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Is it Time for Cognitive Bioinformatics?
The concept of cognitive bioinformatics has been proposed for structuring of knowledge in the field of molecular biology. While cognitive science is considered as "thinking about the process of thinking", cognitive bioinformatics strives to capture the process of thought and analysis as applied to the challenging intersection of diverse fields such as biology, informatics, and computer science collectively known as bioinformatics.
Ten years ago cognitive bioinformatics was introduced as a model of the analysis performed by scientists working with molecular biology and biomedical web resources. At present, the concept of cognitive bioinformatics can be examined in the context of the opportunities represented by the information "data deluge" of life sciences technologies. The unbalanced nature of accumulating information along with some challenges poses currently intractable problems for researchers. The solutions to these problems at the micro-and macro-levels are considered with regards to the role of cognitive approaches in the field of bioinformatics.
Deluge of Life Sciences Big Data
Modern molecular biology studies the function and interactions of biological molecules, processes and systems. Molecular biology primarily focuses on DNA, RNA, proteins and metabolites utilizing four corresponding "omics" technologies: genomics, transcriptomics, proteomics, and metabolomics. Advances in sequencing technologies enable researchers not only to decipher the human genome, but also to uncover features of epigenetic regulation. The level of gene expression is the object of transcriptomics; proteomics provides information about the diversity of the protein molecules encoded by the genome; metabolomics focuses on studying metabolites.
The technical capabilities of modern "omics" significantly exceed the capabilities of researchers to meaningfully process incoming experimental information. A typical microarray study can generate the data on 500,000 single-nucleotide substitutions of DNA that differentiate the genome of one person from another [1]. Transcriptome analysis allows measuring the activity levels of each of 20,000 human protein-coding genes, with the signal of each gene detected by two or three different sequences [2]. An in-depth study of the proteome can quantify up to 10,000 protein products of the genome [3] and elucidate structural modifications of at least one third of them [4].
Current international projects are designed not only to read the DNA sequence, but also to decode the meaningful message from this molecule. The question of how to re-interpret the genome in the context of harmful mutations and diseases is of great interest to biomedical researchers [5]. Such projects that are the sequels of the Human Genome Project include: HapMap, EnCode, 1000 Genomes, Cancer Genome, Human Proteome and a number of other large-scale initiatives. The projects like the NIH Brain Initiative, the Human Microbiome Project are generating the data that will build a framework for understanding the human condition. These projects combine the technical and intellectual capacities of numerous countries into international efforts.
There is no lack of baseline data on the state of molecular systems within a human body. On the contrary, the exponentially growing stream of the information produced by "omics" is a challenge to the technology of data storage and processing [6]. The unbalanced nature of accumulating information redoubles the challenges of the 5Vs of Big Data: veracity/reproducibility [7], variety, value and, to a lesser extent, velocity and volume [8].
The challenge of interpreting the genome is currently being tackled in many labs by using brute-force algorithms, making exhaustive searches for genetic variants, the laborious matching of scattered IDs and hand-curating datasets. However, the data assembled from all sources are left to languish in repositories "till better times" until the development of bioinformatics grows to the capability of gaining knowledge from the data sets accumulated.
Challenges and Opportunities with Life Sciences Big Data
Is there a background in modern bioinformatics to beat the challenge of current data deluge? In 2004, Kuchar et al. [9] introduced cognitive bioinformatics as an instrument of scenario analysis performed by scientists working with molecular biology and biomedical web resources. The term "Big Data" is mainly used to describe a massive volume of both structured and unstructured data that is too large or complex to process it using traditional database and software techniques. Bioinformatics accumulates the data primarily borrowed from the statistics, machine learning and pattern recognition methods (except for the specific tasks of molecular modeling and comparative genomics). Thus, the algorithms of digital data processing cannot be transferred to biological and biomedical outcomes without significant expert adaptation. It is not surprising, for example, that the modern practice of clinical diagnostics has hardly been updated with new biomarkers despite the petabytes of the data generated. Potential solutions can lie in an analysis of network interactions from the micro-level (biological molecules, e.g., [10]) to the macro-level (exposome, e.g., [11]).
Micro-level: It's a Small World of Genes and Proteins
Socially relevant diseases affecting almost all people are multigenic. Thus, association studies are to be conducted to establish the link between multiple variations and the risk of disease development (GWAS - genome wide association studies). Sometimes, it is relatively easy to determine variation/disease relationships in controlled environments. However, to establish a relationship between a set of variations and a disease is rather difficult [12] due to the genome variability interfering with environmental factors.
It is possible to reduce the level of genomic variability at the level of proteins. The proteins, as the final products of the genome, have more direct influence on the condition of the body and can serve as reliable diagnostic markers. This issue has been thoroughly studied in the field of proteomics for the last 15 years. However, clinically useful biomarkers that can impact human health are lacking despite the reported hundreds of potentially relevant diagnostic molecules [13].
A single biomarker can be fallible because proteins interact with each other. They also interact with genes forming a genomic regulatory network. Networks of molecular interactions are studied in the framework of interactomics. This term labels the biology to be investigated but does not describe an appropriate approach. Graph theory (Petri nets), Bayesian models, support vectors, and random forest are some of the approaches that have been used to describe the networks of molecular interactions [14]. At present, it is only known that an organizational framework of hubs structured around the interacting partners can be detected only in the composition of networks with more than 200,000 binary interactions [15]. But such scale of experimental measurements is not affordable.
Macro-level: The Exposome and Smart-phones
Disease development is determined by multiple conditions and in no way depends solely on personal genome [16]. The factor of genetic predetermination of a disease is relatively small. Pathologies in a genetically viable organism are formed by the components of environment collectively called the exposome [11]. It is a combination of environmental factors that an organism has encountered along with some susceptibilities inherent in the organism, which in combination leads to a disorder.
Data deluge suggests that solutions should encourage and harness the future convergent synthesis of exterior and interior life factors. The prerequisites for such a generalization could appear from the study of connectome [17] - the model of the brain as an organ available for the study at the social, cellular and molecular levels. It is impossible to prove the unity of these structures – the systems and a cell as a "society" of molecules. At the present level of knowledge, current mathematical tools do not adequately reflect the fundamental properties of the social, neural and biological networks, especially their time-dependent multi-layering. The attempts to construct planar, tree-like architectures of biological systems have been exhausted. Thus, there is a need for fundamentally different, probably non-digital, information processing tools to succeed in multi-dimensional descriptions.
Health Information
Although it is possible for a clinician to get an enormous amount of the data on internal molecular systems of the body, he/she usually lacks the detailed information with respect to the exposome. Generally, the exposome is captured as a personal health record based on often-faulty memories of patients. Recent developments in modern telecommunication sphere have resulted in an opportunity of collecting the exposome data. First of all, it can be periodically received from our data communicators such as geolocations [18]. With respect to the health characteristics of an individual, the sequence of geolocation is no less informative than the DNA sequence in the genome [19]. The information kept in electronic financial systems (for example, the information on purchases) along with Google searches and Facebook activity can be used to accurately build the behavioral profile of an individual. Some wrist trackers can measure physical activity, food/ drug intake and other health parameters and generate such profiles as well. To avoid faulty memories these profiles can then be shared with a physician for a more accurate accounting of the patient's exposome. In addition, these profiles can be shared with others or connected to a community of like-minded (http://www.myfitnesspal.com [20], www. mynetdiary.com [21]). Such detailed profiles can also be valuable for evaluating drug side effects as well [19].
Geo-data are becoming a source of the prediction of behavioral profiles leading to the development of socially relevant diseases: diabetes, pathologies of the cardiovascular system and depression [22]. Further development of these concepts depends on creating a mathematical approach and the appropriate tools to describe the multi-layered cognitive slices. Today, there are no published computational principles that can surmount the barrier between the statics of traditional neural network and dynamics of real biological system. A strong attempt was made by IBM which provided its Watson artificial intelligence for medical application [23, 24].
