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This is the second in a series of essays on the shifting state of global power and influence by WikiTribune contributor Jean-Jacques Subrenat, a former French ambassador. His first in this series was on isolationism in the United States.
Since its formation, China consistently designated itself as a pivotal state. In Mandarin it is known as 中国 or Zhongguo — "the country at the center". With a new doctrine of international assertiveness espoused by President Xi Jinping, that concept is now more tangible than ever and could become a defining characteristic of world affairs in 2018 and beyond.
First, a little history
Whereas the classical Roman Empire (27 BCE – 395 CE) conquered a range of cultures, for most of its history China did not expand beyond its own cultural sphere. However, this pattern of centrality was broken when Genghis Khan the founder of the Mongol Empire, conquered most of Eurasia. His heirs extended that empire to most of modern-day China, Korea, Central Asia, regions in Eastern Europe and Southwest Asia. It is estimated that at its height, the Mongol Empire comprised one fifth of the world's inhabited land area. By contrast, China did not engage in maritime exploration, with the notable exception of Admiral Zheng He (郑和, 1371 – 1435?) who went as far as East Africa, seeking commerce but not territorial gain. After the Mongol empire was replaced by the Ming dynasty, an inward-looking policy prevailed till the current phase of China's territorial disputes with Brunei, Japan, the Philippines, South Korea and Taiwan.
"Hide your strength and bide your time" has given way to putting China "closer to center stage"
From Mongol cavalry to nuclear weapons
Created in 1927 as a clandestine force, today the People's Liberation Army is the largest in the world with more than two million members. China's defense budget is second only to that of the United States. Until the 1990s the Navy was an appendix of the army, but today its blue-water capability is among the strongest in Asia.
This military capability is increasingly matched by a new confidence under President Xi Jinping (习近平, born in 1953) in looking outwards and making full use of China's diplomatic, economic and strategic clout. In the 1980s, his most comparable predecessor Deng Xiaoping ( (邓小平 1882-1987) advised China's leadership to "hide your strength and bide your time", a formula which has now given way to putting China "closer to center stage" (The New Yorker).
In all of the Far East, the air superiority of the United States is still unequaled, thanks to its bases and troops in Japan and South Korea, but China is gradually building up its air force (South China Morning Post). Alongside traditional forces, China is also enhancing its capability in missiles, cyber-warfare, space-based warfare and intelligence.
It is noteworthy that China tested its first atomic device in 1964, less than a decade after Moscow refused to share its nuclear weapon technology with Beijing. China also tested its first hydrogen device in 1967 — the shortest "fission-to-fusion'' development cycle in the world (32 months from atomic to hydrogen weapon). Currently, the country's nuclear stockpile is estimated at between 100 and 400 warheads (Arms Control Association). It is believed that China does not deploy SLBMs (submarine-launched ballistic missiles), unlike the other signatories of the Non-Proliferation Treaty (NPT), i.e. the United States, Russia, the U.K. and France. And like the four other permanent members of the United Nations Security Council, China has veto power.
Global power built on domestic transformation
After the creation of the Republic of China in 1912, its influence was limited by the magnitude of its domestic issues. Demographic growth, widespread poverty, limited access to resources, a feeble economy, a weak and corrupt administration, as well as secessionist tendencies in several regions all took their toll.
After the Chinese Communist Party (CCP) took power in 1949, China depended heavily on aid from the Soviet Union. The two countries even joined forces against the U.S. and their allies during the Korean War 1950-53.
Paradoxically, modern China's quest for power and influence started with the Sino-Soviet rift in 1956, brought about by the Kremlin's refusal to share nuclear weapon technology with Beijing. The Soviet Union viewed China as a possible competitor for leadership of world Communism and developing nations. The Non-Aligned Movement (NAM), initiated in 1956 by the Yugoslav leader Josip Broz Tito, proclaimed its neutrality between the U.S. and the U.S.S.R. which were then engaged in the Cold War. But it is interesting that the NAM was inspired in part by the Bandung Conference of 1955, attended by the Chinese prime and foreign minister, Zhou Enlai (周恩来, 1898-1976). In 1964, when Mao Zedong (毛泽东, 1893-1976) and his supporters launched a massive upheaval, which they called Cultural Revolution to conceal their struggle to regain total power, many turned away from China, with the exception of regimes such as North Korea and the murderous Khmer Rouge in Cambodia.
From poverty to a leading economy
From the late 1930s to the late 1950s, China had to overcome major difficulties: the Japanese occupation, the Korean War and the curtailment of Soviet aid. All these were major impediments to China's economic recovery and modernization. When the CCP took power in 1949, China had a population of roughly 600 million and rising rapidly. Agricultural and other resources could barely keep up with demographic growth. With a very weak transport infrastructure, distribution between China's regions was very limited.
China's economy evolved in three phases: 1949-80, 1980-2000 and 2000 to the present. Deng Xiaoping is credited with the major turnaround from 1982 onward, when more "responsibility'' was granted to all economic actors, thus reversing the policy of complete control by the central government. Faced with fallout from the global financial meltdown of 2008, in 2010 China's Economic Stimulus Plan aimed at providing affordable housing, lower credit restrictions for mortgage and SMEs, lighter taxation on commodities and real estate sales, while channeling public investment into infrastructure development (rail, roads and ports).
With an average annual growth rate of 10 percent from 1990 to 2004, the Chinese economy gradually climbed the global charts. By 2016 its economy was the world's second largest. From the "workshop of the world'', China has also become a global actor in research and development in areas such as biotechnology and information technology. U.S. sources concede that in 2016 China even overtook the U.S. in supercomputing capacity (Science), and is now a leader in quantum Internet capability (Scientific American). It is worth remembering that China, the world's most populous country, has a literacy rate of about 96 percent while the world average is 83 percent. By comparison, Brazil's rate is 92 percent, India's 72 percent, Russia's 99 percent and the U.S. has 86 percent.
Shortly after he was first designated as Secretary General of the CCP, Xi Jinping visited Shenzhen Special Economic Zone (深圳经济特区 Shenzhen jingji tequ, a brainchild of Xi's own father) where Deng had ignited the dramatic economic reforms of the 1980s. During that visit, Xi gave a forceful message to Party leaders: modernization and top-down reform are acceptable, but anything resembling former Soviet leader Mikhail Gorbachev's Glasnost (гла́сность = government accountability), which led to the implosion of the U.S.S.R., will be suppressed.
In Mao's era, capitalism and personal wealth were contrary to Communist doctrine and severely punished; in today's China they are proudly shown off as proof of the country's rapid progress. Now, private enterprise is arguably less accountable in that country than, say, in the Netherlands or Sweden. As a result, wealth and power have become conjoined to such an extent that high-level corruption is a major issue in China. But because anti-corruption campaigns are also potent political weapons, they can only be initiated and fed by the top leader himself.
Since 2012, over a million officials have been disciplined on charges of corruption (The Conversation), a measure which has enhanced the popularity of President Xi. But while such campaigns are aimed at eliminating corruption, they also help Xi consolidate his power by neutralizing political high-fliers such as Bo Xilai (薄熙来 born in 1949), Sun Zhengcai (孙政才 born in 1963) and more recently Lu Wei (鲁炜 born in 1960) who was in charge of consolidating The Great Firewall and tightening internet censorship in China.
In short, in today's China many things are permissible, including all the tools of capitalism, provided they do not jeopardize the over-arching power of the CCP.
Can China export its politics as well as its goods?
In Part 1 in this series, I drew attention to some trends in the United States, which could weaken Washington's future influence on global issues. China needs to be analyzed in the same light.
Beijing's claim that it has developed "a Chinese form of Socialism" begs the question: what type of country might freely choose China's implacable single-party system as a model?
Under Mao's rule, China's ideological clientele was made up of poor and developing countries, and some intellectuals in the West. Today, China's importance is tangible in international trade, finance, manufacturing, transport and tourism, while its single-party ideology has become generally less attractive. At least since Deng Xiaoping, the leadership has been aware of this, and its foreign policy has evolved accordingly.
Since the beginning of the 21st century, China has sought to increase its influence in global terms. Three examples are worth mentioning. First, the Asian Infrastructure Investment Bank (AIIB) was set up after a proposal by China in 2009, and officially launched in 2013 by President Xi during a visit to Indonesia. Previous to that, China was already engaged in international financial institutions such as the International Monetary Fund (IMF), the World Bank (WB) and the Asian Development Bank (ADB), where the influence of the U.S., Japan and several European countries was traditionally predominant. The AIIB is a major financial initiative in Asia and the Pacific, with loans totalling about 1.7 billion US$ at the end of 2016. China accounts for the largest capital subscription, and therefore holds the largest voting rights in the AIIB.
The second example is the Silk Road Economic Belt and the 21st-century Maritime Silk Road (丝绸之路经济带和21世纪海上丝绸之路), also unveiled by Xi Jinping in 2013, which aims at creating a modern equivalent of the famous Silk Road by which trade was carried out in the past between China and many parts of Asia and Europe. The modern project aims at bridging the 'infrastructure gap' hindering development in a number of countries, especially in East, South and Central Asia, and could become a major instrument of Chinese influence throughout some of the most populated areas of the world.
The third example of China's multi-layered approach to international relations is its growing network of Confucius Institutes (孔子学院 Kǒngzǐ Xuéyuàn), an attempt at using soft power alongside the traditional vectors of trade, investment, development aid, recognition and prestige. Until the 1980s, China criticised foreign cultural or development agencies (U.S. Peace Corps, Alliance française, British Council…) as agents of imperialism, but their impact on the overall foreign policy of the U.S., the United Kingdom or France was gradually recognized in Beijing. Begun in 2004 with a first establishment in Uzbekistan, the network now operates more than 500 institutes worldwide, usually in association with a local university or educational entity. In a number of democracies, the purpose, content and methods of Confucius Institutes have given rise to controversy.
As I wrote in the first part of this series: "President Trump's decision to withdraw the U.S. from international efforts to avert induced climate change, has placed others in the limelight: French President Macron, German Chancellor Angela Merkel, but also Chinese President Xi Jinping. It is quite a novelty to see China, still one of the largest sources of atmospheric pollution, now being looked upon with more sympathy than the U.S. in environmental issues.''
In 2018 and beyond, China's influence in global issues could increase quite dramatically. First because China itself understands the advantage of being a global actor, even at the expense of furthering its ideology. And second because in today's multipolar world, isolationist tendencies such as those defended by President Trump, are providing new opportunities for emerging global powers.
This is the second in a series of essays on the shifting state of global power and influence by WikiTribune contributor Jean-Jacques Subrenat, a former French ambassador. His first essay in the series was on isolationism in the United States.


