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New EU label calls palm oil what it is | Environment | DW.DE | 16.12.2014
www.dw.de/new-eu-label-calls-palm-oil-what-it-is/a-18134682?maca=en-rss-en-all-1573-rdf, posted 18 Dec by peter in environment eu food health transparency
Very often, new palm oil plantations result in the clearing of rainforest. Researchers at Princeton University have shown that more than half of the palm oil plantations in Indonesia and Malaysia are located in areas where there used to be rainforest. So by choosing a specific product, the consumer unwittingly has an impact on deforestation of rainforest and the fate of endangered species like orangutans or tigers.
What It Would Really Take to Reverse Climate Change - IEEE Spectrum
spectrum.ieee.org/energy/renewables/what-it-would-really-take-to-reverse-climate-change, posted 25 Nov by peter in energy environment science
We decided to combine our energy innovation study's best-case scenario results with Hansen's climate model to see whether a 55 percent emission cut by 2050 would bring the world back below that 350-ppm threshold. Our calculations revealed otherwise. Even if every renewable energy technology advanced as quickly as imagined and they were all applied globally, atmospheric CO2 levels wouldn't just remain above 350 ppm; they would continue to rise exponentially due to continued fossil fuel use. So our best-case scenario, which was based on our most optimistic forecasts for renewable energy, would still result in severe climate change, with all its dire consequences: shifting climatic zones, freshwater shortages, eroding coasts, and ocean acidification, among others. Our reckoning showed that reversing the trend would require both radical technological advances in cheap zero-carbon energy, as well as a method of extracting CO2 from the atmosphere and sequestering the carbon.
Fukushima disaster site ′like a science fiction film′ | Environment | DW.DE | 05.11.2014
www.dw.de/fukushima-disaster-site-like-a-science-fiction-film/a-18039892?maca=en-rss-en-all-1573-rdf, posted 16 Nov by peter in energy environment fukushima health japan jpquake
Science journalist Ranga Yogeshwar has gained extensive access to Japan's battered Fukushima power plant. He speaks to DW about exploring radiation-contaminated zones, and how the cleanup has progressed so far.
Fukushima radiation still poisoning insects | Science/AAAS | News
news.sciencemag.org/asiapacific/2014/09/fukushima-radiation-still-poisoning-insects, posted 25 Sep by peter in environment food fukushima health jpquake science toread
Eating food contaminated with radioactive particles may be more perilous than thought—at least for insects. Butterfly larvae fed even slightly tainted leaves collected near the Fukushima Daiichi Nuclear Power Station were more likely to suffer physical abnormalities and low survival rates than those fed uncontaminated foliage, a new study finds. The research suggests that the environment in the Fukushima region, particularly in areas off-limits to humans because of safety concerns, will remain dangerous for wildlife for some time.
Your Very Own Indoor, Hydroponic Grove ⚙ Co.Labs ⚙ Code + Community
m.fastcolabs.com/3035102/your-very-own-indoor-hydroponic-grove?utm_content=buffer07698&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer, posted 6 Sep by peter in environment food startup
Designed to fit alongside the appliances in and blend into the décor of your kitchen, Grove Labs' device lets you grow fruits and vegetables hydroponically, without leaving your house. The whole setup includes the hydroponic chamber, which you can monitor through the transparent encasement, as well as a mobile app to keep track of growing conditions and link up to vendors to replenish your materials. The Grove Labs team calls the contraption a grove, not to be confused with a greenhouse.
Tallying the environmental cost of meat | The Japan Times
www.japantimes.co.jp/life/2014/08/23/environment/tallying-environmental-cost-meat/, posted Aug '14 by peter in environment food health politics
"The human appetite for animal flesh is a driving force behind virtually every major category of environmental damage now threatening the human future — deforestation, erosion, fresh-water scarcity, air and water pollution, climate change, biodiversity loss, social injustice, the destabilization of communities and the spread of disease," reported the 2004 July/August issue of World Watch Magazine.
EcoDrain recycles the wasted heat from your shower water | Digital Trends
www.digitaltrends.com/home/ecodrain-recycles-wasted-heat-used-hot-water/, posted Jul '14 by peter in diy energy environment toread
Think for a second how much energy is literally washed down the drain when you take a shower. Not the water itself — just the energy that's lost when you heat up said water, pump it through a series of pipes to your showerhead, and then let all that warm goodness run straight down your body and into a hole in the floor. By some estimates, 80 to 90 percent of the energy it takes to heat that water ends up going straight to the sewer. Considering the fact that the energy required to heat water is one of the biggest energy expenditures at home (right behind heating/cooling/ventilation), that's a monumental waste of juice. But not to worry; there's a new device on the market that could help to recapture some of that wasted energy.
It's called EcoDrain, and while it's definitely not a new concept, it's a fresh new take on an old idea, and finally makes waste heat recovery a viable possibility for regular homeowners.
Wood Gas Camp Stove | MAKE
makezine.com/projects/make-27/wood-gas-camp-stove/, posted Jun '14 by peter in diy energy environment howto nature trekking
There are many designs for efficient stoves, and gasification is only one way to boost the efficiency of a cooking fire. The wood gas stove in this article is an elegantly simple gasifier design called a TLUD stove (for top-lit updraft), also known as an inverted downdraft stove. If you don't care how it looks, you can build it with a can opener, a punch, and a big rock. This design, which I've adapted from one I first saw on Instructables, is built around a 1-quart paint can. It easily boils enough water for a small pot of tea or a bowl of noodles, using nothing more than a fist-sized charge of scrap wood.
How Fukushima Is Contaminating More Water - Atlantic Mobile
m.theatlantic.com/health/archive/2013/10/how-fukushima-is-contaminating-more-water/280671/, posted Oct '13 by peter in environment fukushima health japan jpquake msm
These water issues are clearly major problems that will take decades, new technologies and billions of yen to resolve, but they are a completely different beast from the problems of the accident's early days. Fukushima's problems are fodder for debates on broader issues, making it crucial that these latest concerns about leaks and groundwater contamination be neither overblown nor understated. Our goal here is to try to draw a clear and evenhanded picture of the situation at Fukushima Daiichi today and the risks it poses. § [An MSM article refreshingly free of both alarmism and "everything is fine" rhetoric. Only discusses water, though, and not, for example, structural integrity of buildings.]
Scientists discover what's killing the bees and it's worse than you thought - Quartz
qz.com/107970/scientists-discover-whats-killing-the-bees-and-its-worse-than-you-thought/, posted Jul '13 by peter in environment food health msm science
Scientists had struggled to find the trigger for so-called Colony Collapse Disorder (CCD) that has wiped out an estimated 10 million beehives, worth $2 billion, over the past six years. Suspects have included pesticides, disease-bearing parasites and poor nutrition. But in a first-of-its-kind study published today in the journal PLOS ONE, scientists at the University of Maryland and the US Department of Agriculture have identified a witch's brew of pesticides and fungicides contaminating pollen that bees collect to feed their hives. The findings break new ground on why large numbers of bees are dying though they do not identify the specific cause of CCD, where an entire beehive dies at once.


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Vestavia Hills has 9 schools. Some of the best schools in Vestavia Hills are Vestavia Hills Elementary Central School with a GreatSchools rating of 10/10 and a parent rating of 5/5 stars, and Vestavia Hills High School with a GreatSchools rating of 10/10 and a parent rating of 5/5 stars. The average GreatSchools rating for Vestavia Hills public schools is 10/10, with an average student/teacher ratio of 13:1.
School data provided by National Center for Education Statistics, Maponics, and GreatSchools. Intended for reference only. GreatSchools Ratings compare a schools test performance to statewide results. To verify enrollment eligibility, contact the school or district directly.
Buyers and Sellers are equally advantaged. Homes sell at approximately the same rate at which they are listed. Homes will often sell at the asking price.
Rental property is in high demand and availability is low. Rent prices have decreased by 7% over the past 3 months. This is 38% higher than the county average of $980 and 33% higher than the state average of $1,054.
Trend data coming soon.
For Sale: 1,164 | New: 113 | ||
$184,808 | $331,638 | Recently Sold: 1,012 | Reduced: 399 |
Average Home Price | Average Sold Price | Property Records: 43,421 | Foreclosed: 34 |
The average home price in Vestavia Hills is $184,808, which is 44.3% lower than the average sold price in Vestavia Hills ($331,638) . The average home price per square foot in Vestavia Hills is $138 and about 2% of all homes in Vestavia Hills sold in the last 6 months. For Vestavia Hills home values, real estate prices, and city market trends, research the 43,421 property records or search our 1,012 recently sold or 1,164 homes for sale listings. The listings and properties in Vestavia Hills are only a part of the 1,557,267 properties and 34,300 homes for sale in Alabama. Because of this, the average home price and average home value of Vestavia Hills also influence the average home price $127,132 and average sale price $178,623 of Alabama. Listing counts, Vestavia Hills home prices and home values in Vestavia Hills are sourced daily from listing and property data on realtor.com®, which is the most up-to-date and accurate aggregation of real estate listings in the industry and includes approximately 800 regional MLSs and is the official website of the National Association of Realtors®.
26,960 | 38 | $112,000 |
Population | Median Age | Median Household Income |

