsalted butter, for greasing
- icing sugar, to dust
Directions See How It's Made
- Preheat the oven to 200°C/400°F.
- Grease a baking tin or tian with a little butter; size about 6" x 9" or 12" long for an oval dish.
- In a food processor, blend together all the clafoutis batter ingredients, except the cherries.
- Pour the clafoutis batter into the greased tin or tian.
- Scatter the cherries into the top of the clafoutis batter.
- Bake in the oven for about 30 to 45 minutes or until risen and firm to the touch and golden brown.
- Serve warm with creme fraiche or cream.


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Someone was walking around the streets of Republic City. He hasn't been here for a long time and can't believe how much it has changed. Theirs a wall surrounding the entire city just like Ba Sing Se. 'There' 'were guards everywhere. Crime has gone up since the war started. People are afraid that the Chimera will come one day, so they do what ever they want before that happens. 'As the person is walking, a man stops him.
"Where do you think your going? Your not suppose to be here" said the man.
"I'm sorry, I must have taken a wrong turn. I'll be going now," said the person.
"Is that so. So your not even going to say hi to me Nazo?"
"Wait a minute. Is that you Ash?"
"The one and only. How are you doing? It's been a long time."
"Yes it has been a long time. I've been doing well lately. It looks like you joined the military."
"Yes I have. It's better then sitting in a cave all day." Nazo looked at him with a sad look. Ash looked back at Nazo. He felt very bad for saying that. "Sorry that I said that. I guess I said too much."
"I don't want to talk about it."
"That's wrong with you Nazo. You don't like to talk about things from your past. Look what you did wasn't your fault."
"Your sounding like my sister."
"Don't be like that Nazo. You know were both right about this. Now come on, your not suppose to be here."
"I don't know where to go. I just got back…"
'"I know where your sister lives. I visit her from time to time." Ash starts to bring Nazo to his sister's house. Nazo looks around some more. He sees a lot of poor people living on the streets. A lot of people looked at him. He's not sure if they know who he is. If they do know, then they must hate him. They arrive at his sister house and Nazo knocks on the door. The door opens and she looks at them.' She looked at her brother in shock. He was out of that cave. Tears came down her eyes and she hugged her brother.
"You decided to get out of the cave," she said.
"It's good to see you too Aria" Nazo said.
"I must have put some senses into you."
"You sure did. You're right it wasn't my fault and now I have to do something about this war."
"That's what I wanted to hear, but how are you going to help?"
"Well there are some places that need help fighting off the Chimera. You can start there," Ash said.
"Isn't there a lot of places that need help," Aria asked.
"Yes there are, but I think the Avatar can handle it."
"I'll try my best, but how are we going to get to these places. I lost my animal guide years ago and I doubt a car can drive on water," Nazo said.
"I know where we can get some transportation." Nazo and Aria follow Ash to the military base in Republic City. They walk into a room where a man was sitting at his desk. "Hello General Jun. I need to…" Jun looked at Nazo and got up. He looked at him with a death stare.
"So you decided to come back after all these years Avatar" Jun said.
"It's good to see you too Master" Nazo said.
"Wait so you know him" Ash asked.
"Yeah, He taught Nazo Earth bending" Aria said.
"That's not why you come to see me. So what do you want" Jun asked.
"I need some transportation," Nazo said.
"Why should I give you transportation? You didn't help us when the war started. So why should I help you?"
"Your right, I didn't help, but people still need my help. I have to redeem myself to the people of the world." Jun looked back at his former student. He looked into his eyes and saw that he meant what he said.
"Follow me then." Jun brought them to a big cage. The cage was so dark that you couldn't see what's inside. There were guards everywhere.
"So what's in there" Aria asked. Then fire came out of the cage. It lit up the cage and for a brief moment saw a black and white dragon.
"Does that answer your question? So your giving him Blaze" Ash asked.
"She will bring the Avatar where ever he needs to go" Jun said as he opened the cage. Blaze walked out of her cage and spread her wings. She made a huge roar. She's been in that cage for a very long time and she's never been out of that cage in till now. "Take good care of her Avatar. Also Ash I want you to go with him."
"Why do you want me to go with him" Ash asked.
"To make sure he's helping people and to report on what's going on out in the world. We haven't had contact in a lot of places for years."
"What ever you say sir."
"I'm coming to," Aria said.
"Are you sure? It's going to be dangerous," Nazo said.
"It's better then staying at home all day."
"Then lets get going. The world needs us." Nazo, Aria and Ash all get on Blaze as the ceiling doors open.
"Good luck to you all. Your going to need it" Jun said. Blaze lifts off the ground and flies into the skies.


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There were good performances from Newcastle players all over the pitch in our 1-0 loss at Leicester City on Monday night in Rafa Benitez´ first game in charge.
One way of seeing that is it´s not often we have six players getting over 9% of the vote, but that´s what we have after Monday night´s very good performance – even if the result was another defeat.
It was a very good team performance and for the third time running since returning from their short holiday in La Manga, Spain the captain Jonjo Shelvey was our Man of the Match and he had 22% of the vote.
Jonjo leading the team out at Leicester
Jonjo Shelvey had another good game for us and he has provided some creativity to the Newcastle side since he was signed in January from Swansea City.
