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Papers That Might Change Your Practice: Review Of The Introduction of a New Screening Tool for the Identification of Cognitively Impaired Medically At-Risk Drivers
David B. Hogan, MD, FRCPC1, Michel Bédard, PhD2
1 Professor and Brenda Strafford Foundation Chair in Geriatric Medicine, University of Calgary, Calgary, AB, 2 Canada Research Chair in Aging and Health, Director, Centre for Research on Safe Driving, Lakehead University and Northern Ontario School of Medicine, Thunder Bay, ON.
Paper Title: The introduction of a new screening tool for the identification of cognitively impaired medically at-risk drivers: the SIMARD A Modification of the DemTect
Authors: Bonnie M. Dobbs, PhD (Department of Family Medicine, University of Alberta), and Donald Schopflocher, PhD (Faculty of Nursing, University of Alberta)
Reference:Journal of Primary Care & Community Health 2010;1:119–27
Family physicians, geriatricians, and others need an effective, efficient, office-based approach to assessing driving risk in older patients. The Screen for the Identification of cognitively impaired Medically At-Risk Drivers (SIMARD) has been suggested on the web (http://www.mard.ualberta.ca/Home/SIMARD/), in a Pfizer-sponsored toolkit for physicians, and in other venues as a way to do this. The 2010 BC Guide in Determining Fitness to Drive recommends using the SIMARD to determine whether patients with persistent cognitive impairment and a long list of additional conditions (i.e., chronic renal disease, end-stage renal disease, or renal transplant; chronic obstructive pulmonary disease or other respiratory disease; vestibular disorders; congestive heart failure or postcardiac arrest; mood disorders, attention-deficit hyperactivity disorder or schizophrenia; stroke or cerebral aneurysm; multiple sclerosis, Parkinson's disease, or cerebral palsy; traumatic brain injury; intracranial tumors; obstructive sleep apnea–hypopnea syndrome or narcolepsy; psychotropic drug use; general debility or lack of stamina) should be referred to DriveABLE for a driving assessment.(1) What is the available evidence on the SIMARD? Does it justify such widespread use? To answer this question, we reviewed the only published paper then available about this instrument.
2010 was the first year of publication for the peer-reviewed journal where the paper appeared. There is no Journal Citation Reports impact factor for the Journal of Primary Care & Community Health, and it is not indexed on MEDLINE. Both authors are on faculty at the University of Alberta and have previously published on this topic. Dr. Dobbs is well known for her work on driving.
The paper starts by noting the importance of motor vehicle crashes (MVCs) and identifying those 65+ as high-risk drivers (when MVC rates are expressed per kilometer driven). The authors feel this is due to the high prevalence of medical conditions among older persons. Cognitive impairment is high-lighted as being particularly important. Most would agree that a diagnosis of mild cognitive impairment or dementia should not in itself be sufficient grounds to lose driving privileges,(2) but to date no brief cognitive test has shown sufficient sensitivity and specificity to justify its use as the sole determinant of driving safety. The authors conclude that there is a need for an instrument to screen for "cognitive impairment relevant to driving."
There are limitations to the literature review provided. It focuses solely on the use of cognitive instruments for the detection of concerns about driving. Information on the global severity (or functional impact) of cognitive impairment, the personality and behavior of the driver, his or her driving history (e.g., history of MVCs or citations), and whether concerns have been raised by the family should also be considered. Recent recommendations on the assessment of driving risk are not referenced—for example, the authors quote from the Canadian Medical Association 2000 guide on determining medical fitness to operate a motor vehicle but not the 2006 one.(2) While there is room for improvement, clinicians already have approaches to the assessment of driving risk among those with impaired cognition, and over time persons with a dementia do give up driving.(3)
Research Question
Stated goals of the study are "…to develop and validate a brief, scientifically based, easy-to-administer, easy-to-score, paper and pencil screening tool to be used in the primary care setting for the identification of individuals at risk for declines in driving competence due to cognitive impairment with or without dementia…[and] introduce dual cut-points to identify those who would very likely pass or fail a driving assessment, leaving those who fall between the cut-points to be referred for a driving assessment to determine competency."
Study Methods
Two study groups were recruited: an instrument development cohort (n = 181) followed by a tool validation one (n = 244). Both were mainly people referred for a driving assessment from community-based family physicians (146/181 and 192/244 [total 338/425, 79.5%]). The remainder were community-dwelling "healthy" (not defined) seniors actively recruited by posters or through community-based agencies (35/181 and 52/244 [87/425, 20.5%]). Inclusion criteria for those referred consisted of the presence of cognitive impairment (with or without a dementia), fluency in English, a valid driver's license, currently driving, and consenting to the study. We infer that the healthy controls had to be fluent in English, in possession of a valid driver's license, currently driving, and consenting. The participants studied were not a representative sample of patients seen in primary care. Nearly 80% were referred for a driving assessment with the rest being healthy volunteers. Those referred had already been deemed by their family physicians to be at higher risk for continued driving. Possibly this was on the basis of cognitive impairment, as all had deficits. The healthy volunteers were self-selected and probably very confident in their driving abilities. Both sources of participants required fluency in English. Referral and volunteer bias is likely. An unstated number of individuals approached for the instrument development component of the study declined to participate. We are told they were similar to those studied with regard to age, sex, and pass rate, but no further information is given. This raises concerns about possible non-respondent bias.
The investigators selected the DemTect as the cognitive test they were going to work with. It was not clearly stated in the paper why they chose it rather than some other brief cognitive measure, nor why they decided to deconstruct it. The DemTect takes 10–20 minutes to complete and consists of five tasks (word list immediate recall, word list delayed recall, number transcoding, semantic word fluency, and digit span reverse).(4) Presumably the duration required for the full test was felt to be too long, or the full test was not as predictive as a combination of the subtests. They looked at the subtests plus the time required as possible predictors of driving performance, selected which ones to include in their new cognitive test, developed a scoring scheme, and determined dual cut-points to categorize participants as unsafe, indeterminate, and safe on an on-road test. An indeterminate classification meant the cognitive test could not accurately predict the result of the on-road test. These participants would have to be referred for further testing.
On-road driving tests are considered a valid measure of driving safety.(5) One of these, the DriveABLE on-road driving test, was used as the measure of driving performance. Participants underwent a standardized road test in a dual-brake car with a trained evaluator who was blinded to the driver's diagnosis and cognitive test results. Results for the on-road test were reported as either pass or fail. The performance and interpretation of this particular on-road test is somewhat of a "black box," but what we know of it indicates that it is a reasonable approach to the assessment of driving risk.(6–9) One issue with it might be the use of a standardized vehicle and not the car owned by the person being tested, though there are arguments supporting the use of a standardized vehicle.(8) Usually DriveABLE results are reported as "recommend pass," "borderline pass," or "recommend cessation." We suspect the fail or unsafe grade in this study was the "recommend cessation" result, but this was not stated.
Data were collected by trained psychometricians but it isn't stated when, where, or in what sequence the cognitive tests were done. We are not told whether the psychometricians were blinded to the source (i.e., those referred ... and driving test results of the participants), cognitive status, diagnoses, and driving test results. This raises concerns about the possibility of expectation bias.
For predicting the results of the road tests the authors did not consider participant characteristics other than cognitive test results. Specifics were not given on how the regression was done, or what decision rules were used to select the components of the DemTect included in the final model. The authors claimed that the proportion predicted to fail who actually did fail the on-road test was "analogous to sensitivity" while the proportion predicted to pass who did was "analogous to specificity." We disagree. This is not how sensitivity and specificity are calculated. We also fear the qualification "analogous" will be dropped quickly.
Ethical approval was obtained but the specific board from which it was received is not mentioned. Participants provided informed consent but it was not stated whether this was in writing or oral. There was no comment on how the five healthy controls who "failed" the on-road test were dealt with. The authors report that the CEO and President of DriveABLE is the spouse of the lead author but that the lead author owns no shares or has a financial relationship with DriveABLE and that her spouse was not involved in the research. The second author has no reported current connection with DriveABLE, but between 1993 and 2001 consulted with the firm. The study was supported by a grant from the Alberta Centre for Injury Control & Research.
Baseline information on the participants is provided in the paper. Their average age was in the mid-70s and 70% were men. The mean Mini-Mental State Examination (MMSE) score was about 26. Approximately half of all participants failed the on-road test. The failure rate was low among the volunteers (5/87, 5.7%; based on information provided in Table 1 and the Discussion section of the paper) and substantially higher among those referred (208/338, 61.5%).
Three subtests of the DemTect (semantic word fluency, delayed recall, and Arabic into word number transcoding) were selected for the new screening tool (called the SIMARD). These items modestly predicted on-road performance (R2 = 0.265; adjusted R2 = 0.253). Based on the available literature the predictive tests chosen have relatively low face validity.(10,11) The scoring scheme used was as follows: score = (number transcoding × 10) + (delayed recall × 8) + semantic word fluency. No information is provided on interrater and intrarater reliability testing. No information is provided on how the test operates when administered and scored by those with minimal or no training.
The cut-points selected were 30 and 70. Those scoring 30 or less were judged to have a high probability of failing the on-road driving assessment while those scoring over 70 were categorized as having a high probability of passing. In the instrument development group, 49 (27.1%) scored 30 or less and were predicted to fail (42 [85.7%] failed the on-road test), 89 (49.2%) had an indeterminate score (40 [44.9%] of these participants failed the on-road test), and 43 (23.8%) scored over 70 and were predicted to pass (36 [83.7%] passed). The authors reported an "analogous to sensitivity" rate of 86% and an "analogous to specificity" rate of 84%. These results are, respectively, the predictive value of a positive test and the predictive value of a negative test. The authors used three categories (predicted fail, indeterminate, and predicted pass) for the results of the SIMARD. While sensitivity and specificity are calculated with dichotomous variables, we can use multilevel likelihood ratios to determine whether the pretest probability of a condition (here failing the on-road driving assessment) changes substantially after a test is done (here the SIMARD). (12) Using the data presented, the likelihood ratio of failing an on-road assessment with a score of 30 or less is 3.95. It is 1.05 for a score of 31 to 70 and 0.14 for a score greater than 70. Guyatt et al.(13) suggest that likelihood ratios of less than 5 result in small changes in probabilities. Using the likelihood ratio of 3.95, if there is a 50% pre-SIMARD probability of failing the on-road driving assessment, a value of 30 or less on the SIMARD would increase the probability of failing the on-road driving assessment to 80%, which we feel would be insufficient in itself to recommend license revocation.
The authors propose that physicians be aware of driving "red flags" and administer the SIMARD if cognitive impairment is suspected. These results would then be used to counsel patients. Those scoring between 31 and 70 would be referred for an on-road driving test. How effectively this would work in a primary care setting and whether it offers any advantages to other approaches(2,3,14–17) cannot be answered by this study.
On-road testing is relatively expensive and not available in all jurisdictions.(18) The authors state that the SIMARD might eliminate up to 60% of requests for in-depth driving assessments. We suspect the volume could easily increase if the SIMARD became widely used as an unknown number of individuals would undergo an on-road evaluation primarily on the basis of an indeterminate test score. We feel the false negative and -positive rates are too high for the SIMARD to be used as the sole determinant of whether someone should be offered an on-road evaluation, especially for such an important issue. Losing the right to drive can have devastating effects on the person, yet continued driving by an unfit driver endangers both themselves and others. Based on the figures in the paper, approximately 1 in 6 (15%) of those who scoring over 70 on the SIMARD will fail an on-road assessment. The same proportion scoring 30 or less would pass it. These misclassification rates are relatively high. A receiver operating characteristic curve (along with the area under the curve) would have shown the problems with the accuracy of the SIMARD.(19) The posttest probability seen with the SIMARD does not justify making licensing recommendations solely based on the results of this test. Moreover, how the test would work in diverse primary care settings (where test administration is predictably not as standardized as seen in research settings) is unknown. We feel the risk of misclassification might be even higher. This would be particularly problematic for individuals with the other medical conditions listed in the 2010 BC Guide for whom no data are available.
The authors compared the SIMARD to the MMSE. While using two cut-points and a three-level classification scheme that excluded half of all participants when considering the performance of the SIMARD, the authors used a single cut-point (a score of 24 or more predicted pass while a score of less than 24 predicted failure on the on-road test) that included all participants in the calculation of sensitivity and specificity for the MMSE. They found that 81% of those predicted to fail by their MMSE score did in fact fail the on-road test while 58% of those predicted to pass did. For the reasons outlined, these figures cannot be directly compared to the "analogous" sensitivity and specificity reported for the SIMARD. We are not suggesting that the MMSE is a good stand-alone test for assessing driving risk.(5,10,14,16,17,20) If used at all, the MMSE would be part of a global assessment of driving risk, and there would be a more nuanced interpretation of the MMSE results obtained. For example, while an MMSE score of 24 or less might identify an increased risk of unsafe driving, no claim would be made that a higher score indicates no concern.(5)
Assessing the risk of driving in older adults is complicated with no easy answers.(18) While Drs. Dobbs and Schopflocher should be complimented on their contribution to the literature, we can't support the routine use of the SIMARD at this point in time. To adopt a new cognitive instrument for a limited indication, practitioners have to be convinced that it offers striking benefits. We don't believe the SIMARD has been shown to work more effectively in a primary care setting than other approaches to assessing driving safety, such as the one outlined in the 7th edition of the CMA Driver's Guide(2) and the practice parameter update of the American Academy of Neurology.(5) The SIMARD is not in our opinion sufficiently accurate to be the sole determinant of who should go for an on-road driving test. Further research, including confirmatory studies, is required to determine the role of the SIMARD in the assessment of driving risk among older patients.
While we would like to thank colleagues for their thoughts and comments, the opinions expressed in this paper are our own.
We have no conflict of interest to declare. This material paper is based on a presentation by D.B.H. at a Division of Geriatric Medicine (University of Calgary) Journal Club (October 27, 2010).
1 British Columbia Ministry of Public Safety and Solicitor General Office of the Superintendent of Motor Vehicles. 2010 BC guide in determining fitness to drive [Internet]. Victoria: Office of the Superintendent of Motor Vehicles; 2010 Jul 12 [cited 2011 Jun 3] Available from: http://www.pssg.gov.bc.ca/osmv/publications/docs/2010-guide-in-determining-fitness-to-drive.pdf
2 Canadian Medical Association. Determining medical fitness to operate motor vehicles: CMA driver's guide, 7th ed. Ottawa: Canadian Medical Association; 2006.
3 Herrmann N, Rapoport MJ, Sambrook R, et al; Canadian Outcomes Study in Dementia (COSID) Investigators. Predictors of driving cessation in mild-to-moderate dementia. CMAJ 2006;175:591–5.
4 Kalbe E, Kessler J, Calabrese P, et al. DemTect: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia. Int J Geriatr Psychiatry 2004;19:136–43.
5 Iverson DJ, Gronseth GS, Reger MA, et al. Practice parameter update: evaluation and management of driving risk in dementia: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2010;74:1316–24.
6 Dobbs AR. Evaluating the driving competence of dementia patients. Alzheimer Dis Assoc Disord 1997;11(Suppl 1):8–12.
7 Dobbs AR, Heller RB, Schopflocher D. A comparative approach to identify unsafe older drivers. Accid Anal Prev 1998;30:363–70.
8 Kowalski K, Tuokko H. On-road driving assessment of older adults: a review of the literature. Victoria: University of Victoria Centre on Aging and Justice Institute of British Columbia; 2007.
9 Korner-Bitensky N, Sofer S. The DriveABLE Competence Screen as a predictor of on-road driving in a clinical sample. Aust Occup Ther J 2009;56:200–5.
10 Molnar FJ, Patel A, Marshall SC, et al. Clinical utility of office-based cognitive predictors of fitness to drive in persons with dementia: a systematic review. J Am Geriatr Soc 2006;54:1809–24.
11 Mathias JL, Lucas LK. Cognitive predictors of unsafe driving in older drivers: a meta-analysis. Int Psychogeriatr 2009;21:637–53.
12 Haynes RB, Sackett DL, Guyatt GH, et al. Clinical epidemiology: how to do clinical practice research, 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2006.
13 Guyatt G, Rennie D, Meade MO, et al. Users' guides to the medical literature, 2nd ed. New York: McGraw-Hill; 2008.
14 Hogan DB. Which older patients are competent to drive? Approaches to office-based assessment. Can Fam Physician 2005;51:362–8.
15 Byszewski A; Ottawa Driving Toolkit working group. The driving and dementia toolkit, 3rd ed for health professionals. Ottawa: The Champlain Dementia Network and the Regional Geriatric Program in Eastern Ontario; 2009. http://www.champlaindementianetwork.org/uploads/Resources/kitjune09.pdf
16 Carr DB, Ott BR. The older adult driver with cognitive impairment: "It's a very frustrating life". JAMA 2010;303:1632–41.
17 Molnar FJ, Simpson CS. Approach to assessing fitness to drive in patients with cardiac and cognitive conditions. Can Fam Physician 2010;56:1123–9.
18 Rapoport MJ, Herrmann N, Molnar FJ, et al. Sharing the responsibility for assessing the risk of the driver with dementia. CMAJ 2007;177:599–601.
19 Bédard M, Weaver B, Man-Son-Hing M, et al. The SIMARD screening tool to identify unfit drivers: are we there now? J Prim Care Community Health 2011;2:127–32.
20 Brown LB, Ott BR. Driving and dementia: a review of the literature. J Geriatr Psychiatry Neurol 2004;17:232–40.
Correspondence to: Dr. David B. Hogan, HSC-3330 Hospital Dr. NW, Calgary, AB T2N 4N1. E-mail:firstname.lastname@example.com
Canadian Geriatrics Journal, Volume 14, Issue 2, June 2011
- There are currently no refbacks.
ISSN: 1925-8348 (Online)


