text:
Light from Above
A Voice from the Chorus
In the 1960s readers in the West speculated about the identity of "Abram Tertz," whose work, arriving from Soviet Russia, was being published in Paris, London, and New York. The writing was highly original and varied in tone: humorous, terrifying, phantasmagoric, satiric, devout. Between 1959 and 1965 there appeared an essay, "On Socialist Realism," two short novels, The Trial Begins and The Makepeace Experiment, a book of reflections, Unguarded Thoughts, and a collection of tales, Fantastic Stories. The secret of their authorship was well guarded.
Then, on September 8, 1965, Andrei Sinyavsky, a Russian scholar and critic, member of the Gorky Institute of World Literature, teacher at the University of Moscow, contributor of biographical studies to the History of Soviet Russian Literature and of reviews to the literary journal Novy Mir, was arrested and charged with slandering his country abroad in smuggled publications under the pseudonym of Abram Tertz. He was held five months in Lefortovo jail, brought to trial on February 10, 1966, and four days later sentenced to seven years at forced labor. From March 1966 to June 1971 he sampled three different prison camps, peopled by various kinds of offenders: religious zealots, "military criminals," Moscow dissidents, and ordinary felons. In the spring of 1971 he was released, and a year later was permitted to emigrate. He is now living in Paris.
The dedication of the work under review—it has been faithfully translated and is prefaced by an informative and sympathetic introduction—explains its origin:
To my wife, Maria, I dedicate this book based almost entirely on my letters to her during my years of imprisonment 1966-1971.
Twice a month Sinyavsky was allowed to send letters and to receive mail, and twice a month he sent to Maria Sinyavsky the notes he wrote down from day to day in his free time, telling her about what of interest had happened "within or around" him. She could be counted on to share his interests and appreciate his thoughts:
Oddly enough, all this idle chatter in my letters is in large measure not so much self-expression on my part as a form of listening to you—turning things over this way and that and seeing what you think about them. It is important for me, when I write, to hear you. Language thus becomes a scanning or listening device, a means of silent communion….
There is amazingly little in the book about the physical aspects of his incarceration, partly no doubt because Sinyavsky knew that all correspondence was censored, partly to spare his wife, but mostly because he was absorbed in matters of another kind. Even the sparse references to his mode of life bear on his writing:
They shout terribly—always, as usual, about things of no importance and it is difficult to write to such an accompaniment.
During these years I have grown so tired of…
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text:
Travis Manion Foundation
Accredited Charity
Meets Standards
164 East State Street
Doylestown, PA 18901
164 East State Street
Doylestown, PA 18901
Accredited Charity
Meets Standards
Standards Legend
- Meets Standards
- Standards Not Met
- Did Not Disclose
- Review In Progress
- Unable to Verify
Standards For Charity Accountability
Board Oversight
Standard 1 (Oversight of Operations and Staff)
Organizations shall have a board of directors that provides adequate oversight of the charity's operations and its staff. Indication of adequate oversight includes, but is not limited to, regularly scheduled appraisals of the CEO's performance, evidence of disbursement controls such as board approval of the budget, fund raising practices, establishment of a conflict of interest policy, and establishment of accounting procedures sufficient to safeguard charity finances.
The organization meets this standard.
Board Size
Standard 2 (Number of Board Members)
Soliciting organizations shall have a board of directors with a minimum of five voting members.
The organization meets this standard.
Board Meetings
Standard 3 (Frequency and Attendance of Board Meetings)
An organization shall have a minimum of three evenly spaced meetings per year of the full governing body with a majority in attendance, with face-to-face participation. A conference call of the full board can substitute for one of the three meetings of the governing body. For all meetings, alternative modes of participation are acceptable for those with physical disabilities.
The organization meets this standard.
Board Compensation
Standard 4 (Compensated Board Members)
Not more than one or 10% (whichever is greater) directly or indirectly compensated person(s) serving as voting member(s) of the board. Compensated members shall not serve as the board's chair or treasurer.
The organization meets this standard.
Conflict of Interest
Standard 5 (Conflict of Interest)
No transaction(s) in which any board or staff members have material conflicting interests with the charity resulting from any relationship or business affiliation. Factors that will be considered when concluding whether or not a related party transaction constitutes a conflict of interest and if such a conflict is material, include, but are not limited to: any arm's length procedures established by the charity; the size of the transaction relative to like expenses of the charity; whether the interested party participated in the board vote on the transaction; if competitive bids were sought and whether the transaction is one-time, recurring or ongoing.
The organization meets this standard.
Measuring Effectiveness
Effectiveness Policy
Standard 6 (Board Policy on Effectiveness)
Have a board policy of assessing, no less than every two years, the organization's performance and effectiveness and of determining future actions required to achieve its mission.
The organization meets this standard.
Effectiveness Report
Standard 7 (Board Approval of Written Report on Effectiveness)
Submit to the organization's governing body, for its approval, a written report that outlines the results of the aforementioned performance and effectiveness assessment and recommendations for future actions.
The organization meets this standard.
Program Expenses
Standard 8 (Program Service Expense Ratio)
Spend at least 65% of its total expenses on program activities.
The organization meets this standard.
Fundraising Expenses
Standard 9 (Fund Raising Expense Ratio)
Spending should be no more than 35% of related contributions on fund raising. Related contributions include donations, legacies, and other gifts received as a result of fund raising efforts.
The organization meets this standard.
Accumulating Funds
Standard 10 (Ending Net Assets)
Avoid accumulating funds that could be used for current program activities. To meet this standard, the charity's unrestricted net assets available for use should not be more than three times the size of the past year's expenses or three times the size of the current year's budget, whichever is higher.
The organization meets this standard.
Audit Report
Standard 11 (Financial Statements)
Make available to all, on request, complete annual financial statements prepared in accordance with generally accepted accounting principles. When total annual gross income exceeds $500,000, these statements should be audited in accordance with generally accepted auditing standards. For charities whose annual gross income is less than $500,000, a review by a certified public accountant is sufficient to meet this standard. For charities whose annual gross income is less than $250,000, an internally produced, complete financial statement is sufficient to meet this standard.
The organization meets this standard.
Detailed Expense Breakdown
Standard 12 (Detailed Functional Breakdown of Expenses)
Include in the financial statements a breakdown of expenses (e.g., salaries, travel, postage, etc.) that shows what portion of these expenses was allocated to program, fund raising, and administrative activities. If the charity has more than one major program category, the schedule should provide a breakdown for each category.
The organization meets this standard.
Accurate Expense Reporting
Standard 13 (Accuracy of Expenses in Financial Statements)
Accurately report the charity's expenses, including any joint cost allocations, in its financial statements. For example, audited or unaudited statements which inaccurately claim zero fund raising expenses or otherwise understate the amount a charity spends on fund raising, and/or overstate the amount it spends on programs will not meet this standard.
The organization meets this standard.
Budget Plan
Standard 14 (Budget)
Have a board-approved annual budget for its current fiscal year, outlining projected expenses for major program activities, fund raising, and administration.
The organization meets this standard.
Fundraising & Info
Truthful Materials
Standard 15 (Misleading Appeals)
Have solicitations and informational materials, distributed by any means, that are accurate, truthful and not misleading, both in whole and in part. Appeals that omit a clear description of program(s) for which contributions are sought will not meet this standard. A charity should also be able to substantiate that the timing and nature of its expenditures are in accordance with what is stated, expressed, or implied in the charity's solicitations.
The organization meets this standard.
Annual Report
Standard 16 (Annual Report)
Have an annual report available to all, on request, that includes: (a) the organization's mission statement, (b) a summary of the past year's program service accomplishments, (c) a roster of the officers and members of the board of directors, (d) financial information that includes (i) total income in the past fiscal year, (ii) expenses in the same program, fund raising and administrative categories as in the financial statements, and (iii) ending net assets.
The organization meets this standard.
Website Disclosures
Standard 17 (Web Site Disclosures)
Include on any charity websites that solicit contributions, the same information that is recommended for annual reports, as well as the mailing address of the charity and electronic access to its most recent IRS Form 990.
The organization meets this standard.
Donor Privacy
Standard 18 (Privacy for Written Appeals & Internet Privacy)
Address privacy concerns of donors by (a) providing in written appeals, at least annually, a means (e.g., such as a check off box) for both new and continuing donors to inform the charity if they do not want their name and address shared outside the organization, (b) providing a clear, prominent and easily accessible privacy policy on any of its websites that tells visitors (i) what information, if any, is being collected about them by the charity and how this information will be used, (ii) how to contact the charity to review personal information collected and request corrections, (iii) how to inform the charity (e.g., a check off box) that the visitor does not wish his/her personal information to be shared outside the organization, and (iv) what security measures the charity has in place to protect personal information.
The organization meets this standard.
Cause Marketing Disclosures
Standard 19 (Cause Related Marketing)
Clearly disclose how the charity benefits from the sale of products or services (i.e., cause-related marketing) that state or imply that a charity will benefit from a consumer sale or transaction. Such promotions should disclose, at the point of solicitation: (a) the actual or anticipated portion of the purchase price that will benefit the charity (e.g., 5 cents will be contributed to abc charity for every xyz company product sold), (b) the duration of the campaign (e.g., the month of October), (c) any maximum or guaranteed minimum contribution amount (e.g., up to a maximum of $200,000).
The organization meets this standard.
Standard 20 (Complaints)
Respond promptly to and act on complaints brought to its attention by the BBB Wise Giving Alliance and/or local Better Business Bureaus about fund raising practices, privacy policy violations and/or other issues.
The organization meets this standard.
Travis Manion Foundation meets the 20 Standards for Charity Accountability.
Year, State Incorporated
Stated Purpose
to assist our nation's veterans and the families of Fallen Heroes.
TMF administers three principal programs veterans services, Character Does Matter (CDM), and survivor services. The veteran services program seeks to help returning veterans transition into successful careers. The Character Does Matter program is designed to empower veterans to utilize their inherent leadership skills to develop character in our nations youth. As reported by the organization, this program touches over 30,000 young adults annually. Finally, TMF's survivor services program empowers families of the fallen to honor their loved one through an act of service. This service is accomplished during the 8 expeditions and 6 service projects the organization plans and organizes each year.
For the year ended December 31, 2014, Travis Manion Foundation's program expenses were:
|Charitable investments and community activation
|Character and leadership development
|Veteran and survivor support
|Total Program Expenses:
Governance & Staff
Chief Executive
Ryan Manion Borek, President
Chair of the Board
Barbara Orr
Chair's Profession / Business Affiliation
Executive Vice President and Co-owner; Partner of Poretta & Orr, Inc.
Board Size
Paid Staff Size
Method(s) Used:
Direct mail, special events, television appeals, radio appeals, grant proposals, and Internet appeals.
Fundraising costs were 9% of related contributions. (Related contributions, which totaled $6,310,622, are donations received as a result of fundraising activities.)
Tax Status
This organization is tax-exempt under section 501(c)(3) of the Internal Revenue Code. It is eligible to receive contributions deductible as charitable donations for federal income tax purposes.
The following information is based on Travis Manion Foundation's audited financial statements for the year ended December 31, 2014.
|Source of Funds
|In-kind contributions
|Program service revenue
|Merchandise sales
|Investment Income
|Total Income
- Programs: 88%
- Fundraising: 8%
- Administrative: 4%
|Total Income
|Program expenses
|Fundraising expenses
|Administrative expenses
|Other expenses
|Total expenses:
|Income in Excess of Expenses
|Beginning Net Assets
|Other Changes In Net Assets
|Ending Net Assets
|Total Liabilities
|Total Assets
An organization may change its practices at any time without notice. A copy of this report has been shared with the organization prior to publication. It is not intended to recommend or deprecate, and is furnished solely to assist you in exercising your own judgment. If the report is about a charity and states the charity meets or does not meet the Standards for Charity Accountability, it reflects the results of an evaluation of information and materials provided voluntarily by the charity. The name Better Business Bureau is a registered service mark of the Council of Better Business Bureaus, Inc.
This report is not to be used for fundraising or promotional purposes.

