text:
Children's Health
Cerebral Palsy - Cause
Cerebral palsy (CP) is a result of an injury to the brain or abnormal development of the brain. In many cases, the exact cause isn't known. The damage or abnormality may occur during pregnancy or birth or within the first 2 to 3 years of life.
- Possible causes of CP during pregnancy or birth can include genetic problems, infections or health problems in the mother or baby during pregnancy, or problems related to labor and delivery. Health problems in a newborn, such as untreated low blood sugar, can also cause brain damage that leads to CP.
- Possible causes of CP related to an early birth (premature birth) are related to the brain's development. For example, babies born too early are at risk for bleeding in the brain.
- Possible causes of CP within the first 2 or 3 years of life are usually related to brain damage from a serious illness, injury, or lack of oxygen to the brain.
In this article
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.
WebMD Medical Reference from Healthwise
Cerebral Palsy Topics
Today on WebMD
Loaded with tips to help you avoid food allergy triggers.
Sending your email...
This feature is temporarily unavailable. Please try again later.
Now check your email account on your mobile phone to download your new app.


text:
Students from seven Florida universities are joining forces to rally against what they're calling, an "attack on higher education".
Rallies are taking place at the University of South Florida, USF St. Petersburg, University of Florida, University of Central Florida Florida International University, Florida Atlantic University and Florida State, according to a media release from the group.
"Along with the Florida Legislature, Gov Scott has taken aim at students through countless bills. The tuition of all state universities is poised to rise 15 percent each year for up to a decade," the release states.
It goes on to say that the state academic scholarship, Bright Futures, is covering less per credit each year, and the program could lose funding all together.

subset: commoncrawl


text:
Thursday, February 13, 2014 5:30 p.m. to 7:30 p.m.
Cathedral School Room No.: Lobby
Floor No.: First
1047 Amsterdam Avenue, New York NY, 10025
- Contact
Anshu Wahi / 212-875-4717 / email@example.com
- Tagged
POSTPONED DUE TO WEATHER: Brother Outsider: The Life of Bayard Rustin
Event Description
POCOC, (Parents of Children of Color), in collaboration with The Cathedral School's POSOC invites you for a screening and discussion honoring the life of Bayard Rustin, architect of the March on Washington and openly gay civil rights activist.
1047 Amsterdam Ave at 110th Street
5:30 PM: Wine & cheese reception
6:00 PM: 50-minute film & panel discussion
Brother Outsider is a highly acclaimed, multiple award wining documentary honoring the life and work of Bayard Rustin. Don't pass up on the opportunity to see this powerful and inspirational film and discuss its implications to our current civil rights struggles.
Please note: if you plan to attend, you must RSVP to the following email in order to follow Cathedral's security procedures — email@example.com
Suggested donation of $10 per person, with all proceeds going to the Bayard Rustin Fund, Inc., a non-profit dedicated to teaching younger generations about civil and human rights, peace and nonviolence, and respect for others, regardless of race or sexual orientation.
This film contains graphic imagery from the Civil Rights Movement and may not be suitable for young or sensitive children. If you are thinking of bringing older children, you may want to preview the film and/or prepare your children in advance.


text:
Prior to the PA primary, Rep. Chris Carney (D-PA) "said he wouldn't endorse either" Barack Obama or Hillary Clinton "unless one of them won in a landslide."
Well, Clinton got nearly 70% of the votes in Carney's district -- "considered by many to be a landslide -- yet Carney remains silent on his endorsement." Carney spokesperson Rebecca Gale: "Not yet. It's April; it's still early. The decision doesn't have to be made until August. ... In the meantime, [he] feels it's best to let people vote and the conversation continue."
But GOPers are "pressing" Carney. NRCC spokesperson Ken Spain said 4/29 that Carney "should take a stand now that the primary is over." Spain: "Carney's decision not to support Sen. Clinton ... can only be construed as a de facto endorsement of Sen. Barack Obama. Instead of sitting idly by, Chris Carney should be condemning Sen. Obama for claiming that Pennsylvania voters 'cling' to religion and Second Amendment rights because they are 'bitter.'"
Carney, a member of the conservative Blue Dog Coalition, barely defeated four-term ex-Rep. Don Sherwood in '06 -- "the first time" a Dem has held the seat "in more than 40 years." (His election "was largely a result of Sherwood's misstep" -- getting sued by his 35-year-younger mistress, who accused Sherwood of choking her. The case was settled out of court for 500K.)
Carney "said the charge that he is out of step with conservative voters won't stick. He has staffed his office" with Dems and GOPers and "said he hasn't been afraid to buck" the Dem leadership (O'Boyle, Pennsylvania Times-Leader, 4/30).
Shifting The Conventional Wisdom
Newsday's De Luca writes, "It's time for the [Dem] leadership to act. The best way to bring this bitter" Dem race to a close "in a way that is thoroughly fair and absolutely decisive is to move the convention date from late August to late June."
"Moving up the convention" to 6/28-7/1 "would allow fair competition for each candidate in the remaining primaries, while avoiding a summer-long battle for holdout delegates. As an added bonus," it allows Dems "to end with a patriotic flourish just before the Fourth of July."
"Moving up the convention date also would do more than simply advance the day of decision: It would force the issue of choosing the nominee in a way nothing else can. The 300 or so remaining superdelegates would have no choice but to get off the fence -- and to do so soon"
"Moving such a large convention in time would surely be a logistic nightmare, not to mention a sharp break with tradition. But these problems are dwarfed by the real possibility of hopelessly dividing the party and losing the presidency" (4/30).
This article appears in the April 30, 2008 edition of Latest Edition.


text:
November 7, 2014
Event By: Sevierville Chamber of Commerce Address: 129 Showplace Blvd. Pigeon Forge, TN 37863 Phone: (865) 453-2003
On November 7, 2014 Con Hunley and Jimmy Fortune will be performing at the Country Tonite Theater. For more information go to (865) 453-2003 or visit www.firstclassconcerts.com.
View on map
City: Pigeon Forge, TN
City: Pigeon Forge, TN
Region: East Tennessee
Subregion: Smoky Mountains


text:
Advanced Aerospace Systems Design and Engineering
At the heart of any aerospace operation is performance. The entire aircraft supply chain is looking to further their engagement with Large aircraft OEMs to bring about a more robustly integrated and optimized aircraft that perform better than their predecessors. This necessitates a high degree of engineering and specialization.
Aerospace Systems Engineering Services
At QuEST Global, with our decades of cumulative experience in aerospace systems and worldwide presence, we offer tailored solutions to the aerospace industry. Our aerospace systems engineering support services include:
- Mechanical
- Electrical and avionics systems on various activities like:
- Design Support
- Engineering Analysis
- Stress Validation
- Cost Reduction
Our sub-system capabilities include:
- Thrust Reverser Systems
- Hydraulic Systems
- Fuel Systems
- High Lift Systems
- Avionics Systems
- Landing Gear Systems
- Electrical Harness
Come work with us and transform your aerospace business. To learn how you can benefit from our association, click here to download our whitepaper on our aerospace systems engineering services.


text:
Encyclopaedia of Magical HerbsPaperback Llewellyn's Sourcebook Series
List price $24.22
You save $9.78 40% off
Free delivery worldwide
Dispatched in 2 business days
When will my order arrive?
- Publisher: Llewellyn Publications,U.S.
- Format: Paperback | 336 pages
- Dimensions: 150mm x 226mm x 23mm | 544g
- Publication date: 8 April 2000
- Publication City/Country: Minnesota
- Edition: 2, Annotated
- Edition statement: 2nd annotated edition
- Illustrations note: ill
- Sales rank: 4,773
Product description
Do you work magic with herbs? Do you use them in spells, for talismans or simply use their innate powers? If you don't have "Cunningham's Encyclopedia of Magical Herbs, "you need to get it right away. This book has become a classic in its field. Paul Beyerl, a respected author on herbs calls it ..".an essential reference book by students of herbalism and magick alike ... Scott's personable charm touches every page... I highly recommend this book." And Jeanne Rose, famous author of books on herbs and developer of an herbal course says "I love books like this ... It is accessible, easy to read, and with its encompassing index (all too often neglected), simple to use as well." Over 200,000 people already have this book and use it frequently. In this edition of the book (it's expanded and revised on the 15th anniversary of original publication) you will find the magical properties and folklore of over 400 herbs! You'll also find lists of herbs based on their magical powers, their genders, their planetary rulers, and more. Perhaps the most important list is the folk name cross-reference. With that information, when a recipe calls for "bramble, " you'll know it needs blackberry. Or if the magic calls for "enebro," you'll know you that is juniper. The main part of this book is the listings of the herbs. Each one includes names, associations, and magical attributions. Violets can be used for protection, luck, love, and more. Primrose is for protection and love. Garlic is for protection, healing, exorcism, lust, and prevention of theft. This book is considered a classic. It is probably consulted more than any other book on this subject. If you want to learn the secrets of magical herbs, this book is a must!
Add item to wishlist
Other people who viewed this bought:
The Complete Book of Incense, Oi...
USD$12.94 - Save $10.48 44% off - RRP $23.42
Earth, Air, Fire and Water
USD$12.10 - Save $6.64 35% off - RRP $18.74
Magical Herbalism
USD$11.75 - Save $7.78 39% off - RRP $19.53
USD$10.86 - Save $9.44 46% off - RRP $20.30
Magical Aromatherapy
USD$8.08 - Save $4.41 35% off - RRP $12.49
Enciclopedia de Las Hierbas M?gi...
USD$13.38 - Save $1.57 10% off - RRP $14.95
Other books in this category
Women Who Run with Wolves
USD$7.61 - Save $4.88 39% off - RRP $12.49
You Can Heal Your Life
USD$10.85 - Save $6.32 36% off - RRP $17.17
Heal Your Body
USD$7.19 - Save $3.73 34% off - RRP $10.92
The Secret Language of Your Body
USD$13.63 - Save $5.11 27% off - RRP $18.74
The Body Keeps the Score
USD$21.27 - Save $6.68 23% off - RRP $27.95
You Can Heal Your Life
USD$14.05 - Save $6.25 30% off - RRP $20.30


text:
Clark Labs is dedicated to providing its registered users with quality technical support through our online Support Center. We are glad to respond to routine technical support questions. For those requesting a higher level of support, you can purchase incident support for $295. Clark Labs offers consulting services for longer application or system development needs.
Before You Contact Technical Support
Make sure you are running the latest version of TerrSet
We maintain free Service Updates accessible from the Downloads area of this website. Make sure you are running the latest update of TerrSet by checking your installed version number against the available update. You can check your version number by going to the About box from the TerrSet Help menu. After updating, check if your problem has been resolved. The Downloads page also provides the service updates for older versions of IDRISI.
Check the Help System for notes on specific modules
If you are experiencing a technical problem with a specific module, or you are receiving unexpected results, the resolution may be found in the software's Help System. Check the Help System entry for the module you are running, particularly the Notes section, for information on data requirements, module limitations and technical notes.
Visit the Clark Labs Support Center
The Clark Labs Support Center is hosted by Clark Labs for the purpose of providing an interactive forum for our user community. The forum is a place to ask questions, as well as review posts from other users, to solve technical and application issues, and to share knowledge related to the TerrSet System.


