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Publications: Down, Barry
Journal Article
Robinson, J.ORCID: 0000-0003-0958-4973, Down, B. and Smyth, J. (2018) 'Shaking up' neoliberal policy in schools: Looking for democratic alternatives in Jacinta's satchel. Global Studies of Childhood, 8 (4). pp. 392-403.
Down, B., Smyth, J. and Robinson, J.ORCID: 0000-0003-0958-4973 (2017) Problematising vocational education and training in schools: using student narratives to interrupt neoliberal ideology. Critical Studies in Education . In Press.
Down, B. and Choules, K. (2017) Towards a pedagogy of personalisation: What can we learn from students? Curriculum perspectives, 37 (2). pp. 135-145.
Brand, G., Morrison, P.ORCID: 0000-0002-3389-8393 and Down, B. (2015) "You don't know half the story": Deepening the dialogue with young mothers in Australia. Journal of Research in Nursing, 20 (5). pp. 353-369.
Brand, G., Morrison, P.ORCID: 0000-0002-3389-8393 and Down, B. (2014) How do health professionals support pregnant and young mothers in the community? A selective review of the research literature. Women and Birth, 27 (3). pp. 174-178.
Johnson, B., Down, B., Le Cornu, R., Peters, J., Sullivan, A., Pearce, J. and Hunter, J. (2014) Promoting early career teacher resilience: A framework for understanding and acting. Teachers and Teaching: Theory and Practice, 20 (5). pp. 530-546.
Brand, G., Morrison, P.ORCID: 0000-0002-3389-8393, Down, B. and WestBrook, B. (2014) Scaffolding young Australian women's journey to motherhood: A narrative understanding. Health & Social Care in the Community, 22 (5). pp. 497-505.
Wright, P.ORCID: 0000-0002-6433-3889, Davies, C., Haseman, B., Down, B., White, M. and Rankin, S. (2013) Arts practice and disconnected youth in Australia: Impact and domains of change. Arts & Health, 5 (3). pp. 190-203.
Johnson, B. and Down, B. (2012) Critically re-conceptualising early career teacher resilience. Discourse: Studies in the Cultural Politics of Education, 34 (5). pp. 703-715.
Down, B. and Smyth, J. (2012) 'Getting a job': vocationalism, identity formation, and critical ethnographic inquiry. Journal of Educational Administration and History, 44 (3). pp. 203-219.
Robinson, J.ORCID: 0000-0003-0958-4973, Smyth, J., Down, B. and McInerney, P. (2012) Pushed out, shut out: Addressing unjust geographies of schooling and work. International Journal on School Disaffection, 9 (2). pp. 7-24.
McInerney, P., Smyth, J. and Down, B. (2011) 'Coming to a place near you?' The politics and possibilities of a critical pedagogy of place-based education. Asia-Pacific Journal of Teacher Education, 39 (1). pp. 3-16.
Pearce, J. and Down, B. (2011) Relational pedagogy for student engagement and success at university. The Australian Educational Researcher, 38 (4). pp. 483-494.
Smyth, J., Down, B. and McInerney, P. (2010) Hanging in with kids in tough times: Engagement in contexts of educational disadvantage in the relational school. Inside Teaching: The professional journal of the Australasian Teacher Regulatory Authorities, 1 (2). pp. 36-41.
Pearce, J., Down, B. and Moore, E. (2010) Working-class heroes. Professional Educator, 9 (4). pp. 18-21.
Pearce, J., Down, B., Aveling, N. and Price, A. (2009) 'Critically' reinvigorating teacher education: Issues and dilemmas. New Community Quarterly, 7 (4). pp. 6-9.
Down, B. (2009) Schooling, productivity and the enterprising self: beyond market values. Critical Studies in Education, 50 (1). pp. 51-64.
Pearce, J., Down, B. and Moore, E. (2008) Social class, identity and the good student: Negotiating university culture. Australian Journal of Education, 52 (3). pp. 257-271.
Down, B., Ditchburn, G. and Lee, L. (2008) Teachers' ideological discourses and the enactment of citizenship education. Curriculum perspectives, 28 (2). pp. 1-27.
Smyth, J., Angus, L., Down, B. and McInerney, P. (2006) Critical ethnography for school and community renewal around social class differences affecting learning. Learning Communities: international journal of adult and vocational learning, 3 . pp. 121-152.
Down, B. (2006) Educational science, mental testing, and the ideology of intelligence. Melbourne Studies in Education, 47 (1/2). p. 333.
Down, B. (2006) A critical pedagogy of vocational education and training in schools and communities struggling with shifts in the global economy. Learning communities: international journal of learning in social contexts (3). pp. 94-120.
Down, B. and Wooltorton, S. (2004) Beginning teaching in rural-remote schools: implications for critical teacher development. Change: Transformations in Education, 71 (1). pp. 31-46.
Smyth, J. and Down, B. (2004) Beyond the divide: individual, institutional and community capacity building in a Western Australian regional context. Education in Rural Australia, 14 (2). pp. 54-68.
Down, B. (2004) From patriotism to critical democracy: shifting discourses of citizenship in social studies. History of Education Review, 33 (1). pp. 14-27.
O'Brien, P. and Down, B. (2002) What are teachers saying about new managerialism? Journal of Educational Enquiry, 3 (1). pp. 111-133.
Down, B. and Hogan, C. (2001) Critical reflective practice and workplace learning: Impediments and possibilities in teacher education. Australian Journal of Teacher Education, 25 (2). pp. 14-23.
Down, B. (2001) Educational science, mental testing, and the ideology of intelligence. Melbourne Studies in Education, 42 (1). pp. 1-23.
O'Sullivan, D. and Down, B. (2001) Policy Decision-making models in practice: A case study of the Western Australian "Sentencing Acts". Policy Studies Journal, 29 (1). pp. 56-70.
Down, B., Chadbourne, R. and Hogan, C. (2000) How are Teachers Managing Performance Management? Asia-Pacific Journal of Teacher Education, 28 (3). pp. 213-223.
Down, B. (2000) State secondary schooling for all. Education Research Perspectives, 27 (1). pp. 57-80.
Down, B., Hogan, C. and Chadbourne, R. (1999) Making Sense of Performance Management: official rhetoric and teachers' reality. Asia-Pacific Journal of Teacher Education, 27 (1). pp. 11-24.
Hogan, C. and Down, B. (1996) Interrupting the institutional, narrative on teacher training: The potential of school-based teacher education. Australian Journal of Teacher Education, 21 (1). pp. 23-33.
Down, B. (1994) Human capital theory and secondary education. Unicorn, 20 (3). pp. 54-61.
Down, B. (1994) Marxist history and schooling: Beyond economism. Issues in Educational Research, 4 (1). pp. 1-17.
Down, B. (1994) A different more practical education: Aboriginal education in Western Australian secondary schools after the second world war. Education Research Perspectives, 21 (2). pp. 47-68.
Down, B. (1993) Restructuring secondary education: Pathways in WA. Education Australia (24). pp. 21-24.
Down, B. (1990) Education reform in context. Unicorn, 16 (1). pp. 15-17.
Down, B. (1990) Oral history, critical theory and politics: Rethinking first impressions. Oral History Association of Australia Journal (12). pp. 76-83.
Down, B. (1990) The state and educational reform: A case study of the Beazley and better school reports in Western Australia. Critical Pedagogy Networker, 3 (3). pp. 1-5.
Down, B. Book Review: The Toxic University: Zombie leadership, academic rock stars, and neoliberal ideology by John Smyth ISBN 978-1-137-54976-1, London, UK, Palgrave MacMillan, 235 pp., 2017. Australian Universities Review, 59 (2). pp. 94-95.
Conference Paper
Johnson, B., Down, B., Le Cornu, R., Peters, J., Sullivan, A., Pearce, J. and Hunter, J. (2010) Conditions that support early career teacher resilience. In: Australian Teacher Education Association Conference (ATEA) 2010, 4 - 7 July 2010, Townsville, Queensland
Down, B. (2007) 'Troubling' vocational education and training in disadvantaged schools. In: Addressing Inequalities through Community, 20 June 2007, University of Ballarat
Down, B. (2006) Developing critically reflective teachers in 'wacky' times. In: Making teaching public: Reforms in teacher education. Proceedings of the 34th Annual Conference, Australian Teacher Education Conference, 5-8 July 2006, Fremantle, Western Australia. pp. 84-95.
Down, B. (2006) Re-imagining teachers' work for the 21st century. In: 2006 Conference of the Australian Association for Environmental Education, 3 - 6 October, Bunbury, Western Australia pp. 37-52.
Conference Item
Down, B. (2013) 'You can't be neutral on a moving train': Why critical educational research matters in 'dark times'. In: Western Australian Institute for Educational Research 28th Annual Research Forum, 10 August 2013, University of Notre Dame, Fremantle, Western Australia.
Down, B. (2012) Hope required when growing roses in concrete: Rethinking student engagement for learning. In: South East Education Community (SEEC) and Discover Conference, 30 January 2012, Murdoch University, Murdoch.
Down, B. (2012) Talkin' bout their generation: Empowered youth in an era of chaos and indecision. In: Inaugural International Youth Studies Congress, 11 April 2012, University of Calgary, Canada.
Down, B. (2011) Research in Big Picture schools. In: Big Picture Education Conference Workshop 2011, 19 - 21 October 2011, Newport, VIC.
Down, B. (2010) Community listening forum. In: Critical friend at the Addressing Disadvantage and Inequality in Education and Health Annual Conference, 29 October 2010, University of Ballarat, VIC.
Down, B. (2010) Utilising the school research framework (SRF). In: Big Picture Education Conference, 1 December 2010, Cannington, Perth.
Down, B. (2009) Reinvigorating student learning in the middle years. In: Kolbe Catholic College, 29 January 2009, Rockingham, W.A.
Down, B. (2007) Doing critical educational research. In: School of Education. Research Seminar Series, 2007, Murdoch University, Murdoch, W.A.
Down, B. (2007) Student engagement and connecting to young lives. In: Rockingham Senior High School, 28 January 2007, Rockingham, W.A.
Down, B. (2007) Supervisors as provocateurs. In: Supervision Seminar Series, 2007, Murdoch University, Murdoch, W.A.
Down, B. (2007) The middle years of schooling: Taking action. In: Workshop for 20 Teachers and Academic Colleagues, 26 April 2007, Murdoch University, Murdoch, W.A.
Down, B. (2006) Draft profile of conditions supporting school retention and student engagement. In: Research Project Workshop for 28 teachers and principles, 30 May 2006, City of Rockingham, Rockingham.
Down, B. (2006) Middle schooling: What's the research saying? In: Kwinana Education Precinct Public Forum, 2006, Town of Kwinana Performing Arts Centre, Kwinana.
Down, B. (2006) Participative writing workshop on school retention and student engagement modules. In: ARC Research Project Workshop for 14 teachers and principles, 3 July 2006, Murdoch University, Murdoch, W.A.
Down, B. (2006) Values education good practice schools project. In: Faculty of Education. University of Western Australia, 2006, Perth, W.A..
Down, B. (2005) Enhancing school retention and student engagement. In: School of Education. Research Seminar Series, 2005, Murdoch University, Murdoch, W.A.
Down, B. and Ditchburn, G. (2005) Teachers' ideological discourses and the enactment of citizenship education. In: School of Education. Research Seminar Series, 2005, Murdoch University, Murdoch, W.A.
Book Chapter
Robinson, J.ORCID: 0000-0003-0958-4973, Down, B. and Smyth, J. (2019) Jacinta's story. In: Riddler, S. and Apple, M.W., (eds.) Re-imagining Education for Democracy. Routledge, pp. 156-173.
Down, B. (2018) Moving beyond the academic and vocational divide in Australian schools. In: Gannon, S., Hattam, R. and Sawyer, W., (eds.) Resisting Educational Inequality. Routledge as part of the Taylor and Francis group, pp. 41-50.
Down, B. (2016) Rethinking Mis/Behaviour in schools: From 'Youth as a Problem' to the 'Relational School'. In: Sullivan, A., Johnson, B. and Lucas, B., (eds.) Challenging Dominant Views on Student Behaviour at School. Springer Singapore, pp. 77-95.
Down, B. and Smyth, J. (2012) Introduction: From critique to new scripts and possibilities in teacher education. In: Down, B. and Smyth, J., (eds.) Critical Voices in Teacher Education. Springer, Dordrecht, Netherlands, pp. 1-9.
Down, B. (2012) Reconceptualising teacher standards: Authentic, critical and creative. In: Down, B. and Smyth, J., (eds.) Critical Voices in Teacher Education. Springer, Dordrecht, Netherlands, pp. 63-80.
Netherwood, K., Buchanan, J., Palmer, D., Stocker, L. and Down, B. (2009) Valuing diversity in children's voice: a case study of children, stewardship and mapping care of special places in the Western Australian Community. In: Lovat, T. and Toomey, R., (eds.) Values Education and Quality Teaching: The Double Helix Effect. Springer, New York, pp. 83-103.
Hogan, C. and Down, B. (1998) Acknowledging professional lives: A case study in rethinking teacher education. In: Down, B., Hogan, C. and Swan, P., (eds.) Reclaiming Professional Knowledge: New ways of Thinking about Teachers' Learning. Murdoch University. Centre for Learning Change and Development, Murdoch University, W.A., pp. 51-59.
Hogan, C. and Down, B. (1998) Rethinking the way we teach teachers in a regional community. In: Hogan, C. and Strickland, L., (eds.) Learning Journeys: Working together for school change: Case studies from the Innovative Links Project. Murdoch University. Centre for Learning Change and Development, Murdoch University, W.A., pp. 64-66.
Palmer, M. and Down, B. (1995) Privatising public health care: Community resistance in Bunbury. In: Spoehr, J. and Broomhill, R., (eds.) Altered states: The impact of free market policies on the Australian states. University of Adelaide. Centre for Labour Studies/Social Justice Research Foundation, Adelaide, S.A., pp. 162-181.
Down, B., Smyth, J. and Robinson, J.ORCID: 0000-0003-0958-4973 (2018) Rethinking School-to-Work Transitions in Australia: Young People Have Something to Say. Springer International Publishing.
Smyth, J., Down, B., McInerney, P. and Hattam, R. (2014) Doing Critical Educational Research: A Conversation with the Research of John Smyth. Peter Lang, New York, Bern, Berlin, Bruxelles, Frankfurt am Main, Oxford, Wien.
Smyth, J., Down, B. and McInerney, P. (2014) The Socially Just School: Making Space for Youth to Speak Back. Springer Netherlands.
Down, B. (Ed) and Smyth, J. (2012) Critical voices in teacher education: Teaching for social justice in conservative times. Springer, Dordrecht, Netherlands.
Johnson, B., Down, B., Le Cornu, R., Peters, J., Sullivan, A., Pearce, J. and Hunter, J. (2012) Early career teachers: Stories of resilience. Australian Government. Australian Research Council/Early Career Teacher Resilience, Adelaide, S.A..
Smyth, J., Down, B. and McInerney, P. (2010) 'Hanging in with kids' in tough times: engagement in contexts of educational disadvantage in the relational school. Peter Lang, New York.
Smyth, J., Lawrence, A., Down, B. and McInerney, P. (2009) Activist and socially critical school and community renewal: social justice in exploitative times. Sense Publishers, Rotterdam.
Smyth, J., Lawrence, A., Down, B. and McInerney, P. (2008) Critically engaged learning: connecting to young lives. Peter Lang, New York.
Down, B., Swann, P. and Hogan, C. (1998) Reclaiming professional knowledge: New ways of thinking about teachers' learning. Murdoch University. Centre for Learning Change and Development, Murdoch University, W.A..
Down, Barry F.R. (1993) Re-reading the history of Western Australian state secondary schooling after 1945. PhD thesis, Murdoch University.
Down, B., Choules, K., Hogan, J., Carr, D. and Stone, H. (2018) Promising practices: What students, parents and teachers say about learning in a Big Picture context. Murdoch University/Big Picture Education Australia
Wright, P.ORCID: 0000-0002-6433-3889, Down, B., Rankin, S., Haseman, B., White, M. and Davies, C. (2016) BIG hART: Art, equity and community for people, place and policy. Australian Research Council/ Murdoch University, Murdoch, W.A.
Down, B., Smyth, J., Robinson, J.ORCID: 0000-0003-0958-4973 and McInerney, P. (2014) Rethinking the conditions for young people 'getting a job': Kids have something to say. Australian Research Council/ Federation University Australia/Murdoch University, Murdoch, W.A.
Down, B. and Choules, K. (2011) The secondary engagement evaluation project in low SES schools. Murdoch University. Centre for Learning Change and Development, Murdoch University, W.A..