If we do survive this season Jonjo will be one reason we manage to do that.
Aleksandar Mitrovic was second in the voting with 13%, although we need to see more goals from the young Serbian striker and Wijnaldum and Sissoko were next in line with 12% each.
That´s significant because as we have pointed out yesterday those two very good players don´t usually even turn up for away games.
So we expect both of them to be in really good form at home to Sunderland on Sunday – and we really need to get our recovery going with a win in that game.
Ayoze Perez (10%), who started the game and Daryl Janmaat (9%) make up the six players with over 9% of the vote.
The first performance under Rafa Benitez augers well for the future, as we desperately try to save ourselves from relegation.
Now we have to beat Sunderland on Sunday and we have to score to do that of course.
Here´s hoping.


text: The hotel was built near the beach and has a restaurant, wireless high-speed Internet access in public areas and also has indoor and outdoor parking. There are 31 rooms in total at this beach hotel, where guests are welcomed in the lobby with a 24-hour reception, a hotel safe and a cloakroom. A supermarket, a café, a bar and conference facilities also feature.The rooms have air conditioning, a safe, ceiling fan, balcony with views of the beach, the ocean (in part) or the swimming pool, and cable TV. The beds are dressed in blankets and access to all rooms is via exterior corridors. In addition, the hotel offers a nightly turndown service and daily housekeeping. Guests can request wake-up calls. All of the rooms are en suite with a shower, while a double or king-size bed and Internet access also come as standard.


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The renowned Chiang Mai Mandarin Oriental Dhara Dhevi Hotel was the venue for the Tourism Authority of Thailand (TAT) campaign initiated in 2008 to develop the French weddings and honeymoon market. Fifteen French couples participated in a lavish Lanna style wedding ceremony with the theme "Amazing Romance Je t'aime in Lanna".
The TAT and the Mandarin Oriental Dara Dhevi hotel organized the Lanna wedding ceremony for the 15 couples including elephant led procession, Lanna cultural activities, cooking classes, Lanna lifestyle show and wellness and beauty treatments.
Weddings and honeymoons are part of the TAT's global marketing campaign to stress niche market tourism, and France is a market with significant potential. More than 300,000 couples tie the knot in France every year, and then go abroad for a honeymoon. Normally, they choose to travel to the Pacific islands and other islands still under the French administrative mandate, but the TAT Paris office felt romantic couples could be persuaded to try something different.
In February, the TAT Paris office organised a contest in which the romantic couples wrote essays on why they should be selected to marry in Lanna traditional wedding setting in Chiang Mai.
This batch of 15 French couples had a wonderful time in Chiang Mai. Their first day in Chiang Mai started with a visit to Doi Suthep. After a briefing of the entire program followed by a welcome lunch, dress fittings and rehearsal was in order. The honeymoon spa treatments were next.
The following day was the actual wedding ceremony complete with Lanna traditional costumes in the splendor of the elaborate ballroom Mandarin Oriental Dara Dhevi Mandarin Oriental Dara Dhevi. The bridal couples were transported to the ceremony by elephant.
They enjoyed the full ceremony, complete with the lustral water ceremony during which guests will offer their blessings by pouring the lustral jasmine scented water onto the couple's hands.
In the evening, a grand wedding reception was held on the emerald green lawn, with wedding couples arriving at the venue by cozy tuk tuk. The party came alive with all couples appearing on stage for brief interview to state their impressions and wishes for the future. Not surprising, many wished to remain here or return to Chiang Mai to live.
Over the next two days, they enjoyed visits to villages observing the daily culture and participating in a traditional cooking class, taking in leisurely drives and more spa treatments.
Another often said promise from this group "We all had a really nice time and we will go back to encourage our friends and relatives about this experience."
The most senior couple, 61 and 62 years are both professionals who met in Bangkok 15 years ago and returned to marry this year. The husband already sold his house with plans to retire in Chiang Mai by December 2009 even before he knew of the contest.
Another couple was so touched by the meaning of the sacred string to hold in the good spirits they had received from all participants around them during the Lanna wedding ceremony. The bride had happy tears in her eyes as she said how much the ceremony meant to her.
The wife of the third couple interviewed was from Laos and she and her husband both wore Asian styled outfits in beautiful purple color of the tropics at the evening reception.
The evening ended with many "Kome Loy" or floating lanterns set aloft into the heavens carrying wishes of the couples in appreciation of all the happiness experienced on this unforgettable day.
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Chriss Street's accusers and defenders took one last swing at each other Friday over his management of a bankrupt trust.
Attorneys for the bankrupt Fruehauf Trailer Corp. accused Street, its former trustee and now the Orange County treasurer-tax collector, of hurting creditors "in an effort to serve his own selfish ends." They want Street to pay $11.9 million in damages.
Street's lawyer, Phillip Greer, said his accusers "authorized the conduct that they now challenge." He likened allegations in the lawsuit to "Monday morning complaints."
The written arguments are the next-to-last act in a long-running legal soap opera. The case now rests with U.S. Bankruptcy Judge Richard M. Neiter, who has indicated he hopes to rule soon.
Street was trustee of the End of the Road Trust, successor to Fruehauf, from October 1998 until creditors forced him out in August 2005. His successor as trustee, Los Angeles money manager Dan Harrow, sued him for fraud and breach of fiduciary duty in February 2007.
