text:
Unnamed Martial Arts Harem Comedy Pitch
In my defense, I was BORED .
Goal: A humorous deconstruction of the Harem Genre and Martial Arts genres in manga. A Battle Harem with young ladies skilled in martial arts styles from all over the world is a given. The deconstructive element is that the harem has not one, but two male leads, who get roughly equal screen time and actually end up competing over the harem's attention. Each one is just enough of a Genre Savvy nerd to realize that they're in a harem story, and each one feels they are better suited to be the protagonist (one feels this way because he's an aggressive pervert, and the other feels this way because the alternative is leaving the women to an aggressive pervert).
I'd like to make the plot arcs more Character Development-driven than anything. Will aim for slightly more realism than your average martial arts manga setting, but you can't deny the Rule of Cool. I'd like to avoid "tiers" of power and Can't Catch Up; the only martial artists that will be portrayed as way beyond anyone else's level are over 60 years old and have been training for over twice as long as any of the main characters have been alive. I'd like to subvert and double subvert the Sorting Algorithm of Evil if at all possible.
Main Characters
The Guys
The Yang Protagonist
Fighting Style: Based primarily on Karate. Incorporates other styles from the characters he trains most with.
Tropes that apply:
- Chivalrous Pervert - for a loose definition of chivalry. Note: never scores.
- The Determinator
- Fearless Fool
- Foil - to the Yin protagonist. Practices a more aggressive "hard" style. He's got relatively more fight scenes and important development as a martial artist. He's loud, overconfident, and risks injuring himself with vigorous and foolhardy training. Initially, too forward around women.
- Glory Seeker - at first, eventually matures out of caring about reputation.
- Harem Seeker - Ironically, he is viewed more affectionately by the female cast the more he grows out of this behaviour.
- Heroic Resolve
- Hot-Blooded
- Idiot Hero
- Lovable Sex Maniac - Note: never scores. Neither of the protagonists do, actually.
- My Kung-Fu Is Stronger Than Yours
- Red Oni, Blue Oni - obviously the Red one.
- Spirited Competitor
- To Be a Master - His initial motivation; evolves into something more nuanced.
- Training from Hell - Subverted and parodied. He watches too much anime and always assumes at first that this is the route to true power, so he'll invent some outlandish and nigh-suicidal training regime that won't do much more than injure him at best. The teacher characters in the series have to spend a lot of time beating into him the notion that diligent, disciplined, and intelligent training is the key to development. The Aesop for him is that there are no shortcuts.
- What the Fu Are You Doing? - see Training from Hell above.
- Wouldn't Hit a Girl - played straight at first, eventually subverted after the various harem members spend a training arc or two beating the sexism out of this guy.
The Yin Protagonist
Fighting Style: Based primarily on Aikido. Incorporates other styles from the characters he trains most with.
Tropes that apply:
- Accidental Pervert - the Running Gag is that he tries to police the Yang Protagonist's behaviour, attempting to stop him from peeking on the baths and whatnot. He's about as successful at this as Lloyd Irving, to similar results.
- Apologizes a Lot - he may appear as an Expy of Keitarou Urashima at first. Eventually gets over this he develops confidence and discipline.
- Brilliant, but Lazy - while the Yang Protagonist's discipline problems lie elsewhere (self-preservation, not getting into idle fights, listening to his teachers), the Yin Protagonist has a motivation problem getting himself to practice regularly. His Character Development arc involves rediscovering his love for martial arts and how he can enjoy practice for its own sake.
- Butt-Monkey - See Accidental Pervert and Apologizes a Lot above.
- Dogged Nice Guy - but, like his fellow male lead, never scores.
- Foil - to the Yang Protagonist. Practices a less aggressive "soft" style. He's got relatively more romantic scenes and important development in his relationships. He's quiet, submissive, and occasionally becomes rusty when he doesn't practice enough. Initially, insecure around women.
- Headphones Equal Isolation - he is introverted and really likes listening to music. Gets distracted easily during training when he starts to play songs in his head. Over time, he develops attention and discipline, and while he never becomes extroverted he loses his nervousness in social situations. This transformation is reflected by the headphones appearing less on his head and more around his neck. Late in the series, a resurgence of this trope would indicate a Heroic BSoD.
- Martial Pacifist - becoming this is his goal. Accidentally subverted and played for laughs when an angry opponent takes a throw really badly and breaks their own arm by accident.
- Red Oni, Blue Oni - obviously the Blue one.
- Straight Man
- Wouldn't Hit a Girl - averted entirely. He won't hit anyone, regardless of gender. He makes it a major priority to not injure his opponents if at all possible, and relies on throws and submission holds.
The Combat Harem
The Dojo Heiress
Fighting Style: Her family's school of sogo bujitsu, covering unarmed and armed combat. Trains more often with the Yin Protagonist.
Tropes that apply:
- Arrogant Kung Fu Girl: At first. She loses a lot of condescension over time, but can still be a little haughty.
- Defrosting Ice Queen: She's very icy and aloof at the beginning.
- Kuudere: This is what she "defrosts" into. Though she learns to become more affectionate, she never completely loses the chill.
- Martial Arts and Crafts: Her family's school is a sogo bujitsu, or "all weapons" style that covers striking, grappling, kenjutsu, jojitsu, tantojutsu, naginatajutsu, archery, horseback riding, and all other weapons forms and techniques traditionally considered to be part of a Japanese warrior's training. The catch is that she's also trained to combine the different techniques at any time. Some of these combinations make historical and logical sense, such as mounted archery. It starts to get a little ridiculous when she demonstrates that she knows how to do joint locks from a mounted position or fold a dogi with a naginata instead of her hands, however.
- The Ojou: Not actually rich, but all of the kohais at her dojo treat her like royalty anyways.
- Running Gag: See Martial Arts and Crafts, above. Eventually "[family name] ryu bujitsu is never caught unprepared!" will become her Catch-Phrase.
The Loud American
Fighting Style: A combination of MCMAP Close-Quarters Combat (learned from her Marine father) and the 52 Blocks style of Jailhouse Rock (learned from her uncle, who did time in Rikers Island Penitentiary). Trains more often with the Yang Protagonist.
Tropes that apply:
- Animal Motifs: Is identified with dogs (of which she's very fond). Is viewed as The Rival by the Token Mini-Moe, who is jealous of the time she spends with the Yang Protagonist (among her other assets).
