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Critical Care Research and Practice
Volume 2013 (2013), Article ID 715915, 8 pages
Short- and Intermediate-Term Outcomes of Preterm Infants Receiving Positive Pressure Ventilation in the Delivery Room
1Department of Pediatrics, University of Alberta, Edmonton, AB, Canada T6G 2R3
2Division of Neonatology, Department of Pediatrics, Medical University Graz, 8036 Graz, Austria
3Department of Newborn Medicine, Royal Alexandra Hospital, 10240 Kingsway Avenue NW, Edmonton, AB, Canada T5H 3V9
Received 13 July 2012; Accepted 18 December 2012
Academic Editor: Manuel Sánchez Luna
Copyright © 2013 Megan O'Reilly 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.
Although recent advances in neonatal care have improved survival rates, rates of bronchopulmonary dysplasia remain unchanged. Although neonatologists are increasingly applying gentle ventilation strategies in the neonatal intensive care unit, the same emphasis has not been applied immediately after birth. A lung-protective strategy should start with the first breath to help in the establishment of functional residual capacity, facilitate gas exchange, and reduce volutrauma and atelectotrauma. This paper will discuss techniques and equipment during breathing assistance in the delivery room.
1. Introduction
Approximately 20% of premature infants require breathing support at birth [1, 2]. An international consensus on resuscitation suggests equipment and techniques if infants fail to initiate breathing [3]. It is agreed that positive pressure ventilation (PPV) is the cornerstone of respiratory support at birth [3]. During the application of PPV in the delivery room (DR) the lungs of preterm infants are exposed to potentially injurious tidal volumes () [4, 5]. Although neonatologists are familiar with the concept of reducing lung injury and are increasingly careful in the neonatal intensive care unit (NICU) to apply PPV strategies that are gentle to the lung, the same gentle approach has not been translated into practice in the DR [6]. Ideally, a lung-protective strategy should start immediately after birth. At birth, the lungs of very preterm infants are uniquely susceptible to injury because they are structurally immature, surfactant-deficient, fluid-filled, not supported by a stiff chest wall, and are unable to generate adequate end expiratory pressure to maintain open alveoli [6]. To facilitate early development of functional residual capacity (FRC), reduce atelecto- and volutrauma, and improve oxygenation, sustained inflations (SIs), positive end expiratory pressure (PEEP), and continuous positive airway pressure (CPAP) have been advocated [7–15].
This paper summarizes the various methods available to clinicians for the provision of positive pressure ventilation to preterm infants in the DR, the impact on clinical outcomes, and potential areas for further research.
2. Search Strategy
The aim of this article was to review the available literature about delivery room interventions and their effect on outcomes in newborn infants. We reviewed books, resuscitation manuals and articles from 1960 to present with the search terms "Infant, Newborn," "Delivery Room," "Neonatal Resuscitation," "Intubation," "Surfactant," "Positive Pressure Respiration," and "Continuous Positive Airway Pressure."
3. Respiratory Support in the Delivery Room
The purpose of PPV is to establish FRC, deliver an adequate to facilitate gas exchange, and stimulate breathing while minimizing lung injury [6]. The International Liaison Committee on Resuscitation and various national resuscitation guidelines recommend equipment and techniques for neonatal resuscitation [16–18].
3.1. Ventilation Devices during Respiratory Support in the Delivery Room
There is currently limited evidence to guide clinicians' choice of device for providing PPV in the DR [19]. Self-inflating bags, flow-inflating bags, or T-piece devices may all be used for mask ventilation. A self-inflating bag, however, does not provide PEEP or CPAP [6, 20]. An attached PEEP-valve provides inconsistent PEEP and cannot deliver CPAP [21–24]. A flow-inflating bag provides variable- and operator-dependent PEEP [16, 25]. With a T-piece device a more consistent, predetermined level of PEEP and PIP can be delivered [5, 21, 22]. In addition, a T-piece device has been shown to be the most accurate device for delivering a sustained inflation breath [17, 22, 26, 27].
3.2. Respiratory Function Monitor
The use of respiratory function monitor (RFM) has been described during neonatal simulation [28], neonatal resuscitation [29, 30], and neonatal transport [31]. A Respiratory Function Monitor uses a small, low dead space flow sensor (~1 mL), which is placed between a ventilation device and a facemask or endotracheal tube [30]. The monitor can be set to continuously display airway pressure, gas flow, and tidal volume waves. It also measures and displays numerical values for peak airway pressure, PEEP, CPAP, , respiratory rate, and expiratory minute ventilation [30]. Adverse events (e.g., mask leak or airway obstruction) can be identified by observing the displayed waveforms [30]. The leak between mask and face or around an endotracheal tube is expressed as a percentage of the inspired . Leak is graphically presented as the difference in area under the flow curves above (inflation) and below (deflation) zero flow (Figure 1(b)) [30]. Several observational studies in the DR have reported on the advantages and disadvantages of an RFM during neonatal resuscitation. Recently, a randomized trial by Schmölzer et al. compared the additional use of an RFM with clinical assessment versus clinical assessment alone and reported significant reduction in mask leak, significant increase in CPAP use, and significant less intubation in the DR [29]. Although this is promising, further trials are warrant.
3.3. Mask Ventilation in the Delivery Room
Using airway maneuvers (e.g., jaw thrust or chin lift) to maintain airway patency is a crucial step during mask ventilation in adults and children [32]. However in newborn and infants several factors can reduce the effectiveness of mask ventilation, including poor face mask technique resulting in leak or airway obstruction, spontaneous movements of the baby, movements by or distraction of the resuscitator, and procedures such as changing the wraps or fitting a hat [33, 34]. Delivery room studies have shown that mask leak and airway obstruction are common problems during PPV [5, 33, 34]. Both leak and obstruction are usually unrecognized unless expired CO2 detectors or RFM (Figure 1) is used [33, 34].
3.4. Assessment of Mask Ventilation
If infants fail to initiate spontaneous breathing immediately after birth, PPV should be given [16]. A rapid increase in heart rate is the most important clinical sign for adequate mask ventilation [16, 35, 36]. If no heart rate increase is observed, chest wall movements should be assessed to gauge mask ventilation [16]. However, the current neonatal resuscitation guidelines do not describe how chest wall movement should be assessed [16]. Two observational studies in the DR compared clinical assessment with measurements of an RFM [4, 5]. Schmölzer et al. compared chest rise with measurement during mask PPV in the DR [5]. Assessing chest wall movement during mask PPV whilst standing at the infant's head was difficult and unreliable [5]. However, limitations of this study were the inexperience of the resuscitators and the potential obstructed view of the resuscitators by the ventilation device [5]. Poulton et al. compared chest rise observed from two different angles (head view versus side view) and different level of experience (junior staff versus senior staff) [4]. Overall the accuracy of clinical assessment of chest wall movement was poor and did not appear to be influenced by either the observers' position or the level of experience. However, more resuscitators were unable to assess chest wall movements while performing PPV than those observing from the side [4]. These two studies demonstrate that resuscitators were unable to accurately assess chest wall movements during mask PPV. The additional use of an RFM to continuously measure and displays delivery might improve the effectiveness of neonatal resuscitation. During mask PPV an RFM continuously display wave forms which can be used to guide mask ventilation. The clinical team can identify mask leak or airway obstruction as well as high or low delivery to guide ventilation. A recent randomized trial by Schmölzer et al. demonstrated that an RFM additional to clinical assessment demonstrated significant reduction in leak during mask PPV in preterm infants in the DR [29].
