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PDE/User Guide
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- 1 Getting Started
- 2 Concepts
- 3 Tasks
Getting Started
PDE Overview
The Plug-in Development Environment (PDE) provides tools to create, develop, test, debug, build and deploy Eclipse plug-ins, fragments, features, update sites and RCP products.
PDE also provides comprehensive OSGi tooling, which makes it an ideal environment for component programming, not just Eclipse plug-in development.
PDE is broken into three main components:
- UI - A rich set of models, tools and editors to develop plug-ins and OSGi bundles
- API Tooling - Tooling to assist API documentation and maintenence
- Build - Ant based tools and scripts to automate build processes
Discover the latest features in the What's New section.
PDE UI provides a editors, wizards, launchers, views and other tools to create a full featured environment to develop and deploy Eclipse plug-ins, fragments, features, update sites, RCP products and OSGi bundles.
Some of the PDE tools include:
- Form-Based Manifest Editors: Multi-page editors that centrally manage all manifest files of a plug-in or feature.
- RCP Tools: Wizards and a form-based editor that allow you to define, brand, test and export products to multiple platforms.
- 'New Project Creation Wizards: Create a new plug-in, fragment, feature, feature patch and update sites.
- Import Wizards: Import plug-ins and features from the file system.
- Export Wizards: Wizards that build, package and export plug-ins, fragments and products with a single click.
- Launchers: Test and debug Eclipse applications and OSGi bundles.
- Views: PDE provides views that help plug-in developers inspect different aspects of their development environment.
- Miscellaneous Tools: Wizards to externalize and clean up manifest files.
- Conversion Tools: Wizard to convert a plain Java project or plain JARs into a plug-in project.
- Integration with JDT: Plug-in manifest files participate in Java search and refactoring.
To get started, try out the following cheat sheets:
- Creating an Eclipse Plug-in
- Creating a Rich Client Application
PDE API Tooling
PDE API Tooling assists in the documentation and maintenance of APIs provided by plug-ins and OSGi bundles.
Some of the features include:
- Compatibility Analysis : Identify binary compatibility issues relative to a previous version of a plug-in.
- API Restriction Tags : Javadoc tags are provided to explicitly define restrictions associated with types and members.
- Version Number Validation: Identify invalid plug-in version numbers relative to a previous version of a plug-in.
- Javadoc
@sinceTag Validation: Identify missing and invalid
@sincetags on types and members.
- API Leak Analysis : Identify API types and methods that leak non-API types.
- Quick Fixes : Quick fixes are provided to adjust plug-in versions and @since tags appropriately.
To get started, see the tasks:
PDE Build
PDE Build facilitates the automation of plug-in build processes. PDE Build produces Ant scripts based on development-time information provided by, for example, the plugin.xml and build.properties files. The generated Ant scripts, can fetch the relevant projects from a CVS repository, build jars, Javadoc, source zips, put everything together in a format ready to ship and send it out to a remote location (e.g., a local network or a downloads server).
To get started, see the following:
Extensions and Extension Points
A basic rule for building modular software systems is to avoid tight coupling between components. If components are tightly integrated, it becomes difficult to assemble the pieces into different configurations or to replace a component with a different implementation without causing a ripple of changes across the system.
Loose coupling in Eclipse is achieved partially through the mechanism of extensions and extension points. The simplest metaphor for describing extensions and extension points is electrical outlets. The outlet, or socket, is the extension point; the plug, or light bulb that connects to it, the extension. As with electric outlets, extension points come in a wide variety of shapes and sizes, and only the extensions that are designed for that particular extension point will fit.
When a plug-in wants to allow other plug-ins to extend or customize portions of its functionality, it will declare an extension point. The extension point declares a contract, typically a combination of XML markup and Java interfaces, that extensions must conform to. Plug-ins that want to connect to that extension point must implement that contract in their extension. The key attribute is that the plug-in being extended knows nothing about the plug-in that is connecting to it beyond the scope of that extension point contract. This allows plug-ins built by different individuals or companies to interact seamlessly, even without their knowing much about one another.
The Eclipse Platform has many applications of the extension and extension point concept. Some extensions are entirely declarative; that is, they contribute no code at all. For example, one extension point provides customized key bindings, and another defines custom file annotations, called markers; neither of these extension points requires any code on behalf of the extension.
Another category of extension points is for overriding the default behavior of a component. For example, the Java development tools include a code formatter but also supply an extension point for third-party code formatters to be plugged in. The resources plug-in has an extension point that allows certain plug-ins to replace the implementation of basic file operations, such as moving and deletion.
Yet another category of extension points is used to group related elements in the user interface. For example, extension points for providing views, editors, and wizards to the UI allow the base UI plug-in to group common features, such as putting all import wizards into a single dialog, and to define a consistent way of presenting UI contributions from a wide variety of other plug-ins.
A feature is used to package a group of plug-ins together into a single installable and updtable unit.
Features have a manifest that provides basic information about the feature and its content. Content may include plug-ins, fragments and any other files that are important for the feature. A feature can also include other features. The delivery format for a feature is a JAR, but each included plug-in will be provided as a separate JAR.
Once you have created your plug-ins and fragments you can create a new feature by creating a New Feature Project.
You can also create Feature Patches in PDE. A feature patch is developed in the same fashion as a normal feature, but is used to edit an existing feature rather than create a new one.
A fragment is used to replace or extend the functionality of an existing plug-in. A common use for fragments is to put environment (operating system, architecture, etc.) specific code into fragments. Depending on the environment the plug-in is installed in the base plug-in code along with the correct fragment can be installed. Fragments are also ideal for shipping features like language or maintenance packs that typically trail the initial products for a few months.
When a fragment is detected by the platform and its parent plug-in is found, the fragment's libraries, extensions and extension points are "merged" with those of the parent plug-in.
While this merging mechanism is good from a runtime point of view, developers need to view fragments as separate entities while working on them.
PDE provides full support for fragment development. Fragments can be viewed as "limited plug-ins". They have all of the capability of regular plug-ins but have no concept of life-cycle. Fragments have no top-level class with "startup" and "shutdown" methods.
To create a fragment use the New Fragment Project wizard. Editing fragments is very similar to editing plug-ins.
A plug-in is used to group your code into a modular, extendable and sharable unit.
Plug-ins are modular as each plug-in contains some portion of code. The plug-in specifies other plug-ins (or java packages) it requires to be available to run and it also specifies the set of java packages it provides. An Eclipse based program or product will contain multiple plug-ins, which can be added, replaced or removed to alter the functionality of the program.
Plug-ins are extendable using extensions and extension points. A plug-in can provide one or more extension points so other plug-ins can add to the functionality of the plug-in. A plug-in may also provide extensions to connect to other plug-ins.
Plug-ins are sharable. A plug-in can be exported as a directory or as a jar which can be added to other applications. Plug-ins can be grouped into features which can be distributed and installed into applications.
Eclipse plug-ins are based on OSGi bundles. OSGi is used to manage the plug-ins in an Eclipse application. A plug-in must contain a manifest file with valid OSGi headers for plug-in name and version. Extensions and extension points functionality added by Eclipse in addition to OSGi. To use extensions you must provide a plugin.xml file. PDE provides a full featured project and editor for creating and editing these files.
An Eclipse based product is a stand-alone program built with the Eclipse platform. A product may optionally be packaged and delivered as one or more features, which are simply groupings of plug-ins that are managed as a single entity by the Eclipse update mechanisms.
Products include all the code and plug-ins needed to run them. This includes a Java runtime environment (JRE) and the Eclipse platform code. The plug-in code, JRE, and Eclipse platform are typically installed with a product-specific installation program. Product providers are free to use any installation tool or program that is appropriate for their needs.
Once installed, the user launches the product and is presented with an Eclipse workbench configured specifically for the purpose supported by the product, such as web development, C++ program development, or any other purpose. The platform makes it easy to configure labels, about dialogs, graphics, and splash screens, so that the user has no concept of a platform workbench, but instead views the workbench as the main window of the product itself.
PDE provides a product configuration file and associated editor to make it easy to create products in the correct format.
Target Platform
The Target Platform refers to the plug-ins which your workspace will be built and run against. It describes the platform that you are developing for. When developing with PDE, the target platform is used to:
- Compile - Plug-ins in the workspace are built against the target platform so you do not have to have everything in your workspace
- Launch - When using PDE's launchers you can choose the set of plug-ins you want to launch. By default the Eclipse Application Launcher will start with all plug-ins in the target, but will use workspace plug-ins instead when available
- Calculate Dependencies - PDE assists you in finding the plug-ins your plug-ins was include/require to compile correctly by looking at what is available in the target platform
- State - An OSGi state is created for the target platform so it can be used by other tooling. The state can also be viewed in detail using the Target Platform State View
- Other Tools - Other PDE tools use the target platform to determine their options, such as the import wizards
Whereas the target platform refers to your currently active bundles, a Target Definition is a way of determining the plug-ins to add to the state. You can have multiple target definitions, but only one definition can be selected as the target platform.
The target platform and your target definitions are managed on the Target Platform Preference Page. This page lists all target definitions that PDE has access to and displays which definition is being used as your current target platform. Target definitions can be created and edited here using the Target Definition Content Wizard. To make for easier sharing among a development team, targets can also be created and edited in the workspace as xml files with the extension ".target". These files can be edited using the target definition editor and can be created using the New Target Definition Wizard.
By default PDE provides a default target platform which simply points to the plug-ins in your currently running Eclipse instance (often referred to as your host). For Eclipse plug-in developers this might be all you need. RCP developers must be more careful managing their target as adding dependencies increases the size and complexity of their application. When creating a new target definition for RCP, consider using the RCP template (available with or without source).
For up to the minute target troubleshooting help see the Target Definitions Wiki Page.
Update Site
Update Sites are used to organize and export features so they can be installed into Eclipse applications.
To create an update site you must develop a site.xml file and build the site. PDE provides an editor and project for creating sites. A site will contain one or more features organized into categories.
When the site is built, the included features (along with all plug-ins part of those features) will be exported into an installable form. The exported plug-ins and features will be put into two folders "plugins" and "features". Two other files, "content.xml" and "artifacts.xml" will also be generated and contain metadata for the exported files that make installing easier. These files, along with "site.xml", collectively form an Eclipse update site. To make the update site available to others you must make all these files available in a shared directory or web site.
PDE Build
Automated building an RCP application from a product definition file
PDE Build comes with infrastructure to build a complete RCP application from a product configuration file. Most of the setup necessary for such a build can be done through a few modifications to the template build.properties provided in PDE build. The following section focuses on setting up a simple product build assuming that all plug-ins and features (both to build and pre-built) referenced by the product file are already locally available on disk.
Basic setup
The first step in setting up a build is to create the directory in which the build will take place. This directory will be referred to as the build directory and will contain the plug-ins and features to build as well as all the generated artifacts. Next, copy your plug-ins and features respectively into "plugins" and "features" subdirectories. Your product configuration file is expected to be in one of these plugins/features.
The second step in setting up a build is to copy the template build.properties file from org.eclipse.pde.build/templates/headless-build to a new directory which will be the build configuration directory (also referred to as the configuration directory). Edit the copied build.properties file and set the following properties:
- product: the location of your product configuration file in the form "/<plugin or feature id>/path/to/.product"
- baseLocation: the location of an eclipse install containing all the pre-built features and plug-ins that your product requires in features/ and plugins/ subdirectories. The RCP delta pack (it is * available from the eclipse download page) is mandatory as it includes the org.eclipse.platform.launchers feature which contains the launchers and root files necessary for a product.
- buildDirectory: the directory the build will take place in. Set this to the full path of the build directory created previously.
- configs: list the configurations for which you want your product to be built. You can uncomment the configuration(s) provided (be careful of the line continuations).
- archivePrefix: the name of the directory of your product once installed on disk.
Overview of the directory structure
<buildDirectory>/ plugins/ pluginToBuildA pluginToBuildB myProduct.product ... features/ featureToBuild ... <buildConfiguration>/ build.properties <baseLocation> plugins/ org.eclipse.core.runtime org.eclipse.ui ... features/ org.eclipse.rcp org.eclipse.platform.launchers ...
Running the build
To run the build you will use the org.elipse.ant.core.antRunner application. When invoking eclipse with this application to perform a build you need to set two arguments on the command line:
- -buildfile </path/to/productBuild.xml>: This is the path to the productBuild.xml provided by pde build. It is located in the org.eclipse.pde.build/scripts/productBuild directory. This is the build file that drives the whole product build process.
- -Dbuilder=</path/to/configuration folder>: This is the path to the build configuration folder.
Run the antRunner application using the following command:
java -jar <eclipseInstall>/plugins/org.eclipse.equinox.launcher_<version>.jar -application org.eclipse.ant.core.antRunner -buildfile <<eclipseInstall>/plugins/org.eclipse.pde.build_<version>/scripts/productBuild/productBuild.xml> -Dbuilder=<path to the build configuration folder>
Advanced scenarios
Behind the scenes this setup will generate a feature containing the plugins or features specified in your product configuration file. This generated feature is then used to drive a normal feature based headless build. If you require more customization of the build, ie fetching from a repository, see the Advanced PDE Build topics for more information.


