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SAMJ: South African Medical Journal
On-line version ISSN 2078-5135
Print version ISSN 0256-9574
SAMJ, S. Afr. med. j. vol.100 n.6 Pretoria Jun. 2010
An evaluation of nutritional practice in a paediatric burns unit
Sanne VijfhuizeI; Manon VerburgI; Luise MarinoIII; Monique van DijkII; Heinz RodeIV
IMD. Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
IIPhD. Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
IIIMMedSci Nut (Sheffield). Division of Dietetics, Red Cross War Memorial Children's Hospital, Cape Town
IVMD, FRCS (Edin), MMed (Surg), FCS (SA). Division of Paediatric Surgery, Red Cross War Memorial Children's Hospital, Cape Town
INTRODUCTION: Burn injuries evoke a systemic metabolic response with profound effects on organ function, susceptibility to infection, wound healing, growth and development, and mortality. Children are especially vulnerable to nutritional deficiencies owing to their limited energy reserves.
METHODS: We evaluated the feeding practice in a paediatric burns unit. All children admitted to the unit were studied for a minimum of 3 consecutive days. Patients were divided into two groups: those with <20% (group 1) and burns >20% of total body surface area (TBSA) (group 2). Dietary prescriptions, intake, compliance with feeding practices, and the use of supplementary nutrition were assessed. Under-feeding and over-feeding were defined when there was a discrepancy between prescribed and actual food intake.
RESULTS: Forty children (mean age 5.8 years) were studied. They sustained between 2% and 55% TBSA burns. Inadequate caloric intake was seen in 19 of 29 patients and in 9 of 11 patients in groups 1 and 2, respectively. In contrast, excess protein supplementation was seen in 24 of 29 group 1 patients and 6 of 11 group 2 patients. The dietician's food prescription was followed for 170 of 211 days; prescription compliance was correct in only 39 of 211 days.
CONCLUSION: Adequate nutrition is essential for burns patients, but several factors can lead to either under- or over-feeding. A daily dietary consumption chart and evaluation of compliance are essential for each patient. There should be greater acceptability of tube enteral feeding.
There have been rapid advances in burn care since 1939. Before World War II, the average burn size associated with a 50% mortality rate was less than 30% of total body surface area (TBSA) burnt; currently, the LD50 has increased to 65 - 80% TBSA.1 This progress came about from effective resuscitation, infection control, early surgery, management of inhalation injuries and nutritional support.
A burn injury exceeding 15 - 20% TBSA evokes a major and integrated systemic metabolic stress response, with changes in the metabolism of carbohydrates, proteins and lipids, thermal homoeostasis, and haematological, biochemical and endocrine systems, leading to severe catabolism, tissue breakdown, diminished immunity, retarded wound healing and multiorgan dysfunction.2 These conditions can persist until wound coverage and healing have completed - sometimes for up to 2 years.2
The well-established beneficial effects of early enteral nutrition in thermal injuries have become an essential component of care.2,3 Children are especially vulnerable because a negative energy balance can easily develop - they have smaller energy reserves, require extra calories for growth and development and, when sick, often cannot meet the required intake orally.4
Other factors contributing to nutritional depletion include chronic malnourishment, perioperative fasting periods, gastro-intestinal intolerance, septic episodes and physical activities. On the other hand, excessive nutritional support may compromise cardiac, pulmonary and renal functioning. Therefore, adequate nutrition demands high priority in the management of burn injuries, but is unfortunately often neglected in clinical practice.2
The purpose of our study was to evaluate nutritional intake in burnt paediatric patients, with the emphasis on required versus received nutritional intake, ward diet, and adherence to dietician instructions.
Patients and setting
All children admitted for at least 3 consecutive days to the Burns Unit at Red Cross War Memorial Children's Hospital were included. Discharge policies based on extent and depth of the wound and progress towards healing determined the period when the studies were conducted. Patients were divided into two study groups: those with burns less than 20% TBSA (group 1) and those with burns >20% TBSA (group 2). Although the length of the assessment periods varied between the two groups, the calculated nutritional needs and their provision remained the same for each patient. Children with <20% TBSA burns were followed up for 3 consecutive days, and the others for 3 - 35 days. As this study only assessed dietary prescriptions, intake, compliance with feeding practices and supplementary nutrition, other nutritional parameters were not included in the final analysis. Under- and over-feeding were identified when there was a discrepancy between prescribed and actual intake.
Dietary prescription
A dietician specialising in the nutritional aspects of burn care, prepared individual dietary prescriptions including kilocalories, amount of protein and, where necessary, tube enteral or supplementary feeding.
Guidelines for this prescription were:
protein: <20% TBSA burned - 1.5 g/kg/day; >20% TBSA burned - 3 g/kg/day
kilocalories (rule of Mayes):6 0 - 3 years - 108 + 68 (pre-burn weight in kg) + 3.9 × % burn = kcal/day; >3 years - 818 + 37.4 (pre-burn weight in kg) + 9.3 × % burn = kcal/day.
Dietary intake
Actual dietary intake was retrieved from case record forms completed by nurses of the burns unit. Children were encouraged to eat all the offered food. To assess the quantity offered, the different components (starch, vegetables, meat/ fish) were weighed separately. The regular diet consists of three meals a day, with lunch and supper both warm meals. Porridge is the main component of breakfast. Food and snacks eaten between meals were also recorded. The feeding assistant kept a list of children who had not consumed their entire meal, and divided the leftovers into three categories: ¼, ½ or ¾ of the total amount given. It was not possible to separate individual food components after a meal as mothers usually mix the foods for infants and, in older children, leftovers are scraped together. Although this process was the same for all children, it could lead to errors in caloric and protein intake calculations. By deducting the leftovers from the amount of food that was served, we calculated the actual dietary intake.
The energy and protein content of all food and drinks was calculated using the South African Food Composition Tables and Quantities Tables.5 Product information provided data on the composition of special supplements given to the patients.
Intake analysis
The number of kilocalories eaten per day was calculated for each patient and compared with the dietician's prescription, resulting in either an excess or deficit balance. In addition, the average balance per patient was computed by adding all daily balances and dividing the sum by the number of assessment days, which made computations of the average excess or deficit of kilocalories (per day) during the study period possible. Dividing the average excess or deficit by the prescribed amount × 100 gave the average percentage over- or underfeeding per child. The protein intake was calculated likewise, resulting in an average protein balance per child.
Prescription compliance
The intake section in the patient's folder was compared with the original dietary prescription for the type of food and volume provided. From the results of intake analyses, daily assessments were made for dietary prescriptions.
Energy-enriched supplement
An energy-dense complete feed for enteral use (Frebini Energy Fibre, Fresenius Kabi, 1.5 kcal/ml and 3.75 g/100 ml protein) is a frequently used carbohydrate-rich supplement. For patients with burns >20% TBSA, Frebini is prescribed to compensate for shortages in caloric intake. The daily dosage of Frebini given was recorded and converted to the amount of kilocalories ingested from Frebini on that day.
Forty patients with a mean age of 5.8 yrs (range: 7 months - 11 years) were included; 29 had burns <20% TBSA (range 2 - 19%) (group 1), and 11 had burns >20% TBSA (range 20 - 50%)(group 2). Hot water and flames caused 35 of the injuries. Children in group 1 were significantly younger (2.8 years) (p=0.001). The type of burn also differed significantly, with 72% hot water burns in group 1 opposed to 9% in group 2 (p=0.001).
Dietary intake
Nineteen of the 29 patients in group 1 were underfed (range 0.5 - 63.5%), and 10 were overfed (range 5.5 - 280.5% above the energy requirements prescribed by the ward dietician) (Table I). Table II sets out the data for group 2: 9 of the 11 patients were underfed (range 0.5 - 43%); these figures were based on 3 - 35 days of assessments. The other 2 patients ate 3 - 19.5% in excess of the prescribed food.
Of the 29 patients in group 1, 24 had excess protein intake (range 1 - 226%), and 5 received less than the calculated protein requirements (Table I). Three patients were followed up for more than 3 days, owing to complications resulting in prolonged hospitalisation. Six of the 11 patients in group 2 received 6 - 50% in excess of calculated requirements. The other 5 were protein-underfed, with a range of 24.5 - 43.5% below the prescribed protein requirements (Table II).
Prescription compliance
Dietary intake was compared with the original dietary prescription for 211 assessment days. The dietician's foodtype prescription was followed on 170 of 211 days (80.6%), and the rate was correct for 55/211 days (26.1%). Prescription compliance was correct in only 53 of the 211 days and, in 39 children, neither the type of food nor the amount provided was correct.
The average percentage of kilocalories from Frebini consumption was 64% (range 52 - 71%) for 14 patients in group 1, and 53% (47 - 58%) for the 11 patients in group 2.
The study evaluated only the nutritional requirements, prescription practices and dietary outcomes of what the patients received, as an indication of the unit's nutritional practice. The latter was based on a specific feeding formula for paediatric burn patients, and was administrated either orally or enterally, by nasogastric or nasoduodenal tube. Oral and tube feeding was well tolerated; feeding was not interrupted by vomiting or diarrhoea.
Although the exact nutrient requirements of burns patients are debatable, it is accepted that maintenance of energy and protein requirements, replacement of high protein losses, trace elements and other micronutrients is vital. Weight as a measure of nutritional status should not decrease by more than 10% of the admission weight throughout the hospitalisation period. Protein losses also take much longer to replenish, even with adequate nutrition and exercise, and should therefore be carefully managed. On the other hand, acute nutritional losses incurred for any reason are very difficult to replenish over a short period. Acute over-feeding can lead to hyperglycaemia, fatty liver and renal abnormalities. A stressbased hypermetabolism cannot be reversed by over-feeding until the hormonal imbalances caused by the burn lesions have returned to normal.1
Children have smaller reserves and greater caloric and protein requirements than adults and, if starved, rapidly enter into a negative balance. Consequently, the tendency is to initiate feeding as soon as possible, especially early enteral feeding for moderate to major burns.7,8 Parenteral nutrition confers no advantages over enteral nutrition, if the latter is feasible, and all burn patients in our study could easily be managed with enteral feeding.
A minority of patients received excess feeding during the study period, which might have been caused by the overuse of Frebini tube feeding despite adequate oral intake, or incorrect tube feeding rates. This expensive energy- and protein-rich drink is frequently used, especially at night. For patients with extensive burns, Frebini is ideal for compensating for shortages in caloric intake, which justifies the cost. Although patients with lesser burns did not need this supplement, it was given to almost every second patient and, at times, when not prescribed or requested by the children.
Of concern was the low compliance with dietetic prescriptions, which were followed in only 25% of the assessment days. This fact contributed to both the under- and over-feeding rates, and made it difficult for the ward dietician to work effectively. We identified several single and multiple factors that, although not specifically documented for each patient, led to underfeeding in 82% of patients with major burns and 66% of those with lesser burns. Underfeeding resulted from anorexia due to the burn injury, long starvation periods before and after surgery, questionable quality of the ward diet, and eating difficulties owing to splints, unhealed wounds, the ward environment, and the absence of parents. A multimodal approach is required to overcome these practical shortcomings, and should include improving the ward diet and catering for special needs, appointing a nutritional nurse and/or volunteers to help young or incapacitated patients, and encouraging caregivers to stay with their children.
In conclusion: We demonstrated that meeting nutritional requirements is difficult in a paediatric burns population, and we identified several contributing factors.
To balance prescribed and actual intake, the following should become standard practice:
The nutritional needs, as determined by the thermal injury, pre-morbid status and individual factors, must be determined for each patient at outset.
Dietetic instructions must be clear and be followed, and any deviation must be substantiated. A daily dietary consumption chart is essential, and nutritional follow-up is advised for each patient, especially in complicated cases.
Supplementary feeds must be used judiciously.
Enteral tube feeding should be encouraged, especially in children with major burns, those who require frequent surgical procedures, and where other factors may influence adequate oral intake.
Nutritional education must become part of daily unit routine; the introduction of a nutritional nurse and feeding volunteers to help incapacitated children to eat is recommended.
1. Deitch EA. Nutritional support of the burn patient. Crit Care Clin 1995; 11: 735-750. [ Links ]
2. Jeschke MG, Chinkes DL, Finnerty CC, et al. Pathophysiologic response to severe burn injury. Ann Surg 2008; 248(3): 387-400. [ Links ]
3. Hart DW, Wolf SE, Chinkes DL, et al. Effects of early excision and aggressive enteral feeding on hypermetabolism, catabolism, and sepsis after severe burn. J Trauma 2003; 45: 755-764. [ Links ]
4. Trocki O, Michelini JA, Robbins ST, Eichelberger MR. Evaluation of early enteral feeding in children less than 3 years old with smaller burns (8-25 per cent TBSA). Burns 1995; 21: 17-23. [ Links ]
5. South African Medical Research Council. Food Composition Tables. 3rd ed. Cape Town: Medical Research Council, 1991. [ Links ]
6. Mayes T, Gottschlich MM, Khoury J, Warden GD. Evaluation of predicted and measured energy requirements in burned children. J Am Diet Assoc 1996; 96: 24-29. [ Links ]
7. Chiarelli A, Enzi G, Casadei A, et al. Very early nutrition supplementation in burned patients. Am J Clin Nutr 1990; 51: 1035-1039. [ Links ]
8. Venter M, Rode H, Sive H, Visser M. Enteral resuscitation and early enteral feeding in children with major burns - effect on McFarlane response to stress. Burns 2007; 334: 464-471. [ Links ]
Accepted 31 August 2009.
Corresponding author: M van Dijk (email@example.com)


