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Studnicki J, Fisher JW, Tsulukidze MM, Taylor YJ, Salandy S, Laditka JN. Career Phase of Board-Certified General Surgeons: Workload Composition and Outcomes. Arch Surg. 2011;146(11):1307–1313. doi:https://doi.org/10.1001/archsurg.2011.265
© 2019
Author Affiliations: Department of Public Health Sciences (Drs Studnicki, Fisher, and Laditka) and Doctoral Program in Health Services Research (Dr Tsulukidze and Mss Taylor and Salandy), College of Health and Human Services, University of North Carolina, Charlotte.
Objective To examine surgeon career phase and its association with surgical workload composition and outcomes of surgery.
Design Cross-sectional study.
Setting The study used data from calendar years 2004 through 2006 from 4 Florida general surgeon (GS) cohorts determined by years since board certification.
Participants American Board of Surgery–certified GSs regardless of subspecialty (n = 1187) performing 460 881 operations on adults 18 years or older.
Main Outcome Measures Workload composition based on the Clinical Classification System, complications identified by patient safety indicators, and in-hospital mortality. Poisson regression with robust error variance estimated adjusted rate ratios (RRs) for complications and mortality.
Results Compared with late-career surgeons, the rate of complications from cardiovascular procedures was higher for surgeons in the early-career phase (RR, 1.23; 95% CI, 1.06-1.44) and the late middle–career phase (1.18; 1.02-1.37). The mortality rate for cardiovascular procedures also was higher for early-career surgeons (RR, 1.23; 95% CI, 1.04-1.46). For digestive procedures, early-career surgeons had lower complication rates than late-career surgeons (RR, 0.86; 95% CI, 0.75-0.99).
Conclusion Late-career GSs perform both better and worse compared with early-career GSs, relative to their workload composition and proportional surgical volume. Factors such as training and case complexity may contribute to these career-phase differences.
For more than 46 million surgical procedures performed in the United States each year, reducing adverse events is important.1 An extensive body of literature has examined the role of hospital volume and found that higher volume is associated with better outcomes for many surgical procedures.2,3 Findings from a 2003 study4 of Medicare claims data suggest an inverse relationship between surgeon volume and mortality for 8 types of procedures after adjusting for patient and hospital characteristics. A systematic review of the volume-outcome literature by Halm et al3 covering 1988 to 2000 found a statistically significant association between patient outcomes and physician volumes in 69% of studies reviewed. More recently, the role of surgeon experience has been examined. A study examining inpatient complications, mortality, and hospital length of stay after colon resection found that increasing years after board certification were associated with reduced morbidity and mortality after adjusting for patient and hospital characteristics.5
For general surgeons (GSs) with training in a broad range of surgical areas, volume may not be concentrated within a specific set of procedures. Ritchie Jr et al6 examined the relationship between the workloads and practice patterns of 2434 nonspecialist GSs in the United States during a 3-year period and found that, on average, surgeons performed 398 operations per year. Operations involving the abdomen and the alimentary tract comprised 41% of the total, followed by breast and endoscopic operations with 13% each and vascular operations with 10%. Operations involving trauma and the head and neck comprised less than 2% of those performed. Workload and practice patterns were found to vary by practice type, geographic location, and rural or urban status. In a comparison of 10-year and 20-year practice cohorts, the 10-year cohort performed a slightly higher number of operations, but outcomes were not examined.
An important related question is how specialization by GSs early or late in their careers affects patient outcomes. In a review of the effect of surgeon experience and specialization on cancer surgery outcomes, Bilimoria et al7 found that specialized surgeons had better outcomes and that time since American Board of Surgery (ABS) certification was a significant predictor of patient outcomes. This finding is supported by research suggesting that accumulation of knowledge and skills during years in practice results in superior quality of care and better outcomes.8 However, limited research has examined the relationship between surgeon case load volume and career phase and the association between these factors and patient outcomes. The hypothesis under consideration in this research is that the career phase of GSs, as indicated by years since board certification, is associated with variation in case load composition, cumulative and cross-sectional volume, surgical complications, and in-hospital mortality.
A cross-sectional study design was used to examine the composition, workload, and outcomes of GS practice. Surgeons were categorized into 4 cohorts based on their career phase as expressed in terms of years since board certification: less than 10 years (early), 10 to 19 years (early middle), 20 to 29 years (late middle), and 30 years or more (late).
The study used 2004-2006 Florida Patient Discharge Data, available from the Florida Agency for Health Care Administration. Data included demographic characteristics such as sex, race, ethnicity, age, patients' residence zip code and county, the diagnosis-related group, admission source, length of stay, year and quarter of admission, discharge disposition, payer category, and a unique hospital and surgeon identifier. Each record also provided the principal and secondary diagnosis and procedure codes. Using unique surgeon identifiers, patient discharge data were linked with the practitioner profile available from the Florida Department of Health. The practitioner profile includes self-reported information regarding practicing physicians, such as program type (internship, residency, fellowship, or other) for graduate medical education, the year the licensee began practicing, the date the licensee began attending medical school, the title of the degree awarded to the licensee, the date of graduation, the educational institution name, and the specialty certification name. The date of board certification was obtained from the ABS online database.
Only surgeons with ABS certification in general surgery were included in the study. For each surgeon identified as the operating physician for an operation occurring during the study period, data from the Florida Practitioner Profile Database were used to identify certification in general surgery regardless of subspecialty. Then, surgeons were matched with ABS certification data to verify board certification status. A total of 1300 GSs performing 528 985 operations during the study period were identified. Of these, 100 surgeons performing 39 401 operations were excluded because certification status and date could not be verified through the ABS database. Also, 28 703 operations performed on children were excluded, along with 13 surgeons who had performed operations only on children during the period. Thus, 1187 surgeons performing 460 881 operations on adults 18 years and older remained in this analysis.
Patient safety indicators (PSIs) were used to measure complications associated with each discharge record. The PSIs are a set of indicators developed by the Agency for Healthcare Research and Quality to provide information regarding potentially preventable in-hospital complications and adverse events. For the purposes of this study, we selected 11 PSIs based on clinical relevance for general surgery: death in low-mortality diagnosis-related groups (PSI 2), foreign body left in patient during surgical procedure (PSI 5), iatrogenic pneumothorax (PSI 6), selected infections due to medical care (PSI 7), postoperative hemorrhage or hematoma (PSI 9), postoperative physiologic and metabolic derangements (PSI 10), postoperative respiratory failure (PSI 11), postoperative pulmonary embolism or deep vein thrombosis (PSI 12), postoperative sepsis (PSI 13), postoperative wound dehiscence in abdominopelvic surgical patients (PSI 14), and accidental puncture and laceration (PSI 15). Patients were identified as having a complication if any of the 11 PSIs were present on the discharge record.
The composition of GS workload was characterized using Clinical Classification Software (CCS), a tool that uses the International Classification of Diseases, Ninth Revision, Clinical Modification to classify diagnosis and procedure codes into clinically relevant categories.9 The CCS was designed for use with hospital discharge data. Previous studies have applied the CCS to inpatient data to determine reasons for hospitalization10,11 and to characterize the workload composition of GSs.12
The single-level CCS includes 231 surgical procedure categories, which are grouped by major organ systems into 16 broader categories. The following categories based on site of the procedure were used: nervous system; endocrine system; eye; ear; nose, mouth, and pharynx; respiratory system; cardiovascular system; hemic and lymphatic system; digestive system; urinary system; male genital organs; female genital organs; obstetric; musculoskeletal system; integumentary system; and miscellaneous diagnostic and therapeutic. For each of the categories, total volume of procedures was calculated for all surgeons combined and then for each cohort of surgeons.
To accommodate differential patient risks, we used version 3.5 of the Comorbidity Software distributed by the Agency for Healthcare Research and Quality.13 The comorbidity measure used by the software was developed by Elixhauser and colleagues14 to predict length of hospital stay, total charges, and in-hospital mortality.
Descriptive statistics, including means and percentages, were calculated for all surgeons combined and for each cohort separately. For unadjusted analysis, we used the χ2 test to examine associations between career phase and workload composition and patient characteristics.
For adjusted analysis, Poisson regression with robust error variance15 was used to estimate rate ratios (RRs) for complications and in-hospital mortality. This method uses generalized estimating equations16 to adjust for clustering of patients within physicians and for physicians within hospitals. Clusters were defined using a combination of surgeon identification and hospital identification to account for surgeons practicing in more than one hospital. Models were adjusted for patient characteristics (age, sex, race/ethnicity, health insurance coverage type, and comorbid conditions in the Elixhauser Comorbidity Index), hospital characteristics (ownership type and mean volume of surgical procedures during the study period), and mean surgeon volume. One condition included in the Elixhauser Comorbidity Index, peptic ulcer disease, was excluded from the model because of small frequencies (<50 observations) within surgeon cohorts. Analyses were conducted using SAS statistical software, version 9.2 (SAS Institute, Inc, Cary, North Carolina). All tests were 2-sided, with statistical significance determined by P < .05.
Among 1187 GSs in the analysis, the largest percentage had been board certified for 10 to 19 years (38.4%), followed by 20 to 29 years (26.8%), less than 10 years (19.2%), and 30 years or more (15.6%) (Table 1). Most surgeons (90.3%) practiced in a metropolitan area and had graduated from US medical schools. Yet, one-third of surgeons 20 to 29 years after certification were foreign medical graduates, reflecting the larger share of foreign medical graduates among newly licensed physicians 3 decades ago. Important combinations of certification and training represented within our study population of board-certified GSs include the following major categories of dually certified surgeons: 172 ABS/American Board of Thoracic Surgery certified, 107 ABS/vascular surgery subspecialty certified, 102 ABS/American Board of Plastic Surgery certified, and 49 ABS/American Board of Colon and Rectal Surgery certified (data not shown).