The methods for quantifying the exposome in terms of the environmental factors are generally indirect. For example, if the taxi order is accepted with a delay less than 5 minutes, it could indicate an aggressive industrial environment. The less the delay is, the more the chance is that a person's current location is within the generally unsuitable environment with hard traffic, noise and air pollution. Hypothetically, it is also possible to measure even mental environment by analyzing the number of calls per hour/per day, voice timber in a conversation and the diversity of vocabulary, as has been recently implemented in the service "Okay, Google".
Of course, the usefulness of exposome data cannot be disclosed until the data will be collected and provided for an analysis. The good news is that there is no need to invest scientific money into the collection of exposome data. The process of collection is fueled by business and goes in a fully automatic mode. The challenge is to make the data collected available to science and to develop the artificial intelligence to tackle this data.
Multi-layer cognitive biological systems should be based on a detailed description of the surrounding world. Artificial intelligence will perceive the physiological and emotional status of a person only if a critical mass of people consciously and without any pressure shares information about their location, the genome and diseases. And many other things that today we prefer to hide. Modern society is not fully prepared to accept such relationships due to ethical requirements regarding the protection of personal data. In medicine, in addition to this issue, there is a considerable need for a physician who can turn biomedical information into life-changing decisions.
Clinical Diagnosis Support
A physician never makes a diagnosis solely based on the results of in-vitro tests. Even when there is a patient with an off-the-scale LDL cholesterol level, the physician will never diagnose without an additional research, including examination data and questioning the patient. A correct diagnosis always depends and will depend upon the professionalism of the physician - perhaps the only parameter that cannot be formalized within the standards of medical care.
The development of "omics" as the technologies providing redundant information on the subject is essentially antagonistic to the concept of medicine. Indeed, if in the future (not that far, by the way!) bionic implants transmit gigabytes of the data on the state of a single molecule, a physician is unlikely to be able to read, understand and use these data without pre-buffering and analytical processing. But, such analysis will be completely useless until it is possible to compare the data between people, which will provide a sufficient pool of training images and an assessment of a "human norm".
It should be assumed that future systems with a cognitive component will be in demand as an interface between a physician and a patient data deluge. At present, the abundance of the data on a patient (for example, her/his genome) is more likely to overwhelm a physician than help in decision making. Currently, modern bioinformatics is aimed at decreasing the complexity of "omics" data through data reduction. Yet during this reduction, a valuable, individual, personalized picture disappears. A good contact between a physician and a patient in the array of "omics" data will be maintained only in case of the virtualization of both the physician and the patient. After virtualization the personal experience of decision-making of the physician can be copied repeatedly, resulting in the artificial "proliferation" of physicians. In the long term, the introduction of cognitive technologies in medicine should provide every citizen with a readily available ultra-professional virtual physician with an infinite memory of "clinical records" characterized by hundreds of thousands of molecular parameters. The physicians as persons will become supervisors of a network of medical community and the most complex cases that require human intervention will rise to their level.
Living organisms are complex systems. Thus, immense datasets are being generated by modern "omics" technologies to adequately represent and understand them. Yet these datasets overwhelm the capabilities of any scientist, lab or research center to transform the data to actionable knowledge. Ironically and perhaps fortuitously, some of these datasets also contribute to our understanding of the brain and its cognitive processes and thus can be used to enhance our capabilities. Perhaps cognitive bioinformatics can formalize the logic of human thinking and apply it to organize the existing arrays of experimental data in the form of networks with dynamic behavior. The principles of networking between the neurons of the brain are likely to become scalable both from the macro level to the level of social networks and from the micro level to the level of intermolecular interactions in a cell. By applying one of the wonders of nature — the thought process — we can build this framework and analyze the approaches necessary to understand its secrets.
[1] The International HapMap Consortium (2004) Integrating ethics and science in the International HapMap Project. Nature Genetics 5: 467-475.
[2] Nagaraj N, Wisniewski JR, Geiger T, Cox J, Kircher M, et al. (2011) Deep proteome and transcriptome mapping of a human cancer cell line. Mol Syst Biol 7: 548.
[3] Mann M, Kulak NA, Nagaraj N, Cox J (2013) The coming age of complete, accurate, and ubiquitous proteomes. Molecular cell 49: 583-590.
[4] Kelleher NL (2012) A cell-based approach to the human proteome project. J Am Soc Mass Spectrom 23: 1617-1624.
[5] Tejedor JR, Valcárcel J (2010) Gene regulation: Breaking the second genetic code. Nature 465: 45-46.
[6] Pennisi E (2011) Human genome 10th anniversary-Will computers crash genomics? Science 331: 666-668.
[7] Collins FS, Tabak LA (2014) NIH plans to enhance reproducibility. Nature 505: 612-613.
[8] Roger H, Haynes W, Stanberry L, Stewart E, Yandl G, et al. (2013) Unraveling the Complexities of Life Sciences Data. Big Data 1: 42-50.
[9] Kuchar OA, Reyes-Spindola JF, Benaroch M (2004) Cognitive bioinformatics: computational cognitive model for dynamic problem solving. In Cognitive Informatics. Proceedings of the Third IEEE International Conference on, Canada.
[10] Gstaiger M, Aebersold R (2013) Genotype–phenotype relationships in light of a modular protein interaction landscape. Mol Biosyst 9: 1064-1067.
[11] Brunekreef B (2013) Exposure science, the exposome, and public health. Environ Mol Mutagen 54: 596-598.
[12] Kaiser J (2012) Genetic influences on disease remain hidden. Science 338: 1016-1017.
[13] Veenstra T (2011) Where are all the biomarkers? Expert Rev. Proteomics 8: 681–683.
[14] Shoemaker BA, Panchenko AR (2007) Deciphering protein–protein interactions. Part II. Computational methods to predict protein and domain interaction partners. PLoS Comput Biol 3: e43.
[15] Cho YR, Zhang A (2010) Identification of functional hubs and modules by converting interactome networks into hierarchical ordering of proteins. BMC Bioinformatics 11: S3.
[16] Bartol J (2013) Re-examining the Gene in Personalized Genomics. Science and Education 22: 2529-2546.
[17] Toga AW, Clark KA, Thompson PM, Shattuc DW, Van Horn JD (2012) Mapping the human connectome. Neurosurgery 71: 1-5.
[18] de Montjoye YA, Hidalgo CA, Verleysen M, Blondel VD (2013) Unique in the Crowd: The privacy bounds of human mobility. Sci Rep 3: 1376.
[19] White RW, Tatonetti NP, Shah NH, Altman RB, Horvitz E (2013) Web-scale pharmacovigilance: Listening to signals from the crowd. J Am Med Inform Assoc.
[20] 404-408. 20. https://www.myfitnesspal.com.
[21] http://www.mynetdiary.com.
[22] Pentland A, Lazer D, Brewer D, Heibeck T (2009) Using reality mining to improve public health and medicine. Stud Health Technol Inform 149: 93-102.
[23] IBM and Apple Expand Partnership to Help Transform Medical Research. IBM news releases, 2015.
[24] IBM Watson at Work: Transforming Healthcare - Boston Children's Hospital, Innovation Summit, 2014.
Citation: Andrey L, Elizabeth S, Eugene K (2015) Is it Time for Cognitive Bioinformatics? J Data Mining Genomics Proteomics 6: 173. doi:10.4172/2153- 0602.1000173.