- But Not Too Foreign: Completely averted. She's 100% African American.
- Combat Pragmatist: She is quick to employ improvised weapons and sucker punches. In the Yang Protagonist's character arc, she spends a lot of time teaching him not to think about honour in a serious fight ("Would you put honour before your own life? What about if you're protecting someone else's?"). In the Yin Protagonist's arc, she teaches him that if he wants to win without hurting others, he'll need to take every edge he can get.
- Knife Nut: While the Dojo Heiress and the Bodyguard are technically better than her with a knife, no other character quite shows the same care for a weapon that she shows for the K-BAR combat knife she got from her dad.
- Military Brat
- Phenotype Stereotype (and by extension, Dark-Skinned Blonde): Completely averted.
- Sassy Black Woman
- Semper Fi: Daddy's a Marine, and as a military brat she picked up a lot of the culture. Her father's posting on the Japanese bases intersected with her grade school years, which is why she can speak Japanese.
- Tsundere: Type A, played straight with a little twist. She is just naturally bad at expressing her feeling, but is comfortable with physical contact and likes roughhousing with her friends. As she warms to the protagonists, they'll realize that the abuse is actually a sign of her approval. Eventually they find themselves wondering which is more dangerous, her displeasure or her affection.
The Chinese Beauty
Fighting Style: A combination of Pa Gua Chang and Hsing Yi Chang. Trains more often with the Yin Protagonist.
Tropes that apply:
- Beware the Nice Ones: She's one of the two nicest members of the combat harem. She can also beat you senseless with ease.
- Chinese Girl: Yes, we should see her in a qipao.
- Eyes Always Shut: Much like Nagase Kaede, she will occasionally open one for emphasis. If they are both open, it is a sign of extreme shock, fury, or affection.
- Mama Bear: she becomes scarily protective of her friends.
- Obfuscating Stupidity: Will occasionally fake being unable to speak Japanese to get out of a sticky situation (she's as fluent as any other member of the cast). The Nerdy Girl will exasperatedly call her out on this.
The Quiet Classmate
Fighting Style: Yang style Tai Chi. Trains more often with the Yin Protagonist.
Tropes that apply:
- Beware the Nice Ones: Like the Chinese Beauty, she is a much more capable combatant than her polite and unassuming demeanour would imply
- Emotionless Girl: Most of the time, her expression is an attentive poker face. She occasionally smiles, she rarely frowns, and she never looks angry.
- Ill Girl: She originally started training in Tai Chi to recover from a nasty lung infection back in her grade school years. This was a factor in her asocial personality; her friends moved on without her, and she didn't make new ones. (Think Nagisa at an earlier age, without angst.)
- Innocent Fanservice Girl: In a manner that often gets her mistaken for a boy.
- Older Than They Look: Her lung infection held her back a year in school.
- Waif-Fu: One of the few true examples in the series. All the other females have visible muscle tone, but the Quiet Classmate has a diminutive stature (even the Token Mini-Moe has more visible biceps than her) and probably weighs 100 pounds soaking wet.
- Weak, but Skilled: Exaggerated. Having trained for hours every day from her grade school years, she's far and away the harem's most skilled martial artist. She also needs help lifting heavy boxes or moving furniture. It's revealed that she has two copies of every school textbook, one at home and one at school, so she can avoid having to carry the extra weight.
The Token Mini-Moe
Fighting Style: Karate, as she comes to idolize the Yang Protagonist, with whom she trains more often.
Tropes that apply:
- A-Cup Angst: The Running Gag is that her rants are often interrupted by the Quiet Classmate, who doesn't understand what all the fuss is about.
- Animal Motifs: Is identified with cats (of which she's very fond). Views the American as The Rival (it's a mutual Tsundere-esque rivalry, and they grow fond of each other, up to and including a Sleep Cute scene after recovering from a fight).
- Kick Chick: Given her small size and mass, she requires kicks to get real power and reach behind a strike. She can still punch when she needs to.
- Like Brother and Sister: She's got no luck getting past this stage with re: to the Yang Protagonist, much to her disappointment.
- Mouthy Kid
- Oblivious to Love: On the receiving end. She's probably the most aggressive member of the harem in her pursuit, but the Yang Protagonist fails to see her as anything more than a kid sister.
- Token Mini-Moe: Natch. She's in her last year of grade school, so not as extreme a case as most other examples of the trope, but still.
The Bodyguard
Fighting Style: Tantojutsu, with whatever Yakuza street fighting experiences that informed her empty handed combat. Trains more often with the Yang Protagonist.
Tropes that apply:
- Badass in a Nice Suit
- Bodyguard Crush: Averted yet invoked. While a fiercely loyal friend to the Yakuza Daughter, the Bodyguard is not attracted to her in any way; in fact, it's her charge's older brother, a famed Yakuza enforcer and heir to the clan, who is her initial crush. Despite this, everyone suspects the Bodyguard of being a lesbian, to her dismay.
- The Comically Serious: Her ward is The Hyena, which inevitably clashes with her stoic professionalism.
- Knife Fighter: uses a weapon more often than any other harem member.
- The Stoic: in public. She loosens up in private around her ward.
- Yakuza
The Noncombat Harem
The Yakuza Daughter
Tropes that apply:
- Bi the Way: Even her trusted bodyguard doesn't know this at first.
- Bodyguard Crush: Averted. Despite actually being bisexual, she considers the Bodyguard a good friend.
- The Chessmaster: Most of the "protagonists get into fights with organized crime groups" plot arcs are actually her way of giving the rest of the cast warning before said organized crime groups actually start threatening people close to the cast.
- Death Glare: shows it rarely, but when she does, she actually is more scary than her knife-wielding bodyguard...or the rest of the cast...put together.
- The Hyena: Most of the time. If she's stopped laughing, she's either asleep or you've pissed her off.
- Mafia Princess
- Obfuscating Stupidity: Pretends to be The Ditz, but is actually very cunning.
- The Tease: part of the reason people see a Bodyguard Crush relationship between her and her bodyguard. It doesn't help that the original reason she's got a female bodyguard was so that her protector could follow her into places like bathrooms and hot springs.
The Nerdy Girl
Tropes that apply:
- Adorkable: female version.
- Book Dumb: Played with. She struggles in every subject except one.
