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Saturday, October 4, 2014
Semana cuatro in the MTC!
Oct. 5, 2014
FAMILIA! wow this week has flown by it is so crazy. Like I am leaving the mtc in two weeks what!? This week was a great one indeed! one for the books! Don't even know where to begin. This time next week I'll be tellin y'all about my travel plans cause we get them next week yeeee we are all freaking out! I don't think I will have any problems with my visa mama, but man oh man I just wanna get out to Argentina! .
So tbt to last Sunday. It was fast Sunday for us...so that meant fasting for a full 24 hours! As many know, the farrow's do not do well without getting fed, so I was like, crap. We're not even good at fasting just for one meal on sundays haha. But I decided that I could do this. SO i started my fast with a prayer Saturday night and asked for strength and to receive answers to questions that i have had. I asked to have His spirit with me and feelings of peace and comfort. Sunday came and not even kidding I didn't even think about food..at least for a while haha. Every Sunday we have to prepare a sacrament meeting talk in espanol and then in sacrament meeting, our branch pres announces who will be speaking. So i wrote mine on enduring to the end and I was kinda bummed that it was testimony meeting cause my talk was pretty good and I was ready to give it haha. During sacrament, I just had these overwhelming feeling of the spirit with so many good thoughts. I felt so prompted to bear my testimony and I did and don't even know what came outa my mouth. Relief Society was so good too and I felt the spirit so strongly in every one of my meetings and during my personal studies. It was just amazing to me to see that when we sacrifice and put our selfish thoughts aside, we are so blessed. The Lord hears and answers our prayers. Like Elder Holland said today in the afternoon session, we should fast when we can. I have a new and improved love and testimony of the Law of the Fast and am grateful for that experience I had.
Our lesson this week all went really well! One of our investigators is Benjamin and he is the most stubborn person I know haha. He believes God has favorites and I can just tell there is something that is holding him back from wanting to accept the fact that God knows him personally. In one of our lessons this week, I just had the thought "ahh why can't he just understand and accept what we're telling him?" I was so annoyed haha but then I had this thought that I need to have patience and love for him. If there's one thing that I've learned on my mission so far is that patience is key and to have faith in the Lord's timing! We must put our selfish feelings aside and put our investigators, or friends/family/others in need in front of ourselves. That is what this mission is all about. I have prayed for love towards my investigators and companions and I have seen an evident difference and I set my personal needs aside!
We got a new investigator this week named Maribel and wow do I love this lady! She is from Mexico City and she reminds me soo much of grandma Moon! even her smell! I have loved teaching and getting to know her and I loved talking to her about my grandma and grandpa moon's story! We had our third lesson with her yesterday and twas amazing. Her spirit and love for Christ was so strong. We showed her the video "Gracias a el" or "because of him" and that gets me every time. Everyone go watch it, but watch it in Spanish cause that's what we do! Anyways, after we showed her this, she was in tears and bore her testimony to us. Instead of me teaching and testifying to her, she is the one who taught me. She spoke so dang fast and I could only understand like half of her espanol, but I have never felt the spirit like that before. I had such an overwhelming love for Maribel and it made me SO excited and pumped that this is what I'm going to be doing for the next 17 months!!
Wasn't conference so amazing today? I loved it. I went in with a few questions I had written down this week and I cannot believe how every one of them was answered! I love the way the Lord works. I'll share just a few things I liked from today's sessions. Chi Hong Wong (haha) spoke in his Cantonese language and I love his talk! He said "When we assist Christ in His mission of saving souls, we too will be saved in the process". Es la verdad! I have already seen my testimony strengthened each day as I testify in my broken Spanish of the divinity of my Savior and His work. I also loooved Pres Uchtdorf's talk. "God wants to answer our questions and we need to learn to listen to His voice" Oh and that German guy Jorg Klebinat's talk was on point! So good! And of course Elder Holland's talk was amazing like usual!
I truly am beyond blessed to have this opportunity to be a servant of God. I absolutely love being here and feel so at peace. There is no doubt in my mind that this is where I am meant to be and have already seen it bless my life in so many ways. I am so happy :) I love this gospel and have gained such a love for Jesus Christ through these past 4 weeks. He is so real! El es nuesto Salvador y Redentor! Dios es nuestro Pardre Celestial. Yo se que Jose Smith fue el profeta de la restauracion. Y por que Joes Smith fue el profeta, el libro de mormon es la palabra de dios y el la verdad. Yo estoy muy agradecido por este oppurtunidad a servir mi mission! Me encanta este evangelio y yo se que es la verded con todo mi corazon!
I love you all! I miss my family and am so grateful for each on of you. I pray for my each one of you by name every night and think about you always! Shout out to debs for being the best mama in the world and for the cutest package! my comps loved it too! and thank ya nicholas for the package and all that candy hehe :)
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Course for Flute with Natalia Gerakis
Natalia Gerakis, Soloist, Orchestra and
Chamber Musician and Pedagogue,
The course adresses young professionals, music students, music teachers, scholars, as well as advanced amateurs, who will have the opportunity to meet and work in a relaxed and pleasant environment. Solo and chamber music repertoire for flute and piano, as well as basic technical issues, are the main focus of this course. The participants will intensively work individually and in the group on the realization of one's own targets, the preparation of concerts, competitions and auditions. Each participant should prepare 2-3 pieces of his choice.
In addition to the individual lessons there will be the possibility to play chamber music with participants of the parallel courses for Recorder, Guitar and Harpsichord/Pianoforte. You are welcome to bring your own choice of music. A list of proposals for chamber music can be send on request.
The course offers
Info- Flyer (PDF)
Application form (PDF)
Natalia Gerakis - Flutist
www.nataliagerakis.com, mail at nataliagerakis.com
Natalia Gerakis is considered one of the most accomplished flutists in Greece today. Both Stuttgart- and Athens-based, she has performed as a soloist, chamber musician and orchestra player at major halls and festivals throughout Germany and Greece. Besides, concerts and tours have brought her to numerous European and Mediterranean countries. She has been principal flutist of the Thessaloniki State Symphony Orchestra, has performed with the Athens State Orchestra, the Mikis Theodorakis Popular Orchestra, the Wuerttembergisches Kammerorchester Heilbronn and has collaborated with the Chamber Theater of the Stuttgart State Opera Haus. She completed her studies in Paris at the Nadia & Lili Boulanger Conservatoire in Paris with the "1er Prix de la Ville de Paris" and at the State Music Academy in Stuttgart under Prof. Jean-Claude Gérard on scholarship of the Greek State. Currently Natalia Gerakis is a sought-after tutor of international music courses (European Academy of Camerata Europaea/Germany, Adams European Flute Center/Holland, Internationaler Arbeitskreis für Musik/Germany, International Forum for Flute und Piano/Luxembourg, Springiersbacher Meisterkurse/Germany). She particularly enjoys working for concentrated short periods of time with young flutists, helping them towards achieving their own goals.

subset: commoncrawl


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The vertex of a parabola is at (12,-4), and its axis of symmetry is vertical. One of the x-intercepts is at (15,0). What is the x-coordinate of the other x-intercept?
distance from one x-intercept from the vertex is the same as the other x-intercept.
the distance from vertex's x coordinate 12 to 15 is 3 thus 3 in the other direction is (9,0)