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It's the New American Holiday.Bruce Sterling takes the kids to the Temporary Autonomous Zone,where survival is a personal choice.
__ Thursday, August 29__
Stopped at the gas station for directions to the Burning Man Festival. Grizzled, portly Nevadan local growls: "If ya have to ask, you don't belong there!"
As if anybody was gonna drive all the way to Gerlach, Nevada (population 340), for some other reason.The gas station was packed with mobile homes and junker slackermobiles. The guy relented and gave us directions. Seems a multiple-pierced and tattooed lovely in a clingy peach taffeta costume had melted his heart.
Drove 16 miles. Then drove another 12 miles across the bottom of a very dead lake. Driving across the playa is like space travel: you point the front of the vehicle into emptiness and launch. Gaseous tails of flying white dust spurt up like jet exhaust. Cars and trucks leave huge wakes on the horizon, like white prairie fires. If the wind kicks up, the world becomes a twilight zone of milky haze. Driving fast in a whiteout dust fog is an excellent way to get killed.
We're in a 22-foot Ford recreational vehicle, in which I've brought the family to Burning Man: Nancy Sterling (wife, mom), Amy Sterling (9 years), and the littlest desert fox, Laura of Arabia, a hardened travel veteran at 4 months. We've never lived in an RV before. It's a mutant cross between an aircraft and a small chunk of suburbia. It's brand-new, but it shudders, moans, vibrates, rattles, squeaks, and emits foul generator exhaust.
Reached the camp, found a place to park, got out to walk around. Maybe 500 vehicles here already. People are setting up tents, parachutes, awnings, tiki torches, tribal flags. The lake bed is a Euclidean plane with zillions of dry fractal cracks. The parched Nevada mountains of the Black Rock Desert rise on three sides. Weary treeless hills full of sullen majesty.
__ Friday, August 30__
A guy got killed last night. He rear-ended a truck while zooming along the darkened playa on a blacked-out motorcycle.
The place feels like the afterlife. When you walk across it, you just drift over endless cracked whiteness, lifting your feet maybe a quarter inch from the surface. It's all mobile; it's all temporary. Twist the ignition key and drift with the wind.
Burning Man is an art gig by tradition. Over the longer term it's evolved into something else; maybe something like a physical version of the Internet. The art here is like fan art. It's very throwaway, very appropriative, very cut-and-paste. The camp is like a giant swap meet where no one sells stuff, but people trade postures, clip art, and attitude. People come here in clumps: performance people, drumming enthusiasts, site-specific sculptors, sailplane people, ravers, journalists, cops. I'm a journalist and a newbie, but even I can tell the pros from my fellow newbies. The veterans have brought their own pennants, bicycles, flashlights, and tiki torches, plus enough water for anything.
The alkali dust is like a fine and bitter talcum. It gets into everything, so why fight it? Just throw off your clothes. Keep maybe a straw hat, shades, and boots. Throwing off all your clothes is the cheapest, quickest way that was ever invented to cop an attitude. It's also a cool youth-culture solidarity move. Young people look great without clothes. Young people don't need 'em.
Vehicles have scattered all over the playa. It's as if a giant bowl of mixed nuts had dropped off a kitchen counter onto white linoleum. The parachute-covered Central Camp does duty as the broken bowl. All around it are cashews, peanuts, and sunflower seeds: dinky pup tents, some bigger pop tents, RVs, pickups, trailers. There's even an honest-to-goodness geodome erected by some ambitious guys who have brought a crane. Their towering construction crane arouses much envy, and they get to boast of having "the biggest tech on the playa."
The streets are vaporous formalities. They're premarked with tiny colored plastic flags: the flags get bent, they get stepped on, they even get run over. But once the* idea* of a street is established, the community standard holds.
You're not supposed to throw anything away on the playa. You're supposed to leave nothing at all. The idea of leaving no visible trace is a central part of the Burning Man zeitgeist, a performance-art process move. The organizers are very specifically eco-correct - maybe because they're so lighthearted about tolerating most anything else.
We're new here, and as a married couple with kids we are very adult and polite. So we dutifully follow orders, and we don't dump anything. It's a quick and brutal lesson in the gross inconvenience of modern convenience. Everything we own or want to get rid of becomes a burden: toilet paper, snack bags, beer cartons, dirty diapers, our unwashed clothes. Nancy and I take to wolfing down Amy's food so that we won't have to store it in malodorous twist-tie bags.
There's some good art here. When you see the good art - even though it is very temporary - it's like finding a pearl in a bag of salted peanuts. The Burning Man is good art. Flat on his back, he looks like a giant abandoned packing crate, but when he's catapulted into standing position, he becomes a striking neon symbol of pretty much everything that matters. You can sit on a hay bale at the foot of the Burning Man and the whole world passes by. It's like hanging out on the Venetian Rialto.
Had a long chat with a guy about Moscow. I'd never met this guy except through email, but he recognized me, and we immediately struck up a conversation. We talked about Russians and their literature for an hour, as we sat in a desert - bathing blue neon glow from the 40-foot Burning Man. We ruminated thoughtfully on the fate of Eastern Europe as people drove past on motorcycles that looked like aardvarks and bananas. Witchy pagan chicks stalked by in coats of body paint. Crypto-Arab hippies sauntered by arm in arm with bearded punks wearing devil horns. It felt very soothing and cosmopolitan.
The Stupa is also real art. It's constructed of books, mud, water, and wood. It's about 15 feet high. It's very majestic and spiritual. To the east there's a Forest of Meditation that is also real art. It's made of black rocks and twisted pieces of plumbing pipe, and it's about a mile across. People keep trying to camp inside that art. It's beautiful.
Had a few words with the justly legendary Larry Harvey today. Ten years ago, Larry went out and set fire to a big wooden statue on a beach. Kind of a private act of purgation and cleansing, by all accounts, but his idea caught on big time. Larry is a heavy hipster dude. He's beyond mere trendiness. Guys of his ilk can create social trends at will, out of straw, hot air, and attitude. Larry is an artist, but under these circumstances he looks just like you would expect the mayor of an impromptu city of 10,000 people to look. Larry looks real busy. He's wearing his trademark fedora, and he hasn't shaved, and his eyes are red-rimmed with dust. He's biting his lips a lot. Larry's puttering around on his battered motorcycle, putting out impromptu social fires: diverting ego trips and freak-outs, coordinating the uncoordinatable.
Larry appears to have a couple dozen city councillor running buddies who he can trust to mortar over the cracks. They all have this certain look, these tribal elder hippie-guru characters. Time has given them the faces they deserve. They all end up with this spacey Crowleyan smirk ... not seamy exactly, but some kind of terrible wisdom, like a cross between Gandalf and Nietzsche. It's truly a very interesting way to live, but you get to where you can smell it after a while. You don't want to clutch your wallet when you're around these guys, it's not like they're as degraded as, say, car salesmen or members of Congress. But when you're in their company you feel a distinct witch-doctor vibe. I kinda suspect that Larry Harvey could do interesting and terrible things to the soul of '90s America, if he really put his mind to it. And if '90s America had more soul for Larry and his friends to work with.
Burning Man is a standard hippie tribal thing, except for the highly nonstandard fact that it is not kitschy '60s nostalgia. This event is very '90s, very big, and very much alive. It's a Tim Leary, Wavy Gravy, Deadhead caravan, grab-the-mike-at-Woodstock kind of event. Feels lovely and enormously persuasive. Nonbureaucratic, participative, solidarity-driven, noncommercial, arty. With all those manifest virtues, you have to wonder why a setup like this can't seem to last any longer than a Labor Day weekend.
Maybe it's because* real* tribes aren't tattooed postmodern termite artists like the Burning Man people are. Actual, no-kidding tribes were tattooed hunter-gatherers, who lived in a world where nothing ever, ever changed. A world where witch doctors made all the important decisions.
There's another thing really different and novel about Burning Man. It's a hippie gig, but it's swarming with cops. The Nevada cops have been in from the get-go. There are plenty of concert-security type Danger Rangers, too. Security people are all over the place, and they could give two pins that people are running around naked, setting fires, and blowing things up. I think this proves that Temporary Autonomous Zones really can work in real life - as long as the cops help create them.
__ Saturday, the last day of August__
Fiends in human guise greeted the dawn by wailing for half an hour on didgeridoos. This should be a capital offense.
Woke up, had breakfast. Looked out my RV window and saw a guy sitting on a toilet. He was skidding by at about 45 mph in a massive trail of dust. He had his toilet mounted on a wooden sled, and he was being towed by a pickup. His pants were around his ankles, and he was reading a magazine as he skidded along. It was the magazine reading that made this truly a memorable gesture.
Left "town" for a while to fetch more water. Can't take risks. We've got a baby on board. Came across a spectacular highway casualty. Bunch of Nevada sheriffs and paramedics were pounding on the rib cage of a guy sprawled right in the middle of the highway. He was lying there in a sea of shattered glass amid his violently scattered possessions: a mattress, assorted camping gear. The cab of his little Toyota truck was crushed like a bug. I can't say for certain that this dead or dying kid was headed out to Burning Man, but a hell of a lot of the traffic stacked up behind him certainly was.