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On-Site Bridal Makeup is on the Rise
As time continues to progress, the 'wedding' in a traditional sense, is beginning to change as well! While many of us may remember making the endless appointments for our bridal party, traveling from salon to home, dress shop, to rehearsal dinner, home, store, venue and so forth – now we have the luxury of on-site bridal makeup and hair salon services. This is actually quite convenient and offers a more intimate, relaxed setting for which you can enjoy your special day. Why should you elevate the stress levels on your wedding day? The answer is that you don't have to be stressed, we are here to tell you that if you choose our on-site bridal services you can streamline the wedding day preparation experience.
Slow Down the Pace
Wedding planning is oftentimes very fast paced, and can almost become more stressful than enjoyable for those people who are involved. It is so incredibly easy to get wrapped up in everything trying to ensure that the day is going to go perfectly – but more than likely, something usually arises. It decides to rain, the dress wasn't altered properly – the salon double booked an appointment, this list can go on forever! Instead of having to worry about traveling and going to a salon, you can have a professional salon service come to your home and do your hair and makeup for you – possibly even your nails, depending on their professional background and service offerings. This offers a convenience and change of pace that is actually quite pleasant.
You don't have to worry about making any particular wedding day appointment – you can opt to just sit back – breathe, and let the professional take care of you. You deserve to be pampered, it's your special day!
Contact Lashes and Lace to learn more about their on-site bridal services - Charleston & Mt. Pleasant SC
Lashes and Lace is owned by Kacie Faulling Pecora, a Charleston native who grew up visiting the premiere wedding venues in Charleston, SC. She created Lashes and Lace with the vision of catering to brides on the most important day of their lives. Lashes and Lace is a team of dedicated stylists who travel to you on your wedding day to make you feel and look your very best. Lashes and Lace has quickly grown to become Charleston's top choice for bridal hair and makeup and was voted Best of 2014 and Best of 2015 by the knot!

subset: commoncrawl


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How wayk works
WAYK uses an innovative combination formula to create a multi-purpose caffeine supplement that boosts energy, improves mental function, and helps you maintain concentration. WAYK contains Guarana, a natural source of caffeine that gives you the energy boost without the intense crash associated with synthetic caffeine.
The formula
GUARANAGuarana's highly concentrated dose of natural caffeine, combined with its tannin molecules, provides a more efficient long-lasting release of energy. By increasing alertness and reducing tiredness, guarana helps you maintain your focus and concentration over a sustained period.
ZINCZinc, which is an essential mineral used by the brain, will help to maximise your cognitive function. It regulates communications between neurons of the hippocampus, the area of the brain that controls learning and memory.
VITAMIN BVitamin B complex (B1, B2, B3, B5, B6, B7, B9, B12) aids the production of serotonin and melatonin in the body. By controlling stress, improving your mood, and efficiently releasing energy from food, Vitamin B complex enhances focus and maximises cognitive function.
VITAMIN CVitamin C plays an important role in body's production of Carnitine; a compound that helps your body turn fat into energy. It is also well-known to enhance your immune system, which can be weakened by stress and a lack of sleep.


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Open Access News
News from the open access movementJump to navigation
Mendeley growing rapidly; alternative model for repositories
John MacColl, Mendeley scrobbles your papers, HangingTogether, September 24, 2009.
Comment. To me, the better analogy may be Napster. I don't necessarily mean that pejoratively: both Napster and Mendeley watch a folder on the user's computer and automatically share files in that folder. That takes the effort out of sharing, which means more documents get shared. It also means that metadata will often be incomplete or inaccurate. In addition, since there's less emphasis on copyright compliance, I'd suspect that some authors may share documents in ways that violate their publisher's contract -- more so than traditional repositories. In short, the Mendeley model seems to have some major advantages over traditional repositories, but also some significant shortcomings vis-ŕ-vis traditional repository goals. I think there's a place for both in a healthy scholarly communications ecosystem, with both competition and collaboration.
See also our past posts on Mendeley.
Update. See also Dorothea Salo's comments.


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Cookbooks are avenues into homes and to the women who are their guardians. By reintroducing the nostalgic and familiar form of the recipe book in a new profile, the food industry managed to co-opt cookery and transform the kitchen into the marketplace. Many author-cooks who were allies of social reform and women's rights adapted to the new commercialism and became, in the words of Glenna Matthews, "The Handmaidens of Industry." Their images and voices endorsed the products which were marketed to consumers. The friendly woman-to-woman exchanges which had characterized many cookbooks until this period were replaced by new and impersonal texts. Masquerading as creators of easy and economic cuisine, with efficient, labor-saving products, the manufacturers replaced the author-cooks as experts and guides in household matters. The pamphlets and books that marketed new products and technology, often with introductions by famous women, eventually became household names of their own. The moguls of industry even manufactured "women" such as Betty Crocker and Jane Parker as stand-ins for absent authors. The named products--Jell-O, Baker's Chocolate, Crisco, General Foods--carried as much prestige as the popular cooks and teachers of the previous era. Powerful warnings were attached to these products: "Accept no substitutes."
The introduction of the new technology--everything from chemical leavening to stoves and kitchen gadgets--launched the "de-skilling" of the American housewife and diminished the prestige associated with skilled labor. Advertising campaigns eventually convinced women that homemade foods were not as healthful or desirable as the standardized and uniform products that could be bought at the grocery. A craft tradition--cooking--and the generations and communities of women who had fostered it to its peak was diminished in the name of progress and social reform. The women activists who labored to elevate the status of the housewife ultimately contributed to her debasement. The era of the housewife's anomie had taken hold.
Last update: Monday, 02-Jun-2014 22:38:53 EDT


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Now you already know that our route was going to be the following: home – Warsawa – Ostrava – Vienna – Maribor – Portorož – Opatija – Zagreb – Opatija – Villany – Budapest – Domaša – Warsawa – home
(I hope I'll remember to link the other towns later too)
Sorry, I cannot find this song from my Soundcloud, so you'll only give the Youtube link (our signature song from this vacation):
So till Vienna it had just been lots of driving and eating. 🙂
As every year, we had lunch in Vienna, Hofburg Place. There is this one cafe we always go to, it's called Hofburg Cafe (http://www.cafe-hofburg.at/en/). We like our cakes and of course our champagne there. It is situated in this really nice and quiet square, so definitely worth going there.
About the Hofburg Palace – taken from Wikipedia. 🙂
Hofburg Palace is the former imperial palace in the centre of Vienna, Austria. Part of the palace forms the official residence and workplace of the President of Austria. Built in the 13th century and expanded in the centuries since, the palace has housed some of the most powerful people in European and Austrian history, including monarchs of the Habsburg dynasty, rulers of the Austro-Hungarian Empire. It was the principal imperial winter residence, as Schönbrunn Palace was their summer residence.
We were about to start leaving, when my sister remembered that when she and her boyfriend were there, they went to this really cool and nice cafe, which is called Cafe Sacher Vienna (https://www.sacher.com/en/original-sacher-cake/sacher-cafe-en/cafe-sacher-wien-2/), I recommend that when you like sweets and cakes, it's especially famous for it's Original Sacher-Torte. The place was quite beautiful too, so definitely worth visiting. 🙂
And of course they have their own hotel as well, which we decided to stay at the next time we come to Vienna. So when you're looking for a hotel in Vienna, then please choose Hotel Sacher Wien ***** (https://www.sacher.com/hotel-sacher-wien/), it is just amazing!
This was it about Vienna, we had to move on to Maribor to get to Portorož for the right time. 🙂


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A Potter Road woman believes her experience in management and business will make her a good county councilwoman.
Kathy Sistare, 54, has announced that she intends to run for the County Council District 7 seat as a Democrat. The seat is held by one-term Councilman Wayne Kersey, also a Democrat.
"I'm getting more excited by the day," said Sistare, who announced her candidacy in newspaper ads over the weekend.
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Trango Towers Pakistan
Great Trango was 1st climbed in 1977 . All of the Trango Towers lie on a ridge, trending northwest-southeast, between the Trango ice mass on the west and also the Dunge ice mass on the east. Great Trango itself could be a giant formation, with four classifiable summits.