3.5. Mask Leak
Mannequin studies demonstrated large mask leaks during simulated mask ventilation, and operators were usually unaware of the extent of mask leak [37, 38]. Observational studies in the DR reported similar results with mask leak exceeding 75% in 50% of analyzed resuscitations [5, 34]. The leak between the mask and the face is an enemy of mask PPV, causing a reduction in tidal volume delivery and impairing resuscitation efforts. A mannequin study demonstrated that operators observing RFM graphics (Figure 1) were able to reduce mask leak during PPV [39]. A recent randomized controlled trial comparing mask PPV in the DR performed with either an RFM visible or masked showed similar results [29]. Observation of flow waves significantly reduced mask leak from 54% to 37% [29]. Furthermore, fewer infants were intubated or required oxygen at five minutes after birth, and more infants left the DR on CPAP [29]. Although no difference in any long-term outcomes was observed, the results of this study may indicate that flow wave guidance improves mask PPV and decreases short-term adverse outcomes [29].
3.6. Airway Obstruction
Current resuscitation manuals suggest that during mask PPV airway obstruction may be due to (i) manual compression of the soft tissues of the neck and tongue, (ii) hyperextension or flexion of the head, or (iii) the face mask being held on the face so tightly that it obstructs the mouth and nose [16, 33, 34].
Two observational studies in the DR reported on airway obstruction during resuscitation of preterm infants [33, 34]. Finer et al. used a colorimetric CO2 detector to identify obstruction during mask PPV. They found airway obstruction in 75% of infants receiving PPV in the DR [33]. Although CO2 detectors can be very useful to assess effective ventilation, they do not differentiate between an inadequate , airway obstruction, or circulatory failure [40–43]. In contrast an RFM, which displays flow and tidal volume signals (Figure 1), may distinguish mask leak and airway obstruction, [30, 34]. A recent observational study in the DR showed that severe airway obstruction defined as a reduction in of >75% occurs in 25% of infants receiving mask ventilation [34].
Several airway maneuvers, such as jaw thrust or chin lift, are recommended in children and adults to maintain airway patency during resuscitation [16]. An airway obstruction has been reported in 50% of cases when either chin lift or jaw thrust was applied during mask PPV, while using the combination of both, no airway obstruction was observed [32]. Similar studies are needed in newborn infants to clarify the best head and airway position.
3.7. Tidal Volume Delivery
During PPV a peak inflation pressure (PIP) is chosen with the assumption that this will deliver an adequate [5]. However, the delivered is rarely measured, and therefore airway pressure is not adjusted accordingly [4, 5]. A low may be insufficient to achieve adequate gas exchange and may cause hypercapnia and atelectotrauma, whereas excessive may cause hypocapnia and volutrauma [6]. Both low and excessive delivery promote release of inflammatory mediators, which contribute to bronchopulmonary dysplasia (BPD) [44, 45]. In addition, clinicians struggle to achieve a balance between aerating the distal gas exchange units (alveoli) without overdistending the lung causing damage [6]. An animal study demonstrated that a few large manual inflations can damage the lungs [46]. Tidal volumes similar to this study have been reported during mask PPV of preterm infants [4, 5]. In addition, several animal studies demonstrated that PPV with high s contributes to lung injury [45, 47]. Using a lung simulator Kattwinkel et al. demonstrated that operator adjusted to compliance changes faster when was displayed compared to pressure [48, 49]. A recent randomized control trial compared guidance with clinical assessment during mask PPV in the DR in infants <32 weeks of gestation [29]. Mask leak was significantly decreased in the RFM visible group; however was similar in both groups [29]. Promisingly, the infants in the RFM visible group received less high (>8 mL/kg) delivery compared to the masked group [29], which have been shown to contribute to lung injury [45, 50].
3.8. Sustained Inflation
In preterm infants a lung protective strategy should be started at birth to support lung fluid clearance and to establish FRC. Establishment of lung inflation in apneic newborn infants can be achieved with either shorter or longer inflation times [16]. In an experimental non-breathing rabbit model of neonatal resuscitation, a prolonged sustained inflation (SI) of 20 s coupled with PEEP resulted in a rapid increase in FRC as did PEEP alone when compared to PPV with or without PEEP [51]. Evidence in preterm infants comes from observational and randomized studies [7–9, 52]. Lindner et al. introduced a series of interventions in the DR that included giving a 15 s SI [8]. They observed a dramatic reduction in DR intubation rate from 84% to 40%, and the proportion of preterm infants never intubated during their admission at their institution increased from 7% to 25% [8]. Similarly, Lista et al. compared an initial 15-second SI in addition to PPV to control infants who did not receive SI [7]. They reported a reduction in surfactant (45% versus 61%) mechanical ventilation (51% versus 75%) and postnatal steroid (10% versus 25%) use. In addition, infants surviving without BPD increased from 7% to 25%, and mean duration of mechanical ventilation (5 versus 11 days) and oxygen therapy (21 versus 31 days) among infants <29 weeks was reduced [7]. Lindner et al. randomized 61 infants <29 weeks to receive a 15 second SI and PPV or PPV alone through a single nasal prong in the DR [8]. Although no difference in mortality, severe intraventricular hemorrhage, or BPD was observed, 30% to 40% of preterm infants were not intubated or mechanically ventilated within the first 48 hours after birth [8]. Harling et al. randomized 52 preterm infants to an initial 5-second SI and PPV compared to PPV alone and did not find a difference in cytokines measured in bronchoalveolar lavage fluid [52]. Te Pas and Walther randomized 207 preterm infants <33 weeks to an initial 10-second SI followed by nasal CPAP compared to mask PPV without PEEP [9]. Lower intubation rates in the DR (17% versus 36%), shorter duration of ventilatory support, and BPD (22% versus 34%) were observed in the infants randomized to SI/CPAP compared to those receiving mask PPV without PEEP [9]. Although these studies suggest that SI has the potential to reduce BPD, the results have to be interpreted with caution. Cohort studies are subject to confounders and can at best suggest an association between the use of an SI and improved outcomes. For example, infants in Te Pas and Walther's study were on average 500 g heavier compared to those in Lindner et al.'s study [8, 9]. Both Lindner et al.'s and Te Pas and Walther's studies reported more than one DR care change, with SI being just one element among [8, 9]. In addition, the randomized studies were not adequately powered to detect differences in important clinical outcomes [8, 9, 52]. Consequently, it is not possible to determine how many, if any, of the differences observed between the groups were related to the use of SI. Large randomized controlled studies of SI in preterm infants are urgently needed.
3.9. Continuous Positive Airway Pressure or Intubation
Observational studies have reported an association between decreased rates of BPD and increased use of early CPAP [53–56]. Avery et al. compared BPD rates in eight NICUs with one center having a significant lower BPD rate with much greater use of CPAP compared to the other centers [53]. Van Marter et al. reported that rates of BPD differed substantially between Columbia and Boston centers (4% versus 22%) [54]. Initial respiratory management was more likely to include mechanical ventilation (75% versus 29%) and surfactant (10% versus 45%) at Boston centers compared to Columbia, respectively [54]. A retrospective analysis of 261 preterm infants compared intubation and ventilation at birth with CPAP and reported lower mortality and rates of surfactant administration, BPD, or intraventricular hemorrhage in infants receiving CPAP [55]. Surprisingly, patent ductus arteriosus was more common among infants receiving CPAP [55]. Two randomized trials compared PEEP/CPAP with no PEEP in the DR [15, 21]. In a feasibility study Finer et al. randomized 104 extremely low birth weight infants to receive CPAP/PEEP or no CPAP/PEEP in the DR. The aim of the study was to sue CPAP/PEEP to avoid routine endotracheal intubation and to explore the CPAP or PEEP in the DR. Although no differences in rates of intubation, death, and BPD were reported, the use of CPAP/PEEP as initial respiratory management was feasible [15]. Dawson et al. randomized infants <29 weeks' gestation and reported no difference in oxygen saturation or heart rate at 5 min, mortality, rate of intubation, or BPD [21]. Two large trials randomized 1926 infants between 24 and 29 weeks of gestation to receive CPAP or endotracheal intubation at birth [12, 13]. The COIN trial reported fewer days of ventilation and reduction of surfactant use in infants receiving CPAP than those in infants endotracheally intubated at birth [13]. Worryingly, infants in the CPAP group had a significantly higher incidence of pneumothorax [13]. The SUPPORT trial randomized 1316 infants to receive CPAP or intubation and surfactant. Infants in the CPAP group had lower rates of postnatal steroids and had fewer days of mechanical ventilation than those in the latter group. However mortality and BPD rates were similar between groups in both trials [12]. Nonetheless, the results suggest that respiratory support in the DR should be started with CPAP before intubation and surfactant are considered.
