text:
Simple Decompression Versus Anterior Transposition of the Ulnar Nerve
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
|ClinicalTrials.gov Identifier: NCT01051869
Recruitment Status : Completed
First Posted : January 20, 2010
Last Update Posted : September 12, 2018
- Study Details
- Tabular View
- No Results Posted
- Disclaimer
- How to Read a Study Record
|Condition or disease
|Humeral Fractures Ulnar Nerve Compression
|Procedure: Simple decompression Procedure: anterior subcutaneous transposition
|Not Applicable
|Study Type :
|Interventional (Clinical Trial)
|Actual Enrollment :
|56 participants
|Intervention Model:
|Parallel Assignment
|None (Open Label)
|Primary Purpose:
|Official Title:
|A Multicentre, Randomized Trial of Simple Decompression Versus Anterior Transposition of the Ulnar Nerve for Acute, Displaced Fractures of the Distal Humerus Treated With Plate Fixation
|Study Start Date :
|September 2010
|Actual Primary Completion Date :
|September 2018
|Actual Study Completion Date :
|September 2018
|Active Comparator: simple decompression
Procedure: Simple decompression
Fracture fixation will be performed through a posterior approach, as this provides excellent visualization of the distal fragments. A triceps split will be used to expose the distal humerus. A midline incision will be made from proximally to distal onto the shaft of the ulna. Equal portions of the triceps muscle will be reflected medially and laterally, with use of sharp dissection to remove the triceps insertion from the olecranon. The ulnar nerve will be identified and protected proximal and distal to the medial epicondyle. Fracture fixation will be performed after anatomic reduction using standard fixation techniques and plate fixation on both the medial and lateral column.
In the simple ulnar nerve decompression group, no further treatment of the ulnar nerve will be undertaken.
|Active Comparator: anterior subcutaneous transposition
Procedure: anterior subcutaneous transposition
In the anterior transposition of the ulnar nerve group, the ulnar nerve will be placed subcutaneously anterior to the medial epicondyle free from any pressure.
- The primary outcome will be signs of ulnar neuropathy, measured using two clinical staging systems to assess the degree of dysfunction of the ulnar nerve (the classification system of Gabel and Amadio13). [ Time Frame: 1 Year ]
- Secondary outcome measurement will include a patient-oriented, limb-specific, functional measurement questionnaire (Disabilities of the Arm, Shoulder and Hand Instrument-DASH) [ Time Frame: 1 Year ]
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
|Ages Eligible for Study:
|16 Years to 60 Years (Child, Adult)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- Men or women aged 16 to 60 years of age
- Displaced, distal humerus fracture (OTA 13A or 13C) as seen in radiographs
- Fractures ≤ 28 days post injury
- Closed fractures
- No history of previous ulnar neuropathy or elbow pathology
- Provisin of informed consent
Exclusion Criteria:
- Vascular injury
- History of previous ulnar neuropathy or elbow pathology
- Fractures more than 28 days post-injury
- Limited life expectancy due to significant medical co-morbidity or medical contraindication to surgery
- Inability to comply with rehabilitation or form completion
- Likely problems, in the judgement of the investigators, with maintaining follow-up (i.e. patients with no fixed address, patients not mentally competent to give consent, etc.)
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01051869
|Canada, Ontario
|St. Michael's Hospital
|Toronto, Ontario, Canada, M5C 1R6
|Principal Investigator:
|Emil H Schemitsch, MD, FRCS(C)
|St. Michael's Hospital, Toronto
|Responsible Party:
|St. Michael's Hospital, Toronto
|ClinicalTrials.gov Identifier:
|NCT01051869 History of Changes
|Other Study ID Numbers:
Ulnar Nerve 06-Jan-10
|First Posted:
|January 20, 2010 Key Record Dates
|Last Update Posted:
|September 12, 2018
|Last Verified:
|September 2018
distal humerus
ulnar nerve
simple decompression
anterior transposition
Ulnar Nerve Compression Syndromes
Nerve Compression Syndromes
Fractures, Bone
Humeral Fractures
Wounds and Injuries
Arm Injuries
Ulnar Neuropathies
Peripheral Nervous System Diseases
Neuromuscular Diseases
Nervous System Diseases
Cumulative Trauma Disorders
Sprains and Strains


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Mario Diaz-Balart spoke bluntly to his fellow U.S. House Republicans during a closed-door meeting at Washington's Capitol Hill Club.
"Immigration is the 800-pound gorilla," the Miami congressman told the room of vote-counting whips just seven days after November's election.
"The 800-pound gorilla just punched us in the face."
Indeed, Hispanic voters had turned from Republicans in record numbers, in heavy measure because of the way the party's candidates handled immigration.
But beyond the political numbers, Diaz-Balart said, the immigration policy data mattered even more.
About 11 million immigrants illegally live in the country. The system is broken. The time to fix it, he said, is during a nonelection year.
"After I was done speaking, unlike in previous years, a huge number of my colleagues on the whip team came up to me to tell me it was time to do it," Diaz-Balart told the Miami Herald.
"What really changed," he said, "was a willingness by many to confront the small handful of members who have been very vocal against doing anything, against doing anything realistic."
That day, Nov. 13, marks not just a turning point in the immigration debate, but a significant moment in Diaz-Balart's political career. Today, the longtime lawmaker plays one of the most crucial Washington roles in immigration that many have never heard about.
The scion of Miami's pre-eminent Cuban exile family, Diaz-Balart is a former state legislator, five-term congressman and former nephew by marriage of Fidel Castro and cousin to the dictator's first son and namesake.
Diaz-Balart's oldest brother, Lincoln, left Congress in 2010, having passed a significant Central American immigration-citizenship law and a codification of the Cuban embargo.
As Lincoln (they're known by many in Miami by just their first names) served his last term, Mario emerged as an even more important immigration-reform player.
The contrast with his fellow Miami Republican and friend, Sen. Marco Rubio, is sharp.
Rubio, a fixation of the national press, has saturated the news media as a leading member of the Senate's bipartisan "Gang of Eight," which has met for the past four months.
By comparison, Mario Diaz-Balart has operated more in the shadows, where his friendly back-slapping, consensus-building style has smoothed over partisan rifts.
Ever since 2009, Diaz-Balart and a bipartisan group of House members have clandestinely met on and off to hammer out an immigration-reform bill. The bill was about 90 percent finished when it was shelved in 2011, as the new GOP House leadership showed as little interest in reform as the old Democratic leadership.
The bill is being updated and, as the Senate votes on its similar version, will be publicly introduced soon as one mammoth piece of legislation or in parts.
Regardless of its final form, the House bill sounds like a blueprint for what became the more publicized Senate deal.
Because immigration reform has to go through a House run by Republicans — a party less inclined over the years to support comprehensive immigration reform — Diaz-Balart's part in getting a final law out of Congress rivals, if not surpasses, that of Rubio, who serves in a Democrat-controlled chamber.
Diaz-Balart and his fellow group members won't talk about their bill, their deals, discussions or progress. Unlike the sieve-like Senate, the House members and staffers didn't leak info for years. They weren't regulars on the Sunday talk-show circuit.
The House group meetings were held in different rooms in Washington. Some staffers made sure they weren't seen congregating outside meetings so as not to arouse attention.
Was there a secret handshake?
"I'd tell you, but I'd have to kill you," Diaz-Balart quipped.
The club was, members say, the best-kept secret in Washington, where secrets have a shelf life of about three minutes. The club was anti-Washington in this regard as well: It was all about consensus, finding common ground and not scoring points.
No votes are taken. Harsh words, threats and posturing are looked down upon.
"No one feels like a loser," said U.S. Rep. Luis Gutiérrez, an Illinois Democrat.
"One day, Mario said, 'Luis, we really have to never end a sentence with the phrase: 'This will kill the deal.' It was a great idea. And ever since, we don't do it. And it's not only me. It's everyone in the group."
Among Diaz-Balart's better qualities, Gutiérrez said, is his ability to "take off his partisan hat" — a feat for a member of the Republican whip team.
Before the two were to appear last week on Univision's Al Punto — a Meet the Press-like show for Spanish-speaking political junkies — Diaz-Balart lobbied Gutiérrez on the House floor to do the interview together.
"We're really working together. Shouldn't we exemplify that by appearing together?" Diaz-Balart said.
So they sat side by side, unlike Democratic Sen. Bob Menendez of New Jersey and Rubio, who appeared separately on the same broadcast.
"Unlike other Republicans — who are great and I love working with them — who always talk exclusively about enforcement," Gutiérrez said, "Mario talks about the 1,400 people who are deported every day. He talks about the effect on the family. You can see it on Al Punto."
"If you didn't know it, that he was a Republican from Florida, you would think that he was a Democrat," Gutiérrez said.
Rep. Jeff Denham, a California Republican, also sits on the secret immigration group and is a member of the House whip team with Diaz-Balart.
"When he speaks at the whip meetings, it's because he has something important to say," he said. "There are those who get up and speak all the time about every single topic. Then, there are those like Mario — very few — who don't talk all the time and only speak when they have something to say. Everybody stops and listens."
Denham recalls the "passion" of Diaz-Balart's speech at the team's first meeting after the election, when he discussed the harm of splitting up families through deportation.
Diaz-Balart also noted he had been warning Republicans for a decade about handling immigration reform. Fellow Miami Rep. Ileana Ros-Lehtinen had been doing it for longer, as had Lincoln Diaz-Balart.
The three in 2010 accounted for the eight Republican House votes in favor of the Dream Act, which provides a citizenship path for certain students and military-bound younger people. The act failed in the Senate amid strong Republican opposition.
Former Gov. Jeb Bush, a Coral Gables resident who co-wrote the just published Immigration Wars policy book, said he's "not surprised" that Diaz-Balart is in this role.
"Mario is a connector," Bush said. "When I was governor, and he was a legislator, and I had something big to do, he was always at the top of the list. He's not confrontational. He is smart, but he listens well. He shares credit. He's not grandstanding."
The non-Hispanic white vote — the GOP's base — is proportionately shrinking as the Hispanic vote is growing overall. It's also trending more Democrat because GOP rhetoric has sometimes sounded offensive.
"Both parties have used immigration as a political tool," Diaz-Balart said. "The difference is, it has worked for Democrats as a wedge. For Republicans, immigration has been suicide."