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Participants can fundraise for a charity of choice at O'Bleness Health System Race for a Reason April 28.
Photo courtesy of: Allie Pisching
Race for a Reason is hosted by Ohio University Center for Sports Administration and Athletes in Action.
Photo courtesy of: Allie Pisching
Athletes can choose between three events, a 5K road race, a triathlon or a mud run, being promoted here.
Photo courtesy of: Allie Pisching
Apr 24, 2012
By Tessa Dufresne
Spring at Ohio University can be identified by cherry blossoms and warm weather, but it would never be such without the swarm of 5K races that take over the streets of Athens beginning each March. Among the runs and hustles for "insert charity here," emerges the idea of a race where each individual participant works toward a personalized cause.
O'Bleness Health System Race for a Reason will introduce that concept April 28.
Hosted by Ohio University Center for Sports Administration and Athletes in Action, the charity event allows athletes to choose between three different courses: a 5K road race, a mud run and a triathlon. Individuals as well as student organizations can participate in any of the courses, and when student organizations register for either the 5K or mud run, half of its members' entry fees will automatically be donated to their chosen reason.
"It's great for organizations as we take care of all the logistics – T-shirts, race sponsors, volunteers and permits," said Allie Pisching, second-year sports administration graduate student and event chair for the O'Bleness Health System Race for a Reason. "We're just encouraging them to come out and participate."
The call for group participation and the distinctive setup of the race was not lost on Andrew Wade, senior sports administration major and president of the Sports Business Association (SBA). Wade brought the race to the attention of SBA, and members were motivated by the idea that they could raise money for any charity they wished.
The SBA team, which includes Wade, will race for the Bradley Allen Moorhead Scholarship, which is awarded each year to a senior sports management student at Ohio University's Athens campus. Moorhead, a former sports management student at Ohio University, was killed in a car accident in 2005 while driving to his internship.
A 2001 graduate of Centerville High School in Dayton, Ohio, Moorhead was set to graduate from the OHIO sports management program in 2005. While on campus, he was involved in the Sports Marketing Club, now SBA. According to Wade, Moorhead was known for his love of athletics and his altruistic nature.
"(He) was a friend to all, and will always be remembered for his kind heart," wrote Wade on the Race for a Reason registration website.
In the past, SBA carried on Moorhead's benevolence by fundraising for his scholarship each year at the B.A.M. 3 on 3 Basketball Tournament. Wade said SBA is excited to have another route to fundraise for the scholarship.
"Raising money to help people is something a lot of students believe in at OU, and this is just one way we can give back as students and members of the Athens community," he said.
Moorhead's story is one of eight reasons featured on the Race for a Reason website. New registrants can add their own reasons or contribute to one of the existing causes, adding an exciting, personal twist to Saturday's event, according to Pisching.
"It's great to see people taking part in something that moves them," she said.
For more information on the O'Bleness Health System Race for a Reason, visit http://www.sportsad.ohio.edu/events/raceforareason/.

subset: commoncrawl


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The EnGenius FreeStyl1 offers more coverage than any other consumer-rated cordless phone on the market: up to 25,000 square feet, 10 acres, and 6 floors of penetration. Expandable up to 9 handsets, FreeStyl1 can grow along with your business.
Packed with powerful phone features:
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Convenient calling features — include speakerphone on base and handsets, Call Waiting/Caller ID, call transfer, 4-line backlit display, 50-entry Call ID phone book, broadcast page, call hold, selectable ring/vibrate mode, selectable ring tones, 2.5mm headset jack, rapid charging, and more.
Digital Spread Spectrum Technology — allows you to make secure calls and talk in confidence.
Also Consider...