- Everybody Hates Mathematics: Her weakest school subject, although she's not hot in science, history, or PE either.
- Guile Hero: Just because she doesn't fight doesn't mean she can't be heroic when she needs to be.
- Hollywood Pudgy: A lot of this is in her head; she has a bit of a weight complex. But complex aside, she is still the "healthiest" young lady in the cast. This is not always viewed as a negative.
- Non Action Girl: She's more or less the translator.
- Teen Genius: In a world with very mundane martial arts, and characters who need significant time to recover from injuries in serious fights (albeit faster than in real life), the most superhuman ability in the story is the Nerdy Girl's talent for languages. She's brilliant at both the science of linguistics, which she wishes to study in university, and the actual task of learning languages. She's fluent in five languages at the start of the series, surprises the American and the Chinese harem members with her ability to pass as a native speaker of their languages, and knows a smattering of about a dozen more. For the story arcs which require travel to other countries, she will spend a week or two preparing and manage basic conversational skills (and will always return home with at least intermediate proficiency if not fluency). The story function she fulfills is allowing me to depict language barriers realistically when other characters don't speak Japanese.
The Apartment Manager
- Adults Are Useless: Averted. She's the harem's therapist, which is an important position given the various issues of the other main characters.
- Christmas Cake
- Cute Clumsy Girl
- Harem Nanny
- The Heart
- Landlady
- Meganekko
- Team Mom
- Through His Stomach: Discussed but not specifically planned: she's a real good cook, and once the other harem members start considering the male protagonists as potential boyfriends, the Manager's head start in this area causes worry in her rivals.
Planned Major Story Arcs
Rogues Gallery
The Drunken Boxer
Nationality: Chinese
Fighting Style: Zui Quan/Suikenpou/Drunken Boxing Kung-Fu, natch
Applicable tropes: Artful Dodger, Dogged Nice Guy, Drunken Boxing
The Thai Enforcer
Nationality: Thai
Fighting Style: Muay Thai/Muay Boran
Applicable tropes: Blood Knight, Boisterous Bruiser, The Hyena, Jerk with a Heart of Gold
The Indonesian Challenger
Nationality: Indonesia
Fighting Style: Pentjak Silat (not sure which, maybe Tiger Silat)
Applicable tropes: Best Served Cold, Dance Battler, Defrosting Ice Queen
The Avenger
Nationality: Korean
Fighting Style: Kungjung Musul
Applicable tropes: Arrogant Kung-Fu Guy, Dark and Troubled Past, Dead Girlfriend, Death Seeker, Don't You Dare Pity Me!, Roaring Rampage of Revenge, Sympathy for the Devil, Troubled, but Cute (in many ways this guy was inspired by Tanimoto)
The Unlucky Brazilian
Nationality: Brazilian
Fighting Style: Capoeira
Applicable tropes: Butt-Monkey, Dance Battler, Deadpan Snarker, The Drag-Along, Meta Guy, Snark Knight
The Other Soldier's Daughter
Nationality: Israeli
Fighting Style: Krav Maga
Applicable tropes: Action Girl, Badass Israeli, Combat Pragmatist, Cuteness Proximity, Fiery Redhead, Foil (to the Loud American), Knife Nut (gets into arguments over the superiority of her Sykes-Fairbarne trench knife to the standard Marine KBAR), The Rival (mutually between her and the American)
The Traceur
Nationality: French
Fighting Style: Savate
Applicable tropes: Damn, It Feels Good to Be a Gangster!, Jerk with a Heart of Gold, Le Parkour, Satisfied Street Rat
Tropes that apply to all of the above: HeelFace Turn, Worthy Opponent
Non-Befriendable Enemies
Other Characters
Martial Arts Teachers
The Karate Instructor
Tropes that apply:
The Aikido Instructor
Tropes that apply:
Obviously a work in a sorry state of progress. Yes, I'm a fan of Kenichi: The Mightiest Disciple, and Ranma ½ before it. You could tell?
To whoever came up with this idea - love it! How's this for a title - Harem of the Flying Fists?
- Whoa, really? I didn't think anybody'd notice it.
Speaking of deconstructing the harem genre...


text:
By: Bill Leon (A Toast) –
This review is spoiler free!
If you don't know Metalocalypse, it's the ongoing saga of death metal band of misfits called Dethklok- in their universe, the greatest and most financially lucrative THING of ALL TIME. Their brand accounts for a large portion of the entire world's economy, so much so that there's a Illuminati-style 'Tribunal' made up of some of the most powerful men on earth which monitors their every move AND… you know what? You just need to watch the series, Metalocalypse. Get caught up because this 47 minute rock opera is almost entirely story driven and requires you to know the significant story events from the first four seasons. If you are all caught up with the story, this is an unbelievably satisfying hybrid of music, animation, character development and story-telling.
A Toast
Brendan Small has created a masterpiece. Metalocalypse: The Doomstar Reqiuem is a masterpiece. It's first priority is developing the story and wrapping up the loose ends of season 4 and it does this beautifully with only music and lyrics. The music is phenomenal, well-crafted, clever, varied, and just plain fun. If I had made a top 10 albums of 2013, this would have been number one. The amount of effort and thought at work here is jaw dropping. THIS, Ladies and Gentlemen, Metalocalypse: The Doomstar Requiem, is quality.
The looming Metalocalypse prophecy
The voice acting/singing is lead by Small, who does a great job with every character he does. You get small vocal contributions from series regulars George 'Corpsegrinder' Fischer, Mark Hamill, Malcom McDowell, and Victor Brandt as well as a small cameo from Jack Black and the vocal debut of Dethklok rhythm guitarist Mike Keneally taking over the singing for Toki Wartooth. Toki Wartooth and William Murderface were previously voiced by series co-creator Tommy Blacha who unfortunately isn't part of this production. I would've loved to see just a bit more Murderface in this thing but oh well. What we got is awesome.
Metalocalypse has had a few more tangible and emotional moments on the show but they're pretty few and far between. This special actually manages to be heartfelt and sort of serious at times. They give you some emotional depth as well as character development which I did not see coming… at least not to the capacity at hand. This isn't something for everyone but you should see it if you like the show and/or if you like EXTREMELY well written music which also furthers the EPIC story of Metalocalypse. Yeah, epic is an overused word but Metalocalypse fans- Back me up here. This series and this piece especially merits the word EPIC… andifyoudon'tagreewhatever…
From start to finish, this is a well done piece across the board and I cannot sing its praises enough.
