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Brenner Children's pediatric emergency department has moved back to its original location. Learn more
In order to help protect patients, family members and health care workers from the spread of COVID-19, no visitors are allowed at any of Wake Forest Baptist Health's outpatient or inpatient facilities, except in certain situations.Learn moreMore COVID-19 Updates
Hard falls and collisions are a reality of sports, and they often lead to injuries. Taking a spill and falling on a shoulder or with arms outstretched puts tremendous stress on the shoulder and on a small bone called the clavicle, or collarbone. If the stress is too great, the collarbone can break.
Broken collarbones are one of the most common sports injuries among kids and teens.
The collarbone runs between the top of the breastbone (sternum) and the shoulder blade (scapula) and helps connect the arm to the rest of the body. You can feel your collarbone by touching the area between your neck and your shoulder. Most people can see their collarbones sticking out beneath the skin when they look in the mirror.
A broken collarbone typically is the result of a direct blow to the shoulder or a fall onto an outstretched arm. Collarbone breaks (fractures) are common in contact sports (like football, lacrosse, and hockey) and in sports where there is a chance of a hard fall (such as biking, skiing, snowboarding, and skateboarding). They also can follow direct trauma to the collarbone during a car collision or other accident.
Most collarbone fractures will heal on their own if the arm is properly immobilized in a sling and the injury is treated with ice and physical therapy. Sometimes, however, if the collarbone is significantly displaced or the break is severe, surgery may be needed to realign the bone, with screws and plates inserted to hold the collarbone in place as it heals.
If your child has a broken collarbone, the most obvious symptoms will be pain in the affected area and difficulty moving the affected arm. Other symptoms include:
To diagnose a collarbone fracture, a doctor will ask about the injury and what symptoms your child has. The doctor will examine your child's shoulder and may press gently on the collarbone to see if it is tender, determine where the fracture is, and make sure no nerves or blood vessels are damaged. The doctor might check the feeling and strength in your child's arm, hand, and fingers to see if there is nerve damage.
If a broken collarbone seems likely, the doctor will order X-rays of the shoulder and the affected area to pinpoint the location of the break and check its severity. X-rays also show if any other bones are broken. In some cases, if other bones are broken or if the doctor needs to see the fracture in greater detail, a computerized tomography (CT) scan will be performed.
Most collarbone fractures are due to a fall onto the shoulder, but they can also follow a fall onto an outstretched hand or a direct blow to the collarbone itself (as from a sports-related injury or car accident). Newborns also can incur a broken collarbone as they pass through the birth canal.
In a collarbone fracture, the break can happen in three areas of the collarbone:
Risk factors that can increase the chances of a collarbone fracture include:
Because they happen suddenly and unexpectedly, collarbone fractures can be hard to prevent, but a few precautions can help kids decrease their risk:
Treatment for a collarbone fracture depends upon the type of fracture and how severe it is. Most fractures can be treated with simple comfort measures until they heal.
But fractures where bone fragments on each side of the break are severely shifted (displaced fractures) or where the bone is broken into several pieces (comminuted fractures) may require surgery for proper healing. Compound fractures, where the broken bone pierces the skin, require immediate, aggressive treatment to reduce the risk of an infection.
For fractures where the bone fragments stay aligned, these treatments are recommended:
The special screws and metal plates used when a significantly displaced, compound, or comminuted fracture requires surgery won't need to be removed once the bone has healed unless they cause irritation.
After surgery, doctors will often prescribe a therapy routine to help restore movement and strengthen the shoulder. Usually, therapy will start with gentle motion exercises, and strengthening exercises will be added as the bone heals.
For younger children, healing time can be as fast as 3-4 weeks. For teens, healing time is usually about 6-8 weeks. During this time, your child should take it easy to reduce the risk of reinjuring the bone. After that, follow up with the doctor about when your child can return to normal activities.