subset: commoncrawl


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13th June 2018, 01:09
AI:MMO, educational gaming platform, Ocado Technology, Hatfield, Hertfordshire
22nd May 2018, 09:47
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ENGL 135 (CA) Introduction to Creative Writing (1)
This course introduces students to the practice of writing as an artistic medium. Combines analysis, study of form, and hands-on experience. May be single genre, or multiple genres, covering poetry, fiction, creative nonfiction, or dramatic writing.
- General Education Requirement Fulfillment: Creating in the Arts
- Offering: Fall/Spring
- Instructor: Staff


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text:
The State Museum of Pennsylvania Announces March 2013 Highlights
Feb 22, 2013, 10:08 EST
HARRISBURG, Pa., Feb. 22, 2013 /PRNewswire-USNewswire/ -- The State Museum of Pennsylvania today announced its program schedule for March 2013:
StoryTime, A Curiosity Connection Reading Series: State Museum volunteers and staff will continue the popular children's reading program on March 1 and March 8. The readings begin at 10 a.m. followed by a related play activity. Suggested for ages 3–5 years, but all ages can enjoy the reading. Free with museum admission. March 1 book: "Papa, Please Get the Moon for Me" by Eric Carle. March 8 selection: "Tip Tip Dig Dig" by Emma Garcia.
Student Art Exhibit: The South Central Pennsylvania Arts and Writing Awards presents "Personal Perspectives," award-winning artwork by students in grades 7–12 from Adams, Cumberland, Franklin, York, and Dauphin counties from March 9–April 28, 2013. The exhibit is sponsored by Commonwealth Connections Academy.
Sunday, March 10: Admission is free as the museum celebrates Pennsylvania's 332nd birthday on "Charter Day," a commemoration the granting of the colony's charter to founder William Penn by King Charles II of England. The annual display of the original 1681 charter is featured (March 8–17) and activities include:
Student Recognition Ceremony, 1 p.m.: Meet the 2012 student winners of National History Day in Pennsylvania as well as students from Harrisburg's SciTech High serving as special docents at The State Museum this spring. National History Day in Pennsylvania is a project of the Army Heritage Center Foundation, Carlisle.
Mammal Hall and Giant Map of Pennsylvania, 1:30–4 p.m.: Meet The State Museum's SciTech High School student docents as they interpret the museum's dynamic natural history dioramas and a new giant map of Pennsylvania on which students and visitors can traverse the state in their stocking feet. The SciTech Student Docent program is sponsored by Penn National Insurance. The giant map of Pennsylvania was created and provided by the Pennsylvania Alliance for Geographic Education.
DOSHI Gallery Exhibit and 3rd in the Burg: The Susquehanna Art Museum (SAM) will open a new exhibit in its DOSHI Gallery at The State Museum entitled "Course and Discourse," pairing works by students and their professors from central Pennsylvania colleges and universities, including Franklin and Marshall College, Millersville University, Pennsylvania College of Art and Design, Lebanon Valley College, Messiah College, Elizabethtown College and Wilson College. The exhibit will be on display through May 6. SAM will host a free reception for the exhibit at The State Museum on Friday, March 15, 6–8 p.m.
The State Planetarium: Bigger, Brighter, Bolder! The State Museum presents its newly-upgraded Planetarium XD, featuring the latest state-of-the-art technology. Shows offered from March 2 through May 26 include:
"Astronaut" (grade 3 and up)
Explore the amazing worlds of inner and outer space, from floating around the International Space Station to maneuvering through microscopic regions of the human body. Narrated by Ewan McGregor. Saturdays, 11 a.m. and 1 p.m.; Sundays, 1 p.m.
"BIG" (grade 6 and up)
An imaginative look at the size and scale of our universe. Explore the universe beginning with space probes reaching out to our Solar System, then telescopes collecting the light from the stars. With a lighthearted storytelling style and unique characters, "BIG" brings a really big subject down to earth. Narrated by Sir Richard Attenborough. Saturdays, noon and 2 p.m.; Sundays, 2 p.m.
Planetarium shows are $2 per person, in addition to general admission; free to State Museum Affiliate Members.
Holiday Closure: The State Museum will be closed on Easter Sunday, March 31.
The State Museum of Pennsylvania, adjacent to the State Capitol in Harrisburg, is one of 25 historic sites and museums administered by the Pennsylvania Historical and Museum Commission as part of the Pennsylvania Trails of History®. The State Museum offers expansive collections interpreting Pennsylvania's fascinating heritage.
With exhibits examining the dawn of geologic time, the Native American experience, the colonial and revolutionary era, a pivotal Civil War battleground, and the Commonwealth's vast industrial age, The State Museum demonstrates that Pennsylvania's story is America's story.
Museum hours are Wednesday through Saturday, 9 a.m. to 5 p.m., and Sunday, noon to 5 p.m. Admission is $5 for adults, $4 for children and senior citizens.
For more information about the museum, visit www.statemuseumpa.org.
Media contact: Howard Pollman, 717-705-8639
SOURCE Pennsylvania Historical and Museum Commission


text:
< North Central Washington Gets The Shakes
Jun 27, 2013 06:37
Category: General News
Category: General News
WA Lawmakers Want To Monitor Repeat Drunk Drivers
OLYMPIA, Wash. (AP) — Washington lawmakers are hoping to give final approval today to legislation that monitor repeat drunk drivers. The Senate yesterday approved a revised proposal that would require interlock devices in vehicles of people with a second DUI offense. The state would also begin a pilot program to conduct daily alcohol monitoring on a person convicted twice under the DUI law.