© 2015 Andrey L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Lisitsa Andrey 1, 2
Stewart Elizabeth 2, 3
Kolker Eugene 2-5
1 The Russian Human Proteome Organization (RHUPO), Institute of Biomedical Chemistry, Moscow, Russian Federation.
2 Data Enabled Life Sciences Alliance (DELSA Global), Moscow, Russian Federation.
3 Bioinformatics and High-Throughput Data Analysis Laboratory, Seattle Children's Research Institute, Seattle, WA, USA.
4 Predictive Analytics, Seattle Children's Hospital, Seattle, WA, USA.
5 Departments of Biomedical Informatics & Medical Education and Pediatrics, University of Washington, Seattle, WA, USA.
Corresponding author:
Lisitsa Andrey
E-mail: firstname.lastname@example.com


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March 2, 2019 - June 8, 2019
It's in your gift cards and maybe even your transit pass. It's starting to appear on your phone. How far is it going to go and why is the Bank of Canada interested? Come take a look at the recent past and near future of e-money in this dynamic new exhibition by the Bank of Canada Museum. Expect cutting-edge interactives and eye-opening descriptive graphics that are aimed at all ages.
Decoding E-Money explores the voyage of your dollars from purchase to deposit through various traditional and e-payment systems. Explore more than 60 artifacts covering the way Canadians have spent their money over the course of 200 years. From trading tokens to the most recent precursors of today's e-money, these artifacts at one time challenged our notions of acceptance much the way that Bitcoin challenges us today.
This is a travelling exhibition from the Bank of Canada Museum.


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Student Experiences
Shumon Mori, Japan
"I am a Japanese citizen with a BSc of Physics from Technion. The five years I studied at Technion were wonderful! I first learned about Technion over the Internet. As I heard, studying in Technion was not easy, but my friends, teaching assistants, and professors helped me with full kindness, and constantly encouraged me."
Ari Teger, USA
"The small classes let me develop a close relationship with the other members of the TIS program and academic staff. This unique relationship and the support it offers helped develop my academic skills. The extracurricular activities and the trips are fun and educational. I am looking forward to learning new subjects in the next four years."
Ilan Melchior, Denmark
"I decided to study at TIS because I liked the idea that I could study in Israel in English without being fluent in Hebrew. I think that the best part of the program has been living with people from different countries and cultures. TIS has done everything so we would feel comfortable here and for that I'm very grateful."
Salvador Bentolila, Venezuela
"When I heard about the international program with a chance of studying in English at one of the top engineering universities in the world, everything changed for me. I have enjoyed making new friends from the program and getting to know Israeli students studying in the same building as ours during our first semester."
Fjordi Bisha, Albania
I heard about TIS from a friend in Albania. The best part of TIS is gaining new friends from 30 different countries, having new experiences, experiencing new cultures, meeting new people, a new way of life, having a lot of fun and the most important ̵ studying."
Akshay Vajpayee, India
"I chose Technion because of the expertise of Israel and Israeli universities in high end research and development projects, which are a prime objective of mine. TIS is very lively compared to the rest of the Technion. The individual attention that is given is remarkable. I have a great opportunity to meet completely different societies and cultures."Ashkay has been accepted to graduate studies at Stanford University.
David Goldberg, South Africa
"Wanting to be in Israel and to study engineering, I was naturally drawn towards the Technion. I love travelling and meeting people from all over the world and here, I've met so many interesting people from diverse backgrounds and nationalities. I love Israel and its people. I am proud to call Israel my new home."
Shayma Sharif, Beit Hanina
"Whenever people hear where I'm studying they say, 'Wow, you're a Technion student,' and it's an amazing feeling. My relationships with the professors here are excellent; their doors are always open to us. At Technion I met the beautiful side of Israel, and at the International School I had a feeling of being exposed to the world – close to home."
Alex Bouaziz, France
"I came to study at Technion International because I wanted to study in Israel, at an excellent engineering school. My experience here has been wonderful. I benefited from a supportive environment and made good friendships. In Paris I never had non-Jewish friends and here in Israel I've made several."
Alex has been accepted to graduate studies at MIT.
David Debash – Italy
"We were the first class of the International School, a melting pot of students from a variety of cultures from around the world. It took us a while to get to know each other and bond as a group, but today we are a family. Thank you Technion for this unforgettable period." David Debash was the valedictorian of the 2013 graduating class of the B.Sc. program in Civil and Environmental Engineering.
Chana Haboucha – Canada
"What a difference the past 6 months have made: I've gained the confidence to speak despite my mistakes, and to conquer the language block I experienced in my first days here at Technion. Barely a day goes by where I am not encouraged by a stranger, to sit down for a cup of tea or coffee.
This is what I love about this country – no matter how busy someone may be, they will take the time to comfort and encourage a (sometimes lost) little Canadian."
Yuting Wang, China
"The Technion inspires the student to think and explore by themselves. It never restrains different thoughts, but helps to realize them." Yuting is a graduate of the BSc program in Civil Engineering. She is currently pursuing a Master's degree in Civil and Environmental Engineering at Stanford University.
Yuting Wang, China
"The small classes let me develop a close relationship with the other members of the TIS program and academic staff. This unique relationship and the support it offers helped develop my academic skills. The extracurricular activities and the trips are fun and educational. I am looking forward to learning new subjects in the next four years."


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I'm a mom and cradle catholic who is wondering about how to school my kids. I see from your info on this blog that you attended public schools through high school. To what do you attribute your strong faith now? What people, practices of faith, challenges, shaped you into the person you are today? What would you do differently? You also seem to have a good balance with popular culture, not shunning it altogether yet being discerning in your choices. This is an important skill to learn, because we're social by nature and it is hard to share Christ if you're too sheltered. Any thoughts on this aspect of being a good Catholic?
Good question. I will warn you…the short version of my answer to the homeschool vs. public school vs. private school question is simply: "I don't know." It is something I go back-and-forth on all of the time, to be honest. I will try to answer your questions about my specific background and we will see if that is helpful to either of us 🙂
Hands down, I attribute my faith to my family more than any other influence, and specifically to my parents (and of course it goes without saying that I was given such an amazing and faithful family by the grace of God). Yes, I went to public school and no, we didn't always get a family rosary in or memorize the Baltimore Catechism, but I never once questioned my parents' love for Christ and His Church. Religion wasn't a game; and God was real. Conviction like that demands your attention no matter how it is expressed.
For my family, it was expressed by living out the faith no matter what situation we were in. If my sister and I had a cheerleading competition that happened to fall on Sunday, we may have had to skip out a little early and miss the awards ceremony because mass came first. One year, we hosted an "All Hallows' Eve" party at our house, which included listening to a portion of the Screwtape Letters on tape. If we happened to have school on Good Friday, we would be taken out a little before noon to spend the afternoon either at service or in silence.
It wasn't always easy; but I don't think any path ever is. Homeschoolers sometimes talk about feeling like they were missing out in high school when I often found myself feeling like I didn't fit in entirely (there aren't a whole lot of teenagers who are serious about taking their faith seriously). Fortunately for me, that classic "rebellion against authority" phase that teenagers are often prone to often found its expression in taking pride in the fact that being a devout Catholic isn't exactly "mainstream".
And my parish youth group helped. Actually, my youth group helped a lot. And so did the fact that my parish had a blessed sacrament chapel open 24/7 to those who knew the door code…not that my parents ever let me go by myself past 6pm, but that chapel meant everything to me in high school.
Bottom line: I don't think my parents laid out a battle plan the day my oldest brother was born and had it all figured out. I think they followed God's will to the best of their abilities and, for us, that ended up meaning living very much in the world, but always doing our best not to be of it.
All of that being said— I spent the past three years of my life in college getting to know some of the best people I have ever met. Being at a small Catholic university, a good amount of them had been homeschooled. And I'm not afraid to admit: there is a lot to love about homeschooling.