The case hinges on Street's decision as trustee to buy two failing truck-trailer manufacturers. He bought the companies, American Trailer Inc. and Dorsey Trailers, in an attempt to build up the trust's one profitable operation, Mexican manufacturer Fruehauf de Mexico. Both companies ultimately collapsed after the trust poured millions of dollars into them.
Greer argued that independent oversight groups approved both transactions. Street merely supported the purchases and later managed the companies.
"These are savvy institutional investors" who knew what they were doing when they approved the purchases, Greer said. They have no legal grounds to complain now, he said.
But Harrow's attorney, Robert Kugler, said both deals were shams. Street didn't get approval from the proper people for the American Trailer purchase and, in any case, paid nearly 50 percent more than he purportedly was authorized to spend. He used a legally separate pension fund to buy Dorsey, then used trust money to prop it up.
Harrow originally asked for $7 million in damages. But an expert witness testified Street actually caused $9 million in damages. With interest since August 2005 plus Street's $2 million salary – which the trust now says he should repay – the total comes to $11.9 million.
Contact the writer: 714-796-5030 or firstname.lastname@example.com


text: Gynecology The Gynecology department at Southern Regional provides treatment for women of all ages and with many different needs, ranging from minor surgeries to hysterectomies. Tests and Procedures If you are scheduled to have a test or procedure, you may have some questions about the test or procedure, or about the facility and department performing the test. As a service to our patients and their loved ones, we want to help you become more informed and try to answer as many of your question as possible. Southern Regional is committed to providing the best in screening, diagnosis and treatment of breast cancer. Our state-of-the-art tests and procedures include: Women's Tests and Procedures X-Ray Hysterosalpingogram Women's Center Mammography Bonedensitometry/Dexa Scan 3D Mammography 2D Mammography Needle Localization Stereotactic Biopsy Women's Center Ultrasound Breast Ultrasound OB Bio-Physical Profile Ultrasound Obstetrical Ultrasound Pelvic Ultrasound (GYN Exam)


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Black Friday 2010
October 29, 2010 by staff
Black Friday 2010, 2010 Black Friday ads are starting to go out and do not think sales will be highest in deep discounts this year!
With the economy still, unemployment is rampant, there is no doubt that many people will be trying to take advantage of discounts HUGE Black Friday brings.
Some major retailers are already launching their Black Friday ads 2010 and it seems that this year is no exception to the savings.
It has been reported that Amazon has already initiated some Black Friday sales on their site as soon as the first week of November.
Many are hoping for better gadgets like the iPhone, iPad, MP3 players, game consoles, phones and cameras with the major events of 2010 Black Friday sales!
The Pre-Thanksgiving and Black Friday deals were announced today and some stores even be an all-to four-day sales events. We will update as more information comes to where to get the most out of the 2010 Black Friday savings and discounts! Also let you know when new Black Friday 2010 ads come to inform you of your vital information on 2010 Black Friday savings.
Please feel free to send if you have any questions regarding this post , you can contact on
Disclaimer: The views expressed on this site are that of the authors and not necessarily that of U.S.S.POST.


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October 17, 2016
| Video
As Halloween continues to grow in the U.K., so, too, will the demand for spooky nail art designs. Sheena, owner of Decadent Digits in the U.K., guides us through her 2016 Halloween nail art menu.See more Halloween nail art by clicking here.
October 11, 2013
| Blog Post
Toni Cassidy, Simply Beauty by Toni, Surrey, U.K.Ashley Kilpatrick, Nebraska City, Neb.Jamie Panici, Headhunters Beauty Salon, Bourbonnais, Illinois
April 13, 2012
| Article
With a growing number of men opting to pay bills and forge careers from behind a nail table, NAILS takes a look at some male techs to find out what they think of their chosen profession and how they're making it in a female-dominated industry.
September 1, 2007
| Article
Many have tried — and many have failed — to do for nail salons what Starbucks did for coffee shops. Our report shows that it'll take innovative hiring, a simple and consistent sanitation program, and a major consumer PR campaign in order for a salon chain to become the name that clients most trust.
June 1, 2005
| Article
Full-service beauty salons are the most typical salon environment in England, but a growing number of nail bars have been popping up in the larger metro areas in recent years.
June 1, 2003
| Article
July 1, 2000
| News
Deal will help international customers.
September 1, 1998
| Article
The Professional Association of Nailcare Specialists and Nailtechnicians of Germany is formed to support German nail techs.
June 1, 1986
| Article
Cosmoprof North America 201758 photos
Readers' Favorite Pedicure Products13 photos
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text:
Manhattan's homeless population is mutating, and these "Cannibalistic Humanoid Underground Dwellers" -- aka C.H.U.D. -- are hideous, hungry and headed for the streets. A photojournalist, his girlfriend, a cop and a crazy bum try to save the day.
Rent DVDs for only $4.99 a month.
Movie Details
- Director
- Douglas Cheek
- Genres
- Horror, Cult Horror, Sci-Fi Horror, Monsters
- Format
- Ratings
RRestricted. Under 17 requires accompanying parent or adult guardian.
Widescreen Anamorphic 1.77:1Subtitles
NoneClosed captioned
NoLanguage and sound
English: Dolby Digital MonoOther features
Color; interactive menus; scene access; filmmakers' commentary; trailer; still gallery.