Surgical procedural volume examined by career phase showed several trends (Table 2). The mean surgeon volume peaked in the early middle–career phase, plateaued in the late middle–career phase, and decreased for surgeons in the late-career phase for all CCS categories. However, for 2 CCS categories, the late-career physicians had significantly higher (cardiovascular) and lower (digestive) percentages relative to total workload than the 3 less-experienced cohorts. For all GSs, digestive and cardiovascular procedures accounted for nearly 75% of total workload. Although significant differences were observed in other CCS categories, the numbers were too small to represent a meaningful difference in practice composition.
Examination of patient characteristics by career phase also revealed notable trends (Table 3). Late-career GSs treated disproportionally larger numbers of Hispanics than all other cohorts. Also, patients within the cohorts generally reflected the age of their surgeon. That is, with the exception of the patients aged 60 to 69 years, late-career surgeons had proportionately fewer young patients and proportionately older patients than surgeons in earlier phases of their careers. Consistent with the patient age distribution, late-career GSs also saw more patients covered by Medicare and fewer covered by commercial health insurance.
The rate of complications from cardiovascular procedures was higher for surgeons in their early-career phase (RR, 1.23; 95% CI, 1.06-1.44) and late middle–career phase (1.18; 1.02-1.37) when compared with surgeons in their late-career phase (Table 4). The mortality rate for cardiovascular procedures also was higher for early-career surgeons (RR, 1.23; 95% CI, 1.04-1.46). Conversely, for digestive system procedures, complication rates were lower for early-career surgeons (RR, 0.86; 95% CI, 0.75-0.99) when compared with late-career surgeons.
Few studies have examined the relationship between GS career phase, workload composition, and patient outcomes. Our findings indicate that increasing career phase was associated with an increased emphasis on cardiovascular and decreased emphasis on digestive system procedures. Likewise, patient outcomes were better for late-career surgeons when cardiovascular system procedures were examined but worse for digestive system procedures. These findings support the relevance of specialization as measured by proportional volume and provide a new context for examining the volume-outcome relationship.
Specialization has been found to enhance surgical proficiency and, in turn, to improve patient outcomes. A systematic review by Chowdhury et al17 included 163 studies examining 42 different types of surgical procedures and covering 13 surgical specialties. Twenty of 22 studies examining the performance of specialized as opposed to generalist GSs reported significantly better outcomes for the specialist surgeons. The review also noted a varying magnitude of the benefit of high surgeon volume and specialization across the specialties. The study concluded that surgeon volume and surgeon specialization are independently positively associated with patient outcomes. Of interest, our study finds a relationship between reduced total volume but increased proportional volume and improved results for cardiovascular system procedures. We found the opposite, although we had expected a pattern of diminished results associated with lower proportional volume for digestive system procedures.
A comprehensive review of the literature by Halm et al3 also noted that surgeon volume was a more important determinant of outcomes than hospital volume in many studies. This occurred with regard to coronary artery bypass grafting, carotid endarterectomy, surgical prodecures for ruptured abdominal aortic aneurysm, and procedures for colorectal cancer, all of which are included in the scope of general surgery.
Our finding that cumulative (rather than cross-sectional) surgical volume may be a valid indicator of improved outcomes also has been supported by previous research. A study17 that controlled for volume discrepancies between specialists and GSs to examine independent contributions of volume and specialization found that the benefit from specialization remained significant. This finding suggests that improved outcomes can be explained partly by cumulative volume.
Similar to our finding suggesting that surgeons with less than 10 years' experience have worse outcomes for cardiovascular system procedures, Wurtz et al18 found that new surgeons in 2 surgical subspecialties had higher class I surgical site infection rates compared with their experienced colleagues. Also, their operation time was longer, and they did not operate on sicker patients. However, with the accumulated experience (as measured by cumulative cases, which can be considered advancement in career phase), their operating room times and surgical site infection rates decreased toward the level attained by their experienced colleagues. However, the study was based on data from 1 hospital.
In their systematic review of the relationship between clinical experience and quality of health care, Choudhry et al19 found an overall inverse relationship between the number of years in practice (measured as years since graduation from medical school, years since certification, or physician age) and the quality of care provided by the physician. A study by Rhee20 included in the review showed that most appropriate care was provided by physicians who had been practicing 6 to 15 years; physicians with more or fewer years of experience provided less appropriate care. That study, however, acknowledged several limitations, including insufficient control for patient comorbidity, other physician factors, and the clustering of patients within physicians. Also, trends toward greater specialization across the career trajectory were not addressed.
An increasing trend toward specialization among general surgery residents has led to what some describe as a "crisis" in the GS workforce.21 The total number of trained GSs who practice as generalists has decreased, and in 2007, less than 25% of chief residents pursuing certification by the ABS indicated that they would not pursue a subspecialty.21 Now, GSs tend to specialize sooner after completion of their residencies,22,23 suggesting the need to go beyond examinations of the number of available surgeons to determine the types of services they provide.22
A principal limitation of our ability to interpret the findings associated with career phase is related to the many possible combinations of training represented by GSs and the composition of their surgical workload in terms of complexity and technical difficulty at the procedure level. Combinations of dual board certification and other training characteristics are likely to influence the composition of surgeons' practices. For example, we would expect that surgeons with ABS/American Board of Thoracic Surgery certification would be more oriented toward cardiovascular system procedures and that their case mix of those procedures is likely to be of greater complexity than that of other GSs. These important differences in training and complexity composition may influence the cohort-level comparisons in ways that are not discernable through the present study.
As with all studies using administrative data, we were unable to examine and control for clinical detail, which may affect the outcomes notably. However, many studies3,24,25 using clinical data also have shown a significant effect of volume on outcome. We also accounted for only a limited number of structural and organizational factors in our analysis. Other factors that often are likely to contribute to improved surgical outcomes (eg, multidisciplinary team, staffing ratios, and availability of technology and specialized equipment, including specialized intensive care units and operating rooms) were unavailable.
Our assessment of complications using PSIs lacked the "present on admission" indicator, which was legislatively mandated to be added to administrative claims data in 2007.26 However, 8 PSIs used in our study (PSI 5, PSI 6, PSI 7, PSI 9, PSI 10, PSI 11, PSI 13, and PSI 15) have been found to remain potential patient safety problems after eliminating conditions reported as present on admission.26,27 Two PSIs used in our analysis (PSI 2 and PSI 14) have numerators based on procedure codes or discharge status26 that cannot be present on admission. After eliminating conditions reported as present on admission, the only PSI with less likelihood still to be considered a potential patient safety problem was PSI 12, postoperative pulmonary embolism or deep vein thrombosis.26 Thus, PSIs selected for the analysis in our study are valid measures of in-hospital complications even in the absence of present-on-admission prompts in the data set.
Each CCS category encompasses multiple types of surgical procedures with widely varying degrees of complexity, the examination of which was beyond the scope of this article. However, we recognize that changes in volume may be accompanied by variation in the technical difficulty or complexity of the procedures.
Finally, the nature of this cross-sectional study did not permit us to follow the cohorts for an extended period. However, our longitudinalized approach to study design relies on the assumption that the patterns of practice represented by the 3-year period are an accurate representation of GS career experience.
In conclusion, investigators of the volume-outcome relationship have called for further scrutiny of underlying mechanisms of the volume effect.3,28 This study has shown that practice patterns and proportional surgical volume vary across career categories of GSs in Florida. The underlying contributory factors to these cohort differences, such as training and practice complexity, require further analysis. The improved understanding of the relationship among physician workload, volume, and clinical outcomes may provide important policy and practice implications.
Correspondence: M. Maka Tsulukidze, MD, Doctoral Program in Health Services Research, College of Health and Human Services, University of North Carolina, 9201 University City Blvd, Charlotte, NC 28223-0001 (firstname.lastname@example.com).
Accepted for Publication: June 3, 2011.
Author Contributions:Study concept and design: Studnicki and Fisher. Acquisition of data: Studnicki and Fisher. Analysis and interpretation of data: Studnicki, Fisher, Tsulukidze, Taylor, Salandy, and Laditka. Drafting of the manuscript: Studnicki, Tsulukidze, Taylor, and Salandy. Critical review of the manuscript for important intellectual content: Studnicki, Fisher, Tsulukidze, Taylor, Salandy, and Laditka. Study supervision: Studnicki.
Financial Disclosure: None reported.
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We're a group of dedicated neighbors working to save and convert this magnificent building into a key part of Great Barrington's arts and community culture.
Berkshire Trade & Commerce – November 2016
Saint James Church taking on new role as cultural, community center Local couple spearheading complex restoration effort By John Townes The collapse of a stone wall in a historic church eight years ago set things…Read More
The Berkshire Eagle – September 30, 2016
Saving St. James shows couple's devotion to community Saint James Place may never be the same. That's because two extraordinary people decided to put their all into saving Saint James Episcopal Church on Main Street…Read More
The Berkshire Edge – July 4, 2016
Saint James Place receives major restoration grant Great Barrington — Saint James Place, the 1857 Gothic Revival church in downtown Great Barrington, has received a matching grant of $247,000 from Mass Development and the Massachusetts…Read More

