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Deficiencies in culturally competent asthma care for ethnic minority children: a qualitative assessment among care providers
Asthma outcomes are generally worse for ethnic minority children. Cultural competence training is an instrument for improving healthcare for ethnic minority patients. To develop effective training, we explored the mechanisms in paediatric asthma care for ethnic minority patients that lead to deficiencies in the care process.
We conducted semi-structured interviews on care for ethnic minority children with asthma (aged 4-10 years) with paediatricians (n = 13) and nurses (n = 3) in three hospitals. Interviews were analysed qualitatively with a framework method, using a cultural competence model.
Respondents mentioned patient non-adherence as the central problem in asthma care. They related non-adherence in children from ethnic minority backgrounds to social context factors, difficulties in understanding the chronic nature of asthma, and parents' language barriers. Reactions reported by respondents to patients' non-adherence included retrieving additional information, providing biomedical information, occasionally providing referrals for social context issues, and using informal interpreters.
This study provides keys to improve the quality of specialist paediatric asthma care to ethnic minority children, mainly related to non-adherence. Care providers do not consciously recognise all the mechanisms that lead to deficiencies in culturally competent asthma care they provide to ethnic minority children (e.g. communicating mainly from a biomedical perspective and using mostly informal interpreters). Therefore, the learning objectives of cultural competence training should reflect issues that care providers are aware of as well as issues they are unaware of.
Asthma outcomes are generally worse for children from ethnic minority backgrounds
Low adherence to preventive treatment with daily inhalation corticosteroids (ICSs) is an important barrier to achieving optimal asthma control
Cultural competence is regarded as an instrument for improving quality of care for ethnic minority patients, and is generally defined as the combination of knowledge, attitudes, and skills necessary for delivering high-quality care to an ethnically diverse patient population
The aim of this qualitative study was to explore those mechanisms in paediatric asthma care that lead to deficiencies in the care process for ethnic minority patients. The results will be used to develop cultural competence training for specialist paediatric asthma care providers.
We conducted semi-structured qualitative interviews with care providers in specialist paediatric asthma care that focussed on their own experiences and reported concrete behaviour with children from ethnic minority groups with asthma (aged 4–10 years) and their parents. We defined "children from ethnic minority groups" as children who had at least one parent who was born abroad
We chose to conduct individual, qualitative interviews because of its appropriateness to provide an in-depth understanding of the care process for ethnic minority children with asthma. Although Dutch law (the Medical Research Involving Human Subjects Act) did not require ethical approval for this interview study, each respondent was adequately informed of the aims and methods of the study and we took every precaution to guarantee the respondents' anonymity.
We established a purposive sample of nine paediatricians (two male, seven female) and four paediatric pulmonologists (three male, one female) in three hospitals in Amsterdam (two paediatric university hospitals, one general inner-city teaching hospital). Their experience in working as paediatricians varied between <10 years (n = 7), 10-20 years (n = 3) and >20 years (n = 3). We chose Amsterdam because over 50% of its young population (aged 0-15) is from non-Western ethnic minority backgrounds
Eight physicians worked in an academic setting, and five in the general hospital. We chose these different settings to ensure variation in ethnic patient population, provider population, asthma severity, and type of healthcare organisation. Additionally, an asthma nurse was interviewed in each hospital (all female). Respondents were selected because they worked at one of the three hospitals' paediatrics department at the time of the study. They were approached by the first author (CS). Three care providers declined an interview: two because of time constraints and one because of illness. We stopped approaching care providers when interviews revealed no new information (saturation of data).
Data collection
We used a semi-structured topic list based on issues of specific importance in asthma care in an ethnically diverse healthcare setting (Table
Data analysis
We used a framework approach to analyse the transcripts
Central problem: non-adherence
Non-adherence (especially to daily preventive ICSs but also to lifestyle recommendations) is generally known to be the major problem in paediatric asthma care, and respondents in our study identified issues that add on non-adherence in asthma care to ethnic minority children.
The first section describes three factors of influence on adherence in patients from ethnic minority backgrounds as mentioned by the respondents: social context, illness perception, and language. The second section describes the respondents' reported reactions to patients' non-adherence. Quotes are presented throughout the results to illustrate the findings.
Factors of influence on adherence in ethnic minority patients
Social context
Respondents related children's adherence to families' social context. Several respondents described multi-problem families in which various problems coexisted: a sick parent, problems in the parents' relationship, and parenting problems. These problems affected children's adherence in different ways. Sometimes the responsible parent was so caught up in his or her own problems that there was barely any attention left for the child's asthma. Or a parent had difficulties getting a child to take the medication, while other parents shifted too much responsibility onto the child. The following case, described by one of the respondents, illustrates these issues:
Illness perception: chronicity of asthma
Respondents also ascribed non-adherence to different illness perspectives. Some respondents merely said that parents from ethnic minority backgrounds "perceive their child's illness differently"; others had more concrete ideas of differences in illness perception. They expressed more difficulties explaining the chronic nature of asthma to parents from ethnic minority backgrounds, and found it harder to get them to understand the consequences this has for daily life. The following respondent related these differences to culture:
This was also explained as a "phase" difference – a phase Dutch society (and patients) have already gone through, and patients from minority backgrounds have not:
Furthermore, respondents indicated that differences in perceiving the chronic nature of asthma create the unmet expectation that asthma can be cured:
Although respondents did not label language barriers as a large problem, at the same time "language difference" was described as a factor that hindered parents' understanding of asthma and its treatment. Respondents explained that the message they generally communicate (which they described as "what asthma is and what do you have to do about it") was a complex one.
Care providers also mentioned that a language barrier made it more difficult for them to assess whether their information was well understood:
Reported reactions to patients' presumed non-adherence
In this section we describe the reactions reported by respondents to patients' non-adherence, including retrieving information, providing information, occasionally providing referrals for social context issues, and using informal interpreters.
Retrieving additional specific information
Care providers need to get a clear picture of what is going wrong, and therefore expressed a need for specific information from patient and parents on the child's health situation and the extent of and reasons for non-adherence. Respondents experienced more barriers in gathering such information from ethnic minority patients due to two mechanisms: communication barriers and a discrepancy in care providers' information needs and patients' daily lives.
Communication barriers
Respondents described various strategies for retrieving information, including additional questioning, asking questions in an empathic way ("It's very difficult to get a child to take his medication every day – how is that for you?"), or asking children directly instead of parents. These techniques did not always yield the desired information. Respondents recognised specific communication patterns with ethnic minority parents, including "yea-saying", i.e. socially desirable response behaviour. In their eyes, these patterns hindered information retrieval. Keeping an asthma diary as an alternative source of information also caused difficulties because of functional illiteracy and language barriers.
Discrepancy in care providers' information needs and patients' daily lives
Sometimes the type of information care providers required did not seem to be in keeping with patients' daily lives. Respondents expressed the feeling that their questions did not yield the "right" information. A respondent explained that the information physicians are looking for is very concrete: how often and how much medication was used during which time span? Whereas Dutch parents are usually able to answer these questions, with ethnic minority patients this kind of information seems harder to retrieve. This respondent believed that giving medication in ethnic minority families is something that blends into the day rather than something that happens according to a schedule and that can easily be reproduced when a care provider asks for it.
Some respondents explained that in cases where they lacked insight into home situations, they tried to monitor the patient more closely (e.g. by being more prescriptive in their treatment recommendations instead of stimulating self-management).
Providing biomedical information
Providing information was our respondents' strategy of choice for improving adherence. They focused on transferring biomedical knowledge (sometimes repeatedly) to help parents understand their child's medical situation.
