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Ten Situations to Avoid This Thanksgiving
Categories: Twitter
For the rest of you: Thanksgiving can be an extremely uncomfortable time spent with family and old friends. Here, in no specific order, are ten of the most awkward situations you may find yourself in over the holiday weekend. Hopefully this list will allow you time to prepare a few exit strategies. (Note: Pretending to text won't deliver you from all these encounters.)
Good luck. You'll need it.
For your convenience, below is a probability scale of these situations actually happening, using this Butterball Breakdown (BB.)
= Unlikely to happen.
= In Thanksgiving parlance, you're mince meat.
|Three delicious pitchers of mistakes, waiting to happen.
It's Thanksgiving Eve and you find yourself reuniting with friends at your old college bar and/or high-school hang-out, he or she walks into the room and you're forced to create conversation with your ex while your friends jab each other in the ribs and make lewd gestures in the background.
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|Debra LaFave.
While Debra LaFave was convicted of statutory rape involving a tryst with one of her students, the prospect of you actually running into that teacher of yours who stirred your fantasies back in high school are pretty remote. And if it does happen, it's best to take the high road. Unless of course you have no extended family enrolled in said school and no one would ever, ever find out. At which point we suggest cranking up the '80s rock, cause you're living in a Van Halen video.
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Feeding old relatives too feeble to eat themselves, certainly can be a harrowing and messy experience. Although as we've learned from 30 Rock, people of all ages can at times require a little assistance delivering food to gullet. But at Thanksgiving, the only time you should absolutely leap at spoon-feeding is when it involves a baby. They're mostly adorable, they don't talk (much) and most importantly they distract you from talking to your second-cousin about his Harley-Davidson or her illegitimate child.
|Image Via
Not everyone can be like the chap above, with a state-of-the-art PC and pictures of his rock-climbing adventures posted on his wall. So if the topic of your nose-diving career, or more likely, perpetual unemployment comes up, spare everyone the story about your job prospects and ask someone to pass the yams.
|Image Via
There's room for one more on that couch above. If you don't think so, wait until Thanksgiving when you're ass-to-ass with your extended family watching that awful Detroit Lions game on a velvet sofa. You're better off faking the trots and exiting for the bathroom. There you're at least assured a seat by yourself.
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Linguistik-Klassifikation: Übersetzungswissenschaft / Translation science
- Polnisch (4) (remove)
- How to spice up a breakfast cereal or the translation of culturally bound referential items in "The bluest eye" by Toni Morrison and "Vineland" by Thomas Pynchon (2011)
- This article will attempt to suggest translation procedures necessary to translate culturally bound items in the referential level of a literary work illustrated with examples from two novels: "The Bluest Eye" by Toni Morrison and "Vineland" by Thomas Pynchon. First, the article will include a general description of the referential level in literary works offering possible avenues of 285 its rendition, then and finally suggest a translation methodology and techniques together with practical examples of the theory at work.
- G.A. Kleparski, R. Kieltyka (eds): Podkarpackie forum filologiczne seria: Językoznawstwo, Jaroslaw, Wydawnictwo Panstwowej Wyzszej Szkoly Zawodowej, 2010. (2011)
- Metaphorization and selected translation techniques : the case study of "National Geographic" (2008)

subset: commoncrawl


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In this course, Chris Meyer helps beginning After Effects artists take their animations to the next level. Chris shows how to refine animations to create elegant, coordinated movements with the minimum number of keyframes—as well as slam-downs, whip pans, and other attention-getters. Additional movies show how to reverse-engineer existing animations, create variations on a theme, and master other parts of the program. Even though this course is designed for beginners, even veterans should learn tricks that many experienced users are unaware of. Chris' friendly running commentary lets you in on his mental process as he works on an animation. Exercise files are included with the course.
The After Effects Apprentice videos on lynda.com were created by Trish and Chris Meyer and are designed to be used on their own and as a companion to their book After Effects Apprentice. We are honored to host these tutorials in the lynda.com Online Training Library®.
A very important part of the Graph Editor is deciding what type of graphs are being drawn, and that's set by the second pop-up menu, Choose graph type and options. The default is to auto-select the graph type, show you the type of graph that makes the most sense at that given time. For example, with Snowflake most of the parameters are simple values that change over time. They're temporal keyframes. Therefore, we'd see value graphs for those parameters, and the value rule is here along the left side of the screen, from 0 to 500, and also going negative, depending on what the value is.