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Artist: K-otic Sita
Album: Bulletproof
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Thanks to [email protected] for these lyrics.
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Got a smile on his face - Thinking: 'What a wonderful life'
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text:
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The Columbus Crew faces off Sporting Kansas City this Saturday in the regular season finale, a week before a bye, in a game that could have playoff implications.
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Poteau Voters Approve Funding For New Buses
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Aurnhammer, M., Hanappe, P. and Steels, L. Augmenting Navigation for Collaborative Tagging with Emergent Semantics. International Semantic Web Conference, 2006
Sony CSL authors: Melanie Aurnhammer, Peter Hanappe, Luc Steels
Type: inproceedings
Keywords: emergent semantics, tagging
BibTeX entry
@INPROCEEDINGS { aurnhammer:06b, AUTHOR="Aurnhammer, M. and Hanappe, P. and Steels, L.", BOOKTITLE="International Semantic Web Conference", TITLE="Augmenting Navigation for Collaborative Tagging with Emergent Semantics", YEAR="2006", }
Steels, L. Collaborative Tagging as Distributed Cognition. Pragmatics and Cognition, 14(2):287-292, 2006
Sony CSL authors: Luc Steels
Type: article
Keywords: tagging
BibTeX entry
@ARTICLE { steels:06g, AUTHOR="Steels, L.", JOURNAL="Pragmatics and Cognition", NUMBER="2", PAGES="287--292", TITLE="Collaborative Tagging as Distributed Cognition", VOLUME="14", YEAR="2006", }