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The future is written in the stars. Are you ready to find it?
The Star Secret event will run from December 30th 5:00 LNST to January 5th 23:59 LNST and features the Tiger of Tail and Earth Bat of Girl sets. It operates like a 2 vs 2 Stylist Arena, where players will pair up with AIs in stylist battles.
This is the second round of a returning event. Those who missed out on the original event suits will get another chance at obtaining them now!
We also have an event guide available! Good luck, and happy styling!


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Sea NY T-Shirt (similar here) / Antoni Alison Vest (similar here) / Prada Bag / Zara Pants / Zara Shoes (similar here) / Persol Sunglasses
Good morning beautiful people! Another blog post with more blue (I cannot seem to getenough!). Living out of a suitcase for so long now, I have really found my true staples, and core colours at that (grey, black and white, with hints of navy and tan).
A casual weekend outfit for me often consist of kicks and skinnies, with a relaxed tee or jumper (my current fave is this supercuteSea NY t-shirt). To lift the outfit just add some leather and key accessories (my Prada has not left my side for months).
Wishing you all the best weekend (I will be knee deep in boxes starting the gruelling, yet exciting part of moving in!).
Anneli x


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Rotel have made solid, high performance cd players for nearly 30 years so it is no surprise that the latest CD14 hits the ground running!
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2017 All-813 High School Baseball Team
2017 All-813 High School Baseball Team
Most Valuable Player – Jordan Butler, Alonso
The Ravens leader on the mound and at the plate, Butler was one of the county's best his entire high school career. In his senior campaign, the lefty led the county with 122 strikeouts, while going 9-2 with a 1.22 ERA.
He was just as good at the plate with a .451 average, with 35 RBI, 14 runs scored and eight home runs.
Butler went 28-5 in his high school career (three years at Alonso and his freshman season at Tampa Catholic with career 329 strikeouts.
Outside of high school, Butler was a three-time member of USA Baseball teams that won world championships at three different age levels.
Butler was selected in the 34th round (No. 1022 overall) by the New York Yankees in the Major League Baseball first-year players draft, but has announced he plans to continue his baseball career at the University of Florida.
Pitcher of the Year – Brian Lee, King
A senior year for the ages, the 5-foot-9, 160-pound Lee was a giant on the mound for the Class 7A state runner-up King Lions.
With deceptive breaking pitches and a funky delivery, Lee went 11-2 with a 1.00 ERA and 63 strikeouts, including a complete-game win in the state semifinals.
Lee tossed seven complete games this season, including four-straight to end his year starting in the district semifinals.
An International Baccalaureate student and member of the National Honor Society at King, Lee is leaving baseball behind to focus on his education at Boston University where he plans to study business.
Coach of the Year – Jim Macaluso, King
Coach Mac eclipsed the 600-win mark and coached in his 1,000th game as the skipper of the King Lions this season.
However, that was just the start as the 43-year Lions head coach led his alma mater to the FHSAA state championship game for the first time in program history, where King finished as the Class 7A state runner-up.
First Team
|Jesuit SP Jack Anderson (photo courtesy Jesuit High).
Jack Anderson, P, Jesuit – The Tigers junior won five-straight, postseason games on the mound, including a complete-game shutout in the Class 6A state semifinal. Anderson, a FSU verbal commit, went 7-4, with a 0.79 ERA and 78 strikeouts.
|Wharton SP Austin Appel.
Austin Appel, P, Wharton – After just 17 innings on the mound in his sophomore and junior season, the senior righty went 7-2 in his senior year, with a 1.88 ERA and 73 strikeouts, helping the Wildcats win a district title and reach the Class 8A region final.
|Julian Bosnic, Berkeley Prep
Julian Bosnic, P/1B, Berkeley Prep – The junior lefty was tough to hit, posting 93 strikeouts and an 0.93 ERA, while going 7-3 on the mound. The Wake Forest commit also chipped in on offense, hitting .351, with 18 RBI and three home runs.
Jose Cadenas, OF, Gaither – The Cowboys' lightning-fast leadoff hitter paced the county with 24 stolen bases with 25 runs scored. In his first season as a switch-hitter, Cadenas hit .459.
|Jarrod Cande, Hillsborough
Jarrod Cande, OF/P, Hillsborough – The Terriers centerfielder hit .451, with 29 runs scored, 19 RBI, nine doubles and three homers. He also proved a weapon on the mound going 6-1 with a 2.49 ERA and 51 strikeouts.
|Wharton's Drew Ehrhard
Drew Ehrhard, SS, Wharton – The University of Tampa signee was named the Wade Boggs Award and Saladino Memorial Baseball Award winner, after hitting .422, with 24 runs scored, 24 RBI, nine doubles and four homers in his senior season, while helping the Wildcats win a district title and reach the Class 8A region final.
|Saladino Award winner - Wharton SS Drew Ehrhard
Danny Gutcher, C, Gaither – The Cowboys catcher had a .361 average, with 19 RBI, 16 runs scored and eight stolen bases.
Jeff Hakanson, P, Jesuit – The senior specialist was a force out of the Jesuit bullpen, posting a 3-1 record with four saves, a 1.42 ERA, while striking out 59 hitters in just 39 innings. The UCF signee was named the Saladino Tournament MVP after working five shutout innings of relief, helping the Tigers claim the tourney crown.
|Jesuit reliever Jeff Hakanson (photo courtesy of Jesuit High School).
|Steinbrenner OF Jordan Lala.
Jordan Lala, OF, Steinbrenner – The junior outfielder provided a spark as the leadoff man hitting .378, with 15 runs scored, 16 RBI, with twelve stolen bases for the region finalist Warriors. Lala, a Miami commit, hit three post-season home runs.
Robby Martin, OF, Jefferson – The county's leading RBI man with 44 and home run hitter with nine, was key to the Dragons offense helping Jefferson to the region semifinals. Martin, a junior and Florida State commit, finished the year hitting .418, with 27 runs scored and six doubles.
Beau Nichols, P, Newsome – The UNC-Asheville signee went 8-3, with an 0.69 ERA and 80 strikeouts. In April the righty tossed a perfect game with 12 strikeouts against Palm Harbor.
|Newsome SP Beau Nichols (photo courtesy Anna Gawel).
|Hillsborough 3B Nick Romano
(photo courtesy of Margie Terp)
Nick Romano, 3B, Hillsborough – The district champion Terriers had murderers row of hitters, and Romano took full advantage driving in 27 runs, while scoring 23 times, with a .437 average and five homers.
|Riverview 2B Tyler Salomon
Tyler Salomon, 2B, Riverview – The Sharks senior was one of the toughest outs in the county, striking out just four times, while hitting .409, scoring 27 times and stealing 13 bases.
Connor Scott, OF/P, Plant – With a sweet lefty swing, power and a good eye at the plate, the junior and Florida commit had a .364 average, 19 runs scored, 16 RBI, and four home runs. Scott was also key on the mound as a long reliever posting a 5-3 record, with a 1.28 ERA, three saves and 65 strikeouts.
|Plant centerfielder and pitcher Connor Scott.
|Riverview pitcher and shortstop Freddy Tarnok
Freddy Tarnok, SS/P, Riverview – An impact player for the Sharks at shortstop, Tarnok posted a .393 average with 18 runs scored, 11 doubles and two home runs. But on the mound, Tarnok was even sharper winning seven games with a 0.66 ERA and 63 strikeouts. The right-handed pitcher was selected by the Atlanta Braves in the third round (80th overall) of the MLB first-year player's draft.
|Jesuit SS McGuire Weaver (photo courtesy Jesuit High)
McGuire Weaver, SS, Jesuit – The slick-fielding junior was big at the plate for the 6A state runner-up Tigers posting a .400 average, scoring 26 runs, with 21 RBI, eight doubles, three triples, three home runs, and 14 stolen bases.
Second Team
Thomas Bencivenga, 3B, Jesuit
Jared DeSantolo, 3B, Alonso
Michael Dominguez, P, Jefferson
Tim Elko, 1B, Hillsborough
Frank Furey, Utility, Carrollwood Day
Conor Grady, P/DH, Tampa Catholic
Austin Hessinger, 2B, Cambridge Christian
Duncan Hunter, OF, Jesuit
Matt Jernigan, C, King
Dehreon Pressley, SS, King
Ethan Richards, P, Plant
Ryan Romano, SS, Hillsborough
Jonah Scolaro, P/OF, Durant
John Shields, SS, Plant
Garrett Thompson, 1B, Riverview
CJ Van Eyk, P/DH, Steinbrenner
Third Team
Joel Brewer, OF, Jesuit
Sevas Cardona, SS, Cambridge Christian
Austin Carter, P/Util, Cambridge Christian
BJ Carter, P, Brandon
Nate Chevalier, OF, Bloomingdale
Aaron Cohn, P, Wharton
Justin Farmer, OF, Riverview
Nick Gonzalez, 2B, Alonso
Jamarcus Lyons, 3B, King
Andrew Mathis, OF, Jefferson
Rodrigo Montenegro, 3B/C, Carrollwood Day
Patrick Morris, Util, Steinbrenner
Patrick Puentes, P, Hillsborough
Huston Richter, P, Steinbrenner
Nico Saladino, SS, Brandon
Dalton Wingo, OF, Plant City
Honorable Mention
Alonso: Franco Aleman, Ryan Drumheller, Jose Ciccarello; Armwood: Gareth Johnson; Bayshore Christian: Caleb Holt, Keeshawn Royal, David Santiago; Bell Creek: Pablo Molina; Berkeley Prep: Marcus Ayers, Khalib Bayona, Michael Hill, Gordon Stetson; Blake: Elyjah West; Bloomingdale: Jett Davis, Bryce Hazzard, Brock Wilken, Cody Wilson, Vladimir Zavala; Brandon: Teddy Flynn, Jermaine White; Brooks DeBartolo: Jackson Alvord, DeAndre Mahoney; Cambridge Christian: Michael McCarty, Alex Smith; Carrollwood Day: Gabriel Partridge; Chamberlain: Darryl Mitchell; Durant: Brien Johnston, Alex Molinelli, Steven Witchoskey; East Bay: Jake Gilbert, Peyton Zoeller; Freedom: Khalil Al'mutasim; Gaither: Chipper Holland, Kenny Rodriguez; Hillsborough: Terence Doston, Aaron Jensen; Jefferson: Isaiah Gonzalez, Jack Rodriguez; Jesuit: Jake Jones, Alex Mocny, Price Sartor; King: Addison Barger, Danny Terp, Justice Thompson; Lennard: Keith Harden, Yaziel Nunez, Victor Schilling, Eli Wilborn; Leto: Andreas Morales, Fernando Muniz, Felix Rosario; Newsome: Will Ohme, Cody Shook; Plant: Brock Fagler, AJ Hubbard, Chase Sanguinetti; Riverview: Manny Martinez, Josh Rulli; Robinson: Pete Feinman; Sickles: Trey Bacon, Danny Bernstein, Dylan Eskew; Seffner Christian: Jacob Beauchamp, Will Gilbert, James Peeler; Steinbrenner: Cam Coakley, Tyler Lala, Noah Luke, Zack Zayas; Strawberry Crest: Alex Marshall, Ben Pues, Damien Torres; Tampa Bay Tech: Jaisen Randolph; Tampa Catholic: Mitchell Carter, Calvin Rucker; Tampa Prep: JD Urso, Aaron Muench; Wharton: Leo Alfonzo, Ricky Nieves.
* The All-813 Baseball Team was selected by editor Jarrett Guthrie, based on the more than 50 high school games he saw this season, as well as contact with coaches, while stats compiled by MaxPreps.com and public school coaches Western Conference selections were also considered.