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Situated beside the Coosawattee River and the Blue Ridge mountains of North Georgia, the little town of Ellijay is a picturesque holiday destination. With forests, rivers and streams, it's a haven for lovers of nature and outdoor activities. Instead of a restricting hotel, consider renting a log cabin beside the river or by the creek. Not only will it save you money, but it will give you more freedom and independence. You will have the countryside on your doorstep, and you and your family will have space to relax in.
Ellijay is a delightful place to be at different times of the year. Plan your trip for April and you can go on a picturesque apple blossom tour; in October, the annual apple festival takes place. Golf enthusiasts will find several golf courses within a few miles of Ellijay, the nearest of which is at the White Path Golf Club. If you want to experience the thrill of whitewater rafting, head for the Ocoee Whitewater Center, which is half an hour's drive from Ellijay. Even if you're not feeling active, you can sit and take in the wonderful scenery. For a change, you could go to a wine tasting or visit Ellijay's fascinating antique shops. If you really feel like a day in the city, Atlanta is only an hour's drive away.
Be sure to visit Hillcrest Apple Orchard: your children will love the petting zoo and pony rides. There is also a playground, or you can go for a walk through the woods. Explore the Chattahoochee National Forest, where you can go hiking, cycling, horse riding, fishing, canoeing or kayaking. If you are visiting Ellijay in December, don't miss the Christmas Tree Festival in the library.
Ellijay is a delightful place to spend a holiday in, and renting a log cabin for your stay seems to suit the surroundings better than a hotel. You will feel at one with the rivers and mountains all around you, as well as saving money. Have a look at the rental properties we can offer, and see which one you think will suit you and your family best. We can assure you of excellent value, and we know your holiday in Ellijay will be a memorable one.
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That is one of the conclusions in my new paper, "Made on Earth: How Global Economic Integration Renders Trade Policy Obsolete."
For hundreds of years, trade policy has been premised on the assumptions that exports are good, imports are bad, and the interests of domestic producers are tantamount to the "national interest." Though that mercantilist worldview has never been accurate, its persistence as a pillar of trade policy into the 21st century is especially confounding given the emergence and proliferation of disaggregated production processes, transnational supply chains, and cross-border investment. Those trends have blurred any meaningful distinctions between "our" producers and "their" producers and speak to a long chain of interdependent economic interests between product conception and consumption.
Still, trade policy places the interests of domestic producers above all else even though the definition of a domestic producer is elusive and even though actions on behalf of producers often harm interests along the product continuum, which include engineers, designers, financiers, processors, assemblers, marketers, shippers, retailers, consumers, and others.
In 2008, foreign nameplate automobile producers, employing American workers, paying American taxes, and supporting American businesses, communities, and charities, accounted for almost half of all U.S. light vehicle production. The largest "U.S." steel producer, Arcelor-Mittal, is a majority-Indian-owned company with headquarters in Luxembourg and Hong Kong. The largest "German" producer, Thyssen-Krupp, is completing a $3.7 billion green-field investment in steel production facilities in Alabama, which will create an estimated 2,700 jobs in that state.
So, who are "we"? And who are "they"?
Are these foreign-named or –headquartered companies not "our" producers because some of the profits they earn are repatriated or invested in operations outside the United States? If so, then shouldn't we consider U.S. Steel Corporation, which earned 25 percent of its revenue last year on steel produced in Slovakia and Serbia, and General Motors, which has had success producing and selling cars in China, to be "their" producers? Why should U.S. Steel, General Motors, and the unions that organize workers at those companies dictate the parameters of U.S. trade policy, while Toyota, Thyssen and their non-union workers have no input? Why should trade policy reflect a bias in favor of producers—or worse, particular producers—at all? That bias hurts other interests—both foreign-based and domestic—in the supply chain.
Global commerce isn't a competition between "us" and "them." It is instead a competition between entities that defy national identification because of cross-border investment or because the final good or service comprises value added from many different countries. This reality demands openness in both directions, which flies in the face of conventional trade policy wisdom, which seeks to maximize access for domestic producers abroad while minimizing access for foreign producers at home.
It is only for simplicity's sake that a container full of iPods shipped from China and unloaded in Seattle registers as imports from China. But the fact is that only a few dollars of the $150 cost to produce an iPod is Chinese value-added. The rest is mostly value attributable to Japanese, Korean, Singaporean, Taiwanese, and American components and labor. Then iPods retail for about $300 and most of the mark-up accrues to Apple, which uses the profits to support innovation and higher paying jobs in the United States.
From a trade policy perspective, each iPod imported from China adds $150 to our bilateral deficit in "high tech" goods. It is regarded as a problem to solve. The temptation is to restrict.
But from a commercial perspective, each imported iPod supports U.S. economic activity up the value chain. Without access to lower-cost labor abroad—if rudimentary component manufacturing and assembly operations were required to take place in the United States—ideas hatched in American labs would be far less likely to make it beyond the white board. Much higher costs would make it far more difficult to create these ubiquitous devices that have, in turn, spawned new ideas and industries.
Essentially, the factory floor has broken through its walls and today spans borders and oceans, making Chinese and American labor complementary in this and many other industries. Yet, despite all of this integration, despite the reliance of producers in the United States and abroad on imported raw materials, components, and capital equipment, trade policy still pretends that access to the domestic market is a favor to grant or a privilege to revoke. Trade policy is officially ignorant of commercial reality.
Openness to trade in both directions is an imperative in the 21st century. Policies that do not try to channel incentives for the benefit of specific groups but rather provide the greatest opportunities for citizens to participate most effectively in our increasingly integrated global economy are the ones that will maximize economic growth and national welfare. People in other countries should be thought of more as customers, suppliers, and potential collaborators instead of competitive threats.
In the 21st century, instead of serving the exclusive interests of domestic producers, trade policy should be about welcoming investment and attracting and cultivating the human capital necessary to make the United States the location of choice for the world's highest value economic activities.


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Here are the basics for getting FFVII to run in newer versions of Windows (2000 and higher). You will need:
- The Microsoft Application Compatibility Toolkit. This can be installed at any time. After FFVII is installed, set ff7.exe to run in either Windows 95 or Windows 98 compatibility mode.
- The following patches, directly available on the Citadel's Downloads page: ff7betap1.exe or codecmaj.exe, and the Chocobo Patch. After FFVII is installed, simply run these patches and you should be good to go.
Square Enix has additional files and patches in case you need them, all of which are available here (just use your browser's search function and look for "Final Fantasy"; they should show up fairly quickly). In addition to ff7beta1.exe, these files include save games for use in skipping certain FMVs and patches specifically for laptops, and computers with Cyrix processors.
This support thread, by the way, is for the official retail version of FFVII PC, originally published by Eidos in multiple languages. Although the Citadel does not condone piracy of this game, at the same time I realize that it has long been out of print (and therefore, very difficult to find otherwise); however, from a technical standpoint, there are no guarantees that these will work using a pirated copy of the game.
If you are having additional problems, please list them below so that your fellow forum members can help you out. Of course, if you have any tips, additional patches, etc., those are welcome too Suggestions for enhancement patches, such as those that improve the graphics, music, etc., are also valid for this thread, but should be clearly marked as being optional. Discussion of FFVII for the PS1, whether or not it is related to emulation, is forbidden in this thread.
Finally, DO NOT PM ME ABOUT YOUR PROBLEMS WITH FFVII PC. Believe it or not, there are some issues that I can't help people with (especially if they involve any version of Windows that's newer than XP SP3). This thread was made so that anyone can offer help to those who need it.


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Error Failed Dependencies: libaudiofile.so.0 is needed by nxclient-3.4.0-7.i386 Installing NX Client
While looking for a light weight way to run XChat all the time without having to disconnect every time I shutdown my laptop I discovered NoMachine NX which is easy to install, configure, and use. It provides remote X sessions and is fairly reasonable in terms of bandwidth. When installing the NX Client on one of the CentOS servers I was installing this on I ran into an error complaining about libaudiofile. Below I describe the error in more detail, how I located the package to install, and show the package being installed.