People think it's good that Burning Man is difficult and rather dangerous to reach. This keeps the gawking frat boys and the sodden alcoholics at bay. To get this far Out Here you've got to pay some dues and take some risks. Gotta live on the edge, at least a little. "Survival is a matter of personal choice," as the Burning Man official tabloid puts it. But when there are 10,000 people making risky choices, cold statistics dictate that some will surely croak.
Ran into Danny Hillis, the supercomputer designer, today. Hillis was standing in the coffee line. He's here with his wife and their three little kids. His two twin toddler sons are real chips off the block. They have a real engineer's mind-set. With absolute desolation around and nothing much to play with, they ingeniously began pelting each other with dust.
Not a lot of little kids in this burg. Scarcely any old people. With a babe in arms, you're an instant public attraction. Got two shots of tequila from a crew of friendly Australians merely for allowing a young woman to dandle my infant. My baby's wearing a red tie-dyed onesie for the sake of local color, and she's coming across like The Littlest Deadhead. I'm wearing a nuclear-power-plant worker's jumpsuit, shades, sandals, and a cowboy hat with a bandanna. Nancy and Amy have flowing tie-dyed seraglio robes with veils and canteens. We're passing for normal.
Visited the i-STORM trailer where the World Wide Web contingent is putting together the live Burning Man Web site,www.istorm.com/burningman/. I enjoy hanging with these happening GenX Web entrepreneurs. They're nice guys just fizzing with creativity. It's like meeting Walt Disney when he was still drawing on a tabletop in Kansas City, Missouri. Before Walt Disney became the scary, litigious, freeze-dried media titan. OK, maybe I shouldn't give Disney any lip. Danny Hillis works for Disney these days.
Walking around the playa with my family at night. This is the time to tour the site, because Burning Man is truly weird then. "Black Rock City" has no power system, so at night it's all lanterns and chugging generators and tiki torches and lots of chemglow. Colored strings of chemglow out in the desert, woven through the spokes of bicycles and mysteriously revolving. Looming figures in costume. Huge dramatic bowl of desert stars overhead. Fireworks and flying flares casting a lurid trench-warfare glow above the massive camp. Drum-pounding maniacs with guys dancing in the grip of hallucinogens, nerdy guys capering with out-of-it clumsiness, as if they had never danced in their lives.Daughter Amy starts grumbling and complaining. It dawns on us that she's getting scared. Something to do with the evil Helco pavilion with its saw-edged performance machines and the gruesome cutout movie stars from the LA Cacophony Society. Amy is a sensitive and imaginative child. She bursts out suddenly: "This is awful! It's like a LIVING NIGHTMARE!"
It is, too, which is pretty much why we jaded adults are really living it up. But Amy won't be comforted and has to go back to the RV with Mom. It's getting late. I hitch a ride on the Aggravator, a monstrous steam-punk contraption with a flamethrower and four sets of bicycle pedals.
I then sit on the Aggravator's iron tractor seat and watch an astounding presentation, over by the sinister temple towers of the City of Dis. A formal procession begins with honks, rattles, and electronic squeaks. Pagan hierophants in tall headdresses and silver lamé march in slow step, toting flaming standards of arcane device. Swarms of nude dancers, male and female, caper up in bizarre sword-and-sorcery bondage gear. The soundtrack switches to repeated, insane, bestial screaming. An awe-inspiring insect goddess - a hunchbacked bug on red stilts - comes towering and tipping and tottering into the firelight, like a mad Kafkaesque advent. It's like a cross between Vatican ceremony, Cirque du Soleil, and a necro-erotic cannibal mantis mating ritual. The performers seem ready to burst into a flagellant orgy at any instant, in front of a solid milling crowd of at least 3,000.
This sure isn't the sort of thing one sees every day. It's something that a desperately horny sci-fi fan might see on acid and cough syrup. Then the performers set fire to the set. The tall rebar towers, turned to instant chimneys, glow white-hot and vent livid five-story flames. I'm really enjoying this.
OK, so they're not professional exotic dancers. They're eager amateurs. They dance the way '50s B-movie starlets danced in some cheesy lost-race epic. "OK, Jim, Cindy, you guys are pagan babes at the palace orgy, so just go out there and lose it, get really lusty!" They caper and dance very lustily for more than an hour, and then they get pretty tired and out of breath, and they have to sit down. But it's a lot of fun watching these tattooed San Franciscans flinging the dour garments of repentance. It's sweet to watch them lose themselves in the moment.
After the towers buckle and collapse, the screaming and chanting Greek chorus takes a well-deserved rest. The dancers hug each other, all bright-eyed and happy, and the crowd dissipates into the desert.
Then a bunch of drummers wander in and take over by the smoldering bonfire. There are swarms of drummers here. Most can't beat a steady rhythm worth a dang. But we've got a cadre of guys who really can drum, accompanied by some crazy dancers who are not half bad, either. They go at it hot and heavy, booming-banging-boogying. The drummers are really savoring the joy of life. It's worth coming a long way to see this.
__ Sunday, September 1__
Our noses are parched and crusty. Our lips are chapped. Our lungs are lined with a fine layer of alkali dust. We haven't slept much. We decide to go out to the hot springs.
Fabulous place. It's got a geyser. Eerie maroon towers of hot mineral concretion. The water's hot enough to hard-boil eggs, but it flows out into a broad series of weedy muddy pools, so you can pick your temperature. There are about 200 hippies here, naked and covered with mud.
A nude woman covered with mud is an interesting sight, but mostly she looks like she's undergoing a spa treatment. But take some nude muscular young guy and armor him face-to-foot in black and gray sulfurous muck and he looks genuinely impressive, like a New Guinea head-hunting Mud Warrior. Hey, Nancy and I are with this. It works for us. We strip the dusty clothes from our middle-aged, married-couple carcasses and we cover ourselves with mud. The baby skips the mud bath, and my 9-year-old's not real thrilled at this prospect either, but Nancy and I are getting seriously hot, down, and slimy.
The sky is blue, and the water is poaching our desert-parched hides with deeply gratifying effect, and for the first time we really feel like we're on vacation.
A lot of air stuff today. Hot air balloon, paragliders, a skywriter plane. At night somebody constructs a fake constellation. It's a glowing mass like the Little Dipper, and it looks just like stars, except they're moving across the night sky without visible means of support. Faking the stars, cutting-and-pasting the desert sky - now that's a good trick. It's good art. I truly can't believe what I'm seeing.
Then night falls, and it's time to finally burn the Man. I've got Amy up on my shoulders videotaping this, in the midst of an enormous, boisterous, cheering crowd. A procession marches up, solemn, freakish, and deeply hilarious. Then they fire up the guy, and he explodes in sheets of colored fireworks and giant livid gouts of flames. This spectacle seriously lights my fourth-grader's circuits. "BURN HIM!" Amy is screaming, wriggling like an eel. It's without doubt the most exciting thing she's ever witnessed. "Look at him BURN! This is AMAZING! I can't BELIEVE IT! WOW!!!"
When the man's about to collapse from sheer conflagration, some brave and hefty folks grab a pair of dangling steel cables from the Burning Man's shoulders. They tug and yank. The giant wooden man goes into a weird spastic dance, pointy arms upraised and shedding massive showers of fire. A 40-foot-high wooden doll dancing in flames is a sight that really hits the 9-year-old demographic. My kid is in ecstasy, she's loudly swearing that she'll remember this for the rest of her life. I'm sure this is true.
Baby's asleep in mother's arms. It's OK. She can see it when she's older. We've got it all on tape.
__ Monday, September 2 __
Back to Reno. There are places in Reno that are seriously weird. There are lessons here. Las Vegas is a major family destination. Nevada casinos have become American family values now. It's considered just fine to go into one of these windowless scary gambling-malls, drink yourself silly, lose your ass at roulette, and then go ogle showgirls with breast implants. Republicans do this now. Working-class folks do it in polyester stretch pants. It's normal.
Meanwhile, if you want to get high and be a naked hippie, you're under suspicion of engaging in the moral equivalent of terrorism. You've got to haul out into the middle of some godforsaken desert and hope that not too many people find out about it.
It's all exactly backward. If you want to have a naked pagan art fair, you ought to have it in the padded comfort of a sealed, air-conditioned casino. It would be perfect for this kind of activity. If you want to divorce somebody or feed the gambling bug or lick your chops over paid nudity, then you ought to have to creep off to do that in some remote boondocks where the rest of us don't have to witness your gross behavior. I wonder how our culture got into this oxymoronic situation. It can't be good for us.
I went to Burning Man. I took my kids. It's not scary, it's not pagan, it's not devilish or satanic. There's no public orgies, nobody gets branded or hit with whips. Hell, it's less pagan than the Shriners. It's just big happy crowds of harmless arty people expressing themselves and breaking a few pointless shibboleths that only serve to ulcerate young people anyway. There ought to be Burning Man festivals held downtown once a year in every major city in America. It would be good for us. We need it. In fact, until we can just relax every once in a while and learn how to do this properly, we're probably never gonna get well.