For example, the Snowflake is rotating from -90 degrees to 0, while opacity is starting at 0 and going to 100%. On the other hand, position is more of a spatial value. I'll select the Snowstorm Title to show that. In this case, the graph type will change to showing the velocity, how many pixels per second my layer is traveling, as opposed to a specific pixel value. And again, along this left side you can see the ruler, from 0 to 100 pixels per second and higher in the case of this particular animation.
Now if this automatic behavior is a bit confusing, you can select the type of graph you want to see. For example, let's say Edit Value Graph. Now our position has been split out to separate green and red graphs for the X and for the Y position values. This so happens that this title is not moving in axis. It's not moving left and right, so I get a perfectly flat graph, because its value is not changing over time. And contrast this to the Y dimension, where it's rising over time, moving up the comp. Just moving from being a high-pixel value, very low in the comp, to a lower- pixel value, which actually means a higher in the comp in the case of Y. This is even more fun in the case as Snowflake, because position is following a curved path.
You can see how this path curves through the Timeline panel. I'll even turn on the rulers, Command+R, so you get an idea where these values reside. And down here in the Timeline panel, you can also see the curves independently for the X dimension and for the Y dimension. And as I move my Current Time Indicator through my animation, you can see how the position of that layer follows the pixel values for those X and Y dimensions down in the Graph Editor. Now you might remember back in the normal view--I'll turn the Graph Editor off-- if you hovered the cursor over a keyframe, you received information about that keyframe: what time it was at and what its value is.
As you might have noticed already in the Graph Editor, you get that information and more. You do indeed get the time and value for individual keyframes, but also, as you hover the cursor over the graph itself, you get to see the value at each specific point in time. So you get a lot more information. You can see what values are as they interpolate between keyframes. And by the way, in After Effects CS4 and earlier, when you hover the cursor of the keyframe, you actually did not get a tooltip. They fixed value as 5, so now you get a tooltip, whether you're on a keyframe or just on a graph in between keyframes.
So these are how the values are changing over time. Let's instead see how the speed, or the velocity, of these parameters is changing over time. I'll go back down to my type, and this time select Edit Speed Graph. Now remember I've mentioned most of these keyframes were linear, which means constant speed and very sudden speed changes. You can really see that when you're looking at speed graphs. Flat lines mean constant speed. A flat line on zero means nothing is happening at all.
You can also see where in this case the Snowflake is moving faster during the first half of this animation, then moving slower, not quite as faster in the second half. I'll RAM-preview again. You can see that speed change reflected in the height of the Speed Graph in the Graph Editor. If you want to see both of these graphs at the same time, you can select one, such as Edit Value Graph, and then select Show Reference Graph. What this will do is show the unchecked or unselected graph type, like speed, as gray lines behind.
So in the case of the position of the Snowflake, this grayish pink line is how its speed is changing over time, while the red and green lines are how the actual value is changing over time. You might want to experiment with these as you get comfortable with the Graph Editor. Personally, I find that the Auto- Select Graph Type is actually what you want most of the time. Most of the time it shows you values. The difference is when it is showing position and it shows you speed. And as you may have noticed, there are other view options as well, to show a Waveform overlay, if you happen to have an audio on a particular layer, In/Out Points, Markers, Expressions.
But I'm going to show just Graph Tool Tips, this my only other option for now. As you can see here from where I've rested my cursor, when you're past the last keyframe inside a graph, you just get a dotted line, because all it's going to do is hold that constant value for the rest of the Timeline. Now, let's dive in and start editing these graphs.
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What's next for Ed Reed?
The future Hall of Fame safety was cut by the Texans on Tuesday, sent to the waiver wire just halfway through his first season of a three-year, $15 million deal he signed with a lot of fanfare in the offseason.
To say it didn't work out so well in Houston is a huge understatement. Reed was slowed first by offseason hip surgery, then just by the fact that he's 35 and his skills are in rapid decline. Reed played in seven games for the Texans and they lost them all. He was benched, saying after the most recent loss that the Texans were outcoached, and then he was kicked to the curb on Tuesday.
Not exactly the way a Hall of Fame career should end, but few NFL careers end on the player's terms. Of course, Reed had that chance. He could have walked off into the sunset holding the Vince Lombardi Trophy in his hometown of New Orleans last February. But he decided to give it another go, and he pocketed a few more million for doing so.
Now he's sitting on the waiver wire, no different than a hundred other fringe players hoping for their shot in the NFL.
Will Reed get another one?
The Ravens are not expected to put in a waiver claim on him. They moved past Reed when they chose to let Houston out-bid them for his services this offseason, and Reed has done nothing this season to make them change their mind.
The Ravens have taken their lumps this season, but they have made it clear they want to be younger and faster, and Reed fits that formula not at all.