As of this writing, the special has been available on youtube since its debut. It has not been released to DVD or Blu-ray yet but is currently available on Amazon Instant Video and youtube for only $1.99.
Drinking Game
Take a Drink: when the song changes
Take a Drink: when past story events from the series are referenced
Take a Drink: when Brendan Small is NOT the one singing
Take a Drink: when a dead character is referenced (He's dead. Oh… throw him in the garbage…)
D0 a Shot: for 'The Duel' between Toki Wartooth and Skwisgaar Skwigelf

subset: commoncrawl


text:
Formerly partner of GROSSWEBER. They practice what they preach. They offer trainings for modern software technologies like Behavior Driven Development, Clean Code, Git, HTML5 and, my personal favorite, Expression Blend. Their staff is fluent in a variety of languages, including English.
This small sample will show you the possibilities of Silverlights (and WPFs) BezierSegment class. To draw a bezier curve you have to encapsulate the BezierSegment as part of a Path element as shown in the following lines of code:
1 <Path x:Name="Curve" Stroke="#FFFFFFFF" StrokeThickness="2">
2 <Path.Data>
3 <PathGeometry>
4 <PathGeometry.Figures>
5 <PathFigureCollection>
6 <PathFigure x:Name="Figure" StartPoint="27,56">
7 <PathFigure.Segments>
8 <PathSegmentCollection>
9 <BezierSegment x:Name="Bezier" Point1="227,156" Point2="267,36" Point3="380,30" />
10 </PathSegmentCollection>
11 </PathFigure.Segments>
12 </PathFigure>
13 </PathFigureCollection>
14 </PathGeometry.Figures>
15 </PathGeometry>
16 </Path.Data>
17 </Path>
The curve itself is rendered using four points: the StartPoint attribute of the PathFigure element and the three points Point1, Point2 and Point3 of the BezierSegment. Try to play around with this sample and feel free to have a look into the sources.
My name is Marcel Hoyer. I live in Leipzig, Germany, with a cat and three co-residents. I am a software developer at CID, a Software firm located in Germany. The CID Group focuses on the development of customized, up-to-date software solutions that digitalize and enhance business processes within enterprises and lead to an improvement of communication in relationships between companies and their customers. Next to those technological hobbies I like digital art, photography, travelling and music.
Powered by: newtelligence dasBlog 2.3.9074.18820
The opinions expressed herein are my own personal opinions and do not represent
my employer's view in anyway.
© Copyright 2004-2019, Marcel Hoyer


text:
Leiras Finland is seeking late stage (phase III onwards) prescription products in the following therapeutic indications; respiratory diseases, pain management, oncology diseases, cardiovascular health and metabolic diseases.
The company wishes to in-license the products into the four major Nordic countries. Any drugs to be considered should adhere to the following requirements;
1) Should have undergone phase II clinical trials, be NDA ready/submitted or marketing authorization
2) Should not require participation from Takeda/ commitment on new Clinical Trials
3) Serves an unmet medical need
4) Has patent coverage available for many years
5) Is directed mainly to a specialist
6) Be delivered in complete final packages and undergo release in the EU by a supplier
Leiras Finland is looking to in-license any potential candidates.


text:
Right now Nordstrom is running a great gift with purchase from Clinique. For this Nordstrom exclusive gift with purchase, Clinique teamed up with designer Trina Turk to create a gift with the designer's favorite products in mind. This gift with purchase also features a makeup bag designed by Trina herself. Here's what's in the gift with purchase:
- Rinse-Off Foaming Cleanser
- Zero Gravity Repairwear Lift Firming Cream
- Clinique Colour Compact
- Lash Doubling Mascara
- Long Last Lipstick with case in Beach Coral
- Long Lost Glosswear SPF 15 in Bamboo Pink
The Clinique Colour Compact has gorgeous shimmering plum and bronze eyeshadows and a mauve blush, very pretty! You can snap this Clinique gift with purchase at Nordstrom online or in store from now until November 21st.


text:
If you want to see East Gippsland's forests and threatened species protected from logging you can contact the decision makers who have the power to act. See their contact details below.
The Premier of Victoria the Hon Daniel Andrews MP - email@example.com
Ph: (03) 9548 5634
Minister for Energy, Environment and Climate Change, Minister for suburban development, The Hon Lily D'Ambrosio MP
G02/30 Oleander Drive, Mill Park, VIC 3082
Ph: (03) 8392 2100
Minister for Agriculture and Regional Development The Hon Jaala Pulford MP - firstname.lastname@example.com
Ph: (03) 9637 9940
Treasurer of Victoria, the Hon Tim Pallas MP - firstname.lastname@example.com
Ph: 03 9651 5201


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Value-based healthcare is an approach to providing care that aims to restrict the growth in healthcare costs while maintaining or improving quality. The United States Medicare and Medicaid programs, along with a few pioneering employers and private health systems, are testing multiple strategies in this social experiment.
1. What is value-based healthcare and how will it impact healthcare?
Value-based healthcare is an approach to providing care that aims to restrict the growth in healthcare costs while maintaining or improving quality. In the US healthcare system, the emphasis on paying for units of service through fee-for-service plans has encouraged providers to order many services so they get the highest payment. Value-based healthcare strategies reward providers for improving health outcomes and quality while restricting the growth in costs.
Value-based healthcare is not a new concept nor is it more popular with one political party than the other. The March 2010 national health reform legislation, the Affordable Care Act (ACA), encourages value-based healthcare in several ways. The ACA calls for implementation of demonstrations, pilots, and programs for accountable care organizations (ACO), patient-centred medical homes (PCMH), payment bundling, and pay-for-performance (P4P) initiatives, and it extends a gain-sharing demonstration. The ACA also encourages the development of value-based insurance design, which is discussed in more detail later, and other value-based healthcare techniques. In addition, over at least the past eleven years, many non-partisan laws have furthered value-based healthcare approaches.
2. What specific impact will value-based healthcare have on American healthcare?
Value-based healthcare can affect US healthcare in at least three areas: (1) the organisation of delivery and payment systems, (2) the further integration of provider networks, and (3) a flattening of provider hierarchies in the healthcare system. All three of the trends will be fortified by re-structuring rules that govern relationships between purchasers, consumers, and providers. For example, accountable care organisations (ACOs), patient-centred medical homes (PCMH), and models that integrate primary care and behavioural healthcare will encourage all three of these trends.