subset: commoncrawl


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Weekend Cook and Tell Round Up: Holiday Food Gifting
Our last challenge for Weekend Cook and Tell was for all of you to share your favorite food gifting recipes. We called this Holiday Food Gifting. Visions of mochi, secret dipping sauce, and coquito danced through our heads. (we'd prefer our belles - SE holiday food gift trade?) Thank you for sharing. We hope this list finds you and your giftees well.
Fair warning: There was an above average submission of gorgeous gifts. Your eyes will be treated but your bellies may growl after viewing this post.
Grandmothers are smart creatures. zahavah's bribed her with chocolate-covered graham crackers in order to drink all of her milk. On second thought, maybe zahavah was the smart cookie here.
somaR made good friends this year with Ricotta Chocolate Dried Fruit and Nut Fudge. Easy to box and easy to transport to a friend's holiday party.
missmochi likes to get creative with her - well, mochi. "My super easy microwave mochi uses jello and fruit juice to make delicious mochi in 5 minutes! More traditionally are my purple sweet potato mochi, beni imo mochi, and my fresh strawberry mochi, ichigo daifuku are a little more time consuming but my favorites. Last year, I made a triple layered mochi that was Christmas colored!"
If you're looking for a gift to go with your favorite cocktail, meatballs&milkshakes recommends brandied maraschino cherries. Think of them as gifts to your glass.
Juliasalbum believes a lot of cookie baking is the way to go. You can choose between her more traditional almond shortbread cookie with Amaretto or try this gorgeous peach cookie with dulce de leche filling (made with natural coloring!).
To add a little spice to your holiday gifting, try KarmaFreeCooking coquito recipe. Coquito is the Puerto Rican version of eggnog and includes ginger, anise seeds, star anise and cinnamon. KarmaFreeCooking also notes the only way you'll know her version does not involve alcohol is, "because you'll not get drunk... because it still has a nice kick."
Hipsteaders homemade extracts make a perfect holiday gift. You can make large batches and then package them up in cute small bottles. Here are recipes for vanilla and almond.
Finally, sabrinasue enjoys filling lovely tall glass bottles with Vanilla Caramel Liqueur. This somehow seems fit for bottles you might have curated throughout the year.
Don't forget dhorst's SDS (Secret Dipping Sauce) which many of our community members plan to make and gift. An additional tip mentioned by zucchini is to affix labels to jar lids when canning. No sticky label to remove if reusing the jars for next year. (assuming you have nice friends who return jars.)
A big thank you to everyone for sharing their warm, brothy love for this week's Weekend Cook and Tell challenge. Be sure to head over to Talk and read about next week's challenge: A Hanukkah Feast
All products linked here have been independently selected by our editors. We may earn a commission on purchases, as described in our affiliate policy.


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Despised Washington D.C. Is Now Richer Than Silicon Valley
It's a proud day to be an American, as our nation's capital has overtaken San Jose as the country's wealthiest metropolitan area. Isn't this inspiring, to see the most hated city on Earth sucking up the remaining few dollars in America's cash pool by attracting more and more lawyers and fixers to do the hard work of ruining the rest of the country? Throw your beloved diamond-shaped federal office park of a capital a celebratory parade, you other, poorer people!
Washington, Bloomberg reports, "has swapped top spots with Silicon Valley, according to recent Census Bureau figures, with the typical household in the Washington metro area earning $84,523 last year. The national median income for 2010 was $50,046." Wait! There's a perfectly reasonable explanation for this. All of the growth is coming from the sort of productive, value-adding, innovative sectors that make this country great. For example:
Lobbyists play a prominent role in the Washington economy. In 2010 there were 12,964 registered lobbyists, with most working in or around the nation's capital, according to figures compiled by the Center for Responsive Politics, a Washington- based research group that tracks political spending. Spending on lobbying efforts reached a record $3.51 billion last year, up from $3.49 billion in 2009.
Apple pie, baseball games, fireworks, and multi-billion dollar lobbying booms: This is America. You gross poor-people cities want the big bucks, do you? Set up a national capital with in your hometown; oh wait you can't, suckers.
Also, one should note that Washington's wealth is not exactly broadly distributed!
[Image via AP]