Might a contender take a flyer on Reed, knowing he can be had on the cheap, and bring a Super Bowl ring and Hall of Fame resume to the locker room? And does the fact that he threw his coaches under the bus this week affect that?
The Colts are considered a possibility. Colts coach Chuck Pagano and Reed have been together with the Ravens and all the way back to the University of Miami. The Colts are thin at safety. But they have two established starters in LaRon Landry and Antoine Bethea. Both are better than Reed at this point. Reed made it clear he wasn't happy as a backup in Houston, and there's not much reason to think he would be with the Colts.
The Patriots are another potential landing spot, as Bill Belichick has long been a Reed admirer. Ditto for the Jets and former Ravens defensive coordinator Rex Ryan.
But no one would be getting the player Reed was when Ryan was on the Ravens' sideline. If that Reed were still around, the Texans never would have cut him (and, in fact, the Ravens would have kept him.)
It's possible that a contender will kick the tires on Reed via a waiver claim, but the bet here is he's played his last NFL game.


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He's done a fantastic job. Why wouldn't we re-elect him?
The professional lobbyist received more money? I'm shocked!
Wait, $1.34 million? I would love to see the break down of this figure. They probably get paid $300 to sharpen a pencil.
We need more transparency. We need to end the political criminals careers. Vote for Ron Sparks and get some honesty in the Governors mansion.
I like your last sentence, John Tyson much?
They do have a legal/illegal standard. It is called the 6 point test. The task force just has not pursued having any of the machines tried in court and put to the test.
Prepared to discuss this case? Are you the prosecutor? Are you out of your mind? Go back to blogging for Downs, don't you people get paid per post. Quit trying to sound smart.
I just want to know how these people sleep at night. I mean, it is one thing to make a negative campaign ad that is true to try and defeat your opponent, but to make up lies that will put people in prison for the rest of their lives, that is just wrong and is like murder.
Won't arrest Gilley? That is because then they would be forced to actually prosecute him and when there is no evidence of wrong doing found their little Indian monopoly they have set up will be ruined.
If Ron Sparks is elected and successful with his plan you can expect this state to experience significant improvement in the average person's quality of life. With all the jobs that he's talking about creating and the added money for the state with the lottery and the bingo taxing. There's no way we can go wrong with Ron Sparks as our governor.
No, maybe the people who care about this will continue to care about each other and the community. What should I focus on? What should we focus on? Please tell us what is right! Getting more kids who deserve college to attend? Maybe something evil like medicaid funding? You know, all the legal stuff, much like electronic bingo.
That sure is quite a lot of money that will certainly be missed, especially in these times of hardship.
Ron Sparks has several thought out plans to create jobs and better our educational system. Bentley thinks that some kids don't deserve to go to college. I think every kid should at least be given that choice. My vote is for Sparks all the way.
Every time you read something about Bentley he just slips further and further. This guy is digging his own grave. Passing information that proves he isn't ready to hold this position and holding positions on certain issues like children going to college that make him look like a monster and a smug high society person who doesn't understand the people he wants to represent.
sounds like grounds to dismiss him to me, he can't be trusted
Well VL was the last place to go in Alabama, looks like Ill have to find something else to do till January. I'll be danged if I'll be giving my hard earned dollars to those tax free indians takin peoples jobs.
This is horrible. I don't know how Riley can sleep at night. He has got rid of more jobs than he has created.
this is horrible news!!
This is simply pathetic. The people don't want the task force, BOTH gubernatorial candidates don't want the task force, the only one who does is Indian casino mob boss, Bingo Bob.
I don't get what his goal is.
Does he want to go down in history for the worst unemployment rate in Alabamian history or does he plan to retire elsewhere with his 13 million dollars from them Indians.
Either way this is pretty disturbing.


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Following on from Tap & Modern Jazz combined classes, the techniques are now separated to enable us to spend sufficient time working with the students on each technique. It also allows students who may be stronger in one technique than the other to continue to progress and move onto higher levels.
Technique is further developed and more challenging steps are tackled such as single, double and triple timesteps, 'beat wings', 'riffs' and 'pull backs'. Performance skills and musicality are also vital components and continue to be one of the main focusses in class in order to create good performers.
We have an Unset Tap Class for students at Grade 3 level during which the exercises change regularly. This helps students learn how to pick steps up quickly and become quick thinking dancers.
Students work towards graded and vocational exams with the IDTA, the higher levels of which are accredited and on the National Qualifications Framework alongside GCSEs, NVQs etc. Dance exam results can therefore be used on University applications (UCAS forms) and count as 'points' towards entry.