subset: commoncrawl


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Team Penske Enjoys Successful 2008 IndyCar Series Season
December 3, 2008
MOORESVILLE, N.C. (December 3, 2008) - It's been an exciting year for Team Penske, with drivers Helio Castroneves and Ryan Briscoe both finishing in the top-five in the 2008 IndyCar Series Championship, racking up five wins and six pole positions over the 18-race season, overcoming adversity, creating milestones and setting records along the way.
Veteran driver and two-time Indianapolis 500 winner Helio Castroneves and his No. 3 Team Penske Dallara/Honda team finished a hard-fought second place in the 2008 IndyCar Series Championship standings. Castroneves' championship-bid season featured two wins, including the second-closest finish in IndyCar Series history at Chicagoland Speedway and a dominating performance at Infineon Raceway, a series-record eight second-place finishes, 15 top-fives and three pole positions.
Ryan Briscoe, a newcomer to Team Penske in 2008 and driver of the No. 6 Team Penske Dallara/Honda, had a breakthrough season, posting two regular-season victories, including Penske Racing's 300th championship points win (Milwaukee) since the team's inception in 1966. Briscoe also recorded a dominating victory at Mid-Ohio to go along with five top-five and 11 top-10 finishes. His hard work resulted in a fifth-place spot in the 2008 IndyCar Series Championship standings.
Briscoe capped off his outstanding year with a post-season non-championship points win in his home country of Australia, making him the first Australian to win the eight-year-old race. The win made him the only driver in the Series to win on all three types of circuits in 2008 - oval (Milwaukee), permanent road course (Mid-Ohio) and temporary street course (Australia) and prepared him and the No. 6 team for the 2009 season, which kicks off with two temporary street course events - St. Petersburg and Long Beach.
A Team Penske summary of the 2008 IndyCar Series events:
March 29, GAINSCO Auto Insurance Indy 300, Homestead Miami Speedway - Castroneves fourth, Briscoe 19th
Race winner: Scott Dixon
Castroneves piloted a strong race car to a fourth-place finish in the GAINSCO Auto Insurance Indy 300, the season opener for the IndyCar Series. Briscoe, making his debut for Team Penske, was collected by a spinning race car and crashed, eventually finishing 19th.
Castroneves said he could have done better but was pleased with his showing. "The Team Penske car handled really well tonight," he said. "But we just didn't have the speed that the top few guys had. Thankfully, we were able to stay out of trouble and bring home a solid finish. The championship is our ultimate goal, and we were able to score some valuable points."
Briscoe's luck went the opposite way. On the 127th lap of the 200-lap race, he was caught in the crash of Milka Duno's car. At the time, Briscoe was racing solidly among the lead group.
April 6, Honda Grand Prix of St. Petersburg - Castroneves second, Briscoe 23rd
Race winner: Graham Rahal
In St. Petersburg, Castroneves challenged eventual race-winner Graham Rahal on the final restart before finishing second in the first street race of the IndyCar Series season, a showing that gave him the points lead after the second race of 2008.
"At the end, I was really, really trying," Castroneves said of his late-race pursuit of Rahal. "I wanted no yellows at that point. When I saw Graham lock his tires, I was like, 'OK, here's my chance.' I kept waiting for another chance, but he never gave me one."
Briscoe led 11 laps before a crash on the 57th lap of the 83-lap race left him 23rd in the final results. "We had made all the right calls on tires and pitting, but unfortunately I cost us a chance at a win," Briscoe said. "It's a frustrating start to the season because we've had great cars with a chance to contend for the win in both races."
April 20, Indy Japan 300, Twin Ring Motegi - Castroneves second, Briscoe ninth
Race winner: Danica Patrick
Castroneves maintained his IndyCar Series points lead by finishing second for Team Penske in the Indy Japan 300.
Castroneves led 94 of the 200 laps and worked his way back to the front with five laps to go. But he slowed dramatically heading into the third turn on the 198th lap when his car ran low on fuel, and Danica Patrick took the lead. She became the first woman to win a major closed-course auto race. "She passed me fair and square," said Castroneves after the race. "I didn't have enough fuel even if I wanted to fight with her."
Teammate Briscoe finished ninth.
April 27, Road Runner Turbo Indy 300, Kansas Speedway - Castroneves fourth, Briscoe seventh
Race winner: Dan Wheldon
Both Team Penske drivers finished among the top seven, while Castroneves finished fourth to hold the lead in the IndyCar Series standings.
"Thankfully, we were able to stay out of trouble and bring home a fourth-place finish, which keeps us in the championship lead heading into Indy," said Castroneves after the race.
Briscoe scored a seventh-place finish, his best result in the first four races of the season.
May 25, The Indianapolis 500, Indianapolis Motor Speedway - Castroneves fourth, Briscoe 23rd
Race winner: Scott Dixon
Castroneves came back from serious damage to his car to finish fourth in the 92nd running of the Indianapolis 500. After he struck debris from a crash early in the day, Castroneves' watched his crew repair the No. 3 Team Penske Dallara/Honda to get him back in the race.
"Fourth place is definitely not what we expected," Castroneves said. "We tried everything we could. We had a little issue with the debris. I was trying to avoid a slow car; I slammed on the brakes instead of hitting him. I pulled away and a piece of the debris hit my front wing, so we had to stop to change that. Let me tell you, wow, what a team."
Meanwhile, Briscoe encountered trouble in the pits and finished 23rd. The young Australian was running well when he collided with Danica Patrick's car on pit lane. The accident forced Team Penske to park the No. 6 car.
"From what I can see, there was still plenty of room on the right side for her to get around and there are people pointing fingers, but that's not the way we are," Briscoe said. "We both have a brake pedal in our cars, and from what I can tell, there was still plenty of room for her to get around me. I was trying to get around (Dan) Wheldon, and I was staying in the middle lane. I got ran up in the back, and it's a shame."
June 1, ABC Supply/A.J. Foyt Indy 225, The Milwaukee Mile - Castroneves fifth, Briscoe first
Race winner: Ryan Briscoe
Briscoe had his first - and Penske Racing had its 300th. Briscoe narrowly avoided a crash with two laps remaining and went on to win the ABC Supply/A.J. Foyt Indy 225, his first victory in the IndyCar Series and the 300th championship points victory in the history of Penske Racing.
Briscoe was leading Scott Dixon when Marco Andretti's car slid up the track in Turn 2 and clipped Ed Carpenter's car, which spun and hit the wall. As Briscoe and Dixon approached the crash, Vitor Meira's car stuck Andretti's car and became airborne. Briscoe braked suddenly and missed the wreck, then idled around the track to w


text:
Pudner, Rosie (2002) Wound bed preparation. Journal of Community Nursing, 16(5),Full text not available from this archive.
Official URL: http://www.jcn.co.uk/journal.asp?MonthNum=05&YearN...
|Item Type:
|Research Area:
|Nursing and midwifery
|Faculty, School or Research Centre:
|Faculty of Health and Social Care Sciences (until 2013)
|Depositing User:
|Lucinda Lyon
|Date Deposited:
|17 Feb 2009 12:14
|Last Modified:
|21 Aug 2010 13:26
Actions (Repository Editors)
|Item Control Page


text:
New York Yankees 2012 Offseason Recap and Preview
The Yankees season was really a culmination of surprise seasons from players. Including, but not limited to, the guys in this next picture:
Grade: B
Notable Additions:
Michael Pineda, Russell Branyan, Bill Hall, Hiroki Kuroda, Hideki Okajima, and Dewayne Wise.
Notable Subtractions:
Jesus Montero, Andrew Brackman, Bartolo Colon, Hector Noesi, Jorge Posada, and Scott Proctor.
Why?: Ok, I know that everyone wants to know how the Yankees and Mariners could possibly both end up being better. I *do* think that the Mariners got the better talent. However, I think the Yankees did what was best for the team. The Yankees have long been an offensive powerhouse, but they needed cheap pitching. The Yankees may have been able to effectively use Montero, but what we know they needed is to get more pitchers in their rotation. That is what all the Yankees fans were complaining about. I realize that being a GM is mostly about winning and not pleasing people, but when you operate your own network like the Yankees do, it has an elelment of pleasing the crowd to it, because hype surrounding the team going into a season boosts the rating early on in the year.
While this may be a short-term benefit, there is also a long-term one to this trade. As you may or may not have heard, the Yankees are trying to get under the luxury tax threshold within the next two years, as MLB is hiking up the penalties for being over it. The goal being to try and save about $100 million over the three years after that with the raised penalties. Pineda satisfies this goal, because he will cost about $7 million a year for what appears to be a number 2 starter. Starting Pitching usually cost more on the open market than hitting. So the Yankees will be both trading a surplus category for a stregnthening of a weakness and will be getting a pitcher for less than a pitcher of his talent would have cost on the open market. So if they had to sacrifice some talent and take on some risk, so be it. This is my take on it, anyway.
As for the other players, I really don't feel much like analyzing EVERY one of the players added and subtracted. I mean like "Hiroki Kuroda is better than Bartolo Colon, but is he given the fact that Scott Proctor went to Japan?" Yeah, that stuff, I don't see as that important when looking at the Yankees' offseason this year. I just looked at the aggragates and thought it seemed like they a B/B+ job this offseason. The aformentioned, Montero, Pineda trade seemed like a C+/B- trade so I averaged.
Predicted Record Range: 94-99 wins Yeah they did win 100 games last season, but I also think that a bunch of players over performed what they usually do and the Yankees will come back to earth this year.


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ROCKFORD - A regional title in girls basketball has been elusive for Dakota the past couple of years. But the brief drought ended Friday night.
With their defense setting the tone early, the Indians rolled on to a 48-27 victory over Christian Life in the Class 1A Christian Life Regional final.
"It starts and ends with your defense," Dakota coach Kevin Cline said. "It's tough to make shots in the postseason sometimes and when you play as well defensively as we did, it can be even tougher."
After a shaky first couple of minutes in front of the Eagles' excited home crowd, Dakota (25-6) was able to take control by forcing Christian Life into turnovers - 10 of them in the first quarter alone - and turned them into points at the other end. After the Eagles' 4-0 start to the game, the Indians closed the first quarter on a 17-0 run.
"Coming out on their home court obviously they have an advantage," said Dakota junior Jaycee Cleaver, who scored a game-high 16, "But we settled down and just did what we knew we could do."
Christian Life (12-12) managed to swing the momentum slightly back in its favor with a 7-0 run that pulled the Eagles within seven at halftime, but the Indians quickly took back the momentum in the third quarter.
"They made that nice little run and I think that was actually good for us," Cline said. "It caused us to go in the locker room a little more focused. We knew we had to come out and own the first three or four minutes of that (third) quarter and that's exactly what we did."
Dakota did it by holding Christian Life scoreless in the third. The Indians scored 10 in the quarter to take a commanding 17-point lead into the fourth as they pulled away to secure their first girls basketball regional plaque since 2011.
"This is basically what I've been wanting since seventh grade," Ebbers added. "I just wanted a piece of the net and I finally got it. It's really exciting."
Dakota will take on Amboy (20-6) in the first Forreston Sectional semifinal Monday (6 p.m.). The Clippers, who beat Erie to win the Amboy Regional on Thursday, are making their first sectional appearance since 1990.


