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This study investigates geographic variation in chemotherapy utilization for ovarian cancer in both absolute and relative terms and examines area characteristics associated with this variation.
Surveillance, Epidemiology, and End Results (SEER) Medicare data from 1990 to 2001 for Medicare patients over 65 with a diagnosis of ovarian cancer between 1990 and 1999. Chemotherapy within a year of diagnosis was identified by Medicare billing codes. The hospital referral region (HRR) represents the geographic unit of analysis.
A logit model predicting the probability of receiving chemotherapy by each of the 39 HRRs. Control variables included medical characteristics (patient age, stage, year of diagnosis, and comorbidities) and socioeconomic characteristics (race, income, and education). The variation among HRRs was tested by the χ2 statistic, and the relative contribution was measured by the ω statistic. HHR market characteristic are then used to explain HRR-level variation.
The average chemotherapy rate was 56.6 percent, with a range by HRR from 33 percent to 67 percent. There were large and significant differences in chemotherapy use between HRRs, reflected by a χ2 for HRR of 146 (df=38, p<.001). HRR-level variation in chemotherapy use can be partially explained by higher chemotherapy rates in HRRs with a higher percentage of hospitals with oncology services. However, an ω analysis indicates that, by about 15 to one, the variation between patients in use of chemotherapy reflects variations in patient characteristics rather than unexplained variation among HRRs.
While absolute levels of chemotherapy variation between geographic areas are large and statistically significant, this analysis suggests that the role of geography in determining who gets chemotherapy is small relative to individual medical characteristics. Nevertheless, while variation by medical characteristics can be medically justified, the same cannot be said for geographic variation. Our finding that density of oncology hospitals predicts chemotherapy use suggests that provider supply is positively correlated with geographic variation.
Each year in the United States, 24,000 women are newly diagnosed with ovarian cancer and over 14,000 die of the disease (American Cancer Society 2004). Ovarian cancer is the fifth most common and fourth most deadly malignancy in U.S. women. While overall 1-year survival of patients with newly diagnosed ovarian cancer is 80 percent, survival varies greatly by age and cancer stage (SEER 2000). Nearly 50 percent of diagnosed cases occur in women over age 65 (Yancik et al. 1986). Chemotherapy is recommended for all women with ovarian cancer except those with ovary-limited disease that is well or moderately histologically differentiated (McGuire et al. 1996; McGuire and Ozols 1998).
Ovarian cancer treatment has changed greatly in the past decade. Survival has improved with the introduction of platinum agents and the use of platinum/paclitaxel regimens (Neijt 1996). However, chemotherapy use still varies significantly (Ries 1993; Devesa, Grauman, and Blot 1994; Hightower et al. 1994; Sundararajan et al. 2002). Little is known about which nonclinical factors determine these treatment variations. One study found a lower rate of chemotherapy for ovarian cancer among black patients (Sundararajan et al. 2002) which suggests that nonmedical factors, including sociodemographic characteristics and geography, may play a role. The absolute and relative contribution of these factors is unknown.
While geographic variation in chemotherapy has received minimal attention (Earle, Venditti, and Neumann 2000), many have identified geographic differences in cancer treatment (Farrow, Hunt, and Samet 1992; Lu-Yao and Greenberg 1994; Lai et al. 2001; Baxter et al. 2004). No studies have assessed the relative importance of geography as a driver of treatment decisions compared with individual medical factors. Further, the factors responsible for the geographic variation are still uncertain.
We sought to evaluate chemotherapy use among elderly patients with ovarian cancer to parse out the relative and absolute contribution of geography as a determinant of chemotherapy. Using Surveillance, Epidemiology, and End Results (SEER) Medicare data and hospital referral regions (HRRs) as the geographic unit, we explored the role of geography relative to the medical factors of stage and age, and the non-medical factors of race, education, and income. We also explored the role of market characteristics of a geographic area as a predictor of area variation.
We studied patients from the 11 tumor registries that participated in the SEER program of the National Cancer Institute between 1990 and 1999. About 97 percent of the incident cases of cancer diagnosed in the registry regions were captured (Zippin, Lum, and Hankey 1995). The SEER sites, covering 14 percent of the U.S. population (Ries et al. 1997), are representative of the U.S. population (Nattinger, McAuliffe, and Schapira 1997). The SEER records include stage, histology, date of diagnosis and death, and patient sociodemographic characteristics. Medicare claims through 2001 were linked to SEER cases with a 94 percent match rate (Potosky et al. 1993).
We studied Medicare patients who were older than 65 and had an ovarian cancer diagnosis between 1990 and 1999 in the SEER registries (N =10,986). We excluded the following: women enrolled in a Medicare health maintenance organization (HMO) at baseline (n =1,778) (because complete treatment information is unavailable); women who died in the first 30 days (n =811) (because they had insufficient opportunity to receive chemotherapy); patients in HRRs with fewer than 20 patients (n =404) (to remove those referred to SEER sites from outside the defined region); and patients missing key descriptive data (n =15). The final sample size was 7,978.
We used Medicare billing codes from Medicare claims to identify chemotherapy within a year of diagnosis. Postsurgery chemotherapy was identified by service codes in inpatient, outpatient, and physician part B files: International Classification of Diseases, 9th revision (ICD-9), procedure codes for therapy (99.25); Healthcare Common Procedure Coding System (HCPCS) codes 964xx, 965xx and Common Procedural Terminology (CPT) codes 36640 and 36260 for chemotherapy administration; and HCPCS codes for ovarian cancer-specific chemotherapy drugs (J8999–J9999 and Q0163–Q0185).
We modeled comorbidity severity using a pool of potential variables (Elixhauser et al. 1998; Silber et al. 2001). We coded 47 comorbidities using ICD-9 diagnostic codes recorded 90 days before each patient's ovarian cancer diagnosis on the Medicare portion of the SEER/Medicare file. We used SEER to obtain other disease characteristics (e.g., stage, age, and date of diagnosis) and race/ethnicity. Other socioeconomic characteristics (median per capita income and education attainment) were based on links between patients' census tracts and the 1990 Census (Krieger 1992).
The geographic unit of this analysis was the patient's HRR, a geographic area defined by The Dartmouth Atlas of Health Care (Wennberg et al. 1998). It represents a regional health care market for tertiary medical care. The SEER site comprises both metropolitan regions (San Francisco/Oakland, Detroit, Seattle/Puget Sound, Atlanta, San Jose/Monterey, and Los Angeles) and entire states (Connecticut, Hawaii, Iowa, New Mexico, and Utah). The use of HRRs allowed for comparably scaled geographies and alignment of residence with the likely area of receipt of health care services. There are 306 hospital referral regions in the United States and 39 HRRs in SEER.
We also linked health system characteristics of the HRR, such as HMO penetration, density, oncologists per MD, percentage of hospitals with an oncology facility, percentage of teaching hospitals used by SEER patients, MDs, and hospitals from the Area Resource File of the Federal Bureau of Health Professions. We chose these HRR characteristics on the basis of literature about the determinants of health care supply and demand in a health care market. We used the HRR density characteristic because demand is typically higher when travel distances are shorter (Goodman et al. 1997). We used the number of hospitals, MDs, oncologists per MD, and percentage of hospitals with oncology facilities because demand increases when more facilities are available (Ginsburg and Koretz 1983; Rohrer 1990; Roemer 1991; Brown and Barnett 1992). We used both the number of hospitals and MDs and the more chemotherapy-relevant measure of percentage of hospitals with oncology facilities and percentage of oncologists. We also included HMO penetration because although these are Medicare fee-for-service patients, some reports support spillovers to non-HMO patients in areas with higher HMO penetration (Baker 1997).
The first analysis assessed determinants of chemotherapy variation and established whether geography is a significant determinant. The second analysis identified area characteristics associated with geographic variation in chemotherapy use. Both analyses assessed the relative contribution of various factors to variation in chemotherapy use via the omega (ω) statistic (Silber, Rosenbaum, and Ross 1995).