We currently have students up to Intermediate level Tap but we can also offer Advanced 1 and Advanced 2 levels as required.
Tap dancing is considered to be one of the three core dance techniques, along with Ballet and Modern Jazz and therefore assists in vocational college entry for those who wish to pursue dance or Musical Theatre as a career.


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The Anarchy of Silence
John Cage and Experimental Art
written by Yve-Alain Bois, Branden W Joseph, Liz Kotz, Julia Robinson
Actar | ISBN 9788492505142
Paperback – 297 pages
Member's price: $99.00
Usually ships within 2–11 business days.
John Cage (1912-92) defined such a radical practice of musical composition that he changed the course of modern music in the last century and shaped a new conceptual horizon for post-war art. This book traces a path through the artist's career, from his initial works in the 1930s, pieces that broadened the parameters of percussion music by incorporating the most unconventional of instruments, leading to his 'prepared piano', moving to his famous theory on 'silence' (and the score 4'33"), his pathbreaking deployment of chance and then indeterminacy, and culminating his innovative multimedia work, which began in the 1960s and continued through the 1980s. With this book, the Museu Dart Contemporani de Barcelona aims to capture the relevance of Cage's contribution to present day contemporary art. One of the sections will chart the network of repercussions as Cage's radical conceptual transformation of 'composition' entered the strategies of advanced art. A trajectory framed by dialogues with artists - Marcel Duchamp, Robert Rauschenberg, Robert Morris, Ellsworth Kelly, Fluxus among many others - and reacting to the same emergent media as Andy Warhol.


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Dear Ted:
RE: The Lohan trainwreck. So the court orders her to behave and everyone around her (her lawyer, her mother, etc.) has hissy fits. What has to happen before someone actually helps her? So far the judge seems to be doing the most—and it ain't much! Forcing her to follow through on the bracelet, the drug tests and the alcohol classes will only go so far when her lawyer fights so hard to enable Lohan to continue her downward spiral.
Dear Step One:
La Lohan herself has to admit she actually needs help. The newly blond babe is in just as much denial as her enabler mother and cling-on friends—it's going to take more than a SCRAM bracelet and slap on the hand from a judge to fix Lindsay.
Dear Ted:
Jennifer Aniston looks fab in her new H2O ads. And we know she's secretly a chain-smoker. While some of us take water breaks when working out, Jen takes ciggie breaks. How does Ms. Healthy's body look so good when cigarettes are her main food group? (Although I do think all the cigs are starting to show on her face.)
Dear Up In Smoke:
While most would chalk it up to another H'wood miracle, my good pal Answer B!tch gives a much more scientific answer. But hell, I'll still say it's a miracle.
Dear Ted:
There are rumors that Danneel and Jensen are already having trouble. She is not getting the PR she thought she would and Jensen is not getting the vacation he wanted. Have you heard anything about this or any other issues they are having? Thanks! P.S.: I have two stray cats that I adopted, and I don't mean members from the '80s band.
Dear Wedding Woes:
As much as the Jackles fantatics would love to hear divorce papers have already been filed, the couple is still in its honeymoon period. And by "honeymoon," I mean loving the PR splash they made at the TV upfronts just days after they said "I do."
Dear Ted:
The Kirsten Dunst burglary suspect says drugs were involved. Has she ever been a Blind Vice? If so, can I get a clue?
Dear Onto Something:
Yes, Kirsten is actually a very famous member of the Blind Vice club. All sorts of charming debauchery were involved.
Dear Ted:
First of all, I must say that you are absolutely the only columnist I trust. Love your stuff! My question is about Jared Leto. I've always gotten the feeling that he only has a passing acquaintance with sanity, which is how I seem to like my men. I believe you've said he's been a B.V. Any hints as to which one? I don't own any rescue pets, but I do round up strays and take them to no kill shelters, where they'll hopefully get a better life. Thanks.
Dear Leto Lover:
Met him several times, I like him. He's weird, a bit quirky, handsome and totally not into the PR spin. Also pretty talented, not that that many people know it, as Jared hates playing the Hollywood game.
Dear Ted:
Longtime reader, first-time writer. I was just curious, when you are generating the names for your B.V. stars, how revealing are you being? Are you just using a random word generator or do the names give sneaky insights into the identity/behavior/details? Whether you answer or not, love your site and your delicious, scandalous B.V.s!
Dear Name Game:
Definitely not random, babe. There's plenty of thought that goes into each B.V. star's name, whether it be a clue to their personal appearance, public rep, or nasty little habits.