First of all: these people knew more about the faith when they were twelve than I knew going into my freshman year of college (and I was no dummy!). Of course, that doesn't necessarily mean they loved God more than I did—but they knew a lot more about Him and therefore were able to love more about Him than I could. Maybe I wouldn't have appreciated it as much when I was nine…but who knows?
Secondly: as a public schooler, talking to a homeschooler about the books I have read (or, um, haven't read) can just be embarrassing (a lot of smiling and nodding along happens). Of course, there are exceptions: homeschoolers who hate reading and public schoolers who read everything. But by and large, homeschoolers have read the classics by age 10 and public schoolers can graduate high school with an eighth grade reading level.
When it comes down to it, there are pros and cons to everything. If you choose to homeschool, your kids will miss out on certain things, but the same will be true if you choose to put them in public school. There is no objectively right or wrong way here; it is just what works best for you and your family (and ultimately, what will help get your children to Heaven…because, as far as I can tell, that is why God gives people children in the first place).
So, that's my take. Any homeschoolers out there want to share their perspective?


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Homepage › Forums › General Scouting › Board of Reviews: No "Testing," No Point!
- This topic has 26 replies, 1 voice, and was last updated 1 year ago by Q.
December 17, 2015 at 10:26 pm #48686Randall ReedGuest
I don't know if this is a recent development, but after a 15 year hiatus, I find the current incarnation of the BoR a puzzling development: I have been asked to participate in numerous BoRs this fall and, on reading ambiguous official BSA writings, I am told that the BoR is not an occasion to retest prior knowledge because that is done in the Scoutmaster's Conference. As a 30 year instructional design veteran and an evaluation and testing professional, I have big problems with this logic. If we cannot sample required knowledge, particularly in the first 3 ranks, then what is the point of the BoR? The Scoutmaster is suppose to test the Scout's content knowledge prior to the BoR. This is instructionally dubious, at best. Does the SM really have that kind of time? Further, the BoR is suppose to ask affective and attitudinal questions about how the Scout "feels" about things. Who knows the inner Scout better, the SM or the BoR? The SM, of course. I believe the SM should be asking the affective questions and gauging attitudes and motivations while the BoR inspects the uniform and addresses the "nuts and bolts" of the rank requirements. The way it is now, the BoR is a pointless exercise to instill confidence and purpose into the Scout, a task performed much better by patrol members and Scoutmasters. I believe it has evolved into a trivial exercise. What am I missing?
December 17, 2015 at 11:11 pm #48688Randall ReedGuest
BSA website (section 220.127.116.11) is a complete wishy-washy mish-mosh. We are told that the BoR can fail to "promote" or approve the Scout. Yet, we are told, "The BSA discourages mock or practice boards of review. 'Practice' reviews may imply that board members will ask predetermined questions or that the board of review is anticipated to be other than a positive experience." Come on folks! Is this fish, fowl, or neither? Clearly, if a candidate can be rejected, it is not something to be approached with light-hearted joy. (They admit the Scout could be "nervous." Why?) Does this imply that Scouts should not be rejected? Then what is the point for a meaningful BoR?
Further, we are told, "In a case where there is concern the Scout has not fulfilled the requirements for a rank as written, it is appropriate to advise the young man that he might not pass the board and to make suggestions about what he might do to improve his chances for success."
Give me a Break! If the BoR is not allowed to examine and "test" the Scout on rank-appropriate topics, why advise the Scout that he "might not pass" if the BoR is not allowed to test the requirements for rank as written? That is tautology to a fine point and BSA should know better than to write this kind of uninformed, pointless, boilerplate. Please, folks, bring in an experienced learning and testing expert to straighten out this mess and to explain the finer points of formal and informal evaluation methods.
December 19, 2015 at 8:23 am #48727QGuest
Welcome back to scouting! Thank you for your service. And, yes, in a boy-led troop an SM and the ASMs have plenty of to test and coach boys who may not have yet mastered a skill. We often give more than one conference per rank … The final one being when we think the boy has mastered skills and shown marked growth in scout spirit.
The point of the BoR, is for the people who are to put the most effort in supporting the SM to hear directly from qualified scouts what they like about the troop, what they would like the troop to do next, and what challenges the boys are facing.
If you are concerned about scouts not mastering skills, provide more program where those skills must be practiced. If you think you would be better suited to evaluating skills rather than reviewing tenure, then consider putting in an application for assistant scoutmaster or merit badge counselor.
December 19, 2015 at 10:04 pm #48736Randall ReedGuest
While I value your opinion, I can't help but feel that if the BoR was to "test" the affective development of the Scout, then it should simply say that and the commentary and examples should support that concept.
While I agree that the BoR is an opportunity to "hear directly from qualified scouts what they like about the troop, what they would like the troop to do next, and what challenges the boys are facing," unfortunately, the language used Regulations 22.214.171.124 and 220.127.116.11 do not support intent when taken in their entirety. If your observation were correct, rank advancement assessment is a very curious occasion for such a wildly off-topic activity, even for the BSA.
Why should these regs be so obtuse? If ambiguity is really the hidden intent, why don't they simply say so?
As a veteran testing and evaluation professional, I am experienced with task analysis and the creation of measurable learning objectives. It is not difficult to create test items to confirm mastery of learning objectives (read: "Rank Requirements"). But, I am beginning to think that these regs are purposely ambiguous because BSA does not want to get into the business of creating and maintaining a "Guide to Conducting Boards of Review." I humbly submit, however, that benign neglect is not a responsible solution to this conundrum.
What IS the point of the BoR? Perhaps it is entirely dispensable, else why this persistent lack of clarity?
December 19, 2015 at 11:44 pm #48737QGuest
From the troop committee handbook:
The review has three purposes:
To make sure the work has been learned and completed.
To see how good an experience the Scout is having in his unit.
To encourage the Scout to advance to the next rank.
None of my BORs as scout decades ago involved retesting. At every level there was no doubt that I had mastered scout skills at each rank. (Skills that members of the board may have never learned.) The trustworthiness of my PL, SPL, and SM were beyond question. If the SM said one of his scouts learned and completed a rank, the committee was sure that was the case … Purpose #1 fulfilled.
The real work of the committee in holding boards of review is purpose #2 and #3.
December 20, 2015 at 8:01 am #48741QGuest
One more thought …
In the scouting skills framework, retesting by a board in a typical setting (e.g. a parlor or classroom) would provide an inadequate and biased sample of a scout's competencies. E.g., firerebuilding materials are few (maybe pencils and a wood chair?), ingredients for a meal are lacking (unless you're in a kitchen or pantry), the place has been swept of poisonous plants or venomous beasts, the topographic variation is minimal, skylights are few and nearby metal frames distort compasses, and 25 yards of head-deep water is nowhere (maybe the baptistry?) and certified guards among the board are rare!
December 20, 2015 at 2:57 pm #48744Randall ReedGuest
Q: The Troop Committee Handbook is merely parroting the language of the regs I previously cited. For your edification: "Sampling" is a perfectly valid method of assessment. No one ever implied any examination had to be exhaustive. Can you name me a test that is? And your examples are nonsensical and farcical, hardly worthy of adult discussion.
Further, your assertion that testing in a secondary environment is somehow flawed or biased is just plain silly. 90% of all testing is indirect measurement of knowledge, skills, and aptitudes that cannot easily be observed directly. It does not take a genius to craft deductive questions that provide strong indicators of mastery. A question like "What would you use for tinder after a hard rain?" provides quite a bit of information as to what the Scout knows or does not know and what he can do and can't do regarding fire building.
As is so often the case with loophole lawyering, you are offering your own interpretation by assuming that only the last two of the three stated purposes is in play. Who gave you permission to ignore #1?