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Payment for performance in the Family Health Programme: lessons from the UK Quality and Outcomes Framework
Pagamento para desempenho no Programa Saúde da Família: lições do Quality and Outcomes Framework da Inglaterra
Pago para desempeño en el Programa Salud de la Familia y lecciones del Quality and Outcomes Framework de Inglaterra
Matthew Harris
Imperial College London. London, United Kingdom
OBJECTIVE: Payment for performance financial incentive schemes reward doctors based on the quality and the outcomes of their treatment. In Brazil, the Ministry of Health is looking to scale up its use in public hospitals and some municipalities are developing payment for performance schemes even for the Family Health Programme. In this article the Quality and Outcomes Framework used in the UK since 2004 is discussed, as well as its experience to elaborate some important lessons that Brazilian municipalities should consider before embarking on payment for performance scheme in primary care settings.
Descriptors: Physicians, Primary Care. Family Health Program. Motivation. Reward. Quality Assurance, Health Care.
OBJETIVO: Esquemas de pagamento para desempenho recompensam o médico baseado na qualidade e no resultado do tratamento dos seus pacientes. O Ministério da Saúde brasileiro analisa seu uso em hospitais públicos e alguns municípios estão desenvolvendo estratégias de pagamento por desempenho para o Programa de Saúde da Família. No artigo discute-se o Quality and Outcomes Framework - esquema de pagamento para desempenho usado no Reino Unido desde 2004, bem como sua experiência para elaborar algumas lições importantes que os municípios brasileiros devem considerar antes de empreender o esquema de pagamento por desempenho na atenção primária.
Descritores: Médicos de Atenção Primária. Programa Saúde da Família. Motivação. Recompensa. Garantia da Qualidade dos Cuidados de Saúde.
Esquemas de pago para desempeño recompensan el médico basado en la calidad y en el resultado del tratamiento de sus pacientes. El Ministerio de la Salud brasileño analiza su uso en hospitales públicos y algunos municipios están desarrollando estrategias de pago por desempeño para el Programa de Salud de la Familia. En el artículo se discute el Quality and Outcomes Framework - esquema de pago para desempeño usada en el Reino Unido desde 2004, así como su experiencia para elaborar algunas lecciones importantes que los municipios brasileños deben considerar antes de emprender el esquema de pago por desempeño en la atención primaria.
Descriptores: Médicos de Atención Primaria. Programa de Salud Familiar. Motivación.Recompensa. Garantía de la Calidad de Atención de Salud.
Although there is much variation in its definition and approach, several developing country health systems have experimented with payment for performance (P4P) schemes.6 These are financial incentive schemes that reward doctors based on the quality and the outcomes of their treatment. The better the quality, the more they are paid.
The Brazilian Ministry of Health is looking to scale up its use for civil servants and in public hospitalsª and some municipalities are developing P4P schemes even for the Family Health Programme (e.g. Prefeitura Municipal do Belo Horizonte; Prefeitura Municipal do Rio de Janeiro). The recent 11th Congress for Family and Community Medicine had an entire panel discussion dedicated to the subject.b
This article aimed to discuss payment for performance, by drawing on the eight years of experience that the UK has had with their system of payment for the Quality and Outcomes Framework (QOF) performance. If P4P is to be used in the Family Health Programme, it would be worthwhile to learn from the pitfalls and challenges that have been experienced in the UK and potentially avoid replicating mistakes.
The payment of quality of care incentives to general practitioners (GPs) in the UK is one of the great revolutions in primary health care in the last 20 years. First implemented in 2004, GPs receive financial rewards on top of their salaries if they manage to reach certain targets in healthcare quality, process and outcome. There are 134 different targets that the GPs are paid to achieve in the QOF.c The targets cover clinical, organizational, patient experience and additional service domains (Table). Each target is allocated a number of points depending on how challenging it is and GP practices are rewarded up to 1,000 points each year for reaching the targets. Every point attained equates to a payment of £126.00 to the GP.
Selecting indicators is a complex and dynamic process that is the responsibility of four organizations in the UK QOF. The National Institute for Clinical Excellence (NICE) identifies whether reaching defined targets in clinical care quality could result in significant public health impact. The University of York calculates the cost-benefit of paying for doctors to reach the target. Two National Health Service (NHS) departments (the NHS Information Centre and NHS Evidence) consider whether systems are in place for GPs to collect data on progress towards the target and the implications, in terms of workload, in doing so.
For example, if the blood pressure of diabetic patients is well controlled, this can lead to better health outcomes, avoid hospitalizations, and complications.d,e One of the new diabetes targets in the QOF, replacing the DM12 indicator, is the indicator DM30 and is worth 8 points.f A GP should maintain the blood pressure in his/her diabetic patients at under 150/90. If the GP reaches the defined target of 71% i.e. 71% of the GP's diabetic patients have a record of successfully maintaining their blood pressure at less than this level, then the GP practice will receive £1,000.00 (8 points multiplied by £126.00).
The financial rewards are only for GP practices, not secondary care specialists, and so the indicators are chosen in areas that are sensitive to primary care services, i.e., where primary care has a direct and clear responsibility for the continuous care and management of the condition; in areas where there is evidence that good care at the primary care level results in positive and beneficial outcomes; and in areas where the disease is a public health priority. The UK has invested over £1billion in the QOF so far. GPs income has risen by 60% in the last eight years and 20% of GPs' salaries are directly derived from the financial payments made from the incentive scheme. GP performance, as identified through the QOF, is published annually and is publically accessible. This adds considerable pressure for GPs to perform to a high standard, reaching the set targets, because patients are able to choose which GP they are registered with in the UK.
The Impact of the QOF
Despite this investment in GP performance, there are divergent views as to whether the QOF has had any meaningful impact on public health.4,12 In part, this is because of limitations in research study design and the fact that the QOF was implemented throughout the country - there are no control settings.12 Nonetheless, the wide variation in quality of care by GP practices experienced prior to the implementation of the QOF has decreased across all QOF domains. This has disproportionately benefitted poorer areas and so by implication health inequalities have actually improved as a result of the QOF.5,12 The QOF led to overall improvements in clinical care quality specifically for asthma and diabetes in the first two years of its use.2 Conversely, these improvements levelled off once targets had been reached and there was a worsening of continuity of care measures.2 Despite the QOF, ethnic disparities still persist in the management of cardiovascular disease9 and it has had a minimal impact on hospitalizations.1 Improvements in some clinical outcomes, such as hypertension management, had been occurring even before the incentive scheme was introduce.10
Lessons from the QOF
Paying doctors extra for achieving a higher standard of care for their patients could be an interesting approach for the Family Health Programme as it might reduce the current variation in quality experienced across the country. However, there are important pitfalls and challenges in the experience of P4P in the UK that should be considered before implementing these schemes.
Developing the indicator set
Choosing a good indicator requires a trade off between several features: the scope of the indicator, the target to be reached, its value in terms of financial reward and when it will be retired or replaced. This process is a politico-institutional one in the QOF and whilst NICE, York University, NHS Information and NHS Evidence work hard to create fair yet relevant indicators, based on the best available evidence, professional lobbying groups influence which indicators get adopted and which do not. Care needs to be taken to ensure that there is consensus around indicator development. The legitimacy of P4P targets can be undermined if there is not sufficient buy-in from clinicians. Setting the target too high and the doctors will not get rewarded. Too low, and it will not discriminate between the high and low performers. None of the 134 targets are set at 100% and the GP will receive a financial reward for most of the indicators even if only 40% of the target is met.
There is an ethical question: should doctors be rewarded for providing high quality care for only some and not all of their patients? All indicators reach a plateau eventually: their ability to influence and motivate better standards of care levels off over time. It is necessary to consider when to retire some indicators and when to create new ones to keep the financial reward scheme relevant.
A choice has to be made between emphasizing process, outcome and impact indicators. Processes, e.g. measurement of HbA1c in diabetic patients, are easy to capture, however they do not automatically lead to desired outcomes. Outcomes, e.g. HbA1c levels below 7%, are of interest, however case mix needs to be taken into account for targets to be considered fair. Impact, e.g. number of hospitalizations due to diabetes, is of ultimate interest, however it is difficult to associate the activities of the Family Health Programme teams directly with these broader changes in health. Often a blend of all three might be required. Macinko et al7 (2007) have developed a validated primary care evaluation tool for the Family Health Programme that could be a useful starting point for the standardisation of performance monitoring across different Family Health Programme teams.
Exception reporting
If a GP has been unable to meet a target, it might not have been from lack of effort or poor performance. The QOF has some flexibility in this regard called 'Exception Reporting'. GPs are allowed to exclude patients ('exceptions') from the performance target when it is appropriate to do so but they can only do this if the patient fulfils one or more of the following criteria:
The indicator is not appropriate in the patient's case
Appropriate services are not available
The patient is already on the maximum tolerated or permitted dosage of a treatment
The patient has an allergy to the medication
The patient has a co-morbidity of greater severityThe patient refuses treatment
