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The present invention relates generally to intervertebral disc devices and methods and instrumentation for intervertebral disc procedures. An intervertebral disc repair and diagnostic device that is minimally invasive, actively guided, and provides direct and consistent access to the inner surface of the posterior anulus, which will not unintentionally exit the posterior anulus and cause harm to the spinal cord, is provided.
1. A method of manipulating a bodily tissue, wherein the tissue is enclosed by a definable outer layer of the same or different bodily tissue, the method comprising:
locating an opening in the outer layer, wherein said outer layer comprises bony or spinal tissue;
inserting within said opening to a point past the outer layer a distal end of a hollow cannula,
said cannula having a proximal end and a distal end and having an elongated longitudinal axis,
said cannula slideably housing an advancer coupled to a probe member,
said probe member having a proximal end connected to the advancer and said distal end of said probe member connected to a tip,
said distal end of the probe member capable of being advanced and retracted through a curved slot at the distal end of the cannula via longitudinal movement of the advancer within said cannula; and
advancing the advancer within the cannula and causing the probe member to be advanced outward from the curved passage at an angle between 30 and 150 degrees relative to the long axis of the cannula such that the probe tip travels and manipulates tissue parallel to the intersection of the tissue with the definable outer layer of tissue.
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This application is a divisional of U.S. application Ser. No. 10/020,507, filed Dec. 11, 2001, now U.S. Pat. No. 6,821,276, which is continuation-in-part of U.S. application Ser. No. 09/642,450, filed Aug. 18, 2000, now U.S. Pat. No. 6,482,235 and claims priority under 35 U.S.C. �119(e) to U.S. Provisional Appl. No. 60/298,605, filed Jun. 14, 2001, all herein incorporated by reference.
1. Field of the Invention
The present invention relates generally to devices and instrumentation for intervertebral disc diagnosis and treatment, and methods thereof.
2. Description of the Related Art
An intervertebral disc performs the important role of absorbing mechanical loads while allowing for constrained flexibility of the spine. The disc is composed of a soft, central nucleus pulposus surrounded by a tough, woven anulus fibrosis. Herniation is a result of a weakening in the anulus. Symptomatic herniations occur when weakness in the anulus allows the nucleus to bulge or leak posteriorly toward the spinal cord and major nerve roots. The most common symptoms of herniation include pain radiating along a compressed nerve and lower back pain, both of which can be crippling for the patient. Herniation, and the resulting dehabilitating symptoms, are of significant medical concern in the United States because of the low average age of diagnosis. Indeed, over 80% of patients in the United States diagnosed with herniation are under the age of 59.
Information regarding anular thickness, internal dimensions of the disc space normally occupied by the nucleus, and the location of anular apertures and lesions in relation to the vertebral endplates and lateral walls of the anulus facilitates accurate diagnosis and treatment of intervertebral disc conditions. For example, medical procedures involving the implantation of an artificial nucleus or anular augmentation depend on this information for accurate sizing of such implants. Also important are safe, dependable, and minimally invasive methods and devices for the manipulation of anular and nuclear tissue, especially along the inner wall of the posterior anulus. For example, tissues in the anulus and nucleus are commonly removed or manipulated during the implantation of artificial discs either to clear a path for the insertion of other types of prosthetic devices or as part of a discectomy procedure.
Specialized tools have evolved for the surgical treatment of intervertebral discs in the lumbar, cervical, and thoracic spine, which have suffered from tears in the anulus fibrosis or herniation of the nucleus pulposus. These tools are well-known in the prior art. The devices of the prior art, however, are designed for specific procedures, including complete discectomies (as opposed to partial discectomy or minute removal of tissue) and the installation of vertebral fusion implants. Accordingly, these devices cannot be used to manipulate anular and nuclear tissue in a precise and minimally invasive manner. Moreover, such devices are typically designed to access the disc using an anterior approach, i.e., through the abdomen. Although an anterior surgical approach provides direct access to intervertebral discs, it is highly invasive to the abdominal organs. Thus, surgery is typically more complicated and time consuming. A direct posterior approach is not anatomically practicable because the spinal cord and its surrounding bony protective sheath lies directly in front of each vertebral disc. An posterior-lateral aspect approach is the least invasive of these methods but provides limited and oblique access to the disc and its interior. Depending upon the surgical necessities involved, several methods of percutaneous disc tissue manipulation are available, including chemonucleolysis (e.g., U.S. Pat. No. 4,439,423), laser (e.g., U.S. Pat. No. 5,437,661), manual, focused energy, ultrasonic disruption (e.g., U.S. Pat. No. 5,772,661), arthroscopy and endoscopy.
Endoscopic instrumentation has evolved over the past 25 years and permits viewing, irrigation, suction, and cutting. Probes that permit automated percutaneous suction such as nucleotomes or cylindrically housed rotating cutting means, such as debreders, provide gross but efficient removal of disc tissue. Varying tip profiles control the amount and direction of tissue resection as well as the likelihood of damage to surrounding tissue. These devices tend to be limited by the size of the cannula which houses the instrumentation and its ability to maneuver around vertebral bodies and delicate tissues of the spine.
Hand tools for use in the spine are also well known and can be inserted through cannulae or freely guided by hand. These tips may be blades, burs, rongeurs, curettes or forcep-like "graspers" that are capable of pinching of small amounts of material. To the extent that these instruments can access the various tissues, these devices provide good tactical feedback and control. However, if used in an antero-lateral spinal approach, these tools are generally limited by the indirect approach necessitated by the laminae and spinous processes of the adjacent vertebrae, and thus, access to tissues is substantially hampered.
Some intervertebral disc devices have been designed with flexible tips that are designed not to perforate or deflect off of the interior surface of the disc. Unfortunately, such tips deflect off of healthy disc tissue only, not the pathological tissue that caused the need for the surgery in the first place. Thus, such instrumentation can exit the anulus and cause considerable damage to the surrounding tissues and spinal cord. Also, the flexible probe tips on some instruments which permit access to remote locations within the disc can only do so by sacrificing direct control because the devices are passively guided or blindly "snaked" within the disc. Accordingly, delicate and precise work within a disc is not possible with such instruments.
Among other disadvantages, the devices and methods of the prior art are typically invasive and destructive to surrounding tissue, frequently causing disc infection and nerve root injury. Moreover, such devices are unable to precisely manipulate disc material along the posterior anulus in a minimally invasive manner. Accordingly, there is a need for an intervertebral disc diagnostic and manipulation device which is capable of performing delicate and precise work within a disc, especially along the posterior anulus and between anular lamella.
The current invention relates generally to devices and instrumentation for intervertebral disc diagnosis and treatment, and methods thereof. In several embodiments, the present invention provides for a minimally invasive and actively guided intervertebral disc repair and diagnostic device. This device provides direct and consistent access to the inner surface of the posterior anulus and will not unintentionally exit the posterior anulus and cause harm to the spinal cord. One skilled in the art will understand that this device is not limited to intervertebral disc applications, but includes medical procedures in which a minimally invasive, actively guided device for diagnosis, repair or treatment is desired. These procedures include, but are not limited to, arthroscopic, endoscopic, and endovascular applications. Further, one skilled in the art will appreciate that, in many embodiments, this invention may be used percutaneously or intralumenally.
Various embodiments of the invention may be guided by tactile feedback or through active viewing. Also, various embodiments may be used in conjunction with medical imaging technologies, including MRI, ultrasound, or fluoroscopy. Further, several embodiments of the invention having radiopacity or selective radiopacity may be used in conjunction with imaging methods for guidance and/or to facilitate measurement of organs or tissues.
Various embodiments of the current invention are particularly advantageous because they provide active controlled direction of the working end of the instrument within the anulus or nucleus. Further, several embodiments provide access to the posterior portion of the anulus using a posterior surgical approach. In various embodiments, access to the posterior anulus, via circumferential navigation of the instrument as it is deflected from the lateral, anterior, opposite lateral, and finally to the posterior anulus, is avoided. This is advantageous because circumferential deflection of the working end of the instrument within the anulus can result in the tip of the instrument passing through a fissure in the posterior anular surface and outward to the spinal cord. This can occur because the circumferential navigation from a typical posterior surgical approach eventually directs the tip perpendicular to the posterior anular surface, which may contain lesions large enough to allow protrusion of the tip directly through to the spinal cord.
There is provided in accordance with one aspect of the present invention, a device for treating the spine. The device comprises an elongate guide having a longitudinal axis. An axially moveable actuator is carried by the guide. A probe is movable with the actuator, and a deflection surface is carried by the guide. Axial movement of the actuator causes the probe to advance along the deflection surface and extend away from the guide at an angle to the longitudinal access of the guide.
In one implementation of the invention, the guide comprises an elongate tubular body having at least one lumen extending therethrough. The actuator extends through at least a portion of the guide. The probe may comprise an elongate flexible body, attached to the actuator. The probe may be biased in a nonlinear configuration. In one embodiment, the probe comprises a nickel titanium alloy.
In accordance with another aspect of the present invention, there is provided a method of treating a disc in the spine. The method comprises the steps of advancing a device at least part way through an anulus. A probe is advanced laterally from the device in a first direction along a portion of the anulus.
In one application of the invention, the advancing a probe step comprises advancing the probe in between adjacent (anular lamella) layers of the anulus. In another application of the invention, the advancing a probe step comprises advancing the probe along an interior surface of the anulus, between the anulus and the nucleus. The method may further comprise the step of repositioning the probe and advancing the probe in a second direction along a second portion of the anulus.
In accordance with a further aspect of the present invention, the method additionally comprises the step of introducing media through the delivery device and into the disc. In one application, the media comprises contrast media, to permit fluoroscopic visualization. The media may alternatively or additionally comprise a medication, and/or a nucleus augmentation material. The method may additionally comprise the step of introducing a prosthesis into the disc. The prosthesis may be introduced by proximately retracting a push rod from a lumen in the delivery device, and introducing the prosthesis into the disc through the lumen.
