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Research Article | Open Access
K. Rodriguez, E. Kaselitz, J. Wong, S. Ligard, D. Peck, V. Hugo Mena, F. Gordillo, D. Serlin, M. Heisler, "Improving Preclinic Preparation for Patients with Chronic Conditions in Quito, Ecuador: A Randomized Controlled Trial", International Journal of Family Medicine, vol. 2015, Article ID 724245, 7 pages, 2015. https://doi.org/10.1155/2015/724245
Improving Preclinic Preparation for Patients with Chronic Conditions in Quito, Ecuador: A Randomized Controlled Trial
Objectives. As in many settings, patients in community health centers in Ecuador do not complete previsit forms or receive assistance to identify questions and concerns they would like to address in brief clinic visits with physicians. We examined the comparative effectiveness of providing (1) a previsit form to complete; (2) a previsit form along with assistance in completing the form; and (3) usual care. Methods. Parallel, three-arm randomized controlled trial in two health centers serving indigent to low-income communities in Quito, Ecuador, among 199 adult patients who took medications for at least one chronic condition. Outcome measures were self-reported satisfaction with the visit, confidence in asking questions, and extent to which patients' objectives were met. Results. Patients who received assistance in completing a previsit form were more than twice as likely as participants in usual care to report achieving everything they wanted during their visit (AOR 2.2, ). There were no differences in any outcomes between the groups who received the previsit form with no assistance and usual care. Conclusions. For high-quality patient-centered primary care, it is important to develop and test innovative and scalable interventions for patients and physicians to make the best use of limited clinic time.
1. Introduction
Since 2007, Ecuador has created a system of free, universal health care with government-funded primary care centers in low-income neighborhoods throughout the country. There is overwhelming demand for primary care services at these community health centers, and patients often experience long waits for their clinic visits. Moreover, because clinic visits are necessarily brief, clinicians often do not have sufficient time to address all patient concerns and needs. Such time constraints pose a significant challenge to providing patient-centered care [1].
In such contexts, it is critically important for patients to be well prepared for their primary care clinic visits, with a clear idea of the principal questions and concerns they would like to address. Research conducted in the United States using videotaped primary care encounters has shown that the first item addressed during the primary care visit receives the bulk of the attention (5 minutes versus 1.1 minutes for the next five out of six total topics addressed during the typical 15-minute visit) [2]. Other visit content analyses have found that the likelihood of preventive screening declines with each additional concern brought up by patients [3], and more complex patients are less likely to have medication dose changes [4]. The number and complexity of health issues and comorbidities a patient has—as well as any behavioral, emotional, and social issues they face—all added to the challenges of adequately addressing all of a patient's key concerns and needs [5, 6]. Low-income Ecuadorian adults with chronic illnesses often have low health literacy and face multiple social and other challenges to managing their conditions. Accordingly, effective ways to better enhance their ability to prepare to best convey to their provider their principal concerns for a primary care visit are especially needed [7].
Public primary health care centers in Ecuador, such as those serving the low-income communities of southern Quito, currently do not have any kind of previsit form for patients. Previsit forms can help patients identify their principal health concerns and questions, list their current prescribed medications and known medical conditions, and provide other basic information to help their providers prioritize patient concerns and topics to be addressed during office visits. In spite of long preclinic visit waits, patients currently do not have any preclinic visit preparation and do not complete previsit forms. Due to the high numbers of patients who often have long clinic waits for appointments at the local health centers, clinic waiting rooms are an ideal setting in which brief interventions are delivered to patients while they wait for care.
The basic concept of encouraging patients to prepare for their physician appointments is not new [8–12]. A number of studies have explored the impact of interventions and brief coaching on patient involvement and outcomes during clinic visits [12–15]. One pilot study found that sharing personalized, clinical information with patients before clinic visits improved doctor/patient communication and increased patient participation without increasing the length of visits [13]. However, a systematic review by Kinnersley and colleagues (2008) found that previsit interventions to promote question asking only provide a small benefit to patients, possibly because it is difficult to change established norms between patients and physicians during these encounters [14]. More research is needed on how to optimally help prepare patients, especially low-income patients with low health literacy who face multiple barriers to chronic disease management, for health care visits [9, 10, 16]. Truly patient-centered care requires that care interactions include consideration of patient priorities and preferences [17–19].
To address this need, we evaluated the effectiveness of a written previsit form for adults with chronic conditions to complete while waiting for their clinic visit to help prepare them to ask questions and provide information on their medical conditions and concerns to physicians. Because patients with little formal schooling may face literacy obstacles to completing a written form on their own, we also sought to assess outcomes from providing assistance to patients to complete the form. We hypothesized that patients who completed a brief written form on their own and patients who completed the form with the help of research staff before the clinic appointment would be more likely to report having their main health concerns and questions addressed in the subsequent clinic visit and thus improved satisfaction with the visit compared to patients receiving usual care. If we found improved outcomes, we could then make the form available to the clinic for continued use after the intervention.
2. Methods
2.1. Study Design and Setting
We conducted a parallel, randomized controlled trial (RCT) with scheduled patients waiting to see their primary care physicians in two community health centers serving indigent to low-income communities in southern Quito from June 2011 through August 2011. The patients were randomized to one of three arms: (1) usual care with no preclinic visit preparation; (2) provision of a brief written form for patients to complete on their own; or (3) provision of the written form with assistance from a member of the research staff in completing the form. The study received IRB approval from the University of Michigan, the Pontifical Catholic University in Quito, Ecuador, and the Ministry of Health in Ecuador. When adult patients arrived at the clinic for their appointment, they were told that the clinic was evaluating patients' experiences with clinic service and possible ways to improve service. They were then asked if they had any chronic conditions for which they had taken medications regularly for 3 months or longer to screen out patients who were recently diagnosed or were not getting regular care at the clinic. If they met this criterion, they were asked if they were willing to talk to a study team member to consider participating in an intervention study. If they agreed to participate, a study team member proceeded with oral informed consent and administered orally a brief baseline survey.
In order to avoid contamination, we randomized clinic sessions to one of the three study arms. Random sequence generation and treatment group assignment were determined centrally. The randomization was assigned weekly with each center carrying out one of the three study group conditions daily. Sequence was concealed until interventions were assigned. Data assessors were blinded to group assignment in analyses of the data. Depending on which of the three arms the clinic session had been randomized to that day, participants received no previsit form (usual care) (Group 1), a written previsit form to complete alone with brief oral instructions from a team member (Group 2), or a previsit form to be completed with the help of a team member (Group 3). In Group 3 the staff member reviewed the questions on the form orally with the patient and was available to help with form completion and questions while the participant was completing the form. This active assistance in completing the form took on average 5–10 minutes, and the most common questions concerned explanations of the questions on medication side effects, diet, and exercise. The research staff practiced their approach to providing oral assistance together before beginning the intervention to ensure uniformity across different staff. After their clinic visit, patients in all three groups were given the same instructions to complete a postclinic visit questionnaire administered orally by one of the study team. The study did not involve invasive procedures, medical recommendations, or review of medical records or other health record data.
2.2. Description of Previsit Form That Patients Completed to Prepare for Visit
The previsit form encouraged patients to think about what they wanted to achieve during the visit. It included a list of medical conditions for patients to check off for past medical history. It also included a list of signs and symptoms that patients could check off if they were experiencing any at the time of their visit. Technical terminology was avoided, and local colloquial terms were used (e.g., coto, vinagreras) to facilitate patients' understanding. We also asked about their substance abuse history, as well as family history. There was a section for the patients to write in medical allergies and the list of their current medications, including prescription, over-the-counter, or any natural remedies. Below the list of medications, we asked if they were experiencing any side effects from the medication and if for any reason they had stopped taking one of their medications in the last 6 months. The form asked patients to write their chief concern they wanted to address in the visit and provided a space for them to list the questions and concerns they had for that day's clinic visit. To encourage patients to write down questions, examples were given such as "drug side effects." Participants were also encouraged to show the form to their providers during the clinic visit (see Appendix in the Supplementary Material available online at http://dx.doi.org/10.1155/2015/724245 for previsit form).
2.3. Study Measures
The baseline survey included age, gender, self-reported health status [20], education level, health literacy [21], comorbid conditions, chronic disease self-efficacy [22], level of patient activation [23], and understanding of and adherence to medications [24]. The survey also included patients' self-reported evaluations of their diet and exercise.
We examined three main study outcome measures from a survey orally administered immediately after participants' clinic visit. Individual items from the RAND Patient Satisfaction Questionnaire were examined [25]. These were as follows: (1) satisfaction with clinic visit "Are you completely satisfied with your clinic visit today?"; (2) whether the participants "achieved all that they had wanted to during the doctor's visit today"; and (3) whether the participants felt "confident about asking questions to the doctor" in the clinic visit (see Appendix in the Supplementary Material for the baseline survey in Spanish and Appendix in the Supplementary Material for the postvisit survey in Spanish). We also examined differences between Group 2 (previsit form only) and Group 3 (previsit form and assistance) in whether participants wrote down at least one question or concern that they wanted to discuss with their doctor during the upcoming clinic visit and mean number of questions or concerns listed on the form.
To determine differences in self-reported measures among the three groups, our recruitment goal was approximately 200 participants (approximately 65 participants per group). The xtmixed command in STATA, version 12.0 (StataCorp, College Station, TX), which fits multilevel mixed-effects linear regression models, was used to examine intervention effects.
3. Results
Figure 1 shows the flow of patients through the study. Of the 222 potential participants approached, 199 agreed to participate (90% participation). Consenting participants were randomly assigned to one of three groups: 64 were randomly assigned to the first group; 68 to the second group; and 67 to the third group. Of the 199 patients enrolled, 187 (94%) completed the post survey assessments.
Table 1 shows characteristics of participants who completed the initial survey () and assessment results. The groups did not significantly differ in any measure, except for gender. Therefore, all analyses were adjusted for gender.
|Usual care; bgroup receiving form alone; cgroup receiving form and assistance completing form.
