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The technology provides supply chain with a real time accountability of supplies.
Oax Health, the provider of the Press™ Inventory Replenishment System, is delighted to announce the execution of an Anchor Agreement with Orlando Health Central.
Press™ provides a real time, dynamic replenishment solution, optimizing both supply availability and nursing productivity. As a result, better patient outcomes and ultimately reimbursement for the organization as a whole are delivered. Joint success is ensured through integrating cross functional teams (Supply Chain and Nursing), bridging the gap that exists today.
"The sharing of ideas and endless customization to build the right product for the right application has been priceless" Marc Lillis, Administrator-Support Services of Material Management at Health Central Hospital
Under the guidance of their innovative Supply Chain leader Marc Lillis (Administrator-Support Services), Health Central Hospital has transformed existing manual processes and storage solutions to real time data to the benefit of both Supply Chain and Nursing in tandem; "Working with Oax from the beginning has helped Orlando Health Central build a solid platform for Supply Chain. The sharing of ideas and endless customization to build the right product for the right application has been priceless. We were looking for a system that can help us control high moving, low cost items without spending a fortune, Press™ proved to be our answer. The technology provides supply chain with a real time accountability of supplies. The future goals of this relationship will help reallocate FTE's, create a JIT LUM system with our distribution warehouse, and provide data that can help us better control supply costs per patient day".
Julie Herrman, (Nursing Director at Orlando Health Central), stated "The technology pilot program on the unit was a very collaborative effort between the nursing staff and the Central Supply team. Once my team reached the point of comfort and making it a part of their daily routine, they also found themselves taking ownership of the process. They found that their supplies were being replenished before they had an empty bin. Our Central Supply team did an outstanding job working with my team and Oax Health. We made many adjustments to ensure ease of use and there was great communication throughout the process. The team is looking forward to continued use!"
The vision of Marc, Julie and their teams has been truly outstanding and we look forward to partnering with similar thought leaders in the future.
Learn more about Press: See How It Works
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All Smart Replenishment Success Stories


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You've already heard my thoughts on how any effort to rank NGOs will descend into absurdity. The major difficulty with such an endeavor stems from the remarkable range of organizations that fall in the "NGO" bucket. Let's call that the "Wikimedia v. Oxfam" problem. How would you ever make a meaningful statement about which of those organizations is "better"?
A slightly smaller hurdle is presented by the range of activities within a given organization. Many large NGOs conduct a variety of activities (direct relief, long-term development, policy advocacy, etc.) across a range of issues (education, health, WASH, etc.) in a variety of countries. Even if we acknowledge the intractability of the "Wikimedia v. Oxfam" problem, we may still want to get a handle on how a given organization is doing on its own terms. Can the M&E of those disparate activities be added up to something more comprehensive?
The tentative answer is: "Yes, but it's tricky." Let's start with the "why" and then move into some of the complications. I'll draw a few lessons from the corporate world, and then a later post will have a case study from a real live NGO.
1. Why pursue measurement at the agency level?
There are two possible reasons to do this, and they may lead to different decisions on the "how" questions. Measurement at the agency level could serve…
As a management and strategy tool: Picture yourself as a board member of a large international NGO. The CEO stands in front of you, telling you that the organization has had a great year and that she has a plan for making the next year even better. Do you believe her? To make a proper judgment, you need more than just a financial report. You need to understand the whole scope and impact of the NGO's work. But you're a busy person and you don't have time to analyze detailed narratives of every program (nor does some poor staffer have the time to assemble them). You need a relatively small set of numbers and visual aids to convey the information, so you can digest it and draw appropriate conclusions. So what should the CEO put in front of you to convince you?
As a public relations/fundraising tool: Picture yourself as a donor, scanning NGO websites. Most of them provide you with a few numbers on the size and scope of their work: number of countries they operate in, number of staff, annual expenditures, etc. These numbers can be useful for establishing legitimacy, but as GiveWell has observed, they don't tell us much about what the agency actually does or what impact it has.
Depending on which audience you choose to serve, you might make different decisions in the measurement process. I'm more interested in the first use: to inform management and strategy decisions. The rest of this series will focus on that. Even at levels lower than the board, such data can be useful for troubleshooting problems, spotting opportunities, and generally helping managers focus their attention more efficiently.
2. What complications arise?
As I hinted above, there are a number of challenges to agency-wide measurement. Here are just a few:
- Type of programming: Some issues lend themselves more easily to quantitative indicators. Compare health interventions to local peacebuilding work: there's far more consensus around the appropriate indicators for the former than for the latter.
- Variety of programming: NGOs that work on only one or a few issues will find it easier to maintain the same indicators across multiple programs, which naturally makes aggregation easier.
- Variety of context: Even similar programs in wildly different regions may be hard to capture with the same set of indicators.
- Long-term impacts: These are notoriously hard to measure in any circumstance. For certain agencies and activities, it may be particularly tricky to make useful measurements. For example, in a humanitarian relief setting, the decision loop is much too short to observe the long-term impacts of any given action. The tendency will be to focus on activities and outputs instead.
- Organization-specific factors: There are as many types of NGOs as there are NGOs. Organizational culture matters a great deal. So do factors like whether an NGO is highly decentralized, currently has strong M&E systems, or gets funding from a variety of sources. So as always, individual results may vary.
These are just a few of the hurdles. I'm sure you can think of more, like simple organizational inertia. Speaking of which…
3. How do you even get this system off the ground?
Forget the bullet points above. The biggest challenge? Simply managing the whole process of implementing such a system. You have to create an overall framework, define the specifics, design something to manage the information, and eventually implement it all. If done right, this process will allow you to sort through the problems mentioned above.
You'll need input and involvement from all corners of the organization. If you've ever tried to manage a project across multiple departments/countries, you understand what a slog it can be. It requires support at the executive level, a fair amount of cohesion across the organization, and persistence.
4. An aside: How does the corporate world manage it?
I'm a bit skeptical of the "run NGOs like businesses" attitude that pervades many parts of our sector. I don't believe that the attitude is wrong, so much as incomplete. I would suggest a fuller version: run NGOs like good businesses, and run businesses like good NGOs, and generally learn best practices regardless of where they come from.
That said: I think this is a topic where business best practice is well ahead of almost every NGO. Although profit is any company's final metric, most will rigorously track and manage to a number of daily metrics: size of average purchase, number of customers served, delivery time, staff efficiency, repeat customer rate, etc. These metrics are the drivers of success for which mid- and lower-level employees are held accountable. They're different for every company.
Companies face the same set of challenges as NGOs when selecting metrics, implementing systems to track them, and making decisions based on them. We can learn from the corporate experience. The first lesson is that it takes real investment in infrastructure (both human and technological) to overcome these challenges. The second lesson is that the payoff to doing it right (in terms of success against mission) can be huge.
5. Still seems a bit abstract, huh?
I'm working on a case study on how one large NGO tackles this issue. That should give you a clearer picture of how this works in practice. I might do a few case studies on other organizations too, depending on what information is available and how much time I have. If you think your organization handles agency-level measurement well, or has a unique situation, or just has some interesting lessons to share, please get in touch.
Stay tuned…
Related posts:
- Measurement at the agency level, part 2: Mercy Corps case study
- Measurement at the agency level, part 3: One Acre Fund case study
Measurement at the agency level, part 2: Mercy Corps case study « Find What Works February 24, 2012 at 7:09 pm
[…] Last week I discussed why NGOs might want to measure results at the agency level, rather than just at the program/project level, in order to improve management decisions or better make the case for the agency's impact. This is harder than simply aggregating program level metrics. An effort to measure at the agency level will face challenges due to the variety of an NGO's programming, the variety of contexts it operates in, and the inherent difficulty of managing an organization-wide process of measurement. […]
Measurement at the agency level, part 3: One Acre Fund case study « Find What Works February 28, 2012 at 12:32 am
[…] is the third and (probably) final post in a series on measurement at the agency level. Part 1 discussed the basic idea and the challenges involved. Part 2 looked at how Mercy Corps has dealt with […]

subset: commoncrawl


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Archifest is an annual public festival for Singapore to celebrate architecture and the built environment. It will build upon the pillars of the festival: Archi-Interfaces, Conference, Conversations, Archicraft and Architours. Held from 4 to 15 of October featuring a line-up of more than 50 events taking place at various locations island-wide over 2 weeks, the goal is to invite conversations and establish greater collaboration between various institutions and communities for an exciting festival.
This year's theme-'Building Agency'-emphasizes the facilitating and building up of agency and citizen participation through architecture. It foregrounds the agency of buildings as important materials and spaces of urban life and is about an empowerment of the people as active agents in the making of our built environment.
For more information, visit www.archifest.sg
SIA Conference
Always a highly anticipated annual event for the industry, the one-day Conference Will be a day full of shared experiences and ideas, a roundtable discussion of issues pertinent to our urban environment.
The Conference will revolve around the Festival Theme each year; and have covered the following themes:
Come join us for a day dedicated to architecture in Singapore!
Image courtesy of Brandon Hong
Featuring award-winning projects and other best-kept built secrets in the city, join the Architours to discover the beauty of buildings, spaces and communities.
Take this opportunity to have an exclusive peek into exquisitely designed houses, public institutions, and hidden gems tucked away in hidden corners of the city.
Also, learn about the design strategies that were employed in these projects as told by the architects and designers themselves as they take you on an experiential journey through their creations.
Festival Highlights
Image courtesy of Teo Zi Tong
Image by Singapore Institute of Architects