As will be appreciated by those of skill in the art, the present invention, therefore, provides a minimally invasive access pathway into the anulus and/or nucleus of a vertebral disc. The pathway may be utilized to perform any of a wide variety of procedures, including diagnostic and therapeutic procedures, some of which will be identified below.
Several embodiments of this invention provide a new intervertebral disc manipulation and diagnostic device.
One or more embodiments disclosed herein provide a convenient, reliable, and accurate way to measure the anular thickness and the internal dimensions of the disc space normally occupied by the nucleus pulposus.
Several embodiments of this invention provide a device useful in determining various disc dimensions in order to enable a surgeon to size various implants and tools and facilitate their guidance within the disc.
Various embodiments provide for the manipulation through an opening in the anulus. Manipulation includes, but is not limited to, dissection, resection or ablation of disc tissue. The opening may be a single iatrogenic hole, such as an anulotomy, a naturally occurring hole, or a lesion in the anulus.
One or more aspects of the current invention prepare or manipulate disc tissue in preparation for the insertion of an implant or other instruments.
Several embodiments of the present invention diagnose and manipulate disc tissue with minimal invasiveness and risk of unintended passage of the device outside of the posterior anulus in the direction of the spinal cord or other sensitive areas proximal thereto.
Various aspects of this invention permit direct access to the interior aspect of anulus via an anulotomy.
Several embodiments of invention provide an intervertebral disc manipulation and diagnostic device wherein the travel of the working end of the device is parallel to the lamellae of the anulus.
This disclosure utilizes particular orthopedic references, nomenclature, and conventions. Accordingly, several background figures and descriptions are included to aid in the understanding of the environment under which specific embodiments of the invention may be used. In this description and the following claims, the terms "anterior" and "posterior", "superior" and "inferior" are defined by their standard usage in anatomy, i.e., anterior is a direction toward the front (ventral) side of the body or organ, posterior is a direction toward the back (dorsal) side of the body or organ; superior is upward (toward the head) and inferior is lower (toward the feet).
In one aspect of the invention, there is provided a guide such as a hollow delivery cannula having a distal end and a proximal end. The guide is dimensioned to fit within a small anulotomy as might be created by a surgeon or through a naturally occurring hole or lesion in the anulus. An advancer, push rod, or actuator is axially moveably carried by the guide, and coupled to a flexible probe member. The flexible probe member has a proximal end connected to the advancer and distal end connected to or formed into a probe tip.
The probe is advanceable outwardly from the distal end of the cannula via axial movement of the advancer within the cannula. In the illustrated embodiment, the probe member exits through a slot having a curved pathway or deflection surface located at the distal end of the cannula and can be advanced outwardly therefrom generally at an angle of between about 30 to about 150 degrees relative to the cannula's longitudinal axis. Accordingly, when the distal end of the cannula is properly inserted within the anulotomy at sufficient depth, the probe travels along a path that is parallel to and along the surface of or in between the anular lamellae. The probe may be retracted via reversing the action (e.g. proximal retraction) of the advancer.
A means for measuring the distance advanced by the probe is associated with the probe and cannula. Any of a variety of measurement indicia may be used, such as calibrated markings on the advancer visible through or proximal to the cannula. An indicator for measuring the distance advanced by the cannula within the anulotomy or lesion may also be included. For example, a calibrated depth stop may be affixed in a slideably adjustable manner to the delivery cannula.
The probe tip at the distal end of the probe member may be an integral piece of the probe wherein the tip and the probe are of a unitary construction. Alternatively, the tip may be secured, either releasably or permanently to the probe. The tip can be blunt enabling it to forcibly part the tissue without cutting it (blunt dissection) or be sharpened to present a sharp dissecting blade surface (sharp dissection).
The tip may also be constructed in a backwardly curved manner facing back towards the longitudinal axis of the cannula and with its reverse facing edge sharpened to facilitate resection or sharp dissection as it is retracted. This curved shape also serves to present a blunt profile that is less likely to perforate the anulus as it is advanced, even in the presence of uneven or degenerated anular tissue. Alternatively, the curved resection tip or blade may be formed as a multi-sided scoop with a concave trailing surface and convex leading surface such that it presents a blunt frontal profile even when advanced off-angle into the anulus or toward a vertebral endplate.
In another embodiment, the tip may be configured to house an ablation element. This element may be preferentially insulated on particular surfaces of the probe and/or tip to minimize unwanted damage to adjacent tissues. For example, the surface of the probe or tip facing an inner aspect of the anulus may be insulated to prevent unwanted travel through or harm other portions of the anulus, nucleus and vertebral endplates. Ablation energy is instead directed to the targeted tissue adjacent to the probe tip and not the endplates or tissue facing the insulted side of the probe tip.
Intervertebral disc 315 is comprised of the outer AF 310 which normally surrounds and constrains the NP 320 to be wholly within the borders of the intervertebral disc space. Axis M extends between the anterior (A) and posterior (P) of the functional spine unit. The vertebrae also include facet joints 360 and the superior 390 and inferior 390′ pedicle that form the neural foramen 395.
The delivery cannula 30 may be manufactured in accordance with any of a variety of techniques well known in the medical device arts. In one embodiment, the cannula 30 comprises a metal tube such as stainless steel or other medical grade metal. Alternatively, the cannula 30 may comprise a polymeric extrusion such as high density polyethylene, PTFE, PEEK, PEBAX, or others well known in the medical device arts.
In general, the axial length of the delivery cannula 30 will be sufficient to reach the desired treatment site from a percutaneous or small incision access through the skin. Lengths within the range from about 10 centimeters to about 30 centimeters are contemplated, with a length from a proximal end 32 to distal end 34 within the range of from about 14 to about 20 centimeters contemplated for most posterior lateral access pathways. The length may be varied depending upon the intended access pathway and patient size.
Preferably, the outside diameter of the delivery cannula 30 is no greater than necessary to accomplish the intended functions disclosed herein. In general, outside diameters of less than one centimeter are preferred. In typical embodiments of the present invention, the delivery cannula 30 has an outside diameter of no greater than approximately 5 millimeters.
Referring to
Push rod 40 is preferably dimensioned to extend throughout the length of the delivery cannula 30, so that the probe 20 is fully extended from the intradiscal tip 50 when the ring handle 45 is brought into contact with the cannula handle 35 or other stop surface.
The device 10 may optionally be provided with one or more axially extending lumens, for placing the proximal end of the device 10 in fluid communication with the distal end, for any of a variety of purposes. For example, one or more lumens may extend through the push rod 40. Alternatively or in addition, the outside diameter of push rod 40 may be dimensioned smaller than the inside diameter of the delivery cannula 30 to create an annular space as is well understood in the catheter arts. A first lumen may be utilized for introduction of radiopaque dye to facilitate visualization of the progress of the probe 20 and or distal end of the device 10 during the procedure. The first lumen or second lumen may be utilized to introduce any of a variety of media such as saline solution, or carriers including any of a variety of medications such as anti-inflammatory agents e.g., steroids, growth factors e.g., TNfα antagonists, antibiotics, and functional proteins and enzymes e.g., chympopapain. A lumen may also be utilized to aspirate material such as nucleus pulposus, and/or to introduce nucleus augmentation material during or at the end of the procedure.
Referring to
The distal end 34 of the cannula 30 may be provided with any of a variety of constructions, depending upon the mode of deflection of the probe 20. In the illustrated embodiment, the distal end 34 is provided with a cap 52 which contains the deflection surface 62 therein. Cap 52 may be molded from any of the polymeric materials identified elsewhere herein, and secured to the distal end 34 by adhesive bonding, interference fit, or other conventional securing technique. Cap 52 has an atraumatic distal surface 50, which may comprise the distal end of cap 52, or may include a coating or layer of an atraumatic material such as silicone, carried by the cap 52.
Any of a variety of alternative deflection surfaces may be used, depending upon the desired distal tip design. For example, the distal molded cap 52 may be eliminated, and the deflection surface formed instead by an inside surface of the tubular cannula 30. This may be accomplished by providing two opposing axial slots extending proximally from the distal end 34 of the cannula 30 to isolate two opposing axial ribbons on the distal end 34. A first one of the ribbons is severed and removed, while the second one is curved across the central axis of the cannula 30 to provide a curved deflection surface.
Alternatively, the deflection surface may be eliminated in certain circumstances. For example, in the procedure illustrated in
The foregoing axial launch embodiment of the invention may be utilized through the naturally occurring defect. However, the axial launch device is more likely to find application through an iatrogenic access pathway, created through the annulus spaced apart from the natural defect such that the longitudinal axis of the iatrogenic access is substantially parallel (e.g., no more than about+/−20 degrees) from the plane in which the natural defect resides.
As a further alternative, the probe 20 may be laterally deflectable in response to manipulation of a deflection control at the proximal end of the device 10. For example, the probe 20 in one construction comprises a flexible metal or polymeric ribbon, extending from the distal end of the advancer 40 or other axial support. An axially extending steering element is attached to the probe 20. Generally the steering element will be attached near the distal end of the probe 20. Axial proximal or distal movement of the steering element relative to the advancer 40 will cause a lateral deflection of the probe 20.
The radius of curvature of the deflection can be controlled in a variety of ways as will be apparent to those of skill in the art in view of the disclosure herein, such as by varying the lateral flexibility of the probe 20, and the attachment point of the steering element to the probe 20. Due to the differing physical requirements of devices under tension compared to compression, the cross section of the device may be minimized if the steering element is a pull wire or ribbon such that axial proximal retraction of the pull wire relative to the probe 20 causes a lateral deflection of the probe 20. The lateral deflection can be coordinated with the extent of distal advance to cause the probe to follow the desired curved path either by mechanics in the proximal handpiece, or by the clinician. For this purpose, the proximal handpiece can be provided with any of a variety of controls, such as slider switches or rotatable levers or knobs to allow the clinician to control deflection as well as distal (and lateral) advance.