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The Collection Residences hosts Pre-Gala Fashion Show and Luncheon
Coral Gables philanthropists will gather in October for a good cause and elegant affair for the Coral Gables Community Foundation's A Night in Old Shanghai Gala, but first they need to answer an important question – What to wear? Gorgeous gowns and chic trends graced the runway at Neiman Marcus in The Village of Merrick Park for a fashion forecast on Friday, September 25. This stylish event featured a luncheon and fashion show sponsored by the most fashionable new address in The City Beautiful, The Collection Residences.
The Coral Gables Community Foundation provides the philanthropic conduit to connect individuals and corporations looking to positively impact the success of the Coral Gables community. The fashion-forward event honored philanthropists Yolanda Berkowitz, Chanin Carlin, Carol Williamson, and Leslie, Suzanne and Jennifer Murphy. Guests joined Miami Market President of Stonegate Bank, Erin Knight, and Coral Gables Community Foundation Gala co-chairs Sissy DeMaria and Mary Young to enjoy fine fair and preview elegant fashions selected by expert Neiman Marcus stylists.
To view more photos from the fashion show and luncheon, please visit our Facebook page.


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Rolls Royce 103EX Futuristic Concept
"With the Rolls-Royce VISION NEXT 100 we were mindful not to dwell on the past. We wanted to be as innovative as possible and at the same time transcend the design history of the marque," Rolls-Royce Motor Cars design director Giles Taylor said in a statement.
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The dramatic building marks the latest phase in Paddington's reinvention from run-down bedsit land to premium office location, writes Paul Finch
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This week's top stories reviewed by the AJ's Simon Aldous. HAT Projects' Pocket Living loses appeal • AJ survey shows slight boost for Labour • Dulwich Pavilion to be turned into planters • Hawkins\Brown profits plummet • Níall McLaughlin museum scheme axed • Takero Shimazaki reworks Barbican flat
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By Joshua Comaroff
With capacity for a staggering 2,100 children, this nursery school has found a new language for early learning, writes Joshua Comaroff. Photography Bogle Architects/Infinitude
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SLO Credit Union Wins Prestigious Award for Rebranding Campaign
SLO Credit Union wins Campaign of the Year for Branding Campaign
SLO Credit Union (SLOCU) won Campaign of the Year for their Branding Campaign in the Public Relations Society of America (PRSA) Central California Chapter's 2010 Image Awards. This recognition is the competition's top award.
Verdin Marketing Ink (VMI) was hired at the end of 2008 to lead the SLO Credit Union in their first-ever marketing efforts. The implementation of the rebranding efforts for the SLOCU produced a focused and cohesive identity, a modern and welcoming website, and a fresh look for the exterior of the branch office in San Luis Obispo.
"The past year and a half of marketing efforts have been a proven success with a 4.2 percent increase in membership growth from 2008 to 2009," said SLOCU CEO Suzanne Leedale. "Our growth has astonishingly occurred during a tough economic period and is a welcome change from the historical growing decline." Leedale was named CEO in November, 2007.
Since 1953, the SLO Credit Union has been serving its members with the full range of financial services – from savings and checking accounts to auto loans and home equity lines. Refinancing programs and debt consolidation are also available – all at highly competitive rates. Membership is open to all government employees in SLO County, all SLO Downtown Association Members and many more. For more information on SLO Credit Union, visit www.slocu.com or call 543-5839.
Water & Wastewater Management Element Update Informational Meeting
Dear Community Member,
Please come to an informational meeting regarding an update of the Water and Wastewater Management Element of the City's General Plan. The Planning Commission provided its input to the update at two public hearings and the next step is to take it to the City Council on July 6, 2010.
We'd like to let you know what has changed in the element. The meeting will give us (the community and City staff) a chance to dialogue about the proposed updates and answer questions you may have prior to the Council meeting.
Q: What is a Water and Wastewater Management Element?
A: It is part of our City's General Plan and it guides how the City provides water and wastewater service to the community.
Q: Why do we need to update our Water and Wastewater Management Element?
A: The City's water resources have changed and our water and wastewater policies are out of date.
Q: What should I expect if I attend?
A: Some of the things City staff will present are proposed revisions to water-related policies, reestablishing a reliability reserve, and consideration of setting aside water to account for future siltation losses. We will also be writing down community comments about policies related to water and wastewater and convey this information to the City Council. And we'll get you out on time!
Please call the Utilities Department at 781-7215 if you have questions. Hope you can attend!
Carrie Mattingly
Utilities Director
Talk Show Host Jenny Jones Surprises Hometown Hero John Baer with Grant to Purchase Instruments for Children's Music Van
Jenny Jones selected Arroyo Grande resident John Baer from thousands of applicants to receive a "Jenny's Heroes" grant. John requested $4,000 to purchase music instruments for the SLO Symphony's Music Van, which brings demonstrations to thousands of children each year, allowing them to play the instruments themselves.
John received a surprise phone call from Jenny Jones on Wednesday, June 16, at 12:00 pm and was given the good news. John is a retired airline pilot, and volunteer at the San Luis Obispo Symphony.
Jenny Jones is giving away $2 million of her own money. Pleas visit www.jennysheroes.com to see how everyday people are using her money to benefit their local communities.
For more information on the SLO Symphony and the Children's Music Van, visit www.slosymphony.com.
Jack's Helping Hand Annual Fundraising BBQ
Reserve your table or tickets now for the fourth annual Jack's Helping Hand barbecue fundraiser to be held at the Santa Margarita Ranch on Saturday, July 10th. The event starts at 4:30 p.m. with wine and appetizers, followed by a sumptuous barbecue dinner. Silent and live auctions with volunteer auctioneer Jim Settle will be held, plus music by "The Bangin' 58's." Every year, the fundraiser provides much needed donations to support the special needs children in SLO County through the ongoing programs and services that Jack's Helping Hand is proud to offer.
Tickets are $50 each and all proceeds will benefit Jack's Helping Hand.
Call 547-1914 for more information or to reserve your tickets today.
Jack's Helping Hand is a non-profit 501 (c) (3) organization that assists children with illnesses and disabilities, providing special treatments, services, equipment and transportation that are not provided by other sources; or which exceed family financial capabilities.
A Bank By Any Other Name
American Principle Bank announces change in name only
On May 25, shareholders voted to confirm the legal name change from American Principle Bank to American Perspective Bank (APB). That change was made official today, June 10, 2010.
"This is a change in legal name only," said President and CEO Tom Beene. "We are delighted to be making this change, however, as it better reflects the unique business banking services and localized perspective we offer."
American Perspective Bank remains the same company, with no changes in owners, directors, management, or employees; no change in office location or mailing address; no change in phone numbers or bank account numbers. The new Internet address is: www.AmericanPerspectiveBank.com and email addresses are changed to: firstname.lastname@example.com.
A new website with the new bank name and a redesigned "look" was also launched today. According to Beene, more online banking features and constantly updated financial information make business banking even easier.
American Principle Bank opened its doors in 2007 with the focus on five founding principles: Integrity, Commitment, Expertise, Communication, and Service.
"When I stepped into this position just a few months ago, I was impressed with the strength and resilience of this relatively young bank," said Beene. "Our strong financial foundation, longstanding board members, and local ownership give us the kind of forward-thinking perspective our clients require to prosper in 2010 and beyond."
Since 2007, American Principle Bank, now American Perspective Bank, serves commercial enterprises, professionals, real estate investors, family business entities, and residents in San Luis Obispo County and northern Santa Barbara County. Visit http://www.AmericanPerspectiveBank.com for more information.
Rotary de Tolosa Awards Over $15,000 in Grants To Local Nonprofits
Ten local nonprofits benefit from grants supporting San Luis Obispo's youth
SAN LUIS OBISPO, CA – In a time when donations are down due to a struggling economy, ten local nonprofit organizations are the recipients of over $15,000 in grants from the Rotary Club of San Luis Obispo de Tolosa. Through grants, Rotary de Tolosa supports projects and services that target the greater San Luis Obispo areas' youth. Through annual fundraising events, over $15,000 to distribute to local nonprofit organizations, including:
- Arts Obispo, to support Arts Curriculum Assistance to under-funded elementary schools throughout San Luis Obispo County.
- Big Brothers & Big Sisters of SLO County, to help fund group activities for children of single, low-income, or incarcerated parents and their volunteer Big Brother or Big Sister.
- Food Bank Coalition of SLO County, to provide low-income families with food for a healthy and balanced diet.
- Girl Scouts of CA Central Coast, the world's preeminent organization dedicated solely to girls where, in an accepting and nurturing environment, girls build character and skills for success in the real world like leadership, strong values, social conscience, and conviction about their own potential and self-worth.
- Jack's Helping Hand, to support the Teen Yoga Program, which benefits local teens with physical disabilities.
- Opera San Luis Obispo, to provide scholarships to children so that they can have a summer opera camp experience, centered on the practices of stage, music, and drama.
- San Luis Obispo Literacy Council, to purchase books and train members of the community to become volunteer tutors who will teach parents of young children to read and write.
- San Luis Obispo County YMCA, to support the YMCA No Place for Hate initiative, which enables people to challenge anti-Semitism, racism, homophobia, and all forms of bigotry in their communities and schools.
- Teach Foundation, to provide unique classroom and enrichment activities that benefit students of the San Luis Costal Unified School District.
- Youth Outreach of the PAC (YOPAC), to bring rich and diverse performing arts experiences to every student on the Central Coast, and provide invaluable opportunities for students to participate as audience members, performers, and investigators of the performing arts.
For more information, please log onto http://www.rotarydetolosa.org, or to www.rotary.org.
Caption: Ten local nonprofit organizations received grants from Rotary de Tolosa this year. Pictured:
Back row, L to R: Donna Lewis, Rotary de Tolosa President; Cathy Enns, Food Bank of SLO County; Bernadette Bernardi, Literacy Council; John Callahan and Jenifer Rhynes, YMCA; Barbara Radovich and Marta Peluso, Arts Obispo; Judy Philbin, TEACh; Heather Vesterfelt
Front row, L to R: Anna Boyd-Bucy, Big Brothers Big Sisters; Sharon Dobson, Opera SLO; Melody Klemin, YOPAC; Leslie Crawford, Jack's Helping Hand
San Luis Obispo Youth Symphony Takes to the Road
San Luis Obispo Youth Symphony Takes to the Road
The SLO Youth Symphony will play two out-of-town concerts this month
SAN LUIS OBISPO, CA―This month, the San Luis Obispo Youth Symphony hits the road for a five-day tour from June 21 to June 25 that will include two performances, one in San Diego and one in Santa Barbara. Thirty-seven students from the Concert Orchestra will board the bus, along with their conductor Nancy Nagano, administrative staff and chaperones.
Concert repertoire selected for the tour includes pieces by Strauss, Vivaldi, Rossini, Dvořák, and Beethoven, as well as more contemporary music from the movie Pirates of the Caribbean.
"I am so proud of this orchestra and of how they have all worked hard all year to produce such a wonderful sound," said Nagano. "Touring is a great way to continue building ensemble skills in young musicians and it should be great fun too!"
The San Diego Concert is scheduled for Tuesday, June 22nd at 3 p.m. at Seaport Village, 849 West Harbor Drive, by the West Plaza Fountain. This outdoor event is free for all and will include some additional "kid-friendly" pieces such as "Chicken Dance" and the "Trisch Trasch Polka." The Santa Barbara Concert will take place Friday, June 25th at 4 p.m. at First Presbyterian Church, 21 East Constance Avenue in Santa Barbara. (Donations will be accepted at the door.)
In addition to performing, students will attend a master class at San Diego State University with viola professor, Travis Maril. Other plans include a trip to Sea World, a visit to historic Balboa Park, and attending a private rehearsal at the Music Academy of the West.
Founded in 1965 by Dr. Wachtang "Botso" Korisheli and staffed by conductors and coaches with extensive experience, the San Luis Obispo Youth Symphony provides an excellent environment for young musicians to develop their skills through symphonic and chamber music training. The Concert Orchestra is the most advanced ensemble within the Youth Symphony and includes students ranging in age from thirteen to eighteen. For more information about the San Luis Obispo Youth Symphony, please visit their website at www.sloyouthsymphony.org or call (805) 543-3533.
New Hearing Aid is Completely Invisible and Removable
Advanced Hearing Aid Center now offers ground-breaking hearing instrument
Advanced Hearing Aid Center now offers a ground-breaking new product―the first-ever 100% invisible hearing aid. Hearing specialist Aaron Marquis has just completed the intensive, hands-on training at Eden Prairie, Minnesota that allows him to fit and dispense Audibel's new "Invisibel™" hearing aid.
"One of the main reasons why people hesitate to correct their hearing loss is because they don't want their hearing aids to be visible," said Marquis, a Board Certified Audiosprosthologist. "This new device is 100% invisible and undetectable in the ear."
This invisible-in-the-canal (IIC) hearing aid lives in the second bend of the ear, but unlike previous versions of this type of aid, the "Invisibel" is removable. Past versions that were not removable posed issues with battery replacement and overall health of the ear. This one is designed to be removed daily, eliminating those concerns.
"Not every patient is a good candidate for this new hearing aid," cautioned Anja Sedar-Marquis, Patient Care Manager with Advanced Hearing Aid Center. "We encourage anyone interested in this device to schedule a consultation to be sure they meet the fitting criteria for an IIC hearing aid."
Backed by over 35 years experience, Advanced Hearing Aid Center offers hearing evaluations, video ear inspections, custom hearing protection, hearing instrument fittings, and aural rehabilitation. Aaron Marquis is the only Board Certified Specialist on the Central Coast with a Master's Certificate in Auditory Prosthetics. Call 805.544-EARS (3277) for more information. Visit www.AdvancedHearingSLO.com or stop by the office at 1495 Palm Street in San Luis Obispo.


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"It's looking like a significant part of the increase in imaging utilization is due to self- and same specialty referral," says G. Scott Gazelle, MD, MPH, PhD, director of the Institute for Technology Assessment in the Massachusetts General Hospital (MGH) Department of Radiology, who led the study. "We need to have some mechanism in place to control this sort of inappropriate utilization of imaging."
The current study was designed to retrospectively examine how frequently physicians ordered imaging studies for outpatients and if that varied depending on whether the studies were performed by radiologists or by members of the referring physician's own specialty, who could be colleagues in the same practice.
The researchers analyzed data from a nationwide, employer-based health plan with around 4 million members. The results showed that, depending on the medical condition and imaging technique, physicians making self- or same-specialty referrals were from 12 percent to more than 200 percent more likely to order an imaging procedure than were physicians referring to radiologists.
"Some of those who self-refer will say that their patients are sicker, but we found that controlling for the effect of patients' age and additional health conditions made the likelihood of imaging among self- or same-specialty referrers even stronger – more than 300 percent in some conditions. Others may claim to be offering greater convenience for patients, but when we looked specifically at CT and MR studies, less than 20 percent were carried out on the same day as the referring physician visit, which means the procedures should not be considered part of an office visit but rather separate visits specifically for the purpose of imaging," says Gazelle.
MEDICA.de; Source: Massachusetts General Hospital