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Degree type(s): Master's
Degree field(s): Healthcare; Nursing; Management; Leadership
Location(s): Online
Program offerings by location and modality are subject to change.
BSN to MSN Online Degree Program: Nursing Leadership and Management
Expand your nursing career opportunities and income potential by taking the next step with an MSN degree. You can earn your master's degree in nursing leadership and management from the University of Mary in an online, accelerated, and accredited program.
Blending theory and practice, the online master's degree in nursing leadership and management opens up opportunities for nurses in administrative and management positions in healthcare. This online BSN to MSN program provides a broad background in healthcare business concepts, with an emphasis on leadership and management in the context of advanced nursing practice in healthcare. And, as part of the online MSN program, students are required to participate in a practical experience within a clinical setting.
If you currently hold an associate's degree and are looking to expand your nursing career opportunities, our ADN to MSN online program may be for you!
BSN to MSN Online Degree Program Highlights
The University of Mary, an accredited, Catholic university, was founded by Benedictine sisters with a long history of leadership and service in the field of nursing. The online BSN to MSN Nursing Leadership and Management program offers students opportunities to:
Participate in Unique Clinical Experiences
The online BSN to MSN program includes clinical opportunities where you'll gain practical experience through coursework. Infused with Benedictine values, the program prepares nurses with the unique blend of clinical and leadership skills necessary to manage and administrate nursing programs, and to make broad contributions to the healthcare system as a whole.
Earn Your Degree with Flexibility and Convenience
Students can complete their MSN degrees online with flexibility and convenience while balancing work and family obligations at home. Online classes are led by faculty who are professionals in their fields and encourage collaborative learning through discussion and hands-on management experience.
The BSN to MSN program at the University of Mary encourages collaboration amongst the students. Classes were arranged so I could remain employed and be successful in the program. There was great support from the instructors and other staff from the university."
Why Earn Your MSN Degree?
The BSN to MSN program at the University of Mary offers students the opportunity to succeed in a growing job market.
Financial Benefit
As of May 2017, the median pay for medical and health services managers was $98,350 per year (or $47.29 per hour).
Forecasted Industry Growth
In 2016, there were 352,200 medical and health services manager positions nationally. With forecasted industry growth of 20% between 2016 and 2026, this profession will grow much faster on average than other professions. The medical and health services manager industry will add 72,100 more jobs between 2016 and 2026, increasing the demand for degreed professionals nationwide.
* Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Medical and Health Services Managers
The Nursing Leadership and Management program at the University of Mary includes courses covering a wide range of topics, such as nursing, leadership, current issues in healthcare administration, management and organizational behavior, healthcare law and policy, and more. You will develop the skills to be a service-minded nursing leader or manager who can innovate and create system-wide changes built on evidence-based decisions.
This online MSN degree includes a seminar and service project. Students will complete a total of 500 hours of practical leadership experience as part of coursework assignments.
An undergraduate or graduate statistics course must be successfully completed prior to the nursing leadership and management program of study.
Required Courses
- HUM 506 - New Nursing Graduate Student Orientation
- NUR 510 - Healthcare Across the Population
- NUR 551 - Critique and Design of Nursing Research
- NUR 560 - Applied Healthcare Economics, Finance and Budgeting
- NUR 601 - Evidence-based Practice and Strategic Healthcare Decision Making
- NUR 612 - Professional Roles in Advanced Nursing
- NUR 614 - Resilient Nursing Leadership
- NUR 648 - Healthcare Law & Policy
- NUR 696 - Seminar and Service Project I
- NUR 697 - Seminar and Service Project II
- BUS 504 - Management and Organizational Behavior
- BUS 505 - Human Resource Management
- BUS 630 - Contemporary Issues in Healthcare Administration
- HUM 799 - Graduate Studies Assessment: Nursing
- Statistics - Students must successfully complete an UG or GR statistics course before or during their course of study. Options include MAT 180, MAT 204, NUR 565, or an approved transfer course.
Application Requirements
- Completed application
- Undergraduate GPA of 2.75 or higher on a 4.0 scale
- Current unencumbered RN license
- Official transcripts from all degree-granting institutions attended
- Two letters of reference
- Criminal background check
- Criminal background check release form
- Resume
- Goal statement
Apply NowAcceptance at the University of Mary does not automatically qualify you to pursue
a program in one of the academic programs of study. Application requirements are specific
to each major or academic program.
Admission Requirements
We recommend consulting your advisor for details. Applications are reviewed by the faculty members of the program. You will be notified that you have been admitted or denied admission to the program.
Can I work while I earn my degree?
Yes, the BSN to MSN program is flexible and designed for working professional nurses. Classes can be taken on a full-time or part-time schedule to allow you to have a good work-life-school balance.
When can I start my classwork?
Classes begin three main times during the year – January, May, and September. However, smaller starts may be available throughout the year, allowing you to begin your courses as soon as you're ready.
Does this program require the GRE or other prerequisites?
The GRE and other prerequisites are not required. However, the program does require a statistics course (graduate or undergraduate) or transfer course equivalent from an accredited college or university. If you need the statistics course, it is integrated as part of your program of study so you do not need to take it beforehand.
How long does it take to earn an MSN degree?
The average completion time for a BSN to MSN degree is 16 months.
How do I apply?
It's easy to apply, visit www.umary.edu/Apply to apply online or email [email protected] with any questions.


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Do your Grandma proud and bring that sweater she spent her blood, sweat & tears making! That's right, wear your ugliest sweater during the day, showing it off in all it's glory for everyone on the mountain to see.
After you've rocked the mountains all day in your finest, join us in the T-Bar Pub for our Ugly Sweater Party! DJ Phenomenorm will bring the Funk, Disco and Old School Hip Hop to the Pub, starting at 9 PM.
Prizes will be awarded for the best / worst ugly sweaters.


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There is a voice that doesn't use words. Listen. Rumi.
Mindful Soundscapes is a collaboration between mindfulness and meditation teacher Maya Nova and musician George Edgar (Molly and the Chromatics, Lakes).
Join us on this co-creative exploration of music and meditation at the foot of Mt Vic in Devonport and enjoy sweet sounds, deep relaxation and magnificent views of Auckland's Skyline.
Both music and meditation have the capacity to open and expand our minds and hearts and let our spirits soar free.
Maya will be guiding the meditations and George will be layering the sounds - we will dive deep into presence, joy and creativity together - come play with us!
We want to be as inclusive as possible for this event so if the price is a problem just contact us.


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A preferred supplier to the world's largest resource company, Cell-media works with a range of clients across a broad range of industries.
An award-winning company, we bring to the table specific knowledge of our clients' industries and processes. Cell-media strives to create innovative products which are both cutting edge and 'best-in-industry'.
We look forward to working with new clients and seek to expand our knowledge further at every opportunity.
With over 17 years of experience in the Multimedia Induction Industry, sometimes we've managed to get it right...
Some of our clients were even kind enough to write about it! Take a look:
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As far as I am concerned, congratulations on a project well done!!Thanks on behalf of the client"
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Having the ability to access the portal and see those changes and our idea coming to life was great and we can't thank you enough for delivering such a great product. We had a few teething problems with log-in credentials after initial roll-out (not Cell-media's fault) however you were more than accommodating and solution minded, which was comforting.
Thanks again Thomas and the team at Cell-media. We look forward to SSO and getting the whole project completed."
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As you can imagine, after being in the industry for over 12 years, Cell-media has worked with quite a few clients. Let's face it, it's our greatest selling point. You might even recognise some of their logos:


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RICCARDO BESTETTI wedding photographer
After having attended a university level master degree program and receiving a diploma in advertising and industrial photography at the European Institute of Design in Milan, he took his first steps in the studios in Milan where he started taking his first professional shots.
As the years have gone by, Riccardo is more and more attracted to social photography, a sector which delights him as he finds a working environment not as cold and vapid as the studio where he has worked.
Reliability and vocation have contributed to the fact that with age, Riccardo Bestetti has improved so much to become a reference point in photography. Supported by valid partners and co-workers he has succeed in renewing himself, making the best of the new technologies.
The study is located in a strategic area of northern Italy and worked in particular on the Como lake, Garda lake, Maggiore lake and Lugano lake, but at present his shots are showed in various Italian regions and abroad.