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You are here
The USA Men's National 15s team took Romania apart 34-3 Saturday in Bucharest, showcasing a flair and open, attacking style that ran the Oaks ragged.
Chris Wyles collected 19 points on the day to take his test match total to
Early on the USA made their intentions clear, as they tested the Romanians sideline to sideline. In the opening minutes they looked impressive, working their way downfield and getting everyone, especially Biarritz star Taku Ngwenya, involved.
But that attack ended on an in-from-the-side penalty, and moments later Romania easily sliced through the USA line, with centers Csaba Gal and Ionel Cazan combined to race all the way down the field. The Eagle cover was there, though, and then the Americans defended their line desperately for a worrying few minutes. Eventually the inevitable penalty put Romania up 3-0, but more to the point, signaled to the USA that they were in a rugby game.
The Eagles responded very well after that, pinning Romania in their end and making the Oaks forwards run by shifting the point of contact around the field. Scrumhalf Mike Petri's quick service helped, and in addition, they brought Ngwenya in the line all over the field, giving the Romania defense plenty to think about.
That approach began to bear fruit. After a couple of big runs from Todd Clever and Ngwenya, A lovely long pass from flyhalf Toby L'Estrange and an equally good one from Chris Wyles found center Andrew Suniula on the wing. Suniula had Ngwenya with him, as the Oaks defense was painfully aware, but he didn't need any support and the big Chicago Griffin center powered over in the corner.
Wyles hit the conversion from the sideline and the USA led 7-3. It wasn't too long until it looked like it would be 12-3. The USA went wide again and Wyles and Ngwenya connected. But Ngwenya had to juggle the pass and even though he managed to gather the ball, he was held up in-goal – no try.
The forwards had their moments, too. Flanker John Quill surprised Romania with a long run. He linked with Scott LaValla, but the Romanian defense just stopped that one from becoming ugly for the hosts.
Still the Americans pressed, and eventually a nifty pass inside from Luke Hume put Paul Emerick right through the line and 22 meters later he was in at the corner. 12-3 USA.
At that point the Eagles realized they could really run on Romania. That, coupled with the fact that they weren't dropping the ball much, and thus not bogged down in a series of scrums, encouraged them to stretch their legs. Wyles added an easy penalty to make it 15-3 and keep up the pressure. Only silly USA penalties put the Oaks in any sort of attacking position.
In the end, the Eagles ended the half as they began it, in the Romanian 22. This time, though, they got points, as a free kick off a scrum infraction saw Todd Clever tap and run, and quick ball out to Emerick allowed the center to make a break before feeding Wyles, who broke through a rather high tackle to score in the corner. The fullback then belted over the touchline conversion. It was a snappy way to end the half – USA 22 Romania 3.
There was no letup in the second half by the Eagles. If anything, they opened things up even more. An attacking lineout almost saw Lou Stanfill lumber in from 15 meters. He was stopped, but the USA forwards were patient and after several phases setting up the attack, Petri send it wide left and Wyles ghosted in. 27-3 USA.
The big blot on the game was the many incidents of foul play that threatened to bring the game down into a brawl. It never did, and the yellow cards Romania probably deserved never materialized. We did see red, though, as John Quill and Vasile Rus were sent off after they got into a donnybrook that, on camera at least, appeared to involve Rus punching Quill in the face, and both teams rushing to continue the discussion. It was harsh for the USA given what they had tolerated.
Romania had opportunities after that, but seemed intent in baiting the Eagles into losing their composure. A few off-the-ball incidents earned a couple of stern talking-tos from referee Leighton Hodges. More to the point, the Oaks kept losing momentum, at one point seeing a penalty in the USA 22 reversed for foul play. That reversal hurt them greatly, because it set up a USA attack that finally got the ball to Ngwenya with some space. The USA wing toasted the defenders hoping to catch him, and he was in from 50 meters out.
Wyles hit the conversion, putting him above 100 test points with 101, just passing former SFGG star Grant Wells.
At this point USA Head Coach Mike Tolkin rang the changes. Roland Suniula came on for his brother Andrew. Robbie Shaw replaced Petri, and Derek Asbun replaced Chris Biller at hooker. In the past two games, the Eagles had struggled to keep their defensive communication together when making changes. This time, they looked better, keeping their physicality up and making the Oaks work for their territory.
Up by 31 points, the Eagles almost got more as Robbie Shaw pulled something out of his hat. The USA won a scrum under pressure, and Todd Clever was forced to flip a hard ball to Shaw. The scrumhalf danced away from one tackler, found a seam, and was away for a long run. He had LaValla on one side, but opted not to use the lock, choosing instead Paul Emerick on his left. But Emerick had a tackler right on him, and his desperate pass to support fell to Romanian hands. Even worse, Emerick pulled up lame and had to leave the game, bringing Zach Pangelinan on at fullback, and Chris Wyles up to play center.
But the key there was that the USA held it together. They played the game we knew they could, and executed superbly well. They went into hostile territory in Bucharest and torched a very capable Romanian side for five tries. Wyles was brilliant, kicking well and leading the attack. Several other players played well. But the most important news was the team commitment to an exciting game plan. Tolkin said he wanted to get after it, and said he wanted to involve dangerous players like Ngwenya, Hume, and Wyles more, and he did. The result, thanks to a committed performance by the forwards, was one of the USA's most impressive victories in years.
Tries: Wyles 2, A. Suniula, Emerick, Ngwenya
Convs: Wyles 3
Pens: Wyles
Romania 3
Pens: Filip
Romania: 1. Petru Tamba, 2. Otar Turashvili, 3. Mihaita Lazar, 4. Cosmin Ratiu, 5. Alin Coste, 6. Vasile Rus, 7. Mihai Macovei (C), 8. Ovidiu Tonita, 9. Florin Surugiu, 10. Andrei Filip, 11. Ionut Botezatu, 12. Csaba Gal, 13. Ionel Cazan, 14. Madalin Lemnaru, 15. Catalin Fercu.
Rezerve: 16. Andrei Radoi, 17. Horatiu Pungea, 18. Vlad Badalicescu, 19. Alexandru Manta, 20. Viorel Lucaci, 21. Grigoras Diaconescu, 22. Ionut Florea, 23. Constantin Gheara.
USA: 1. Shawn Pittman, 2. Chris Biller (Derek Asbun at 60), 3. Eric Fry, 4. Scott Lavalla, 5. Louis Stanfill (Graham Harriman at 75), 6. John Quill, 7. Peter Dahl (Inaki Basauri at 70), 8. Todd Clever (C), 9. Mike Petri (Robbie Shaw at 60), 10. Toby L'Estrange, 11. Luke Hume, 12. Andrew Suniula (Roalnd Suniula at 60), 13. Paul Emerick (Zach Pangelinan at 73), 14. Takudzwa Ngwenya, 15. Chris Wyles.
Rezerve: 16. Derek Asbun, 17. Nick Wallace, 18. Zachary Fenoglio, 19. Graham Harriman, 20. Inaki Basauri, 21. Robbie Shaw, 22. Roland Suniula, 23. Zachary Pangelinan.


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Category: Solar System
Status: Продано
Click on a picture, to see the products gallery..
Uranus Pendant made specialy for Solar System collection.
Beaded with many Swarovski crystals and elements, high quality japanese beads.
Unique, original design completely created by me
Technique - bead embroidery, bead weaving
Backside - leather
Size - 10 cm long
Chain - 50 cm


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Funny Signs – Amber Lamps
Webmasters Note: If I remember where I find these pictures, I will give you credit. If they're yours let me know and I'll make sure I credit you for them.
Also, to see the entire list I have so far, select Funny-De-Motivational from the Category drop down list.
40.365071 -76.745195


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Guiding Principles
Barnard's Events Management policies and procedures are designed to distribute space for events as fairly and efficiently as possible while keeping the College's core mission in mind. Events should strive to further faculty scholarship, research, and teaching; enhance students' academic and personal growth; support our vibrant culture of inclusion; strengthen our community as a whole; and increase our visibility in New York City and beyond.
To achieve these goals, all campus events will be evaluated based on the following criteria:
- Intellectual or academic 'fit' with the mission of the College;
- Potential for building or maintaining relationships with the College's neighbors and community partners.
Approval Process
The following constituencies are eligible to request space and related services for events at Barnard College:
- Governing Board at Barnard (GBB)-Recognized Clubs and Organizations which include groups recognized under the following governing boards: Club Sports, Community Impact (CI), ABC, IGB, SGB, and Sororities -- who have attended Club ReFUEL and with approval by a Student Organization Advisor.
- Barnard faculty, administrators, and staff planning college-sponsored or co-sponsored events.
All members of the Barnard community who wish to hold events on campus must make event requests online providing all event details including expected attendance and set-up needs. Depending on the nature of the event, an event review with Events Management and representatives from fulfillment departments (e.g. Public Safety, Facilities Services, Instructional Media and Technology Services) may be required to discuss the event details before the event is confirmed.
Faculty and staff event organizers must submit event requests a minimum of 14 days prior to the proposed event. We ask that designees for Recognized Clubs and Organizations submit event requests a minimum of 28 days prior to the proposed event for planning purposes. This allows time for the scheduling of space and resources. For events with no set-up or audiovisual needs, requests may be submitted up to three days prior to the event.
After submitting an event request, the event organizer will receive an e-mail regarding the status of the request. Events Management will evaluate the event request and determine the most appropriate event location based upon the availability of campus space and resources. Flexibility about location and date is helpful given the high volume of activity on campus throughout the academic year. After arrangements are finalized, the event organizer will receive an online event confirmation which includes the date, time, and location of the event as well as other related information (e.g. set-up description, list of audiovisual equipment, catering information).


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The '60 Minutes' breakdown
Jeff Fager, the CBS News chairman and executive producer of "60 Minutes," has said that his team spent "more than a year" reporting the story about the attack on Benghazi that aired on Oct. 27.
Yet it wasn't until Thursday night that they learned first-hand what their principal source, a security contractor named Dylan Davies, had told the Federal Bureau of Investigation about the attack.
Story Continued Below
In conversations with POLITICO, sources familiar with "60 Minutes" reporting said that it was only on Thursday night that "60 Minutes" obtained the official account of events that Davies had given to FBI officials after the 2012 raid — an account that contradicts the version of events he gave in a new book and in his interview with "60 Minutes" correspondent Lara Logan last month. Those contradictory accounts were the subject of New York Times report published late Thursday night.
( Also on POLITICO: CBS failure recalls Dan Rather in 2004)
The evolution of CBS's knowledge of the FBI report can be seen in the changing nature of their response to the controversy: On Wednesday, Lara Logan, the correspondent who interviewed Davies, defended the report. On Thursday night, "60 Minutes" announced that it had "learned of new information that undercuts the account told to us by Morgan Jones" (Davies' pseudonym). On Friday, both Logan and Fager issued full-throated apologies.
That "60 Minutes" could have conducted a year's worth of reporting without adequately vetting Davies or obtaining the FBI's report was the subject of much hand-wringing over at CBS News on Friday, according to sources that spoke with POLITICO. For some, it was also proof of a greater truth: that "60 Minutes" greatest asset — its longstanding reputation as one of the most reliable brands in television journalism — can also be its greatest liability.
"60 Minutes" exists in a silo at CBS News, often by choice, these sources said. Throughout their reporting, Lara Logan and the "60 Minutes" team did not seek assistance from their colleagues in CBS News's investigative unit, many of whom are well-sourced with the FBI and would likely have been able to assist in the vetting process.
( Also on POLITICO: Logan: We were wrong on Benghazi)
"The question folks are asking is: Did anybody at '60 Minutes' reach out to anybody outside of '60 Minutes' to vet this guy. The answer is 'no,'" one source with knowledge of the events said.
"Between John Miller, Chris Isham and Len Tepper you have three journalists who have about as good as sources as you could have at the FBI," one source said, referring to members of the CBS News investigative team. "Why weren't they asked, 'What does that FBI report say?'"
Over the last year, "60 Minutes" has also become freer from CBS News's editorial oversight. Until the beginning of 2013, the show's high-profile news packages were overseen by a senior network vice president responsible for standards. Since the departure of Linda Mason in January, that position has become effectively non-existent. Al Ortiz, who replaced Mason, was not given the same editorial control. He was not consulted for the program's package on Benghazi, sources said.
Kevin Tedesco, the spokesperson for "60 Minutes," declined POLITICO's request for an interview regarding the error and both Tedesco and Sonya McNair, the senior vice president for communications at CBS News, declined to say when the network learned about the FBI account.
( Earlier on POLITICO: 60 Minutes probes source)
Instead, Tedesco forwarded a press release from Friday morning announcing Logan's apology, which took place on "CBS This Morning." In that apology, Logan said, "We take the vetting of sources and stories very seriously at '60 Minutes' and we took it seriously in this case. But we were misled and we were wrong, and that's the important thing." She added: "We have to set the record straight and take responsibility."
Logan is also scheduled to deliver another brief apology on the Friday edition of the CBS Evening News, during which the network will tease a longer apology that is set to air on Sunday's edition of "60 Minutes," POLITICO has learned.
Fager, the "60 Minutes" EP and CBS News chairman, also apologized in an interview with Variety on Friday afternoon.
"We like to think we are perfect as much as we can be. In this case, we were not," he said. "The most important thing now is that we own it: We made a mistake. We are sorry."