Figure 2 shows changes in study measures for participants between baseline and the postclinic visit measures and compares postclinic visit assessments among Group 1, Group 2, and Group 3. In analyses adjusting for gender, patients who received the revisit form along with assistance from a team member (Group 3) were more than twice as likely as participants in Group 1 to report that they had achieved everything they wanted during their visit (AOR 2.2, ). While not statistically significant () participants in Group 3 were 1.86 times as likely as Group 1 to report that they felt capable in their clinic visit of asking questions. Although a higher percentage of participants in Group 3 reported greater levels of satisfaction with their clinic visit than participants in Group 1, this difference also was not statistically significant. There were no differences between Groups 1 and 2 in any of our study outcome measures.
Figure 3 shows the comparison between the number of questions or concerns participants who received assistance in completing the form (Group 3) wrote down to discuss with their physician at the upcoming clinic visit compared to the number among participants who were just given the form to complete alone (Group 2). Patients who received help from a team member were more likely to write down at least one question (80% of patients in Group 3 wrote down at least one question or concern compared with 50% in Group 2, ). Patients in Group 3 wrote down a mean of 1.6 questions compared to those in Group 2 who wrote down a mean of 1.1 questions.
4. Discussion
Among this sample of low-income Ecuadorian adult patients with very low levels of formal education and at least one chronic condition requiring medication at a government-funded community health center in southern Quito, patients who received assistance in completing a previsit form were more likely to engage in the consultation and to report accomplishing all their primary care visit goals and feeling capable of asking their physician questions at that visit than participants who did not receive any form or assistance. They were not, however, more likely to report feeling completely satisfied with their clinic visit than participants in the other groups. There were no differences in any measures between the group who received a previsit form but no assistance in completing the form and the group receiving no previsit forms or assistance.
Our findings reinforce evidence from observational and nonrandomized studies that suggest health benefits from receiving assistance in formulating questions and concerns for a clinic visit before the visit [9–12, 16]. Our findings also add to the literature by emphasizing ways such assistance may need to be adapted to meet the needs of low-literacy populations with low levels of formal education such as those served by many community health centers in low-income communities. Assistance in completing a previsit form appeared to be more effective than receipt of a written form alone in improving some postclinic visit outcomes, but not all outcomes. Because Group 3 combined assistance completing a previsit form with receipt of the form, we cannot determine whether orally eliciting patients' questions and concerns might have led to similar benefits without completion of the previsit form. Further research should explore reasons why providing the previsit form alone was not more effective than no previsit form and whether a different, simpler form could be effective. One possibility is that providing previsit forms alone is not effective among populations with high rates of low literacy. In our study sample, approximately 23% of participants in each group reported that they did not feel comfortable with filling out forms alone, and over 40% had only completed some primary school. Of note, however, these variables were not associated with whether patients wrote down at least one question or concern in Group 2, the group that received the previsit form alone. It is also worth noting that while most primary care practices in the United States routinely have patients complete revisit forms of some sort, there is little evidence from the United States or Europe on how completing previsit forms alone influences the subsequent primary care visit and discussion. There are, however, studies showing that providing cancer patients with question prompt sheets before oncology visits increases the number of questions patients ask in those visits [26–28].
Community health centers in southern Quito lack salaried staff who could provide assistance to patients in completing previsit forms. Thus, even though it only took 5–10 minutes to provide this assistance, different modalities to provide previsit coaching or assistance in formulating questions and concerns should also be explored. For example, as all the health centers in southern Quito have television screens and the capacity to show DVDs on these screens, it might be possible to develop an instructional DVD that could be shown in the waiting rooms to provide guidance to patients to think of questions and concerns they would like to discuss with their physician and to help in understanding how to fill out a previsit form.
Our study has a number of limitations. First, we only conducted a single preclinic brief intervention and only assessed participant-reported outcomes immediately after the clinic visit. Future studies should test previsit assistance interventions in this population over longer periods and include clinical outcomes along with patient-reported outcomes. Second, although we randomized clinic sessions to prevent contamination among the patients waiting to see the providers, the nature of the intervention prevented blinding of nurses and providers to the intervention itself. Moreover, it is possible that having patients in some clinic sessions bringing in the previsit form with listed questions and concerns may have influenced physician behaviors with patients who did not complete previsit forms. If anything, however, this would have introduced bias that would have reduced any differences between study groups. Third, this intervention focused exclusively on activating patients to discuss questions and concerns with their providers and did not address providers. Research by Chew-Graham and colleagues (2013) analyzing primary care visits for long-term health conditions found that patient concerns were often missed or disregarded by providers during clinic visits [29]. A more powerful intervention would also target provider behaviors to acknowledge and address patient concerns and questions they listed to be addressed at the clinic visit. The providers that participated in this intervention had a very favorable response to the previsit forms but were not given any guidelines on how they should use the forms during the visit, and no data was collected on how the forms influenced their behavior. Another significant limitation is that the form started with targeted questions about medical conditions, medications, and adherence before asking about more general questions and concerns the patient had for that clinic visit. This ordering and predominance of medical questions may have unintentionally restricted patients in the concerns they felt comfortable to bring up and failed to adequately encourage them to raise their own concerns that may have extended beyond a medical focus. Finally, we conducted this study among a predominantly female adult patient population in only two primary care clinics in one region of Quito. Our findings may not generalize to other populations and settings.
In conclusion, our study suggests that providing assistance with completing a previsit form designed to help patients formulate questions and concerns to discuss with their provider improved their confidence in asking questions and belief that they had achieved all their visit goals. Our study findings, however, do not support the provision of previsit forms alone for community centers serving low-income communities in which levels of formal education are low. Future research is required to determine what strategies would be necessary to improve benefits from providing a previsit form: providing more extensive initial orientation to completing such forms; making available staff or volunteers to provide ongoing assistance with completing the form such as what was provided in this intervention; or offering a simpler form that focused on eliciting the patient's main overall concerns and questions. A key question continues to be how best to both elicit patients' key priorities and concerns for primary care visits and also provide necessary information to primary care providers to meet the medical needs of patients with chronic conditions. To meet the goal of achieving high quality, patient-centered primary care in all settings throughout the Americas, it is critically important to continue developing and testing innovative and scalable interventions to better prepare both patients and their physicians to make the best use of the limited time in primary care visits [30, 31]. Our study findings support the hypothesis that providing active assistance to help patients identify their key questions and concerns before a clinic visit improves their visit satisfaction and belief that their objectives for the visit were met.
Conflict of Interests
The authors declare that there is no conflict of interests regarding the publication of this paper.
This work was supported by the University of Michigan Global Research, Education and Collaboration in Health (REACH); the University of Michigan Medical School; the Michigan Center for Diabetes Translation Research (MCDTR); and the National Institute of Diabetes and Digestive and Kidney Diseases (Grant no. P30DK092926). The study team thanks all of the clinic staff at the study sites who helped make this study possible.
Supplementary Materials
The supplementary materials include the pre-visit form and surveys used in the study. Appendix A is the pre-visit form provided to patients to fill out before their visit with the provider. Appendix B is the baseline survey given to patients before the intervention, and Appendix C is the post-visit survey given to patients after the visit with their provider.
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Copyright © 2015 K. Rodriguez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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Shruti Thakur, Vijay Thakur, Ram Gopal Sood, Charu Smita Thakur, Shweta Khanna
Department of Radiodiagnosis, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India
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Encephalocraniocutaneous lipomatosis (ECCL), also known as Haberland syndrome, is a rare syndrome with unknown etiology. The syndrome is characterized by a triad of unique cutaneous, ocular, and central nervous system (CNS) manifestations. The cutaneous hallmark, nevus psiloliparus (NP), along with overlying alopecia is a constant feature. Choristoma of the eyelid is the most common ocular manifestation, while intracranial lipoma is the predominant CNS finding. Genetic counseling is required to emphasize that the disorder, although congenital, is not inheritable. We present a 21-year-old female with cutaneous, ocular, and CNS features satisfying the diagnostic criteria for ECCL. To our knowledge, this is the first case of ECCL having a large temporal exostosis. The objective of this article is to better understand the phenotypic spectrum of this syndrome whose molecular basis is still unknown.
Keywords: Choristoma; encephalocraniocutaneous lipomatosis; exostosis; neurocutaneous; nevus psiloliparus
Correspondence Address:Shruti ThakurDepartment of Diagnostic Radiology, Indira Gandhi Medical College and Hospital, Shimla 171 001, Himachal Pradesh IndiaSource of Support: None, Conflict of Interest: NoneCheck4DOI: 10.4103/0971-3026.125607
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By Stanley E. Porter
The first a part of this quantity incorporates a precis of this significant region of research in either Septuagintal and New testomony Greek, and a evaluation of those concerns within the context of linguistic learn usually. A moment half comprises contributions on features of analysis into the Greek of either Testaments, that includes either new components of study, reminiscent of severe discourse research, and extra conventional concerns resembling the character of the Septuagint translation.
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Extra resources for Diglossia and Other Topics in New Testament Linguistics
Example text
18 This grammatical feature became distinct as a result of changes from the old northwest Semitic verbal system, in which the yaqtul preterite was productive. Secondly, the memory of the old preterite waned and the waw-consecutive became increasingly marginalized as an operative verbal tense during the period of LBH (Kutscher 1982: 45, §67). Thirdly, a further restructuring in the verbal system occurred, producing the changes seen in MH, including complete loss of waw-consecutives and the rise of a productive periphrastic present/future using rrn plus participle (Kutscher 1971: 16001601; Segal 1927: 150, 156-57).
Rendsburg is drawing on an idea expressed earlier by Segal in 1927: 73 (§ 157): It may even be doubted whether the consecutive construction ever attained in popular speech that dominating position which it occupies in the literary dialect. ' SMITH The Question ofDiglossia in Ancient Hebrew 47 innovation, which also must be sought in spoken language. Hence, methodologically, we cannot transfer grammatical features from one period back to an earlier time in neglect of the diachronic developments in the language.
The history of textual transmission also makes it difficult to differentiate the idiolect of the original user, when a manuscript such as the New Testament has undergone a regularizing influence in the hands of Atticistic copyists, who tended to conform syntax and even spelling to their idealized classical norms. Despite these difficulties, there have been numerous studies of the languages of Palestine in the first century (see Porter 1994 for a recent survey). Very few of these studies, however, are concerned to analyse the languages in use in terms of sociolinguistic categories (but see Silva 1980).