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Erasmus placement offers
Below you may find a List of Erasmus Placements
Do not use this listing as your sole resource! There may be other Erasmus Placement offers available to you based on your background, affiliations and specific interests.
Carry out your own research: Many students find the work placement independently by having direct contact with an employer in another European country or through responding to calls for work placement applications from employers on a website or other form of advertisement
17/12/2014 : Placement offer, Slovenia
17/12/2014 : Spanish School, Spain
17/12/2014 : Traineeship Offers Italian Schools, Italy
17/12/2014 : Erasmus placement offers, Slovakia
20/08/2014 : Erasmus Placement Offer - TECHNOLOGICAL PARK OF ÓBIDOS - Portugal, Portugal
20/08/2014 : German placement offer, Germany
20/08/2014 : Placement Offers from Turkey, Turkey
20/08/2014 : placement offer - Poland, Poland
20/08/2014 : ES-Traineeship offer, Spain
20/08/2014 : Placement offer from Turkey, Turkey


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FabFitFun is one of the most popular subscription boxes out there and pretty easy to see why. — Their quarterly boxes are always jam-packed with full size, name brand items and the value is consistently amazing. Typically over $200 retail value!
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Disclosure: Post may contain affiliate links.
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Annas, J., Snow, N., & Narvaez, D.(Eds.).(2016). Developing the Virtues: Integrating perspectives. New York, NY: Oxford University Press.
Overview: Ethicists and psychologists have become increasingly interested in the development of virtue in recent years, approaching the topic from the perspectives of virtue ethics and developmental psychology respectively. Such interest in virtue development has spread beyond academia, as teachers and parents have increasingly striven to cultivate virtue as part of education and child-rearing.
Looking at these parallel trends in the study and practice of virtue development, the essays in this volume explore such questions as: How can philosophical work on virtue development inform psychological work on it, and vice versa? How should we understand virtue as a dimension of human personality? What is the developmental foundation of virtue? What are the evolutionary aspects of virtue and its development? How is virtue fostered? How is virtue exemplified in behavior and action? How is our conception of virtue influenced by context and by developmental and social experiences? What are the tensions, impediments and prospects for an integrative field of virtue study? Rather than centering on each discipline, the essays in this volume are orgnaized around themes and engage each other in a broader dialogue. The volume begins with an introductory essay from the editors that a wide-angle view of the fuller range of philosophical and empirical issues that have surrounded the notion of virtue in recent years.
Buy the book: Annas, J., Snow, N., & Narvaez, D.(Eds.).(2016). Developing the Virtues: Integrating perspectives. New York, NY: Oxford University Press.
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Our pastry and baking equipment creates more than just cakes and pastries. It creates delicious smells, mouth-watering treats and eye-catching delights. With the right tools such as cake decorating equipment, quality moulds, ramekins, non-stick bakeware in a range of shapes and sizes and an array of exciting pastry cutters, you are all set to bake, decorate and create a huge smile across your customer's face. Compliment your baking skills with our essential baking equipment such as mixing bowls, sieves, kitchen scales and jugs, rolling pins, baking paper, foils and films as well as cake boxes, pastry and palette knives.
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Donate to the Mid-Ohio Foodbank at any winter hike to help feed hungry families and you'll get a Metro Parks mug. The hike at Slate Run will take place on Sunday, February 17th starting at 2:00 p.m.
- Look for the Metro Parks collection truck and canopy tent
- Donate four items or more for your mug (one mug per person please)
- Sealed non-perishable items only
If you would rather donate financially to Mid-Ohio Foodbank, Metro Parks will collect $5.00 donations by credit card only. Monetary donations will be taken 30 minutes before hike start time and up to 90 minutes after the hike has started. One $5.oo donation equals one mug.
1375 St. Rte 674 North, Canal Winchester, OH 43110


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- Clinical Center
- Medical Oncology
- Surgery
- Gynecologic Oncology
- Traditional Chinese Medicine/Integrative Oncology
- Radiation Oncology
- Anesthesiology
- Medical Laboratory
Contact Us
Tel: +86-731-88651900
Fax: +86-731-88651999
Mail: firstname.lastname@example.com
Add: 283 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, P.R. China
Doctor Profile Home > Departments > TRADITIONAL CHINESE MEDICINE/INTEGRATIVE ONCOLOGY > Traditional Chinese Medicine Department
- Dr. LI Yueheng
- Traditional Chinese Medicine Department, Professor
Education & Professional Experiences:
Graduated from TCM Clinic, Hunan University of Chinese Medicine.
Proficient in TCM treatment for tumor, by unique Chinese and integrated Chinese and western medicines, to treat liver cancer, lung cancer, digestive tract cancer, breast cancer, nasopharyngeal carcinoma, lymph cancer, and gynecological tumor, to alleviate toxic and side effects of radiotherapy and chemotherapy, to delay tumor recurrence and metastasis of tumor, and realize rehabilitation. The clinical effect reaches national advanced level in treatment of liver cancer and lung cancer.
Awarded the first prize of TCM science and technology progress and 6 scientific research achievements.
Multiple papers in national academic journals.
Editor-in-chief of A Complete Collection of the Treatment of Tumour in Traditional Chinese Medical Science and A Complete Collection of the Treatment in Internal Medicine of Traditional Chinese Medical Science.
Academic adviser of TCM department.
An expert enjoying the State Council special allowance.
Prestigious TCM doctor of Hunan.
Academic experience inheritance guidance teacher for first-batch TCM experts in Hunan and China.
Chairman of Hunan Oncology Society of Integrated Traditional Chinese and Western Medicine.
Vice chairman of Hunan Chinese Medicine Oncology Society.
Member of Oncology Society, World Federation of Chinese Medicine Societies.
Member of Chinese Medicine Tumor Society.
Member of Chinese Medicine Tumor Society of Chinese Anti-cancer Association.
Member of Chinese Medicine Tumor Society of Cancer Foundation of China.
Member of Chinese Geriatric Oncology Society.
Out-patient Schedule:
Wednesday morning and Friday morning
- Related


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Would you recommend this product?
1 Review
I'm a bit nervous to start using it, even though I know it will be good for me. I'm very attached to my 20+ tabs and I'm not sure I'm ready to let them go after just 12 hours. As @joostschuur said maybe 24 or 48 hours would be a good upper limit so I can ease in to this.
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I was made aware of this awesome Chrome Extension a few days ago. It automatically closes inactive tabs (you set the interval), and lets you grab them right back or close them permanently. It's been really useful for my productivity (and sanity).
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It seems to have a 720 minute (12 hour) limit right now. I really wanted to set this to 2 days. I'm pretty sure there's a valid reason why I'd _actually_ want it to be much less than that, but it's a shame I can't start at 2 days and work my way down :(


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Home | Shop | Where to Go | Luxor Day Tours and Excursions | Day trip to Luxor from El Gouna by private vehicle
El Gouna Excursions, Day trip to Luxor from El Gouna by private vehicle and private guide to visit the Karnak temple and Luxor temple in east bank, Hatshepsut temple, Valley of Kings and colossi of Memnon in the west bank, Lunch meal is also included, drive back to El Gouna.
You will be picked up from your hotel / Villa in El Gouna by air-conditioned private vehicle to Luxor 3 hours safety driving with amazing view for the mountain and desert. Upon arrival in Luxor start with visiting the valley of the kings located in the west bank, the valley of the king was the royal cementry for 62 pharaohs as King Tutmosis I, Tutmosis III, Tut-Ankh-Amon, King Ramssess VI, King Mrenptah and AmonhotepII. proceed your trip to visit hatshepsut temple (Deir el Bahari), the temple is one of the most dramatically situated in the world. Hatshepsut queen ruled Egypt about 20 years. then you will visit the colossi of Memnon they are only remains of the mortuary temple. Lunch will be served during your trip, then continue your trip to visit the karnak temple (ipet- isut) it is the most sacred of places, Karnak temple is culmination of three main temples and several smaller enclosed temples around twenty nine temples so it is the largest and most impressive of all temples in Egypt, free time in Luxor then drive back to El Gouna with direct transfer to your hotel in El Gouna.
Day trip to Luxor from El Gouna by private vehicle
Tour Includes:
Pick up and drop off services from your hotel in El Gouna
Admission fees to the sites in Luxor as per itinerary
Lunch during the tour at local restaurant in Luxor
Egyptologist English speaking tour guide in Luxor
All transfer by AC van class in El Gouna and Luxor
Tour Excludes:
Gratuities (recommended)
Personal expenses
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|17-35 Persons
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Alfa Romeo Giulia: No Manual Is Sacrilege For Italian BMW
Most of the details we know about the Alfa Romeo Giulia right now is about the top of the range model. Alfa Romeo is now ready to release some additional details about the lower trim model although we do not think that the manual fans will be too happy.
The new Alfa Romeo Giulia will come with three trim, the base model, Ti as well as the top of the range Quadrifoglio model. Other than the top of the range model, the other two will come running on a 2.0 liters four-cylinder engine that will be delivering about 276hp and 295lb ft of torque. The engine will come mated to an eight-speed auto transmission. From what we know now, it looks like Alfa Romeo has no plans to offer a manual transmission option.
The base powertrain will allow the Alfa Romeo Giulia and Ti model to go from 0-60mph in 5.5seconds. Other features that customers will get includes a seven-inch driver info display, keyless start as well as a flat bottom steering wheel.