Some explained that they tried to connect with what parents put forward during the consultation:
The respondents explained they use drawings or anatomical models to visualise the information for parents. Or they compared the "invisible" (inflammation of lung tissue) with something "visible" (like eczema on the skin). Almost all paediatricians mentioned a preference for referring patients to an asthma nurse for more detailed asthma education. Which patients were actually referred differed per healthcare organisation (e.g. all new patients, patients with uncontrolled asthma, or patients who had been prescribed new medications).
One care provider used a specific metaphor to get information across:
The story of the cowboy
A cowboy has two things. He has a horse, which is reddish brown (a colour similar to the corticosteroid inhaler) and he has a pistol, which is steel blue (a colour similar to the Ventolin inhaler). A good cowboy looks after his horse twice a day and only shoots when he has to. If the cowboy only wants to take care of his horse when he really needs one, you can imagine the horse will be dead by then. That doesn't work. And that doesn't work for the medicine either. (A10)
Social context issues: occasional referrals
In cases where social context issues such as a parent's illness or parenting problems influenced a child's adherence, respondents explained they find it important to acknowledge the problem to parents, but they doubted the extent to which they could support them in these issues. Although in some cases they referred parents for psychosocial support, these referrals were not formalised in protocols.
Using informal interpreters
Often, respondents associated patients from ethnic minority backgrounds with language barriers. Although respondents regarded language barriers as posing a risk to transferring and gathering information and therefore posing a risk to adherence, the general opinion was that "the language problem wasn't so bad." In daily practice, respondents seldom used formal interpreters (which was free of charge in the Netherlands). Respondents mentioned several barriers that hampered communication when using formal interpreters: it takes too much time to request an interpreter, the conversation gets impersonal with an interpreter on the phone, and the conversation is reduced to one-liners. The respondents regularly used informal interpreters (like family and friends) brought in by parents. These conversations proceeded naturally, and informal interpreters were given no instructions on how the respondents would like them to translate the conversation. Respondents were aware of risks that may arise from using informal interpreters, but saw little danger in using them in standard asthma care:
In this study we showed that mechanisms in paediatric asthma care that lead to deficiencies in the care process for ethnic minority children were mainly related to non-adherence. It seems that most factors our respondents discussed (such as influence of social context factors and difficulties in understanding asthma as a chronic disease) are not related to ethnic minority patients in particular. Rather, they emphasise certain aspects of asthma care that are likely to create problems in the general patient population.
Educational literature describes different stages of competence. In the stage "conscious incompetence," care providers recognise mistakes and difficulties in their actions, and will be able to report them. However, this stage is preceded by the stage of "unconscious incompetence": a stage in which learners (or care providers) are unaware of their incompetence
A first difficulty the respondents seemed unaware of is related to providing information. Providing information was our respondents' strategy of choice in case of non-adherence, with the intention of increasing parents' knowledge on asthma. Studies have shown that medical information is generally not easily understood by patients due to such things as unfamiliarity with medical technical terminology
A second difficulty respondents seemed unaware of is related to language. Respondents recognised language difficulties as a barrier to information transference. Respondents explained that language barriers were overcome by using informal interpreters instead of formal ones. However, research has shown that using professional interpreters in healthcare has added value over the use of informal interpreters
Respondents indicated that different illness perspectives were related to non-adherence. Kaptein et al.
Self-reflection receives much attention in the literature on multicultural care
To develop effective, meaningful cultural competence training for specialist paediatric asthma care providers, we have to turn our findings into learning objectives that reflect both the issues care providers were
Ability to use patient-centred communication skills in giving and retrieving information;
Awareness of different illness perceptions and ability to communicate effectively about this;
Ability to effectively overcome language and health literacy barriers;
Ability to reflect on one's own background and stereotyping in intercultural contexts (Table
Evaluation of care provided to ethnically diverse patients often showed a "magnifying glass effect"
By using a qualitative research method, we obtained insight into issues respondents themselves related to adherence in children from ethnic minority backgrounds. By putting respondents' experiences in the context of the general literature on asthma care and cultural competence, difficulties respondents were unaware of also became apparent.
Research on care providers' cultural competence commonly uses instruments to measure their self-perceived cultural competence
A limitation of this study is the small number of interviewed respondents (n = 16). This was due to rapid saturation of the data. An explanation for limited variation in data and rapid saturation might be homogeneity of the respondent group. Although gender, years of experience and setting (academic/non-academic) did vary between respondents, we did not verify respondents' country of birth. Based on their last names, mastery of Dutch language, and appearances, we assume they all had a western/an ethnic majority background. It might be that care providers from ethnic minority background would have put forward different experiences or communication styles during the interviews that would have diversified the data.
Developers of cultural competence training can use our findings as input for developing learning objectives. Although it is important to meet the educational needs of care providers when developing cultural competence training, we have shown it is equally important to take into account issues care providers are unaware of. However, care providers must first become aware of their "incompetence" before they will recognise their need to learn about these issues. We therefore recommend that creating awareness of providers' "incompetence" should become a part of the training itself or a separate learning activity before the actual training.
Our study was limited to cultural competence at the level of care providers
This study provides keys to improve the quality of specialist paediatric asthma care to children from ethnic minority backgrounds. Importantly, we showed that care providers do not consciously recognise all the mechanisms that lead to deficiencies in culturally competent asthma care they provide to ethnic minority children ("unaware incompetence"). Therefore, the learning objectives of cultural competence training may need to start with issues that care providers are aware of, to get their interest. Once having them inside, cultural competence training should address unaware incompetence issues and change these into "awareness" and then into "competence" (e.g. the use of formal interpreters to overcome language barriers). Fortunately, our results also give reason to believe that if care providers continue to improve on the patient-centred skills they learn during medical training, they already "come a long way."
Competing interests
The authors declare that they have no competing interest.
Authors' contributions
KS, WvA and MLE-B wrote the grant application. KS, WvA, MLE-B and CS designed the study. CS collected the data. Data were analysed by CS, under supervision of MLE-B. CS drafted the article, all others contributed intellectual content to the paper, provided comments on subsequent drafts and approved of the final version. All authors read and approved the final manuscript.
This study was funded by The Netherlands Asthma Foundation, the Netherlands Organisation for Health Research and Development (ZonMw), and The Netherlands Organisation for Scientific Research (NWO). The authors would like to acknowledge all care providers that took part in our study. Additionally we would like to thank Jeanine Suurmond and Majda Lamkaddem for their thoughtful comments on previous drafts of the paper.
Racial/ethnic variation in asthma status and management practices among children in managed medicaid
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Low parental literacy is associated with worse asthma care measures in children
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Promoting health care equity: is health literacy a missing link?
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Pre-publication history
The pre-publication history for this paper can be accessed here:


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|Trad, 90'
|YDS: 5.8 French: 5b Ewbanks: 16 UIAA: VI- ZA: 15 British: HVS 4c [details]
|Unknown, Pre 2003
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By Matt Michael
From: Oceanside, CA
Dec 6, 2013
rating: 5.7 5a 15 V+ 13 MVS 4b
|Only wish It was another 90ft longer!
By Eric Van Williams
From: Oside,CA
Dec 14, 2013
rating: 5.6 4c 14 V 12 S 4b
|Wish it was taller, a frisbee sized flake ripped off near the top while I was I this one.
By Lou Cerutti
From: Carlsbad, California
Nov 27, 2016
|Best half rope-length of "easy" crack climbing in SD. I had so much fun climbing this. Double crux in second half of the route. Pretty exciting climbing out of the crack and above your last piece; I'd guess that's where the 5.8 comes in. A must do while in the area. I almost skipped over it. Glad I didn't. TONS of dormant poison oak (leaf less) during this time of year. It was crawling right up the wall around the double dragon arete. We moved it but be VERY careful if you're sensitive. Make sure you're able to identify it.