There are considerable differences in Exception Reporting rates between different GP practices and in some municipalities, there are GP practices that Exception Report several times more patients than other GP practices.11,g Should these practices be rewarded in the same way as the other practices? The GP practice, the patient register and even patients' notes are subject to annual review. However, this is not a particularly well audited or enforced area and the system is susceptible to fraudulent behaviour. In the Family Health Programme, therefore, P4P schemes should allow some flexibility whilst at the same time ensure proper safeguards against fraud.
The local prevalence of a disease is not considered in the QOF and GPs working in low socioeconomic areas become disadvantaged relative to colleagues in wealthier areas. In areas that have a very high prevalence of a particular disease, reaching the target for an indicator in that disease area will be more challenging and require more resources, time and effort by the doctor than in areas that have a very low prevalence. The incentive payment per patient becomes less than for clinicians in wealthier areas. Some GPs have argued for a review of the payment formula so that health inequalities are not worsened. In the Family Health Programme, therefore, P4P schemes should take into account local epidemiology and provide a weighted reward for performance.
Team working and changing roles
The emphasis on reaching targets has generated a target culture which is inappropriate in primary care. Primary care cannot be easily broken down into small, measurable parts and is complex, messy and dynamic. Not everything that can be measured is of value, and that which cannot be measured may, nonetheless, be of high value. QOF has changed attitudes within GP practices; GPs treat patients more as a collection of measurable indicators than as an individual.3 Patients are called back to the GP practice on multiple occasions so that procedures, examinations and tests can be carried out, the sole purpose of which is to fulfil and reach desired QOF targets. In the Family Health Programme, P4P schemes should enhance not detract from good quality primary care, and doctors must not lose sight of the patient within this process.
Reward structures
The QOF uses financial payments linked to performance measures to reward GPs and the payments are directed towards the GP practice at the end of the financial year. In the UK, GPs are independent contractors to the State, and although the payment goes to the GP practice as a whole, the GP who owns that practice can decide how the rewards should be best divided and allocated; it bolsters salaries, in particular for the GP. However, primary care performance is stochastic, it is team-based - many professionals are involved and it is difficult to determine directly whose effort it was that led to a positive outcome. Without careful attention, P4P schemes can cause dissention and attrition between health professionals of different disciplines. Rewards for the team as a whole would be a better incentive structure.
Furthermore, financial rewards like the QOF attends to one of the very lowest of Maslow's hierarchy of needs and motivation.8 There are many other rewards that can be considered to motivate health professionals other than financial ones. For example, building reputation, training, attending conferences, supporting self-actualization, career promotion, and space to innovate and be creative within the workplace. These are likely to be more effective motivators of good performance in health professionals than simply paying them more. P4P schemes should be creative in the use of different types of incentives in the Family Health Programme and consider rewarding all health professionals, not just the doctors.
P4P systems can be useful to bring about an improvement in quality of care and health outcomes in some areas sensitive to primary care activities. However, they are very expensive to develop and maintain, requiring complex information technology systems, and can distort the priorities of healthcare professionals. Financial incentives exist in the Brazilian Unified Health Care System (Sistema Único de Saúde - SUS) but these are for municipalities to create Family Health Programme teams, rather than to improve their performance. The growing interest in P4P schemes in the Family Health Programme is complicated by the relatively weak performance monitoring culture at municipal and state levelsh and there are few systematic attempts to analyse routine data sets e.g. (Sistema de Informação da Atenção Básica). Macinko et al7 (2007:174) noted that a major challenge for the Family Health Programme will be to 'develop and use systems to monitor and improve the quality of care delivered in order to maximize the potential health gains of this innovative approach to integrated primary care delivery'.
Based on the experiences of the QOF in the UK, there are important principles that Brazilian municipalities should consider before embarking on a P4P scheme:
Is there consensus around the indicator set?
Is there an evidence base for the indicator?
Are the targets reasonable and an ethical use of resources?
Can indicator performance be evaluated and can they be retired and renewed as necessary?
Is the local context and case mix being taken into account in the measurement of doctor performance?
Can performance data be independently verified and audited on a regular basis?
Is the P4P having a negative impact on team roles, the doctor-patient relationship and the patient experience?
Is the reward and incentive structure the most appropriate one for the professionals in the Family Health Programme?
The growing interest in P4P schemes in Brazil should be an opportunity to develop experimental studies so that the impact and value of the incentives can be properly evaluated.
To Dr Luis Pisco of Universidade de Lisboa (Portugal) and to Dr Juliana de Santos of Belo Horizonte Municipal Health Secretariat (Brazil) for comments on an earlier draft.
1. Bottle A, Gnani S, Saxena S, Aylin P, Mainous 3rd AG, Majeed A. Association between quality of primary care and hospitalization for coronary heart disease in England: national cross-sectional study. J Gen Intern Med. 2008;23(2):135-41. DOI:10.1007/s11606-007-0390-2
2. Brazilian Court of Audit. Evaluation of the Family Health Programme. Brasilia; 2003.
3. Campbell SM, Reeves D, Kontopantelis E, Sibbald B, Roland M. Effects of Pay for Performance on the Quality of Primary Care in England. N Engl J Med. 2009;361:368-78. DOI:10.1056/NEJMsa0807651
4. Checkland K, Harrison S. The impact of the QOF on practice organization and service delivery. In: Gillam S, Siriwardena AN, editors. The quality and outcomes framework: transforming general practice. Oxford: Radcliffe; 2011. p.93-111.
5. Dixon A, Khachatryan A, Boyce T. The Public Health Impact. In: Gillam S, Siriwardena AN, editors. The quality and outcomes framework: transforming general practice. Oxford: Radcliffe; 2011. p.70-82.
6. Doran T, Fullwood C, Kontopantelis E, Reeves D. Effect of financial incentives on inequalities in the delivery of primary clinical care in England: analysis of clinical activity indicators for the quality and outcomes framework. Lancet. 2008;372(9640):728-3. DOI:10.1016/S0140-6736(08)61123-X
7. Eldridge C, Palmer N. Performance-based payment: some reflections on the discourse, evidence and unanswered questions. Health Policy Plan. 2009;24(3):160-6. DOI:10.1093/heapol/czp002
8. Macinko J, Almeida C, Sa PK. A rapid assessment methodology for the evaluation of primary care organization and performance in Brazil. Health Policy Plan. 2007;22(3):167-77. DOI:10.1093/heapol/czm008
9. Maslow AH. A theory of human motivation. Psychol Rev. 1943;50(4):370-96. DOI:10.1037/h0054346
10. Millett C, Gray J, Bottle A, Majeed A. Ethnic disparities in blood pressure management in patients with hypertension after the introduction of pay for performance. Ann Fam Med. 2008;6(6):490-6. DOI:10.1370/afm.907
11. Serumaga B, Ross-Degnan D, Avery AJ, Elliott RA, Majumdar SR, Zhang F, et al. Effect of pay for performance on the management and outcomes of hypertension in the United Kingdom: interrupted time series study. BMJ. 2011;342:d108. DOI:10.1136/bmj.d108
12. Sigfrid L, Turner C, Crook D, Ray S. Using the UK primary care Quality and Outcomes Framework to audit health care equity: preliminary data on diabetes management. J Public Health. 2006;28(3):221-5. DOI: 10.1093/pubmed/fdl028
13. Steel N, Willems S. Learning from the QOF: a review of existing research. In: Gillam S, Siriwardena AN, editors. The Quality and outcomes framework: transforming general practice. Oxford: Radclifee; 2011. p.31-70.
Matthew Harris
Imperial College London
Department of Primary Care and Public Health
St Dunstans Road
W6 8RP London, UK
E-mail: email@example.com
Received: 8/12/2011
Approved: 12/13/2011
This article is based on a presentation given at the 11th National Congress for Family and Community Medicine, June 2011, Centro de Convenções Ulysses Guimarães, Brasilia.
The author declares no conflicts of interests.
a Ministério da Saúde (BR). Portaria no1.537, de 4 de Julho 2011. Altera a Portaria no 3.627/GM/MS, de 19 de novembro de 2010, que fixa os critérios e procedimentos específicos de avaliação de desempenho individual e institucional para efeito de pagamento da Gratificação de Desempenho da Carreira do Plano Geral de Cargos do Poder Executivo (GDPGPE), da Gratificação de Desempenho da Previdência, da Saúde e do Trabalho (GDPST) e da Gratificação de Desempenho de Pesquisa e Investigação Biomédica em Saúde Pública (GDPIB), devida aos servidores do quadro de pessoal do Ministério da Saúde pertencentes ao Plano Geral de Cargos do Poder Executivo,à Carreira da Previdência, da Saúde e do Trabalho e ao Plano de Carreiras e Cargos de Pesquisa e Investigação Biomédica em Saúde Pública, respectivamente. Diario Oficial Uniao. 05 jul 2001;Seção1:37.
b Anais do 11º Congresso Nacional de Medicina da Família e Comunidade; 2011; Brasília; BR, Brasília: Sociedade Brasileira de Medicina da Família e Comunidade; 2011.
c National Health Service (UK). Information Centre. Quality and Outcomes Framework Achievement Data 2009/10. London; 2010[cited 2011 Jul 12]. Available from: http://www.ic.nhs.uk/webfiles/QOF/2009-10/QOF_Achievement_Prevalence_Bulletin_2009-10_v1.0.pdf
d National Collaborating Centre for Chronic Conditions. Type 2 diabetes: national clinical guideline for management in primary and secondary care (update). London: Royal College of Physicians; 2008[cited 2011 Jul 12]. Available from: http://www.nice.org.uk/nicemedia/live/11983/40803/40803.pdf
e Scottish Intercollegiate Guidelines Network. Management of diabetes. Edinburgh; 2010[cited 2011 Jul 12]. Available from: http://www.sign.ac.uk/guidelines/fulltext/116/index.html
f National Health Service (UK). Quality and Outcomes Framework guidance for GMS contract 2011/12: Delivering investment in general practice. London; 2011[cited 2011 Jul 12]. Available from: http://www.nhsemployers.org/SiteCollectionDocuments/ QOFguidanceGMScontract_2011_12_FL%2013042011.pdf
g National Health Service (UK). Information Centre. Quality and Outcomes Framework Exceptions Data 2009/10. London; 2010[cited 2011 Jul 12]. Available from: http://www.ic.nhs.uk/webfiles/QOF/2009-10/Exception/QOF_Exceptions_Bulletin_2009-10_v1.0.pdf
h Brazilian Court of Audit. Evaluation of the Family Health Programme. Brasilia; 2003.