For Parents
Common Sense Note
- Age appropriate
- Not an issue
- Depends on your kid and your family
- Not appropriate for kids of the age most likely to want to see it


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Review article: Simulation: a means to address and improve patient safety
- First Online:
- Received:
- Accepted:
- Citations
- 2k Downloads
The purpose of this article is to review the role of technical and nontechnical skills in routine and crisis situations. We discuss the role of different simulation modalities in addressing these skills and competencies to enhance patient safety.
Principal findings
Human and system errors are a recognized cause of significant morbidity and mortality. Technical skills encompass the medical and procedural knowledge required for patient care, while nontechnical skills are behaviour-based and include task management, situation awareness, teamwork, decision-making, and leadership. Both sets of skills are required to improve patient safety. Healthcare simulation can provide an opportunity to practice technical and nontechnical skills in a patient-safe environment. More specifically, these skills are most required in dynamic and crisis situations, which may best be practiced in a simulated patient setting.
Healthcare simulation is a valuable tool to improve patient safety. Simulation-based education can focus on the necessary technical and nontechnical skills to enhance patient safety. Simulation-based research can serve as a means to identify gaps in current practice, test different solutions, and show improved practice patterns by studying performance in a setting that does not compromise patient safety.
Article de synthèse: La simulation: une façon d'aborder et d'améliorer la sécurité du patient
L'objectif de cet article est de passer en revue le rôle des compétences techniques et non techniques dans les situations courantes et les situations de crise. Nous discutons le rôle de différentes modalités de simulation pour aborder la question de ces compétences afin d'améliorer la sécurité du patient.
Constatations principales
Les erreurs humaines et de système sont une cause reconnue de morbidité et de mortalité significatives. Les compétences techniques englobent les connaissances médicales et procédurales nécessaires aux soins des patients, alors que les compétences non techniques sont fondées sur le comportement et comprennent la gestion de tâches, la prise de conscience de la situation, le travail d'équipe, la prise de décision et le leadership. Ces deux ensembles de compétences sont nécessaires à l'amélioration de la sécurité du patient. La simulation en soins de santé peut constituer une occasion d'exercer des compétences techniques et non techniques dans un environnement sécuritaire pour le patient. Plus spécifiquement, ces compétences sont nécessaires particulièrement dans les situations dynamiques ou de crise, et un environnement simulé est alors l'endroit idéal pour les exercer.
La simulation en soins de santé est un outil utile pour améliorer la sécurité du patient. La formation fondée sur la simulation peut être dirigée sur les compétences techniques et non techniques nécessaires afin d'améliorer la sécurité du patient. La recherche fondée sur la simulation peut constituer un moyen d'identifier les lacunes dans la pratique actuelle, de tester diverses solutions, et de montrer des schémas de pratique améliorés en étudiant la performance dans un cadre qui ne met pas en péril la sécurité du patient.
Errors create a case for improvement
The nature of human and system errors that lead to adverse outcomes has been investigated in complex systems, such as the commercial aviation industry and the nuclear power industry. These organizations are collectively known as "high-reliability organizations" (HROs), and detailed descriptions can be found in safety literature.1 High-reliability organizations are defined as high-risk error-intolerant systems that repeatedly carry out potentially dangerous procedures with minimal error. High-reliability organizations understand circumstances that are likely to lead to adverse events known as "error-producing conditions" (EPCs). After careful analysis of accidents and near-miss incidents, sets of these conditions have been established with the use of mathematical modelling of contributing factors.2,3
As business practices are increasingly applied to medicine, many have argued that healthcare could be viewed through the lens of an HRO. Technological advances in healthcare and evidence-based practices have improved care for our patients; however, now more than ever, we are aware of errors and the ways in which they compromise patient safety. Over a decade ago, The Institute of Medicine disclosed that error is a significant cause of death in the United States that accounts for 44,000 to potentially as many as 98,000 deaths annually.4,5 This magnitude makes errors more lethal than motor vehicle collisions, breast cancer, and AIDS.6 In Canada, approximately 7.5% of hospital admissions will result in an adverse event.7 What is more surprising than the frequency of these events is the realization that up to one-third of these events are highly preventable. Perhaps less surprising is the fact that most of these highly preventable events do not result from individual negligence but from the failure of systems and teams.
Five hallmarks of HROs that account for their less than expected number of accidents are: 1) preoccupation with failure; 2) reluctance to simplify interpretations; 3) sensitivity to operations; 4) commitment to resilience; and 5) deference to expertise. Together, these qualities are termed "mindfulness".8
Common errors and error-producing conditions (EPCs) in trauma management
Common Errors in Trauma Care
Error-producing Conditions (EPCs)
Airway management
-High-risk/low-frequency event
-Information overload
-One-way decision gate
-Simulation training
-Procedural checklists and algorithms
Missed injuries on surveys
-Poor information transfer
-Time pressure
-Information overload
-Low signal to noise ratio
-Checklist use,
-Adherence to established standard
-Vigilant primary and secondary survey
Inappropriate triage
-Time pressure
-Faulty risk assessment
-Normalization of deviance
-Cognitive bias training
-Simulated surge capacity analysis
Delayed surgery
-Time pressure
-High-risk/low-frequency event
-Poor information transfer
-Faulty risk assessment
-Adherence to standard protocols
-Teamwork decision-making
-Communication skills training
Prolonged surgery
-Faulty risk assessment
-Time pressure
-Situational awareness strategies
-Team training
Critical care
Missed diagnosis
-Poor information transfer
-High-risk/low-frequency event
-Cognitive bias prevention strategies
-Simulation training
Forgotten prophylaxis
-Lack of standardization
-Faulty risk assessment
-Inaccurate communication
-Standardized orders
-Team training
-Communication skills training
Technical and nontechnical skills for patient safety
Healthcare definitions of nontechnical skills10
Nontechnical Skill
Task Management
The planning, preparation, and prioritizing in the management of a patient. Identifying and appropriately utilizing resources.