subset: commoncrawl


text:
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As the cloning word of humankind continues we insight ourselves in an remarkable difficulty. We see the call for of same to increase knightly one's own lifetime as an natural characteristic; preservation has e'er been one of mankind's top drivers of motivation. World Religions in their swiftness to gather together federation strut and municipal charge amongst the lots have in fact been competent to capitalize on this to a enormous degree, purposing the opinion of enduring rescue for a pledge of the own in this life circumstance to do as they are told and unrecorded their time in a absolute way. That positive way includes among new things; not difficult the established hierarchy of powerfulness. Human Beings unquestionably have questions which involve to be answered such as; How did I get here, How did all this begin, what happens to me once I die and what will crop up to the total of all I see in the end, once will it all end. World Religions can use these wants of the several to know such belongings as a bar to standardize their psyche, by fussily answering all those questions in every variety of believable and yet un-provable way. Of curriculum concluded example as much knowledge domain desk light is barn on a mixture of subjects these religions must fit their fable file a bit to hold on to all the believers buying the plot. Most of the best flourishing religions have through with a favourable job of victimization unfocused clarification on the answers so that they are able to adjust done time.
As the spoken communication changes they can retrovert rear to the old definitions, select the new ones, lug a broader representation in a non-literal cognisance or stick next to a fundamentalistic direct reading. Often contrary groups in divers regions or cultures may select all of these methods. Similar to our laws, wherever you as an peculiar can do thing you aspiration provided you have the apposite attorney to re-interpret the law, use the missive of the law, use suit law on any on the side to store buoyant on the greyness of the law. In the end all correctness is relative from the view of the individual, go-between or jury you see? Why is this important? What does this have to do near Cloning? Well simple, those in opposition biological research are mostly fundamentalist in rational or they but cannot grasp the benefits or momentary body of water which biological research may well inflict and for this reason have sided next to the fundamentalists views as a trickle fund situation.
Cloning has some critical advantages in that genetically muttering those who at first can afford to clone will locomote from men of system or of economic condition. Having much than one of you strength be an unimagined leg up on the planetary no hesitation. Many society next to matching vision and skills will be able to do more with little and added ones pains in society, business, activity positions, etc. If full home units are made up of those who are cloned, who dew pond equipment they will in information do recovered than families who are not exploitable mutually so keenly and are not cloned, want the discipline of a decisive and cohesive vision or are diffused as respectively sets out into the worldwide to sort their way. Which is by and large the shield in America. Where we drill our teen to go out into the global get a institute level and go effort for jumbo companies or else families who own businesses and corporations. Those other families and their collected teams, corporations, networked groups and families in this manner use those who option to sort a heading for themselves the possibleness to early inside a new family, the corp. For this the ascendant teenage star can be notably stipendiary or economically enslaved if they come to nothing to congregate expectations of the livelong of the family, house or it's shareholders.Post ads:
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This of trajectory we know. As we monitor the classic conflict betwixt association and enterprise and the fights of corporations and families from several different countries occupation equally at present time and then peer it out in the flea market situate at others, recurrently achievement organization to struggle the corral in their benignity long-run adequate to rank other blow to their contender. Meanwhile the preteen new goods into the economical orientated home is barraged near a cipher of decisions as to what they impoverishment out of their personalized time for fulfillment as they sieve done the varied messages of advertising, person pressure, devout doctrines, governmental rallied nationalism or attraction of a mate.
The capitalist or initiation families of the companies or those heavily leveraged in its' end and occurrence garner from these pains along next to the individualistic ascendant figure or up and future if they are to goody their pains and dedication the very way next to the aforementioned convictions. This is finished by incentives, hackneyed options, aureate handcuffs, large titles, general reputation and money, detected material comfort and/or the aptitude to added purchase proposed proceeds through with appropriation from gratitude unions and banks to stay alive at a higher standard of sentient or in a theory set of contacts of aspect of being and dawn to a new tableland in ones career? Is this apposite or bad? Well it right is and this need of the single is hanging around the needs of the business firm. Again why is this esteemed to cloning? Well in cloning those who are cloned can serve the necessarily of the singular promotion inside the cohort in a way never in the past executable after-school the tie run loaded genus families.
At early cloning will solitary be easy to those who have the capacity to pay for it and simply those who have out of province hideaways to do it, since the whole socio-economic models of market economy right now in position in most countries may perhaps be in risk as those beside the funds could lose their domination to those beside the maximum digit of inter-related kith and kin clones. In numerous countries we have exceptionally almighty groups of families and in some cases one family unit in order of the whole country, the ethnic group of these countries are allowed adequate angular distance of freedom as drawn out as they execute for portion in the set-up. Those who do not go along next to these pre-agreed upon methods are killed, exiled, leave, ready-made slaves or are conveyed to detention. Those in cite last to brand definite they besides edict concluded the type of organization in such a way, which keeps them in power, wouldn't you? If your answer is no and you are beneficent by nature, it would not pocket you drastically perennial to soul.Post ads:
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We condition to be intelligent if we are prepared for a paradigm displacement which might occurrence the stability of clout of Corporations by creating Super Families of Clones. Think roughly it.


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Influential people in 2017 Education – Michael Haggen, Leadership
1) Michael Haggen is one of my top 10 influential people in 2017. He is one of the top executive talent in Education. Michael is known for his transformation and innovative approach to School Turnaround. Michael has a distinguished taste for style, travel and food. He has traveled the 7 continents providing and starting up schools with academic excellence as the key mission. In 2016, Michael Haggen was named Chief Academic Officer for Scholastic Education. http://www.scholastsic.com Michael brings more than 20 years of experience in education. I would recommend him as the next U. S. Secretary of Education.
Influential people in 2017 Education – James Nesbit, Administration
2) James Nesbit a phenomenal administrator and all around Great Guy. James Nesbit is known for his instructional leadership and ability to staff a school with the people who exemplify the right skill set for the cultural of the building. He builds a strong bond with parent and community leaders. James is an expert at school administration and operational excellence. I would recommend him also as the next U. S. Secretary of Education. http://www.slps.org
Influential people in 2017 Human Resources/Transportation – Darlene Rector, HRIS Director
3) Darlene has been with Enterprise Holdings for more than 17 years and leads a dynamic HRIS team. She is very smart and community involved. She is a great mother and believes in family work life balance. Although, she has a hectic schedule, she maintains a smile and always says thank you for her team's hard work. Darlene is an expert in Human Capital Management Software systems. I recommend her and see her being a VP of System Operations. https://go.enterpriseholdings.com/
Influential people in 2017 Human Resources Business Partner II/Healthcare, Pharmaceutical – Mallory (Downs) Mancini, PHR
4) She is a Business Partner II at Barnes-Jewish Hospital. BJC is ranked as one of the worlds leading Hospitals by U. S. news and World reports. http://health.usnews.com/best-hospitals/area/mo/barnes-jewish-hospitalwashington-university-6630930 Mallory works with executives in various departments. She is hands on with organizational initiatives and quickly acclimates to new challenges and growth opportunities.
Influential people in 2017 Business Woman – Barbara Corcoran
5) Barbara Corcoran a savvy business woman after my own heart. When I ventured into real estate I found her on the internet and basically patterned my business moves based on what she had done or was doing. I guess you could say she was my unofficial business mentor. She is an accomplished real-estate mogul, business woman, consultant, speaker and TV personality. She is said to have a networth of $9 million! She is such an inspiration. " She is a Shark" You can check her out on http://www.thesquander.com & http://www.barbaracorcoran.com/
Influential people in 2017 Senior IT/Clinical Recruitment – Manish Choudhary
6) If you are looking for a job Manish is the person to contact. He is one of the best recruiters in the business. He is genuinely concerned about each of his placements and hires. He keeps in touch and supports their career goals long after the assignment is over. Manish has a sense of humor and is driven and motivated by his client's success. I look and recommend Manish Choudhary for VP of Talent acquisition in the future.