text:
Sidebar widget filled with random subversive words designed to create more work for your friendly national electronic surveillance agency.
No reviews yet! Be the first to review this plugin!
You must log in to submit a review. You can also log in or register using the form near the top of this page.


text:
Teachers who work with English as a Second Language learners will find ESL/ESOL/ELL/EFL reading/writing skill-building children's books, stories, activities, ideas, strategies to help PreK-3, 4-8, and 9-12 students learn to read.
Family Literacy Night
Children can learn to enjoy reading early in life by listening to storybooks read by parents or other caregivers. By participating in storybook reading, they learn a variety of literacy skills that prepare them for learning to read. For example, they begin to become familiar with typical story elements and with print concepts, such as directionality and how it works in our culture (reading from left to right, top to bottom). Yet one of the most heartfelt rewards when sharing reading with children is to see them begin to express their personal reactions and show their curiosity about things that are read to them (Green, Lilly, & Barrett, 2002). Having access to a variety of literacy experiences during childhood helps children begin to build interest in reading. For this reason, parents and educators should become role models and read to children to help them discover the love for reading (Moore, 2003).
Research has also shown that parents, educators, and caregivers need to be aware of the ways in which cultural background can affect family reading practices. Some books may be more difficult for English language learners because of vocabulary or culture-based content. Cultural issues may also affect families' access to books. To support parents in continuing to read to their children, educators should become familiar with the types of books children read and how to better use them to teach important comprehension/reading strategies (Green, Lilly, Barrett, 2002).
Classroom application
Marty Izaguirre teaches English for Speakers of Other Languages (ESOL) in Okatie, South Carolina. Her elementary school holds Bilingual Family Literacy Nights, which take place after school hours every other month, and provide working parents with an opportunity to read to their children in both English and Spanish. Once parents come in, they find read-aloud circles (where teachers read books aloud to a small group), as well as areas where they can go and read with their child separately. The variety of activities provided to the parents allows them to join in an activity in which they feel comfortable. Adults and children are allowed time and space to read together. Marty Izaguirre's school also provides an opportunity for parents and children to create their own special bookmark as they enjoy some refreshments. Marty believes the events can provide parents an opportunity to meet other parents as they show their children the importance of reading.
Hot links
- Talking About Wordless Picture Books
Talking About Wordless Picture Books: A Tutor Strategy Supporting English Language Learners is designed to support tutors who are working with low-intermediate English language learner (ELL) parents in family literacy programs. Developed by NCFL with funding from UPS, the strategy provides detailed instructional activities to help ELL parents build and practice English conversational skills.
- Parents + Schools = Successful Children: Practioner Guide
The Parents + Schools = Successful Children series is a project developed by the National Center for Family Literacy. The project includes bilingual materials to promote the importance of parent involvement and literacy support at home. This Practitioners' Guide offers numerous ideas and resources for reaching out to parents.
- Voces del Corazón: Voices from the Heart
The National Writing Project (NWP) presents a Literacy Night event where students read, write, and reconnect with their families. This article provides some guidelines on how to prepare a creative and inviting environment for a positive reading experience.
- Family Reading Night
This website from PTO Today provides all the information needed to organize a successful Family Reading Night event. You can also request a Family Reading Night Kit, which includes a planning guide, posters, brochures, and many fun creative ideas to use at your event.
- Family Night Fun Programs
These parent and child programs were designed by educators at the Pennsylvania Center for the Book to be used by professionals who are training parents or caregivers to support young children's literacy learning.
Click the "References" link above to hide these references.
Green, C. R., Lilly, E., Barrett, T. M. (2002). Families reading together: Connecting literature and life. Journal of Research in Childhood Education, 16(2), 248-262.
Moore, K. B. (2003). Let's go to the library! Scholastic Parent & Child, 10(5), 59-61.
Click the "Endnotes" link above to hide these endnotes.
Marty Izaguirre has been teaching or over 30 years. She works very closely with her community through the Immigrant Educational Program, providing support and promoting parental involvement.
Comments and Recommendations
|0 recommendations
Would you like ideas on this topic from other educators? Join the conversation about ELLs on our free social network on Ning, the Colorín Colorado Community!


text:
Option Spreads: Diagonal Spreads
By John Summa, CTA, PhD, Founder of OptionsNerd.com
Spreads with Different Months and Different Strikes
Now that we have covered the basic spreads - debit/credit vertical and debit/credit horizontal - taking the next step to a diagonal should be easier. Recall that spreads can be done either as debits or credit spreads, and can be constructed with puts or calls. That said, with a diagonal spread, we are going to take the horizontal time spread and move the long leg to a different strike. That's it! It's easy. Diagonal simply refers to choosing a back-month leg that is not the same as the front-month leg. Figure 1 contains the key relationships in terms of months and legs for our three types of spread constructions - vertical, horizontal and diagonal.
|Figure 1 - Spread types - months and strikes
To understand diagonal spreads, you first must understand differential time value decay, which we explained in the horizontal spread section of this tutorial. Unlike in a horizontal spread, when we go diagonal there are multiple combinations of possible constructions. A diagonal spread has only two possible strike combinations, which must always be the same. While it is possible to establish an out-of-the-money horizontal spread, the basic dynamic at work in diagonals and horizontals is the same - differential Theta.
Let's view an example of a diagonal call spread using IBM again. In this case, we will construct the diagonal with a credit (there are other possibilities) using puts instead of calls. Suppose we sell an out-of-the-money call at 90 and buy a further out-of-the-money call at 95. And let's say we sell the 90 in September and buy the 95 in October. If we sell the September for 50 and buy the October for 10, we would have the maximum profit at the short strike of 50 when September expires, as can be seen in Figure 2. This is easy to understand. If IBM trades up to the short strike of the diagonal spread and expires at that strike, we retain the entire $50 for selling the September 90 strike.
|Figure 2 - Diagonal call credit spread profit/loss
At the same time, the October 95 is going to have additional time premium on it as it is presumably now only five points out of the money (recall that when we put this on, IBM was trading at 82.5). Therefore, there also will be a profit on the long October 90 call, even though time premium decay will have taken some value out of the option. Let's say the October 95 now has $30 in premium. Taken together the total position at this point would have made $80 if closed out.
|Figure 3 - Diagonal put credit spread profit/loss
The advantages of using a diagonal spread for credit spread can be found in the potential gains on the long back-month option. In terms of position Vega, meanwhile, unless you go too wide on the spread between the nearby and back month options, you will have a positive position Vega - which gives you a long volatility trade, just like our horizontal time spreads seen above. What is interesting about the diagonal, however, is that it may begin at neutral or slightly position Vega short (typical if a credit is created when putting it on). But as time value decays on the nearby option, it gradually turns position Vega long. This works particularly well if using puts to construct the spreads because if the stock moves lower, the long option captures the rise in implied volatility that usually accompanies increasing fear surrounding the stock's decline.
When the diagonals are reversed, just as with reversed horizontal spreads, the spread experiences a flip to basically short Vega (loses from rise in volatility) and negative position Theta (loses from time value decay). The trade has the mirror image of potential profitability seen in Figure 2 and Figure 3. Generally, these trades should be constructed mostly with the idea of trying to profit from a quick change in volatility, since the probability of having a big enough move of the underlying is usually quite low.
Strike WidthThe difference between the strike price of an option and the ...
Inverse TransactionA transaction that can cancel out a forward contract that has ...
Reference EquityThe underlying equity that an investor is seeking price movement ...
Boundary ConditionsThe maximum and minimum values used to indicate where the price ...
Delta-Gamma HedgingAn options hedging strategy that combines a delta hedge and a ...
Gamma HedgingAn options hedging strategy designed to reduce or eliminate the ...
What types of investors are best-suited for stop loss orders?Use a stop-loss order to mitigate downside risk. Whether you are a conservative beginner or a seasoned day trader, a stop ...
How does a forward contract differ from a call option?Find out more about forward contracts, call options, the mechanics of these financial instruments and the difference between ...
What are common delta hedging strategies?Learn about common delta hedging strategies, including how to make a position in options delta neutral by offsetting risk ...
How do I determine the breakeven point for a short put?Learn how to determine the breakeven point for a short put. Shorting puts is appropriate for sophisticated traders who understand ...