text: Small Intestine, Obstruction View Full Chapter Figures Only Tables Only Videos Only Print Share Email Twitter Facebook Linkedin Reddit Get Citation Citation AMA Citation Small Intestine, Obstruction. In: Doherty GM. Doherty G.M. Ed. Gerard M. Doherty.eds. Quick Answers Surgery New York, NY: McGraw-Hill; 2010. http://accesssurgery.mhmedical.com/content.aspx?bookid=853§ionid=49662286. Accessed August 20, 2018. MLA Citation . "Small Intestine, Obstruction." Quick Answers Surgery Doherty GM. Doherty G.M. Ed. Gerard M. Doherty. New York, NY: McGraw-Hill, 2010, http://accesssurgery.mhmedical.com/content.aspx?bookid=853§ionid=49662286. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley © Copyright Tools Search Book Top Return Clip Autosuggest Results ++ Proximal Obstruction + • Vomiting• Abdominal discomfort• Abnormal PO contrast x-rays ++ Mid or Distal Obstruction + • Colicky abdominal pain• Vomiting• Abdominal distention• Constipation-obstipation• Peristaltic rushes• Dilated small bowel on x-ray ++ Epidemiology + • The most common surgical disorder of the small intestine• Common causes of obstruction:-Adhesions: The most common cause of mechanical small bowel obstruction-Neoplasms: Intrinsic or extrinsic-Hernia: Due to incarceration of bowel-Intussusception: Common in children-Volvulus: Often results from congenital anomalies or acquired adhesions-Foreign bodies: Luminal blockage-Gallstone ileus: Passage of a large gallstone through a cholecystenteric fistula-Inflammatory bowel disease: Lumen isnarrowed by inflammation or fibrosis-Stricture-luminal narrowing-Cystic fibrosis: Partial obstruction of the distal ileum and right colon-Hematoma-Paralytic ileus: Neurogenic ++ Symptoms and Signs + • Vomiting• Cramping abdominal pain• Obstipation• Distention-Minimal in proximal obstruction-Pronounced in distal obstruction• Mild abdominal tenderness• Audible rushes and high-pitched tinkles ++ Strangulation Obstruction + • Shock• High fever• Abdominal pain: Severe and continuous• Vomitus may contain blood• Abdominal tenderness and rigidity ++ Laboratory Findings + • Hemoconcentration• Leukocytosis• Electrolyte abnormalities that depend on the level of obstruction and the severity of dehydration• Serum amylase is often elevated ++ Strangulation Obstruction + • Marked leukocytosis not accounted for by hemoconcentration• Metabolic acidosis ++ Imaging Findings + • Abdominal x-ray -Dilated bowel-Air-fluid levels (minimal in early, proximal, or closed loop obstruction)• The colon is often devoid of gas• Intraperitoneal air indicates perforation• Contrast upper GI series: Assesses completeness of obstruction• CT scan-Intraperitoneal free fluid-Dilated bowel proximal and decompressed distal to the obstruction-Point of obstruction may be visualized• Gas within the bowel wall or portal vein may be seen in strangulation• Intraperitoneal free air or air-fluid levels indicate perforation + • Classification of small bowel obstruction• Functional (failure of peristalsis to propel intestinal contents) or mechanical (a physical barrier impedes aboral progress of intestinal contents)• Complete or partial• Simple (occludes the lumen only) or strangulated (impaired the blood supply leading to necrosis of the intestine)• Open loop (the lumen is occluded in 1 place) or closed loop (the lumen is occluded in at least 2 places)• 33% of strangulation obstructions are unsuspected before operation ++ Rule Out + • Acute appendicitis• Obstruction of the large intestine• Acute gastroenteritis• Acute pancreatitis• Mesenteric vascular occlusion• Pseudo-obstruction associated with scleroderma, systemic lupus erythematosus, amyloidosis, drug abuse, or radiation• Intrinsic dysmotility + • Abdominal x-ray• CBC• Serum electrolytes• ABG measurements (if strangulation suspected)• Serum lactate• Serum amylase and ... GET ACCESS TO THIS RESOURCE Sign In Username or Email Please enter User Name Password Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. What is MyAccess? Create a FREE MyAccess profile to: Use this site remotely Bookmark your favorite content Track your self-assessment progress and more! GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessSurgery 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessSurgery Full Site: One-Year Individual Subscription $995 USD Buy Now View All Subscription Options Pop-up div Successfully Displayed This div only appears when the trigger link is hovered over. Otherwise it is hidden from view. Please Wait


text:
The War Machines
- Sci-Fi
- 1966
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Reviewed by Ross Ruediger
hroughout most of the William Hartnell era of "Doctor Who," stories basically fell into one of two categories: tales set far in the future or adventures set way in the past. But then "The War Machines" came along and changed everything by presenting a story set in London of the present day. Given that so much of the series today is reliant on such stories, it's almost hard to believe there was a time when it wasn't the norm, and yet for the first three seasons, the here and now wasn't even a factor in the program.
Unfortunately, Hartnell's Doctor was so accustomed to time travel, that by the time he ends up dealing with everyday, mundane people he ironically feels out of place and time. The one place his Doctor simply didn't work well was in the here and now, and yet, as the story struggles against its previous templates to show, "Doctor Who" needed to become relevant in order to survive. Watch "The War Machines" and picture Patrick Troughton playing the Doctor and you've got a passable story. But Troughton's not there – Hartnell is, and his Doctor continually feels at odds with the material. It's a story with one foot in the past, and one in the future, and the two feet are running so far from each other that the story has a tough time trying to keep up.
None of this changes the fact that "The War Machines" is a fascinating slice of "Who" for those interested in the history of the program. The Doctor and his companion Dodo (Jackie Lane) arrive in 1966 London, and he senses a strange something or other coming from the recently opened Post Office Tower (which these days is known as the BT Tower). They go to the tower and meet Professor Brett (John Harvey), who has invented a massive computer called WOTAN, which knows everything and is capable of thinking for itself. As you can imagine, such a machine is destined to become an evil entity, and it begins building these clunky War Machines, which will help it to take over London and soon the world. Meanwhile, the Doctor and Dodo meet secretary Polly (Anneke Wills) and seaman Ben (Michael Craze), both of whom will eventually be instrumental in defeating the computer, and also end up becoming the Doctor's new companions.
Much of the story is obtuse, and WOTAN and the War Machines are laughably ineffective by today's standards. Sometimes you can forgive dated material and place it in the context of the time it was made, but this is a case where that's really difficult to do. But at the same time there's some wonderful stuff here that might be considered must see "Who," such as the scenes on the swinging nightclub called The Inferno, and the couple of scenes where WOTAN actually refers to the Doctor as Doctor Who – the only time in the series this has ever happened. The machine bellows, "Doctor Who is required!" Heh. It's also the only full story that exists featuring Ben and Polly, which in and of itself is bound to be of interest, as well as one of the worst companion exits ever from Dodo, who doesn't even get to say goodbye to the Doctor.
On top of everything else, the Restoration Team has gone to great lengths to restore "The War Machines" so that it's as close as possible to its original form, which according to one of the special features was no mean feat. "The War Machines" is not required, but it is certainly recommended to anyone wanting to see the bigger "Who" picture, warts and all, as it's an important stepping stone in the show's long history.
Special Features: An audio commentary with Anneke Wills and director Michael Ferguson is far more energetic than you might expect, and both participants have quite a bit to say. Further, they claim to have not even seen each other since the story was shot in 1966! "Now and Then" is a featurette on the locations used in the story. There's also a selection of clips from "Blue Peter," a non-"Who" related featurette called "One Foot in the Past" that talks about the history of Post Office Tower, and finally, "WOTAN Assembly," which describes all the work that went into preparing the story for DVD. A photo gallery, production notes, optional Radio Times listings, and an Easter Egg round out the extras.
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The Strength Room, located in Maggs Room 160, contains a wide variety of free weights, dumbbells, bench press, incline/decline benches, squat racks, platforms, cable cross-over, lat machines, and smith machine. Users are responsible for their own possessions; nearby locker rooms are available. Please warm-up and stretch out properly before exercising. Review the posted Strength Room rules and flyers. Always use spotters and collars.
Please re-rack all weights/bars/benches when finished.
- Top -