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|AFM Surveillance United States 2014-2017 - Credit CDC
Acute flaccid myelitis (AFM) is a rare polio-like illness that affects a person's nervous system - specifically the spinal cord - and is characterized by sudden weakness in one or more arms or legs, along with loss of muscle tone and decreased or absent reflexes.
AFM is a subset of conditions that fall under a broader `umbrella' of syndromes called Acute Flaccid paralysis (AFP), which may include myelitis, peripheral neuropathy, myopathy, Guillain-Barré syndrome (GBS), toxic neuropathy, and other muscle disorders.
While the exact causes of Acute flaccid myelitis aren't fully understood, it has been linked to a number of viral infections, including West Nile Virus, Adenoviruses, and a number of (polio and non-polio) enteroviruses, including EV-71 and more recently, EV-D68.A nationwide outbreak of EV-D68 was linked to a concurrent spike in AFP cases across the United States in the fall of 2014, and while a pretty strong circumstantial case has been made over the past couple of years (see EID Journal Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014), no definitive causal link to EV-D68 has been established.
Since then we've seen a number of EV-D68 outbreaks around the world (see here, here & here) where a concurrent spike in AFM cases have also been reported.Today the ECDC's Eurosurveillance Journal has a review of the literature, and an examination of the available evidence using the Bradford Hill criteria, that attempts to establish a potential link between EVD68 infection and AFM.
The authors found that analysis based on the Bradford Hill criteria suggested good evidence for EV-D68 being a cause of AFM. Today's review is a lengthy, detailed one, which most of my readers will want to read it in its entirety.
The link and a few small excerpts follow:
The association between acute flaccid myelitis (AFM) and Enterovirus D68 (EV-D68) – what is the evidence for causation?(EXCERPT)
Amalie Dyda1, Sacha Stelzer-Braid2,3, Dillon Adam1, Abrar A Chughtai1, C Raina MacIntyre1,4
Historically, the incidence of EV-D68 has been low, with sporadic cases and small clusters of mild illness reported. Whether this represents under-ascertainment or true low incidence in the past is unclear, but active EV surveillance studies in several countries including Germany in 2013-14, Hong Kong in 2014, France in 2014 and China in 2011-15 suggest that EV-D68 was a rare cause of clinical infection in the past [18-21]. Since 2014, the number of reported infections and clusters has increased. In addition, severe complications including AFM have been reported since 2014 [3]. Several clusters of AFM in recent years were associated with EV-D68 and a large outbreak of EV-D68 in 2014 in the US was associated with severe respiratory illness.
Our application of the Bradford Hill criteria suggested good evidence for EV-D68 being a cause of AFM. While EVs in general are neurotropic, AFM has never previously been associated with EV-D68. It could be that incidence of EV-D68 was genuinely been much lower in the past, so that rare complications of infection have not been apparent. An analogous example is the association between Zika virus and microcephaly which was only recognised during a large-scale epidemic in Brazil in 2015 [62,63]. However, retrospective analysis of a large outbreak of Zika virus in French Polynesia two years earlier showed the same association with microcephaly but was not recognised at the time [64]. In addition, clades A, B and B1 of EV-D68 were highly neurovirulent in animal studies, with specific tropism for motor neurons [47]. It appears that these strains which evolved after the year 2000 are capable of causing AFM, as demonstrated in a mouse model, while the original Fermon and Rhyne strains do not cause AFM [47].
There is a need for phylogeographic epidemiology to ascertain temporal and geographic changes in the virus and whether such changes could explain why AFM is newly associated with the virus. Genetic changes in the virus which have rendered it more neuropathic could explain the association, and several clades have been shown to be highly neurovirulent. Phylogenetic studies have demonstrated that strains isolated in recent outbreaks are very divergent from the original Fermon strain isolated in 1962 [15]. Clades B1 and B2 caused the 2014 outbreak [30] and clade B3 caused an outbreak of severe EV-D68 infection in the Netherlands in 2016 [17]. Strains in clade B1 have mutations in structural and non-structural proteins, which could play a role in the reported neurovirulence of these strains [12], and all EV-D68-infections in human AFM cases were attributed to clade B. However, mouse studies showed that multiple clades (A, B and B1) cause paralysis [47]. The observation that clade B1 was associated with AFM in 2014 may be due to the much higher incidence of clade B1 infection in 2014. More research is needed to study biological gradient and to quantify measures of association between EV-D68 and AFM.
Given that the association of AFM with EV-D68 is recent, there is a strong case for systematic and enhanced EV surveillance, which will enable investigation of epidemiological data for measures of association. While past studies and EV surveillance showed that EV-D68 was a rare cause of EV infection, there has been a change in disease epidemiology since 2014, including a rise in the incidence of clade B infections. The lack of association between AFM cases and EV-D68 in the US in 2015 and 2016 [11] does not detract from our analysis, as AFM is a clinical syndrome with multiple possible aetiologies. More recent AFM cases could be due to a different aetiology, as other EVs continue to cause AFM, or could reflect the difficulty in isolating the virus from tissue and CSF. The Bradford Hill criteria are a tested and systematic method for evaluating causality and could be applied to other EVs.
(Continue . . .)In summary, the application of the Bradford Hill criteria suggests that EV-D68 causes AFM. AFM has not previously been associated with EV-D68, and a mouse model shows that the original Fermon strain does not cause AFM, whereas the 2014 outbreak strain does [47]. It appears that the incidence of this infection and the clade-specific epidemiology have changed. Phylogeographic epidemiology will further our understanding of the temporal and spatial spread of increasingly neurovirulent clades and improve risk analysis. Further investigation into this relationship is important because of the severity of AFM, ongoing outbreaks of AFM and because there is currently no treatment for AFM related to EV-D68, and no vaccine to prevent infection [24,65].


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Women's Mentoring Ministry invites you to prayerfully consider walking alongside us as we seek to encourage one another to grow in character: reflecting Christ-likeness; in conviction: knowledge of the Truth leading to maturity in Christ; and in competence: having opportunities to use our spiritual gifts to serve and love others, all to the glory of God and His Son, Jesus Christ.
This Year's Themes
Click below to see more information about the Mentoring Ministry, including dates, times, topics, and teachers.
For More Information
If you would like to sign up or have questions regarding child care, please contact the leader of the group you would like to join. For further inquiries, contact Margaret Tran.
Jonah DownloadsJonah Chapter 1 Jonah Chapter 2 Jonah Chapter 3 Jonah Chapter 4
Click Here for last year's Esther Resources
Home Mentoring Groups
Leaders: Mandy Schoonhoven (firstname.lastname@example.com) & Sharon Kaufman (email@example.com)
- Day of Week: 3rd Tuesday evening of the month
- Time: 7 pm-9 pm
- Location: Home of Cathy Diaz, 166 Gold Valley Way, American Canyon
Leader: Karen Fernandez (email@example.com)
- Day of the Week: 3rd Wednesday morning of the month
- Time: 9:30 – 11:30 am
- Location: Home of Annette Rogelstad – 408 O'Farrell Drive, Benicia
Leader: Margaret Tran (firstname.lastname@example.com) & Becky Reyes
- Intern: Abi Fredeluces
- Day of the Week: 3rd Thursday morning of the month
- Time: 9:30 am – 11:30 am
- Location: Home of Janice Baker – 1001 Western Avenue, Vallejo
Leader: Natalie Suico (email@example.com)
- Intern: Sandy Lee
- Day of Week: 3rd Thursday morning of the month
- Time: 9:30 am – 11:30 am
- Location: Home of Jenny Harris: 122 Horizon Way, American Canyon
Leader: Rosa Loving (firstname.lastname@example.com)
- Day of Week: 3rd Thursday morning month
- Time: 9:30 am – Noon
- Location: Home of Debbie Thornton – 901 Greenmont Dr, Vallejo
How to Sign Up
We invite you to join us as we study His precious Word together and fellowship with one another. If you find a group you'd like to be a part of, please contact the group leader.
For further questions, please contact: Margaret Tran.
About This Ministry
It is the desire of the women's ministry to continually teach women, through instruction and by example, the beauty, glory, joy, and freedom of biblical womanhood to the exaltation of Christ.
"Older women likewise are to be reverent in their behavior, not malicious gossips not enslaved to much wine, teaching what is good so that they may encourage the young women to love their husbands, to love their children, to be sensible, pure, workers at home, kind, being subject to their own husbands, so that the Word of God will not be dishonored." Titus 2:3–5
Mentoring groups provide a place where women are encouraged and equipped through the study of God's Word and fellowship with one another. We desire to help women grow in character-reflecting Christ-likeness; in conviction-knowledge of the Truth leading to maturity in Christ; and in competence-having opportunities to use their spiritual gifts to serve and love others, all to the glory of God and His Son, Jesus Christ. We hope you would prayerfully consider walking alongside us as we seek to walk in a manner pleasing to Him.