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Migration and Inequality of the Labor Market in China Introduction A. Purpose of Study How does migration affect the labor market of China? B. Rationale Since economic reform in the late 1970s, the Chinese economic has been drastically developing. However, China is a classic example of what the Noble Prize economist Arthur Lewis suggests: "Development must be inegalitarian because it does not start in every part of the economy at the same time." or of Deng Xiaoping's blunt words:
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Attitudes to migration are a controversial and progressively central focus in the public policy discourse. Castles and Miller (2009) noted that 'population movement have always been part of human history' and there has been a major change in migratory patterns in Britain since the 1970s. Many sociologists argue that throughout the world the numbers of refugees and asylum seekers increased considerably. Haralambos and Holborn (2000) pointed out that in 1980, there were estimates of 8.2 million
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America. The immigrants were initial drawn mainly from southern Europe, by the late 1960s, they mostly came from developing countries in Africa, Asia, to the Caribbean and the Middle East. There is a reciprocal relationship between migration and development. Migration is driven by economic development. Economic development in urban areas generates demand for labor, but economic development in rural areas makes many peasants redundant. As a result, a large number of peasent move to cities to work
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Migration is a permanent move to a new location, and happens every day all around the world. For this immigrant interview, I talked to a senior at Lely High School named Lesly Perez. She was born in Mexico in March of 1996 and emigrated from her hometown at the age of four. I chose to interview her because of the large increase of Latin American immigrants in America. With so many people traveling across the border to the United States, I was curious as to what their motives and experiences were
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citizens", as stipulated in the 1958 Migration Act, Division 6, Section 189(1): 1. If an officer knows or reasonably suspects that a person in the migration zone (other than an excised offshore place) is an unlawful non-citizen, the officer must detain the person. 2. If an officer reasonably suspects that a person in Australia but outside the migration zone: (a) is seeking to enter the migration zone (other than an excised offshore place); and (b) would, if in the migration zone, be an unlawful non-citizen;
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their home country. It can be due to the economic, cultural, or environmental issues that one encounters, which are called push and pull factors. In this case many Africans are migrating from their homelands because of economic issues and forced migration. There's not enough jobs and food to survive and some simply cant live in a certain place due to the violence and are forced to leave as refugees. This article explains why many people have to take their chances to seek a better life despite the
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Mexican migration into the U.S There are many impacts of Mexican migration into the U.S. There are many positive and negative impacts for the U.S and for all of the Mexicans entering America. There are many political, social, economical, and environmental impacts. Many think it is the entire Mexicans fault for all of these negative impacts but the U.S brings it on themselves. There are many environmental impacts of migration. The United States is making a border intending to stop Mexicans from
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Module 1 Essay Question # 3: What role will migration play in 21st Century demographic change? Will the societies benefit from migration in 21st century? Even though there is not a reliable data on immigration to forecast, immigration is expected to continue to be one of the main drivers of the population growth in the future, particularly in Western Europe (Coleman, 2008). When the main reasons of the immigration in the last century are analysed, it is not hard to understand that the motivations
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There were many transformations in world migration patterns that caused changes and continuities between the 1700s and the 1900s. Some changes that occurred were that the Industrial Revolution occurred: bringing new technology such as boats, which allowed more sea migration, trains/railroads, which also allowed for more land migration than ever before. As many more opportunities became available for further migration many things stayed the same. Immigrants used the same methods to migrate to the
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mobs attacked Catholic schools and conveys - were shunned and denied work http://www.eyewitnesstohistory.com/irishfamine.htm Voluntary Migration or Forced Migration? Irish immigration to the United States was considered voluntary and forced. Due to the potato famine Irish people moved the US to escape disease and famine which could be considered forced migration out of Ireland.Irish immigrants to the United States were considered voluntary migrants due to the fact that they came here for economic
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Rural to urban migration is the movement of people from countryside to city areas. This type of migration happened in MEDCs from the 18th Century onwards on a large scale, and has gradually slowed down. The causes of rural to urban migration are due to various push and pull factors as per Lee's migration model which shows that people migrate due to a combination of pull and push factors and also suggests that there are factors that encourage people to stay in their locations. One of the possible
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immigration of the past century. Throughout his voluminous and varied writings ?close to a hundred publications, including eight books spanning the destruction of Algeria's traditional peasantry at the hands of French colonialism, the dynamics of migration chains from Kabylia to France, the impact of decolonization on the reception of Algerian workers in Marseilles, the odyssey of those workers and their children through the layers and institutions of French society, the social uses and political abuses
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linked in the quest of a homeland, either as in a physical territory or as an imagined community". (2003, Internet source, retrieved June 10, 2004) Bhabha (1994) suggests the idea of "liminal space", shaped by business globalization, Internet, and migrations, which is the imaginary space of diasporic subjectification, the "third space […] which destroys the mirror of representation" and reveals culture as "an expanding code", as an "in-between space" that can enable individuals and groups "to elude
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Social Marginalization in U.S.-Bound Migration from Mexico and France-Bound Migration from North Africa Nicholas Spurgeon Transnational Migration Dr. David Sandell May 7, 2013 Migration has played a key role in the human experience from time immemorial. The need for populations to move to secure subsistence began with the simple search for edible food stuffs and evolved through our varying interactions to the present day model. Scavenging for plants, edible tubers and berries, and the
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Philippine Migration Migration from the Philippines has historically been gendered. United States' imperialist relations with the Philippines after World War II established a somewhat Americanized state. Americans established English schools, educated women as nurses, and many other things that helped to create a more Americanized state. This helped to create gendered migration pattern. Different employment needs around the world helped further a gendered migration pattern. Men are typically
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Adith completed his schooling he was 17 years old, at that point in time he was planning to migrate to Australia in the hope of a better life. His plans required him to frequently go the main Delhi District where he applied for all the appropriate migration certificates and papers. After almost 3 years of waiting he received all the required documents (passport, visa, etc). At present he is 23 years old living in Homebush, a suburb located in the Inner-west region of Sydney, Australia. Adith moved
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Smith argue that the Lewis model isn't effective in explaining recent trends where mass movements from rural areas to industrial areas occur despite increasing unemployment in city areas (p. 337). To explain this occurrence we use the Harris-Todaro migration model. In this model there is also an agricultural and urban sector, but the urban sector is split between the urban formal sector and the urban informal sector. The urban formal sector is comprised of workers hired officially on contracts, whereas
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31. Why early nineteenth-century immigrant vessels were termed "floating coffins"? Termed "floating coffins," early nineteenth-century immigrant vessels usually arrived in American ports rampant with contagious disease.Port communities feared their arrival each year. The North American cholera epidemics of the 1830s and typhus epidemics of the 1840s were likely imported on boats carrying immigrants. 32. Where, how, and why did one of the greatest immigration tragedies in Canadian history
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pot' because there are so many cultures that inhabit it now. Many of these immigrants fall into the category if diaspora. Diaspora people are influenced to migrate to other countries not only by the economy and political issues but also by previous migration experience of earlier family members and their social status as minorities in their own country of origin. Residing in different countries and assimilating different cultures, yet still having links to their place of origin shapes the identity of
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size: realties to degree of spatial interaction "More people means more migration" Distance: is inversely related to spatial interaction "Further away means you are less likely to migrate there" Immigration: A move across international orders. Migration: A permanent change in residence to outside one's community of origin. Migration Counter-stream: Migration that runs opposite to a migration stream. Migration Selectivity: The tendency for certain types of people to migrate. Age, education