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A crystal clear picture, all your favorite channels, premium selections, music stations, on demand programs and advanced features, such as high-definition (HD) and whole home digital video recording (DVR). Santel Cable has it all!
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Call to start watching! 605-796-4411 or 777 from your Santel phone.
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Thanks for looking!
Wednesday, 12 April 2017
CAS-ual Fridays Rainbow challenge
Hello, today I'm playing along with the CAS-ual Fridays Rainbow challenge. I stamped and white heat embossed leaves from the CAS-ual Fridays Mon Ami stamp set, then coloured them with Zig brush markers. My sentiment is from the CAS-ual Fridays Shenanigans set.
11 comments:
Love how you used those leaves Michelle very cleverReplyDeleteReplies
Thanks Tristan, I almost threw it in the bin!Delete
This is gorgeous Michelle! Love how you used the leaves and your coloring is fantastic!ReplyDelete
Really beautiful and such a creative use of the leaves!ReplyDelete
I love your cards. They are gorgeous. Love the colors and how they blend so well. Terrific job. I need to use heat emboss more.ReplyDeleteReplies
Thanks so much Kathlene!Delete
Very striking card, Michelle! Love it!ReplyDelete
I love this! You have chosen and blended the colors perfectly. The organic nature of it is very fresh and appealing. Well Done!ReplyDelete
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Get Involved
Donations are always welcome.
Donate via credit card by clicking on the button below or send a check to: Berkeley Holiday Fund, P.O. Box 9779, Berkeley, CA 94709.
If you shop on Amazon, try AmazonSmile instead. When you shop at smile.amazon.com, Amazon will donate a portion of the purchase price to your favorite charitable organization, all in the background and you'll find the exact same shopping experience. On your first visit to AmazonSmile you select a charitable organization - Berkeley Holiday Fund we hope - to receive donations from your purchases before you begin shopping. AmazonSmile remembers your selection, and then every eligible purchase you make at smile.amazon.com will result in a donation. Learn more about it here.
Want to help? We are always looking for people to work with us on small jobs during our annual fundraising drive in October. Email firstname.lastname@example.com to find out more.
We only send a few emails a year to share highlights of our annual campaign, how much we have collected and who we've helped.


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According to the Stanford Revision of the Binet-Simon Scale of Intelligence, the average IQ score is between 90 and 109, so an IQ of 110 or higher signifies above-average intelligence. Genius level IQ begins between scores of 140 to 145.
Only 1/4 to 1 percent of test takers score 140 or higher. The highest genius level is a score between 180 and 200. Any score below 70 indicates a mental handicap, with varying degrees depending on the score. An IQ under 20 is considered profound mental retardation, and only 1 percent of those who score below a 70 are in this range.