subset: commoncrawl


text:
Louis Vuitton Fall 2009: Bunny Ears, Bunching, and Boots
>> Marc Jacobs's signature collection started a minute early, and Louis Vuitton started just seven minutes late — which according to the way most fashion shows run, is still early, causing loads of people to miss the beginning — Suzy Menkes climbed over the runway after the first model walked out — and many to be locked out. Lucky for them, the show was staged in a clear tent in a Louvre courtyard, so late editors and passersby could watch the show.
Bunny ears topped heads — show stylist Katie Grand was inspired by "a black doe rabbit in the pet shop on the corner" — necklaces were modeled after paper garlands, ruching was everywhere, and Rose Cordero finally made a Paris runway appearance. Marc Jacobs said he was inspired by "all the great, elegant Parisian women, like Loulou de la Falaise," and the LVMH-Gareth Pugh connection continues: Pugh sat front row, two seats away from Bernard Arnault, still denying the Dior Homme rumors.
*image: source
- ASAP Rocky is basically a wizard when it comes to clothes — The Cut
- Even accessories have accessories now — Style.com
- Meryl Streep's daughters just landed a cool new fashion gig — HuffPost Style
- Elizabeth Taylor always wore the best jewels — InStyle
- Would you buy an Apple Watch just to make a statement? — Racked
- The shirtdress may be making a comeback this Spring — SheFinds
- Why you should be on board with dresses over pants — Who What Wear
- Kate Spade Saturday is having a crazy-good sale right now — Lucky
- 1 woman weighs in on whether or not we need fashion — Man Repeller


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K-12 Educator Registration Scholarships
Thanks to a generous gift from Phyllis Gottesfeld Knight of Denver, the Graduate Program in Creative Writing at Western is pleased to offer several general registration scholarships to K-12 educators who wish to attend the Symposium on Poetry Criticism as part of Writing the Rockies this summer.
Each scholarship is for $250, reducing the cost of tuition for the conference to just $100.
Applicants must submit a completed scholarship application form (available here), along with a formal request for the Symposium Educator's Scholarship, and a letter, on letterhead, from an administrator affirming their employment at any educational institution, public or private, at any level from primary school through high school.
Please fill out all materials and send them in pdf format to email@example.com.
Once we have processed your scholarship application, we will provide you with a scholarship code that will enable you to register on the storefront. Numbers are limited -- please apply early.
Register Now for Writing the Rockies
Credit Options for Teachers
Teachers with an undergraduate degree from an accredited institution can earn one non-degree graduate level credit in "ENG 510," which is run through the Western Teachers Institute, administered by Western's Extended Studies Office. Additional fees apply.
For further information, contact:
- Western's Extended Studies Program at or 1-800-876-5309 , ext. 7, or email@example.com, or
- David J. Rothman, Graduate Creative Writing Program Director / Poetry Concentration Director / Conference Director, at email@example.com
Register Now for Writing the Rockies
Graduate Program in Creative Writing, Application Information


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How to Import Brushes to Paint Shop Pro
Brushes help you add extra nuances to your graphic imagery, and they are everywhere on the Internet. This article will tell you how to add brushes to Paint Shop Pro.
- This article written using PSP X3.
1Look on the Internet for the brushes that you would like to install.
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2Download the brushes and unpack them. They are usually in a zipped file, so you will need to unzip them.
3Open up Paint Shop Pro. Click on File >> Import >> Custom Brush.
4Click on Open and navigate to where the brushes are.
5Select some, or all, of the brushes. Once you have selected them, you will see the ones you chose on the left of the dialog box.
6Click on Add All >>. This will move all of the brushes to the right of the screen.
7Click on OK. This will take you back to PSP.
8Click on the brush icon, then click on the brush down arrow. This will bring you to all of your installed brushes.Ad
We could really use your help!
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Asian-Style Courtyards
Adding Asian elements to your courtyard creates a calm, serene outdoor space you can enjoy for years. Check out these Asian-style courtyards to get ideas for your outdoor space.
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If you missed an episode, check out our archived episodes below!
Click on the episode name for more information, audio files, and discussion boards.
Episode 13
"Ideology and Curriculum:
30 Years of a Discussion"
Michael W. Apple
Original airdate: February 14, 2010, 5 p.m. central.
If an audio player does not appear or if it doesn't work, click here to listen.
What political and economic forces affect teachers as they write their lesson plans? How does socialization create the kind of education we give our children? Why isn't school politically neutral? In our next episode of Why? we will ask these questions and more, focusing on Michal Apple's influential book Ideology and Curriculum. For thirty years, the book has challenge educators, directed policy conversations, and inspired those who want to think differently about schools and their roles in a democracy.
Professor Michael W. Apple is John Bascom Professor of Curriculum and Instruction and Educational Policy Studies at the University of Wisconsin, Madison. He teaches courses in curriculum theory and research and in the sociology of curriculum. His major interests lie in the relationship between culture and power in education. He has many influential publications including the books,Ideology and Curriculum, The State and Politics of Education. Educating the "Right" Way: Markets, Standards, God and Inequality, Official Knowledge: Democratic Knowledge in a Conservative Age; Cultural Politics and Education;Education and Power.
Why?'s host Jack Russell Weinstein says, "This book helped me better understand what it means to be a teacher and what I bring to my classroom. I'm very excited to talk with Michael and further challenge my understanding of what education is. I'm hoping that school teachers, parents, and anyone who has an interest in what happens in our schools will call or write in, making this a lively and unpredictable discussion.
New to the show or want to revisit old episodes? Click here for our complete archive. Every show is available!Or just start with one of these fan favorites. You'll love them! |
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Euro Crisis: Britain's Financial Arsonist Returns to the Scene of the Crime
by Finian Cunningham
December 14, 2011
The incendiary finance capitalism unleashed by Britain 25 years ago is at the heart of Europe's raging debt woes
You either have to admire British Prime Minister David Cameron's brass neck, or wince at his arrogant stupidity. The smart money is probably on the latter option.
For here you had the British leader heading to the European Union summit convened last week to "salvage" the EU from its the terminal debt crisis – a crisis that is threatening the survival of the Euro single currency, the political future of the European Union and may even be sounding the death knell for the faltering capitalist world economy.
Yet, given the stakes involved, all Cameron wanted to do was exploit the crisis in order to claw further concessions for the City of London's stock exchange. Such self-serving opportunism was rebuffed by his German and French counterparts, whereupon Cameron stomped his feet and declared that Britain would exercise its veto over EU plans for tighter fiscal controls on member states. The British veto may now hamper the EU's ability to assuage the financial markets, which are daily extracting pounds of flesh with exorbitant rates of borrowing on government bonds.
Not that the leaders of the other 26 EU states are acting as noble knights in shining armour, vying to protect their populaces from further economic suffering. The revised EU treaty they have in mind will only deepen that suffering by expanding austerity and cutbacks for the majority of people across Europe. The fiscal and economic policies of member states will henceforth be dictated by the European Central Bank and the International Monetary Fund. That is, national sovereignty supposedly serving the people, according to their votes, is to be replaced by the rule of unelected bankers and technocrats. In a very real way, the debt crisis of Europe is serving to usher in a dictatorship of finance capitalism. As Paul Craig Roberts noted recently on Global Research with regard to the EU – "the banks have taken over" [1].
link to globalresearch.ca
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Found: Early Black Hole 12 Billion Times More Massive Than Our Sun
Chemicals From Beauty Products Have Migrated To Antarctica
New Mysterious Craters Found In Siberia
Human Head Transplants Will Not Be Possible By 2017
How Many Constitutional Rights Have We Lost?
North Carolina Legalizes Prostitutes For Politicians
KFC to Serve Edible Coffee Cups
Google wants to rank websites based on facts not links
Eleventh Hour Drama For Net Neutrality
Cyber Bullying Legislation Passes PA House. House Bill 229 would make cyber harassment of a child a punishable offense
DNA Activation for the Golden Age
Are We Living In A Holographic Universe?
Scientists Fear CIA Funding Geoengineering to Control 'Weaponized Weather'
IBM Watson Dehumanizing Veterans Care
Max Keiser: Welcome to the New World Order
Forced Adult Vaccinations at Federal Levels
The Media Is "Run By A Tiny Group Of Politically Motivated Moguls", And "Controlled By The CIA"
Inside The Food Industry: The Surprising Truth About What You Eat
Monday Feb 23 Will Be GLPVCs TheRawFeedLive's Last Show
Hollywood Studio Caught Producing ISIS Videos
A meteor going 45,000 MPH lit up the sky in western PA. You could see it from Ohio and New York!
America : Freedom to Fascism
Rapper Afroman Caught On Video Punching Woman At Nightclub
USDA Approves First GMO Apple For Planting
US Senator used old photos of Russian troops to push Ukraine war propaganda