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the world. As a black man living in southern America in the late nineteenth century he witnessed the great migration in which half a million blacks left the south, many heading north. Slightly prior to the great migration the term 'The new Negro' appeared describing a growing sense of political awareness and search for empowerment amongst the black people, this along with the great migration to the North was known as the new Negro renaissance. Hughes drew on his experiences in regard to the 'New Negro'
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Migration of a standardized CRM system within DeVry Educational Group Christina Sanders Managerial Applications of Information Technology – MIS535_60304 Keller Graduate School of Management August 17, 2014 Table of Contents Abstract 3 Company background 3 Business problem 4 High-level solution 7 Approach 7 Solution Options 8 High-level implementation plan 10 Conclusions 10 Summary of Recommendations
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HIS 102 October 5, 2014 Summary and Analysis Paper of Historical Documents Readings from "Reading the American Past" - Chapter 17: Documents 17.1 - The Pun Chi's Appeal to Congress, and 17.4 - Chief Joseph's Speech The historical documents from chapter 17 of the reader describe the views and wishes of the leaders and chosen representatives of thousands of those who were considered "not American and not White" at a time the United States was claiming its territory and establishing its governments
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Migration Joel Griffiths Professor Cristina Notaro GEO-102-102-Culture and the Environment African American life in the United States has been framed by migrations, forced and free. What is migration? Migration is movement. It is a process. It is an observable phenomenon for those willing to see it, and is almost always evocative when witnessed. Migration applies to animals as well as plants. It occurs worldwide to populations as well as to species within a microclimate. There
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Role of Women in Salih's "Season of Migration to the North" In the Season of Migration to the North, Tayeb Saih portrays the heavy issues of sexism and colonialism through the role of women. The book not only informs its readers of the stereotypical gender roles, but it also illustrates the truth behind colonialism as a conquest of a people often enslaving them mentally and leaving them empty. According to this lens, the gender roles of men like Mustafa Sa'eed and Wad Rayyes represent the colonizers
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Course Paper: MSP, LLC Migration Proposal MSP, LLC is an industry leading graphics company that needs to upgrade its hardware and software to maintain its edge amongst other companies similar to itself. If MSP wants to continue to attract high-level employees we must provide them with high-level equipment. In order to do that we must upgrade the operating systems that we currently run and the hardware that we will use along with it. MSP currently uses
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Discuss the issues related to genetic diversity: mutations, sexual reproduction, migration, and population size. --- Generally speaking, there are numerous issues related to genetic diversity which include mutations, sexual reproduction, migration, and population size. To begin with, mutations (any change in the DNA sequence of an organism) introduce new genetic information into a population by altering alleles (a form of a gene usually arising through mutation) that are already present. Occasionally
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– 06 – Option 1 Evaluate the claim that migration creates global connections. In this assignment, the strengths and weaknesses of the claim that migration creates global connections, will be discussed. This will be done by discovering what counts as migration and how it is valued, how global connections can be both positive and negative, about the concepts of 'diaspora' and 'translocalism' and how important they are when considering both migration and global connections. To enable the discussion
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Aruba Migration Guide 802.11AC MIGRATION GUIDE 802.11ac Aruba Migration Guide Table of Contents Introduction 802.11AC basics Why 802.11ac? 802.11ac technology overview Backward compatibility RF spectrum Multistation MAC throughput > 1 Gbps 256 QAM Wider channels More spatial streams Downlink multi-user MIMO Pros of 802.11ac Cons of 802.11ac Strategy and planning for 802.11ac migration Site planning basics Planning process Minimum requirements and actions to implement 802.11ac Aruba
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"Critically evaluate how social psychology relates to the 'European Migration Crisis' of the summer 2015 using the two news articles provided." ''Migrants and refugees streaming into Europe from Africa, the Middle East, and South Asia have presented European leaders and policymakers with their greatest challenge since the debt crisis, '' Jeanne Parker, Deputy Director Council of Foreign Relations (September, 2015). It has been estimated by the IOM that within the first few months of this year
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provides a different body type, a different playing style.With the increased opportunity now at hand, 's fantasy prospects are clearly on the rise advance of the coming NFL .Scotland prepare for their 2018 UEFA Nations League campaign with friendlies against Costa Rica, Hungary, Peru and Mexico, the Scottish FA have announced.Portland Trail Blazers vs.Portland Trail Blazers vs.
He'll be taking aim at a Kansas City defense that allowed average of 118 rushing yards during the regular .Won't blow up blocker front of him causing a log jam the hole.Hungary: Gulacsi , Fiola , Otigba , Lovrencsics , Hangya , Pinter , Kleinheisler , Dzsudzsak , Varga , Guzmics , Szalai .Oklahoma City Thunder vs.Philadelphia 76ers vs.
While the 6-foot-3-pound 's powerful running style still makes him the heavy favorite to lead the team touchdowns, the -cow workload owners were hoping for to take on the wake of DeMarco 's release is unlikely to materialize following ' signing.His father, Drury, was drafted 42nd overall by the Flames 1989 and skated 414 career NHL with the Whalers, Flames, Senators, Mighty Ducks, Islanders and Blue Jackets.Tonight there was a wee bit of familiarity and there were outstanding performances from young players that we believe have got a great future.
ManU's array of marketing partners get extensive eyeballs across the nation, with many supporting via multi-media marketing.But I know that one's got a certain skill set and another body type and one is a little smaller, probably a little quicker, and has a different running style.There was some thought would handle a -cow role after DeMarco was released early March, but the Titans then acted quickly to sign , who profiles as ideal complement for the 240-pound Heisman Trophy winner.Maturity questions were raised after transfer from Miami.
Some 60 rubber ducks drop off the Wabash Bridge into the Chicago River on Aug.It also won't be a huge surprise if gets a shot at a three-down role at some point during the upcoming , considering played nine or fewer games each year from 2012 to 2016.If is unable to make significant progress over the next few days, could find himself helming the Tennessee Titans' backfield once again AFC road wild-card showdown next Saturday afternoon against the Chiefs.
July http://authenticwildstores.com/chris-stewart-jersey_c-468.html 26 Barcelona FedEx Field, Washington, D.C.Tonight there was a wee bit of familiarity Chris Stewart Jersey and there were outstanding performances from young players that we believe have got a great future.Brown was set to participate int eh Senior Bowl, but injury kept him off the field.
recent years, so naturally it is something that everybody is very much looking forward to this .01 2018 by RotoWire Staff http://www.coltsfootballofficialprostore.com/WOMENS_YOUTH_DENICO_AUTRY_JERSEY.html | RotoWire Titans' : Career-high rushing total playoff debut.Switzerland's comfortable 3 win Latvia means they stay three points clear at the top of Group B but automatic progress is not beyond Portugal, who Denico Autry Authentic Jersey host Switzerland their final fixture.It also won't be a huge surprise if gets a shot at a three-down role at some point during the upcoming , considering played nine or fewer games each year from 2012 to 2016.
03 2018 by RotoWire Staff | RotoWire Titans' : Set to share time backfield.July 23 Real Madrid Levi's Stadium, , Calif.By Barry Janoff 22: Manchester United, one of the most popular and most valuable soccer franchises the world, is heading back to the U.S.Switzerland currently hold a three-point lead but Portugal's vastly superior goal difference means it is essentially winner takes all, though a draw would also see the Swiss through.soccer fans and consumers: jersey-front sponsor Chevrolet, adidas, 20th Century Fox, , EA Sports, , New Era, Tag Heuer, Columbia , Epson, Foods, Toshiba and Uber.
July 23 Real Madrid Levi's Stadium, , Calif.Are times he overruns the hole due to poor vision, fails to recognize his misstake and reset.9D ago by RotoWire Staff | RotoWire Titans' : Ready for outside zone.
Scotland continue their preparations for the UEFA Nations League with a trip to Lima to face Peru on May 29.'s outplayed DeMarco on a per- basis all and likely be leaned on next week regardless of his veteran teammate's status.Davy Propper, a surprise inclusion place of playmaker Sneijder, scored his first international goal after seven minutes a bright start for the hosts, who had not won their previous seven matches at the Amsterdam Arena.By Barry Janoff March 22: Manchester United, one of the most popular and most valuable soccer franchises the world, is heading back to the U.S.Brothers and Brown were top recruits coming out of Wichita East High School, as a linebacker signing with Miami 2008 and his brother going to Tennessee as a running back 2009.
The club said it has more than 659 million fans worldwide.At 6-foot-3 pounds, the 2016 second-rounder should have no problem handling the added workload store.could get some competition for touches out of the backfield 2018 after the Tennessee Titans agreed to terms on a contract with on Tuesday, of The Tennessean reports.'s breakout performance the postseason suggests he'll likely still receive the bulk of early down work, but the versatile should nearly monopolize the snaps on passing downs.