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WINNER: Toyota Land Cruiser 70
Bet you didn't see this coming, what with the influx of such glamour utes as Ford's Ranger, the Holden Colorado, Nissan's 550Nm Navara torque-meister and more versions of Volkswagen's Amarok.
The trouble was, new utes are becoming increasingly suburban and more car-like than cars.
As the others bragged about their electronic cleverness and whisper quiet cabins, along chugged the new Toyota Land Cruiser 70 double cab ute, leaving muddy tyre prints behind it.
The 70 bucked the trend. It had almost no electronic aids. It only just got ABS, a couple of airbags and rear disc brakes. Its tyres were not street-oriented. It was the only Japanese ute left with a whack-it-into-the-rocks beam axle front suspension.
It even came standard with a raised air intake for driving across rivers deep enough to lap against the windscreen. Its V8 turbodiesel won't care.
Tick the optional $2500 front and rear differential locks and little could stop it. This would be the one you'll want if one of our volcanoes suddenly blows.
Like the single cab versions that have been around for years, the double cab Cruiser 70 was an ultimate working ute, tough as an anvil but now even more useful with its extra set of full-sized rear seats.
Read Phil Hanson's test of the Land Cruiser 70
- Phil Hanson
Runner up: VW Amarok Auto
WINNER: BMW Gran Coupe 650i
BMW New Zealand's luxury four-door coupe won this award by a nose - in particular its 'shark nose' front grille.
The styling of this vehicle followed the 6 Series family, with the same exterior cues and interior design.
The interior was all class befitting this segment.
We picked the 650i over the 640 diesel as the petrol engine had a twin Power variable twin-turbocharged 4.4-litre direct injected V8 petrol engine (330kW at 5500-6000rpm, 650Nm at 2000-4500rpm)
Added to that was an eight-speed automatic transmissions with steptronic and assisted by Driving Experience Control. This allowed you to select differing modes - Eco-Pro, Comfort, Sport and Sport+ - that, among other things, alter the engine's response.
It also won praise for its intensive safety package including park assistant, rearview camera, heads-up display, and the optional speed limit info that reflected the road speed in the heads-up display.
Low slung, it hugged the road and powered through corners with ease - just like a shark in search of prey.
Read more on the Gran Coupe here
Runner up: Mercedes-Benz SL500
WINNER: Triumph Explorer
The year started with an MV Augsta Brutale, and ended aboard a Hyosung LAMS learner-approved bike; from an Italian hooligan with heritage and a price tag to match, to a Taiwanese machine aimed at learner riders seeking something with style on a budget. In between we rode Harleys, Hondas and Husqvarnas; Syms and Suzukis; Aprilias, Moto Guzzis and Triumphs; Yamahas, Kawasakis and more; some brands were in short supply and we missed a few completely.
New Zealand road bike sales were hit badly by the recession, but bikes make affordable congestion-busting runabouts and cheap performance toys; cars don't deliver the bang for buck a motorbike can. So what should you buy?
No Bike of the Year award is truly definitive without riding every motorcycle on sale, but we get just 30 or so each year.
So some worthy contenders don't appear on our shortlist simply because they weren't available; BMW's launched some exciting machines this year, but they're in short supply, and Ducati's press fleet is based in Australia so doesn't get ridden on Kiwi roads, to name but two.
The winner had to suit a wide variety of riders, and the roads on which we Kiwis ride; had to push the bar out a bit and preferably not break the bank.
Aprilia's Tuono hit my shortlist - high performance that works in the real world, but unless you're a track bunny the fancy electronics just add cost.
Honda's NC700S also scored highly. A modest price, outside-the-square design that puts storage space into the 'tank' and keeps weight low, and frugal running in an agile package you'll enjoy hustling through a tricky set of bends despite the modest capacity.
But it couldn't trump the winner - the Triumph Explorer. A large dual purpose bike with an adjustable seat height to suit a wide range of riders, it boasts a new purpose-designed 1215cc three-cylinder engine, a six-speed floating gearbox and a robust build it'd be as easy to fix on the East Cape or the Russian Steppes. It's not as agile as a sports bike but the wide bars let you tip it deep into bends, the motor pulls strongly and progressively from low revs to an eyebrow-raising high-rev punch of acceleration, and the suspension will absorb almost anything NZ's varied roads can deliver. It also gets lots of clever high-tech functions including ABS and traction control, an extensive options list to tailor it to almost any need, and a price set a whisker below its BMW competition.
Honourable mentions go to bikes I'd happily add to my own garage, where personal preference trumps objective common sense. Husqvarna's Nuda back-roads hooligan and Ducati's Streetfighter, quite possibly joined by that Honda, for runs to the dairy or rural-urban commutes when a two-wheeled equivalent of your Hyundai makes more sense than an Italian thoroughbred.
Read more about the Triumph Explorer here
- Jacqui Madelin
Runners up: Aprilia Tuono & Honda NC700S


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FINALISTS: Indian Springs M.S. to send spellers to state showdown
COLUMBIA CITY — Competition doesn't just take place on a grassy field. For Indiana Springs Middle School Spell Bowl team, competition will take place at Purdue University with pencil and paper in hand.Middle school students recently learned that for a second year in a row, they will be spelling at the state level. This year, ISMS is the only school from Whitley County to advance, after being named conference champions Oct. 17."We've had a record-setting year," said ISMS Coach Dennis Beckner. "We came into this year with the understanding that we were still building a strong team, but the results have been exciting. Our team has done very well."Since Beckner took over the team in 2006, ISMS has logged several conference titles, as well as area championships. But it's not about the win for the sixth through eighth graders. Although blue ribbons and trophies are valued, the students appreciate the overall spelling experience.Cris Robinson, a seventh grader, is a first-year speller. He now realizes he should have joined a year earlier.To read the rest of this story, see the Oct. 31 issue of The Post and Mail. Don't have a subscription? Call (260) 244-5153 or subscribe to our e-edition. For breaking news, sports updates and additional coverage, bookmark the homepage and find us on facebook and twitter.


text:
Make the filling: Bake the potatoes in a preheated 350 degree F. oven until fork tender, about 30 to 40 minutes. Peel, and while still warm, pass through a food mill. In a small saute pan, heat the butter over medium heat. Add the shallots and garlic, and cook until soft. In a medium bowl, combine all the cheeses, the herbs, and the beaten egg. Add the cooked shallots and garlic and the warm potato. Stir until blended (being careful not to overmix, or the mixture will get pasty). Season with salt and pepper. Cover and refrigerate until needed. Then, with lightly moistened hands, roll into 1/2 ounce balls, about the size of golf balls.
Cut the pasta dough into 4 portions and work with 1 portion at a time, keeping the remaining dough covered with plastic wrap. Lightly dust the work surface with flour. With a pasta machine or a rolling pin, roll out the dough about 20 inches long and 4 inches wide. Brush the dough with egg wash and arrange 9 to 10 balls of filling on the lower third of the length of the dough, about 1 to 1 = inches apart.
Fold the top half over to cover the balls. Press the dough around each ball to seal, making sure that you do not have any air pockets. With a 2-inch round cookie cutter, cut the ravioli. Dust a tray with flour and arrange the ravioli on the tray, dusting with more flour. Repeat with the remaining dough, egg wash, and filling. Refrigerate, covered, until needed.
Bring a large pot of salted water to a boil. Cook the ravioli until al dente, about 3 to 4 minutes.
Meanwhile, in a large saute pan, over high heat, add the oil and the butter. Cook the butter until it begins to brown. Drain the ravioli and toss into the browned butter, turning to coat both sides. Add the Parmesan cheese and season with salt and pepper. Garnish with parsley and hazelnuts and serve immediately.
In a food processor fitted with the steel blade, combine the flour, egg yolks, salt, olive oil, and 2 tablespoons of the water. Process until the dough begins to hold together, then stop the machine and pinch the dough to test it. If it's too dry, add up to 1 more tablespoon of water and process until it forms a moist ball. Turn out on a lightly floured smooth work surface and knead by hand, until a smooth ball is formed. Loosely wrap in plastic wrap and let rest at room temperature for 30 minutes to 1 hour.
Cut the dough into 4 equal pieces. Keep the other pieces covered in plastic while you roll out 1 piece at a time, by hand with a rolling pin or through the rollers of a pasta machine, stretching the dough to the desired thickness.
If using a pasta machine, set the rollers at the widest opening. Flatten the first piece of dough into a thick strip no wider than the machine, to enable it to pass through the rollers. If necessary, dust the pasta very lightly with flour. Run the pasta through the machine. Fold in thirds, crosswise, and run through the machine again. Repeat this procedure 2 or more times, until the dough is smooth and somewhat elastic. Set the machine to the next smaller opening and run the dough through the rollers.
Continue rolling and stretching the dough, using the smaller opening each time, until the next to the last or the last opening is reached, dusting lightly with flour only as necessary. (The strip of dough will be long. If you don't have enough space on your worktable, halfway through the rolling process cut the strip of dough in half and continue to work with each piece separately, keeping the unused dough covered).
Adjust the cutting mechanism to the desired width, cut the noodles, and allow them to dry before cooking. A convenient way to dry pasta is to arrange the cut pasta on a pastry tray sprinkled with flour, preferably semolina flour. As 1 layer is completed, sprinkle flour over the noodles, place a piece of parchment paper over them, and continue layering with noodles and flour. Dry for at least 15 to 20 minutes.
Repeat with the remaining pieces of dough.
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text:
Jared Berggren scored 15 points and grabbed a season-high 12 rebounds, and Traevon Jackson added a career-best 14 points to lead Wisconsin over No. 12 Illinois 74-51 Saturday.
The Badgers (12-4, 3-0 Big Ten) scored the game's first 14 points and led by 20 at halftime on the way to their sixth straight win.
It was a stunning performance from a team that scored just 47 in the previous game against Nebraska, but a supposedly slow and methodical team locked into a higher gear and ended the suspense almost as soon as the game began.
Whether they were making 3-pointers, driving for layups, putting back misses or throwing down dunks, the Badgers had their way in this one. They outshot Illinois 49.1 percent to 35.3 percent, making 10 of 23 3-pointers, and outrebounded the Illini 43-24.