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Stella Kuru necesitaba un nuevo diseño de tema de wordpress y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 21 diseños de 3 diseñadores freelance.
Byrneholics Online http://www.byrneholics.com
Byrneholics Online is a fan site devoted to the actor Gabriel Byrne. It has been up and running for almost a year. We have a picture gallery that has seen 50K+ hits in that time and a pretty active forum, with a WP blog set up as the homepage. We are seriously committed to creating a central place for all things Gabriel Byrne, including news, interviews, info about his charity work and projects, media (mostly film clips and YouTube vids), and photos. And we also provide access to fan-created media, fiction, and other creative outpourings.
The fans who visit are well-educated, thoughtful, and generally crazy about Gabriel Byrne! They tend to be female (surprise!), but we are seeing more guys joining in. The audience is becoming more global, as the HBO show In Treatment becomes available in Europe and other countries outside the US. Also, professional media people are beginning to become aware of the site. Our target audience is really anyone interested in Gabriel Byrne, acting, writing, theatre, and political and social activism.
We enjoy our fun, but we're interested in good design and transparent navigation, too.
1. Design should be clean and visually striking (check out the Byrneholics Gallery for inspiration!).
2. Stick to a blue(ish) palette.
3. Fonts should be medium-sized (too small makes people angry!)
4. Think about using a CMS template like Our Magazine from ThemeForest--this is really what we are going for: more user interaction and engagement
5. The current Gallery and Forum will be included in the new design; we'll just link to them, I hope!
6. Navigation needs to be as transparent as possible--we get some visitors who are not tech savvy
Additional info:
Site navigation links, including subpages, are:
-> Bio
-> Career
-> Projects
-> Videos
-> Film Info
-> Reviews
-> Interviews
-> Articles
Photo Gallery
-> FAQs
-> Us
Hopefully these can be drop down/hover thingies or the design can be sized to accommodate the sublinks and display them.


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Elisabeth Kübler-Ross
This article may be expanded with text translated from the corresponding article in Esperanto. (April 2012) Click [show] for important translation instructions.
|Dr. Elisabeth Kübler-Ross
Elisabeth Kübler-Ross
July 8, 1926
Zürich, Switzerland
|August 24, 2004
(aged 78)
Scottsdale, Arizona, USA
|University of Chicago
|Known for
|Kübler-Ross model
|Caroline Myss, Vern Barnet, Bruce Greyson, Sogyal Rinpoche
|Manny Ross (1958–1979)
|Ken Ross
Barbara Ross
Elisabeth Kübler-Ross (July 8, 1926 – August 24, 2004) was a Swiss-American psychiatrist, a pioneer in near-death studies and the author of the groundbreaking book On Death and Dying (1969), where she first discussed her theory of the five stages of grief.[1]
She was a 2007 inductee into the American National Women's Hall of Fame.[2] She was the recipient of twenty honorary degrees and by July 1982 had taught, in her estimation, 125,000 students in death and dying courses in colleges, seminaries, medical schools, hospitals, and social-work institutions.[3] In 1970, she delivered The Ingersoll Lectures on Human Immortality at Harvard University, on the theme, On Death and Dying.
Birth and education
Elisabeth Kübler was born on July 8, 1926 in Zürich, Switzerland, one of triplets. Elisabeth was born fifteen minutes before her identical sister, Erika. Minutes later came her sister, Eva.[4] Her family were Protestant Christians. Her father did not want her to study medicine, but she persisted. Eventually her father took pride in her career. In an interview she stated:
In Switzerland I was educated in line with the basic premise: work work work. You are only a valuable human being if you work. This is utterly wrong. Half working, half dancing - that is the right mixture. I myself have danced and played too little.[5]
During World War II she became involved in refugee relief work in Zürich and later visited Majdanek death camp. She graduated from the University of Zürich medical school in 1957.
Personal life
In 1958 she married a fellow medical student from America, Emanuel ("Manny") Ross, and moved to the United States. Becoming pregnant disqualified Kübler-Ross from a residency in pediatrics, so she took one in psychiatry. After suffering two miscarriages, she had a son, Kenneth, and a daughter, Barbara, in the early 1960s.[6] Her husband requested a divorce in 1979.
Academic career
Kübler-Ross moved to New York in 1958 to work and continue her studies.
As she began her psychiatric residency, she was appalled by the hospital treatment of patients in the U.S. who were dying. She began giving a series of lectures featuring terminally ill patients, forcing medical students to face people who were dying.
In 1962 she accepted a position at the University of Colorado School of Medicine. Kübler-Ross completed her training in psychiatry in 1963, and moved to Chicago in 1965. She became an instructor at the University of Chicago's Pritzker School of Medicine. She developed there a series of seminars using interviews with terminal patients, which drew both praise and criticism.[7] She sometimes questioned the practices of traditional psychiatry that she observed. She also undertook 39 months of classical psychoanalysis training in Chicago.
Her extensive work with the dying led to the book On Death and Dying in 1969. In it, she proposed the now famous Five Stages of Grief as a pattern of adjustment: denial, anger, bargaining, depression, and acceptance. In general, individuals experience most of these stages when faced with their imminent death. The five stages have since been adopted by many as applying to the survivors of a loved one's death, as well.
Healing Center
Kübler-Ross encouraged the hospice care movement, believing that euthanasia prevents people from completing their 'unfinished business'[citation needed].
In 1977 she persuaded her husband to buy forty acres of land in Escondido, California, near San Diego, where she founded "Shanti Nilaya" (Home of Peace). She intended it as a healing center for the dying and their families. She was also a co-founder of the American Holistic Medical Association.
In the late 1970s, she became interested in out-of-body experiences, mediumship, spiritualism, and other ways of attempting to contact the dead. This led to a scandal connected to the Shanti Nilaya Healing Center, in which she was duped by Jay Barham, founder of the Church of the Facet of the Divinity. Claiming he could channel the spirits of the departed and summon ethereal "entities", he encouraged church members to engage in sexual relations with the "spirits". He may have hired several women to play the parts of female spirits for this purpose.[8] Kubler-Ross' friend Deanna Edwards attended a service to ascertain whether allegations against Barham were true. He was found to be naked and wearing only a turban when Edwards unexpectedly pulled masking tape off the light switch and flipped on the light.[9][10][11]
AIDS work
One of her greatest wishes was her plan to build a hospice for infants and children infected with HIV to give them a last home where they could live until their death, inspired by the aid-project of British doctor Cicely Saunders. In 1985 she attempted to do this in Virginia, but local residents feared the possibility of infection and blocked the necessary re-zoning. In 1994, she lost her house and possessions to an arson fire that is suspected to have been set by opponents of her AIDS work.[12]
She conducted many workshops on AIDS in different parts of the world. In 1990 she moved the Healing Center to her own farm in Head Waters, Virginia, to reduce her extensive traveling.
Kübler-Ross suffered a series of strokes in 1995 which left her partially paralyzed on her left side, and the Shanti Nilaya Healing Center closed around that time. She found living in a wheelchair, slowly waiting for death to come, an unbearable suffering, and wished to be able to determine her time of death.[13] In a 2002 interview with The Arizona Republic, she stated that she was ready for death. She died in 2004 at her home in Scottsdale, Arizona, and was buried at the Paradise Memorial Gardens Cemetery.
Honorary degrees
- Doctor of Science, H.C., Albany Medical College, New York 1974
- Doctor of Laws, University of Notre Dame, IN.,1974
- Doctor of Science, Smith College 1975
- Doctor of Science, Molloy College, Rockville Centre, NY, 1976
- Doctor of Humanities, Saint Mary's College, Notre Dame, IN. 1975
- Doctor of Laws, Hamline University, MN. 1975
- Doctor of Humane Letters, Amherst College, MA. 1975
- Doctor of Humane Letters, Loyola University, IL 1975
- Doctor of Humanities, Hood College, MD 1976
- Doctor of Letters, Rosary College, IL. 1976
- Doctor of Pedagogy, Keuka College, NY 1976
- Doctor of Humane Science, University of Miami, FL 1976
- Doctor of Humane Letters, Bard College, NY 1977
- Doctor of Science, Weston MA., 1977
- Honorary Degree, Anna Maria College, MA., 1978
- Doctor of Humane Letters, Union College, New York 1978
- Doctor of Humane Letters, D'Youville College, New York 1979
- Doctor of Science, Fairleigh Dickinson University, 1979
- Doctor of Divinity, 1996
Selected bibliography
- On Death & Dying, (Simon & Schuster/Touchstone), 1969
- Questions & Answers on Death & Dying, (Simon & Schuster/Touchstone), 1972
- Death: The Final Stage of Growth, (Simon & Schuster/Touchstone), 1974
- Questions and Answers on Death and Dying: A Memoir of Living and Dying, Macmillan, 1976. ISBN 0-02-567120-0.
- To Live Until We Say Goodbye, (Simon & Schuster/Touchstone), 1978
- The Dougy Letter -A Letter to a Dying Child, (Celestial Arts/Ten Speed Press), 1979
- Quest, Biography of EKR (Written with Derek Gill), (Harper & Row), 1980
- Working It Through, (Simon & Schuster/Touchstone), 1981
- Living with Death & Dying, (Simon & Schuster/Touchstone), 1981
- Remember the Secret, (Celestial Arts/Ten Speed Press), 1981
- On Children & Death, (Simon & Schuster), 1985
- AIDS: The Ultimate Challenge, (Simon & Schuster), 1988
- On Life After Death, (Celestial Arts), 1991
- Death Is of Vital Importance, (Out of Print- Now The Tunnel and the Light), 1995
- Unfolding the Wings of Love (Germany only - Silberschnur), 1996
- Making the Most of the Inbetween, (Various Foreign), 1996
- AIDS & Love, The Conference in Barcelona, (Spain), 1996
- Longing to Go Back Home, (Germany only - Silberschnur), 1997
- Working It Through: An Elisabeth Kübler-Ross Workshop on Life, Death, and Transition, Simon & Schuster, 1997. ISBN 0-684-83942-3.
- The Wheel of Life: A Memoir of Living and Dying, (Simon & Schuster/Scribner), 1997
- Why Are We Here, (Germany only - Silberschnur), 1999
- The Tunnel and the Light, (Avalon), 1999
- Life Lessons: Two Experts on Death and Dying Teach Us About the Mysteries of Life and Living, with David Kessler, Scribner, 2001. ISBN 0-684-87074-6.
- On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss, with David Kessler. Scribner, 2005. ISBN 0-7432-6628-5.
- Real Taste of Life: A photographic Journal
- ↑ Broom, Sarah M. (Aug 30, 2004). "Milestones". TIME.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
- ↑ "Elisabeth Kübler-Ross". Women of the Hall. National Women's Hall of Fame. Archived from the original on 3 January 2008.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
- ↑ Turn on, tune in, drop dead by Ron Rosenbaum, HARPER'S, July 1982, pages 32-42
- ↑ Newman, Laura. Elisabeth Kübler-Ross. (2004). British Medical Journal, 329 (7466), 627. Retrieved November 17, 2006.
- ↑ de.wikipedia
- ↑ Kübler-Ross, Elisabeth
- ↑ Kubler-Ross, Elizabeth (1997). The Wheel of Life.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
- ↑ Sex, Visitors from the Grave, Psychic Healing: Kubler-Ross Is a Public Storm Center Again by Karen G. Jackovich. In People, October 29, 1979, page found 2011-03-05.
- ↑ Playboy Interview with Elizabeth Kubler-Ross Playboy Magazine, May, 1981
- ↑ TIME.com, The Conversion of Kubler-Ross, TIME, November 12, 1979
- ↑ Elisabeth Kubler-Ross in the Afterworld of Entities by Kate Coleman, New West, 30 July 1979
- ↑ Kinofenster.de (German)
- ↑ Elisabeth Kubler-Ross, On life After Death, Foreword by Caroline Myss p.vii. Celestial Arts. ISBN 9781587613180
Further reading
- Quest: The Life of Elisabeth Kubler-Ross, by Derek Gill. Ballantine Books (Mm), 1982. ISBN 0-345-30094-7.
- The Life Work of Dr. Elisabeth Kübler-Ross and Its Impact on the Death Awareness Movement, by Michèle Catherine Gantois Chaban. E. Mellen Press, 2000. ISBN 0-7734-8302-0.
- Elisabeth Kubler-Ross: Encountering Death and Dying, by Richard Worth. Published by Facts On File, Inc., 2004. ISBN 0-7910-8027-7.
- Tea With Elisabeth tributes to Hospice Pioneer Dr. Elisabeth Kubler-Ross, complied by Fern Stewart Welch, Rose Winters and Ken Ross, Published by Quality of Life Publishing Co 2009 ISBN 978-0-9816219-9-9
External links
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|Wikiquote has quotations related to: Elisabeth Kübler-Ross
- Elisabeth Kübler-Ross Foundation
- Women's International Center biography
- Obituary in The Guardian
- Obituary in The Economist
- Featured on public radio's Kindred Spirits
- Elisabeth Kübler-Ross — Dem Tod ins Gesicht sehen (aka Elisabeth Kübler-Ross: Facing Death) on IMDb a 2003 Swiss German documentary
- Publications by and about Elisabeth Kübler-Ross in the catalogue Helveticat of the Swiss National Library
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The name of only one candidate is on the ballot in Monticello, incumbent city Councilman Walter Bird. However, three city residents have filed as write-in candidates, including Scott Christensen, Scott Shakespeare and Jerry Ward.
Election officials say voters will need to clearly signal their intended candidates when writing in the candidates.
A profile of candidates for Monticello City Council is found on page five of this newspaper.
There are five names on the ballots of those seeking the three open positions on the Blanding City Council. They include incumbents Eric Johnson and Kelly Laws and challengers Joe B. Lyman, Kim Smith and Charlie Taylor.
A profile of candidates for Blanding City Council is found on page four of this newspaper.
Three Bluff residents are on the ballot for the three open positions on the Bluff Service area board of trustees. They are incumbent Skip Meier, Susan DeLorme and David Carpenter.
In addition to the candidate races, residents of Blanding will cast their votes on two sales tax proposals that could generate revenue for recreation projects. Information about the proposal can be found on page three of this newspaper.
Voters throughout the county and throughout the state will vote on the proposed school voucher program. Information in support of vouchers is on page seven of this paper, while information oppposed to vouchers is on page six.
Voting locations open early on Tuesday, November 6. Voters in six San Juan County precincts will vote with mailed ballots. A growing number of voters are taking advantage of early voting by simply showing up at the office of the San Juan County Clerk in the courthouse in Monticello.