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Pediatric Aspects of Inpatient Health Information Technology Systems
In the past 3 years, the Health Information Technology for Economic and Clinical Health Act accelerated the adoption of electronic health records (EHRs) with providers and hospitals, who can claim incentive monies related to meaningful use. Despite the increase in adoption of commercial EHRs in pediatric settings, there has been little support for EHR tools and functionalities that promote pediatric quality improvement and patient safety, and children remain at higher risk than adults for medical errors in inpatient environments. Health information technology (HIT) tailored to the needs of pediatric health care providers can improve care by reducing the likelihood of errors through information assurance and minimizing the harm that results from errors. This technical report outlines pediatric-specific concepts, child health needs and their data elements, and required functionalities in inpatient clinical information systems that may be missing in adult-oriented HIT systems with negative consequences for pediatric inpatient care. It is imperative that inpatient (and outpatient) HIT systems be adapted to improve their ability to properly support safe health care delivery for children.
- health information technology
- electronic health record
- quality of care
- pediatrics
- hospital
- inpatient
- clinical decision support
- pediatric functionality
Children remain at higher risks than adults for medical errors in inpatient environments.1,2 The American Academy of Pediatrics (AAP) recognizes the important role of electronic clinical information systems in ensuring and improving the safety3 and quality4 of pediatric patient-centered care.5 In 2008, the AAP published "Pediatric Aspects of Inpatient Health Information Technology Systems," which described the goals and mechanisms of clinical information systems in inpatient pediatric work.6 In 2010, most pediatric hospitals still lacked basic electronic health record (EHR) functionalities.7 Since then, the United States has seen a surge8 in adoption of health information technology (HIT), largely because of incentives offered by the American Recovery and Reinvestment Act in 2009 (Pub L No. 111-5)9 and, specifically, the Health Information Technology for Economic and Clinical Health (HITECH) Act. HITECH offers $18 billion in payments to practices and practitioners who meet criteria for "meaningful use"10 of certified EHR technology11 with the goal of improving care and facilitating aggregated reporting of quality measures from electronic clinical data. Although pediatric hospitals have made great strides in adopting information technology since the AAP published its first report on inpatient systems, a lag for smaller teaching and nonteaching hospitals12 as well as regional differences in adoption13,14 have been revealed. Even with progress in digitizing US hospitals and physicians' offices,15 subsequent research into usability, implementation, patient safety, and cost and value of EHRs16,17 has demonstrated that much work remains to improve the quality, functionality, usability, and effectiveness of inpatient pediatric HIT systems.18,19
In 2012, children younger than 18 years accounted for 24.1% of the population of the United States.20 Children and infants are a vulnerable population because of age-specific physiologic and developmental variances that may not be adequately addressed by adult-specific data tools.16,21 Despite this, no inpatient EHRs developed specifically for the care of children are available commercially. HIT tailored to the needs of children and pediatric health care providers can help to reduce risk by decreasing the likelihood of errors through information assurance (reducing variability in the entry, communication, processing, and recall of patient data)22,23 and minimizing the harm that results from errors (pediatric-specific error detection, redundancy, and contextual decision rules).24–27
Pediatricians' input on clinical data needs and HIT functionality in ambulatory settings has been outlined.28,29 Many of these needs and functions (weight-based drug dosing, anthropometric analysis, immunization tracking, specialized growth charts, and forecasting) are common to pediatric inpatient settings, but there are additional pediatric needs and functions in inpatient clinical information systems and the interfaces that connect inpatient and ambulatory systems. Adult-oriented HIT systems may lack these pediatric data needs and functionalities, which may have a negative effect on adoption of HIT and user satisfaction in pediatric inpatient care. Furthermore, evaluations of pediatric workflows from a human factors viewpoint identified areas of great complexity (patient identification, medication ordering and administration, alerts, growth charts, vaccinations, laboratory reporting, newborn care, privacy, and radiology reporting) with high stakes for adverse events that may benefit from information technology intervention.30
A base requirement of pediatric HIT functionality is the availability of accurate and appropriate pediatric-specific data. These data and data format requirements for outpatient EHRs have been identified (via HITECH) with articulation of a Model Pediatric EHR format31 (based on the HL7 Child Health Functional Profile32). The Model Pediatric EHR format focuses primarily on pediatric ambulatory HIT. The goal for this technical report is to expand on this model to explore and define inpatient-specific pediatric concepts, data, and functions (Table 1). This technical report uses "must," "should," and "required functionality," similar to the Model Pediatric EHR format, not as a mandate but to indicate that these functionalities are critical for the recognition of a system as with full pediatric functionality.
This technical report focuses solely on the distinct needs and functionalities of pediatric inpatient HIT applications and infrastructures to ensure effective and safe pediatric health care delivery beyond those functionalities already supplied in adult-oriented systems. However, this does not imply that standard HIT functionalities omitted from this report are considered unnecessary for pediatric inpatient systems. Furthermore, adult care may benefit from the pediatric-specific functionalities because there are surprising similarities between pediatric and geriatric care (such as extremes of age, physiology that may differ from younger adult populations, different signs and symptoms of disease, and the need for advocates and guardians).33 Many issues addressed in this report—for example, adolescent privacy or interoperability with immunization registries—are not inpatient specific but also apply to outpatient systems.
Systems that are included in this analysis include EHRs, anesthesiology documentation systems, provider order entry systems, and stand-alone systems, such as human milk management systems or antimicrobial stewardship management tools.34,35 This technical report was narrowed to systems that are used directly by child health care providers in the retrieval of information and the documentation or treatment of children. Although pediatric data are stored and manipulated in other hospital systems as well, such as laboratory management and radiology information systems, this report focuses on systems that are closer to the interface among patients, providers, and information technology systems and the requirement of these systems to support pediatric care.
This technical report can be used as a resource for hospitals and institutions when selecting a new inpatient information system or improving or enhancing existing systems and for developers, designers, or vendors of such systems for guidance on basic pediatric functionality.
Children and their families are central stakeholders in any form of pediatric care as the direct beneficiaries of care (and also as victims of iatrogenic harm resulting from errors). Their vested interest in the best available tools to manage pediatric care is self-evident.
Pediatricians, pediatric nurses, pharmacists, and other pediatric providers are additional interested stakeholders. Their need for the appropriate tools is driven by the desire to provide the best and safest care possible, in the most efficient manner possible, with the least harm and best outcomes to children and to reduce liability, improve efficiency, and reduce errors and waste.
HIT vendors form a third stakeholder in software and system development as the builders of HIT systems used by providers and hospitals. Their goals are to gain market share, meet production milestones, and ensure and maintain information confidentiality, integrity, and availability. Frequently, they may find conflicts in design and implementation goals that may impede timely development and prioritization of pediatric-specific HIT functions.
Policy makers at the institutional and governmental levels are another important stakeholder group. As the prevalence of HIT in clinical work grows, issues of governance take on increasing importance, especially as increasing amounts of resources are devoted to the adoption and maintenance of institutional HIT infrastructures. At the national level, policy makers have created incentives for HIT adoption to create such infrastructures to measure the effects of health care innovations (including the adoption of HIT).
It is essential for the interests and needs of children and pediatric care to be represented at the policy-making table. As such, members from all stakeholder groups must have input on the directions that national HIT efforts take. This includes input on the development of infrastructures, standards, and tools to share health information in a secure yet transparent fashion to optimize care.
Inpatient care environments, increasingly managed through HIT, must be able to meet the needs of children's health. Mismatch of care technologies and patient needs can potentiate harm (or block the benefits of HIT through misuse or nonadoption), resulting in hazards to children. Children and infants are particularly vulnerable populations because of the following:
the wide range of permissible body weights (less than 1 kg to more than 100 kg) for which medications may be prescribed;
the need for universal specification of care based on body weight and variances on those specifications (with smaller tolerances for errors, especially at lower weights) based on age/physiology;
care contexts that are not adequately addressed by adult-specific technology (size of tools), lack of data granularity (grams instead of kilograms), and special measures (such as gestational age or Apgar scores);
the high frequency of off-label use of medications;
pediatric specific drug–drug interactions
the high degree and variation of dependence on guardians or other caregivers for decision making; and
the fragmentation of the pediatric population into distinct subgroups, each with its own clinical and information needs.36
The vulnerabilities of children in health care settings are not isolated to anatomic and physiologic realms. Psychosocial issues, such as adolescent hidden agendas or difficulties in communication, may impair the discovery of important clinical concerns (such as pain in a nonverbal child). Lack of advanced reasoning may result in the health care system itself being perceived by children as a threat, resulting in further ineffective communication. Avoidance of such problems requires both child advocacy in technical design, implementation, and evaluation and an organizational approach to pediatric patient safety with high reliability.
The design of HIT tailored to the need of pediatric health care providers can and must help reduce errors by adequately meeting these pediatric data needs and by reducing variability in data entry, communication, and display. In addition, HIT can and should provide an active learning infrastructure (of child health care providers) in which such errors (and the harms that may result from them) can be prevented, identified, and corrected.
Since the previous report, "Pediatric Aspects of Inpatient Health Information Technology Systems,"6 some progress has been made in the development of pediatric-specific technology standards. However, lack of standards has remained a significant technical barrier to adoption of pediatric HIT and the exchange of health information.
The development and dissemination of the Model Pediatric EHR format, which was funded by the Agency for Healthcare Research and Quality and supported by the AAP, has advanced standard development on outpatient pediatric EHRs. The Model Pediatric EHR format identified functional requirements for an EHR to meet the particular needs of children. It identified gaps between existing systems and an optimal EHR for children and created recommendations for functional requirements. Based on the Health Resources and Services Administration's Health IT for Children Toolbox,37 the Health Level Seven International (HL7) EHR-S Functional Model,38 and the HL7 Child Health Work Group's Child Health Functional Profile,39 the resulting format is a set of instructions for EHR vendors that defines functionality and data standard requirements that are essential to pediatrics. It includes more than 700 requirements organized by 21 topic areas. Pediatricians can use the Model Pediatric EHR format to advocate for improved pediatric-specific functionality within their outpatient EHR systems. Similar efforts are missing for inpatient systems.
Most children are cared for during episodes of acute illness in hospitals that also care for adult patients. Pediatric leaders should be aware of clinical stakeholders and their interests regarding HIT adoption. In purely pediatric hospitals, such as tertiary or quaternary university referral centers, obstacles and barriers to the alignment of leadership, staff, resources, and governance may be different from those in nonpediatric hospitals in which smaller groups of child-health focused personnel (ie, child advocates) may have to compete with larger groups of adult-oriented care providers, in both general and specialty care areas.
Pediatric use of EHRs suffers from similar problems as use in adult care, such as increased time to document,39 modification of workflow40,41 and communication processes, and a host of new unintended errors.42 The specific challenges to use of EHRs in pediatrics and the resulting requirements are listed here.
Data Requirements
Although pediatric medicine has many similarities with adult medicine, substantial differences exist because physiologic, development, anatomic, and psychiatric changes occur at a rapid pace in early life and then slow substantially by the time humans reach adulthood. A function of this velocity of change is the constant variation of norm values based on age in any measurable human variable.
The work of a pediatrician is geared toward assessing and evaluating patients and diagnosing and treating illnesses and conditions with a focus on the age-specific norms and diagnoses as well as the velocity of change over time of these parameters. Any HIT must support the age- and development-centric aspect of data interpretation and care—an essential aspect of pediatric health care that is much less important in adult medicine.21
Inpatient systems must further support the recording of data in a meaningful fashion to allow immediate interpretation. A good example is the appropriate unit of measure for age: a 0.019-year-old child and a 4440-day-old child do not use units of age that allow immediate interpretation, but a 7-day-old or 12-year-old child include units that allow a provider to immediately switch to age-specific context.
Pediatric data standards must enforce universal consistency of content, format (including data types and standard units of measure), and contexts of use. For example, there is a need for universal neonatal data entry and presentation that uses grams for weight, whereas adult data entry may allow only kilograms or pounds. Birth date and time is necessary knowledge for appropriate infant care because infant weights change daily and birth weights carry special significance, especially in context of gestational/postconceptual age (small-, appropriate-, or large-for-gestational-age infants). Hour of life information is also used when interpreting neonatal data, such as bilirubin.
For therapeutics, units of measure must be adjusted to reflect pediatric-specific doses, which are usually lower than adult doses. For providers, a dose of 40 mcg is easier to process than 0.04 mg. To avoid dosing errors, unit of measure should be adjusted to allow the dose to be represented with the least complexity.43
Several specific data elements only occur within neonatal care. Examples include gestational age (in weeks and days), birth weight (in grams), Apgar scores (score plus time of administration; at 1, 5, and 10 minutes after birth),44 scores for neonatal abstinence, withdrawal45 and/or sedation (multiple formats), and infant critical care risk.46 In addition, specimens (such as human milk and cord blood) may need to be tracked for future use for specific infants and require auditing data fields (infant identification, mother identification, donor [if not from mother], date of donation, date of use, amount [in milliliters], etc). For fetuses undergoing interventions in utero, prenatal events must be stored and linked to postnatal records.