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This article provides a brief overview of the benefits of and differences between English as a Second Language (ESL) programs and Intensive English Programs (IEPs).
This article outlines the different types of US institutions and a few types to choose the best type for you.
This article outlines some of the United States' most broad and common social norms and gives tips for interacting with them.
Learn more about the field of business administration, management, and operations in the U.S.
To master the TOEFL, one must practice and prepare for it over time. The following article provides advice for practicing and preparing for the TOEFL.
Copyright © 1995-2017 EducationDynamics, LLC.


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Call 800.820.4722
Stock #: GPPCB2050311
These 5" x 3" x 11.5" Crimp Bottom Cello Bags have an excellent barrier of protection from moisture, gas, and aroma. They are great for presenting and containing snacks such as candy, dried goods, or potpourri. Their 3 inch side gusset allows them to be versatile and well-formed. The secure crimped bottom creates an airtight seal and provides durability for heavier products. The clear cello bags are constructed of 1.2 Coex BOPP (co-extrusion biaxially oriented polypropylene) material, which gives them a glossy shine and extreme clarity. These treat bags can be sealed with a twist tie, heat sealer, or bag tape; they are packed 1000 per case.


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By RICH FOLEY
Back when I was in second grade, my teacher used to brag about how one of her ancestors came to America on the Mayflower. I'm sure I heard her story at least a dozen times. Too bad she's not still with us. I now have a story or two of my own that might shut her up, or maybe even send her running for cover.
My sister has been working on our genealogy the past few years and finally came up with a shocker. She went back ten generations, finding Thomas and Martha Foley (who had a son named Richard). It's Martha's roots that none of us were expecting.
Martha's mother was Keziah Arroyah, a Patawomeck (or Potomac) Indian. Keziah's father was Chief Wahanganoche, her grandfather Japasaw. Japasaw's brother was Chief Powhatan, who was father of Pocahontas.
Who hasn't heard the tale of Pocahontas saving the life of John Smith? The story may or may not be true, but when you're talking famous Native Americans of the 17th century, that's about as good as it gets.
I think that makes me Pocahontas's great-great-great-great-great-great-great-great-great-great-great-great nephew. Or is it cousin? I'll have to look into that, I never was any good at figuring out family relationships.
Either way, I think that story trumps my old teacher's Mayflower anecdote. My ancestors were here for hundreds, if not thousands of years before hers. And, after doing some online research, I discovered that other descendants still live in Virginia.
Living descendants of the Patawomeck tribe reorganized a decade or so ago, and according to the article I read, were asking for official recognition from the state of Virginia. Among those pressing the case were current chief Robert "Two Eagles" Green and entertainer Wayne Newton, another tribal member.
That's one of the interesting things about genealogy—you never know who you might end up related to. I found a list of famous descendants of Pocahontas and along with several "famous" people I never heard of, there were a few I wish I'd known about earlier.
One was Edith Wilson, second wife of President Woodrow Wilson. Some historians credit her with being our first woman president, claiming that she pretty much ran the country for an extended period after her husband's stroke.
That happened 40 years before I was born, but also on the list was Nancy Reagan, who I could have asked for a White House tour if I'd known we were related during the Reagan administration. At least it's not too late to hit up Wayne Newton for a tour of Las Vegas.
After discovering my connection to Pocahontas, it dawned on me why I was always wanting to visit the Illinois town of the same name whenever I made a trip to Missouri. Situated about 40 miles northeast of St. Louis, it made a convenient final stop before taking on the big city traffic. Now I've got another connection.
I suppose it's time to start thinking about an Indian name. "Two Eagles" and "Dances with Wolves" are already taken, unfortunately. Those under consideration include "Writes Weird Columns," "Collects Snuggle Bears" and the early favorite, "One Brick Shy."
After I get the name thing settled, I'm thinking I should follow the lead of many other Native Americans and start my own casino. I'm pretty sure there isn't a big enough parcel of land in the Fayette area for my needs, so I'm going to have to approach the State of Ohio with another idea.
How about putting a riverboat casino on Harrison Lake? To me, the park seems under-utilized during the week and a casino should help to draw a crowd as well as provide employment in the Fayette area. Since I can now prove Native American ancestry, can anyone stop me?
The biggest problem might be finding a riverboat with a small enough draft to ply the placid waters of Harrison Lake without hitting the bottom. That, and the ability to turn on a dime. The captain will have to be skilled at making a bootleg turn.
Once the riverboat problem is solved, all I have to do is call Wayne Newton, whom I'm sure will help a fellow Patawomeck with the casino details. I'll even let him perform in the showroom if he wants.
For the grand opening, I'm going to invite my old favorite Neil Young to play. After all, he sang a song about Pocahontas on his "Rust Never Sleeps" album. I'm sure he'd be willing to help one of her relatives.
All these plans sound like fun, don't they? Wherever she is today, I'd bet my second grade teacher is jealous.


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About usEstablished in 1997, GTS sa is a specialized company in Furniture Manufacturing and in Trade Business of a variety of products.Business Type: Manufacturer, Trading Company and DistributorNumber of Employees: 285 Year Established: 1997 Address B.P. 2283, Avenue de l
FurnitureOffice, House, Garden, Hospital, School, MotorsDealer of automobiles and providing after sale services. Supply, installation, and service of generators from 1 to 1000 kVA. Supply, installation, and service of air conditioners
Security Supply, installation and maintenance of fire-fighting products Decoration
1. office / showroom / production : 6500 m
Copyright 2007 GTS General Trading Services Bujumbura Burundi TEL. 22244747 - 22244746 - 22213921I


text: First, scroll down to the tote color selection & select your color. Then, click "Style" and select your monogram style. Next, scroll up and click the icon at the top right of the editor window. Add your initials and select your thread color. Once done, click the X at the top right and scroll down and click "Add to tray".