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Julie Salverson
Atomic Quest
As a sixteen-year-old growing up in Toronto, Julie Salverson was obsessed with the threat of atomic war. Fearing a nuclear holocaust, she'd scan the night skies for signs of invading bombers, research emergency evacuation routes and plan survival shelters. Later, as a young, post-Queen's Drama graduate in Vancouver, she looked into the organization of the city's emergency planning infrastructure – just in case.
Today, Salverson is a professor of drama and cultural studies at Queen's, an author and playwright. In some of her work, Salverson uses theatre with groups and communities who have suffered from violence or violation – such as refugees and people living in poverty – as a vocabulary for analysis, education, activism and healing. Her experience in this community-based practice informs her scholarship. She has written extensively about the role of the witness – in ethical relationships that don't reduce people to victims or heroes – and the role of the artist – as a storyteller who challenges readers and audiences politically and aesthetically.
"Everyone has a story to tell," says Salverson. "When you tell it in a collaborative kind of way, you can learn about your own situation, personally and socially. But in a group, it's not only the telling of stories that happens – it's having a listener, and being a witness. And it's an analysis of those stories, an investigation into a possible future that might be better than you think."
In her most recent project – the latest in a line of award-winning essays, plays and videos – Salverson has penned the libretto for an innovative opera inspired by a little-known aspect of Canada's connection to the atomic bombs dropped on Hiroshima and Nagasaki in 1945.
"Everyone has a story to tell," says Salverson. "When you tell it in a collaborative kind of way, you can learn about your own situation, personally and socially. But in a group, it's not only the telling of stories that happens – it's having a listener, and being a witness."
The opera is the culmination of more than a decade's worth of in-depth investigation into the story of the atomic bomb and Déline, a tiny Dene community on the western shore of Great Bear Lake in the Northwest Territories. During the closing months of the Second World War, many Déline men found employment ferrying sacks of uranium ore, mined at nearby Port Radium, on boats across the lake. From the opposite shore the ore was transported into Alberta and then to Port Hope, Ontario, where it was refined into the uranium that would be used in the Manhattan Project and war-ending atomic bombs used in Japan.
The people of Déline who carried the sacks on their backs and in their boats were never told about the nature of their cargo or its ultimate destination. Nor were the white miners who worked underground. Over the years, there would be many deaths from cancer and all manner of unexplained illness – but no government explanations or apology. When the Dene finally did learn of their fateful connection to the bomb, the Déline folk wasted no time in sending a delegation to Japan to deliver their own apology to the survivors of the blasts.
Salverson first learned of these events in 2001, and has travelled to Déline and – with colleague Peter van Wyck of Corcordia University, who has written extensively on the subject – to New Mexico to follow the uranium trail that led to the birth of the Atomic Age. She also travelled to Japan and met some of the same people who accompanied the Dene visit in 1998. Her deeply personal journey has spawned an equally personal book entitled Lines of Flight: An Atomic Memoir.
Salverson's opera, entitled Shelter, interprets these events through the story of a husband and wife who give birth to a radioactive daughter and try to hide her from the world. The opera is interesting not only for its premise, but for how it's presented: Salverson has chosen to use a theatrical form called "clown" – which is not to say that the characters are wearing big red noses and goofy costumes. Rather, clown simply employs absurdist humour to reveal truths, perhaps uncomfortable ones, about life. It doesn't make fun or light of its subject matter, but it helps audiences explore it from a different, perhaps less threatening or preachy, perspective. "In clown work you can look at absolutely dreadful things, but you're surprised by what you see, so you can look at it in a fresh way," explains Salverson. "I think there's a humanity that can come through."
Salverson uses the clown approach in her drama classes at Queen's and at the Royal Military College of Canada. Last November, at the Queen's RMC-sponsored Canadian Military and Veteran Health Research Forum, her Queen's drama students presented a piece they wrote based on soldier testimonies collected by Canadian military nurse Susan Ray. "It got a lot of people talking to each other, not just the presenter talking to the room," says Salverson. "That's the object of the whole exercise."
Shelter premiered with Edmonton Opera/Tapestry New Opera Works in November, 2012.
Profile by Alec Ross
(e)Affect Issue 2, Fall 2012
Learn more about:
Julie Salverson's research


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While the entire country will celebrate Independence Day later this week, residents of Hays and the surrounding area know this is the time of year for the biggest festival in northwest Kansas.
The 19th annual Wild West Festival kicks off Wednesday with its traditionally strong lineup of music, rides, food and entertainment for the whole family. And since there are fireworks bans in place throughout all of Ellis County, the WWF aerial pyrotechnics not only will be the biggest show in town -- it will be the only show in town. Ensure you have a good view of the sky for the fireworks that begin at 10 p.m. Thursday.
Hays Municipal Park on south Main Street will be the place to be for live music starting Wednesday. The headline act will be Love and Theft, an American Country Music Award-nominated duo. Warming up for them will be Dustin Lynch, preceded by Kansas farm boy Rusty Rierson and Forever Young.
On Friday, Sister Whiskey will get the audience rocking first. With band members from Russell, Liebenthal, Sylvan Grove and Salina, Sister Whiskey starts at 6 p.m. Following them will be the Cleverly Family, picking their way to Hays from the Ozark Mountains. Capping off the eclectic lineup will be headliner Neal McCoy, who makes regular appearances in country music's top 10 songs and albums.
Onstage Saturday will be The District, followed by another Kansas band -- Homebrew. Homebrew is a quartet of rockers from Great Bend. The finale act will be none other than the Little River Band. The Australian band was huge during the 1970s and '80s, and remains solidly booked in venues throughout the world. If "Reminiscing," "Lonesome Loser," "Help Is on Its Way" or "It's a Long Way There" don't automatically register in your head, they will once you hear them. The vocal group is a mainstay on the radio to this day.
Of course, there is more to the Wild West Festival than music. Kids of all ages will be seen at the Heart of America Carnival set up west of the concert stage. The carnival runs from 6 to 10 p.m. all four nights.
Wild Bill Hickok will be making frequent appearances at the Ellis County Historical Museum in the form of historical interpreter Dave Wood. Kids 15 and younger can swim for free at the Hays Aquatic Park from noon to 7 p.m. Thursday. There will be a baseball tournament at Larks Park, a soccer tournament at Bickle-Schmidt Sports Complex, a 5K Run/Walk and the Ellis County Ministerial Alliance's Swingin' for Support golf tournament.
And don't forget the parade on Main Street starting at 10 a.m. Saturday. "Get Your Wild West Fest On" will be grand marshalled by Keith Eilts, this year's All-American Citizen. Eilts, who has decades of service as a local Boy Scout leader, also will be honored with special recognition Saturday night at the concert.
In short, there's something for everyone at the annual Wild West Festival. For more details, see the insert inside today's paper or visit www.wildwestfestival.com.
Editorial by Patrick Lowry


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Talia Balsam doesn't see marriage in ex-husband George Clooney's future.
"You'd have to ask him that, but I doubt it," she tells reporters during Tuesday's Hermès Men's Store opening held in NYC. "It doesn't look that way."
If he were to tie the knot with Italian TV presenter Elisabetta Canalis, whom he has been squiring since mid-2009, she "doesn't know" why he would make a good husband even though they remain on friendly terms.
For the Mad Men actress, 50, who has been married to co-star John Slattery since 1998, calling the Oscar winner her mate from 1989-1993 was less than glamorous. During that time, George's most prestigious acting roles included guest stints on Roseanne and Sisters.
He was also down on his luck, having been dismissed from Baby Talk in 1991.
"I've been fired off a lot of TV shows over the years," George, 48, has said. "I like when they pick up a show, and they go 'hey, the show's picked up' and then they replace you. I did this show called Baby Talk, which was the sitcom of Look Who's Talking, and Ed Weinberger, who was the producer – he and I didn't get along. Eventually, I'm not sure if I was fired or quit from that one."
He told OK!, "Fame was sort of an overnight thing for me after 12 years of doing really bad television."
In 2009, Talia admitted she and George maintain a friendship.
"We don't hang out with our exes and presents, but we are totally cordial," she told OK!. "John's worked with him many times. We both did K Street, so we've worked together, but we don't have a daily conversation."
Still, Talia isn't picking favorites and rooting for her ex in the best picture category during the Academy Awards – even though George's movie Up in the Air is in the running.
"I feel like I haven't caught up yet," she says. "I know what I like, but I haven't seen everything yet. There's a lot of good stuff out there."