Value-based healthcare encourages new service delivery and payment models. Accountable care organisations are networks or groups of providers (for example, primary care physicians, nurses, specialists, and hospitals) that are collectively responsible for healthcare quality and costs for a particular population. The ACOs share in amount saved by reducing growth in healthcare costs while still meeting established quality targets. The ACA legislation lets ACOs use a broad range of organisational forms. These include integrated health systems, physician hospital organisations, and group and independent practices.
Patient-centred medical homes assign each patient a primary care provider who leads an interdisciplinary care team. This provider facilitates seamless care across services and settings. The PCMH model exists in diverse settings and evidence is building for improved quality and decreased healthcare costs. The PCMH complements the ACO models and, in many cases, is expected to reside within ACO frameworks.
These new service delivery models will be paired with an increasingly nuanced understanding of payment systems and financial incentives. Bundled payment, pay-for-performance, and gain-sharing (similar to profit sharing) will continue to be revised as value-based healthcare evolves.
Value-based healthcare also encourages vertical integration of providers into ACO networks. As ACOs are a relatively new concept, it is not yet known if they will reduce the escalation in cost growth. It is possible that within particular local markets, ACOs will result in a monopoly where they could unilaterally raise prices. There are, however, provisions in the ACA designed to prevent this.
Finally, value-based healthcare encourages delivery of patient care through interdisciplinary patient care teams. In the past, large physician practices, hospitals, and some other settings have used interdisciplinary care teams. However, the ACA calls for significant expansion of these care models in all patient care settings. Interdisciplinary, team-based practices require flatter management structures that encourage collaboration and shared decision making as all team members with function as co-managers of care. This means that there will be a re-definition of traditional roles of specialists, primary care physicians, nurse practitioners, nurses, and other care team members. All team members will share responsibility for the clinical and financial outcomes of patient care. This will result in a flattening of the traditional hierarchical provider roles in American healthcare.
3. What are the key elements of value-based healthcare?
With US healthcare expenditures climbing to 18 per cent of GDP, a driving force behind the adoption of value-based healthcare strategies is curbing cost growth. However, the value-based healthcare equation is not one of cost control alone. When evaluating a value-based healthcare initiative, the important dimensions to consider are cost escalation, patient health outcomes, patient satisfaction, and process and other measures of quality of care.
The pursuit of value-based healthcare in the US follows a path littered with many barriers. Multiple, fragmented delivery and payment systems and entrenched political interests play a major role in influencing the design of those systems. Medicare and Medicaid are very large and initiatives launched through them are often adopted by private insurance carriers. Through the ACA, and multiple earlier laws, value-based healthcare techniques will be promulgated through Medicare and Medicaid demonstrations, pilots, and programmes. This is sure to have a profound effect on the overall structure of the American healthcare system.
4. How does value-based healthcare help in saving cost and promoting healthful practices?
Value-based healthcare techniques change incentives to consider the total health of the individual consumer. Patient-focused care reduces hospitalizations, re-hospitalisations, emergency department visits, and other expensive encounters. It also promotes good health. Consider the case of value-based insurance design (VBID), which seeks to increase value in healthcare through insurance design and incentives. One model of VBID reduces or eliminates cost sharing for services that are shown to have strong clinical benefits. VBID uses cost-sharing incentives to encourage consumer behaviour toward actions with clinical benefit. By encouraging patients to adhere to prescription drug regimens through low co-payments, purchasers expect to lower high cost hospitalisation, re-hospitalisation, or emergency department visits. While the cost of prescription drugs may be higher than before the new insurance design, the overall goal is to lower total healthcare costs.
VBID takes a broad view of purchaser healthcare costs. If one considers pharmaceutical costs without considering how adherence affects patient health, then it is possible to miss the opportunity to lower overall healthcare costs. Beyond VBID, pharmaceutical care management plays an important role in disease management, telemedicine, and other value-based strategies. Behind many of these initiatives, strategies that encourage patients' prescribed drug regimens—or the introduction of preventive drug regimens—plays a vital role in preventing higher-cost medical procedures, visits, or needs. These are just a few examples highlighting VBID and related pharmaceutical care management practices that improve health and encourage prevention of illness while reducing the price tag of a particular condition or set of conditions. This is the general idea behind value-based healthcare—promoting health means less expensive healthcare needs for the individual.
5. How will this benefit providers and patients?
As the healthcare system adopts value-based healthcare strategies, providers have greater access to a more complete patient health history through electronic medical records, integrated health teams and systems, and innovative communication technologies. This improves the provider's ability to oversee prevention, diagnosis, and treatment. Also, value-based delivery and payment systems are aligned with the patient's best interest, so providers have fewer barriers to providing the best possible care. As care teams become more integrated, communication between providers along the care continuum will improve. This will result in fewer communication errors in patient care. As part of the ACA, health insurance exchanges and Medicaid expansions are being implemented to expand access to affordable health insurance for uninsured populations in the US This is intended to align incentives in the healthcare system towards the patient's highest attainable health status.
6. How do you see value-based healthcare evolving in the future?
In the US, how value-based healthcare evolves will depend on the resolution of three challenges or apparent conflicts.
So, how is value-based healthcare going to evolve in the US? A few pioneering integrated networks and purchasers are going to continue to lead the way until certain value-based healthcare strategies implemented by Medicare—and, in some cases, Medicaid—take shape. After one or two decades, other players will begin to adopt these value-based healthcare strategies as administrative, reporting, and payment systems begin to merge due to the power of Medicare, in particular, to drive market change. Electronic medical records, harmonisation of telemedicine innovations with privacy laws, and provider behaviour change will continue to be barriers in the short to mid-term. The political and policy negotiations on these three topics will play a vital role in accelerating the direction of the value-based healthcare trajectory.
7. Any other comments?
Thank you for the opportunity to share these insights and findings from the work at Altarum Institute's Systems Research and Initiatives Group. This work focuses on advancing heath system reform by identifying what works and what doesn't in the value-based healthcare arena: http://www.altarum.org/publications-resources-health-systems-research/strategic-innovations-healthcare-series.