Reviewed by: Alfred Atanda Jr., MD
Date reviewed: September 2014
© 2019 Brenner | Site Policies & Statements
The information on this Website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified healthcare provider. If you have a medical problem or a health-related question, consult your physician or call Health On-Call at 336-716-2255 or 1-800-446-2255.


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Single Serve Tab Boards - Gold 110 x 60mm Rectangle 100PK
Product Code: 300-TBRLGOLDCCB
Dispatched within 1-3 business days
Looking for smaller cake and slice boards to move and store your cakes? The cute single serve tab boards are just perfect for any occasion.
Key benefits of the Single Serve Tab Boards - Gold 110 x 60mm Rectangle 100PK
- Food grade safe
- Use for your chocolate, cookie and sweet creations
- Easy to use and be used within our boxes
- Save money by purchasing this product in bulk or start small and grow with us
- Wholesale pricing available online
Like this product so what's next?
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|Shipping Weight
|Product Purpose
|Food Packaging
Dispatch of your order will depend on whether you are purchasing a stock product, manufactured to order product or a large quantity.
Dispatch time on stocked products: 1 to 3 Business Days (not including weekends)
All PACKQUEEN stock orders are dispatched from our warehouse in Thomastown, Victoria within the next 1-3 business days from receipt of orders unless otherewise specified.
Dispatch time on Manufactured to Order Products: 5 to 10 Business Days (not including weekends)
For all our made to order products, we have clearly stated this on the relevant product page. You can check this information out in the top right hand corner of any product page whereby it will state if this product is MANUFACTURED TO ORDER. In addition, when you check out and on your invoice, it will state directly underneath the product name if this is a MADE TO ORDER item.
Dispatch time on Large Quantities: 5 to 10 Business Days (not including weekends)
For larger quantities we manufacture to order and there may be a 5-10 day lead time.
What if my order is urgent?
If your order is urgent, please specify in the comments section when checking out. We will try our best to meet any deadlines that you have and if there are any issues, we will notify you immediately.
Once dispatched, how long do the couriers take to deliver my order?
The below information is to be used as a guide only. Once your order has been dispatched and is in the hands of our courier we cannot guarantee specific delivery dates or times.
For orders under 5kgs we typically use Australia Post
Aust. Post Standard:
- Austrailan Capital Cities (excluding Perth): 2-4 Business Days from warehouse dispatch
- Outside Capital Cities (including Perth): 3-10 Business Days from Warehouse dispatch
For orders over 5kgs we use Direct Freight/Star Track
Star Track/Direct Frieght:
- Adelaide, Albury, Bendigo, Canberra, Geelong, Melbourne, Shepparton, Sydney & Traralgon: 1-2 Business Days from warehouse dispatch
- Brisbane, Central Coast NSW, Coffs Harbour, Newcastle, Orange, Tamworth & Wollongong: 2-3 Business Days from warehouse dispatch
- Darwin, Gold Coast, Hobart, Launceston, Mackay, Perth, Sunshine Coast, Townsville & regional areas: 3-7 Business Days from warehouse dispatch
What delivery address should I use?
We highly recommend using a business address for all deliveries. However, if you are unable to do so, by proceeding with your order, you are agreeing that your parcel will have an automatic authority to leave if your premises are unattended. You can provide additional delivery instructions such as 'leave on front door step' or 'leave at backdoor under carport'. Please note that our courier is unable to contact you prior to delivery or deliver at a specific time. .

subset: commoncrawl


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Sheet music downloads have become the preferred method of acquiring classical music repertoire. Created by professional musicians, EveryNote.com presents classical sheet music download of over 20.000 popular and hard-to-find music scores over 1000 composers. A major Internet provider of classical sheet music files download online, EveryNote.com offers the largest and most complete digital sheet music download library on the Web in the world. Instantly download, view and print your favorite classical music score. Everynote.com currently offers thousands of classical music compositions for Piano, Violin, Cello, Flute, Clarinet, Classical Guitar, Voice, Chamber and Choral music.Many more instruments, composers, genres added every day! EveryNote.com has been featured in The New York Times, Globe and Mail, Musical America and many other publications.