Influential people in 2017 Not for Profit, Bereavement Counseling and Family Care – Cheryl McGee
7) Cheryl is an amazing person. She has a smile and touch that can warm the hearts of the angriest mob. Whether she is performing as a lead receptionist or working in her ministry as a bereavement counselor she is a joy to work with.
Influential people in 2017 Human Resources, Deputy Director Staffing – Clifton Yancy
8) Clifton started his career with the government and has over 20 years filling vacancy and on boarding talent all over the country. He leads several state, region and national hiring initiatives to keep the government running and servicing the various programs in defense, treasury and agricultural. I recommend him for the next United States Deputy Secretary of Agriculture.
Influential people in 2017 Human Resources Information System/Healthcare, Rebecca Feldman.
9) Rebecca Feldman is a ball of positive energy. She is creative, smart and a leader in HRIS. She is self motivated and truly loves what she does. Inspired by Recbecca and listening to her conduct webinars on ERP systems and integration, she helped catapult my career into HRIS as an HR Coordinator, ERP Specialist, and Business System Analyst for large organizations. I look to her and recommend her for a VP of System Operations. http://www.ssmhealth.com/system
Influential people in 2017 Human Resources/HRIS for large organizations –
Carmen Hill
10) Carmen Hill, MBA started her career in HR as an HR management intern. She is now an HR Blogger, Business System Analyst, Entrepreneur, Business Consultant and Founder of Cobra Consultants1.com. http://CobraConsultants1.com She has worked in every functional area in HR. she has spent most of her career supporting executives in large organizations achieve business goals and transform cultures. She started her online business blog in 2014 and is the author a new book titled " Guidelines on How to Get off The Sidelines." A copy of her e-book can be purchased for $2.99 at Amazon.com http://www.amazon.com/dp/B01LFSUXRK
She is a woman of faith and believes in the awesome power of God as he manifest his presence daily in your business and career goals. I see her doing whatever she wants to do in the business world and being great at fulfilling her life assignments.


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Please use this identifier to cite or link to this item:
Salvador, Regina
Year of Publication:
Series/Report no.:
54th Congress of the European Regional Science Association: "Regional development & globalisation: Best practices", 26-29 August 2014, St. Petersburg, Russia
In these last four or five years, the creation of a Maritime Cluster in Portugal has been an issue of first political and economic relevance in the Country. The enlargement of the Continental Shelf under national jurisdiction into a total surface of 2.2 millions square kilometres (with a predictable high level of mineral, genetic and hydrothermal resources) ? particularly taking into account the economic crisis in current context ? awakes all kinds of hopes and ambitions. This "last big change in the World Map" ? in direct connection with the main guidelines of the Integrated Maritime Policy for the European Union ? requires the creation of a maritime mega-cluster. It should include both traditional (fishing, canning industry, ship building, maritime transports), and modern sectors (wave and tide energy, biotechnology), in a country that it is not known for a high level of social capital or its capacity of developing joint efforts. The current paper defines and presents the Maritime Cluster basic and most important characteristics in terms of main territories and regions. More specifically, the critical stage which corresponds to the Cluster initial emergence (during which the seeds for future economic growth are launched) has a strong dependence from different local conditions and the launch of specific processes. Starting with the assumption that geographical proximity and enterprises/institutions strategic cooperation promote competitiveness and innovation and, in consequence, the development, we propose to determine the existence of cooperation relationships and/or partnerships between activities connected with the maritime sector; if those relationships exist, are they partnerships at local, regional or national scale; and if recent trends point out towards innovation. The paper quantifies the sea cluster main intersectorial linkages, based on the integrated system of Portugal's Input-Output Matrix, to which we call Sea Input/Output Matrix (SIOM). It is also put in evidence the multiplier factors of direct, indirect and induced effects. Taking into consideration the final quantitative results, the authors present some remarks in terms of Employment, GVA and Investment in Portuguese Sea Cluster Economic Sectors. Finally, it is presented the preliminary results of a questionnaire that was launched among the members of the so called Sea Entrepreneurial Forum.
Maritime Cluster
Input-Output analysis
Extension of the Continental Shelf
Input-Output analysis
Extension of the Continental Shelf
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Conference Paper
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Download: https://infinati.bandcamp.com/
Infinati's "Interdementia EP†was created in a half-dream state over the course of endless dreamy nights. It revolves around the concept of forgetting about our interdimensional nature in our demented waking lives, and then fully remembering when you sleep and go on spirit journeys, become geometries, and traveling through wormholes. Infinati is electronic folk music in a sense, as the inspiration is from interdimensional traveling, where spiraling melting bass, algorithmic glitch harmonies, and manipulated field recordings squish and stretch your consciousness into a downtempo acid mud dance.
released December 28, 2015
Mastered by Ion Driver
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Produced by Sergio Blue
Licence : All Rights Reserved


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Baby Android 18 by tcwouaWatch
©2010-2017 tcwoua
This is just too adorable, granted this could be her before she got turned into an android.
Instant fave.
Instant fave.
I absolutely love this pic and this art style. Would you be open to a commission to do one of these for Weiss from RWBY?
The eyes have it for sure!
awwww so cute
it would be weird if cell was a baby and he tried to absorb 17 and 18 but then 16 breaks his tail and ends up crawling away but crying at the same time
Who's my cute wittle baby!?
She kinda looks like Ino from Naruto but the eyes give it away that shes Android 18
oh wow this is great work
Baby Android 18: *beats Dr. Gero to death with baby rattle*
sweet ^^
I like the way you draw her as a baby, but you still draw her sharp eyes perfectly!
Awww, that's so adorable^^ Great job^^
Awwwww she's got Krillen's nose!
oh my jesus adorable!
too cute
dear god that is too cute
Cute. Can u make 17 a baby too.
yes, maybe if someone commission me too
Cute I couldn't pass up this pic.
This is so Adorable!
Do you also have a baby version like this but than from android 17?!
Do you also have a baby version like this but than from android 17?!
thank you , i think there is more babies but not from DBZ
cute make baby 17 but asowme
she so cute, hehe great job dude
DUDE I ABSOLUTLY LOVE YOU (i may have spelt that wrong) this picture is quality, there isnt enough Dragon Ball Z age regression out there (god knows why) i would love to see an AR process... no money for commision though, typical
OMG, that's ADORABLE.


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I don't watch a lot of television, but I do watch enough to feel guilty about it. (Ah, guilt).
One of the shows I like is Boston Legal, mainly because the actors are older than me.
I've watched James Spader (Alan Shore), Candice Bergen (Shirley Schmidt) and William Shatner (Denny Crane) perform in different things throughout my formative years, if you call late adolescence and young adulthood formative. I would.
Anyway, both Alan Shore and Denny Crane, successful lawyers, think about sex a lot. Not that there's anything wrong with that.
It drips validation to baby boomers, the aging middle-aged. Ever notice how young people aren't "aging"? What are their cells doing, anyway?
On the television show Alan and Denny are constantly communicating their awareness of the female body. Denny's pretty loose, touches, kisses every woman he sees, clearly maniacally hyper-sexual. (Shatner's marvelous. You almost wonder if he has bi-polar disorder he's so good).
Anyway,imagine our surprise to find that on the season opener Denny admits to having sex with a life-size doll, the likeness of Shirley Schmidt, his law partner. He's always hitting on Shirley, simply adores her. He uses this doll in a closet at work.
Alan also has issues, too, for he apparently has used the services of a sex surrogate, a professional, to get him through some kind of sexual problem, we're not sure what. He admits that his family was light on affection, as in, there wasn't any from Mom.
He makes a good case in court, by the way. Behavior sex therapy is preferable to pharmaceuticals like Viagra, even if the therapist is a surrogate.