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Asia Stocks Higher As China Factory Output Grows
By PAMELA SAMPSON
BANGKOK (AP) â¿¿ Asian stock markets swung higher Friday after a survey showed an improvement in China's manufacturing, offsetting gloom from a sharp drop in Japanese business confidence.
HSBC Corp. said its preliminary Purchasing Managers' Index for December rose to 50.9, a 14-month high and up from November's reading of 50.5. Numbers above 50 represent an expansion of manufacturing.
"I think it adds further encouragement that China is moving in the right direction," said Andrew Sullivan, a self-employed analyst based in Hong Kong. "But we are also seeing a lot of money sitting on the sidelines at the end of the year, and people want to get it invested. In previous years, we've seen good rallies around the end of the year."
The preliminary version of the HSBC index is based on responses from 75 to 80 percent of the 420 companies surveyed each month. The full report is due out at the end of the month. Hong Kong's Hang Seng pulled out of negative territory to advance 0.6 percent to 22,579.2 by midday. Mainland Chinese shares posted sharp gains, with the Shanghai Composite Index surging 2.9 percent to 2,120.84. The smaller Shenzhen Composite Index shot up 2.9 percent as well, to 806.67. Japan's Nikkei 225 index erased morning losses that followed the release of a Bank of Japan survey which showed large Japanese manufacturers are more pessimistic about business conditions. The "tankan" index for the December quarter dropped from September's minus three to minus 12, much worse than expected. The benchmark in Tokyo posted a 0.2 percent gain to 9,760.32, a day after closing at an eight-month high. A weakening yen helped export shares, with Japan's Fujitsu Ltd. surging 6.2 percent and Sharp Corp. jumping 3.2 percent. South Korea's Kospi fell 0.3 percent to 1,997.38. Benchmarks in India, Indonesia and Taiwan also fell. Australia's S&P/ASX added less than 0.1 percent to 4,585.90.Check Out Our Best Services for Investors
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Students update classic animation technique
(Phys.org) —Computer Graphics students at Victoria University have created an alternative to an animation technique used by studios such as Disney and Pixar.
(Phys.org) —Computer Graphics students at Victoria University have created an alternative to an animation technique used by studios such as Disney and Pixar.
Historic records show Franz Josef Glacier retreated three kilometres in the last century and mathematical modeling indicates it is likely to retreat even more this century.
(Phys.org) —Just-published research from Victoria University of Wellington and the University of Oxford highlights the urgency of reducing global emissions of carbon dioxide.
Creating and manipulating particles made of just a few atoms is all in a day's work for Dr Richard Tilley.
Space is being cleared and prepared for planting behind the University's Māori Studies (Te Kawa a Māui) building.
Anna Carter is conducting a climate modelling study on Stephens Island in Cook Strait, home to New Zealand's largest tuatara population.
(Phys.org) —Research carried out at Victoria University of Wellington shows that exposure to some commonly used pesticides makes an invasive ant species more aggressive and more likely to survive conflict with a native ...
According to research carried out by a Victoria University of Wellington PhD student, despite the popularity of reggae music around the world, the economic return to Jamaica is very low, with most music rights being foreign ...
(Phys.org) —A Victoria University mathematician has experienced his own eureka moment, solving a 40 year-old mathematical problem.
New research from Victoria University shows government agencies are more likely to write off unpaid tax than welfare debt—even though the outstanding tax bill is almost six times larger.
(Phys.org) —A study involving Victoria University researchers supports the longstanding theory that taking part in extreme, painful rituals increases prosocial behaviours and attitudes including making ...
Research carried out at Victoria University has found little difference in how men and women cast their party vote at the 2011 New Zealand general election, except in the case of one political party.
Research carried out at Victoria University challenges criticism of internal assessment in schools and shows the assessment method plays an important role in helping students to think critically.
Pioneering technology developed at Victoria University has been shown to protect valuable equipment from up to 90 per cent of the forces generated by earthquakes.
A Victoria University academic aims to use his newly acquired skills to create an updated Samoan language dictionary on the web, as well as a larger collection of work documenting the language.


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The economics of hunting and fishing
Published 04/27/2012, The Jamestown Sun
Last week I sent a far-too-large personal check to a lodge in Alaska to book a fishing trip for Laurie and me, and it got me to thinking about the shaky economics of hunting and fishing.
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#50231510 -
Girl dressed as a painter
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Date: 4 years ago
Runtime: 1:48
Views: 12,873
All Comments
I love how you bounce it hard and fast! I looks like it feels amazing! I have been wanting to get a rambone inside of me for a long time!!!
FUCKING HOT!! What are you using for lube? Try j-lube..very slick. You may be able to get more length in your ass.


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PlantFiles: Hellebore, Lenten Rose
Helleborus x hybridus 'Yellow Lady'
Family: Ranunculaceae (ra-nun-kew-LAY-see-ee) (Info) Genus: Helleborus (hel-eh-BORE-us) (Info) Species: x hybridus (hy-BRID-us) (Info) Cultivar: Yellow Lady Additional cultivar information: (Lady series) Hybridized by Gisela Schmiemann One vendor has this plant for sale. 3 members have or want this plant for trade. Category: Height: Spacing: Hardiness: Sun Exposure: Danger: Bloom Color: Bloom Time: Foliage: Other details: Soil pH requirements: Patent Information: Propagation Methods: Seed Collecting: | Click thumbnail to view: By growin By onewish1 By Todd_Boland |
No details have been posted.
This plant has been said to grow in the following regions:
San Francisco, California
Vista, California
Winnetka, Illinois
Sandwich, Massachusetts
Denville, New Jersey
Ashland, Oregon
Wilkes Barre, Pennsylvania
Hurt, Virginia


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Matt Crafton led the way in both NASCAR Camping World Truck Series practice sessions Thursday at Phoenix International Raceway.
Crafton clocked a lap at 130.458 mph in opening practice and followed that up with a lap of 132.836 mph in Happy Hour.
David Starr recorded the second fastest lap in the first session with Kyle Busch, Johnny Sauter and Clint Bowyer completing the top-five. Clint Bowyer, Austin Dillon, Aric Almirola and Mike Skinner were second through fifth in final practice.
Qualifying for the Lucas Oil 150 NASCAR Truck Series race at Phoenix will be on SPEED at 4:30 pm ET Friday afternoon.


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The inward movement of European peoples and the southward migration of Bantu tribes supply the key to South African history and, write Edna and Frank Bradlow, to the problems that confront the country today.
The Battle of Majuba Hill during the First Boer War, had immense political and military significance to British arms—and not only in South Africa. Its chief cause, writes Brian Bond, was a gross underestimation of the Boer's tactical aptitude and courage.
On November 17th, 1874, when Henry Morton Stanley marched away from Bagamoyo on what was to be his greatest exploring achievement, he was retracing his own steps of 1871 along the well-worn caravan route used by Burton and Speke in 1857; by Speke and Grant in 1860, and, writes C.E. Hamshere, many Arab traders before them.
Patricia Wright describes the first Italian attempt to capture Ethiopia.
During the winter of 1935-6, writes Patricia Wright, Italian armies overran Ethiopia and annexed the Empire to the Italian Crown.
Prospects seemed encouraging for the Italian Empire in 1940, writes Patricia Wright, but an arduous defeat ensued.
The traditions of organized statehood in the countries of French West Africa stretch back for some fifteen centuries. During the past sixty years, writes Basil Davidson, French influence has greatly strengthened the feeling of federal community that inspires many of the newly evolving republics of the Western Sudan and the Guinea coast.
Colonialism was predicated on the negation of African history or, as one of the two editors of this volume, John Parker, wrote in his African...
Raoul McLaughlin talks about Rome's desire for an African empire, a fierce struggle for trade, land and the search for the source of the Nile.
"A game of bluff from start to finish," said Robert Baden-Powell, British commander during the Second Boer War. Nicholas King describes the seven-months' siege, that took place in present day South Africa.