And if the sign-off of the SM was sacrosanct, why the whole creation of the BoR? Perhaps your troop lives in a perfect world, but for the rest of us, not so much. A wise founder might have suggested the BoR as a second check on mastery, don't you think? Whatever the history, I think this is one of the least focused functions in Scouting and desperately needs either revision/clarification or outright elimination.
Currently, there is no uniformity in execution, there is only marginal adherence to the regs, and there is no clear concept of purpose.
December 20, 2015 at 3:23 pm #48745QGuest
Apologizing in advance for so many posts, but this helpful reference came to mind:
Longtime Scouter left behind template for running Eagle Scout boards of review
Although it is about Eagle boards, I think the attitude and techniques apply to earlier ranks (and venturing and sea scouts) as well.
One of the things that people outside of the troop always would tell me about our seasoned scouts was how they would hold conversations as equals with adults. Even if they weren't academically inclined, they were articulate and great to work with. I credit that to the committee members who would meet with them every whip-stich and just talk about life: what they've done, what they'd like to do, and what might help them along their way. This translates into practical things like correcting troop priorities, adults signing up to counslel certain merit badges, creating new service opportunities, boys finding jobs or education.
I don't want to undervalue the importance of testing and evaluation. We are constantly coaching our patrol leaders to improve in his area. (In the name of all that is good about western civilization, if anyone has professional techniques that can help our boys excel beyond the EDGE method, please pass on your skills to your older scouts.) I just want to be clear that the best venue for it is not the board of review.
December 22, 2015 at 9:17 am #48767perdidochasGuest
The real purpose of the lower ranks BORs is not to test the scout. It's to assess the program. It gives the Committee members and parents a chance to figure out how the troop is running. When I was a committee member (and participated in a lot of BORs) I learned a lot about the troop, and it's strengths and weaknesses. We were good about camping every month (except December), but we failed at providing the boys with adventure, partly because our SM at the time was a one man show. When our next SM came in, I used what I learned to guide him as his ASM towards higher adventure for the troop. We have succeeded. Since the new admin, we have gone on several kayaking trips, a caving trip, several backpacking trips, and a few snorkeling trips. Our troop is growing in response.
December 22, 2015 at 5:25 pm #48773Commissioner BenGuest
It's pointless to try and convince him of anything. Randall's either an amusing troll or wants the BSA to completely revamp our Board of Review system in exchange for something conjured up in an Oxford lab.
December 22, 2015 at 7:58 pm #48776Randall ReedGuest
Ben: Just because you don't understand something, please do not belittle it. "Oxford lab" indeed. Now you are sounding like an anti-intellectual or anti-learning grognard. If you do not understand what I am talking about in regards to testing and evaluation, that is perfectly OK. I have had 30 years to get well versed in the subject. Certainly, I hope that I did not insinuate that a master's degree was necessary to understand my concerns about the structure, purpose, and goal of the BoR. My obligation was to explain it more clearly. I probably did not do a good enough job in that department. My apologies.
But, do I think that the rules and regs concerning BoR should be revamped? You bet. Why? Because they fly in the face of good learning and evaluation principles which have been well-proven since the 1960s. And the extant language is disjointed and ambiguous.
Maybe we should simply take a more comparative view of the rules and regs that apply to BoR. In that respect, do you think that the explicit guidance in the Guide to Advancement pub in most matters of advancement have not be nearly so well defined in those parts pertaining to BoR. I, personally, find them absolutely contradictory and non-directive.
We can do better in creating a balanced, nuanced, approach to the BoR. Personally, I think it is a very important check-and-balance within the troop to offset possible biases of the Scoutmaster. It is also an effective way to emphasize that advancement requires personal accountability and accomplishment on the part of each Scout. Advancement should not be a rubber stamp.
If you feel personally wounded by our exchanges, I am sorry. That detracts from a productive discussion of what can be made better in Scouting. Things might have been more civil had you been able to more accurately paraphrase and summarize what points I was making in my original posts, instead of interpreting them solely within your own frame of reference. Water over the bridge.
December 22, 2015 at 8:17 pm #48777Randall ReedGuest
perdidochas: This is a discussion about the rules and regs explicit in BSA National publications. I am not familiar with the regulation you cite as "The real purpose of the lower ranks BORs is not to test the scout. It's to assess the program." Where did you get THAT? Nothing in rules 22.214.171.124 to 220.127.116.11 supports your assertion. Frankly, you are simply stating your opinion unsupported by what is in the regs. I find your belief that the
BoR is to test the troop to be, frankly, quite a stretch. And not supported at all by the regs. If you can point to a rule or reg that supports that contention, I will will stand corrected.
December 23, 2015 at 9:59 am #48801perdidochasGuest
If you want a dynamic troop, the BOR will be an assessment of the Troop. I learned it in some training, although I don't remember which one–I'm a trained Committee member and trained Assistant Scoutmaster. It may have just been a word of advice from a former SM.
It is in the regs:
184.108.40.206 How Boards Can Lead to Program Improvement
Periodic reviews of members' progress can provide a measure of unit effectiveness. A unit might uncover ways to increase the educational value of its outings, or how to strengthen administration of national advancement procedures. For example, if it is discovered troop leaders are not ensuring that all requirements have been met before Scouts present themselves for the board of review, then process improvements can be recommended. A board can also help by considering the style of leadership best suited to current circumstances and ways to adjust it to different needs. Note that boards of review may also be held for Scouts who are not advancing. Much can be learned from them, as well.
December 23, 2015 at 10:00 am #48802perdidochasGuest
Why did you stop at 8.01.11? Is it because you knew 8.01.13 supported my view? A Scout is honest.
December 22, 2015 at 8:56 pm #48781Commissioner BenGuest
I wasn't "wounded," just found it amusing you speak so formally. Nobody I know or knew in college ever talked like that. It was like I was living in a New Yorker cartoon. Granted, while I'm just so dumb hick who doesn't have the capacity for abstract thought, or a Ph.D in testing and examination, I don't think the current Board of Review serves as a rubber stamp for advancement. To require or even allow the Board to make a scout do one or more requirements again opens up the possibility for issues and abuse. The scouts are already completing the requirements once. If you allow Boards to let them retest scouts on any given requirements, imagine the open-ended problems that could develop. One parent might say the Board required their son to be retested on *insert said requirements* while on the same night, another scout with the same Board members didn't have to retest anything. How is that a fair process? The current regs already address this by requiring the same standards for all scouts. Allowing Boards to retest whoever and whatever they want is less wise than not. On paper, your revised regs read great. Let's retest scouts to examine their mastery. But in the real world, people aren't perfect and will take advantage and abuse that system. If there's a Board member who doesn't like or is fearful of a scout's parents, that creates an imperfect system. It can be said, Board members shouldn't be influenced, but they could. I've seen politics play a role in decision making at the unit, district and council level. The best thing we can do is not allow it when possible. I still stand by my comment that the system isn't broken. But what do I know, I'm just some dumb hick.
December 22, 2015 at 9:58 pm #48784Randall ReedGuest
I apologize for using big words you do not understand. I will try to lower my reading level for your sake. I believe that I have been fairly consistent in my assertion that the wording of the regs is flawed. I personally believe from personal and professional experience, that some sort of macro assessment (sampling) could be fair and fruitful. Otherwise, with the current wording and the lack of ability to ask discriminating questions, it is beyond my ken as to what clear and distinctive function the BoR serves in ensuring the integrity of advancement. If it disappeared tomorrow, in what specific ways would the advancement process suffer?
December 23, 2015 at 9:29 pm #48823Randall ReedGuest
P: I stand corrected. Thank you for further explanation.
December 31, 2015 at 1:33 am #48940QGuest
Thanks everyone for throwing in a lot more data and sources to this discussion.