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Xperia X Ekero FolioWallet 2in1 - Black or Cognac
Xperia X Ekero FolioWallet 2in1 - Black or Cognac
Prefer a wallet or a cover? Well, how about getting both! These beauties go perfect together as well as apart. The smart connecting function will keep your device securely attached to the wallet while still being easy to remove. Influenced by the contrasts between the serene nature and the modern city, the Ekerö Collection will suit your everyday outfit. Classic colours combined with a vintage look, all in a slim and minimalistic design.
For: Xperia X
Material: High quality artificial leather/Lining: Microfiber
- Magnetic closure
- Provides full access to the screen
- Talk with lid closed
- Stand function
- Multiple credit card slots
- Pricise cutouts for all fucntions
- Removable cover with credit card pocket


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Do you think it's time to redecorate your bathroom? Copper Ideas offers a great selection of copper bathroom accessories that will be perfect for you! Choose from beautiful bathtubs, plumbing fixtures, sinks, switch plates, tiles and much more that will bring out the best in your bathroom. Browse our selection of copper bathroom accents and choose the best options for you.
Products Per Page: 12 24 48 72 96


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Category:Railroad Companies
From West Virginia Railroads - Model Railroading
Information regarding railroad lines and operating companies located in West Virginia. Companies and lines of the present-day are listed under "articles"; historic railroads and railway companies from past eras are listed under the sub-category "historic."
This category has only the following subcategory.
Pages in category "Railroad Companies"
The following 8 pages are in this category, out of 8 total.


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BANK of Ireland has claimed that rescue loans it has repaid to the State have helped to pay for public services and keep down taxes.
The claim by chief executive Richie Boucher was made as he said his bank would seek to veto any proposal from Personal Insolvency Practitioners (PIP) featuring mortgage write-down for its customers.
Bank of Ireland's policy is only to write off mortgage debt in cases of bankruptcy or personal insolvency, where the bank is forced to make the move, chief executive Richie Boucher told the Oireachtas Finance Committee.
And the bank will seek to recoup the outstanding balance on a home loan even after the property has been sold to pay off the debt, he said.
The bank's tough stance is in contrast to AIB, Ulster Bank and Permanent TSB, whose bosses had all said earlier in the week that people voluntarily selling their home to repay a loan could be allowed to walk away from any residual debts.
Labour's Kevin Humphreys TD said people would be better off bankrupt, rather than selling their home and remaining indebted to Bank of Ireland, given its hard line.
But Mr Boucher said his bank's apparently tough stance partly explained why it was the only bailed-out lender to have returned cash to the taxpayer.
The €6bn repaid to the State by Bank of Ireland means "tax rates can be kept lower and services provided", Mr Richie Boucher told the committee.
To date, Bank of Ireland has been involved in four personal insolvency arrangements (PIAs), of which it supported two and opposed another two –one of which was approved anyway, he said.
It is significantly ahead of targets to restructure problem mortgages set by the Central Bank, Mr Boucher said.
Offers had been made to 64pc of customers who are three months or more behind on their home loan, against a target of 50pc set by authorities.
Deals had been completed in relation to 40pc of the problem mortgages, against a target of 15pc, officials at the bank said.
Numbers presented by the bank to the committee show around one in four "resolved" cases involves the loss of the home through either sale or repossession.