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Author: Kelvin Newman
Kelvin Newman is SiteVisibility's Creative Director and is the editor of the UK's most listened to Marketing Podcast. He also spends his time at conferences, tweeting too much and working on top secret research and development projects.
You can download his book on Linkbuilding 'Becoming a Clockwork Pirate' for free online.
Five interview questions to ask search marketing candidates
Recruiting the right talent for your team is tricky no matter what industry you're in, but people working in search marketing face some very particular challenges.
There aren't a lot of experienced and talented people to go around. Equally, experience doesn't always correlate with talent.
There are a lot of excellent search marketers with only a few years experience and others who've done the years but don't have the skills.
Lots of people are responding to this by taking on trainees, this can work a treat but does eat into one of your most precious resources – your senior team's time.
So if you decided to recruit someone with more experience what do you ask them?
Seven SEO tools to improve your online PR efficiency
Recently I've had the pleasure of training a number of PR agencies on how they can work Search Engine Optimisation into their service offerings.
It's no secret that lots of SEO agencies and teams are trying to do the reverse at the same time.
While this merging of disciplines is no big surprise, something that I hadn't anticipated is just how useful SEO tools can be for people carrying out online PR.
Early thoughts on what Facebook's Graph Search means for SEO
Now there's one thing you can be certain of whenever there's a new launch from Facebook there's going to be a huge amount of speculation about what it means for digital marketers; but now they've made a stab at launching a search engine - there will be even more than usual.
First, let's get the biggest caveat out the way, I've not used the search functionality yet, I'm on the beta waiting list, along with thousands of others, but I have poured over all the write ups including this excellent write up of the story behind by Steven Levy, which I think even tops his great piece about the launch of Google Plus.
Despite that lack of practical experience of the new functionality, for the last couple of years I've thrown myself into understanding the Edgerank Algorithm, aka the rules that decide what appears in your newsfeed and come from a search marketing background.
19 tools to improve your content marketing strategy
As we wave goodbye to 2012 and say hello to 2013, there's a good chance, you, like many other people, have been working to put together a content marketing strategy for the new year.
No doubt you'll have the objectives in place, created a well thought out strategy and work plan as long as your arm.
It's that last element I want to help you with in this blog post, by sharing a clutch of tools and services which will save you time, improve your results and give you the freedom to work on the creative aspects of your campaign.
12 brands increasing conversions by understanding human psychology
First up a great big caveat emptor: in conversion rate optimisation there's no such things as rules, there's only findings. What may prove emphatically effective in one test, might be a waste of time in another similar situation.
Having said all that, there are a number of hardwired human traits and behavioral patterns understood by psychologists, behavioral economists and other social scientists that we can use to increase our conversions.
I have identified 12 brands that understand some of these common behaviors and have reflected it within their web designs. Examples like this can give you some ideas of potential things to try and test on your users.
Facebook Edgerank: what marketers need to know
It's been nine months since I wrote the original Ultimate Guide to the Facebook Edgerank Algorithm. I was amazed to see the reaction to the piece.
It clearly seemed to strike a chord as it went on to be the most popular guest post on Econsultancy in 2012.
But a lot has changed since then in the world of Facebook. As I'm currently putting together a presentation for the upcoming Econsultancy Digital Shorts event in Manchester on Edgerank and other social algorithms, now seemed the perfect time to revisit the piece to update and expand it.
Search plus: five changes you need to make to your SEO campaigns
Well, it's a few days since Google announced Search Plus Your World and I've had a chance to start to think a little about how this dramatic shift in the personalisation of results might change the day-to-day tactics of the search campaigns I work on.
Please note: I'll be referring this as Search+ henceforth, rather than the namepuke "Search Plus Your World".
Here are six small tweaks to make to your SEO campaigns, thanks to Search+...
Five tricks our minds play on us and what marketers need to know
There's a phenomena on the cusp between behavioral economics and psychology known as cognitive biases which are essentially scientifically documented tricks that our minds play on us.
As all of us in the world of digital marketing are in the business of persuasion, understanding these often irrational tendencies can help us do a better job.
Some are glaringly oblivious when you're alerted to them, other are far more subtle in the way they influence decision making.
I recently delivered a talk at A4U Expo London exploring a few of these 'mind tricks' but I want to explain them further and in more depth.
The ultimate guide to the Facebook Edgerank algorithm
EdgeRank is one of the most important algorithms in marketing. Despite this, very few people have heard of it and fewer still can claim that they fully understand it.
EdgeRank is the name of the algorithm which Facebook uses to determine what appears in their users' news feeds. The news feed is Facebook's 'Killer App'. There is a plethora of information available to Facebook users, and the newsfeed is the order in which it appears.
It determines which of your connections is the most important to you and thus appears most frequently, and which kinds of content should appear higher than others. For anyone seeking to market a product or service on Facebook it's essential you understand how this algorithm works.
Understanding the rules of the algorithm and changing your tactics to reflect the system can make the difference between a business changing campaign and an embarrassing failure. Yet despite this huge importance very little has been written about the algorithm.
Why Google + is already giving better social ranking signals than Twitter
There's no secret in the SEO world that many of us suspect that the reason why Google has been pushing Google+ so aggressively.
It isn't just to build its own successful social network, but also to gain access to data on what content and websites are being shared socially as this could be a great addition to their search algorithm.
You have to have been living below a rock the last year to have missed out on studies which have suggested volume of shares on Facebook and Twitter having a correlation with high rankings.
There might not be causation there yet, but that certainly seems the direction we're heading in, with social signals becoming a ranking factor.
Here are five reasons why Google+ is already finding this data more useful than the Twitter Firehose...
Eight tools and techniques to boost your link building efforts
There's no question the difference between a successful search marketing campaign and one that fails is very rarely due to a lack of creativity or a naive strategy. Far more frequently it's down to inefficiencies or wasted resources.
So what can you do to reduce those problems? Try and constantly improve things. Those changes are very rarely revolutions in your process, but just small refinements.
What follows are eight of those small refinements and improvements that I've made recently which I think have made me a better link builder.
What did I learn swapping a book for a retweet?
A few weeks ago I released a mini eBook about link building for SEO titled "Becoming a Clockwork Pirate." Although I put my heart, soul and everything I know about link building into the 30,000 word digital mini-book, that's not what made the book most interesting.
What made it unusual was the approach I took in 'monetising' it.


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Article Text
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Question Can early labour assessment improve intrapartum outcomes?
Randomised controlled trial.
A large teaching hospital in southwestern Ontario, Canada.
209 women (mean age 25 y) who were ≥37 weeks gestation, had no previous live births, were identified as low risk according to the Ontario antenatal record, and who had spontaneous labour.
105 women were allocated to early assessment of labour status (active or latent). Active labour was defined as the presence of regular, painful contractions and cervical dilation >3 cm. Those not in active labour were provided with encouragement and advice and told to return home or walk outside until labour became more active. 104 women were allocated to direct hospital admission. All women received usual intrapartum care.
Main outcome measures
Rates of caesarean section birth; oxytocin, epidural, or narcotic use, forceps delivery; vacuum extraction; amniotomy; labour duration and experience; and newborn outcomes.
Main results
Analysis was by intention to treat. Women who received early labour assessment used less oxytocin, epidurals, or narcotics (table⇓); had shorter durations between admission and delivery (8.3 v 13.5 h, p=0.001) and between full dilation and delivery (77 v 95 min, p=0.045); and more positive experiences (higher Labor Agentry Scale scores, 158 v 142, p=0.001) compared with women who were admitted directly. No differences existed for caesarean section births, forceps delivery, vacuum extraction, or amniotomy (table⇓); or newborn outcomes.
Early labour assessment did not decrease caesarean section births but decreased oxytocin, epidural, or narcotic use, and labour duration; and improved the labour experience.
Past research has shown that women with a mean cervical dilation of ≤3 cm on hospital admission have longer lengths of labour, an increased number of intrapartum interventions, and more diagnoses of complicated labour.1 To diagnose active labour, some hospitals have established early labour assessment or triage programmes. The study by McNiven et al is the first randomised controlled trial to evaluate such a programme.
Study strengths include the random assignment of women to early labour assessment or direct admission to hospital. The outcomes measured were not only about interventions, labour, and the newborn but also about the women's evaluations of the experience. 2 limitations could have affected study results. Firstly, although there were fewer caesarean section births in the early assessment group, the difference did not reach statistical significance. The authors explain that they were not able to calculate a sample size and therefore chose 200 to be a feasible sample size. This sample size may have been too small to detect differences in caesarean delivery rates. Secondly, all caregivers did not comply with the study protocol and therefore a large number of women in the control group were sent home from the labour and delivery unit. Because some women in the control group received the intervention, the 2 groups were more alike than intended.
Assessment area nurses or medical interns conducted vaginal examinations to determine cervical dilation and whether active labour had begun. They also provided support, encouragement, and advice. When it was unclear whether a woman was in labour, the nurse asked the patient to remain in the assessment area for several hours to reassess her labour progress. When active labour was reached, the nurse transferred the woman to the labour and delivery unit. It is important that nurses assess each woman individually not only to determine onset of labour but also to evaluate their emotional status. Some women, particularly those who are poorly supported, frightened, or who have had past adverse experiences, may benefit from remaining in the hospital setting.
Source of funding: University of Toronto.
For correspondence: Dr P S McNiven, McMaster University Midwifery Education Programme, St Joseph's Hospital, Fontbonne Building, F622, 50 Charlton Avenue East, Hamilton, ON L8N 4A6, Canada. Fax +1 905 521 6014.
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Isaac Asimov · Robotics Quotes 5
All Writing Science People Knowledge Law God Death Life Robotics Religion Ignorance Robot Heaven Society Computer Fear Hell Atheism Science-fiction America World Atheist Understanding The-bible Scientist Learning Error Belief Intelligence Inevitable Typing Thinking Woman Finger School Talking Stature Origin Wisdom Speed-reading
Isaac Asimov
(1920-01-02 - 1992-04-06) was a Russian-born American author and biochemist. Regarded the father of robotic Science Fiction, and one of the best Hard Science Fiction writers ever.
Nationality: American
Occupation: Writer
Sources by Isaac AsimovThe Roving Mind
I, Robot
Yours, Isaac Asimov
How Easy to See the Future
The Alchemist
The Picture of Dorian Gray
The Story of My Experiments with Truth
The Notebooks of Leonardo da Vinci


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TwitLonger API - SDKs
TwitLonger allows Twitter users to post longer Twitter posts, beyond 140 characters, when necessary. TwitLonger works with your Twitter account, providing a link to the longer Tweet. The TwitLonger API is very basic, but allows developers to integrate the TwitLonger functionality into desktop, mobile, and web applications. Public documentation is not available; those interested in integrating TwitLonger should email email@example.com to get access to the API.