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I use my o-ring every single day I have almost every single color you make and just love it!
I now have one for every season and often use them as gifts too!
I purchased Animal Print Mocha and Fifty Shades Lizard for birthday presents. There was a gasp and an "AWWWWW" from the group when these 2 ladies opened up their boxes. Quality #1, Fashion #1, Convenience #1 and you can clean them too. Highly recommend!
Love my keychain


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Saturday, March 30 | 7 p.m. | Planetarium (BR 167)
Gustav Holst's great orchestral suite, The Planets, has been popular ever since its premiere about 100 years ago. In this planetarium show we will explore the music, mythology, and astronomy associated with this musical work. The presentation will be Saturday, March 30 at 7 p.m. in the Planetarium, Bridges Hall 167. Tickets will be available online and at the door.


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While we last heard from him earlier this month with "Grabbit", Bordalo II is now in Northern Europe where he just finished working on a brand new piece.
Working at Urban Spree in Berlin, Germany, the talented Portuguese artist gathered local trash and found materials to build yet another unique and highly creative piece. Entitled "Froehlicher Tucan", this is a perfect spring installation for the local pedestrians. The project was CO-sponsored by CO_labs and Londongraffiti.
Hit the jump for a closer look at this giant Tucan and as usual stick with your friend at StreetArtNews for more lovely updates from Europe.
Second image via Co_Labs


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Professional Cleaning Good For Your Health
That feeling you get when you walk into your five-star hotel room at night is uplifting, if not, quite reassuring. There is that pleasant whiff in the air that gives the visitor a sense of knowing that the maid has been around. She has given the already well-appointed suite a


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Barbara Nerness: Doublevision
January 12, 2019 12:00 am
Location: CCRMA WAVE: Wall for AudioVisual Expression - Map Link
Event Navigation
Barbara Nerness presents her interactive installation Doublevision, a video installation that turns audio and movement into visuals. The visuals are created using only audio signals by exploiting old CRT television technology. The work aims to remove the boundary between audio and video as physical media, and highlight the perceptual distinction. Ambient sounds and movements affect the visuals in real time, hence the name Doublevision.
This is the first in a series of works to be displayed on the CCRMA WAVE: Wall for AudioVisual Expression, located in the CCRMA lobby. In this space, CCRMA will showcase audiovisual works by in-house and external artists. The Doublevision installation will run until January 27th.


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Did you know…
- you can make pizza dough in the food processor?
- you can make cookies out of bread crumbs?
- banks are out to make a buck, but credit unions are member-owned not for profits?
- you can make "magic" quiche without biscuit mix?
- you can open an envelope in the microwave… and then use it again (of course, not the postage!)?
- you can use a plastic grocery bag as a salad spinner?
You can find these and tons more frugal tips in Amy Dacyzyn's book, The Complete Tightwad Gazette. Back in the '90s, Mrs. Dacyzyn was a stay-at-home mom to six, living in Leeds, Maine. Although she's not originally from Maine, sometimes even transplants know a thing or two about frugality. Mrs. Dacyzyn began publishing a quarterly newsletter for tightwads about all things frugal in the early part of the decade, out of her home. It was only read locally at first, but then it took off! She appeared on numerous television programs and people from all over the country were writing in to give tips or ask for advice. This book is over 900 pages of compiled newsletters, published after the newsletter ceased to be.
The tips and information range from useful, to weird, to obsolete (1990s interest rates? no thank you!). However, if you are frugal or aspire to be, I guarantee you can find a tip that will work for you in The Complete Tightwad Gazette.


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When purchasing from Chateau Dorrien Wines your financial details are passed through a secure server using the latest 256-bit SSL (secure sockets layer) encryption technology.256-bit SSL encryption is approximated to take at least one trillion years to break, and is the industry standard. If you have any questions regarding our security policy, please contact our customer support centre: firstname.lastname@example.com
You value your privacy. And we respect that. We believe that you have a right to know how we use any information provided by you and how we keep it secure. So we've answered the most frequently asked questions below.
What information do we collect?
When you register on our website, we need to know your name, email address, mailing address, phone number, billing address, shipping address, so we can process and fill your order. It also lets us keep you updated on the status of your registration. When you visit our website, we also collect IP addresses linked to your personally identifiable information to protect you from fraudulent use of your account.
How do we use the information?
We may send you an email to confirm or to update you on your order. We may also need to contact you by regular mail, email or phone if we have any questions about your order.
We won't sell, trade or rent any of your personal information.