Macro assessment and sampling of scout skills is important, but it is more accurately the purview of the Scoutmaster and Senior Patrol Leader as they challenge boys in the method of Outdoor Program. For example, a scout may cram to re-learn the timber hitch for a rank sign-off, but that's no indication of how quickly he'll use it when the time comes to haul timber!
But, routinely put scouts in situations where a timber hitch needs to be tied (e.g. To anchor a ridge line around a large tree) and the real test begins! So, when your SPL comes up for his next rank review, you might ask "Do your boys tie a lot of timber hitches? Are they good at it? What should we get for you to make sure they do them well? Can you think of a service project where tying knots like that might come in handy?"
In the boards of review, we really want to help scouts be reflective by building that sense of adult association.
January 11, 2016 at 3:06 pm #49111KypGuest
The point of a Board of Review is not to re-test and then pass/fail a Scout for requirements he already has signed off.
The point of a Board of Review is for the committee to get a quality assurance spot-check of the program being offered; and gives them a chance to check in with the Scouts as they move through the program.
You certainly can review what the Scout has done up to this point (heck, it's in the name Board of REVIEW). You can ask what campouts he went on, what service projects he helped with, what meals he help cooked for the various requirements, etc. You can ask questions about the skills he learned (What did you learn from your menu planning experience? What would you do differently if you were going to do that 5-mile hike again? Have you had to use any of the first aid skills you learned? What knot do you think is the most useful?) But it's not a time to re-test a Scout and question the signatures in his book. And there's no benefit from putting him on the spot and making his sweat it out with an overly specific or "gotcha" question to make him prove what he's done.
If a Scout is at his Board of Review for First Class and is unable to tie a bowline, it is not the time nor the place to take out the white-out and remove the signature from First Class requirement 8a and require that he go remaster the skill that he's already been signed off on and then come back some other time before you pass him.
If a Scout is unable to tie a bowline, it may be worth looking at how the troop teaches knots. But it's not appropriate to void the signature on a Scout's requirement and fail him.
The board can use the Board of Review to find out what the Scouts like and don't like about the program; what is going well and what isn't. They can be really insightful in helping guide the Scout as he moves forward and in guiding the troop as well. It's a time for the board to learn from the Scout, not for the Scout to put on a big show and prove himself to the Board. We don't need to make the Scouts jump through all the hoops again at some big "final exam" for each rank – that's not how the advancement program works.
February 4, 2016 at 8:54 am #49691BryanGuest
This is a test.
February 15, 2016 at 11:23 am #50009PaulGuest
Assuming that Randal ONLY wants to run a good unit, I thank him for his interest & enthusiasm driving this discussion.
That being said… IMO he's doing everything ELSE "wrong". Neither the Scoutmaster Conference or the Board of Review is a "retesting time" for the basic scout skills. When they are tasked with "making sure" skills are done, they are checking the Requirements pages are being signed off, the dates and signatures match, and the TIME between advancement. (NOTE: These are the same Requirements pages that need to be copied and sent along with their Eagle Applications and Advancement Records to "prove" to National that the scout "learned" and completed all the requirements at the right times & order.)
"Testing" is what happened BEFORE the handbook got signed.
"Testing" is what happened BEFORE the MB Blue Card got signed.
The "testing" that happens at the SMC or the BOR is a time to TEST THE PROGRAM, the LEADERS, and the SPIRIT, not the minutia of the "hard scout skills". ANYONE making boys "tie knots" or "first aid bandages" at a SMC or BOR needs a pie in the face!
These review times test the TEACHING METHODS… test the SUPPORT that the boys have from adult leaders… test the TEAMWORK happening in their patrols…. test the ENJOYMENT of the monthly events… and test the ENTHUSIASM to keep moving forward in the Scouting Program… test the QUALITY of the SM and his assistants… test the SELECTION of camp sites & activities… It's all the "other stuff" the Committee is responsible for. The Committee does not run the direct interaction with the boys, that's the job of the SM and the ASMs. Through the BOR, the Committee confirms they've "hired the right guy" to run the program.
Remember, we teach Character as much as we teach "Scout skills". We need to have a holistic view of the PROGRAM and not just the "stuff" on the Rank Advancement pages in the book.
May 11, 2019 at 5:52 pm #202743guruGuest
Paul – This is by far the single best response I've ever read!
You are absolutely correct, there are a lot of Scouters who don't take the "holistic" approach to Scouting and therefore they don't properly understand WHAT their jobs are supposed to be, or HOW their jobs are supposed to be done. Take this Randall guy for example who is ready to run every Scout through a gauntlet of tests, knots, bandages, situps, pushups and who knows what else for the rank advancements that require Merit Badge completion. Oh brother!!!
Paul you're 100% on target! If a Scout doesn't KNOW the skill, then the SM shouldn't sign the book or the MBC sign the blue card. Once signed, the Scout moves upwards into a completely different level of intellectual discussion & Program content; not the "hard skills" as Paul calls it, but the finer nuances of the "program" itself and the way the Troop functions as a whole.
May 9, 2019 at 12:02 pm #201226KeeBirdGuest
What to do when the Scout sitting for his Tenderfoot Rank can not even tell the BOR what the Scout Law means to him or how he should live it. Yes he can recite it but it has no meaning to him.
May 11, 2019 at 5:52 pm #202750guruGuest
This is a warning sigh that you have a SM who doesn't embrace the character development aspects of Scouting.
If a boy can't articulate an intelligent response to something as basic as the Scout Law, it's NOT time for him to advance. Not only should your Committee (BOR) have a talk with the Scout and explain to him the far reaching concerns are of missing the most basic aspect to Scouting's "spiritual" mission of building boys into men, but it's also time to bring the SM and ASMs into a room and share your concerns that they may be too quick to sign off on requirements, and what I think is of greater concern, "glossing over" the CHARACTER aspects of the Scouting program itself.
As I have said to my boys many times, you can fish, bike, camp, and hike ANYWHERE in blue jeans and a tee shirt, but to wear a Scout uniform means you're a part of something "special".
Don't ever let Scoutmasters water-down the "something special" aspect of Scouting! There's too much of that happening at "head quarters" already, don't accept it at the Unit level.
May 14, 2019 at 8:38 am #203698JasonGuest
Q mentioned the handbook stance on BoR's. What seems to be up for debate is an interpretation of the first point, which is to "make sure the work as been learned and completed." This statement is ambiguous in that it either gives the BoR room to retest the scout OR it means for the BoR to accept the signed off sections as fact and that the SM or ASM did their due diligence before signing. I don't know which approach is right, but I do know that I've had scouts come to BoR's that were unprepared to recite the scout oath, scout law, or even talk about intelligently about their advancements. When that happened, you bet your sweet monkey we took the "make sure" step very seriously and sent them back to the SM and ASM without advancing them. I don't see how BSA could possibly expect a BoR to be a rubber stamp process.
May 17, 2019 at 8:28 am #204655guruGuest
The BOR isn't a rubber stamp, but it's also not a retest. That is stated clearly as in all BSA publications, so there's no ambiguity. If anything, a boy who can't recite the Oath/Law requires more scrutiny for the SM and the ASM who are apparently signing the handbooks too readily.
Part of a reason behind the Committee having a chance to interview the scouts for advancement is to also get a sense of the health of the program itself, including the SM and ASMs and they job they're doing.
Great questions to ask – Are boys learning? Are the trips/destinations fun & interesting? Is the SM patient and genuinely interested in you? Are you comfortable asking your SM / ASMs for help with skill instruction? Do you think the SM does too much and may be keeping the SPL and the Troop from being "boy led"?
These not only answer questions you need to know about the Troop, but shifts the focus of the boy and onto others, which should help him relax and talk more easily. THEN you can turn the questions inward and ask about his individual accomplishments once you have him talking.