3.10. Surfactant Administration
Surfactant deficiency is a contributing factor in the development of respiratory distress syndrome (RDS) and has become the standard of care for the treatment of RDS. Systematic reviews from randomized trials 15 years ago showed that prophylactic surfactant administration reduced mortality and initial inspired oxygen requirement for intubated infants <30 weeks' gestation or with birth weight less than 1250 g [57]. This led many to advocate routine intubation and surfactant administration for infants at risk of RDS [58–60]. However, the care of very immature babies has changed considerably over the last decade, and early CPAP has become an accepted alternative to endotracheal intubation and surfactant treatment [12, 13, 61–65]. In a retrospective cohort study, selective intubation of ELBW infants resulted in a significantly reduced need for intubation, lower incidence of BPD, intraventricular hemorrhage, and decreased length of hospital stay as compared to routine intubation [8]. A recent Cochrane review summarized that early stabilization on CPAP with selective surfactant administration compared to prophylactic surfactant administration and mechanical ventilation lowers the risk of BPD or death [66]. Verder et al. described his "INSURE" technique "Intubation-Surfactant-Extubation" which aimed to intubate infants only for surfactant delivery while on nasal CPAP [61]. In a multicenter randomized trial the INSURE technique reduces the need for mechanical ventilation; however no difference in important long-term outcomes (e.g., BPD) was reported [61]. The major criticism of the INSURE technique was the necessity of analgesia and naloxone to reverse the potential respiratory depression because of opioids. Various techniques of minimally invasive surfactant therapy have been described. Kribs et al. described surfactant delivery in spontaneous breathing infants on CPAP [63]. Using a flexible feeding tube positioned in the trachea with Magill's forceps surfactant is delivered [63]. Compared to historical controls the rates of mortality, severe intraventricular hemorrhage, and pulmonary interstitial emphysema were significantly reduced [63]. Two further observational cohort studies by Kribs et al. showed similar results [64, 65]. In both studies the rates of mechanical ventilation, BPD, and death were significantly lower compared to infants receiving intubation and mechanical ventilation [64, 65]. A recent multicenter randomized control trial using the Kribs technique reported a decrease in need for mechanical ventilation in the group who received surfactant while one CPAP [67]. However, no differences in mortality, BPD or other serious adverse events were observed. Alternative Dargaville et al. described "The Hobart Method" were surfactant is in stilled using a 16 gauge vascular catheter. With this technique the catheter is inserted through the vocal cords and surfactant instilled [68]. The catheter is then immediately withdrawn and CPAP reinstituted. A recent observational study by Dargaville et al. reported a reduction in need for intubation <72 h in infants receiving minimally invasive surfactant therapy compared with controls [69]. Although infants receiving minimally invasive surfactant therapy had shorter duration of oxygen therapy, duration of ventilation and incidence of BPD were similar [69]. Currently a large RCT using "The Hobart Method" is underway.
4. Conclusion
Ideally, a lung-protective strategy should start immediately after birth. At birth, the lungs of very preterm infants are uniquely susceptible to injury because they are structurally immature, surfactant-deficient, fluid-filled, and not supported by a stiff chest wall. To facilitate early development of functional residual capacity, reduce atelecto- and volutrauma, and improve oxygenation, various methods have been advocated. However, randomized control trials are urgently needed to investigate short- and intermediate-term outcomes.
PPV: | Positive pressure ventilation |
: | Tidal volumes |
NICU: | Neonatal intensive care unit |
DR: | Delivery room |
FRC: | Functional residual capacity |
SI: | Sustained inflation |
PEEP: | Positive end expiratory pressure |
CPAP: | Continuous positive airway pressure |
RFM: | Respiratory function monitor |
PIP: | Peak inflation pressure |
BPD: | Bronchopulmonary dysplasia |
RDS: | Respiratory distress syndrome. |
Conflict of Interests
The authors declare that they have no conflict of interests.
GMS is supported in part by a Banting Postdoctoral Fellowship, Canadian Institutes of Health Research, and an Alberta Innovate Health Solution Clinical Fellowship.
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- G. Lista, M. Colnaghi, F. Castoldi et al., "Impact of targeted-volume ventilation on lung inflammatory response in preterm infants with respiratory distress syndrome (RDS)," Pediatric Pulmonology, vol. 37, no. 6, pp. 510–514, 2004. View at Publisher · View at Google Scholar · View at Scopus
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- L. J. Björklund, J. Ingimarsson, T. Curstedt et al., "Manual ventilation with a few large breaths at birth compromises the therapeutic effect of subsequent surfactant replacement in immature lambs," Pediatric Research, vol. 42, no. 3, pp. 348–355, 1997. View at Scopus
- N. H. Hillman, S. G. Kallapur, J. J. Pillow et al., "Airway injury from initiating ventilation in preterm sheep," Pediatric Research, vol. 67, no. 1, pp. 60–65, 2010. View at Publisher · View at Google Scholar · View at Scopus
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- G. R. Polglase, N. H. Hillman, J. J. Pillow et al., "Positive end-expiratory pressure and tidal volume during initial ventilation of preterm lambs," Pediatric Research, vol. 64, no. 5, pp. 517–522, 2008. View at Publisher · View at Google Scholar · View at Scopus
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- L. J. Van Marter, E. N. Allred, M. Pagano et al., "Do clinical markers of barotrauma and oxygen toxicity explain interhospital variation in rates of chronic lung disease?" Pediatrics, vol. 105, no. 6, pp. 1194–1201, 2000. View at Scopus
- A. Ammari, M. Suri, V. Milisavljevic et al., "Variables associated with the early failure of nasal CPAP in very low birth weight infants," Journal of Pediatrics, vol. 147, no. 3, pp. 341–347, 2005. View at Publisher · View at Google Scholar · View at Scopus
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- A. Kribs, F. Pillekamp, C. Hünseler, A. Vierzig, and B. Roth, "Early administration of surfactant in spontaneous breathing with nCPAP: feasibility and outcome in extremely premature infants (postmenstrual age ≤27 weeks)," Paediatric Anaesthesia, vol. 17, no. 4, pp. 364–369, 2007. View at Publisher · View at Google Scholar · View at Scopus
- A. Kribs, A. Vierzig, C. Hünseler et al., "Early surfactant in spontaneously breathing with nCPAP in ELBW infants—a single centre four year experience," Acta Paediatrica, International Journal of Paediatrics, vol. 97, no. 3, pp. 293–298, 2008. View at Publisher · View at Google Scholar · View at Scopus
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- M. X. Rojas-Reyes, C. J. Morley, and R. Soll, "Prophylactic versus selective use of surfactant in preventing morbidity and mortality in preterm infants," The Cochrane Library Issue, no. 4, Article ID CD000510, 72 pages, 2011. View at Publisher · View at Google Scholar
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- P. A. Dargaville, A. Aiyappan, A. Cornelius, C. Williams, and A. G. De Paoli, "Preliminary evaluation of a new technique of minimally invasive surfactant therapy," Archives of Disease in Childhood, vol. 96, no. 4, pp. F243–F248, 2011. View at Publisher · View at Google Scholar · View at Scopus
- P. A. Dargaville, A. Aiyappan, A. G. De Paoli, et al., "Minimally-invasive surfactant therapy in preterm infants on continuous positive airway pressure," Archives of Disease in Childhood. In press.