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'Razzle Dazzle' review: Michael Riedel pulls back the curtain on for Broadway/
Remember when an evening at a Broadway musical required scurrying past seedy, adults-only shops and all manner of colorful entrepreneurs on the way to the theater? If your impression of Times Square dances with Disney characters and shiny retail meccas, you probably don't remember. But Michael Riedel's new book, "Razzle Dazzle," brings this gritty world back to life. His history of Broadway in the 1970s and '80s paints a candid and thoroughly entertaining portrait of the period just after New York theater's golden age. Money for artistic endeavors was scarce, and the city seemed adrift in economic and social turmoil. Broadway, Riedel argues, was both a beneficiary of and a critical factor in the city's astonishing transformation in the following decades.
Riedel is the theater critic for the New York Post and the co-host with Susan Haskins of PBS's "Theater Talk." He's also a formidable presence in the Broadway world, known as much for his way with words as for his withering critiques of productions that miss the mark. But in this book, Riedel saves his bon mots for the offstage drama: The subject at hand in "Razzle Dazzle" is the "business of show," not the artistic merit of the productions themselves. He draws on decades of interviews, memoirs, reviews and newspaper articles to reconstruct the feuds, ambitions, catastrophes and successes of this fascinating period.
The central narrative of "Razzle Dazzle" is the story of the Shubert Organization, established by three brothers from Syracuse, N.Y., in the late 19th century. The Shuberts' modest, early efforts were in vaudeville, but by 1929, the Shubert Organization comprised a network of theaters across New York City, including the Imperial Theatre and the Winter Garden. As Riedel explains, in the postwar years, Broadway produced a string of unprecedented smash hits, and the medium of the musical hit its stride: "West Side Story," "The Sound of Music," "Damn Yankees," "Kiss Me, Kate," "The Pajama Game" and scores of other productions kept theaters busy, with about 7 million patrons per year.
Riedel weaves together the story of the diverse forces that changed all that. The stock market crash of 1969, though not as calamitous as that of 1929, sent a fiscal chill through the country. The population of New York had shrunk by a staggering 800,000, following a pattern of white flight that swelled suburbs all over America. By the early '70s, theater attendance was halved. "The Broadway audience has always been white, middle-aged, and upper-middle class," Riedel notes, and with its core population drastically reduced, the musical theater world was foundering.
Broadway might have drifted into financial and cultural oblivion were it not for three men who intervened, set on saving the industry they loved. These were Jimmy Nederlander, whose theater-buying habit made him a Shubert rival, and Gerald Schoenfeld and Bernie Jacobs, who took control of the Shuberts' 17 theaters. Both camps began turning out hits: In 1975, "A Chorus Line" opened at a Shubert theater, and Nederlander had a smash with "Annie" in 1977. Amid these triumphs, Riedel hastens to point out, competition was stiff and producers were forced to take sides. His descriptions of the vices and foibles of the producers, choreographers and directors who shaped these productions would not seem out of place in a page-turning Hollywood tell-all.
Broadway's extraordinary rebirth paralleled the transformation of Times Square and New York City itself. One especially compelling example is the iconic "I Love New York" campaign, dreamed up by the advertising agency Wells Rich Greene in the late '70s. The TV ad featured a song by veteran jingle-writer Steve Karmen, performed by cast members from "The Wiz," "A Chorus Line," "Annie" and "Grease," plus Yul Brynner and pint-size children from the cast of "The King and I." This became one of the original "brand videos," to employ an anachronism: The actors were selling the idea of Broadway, not their individual productions. The "I Love New York" campaign was a huge hit, and we all know what happened next: "Les Misérables," "The Phantom of the Opera" and — cue the furry jazz hands — "Cats."
Broadway and Times Square today would not be recognizable to those who last saw them in the mid-'70s or, for that matter, in the late '20s. Broadway musicals are as popular as ever, but much of the grit and seediness has been washed clean, and the area is now more akin to a family-friendly theme park than a bawdy vaudeville enclave. Riedel unearths treasures from the recent past and contextualizes events that would otherwise be too easily forgotten. "Razzle Dazzle" helps explain how each of these distinct eras could unfold in the same physical place, each one a potent sign of its times.