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Then I realized you can't decide to have a party, plan a party, clean for the party, buy for the party, and have the party all in four days when you are looking at the likes of 16 children gracing the halls of your humble abode plus their moms (and perhaps a stray dad or two...I know my husband was planning to be 'busy' that day...). Instead, we canceled - or postponed, as it were - and, rather, each child old enough to talk was given their own party and invited their own friends over for their own special day.
T invited his friends over on a 'late start' day of school - when moms dropped them off, the boys stayed outside to play, then came in to make cinnamon ornaments, spread some frosting on prebaked cookies, and head off to school, fully loaded on sugar and fun. Two days later, when the ornaments were dried, T delivered them to his friends' homes, complete with Santa hat adorning his red head.
Meiners and I invited our friends over for a relaxed Friday lunch and playtime. The boys ate the sack lunches their moms brought for them. I rolled cookie dough onto individual sheets of parchment paper for each boy the night before, and after their lunch, the boys chose their cookie cutters and went to town. While they played in the playroom, the cookies baked, and the moms enjoyed lunch of homemade soup and salad. Then the frosting came out, and the fun ended with sweet smiles on their little boy faces.
Pookie's party was last (but not least!). She chose her party on an 'early release' day of school. Her friends were greeted with individual stations of dough and oodles of cookie cutter choices. They played dress up while the cookies baked, then tried their hands at real decorating tools, making rosettes and outlining their snowflakes before sprinkling colored sugars and sprinkles onto their creations. Before they left, we nabbed a print of their thumb to make unique ornaments. We'll be delivering those this weekend.
I hope all the children enjoyed themselves! We certainly loved having them join us in our cookie fun!


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The gap between the benefit of a medical research project and true improvement in a clinical setting can be quite large. Heather Canavan, an Associate Professor in Biomedical Engineering at the University of New Mexico, works with her students to reduce that gap. Through her efforts of promoting human-centered design, she and her students are embracing a spirit of collaboration and creative thinking to ascertain better healthcarerelated solutions. Inspiration can strike anywhere at any time! Whether it be while watching make-up tutorials on YouTube or while enjoying a refreshing bubble tea. Unfortunately, most people tend to drop their ideas that have potential to be something great. Alternatively, people in the Canavan lab group are encouraged to not only hold on to their ideas but establish a way of seeing their ideas come to life. For instance, one of the most promising research projects gathering momentum in the group started off by the simple act of drinking a bubble tea. Bubble tea contains chewy tapioca balls that can be peculiar to some people, but inspired a group of engineers to use it as a platform to create an alternative to colonoscopy preparation.
Read about The BubblyteTM Project and The Genius Beauty Queen Project in the full article here: https://cdn.ymaws.com/www.surfaces.org/resource/resmgr/surfacts/surfacts-winter-2019.pdf
Learn about our fund


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Microsoft has released Windows Admin Center 1809 and its SDK, with a variety of tweaks and enhancements to Redmond's latest take on managing a Windows environment.
We took a look at the browser-based product back in April when it was just emerging from its Project Honolulu days and found much to like, but also a bit to dislike about the remote management tool.
Microsoft, on the other hand, is chuffed to bits about how its new server wrangler is getting on, trumpeting in the announcement that it was the fastest growing Windows Server management toolset ever, hitting more than one million total managed nodes in just over two months.
With Windows Server 2019 likely to hit in October, alongside a new version of Windows 10, Microsoft has emitted a new version of Admin Center to support the new OS. If you're already an Admin Center user you have a mere 30 days to upgrade to version 1809 in order to remain supported. Eek.
Fear not, however, because at least one of our complaints has been addressed in the new version. It is now possible to manage Windows 2008 servers (R2 at any rate) in the new version. Admittedly, Windows Insiders have had this functionality since June but 1809 marks the point it becomes generally available.
Windows Admin Center: Vulture gets claws on browser-based server adminREAD MORE
Sadly, it's a bit limited and there is still no in-browser remote desktop malarkey to be had. But key functions such as PowerShell, Events, Services and the Registry are all present and correct, which should sate the appetites of most admins.
Microsoft has blamed the lack of Remote Desktop on a "bug in the HTML RD client" and promises a future fix. However, there is little point in hoping for support for desktops earlier than Windows 10 and with support for Windows Server 2008 R2 ending in January 2020, further retro-Admin Center goodness is unlikely. Perhaps sir would care to consider an Azure migration instead?
As well legacy server OS support, Microsoft has also provided the ability to view the underlying PowerShell scripts used by the tool and set-up scheduled tasks. Admins are able to view and remove store and Win32 apps on Windows 10 as well turning on and off Windows features, and also do the same for Win32 apps on the Server. File shares may also be remotely created and edited, and permissions assigned.
With additional support for Hyper-V and clusters, the tool is very much aimed at combining the management of physical machines with things that are a bit more virtual and cloudy (and not necessarily on Microsoft's own Azure).
The arrival of the SDK will also see other vendors able to extend the scope of Admin Center to their own hardware, with the likes of Fujitsu and Pure Storage promising support. ®


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30% off Sale
Extra Long Curve Embracer Slim Straight Jeans 61590
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These slim straight jeans are the perfect fit for the curvy hourglass-shape woman. Plus we're updated these jeans to be to be even more comfortable they're now made up of 97% Cotton and 3% Elastane.
Made in an extra long women's jeans are unhemmed, have a 37'' inseam and can be tailored to suit your personal height. In-store and online this style is available in Long (85cm).
Inseam: 96.5cm / 38''


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Why doTERRA?
doTERRA essential oils are the highest quality, 100% pure, potent, safe and effective. Created by an amazing company with a huge heart, helping communities around the world.
dōTERRA's commitment to providing the highest quality essential oils in the industry has taken them around the globe! They have formed partnerships with suppliers in over 40 countries to ensure that our oils are derived from plants that are nurtured in their most favourable environments. dōTERRA relies heavily on the growing expertise of local farmers - many of whom have nurtured essential oil plants for generations.
You and your family deserve only the most pure, potent, and effective oils on earth.
doTERRA takes great pride in sourcing them for you.


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I Told My Kid I Ate All Their Halloween Candy
Halloween is by far one of my favorite holidays. My favorite part as a child was trick-or-treating. Not just that, though. The best part of it all was running to my room with my sister, after hours of going house to house collecting as much candy as my bag could hold without breaking, and dumping out everything to see the final result. We would sit in our room for hours, comparing each of our bags and trading the pieces we didn't want, stuffing our faces with more candy than either of our stomachs could handle.
For the past two years, Jimmy Kimmel issued a challenge to all parents to: tell your children you ate all their Halloween candy, film the whole thing and then post it to YouTube. Previous years the challenge became famous, gaining over 34 million views. Since there was such a great response, he decided to do it again this year.
Here is the clip:
Despite the last three kids' remarks, one of whom says, "Its alright, I just want you to feel happy," I, honestly, would have probably been one of those kids to throw a huge fit. I hope everyone had a great Halloween!
Posted on October 31, 2012, in Food/Beverages, October and tagged candy, Halloween, jimmy kimmel, pranks, treats, tricks. Bookmark the permalink. Leave a comment.


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Spanish Pine-Nuts coated with a thin...
Blood Sausage with Onions similar to the French boudin noir.
A vital ingredient in the fabada stew from Asturias, Spain.
Morcilla de Cebolla Doña Juana
Each contain 2 links - Aprox. 8oz
Warning: Last items in stock!
* Availability date:
How is morcilla served?
Grill, broil or sauté in olive oil. Server as a hot tapa. Ideal for flavoring legumes, rice dishes, casseroles and stuffed pastries. Essential for making Fabada Asturiana and other stews (cocidos).
|Made from pork, Dehydrated Onions, beef blood, salt, paprika, spices, garlic, sodium erithorbate, sodiu nitrite
|You Save
|Up to $11.60
is delicious fried
I make mine with my pinto beans and eat it with french bread. Delicious
Not much tasten
I dint like it not like Spanish morcillas dint taste that great the ones from la tienda are more like Spanish morcillas
Best blood sausage
This is a staple in my fridge. I use it for my stews like cocido, fabada, callos and even for my cassoulets. Its holds up pretty well when fried and used as topping for montaditos. I tried a different blood sausage (german) but it just melted away when fried.
The Best
This is the best Morcilla I've ever had. Its high quality, USA source makes it a perfect addition to Cocido (Spanish Traditional Stew/Soup).
I deep fried some in canola oil and ate it wrapped in a soft tortilla shell. You can also fry it in a skillet, turning often too.
2 votes
Typical dish from the Valencian Community. It is cooked, as its name...
1 votes
This easy recipe for Tolosana bean stew can be enjoyed by experienced chefs...