text:
One of the most rewarding things that can happen when picking up an album from a band you're less than familiar with is being summarily blown away by it. The unexpectedness is everything. There are no preconceptions that you are going to love it, so it's a great feeling when you find that you do. Running From a Gamble, the second studio album from Chicago four-piece Company of Thieves, is the case in point. The band has a big, almost stadium sound full of urgency and strong dynamics, and the record has a genuinely coherent feel to it, with each song seemingly flowing from a central theme of taking chances and learning from them.
Singer Genevieve Schatz is very much to the fore, commanding the proceedings with rock chick vigor, assured in her full-on moments and quietly susceptible in the softer ones. There's a nice mix of songs with immediate hooks and clean melody lines like "Queen of Hearts", "Modern Waste", and "Look Both Ways", while "Death of Communication" has a particularly attractive descending melody line in the verses and a totally knockout chorus. All the songs here are illuminated by some truly great guitar work from Marc Walloch, descriptive organ, and a crisp, tight rhythm section that can also rock out with the best.
"Nothing's in the Flowers" is an example of the mellower side of the band, yet again it has some quite stunning guitar in the latter half that takes it to an altogether different place. It happens again on "Gorgeous Grotesque", a slow-burn blues that simply explodes into an orgy of searing guitar and fiery organ. There isn't a filler track in this entire collection, and it is equally clear that Company of Thieves does not take pigeonholing easily. The horn-driven "Tallulah" is a very decent slice of funk delivered with a Motown chorus line and a vibrant, highly charged vocal from Schatz.
It is a pleasure to listen to an album as well-crafted and original in its construction as Running From a Gamble. It's a record that doesn't get you reaching out for the usual "sounds like" comparisons. It has immediacy but grows on you with repeated plays. Producer Rob Schnapf also deserves credit for his intuitive approach to capturing the intensity of live music and bottling it in the studio. All in all, I'd be surprised if this record isn't up there when it comes time to compile album of the year lists in December.


text:
See other Playa del Carmen properties
Hotel Colorado Playa del Carmen
Calle 4 nte. between 20 y 25 Av. Col. Centro, Playa del Carmen, Mexico, Distance from city centre: 1.5km
Real Reviews
Real reviews from fellow travellers
These are trusted reviews from guests who have actually stayed here. We hope you find them helpful.
Note: we only give a property a rating once it has received a minimum of 3 reviews.
- Page:1/1
- " Good hostel and thought it was quite friendly. "
- 24 Apr 2015 Akhil Canada
- " Very large shared areas w. pool. Great atmosphere. Owner Marcus might een BBQ for you (bring your own food). -George Erikson "
- 25 Feb 2015 George USA
- " Perfect stay for my first night in cancun. Friendly staff and far enough away from the busy street to not hear the music. "
- 09 Jan 2015 Isabella England
- " Nice location, the room was clean and decorated into the Mexican hacienda style. The staff, I mean Jacqueline, was very professional and helpful. This women made my stay extra special with all her kindness especially when I had trouble with my credit card, she was there to reassured me! Thank you Jacqueline. "
- 22 Oct 2014 Anonymous France


text:
This hyperlink does not constitute endorsement by the Department of Defense, the U.S. Army, or Moncrief Army Community Hospital of the Web site to which this link leads, the information, products or services contained therein. For other than authorized activities such as military exchanges and Morale, Welfare and Recreation sites, Department of Defense, the U.S. Army, and Moncrief Army Community Hospital do not exercise any editorial control over the information you may find at these locations. Such links are provided consistent with the stated purpose of this DoD Web site.
Click the link below to proceed or close this message to return to the previous page.
EFMP is a mandatory enrollment program that works with other military and civilian agencies to provide comprehensive and coordinated medical, educational, special housing accommodations, community support, and personnel services to Families.
An Exceptional Family Member is a Family member (child or adult) with any physical, emotional, developmental, or intellectual disability that requires special treatment, therapy, education, training, or counseling.
Enrollment allows assignment managers to consider the documented needs of the exceptional Family members. When possible, the Soldier is assigned to an area where the Family member's needs may be met. This will depend on a valid personnel requirement (s) for the Soldier's grade, specialty, and eligibility for the tour.
Enrollment in EFMP does not adversely affect selection for promotions, schools, or assignments. Information concerning enrollment in EFMP or any of the data used in the program is not made available to selection boards. EFMP enrollment does not guarantee assignment deletions, deferments, or compassionate reassignments. All Soldiers are still eligible for worldwide assignments and enrollment will not guarantee that a Soldier will not serve an unaccompanied tour.
Special education needs are only considered in assignment outside the United States. Assignments within our 50 states and trust territories are not based on the educational needs of the children. Every local school system must obey public laws regarding the provision of special education.
Additional services include information and referrals, advocacy, support groups, respite care, and relocation assistance. However, enrollment does not guarantee special consideration for priority housing, appointments, or other benefits not routinely available to Families.
The Soldier or spouse goes to the EFMP office at Moncrief Army Community Hospi-tal to complete an enrollment form (s) for the assessment process to begin. Once the assessment is completed, the enrollment form (s) will be reviewed to verify accuracy prior to them being sent to Brook Army Medical Center for coding. Your enrollment is required to be updated every three (3) years or more frequently, if there are substantial changes.
Download DA Form 5888
- Family Member Deployment Screening Sheet
** The DA Form 5888 Family Member Deployment Screening Sheet is to be FORWARDED back to Strength Management after completion. DO NOT FORWARD TO FORT JACKSON EFMP OFFICE FOR PROCESSING WITHOUT GOING THROUGH STRENGHT MANAGEMENT OR MPD.
*** AUTHENTICATION...Without Authentication we can not process your document...
If you are Traveling Overseas and intend on taking your family members with you, your family members will need to obtain a head-to-toe physical from their Primary Care Provider. Or, you can download a DA Form 5888-1 and take to the Primary Care Manager/Provider to complete. If the family member (FM), is under 6 years old, they will need to have a (PDQ) / Denver Prescreening Developmental Questionnaire, that can be requested from the Ft. Jackson EFMP office. This can be emailed to your location.
Download DA Form 5888-1
- Screening of Family Member in Remote OCONUS Areas
On the DA Form 5888-1, if any boxes are checked yes, this authorizes the screener/medical provider to complete the DD Form 2792 Medical Enrollment or DD Form 2792-1 Education, and look further into evaluating the individual for requiring environmental/architectural considerations. Attach this page to DA Form 5888 (Family Member Deployment Screening Sheet).
Download DA Form 7246
- EFMP Screening Questionnaire
The DA Form 7246 needs to be completed by the Sponsor or Spouse. List all family members that are are accompanying the Sponsor overseas. The Family Member Prefix is (#30 for the spouse, #31 if it is the second, #32 for third… If it is your child, it would be how they are annotated in DEERS. 01 for first child, 02 for second, 03 for third...). Please answer all questions. Do not leave any blocks blank. THIS ONLY DELAYS YOUR PAPERWORK... Sign the back of page 2, where it states, "Sponsor or spouse completing this form." Our provider will sign this form. DO NOT TAKE THIS FORM TO YOUR PROVIDER.
Download DD Form 2792
- Family Member Medical Summary
** COMPLETE DD FORM 2792 AND 2792-1 if you are Enrolled in EFMP or Have a Chronic Medical Condition or Individual Education Plan...
If you have a Medical Condition and you are not sure if that medical condition meets the criteria for enrollment, please contact Fort Jackson's EFMP office before you start the process, so that we can assist you further. Once you have determined that, you need to complete the DD Form 2792 or 2792-1, this is how they need to be completed...
Instructions for Completing DD Form 2792. Family Member Medical Summary:
Please read, print and sign page 1. Put your Relationship to the Patient. DO NOT DATE UNTIL AFTER THE THE PROVIDER HAS COMPLETED THEIR PORTION OF THE FORMS.
Page 2 – Please complete in it's intirety. If you are the parent, please sign for the child. * If the child is 18 or older, the dependent has to sign for themselves* Sponsor's can not sign for their spouse. NOT DATE UNTIL AFTER THE THE PROVIDER HAS COMPLETED THEIR PORTION OF THE FORMS.
Page 3 – 11 - Complete the TOP PORTION ONLY Demographics…..
Pages 4-7 (Medical Summary) These pages are completed by the Specialist: Please ensure that the Medical Specialist provides Prognosis, Treatment Plan and Frequency of care for the Diagnoses the patient has. If you require a Summary Report to take to your provider, please contact us AHEAD of time, so that we can accommodate you. If your dependent has: Environmental / architectural consideration or Adaptive equipment / special medical equipment, you will need to have the provider annotate the make and model information on page 7 of the DD Form 2792.
Page 8 - Addendum 1 – Asthma/Reactive Airway Disease Summary: *If there is a Diagnosis of Asthma/Reactive Airway Disease (RAD), pages 4-7 needs to be completed as well as page 8. This page is completed by your Provider ONLY. If the dependent has been evaluated or treated for asthma or RAD within the past 5 yrs.
Page 9 and 10 – Addendum 2 – Mental Health Summary: To be completed by a Qualified Clinical Provider. If there is a Diagnosis of Mental Health, pages 4-7 needs to be completed as well as pages 9 and 10. The Mental Health Summary should be completed by the Mental Health Provider (i.e., Psychologist, Psychiatrist, Mental Health Counselor).
Page 11 – Addendum 3 – Autism Spectrum Disorders and Significant Developmental Delays. If your dependent has been diagnosed with an autism spectrum disorder, pages 4-7, and pages 9, 10 and 11 will have to be completed by the provider.
ALL DEMOGRAPHIC BOXES OF THE DD FORM 2792 MUST BE COMPLETED ON ALL PAGES 3-11. DO NOT SIGN DOCUMENT UNTIL AFTER SEEING PROVIDER. ** If your dependent is also on an Individual Education Plan (IEP), complete the DD Form 2792-1.
Download DD Form 2792-1
- Special Education/Early Intervention Summary
This form is completed by the parent and school or Early Intervention Staff. The Sponsor or Spouse should complete all the demographic information on page 2 of 3 Pages, from 1-8d. On page 3, complete 1a – 2d. After completion of the top portion of page 3, present DD Form 2792-1 to school. Early Intervention Staff will complete the remainder of form 3 – 8, and return to parent or guardian. The completed DD Form 2792-1 should be returned to Fort Jackson, EFMP office by parent/guardian for processing.
* A copy of the most current (IEP) Individual Education Plan is required on enrollment/update at the office*.
The following Soldiers with exceptional Family members must enroll in the program:
Department of the Army civilian employees do not enroll in the program. However, they must identify dependent children with special education and medically related service needs each time they process for an assignment to a location outside of the United States where Family member travel is authorized at Government expense.
Moncrief Army Community Hospital 4500 Stuart Street Ft. Jackson, SC 29207, 8th Floor, Room 8-36
Tuesday thru Friday, 0800 to 1130 and 1300 to 1600
Tuesday 0900 to 1100 and Thursday 1300 to 1500
Office: (803) 751-2505 DSN: 734-2505 Fax: (803) 751-6657
Click the image below to go directly to our ICE Comment Card.
Click here to download the Exceptional Family Member Brochure
This page has been visited 7763 times.