In an alternate construction, the probe launches axially from the distal end 34 of the cannula or other guide 30, but curves under its own bias to travel in a lateral arc and slide along the posterior annulus or other desired surface. This may be accomplished by constructing the probe from a nickel—titanium alloy such as Nitinol and providing it with a lateral pre bent orientation. The probe is restrained into an axial orientation within the cannula 30, but extends laterally under its own bias as it is advanced distally from an opening in the distal end of the cannula 30.
The probe member 20 in the illustrated embodiment may be formed from a superelastic nickel titanium alloy, or any other material with suitable rigidity and strain characteristics to allow sufficient deflection by deflection surface 62 without significant plastic deformation. The probe member 20 can be formed from an elongated sheet, tube, rod, wire or the like. Probe 20 may also be constructed in various cross-sectional geometry's, including, but not limited to hemicircular, semicircular, hollow, and rectangular shapes.
A probe tip 80 at the distal end of the probe member 20 can be used to dissect between the anulus 310 and nucleus 320, to dissect between layers of the anulus 310, or to dissect through the nucleus. The probe tip 80 can be constructed of the same material as the probe member 20 or another suitable material for the purposes of cutting or presenting a blunt rounded surface. A sharpened surface on the distal edge of the probe member 20 forming the probe tip 80 can be used to dissect a path to enable the insertion of an implant in the created space. Similarly, a blunted tip profile may be used to separate or disrupt anular lamella and create an open space between the anulus 310 and nucleus 320 or within the nucleus 320 itself.
The probe tip 80 may also be provided with a backward curve as shown in
The distal end of device 10 is shown in
As demonstrated in
The probe tip 80 may also be coupled to an ablation unit for ablating tissue, as shown in
An embodiment of a bipolar radio-frequency unit is depicted in
Tube 92 is shown attached to probe 20 to provide an escape path for vapor and material ablated or for the infusion of fluids or gasses. These fluids or gasses may be added to alter the conductive characteristics of the tissue or may include various drugs, medications, genes or gene vectors or other materials to produce a desirable therapeutic affect. Tube 92 is shown with a single distal orifice. It may alternatively comprise any number of side holes or channels to increase the spread of fluids or gasses within the tissue or similarly to remove such materials as required by the procedure. Axial lumen are provided as needed to place the side holes or other apertures in communication with the proximal end of the device 10. The ablation unit could be activated as the probe member 20 is advanced through the tissues to create a cavity or activated as the probe member 20 is retracted after it has been advanced to a desired distance. Moreover, the power supplied to the ablation unit 90 could be varied according to the instantaneous velocity of the probe member 20 in order to ablate a more uniform cavity within the disc.
Whether used to dissect, resect or ablate tissue within the disc, device 10 may be used as part of an implantation procedure by creating a cavity or dissected region into which any of a variety of intradiscal implants or medications may be inserted. This region may be between or within anular layers 310, within the nucleus 320, or between the anulus 310 and nucleus 320. It may include a portion or the entirety of the nucleus. Increasing amounts of disc tissue may be removed by advancing and retracting the probe tip repeatedly at different depths within the disc. Intradiscal implants may be inserted independently using separate instrumentation or along, through, or around probe 20. Suitable implants include, among others, those disclosed in U.S. patent application Ser. No. 09/642,450 filed 8/18/200 entitled Devices and Methods of Vertebral Disc Augmentation, the disclosure of which is incorporated in its entirety herein by reference.
By rotating the device 10, while the probe member 20 is fully retracted, 180 degrees and performing the same action in the lateral direction, as shown in
Depth stop 70 may also be used to coordinate the dissection or resection of a space within the disc with the placement of another intradiscal instrument or implant. This method may be particularly useful for placing an implant along an inner surface of the anulus fibrosus. The thickness of the anulus as determined by any of the measurement techniques described above may be used for setting depth stops on other implantation instruments used to place an implant along the anulus. As an example, if the posterior anulus is measured to be 7 mm thick using device 10, a depth stop may be set on an implantation instrument to limit the penetration of this instrument into the disc to 7 mm or another depth that is relative to 7 mm. This would allow for an implant placed by this instrument to be inserted into a space previously dissected within the disc by device 10 along the inner surface of the posterior anulus.
Probe 20 may be used as part of the placement of an intradiscal implant in any of a variety of ways. One advantageous use of the probe 20 can be achieved by detaching it from advancer 40 once probe 20 is in a desired position within the disc space. Implants may then be passed along, behind or in front of probe 20 into this desired position. Probe 20 may then be removed from the disc space.
The measurement techniques described above may also be used to achieve the complete resection of the nucleus from the disc space. For example, a resection or ablation tip as described above may be passed repeatedly into the disc to the lateral borders of the nucleus. This process may be repeated at varying depths within the disc from the inner aspect of the posterior anulus to the inner aspect of the anterior anulus as determined by the depth stop.
While this invention has been particularly shown and described with references to preferred embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the scope of the invention encompassed by the appended claims.
Patent Citations
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1. I am delighted to welcome you all to Abuja, our capital city, for the 7th Summit of the African First Ladies Peace Mission (AFLPM). The convening of this Summit is a great honour and privilege for the Government and people of Nigeria. I am confident that you will have a pleasant stay in our country.
2. Let me specially thank Her Excellency, President Joyce Banda of Malawi for her insightful and inspiring keynote address. Her thought-provoking contributions on the important role of the African First Ladies Peace Mission (AFLPM), and the value of our collective search for peace and security in Africa, sets the right tone for further reflections on the subject.
3. Madam President, we are grateful.
4. Today's summit reaffirms the sense of urgency that we all feel about the challenging political and security situation facing several countries on our dear continent. As we grapple with old challenges, new threats such as drug and human trafficking, climate change, kidnapping, terrorism, poverty, sectarian conflicts and others take center stage. All these undermine our determined efforts to work towards achieving sustainable peace and development in our various countries.
5. It is of great concern that women and children, especially the girl-child, are the main victims of this unfortunate situation. They are not only subjected to dehumanizing conditions, they are often times the targets of abuse, resulting in the violation of international conventions on the rights of women and girls, to which African countries are parties.
6. There is no doubt that the prevailing circumstance requires strong advocacy, cooperation, human development, the sharing of knowledge and the protection of basic rights. Credible voices that draw attention to the dangers of conflict, the plight of women and children under difficult circumstances need to be heard more loudly.
7. We must work together as individuals and countries to promote the cause of peace. We have a duty to promote love and harmony in our continent.
8. I therefore consider the theme of your Summit: "The Africa Woman: A voice for Peace" pertinent to the main contemporary challenge in our land. As wives, mothers and leaders, Africa's First Ladies, have important roles to play in the promotion of peace and security on the continent.
9. Our history is rich with examples of the enviable role that our women played in maintaining peace and stability in our societies. In recent times the contribution of women to the ECOWAS mediation efforts that led to the resolution of the civil war and political crisis in Liberia and Sierra Leone is particularly noteworthy.
10. The AFLPM must continue to serve as a voice for the dis-empowered, the dispossessed, and the violated, especially women and children. More importantly, it must continue to stand firm as a special advocate for peace and the growth of our mother continent.
11. To achieve these goals, AFLPM must encourage governments to implement existing international legal frameworks that promote peace, security and human development. It must also summon the will to speak up wherever and whenever these frameworks are abused. But the task is not for you alone, raising the standards of survival in Africa is a collective task.
12. The African First Ladies Peace Mission has committed itself to the cause of peace and the advancement of women in Africa and we must support you to realize your vision.
13. Nigeria shares the laudable objectives of the AFLPM and will continue to lend support to the attainment of its goals. As a demonstration of that support, we are hosting the interim Secretariat where this meeting is taking place and providing facilities to enhance its work. A parcel of land that will host the permanent site of the AFLPM Secretariat here in Abuja has also been provided.
14. I am happy to note, that the commissioning of both the Interim Secretariat and the Foundation Stone Laying of the Permanent Secretariat and Tree planting ceremonies were successfully held yesterday. We look forward to the completion of the building project as scheduled.
15. Madam President, Your Excellencies, the countries of Africa must intensify efforts to remove all barriers that limit women and the girl-child from actualizing their dreams. Our women must be protected against all forms of discrimination and be given equal opportunities and access to education, politics and the economy.
16. If Africa is to move forward and be competitive in the 21st century, then gender equality must be a major component of our national policies.
17. Thus, I believe that the most sustainable way to support womanhood and guarantee peace is through empowerment. In this respect, our transformation agenda as a nation goes beyond the 30 - 35% of political offices being demanded by women, but creating various opportunities for women empowerment.
18. In my cabinet of 42 Ministers, 13 are women. The coordinating Minister of the Economy who also doubles as the Finance Minister is a woman. For the first time in our country, a woman occupies the position of Minister of Petroleum Resources.
19. Also for the first time, we have admitted women into our prestigious Nigerian Defence Academy to prepare women as full combatants in the Army, Navy and Airforce. Eight days ago, precisely on the 16th July 2012, I appointed the first female Chief Justice in Nigeria. Our Permanent Representative in the United Nations is a woman, so also is our Commissioner in the African Union and the Nigerian Commissioner in the ECOWAS Commission.
20. Our expectation is that these women will encourage other women and inspire the younger generation.
21. My Administration will remain resolute in the implementation of its policy on effective representation of women in all aspects of government.
22. Our commitment to electoral reforms and justice has ushered in an era where women can deploy their numerical strength to ensure that their preferred candidates win elections at all levels. This has been made possible in every instance by our administration commitment to the electoral principle of one man one vote, one woman one vote, and one youth one vote.
23. Your Excellencies, distinguished ladies and gentlemen, your deliberations are important to a world in search of peace.
24. On behalf of the people of Nigeria, I want to once again thank you for coming and it is on this note that I declare the 7th Summit of the African First Ladies Peace Mission open.
25. I thank you.