Paul Abraham Dukas
1865 – 1935
Dukas short biography
An important and influential French composer, pianist and teacher, Paul Dukas studied at the Paris Conservatoire. Dukas was twice the recipient of the prestigious Prix de Rome: in 1886 for a counterpoint and fugue, and in 1888 for his cantata, Velleda. Dukas assumed a very prominent position as the music critic for 2 important papers, Revue Hebdomadaire and Gazette des Beaux-Arts, at the same time working as a professor of the Conservatoire. Dukas was very highly acclaimed and respected as a teacher. Dukas's most famous composition, L'Apprenti Sorcier, has been recently incorporated by Walt Disney in Fantasia with Mickey Mouse as the wicked apprentice.
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DUKAS Orchestral Parts sheet music download Orchestra on EveryNote.com
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In January 2012, research group Environment California released a report highlighting the phenomenal growth of solar energy in the state of California. California, which is leading the nation in deployments, has installed just over 1,000 megawatts of solar power through 2011. While California is the standard-bearer for solar energy in the U.S., countries such as Germany have installed 17 times that amount, with 4,000 megawatts deployed in the month of December 2011 alone.
The good news is that, according to the National Renewable Energy Laboratory (NREL), California has just begun to tap its potential for renewable energy. NREL estimates that existing buildings have the capacity to support up to 80,000 megawatts of rooftop solar systems. With ample rooftop space and surging energy demands, the potential to grow solar in California and beyond is significant. The question remains, however: how do we get there from here?
Financial innovations such as commercial Property Assessed Clean Energy (PACE) and expanded residential leasing options can help make solar more affordable for people who own their roof. For everybody else, a new kind of solar model is emerging: solar hosting.
Solar hosting provides another option for renters who don't own a roof, as well as property owners with rooftops that aren't ideal for solar due to technical limitations such as excess shading, lack of a proper southern orientation or having an uncertain roof replacement time horizon. Solar hosting also solves a problem for people reluctant to make long-term financial investments or individuals living or working in high-density, multi-story buildings that simply don't have enough rooftop space to hold enough panels for everybody.
How does it work?
Solar hosting is a lot like web server hosting. If you don't want to run your own server, you keep it in a co-location facility (sometimes called "the cloud") and let somebody else take care of the network infrastructure and physical location management. Solar hosting works the same way. It lets you enjoy the benefit of solar panels, without having them physically located on your roof.
A variety of underlying business models can be supported with solar hosting. One size will likely not fit all needs, and several approaches and pricing models are expected to emerge in this growing marketplace. Solar can be sold as a "service," which would be structured as a subscription. For example, you might "rent" a panel or purchase a block of kilowatt-hours. Alternatively, it could involve a fractional ownership model structured as a co-op, where the members have an ownership stake in an entity that owns the land and produces power. Another possibility is an allocation as part of a larger property deed similar to how some condominiums include title to a detached parking space. The condo complex or master-planned community of the future could include a small plot of land to host your own solar panels as part of your ownership deed.
Policy to the Rescue
In California, a bill (SB843) has been proposed to help unleash the potential of this new solar deployment framework. This policy innovation would allow individuals to subscribe to or own solar generation assets on non-contiguous parcels and credit them back to their own utility bill. Details of the billing mechanism have not yet been finalized, such as the price at which the solar generation credit is applied back to an individual's utility bill. However, the potential to open up the solar market to both renters and rooftop owners with an "inhospitable environment" is certainly tantalizing.
Meanwhile, Colorado has already passed a solar hosting law and is in the early phases of a 6-megawatt pilot project; San Diego Gas and Electric has proposed a 10-megawatt pilot project to the California Public Utilities Commission (CPUC); and the state of Maryland has introduced its own solar hosting legislation (SB595).