text:
The Elbert County Blue Devil basketball squads travelled to Watkinsville, Georgia yesterday to take on the Oconee County Warriors. Both squads came away with victories.
The Lady Devils had trouble getting their shots to drop early in their game with the Lady Warriors. However, by the end of the 2nd quarter the Lady Devils were on fire and on an 18 to 4 run that saw them up 29-21 at the half. Coming out of the half the Lady Devils would continue their dominance and win 66-41. Jimerra Hill was the Tri-County Technical College player of the game with 18 points. Bri Moon had 15 and Kara Ledbetter coming off the bench had 12.
The Blue Devils also came out slow in their game in Oconee County. The Blue Devils led at the half 37-31. Terell Hughs led with 13 points going into the half and would come out in the second half continuing his good play. Hughs would be named the Tri-County Technical College player of game as he finished with 18 points. Randy Jones would have 13 and Ben Routh 12 in the 78-59 victory.
The Blue Devil Basketball squads will be back in action to take on Hart County this Friday in the Inferno.


text:
Click Here to Watch the Whole Video in HD at Cocky Boys
It's Hotter in Southern California: Kyle Majors Cocky Boys! The Men are hotter in Southern California: COCKYBOYS.COM
Don't let Joey's last name fool you - this kid ain't no angel - not unless they started handing out dildos in heaven. This toned tatted hottie starts off by working out on the punching bag but then quickly decides to show that he ain't afraid to work out his hole too. Lucky for me (and you) he's not shy about it either! This kid makes his way through three different dildos and even uses his punching bag to bounce up and down on while he fucks himself on one - all the while jerkin' off his hot cock. After filling his hole up, he's finally able to shoot his load all over his tight washboard abs and even treats himself to a taste of his own cum. Dirrrrrrty.
Pixels: 320X240 | Bitrate: 350K
Pixels: 640X480 | Bitrate: 700K


text:
Full detailed profile on Mickey Horton Played by Kevin Dobson on Days of Our Lives Daytime Soap Opera.
Kevin Dobson (Guignebourg/JPI)
Birthday: March 18, 1943
At Chez Rouge, Mickey tells Maggie, "You know, red, I have a hard time saying no to you," when she thanks him for taking a chance on EJ.
Back at their table, Sami warns EJ not to make Mickey look bad. Mickey stops by and notices them arguing. He comments they're like an old married couple. Mickey leaves them alone and EJ thinks she made Mickey uncomfortable. He tells her the man is his future employer. She says that they need to stop arguing and she has a plan. EJ says he likes arguing with her.
« Back to Mickey Horton profile


text:
"How Educators Around the Globe are Using the Dynamic Environment of Simulation for Effective Teaching"
On this web site you will find information on the conference program, registration, call for papers, accommodations, travel and other necessary information. Visit this site frequently for updates on the latest conference news!
The conference will include:
Accommodations have been arranged in the historic town of Plymouth, MA, a short distance from the campus of Massachusetts Maritime Academy. Transportation from Plymouth to MMA will be provided daily.
A downloadable and printable informational Flyer for the conference can be found by clicking HERE.
We would very much appreciate your registration for the conference as soon as possible. We look forward to hosting this meeting and seeing all of you in September 2014!
Questions about the conference can be sent to: email@example.com
We'd like to thank Transas for their Admiral's level sponsorship!
last updated 5-16-2014 by email@example.com


text:
Franchise Encyclopedia ▪ 1977-78 Kansas City Kings ▪ 1979-80 Kansas City Kings
Record: 48-34, Finished 1st in NBA Midwest Division (Schedule and Results)
Coach: Cotton Fitzsimmons (48-34)
PTS/G: 113.1 (7th of 22) ▪ Opp PTS/G: 110.2 (11th of 22)
SRS: 2.73 (5th of 22) ▪ Pace: 107.3 (5th of 22)
Off Rtg: 104.5 (9th of 22) ▪ Def Rtg: 101.9 (4th of 22)
Expected W-L: 48-34 (6th of 22)
Arena: Kemper Arena ▪ Attendance: NA
NBA 1979 Playoffs:
Lost NBA Western Conference Semifinals (1-4) versus Phoenix Suns (Series Stats)
Our primary support comes from users like you. Sponsor this page for $10. Your message will replace this ad.
Transactions listed are from July 1, 1978 to June
30, 1979.
Click on the Team for team roster and stats.
Click on the Player for career stats and accomplishments.
July 10, 1978
Traded Geoff Crompton to the Denver Nuggets for a 1981 4th round draft pick (Kenny Dennard was later selected).
September 14, 1978
Signed Marlon Redmond as a free agent.
Signed Billy McKinney as a free agent.
September 18, 1978
Kevin Restani signed as a veteran free agent with the Milwaukee Bucks; received FROM_TRADE as compensation.
October 2, 1978
Waived Jeff Cook.
October 11, 1978
Waived Mike Evans.
October 27, 1978
Signed Gus Gerard as a free agent.
February 2, 1979
Waived Marlon Redmond.
March 9, 1979
Signed Ron Behagen to a 10-day contract.
March 20, 1979
Waived Marlon Redmond.
March 29, 1979
Waived Ron Behagen.
April 9, 1979
Signed Lars Hansen as a free agent.
June 25, 1979
Drafted Russell Saunders in the 10th round (200th pick) of the 1979 NBA Draft.
Drafted Reggie King in the 1st round (18th pick) of the 1979 NBA Draft.
Drafted Terry Crosby in the 3rd round (62nd pick) of the 1979 NBA Draft.
Drafted John McCullough in the 4th round (85th pick) of the 1979 NBA Draft.
Drafted Curtis Watkins in the 5th round (105th pick) of the 1979 NBA Draft.
Drafted Bob Roma in the 6th round (126th pick) of the 1979 NBA Draft.
Drafted Nick Daniels in the 7th round (145th pick) of the 1979 NBA Draft.
Drafted Tony Vann in the 8th round (164th pick) of the 1979 NBA Draft.
Drafted Gary Wilson in the 9th round (181st pick) of the 1979 NBA Draft.


text:
Our Mission:
The First Presbyterian Church of Midwest City exists to proclaim Gods glory through word and deed.
Recognizing that we live in a changing society, we endeavor to bring people to Christ through these ministries:
· Worship
· Prayer
· Ministry to the community
· Spiritual care
· Christian education
· Mission and service opportunities
Since its beginning, First Presbyterian has been an active congregation, committed to worship, Christian education, mission and service to Christ. We have been blessed with strong leadership from members and pastors. When one enters the doors of the church on a Sunday morning, Gods spirit is alive and welcoming to all who are present. We are ready to fellowship, study, serve, and worship, and that spirit is contagious to all who visit the congregation.
As a congregation, we believe that our ministry is to work toward fulfilling a vision of the world that is without conflict, hunger, pain or despair; a world in which everyone is able to achieve his or her God-given potential. Our primary goal is to share the good news of Jesus Christ as expressed to us through the scripture and serving the God who is at work in the world. We welcome and invite others to come and see what motivates us to participate in the ministry in which we are involved. Our ministries in the world already include engaging with Eastside Elementary School, crafting hand-made items for those in need through Create-to-Share, and supplying non-perishable items for local food pantries. There is a prevalent understanding in the congregation that ministry happens when we open ourselves and our doors to our community and it is exciting to think about where that understanding will lead this congregation.
The church was established in what was the first square mile of the city. One of the biggest assets of Midwest City is Tinker Air Force Base, which focuses on air logistics and communication. Many folks in the greater Midwest City area came to experience this city while they were stationed here, and have ended up retiring in this area and putting down deep, permanent roots. The church is next door to an elementary school, and we have a great relationship with these children.
As we look at the reality of our context and the vision of the gospel we discover our call to go into the world and do to others as Christ has done for us. In increasing our ministry so we may be more faithful to God, we believe we will build relationships and partnerships that will enrich us as a congregation and in turn challenge us to understand our discipleship in new and exciting ways. Some of these early attempts to connect with our community will include expanding childrens ministry, coordinating need response with neighborhood churches, developing a community garden, and enhancing our older adult ministry. We realize that these hopes and dreams challenge us to be responsible stewards of our time, talents and money as we engage in the holy work of fulfilling the gospel.
We realize that our vision may require resources beyond those currently available within our church. We also realize that some infrastructure and staff must be maintained in order to support efforts to achieve our vision. To meet these challenges we need to inspire stewardship among our members, encourage growth that will develop out of our ministry with the community, and solicit needed services and resources from agencies and corporations outside the faith based community.
Who knows where the next sixty years will carry this congregation? But with the wind of Gods spirit blowing, the amazing enthusiasm of this worshiping community, and the belief that our purpose is to serve God to the best of our ability in this place, there is very little that can limit where the future will take us as we minister in Gods name.
Home Page | Staff | News | Calendar | Email Comments | Street Map | Links | Newsletter