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It doesn't break the record for most vulnerabilities patched, or even the most security bulletins in a single Patch Tuesday, but Microsoft comes pretty close. For the February 2013 Patch Tuesday, Microsoft has a whopping 12 security bulletins, which fix a mind-numbing 57 separate flaws.
Paul Henry, security and forensic analyst at Lumension, says, "It's going to be a rough Valentine's Day for many IT admins this month. With ongoing issues with Java and 12 bulletins from Microsoft, including 5 critical issues and many restarts, it's going to be a very disruptive Patch Tuesday."
Senior Manager of Security Engineering, Ross Barrett, senior manager of security engineering for Rapid7, on the other hand, tries to stay positive. "On the plus side, none of the issues patched this month are known to be actively being exploited "in the wild"."
That is definitely good news, but IT admins still have their work cut out for them. Henry notes, "It's disturbing to note how many different Microsoft platforms are critically affected this month. Everything from Windows XP to the new Windows RT is critically impacted."
So, what does Microsoft have in store for you this month? Of the twelve security bulletins, five of them are rated as Critical, and the remainder are all Important. The patches span Windows, Office, .NET Framework, Microsoft Server Software, and not one, but two separate security bulletins dealing with Internet Explorer—both Critical.
Andrew Storms, director of security operations for nCircle, stresses the urgency of patching flaws in Internet Explorer and Flash immediately. Both are remote execution bugs that pose a serious risk of exploit.
Storms explains, "We received two bulletins that include a total of 14 CVEs [vulnerabilities] affecting all versions of Internet Explorer today. Both bulletins fix 'drive-by bugs' that only require the victim to browse a website to become infected with malicious code."
Wolfgang Kandek, CTO of Qualys, agrees that Internet Explorer is the top priority, and provides a little more detail as to what each security bulletin addresses. He says that MS13-009 is the core Internet Explorer update, which fixes 13 different flaws, while MS13-010 resolves a vulnerability in an ActiveX DLL (dynamic link library). Contrary to the comment from Barrett, though, Kandek says the ActiveX flaw is particularly urgent because it's being actively exploited in the wild.
Marc Maiffret, CTO at BeyondTrust, points out that there are urgent issues aside from Internet Explorer. "The TCP/IP vulnerability addressed this month looks like it could be a pretty nasty one. It is an unauthenticated remote denial of service vulnerability affecting versions of Windows from Vista and onward, with no available workarounds."
And, once again Microsoft is not the only game in town. Adobe also has some patches you need to be aware of. There are fixes for remote code execution flaws in Flash and Shockwave. Storms says, "The Adobe updates are just as important because successful attacks can allow attackers to gain complete control of infected systems."
Consumers and most small businesses should have Automatic Updates enabled, in which case your PC will just download and install the patches—requiring a reboot. IT admins should review all of the security bulletins and the updates from Adobe, and implement a plan to deploy the patches in order of urgency and potential impact.

subset: commoncrawl


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This note, from Michelle in Denver, displays the remarkable lengths that some people will go to avoid confrontation.
"This bright-green gem wasn't the only priceless thing visible," Michelle says. "On the cubicle wall closest to the refrigerators was a camera…and it was actually connected to the computer and recording a live feed. This is why you don't steal from the fridge when you work for a multimedia corporation!"
related: ABP on the V8


text: Advancing standards in safety Advancing standards in safety A tradition of excellence continues with the 2022 Subaru Ascent, which is built on the Subaru Global Platform (SGP) to deliver class-leading agility, strength and security. This stellar starting point is reinforced with the most sophisticated active and passive safety systems available. All of these advances are designed to work in perfect harmony to protect you and your family on all roads and in all conditions—full stop.