The establishment of a shared mental model in managing a patient. The exchange of information and the coordination of a team in a strategy to manage a patient.
Supporting others while setting standards and expectations in managing patients.
Situation Awareness
The gathering and understanding of information to project and anticipate the future state of the patient.
Considering the options to choose, implement, and review regarding patient management.
Effective simulation modalities to teach Canadian interprofessional patient safety competencies
Safety Competencies
Simulation Modalities
Perioperative Example
Contributes to a culture of patient safety
-standardized patients
-task trainers
-web-based virtual patients
Reminds and reinforces the need for team members to wash their hands and wear protective equipment.
Works in teams for patient safety
-high-fidelity mannequin team training
Collaborate to manage a difficult airway in a patient with facial trauma.
Communicates effectively for patient safety
-standardized patients
-high-fidelity mannequins
Uses appropriate graded assertion to communicate during an intraoperative crisis.
Manages safety risks
-hybrid task trainers
Practices sterile technique for insertion of central venous catheters.
Optimizes human factors and environmental factors
-standardized patients
-task trainers,
Recognizes the risks of cognitive bias in making diagnoses, especially when fatigued
Recognizes, responds to, and discloses adverse events
-standardized patients
-high-fidelity mannequin team training
Disclosure to a patient's family following the diagnosis and management of unrecognized malignant hyperthermia.
Perhaps the most important consequence of identifying these nontechnical skills or non-medical expert competencies is the recognition that they are not inherent despite being based on behaviour.15 Any teaching of these competencies is accomplished informally in the clinical setting and probably attributed most to role modelling from mentors. Delivery of nontechnical skills solely by this process is potentially flawed as it is based on many assumptions. First, it assumes that faculty supervisors are experts in these competencies. Second, as mentioned earlier, many of these skills are required most during emergency or crisis situations, which are increasingly rare in modern day medicine. Finally, learning based entirely on role modelling may perpetuate negative learning where less than ideal behaviours can spread without assessment, feedback, and correction.16 Ideally, role modelling should be complemented with other education modalities.
Nontechnical skills must be formally taught, and in fact, probably more time is required to develop curriculum for these skills because they are more difficult to teach and assess than their technical skill counterparts.17 Without balanced curriculum design, the challenge in teaching nontechnical skills for patient safety can result in their overall marginalization. The biggest challenge to engage learners in these important competencies through conventional didactic instruction is the lack of context. Contextualizing these concepts can be beneficial for both faculty and learners as it can ease the instructional difficulties of teaching behaviours and facilitate sharing important mental models.18-20 By definition, most of these nontechnical skills are not practiced in isolation by any professional. An important aspect of translating mental models to a clinical context is incorporating an interprofessional faculty and audience. A mixed faculty and audience provide a variety of perspectives to appreciate the required communication and collaborative competencies. Other industries (i.e., military and aviation) have embraced interprofessional models for training.21 Team training in healthcare has included simulation to provide the appropriate context for interprofessionals to improve patient safety.19,22,23
Simulation modalities available for patient safety
Simulation can provide a forum for contextualized learning. As it relates to healthcare, simulation is defined as a technique rather than as a technology. It amplifies real patient experiences in a fully interactive manner.24 Simulation is an educational tool amongst many modalities that can improve patient safety directly by guiding clinical practice or indirectly through best education practice. While simulation is not the only tool in the arsenal of workplace or work-based contextualized lifelong learning, there is growing evidence that it is a powerful tool.
Over the last three decades, it has become more common to have trainees learn skills in medical history taking and physical examinations using standardized patients and to have them learn procedural skills using animal models.25 In the 21st century, advancements in engineering have ushered in a new era of simulator technology, including more complex partial-task trainers (i.e., models that replicate reality in a limited fashion to teach a specific delineated skill, such as central line placement or thoracentesis) and virtual reality simulators for surgical and procedural skills (i.e., hardware and software that provide haptic feedback for performing realistic laparoscopic cholecystectomy, bronchoscopy, colonoscopy, and echocardiography).
As mentioned previously, most consider that the strength of simulation to improve patient safety lies in modalities that address systems and team competence. For the anesthesiologist working in the operating room, patient safety is best addressed by mannequin-based simulation—the mode of simulation we pioneered and with which we are most familiar.26
The development of mannequins has advanced significantly over the last two decades, and software advances have allowed the most advanced mannequins to recognize injection of medications or therapeutic maneuvers, such as cardiac massage, and to respond in an appropriate physiologic manner. When preprogrammed responses are not available, mobile technology allows real-time physiologic manipulation; however, it would be a mistake to focus on these technological mannequins to improve safety alone. In fact, instead of precise replication, there is mounting evidence that only lower fidelity may be needed to approximate a simulator's true anatomy and physiology.27-29 Patient safety educators dedicated to improving nontechnical skills focus their programs on improving the environmental fidelity of their scenarios.
