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music mondays.16:00
This is an album I have been anticipating for quite awhile. I spontaneously visited London last summer to see friends, here I went down to Lock 17 in Camden and saw Gabrielle performing to a sold out crowd. The atmosphere was electric. We then headed to Barn on the Farm where she headlined. An incredibly humble person is Gabrielle and even when told not to perform in Dublin last month in The Academy by doctors, she couldn't let the crowd down.
The album is graced with the ever popular Home, number one single Power of Love (John Lewis advert this Christmas) and her up and coming single Panic Cord. Also Human which I currently have on repeat, Among others where you get lost in the lyrics, highly relatable and easy listening. Her album is available on iTunes right now and I really hope you take a look at her on Youtube, such a bubbly personality and also owns a pet Ferret called Ferris. What's not to love.
Check her out on Twitter - @GabrielleAplin
and her Youtube Channel - http://www.youtube.com/user/Gaberrz
Would love to know what you think of her, or if you've bought the album?


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Former Indiana Gov. Mitch Daniels has been named to the board of directors of Norfolk Southern Corporation.
He will be joined on the board by Marcela Donadio, a retired partner at Ernst & Young.
Daniels is the president of Purdue University and served as the governor of Indiana between 2005 and 2013.
In other news, Elaine Chao is expected to become the U.S. Secretary of Transportation in the Trump administration.
Chao is a former deputy transportation secretary under President George H.W. Bush between 1989 and 1991, and served as the Secretary of Labor under President George W. Bush between 2001 and 2009.
Tags: Elaine Chao, Marcela Donadio, Mitch Daniels, Norfolk Southern, U.S. Department of Transportation

subset: commoncrawl


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South African Champion Empress Club Dies
Empress Club, a South African Horse of the Year, died suddenly Dec. 19 at Gainesway Farm (Antony Beck, president) near Lexington. Owned by South African owner Laurie Jaffee, the stakes-producing daughter of Farnesio out of the El Gran Capitan mare Elysee was in foal to Gainesway stallion Orientate.
Empress Club was bred in Argentina and imported as a yearling by Jaffee to South Africa. In her new land, she won 15 of 20 races, including eight group I stakes, and was a five-time South African champion. Following her arrival in the U.S., she won the 1994 Hillsborough Handicap (gr. IIIT) at Bay Meadows.
Empress Club retired to Gainesway, then operated by Beck's father, Graham J. Beck of South Africa, with a record of 16 wins from 26 starts and earnings of $1,155,235. Her first foal was a Lyphard colt. Named Azouz Pasha, he was an English stakes winner. Empress Club's other two winners also were Northern Hemisphere winners. Empress Club produced six named foals. Her youngest offspring is an unnamed 2004 colt by Thunder Gulch.


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NEW YORK (MarketWatch) -- Treasury prices came under a little more pressure and the dollar edged up on Wednesday after a report showed U.S. sales of new homes in December rose more than expected. The dollar index DXY, +0.16% which tracks the U.S. unit against a basket of six other currencies, edged up to 78.010, from 77.937 before the data and versus 77.973 in North American trade late Tuesday. The euro EURUSD, +0.0086% bought $1.3655, from $1.3664 earlier and down from $1.3682 late Tuesday. Yields on 10-year notes TMUBMUSD10Y, -0.44% which move inversely to prices, rose 7 basis points to 3.40%.
Treasury yields, dollar inch up after data
Quote References
+0.15 +0.16%
+0.0001 +0.0086%
-0.01 -0.44%


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Mold tends to alive outdoors on plants, decay, and the soil. They prosper in an ironic moisture environment, damp and wet areas indoors can produce mold easily. They frequently occur in the bathroom on tiles, sinks, basement walls, and windows. Any zone in your home that is dripping water or has water condensed or trickled is a great place for mold to grow. You can also schedule an appointment through thatmoldlady.com/ for the mold inspection at your home.
The mold initiates as tiny spores that travel in the air and can land on damp areas inside and that's when they flourish and cultivate in your home. The mold will eat whatsoever it lands on to endure and this will cause a lot of destruction to your home if you don't pay attention to the problem right away. Mold inspection services will help you detect the problem and tell you how to check the mold from growing in your home anymore.
When you determine mold in your home, the first thing you should do is request a mold inspection service to come and do an inspection on the house. This way they can tell you how severe the mold is and if you should be really worried or not. They will then command solutions to getting rid of the problem.


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fuel injection ? bank 2
2 Answers
OK DID YOU GET A FREE CODE READING TO GET TO THE fuel injection ? bank 2 ????? AT THIS POINT ADD 1 BOTTLE OF ZMAX FUEL TREATMET TO 1/3 TANK OF GAS..WHILE YOU AND OR US GET SOME INFO..THIS WAY THINGS WILL GET A LITTLE CLEANED UP IN THERE...
there are about 13 different things that would set the code....Oxygen O2 Sensor .IS IT RICH OR LEAN???ENGINE MISS?...Fuel pressure regulator problems
Search Mazda Millenia Questions
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ideas, innovations and apps for social work in the age of smartphones and social media
According to some scholars, digital media provide young people with the tools, spaces, and communities to develop the knowledge, skills, dispositions, and social practices needed for full participation in contemporary society as consumers, producers, and civic actors. Surely all children can learn something through their use of digital media. But some of these lessons hold greater value to their present and future lives than others.
See on mindshift.kqed.org


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Jayson Nix has cleared waivers and accepted his assignment to Triple-A, the team announced. The Yankees signed him to a new one-year deal worth $900k last week, then immediately designated him for assignment. Nix agreed to accept the Triple-A assignment if he cleared waivers, so he remains with the organization but is no longer on the 40-man roster.
River Ave. Blues » Jayson Nix clears waivers, accepts assignment to Triple-A


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Experimental Mercury Monkey (Nufan)
Chiron ( Monkeys Journey to the East )8:3619 2Like Reshare SocialAddDownloadto Set to Group to Playlist8:36
Teaser track from the forthcoming Mercury Monkey album due out this Christmas.
This track was tagged with the following keywords: Experimental.
Listen to all music and sounds of Mercury Monkey (Nufan) and follow this user by signing in for free.


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Yesterday, I put Little Guy and Princess in the car ready to meet a friend at the park. Then I got in. There was an odd smell in our car.
We came home - blah, blah, blah. Most the time, I grab the two kids and go in the house leaving diaper bags, toys, drinks, etc in the car. There is just too much to carry. Last night I told Hubby that we need to clean out the car since I am picking up friends at the airport today.
We go out to the car, clean out the trunk. I said "do you smell that?" Hubby did, but it wasn't too bad. Then we opened the door to the back seat. Hubby said, "UGH!!! That smells like a dirty diaper was left in here!"
To make a long story short, we found the culprit. You will never guess. It was a tube of Balmex diaper cream that went rancid from being in the heat. We through the diaper bag away it because it smelled so bad. I washed some clothes and a bib that was in the diaper bag. After one wash the clothes still smell horrible.
Who would have thunk it? - Balmex!


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Thursday, May 21, 2009
Church Carnival
Our church had a carnival on Saturday. They had inflatables, games, face painting, etc... The girls had a lot of fun.....here are some pics.
Posted by Kelly at 7:57 AM No comments:
1 yr. stats....
Jenna had her 1 yr. check-up on Monday! The doctor said that she is doing great and impressed with how well she gets around!
Weight: 20 lb. 1 oz (31 percentile)
Height: 29 in. (45 percentile)
Avah's stats at 1 yr.....
Weight: 20 lb. 10 oz (45 percentile)
Height: 30 1/4 in. (85 percentile)
Weight: 20 lb. 1 oz (31 percentile)
Height: 29 in. (45 percentile)
Avah's stats at 1 yr.....
Weight: 20 lb. 10 oz (45 percentile)
Height: 30 1/4 in. (85 percentile)
Posted by Kelly at 7:52 AM No comments:
Monday, May 18, 2009
Jenna's 1st Birthday
We had Jenna's birthday party yesterday at the park. It was a lot of fun and she got lots of fun new stuff!
Posted by Kelly at 5:43 PM No comments:
Friday, May 15, 2009
1 year ago today....
I can't believe that my baby is 1 year old today! Where did the time go?? Here are some pictures of the day she was born....
Posted by Kelly at 12:05 PM No comments:
Monday, May 11, 2009
First Sucker
Posted by Kelly at 11:38 AM No comments:
Papaw's Birthday
Jenna got a new toy!
(oops...don't know why the picture is turned)
Hi, Riley!
(Riley is Uncle Nate and Jamie's dog)
Avah wanted Papaw to have her animal puzzle....she said that she didn't need it anymore!
(We got him a real present as well!)
Playing with Bishop and Quincy.
Posted by Kelly at 11:21 AM No comments:
Mammy's Birthday
Mammy and her girls.
Avah insisted that we should make a blueberry cake, so we made a blueberry cheesecake. It was yummy!
Avah is excited for Mammy to open the card she picked out....it is a singing card!
Posted by Kelly at 11:05 AM No comments:
Hanging Out
Avah made her own seat to read her book.
Reading to the class!
Jenna and Naelee
Getting ready for a picnic.
Posted by Kelly at 10:49 AM No comments:
Daddy's Turkey
Posted by Kelly at 10:42 AM No comments:
Subscribe to: Posts (Atom)