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International Opportunities
Submitted March 3, 2017
Veterinarian - Iraq/Afghanistan
Apply at: https://chsmedical-hr.silkroad.com/epostings/index.cfm?fuseaction=app.jobinfo&jobid=2920&source=ONLINE&JobOwner=992375&company_id=16120&version=1&byBusinessUnit=NULL&bycountry=0&bystate=0&byRegion=&bylocation=&keywords=veterinarian&byCat=&proximityCountry=&postalCode=&radiusDistance=&isKilometers=&tosearch=yes&city=
Job Description
The Veterinarian is a member of a field veterinarian and veterinarian technician team responsible for the overall canine health of canines supporting the Department of State Explosive Detection Canine teams. Performance locations will be OCONUS in both Iraq and Afghanistan.
All services shall be provided in accordance with established standards, principles and ethics of the profession, applicable professional specialty organizations, and the high-quality standard for which CHS is recognized.
Required Experience
Minimum Position Requirements
· Shall possess or be able to obtain a minimum MRPT or SECRET level clearance.
· Shall have a degree from a 4-year program at an accredited college of veterinary medicine
· Shall be licensed as a Doctor of Veterinary Medicine (D.V.M or V.M.D.)
· Shall have a minimum experience of two (2) years as a veterinarian in a private practice or the military
· Shall have knowledge of the chemical composition, structure, and properties of substances and of the chemical processes and transformations that they undergo (this includes uses of chemicals and their interactions, danger signs, production techniques, and disposal methods)
· Knowledge of plant and animal organisms, their tissues, cells, functions, interdependencies, and interactions with each other and the environment.
· Experience in maintaining canine health records and canine international health certificates
· Shall have experience with a microchip program that scans, reads and tracks canines
· Shall be willing to live and work in conflict/combat areas or similar hazardous environments
Position Duties
· Examine animals to detect nature of diseases or injuries.
· Treat sick or injured animals by prescribing medication, setting bones, dressing wounds, or performing surgery.
· Inoculate animals against various diseases such as rabies and distemper.
· Collect body tissue, feces, blood, urine, or other body fluids for examination and analysis.
· Operate diagnostic equipment such as radiographic and ultrasound equipment, and interpret the resulting images.
· Advise handlers regarding sanitary, feeding, and general care necessary to promote health of animals.
· Educate handlers/trainers about diseases that can be spread from animals to humans.
· Train and supervise workers who handle and care for animals.
· Euthanize animals at the direction of the COR.
· Establish and conduct quarantine and testing procedures that prevent the spread of diseases to other animals or to humans, and that comply with applicable government regulations.
· Conduct postmortem studies and analyses to determine the cause of animals' deaths.
· Perform administrative duties such as scheduling appointments and maintaining records.
· Inspect and test animals to detect the presence of communicable diseases.
· Research diseases to which animals could be susceptible.
· Inspect animal housing to determine cleanliness and adequacy.
· Determine the effects of drug therapies, antibiotics, or new surgical techniques by testing them on animals
· Work effectively independently, however be capable to give medical advice telephonically to a staff of Veterinarian Technicians that are operating at remote locations.
· Must have a valid, current U.S. Driver's License
· Must have a current U.S. Passport.
o Must sign a CHS Foreign Service Agreement (FSA) and is bound to the terms and conditions of the FSA.
· Shall be proficient in the ability to speak, write and communicate in English.
o Work hours are based on a 72 hr. work week; typically six 12 hour days but other variations may apply.
o Requires a favorably adjudicated Moderate Risk Public Trust (MRPT) investigation or Secret clearance conducted by the Department of State, Bureau of Diplomatic Security.
o Shall Attend a Foreign Affairs Counter Terrorism training course prior to deployment to Iraq for work on the MSSI-Iraq contract. Training may include: Combat First Aid, Weapons
o Familiarization, Defensive Tactics/Driving, IED recognition, Surveillance Detection and Hostage
o Survival and Personnel Recovery.
· Shall demonstrate proficiency in the use of basic word processing programs and the CHS Medical
o Management System software.
· Ability to communicate clearly and effectively, both verbally and in writing.
· Must be confirmed by a medical examination to be "medically and dentally fit" in accordance CHS Medical Readiness Guidelines and Policies and/or as dictated by the Client
· No conditions that would prevent the wear of personal protective equipment; including protective mask, ballistic helmet, body armor and chemical/biological protective garments or conditions that would prevent the capability of donning, lifting or carrying of up to 70 lbs. of referenced gear while running to a bunker or protected area in the face of perceived or imminent danger.
· Work is normally performed in a typical interior/office work environment; travel in Iraq and Afghanistan is required by surface or air.
· The climate is desert-like, hot, and prone to dust storms.
Comprehensive Health Services is an Equal Opportunity Employer (EOE). Employment selection and related decisions are made without regard to race, color, national origin, religion, sex, disability, veteran status, gender identity, and sexual orientation, and other statuses protected by law.
Job Location
Cape Canaveral, Florida, United States
Position Type
Employment Type
Full time Regular


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Butler's Matt Howard Wins Elite 88 Award
April 2, 2010
NCAA Release
INDIANAPOLIS - Matt Howard, a junior at Butler University, is the recipient of the Elite 88 award for the 2010 NCAA Division I Men's Basketball Championship.
The Elite 88, an award founded by the NCAA, recognizes the true essence of the student-athlete by honoring the individual who has reached the pinnacle of competition at the national championship level in his or her sport, while also achieving the highest academic standard among his or her peers. The Elite 88 is presented to the student-athlete with the highest cumulative grade-point average participating at the finals site for each of the NCAA's 88 championships.
Howard, majoring in finance, currently carries a 3.795 GPA. Howard was presented with the award during the Men's Final Four Salute Presentation on Thursday evening in Indianapolis.
All GPAs are based on a straight grading scale to ensure consistency among institutions. All ties are broken by the number of credits completed.
Eligible student-athletes are sophomores or above who have participated in their sport for at least two years with their school. They must be an active member of the team, traveling and competing at the championship.
For more information on the Elite 88 award winners, log on to NCAA.com/elite88.


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April Jeanette Mendez is an American professional wrestler. She works for WWE under the ring name AJ Lee, where she is the current WWE Divas Champion.Before signing with WWE , the Mendez for several promotions Northeast – based independent and Miss April , including the stars of women Uncensored (WSU), where she held the WSU Tag Team Championship once.After signing with WWE in 2009, AJ was part of the third season of NXT in 2010 , put the third place in the competition. In 2012, after his involvement in several relationships with wrestlers rival the WWE Championship and the Heavyweight Championship World (Punk, Daniel Bryan, Ziggler Dolph, John Cena and Kane), while also being Director General of crude for almost three months, and was named in the WWE AJ " Diva of the year ". Recovery in pay – per – view in June 2013, AJ won her first WWE Divas Championship, beating her ex – husband 's best friend Kaitlyn.The 26 year old has a great time and she achieved allot before the big career gear up for her.
Every fan of WWE and AJ Lee check his net worth, monthly income, yearly income profit with salary payslip, single match fees, tour and total tournament earning details here from. we are working also on every WWE wrestler profile for sure to provide our fans exact details on WWE stars net worth, salary and much more information only on Incomefile.
AJ Lee Salary – Net Worth – Total Earnings
Full Name: April Jeanette Mendez
Born: March 19, 1987 (age 26), Union City, New Jersey, United States
Height: 1.57 m
Nationality Country: American
Education: Tisch School of the Arts
Divas Age : 26 Year Old
Income of Source : Wrestling , WWE RAW
Country / Birthplace : Union City, New Jersey , USA
Salary : $104,300
Real Name : April Jeanette Mendez
Wrestling Championships :
- FCW Divas Championship
- Queen of FCW
- WWE Divas Championship – Current Holder
Awards : Achievements :
- Slammy Award for Diva of the Year
- Slammy Award for Best Kiss of the Year with John Cena
Find This Income Profile by:
- aj lee net worth
- AJ Styles Net Worth
- aj lee salary
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- WWE Diva Champion Net Worth AJ Lee


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Keegan, who quit the club 11 years ago, made a stunning return to St James´ Park on Wednesday night when he was announced as Sam Allardyce´s successor.
"I know what they want and I know what they don´t want as well," he told talkSPORT. "As long as they are realistic and patient I think we can try again to help them have dreams and possibly win something."
Copyright (c) PA Sport 2008, All Rights Reserved.
Do YOU want to write for GiveMeSport? Get started today by signing-up and submitting an article HERE: https://www.givemesport.com/writeforgms


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Rapper J. Cole has delayed the release of his second album to allow himself time to perfect his new material.
Born Sinner, the follow-up to the star's 2011 debut Cole World: The Sideline Story, was set to hit stores on 28 January (13), but it has now been pushed back.
Cole, who is signed to Jay-Z's Roc Nation record label, has reached out to fans to explain he needs extra time to work on his new tracks.
Speaking to PopStopTV.com, he says, "It's not going to make January 28th. It's going to be a little later than that. I needed more time to get it done. I don't even know what (fans are) going to feel. I hope they're going to love it, but I don't know if it's going to be the production or the stories."


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HOCKESSIN, Del. - February 2, 2013 --Delaware State Police say a man driving under the influence of alcohol crashed his car into a dry cleaners business.
It happened around 2:25 a.m. Saturday in Hockessin.
Police say Jose D. Garcia was trying to back out of a parking space next to Hockessin Cleaners on Lancaster Pike when his foot apparently slipped off the brake.
The car crashed into the side of the building, which was damaged.
Police say Garcia wasn't injured but has been issued a citation for driving under the influence of alcohol.