Author BIO
Gloria N Eldridge has worked extensively in health policy and on the politics of national health reform. She is a Senior Analyst at Altarum Institute, most recently engaged in reviewing the major evidence in the field of value based purchasing. Dr. Eldridge is director of Altarum's Strategic Innovations for healthcare Reform initiative and senior manager on the Congressionally mandated Centers for Medicare and Medicaid nation-wide review of wellness and prevention programs and their evaluation design. She is also a collaborating member of Altarum's Center for Policy and Research Translation and Center for Elder Care and Advanced Illness. She holds degrees from the University of Texas at Austin, The London School of Economics, and Yale University.


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Steel Maker OKs New Labor Contract
Republic Technologies International workers approved a new labor contract Thursday as the company tries to emerge from bankruptcy court protection.
The contract runs through April 2006 and cuts employee wages by 15 percent for five months to trim costs for the troubled steel maker. Workers also agreed to put off pay increases and bonuses due last Nov. 1, until Jan. 1, 2003.
Republic will cut the equivalent of 200 full-time employees, including outside contractors, as part of the deal reached with the United Steelworkers of America.
The agreement covers more than 3,500 union workers at Republic plants in Canton, Massillon and Lorain in Ohio; Beaver Falls, Pa.; Chicago and Harvey, Ill.; Gary, Ind.; Lackawanna, N.Y.; and Hamilton, Ontario. The previous contract was to expire in October 2003.
The company had 2000 sales of nearly $1.3 billion. Its carbon and alloy steel bars and rods are used primarily in the automotive and industrial equipment industries.
On the Net:


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Contact Us
At Framingham Pediatrics, we encourage you to contact us whenever you have a concern or question related to your child's care. You may Call Us anytime of the day using our main office number, (508) 879-5764. For emergent after hours calls that cannot wait until the office opens at 8:30 the next morning, our main number will direct you to our answering service and the on-call physician or nurse triage service will be paged to discuss your concerns.
If you would like to email us, we prefer you use the Framingham Pediatrics Patient Portal. It easy to use and SECURE. Your email attaches automatically to your child's electronic medical record and becomes a permanent part of your child's health history. We check messages regularly during regular business hours during the week, however, please DO NOT use the Patient Portal for emergent issues. Please call us directly to discuss with our staff your concerns
If you do not have a Patient Portal account, please call the office at (508) 879-5764 and ask to be "web enabled".
You can also reach us by completing the quick link below, however it is not a confidential email service.
DO NOT USE THIS QUICK LINK IF YOU HAVE A QUESTION/COMMENT THAT CONTAINS CONFIDENTIAL PATIENT INFORMATION! (for example; medication refills, medical question about a specific patient or demographic information)
Please use our Patient Portal for confidential information.


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The word "fat" is so confusing – whether it be the type that we wear on our bodies or the type we put into our bodies. Good fats, bad fats, healthy fats, trans fats. What does it all mean? Let's start with the one that's been in the news lately – trans fat. A brief history: In the early 1900s a German chemist named Wilhelm Normann discovered a way to turn vegetable or fish oils from liquid to solid or semi-solid by treating them with hydrogen gas. More versatile, longer-lasting and cheaper than animal fats like butter, lard or beef tallow, partially hydrogenated oils like margarine, shortening { Read More }
Shaving Face
It's funny how there were certain things that, as a young girl, I looked forward to with longing and couldn't wait to happen. Yet once they happened, the thrill wore off quickly. For instance, I couldn't wait to get my period. I couldn't wait to finally be able to call myself a "teenager." I couldn't wait to earn my own money. (Well, that thrill still lives on). I couldn't wait to shave. The so-called thrill of shaving, like many others, got old rather quickly...and before too long it became a somewhat mundane chore. And now, as if I wasn't tired enough of it, comes another body part to add to the { Read More }
Pedaling Like Mad (and Getting Nowhere Fast)
"Let's go to spin class together, mom! There's a new Soul Cycle that opened in Westport." How could I resist my darling 29-year-old son's request? I'm an empty-nester, after all, and we don't get to spend much one-on-one time together. Jonathan was planning on visiting for the day, and what better way to kick off the morning than with some high-energy exercise? I thought back nostalgically to when he first mastered a two-wheeler, remembering the pride I felt in handing down his bright red trike to his younger brother Jeremy. I longingly thought about our bike rides through the bucolic winding { Read More }
Five Ways to Enjoy a Pain-Free Vacation
You've looked forward to it all year…researched, planned and anticipated. It's finally here - vacation time! And you're determined not to let anything ruin it. Unfortunately, no matter how meticulously you plan, there are a lot of things that can derail a vacation. Some are simply out of your control – like delayed flights, lost luggage, and perhaps the most infamous of all – the weather. Fortunately, you can control one of the worst travel 'disasters' – and that's spending your vacation in pain. I'm going to give you great ways to avoid pain in the first place, so your vacation can be as perfect as { Read More }
Old Age is the New Middle Age
When the idea of starting my own blog was just a so-called 'twinkle in my eye,' I spent a lot of time coming up with what to call it. What was the right name? I knew what I wanted to write about - midlife - that period of time when you think you have it all figured out but then realize that no one ever has it all figured out. That time in your life when you can look back on all your mistakes, accomplishments, precious moments or moments you'd rather forget; the time that allows for new growth and opportunity..(if you keep your eyes open to all the possibilities). To get some feedback and { Read More }
Is Bruce Jenner Having a Midlife Crisis?
Yesterday at the gym while stretching post-workout, I overheard two women talking about Bruce Jenner's recent announcement that he was transitioning into a woman. (I wasn't exactly eavesdropping; if you saw the small area devoted to stretching, you'd understand why it isn't easy to ignore nearby conversations.) "Why do you think he waited so long to come out with that?" asked one. (I had often wondered that myself, but was pretty sure I understood the possible answer.) I was already getting annoyed. She lifted one leg effortlessly into a yoga-like pose, adjusted her stance slightly, then { Read More }
Aging (and Why You Sometimes Need to Pucker Up!)