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Change port
Lists or changes the COM port mappings to be compatible with MS-DOS applications.
change port [{portx=porty|/d portx|/query}]
portx = porty : Maps COM port x to porty.
/d portx : Deletes the mapping for COM port x.
/query : Displays the current port mappings.
/? : Displays help at the command prompt.
Most MS-DOS applications support only COM1 through COM4 serial ports. The change port command maps a serial port to a different port number, allowing applications that do not support high-numbered COM ports to access the serial port. For example, to map COM12 to COM1 for use by an MS-DOS-based application, type change port com12=com1. Remapping works only for the current session and is not retained if you log off from a session and then log on again.
Use change port without any parameters to display the available COM ports and their current mappings.
Formatting legend
Format |
Meaning |
Italic |
Information that the user must supply |
Bold |
Elements that the user must type exactly as shown |
Ellipsis (...) |
Parameter that can be repeated several times in a command line |
Between brackets ([]) |
Optional items |
Between braces ({}); choices separated by pipe (|). Example: {even|odd} |
Set of choices from which the user must choose only one |
Courier font |
Code or program output |


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Quick View 10580 LEGO DUPLO Deluxe Box of Fun by LEGO® In stock online $59.95 Give your child hours of entertainment with the LEGO® DUPLO® Deluxe Box of Fun. This set makes the perfect introduction to LEGO building fun, with a huge range of classic and special DUPLO bricks. From teaching counting with the decorated number blocks to inspiring role play with the DUPLO… See Details $59.95 was $59.95
Quick View Nutty Ball Track by Janod In stock online $59.95 This is a set of activity that fosters motivation physical development, in particular motor skills and dexterity as they should slide to cart hazelnuts from the top of the tree. Your children spend hours watching as hazelnuts 3 levels down and rush to put them back in their lane drop. The wooden… See Details $59.95 was $59.95
Quick View HopHop Trampoline by Diggin Out of stock online $59.95 The HopHop Trampoline by Diggin is hours of hopping fun! This toddler trampoline includes a padded easy-grip handle and a sewn, padded cover for safe bouncing. Ideal for small spaces! Jumping is an excellent way for kids to build strength and to improve both balance and coordination. An… See Details $59.95 was $59.95
Quick View Oops Safe & Fun Playmat - Forest In stock online $59.95 "Oops, do it again!" Let your toddler explore and learn with this forest themed Safe and Fun Playmat. This fun mat doubles as a giant 23-piece floor puzzle for your toddler to take apart and put back together again and again. Featuring some of their favourite characters Mr. Wu, Chocolat, and… See Details $59.95 was $59.95
Quick View My 1st Scooter Sport by Radio Flyer In stock online $59.95 Best beginner scooter, with two front wheels for maximum stability, and extra-wide base for better balance. Features a tapered base for a clear kick path, and easy to use foot brake for added control. No assembly required. Weight Capacity: 50 lbs. For ages 2- 5 years. See Details $59.95 was $59.95
Quick View 10525 LEGO Duplo Big Farm by LEGO® In stock online $59.95 This Big Farm set with buildable models has everything you and your child need to live life on the farm! There's a barn for storing food, a farmhouse with chairs, and a stable for the horse. Out in the yard, the cows are enjoying their food while the tractor is ready to start working in the… See Details $59.95 was $59.95
Quick View 3 IN 1 BOUNCE STRIDE & RIDE ELEPHANT by Fisher Price In stock online $59.95 Three "grow-with-me" ways to play: Sit & Bounce; Stand & Walk; Scoot & Ride! •Over 30 sung songs, tunes, fun sounds and phrases •Colorful light-up buttons •Wobbly-action bumblebee •Bat-at rollerball with rattle bead sounds •Adorable first friend for baby—steadies first steps, too!… See Details $59.95 was $59.95
Quick View Supermaze by Hape In stock online $59.95 This popular classic provides the ideal opportunity for exploring three dimensions. Fun play and formal learning are accommodated as children develop fine motor skills and recognize shape, color, size and spatial concepts. Ages 2 years+. See Details $59.95 was $59.95
Quick View Van Walker by Plan Toys Out of stock online $59.95 This walker is a van and could be used for storage for other little toys too. Just the right size babies taking their first steps. For more than 30 years, PlanToys has been consistently developing its products and activities with a strong commitment to contribute positively to the world. By… See Details $59.95 was $59.95
Quick View Alpine Slasher Sleigh Out of stock online $59.95 Made in Canada by Canadian craftsmen. Wood seat slats are constructed with Ontario Ash Hardwood. A water based dipped finish insures a quality appearance for seasons of winter conditions. This sleigh is accented with attractive red polypropylene runners and back support hoop. The Alpine Slasher… See Details $59.95 was $59.95
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Contact Vacutech
Vacutech Sheridan Headquarters: 1350 Hi Tech Dr. Sheridan, WY 82801 (307) 675-1982 Denver Area Location: 6810 South Jordan Road Centennial, Colorado 80112 (303) 327-7870
Web Address: www.vacutechllc.com
Toll Free: 800.917.9444 Phone: 303.327.7870 Fax: 303.327.7874
email: email@example.com
Come take a virtual tour of our new factory in Sheridan, WY. Click and drag anywhere on the image to look around. Use the arrows to move to the next location. Finally, use the link in the upper right hand corner to enter full screen view. Flash Player Required
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Ohne Titel Straddles Primitive Egyptian Modernity for Spring 2010
>> Ohne Titel's Alexa Adams and Flora Gill told Fashionista backstage that their Spring 2010 collection was their strongest yet, and they weren't kidding. Inspired by "the graphic lines, lush textures, and bold colors in Egyptian reliefs and sculptures," according to their show notes, Adams and Gill adapted their signature tailoring and body-con sensibilities to span an oxymoronic look of primitive modernity. They elaborated to The Cut: "We looked at a lot of wall painting and sculptures, and so we're kind of playing with taking those same kind of proportions and applying them on the body."
Lace-up heels, flats, and thigh-high boots done in collaboration with Cesare Paciotti are sure to have the shoehounds drooling, and the prevalent texture in the collection — including patches of multicolored hand embroidery — was exquisite. Alastair McKimm, who worked with Alexander Wang the last two seasons, styled, and both Cathy Horyn and Visionaire's Cecilia Dean appeared front row.
- The SF show will focus on the late designer's life — Who What Wear
- We'd totally wear these Reebok trainers to brunch — Lucky
- Why the fashion that's filling your feed is a big deal — The Cut
- We're totally pulling a Solange for our next airport adventure — InStyle
- J.Crew just opened a store in this city for the first time . . . — Racked
- The new tee you can wear every single day of the week — HuffPost Style
- You won't believe which type of denim Eva Mendes prefers — SheFinds
- The fashion world is about to get a treat from Kanye West — Style.com
- Why the next Alexander McQueen exhibit is sure to be cool — Harper's Bazaar


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Which Cancelled CW Teen Soap Will You Miss The Most? (POLL) Luke Kerr May 9, 2014 Polls, Pop Confidential, Star-Crossed, The Carrie Diaries, The CW, The Tomorrow People, TV, TV Renewals 3 Comments * Star-Crossed * The Carrie Diaries * The Tomorrow People
Did The CW's Star-Crossed Capture Your Heart? (POLL) Jenna Dorsi February 19, 2014 90210, ABC Family, Drama, Friday Night Lights, Star-Crossed, Teen Wolf, The CW * Awesome! I can't wait for next week. * I didn't love it, but I'll still tune in again. * Hated it. I won't be watching.
The CW Shakes Up Spring Schedule Luke Kerr December 13, 2013 Arrow, Hart of Dixie, Star-Crossed, The 100, The CW, The Tomorrow People, TV, Whose Line is it Anyway? 2 Comments The CW is rearranging the deck concerning its schedule. The netlet announced its new spring schedule, which includes the premieres of Star-Crossed on February 17 and The 100 on March 19. The Tomorrow People, starring As The World Turns grad Peyton List, will be teleporting from Wednesdays to Mondays. Meanwhile, Hart of Dixie, featuring The Young and the Restless alum Wilson Bethel, is being shipped South to Fridays, where it will be paired with Aisha Tyler's Whose Line Is It Anyway. See The CW's new schedule after the jump!
The CW Unveils Promos for The Tomorrow People, The 100, Reign, Star-Crossed and The Originals (VIDEO) Luke Kerr June 4, 2013 Fall TV, Pop Confidential, Reign, Star-Crossed, The 100, The CW, The Originals, The Tomorrow People, TV, TV Trailers 3 Comments The CW will debut a number of new teen soaps next season. From Mary Queen of Scots in Reign to an alien/human love affair in Star-Crossed, the netlet is hoping its high-concept content will lead to big ratings. Check out promos for The Tomorrow People, The 100, Reign, Star-Crossed and The Vampire Diaries' spinoff, The Originals, after the jump!
Peyton List Among 'The Tomorrow People' at CW Upfronts (PHOTOS) Daytime Confidential May 17, 2013 All My Children, Arrow, Beauty and the Beast, Comedy, Days of Our Lives, Drama, General Hospital, Hart of Dixie, Nikita, One Life to Live, Photos, Pop Confidential, Reign, Star-Crossed, Supernatural, The 100, The Bold and the Beautiful, The Carrie Diaries, The CW, The Originals, The Tomorrow People, The Young and The Restless, TV Former As the World Turns star Peyton List (ex-Lucy Montgomery) joined her The Tomorrow People co-stars Luke Mitchell and Aaron Yoo at The CW's 2013 Upfront Presentation on May 16. The event featured several current and former daytime stars, including: Hart of Dixie's Wilson Bethel (ex-Ryder Callahan, The Young and the Restless), Star-Crossed's Natalie Hall (ex-Colby Chandler, All My Children), The Talk's Aisha Tyler and Let's Make a Deal's Wayne Brady. Check out more photos of stars from The Vampire Diaries, The Originals, The Tomorrow People, Hart of Dixie, Arrow, Reign and more after the jump!