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Universal Health Coverage (UHC) needs to be truly equitable and universal
On 6 December the Global Conference on Universal Health Coverage for Inclusive and Sustainable Growth convened in Tokyo, Japan. The event was co-organized by the Government of Japan and the World Bank Group under the Japan-World Bank Group Partnership Program for UHC.
World Bank Group's commitment to UHC was laid out by its President, Jim Yong Kim: "At the World Bank Group, achieving universal health coverage and equity in health are central to reaching the global goals to end extreme poverty by 2030 and boost shared prosperity" and "Helping countries advance universal health coverage is a strategic priority across the World Bank Group".
The World Bank and World Health Organization released a joint framework for monitoring progress towards universal health coverage, with one target for financial protection and one for service delivery.
Oxfam response
Oxfam applauds the World Bank's continuing leadership on Universal Health Coverage and their ongoing collaboration with the World Health Organization, which increasingly highlights inequity as the crux of the problem.
We welcome the clear commitment laid out in two new objectives – to halve the number of people impoverished by health care payments by 2020 and eliminate the problem altogether by 2030, and to double the number of poor people with access to health care services by 2020 - from 40% to 80%.Setting targets and deadlines at last gives us progressive goals the world can hold the World Bank Group accountable to. We urge the World Bank to incorporate these targets into its results framework for IDA 17.
Oxfam welcomes Jim Kim's public commitment to reduce out-of-pocket payments. User fees are the most inequitable method for financing health care services. Worldwide every year 100 million are pushed into poverty by direct health-care costs – the equivalent of a quarter of a million people every day. But we would like to see a much more explicit and detailed plan from the World Bank Group as to how it will help countries to remove fees for health care. The World Bank can and should support countries to develop more efficient and equitable ways of raising revenue for health. User fees should not be replaced by health insurance schemes that rely on collecting premiums from people who are too poor to pay.
There is strong evidence to show that the countries making most progress towards UHC have prioritized spending on health from general taxation – either on its own or pooled with formal sector payroll taxes and international aid. Read our report on this issue.
We support the new targets for improving access to health care services for the poor, but we urge the World Bank to be clearer that this is not about selective or basic health care interventions – the ultimate goal must be to deliver comprehensive primary health care to all. The ambition to expand access to health care for the poor should also be greater and not stop at 80% coverage. Our collective priority must be financing and delivering services to reach all people and especially the poorest and most vulnerable 40%.
Oxfam especially welcomes the focus on equity principles and recognition by the World Bank that countries need to prioritize policies that actively redistribute resources and reduce disparities. UHC reforms must be explicit about reducing inequality in access to health services, so that everyone has the same financial protection and access to the same range of high quality health services according to need and not their ability to pay. Equity must be designed into the system from the beginning with governments and donors ensuring that the poor benefit at least as much as the better off at every step of the way towards universal coverage. Oxfam would like to see the World Bank playing a more pro-active role in helping Governments to ensure that funds for health are raised equitably, and actively redistributing resources.
Oxfam welcomes Jim Kim's support for UHC in the post-2015 development framework and this is something we urge all world leaders to embrace. Universal health coverage provides the opportunity to accelerate progress on the health-related Millennium Development Goals, address the growing burden of non-communicable diseases, and most critically to move towards a more comprehensive approach to deliver on the right to equitable and affordable health care for all.
We caution against the World Bank Group ongoing promotion of an ever-increasing role for for-profit companies in delivering health care in poor countries (primarily through the IFC). Those countries that have been successful at reaching the poor at scale and delivering on these new targets set by the Bank have done so by prioritizing the scaling up and strengthening of public health care delivery.
Related blogs
Universal Health Coverage: key to the success of the World Bank's new vision
In sickness and in wealth: The case for universal health care


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BURLINGTON, N.C. – Lauren Smith retired 21 consecutive batters after allowing a bunt single in the top of the first and Kalie Smith belted a third-inning home run as second-seeded Mount Olive stayed alive with a 3-0 victory over No. 4 seed Queens in an elimination game.
Mount Olive (30-13) will play another elimination game Sunday at 11 a.m. against top-seeded King, which eliminated No. 8 seed Pfeiffer Saturday night.
Smith (6-4) allowed her only baserunner of the game when Whitney Britt bunted a slow roller down the third base line on the first pitch of the game and beat the throw to first. Smith retired the next two batters on a sacrifice and a groundout as Britt advanced to third. Smith ended the inning with her only strikeout of the game.
Smith went on to retire the side in order in each of the next six innings, throwing a total of 78 pitches for the game, 54 for strikes. She allowed only six balls hit out of the infield and benefitted from a defensive gem from first baseman Beth Overman for the final out. Shortstop Jennifer Jones' throw was high on Kaitlyn Cheek's grounder, but Overman made a leaping catch and landed on the bag a half step ahead of Cheek.
Kalie Smith gave Lauren Smith all the support she needed in the bottom of the third when she sent a 1-2 pitch over the 225-foot left-centerfield fence for her fifth home run of the season. Her home run was Mount Olive's 35th of the season, tying a school record set in 2008.
The Trojans added a pair of insurance runs in the sixth on Kelsey Akers' RBI-double and Danielle Mitchell's RBI-single.


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This week in Island history
The news of 10 and 15 years ago is from the Jamestown Press. The news of 25, 50, 75, and 100 years ago from the Newport Daily News comes from the collection of the Newport Historical Society.
100 years ago From the Newport Daily News, December 4, 1906:
The pupils who attend high school in Newport returned home today on the 10:30 trip of the ferry, it being so cold in the building that school was dismissed.
Today is by far the coldest of the winter, as the thermometer in the most exposed positions in the town registered 5 above zero early in the morning.
From the Newport Daily News, December 11, 1906:
Several parties of hunters are on the island today after rabbits.
75 years ago From the Newport Daily News, December 4, 1931:
As an experiment, the Carr school is commencing its afternoon session at 1 o'clock instead of 1:15 as heretofore.
The monthly practice meeting of the Jamestown fire department was held last evening when the new apparatus was given a trial.
From the Newport Daily News, December 7, 1931:
The Holy Ghost Society hall was well filled with dancers Saturday evening, when a masquerade ball was held, many from Newport, Providence and Fall River attending. The Monponsette orchestra from Newport, which made its first appearance in Jamestown, furnishing excellent music for dancing.
50 years ago From the Newport Daily News, December 4, 1956:
A joint meeting of the Jamestown Town Council, the Recreation Commission and representatives of civic groups was held last night to discuss the future of organized recreation on the island. . . . It was voted to open the Center and Alfred V. Richardson was voted custodian. The Council in cooperation with the Recreation Commission will try to obtain the services of a trained director.
The Council last night voted to close Beavertail area for the season.
From the Newport Daily News, December 7, 1956:
Formation of a boys club to be affiliated with the Boys Club of America Inc., was discussed yesterday afternoon in the Recreation Center
From the Newport Daily News, December 10, 1956:
The Keep America Beautiful Committee met Saturday at the Jamestown Recreation Center to consider entering the "Cleanest Town Contest."
25 years ago
From the Newport Daily News, December 7, 1981:
Conanicus (sic) Island was beginning to come to life this morning after a weekend storm dumped about 15 inches of snow and knocked out power on much of the island. Some homes still were without electricity and heat this morning.
(The building inspector issued five building permits.)
From the Newport Daily News, December 8, 1981:
Sen. John H. Chafee was told Saturday that the town's most pressing problem was the size of the proposed new Jamestown bridge and connector road.
From the Newport Daily News, December 9, 1981:
Christmas lights went on all over the downtown village of Jamestown Tuesday night during festivities at East Ferry Green. Christopher Powell was the coordinator. Although the snowstorm caused a two-day delay of the traditional lighting, the snow added to a real New England scene. The event was sponsored by the Jamestown Rotary Club and the Junior Women's Club.
15 years ago From the Jamestown Press, December 5, 1991:
The new cross-island road cannot be much smaller than what state plans now call for without going below the criteria used by highway designers. . . . Council members want the new bridge-connector road to have a slower speed limit and narrower median than the road the state proposes to build.
The Town Council, after getting a preview of next year's budget. Monday night, decided to hold five workshops on the 1992-93 spending plan beginning Jan. 4.
10 years ago From the Jamestown Press, December 5, 1996:
Voters at Monday's special financial town meeting approved spending $114,843 of the town's budget surplus to buy land for the golf course and complete major renovations at the Senior Center. . . . Some 112 of Jamestown's 3,921 registered voters attended the meeting, which ended 10 minutes after it began.
Members of the Jamestown VFW and the American Legion posts will observe the 55th anniversary of the bombing of Pearl Harbor at 11:30 a.m., Saturday, Dec. 7, at East Ferry.
The annual lighting of the Village Christmas Tree this Saturday evening will be the final event of a day filled with festive island holiday activities.


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Floral Nightie
Added Jan 29, 2013
by thundergirl
Melbourne, Austr...
Kwiksew 1812 – You could almost call this a vintage pattern now.
This is the first garment with my new sewing machine. I thought it would be a good idea to make a nightie as if the sewing went badly it wouldn't matter too much.
I misjudged some of the buttonhole placements but otherwise it went very well. my old sewing machine was like an extension of myself so it will take a little time to adjust.
I essentially followed the pattern except that:
1.I bound the armhole with bias binding rather than lace.
2. Used ecru cotton lace, very slightly gathered and bias binding around the neckline and
3. Added a plain, flat hem on the bottom.
No scratchy lace issues this way!
Material Notes
The fabric was a cotton lawn by John Kaldor Fabricmaker from my stash. What a shame they went out of business in 2004.
- For
- Women
2 Comments Sign in to add a post
Jan 29, 2013, 10.38 PMby bubbley74
hi love the style can you say what pattern you used please.Gaynor.
Jan 29, 2013, 06.56 PMby jacquipardue
it's beautiful!
Add to Favorites 1 person added it


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Smallbore standard rifle holds second day of shooting
The NRA National Silhouette Championships continued Monday with the second day of three days of shooting in smallbore standard rifle at the Ridgway Rifle Club smallbore range. Cathy Winstead-Severin (Joplin, Mo.) and Angelica Kuess Davila (Laredo, Texas) each had scores of 38 and Gabriel Guerra (Monterrey, Mexico) was third with a 37. Kenneth M. Haupricht (Johnsonburg) was the master class winner Monday with a score of 35. Alan Bruce Finley (Calhoun, La.) was second with a 35 and Ron Bain (New Haven, Mo.) was third with a 35. Ben Marzella (Ridgway) was fourth with a 34 and Enrique Kuess Jr. (Laredo, Texas) took fifth with a 34. Wally Howard (Hazel Hurst) was sixth with a 34 and Laura Goetsch (Whites Creek, Tenn.) had a seventh-place finish with a 34. Greg Engel (Flossmoor, Ill.) was eighth at 33 and Mallory Nichols (Fort Smith, Ark.) took ninth at 33. In AAA class, David Leedy (Rebersburg) won with a mark of 35. Jorge Moreno (Saltillo, Mexico) was second at 34 and Enrique Kuess Sr. (Laredo, Texas) was third with a 31. Jim Pendleton (Markdale, Ontario, Canada) took fourth with a 31 and Carlos Moreno (Saltillo, Mexico) was fifth at 30. Scott Lurie (Browntown, Va.) was sixth at a mark of 30 and Larry Armstrong (Export) took seventh with a score of 30. Glenn Hughes (Birmingham, Ala.) was eighth with a score of 30 and Kelly Engel (Brighton, Mass.) was ninth at 30. In AA class, Mark Latham (Washington, Mo.) was the winner with a score of 32. Tyler S. Bonson (Reedsville) was second with a score of 30 and Kathryn Grigg (Shelby, N.C.) was third with a score of 27. David Gillispie (Reedsville, W. Va.) was fourth at 25 and Hunter Hinds (Loganton) had a fifth-place finish at 25. Tyrus Grim (Glen Rock) was sixth at 24 and Jake Sprague (Cary, N.C.) was seventh at 24. Thomas Danias Sr. (Erie) was eighth at 24 and David Wester (Combine, Texas) was ninth at 24. Patrick Petrillo (Hollywood, Fla.) was 10th with a score of 23. In A class, Ryan Labenne (Ridgway) was the class winner with a score of 24. Nick Opperman (Lalucia, Durban, South Africa) was second at 20 and Alex Pierce (Lewistown) was third with a score of 19. Kelli Grim (Clarksburg, Md.) was fourth with a score of 18. Adam Braverman (Sedalia, Mo.) was fifth at 16. Deon Germishuizen (Windsor, Ontario, Canada) won B class with a score of 20. The final day of smallbore competition begins at 9 a.m. Tuesday morning.