So as a self-proclaimed Viagra hater, I was pleased. Read my post in the archives, unless I haven't written it. I know I wrote something about sexual intimacy and relationships in May or June.
At the end of the show the two men are having their a drink (ah, alcohol, America's favorite drug), half glasses of scotch (I guess it's scotch) on Denny's balcony and they're talking. The show always ends this way, the two on the balcony outside, drinking and philosophizing.
Alan has told Denny about his mom. Then he turns to Denny with full sincerity and asks, "Denny, do you ever get lonely?"
Denny thinks about it awhile. "No," he finally answers, and scowls at having had to think about this disturbing question. Then he tosses it back. "Do you?"
Alan, who is so sensitive and squeezable, without skipping a beat, perhaps having read the look on Denny's face says flatly, "No."
Why am I writing about this again?
Loneliness has been the theme of the week and it's only Tuesday night. More on that one soon.
Copyright 2006, TherapyDoc


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A Solitary BlueWell, considering Jeff Greene is the main character in this book, this is a most appropriate question. What is ironic about the way you asked the question is that Jeff Greene is also the only...
A Solitary BlueThe search for love and trust are the central themes in the book, most clearly shown in the central character Jeff's experiences. Consumed by longing for the love of the manipulative mother who...
A Solitary BlueThe various settings of this story include Baltimore, where it begins, and then it moves between Charleston, South Carolina, and Baltimore, and finally ends in Crisfield, Maryland.
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I found a funny Vs. hacking video game of Fire Emblem: Rekka no Ken and The Sacred Stones while I was looking at in YouTube. It is a VS. Hacking Video of Eirika from FE8 vs. Lyn from FE7. The winner of the VS match is Lyn.
"The Female Lords of FE7 and FE8 Clash!"
—Uploader's comment from YouTube


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Amanda C. Yen
Areas of Practice
Bar Admissions
- Idaho, 2007
- Nevada, 2005
- J.D., University of Nevada, Las Vegas, William S. Boyd School of Law, magna cum laude and William S. Boyd Outstanding Graduate Award, 2005
- B.A., International Studies and Theatre Arts, cum laude, Pepperdine University, 1999
Professional Background
Amanda's practice focuses on Commercial & Complex Litigation, Employment & Labor Law and Appellate.
Ms. Yen, attended Pepperdine University in Malibu, California, graduating cum laude in 1999 with a Bachelor of Arts in Theatre Arts. Ms. Yen continued her education at the William S. Boyd School of Law, UNLV, graduating magna cum laude in 2005 and receiving the William S. Boyd Outstanding Graduate Award.
During law school, Ms. Yen worked in the Juvenile Justice Clinic and was a Student Notes Editor for the Nevada Law Journal. Ms. Yen also worked as a tutor in the Center for Academic Success and Enrichment, where she assisted fellow law students in achieving academic success.
Before joining McDonald Carano, Ms. Yen was a judicial law clerk for the United States District Court where she wrote briefs, attended trials and prepared orders on all types of civil and criminal matters. While a clerk, Ms. Yen also prepared bench memorandum for and attended hearings at the United States Court of Appeals for the Ninth Circuit.
Commercial & Complex Litigation
Ms. Yen has handled cases in both federal and state courts. As a former federal law clerk, Ms. Yen is particularly skilled in handling procedural issues before the United States District Court. Ms. Yen litigates a variety of matters including contract disputes, adversary proceedings in bankruptcy court, tortious interference, landlord/tenant issues, fraud and misrepresentation, quiet title actions, and matters involving injunctive relief. Ms. Yen has achieved considerable success in motion practice, particularly in summary judgment motions and in obtaining temporary restraining orders.
Employment & Labor Law
Ms. Yen's employment law practice focuses on counseling employers on all aspects of employment law, updating clients on changes in employment law, and providing advice on charges before the Equal Employment Opportunity Commission and the Nevada Equal Rights Commission. She has handled various employment issues, including matters involving the disclosure of trade secrets and non-compete agreements.
Appellate Practice
Ms. Yen has assisted in representing clients before the U.S. Supreme Court, the Ninth Circuit Court of Appeals, and the Nevada Supreme Court.
Awards and Recognition
- Special recognition for pro bono work, Legal Aid Center of Southern Nevada
- The Best Lawyers in America (Appellate Practice)
- "Mountain States Super Lawyers": Rising Star and Super Lawyer
- Nevada Business Magazine – "Legal Elite Best Up & Coming" and "Legal Elite"
- Las Vegas Business Press – "Women Who Mean Business"
- Martindale Hubbell AV® Preeminent™ Peer Review Rated
Community Engagement
- Young Lawyer Liaison, Meritas Law Firms Worldwide
- Member, Meritas Young Lawyer Advisory Board and Chair of Meritas Community Sub-Group
- Member, Nevada Commission on Ethics
- Board Director & Treasurer for the Redrock Little League
- Member, Sierra Club, PKD Foundation
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text:
MixSIH: a mixture model for single individual haplotyping
Selected articles from ISCB-Asia 2012
ISCB-Asia 2012
Haplotype information is useful for various genetic analyses, including genome-wide association studies. Determining haplotypes experimentally is difficult and there are several computational approaches that infer haplotypes from genomic data. Among such approaches, single individual haplotyping or haplotype assembly, which infers two haplotypes of an individual from aligned sequence fragments, has been attracting considerable attention. To avoid incorrect results in downstream analyses, it is important not only to assemble haplotypes as long as possible but also to provide means to extract highly reliable haplotype regions. Although there are several efficient algorithms for solving haplotype assembly, there are no efficient method that allow for extracting the regions assembled with high confidence.
We develop a probabilistic model, called MixSIH, for solving the haplotype assembly problem. The model has two mixture components representing two haplotypes. Based on the optimized model, a quality score is defined, which we call the 'minimum connectivity' (MC) score, for each segment in the haplotype assembly. Because existing accuracy measures for haplotype assembly are designed to compare the efficiency between the algorithms and are not suitable for evaluating the quality of the set of partially assembled haplotype segments, we develop an accuracy measure based on the pairwise consistency and evaluate the accuracy on the simulation and real data. By using the MC scores, our algorithm can extract highly accurate haplotype segments. We also show evidence that an existing experimental dataset contains chimeric read fragments derived from different haplotypes, which significantly degrade the quality of assembled haplotypes.
We develop a novel method for solving the haplotype assembly problem. We also define the quality score which is based on our model and indicates the accuracy of the haplotypes segments. In our evaluation, MixSIH has successfully extracted reliable haplotype segments. The C++ source code of MixSIH is available at
Human somatic cells are diploid and contain two homologous copies of chromosomes, each of which is derived from either paternal or maternal chromosomes. The two chromosomes differ at a number of loci and the most abundant type of variation is single nucleotide polymorphism (SNP). Most current research does not determine the chromosomal origin of the variations and uses only genotype information for the analyses. However, haplotype information is valuable for genome-wide association studies (GWAS)
Let us consider a simple example to demonstrate the importance of haplotype information. Suppose that in a gene coding region, there are two SNP loci, each of which has an independent deleterious mutation in either one of the two homologous chromosomes. If both of the two deleterious mutations are located on the same chromosome, the other chromosome can produce normal proteins. On the other hand, if each chromosome contains either one of the two deleterious mutations, the cells cannot produce normal proteins. It is not possible to distinguish these two cases with only genotype information.
There is a group of algorithms for haplotype inference that statistically construct a set of haplotypes from population genotypes
Another group of algorithms is single individual haplotyping (SIH) or haplotype assembly. These algorithms infer the two haplotypes of an individual from sequenced DNA fragments
Figure 1
An illustration of SIH
An illustration of SIH. An illustration of single individual haplotyping (SIH). The input data for SIH are the SNP fragments (B) which are extracted from the heterozygous alleles in aligned DNA fragments (A). SIH algorithms (C) reconstruct the original haplotypes (D) from the SNP fragments.