subset: commoncrawl


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Ankh: Heart of Osiris Now AvailableJanuary 5th, 2008 by duglambier
Thanks to duglambier for letting us know that the adventure game Ankh: Heart of Osiris is now available at the online retail stores Tux Games and ixsoft for $42 US and 39.95 € respectively. Ankh: Heart of Osiris and its predecessor were ported to Linux by RuneSoft.
Here's the feature rundown:
- Classic adventure game style
- A zany story in strange locations
- New characters and familiar faces
- Graphics with dynamic light, shadow and glow effects
- Cinematic full-motion sequences
- Pitch-black humor
A demo should be released on the 18th of January.


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Do they have a hanging loop like the towels of the same brand?
Initial wash a little pill noticed. Used first time felt the pills left on my body when drying myself off. Washed a second time and have no further issues. Our towels are used for several days in a row hang dry between showers and towels remain soft not scratchy or rough. Towels arrived promptly in adequate/size correct plastic wrap bag that withstood shipping. Very pleased overall though using such a large towel-sheet takes some getting used used to I love the softness and ability to wrap completely around me. Only complaint was they weren't available in all colors listed/produced when I went to order. Will buy more if color choices improve....
Superior Collection Luxurious Egyptian Cotton Bath Sheet (Set of 2)
Wrap yourself in the greatest comfort after a shower or bath in a luxurious 100-percent Egyptian cotton bath towel. A set includes two of these 34 x 68-inch extra large towels that come in several different colors. The towels are machine washable.
ITEM#: 11387150Measuring 34 x 68 inches, these over-sized towels are ideal for wrapping around yourself after a shower or a bath. The luxurious 100 percent Egyptian cotton material makes these towels soft and absorbent, while leaving them durable enough to handle multiple trips through the washing machine. The wide range of colors makes it simple to choose the color that best complements your bathroom - chose a single color or fill your linen closet with multiple colors of these beautiful towels.
- Set includes: Two bath sheets
- Luxurious bath sheets woven from 100-percent Egyptian cotton
- Extra large bath sheets measure 34 inches wide x 68 inches long
- Towels boast extra absorbent fabric
- Sturdy, fold-over edging for years of use
- Machine washable
- Color options: White, ivory, mocha, taupe, blue, peach, sage, silver, gold, toast, black, burgundy, linen, grey
|Egyptian Cotton
|Solid Color
|Set Include
|2 Piece
|Bath Sheets
|Black Blue Brown Gold Green Grey Off-White Pink Purple Red Tan White
|Comfy Fluffy Luxury Plush Quality Smooth Soft Warm
|34 in. W x 68 in. L
|Model Number
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Super soft towels - great price
Initial wash a little pill noticed. Used first time felt the pills left on my body when drying myself off. Washed a second time and have no further issues. Our towels are used for several days in a row hang dry between showers and towels remain soft not scratchy or rough. Towels arrived promptly in adequate/size correct plastic wrap bag that withstood shipping. Very pleased overall though using such a large towel-sheet takes some getting used used to I love the softness and ability to wrap completely around me. Only complaint was they weren't available in all colors listed/produced when I went to order. Will buy more if color choices improve.Read More
Best towels ever.
I bought a set for my guest bathroom. They are so nice that I bought a second and third set for two friends in Scotland. They can not get these huge, fluffy towels over there.Read More
Great towels
These are wonderful towels. However, they were way too big for us so gave them to our daughter who's husband is over 6' tall.Read More
The bath sheets are luxurious as said in the description. I would order these again. Comfort and durability is exactly what I was looking for and found it in this purchase.Read More
Bought as a gift
The recipient said they were nice but I've never seen them in person.Read More
great deal / feel great / dry quickly after use
bath sheets like this would usually be 40-50 dollars for just one. These are very thick /huge and very absorbent..... I washed them before using and they came out soft and fluffy- after continued washings they continue to look great and are not snagging or getting any less fluffy. ( I bought white- so have no comment on color) They are not smooth towels- meaning they have a loft to them- and not much of a decorative border which i like since that part never drys you anyway. They are a casual looking towel that you can double wrap your whole body in and they dry quickly after you use them - which is amazing considering the amount of cotton in them....total bargain!Read More
OK, but Sheds
These towels do absorb like Egyptian Cotton, therefore I believe they are Egyptian Cotton. But the threads are extremely short, causing the towels to shed like no towel I have ever seen before. I inherited a 30+ year old Egyptian Cotton robe that has barely shed a thread. We cannot touch these towels before putting in contact lenses or shaving, or else the short threads will cause problems. One of the 4 towel's bindings is already ragged, in less than 3 months.Read More
There are pulled loops that left threads hanging. A lot of lint, large balls. Poor quality for this money. I am very disappointed!Read More
Egyptian Cotton Bath Sheets Awesome!
Love these towels and plan to purchase more. Bought for master bath but at the great price will buy some for my guest bathrooms.Read More
Fine product
Towels are always tough to buy; you want them to be soft enough, yet absorb! These do a fine job. Probably not top quality, but good enough for my kids.Read More
Questions & Answers
Hello dinahmichael, thank you for your inquiry. If you are referring to the tag, then they should as the newer towels are being made with them but the older ones do not have them. If you receive one without it, it could be either that the towel is from an older shipment or the newer tags have yet to arrive. Please let us know if you have any further questions.
Why did you choose this product?
Big soft plush Egyptian cotton
I've ordered these towels before and they are fabulous. They last forever.
We needed bath sheets!
Great Buy...
ratings and colors available
sounded appealing and I liked the thread count
matches the other towels chosen
looking for quality bath towels.
Love the colors and the size.
I bought this for my son's family. I bought some Egyption cotton sheets and we love them, so I thought these towels would be of the same quality.
Reviews and price
Have purchased these before. Exceptional quality!
Pricing for set of 2
Large size of towels
I gave bath sheets to my other two niece and nephew. Since I am disabled I heard about your website so I ordered them from your site.
I have a few sets and I bought this as a gift!
i liked the reviws and they looked like a good value. i will let yo know once we receive them and try them out to see if they truly are a good value
What is the weight of these bath sheets?
Hello fbed, Each towel is 2 pounds. Thank you for shopping with us!
If you are looking for the weight as far as it feels. It feels nice and heavy and is very cozy and warm.
They are not soft at all.
like akgal57, i found them very thick and warm; i don't know if the quality varies from color to color (i ordered burgundy) but it seems like it shouldn't! i do have to admit that just rubbing against the towel bar every time you take the towels off and then hang them back up, they shed rather a lot of fluff on the floor, and it takes upwards of 4-5 washes before they stop leaving a very thick layer of fuzz in the dryer filter. (although so far that doesn't seem to affect how nice and thick they feel.)
Is there some sort of cotton symbol on the merchandise tag? If so, please describe.
Thank you for contacting us oceanterrace. There is no symbols on these. Please let us know if you have any further questions.
Can this be shipped to an APO address?
Thank you for your inquiry; you will be contacted by Customer Care.
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text:
"Nobody ever told me I was doing a great job before," says Baxter. "When I feel like I'm not doing so well, I call or write them. They're my friends, and they're my strength. They tell me: Take a deep breath, take a bath."
Hurricane Katrina actually presented a kind of meteorological bookend for some of the former Sigma Delta Tau sisters. Forty years earlier, they had arrived in New Orleans as freshmen at H. Sophie Newcomb Memorial College (then the women's school at Tulane University), just as Hurricane Betsy ripped through the city, earning the nickname Billion Dollar Betsy for the amount of damage left in her wake. They slept in dorms with no electricity and helped clear Betsy's detritus from the campus. Close friendships were formed in an era of bouffant hairdos and war protests; after college, there were occasional updates about marriages, children, divorces. But over the years, their lives and careers spread out across the four corners of the country: Sondra Daum Berman became a financial advisor in Florida; Marilyn Zwick Storch did marketing for hospitals in Illinois; Janis Dropkin Smythe produced commercial music in New York. In time, most of them lost touch with one another.
Until Katrina. Cheryl Josephs Zaccaro, a retired occupational therapist from Pittsfield, Massachusetts, hooked up with Habitat first. She slept in a trailer with other volunteers, building low-cost houses, a job for which she had no prior training. Zaccaro began e-mailing her sorority sisters, asking, "Is this something we want to do?" From Texas and Pennsylvania and Georgia, the answers came back: yes, yes, yes! Everyone had sent checks to the relief organizations, but it didn't seem like enough.
Zaccaro returned to Habitat with her sisters ten months later — an act of extraordinary selflessness, since she'd just completed chemotherapy for breast cancer. "But I kept thinking, I get to go home," she says, "while all these people were still homeless, still dealing with the mess." And after hearing the story of Baxter and her children, the group determined to get involved in an even more personal way.


text:
A programme focused on youth culture, mainly through participatory and educational projects. It supports the creation of new forms of cultural activities through platforms, partnerships and networking. The programme is based in two segments: Daily Club Molekula (a non-profit making cultural club) and Nukleus (youth educational programme).
There are currently four active organisations in Molekula: Filmaktiv (film and video workshops); Amandla (panels, debates, lectures, talks on current issues); Infoshop Skatula (offers magazines, fanzines, books from the field of activism and social changes); and Drugo more (educational programme Nukleus, film projections, promotion of artists, lectures and talks on different fileds of cultural activity).
An important part of the Daily club is Linux, an operational system installed on all computers for the purpose of supporting the use of free software.
|The Other Sea
|Infoshop Skatula
Related keywords
Type of project: Networking
Country: Mediterranean region
Location: Croatia
Arts & cultural categories Audiovisual & Media , new media & digital arts , Literature & Publishing , e-literature
Tagged as
intercultural, interdisciplinary