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Introduction: It's Time for a Snack- Cinnamon Rolls
Cinnamon Rolls are a classic favorite in many households. But I have never made any since this week surprisingly so I decided to give it a try. I started out with a basic sweet bread recipe added some sour cream, made cinnamon sugar, and jelly rolled my dough. They turned out fantastic and were delicious hot out of the oven. Imagine pouring hot glaze to finish it off...
This is an entry in the CHOW Thanksgiving Recipes Contest so please vote! :)
Finalist in the
CHOW Thanksgiving Recipes Contest
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14 Discussions
Is it okay to substitute jam or other filling instead of the cinnamon?
Yes that should be fine. Try it out and let me know!
these look yummy! hope you post instructions soon!
to everyone who wants some for this week here's a recipe you could use until this one is posted! :)
Ooooo! Those look yummy! Have you tried making those?
I haven't made any cookies this year..... yet! :P I'm waiting till the last second haha
they do look mighty good though
Ahhh I see. I plan on posting a cookie recipe when I have the time but I haven't really made that many. Well let me know if you do. :)
will do! I'm looking for a good oatmeal butterscotch recipe. :)
Oooo sounds de-lish! I might have to experiment...I mean a combination like that can't go wrong :)
Yum! I love dipping these into coffee.
And adding some glaze....delicious!
Please post instructions :D
:) Glad you want to make them! I will as soon as I can....I hope :)
They look great, were you going to post instructions?
Thanks! And I might be posting instructions soon. :)


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EXCLUSIVE: Top NYPD cop warns officers not to wear their uniforms in public for their own safety following assassination attempts on police as suspect is pictured handcuffed to hospital bed
A top NYPD official has warned officers not to wear their police uniforms or department logos in public following back-to-back assassination attempts on cops in the Bronx.
Hazel Jennings, chief of the Department of Corrections, issued a memo on Sunday night essentially urging officers to hide their police affiliation to avoid being targeted.
The memo came after a career criminal carried out two separate attacks on officers in the Bronx in the span of just 12 hours, leaving two officers injured.
Robert Williams, 45, was taken into custody on Sunday after he allegedly opened fire on a police station in the Bronx shortly before 8am. He struck Lt Jose Gautreaux in the arm and narrowly missed other police personnel before the running out of bullets, lying down and tossing his pistol as he was swarmed by officers.
Hours earlier, Williams approached a patrol van in the same part of the Bronx late Saturday and fired at two officers inside, wounding one before escaping on foot, police said.
The suspect - who was out on parole after a 2002 attempted murder conviction - was seen handcuffed to a hospital bed on Sunday in photos obtained exclusively by DailyMail.com. He is expected to be arraigned on Monday morning.
Authorities said they brought a woman in for questioning who is believed to be Williams' girlfriend Liza T Valdez, a communications technician for the NYPD.
Scroll down for video
A safety memo issued by Jennings on Sunday night is seen in full above. It essentially urges officers to hide their police affiliation to avoid being targeted
Suspect Robert Williams is seen handcuffed to his hospital bed in photos obtained exclusively by DailyMail.com
Williams appeared to be sedated and his severely swollen face was covered in dried blood from a wound on his cheek
Williams (left) was reportedly out on parole after a 2002 attempted murder conviction. Authorities were also questioning a woman believed to be Williams' girlfriend Liza T Valdez (right), a communications technician for the NYPD
Surveillance footage shows Williams before the Saturday night shooting (left) and inside the 41st precinct station before the Sunday morning shooting (right)
New York City leaders held a press conference on the case on Sunday afternoon, where NYPD Commissioner Dermot Shea and Mayor Bill de Blasio blamed the attacks on an anti-police atmosphere fueled by recent protests.
Cops are circulating this doctored photo of DeBlasio with Williams. The mayor started a program that gives Mets tickets and other freebies to defendants to entice them to return to court
Shea hit out at criminal justice reform activists who've held demonstrations against use of excessive force, referencing a protest on January 31 in which dozens of members of a radical police-hating group stormed Grand Central Terminal chanting anti-NYPD slogans including 'F**k cops!' Cops
'These things are not unrelated. We had people marching through the streets of New York City recently,' Shea said. 'Words matter. And words affect people's behavior.'
Shea didn't offer any evidence that Williams knew of those protests or was influenced by them.
De Blasio, who was elected partly on a promise to reform overly aggressive policing of minority communities, also suggested that anti-police sentiment had gotten out of hand.
'Anyone who spews hatred at our officers is aiding and abetting this kind of atmosphere; it is not acceptable,' de Blasio said. 'You could protest for whatever you believe in, but you cannot vilely attack those who are here to protect us. It creates this kind of dynamic.'
NYPD Commissioner Dermot Shea (left) and Mayor Bill de Blasio (right) spoke at a press conference on Sunday and blamed the attacks on an anti-police atmosphere fueled by recent protests
Thousands of protesters flocked to Grand Central Terminal and flowed out into Midtown's streets on January 31 to protest police use of excessive force
The first attack unfolded just before 8.30pm Saturday when a man approached a locked police van with its emergency lights activated and asked the officers inside, Paul Stroffolino, 31, and Brian Hanlon, 33, for directions.
The suspect then pulled out a gun 'without provocation' and fired multiple shots into the van, striking Stroffolino on the chin and neck, narrowly missing his carotid artery.
Neither Stroffolino nor Hanlon, who have been friends since middle school and partners for eight years, fired a single shot. Hanlon then drove Stroffolino to a nearby hospital, where he was held overnight for observation.
The shooting happened near the junction of East 163 and Barretto streets, where the officers were stationed because of recent drug activity and violence, officials said.
Police released a photograph of the suspected shooter and were combing the city for him when Williams walked into the police station coordinating the manhunt, strolled to the desk and brandished a gun just before 8am.
Two security cameras captured video of the chaotic scene at the 41st precinct station.
Williams struck Gautreaux, who was sitting at the front desk, and the lieutenant returned fire but did not hit the suspect.
He then rushed into a side room and fired at two people, including a civilian employee, before retreating into the lobby and diving on the floor when he ran out of ammunition.
Video from a different angle shows an officer in the precinct lobby reacting to the first gunshot. One uniformed cop is seen punching the suspect as other officers converge, pointing their guns, and the gunman's pistol is seen sliding away from him across the floor.
Williams is seen diving on the floor and surrendering after he ran out of bullets
Several officers swarmed the suspect after he surrendered his weapon
The two shootings took place only blocks away from each other less than 12 hours apart
The suspect is seen raising his gun and firing at cops in security camera footage from Saturday's incident
The suspect (pictured) was filmed walking away from the scene of Saturday's shooting, which police say was unprovoked
Emergency vehicles rushed to the 41st precinct after a lieutenant was gunned down at the front desk on Sunday morning
EMS are seen taking the victim out of the 41st precinct on a stretcher on Sunday morning
Police released this photo of a firearm Williams allegedly used in both attacks
At Sunday's press conference, Commissioner Shea said that the suspect was paroled in 2017 for an attempted murder conviction in 2002 in the Bronx. He said the suspect had carjacked a woman, crashed the car and then engaged in a gunfight with NYPD officers.
Williams was recently released from police custody after being jailed on charges of heavy weapon possession and was due in court in the coming days.
Shea referred to the suspect as a 'coward' and said authorities were confident that he was involved in both the precinct shooting on Sunday and the patrol shooting the night before.
'This is not a crime gone bad. This is not a liquor store robbery interrupted that a tragedy erupts from. This is a premeditated assassination attempt,' Shea said.
'It is only by the grace of God and the heroic actions of those inside the building that took him into custody that we are not talking about police officers murdered inside a New York City police precinct.'
Mary Williams, the suspect's grandmother, told News 4 she was 'really shocked' by the allegations levied against him
The suspect's grandmother, 80-year-old Mary Williams, spoke to NBC 4 New York after the attack on Sunday and said she was 'really shocked' by the allegations levied against him.
She said she spoke to her grandson, whom she raised in the Soundview section of the Bronx, a few hours before the first attack.
She said Williams had been looking for a job recently, adding that he 'didn't have no problem with no police lately'.
The grandmother also noted that Williams' own son was shot and killed in the Bronx two years ago but declined to elaborate on his death.
Authorities said they were interviewing a woman who was 'present in the general area' and may have driven Williams to the precinct.
Police did not name the woman as she is not considered a suspect but sources identified her to DailyMail.com as Valdez, Williams' girlfriend.
The woman's mother spoke to ABC 7 on Sunday night and said she was not Williams' girlfriend, but the pair were childhood friends.
The mother insisted that her daughter 'has nothing to do with this' and suggested that Williams tricked her into driving him to the precinct.
Paul Stroffolino, the officer injured in the Saturday shooting, was released from Lincoln Hospital on Sunday morning
Stroffolino had a bandage over his neck as he left the hospital, where fellow officers gathered to shower him with applause
Stroffolino smiled at his wife as he departed from Lincoln Hospital (left). The couple are seen right in a Facebook photo
Stroffolino gave a thumbs up to the supportive crowd after he got in a car to head home
Sunday's official press conference was held at Lincoln Hospital, where the officer injured in the shooting the night before was treated.
Stroffolino was released on Sunday morning and is expected to make a full recovery.
The 15-year veteran of the NYPD was showered with applause from fellow officers as he was carted out of the hospital and gave a thumbs-up to the crowd.
Shea said the Saturday night shooting 'harkens back to some bad times', referencing previous assassinations of police officers.
In 2017, a gunman killed Officer Miosotis Familia as she sat in her patrol vehicle in the Bronx. In 2014, two officers, Rafael Ramos and Wenjian Liu, were shot dead in their patrol car in Brooklyn by a man upset about recent police killings of unarmed black men.
The commissioner said Ramos and Liu's deaths were 'not something that engenders anything but the worst memories'.
He said that 'everyone should be speaking against this', adding: 'I condemned it then and I condemn it right here today.'
In the wake of the killings of Ramos and Liu, some officers blamed de Blasio for expressing solidarity with the demonstrations, and turned their backs on the Democrat at the funerals.
De Blasio spoke after Shea at Sunday's press conference and echoed his characterization of the shooting, calling it 'an attempt to assassinate police officers'.
'There's just too much hatred out there right now,' De Blasio said.
Robert Gangi, executive director of the Police Reform Organizing Project advocacy group, said it was 'irresponsible' for Shea and de Blasio to say the violence this weekend was linked to the recent demonstrations, which he said involved activists 'protesting in a legitimate fashion.'
Of the gunman, though, Gangi said there is 'no defense for a lunatic who opens fire on police.'
At Sunday's press conference, Commissioner Shea referred to the suspect as a 'coward' and said authorities were confident that he was involved in both the precinct shooting on Sunday and the patrol shooting the night before
De Blasio echoed Shea's characterization of the shooting, calling it 'an attempt to assassinate police officers'
A heavy police presence is seen outside the 41st precinct after the shooting on Sunday morning
Officers with the NYPD's Technical Assistance Response Unit are seen near a vehicle believed to belong to the gunman
New York City police direct foot traffic on the corner of 163rd and Fox Street at the scene of Saturday's shooting
Trump tweeted: 'I grew up in New York City and, over many years, got to watch how GREAT NYC's "Finest" are. Now, because of weak leadership at Governor & Mayor, stand away (water thrown at them) regulations, and lack of support, our wonderful NYC police are under assault. Stop this now!'
President Donald Trump spoke out against the latest violence against police, blaming New York Governor Andrew Cuomo and Mayor Bill de Blasio for the attacks
New York Governor Andrew Cuomo said he was 'horrified' after the recent attacks
Cuomo had tweeted to condemn the 'heinous' attacks on those who serve the city.
'Horrified by the multiple attacks on officers in the Bronx,' New York Governor Andrew Cuomo tweeted. 'NY's law enforcement officers put their lives on the line every day to keep us safe. These attacks are heinous. Those responsible will be brought to justice & held accountable to the fullest extent of the law.'
He shared in an official statement that state police would be on hand to help and said the perpetrator will be punished harshly.
NYC Council Speaker Corey Johnson also tweeted about the shooting
'I am horrified by the two attacks on NYPD officers that occurred last night and this morning in the Bronx,' Cuomo stated. 'Members of New York's law enforcement community put their lives on the line every day to keep us safe, and they deserve our respect and appreciation. I have asked the New York State Police to reach out to the NYPD to offer any assistance necessary.
'We have zero tolerance for attacks of any kind against law enforcement, and the person or people responsible will be held accountable to the fullest extent of the law.'
NYC Council Speaker Corey Johnson tweeted: 'We have another shooting of a police officer in the Bronx. Prayers for the officer in the latest shooting, who is at Lincoln Hospital w/non-life threatening injuries, the officer who was shot last night, and all those who serve our City. This horrific violence must end.'
The president of the Police Benevolent Association said the streets needed to be fixed.
'It is a double miracle that we are not preparing for two funerals right now,' Patrick Lynch, PBA president, said in a statement. 'These targeted attacks are exactly what we have warned against again and again. The hatred and violence directed at cops continues to grow. Good luck and kind words are not enough to keep police officers or the public safe.
'Our elected officials need to start listening to us and working with us — not against us — to fix the deteriorating environment on our streets.'
He added outside the hospital on Sunday: 'Start backing our police officers. Our elected officials who stand and nod their heads with us, it's time you open your mouth and say "This must stop."'
The first officer was shot at 906 Simpson St in the Bronx New York on Saturday, February 8
NYPD issued a warning to avoid the area as helicopter is called in to search for the suspect
An NYPD cop is seen on the scene of the first shooting on Saturday night