SIH algorithms did not attract much attention until recently, since the read fragments of next-generation sequencing experiments are not long enough to span multiple heterozygous loci, which exist at only one in one kilo-base on average
The haplotype information which contains errors is likely to lead to wrong results in downstream analyses. For example, in detecting the recombination events from the parent-offspring haplotypes
The algorithms for SIH are classified into two strategies; most of the previous algorithms use deterministic strategies
On the other hand, the probabilistic approaches of Kim
In this paper, we develop a novel probabilistic SIH model that is very different from the probabilistic models of Kim
Additional file 1
This file includes the explanation of our model, detail of the parameter optimization and some additional analyses.
Click here for file
Algorithms and implementation
Throughout the paper, we denote the number of elements of any set
The SIH problem takes a set of aligned SNP fragments
Mixture model
We model the probabilistic distribution of the observed fragments
where Θ represents a set of parameters defined later, Φ(
is the probability that we observe
We take
We explain the difference between our model and the models of Kim
The minimum connectivity score
As described above, the two haplotypes
Suppose that the probabilistic model is optimized for two segments of SNP sites between which there are no connecting fragments, then the association of the haplotypes {0, 1} to the true paternal and maternal chromosomes are selected at random for each segment. Even if there are several connecting fragments, the associations in each segment are determined almost randomly if the number of connecting fragments is not sufficient or there are many conflicting fragments. Such sites often cause switch errors. We define the connectivity at site
For each pair of sites (
We extract confidently assembled regions by selecting the pairs (
Variational bayesian inference
We use the VBEM algorithm to optimize the parameters Θ
In our model, the parameters often converge to sub-optimal solutions, because switch errors existing in the sub-optimal configurations are not removed by gradual parameter changes. Therefore, we apply a heuristic procedure that re-runs the VBEM several times with twisted parameter configurations after every convergence:
1. Do VBEM and calculate the connectivities for all the sites.
2. Do another VBEM with a parameter set Λ that is twisted at a site with low connectivity.
3. Repeat until convergence.
Here, the twist of hyperparameters Λ = {
Inferring haplotypes
We set
We select the phase
Possible extensions of the model
In this paper, we consider only the binary representation of heterozygous sites. We also constrain the error rate to be constant throughout the sequence. However, some of these constraints are easily removed. We can include homozygous sites and four nucleotide alleles by expanding the phase set Δ. For example, the phase set of a multi-allelic variant is represented like Δ = {(A,C),(A,G),(C,A),(C,G),(G,A),(G,C)}. We can even include small structural variations if they can be represented by additional allele symbols and the phase set of a structural variant is represented such as Δ1 = {(A,-),(-,A)} for indel and Δ2 = {("AC","ACAC"),("ACAC","AC")} for short tandem repeats. With these extensions, the accuracy of genotype calling of multi-allelic variants from sequencing data might be improved by considering haplotypes simultaneously
Datasets and data processing
Dataset generation
Simulation data were created through a strategy similar to the one reported by Geraci
For the real data, we used the dataset of Duitama's work
The normalized linkage disequilibrium
We compared our MixSIH software with ReFHap
For the comparison of the runtimes, we generated simulation data with
Accuracy measures
As described in the introduction, our algorithm is focusing on extracting the reliable haplotype regions. To examine whether we have succeeded in extracting the reliable haplotype regions, an accuracy measure which evaluates the quality of the piecewise haplotype regions is needed. However, existing accuracy measures are designed to compare the efficiency between the algorithms and are not suitable for evaluating the quality of the piecewise haplotype regions.
Let Φ(
Many previous papers used the Hamming distance to measure the quality of assembled haplotypes
where Φ0 represents a fully assembled haplotype prediction and
However, this definition is inconvenient because the minimization is applied for each segment and this accuracy measure can always be improved just by breaking a segment into smaller pieces at random positions.
The switch error rate
Figure 2
An illustration of pair consistency
An illustration of pair consistency. Consistency of pair sites. A. a. We assume that the two true haplotypes are the sequences of all 0 and all 1. b. Inferred haplotypes contain switch errors indicated by the arrows: (i) a consistent pair, (ii) an inconsistent pair, and (iii) if there are an uncontrolled number of switch errors between a pair, the probabilities of being consistent or inconsistent are both 0.5. B. The example of the case that switch error rate is not suitable to evaluate the quality of the segment. The consistency of a reconstructed haplotype which has single switch error in the middle (top) is high than a reconstructed haplotype which has single switch error located at an end of the segment, but switch error rate cannot distinguish these situations. Two contiguous switch errors, which are caused by sequencing error or genotyping error and do not disrupt the consistency between front and back parts, are regarded as twice of a single switch error in switch error rate (bottom).
Here, we propose another simple accuracy measure based on the pairwise consistency of the prediction with the true haplotypes. This pairwise consistency score is inspired by the
We define the total prediction space as follows. We consider a graph whose nodes are the set of all the heterozygous sites. We connect two nodes by an edge if there is a fragment spanning both the sites. We collect all the connected components with at least two nodes and consider each of the corresponding clusters of heterozygous sites as an independent segment. The total number of pairs is the sum of the numbers of all the pair sites over the segments. Although it is rare, there are cases in which some segments consist of noncontiguous heterozygous sites. For example, segment sets such as {(1, 4, 5), (2, 3)} and {(1, 3), (2, 4, 5)} may occur for the consecutive heterozygous sites (1, 2, 3, 4, 5). We define
A more detailed discussions of other accuracy measures is given in Additional file
Potential chimeric fragments
The processed sequence data derived from fosmid pool-based next-generation sequencing might contain chimeric fragments if a pool contains DNA fragments derived from the same region of different chromosomes and reads with different chromosomal origins are merged into a single SNP fragment. By using the trio-based haplotypes, we compute the 'chimerity' of each SNP fragment
Results and discussion
Comparison of pairwise accuracies
We examined whether MixSIH can extract the accurate haplotypes regions by using MC. Figure
Figure 3
Comparison of pairwise accuracies
Comparison of pairwise accuracies. Precision curves based on the consistent pair counts. The
Effects of potential chimeric fragments
Inspecting the switch errors in the prediction for the real dataset, we found that there are potential chimeric fragments that have a considerable effect on the pairwise accuracies. A chimeric fragment is defined as a fragment whose left and right parts match different chromosomes very well. Such fragments can occur in fosmid pool-based next-generation sequencing data. We show the chimerity distribution in Additional file
Figure 4
Effects of potential chimeric fragments
Effects of potential chimeric fragments. The precisions of the algorithms for the dataset in which fragments with chimerity greater than 10 are removed. For comparison, the precisions of MixSIH for the original dataset are also shown as diamonds.
These results suggest that more careful data processing to avoid spurious chimeric fragments is necessary to obtain high-quality haplotype assembly.
Incorporation of the trio-based data
Although the trio-based statistical phasing method can determine most of the phases of the sites, there still exist SNP sites whose phases cannot be determined by this method. SIH is capable of determining the phases which are not determined by the trio-based data, and we can obtain more complete haplotypes data by combining both of the SIH-based data and the trio-based data. To examine how many phases of the sites can be determined anew by combining both of the SIH-based data and the trio-based data, we devise a method that combines both information to determine the phases (see the Additional file
Spatial distribution of MC values
Figure 5
Spatial distribution of MC and LD
Spatial distribution of MC and LD. A. A colored density plot of the MC values and the number of fragments. The
Dependency of MC values on the fragment parameters
Figure 6
Dependency of MC values
Dependency of MC values. Dependency of the lowest MC value with precision
Optimality of inferred parameters
We use a heuristic method for parameter optimization to avoid sub-optimal solutions. To test whether the optimized parameters actually reach the global optimum, we compared the log likelihood of the optimized parameters with the approximate maximal log likelihood obtained by optimizing the parameters with an initial condition in which the optimal solution falls into the set of true haplotypes; we add one to the Dirichlet parameters for the true phase probability: that is,
Figure 7
Optimality of inferred parameters
Optimality of inferred parameters. Increase of log likelihood values for each iteration. The dotted line represents the approximate maximal log likelihood; the solid line, the changes of the optimized log likelihood for each twist operation; the broken line, the connectivity values at the positions that the optimizing parameters are twisted.