Dear Ted:
I've just read Kristen's interview in Elle. She's been saying for a while she doesn't talk about her relationship 'cause she wants to protect it (I wonder from what?) and now she's spilling the beans by riddles? (Guess who's the guy of her iPod's pic?) I thought she was more coherent. It's getting pathetic, don't you agree?
Dear Disagree:
While our numero uno chick certainly doesn't want to blab every detail of her relaysh with good old Rob, I've told you millions of times that the couple loves to tease the fans who are so into them. Elle was no exception.
Dear Ted:
Big fan of the column! I am sorry if you have already addressed this, but I was wondering if you have any insight into the realness of the Erin Andrews-Maksim relationship? I never once believed that Chad and Cheryl were actually dating, but somehow Erin and Maks do seem realistic. Is it just a good act for the show, or is something real going on? Either way they both seem really nice. Thanks!
Dear Dancing Duo:
The couple is loving the attention they're getting about whether they are or are not dating—and, trust, they're loving every second of it. More than each other, at least. But hey—all those dance rehearsals probably led to some chemistry, right?
Dear Ted:
With all of these recent celeb deaths, I have to know, is Toothy Tile still alive and well? Also is there any chance he'll be out of the closet or is he lost in Narnia?
Dear Obituary:
Babe, don't you think I would have gone through some sort of grieving if T2 had passed away? No he's still alive and better than ever. As for coming out though, doubt it anytime soon. No reason for him to, that's how he sees it.
Dear Ted:
I was thinking about Nelly Fang the other day and was wondering, when did these "encounters" take place? Were they last year (since the B.V. was posted in December) and what month(s)? I was thinking that knowing the timeline may help with confirming or clearing the one remaining obvious choice, if one were to consider filming locations and schedules.
—C'est Moi
Dear Not So Fast:
You don't honestly expect me to just give that dish away once you've revealed your master plan to me, do you, Frenchie? Got to be a lot more clever than that! Weather was warm, though, I'll tell ya that much
Dear Ted:
I've got it! Moisty Mohr is Drew Carey! Right?
Dear Funny Man:
Sorry, Cath, but M2 still remains a mystery. Think far less funny than Carey.
Dear Ted:
I've recently become hopelessly addicted to your column (much love from the U.K.). Reading up on the sleazy and kind of tragic epic of JJO and DDD has made me wonder; are there any closeted celeb couples in Tinseltown in happy relationships you just don't tell us about because they behave? Or does it always end like a bad soap plot like it has has for poor DDD and his dreamy ex? I'm a sucker for any kind of happy ending, though, so any chance these two can reconcile and be together with or without beards even in secret? What would it take? Props for all the effort you put in for our adorable animal friends BTW.
—B.V. Addict
Dear Heart Breaker:
Sure, being on the DL doesn't help a relaysh—and while some can make it work (Toothy and Grey), it's tough to keep things together with so much pressure. Especially when these dudes see out couples like Neil Patrick Harris and his BF being honest and happy.
Dear Ted:
I felt bad for Jesse James upon hearing that he claims his father beat the tar out of him when he was a kid but...how can he blame that for all the "sleeping with skank of the month" stuff he did while married to Sandy? Do you see some sort of connection there that I missed? Thanks! You're still the best of all the gossip hounds out there!
Dear Excuses Excuse:
Thanks! As to James, not only does the dad deny the charges, it's just another attempt at trying to pass the guilt instead of 'fessing up to Jesse's own mistakes.
Love Ted? Follow @theawfultruth on Twitter.
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2013 President's Report: Quarter Four
Greetings Division 13 Members and Happy New Year!
This month I am working the final duties of my year as president and have so much to share with you! Front and center at this point has been preparations for our annual 2014 Midwinter Conference. Conference co-chairs Carol Kauffman and Bill Berman have put together a fantastic program this year.
Leadership Changes
The newly elected SCP Executive Board Members will enter into their roles at the Midwinter Conference Closing Ceremony on Saturday, Feb. 8, 2014. I congratulate each of our new officers on this recognition and so appreciate their willingness to serve.
- Vicki Vandaveer, SCP President (2014-15)
- John Fennig, SCP President-elect (2014-15)
- Melanie Kinser, Domain Leader, Education (2014-17)
- Rodney Lowman, Domain Leader, Research (2014-17)
- Carolyn Humphrey, Secretary (2014-17)
Special thanks to Amy Owen Nieberding, rotating off the coard as past-president and Karen Wilson-Starks as secretary; for their many contributions and dedicated service.
Communications Leader: We welcome Adam Feiner as our lead in communications. Adam will oversee internal and external communication and will also be collaborating with our Social Media Lead, Alok Sawhney, our External Media Lead, Ben Dattner and our board. Alok Sawhney has been hard at work creating our new LinkedIn account and will be managing the account.