220.127.116.11 Conducting the Board of Review
188.8.131.52 Not a Retest or "Examination"
Though one reason for a board of review is to help ensure the Scout did what was supposed to have been done to meet the requirements, it shall become neither a retest or "examination," nor a challenge of the Scout's knowledge. In most cases it should, instead, be a celebration of accomplishment. Remember, it is more about the journey. A badge recognizes what a Scout has done toward achieving the primary goal of personal growth. See "Personal Growth Is the Primary Goal," 126.96.36.199. It is thus more about the learning experience than it is about the specific skills learned. See also "Mechanics of Advancement in Scouts BSA," 126.96.36.199.
May 22, 2019 at 8:38 am #206911QGuest
Jason, I think the GTA gives the BoR latitude to ask the scout, "Can you do ___?"
A scout is trustworthy.
If he answers in the negative, they can decide to finish the board when he can.
It sounds like that's what your board did. I don't consider that to be testing. The board should be looking for a scout who can reflect on what he learned, and if he can't recite oath and law or describe what a point means in his daily life, you don't have someone who's been reflecting on these things the way we'd like.
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Louisiana State Troopers reported that a 83-year-old woman suffered fatal injuries in an Oct. 16 accident in East Baton Rouge Parish. The 4 p.m. incident reportedly occurred on Louisiana Highway 64.
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"I've never given up on anything in my life and I'm not going to start now."
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Watched Rio, the cartoon about the rare Brazilian birds, with the kids last night and woke-up disappointed not only about the blatant hueism, but also about how slow I am to catch these things when I catch them at all. There is always so much isms to discuss with kids when we watch any cartoons and with Rio the thing sticking out glaringly for me was the African American voices–dogs seem to commonly have Black-sounding voices, especially if they are the only dog in the movie and more so if they are naughty/naughtyish, such as the bulldog in Rio being played by Tracy Morgan. Really? A bulldog? Sigh. Likewise, a naughty blackish kind of bird I see is actually a Canadian Goose is played by Wanda Sykes. I smell a trope here. And George Lopez is a Brazilian-residing Toocan? Ok, like I said, always a lot to critique in my kids' seemingly innocent little movie watching, but here in Rio the hueism is what I most pressingly need to rewatch the movie with my kids so that we can discuss it.
So in a Brazilian nutshell (yes, I did) the Good guy, a bird-loving and saving ornithologist, is so fair-skinned that I wasn't sure if he was even supposed to be Brazilian–the kids watched the movie in French the first time around, so the accents were all, well, accented to me. And yes, I understand Brazilians come in a full spectrum of skin tones, including White, and that is why it is all the more upsetting that the Bad Guys were all noticeably darker than the Good guy. The three bird thieves, as well as the little orphan-like boy who is pressed into working for them are all darker-to-Black. This blatant racism seems especially hurtful because Brazil is always held up to this color-blind fallacy, as in "Look at Brazil, all the colors are co-mingled and getting along so well!"–not– and also the guy who made the film is from Brazil and in the features section of the video he is so very, very "excited" to share his "colorful" country with us, the viewers. Sadly, the background characters are all pretty white washed too.
I was happy to see the kids were doing some critical watching as well as self-correcting while viewing the film, they were being clear to differentiate between the US and South America in their discussion and my eldest son made a comment in which he changed "foreign countries" to "just countries." Perhaps this is an earlier indicator that my kids will not be as insensitive to these issues as I was indoctrinated to be. Also, the eldest asked me about the poverty, specifically noting the metal-roofed shanties which we also see here in Morocco, without this connection I don't know that he would noticed the poverty–the younger kids didn't mention it. I'm sure they will be thrilled to watch it again with me sometime this weekend, so I'm doing a little pre-discussion preparation. I want to discuss with them the hueism problem, as well as the White Savior trope which comes up with the orphan-like kid being adopted in the end and also try to get them to discuss some of the roles played by Black voice-overs in order to see if they notice how those characters are much sillier compared to the others.


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Each bag is designed with a flat bottom seal to eliminate weak spots and create a two-dimensional bag that holds 30% more than star bottom plastic trash bags. Star seals may be a little more durable, but their design limits the amount of space.
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Wolters Kluwer | Lippincott Williams and Wilkins Radiation Oncology Management Decisions 3rd Edition by Chao
Ideal for on-the-spot consultation, this pocket manual, Radiation Oncology: Management Decisions, provides easily accessible information for residents and practitioners in radiation oncology. It presents the most essential information that is immediately required in the clinical setting. The first eight chapters of the book focus on key basic concepts; the remaining 46 chapters describe treatment regimens for all cancer sites and tumor types. Includes coverage of pain and palliation, and covers all latest therapeutic techniques. This edition includes expanded information on image-guided therapy, 3D techniques, and 4D protocols. The updated cancer staging guidelines have been used throughout the manual. In addition, there is a brand-new chapter devoted to QUANTEC dosage recommendations.
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Since 2000, HMOs have been required to recognize Religious Nonmedical Healthcare Institutions. However, to have an HMO help pay your expenses at a Christian Science nursing facility, your HMO will probably require written authorization in advance of your admission to a facility Christian Science nursing administrators can provide more information on HMO coverage. Christian Scientists who are under HMO coverage through their employers should contact their Human Resources Offices with this information in advance of filing a claim, and request that the HMO recognize their local Christian Science nursing facility as an authorized care giver.
HMOs are groups of medical health care providers that furnish their members with all the medical services they may need but require that their members use only the facilities designated by the HMO. They do not pay for care at Christian Science nursing facilities without a prior written agreement with the facility. When you join an HMO, you give up the right to use your Medicare benefits in a Christian Science facility that does not have an agreement with your HMO. You must withdraw from the HMO in order to reinstate your Medicare benefits. This can be a time consuming process, and it may take a month or more before your Medicare benefits would again be available.


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Todd McLellan wasn't specific — understandable under the circumstances — about what he may have in mind, but he said this morning that he was considering some line changes.
And later, when asked to clarify if that was line changes or lineup changes, he had a one-word answer: "Both."
Once again, Jason Demers did not skate with the team so do not expect his appearance to be one of those changes. And, yes, McLellan acknowledged that Demers's absence does change the game plan.
"Our belief in Jason and his ability is very strong," the coach said. "He's played a very key role in our team play this year. He's an offensive guy with very good eyes and very good hands, thinks the game creatively.
"Huskins is a different player. When you put Kent in, it changes. He's a defender. He's more about staying at home and playing in a smaller sheet of ice than the bigger sheet.
"So it does change the dynamic somewhat. You have to ask others to do a little bit more in offensive situations. But it's not the end of the world."
Some players have talked about the need to approach tonight as if it were Game 7. Here's McLellan's reaction to that:
"I think when you're in the playoffs, if you have the approach that Game 1 is like Game 7 and Game 2 is like Game 7, I think that's a real good indicator of intensity and focus. Our job is just to win Game 3. However we want to approach it from the mental perspective, it's to win Game 3.
"We know we're going to play Game 4. We'd like to play it with a record of 2 1 versus 0 3. But we can't look ahead. We've got to deal with today. We obviously need a better game than we had in Games 1 and 2. We're looking for that tonight."
***More later.


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Welcome to Speed Fresh Exotics (UK) Ltd.
Speed Fresh have been the leaders in providing superb quality fresh fruits and vegetables to the North of England since 1999. Our stock contains fresh produce from around the globe you name it we've got it, if not, we can arrange to get it especially for you.
Our staff are friendly and have years of experience under their belt in dealing with new and existing customers. Feel free to give us a ring, drop us an email or why not pop in and visit us.Our staff will be happy to show you around and give you a chance to see the variety of products for yourself.
Why not try something new?


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Perry is, literally and figuratively, "Where Georgia Comes Together." Building upon our central location in Georgia and our historical identity as "The Crossroads of Georgia" while integrating the many reasons why people visit Perry, such as the Georgia National Fair and our Downtown, the new Perry Brand embodies who we are as a community. For people looking for a relaxing break in their journey and for the charm of authentic southern small towns, the City of Perry is in central Georgia along I-75, whose Downtown conveniently serves the classic Georgia hospitality people seek, so that their experiences are more personal and they will feel enriched.
The Perry Brand has been built, and will continue to be built, through the unique, collective Perry experience. This experience embodies our promise, our promise to those living in Perry, our promise to people who do business in Perry, and our promise to the hundreds of thousands of people we welcome to Perry each year. For more information on the Perry Brand, the community-driven process behind the Brand, and how you or your business might be able to utilize the Brand, please click the link below:
While the logo and tagline are the official City of Perry logo and tagline, we encourage community members and organizations to embrace the new Perry Brand and invite you to utilize the creative elements associated with the Brand. We have provided all of the pertinent creative elements for download and use once you have read and agree to our Graphics and Logo Usage Agreement.
By clicking on the "I Agree" button at the end of the Graphics and Logo Usage Agreement, you indicate your acceptance of the rules and guidelines regarding the Perry Brand and the City of Perry logo and tagline. The complete Graphic Brand Standards can be found by clicking the following link: Perry Brand Graphic Standards. The City of Perry reserves the right to seek legal action for improper use of its logo, images, graphics, or other Perry Brand elements.
If you have any questions about the Perry Brand or use of the associated creative elements, please do not hesitate to contact Tabitha Clark, Communications Manager with the City of Perry, at (478) 988-2760 or via email at firstname.lastname@example.com.


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Something this way Friday comes ….
From 6:30pm December 17 we will be meeting in the OrganiGallery for a few speeches and the chance for the CBD community to meet our first round of artists.
Please then join us for a wander through the other spaces and a chance to celebrate all the hard work of Jo, Jan, Jamie and Katelyn (and their exceptionally supportive entourage of helpers) who have put in an amazing number of hours over the last couple of weeks to have their spaces ready for Friday night.
After what has been a rollercoaster six months or so of negotiations and careful planning for the Renew TSV team we cannot satisfactorily express how grateful we are of everyone who has helped us get to this critical point in the life of the project.
We hope to see you there on Friday night to share a glass of bubbly – and a collective sigh of relief – as we turn our attention to the next phase of the project.
Please, if you know of anyone who has the arts bug and would be inspired by the Renew TSV concept, invite them along on Friday to witness the energy and enthusiasm that the project has engendered in our ever increasing pool of artists, supporters and volunteers.


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I have always been interested in volunteering, charity and development work. I have taken part in projects in Thailand, Cambodia and Australia. In Taipei, I regularly volunteered with Harmony Home, a centre for women and children who have or whose lives have been affected by HIV. I also helped out at Animals Taiwan and TSPCA whenever I could and loved being involved with their annual fundraisers and events.
I am passionate about international development, and the role that volunteers play. I hope to learn how to maximise the efforts of foreign volunteers, as well as honing my fundraising skills here and to share my experiences with you!
After spending 4 years teaching English and volunteering in Taiwan and Vietnam, I have decided to move back to the UK to pursue a more permanent job in the charity sector. I also plan to expand this blog and make it a good solid reference for those wanting to get into volunteering. My focus will still mainly be overseas volunteering but I also plan to volunteer in London and share information for that here too. Please feel free to comment on my posts, or alternatively, contact me on firstname.lastname@example.com.
Your input is valued and important!


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Honey and Oat
What it is:
A gentle daily gel cleanser formulated with key ingredients Honey and Oat Extract in a soothing base of 100% Organic Aloe Vera Leaf Juice.
What it is formulated to do:
Gently remove impurities without stripping the skin of its natural moisture balance. An ideal daily cleanser for all skin types to cleanse and prep the complexion for next skincare regimen steps. A true Michael Todd, "Hero" product with a growing fan base.
What it is formulated WITHOUT:
-Water or Cheap Fillers
-Artificial Dyes
-Synthetic Fragrance
-Mineral Oil
What else you need to know:
Intended for All Skin Types.
200 ml/ 6.7 fl oz
Benefits & Key Ingredients
- Naturally moisturizing & rich with antioxidants
- Soothes at it enhances the complexion for increased radiance
Oat Extract
- Helps to draw out deep set impurities in the skin without irritating
- Antioxidant-rich to help protect the skin's youthful appearance
- Soothing and moisturizing
Organic Aloe Vera Leaf Juice
- One of nature's most beneficial ingredients for skin, known for its moisturizing & soothing properties
- Ideal for use with the Soniclear™ or with hands alone. Wet face and hands with warm water. Apply cleanser onto hands or brush head and gently massage onto damp face in upward, circular motions. Rinse thoroughly.
Organic Aloe Barbadensis Leaf (Organic Aloe Vera) Juice, Disodium Cocoamphodiacetate, Decyl Glucoside, Coco Glucoside, Sodium Cocoyl Glutomate,Glycerin, Oat Beta Glucan, Olea Euopaea (Olive) Leaf Extract, Alpha Tocopherol, Panthenol, Honey, Glycol Stearate, Lavandula Angustifolia (Lavender) Oil, Citrus Aurantium Dulcis (Orange) Peel Oil, Acrylates/C10-30 Alkyl Acrylate Crosspolymer, Sodium Phytate, Benzyl Alcohol, Dehydroacetic Acid
Information on Ingredients: We are constantly updating the ingredients in our products to bring you the most effective and natural skin care, without cheap water fillers, parabens, sulfates, artificial colors or synthetic fragrances. The above listing represents the current up to date formulation for this product. Due to long lead times for production of our packaging, the ingredients listing on the package may not reflect all current ingredients. Refer to the ingredients listing on our website for the most up to date information on ingredients.


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Home > Catseye > by Range > Catseye (Retired)
Our Catseye Bathing Belles Nail Files make the perfect gift for a friend or the ideal treat for you. The Catseye range of designer purses, bags & stylish accessories are eye-catching, trendy and a must have item for the fashion conscious.
Supplied in gift packaging, finished with a ribbon bow.
Brand: CatseyeSize: 20cm
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Actress and producer Salma Hayek shared wise words for women and girls over the weekend in a speech she gave at the Variety Power of Women Luncheon in California.
"I think the most important thing to tell for the new generations is to have the courage to be unique, to be curious about who they are, instead of trying to blend in," said Hayek.
Hayek was honored at the luncheon for her charitable work with Chime for Change, a nonprofit that seeks to provide education, health and justice programs for girls and women around the world.
Hayek said she has young girls like her daughter, 8-year-old Valentina, in mind when she imagines a world in which girls can learn that they don't need to be like everyone else, that they can strive to "really be profound thinkers that are excited about their differences and explore what they are and who they are and what can come out of the new."
While she believes that women have a voice that can change the world, she also says women have been busy up until this point, trying to fit into the roles assigned to them by men.
"Women represent 50 percent of the population of the world, but even with all of the lack of opportunities, education and all the limitations that come our way, we are 66 percent of the work power of the world," she said in her speech. "However, we only get 10 percent of the income of the world."
Hayek said she's excited about the changing role of women in the entertainment industry.
"We're not the women who just want to see a movie of how our prince is going to come and rescue everyone," she said. "We changed, but nobody took the time to change with us in the industry. So it's a really exciting time to really define who we are, and I think this is the true heart of equality: not only when we can make as much and we can speak as loud, but when we really have the freedom to be ourselves instead of trying to survive or fit in."
But Hayek also shared her hope for the future. "I'm feeling very confident that we are the generation that is going to experience the difference, the transformation … We are such an economical power, women, in the country, and we represent such a strong part of the audience that they cannot ignore us anymore."