Environmental fidelity refers to the relationship between the simulation learning environment and the setting in clinical practice.30 Improving the environmental fidelity means incorporating all the structural and mechanized elements that would be present in the management of similar scenarios in the clinical realm. As discussed, the most important aspect is assembling a similar interprofessional cohort that would manage patients in the clinical environment. Fidelity is enhanced when the interprofessional team is dressed as they would be for clinical activities. This can be particularly important for the anesthesiologist, as it forces the team to address communication barriers unique to our environment, such as role identification and the interpretation of non-verbal cues when offered behind masks and surgical gowns. The costs to re-create all of these important clinical elements in a simulation centre can be prohibitive. In-situ simulation in an actual clinical setting can mitigate these costs, with the only expenses being the simulator, human resources, and disposables. This approach also potentially addresses barriers in assembling interprofessional teams for an educational activity during working hours. Recent advances in wireless technology have facilitated operationalizing in situ simulation, and they are recognized as solutions to increasing fidelity in the absence of simulation centre resources.
When live interaction between different health professions is unavailable, current research is also preserving fidelity by practicing communication and collaboration in a virtual environment.31,32 From isolated settings, doctors, nurses, and other allied health professions can work together online in the management of Web-based patient scenarios.33 While fidelity may not be optimized as in a live environment, this interprofessional learning supports the importance of team interaction and may be particularly applicable to the geography of Canada.
Simulation-based education: how it works
The success of simulation as a learning modality can be summarized by four basic principles: pattern recognition, the interplay of emotions and learning, the effectiveness of debriefing, and the importance of deliberate practice.
First, pattern recognition has been defined as the probability and efficiency of retrieving an item from memory. Pattern recognition depends on the similarity of the conditions in which an item has been encoded to memory and the similarity of the conditions in which it needs to be retrieved.34 With simulation, a healthcare professional can be exposed not only to rarely encountered clinical scenarios but also to learning in an almost identical clinical context where the skills will be required.
Second, there is evidence that learning can be more constructive when emotions are engaged. With simulation, learners are often confronted with situations that spark curiosity, perplexity, and confusion that can enhance learning if managed well by faculty.35 Faculty development is required to manage the delicate balance of emotions and learning effectively through feedback from direct observations in a debriefing – a hallmark of simulation-based education.36
Simulation-based education is based on the experiential learning cycle where learners participate in a scenario or procedure and manage the entire task from the beginning to a predetermined end to the scenario.37 Following the scenario, a trained instructor provides feedback in a debriefing session, often with video playback, so learners can reflect on both the positive and negative aspects of their performance.38 The cycle is completed by allowing trainees the opportunity to compare their performances with their existing knowledge and also to participate in the same scenario or a similar scenario requiring the identical skills.39
Deliberate practice refers to a process that allows learners to focus on intensive practice of specific tasks in a controlled setting while receiving coaching and formative assessment through timely and thoughtful feedback from an expert supervisor.40 A main feature of deliberate practice is that it occurs over a long time period and requires many hours to advance from novice to expert. Expertise in medicine, as in athletics, chess, and music, is closely related to the amount of time devoted to deliberate practice.41 Simulation is ideal for deliberate practice because it offers standardized conditions and the ability to repeat the same tasks frequently without compromising patient safety.
Simulation-based education: maintaining competency
Recognizing the importance of deliberate practice is closely associated with acknowledging that even mastered skills will most likely decay if not exercised regularly.42 Almost every anesthesiologist will experience the stress of managing a difficult airway and, more specifically, the "can't intubate, can't ventilate" situation; however, with an incidence of approximately one in 10,000, both the technical and nontechnical skills required to manage these crises have not been rehearsed, practiced, or experienced in months or even years.43 Decay and attrition of skills is inevitable and demonstrable.44 Ultimately, it is equally important to develop lifelong learning strategies to manage crises as it is to manage knowledge translation and retention more effectively.45 Simulation may be a powerful enabler in the development of these strategies.
Furthermore, equally important as the development of education programs is the increasing need for physicians, as a self-regulated profession, to demonstrate accountability to the government and the public by creating assessment strategies that ensure they maintain their competence. Taxonomies of assessment, such as Miller's pyramid, are useful to enable us to identify different levels of performance that may be assessed with different tools.46 With multiple-choice questions and oral examinations, we can assess the "knows" level of factual information. When designed to be rich in a clinical context, we can use the same tools to probe the integration of that knowledge into clinical judgement and decision-making, the "knows how" level of assessment.47 It has been suggested that simulation has advantages over other exam modalities in the domain of crisis management because it can assess what trainees would actually do rather than what they write or say, the "shows how" level of performance.48 More importantly, with simulation, we can potentially assess the competency of learners in a way that reflects actual clinical practice more closely than other assessment methods. By better replicating clinical practice, simulation allows for simultaneous assessment of multiple competencies, both technical and nontechnical. The "does" level of assessment can be performed only in the workplace where logistical and patient safety issues present challenges in this complex and dynamic setting. Thus, simulation may offer the best alternative to workplace assessment by providing a medium for work-based assessment.