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Lady Vols lose season-opener
COLUMBUS – Starkville Academy girls basketball coach Glenn Schmidt wanted her team to go through a game to see where it was.
The Heritage Academy Tournament has provided that opportunity before November and the first game has revealed exactly what Schmidt needed to see.
The Lady Volunteers lost a 58-34 decision to Madison-Ridgeland Academy and it was a game where Schmidt said SA couldn't seem to shake the "first game jitters."
"When we didn't make any shots early, we let up a little bit and lost our self-confidence," Schmidt said. "The moral of the story is if you are not making shots, you've got to do two other things and that's play defense and rebound. I'm not worried because I think we can fix all of that."
Sallie Kate Richardson hit the first basket of the game to put the Lady Vols on top, then a pair of Julianne Jackson buckets gave SA a 6-1 lead with 4:30 remaining in the first quarter.
After Haley Cox scored for MRA, Anna Prestridge made a shot for the Lady Vols to push the advantage out to 8-3 at the 3:39 mark of the opening quarter.
That's when the Lady Patriots took control of the game as they closed out the first quarter on a 14-0 run to take a 17-8 lead.
MRA stretched the margin to 33-14 by halftime and 46-25 after three quarters.
"This was an 'oh my goodness, it's basketball season' type of game," Schmidt said. "It's going to take a few games for us to get our feet under us and get confident in our shooting. We probably didn't even shoot 20 percent.
"They needed to play badly to feel where they were. I have confidence in them and they'll get confident themselves and it's going to be a great season."
Richardson, a freshman, had 11 points to lead SA in scoring, while Cox poured in 21 points for a strong MRA squad.
"That's a pretty good club we played and we'll come back," Schmidt said. "That's one game out of about 35."


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The PGA Tour is in Oahu this week for the first full-field event of the 2012 season -- the Sony Open in Hawaii at the Waialae Country Club.
Flight-time from last week's stop in Maui to this week's stop in Oahu is roughly 20 minutes. That said Waialae couldn't be more different than Kapalua, as Waialae PGA Head Professional Kevin Carll explains in this week's Local Knowledge.
Waialae Country Club is the venue for this week's Sony Open in Hawaii. Have you played it? If so, click on its name to write a review of your experience. Also, be sure to check out our PGA.com Course Guide to review all the courses you've played and to find the perfect course for your next round.
Find more PGA Professionals in our PGA.com Instructor search.
Carll gave a lot of great insight about the event, as well as what it's like to make your PGA Tour debut -- something he did in the Sony Open seven years ago.
PGA.com: Thanks for joining us again, Kevin. We're sure it will be another great week in paradise. Let's start with the defending champion, Mark Wilson. His win at the Sony Open in Hawaii in 2011 set the tone for a spectacular season, which included two wins and nine top 25s. It may be the first full-field event of the year, but is it safe to say that the Sony truly is a tone setter for a lot of the players?
Carll: I think so. I would hope the $990,000 first-place prize brings a sense of calm as well as a confirmation that you can still win on the biggest stage. Maybe the challenge then becomes the ability to sustain your drive throughout the year.
PGA.com: Speaking of setting a tone, through the years the Sony Open has become the first PGA Tour start ever for many rookies. In fact, you made your first start there seven years ago. What's it like to see some of the rookies who have never participated in a Tour event throughout the week, realizing a dream come true?
Carll: Yes, I qualified for the Sony Open seven years ago. It was such a surreal experience. For years I was focused on perfecting my game in hopes of one day playing in a PGA Tour event and here I was, checking in to receive my credentials for the week. Everyone told me to soak it in and treat it like every other tournament I have played in. I thought to myself, sounds easy enough. I soon realized it was a bit more than our PGA Section Championship. I put way too much effort into my practice rounds and consistently asked myself if I could play with these guys. I didn't sleep much Wednesday night knowing the following day would be my first round in a PGA Tour event. I struggled for 36 holes and my game never felt comfortable. The entire experience is one that I'll never forget and I hope to have some redemption one day.
PGA.com: What's the best aspect of your job at Waialae Country Club?
Carll: Without a doubt, our membership. We have members from all walks of life and the life lessons as well as professional advice is priceless. I continue to learn each and every day I come to work.
PGA.com: You've got a number of players making the short trip to Waialae from last week's event at Kapalua, including champion Steve Stricker. For people who might think the two courses are similar because they're both in Hawaii, can you please explain how -- in reality -- the two courses couldn't be more different?
Carll: There are two similarities between Waialae Country Club and Kapalua's Plantation Course -- Bermuda grass and we're both located in the state of Hawaii. The two courses are on opposite ends of the spectrum. Kapalua must cover four times the acreage we have at Waialae. Kapalua has extreme changes in elevation from tee to green while our facility is fairly flat. Waialae Country Club has two holes on the water and Kapalua is situated in the foothills above the ocean. Waialae is a classic design with a Redan hole as well as a Biarritz hole while Kapalua has 18 holes of their own.
PGA.com: In your mind, what would make for an ideal finish late Sunday afternoon?
Carll: Good weather and a grateful winner.


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October 8, 1979
To: Deans, Department Chairs, Administrative Heads
From: President Gail Fullerton
Subject: Support Staff Coffee
The Support Staff Coffee, held each year to commemorate Support Staff week, will be held this year on Tuesday, November 6, from 9:30 a.m. until 11:00 a.m., in the Umunhum Room of the Student Union.
I hope you can arrange your department schedule on that day so that all Support Staff members wishing to attend the Coffee will be given at least twenty to thirty minutes extra time off to attend.
Academic Vice President
Executive Vice President
Associate Executive Vice President Director, Business Affairs
Dean, Student Services
Director, ISCS
Director, Admissions & Records Personnel Officer


text: In the blur of fashionable handbag-like diaper bags for mom, where is a dude-like dad to turn? With this messenger diaper bag, all you dads who fear diaper duty can chill with a manly messenger diaper bag that doesn't look like a baby bag and comes with lots of handy features for on-the-go parents. Perfect for Father's Day or a Baby Shower! It's made of durable nylon that stands up to everyday use. The ergonomic across-the-chest design is super comfy and saves your shoulders. The strap is wide and adjustable with a padded panel; it easily clips open and closed for easy on-and-off. It also features a padded back for extra comfort against your body, three exterior zip-closed pockets that are perfect for wipes, an elasticized bottle pocket that easy to reach, a removable on-strap cell phone pouch, a large inner compartment with zip-closed pocket and special pouch for diapers, and two handy clips for keys (or a pacifier).


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Pharmacy students travel to Thailand in March thanks to agreementUniversity of Hawaiʻi at Hilo
Alyson Kakugawa-Leong, (808) 974-7642
Dir, Media Rel, University Relations
Dir, Media Rel, University Relations
Posted: Dec 2, 2011
Students from the College of Pharmacy at the University of Hawaiʻi at Hilo will gain professional experience in Thailand beginning this school year through an agreement with the Faculty of Pharmacy, Chulalongkorn University in Bangkok.
The program is known as "U.S.-THAI Student Pharmacists and Pharmacists Exchange Program." It was established to promote global health through the exchange of international experiences in elective courses in Advanced Pharmacy Practice Experience (APPE) and human resource development in higher education programs.
Dr. Supakit Wongwiwatthananukit, associate professor of pharmacy practice at UH Hilo, drafted the Memorandum of Understanding with Chulalongkorn University that was signed in June.
"I began this process in January 2010 with the support of Dr. Carolyn Ma, and then was encouraged by Dr. Ron Taniguchi and Dr. Lara Gomez, who helped edit the final document. Chris Iha also helped to communicate with the UH legal counsels and UH procedures in making this MOU happen," said Wongwiwatthananukit, who also is a registered pharmacist in Hawaiʻi, Illinois and Thailand. "To be in the top 25 pharmacy schools, we need to have an international rotation/clerkship for our students and/or faculty to collaborate in terms of teaching and research with faculty/practitioners internationally as well."
After gaining support of the department and Dean John Pezzuto, Wongwiwatthananukit met with Dean Pintip Pongpech of Faculty of Pharmacy Chulalongkorn University, Dr. Narat Kasettratat and Dr. Thitima Wattanavijitkul, who are the former and current Head of the Department of Pharmacy Practice at Chulalongkorn University who indicated they would be happy to welcome UH Hilo students to practice over there as an International Elective APPE.
"Not only are we happy to have the involvement of students from the University of Hawaiʻi at Hilo, we are hoping to send staff and pharmacy practitioner (preceptors of the school) to get more training at your contemporary pharmacy practice facilities," Drs. Kasettratat and Wattanavijikul said.
The first two students from the class 2012 will have rotation/clerkship between March 26 - May 4, 2012. Two students from the class of 2013 will work in Bangkok from November to December 2012.
Students will visit and practice in several healthcare sites such as the Ministry of Public Health (i.e., Thai FDA, Pharmacy Consumer Protection agency), a private hospital, a government hospital and community pharmacy.