The first analysis evaluated variation in chemotherapy rates by HRR using logistic regression with HRR fixed effects. We performed four regressions. The first contained only the fixed effects so that the raw variation between HRRs could be measured. The second added disease-specific characteristics (stage, age, comorbidities, and time) to assess the contribution of these characteristics to chemotherapy use and to assess their contribution relative to geographic area. The third added sociodemographic characteristics (race, education, and income). The fourth removed income and education to parse out the relationship between race and socioeconomic status (SES) as a determinant of chemotherapy use. In the second analysis we replaced the HRR indicator variables with HRR characteristics (HMO penetration, density, oncologists per MD, percentage of hospitals with an oncology facility, and population). We used the robust estimator of variance assuming correlation among observations within HRRs but independence between them (White 1980).
We then repeated the first analysis separately for patients diagnosed between 1990 and 1995 and those diagnosed between 1996 and 1999. The stratified analysis permits investigation of how HRR variation changed from the "pre" time period (1990–1995), when knowledge of effective chemotherapy for ovarian cancer was sparse, to the "post" time period (1996–1999), when effective treatment became widely adopted following the January 1996 report of McGuire et al. demonstrating improved outcomes after paclitaxel chemotherapy for advanced ovarian cancer. We hypothesized that HRR variation would be greater before the demonstration of effective treatment.
The extent to which the set of HRRs or HRR characteristics contribute to chemotherapy variation was tested by the likelihood ratio χ2 test for the set of variables. The contribution of individual medical, socioeconomic, or HRR characteristics was measured by their odds ratio (OR). These effects were identified as statistically significant at a two-sided p-value of .05.
An ω analysis (Silber, Rosenbaum, and Ross 1995) can be used to measure the relative contribution toward the explanation of variation among different sets of variables. Here we used ω to measure the relative contribution of the set of HRRs (or HRR characteristics) compared with the set of disease and sociodemographic characteristics in explaining variation in chemotherapy use.
More formally, ω measures the relative contribution of the x's and the z's to predicting B where, for example, x1, …, xj describe patient characteristics; z1, …, zk describe HRR characteristics; and B is the binary outcome of chemotherapy use for patient i. (For notational convenience, x1, …, xj and z1, …, zk were centered by subtracting their means.) If
where and then
Each patient i has a πi and a Θ and fitting the logit model yields estimates of these quantities. The distribution of π and Θ is displayed in the left panel of Figure 1 on a log scale to the base of 2. If ω =0, all the variation between HRRs in chemotherapy use is predicted by characteristics of patients in the HRRs. If ω =1, the HRR characteristics predict as much variation in chemotherapy use as do patient characteristics.
Although ω describes variation among patients, it is often of interest to describe the variation among groups of patients, for example the variation among HRRs. For this analysis, one examines the average πi in an HRR and the average Θi in an HRR. , the HRR-level ω (Silber, Rosenbaum, and Ross 1995), is computed from these averages. Each HRR j has and . Fitting the logit model yields estimates of these quantities (Figure 1 shows the distribution of and ).
Table 1 shows the patient characteristics. Most patients had stage 3 or 4 ovarian cancer. Most (49 percent) were in their 70s, 27 percent were 80 or older; and 24 percent were 65–69. Patients were fairly evenly distributed across SEER sites. The chemotherapy rates by HRR ranged from 33 percent in Des Moines, Iowa, to 63–67 percent in the HRRs representing the cities of Everett, Seattle, and Olympia in Washington. The average rate of chemotherapy use was 56.6 percent. This is lower than other published rates for this population (Sundararajan et al. 2002) because we excluded patients who died within 30 days rather than 120 days.
Table 2 displays results of the four logistic regression models. In Model [1], with HRR indicators only, geographic variation was a highly significant predictor of chemotherapy variation (χ2=146; df=38; p-value<.0001). In Model [2], when disease characteristics, risk factors, and time trend are added, geographic variation became a more significant predictor (χ2=168; df=38; p-value<.0001). In Model [3], with the addition of individual socioeconomic characteristics, the significance of geographic variation was slightly reduced (χ2=149; df=38; p-value<.0001).
Disease and risk characteristics were strong predictors of chemotherapy use. Patients with stage 3 disease had the highest odds of chemotherapy use and those with stage 1 disease had the lowest. The odds of receiving chemotherapy declined with age. Comorbidities, as a group, were highly significant determinants of chemotherapy use. A positive time trend was observed between 1990 and 1999 (annual odds, 1.04); chemotherapy use was increasing over this period.
Black patients had lower odds than white patients, and odds increased with income. When income and education were removed from the model (Model [3b]), the OR for black patients dropped to 0.48 from 0.66 and became more strongly significant, suggesting that the lower average income among black patients partially explains lower rates of chemotherapy in this group.
To better explain the factors that contribute to geographic variation, we replaced the 38 HRR indicators with seven HRR characteristics in the logistic regression. Table 3 displays the chemotherapy use ORs for these characteristics. Areas of higher population density tended to have lower chemotherapy rates (OR=0.82; p-value=.111). The number of hospitals was strongly correlated with chemotherapy use (OR=1.00 for a one-hospital change; p-value=.001), as was the percentage of hospitals with oncology facilities (OR=2.49 for a change from 0 percent to 100 percent; p-value<.001). However, the density of teaching hospitals in HRRs and the other selected HRR characteristics were not associated with chemotherapy use.
Table 4 summarizes the strongly significant absolute contribution of HRRs toward variation in chemotherapy use and reports on the relative contribution of HRRs via ω (with its 95 percent confidence interval). In comparing one patient with another, most variation in chemotherapy use between patients is predicted by variations in medical characteristics rather than unexplained variations among HRRs; indeed, the estimated ω of 0.066 in Model [3] suggests patient health contributes 15 times (1/0.066) more than variations among HRRs. However, in comparing one HRR with another, this situation is reversed: variations in average patient medical characteristics contribute little to the variation in average chemotherapy use among HRRs; indeed, the estimated (i.e., ω at the HRR level) of 6.19 in Model [3] says HRR indicators are six times more important than average patient medical characteristics at predicting variation among HRRs. These two very different stories result from the fact that while there are enormous variations from patient's medical characteristics within each HRR, these variations tend to average out for comparisons between HRRs.
In Model [3], the ω for SES versus medical (0.041) suggests a minor marginal contribution of SES. However, whether typical chemotherapy rates by HRR can be explained by typical medical risks or by typical SES of the population in that HRR requires an evaluation of . From this perspective, SES variation is 0.88 times as important as medical variation or 20 times the 0.041 value for ω Thus, while SES plays a relatively minor role in explaining variation in chemotherapy use among individual patients, it does play a relatively large role in explaining variation in chemotherapy use among regions.
Figure 1 summarizes the ω story with boxplots of the Θi's and πi's. The ratio of ΣσΘ2 and Σζπ2 forms ω and . The left panel describes individual patients and the right, HRRs (i.e., averages over all patients in an HRR). See "Methods" for details. For instance, the boxplots labeled "med" refer to variables that describe patients' medical condition. Although medical variables are important to the treatment of individual patients (the "med" boxplot in the patient-based panel), most of this variation averages out within HRRs; thus, variation in the average health of patients in HRRs contributes little to variations among treatment between HRRs.
Finally, Table 5 summarizes the stratified analysis by diagnosis date. Variation by HRR was reduced in the "post" period with adoption of effective treatments for ovarian cancer, shown by the lower χ2 (127 in the "pre" period and 63 in the "post" period) and by the ω of HRR relative to medical characteristics. The HRR versus medical ω in the "post" period (0.069) was 75 percent of the ω in the "pre" period (0.093).