A few years ago, I had the pleasure of turning a virtual friend into a "real" friend when fellow writer Ruth Pennebaker moved from her native Texas to New York City with her husband for a year. I found Ruth to be as brilliant and witty in person as she was on the page and after spending time with her, I always felt enriched and somehow smarter. When Ruth told me she was working on another book called Pucker Up! I knew it would be as entertaining as all her other reflective and insightful works. I just got a sneak peak (it's great to have friends in high places), and was right. Pucker Up! is available { Read More }
What Wake-Up Calls Teach Us
Not to be all depressing and morose, but this past week has been kind of sad. I've heard one bad story after another. A friend's 17-year-old daughter diagnosed with ovarian cancer; a cousin's 28-year old son's thyroid cancer diagnosis; a co-worker of my husbands with a blood disease so rare I've never heard of it nor can I pronounce it or understand just how the body can turn on itself that way. I've had my personal share of cancer-at-an-early-age, and with that, there's always that jolt, otherwise known as a wake-up call: it spurs you into action to do something, change something, make promises to { Read More }
Natural Beauty: It Keeps Getting More Expensive
Spoiler Alert: If you love a giveaway (and who doesn't?), read all the way through! As I get older, I realize that this so-called thing, "natural beauty," gets more and more expensive as we age. I think I'd have a lot more money - and a lot more time - if I didn't care so much about covering my gray, having nice nails (to deflect from the age spots on my hands), taming my frizz and smoothing my wrinkles; but I'm not one of those women who doesn't mind aging naturally. I feel better when I look good; what's wrong with that, really? I used to feel funny about admitting that, fearing I'd come off as { Read More }
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Georgia Records
Records have been found in Georgia for four Holdridge men, between the years of 1824 and 1850. These men are Aaron Holdridge, whose relationship to William4 Holdridge of Laurens County, South Carolina has not been established; James5 Holdridge, son of William4; and John6 and Edmond D.6 Holdridge, sons of James5.
Aaron Holdridge
The earliest Holdridge record found in Georgia was this, "List of Letters remaining in the Post Office, Augusta, Ga., 1st January, 1824, Aaron Haldridge." [1] Aaron Holdridge is not one of the proven sons of James5 Holdridge, but he did appear on this list in Georgia the same year that James first appears on a tax record.
Aaron Holdridge lived in Upson Co, GA when he won land in Troup Co. during the Georgia Land Lottery of 1827. [2] He drew lot number 52 in District 6 of the third section of Troup County. He sold that land to Brittain D. Harris of Montgomery Co., Ga and then in 1830 Brittain D. Harris of Lowndes Co. sold the same lot to Arthur Smith of Troup Co. and in the deed mentioned it was the same land as drawn by Aron Holdridge in the lottery. [3] Aaron Holdridge was named in a land fraud case in 1830, accused of entering the lottery illegally, because he did not serve in the late war with Britain or reside in Georgia three years prior to 1827. [4]
James5 Holdridge
The first record found for James Holdridge in Georgia is the 1824 tax list for Fayette County, Capt E. Dodson's District. He owned no land but paid tax of .31 ¼. Next to him on the list was Joseph Hewy [Huey]. [5]
James5 Holdridge was in the Estray records, 1826, Captain Morgan's District, Fayette County, Georgia. Fayette is west of Henry County, but some parts of Fayette County were originally Henry County. [6]
James Haldridge appears again on the tax lists in 1827 in Fayette County, Capt. H.C. Morgan's District, no land entered, tax .31 ¼. [7]
Georgia 1733
Georgia 1834
Georgia 1838
Although I found no record of land purchased by James Holdridge in Fayette County[8], the next record found was a notice in the August 1829 issue of a Macon newspaper for a Fayette Tax Collectors Sale: "On the first Tuesday in September next will be sold before the courthouse in the town of Fayetteville, Fayette County between the lawful hours of sale the following lands or so much thereof as will satisfy the taxes for the year 1828. 202 1-2 acres, No. 112 in the 13th District formerly Henry now Fayette sold as the property of James Holdridge." [9]
On April 25, 1830 James Holdridge married Nancy Blackstock in Brushy Knob, Henry County, Georgia. [10]
In the 1830 Georgia Census, Henry County, the James Holdridge household included two free males 5-10, one male age 10-15, one male age 15-20 [John H.], one age 40-50 [James]; one free female 20-30. [11]
In 1831, Henry County, Georgia, Captain House's District, James Holdridge paid one poll tax of 31 shillings. He apparently owned no land, slaves, or carriages, as a line was drawn through these entries and through the entries for land, quality, district, and water. [12]
In 1840, James Holdridge was in the Newton County Georgia census, with one male under 5, two males 5 and under ten, one male 40 and under 50 [James]; one female under 5, one female 5 and under ten, one female 20 and under 30 [Nancy]. [13]
On April 4, 1843, James Holdridge died in Brushy Knob, Henry County, Georgia.[14]
Edmond D. Holdridge
In 1840, Edmund D. Holdridge, son of James5, was enumerated in the Upson County, Georgia census, with two males under 5, one male 30 and under 40; one female 5 and under ten, one female 20 and under 30. He has not been located in the 1850 census. One daughter, Nancy reported in the 1870 census that she was born in Alabama in 1841.