Simulation research to demonstrate improved patient safety
Simulation has a great capacity to inform the patient safety movement and guide best practices for patient safety. Simulation can be used as an "object" of research, validating its efficacy as an educational tool, or it can be used as a "means" of research to study clinician performance in a patient-safe environment that is similar to the clinical setting.
The "gold standard" in validating simulation for patient safety is translational science. Traditionally, translational science has referred to biomedical research that advances or accelerates the application of results from the laboratory to patient care.49 Simulation research meets the criteria of translational science when it can demonstrate that the learning in a simulation laboratory impacts actual patient care. The T1 realm of simulation research would exhibit performance improvements in the simulation environment, while the T2 realm would demonstrate that the learning in the simulation laboratory translates directly to improved performance on patients. The T3 realm of research would improve the overall health of patients and society.50 Given the breadth of simulation literature and the importance of translational science on patient safety, this discussion focuses on the T2 and T3 realms of simulation research.
Procedural skills simulators have garnered the most attention in the patient safety movement, and T2 research has demonstrated that skills learned on simulators reduce the risk of errors by trainees when compared with traditional apprenticeship models of medical education. For example, learning laparoscopic cholecystectomy surgery on virtual reality simulators has led to a demonstrable reduction in predefined errors on patients in the operating room when compared with conventional instruction.51,52 Even more powerful is T3 evidence that individual procedural competence can be mastered through using simulators to gain expertise in complications of sepsis caused by central venous catheter insertion and brachial plexus injuries due to shoulder dystocia.53-55 Further research will determine whether simulated performance of the skills or familiarity with a procedural process is most responsible for the reduction in errors and, consequently, the improvements in patient safety.56 Ultimately, re-creating the clinical context and practicing processes may be more essential than incorporating a particular procedural simulator technology into a curriculum.57,58
Validating mannequin-based simulation with T2 and T3 research is far more challenging. As discussed, mannequins are used predominantly to teach the management of clinical crises. Crises are clinical events that occur rarely but are "high-stakes" situations associated with significant morbidity and mortality. Since these situations are rare and unpredictable, it is difficult to measure the effectiveness of simulation education in the clinical context. Furthermore, there are ethical concerns involved in allowing trainees to manage a patient crisis fully without intervention from a senior clinician. As such, there is a paucity of prospective T2 and T3 research evaluating the impact of mannequin-based simulation on patient safety.
In a retrospective case control study, management of patients using the Advanced Cardiac Life Support (ACLS) techniques was examined and a comparison was made between the results of residents who had received training in a simulator and the results of those who had not.59 Results showed that residents who had learned on a simulator were more likely to adhere to the ACLS guidelines than those who had learned by more traditional methods. In a recent prospective randomized study, the effects of using simulation to train residents to wean patients from cardiopulmonary bypass were compared with the effects of using a traditional interactive seminar. This study showed that the residents trained with simulation were more successful in executing both the technical and nontechnical skills required to wean patients from cardiopulmonary bypass, and their skills were better retained compared with the residents trained in the traditional manner.60
By providing a similar mock complex clinical environment, simulation can provide a "means" to study and dissect the management of crises and procedures critically.44 By deconstructing our current practices, we may identify gaps and deficiencies that need to be addressed. Furthermore, simulation can provide an environment free from patient harm to study the introduction of new equipment and to learn strategies for effective and safe practice. Simulation can provide a platform and environment that better controls for confounding variables for stronger study designs in this area of research.
Ultimately, researchers will strive to examine the effects of simulation on patient morbidity and mortality, but the logistics and ethics of measuring outcomes prospectively have proven challenging for rare and unpredictable emergency situations. Nevertheless, Gaba has stated, "No industry in which human lives depend on the skilled performance of responsible operators has waited for unequivocal proof of the benefits of simulation [or crisis resource management] before embracing it."61
Patient safety is the keystone of good patient care. In order to keep patients safe, healthcare professionals not only need safety competencies, they also need an understanding of the context in which errors occur. Error-producing conditions describe the context and environment where gaps in practice can lead to poor outcomes. Simulation is a powerful tool that can contextualize learning, assessment, and research of competencies and ultimately improve patient safety.
Key points
High Reliability Organizations (HROs) are preoccupied with potential failure; as a result, they have developed methods for effective management of unexpected situations in high-risk environments. Healthcare can be viewed through the lens of an HRO to address patient safety.
Technical skills (medical knowledge and procedural ability) and nontechnical skills are both required to mitigate Error Producing Conditions (EPCs).
Nontechnical skills include task management, teamwork, situation awareness, decision-making, and leadership. Nontechnical skills need to be taught.
Simulation-based education with interprofessional teams provides a context for learning nontechnical skills and facilitates sharing mental models. Environment fidelity is important as a context for learning.
Translational research is emerging to validate simulation-based education for patient safety.
Financial support
Conflict of interest
None declared.


text:
"Who are all these pirates, and why are they calling me Captain?"
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Because they spend months at C."
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though it could use a bit more rum, don't you think?"
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"There are some who call me... the Last Mate?"