Our study indicates that 56 percent of patients with newly diagnosed ovarian cancer over age 65 received chemotherapy within 1 year of diagnosis. As expected, medical factors were the primary determinant of this chemotherapy use. Race, income, and geographic location also were significant in predicting chemotherapy use, although far less so than medical characteristics.
The role of stage, age, and comorbidities in the choice to administer chemotherapy is well known. Chemotherapy is not a primary therapy for stage 1 ovarian cancer but is increasingly recommended for stages 2 and 3 (Chen and Berek 2001). The odds of chemotherapy use by stage estimated here reflect these recommendations. A decreased likelihood of chemotherapy as patients' age has been shown for ovarian cancer (Sundararajan et al. 2002) and other cancers (Greenfield et al. 1987; Ries 1993; Hightower et al. 1994; Hillner et al. 1996). That comorbidities typically reduce the odds of chemotherapy use has been shown elsewhere (Desch et al. 1996; Extermann et al. 1998; Earle, Venditti, and Neumann 2000). These factors are often related to the probability of tolerance or complications of chemotherapy. Finally, time trend has been grouped with medical factors to account for changes in practice patterns and technology. Chemotherapy use increased in the 1990s, consistent with the growing application of new chemotherapy technologies (Chen and Berek 2001).
Less understood is the role of geography (Wennberg and Gittelsohn 1973) and SES (Bradley, Given, and Roberts 2002; Madison et al. 2004) in determining treatment rates. Consistent with the literature, we found a robust, statistically significant relationship between geography and chemotherapy use. This relationship was slightly stronger after adjustment for medical factors and was slightly weaker after adjustment for socioeconomic factors. SES was also important: being black or poor was correlated with lower rates of chemotherapy for ovarian cancer. A previous paper found lower chemotherapy rates for ovarian cancer in Hispanic but not black patients (Sundararajan et al. 2002). The lower rates for black patients are consistent with findings in lung and colorectal cancers (Shavers and Brown 2002).
Although HRRs were a strongly significant determinant of chemotherapy use, their influence was small relative to that of medical characteristics. Figure 1 best describes this finding. Studies of determinants of use typically do not separate the contribution of the various factors toward the variation between patients or between regions. The ω statistic provides this perspective. The ω of 0.066 between HRRs and medical characteristics (Table 4, Model [3]) suggests that characteristics of individual patients are 15 times more important than HRRs in predicting which patients will receive chemotherapy. If medical characteristics are the determinants of use at the patient–physician encounter and HRR is a marker for where that encounter occurs, this suggests that, to the degree that chemotherapy use can be explained, it is mostly determined at the patient–physician level. The HRR in which the patient lives does not seem to be a determinant, a somewhat reassuring finding.
The systematic variation among regions that does exist may still offer opportunities for improving practice, even if dwarfed by patient-level factors. This is most dramatically demonstrated in the stratified analysis by time. Practice improvements due to use of paclitaxel led to a remarkable reduction in HRR variation. Other opportunities to improve practice through market factors may also exist. We found that more hospitals with oncology facilities in a market predicted greater use of chemotherapy. It is unclear whether oncology providers induce excess use of chemotherapy or whether the lack of oncology facilities in a market leads to underuse. However, the manner in which health systems are organized clearly influences the probability that patients residing in those systems will receive treatment—but again, these effects are small when compared with seemingly appropriate medical considerations.
In addition, the HRR level of variation in SES relative to medical variation has an of 0.40, while the same ω at the patient level was 0.04. Taken together, these data suggest that an individual's SES contributes little to the odds of receiving chemotherapy in ovarian cancer, but patients in higher-SES regions are more likely to receive chemotherapy than patients in lower-SES regions. The small role of individual SES may be partially explained by the fact that all patients studied had Medicare coverage for treatment. However, these patients may still have differences in supplemental coverage which could still play a role in chemotherapy use. A region's average SES predicts the degree of intensive treatment in the HRR. A region's market characteristics also appear to matter. However, the largest part of the variation remains unexplained.
Our study had several limitations. First, the findings for the Medicare non-HMO patients may not be generalizable to all elderly patients or all patients with ovarian cancer. Similarly, the SEER sites are not entirely representative of the U.S. population. Finally, our use of the HRR may not completely reflect the region by which health care delivery decisions are made. In some areas, a narrower or wider geographic definition may be more appropriate.
The factors influencing the decision to administer chemotherapy are generally based on appropriate variables. One could argue that all the variation in chemotherapy use should be explained by patient's medical factors and not by the patient's geographic region. However, this may be unrealistic. The policy question may be what amount of variation across regions is acceptable. We are reassured that racial and SES disparities inside the HRR do not seem to be great. However, the SES of the HRR does slightly influence decision making, which raises equity concerns.
As for the effects of oncologist providers on the practice of receiving chemotherapy, why should the accessibility of a hospital with oncology facilities influence the chance of receiving chemotherapy? On the surface, this implies that oversupply drives demand or that insufficient supply leaves some without needed chemotherapy. However, if this finding denotes a relationship between MD/oncologists and other regional variables not fully defined, then physician- or hospital supply-driven demand may not be the only explanation. Whatever the reason, it remains reassuring that this effect is small compared with the influence of medical characteristics.
This paper was supported by NCI Grant #R01-CA095664 (J. H. S.) and NSF Grant SES-0345113 (P. R. R.). This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. Tha authors acknowledge the effort of the Applied Research Program, NCI; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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The History:
Formed in 1924 as Gebrüder Dassler Schuhfabrik by Adolf and Rudolf Dassler, relationships between the two brothers deteriorated until the two agreed to split in 1948, forming two separate entities, Adidas and Puma..
Following the split from his brother, Rudolf Dassler originally registered the new-established company as Ruda, but later changed to Puma. Puma's earliest logo consisted of a square and beast jumping through a D, which was registered, along with the company's name, in 1948.
Puma's shoe designs feature the distinctive "Formstripe" with clothing and other products having the logo printed on them.The company is known for its football shoes and has sponsored acclaimed footballers, including Pelé, Eusébio, Johan Cruijff, Enzo Francescoli, Diego Maradona, Lothar Matthäus, Kenny Dalglish, Didier Deschamps and Gianluigi Buffon. Introduced back in 1968, the Puma Roma 68 was designed to honour the National Italian Football Team winning the European Cup in 1968. Whew!Whats on the menu for Spring?
As ever, Spring is an ideal time to shop around for new shoes..... Puma Roma 68 is one of those styles to satisfy your passion of great quality footwear and is this seasons must have kick of all the sneaker connoisseurs everywhere! The Roma 68 - a true treasure from the Puma Archive. Ideal for easy running and leisure activities. This sneakers design is a great representation of the iconic character. Even the colors and material AND it all began at a time when people in extreme cases had to wear dull, conforming shoes. SO Vintage is in! Come and get the sneaker that embodies it! Come on guys, get acquainted!
Anyways, hope you all are having a great day whether you're at home, work, dreaming of the weekend on the footie terraces or just out with the lads... for us Pumatalking it's all the same! Have a great day!
•This vintage design is now available in Blue
•Suede toe cap
•Rubber herringbone design sole
•Logo patch at the back
•Lace up type
•Logo brand patch on the tongue
•Rubber mud guard and leather upper
Cool material combination: Smooth leather upper with suede PUMA formstrip.
Front with T-Toe and raised rubber sole. Gives the Roma extra stability.
With PUMA Archive logo.