SCP News
- Fellows Committee: The Fellows Committee has recommended Florence Kaslow to be recognized as a fellow in SCP. I extend a hearty congratulations to Kasklow on this honor, she will be publicly recognized at the upcoming Midwinter Conference.
- Chair of the APA Board of Professional Affairs 2014: Stewart Cooper was elected as chair of the APA Board of Professional Affairs for 2014. The Board of Professional Affairs is one of the six boards in APA Central Governance. Its focus is to promote the practice related issues of all psychologists, both general applied psychologists and health services provider psychologists.
- Interview with our New CPJ Editor Rob Kaiser : If you have not seen it yet. There is an interview of our new journal editor on our website.
- SCP 2014 Awards: The Awards Committee led by Judith Albino will be recognizing David Peterson, John Fennig, Rodney Lowman and Amy Owen Nieberding at the Awards Ceremony at the Midwinter Conference.
- SCP Presidential Citations: Katie White and Rodney Lowman will be receiving Presidential Citation for years of dedication and service to the Society. Katie White will be receiving a citation for her years of services as our administrative and accounting support and Rodney Lowman for his years of service and dedication has our CPJ editor.
Board News
Presidential Initiatives
- SCP creates a Second Fund: The SCP Fund Committee in collaboration with APF has created a Second Fund. The creation of a second APF fund called Consulting Psychology Research Fund has been created to focus this fund on creating small grants to promote research for the division. The first SCP Fund will now focus on Education and Early Career Psychologists while our second fund will focus on research.
- MidCareer Consulting Psychologists Summit: Our MidCareer Consulting Summit if almost full. Our midcareer psychologists are preparing case studies in preparation and will have the opportunity to hear from experts in our field thank you to Ann Bowers-Evangelista and Adam Bandelli.
- Diversity: Becky Turner, our advocacy leader and Felix Caraballo, chair of the Diversity Committee have created a diversity statement for our society. It will be posted on the website shortly. We also just received news that the Leadership Diversity Team which includes five other divisions will be presenting at the APA conference in Washington, D.C. in August. This year the Midwinter Conference team has also organized a Diversity Reception Thursday night. Please join us.
Midwinter Conference and Summit in San Antonio 2014
International Congress on Coaching and Midwinter Conference in San Diego 2015
Vicki Vandaveer, our upcoming president is working on hosting for SCP an International Congress on Coaching prior to the MW Chaired by Karen Steadman. Ann Bowers-Evangelista and Doug Riddle will co-chair the 2015 Midwinter Conference in San Diego, February 2015
In Conclusion
As a final note, I'd like to thank you, the members of our society. This has been an extraordinary year; I have been truly inspired by the commitment and passion of all that I have had the privilege to engage with this year. We indeed have something special as members of this society, let's keep building!
With Warmest Regards,
Lyne Desormeaux, PsyD
2013/14 SCP President


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Well I finally saw a doctor after 35 years. And, I'm healthy.
Larry Smith
Felton | Unemployed
Well I finally saw a doctor after 35 years. And, I'm healthy.
Larry Smith
Felton | Unemployed
Matthew McConaughey for Dallas Buyers Club. I never appreciated his work before but I found him very credible and just enjoyed the role.
Sue Kuncl
Santa Cruz | Office Assistant
Well, I've always felt pretty safe in Santa Cruz, and although that was a shattering experience for our community, I still feel pretty safe here. I think we have a great sense of togetherness, really good support services for homeless people and others, and I think I feel no less secure now than I did a year ago.
Dori Schack
Santa Cruz | Market Representative
Walking West Cliff at sunset.
Tanya Mansfield
Santa Cruz | Spa Therapist
I am very worried about the radiation that's coming from Fukushima, and I don't know how it's showing up—whether it's in seafood, or just through the air. But I think we are being impacted. I'll bet you if we checked with the local hospitals on people's lymphs and things like that ... I know I've experienced a little of that and I'm having some tests. I'm not eating any fish.
Kirk Hatfield
Santa Cruz | Writer
The art in this community that we have, [like] Tom Scribner's statue, is a gathering place—as is a lot of the fine sculpture. I think it's a part of the community that brings us all together, and I hope that we have a lot more of it.
John Sandidge
Santa Cruz | DJ
I hope that she, when thinking about it, thinks long term.
Allison Harre
Santa Cruz | Psychotherapist


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We're backing Britain
all products sold on this site are made in England
Below are tracks from our library that never made it onto one of our compact discs. They can be downloaded here as high quality 320kbs AAC encoded (MP3) files.