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Monday, February 15, 2010
A Call for Hospice Reform: Nurse Practitioners Lead the Way
I worked as a hospice case manager in the community for eight years prior to becoming a nurse practitioner (NP) and have blogged in the past here about similar concerns. In my experience, most hospice nurses know a lot more about how to manage generic end of life physical symptoms than many physicians, particularly pain management and psychosocial symptoms/issues. Highlight generic. Physicians and NPs are trained to think pathophysiologically. We think via differential diagnosis. For example, as a hospice nurse (RN), I might have managed shortness of breath (SOB) in a patient with heart failure with low dose morphine. As an NP I might also look for subtle signs of fluid overload (JVD, bibasilar crackles, dependent edema) for possible diuretic adjustment and think about how the patient's renal function might factor into these decisions. I might check if there are co-morbidities to consider (aortic stenosis, atrial fibrillation, myelodysplasitic syndrome/chronic anemia, COPD, Parkinson's, anxiety, GI dysmotility) when thinking about meds (including opioids) in determining the source and treatment for the SOB. As an RN, if a patient became confused I would check for pain, constipation, and urinary retention. But then what? I might give lorazepam or haldol. These are likely pre-signed orders that may even be in the home for those "just in case" times. Convenient. As an NP, I might also think about infection, co-morbidities, polypharmacy, and medication side effects (particularly in the elderly.
Registered nurses are trained to alleviate suffering through diagnosis and treatment of human responses to actual or potential illness. We are trained to assess and treat based on holistic goals and to view the patient in the context of their defined family. Palliative care and nursing philosophy share a holistic approach to care that encompasses physical, emotional and spiritual concerns of the patient and family unit. It is no small wonder that nurses have been the foundation of community hospice work since its beginnings. Physicians are trained to formulate and treat medical diagnoses. Nurse Practitioners are, well, the middle children. We are nurses who have advanced training in diagnosis and treatment of medical conditions in addition to our foundational training. Our medical training is not as deep or broad as that of physicians. Nurse practitioners often pursue further training to develop an area of expertise.
None of us truly knows what we don't know. Even the most experienced hospice nurses don't know how their practice would differ if they had the advanced education and training of a nurse practitioner. Few physicians or physician assistants understand the level of training of RNs or LVNs/LPNs, nor their scope of practice. How could they? They're not nurses. Only the nurse practitioner holds the dual training and, as such, is the perfect liaison for optimal collaboration between these two disciplines.
Surprisingly, nurse practitioners do not play a pivotal role in most community hospice agencies. Medicare requires that there be a physician medical director. Registered nurses usually function as the hospice case manager for the care of the end stage illness.
Hospice nurses are well trained in using medications to manage symptoms. Hence the array of the (all too often) 'one size fits all' order set of PRNs. This makes sense when the nurse is out in the home or on the phone doing her/his very best to assess and treat distressing symptoms at the end of life. It's pretty difficult to track down the doctor of record, contact her/him, describe the situation, request an order and get it to the patient within a reasonable period of time such that the patient (and family) does not suffer for hours longer. Having pre-signed orders to use PRN can be a life-saver (no pun intended) at times. The downfall is the one size fits all practice. Shortness of breath equals morphine; anxiety equals lorazepam; confusion/agitation equals haldol.
There is continued grumbling among hospices and palliative care folks that patients are often referred too late to hospice care. However, at least in the case of patients with some non-cancer diagnoses, are they? Is our system set up to care for these patients optimally at the end of life? Sadly, I think not.
Happily, there is a relatively easy solution – use nurse practitioners who have advanced training in palliative care and (my bias) gerontology.
What if hospice nurses had easy access to a palliative care NP who had the training to assess and treat medically complex patients at the end of life? What if the hospice nurses had access to someone who understood their practice and could provide the appropriate education and support to improve their practice? What if the NP was available for home visits? Hospice nurses might practice differently. Patients would get better care. And health care providers might not be so reticent to refer their patients a little earlier.
The Medicare Hospice Benefit requires the provision of 24-hour nursing services and a physician medical director who reviews medical orders and participates in an interdisciplinary team group overseeing patient care. Why not a nurse practitioner and physician as co-directors? It makes sense. It's time. And it's the right thing to do.
20 comments:
- risaden said...
Couldn't agree with you more, couldn't have said it better. Hospice care needs to be individualized, chronic diseases should be managed with comfort as a goal, there is no "one size fits all". Thanks for continuing to advocate for improved hospice care!
- February 15, 2010 at 5:45 PM
- Christian Sinclair, MD said...
Awesome post. Too tired and too much to do to leave a better comment. but this one is one of my favorite on Geripal this year. You have made a great case for all hospice disciplines not to be dogmatic and actually think through good medical and nursing practice.
- February 15, 2010 at 10:10 PM
I also believe that some of this will improve as home palliative care becomes more prevalent in the community. I think that many hospice programs are managing patients that should be receiving palliative care rather than hospice care. For example, CHF is a difficult diagnosis to manage. Cardiac meds, blood tests, x-rays etc. the list goes on and on. Many of us manage these patients but in all honesty, I don't think that most of us (doing hospice) truly manage CHF (or other chronic ilnesses) as it should be managed. There is pressure for the sustainability of most hospice programs to limit interventions, meds, bloodwork etc based on "focusing on comfort." In this respect I do see the need for outpatient/home palliative care, where the focus will begin to shift but management of chronic illness follow the standards of care. When the patient begins to significantly decline, despite maximal medical therapy the transition to hospice can occur. In this light, I agree with the author, I see Nurse Practitioners as a significant resource in the involvement of home/outpatient palliative care and hospice care.
- February 16, 2010 at 4:47 PM
- Eric Widera said...
I agree that hospice may at not manage CHF or other chronic disease as they sometimes should be managed. However, I still think that they probably do a better job than what is standard of care when discharging patients from the hospital. This standard of care usually involves a complete lack of post-discharge support, most notably no follow-up appointments with their primary care provider within 30 days of discharge. This results in a 1 in 4 chance of being readmitted in 30 days, and 2 out of 3 chance of being readmitted within the year, and a 1 in 3 chance of dying within a year.
It makes pretty good sense to me that adding some type of post-discharge follow-up support would help with these abysmal stats. This can be with hospice care, AIM programs, or some other hybrid. Should NP's be involved - absolutely. The biggest problem that I see is that physicians are not often involved in their patients care once they are admitted to hospice care. NP's can act as a bridge to improve the quality of care for patients with complex medical conditions.
- February 16, 2010 at 8:38 PM
- Eric Widera said...
I would also love to hear what hospice nurses think about this...
- February 16, 2010 at 8:39 PM
- karen gossage said...
I think you are
courageous to have written such a piece and agree wholeheartedly with
your sentiment. I am sure it will stir up some controversy
particularly from hospice nurses and maybe the unlightened MD who may
not have been exposed to NP's. I especially liked your points about
hospice care being a little too generic (something that used to worry
me when I was a hospice nurse) and "none of us truly knows what we
dont know......hospice nurses ..how practice would differ if they had
received NP education"
Hospices should welcome your suggestions in several aspects in that it
may afford the patient better symptom control, enhance the publics
opinion of hospice (particularly those who claim that all hospice does
is "give morphine and help the pt to die") and also could keep pts on
the program longer for revenue.
- February 18, 2010 at 7:22 PM
- Dan Matlock said...
As a physician, I often find myself wondering what's so special about the MD. Wonderful post.
Just to play devils advocate a little bit, I do think there is value to a philosophy of care that masks symptoms until a patient dies, rather than working them up. SOB in CHF is a great example of where masking the symptom with morphine is likely not the best approach. "Terminal delirium" on the other hand is perhaps a little different. I suspect that many episodes of "terminal delirium" would be reversible in the short term if each of the many factors causing the delirium were addressed (O2, sodium, dehydration, renal failure). Perhaps a model of care where we are comfortable ignoring the many underlying factors and instead use large doses of symptom medications (antipsychotics in this case) is the best approach.
That said, I would vote for NPs to lead the way! (just as long as they weren't completely wrapped up in the traditional medical model).
- February 20, 2010 at 12:39 AM
- Nurse Practitioners Save Lives said...
My great grandmother just passed recently after a short battle with pneumonia. She suffered for hours in the hospital setting all the while crying and begging for help. It sickens me that we still let patients suffer in this manner. I think NPs are a vital resource for Hospice care.
- February 20, 2010 at 12:44 PM
I'm a palliative care/hospice NP who recently took a position as the second NP at an in-patient hospice unit. (The other NP who works on weekends and does follow up visits.) It's been interesting to watch the nursing and physician staff as they figure out what a hospice NP does and how to relate to a provider who's not a physician. The general feedback is the NP is the best of both worlds: able to handle the medical aspects of care but also more sensitive to the psychosocial ones. And, more sensitive to any issues the nursing staff may be having. The combination of all these providers improves all of our care. Here's hoping there will be more such combinations in the future!
- February 20, 2010 at 4:51 PM
I appreciate the thoughts shared and the goal of improved hospice care. Reimbursement needs to improve so that it's not an economic black hole to do the occasional lab and true palliation for non-cancer patients.
- February 20, 2010 at 6:01 PM
- Queen Bee said...
Great post on one of my very favorite topics! I, too, am a former hospice nurse, former director of patient care services, and current gero NP. I became a GNP so I could do better EOL care; I believe hospice care is quintessential nursing and that there is no better fit than a NP and hospice. Medicare rules must change.
- February 20, 2010 at 11:08 PM
- Patrice Villars said...
I agree with many (all?) of you that palliative care needs to be reformed upstream and post discharge. I also think Dan makes a good point that we need to think about when it's OK to aggressively treat the primary underlying cause of the symptoms and when it's OK to mask them (that good old benefit/burden ratio), even with heart failure management.