text:
BMW Sauber F1.08 - nose winglets 14 March 2008
This is, without doubt, one of the most radical solutions seen so far in 2008 and was introduced by BMW Sauber to try to optimise the F1.08's balance. The solution provides a better quality of airflow to the car's sidepod inlets and rear end, without generating a noticeable amount of downforce. The on-board camera housings (1) have been placed at a level where they redirect air towards the 'delta winglets' (2), thus improving the flow of air to the car's sidepods. This is especially important, as BMW Sauber have followed the trend to taper the car's sidepods at the bottom, with smaller inlets and radiators of a smaller cross-sectional area.

subset: commoncrawl


text:
I recently bought a KA 1.3 1997.
At times the steering feels like its going over bumps. Also it locks up. I was trying to overtake a bus when the steering jammed. It doesn't happen all the time. I've took it into the garage and the mechanic said the knuckle was new. Any ideas please.


text:
I remember a time when I thought Ha! I'll never get writer's block! Writer's block is for losers. I can always think of things to write about - it's not rocket science!
I remember it so well. It was a week ago last Monday.
Today, all I have done today is feel rather sorry for myself and eat some peppermint cream mixture from an enamel mug without even bothering to make it into little ovals. I'm just eating it with a spoon.
Some of my lacklustre day can be attributed to my PCOS. My goodness, my ovaries hurt earlier. It doesn't put you in the best frame of mind for anything.
This brings us to my first theory-into-reality (TIR) moment of working for myself:
If you're ill, you can't work:
I couldn't work earlier because my pre-existing, hard-to-fix condition was hurting. Dealing with PCOS is written about a lot and there are a lot of strategies but aside from having part of your reproductive system removed, you can't just mend it. All you can really do is try not to get stressed and make sure you don't put on too much weight.
I took two types of painkillers, rubbed on an aromatherapy blend, used a hot water bottle, listened to some New Age-y electronic warbling on Youtube and made potato and cauliflower soup. These things were nice and I felt better within about an hour. I still didn't want to write very much thought. I did write two blog-posts which means I am not allowed to beat myself up about today. I still got something done today, even if it didn't fulfil all the plans I had.
I had really already experienced this on my second day of freelancing, when I promptly came down with a bad cough following a weekend of a stomach upset. I lay there in bed, knackered and sweaty thinking Oh wow....I can't work...I can't earn money. Today is the day I'm supposed to be earning money...But I can't.
The other reason I didn't get much in the way of freelancer jobs done today is because I couldn't quite face it.
About two weeks ago, three people cancelled our work agreement within the space of a week. One got their work done for free, the other said they used someone different because I didn't call on the Thursday despite our agreement that I would call on the Friday. One just stopped responding.
I went from the wonderful feeling of safeness in knowing I had a substantial bit of money in the pipeline to a plummeting mixture of impotent fear, anger and frustration. Great, there's my financial safety-net for the month gone, back to the breadline.
Your sense of self-worth can't come from external sources
I am now struggling to work because I allowed my sense of worth to rely on those two customers. This cannot be allowed when you are freelancing. Firstly, because situations like this happen and more importantly because it doesn't say much about your work.
What kind of person starts up self-employment if they aren't sure of their services and don't believe in themselves 100%? You can't and you mustn't. It will only end in tears (or hiding on the sofa reading William Gibson and eating peppermint cream mix out of a mug with a spoon).
I started this work because I am sure I am good at putting together words and I am sure I am an all-round marvellous type of lady who can guide and propel herself. This week's blip was contributed to by something else that is both separate and related to my cancellation issues. I need to face up to marketing myself more strongly - I can't survive on anonymous, simple internet jobs.
It's time to sort out that marketing strategy
I haven't had any good feedback from my freelance proposals over the last couple of weeks. I'm not sure why. It's forcing me to consider two things; why do some of my freelance proposals succeed when others fail and when am I going to start marketing properly? Online bids and proposals have done me alright for the past couple of months but it's barely generating enough money. I need to find out what language works best for online proposals and do an email campaign. I also need to spend some money to get a brand guideline, print some leaflets and do some proper real-life marketing.
I think I'll go for the email campaign first...one step at a time, eh?


text:
Master Sgt. James Owens watches a scene play out from the U.S. Army's new interactive suicide prevention training program, while attending a training session at Joint Force Headquarters – Milford, Massachusetts, March 4, 2008. During the month of March, the Army conducted a stand-down from normal training to ensure all Soldiers received suicide prevention training. (U.S. Army photo by Staff Sgt. Don Veitch)
MILFORD, Mass. – The Massachusetts National Guard kicked off another round of an aggressive suicide prevention campaign from its headquarters here, March 17, 2009.
The strategy of the U.S. Army's Suicide Prevention Program includes efforts to reduce the stigma of seeking mental health care; improve access to behavioral health providers; and raise the awareness of junior leaders while instilling intervention skills.
An Army-wide "stand down" was ordered for the past month so that commands and individual units could take part in training sessions on how to recognize and try to prevent suicides after the Army reported an all-time high of 143 Soldiers who committed suicide in 2008.
The Adjutant General of the Massachusetts National Guard, Maj. Gen. Joseph C. Carter, supported the "stand down" so that the leaders of every Massachusetts Army National Guard unit could make teaching this aggressive suicide-prevention campaign their top priority.
"The reason I directed a 'stand down' was to ensure that leaders would have the time they need to implement this important program that will enable our Soldiers, civilians, and family members to take care of each other. The people who comprise our total force are our greatest resource; therefore, we need to ensure that they have every available tool to take care of themselves," said Carter.
The Massachusetts Army National Guard will complete the training in three phases. During the first phase, trainers instruct senior leaders how to implement the program using the Army's train-the-trainer approach. In turn, they will teach the program to subordinate leaders and will be responsible for ensuring that every Massachusetts Army National Guard Soldier participates.
The second phase incorporates a broader training session for Soldiers, Department of the Army civilians, and family members. In this phase, leaders and family members will learn to be aware of risk factors, suicidal behavior warning signs, and how to intervene on a Soldier's behalf.
"It is important to include Army civilians into this training because they work with Soldiers before and after they have deployed; therefore, they may be able to recognize changes in their behavior," said Maj. Dana P. Sanders-Udo, commander of Headquarters Detachment, Joint Force Headquarters, Massachusetts Army National Guard.
The third phase, which will run concurrently with phases one and two, will establish an annual suicide prevention training requirement as well as a deployment support cycle.
The training is intended to be delivered to most Soldiers by their squad leaders, who are the Noncommissioned Officers who provide direct leadership to Soldiers whether they are learning first aid during a drill weekend or on a combat patrol overseas.
The program highlights the roles and responsibilities of first-line leaders and peers to identify and intervene on behalf of Soldiers who may be at risk. This training is dependent on the personal connections that exist between Soldiers, and also between Soldiers and their families. These relationships are important because no one can gauge a Soldiers emotional state better than their spouse, best friend or "battle buddy."
Many family members will receive the training from members of the Massachusetts National Guard's Family Program Office. The Family Program staff establishes ongoing communication, involvement and support between the National Guard and Guard Families during times of deployment and non-deployment.
The program of instruction is packaged in an interactive DVD, titled "Beyond the Front," that was produced by Lincoln University and the U.S. Army Research Laboratory. The DVD shows the trainees emotional scenarios performed by actors. After each scene, the facilitator presents the trainees with a few options to choose from. Each choice has consequences and the trainees learn which methods of intervention are the most productive.
Master Sgt. Stephen Kelsch, acting first sergeant of Headquarters Detachment, Joint Force Headquarters, Massachusetts Army National Guard, has facilitated the training for not only his unit but also many Guardsmen who work full time for the National Guard.
"During the training a few Soldiers had reactions to it and we referred them to behavioral health care. If this training can save even one life it is worth it," said Kelsch.
To ensure that this training reaches more than 6,000 Massachusetts Guardsmen plus many of their family members in a relatively short period of time is challenging. To make it all happen, commanders will use video teleconferencing to permit some Soldiers to participate remotely from several armories across the state.