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Biting Commentary in New York: Yuji Ramen
Miso uni mazemen (left) and shoyu ramen
I've never had ramen like this. My first introduction to mazemen at Yuji Ramen in New York City reminds me more of pasta than it does the ramen I'm used to.
While ramen in Honolulu almost always comes in soup, New York ramen chefs have been playing around with mazemen, a brothless ramen style, amping up bowls with various toppings far beyond charsiu.
At Yuji Ramen, I order a spicy tuna mazemen, topped with tuna, kale, togarashi and chili threads, the tuna flamed with a blowtorch to give it a pleasant char and crispy edges that remind me of yakitori. The bowl, when mixed together, is almost unbelievably flavorful, with undercurrents of sesame oil and a heavy hit of spice. Then, after everyone in a group of seven orders the miso uni mazemen, I get that, too. This bowl arrives with fresh orange zest, shiso and seaweed, all of which add a new dimension while also amplifying the best parts of uni—its sweetness and brininess.
For the mazemen, the noodles are thicker and springy, more like chow mein than typical ramen noodles.
Yuji Ramen also offers a daily shoyu ramen, the broth made with bones from the Whole Foods Market butcher counter (yes, this amazing ramen is served inside a Whole Foods). The day I go, tuna, beef, chicken, lamb, pork and mussels all went into the soup, which explains its complexity, though a pleasant fishiness still dominates.
While there's a note on the menu about the broth, there¹s no mention of the noodles, which come from Hawaii's own Sun Noodle, from its New Jersey factory.
Yuji Ramen at Whole Foods Bowery, 95 E. Houston St., New York, (646) 262-1358, yujiramen.com


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Further. Straighter. Higher.
The Minimalist Golf Swing System (MGSS) is for you. It is the only golf swing that is based 100% on the science of kinesiology, with research to back it up.
This personal-use instructional content will allow you to get:
Join our mailing list and enjoy a free introduction to the Minimalist Golf Swing System. By signing up, you will be the first to learn about new lessons and potential game changing techniques.


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Four years ago, the International Conference to Review the Global Vision of the Holocaust' was held in Tehran on December 11, 2006. Manouchehr Mottaki, the Iranian Foreign Minister, stated at the time that the aim of the conference was to "neither to deny nor prove the Holocaust but to provide an appropriate scientific atmosphere for scholars to offer their opinions in freedom about a historical issue."
Those who contributed to the scientific atmosphere at the conference, included David Duke, a Ku Klux Klan leader and former US state representative, Robert Faurisson, a convicted Holocaust denier from France and a number of other academic professors and educators all engaged in Holocaust Denial research and rhetoric. One such professor, Dr. Fredrick Toben, an Australian citizen, runs an Internet site vilifying Jews while promoting that Nazis did not commit the mass murder of the Jewish people. Several right-extremist politicians from Germany's neo-Nazi NPD party were invited as well, although the German government barred them from attending.
However, the central purpose of the conference went beyond providing a friendly environment for international Holocaust deniers to share their twisted sentiments. The Iranian Foreign Minister elaborated that "If the official version of the Holocaust is thrown into doubt, then the identity and nature of Israel will be thrown into doubt. And if, during this review, it is proved that the Holocaust was a historical reality, then what is the reason for the Palestinians having to pay the cost of the Nazis' crimes?"
That argument has been reiterated time and time again by Ahmadinejad, notably in exclusive interviews he has granted with US television networks; NBC and CBS. In two major interviews with the American TV networks, Ahmadinejad smoothly skirted over the reporters' questions about his Holocaust Denial, always deflecting his responses back to Palestinian issues and the State of Israel instead.
The Intelligence and Terrorism Information Center calls Ahmadinejad's use of Holocaust Denial "a tool" of Iranian policy. "The Holocaust Denial campaign, as a main component of the Iranian regime's anti-Israeli policy, is not only an expression of the hatred for Jews which is rooted in Iranian politics and society, but also a clever, well planned strategy under Ahmadinejad." According to the IICC, Ahmedinejad uses the denial tactics to delegitimze the Zionist movement and the State of Israel as ideological and moral preparation for Israel destruction, as well as to increase Iranian influence among Palestinians while advancing Iranian aspirations for regional hegemony.
Indeed, Ahmadinjad's repeated rhetoric in promoting the Islamic Republic's anti-Israel agenda have been ultimately successful. Although the 'International Conference to Review the Global Vision of the Holocaust' elicited much international condemnation in 2006, the Iranian President's repeated hateful rhetoric cause very few to flinch in the international community today.
Nobel laureate and Holocaust survivor Elie Wiesel stated back in October 2008 that Ahmedinejad's annual appearances at the UN General Assembly demonstrates that the world has learned nothing from the Holocaust.
"Ten years ago, and less, the ruler of a country that announced its aspiration for Israel to be wiped off the map would not have dared appear and speak on the UN's podium," Wiesel stated in an Ha'aretz interview. A few months later, at the Durban II conference, a member of Ahmadinejad's entourage accosted Wiesel screaming at the Holocaust survivor, 'Zio-Nazi.'
Furthermore, US President Obama's friendly attempts to forge dialogue with Iran, while simultaneously giving Israel a cold shoulder, have scored no points with Ahmadinejad. A warm message from President Obama marking the Iranian new year was met with scorn from the Iranian leader. As reported by Reuters April 3, Ahmadinejad said the note contained "three or four beautiful words" but nothing new of substance.
"What changed? Your sanctions were lifted? The adverse propaganda was stopped? The pressure was alleviated? Did you change your attitude in Iraq, Afghanistan and Palestine," asked Ahmadinejad in a televised address. Iran supports Islamic insurgents targeting American troops in Iraq and Afghanistan both financially and militarily.
While Obama has decided to pursue new UN sanctions in response to Ahmadinejad's continued rejections, Iran according to Ahmadinejad, could easily cope with such petroleum sanctions.
"You should know that the more hostile you are, the stronger an incentive our people will have, it will double," he said.
Although President Obama would like to believe that he is dealing with a rational leader with whom dialogue will eventually reach, Ahmadinejad has never been one for Western rationality. After his UN speech in 2005, the Iranian president told Iran's leading cleric Ayatollah Javadi Amoli that he sensed a light surrounding him while he was delivering his address to world leaders at the General Assembly. "For 27-28 minutes all the leaders did not blink. They were astonished as if a hand held them there and made them sit. It had opened their eyes and ears for the message of the Islamic Republic," Ahmedinejad reportedly stated in a video made about his experience that was widely distributed across Iran, as reported by Golnaz Esfandiari in Radio Free Europe.
During his UN speech in 2005, Ahmadinejad called for the reappearance of the 12th Imam, who according to Muslim tradition is the final spiritual and political successor to Muhammad and savior of humankind who will return to lead an era of Islamic justice. The Iranian president has been quoted as saying that the "main mission of the revolution is to pave the way for the reappearance of the 12th Imam."
If anything should be learned from Holocaust Memorial Day this year, it is that appeasement policies do not work with leaders like Hitler and Ahmadinjad. Seventy-two years ago, when France, Italy and Britain's Neville Chamberlain, agreed to the Munich Agreement with Germany, the European powers wrongly believed that the annexation of Czechoslovakia would stop the Hitler war-machine. Following this appeasement agreement, over 60 million people were killed in the Second World War, a horrific tragedy that took root when no one bothered to heed Hitler's anti-Semitic rhetoric and tirades.
Anav Silverman is the International Correspondent for Sderot Media _Center_: www.SderotMedia.org.il.


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Lois Cordova: Moving Toward A New World – October 26, 2011
The Occupy movement to me is a cry from the people of this country, and now from the world, that we exist. Yes, us, people. We exist. Separation of corporation and state is a great beginning. But I see and hear more and deeper discussions going on.
Too long, the poor and getting poorer have not had any voice in the processes that maintain a system that exists for itself, and not for the people, the citizens "the system" ostensibly serves. Top to bottom, local to national to global, we have lost our collective heart.
Money speaks. Money buys politicians and policy and law. "Helping" the poor has become designing one size fits all "programs" where boxes are checked and a path laid out that ends up not accomplishing much, if anything at all.
For instance, the "welfare to work" programs that disregard many obstacles to actually getting and keeping a job, like, where ARE those jobs? (I worked with this "population" for several years).
There is a built-in assumption any employed individual will "advance" and get raises and health insurance etc. We are told if we work hard we can "succeed." Why are so many very hardworking folks now without jobs, losing their homes, hungry?
We live in a world where it is somehow OK for our neighbors to be hungry while we all talk about it. It is OK for people to to be houseless while we all talk about it. It is OK to not even have a public restroom while we all talk about it.
It is time to stop talking about it and JUST DO IT.
We finally have an opportunity to change our world into a place where we can all truly live and thrive instead of working 16-hour days in two jobs just to pay the mortgage and the essential bills and keep food on the table.
It is an opportunity to rebuild our communities to places where "it takes a village to raise a child" is not a campaign slogan, but a PRACTICE to which we are all committed.
I truly want to see the day when "we had to fight City Hall just to feed people" is a distant and embarrassing social memory.
I want to see a world where all labor and effort is valued, and where no one is hungry and where there is a safe place to sleep at night for everyone; where I have a say as to how my taxes are spent and that most of those dollars remain in the community in which I live.
I want to see a world where we simply do not ever cut educational funding. Our children are the future. I do not understand scrimping on the education of our children nor in devaluing the teachers who work so hard to educate our children.
I want to see a world where we value and respect one another rather than bicker and fight and focus on our differences and use those to continue to bicker rather than making sure our neighbors are truly OK, regardless of their beliefs or lifestyle.
In the Occupy movement I see a place where everyone has an equal place at the table and bullying is not allowed. No one is "more important" by virtue of what they HAVE. No voice is louder than that of any other.
I see a place where caring about one another is the highest priority. It all begins inside of each of us, of committing to really listening, to a high sense of personal integrity, to caring about one another and not "what can I get out of it?"
I see a place where by being our best selves we realize that I am no stronger than my weakest neighbor. I am only strong when I am PART of a thriving community.
My community cannot thrive unless every last individual does not want for essential human needs.
I am one voice. What I see occurring and want to participate in is a place we amplify each other's voice and together we are really heard.
There is not hierarchy. There is respect.
Lois Cordova is a participant in Occupy Arcata.