text:
Official Radeon 7970 Review and discussion thread
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Registered User
Join Date: May 2005
Posts: 17,982
Re: Official Radeon 7970 Review and discussion thread
Originally Posted by
I'd say that PhysX is even more niche than 3d gaming... Few titles use it and the ones where it could really help immersion are done on a CPU physics engine instead.
The driver argument while I can't say I fully agree with is being addressed. The main thing is that they did finally get around to allowing custom profiles much like Nvidia. This should really help for CFX users and getting new titles to work.
That whole page is definitely worth a read as it goes into a lot more detail about trying to improve relationships with developers to get their software more optimized. Nvidia definitely does have an advantage in some titles which becomes apparent when compared two evenly matched cards.
All in all it's a pretty solid card. I really like how they tweaked all of the power options. IMO it seems like a lot of gamers don't care if the fan has to be a bit louder if it keeps their GPU cool during a game. Once you're out of game though getting that card throttled down as much as possible to make your pc silent is great for everything else. My main pc could easily be used to surf the web / perform as a HTPC without making my room a sauna. Then it still packs more than enough power to play games.
The 3 seperate displays with seperate audio is intriguing, but one thing that still needs to change is input support. If I could use those as completely seperate "VM's" I would be all over this card. There are a lot of games in which my main pc is more than adequate to host multiple instances, but I don't have a way to use them as such. Imagine having a CFX setup with eyefinity on a SNB-E pc. When you're playing by yourself you can have all of the fun an immersion of triple panel gaming. A couple of friends want to stop by to play a game, but having to haul their whole rig is time consuming and a bit of a hassle. If you could break up your 3 monitors into seperate computers so they could join in it would be awesome.
That is an application of VMs I'd never considered. Is that even possible? With the API's dealing with the drivers and such? I think it'd be rather neat.
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text:
It was another gorgeous day in City Park yesterday. Couldn't resist taking out the camera.
City Park - New Orleans, LA - November 28, 2007
Tad Gormley Stadium - City Park - New Orleans, LA - November 28, 2007
Did anyone notice that Ted on How I Met Your Mother was wearing a New Orleans Saints t-shirt in one scene on Monday night's episode (The Yips)? You can watch the episode on their website if you like. Good on you, Ted.
Quote of the Day
Is it going to be a Jeff Garcia game plan? Well, if Garcia plays, then it will be. But if Jeff doesn't play, then what do you prepare for? I think keeping it a little unsure can be a good thing strategically from our standpoint.
Paul Hackett, Tampa Bay Bucs QB Coach
Blog of the day here.
Quote from said blog: "Second, she seems to be more carefree these days. She no longer looks over her shoulder every few minutes just to check if I'm okay."


text:
Although it remains a working day in most countries, Saint Valentine's Day, commonly known as Valentine's Day, or the Feast of Saint Valentine, is observed on February 14 each year.
Kenya is not left out as the day never goes unmentioned despite the harsh economic times. However, despite the fact that you are never too old to be in love, most of the older couples in Kenya do not recognise this day. CATHERINE MUKEI spoke to a few senior spouses who have been married for long.
Mrs Lois Mwangi
I know that Valentine's Day does exist but I have never celebrated it. My husband and I have been married for 45 years but we have never celebrated our love for each other on this day. I don't know the meaning of it anyway. My husband is also less concerned and just like me, he may not have a clue about it because our idea of such a day is renewing our vows in church and attending marriage retreats with other couples. When is it anyway? I will probably be at the shamba or doing some house work depending on that day's schedule. Come to think of it, our children have really tried to tell us about it but I think it is a young generation's thing. In fact in the past few years they have been sending me flowers and texting me on Valentine's Day. The ones who are still single also call me to tell me that I'm their Valentine. Let the young ones enjoy it in the modern way before they get older.
Mr Jepson Muthara
When is it? I know it is this week but I'm not sure when. However my wife and I will still celebrate it. This will be the first time we are doing it in the 40 years of our marriage. Now that you have confirmed the actual date and day, I realise that it actually coincides with my birthday. In the past we have only celebrated my birthday but this year it will be different. We recently attended a couples' seminar and we were reminded to always do something to keep the fire burning. Our children too keep insisting that we should take some time off and observe the day. They even buy gifts for their mother. Love is like fire and no matter how old, couples still need to rekindle the flame. Things are really changing and so should we.
Mrs Esnas Kyungu
We are not very keen on these things as we grow older but now that you have informed me about it, I will actually celebrate it. My husband just came back from upcountry and that calls for a celebration; good timing indeed. This however does not mean that we never do something special in our marriage. It's only that whenever we celebrate, it is on a small-scale level. I'm only hoping that we are going to do it big this time. I'm still planning on what to do for him after many years of marriage. I think that all people in love should observe this day.
Mrs Emma Ngumbi
My husband and I have never celebrated Valentine's Day in our 20 years of marriage. But we celebrate our love every other day. Our children are a reminder of why we fell in love in the first place. We invent our own ways of keeping the flame burning once in a while. My husband takes me out for dinner sometimes and once a year we also attend couple retreats or seminars. Spiritual guidance is the secret to our love. Not that I mind it though. It is not a big deal for me; it's just not my thing. But I would would actually recommend it to my teenage children when they grow older. This year it may also go unnoticed because we have not even talked about it.


text:
The debate about whether or not Africa should turn to genetically modified (GM) food production as a measure to end hunger has been going on for several years now. The big question is why is the issue of adopting what clearly appears to be a short cut to the continent's huge hunger problem taking so long to be decided upon what appears to be the miracle solution to a problem they are otherwise working in vain to solve?
GM organisms are developed in laboratories by slicing genes from unrelated species into the host organism - unlike in the natural breeding system where select plants or animals with desirable traits are crossbred within a species to produce better crops or animals. Many scientists, like Andrew Taynton of Safe Age, a South African consumer movement, believe that there is a big risk in consuming GM foods.
"For example, bacteria or virus genes are sliced into food crops and then reproduced in each and every cell in the plant," he says. "This carries several risks as it is a random and imprecise process. It can scramble the genome, cause mutations, fragments, and multiple copies or turn neighbouring genes on or off. The main concerns about eating GM food are the development of new allergies, new toxins, new diseases, antibiotic resistance, and changed nutritional value."
A respected pan-African magazine, New African, devoted about 12 pages of its January 2009 issue to the debate of whether GM Food is good for Africa. There was hardly a sentence in the publication that could encourage any developing country in Africa to turn to GM food production.
South Africa, of all African countries, was singled out as already having adopted the production of GM food. The proponents of GM food for Africa like David King, director of the Smith School of Enterprise and the Environment at Oxford University argue that if Africa turned to GM food, it would end its hunger woes just like India and China who went GM, did. He also attacked Prince Charles, heir to the British throne, for standing up for organic farming.
Prince Charles in The New African once said in August 2009, "Growing GM crops in the developing world, represents the biggest environmental disaster of all time. Multinational corporations who are encouraging the growth of GM crops are conducting a gigantic experiment with nature and the whole of humanity which has gone seriously wrong." Some industrialised countries such as France have their own reservations about GM food and are encouraging more the consumption of organically grown food for their nationals.
What most advocates of GM food don't say is the greed for money and profit of especially agro-chemical corporations. Africa is hungry and there is no doubt about that but in order to come out of that difficult position it must not automatically follow the examples of India and China. In the current issue of New African the former UN Secretary General, Kofi Annan, has clearly indicated that the total land area available for agriculture in Africa is greater than that of Western Europe, the US, China and India - combined. Kofi Annan today heads the Alliance for a Green Revolution in Africa (Agra).
He is not talking about growing GM food, rather, he is talking about African governments investing at least 10 per cent of their annual budgets to support and develop small holder farmers, using improved seeds, environment friendly fertilisers and quality animal breeds. And as he has mentioned in the article written for New African, this month countries like Ghana, Rwanda, Tanzania and Malawi are already showing signs of overcoming hunger through these simple methods.
GM also is not so much about African foods like millet, sweet potatoes, cassava or yams and the various African vegetables. We need to develop our own food crops as we fight hunger and we don't have to automatically switch to foods from other continents. The more we adapt to western technology the more we have to spend on machinery and chemicals manufactured in the west.
After all, the industrialised countries will not buy our surplus food (including GM food) since they always have enough food and anyway they have safely put in place trade barriers that discourage African products access to their markets. Our food and poverty problems must be solved right on our small plots of land and by ourselves as farmers and researchers.