Joe Montiverdi, the distance learning manager at the Massachusetts National Guard's Joint Force Headquarters said, "This medium is the best way to train a lot of people at one time. We have seven distance learning classrooms across the state. They are normally used for training Soldiers using online training resources."
The training is scheduled to be completed by all Massachusetts Army National Guard Soldiers by July 15, 2009.


text:
Oct 16, 2012, 09:49 PM | ||||
Here's a flight today - mostly to check colors and color stabilty with 0.49, fluorescent etc. You can see the edge effects, glad it's only for this one
Oct 17, 2012, 02:19 AM | ||
Joined Nov 2010
2,720 Posts
The red LED is an indication that you have pressed the button, it does not tell you that the camera is ready to use. You have to wait until the yellow LED is on. Yes, the manual needs to be updated. I will update the detailed manual when I have the time. The developer will also update his manual, also when he has the time. I never complained about how the power-on used to function, but I am very pleased how it functions now. In the past, I too have had black videos and a flat battery.... |
Oct 17, 2012, 03:24 AM | |
Germany, NDS, Oldenburg
Joined Mar 2012
30 Posts
And with plugins nearly any other format. http://www.rcgroups.com/forums/showt...1#post21413882
Oct 17, 2012, 03:44 AM | View Post |
qqai | |
A moderator felt this post violated the following rule: Excessive Advertising (Spam).
Show it to me anyway.
Oct 17, 2012, 07:31 AM | ||||||
Joined Oct 2006
5,302 Posts
and if others want to jump in to say no-n-NO, I know one person will, he he he? With the lenses I own the deal extreme , usbfever, kodak known as wx-67, fe-20, They are metal and glass, I gotten the moisture out with general heat from a toaster oven, not inside, If I can find that video, I shall post it up or redo it? I placed on to a towelette/napkin, then on a plate, evn a Coffee cup ( may be better) and allowed time. that done the trick, for me? You can mark the lens in two spots, and open up the lens itself and try to allow some heat to get the moisture out. and refocus. SInce the lens is plastic, you must be a little more careful FISHYCOMICS That is correct, I used a ______!
Last edited by fishycomics; Oct 17, 2012 at 07:49 AM.
Oct 17, 2012, 08:15 AM | |
I know it seems obvious, but be sure battery is fully charged. I had similar issue, and I thought my battery was charged but it wasn't. Also, cold temps will drastically reduce battery life/charge. When the battery is low, you can turn it on & record for a minute or two, then it turns itself off. You can turn it on again when you notice, and it turns itself off after 30 seconds or so. You would think if battery was dead, it would not turn on at all, but that is not the case, which made it difficult to diagnose at first.
Oct 17, 2012, 08:46 AM | |||
Joined Nov 2010
2,720 Posts
Oct 17, 2012, 09:08 AM | ||
Oct 17, 2012, 09:52 AM | |||||
Joined Oct 2006
5,302 Posts
Key cam 808 #16 what we are delt with. With older cams the cable was not as bad
Enjoy the clip,
this vid has helped out a person. My job is done. for this one.
Last edited by fishycomics; Oct 18, 2012 at 08:42 AM.
Oct 17, 2012, 12:56 PM | |
Joined Oct 2012
41 Posts
i did another loop mode/battery life test. got 4h15m on a fully charged camera w 2 fresh external AAs
Previous test was 3h5m or something like that. Not sure what might cause the variance, and don't really care: 3h is plenty for me. Great cam. Going to wipe the cam and do a 60s time lapse connected to a PC so it will only be limited to the size of the card...going to be pretty silly long w a 32GB card. That will be my last test, and its just for fun. |
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Mammary gland factor (MGF) is a transcription factor discovered initially in the mammary epithelial cells of lactating animals. It confers the lactogenic hormone response to the milk protein genes. We reported recently the isolation of the cDNA encoding MGF. MGF is a novel member of the cytokine-regulated transcription factor gene family. Members of this gene family mediate interferon alpha/beta and interferon gamma induction of gene transcription, as well as the response to epidermal growth factor and interleukin-6, and have been named signal transducers and activators of transcription (Stat). The name Stat5 has been assigned to MGF. We studied the mechanisms involved in the prolactin activation of Stat5 in COS cells co-transfected with cDNA encoding Stat5 and the prolactin receptor. Prolactin treatment of the transfected cells caused activation of Stat5 within 5-10 min. This activation does not require ongoing protein synthesis. Tyrosine kinase inhibitors prevent Stat5 activation in transfected COS cells. Treatment of recombinant Stat5 with a tyrosine-specific protein phosphatase in vitro abolishes its DNA binding activity. Prolactin stimulation of transfected cells induces Stat5 phosphorylation on tyrosine. Phosphorylation of in vitro transcribed and translated Stat5 with the Jak2 tyrosine kinase, but not with fyn, lyn or lck, confers DNA binding activity. The prolactin response of the beta-casein milk protein gene promoter can be observed in COS cells transfected with cDNA vectors encoding Stat5 and the long form of the prolactin receptor. The short form of the prolactin receptor is unable to promote Stat5 phosphorylation and confer transcriptional induction in COS cells.(ABSTRACT TRUNCATED AT 250 WORDS)
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Watch Ball Of Light Online. About this episode This 15-minute documentary tells the story of Denis Smith, professional light painter.
Two years ago, Denis was in a high pressure sales job, struggling with drink, debt and depression. Discussing sb-800 How to turn on af assist? in Nikon D3 D3s D3x. Discussing AF Assist Illuminator in Nikon D700. PIXistenz says: Hi, I have this weird problem about the AF Assist light : there are 3 settings on the back of the D700: - Auto-area (top), - Dynamic (middle) and - Single (bottom). Nikon SB800 AF-TTL Speedlight - Part IV. File size: 62k HTML Loading..... Auto FP High-Speed Sync mode (for cameras compatible with CLS) High-Speed flash synchronization at your cameraís highest shutter speed is now possible. In this mode, the Auto FP High-Speed Sync mode is automatically set when the shutter speed exceeds the cameraís sync shutter speed. This is useful when you want to use a wider aperture to achieve shallow depth of field to blur the background.
This flash feature is available with cameras compatible with CLS. Dutch angle. A special axis head allows for cinematographers to set up Dutch angles.
The Dutch angle, also known as Dutch tilt, canted angle, oblique angle or German angle, is a type of camera shot where the camera is tilted off to one side so that the shot is composed with vertical lines at an angle to the side of the frame. In cinematography, the Dutch angle is one of many cinematic techniques often used to portray psychological uneasiness or tension in the subject being filmed.
Many Dutch angles are static shots, but in a moving Dutch angle shot the camera can pivot, pan or track along the established diagonal axis for the shot.[1] A Dutch angle differs from a high-angle shot and low-angle shot in that those refer to placement of the camera in height relative to the subject, which for human subjects is mostly defined by a person's eye-line. Go Dutch to make a better photograph - home - A Better Photograph.
In making photographs, our normal inclination is to make the horizon level.
And in fact, many cameras now a menu item that allows the display of a built-in level to assist with that. But sometimes, skewing the horizon line in the photograph can add impact to an image. In cinematography, Dutch angle means tilting the camera to create a sense of exoticness or unease. It's a technique that has been used often in film, and photographers use the technique as well.
Beyond the pyschological effects it can engender, I like to use it to add more of a graphic quality to the composition, or make an image seem more candid. Photographic composition – tilted compositions / Dutch angle « Neil vN. I am not a huge fan of tilted images, and I see it as an unfortunate visual 'tic' when I notice entire wedding galleries by other photographers where pretty much all the images are tilted at a very specific angle.
That just means that little thought went into composition, and that composition and holding the camera has become a reflex action .. which just happens to include a 30′ tilt to the camera. I tend to keep horizontal and vertical lines exactly that way … horizontal or vertical. Tracy's Trinkets and Treasures: Angled Photography Ideas. I really think this next party is going to be tons of fun.