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5669 Bentwood Dr Mason OH
Sold for $323,000
Beautiful Home In Crooked Tree! 4300SF Granite In Kit w/ SS APP & Hdwd Floors in Kit, Foyer & Sunroom. All Bdrms Are Oversized & Mstr Bd. Full Fin Bsmt w/ Full Ba, Bar Area, Media Areas & Rm For Kids. Freshly Painted. Walking Distance to Community Pool!
Directions to 5669 Bentwood Dr Mason OH 45040: North On Butler Warren, Right On Bethany, Left On Pinnacle, R On Crooked Tree, R On Bentwoo
Sold on 11-05-2018
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Plum Tree Realty
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Current Gerontology and Geriatrics Research
Volume 2014, Article ID 735235, 7 pages
A Cross-Sectional Study to Examine Factors Associated with Primary Health Care Service Utilization among Older Adults in the Irbid Governorate of Jordan
1Faculty of Nursing and Midwifery, Jerash University,
Amman, Irbid International Street, Jerash 26150, Jordan
2Faculty of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA
3Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
4Faculty of Nursing, Jordan University, Amman 11942, Jordan
5Faculty of Medicine, Jordan University, Amman 11942, Jordan
Received 27 June 2014; Revised 8 October 2014; Accepted 12 October 2014; Published 6 November 2014
Academic Editor: Tomasz Kostka
Copyright © 2014 Abdullah Alkhawaldeh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background. Recently, the percentage of older adults in developing countries has increased significantly. Objective. This study examined patterns and factors associated with primary health care services utilization in the past 1, 6, and 12 months. Method. A cross-sectional study design was used to collect data from 190 older adults in the Irbid governorate of Jordan. Results. Primary health care services were used by less than half of the participants in the past 1 month, by 68.4% in the past 6 months, and by 73.8% in the past 12 months. Primary health care (PHC) services use was associated with age, education level, tobacco use, chronic illnesses, perceived general health status today, a physical component summary score, employment, and perceived general health status in the past 6 and 12 months. The primary predictor of PHC services use at 1, 6, and 12 months was chronic illnesses (), (), and (), respectively. Conclusion. Although many factors were associated with PHC service utilization, the strongest predictor of PHC service utilization was chronic illnesses.
1. Introduction
Recently, the percentage of older adults in developing countries has increased significantly [1]. Middle income countries have found that this increase in older adults represents a major challenge for health care organizations as a result of the physical, social, and psychological changes associated with complex morbidity and mortality profiles [2]. Subsequently, all countries need to be prepared to address the consequences of the demographic trends associated with aging populations. Worldwide, the increasing health care demand of older persons requires a better understanding of factors influencing health care service utilization patterns [3]. In several parts of the developing world, primary health care (PHC) use is inadequately understood [4]. In Jordan, there is an inadequate amount of reliable data existing on health care utilization rates and thus health care planners are unable to estimate accurately the real needs of the population [5].
Some studies have explored health services utilization patterns across several countries [6–8]. A study of older Estonians found that about 81 percent indicated having visited a general practitioner or specialist during the prior 1 year [9]. Similarly, health service utilization among older Nigerians was high, finding that 95.3% had visited a health care facility and 90.3% reported being sick frequently; however, just 67.8 percent visited a health facility once they were critically sick [6]. In contrast, health service use among older Chinese in the past 6 months was less than 50 percent and consisted of general outpatient clinic services (36.7%) and specialist outpatient clinic services (20.8%) [7]. Similarly, health care services use in the past 1 month among older adults in Hong Kong was less than 50 percent and the services were provided by Western medicine physicians (both generalists and specialists) in a Government clinic (31.1%), private physicians of Western medicine (11.1%), practitioners of Chinese medicine (2.5%), and Western medicine practitioners in emergency units (1.9%) [8]. In Spain, researchers found that, of the health care services utilized by 74.5% of older adults in the past 3 months, 18.4% were nursing staff visits, 59.4% were general practitioner visits, and 16.5% were specialist visits [10].
Patterns in health services utilization by older adults have been found to be associated with many factors [7–13]. For example, among 787 older adults over 64 years of age in Spain, health service contacts were greater for females than males. Moreover, educational level was negatively associated with outpatient services, chronic diseases, and medication use. Additionally, poorer health status was positively associated with general practitioner consultations, smoking was negatively associated with health care use, and older adults with depression or the perceived need for care were associated with greater health care use. In Spain, the significant predictors of general practitioner use were perceived need for care, self-reported health status, and educational level [10]. In Hong Kong, a study found that age was significantly associated with hospital use, income was significantly associated with both general and specialist outpatient clinic services utilization, and family instrumental care was significantly associated with hospital use. Self-rated health status and particular kinds of chronic illness were significantly associated with use of the four services. Also, poorer activities of daily living scores were associated with both emergency room and general outpatient clinic use, and greater symptoms of depression were associated with hospital use [7].
A study conducted in Ghana reported that health care utilization was associated with participants' age group, occupation, medical history of chronic conditions, cognitive impairment in past 30 days, and self-reported health status. In addition, significant predictors were age group, medical history of chronic condition, cognitive impairment, self-perceived health, and difficulty with picking up items in the past 30 days [13]. In Korea, a study found that those most likely to have used long-term care services were 80 years and older, had less than 13 years of education, lived with others, were religious, had no income and health insurance, had poor health status, and had activities of daily living/instrumental activities of daily living (ADL/IADL) limitations and cognitive impairment. Determinants of long-term care services use were health status, ADL/IADL limitations, and cognitive impairments [12]. A Thai study found that greater health care services utilization in the past year, among 504 adults aged 60 and older, was associated with older males [11]. The utilization of health care services was also connected with married, less educated participants, and diagnoses with a chronic illness [11].
Although there were some studies that studied health status of older adults in Jordan [14–19], a comprehensive literature review revealed a dearth of research regarding factors that influence PHC service use among older adults in Jordan. Hence, this study aimed to examine patterns and factors associated with PHC utilization by Jordanians aged 50 years and older living in the Irbid governorate of north Jordan.
2. Materials and Methods
2.1. Design
A cross-sectional study design was used to examine PHC services utilization patterns and to identify factors associated with and predictive of health care utilization/nonutilization in the past 1, 6, and 12 months. The study was conducted in the catchment areas associated with three comprehensive PHC centers which provide services from 8 a.m. to 4 p.m., and most of these health centers serve large numbers of people and offer many preventive and curative health care services situated in areas within the Irbid governorate of north Jordan [20].
2.2. Participants
Adequate sample size needed for binary logistic regression [21] was determined using the formula proposed by Peduzzi et al. [22]. They suggested a minimum that is at least 10 times , where is the number of predictors in the model. Using their criteria, the minimum sample size needed for this study was 190 participants.
A proportional convenience sample of 190 older adults, aged 50 and older, participated in this study from three areas (south (), center (), and north ()) of the Irbid governorate in Jordan (Irbid is the third largest inhibited city). These primary health care centers serve around 69,088 inhabitants.
2.3. Measures
2.3.1. Dependent Variables
PHC service utilization in the past 1, 6, and 12 months.
Participants were asked the following. Did you visit the primary health care center in your region during the past month? Past 6 months? Past 12 months?
2.3.2. Independent Variables
Based on Anderson's behavioral model, predisposing, enabling, and need factors were included as follows [23]: predisposing factors included age (years), gender (male or female), health behavior measuring tobacco use (smoker or nonsmoker), employment status (unemployed, retired, and employed), education level (no education, primary school, and secondary), and marital status (married, single, separated or divorced, and widowed). Enabling factors included monthly income and health insurance coverage (insured or not insured). Need factors included chronic illness self-reports (have/do not have a chronic illness).
Additionally, cognitive impairment was measured by using the Elderly Cognitive Assessment Questionnaire (ECAQ) [24]. Perceived general health was measured in two ways: (1) on a scale of 1 to 10, with a 1 representing the "worst I have ever felt" and a 10 representing the "best I have ever felt." What number would best represent your general health today? 6 months ago? 12 months ago? And (2) perceived general health status in the past 1-month period was measured using the 12-Item Short Form Health Survey version 2 (SF-12v2) [25]. SF-12v2 measures eight health domains: physical function, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health. These domains are summarized as physical component summary (PCS) and mental component summary (MCS) scales and use norm-based scoring. When the scores are transformed, the general population has a mean of 50 and a standard deviation of 10. So, when compared to the general population, health related quality of life (HRQOL) is considered to be lower than the norm if PCS or MCS scores are calculated to be lower than 50 [25].
2.4. Data Analysis
Descriptive statistics were used to describe study variables. Chi-square associations with categorical variables and Pearson correlations were conducted to establish associations between independent and dependent variables and to identify which variables would enter logistic regression model. Correlation tests included were Spearman's rho, Point Biserial , Phi coefficient (), and Cramer's V and were used depending on the level of measurement for each variable. Three binary logistic regression models were developed for utilization/nonutilization of PHC services during the past 1, 6, and 12 months. The probability () was taken as minimum level of significance.
2.5. Ethical Considerations
Permission for conducting study was obtained from the University Of Jordan School Of Nursing and the Jordan Ministry of Health Ethical Committee. Permission to use the ECQA instrument was obtained from the instrument developer and permission to use the Algerian (Arabic) SF-12v2 was obtained from Quality Metric Incorporated (License agreement CT130430/OP011094). All participants were notified that the data collected would be treated with anonymity and confidentiality. In addition, personal informed verbal consent was obtained from all participants.
3. Results
3.1. Participants
Table 1 depicts participants' characteristics. The mean age of participants was 64.6 years (SD = 9.7). There were more male (57.4%) participants, and the majority of participants were married (88.4%). About 36.8% of participants had no formal education, although 42.1 percent of the participants received a primary school education and 21.1 percent received a secondary education or higher. Most of the participants were unemployed (55.3%) and nonsmokers (71.1%). The majority (93.7%) had some type of health insurance coverage. The mean monthly income per participant was 218.2 Jordanian Dinars. About 72.1% of participants had chronic illnesses and 96.8% showed no evidence of cognitive impairment. For perceived general health status on the SF-12v2 for the past 1 month, the mean physical component summary (PCS) score was 41.28 (SD = 11.0) and 50.46 (SD = 7.3) for the mental component summary (MCS) score. For perceived general health status today, in the past 6 and 12 months, the means were 6.61 (SD = 1.3), 6.46 (SD = 1.3), and 6.64 (SD = 1.3), respectively.
3.2. Older Adult PHC Services Utilization Patterns
In the past 1, 6, and 12 months, 41 percent of participants used medical services in the past 1 month. In the past 6 months, 68.4 percent of participants had used medical services, and in the past 12 months, 73.8 percent of participants had used medical services.
3.3. Factors Associated with Older Adults' PHC Services Utilization
3.3.1. In the Past 1-Month Period
Participants who used significantly more PHC services in the past month were those who (a) had no formal education or had a primary school education, (b) were nonsmokers, (c) had a chronic illness, (d) had perceptions of poorer health status, and (e) had symptoms or poor physical health (lower SF-12v2 PCS score) (see Table 2).
3.3.2. In Past 6-Month Period
Factors significantly associated with increased use of PHC services were (a) increasing age, (b) being unemployed or retired, (c) having no formal education or only a primary school education, (d) being nonsmokers, (e) having a chronic illness, (f) those having poor self-rated general health status today, and (g) those having a poor self-rated general health status in the past 6 months (see Table 2).
3.3.3. In Past 12-Month Period
Significantly greater use of PHC services was associated with (a) increasing age, (b) being unemployed or retired, (c) having no formal education or only a primary school education, (d) being nonsmokers, (e) having a chronic illness, (f) those having poor self-rated general health status today, and (g) those having poor self-rated general health status in the past 12 months (see Table 2).
3.4. Factor That Predicted Primary Health Care Service Utilization
The variable associated with PHC services utilization in the past 1-, 6-, and 12-month period was chronic illness (OR 13.324, 95% CI 3.614–49.128), (OR 19.634, CI 7.679–50.203), and (OR 17.915, 95% CI 6.974−0.023), respectively (see Table 3).
4. Discussion
4.1. Utilization Patterns
For older adults in three catchment areas of the Irbid governorate of Jordan, data on medical services utilization in the past 1, 6, and 12 months were not consistent. The findings showed that rate of medical services use by older adults in the past one month was less than 50%, which was consistent with a study in Hong Kong [8]. In the past 6 months, the findings showed that two-thirds of older adults used PHC services for medical health services, which differed from rates reported by Chou and Chi [7] study. In the past 12 months, the findings indicated that three-quarters of older adults used PHC services for medical health services, which is close to the Estonian study [9]. The high rate of medical service utilization in past 12 months compared with rate of utilization in the past 6-month and 1-month periods in the present study can be accounted for by the use of a longer time period. This would have increased the chances of including those who rarely used PHC services. Further studies need to be conducted on the utilization of more and different types of health care service in the changing health care context.
4.2. Factors Associated with PHC Service Utilization
4.2.1. Predisposing Factors
In the present study, older age was not associated with PHC service utilization in the past 1 month, similar to that found in Spain [10]; however, older age was positively associated with PHC service utilization in the past 6 and 12 months. In contrast, older age in Thailand was associated with fewer health care services use in the past year [11]. Lower education level was associated with greater PHC service utilization in the past 1, 6, and 12 months, which was also found in other studies [10, 11]. Those who were unemployed or retired used more PHC services than those employed in the past 6 and 12 months. As limited PHC literature includes older adults, employment status was among the factors not included in many studies. However, similar results were observed in Ghana [13]. Nonsmoking older adults used more PHC services in the past 1, 6, and 12 months compared with smokers. This result was consistent with a previous study [10].
4.2.2. Needs Factors
Chronic illness was significantly associated with PHC service utilization in the past 1, 6, and 12 months, consistent with studies in Thailand and Spain [10, 11]. Cognitive impairment was not associated with PHC service utilization in the past 1, 6, and 12 months which is in contrast to earlier findings [12, 13]. This disagreement may be attributed to the fact that only 3.2% of the sample had cognitive impairment in this study and due to different measures being used across studies. The perceived general health status factors were found to be negatively associated with PHC service utilization, indicating that participants who perceived that they were in poor health on the day of the interview tended to use more PHC services during the past 1, 6, and 12 months. One explanation may be that older adults, especially those who have chronic illnesses, tend to go to health centers mainly to obtain their prescribed medication. Also, both aging and many chronic illnesses are associated with disabilities and complications that are difficult to manage without utilizing health services. Also, chronicity does not portend improvement over a 1-year time period.
Further studies need to be conducted to confirm that perceived general health status today correlates with PHC service utilization of older adults. Also, those older adults who perceived that they were in poor health, in particular, poorer physical health (PCS score) in the past 1 month, tended to use more PHC services in the past 1 month. This result disagrees with previous studies [10, 13]. Older adults who perceived that they were in poor general health status in the past 6 and 12 months used more PHC services in those time periods and this has been found previously [10].
4.3. Predictors of PHC Services Use in the Past 1, 6, and 12 Months
Age was not a significant predictor of PHC services utilization in the past 1, 6, and 12 months, in contrast to a study in Ghana [13], and education level was not a significant predictor of PHC services utilization in the past 1, 6, and 12 months, which was similar to a South Korean study [12], and neither was employment status a significant predictor of PHC services utilization in the past 1, 6, and 12 months, consistent with the findings by [13]. Likewise, tobacco use was not a significant predictor of PHC services utilization in the past 1, 6, and 12 months, similar to a Spanish study [10].
Chronic illness was the strongest significant predictor of PHC services utilization in the past 1, 6, and 12 months. Multivariate analysis indicated that older adults who had chronic illnesses were 13.3, 19.6, and 17.9 times more likely to use PHC services than those who did not have chronic illnesses in the past 1, 6, and 12 months, respectively. This finding is consistent with another study [7]. The findings in this study can be explained by the fact that the majority of the older adults who used PHC services in the past 1, 6, and 12 months had at least one chronic illness, and chronic illnesses need continuous treatment. These data are important for planning purposes for the PHC service centers and suggest that patients with one or more chronic illnesses should be identified so that the PHC can be responsive to their continuous needs.
Perceived general health today was not a significant predictor of PHC services utilization in the past 1, 6, and 12 months. Likewise, the PCS score was not a significant predictor of PHC services utilization in the past 1 month. This finding diverges from a prior study [7]. One justification for this difference could be related to differences in measures that were used to assess the self-evaluation of physical health and to differences in recall periods in assessing the utilization.
4.4. Limitations
Health care services use, history of chronic illnesses, and perceived health status of participants were self-reported. However, several attempts were made to reduce the possibility of recall bias: (a) the study used different recall periods (1, 6, and 12 months), (b) PHC services use and history of chronic illnesses were measured as a dichotomous variable, which is easier to recall, and (c) the study participants were community dwelling older adults with a relatively low frequency of cognitive impairment (about 3.2% had evidence of cognitive impairment based on the ECAQ) [24]. Also, the results cannot be generalized to PHC services in other governorates or in the entire country.
5. Conclusion
About three-fourths of older adults in this study reported having at least one chronic illness. Hence, there was an unusually high rate of chronic illness among the participants in this study. In terms of utilization patterns, the findings reflected high utilization rates of PHC services among older adults over a one-year period. The present study identified several predisposing and need factors that were associated with PHC service utilization. However, the strongest predictor of PHC service utilization was a medical history of chronic illnesses.
The results of this study add to the body of knowledge in geriatric nursing regarding older adults' health seeking behavior which will help in developing an effective nursing care programs to promote well-being in Jordanian older adults. Good health care planning requires an understanding of PHC service use, and the approach used in this study could be replicated throughout Jordan. As such, it would enable the Ministry of Health in Jordan to gather relevant data necessary to provide appropriate health care services for older adults that are both efficient and cost-effective. Moreover, such data could help planning for healthier lifestyles throughout the life course and to build comprehensive and preventative health care programs in the PHC centers that will promote better health for older adults, instead of the current focus on cure and/or medication prescriptions.
Conflict of Interests
The authors declare that there is no conflict of interests regarding the publication of this paper.
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"i want some sugar in my bowl…" (what's that even mean?)
by epi
#3: Goodbyes
From day one of 2010 I knew three things with an almost absolute certainty (1) that time, filled with delights or horrors, flies (2) that Tulsa fumbled it's way into my heart, nudging & cutting and slipping into a place I'd marked off for a place I'd one day call "home" and (3) halfway through its marching months, I'd be leaving. I hated that. Six months seems so long, but no time is ever long enough. There's never enough time. There's no pause button. No rewind. No "please please please, take your time, my heart can't survive another round of goodbyes." One more reason, surely, to hate this year. I'm always saying goodbye.
And even on that day, I could tell you a million things I'd learned during my short time in T-town. I could outline how I'd use the sometimes painful, sometimes beautiful, lessons in the future, how it'll make me a better person. I could point out that goodbye is almost always met with hello. That I'd be able to get to know my family better in the STL. It wasn't enough. I still counted the year as bad.
I guess what I refused to see was that, I'm home. For right now, for this moment, and hopefully the next, I'm home. And maybe STL will take Tulsa's place, and maybe it won't, and maybe I'll be back and maybe I won't, but none of that needs to matter right now. (Look, I've spent my life worrying about tomorrow, letting planning my life tomorrow get in the way of living today. I won't make that mistake here. Not again. I'll worry about tomorrow, tomorrow. Today, I'll drink coffee and read my Bible and memorize the skyline and understand that THIS right here… this now, is all I have. Because time flies. And I only have this moment and maybe the next and the knowledge that somehow & without my permission I found myself with what I've always wanted. I don't care that it'll hurt to leave. I'm just glad it'll hurt. A breaking heart means there's a heart to break. The fear of losing something means that there's something to lose.
And without leaving, I never would've realized that I wanted to stay. What do you say to that, 2010?