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Lebau & Neuworth clients have fared well before the U.S Equal Employment Opportunity Commission in the past few weeks.
In one case, our client was fired for complaining of sexual harassment by a customer of her employer, a major government contractor. After a lengthy EEOC investigation and a favorable determination, we were able to obtain a six-figure settlement for our client. This was not an easy case due to the lack of witnesses, but fortunately our client had documented her case very well and the employer failed to conduct a truly non-biased investigation.
In another case, we obtained a near six-figure settlement in pregnancy discrimination case after our client was terminated shortly after she disclosed she was pregnant. The employer claimed that it had a eliminated her position in a reduction-in-force. We were able to convince the EEOC that the employer's reason was pretextual. The EEOC found for us, and the offending employer settled.
We also settled a race discrimination case through the EEOC's mediation process. This case involved a young African-American employee of a major U.S. law firm. She was fired after she complained on several occasions about her co-workers making racist comments concerning recent news stories. Our client obtained a relatively quick settlement and was able to successfully move on with her career.
Of course, each case rests on its own set of specific facts and we can't promise any certain results or outcomes. But we welcome your inquires; contact Lebau & Neuworth at 888-456-2529 or lebauneuworth.com/contact-us.
Contact the Lebau & Neuworth team to discuss your matter.
We are here to help.


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Watch, listen, browse and search Eugene Monroe videos, audio, and more in the 1080 The Fan Audio Vault
Eddie Lacy signed with the Seahawks, NCAA Tourney Cinderellas, and the Toradol issue in the NFL.
A little more on the election, some NFL chatter, and stadium vote news!
A smorgasbord of topics including the election, flying in planes, Blazers, and an interview with Gary Andersen.
Should the University of Houston join the Pac-12, could we see the marijuana ban lifted in the NFL, and where will Kevin Durant play next year?
Dirt & Swag revisit the Cavs loss in Toronto, preview game 4 of the Warriors-Thunder series, and the Stanley Cup Playoffs.
Dirt & Swag debate proper neighbor etiquette when it comes to barking dogs, if the NBA went to light on Draymond Green, and if the Cavs are in trouble.
Audio & Video
Jeff joins Travis and Josh to preview the 2013 Jaguars.
the years. we got an ball and unlawful to Jacksonville Jaguars did with their first read text demagogue like you. Eugene Monroe the tackle from Virginia to anchor the are in Britain that in the second round. First round talent will be called
eight franchise left tackle you're going to put out for ten years and be happy What they could start right away which Eugene Monroe I think you've the past couple in the class Jason Schmidt has been. The consensus number one god but when you watch
group and maybe the number one overall pick. I like Eugene Monroe to tackle from Virginia I think he's definitely in ..... lines want to go tackle I think it'll end up being Eugene Monroe out of Virginia. Let's bunting national football
Alabama. The Rams are second on the board I think they go all to tackle as well to really be offensive tackle class. Eugene Monroe Virginia would be till. Number three I think Scott pioli balance short take a peek out at comic in the its former


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I will attempt to finish this attack on Bright Angel so I can get it off again to my reader - she stopped reading it so I could go in and do some major jigging around. I feel pretty pumped about it so far. I have about fifty pages to finish and think I'll be done tomorrow if nothing stops me. In between bouts of writing I 'll clean and pack.
We leave early Saturday morning (have you ever wondered why Saturday gets a capital but morning doesn't?) and will travel to Red Bay, Labrador. I'll post later on my Labrador site - Sojourner - the route and recent pictures so check there from time to time if you are interested. Red Bay is a UNESCO World Heritage Site because of the Basque Fishing Museum etc... We stay there one night and then take the ferry from Blanc Sablon to St. Barbe on the island of Newfoundland. There we will travel down the coast staying one night along the way (hopefully near Gros Morne National Park) and then taking the ferry from Port Aubasque to North Sydney, Cape Breton - then zoom down to home (about 5 hours to Prospect) hopefully stopping on the way to see dear buds of ours.
Bright Angel is a book about a road trip. I grew up having at least one road trip a year - often more. We moved every couple of years (daddio being an air force guy) and when we weren't moving we still hit the road to stay in little motels ($6 a night would be an expensive one) or camping with our trusty tent trailor. I love road trips - I like starting early in the morning. I like plaid cooler bags (alas none available) and a thermos of coffee. I like pouring over maps and stopping to take pictures. I like wildlife and towns I've never been to. I adore motels and roadside attractions. I particularly love doing it with my fella - he's a polymath which makes him an ideal travelling companion. I say 'what kind of wildflower is that?' or 'when was this place settled?' and he tells me. He is my own google guy.
here is a pic of the family station wagon at the Great Divide.In Bright Angel there are three parts to the trip the main characters go on. They travel by air from Nova Scotia to New Mexico and then they travel from Albuquerque to Santa Fe by car down the lovely Turquoise Trail. Then they stay in Santa Fe for a bit before another road trip to the Grand Canyon. I've done a family road trip to the Grand Canyon so I know how it feels to come upon the most magnificent hole in the ground ever. I remember my mother's look of dismay and her comment 'they should put a fence around this' and my dad's 'Well, you've seen one Grand Canyon you've seen them all'. I can even remember what my mother was wearing (a folkloric skirt popular in the fifties) and carrying (a hand-tooled purse from our road trip to Mexico). I remember all the roadside attractions we went to from Colorado to California and there were a lot of them. All handy.
I wonder if this trip will make it into a novel? For sure it will make it into a poem or two.
See you on the other side - my next post will be from Nova Scotia!


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2017 Giant TCR First Impressions. Life Is Like A Box Of Chocolate
It's early October and I just got back from riding rollers and steep hills in Lancaster PA. and Northern VA. Lancaster is Amish Paradise miles away from suburbia while Northern Virginia is Dodging Dumb Drivers. Picking the right time of day to ride is critical … Continue Reading ››