"I'll run a sound check as soon as I'm done petting this kitten."
"Would you like a CD, a T-shirt, or a stab wound?"
©2017 Pirates for Sail


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NHIAA Awards
The following are various awards that are given each year by the NHIAA. Contratulations to each of this year's winners!
Walter Smith Award
The NHIAA Walter A. Smith Award: Given annually to an individual who has overcome special circumstances and contributed significantly and positively to Interscholastic Athletics.
The 2016-17 recipient is Gopal Timsina of Concord High School. Congratulations!
James W. Desmarais Service Award
James W. Desmarais Service Award: Instituted in 1970 and renamed for former long time NHIAA Executive Director, James Desmarais, this award is given to recognize meritorious service to the NHIAA. There have been 63 dedicated individuals recognized for this honor since 1970.
This year's dedicated and capable nominee certainly meets the criteria of the award and matches the contributions of the former inductees.
The 2016-17 recipient is Pierre Lafitte from Littleton High School. Congratulations!
Carol Dozibrin Advancement of Girls Sports Award
- Carol Dozibrin Advancement of Girls Sport Award Nomination Form
- Carol Dozibrin Advancement of Girls Sports Award Past Recipients
The Carol Dozibrin Advancement of Girls Sports Award Program: First given out in 1996, this award recognizes an individual who has contributed to the development of girls' athletics at the high school level.
The NHIAA Award Committee is pleased to have selected Ms. Jeanne O'Brien as the 2016-17 recipient. Congratulations!
NHIAA Hall of Fame Award
Press Release: NHIAA Hall of Fame Class of 2016
Charlie Burch - Coach
Harry Hallsey - Administrator
Carol Hamilton - Official
Michael Jackson - Administrator
Katie King - Athlete
Curtis Martin - Coach
Lindsey Prichard - Athlete
Lawrence "Poody" Walsh - Contributor
The NHIAA Sports Medicine Committee will recognize annually one student from an NHIAA member school through the awarding of a Preston R. Clark Memorial Scholarship. This student will be selected from an applicant pool of students (state-wide) who: Express a career interest in medicine, athletic training, nursing, and/or the care and treatment of sports injuries, Have not yet matriculated at an undergraduate institution, maintained a scholastic average (GPA) of 3.0 or above through the first semester of their senior year, and Have the recommendation of their school principal and athletic director.


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2012 Toyota Camry Hybrid Questions
Get answers to questions about your 2012 Toyota Camry Hybrid at RepairPal. Find solutions, diagnose problems and get back on the road.Refine by vehicle
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Hi, I got the code C1391, which means there is a leak in the ABS actuator, Every time I clear the code the ABS work fine for 10 minutes then the lights come on again, No ABS, and breaks need more push.
I made the alignment at Tire Kingdom, and asked them to do the calibration of center steering, but nothing changed, recently I knew after changing some parts like the steering rack I have to do a calibration also for the yaw sensor.
I want to know is the actuator was damaged just after changing the steering rack? or it is a calibration matter? and do you know the exact steps for the calibration.
Thank you, I appreciate your help in advance.
I should be getting 30-43 mpg on the trips I take but not only get 24-26 mpg ??


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Our programmes
The mission of this Challenge is to enable New Zealanders to adapt, manage risk, and thrive in a changing climate. This will be achieved through a framework that connects society with scientists through five inter-linked programmes.
Helping New Zealanders to make decisions informed by climate science, and to inform Deep South Challenge research.
Vision Mātauranga
Strengthening the capacity and capability of iwi/hapū/whānau and Māori business to deal with climate change impacts, risks and adaptation.
Impacts and Implications
Understanding the potential impacts and implications of climate change for New Zealand to support planning and decision-making, and aid adaptation efforts.
Earth System Modelling and Prediction
Developing and utilising the New Zealand Earth System Model to produce improved projections of climate change.
Processes and Observations
The aim of this programme is to improve our understanding of the global climate system by observing processes in Antarctica, the Southern Ocean, and the atmosphere.


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i have been looking through the Community but could not find an answer to my question. That's why i post it now.
When i setup E-Mail it works fine but the Email is always sent and received by the same mail address.
I have a lokal Mailserver sending the E-Mail and would like to have a different Mail address that shall receive the email.
How can i set this up?
This topic was created during version 1.1.
The latest version is 7.5.00101.
3 Replies
Feb 15, 2007 at 7:05 UTC
It sounds like that mail server would have to be setup as a mail relay if the intended destination is not local to that mail server. The other option is setting the SMTP server to the server that is the destination for that email address.
Feb 16, 2007 at 10:02 UTC
You have the correct setup for your email. Spiceworks only sends to the email address you specify in Settings > My Profile. To ensure all mail systems will accept the message, Spiceworks also sets the sending email address as the same address.
I am unsure of what the options coming up in the next release are so I'll have to report back about v1.5 to see if you can specify other email addresses. Some people have asked for monitors that can email specific groups and not send to the generic email address. With multi-user support expected in v1.5, multiple email addresses may be a possibility.
So for the next few weeks, you may have to endure keeping your email to and from the same user.
Apr 18, 2010 at 5:59 UTC
Niagara Technology Group (NTG) is an IT service provider.
Heffa, are you all set now?
This discussion has been inactive for over a year.
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