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It's Pride month and it has been 50 years since the Stonewall riots. Dr. Scott & Dr. Shiloh continue to highlight marginalized victims by covering several serial & mass killings in which the victims, perpetrators or motives were part of the LGBTQ+ community. Included are the Trash Bag Murders of NYC, Jeffery Dahmer, Andrew Cunanan, the Pulse Nightclub shooting, Bruce MacArthur and the missing men of Toronto's Gay Village, and the mysterious circumstances of Ed Buck in Los Angeles.
S2 E4 Bonus The Exorcist Superfan
In this Bonus Halloween episode, Dr. Scott and Dr. Shiloh interview their dear friend, Al Hobbs, a super fan of the The Exorcist. He will fill us in on how he became fascinated with the movie & the book, personal stories of the real possession victim and will help us dive deeper into the experiences of the film crew and actors.
S2 E4 The Exorcist- Crossover with Hollyweird Paranormal
Dr. Scott and Dr. Shiloh team up with Tammie and Brice of the podcast Hollyweird Paranormal to examine the classic horror film, The Exorcist. Dr. Scott will catch you up on the history and cultural aspects of possession, while Tammie gives you the receipts on the true story of possession that influenced the movie. Then Brice fills us in on the curse of the production of the film and Dr. Shiloh finishes this thrilling episode off with a tale of a serial killer likely linked to the film.
S2 E1 Light My Fire
This first episode of Season 2 centers around the criminal behaviors of Arson and the psychological disorder of Pyromania. After being contacted by Frank Girardot, the true crime author, about his recently released book Burned: Pyromania, Murder and a Daughter's Nightmare, Dr. Shiloh and Dr. Scott decided that it was timely to cover the story of John Orr, the most notorious serial arsonist. In this red-hot episode, they also discuss the phenomenon of firefighters who commit arson and discuss Girardot's book & the made for TV movie, Point of Origin based on the murderer's own screenplay.