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Ground broken on new Neighborhood Policing Center
COLUMBUS – Ground was broken today (6/7) on construction of new Neighborhood Policing Center in the University District, the result of a joint commitment between The Ohio State University and the city of Columbus to strengthen neighborhood safety and community ties. University President Karen A. Holbrook, Mayor Michael B. Coleman, City Council members Michael C. Mentel and Andy Ginther, and public safety officials joined area residents and community leaders in the ceremony.
"This policing center brings together law enforcement agencies and community organizations in an innovative and unique way to increase safety and visibility of police officers in the University and Weinland Park area," said Mayor Coleman.
Located at 248 E. 11th Ave. between Summit and North Fourth streets, the $4.4 million, 13,500 square-foot facility will serve as the new Columbus police substation for Precinct 4 and will include permanent office space for University Police, Community Crime Patrol and a Neighborhood Pride Center. Meeting rooms will also be provided for residents and community organizations. Construction is scheduled for completion in summer 2008. Ohio State and the city will share equally in the cost.
"Today's groundbreaking brings us one step closer toward realizing one of the most important partnerships between the university and the city," Holbrook said. "The start of construction is a major step toward securing an increased police presence in this community for our students and longtime residents."
Columbus police officers in Precinct 4 will continue to work out of the current substation located at 2636 Deming Ave., through the construction period. Columbus Fire Station No. 13 will remain at the adjacent Arcadia Avenue location.
Mayor Coleman announced that the building will be named to honor the legacy of two people whose concern for the community and the university has been unparalleled – Tom Moody, the 44th mayor of Columbus from 1972-84 and Bill Hall who amassed a 28-year career at the university. Hall served as vice president for student affairs at the time of his death in 2005.
Richard A. Hollingsworth, vice president for student affairs, added that the policing center will be complemented by a number of existing safety programs and services provided by the university, including a student escort service, residential weekday and late-night transportation services, and the Community Ambassadors Program.
"Bill Hall worked diligently to build stronger relationships between the university and other groups concerned about safety in the University District, particularly the officers of the Columbus Division of Police," Hollingsworth said.
"He was a strong advocate for students and respected by all for his dedication and integrity. Including his name on this policing center is a fitting tribute to his memory and legacy of service."
Mayor Coleman noted other University-area initiatives, including the investment of more than $953,000 in city funds to install streetlights between 12th and 19th avenues this fall. Adding street lighting in neighborhoods was a priority set by the city in partnership with leaders from Ohio State Undergraduate Student Government.
"These combined efforts, including the unique alliance between University Police and the Columbus Police Department, will have a significant impact on the quality of life for residents of this community," Holbrook said.
Robert Caldwell, president of the Weinland Park Civic Association, added that the policing center will launch a new era in community relations between the Columbus Police Department and area residents.
"The additional neighborhood support services that will be provided through the policing center will allow residents to take a collaborative role in building a community that is safe and productive for families, schools and businesses," Caldwell said.


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Pittsburgh, PA (Sports Network) – Jaron Brown scored 18 points and Chris Taft
added 14, as No. 7 Pittsburgh escaped with a 68-58 victory over Boston College
in a Big East battle at the Petersen Events Center.
Carl Krauser contributed 12 for the Panthers (20-1, 6-1 Big East), who have
won 37 in a row at home and remained perfect (32-0) at the Petersen Center.
"We have a winning steak at home and we let the other teams know about it,"
said guard Julius Page. "A 20-win season doesn't mean anything if you don't
make it to the championship. I won't be happy until I have the [championship]
trophy in my hand."
Uka Agbai scored 17 points to lead the Eagles (13-6, 2-4), who have lost four
of their last six games.
Boston College, which trailed throughout the second half, held a one-point
lead with under three minutes remaining. Krauser, however, scored five
straight points to give the Panthers a 59-55 lead.
"In crunch time I like to think of myself as Isiah Thomas," said Krauser. "He
hit the big shots when he needed to and I can use that in my game."
Pittsburgh then put the game away from the free throw line. Brown and Taft
each made a pair from the stripe and a Brown jumper with 40 seconds left gave
the Panthers a 65-55 lead. The Panthers would score 14 of the final 18 points
to pull out the win.
The game was tied at halftime, but Pittsburgh scored 12 unanswered points to
begin the second half. Taft scored six during the run and a jumper by Chevon
Troutman gave the Panthers a 39-27 advantage with 16 1/2 minutes left.
The Eagles, trailing 46-34, used an eight-point burst to cut their deficit to
four. Agbai hit a jumper to begin the run and added a trey, as Boston College
pulled within 46-42 midway through the second half.
Down by five, 54-49, Boston College scored six straight points to take the
lead. A field goal by Jermaine Watson with just under four minutes to play
gave the Eagles a 55-54 edge. It would be the Eagles first and last lead of
the second half.
With the game tied at 11-11 in the early going, Craig Smith scored six points
in a 10-2 run. Watson capped the burst with a jumper that gave the Eagles a
21-13 lead with just over seven minutes left in the first half.
The Panthers responded with an 8-2 spurt, including four points from Brown, to
pull within two, 23-21.
The game was tied, 27-27, at the break.
Smith finished with 12 first-half points to lead Boston College, while Brown's
seven paced the Panthers.


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To all our friends and future friends, Welcome to Mexico Beach Marina, the one and only full service marina in Mexico Beach, Fl. We are a family-owned and operated business that prides itself on customer service with a focus on true southern hospitality. Our knowledgeable and experienced staff along with our well equipped facility offers you everything you need: ethanol free gas, live bait, tackle, boating accessories, wet storage, bulk and block ice, kayak rentals and Yamaha sales and service. Plus our Ship Store offers all the best in fishing, beach and boating gear like AFTCO, Guy Harvey, Sperry Top-Siders, Costa Del Mar sunglasses, Under Armour, Columbia, Pelagic, Yeti Coolers, Tervis Tumbler and the best selection of t-shirts around. As a Action Craft Power Boats, Donovan Marine and Land & Sea Dealer, we have all your boating accessories as well.
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Bobby Williams of Jensen Beach nails a nice 48 lb AJ with Southbound Charters.
The Crew of "My Turn", Shannon, Steve, Charlie and Al nail a monster Swordfish out of MB.
Brands We Carry