An informal survey of the AAP Council on Clinical Information Technology mailing list produced the list of pediatric-specific measures in Table 2. Of note, not all measures contain data derived from pediatric patients. One example, based on the recent recommendation by the AAP to screen mothers of newborn infants for postpartum depression, is that pediatric inpatient systems should facilitate scoring for the Edinburgh Postnatal Depression Scale documentation.47
Inpatient pediatric systems must allow pediatric-specific data elements to be recorded using the appropriate data type and must allow selection of patient population based on a search of specific values of these data elements (eg, creation of a list of all newborn infants with Apgar scores less than 5).
The nature of pediatric care further requires variables that do not exist or are not used in adult care.48 For example, the ability to record the gender of a newborn child as ambiguous is critical to initiate the appropriate documentation and diagnostic and therapeutic processes.
Pediatric-Specific Functionality
Of particular interest in newborn infants and small infants is the concept of the mother–infant dyad.48 This function pertains to the ability to automatically extract and digest maternal data that are pertinent to the health and well-being of the newborn with respect to treatment or prophylaxis. For example, it is important to know that an infant was born to an HIV-positive mother. Knowledge about the maternal infection will allow the pediatrician to treat the infant adequately with antiviral medications to prevent vertical transmission. Data from the mother–infant link ideally should be pulled directly into the infant's clinical documentation and/or problem list. Gestational age at delivery obtained from the delivery record should be used to automatically calculate the infant's postconceptual age to allow for gestational age-appropriate treatment, such as medication dosing. Data not immediately available but of interest to the pediatrician, such as placental abnormalities, should be automatically incorporated into the neonatal record as well.
It is not unusual for infants to undergo name changes during their initial admission—for example, from the mother's last name to the father's last name. These patients must be disambiguated in the EHR and in ancillary systems, such as the blood bank.
Recently, the AAP endorsed marriage for gay parents to promote the well-being of their children.49 For inpatient systems, the changes occurring in the family concept mean that systems must be able to record a variety of core family units, such as 2 fathers or 2 mothers.50,51 For children in foster care or other custodial arrangements, inpatient health information systems must be able to capture routinely during the admission process (when possible) information on who is permitted to make medical decisions and can consent to care, who is permitted or not permitted to see the child's health information, and who may or may not visit.52
Access to Information
In pediatrics, providers are faced with patients who develop from total dependence on the care and supervision of others to relative independence and autonomy. Although the reverse is sometimes true in adult medicine (going from autonomy to dependency), the transition is a regular event for pediatricians, with resulting changes of who is permitted to access information and make decisions in the care of a pediatric patient developing over time. The management of this change must be included in inpatient pediatric systems to avoid privacy, confidentiality, and legal issues. The increasing use of patient portals that provide access to subsets of EHR data has minimized barriers for minor patients to access their own information and make this issue even more pertinent as adoption rates increase.53
Of particular concern is the need to guarantee privacy for adolescent patients to ensure that these patients will seek help for their issues without the fear of parental or societal repercussions.54 Requirements for adolescent privacy have been delineated.55 Inpatient systems must also support the care of emancipated minors, who in turn may be the parent of another pediatric patient. Emancipated minors must be able to make decisions for their health and their children, which means that systems must be designed to allow obtaining and recording consent by an emancipated minor.56
Pediatricians are only too aware of the challenges in caring for children in foster care.57,58 Handling consent issues and privacy for these children is more difficult.59 Managing information on guardianship and obtaining consent while at the same time supporting the patient's privacy are minimum pediatric requirements for inpatient HIT systems.60 Eventually, children will transition their care from their pediatrician to an adult health care provider. In inpatient settings, this means that records created during childhood should be available to adult providers in the future.
Pediatric systems must facilitate transfer of relevant pediatric-specific data in handoffs. Handoffs occur between hospital units, hospital services, different shifts, and outpatient and inpatient providers. Handoffs are known to be high-risk procedures introducing discontinuity of care and are a prime source of medical errors. Methods such as ISBAR (identification, situation, background, assessment, and recommendation), adjusted to permit pediatric data elements (see previous discussion), may improve the safety of handoffs.
A major goal of widespread HIT adoption is the establishment of interoperability between health care systems and primary care providers within a region (and nationally). However, nonalignment between systems because of competition may create barriers to the interoperability and integration of electronic child health information.61 Pediatric leaders within health systems (hospitals, group practices) should be aware of regional efforts to promote health information exchange standards for such systems as registries for childhood immunizations as well as metabolic/genetic and hearing screening tests. The goal should be to harmonize institutional standards with business affiliate groups under the Health Insurance Portability and Accountability Act (Pub L No. 104-191 [1996]).
Inpatient stays are usually associated with episodes of acute illness requiring evaluation and treatment followed by subsequent discharge to either home or another institution. Children may have extended lengths of stay in the hospital for days, weeks, or months. Although the main focus of providers will be on the episode of acute illness, health maintenance efforts for this captive pediatric population are important. Inpatient systems must support ordering and documentation of well-child care and health maintenance tasks such as those recommended in Bright Futures for children hospitalized for long period of times.62 The ability to document developmental milestones is necessary for pediatric inpatients. Disease may present with delayed or failed attainment of developmental goals.63 Thus, in an inpatient setting, guided documentation for capturing age-appropriate milestones can provide vital diagnostic clues.
Inpatient systems must support documentation, tracking, and notification associated with newborn screening and genetic testing. Furthermore, because requirements for newborn screening vary from state to state, systems must support documentation according to local laws. Reporting of newborn screening results may not improve follow-up of abnormal findings. Thus, clinical decision support to aid providers in the management of results, including testing of relatives, is needed to address this issue.64
It is vitally important that inpatient systems not only allow for the ordering but also the documentation of immunizations.65 Two-dimensional barcode technology should be supported. An exchange of immunization data with a health information exchange or an immunization repository must be available. The ability to connect to immunization forecasting tools with reminders will improve the number of patients who receive immunizations while hospitalized.
Growth charts that allow a provider to compare the patient's height, weight, and BMI to norm values and allow the determination of a growth velocity are vital to the work of pediatricians and must be included in inpatient systems. Growth charts should allow for automatic plotting of values and percentile determination. In addition to normal charts, the system should provide specialty growth charts for specific diseases, such as Down syndrome.66
Children frequently have different norm and critical values than adults. These different norms can be found in vital signs, physical examination features, laboratory values, or findings on imaging studies. Inpatient systems that store and display pediatric values should accommodate these different norm values and should not only display the age-appropriate reference ranges but also display results in adjusted graphs.67 For example, the blood pressure of a preterm neonate should not be displayed on an adult graph with y-axis values ranging from 0 to 200 mm Hg but on a neonatal graph with y-axis values from 0 to 80 mm Hg. Laboratory values should display norm values for the age of the patient, and any clinical decision support designed to alert providers of abnormal values should be designed with age-specific norm values in mind to prevent meaningless alerts and resulting alert fatigue.68–71
Nutritional choices for very young children are different from those for adults. Inpatient HIT systems must support the ordering, dispensing, and feeding of age-specific nutrition, including the appropriate modality (eg, formula or breastfeeding). An inventory of human milk and age-specific formulas for neonates or infants, as well as special diets for older children with developmental or nutritional problems, must be available. Because support of adequate growth and, recently, the prevention of obesity are important in pediatrics, caloric densities to allow for easy calculation of intake should be available.72 Weight velocity calculations should have age-appropriate calculations (eg, g/kg/day or g/day).
Inpatient settings must have systems in place that manage the storage, expiration dates, and proper administration of human milk73 and, to prevent inadvertent exposure, should reduce the risk of the feeding of human milk from the wrong mother. With donor human milk being used in NICUs, this nutritional alternative should be managed as well.
Educational materials and handouts tailored to both the pediatric-specific conditions (such as congenital heart disease) as well as the appropriate cognitive and reading level for both children and their parents are important to keeping families informed and teaching them to manage chronic diseases. In pediatric settings, multiple versions of the same material may be required to serve the needs of both child and guardian.
EHRs must further promote the creation and documentation of pediatric quality measures to ensure that services provided to children can be measured in a meaningful way to capture the impact of services and interventions on the health and well-being of children.
Therapy and Intervention
One of the most important functions of pediatric inpatient systems is the requirement that systems must be able to support pediatric weight-based dosing and dosing based on body surface.23,74,75 These calculations must extend into dose range alerts as well, in which systems should be capable of creating alerts based on the dose per weight, total daily dose per weight, dose per surface area, total daily dose per surface area, and total dose and total daily dose. Providing weight-based dosing has been shown to reduce errors and potential patient harm in continuous infusions26 and nutrition (parenteral and enteral) orders3 as well as regular medications.25 In the ordering of chemotherapy medication with narrow therapeutic windows,21 the use of both weight-based dosing and weight-based dosing alerts has been found valuable.77 For pediatric patients who are at the beginning of their exposure to medications and radiation, the implementation of lifelong cumulative dose range checks are more important than in adults. When building pediatric dose range alerts, institutions should be cautious to prevent overalerting, which can result in fatigue. Underdosing alerts provide less value to providers than overdosing alerts.78 The highest value for dose range alerts may be found in pediatric oncology patients.78
Building medication orders with prepopulated dosing recommendations provides incentives to providers to select preferred doses by making ordering less time-consuming for providers. These selections result in standardization, reduced prescribing errors, and increased safety to pediatric patients.79
Order sets for children should be available that allow providers to select the correct evidence-based laboratory tests and radiology studies, which may minimize the amount of blood required and the radiation exposure. HIT systems should also support radiology protocols, which may allow standard radiation doses to be adapted as suitable for children. Preferred imaging studies may vary depending on age and development and can minimize radiation exposure.80
Past experiences have illustrated the importance of allowing health care providers to "do the right thing" and not to stop them from performing appropriate actions. The implementation of computerized physician order entry described by Han et al demonstrated the importance of permitting order placement on preadmitted patients.81 A pediatric-specific need in the age of advanced prenatal diagnostics is the ability to place orders for patients who have not yet been born and thus are not legally considered "persons." For example, a delivery of an infant with complex heart disease is anticipated, and a prostaglandin drip is desired to be started immediately after delivery. In this case, the ability to order, dispense, and deliver the medication before the physical arrival of a patient is crucial.
The Future for Inpatient Pediatric Hit Systems
As a result of the American Recovery and Reinvestment Act, many hospitals have implemented HIT systems to achieve eligibility and collect meaningful use incentive payments. Children's hospitals report an increase in EHR adoption from 21% in 2008 to 59% in 2011.12 Although the HITECH Act has many requirements aimed at improving the effective use of HIT, only stage 2 contained valid pediatric measures for the use of HIT in children. Although these measures are helpful, they do not address one a of the core problems of HIT in inpatient settings: —many systems were designed with adult care in mind and lack basic safety features as outlined in this paper article to prevent injury or harm as a result of the use of these systems in children.
A recent analysis of costs demonstrated that the use of advanced EHRs in pediatric inpatient settings increased costs by 7%.82 Of note, this study did not inquire whether the hospitals were using EHR technology that was customized for use in children. Effort must next be directed in addressing the specific needs pediatric patients and their providers have in the inpatient setting, with the goal of increasing safety and effectiveness but also to realize the savings experienced in adult settings.83,84
As stakeholders, parents and pediatricians must continue to lobby for improvement of inpatient (and outpatient) HIT systems to enhance their ability to properly support safe and efficient health care delivery for children. The design, development, and adoption of pediatric-specific functionality in inpatient HIT systems is the only clear path toward achieving this important goal.
Christoph U. Lehmann, MD, FAAP, FACMI
Stuart T. Weinberg, MD, FAAP, Chairperson
Gregg M. Alexander, DO
Eric L. Beyer, MD, FAAP
Mark Andrew Del Beccaro, MD, FAAP, Immediate Past Chairperson
Anne B. Francis, MD, FAAP
Eric G. Handler, MD, MPH, FAAP
Timothy D. Johnson, DO, MMM, FAAP
Eric Steven Kirkendall, MD, MBI, FAAP
Donald E. Lighter, MD, MBA, FAAP
Stephen James Morgan, MD, FAAP
Mordechai David Raskas, MD
Eric Tham, MD, MS, FAAP
Emily Chui Webber, MD, FAAP
Lisa Krams, MS, CHES
The author thanks the members of the Council of Clinical Information Technology for their help with the pediatric-specific measurement collection and Drs. Michael Leu and Eric Kirkendall for the critical first review of this manuscript.
This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.
The guidance in this report does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.
All technical reports from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.
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- Copyright © 2015 by the American Academy of Pediatrics