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Very large pothole
Reported in the Potholes / Highway Condition category anonymously at 17:28, Fri 8 November 2019
Sent to Northamptonshire County Council 3 minutes later. ref: 1838380.
I have now hit this twice in my car and it is going to cause an accident if hit by a cyclist
Thank you for reporting a fault. We will use the information you have provided to assess and prioritise this fault in accordance with our published response times for fault reports.
State changed to: Investigating
Posted by Northamptonshire County Council at 17:30, Fri 8 November 2019
Two hour defect triggered to utility company to make safe on 11/11/2019 am.
Posted by Northamptonshire County Council at 15:50, Fri 15 November 2019
Following a review this issue is not a Northamptonshire County Council responsibility.
State changed to: not the council's responsibility
Posted by Northamptonshire County Council at 09:06, Tue 19 November 2019
This report is now closed to updates. You can make a new report in the same location.


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You don't need to register a brand name or logo with the U.S. Patent and Trademark Office to claim protection as a trademark. While registration offers further legal rights, a common-law trademark is recognized if you use the trademark in commerce. Yet it still requires due diligence on your part to discover if anyone is already using a similar mark. If your planned trademark can be confused with others to identify similar goods and services, you can run into legal trouble if you attempt to use the mark. Even if you don't plan to register your trademark, the Trademark Office is still a good place to start.
Search the Trademark Office's Trademark Electronic Search System using the "basic word mark" option to discover any word or phrase trademark that would conflict with yours due to a "likelihood of confusion" between the two. Confusion can be legally found to exist if the words are similar in appearance or sound, and if they identify the source of related goods or services. Word marks spelled differently would still conflict if the pronunciations are the same or similar. Yet there would be no conflict if the goods and services are not related, such as one mark covering clothing, the other computer programming.
Determine the code you need from the USPTO's Design Search Code Manual to search for graphic trademarks. The manual identifies graphic elements in a numerical code and divides them by categories. For instance, celestial bodies, geographic maps and natural phenomena fall under the code "01." Stars that have three points are coded 01.01.01. You can combine codes to search for registered trademarks with several design elements. The graphic need only be similar to be a potential conflict if it identifies similar services and goods.
Compare your planned trademark to those used by potential competitors or any company or organization offering similar goods or services. You can discover similar character trademark usage through Internet search engines and domain names. Trade groups also have listings of members you can study for similar names and logos. If you plan to do business only in one state, you can check with the secretary of state or other office that handles business and corporate filings to see if there is a state trademark similar to yours. A state trademark only offers protection within the state.
Begin using the trademark in commerce to identify the services you offer or goods you sell. Use the initials TM in subscript or in parentheses next to the logo or characters to notify the public of your claim in connection with goods sold. Alternately, use the initials SM to identify a service mark for the services offered.
Even if you intend to register your trademark, you need to begin using it in commerce before your registration is accepted. The registration process can take months or years. Searching for potential trademark conflicts before applying for registration can save time and extensive legal costs.
You cannot use the registration mark -- an R in a circle -- with your trademark unless you apply for and the Trademark Office accepts your registration.


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As with people, dogs can get into trouble when they run with the wrong crowd, or should I say, the wrong pack. Tippy found this out a couple of weeks ago. We had gone for our walk in the neighbor's field and she disappeared before we got back. She does this sometimes, but always comes back within 10 to 15 minutes. I figure she can't get into too much trouble in that short period of time. However, on that day, the neighbor called to let me know that he had seen Tippy and the neighbor's two Pit Bulls barking at his cows. Uh oh!
He was actually very nice about it and said he didn't think they would do any harm, but he had three new calves and they were aggravating the mom's to death. He asked me to keep Tippy up for a couple of weeks, until the calves are better able to take care of themselves. He also told me that he has had problems with those Pit Bulls for over two years. I have since learned that they run the horses that belong to their owner. That's not good.
So, for over a week now, Tippy has either been inside, tied out, or on leash. She's not happy. I feel bad for her and wish I could make her understand why she isn't allowed to run free. If I could, I'm sure she would chose freedom over hanging out with the other dogs.
Yesterday, I'm convinced the Pit Bulls came by for a visit and she really wanted to go out to play. Here is what I saw and heard.
When that didn't work, so she made one last ditch effort.
I did eventually take her out for a nice walk, but only after I was sure that the Pit Bulls had moved on. I have figured out a way to let her get some running in with little potential for "escape." I drop the leash, throw a treat, which she will run to retrieve and devour, then run back to me and sit down to wait on the next treat to be thrown. This has the added bonus of working on her recall. Sure wish I had made that a priority when she was a puppy.
Just a few more days and I will let her have more freedom. Living on a farm, I hate to have to keep her restrained – especially since she's used to being able to run free and she has so much energy. But, having grown up on a farm, I also understand that she can't be allowed to aggravate the cows. For a long term solution, I am researching GPS dog collars that will allow me to keep track of her when she is out of my sight. Maybe that will keep us both from getting into trouble in the future.
Tippy and I wish you all a very happy and trouble free 2018!


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The wait is over! "In A Heartbeat", an animated short about a young boy whose heart threatens to drag him out of the closet, is finally done and available to watch.
"In A Heartbeat" is a dialogue-free animated short that follows Sherwin, a boy deep in the throes of a crush on his oblivious classmate Jonathan. He moons over Jonathan but can't get up the courage to share his feelings. Suddenly, his heart leaps from his chest. Will Sherwin be able to contain his heart before it gets him into trouble? Watch below and find out!
Many young LGBT+ people can empathize with Sherwin's desperation. On top of the agony everyone feels during first love, LGBT+ kids have to worry about whether the object of their affections is also queer. There's also the fear of harassment and bullying by other kids who don't understand, or whose parents have taught them that being gay is wrong. Having a film like this, one that shows boys in love in a positive light, can help lessen those fears.
Creators Beth David and Esteban Bravo made "In A Heartbeat" at Ringling College of Art as part of their Computer Animation major. They tried to make a film "that deals with a real and personal topic in a very sweet and lighthearted way." This was definitely a success: the finished film brought a smile to everyone in the room when we watched it. (There were also several high-pitched squeaking noises and one gasp.)
The project might not have drawn as much attention as it has, but as their animation neared completion last year David and Bravo decided to have a custom original score created. The pair turned to Kickstarter to raise the three thousand dollars needed to hire a professional composer. Their project charmed viewers (including your editors here at The Geekiary). People shared it back and forth, and by the time the campaign closed last November it had more than quadrupled its funding goal.
David and Bravo got their original score, and it is beautiful. The whole film is beautiful, with bright, smooth animation and a score that makes dialogue unnecessary. Every emotion is carefully rendered: Sherwin's infatuation, the panic when his heart escapes, Jonathan's awkward surprise, the other kids' confusion that balances right on the edge of scorn without quite tipping over… Basically, it hits all the right notes to rip your heart out (and put it back).
The creators released "In A Heartbeat" for free, but they could use help getting it to festivals. Anyone who wants to help support the film can buy "In A Heartbeat" swag from their Redbubble store. You can also follow the project on their official blog.
What did you think of "In A Heartbeat"? Have you shared it with an LGBT+ kid in your life? Tell us what you think in the comments below!
Author: Khai
Khai is a writer, anthropologist, and game enthusiast. She can talk fandom in five languages, and her proudest nerd moment so far was presenting original research titled "Gender, Sex, and Werewolves" at an international anthropological conference. Her first game, None For Me, is due out from Calico Games early next year.
Read our before commenting.
Do not copy our content in whole to other websites. Linkbacks are encouraged.
Copyright © The Geekiary


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I was SO SO excited to meet little Devany a little while ago…not only because I knew she'd be an adorable 8 day old baby girl, but also because her parents are past wedding clients of mine! Megan & Joey got married in 2009, and I LOVED photographing them and getting to know them :) I am so excited for them during this new time in their lives!!
Congratulations Megan & Joey – she's absolutely beautiful!!


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The Debt
NCIS: Los Angeles — Season 3
A botched assignment forces Hetty to fire Deeks and send him back to the LAPD. Meanwhile, an awkward goodbye between Kensi and Deeks leaves her with unexpected emotions for her old partner
No recaps, be the first to add one below!
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Most people are familiar with the Miranda warning "what you say can be used against you in a court of law" because of crime drama shows like "Law & Order." However, they may not realize that the same concept applies when it comes to wrongful termination or employment discrimination. This means that email transmissions and more importantly, social media posts can become discoverable evidence in litigation.
So what does that mean for potential plaintiffs who may sue their employers after being terminated or denied a promotion? It essentially means that you must watch what you say and when you say it. Like other cases, such as divorces and criminal matters, investigators can comb through email records to find messages that you may have developed and sent, even if you believe that you have deleted them from your box.
The same can be said with statements made over social media sites. Posts on Facebook, Twitter and Instagram are basically public record, which, more importantly, show when the posts were made. If they are made during work hours, they may negatively affect your case. After all, employers want their employees doing their assigned tasks during work hours, and combing through Facebook can leave the appearance that an employee is goofing off instead of working. This may not sit well with a judge or arbitrator, regardless of how meritorious your claim may be.
While people may spend a majority of their waking hours at work, it is important to realize the correct times to spend time on social media sites.
Source: HuffingtonPost.com "


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On weekends in particular, Carolina Beach surf spot can get crowded. It is popular with beachies and surfers, so both the sand and waves can be pretty crowded. The surf is great though and you will see surfers at any level out there.
You can earn kudos too! Try these:


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Flutter is currently on a mission to become a true "write-once, run anywhere" technology. iOS and Android platforms are extensively supported and it's already possible to build macOS applications using Flutter.
ℹ This post solves a very technical issue – if you're interested in learning more about Flutter and why to use it, this article provides a higher-level overview and explains why we are building our AI-assistant with Flutter.
Building and running a macOS application with Flutter has become quite easy in the last few months. Unfortunately, the tooling around Flutter Desktop applications still lacks some essential features – but be assured that the maintainers of Flutter are already working on most of them.
Shipping a Flutter Desktop application to customers
One of the essential features currently missing is the capability to build a macOS Installer (usual a .dmg file) for distribution. By default, Flutter builds a .app file, which can be executed straight away:
$ flutter build macos --release Running pod install... Building macOS application... $ ls build/macos/Build/Products/Release Neo.app
Building a .dmg with Flutter
But what, if you would like to distribute an installer?
There is a great project called "create-dmg" out there, which can be installed using Homebrew (refer to the project's README for other setup methods):
To give it a try, switch to the /build/macos/Build/Products folder after building your macOS application.
Customizing your installer
To make your installer more fancy, you can customize the volume name, volume icon, and installer background. You just need to fiddle with the icon placement and text size and you'll end up with a few command lines:
#!/bin/sh test -f Neo-Installer.dmg && rm Neo-Installer.dmg create-dmg \ --volname "Neo Installer" \ --volicon "neo_icon.icns" \ --background "installer_background.jpg" \ --window-pos 200 120 \ --window-size 800 529 \ --icon-size 130 \ --text-size 14 \ --icon "Neo.app" 260 250 \ --hide-extension "Neo.app" \ --app-drop-link 540 250 \ --hdiutil-quiet \ "Neo-Installer.dmg" \ "Release/"
The script automatically prepares the DMG installer with the desired settings. Don't be spooked by some windows automatically appearing in the process:
Even more fancy with Retina support
By default, the background image does not support retina resolutions and might look a bit blurry. Fortunately, it's possible to use a TIFF image instead of PNGs / JPGs. Just create a @2x version of your background image with twice the resolution. On macOS you can use tiffutil to create a retina-ready background image for your installer:
tiffutil -cathidpicheck installer_background.jpg [email protected] -out installer_background.tiff
There are a few more options to consider when using create-dmg. For example, you can attach your own EULA / license. Keep in mind, that this manual step (of creating a DMG installer) might be obsolete in future versions of Flutter. But for today, this enables you to get up and running with your own, distributable Flutter desktop application in no time.