text:
H&R Block and Liberty Tax have been expanding from traditional tax preparation services into other areas such as bookkeeping as they reach out to service small business clients year-round, giving traditional accountants some extra competition.
On Tuesday, Liberty announced a bookkeeping service built around the cloud-based accounting software Kashoo. The new bookkeeping service, dubbed Liberty Accounting, is intended to help Liberty Taxs 4,400 franchisees expand beyond tax season and provide additional services besides tax prep and filing.
The number one tax prep chain, H&R Block, recently announced plans of its own to attract CPAs and other accountants into selling their practices to Block or becoming franchisees (see H&R Block Reaches out to Attract Accounting Firms). In conjunction with that effort, Block also said it would start offering bookkeeping and payroll services to small businesses through cloud technology.
Competing tax chains such as Jackson Hewitt and TaxSlayer are still sticking to their core tax prep services, but if they see significant growth from Block and Liberty, they could be induced to change their minds.
This isnt entirely a new trend. Individual franchisees for Block have already offered services such as bookkeeping and payroll in the past. Another franchiser known as BookKeeping Express offers bookkeeping services to small businesses through its franchisees. Block made a major move into the accounting field in 1999 with RSM McGladrey, operating what it called an alternative practice structure in conjunction with the CPA firm McGladrey & Pullen before selling the business back to McGladrey in 2011.
Block has tried other financial businesses in the past, such as the ill-fated Option One subprime mortgage business that it was forced to sell at a heavy loss in 2007. In this case, Block does not appear to be making such a heavy bet and is mainly out to attract small CPA firms whose owners are looking to retire or planning for an eventual exit.
If the idea catches on, small accounting practices could find themselves competing against Block, Liberty and perhaps other chains for their small business clients and will need to diversify further by adding extra services to avoid being lumped in with the franchises.
Do you think H&R Block and Liberty Tax will provide serious competition to traditional accountants in the small business market?
12 Comments
To: sroth
Do you happen to know that some of the Liberty's Franchisees are pulling a real fast one on the community they suddenly open up office? I know for a fact of TWO Franchisees that opened; office in two different communities and took everyone for everything they could! Once in the office were opened, they snowed the owner of the building into waiting for the rent payments till the 15 of April...Well yes, you guessed it...The fifteen of April came and the landlord was told "We are so busy today......can you came back tomorrow?" Innocent enough, right??? Well the morning of the 16th the Liberty Franchisees were so...long gone.....it wasn't funny! They emptied the office of all the furniture computers and files in the middle of the night and...VOILA'....they were gone! Know anyone like those two? And to whom would a property owner complain to?? No one! Definitely NOT Liberty...I think Liberty should vet their Franchisees far more carefully...and make sure they are not thieves and scammers... They left such a bed test on everyone's mouth that I am positive they ruined it for all the other Liberty Franchisees in the area ...Not that I care.... Just saying....
Posted by: SNAFU | September 8, 2014 4:54 PM
There are differences between bookkeeping and accounting, between what bookkeepers do and what controllers/CFOs do. If our practice was only on the low-end, I would be worried. But H&R Block and Liberty are not serious competitors for higher-order financial operations and strategic financial advisory services. Nonetheless, that could change, and underestimating competitors has been the undoing of many previously-successful firms...
Thomas D. is right; CPA firms need to be exploring cloud-based outsourced accounting services to move beyond commodity tax, assurance and old-fashioned write-up work.
Check out my outsourcing blog at www.virtual-lucidity.com.
Posted by: jjcaru | September 7, 2014 6:08 AM
I just fired one of HR Blocks finest with 11 years of experience and bookkeeping experience too. I found out that her tax work was never reviewed and that she had relied on the CPA to find her bookkeeping errors at her other jobs. When I keep finding errors and tried to ask her about them, she told me she had really just been a data input person. Oh, but she is an EA. If this is what these business are planning to hire, good luck to the public.
Posted by: fluffster | September 4, 2014 4:12 PM
Bundled, fixed price small business cloud bookkeeping and payroll services represent a tremendous opportunity for accounting and tax professionals. Any firm that doesn't see this and adapt to the fundamental change of cloud apps will see declining customer counts, revenues and profits. The marketplace is in charge of all of this, folks.
Posted by: whitelist | September 4, 2014 2:52 PM
Based on the quality of the chains' tax preparation service, bring 'em on. This should provide an additional source of referrals as soon as the screw-ups get out and the notices flood the mails. I don't know whether it's H&R or TurboTax, but both provide a pretty steady source of new business.
It's pretty funny, unless of course, you're the taxpayer.
Posted by: topbeancounter | September 4, 2014 1:23 PM
I agree with the above comments. You cannot trai someone to be a good bookkeeper or a tax return preparer in 90 days. They can't do tax returns properly and I expect the same resuklts from their bookkeeping attempts. I'll be happy to rescue anyone who starts with any of these services.
Posted by: joeltaxpro | September 4, 2014 12:36 PM
I agree with ontargettax. Many of my clients came to me after the IRS contacted them on a return prepared by one of the tax chains. You cannot train a bookkeeper in 90 days. A client used Kashoo and found it acceptable for a A/P and A/R but extremely clunky and difficult to use for anything else. I expect my business to increase because of this.
Posted by: Andrew H | September 4, 2014 9:24 AM
I do see Liberty Tax being competition for the CPA's and small bookkeeping firms, for one many of Liberty tax franchisees already have that small business bookkeeping incorporated in to their business plans and are already attracting them to move over, as far as pricing our bookkeeping and payroll rates are far less then the competition out there so its just a matter of time that small businesses who are already watching their budgets to come over to Liberty for great pricing and outstanding customer service, I can speak for myself and as a Liberty Tax franchisee with over 15 yrs experience in the bookkeeping and quick books area along with payroll that we are now training our managers on this side of the business and for me most of my employees already have that knowledge. so I believe in my area that we are going to have an impact as this is just another avenue for clients to come over from the high paying CPA firms and build relationships with us.
Posted by: sroth | September 2, 2014 10:05 AM
"Ontargettax" makes excellent observations. It is doubtful that the large franchises have the ability to provide the training and required software technology for the employees that their low wage structures will be able to attract.
Franchisees with inadequate professional education and management experience may well drive business to well established, but unmarketed accounting practices.
Accountants' World and a few other companies already have cloud based suites of accounting and other applications that will provide strong competition to the tax franchisee firms.
Posted by: Pewsbury | August 29, 2014 5:21 PM
No. I don't think they will be competition.
Posted by: Sue H | August 29, 2014 11:34 AM
That's just what I was looking for... someone to give a 30% royalty to, for my business model!
Posted by: ShammahRama | August 29, 2014 10:39 AM
Competition...if they charge for bookkeeping like they charge for tax prep; NO. If they undercut us on price then , yes. But with their history of paying employees slightly better than minimum wage, I'm not sure where they are going to find all of these qualified bookkeepers. One must remember garbage in, garbage out. They cannot train a bookkeeper in 90 days even to do the simplest set of books. With the software they are using, most info will be by bank and credit card download; you just have to assign the correct account. But how about assets and liability accounts and COGS and general journal entries? a newbie won't be able to do them. and having once worked for them as a multiple store manager; i wouldn't want to supervise a bunch of green bookkeepers. It's bad enough supervising beginning tax preparers; at least W-2's have all the same info on them. Any business owner who approaches them for bookkeeping needs to ask the following question; how long has the person who will be doing my bookkeeping been doing bookkeeping and what are their credentials?
Posted by: ontargettax | August 29, 2014 10:24 AM
Add Your Comments...
Already Registered?
If you have already registered to Debits & Credits, please use the form below to login. When completed you will immeditely be directed to post a comment.
Not Registered?
You must be registered to post a comment. Click here to register.


text:
- Subscribe to ORV Trail updates from Michigan DNR
- ORV/ATV Riding in MichiganMichigan offers many trail riding opportunities. Michigan's public Off-Road Vehicle (ORV) trail/route system provides four types of riding opportunities: motorcycle trails, all terrain vehicle (ATV) trails, ORV routes which are open to ORVs of all sizes including Secretary of State licensed vehicles, and scramble areas.
There are five scramble areas, two of which are on state forests (St. Helen's Motorsport Area and Black Lake Scramble Area), one at Silver Lake State Park, one at Bull Gap in the Huron National Forest, and one at The Mounds, a Genesee County Park. Please note that a Recreation Passport is required for entry into Silver Lake State Park. Check with the land owners of the other scramble areas for entry requirements in addition to an ORV license.
The ORV trail/route system covers 3,700 miles with 73% on state forests. Of the system, 30% is cycle trail, 50% is ATV trail and 20% is route. In the Lower Peninsula, the system is the only legal place to ride Non-Secretary of State licensed ORVs on public lands other than frozen waters. In the Upper Peninsula, it is legal for ORVs to operate on state forest roads as well as the designated trail system, unless a specific state forest road is posted closed to ORV use. Trails are lightly groomed and riders are likely to encounter narrow sand trails, rough moguls, steep hills, stumps, rocks, brush, loose surfaces and other hazards.
Learn about the restructuring of hunting, fishing and ORV licenses
- ORV License Structure Chart
ORV Advisory Workgroup
- ORV Advisory Workgroup The purpose of the Off-Road Vehicle Advisory Workgroup (ORVAW) is to assist the Michigan Snowmobile and Trails Advisory Council (MSTAC) in performing the duties and responsibilities of the MSTAC and to provide the Department of Natural Resources (DNR) advice related to the off-road vehicle program. This includes advice related to the creation, development, operation, and maintenance of the designated ORV trail system.


text:
Oscar-winner Denzel Washington and Star Trek's Chris Pine team with action director Tony Scott in this non-stop thriller. A massive unmanned locomotive, nicknamed "The Beast" and loaded with toxic cargo, roars through the countryside, vaporizing anything put in front of it. A veteran engineer (Washington) and a young conductor (Pine), aboard another train in the runaway's path, devise an incredible plan to try and stop it - and prevent certain disaster in a heavily populated area. See my review before you catch this train wreck. http://www.flickedup.com/
FlickeduP is a movie review show from a film critic who has been reviewing movies for many years. Brett Martin is a long-time member of the BFCA (Broadcast Film Critics Association). He has interviewed nearly every A-list movie star in the past 10 years.