John6 Holdridge
John H. Holdege (sic) was a winner in the 1832 Cherokee Land Lottery. He received lot #242 in the 24th District, 3rd section of Cherokee County. He was a resident of House's District, Henry County, Georgia, at the time of the drawing. Registrants for the 1832 lottery had to be a resident of Georgia since January 1,1829. Immediately after the drawings, Cherokee County was divided into ten counties. John's lot was in the new Floyd County. A map of Floyd with the lot numbers is available online at the Georgia Archives. Lot #242 is in the lower left corner. [15]
John Holddidge (sic) was a fortunate drawer in Georgia's 1832 Gold Lottery; he drew lot #278 in the 3rd district of section 2. This was located in the east side of the new county of Cherokee, one of ten counties formed from the old Cherokee County immediately after the drawing of the earlier Land Lottery of 1832. A map of the new Cherokee County showing the lot numbers is available online at the Georgia Archives. Lot #278 is in the upper left quadrant, seven lots down from top left, ten lots to the right. [16]
John Holdridge appeared on the 1837 defaulter's list in Henry County, Georgia. James Holdridge did not appear on the tax list. [17] "A list of persons owing taxes was often included at the end of the tax digests. These lists were usually published in a local newspaper, as well. Sometimes the lists were published before the tax deadline, and are really lists of persons who had not yet filed their returns, as opposed to actual defaulters." Other reasons to be on the list: "The taxpayer had moved out of the geographical area of the militia (tax) district. Or the person actually failed to pay their taxes." [18]
John Holdridge, private, appears on the Muster-in Roll for Captain [John S.] McMullen's Co., 2nd Regiment (Turk's) Georgia Militia, joined for duty and enrolled May 14, 1838, New Echota, Georgia, for three months. He served during the Cherokee Removals. [19]
In 1838, James Farmer and others (family) sold to John Falls, "a certain part-lot, or parcel of land, situate, lying, and being in the eleventh district of originally Henry, now Newton County. Known and distinguished in the plan of said district by being No. 171, one hundred and seventy one, and more particularly distinguished by being all that part, or parcel of same lot of land situate and lying in the north side of South river, adjoining lands of Clark on the east, HOLDRIDGE on the north, and McLennon on the west, and bounded as aforesaid on the South by South river, containing one hundred and sixty acres, more or less." This HOLDRIDGE was either John Holdridge or James Holdridge, but James Holdridge was not even on the tax list in 1837 and John Holdridge was on the tax list. [20]
John Holdridge and Edy Coley obtained a marriage license 18 July, 1839, in Newton County, Georgia. They married 21 July, 1839 in DeKalb County, Georgia. [21]
John Holdridge was on the 1840 Newton County census with one male under 5 [James W.], two males 20-30m [John]; one female 15 and under 20 [Edy]. One of these older males may be a brother of John. Both adult males were born between 1811 and 1820. [22]
Based on the reported ages and birthplaces of Mary W. Holdridge (in Georgia) and Edmond Carey (in Alabama), the John Holdridge family moved from Georgia to Alabama between 1845 and 1847. [23]
1. Aaron Haldridge mail notice, Augusta Chronicle, Augusta Georgia, Saturday Jan. 03, 1824, Issue 169, Col. A, Classified Ads
2. Miss Martha Lou Houston, Reprint of Official Register of Land Lottery of Georgia 1827, (1827; reprint 1992 for Clearfield Company by Genealogical Publishing Company: Baltimore) page 166
3. Aaron Holdridge, "Land Fraud Case", in e-mail from Troup County Archives email@example.com to Cindy Smith, 04 Aug 2001
4. Aaron Holdridge, Superior Court Records, Troup County, Georgia, p. 182.
5. Fayette County GA Tax Digests for the Years 1823, 1824, 1827, 1829, 1831, 1832, 1833, 1834, (Ancestors Unlimited, Jonesboro GA: 1988), Georgia Department of Archives and History, p. 15
6. Fayette County Georgia Estray Book 1823-1873, US Genweb, online at http://ftp.rootsweb.com/pub/usgenweb/ga/fayette/court/wl237records.txt
7. Fayette County GA Tax Digests for the Years 1823, 1824, 1827, 1829, 1831, 1832, 1833, 1834, (Ancestors Unlimited, Jonesboro GA: 1988), GDAH
8. Fayette County Superior Court Deeds and Mortgages General Index, 1821-1900, drawer 93, box 45, Direct and Indirect Index, GDAH. No Holdridges or variations found.
9. James Holdridge Tax Sale, The Macon Telegraph, (Macon, GA) Saturday, August 15, 1829, Issue 33, pg. 132, col A, Multiple Classified Advertisements, online at www.galegroup.com
10. James Holdridge, Pension and Bounty Land Warrant Applications, file WL28340, Washington, D.C.: National Archives and Records Administration
11. James Holdridge household, 1830 U.S. Census, Henry County, Georgia, MyFamily.com, Inc., Provo, Utah, page 227, online at MyFamily.com, Ancestry.com image 57
12. James Holdridge tax roll entry, 1831 Henry County, Georgia, Tax Digest, Captain House's District; FHL film #0159152; Family History Library, Salt Lake City, UT
13. James Holdege household, 1840 U.S. Census, Newton County, Georgia, MyFamily.com, Inc., Provo, Utah, District 476, page 50, Ancestry.com image 3
14. James Holdridge, Pension and Bounty Land Warrant Applications, file WL28340, Washington, D.C.: National Archives and Records Administration
15. James F. Smith, The Cherokee Land Lottery Containing A Numerical List of the Names of the Fortunate Drawers in Said Lottery (1838; reprint New York: Harper & Brothers, 1968)
16. Mary Bondurant Warren, compiler, Alphabetical Index to Georgia's 1832 Gold Lottery, page 107(Danielsville, GA 30633: Heritage Papers, 1981).
17. John Holdridge entry, 1837 Henry County, Georgia, Tax Digest, Captain Posey's District, FHL film #0159152; Family History Library, Salt Lake City, UT.
18. Georgia Archives, Georgia Tax List FAQs, online at http://www.sos.state.ga.us/archives/what_do_we_have/taxfaq.htm
19. John Holdridge, Cherokee War Military Service Record, Record 397, Washington, D.C.: National Archives
20. James Farmer, Newton County, Georgia, Deed Book F, transcribed online at http://ftp.rootsweb.com/pub/usgenweb/ga/newton/deeds/dd289farmerfa.txt
21. John Holdridge and Edie Coley Marriage License, Newton County, Georgia, page 75
22. John Holdege household, 1840 U.S. Census, Newton County, Georgia, MyFamily.com, Inc., Provo, Utah, District 476, page 50, Ancestry.com image 3
23. John Holdridge household, 1860 U.S. census, MyFamily.com, Inc., Provo, Utah, western division, Youngville post office, dwelling 1309, family 1309, page 193/387, Ancestry.com image 16


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Using the Silverlight Downloader Object
Play Using the Silverlight Downloader Object
In this screencast, you'll see how the Downloader object can be used for retrieving assets and XAML as an asynchronous background task.P>
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The Discussion
So is it possible to download from domains other than the one the the silverlight control was loaded from?
Has anyone tried to use the Downloader Object and .zip files with Silverlight Streaming?
I have an application that uses it and everything is working EXCEPT the content that I have inside .zip files is not working. It's not throwing any errors it's just not working.
Any ideas?
".Zip has been added to the upload "allow list".
The zip file extension has been added as a supported file type within the uploaded zip archive. You can now include zip archives to the Silverlight Streaming application package. This allows applications to use the downloader object in Silverlight."
So it should be working according to that link. What's the deal. Anyone?
Ok weird...It just started working...must have been a cache issue...
Oh happy day!