The party will be April 12th so you have plenty of time to snap those photos and create a post. Every time I take a photo I feel like I learn something. That's what these parties are all about. Getting out your camera and capturing moments.
Stock Photography: Search Royalty Free Images & Photos. Shutterstock: Royalty-Free Subscription Stock Photography & Vector Art. Popular Photos. Photographic Licencing. This page provides information about obtaining permission to use any of Adam Dimech's images.
If you are interested in using any of Adam Dimech's photographs, be it for a personal website, a publication, or a commercial project, you must obtain a licence first. Failure to do so is a breach of the Copyright Act 1968 (Commonwealth of Australia) or equivalent legislation in most other countries, as per the Berne Convention. The Leading Provider of Education for Photography and Creative Professionals Worldwide.
Photoshop Training - Smooth Skin tutorial (part 2/2) Create in Photoshop a new layer on top of the Blemishes layer by clicking on the Create a New Layer icon .
Rename this layer to Smooth Skin by double clicking on its name in the layers palette. Hold down Ctrl + Alt + Shift + E (Command + Option + Shift + E on the Mac) to merge all visible layers on the active layer (Remember this Photoshop shortcut, it's a very useful one) or in other words; the layer Smooth Skin will contain the image that was visible in the document window when you used this shortcut, which includes all the corrections we did to remove blemishes. We're going going to use the Median filter to make the skin look smooth. For photographers and aficionados. DSLR Video Green Screen Test with Premiere CS5 Ultra Keyer. Strobist. The Collective Shift.


text: "Only when you cease to adore your own reflection in the pond of pride will you begin to be open to the Holy Spirit's action in you. In order to become more like God, you must turn away from your own ego and submit yourself fully to His will." (Behold I Stand at the Door and Knock, pg. 60) |


text:
Unbiased Reviews by Real People
As a new apartment owner, I needed a small washer and dryer to fit in my kitchen. Using epinions and Consumer Reports, I did a load of research and narrowed down my candidates. I was dismayed and surprised to find out that most electric dryers required their own dedicated outlet/circuit. And buying a gas model would require me to hire someone to install. I also had a bit of a problem with venting. My building doesn't allow venting though the window. I ultimately purchased this model. It needed NO INSTALLATION. All I had to do was plug it in. I could use the outlet/circuit for other things at the same time, as it did not need a lot of power. At Home Depot, I purchased a little box (called a 'condenser' or a 'lint catcher') which allowed me to vent directly into the box. The dryer is relatively small in size, but can handle a reasonably sized load. Its sturdy and I've had no problems with it. I purchased the stackable rack separately and it is bolted on top with the washer on bottom. If you plan to do this, make sure you have someone (or two someones!) to help you hoist it onto the rack as its quite heavy. There are several settings on the dial for different temperatures and cycles. And the lint filter is very, very easy to clean. My only disappointment is that it takes longer than I thought to dry a load. About an hour for a load of regular clothes and possibly more for really think towels.
Amount Paid (US$): 325


text:
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InDesign CS4: 10 Things to Know About Interactive PDFs Explores the great features within interactive PDF files and the techniques used to add movies and sounds to PDFs.
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Emory Campbell & Penn Center's Legacy
Posted by Nick Gray on February 14, 2013Over 150 years after its founding, the Penn Center continues to inspire through its legacy of promoting freedom through education. In the above photo, a class visits in 2012. |
"This place will let you know, as you walk through with the Spanish moss hanging, that something happened here."
—Emory Campbell on the Penn Center
On February 13, Bank Street's Pemberton Society celebrated Black History Month with an event honoring Emory Campbell, who delivered a talk on "Penn Center: A Distinctive Change Agent for Freedom, From Emancipation Day to Present."
Pemberton Society founder Lucia Henley Jack with Emory Campbell |
Campbell is Director Emeritus of the Penn Center, a national historic landmark and the site of one of the earliest schools for freed slaves. The Penn Center works to preserve the legacy of Gullah culture—descendents of slaves living in the coastland and island communities of South Carolina, Georgia, North Carolina, and Florida.
He is currently the President of Gullah Heritage Consulting Services, through which he furthers cultural awareness of the Gullah legacy.
This Place is Eyewitness to History
"Penn Center has always been focused on freedom," Campbell said.
"When you visit, you'll see a beautiful campus of 21 structures—very significant structures. Some of them were houses that civil rights workers lived in, but before then, where people went to school, and where they lived while going to school. This place is eyewitness to history. When Laura Towne and Ellen Murray founded this place, they found people who were yearning for education. And they had no idea that it would be like this today, where people would come and see it as a resource for studying history."
Diversity at Bank Street, and a Meaningful Collaboration
During the 1960s, Dr. Martin Luther King lived for a time at the Penn Center while planning the "March on Washington." He is shown here with Courtney Siceloff, then Executive Director of the Center, and the Siceloff family. |
The Gantt Cottage, where King stayed. Penn Center was one of the only places in South Carolina where biracial groups could meet. |
The Pemberton Society, an important alumni initiative for the Graduate School, hosted the event. The Society's mission is to support students of color at Bank Street through fundraising for diversity scholarships and other services.
At the event, Virginia Roach, Dean of Bank Street's Graduate School, introduced Campbell, who was awarded an Honorary Doctorate at Bank Street in 2000.
Regarding Pemberton, Dean Roach noted,
"It's through the vitality of the Pemberton Society that we work on ensuring that we have diverse cultures infused in our Bank Street life and community every single day. And we are eternally grateful for the ways in which they contribute to our school."
Before Campbell's talk, the Pemberton Society presented him with the Leadership in Diversity Award. Given annually since 2007, the award recognizes individuals who champion values that promote a diverse, democratic society.
Bank Street's relationship with the Penn Center goes back over a dozen years. In 2000, then-Dean of Continuing Education Fern Khan led a Long Trip to the Penn Center. In 2012, Bank Street featured an exhibition honoring Penn Center's 150th anniversary.
"I am elated to be back at Bank Street—my honorary alma mater," said Campbell, who first became acquainted with Bank Street nearly 20 years ago, when Lucia Henley Jack—founder of the Pemberton Society—visited the Penn Center on a trip to South Carolina. Their friendship has remained strong since.


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Dec 23, 2012, 05:45 AM | |||
GosHawk 26iV 2mm EPP wing: Good Flight &Good Gliding
GosHawk 26iV 2mm EPP wing: Good Flight &Good Gliding
GosHawk 26iV 2mmEPP wing Light Ornithopter With New GLDAB for Gliding. Test Flight3. I added 0.8mm Carbon rod on wings for to increase thrust. Good flight and Good Gliding. Width 94cm Length 44cm Weight 69g Total 79g (160mA 2cell Lipo) Receiver: OrangeRx R415 Spektrum DSM2 Compatible 4Ch Micro 2.4Ghz Receiver Servo: HK-5320 Ultra-Micro Digital Servo 1.7g*2 Motor:C05XL Micro Brushless outrunner 10800kv ESC: Cosmotec 7A 4.4g Max Power CT-7A V2.2 Gear:Main Gear:GWS Spur Gear IPS A 82TM0.3, Second Gear DIDEL M0.3 Outer 60T Inner12T SPurGear G260 (inner 12Tgear was exhaged by GWS 12T M0.3 copper pinion gear) ,Third Gear: DIDEL Outer48T Inner12T M0.3SpurGear G348, M0.3 9T PinionGear Battery:Lipo2cell130mAh G3, 2cell160mAh G3,2cell180mAh G3 Wing: 2mm EPP Control: 3CH (a motor, inverted Vtail: 2 servo) Gliding system:New GLDAB It follows TB30--- http://trhk.exblog.jp/i16/ |
Dec 23, 2012, 06:10 AM | |||
FalcoHobby 22iV Acrobatic Flight: Looping
FalcoHobby 22iV Acrobatic Flight: Looping
Good acrobatic flight. I added 1mm Carbon rod on wings for to increase thrust. Then, Loop is OK. |
Dec 29, 2012, 12:33 AM | |||
GosHawk 25iV with Articulation wing : First test Flight
GosHawk 25iV with Articulation wing : First test Flight
Flight is OK. Thrust is OK. I learned this system from KJELL and FUSHIMIbird. Thank you KJELL. |
Dec 29, 2012, 10:10 PM | |||
GosHawk 26iV Orcon film wing Light Ornithopter
GosHawk 26iV Orcon film wing Light Ornithopter
With New GLDAB for Gliding. Good Flight and Gliding.