text:
Compiled for Reuters by Media Monitors. Reuters has not verified these stories and does not vouch for their accuracy.
THE AUSTRALIAN FINANCIAL REVIEW (www.afr.com)
The Boston Consulting Group (BCG) has been engaged by National Australia Bank (NAB) to perform a review of the bank's cost base as part of the bank's strategy to reduce outlays and increase profits, according to industry observers. BCG will also be expected to identify any underperforming sections or operations within the bank. "Cost management" would be central theme when the bank releases its update on "strategic priorities", said NAB chief executive Cameron Clyne last week. Page 15.
Investment management company Perpetual took out the top spot in the survey of 137 Australian share fund managers compiled in financial adviser Mercer's review of 2012. The wholesale ethical investment fund run by Perpetual's Nathan Parkin rated in first place with the wholesale share-plus fund run by Paul Skamvougeras taking third. Page 15.
Wealth management firms JBWere and AMP Capital are both majority owned by National Australia Bank and both are predicting investors will depart cash and term deposits and return to equities as the share market is now taking off. Brokerage revenue was up 25 percent during the last quarter, compared to the same period the year prior, stated Paul Heath, head of JBWere. Craig Cleary said AMP advisers were finding clients expressing an increased interest in equities, property and infrastructure. Page 15.
Coffey International, a company providing services consultancy with expertise in geosciences, international development and project management, is expected to deliver a first-half profit of around A${esc.dollar}14.5 million at today's results presentation, according to market analysts. This compares to A${esc.dollar}5.7 million for the same period last year. Managing director John Douglas said last year's strategic refocus from mining into oil and gas had been an important and timely change for the group. Page 17.
Last week Bendigo and Adelaide Bank raised A${esc.dollar}850 million with an issue of residential mortgage-backed securities and this was the least expensive money the bank has raised since the global financial crisis, said the bank's chief of capital Will Rayner. With cheaper finance becoming available, smaller home lenders should be able to compete more effectively against the big four banks. Securitisation markets have "continued to improve in recent months" stated the Reserve Bank of Australia on Friday in its monetary policy statement. Page 18.
Westpac Banking Corporation has increased the percentage of its mortgage holders in flood-affected Queensland that also insure through the bank from 21.6 percent to 26.1 percent over the last three years, according to data from market researcher Roy Morgan. The increase was a result of successful cross-selling combined with some insurers departing the flood-prone areas, said Jim Glossat of the bank's wealth management division BT Financial Group. Page 19.
THE AUSTRALIAN (www.theaustralian.news.com.au)
Consolidated Media Holdings (CPH), James Packer's private company, last year lifted its net profit to A${esc.dollar}179.3 million, up from A${esc.dollar}119.7 million the year prior and almost double 2010's A${esc.dollar}74.4 million. CPH has now finished a major restructure during which non-core assets, such as financial services and media, had been divested, said Michael Johnston, the company's executive director. Page 19.
Hardware group Bunnings has registered a company in New Zealand with the name Masters Home Improvement Limited, with a Bunnings spokeswoman claiming yesterday that the registration was to protect intellectual property. Woolworths has claimed Bunnings is running a "dirty tricks campaign" that includes buying land to prevent its use by Woolworths for its Australian Masters outlets and pressuring suppliers into not selling to the Masters business. Page 19.
Hastings Funds Management, an A${esc.dollar}8 billion infrastructure fund manager, is looking to benefit from weaknesses in European economies by acquiring motorways, airports and seaports throughout the zone. The impact of Basel III obligations will cause various banks to offload some of their investments, providing opportunities for his company, said Hastings chief executive Andrew Day. Page 19.
Clive Palmer's resources exploration and development company Mineralogy and its Chinese joint venture partner Citic Pacific have abandoned attempts a mediation and will meet in the Western Australian (WA) Supreme Court on Wednesday. Under consideration will be a royalty dispute related to the US${esc.dollar}8 billion Sino Iron magnetite joint venture in the Pilbara region of WA, with Mr Palmer saying that the disagreement was: "A clash of cultures in China they don't have the rule of law". Page 20.
-- Stockbroking firm Wilson HTM is considering taking the takeover attempt from corporate investor Mariner Corp to the Takeovers Panel following Mariner's extension of its offer to shareholders on Friday, said Wilson chief Andrew Coppin. Mr Coppin said the change was indicative of below-market behaviour, similar to David Tweed's modus operandi, where personal approaches were made to shareholders offering them less than the true value of their shareholdings. Page 21.
Chris Roberts, chief executive of Cochlear, Australia's hearing implant manufacturer, yesterday expressed criticism of the Fair Work laws created by Australia's Labor Federal Government. "Jobs have already gone overseas because of these regulations," Dr Roberts said, adding that Cochlear planned to keep its manufacturing operations in Australia as part of its strategy to compete with Swiss company Sonova. Page 21.
THE SYDNEY MORNING HERALD (www.smh.com.au)
Patrick Keane, outgoing Chief Justice of the Federal Court, said as he prepares to move to the High Court, that during his tenure, the Federal Court staff, both justices and administrative, had been "heroic" as they did more with less. The budget had fallen from A${esc.dollar}93.5 million in 2010 to A${esc.dollar}89.7 million in 2011 then climbed to A${esc.dollar}90.2 million for 2012 and during this time the workload of the court rose by 20 percent, according to Chief Justice Keane. Page B1.
Sales of ready-to-drink products, known as alcopops, for Diageo Australia dropped by 1 percent during the December half after four years of flat-lining, reported Tim Salt, managing director for the company's Australian operations. Diageo was looking at innovations, such as a pre-mix of Bundaberg Rum with a soft drink currently being trialled in Queensland, and would not use discounting to increase market share, added Mr Salt. Page B3.
THE AGE (www.theage.com.au)
Japan Airlines (JAL) has entered discussions with Brisbane Airport over resuming direct services between Brisbane and Tokyo. Last year visitor numbers from Japan rose by 5 percent, reaching 352,000, a figure still much lower than the record 800,000 reached in 1997. JAL reduced services when it entered bankruptcy protection in 2010 but has been expanding its network since relisting last year on the Tokyo Stock Exchange. Page B3.
China, a country of increasing affluence where each year at least 30,000 babies were born with profound hearing difficulties, presented a "huge opportunity" said hearing implant company cochlear chief executive Chris Roberts yesterday. The company was aiming to grow via innovation, not merger or acquisition, added Dr Roberts, following up on last week's announcement of a A${esc.dollar}77.7 million first-half profit. Page B4.


text:
Please select dates of travel and the number of guests to get accurate room availability and rates.
Need more than 8 rooms?
Contact our Group Travel Department
Location. Located in Maggie Valley Microtel Inn amp Suites Maggie Valley is in the historical district and close to Cataloochee Ski Area.
Hotel Features. Recreational amenities include an indoor pool and a spa tub. Complimentary wireless Internet access is available in public areas. The hotel serves a complimentary breakfast. Guest parking is complimentary. Additional property amenities include laundry facilities.
Guestrooms. Air-conditioned guestrooms at Microtel Inn amp Suites Maggie Valley feature coffee/tea makers and complimentary newspapers. All rooms include separate sitting areas and desks. Refrigerators and microwaves are offered. Bathrooms feature shower/tub combinations complimentary toiletries and hair dryers. Wireless Internet access is complimentary. Guestrooms offer phones with voice mail as well as free local calls restrictions may apply. Televisions have satellite channels and pay movies. Rooms also include windows that open and blackout drapes/curtains. A nightly turndown service is offered and housekeeping is available daily.
Swimming pool - indoor
Air-conditioned public areas
Microwave in lobby
Laundry facilities
Spa tub
Television in lobby
Complimentary breakfast
Parking free
Self parking
Safe-deposit box - front desk
Picnic area
Meeting rooms small groups
Wireless high-speed Internet access - complimentary


