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On Tuesday, Yemeni President Abed Rabbo Mansour Hadi was in Shabwa for a series of meetings with tribal leaders.
In video of the meeting aired on state TV, Hadi he urged the tribes to unite with the government in the fight against al-Qaida. He also warned them against providing shelter to militants, saying the government "will not tolerate anyone who helps al-Qaida."
The same day, authorities discovered three decapitated bodies that had been dumped in an open-air market in the eastern province of Marib. Local media reported that CDs found next to the bodies showed the men confessing to being government informants against al-Qaida and placing tracking devices on cars that became targets for U.S. drone strikes. One of the men said he worked for a tire repair shop and used to plant chips in militants' vehicles while replacing their tires.
The killings could deal a blow to the government's efforts to build trust with local tribesmen in the fight against al-Qaida.
Washington, which considers Yemen's al-Qaida branch to be the terror network's most dangerous offshoot, has launched dozens of drone attacks targeting the group's leaders.


text:
A place travelers can visit Lambrino Restaurant
Reviews: Lambrino Restaurant
Category: Food & drinks
Subcategory Restaurant
Subcategory Restaurant
Food & Drinks
Overall Rating
General description: Lambrino RestaurantUnfortunately, "Lambrino Restaurant" does not yet have a general description. Your valuable travel experience is needed. Help other guests by providing objective and detailed information.
Hotels nearby
88% recommendation
Hotel :
offers from $31.39
per night
per night
10.0 km away
100% recommendation
Hotel :
offers from $122.32
per night
per night
14.9 km away

subset: commoncrawl


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Box Office Report: 'Warm Bodies' Tops Friday With $8.1 Mil; Stallone's 'Bullet to the Head' DOA
Summit Entertainment's Warm Bodies topped the Friday box office with a handy $8.1 million, putting the romantic zombie pic on course for a $19 million to $20 million debut, one of the top grosses for Super Bowl weekend.
The news wasn't good for Sylvester Stallone's new action pic Bullet to the Head. The R-rated film appears to be D.O.A., taking in $1.7 million Friday for a $5 million to $6 million weekend. The pic, earning a B- CinemaScore, came in No. 5.
A supernatural twist on Romeo and Juliet, Warm Bodies stars Nicholas Hoult as a zombie who rescues a girl (Teresa Palmer) from imminent death at the hands of his fellow undead. An unlikely romance develops, setting off an unforeseen chain of events. Warm Bodies received a B+ CinemaScore.
Jonathan Levine directed Warm Bodies, based on the popular young-adult book by Isaac Marion. (Summit, of course, is the studio that adapted Stephenie Meyer's blockbuster YA Twilight series.)
Paramount and MGM's Hansel and Gretel: Witch Hunters came in No. 2 on its second Friday, grossing $2.9 million for a cume of $28.2 million.
PHOTOS: In the Line of Fire: Sylvester Stallone's On-Screen Arsenal of Guns Through the Years
David O. Russell's Silver Linings Playbook continued to wow the industry with its hold, grossing $2.4 million for a domestic total of $74.7 million. From The Weinstein Co., the Oscar best picture contender is expected to hit $80 million by Sunday.
Universal's micro-budgeted horror hit Mama placed No. 4 on Friday, grossing $2.3 million for a total $53.8 million.
Bullet to the Head marks the third R-rated action pic in a row to fall flat at the North American box office after Arnold Schwarzenegger's The Last Stand and Jason Statham's Parker.
Produced and financed by Joel Silver's Dark Castle Entertainment and IM Global/Reliance, Bullet to the Head is based on the French graphic novel Du plomb dans la tete and stars Stallone as a hitman who teams up with a young Washington, D.C. detective (Sung Kang) to track down a team of ruthless criminals behind two murders that brought them together in the first place. Warner Bros. is releasing the movie domestically per its deal with Dark Castle.
PHOTOS: Cinema With Brains: Hollywood's 12 Best Zombie Flicks
At the specialty box office, crime comedy Stand Up Guys, starring Al Pacino, Christopher Walken and Alan Arkin, opened to a soft $528,000 on Friday from 659 theaters for a dismal location average of $801. Lionsgate and Roadside Attractions are partners on the film.
Stand Up Guys was directed by Fisher Stevens. In the film, Pacino's character is reunited with his old partner in crime after serving 28 years in prison, only to find that his partner has his own ax to grind.
Email: firstname.lastname@example.com; Twitter @PamelaDayM
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Justin Bieber Roast: Ludacris Speaks Out About "Over the Line" Paul Walker Jokes


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i love that the rooms are clean, beds are big! in front of a bank and very near real coffee. staff is friendly and its just a few steps away from the beach front! if you want a bang for your buck, milflores is the best bet!
- Official Description (provided by the hotel):
- A charming inn found in Station 1 of the Boracay Islands, Milflores de Boracay is a 2-min walk to White Beach. The inn, work of designer Jonathan Matti, boasts of ten 30-sqm, high-ceiling rooms with two queen beds, spacious enough to fit four people comfortably and with ample space to move around. The bathrooms are classy and elegant, featuring black granite counters, rainshowers and custom-made tiles. The inn displays a subtle sophistication comparable to none. ... more less
- Reservation Options:
- TripAdvisor is proud to partner with Odigeo so you can book your Milflores de Boracay reservations with confidence. We help millions of travelers each month to find the perfect hotel for both vacation and business trips, always with the best discounts and special offers.
- Also Known As:
- Milflores De Boracay Hotel Boracay


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The assistant bank manager helps ensure that their institution runs smoothly on a day-to-day basis. This position requires the ability to communicate effectively, especially in strengthening or establishing relationships with current and prospective customers; because a large variety of customers use banks, the assistant bank manager must be knowledgeable about their institution's offerings.Read More...
The assistant bank manager must be able to manage the bank's employees as well. This typically involves involve training, directing, and evaluating performance, in addition to planning and directing day-to-day staff activities. Other responsibilities include planning and facilitating staff meetings, assigning performance goals to employees, and occasionally providing final decisions on difficult client issues. Although sometimes the assistant bank manager reports to the bank manager during their shift, the assistant manager may be the highest-ranking employee available to staff (especially when the bank manager is unavailable or out of the office). The assistant bank manager works indoors during regular business hours.
The assistant bank manager position usually requires at least a high school diploma or equivalent, although some employers prefer postsecondary education as well. Relevant experience in banking, retail, or managerial experience is often preferred. An assistant bank manager must also be proficient at math and have basic computer skills.
Assistant Bank Managers usually report a few specific skills. Most notably, skills in Sales Management, People Management, Operations Management, and Sales are correlated to pay that is above average. It is often found that people who know Customer Service are also skilled in Sales.
Median of all compensation (including tips, bonus, and overtime) by years of experience.
Assistant Bank Managers with a lot of experience do not necessarily enjoy more money. Salaries of relatively inexperienced workers fall in the neighborhood of $40K, but folks who have racked up five to 10 years see a notably higher median of $43K. Assistant Bank Managers bring in $45K after working for 10 to 20 years. Veterans who have surpassed the 20-year mark may make no more than those who are navigating the mid-career stage.
|Highly satisfied
Rated 4 out of 5
based on 45 votes.
74 %
26 %
|Medical: 86%
|Dental: 81%
|Vision: 69%
|None: 11%


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stoney225August 30, 2009
bob61, my name is Jeremy. I am from and currently live just outside of Baton Rouge. A friend of mine saw your reply to my question about T. mooreana and told me who you are. I would really like to talk with you if I could. If you do not mind, send me an email. My email address is email@example.com.


text: Tabcorp Holdings Limited Company Profile (ASX:TAH) Tweet Analyst RatingsEarningsDividendsInsider TradesCompany Profile Consensus Ratings for Tabcorp Holdings Limited (ASX:TAH) (?) The ratings breakdown includes the most recent rating from each analyst that has rated the stock within the last twelve months. The ratings score is a calculation of the average number of sell, hold, buy and strong buy ratings (0-1.5 = Sell, 1.5-2.5 = Hold, 2.5-3.5 = Buy, >3.5 = Strong Buy). The consensus price target is a mean average of the most recent price target set by each analyst that has set a price target for the stock in the last twelve months.Ratings Breakdown: 1 Hold Rating(s), 1 Buy Rating(s)Consensus Rating:Buy (Score: 2.50)Consensus Price Target: A$4.22 Analysts' Ratings History for Tabcorp Holdings Limited (ASX:TAH) Show: All Ratings For This Stock Only the Most Recent Rating From Each Brokerage DateFirmActionRatingPrice TargetDetailsShare12/16/2014Deutsche BankDowngradeHold$3.90View 12/8/2014Deutsche BankDowngradeHold$3.90View 11/5/2014Bank of AmericaReiterated RatingBuy$4.54View 10/28/2014Bank of AmericaReiterated RatingBuy$4.54View 10/20/2014Bank of AmericaReiterated RatingBuy$4.54View 8/26/2014Deutsche BankReiterated RatingHold$3.70View 8/18/2014Deutsche BankReiterated RatingHold$3.70View 8/10/2014Deutsche BankReiterated RatingHold$3.70View 7/15/2014Deutsche BankReiterated RatingHold$3.45View 7/7/2014Deutsche BankReiterated RatingHold$3.45View 6/29/2014Deutsche BankReiterated RatingHold$3.45View 2/26/2014CIMBReiterated RatingReduce$2.70View 2/18/2014CIMBReiterated RatingReduce$2.70View 2/10/2014CIMBReiterated RatingReduce$2.70View 11/1/2013Citigroup Inc.Reiterated RatingBuyView 10/24/2013Citigroup Inc.Reiterated RatingBuyView 10/16/2013Citigroup Inc.Reiterated RatingBuyView 8/27/2013CIMBReiterated RatingUnderperform$2.70View 8/19/2013CIMBReiterated RatingUnderperform$2.70View 8/11/2013CIMBReiterated RatingUnderperform$2.70View 7/9/2013JPMorgan Chase & Co.Reiterated RatingOverweightView 7/1/2013JPMorgan Chase & Co.Reiterated RatingOverweightView 6/23/2013JPMorgan Chase & Co.Reiterated RatingOverweightView 4/2/2013NomuraReiterated RatingNeutralA$3.02View 3/28/2013JPMorgan Chase & Co.Reiterated RatingOverweightA$3.48View (Data available from 3/27/2013 forward) Earnings History for Tabcorp Holdings Limited (ASX:TAH)No earnings announcements for this company have been tracked by Analyst Ratings Network Dividend History for Tabcorp Holdings Limited (ASX:TAH)No dividend announcements for this company have been tracked by Analyst Ratings Network Insider Trading History for Tabcorp Holdings Limited (ASX:TAH)No insider trades for this company have been tracked by Analyst Ratings Network About Tabcorp Holdings Limited Tabcorp Holdings Limited (Tabcorp) is a diversified entertainment company. The Company operates in four business segments: Wagering, which is engaged in the totalisator and fixed odds betting activities; Media & International, which is engaged in the national and international broadcasting of racing and sporting events; Gaming, which is engaged in electronic gaming machine operations in licensed hotels and clubs, and Keno, which includes Keno operations in licensed clubs and hotels within Victoria, New South Wales and Queensland. The Company's customer brands in Australia includes tab.com.au, Luxbet, Sky Racing, Sky Sports Radio, Tabcorp Gaming Solutions (TGS), and Keno, serving millions of customers every year. The Company incorporates ACTTAB into its portfolio and bringing its skills and capabilities to the ACT market. Headlines: (11/4) Snapshot for Tabcorp Holdings Ltd (TAH) (3/22) Tabcorp Subordinated Notes Interest Rate Notice (12/17) Tabcorp Holdings Limited Downgraded to Hold at Deutsche Bank (TAH) (12/15) Tabcorp Holdings Limited Downgraded by Deutsche Bank to "Hold" (TAH) (12/9) Deutsche Bank Lowers Tabcorp Holdings Limited to Hold (TAH) (3/5) Here's why Tabcorp Holdings Limited has crashed today (2/9) Why Tabcorp Holdings Ltd Shares Soared Today (3/4) Tabcorp Holdings Ltd completes retail component of capital raising (12/16) TABCORP HOLDINGS LIMITED Industry, Sector and Symbol: Sector: N/A Industry: N/A Sub-Industry: N/A Exchange: ASX Symbol: TAH CUSIP: Key Metrics: Previous Close: $3.7050 Day Moving Average: $4.85200 Day Moving Average: $4.21P/E Ratio: 20.60P/E Growth: 3.53Market Cap: $3.66BCurrent Quarter EPS Consensus Estimate: $0.22 EPS Additional Links: View TAH on Google FinanceView TAH on Yahoo FinanceView TAH's Company Profile on ReutersSearch for Tabcorp Holdings Limited on Google


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Category: Apartment Life
Packing for Snacking — Great Road Trip Eats and Treats!
Keep car passengers satisfied and costs down with these simple, savvy and fun road trip snack ideas!View Post
Evolution of a Single Guy's Apartment
As a man's relationship status changes so does his apartment. Let's explore his evolution via his furniture, décor, foods, and cleaning methods.View Post
Spring Your Apartment into Style #HomeChat
Join @AptsForRent on Twitter, 3/19/15 at 8pm ET, for the Spring Your Apartment into Style #HomeChat! RSVP here for your chance to win 1 of 5 $50 gift cards!View Post
15 of the Weirdest Superstitions in Sports
We like to think of mankind as being logical and intelligent. After all, you don't see hamsters building rockets to the moon or solving Rubik's Cubes, now do you? But despite all of the advancements we've made as a species, in many ways we're still just a bunch of cavemen throwing rocks at our own […]View Post


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|SUMMARY: On average, your site visitors want to find the information they need in under eight seconds. So, clean, simple design works best to help them find what they want quickly. But, how can you design for many different types of visitors, from consumers to distributors, from dozens of countries all coming to the same home page? Dolby executives revealed behind-the-scenes details on their recent redesign with MarketingSherpa. Discover how the new site appeals to everyone, including territory marketing heads around the globe.
Get the latest research on email, lead gen, and social media along with MarketingSherpa updates and promotions.
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text:
Big Book of Trains
Describes the locomotives, cars, tunnels, stations, and functions of such trains as freight trains, channel tunnel trains, bullet trains, mountain trains, and snow trains.
Publisher: New York : DK Pub., 1998
Edition: 1st American ed
Characteristics: 32 p. :,col. ill. ;,36 cm
Additional Contributors:
Alternate Title: DK Big book of trains
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Medicare information meetings set locally
By Debra Shea
Douglas County Medicare Specialist
Happy fall!
This is Debra Shea, pinch hitting for Mary Krueger this week. You probably guessed the topic: Medicare open enrollment.
Yes, it is that time of the year again. Are your mail boxes filling up? From October 15 until December 7, you have the opportunity to look over your health plan as well as your Part D drug plan.
Are you a newspaper subscriber but you don't have a Digital Access account yet? https://secure.forumcomm.com/?publisher_ID=40&event=subscriber/lookup.
You will need your subscription account number and phone number. Not sure if you have an account? Email us at email@example.com and we can help you.


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Obama's Poll Numbers Take a BeatingQuicklink submitted by M. Wizard Permalink
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|As President Obama navigates his way through a series of issues as controversial as they are vital, he's getting a yellow flag from the American people. For the first time since Obama took office, fewer than half of Americans agree with the president on issues important to them, according to a CNN/Opinion Research Corp. poll released Tuesday. A majority, 51 percent, disagree -- a jump of 10 percentage points since April.
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i stayed on night
but if you want to stay for a week, i defenetely recommend it
nice hotel, great room, well located
wifi should be reviewed
delicious breakfast
very good price and the attention was very kind
- Official Description (provided by the hotel):
- The Fortune House Hotel is located on Brickell Ave in downtown Miami at the center of the financial district and offers fully furnished apartments to our guests available on a daily, weekly and monthly basis. Designed as an executive retreat as well as a family-friendly property, Fortune House Hotel provides its residents all the comforts of a home-away-from-home. Each apartment has a full-size kitchen, living area, bathroom, bedroom, walk-in closet, balcony, and washer and dryer in the unit, thus making it extremely comfortable for short or long term guests. ... more less
- Reservation Options:
- TripAdvisor is proud to partner with Expedia, Booking.com, Travelocity, Orbitz, Hotels.com, Hotwire, getaroom.com, Cheap Tickets, Despegar.com, TripOnline SA, Odigeo and Tingo so you can book your Fortune House Hotel reservations with confidence. We help millions of travelers each month to find the perfect hotel for both vacation and business trips, always with the best discounts and special offers.
- Also Known As:
- Fortune Hotel Miami
- Fortune House Miami


text:
Quality management in health care (Qual Manag Health Care)
Journal description
This peer-reviewed quarterly journal provides a forum to explore the theoretical, technical, and strategic elements of total quality management in health care. Each issue of Quality Management in Health Care (QMHC) features a timely symposium that addresses a key issue in health care quality management. Also included in each issue is an in-depth interview with a key individual in health care quality management, an educational tutorial on basic quality management tools and processes, an information clearinghouse to encourage informal communication among those involved in the field of health care quality management, and a reference center that reviews books, journal articles, seminars, and videos of interest.
Current impact factor: 0.00
Impact Factor Rankings
Additional details
|5-year impact
|Cited half-life
|Immediacy index
|Article influence
|Quality Management in Health Care website
|Other titles
|Quality management in health care, QMHC
|Material type
|Document type
|Journal / Magazine / Newspaper
Publisher details
Lippincott, Williams & Wilkins
- Author can archive a pre-print version
- Author cannot archive a post-print version
- 12 months embargo
- Some journals have separate policies, please check with each journal directly
- Pre-print must be removed upon acceptance for publication
- Post-print may be deposited in personal website or institutional repository
- Publisher's version/PDF cannot be used
- Must include statement that it is not the final published version
- Published source must be acknowledged with full citation
- Set statement to accompany deposit
- Must link to publisher version
- NIH authors will have their accepted manuscripts transmitted to PubMed Central on their behalf after a 12 months embargo (see policy for details)
- Wellcome Trust and HHMI authors will have their accepted manuscripts transmitted to PubMed Central on their behalf after a 6 months embargo (see policy for details)
- Publisher last reviewed on 19/03/2015
Classification yellow
Publications in this journal
[Show abstract] [Hide abstract]
ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.Quality management in health care 06/2009; 18(3):149-50. DOI:10.1097/QMH.0b013e3181aea1ce
Article: A standardized curriculum to introduce novice health professional students to practice-based learning and improvement: a multi-institutional pilot study.[Show abstract] [Hide abstract]
ABSTRACT: Practice-based learning and improvement (PBLI) combines the science of continuous quality improvement with the pragmatics of day-to-day clinical care delivery. PBLI is a core-learning domain in nursing and medical education. We developed a workbook-based, project-focused curriculum to teach PBLI to novice health professional students. Evaluate the efficacy of a standardized curriculum to teach PBLI. Nonrandomized, controlled trial with medical and nursing students from 3 institutions. Faculty used the workbook to facilitate completion of an improvement project with 16 participants. Both participants and controls (N = 15) completed instruments to measure PBLI knowledge and self-efficacy. Participants also completed a satisfaction survey and presented project posters at a national conference. There was no significant difference in PBLI knowledge between groups. Self-efficacy of participants was higher than that of controls in identifying best practice, identifying measures, identifying successful local improvement work, implementing a structured change plan, and using Plan-Do-Study-Act methodology. Participant satisfaction with the curriculum was high. Although PBLI knowledge was similar between groups, participants had higher self-efficacy and confidently disseminated their findings via formal poster presentation. This pilot study suggests that using a workbook-based, project-focused approach may be effective in teaching PBLI to novice health professional students.Quality management in health care 01/2009; 18(3):174-81. DOI:10.1097/QMH.0b013e3181aea218
Article: Peers, regulators, and professions: the influence of organizations in intensive insulin therapy adoption.[Show abstract] [Hide abstract]
ABSTRACT: Following the landmark Leuven study in 2001, health care organizations implemented intensive insulin therapy (IIT) as the standard of care for critically ill patients. However, a recent meta-analysis showed no mortality benefit and an increased safety risk for patients treated with IIT. IIT affects labor and capital decisions related to nurses, physicians, pharmacists, managers, laboratory personnel, and informatics staff. The expenditure of labor and capital to provide IIT without corresponding outcome improvements suggests the adoption of IIT produces inefficiency in hospital. In sociology and organizational studies, the tendency for organizations to become more similar without necessarily becoming more efficient is called normalfont institutional isomorphism. Institutional isomorphism examines the pressure that organizations encounter from peers, regulators, and professions through mimetic, coercive, and normative mechanisms, respectively. To enhance their prospects of survival, organizations establish and maintain legitimacy by adopting socially acceptable approaches to work endorsed by successful peer organizations, regulatory agencies, and professional societies. ORGANIZATIONAL INFLUENCE IN THE ADOPTION OF IIT: This paper describes how organizational influence-through the Leuven study, the Joint Commission, and professional organizations-played a role in the widespread adoption of IIT. Divergence from institutionalized forms may explain variation in IIT studies following Leuven. Health care researchers practitioners, and managers should consider organizational influence when implementing large-scale clinical activities.Quality management in health care 01/2009; 18(2):115-9. DOI:10.1097/QMH.0b013e3181a02bac
Article: Implementation of a pharmacy automation system (robotics) to ensure medication safety at Norwalk hospital.[Show abstract] [Hide abstract]
ABSTRACT: This article reports an intervention to improve the quality and safety of hospital patient care by introducing the use of pharmacy robotics into the medication distribution process. Medication safety is vitally important. The integration of pharmacy robotics with computerized practitioner order entry and bedside medication bar coding produces a significant reduction in medication errors. The creation of a safe medication-from initial ordering to bedside administration-provides enormous benefits to patients, to health care providers, and to the organization as well.Quality management in health care 01/2009; 18(2):103-14. DOI:10.1097/QMH.0b013e3181a02771
[Show abstract] [Hide abstract]
ABSTRACT: Quality improvement in health care organizations requires structural reorganization and system reform and the development of an appropriate organizational "culture." In 2007, the Division of Quality and Excellence in Civil Service in Israel developed a concept to improve quality management in governmental institutions throughout the country. To put this strategy into practice, Western Galilee Hospital, a governmental hospital, in northern Israel, developed a plan to advance the quality management system where each department and unit is autonomously responsible for its own quality and excellence. Since the hospital has been certificated by ISO 9001 for more than 10 years (the only hospital in Israel to have this certificate), the main challenge now is to improve the quality and excellence system in every department. The aim of this article is to describe the implementation of a comprehensive program designed to raise the ability of managers and workers in Western Galilee Hospital in addressing all of the government's requirements for quality and excellence in service in Israel.Quality management in health care 01/2009; 18(2):141-5. DOI:10.1097/QMH.0b013e3181a02c5e
Article: Linking health professional learners and health care workers on action-based improvement teams.[Show abstract] [Hide abstract]
ABSTRACT: Medical students, nursing students, and other health care professionals in training were integrated with health care workers on interprofessional quality improvement (QI) teams at our academic health center. Teams received training in QI, accompanied by expert QI mentoring, with dual goals of increasing expertise in improvement while improving care. Eighty-six learners and health system workers participated in 12 improvement teams in 2 years. Upon completion of the training, participants expressed that the program enhanced QI and teamwork skills and increased understanding of other health care professions. At the end of the program, fourth-year medical students showed greater ability to apply QI skills, as measured by the QI Knowledge Assessment Tool than did control students who did not participate in the program (P < .0001 in 2006-2007 and P < .0005 in 2007-2008). Many teams were successful in improving care processes. The design of "learning QI by doing," accompanied by just-in-time training and ongoing expert mentoring in QI, was identified by faculty as the most important factor contributing to success. This model successfully improved application of QI skills by learners while improving care within our academic health center. Testing of the model at other academic health centers and in other training environments is warranted.Quality management in health care 01/2009; 18(3):194-201. DOI:10.1097/QMH.0b013e3181aea249
[Show abstract] [Hide abstract]
ABSTRACT: To create an index that would serve as a simple tool to measure the quality of hospital care by race and ethnicity. Following extensive review of existing disparities indices, we created a disparities quality index (DQI) designed to easily measure differences in the quality of care hospitals deliver to different populations. The DQI uses performance data already collected by virtually all hospitals. It highlights areas where there are large numbers of patients in a specific population receiving potentially lower-quality care. Data were collected from 2 acute care hospitals that participated in a multihospital collaborative. We applied the DQI to 2 hospitals' quality data, specifically to their performance on the Hospital Quality Alliance measure for patients with heart failure who were receiving angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. The DQI was simple to apply and was able to measure differences in the care of different ethnic groups. It also detected changes in disparities over time. The DQI can help hospitals and other providers focus on the domain of equity in their quality-improvement efforts. Further testing is required to determine its applicability for community-wide equity projects.Quality management in health care 01/2009; 18(2):84-90. DOI:10.1097/01.QMH.0000349973.61836.41
Article: Using QSEN to measure quality and safety knowledge, skills, and attitudes of experienced pediatric oncology nurses: an international study.[Show abstract] [Hide abstract]
ABSTRACT: This pilot study describes the development of an instrument to measure nursing quality knowledge, skills, and attitudes for practicing pediatric oncology nurses. Because many nurse leaders of academic centers are responsible for outcomes at both local and global level, ensuring nursing quality is critical, given the variability in practice outcomes. Quality Improvement Knowledge, Skills, and Attitudes (QulSKA), a 73-item electronic questionnaire was developed using QSEN competencies; the six domains include: quality improvement (QI), safety, evidence-based practice, teamwork, patient-centered care, and informatics. Content validity was established by pediatric oncology, QI, and test-construction experts. Nurses from St Jude Children's Research Hospital and US and Latin American affiliate sites were surveyed. Thirty-seven of 216 RNs surveyed participated in the study. The QulSKA inter-item correlation coefficient was 0.839 (P = .001). The mean knowledge score (based on 100) was 69.2 +/- 11.3. Scores were highest for safety (82.9%) and lowest for teamwork (48.6%). The mean skills rating was 3.3 +/- 0.74 (used 2-4 times). Lowest rated skills were in analysis and QI tools. The mean attitude rating was 3.8 +/- 0.25 (highly important). Data suggest that QulSKA may be reliable to measure quality knowledge, skills, and attitudes among pediatric oncology nurses-nurses were knowledgeable in QI, yet they lacked skills in practice application.Quality management in health care 01/2009; 18(3):202-8. DOI:10.1097/QMH.0b013e3181aea256
Article: Impact of retail walk-in care on early return visits by adult primary care patients: evaluation via triangulation.[Show abstract] [Hide abstract]
ABSTRACT: Retail medicine clinics have become widely available. However, few studies have been published reporting on the outcomes of care from these clinics. The purpose of this study was to assess the risk of early return visits for patients using a retail walk-in clinic. Medical records of patients seen in a large group practice in Minnesota in the first 2 months of 2008 were analyzed for this study. Three groups of patients were studied: those using the retail walk-in clinic (n = 300), a comparison group using regular office care in the previous year (n = 373), and a same-day acute care clinic in a medical office (n = 204). The dependent variable was a return office visit within 2 weeks. Multiple logistic regression analysis was used to adjust for case-mix differences between groups. The percentage of office visits within 2 weeks for these groups was 31.7 for retail walk-in patients, 38.9 for office visit patients, and 37.1 for same-day acute care clinic patients, respectively (P = .13). The corresponding percentages of return office visits within 2 weeks for the same reasons were 14.0, 24.4, and 20.6 (P < .01). After adjustment for age, sex, marital status, acuity, and number of office visits in the previous 6 months, no significant differences in risk of early return visits were found among clinic types. Our retail walk-in clinic appeared to increase access without increasing early return visits.Quality management in health care 01/2009; 18(1):19-24. DOI:10.1097/01.QMH.0000344590.61971.97
Article: Electronic influenza monitoring: evaluation of body temperature to classify influenza-like illness in a syndromic surveillance system.[Show abstract] [Hide abstract]
ABSTRACT: The Centers for Disease Control and Prevention (CDC) defines influenza-like illness (ILI) for its sentinel providers as fever (temperature > or =100.5 degrees F or 37.8 degrees C) and a cough and/or a sore throat in the absence of a known cause other than influenza. For electronic disease surveillance systems, classifying ILI with clinical data that identify only individual aspects of the case definition may add excessive levels of unwanted noise to the system; however, the capability to analyze a patient's body temperature along with other available clinical data (International Classification of Diseases, Ninth Revision codes) could improve diagnostic precision and more accurately classify cases of ILI in a syndromic surveillance system. Developing Boolean algorithms to properly classify true cases of influenza plays an important role toward understanding accurate levels of disease in a community and can also be a key tool for allocating urgent prophylaxis such as antiviral medications during severe outbreaks and pandemics. Results for this study show that elevated body temperature was 40% efficient in correctly predicting laboratory-positive confirmations of influenza (sensitivity) but at the same time was 76% efficient in ruling out influenza (specificity) in the group of sampled members who were tested for influenza.Quality management in health care 01/2009; 18(2):91-102. DOI:10.1097/QMH.0b013e3181a0274d
Article: Associations between self-reported quality of care and county characteristics are largely similar in rural and urban settings.[Show abstract] [Hide abstract]
ABSTRACT: The content and spectrum of rural health care services are different from those in urban areas. The extent to which health care consumers' perceptions of the quality of these services vary across settings and the association of these perceptions with features of rural and urban settings are unclear. To determine whether perceptual differences of quality exist and contrast rural/urban associations between contextual characteristics and perceived quality of health care. Multilevel, cross-sectional analysis of a state-representative sample of 33 786 adults, stratified by rural/urban status linked with county-level data describing contextual features (eg, health care, economics, and social capital). The dependent variable was respondents' perceived quality of health care received in the past year. Weighted multilevel random intercept models examined the independent association of contextual characteristics with perceived quality. Overall perceived quality did not differ between rural and urban settings. Similarly, the pattern of associations between perceived quality and contextual characteristics was generally comparable between settings. A notable difference was an association between higher quality with an increasing proportion of hospitals offering more than 25 services in urban areas (beta = .763; P < .05). Despite rural/urban differences in contextual characteristics with potential influence on health care delivery, overall consumer perception of health care quality was similar in both settings. This suggests that health care managers may be adopting setting-specific strategies to enhance consumer satisfaction despite contextual differences.Quality management in health care 01/2009; 18(4):257-67. DOI:10.1097/QMH.0b013e3181bee1ce
Article: From professional silos to interprofessional education: campuswide focus on quality of care.[Show abstract] [Hide abstract]
ABSTRACT: The Institute of Medicine called for the integration of interprofessional education (IPE) into health professions curricula, in order to improve health care quality. In response, we developed, implemented, and evaluated a campus wide IPE program, shifting from traditional educational silos to greater collaboration. Students (155) and faculty (30) from 6 academic programs (nursing, medicine, public health, allied health, dentistry, and pharmacy) engaged with a university hospital partner to deliver this program. The content addressed principles of IPE, teamwork development and 2 common quality care problems: hospital-acquired infections and communication errors. Pre-/post-surveys, the Readiness for Interprofessional Learning Scale, and the Interprofessional Education Perception Scale, were used for descriptive assessment of student learning. Students demonstrated increased understanding of health care quality and interprofessional teamwork principles and reported positive attitudes toward shared learning. While responses to the Readiness for Interprofessional Learning Scale grew more positive after the program, scores on the Interprofessional Education Perception Scale were more homogeneous. Both students and faculty highly evaluated the experience. This program was a first step in preparing individuals for collaborative learning, fostering awareness and enthusiasm for IPE among students and faculty, and demonstrating the feasibility of overcoming common barriers to IPE such as schedule coordination and faculty buy-in.Quality management in health care 01/2009; 18(3):165-73. DOI:10.1097/QMH.0b013e3181aea20d
Article: Uncovering differences among health professions trainees exposed to an interprofessional patient safety curriculum.[Show abstract] [Hide abstract]
ABSTRACT: In response to the Institute of Medicine challenge to improve patient safety and quality of care, an office directing patient safety/quality of care at an academic medical center and faculty from health professions schools collaborated on design, delivery, and evaluation of an interprofessional student curriculum on patient safety, quality, and teamwork. Annually for 6 years, second-year medical students, senior baccalaureate nursing students, second-year masters in health administration students, and junior baccalaureate respiratory therapy students participated. A pre-/postsurvey assessing students' attitudes about quality, safety, and teamwork was developed and modified to reflect course revisions. Survey items were grouped into 1 of the 6 subscales: human fallibility, disclosure, teamwork/communication, error reporting, systems of care, and curricular time spent with other professionals. At pretest, there were significant professional group differences in all the 6 subscales. At completion, differences in 4 subscales were resolved with the exception of human fallibility (P < .001) and curricular time spent together (P < .001). Interprofessional exercises within our curriculum mediated most differences among student groups. As more interprofessional curricular experiences are designed, examining baseline group differences is essential to optimize learning outcomes.Quality management in health care 01/2009; 18(3):182-93. DOI:10.1097/QMH.0b013e3181aea237
Article: Assessing the appropriate use of metformin in an inpatient setting and the effectiveness of two pharmacy-based measures to improve guideline adherence.[Show abstract] [Hide abstract]
ABSTRACT: To demonstrate the level of compliance to metformin-prescribing guidelines and to evaluate the effectiveness of 2 pharmacy-based interventions. Retrospective chart review of all inpatients who had received at least 2 doses of metformin while hospitalized. Two cohorts of patients had chart audits-one group (group A) hospitalized between March and August of 2003 (487 patients) and one group (group B) hospitalized between August of 2005 and January of 2006 (370 patients). In December of 2003, the pharmacy inserted a safety alert in the electronic ordering system and mailed a printed safety alert to all clinical staff outlining the contraindications and precautions concerning metformin use. More than two-thirds (69.3%) of the charts reviewed demonstrated that metformin was used in accordance with the prescribing guidelines. Surgical procedures, intravenous contrast use, and elevated serum creatinine levels accounted for the greatest percentage of guideline violations. The prescribing guidelines were violated 27.4% (47/137 charts) of the times in group A and 34.3% (40/146 charts) of the times in group B. The significance of this study is that metformin is often given in spite of the presence of contraindications to its use. Two pharmacy interventions were ineffective in decreasing the guideline violation frequency in a group of patients who were prescribed the drug.Quality management in health care 01/2009; 18(1):71-6. DOI:10.1097/01.QMH.0000344595.48510.cb
Article: Can branding by health care provider organizations drive the delivery of higher technical and service quality?[Show abstract] [Hide abstract]
ABSTRACT: Despite the widespread use of branding in nearly all other major industries, most health care service delivery organizations have not fully embraced the practices and processes of branding. Facilitating the increased and appropriate use of branding among health care delivery organizations may improve service and technical quality for patients. This article introduces the concepts of branding, as well as making the case that the use of branding may improve the quality and financial performance of organizations. The concepts of branding are reviewed, with examples from the literature used to demonstrate their potential application within health care service delivery. The role of branding for individual organizations is framed by broader implications for health care markets. Branding strategies may have a number of positive effects on health care service delivery, including improved technical and service quality. This may be achieved through more transparent and efficient consumer choice, reduced costs related to improved patient retention, and improved communication and appropriateness of care. Patient satisfaction may be directly increased as a result of branding. More research into branding could result in significant quality improvements for individual organizations, while benefiting patients and the health system as a whole.Quality management in health care 01/2009; 18(2):126-34. DOI:10.1097/QMH.0b013e3181a02c04
[Show abstract] [Hide abstract]
ABSTRACT: In response to growing concerns about patient safety, many hospitals are implementing rapid response teams (RRTs). Although the staff nurse plays a critical role in recognizing the need for the RRT and initiating the call, little is known about actions of staff nurses in relation to the RRT. The purpose of this study was to examine relationships between nurse educational preparation, years of experience, degree of engagement, and the RRT call status (independent vs dependent). Nurse engagement was measured by the Manifestations of Early Recognition Scale. A descriptive correlational design was used. The sample comprised 75 staff nurses at an academic medical center who cared for patients for whom the RRT was called. Educational level and nursing experience were independent predictors of call status, after controlling for effects of other independent variables. Independent callers were almost 5 times more likely to have a BSN degree, and almost 4 times more likely to have more than 3 years of experience, than did RNs who called because someone asked them to call. High levels of engagement were also significantly associated with call status, but after controlling for educational level and nursing experience, the relationship was not significant. This study has implications for clinicians and managers in health care facilities that rely on RRTs.Quality management in health care 01/2009; 18(1):40-7. DOI:10.1097/01.QMH.0000344592.63757.51
Article: A systematic approach to practice assessment and quality improvement intervention tailoring.[Show abstract] [Hide abstract]
ABSTRACT: The ways in which tailored interventions foster sustained improvement in the quality of health care delivery across different practice settings are not well understood. Using the empirically developed Practice Change Model (PCM), we identify and describe assessment and tailoring activities with potential to enhance the fit between proposed interventions and practice settings. We obtained quantitative and qualitative data from 2 quality improvement trials conducted in diverse primary care practices in northeast Ohio. A multidisciplinary team used a PCM-based template to identify features of practice assessment and tailoring associated with practices' willingness and ability to change. Our results suggest that intervention tailoring requires assessment of key stakeholders' motivations, external influences, resources and opportunities for change, and the interactions between these factors. Using this information, intervention tailoring then includes seeking and working with key stakeholders, building assets, providing options, keeping change processes flexible, offering feedback, providing exposure to scientific evidence, facilitating group processes, involving new partners, brainstorming, using stories/play acting/humor, assuming a consultant role, reframing, moving meetings off-site, and stepping back or pausing. A model-driven approach guiding practice assessment enables tailored responses to the unique and emerging conditions that distinguish health care practices and influence implementation of quality management interventions.Quality management in health care 01/2009; 18(4):268-77. DOI:10.1097/QMH.0b013e3181bee268
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.


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Recent comments
A Life-Saving Mission Two Miles High in Rocky Mountain National Park
Thanks for highlighting this event and especially detailing the role of the Rocky Mountain Nature Association and the philanthrophy that helped save this man's life. It is very rare to hear about the work of "quiet conservationists" like friends groups or cooperating associations or donors who help support our public lands. The numerous donors who helped purchase this equipment for just such an emergency should be very proud of this accomplishment.
Is an International U.S.-Mexico Park At Big Bend Moving Closer to Reality?
Antonio -
Good catch! You're right; according to a "Big Bend Fact Sheet" on the park website, the correct elevation for Casa Grande is 7,325 feet.
I was guilty of copying a caption from the DOI press release without verifying the info. I'll correct the caption on this story.
Thanks for the correction.
Heat Claims the Life of Boy Stranded for Five Days in Isolated Area of Death Valley National Park
I think one of the symptoms of dehydration/heat stroke includes delirium, so it's possible that there was a loss of sensible thought. She also could have panicked, especially seeing her child in distress. I don't think eating the dog would really have helped, since they probably needed more water than they had and a cooked dog doesn't yield that much water. I might have not given the dog water over giving my son the water, but that's neither here nor there.
Plus she was hispanic, and if English was her second language, there may have been some difficulties there, since I've noticed that a lot of warnings are English only.
Staying with the vehicle has generally been the better strategy when lost. It's a bigger target to find, and it's always easier to find a still target than a moving target.
I agree that proper planning could have prevented the tragedy. People are too reliant on technology, and assume that nature is tamer than it really is. We see people walk up to alligators all the time, and warn them that those critters certainly could outrun them at that close distance. GPSs are a tool, but are not infalliable. It's like relying on outdated maps. We've had enough troubles with bad routings in urban areas, no way would I trust my GPS in a rural area.
Is an International U.S.-Mexico Park At Big Bend Moving Closer to Reality?
The elevation of Casa Grande in Beg Bend National Park is much more than 5400 ft. The Chisos Basin Campgroung is at least 5200ft.
Upon Further Review: "But My GPS Unit Said Go Thataway..."
Vehicle GPS has gotten people in trouble when they failed to put their BS meter in gear. My GPS unit always gives a particular route from my house which I know isn't the ideal way to get to the freeway. Sometimes it takes forever for it to get a GPS lock - maybe up to 5 minutes.
Apparently the mother whose kid died at the edge of Death Valley was solely relying on a GPS for navigation.
Fatal Fall from Angels Landing in Zion National Park
My wife and our two friends arrived at Scout's Landing about 45 minutes after her fall. We passed the family going back down on Walter's Wiggles but did not learn of the fall until we reached Scout's Landing. Needless to say, we did not continue up to Angel's Landing. Our heartfelt condolences goes out to Nancy and her family. This was truly a tragic accident. It made our group and many other hikers that morning keenly aware of how precious and fleeting life is.
Volunteers Needed to Help Monitor Sea Turtle Nests at Cape Hatteras National Seashore
Renardo, Call the number in the last graf, 252-216-6892.
Volunteers Needed to Help Monitor Sea Turtle Nests at Cape Hatteras National Seashore
how do you become a volunteer.i am very interested,love sea turtles and have some working knownledge and free time.
Is an International U.S.-Mexico Park At Big Bend Moving Closer to Reality?
I for one would love to see wilderness areas, parks, conservation areas...whatever you want to call them established without regard for the international border. R. Stefancik excellent story of the trinkets sold out of a basket on the honor system shows what is possible with the vast majority of us humans regardless of location of birth.
However, another factor sometimes dominates our reality perpetrated by a very small human faction. While visiting Organ Pipe Cactus National Monument along the US/Mexico border we came across the Kris Eggle Visitors Center. We were curious about who Kris Eggle was and how the visitor center came to be named for him and was enlightened by a sign and tribute outside the center. The story is a sad one as well as maddening...Kris was killed in the line of duty, performing as a NPS law enforcement ranger by thugs of a drug cartel.
I only add this to the discussion as a concern to be considered...as a reality that must be faced in that region of the country at this point in time. A sad reality for us all...on both sides of the border.
Web Page Provides Keys To Finding Olympic National Park's Waterfalls
That's a cool offering. Marymere is pretty easy, since there's a well-trodden trail right to it. Some of the others can be a bit dicey. I notice they don't point out Service Falls up at the head of the Queets Valley. Gorgeous, big waterfall, but supposedly only a couple people have ever managed to see it from the ground. Olympic certainly has some remote attractions.
Is an International U.S.-Mexico Park At Big Bend Moving Closer to Reality?
"Building upon our shared history of ecosystem and species conservation, the plan will develop a model of bi-national cooperation for the conservation and enjoyment of shared ecosystems for current and future generations," said Secretary Salazar.
A key word to me in that sentence is "enjoyment". Currently, it is impossible for the people of Mexico and the US to easily enjoy the other country's portion of the region because there is no longer a border crossing within Big Bend NP. The nearest crossing is at Presidio, TX., some distance of about 40 miles from the park, as I recall. The residents of Mexico across the Rio Grande from Big Bend would greatly benefit from tourists stopping over to "enjoy" their part of this incredible wilderness. One of my lasting memories of my most recent visit to Big Bend was a spot on a hiking trail near a canyon (I won't identify the canyon in order to protect the Mexican "criminal") where someone from Mexico was crossing the river and leaving home made trinkets on the side of the trail with a basket for tourists to leave money on an honor system. I was pleased to purchase a few wire scorpions and leave some money behind. I was more pleased to see about $30 that had accumulated without someone from our side pocketing the money for themselves.
Glacier National Park Officials Decide to Remove Grizzly Bear Family From Park
@ R. Stefancik:
With your excellent background you should be able to deduce yourself why it would be harmful to move a Rocky Mountains Grizzly to Alaska, where she could reproduce. Small hint: We are talking about a protected specie in protected areas.
Fatal Fall from Angels Landing in Zion National Park
I was hiking the morning this happened, you are warned about the skill level it takes to do this hike. There were many children on the hike ..It was a simple slip and fall, so you must be careful..all we need is MORE government telling us what we can and cannot do....
National Park Mystery Photo 12 Revealed: It's Voyageurs National Park
As long as we are talking about Voyagers NP and the Boundary Waters Canoe Wilderness, I would at least like to give praise to the Canadian Quetico Canoe Wilderness just over the border from the Boundary Waters. The Canadians issue fewer backcountry permits and the 3 times I visited there, I found a much more serous wilderness experience. I honestly saw more moose than I saw groups of humans, as opposed to the Boundary Waters where I saw an average of 5 groups/day and very little wildlife. In my three 1 week treks in the Quetico, I never saw more than 3 other groups the entire trek. Access to the Quetico can be made through border crossings from the Boundary Waters. I believe the outfitters serving the Boundary Waters in Ely, MN can provide the necessary forms to send in to the Canadians to reserve a permit in advance. I would forwarn you though that to get into the Quetico requires a couple of serious portages of more than 200 rods. But is is well worth the effort because those portages scare away a lot of casual groups.
Glacier National Park Officials Decide to Remove Grizzly Bear Family From Park
Thanks for your reply. As a pathologist who has studied biology, genetics, and zoology while an undergrad, I was most of the time led to believe that genetic diversity was a good thing. Do you know of specific instances where the introduction of genetic "strangers" has harmed a wild population? It would seem that inbreeding would lead to more dire consequences as harmful recessive traits would be more likely to manifest themselves in a given population. I know this has been an issue with the wolf populations at Isle Royale NP, but I also realize that is a much smaller population. Just wondering.
Upon Further Review: "But My GPS Unit Said Go Thataway..."
I've experienced first-hand the shortcomings of GPS at Chaco Canyon. My Garmin Unit pointed me to a site that was one hour and half away from the real place. If it was not for a road sign, I would not have found it. As a result, I arrived too late and missed the light.
Upon Further Review: "But My GPS Unit Said Go Thataway..."
Thanks for the very interesting and well-written piece, Jim. I'm enough of a Luddite that I probably wouldn't use a GPS, even if I could afford one. I'm guessing spare batteries might be worth carrying. I'm also ancient enough to have made topographic maps the old-fashioned way with a surveyor's plane-table. The suggestions to also carry map & compass are very sensible, but one must be on guard with these as well. Metal objects and occasionally local geology can deflect compass needles. The generally excellent USGS topos produced from air photos can have errors ranging from misnamed and mislocated cultural features to incorrect drainage patterns due to floods, glacial advance/retreat, and very deep snowpacks present when the photos were taken. I've also seen pranks & vandalism regarding signs, even a few incorrectly placed by the Park Service.
I think it was Mark Twain who wrote that ignorance is not as dangerous as what you think you know that just
ain't so.
Entrance-Fee-Free Weekends Are Costly To National Park Service, But Seem to Be Boosting Visitation
As the price of something goes up, demand goes down.
As the price goes down, demand goes up.
Is the National Park Service stating something else?
Seems rather suspect.
Upon Further Review: "But My GPS Unit Said Go Thataway..."
I'd like to know which base map they were using: 24K or 100K. I have a Garmin with Topo USA maps but they're 100K so not too useful in canyon country. In fact friendsand I were lost for a couple of hours (missed a side canyon) in the Maze district of Canyonlands and we were using 24K topo maps (pre-GPS). Even that map scale is lacking in canyon country and Zion is definitely a challenging place for navigation.
Upon Further Review: "But My GPS Unit Said Go Thataway..."
Some good comments!
Bob Mishak is right on target with his comment for GPS use "off the road" or even on roads in remote areas.
The moral of the story is, never depend on just a GPS, map or compass. Use all three and make sure you know how to use them.
There's no question GPS can be a great tool. Earlier this summer I was on a couple of all-day boat trips in Alaska. The captain had a laptop computer running GPS superimposed on a detailed nautical chart, which made a great combination, and the screen on the computer was large enough to give quite a bit of detail. However... he also had radar, a depth finder, a compass, and a paper copy of that same chart.
The small, hand-held devices many people carry can also be a useful tool, even in the backcountry, as long as we don't follow the advice blindly, or rely on it as the sole source of information for navigation – especially in remote areas that are unfamiliar terrain.
Several earlier stories and comments in the Traveler are linked in the story above, and point out the reason for caution with GPS in such areas:
A comment by Bogator on the recent Death Valley incident was an excellent one:
One of the ways this can be fixed is for the GPS manufacturers and programmers to stop letting their programs use primitive roads as a viable option. As an example, in order to go from Escalante to Big Water, both my GPS and Microsoft's Streets and Trips wanted to send us down the Missing Canyon Road (Smoky Mountain Rd), BLM road 300.
On the BLM map, this road is marked as a ATV road. I did research the road, as well as look at it on Google Maps, and saw that it was not a road we wanted to go down. And this was just one of serveral examples.
The routing programmers need to classify these kinds of roads as primitive/4wd roads and not use them in routing unless the user has specifically requested primitve roads as an option.
I did contact Garmin, my GPS company, about the problem, but so far, nothing has happened. GPS's are wonderful devices; My wife and I have traveled all over the US with one, but I never follow it blindly, especially in rugged areas.
One other example: the website for Chaco Culture National Historical Park in New Mexico includes the following caution:
Warning: Numerous visitors have reported that GPS devices are not accurate in the Chaco area. Please use our written directions below to avoid getting lost.
So... no intention to dismiss the use of GPS away from the big city, but good judgment by the user is necessary. Sometimes, you need to take the information given with a block--not a grain--of salt.
Entrance-Fee-Free Weekends Are Costly To National Park Service, But Seem to Be Boosting Visitation
"The bottom line, according to the Park Service analysis, is that there was no obvious trend."
A stunning statement. I'm no statistician, but my takeaway from their numbers is that 87% of the units had higher visitation on the fee-free weekends than on either one or both of the weekends before and after. Seems like a pretty clear trend to me.
When Salazar announced the free weekends NPS estimated that they would lose $500,000 per day in entrance fee revenue. Now only two months later that estimate has morphed to $750,000 to $1 million. Something fishy going on there.
The bottom line is that NPS has a vested interest in proving the inherently illogical proposition that entrance fees have no effect on visitation. They've been "marketing" and commodifying the Parks for years, claiming to take a more "business-like" approach, but they deny the most fundamental reality that real businesses have to face every day: the effect of pricing on supply and demand.
For decades the highest entrance fee to any Park was $10 and most were $5 or less. Many more than today had no entrance fee at all. The Parks were managed as a public good, not as a profit-making enterprise. Then came Fee Demo and each Park got to keep all the money it could collect, with predictable results: entrance fees went up, and visitation went down. Econ 101. Some would view that as a good thing, after all the years of saying that overuse was damaging the Parks. Others would view it as a bad thing because of the social effects (those with the lowest incomes are impacted the most) and the likelihood that reduced visitation will be followed by reduced appropriations from Congress.
Regardless of your point of view, the question of whether entrance fees deter visitation has been settled.
National Parks Will Waive Entrance Fees on September 27, National Public Lands Day
They've renamed the Golden Age Passport. It's now called "America the Beautiful – National Parks and Federal Recreational Lands Pass – Senior Pass," and costs $10.
This is a lifetime pass for U.S. citizens or permanent residents age 62 or over. The pass provides access to, and use of, Federal recreation sites that charge an Entrance or Standard Amenity. The pass admits the pass holder and passengers in a non-commercial vehicle at per vehicle fee areas and pass holder + 3 adults, not to exceed 4 adults, at per person fee areas (children under 16 are admitted free). The pass can only be obtained in person at the park. The Senior Pass provides a 50 percent discount on some Expanded Amenity Fees charged for facilities and services such as camping, swimming, boat launch, and specialized interpretive services. In some cases where Expanded Amenity Fees are charged, only the pass holder will be given the 50 percent price reduction. The pass is non-transferable and generally does NOT cover or reduce special recreation permit fees or fees charged by concessionaires.
Entrance-Fee-Free Weekends Are Costly To National Park Service, But Seem to Be Boosting Visitation
Anon: Anecdotal evidence from the free weekend in June showed that some sales were up, some were down in the bookstores, restaurants, etc. Beyond that, those fees go to concessionaires and not to the NPS, so any increases wouldn't offset the loss in entrance fee dollars to the NPS.
As to your second question, the Park Service did not question folks as to why they visited on the fee-free weekends, but it'd be a great answer to know!
Upon Further Review: "But My GPS Unit Said Go Thataway..."
I think the key phrase here is,
"That "level of detail" issue came into play on a May morning several years ago in Utah's Zion National Park."
Note, several years ago. The GPS of today is a far cry from the GPS of even a few years ago.
Kurt and I both found the even todays GPS may not be 100% accurate. We camped on an island in Muscungus Bay, Maine, that the GPS said didn't exist. We also paddled across dry land on Yellowstone Lake, according to our GPS that is.
The moral of the story is, never depend on just a GPS, map or compass. Use all three and make sure you know how to use them. 'Nuff said...
Upon Further Review: "But My GPS Unit Said Go Thataway..."
Great story ----- I have had 2 GPS one from Garmin and one from DeLorme ----- both are much less than accurate in the back country. From my narrow point of view DeLorme has no plauseable excuse because they put out nearly accurate maps in thier gazeteer book maps. I complained and they say "it is two different formats" maybe so but it is the same world. How ever they did give me a full refund . I now have a Garmin nuvi and a garmin map 76csx - both are great units but their maps still stink in the back country -- it is difficult to tell the roads from the elevation lines , in some places they just perpetuate errors from US Geological surveys done in the 1930's and 40's.
Even the city maps that are a lot more accurate are about 2years behind on road changes and resturaunts that have moved or gone out of business. I guess that is somewhat undrstandable.
To sum it up ---- GPS is a great step forward with many steps left to go --- Hope they get with it soon


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Kukla's Korner Hockey
Category: Washington-Capitals
Caps Re-sign Fedorov
by Paul on 07/09/08 at 10:54 AM ET
Comments (0)
from TSN,
The Washington Capitals have re-signed forward Sergei Fedorov to a one-year $4 million contract.
added 3:57pm, from Capitals Insider,
General Manager George McPhee just confirmed moments ago that Sergei Fedorov has agreed to terms on a one-year, $4 million contract. The terms have been agreed to by both sides, but it still awaits Fedorov's signature.
'It's paperwork," McPhee said when asked about why the deal had not been announced. "We just have to do some administrative things."
Filed in: NHL Teams, Washington Capitals, | KK Hockey | Permalink
Tags: sergei+fedorov
The Theodore Theory
by Paul on 07/08/08 at 09:12 PM ET
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from Adrian Dater of the Denver Post at All Things Avs,
Don Meehan, the agent for former Avs goalie Jose Theodore and current left winger Ryan Smyth, is one of the good guys in the business….
Today, I spoke with him on the phone about the situation that went down with Theodore and the Avs….
As Meehan said, "Both sides were in a position to make the choices they made. And that's what happened. I don't think there's anybody "at fault" here. It's just what both parties decided was in their best interest."
True enough. It's nothing personal, just business. I know that, and am not trying to take sides. I just personally still find it weird at how the whole thing ended.
Filed in: NHL Teams, Colorado Avalanche, Washington Capitals, | KK Hockey | Permalink
Tags: jose+theodore
Fedorov May Be Close To Re-signing In Washington
by Paul on 07/08/08 at 01:55 PM ET
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from On Frozen Blog,
Our thanks to Sovetsky Sport's Dmitry Chesnokov for tracking down and translating the following piece of intriguing news:
At a press conference today in Moscow, Alexander Medvedev, the head of the newly formed Continental Hockey League, or KHL (which repaced the Russian Super League after the 2007-08 season), told Pavel Lysenkov of Sovetsky Sport:
"It is sad that we will not see Sergei Fedorov in the KHL. Most likely, today he will sign a new contract with Washington."
added 1:39pm, via Capitals Insider,
Such a report is premature according to Captials officials, though, who said the team is still in negotiations with Fedorov, that an agreement has not yet been reached and an there is no expected announcement.
Filed in: NHL Teams, Washington Capitals, | KK Hockey | Permalink
Tags: sergei+fedorov
Is Theodore The Answer
by Paul on 07/05/08 at 04:04 PM ET
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from Jason Kay of the Hockey News,
GM George McPhee deserves credit for acting swiftly in securing Plan B, but, if I'm a Caps fan, it's going to be a while before I find a comfort level with the team's new No. 1 man.
We all know Theodore, still young at 31, has the physical composition to be one of the league's best stoppers. His Hart and Vezina trophies in 2002 are testaments to his skill.
It's the ensuing years that would have me nervous. His plunge in Colorado, and accompanying off-ice distractions, had some thinking he was playing himself out of the league.
Filed in: NHL Teams, Washington Capitals, | KK Hockey | Permalink
Tags: jose+theodore
Fedorov & Capitals Still Talking
by Paul on 07/03/08 at 07:22 PM ET
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from Tarik El-Bashir of Capitals Insider,
The talks with UFA center Sergei Fedorov are moving in a positive direction. "We've talked Sergei," McPhee said. "He wants to come here and is willing to wait until some of the dust settles. We'll continue to talk to him, but we're pretty confident that we'll get something done here."
more on the Caps including Matt Cooke will not be returning…
Filed in: NHL Teams, Washington Capitals, | KK Hockey | Permalink
Tags: sergei+fedorov
Laich May Sign Offer Sheet
by Paul on 07/03/08 at 01:53 PM ET
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from Capitals Insider,
I was also told that Laich has been fielding offers from other teams who are interested in possibly signing him to an offer sheet. When I asked if Laich was close to signing a sheet, I was told by the source, "You're barking up the right tree."
Filed in: NHL Teams, Washington Capitals, | KK Hockey | Permalink
Tags: brooks+laich
Caps Sign Keith Aucoin
by Paul on 07/03/08 at 12:06 PM ET
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via the Washington Capitals,
The Washington Capitals have signed free agent center Keith Aucoin to a two-year contract, vice president and general manager George McPhee announced today. In keeping with club policy, financial terms of the deals were not disclosed.
Update 2:18am July 4th (alanah): Aucoin's salary for 08/09 is reported as $475,000.
Filed in: NHL Teams, Washington Capitals, | KK Hockey | Permalink
Tags: keith+aucoin
Morning Line
by Paul on 07/02/08 at 09:06 AM ET
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We couldn't come to terms with Cristobal Huet even though we met his ask and NOT for a lack of trying. We became very concerned that this player just didn't want to sign with us so we had to move quickly to sign a new number one goaltender. We believe that Jose Theodore will fit in nicely in DC
-Ted Leonsis at Ted's Take
Filed in: NHL Teams, Washington Capitals, | KK Hockey | Permalink
AO Receives His College Degree
by Alanah McGinley on 07/02/08 at 12:20 AM ET
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From Sportsbox.ru, translation by the Alex Ovetjkin blog,
"I was very nervous, almost like during the game" confessed Ovi to "MK". "Still, these are different emotions. Probably because of the fact that at the games I work out physically, but here it was different, it was brain's work out! Now I've realized that I can succeed not only playing hockey, but in other areas of life… College education will to add to my game, now I'll try to think more during the game, to use the theory in practice…"
Ovechkin's diploma thesis was about "Speed training of the top level hockey players". He defended it with an "A"
more including a photo of Ovechkin receiving his degree
Filed in: NHL Teams, Washington Capitals, | KK Hockey | Permalink
Tags: alex+ovechkin
Capitals Sign Jose Theodore for 2 Years
by Alanah McGinley on 07/01/08 at 04:56 PM ET
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From TSN:
The Washington Capitals have signed goaltender Jose Theodore to a two-year contract.
Update 3:25pm ET: TSN reports that Theodore's deal is for 2 years, $9 million.
Filed in: NHL Teams, Washington Capitals, | KK Hockey | Permalink
Tags: jose+theodore
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Teaching Activity. By Bill Bigelow. 17 pages.
A role play allows students to examine issues of race and class when exploring both the accomplishments and limitations of the Seneca Falls Convention.
Profile. Zinn Education Project. 2014.
Brief bios of a few noted women involved in the labor movement.
Teaching Activity. By Bill Bigelow. 8 pages.
Role play in the form of a trial to determine who is responsible for the death of millions of Taínos on the island of Hispaniola in the late 15th century.
Teaching Activity. By Bill Bigelow. 15 pages.
A lesson examining the motives, goals, and environmental consequences of the coal mining industry.
Article for Teachers and High School Students. By Ruth Shagoury. 6 pages.
A review of children's picture books about the life of Helen Keller reveals the omission of any description of her active role in key social movements of the 20th century.
Teaching Activity. By Wayne Au. 7 pages.
The author describes how he used a study of the Black Panther's Ten Point Program to help students assess issues in their own communities and to develop Ten Point Programs of their own.
Teaching Guide. By Bill Bigelow. 2008.120 pages.
Lessons to introduce students to a more accurate, complex, and engaging understanding of U.S. history than is found in traditional textbooks and curricula. Published by Rethinking Schools.
Teaching Guide. Edited by Enid Lee, Deborah Menkart and Margo Okazawa-Rey. 2006. 436 pages.
Guide for teachers, administrators, and parents shows how teach from a multicultural perspective that goes beyond the superficial "heroes and holidays" approach.


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Air-layering ficus Benjamina
Al or any experienced potted-plant growers:
I am wondering if it is a good idea to air-layer a thicker branch of ficus that probably should be pruned off.
Dunno - that's for you to decide, but it's very doable. It's a good way to start a plant that already has a little thicker trunk than you're likely to get from a cutting. Let me know if you want to try it and I'll give you some tips that'll help.
Thank you for responding.
I ask about this tree earlier this year & got advice from you (which I am following).
I was just thinking that since some of the branches will be pruned, maybe it's worth trying to get another tree or two. Obviously I don't know which ones will eventually go, but most are 2-4.5" diameter.
If air-layering is successfull, roots will take some time to grow, right?
On branches that size, you wouldn't be able to separate the layer until at least this time next year. You should be able to take lots of pencil-size cuttings for starts, though.
Air layering uses various techniques to force formation of adventitious roots from a point above the plants normal root system. Commonly, various methods are employed to stop the downward flow of photosynthate (carbohydrates) and the growth regulator, auxin, by removing all or part of the cambium or using a tourniquet to shut off the downward movement of carbohydrates and auxin.
I'm using zip ties on this plant to layer off the entire top of the tree, because the root system is unusable for bonsai - so I'm growing a new one.
The little holes will be filled with a rooting aid, then the entire plant will be repotted extra deep. New roots will form where the holes are and I'll have a perfect root system
Instead of zip ties, I used wire on this maple. You can still see it embedded in the wood. I sawed the old root system off immediately below the wire, and the plant is ready to be potted up and work started on moving it toward one day being a bonsai. Notice how swollen the trunk is immediately above the wire.
In this picture, I started a layer w/o bare rooting. I applied a tourniquet, drilled the holes, and added extra soil on top of the old soil.
The 'layer' is going on in the green pot with duct tape on top of the clay pot. The tree was much too tall for the trunk thickness, so I shortened the tree by about 6" by growing a new root system and cutting off the bottom of the tree.
If I was doing the layer on a branch, instead of a trunk, I would either wrap damp sphagnum moss (not peat)
around the layer and then wrap that in plastic wrap and then aluminum foil. If the branch was vertical, I might use a pot filled with soil, like the green one, to surround the layer.
There are a LOT of ways to air layer. Some like to girdle the entire branch, removing all the bark and cambium right down to the xylem. Sometimes, flaps of bark are cut from the bottom up and held open with a toothpick or similar so roots will form from cambial tissues.
If you have the time, applying a tourniquet in advance of beginning the layer, and wrapping electrical tape around the area above the tourniquet (sticky side out) to keep out light and predispose the area to the formation of root initials is a really good way to speed things along and add an extra measure of insurance for success.
I am no expert, hope Al will have time to offer some tips.
I only read about it some time ago and actually tried once.
I had a palm (no name) abt. 35 (!) yrs old that grew very tall with very skinny trunk. I had to support it, and it was also hitting the ceiling so I decided to 'shorten' it.
I nicked the trunk in approx. middle, dusted some rooting hormone powder over the nicked area, wrapped moist spaghnum around it & covered in plastic. I kept it moist. In few months the roots appeared.
I cut off below the new roots & planted new, shorter tree. 7yrs. later it is still alive.
Begginer's luck...
Sorry, I guess I posted at the same time.
You said to take pencil size cuttings - but not to air-layer them? And what is best time to take cuttings - would it be when repotting/pruning?
If air-layering was done on thicker branches, would it be possible to still repot & root prune the tree this summer while waiting for the roots to appear?
How long (approx.) would tourniqet and tape have to be there before air-layering?
Thnx. Rina
You can layer small branches if you wish, but they come easy from cuttings, so .....
Cuttings and air layers are best started when energy levels are at their highest, but there's a qualifier. Energy levels are highest in August, but the plant should be started & well rooted before winter, so the CUTTING has a chance to sock away some energy for the winter, so late Jun or Jul in your area would be best. That doesn't mean you can't/won't have success at other times, just that if you're interested in why certain timing is better .... That's why repotting tropicals is best done in mid-summer when energy levels are highest - fastest recovery & less chance of disease/insect predation when defenses are lowered due to the extended recovery periods during times of low energy reserves.
Yes, you can repot/root prune when there is a layer underway.
How long the tourniquet should be in place before the layer starts depends on when you apply it. Your Ficus is going to expend most of it's energy before Father's day on growing leaves and lengthening branches. After the Summer solstice, the tree starts to shift more toward storing energy, and slows vegetative growth. That's when the tree grows fat (thickens) instead of long. You might put on a tourniquet in Oct/Nov and not have any significant thickening until May or Jun, but then it will thicken FAST. Applying a tourniquet now, you would prolly see significant swelling by late Jul. If you started the layer then, you might be able to separate it by this time next year.
Thank you again.
I find it very interesting what could be done with plants.
I have another question if you don't mind.
Is it possible - and how - to 'clean' the ugly stubs left after previous incorrect pruning - Like this one:
(I remember you mentioning using a waterproof glue in some situations - would this be one of them?)
Thnxs. Rina
I use a tool called a knob cutter, which kind of digs out the branch and makes a concave hole so the wound heals smoothly. I might also use a Dremel tool on small branches, or a die grinder on large branches to remove the deadwood so the branch collar you can see forming in the picture can roll over the wound. I use waterproof glue when I flush-cut the branch (not recommended for plants in the landscape, but perfectly acceptable for containerized woody material). I would have removed the branch flush with this
then 'scooped' out a little hollow with this
You can see how I hollowed the wound on this maple I'm just starting on. The plant was about 5 ft tall before the chop. I'll start developing the lower branches now, and build a top later, normal procedure with plants as apically dominant as the upright maples.
It's amazing how something that starts off so ugly can look so good after 5-10 years of work.


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Economy Single RoomMax Occupancy: 1 guest
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In addition to complimentary wireless Internet access and complimentary high-speed (wired) Internet access, guestrooms feature iPod docking stations along with microwaves and air conditioning.Information missing or incorrect? Tell us!
Hotel Amenities
Hotel Amenities
The hotel offers a restaurant. A bar/lounge is on site where guests can unwind with a drink. A computer station is located on site and high-speed wired and wireless Internet access is complimentary. 6 meeting rooms are available. This family-friendly hotel also offers a fitness center, tour/ticket assistance, and multilingual staff. A total renovation of this property was completed in March 2012.
Derag Livinghotel Düsseldorf has designated areas for smoking.
- Restaurant
- Total number of rooms - 162
- 24-hour front desk
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- Number of floors - 6
- Number of meeting rooms - 6
- Bar/lounge
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- Elevator/lift
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- Designated smoking areas
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- Year Built 1971
- Number of buildings/towers - 1
Available in all rooms: Free WiFi , Free wired high-speed Internet
Available in some public areas: Free WiFi , Free wired high-speed Internet
Room Amenities
- Premium bedding
- Iron/ironing board (on request)
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- Daily housekeeping
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Where to Eat
Buffet breakfasts are available for a surcharge and are served each morning between 6:30 AM and 10 AM.
Die Olive - This restaurant serves breakfast, lunch, and dinner.
Hotel Policies
Check-in time starts at 2 PM
Minimum check-in age is 18
Check-out time is 11 AM
Payment types
Pets allowed, Maximum number of pets per room 1
You need to know
Extra-person charges may apply and vary depending on hotel policy.
Government-issued photo identification and a credit card or cash deposit are required at check-in for incidental charges.
Special requests are subject to availability upon check-in and may incur additional charges. Special requests cannot be guaranteed.
Parking height restrictions apply
- Fee for buffet breakfast: EUR 17 per person (approximately)
- Self parking fee: EUR 15 per night (in/out privileges)
- Pet fee: EUR 12 per pet, per night
- Rollaway bed fee: EUR 25 per night
We should mention
Children 12 years old and younger stay free when occupying the parent or guardian's room, using existing bedding. Only registered guests are allowed in the guestrooms. The property has connecting/adjoining rooms, which are subject to availability and can be requested by contacting the property using the number on the booking confirmation. Guests can arrange to bring pets by contacting the property directly, using the contact information on the booking confirmation (surcharges apply and can be found in the Fees section).
National Rating
Hotelstars Union assigns an official star rating for properties in Germany. This property is rated 4 stars.


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[simage=7021,max,n,center,] The Drawing Marathon at Central College is currently underway.
Keywords: Drawing Marathon, Lubbers Center for Visual Arts, Professor Mathew Kelly
This weekend students at Central College will be participating in a drawing marathon.
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This weekend people will be drawing non stop at Central College, literally.
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Safety experts say we could save lives by raising the age when one can obtain a drivers license from 16 to 17. Is this a good idea?
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