Dec 29, 2012, 11:49 PM | |||
GosHawk25iV with articulated wing
GosHawk25iV with articulated wing
So that the 0.8mm piano wire which I use in order to bend wings sags, I tied 1.4mm carbon rod beside piano wire. By this sagging down of piano wire disappeared. The wings came to turn well and thrusts increased. A side to the body of this wings has Airfoil. Width 94cm Length 49cm Weight 128g battery Lipo 2cell 240mAh17g Total flight weight 145g Receiver: Castle Creations Berg Microstamp 4L 4Ch Micro Rx FM cryistal: Castle Creations Micro Crystal Berg (72MHz) Servo: Vtail: elevator & rudder (DM 4.7g servo *2) Motor: Turnigy 1811 Brushless Indoor Motor 3800kv ESC: H-KING 10A Fixed Wing BrushlessESC Gear: Main gear: 66TM0.4 Acetal GWS EPS D (Stainless shaft3mm, 3mm ball bearing), First gear: 56TM0.4 GWS EPS 2 (=GWS IPS-42), 64P8TPinionWire(with 4mm ball bearing), Pinion Gear M04 10T(=64P 10T) Battery: Lipo 2cell 240mAh G3 Film of a wing Orcon filmAN36 Control: 3CH (a motor, inverted Vtail: 2 servo) Gliding system New GLDAB |
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Since inception in 2000, WOUGNET has hosted its websites and mailing lists with Kabissa, A network of African civil society organisations. However, in April 2009, Kabissa changed their mode of operation. They streamlined their Internet services to focus on being a trusted Domain Registrar for organizations in the Kabissa network. This means that while they will continue to register and help manage domain names for their member organizations, they will no longer offer website and email hosting services.
Therefore, just like other Kabissa members in Uganda and around Africa, WOUGNET had to find an alternative host for our email, website and mailing lists. We have found a new partner to host our mailing lists, the brand new Pamoya website. Pamoya is the first fully Ugandan Social Network, hosted and run inside Uganda. Currently in active beta, but steadily expanding to become the No #1 Ugandan website.
WOUGNET saw this as an opportunity for two major changes. The first change involves hosting the WOUGNET websites in Uganda which should improve the surfing experience for those in Uganda. The second is to enhance the information sharing and networking via WOUGNET mailing lists using web-technology and web 2.0 approaches.
So far we have done the following:
As the website is hosted inside Uganda, using the website to create, read and respond to emails is much faster for those who are using a Ugandan Internet connection. The speed can be up to 20 times faster than using gmail or yahoo.
There are 2 major differences between the old and the new mailing lists.
The first one is the way Pamoya handles attachments. Attachments are never sent by email again, and will only be available as a download from the mailing list host website, Pamoya. A link to the location of the attachments (if there are any) is provided in the emails that are sent out. The reason we do not send the attachments along with the emails is that the Pamoya servers are located in Uganda. If someone sends an email with a 600K Word file attached to it, this will result in sending out about 1 full CD of data to all recipients (multiply the attachment by the number of recipients). Even worse, all Ugandan readers would have to download the attachment from their yahoo and gmail accounts again, into Uganda. This way, we would be wasting the little amount of bandwidth that Uganda has, twice. This is very similar to the way DGroups is handling attachments.
Secondly, Pamoya sends all emails with the sender as <email@example.com>. There is a very good reason for this, which is privacy. Every time you share your email address with a group of 1700 people (the size of the wougnet-l mailing-list), there is a chance a spammer might find it, and start sending you a lot of spam in return. We have also noticed that some companies in Uganda have picked up the habit to directly send spam messages to people who are active on mailing lists. Just like on facebook, linkedin and all the other sites, we think your email address should be private. However, there will still be a provision for members to contact each other off-list, soon.
A few people have raised issues about this, and we have increased the visibility of the originator of emails on the mailing lists, by added their username to the subject and header of the emails we send. All messages on the Pamoya website also have a clear link to the profile of the person who sent the email.
So, having an updated profile helps your visibility on Pamoya. Updating your name, picture and optionally username will look much better!
We are currently tuning the website to optimize the usefulness as much as possible. There are 2 main issues that have our full attention:
We apologize for any disruptions you might experience, in accessing our email, websites (www.wougnet.org and www.kic.wougnet.org) or mailing lists during this initial phase.
In the meantime, we would like to invite everybody to update his or her Pamoya user profile. You can login and access your profile at http://www.pamoya.com/user. Also, for a short period, you will be able to change your username. This is because the technical team at Pamoya had to generate automatic usernames based on your email address, but we would like to give you the opportunity to input your preferred username. Please note that Pamoya will disable this feature at the end of July 2009.
If you did not receive your username & password, then you can request your password through: http://www.pamoya.com/user/password. Just fill in your email address and we will send you a new password.
For further information or for queries, you may read the Pamoya FAQ page or contact techsupport [at] wougnet [dot] org.
Milton Aineruhanga
Sr. Program Officer - Technical Support
Women of Uganda Network - WOUGNET
You can find this same article on the WOUGNET website.


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"All right," Lionel declared when I reached him by phone that afternoon. "So when do we start studying?"
Immediately of course, but not before I plunged headfirst into the unabashedly brainy Jeopardy! subculture that flourishes on the Web. The recent monster success of Who Wants to Be a Millionaire? notwithstanding, Jeopardy! remains the Everest of quiz shows, the one mountain that all intellectual showoffs hope to conquer.
In my search for tips to augment Lionel's wisdom, I found dozens of sites detailing behind-the-scenes accounts of past contestants, mostly winners. I also discovered that there was such a thing as a hard-core Jeopardy! fan, the kind of person who knows the names of legendary past champs such as Chuck Forrest, Frank Spangenberg, Dave Sampugnaro. Most devotees, like Lionel, are former contestants themselves. (Lionel, I learned, occupied 124th place on the all-time money-winners' list.)
Fascinating as all this was, my number one priority was filling my trivia quiver with as many arrows as possible. I began delving into The Dictionary of Cultural Literacy, An Incomplete Education, and The New York Public Library Book of Popular Americana. I watched Jeopardy! religiously, keeping track of my score. A half-dozen times I watched the show while on the phone with Lionel, which was fun (what with the Jack Kerouac anecdotes and all) but of dubious training value. Jen drilled me with Trivial Pursuit cards -- and of course, the questions in the Book.
How to Get on Jeopardy! and Win! by Michael Dupée has become the unofficial bible of Jeopardy! geeks. Dupée, an attorney from Gainesville, Florida, won the 1996 Tournament of Champions; he now operates a trivia Website. His book, published in 1998, contains thousands of practice questions in the kinds of categories Jeopardy! loves (Presidents, Shakespeare, food and drink, holidays).
But as the summer wore on, I began to doubt I'd be getting the call. Meanwhile my mid-October wedding day was approaching. By September my Jeopardy! fantasies were fading, and my training regimen was flagging. By the time Jen and I set off for our European honeymoon in early November, I'd all but given up hope.
Two days after our return to South Florida, I found myself staring at a duffel bag, trying to remember if that was the one with the clean clothes or the dirty clothes. The phone rang.
It was Grant.
Grant from Jeopardy!
He wanted to know if I would be available to fly out to L.A. for two days of taping, December 14 and 15.
I said something blindingly witty like: "Um, sure."
First I called my wife. Then I called Lionel. "Wow, congratulations," he said. "We've really got to get on the ball now."