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Summary & Details:
Media Consulta
3. How hard is it measure?
- 3.1 Factors affecting blood pressure measurement
- 3.2 Blood pressure measurements in routine clinical practice
- 3.3 Blood pressure measurements in epidemiological / observational studies
- 3.4 Mercury sphygmomanometers
3.1 Factors affecting blood pressure measurement
It is important to be aware of the factors that affect blood pressure measurement (Rose 1965):
(1) The technical skills of the observer;
(2) The inherent variability of blood pressure;
(3) The accuracy of the device, including its limitations and applications;
(4) The difficulty in measuring blood pressure in some special groups, e.g. the elderly, patients with arrhythmias, patients with a large arm, children, pregnant women. The most important element in using auscultatory methods is the observer. All observers need adequate training in listening and recognising the correct sounds. Most common sources of error in many reports are mostly due to the observer, including poor hearing, difficulty/failure in interpreting the Korotkov sounds and lack of concentration. Most serious errors involve the interpretation of the Korotkov sounds and recognising diastolic pressure. Observers may be influenced by the subjects. For example, observers tend to be reluctant in diagnosing young healthy subjects as hypertensive or obese older persons as normotensive when the blood pressure is around 140/90 mmHg (systolic/diastolic blood pressure) resulting in a tendency to under read in the first case and over estimate in the latter. Observer-related issues include: prejudice and bias such as threshold avoidance; terminal digit preference; fast deflation, etc. (Beevers et al. 2001).
To accurately measure blood pressure, the following important criteria have to be applied, irrespective of what type of device is being used.
- Posture of the patient supine, sitting or standing.
- Cuff at heart level and arm supported; if not supported, isometric exercise is performed and will result in recording a higher blood pressure.
- The use of correct cuff and bladder size for the appropriate arm/leg size. Over cuffing (use of a bladder that is too large) will lead to under estimation of blood pressure, and under cuffing (use of a bladder that is too small) will over estimate the blood pressure.
- Measurement of the blood pressure on both arms at first visit to help identify consistent difference in blood pressure between the arms.
- Accuracy of the device; the device should be well maintained, in pristine condition, calibrated as per the manufacturer's instructions and validated according to accepted standards using appropriate protocols.
3.2 Blood pressure measurements in routine clinical practice
Repeated office blood pressure measurements are mandatory in clinical practice to characterise precisely the blood-pressure-related cardiovascular risk of individual subjects. Precise recommendations are available to ensure standardised accurate measurements (O'Brien et al. 2003, Parati et al. 2008a), which until now have been obtained in most cases through the auscultatory technique making use of mercury or aneroid sphygmomanometers. Given the fact that aneroid manometers easily lose calibration, mercury manometers have been, until now, the recommended tools for auscultatory blood pressure readings, on which the conventional management of hypertensive patients has been based over the last 60-70 years. In more recent years an increasing use of home blood pressure monitoring and 24-hour ambulatory blood pressure monitoring has been observed (both based on oscillometric blood pressure measurements), aimed at complementing the information provided by office blood pressure measurements. This is based on the evidence of a stronger prognostic value of 24-hour ambulatory and home blood pressure monitoring as compared to isolated office readings (Parati et al. 2008b, Parati et al. 2009b, Verdecchia et al. 2009). A slow progressive increase in the use of oscillometric blood pressure measuring devices at the time of the office visit has been recently observed, although auscultatory readings are still preferred by physicians in most countries.
There are a number of physiological and pathological states that may influence the ability of an oscillometric device to obtain an equivalent reading to a mercury sphygmomanometer. Oscillometric measurements are dependant on movement, and changes in the amplitude of this movement, in the artery, and therefore maybe altered. Oscillometric measurements cannot be relied on in patients with arrhythmias, or some valvular heart disease such as aortic incompetence. Other patients with altered vascular compliance, such as diabetics, or the elderly, could have less accurate blood pressure readings using oscillometric measurement. Changes in vascular compliance may also be confounded by oedema, intravascular volume, hyperdynamic circulation and by changes in cardiac output such as pre-eclampsia, in which oscillometric readings frequently underestimate the blood pressure (Shennan and De Greeff 2007). Although the accuracy and reproducibility of Korotokov sounds in these disease states are not known, listening to the Korotkov sounds remains the technique in which current knowledge of indirect blood pressure is determined, and therefore, the auscultatory method of blood pressure is recommended in such populations.
3.3 Blood pressure measurements in epidemiological/observational studies
Very comprehensive research on population blood pressure exists throughout the world. These studies are essential for defining hypertension prevalence, awareness and treatment in any geographical region/country. A change in population blood pressure of 2 mmHg in systolic blood pressure translates to a change in stroke mortality of ten percent and coronary heart disease mortality of seven percent (Lewington et al. 2002). Therefore, data on progression from normotension to prehypertension and hypertension are very important in epidemiological research. The data have documented that prehypertension carries an increased risk for cardiovascular morbidity and mortality, and a high risk for progression to sustained hypertension (Hansen et al. 2007a, Julius et al. 2006). In this respect, changes from normotension to prehypertension are as important as the observation of hypertension itself. Reliable data are heavily dependent on blood pressure measurements carried out meticulously by properly trained personnel and with precise equipment. For this, adherence to a standardised technique over time is crucial. Findings of changes in population blood pressure are only meaningful if they are ascertained to be true differences and not related to a change in methods applied.
Nearly all results on population blood pressure have been obtained by the use of a standard mercury sphygmomanometer by well-trained health personnel (Cutler et al. 2008). Despite this, the readings are not without observer bias and end-digit preference. In an attempt to minimise observer bias and end-digit preference, a number of highly recognized epidemiological research institutions have used the Random Zero Mercury Sphygmomanometer, where the reader has to subtract a random chosen magnitude of mmHg (from 0 to 20 mmHg) at the very end of the measurement. Despite minimising observer bias, the equipment has been shown to slightly underestimate the "true" blood pressure level as obtained by the use of a standard mercury manometer (Yang et al. 2008). Another approach that has been employed is the "London School of Hygiene Sphygmomanometer" (Andersen and Jensen 2007) where the reader is blinded to the mercury column but has to tap a button when they hear the first and the fourth Korotkov sounds (phase 1 and phase 5). In recent years, 24-hour ambulatory blood pressure measurements have been introduced in population studies and comprehensive databases have been constructed, e.g. the Idaco Database on population studies with contributions from many parts of the world (Hansen et al. 2007b). All these studies have convincingly shown that 24-hour ambulatory blood pressure measurements determined with oscillometric devices (at approximately 80 readings over 24 hours), are superior for prediction of cardiovascular morbidity and mortality as compared to a few measurements of blood pressure performed in clinical conditions with a standard mercury sphygmomanometer. In almost all these studies, although not exclusively, the comparator has been the standard mercury sphygmomanometer (Hansen et al. 2007b).
Research into normal values for home blood pressure and the prognostic implication is less comprehensive. This research has been almost exclusively carried out with automatic oscillometric devices, with measurements being compared to the mercury sphygmomanometer. Data are accumulating showing that the predictive prognostic value of a certain number of home blood pressure readings is superior to a single or a few blood pressure readings performed in a clinic using a mercury sphygmomanometer (Sega et al. 2005). The home readings are a reflection of more precise estimation of the actual blood pressure levels over many readings as compared to few readings in the clinical setting. So far, comparisons of measurements obtained with mercury sphygmomanometer versus oscillometric automatic devices, obtained in the same clinical setting for determination of population blood pressure and prognostic implications, are missing. However, in the Pamela Study, three clinic readings with a mercury sphygmomanometer were compared to two home blood pressure oscillometric readings (Sega et al. 2005). As expected, the clinical readings were somewhat higher, but the prognostic implication was not that much different.
In long-term outcome clinical trials, usually running for three to five years, mercury sphygmomanometers have been used as the gold standard for office blood pressure measurement. In some recent trials (the HOT Study, the ASCOT Study and the OnTarget Study) automatic oscillometric devices were used (Dahlöf et al. 2005, Hansson et al. 1998, Yusuf et al. 2008). In some of these studies it was shown that small differences in measured blood pressure already can have an impact on cardiovascular diseases.
There is rapidly growing information on normal values and the prognostic implications of 24 hour ambulatory blood pressure measurements with oscillometric devices, while knowledge on self/home blood pressure measurements with oscillometric devices is less substantial. So far, a direct comparison between clinic blood pressure and prognostic implication based on measurements carried out with mercury sphygmomanometer and those with automatic oscillometric devices is lacking.
In conclusion, the vast majority of information on population blood pressure (secular trends, progression to hypertension and prognostic implications, and also the benefits from treatment-induced blood pressure reduction in terms of cardiovascular events prevention) has so far been obtained with the use of mercury sphygmomanometers. Reliable data on changes in population blood pressure level, incidence and prevalence of hypertension, awareness and treatment, derived from follow-up studies are dependent on the use of consistent and trustworthy methods. It can be expected that epidemiological/observational studies in the future will comprise repetitive blood pressure measurements at home carried out with well-calibrated, well-validated automatic oscillometric equipment. For the moment, mercury sphygmomanometers are essential for such validation of newly developed blood pressure measurement devices. Otherwise, the conclusions based on the results of long–term epidemiological studies on changes in population blood pressure may be seriously jeopardised.
3.4 Mercury sphygmomanometers
The mercury-containing sphygmomanometer should not be viewed as an absolute standard. It is however, with all its faults as an indirect blood pressure determination, the method used to establish our current knowledge. Since Riva-Rocci's times mercury sphygmomanometers associated with the occlusion-auscultatory technique have been used in clinical and epidemiological studies on hypertension. They represent the cornerstone for cardiovascular disease prognosis and prevention, as well as in the daily clinical management of patients with high blood pressure. As a result of this time- honoured use, blood pressure values are still quantified in mmHg both in current practice and in research, and doctors keep watching the mercury column as the most faithful indicator of the blood pressure levels in their patients. A commonly perceived advantage of mercury manometers lies in the fact that, when they are well maintained (see below), they offer "absolute" measurements of blood pressure, and represent a "gold standard" reference technique used to validate all other methods which provide information on blood pressure levels in mmHg without using a mercury column. The blood pressure measurement based on the mercury sphygmomanometer is an indirect blood pressure determination, and is difficult to perfectly mimic with other techniques unrelated to auscultation of Korotkov sounds.
3.4.1 Characteristics
The high-density of liquid mercury metal provides an acceptable short length of the rising column for visualization of the pressure in the cuff. Therefore, the mercury column in a sphygmomanometer is used as a simple, gravity-based unit. When properly maintained and serviced and when used by knowledgeable trained health professionals, it can give accurate indirect measurements of both systolic and diastolic pressure. Currently it is considered to be the most accurate technique (O'Brien et al. 2003).
A complete mercury sphygmomanometer requires a cuff, bladder, tubing and a rubber bulb, and should be maintained in good condition and serviced regularly according to the manufacturers' instructions. Mercury sphygmomanometers are easily checked and maintained, but great care should be taken when handling mercury. The revised European Standard (EN 1060 series) recommends that mercury sphygmomanometers display a warning to this effect (CEN 1995a).
3.4.2 Limitations
Despite its widespread availability for almost a century, there can be major problems with the use of mercury sphygmomanometers in clinical practice. Reports from hospitals and family practices have suggested that many mercury sphygmomanometers are defective because of poor maintenance (Beevers and Morgan 1993, Burke et al. 1982, Feher et al. 1992, Gillespie and Curzio 1998, Hutchinson et al. 1994, Markandu et al. 2000, Wingfield et al. 1996).
Moreover, several studies have shown that there is a lack of knowledge of the technical aspects of the actual blood pressure measurement in both doctors and nurses and other health care professionals who use the mercury sphygmomanometers. The reports also suggest that the technique of blood pressure measurement is not applied very well. Additionally, there is a lack of knowledge of the appropriate blood pressure equipment and how to maintain the devices so that they are calibrated and in pristine condition. One should be aware of the fact that issues of maintenance are a factor for every blood pressure measurement device.
There are several other limitations of using the auscultatory method which affect both mercury and aneroid manometers:
- Terminal digit preference: Tendency of the observer to round off the number to their choosing e.g. 144/96 mmHg as 140/100 mmHg or 150/90 mmHg (systolic/diastolic blood pressure). This is the zero preference. The observer finds it easier to read the prominent larger 10 mmHg markings instead of the smaller, 2 mmHg markings.
- Errors may occur when the manometer is not kept vertical (see fig. 1), and the device is rested on the side of the bed or, having it tilted against the pillow. This is an issue when the device is being used at the patient's bedside, not when used for public- health monitoring. Positioning of the Hg manometer
- positioning of the Hg manometer (see above) dynamic response of the Hg column (see below) clearness of the display
Figure 1: Measurement error due to incorrect positioning of the Hg manometer. In this diagram the incorrect positioning of the tube results in a measurement error of ca. 12 mmHg.
- Inflation/deflation system: Another important limitation to consider is the performance of the inflation/deflation system and of the occluding bladder encased in a cuff, and proper application of auscultation with a stethoscope. Those issues apply to all blood pressure measuring devices using the auscultatory method.
The inflation/deflation system consists of an inflating and deflating mechanism connected by rubber tubing to an occluding bladder. The standard mercury sphygmomanometers used in clinical practice are operated manually, with inflation being effected by means of a bulb compressed by hand and deflation by means of a release valve, which is also controlled by hand. The pump and control valve are connected to the inflatable bladder and thence to the sphygmomanometer by rubber tubing. Leaks from cracked or perished rubber make accurate measurement of blood pressure difficult because the fall of the mercury cannot be controlled. The length of tubing between the cuff and the manometer should be at least 70 cm and that between the inflation source and the cuff should be at least 30 cm. Connections should be airtight and easily disconnected.
In addition, technical (maintenance) problems may exist such as:
(i) Oxidisation of the mercury is another very common occurrence, which can increase with time and make the columns difficult to read.
(ii) The markings on the column also fade with time, again making it impossible to read accurately.
(iii) Dynamic response
3.4.3 Technical accuracy of Hg sphygmomanometers
The mercury manometers incorporate the (non SI unit) mmHg as a read-out system. The use of this manometer does not automatically guarantee that the cuff pressure measurement is always correct. In 1952, the Physikalisch-Technische Bundesanstalt in Germany issued requirements for these sphygmomanometers on a voluntary basis. The International Organisation of Legal Metrology published its first International Recommendation (IR 16) in 1973 and at approximately the same time national standards and similar documents were published in several countries such as the USA and Switzerland. Since then, these documents have been updated several times. To support the "Council Directive 93/42/EEC concerning medical devices" the European standards organisation CEN developed a standard (EN 1060, part 1-4) between 1995 and 2004 (CEN 1995a, 1995b, 1997, 2004), which became a harmonized standard in that framework. Recently the international standard organisations ISO and IEC jointly developed standards to test sphygmomanometers; they were published between 2007 and 2009 (IEC 2009, ISO 2007). These standards are expected to replace the CEN standards in the near future.
Regarding the accuracy of Hg manometer there are three main aspects to be considered:
Since the technical accuracy of the Hg manometer is affected by the inclination relative to gravity, means need to be provided to ensure the correct positioning of the reservoir and the tube, e.g. a water-level. Figure 1 illustrates the effect of incorrect positioning on the accuracy. According to ISO 81060-1 (ISO, 2007) a portable Hg manometer "shall be provided with an adjusting or locking mechanism to secure it in the position for use as indicated in the accompanying documents".
To prevent the spillage of Hg the ISO 81060-1 standard requires the following: The Hg manometer shall incorporate a stopping device at the top of the tube that
- permits both the inward and outward flow of air, and
- prevents the passage of liquid mercury.
The reservoir shall also be fitted with a stopping device to prevent the Hg from flowing out of the reservoir neck and into the attached tubing and permits the inward and outward flow of air.
When the passage of air is limited owing to contamination or deterioration of the stopping devices, the falling pressure is displayed with some delay by the mercury column in the tube. This delay prevents the user from reading the correct pressure value; when measuring during cuff pressure deflation, there will be a systematic error resulting in too high blood pressure values.
Consequently the metrological test of a Hg manometer has to include The following list summarises the technical features determining the accuracy of mercury sphygmomanometers (O'Brien et al. 2003).
Features affecting accuracy of the mercury sphygmomanometer:
- The top of the mercury meniscus should rest at exactly zero without pressure applied; if it is below, add mercury.
- The scale should be clearly calibrated in 2 mm divisions from 0 to 300 mmHg and should indicate accurately the differences between the levels of mercury in the tube and in the reservoir.
- The diameter of the reservoir must be at least ten times that of the vertical tube, or the vertical scale must correct for the drop in the mercury level in the reservoir as the column rises.
- Substantial errors may occur if the manometer is not kept vertical during measurement. Calibrations on floor models are especially adjusted to compensate for the tilt in the face of the gauge. Stand-mounted manometers are recommended for hospital use. This allows the observer to adjust the level of the sphygmomanometer and to perform measurement without having to balance the sphygmomanometer precariously on the side of the bed.
- The air vent at the top of the manometer must be kept patent, as clogging will cause the mercury column to respond sluggishly and to overestimate pressure.
- The control valve is one of the most common causes of error in sphygmomanometers and when it becomes defective it should be replaced. Spare control valves should be available in hospitals and a spare control valve should be supplied with sphygmomanometers.
The GreenFacts Three-Level Structure used to communicate this SCENIHR Opinion is copyrighted by Cogeneris SPRL.