subset: commoncrawl


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LONDON, March 21 (Reuters) - Stemcor has secured a new $1.15 billion syndicated loan that the UK-based steel trader expects will breath new life into its trading activity, which fell sharply after the company defaulted on an $850 million loan last year.
The loan comes after the privately owned firm won UK court approval last month to restructure its billion dollar debt and borrow the extra funds up to December 2015.
Stemcor's lenders include ABN AMRO, HSBC, ING, Natixis and Societe Generale.
Like many steel firms, Stemcor was hit hard by the global financial crisis, and remains under pressure to sell its iron ore assets in India in order to repay its more than $1 billion debts.
Regarding the recent loan, Stemcor said it has been provided on a committed basis, whereby banks sign contracts to provide funding for a period and so can not withdraw it during that time.
"Thanks to the overwhelming support of our banks, we now have a strong platform from which we can increase our trading capability. Today represents a major turning point for Stemcor," said chief executive Julian Verden in a statement. (Reporting by Maytaal Angel; Editing by Elaine Hardcastle)


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I have released the beta of DTank, a non-destructive image manipulation system. It's free; if it sounds interesting, by all means check it out.
A new SW station is presently running test transmissions between 11:00 – 14:00 UTC. The transmitter is located near Perth, Western Australia, on 5,045 kHz, and is running 75 watts (300 PEP.) You can send listener reports to firstname.lastname@example.com.
At present, the station is ghosting the audio from sister station http://www.77400.fm/, so you can use that to confirm what you're hearing.
It'll likely be a tough catch here in the USA, but that's the fun of it!
We can (if we are honest) observe that progress, and the potential it unleashes in many cases, is not all that closely linked with what's commercially available or common around the time of the fundamental invention. In the first decade after lasers were invented, for instance, there was no significant commercial application. When the integrated circuit was invented, it wasn't much to look at and functionally speaking, for decades, it was outright pitiful compared to ICs today. We're still dealing with developing a full understanding of how neurons do what they do. In laser parlance, in 2017 we are yet pre-laser, and in my opinion, anyone who tries to tell us that lasers, figuratively speaking, can't do X at this point should be considered, at most, a hand-waver in the grips of a fit of profound hubris.
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So I bought a new (old) Mac Pro; late 2009, 12/24 core, 64GB, NVIDIA GeForce GT 120 512 MB. It's running macOS 10.12.3 Sierra. I hooked up one monitor to the HDMI port, and one to the DVI port. Seemed to work fine.
Until I rebooted the machine.
Then it refused to show the mouse pointer (Apple magic mouse), although It would warn of the mouse's disconnect and reconnect if I powered the mouse up and down. Likewise, there was no response to the keyboard. It just sat there showing login options for me and a guest; it wouldn't respond to anything at all I did with mouse or keyboard.
After trying power downs, pulling the plug for a while, pounding on the keyboard, powering the mouse up and down, I finally thought to pull a connection to a monitor. Specifically, the DVI-connected monitor. Immediately the mouse pointer showed up, and I was able to log in.
Up to this point, I had the machine set up so that the HDMI monitor was on the left, and was my home (boot screen) monitor. That's the one you drag the menu bar to in the Prefs / Displays panel. But I noticed when the machine booted, it showed up on the DVI monitor first, then the HDMI monitor, and then it locked up.
So, still booted up after all this screwing around, I swapped monitor cables, then set the DVI monitor to be the home monitor, as the left monitor was now my DVI-connected monitor instead of my HDMI-connected monitor.
Now the machine restarts cleanly, or at least, it has a few times in a row.
So if you're having this kind of problem, after the login screen shows, try pulling one or the other or both of the monitor cables to see if it will unlock the mess. And make sure the DVI monitor is your home monitor once you get things running again.
If you want to be a webmonkey / script-kiddie, sure, learn Javascript first and to heck with a quality skillset. But is that what you want?
On the other hand, if you want to be a quality programmer, that is, a good programmer?—?and not just hope or falsely claim you are one, because hey, you can actually write one— what you have to work through is a six-step language set:
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Star Wars
Dec 27
Here's how the Star Wars franchise has hit me over the years; I saw each movie when it came out. I consider myself a fan. I almost never see a film in the theater; but I saw every Star Wars film the first day I could get to the show.
|Star Wars ep. IV
|"A New Hope"
|Star Wars ep. V
|"The Empire Strikes Back"
|WOW! Again… WOW!
|Star Wars ep. VI
|"Return of the jedi"
|Wait, what? Ewoks? Who stimulated that think? When did the target audience become drooling three-year-olds?
|Star Wars ep. I
|"The Phantom Menace"
|Jar-Jar, "Gungans" featured, the spirituality-diluting idea of the "midi-chlorians", Darth Maul, a great character, barely a cameo… this is not good…
|Star Wars ep. II
|"Attack of the Clones"
|Overall better, Jar-Jar nearly vanished, thank the force. Meesa thinks someone needs to kill him. Horribly.
|Star Wars ep. III
|"Revenge of the Sith"
|Okay, we're back to Wow!
|Star Wars ep. VII
|"The Force Awakens"
|Disney grotesquely fumbles the ball. BB8: Sigh… 3y/o-level (attempt at) cute (but only achieving ridiculous.) Again. Ex-stormtrooper Finn is a monumentally weak character, and the poor acting of that character helps the film out not at all. Then there's the very lame "monster on a freighter" scene with Solo and Chewbacca. Darth Angst… is angsty. Then Solo dies, poorly, at the hands of Darth Angst. Can you say "sucks"? The only redeeming major character in the entire show is Rey.
|Star Wars ep. VIII
|"Rogue One"
|Ooo, much, much better. Damn, these movies are so variable. It keeps me going back, though, so there's that.
R.I.P. Peter Cushing
R.I.P. Carrie Fisher
R.I.P. Alec Guinness
You can learn more and/or download the new SdrDx from this page.
New Features
- 14 user-configurable, band-stacking VFOs
- Old-time radio style station labeling
- Dual-antenna phasing & noise reduction with AFE822 SDR
- SwDb application to edit custom freq database
- Deeper integration w/Dx Toolbox 4.7 and up
- SITOR demodulator added
- C-QUAM AM stereo demodulator added
- Vector scope auto-set w/RTTY, SITOR
- 10 RF notches added
- DNR now fully configurable
- 4 span memories added
- 100% re-mappable keyboard commands
- Comprehensive keyboard locking; time, codes, more
- Integrated comprehensive key command reference
- Two new spectrum / waterfall DSP processes
- Stereo VU meter for stereo FM
- Stereo Reverse added
- Direct frequency, demodulator entry
- Sideband demodulation extended to 20 KHz
- FSK and CW carrier offsets
- CB channel info for US, Euro, Down Under
- Passband center indication
- Auto-adjustment of waterfall
- Bandwidth memory spread from BW1 to BW7
- Mouse snap control
- DGPS band added
- RTTY demodulator improved
- File dialog improved
- AFEDRI SDR handling improved
- Memory tooltips improved
- Bandwidth tooltips improved
- Zone memset / drawing now optional
- Audio waterfall improved
- Anti-ringing improved
- Bandwidth memories now include "-Ri"
- Grid spacing and control improved
- Audio scope spectrum improved
- Audio scope vector improved
- Various bug fixes
Goodies for the technical crowd
- New TCP / UDP commands
- Integrated network debugging for scripting, apps
- Remote marker designation for scripting, apps
- Improvements aimed at next beta test series
- BUG button for instant bug reports


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Counsel, Group Protection The candidate will provide general legal advice and compliance support to Group Protection Division, which develops, sells and administers group insurance products. Provide legal advice and support on the development, implementation and oversight of firm's Group Protection products and services, including claims, operations, underwriting marketing and distribution. Manage the review and drafting of Group Protection contracts and provide advice to business areas in consultation with other Legal staff. Research, analyze and advise on Group Protection sales and distribution matters including broker matters, sales issues and benefit and compensation plans. Research, analyze and advise on e-business technology matters to assess risk and ensure that new trends/developments are appropriately incorporated in Group Protection products and services. Research, analyze and advise on information sharing and privacy requirements to assess risk and ensuring that appropriate safeguards are appropriately incorporated in Group Protection products and services. Lead and/or participate on special projects and work with project team to create and improve products and services. Lead and collaborate with other Legal and Compliance staff to develop mutually beneficial outcomes to issues impacting the business. Lead and collaborate with internal and external partners to develop mutually beneficial outcomes to issues impacting the business. Participate as a member of Group Protection Legal and Compliance leadership team. Participate as a member of Group Protection business leadership team. Identify and communicate legal exposure and risk in a timely and proactive manner to key stakeholders. Research, analyze and provide legal advice regarding laws, regulations and case law; and prepare analysis and advice for key stakeholders.
Qualification and Experience
The candidate must have Undergraduate Degree. Should have JD degree from ABA-accredited law school and current License to practice law. Should have 5-7 years of experience in Law that directly aligns with the responsibilities of the position. Educational experience or proficiency in: Corporate legal and compliance matters; Employee benefits, life insurance or other financial services; Drafting and reviewing contracts and agreements; Drafting policies and procedures; Advising and working directly with clients.
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Tech Consulting
Applies basic foundation of a function's principles, theories and concepts to assignments of limited scope. Uses professional concepts and theoretical knowledge acquired through specialized training, education or previous experience. Develops expertise and practical knowledge of applications within business environment. Acts as team member by providing information, analysis and recommendations in support of team efforts. Exercises independent judgment within defined parameters.
- Responsible for delivery of assigned tasks within the delivery cycle of a project. Understands a number of HP technologies in order to provide technical systems management support or deliver part of a detailed technical design which meets customer requirements. Tasks may include performing systems configurations, troubleshooting systems errors/problems, monitoring and/or testing systems performance, and contribute to the design of technical solutions for customer environments.
- Works under supervision of technical lead and with customer nominated representatives to accomplish assigned tasks.
- Acts professionally with HP customers.
- Participates as part of a team and maintains good relationships with team members and customers.
- Understands HP's strategy.
- Is aware of knowledge tools and their application.
- Participates in chosen technical community or profession, and regularly attends profession or community of interest events.
Education and Experience Required:
- 1 - 3 years of technical experience and an Associate of Arts/Science or equivalent degree (two year college program) in computer science or related area of study; without a degree, one additional year of relevant technical experience (2-4 years in total).
Knowledge and Skills:
- Has sufficient technical knowledge to assist with the completion of specific deliverables.
- Able to communicate concepts with team and to peers.
- Able to produce basic documentation to required standards.
- Demonstrates understanding of assigned discipline or technical area.
- Demonstrate fundamental technical knowledge.
Meet Some of HP's Employees
Elizabeth B.
Product Manager
Elizabeth focuses on the HP consumer experience, scaling best practices across premium consumer notebooks, testing products before public release, and crafting the compelling story of their design and performance for press workshops.
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Comment on this Motifake
Pi, it's everywhere.
Creator: marvelousmarvin12
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The third in our series of themed shows on Blood, Sweat and Tears.
This [series episode segment] has
From Shakespearean tragedies to sentimental kids books, literature has a huge power to move us to tears.
It usually ends in tears for the female roles in opera. Why?
William McInnes explains the tricks of the trade actors use to tear up for the cameras and on stage.
Tears run through the blues, but one of the genre's leading Australian exponents rarely even mentions them. Onstage, her eyes are dry. Lil' Fi explains why, and divulges what does make her cry.
Isabel Angus and Rachel Davis are a comedy duo whose show Edge! won the award for Best Comedy at the 2013 Melbourne Fringe Festival. They're brought to tears by one of their favourite stage creations.
Sue Saxon is a visual artist who uses real tears in the making of her artwork. They can be she says - an alternative history marking emotions rather than events.
RN presenters reveal which movies make them weep and admit to finding their choices a little pathetic!
what are these?
Add your comment
Monday to Friday 10am and Saturday 2pm
Repeated: Tuesday to Saturday 2am
Presented by Michael Cathcart and Sarah Kanowski