text:
From "Can Percent Free Prostate-Specific Antigen Reduce the Need for Prostate Biopsy?" Effective Clinical Practice, November/December 1999. 2:266-271.
Figure 1. The Kaiser Permanente study. Although free PSA was measured after prostate biopsy, the observers were blinded to the biopsy results. In clinical practice, the order of testing would be reversed.>


text:
Nest Fest
Real estate news in San Antonio.
Posts filtered on Tag
Transwestern fills office space
KBS Realty Advisors, which owns the Corporate Square Tower office building at 4801 NW Loop 410 near Callaghan Road, has signed two new leases. The MCS Group Inc., a company that provides outsourcing to law firms and insurance companies, signed a new lease. The company is relocating from the Lincoln Center office building. THH Acquisition […] [Read More]


text:
NEW BRITAIN, Conn. – Freshman DeAndray Buckley (Romulus, Mich.) and senior Tyrone Conley (Burlington, Vt.) scored 12 and 11 points, respectively, but the University of New Hampshire men's basketball team dropped a 71-50 decision to Central Connecticut State University on Wednesday evening at Detrick Gymnasium.
The Wildcats fall to 5-5 on the season, while the Blue Devils improve to 6-5.
Buckley, fresh off a career-best 11-point performance at Rhode Island on Dec. 18, was 3-for-7 from the floor as he earned America East Player of the Game honors. Buckley added five rebounds, two assists and two steals in a career-high 28 minutes. Conley was 3 of 8 from the floor, including 2-for-4 from behind the arc, and also pulled down five boards in 23 minutes.
Ken Horton led the Blue Devils with 19 points and eight rebounds.
With the game tied at four just 2:20 into the game, Central Connecticut ripped off a 24-3 run to take a 28-7 lead with 5:36 to play in the opening half. The Wildcats cut it to 30-10 just over a minute later when five straight points opened the Blue Devils' lead to 25 with 3:26 left. Three straight points from Conley made the deficit 22, but a Joe Efese layup with three seconds on the clock closed the scoring and gave CCSU a 37-13 advantage heading into the break.
Conley kicked off the second half with a 3-pointer that cut it to 21, but with the deficit the same (43-22) with 15:48 remaining, a 13-0 run gave Central Connecticut its largest lead of the game at 56-22 with 12:46 to go. After the teams traded baskets, a 6-0 run – capped by a Scott Morris (Walkersville, Md.) trey – made it 58-30 with 10:47 left.
The gap was still 28 (71-43) with 1:29 to go when the Wildcats closed the scoring with seven straight points – two layups from freshman Kazadi Nyanguila (Montreal, Quebec) and a 3-pointer by Buckley as time expired.
Morris matched his career high with six points, while Nyanguila also finished with six – the first points of his career. Senior James Valladares (Kaufman, Texas) netted seven points and junior Brian Benson (Rochester, N.Y.) matched his career high with nine boards and set a new career best with five blocks.
Central Connecticut outshot UNH, 44 percent (27-61) to 31 percent (16-51), from the floor and forced a season-high 24 turnovers while only turning it over 11 times themselves. The Wildcats won the battle on the glass, 42-38, including 17-12 on the offensive end.
The Wildcats break for the Christmas holiday before returning to action Wednesday, Dec. 29 (5 p.m.) against Cornell University in the first round of The Richmond Marriott Holidays on the Hardwood Classic at Virginia Commonwealth University's Verizon Wireless Arena.


text:
Ways to get involved in promoting the Victorious Gospel
0 Members and 1 Guest are viewing this topic.
Hi Paul. Thanks. It sounds to me like the Bible was used, as one vehicle, to reinforce what was already in someone's (unfortunately, your parents) heart - whatever the source of that was. Blessings to you on your jouney of recovery from that.About anything can be used properly and for good, or misused for harm and destruction. I believe that's from the condition of the human heart (or mentally ill mind, etc.) - and though the Words of God are obviously good, a demented mind can twist them and hurt with them. They crucified the Savior. He is risen.
and then suddenly.Matthew 25: 8-10


text:
Pamella's a hit with Kinks star
Posted: February 07, 2013|
A singer has described as "truly memorable" a mentoring session with rock legend Ray Davies.
Pamella Moo, of Thorpe Astley, won the chance to meet and play her music for the Kinks frontman in a competition on a music website.
She recorded a cover version of The Kinks' hit Sunny Afternoon after the band invited musicians to interpret any of their tracks for the competition on the website Talenthouse.
The band specified the cover should express the musician's creativity and originality.
Pamella, formerly a backing singer with Leicester Community Gospel Choir, who went solo two years ago, said: "It was truly memorable. I just had probably the best day I can remember.
"It was really nice to meet him, he's a lovely guy
"The sound engineer recorded four songs, three of my own and the cover version of Sunny Afternoon."
Pamella, guitarist Benn Hartmann, sound man Edgar Peyton and Luke O'Downie, had filmed a video in Leicester's Abbey and Western parks last summer to accompany the entry.
At the meeting with the 69-year-old legend, Pamella, who works at Sainsbury's in Fosse Park, was given tips on how to further her music career.
She said: "Ray was really interested in the video we had made to go with the song and asked what we had used to film it. I told him it was a £50 camera from Argos.
"He said I'd got a good sense of humour and he listened back to my songs including Blue, an acoustic soul song which he was rocking his head to.
"Ray said it was crying out for a drummer and he told me three times to get a band, so that's the next step."
Pamella, who went to the band's Konk Studios in north London, with guitarist Benn, said: "The songs we recorded are for me to use as demos to approach record companies."
Pamella will be at The Musician, in Clyde Street, Leicester, on Monday supporting Wave Pictures.
Her winning competition entry is at:


text:
MIDI Clock is a measure/beat driven pulse clock or "beat clock". It includes Play, Stop, Forward, and Backward commands as well as tempo data. MIDI clock also has the unique ability to slew to tempo changes, i.e. speed-up or slow-down when driven by a tempo map for example. A master sequencer such as Tracktion generates MIDI clock and controls the tempo map. This clock is then sent to hardware-based rhythm machines, outboard sequencers and other software-based synth/sequencer combo programs such as Reason. These devices and programs usually benefit from external tempo/measure control because they are often slaved to a master sequencer and this is why they are capable of receiving MIDI clock.
Why use a tempo map? Just listen to a rhythm machine - playing at a perfect tempo. Is that really the 'feel' you want? Have you noticed a phantom tempo?
So what is a real drummer (or band) really doing with respect to tempo when playing a song? Does he/she suddenly speed-up at the beginning of the chorus? Not at all. The drummer actually anticipates the arrival of the chorus and ramps-up the tempo in the last measure (or half measure) leading up to the chorus. At the end of the chorus, the ramp-down is (in many cases) even quicker. The tempo of the second verse (and subsequent verses) may be 1 or 2 beats per minute faster than the first. These tempo changes are very subtle. Towards the end of the last chorus - the tempo might also need to be a few beats per minute (bpm) faster than the preceding choruses. If the chorus is extended - the tempo changes would happen (approximately) at the top of each 8 or 16 measure section. Also, at the very end of the song you might want to dramatically ramp-down the tempo just as a drummer might.
Note: Tracktion includes a tempo ramp feature just for the reasons stated above.
What affect might a tempo map have on program/sysex changes, or controller data originating from your master sequencer? As the tempo slews and the MIDI project slows down or speeds up - program/sysex/controller changes are also being altered in time just as MIDI notes are (and anything else in the project) so happily, all outboard effects patches (for example) also change with respect to tempo and time in your project. It should be noted that the 'audio event start time' is also affected (if your sequencer is also playing audio) but the speed in which the audio event plays is not - this has to do with logic/DSP regarding 'time compression/expansion while retaining pitch' and affects synchronization (see below). This is an insurmountable problem for most software programs to overcome and there are no simple solutions. It is more a question of forecasting or anticipating obstacles that accompany tempo maps, and is a discipline in and of itself - hard earned by engineers, producers and composers alike. Some MIDI/audio programs offer time/pitch tools for adjusting audio tracks but keep in mind, this involves heavy DSP and should be avoided unless absolutely necessary.
See Locking Tempo Map below.
"Don't be tempted to change the map mid-stream i.e., after you have started to record musicians"
So it becomes clear - the difficulty is, getting the map 'right' when you haven't even started tracking the session players. How can this really be done? Well, using a drum machine when building the tempo map is very important. But even more important - setup a session just prior to tracking where the drummer and bass player (or the entire band) can jam to the map. They can then, 'weigh-in' and help you fine tune the map before the dreaded lock-down.
The bottom line - when used correctly, the tempo map should be transparent i.e., not noticeable unless you are going for a 'dramatic change'. Tempo maps help add a more organic feel to music that originated from a software-based sequencer.
Press |
Register a product |
Dealer Locator |
Jobs |
Corporate Info |
Legal |
Alvarez |
Ampeg |
Copyright ©
LOUD Technologies Inc. All Rights Reserved.


text:
, Don't Miss Your Next Issue. Renew Now!
You are required to update your information once a year in order to continue receiving your complimentary subscription to Financial Planning magazine. Renew your subscription today so you don't miss any of our special issues. Don't lose your subscription to another qualified professional by not renewing.
Renewal deadline Monday, August 3, 2015
Renewal deadline Monday, August 3, 2015


text:
Oceania Hotels > Special offers
Our special offers
Flash sales!
Offer valid from 31-07-2015 to 31-12-2015
5 days to book with up to 31% off!
From €51 for 2 pers.
Summer offer
Offer valid from 01-07-2015 to 31-08-2015
Celebrate our 40th birthday with us, and take advantage of an exceptional summer deal !
From €59 for 2 people
Family Offer
Offer valid from 21-07-2015 to 30-08-2015
Family offer
From €85 4 people
Early Booking
Book in advance and take advantage of the best rates!
From €53 for 1 person
VIP Night
Treat yourself with a VIP moment and champagne!
From €89 for 2 persons
Weekend Rate
Take advantage of the week-end rates with Oceania Hotels.
From €59 for 2 persons, breakfast included
Smart weekends
Profitez pleinement de votre week-end en choisissant le package de vos envies ! Un Week-end Malin chez Oceania Hotels, c'est une offre week-end clé-en-main !
From €100


text:
Click here to download January 28, 2007-February 1, 2007 theater listings.
This entry was posted
on Monday, January 29th, 2007 at 12:00 am and is filed under TFP Version 1.
You can follow any responses to this entry through the RSS 2.0 feed.
Both comments and pings are currently closed.
Comments are closed.


text:
"Great quality, perfect colors. fast shipping. We used these as labels for the top of a small mason jar for wedding favors. Perfect fit."
"I loved everything about this gift tag! Looked great on clear cellophane goodie bags for my son's Star Wars themed birthday party."
"We ordered these stickers to be placed on the gifts given out at a baby shower. They pulled everything together. From the invites to the thank you cards, everything coordinated and looked polished and professional."
"We had a hot air balloon theme that had banners hanging, and this sticker was a PERFECT way to send off our guests. We used these on his party favor bags, and it just looked really adorable."
"I ordered these labels to place on favor bags for my husband's 50th birthday. They look exactly as shown. They were shipped quickly and I received them earlier than I expected,which helped a great deal. I would certainly order from here again!!"