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An American start-up manufacturer has begun using Chinese-made glider kits for a line of medium- and heavy-duty alternative-fueled trucks for North America. It could be the first employment of Chinese commercial vehicles in the U.S., but they are only a means to an end for the new firm, Alkane Truck Co.
Alkane-brand cabover trucks will be based on Daimler Foton engineless gliders that are being shipped to the Port of Charleston, S.C., and then to a nearby "integration" plant. There workers will install propane and natural gas engines and fuel systems, and automatic or automated manual transmissions, said Steve Rayborn, the firm's national sales director.
He is one of a small team of people who founded the company in Myrtle Beach, S.C., about four years ago, and has been planning the products and how to market them. The low cost of alternative fuels prompted the decision to offer only propane and natural gas-powered trucks.
"We will be a niche marketer, and we don't need to sell even 10,000 trucks a year to be a success," Rayborn said. American and Canadian dealers representing 120 locations have signed memoranda of understanding contingent on their inspection of and satisfaction with production trucks.
He and Bob Smith, the company's CEO, have varied business backgrounds but no experience in truck manufacturing, Rayborn said. They have hired experts to manage engineering, the acquisition of name-brand domestic components needed for the trucks, and the production of them.
Alkane will field P-33 Class 7 trucks using Power Solutions International 8.8-liter V-8 engines with propane fuel systems from Bi-Phase Technologies, an arm of Schwan's Food Service, a user of propane since the 1970s. Allison 2000 and 3000 series automatic transmissions will send power to rear axles, which are included in the Foton gliders.
Also in the catalog is a P-26 model, which would be offered to those who wish to avoid CDL requirements for operators. It would be a P-33 with lower rated axles and other chassis equipment, and would stay at the heavy end of Class 6.
A yet unnamed Class 8 model will use the Cummins ISX12 G natural gas engine and an Eaton UltraShift automated gearbox. A prototype has a liquefied natural gas system, but Alkane might start production with compressed natural gas systems because more fleets have begun using it and more CNG stations now exist.
For medium-duty models, "We chose propane autogas because it's the most-used alternative fuel in the world, and has the most filling stations in the U.S. – 2,700," he said. "We can turn customers onto a variety of propane marketers, like Ferrellgas and Suburban, and they will put in a tank free and then wholesale the propane to the fleet."
Triad Services Group of suburban Detroit assisted in designing the trucks and is managing the integration and assembly operations for the South Carolina plant. It is now being staffed and Rayborn expects that 60 employees will work there. Full production should begin in 60 to 90 days.
Part of the work at the plant will be to change the Chinese cabs' window glass and lighting fixtures because they do not meet American performance standards, Rayborn said. They will be replaced with domestic products.
Alkane trucks will be displayed at the major truck shows early next year. Niche markets for the trucks include propane, beverage and snack delivery, Rayborn said. He has made contacts with major private fleets whose managers are interested in or already using alternative fuels.
"What we have found is that there is no one fuel, so we have to be ready to change," he said. "We can do that quickly because we're a small group of businessmen, not a big, bureaucratic corporation." In addition to him and Smith, the company's website (www.alkanetruckcompany.com) lists two other executives plus communications specialists.
The team picked Alkane as the company's name because it's in the Periodic Table of the Elements, where it comprises gaseous fuels, including propane and natural gas.
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Ten union organizers and supporters participate in an act of civil disobedience by sitting down at the corner of Century Boulevard and Avion Drive, Los Angeles, California May 1, 2012. Reuters/Gus Ruelas
In California, the mid-1990s were an era of poisonous immigrant-bashing and stepped-up workplace raids. Many immigrants felt abandoned by government, and by most social and political institutions as well. Where I come from, the two exceptions were the Catholic Church and organized labor.
When the history of our times in Los Angeles is written, one of the proudest chapters will record how the LA labor movement, led by my predecessor and late husband, Miguel Contreras, and the cardinal archbishop of Los Angeles, Roger Mahony, steadfastly championed immigrants and workers, and unequivocally stood against prejudice and fear. Starting with the opposition to Proposition 187, the anti-immigrant initiative pushed by Republican Governor Pete Wilson in 1994, the LA labor movement and the struggle for immigrant rights became inextricably linked.
We in the LA labor movement led American unions in standing up for the rights of immigrant workers, and labor across the United States took up the cause. Just as important, since the mid-'90s we in LA labor worked with our local unions in mobilizing Latinos to vote and unleashing the enormous potential of their participation in civic and political life.
We taught immigrant housekeepers, janitors and homecare workers—and now sanitation and car wash workers—to take part in civic affairs and election campaigns. In Los Angeles, they have elected mayors, City Council members, county supervisors, legislators, speakers of the State Assembly and governors. In 2010, when Tea Partiers swept the nation, they were stopped at the California border: we elected Jerry Brown governor, re-elected Senator Barbara Boxer and put Democrats in every statewide office. A key factor in those victories was the Latino vote.
We experienced our own Wisconsin-style anti-union attack last year in California, when ultra-rich ideologues placed Proposition 32, aimed at destroying labor's ability to lobby and campaign politically, on the November ballot. But we defeated Prop 32 and passed Proposition 30, raising taxes on the wealthiest Californians. At the same time, the Los Angeles County Federation of Labor and UNITE HERE together turned out the vote for a successful hotel workers' minimum-wage proposal in Long Beach.
Today, on the national stage, immigration reform is the potential game changer for American labor. But as much as we must battle for it with every fiber of our being, immigration reform is not a panacea: we could win on it and still see private sector union membership fall further. Here in Los Angeles, unions have successfully organized mostly immigrant janitors and hotel, sanitation and car wash workers. The only way immigration reform will change the game for labor nationally is if labor aggressively organizes immigrants—and switches from defense to offense.
Also in This Forum
Josh Eidelson: "How Can Labor Be Saved?"
Kate Bronfenbrenner: "Unions: Put Organizing First"
Richard D. Kahlenberg and Moshe Z. Marvit: "Make Organizing a Civil Right"
Suresh Naidu and Dorian T. Warren: "What Labor Can Learn From the Obama Campaign"
Larry Cohen: "Build a Democracy Movement"
Bhairavi Desai: "Become a Movement of All Workers"
Karen GJ Lewis: "Fight for the Whole Society"


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Written by: John Mellencamp
There's a black man with a black cat livin' in a black neighborhood
He's got an interstate runnin' through his front yard
You know he thinks that he's got it so good
And there's a woman in the kitchen cleanin' up the evenin' slop
And he looks at her and says, "Hey darlin', I can remember when
You could stop a clock. "
Oh but ain't that America for you and me
Ain't that America somethin' to see baby
Ain't that America home of the free
Little pink houses for you and me
There's a young man in a t-shirt
Listenin' to a rockin' rollin' station
He's got greasy hair, greasy smile
He says, "Lord this must be my destination."
'Cause they told me when I was younger
"Boy you're gonna be president."
But just like everything else those old crazy dreams
Just kinda came and went
Well there's people and more people
What do they know know know
Go to work in some high rise
And vacation down at the Gulf of Mexico
Ooh yeah
And there's winners and there's losers
But they ain't no big deal
'Cause the simple man baby pays for the thrills, the bills,
The pills that kill


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Red Blood Cell Separation from a Flow Channel
Before conducting certain blood sample analyses, researchers need to separate the red blood cell particles from the blood plasma. Using lab-on-a-chip (LOC) technology, red blood cell separation can be achieved via magnetophoresis (i.e., motion induced by magnetic fields). Since the magnetic permeability of the particles is different from the blood plasma, their trajectory can be controlled within the flow channel of the LOC device and then separated out from the fluid.
Blood Plasma and Red Blood Cells
Whole blood consists of red and white blood cells, as well as platelets suspended in a liquid referred to as blood plasma. According to the American Red Cross, plasma is 92% water and makes up 55% of blood volume. The permeability of blood plasma is equal to 1.
Red blood cells make up slightly lower blood volume than blood plasma — about 45% of whole blood. As you probably already know, these types of blood cells contain hemoglobin, which in turn consists of iron that helps transport oxygen throughout the body. The permeability of red blood cells is slightly less than 1 (1 – 3.9e-6). Or to put it in words, red blood cell particles are diamagnetic.
Red Blood Cell Separation via Magnetophoresis in LOCs
Lab-on-a-chip devices (LOCs) are very small (picture an area in the millimeter-centimeter range) microfluidic devices consisting of flow channels that perform one or more lab functions on a single chip. LOCs are frequently used in medicine and research for analyzing samples of blood, thanks to the reduced risk of sample contamination made possible by the ability to collect and study very small samples.
Due to their aforementioned magnetic properties, red blood cells may be separated from the plasma using a magnetophoretic approach. If we were to subject the LOC channel to a magnetophoretic force, we could control where the red blood cells and the plasma go within the channels. In other words, because the red blood cells have different permeability, they can be separated from the flow channel.
Suppose we have an LOC containing blood plasma (in this case, that's considered the background fluid) and red blood cell particles in a channel that splits into three branches, or outlets (see image below). The drag force of the background fluid pushes the particles forward along the flow channel. Now, suppose we have a permanent magnet on each side of the channel, as such:
LOC: Two neodymium permanent magnets and a flow channel with three outlets and an array of soft iron patches.
The magnetophoretic force of the magnets will push the blood cell particles inward. Combined, the drag force and the magnetophoretic force will simultaneously push the particles toward the center and through the main channel, bypassing the two channel branches. Meanwhile, the blood plasma, which has a permeability of 1, is not affected by the magnetic field and simply travels along in the direction of the drag force. This ultimately leads one third of the plasma to flow through each of the channels, while all of the red blood cells are concentrated in the center channel — providing us with a high enough concentration to study.
My colleague John Dunec created a multiphysics simulation to illustrate this concept:
Red blood cell separation: An LOC device, zooming in on the flow channels. The red blood cell particles travel in the center channel.
The above simulation was created with the COMSOL Multiphysics® software together with the AC/DC, Microfluidics, and Particle Tracing modules.
Editor's note: The following section was added to this blog post on 09/06/2016 to include related simulation research.
Approaching Noninvasive Prenatal Diagnosis with an LOC Device
Using a similar method to approach noninvasive prenatal diagnosis (NIPD), a group of researchers at the Polytechnical University of Turin and Heriot-Watt University designed an LOC device to separate fetal cells from a mother's blood. Since fetal nucleated red blood cells have the same magnetic properties as an adult's red blood cells, these two types of cells can be separated from the rest. A second separation could then differentiate the nucleated and anucleated cells.
The LOC device's fluid velocity field in the vertical (y-component) direction. Image by Giuseppe Schiavone, Deirdre M. Kavanagh, and Marc P.Y Desmulliez and taken with permission from their COMSOL Conference presentation.
To verify their design, the researchers used COMSOL Multiphysics to create a model of the LOC device. By simulating the magnetic field distribution and fluid velocity field, they were able to correctly size the device for efficient and reliable cell separation. The team then used particle tracing to calculate the motion of the cells injected into the microdevice. This enabled them to determine the required cell separation length and, in turn, the length of their LOC device.
Read More About Simulating Lab-On-A-Chip Devices
- Want to model your own LOC device? Download this tutorial: "Red Blood Cell Separation"
- Read about related simulation research:
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Happy Elliesmini lamp
This sweet little elephant lamp is 5 inches wide by 6 1/2 inches tall. It is similar to a nightlight, but has an 8 foot cord with switch so it can be placed on a shelf or table rather than only at an outlet. Perfect for a nursery. Comes with a 7 watt bulb. 25 watt maximum. Handmade by us of course!


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Christmachine Easy On The Ears Debut Volumes – The Calm Before The Storm…
Here we go, finally! Tomorrow begins the reviews en masse. The first new post review format (tomorrow) will be longer than others that follow because it will include all the information on the way this new format will be presented. It will also include, most importantly, the specific album review itself.
How it will work is that I will name tomorrow's review, "Christmachine Easy On The Ears Volume #30". The reason for this is that over the past few years we have done 29 reviews of albums (Located in past posts on this website), the thing is that they were not labelled and tagged with the new "Easy On The Ears Volume # xxx format.
So in this last post before the new series begins (tomorrow), I wanted to give direct links to the previous reviews here on the website to make it easier for newcomers to understand how past legacy works relate to those that follow. Further to make it easier for everyone to just click the links posted below, for those who want to view them without having to navigate the whole website.
So, here goes…
Christmachine Easy On The Ears Volume #00001
Beck – "Morning Phase" The Review: My Process ~ Vinyls Vs. Digitals CD/HD Tracks…
Christmachine Easy On The Ears Volume #00002 – #00004
The Beatles – "Sgt. Peppers Lonely Hearts Club Band" The Ultimate Review: My Process ~ Vinyls Vs. Digitals W/ Mono And Stereo Love!…Part #1
Christmachine Easy On The Ears Volume #00005
The Beatles – "Sgt. Peppers Lonely Hearts Club Band" The Ultimate Review: My Process ~ Vinyls Vs. Digitals W/ Mono And Stereo Love!…Part #2 [2 UPDATES]
Christmachine Easy On The Ears Volume #00006 – #00020
Christmachine Easy On The Ears Volume #00021 – #00029
The Best Of The "Led Zeppelin" Catalog Pressings…[Post Special] [Second Pass Edit 07/02/14]
So there you have it. Nice and simple…hope we explained so as not to confuse others that are unfamiliar. I look forward to this new format, as well as writing more in between over the coming years. Be well.
Love You Lots! Stay Well, Be Kind & Bless.
Tak Tak, Bless!
Grazie, Ciao!
Obrigadx, Tchau! Adeus!
Gracias, Adios!
(Vielen) Danke, Tchuss!
Merci, Au revoir!
Dank je…Bedankt, Alstublieft!
Merci Vilmal, Adeau!
Gracies, Adieu!
Gracies, Adeu!
Please do not reproduce this article either all or in part without the expressed written permission of the (nutty) author who can be reached via the "Contact" section in the header menu. You may link to the article if you wish, all that we ask is that you give credit to the respective author…"Christmachine" wherever you post a link. Thank you.
Copyright © 2017 Christmachine. All Rights Reserved.
©2014 – 2020 Christmachine ☕


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There is a secret behind every open office in Silicon Valley — and it isn't the drain on productivity.
Tech companies have been the vanguards for pushing corporate culture forward toward "radical transparency." Mark Zuckerberg works in a fully transparent four-walled glass office surrounded by the rest of Facebook. Valve got rid of managers and titles so everyone can be their own boss. Startup founders host weekly town halls, Friday all-hands, and AMAs. Companies go to painstaking lengths to signal that they trust their employees – to show that this is your company.
But while your company might adopt an open floor plan and give out free snacks so you can feel closer to your coworkers, they likely don't want you knowing how much they make, who is affected by the impending layoffs, or whether executives are making the right decisions.
The open office has never been more closed, and tech companies are no different than old corporate America in their authoritarian approach to controlling how their employees should think about issues that matter in the workplace. In fact, it may even be more insidious because it's tucked away behind the veneer of a cheerful, open office.
This is what makes social network Blind so fascinating. Raw and unfiltered, Blind is the antithesis to HR's utopic vision of a manageable and orderly corporate culture. Instead, it operates outside the walled gardens of IT with no rules and no official corporate supervision.
With Blind, users are completely anonymous, but are required to submit a verified work email to join a company channel. Inside, they are able to freely ask, discuss, prod, and complain without fear of retribution or judgment.
In short, it's HR's worst nightmare, and it's wildly successful.
Building a compelling social product
Blind's engagement numbers are staggering. It has over 2 million users, including 43K at Microsoft, 28K at Amazon, and 10K at Google. In South Korea, half of all employees at companies over 200 people are active monthly. The typical monthly active user logs in three to four times per day and spends 35 minutes using the app. At the height of the Susan Fowler scandal, Uber employees were spending almost 3 hours a day on Blind. All that, and the entire company is 38 people.
At the heart of Blind's magic is something universal to every person who has ever been employed — the duality between our personal selves and our "work" selves, and the human drive to be both intimate and in control of our relationships. There is no place more difficult to navigate this duality than the workplace, where we want to feel loved and understood, but also respected.
Hierarchy, politics, and negative career impacts burden conversations about difficult topics, and so Blind tears these barriers down one employee at a time, affording a space for uninhibited dialogue. More importantly, Blind succeeds as a resource for questions not only company-related, but also around career, family, and life decisions.
Blind is in many ways an evolution of a long lineage of ideas in social networking. It's unique achievement is the recombination of these different ideas to create a platform that is both a safe space for free and open conversation (via anonymity), along with a vetted, contextually relevant community (via workplace email authentication).
Let's walk though each of these categories to understand Blind's success.
Lack of Context (Anonymous + Individual/Personal) – Companies like Yik Yak, Secret, and Whisper pioneered the anonymous social network on the consumer side. However, they were beleaguered by cyberbullying, and served more as a digital exhaust pipe for teenage angst and trolling. Perhaps the most successful semi-anonymous social network today is Reddit, where legions of loyal community members cover every topic imaginable. However, what all of these anonymous communities lack is the critical element of shared context and circumstance.
Put another way, your fellow community members on Reddit may share your interest in ice fishing, but they likely will not understand who you are. As Blind cofounder Kyum Kim puts it, "it's hard for someone to complain on Reddit about feeling poor while making $200K a year without fear of backlash, but on Blind, your coworkers are in the same income bracket, and likely similar education levels, neighborhoods, etc. They can empathize with your situation." On Blind, there is a single community (your workplace) that spans multiple topics, and there's a baseline, tacit understanding of each other's life circumstances, allowing for deeper conversations.
Self-Promoting (Non-Anonymous + Individual/Personal) – LinkedIn and Quora are useful professional platforms, but because individuals and brands are the stars of these platforms, posturing and self-promotion can be quite frequent. When you ask a question on Quora, you are submitting your inquiry to a body of self-proclaimed experts. While many responses can be genuine, the ultimate currency that drives the platform is credibility and brand building, which inhibit authentic and vulnerable conversations from occurring.
Self-Censored (Non-Anonymous + Employee/Work) – On the enterprise side, Yammer, Jive, and recently Slack have attempted to upgrade the creaky company intranet into the enterprise social network. While these tools might make it easier to connect to your coworkers, the conversations happening on these platforms are no different than before – ultimately, these tools are designed to get work done, not for questioning, debating, or reflecting on how work should be. Conversations about sensitive subjects (e.g. how to deal with a bad manager) are unlikely to happen on a non-anonymous, corporate-sanctioned platform where that same bad manager might well be watching.
Finally, we have Blind. The platform strikes a balance between the freedom of anonymity and the context of a shared workplace. The result is a forum for surprisingly rich, relevant, and authentic conversations. While company channels are accessible only to insiders, a look at Blind's public site (where you still need a verified work email, but you can chat with anyone outside your company) reveals a flavor for the types of conversations that are possible. An engineer at Amazon recently posted about how to deal with a mid-life crisis, with 42 responses of encouragement and advice. Another employee moving from India has a wife suffering from depression and is seeking help navigating the US healthcare system.
It turns out that where we work is a good proxy for who we are, and our coworkers have been an untapped community of wisdom.
Trust and safety
Blind is by no means perfect. Like all online platforms and particularly anonymous ones, it invites its share of trolls. One look at the "Relationships" section on Blind's public site and you'll find questions about how to deal with one-night stands with coworkers and a poll asking guys how many girls they've slept with before marriage. While these questions could certainly have come from a genuine place, they are easy fodder for trolls, and the ensuing conversations can be alienating and provide an unnecessary megaphone for toxic bro culture.
Blind acknowledges that these issues exist, but claim that they happen less frequently inside company channels. Because users authenticate with their work emails, cofounders Sunguk and Kim believe that Blind users feel a greater sense of responsibility to each other because they are engaging a real community with shared context and goals.
The vast terrain of cyberspace might suffer from the tragedy of the commons and moral hazard, but within your workplace channel on Blind, your digital community maps onto a physical community – even though you are anonymous. This is evidenced by the successful self-policing on the platform, where 0.5% of all posts have been removed (higher than average for a social media platform), and all of these originated from user-generated flags.
A More Perfect Union
Blind's success illuminates a reality that is often overlooked: corporations aren't naturally democratic or transparent. While there are platforms to discuss our roles as individual working professionals (e.g. LinkedIn), there are very few places to gather and organize as employees of companies to collectively bargain for a better workplace.
This is by design. HR, the supposed watchdog of employee wellness, is neither elected nor truly representative, as they must balance the competing goals of being a third party resource for employees while also protecting the company against its employees.
Companies will always be incentivized to maintain an asymmetry of information. Friday all-hands and town halls are heavily scripted by companies. Rarely do we see anyone describing a healthy, transparent culture as a place where employees are freely conversing amongst themselves.
For companies with something to hide, the idea of a public square where conversations happen freely should be alarming. Blind has already been at the center of exposing two major scandals (e.g. the "nut rage" incident by a Korean Air executive and the news that Lyft was spying on its users.)
Blind picks up where labor unions left off and where HR has failed — to serve as a safeguard against corporate overreach, and to provide a protected space for employees to collaborate around solutions to improve the workplace.
A truly open office
For companies, Blind's rise shouldn't be seen as bad news. Blind can be a rich source of insight where HR software falls short. While employee engagement surveys have become popular in HR circles (and a crop of well-funded HR tech companies have consequently flooded the market), these practices suffer from the same issues of hosting a town hall. The company decides on the questions asked and interprets the answers given. With Blind, for the first time, HR and executives will have a pulse on employee sentiment that is both real-time and authentic. As Moon puts it, "no company is perfect, and if it was, Blind would not need to exist."
In short, Blind understands more about your employees than anything in your HR stack.
Where does Blind go from here? Moon and Kyum believe they're just getting started. Today, Blind is only available in the U.S. and South Korea, and it has been focused on tech companies. Their push into more traditional industries is showing some early signs of success with Johnson & Johnson, Dow Chemical, Barclays, and the US Navy coming online recently. There is still work to do in cleaning up different communities to ensure that conversations are inclusive and not alienating. And of course, Blind has to find a path to becoming a sustainable, revenue-generating company without compromising its integrity with users.
But one can only imagine the potential for Blind if it continues on its path upwards — the anonymous social network that understands who you are, the pulse survey that is authentic and real-time, and the first truly safe and open office made for employees, by employees.
By Danny Crichton


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Following the interest in our Twitter Tongues map for London, Ed Manley and I have teamed up with Trendsmap creator John Barratt to offer this snapshot of New York City's Twitter languages. We have visualised the geography of about 8.5 million geo-located tweets collected between Jan 2010 and Feb 2013. Each tweet is marked by a slightly transparent dot coloured according to the language it was written in. Language was detected using Google's translation tools. The above map (click for interactive version courtesy of Oliver O'Brien) has the top ten languages plotted together and the one below takes the top 24 in turn (excluding English) and orders them by popularity. English (in grey above) is by far the most popular with Spanish (in blue above) taking the top spot amongst the other language groups. Portuguese and Japanese take third and fourth respectively. Midtown Manhattan and JFK International Airport have, perhaps unsurprisingly, the most linguistically diverse tweets whilst specific languages shine through in places such as Brighton Beach (Russian), the Bronx (Spanish) and towards Newark (Portuguese). You can also spot international clusters on Liberty Island and Ellis Island and if you look carefully the tracks of ferry boats between them. Ed has written up some more in depth analysis of the data here.
Ambien this is the most popular sleeping pill in the US.
The principle of action of http://www.montauk-monster.com/cialis-generic is due to its ability to block the enzyme PDE5 (type 5 phosphodiesterase), the concentration of which is especially high in the tricky bodies of the genital organs.
Making the Maps
For those interested, the maps above were produced using the R software platform with the ggplot2 package. Both coped surprisingly well with plotting 8.5 million points (it took about 15 minutes on my two year old iMac) and the results are really great. Here is the code I used to produce the black and white map above:
#two input data frames here. "lang_freqs" has the total frequency of each language and is ordered highest to lowest (this is used for the facet ordering) and "twit_lang" is a data frame with each tweet's location (lat, long) and its language (lang) (it therefore has 8.5 million rows).
#here I create a new column lang1 to twit_lang which is used to order the faceting.
p1<-c(geom_point(data=twit_lang,aes(x=long, y=lat),colour="white", alpha=0.1, size=1.2))
p+p1+ quiet + facet_wrap(~lang1, ncol=4) + opts(strip.text.x=theme_text(size=8))+opts(strip.background = theme_rect(colour="white", fill="white"))


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Last night, Lena Dunham took to the stage over at 30 Rock as the host of Saturday Night Live on International Women's Day, and she did not hold back. The episode had some standard Dunham nudity, enough of her saying "I just feel like" to last a lifetime of therapy, and even a planned parenthood shoutout! In her opening monologue, she discussed how everyone seems to approach her to talk about their sex lives…including her grandmother.
SNL took a page out of the Bible/Biblical movie trend we're going through, with Girl, the Lena Dunham take on the story of Adam and Eve, featuring Adam (Driver), relationship-defining, and of course, apple-shaming.
Also, Jon fucking Hamm casually showed up on the teen girl talk show about "flirting your way right into a boy's heart—and mouth," awesomely titled What Are you Even Doing? You're Being Crazy.
The cast also did a pretty brilliant rendition of Scandal, highlighting just how much reality viewers must suspend in order to make in through an episode of that show. Also, the Liv/Fitz moment is absolutely spot on.
Other sketches included an awkward moment with a men's rights activist at a ladies jewelry party and Katt Williams talk show in which Lena Dunham played Liza Minelli and Noël Wells played Lena Dunham.


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1. Tromsø: All Inclusive Northern Lights Chase Minibus Tour
Journey outside of Tromsø, away from the city's light pollution, in search of the Northern Lights together with an experienced guide. Marvel at the immense majesty of the Arctic as you share stories with your companions by a crackling bonfire. Depart from the meeting point in the center of Tromsø and embark on a truly once-in-a-lifetime experience in the Arctic wilderness. Your experienced guide will then lead you in the pursuit of the spellbinding natural phenomenon that is the Aurora Borealis. As you search the skies in multiple locations, take in the rugged beauty of your surroundings. Listen to local myths and stories about the lights, as well as a scientific explanation about why they exist. After finding the best spot to watch the lights, crunch through fresh snow surrounded by towering mountains and deep fjords. Take the time to really admire this incredible natural display of light, where colors dance in the air in beautiful, mesmerizing patterns. Keep your energy up with hot drinks, snacks, and warm locally-made stew. Then be taken back to memories of summer camp as you roast marshmallows on a smoky bonfire. Take lots of great photos throughout the night with the tripod provided. Your guide will offer advice to set up your camera properly, and also take photos of your group with the Northern Lights in the background. After a memorable evening, you will be dropped off at your accommodation in Tromsø.


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What does the "Cinderblocks2: The Partnership with PatientsContinues" conference (in Grantsville, MD pop. 825) and Doctors 2.0 & You conference (in Paris, France pop. 2 million) have in common?
Both events are focused on innovation and better communication within healthcare.
Doctors 2.0 has the over arching goal of identifying the ways in which the inclusion of health 2.0 tools and social media platforms can improve care.
Cinderblocks2 is a mash up of art, activism, medicine, social media, HIT, patient rights and fire-dancing. It is sort of like if Burning Man met healthcare.
Both events were founded and are organized by two powerful women:
Denise Silber is the founder of the Doctors 2.0 & You conference series. She is a healthcare social media influencer, keynote speaker, and valued strategic advisor.
Denise was awarded the French Legion of Honor in 2011 for her work in promotingeHealth trans-Atlantically. A Smith College graduate in Government, Denise wasa US Foreign Service Officer before getting her MBA from Harvard BusinessSchool. She then spent 9 years in the pharma industry before creating her own medical communications companies and helping to found digital health start-ups.
As for Cinderblocks, I am Regina Holliday. Sometimes called the Rosa Parks of Healthcare. I graduated Sapulpa high school in Oklahoma. (GO Chieftains!) I worked retail for 16 years before my loving husband Fred died of cancer in 2009; then I became a patient rights activist and artist. I am a keynote speaker, a health information technology change agent and am currently creating The Walking Gallery Center for Arts and Healing in Grantsville, MD.
Both events are on the same days!!!
Doctors 2.0 is on June 4-5, 2015. Cinderblocks2 is on June 4-6,2015. Now some conference planners would be shooting eye daggers at each other over that, not Denise and I. We are all about spreading the love.
The most important thing both events have in common is that they will benefit from Patient Travel Scholarships issued by the Society for Participatory Medicine!
In 2012, The Society for Participatory Medicine created a patient travel fund so they could award ten $500.00 patient travel scholarships. These were issued to patients so they could afford to attend Cinderblocks1 in Kansas City. We crowdfunded the money and we asked for direct donation to the site. We were successful thanks to many kind donors.
When Denise pointed out that our events were on the same days she said it would be great if we could connect them in some way, so we decided we are going do some live streamed interviews between the two conferences. But why stop there? I said that the Society for Participatory Medicine (#S4PM ) was going to provide patient travel scholarships once again for Cinderblocks, would she like to include Doctors 2.0 in the competition? She said yes! #S4PM said yes, they could issue awards for either event!!!
SO…. One day after I announce that HIStalk is epically cool and issuing travel scholarships for HIMSS,
I am announcing that the Society for Participatory Medicine will issue $500.00 Patient Travel Scholarships to attendees of Doctors 2.0 or #Cinderblocks2.
How do you enter?
You must post a blog entry by
March 31, 2015 NOW EXTENDED to April 20, 2015 explaining why
you want to go to either Doctors 2.0 or Cinderblocks2 and why a patient travel
scholarship is needed.
You must send a link to the post to me by either twitter or facebook prior to
March 31, 2015 NOW EXTENDED to April 20, 2015 If you do not have a blog, please send me your post as an attachment and
I will find a blog you can post on as a guest blogger.
You must also encourage people to donate to the travel fund. These scholarships will come from donations to the fund. I will do my best to encourage companies to sponsor folks but I have found when it comes to patients many small donations add up. (Below is just a screen shot you must go here to donate.)
How will you be judged?
We will judge entries based on writing ability and need. We will announce the winners on
March 31, 2015 April 24, 2015. Payments will
be issued after the conference events.
Responsibilities of the winners:
You will need to attend the conference of your choice. We encourage you to use social media during the conference. We will need you to post a report of your experience on a blog. After these responsibilities are fulfilled, the Society for Participatory Medicine will issue the $500.00 scholarships.
It is sure a great time to be a patient activist! Spread the word and good luck!


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- APP : Flipboard
- OS : Android
- นักพัฒนา : Home
- หมวดหมู่ : ข่าวสารและนิตยสาร
Flipboard ดาวน์โหลด(APKPure)
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Discover quality content for all your interests – personalized articles and videos about news, food, photography, entertainment, tech, lifestyle, sports and much more. We'll deliver the latest headlines, events, and entertainment stories to save you time, keep you informed and inspired, and make sure you're always up-to-date with what's happening.Watch video from hundreds of publishers, TV stations and independent producers for free. Visit the Explore tab to select from curated video channels for news, politics, travel, lifestyle, celebrity, sports and more.Trust our unique combination of professional editors and smart algorithms to customize and deliver must-read stories and undiscovered gems. Get the full perspective on the latest news – and share what you find. Our editors blend expert voices and curated sources, and even recommended stories they know you'll like, so you can sit back and flip through what matters most to you. You can even customize your personalized newsstand: pick your interests and personalize each topic feed. Are you interested in world news, events or tech developments? Want to read articles from national newspapers, discover sports podcasts, and skim the latest news? Looking to seize the zeitgeist from trending lifestyle stories? Flipboard has you covered. Plus, you can create your own personal magazines: find articles you want to read later or you want to share, and use the "+" to flip them into your magazines. MAKE THE BEST USE OF YOUR TIME ON FLIPBOARD:• Discover the latest news from The New York Times, National Geographic, Vanity Fair, and thousands more top newspapers and magazines, local, national or from around the world• Create and customize your personalized topics: bundle together sources, people and even hashtags to get access to truly personalized news• Customize your home feed: collate up to 9 of your favorite personalized topics together for quick access to the features you love• Read The Daily Edition: keep up with the latest headlines and trending events in our daily roundup of important stories and personalized news articles• Curate your perspective: collect stories around specific themes and add them to your own personal magazinesTOP PUBLISHERS ON FLIPBOARD:- News & Politics: discover the latest headlines in national and world news, with newspapers and publications like The New York Times, CNN, Politico, Axios- Tech & Science: read the latest tech news with TechCrunch, trending science stories with Wired, and more- Business & Entrepreneurship: get personalized news relevant to your interests from The Wall Street Journal, Bloomberg, Forbes- Sports: national pastimes or world news, never miss key sporting events with ESPN, CBS Sports- Entertainment: get world news, even for celebrities and entertainment with People, Rolling Stone, Variety- Lifestyle & Wellness: explore emerging lifestyle trends with Brit + Co., Self, Women's Health- Food & Cooking: get some serious food inspiration from Bon Appetit, Food & Wine, Serious Eats- Travel: feed your wanderlust with National Geographic, Travel + Leisure, Lonely Planet- Home & Gardening: dream up your ideal home ELLE DECOR, House Beautiful- Style: avant-garde or corporate with an edge… get sartorial inspiration from Vogue, Refinery29, W Magazine, GQKEEP UP WITH FLIPBOARD:For product updates and the latest headlines from our blog, including tips on how to use Flipboard and interviews with actors, writers, musicians, and more. Follow us on:email@example.com/Flipboardhttps://www.linkedin.com/company/flipboard-inc-For videos on how to use Flipboard, visit https://about.flipboard.com/tutorials/Need help using the Flipboard app? Browse our help articles by opening Settings then Help & Feedback. Or, click the contact button at flip.it/help


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Ed Anger officially endorses Mitt Romney for President!
Ed Anger told WWN that he was not a big fan of John McCain. "He was a midget from Arizona who loved sucking on the shoes of Barack Obama."
This time around, Ed is extremely passionate about who he does NOT want in the Oval Office. "The Teleprompter Kid has been in long enough. He should have been kicked out of the Office right after the inauguration. This country is going to hell in a Bama Basket. We need to get him out before he turns this whole country into a communist bread line. I'm voting for Mitt Romney and you better, too!"
Ed recommends that anybody who wants to vote for President Obama get "their head examined" and "book a flight out of the country when Romney wins" because Ed believes that the country only has room for those citizens that bleed red, white and blue.
Ed Anger has been working with Donald Trump on the HUGE announcement that will be made on October 24th. "Donald and I uncovered the truth about Barry O. and when we make our announcement, the President is only going to get 1% of the vote. And that's a fact!"
We shall see…


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Pa. to unveil new grading system for schools
Education officials are set to unveil a new grading system for public schools across Pennsylvania.
The School Performance Profile will offer an overview of academic achievement in every building. It replaces the previous standard known as AYP, or adequate yearly progress.
Acting Education Secretary Carolyn Dumaresq has scheduled a news conference for Wednesday morning in Harrisburg.
The new profiles will be based on data like attendance, participation in standardized testing, graduation rates and closing the achievement gap.
AYP was based solely on student exam scores in math and reading. Pennsylvania isn't using that benchmark anymore because of a waiver from the federal government.
School profiles will be publicly available. They'll also be part of the state's new teacher and principal evaluations.
WHYY is your source for fact-based, in-depth journalism and information. As a nonprofit organization, we rely on financial support from readers like you. Please give today.


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ForumsQuestionsFeature Reqest: Add Task Multiple Contexts/Folders
Feature Reqest: Add Task Multiple Contexts/Folders
I couldn't find this feature anywhere....
Add a task to multiple contexts i.e.
Look for widget- @Target, @Grocery, @Wal-Mart, @Google/Online
This would add "Look for widget" to each context and would remind you to look for widget when you are in the specified context (or folder, for those that use them).
I need this functionality for my job and it would be useful for other situations as well.
Toodledo Founder
You cannot currently add multiple contexts to the same task, but you can add multiple tags, so you might want to switch and start using that.
Hope that helps.
I'd like to see such a feature added, too. I'd like to be able to assign multiple contexts to a task, for instance, work and home, so that when I'm looking under each of those contexts, a task that I can complete either at work or at home would show up. I'd be willing to upgrade to a pro subscription for the privilege.
What would be nice is if we had the option to set groups of context so that we could add tasks to every context in that group....kind of like distribution lists in outlook...you send one email to a group and inside of that group is ten people that the email is sent to.
Tags are nice but not easy to manage on 300-400 tasks...unless someone has a suggestion of how they use tags?
@Rachel, the PRO is worth more than just this feature IMHO, I would encourage you to dig into the program to see the benefit.
This message was edited Dec 06, 2008.
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A rather unique video from Syria has been posted online that shows a weapons workshop operated by the Free of the North Battalion, who are based in the Aleppo and Idlib region
Bjørn H Jespersen who has his own great blog looking at Syria has been examining the video with me, and we've come to the following conclusions about the video. The workshop seems dedicated to making ammo for this six barreled launching device, which itself appears to be homemade
Libyan rebels the FSA are turning to DIY weaponry to make up the shortfalls in their armaments.
You can contact the author on Twitter @brown_moses or by email at email@example.com


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Good Morning Runners! I have an opportunity for some support staff at Wanderlust 108 this Sunday, May 15, 2016. Details below:
WANDERLUST 108 - Portland
Time: Arrival time BY 7:30 AM. Should be wrapped up 10:30 AM.
Location: Laurelhurst Park, 3756 SE Oak St, Portland, OR 97214.
What to wear: Something comfortable whether jeans/shorts and t-shirt/sweatshirt and probably a rain jacket. We will have Wanderlust t-shirts to wear once we get you all checked in.
What to expect: The team will help with laying out course signs, start/finish line (managing the 1,500ish runners), being course marshals along the route and helping with the water station. It'll be a little chaotic as it's a 3 lap course. Everyone knows it'll be chaotic. So in general, we just need help keeping things organized with the laps, water station, etc.
Contact information: Heather Pearl © 631.875.9895 (e) [email protected]
The event is really awesome, you are welcome to stay and enjoy the yoga, vendors and meditation after the 5K is done. I'm looking for 2-3 more volunteers and will make a donation to TRL!
Thanks a bunch,


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VERMONT – Hurricane Irene washed away the Bartonsvile Bridge.
The Bartonsville Bridge in Bartonsville, VT is a historic piece of architecture. It was built in 1871 and was one of the longest town lattice bridges in Vermont. We say "was" because over the weekend, flooding due to Hurricane Irene wiped it out.
Here's a shot at what the inside used look like:
Watch the bridge collapse:


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In order to determine if one has rabbinic ancestry it
is important to start with the names of ancestors and
see if there is any correspondence with known rabbinic
lines. The best starting point, however, comes from
family tradition that may speak to such a connection.
The first step in this process is to discuss the
matter with the elders of the family. By bringing up the
subject of possible rabbinical links, a relative may
recall earlier conversations in the family that may
point to rabbinical connections.
There are several problems in searching out this kind
of information:
Here are some clues on how to identify and locate
rabbinical antecedents:
L. FrankCalabasas, California, USA


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PayPal is an alternate method for purchasing your order. It enables any individual or business with an email address to securely send payments online. With a PayPal account, you can choose to pay with your credit card, debit card, bank account, or PayPal account balance for any purchase you make. Your credit card and bank numbers are never seen by the seller or merchant. Plus, you're 100% protected against unauthorized payments sent from your account.
PayPal Process
For more information, visit the PayPal Help Center.


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Game Room Pacman Canvas Art Prints | Poster Painting Framed
Game Room Pacman Canvas Art Framed Poster Painting
WHY Buy From Us? This is not cheap knockoffs, it's the most premium and unique Canvas Prints on the planet. High Quality thick canvas with environmental ink. High resolution Canvas Art prints with vibrant colors.
- 100% High Quality Product
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Game Room Pacman Art Decor Modern with vivid color with thick canvas to brighten your walls of your home or buy as a gift. Comes framed Game Room Pacman Decor painting has been stretched on wood frames, ready to hang! These prints are amazing, must see in person.
Game Room Pacman Canvas Art Wall Art | Size Options
Size 1 - Framed - Total: length 40in - height 22in
Size 2 - Framed - Total: length 60in - height 32in
Size 3 - Framed - Total: length 80in - height 40in
Custom Prints?
Do you have your own photo. We can customize any Canvas Prints for you, send us your high resolution picture today.
Game Room Pacman Canvas Art Painting Poster | Disclaimer
Don't open the package if it's damaged. Once we receive your returned item we will resend or refund to you. Any product you return must be in the same condition you received it and in the original packaging.
Thrill your walls today with this one of kind Game Room Pacman Wall Art Framed Painting Design. Free Shipping plus 50% Off this week only.
If you love the item and our service, we really appreciate if you can give us a positive review. If you have any question or inquiries, please don't hesitate to send us a message.
Q: I just placed an order, when will i receive it?
A: 7 - 10 days.
Our prints will be created, dried, pressed, framed and shipped within 6 Business days from the time they are ordered. In order to maintain quality, they are created as they are purchased. Tracking codes can be requested 6 or 7 business days after the order is placed.
USA shipping times - if order fast shipping option will take 2 - 3 days.
Slow shipping options will come from overseas will take 10 - 15 days.
Please do not panic if it does not show up immediately, it's on its way :)
If you still have questions, you can contact us any time.
Email: email@example.com
Q: I placed an order, but have not received any email from you with details about the order. When will I receive that?
A: All order detail emails are sent out as soon as you complete order. If you can't find it, please check your Spam mail box as it might have been placed in there. If you still can't find it, please make sure that you have entered your email address correctly. Sometimes mistakes do happen.
Q: It Says My Address Is Not Found
A: If you have a PO box and do not get mail at your physical address, you should use the PO box. The verification can be tricky on specific abbreviations as well. Best would be is to use the "find zip code" or "zip code lookup" on your local post office website to help find your specific abbreviations and how to verify your address. Depending on your country, your package will be shipped by either USPS, Canada Post, FedEx, Australia Post, etc..
Q: You Made A Mistake On My Order.
A: We are very sorry. It doesn't happen often, but nobody's perfect. Email me and we'll work with you to make it right.
Q: I ordered 2+ items, but only received one... where's my order?
We have a large assortment of products not stocked in house, when you order multiple items at a time, they may be shipped separately so they get to you faster. You may receive one item before the next. So don't panic if you don't receive all of your items at once…they are on the way :)
Q: Can I Get Refund?
Note: Orders must be canceled within 24 hours from when you placed your order. Otherwise the item must be returned in order to provide a full refund.
To be eligible for a return, your item must be unused and in the same condition that you received it.
Q: I have a question that wasn't answered, can you please help?
A: Absolutely! We are here to help you make your home beautiful! Please contact us and we will be happy to assist you in any way we can. We do receive a large number of emails, If you wish to get a prompt response please attach your order number and address the problem clearly, thanks.
We offer a number of shipping options within the US. Please note that it usually takes 6 or 7 days for orders to process and get out the door.
Email Address - email@example.com
The Size Listed Is The Total Size.
5 Panel
4 Panel
3 Panel