text:
Lunch with Santa/ Barbara Matt
On December 13th we were visited at Fox's Pizza in Hinsdale by Santa. Children listened to Santa read 'Twas the Night Before Christmas. Santa even brought his "Naughty or Nice List." Each child was able to spend one on one time with Santa. Below you will find some photos from the event.


text:
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text:
It Can Be Acquired and Learned: Building a Writer-Centered Pedagogical Approach to Creative Writing
Date of Award
Document Type
Degree Name
Doctor of Philosophy (PhD)
First Advisor
Patrick Bizzaro, Ph.D.
Second Advisor
Resa Crane Bizzaro, Ph.D.
Third Advisor
Bryna Siegel Finer, Ph.D.
Fourth Advisor
Dianne Donnelly, Ph.D.
Because creative writing studies is a developing discipline and research shows that many creative writing faculty are underrepresented in scholarship, this dissertation study aims to explore current pedagogical approaches in American undergraduate creative writing classrooms. To achieve this goal, the researcher collected nearly 70 course syllabi, along with survey data to situate the syllabi, and conducted discourse analyses on the data utilizing NVivo software. As part of the analysis, the software searched for a predetermined list of codes (terms identified as appropriate in the dissertation's pilot study). Additionally, the software identified trends in the data (terms and activities that were commonly used by creative writing faculty). The hypotheses and analysis were based on a dual theoretical framework of (1) acquisition and learning-based pedagogical approaches, and (2) writer-centered teaching. According to the hypothesis, pedagogical approaches that implement both acquisition (practice-based knowledge construction) and learning (theoretical analysis of the process of knowledge construction) should be the preferred approaches among creative writing faculty. Additionally, creative writing pedagogy should focus on students' unique goals and interests with both reading and writing. Based on the data collected and the initial hypothesis, the researcher called for changes in approaches to creative writing studies research and presented several ideal teaching practices and theoretical foundations for these practices.
Recommended Citation
Girardi, Tamara A., "It Can Be Acquired and Learned: Building a Writer-Centered Pedagogical Approach to Creative Writing" (2014). Theses and Dissertations (All). 882.


text: The internet continues to spread to more and more Swedes, and it is believed that Sweden is already one of the countries with the highest number of internet users. In 2014, nine out of ten Swedes have access to both the internet and a computer. In total, we spend 21.6 hours per week on the internet. Access to smartphones and tablets are also increasing, however they have not replaced the computer but work as a complement.


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Clone Wars Declassified: 520 – The Wrong Jedi/
Star Wars: The Clone Wars reaches a climax with the trial of Ahsoka Tano in The Wrong Jedi. Wrongly accused for a crime she did not commit, Ahsoka finds herself on the verge of losing her freedom, and possibly more. What brought this once promising Jedi padawan to such a moment of great despair? And what is the future of The Clone Wars… if any? Joining Jimmy Mac to discuss the fate of Ahsoka in this Season Five finale roundtable are RFR favorites, film director Kyle Newman (Fanboys) and Emmy-nominated artist Paul Bateman.


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Hacking VR For the Global Mission Field
This past weekend I flew up to Seattle with a co-worker to participate in a global hackathon (my first) where Christians in 13 cities around the world will simultaneously be building Kingdom-minded products.
Had a great time working alongside World Vision to build an immersive virtual reality experience to showcase projects on the ground utilizing Google Cardboard.
We named it, "Vision Caster", and ended up winning one of the prizes!
The project was executed this entirely in HTML5 and JavaScript instead of building out a native mobile app. Mostly because of the skill set we had available in our group, but it ended up being a really fun experiment to see if we could pull off.
We didn't get to include every feature/function that we intended to, but within the time constraints of a 48hr hackathon I think we ended up with something pretty cool. You can view the end result of our project yourself here:
It is best experienced using a Google Cardboard headset in stereoscopic imaging, but you may also view it normally on your mobile device or on s desktop browser with a mouse.
Utilizing your mobile devise, you can change to a different scene by rotating your phone 90° (the browser rotation is what triggers the next scene to load).
Please feel free to fork this project on GitHub and build on it yourself here (just let me know if you do, I'd love to know what you do with it!): https://github.com/reescott/visioncaster
This was an extremely fun project to work on and I learned a bunch, not just about the overall hackathon experience, but about creating a fully immersive experience using a very simple piece of cardboard. One of my biggest learnings was discovering the word "equirectangular" and the vast amount of photo and video content that is only just now starting to emerge.
Afterward winning the prize money, we all unanimously voted to spend the proceeds on equipment to better capture more of these moments on the ground around the world.
Photos from the trip:
November 13-15 Bay Area Hackathon
The major catalyst for attending this event wasn't to necessarily visit Seattle to build a specific product at all, but to learn from the organizers about what it takes to host a hackathon event.
Next month Venture Christian Church, along with any other partners wish to join us between now and then, has committed to hosting a hackathon for the entire Bay Area taking place at City Team in San Jose.
If you are at all interested in participating, please learn more info and sign up today here:
Here's a short video from last year's Bay Area event:
I really hope you will consider joining us, and I can now tell you from first-hand experience just how much fun you will have!


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I recently got my gorgeous 2017 Toyota Corolla it 24,000km serviced at your business & was impressed with how quickly & efficiently it was done. I also appreciate my car being washed after every service appointment. Great touch !!
I will continue bringing my car into your business for all my service needs.
I'd like to add that I was genuinely impressed that the sales representative that leased my car to me almost a year ago, remembered me by name at my recent service appointment.
You have a great facility with excellent service & friendly, professional people working there.
Robin George


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we've got the space if you've got the pals
And it won't cost you a bean. We can accommodate up to 60 people seated, or 120 people standing. We currently offer a 3 course Christmas dinner for groups of 6-30, or a buffet option for groups of 10-60.
To book please contact us on 01273 325850 or via email at firstname.lastname@example.com
Capacity: 120
Price: FREE


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26 East/
After months of anticipation and preparation, I checked the roof racks on the Syncro one last time, said good-bye to my mom and left the Gorge heading east. With my brother Tim sitting shotgun, we pumped "The Weight" as an homage to Easy Rider and cruised down highway 26 at a steady 63 mph. I rolled down the manual crank window, put on my sunglasses and enjoyed the dry air.
Taking turns behind the wheel, we took the in the scenery and headed towards Colorado by way of Oregon, Idaho and Utah. Sticking to the back roads, we moved slowly, camping by night on BLM land and cooking our meals at rest stops and state parks.
Open Country.
300 win mag near the John Day River in Eastern Oregon.
Brush fires in Southern Idaho. Bruneau Dunes.
Modern navigation.
A barn in Central Oregon.
John Day River Valley.
Dinner by Tim, mug by Snow Peak.
Does any one know what kind of snake this is?
Sunset on I-84.
Gas can, dry bags and 14 gallons of water.
Tim on a morning hike.
After four days , 1100 miles, and 57 gallons of gas, we finally crossed over into Colorado from southern Utah. For the next few weeks, we are cruising around CO, backpacking, fishing and enjoying the mountains.
Here are some more links,