Yes, the system needs to change. Change is too darn sloooow if you ask me, but it's happening. 'Bridge' and advanced illness management programs are increasingly utilized; the idea of patient-centered medical home is becoming (again) a hot topic; Acute Care for the Elderly (ACE) units are popping up. The fact that there are now so many palliative care physicians is a huge shift from ten years ago.
While I agree that reimbursement and medicare regs for palliative and hospice care are antiquated, we cannot only grumble in frustration waiting for government or insurance companies to get this right. Hospice agencies are growing and struggling. They need referrals to survive AND want/need to provide the best care to grow their services and business. NPs – find out what the hospices/home care agencies perceive to be their limiting factors to reach their goals. Show them that you (we) are the app to meet their needs.
- February 21, 2010 at 10:00 AM
I am a NP certified in Gerontology and Hospice and Palliative Care. I have also worked in hospice for 12 years and went for NP training with the specific goal of working in hospice. I have been doing just that for the past four years. I practice in Texas and Arkansas and serve as a provider in conjunction with the attending. As part of my responsibilities, I visit all patients that I can provide orders on, I take call, make additional home visits, and actively review each patient prior to recertification. I feel since I see the patient in their home environment and have special training and experience in end of life care that I can provide a great service to our staff and patients in their end of life journey. I love what I do and am blessed every day with the staff, patients and family I get to work with.
Reimbursement for my service to our hospice however is limited. While Medicare states the NP can serve as attending, state law in Texas and Arkansas do not include NP in the definition of attending physician (that is their language). Medicare only permits reimbursement of NP when they are the attending (a bit of a conundrum for me). I know I help improve the quality of the patient's care with my immediate availability and familiarity with them and their home situation, but I am limited to prescribing Schedule III-V. So, here I think advancing nurse practitioner opportunities in hospice provision of care would be helpful. Just my experience and my thoughts. Thanks for bringing this up!
- February 21, 2010 at 1:00 PM
- Judy Dobson, RN, CNS, CHPN said...
Kudos to my NP colleagues! I'm too old now (67) to go back to school, but I'm a clinical nurse specialist (close to NP but no cigar). As a nurse for 45 years and a former hospice director, I've been teaching around the country for 5 years for PESI healthcare. My husband and I have been to 38 states, and counting, doing this together. (He's my computer guru). I teach research based care of 9 non-cancer diseases. That would include Dr. Sarah Goodlin's CHF protocol for palliative as well as hospice care of the patient at levels 3 and 4 of the NY heart association. It's imperative that we look at the physiology of the symptom SOURCE and not just treat the symptom itself. With CHF, we have to control the weight, diet, and fluids,teach the family about fatigue,and know how to check for renal insufficiency. I could not prepare my presentations if the research was not available to me from the physicians and others doing it and publishing it. In addition to information from Journal of Palliative Medicine,I get the MP3's from the annual conferences, (if I can't get there) and listen to the presentations. From another presentation, I learned how to keep a patient awaiting liver transplant on hospice by working with the transplant team,using the MAYO MELD protocol,combining the care of the terminally ill patient with end stage hepatic failure with the hope of getting a new liver. The two are not mutually exclusive. And CMS has listed this as appropriate. I am looking forward to hearing this years' presentations. Keep up the good work, and know that we are out there trying to do the right thing so patients can have quality days, and more of them!
I do want to mention another thought to prevent re-admission to hospital for those with no "safety net" and serious end stage disease. If we placed, on the discharge planning sheet, information from the Karnovsky or PPS as to where the patient is functionally, and whether they have a terminal disease, and whether they have had a pc consult, or important prognostic conversation with their physician, the "disposition" of the patient becomes a hugely important discharge recommendation. Impossible? We should do it before it's imposed on us....
Regards to all. I wish I could be in Boston with you!
- March 3, 2010 at 8:25 AM
Wow! I had no idea that I was not the only hospice nurse that went to school to become an NP in order to give better care! This post completely sums up all the thoughts that I have had about hospice and palliative care. I have had patients that I knew that needed hospice but I was reluctant to transfer their care because as a palliative care NP, I was managing symptoms or disease process that I feared would be overlooked, misunderstood or overmedicated by the hospice RNs. Why did I have this fear? Because I was a hospice RN before becoming an NP. I have encountered physicians that don't understand my concern about this and as Patrice stated in her post, why would they? They aren't educated in our profession and they don't understand the difference between the different degrees that nurses and NPs have. I don't mean to sound unsupportive of the hospice nurse but in many hospices, I don't think that they are clinically supported by their institutions or their medical directors in order to learn about or manage the non-oncologic terminal diseases. In my city, the hospice nurse is often the only clinical team member that sees the patients as many medical directors are part-time and don't do even one visit to assess the patient, they only have knowledge of the patient from the IDT meeting. NPs need to be in hospice, I have believe this since I was a young nurse in 1996, and I believe it even more strongly so many years later. I just wished that the Hospice Medicare Benefit supported us more in that role. I will keep that faith that eventually, things will change for NPs in hospice.
Also, I want to thank all of the wonderful, enlightened MDs on GeriPal that do understand and support us on the forum. Your supportive comments have meant a lot to me. I love being an NP, am one of 8 nurses in my family and have wanted to be an NP for most of my life. On some days however, when I have had to explain the difference between an LVN and an NP and I again have to explain why I can't write the prescription for the opiates even when I am managing all other aspects of the care, or when I have read the statements that the AMA has issued to usurp our role, I wonder why I didn't choose the easier (in some respects), more socially understood role of doctor. When I read the supportive comments here that you have written in support of us, it energizes and sustains me to keep working hard with patients, to keep educating the medical students and to know that one day, others will understand and support the NPs that work in their institutions and in their communities, knowing that we want to work along with you to improve the care that we all give.
- March 14, 2010 at 7:09 AM
- My leadership journal said...
I agree with you that the role of an NP would be a perfect fit for palliative and hospice care. An NP would shine in a field who's primary focus is to address the the health care goals and needs of patient and family. APNs have many things to offer the emotionally challenged long-term care patient. It has often been said that NPs spend more time with their patients and that they take the time to really listen to them. NPs teach, guide and coach their patients in managing their health/illness and they involve them in the plan of care.It is what they are trained to do. Using NPs for palliatve and hospice care would provide continuity of care for the patient in the end stages illness which would be comforting to them and their families, as opposed to being referred to a different service during the last months or weeks of life. History has proven that APNs have always delt with barriers to practice in new settings and they are always the same: clarifying the APN role and scope of pratice in a given setting, re-imbursement issues and without these comes the inability to practice independently. Although there may be a way to work around these barriers, the key is change in policies to allow the growth of NP practice in the given setting.
- March 26, 2010 at 1:08 AM
- Hospice Simi Valley said...
This is really a nice blog i like to read this blog daily it has got all the informative stuff that i want to know about. i want to subscribe it so can tell me when your blog gets updated.
- April 12, 2010 at 5:41 AM
I read with interest your blog post. I am a "veteren" hospice nurse from way back and have seen so many changes in this field. And I welcome, what I see, is a new way of looking at end of life care slowly emrging. I had the good fortune of working with NP's in the field when our agency "dabbled" with incorporating them in homecare. Simply stated, economics killed that program before it ever had a chance to blossom. Too bad, it provided our home care program an added sophistication and a higher level of practice that was enjoyed , not only by patients and families but by staff as well. I am trying in earnest to start a new Dementia program at our Hospice. Clearly, the "cookie cutter" approach is highly innappropriate for this population. I agree wholeheartedly, time to think outside the box.
- June 29, 2010 at 8:00 AM
- Denise said...
I'm trying to find a post masters program for NP with a hospice/palliative care specialty. I find gerontology programs, oncology programs, etc but having difficulty finding a Hospice program. Does anyone have suggestions of universities that are offering this? I've been doing an internet search without a lot of results. (My Masters was obtained a while ago with an emphasis in critical care)
- August 22, 2010 at 6:57 AM
When my wife enter a hospice facility for pain management, she could converse, walk short distances with a walker, bath herself with a wash cloth, fed herself, sit up, watch TV, sit in a chair, look at a newspaper, etc. With a little help, she could take care of her basic needs. A few hours after entering a hospice facility, hospice managed to turn her into a bedridden zombie that can no longer do any of these things. Since she has been here, hospice has fed her almost nothing and has given her little to drink. Actually, they almost immediately put her in a condition where she could not eat and could only occasionally drink small amounts. Of coarse they blame this rapid, almost instantaneous, decline on her. Hospice claimed that it was completely innocent of this immediate decline. After I complained, hospice reduced the medication, so now my wife can tell someone that she is thirsty, hungry, or in pain. Unfortunately, hospice had weaken her so much that she remains an invalid. Hospice's policy seems to be to get the patient to the morgue as quickly as possible. It seems to be practicing a form of covert euthanasia. I am convinced that hospice has taken days if not weeks off my wife's life. Don't let hospice get its hands on anyone you love — especially at one of its facilities.
- October 26, 2011 at 9:12 AM


text:
PG Ellington back with Gamecocks after football
By PETE IACOBELLIAP Sports Writer
COLUMBIA, S.C. (AP) - South Carolina leading receiver Bruce Ellington has returned to basketball practice Tuesday and is expected to play when the Gamecocks travel to No. 9 Oklahoma State Friday night.
Ellington called South Carolina coach Frank Martin on Monday night, asking if he could rejoin the team while the football Gamecocks took a break awaiting their bowl destination.
Ellington has shuttled between the sports for the past three seasons. This is his senior year in basketball, making him among the few upperclassmen on a Gamecocks club with eight newcomers - seven of them freshmen.
Martin said Ellington will be part of the team until he goes back for bowl practices and the game. Ellington should return to basketball fulltime next month.
Ellington led the football team with 43 catches for 645 yards.Copyright 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.