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|Dave Bowden speaking at IFLAS
Dave Bowden is a selfish man.
He runs a social enterprise company, Cumbria Recycling, which prevents thousands of electrical goods from going into landfill each year.
Many of these items are resold at affordable prices in the local community. Dave has provided employment and support for people who had previously been unable to find work.
And when they're having financial problems Dave has been known to help them out from his own pocket.
But he does it all for selfish reasons; he finds running a social enterprise good fun, and he says it makes him feel good.
Speaking as part of the IFLAS open lecture series to an audience of members of the local business community and Leadership and Sustainability MBA students from the University of Cumbria and Robert Kennedy College, Dave explained how he became involved with the company, and how it changed his perceptions of social enterprise.
Dave's first career was in the newspaper business - starting out as a distribution driver, he worked his way up to become a managing director within the Carlisle-based CN Group.
He retired six years ago, took a week off, and then started his new role as MD of Cumbria Recycling.
He said: "When I heard that Cumbria Recycling was a social enterprise, my heart sank. I had rather a dim view of what social enterprise was.
"I thought they soaked up grant funding, and had good objectives but weren't sustainable once the funding had run out. I was very wrong.
"In the first few days there was nothing to change my perceptions. I thought the company faced a genuine struggle to survive and that I would be there for six weeks. But having written a business plan, I was happy to stay on. I fancied the challenge."
Dave brought all of his business experience to bear in his approach to running Cumbria Recycling. The company was started with a £50,000 loan (since repaid) and now makes a healthy profit, with income streams including a major council contract, supported by manufacturer funding for collection and processing of electrical equipment and a local retail operation.
He said: "Doing good within the community is fine but it's only sustainable if there's a strong commercial model. It's no different to any other successful business."
Cumbria Recycling holds the contract to collect discarded electrical goods from Cumbria County Council's recycling sites.
Old-style cathode ray tube TVs are tested, repaired and then exported through approved companies overseas for resale. Cumbria Recycling works with carefully-chosen partners to ensure that they are sold for reuse and not simply to be stripped of their re-sellable materials.
Washing machines, tumble dryers, dishwashers, laptop computers, flat screen TVs and other items are tested and repaired before being resold in the company's own retail outlet in Workington.
Sales staff have discretion to negotiate prices with customers and the company even offers a mobile repair service.
The job has opened Dave's eyes to the extent of our throw-away culture. An astonishing number of electrical items recovered by Cumbria Recycling are in perfect working order - thrown away because the owner decided it was time for an upgrade. Others end up on the scrapheap when only minor repairs are needed. On one occasion the company received a 'broken' £800 washing machine that was repaired with a part costing £4.
Items that are beyond repair are sold to other specialist recyclers who recover the precious metals, steel and plastic for reuse.
The end result is the total elimination of electrical goods going to landfill and a steady supply of affordable, safe second hand goods on the resale market.
Staff at the company – many of whom Dave has helped to overcome problems in their personal lives – all receive 25 per cent of the profits on top of their salaries.
Dave said: "People like me who have retired should come into a business like this.
"I'm proud to be called a social entrepreneur, something I would never have dreamed of. Six weeks has turned into six years and I don't know if I'm ever going to leave, because I'm having so much fun."
Helping the planet; supporting the community; promoting sustainability: the world needs more people as selfish as Dave Bowden.
- To find out more about courses offered by IFLAS, including the new Postgraduate Certificate in Sustainable Leadership, visit www.iflas.info


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Okay, so the 15th snuck up on me…and I'm supposed to have a cupcake recipe completed by today. Well, this little person has all my days (and nights) blending together!!
So, these cupcakes for this months MS challenge sound good and I really want to give them a shot – so hopefully he'll give me a chance to get to my kitchen today…if not I'll have to wait until my dear husband gets home and maybe this evening I'll be able to make them up!


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veloPOLAR™ antiFOG
Sort By
The most stylish, sport semi-rim out there, the Seventh has a flat top to give it a more casual appearance than its more aggressive-looking peers. And it does this without sacrificing the performance benefits that make semi rims so popular for athletic endeavours. In fact, the Seventh performs better than many frames out there because of its fully-adjustable, hydrophilic nose pads and temple tips that allow you to custom fit the frame to suit your face, your helmet and the desired amount of airflow behind the lens.
veloPOLAR™ antiFOG
The most stylish, sport semi-rim out there, the Seventh has a flat top to give it a more casual appearance than its more aggressive-looking peers. And it does this without sacrificing the performance benefits that make semi rims so popular for athletic endeavours. In fact, the Seventh performs better than many frames out there because of its fully-adjustable, hydrophilic nose pads and temple tips that allow you to custom fit the frame to suit your face, your helmet and the desired amount of airflow behind the lens.
Specs and Measurements
- Fit
- Medium-Large
- Weight
- 30 g
- Base Curve
Fit GuideFind the best fit
veloPOLAR™ antiFOG Light Grey
veloPOLAR™ antiFOG
RYDERS veloPOLAR™ has been developed specifically for road cyclists. In contrast, traditional polarized lenses can hide slippery surfaces, black out LCD screens on cycling computers, and produce undesirable optical anomalies that alter depth perception on features like sewer covers, windshields and road patches. Some road cyclists aren't bothered by these side effects, but others find them to be very problematic. It's for this reason that we've developed our veloPOLAR™ lens—a lens that's fine-tuned to give road cyclists the benefits of polarized technology without the compromises, allowing it to filter out the blinding part of the glare without hiding a slippery surface or blacking out an LCD screen. It even minimizes optical anomalies and utilizes our antiFOG and hydrophobic coatings.
- road
Lens Features
100% UV400 Protection
All of our lenses block 100% of UVA, UVB, and UVC rays and harmful, high energy light to 400nm. These rays are a leading cause of cataracts, skin cancer and wrinkles around the eyes—all great reasons to block them out.
Hydrophobic + Oleophobic Coating
An altogether misleading name, this coating isn't nearly as scared of water as water is of the coating. In fact, water runs away at first contact, leaving clear lines of sight that are free from droplets and water marks. The Oleophobic characteristics repel dirt and grease, making the lenses very easy to clean.
Impact Resistant
All of our lenses are impact resistant, meaning they resist breaking up into dangerous little shards when impacted. If astronauts trust this material to keep their heads from exploding while on a 17,000 mph space walk, you'll have nothing to worry about on your adventures, no matter how fast you're going.
Optically Correct
All of our lenses are made by injecting molten polycarbonate into a mold that is specially formed to eliminate distortion. This process makes the lenses optically correct (also referred to as decentred), increasing long-term comfort and minimizing eye fatigue.
Scratch-Resistant Coating
We apply a scratch-resistant coating to all of our lenses. Though this process makes the surface of the lens considerably harder than the base lens material, it's impossible to make the lenses completely scratch proof (short of making them from diamonds) so please care for them properly as they may still scratch under certain conditions.
Frame Technology
Adjustable Nose Pads + Temple Tips
Adjustable nose pads and temple tips allow you to customize the fit of your eyewear for comfort and stability. These components are also used for fine-tuning the amount of airflow behind the lens to keep your face cool and combat fogging.
Grilamid TR90
A Swiss technology, this incredible thermoplastic is the material used in all of our sunglasses (with the exception of our metal frames). Its extreme flexibility, durability and light weight make it the perfect material for performance eyewear.
Hydrophilic Nose Pads + Temple Tips
Hydrophilic [anti-slip] nose pads are an important feature to look for in performance eyewear. Hydrophilic temple tips give that extra little bit of grip that can come in handy in many situations. The material we use to make these features is so effective that it actually grips better when it's wet — exactly when it's needed.
Go to guiding pair5 out of 5
steve reid (verified owner) –
As a full time bike guide i need good eyewear that doesn't break the bank. and the photochromic lense is a game changer – you just throw the glasses on and they're perfect all day, whether you're in and out of trees, or the weather takes a turn. flawless. great fit, too.
Go to riding glasses5 out of 5
Shaun Fry –
I've got the Seventh Photo anti-fog. Love the glasses, the photochromic means I don't need to worry if its sunny or rainy, grab them and go. great fit with the flexible arms, ive never had them slip off my face or helmet. highly recommended!
Versatile Glasses for all conditions5 out of 5
Anna –
My favourite thinG about my seventh glasses is the dependability of my anti-fog LENSES! i've worn my glasses in all sorts of weather, from scorching, sweaty days, to damp and rainy conditions. The anti-fog has never let me down. the adjustable nose piece ensures the glasses stay in place and the light, sleek design makes it easy to forget you're even wearing them at all.
Love them
Carlos –
I have the anti-fog/Photochromatic. Light grey lenses and black frame. I use them for cycling. the lenses adjust quickly to outdoor and indoor light changes. Sometimes I forget I have them on inside and outdoors. The fit is very good & secure. I think these would be great for almost all outdoor sports like running, cycling, etc. You might want darker for snow sports or water sports but they would be good for those also. Also don't be afraid to try the color lenses like Yellow, rose, etc. It takes a little getting use to but the contrast of colored lenses make objects appear more vivid, distinct and slightly easier to see.
Amazing in all light and perfect for beach vball and ski touring alike5 out of 5
Js (verified owner) –
I just hope they don't stop making these or I'm screwed. It's the only sunglasses that don't get fogged and work on both cloud and full sun for beach vball. No blind spots either. I probably should order a backup pair.


text: About Liquid Repelling Treatment Rust-Oleum® NeverWet® is a two-step product system designed to create a moisture repelling barrier on a variety of surfaces. It is suitable for use on metal, wood, aluminium, galvanised metal, PVC, concrete, masonry, asphalt, vinyl siding, fibreglass, canvas, most plastics and more. Dries fast — 30 minutes to touch Dries to a flat finish Durable formulation, ideal for indoor/outdoor conditions Not intended to be applied to electronic devices or clothing


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Zerto, based in Boston and Herzliya, Israel, in April got a C round of funding worth $13 million to help deliver its solution for enterprise data replication and recovery designed specifically for virtualized infrastructures and the cloud. The company, founded in 2009, raised more than $21 million in previous funding rounds.
The Zerto Cloud Disaster Recovery Ecosystem includes more than 100 cloud providers that use Zerto Virtual Replication to power their cloud disaster recovery offerings for helping businesses protect production applications both to the cloud and in the cloud.
The new investment is targeted at helping Zerto accelerate its go-to-market strategy for its hypervisor-based replication solution for enterprises and cloud service providers and for expanding its development and cloud product teams and its sales and marketing operations.