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Palomar Divide Truck Trail question:
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rockin' the toaster
Joined: Jul 2007
Location: sunny SoCal
Oddometer: 2,329
I rode along the north ridge of Palomar today, up High Point Truck Trail from the 79/371 intersection near Aguanga and down Palomar Divide Rd., exiting 2 miles south of Sunshine Summit/Holcomb Village.
Also spoke with a ranger at the Oak Grove station on hwy 79 who mentioned Oak Grove Truck Trail is gated as it crosses private land.
There's another route to the top, Halfway Truck Trail, which intersects hwy 79 at Sunshine Summit.
This is gated seasonally but the ranger believed it is currently open. I didn't check.
As BajaRider650 mentioned, there's a gate near the firewatch tower that effectively seperates Palomar's north and south sides. There's also a gate at the bottom of the spur road to the tower so I wasn't able to ride up to its base at High Point.
The roads are in pretty good shape and certainly big bike friendly (BBF?) as I managed tolerably even on my R80ST striped street pig (SSP).
I saw two trucks on my way up and four parked at the Barker Valley trailhead.
A few miles at the southern end of Palomar Divide Rd. are primitively paved.
High Point Truck Trail
the gate
Palomar Observatory from the gate
just a short walk to the tower
Barker Valley trailhead
fine views all day long
"If you want to fix it with a rock, you have to stick to stone-age technology" -Anton
"...solving the latest crisis that is preventing my Airhead from taking me to the bar."
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text:
MV Xue Long
Xuě Lóng departing for the 31st Antarctic voyage on 30 October 2014.
|Xuě Lóng (雪龙)
|Polar Research Institute of China[1]
|Port of registry:
|Shanghai, People's Republic of China
|Kherson Shipyard, Ukraine
|Laid down:
|1 January 1990[1]
|1 March 1993[1]
|1 March 1993[1]
|IMO number: 8877899
Call sign: BNSK
MMSI number: 412863000[2]
|In service
|General characteristics
|Research vessel
|21,025 tons
|167 m (548 ft)
|22.6 m (74 ft)
|9 m (30 ft)
|Ice class:
|Installed power:
|BMZ 8DKRN60/195 (13,200 kW)
|Single shaft, ducted controllable-pitch propeller
|18 knots (33 km/h; 21 mph) (max)
1.5 knots (2.8 km/h; 1.7 mph) in 1.1 m (3 ft 7 in) ice
|20,000 nautical miles (37,000 km; 23,000 mi)[3]
|34 crew, 128 passengers or researchers
|Aircraft carried:
|One helicopter
|Aviation facilities:
|100 m2 (1,100 sq ft) laboratory space
Xuě Lóng (Chinese: 雪龙; pinyin: Xuě Lóng; literally Snow Dragon)[4] is a Chinese icebreaking research vessel. Built in 1993 at Kherson Shipyard in Ukraine, she was converted from an Arctic cargo ship to a polar research and re-supply vessel by Hudong-Zhonghua Shipbuilding of Shanghai by the mid-90s. The vessel was extensively upgraded in 2007 and was expected to go through another upgrade in 2013, but it is not known if the latter refit was carried out.
As of 2012[update], Xuě Lóng is the only Chinese icebreaking research ship in service. A second Chinese polar icebreaker, slightly smaller but more capable than Xuě Lóng, is currently at the design stage and is expected to enter service in 2016.[5][6]
Built at the Kherson Shipyard in Ukraine and completed on 25 March 1993, Xuě Lóng started her life as a Project 10621 icebreaking cargo and supply ship designed for the Russian Arctic.[7][8] She was purchased by the People's Republic of China and converted to a polar research and re-supply vessel in 1994.[9][10][11] In 2007, the ship was extensively upgraded to extend her service life by another 15 years. During the mid-life refit, the ship received a new superstructure that considerably changed her external appearance.[12] She was expected to receive another technical update in 2013,[13] but it is not known whether this was carried out.
Xuě Lóng is 167 metres (548 ft) long and has a beam of 22.6 metres (74 ft). When loaded to a draft of 9 metres (30 ft), she has a displacement of 21,025 tons. The ship is powered by a single[13] 8-cylinder BMZ 8DKRN60/195 low-speed two-stroke diesel engine, a licence-built version of B&W 8L60MC, producing 13,200 kW (17,700 hp). The main engine is coupled to a ducted controllable-pitch propeller.[14][15] In open water, Xuě Lóng can achieve a maximum speed of 18 knots (33 km/h; 21 mph) while in 1.1-metre (4 ft) ice she can proceed at 1.5 knots (2.8 km/h; 1.7 mph). Her ice class, assigned by the China Classification Society (CCS), is B1.[3]
Xuě Lóng has a crew of 34 and can accommodate 128 researchers or passengers. She has 100 square metres (1,100 sq ft) of laboratory space. In addition to a Kamov Ka-32 "Xueying" (Snow Eagle) helicopter, the ship also carries an Arctic class ARV autonomous underwater vehicle on a regular basis.
Visit to Canada[edit]
Xuě Lóng unexpectedly arrived in 1999 at the small Canadian coastal village of Tuktoyaktuk, on the Arctic Ocean.[16][17][18]
The inability of the Canadian authorities to track the vessel stirred enough controversy that the incident is still being cited as evidence of Canadian unpreparedness to defend its northern sovereignty.[16][18]
Arctic expeditions[edit]
The ship undertook a second Arctic expedition from July 15, 2003 to September 26, 2003.[9] More recently the ship had been used in connection with China's efforts to maintain a scientific presence in the Antarctic.
Although used primarily to support China's annual expeditions to Antarctica, Xuě Lóng has made four voyages to the Arctic, via the Bering Strait in 1999, 2003, 2008 and summer 2010. During her 82-day voyage in JUL-SEP 2010, the ice-strengthened research ship was able to reach a new 'highest North' record (for China), reaching 88.22 degrees North latitude, at 177.20 degrees West longitude. At that point a team of scientists boarded the ship's Ka-32 helicopter and flew to the North Pole on 20 August 2010.[19] The ship returned to Shanghai on 20 September 2010. At China's annual Polar conference held in Shanghai in September 2011, the director of the Antarctic & Arctic agency said that Xuě Lóng would undertake her fifth voyage to the Arctic in July 2012.
Trans-Arctic voyage, 2012[edit]
In the summer of 2012 Xuě Lóng became the first ship from the People's Republic of China to cross the Arctic Ocean to Europe amid the record ice melt.[20] The Xuě Lóng left port on 2 July, sailed through the Bering Strait then joined a westbound convoy on the Northern Sea Route to the Barents Sea, before arriving in Iceland in mid-August. It departed Iceland on 20 August, sailed past Svalbard - without stopping to visit China's Yellow River Station - and made a run at the North Pole, falling short. It then sailed a high latitude line east, back to the Bering Strait, returning to her base in Shanghai on September 27, 2012, completing its fifth Arctic voyage.[21] "Unfortunately we didn't reach the North Pole because Xuě Lóng 's icebreaking capability isn't strong enough," said one of the ship's officers.[22] Of note, while China did not state how close Xuě Lóng got to the North Pole in late August 2012, China's Polar Institute did not claim a new "high north" record, suggesting the vessel did not break her record set in 2010.
Antarctic operations[edit]
Xuě Lóng provides annual resupply for China's Antarctic Zhongshan Station at Prydz Bay.[23]
Rescue operation of Akademik Shokalskiy, 2013–2014[edit]
In December, 2013, Xuě Lóng embarked on her first circumpolar voyage in Antarctic.[24] It was heading eastward from Zhongshan Station when it was dispatched along with several other icebreakers by the Australian Maritime Safety Authority to free Akademik Shokalskiy which had become trapped in ice off the East Antarctic coast.[25] By 27 December, Xuě Lóng, closed to within 6 nautical miles of the Akademik Shokalskiy, but had stalled in its efforts to complete the rendezvous due to encountering thick ice.[26] Xuě Lóng withdrew to open water to rendezvous with and provide air support for Aurora Australis and L'Astrolabe.[27][28] On 30 December, after all three icebreakers had failed to penetrate the icepack, a decision was reached to use Xuě Lóng's helicopter to evacuate the 52 passengers off Akademik Shokalskiy, but the flights were grounded due to continuing extreme weather conditions.[29] Originally, the plan was to have the helicopter ferry the passengers to a barge with which they would sail to the Aurora Australis, but the Xuě Lóng became stuck in sea ice itself, unable to launch the barge.[30]
On 2 January 2014 beginning at 18:15 Australian time (07:15 GMT) the Ka-32 helicopter from the Xuě Lóng conducted 5 flights airlifting groups of 12 people from the ice next to the Akademik Shokalskiy and landing them on an ice floe near the Aurora Australis.[31] Two additional flights were made to collect their equipment and baggage. The passengers were transferred to a small boat which took them to the Australian ship Aurora Australis as the Ka-32 helicopter is too heavy for the helipad of the Australian icebreaker.[32] The airlift was completed within 4 hours. By 3 January, the Xuě Lóng remained trapped in ice itself although it was in no immediate danger and her captain declined assistance from the still-nearby Aurora Australis.[33] On 4 January 2014, the American icebreaker Polar Star was dispatched to assist Akademik Shokalskiy and Xuě Lóng at request of the Chinese and Australian authorities.[34][35] However on 7 January 2014, a change of wind direction which loosened the icepack around the ships enabled Xuě Lóng and Akademik Shokalskiy to work their own way free before the American ship arrived.[36]
Search for Malaysia Airlines Flight 370[edit]
Following the Akademik Shokalskiy rescue operation in the Antarctic, Xuě Lóng docked in Perth, Western Australia.[37] On March 8, 2014, Malaysia Airlines Flight 370 from Kuala Lumpur International Airport to Beijing Capital International Airport disappeared. Satellite imagery from the Australian authorities led the search for the aircraft to an area in the Indian Ocean, approximately 2,500 km (1,600 mi) south-west of Perth. Due to its proximity to this area, Xuě Lóng was dispatched to join the multinational search operation.[38] As of 1 April 2014, Xuě Lóng was on its way back to its home port, Shanghai.
See also[edit]
- ^ a b c d e f g China Classification Society
- ^ "Xue Long (8877899)". Equasis. French Ministry for Transport. Retrieved 2012-09-12. (registration required (help)).
- ^ a b A Brief Introduction of R/V Xuelong. Chinese Arctic and Antarctic Administration. Retrieved on 2012-07-17.
- ^ Alan Boyle (2013-12-30). "How icebreakers work — and why they sometimes don't work". NBC News.
- ^ China to build new icebreaker for polar research expeditions. NDTV, 5 January 2014. Retrieved on 2014-03-24.
- ^ New icebreaker planned by 2016: officials. Chinadaily.com.cn, 6 January 2014. Retrieved on 2014-03-24.
- ^ Alltför svåra isförhållanden för de tillgängliga fartygen. Sjöfarts Tidningen, 4 January 2014. Retrieved on 2014-01-17.
- ^ List of ships designed by "Chernomorsudoproject" S.A. since 1955. Chernomorsudoproject S.A. Retrieved on 2012-11-27.
- ^ a b ""雪龙"船简介 (Xuě Lóng Ship Profile)" (in Chinese and English). Polar Research Institute of China. Retrieved 21 December 2008.
- ^ John Rutherford, Antarctic Support and Research Vessels (DOC), Woods Hole Oceanographic Institute, p. 34, retrieved 21 December 2008 Note that the author is mistaken about the name: "Snow Dragon" is the translation of "Xue Long", not a former name of the ship.
- ^ "February 2006" (PDF). Davis Station News (Australian Antarctic Division). Retrieved 21 December 2008.
- ^ Chinese Antarctic Expedition: Xue Long (Snow Dragon). International Polar Foundation, 14 November 2008. Retrieved on 2012-09-12.
- ^ a b New icebreaker to improve China's polar research. The 4th Media, 4 November 2011. Retrieved on 2012-09-12.
- ^ La Chine s'intéresse à l'Arctique et à l'Antarctique — Textes Gilles Barnichon & Françoise Massard / Photos Agence Adhemar.
- ^ "Ivan Papanin (880680)". Register of ships. Russian Maritime Register of Shipping. Retrieved 2013-06-20.
- ^ a b "The Standing Senate Committee on National Security and Defence". Parliament of Canada. March 8, 2005. Retrieved 26 January 2008.
- ^ Ed Struzik (November 18, 2007). "Who will guard our gaping back door?". The Edmonton Journal. Retrieved 26 January 2008.
- ^ a b Jane George (February 1, 2001). "Arctic borders need tighter control, former commander says". Nunatsiaq News. Retrieved 26 January 2008.
- ^ China's Xinhua news agency report from onboard Xuě Lóng, 31 August 2010; "Icebreaker Xuelong ends Arctic Scientific Expedition"; accessed 20 JAN 2012.
- ^ First Chinese ship crosses Arctic Ocean amid record melt Aug 17, 2012
- ^ Icebreaker Xuelong concludes Arctic expedition
- ^ [1]
- ^ "Icebreaker Xuelong begins first circumpolar voyage in Antarctic". People's Daily. 2013-12-23. Retrieved 2013-12-30.
- ^ Larry Bleiberg (2013-12-27). "Cruise ship trapped in ice off Antarctic coast". USA Today. Retrieved 2013-12-30.
- ^ "Chinese icebreaker stalled en route to stranded ship". CNN News. 2013-12-27. Retrieved 2013-12-30.
- ^ Alok Jha (2013-12-27). "Antarctic mission on ice as rescue ship is forced back". The Guardian. Retrieved 2013-12-30.
- ^ John Bacon (2013-12-29). "Help on the way for ship stranded off Antarctica". USA Today. Retrieved 2013-12-30.
- ^ "Stranded Antarctic Ship Prepares for Helicopter Rescue". ABC News. 2013-12-30. Retrieved 2013-12-30.
- ^ Nicky Phillips (2014-01-02). "Helicopter rescue delayed as second ship trapped in ice". The Sydney Morning Herald. Retrieved 2014-01-02.
- ^ "All passengers confirmed rescued from icebound Antarctic ship". The Voice of Russia. 2014-01-02. Retrieved 2014-01-02.
- ^ Nicky Phillips (2013-12-31). "Antarctic rescue mission goes awry". The Sydney Morning Herald. Retrieved 2013-12-31.
- ^ "Chinese ship Xue Long 'stuck in ice'". BBC News. 2014-01-03. Retrieved 2014-01-03.
- ^ "US icebreaker heads to Antarctic to help stuck ships". Yahoo News. 2014-01-05 circa 3h45 UTC. Check date values in:
- ^ "U.S. Icebreaker to Assist Stuck Russian, Chinese Ships". news.usni.org. U.S. NAVAL INSTITUTE. 6 January 2014. Retrieved 6 January 2014.
- ^ "Antarctic ships escape from ice trap as weather changes". www.bbc.co.uk. The BBC. 7 January 2014. Retrieved 7 January 2014.
- ^ http://www.theguardian.com/world/2014/mar/21/mh370-search-resumes-as-five-aircraft-look-for-satellite-detected-objects
- ^ http://www.bbc.co.uk/news/world-asia-26691013
External links[edit]
|Wikimedia Commons has media related to Xue Long (ship, 1993).
- Xue Long (from Antarctic Philately Web site)
- M/V Xuelong (brief English-language summary from the Polar Research Institute of China site)