Purchasers of tracks have unlimted personal use but must not pass or sell on to third parties nor broadcast without prior permission from PPL
Veracini led a turbulent life. Born in Florence, the son of a pharmacist and undertaker, he was taught the violin by his uncle, Antonio Veracini, with whom he often appeared in concert. Veracini wrote a concerto grosso for eight instruments he wrote was performed in 1711 at the coronation festivities for the Emperor Charles VI.
There is a legend that, when Giuseppe Tartini heard Veracini playing the violin in 1712, he was so impressed by his bowing technique, and so dissatisfied with his own skill, that he retreated the next day to Ancona "in order to study the use of the bow in more tranquility, and with more convenience than at Venice, as he had a place assigned him in the opera orchestra of that city"
In 1714 Veracini went to London and played instrumental pieces between the acts of operas at the Queen's Theatre.
After some turbulent years spent as a court musicain in Dresden Veracini returned to London in 1733. Here he had mized fortunes as opera composer.
In 1745 after surviving a shipwreck in the English Channel, he again returned to Florence, where he was appointed maestro di capella of the churches of San Pancrazio and San Gaetano, the latter one at which his uncle had worked, focusing on church music. Though he mostly conducted in his later years, he still sometimes appeared as a violinist. He died in Florence.
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Jim Brown would never make it in today's game, especially with Goodell in charge. Jim Brown was beating women and throwing them off motel balconies. He would be suspended more than he would be available to play, his career in today's game would be shorter that it really was. Today's media would never turn a blind eye.
Ummmmm, OK....let's go on the low end
$20.00-$25.00 a spot times 200 spots times 8 games a year=$32,000-$40,000
Now say it has been going on since the new stadium was built, so 13 years
half a million bucks given away sounds like news to me
Ummmmm. Hmmmm. Guess I missed where that had anything to do with a bounty. Don't remember that being in the news.
The relationship between these "bounties" and concussions has yet to even come close to being related. Seems like a huge jump to conclusion by this artist, and an unfair one too. If a player is trying to knock another player out of the game they are going to try to break a bone or twist/turn an ankle, not launch themselves at the other players head. This artist has done nothing but try to tie two big NFL stories ( Junior Seau and the bounty punishments) together. A big stretch and a sad use of someone's death for their own benefit. Shame on Jef Darcy.
Ummmmm, you do realize that there will be no diploma involved in this, right?
Ummmmm, you do realize that there will be no diploma involved in this, right?
Impossible to say without seeing him play his Senior year. Stupid article. Let's talk facts, figures and stats not fantasy. Come on.
If Moss wants to be here then go get him, but he doesn't. He only wants to go to New England and he sure doesn't want to work with Childress again and Childress doesn't want him either.
If Moss wants to be here then go get him, but he doesn't. He only wants to go to New England and he sure doesn't want to work with Childress again and Childress doesn't want him either.
It's not "selling the farm". It's one pick, an "extra" pick we got from the Atl draft day trade last year, use it to upgrade instead of a late first rounder who may or may not make it, remember Quinn c,are at #22
If it costs the Browns #4 & #22 to get RGIII, go for it. Giving up the #22 pick is not that big of a deal, remember we got Brady Quinn at #22, and where is he now?.....exactly. QB needs to be upgraded and RGIII compared to Colt McCoy is an upgrade, stronger arm, more mobile, more exciting, better athlete. Go for it.
As a back up and/or compete for starter spot. But need a QB early in draft, RGIII, or a veteran via free agency or trade.
RGIII a WR and a pass rusher are NEEDED in this draft
No E. Street Band is a sin, if this was going to be done they needed to be included. Rock n Roll HOF is a joke.
Glad to see Nicholas Celebrezze appointed to the House. I'm sure he will win in November and be able to serve the people of the 15th District for years to come.
For those who want to do nothing but focus on his name, shame on you! Do some research, look to see what kind of man he is before you attack him. Nicholas Cleberezze is a fine upstanding man and citizen of Ohio. He has no criminal record,owns his own law firm, has been a low paid Probation Officer for the county, he does good work, hard work that many people shy away from. I'm glad he is in the House, you should be too.
Oh good, finally someone to address all my issues, and for free, no more therapist for me, thanks.
...and maybe if YOU read what I wrote you would have seen the words COUPLE OF FOLKS. Which means more than one person, so I was addressing your comment regarding Lerner getting it and another persons comment regarding Lerner being interested in the team.