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Certificate in Christian Counseling
If you are looking for graduate-level training to equip you with counseling skills but are not sure you want our full MA in Counseling (MAC) degree, then this certificate program may be just what you are looking for. Courses within the certificate program will emphasize helping/counseling skills, an understanding of a broad range of human struggles, and how we grow and change.
What is Christian Counseling?
Simply put, Christian Counseling is counseling that seeks to impart the love, compassion, and wisdom of God to those who are struggling with life's problems. The ultimate goals include symptom relief, skill acquisition, insight, and maturation in the faith.
Who is This Counseling Certificate For?
The counseling skills and knowledge gained from our certificate program fit with a professional model but are also useful for pastors, church leaders, and lay leaders who want to improve their work within the church. Small group leaders, educators, and pregnancy counseling volunteers have also found these courses helpful. Mental health professionals seeking distinctly Christian and faith-based counseling skills may also wish to complete the certificate.
Many certificate holders may wish to consider a future MAC degree. Our admissions counselors can walk you through the process.
What Are the Specific Requirements?
The certificate program requires a completed undergraduate or equivalent degree, and completion of a degree application. Upon completion of the certificate, students may choose to transfer appropriately completed courses into the MA in Counseling (MAC) degree program.
Contact the Admissions Team
If you have any questions, please feel free to call anyone on our amazing admissions team at 800.235.4021
Enrollment and Marketing
MA, MDiv, DMin
ACS, ThM
Financial Aid
General Information
Curriculum within the Certificate in Christian Counseling Program
Required Courses - 9 Credits
MAC510 Helping Relationships
Electives - 6 Credits
MAC525a Ethics and Professional Orientation (2 credits)
Optional Courses
The following counseling courses have prerequisites or may require approval before registration:
MAC601 Marriage and Family Therapy - Prerequisite: Helping Relationships or Pastoral Counseling, including a recommendation from the professor
MAC621 Child and Adolescent Counseling - Prerequisite: Helping Relationships or Pastoral Counseling, including a recommendation from the professor
MAC605 Advanced Counseling Skills - Prerequisite: Helping Relationships or Pastoral Counseling, including a recommendation from the professor
(These courses can only be considered after completing all core courses and may be substituted for electives.)
Total Required Credits - 15
Whether you are looking for more information regarding a program, scheduling a visit, starting the application process, or just wanting to talk to someone about your dreams, our admissions department is always available to assist you and answer any question that you might have.
Meet Our Faculty
Our faculty are known for their dedication to teaching and their desire to fully serve the Lord. Their teaching styles are highly interactive and reflect a high degree of scholarship and practical experience in ministry.


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See also: RTM for Public Health
Book: 2016. Univ. of California Press
RTM in Season 2 of National Geographic's 'Breakthrough'
Risk Terrain Modeling, or RTM, is an approach to spatial risk analysis that was invented by Les Kennedy and Joel Caplan at Rutgers University. It is used to identify risks that come from features of a landscape and model how they co-locate to create unique behavior settings for crime. We say crime as the outcome event because that was RTM's inaugural application. But, it is currently used for a variety of other topics, including injury prevention, public health, epidemiology, traffic/transportation planning, border security, pollution, or maritime piracy. RTM is by all intents-and-purposes a diagnostic method. With a diagnosis of the attractors of criminal behavior or other hazardous outcomes, you can make very accurate forecasts. RTM offers a statistically valid way to articulate vulnerable areas at the micro-level. Read more about RTM here.


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Night Train to Lisbon follows Raimund Gregorius, a 57-year-old Classics scholar, on a journey that takes him across Europe. Abandoning his job and his life and travelling with a dusty old book as his talisman, he heads for Lisbon in search of clues to the life of the book's Portuguese author, Amadeu de Prado. As he gets swept up in his quest, he finds that the journey is also one of self-discovery, as he re-encounters all the decisions he has made - and not made - in his life, and faces the roads not travelled.When night fell, he went down to reception and had them enquire at the airport if there was still a flight to Zurich or Geneva. ... on a hot day, I listened to the various teachers and heard the stuttering answers of anxious students to questionsanbsp;...
|Night Train to Lisbon
|Pascal Mercier
|Atlantic Books Ltd - 2009-05-01
You must register with us as either a Registered User before you can Download this Book. You'll be greeted by a simple sign-up page.
Once you have finished the sign-up process, you will be redirected to your download Book page.How it works:


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Robert Ferguson's 6 Day Detox Drop is ideal for jump starting fitness, breaking cravings, boosting metabolism and maximizing fat loss. Lose up to 11 pounds in 6 days!
This special offer comes with two 6 Day Detox Drop Kits and a savings of $20. Do it with your spouse or friend. Together you can lose up to 22 pounds in 6 days.


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This award has been put together to allow grad students and postdoctoral fellows to get involved in the development of learning clubs and "user groups" in order to transfer acquired scientific and technical knowledge necessary to conduct research in biodiversity science within and between student cohorts.
General rules
- Applicants (or group of applicants) are limited to two Learning Development Award per semester
- Awards can be combined with other awards if allowed by the other funding sources including QCBS.
Amounts of funding: $200 – $500 award per student according to the importance of their involvement. Applicants can apply as a group, requesting several individual awards.
Eligibility requirements
- Active and full time graduate student status;
- Enrolled in one of the QCBS partner universities;
- Supervised by a QCBS member;
- Canadian citizen or permanent resident at time of award application.
Preparing an application
Learning club and user group development award (LeaDA) application must contain the following items:
- Cover letter with the applicant's contact information;
- Applicant's CV (recipients' CVs can be posted on the QCBS website);
- Brief explanation of the relation between the proposed LeaDA and the QCBS research axes and themes (maximum of one page, or ~400 words);
- Detailed work plan and schedule for the proposed LeaDA;
- Detailed budget (including operational budget if needed);
- Two letters of recommendation: one from your advisor and another from a past or potential trainee attesting to the need for the training/improvement and the capacity of the applicant to answer that need
Evaluation process
The QCBS scientific committee will evaluate applications using the following criteria:
- Application completeness (includes the following six documents: cover letter, CV, brief justification for the LeaDA, detailed plan and schedule, detailed budget, recommendation letters);
- Student's eligibility/compatibility with their academic duties;
- Feasibility of proposed activity;
- Innovative and collaborative nature of the LeaDA;
Award timeline
Three application deadlines per year
- Period covered (application deadline) : January to March (November 15), April to August (February 15th) and September to December (June 30th);
Obligations of awards recipients
- Award recipients will make their association with the QCBS visible on their documents and presentations;
- Award recipients will allow QCBS to post information about his/her contribution to LeaDA on the QCBS website, in accordance with publication regulations and policies;
- Award recipients will produce a short technical report for QCBS within 2 weeks of the completed activity (attendee info, evaluation comments, photos etc.).
Award transfer
- McGill Students*
Students of McGill University will receive their award by direct deposit.
*Different procedure for Postdoctoral fellows, contact the QCBS for further details
- Non-McGill Students
Students of all other universities are reimbursed by their supervisor, as the award amount is transferred directly to them.
Questions regarding the application process should be directed to Philippe Auzel.


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Tonight's post was brought about by the weather but before you leave because you think I'm whining about the rain (more on that later) stay tuned because it isn't about the weather at all.
Biking was cancelled and so I used my free time to be creative. Several weeks ago I decided I wanted to make Baby A a dress. So her momma left me a onsie (in my day called a diaper shirt) as the base.
I went onto the internet and found a few tutorial options. Sometimes the issue is that there's so many options. Without too much ado I just picked one and went with it.
I pulled a few pieces of material from my left over stash and decided on the hearts as the base — because of course Baby A has my heart.
A few cuts and a couple of serger seams later I had the easy parts done. The tutorial writer wished she had a serger — I don't use mine often but it makes some tasks so quick.
Then on to the gathering part which is always a bit finicky. I'm not a novice to clothing so I should have remembered that two basting threads are easier that one long one but I forgot. Once I got that on I pulled out the serger again to clean up the edges.
Once prepared the dress is then attached to the onsie with elastic. The nice thing is that the inside of the onsie has only one line of stitching on it. It finished up nicely but I'm not convinced that my elastic didn't stretch out too much on the onsie. We shall see whether it's too long or too wide. As a first attempt it looks cute.
And if it doesn't suit Baby A it looks good on Bear! Maybe a smidge long but overall pretty darn cute! Can't wait to see it on Baby A. It's, I'm totally sure, the first of many gramma made clothing items.
I mentioned the weather earlier. I'm a farmer's daughter, a rancher's sister and a land owner with 110 acres of hay land so I never say no to rain except when the hay is on the ground. It's been a tumultuous couple of weather days with some real stormy skies.
My iPhone doesn't do it justice but Dan's mega expensive camera does! Isn't that just an amazing photo!! He's been out a few times and used our area as a backdrop. Lucky us!!