Solar Everywhere
Rather than simply build out each traditional solar installation to meet only the needs of that particular site's electricity consumption, what if property owners were actually incentivized to utilize 100 percent of their physical space capacity for solar and sell the excess power to other people? If California establishes the proper financial incentive structures, it could give Germany a run for its money. Countless jobs and economic development opportunities hang in the balance.
Just like web servers enabled the transformational model of "cloud computing," solar hosting opens up an entirely new market for renewable energy. While many people will continue to put panels on their own facilities, solar hosting becomes a new option for people who want to "go solar" -- just not on their own roof. Why not give those people a chance to participate and expand solar access for everybody?
Solar hosting opens those doors.
Lee Barken, CPA, LEED-AP is the Energy and Cleantech practice leader at Haskell & White, LLP and serves on the board of directors of CleanTECH San Diego and as Vice-Chair of the WREGIS Stakeholder Advisory Committee. Lee writes and speaks on the topics of renewable energy project finance, green building, IT audit compliance and wireless LAN technology.


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AFI FEST 2008 already feels long past, but allow me the opportunity to plug a few more of the films that landed, briefly, in Los Angeles. Other than the five titles that I mentioned previously, all of which proved stellar, here's another notable quintet:
Pyrotechnic polymath Takeshi Kitano concludes his "artistic suicide" trilogy with the delectably unpredictable Achilles and the Tortoise. Starting out as a somewhat routine, albeit faux, biopic of a budding painter, it soon veers into a nearly structural procession of exceedingly random experiments involving copious paint and various media (walls, bodies, cars, boxing gloves) that are met with consistent commercial failure and even a few deaths. This mordant cri de coeur has the writer/director himself playing the fraught artist in his later years… and every phosphorescently cockeyed canvas is a Kitano original.
Playing the intersection of art and life in a completely different key, Olivier Assayas' Summer Hours follows a globalized French family as it loses a matriarch but inherits a Musée d'Orsay-worthy collection of decorative objects. Assayas, who like Kitano crafts seriously mercurial narratives, considers the film his most Taiwanese effort. And if you had a chance to catch Edward Yang's towering A Brighter Summer Day at the museum a few weeks back, you'll likely see reflections of Si'r's flashlight in Assayas' bubbly antique vase, to cite but a most immediate echo.
A different treatise on family dissolution, the masterful Tokyo Sonata from Japanese genre bastion Kyoshi Kurosawa is a nominal melodrama of untethered salarymen, caged housewives, drifting children, and even a dash of Iraq war weariness. Far less schematic and not nearly as stale as that description, the film is confident and precise in its lyricism.
Ensconced on a landlocked stretch of terrain that seems less pampas and more penal colony, Albertina Carri's La Rabia is almost unbearably intense. Animals of various sizes get slaughtered off and, most often, onscreen while sexual trysts are filmed with the cold alarmism of Akerman and staged with the brutal clarity of Cronenberg. The splattery intervals of watercolor expressionism are the closest thing to a respite from all the blood, screams, and red-bereted macho-monstrosities.
Lighter notes are dappled on Michael Almereyda's wanderlustful Paradise. This perennially unclassifiable filmmaker of vampire nocturnes, urban Hamlet, and Eggleston doc provides neither itinerary nor assignment, just an elliptical, nomadic collage that glimpses flashes of teeming life. Much like Terrence Malick's Captain Smith, included here, we're left perplexed and enraptured by this extant new world.


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text: Wednesday, April 17, 2013 CMS to Host Session on Billing and Coding With Electronic Health Records CMS wants to help health care providers code their billing claims appropriately in this increasingly electronic environment. The Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) will host a presentation and "listening session" on May 3 in Woodlawn, Maryland, to discuss the impact of electronic health records (EHRs) on coding trends, the increase in code levels billed for some Medicare services, and developing standards for coding with EHRs. After a break from the presentations, invited speakers will discuss key issues such as the impact of EHRs on the quality of clinical care, provider efficiency, and coding challenges and opportunities facing various groups, including hospitals, clinicians, and other interested stakeholders. CMS provides a list of invited speakers and online registration at this link.