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These Mickey Thompson Sportsman Pro rear tires come in the same giant economy sizes as the standard Sportsman's, but they have a drag racing compound for better traction and a 2-ply wrinkle wall carcass for better suspension reaction. They are designed for hot rods, t-buckets and muscle cars that have shortened rear ends and tubbed fender wells. They're DOT-approved, too--but just barely.
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The Telugu Desam Party on Wednesday said that people of Karnataka voted the Congress to power in that state as there was no alternative.
Exit-polls have predicted that BJP is on its way out in Karnataka.
BS Yeddyurappa on Sunday said that he was confident of getting a majority and forming the next government in Karnataka.
Veerappa Moily on Sunday expressed confidence that the Congress Party would emerge as a winner with maximum seats in Karnataka.
Infosys co-founder NR Narayana Murthy waited half an hour to cast his vote Sunday morning.
It can`t get more contrasting than this in Varuna Assembly segment of the district.
In a first initiative of its kind in Karnataka, Election Commission has decided to monitor over 1,000 polling booths through web-casting.
Taking strong exception to alleged harassment of party chief Mayawati while campaigning in Karnataka, BSP on Monday demanded immediate removal of the state Chief Electoral Officer.
BJP president Rajnath Singh on Monday said it was unfortunate that Karnataka had to see three chief ministers in five years of his party rule.
Taking on the BJP government in Karnataka, the former captain of the Indian cricket team, Azaharuddin appealed to the people here to vote for Congress to ensure a stable government who can maintain law and order in the state.
Campaigning in Karnataka is at its peak and it's not only the candidates who are putting up with heat but their spouses too have joined the battle.
BJP on Sunday strongly disagreed with JD(U) chief Sharad Yadav`s allegation that the BJP was using money power during elections in Karnataka.
Congress leader DK Shivakumar on Friday caustically said that Janata Dal (S) leader PGR Sindhia was leaving no stone unturned to win the upcoming May 5 Assembly elections.
JD(U) candidate Devappagouda G Patil contesting from Sindagi Assembly constituency on Saturday died at a hospital in Solapur in Maharashtra, an official said.
The average asset of Bangalore candidates of various political parties contesting the May five Assembly elections in Karnataka is Rs 25 crore.
Contrary to claims by state BJP leaders that Narendra Modi would conduct an extensive campaign tour ahead of the May 5 elections in Karnataka, it appears that as of now the Gujarat CM would address only one public meeting.
SM Krishna skipped the manifesto-release event of the party on Wednesday.
The Congress on Wednesday released its election manifesto, which promised interest-free loans to farmers, free laptops to pre-university students and rice at Re one per kg to BPL card holders if it came to power in Karnataka.
Seeking to deflate the anti-graft plank of BJP against UPA government, Congress Vice President Rahul Gandhi on Tuesday made a fierce attack on the party`s rule in Karnataka, accusing it of "looting" the state and calling it a "champion" of corruption.
While claiming that there is a strong wave in favour of Congress in the poll bound state, party leaders are trying to come back in region like Uttar Kannada.
Day in Pics: 5th March
Showbiz World - March 5 2015
10th Annual Caring With Style Fashion Show


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Local employer Bostik
to mark its 125th year
Bostik, leading global adhesive specialist for industrial manufacturing, construction and consumer markets, has announced plans to mark its 125 year anniversary. The firm was founded in 1889 in Massachusetts as the Boston Blacking Company, and numerous localevents and promotional activities are planned to celebrate the role that innovation has played in the company's development.
Bostik has major operations in Wauwatosa, at 11320 Watertown Plank Road, where it employs some 200 people after moving its American headquarters for nonwoven products here this year.
Bostik is a leading global adhesive specialist in industrial manufacturing, construction and consumer markets. For more than a century, it has been developing innovative adhesive solutions that are smarter and more adaptive to the forces that shape people's daily lives. Its products include, for example, the adhesives used in diapers.
North Shore Bank names head of retail banking
North Shore Bank of Brookfield has announced that Susan T. Doyle has been appointed senior vice president of retail banking. Doyle, who was previously a vice president, has 30 years of banking experience.
Doyle began her career at North Shore Bank and returned to it seven years ago. Inhernew role, her core responsibilities include the development of North Shore Bank's branch network, marketing and investment sales. She is currently involved in strategic development of branch transformation models.
Doyle is a Brookfield resident and is a board member and program committee chair of the Next Door Foundation, a non-profit, early education center in Milwaukee's Metcalfe Park neighborhood that serves more than 1,000 children and families. She is a graduate of the University of Wisconsin-Madison.
Alverno appoints head
of business school
Eileen Sherman has been appointed Dean of Alverno College's School of Business. In this role, she will provide leadership to the School of Business, partner with faculty to foster student achievement, and strengthen partnerships between the college and local businesses.
Sherman brings 21 years of experience in higher education to the college. She comes to Alverno from Cardinal Stritch University, where she served as an associate dean in the undergraduate school of their College of Business and Management and as an associate professor.
Sherman earned her Bachelor of Science degree from Worcester State College, and her Master of Business Administration degree from Boston University. She earned her Ph.D. from Marquette University in 1995.
Mount Mary names new health sciences dean
Mount Mary University President Eileen Schwalbach has announced that Cheryl Bailey has been appointed Dean of the School of Natural and Health Sciences. Bailey will oversee Mount Mary's natural and health sciences programs including biology, chemistry, mathematics, and undergraduate and graduate occupational therapy and dietetics.
Bailey will also continue her role as a principal investigator for a National Science Foundation funded project with the American Society of Biochemistry and Molecular Biology working with biochemistry educators to assess and teach foundational concepts.
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- Wauwatosa East teacher Barb Bruesewitz named ProStart Teacher of the Year
- Wauwatosa Virtual Academy meets diverse need of learners
- Pancake breakfast Sunday will raise money for scholarships
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Taking into account all the other gospels, I decided to put up the Easter story according to Mark.
This is not to take away from the others as you will find that all are about the crucifixion and resurrection of Jesus Christ, the Savior. Hope your Easter is a blessed one.
Read the Easter Timeline Mark 11:1-11 - Jesus Rides into Jerusalem on a Donkey Mark 11:12-19 Jesus Clears the Temple Again Mark 11:20-25 - Jesus Says the Disciples Can Pray for Anything Mark 11:27-33 - Religious Leaders Challenge Jesus' Authority Mark 12:13-17 - Religious Leaders Question Jesus about Paying Taxes Mark 12:18-27 - Religious Leaders Question Jesus about the Resurrection Mark 12:28-34 - Religious Leaders Question Jesus about the Greatest Commandment Mark 13:1-23 - Jesus Tells about the Future Mark 13:24-31 - Jesus Tells about His Return Mark 13:32-37 - Jesus Tells about Remaining Watchful Mark 14:1-2 - Religious Leaders Plot to Kill Jesus Mark 14:10-11 - Judas Agrees to Betray Jesus Mark 14:12-16 - Disciples Prepare for the Passover Mark 14:17-26 - The Last Supper Mark 14:27-31 - Jesus Predicts Peter's Denial Mark 14:32-42 - Jesus Agonizes in the Garden Mark 14:43-52 - Jesus is Betrayed and Arrested Mark 14:53-65 Caiaphas Questions Jesus Mark 14:66-72 - Peter Denies Knowing Jesus Mark 15:1 - The Council of Religious Leaders Condemns Jesus Mark 15:2-5 - Jesus Stands Trial before Pilate Mark 15:6-15 Pilate Hands Jesus Over to be Crucified Mark 15:16-20 Roman Soldiers Mock Jesus Mark 15:21-24 Jesus is Led Away to be Crucified Mark 15:25-32 - Jesus is Placed on the Cross Mark 15:33-41 - Jesus Dies on the Cross Mark 15:42-47 - Jesus is Laid in the Tomb Mark 16:1-8 - Jesus Rises From the Dead Mark 16:9-11 - Jesus Appears to Mary Magdalene Mark 16:15-18 - Jesus Gives the Great Commission Mark 16:19-20 - Jesus Ascends into Heaven This is the Word of the Lord ... It is meant to change the way that we think, and the way that we live.