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|[Sandals] Forever 21 [Suit] Topman [Sports Vest] Evisu [Tie] Next [Structured Dr's Bag] Vintage [Sunglasses] AcneStudios
You've probably noticed Architecture plays a big impact on my so called 'Editorials'. The context, colours, and overall atmosphere of a photo is more than just standing in the middle of the street (style). Let's keep it natural like the super sunny weather we have in London. On minute it's hot, so you whip of your blazer, and reveal a magic trick with the modernised twist of sports jersey Evisu Vest. Out of the ordinary with socks & sandals once again, but I suppose the public's verdict on Socks and feet is beyond your fetish preference. We've all seen the predictable tailored suits, but sporting basketball boldness has indeed brightened up my day. Combining sportswear and traditional suiting, is beyond an unusual mix but who is to say what's in season. When all that matter is the sun shining and everyones smiling right? Time to loose the layers and say hello to Summer (soon...)
Photo's by Alicepoint


text:
Healthcare System Makes Top 100 List for 13 Years in a Row
Healthcare System Makes Top 100 List for 13 Years in a Row
Patients and medical providers are more connected than ever before thanks to technology – something Eileen Jekot, MD, a pediatrician with ThedaCare Physicians-Pediatrics in Neenah, knows well. She recently returned to an exam room with results from a rapid strep test only to find the patient's mother already knew the results – thanks to an email from MyThedaCare on her phone.
"It's amazing the role technology plays in linking patients and doctors," Dr. Jekot said. "Patients have never before had so much information at their fingertips."
ThedaCare's focus on patient communication and increased access to information and medical records helped the Appleton-based health system earn top marks on Hospitals & Health Networks magazine's "100 Most Wired" hospitals and health systems list. This is the 13th year in a row that ThedaCare has made the list for the magazine, which is a journal for the American Hospital Association. ThedaCare is one of nine health systems in Wisconsin to make the list and the only one based in the Fox Valley.
Electronic medical records, which allow doctors to view and update patient files from multiple locations, and My ThedaCare, a secure online portal for patients, enhance medical care, bringing better care to patients, said Keith Livingston, senior vice president and chief information officer for ThedaCare. Electronic medical records are especially vital since they keep doctors informed about their patients, he added.
"From Green Lake and Ripon right through Oshkosh and Appleton and north to Shawano – wherever we have providers – there's a single electronic medical record for each patient and that means medical providers all have the same information about a patient's tests, health history, and medication," Livingston said. "That leads to better patient care because everyone is working from the same piece of information."
The health system joined the Care Everywhere network earlier this year where patients can give their permission for their electronic medical records to be shared outside of ThedaCare with leading healthcare providers in Wisconsin and beyond. ThedaCare is also a member of the Mayo Clinic Care Network, which means doctors can share information about patients electronically with Mayo specialists.
"We've been successful creating a community electronic medical record with more than 1.2 million unique records so information is easily shared," Livingston said. "There are more than 800 clinicians in ThedaCare or affiliated with ThedaCare who are part of our records system. So if you're at a specialist, such as an OB-GYN or an orthopedics doctor, your primary care doctor can see what happened during that visit. That communication is vital in leading to a better level of care."
ThedaCare was an early pioneer implementing electronic medical records when it began transferring paper medical records to electronic files in 1999. Today, patients benefit from ThedaCare's digital file system, which gives their health care providers instant access to their medical information, regardless of location. In addition to helping inform providers about a patient's medical history, the system also draws attention to possible medication interactions, allergies and reminds the provider of any tests or immunizations the patient may need.
Using the MyThedaCare portal, patients can access their own health information, communicate with their providers and schedule appointments, Dr. Jekot said. She said using technology to stay connected benefits both patients and their medical providers. She said online scheduling is especially helpful since it can be done at any time – not just during office hours.
"As a working parent myself, I often don't have down time until well after the doctor or dentist's office is closed. Online scheduling allows a parent to efficiently get an appointment on the books, without having the office to be 'open' and without waiting on the phone," Dr. Jekot said.
MyThedaCare also helps parents when they may have a simple question or if they want to give the doctor a heads up before the appointment about a potentially sensitive topic that might be difficult to discuss in front of the child so the doctor is aware of what's going on, Dr. Jekot said. "MyThedaCare cuts down on the missed phone calls between the office and patients and puts the information in patients' hands when they need it," she said.
The 100 Most Wired hospitals show better outcomes in patient satisfaction, risk-adjusted mortality rates and other key quality measures through the use of information technology, according to an analysis by Most Wired Survey. In addition to MyThedaCare and electronic medical records, here are some other examples of how ThedaCare's technology improves patient care and satisfaction:
The Most Wired Survey is conducted annually by Hospitals & Health Networks magazine, the journal of the AHA, which uses the results to name the 100 Most Wired hospitals and health systems. It focuses on how the nation's hospitals use information technologies for quality, customer service, public health and safety, business processes and workforce issues. Hospitals & Health Networks conducted the 2014 survey in cooperation with McKesson Corp. and the College of Healthcare Information Management Executives. The July H&HN cover story detailing results is available at www.hhnmag.com.
The 2014 Most Wired Survey is conducted in cooperation with McKesson Corp., AT&T, the College of
Healthcare Information Management Executives, and the American Hospital Association. This is the survey's 16th year.
The AHA is a nonprofit association of health care provider organizations and individuals that are committed to the health improvement of their communities. The AHA is the national advocate for its members, which includes nearly 5,000 hospitals, health care systems, networks, and other providers of care. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information, visit the AHA website at www.aha.org.
ThedaCare™ is a community health system consisting of seven hospitals: Appleton Medical Center, Theda Clark Medical Center, ThedaCare Medical Center-New London, Shawano Medical Center, and Riverside Medical Center in Waupaca. Community Health Network, which includes Community Memorial Hospital in Berlin, and Wild Rose Memorial Hospital are in the process of affiliating with ThedaCare. ThedaCare also includes ThedaCare Physicians, ThedaCare Behavioral Health, and ThedaCare At Home. ThedaCare is one of the largest employers in Northeast Wisconsin with more than 6,175 employees. Follow us on Facebook and Twitter.
© 2015 ThedaCare. All Rights Reserved


text:
Lightweight and low-cut, the AT Plus is built for fastpackers and for those who demand a high performance, long distance hiking shoe GORE-TEX lining for waterproof, breathable protection
Reviewed by 2 customers
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Comments about Montrail AT Plus GTX Shoes for Women:
I use this product for walking through woods and
trails. So far, it seems to be waterproof which
is a good thing.
Best Uses
Comments about Montrail AT Plus GTX Shoes for Women:
This is a great all-around wet weather shoe. I use it to keep up with my dog on adventures. The lateral support is particularly good on uneven terrain. -My foot always squares flat to the ground in it. These shoes also wash well and dry quickly. The arch is well supported, softly, while still allowing room in the toebox for wiggle. These are currently my favorite pair of shoes because they are so good in wet weather and very comfortable. Montrail used to have a shoe similar to this one (hurricane ridge, I think), but "updated" it to a totally different fit. I'm very happy to see this shoe return and hope they offer additional colors in the future.


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I am planning to order the following air rifle through post:
Diana RWS 34 Meisterschutze Pro Compact
I have 3 questions:
1)I got my Rifle Association membership 3 days back, will that make any difference?
2)What if I want to import another air rifle, Are there any restrictions as to the number of rifles I can import?
3)A scope comes in the package unmounted, will that create a problem?


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No. 15 Wolfpack Rifle Meets No. 3 Kentucky on Saturday
Nov. 2, 2012
RALEIGH, N.C. - The NC State rifle team will travel to Charleston, S.C., this Saturday, Nov. 3, for a battle against third-ranked Kentucky in a Great American Rifle Conference matchup. The Wildcats were the runner-up in last year's national championship.
"We're excited to be heading to Charleston this weekend," said head coach Keith Miller. "Given that we don't have a home facility where we can host matches, The Citadel's range is essentially our 'home range.' This will be our first match there this season, and Kentucky's first time ever.
"One of our main goals for this match is to break 4600. Nonetheless we're very positive about the match since we have many things we can focus on besides how our score compares to Kentucky's."
NC State (11-2, 9-0 SEARC, 0-1 GARC) is coming off its second victory of the season at SEARC #2 last weekend, where the team fired a 4582 four the third time in its four contests this season. Junior Madeline Pike fired a personal-best 587 with the air rifle and 582 in smallbore for an 1169 aggregate. Her combined score was just two points short of her career-high 1171 she recorded Oct. 6 against Alaska-Fairbanks, where the team set a program record with a 4599 total.
"Maddy has of course been on a roll and is shooting some great scores," Miller said. "She always finds a way to be successful, so we're comfortable with where she is right now."
Freshman Alex Martin also shot a career-high 576 with the air rifle, helping the team to a 2312 score in that competition.
"We've had some good performances from our freshmen duo of Alex and Daniel [Cliff], but both have been up and down," Miller said. "We hope to see them both shoot more consistently at The Citadel."
Miller also had some comments regarding redshirt junior Amy Roderer and freshman Lee Price, who will compete this weekend.
"Amy Roderer will be back on the traveling squad for this match," Miller stated. "She's worked hard on some position changes so we're anxious to see how it translates in a match. Lee Price will be with us as well. It's his first match ever as a member our team, so we're excited for him. He'll just be shooting air rifle on Saturday, but we hope to have him ramped up on smallbore soon too."
Saturday's contest will stream live target results.