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Top Hair Design Manchester City Centreby Melissa T. DESIGNER OF BEAUTIFUL HAIR
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List of Bali Based Clothing Manufacturers
Bali is becoming the hub of the world when it comes to having clothing manufactured. Many of the Balinese Clothing Manufacturers are actually owned and run by Australians now living in Bali. The Balinese are world renown for their craftsmanship and affordability and most importantly, how they treat their workers.
This article is constantly updated so check back regularly for updates!
Active-wear Bali
- Location: Kerobokan
- Minimum Order is 50 pieces per style
- Starter Packs start at US$129.00
- Ships Worldwide.
Activewear Bali is located in Kerobokan and are the one-stop shop manufacturer for all types of active-wear, swimwear, yoga-wear and sportswear. They have been manufacturing clothing for over thirty years and have a team of highly skilled technical staff, seamstresses and pattern makers.
Bali Swim
- Location: Canggu
Located in Canggu, Bali Swim is Bali's leading manufacturer of swimwear for women. Bali Swim has over 25 years of experience in the garment manufacturing field and they offer ethical manufacturing at an affordable price point.
Bali Products
Bali products are the number 1 store in both Bali and Indonesia for wholesale products. They manage hundreds of Bali based clothing manufacturers and can find one suited to your needs.
CMA Clothing and Manufacturing Agent
CV Bad Ass Garment
Located in Denpasar, they were established in 1995 and manufacture quality garments for the western export market. Their factor specialises in producing beachwear.
Divine Diva
Divine Diva is both a manufacturing and wholesale fashion business specialising in resort wear clothing, women's fashion and they also supply quality stretch fabrics.
Franksland Uniform Manufacturer
Frankland design and create uniforms and have a 15-year track record for designing and producing quality aesthetically designed and well-fitted uniforms. They are located in Kerobokan.
GEMI Clothing Manufacturing
- Location: Denpasar
- Minimum Order: 50 Units
- Has pattern-making facilities
Gemi Clothing do all styles of fashions in a multiple of high quality fabrics. They also do promotional apparel, children's and baby wear and Women's Winter Clothing.
Harris Darmawan Garment
Located in Denpasar, Harris Darmawan was established in 1994 and will manufacture anything you wish!
House of Ioco Fashion Factory
House of Ioco is located in Seminyak and produce designer clothing and couture garments.
King Trading Manufacturer
King Trading is the only Balinese company that can import specific fabrics for your needs tax and duty-free. They are located in Kerobokan. They specialise in producing swimwear.
Lumiga Bali
- Location: Denpasar
- Contact
- List of Products
- Minimum Order: 500 Units
Lumiga Bali produce women's, men's and kid's clothing and they also do wholesale orders. They use first grade fabrics and have high standards.
One Love Fashion Production
One Love are Bali's leading fashion and clothing manufacturers. Owned by Australians, they have been providing quality garments since 2008. They focus on Eco-friendly and sustainable fashion.
Siobhan and Fionnuala Garment Manufacturing
Located in Denpasar, Siobhan and Fionnuala are Australian owned and manufacture ethically clothing including street-wear, resort wear and children's garments.
Sovana Bali
Sovana is a boutique manufacturing facility with friendly and professional customer service. They pride themselves on quality garments with an on-time delivery guarantee.
The Bali Factory
The Bali Factory is a network of clothing manufacturers in Bali. The Bali Manufacturing arm is dedicated to producing quality textiles and garments for the discerning customer with a focus on ethical and sustainable practices.
Vargare Garment & Swimwear Manufacturer
Located in Denpasar, they are the rising star in the manufacturing world with low minimum quantity orders at an affordable price. They specialise in swimwear and activewear.
Visionise is ethical and sustainable clothing manufacturers located in both Bali and China.
Yogi and Boo:
A Balinese based ethical clothing manufacturer and designer. They are located in Kuta.


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When #VB77 was driving for @WilliamsRacing with Massa, Bottas was the #1 driver. Now, things are different. @MercedesAMGF1 has changed the philosophy after Nico retirement. #LH44 is the #1 because he already was a champion in 2008, and there is a possibility to be until the end of his the contract.
It doesn't mean that Bottas is never going to be champion. He fast, clever and consistent to be a champion candidate.


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Microsoft Office 2010 is available in different editions just like the Windows operating system. There is Microsoft Office Home and Student 2010 or Office Professional 2010 for instance. And there is at least one version that is only available to OEMs: Microsoft Office Starter 2010. This version is usually only available for users who purchase a computer system at manufacturers who add it as one of the installed software programs that the system ships with.
The particular version of Office ships with basic versions of Microsoft Word and Excel, the two most popular programs. It is basically free but comes with advertisement to make up for that.
Office Starter 2010 is not available as a public download. The only way up until now was to buy a PC that ships with it to use it. Caschy now discovered that Microsoft stores Microsoft Office Starter 2010 on their servers. Downloads are publicly available and install the product on compatible systems. Compatible currently means that they will install on Windows Vista and Windows 7, but not on Windows XP or Windows 8.
Here is a list of available versions that you can download:
- Microsoft Office Starter 2010 English [download]
- Microsoft Office Starter 2010 French [download]
- Microsoft Office Starter 2010 German [download]
- Microsoft Office Starter 2010 Spanish [download]
I only tried those four country codes. It is likely that Microsoft Office Starter 2010 is available in different versions. Just replace the LCID string in the web address, e.g. en-us with another one. You find a list of strings on this page.
Office Starter 2010 can be installed and used without entering a product key. Also interesting: It is possible to create a portable version of Office Starter 2010 from the program's start menu listing.
Office Starter does not offer all of the functionality that a "full" version of Office offers. It is however a suitable alternative for users who only need to do some light editing and reading.
There are definitely comparable solutions for users who do not want to use Microsoft Office. Among them Open Office, Libre Office or Google Docs.
© Martin Brinkmann for gHacks Technology News | Latest Tech News, Software And Tutorials, 2011. | Permalink | Add to del.icio.us, digg, facebook, reddit, twitter
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Download Microsoft Office Starter 2010
Martin Brinkmann
Wed, 23 Nov 2011 14:37:27 GMT