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Thursday, December 9, 2010
Christmas Frogs
18 comments:
What a cute idea, Janet~he is adorable! Your friend is going to love her:)ReplyDelete
Christmas Frog! I totally love it Janet; I just got inspired to make one for myself. It's just too cute.ReplyDelete
This is so cute! I like that you took Christmas fabric to do it and it is a Christmas frog:)ReplyDelete
Hi Janet! I have stopped by for awhile. Hope all is well with you. The frog is so cute.ReplyDelete
What a merry froggie going on over here! So cute, thanks for the Thursday smile :)ReplyDelete
Cute, cute frogs. These would look sweet in a frog themed tree.ReplyDelete
Way cute!!! AND, what a clever girl you are to dream that up specially for your frog loving friend!ReplyDelete
How sweet is this little Christmas Frog. Here I'd thought I'd done gone and seen it all!!! Heeehehehe!ReplyDelete
You indeed are a very good friend!
God bless ya and have a stupendous weekend sweetie!!!
I just love your Christmas frog. it's so pretty and festive. You are such a talented person. This would make a perfect Christmas gift for a child. Great idea!!
adorable!!! I love the little frog. Hope your holiday season is going great!!!ReplyDelete
What a great craft, Janet. Thanks for the step by steo instructions! Merry Christmas to you! Rib-bit rib-bit!ReplyDelete
He turned out so cute-I know she'll love him : )ReplyDelete
These are so cute! What a neat idea. Thank you for sharing your Christmas frog. My niece likes frogs, so I may have to make her one.ReplyDelete
Hey girl, I was just checkin' in to see how you were doin' and to say 'howdy'!ReplyDelete
God bless ya and have a terrific day my friend! :o)
Janet, that is the cutest frog ever. I love her. The eyes make her--give her personality. She is gonna love it.ReplyDelete
Janet -- I stopped over at your other past blog to see what it was about. I realize you are not using it anymore but leaving posts, etc, on to check out. I was blown away by the header photo of the covered bridge. A beautiful shot! -- barbaraReplyDelete
A very merry Christmas to you and yours!ReplyDelete
How cute!ReplyDelete
My Mother-in-law would love it!!
Thank you for stopping by. I love comments! Leave one and brighten my day. If you are signing as Anonymous, please sign your name, so I will know who you are.


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BJ's Wholesale Club
Busy as a Bee Daycare
Casey Gray Trucking
Day's Jewelers
Flagship Cinema
Music Reflections
Lewiston Sun Press
Sarah Landry Photography
Wal-Mart Supercenter
Treat your daughter to a festive evening of dressing up and dancing with her dad! Girls 4-12 years-old are sure to treasure this special time with their fathers at The Public Theatre's 23rd Annual Valentine Ball.
NOTE EARLIER TIME: 6:30 pm - 8:30 pm
The 2019 Father Daughter Valentine Ball will be held on February 9, 2019 from 6:30 pm - 8:30 pm at The Ramada Inn in Lewiston.
Tickets are $40 for one father and one daughter, additional daughters are $10 each.
Starting, Monday, November 26, 2018 you will be able to download the Valentine Ball Order Form, and mail it in or drop it off at the theatre. No Phone orders are accepted.
Each year tickets sell out quickly, so all reservations are processed in the order they are received.
Mark your calendar and check back after Thanksgiving.


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MUZAFFARGARH: Two women were allegedly paraded naked around in the Khangarh area here when they took a weeding proposal to the house of a girl. According to reports, the women were paraded naked by the family of a girl, for whom they have brought proposal of marriage. TV reports said that Adeela and Shabbir loved each other and wanted to ... Read More »
Tag Archives: Couple's Naked Parade
SHO Held For Man & Woman Naked Parade
KHAIRPUR: A Station House Officer (SHO) has been arrested for his involvement in parading a woman and man naked on streets for their 'intention of adultery'. According to the concerned SSP Police, four policemen nominated in the case have so far been held while raids were being conducted to arrest two more who are at large. The SHO had fled ... Read More »


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We get really excited about DIY projects and party decor (and probably always will, let's be honest) but every once in a while, it's fun to return to our roots and do some traditional paper crafting. So, today on the blog, we're scrapbooking!
For the first project, I had a picture of my adorable nephew and his little friend that I wanted to use. I chose this ombre page out of our Melon Patch paper pad as the background and then added strips of paper and cut out little triangle shapes from other sheets from the same paper pad. Then, I added this cute little photo of my nephew and his friend playing bumper cars. He is the sweetest! :) To top it off, I added cute little Recollections brand monster stickers that I found at Michaels stores.
For this wedding page, I wanted to make a layout from a wedding. I used some simple but elegant pages from our Love Story paper pad. I cut out the letters L, V, E and used one of their wedding pictures as the, "O". The tag page from the paper pad had a lot of cute romantic quotes, and I chose, "When I look at you I am home" - I think the classic typography really echoes the style of their wedding. I polished it off with some pretty stickers from Michaels for a little added embellishment!
Here are pictures of the paper pads used in the making of these scrapbook pages!
We love seeing your projects - tag us on Facebook or Instagram with #craftsmithco and let us know how you're using Craft Smith products in your crafting!


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It's always a cause for celebration when the farm comes out with new cheese options. When I first joined the CSA, the cheese they were making was delicious, but there were far fewer varieties than are available today. I've watched and delighted as smoked cheddar, smoked feta, clothbound cheddar, maasdam, mozzarella, gouda, and jalapeno cheddar have become fast favorites among Brookford fans. This variety helps customers source more food locally while increasing the options for what we can do in our kitchens. I didn't really think it was possible to get even more excited about the cheeses that are available to me each week, and then the farm went and created a queso fresco and Dudley's Dance. These two new cheeses are seriously delicious, and I'm immediately wondering how we ever survived without them. If you haven't tried them yet, here's what they're all about:
Dudley's Dance
About: Dudley's Dance is a semi-hard cheese with the sweet taste of Swiss and the thick creaminess we have all come to love in Brookford cheeses. Named after Dudley, a well-known, 80 year old Contra dance caller and Brookford Farm Milker who has an unwavering love for Brookford Farm.
Flavor and texture profile: This is an incredibly smooth and velvety cheese. The heavenly texture can't be overstated; it is irresistible. It is thick and creamy, with a well balanced sharpness in the finish.
How to enjoy: Dudley's Dance is wonderful on it's own or as part of a cheese platter. It pairs very nicely with sliced apples and pears, and is decadent melted on garlic toast. It's a great match for white wine or any crisp beer.
Queso Fresco:
About: Queso Fresco is a fresh, bright cheese with a mild milky taste. Perfect over nachos or you can replace feta with Queso Fresco in your favorite recipes for a lighter, creamier texture.
Flavor and texture profile: This is an excellent and versatile cheese. It is wonderfully mild with a bright but gentle saltiness. The texture is delicate and light, with an unmistakable freshness.
How to enjoy: Queso fresco can be crumbled over enchiladas, used as stuffing for chile rellenos, or made into a decadent dipping sauce. The gentle nature of this cheese makes it an excellent counterpart for all spicy dishes.


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Centre Point Silom Bangkok presents Special Rate for One – Bedroom Grand Suite(90 sq.m.) at THB 2,999 per room per night! Breakfast Included!!!
Booked: Now – 31 October 2014
Stayed: 01 September – 31 October 2014
Exclusive online offer. BOOK NOW @ http://www.centrepoint.com/CentrePointSilom/PageHotel.aspx
Centre Point Hotel Silom near the Chao Phraya River reminds visitors of Bangkok's rich maritime history in the olden days. The road on which it is located is also the city's first western-style thoroughfare with shop-houses lining both sides.
Centre Point Hotel Silom, situated on the top of Robinson Bangrak Department Store and at the bank of Chao Phraya River, is in proximity to Saphan Taksin skytrain (BTS) station and Sathorn ferry pier; aiding quick and easy transfer to:
The Grand Palace,
Emerald Buddha Temple,
Wat Pho Temple,
Temple of Dawn (Wat Arun), and
Asiatique – the Riverfront and Community Mall(night bazaar).
The Hotel's building is in the Jewelry Trade District of Silom and Sathorn road.
It takes just a 5 min. drive to BKK Sea Shell Museum, and Sri Mahamariamma Temple; a mere 10 min. drive to Pat Pong (night life), and a short 15 min. drive to China Town.
Guests can enjoy the use of the Hotel's outdoor saltwater swimming pool, fitness center, sauna, free wireless internet, a business center, conference room and a coffee corner.
Accommodations comprise of magnificent rooms with dining area, fully equipped kitchen, toaster, microwave, refrigerator, washing machine with dryer, and iron amenities (on request).