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ROOM ONLY BASIS. Breakfast is NOT included.. The total price of the reservation will be charged to your card on the day of booking and is strictly non-refundable. Please note if reservation is cancelled the total price of the reservation is non-refundable. This Rate includes Free Parking, Free Wifi & Free Daily Newpaper
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PayPal is bad for business
Some stupid person bought a game account from me and paid py paypal. About 20 days later she decides that she wants to keep both the money and the account with all the items in it. She files a claim and I respond telling them that they should not do that, and that it is also a business account which is used for deals some of which are worth more than 500.000EUR. She apologizes, says it was a misunderstanding with her mother,cancels the claim.
About 2 weeks later she or her mother go to their bank and say there is an unknown expense statement, knowing full well it was their intended purchase. The bank makes another claim and paypal gives me a negative balance of 1000EUR for the second time for the same thing!!!! Note that mine is a business account!! Of course, it is now unusable, I had to cancel orders, and lose customers, and I am thinking of either using another service like paypal or using only bank deposits for my business. Those people are idiots! Even if paypal was obliged to hold the amount related to the claim, they should do that, independently, and not cause problems to my account. They should do that with their own money, until the case is resolved and not freeze my account for 75 DAYS!!!! This is not professional service in any way! I suggest to merchants mainly, to stay away from paypal. It is BAD FOR BUSINESS.
Posted: July 9, 2014 at 4:54 pm