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Defense and discipline were lacking last night for the Rangers in their 5-3 loss to the Thrashers at the Garden.
So were alternatives to Marian Gaborik and Vinny Prospal with top-nine vacancies up front created by Saturday's injuries to Brandon Dubinsky and Vinny Prospal.
Thus, and partially because coach John Tortorella told front office people early in the week that he preferred not to disrupt the roster with promotions from the AHL Wolf Pack, Prospal played 27:52, including 11:06 in the third, and Gaborik played 26:02, including 11:01 in the final period with the Blueshirts attempting to come from behind.
"I'm not sure what we're going to do [about the roster]," said Tortorella, whose team is 3-7-1 in the last 11 and plays in Ottawa tomorrow afternoon. "We do have the afternoon game coming up, but our games next week are spread out.
"Do I want to play guys 27, 28 minutes? No, no, I don't think that's a great situation but I'm hoping other guys will step up so that they get the minutes. We'll talk about it [today]."
The Rangers were slow to think and slow to react through most of the first two periods in their first game back from a tour of western Canada that concluded with a flight home on Sunday from Calgary. They were made to look foolish by Atlanta's dynamic Ilya Kovalchuk-Nik Antropov-Max Afinogenov unit.
Perhaps the Dreaded First Game Back Home Scenario provides a partial explanation for the fire-drill follies on defense, though the team didn't seek to use it as an excuse.
"A lot of it was what we've been talking about all year about communicating," said Dan Girardi. "It's not one guy, it's the whole team.
"It's our responsibility to be ready at the start, no matter what the situation is with injuries or the schedule. We were outworked a little at the start. There's no excuse for that."
Henrik Lundqvist, in nets for the first time since last Monday, was behind 1-0 just 19 seconds into the match, when Evander Kane burned Michal Rozsival wide before setting up Colby Armstrong for a slam-dunk at the right porch after he'd beaten Michael Del Zotto to the net.
Rozsival had a dismal night on the blue line. It's becoming increasingly difficult to believe that Bobby Sanguinetti isn't deserving of a shot to unseat Rozsival and his $5M cap hit from the third pair. But we, much like the Rangers defense last night, digress.
Kovalchuk, playing with a cast on his broken right foot in his first game back after missing six, did pretty much whatever he pleased. Sniper Gaborik came close to matching his creativity at the other end. Each of the world-class talents scored one for his team.
But the Blueshirts, who cobbled together second and third lines of modest offensive ability and undetectable chemistry (When will the feds solve the case of identity theft plaguing Sean Avery, by the way?) undermined themselves by picking up six minors that included three offensive zone penalties.
"Once again penalties came into play," said Ryan Callahan, whose team yielded two PPG's. "It's killing us. We have to figure it out."
As Tortorella and general manager Glen Sather have to figure out if they can get by temporarily without making a move.


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Hey you guys,
as you might have noticed, I haven't exactly been posting for the past two months. I don't really have a solid excuse…I've been just really lazy. Winter in Estonia can get really depressing and during the short daylight hours I just don't feel like doing anything that involves writing. However, fear not, I've still been DIY'ing a lot. Let me just get you up to date with my life so far.
I can't recall if I've mentioned that I'm on the board of a fairly sized charity organisation called the Grandparents' Fund. Basically we name the Grandma and Grandpa of the Year in Estonia. Due to that, my Grandma and I were invited to participate in the Independence Day ball held by the major. It was good fun, especially since I got to dress up in formal wear 🙂
I actually had to borrow the dress since I was super broke and the time was too limited for me to make my own dress. I got this gorgeous dark green frock from a friend and I love her for it. I got so inspired by the dress (as it reminds me of some of the dresses the women in Spartacus, the TV show, wear) that I decided to braid my hair up in Greek style. The overall image was awesome.
Here are some pictures from that night. I also made my own vintage-looking earrings.
Another thing I was doing in the past month was baking…a lot. There's a local bar called Drink Bar, I've mentioned it in this blog before, and the owner, James, had a great idea. He decided that for the next year each month a customer could bake him cakes or pastries and he would sell them at the bar. The bakers could turn a small profit and have fun at the same time. I was instantly interested since I love baking but I'm not that keen on eating what I bake as I'm not into sweet stuff very much.
I decided to bake brownies. They were very popular. People even bought them to go :). And James was constantly emailing me to order more. All in all I made around 50 euros of profit, which is a lot, considering that it was my first try.
I've also been toying around with the idea of making clutches, for sale that is. I love purses and I love making stuff, and I'm very good at it, so why not profit from it a little bit. I tried working fake leather and it turned out really well. I made myself a simple oversized clutch with hot pink lining. All I need now is some designs and capital and a brand name 🙂 Any ideas?


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Tuesday August 25th- Jump, Toss, Clean, and Snatch!
Skill Work- 17 Min AMRAP
10x Bar Taps (work on height)
:30 Hollow Hold
1x Headstand Progression- 10-15 sec in each position- tri-pod, knee tuck, and full extension, then come down the same way.
Max time Ring/Box Support
10x SL Box Squat/ Pistols (5 per leg)
Max Set of Double Unders
10x Ring Rows (scale up-add weight, place feet on box, get parallel)
1 Min to work on a skill 🙂
WOD- Sprint!!!
50x Box Jumps Overs (20/24")
40x Medball Side Toss (20x eachside) (14/20#)
30x T2Bar
20x Medball Squat Cleans (14/20#)
10x KB C&J/Snatch (per arm)(12kg/16kg)
Score= For Time.
Post Work- Recover, Stretch, and Roll Out!


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Pelargonium 'Kimono'
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The premier geological research institution in the state of Louisiana, LGS provides unbiased geological and environmental information to state agencies and other decision-making bodies to assure environmentally sound natural resource development and economic prosperity for the state.
Responsible for implementing radiation control policies and ensuring safety practices, in full compliance with federal and state regulations, for the well being of the university community, the general public, environment.
Coordinates research and public service programs in process research and technology transfer; sustainable development; energy management; and inherently safer design for the processing of oil, natural gas, salt, sulfur, and lignite.
Conducts and facilitates objective, balanced research on energy-related problems and issues affecting the state's economy, environment, and citizenry.
Provides reference service related to energy research and policy to the academic community, government agencies, non-profit organizations, business and industry, and the general public.
Coordinates multidisciplinary energy research within the University and the State. The division assists in gathering the necessary expertise, securing funding, and providing research management services for the performance of basic and applied research upon request.


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Shirley Hua
Interior Designer Allied ASID
Shirley Hua graduated from the International Academy of Design & Technology (Toronto Canada) with a degree in Interior Design. After 6 years of mentorship at one of the most prestigious trade showrooms, she made a move in August 2013 to explore and pursue her ambitions within the San Francisco Bay Area.
Shirley offers full scale design services and is proficient in AutoCAD. She enjoys challenging spaces and projects that push the creative envelope yet honor the timelessness of classic designs.
"I believe that people know what they like, the tough part is actually putting it together functionally and beautifully. I love working with clients to create an environment and style that reflects who they are and what they love."
Email Shirley: firstname.lastname@example.com Tel: 415.646.5169
Carol Lindorfer
Interior Designer, Allied ASID
Carol is a San Francisco/Bay Area native and can't imagine calling anywhere else home. She graduated from San Francisco State University with a B.A. in Liberal Studies and completed a program in Interior Design at Canada College in Redwood City. She is currently working on completing a certificate in Kitchen and Bath Design.
Her love for Interior Design grew from growing up with a family owned Structural Engineering Firm. Carol likes to think of herself as a design "guide". "My objective is the help people create spaces that are a reflection of what they are passionate about." Helping a client realize their own style by discovering what holds meaning and beauty to them is what drives her love of design. Whether incorporating treasured family heirlooms with more contemporary pieces or creating an entirely new space from the beginning, the objective is the same, to design in partnership with the client to create a space that is uniquely them.
Email Carol: firstname.lastname@example.com Tel: 415.602.7207
Ann McClelland
Also known as the "Queen of Accessories", is an Interior Decorator and Landscape Designer.
After graduating from Cal Poly SLO in Environmental Horticulture she landed a great job selling trees to Landscape Architects, Builders and Contractors. The extent of creative and practical knowledge learned was vast but her favorite aspect was design.
Moving to Northern California 20 years ago with a young family she began designing landscapes, working at Roger Reynolds Nursery, then William Sonoma Home and finally Brick Monkey.
Thirty plus years later she still loves transforming a yard or house into a place of beauty. Her philosophy she imparts " Buy what you love and there will always be a place for it in your home or garden" guarantees your home to be a reflection of your personality.
Email Ann: firstname.lastname@example.com
Valerie Modesitt
Home Stylist, Home Organizer
Valerie graduated with a degree in Fashion Merchandising from the University of Arizona and has worked several years in the Fashion Industry. Fusing together both her love for fashion and interior design defines her basic concept of style. "Just as clothing should be beautiful, functional and comfortable, so should your home. Styling a room is no different then styling your wardrobe. You want your home to reflect who you are. My goal is simple, to help clients create living spaces that are beautiful, stylish, and uniquely you".
Valerie is also passionate about home organization. "For a home to be comfortable you want a space that is peaceful and free from distractions. We all dream of that well ordered home". Valerie loves to make order out of chaos and to bring a sense of order to living spaces. She can assist you with the basic necessities for a beautiful, stylish and well organized home.
Email Valerie: firstname.lastname@example.com