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Sometimes it's good to review exactly what goes on inside your body when you exercise. You might gain some insight on how to approach your workouts, and that will just give you an extra edge to becoming fitter! So, let's go back to the basics and review the differences between aerobic and anaerobic exercises. What have we got to lose, except for maybe some body fat!
Aerobic means "with oxygen." When you exercise aerobically, your breathing and heart rate increase, and your muscle cells demand a steady flow of oxygen. The oxygen is used to convert fat into energy. Glucose and protein can also be used as energy sources, but steady, moderate aerobic exercise actually encourages the use of fats for fuel. Regular aerobic exercise is going to train your body to become better at burning fat, something we all like!
Good examples of aerobic activities:
- Jogging
- Power walking
- Cycling
- Elliptical trainer
- Cross-country skiing
- Rowing machine
- Dancing
For an exercise to be aerobic, you need to:
- Use the larger muscles of the body
- Exercise at a steady, nonstop, moderate effort
- Go for an extended period of time
- Keep your heart rate elevated.
Anaerobic exercise is just the opposite; it means "without oxygen." This kind of exercise is usually of short duration and high intensity. Oxygen isn't used in converting fat into energy. In fact, cellular demand of oxygen often exceeds the supply, so fat is not as readily burned. Instead glucose, an easy to use source of fuel, is used and is taken right from the blood stream or from glycogen that is stored in the muscles.
The beak down of glucose produces energy but also lactic acid. The build up of lactic acid is that burning sensation we feel when we push a muscle to work at a high intensity. Lactic acid build up is also the reason why we can only do so much of an anaerobic activity before our muscles feel like JELL-O and can't move!
The body's anaerobic method for producing energy is important for short periods of intense exertion, like running sprints.
More examples of anaerobic exercises are:
- Weight lifting
- 200 or 400-meter run
- Speed skating
- Baseball
- Football
- Volleyball
- Tennis
- 100-Meter Swim
Activities that incorporate the anaerobic energy system push specific muscles to adapt and become stronger and/or faster.
Which is better? That depends on your goals. If your goal is to shed body fat, you will want to make sure you include regular aerobic activities. If you want to build and sculpt muscle, or work on increasing your speed in a particular sport, you will want to focus on anaerobic exercises.
That being said, please note that both aerobic and anaerobic exercises are important for increased health, fitness, and even better body balance. A wise approach is to include aerobic and anaerobic exercises as part of your fitness/weight loss plan.
This article was also featured in the Weight Management and Fitness Forum 5th Edition.


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Bowing Basement Walls
Bowing walls occur when a home's foundation walls curve inward, forming a "bow." The most common cause of a bowing or leaning wall is excessive lateral pressure on the exterior. When the pressure becomes too much for the wall to handle, it starts to bow, crack, or even break.
In fact, basement walls are under constant pressure from the dirt and rock that surround them, like a submarine under water. Combine this with the constant freeze and thaw cycles of our climate zone and you get a continual battle of shifting forces pressing in against your basement.
Common causes of bowing walls include:
Expansive clay soils are common in our part of the country. These soils readily expand and contract as the moisture in the ground increases and decreases.
Hydrostatic pressure is an accumulation of water in the soil surrounding the foundation wall that exerts pressure against the walls. The ground around your foundation may seem solid, but it is in fact saturated with water depending on the weather.
Frost can also lead to bowing walls as the soil against the wall freezes, expands and applies pressure.
*It's important to remember that damaged foundation walls are an indication of a very serious problem for the home.


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Top trends sighted at Colombia Fashion Week
Aug 03, 2019 | By Sidney Morgan-Petro
Jun 09, 2014
London: Stella McCartney put together a fun-filled collection for Cruise. The free spirit she embodied throughout was reminiscent of the seventies and the fun came in the superhero prints and patchwork print mixes. Dresses came with sexy side cutouts, and insets of sunray pleats – this lighthearted approach was also infused into her signature tailoring. – Lizzy Bowring
Key Items: Scarf dresses / Halter tops / Pant suits / Culottes / Walk shorts / Sporty bomber jacket / Masculine trousers / Wide lapel blazer / Jumpsuit / Oversized parka / Pleated sundresses with cut outs
Color: Purple / Beige / Grey / Cream / Black / Electric blue / Rust
Materials + Trim: Slub linen blends / Silk chiffon trim / Contrast trim
Print + Pattern: Superhero prints / Mixed prints / Birds in flight / Superhero faces / Bold stripes / Stylized floral / Paisley
Accessories + Footwear: Superhero faces shapes in flat clutches / Platform sandals
Know what's next. Become a WGSN member today to benefit from our daily trend intelligence, retail analytics, consumer insights and bespoke consultancy services.


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Today's review is a little different. Only Passionate Curiosity's Homeschool Rescue is actually owned by a former Crew member! When you purchase her program, you have actually purchased your very own homeschool mentor - at least that's what it feels like. When I was working through Heather's course, I felt like I finally knew what many of the women I have talked to about homeschooling over the years must have felt like. See, I have always been the one people come to for homeschooling advice, reassurance, and help, but I have never had *that person* to go to myself. For the most part, I haven't felt like I needed her. I'll confess, though, it was very nice to hear Heather telling me things that I know intuitively, but that it is very, very good to hear said out loud now and then.
I feel like I'm getting ahead of myself, though. What exactly is Homeschool Rescue?
At any point during this process, you can also reference the transcript:
After you've watched the video, there is at least one, and usually more, homework assignment (to protect Heather's intellectual property, I didn't actually include the homework - just the header for this section):
Finally, if you like having things scheduled out for you, you're covered! Heather provides a full 60-day schedule!
Perhaps the most important question is what kinds of things you'll be covering in this course for mom. Basically, anything that concerns you as a homeschooling mom is what you'll be covering! Scheduling, curriculum, time management, and, perhaps most importantly, taking care of yourself. If you have ever wondered if you're a good homeschooling mom -- or even a good *mom* -- this course might be one that you would benefit from.
The way the course works is on a rolling enrollment basis. Because Heather wants to make sure that she can give adequate personal attention to all of her clients, she limits enrollment to the course at any given time. Thus, she only opens up enrollment a few times a year so that she can be completely present to all of her clients, especially since access to her private Facebook group is included in the cost ($97 for lifetime access to the videos and the Facebook group, plus bonuses, or $137 for all of that plus three one-on-one coaching sessions with Heather).
What I Thought
I think there is a real need for courses like this. Too many homeschool moms (or prospective homeschool moms) I talk to seem completely overwhelmed. Sometimes they are drowning in a cup of water, and sometimes they have real issues in their homeschools. Heather addresses both issues. She is compassionate and informed and makes you feel like she is on your side. Even her personal consultation price is extremely reasonable. You would pay more than that for one or two sessions with many personal trainers, therapists, or doctors, but as an expert in her field, Heather is offering you her services at a highly discounted rate. I'm at a different stage in my homeschool career (we are in our ninth year), so I have a pretty good idea of what I'm doing, but Heather addresses many of the questions I had at the start (but didn't want to ask anyone! I hate asking people questions, let alone for help! Is anyone else like that?). Well, with this course, you can keep your vulnerability to yourself while still getting the encouragement and advice you need.
Mine is only one opinion. 99 other Homeschool Review Crew members test drove Homeschool Rescue, so click on the banner below to see what they had to say!


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Even past its prime, this rose is still beautiful in its own way! I think that recognizing beauty in things that are often overlooked is a huge part of being a good photographer.
I am being featured on Todays Flowers again this weekend. Be sure to stop by and see some of my other flower photography, as well as the beautiful work of the other participants!
"Like" Hood Photography on Facebook! Thanks!
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text: Michele Placido's ambitious epic crime film Romanzo Criminale covered 30 turbulent years in the lives of a group of working-class Roman kids from the 1960s to the 90s in the manner of Rosi, Coppola, Scorsese and Leone. His new film, a biography of the reckless Milanese Dillinger-type bankrobber Renato Vallanzasca (played by Kim Rossi Stuart), is much less good, and surprisingly poor on the larger social context. Vallanzasca, a hardman who never made any excuses for his conduct, exposed the incompetence and corruption of the Italian criminal justice system and has been behind bars for 15 years or more now.


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Dietrich's D-Wall Modules
Creativity. Efficiency. Results.
With D-Wall, you can enter the floor layout using your standard choices for wall build-ups, material definitions and construction principles. Position external and internal walls, add window and door openings, or simply import a floor layout from an architectural software package. All definitions result in a 3D model. The first essential information is available with a mouse click: full measurement wall lists with wall length; wall areas (inside and outside); openings; door and window lists; insulation volume; dimensioned floor plans; 2D and 3D views; and rendered images.
In D-Wall you are able to use Logic Blocks for inserting 3D Objects. Bathroom: toilets, showers, bath tubs and basins with faucets. Interior Design: dining room, bedroom, kitchen furniture and appliances. Electric Installation: switches and sockets with processes and 2D symbols.
D-Wall Professional
This module is the tool of choice when it comes to efficiently designing timber frames, stick frames, SIP, CLT, or any other kind of wall construction. After the wall layout is defined in D-Wall, you can work through the individual walls and fill them with the supporting structure of timbers, boards, and panels. The timbers are automatically cut to size and joined according to your definitions. All wall to wall connections and possible interference from other building parts in the 3D model are obvious and can be checked any time.
Along with the building design, the information for your production papers is created while you work:
- BOM – Bill of Materials
- lists with the number of joints and processes (mortises, tenons, bird's mouths, bevel cuts, chamfers, drillings etc.…)
- pre-dimensioned shop drawings of single walls
- drawings for production and assembly
D-Wall Premium
D-Wall Premium is the best module on the market for quickly designing and producing multiple house designs with any construction configuration. D-Wall Premium contains all of the features in D-Wall and D-Wall Professional, with the addition of a Wall Construction Guideline Editor.
The Guideline Editor gives you the ability to create your own parametric construction guidelines. It will analyze the architectural design and apply the defined details for each section accordingly. All you need to do is sit back and watch the screen while the program puts in the timbers, sheathing and panels by following your definitions. Changes that could take hours or even days are done with a mouse click. Did your engineer replace plywood for OSB just after you finished the design; or did your client change his mind just before he signed the final drawings? No problem - take care of it with D-Wall Premium.