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The Lubavitcher Rebbe
For 92 years the Rebbe lived in our midst, and in virtually every talk he gave, every letter he wrote and every directive he issued, the theme, the sign-off and the goal was: the coming of Moshiach and the attainment of the Redemption.
This was the Rebbe's objective in every program he launched, every action he initiated and every community he founded: a world devoid of hate and greed, a world free of suffering and strife, a world suffused with the wisdom and goodness of its Creator. No less.
The idea of a universal redemption, heralded by a global leader called Moshiach (the anointed) is a basic tenet of the Jewish faith. The Jew believes that the world which G‑d created possesses the potential to fully reflect the infinite goodness and perfection of its Creator. And the Jew believes that the realization of this goal is the purpose for which his or her soul has been placed within a physical body and given life on this earth.
The Rebbe often quoted the great Jewish sage Maimonides, who more than 800 years ago had said: a single deed, a single word, even a single thought, has the power to tip the scales and bring redemption to the world.
The Rebbe explained: because the basic nature of our world is perfect and good, our every good action is real and enduring, while every negative thing is just that -- a negative phenomenon, a void waiting to be dispelled. Hence the common equation of evil and good with darkness and light. Darkness, no matter how ominous and intimidating, is merely the absence of light. Light need not combat and overpower darkness in order to displace it -- where light is, darkness is not. A thimbleful of light will therefore banish a roomful of darkness.
No matter how dark the world may seem or feel, light is just a single action away.
The Rebbe saw this and imparted to us this vision. If we open our eyes to this reality, we will bring redemption to the world. Today.
It's true, a single deed or word includes everything and it is not important which qualification you have, because to see everything you have to go through death a lot of times but that means you have to give up everything and than you are able to receive everything. It is just like at the beginning of life you are empty body and will be enriched on earth with lot of wonderful things and persons arround you.
the power to tip the scales and bring redemption A further unique aspect was that this single deed or word had a very simple qualification. Each person according to his own level. The Rebbe's world is absolutely inclusive!
Everything matters
This is what I needed to read today:
"A single deed, a single word, even a single thought, has the power to tip the scales and bring redemption to the world...
"...A thimbleful of light will therefore banish a roomful of darkness...
"...No matter how dark the world may seem or feel, light is just a single action away."
There really are no such things as 'small things,' nor anything which doesn't matter.
- Convergence
- Love According to the Rebbe
- My Rebbe the Rebel
- The Emissaries
- The Reinvention of Man
- The Cure for the Common Cynicism
- An Antidote for the Post-Holocaust Generation
- The Man Who Turned Judaism Outward
- A Rehearsal for Redemption
- 60 Years: An Appreciation
- Footsteps in the Rebbe's Shadow
- View All »
- Light & Darkness (122)
- Good and Evil (103)
- Moshiach and the Future Redemption (379)
- Lubavitcher Rebbe (277)


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The winners of the 2012 Davitt Awards, presented by Sisters in Crime for the best crime books by Australian women, have been announced in Melbourne.
The Adult Fiction prize was won by Sulari Gentill for A Decline in Prophets, the second instalment in her Rowland Sinclair series. The Children's and Young Adult Fiction winner was Meg McKinlay for Surface Tension, and Best Debut novel went to Jaye Ford for Beyond Fear.
Ford was also the joint winner, with Y. A. Erskine, of the Reader's Choice Award. Erskine's novel The Brotherhood is described by its publisher as 'a novel about violence, preconceptions, loyalties, corruption, betrayal and the question a copper should never need to ask: just who can you trust?' (Bantam Australia) The novel is set in Tasmania where Erskine served for eleven years with that state's Police Service.
The 2012 Davitt Awards were presented by Swedish crime writer Ǻsa Larsson. Sisters in Crime reports that Larsson was 'so impressed by the event that she intends to set up Sisters in Crime in Sweden'.
For more news on the Davitt Awards, see the Sisters in Crime website or follow developments @SistersinCrimeA.


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Listen to free music played by DJ_Lea
Blip.fm is internet radio made social. It's easy to search for, play, and discover free music recommended by real people. Join today to create your own free station and start listening to @DJ_Lea.
DJ_Lea Three top ladies @meowwmeoww
The Wailin' Jennys – This Is Where| play
Dec 11, 2012 at 9:23 am via YouTube | AMAZON | ITUNES
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What other DJs are saying about The Wailin' Jennys - This Is Where
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Jun 17, 2012 at 10:08 pm via YouTube | AMAZON | ITUNES
CynDyn Hiya @InnerRhythm :)
Sep 21, 2011 at 3:04 am via YouTube | AMAZON | ITUNES
FMWolter Wailin' Jennys: This is where
Sep 8, 2011 at 6:41 pm via YouTube | AMAZON | ITUNES


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Law Enforcement salary
The average salary for Law Enforcement related jobs is £40,993 per year or £21 per hour. This is around 1.5 times more than the median wage of the country. Entry-level positions start at £29,000 while most experienced workers earn up to £57,000. These results are based on 12 salaries extracted from job descriptions.


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Re: Maria Mazzola, Prov. Palermo, Sicily
In reply to:
Re: Maria Mazzola, Prov. Palermo, Sicily
Maria,I think your Maria Mazzola is a different one, although she could be a relative.My Maria Mazzola born abt. 1847 died Jul 7, 1905, immigrated around 1903.She is from Castelbuono, Prov. Palermo.My grandmother (a grand-daughter to Maria Mazzola) always used to say the Mazzolas in New York, NY who made cookies, found in many grocery stores were her cousins.We may have a more distant connection somewhere. Amy


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The "safe hands" people are expanding their grip on the auto insurance industry.
Allstate Corp, long a major player on the American car insurance scene, is trying to expand its online insurance sales. To that end, it has recently announced that it is in the process of acquiring Answer Financial and Esurance.
The Chigago Tribune reported on a conference call earlier this morning, in which Allstate announced that it would be purchasing both of the other companies for $1 billion. Elaborating on reasons for doing so, Allstate Chief Executive Tom Wilson said that while the company had been growing its direct-to-consumer sales, it hadn't yet, "…captured share from other people."
Wilson also said that he wanted his company to, "…compete aggressively in that segment of the market."
Last year, Allstate's direct business, which had improved by 19.8 percent over the previous year, totaled $745 million, while Esurance, which does its insurance sales entirely online, wrote $836 million in premiums in the same year.
Of course, direct sales are only a small slice of the Allstate pie. The insurer's revenues from property-liability premiums were significantly higher than $745 million in 2010 – almost $26 billion, actually.
Allstate, currently the second-largest home- and auto insurer in the United States, was trading stock at $32.37 earlier today (down 0.5 percent). It is purchasing Answer Financial (which offers customers the opportunity to have online insurance quote comparisons) and Esurance from the White Mountain Insurance Group


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About The Community Cloth
The Community Cloth is a microenterprise initiative empowering refugee women in Houston. Managed by Alliance, it targets economic, educational, and social goals through seed grants, training, peer support, and by expanding market opportunities for refugee women artisans. The Cloth supports them in creating and selling handmade, indigenous arts and crafts such as woven scarves, knitted scarves, household items, children's hats, and more. Through producing and selling their wares, the women have an opportunity to express their culture and heritage, learn new skills that will assist them in transitioning to life in the US, and obtain much-needed supplemental income. All of the proceeds go directly to the artisans and the program. Most of the women involved to date are mothers; some are widows or are the only working member of their families.


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A BRAVE student told yesterday how she risked her life to stop a brutal street robbery while two cops sat in their patrol car just 25 yards away. Gutsy Marie Wastlund, 27, ran to the rescue after a night out when she saw three hooded thugs kicking and throttling a woman in the street.
She claims she frantically waved at the officers, parked just along the road, but they ignored her pleas for help.
Supt Ian Wylie said: "I intend to investigate how we responded to this incident to make sure that our officers are providing the highest possible standard of service."
My comment: Why am I no longer surprised at stories like this about the Police?
Read the full story from the source Mirror
Read all articles about the Police on this blog


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Cheesy Bacon Hash Brown Bake Recipe
"About 15 years ago, a co-worker brought these rich potatoes to a potluck, and they were an instant hit," recalls Patricia Monahan, Smithfield, Rhode Island. "I've been bringing them to gatherings ever since. I usually start with frozen hash browns, bake the casserole twice as long, then transfer it to a slow cooker to keep warm while serving."
- 1 package (3 ounces) crumbled cooked bacon
- 6 cups cooked shredded hash brown potatoes
- 1 cup mayonnaise
- 1/2 cup process cheese sauce
- 1. Set aside 1/4 cup bacon for topping. In a large bowl, combine the hash browns, mayonnaise, cheese sauce and remaining bacon.
- 2. Transfer to a greased 11x7-in. baking dish. Sprinkle with the reserved bacon. Bake, uncovered, at 350° for 20-25 minutes or until heated through. Yield: 6-8 servings.
Nutritional Facts
1 cup: 326 calories, 27g fat (6g saturated fat), 28mg cholesterol, 768mg sodium, 12g carbohydrate (1g sugars, 1g fiber), 8g protein.
Reviews for Cheesy Bacon Hash Brown Bake
© 2017 RDA Enthusiast Brands, LLC


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'Rogue One' The Great Christopher McQuarrie Helped Write The Script
By Matt O'Bryant
With principle photography rumored to be close to completion on director Gareth Edwards' Rogue One: A Star Wars Story another acclaimed director is being tied to the project. Although not as a director on the film, but as a writer. That said director is none other than the Hollywood "script doctor himself" Christopher McQuarrie who was brought in at some point last year to do some finishing touches on the Rogue One script.
This is according to Birth.Movies.Death who says that McQuarrie was brought on to quote "save" the Rogue One script, a heist film about a group of rebels working to steal plans for the Death Star.
Their new confirmed details seem to verify a rumor from Latino-Review last year that McQuarrie had been quietly brought on to the project for a few weeks last year. This is after two other screen writers Gary Whitta and Chris Weitz had each done their part.
While all this sounds kind of bad, it really isn't anything out of the ordinary for a big Hollywood production to bring on multiple writers throughout the process of making of a film, just to polish up some things here and there. This happens all the time.
The most interesting part of this story, is the fact that Disney and Lucasfilm has the ability to bring on such a "big-time" talent like McQuarrie. This gets me even more excited for the film, because every project that McQuarrie has directed, wrote, or been involved in some type of way has been just great filmaking. Check out the guy's filmography and prepare to be impressed.
Rogue One stars Felicity Jones, Mads Mikkelsen, Ben Mendelsohn, Alan Tudyk, Donnie Yen, Forest Whitaker, Diego Luna, Riz Ahmed, and Jiang Wen.
Rogue One: A Star Wars Story hits theaters on December 16th, 2016.
SOURCE: BIRTH.MOVIES.DEATH via Collider