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LetterMpress gives you the experience of producing your designs on a letterpress -- placing and arranging type on the press bed, inking, and then turning the hand crank to make a print.
Every step in the printing process is replicated on the Mac, to give you an authentic, interactive experience.
Try something new. Experiment. Have fun! You'll soon see why the art and craft of letterpress is becoming so popular.
LetterMpress is easy to learn and fun to do, but
What's New in LetterMpress
- 5 additional typefaces: Caslon, Devinne, Fanfare, German Gothic, Hebrew Sans.
- Fanfare and German Gothic include German characters like eszett and standalone diacritics like acute, grave, circumflex, and umlaut.
- Hebrew Sans represents a complete basic set of the Hebrew alphabet.
- 14 new pieces of art including linocuts created by artist Lisa


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The Conservation Board does not generate a formal agenda for its meetings; rather it typically reviews for comment the applications before the next Planning Board and those applications before the next Town Board and Zoning Board of Appeals that may be environmentally sensitive. Their meetings are open to the public and are conducted in a more informal manner than the public hearing format of the Town Board, Zoning Board, and Planning Board. For further information, and to verify that meeting is being held, contact Lori Stid @ 223-0770.
Click here for meeting schedule and to determine if meeting is being held


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Will Arnett, Elizabeth Banks, Morgan Freeman and Chris Pratt and will lend their vocal talents to the LEGO® world, starring as characters in the upcoming original 3D animated LEGO feature, currently in production.
The film, the first-ever full length theatrical LEGO movie, follows Emmet, an ordinary, rules-following, perfectly average LEGO minifigure who is mistakenly identified as the most extraordinary person and the key to saving the world. He is drafted into a fellowship of strangers on an epic quest to stop an evil tyrant, a journey for which Emmet is hopelessly and hilariously underprepared.
Chris Pratt ("Moneyball") stars as Emmet. Oscar winner Morgan Freeman ("Million Dollar Baby") and Elizabeth Banks ("The Hunger Games," Emmy nominee for "30 Rock"), will star as two of Emmet's fellow travelers: Vitruvius, an old mystic; and tough-as-nails Lucy, who mistakes Emmet for the savior of the world and guides him on his quest. She also calls upon the mysterious Batman, a LEGO® figure voiced by Will Arnett (Emmy nominee, "30 Rock"), a brooding hero with whom she shares a history.
The 3D computer animated adventure will open nationwide on February 28, 2014.
Phil Lord & Christopher Miller ("21 Jump Street," Golden Globe nominee "Cloudy with a Chance of Meatballs") are directing from their original screenplay, story by Dan Hageman & Kevin Hageman and Phil Lord & Christopher Miller, based on LEGO construction toys. The film will incorporate some of the most popular LEGO figures while introducing several new characters, inviting fans who have enjoyed the brand's innovative toys and hugely popular video games for generations to experience their visually unique LEGO world as never seen before.
The film will be produced by Dan Lin ("Sherlock Holmes," "Sherlock Holmes: A Game of Shadows") and Roy Lee ("The Departed," "How to Train Your Dragon"). It will be distributed by Warner Bros. Pictures, a Warner Bros. Entertainment Company.
LEGO, its logo, brick & knob configuration and the Minifigure are trademarks of The LEGO Group. ©2012 The LEGO Group. All rights reserved.
For more information, please contact:
Stephanie Phillips, Warner Bros. Pictures
818 954-2351


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Rice Salads Recipes
French Rice Salad Recipe
Salade de riz aux légumes is my attempt to serve my family healthy food that doesn't sacrifice flavor. As you may have noticed, I have a tendency to make food that is a bit rich. We're all trying to workout more and get into good shape, and while I won't ever give up butter and cream, I've learned that I don't have to put it in every dish.
The rice salad is made with a blend of both brown and white rice for a balanced texture. I also added a mix of vegetables that are available this time of the season (the zucchini and squash are from our garden). I used fresh steamed corn, roasted bell peppers, diced tomatoes, grilled eggplant, edamame and tofurkey.
Since there is no cheese involved, I was afraid the rice salad would lack flavor, so I made spicy vinaigrette. Since I still need "real" protein besides the edamame beans and tofurkey, I added smoked turkey in a separate batch. Everyone enjoyed it, myself included!
Full Recipe...


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Jimmie Johnson's title chase ends with wreck in Phoenix
AVONDALE, Ariz. (AP) - Jimmie Johnson's bid for a record eighth NASCAR championship is over.
Needing a win at Phoenix to make the final four in next weekend's championship finale, Johnson saw his hopes crumple with a blown tire that sent his No. 48 Chevrolet into the wall with one lap remaining in the second stage Sunday.
The crash eliminated the reigning and seven-time NASCAR champion from title contention.
Chase Elliott, left, and Jimmie Johnson talk inside the garage area before practice for the NASCAR Cup Series auto race at Phoenix International Raceway, Friday, Nov. 10, 2017, in Avondale, Ariz. Both drivers are looking to fill the final spot for the Championship 4. (AP Photo/Ralph Freso)
"I'm disappointed for sure," Johnson said. "The last couple of months we've been staying alive and at this stage with the Round of 8 and then the Round of 4, you can't just stay alive. You've got to be hitting on all cylinders and we just haven't been there, unfortunately."
It's been a rough ride for Johnson since matching Hall of Famers Richard Petty and Dale Earnhardt with his seventh title a year ago.
Johnson won three races this year, but those came during the first third of the season. He hasn't won since Dover in June and has one top-five finish the last 21 races.
Johnson came to Phoenix last among the eight title contenders, 51 points out of mathematically qualifying. Martin Truex Jr, Kyle Busch and Kevin Harvick already locked into next weekend's championship finale next weekend at Homestead-Miami Speedway, leaving Johnson among five drivers fighting for one spot.
A four-time winner at Phoenix, Johnson started 12th and earned a point by finishing eighth in the first stage. He was running 11th when his right front tired blew right before the caution at the end of the race's second stage.
Johnson drove the car straight to the garage, his day and championship hopes over.
"I didn't know it was coming," Johnson said. "Clearly just got the brakes too hot and popped that tire with like a lap to go or two laps to go before the stage was up. We weren't leading, we were having a decent day, but we were going to need a great day today. I wish we were still out on track to still have a shot for it."
Now Johnson is left with trying to win at Homestead next week and spend the offseason trying to figure out what went wrong during his title defense.
More AP Auto Racing: http://racing.ap.org/
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This trip was completely impromptu, so we did most of our packing in about 20 minutes. Naturally, I managed to pack a suit case full of clothing ( and ended up wearing probably about 1/3 ), Emil however went on a 3-day Vegas trip with a pair of jeans and a shirt:) Yeah! I kid you not! So, once we got to Vegas we had to buy a few things for him:) Initially, we were shopping just for him, but as it happens very often, I can't seem to go to Nordstrom without finding something I love:) Case in point, the Michele watch I am sporting in this post. So elegant and feminine, I just love the mother-of-pearl dial and the changeable strap. I decided to go with a patent leather one, but I am thinking of getting the double wrap strap in the future as well. Perhaps, I'll get it next time we are shopping for Emil:)
MICHELE Deco Diamond dial watch { similar here } & patent leather strap { also love this double wrap strap in white } | Jimmy Choo Typhoon ankle strap pumps | Rebecca Taylor novelty texture top, pant with zippers & tweed and lace moto jacket { also here, here & here } | Chanel Boy flap bag | Nordstrom nail polish in "Lilac" & Essie nail polish in 'Play Date"
Thank you for reading
& Keep On Smiling,