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Tackle Source is proud to introduce a product we have developed in conjunction with FEED Lures and Major Craft. The FEED Jungle series of rods are now available in four piece travel models, with both spin and baitcast available.
Designed with angler comfort in mind when going into combat with mean fish, the Jungle Pack Rods retain all the best attributes from the original Jungle series rods but add the all important portability factor for the world traveller.
For enquiries please email


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Photo: Randy Dausch; Styling: Lindsey Lower
We love the savory ingredients in Pecorino and Parsley Couscous. Grated lemon rind adds a bit of brightness to the flavor in this quick side.
How to Make It
Bring water to a boil. Add couscous. Reduce heat to medium-low; cover and simmer 8 minutes. Stir in parsley, pecorino Romano cheese, pine nuts, lemon rind, salt, and pepper.


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The Old Military Road (R115), through Wicklow mountains, is a very scenic drive located in Dublin and Wicklow counties in Ireland. It was one of the first purpose-built roads of the country.
The road, also known as An Bóthar Míleata, runs north-south from Rathfarnham (Ráth Fearnáin), a southside suburb of Dublin to Laragh, a small village in County Wicklow. It is 38.6 km (23,98 miles) long. The surface is asphalt. This scenic route through the centre of the mountains is narrow, windy and at times quite bumpy. This road was twisty and very lumpy. The bogs cause the road to sag and the condition eliminates most of the flat road and leaves you feeling like you are on the tail end of a roller coaster ride. It's a stunningly beautiful place in all weather.
The road encompasses miles of stunning views through twisty hair pin corners, high elevations and steep grades. The road is narrow in its entirety. You must drive with caution. In many places it is difficult to see very far because of the curves. The views from the road are outstanding. It suffers the harsh meteorological conditions of the area every winter. Often during the winter there are road closures due to snow and ice. Occasionally there are difficulties due to flooding or fallen tres. When the rain comes down, the land that the road runs through turns into bogs and marshes. Sometimes, that causes the road to sink completely.
The road was constructed between 12 August 1800 and October 1809 and runs north-south across the spine of the Wicklow Mountains. This road is very exciting and sometimes very exposed and unsecured driveway in innumerable twists and turns. It has been used in the Circuit of Ireland car rally. It is also a scenic route for visitors. The terrain is rugged, and even in the middle of summer, you'll be blasted with vicious crosswinds the whole time you're on it.


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These five trends include network attacks, especially malicious code attacks using artificial intelligence (AI); attacking e-commerce and financial-banking systems with the aim of stealing personal information and data from users; attacks on infrastructure, internet of things (IoT) equipment, smart urban areas, and taking advantage of these devices to carry out network attacks; intentional network attacks on state agencies and organisations in order to steal information and data; and the tendency to smear, defame and spread malicious information against agencies, organisations and individuals.
Commenting on Vietnam's information security this year, Khong Huy Hung, CEO of the Vietnam Cyberspace Security Technology JSC (VNCS), emphasised the risks and challenges in ensuring information security and data security with the rapid increase of IoT devices.
According to Hung, with the explosion in numbers as well as variety, IoT devices have gradually changed the network attack market when bringing a large amount of resources, leading to a conflict over the control of IoT networks worldwide with hacking organisations. The explosion of malicious code exploiting a wide-ranging IoT device will take place.


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The F Word | F is for: Foster Care
Season 2018 Episode 9 | 8m 21s Video has closed captioning.
Nicole and Kristan are a queer Bay Area couple who want to adopt a child from foster care. As they prepare to have their home inspected, they child-proof their apartment and invite a couple of kids over to examine their handy work. Will they pass the safety check? Episode 1 of a 6-part series.
Aired: 05/04/18
Expired: 07/12/20
Problems Playing Video? | Closed Captioning


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Nature is tough. Why does immediate gratification is seen as a bad thing ? And why should we always be patient for the good things ?
Why am I so tempted to check youtube now instead of developping my business ?
The reason is simple, our mind flow where there is the most feedback.
Youtube is immediate feedback, you click, you see the video.
A video game is immediate feedback, each action will cause a reaction.
Open facebook, and you see all these news on your friends.
Why these things are so addictive ? Because our mind search to attain flow.
Flow is the mental state you experience when you are so focused on something that time and your body seems to disappear.
Flow happens when your mind is too occupied to care about your environment, and it happen thanks to the constant feedback of the task.
Immediate gratification is not a bad things, you can use the same principle on any activity that make you grow.
If you want to stop procrastinating, just ask you this question : How to produce constant feedback when working on my task ?
In software development test driven development is a powerful method that will keep your from procrastinate.
If you want to be fit, how can you create more feedback during physical exercice ?
If you want to expand your knowledge, how will you use it for immediate result ?


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Focusing on the building rather than the content, this book is an alternative guidebook to the site. It uses soundbite captions and photographs from the NMEC archive. In the middle, a transparent section of layered pages shows the engineering and architectural principles of the building. The circular pages and the futuristic packaging are designed by North to evoke the building itself.
Edited in-house by the NMEC, published by Booth-Clibborn Editions on 7 February, priced £9.99
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text: Rj Link International Inc. is pleased to announce that Ann McGirk has been named as Account Manager. In her new role, Ann will be responsible for Contract and service sales. Ann spent the past 5 years working as an Account Manager for Manufacturing Technologies Group out of Rockford, IL. Ann was responsible for overseeing the […]Continue Reading... No Comments.


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This training is focused on the generation of reports and statistics. Based on the Administration training courses, in this training the necessary knowledge for the generation of reports and statistics is communicated. Here you will get to know the display of complex data structures with OMNITRACKER.
Contents of this training are amongst others:
• General Reporting
• Reporting in OMNITRACKER
• OMNITRACKER Report Wizard
• Setup of a Report using the example of the Export scheme
• Introduction in Crystal Reports 2008
• Subspecies of the Export scheme
• Sub-Reports with Crystal Reports 2008
• Automation of Reports
• Charts and contingency tables in Crystal Reports
• Event Statistics
• Basic Statistics
• Dashboard
As you will take the comprehensive training documentation home the numerous exercises and examples can always be reconstructed or revised.
Certification test for OMNITRACKER Certified Professional is given on the last day, and is obligatory.
Duration day(s): 2
Price (incl. VAT): 29 000 rub.
Please note:
Price for combined 5-day seminar "OMNITRACKER Basic Administration + Advanced Administration + Reporting" (incl. VAT): 78 000 rub.
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Such a warm and welcoming but professional service! Beth made me feel completely relaxed when I went shy in front of the camera and we just chatted while she snapped away! Completely overwhelmed with how amazing the photos are. She is amazing!!! Can't wait until I have my next set of photos! Thank you so much! - Eleanor Newton
Thank you Beth for the pictures, we just love them!! Keep being so talented with the camera and keep finding such beautiful places that need to be photographed! -Claudia Moreno
They're beautiful. Thank you so much... we shall certainly be giving you a shout when the kids are a little older. You're an awesome photographer! - Erin Patel
Oh Wow, they're gorgeous. Thank you so much! Had a chance to choose which we'd like prints of. Quite a lot! Hard to narrow down, we love them all so much. - Lucy Greenwood
Beth these are superb. I love them.
Thank you so much for your hard work - Ann Tattam
They are lovely, thank you so much! - Laura Coates