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March 2017, Volume 20, No.7 Abstracts
Author:尹鹏 Source:CGP Published: [03-09] views: 745
Developmental Pattern of British General Practice and Its Enlightenment to China SHAN Hai-yan,QI Hui-meng,YU Xiao-song*
Department of General Practice,the First Hospital of China Medical University,Shenyang 110001,China
*Corresponding author:YU Xiao-song,Professor,Doctoral supervisor;E-mail:firstname.lastname@example.com
【Abstract】 The construction of general practitioners team in China is a vital issue concerning people′s livelihood.The paper analyzes the developmental pattern of British general practice,makes a comparison of community medical conditions and levels between mainland China and UK,discusses the inadequacies of primary health care model in our country,and thus puts forward corresponding improvement measures so as to provide references for deepening reform on the management system of general medicine and community health care in our country.
【Key words】 General practice;Medical model;United Kingdom
Implementation and Incentive Function of Contract Employment and Performance-based Payment System in Community Health Service Institutions
WANG Yong-yi1,XU Ling2,ZHANG Ming-ji1,3,WANG Wei1,HE Lei2,YAN Fei1*
1.School of Public Health,Fudan University;Key Lab of Health Technology Assessment,Ministry of Health(Fudan University);the Innovation Center for Social Risk Governance in Health,Shanghai 200032,China
2.Health Statistics and Information Center,National Health and Family Planning Commission of the People′s Republic of China,Beijing 100044,China
3.School of Public Health,Shanghai Jiaotong University,Shanghai 200025,China
*Corresponding author:YAN Fei,Professor,Doctoral supervisor;E-mail:firstname.lastname@example.com
【Abstract】 Objective To understand the implementation situation and the incentive function of contract employment and performance-based payment system in community health service institutions in four provinces and cities of China.Methods This study used a multi-stage sampling method.By purposive sampling method,Shandong Province and Shanghai City were selected from the eastern region,and Anhui Province was selected from the central region.Shaanxi Province was selected from the western region;and the provincial capital city and one prefecture-level city with good community health service development were selected from the three provinces respectively;district was selected from each city(including Shanghai) respectively and seven districts totally.According to the type of holding body and staff size of community health service institutions in each district,stratified sampling was carried out to extract three community health service institutions at most from each layer,and a total of 61 community health service institutions were selected.Using cluster sampling,all the 713 on-duty health workers at the investigation day were selected from each community health service institutions as the subjects,and 6 community health workers were selected as the interview subjects.The self-designed questionnaire included the basic situation of the community health technical personnel,the implementation of the contract employment system,and the implementation of the performance-based payment system.From August to September 2013,self-administered questionnaire was used to investigate the subjects.713 questionnaires were sent out and 656 valid questionnaires were collected.The effective response rate of the questionnaires was 92.0%.At the same time of questionnaire survey,in-depth interviews were conducted to evaluate the contract employment and performance-based payment systems.Results Among 61 institutions,27 institutions with holding body of public ownership and 18 with holding body of private ownership had implemented the contract employment system.In these 45 institutions the annual income of off-staff personnel covered(82.9 ± 16.6)% of the in-staff personnel,while in the 16 institutions that have not implemented contract employment system,the annual income of off-staff personnel covered(53.0 ± 17.4)% of the in-staff personnel,and these two were significantly different(P<0.05).Among 34 institutions with holding body of public ownership,24 had implemented the performance-based payment system.64.7%(180/278) of the staff in the community health service center and 85.1%(63/74) of the staff in the community health service station believed that the performance appraisal had incentive function.42.1%(153/363) of community health workers believed that the fairness of income distribution of the institution is good.Conclusion Contract employment system and performance-based payment system play an important role in ensuring the income equality and improving the enthusiasm of the employees,but further exploration in breaking the limitation of authorized strength,disaggregate links between authorized strength and welfare and establishing scientific performance-based payment system are still needed.It is recommend that improve contract employment system and increase income channels to ensure income of health workers;set the proportion of performance salary reasonably to give full play to the guiding role of performance-based payment system.
【Key words】 Community health services;Contract employment system;Performance-based payment system;Incentive function
Evaluation Index System Construction of Human-centered Consultation Service of General Practitioners
SUN Chen,LU Xiao-qin*
School of General Practice and Continuing Education,Capital Medical University,Beijing 100069,China
*Corresponding author:LU Xiao-qin,Professor,Doctoral supervisor;E-mail:email@example.com
【Abstract】 Objective To construct a evaluation index system construction of human-centered consultation service of general practitioners.Methods The framework and item pool of the evaluation index system were initially proposed by using the method of literature research.From June to September 2016,the improved Delphi Expert Consultation method was used to conduct a two-round consultation to 18 selected experts.The importance and operability of the indexes were scored by the experts.According to the degree of concentration and coordination of expert opinion,the index system was selected and modified.The expert grading method and the combination weighting product method were used to calculate the weight of each index.Results 18 consultation tables were sent out in the 2-round expert consultation,and all were recovered with the effective response rate of 100.0%.The average authority degree coefficient of the experts on the primary indicators(Cr) was 0.88.In the first-round consultation,the arithmetic average of the score of the importance and operability of each index was 4.00~5.00 and 3.47~4.89 respectively,the rate of full marks was 22.22%~100.00% and 11.11%~88.89% respectively.In the second-round consultation,the arithmetic average of the score of the importance and operability of each index was 4.00~5.00 and 3.17~4.88 respectively,the rate of full marks was 33.33%~100.00% and 5.56%~88.24% respectively.In the first-round consultation,the variable coefficients of the score of the importance and operability of each index were 0~0.26 and 0.07~0.27 respectively,while in the second-round consultation,the variable coefficients were 0~0.21 and 0.07~0.27 respectively.In the first-round consultation,the cooperation indexes of the score of the importance and operability of each index were 0.226 and 0.243 respectively(P<0.05),while in the second-round consultation,the cooperation indexes were 0.247 and 0.237 respectively(P<0.05).The final evaluation indicators were 37 items(5 primary indexes,32 secondary indexes).The primary indexes were inquiry,physical examination,auxiliary examination,patient management,and doctor-patient communication respectively,and their weight coefficients were 0.213,0.208,0.170,0.201 and 0.208 respectively.Conclusion The study has constructed a evaluation index system construction of human-centered consultation service of general practitioners which is scientific,and can be used as the evaluation tool of the human-centered service in the process of consultation of general practitioners.
【Key words】 General practitioners;Quality indicators,health care;Person-centered care;Delphi technique
Job Content and Satisfaction in Community Nurses
TAO Lin,LIU Su-zhen*,LI Ji-ping
School of Nursing,West China Hospital,Sichuan University,Chengdu 610041,China
*Corresponding author:LIU Su-zhen,Professor,Master supervisor;E-mail:email@example.com
【Abstract】 Objective To investigate the status of job content and satisfaction in community nurses in Sichuan Province.Methods We conducted a questionnaire survey between March and November 2014.Using convenient sampling and with the help of the members of Community Nursing Committee under Sichuan Nursing Association,we selected 56 community health service centers(CHSCs) which were willing to cooperate with us in completing the questionnaire survey,from Chengdu,and 11 prefecture-level cities in Sichuan Province.By cluster sampling,we selected all the nurses in the 56 CHSCs as the participants of this study.The questionnaire used in the survey encompasses the baseline characteristics,current job content and satisfaction of the nurses.The final participants were 969 nurses who completed the questionnaire effectively,accounting for 95.5% of the 1 015 first selected nurses.Results The results of the questionnaire survey showed that,the job content was reported as public health and basic medical nursing by 323 nurses(33.4%),basic medical nursing by 290(29.9%),public health nursing by 280(28.9%),management work by 61(6.3%),and non-nursing work by 15(1.5%).The average total score of job satisfaction in the 969 participants was(3.39±0.41).The scores of dimensions of job satisfaction ranked from high to low are as follows:working relationship(4.03±0.63),working ability confirmed by the society(3.83±0.59),balance between family and job(3.79±0.66),work unit management(3.66±0.76),work load(3.12±0.45),personal growth and development(3.05±0.68),the job itself(3.03±0.53),wages and benefits(2.32±0.81).One-way ANOVA found that,there were significant difference in the total score of job satisfaction in community nurses as well as the scores of dimensions of wages and benefits,work unit management,working relationship,personal growth and development among different job content(P<0.05),there were no significant difference in the scores of dimensions of balance between family and job,work load,the job itself and working ability confirmed by the society among different job content(P>0.05).Conclusion The services delivered by community nurses in Sichuan Province are comprehensive,but they are to be further developed.The job satisfaction in community nurses is not satisfactory.Therefore,in order to achieve the sustainable development of community nursing,it is suggested to vigorously develop community specific nursing,and improve the job satisfaction of community nurses especially those engaged in public health nursing and management work.
【Key words】 Community nurses;Job content;Job satisfaction
Construction and Implementation of Intelligence Family Doctors Optimized Coordination Model
GUO Xiao-ling,WU Hao*,LIU Xin-ying,JIA Hong-yan,WANG Dan,WEI Xue-juan,WANG Li,HAO Yan
Fangzhuang Community Health Service Centre;College of General Practice and Continuing Education,Capital Medical University,Beijing 100078,China
*Corresponding author:WU Hao,Chief physician,Associate professor,Master supervisor;E-mail:email@example.com
【Abstract】 Through many years of exploration and practice,the role definition of family doctors,support of "Internet +" and artificial intelligence technology,the cooperation within family doctor team(one-to-one cooperation of family doctors and nurses),and labor division and collaboration among general practice and specialist as well as other medical institutions,Fangzhuang Community Health Service Centre in Fengtai of Beijing thus achieves a new model of people-centered and intelligent resource coordination and service optimization among family doctors.This model has improved the service capacity of community health service institutions and the efficiency of various service sectors,saved the resources of social health services,improved the self-awareness of residents participating in health management,which can provide references for the development of "Internet + family doctor" service and the implementation of hierarchical diagnosis and treatment.
【Key words】 General practitioners;Optimized coordination;"Internet+";Intelligence;Beijing
Path Construction of Community Specific Disease Prevention and Treatment Based on Family Doctor′s Contract Service Cloud APP Platform:A Case Study of Osteoporosis
WANG Tian-ying,ZHUANG Kang-lu,FENG Lei,SONG Hui-jiang*
Sanlin Community Health Service Center of Shanghai,Shanghai 200124,China
*Corresponding author:SONG Hui-jiang,Chief physician;E-mail:firstname.lastname@example.com
【Abstract】 Osteoporosis is a metabolic bone disease characterized by decrease in bone mass,damage in bone tissue microstructure,increased bone fragility and susceptibility to fracture.The family doctor′s contract service is a kind of health management delivered by a family doctor for the people in the area for which the family doctor is responsible,and during the service delivery,the medical resources are optimized at utmost,and allocated and used most reasonably.Currently,one of the difficulties in constructing the path of community specific disease prevention and treatment is,building an osteoporosis health management path that is well associated with the regional contract service system,by which the contracted family doctor can better offer the services.The ways that we used to solve this problem are as follows:Firstly,we investigated the guidelines related to osteoporosis prevention and treatment at home and abroad included by literature search,and chose tools for screening,diagnosis,treatment and follow-up strategies of osteoporosis.Then,in accordance with the experts′ review on the literature retrieval results,we selected the appropriate screening,diagnosis and treatment tools for osteoporosis.Next,we set the related structured themes by brainstorming,in which we identified the procedure of using the tools and obtained the logical chart of community osteoporosis prevention and treatment path.And on the basis of the above,we constructed the flow chart of community osteoporosis prevention and treatment path.Finally,we developed the community osteoporosis prevention and treatment module based on all the above,and added it to Sanlin family doctor service cloud APP platform.This module was taken into practice.It can meet the needs of screening,diagnosis,treatment,rehabilitation,and informationalized management of osteoporosis with a good application prospect.
【Key words】 Osteoporosis;Community health services;General practitioners contract services;Informationization
Research and Design of Validated Chronic Disease Management System
HUAN Hua-min1,ZHANG You1*,FAN Yu-qin2,CHEN Zhi-hua3,SHEN Shi-lai4,CHANG Qing1,ZHENG Yu-qun1,JIN Yan-jie5
1.Xinbei Center for Disease Control and Prevention,Changzhou 213022,China
2.Xinqiao Health Center,Changzhou 213032,China