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Disposable Deli Sleeves
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Mop Caps - disposable hair nets
Disposable Overalls 35gsm
50gsm Disposable coverall
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Find the Best EHR EMR Software (185 Vendors)
Get free recommendations and price quotes. Answer below.
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State of Electronic Medical Record Software Adoption
According to a 2016 release of the National Electronic Health Records Survey, 87 percent of office-based physicians have adopted electronic health records software, more than half a decade after the implementation of the American Recovery and Reinvestment Act and the accompanying HITECH Act of 2009. The purpose of the HITECH Act was to spur the adoption of not just electronic health records, but of healthcare IT in general. The reasons for this are tied to lowering the price difference between the U.S. healthcare system and her peers in other developed countries. The U.S. healthcare system now eats up 17.8 percent of the country's gross domestic product, or an estimated $3.2 trillion.
While these statistics may not be new to the healthcare community, they're still at the forefront of the push for health IT and medical software adoption. CMS's EHR adoption rates are promising, but examining Meaningful Use attestation numbers by specialty leaves much to be desired. Based on recently released numbers of eligible providers who have received Medicare payments, specialties lag behind primary care, family care, and internal medicine.
There's conflicting research on the effectiveness of EHR software, and some studies have found that new types of medical errors may emerge from improper EHR implementation and use. However, a study published in the Journal of Internal Medicine found that in 56 percent of cases EHR usage correlated with significant improvement in at least four healthcare measures.
The general consensus around EHRs in the US remains that implementation for on-premise software remains costly and negatively affects productivity for a certain period of time, but that if the EHR software is configured correctly, it can significantly improve the prevention of medical errors. Cloud-based EHR can offer even greater versatility without the massive upfront cost burden.
This guide examines the most common tools used during Meaningful Use attestation and explores how they contribute to improving quality of care. Additionally, it will provide an overview of what the best EHR software providers include in their offerings today.
- Which EHR EMR solution is right for your practice?
- Find out now
Common Electronic Health Records Software Tools
Computerized Physician Order Entry (CPOE)
CPOE is an EHR function that allows medical professionals to directly enter medical instructions and treatment orders. Physicians can enter orders at the point of care or off-site and those orders are then transmitted to the proper departments for execution or fulfilling (pharmacy, laboratory, and radiology). CPOE helps prevent prescribing errors, which are the largest identifiable source of preventable hospital medical errors. CPOE can check problem lists as well as medication lists in order to make sure that physicians aren't prescribing harmful substances to patients.
Evidence from an early, monumental study by the Harvard School of Public Health suggests that CPOE can reduce adverse drug events by up to 80 percent, while reducing serious medication errors by 55 percent. More current studies have found mixed results, though mostly positive. A 2014 meta-analysis published in the National Center for Biotechnology Information found that, in hospital settings, CPOEs were responsible for 50 percent fewer preventable adverse drug events.
Because treating ailing patients often requires medication, CPOE has become standard fare in many EMR vendors. This feature enables physicians to place pharmacy, laboratory, and radiology orders at the point of care. The electronic medical records software then pushes those orders to the appropriate departments or pharmacies for execution.
CPOE helps physicians avoid common medical errors associated with paper records. Working in conjunction with clinical decision support systems, CPOE can scan a patient's problem list as well as their medication list to ensure that the correct medication is assigned, that unnecessary treatments aren't performed, or that dangerous doses of necessary medication aren't administered.
State of Use
According to CMS data, 83 percent of the eligible professionals who successfully performed core objectives between 2011 and 2013 used CPOE to order medications. Over 90 percent of pharmacies are set up to receive electronic orders from CPOE systems.
Meaningful Use Stage 2 Requirements
To comply with Stage 2 requirements, eligible providers must use CPOE to place at least 60 percent of their medication orders, 30 percent of their laboratory tests, and 30 percent of radiology tests.
Evidence of Benefits
A 2008 Massachusetts Technology Collaborative and New England Healthcare Institute study showed that one in 10 patients admitted to MA community hospitals suffered preventable medical errors. The researchers estimated that MA hospitals could prevent 55,000 adverse drug events and save $170 million a year by fully implementing CPOE.
A study published in the Journal of American Informatics Association found that when prescription drug orders were processed through a CPOE system, the likelihood of error decreased by 48 percent.
The introduction of new technology can also introduce new types of errors and in some cases actually make entry time slower. Also, in emergency situations, CPOE is slower than person-to-person communication. Physicians should also be aware of alert fatigue, a term describing the tendency of physicians to ignore some alerts when presented with excessive numbers of them.
Patient Portals
Patient portals are online applications that allow patients to access their electronic medical records and interact with their healthcare providers. Patient Portals are usually standalone applications that integrate into the existing site of a healthcare provider, but they can also exist as modules that come included with EHRs. Some allow patients to register for office visits and complete check-ups as well as request prescription refills online, order eyeglasses, contact lenses, access medical records, pay bills, review lab results, and schedule medical appointments. Patients can also connect directly with providers by leaving comments, asking questions, or sending messages.
The financial benefit of patient portals has yet to be demonstrated. However, patient portals are an excellent medium for physicians to increase patient engagement, and boost patient retention.
Vanderbilt University's patient portal, My Health at Vanderbilt, has seen patient enrollment increase from 22,000 in 2006 to over 200,000 in 2013.
The manager of Vanderbilt University Medical Center, Anne Dixon, RHIA, listed the following benefits of employing a patient portal:
- patient retention
- increase in new patients and referrals
- employee retention
- improved patient outcomes
- increased connectivity with their care teams
Patient portals typically only connect to one healthcare provider, meaning that patients with multiple providers will likely have to access separate portals. Compliance with HIPAA regulations are also a risk factor in employing patient portals, but any reputable vendor will be able to ensure compliance with federal privacy standards.
Meaningful Use:
Stage 2 requires that at least 5 percent of patients view, download, or transmit their electronic health records through a patient portal. Providers have expressed doubt regarding their capability to drive that level of patient engagement with patient portals, but the previously cited Vanderbilt use case highlights that patients generally react positively to patient portals.
State of Use:
A Health Affairs study of personal health records found that 64 percent of physicians said they had no experience using these tools to communicate with patients. 42 percent of respondents said they would be willing to use personal health records in their practices, while 24 percent disagreed, and 34 percent were neutral. However, a 2012 KLAS study found that 57% of providers had already implemented patient portals.
Accenture conducted a survey in 2013 regarding the state of access patients had to their health records. The study spanned 9 countries, but Accenture found that roughly 36% of American patients had complete access to their health records in electronic form. This same study also found that 41% of patients would switch providers to have more complete access to their health history.
Clinical Decision Support (CDS)
Clinical decision support systems serve as quality checks that help physicians avoid adverse events due to prescription errors. They can be standalone applications or can be embedded within a CPOE.
CDS systems fall into two main categories: knowledge based and non-knowledge based. Knowledge based CDS systems follow logical IF-THEN scenarios,or rules, which reference patients' medication lists and problem lists to determine whether a physician's recommended treatment conflicts with a medication the patient is currently taking. Non-knowledge based CDS systems rely on machine learning that allows the program to adjust its recommendations based on past experiences. Non-knowledge based CDS systems can identify treatment patterns and reference best practices and current search to make recommendations that support a physician's decision making process. In theory, the longer a physician users a non-knowledge based CDS, the more effective the program will become at spotting potential adverse events.
When a CDS system finds a conflicting result, the software alerts the physician that his diagnosis may be in conflict with best practices, or a condition on the patient's problem list. Additional CDS features include overdue reminders for preventative tasks, advice pulled from best practice guidelines, and suggestions for how to resolve various active care issues.
A 2005 systematic review of CDS software found that it improved physician performance 64 percent of the time. However, the Annals of Internal Medicine recently published their own systematic review which cast doubt on the effectiveness of clinical decisions support systems to improve physician performance. Opinion still seems to be divided across the industry as the Journal of the American Medical Association found a positive correlation between CDS and physician performance in their systematic review.
Meaningful Use:
Meaningful Use Stage 2 requires that providers implement five CDS rules related to at least four clinical quality measures utilizing drug-to-drug and drug-to-allergy rules to prevent adverse events.
Considerations When Buying or Switching EHRs
According to Black Book's 2013 review of seven different polls, first generation EHRs have not been living up to physician expectations. Significantly, 60 percent of respondents reported being dissatisfied with how their EHR system affected their practice workflow. Physicians also reported spending 44 percent of their time using their EHR system, compared to 28 percent of their time with patients.
EHR change frequently occurs when private practice physicians join larger hospitals or integrated health systems. In such cases, the acquiring party will often push for a new EHR to be adopted.
Regardless of the motivation for switching to another system, the previous experiences of doctors and other EHR users provides an evidence base from which to make more informed purchasing decisions.
Here are a few of the major considerations:
Specialty versus General
Specialists often require more focused systems than primary care physicians. For instance, specialists often see a narrower selection of patients, so they don't need charting features that cover a wide range of possible conditions or E&M coding assistance for treatments they will never administer. Specialists often simply need less functionality so they can do more, faster. If an EHR system has specific charting templates for that specialty, the physician will spend less time sorting through unnecessary functions, and more time with the patient.
Certain specialties, such as ophthalmologists, are particularly unsatisfied with the current crop of first generation EHR systems, as evidenced by their ranking on a recent KLAS survey.
Over half the specialties polled were at least 10 percent less satisfied with their EHR systems in comparison to internal medicine and family medicine. Oncologists and Ophthalmologists were the least satisfied specialties.
As the EHR market matures, systems will likely begin to emerge that support only one or perhaps only a few different specialties. This could result in highly tailored, and highly efficient software.
If specialists can't find an EHR specific to their patient population and treatment patterns, the next best option is finding a general EHR that allows for heavy customization. Customizing EHR software is often necessary to bridge the gap between a workable EHR, and a highly effective one. Physicians working in specialty specific, solo, or private practices will have greater freedom when choosing an EHR than physicians tied to an integrated health system, although there is evidence that suggests such systems increase the overall efficiency of EHR systems.
Cloud-Based EHR Software versus On Premise, or Server Based
While adoption rates among some types of EHR systems has reached nearly 80 percent nationwide, a significant gap exists between smaller practices and their larger counterparts. A Commonwealth Fund study showed that solo practices are only now reaching adoption rates that approach 50 percent.
The main differentiator? Price, of course. The same study isolated price as the single most powerful obstacle to small and solo practices adoption of EHRs. However, new, more affordable options are entering the market that will help solo practices compete.
Currently, the market is divided into two segments: cloud-based EHR software and on-premise or server-based software.
Server-based software is the most traditional EHR solution, and often requires purchasing new hardware, setting up private servers, and manually maintaining updates. EHR vendors often send implementation specialists directly to offices to help with setup and training. Although more expensive, on-premise software typically allows for a wider range of customization, which could be appealing for specialists or multi-specialty practices.
In contrast, cloud-based EHR doesn't require practices to implement a server, because the EMR software is hosted by the vendor. Additional hardware isn't required expect perhaps for laptops or tablets. And since these types of products work on monthly subscription fees, upfront costs are much cheaper as well. However, after a certain amount of time, it's possible for subscription fees to actually exceed the licensing cost of an on-premise option.
Adoption rates between the two system types vary widely by region. For example, the majority of New Jersey's regional extension center (REC) members in practices of three or less doctors, which makes up about 60 percent of the RECs membership, have adopted cloud-based EHRs. In contrast, only 17 percent of members in Kentucky's REC have chosen cloud-based EHRs.
Several cloud-based EHRs have emerged featuring free service models, most notably Kareo and, until 2018, Practice Fusion; however, following Allscripts' purchase of Practice Fusion in a $100 million deal in February 2018, their new owners have moved away from a free model to a $100 a month fee per physician.
Each solution has its own set of benefits and drawbacks. Let's compare the major benefits of each:
- Lower up-front costs
- Doesn't require in-house IT staff
- Quick implementation time
- Lack of customization
- Continuing subscription fees can eventually be higher than up-front implementation costs
- Physicians may worry about data security and HIPAA compliance
- Greater opportunity for customization
- More robust support from vendors
- More likely to be interoperable
- High initial costs
- Requires in-house maintenance and hardware
- Changing EMR vendors means losing up-front investment
Interoperability and Participation in Health Information Exchanges
As defined by the Health Information and Management System Society, interoperability is "the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities."
Sharing health information is important not only for building complete patient histories, but also for supplying providers with accurate and timely information at the point-of-care. In paper-based systems, medical information may be missing or incomplete, which leads to preventable medical errors that can endanger patients.
Interoperability has three main levels:
1. Foundational
An interoperability model where two health information systems can exchange data without either system interpreting the data in an advanced way. This is purely data transfer from one system to another.
2. Structural
Two or more health information systems can exchange data and can also interpret it by data field. This means each system can understand what type of data it's looking at based on Health Level 7, which is the standard for exchanging health information between clinical systems.
3. Semantic
This is the most complex level of interoperability, and also the most desirable. Semantic interoperability allows health information systems to transfer data and interpret its meaning, such as the transfer of clinical notes. Semantic interoperability is difficult because healthcare terminology is fragmented, and clinicians often refer to the same procedure in different ways.
Since individual EHR vendors receive little value for providing interoperability, they've mostly created systems that don't interface with other EMR. This means that a universal health information exchange (HIE) right now would have to be almost exclusively composed of one EMR software system.
Obviously such a solution is untenable, and the US government seems to recognize this. For healthcare providers, choosing a system that supports interoperability is becoming less and less of an option and more of a requirement.
Interoperability sets the stage for the formation of HIEs, most of which currently exist on the state level. One of the main goals of Meaningful Use is to expand HIEs to a national level so providers can exchange health data across state lines.
When choosing an EHR, make sure to select a system that's Meaningful Use certified by the Office of the National Coordinator for Health Information Technology. The ONC developed the testing methods for Meaningful Use Stage 2, so any EHR with their certification should have the required amount of interoperability. A recent Commonwealth Fund study found that 33 percent of primary care physicians could share clinical summaries with other doctors, while 35 percent could share lab or diagnostic tests with health information systems outside their practice.
- Which EHR EMR solution is right for your practice?
- Find out now