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When it comes to summer peak capacity and power reliability, the city of Chicago is trying to beat the heat this summer. The city installed an emergency power system featuring on-site distributed generation equipment.
Now complete, the installation allows the police department's backup emergency generators, each producing nearly 1MW of power, to be remotely dispatched, monitored and controlled. If Chicago experiences power shortages this year, the police department can easily switch from utility-supplied to on-site generated power. The advantages are no downtime, no 911 glitches and no additional costs for expensive peak electricity.
Chicago built its own 10MW power plant, linking scattered backup generators from eight police stations and three senior citizen cooling centers in order to generate enough electricity to power roughly 4,000 homes.
The $400,000 system was inspired by Chicago's failure to keep the lights on in the Loop during the summer of 1999. Encorp, a Windsor, Colo.-based technology company, worked with project contractor Siemens Building Technology Inc. to retrofit six critical emergency backup generators — four at police stations and two at senior citizen cooling centers. The system will help Chicago curtail costly energy demand, said Scott Castelaz, Encorp's vice president of corporate development and external affairs.
Commonwealth Edison (ComEd), Chicago's main supplier of electric energy, spearheaded the effort to contract for negotiable interruptible power, which provides the utility and Chicago with economic savings during times of peak power demand. In addition, generators retrofitted with Encorp equipment can run independent of the ComEd power grid, thus ensuring the police department's critical equipment, such as telephones and computers, are supplied electrical power even during a power outage. The Encorp control equipment enables the Chicago Police Department to monitor and control its on-site power generation system remotely.
Chicago's Preparedness Campaign fueled the decision for future conversion of the police department's natural gas standby generation units to an interconnected grid system.
A goal of the city's recently announced Energy Plan is to provide 1.3 billion kWh of distributed generation to the electrical grid by 2010 — roughly the amount of energy used by 25,000 homes in a year.
Distributed generation is a key component of the Energy Plan, which states: "Chicago is creating the equivalent of a 10MW power plant by amassing the capability of emergency backup generators located at critical city facilities such as police stations and cooling centers. Chicago's energy plan focuses on building virtual power plants through smart energy management, using modern technologies, employing economically meaningful efficiencies and building both a local supply and demand for renewable power."
After the terrorist attacks of Sept. 11 and concerns about energy security, the city's power plant took on a greater significance. Rather than relying on engineers at each location to switch on the on-site generators, the power plant links all the generators with the flick of a switch from one central spot.
The power plant idea sprang from Chicago Mayor Daley's 2001 Energy Plan — a call to action for how to generate power in the future. The energy blueprint calls for using distributed generation to add 1.5 billion kWh of electricity to the city's power grid by 2010. The energy would be roughly enough to power 25,000 homes. The idea is to link as many independent generators as possible to expand the city's power capabilities.
According to the Chicago Tribune, the concept of distributed power is a major shift in electricity generation. Generally, electricity is dispersed from large plants to homes and businesses. Distributed power makes homes and businesses producers as well as consumers of electricity. Electrons flow on a two-way street. The scheme is called a virtual power plant. Distributed generation can also use newer technologies such as solar cells and wind turbines.
This article originated from Encorp, Windsor, Colo.


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Wikipikipediaedia is one of the most visited sites in the internet. Recently, the team that runs the site decided to build an artificial intelligence editing tool known as Objective Revision Evaluation Service. The special tool is designed to spur innovation in the page, and it will also be able to solve some of the challenges facing it. There are some Wiki edits that are made on the page that mostly damage the credibility and quality of the site. The page also faces a challenge when new contributors are discouraged to edit a Wikipedia page with good intentions. The new intelligence tool will be able to solve these problems at the same time.
With the tool, it will be very easy to detect any type of damage that is made on the page. If Wikipedia revisions made in good faith, the artificial tool will be able to detect too. Every day, more than half a million edits are made on the encyclopedia. However, the quality of the content is undermined by some trolls and newbies who break practices unintentionally when they update a Wikipedia page because they are still not aware of them.
For instance, Larry Madowo, a Kenyan news anchor woke up one day and discovered that his biography in the Wikipedia site has been edited. The new biography said that he was a politician in Kenya, born in 1889.
His fans decided to share the screenshots from the defaced Wikipedia page. The news presenter also shared a light moment with his fans, saying that the page was awesome. The edited version of the story insinuated that the Trend show host was the leader of a political party known as Kai Party.
In the introduction, the Wikipedia biography states that Larry used to be the Chancellor of the country in 1933-1945. It also states that he was a dictator in the country who was responsible for initiating the Second World War in Europe. It also says that Larry was the central figure during the Holocaust. It also goes on to say that he was not born in Kenya. It states that he was born somewhere in Uganda near Toronto. These are some of the Wikipedia edits the management of the site wants to avoid.
If you want to edit or write Wikipedia content, it is important to hire Wikipedia experts who will help you through the process. Get Your Wiki is a company that specializes in this area. The company has qualified and experienced Wikipedia editors who will work hard to ensure that your work is approved in Wikipedia.


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What is a cover letter and, more importantly, what is a good cover letter?
We know that sending a resume without a cover letter is generally a waste of time. The resume rarely gets read or receives the attention it deserves.
Providing concrete evidence of your skills and competencies as they relate to the job opportunity in a well constructed cover letter is an essential step in your successful job search.
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What is a cover letter?
Yes, a cover letter is necessary. Employers are pressed for time. They are likely to ignore resumes that arrive without a cover letter for 2 main reasons:
When your competition has taken the time to compile a well written and targeted cover letter and you haven't, your job application will go to the bottom of the pile.
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Follow these steps to write a cover letter that grabs attention, creates interest, turns the interest into desire and the desire into action.
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Phrases that create a strong closing include:
"I will call you next week to be sure you received my resume and to answer any questions you may have."
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Job Interviews > Sample Cover Letters > What is a Cover Letter?
Use the search box to find exactly what you are looking for.


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The design process is one of give and take. You want white, she wants cream, they want expansive, you want cozy, we want a great room and you want a formal dining room.
And during the design process, you will make many decisions – some tiny, some large – which lead to a finished product. But someone looking at the finished design, whether it be a house or a fork, doesn't have the perspective of all those decisions previously made. The critique could be insightful but most of the time? Its not helpful.
That said, here are some pictures and my humble thoughts on the design, heehee.
Take the picture at the top. During the kitchen remodel, those posts either had to stay or a beam put up in their place – they are structural supports. So, what can you do? Why, make them interesting! This is a good example of making the best of things. Switching out to a support beam would have been much more destructive of the existing space and could have cost a pretty penny.
Now, look at this picture. Not a very exciting kitchen, but its OK. Now find the red pan on the counter and scan upwards to the ceiling. See the open beams? What is that curly pipe? WHAT?!? That's the sewer pipe under the toilet? Ewww! I'da camouflaged that, you can be sure!
Here is a bathroom that has been squeezed into the attic space. They removed the crawl space to get some head height. Discussions about the sense of removing insulating value aside, this is a pretty imaginative solution to making tiny spaces work. Look to the right and there are the shower heads. No separate shower stall, there wasn't room. Nifty idea, I think! If you're worried about getting the toilet paper wet, there are holders available from boat supply places where the rolls are completely protected from water, yet easily accessible.
In this tiny bathroom, a coat rack serves as towel and robe rack. Great idea, but I'd be tripping over the wide angled legs all the time. Better to have a rack with a flat round base.
Are you starting to see a lot of undercounter curtains like this? Reminiscent of Granny's kitchen. I don't have an opinion about it, do you? I DO have an opinion about the open racks above the sink. It just looks messy. And busy. And dusty.
What with all the 'no fire' days this winter, we haven't been able to use our fireplaces very much, have we. This is a striking use of the space, don't you think? Simple, sleek and the shell reminds us of warm summer days to come.
This is a lovely idea, too, although sticking the box out into the room is awkward. I'm guessing they covered over the firebox opening to keep out drafts (or its a fake mantle). Fill a box or basket with tiny white lights and pinecones or kindling and you've got a warm, lovely, warming 'fire'. OK, not so warm but definitely warming…
Oh, yeah, I must admit that most of the pics are from Houzz. If you're looking forward to a remodeling project or you're just a lookiloo, its a fascinating trip into other people's homes. Inspiration abounds. Be warned, you can lose a lot of time wandering around this alternate reality -better set a timer so you come up for air 😉