text:
Funny how fate plays a part in life, especially with baseball.
In 1994, the Dodgers were destined to host the Braves for a series over Labor Day Weekend, but on August 12 that year, the season was canceled and that weekend series never took place, putting my first Braves game on hold - one that would have happened on my birthday.
The next summer, on a family vacation through Northern California, we stopped in San Francisco for the night. My mother, a baseball fan herself, asked me to see if the Giants were in town and who they were playing. To my surprise, they were in town, and hosting Greg Maddux and the Atlanta Braves.
I can vividly recall that game. Sitting in the upper reserve seats well above the third-base line, wearing my Braves sweatshirt, the only Braves gear I had at that time, and chopping as loud as I could as the Braves won 5-1.
I've seen the Braves as often as possible over the years, catching them in Los Angeles nearly every year since 2002, as well as their two ventures down the I-5 from Dodger Stadium to Angel Stadium, and even further down at Petco Park.
Last summer, I planned a trip to Chicago, wrapping the trip around a cousin's wedding in Wisconsin. Luckily, both teams were in town, as the White Sox hosted the Rangers, but where fate really played in was when I looked at the Cubs schedule - they were hosting the Braves the day my brother and I got back to Chicago.
How could that have worked out any better? Seeing the Braves at one of America's most iconic ballparks, Wrigley Field.
This season, I've made sure I have caught the Braves as often as possible.
In April, the Braves visiting the Dodgers, and Chipper Jones celebrated his 40th birthday in prime fashion, hitting a home run and playing a key part in each of the Braves two wins that series.
With the club visiting Fenway Park in June, I knew I could not pass up another iconic ballpark, especially in a city the Braves franchise began.
In August, with my birthday nearing and the Braves visiting both San Francisco and San Diego in the span of a week, I made arrangements to see the club at least once in each city, with the Braves winning both games I attended.
It has been a memorable summer for me. Not only have I seen the Braves seven times in four different cities, I've also stepped foot into Cooperstown and gotten to kiss the Stanley Cup after the Los Angeles Kings victory.
But this upcoming weekend, while it may bring tears to my eyes as I type, is one I will long remember for years to come.
As we all know, Chipper is set to retire at the end of the season, whenever that may come. Earlier this summer, I pushed away the thought I would be able to afford this weekend, knowing after taking 10 days off to volunteer at the Little League Western Region Tournament and an 8 day drip in June, it would be very difficult.
But with the help of a few people, most notably my father and one Braves season ticket holder, they have helped make my second journey to Atlanta possible.
Leading up to this weekend, I couldn't help but realize how lucky I've been as a Braves fan. That first game in 1995 was the year the Braves won the World Series.
This year, seeing Chipper Jones play on his 40th birthday, in Los Angeles, as well as at Fenway Park, have been more than memorable.
But when this weekend is over, I will have seen 10 Braves games in #10's final season, a fateful number for a fan like myself who does not look into things too often.
Yet fate has played a role again.
There have been many people who have been along on the journey I've taken this summer, including family, friends and those I've met along the way with whom I've created a connection with, whether it be in Boston, New York or San Francisco.
And now, my journey leads me to Atlanta, my baseball mecca. My Graceland.
Many nights I've watch the Braves play under the lights of Turner Field, and dreamed of sitting in the seats, chopping along with the Braves faithful and cheering the Braves to victory.
Tonight, Friday night, I get that chance. I get the chance to start a "Let's Go Braves" chant. I get a chance to join in one of the loudest chops I will ever be a part of, with tears flowing, as the Braves honor Chipper Jones.
It has been a memorable ride for Chipper and the Braves this year, and I've down my part to be there every step of the way I could afford.
Baseball has been more than just a game for me, it is a sport fully integrated in my life. Growing up, I heard stories of the greats like Lou Gehrig, Joe DiMaggion, Mickey Mantle and the Babe himself.
My eyes and ears have been on baseball since I could remember, enjoying greats such as Randy Johnson, Ken Griffey Jr., Greg Maddux, Tom Glavine and John Smoltz.
Now, with my own two eyes, I get to witness Chipper Jones play at Turner Field.
In 2010, when I visited Atlanta for Bobby Cox's final series, Chipper had been sidelined with a torn ligament in his knee, and i was left to wait for another chance to see him play under the lights at home.
The memories I've created this summer will last me more than a lifetime. It is a summer I will never forget. To this point, I've seen 24 games in 7 different cities, including Los Angeles and Anaheim, Boston, New York (Yankees), Philadelphia, San Francisco and San Diego.
Don't forget that when volunteering at the Little League Western Region tournament, the last step before the young men head to Williamsport, I took in 30 of the 32 games, watching those young men play with a passion for the game I could not help but embrace.
And now, Atlanta for three.
I look forward to forging friendships and creating more memories that will not soon be forgotten.
I thank the ones who have helped me along my journey and those I've met along the way.
I'll never forget those who have helped my passion for baseball along the way.
--Thank you, and Go Braves!