Comparison of running times
Figure 8
Running times
Running times. The running times of the tested algorithms. The
With advances in sequencing technologies and experimental techniques, single individual haplotyping (SIH) has become increasingly appealing for haplotype determination in recent years. In this paper, we have developed a probabilistic model for SIH (MixSIH) and defined the minimal connectivity (MC) score that can be used for extracting accurately assembled haplotype segments. We have introduced a new accuracy measure, based on the pairwise consistency of the inferred haplotypes, which is intuitive and easy to calculate but nevertheless avoids some of the problems of existing accuracy measures. By using the MC scores our algorithm can extract highly accurate haplotype segments. We have also found evidence that there are a small number of chimeric fragments in an existing dataset from fosmid pool-based next-generation sequencing, and these fragments considerably reduce the quality of the assembled haplotypes. Therefore, a better data processing method is necessary to avoid creating chimeric fragments.
Our program uses only read fragment data derived from an individual. However, it is expected that more powerful analyses could be made by combining SIH algorithms with statistical haplotype phasing methods that use population genotype data. An interesting possibility would be to construct a unified probabilistic model that infers the haplotypes on the basis of both kinds of data.
SIH: Single Individual Haplotyping; MC: Minimum connectivity.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
HM designed the probabilistic model, implemented the software, performed the analyses, and wrote the paper. HK contributed to develop the model, designed the experiments and wrote the paper. Both authors read and approved the final manuscript.
The authors thank their research group colleagues for assistance in this study. This study was supported by a Grant-in-Aid for Young Scientists (21700330), and a Grant-in-Aid for Scientific Research (A) (22240031). Computations were performed using the supercomputing facilities at the Human Genome Center, University of Tokyo. (
The publication costs for this article were funded by a Grant-in-Aid for Young Scientists (21700330), and a Grant-in-Aid for Scientific Research (A) (22240031).
This article has been published as part of
Evaluating associations of haplotypes with traits
A second generation human haplotype map of over 3.1 million SNPs
The importance of phase information for human genomics
Inference of haplotypes from PCR-amplified samples of diploid populations
Maximum-likelihood estimation of molecular haplotype frequencies in a diploid population
A new statistical method for haplotype reconstruction from population data
A comparison of bayesian methods for haplotype reconstruction from population genotype data
MaCH: using sequence and genotype data to estimate haplotypes and unobserved genotypes
Haplotype phasing: existing methods and new developments
An MCMC algorithm for haplotype assembly from whole-genome sequence data
HapCUT: an efficient and accurate algorithm for the haplotype assembly problem
Linear time probabilistic algorithms for the singular haplotype reconstruction problem from SNP fragments
Fosmid-based whole genome haplotyping of a HapMap trio child: evaluation of Single Individual Haplotyping techniques
Diploid genome reconstruction of Ciona intestinalis and comparative analysis with Ciona savignyi
The diploid genome sequence of an individual human
Haplotype reconstruction from SNP alignment
Fast Hare: a fast heuristic for single individual SNP haplotype reconstruction
A map of human genome variation from population-scale sequencing
Real-time DNA sequencing from single polymerase molecules
Haplotype-resolved genome sequencing of a Gujarati Indian individual
A comprehensively molecular haplotype-resolved genome of a European individual
High-resolution mapping of crossovers reveals extensive variation in fine-scale recombination patterns among humans
Calling amplified haplotypes in next generation tumor sequence data
Noninvasive whole-genome sequencing of a human fetus
The structure of haplotype blocks in the human genome
A dynamic programming algorithm for haplotype block partitioning
Finding haplotype block boundaries by using the minimum-description-length principle
Reducibility among combinatorial problems
Inferring parameters and structure of latent variable models by variational Bayes
Genotype calling from next-generation sequencing data using haplotype information of reads
A comparison of several algorithms for the single individual SNP haplotyping reconstruction problem


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Smith & Wesson M&P SHIELD No Thumb Safety 9mm 3" 10035
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text:
Tskitishvili looks like next European prodigy
By Bob Kravitz, The Indianapolis Star
TREVISO, Italy They say Nickoloz Tskitishvili is
Europe's next great player.
They say he is the next Pau Gasol, the next foreign basketball
prodigy to set NBA scouts to salivating. His potential is so limitless, his
skills so alluring, there is talk he could be a top 10 NBA pick next month despite
the fact he almost never gets off the bench for his Italian League team, Benetton
As he waited to take the court for a recent practice, though,
Tskitishvili wasn't concerned with his draft prospects or the brave new world
that could await the precocious 19-year-old, 7-footer from the tiny Republic
of Georgia.
He wanted to know about America, a place he has only seen
on television in his parents' home in the Georgian capital of Tbilisi.
Tskitishvili (pronounced Skits-iss-villee) has a limited
English vocabulary, but his unquenchable curiosity translated readily.
"Tell me, what is America like?" he asked.
A visitor started to answer, and then there was another
question. This was an interview, all right. Except the athlete was asking the
reporter the questions.
"What do they eat there?"
He was told Americans eat Italian food, and Greek, and
Mexican, that America is a melting pot of people and tastes.
Tskitishvili looked confused. "And what about hamburgers?"
he wondered. "Lots of hamburgers, yes?"
Lots of hamburgers, he was told.
He smiled. "I cook a little," he said proudly. "Potatoes.
Eggs. And I make very good hinkali (a Georgian dish of ground beef or pork and
onions inside a shell of dough). You should try. Very good."
Come to America, he was told, and there will be an international
exchange. He will eat a hamburger. An American will eat hinkali.
"Maybe I'll come soon to America," Tskitishvili said with
a smile.
Maybe very soon.
Earlier this week, he was among a long list of underage
college, high school and foreign players who made themselves eligible for this
year's NBA draft. Like so many others, though, Tskitishvili is keeping his options
open. If he gets some guarantee he will be a top 10 pick this year, he will
come out. If he isn't sure, he will withdraw his name by the June 19 deadline
and try again next summer when he is almost sure to be a top 10 pick.
For a raw, young talent viewed as Europe's next great import,
it's just a matter of time.
Here, though, is the most remarkable part of the Tskitishvili
He almost never plays.
He is one of the hottest and most exciting young talents
in the world, a kid with so much potential, there is talk the Phoenix Suns covet
him with the ninth choice in this summer's draft. And yet he sits near the end
of the Benetton Treviso bench.
Think that says something about the state of NBA drafting?
Think that says something about the ascent of international players?
"He doesn't play because he came to us late (because of
problems acquiring his rights) and our (Benetton) team was set up before he
got here," said his coach Mike D'Antoni, a former NBA coach. "If he comes back,
we'll build around him and he'll get 20-25 minutes a game."
Then D'Antoni smiled.
"I've got a clip of him at home I show people," he said.
"He can do some things. He's a Gasol type with better outside shooting."
International scouting
So how do NBA people know about this kid with the Sidd
Finch-ian aura? They watch him practice. For all the excitement that attended
the recent Final Four in Bologna, Italy, one of the most important events for
NBA people and we're talking about general managers, not just European
scouts came during Benetton Treviso's practices.
What they saw was talent: raw, but tantalizing talent.
He's 7 feet and still growing, but he's viewed as a forward, a player who can
handle the ball on the perimeter, run the floor and shoot from the outside.