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County Information
SURPLUS AUCTION BEGINS FEBRUARY 25th
Gila County will conduct the first quarter online auction to dispose of surplus property beginning Wednesday, February 25, 2015. Featured items are miscellaneous office furniture, equipment and automobiles. Interested persons may view a complete list of the items with a photo and a brief description here.
It must be noted that this is an online only auction. Internet access is required to bid on any items. [Note: free internet access is available at all libraries in Gila County.] Also, bidders must be registered at the auction site, www.publicsurplus.com, and may do so in advance of the February 25th "go live" date.
- Bidding will begin Wednesday, February 25th at 12:01 a.m. and close on Friday, March 6th at 5:00 p.m.
- All items are offered "as is" with no seller's warranty.
- Any incorporated municipality within Gila County has the opportunity to purchase any of the auction items prior to the beginning date of the auction. The price for the item will be the minimum or reserve for said item.
For information regarding vehicles, please contact John Root at (928) 402-8524. For all other items offered, please contact Joni Erwin at (928) 402-8897.
The Community Action Program (CAP) of the Gila County Community Services Division is conducting a local needs assessment survey for Strategic Planning purposes to determine how to better serve the community.
Please select a survey which most appropriately pertains to you, i.e., a CUSTOMER of services we currently provide, or a PUBLIC/PARTNER who is involved in providing services.
Here is the CAP Customer Survey Link.
Here is the CAP Public/Partner Survey Link.
With a population of 53,500 residents and covering 4,796 square miles, Gila County has always been a great place to live, work and play. Gila County is in Central Arizona and contains the Tonto Apache Reservation and parts of the Fort Apache and San Carlos Reservations. The county was formed in 1881 from parts of Maricopa and Pinal Counties, and later added the northern portion of the county from Yavapai County. Cities and Towns in Gila County include Globe, Hayden, Miami, Payson, Star Valley and Winkelman, along with a large number of rural unincorporated communities. Gila County is located on the northeastern edge of the Sonoran Desert, and covers a wide variety of life zones, including desert, high desert plains, chaparral, pinon-juniper and pine forests. There are a number of popular recreation areas in Gila County, including Roosevelt Lake, Tonto National Monument, Tonto Natural Bridge State Park, and Fossil Creek, along with several designated Wilderness Areas and popular camping areas within the Tonto National Forest.
Events Calendar
[CALENDAR HOME]Recent News
- SMOKE ADVISORY: Whispering Pines Prescribed Burn
- Gila County Newsletter - Winter 2015
- Gila County Public Health Monitoring Individuals who May have had Contact with a Confirmed Measles Case
- Overnight Delays on ADOT State Route 87 Improvement Project
- Capstone Pinto Valley Mine Sponsors Free Household Hazardous Waste Collection Event


text: Publications Search Results Users may wish to consult What's Included in the Bibliography. Results 1 - 1 Results per page: 25 50 100 Sort by: Pub Date (newest) Title Recent Additions Author Clear All Pub. Year Citation 2005 Rogers, Richard G., Hummer, Robert A., Krueger, Patrick M., Pampel, Fred C. Mortality attributable to cigarette smoking in the United States. Population and Development Review. 31, (2), 259-292. Full Text Options: DOI Worldcat Google Scholar Export Options: RIS EndNote XML [1]