text:
An introducer having a sheath, a guide rod, and at least two wire stabilization guides being elongated members, at least a portion of which extend from an end of the sheath. The portions of the wire stabilization guides include a retention device formed on the portion of the wire stabilization guides that extend from the end of the sheath. The retention device is adapted to selectively expand outwardly, stabilizing the sheath relative to a wound site. The guide rod may be provided with one or more blood marking lumen, having a distal port, for identifying the depth of insertion into an artery or vein based on the presence or absence of pressurized blood in the lumen.
1. A medical device, comprising:
a tubular sheath having two spaced apart wire stabilization guides, the stabilization guides each comprising elongated members having at least a portion thereof extending from an end of the sheath;
a retention device formed on the portion of each of the stabilization guides extending from the end of the sheath, the retention device configured to selectively expand outwardly from the stabilization guide in at least one direction;
a wire moveably disposed within at least a portion of one of the stabilizations guides, the wire being coupled to the stabilization guide, wherein movement of the wire in a first direction causes outward expansion of the retention device; and
a guide rod sized to fit within the tubular sheath and having two slots formed along its length, at least one slot releasably holding a respective one of said wire stabilization guides.
2. A medical device according to
3. A medical device according to
4. A medical device according to
5. A medical device according to
6. A medical device according to
7. A medical device according to
8. A medical device according to
9. A medical device according to
10. A medical device according to
11. A medical device, comprising:
a tubular sheath having two spaced apart wire stabilization guides, the stabilization guides each comprising elongated members having at least a portion thereof extending from an end of the sheath; the sheath further comprising a plurality of tear seams formed along at least a portion of the length thereof and wherein when the sheath is approximated to a wound site and a radial force is applied to the distal end of the sheath in a direction generally perpendicular to the central axis of the sheath, the tear seams are caused to tear increasing the diameter of the sheath,
a retention device formed on the portion of each of the stabilization guides extending from the end of the sheath, the retention device configured to selectively expand outwardly from the stabilization guide in at least one direction; and
a guide rod sized to fit within the tubular sheath and having two slots formed along its length, at least one slot releasably holding a respective one of said wire stabilization guides.
This application is a continuation of application Ser. No. 09/915,107, filed on Jul. 25, 2001, now U.S. Pat. No. 6,533,762, which is a continuation in part of application Ser. No. 09/658,786, filed Sep. 11, 2000, now U.S. Pat. No. 6,322,580, which claims the benefit of Provisional Patent Application No. 60/230,234 filed Sep. 1, 2000 and assigned to the same assignee.
1. Field of the Invention
The present invention relates to a wound site management, for use during and after an invasive medical procedure. More specifically, the present invention relates to wound site management techniques and methodology for diagnostic and interventional procedures occurring at a wound site, for example, a puncture made in the wall of an artery or vein during a medical procedure. The puncture may be the result of a catheter-based intervention, although any puncture is contemplated, accidental or intentional. The present invention has particular utility for use in and around the femoral, radial, and brachial arteries after coronary/cardiac procedures. Other utilities include soft-tissue anchoring, tendon and artery joining, meniscal repair, thoracic lung closure, heart repair, endoscopic procedures, esophageal repair, laparoscopy, skin/epidermal wound closure and general tissue closure.
2. Description of Related Art
Catheters/catheterization procedures are well known, and typically involve insertions through the femoral artery for diagnosis or to treat cardiovascular and/or peripheral vascular diseases. After a diagnostic or interventional catheterization, the puncture formed by the catheter must be closed. The puncture opening in the artery typically ranges from 5F for a diagnostic procedure to 6–10F for an interventional procedure. Traditionally, intense pressure has been applied to the puncture site for at least 30–45 minutes after removal of the catheter. Other approaches include a thrombotic or collagen plug, and/or other suturing methodology for sealing the puncture. Patients who have had a femoral puncture are then required to remain at bed rest, essentially motionless and often with a heavy sandbag placed on their upper legs, for several hours to ensure that the bleeding has stopped. This traditional method of hemostasis following femoral artery access has many inadequacies. When a blockage is removed during a procedure, the patient quickly feels better and they often have more energy than they have had in years, but they must remain motionless for several hours. The weight of the sandbag on the femoral artery often causes the lower leg to tingle or go numb. The recovery time from the medical procedure may be as little as � hour, but the recovery time from the wound can exceed 24 hours. The longer the recovery time, the more expensive the procedure becomes, the greater the patient discomfort, and the greater the risk of complications.
It will be appreciated by those skilled in the art that although the following Detailed Description will proceed with reference being made to preferred embodiments, the present invention is not intended to be limited to these preferred embodiments. Other features and advantages of the present invention will become apparent as the following Detailed Description proceeds, and upon reference to the Drawings, wherein like numerals depict like parts, and wherein:
Tissue Staple
In one aspect of the present invention, a staple is provided to close a tissue wound after a medical procedure. Although the preferred use of the staple of the present invention is to close an artery or vein following a diagnostic or interventional procedure, it should be recognized at the outset that the staple may be used for general tissue repair, not just limited to vascular repair. It will be appreciated throughout the following description that the staple of the present invention can be formed of any biocompatible and/or bioabsorbable materials, including, for example, Titanium (and Titanium alloys), stainless steel, polymeric materials (synthetic and/or natural), ceramic, etc. It will also be apparent from the following description that the staple of the present invention is preferably formed of a deformable material (such as those listed above) that undergoes plastic deformation (i.e., deformation with negligible elastic component.) As a general overview, the staple of the present invention undergoes two positions of deformation: a first position to extend the distal ends of the prongs of the staple outwardly to grab a greater amount of tissue (and also to grab tissue away from the wound locus), and a second position to move the prongs inwardly to close the wound.
Referring specifically to
For certain tissue application, it may be desirable that the staple of the present invention is deployed into tissue such that the prongs do not fully pierce through the tissue, but rather grasp and hold the tissue together. For example, for vascular closure applications it may be desirable that the tissue piercing tapered ends not enter the bloodstream, but rather pierce into the tissue and stop short of piercing through the tissue wall. To that end, and referring to
In the formed position (
Referring specifically to
In either embodiment described above, it should be evident that although the Figures depict four each of the prongs, tabs and shoulders, this should be only be considered exemplary. It may be desirable to adapt the staple 10 or the staple 50 with more or fewer prongs, tabs and shoulders for a given application. Also, it is not necessary that each prong is the same length, or that each prong has the same overall dimensions. In alternative embodiments, the entire staple, or selected portions thereof can be alternatively fashioned from an elastic or shape memory (e.g., nitinol, and/or other elastic materials, including for example temperature dependant shape memory materials) material thereby permitting elastic deformation from the a static closed position to an expanded position and then elastically close about the wound. Also, the embodiment of
Stapler Device
Another aspect of the present invention is a stapler device to deploy the staple 10 of
Alternatively, the actuation mechanism can include a rotating drum (not shown) to replace the cam 408 and 612. The drum may be adapted with lobes formed thereon, similar to lobes 408A–408C and 608A–608B, respectively. Other alternatives may include a rotating screw having a variable width in accordance with lobes 408A–408C or 608A–608B to actuate the mandrel rod and/or sleeve. Of course, instead of the cam mechanisms depicted in the Figures, direct linkage may be used to actuate the mandrel rod and/or sleeve.
Wound Site Management
To facilitate efficient wound closure, another aspect of the present invention provides an introducer formed to stretch the wound site for more efficient and effective closure.
The diameter of distal end of the guide sheath 512 may be formed to expand if outward pressure is applied from inside surface of the guide sheath 512. For example, slits or weakened tear seams (described below) may be formed in the distal end of the guide sheath 512 to allow the diameter of the guide sheath to increase when pressure is applied.
One feature of the guide sheath of this exemplary embodiment is the use of two or more wire guides 514 to maintain the sheath located on the wound site, to provide approximation of opposing sides of the wound, to ensure that the closure device (e.g., stapler/staple, suturing device, cauterization, etc) remains located about the wound so that a closure device is properly deployed, and to provide unobstructed access to the wound site. In this embodiment, wire guides 514 are formed on opposing sides of the guide sheath 512. Having the wire guides 514 on opposing sides helps to ensure that not only is the sheath located on the wound site, but that the sheath is approximately centered thereon. The wire guides are delivered into the artery by the dilator 520, as shown in
As is understood to those skilled in the diagnostic and interventional arts, a puncture in an artery or vein has a general tendency to manifest a slit or an elongated opening, since the cell structure forming this tissue forms circumferentially (rather than longitudinally) to support radial expansion and contraction of the vessel. The wire guides 514A and 514B of the present enable the wound to approximate the natural state of the wound, i.e., elongated circumferentially. The sheath may have a diameter approximately equal to the diameter of the opening or wound, so that the distance between the wire guides 514A and 514B on the sides of the sheath approximately equals the diameter of the long axis of the wound, as best shown in
Importantly, since the wound opening tends to assume the shape shown in
In an alternative exemplary embodiment, instead of using wire guides, a single loop actuation wire 654 is used, as in the exemplary introducer assembly 510′ illustrated in
The guide rod 670 is a tubular member and includes at least one slot 682 formed therein for releasably holding the loop actuation wire 654. As shown in
In this configuration, one end portion 656 of the loop actuation wire 654 is threaded inwardly into one end of the slot 682 at the first recessed area 658 and back outwardly from the slot 682 at the second recessed area 659 in the guide rod 670. Similarly, the other end portion 657 of the loop actuation wire 654 may be threaded through a second slot (not shown), which may optionally include a set of recessed areas (not shown) on the opposing side of the guide rod 670, or elsewhere along its length. The slot 682 may be located along the length of the guide rod 670. For example, as shown in
While not necessary to provide operability to the present invention, an opening within the guide rod may be provided to expose a portion of the central guide wire 502. The central guide wire 502 can then be placed over the loop portion 680 of the loop actuation wire 654 to secure the loop to the guide rod until the central guide wire is removed.
The foregoing assumed that the wire forming the wire actuation loop has a generally circular cross section. However, alternatively other wire shapes may be used, in which case the wire stabilization guides 660 and slot 682 may comprise one or more internal mating components adapted to mate with end portions 656, 657 of the loop actuation wire 654, in which case the end portions 656, 657 would comprise one or more appropriate corresponding mating components.
The use of the foregoing described exemplary introducer 510′ will now proceed with reference to
The wire stabilization guides 660A and 660B depicted in
Note also that the description of the slots in the guide rod to releasably hold the wire stabilization guides are formed in a location most convenient for placing the wire guides into the slots. Also, the slots may be defined such that one slot releasably holds the wire stabilization guide with the wire inserted therethrough, and the other slot is dimensioned to releasably hold just the wire (as may be the case when the lengths of the wire stabilization guides differ). Still other modification may be made.
Thus, a single or multi-lumen sheath device may be stabilized in direct approximation to an arterial, venous or other lumenal puncture. Advantageously, the foregoing described method allows the positioning of a closure modality directly centered over such a puncture. The foregoing described introducer assembly 510′ allows the distal end of the sheath 662 through which the closure device is introduced to be drawn against the artery, vein or other lumen, thereby aiding in sealing the puncture site to prevent leakage, as well as stabilizing the sheath 662 directly over the wound site.
As in the previously described embodiment, the tissue which is stretched by the stabilization guides 660 is caused to slide along the newly ramped angles of the stabilization guides 660 and be forced against the distal end of the guide sheath 662. The foregoing action aids in retaining the guide sheath 662 within the puncture against the vessel. The closure modality (e.g., a staple, as described hereinabove) may next be delivered. As shown in
As those skilled in the art will recognize, it may be necessary for the doctor to determine the point at which the distal end of the guide sheath 662 has reached the approximate location of the artery or venous outer wall prior to removing the central guide wire 672 from the introducer assembly 510′. One exemplary method for identifying insertion depth of a transluminal device will now be described with reference to
In operation, the introducer assembly 510′ is introduced into the percutaneous puncture which tracks into the puncture site, as described hereinabove. The location at which the guide sheath 662 has reached the approximate location of the artery or venous outer wall may be identified by observing the pressurized blood flow from the internal flashback port 684, which enters the internal blood marking port 674 when the internal blood marking port 674 has reached the inner lumen of the vessel. The absence of pressurized blood flow observed at the internal flashback port 684 indicates that the guide sheath 662 has not yet reached the vessel outer wall. The fact that the guide sheath 662 has not entered the inner lumen of the vessel may be confirmed by the absence of pressurized blood flow observed at the external flashback port 688, which enters the extraluminal blood marking port 675 only if the extraluminal blood marking port 675 has reached the inner lumen of the vessel. Likewise, presence of blood in this lumen indicates the guide is too far into the artery or vein. The presence of pressurized blood flow at the internal flashback port 684 and absence of pressurized blood flow at the external flashback port 688 indicate that the distal end of the guide sheath 662 is adjacent to the arterial or venous outer wall.
Thus, the foregoing-described steps provide a method for identifying the depth of insertion of the transluminal device into an artery or vein based on the presence of pressurized blood internal to the vessel and the absence of pressurized blood external to the vessel. Alternatively, more than two blood marking points, lumens, and ports may be provided to further aid in determining precisely the depth of the inserted transluminal device. Furthermore, it is contemplated that the foregoing described insertion depth identifying technique may have utility in other contexts, as well, and those skilled in the art will recognize that the foregoing technique should not be limited to the context described hereinabove.
As described above, either the stabilization loop portion 680 or 680′, or the guide sheath 662 may therefore be approximated to tissue surrounding the wound site, so as to cause spring tension against the surrounding tissue, thereby aiding in approximately centering an introducer about the wound site, as well as in allowing opposing sides of the tissue surrounding the wound site to approximate one another. It is further contemplated that alternatives of the embodiments described above may be implemented consistent with the invention for stretching the wound site and for centrally locating procedures at the wound site. For example, in the above-described embodiments, loop portions 680 and 680′ provide a force to the wire and the guide sheath to spread the sheath outwardly and to approximate opposing portions of the wound site, as shown and described. However, in still other embodiments, the guide sheath can be formed having a biasing mechanism that forces the sheath into the opened or spread position as shown in
There are many alternatives to the foregoing description of
Still other modifications can be made. For example the stabilization guides have been described herein as being generally tubular so that wire can be threaded therethrough. However, this is only an exemplary arrangement. The stabilization guides and wire could be coupled together in other configuration, for example, sliding engagement that may comprise a tongue-and-groove coupling, dovetail coupling, or other arrangement that would permit relative motion between the stabilization guides and the wire, while still providing mechanical strength along at least one axis.
The tissue retention device 820 is generally provided herein to secure the distal end of the sheath to the tissue, e.g., to the arterial waU about the wound site. Deployment of the retention device is depicted in
The retention device 820 of this embodiment is essentially an expanding portion of the wire stabilization guide. To that end,
Returning again to
In the embodiments of
Although the present invention has been described in relation to particular embodiments thereof, many other variations and modifications and other uses will become apparent to those skilled in the art. It is preferred, therefore, that the present invention be limited not by the specific disclosure herein, but only by the appended claims.
Patent Citations
Referenced by
Legal Events
Original Image