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Now contractors have an easy, viable, and cost effective slurry solution that helps keep oceans safe from hazardous wastewater.
(PRWEB) November 21, 2013
As more construction companies become environmentally conscious, they turn to Gelmaxx for a green solution. Gelmaxx has created a product that helps reduce the harmful impact that concrete slurry wastewater can have on the ocean. When contractors grind or cut concrete with water, it mixes together into slurry wastewater that is illegal to dispense into the drain and sewers due to its hazardous nature. Our E CO-QUICKgel slurry solidifier is a super absorbent powder that turns concrete slurry into a dry material that is safe to dispose in any standard waste container.
On August 23, 2013, the Occupational Safety and Health Association (OSHA) proposed new regulations about crystalline silica, aka concrete dust. These new standards have caused more concrete contractors to work with water and produce larger amounts of slurry wastewater. When slurry enters the storm drain, the wastewater is essentially being poured directly into the ocean because it is connected to the storm drains. Since concrete slurry is highly alkaline with larger pH levels, it will negatively disrupt the ocean's delicate biosphere and cause serious harm to the aquatic life.
Even if the slurry wastewaster was left on the ground to dry, the slurry particles can be swept into grass, lakes, streams and oceans. When the dry slurry is exposed to water or rain, it becomes water runoff that eventually leads to the storm drains.
The Environmental Protection Agency (EPA) dictates that we use proper slurry disposal methods, unless we would like to face up to $10,000 in fines. However, many contractors are willing to forgo the risk of fines unless there is an easy and efficient solution to slurry disposal.
With the ECO-QUICKgel slurry solidifier, contractors can quickly and efficiently clean up wastewater without disrupting their workflow. The solidifer is an organic polymer that can absorb up to 500 times its weight without much added volume. 20 grams per gallon of treated material will create a gel like solid within minutes that is safe to dispose and EPA compliant.
MSI Terrazzo Grinding company "loves the ECO-QUICKgel and how simple it is to use" by broadcasting "ECO-QUICKgel over the terrazzo slurry then squeegee it into a pile. After about 5-10 minutes, the waste is solidified and [they] can throw it away in the dumpster. ECO-QUICKgel is definitely a great product."
By using Gelmaxx's ECO-QUICKgel slurry solidifer, contractors can effectively dispose concrete wastewater as conventional waste. Now contractors have an easy, viable, and cost effective slurry solution that helps keep oceans safe from hazardous wastewater.
Gelmaxx, based in California, was established in 2011 and provides contractors slurry solutions specifically designed to help during all parts of the cleanup phase. Gelmaxx was founded by a grinding and polishing expert who understands the challenges the industry faces with strict regulations and growing cost of doing business. For more information, visit http://www.gelmaxxusa.com.


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Monday - Friday: 5:00 a.m. to 6:00 p.m. PST
Saturday & Sunday: 8:00 a.m. to 1:30 p.m. PST
Monday - Friday: 6:00 a.m. to 5:00 p.m. PST
Saturday & Sunday: Closed
Given the vast number of unique finishes offered in our catalog, we have consolidated them into more basic color groups for your convenience. You may select multiple base finishes when filtering your results.
One of the latest trends in interior design is the use of Large Pendant Lighting throughout the home. Traditionally reserved for a breakfast nook or small dining space in a kitchen, Large Pendant Lighting can be used throughout the kitchen, in living rooms, and even in bathrooms and bedrooms. Given Large Pendant Lighting's expanded role in home décor, Sea Gull Lighting offers a complete selection of Large Pendant Lighting from more traditional finishes and styles to more cutting edge, modern lighting solutions.
A common application for Large Pendant Lighting is to add oversized pendants over a kitchen island. Instead of mini-pendants, consider the Pratt Street Collection. The Pratt Street Collection creates an industrial chic look and adds interest to any kitchen island. Available in prismatic glass, bronze and brushed nickel finishes, Pratt Street Large Pendant Lighting is on trend with the latest kitchen designs. The three light Pratt Street pendant in the brushed nickel finish perfectly complements stainless steel appliances or a brushed nickel kitchen faucet. In addition to the Pratt Street Collection, Sea Gull Lighting also offers an alternative industrial chic solution in the Sebring pendant. Available in black, stainless steel and weathered copper finish, Sebring creates a unique look in any kitchen with a nautical inspired design that fits beautifully into a beach house as well as an urban loft.
Sea Gull Lighting still offers the classic Large Pendant Lighting options for the breakfast nook or small eating area. With a variety of glass shade options, from the café tint glass and bronze finishes of the Del Prato and Lemont collections to the satin etched shades and polished nickel finishes of the Solana collection, Sea Gull Lighting has a solution for all of your kitchen lighting needs.
As you transition from the kitchen to the living room, Large Pendant Lighting with fabric shades provide a warm and simple solution to lighting a formal living room. Available in rectangular and circular shaped shades, the Dayna collection features linen shades with an acrylic diffuser to create both ambient and task lighting. The Jordyn features a shade-within-a-shade design that creates both visual interest and depth. The translucent outer shade looks light and airy while the linen inner shade directs the light downward. An acrylic diffuser, held in place with a metal finial, finishes off the look of the Jordyn large pendant light.
Large Pendant Lighting may also be used in bedrooms or bathrooms. The Academy collection, with its white schoolhouse glass and chrome, bronze and antique brushed nickel finishes, includes pendants that work well with white glossy subway tile and beautiful pedestal sinks to create a retro style and feel to the bathroom. To extend the retro feel into the bedroom, consider the throw back style of the single light globe pendant with white opal opaque glass. Available in various sizes, the Hanging Globe Collection hangs with sleek white, cuttable wire for varied hanging lengths. It's a perfect solution to a study area or cozy corner with a patterned lounger or shag cloud couch. Another retro solution with a pop of color are the one light warehouse shade pendants in red, white, green and brushed stainless finishes – a perfect and inexpensive way to illuminate a study area in a teen's bedroom or a college apartment.
Easily update the look of your home with chic Large Pendant Lights by Sea Gull Lighting. Sea Gull Lighting also offers complete collections of bath, kitchen and outdoor lighting in matching finishes and designs to complete the look of your home. Please view the rest of the Sea Gull Lighting products throughout our website to find additional lighting solutions to coordinate with your Large Pendant Lighting selection.
Check out Sea Gull Lighting's large collection of Large Pendant Lighting including: Contemporary, Traditional and Transitional.
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Good fortune this Chinese New Year
Hello everybody! Gong Xi Fa Cai! How was your long break? Most of you should be back at work already right? We had such a blue time trying to get back to routine. Ethan almost did not want to go back to school. Let's take a quick look back at my Chinese New Year celebration: My CNY started with a toss of octopus yee sang at my in-law's. Chinese New Year ootd. Selfie before heading […]
Come Escape With Me
We were at Shangri La Kuala Lumpur recently for the preview of ESCAPE by Celcom Axiata Berhad. With Celcom, even our drinks are BLUE :D Escape is a new service provided by Celcom's wholly-owned subsidiary Escape Axiata Sdn Bhd, which allows subscribers to enjoy various forms of content created, produced and packaged to suit a digital mobile lifestyle. "(Escape) subscribers can watch movies, television series, life broadcasts […]
Celcom 4G LTE
You know Usain Bolt? Usain Bolt is a Jamaican sprinter and Olympic champion, known as the fastest man ever. He is the first to ever hold both the 100m and 200m world records and is also the first man to win 6 Olympic gold medals in sprinting. He is also 5 time World Champion and has the highest record breaking margin for the 100m sprint from 9.69 (his own previous record) to 9.58. His achievements […]
On Ground Frenzy
It was a loooong weekend and we were at a place that I've not stepped into for ages! Back in my college days I used to frequent this place but now, not anymore. Anyway, we were here today as Darling needed to meet up with one of his client. Yeah I KNOW! Talk about NOT working over the long weekend! >_< We were in Carrefour, Subang Jaya if you need to know. I managed to […]
Celcom First WiFi – The WiFi that powers the nation
We are in that era where we just HAVE to be connected at all times, aren't we? If you've been following my blog you'll know that I've recently 'complained' about not having connection when I was back at my in-laws. I can't live without my laptop, smart phone and now even the camera comes with wi-fi! Celcom has launched Celcom First WiFi, a wireless internet service available for all. At selected public places, everyone and […]
Celcom First Voice : New Postpaid Plan from Celcom
Celcom Axiata Berhad introduced 3 new postpaid plans under the brand Celcom First recently. The 3 new plans are Celcom First Prime, Celcom First Premier and Celcom First Elite. "We realise that our customers have very significant needs, thus, Celcom provides them with priority services and privileges, while allowing them to have control and the right tools for their convenience. "We also want to address our customers' increasingly varied requirements by offering a superior solution for all […]
Feeding elephants and Celcom's wildlife adoption project
It was Wednesday afternoon and we were in Zoo Negara. How random can that be right? About 45 mins away from home, we made our way there after Ethan's Mandarin class for Celcom First launch. Celcom Axiata Berhad launches the much awaited Celcom First Voice plans, a range of superior voice plans that will let Celcom customers step up to bold, more innovative and advantageous services for an optimum customer experience. At today's launch, Celcom First […]
Pre-register ONLINE to win a Samsung GALAXY S III NOW!
*48 hours sticky post. Scroll down for latest update* The new and much anticipated Samsung GALAXY S III was launched to the media on the 24th May to a rousing applause from the audience. We were amazed by the smooth presentation and outstanding product demo. I am sold! Yeah I am really SOLD! Read about it here if you don't already know how SOLD I am >_< I super love the huge 4.8" HD Super […]
Red Carpet Avenue Carnivale
Encorp launches Red Carpet Avenue in conjunction with Malaysia Day on the 16 September 2011. Inspired by the famous Champs-Elysees in Paris, Encorp Berhad's Red Carpet Boulevard is the longest alfresco boulevard ever built in the Klang Valley. The Red Carpet Avenue has been crafted by world-renowned French architect Nicolas Ayoub with a contemporary twist. Dubbed Carnivale, the event was in collaboration with Celcom Axiata Berhad, the main event partner. So we got the invites […]
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About Me
Home is where MY heart is.
I am a mother to two boys; Ethan and Ayden and a wife to Darling William. I'm a stay at home mum who blogs to break the monotony of life and to avoid feeling jaded. Would love to get to know all the Super Mommies and Daddies and Babies or Singles out there with the hope that we can learn more from each other. Most of all, I am a happy person, and I hope YOU are too.
Click here to learn more about me ^_^
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Location: Newcastle
Salary: Up to £48,500 + fantastic benefits
Job ID: 164903
Our Client is embarking on a major change programme that will radically transform the way in which the organisation delivers its services with a focus on self-service supported by effective ICT and digital delivery. Due to growth and expansion they are looking to recruit an experienced Service Architect.
This Service Architect role will be responsible for ICT solutions fully exploiting the opportunities that Digital Service can provide as our client transforms the way it provides services. You will have a detailed knowledge of technology, augmented by demonstrable digital strategy and agile delivery experience, with a proven record of delivery for service architecture solutions within large-scale enterprise and cloud environments.
The post holder will work with business areas to understand and shape the requirements and will be accountable for the control of the ICT Blueprints which define the end state architecture, current state and the transition roadmaps for our client. This includes supporting the creation and execution of technology and service roadmaps that will drive the current ICT estate towards cloud technology for strategic systems whilst decommissioning a large proportion of the legacy.
Responsibilities include providing strategic advice and key constraints to Technology teams in ensuring that project deliveries remain aligned to the Blueprints and help to realise the roadmap.
You will be actively involved in creating and maintaining ICT requirements for procuring ICT services and the selection of 3rd party providers delivering ICT services and working closely with them to provide solutions for the Business, however some of the solutioning will be brought in-house.
Salary: Up to £48,500 plus excellent benefits.