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This Red Nokia 6555 is a sleek basic flip phone that has an external display that shows time, date and battery and signal strength. Just above the external display is the 1.23-megapixel camera which you can use to take pictures and record videos. Save up to 1000 phone book entries with multiple numbers per contact. This phone supports email, EMS, instant messaging, MMS, and text messaging. It can also play music with MP3, AAC, eAAC+, WMA files. The Nokia 6555 is also GSM quad-band phone which means you can use this phone anywhere in the world as long as you will use a sim card that works in the area. Order this used Red Nokia 6555 Bluetooth Camera Music Unlocked at a very cheap price.
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Nokia 6555 BluetoothNokia 6555 Bluetooth Camera Music Red Phone Unlocked$29.99
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Currently there is no framework for those involved in the identification, evaluation and prioritisation of new diagnostic technologies. Therefore we aimed to develop prioritisation criteria for the assessment of new diagnostic technologies, by gaining international consensus on not only which criteria should be used, but also their relative importance.
A two-round Delphi process was used to generate consensus amongst an international panel of twenty-six experts on priority criteria for diagnostic health technology assessment. Participants represented a range of health care and related professions, including government, industry, health services and academia.
Based on the responses to the first questionnaire 18 criteria were placed into three categories: high, intermediate and moderate priority. For 16 of the 18 criteria, agreement with the categorisation of the criteria into the high, intermediate and moderate categories was high at ≥ 70% (10 had agreement ≥ 80%). A further questionnaire and panel discussion reduced the criteria to 16 and two categories; seven were classified as high priority and nine intermediate.
This study proposes an objective structure of prioritisation criteria to use when assessing new diagnostic technologies, based on an expert consensus process. The value of these criteria is that no one single component should be used as the decisive driver for prioritisation of new diagnostic technologies for adoption in healthcare settings. Future studies should be directed at establishing the value of these prioritisation criteria across a range of healthcare settings.
A correct diagnosis is central to guiding choice of treatment, monitoring the effects of that treatment, as well as determining prognosis. Diagnosis involves both clinical skills (e.g. physical examination), as well as techniques to measure physiological parameters (e.g. blood pressure), and biochemical, haematological, other pathological and radiological investigations. New diagnostic technologies are continually being developed and marketed, while technologies that are currently used in hospital or traditional laboratory settings are increasingly being repackaged as point of care devices. However, improvements in diagnostic technologies do not inevitably translate to benefits to patient care [1]. For example, a new test may not have a clearly defined role in an existing diagnostic pathway, or may simply contribute to diagnostic uncertainty. Unlike randomised trials of interventions, which have a control arm, most studies of diagnostic accuracy do not compare the outcome from the use of the new test with existing tests [2].
In order for health care purchasers and providers to assess the importance and role of a new diagnostic technology in the diagnostic pathway, it is vital to have a process that can identify which technologies require more detailed or formal assessment, such as technology assessments or evidence-based summary reports. Simply using the efficacy data of a new diagnostic technology derived from a clinical study to determine adoption in the healthcare setting is inadequate [3]. This approach does not take into account all the factors influencing adoption of a test, such as the clinical setting, disease prevalence and proposed use.
Prioritising health technologies for further assessment, particularly for therapeutic interventions, is well established among international health technology assessment (HTA) bodies. Priority setting has involved both quantitative methods or scoring systems [4], as well as consensus guidelines. Quantitative models have been developed, for example by the Institute of Medicine in the USA, who developed a specific quantitative method to calculate priority scores based on criterion weight, as well as scores proposed by the Committee on Priorities for Assessment and Reassessment of Health Care Technologies [4], and the Technology Assessment Priority-Setting System (TAPSS) developed by the Council on Health Care Technologies [5]. In Europe, the EEC-funded EUR-ASSESS project for the coordination of HTA activities produced a set of guidelines for the priority setting of HTA projects [6]. Indeed, a recent systematic review identified 12 different priority setting frameworks used among 11 international HTA agencies, with a total of 59 different priority setting criteria [7]. Although the existing frameworks are intended to be applied to all technologies, there is a paucity of guidance on methods for prioritising diagnostic technologies in particular.
There are several reasons why diagnostic technologies require prioritisation criteria that are distinct from existing frameworks. Diagnosis usually involves a pathway in which a new technology may have a variety of roles such as replacing an existing test, triaging, or as an add-on test. In addition diagnostic accuracy may vary widely between different clinical settings and populations due to variations in prevalence and spectrum of disease. Key issues that are important in the evaluation of new diagnostic technologies have been proposed previously - these fitted into three broad domains, those related to the disease or target condition, the new diagnostic technology itself, and the impact of the diagnostic technology [8]. To address the important gap in the technology prioritisation of diagnostic technologies we aimed to build on these criteria, by refining them and including additional criteria. We also aimed to assess the criteria systematically by developing an international consensus on not only which criteria should be used to prioritise diagnostic technologies, but also their relative importance.
We used the Delphi method, which is an objective process that gathers consensus opinion from a panel of experts through an iterative questionnaire process interspersed with controlled opinion feedback [9]. Panels generally involve 10 to 50 members and experts who are anonymous, in that other panel members do not know their identity at the time of data collection. The Delphi method has been used extensively in developing criteria frameworks [10,11]. No ethical approval was required for this study.
We identified an international group of experts as follows: (1) membership of early awareness and alert networks (e.g. The International Information Network on New and Emerging Health Technologies [EuroScan]), (2) recommendation from researchers in the field of health technology assessment, (3) contacts in diagnostic technology industries, (4) contacts in government bodies tasked with health technology assessment, and (5) recommendations from researchers and providers in the field of primary health care and diagnosis. Experts were contacted by email and invited to contribute to the study using either email or a web-based format and were from a variety of health care sectors and related professional disciplines (Table 1).
Table 1. The Panel: Sectors and Main Professional Roles
The first questionnaire used prioritisation criteria developed by Summerton [8], which were compiled into an initial questionnaire following preliminary discussions amongst a small group of experts. The initial questionnaire consisted of 18 criteria, which were grouped into those pertaining to (1) the disease or target condition, (2) the new diagnostic technology, and (3) the impact of the diagnostic technology (Table 2). Participants were asked to rate the importance of, or their level of agreement with, each criterion using a seven-point Likert scale, where 1 indicated low and 7 high importance or levels of agreement. Open comments or clarifications on each item, as well as general comments and suggestions regarding items overlooked in the questionnaire were solicited. In total 26 respondents participated in the first questionnaire.
Table 2. Criteria appraised by experts: Round 1 Questionnaire
Responses to the first questionnaire were categorised according to the proportion of respondents that ranked criterion as a 6 or 7 on the Likert scale. Based on this analysis three priority groups were created: (1) high priority, at least 70% of respondents ranked 6 or 7, (2) intermediate priority, 50-69% of respondents, and (3) moderate priority, less than 50% of respondents.
A second questionnaire was then developed, placing the criteria in the aforementioned three priority groups. The experts were informed of the method used to group the criteria and were asked to indicate whether they agreed or disagreed with the placement of each criterion into its respective priority group. If they disagreed with the placement of a criterion, they were asked to suggest which category the criterion should be placed into (high, intermediate or moderate) and provide clarifying comments for their opinion. General comments were also invited. The final questionnaire responses were reviewed at a focus panel meeting of a smaller group of experts.
The 26 respondents represented a broad section of the health care sector: government (10%), industry (24%), academic (28%) and health services (38%), with diverse professional roles (Table 1). In some instances participants had more than one professional role and/or worked for different sectors (e.g. health care services and academic).
Round 1 Questionnaire
For 5 of the 18 criteria in the first questionnaire (Table 2; criteria 1, 3, 9, 15, 16), we found a high level of consensus existed as to their prioritisation importance. For example, 88% of respondents assigned a high importance to "The potential that the technology will have an impact on morbidity and/or mortality of the disease" and 85% to "The new technology reduces the number of people falsely diagnosed with the disease or target condition". Although 73% of respondents ranked "The disease or target condition to which the diagnostic technology will be applied can be clearly defined" as a 6 or 7 on the scale of importance, 13%, primarily from the academic sector, considered this criterion unimportant, ranking it as 1 or 2 on the Likert scale.
Seven criteria (Table 2; criteria 2, 4, 6, 8, 14, 17, 18) showed a substantial variation in ranking of their importance. For example, 46% of respondents assigned a low level of importance to "The relevance of the disease or target condition to current regional or national health policies and/or priorities", with 23% scoring a 1 or 2, whereas 23% rated this criterion as important, scoring a 6 or 7. Respondents ranking this criterion as being of low importance (1 or 2 on the Likert scale) came from academic, industry and health services sectors, whereas respondents from the government sector gave this criterion more importance (4 to 6 on the Likert scale). Reasons provided for rating this criterion low included: regional and national policies are sometimes out-of-date, priorities can be skewed by political pressure, and it is most important how much morbidity and mortality can be avoided rather than whether it is a government priority. However some respondents from industry and academia ranked this criterion as a 7 in terms of its importance. Regarding "The prevalence or incidence of the disease or target condition", respondents commented uncommon conditions could still be important to consider for research. "It would be feasible to change current practice to incorporate this technology (e.g. additional training, infrastructure, or quality control)" showed the most rankings of 5, indicating that this criterion was deemed somewhat important, but not the most important.
"The potential that the technology will have an impact on morbidity and/or mortality of the disease" scored the highest mean Likert value of 6.5 and the criterion that "The relevance of the disease or target condition to current regional or national health policies and/or priorities" had the lowest mean value of 4.2. Based on the responses to the round 1 questionnaire, we categorised the criteria into high (70% or more respondents ranked criteria as 6 or 7 on the scale of importance), intermediate (50-69% ranked criteria as 6 or 7 on the scale of importance) and moderate priorities (less than 50% ranked criteria as 6 or 7 on the scale of importance) for the second round questionnaire.
Round 2 Questionnaire
A total of 24 (92%) of those who participated in the first questionnaire responded to the second questionnaire. For 16 of the 18 criteria, agreement with the categorisation of the criteria into the high, intermediate and moderate categories was high at ≥ 70% (10 had agreement ≥ 80%). There was low agreement for two criteria: "The prevalence or incidence of the disease or target condition" (54% agreement) and "There is variation in treatment or patient outcomes resulting from current diagnostic variability" (67% agreement). For the latter, a number of respondents commented it should be moved from the intermediate to high priority groups, since practice variation is an important driver of prioritisation and variation in outcomes is a clear sign that the current diagnostic process is not fit for purpose. For "The prevalence or incidence of a disease or target condition", several experts disagreed with its placement into the intermediate category and suggested it should have a high priority. The main reason given for this was technologies that have an impact on highly prevalent diseases would have the greatest impact within the health care system. However, other experts felt this criterion should be moved to moderate priority, as they considered that it would not be a useful criterion in itself if the technology did not meet any of the other criteria.