What followed was six weeks of cramming. I concentrated on plugging the yawning gaps in my knowledge. My blind spots were (and still are):
any prose literature originally written in English
any poetry, period
classical music, opera, and dance
the Bible
prime-time network TV shows
I kick ass in history (especially wars and Presidents), geography, basic science, and German or Russian literature. And all things Muppet or Star Trek.
It was crucial that I bone up on my weak areas because, as those of you who watch Jeopardy! surely know, the show is designed to test breadth of knowledge as much as depth. Every game consists of two rounds of 30 questions, divided into six categories per round. The clues in the first round are worth $100 to $500. In Double Jeopardy, the dollar values um double, and the clues generally are more difficult. The game ends with a single Final Jeopardy question, on which players may wager as much as they've earned.
My wife and I carpooled everywhere, with me driving and her reading questions to me out of the Book. My lasting impressions from that work: Damn, Charles Dickens wrote a lot of novels, and the ones you've never heard of sound like you'd never want to hear any more about them. (What is Barnaby Rudge? And who the hell cares?)
I spent a few more sessions at Lionel's cramped condo watching episodes on tape. Even before he became my training guru, he would tape every episode, every day. Lionel also provided me daily updates on his attempts to get on Who Wants to Be a Millionaire?, which most Jeopardy! devotees, of course, consider to be pathetically easy.
By my final week of practice, I was averaging 48 correct answers out of 61 per game. According to the Book, that was good enough to give me a fighting chance for a big payday.
And I was going to need it. You see, Jeopardy! neither pays for your flight nor puts you up in a hotel. And appearing on a game show was not the kind of activity that prompted my bosses to give me a week off. So Jen and I had to book an early-evening flight, which meant arriving at one in the morning, 4 a.m. Eastern time. We then had to drive to my uncle's place in the Valley. Four hours later we got back in the car in order to beat the rush-hour traffic to Culver City, where Jeopardy! is filmed.


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The upmarketl Zafira Tourer marks a smart new era for Vauxhall's compact people-carrier with the new family styling.
Saturday, August 4, 2012
Vauxhall has raised the compact people-carrier bar with the Zafira Tourer, says Andy Russell.
Price: £27,415 (range from £21,010)
Engine: 1,956cc, 165PS, four-cylinder turbo diesel
Performance: 0-62mph 9.1 seconds; top speed 129mph
MPG: Urban 45.6; extra urban 61.4; combined 54.3
Emissions: 137g/km
Benefit-in-kind tax rate: 21pc
Insurance group: 19E (out of 50)
Warranty: Lifetime or 100,000 miles for first owner
Will it fit in the garage? Length 4,658mm; width (including door mirrors) 2,099mm; height 1,690mm
It's hard to believe that Vauxhall's Zafira people-carrier has been around for 13 years… and that it is still going strong.
Having set a new benchmark in the compact multi-purpose vehicle sector with enough space to seat seven in acceptable comfort and its clever Flex7 seating allowing the five rear seats to fold down to create a long, flat load floor rather than seats having to be physically removed altogether it's hardling surprising it made such an impact. Even in the second decade of the new millennium it was still the best-seller in it class accounting for about one in fivesales.
Now Vauxhall is tightening its hold on the compact people-carrier market with the all-new Zafira Tourer – not a direct replacement but an addition, hence the Tourer tag, because the Zafira will continue as an entry-level seven-seater and, with prices from just under £14,000, will still find favour with plenty of families.
The Zafira Tourer, which features the smart new family styling of contoured and sculpted curves – the 'wings' and 'boomerangs' first seen on the Insignia and since used to great effect on the latest Astra and Meriva – takes Vauxhall upmarket with the key competition being Ford's sporty S-Max which, crucially, it also undercuts on price.
But this is a sector where versatility is as important as verve, how it measures up as practical family transport rather than how it looks on the driveway. And the Zafira Tourer doesn't disappoint.
Being bigger than the Zafira means the new Tourer version is more spacious and even more versatile inside. Even so, the two rearmost seats which fold up out of the boot floor are most suited to children and, despite decent access to them with the middle row folded forward, you need to be reasonably lithe. The middle row of three seats have 210mm of travel back and forth and, right back, give limousine-like levels of legroom. Top SE and Elite models also benefit from 'lounge seating' – being able to fold forward and rotate the back of the middle seat to form an armrest for the outer seats which can then slide back 280mm and inwards 50mm for extra shoulder room.
The deep, flat-sided boot has also grown in five-seat mode by 65 litres to a vast 710 litres – more than enough for a family of five – and fold all five seats down to create a long, flat load floor and you have a small van-like 1,860 litres – 40 more than the original Zafira. With all the seats in use there's just about enough space for a couple of holdalls with the roller tonneau cover stowing under the back of the boot floor.
As befits a vehicle of this kind, the classy cabin has more than 30 storage spaces. The most clever is the innovative FlexRail system in the centre console between the front seats which features a lidded armrest which slides back to reveal cupholders which then slide back to give access to a large cubbyhole.
The new family fascia is a huge improvement on past Vauxhalls with big, clear dials and sensibly-sited main controls and switchgear but there are also a lot of small buttons to find your way round. Plenty of adjustment means you soon feel at home behind the wheel while slim pillars, plenty of glass and large door mirrors give good all-round visibility.
Power comes from 1.4-litre turbo and 1.8-litre petrol engines, both rated at 140PS, but the sensible money will go for one of three 2.0-litre diesel engines with outputs of 110, 130 and 165PS. I drove the most powerful diesel which trickles along happily at low revs and has lots of mid-range poke – just as well as it gets quite boomy when driven hard. With standard automatic engine stop/start it regularly returned 45 to 50mpg overall.
For a tall-sided vehicle it drives well, cornering confidently even fully loaded and the light steering makes parking a doddle although it lacks feel at speed.
The ride is sensitive to pockmarked roads when travelling slowly – not helped by the larger 18in wheels on top models – but improves with speed and feels less fidgety with a full load on board which makes it a capable and comfortable over long distances.
The Zafira Tourer comes in five trim levels – ES, Exclusiv, SRi, SE and Elite – so there's plenty of choice to meet families' needs. All come attractively equipped with range-topping Elite getting leather seats, a panoramic glass sunroof with electric blind to flood the cabin with light and a panoramic windscreen which extends over front passengers' heads.
The Zafira has been a huge hit with families, the new bigger Zafira Tourer again raises Vauxhall's game when it comes to people-carriers and building on that success will appeal to growing families.
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Exciting electric BMW i3 clean, green and mean – it really is a pure pleasure to drive.


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Birthdate - Jan. 24, 1959 CAREER HIGHLIGHTS * Picked up his first Travers victory in 2010 when Afleet Express skimmed the rail to beat Fly Down by a nose. * Saddled Quality Road to a track record victory (1:47.72) in the 2009 Florida Derby * Artie Schiller set a course record of 1:45.50 in the 2004 Jamaica at Belmont Park and the following year gave Jerkens his first Breeders' Cup victory by winning the Mile. .* Followed Hall of Fame father H. Allen Jerkens, for whom he worked as an assistant for many years, into the business. NOTABLE STAKES WINS Afleet Express: Travers (2010) Artie Schiller: Breeders' Cup Mile (2005); Bernard Baruch (2005); Jamaica (2004); Museum of Racing/Hall of Fame (2004); Hill Prince (2004) Christmas Kid: Ashland (2007) Celtic Melody: Humana Distaff (2002) Corinthian: Metropolitan H. (2007) Dat You Miz Blue: Garland of Roses (2002); Iroquois (2002); Vagrancy (2001); Broadway (2001) Iron Deputy: Brooklyn (2003); Count Fleet (2002) Quality Road: Florida Derby (2009) Smokey Glacken: Distaff (2006); Floral Park (2005); Victory Ride (2004); Valley Stream (2003) Zaftig: Acorn (2008); Nassau County (2008)
Recent NYRA Statistics: