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Multimorbidity is now acknowledged as a research priority in primary care. The identification of risk factors and people most at risk is an important step in guiding prevention and intervention strategies. The aim of this study was to examine the relationship between literacy and multimorbidity while controlling for potential confounders.
Participants were adult patients attending the family medicine clinic of a regional health centre in Saguenay (Quebec), Canada. Literacy was measured with the Newest Vital Sign (NVS). Multimorbidity was measured with the Disease Burden Morbidity Assessment (DBMA) by self-report. Information on potential confounders (age, sex, education and family income) was also collected. The association between literacy (independent variable) and multimorbidity was examined in bivariate and multivariate analyses. Two operational definitions of multimorbidity were used successively as the dependent variable; confounding variables were introduced into the model as potential predictors.
One hundred three patients (36 men) 19–83 years old were recruited; 41.8% had completed 12 years of school or less. Forty-seven percent of patients provided fewer than four correct answers on the NVS (possible low literacy) whereas 53% had four correct responses or more. Literacy and multimorbidity were associated in bivariate analyses (p < 0.01) but not in multivariate analyses, including age and family income.
This study suggests that there is no relationship between literacy and multimorbidity when controlling for age and family income.
Multimorbidity, the coexistence of two or more chronic diseases in the same patient, has received growing interest in the primary care literature over the past few years and is now acknowledged by many as a research priority [1-6]. Patients with multimorbidity seen in family practice represent the rule rather than the exception [7-9]. These patients are more likely to present poor health outcomes such as a decrease in quality of life [10], increased psychological distress [11], more postsurgical complications [12], longer hospitalisations [13,14], and higher rates of mortality [15,16].
In the wake of prevention and intervention strategies to address this issue, the identification of risk factors and of people most at risk is an important aspect. Aging [7,9] and low socioeconomic status [8,9,17,18] are already clearly associated with an increased incidence of multimorbidity. Without directly measuring multimorbidity, many studies have also assessed a relationship between low literacy and poorer health status using global health measures [19-26] which raises the possibility of an independent association between literacy or health literacy and multimorbidity.
The Institute of Medicine defines health literacy as "the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions" [27]. This definition presents health literacy as a set of individual capacities that allow the person to acquire and use new information [28]. Others have argued that health literacy is the ability to function in the health care environment and depends on characteristics of both the individual and the health care system [28]. In both cases, individual capacity, including reading fluency and prior knowledge, have an influence on health literacy [28]. Reading fluency, or literacy [29], is the ability to mentally process written materials and form new knowledge. The first National Adult Literacy Study [30] divided literacy into three skill sets: 1) the ability to read and understand text; 2) the ability to locate and use information in documents; and 3) the ability to apply arithmetic operations and use numerical information in printed materials.
Notwithstanding the interest in looking into a potential association between health literacy and different health outcomes such as multimorbidity, health literacy is easier to conceptualize than to measure. Even if valid measures of literacy exist, a measure that accurately depicts the multiple dimensions of health literacy is still needed [28,31]. Most studies measuring an association with outcomes used a measure of literacy.
A low level of literacy has been linked to several negative health outcomes in patients: poorer knowledge of their health problems [32-35], poorer health status, and higher hospitalization rates [36,37], than those having an adequate level of literacy. Inadequate literacy has also been associated with problems with the use of preventive services [38], delayed diagnoses [39], and all-cause mortality among community dwelling older aged people [40,41].
The aim of this study was to evaluate the relationship between literacy and multimorbidity while controlling for potential confounders.
Study design and setting
A descriptive study was conducted among patients attending a family medicine clinic of a regional health centre in Saguenay (Québec), Canada. The Saguenay region's population is approximately 150,000 living in one major city and several smaller boroughs. The Saguenay region has about 130 general practitioners, nearly 80% of whom have a general practice and work in a private office or a public institution. The present study was carried out in an institutional practice (Centre de santé et de services sociaux de Chicoutimi) where 12 family doctors and four nurses provide their services to 9,000 registered patients.
Participants and sampling
The sampling process took place during 10 four-hour sessions over a two-week period. Patients solicited were asked to complete a short questionnaire to determine eligibility. To be included in the study, participants had to be aged 18 years or older and regular patients of the family medicine clinic.
Patients were excluded if they presented an unstable acute or psychiatric condition, or if they were pregnant or unable to provide informed consent. Non eligible patients were thanked for completing the short questionnaire for eligibility and no further action was taken with them.
Literacy was measured with the Newest Vital Sign (NVS) [42]. The NVS consists of a nutrition label from an ice cream container. The label is given to the patient, who is then asked six questions about it. The first four questions require document and quantitative skills, including the ability to calculate percentages. It takes approximately three minutes to administer. The NVS is reliable (Cronbach alpha > 0.76) and correlated with the Test of Functional Health Literacy in Adults (TOFHLA), another instrument measuring literacy [42]. The NVS is a markedly better predictor of patients with low literacy than education or age alone. Patients with four correct responses or more are considered as having adequate literacy whereas fewer than four correct answers indicate low literacy. The NVS was treated as a dichotomous variable: 1) low literacy (NVS < 4), and 2) adequate literacy (NVS ≥ 4) [42].
Multimorbidity was measured with a simplified version of the Disease Burden Morbidity Assessment (DBMA) by self-report described by Bayliss and colleagues [43]. The original instrument includes 21 diseases. For this study, only 11 diseases with a high prevalence in our setting were kept in order to reduce the time needed to complete the questionnaire: hypertension, hyperlipidemia, asthma, chronic obstructive pulmonary disease, diabetes, osteoarthritis, back pain, other musculoskeletal conditions, overweight, angina/coronary artery disease, and congestive heart failure. To assess their disease burden, patients identified in the list of 11 conditions those that they had, and rated the interference of each condition with daily activities on a five-point scale from 1 ("not at all") to 5 ("a lot"). The total multimorbidity score is the sum of conditions weighed by the level of interference assigned to each. The original DBMA was found to be strongly associated with subjective health status [43].
Two operational definitions of multimorbidity were used: 1) the DBMA score while considering all 11 conditions (DBMA 11); 2) the DBMA score while taking into account only six conditions, which were considered to be associated with lifestyle habits or that have been reported as independently associated with inadequate literacy [44,45]: hypertension, hyperlipidemia, diabetes mellitus, overweight, angina/coronary artery disease, and congestive heart failure (DBMA 6). The latter operational definition of multimorbidity was computed to have a multimorbidity measure that, at least theoretically, could be associated with literacy.
Data collection
The patients were recruited in the waiting room of a family medicine clinic. A research assistant approached each patient to explain the project. All subjects who refused to participate did it at this point, and no data were collected from them. Patients who agreed to participate and met all eligibility criteria were brought to a small separate room where the research assistant obtained their written consent, collected sociodemographic data (sex, age, education and family income), and administered both the NVS and the DBMA. The responses to the NVS were collected by the research assistant while the DBMA questionnaire was completed by the patient in the presence of the research assistant who helped them, if needed (for example, reading the questionnaire to patients who did not have their glasses). Filling out the questionnaires took no more than 10 min. Participants did not receive any payment for participating in the study.
The study was approved by the research ethics board of the Centre de santé et de services sociaux de Chicoutimi.
Data analysis
The associations between multimorbidity (dependent variable) and the other variables (age, sex, education, family income and NVS) were first examined in bivariate analyses. In a multivariate general linear modeling analysis, both operational definitions of multimorbidity were used successively as dependent variable, and the variables with a significant relationship with multimorbidity in the bivariate analysis were used as potential predictors in the model. Correlations between predictor variables were examined to determine the presence of collinearity.
All analyses were performed with PASW Statistics 18 (SPSS Inc.). The α significance level was set at 0.05.
A total of 103 patients (36 men) between 19 and 83 years of age participated in the study; 41.8% had a 12-year or less school education and 30.1% had completed university studies (Table 1). Forty-eight percent of patients had a NVS score within the range of limited literacy (NVS < 4), and 52% had adequate health literacy. The number of subjects with and without multimorbidity was well distributed across the sample (Table 1).
Table 1. Characteristics of the sample
The scores of both operational definitions of multimorbidity showed a wide distribution across the sample. Figure 1 shows the distribution of each definition of multimorbidity score. As expected, the DBMA 11 had the widest variation, with a range of 0–29 and a median of three; the DBMA 6 varied from 0–13 with a median of two. The distribution of both operational definitions of multimorbidity followed a similar trend, the most striking difference being that 16 patients (15.5%) had a DBMA 11 score of zero whereas the number of patients with a DBMA 6 score of zero was 42 (40.8). This was also an expected finding due to the smaller number of chronic conditions considered in the DBMA 6.
Figure 1. Distribution of scores on operational definitions of multimorbidity. DBMA = Disease Burden Morbidity Assessment (see text for description of chronic conditions considered in DBMA 11 and DBMA 6).
In bivariate analyses, age, family income, and literacy were linked to both operational definitions of multimorbidity. There was no association between sex or education and multimorbidity (Table 2).
Table 2. Results of bivariate analyses
In multivariate analyses, only age and family income were associated with both operational definitions of multimorbidity (Table 3). Literacy was no longer related to multimorbidity when age and family income were introduced into the model. No collinearity was found among the predictor variables.
Table 3. Results of multivariate analyses
To our knowledge, this is the first publication addressing the relationship between literacy and multimorbidity. The results of the study suggest that low literacy is associated with the presence of multimorbidity in adults consulting in primary care in bivariate analysis, but this association is no longer present when controlling for age and family income.
Many previous studies have indicated that patients with low literacy were more likely to report poorer health than patients with adequate literacy [19-26], while other studies found no relationship between literacy and health status when controlling for education [46,47]. Many studies were conducted in older aged patients [21,23-25,46,47] making generalization of results to other age groups difficult. One study did not adjust for confounding variables [21]. In another study [20], literacy was not evaluated with a validated tool but by the staff of the institution where the study was carried out. In all studies, health status was evaluated globally using self-rated health status categories. In this research, we used a more detailed instrument to measure patients' disease burden than the studies supporting the existence of a relationship between health literacy and global health measures.
Other research has addressed the relationship between literacy and specific diseases with inconsistent results. One study reported that inadequate literacy (measured with the short form of the Test of Functional Health Literacy in Adults) was an independent predictor of diabetes mellitus and heart failure but not hypertension, arthritis or pulmonary disease, while adjusting for sociodemographic variables (age, sex, race/ethnicity, education and annual income), health risk behaviours (smoking habit and alcohol use), and body mass index [45]. Another study using the same measure of literacy found that heart attack, stroke, hypertension, diabetes, arthritis and depression were all associated with the literacy level [48]. A study accounting for hypertension, diabetes, obesity and depression concluded that only depression remained significantly associated with literacy after adjusting for confounders [46]. Another study reported that individuals with low literacy had significantly higher rates of arthritis and hypertension, but no statistical differences were found in the prevalence of diabetes, pulmonary, or heart disease [25].
A low level of literacy may be linked to certain health issues and not others. As our measure of multimorbidity evaluated chronic diseases as a whole as well as their severity, we may not have detected a link because of the presence of specific health issues not associated with literacy. An association between literacy and multimorbidity may exist when two or more specific diseases individually related to health literacy coexist in one person. The conceptualization and measure of multimorbidity could therefore have an impact on this association. That is why we conducted analysis using two distinctive conceptualizations and measures, in order to verify if results were different. It was not the case.
We found that multimorbidity was associated with age and family income in the multivariate models. The association of multimorbidity with age is well recognized [7-9,49]. The relationship between socioeconomic status and multimorbidity has also been extensively documented [8,9,17,18].
Our results do not allow us to rule on a potential association between health literacy, a more global concept than literacy [28,31], and multimorbidity. A comprehensive measure of health literacy that considers other dimensions of the concept still needs to be developed. We could then verify if there is a link between health literacy and multimorbidity. Although we did not observe a direct association between literacy and multimorbidity, it is still important to continue taking this variable into account in patient care in order to tailor health information to patient needs and in a format they can understand [42].
A limitation of this study is that participants were not randomly selected from the general population. We recruited patients from the waiting room of a single primary care setting. This method may over sample complex patients with several diseases or frequent attendees. However, we were able to recruit a group of patients with a good distribution of multimorbidity and literacy. Another limitation is the lack of statistical power to carry out multivariate analysis by individual disease. Although the study was conducted in one family practice, we expect the same results from similar primary care settings.
In conclusion, this study suggests that there is no relationship between literacy and multimorbidity when controlling for age and family income. Patients with multimorbidity may have specific diseases that are associated with low literacy. Further studies are needed to identify individual diseases and combinations of diseases linked to literacy while controlling for potential confounding variables. A possible association between health literacy and multimorbidity still needs to be explored when a comprehensive measure of health literacy is available.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
CH, MF and M-EP conceived and designed the study. MF supervised the data collection, participated in the data analysis and helped draft the manuscript. M-EP participated in the data collection and analysis and critically reviewed the manuscript. JA and CH analyzed the data and drafted the manuscript. All authors read and gave their final approval of the version of the manuscript submitted for publication. CH takes responsibility for the integrity of the work as a whole.
Martin Fortin is funded by the Canadian Institutes of Health Research and partners (Applied CIHR Chair on Health Services and Policy Research on chronic diseases in primary care/CIHR-IHSPR-CHSRF-CSSSC).
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Pre-publication history
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text:
Mousse Au Chocolat
|Dark cooking chocolate
|8 Ounce, broken into small pieces (About 225 Gram)
|Strong black coffee
|3 Tablespoon
|Unsalted butter
|1 1⁄2 Ounce, cut into small pieces (About 40 Gram)
|4 , separated
|2 Tablespoon
Combine the chocolate and coffee in a heatproof bowl.
Put the bowl over a saucepanhalf-filled with hot water and set the pan over moderately low heat.
Cook the mixture, beating constantly with a wooden spoon, until the chocolate has melted and the mixture is smooth.
Beat in the butter, a few pieces at a time, and continue beating until it is thoroughly blended.
Add the egg yolks and cook, beating constantly, for 5 minutes, or until the mixture has thickened and is smooth.
Do not let the mixture come to the boil.
Remove the pan from the heat and the bowl from the pan.
Stir in the brandy and set the mixture aside for 30 minutes to cool completely.
Meanwhile, beat the egg whites until they form stiff peaks.
Quickly fold the egg whites into the chocolate mixture.
Spoon the mousse into individual serving glasses and chill for 4 hours, or overnight.

subset: commoncrawl


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Malaysia tops survey of 'halal holidays' for Muslims
Published on Feb 18, 2014 1:58 PM
SINGAPORE (AFP) - Malaysia is the world's friendliest destination for Muslim travellers, according to a survey released on Tuesday, but Japan has shown most improvement as it ramps up efforts to cash in on a growing market.
Malaysia was followed by the United Arab Emirates, Turkey, Indonesia and Saudi Arabia in this year's rankings for "halal" friendly holiday destinations released by Singapore-based Muslim travel specialist Crescentrating.
The survey evaluates countries in terms of their attentiveness to the needs of Muslim travellers, including the presence and accessibility of halal restaurants with meat slaughtered to Islamic standards, and the provision of prayer rooms at airports, shopping malls and hotels.
"An increasing number of destinations are now keen on tapping into this segment and adapting their services to take into account the unique faith-based needs of Muslim travellers," said Crescentrating chief executive Fazal Bahardeen.
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Over the last 6 years I've been developing website projects using (x,d)HTML, PHP, MySQL, Javascript, and FLASH sites. My core competency lies more on the development of additional functions and apply modifications on websites. I have the knowledge on forums and blog installations and modifications (like PhpBB and Wordpress). I also have 2 years experience as a Computer Technician in Saudi Arabia. I work fast with quality output. I will do the best I can to satisfy your needs. Contact me if you need your website redesigned or if you want a design in PSD/AI to be converted to wordpress. It will be my pleasure if you will hire me! Previous Projects: (146 projects to date) http://publicproperty.com.au/ www.iyogaprops.com.au http://polite.com.au/ http://designsuite.com.au/ http://apricotzebra.com.au/ http://simplyframeless.com.au/ http://corporatesignindustries.com.au www.corporatesignindustries.com.au/ecommerce http://beyondcreative.com.au/ http://goodoatcompany.com.au
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Flash 2D Animator and Cartoonist
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Over 4 years of experience in art and 2 in animation. I have developed Flash websites in the past, and a wide rage of animations. I am seeking opportunities to create Flash animations for your personal projects and or businesses. Am always open to new content and change.
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Graphic Artist/Photo Editor/Jewelry Editor/Illustrator/ VA
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I seek a position in the field of graphic design where I can utilize my knowledge in Digital Media, Illustration, Animation and Graphic Designing. My combined skills and creativity should help me in contributing to the growth within the organization.
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I'm very proficient (self-taught) in using Adobe Photoshop and Illustrator. I can also do web research and data entry task during my extra periods. I always look for styles in the web to enhance my editing skills to satisfy my clients. I can GUARANTEE great results when hired. I may not be the best in this field but I have a very good work ethic and take my job seriously. * If I applied to your job post, I know to my self that I am confident enough to finish the task perfectly and always on time. *I am not afraid to ask questions if I am confused in the assigned task. *I reply to my clients as soon as possible. *I let my clients know if I'm not available during a certain day because of unavoidable circumstances (vacations, emergencies, etc.) My Expertise: -Background removal using Pen tool or Magic wand (Transparent or White) -Photo Enhancement, Manipulation, Retouch -Photo Restoration (Old Photos, Crumpled Etc.) -Improving Product Photos -Recreate logos/icons/designs using Illustrator -GIFs creation / Small Animation using Photoshop or After Effects -Web Research, Data Entry, Article Writing I have a Skype account for easy communication. Dropbox for uploads and downloads.
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I am a certified video expert with 5 years experience. I have a clear, logical mind with a practical approach to make a creative video/animation. I have a great eye for detail. I am eager to learn, I enjoy overcoming challenges, and I have a genuine interest in video production and animation. I am expert in => Explanation video => Attractive Intro / Outro video => Promotional Video => Motion Graphics Video => Typography style video => Whiteboard Animation Video and => Any kind of video/audio editing work ( Green screen effects, noise reduction, synchronizing, adding visual effects, transitions etc )


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From the Publisher'...most innovative book-length treatment...provides one of the best current examples of the value of the sort of landscape-focused syncretism of processual and postprocessual approaches. ...clearly and effectively written, the illustrations are excellent and the bibliography is particularly valuable for those wanting more on recent Scandinavian archaeology. ...I would urge all interested in state formation, chiefly societies, and the interaction of archaeology and history to read the whole book. This is an important work, required reading for area specialists, and a provocative model for researchers elsewhere.'
American Anthropologist, 104:4 (2002)


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Communities large and small benefit from having a thriving arts climate. But in any given town, while the symphony or art museum may be a leader in terms of patronage, many organizations struggle to get by as athey live in the shadows of better organized groups.
The Lexington Art League started the new year as they have for the past 26 years, with a juried art show celebrating the human form. Arts Weekly's Roger Duvall talked to the Arts League's Amber Scott about what makes this year's nude exhibit unique.


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We visited the park for a track meet. It's a beautiful park. And quite large. It stems into Yonkers.
Getting out of the city in less than an hour with subway 1. This is the place to be. A large park and a small sized house in old style with very authentic pieces of furniture and we had a fantastic volunteer who told us all about it! This is history of American Immigration! The quietness and peace, ideal if...
If you want to hike and take in some history then visit this park . There are a few good old Irish pubs across the street and near by to eat after or visit Wave Hill near by as well .
A quaint little house in Van Cortlandt Park. Not much to see unless you like quaint old houses, but actually worth a visit if the weather is good and you fancy having a picnic in Van Cortlandt Park. Tip: Buy an MTA unlimited ride ticket to get the best value.
The Van Cortlandt House sits in the southwest corner of Van Cortlandt Park in the Bronx. When we visited, we were given a self-guided tour folder and pretty much left on our own (I don't know if that's usual, or if we looked pretty harmless, but I was surprised that there was no one in the house keeping watch). The...
The house itself is nice, just small and not decorated the way I'd imagine the house of the 4th richest man's to be. But, it was nice and the price wasn't bad either. I'd say it was worth the visit either way if you enjoy history.
A very well preserved and historic home brought back to the Revolutionary period. Both the house and grounds are magnificent and the escorts in period dress make it all come alive. There are activities that are shown through out the day to keep the children interested and engaged. It was worth the price of admission.
If youre into Old House and are in The area the Van Cortland House is a nice option
An interesting site. Not a lot goes on here, but they sometimes have demonstrations of colonial life and games. Good for kids and adults. A good example of a period house.
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A large number of Muslim women on Friday protested outside the state women's commission office in Bandra against the comments made by Samajwadi Party (SP) state unit chief Abu Asim Azmi. The women expressed their ire at the remarks of Azmi and his party's national chief Mulayam Singh Yadav.
While Yadav said in an Uttar Pradesh election rally that rapes happen due to little mistakes of boys, and hence, they shouldn't be given capital punishment, Azmi suggested capital punishment for rape victims.
"I think, he has gone mad. How can he put a rape victim on a par with the person who commits the crime. This only shows the mindset they have," said Noorjehan Safia Niaz of Bharatiya Muslim Mahila Andolan (BMMA), which led the protest rally.
"The statement was made to ensure that some people who have a patriarchal mindset vote for them. It is this very mindset that has not allowed women's rights bills to be passed in Parliament. We will shortly be demanding that the party be de-recognised," Niaz added.
The state women's commission, on the other hand, has issued a notice to Azmi. "We strongly condemn what he said. In today's times, women are not required to be told what they should be doing. They know what to do and when to do. The worse part of his statement is that he roped in religion. Women are coming out in large numbers to vote. We have issued a show-cause notice to him and asked him to be present before the commission on April 25," said Susie Shah, chairperson of the commission.
When contacted, Azmi denied having made the "hang the rape victim" comment. He said, "Only a stupid person can say that. I did not say anything of that sort. With respect to the other things, I did not give any bhashan; I just said what Islamic law has to say. In our country it (live-in relationship) is allowed. I will respond to the state commission notice and clear the misconception. Only a mad man can say that a rape victim should also be hanged. Even if I happened to say that, I am sorry for it. But, as per Islam, unmarried people in adultery are punished by caning."


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The Kerala Sasthra Sahitya Parishad has raised apprehensions about the proposed seaplane project and demanded the government to drop the project.
A resolution passed at the district conference of the KSSP noted that the seaplane transport service linking major tourist destinations, the first of its kind in the country for tourism, would lead to the degradation of the Vembanad lake.
According to leaders of the organisation, the water body has already been threatened by various tourism projects.
The biodiversity and ecological balance of the lake must be maintained at all costs, they said.
An Environmental Impact Assessment (EIA) and feasibility study would have to be conducted to determine the possible consequences of the project.
The government and implementing agency had not taken up any such initiatives, they said. A Right to Information Act query on whether such measures had been taken has not yet been answered, they claimed.
The runway for the project would alone require an area of 2,500 feet length and 800 feet width at the Punnamada lake. More area would be required for the other related purposes. Such activities would ultimately congest the lake.
The State government has identified seven locations for launch of the project.
The conference which concluded here on Sunday elected new office-bearers to the district committee. They are R. Sanalkumar (president), N. Gopalakrishnan, K. Thankappan (vice presidents), T.U. Surendran (secretary), T.G. Premnath, K.R. Sugathan (joint secretaries) and K.R. Rajan (treasurer).


text: The other week we brought you some super hot Tracia Helfer and Grace Park pictures from Maxim, and now we've got even more, even hotter pictures of Grace, including some amazing Grace Park side boob action. Oh yeah. Everybody raves about how good a show Battlestar Galactica was for it's ground breaking methods of storytelling in sci-fi. But really, I think it's biggest contribution to sci-fi was two of the hottest Alien Robots ever. Now, if only we could get them to face off against Seven of Nine!


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Panthers recall goaltender Jacob Markstrom
FEB 20, 2013 10:46a ET
The Florida Panthers recalled goaltender Jacob Markstrom from the San Antonio Rampage (AHL), general manager Dale Tallon announced Wednesday.