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Airline brings Cowtown to Mouse town on inaugural flight today
CALGARY, Alberta. June 13, 2011. WestJet today launches new, non-stop service between Calgary and Orange County-Anaheim, California. The inaugural flight departs Calgary International Airport at 9:30 a.m. MT today.
"We're so excited to introduce our guests to Orange County," said Hugh Dunleavy, WestJet Executive Vice-President, Strategy and Planning. "From the magnificent beaches to the great shopping attractions, this destination really does offer something for everyone. As Canada's only airline providing non-stop service to Orange County, we're able to offer WestJet guests quick access to Disneyland and we're thrilled to bring guests closer to the magic of Disney."
WestJet will offer daily service between Calgary and Orange County. The full schedule details of WestJet's new service effective June 13, 2011, are as follows.
Calgary – Orange County (daily service)
From Calgary (WS 1542)
9:30 a.m.
11:49 a.m.
From Orange County (WS1543)
12:30 p.m.
4:35 p.m.
"Canadian families are making lifelong memories at Disneyland," said Marlie Morrison, Managing Director of Sales and Marketing, Disney Parks & Resorts Canada. "WestJet's new non-stop service from Calgary to Orange County makes it easier and more convenient than ever before."
"We are thrilled to welcome WestJet's non-stop service to Orange County to the list of many non-stop destinations that YYC serves," said Stephan Poirier, Vice President and Chief Commercial Officer of The Calgary Airport Authority. "The direct link will serve as a popular destination for people of all ages looking for a quick and easy way to get to the happiest place on earth."
One-way fares, available in both directions on non-stop flights only, are available from $129 plus applicable taxes, fees and surcharges. Fares are available by calling WestJet's Sales Super Centre at 1-888-WESTJET (937-8538), contacting your preferred travel agent or by visiting westjet.com.
WestJet Vacations offers customized vacation packages for most of WestJet's scheduled destinations, including packages to Orange County starting at $489, plus applicable taxes, fees and surcharges, for air and four nights accommodation. For more information, call one of our WestJet Vacations experience specialists at 1-877-737-7001, contact your preferred travel agent or visit westjetvacations.com.
About WestJet
WestJet is Canada's favourite airline, offering scheduled service throughout its 70-city North American and Caribbean network. Inducted into Canada's Most Admired Corporate Cultures Hall of Fame and named one of Canada's best employers, WestJet pioneered low-cost flying in Canada. Named a J.D. Power 2011 Customer Service Champion, WestJet offers increased legroom, leather seats and live seatback television provided by Bell TV on its modern fleet of 96 Boeing Next-Generation 737 aircraft. With future confirmed deliveries for an additional 39 aircraft through 2018, WestJet strives to be one of the five most successful international airlines in the world.
About WestJet Vacations
Launched in 2006, WestJet Vacations provides guests with a wide selection of vacation packages to popular vacation destinations in North America, Mexico and the Caribbean. Leveraging WestJet's friendly employees, extensive network and solid value proposition, WestJet Vacations offers guests a fun, friendly and caring vacation experience.
Connect with WestJet on Facebook at www.facebook.com/westjet
Follow WestJet on Twitter at www.twitter.com/westjet
Subscribe to WestJet on YouTube at www.youtube.com/westjet
Media contact:
Robert Palmer, Media Relations, telephone: 1-888-WJ-4-NEWS (1-888-954-6397), email: firstname.lastname@example.com.
© Calgary Airport Authority - All rights reserved


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Where to Bring Tourists in Prospect Heights
The Botanical Gardens. The Brooklyn Museum. Hell, even the Barclays Center. There are any number of reasons a New York tourist might end up in Prospect Heights, my old home and my favorite neighborhood in Brooklyn.
A stroll around the Heights is as pleasant as can be—the tree-lined streets of brownstones, the magnificent landmarks and Prospect Park at its doorstep. It's a mighty nice place to live, too, with a blend of families that've lived in the area for generations and newer transplants who've fallen in love. And that's reflected in the neighborhood's restaurant makeup, too: some classics, some impressive newcomers.
Not the "Tom's Diner" of Suzanne Vega's song and Seinfeld fame; this is Tom's Restaurant, a charmingly quirky neighborhood landmark that dates back to 1936. Its clientele, unlike that of most Vanderbilt Avenue establishments, is a genuine cross-section of the neighborhood—cops, after-church families, skinny dudes in Fedoras all settle in for pancakes. Are said pancakes the best in town? Perhaps not, but Tom's cheery interior and old-world diner charm are the real draw here (as are the gentle prices).
As an alternative on weekends, consider 606 R&D for brunch—also somewhat homey, though in a sleek 21st century sort of way, with a fabulous bacon-cheddar breakfast sandwich and fresh mini-doughnuts straight from their doughnut robot (!).
Let's assume you've walked off that French toast or bag of doughnuts, perhaps around Grand Army Plaza or into Prospect Park. Ready to get out of the cold? Walk straight to ramen shop Chuko, open at noon every day of the week. While the popular shop crowds up at night, it's easy to walk straight in at lunch, the sooner to warm your face over a steaming bowl of ramen. Don't miss their crispy brussels sprouts fish sauce, either.
Happy Hour
Wow, do I miss The Vanderbilt. It's the sort of neighborhood restaurant perfect for any occasion: classy enough for a holiday brunch with parents, affordable enough for weekly brunch with hung-over friends, open late enough for a midnight cocktail, spacious enough to get a seat.
But I really miss their happy hour, which brings all beers down $2, gets you a "Bartender's Choice" cocktail for $6 and selected wines for $5. Better still are the snacks, which include some of my favorite Vanderbilt dishes: sprouts with Sriracha for $4, duck fat Marcona almonds for $4, pub cheese for $6. It's the perfect way to kill those in-between hours before dinner.
It's best to set aside a few hours for The Islands, a hole-in-the-wall Jamaican spot running on island time. I love taking visitors here, not least for the element of surprise: walk in and you'll see two ladies cooking behind the counter, and hardly enough room for two customers to stand—but climb up the ladder, too steep to fairly be called a staircase, and you'll emerge into a low-ceilinged attic with several tables crowded in. Order your jerk chicken or Jamaican shepherd's pie downstairs, $12-ish plates that could feed three, and it'll (eventually) be handed up to you. Best yet? It's BYO—so keep yourselves contented with a six-pack of Red Stripe until your oxtail shows up.
If cheap Jamaican food in a cramped attic isn't quite your thing (which, psh), may I suggest Franny's? This pizzeria recently relocated a few blocks down Flatbush, but its modern Neapolitan pies are enduringly impressive.
After Dinner
Drinks, or dessert? Perhaps both. When I'm in the vicinity of Ample Hills Creamery, it's nearly impossible to resist. I love their creative, whimsical flavors, which remind us that ice cream is supposed to be fun—just try not to smile after a scoop of the Salted Crack Caramel, studded with bits of their unholy chocolate-butter-Saltine creation.
Come to think of it, I usually need a drink after Ample Hills. So I'd stroll over to classy cocktail den Tooker Alley or Weather Up for a nightcap—well-deserved after a day of neighborhood adventuring.
Still hungry? Follow SE:NY on Twitter and Facebook.
All products linked here have been independently selected by our editors. We may earn a commission on purchases, as described in our affiliate policy.


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If you decide to use, then it is very important to know the facts!
CBD vs THC: What is the difference? Cannabis consumers have long prized potency (a high THC content) as one of the main factors that makes a particular strain more desirable. Though traditional demand for THC has caused an oversaturation of high-potency products, many consumers are starting to prefer less intense products that are lower inRead More
The most researched cannabinoid is delta-9-tetrahydrocannabinol (THC). THC is responsible for the way your brain and body respond to cannabis, including the high and intoxication. THC has some therapeutic effects but it also has harmful effects. Harmful effects may be greater when the strength of THC is higher. The potency (concentration or strength) of THCRead More


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We also provide Gunsmithing for Vintage
Double Shotguns, Handmade Decoys made of Cork
and Wood, Photo Galleries of Upland Game
Birds,Waterfowl, Photos from Friends, and of our
Beautiful Colorado Scenery. There are pages on the
History of Labrador Retrievers, and on Our History
of Breeding Quality, Dual Purpose Labs. You will
find Puppies on our Litters Page, Labradors that we
currently own, and other information about our Labs
on Our Dogs Page. Please take the time to Sign our
Guest book Before you leave.


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Detailed needlework that's durable and withstands repeat washing. High-quality look and feel.
Decoration Care Instructions: Do not iron on decorated areas.
Please review item for specific product care instructions.
Keep your head well covered during cooler weather in our cap that has a 3-inch folding cuff for easy embroidery. Fabric: 100% acrylic. CARE INSTRUCTIONS: Hand wash color with like colors. Only non-chlorine bleach when needed. Dry Flat, do not iron.
One Size Fits Most.


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Looks like the folks at iFixit have already torn apart Apple's new Mac Mini right down to its pretty little ports. Oh, what lovely gadget gore porn!
According to iFixit, these are the highlights of the teardown:
* Departing from previous generations, the Mini's unibody top enclosure is machined from a single block of aluminum.
* With a simple counter-clockwise twist, we were able to gain access into the Mini's internals. Gone are the days of the putty knife. You will be missed, old friend!
* Removing the RAM is very simple this time around, requiring only the simple prying of two clips.
* The fan doesn't have too much work to do, since the new Mac Mini is the most energy-efficient desktop, running on less than 10 watts at idle!
* There are two blind holes in the case of the Mini that are meant for the ends of Apple's custom U-shaped logic board removal tool. We just used two Torx screwdrivers. We call them the "Mac Mini logic board removal tool."
* In keeping with its space saving design, the fins directing air toward the vent hole are slanted to allow for better fan placement.
* The new Mini's power supply churns out a minuscule 7 Amps at 12V. Compare that to the 25.8 Amps at 12V cranked out by the iMac Intel 27", and you can understand how they fit the power supply inside the Mini.
* The Mini's 3/8" woofer dome won't be popping ear drums anytime soon.
* Apple had to get creative with the antenna placement because they switched to unibody construction for this Mac Mini.
For more pictures and details, check out iFixit's complete teardown. [iFixit]