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"Makeup doesn't have to be complicated"
Yciar is an independent makeup artist whose passion for her craft dates back to the day she was old enough to wear lipstick. In 2007, she took a course at the Center for Aesthetic Studies, where she honed her skills and validated her long-standing love affair with cosmetics. This was soon followed by an eye-opening stint with MAC Cosmetics, where she served as counter manager at the Shangri-La store. She then apprenticed with one of the country's leading makeup artists, Jigs Mayuga for two years, assisting him in magazine, billboard, and advertising shoots. The last four years, she was a MAC Affiliate Artist working on MAC-sponsored events and shoots. She is now busy with an assortment of freelance projects throughout the country.


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C$ 79.00A quick-drying, superbreathable technical hoody for warm weather fishing, made from ultralight 100% polyester with 50+ UPF sun protection.
C$ 69.00A lightweight, fast-drying crewneck for warm weather fishing and travel, with 50+ UPF sun protection and Polygiene® permanent odor control. Fair Trade Certified™ sewn.
C$ 79.00A classic travel shirt that breathes, dries quickly, packs light and resists moisture. It's made of 100% nylon plain weave with a DWR (durable water repellent) finish and 40-UPF sun protection.
C$ 99.00A lightweight fishing and travel shirt with knit panels and 30-UPF sun protection for the ultimate in warm-weather comfort and performance.
C$ 119.00A stretchy and ultralight button-up fishing shirt, designed specifically for hot-weather situations and built from a fast-drying blended fabric with 30-UPF sun protection.
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By SAMPATH VINJAMUR RAMANUJAN
This post was written as an assignment for Professor Brynn Saito's multi-genre MFA-level writing workshop, WRC 7093. In this class, students produce new fiction, poetry, and nonfiction, while reflecting on their lives, influences, and processes as artists and writers.
I hadn't heard of his name before, or who he was, or what he was doing; Cindy Shearer, program chair of CIIS' MFA department, had indeed sent an email inviting MFA students to the rehearsal of Alonzo King's latest work under production. I wasn't interested and I didn't go. In fact, Cindy's Saturday Night @ CIIS event postcard announced tonight's program well in advance, which didn't make much of a difference to me then.
And so I walked into Namaste Hall, and surveyed the refreshments MFA program coordinator, Theresa Newman, had relentlessly organized for the evening. My eyes searched for her to confirm which one was vegetarian, as I couldn't identify a dish which looked like one. Alonzo had arrived by that time and was chatting with Cindy and others while I sank into a chair and resigned myself to another session, and mercifully the last, after a long day of workshopping.
Cindy did exceedingly well moderating the event; obviously, she was having a blast, as she mentioned later. It was evident she was an admirer of Alonzo's work and has been closely following his work as the artistic director of the Lines Ballet. She asked several questions pertaining to his art, his ballet company, the collaborators and performances and his upcoming programs.
The responses from Alonzo were phenomenal. Whatever the questions were, Alonzo returned to one answer; the philosophy, or more precisely, the spirituality of art. While the audience wanted to hear more about the ladder he used to reach the artistic heights, Alonzo was actually describing what art feels like after you reach the peak. Hearing him speak about his relationship with art, the capacity for unconditional love for art, the difference between making, doing and being, and the importance of falling and getting up quickly, I could see what he was talking about: something religion and spirituality have been talking about over the centuries: a capacity to "Know Thyself."
When the event was over I felt the urge to get up and go talk to him. At the same time, I didn't want to go. He had said all that he had to say and I had heard what I wanted to hear. Meeting in person became irrelevant. The regret that I didn't go and watch his gracious movements during the rehearsal disappeared.
I just lingered on, unmindful of time, my bus to King and 4th, and the need to catch the 2015 Caltrain to go home.
Alonzo is King.


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Grown-up Retton still strikes a balance
The tiny Texan remembers trying some tumbling at her kids' gymnastics center about a year ago, reliving a sliver of her youth. The next day, she felt so sore she could barely move.
"Your mind says you can still do it," Mary Lou Retton said, flashing the smile that defined the 1984 Summer Olympics.
These days, she leaves the gymnastics to her four daughters. But at 37, she is in impeccable shape, despite the rigors of being a mother and a corporate spokeswoman. Work brought her to San Francisco this week, and she will appear at the Stonestown Mall today on behalf of a sponsor.
People who remember Retton as a 16-year-old gymnast may have to check twice to recognize her now. She is smaller than when she won her all-around gold medal, and at her San Francisco hotel suite Monday, Retton looked rather grown up. She wore perfect makeup, an elegant pantsuit with a small pink sash, stylish chandelier earrings and strappy white sandals with flowers -- a very "Sex and the City goes to Houston" effect.
That's where she lives now, with her husband, former University of Texas quarterback Shannon Kelley, and their girls: Shayla, 10; McKenna, 8; Skyla, 4, and Emma, 2.
The couple married 15 years ago and came to Napa on their honeymoon. "I was only 22 when I got married," she said with a sigh that should denote middle age, but somehow doesn't. When Retton talks, the eternal teenager comes out, her enthusiasm lightly seasoned, but not dulled, by maturity.
"She's what I called 'stupid strong,' " Retton said when she described McKenna. "That's what I used to say about myself. I was stupid strong." Translation: She will try almost anything, confident that her body will come through.
"This child can climb a rope in the pike position, with just her hands," her mom said, demonstrating in her chair, pushing her legs out parallel to the ground, an example of the pike position.
McKenna shows a lot of promise as a young gymnast, Retton said. "Naturally, I have some mixed feelings about that. Will there be unrealistic expectations because she's my daughter, from the media and fans? Will she have to live in my shadow?"
The sport would be better off if every young woman looked like her heir. Retton was a healthy bundle of muscles when she competed, a pleasant contrast to some of the wispy, underdeveloped athletes who turn up at the Olympics. When she watched last summer's Games from Athens, Retton said, she made sure her daughters noted one emaciated competitor from Russia and knew she was misguided.
"She was a little scary to watch," Retton said. "She hasn't come out and said she has a problem, but clearly she does."
It's equally clear that Retton doesn't care for her sport's reputation as a breeding ground for eating disorders. From her perspective, gymnastics cultivated a feisty side, and rewarded it. She doesn't understand how the sport could turn anyone into a victim, or how anyone could spend eight hours a day in a gym while starving herself.
She defends her famous coach, the bearish Bela Karolyi, who has been portrayed as dangerously controlling.
"It always bothers me when I see these stories on TV, criticizing Bela," she said. "Nobody ever calls me."
She said he was demanding, driven and manipulative, all in ways that worked for her. She remembered doing routines or vaults in practice, then looking over to Karolyi for an expected critique. If he wanted more from her, he often looked away, as if to say: "You have to earn my attention."
"Bela, he really knew how to push my buttons," Retton said admiringly.
She said he never made the girls climb onto a scale, which she appreciated. She didn't want to worry about drinking a glass of water at the wrong time, adding a pound just before weigh-in.
"Sometimes he'd tell me, 'You look a little fat,' but I'd just think, 'What about you?' " she said. Apparently, her attitude was as healthy as her physique.
In a poll taken nine years after her Olympic victory, Retton was voted the most popular athlete in America. There have been great U.S. gymnasts since her, and in Athens, Carly Patterson became the second American woman to win the all-around. But Retton transformed the sport in this country, matching her gold medal with a platinum personality. People may have to look twice to recognize the kid from West Virginia in this polished adult, but she's still there. Just ask her how her 8-year-old climbs a rope.
Mary Lou Retton appears at the Stonestown Mall on 19th Avenue in San Francisco from 1-3 p.m. today.