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Custom Box Kits
Custom Box Kits
Corrugated Kits
Cost effective dunnage kits providing protection for parts and reduction in multiple, costly materials. Assembled in-house using Corrugated Material.
Foam Kits
Provides the ability to divide and protect parts during transit ensuring no marks/scratches on final product. Assembled in-house using Corrugated & Foam material.
Multi-Material Kits
Custom solution oriented kits provide access to a variety of protective materials, eliminating quality issues during transit. Assembled in-house using materials such as: Corrugated, Wood, Foam, & Plastic.
Pallet Box Kits
Designed to fit your product needs and shipping requirements. Provides the ability to pack parts in bulk and store easily. Assembled in-house using Corrugated & Wood material.


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Have you started on your Easter cards yet? If you're looking to make something a little more on the whimsical side, you might want to check out this adorable bobblehead bunny:
You can find him HERE
Head over to the Catch the Bug Blog to see what the rest of the DT wants to show you today.
Subscribe to: Post Comments (Atom)


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Isaac Brown
Thirroul JFC is pleased to announce Corey Haines-Gross as Thunderbirds first division coach for the 2016 season.
Corey, who was assistant coach last season, will work with Adam Ward and a coaching team which also includes John Paegle, Todd Yarrow and Oscar Pruks.
John Cropper has also been appointed to the role of Mentor: Coaching and Development, and he will work with all teams across the club.
At this stage it is anticipated that John Paegle will coach the Thunderbirds Youth Grade team playing in a new Football South Coast competition for players aged 16 to 21, while Todd Yarrow will be in charge of second division.
A final decision will be made once the club has a better idea about playing numbers and whether there are three or four Thunderbirds teams this season.
Training for the women's teams has begun and is at 6pm each Monday and Wednesday at Gibson Park.
Thirroul JFC would like to thank last year's coaches, Brad Matiuscenko, Alex Matiuscenko and Jonathon Tobin, for their time, effort and commitment.
Under Brad, the First Division team qualified for the 2014 grand final and were semi-finalists in 2015, while Jonathon's Third Division team were League Champions last season.
Unfortunately, they were unable to commit to coaching roles again this year but the club is excited about the upcoming season under Corey and our senior women's coaching team.


text: Bioclear Matrix offers the latest, most innovative products and techniques evolving from the traditional preparations and matrix systems for anterior and posterior composites. Dr. David Clark has changed the course of dental restorations by bringing a new dimension to aesthetics and function through cutting edge procedural advances. The Bioclear Method for composites is a shift in dentistry offering more affordable options with superior results. It is our mission to provide dentists with the tools and equipment to allow for longer lasting, stronger, and aesthetically superior composites. More about us.


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Sharp makes some of the world's most powerful digital document devices. The current range includes a wide selection of devices from space-saving copiers through to exceptionally versatile high-speed black & white and colour multifunctionals.
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Savino, Klein clean energy vote leaves greens anxious about climate bill
ALBANY — When every member of the Independent Democratic Conference sponsored a comprehensive piece of climate change legislation, environmental groups thought they had found a legislative champion.
But as the end of session and the Big Ugly approaches, two members of the IDC have voted to defund key clean energy and environmental justice priorities that the bill would codify. Now clean energy advocates are increasingly worried they will get jilted on a climate bill that supporters have called the most progressive in the nation.
The "Climate and Community Protection Act" would enshrine the state's renewable energy goals into law, set benchmarks for clean energy initiatives, and direct funding to green jobs and vulnerable communities. It would essentially shift the state's economy to one powered almost entirely by clean energy by 2050.
The bill was largely drafted and backed by NY Renews, a broad coalition that includes more than 100 environmental and labor groups including Environmental Advocates of New York, the Teamsters Joint Council 16 and a slew of environmental justice groups.
Sen. Tony Avella indicated he would amend the bill (S.6617) but did not return multiple calls requesting comment. Unless the same amendments are made in the Assembly, where the bill has not yet come up for a vote but has passed previously, the bill is essentially dead for the year. If the bill remains alive, it will be up to the IDC to push Senate Majority Leader John Flanagan to bring it up for a vote in the chamber, where it is expected to have just enough votes to pass.
"The IDC has to prove it can bring this urgent bill to the floor for a vote, or it raises serious questions about whether their entire stated rationale for existing — that they can engage Republicans to actually pass progressive priorities into law — is nothing more than hollow grandstanding," said Guido Girgenti, a political campaigner with the group 350.org.
"If the IDC can't pass a historic state climate bill in the direct aftermath of [President Donald] Trump pulling out of the Paris Accord, it indicates that they simply do not have the power to get this kind of visionary climate legislation passed, ever," Girgenti added.
The IDC has come under fire from national and state Democratic party leaders and progressive groups for working with the Senate Republicans. Critics argue they are preventing a Democratic majority from achieving big policy victories in New York and some members are likely to face primary challenges.
Two members of the IDC — conference leader Sen. Jeff Klein and Sen. Diane Savino — voted last week in favor of a Flanagan-sponsored measure that would shift funding out of the New York State Energy Research and Development Authority to the state's aging nuclear fleet. Environmental groups lambasted the measure and Environmental Advocates called out the IDC votes on Twitter.
"Those that voted for Senator Flanagan's bill have endorsed an ill-advised scheme to gut funding for renewable energy and kill programs that help working families reduce their energy burden," EANY executive director Peter Iwanowicz said in a statement. "If this bill ever became law, it would drive up air pollution and trigger more death and disease. A yes vote on this is truly an insult to anyone who breathes."
The NYSERDA bill's chances in the Assembly are slim and Gov. Andrew Cuomo will almost certainly veto it if it comes to his desk, but the votes of Klein and Savino are leaving advocates increasingly anxious about their support for the climate protection bill.
"What I hope we're not looking at is a case of legislative schizophrenia," said Eddie Bautista, head of the New York City Environmental Justice Alliance. "Savino has been a champion and got through one of the most significant climate bills in the Senate so it's hard to square."
In 2014 Savino was instrumental in passing the Community Risk Reduction and Resiliency Act, which requires the state to factor in climate change before approving any state-funded projects.
IDC spokeswoman Candice Giove defended the votes of Klein and Savino on the NYSERDA bill and said Avella would be amending the bill but did not indicate if the amendments were different than those made in the Assembly.
"Senators Klein and Savino made a decision based on calls and emails from their constituents who would be stuck paying more for their energy bills to bail out upstate nuclear power plants," Giove said in a statement. "That being said, the IDC has always championed environmental causes and there is no greater advocate in our conference for that than Senator Avella, who is working with climate scientists to make amendments to the Climate and Community Protection Act (CCPA)."
With Trump's withdrawal from the Paris climate accord and numerous cutbacks to clean energy initiatives, states and cities are filling the void to enact policies the federal government has abandoned, heightening the need for the climate protection bill, supporters said.
"It's the most important thing that we could possibly do and punting is not really called for. Action is called for," said state Assemblyman Steve Englebright, who sponsored the bill in that house, where it is expected to pass this week. "There is a crisis that our state and nation needed to deal with yesterday. So delaying is a very bad thing."


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These are really tough days for the LGBT community in Russia, therefore Coca-Cola, the main sponsor of Sochi's Olympics, is now having a really bad times with gays.
All Out, the international gay-rights organization, is putting Coca-Cola under a lot of pressure for some months already. Almost 150,000 people had already signed a petition for the Atlanta-based multinational, asking them to take a strong stand against the Russian anti-gay laws and All Out is working hard on putting Coca-Cola's silence to this request in the international spotlight.
After having raised over $30,000 in a few hours, last Monday three massive billboards were parading in front of the Coca-Cola HQ, saying "Coca-Cola, don't stay bottled up, speak out against Russia's anti-gay laws". Quite impressive, we love you so much!
The message is pretty simple: public opinion is waiting for somebody to say something. None of the sponsors of the games demonstrated support for gay equity in Russia so far, including Coca-Cola, a brand that in the past already supported various LGBT causes. Since image is everything nowadays, especially if you're one of the biggest multinationals in the world, this silence is damaging their own reputation. Being paralyzed in confusion in between your western customers and investments in non-democratic countries has to be difficult. Nonetheless, who cares? We're talking about a place where people who dare to demonstrate in the streets are simply taken away in a police van and disappear.
Masha Gessen is one of Russia's most prominent gay rights activists and she writes for The Times: she made a point saying that sponsors and not athletes should make political statements when it comes to controversial issues during an Olympic event. "It will be a lot more effective to put a rainbow on every Olympic Coke can than for an American athlete to say something that won't even get broadcasted or translated on Russian TV," she said to The New Yorker.
At the moment, the gay community is angry and ready to get even louder and more visible if necessary. These brands should really consider taking some action before further damaging their own name in front of the entire international community. The power of symbols and images is huge, and they know it.
View Results
List of polls


text: The Office of Inspector General (OIG) for the Department of Health and Human Services (HHS) issued its semi-annual report to Congress in which it highlighted the agency's work between April and September of this year (OIG Report) and the record-breaking amount of money it recovered from providers during this period. The OIG Report illustrates the government's expanding scope and effort to combat health care fraud and further demonstrates the challenges facing the government as it seeks to fully implement the Affordable Care Act. Click here for more information.