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Mascotas Nuevas – Peces!
Before I moved to Puerto Rico I was into fish-keeping and had 3 fishtanks in my house. When we moved to Puerto Rico I figured it would be too hot in our un-air conditioned house to keep a fishtank from overheating and pretty much struck that hobby off of my list. Lately, we have been talking with several friends and neighbors about aquaponics and that got me missing my little fish friends ;). So when I was at Wal-Mart the other day, I picked up a 20-gallon tank and decided to set up a little experiment tank.
One of the many pluses of our trees/grass/plants growing in, is that it has made the temperature at our house much cooler. All of the added shade and greenery has literary lowered the temperature at our house by 5 – 10 degrees and made our property a lot more temperate. And ready for a fishtank! After I purchased the tank, I ordered live aquarium plants and real stone gravel online. I prefer live plants and real gravel to the plastic stuff, as the real stuff is beneficial to the fish and creates a little self sustaining eco-system. That means less cleaning and healthier fish. Win-win!
Once the plants and gravel arrived in the mail, I set up the tank and headed to the Mayaguez mall for some fish. There is a little pet shop kiosk there and the two kids working the store were very knowledgable and helpful, even with my bad Spanish. I purchased 2 bettas (1 male, 1 female), 3 tiger barbs and 2 gouramis. All of these types of fish are semi-aggressive, which means they can hold their own. (It's important to keep the same temperament of fish together in an aquarium or else they will fight/nip/annoy the less aggressive species to death.)
Our new fish / Nuestro peces nuevos:
Sydney LOVES the new fish and looks forward to feeding them everyday. The fishtank as a whole adds a great element to our living room and, in my opinion, is much more fun to watch then TV.
Spanish fish hobby words:
Aquarium = Acuario
Freshwater = Agua Dulce
Fish = Peces
I have one freshwater aquarium with seven semi-aggressive fish. = Yo tengo un acuario agua dulce con siete peces semi-agresivo.
(please feel free to correct any of my bad Spanish ;)…)


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About Me
Natalie Wood
- I moved from dank, dark North Manchester, U.K. to Karmiel, Western Galilee, Israel in March 2010. It is, believe me, one of the sunniest, loveliest towns on earth. With a background in local Jewish journalism I continue to write freelance. I manage several blogs, have appeared on Technorati and Blogcritics and now contribute to the online magazine, 'Live Encounters'. My main blog is Alwayswriteagain (http://wwwalwayswriteagain.
Friday, 15 July 2016
Alwayswriteagain: From His Lips …!
Alwayswriteagain: From His Lips …!: Marsha Kolman introduces Yisrael Ne'eman at last night's packed ESRA Karmiel meeting. Mr Ne'eman, an Israel-based historian...
Posted by Natalie Wood at Friday, July 15, 2016
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text: Book Reviews New Instruments and Methods of Engineering Geology. N. V. Glazov and A. N. Glazov. Translated from the Russian by J. Paul Fitzsimmons. Consultants Bureau, New York. 1959. 91 pp. $3.25 See allHide authors and affiliations Science 22 Jan 1960:Vol. 131, Issue 3395, pp. 221-222DOI: 10.1126/science.131.3395.221-b Parker D. TraskFind this author on Google Scholar Find this author on PubMed Search for this author on this site Article Info & Metrics eLetters PDF This is a PDF-only article. The first page of the PDF of this article appears below.


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Friday, September 13, 2013
Bookish Buys: Pillow, Print- oh, and 221B
14 comments:
Love the scrabble rings. Those are too funny. However, I'm terrible with big rings and usually wind up gouging myself with them. And yay for that pillow and print!ReplyDeleteReplies
Haha yeah I don't feel comfortable wearing big rings (and gouging is never good!). But I like admiring them! hahaDelete
I need tons of those pillows! And the iphone case!ReplyDelete
when I see those things I just have to have them! *grabby hands* hahaReplies
Isn't the iPhone case awesome?!Delete
I still need to watch Sherlock! Everyone seems to love them. I think the Scrabble rings are such cool ideas, and I love the pillow!ReplyDeleteReplies
Ooh definitely watch Sherlock! (And then come back so we can talk about it and share theories!)Delete
I. can. not. wait. for. Sherlock.ReplyDelete
IT'S KILLING ME. At least Doctor Who doesn't make me wait so long :-/Replies
Doctor Who 50th Anniversary coming soon! AAAH!Delete
I really want to buy some of those pillows <3ReplyDelete
I love the I Read About It In a Book pillow! I say that line so much that I should probably get a pillow AND it on a tshirt. ;)ReplyDelete
Alice @ Alice in ReaderlandReplies
Haha I think there's a cell phone case, too!Delete
- AnonymousFebruary 29, 2016 at 1:28 AM
The information and the aspect were just wonderful. I think that your viewpoint is deep, it's just well thought out and truly incredible to see someone who knows how to put these thoughts so well. Good job! อย่าง หมอนหัวทุยReplyDelete
i am continually searching for some free stuffs over the web. there are additionally a few organizations which gives free examples. Body PillowsReplyDelete


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Monday, September 8, 2008
Political Dementia, The Narrative and Public Policy
Do you have an opinion about Sarah Palin? Does it have to do with her voting record or do you think she's a spunky conservative powerhouse? Do you find yourself chanting "Yes, we can!" without really knowing what we can do?
After hearing hours of coverage of the conventions and candidates, are you familiar with their budget proposals? Do you agree with their positions on media consolidation? Do you know their records on agriculture issues? You probably know this-- there's been a big surge in enthusiasm over Sarah Palin, Obama has struck back over mocking of "community organizers," Hillary Clinton is plugging Obama while carefully trying not to slam Palin. McCain is a war hero and Obama is a rock star. One represents experience the other change.
Brian Unger, on NPR, did a feature today on Political Dementia, an invented mental disorder with symptoms like being unable to tell the difference between the experienced between the inexperienced, good experience from bad experience and worthless experience from valuable inexperience.
Maybe we can just stop all this political nonsense now and choose our candidate reality show style as this clip, aired today on CNN, suggests.
This feature on a Mad TV segment is listed as one of the top stories right now on CNN.com. As is often the case, the comedian manages to point out something that we've barely noticed. Our brand of news as info-tainment lends itself well to storytelling. We like stories about characters and so we debate politicians rather than politics.
A few days ago I sounded in on the Peggy Noonan open mic viral video and its commentary. I did not include a link to her original Wall Street Journal article and its attached response to her unintended moment of public candor.
Along with the much reported criticism of Palin, Noonan and Mike Murphy criticized a whole system which she referred to later in the introduction to her article as "The Narrative."
"It was just after the 1988 Republican convention ended," she wrote. "I was on the plane, as a speechwriter, that took Republican presidential nominee George H.W. Bush, and the new vice presidential nominee, Dan Quayle, from New Orleans, the site of the convention, to Indiana. Sitting next to Mr. Quayle was the other senator from that state, Richard Lugar. As we chatted, I thought, 'Why him and not him?' Why Mr. Quayle as the choice, and not the more experienced Mr. Lugar? I came to think, in following years, that some of the reason came down to what is now called The Narrative. The story the campaign wishes to tell about itself, and communicate to others. I don't like the idea of The Narrative."
But we have become conditioned to The Narrative. The Narrative tells us which character to root for on Dancing with the Stars or Top Chef. The Narrative lets us choose Santino Rice as a Project Runway villian. It helps us to form an opinion as to whether Randal or Rebecca should be The Apprentice. And The Narrative will help us choose a president.
Don't believe that we don't know the difference between celebrity gossip and politics that affect our lives? The moment that illustrated our political dementia best to me did not come during this election cycle, but last winter when the actor, Owen Wilson, attempted suicide.
An announcer on a television network call in show (I'm sorry, I don't remember the program at this point) was asking his viewers to weigh in on whether the Santa Monica attorney's office was correct in withholding the 911 tapes of the incident from the news media. The announcer in question was making the argument that it was in the public interest-- that the public had a right to know because the actor is a public figure.
Owen Wilson is a publicized figure, but he is not going to make any policy that changes my life or yours. That a journalist would even make the argument that the public had the right to hear these tapes shows the extremes to which political dementia reaches. A reporter should understand that the fact that the public is interested does not constitute public interest.
Gawking, gossip and engaging in Schadenfreude are thought of as negative emotions, but they universal enough that we have to assume they fulfill important social functions. The biggest problem with them is when they drown out other, more important discourse.