3.Zhonglou Center for Disease Control and Prevention,Changzhou 213015,China
4.Xinbei Health Planning Bureau,Changzhou 213022,China
5.Beijing Longteng Xinyang Information Technology Co.,Ltd,Beijing 102208,China
*Corresponding author:ZHANG You,Associate chief physician;E-mail:firstname.lastname@example.com
【Abstract】 By Internet,smart phone software and effective certificate authentication technologies,validated chronic disease management system has constructed a validated management system of hospital diagnosis and treatment and community management.When logging on to the doctor workstation or providing door-to-door service for residents,medical workers need to validate the valid certificate(such as health card) of the patient through a personal computer(PC) or a smart phone,and only in this way can they enter the patient management system,and carry out the on-site management information input(paperless) and real-time upload.The establishment of this system has achieved the digital mobile services for patients with chronic diseases,and ensured the authenticity of management information,and can provide new way and basis for performance appraisal,fund allocation and scientific management of patients with chronic diseases in the basic public health service projects.
【Key words】 Chronic disease;Disease management;Computer communication networks;Artificial intelligence
Clinical Features and Outcome of Acute Pancreatitis in Elderly Patients
WANG Bei-bei,LIAO Shan-ying,NIE Sheng-li,SHA Wei-hong,BU Xiao-ling,MA Juan*
Department of Gastroenterology,Guangdong General Hospital/Guangdong Academy of Medical Sciences,Guangzhou 510080,China
*Corresponding author:MA Juan,Associate chief physician;E-mail:email@example.com
【Abstract】 Objective To investigate the clinical features and outcome of acute pancreatitis(AP) in the elderly.Methods The subjects enrolled in this study were 1 382 consecutive AP patients admitted to Guangdong General Hospital from November 2005 to October 2015.By checking medical records,we obtained the clinical data of them,including gender,age,etiology distribution of AP,severity staging of AP,complications,length of stay,recurrence rate and mortality.Based on age,we divided the patients into the elderly group(aged 60 or over,n=678) and the control group(younger than 60 years old,n=704).Results Significant gender difference in the incidence of AP was found between the two groups(P<0.05).The incidence of AP due to biliary disease in the control group and elderly group was 46.4%(327/704) and 76.8%(521/678),respectively.Etiology distribution of AP differed remarkably between the groups(P<0.05),while the severity staging of AP did not(P>0.05).With regard to the incidence of local complications,the incidences of acute peripancreatic fluid collection,acute necrotic collection and pancreatic pseudocyst were significantly higher in the control group than in the elderly group(P<0.05),but the incidences of encapsulated necrosis,walled-off pancreatic necrosis,hydrothorax,gastrointestinal fistula,intra-abdominal hemorrhage,pancreatic pseudocyst bleeding,splenic/portal vein thrombosis and necrotic colitis were not(P>0.05).In terms of the incidence of systemic complications,the incidences of systemic inflammatory response syndrome(SIRS),intra-abdominal hypertension(IAH)or abdominal compartment syndrome(ACS) were significantly higher in the control group than in the elderly group(P<0.05),but the incidences of organ failure and systemic infection were not(P>0.05).Two groups had similar length of stay and mortality(P>0.05),however,the elderly group had significantly higher recurrence rate(P<0.05).Conclusion Biliary pancreatitis was the most common to be seen in the elderly group.Elderly and control groups had similar severity staging of AP,length of stay and mortality,but the former had higher proportion of women with AP,and recurrence rate.
【Key words】 Pancreatitis;Disease attributes;Prognosis;Aged
Characteristic of Patients with Climacteric Problems in Seeking Treatment
XI Si-si1,BAI Wen-pei2*
1.Department of Gynecology and Obstetrics,Peking University First Hospital,Beijing 100034,China
2.Department of Gynecology and Obstetrics,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China
*Corresponding author:BAI Wen-pei,Chief physician,Professor,Doctoral supervisor of obstetrics and gynecology,Master supervisor of general practice;E-mail:firstname.lastname@example.com
【Abstract】 Objective To study the characteristic of patients with climacteric problems in seeking treatment,and to provide data for the health work of climacteric women.Methods A retrospective analysis of 1 031 patients with climacteric problems admitted to the climacteric general management clinic of Peking University First Hospital from September 2012 to December 2014 was carried out.Self-designed questionnaires including the basic information,menstrual and menopausal symptoms,and medical history of definite diagnosis were used to investigate the enrolled subjects.Body height,body weight and waist circumference were measured,and BMI was calculated.Results A total of 1 007 valid questionnaires were collected,and the effective response rate was 97.7%.The median age of the patients was 51(6),609(60.5%) had a college degree or above,and 598(59.4%) had an individual monthly income equal to or over 3 000 yuan.44.3%(446 cases) of the patients were in postmenopausal period,75.8%(338 cases) of them had gone through natural menopause,and the median age of menopause was 49(5).Concerning the menopausal symptoms,807 patients(80.1%) felt tired,734(72.9%) was worried about insomnia,595(59.1%) had active attitude towards climacteric.There were 551(54.7%) patients combining with central obesity,326(32.4%) combining with overweight,132(13.1%) combining with hyperlipidemia and 132(13.1%) combining with hypertension.Conclusion Most of the patients with climacteric problems in seeking treatment are menopausal and high educated women in upper middle income group.The proportion of patients combined with central obesity,hyperlipidemia and hypertension is relatively high.Thus we should pay attention to the menopausal health care of the whole people,and conduct chronic disease screening for menopausal women so as to improve the overall health of society.
【Key words】 Climacteric;Menstruation;Comorbidity
Cut-off Points of Glycosylated Hemoglobin and Fasting Plasma Glucose for Early Diagnosis of Diabetes Mellitus
ZHANG Jing-yi1*,GUO Jing1,DONG Zhao1,WU Shi - fang1,ZHANG Fei-fei1,ZHENG Bao-xia2
1.Department of Endocrinology,Kailuan General Hospital Affiliated to North China University of Science and Technology,Tangshan 063000,China
2.CT Room,Kailuan General Hospital Affiliated to North China University of Science and Technology,Tangshan 063000,China
*Corresponding author:ZHANG Jing-yi,Professor,Master supervisor;E-mail:email@example.com
【Abstract】 Objective To investigate the cut-off points of glycosylated hemoglobin(HbA1c) and fasting plasma glucose(FPG) for early diagnosis of diabetes mellitus.Methods The subjects enrolled in this study were 766 consecutive outpatients and inpatients of Kailuan General Hospital Affiliated to North China University of Science and Technology who underwent measurement of HbA1c,FPG and oral glucose tolerance test(OGTT) between January 2012 and April 2016.We used HA-8160 Automatic Glycosylated Hemoglobin Analyzer made in Japan with high pressure liquid chromatography to determine HbA1c,and HITACHI 7600 Automatic Biochemical Analyzer with hexokinase method to determine FPG.We divided the patients into diabetic group〔2-hour postprandial blood glucose(2 hPG) ≥11.1 mmol/L,n=628〕 and non-diabetic group(2 hPG<11.1 mmol/L,n=138) based on the Definition,Diagnosis and Classification of Diabetes Mellitus and Its Complications revised by WHO in 1999.We drew the receiver operating characteristic(ROC) curves of HbA1c and FPG,and investigated the optimal cut-off points of them for the diagnosis of diabetes mellitus with analyzing the sensitivity,specificity,positive predictive value,negative predictive value,positive and negative likelihood ratios,Youden′s index and Kappa value.Results The largest area under curve(AUC) of HbA1c′s ROC curve in the diagnosis of diabetes mellitus was 0.918〔95%CI(0.895,0.942),P<0.001〕,the cut-off point was 6.55%,with a sensitivity of 90.1%,specificity of 75.4%,positive predictive value of 90.1%,negative predictive value of 75.4%,positive likelihood ratio of 3.7,negative likelihood ratio of 0.1,Youden′s index was 0.66 and Kappa value of 0.63.The largest AUC of FPG′s ROC curve in the diagnosis of diabetes mellitus was 0.901〔95%CI(0.877,0.926),P<0.001〕,the cut-off point was 6.23 mmol/L,with a sensitivity of 85.0%,specificity of 81.9%,positive predictive value of 84.9%,negative predictive value of 81.9%,positive likelihood ratio of 4.7,negative likelihood ratio of 0.2,Youden′s index was 0.67 and Kappa value of 0.65.The cut off points of HbA1c(6.55%) and FPG(6.23 mmol/L) for the combined diagnosis of diabetes mellitus had a sensitivity of 76.6%,specificity of 95.5%,positive predictive value of 65.5%,negative predictive value of 98.3%,positive likelihood ratio of 17.0,negative likelihood ratio of 0.3,Youden′s index was 0.72 and Kappa value of 0.70.Conclusion HbA1c(6.55%) combined with FPG(6.23 mmol/L) can be one of the methods for early diagnosis of diabetes mellitus,for it has good specificity.Moreover,it has higher Youden′s index and Kappa value than HbA1c(6.55%) or FPG(6.23 mmol/L) used alone as the early diagnosis method of diabetes mellitus.
【Key words】 Diabetes mellitus;Hemoglobin A,glycosylated;Fasting plasma glucose;Diagnosis;Cut-off point
Different Doses of Atorvastatin for the Prevention of Contrast-induced Nephropathy in Patients with Ischemic Stroke after Cerebrovascular Interventions
FU Rui*,DAI Wei,XI Chun-jiang,ZHAO Xing-hui,ZHANG Tong
Department of Neurology,Beijing Shijitan Hospital,CMU,Beijing 100038,China
*Corresponding author:FU Rui,Associate professor;E-mail:firstname.lastname@example.com
【Abstract】 Objective To study the effects of different doses of atorvastatin on the prevention of contrast-induced nephropathy(CIN) in patients with ischemic stroke after cerebrovascular interventions.Methods One hundred and ninety-four consecutive patients with ischemic stroke hospitalized in Beijing Shijitan Hospital,CMU from August 2012 to December 2014 were randomly assigned into high dose of atorvastatin group(n=98) and low dose of atorvastatin group(n=96),and respectively took atrovastatin 40 mg/d,and atrovastatin 20 mg/d orally before contrast agent administration.Comparisons were made between the groups in terms of serum creatinine(SCr),serum cystatin C(CysC) measured before,and at 24 h,48 h after cerebrovascular interventions,post-procedure mean peak SCr,post-procedure increase in SCr from baseline(△SCr),incidence of CIN and incidence of adverse reactions.Results No significant differences were found between the two groups in terms of proportion of male patients,ratio of patients aged ≥70 years old,incidence of hypertension,incidence of diabetes,percentage of patients using angiotensin converting enzyme inhibitors(ACEI) /angiotensin receptor antagonist(ARB),proportion of patients using the dose of contrast agent ≥200 ml(P>0.05).Both groups had no obvious difference in mean SCr(P>0.05),but the SCr before procedure,at 24 h and 48 h after the procedure differed significantly between the groups(P<0.05).Treatment method and duration exerted interaction effects on SCr(P<0.05).The difference in the mean CysC between the groups was distinct(P<0.05).The CysC before procedure,at 24 h and 48 h after the procedure in the high dose of atorvastatin group were significantly different from those in the low dose of atorvastatin group(P<0.05).Treatment method and duration had interaction effects on CysC(P<0.05).The levels of peak SCr and △SCr were significantly lower in high dose of atorvastatin group than in low dose of atorvastatin group after procedure(P<0.05).The incidence of CIN was significantly higher in low dose of atorvastatin group than in high dose of atorvastatin group(P<0.05).Results of routine blood,biochemical and coagulation function indicators in both groups remeasured on the 7th day after procedure showed no obvious abnormalities.Conclusion High dose of atorvastatin offers protection against CIN in patients with ischemic stroke after cerebrovascular interventions.
【Key words】 Stroke;Brain ischemia;Interventional diagnosis and treatment;Atorvastatin;Contrast-induced nephropathy
Synergic Effect of Renin and Aldosterone on the Left-sided Heart Structure and Function in Essential Hypertension with Obstructive Sleep Apnea-hypopnea Syndrome
ZULIMIRE·Abulizi1,SUN Xiao-jing2,CHEN Yu-lan1*,ZHANG Jun-shi1,ZHULEPIYA·Simayi1,XU Xin-juan1,ZHANG Xiang-yang1
1.Department of Hypertension,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China
2.Department of ICU,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China
*Corresponding author:CHEN Yu-lan,Chief physician,Master supervisor;E-mail:firstname.lastname@example.com
【Abstract】 Objective To study the synergic effect of renin and aldosterone on the left-sided heart structure and function in essential hypertension with obstructive sleep apnea-hypopnea syndrome(OSAHS) patients.Methods We selected 277 inpatients who did not take any antihypertensive drugs affecting renin-angiotensin-aldosterone system(RAAS)〔197 males and 80 females with an average of(44.3±7.9) years old(ranged from 18 to 60)〕 from 546 patients hospitalized in Department of Hypertension,the First Affiliated Hospital of Xinjiang Medical University and confirmedly diagnosed with essential hypertension and OSAHS from January 2011 to January 2016,and divided them into 4 groups based on the plasma renin activity(PRA) and plasma aldosterone concentration(PAC) levels: normal PRA and PAC(N group,n=74),high PRA and normal PAC(HR group,n=113),normal PRA and high PAC(HA group,n=22),high PRA and high PAC(HRA group,n=68).Echocardiogram was used to determine the parameters of left-sided heart structure and function,including left atrial diameter(LAD),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),and mitral ratio of peak early to late diastolic filling velocity(E/A).Left ventricular ejection fraction(LVEF) and left ventricular mass index(LVMI) were calculated according to the formula.Radioimmunoassay method was adopted to measure the PRA and PAC levels.And the multivariate Logistic regression analysis was used to study the factors affecting left-sided heart structure and function.Results The contrast in general data between 4 groups: the differences in average 24-hour diastolic blood pressure(24 hDBP) and apnea hypoventilation index(AHI) were statistically significant(P<0.05),while those in gender,age,duration of hypertension,BMI,average 24-hour systolic blood pressure(24 hSBP),fasting plasma glucose(FPG),total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C) were not(P>0.05).The contrast in echocardiographic indicators between 4 groups: the differences in LAD,LVEDD,IVST,LVPWT,LVMI,E/A were statistically significant(P<0.05),whereas those in LVESD and LVEF were not(P>0.05).The multivariate Logistic regression analysis found that BMI〔OR=2.756,95%CI(1.604,4.738),P<0.001〕,high PRA and high PAC〔OR=2.377,95%CI(1.038,5.446),P=0.041〕 were the influencing factors of LAD;factors exerting effect on LVMI were gender〔OR=0.283,95%CI(0.134,0.601),P=0.001〕,BMI〔OR=2.058,95%CI(1.198,3.533),P=0.009〕,AHI〔OR=2.776,95%CI(1.364,5.650),P=0.005〕,and high PRA and high PAC〔OR=3.222,95%CI(1.377,7.537),P=0.007〕;E/A was influenced significantly by age〔OR=2.859,95%CI(1.943,4.206),P<0.001〕.Conclusion The combination of renin and aldosterone determines impairment of left-sided heart structure and function in essential hypertension with OSAHS patients,especially the synergic effect of hyperreninemia and hyperaldosternism is obvious.
【Key words】 Hypertension;Sleep apnea,obstructive;Renin;Aldosterone;Left ventricular and atrial structure;Ventricular function,left
Effect of Plasma Homocysteine Level on the Myocardial Infarction during Perioperative Period and Prognosis of Patients with Non-ST Segment Elevation Acute Coronary Syndrome
LIANG Hai-feng1,YANG Ming1*,LIU Yu2,HAN Ling1,LI Xiao-hong1,XIN Xiao-ming1,YAO Min3
1.Department of Cardiology,Fu Xing Hospital,Capital Medical University,Beijing 100038,China
2.Department of Pathology, Capital Medical University School of Basic Medical Sciences, Beijing 100069, China
3.Coronary Heart Disease Center,Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100037,China
*Corresponding author:YANG Ming,Professor,Master supervisor;E-mail:email@example.com
【Abstract】 Background Coronary slow-reflow(CSRF)/no-reflow(no-RF) is an important complication of percutaneous coronary intervention(PCI) therapy,but studies on its pathogenesis and clinical prognosis are not sufficient at present.
Objective To observe the effects of plasma homocysteine(Hcy) levels on CSRF/no-RF phenomena in PCI,myocardial infarction during perioperative period(PMI) and prognosis.Methods A total of 269 patients with non-ST segment elevation acute coronary syndrome(NSTE-ACS) undergoing elective PCI in Department of Cardiology of Fu Xing Hospital,Capital Medical University and Coronary Heart Disease Center of Fuwai Hospital,Chinese Academy of Medical Sciences from January 2013 to May 2015 were assigned to 2 groups according to their plasma Hcy levels:normal plasma Hcy level group(<15 μmol/L,n=172) and elevated plasma Hcy level group(≥15 μmol/L,n=97).The incidence rate of CSRF/no-RF,PMI as well as the occurrence rate of major adverse cardiac events(MACE) and all-cause mortality 1 year after PCI between the two groups were compared in the study.Results There was no significant difference in the gender,age,smoking rate,occurrence rate of hypertension and diabetes mellitus,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C) levels and usage rate of aspirin,clopidogrel /ticagrelor,β-blocker,ACEI/ARB and statins between the two groups(P>0.05),while there was significant difference in coronary artery disease lesion(P<0.05).The incidence rate of the CSRF/no-RF and PMI in the elevated plasma Hcy level group was significantly higher than that in the normal plasma Hcy level group(P<0.05).The incidence rates of single vessel disease in MACE between the two groups were not significantly different(P>0.05),but the incidence rates of double-vessel disease,multi-vessel disease and overall MACE in the elevated plasma Hcy level group were significantly higher than those in the normal plasma Hcy group(P<0.05),the overall all-cause mortality in the elevated plasma Hcy level group was significantly higher than that in the normal plasma Hcy level group(P<0.05).Conclusion High plasma Hcy levels have a significant effect on CSRF/no-RF,PMI and prognosis of patients with NSTE-ACS.
【Key words】 Acute coronary syndrome;Hemocysteine;Coronary slow reflow/no-reflow;Myocardial infarction;Prognosis
Association between Dietary Factors and Gingival Carcinoma in Fujian Province
LIU Feng-qiong1,YAN Ling-jun1,CHEN Fa1,HUANG Jiang-feng1,LIU Fang-ping1,QIU Yu2,LIN Li-song2,HE Bao-chang1*
1.Department of Epidemiology and Health Statistics,Key Laboratory of Environment Factors and Cancer of Fujian Province,School of Public Health,Fujian Medical University,Fuzhou 350108,China
2.Oral and Maxillofacial Surgery,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350004,China
*Corresponding author:HE Bao-chang,Associate professor,Master supervisor;E-mail:firstname.lastname@example.com
【Abstract】 Objective To explore the relationship between dietary factors and gingival carcinoma in Fujian.Methods A total of 133 patients with gingival carcinoma in Oral and Maxillofacial Surgery in the First Affiliated Hospital of Fujian Medical University from December 2010 to June 2016 were selected as the case group;in the same period,321 healthy adults whose gender and age(±3 years) matched with those of the case group were selected from Xihu and Luoxing community of Fuzhou and taken as the control group.The investigators after unified training conducted a face-to-face survey to the subjects in two groups with the InterCHANGE Lifestyle Questionnaire.The main survey contents included the general situation,dietary habits,oral and health conditions.The effects of dietary factors on gingival carcinoma were analyzed by multivariate Logistic regression analysis,and the interaction between seafood and tea was further analyzed by taking the general situation,dietary habits,oral and health conditions as covariates.Results The intake of meat,fish,seafood,green leafy vegetables,non-green leafy vegetables and fruits were significantly different between two groups(P<0.05).There was significant difference in the intake of processed meat,poultry meat,milk and dairy products,eggs,beans and soy products and pickled foods between two groups(P>0.05).Multivariate Logistic regression analysis showed that the intake of meat,fish,seafood,green leafy vegetables,non-green leafy vegetables and fruits was the influencing factor of gingival carcinoma(P<0.05).Stratify the subjects according to whether they drinking tea or not,and the result showed that the intake of seafood equal to or over 3 times a week among those who were not tea drinkers can reduce the risk of gingival carcinoma〔adjusted OR=0.33,95%CI(0.17,0.66)〕.There was a positive interaction between seafood and tea drinking 〔adjusted OR=0.70,95%CI(0.49,0.98)〕.Compared with those non-tea drinkers whose intake of seafood less than 3 times a week,the risk of gingival carcinoma of those non-tea drinkers whose intake of seafood equal to or over 3 times a week〔adjusted OR=0.39,95%CI(0.21,0.74)〕,tea drinkers whose intake of seafood less than 3 times a week 〔adjusted OR=0.45,95%CI(0.24,0.85)〕,and tea drinkers whose intake of seafood equal to or over 3 times a week 〔adjusted OR=0.35,95%CI(0.17,0.74)〕 had all lowered.Conclusion Dietary factors can affect the incidence of gingival carcinoma to a certain degree,and healthy eating habits,regular intake of fresh vegetables and fruits,moderate consumption of fish and seafood can reduce the risk of gingival carcinoma.
【Key words】 Gingival neoplasms;Diet;Fujian
Practice and Thought of Standardized Psychiatric Training for General Practice Postgraduate Students
LYU Guang-hui1,YAO Mi1,2*,SUN Wei3,LIU Chao-zhong4,CHI Chun-hua1
1.Department of General Practice,Peking University First Hospital,Peking University Health Science Center,Beijing 100034,China
2.Xinjiekou Community Health Service Center,Xicheng District,Beijing 100035,China
3.Department of Sleep Medicine,Peking University Sixth Hospital,Beijing 100191,China
4.Department of Outpatient,Peking University Sixth Hospital,Beijing 100191,China
*Corresponding author:YAO Mi;E-mail:email@example.com
【Abstract】 Mental health service is an integral part of primary care in China.Currently,the number of psychiatric medical staff is small,meanwhile general practitioners(GPs) are valued to play a more important role in providing mental health service.That means GPs will provide mental health service with high quality,which bases on the improvement of GPs training in psychiatry.We summarized the current situation of standardized psychiatric training for general practice postgraduate students of Peking University Health Science Center and also put forward our views on training deficiencies.All these aimed to constantly improving the psychiatric training for general practice postgraduates by which their post competency and capabilities in delivering mental health service will be strengthened,so that the needs of mental health service in China can be satisfied gradually.
【Key words】 General practice;Education,medical,graduate;Mental health services
Discussion on Ophthalmological Emergency Treatment and Standardized Training for General Practitioners JIAO Jian,HUA Wen*
Department of Ophtalmology,Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,China
*Corresponding author:HUA Wen,Chief physician;E-mail:firstname.lastname@example.com
【Abstract】 Ophthalmology is the component of standardized training for general practitioners.Improvement of the ophthalmic clinical ability of general practitioners,especially their ability of dealing with ophthalmological emergency through training is of great importance for patients to acquire effective and correct diagnosis and treatment.Firstly through analysis of the ophthalmological emergency cases,the paper proposes that the pre-hospital care and referral of ophthalmological emergency should be the important part of standardized training for general practitioners.Then the paper makes a classified discussion on the possible ophthalmological emergencies from the perspective of general practitioners,and meanwhile preliminarily discusses how to carry out the patient transfer rapidly and effectively after receiving ophthalmological emergencies.In the process of standardized training for general practitioners,through improving general practitioners′ handling ability of ophthalmological emergencies to cultivate general practice talents of higher levels,so that they can better suit for the gatekeeper of health.
【Key words】 General practitioners;Education,medical;Ophthalmology;Emergency treatment;Patient transfer
Medical and Caring Needs of Older People from Sociological Perspective
HUANG Wen-jing1,2
1.School of Public Health,Guangzhou Medical University,Guangzhou 510182,China
2.Huangbeiling Community Health Service Center,Luohu District(Luohu Hospital Group),Shenzhen 518003,China
【Abstract】 Objective To understand the medical and caring needs of the older people,and to explore the enabling and obstructive factors that affect their perception of the medical and caring needs and their access to and use of these services.Methods In May 2016,8 aged people were selected from 100 old people that participated in the comprehensive health assessment of Huangbeiling Community,Luohu District as the research objects.Participants were born between 1918 and 1952,aged from 64 to 98;3 males and 5 females.The ethnographic research method was applied in the study.The researchers are general practitioners who paid attention to the health and well-being of the older people in community health service centers in Huangbeiling.Results (1) The older people had experienced and were experiencing significant social changes.(2) In the marriage relationship,the female old people mostly played the role of caregiver and conformist,neglected or denied their own needs,and most female "old people(aged≥80)" had lost support of their spouse.(3) The older people had many children,and their relationship between generations was complex.(4) Most of the older people wished to be their own master and take care of themselves,and practised what they preach.They were reluctant to let nanny go into the family for the quality of service,their own security,and balance of their own value.(5) Women had more community partners and participated in community activities,while men were most isolated from society.The sources of information for the older people were mostly from the media or by word of mouth,and the formal information is relatively less.(6) The older people showed fear and avoidance to the hospital,and more likely to choose community health services,their interaction with the community health care staff depended on the continuity and initiative of general health care services.(7) The older people most had comorbidity and in complex state of disease,but this had no necessary relation to perceiving needs and service utilization of the older people.With respect to disease type,their self-positioning and health beliefs had greater effects on the search and use of services.Conclusion General practice should focus on the life experiences of the older people,family and friends,community and environment,health beliefs,and experiences of medical services,which are important for understanding their help-seeking behavior and service utilization.The designer and providers of aging services should observe that the older people born before the baby boom have more traditional cultures and beliefs,have specific needs for expression,behavior and interaction,and pay particular attention to the social isolation of male old people.In developing aging in place and pension service and medical service integration,attention should be given to horizontal and vertical relationships within the family of the older people,their interaction with the outside of the family,and the enabling or obstructive effects of these interactions.Fear and avoidance of services in hospitals among the older people,as well as the progressive development of their relationship with community health care workers suggest that community health care workers should enhance their ability of assessing and understanding the needs of the older people,and provide the older people with culturally sensitive and responsive services by physical psychological and social models.Ethnography is a method to observe and analyze the service object from sociological perspective,provides a unique information basis for the design of service system,meets the whole human and people-centered view of general practice,and helps to provide residents with better quality service.
【Key words】 Aged;Health services needs and demand;Community health services;General practice;Ethnography
Association between Social Support and Attitude towards Aging among the Elderly in China
JI Yun1,2,LI Jin-wei3*
1.Department of Psychology,Langfang Normal School,Langfang 065000,China
2.School of Sociology and Demography,Renmin University of China,Beijing 100872,China
3.School of Economics,Langfang Normal School,Langfang 065000,China
*Corresponding author:LI Jin-wei,Lecturer;E-mail:firstname.lastname@example.com
【Abstract】 Objective To explore the association between social support and attitudes toward aging among the elderly in China.Methods In this study,11 511 elderly people aged 60 or over in the Chinese Longitudinal Aging Social Survey(CLASS) were selected from 134 counties,districts and 462 villages.From August to October 2014,Health Self-assessment Score,Mini-mental State Examination(MMSE),Social Network Scale,and the Attitudes to Aging Questionnaire were adopted to investigate the physical health,cognitive ability,social support,and aging attitude of the elderly respectively.A total of 11 511 questionnaires were sent out and 7 225 valid questionnaires were collected.The effective response rate was 62.77%.Results Among the 7 225 aged people,the score of family support was(10.7±5.9),the score of friend support was(8.7±7.6),the score of social support was(19.4±11.2);the score of self-attitude towards aging was(12.9±3.9),the score of general attitude towards aging was(9.7±3.0),total score of attitude towards aging was(22.5±5.4).There were no significant differences in the score of self-attitude towards aging and general attitude towards aging and total score of attitude towards aging among the elderly of different gender(P>0.05),while there were significant differences in the attitudes toward aging among the elderly of different age,marital status,educational degree,and urban and rural,personal annual income(P<0.05).The results of multiple linear regression analysis showed that the scores of friend support was the influencing factor of the score of self-attitude towards aging and general attitude towards aging of the elderly(b values were -0.102,-0.034 respectively;P<0.05).After the social demographic characteristics were included,score of friend support was also the influencing factor of the score of self-attitude towards aging and general attitude towards aging of the elderly(b values were -0.079,-0.030 respectively;P<0.05);after scores of physical health status and cognitive ability were included,score of friend support was also the influencing factor of the score of self-attitude towards aging and general attitude towards aging(b values were -0.069,-0.021 respectively;P<0.05).Conclusion Friend support has a positive effect on the attitude towards aging of the elderly.
【Key words】 Aged;Aging attitude;Social support
Development Trend and Future Prospects of Total Expenditure on Health in China LIU Qiao1,LI Li-qing2*
1.School of Business,Jiangxi Science and Technology Normal University,Nanchang 330031,China
2.School of Economics and Management,Jiangxi Science and Technology Normal University,Nanchang 330031,China
*Corresponding author:LI Li-qing,Associate professor,Master supervisor;E-mail:email@example.com
【Abstract】 The paper gets the index data that related to health expenditure based on China Health Statistics Yearbook from 2001 to 2014 and China National Health Accounts Report from 2012 to 2014.The paper compares the changing trend of China′s total health expenditure vertically by methods of literature review and contrastive analysis,and compares it with countries in Organization for Economic Cooperation and Development(OECD) and the BRICS(Brazil,Russia,India,China,and South Africa) horizontally so as to further reveal the changing rule in China′s health expenditure and the reality of excessive growth.At the same time,taking the experience of developed countries as reference,the paper puts forward relevant suggestions and future prospects of controlling China′s total health expenditure,and thus provides useful references for the currently deepening health care system reform.
【Key words】 Fees,medical;Development trend;Future prospects
Current Situation of Inter-provincial Health Service Efficiency of China Based on Data Envelopment Analysis and Its Promotion Countermeasure
HUANG Hui-qun
Xiangya School of Public Health,Central South University;Hunan University of Finance and Economics,Changsha 410078,China
【Abstract】 Objective To discuss current status of inter-provincial health service efficiency of China and its promotion countermeasure.Methods Based on China Health Statistical Yearbook in 2010,18 provinces (municipalities and autonomous regions) from 31 provinces (municipalities and autonomous regions) of mainland China were selected as objects of study,including Beijing,Tianjin,Hebei,Shanxi,Heilongjiang,Shanghai,Jiangsu,Zhejiang,Fujian,Jiangxi,Shandong,Hubei,Guangdong,Yunnan,Gansu,Qinghai,Ningxia and Xinjiang,and their inclusion criteria was that they included the following input and output indicators in the statistical material of 2009.Data envelopment analysis (DEA) was used to analyze the efficiency of health services in 18 provinces (municipalities and autonomous regions).The input indicators included the following 5 items:health expenditure (yuan),the number of owned beds per thousand people,the number of owned health technicians per thousand people,the number of owned doctors per thousand people,the number of owned nurses per thousand people;the output indicators included two items-mortality (‰) and birth rate (‰).Results There were four provinces (municipalities and autonomous regions) belonging to the first category:Hebei,Jiangxi,Yunnan,and Gansu,and their corresponding integrated technical efficiencies were 0.944,1.000,1.000 and 1.000 respectively.Three provinces (municipalities and autonomous regions) belonged to the second category:Jiangsu,Fujian,and Hubei,and their corresponding integrated technical efficiencies were 0.878,0.850,and 0.831 respectively.There were 8 provinces (municipalities and autonomous regions) belonging to the third category:Shanxi,Heilongjiang,Zhejiang,Shandong,Guangdong,Qinghai,Ningxia,and Xinjiang,and their corresponding comprehensive technical efficiencies were 0.719,0.623,0.619,0.728,0.628,0.796,0.759,and 0.688 respectively;three provinces (municipalities and autonomous regions) belonged to the fourth category:Beijing,Tianjin,and Shanghai,and their corresponding integrated technical efficiencies were 0.248,0.496,and 0.388 respectively.Further improvement of the efficiency of those 11 provinces (municipalities and autonomous regions) that belonged to the third and fourth categories showed as follows,in the case of constant output,only Qinghai Province and the Xinjiang Uygur Autonomous Region needed not have to adjust their input indicators,the remaining nine provinces (municipalities and autonomous regions) all needed to reduce health expenditure,and slightly compress or fine-adjust "the number of owned beds per thousand people","the number of owned health technicians per thousand people","the number of owned physicians per thousand people",and "the number of owned nurses per thousand people".Conclusion There are differences in the efficiency of inter-provincial health services of China,and the efficiency of health services in some provinces (municipalities and autonomous regions) needs to be further improved from aspects of expenditure,personnel,and hardware equipment.
【Key words】 Health services;Data envelopment analysis;Efficiency;Promotion countermeasure;Inter-provincial
Economic Burden and Correlation of 4 Common Chronic Diseases with Obesity in Rural Residents of Yunnan Province LI Qing1,2,CAI Le1*,WANG Wen-li3,LI Shao-mei3,YOU Ding-yun1,CUI Wen-long1
1.Department of Public Health Management and Health Economics,School of Public Health,Kunming Medical University,Kunming 650500,China
2.Department of Nephrology,First Affiliated Hospital of Kunming Medical University,Kunming 650032,China
3.Department of Hospital Management,the First Hospital of Yiliang,Kunming 652100,China
*Corresponding author:CAI Le,Professor,Doctoral supervisor;E-mail:email@example.com
【Abstract】 Objective The aim of this study was to analyze the relationship between obesity and 4 common chronic diseases,hypertension,diabetes,coronary heart disease(CHD) and stroke,in rural residents of Yunnan Province,and to calculate the economic burden caused by the 4 diseases and to estimate the economic burden attributable to obesity.Methods Using multistage stratified random sampling procedure,we selected 5 040 residents from 12 administrative villages of Yunnan Province between January to September 2015.We collected the general data of the residents by a survey with self-developed questionnaire.The final participants of this study consisted of 4 979 residents who completed the questionnaire.A physical examination was performed in the participants by strictly trained medical examiners.Two-step modeling method was used to measure direct economic burden caused by the diseases,whereas human capital approach combined with disability adjusted life years(DALY) was applied to measure indirect economic burden.And population attributable risk(PAR) combined with the above was adopted to estimate the cost attributable to the combination of systemic obesity and central obesity.Results In the study region,the prevalence of general obesity and central obesity was 6.8%(337/4 979) and 38.4%(1 912/4 979),respectively.The prevalence of hypertension,diabetes,CHD and stroke was 35.3%(1 757/4 979),9.9%(491/4 979),3.8%(191/4 979) and 1.7%(83/4 979),respectively.Results of multivariate Logistic regression analysis showed that,after adjusting for other confounding factors,the prevalence risk of hypertension,diabetes,CHD and stroke in subjects with general obesity was 1.71,3.81,3.53,4.70 times than that in non-general obese subjects,separately.And the prevalence risk of hypertension,diabetes,CHD and stroke in subjects with central obesity was 2.21,1.92,1.61 and 2.10 times than that in non-central obese subjects,separately.Based on PAR,our study estimated that the prevalence of hypertension,diabetes,CHD and stroke accounted for 4.61%,17.51%,14.68%,20.10% attributable to general obesity,respectively,as well as 32.50%,26.80%,19.53%,29.70% attributable to central obesity,respectively.The average cost of hypertension,diabetes,CHD and stroke per person was 6 667.4 yuan,9 126.1 yuan,9 270.0 yuan and 16 187.2 yuan,respectively,and the total costs were 108 185.2 million yuan for hypertension,41 529.5 million yuan for diabetes,16 192.0 million yuan for CHD,and 12 649.0 million yuan for stroke.Of this,the cost of hypertension,diabetes,CHD and stroke attributable to general obesity was 8 167.6 million yuan,6 876.6 million yuan,3 491.7 million yuan,and 2 740.2 million yuan,respectively,and that of the four chronic diseases attributable to central obesity was 34 370.2 million yuan,10 696.1 million yuan,3 232.4 million yuan,and 3 177.0 million yuan,respectively.The total costs of the 4 chronic diseases were 178 555.7 million yuan,in which 11.9%(21 276.1 million yuan/178 555.7 million yuan) was attributable to general obesity and 28.8%(51 475.7 million yuan/178 555.7million yuan) attributable to central obesity.Conclusion The costs of obesity and 4 obesity-related diseases are substantial in rural residents of Yunnan Province.Reducing the prevalence of general obesity and central obesity is helpful to decrease economic burden of the 4 obesity-related chronic diseases.
【Key words】 Chronic disease;Obesity;Cost of illness;Rural health;Yunnan
Establishing and Evaluation of the Item Pool of Xiaoke Eye Disease Patients Reported Outcomes Scale Based on TCM Syndrome Elements
NI Lin-lin1,XU Yun-sheng2*
1.The First Clinical College,Shandong University of Traditional Chinese Medicine,Ji′nan 250014,China
2.General Office,Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Ji′nan 250001,China
*Corresponding author:XU Yun-sheng,Professor,Doctoral supervisor;E-mail:email@example.com
【Abstract】 Objective To establish and preliminarily evaluate Xiaoke Eye Disease(diabetic retinopathy) Patients Reported Outcomes(PRO) Scale based on TCM syndrome elements.Methods The literatures related to the syndromes of Xiaoke eye disease were retrieved systematically from January 2006 to December 2015 from China National Knowledge Infrastructure and VIP Network,and the types of Xiaoke eye disease were collected and summarized,and the composite syndromes were decomposed into single syndrome factor.From July to October 2015,semi-structured depth interview was conducted to the 30 patients with diabetic retinopathy,5 relatives of patients,and 5 medical workers in endocrinology department in endocrinological ward of Shandong Provincial Hospital of Traditional Chinese Medicine.Combining the research results of literatures with the interviewed results,we established the initial item pool of the PRO scale of Xiaoke eye disease.By the lottery method,280 patients with diabetic retinopathy who were admitted to the Department of Endocrinology and Ophthalmology of Shandong University of Traditional Chinese Medicine,Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine and Ji′nan Municipal Hospital of Traditional Chinese Medicine were selected in the study.In order to assess the scale,the initial item pool of PRO scale of Xiaoke eye disease was used to investigate the subjects.A total of 280 questionnaires were sent out and 270 valid questionnaires were recovered.The effective response rate was 96.4%.Results A total of 42 qualified articles were included through literature retrieval,and 15 kinds of syndrome elements were separated,combined with the interviewed results,31 items,including 18 items of physical dimension(9 syndrome effect indicators,9 specific symptom indicators),6 items of psychological dimension,5 items of social dimension,2 items of satisfaction dimension were in the initial PRO scale of eye disease.There were significant differences in syndrome effect indicators and specific symptom indicators in physiology dimension,psychological dimension,social dimension and total scores among patients with different disease classification(P<0.05).The Cronbach′s α coefficient of the total scale was 0.944,and the Cronbach′s α coefficients of syndrome effect indicators and specific symptom indicators in physiology dimension,psychological dimension and social dimension were 0.909,0.901,0.890 and 0.857 respectively.Five common factors were obtained by factor analysis,and the cumulative variance contribution rate was 66.755%.Conclusion The preliminarily established PRO scale of Xiaoke eye disease has good reliability and validity,and can be used in the evaluation of curative effects of traditional Chinese medicine on Xiaoke eye disease.It is recommended to be applied in clinic.
【Key words】 Excess eating-drinking-urine;Diabetic retinopathy;Patient reported outcomes;Symptom complex
Preliminary Development and Evaluation of the Short-version Constitution in Chinese Medicine Questionnaire
ZHU Yan-bo1*,YU Xiao-han2,WANG Qi2,SHI Hui-mei2
1.School of Management,Beijing University of Chinese Medicine,Beijing 100029,China
2.School of Basic Medicine,Beijing University of Chinese Medicine,Beijing 100029,China
*Corresponding author:ZHU Yan-bo,Professor,Doctoral supervisor;E-mail:firstname.lastname@example.com
【Abstract】 Objective To develop and preliminarily evaluate the short-version of Constitution in Chinese Medicine Questionnaire(CCMQ).Methods The total sample size of this study included 4 940 subjects,and they were from 6 different areas to by convenience sampling method,namely:1 632 personnel underwent physical examination in Kaifeng City,He′nan Province from September 2007 to May 2008,466 personnel underwent physical examination in Ruijin City,Jiangxi Province from July 2012 to October 2012,519 personnel underwent physical examination in Hefei,Anhui Province from September 2012 to August 2013,595 personnel underwent physical examination in Zhuhai City,Guangdong Province from February 2013 to January 2014,1 044 personnel underwent physical examination in Beijing from January 2015 to December 2015,684 unpaid blood donors in Beijing from July 2015 to December 2015.Two thirds
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text:
STRANGE SPANNERS being an accounting of strangeness of the warp and woof of my mind
For those of you new here, think of this as 1/2 "Night Gallery"
Our Motto: Nos somnium quisnam es futurus fatum quod insolitus tutus vos!
They are better because they have flaws, just like people. 'Perfect' does not equal 'flawless'.


text:
Taking place in New York State, A woman who is murdered is connected to a prominent man in town; plus a few unsavoury characters. As the investigation continues, and seemingly disrupts the family life of this man among the lives of her son and other estranged family. It is a journey to the soul, the inside of a family, and the overcoming of what has affected an entire town amidst rumours, the truth, and what other people think.
Eddy Diehl is the married man that had an affair with Zoe. Her estranged husband is also suspect in the murder of Zoe in her home early one morning as she was about to leave for Vegas to see if she has a shot at a serious singing career. She never got to Vegas; no one actually knew that she was even going there.
Why in the world would Eddy have an affair with one girl in a small town that everyone knew, that was seen as off the beaten track when he had everything at home – loving family, wife, successful children? The drinking that lead to Eddy's demise and subsequent addiction with getting himself cleared so that the stigma of being accused would forever be off his shoulders.
As Joyce Carol Oates tells the story in different angles and perspectives through Eddy, her ex husband, her son, the ex wife, and the son; she emits this sense of the unknown since it takes the police forever to be cleared from the suspect list and what it ultimately does to both families – the shock, the anger, the distrust, The feelings of being persecuted when one is innocent, and then death by police squad.
Lately, this is happening more and more in our everyday lives, the hurt it causes all of us, the communities that it happens in, and the anguish and pain it causes the families affected is just heartbreaking.
Browse Inside this book
Get this for your site


text:
Full Column here.
It is one thing to ride an agenda of criticism as the opposition party. Republicans, conservatives and people involved with the Tea Party and Town Hall movements have made it very clear they are outraged about what this government is doing, on most every front. In short order, this massive activism has persuaded majorities a serious course correction is mandatory.
At this intersection in time and space, it would be a huge mistake for Conservatives to remain in a critical posture exclusively, and worse, allow infighting and minor skirmishes to distract from the objective: regain as many seats as possible in the House and Senate in November.


text:
INTERNAL CONTROL in Lagos, Nigeria
Job Description
Applications are needed from qualified candidates for the position of Internal Control Officer in a reputable company in Victoria Island.
The Ideal candidate must have 3 - 4 years working experience in process and financial audit. He/She must be chattered or actively working towards it. Qualification required is Bsc in relevant financial courses.
Forward your CV to firstname.lastname@example.com


text: Super excited that Snakes & Lattes chose SCHMOVIE as their featured game for the Toronto International Film Festival! If you're up that way, swing by and play a few rounds! King Street is blocked off for the event, and S&L has a table where they're running rounds of the game. #TIFF14


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France's President, Nicolas Sarkozy, is in the US for his first official visit since taking office. He's previously had an informal chat with President Bush over hamburgers while on holiday earlier in the year, but this is the first proper trip he's made. He gets the rare (in the Bush era) honour of a state dinner and a speech to Congress, although he is travelling stag.
This, and the subsequent visit by Germany's Chancellor Merkel to the US, marks a significant change in relations between the US and Europe. Now that Tony Blair's gone, Mr Bush needs friends in Europe to help him confront Iran over its nuclear programme. It's poisonous for Gordon Brown to associate himself with the White House in the way his predecessor did, so it's no surprise Mr Bush needs to look beyond Downing Street for friends. Although there's no reason why Sarkozy should kowtow to him, especially as he's only got a year left in office, the fact he wasn't President during the bitter spats over Iraq at least means he's willing to talk.
The relationship between France and the US is a strange one. French people, despite a common misconception, do generally enjoy American culture. Line dancing is popular, as is McDonalds. But by merely showing an interest in establishing a better relationship with the White House, President Sarkozy is already being caricatured in the French press as Mr Bush's new poodle. He's already shown plenty during his brief time in office to show he's not a man to shy away from doing something, even if it'll make him look bad. Perhaps Le Poodle is something Nicolas Sarkozy is quite happy to be.
Wednesday, November 07, 2007
Le Poodle
Labels: France, United States
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text:
Kyoshin Elle Ultimate Leathercraft Tool Leather Carving Swivel Knife Medium 11mm
DescriptionYou're looking at a brand new Kyoshin-Elle, fully adjustable leathercraft swivel knife, without blade.
The diameter of the handle of this swivel knife is 11mm in diameter, great for average sized hands or large hands should you wish to add a layer of leather or synthetic grip around it.
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To adjust the length, simply loosen the grub screw with the Allen Key that comes with the knife, raise or lower the finger cup as desired and re-tighten the grub screw.
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Customer Reviews
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You always hear clichés that you should trust your gut feeling, following your heart and blah blah . I'm turning 21 the next week and I realized that whatever I did during these years was normal stuff. Stuff that doesn't make you feel alive. Always following a schedule. Study, eat, sleep, friends. The brain, a strong control freak wanting to have everything planned out. Everything seemed repetitive and monotonous until that day.
I get a call one morning from a friend. He says: "I'm climbing the Himalayas next month! Are you in or out?" Subconsciously I blurted out a Yes. Next thing I know is my brain freaking out. There can be no place for such randomness. How was I to manage my college, tests, gym sessions and other stuff. It is not easy to just disappear off the grid for a fortnight just because your heart wants you to travel. You can't just leave everything because that inner voice tells you to travel, right? There will come a time when everything will fall into place and you can travel without worrying about you boss or spouse or teacher or family or friends, right?
NO. Unfortunately you know it too. The time will never be perfect. You'll either be too old or too young or too tired or too broke. I had a chance to try out a thing I always wanted. I trusted that the voice in me was strong enough to guide me through all the randomness. So today, I managed to schedule everything properly and I'm on my way to the Himalayas. Yes, a fifteen day break right in the middle of the working year. You never know what opportunities may open up once you trust your gut.
I'm currently on my way. Nothing is going as planned so far. There is so much randomness. I haven't figured out where I'll be staying tomorrow. I have the slightest idea where I'll be eating my dinner tonight. I'm low on battery, without proper Internet access and can't even pinpoint myself on a map. It's 2 degrees and my fingers are freezing as I type every word. But there's this adrenaline rush. For the first time in months I have nothing planned. This frenzy is amazing. I'm in love. In love with this chaos. After all life is a big bucket list and getting things done is the way, I believe, to truly make the most out of it.


text:
and I visited Porter Mountain Fellowship in Lakeside, AZ.
This three year old church is going to have difficulties unless it learns to greet one-timers with the same passion as locals. Otherwise it will grow to become a local church club – "no girls allowed."
This makes me want to suggest some ways we at First Southern can better relate to our guests. Here are the steps:
Welcome them.
· Introduce yourself.
· They will usually reciprocate.
· Ask where they are from.
· Respond if you can identify, i.e., you are from the same state or have been there, or know someone.
· Let the conversation grow naturally.
· If they seem uneasy, back off graciously.
· Tell them to make themselves at home.
o Answer questions about the church.
o Identify problems they might have had.
o Get their name again.
o Invite them back.
o Show true interest in them.
After the service follow up with anyone you greeted.


text:
by Dawn Meyers
Brand:Village Candle
Scents: Apples N Oak
Type: 26 Oz. Premium Square Jar
Cost: $21.50
Introduction to my candle review:
Fall is finally here! My family recently relocated from Southern California to the Mid West and I am so excited to see Fall. This has always been my favorite time of year, even with the limited seasonal changes we had in Southern California. The brisk air, leaves falling and cooler temperatures have always been a little shot of Heaven to me so I am really looking forward to what living in a place where the seasons change will bring.
Part of Fall for us candle lovers is burning and melting our favorite Fall scents. I know I look forward to the candle makers putting out their Fall and holiday line of fragrances. One of my all time favorite fragrances is Apples N Oak from Village Candle. From the first time I smelled it I was hooked. I am really, really cheap though, so I have never actually bought the real thing. Until now! I had the opportunity to review this special fragrance for CandleFind, so I went ahead and took the plunge.
What Does My Apples N Oak Jar Candle Look Like?
My candle is a 26 oz square jar from their premium line. They carry this fragrance in both their premium and regular lines and I'm not sure what the difference is. This candle is double wicked and the jar is a really neat square. The wax is a deep apple red color. There is a nice picture of apples and acorns on the front.
What Does My Apples N Oak Jar Candle Smell Like?
The official description on the Village candle site is this:
"Awesome!" is how the founder of our company describes this, his favorite fragrance. You'll just have to try it and let us know if you agree with him."
Since that isn't much help, I'll have to do my best. Apples N Oak to me smells just like what it says. I can smell a deep, fresh apple scent and it's tempered by a sweet, earthy wood scent. My dad was a wood worker by trade and always made things at home. When I was little we had a workshop in our garage and I remember the scent of the wood and the sawdust very well. This smells like piles of fresh cut wood and apples. This is such a unique scent to me and I can't get enough of it.
I lit this candle in my office and within 30 minutes it had filled the room and most of the upstairs with this wonderful scent. I give it an A+ for throw, this sucker threw like mad. The scent strength was medium in my opinion. It was subtle enough that you wouldn't immediately know there was a candle burning, just sort of a something smells good in here feeling.
How Did My Jar from Village Candle Burn?
I think it has something to do with the shape of the container, but despite the two wicks I still had some wax on the edges. The far corners that weren't near the wicks just had a hard time and never melted completely. I had to push the warm wax down with my wick dipper.
As long as I kept the wicks trimmed I had no problem with smoke or soot.
Overall Opinion of My Apples N Oak Jar and Village Candle:
I love Village Candle and especially this scent. The customer service was great. I typed in the wrong expiration date for my credit card and they contacted me right away to straighten it out. My candle shipped promptly and was well packaged. I do think their shipping is a little high, but it would not deter me from purchasing from them in the future. I will probably buy the round jar next time though.
Happy candle burning!
~ Dawn


text:
Tales from the Indiana Hoosiers locker room : a collection of the greatest Indiana basketball stories ever told / John Laskowski with Stan Sutton.
Electronic resources
View other formats and editions
Record details
- ISBN: 9781613210161 (electronic bk.)
- ISBN: 1613210167 (electronic bk.)
- Physical Description: 1 online resource : illustrations
- Publisher: New York : Sports Pub., [2012]
- Copyright: ©2012
Content descriptions
|Summary, etc.:
The best basketball stories from a powerhouse of the Big Ten?newly updated to include tales from the Tom Crean era. Tales From the Indiana Hoosier Locker Room covers over a century of Indiana University basketball. Current and former Hoosiers talk of the excitement, the disappointment, and the celebration that has turned IU basketball into a statewide religion. The history of the Indiana program is revealed through the memories of the school?s hundreds of lettermen. Without a doubt, this is a must-read for every March Madness and college basketball fan.
|Source of Description Note:
Description based on print version record.
Search for related items by subject
|Indiana University, Bloomington > Basketball > History.
Indiana Hoosiers (Basketball team) > History.
Indiana Hoosiers (Basketball team) > Anecdotes.
SPORTS & RECREATION / Basketball.
|Electronic books.


text:
News & media
Echo Yachts release design of 84m Trimaran and 46m support yacht
Australian superyacht builder Echo Yachts has released the first official renderings of both projects that are under construction at their Henderson facility. The yard is building an 84 metre Trimaran superyacht, due in 2017, and a 46m catamaran support vessel, due in the first quarter of 2016. Both projects are under construction for the same owner, with many years of ownership experience.
Read on >>
« back


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text:
I'm currently sitting in the Reference Room of the Hatcher Graduate Library at the University of Michigan, and for the first time in twelve days, I feel at home in Ann Arbor.
I had to come to the library to check some references for the ridiculous weaving tools paper that I started way back in January. When I got to DS110 (the call number for books on archaeology in Israel), I found myself in a wonderland of knowledge, books I'd only dreamed about or heard of or never knew existed. DS110 at the University of Minnesota was rather pitiful, about six or seven shelves in total, and spread out among regular size, quartos, and folios to save shelf space by putting the tall books only with other tall books. DS110 at Michigan is at least 3-4 times as big. Minnesota, annoyingly, stopped obtaining archaeology books around 1980, and had the habit of only acquiring one or two of a series, ie the book on lamps from the City of David but nothing else. Then, you had to engage in a big fight with the interlibrary loan system to convince it that you needed City of David IV, and the one in the collection was City of David II. Here at Hatcher, serials are prettily lined up in rows because they're all here! Plus all the Atiquots, Tel Avivs, Palestine Exploration Quarterlies... heaven. Just heaven. And that was before I turned around and discovered all the books on Jordan, Syria, and Lebanon.
Granted, I could always ILL this stuff, and often did. But as great as the modern computerized card catalogue is, and as helpful as bibliographies are, sometimes visually perusing the shelves is necessary in order to find just the right source. For example, I found a 2008 book called Textile Production in Pre-Roman Italy (in GN799, not DS110, just to be clear) which looks to be relevant and beneficial to the weaving tools project.
The move has been overwhelming in many ways, full of "we're not in Minnesota anymore, Toto" moments. With three and a half weeks between my arrival and the start of classes, I've had a fair amount of time to think about just what I'm getting myself into, not just for the next 5-7 years, but conceivably for the rest of my life. And I've had some doubts, to be honest. But my little sojourn this morning reawakened some passion and excitement, like a little reminder ribbon of who I am and why I'm here. I'm not in Michigan to sit at the DMV for three hours, or to discover the local grocery stores don't carry Rosetto tortellini or the small size of frozen pizza or Mrs Renfro's black bean salsa, or even to go visit my sister only four hours away. The reason I'm here is to utilize the books in DS110 and elsewhere to learn new things and discover new ways to think about those things. And maybe, just maybe, influence the way others perceive and interpret those things as well.
Speaking of, I suppose I should get started on just that.


text: Kids Repeating Observing Science Lab Project Stock Photo (Royalty Free) 138025316 - Shutterstock View Preview Signed model release on file with Shutterstock, Inc. Sign In We're Sorry! Sign in to our Contributor site. Forgot your password? Sign In Don't have an account? Sign Up Create your Free Account Please send me product announcements, helpful advice, and special promotions. Download By creating an account, I agree to Shutterstock's Website Terms, Privacy Policy, and Licensing Terms. Already have an account? Sign In By Ilike Royalty-free stock photo ID: 138025316 Kids repeating and observing a science lab project at home - the baking soda and vinegar volcano science kid child volcano project student scientist soda lab fun vinegar home young chemistry teamwork education chemical smile team scientific analysis analyzing boy chemist discovery experiment friend girl glass happy hold laugh learn liquid little looking observe people person research researching schoolboy schoolgirl surprised table test Show more Show less Categories: People, Science Similar images See all Same model See all Same artist See all


text:
Skip to comments.Off-duty cop fatally shoots husband, child in Brooklyn murder-suicide: sources
Posted on 04/15/2013 8:11:22 AM PDT by ConservativeStatement
An off-duty officer opened fire this morning, killing her husband and 1-year-old son in an apparent murder-suicide in Brooklyn this morning, sources said.
Police and EMS responded to a 911 call of a man shot inside of a building at East 56th Street and Farragut Road about 8:30 a.m., the FDNY said.
(Excerpt) Read more at nypost.com ...
Why do they always take their children with them? Sick monsters.
The percentage of domestic violence by police officers compared to the general public is a chart I would like to see. We are constantly told that guns should only be in the hands of those specially trained, I.E. law enforcement, but it seems to me that there are at least as many violent acts by percentage among law enforcement as the general populace.
We need to completly re-vamp how we police in the western world.
For me, after you get arrested for DUI after blowing a zero but cant stand on one leg because you are nervous, I have lost all respect for police in general.
Re Disco Duck - I really liked that song!
We are told that there is a drug war and that it is being lost. It has all but been surrendered. Persons can smoke pot quite publicly on bar patios and other places where it can be smelled from the street and police never conduct a "raid".
Yet just because you blow BELOW 0.08 (the nationally mandated BAC on the states, imposed through highway funding) does not mean you are "free to go" or "innocent" of DWI. It's a financial shakedown racket for the cities/counties/courts/lawyers/insurance/politicians.
If the same standard was applied to drug possession and use, there might actually be a "war on drugs" being waged.
And watch out, persons in Utah want the BAC lowered to 0.03 and in Sweden it is 0.01. Neo-prohibition, here we come.
In Arizona they charge $17 a mile for a DUI tow. And they bust you at the very edge of the county, to rack up the highest bill possible. My tow cost me $600. And you don't get that back if you are found not guilty. And the cops brother in law owns the towing company. With such a high, legislatively sanctioned, towing rate the corruption is basically inevitable.
So I am standing there in court, the corrupt cops, prosecutors and judge are there and everybody is looking at me like I am some sort of scumbag.
It is just surreal. Really scary stuff.
And the scariest part is, you cant move to another country to escape this. It is everywhere.
And another scary part is that we will never have self driving cars, which would stop this. Because the "DUI Industrial Complex" wont permit it, because there racket is so lucrative that they will prevent this from ever happening.
yes, I agree
Of course. The danger is that the cops will be disarmed before we will.
"The app will allow officers to instantly look up the address of a particular building and discover whether or not that building houses parolees, registered gun owners, or find out if a resident has an order of protection against them."
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.


text:
"Is God able?
Paul, in fact, wrote a letter to the church in Ephesus, saying, "Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us"(Eph. 3: 20).
One dad discovered this truth for himself.
You see, his son was demon possessed, and even Jesus's disciples were unable to cast out the evil spirit. But when the spirit saw Jesus, it immediately threw the boy into a convulsion.
Mark 9 continues the story:
Jesus asked the boy's father, "How long has he been like this?"
"From childhood,"he answered.
"It has often thrown him into fire or water to kill him. But if you can do anything, take pity on us and help us."
"'If you can'?" said Jesus. "Everything is possible for one who believes."
Immediately the boy's father exclaimed, "I do believe; help me overcome my unbelief!". . .
[Jesus] rebuked the impure spirit. "You deaf and mute spirit,"he said, "I command you, come out of him and never enter him again."
The spirit shrieked, convulsed him violently and came out.
The boy looked so much like a corpse that many said, "He's dead."
But Jesus took him by the hand and lifted him to his feet, and he stood up. (vv. 21–27)
Jesus healed the boy despite his dad's lack of faith, demonstrated by his saying, "If you can,"instead of, "If you will."
But as soon as this father realized his mistake, he professed his faith: "I believe."
Then he asked for even more faith: "Help my unbelief."
So even the dad's faith was a gift from God.
But get this. For the first few moments after Jesus prayed, the boy appeared to be dead.
Can you imagine the doubt the father must have felt?
Personally, I think this is good news for those of us who have gotten a bad report or for those of us who continue to pray or believe when our situation seems hopeless.
Through Christ and his power, those things that seem dead can be very much alive.
Pray this:
Dear Lord,
I know you "can," so I choose to trust you, even when I cannot see what you're doing. I choose to look not at the bad report, or the difficult time in a relationship, or the tough situation I find myself in today, or the storm in my life that will not relent, but to you.
In Jesus's name, amen."
Stay Strong!