Several experts also suggested moving the criteria placed into the "moderate priority" category into either the high or intermediate priority categories. Based on the subsequent panel discussion, there did not appear to be a clear reason to differentiate between intermediate and moderate priority categories, so these were combined. Two criteria were removed from the final list as several respondents commented that they overlapped with other criteria. These were the criteria relating to cost-effectiveness and workload, which were already addressed by "The new technology would enhance diagnostic efficiency or be more cost effective than the current diagnostic approach". The latter criterion was then moved to high priority, in line with expert suggestions. The final list consisted of 16 criteria, seven of which were considered high priority and nine of intermediate priority (Table 3).
Table 3. Proposed Criteria for the Prioritisation of Diagnostic Technologies
In this study we have developed prioritisation criteria for the evaluation of new diagnostic technologies. With the aid of a two-round Delphi consensus method, which sought the opinions of 26 experts, 16 criteria were agreed, of which seven were classified as high priority and nine as intermediate priority. To our knowledge this is the first study to address prioritisation criteria for diagnostic technologies using the Delphi method.
This study was designed to canvass opinions from a range of experts from industry, academia, government and health services. The aim of such a process is to obtain a range of opinions from diverse perspectives and, unlike quantitative surveys, does not rely on a large sample to determine outputs with confidence. Although our list of experts is not exhaustive, the group provided a wide range of views and represented several different sectors. The prioritisation criteria presented are therefore not dependent on the views of professionals from one specific constituency or working in a particular health care system or country. However, we acknowledge that the generalisability of the findings of the Delphi consensus approach may be limited by the relatively small number of participants, who may have specific views or agendas. Further studies to verify and refine our results in different or extended groups of participants should be considered.
A wide range of quantitative and qualitative prioritisation criteria for health technologies have been published by committees and organisations involved in health care [5,7]. Generally the criteria lists share three main elements: (1) clinical impact, (2) economic impact and (3) budget impact. A weighted benefit score coupled with cost for prioritising health technologies at the primary care trust level was developed by Wilson et al [12]. The authors applied this score to six proposed services and found that it was practical, however ultimately the primary care trust was not able to use the results of the score as the sole criteria to prioritise which services to fund. Indeed, two of the prioritised services did not receive funding, indicating that the criteria were inadequate. A systematic review of 12 priority-setting frameworks from 11 agencies in 10 countries highlighted differences across HTA agencies regarding categorisation, scoring and weighting of criteria [7]. The review showed that quantitative rating methods and cost benefit considerations for priority setting were seldom used.
Although criteria have been developed for priority setting of new health technologies for early assessment, these are generally applied to novel therapeutic agents and interventions [13]. Selection criteria also differ significantly depending on the early awareness programme, and prioritisation is frequently implicit and undocumented [13,14]. The requirements for diagnostic technologies are somewhat different. For example, while the prevalence or incidence of a disease is a primary criterion listed in many of the existing prioritisation frameworks, the consensus emerging from our study indicates that, in terms of diagnostic technologies, this criterion carries less weight: a test for a relatively uncommon disease (e.g. pancreatic cancer) may still be very important. Diagnostic technologies may also have different outcomes, for example either ruling in or ruling out a disease. Here it emerged that ruling out a disease is of higher priority in diagnosis, although this may not be the case in all clinical settings: in high acuity situations, such as critical care, ruling in a disease may be more important.
Although in some cases there was disagreement amongst the panel regarding the placement of criteria into their respective categories, overall the level of consensus was high. The criteria set out in this study should be relevant to those involved in identification, evaluation and prioritisation of new diagnostic technologies at national, regional or local levels. Our aim is to provide a framework for the selection of new diagnostic technologies for in-depth assessment or implementation, based on how many and the extent to which the listed criteria are satisfied and whether they fall into the high or intermediate priority category. This could be achieved by assessing which criteria are met via a check-list (Table 3). One strategic use of such a checklist, adopted by our Diagnostic Technology Horizon Scanning Centre [15], is to highlight areas where there is lack of evidence and where further research is required. Different specialities may also apply different weights to the criteria, depending on their priorities. These criteria could be adopted by the 'Evaluation Pathway Programme for Medical Technologies' recommended in the NHS Next Stage review and currently being established by UK National Institute for Clinical Excellence, to which some diagnostic technologies will be subject. In addition, they would potentially also be applicable to the Agency for Healthcare Research and Quality's (AHRQ) proposed new Horizon Scanning System in the USA [16]. Future studies should be directed at establishing the value of these prioritisation criteria in such settings. An important challenge will be to identify the supporting evidence base required to assess the high priority criteria in particular.
The prioritisation criteria presented in this study provide an objective structure for the assessment of new and emerging diagnostic technologies. In effect the value of these criteria is that no one single component should be used as the decisive driver for prioritisation of new diagnostic technologies for adoption in healthcare settings, irrespective of the context. We encourage diagnostic technology programmes to evaluate further the value of these criteria.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
All authors conceived of the study, participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript.
Appendix 1: List of expert participants
Anne Mackie, National Screening Committee, UK
Anthony Harnden, Department of Primary Health Care, University of Oxford, UK
Anthony James, NHS Institute for Innovation and Improvement, UK
Birgitte Bonnevie, Danish Centre for Evaluation and Health Technology Assessment, Denmark
Brian Shine, Department of Clinical Biochemistry, University of Oxford, UK
Carl Heneghan, General Practice and Department of Primary Health Care, University of Oxford, UK
Christopher P Price, Department of Primary Health Care, University of Oxford, UK
Danielle Freedman, Royal College of Pathologists, UK
David Horne, Inverness Medical, UK
David Mant, General Practice and Department of Primary Health Care, University of Oxford, UK
Doris-Ann Williams, British In Vitro Diagnostics Association, UK
George Zajicek, Axis-Shield Diagnostics Ltd, UK
Hanns Christian Müller, Roche Diagnostics Ltd, Switzerland
Iñaki Gutiérrez Ibarluzea, Basque Office for Health Technology Assessment, Spain
Jag Grewal, Beckman Coulter United, UK
Janet Hiller, Adelaide Health Technology Assessment, Australia
Jeremy Moss, Roche Diagnostics Ltd, UK
Johan Wallin, Swedish Council on Technology Assessment in Health Care, Sweden
John Clarkson, Atlas Genetics Ltd, UK
Matthew Helbert, Department of Immunology, Directorate of Laboratory Medicine, Manchester, UK
Paul Glasziou, Centre for Evidence Based Medicine, University of Oxford, UK
Philip Wood, Consultant to the Diagnostics Industry
Richard Mayon-White, Department of Primary Health Care and Public Health, University of Oxford, UK
Susannah Fleming, Department of Engineering Science, University of Oxford, UK
Tammy Clifford, Canadian Agency for Drugs and Technologies in Health, Canada
Thierry Buclin, Department of Medicine, University Hospital of Lausanne, Switzerland
The authors would like to thank Richard Stevens for helpful discussions. This study was funded by the National Institute for Health Research, UK programme grant 'Development and implementation of new diagnostic processes and technologies in primary care'.
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First Presbyterian Church: Drawing on the Gifts of God's People First Presybterian Church of Mt. Holly has created an effective system for developing human resources for its extensive community ministry. In its welcome letter to first-time visitors, First Presbyterian underscores its commitment to holistic mission:
Connect with ministry models, mentors and partners
Ministry Patterns and Priorities
The following chart lists possible areas of outreach ministry that a church could emphasize. Identify how high a priority you think each item is for your church, according to what your church actually does. (If the item goes against your understanding of mission, check "Contrary.")
#2: + #10: = Total:
#7: + #13: = Total:
#6: + #12: = Total:
#5: + #15: = Total:
#3: + #16: = Total:
#4: + #11: = Total:
#1: + #8: + #14: + #17: + #18: + #20: = Total:
#4: + #6: + #9: + #18: = Total:
#2: + #5: + #7: + #8: = Total:
#3: + #12: + #15: + #19: = Total:
II. Using the tool for vision discernment This tool can also be used to spark ideas for new directions in ministry. Fill out the chart again, but this time, identify how high a priority you think each item should be for your church, rather than what the church now actually does. This new version can be filled out by everyone in the congregation (perhaps as part of a larger survey), or by the group that is charged with the process of vision discernment (e.g., the Ministry Vision Team). Keep track of everyone's scores. Which three items had the highest scores? These might be avenues of ministry worth exploring. Which three had the lowest scores? These are ministry areas where you are likely to encounter resistance. Prayerfully, as a group, discuss your responses and see what common themes might emerge for desired patterns and style of ministry. This exercise can help anticipate sources of possible conflict in your leadership team's goals for the church, and help the team envision a way of balancing different ministry priorities. (This exercise will be most fruitful if done in conjunction with Tool #7, What Is the Church's Mission?.)
Budget Planning Worksheet - Operating Budget
Use this worksheet to help plan the costs of the proposed ministry program.
Ministry planning:
Partnerships Do's and Don'ts
The following document describes partnerships do's and don'ts for:
Ministry vision team meetings
How do we develop ministry leadership? Cultivate a team of visionary, transformational leaders
GUIDING PRINCIPLES FOR THE MINISTRY JOURNEY Emphasize passionate spirituality. "Step One: Love God with your whole heart, and your neighbor as yourself." Transformational ministry begins as we submit our whole lives to God as instruments of Christ's love (2 Cor. 8:5). Faith without works is dead (James 2:20); activity without devotion is hollow (1 Cor. 13:3). So integrate prayer, theological reflection, and worship at every step. Bottom line: transformation is God's work.
Tenth Memorial Baptist Church: Effective Ministry Partnerships "Whenever you partner with anybody, make sure that their mission and their objective complement yours, so that you don't get absorbed or side-tracked by what somebody else wants to do," advises Rev. Bill Moore. This is particularly essential when churches undertake to collaborate with government.
Activity: Explore & Connect
How do we overcome obstacles to mission? Confront interia, fears, and conflict
Life in Christ Cathedral of Faith and Media Presbyterian Church: Forging an Urban-Suburban Partnership For thirteen years, inner-city pastor Dickie Robbins prayed for a cross-cultural partnership. He participated in several joint church projects, but each one fell through. In one case, he befriended a white pastor who offered to help Life in Christ start a food ministry. The partnership ended, however, when the member of the Anglo church who coordinated the program died, and the person's church stopped supporting the ministry. The partnership had never become central to that church's vision.
Pursue spiritual power for mission
Learn about the local mission of the church
Many churches that undertake a community assessment do the study, write the report, file the report, and forget about the report. But a community study is not information for information's sake; it is gathered for the purpose of equipping the church to share the good news of the gospel in word and deed. Keep this goal in mind. If you allow your study committee to get bogged down in statistics or overwhelmed with details, you will end up with "paralysis of analysis."
Why Partner?
Partnerships are risky. Partnerships take energy and time. It may not be easy to look past the challenges of organizing your own congregation for ministry to see the potential in collaborating with others. Nor is it always easy to adjust to a partnering agency's different methods and priorities. Is the effort worth it?
Few churches can carry out effective holistic ministry without entering into some form of partnership. The attached documents describes that this is true for seven practical reasons and three theological reasons.