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Improving patient access to specialized health care: the Telehealth Network of Minas Gerais, Brazil
Maria Beatriz Alkmim a, Renato Minelli Figueira b, Milena Soriano Marcolino a, Clareci Silva Cardoso c, Monica Pena de Abreu a, Lemuel Rodrigues Cunha a, Daniel Ferreira da Cunha d, Andre Pires Antunes e, Adélson Geraldo de A Resende f, Elmiro Santos Resende g & Antonio Luiz Pinho Ribeiro h
a. Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
b. School of Engeneering, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
c. Medical School, Universidade Federal de São João del Rei, Divinópolis, Brazil.
d. Medical School, Universidade Federal do Triângulo Mineiro, Uberaba, Brazil.
e. Center for Biological and Health Science, Universidade Estadual de Montes Claros, Brazil.
f. Medical School, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.
g. Medical School, Universidade Federal de Uberlândia, Uberlândia, Brazil.
h. University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, Belo Horizonte, 30130-100, Brazil.
Correspondence to Antonio Luiz Pinho Ribeiro (e-mail: firstname.lastname@example.com).
(Submitted: 20 November 2011 – Revised version received: 28 January 2012 – Accepted: 31 January 2012.)
Bulletin of the World Health Organization 2012;90:373-378. doi: 10.2471/BLT.11.099408
Brazil is a vast country of marked cultural, economic, geographic and infrastructural contrasts. It is composed of 27 federative units: 26 states and one federal district that contains the capital, Brasilia. Although the Brazilian Constitution guarantees universal and equitable access to high-quality health care, these contrasts make such access difficult to provide. Primary care is central to Brazil's public health system, which aims to provide comprehensive health care, specialized services and hospital care, as well as health promotion and disease prevention activities.1 Minas Gerais, a large state, has 19 million inhabitants unevenly distributed among 853 municipalities and is characterized by inequities in health care.2
Residents of small and remote municipalities have difficulty accessing specialized care because health resources are concentrated in the largest cities. Health professionals in remote areas tend to be young and inexperienced and are often isolated and in need of further training. The resulting high turnover rates in the primary care workforce compromise service quality. This, plus the small amount invested in linking primary care with other levels of care and the failure to provide good access to diagnostic tests, prevents the Brazilian primary health-care model from fully meeting its objectives.1
Telehealth, or the use of information technologies in the health professions to provide care, impart education or conduct research, has the potential to reduce existing health-care inequities by supporting primary care professionals in remote areas.2–4 Telehealth offers an effective means of improving communication between primary care practitioners and specialists in reference centres, facilitating access to diagnostic tests and enhancing health care quality in under-served communities.2,5 However, little information is available with respect to cost-effectiveness, access to services, process of care and user satisfaction in connection with telehealth.5
Programme development
In 2005, the State Government of Minas Gerais, Brazil, funded the establishment of the Telehealth Network, designed to connect the teaching hospitals of five public universities with municipal health departments.6 The health department of the state initially implemented the programme as a research project in 82 municipalities with fewer than 10 500 inhabitants. Because cardiovascular diseases are the leading cause of death in Minas Gerais and remote areas have a serious shortage of cardiologists, the state health department decided to focus the project on telecardiology [Minas Telecardio Project],6 specifically on tele-electrocardiography (i.e. the use of the internet to send electrocardiograms [EKGs] from remote areas to university hospitals for interpretation). The project proved feasible and financially sound6–8 and satisfaction among physicians working in remote locations increased markedly.9,10
After 2007, the Telehealth Network of Minas Gerais began providing teleconsultations also. In other words, primary-care professionals began using the network's web site to address questions to university staff in areas such as medicine, nursing, dentistry, physiotherapy, nutrition, pharmacy, psychology and audiology. Primary-care professionals can thus perform their clinical activities with the support of a network of specialists on duty in the universities. The specialist who first answers the teleconsultation can seek the help of a subspecialist if s/he considers it necessary. This service is viewed as an ongoing educational tool, since every teleconsultation represents a learning experience. The network was progressively expanded and had reached 608 municipalities by August 2010.
The Telehealth Network relies on low-cost technical equipment easily accessible to poor villages: computers, printers, digital electrocardiographs, digital cameras (e.g. for photographing skin lesions), webcams and low-band-width internet. All teleconsultations take place among health-care professionals, since Brazil's Board of Physicians [Conselho Federal de Medicina] does not authorize teleconsultations between physicians and patients.
A methodology for implementing and maintaining the network was developed. Staff visited all cities in the network and regional meetings with municipal health-care practitioners were held periodically in the municipalities or university hospitals to discuss the benefits of telehealth, the barriers to its implementation (e.g. lack of political support, poor user acceptance, or health-care practitioners' lack of familiarity with teleconsultation and tele-electrocardiography) and ways to overcome them (e.g. community involvement, training of health-care practitioners in the use of teleconsultation and tele-electrocardiography, and adaptation of local work routines to accommodate use of the telehealth system). These meetings were also attended by the Telehealth Network's clinical staff, whose members gave lectures on topics chosen in accordance with the questions most frequently asked during teleconsultations. The meetings provided an opportunity for users and clinical staff to develop a comfortable relationship with one another.
To ensure the quality of decentralized clinical services, a quality control office was established and charged with implementing standard protocols, providing an auditing system and promoting clinical research. Auditing consisted of assessing agreement between different cardiologists' EKG readings. In January 2011, a sample of 905 EKGs was randomly and blindly selected, and every EKG was read by a second network cardiologist, also randomly selected. This cardiologist was not told that the EKG s/he was reading had already been interpreted. Subsequently, a senior cardiologist from Minas Gerais' teaching hospital [Hospital das Clínicas da Universidade Federal de Minas Gerais] with strong expertise in reading EKGs assessed agreement between the two previous examiners and his readings provided the "gold standard".
User satisfaction was constantly monitored by the system by means of the following questions, which were sent to users after they received the response to their teleconsultation: (i) "Did the teleconsultation avoid the patient's referral?" (ii) "Did the teleconsultation answer your question?" (iii) "What is your level of satisfaction with the teleconsultation system?" The first question explores activity efficiency, defined as the number of patient referrals avoided divided by the total number of telehealth activities. The second question gauges the response given by the specialist to the teleconsultations. The third question assesses users' general satisfaction with the system. From January to October 2011, 13 828 teleconsultations were performed and 1284 users responded to the survey.
Cost-effective analyses were conducted and the following economic indicators were developed: implementation cost per site, unitary activity cost (i.e. cost per activity) and patient referral cost (i.e. cost per referral). Implementation costs were broken down into travel and equipment. The unitary activity cost (Ca) was the total operational cost of the system divided by the number of activities. The patient referral cost (Cr ) comprised fixed costs (infrastructural maintenance) and variable costs. Data on the first two indicators were collected from the network management system. Patient referral costs were investigated during visits conducted from August 2009 to August 2011at 86 municipalities within the Telehealth Network. Since telehealth cannot eliminate all referrals and since expenditure is affected, in turn, by activity efficiency (Ea), the savings to the health system (S) can be calculated as follows: (1)where Na is the number of activities. All costs were converted to United States dollars (US$) (at the August 2011 exchange rate of 1.80 Brazilian reais per US$).
The network covers around 9 265 820 inhabitants of Minas Gerais, or 47.2% of the population of the state. From June 2006 to December 2011, 825 349 EKGs and 33 042 teleconsultations were performed. This is equivalent to a daily average of 1450 remote EKGs and 77 teleconsultations (Fig. 1) and to an annual average of 540 EKGs and 30 teleconsultations per municipality. The Telehealth Network has now become an essential component of the health-care system in those municipalities.
Fig. 1. Electrocardiograms (EKGs) and teleconsultations conducted through the Telehealth Network of Minas Gerais, Brazil, June 2006–October 2011
The majority of teleconsultations were performed offline, and the specialties most in demand were internal medicine, dermatology and nursing. The most frequent types of questions pertained to pharmacological treatment and disease aetiology. Approximately 6000 health professionals have been trained through the Telehealth Network. Presently, the service engages 42 technical and administrative staff, 36 health professionals on duty and 43 specialists, including physicians and other health-care professionals.
Auditing showed a 9.4% rate of disagreement with respect to EKG abnormalities that were substantial enough to potentially alter case management. Discordant opinions were discussed between the clinical coordinator and the cardiologists to establish protocols based on standard guidelines for EKG analysis and a structured format for reporting.
The satisfaction survey showed that 80.8% of the teleconsultations had averted a referral (i.e. 80.8% activity efficiency), 97.3% of the surveyed users felt that the teleconsultation had replied to their question, and 97.1% were satisfied with the network.
The economic analysis showed that travel costs were reduced from an average of US$ 2240 per site in the programme's 82 original municipalities to US$ 305 per site in the 328 municipalities that joined the network in 2009–2010. Equipment costs remained approximately constant at US$ 2500 per site, on average, during all phases of network expansion. The average cost per patient referral was US$ 63.60 (US$ 23.42 fixed cost and US$ 40.18 variable cost), whereas the average telehealth activity cost amounted to US$ 6.03. For a total of 759 656 activities, an activity efficiency of 80.8% and a variable referral cost of US$ 40.18 per referral, the telehealth system generated a saving for the public health system of US$ 20 081 840 between June 2006 and October 2011. An investment of US$ 9 000 000 was required to obtain this benefit. Hence, the cost–benefit ratio was 2.24 to 1.
In this paper we have described the development of a large, public, state-wide telehealth system that supports primary care professionals in remote regions of the Brazilian state of Minas Gerais as part of a government strategy to fulfil the constitutional premise of universal access to high-quality health care. Combining assistance and in-service education with simple and inexpensive technology, the telehealth model has been shown to be effective, technically feasible and economically viable. To the best of our knowledge, this telehealth project is one of the most successful to have been described in the scientific literature until now.
The valuable lessons learnt in the course of conducting our study are listed in Box 1. In Box 2 we offer recommendations for implementing a successful telehealth programme based on our experience with the Telehealth Network of Minas Gerais, although some are contained in other guidelines.15 Initially network implementation and maintenance were difficult; the Internet connection was poor at the beginning of the project and health-care practitioners had to be trained continually because of the high turnover in the workforce in remote municipalities. Furthermore, in the Brazilian public health system, telehealth activities are not reimbursable. Hence, the programme's funding is always dependent on specific health department budgets. A stable source of funding will be essential for the sustainability of the telehealth programme.
Box 1. Summary of main lessons learnt
- Telehealth requires a collaborative network of educational and research institutions, government, technology providers and funders to achieve its full potential.
- To be successful, a telehealth service must meet the real needs of local health professionals, use simple and low-cost technology and have some face-to-face components (e.g. personal visits to the municipalities, workshops and training sessions).
- Telehealth must use technology as a means for delivering health-care benefits; to be economically beneficial, it must be applied to address problems for which there is a high service demand.
Box 2. Recommendations for implementing a successful telehealth programme based on experience with the Telehealth Network of Minas Gerais
Collaborative network
Telehealth is an innovative tool, but many aspects – technologies, processes and methodologies – have yet to be developed fully. To enable telehealth to reach its full potential, all new knowledge and technologies developed in educational contexts and research institutions must be shared with technology providers within a government strategy that embraces telehealth.
Real needs
Telehealth activities must meet the real needs of all users (health managers and professionals as well as patients).2–4,11,12 Because it is a new technology, telehealth faces the barrier of user resistance to a new work process.
Telehealth users have a natural tendency to resist altering their work routine unless doing so clearly leads to improved solutions to frequently encountered problems.13,14
Simple, low-cost technology
Technology is a tool intended to improve health care, but it is not telehealth's foremost objective. The technology used must be simple, inexpensive and appropriate for its users and the local infrastructure.2
Virtual and personal process
Although telehealth is essentially a virtual process, it has a human component. The establishment of a strong relationship between users and providers is one of the most important determinants of system acceptance and utilization. Users and providers should know each other personally, and it is important to promote different opportunities to hold face-to-face meetings (site visits, workshops, training sessions, etc.).2
Economic viability
To be economically viable and compensate for high fixed costs, a telehealth programme must be used relatively frequently. Hence, telehealth is most beneficial in fields for which there is a high demand. The cost-benefit ratio also depends on the degree to which the telehealth service can avert other major costs, such as referrals to distant centres, specialized consultations and expensive tests.7 Moreover, the choice of low-cost, commercially available equipment can reduce implementation costs.
This report has limitations. Although we have demonstrated that primary care physicians look favourably upon the Telehealth Network, we did not evaluate whether the programme reduced the high turnover rate among these professionals. Moreover, we did not evaluate the impact of the telehealth programme on the health status of the population and are therefore unable to say whether the programme has prolonged patients' lives or improved their health.5 Both of these questions require future study.
A telehealth programme developed to support primary care professionals in Minas Gerais, Brazil, has produced good results overall at relatively little cost. Initially conceived as a research project, it developed into a state-wide public health strategy covering hundreds of municipalities and thousands of patients. The project's simplicity and interoperability and the international standards adopted for implementing the fully-developed model should make for easy replication in other parts of the world. Furthermore, the lessons learnt during this experience will help programmes of a similar nature elsewhere achieve good results.
The Telehealth Network of Minas Gerais was funded by the State Government of Minas Gerais, by its Health Department [Secretaria de Estado da Saúde de Minas Gerais] and its research agency FAPEMIG [Fundação de Amparo à Pesquisa de Minas Gerais], and by the Brazilian Government, including the Health Ministry and the Science and Technology Ministry and its research and innovation agencies, CNPq [Conselho Nacional de Desenvolvimento Científico e Tecnológico] e FINEP [Financiadora de Estudos e Projetos]. The funding organizations did not limit the conduct of the research as planned and the authors have at all times retained full control of all primary data.
Competing interests:
None declared.
- Paim J, Travassos CF, Almeida CF, Bahia LF, Macinko J. The Brazilian health system: history, advances, and challenges. Lancet 2011; 377: 1778-97 doi: 10.1016/S0140-6736(11)60054-8 pmid: 21561655.
- Alkmim MB, Ribeiro AL, Carvalho GG, Pena M, Figueira RM, Carvalho MB. Success factors and difficulties for implementation of a telehealth system for remote villages: Minas Telecardio Project case in Brazil. J eHealth Technol Appl 2007; 5: 197-202.
- Jennett PA, Affleck Hall L, Hailey D, Ohinmaa A, Anderson C, Thomas R, et al., et al. The socio-economic impact of telehealth: a systematic review. J Telemed Telecare 2003; 9: 311-20 doi: 10.1258/135763303771005207 pmid: 14680514.
- Kirigia JM, Seddoh A, Gatwiri D, Muthuri LH, Seddoh J. E-health: determinants, opportunities, challenges and the way forward for countries in the WHO African Region. BMC Public Health 2005; 5: 137- doi: 10.1186/1471-2458-5-137 pmid: 16364186.
- Deshpande A, Khoja S, McKibbon A, Jadad AR. Real-time (synchronous) telehealth in primary care: systematic review of systematic reviews (Technology Report No. 1002008). Ottawa: Canadian Agency for Drugs and Technologies in Health; 2008.
- Ribeiro AL, Alkmim MB, Cardoso CS, Carvalho GG, Caiaffa WT, Andrade MV, et al., et al. Implantação de um sistema de telecardiologia em Minas Gerais: projeto Minas Telecardio. Arq Bras Cardiol 2010; 95: 70-8 doi: 10.1590/S0066-782X2010005000060 pmid: 20563526.
- Andrade MV, Maia AC, Cardoso CS, Alkmim MB, Ribeiro AL. Custo-benefício do serviço de telecardiologia no Estado de Minas Gerais: projeto Minas Telecardio. Arq Bras Cardiol 2011; 97: 307-16 doi: 10.1590/S0066-782X2011005000080 pmid: 21808852.
- Cardoso CS, Ribeiro AL, Castro RL, César CC, Caiaffa WT. Implementation of a cardiology care program in remote areas in Brazil: influence of governability. Rural Remote Health 2010; 10: 1472- pmid: 20839899.
- Oliveira GL, Cardoso CS, Ribeiro AL, Caiaffa WT. Satisfação de médicos com o cuidado às doenças cardiovasculares em municípios de Minas Gerais: Escala Cardiosatis-EQUIPE. Rev Bras Epidemiol 2011; 14: 240-52 doi: 10.1590/S1415-790X2011000200006 pmid: 21655691.
- Cardoso CS, Bandeira M, Ribeiro AL, Oliveira GL, Caiaffa WT. Escalas de satisfação com o atendimento às doenças cardiovasculares: CARDIOSATIS usuário e equipe. Cien Saude Colet 2011; 16: 1401-7 doi: 10.1590/S1413-81232011000700075 pmid: 21503491.
- Moehr JR, Schaafsma J, Anglin C, Pantazi SV, Grimm NA, Anglin S. Success factors for telehealth–a case study. Int J Med Inform 2006; 75: 755-63 doi: 10.1016/j.ijmedinf.2005.11.001 pmid: 16388982.
- Ohinmaa A, Hailey D, Roine R. Elements for assessment of telemedicine applications. Int J Technol Assess Health Care 2001; 17: 190-202 doi: 10.1017/S0266462300105057 pmid: 11446131.
- Gagnon MP, Godin G, Gagné C, Fortin JP, Lamothe L, Reinharz D, et al., et al. An adaptation of the theory of interpersonal behaviour to the study of telemedicine adoption by physicians. Int J Med Inform 2003; 71: 103-15 doi: 10.1016/S1386-5056(03)00094-7 pmid: 14519403.
- Whitten P, Love B. Patient and provider satisfaction with the use of telemedicine: overview and rationale for cautious enthusiasm. J Postgrad Med 2005; 51: 294-300 pmid: 16388172.
- Whitten P, Holtz B. Provider utilization of telemedicine: the elephant in the room. Telemed J E Health 2008; 14: 995-7 doi: 10.1089/tmj.2008.0126 pmid: 19035815.


text:
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I am currently working on an LOB application which I am basing on the MVVM architecture. Going by the answers to the questions I'm asking, it seems like there are not that many people building large and/or complex applications in MVVM.
Hopefully, there is a number of you who have built such animals. If so, have you found that MVVM scales?


text:
CES 2013: LG "100-inch Laser TV"
In one of the weird niche products LG showed at CES, the HECTO is a laser-based projector with a fixed throw distance. That distance? 22-inches from the lens.
As you can see in the photo, the HECTO is designed to nestle up nearly to the wall, and project a distortion-free 100-inch, 16x9 image.
A few more details after the jump.
Few details were announced, other than a 25,000 hour expected lifespan on the laser light engine Inside is a DLP chip. LG is claiming a "10,000,000:1 dynamic contrast ratio, only proving that they can dim the lasers to at-or-near total black. It's even smart TV features and built-in Wi-Fi.
The picture quality, on the brightly-lit show floor, seemed fine. Which is to say, there didn't appear to be any obvious distortion caused by the close placement. At least one curved mirror is in play, and I presume some extra processing. I imagine there are some concessions to pixel-perfect performance given the optical Twister going on, but until I see one in a controlled environment with known test materials, "fine" is all I'm saying.
A few years ago InFocus tried to sell a wall-mountable rear-projection TV that was about 7-inches deep. My guess is similar methods are being used here.
While the HECTO is certainly a niche product for the US market, in Asia and Europe where the rooms are typically smaller than their American counterparts, this projector offers a larger screen than what might have been possible.
The price is $10,000 and it should ship in March.


text:
The Meeting You Missed
QMU. Town Hall Meeting. Ever heard of 'em? No? Allow me to fill you in then.
QMU stands for "quarterly ministry update," and, as you may have guessed, it happens once a quarter. Crazy. At least one representative, from each team within each department goes to listen and report the latest on Compassion stats for the fiscal year.
I took it upon myself to attend last week's meeting on your behalf. So I would like to take this time to report that . . . God is crazy good.Continue Reading ›


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Talk:Webelos Scout
From MeritBadgeDotOrg
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— Ask your Scouting/advancement-related questions on our forums... several Scouters will be happy to help you.
Third and fourth grade
It say third and forth grade it is forth and fifth grade —Preceding unsigned comment added by Yugidude1 (talk • contribs) December 13, 2010. (Please, sign and date your posts on talk pages.)
- Fixed; thanks. —RWSmith (Bureaucrat), 10:01, December 14, 2010 (EST)
Has the BSA eliminated the compass and points emblem? I can find no mention of it in the wiki? Dawginroswell 12:38, March 3, 2011 (EST)
- See: Webelos Activity Badges#Webelos Compass Emblem and Points. (See also: Help:Searching.) —RWSmith (Bureaucrat), 14:04, March 14, 2011 (EDT)
many, many thanks! Dawginroswell 20:31, March 17, 2011 (EDT)
Outdoor Code
The rank requirements contain an invalid link in item 7c. It refers to the "Outdoor Code" as a sublink on Aims and Methods of Scouting, whereas it really is a page of its own Outdoor Code. This could be updated (sorry, I would have, but the rank section is locked). —Bliss 14:05, May 19, 2011 (EDT)
The link is now fixed. Thank you for pointing this out! —Ajames15 (SysOp) 11:06, May 20, 2011 (EDT)
Scout Oath, Law, Motto, Slogan
Similar to the Outdoor Code comment above, the links for Scout Oath, Scout Law, Scout Motto, and Scout Slogan all link to the Aims and Methods page, which doesn't have that information. I think it would be better if they linked directly to the corresponding pages, e.g., Scout Oath, Scout Law, Scout Motto, Scout Slogan -- Dfscott 11:16, August 10, 2011 (EDT)


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threeFiddy necesitaba un nuevo diseño de logotipo y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 340 diseños de 102 diseñadores freelance.
Fuzzy Future
Fuzzy Future is a software development and consulting business that builds mobile, desktop, and web based applications. Our business is separated into distinct divisions which are often accompanied by a descriptive phrase in addition to our company name. For example, Fuzzy Future Technologies, Fuzzy Future Design, Fuzzy Future Mobile, Fuzzy Future Search Marketing, etc.
We are just a small group of contract software developers in Toronto that get our kicks from building websites and applications using new technologies and ideas.
Our current logo ( you can see it at http://www.fuzzyfuture.com ) is in drastic need of improvement. We can't wait to see what ideas you guys can come up with...
Our target audience is small businesses and individuals who are too small to have a large development team in house, but big enough to have the need for software development.
Our audience is also ourselves, in that we develop many projects for mobile devices and the web and our logo would be used to universally brand each project under the Fuzzy Future banner.
The logo will be primarily used as a digital asset in web pages and applications, with some use in print such as business cards and brochures (but much less).
The logo should reflect:
Futuristic Technologies (cutting edge)
Our current project branding strategy uses the brand name, followed by a distinct division. For example, Fuzzy Future Technologies, Fuzzy Future Mobile, etc. Design for the logo should focus on the Fuzzy Future brand, but please keep this in mind and think about (and maybe show an example?) of how a division would be incorporated. We would like it if the division portion was easily customized to accommodate future projects (or kept entirely separate if need be).
Our business deals primarily with helping people harness future technologies for their business, so a logo that is both professional and gives off a progressive/futuristic feel would be ideal. We are extremely open to any interpretation though, so please feel free to try almost anything that meets our above criteria.
For color scheme, please feel free to use what you think works best. It would be nice if the logo worked well on both light and dark backgrounds (but also not a deal breaker). You can see our current color scheme on our website http://www.fuzzyfuture.com.
Also, please do not use any stock images or photos in the logo.
Descubre cómo funciona un concurso de diseño u obtén más información sobre nuestros servicios de diseño de logo.


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Staffing and solutions
For over 30 years, IBS has been delivering flexible IT staffing and solutions.
IBS provides experienced, talented IT consultants to staff your projects. We find the ideal match to get your job done.
Our managed IT solutions are proven successes. Flexible delivery, cutting-edge technologies, full knowledge transfer.Learn More
Proven processes, cost benefits, flexible team sizes and excellent execution result in satisfied clients.Learn More
Spot on job opportunities. We offer support, benefits, community and recognition.
2625 Butterfield Rd.
Oakbrook, IL 60523
© Copyright 2014. All Rights Reserved.


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RSPP Annual Referee Award*
For the Best Referee Report in Regional Science Policy and Practice
1. Goal
The Award recognizes annually a referee who have demonstrated the capacity to improve the scientific quality of the paper published in Regional Science Policy and Practice through the advice of the referee report.
2. The Award
2.1 The award distinguishes and honours referees that with their anonymous advice helped the development of regional science, policy and practice.
2.2 The Prize is annual and awards the best paper referee report of papers published in two years before of Regional Science Policy and Practice.
2.3 The award selects only one referee report per year.
2.4 The Award involves the payment of 250 € one plaque and certificates for the referee.
3. Jury and Process for Recommending the Award
3.1 In the first quarter of each year, the Editor in Chief of Regional Science Policy and Practice identifies the list of up to three (3) papers published two years before that have highest citations to the date. Each one of the Editors of Regional Science Policy and Practice choose one referee report of the selected papers, which they deem as suitable for consideration for the RSPP Referee Award.
3.2 The Editor-in Chief of Regional Science Policy and Practice will then send the report and the respective submission to a Jury comprising the Editor-in Chief, one Editor and Three Fellows.
3.3 The Jury will appraise the referee reports in a meeting in person and/or by email/teleconference in March to select the paper to receive the Award.
3.4 The Editor-in-Chief of Regional Science Policy and Practice will inform the Executive Director of RSAI of the decision of the Jury, and the Executive Director of RSAI will inform the recipient(s) of the Award.
3.5 The Awardee will be invited to attend one of the Supra-Regional (NARSC, LACRSA, ERSA, PRSCO) meetings or the RSAI World Congress to receive the Award.
*Will initiate in 2019 with review reports of 2017.


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This is how good the cookies are...I bought my husband Michael's Cookies for his birthday last year and he loved them. His birthday is in a couple of days and when I asked him what he wanted, the only thing he said was "those cookies you got me last year, you have to get them for me again!"
What is so great about Michael's Cookies is that not only are they wonderful to eat, they are wonderful to look at. They are delivered in beautiful packages and each cookie looks absolutely perfect! These cookies not only make an amazing present for family and friends, they are also fantastic gifts for business. In honor of Valentine's Day, Michael's Cookies has graciously decided to give away a dozen Triple Chocolate Chunk cookies to one lucky reader ($29.99 value, shown above).
But wait...There's more! For one lucky Grand Prize Winner, only the Gold Collection will do! That's right, Michael's Cookies now has a wonderful Gold Collection gift featuring 2 dozen cookies with cocoas and teas ($69.99 value, first photo shown above).
Here is how to enter:
- Check out the Michael's Cookies website and post a comment below to let us know which goodies you like best and why.
- Post your comment by midnight PST on Monday, February 4th.
- Remember to include your name or blogger login (anonymous comments will not be accepted)
- Please also include your city/state/province/country.
(Please note that any entry not giving all of the information requested above will not be accepted.)
Winners will be announced in a post after February 4th. Winner must check in with Houses, Couches and Babies to collect prize.
Good Luck!!


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Free shipping over € 99
Free shipping over € 99
Second edition (first one in 1988) for the Alessi desk clock designed by Pio Manzù. <
Born in Bergamo in 1939, son of the sculptor Giacomo, he studied at the Hochschule für Gestaltung in Ulm. In 1962 together with Michael Conrad, he won the competition held by Revue Automobile for a new concept of coupé to be applied on the Austin Healey 100 chassis.In 1968 he entered the Centro Stile FIAT as consultant, devoting himself with the study of small sized cars. He died in 1969.


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A.L. November 28 [1858]. [Roxana Chapin Gerdine] to �Dear Sister Em� [Emily McKinstry Chapin]. Athens, [GA]. 4pp.)
Athens Nov 28th"
Dear sister Em-"
I have nothing of importance to write you but as it has been so long since I have written I will commence. I have been very busy for a few weeks past fitting out the children for winter and no little task do I find it. The boys cannot get along as Eddy does with only one new suit of clothes in the winter but have always been accustomed to having their clothes washed every two weeks as they do in summer but I have just told them that I would take a stick to them before they should soil their clothes so therefore you may expect them to tremble for fear of the rod that part of housekeeping I like well enough however but I do despise the cooking for they are all fond of high living. The General I must humor in his whims for goodies but the children the little ones may go without if they are not satisfied


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With the crush of layoffs during the recession, it was easy to play the old "you're lucky to have a job" card with your employees. Now, as the economy starts to sputter back, you're are going to have to come up with some new material — or you're going to have a mutiny on your hands.
The employees left standing have been overworked for several years now, carrying the weight of both their job and the employees that were laid off, leaving the current workforce with a serious case of fatigue.
When times are tough or companies are going through big changes, they rely the most on their top employees. These "recession work-horses" are some of the employees that are most fatigued right now, said Mark Vaughn, a senior partner at Navint Partners , a management-consulting firm that works with a lot of financial firms.
"Every company relies on their top 20 percent," Vaughn said. "And the best [employees] are always at the most risk of leaving — certainly in good times, but even in bad times like this," he said. "Some people I've talked to have just checked out — they don't feel like they can be rewarded in the way they should be for the work they do," he added.
"We have frequently seen high-level employees who are overworked and underpaid becoming disengaged," said Piera Palazzolo, senior vice president of marketing at Dale Carnegie Institute, a corporate-training organization. "Employees who ARE engaged can look beyond their wages, salary and hours and feel a close attachment to the values, ethics and actions embodied by the organization," he said.
Companies are gradually starting to hire again — April was the 19 thstraight months jobs were added to the economy – but few are feeling comfortable enough to start throwing money around for mass hiring or big bonuses for current employees. Just when we start feeling comfortable, another European country falters or gas prices race toward $4 a gallon.
So how do you keep your top employees from jumping ship without putting more money on the table?
"The challenge is for companies to come up with nonmonetary ways of motivating employees that doesn't impact the bottom line," Vaughn said.
He said one key thing — that doesn't cost anything — is offering flexible work hours to your best employees who have been working hard through the recession. Maybe that means working later hours, earlier hours — or working from home sometimes.
"I know I love taking my kids to school — it reminds me why I work," Vaughn said.
You can even go one better and give them more vacation time, Palazzolo added.
Another easy thing is to reimburse them for charitable donations. Chances are, there's already a line in the company's budget for charitable donations — why not let your employees decide where that money goes? Plus, getting reimbursed feels like cash in hand — even when it's not.
Sing their praises!
A little compliment goes a long way. If you increase a top employee's profile in the company – communicate their achievements to management and have them interact with higher levels of management, it gives them a sense of appreciation that's likely to foster more loyalty, even if they get offered another job.
Also: just give them the title they want, already! If you give an employee a better title – even without the monetary compensation — it's going to make them feel more valued.
"Creating incentives such as the 'Team Member of the Month' award will help boost morale and increase employee engagement," Palazzolo said.
Give them more work!
"I know that seems counterintuitive," Vaughn said. "But give your employees more responsibilities and more autonomy in their day-to-day activity. People tend to prosper in that type of situation."
Trim the fat!
Top performers the world over will appreciate this one.
"Companies need to continue getting rid of low performers," Vaughn said. "There's nothing more demotivating to high performers, or the recession work-horse, than working side-by-side with a low performer," he said.
"Your best people understand the value of performance. If you demonstrate that the company values performance, it will absolutely help you retain the best employees," Vaughn said.
Most importantly: find out what they want!
If you offer them a banana and they're allergic to bananas, that's a FAIL.
"Do something in the budget that's important to them. That goes a long way. Build a culture that people want to work in," Vaughn said.
Vaughn said at Navint, they went with ice cream, putting ice-cream machines on every other floor.
"People absolutely love it!" he said.
Who knew? All it took to keep your employees from raising the jolly roger pirate flag in front of corporate headquarters was ice cream!
Jobs, Jobs, Jobs:
- The Best Months to Ask for a Raise
Email us email@example.com or drop a line in the comment box below.
More from The Pony Blog:ponyblog.cnbc.com


text: EquipNet is the world's leading provider of used reciprocating compressors and numerous other preowned compressors. Our exclusive contracts with our clients yield a wide range of used reciprocating compressors from a number of respected OEMs, including Cooper Bessemer, Eagle Hamworthy, Penn Pump Products, Sulzer, Ingersoll Rand, Champion Pneumatic, Worthington, and many others. EquipNet is constantly receiving used reciprocating compressors in various makes and models. If you do not see the used reciprocating compressor you are looking for, call one of our representatives and we will find it for you. We can also source the right tooling and change parts that you need through our huge network of corporate clients from around the globe.


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The McDonald's McFlurry has been around for years, with fans of the ice cream-based dessert able to choose from an array of different flavours.
However, from time to time the fast food chain will introduce a limited edition flavour of McFlurry, which is available for a certain amount of time only.
For those who get excited when a new flavour is added to the McFlurry menu, the news that the Galaxy Chocolate McFlurry has made a return will be a welcome treat.
Our galaxy McFlurry is on a different planet… 😀 #blackpool pic.twitter.com/rSJrK9RdyG
— McDonald's Blackpool (@mcd_blackpool) January 6, 2019
According to the McDonald's website, the dessert is made with "soft dairy ice cream, Galaxy Chocolate pieces and a deliciously smooth Galaxy Chocolate sauce swirled all the way through."
There is also caramel version of this tasty treat available.
Lots of new items on the menu
The return of the Galaxy McFlurry comes after the chain's recent release of a bacon double cheeseburger and the announcement of their first vegetarian Happy Meal.
The veggie Happy Meal features a veggie wrap made with a Red Pesto Goujon, tomato ketchup and shredded lettuce, alongside chips, a drink and a toy.
A spicy veggie wrap has also been added the main menu, with McDonald's aiming to cater for those who wish to choose a meat-free dish.
Happy customers
Fans of the dessert have also expressed their delight on social media at the return of this popular sweet treat.
McDonalds have brought back the Galaxy caramel mcflurry back and suddenly January has been saved
— kirsty (@kirstyvictorix) January 5, 2019
It's Galaxy caramel Mcflurry time 🍦😃 pic.twitter.com/JeXXUFZiIz
— Ian (@CornoDolce) January 4, 2019


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AKOO Clothing is pleased to announce their first ever fashion show collection debut during Mercedes-Benz Fashion Week on September 9, 2011. AKOO will present their Spring 2012 collection to invite-only guests including select top tier media, A-list celebrities and influential tastemakers. It will feature a number of celebrity ambassador hosts, open bar and live music from a celebrity DJ.
Since you you're not on the list (don't worry, neither are we), watch the web broadcast tonight starting at 7pm EST above or on AKOO's Facebook page.


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Designed with a dual-flame sealed burner, this cooktop offers the
widest range of BTU performance in the industry for the utmost versatility — from a roaring 18,000-BTU boil to a gentle 450-BTU simmer.
Professional grade control knobs are designed to provide you with pinpoint precision control.
Keeps spills contained for easy cleanup and lowers the cooking surface to countertop-level, which makes moving oversized pots and pans onto and off of the cooking surface much easier.
Designed for cooking multiple dishes at varying temperatures on a single cooktop. These grates allow easy movement of even the heaviest pots and pans from burner to burner - without lifting.
Our exclusive limited warranty that includes a 3-year coverage
on parts and one year on labor without charge.* (*Eligibility based
on product registration with Electrolux North America within 60 days of purchase. Products must have been purchased on or after July 1, 2013. Coverage includes material parts for 3 years and labor for 1 year.)


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Listen to Barbara Clark in our newest podcast speak about her research in aviation discourse and safety. Dr. Clark is a visiting research fellow at the School of Languages, Linguistics and Film, Queen Mary, University of London. During a career in aviation as a flight attendant, Dr. Clark was inspired to join her passions for the aviation community and that of language and linguistics. She return to graduate school to earn a Masters and PhD in Linguistics from Queen Mary, University of London.
Learn about Dr. Clark's research as she explores the communications of the aviation community and its impact on operations and safety as well as creation of sociocultural sub-communities.


text:
Items where Author is "Al-Jalal, A. A."
Group by: Item Type | No Grouping
Jump to: Article
Number of items: 1.
Khan, M. A. and Gondal, M. A. and Al-Jalal, A. A. and Hussain, M. S. and Bakhtiari, I. A. and Ali, A. Abdullah ON-LINE MEASUREMENTS OF OXIDATION OF CARBON USING VISIBLE SPECTROSCOPY. The 6th Saudi Engineering Conference, KFUPM, Dhahran, December 2002.


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This is not an offer for credit and should be used for estimation purposes only based on the information you provided. You should not base your decision on this estimate alone. Title, registration, tax and other fees, and personal circumstances such as employment status and personal credit history, were not considered in the calculations.
Known for its legendary V-twin power and versatility, the Kawasaki Teryx® side x side is ready to tackle the toughest of obstacles. Built with Kawasaki Heavy Industries Ltd. (KHI) strength and backed by the Kawasaki STRONG 3-Year Limited Warranty, the Teryx is the ultimate off-road adventure partner.
Front - Dual hydraulic discs with 2-piston calipers
Rear - Sealed, oil-bathed, multi-disc
Front - 26 x 9-12 Maxxis®
Rear - 26 x 11-12 Maxxis
Front - Color-matched dual A-arms with new piggyback reservoir coil-over Fox® Podium™ shocks, adjustable spring preload and 24-way compression damping; Travel - 8 in.
Rear - Color-matched Independent Rear Suspension (IRS) with new piggyback reservoir coil-over Fox Podium shocks, adjustable spring preload and 24-way compression damping; Travel - 8.3 in.


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"Downton Abbey" star Michelle Dockery is convinced she would never have been cast in the hit period drama if she had kept her regional accent instead of putting on a posh voice.
The actress, who grew up in Essex, England, speaks in clipped tones for her role as Lady Mary Crawley, daughter of an aristocrat, in the popular period drama, and she admits her regular accent would have put casting directors off.
She tells Britain's Hello! magazine, "I'm not like Lady Mary at all. For one thing, I'm not actually posh. I come from a very humble, working class background. … The Romford (Essex) accent… (has) been beaten out of me a little bit by (drama school). I had a very strong Essex accent when I was younger, and I don't think I would have got the role of Lady Mary if I'd walked into the audition going, 'Allo, nice ter meet yer'."


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60s Pop, Rock & Soul (My Music)
|Episode Description
|Friday, Mar 8, 2013 - 9:00 PM
Legends of the 1960s unite in this all-new live performance "My Music" special. Co-hosts Peter Noone and Davy Jones sing their biggest hits focusing on the years 1965 - 1969. This latest follow up to "My Generation - The '60s", includes pop sounds from Frat Rock to Surf Pop, the British Beats to the Breakthrough Bands, Motown, Soul and Pop classics -- with many artists and groups appearing for the first time on the "My Music" stage. Among the groups performing are Paul Revere and the Raiders doing "Kicks," Jefferson Starship with "White Rabbit," The Kingsmen with "Louie, Louie," and Chad & Jeremy with "A Summer Song." G
Mountain Time
|More 60s Pop, Rock & Soul (My Music) on IDAHO (MT)
Friday, Mar 8, 2013 - 9:00 PM
Wednesday, Mar 16, 2016 - 10:00 PM


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- Naomi Watts and Liev Schreiber are reportedly going through a "rough patch" due to ego problems:
"Basically, it's a total clash of the egos between the two of them. It's always tough to make a relationship work when it's between an actor and actress. Both tend to be self-obsessed to a degree, and Naomi and Liev fit that description to a T," says a source, "Liev would like Naomi to take more of a back seat when it comes to her career, he wants to be the major star and breadwinner and he would like her to be more of a stay at home mom. But Naomi knows that her movie making days are running out fast and she wants to capitalize on her looks and fame while she still can - while she's still young enough." [RadarOnline]
- A source claims that Lindsay Lohan is now getting paid less than Jersey Shore star Nicole "Snooki" Polizzi to show up at parties: "When Lindsay does get paid for attending events, she now gets $5,000 to $10,000, basically less than Snooki makes," the source says, "It is sad and it is only getting worse." [ShowbizSpy]
- Though Dina Lohan has struck back against claims that her daughter, Lindsay is broke, TMZ claims they've seen copies of two bounced checks reportedly written by the actress to her landlord, which were returned due to "not sufficient funds." [TMZ]
- Meanwhile, a source claims that Lohan "is so out of control, nobody wants her to do their club appearances because she's such a liability." [PageSix]
- Actress Tia Carrere, perhaps best known for her role in Wayne's World, has filed for divorce from her husband of seven years, citing irreconcilable differences. [People]
- An "insider" claims that no one on the set of Grey's Anatomy will miss Katherine Heigl very much: ""Most the cast and crew were like, 'Finally!' There was such a release. With every movie, she'd get worse and start acting like she was the star. They're such a family and are glad to have this behind them. I doubt there will be a party to send her off!" [USWeekly]
- A top secret script for the upcoming film Harry Potter and the Deathly Hallows was found at a pub by a Sun reader, who kindly handed it back to Warner Brothers: "I couldn't believe my eyes. I know guys that work on the film drink in the pub, but it's very embarrassing that someone could just leave it there," the good samaritan says, "I'm glad I've helped to stop any surprises being leaked." Ten points for Gryffindor! [TheSun]
- The FBI is now investigating death threats against ESPN's Erin Andrews, which were reportedly sent via email into the Dan Patrick Show. [TMZ]
- According to Andrews' lawyer, Marshall Grossman, the FBI is aware of who the stalker is, and "Erin and her family are protected. It is unfortunate that there are sick people who prey on the fears and threaten the well being of others. Erin is not alone among those who have to deal with such predators." [TMZ]
- Robert Pattinson says that fame has made him suspicious of people's motives: "Being well known is a real burden. I'm less open and have noticed that I'm actually getting paranoid. If people push themselves on me I find it gruelling and repulsive. If I even think someone wants to approach me I feel the need to scream, 'What do you want of me'. Then later I think, 'What if this person only wanted to be nice?'" [TheSun]
- Ricky Gervais has similar feelings: "I go to restaurants but they're safe environments. People don't bat any eyelid in the Ivy but I probably wouldn't go to Nando's on a Friday night in Birmingham, and I don't go to pubs. I've had no bad experiences, everyone's very polite, but you can get phobic. It's about feeling trapped. If you walk into a shop and you see someone go [he whispers behind his hand], then you walk out again. Walking down the street with someone going, 'Love the show' – nothing wrong with that at all. But being plonked somewhere where there's loads of people who you don't know but think they know you – that's a bit weird. We're not really meant to be famous." [TimesOnline]
- Just in case you care, Michelle "Bombshell" McGee went back to work at a strip club last night. [TMZ]
- As Anna noted last night, Erykah Badu has been charged with disorderly conduct by the Dallas Police Department after appearing in public nude while filming her "Window Seat" video. She is facing a fine of $500. [TMZ]
- Former Spice Girl Melanie Brown (aka "Scary Spice") might become a judge on The X-Factor. [DailyMail]
- An American nanny working for Sacha Baron-Cohen and Isla Fisher has been deported from the UK after apparently failing to provide proper documentation. [TheSun]
- Hulk Hogan says he'll "always love" his ex-wife, Linda though the end of their marriage was fairly awful: "It's hard to comprehend when I look at it in retrospect, with a clear head, but Linda's rage and fury was so frequent it just became expected. It was almost routine.
Her cussing and swearing and disappearing felt like the new 'normal' in our household. In fact, we were bombarded by so many moments of misery that any time she said something positive it was shocking." [TheSun]
- A moving van was spotted outside of Jesse James' home, and several items, including a couch, a love seat, and various boxes were seen being removed from the house, as well. [TMZ]
- Jesse James' attorney claims that "this whole thing has destroyed Jesse's entire universe. Right now, he's a broken man." [NYPost]
- Ian Halperin, the man who wrote Brangelina: The Untold Story Of Brad Pitt and Angelina Jolie, now claims that Sandra Bullock and Jesse James made a sex tape together which features feces, profanity, shotguns, and swastikas. [ShowbizSpy]
- Belinda Brewin, who was best friends with Paula Yates before she died of a heroin overdose 10 years ago, worries that Yates' daughter, Peaches Geldof, might be on the same path, and that her father, Bob Geldof, isn't doing anything to stop it: "'Bob's got his head stuck in the sand, but nobody's in a position to influence him. Everyone can see what's happening, but would you really want to be the one to have to tell Bob he's got to do something? If she was my daughter, Peaches would be in her second year of university, not living alone in Los Angeles." [DailyMail]
- Justin Massler, who is accused of stalking Ivanka Trump, apparently also stalked Tucker Max, as well, referring to Max as "the Antichrist." (Oh, the comments this item will produce.) [NYDN]
- Shia LaBeouf says he "hated" the sequel to Transformers: "I thought we missed the mark. I got confused, I couldn't see what the f**k was going on, you know with certain robots… I couldn't decipher what was happening." [ShowbizSpy]
- Christian Bale is reportedly seeking U.S. citizenship. After he's done, maybe he'll board a train that's bound for Santa Fe? [DailyExpress]


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Port Mann South | Cape Horn Cam | King Edward | Johnston Hill
You are viewing high-definition images from the Port Mann/Highway 1 Construction Project. There are 5 cameras located within this project; Grandview Hwy Overpass (Burnaby), King Edward Street (Coquitlam), Cape Horn Interchange, Port Mann Bridge and Johnston Hill (Surrey). Every hour each camera collects 4 - 6 preset images. Click on the cameras name to view the images and camera archive.


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Contest: Connect with your inner critic and tweet your #BaconMoore reviews
July 7th, 2014
UPDATE, July 21, 2014: This contest is now closed, and we will be contacting winners through their Twitter accounts. Thank you to all who participated!
Francis Bacon and Henry Moore: Terror and Beauty is closing July 20 and we hope you've had a chance to see the exhibition or, if not, that you plan to visit before it closes. We've heard from visitors who provided feedback, in words and images, at our in-exhibition response stations; now we're inviting you to share your review of Terror and Beauty on Twitter before July 18, with the hashtag #BaconMoore and tagging us, @agotoronto. Everyone who submits a review of 140 characters or fewer (emoji allowed) will be entered into a draw to win one of five pairs of tickets to see Alex Colville, opening Aug. 23 and running to Jan. 4, 2015. AGO members, who see both exhibitions for free, will be able to transfer the prize to friends if they are selected as winners.
Have questions about the contest? Ask us in the comments.