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Seychelle – Professional Standup Paddle Athlete, SUP Yogi, Adventurer, Optimist
- 24 hour Guinness World Record - Greatest Distance SUP
- 2106 "Fastest on Earth" Female SUP title
- 2016 SUP Woman of the year - Sup Connect
- 2016 SUP Breakthrough Performer of the year - SUP the Mag
- 2016 AWSI SUP Athlete of the Year
- 2 x NYC SEA -Paddle around Manhattan - Champion
- 2 x 11 City Tour - Grand Champion
- 2 x Chattajack 31- Female champion
- 2016 "Fastest in Florida"series winner
- NASM Certified Personal Trainer
- E- RYT 200 Yoga Alliance
- Yoga Alliance Certified Education Provider
- USCG 100ton Master license
I was born and raised in the Florida Keys and have always had a deep connection to the water. I hold a USCG Masters license and for 8 years after school, I sailed around the world as a professional yachtsman. In 2013 I discovered stand-up paddling and moved back to Florida to pursue a career in this sport. With a lot of hard work and dedication, I am now a top 10 world ranked athlete, Guinness World Record holder for long distance, and the 2016 "Fastest Paddler on Earth." I am also a paddle coach, a registered yoga instructor and certified personal trainer. I offer clinics for all level paddlers. My classes and programs are a blend of the diverse coaches, styles and techniques I have practiced and a journey to cultivate strength, energy, endurance, balance, and bliss within our bodies. I am passionate about life, fitness, nutrition, love, and having fun. I believe that anything is possible and if you believe it, then it's true.
I am passionate about life, fitness, nutrition, love, and having fun. I believe that anything is possible and if you believe it, then it's true.
My motto is "breathe and smile"
It is my life's dream to be able to share this with you. Let's set some goals, work hard, and have fun!
Love and Gratitude,
Race Schedule Posting soon.... ;)


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Shmoop has announced the launch of newly updated teacher guides and student diagnostic and practice exams for two Advanced Placement exams: the AP Spanish Language and Culture and AP Chemistry exams.
Guide to the AP Spanish Language and Culture Exam
Imagine a world where people only needed to know seven questions to get by in a Spanish-speaking country:
Where's the bathroom?
Can I have a fork?
I would like two apples.
This is her cat.
Where did the spider go?
Turn left and walk past the post office to arrive at the library.
Seriously, where's the bathroom?
If real life isn't restricted to questions of the mundane and practical, exams shouldn't be either, no? The College Board doesn't think so either, which is why they're introducing a new AP exam format for the Spanish Language and Culture exam. The updates include free response questions that focus on specific interpersonal and presentational communication skills so that students will actually be able to chat with real, native Spanish-speaking people in the not-so-distant future. The written section asks students to write an email and a persuasive essay, and the speaking section will require students to carry on a conversation and present on a cultural comparison...but don't count on it to help you sound less awkward asking out that chica muy bonita.
The revamped AP Spanish Language and Culture exam features six course themes that range from technology to aesthetics. Students can bet that a selection about a family in a community will have something to do with the theme of la familias y las comunidades—and Shmoop is here to make sure they're equipped with all the information they need to take that subject and run with it.
Guide to the AP Chemistry Exam
Since chemistry is really all about studying and understanding the building blocks of all materials on Earth and beyond, the AP exam is now focusing on laying down strong foundations in six guided inquiry investigations called "Big Ideas." Gone are the days of memorizing exceptions to the Aufbau Principle and specific crystal structures. Instead, the exam is all about understanding chemistry—giving students the tools they need to solve problems and think about what is really happening in the lab.
As a complement to completing hands-on chemistry labs in the classroom, Shmoop's AP Chemistry guide, drills, and practice exams will give students the practice they need to succeed.
Source: Shmoop, www.shmoop.com


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I have written several posts on this topic before. However, changes were made to Windows 7 and Windows Server 2008 R2 that warrant a full revisit of this topic.
This post can can also be also be found on the Windows Springboard Series blog here.
Anyone who had been doing operating system deployments long enough has had to deal with configuring default settings for users that log on to the computer after the image is deployed. Some examples of these are folder settings, desktop wallpaper, and screen saver options. Most of these will be initial settings for user preferences that users will be able to change (unlike policies which are enforced). This is done so that users will have a consistent, known experience when logging on to any client computer for the first time.
This can be done in a number of ways. Below are the methods I have seen or used with what I feel are pros and cons of each.
Implementing Default User Settings by modifying the Default User Profile
There are three main methods that have been used to configure the Default User profile. Only one method (B) is now officially supported and I recommend that you use this method.
A. Manual or scripted copy of a configured profile over the Default User profile (unsupported)
The traditional solution for this (developed during the Windows NT Workstation days) was to configure the Administrator account (or another designated account) with the settings, then copy the Administrator (or designated account) user profile over the Default User profile. This was previously documented in numerous Knowledge Base articles (which have now been deleted). A tool called CopyProfile was even created to script this process during unattended installations of Windows XP.
However, there are problems with using this procedure. It is very old procedure from NT4, when the shell was much simpler. The shell is more complicated for Windows 2000 and higher. This process will copy settings that should not be copied to the default user profile. It may seem to work but you will find subtle problems. Windows XP and later have made those subtle problems more visible.
Also, the Default User profile contains some single run actions that occur when the user logs in for the first time, which then setup that user by running those custom actions. If you overwrite the Default User profile, those single run actions do not take place.
The manual profile copy process can cause issues such as:
- Their list of most frequently run programs is not cleared
- Whether the user has been introduced to the Start menu (will be set to TRUE for the source account, but should be FALSE for new users). Windows Explorer does some special things the first time you log on to introduce you to the Start menu and other new features.
- Whether the user is an administrator (and should therefore see the Administrative Tools, etc).
- The personalized name for "My Documents" will be incorrect. All users documents folders will be called "Administrator's Documents". This is documented in the Knowledge Base article "The Desktop.ini File Does Not Work Correctly When You Create a Custom Default Profile" (http://support.microsoft.com/?id=321281).
- The default download directory for IE will be set to the Administrator's Desktop folder.
- The default Save and Open locations for some application with point to the Administrator's documents folder.
- Windows 7 Libraries are broken.
Because of these issues, this process is no longer supported in Windows XP and all later operating systems. Unfortunately, the ability to copy a profile over the Default User profile was not blocked in Windows XP, Windows Server 2003, Windows Vista, or Windows Server 2008. This allowed many administrators to continue using the process and putting their Windows installations into an unsupported state. To prevent this, Windows 7 and Windows Server 2008 R2 now block this scenario by having the Control Panel System applet gray out the option to overwrite the Default User profile.
At this time the only supported way to configure the the Default User profile using a copy of a configured profile is to use the next method described here, the automated profile copy associated with using Sysprep.
B. Automated profile copy with Sysprep (supported)
First introduced in Windows XP Service Pack 2 (http://support.microsoft.com/?id=887816), Minisetup was modified so that it will copy customizations from the local administrator account to the default user profile. All subsequent versions of Windows will also do this with the proper entries in the answer file. This process was designed to avoid the problems with method A and is already automated.
I won't dwell on how the automated profile copy is used since it is documented in several Knowledge Base articles:
How to customize the default local user profile when you prepare an image of Windows Vista, Windows Server 2008, Windows XP, or Windows Server 2003
How to customize default user profiles in Windows 7
However this process does have a drawback. It does not propagate all settings to Default User and there is no known documentation as to what will and will not be propagated. It also can be difficult to determine if a setting did not carry over to a new user because it was considered inappropriate (i.e. not copied to Default User by design) or is being reset by Minisetup/Specialize or first logon processes.
One final important point to remember is the difference in behavior between Windows XP/Windows Server 2003 and Windows Vista and higher with respect to when the answer file setting must be present for the automated profile copy to occur. On Windows XP and Windows Server 2003, if you want to change the behavior of the automated profile copy, the UpdateServerProfileDirectory entry must be present in Sysprep.inf when Sysprep is run. This is because the profile copy happens when Sysprep is run on Windows XP and Windows Server 2003. The exact opposite is true for Windows Vista and higher. The CopyProfile setting must be set to True in the final answer file that is present when the OS restarts after Sysprep (Specialize phase) or the answer file used when Setup is used to deploy the custom image. This setting does not necessarily have to be present in the answer file used during the image build when Sysprep is run (Generalize phase). This is because the profile copy for Windows Vista and higher happens only during the Specialize phase. So if you are using a deployment tool like ConfigMgr or MDT that may modify/replace the Unattend.xml, make sure that CopyProfile is configured in the answer file used for deployment.
C. Targeted changes to the Default User Registry hive and profile folders
I used to use this method in the before the automated profile copy existed. I can be useful when only a small number of targeted changes are required. It can be described as follows:
1. Identify the needed Registry changes. Then use a tool like Reg.exe or KiXtart to load the Default User hive into a temporary location into the Registry, write only the needed settings, and then unload the hive. The Knowledge Base article "How to run a logon script one time when a new user logs on" (http://support.microsoft.com/?id=284193) shows how to do this manually. This can be scripted for an unattended installation using Reg.exe as shown in this example (these lines may wrap due to page width):
:: ***** Configure Default User
:: *** Load Default User hive
reg load "hku\Test" "%USERPROFILE%\..\Default User\NTUSER.DAT"
:: *** Disable Desktop Cleanup
reg add "hku\Test\Software\Microsoft\Windows\CurrentVersion\Explorer\Desktop\CleanupWiz" /v NoRun /t REG_DWORD /d 1 /f
:: *** Unload Default User hive
reg unload "hku\Test"
2. Copy only needed files or shortcuts to the Default User profile folder.
This has the advantage that all changes to Default User are known and predictable. However, this requires that all changes be reduced to "scriptable" items (i.e. Registry or file system changes, no manual configuration).
To get this method to work properly on various service pack versions of Windows XP or Windows Server 2003 you have to disable the automated profile copy. In some cases you have to either install the hotfix from this KB article: http://support.microsoft.com/?kbid=887816 or set UpdateServerProfileDirectory=0 in Sysprep.inf. Which service packs versions have the automated profile copy enabled by default are documented in KB959753. In Windows Vista and higher the automated profile copy is disabled by default. You would then do the Default User hive registry edits before Sysprep runs.
This method can also be used to make changes to the Default User profile for machines that are already deployed in production.
You should exercise caution using this method. Try to keep all changes limited to only the individual Registry or file system changes needed for a particular desired result (e.g., a Windows or application setting). Do not do wholesale export and import of Registry keys or folder trees. This can potentially lead to the same problems as a manual profile copy. You can use a tool like Sysinternals Process Monitor to identify the individual changes.
Implementing Default User Settings by Using Scripts or Group Policy
The following methods are not for configuring the Default user Profile directly. However, they can be used to achieve the same effect (configuring settings the first time a new user logs on). And they have the added advantage of potentially being centrally managed.
D. Local logon script in the RunOnce Registry key
This is documented in "How to run a logon script one time when a new user logs on" (http://support.microsoft.com/?id=284193). This manual process can be scripted with reg.exe.
There are several advantages to using a script in the default user RunOnce key. It completely avoids Sysprep, CopyProfile, Minisetup/Specialize, or first logon processes effects. Also, if after deployment the default initial user settings need to changed, only the script file needs to be updated (instead of having to script a load/unload of the default user hive and fixing multiple settings). Finally, it is easy to "reset" a user's setting to the defaults because the script can be kept up to date and present on every box through software distribution or Computer Startup Scripts. This method also requires that all changes be reduced to "scriptable" items.
E. Local or Domain GPO logon script
A Group Policy logon script can be used to set "default settings" once by having the script set a flag after it first runs (perhaps an HKCU Registry entry) that it will look for and exit if found on subsequent runs. A Domain logon script has the added benefit of being centrally managed. This method also has the same advantages as method D. This method also requires that all changes be reduced to "scriptable" items.
F. Group Policy Preferences
Group Policy preferences first shipped as part of the Group Policy Management Console (GPMC) in Windows Server 2008. GP preferences consist of more than 20 Group Policy extensions that expand the range of configurable settings within a Group Policy object (GPO). Many of these extensions can configure settings that are commonly configured as default settings in a desktop image. Unlike policies, GP preferences can be changed by the user in most cases. Also, GP preferences can be configured to "apply once and do not reapply". This allows them to behave exactly like initial default settings configured in an image but has the benefit of being centrally managed and updated.
GP preferences cover many of the areas where default settings are usually configured such as:
- Environment Variables
- Files
- Folders
- INI File Settings
- Registry
- Shortcuts
- ODBC Data Sources
- Folder Options
- Internet Settings
- Local Users and Groups
- Network Options
- Power Options
- Regional Options
- Scheduled Tasks
- Start Menu
The main disadvantages GP preferences are that it requires either Windows Server 2008, Windows Server 2008 R2, the Remote Server Administration Tools (RSAT) update for Windows Vista with Service Pack 1 or higher, or the RSAT update for Windows 7 to manage them and client-side extensions (CSEs) have to be installed for Windows Vista RTM, Windows XP with Service Pack 2, and Windows Server 2003 with Service Pack 1 or higher. For those still managing Windows 2000 images, you will have to use one of the previous methods mentioned since GP preferences will not work on Windows 2000.
I believe that GP preferences will likely be the best way to manage this going forward. Simply create GPOs using GP preferences, target them as needed, install the CSEs into the image(s) as needed, and you no longer need to worry about configuring these settings in the client image(s).
For information about Group Policy preferences see the following web resources:
Group Policy Preferences Overview
Group Policy Preferences Frequently Asked Questions (FAQ)
Disclaimer: The information on this site is provided "AS IS" with no warranties, confers no rights, and is not supported by the authors or Microsoft Corporation. Use of included script samples are subject to the terms specified in the Terms of Use.
This post was contributed by Michael Murgolo a Senior Consultant with Microsoft Services, U.S. East Region.