A second round pick of the Panthers in the 2008 draft, Markstrom, 23, has played in 33 games for the Rampage this season. He is 16-15-2 with a 2.65 GAA and .920 save percentage. He has allowed two or fewer goals in 11 of last 16 starts. His 994 saves are fourth in the league.
"We have to start putting him in the system, see if he can play some games, get some experience for him," Tallon said. "We also have to stem the tide. I'm not happy. It's a critical part of the season and every game is important now. We need to cut our goals against down. I'm not going to sit still and allow this to continue. We need him to come up and play like he's capable of playing and I am confident he can do that."
The Panthers are currently last in the league with 3.73 goals allowed per game. In 12 games, Jose Theodore has a 3.37 GAA, while Scott Clemensen has a 4.32 GAA in five games.
"We're looking for solutions," Tallon said. "We're not looking for excuses. I'm looking for guys who can step up and do the job."
Markstrom went 2-4-1 with the Panthers last season with a 2.66 GAA and .923 save percentage.
FOXSportsFlorida.com correspondent Erin Brown contributed to this report
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On today's Your Call, it's our Friday media roundtable. This week, we'll have a conversation with investigative journalist Craig Unger about his new book "BOSS ROVE: Inside Karl Rove's Secret Kingdom of Power." We'll also discuss the media coverage of the attacks on US embassies in Cario and Benghazi, Libya with Financial Times' Borzou Daragahi. Who is behind these attacks and why? Join us live at 10 or send an email to firstname.lastname@example.com. Where did you see the best reporting this week? It's Your Call, with Rose Aguilar and you
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The following information was provided by New Hampshire Gov. Maggie Hassan's office on Friday evening, Feb. 8:
CONCORD — Gov. Maggie Hassan has declared a state of emergency for New Hampshire in response to the strengthening snow storm, which is now expected to generate snow totals of as much as 30 inches in parts of the state.
"We have been closely monitoring the storm as it has strengthened, and the expected snow totals have now reached levels where a State of Emergency is needed to allow for the mobilization of additional resources and to access any federal assistance that may become available," Hassan said. "I continue to urge all residents to stay safe, limit their travel and be off the roads by 7 p.m. ahead of the heaviest snowfalls."
The state of emergency went into effect at 5 p.m., allowing the governor to mobilize state assets and resources more effectively as the snow totals increase.
Location, ST | website.com


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9 killed in Maharlika highway accident in Quezon
LUCENA CITY, Quezon, Philippines — Nine persons, including three children, were killed when a Bicol-bound passenger bus collided head-on with a loaded tricycle in Calauag, Quezon, on Sunday morning, police said.
Chief Inspector Edcille Canals, Quezon police media relation officer, said an Arandia passenger bus (EVN-970) was travelling along Maharlika Highway in Barangay (village) Biyan from Manila towards Bicol at around 7 a.m. when it swerved to the opposite lane in trying to overtake another bus and then rammed an incoming passenger tricycle (plate number 2278).
The tricycle, which was bound for the Calauag town proper, was dragged by 56 meters from the point of collision. Its eight passengers all died on the spot, said Canals, quoting the town's police report.
The fatalities were identified as Natividad Ostinado Breva, 51; Federico Tapalla Ebiernas, 44; Letecia Lascano Ebiernas, 43; Jackielyn Pera Casabon, 29; Krizel Olivar Pera, 14; Glicel Pera Casabon, 9; Daniela Tenoreo Olanda, 9; and Kathleen Pera Casabon, 7.
The tricycle driver, Redentor Ingente Olanda, 37, was declared dead on arrival at the St. Peter Hospital in Calauag, he said.
The bodies of the victims were at the Sutarez Funeral Home in Calauag, as of Sunday afternoon, Canals said.
Bus driver Albert Palmiano Oli was detained at the Calauag police jail on charges of multiple homicide and damage to property.
Canals said that members of a radio communication group, Kabalikat Civicom, were the ones who immediately informed the police of the accident.
Chief Inspector Juan Byron Leogo, Calauag police officer-in-charge, rushed to the accident site and supervised the investigation and the flow of traffic, said Canals.
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