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You've got to admit that we all love a little sleepover every now and then. Well, we've found you a sleepover you'll want to be a part of.
The Sleepover Club is a feminist project run by Elise Arumets and Miriam Arbus that wants to celebrate women in the artistic community.
In our current climate, women are underrepresented in exhibitions, solo shows and museum collections. The Sleepover Club encourages collaboration and solidarity among the artistic community to push back against this lack of equality in the arts.
They're funny and light-hearted but also intelligent, leaving you with a powerful feeling. And they've got a number of amazing events planned to get the conversation started, which kicked off with their first exhibition last Friday night.
It was an all-female exhibition that brought together a number of different artists and practices, examining their contemporary female experience. The exhibition provided a catalyst for "transcultural feminist solidarity" with a hope of creating conversation around the future of feminism.
They've decided "safe feminism" is no longer a viable option to get equal representation of LGTBQIA+ women, women of colour and cis women artists, so they're taking it into their own hands.
The next event for the Sleepover Club is their conference on solidarity on September 26. There will be lectures, artist talks and performances followed by live music, so not only can you help make a stand on solidarity but you can have an awesome time doing it.
Here's to being a woman.
Sleepover Club: A Conference on Solidarity
Saturday September 26
12.00pm - 10.00pm
Brunswick Street Gallery


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Medical administrative assistant job duties
What Does a Medical Administrative Assistant Do? By Jennifer Pfeffer on 7/4/2016 Add a Comment. We've broken down everything you need to know from basic job duties to the major differences by location so you can decide if it's the career for you.
Duties of a Medical Office Administrative Assistant | Chron.com
Medical office assistants perform a wide variety of support duties in health care settings. Maintaining patient records and processing insurance claims are also part of the job description of a medical office administrative assistant.
Medical Assistant Duties
Types of Medical Assisting. There are four basic categories of medical assistant duties—clerical, administrative, clinical, and specialist. The job functions of a specialist medical assistant are somewhat separate from those of other medical assistants.
Administrative Assistant – Wikipedia, the free encyclopedia
Administrative Assistant is a broad job category that designates an individual who provides various kinds of administrative support to people and groups in business enterprises. Job Duties Administrative assistants perform clerical duties in nearly every industry.
Office Jobs and Job Descriptions | OfficeTeam
Administrative Assistant Job Description. OfficeTeam places a range of administrative professionals at a variety of office jobs in organizations worldwide. Medical Executive Assistant — Performs administrative duties similar to those of an executive assistant but for medical executives…
Administrative Assistant Duties | Medical Administrative Assistant
The duties described below apply to administrative assistants in specific environments including sales, marketing, medical and human resources. These specialist admin assistant tasks can be combined with the duties of a general administrative assistant to get the full job description.
What is the Job Description of a Medical Assistant?
Discover the benefits and job description of becoming a medical assistant if this career appeals to you. Some medical assistants prefer to specialize in one type although many prefer to perform both administrative and clinical duties.
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What are the Job Duties of School Administrators?
AAMA – What is a Medical Assistant
What is a Medical Assistant? Job Responsibilities | Medical assistants are cross-trained to perform administrative and clinical duties. Here is a quick overview (duties vary from office to office depending on location, size, specialty, and state law)
Top 5 Medical Assistant Job Duties
Top 6 Duties of a Medical Assistant. Work in the front office, completing a variety of administrative tasks. Or build your career on the clinical side, carrying out tasks that range from taking vital signs to counseling patients on medical procedures.
How to Become a Medical Administrative Assistant | eHow
The job duties of a medical administrative assistant depend on the employer. What Are the Personal Characteristics Needed for the Medical Assisting… How to Become a Medical Secretary. Technical Skills Needed to Perform Medical Assistant Duties.
Medical Administrative Assistant with EHR Job… | Career Step
Medical administrative assistants trained on electronic health record software (EHR specialists) are the specialized administrative personnel who keep the modern medical office administration running smoothly. Job duties of a medical administrative assistant would vary from location to location, but…
What does an Administrative Assistant do? | Jobs
Although administrative assistants work in nearly every industry, many are concentrated in schools, hospitals, government agencies, and legal and medical offices. Typical Day Of An Administrative Assistant – Job Description & Duties www.careerstep.com.
Medical Administrative Assistant Program | UMA
One common job title for this career is medical secretary. What does a medical administrative assistant do? Medical administrative assistants do not take patient's blood pressure, give injections or perform any other patient care. Those duties would be performed by a medical…
Medical Assistant Job Description and Duties
The medical assistants handle the administrative part of the doctor's job. They help the doctor take the vital signs of the patient, make the reports for the treatment and even order test by the laboratories. Duties and responsibilities of a medical assistant.
Medical Administrative Assistant Job Description & Duties
The job description and medical administrative assistant duties can vary significantly depending on where you work. So what is the medical office administrative assistant salary, pay scale, salary range, and salary per hour?
Medical Assistant FAQ – Frequently Asked Questions
A. There are three basic types of medical assistants: clinical, administrative, and general (both clinical and administrative). A: There is no requirement for medical assistants to become licensed or certified. However, job duties in many states may be limited for those who are not properly certified.
Medical Office Assistant Articles – Medical Assistant Central
Duties Of A Medical Office Administrative Assistant | Chron.com Record Keeping and Insurance Processing. « Sanford Brown College Medical Assistant. Certified Medical Assistant Jobs Woodbridge Va ».
What are the duties of a medical office assistant?
The administrative job duties of a Medical Office Assistant may include such front desk work as answering telephones, greeting arrivals, asking for the purpose of the visit and directing people to the proper place to go.
Medical Assistant MN Job Description | BestJobDescriptions.com
One of these important jobs in a hospital or clinic is the job of the Medical Assistant. A medical assistant's duties can be in clinical, administrative or specialized.
What is an Administrative Assistant? (with pictures)
The duties of an administrative assistant frequently go far beyond secretarial tasks, and include handling logistical things for the office, like ordering supplies, handling mail and paperwork that goes in and out of the business, and coordinating people's' schedules.
Common job duties of an administrative medical assistant
An administrative medical assistant is a trained medical assistant who performs essential duties required for the efficient operation of the health care They have the option to work in any health care setting and specialty. An additional benefit to working as an administrative medial assistant is job…
Some of the duties that an administrative medical assistant may…
Job description of a medical assistant. Having that certificate shows your prospective employer that you have been trained in the duties that a medical assistant will do on a daily basis whether you will be working as an administrative medical assistant or clinical medical assistant.
Medical Assistant Job Description-Duties of a Medical Assistant
Medical Assistant Job Description. Medical assistants are multi-skilled members of the health care team who perform administrative and These medical assistant duties are the most frequently performed by the medical assistants around the country according to the Bureau of Labor Statistics.
Medical Office Administration Degree | Medical Administration
Preparing to Work as a Medical Office Administrative Assistant. While you are still in school, you will receive hands-on training in a real-world healthcare setting. Outpatient care centers. Health insurance companies. What are job duties for those in medical office administration?
Medical Administrative Assistant Job Duties
This website use H5 Metatag. Google Ads. Medical Administrative Assistant Job Duties. neuvoo.com.ng – Looking for a job You will find on neuvoo all the jobs available in your region Your job search starts here .
Medical Administrative Assistant: Tips, Salary, Job Description
The Medical Administrative Assistant job description will not be identical for the many positions that are available. An Administrative Medical Assistant will perform a wide range of administrative and clerical duties.
Medical Assistant Degree Programs and Training
Medical assistant schools help prepare graduates to work in a variety of medical specialties, so the job duties may be different in any given facility. Overall, however, medical assistants are typically responsible for the completion of both administrative and clinical tasks.
Medical Assistant Salary | Medical Assistant Job Duties…
Medical assistants, also called MAs, complete various administrative and clinical tasks in the offices of physicians, podiatrists, chiropractors, and other In this article (and video), you'll learn the average medical assistant salary for each state, the job duties, education requirements, and some of the…
What are administrative assistant duties
What is the difference between Medical Office Assistant and Medical Office Administrator what are they duties? In Jobs & Education. What are the duties of an administrative assistant? Whatever the boss tells you to do.


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This potato got off the couch
I am over 50 and have completed week one of the C25K. I kept it a secret from everyone because I didn't believe I could run a step, lets face it the last time I run would when I was a toddler! But I did it, and have completed the first run of week 2, would love to hear how any other over 50s managed the programme, did you repeat weeks etc
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Hard Dalek, Cold Dalek, Little can of hate….. Evil Dalek, Angry Dalek, Ex-ter-mi-nate. If you have one of my shirt designs I wanna see you in it. Send photos to my Facebook or Twitter….. Thanks Paul http://www.facebook.com/PaulBradfordGHI http://www.twitter.com/GHIPaul
Tags: doctor-who, science-fiction, space, robots, badwolf
It took me awhile to work on this. I, along with many others, have fallen head over heels for Giffany. She's absolutely awesome and adorable. Anyway, I saw this hadn't been done yet so I figured it was time for a pocket Giffany.
Tags: pocket-tees, pocket, cmyk, obsessive, girlfriend
This design Limited Edition, only available for purchase in few day. If you like this design please order now. If you want best design and best selling, click here: https://www.teepublic.com/user/bestsellers (#bestsellers) . Thanks you.
Tags: top-trend, most, best-seller, best-selling, new


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Bike Ride
1382 ft
- Begins in:
- Hillsborough, NJ, United States
- Created By:
- Steve Mastripolito Best Time: 2:40:00
- Description:
- This is a 46.9 mi Bike Ride in Hillsborough, NJ, United States. The Bike Ride has a total ascent of 1382.32 ft and has a maximum elevation of 600.36 ft. This route was created by mastripo on 06/25/2007. View other Bike Rides that mastripo has done or find similar maps in Manville.
- Type:
- Bike Ride


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With the depositors and collectors, you should add different colors. Each color would also alter where you can put them. Example: Items from a red depositor would be red, and would only be collected by red collectors. This would make the future delivery missions be much better. Imagine having 4 different colored items in one map and you had to deliver them all to different places? That would be neat.
Multi-Colored Items
A topic by Fuff created 184 days ago Views: 153 Replies: 3
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Hey cool, I'm here before Dr Whoop. (I know it doesn't matter.)
Yep, they'll definitely be specific places to deliver certain things, whether it'll be materials or passengers I'm not sure yet.
Log in to replyJoin the discussion. Log in or create a free itch.io account to continue.


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This week- we are playing in the playhouse!
Welcome to the weekly "Just Playing?" Blog Hop hosted here at Child Central Station. If this is your first week joining us- you may wish to learn more by visiting the "Just Playing?" landing page.
Last week- we looked at children playing with a parachute. I have updated the post to include additional insights into the learning that took place during the play. You can see the revised post here.
Now on to this week's photos:
We may be "just playing", but….
What are the children doing here?
What do you see?
What learning is taking place?
What skills are being practiced/developed?
This post is part of the "Just Playing?" Blog Hop!
Thank you for remembering that young children do not "just play." Young children play. They develop through play. They learn through play. They experiment through play. They grow through play. A child's work is play. Play is important!
Please take a moment to reflect upon the photos and questions above. I would love for you to share your observations in a comment. I'd also like to invite you to "hop" on over to all of the other bloggers who are sharing photos of children learning through play this week:
If you are looking for more of our "Just Playing?" posts and resources from around the globe, please visit our Pinterest Board.
Are you a blogger? Would you like to join the JUST PLAYING? blog hop community?
You can join the hop via our Facebook Group: Just Playing?
or please contact Amy from Child Central Station for more information.


text: Maggie Black seems to be one of the most eloquent writers on the issue of Eco-sanitation. That is, containing and managing human 'waste' at source and not contaminating a huge amount of fresh water with it, at great cost. If you are new to this subject, or have never thought about the principle of what you are doing when you flush, then read the links below.


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Enjoy a relaxed stay in our cozy home. Just 10 mins by bus from the heart of Dublin, 30min walk from St.Patrick's Cathedral, serviced by several bus routes. Comfy double bed in a cozy, quiet private room for 1 or 2 guests, with a desk.
You will share the house with Jerry my lovely & friendly Irish husband who will give you the best tips around Ireland.
Off Street Free Parking, you will be provided with towels.
We make Home made Bread and Homemade Granola especially for our guests!
Quiet private room suitable for two guests, just decorated and painted.
At the back of the house we have a garden for smokers with 2 hammocks. You'll find the sitting room and Garden are lovely place to relax, chat, read and listen to music particularly in the Sunshine!
To get here, please look at the 'Getting Around' section below. The bus to Dublin city centre stops just 1 minute walk from my house!
You will be provided with WiFi, towels, toiletries and a key.
I am flexible so if you need anything I will be there to help.
As the bedroom is upstairs and I don't have a lift it's not ideal for wheelchair users.
As you can see from the photos, is a very quiet place, comfortable home.
I have made the guest room a comfy and cozy space for you to come and enjoy your stay in Dublin. The guest room offers a relaxing ambience for your stay.
You have access to the guest room, the Bathroom, the Living Room, the Kitchen and the gardens ideal for resting or smoking. Enjoy the cable TV and wi-fi.
In the morning of your stay, you can help yourself to a range of breakfast cereals, real coffee, tea, fruit and snacks in the kitchen.
The Bathroom is shared between the 4 of us in total and the shower is electric.
If you need anything I will be there to help.If you're looking for places to eat, drink, walk, read, socialise, people watch, bargain hunt: I can give you lots of tips that only we locals know!
If you need some time to yourself that's fine too - just let me know!
I am always here to help guests plan their stay in Dublin. Or to just have a chat and a cup of tea.
If you're here on a Monday the following museums are closed:
National Museum of Ireland - Archaeology (Kildare Street, Dublin 2).
National Museum of Ireland - Natural History Museum (Merrion Street, Dublin 2).
National Museum of Ireland - Decorative Arts & History (Collins Barracks, Benburb Street, Dublin 1).
Some sights are closed on Sundays, Bank holidays or Public holidays so please check in advance to avoid disappointment!
Check-in is after 2PM
No parties or events unless cleared with me first.
I would expect guests to treat my home with respect.
if in doubt, please ask.
No smoking or eating in the guest room.
All guests must be Airbnb verified.
1) Remember it's a shared bathroom so don't be long.
2) Please clean out the shower drain and tidy the kitchen after use.
3) No visitors unless cleared with me first.
4) If you smoke please use the garden area
23 ความคิดเห็น
My name is Danielle and I'm from Mexico, I always dreamt about travel and I knew one day will become true, my 1st abroad trip was to Ireland and since then I can't stop it! One day, I founded a lovely and friendly man: Jerry (you'll meet him) and together we're just even more special, we travel, we love making new friends and we have many more dreams to come, We're delighted to meeting you and to having you in ours!
Welcome home! :)


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Jessica Alba at Valentine's Day - European Premiere - London
Publié le 12 Février 2010
Love is in the air this week. On Sunday it is Valentines Day and to make sure the romantic among you have somewhere to take your sweetheart, there is a movie with the same name just to make it easy. There are lots of top names in this chick-flick though not all were able to come to the Square for this buzzing premiere. Pretty Woman director Garry Marshall has put together an all-star ensemble for this one. I arrived at nine thirty to claim a spot after keeping an eye via the web cam. Mostly young ladies for this one and mostly wanting to see Jessica Alba. An icy wind that cut through four layers was out challenge today. As always there were folk from all over the globe, Spain, Australia, Chile and a lot of Americans. The décor was red of course. Traditional red carpet and lots of pink neon-lit hearts reminded all of the theme. Folk around me did well for autographs and pictures. Most all the stars and other celebs signed and posed. The pushing was manic when Jessica arrived near me. It was a wonder I did not fall off my stool. I was almost horizontal at one point. To make sure I got everything, I waited for departures as she got into the limo then a quick dash home into the warm. Roll on spring time please.


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Top Linksmain detailsbiographyby votesphoto galleryquotes
Filmographiesby yearby typeby ratingsby votesby TV seriesby genreby keyword
Did You Know?photo galleryquotes
Steve (Character)
from Show Boat (1936)
Alternate Names:
FilmographyEdit Credits
- "Great Performances"
- Show Boat (1989) TV episode, Played by Robert Jensen (as Steve Baker)
- Show Boat (1951) Played by Robert Sterling (as Steven Baker)
- Till the Clouds Roll By (1946) Played by Bruce Cowling (as Steve Baker)
- Show Boat (1936) Played by Donald Cook (as Steve Baker)
... aka "Edna Ferber's Show Boat" - USA (complete title)
- Show Boat (1929) Played by George Chesebro (as Steve Baker)
Additional Details
Plot Keywords:
Fun Stuff
Steve: You wouldn't call a man a white man that had Negro blood in him, would you?
The Sheriff: No, I wouldn't; not in Mississippi. One drop of Negro blood makes you a Negro in these parts!
See more »
You may correct errors and omissions on this page directly. Clicking the 'Update' button will take you through a step-by-step process.


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New movie trailers and new music videos 2012. HD Movie trailers for upcoming movie releases. Movie Soundtracks. Wallpapers from movies. Latest music videos. New music and movies for 2012. Movie and music News.
Monday, November 15, 2010
Documentary "Cool It" (2010)
Cast: Bjorn Lomborg
Director: Ondi Timoner
Release Date: November 12th, 2010
Genre: Documentary
Description: Centers on Danish political scientist, lecturer and author Bjorn Lomborg, called one of the 75 most influential people of the 21st Century by Esquire magazine, and his practical approach to solving global warming.
Download movie Cool It (2010)
Trailer Cool It (2010)
Publicat de Daniel Nicolae la 11/15/2010
Etichete: Movie trailers, Movies 2010
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