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Recorded with Lowlands: Gypsy Child (2010), Fathers & Sons (2011), Better World Coming, Beyond (2012), Left of the Dial EP (2013), Low & Lucky EP, Love Etc... (2014)
1) Desert Island Records:
Donald Fagen - The Nightfly
AC/DC - Black in Black
Genesis - Seconds out
Tribe Called Quest - People's instinctive travels and the paths of rhythm
CCCP - Affinita' Divergenze
Peter Gabriel - So
2) Top 5 Piano/Keyboard Players
Thelonious Monk
Ray Charles
Kenny Kirkland
Joey Di Francesco
Richard Barbieri
3) Favourite Bands
Rolling Stones
Joy Division
4) When did you start Playing piano?
I was 7 years old. My dad, a carpenter, used to bring me to his workshop with him on Saturdays. I used to hang out there playing with all the most dangerous tools I could get my hands on. One day, I noticed a blue shadow behind the curtain of a lorry, I jumped on and saw this beautiful blue upright piano. I had never seen a piano before but pushing those blacks and whites I played along to the 9th symphony, listening to my brother's records... that was the start of it but I still don't understand how (and if) I learned how to play...
5) Favourite Pizza Topping
Ham and Gorgonzola


text:
Take Me HomeMusic CD - 2012
From the critics
Community Activity
CommentAdd a Comment
this album is AMAZING. man, all these take me home cd's are hard to track down though. there is no single one version of the cd with every song on that album. thats a little sad, but im okay going on the treasure hunt. the turnout is way worth it. one direction is the best. woohoo.
This is not one of the best albums that I have listened to but I was okay for a first.
I think everyone here can agree that One Direction must be truly affecting our lives if we all go on our library's website to say how much we love them...
Much love to 1D
High-five to all y'all directioners
I love one Direction I barrow this cd before and I LOVED THIS CD the songs they put on t.v. the music videos i mean are called Live While we're Young kiss you and little things i love that song more than any song on this album I LOVE THE SONG LITTLE THINGS. all the girls in my class like one Direction boys not so much i do also have a cd with book by One Direction take me home limited edition yearbook it has a cd inside included.
Love this album my favourite songs are only . . . . . . . . UMmm every song on the album!!!!!!!!!!!
I love this album especially little things
This album is truly amazing! I love all the songs--they're catchy, sweet, and irresistible! I memorized all the lyrics, and Directioners definitely need to listen to this album before they buy Midnight Memories on November 25th! I love the five boys--Louis Tomlinson, Zayn Malik, Liam Payne, Niall Horan, and Harry Styles. Louis is fabuLOUIS, Zayn is amaZAYN, Liam is brilLIAM, Niall is phenomiNIALL, and Harry is extraordinHARRY!! :)
Best album I've ever listened too! It's a must to get. I love They Don't Know About Us & Over Again. If you've seen their music videos, when you listen to a song you will automatically think of the crazy hilarious things they do & it will make you smile :)
This album rocks! The band rocks! If you like it you rock! LISTEN TO THIS ALBUM!!! You will not regret it! P.S. Niall is beautiful.
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yayoi kusama
visit: yayoi kusama's mirrored years exhibition at mca, it's freakin amazing!! going to see this japanese artist's art installations is just like stepping into la la land, a whole different world. cute, magical and full of polkadots! one of the best art exhibitions i've gone to so far. this is definitely a must if you're around sydney from now until 8 june 2009.


text:
White Clinic
As an intimate symbol for youth and rebirth, the calla lily represents beauty in its purest form.
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