"I look up in the stands (during practice) and see (Houston
head coach) Rudy Tomjanovich," Tskitishvili said excitedly. "I only see Tomjanovich
on TV, but now I see him and meet him in life. It's so amazing."
Recent history tells NBA people they shouldn't get too
caught up in playing time and the quality of competition. Dirk Nowitzki played
in a midlevel European league before he was drafted by Dallas. Gasol was a middling,
12-point-per-game scorer in Europe before he took the NBA by storm.
"That's how the draft is now," said Indiana Pacers president
Donnie Walsh. "It's a leap of faith. A lot of people think (Tskitishvili) has
a great all-around game, but nobody has really seen him play against top competition
for an extended period of time."
Walsh quickly added, though, that Jonathan Bender was the
same kind of risk. Very young, very raw, very talented.
So, Walsh was asked, would he consider Tskitishvili at
No. 14?
The Pacers president said he would, but quickly added it's
unlikely the team will have that option. If Tskitishvili doesn't have an assurance
he's going top 10, he's withdrawing his name from draft consideration.
That's not an easy call for a young man from his background
just as it's a tough call for so many young American players who come
from poor circumstances.
Economic concerns
The Republic of Georgia, which is located on the Black
Sea north of Turkey and south of Russia, once was a semi-prosperous part of
the Soviet Union. It was a vacation spot and an area famed for its wine making.
Independence, though, has not been kind. The economy is a shambles, unemployment
is high, the infrastructure is crumbling and expatriates complain that power
outages are the rule rather than the exception.
Tskitishvili knows the money he will make as a mid-first-round
pick could change both his and his family's life immediately. But there are
other considerations that make the top-10-or-bust approach more sensible.
He has a sizable buyout in his Italian League contract,
and an NBA team can only pay $350,000 toward that buyout. The rest would come
out of the player's first-year paycheck. If Tskitishvili went lower than 10th,
he wouldn't have a whole lot of money left over.
A top 10 deal, though, gives him buyout money and plenty
left over for hinkali and life's other pleasures.
In theory, he could take the money that comes with going
at, say, No. 15, return to Treviso and change a lot of lives. The risk, though,
comes if he develops into a star next season and sets himself up as a top 5-caliber
player. Then he would be a top-5 talent making No. 15 money. That's a lot of
cash in any country.
"I know God doesn't give you many chances," Tskitishvili
said. "In my country, people have no money, only the Mafia has money. It is
a risk if I wait because maybe I get injured or my play goes down, but I have
to be smart."
But enough about basketball.
The next Pau Gasol asked a few more questions about America,
then began practicing. At that moment, he seemed a million miles away from an
NBA court. But a month from now, an NBA team might call his name out near the
top of the draft list. And then he will be a very tall, very unlikely millionaire.
Buys a lot of hamburgers, doesn't it?


text:
He's another prospect flying under the radar and is still awaiting his first offer. He's interested in several instate schools, but is hoping to get a serious look from Tallahassee soon.
"I haven't had much contact with Florida State yet, but I'm hoping I can show them I'm worth the offer. I like the school, and the team is on the rise," Cunningham stated.
In order to get FSU's attention Neally is putting in the extra time this off season, both in the weight room and doing several camps.
"My off season plans are to get better in the weight room first off. I will be attending a few camps, hopefully FSU's, and my team looking to participate in 7on7 tournaments this summer as well," he said.
Cunningham said he's unsure about when he's planning on making his college choice, but doesn't rule out an early commitment if he feels right.
"I will commit when I feel I'm ready, once the offers come in I'm going to really have to sort everything out. I've got a 2.6 GPA right now and I'm taking the ACT this spring. I have signed up for the SAT yet, but I plan to do so pretty soon. I know if I get my grades right that'll help me with my offers," Cunningham replied.
Last season Neally finished with 32 receptions for 559 yards and nine touchdowns, coupled 13 rushes for 93 yards with three scores as a dual threat on offense.


text:
Jerome Bernard "Jerry" Orbach (October 20, 1935 – December 28, 2004) was an American actor and singer, well known for his starring role as Detective Lennie Briscoe in the Law & Order television series and as the voice of Lumière in Disney's Beauty and the Beast, as well as for being a noted musical theatre star; most notably Chuck Baxter in the original production of Promises, Promises, Julian Marsh in 42nd Street, and Billy Flynn in the original production of Chicago.
He appeared as Dr. Jake Houseman, Baby's father, in the realistic ending to Dirty Dancing in "Padre de Familia", and as Det. Briscoe in an episode of Law & Order in "FOX-y Lady". Both times, Orbach's characters were voiced by Mark DeCarlo.


text:
The children of Sydney escort Madison Ashton have filed a cross-claim in her legal battle to secure part of the estate of billionaire Richard Pratt, arguing their mother may not "properly represent" their interests.
Ms Ashton has long claimed that when she became Mr Pratt's mistress in the early 2000s he promised to "look after" her and her children. In the years since his death she has fought to have that promise enforced by the courts.
Her claim was based on a series of conversations she had with Mr Pratt in late 2003, during which the pair allegedly reached a "business agreement" whereby she would abandon her escort business and act as his mistress whenever, and wherever, he wanted.
In return, she would be given a $5 million trust for her two children, an allowance of $500,000 a year, $36,000 a year for accommodation and $30,000 a year for travel expenses.
Her initial court action failed, with Justice Paul Brereton finding in the Supreme Court that while these conversations probably took place, they did not amount to a legally binding contract.
Justice Brereton also found that on separate occasions in February and November 2005 - when her relationship with Mr Pratt was effectively over - Ms Ashton accepted termination payments of $100,000 and $50,000.
Despite owing the Pratt estate tens of thousands of dollars in legal costs, Ms Ashton has now taken the case to the Court of Appeal, arguing that Justice Brereton erred in finding that Ms Ashton and Mr Pratt had properly entered into the 2005 deals.
Last week there was another twist in the soap opera-like saga, when Ms Ashton's children sought to appear in the case as cross claimants.
Indra Heslop-Blochowiak, 15, and Xavier Connor Heslop-Kelly, 12, have joined their mother in claiming that Mr Pratt's original "promises" should be enforced.
However they also claim that, in relation to the $5 million trust, "the interests of the children may not be properly represented by Ms Ashton".
A written judgement allowing the children to join the case reveals that the children will claim that, in accepting money from Mr Pratt in 2005, the escort breached her fiduciary duty to them.
They claim that, thus, if this agreement were made, it should not affect Pratt's promise to provide them with both with $2.5 million trust funds.
Interestingly, the children are being formally represented by Liam Kelly – Xavier's father and Indra's stepfather - who is acting as their tutor in the case because they are under 18.
In their reasons for judgment, the appeal judges noted that Mr Kelly is Ms Ashton's partner.
Lawyers representing the Pratt Estate, largely controlled by his wife, Jeanne Pratt, opposed the children joining the appeal as cross claimants.
But the judges upheld their application, finding that the children's "rights and liabilities" would be directly affected by the court's eventual findings on the appeal.


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The Sustainable Finance Toolkit, structured around existing credit processes and integrating substantial input from a number of other leading Equator banks, aims to help banks implement robust environmental and social risk management approaches which are also consistent with the Equator Principles and international good practice.
The Toolkit supports consistent, efficient and comprehensive decision-making at key points in the project engagement and risk management cycle, enabling key staff to rapidly diagnose environmental and social risks in projects and to manage those risks through the systematic application of the Equator Principles policies, guidelines and processes. The outcomes, when effectively applied, will be:
- Consistent identification and management of environmental and social risks in the project finance and risk management process;
- Increased security of deal flow;
- Reduced credit, legal and reputational risk;
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To go directly to the Sustainable Finance Toolkit, click here.