For the coupled of folks saying Randy Lerner is interested in the Browns and is a local guy who gets it...All I can say is HUH??!!?!? Lerner has nothing to do with the team, he rarely ever leaves the East coast, other than to go across the pond and watch his soccer team. And his father lived in Shaker, he didn't grow up here, his a NY guy through and through, born there, college there, still lives there. Lerner has the money, worth about $1.5 billion, but doesn't dip into that pocket for the Browns, where are the big name FAs? Big name coach? Lerner couldn't care less, as long as the team keeps him in the black he is content.
No, Thank YOU Mr. Celebrezze!
"John Lawson, the child's guardian said the ultimate goal is to reunify the mother and child, who now weighs 192 pounds."
Ummmmm, shuldn't the ultimate goal be to get this child healthy?


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Just because somebody tells you that a certain business category is a dying business doesn't mean it's gonna die today or tomorrow. People were still making money on Blockbuster stores a decade after the announcement of their demise.
Business categories do, indeed, die. Almost always because of advances in science. Nobody's making steamships any more.
But some categories that start shrinking aren't necessarily dying. They're just getting smaller.


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Over the last several years, Florida and other states have made great strides toward improving the availability and quality of health care coverage for their citizens. Many of these improvements result from an increased use of managed care health plans, including health maintenance organizations (HMOs) and preferred provider organizations (PPOs).[1] Health maintenance organizations are beginning to occupy a greater share of the health insurance market,[2] and studies indicate that the enrollment growth in these managed care plans is a primary factor in the rate of decline in the spiraling costs of health care coverage.[3]
Some interest groups, however, have promoted legislation that would heavily burden managed care plans by eliminating some of the essential concepts upon which managed care is based.[4] Proponents of this anti-managed care legislation, including some physicians, claim that HMOs place "profits ahead of patients,"[5] alleging that HMOs have achieved their cost savings at the expense of the quality of care provided to enrollees.[6] Much of this proposed legislation is promoted on the basis that it would protect patients and increase the quality of care they receive.[7] Managed care supporters, however, contend that this proposed legislation actually is designed to help doctors rather than their patients and would only drive up health care costs.[8] This battle over managed care was waged in legislatures across the country during 1995 and is likely to continue at both the state and federal levels.[9]
The first part of this Article discusses managed care legislation. Specifically, it provides a summary of some of the last five years of Florida's legislative health care advancements incorporating managed care concepts. It then discusses some of the proposed legislation which targets HMOs and other managed care plans. The second part of the Article presents a comprehensive analysis of medical literature comparing the quality of care provided by HMOs to the quality of care provided to patients with traditional fee-for-service insurance.[10] The available literature indicates that the quality of care provided by HMOs is as good as, if not better than, the quality of care provided in a traditional fee-for-service setting.[11] Finally, the Article concludes that, because studies show that the quality of care in HMOs is as good as the care provided under traditional insurance coverage, legislation which would cripple managed care in the name of preserving quality is unnecessary and counterproductive.
During the 1980s and early 1990s, the spiraling costs of health care threatened to bankrupt the country. In Florida alone, health care expenditures increased 278% between 1980 and 1991.[12] The state's total health care bill was $35 billion in 1991 and $38 billion in 1992.[13] Without a major change in Florida's health care system, some estimated that Florida's total health care bill would reach $90 billion by the year 2000.[14] Nationally, as recently as the late 1980s, costs of group health care plans were increasing at more than 15% annually.[15] As a result of these increasing health care costs, more people were forced to forego health insurance.[16]
In response, many states have enacted, or are enacting, legislation designed to make quality health care available to their citizens at an affordable price.[17] In 1992, Florida increased its efforts to combat these ills by enacting a series of reforms designed to make health care less costly. The Florida Health Care Reform Act of 1992 contained provisions creating the Employee Health Care Access Act, which initiated reforms in the small group health insurance market;[18] the Florida Health Plan, which developed strategies and implemented goals relating to access, cost containment, health care regulation, and insurance reforms;[19] and the Agency for Health Care Administration, which streamlined the regulation of health care in Florida.[20]
In the following year, the Florida Legislature enacted the Health Care and Insurance Reform Act of 1993.[21] Among other provisions, this Act implemented the concept of "managed competition" in Florida through the creation of eleven Community Health Purchasing Alliances (CHPAs).[22] Under managed competition, providers and payers join together to offer health care and insurance in a single package; together they compete for customers in a geographically defined health care market.[23] This Act also implemented health care coverage reforms for Florida employers with fewer than fifty-one employees.[24] These reforms include modified community rating, guarantee-issue requirements, and portability.[25]
The Florida Legislature has continued to consider reforms. In 1994 and 1995, the Florida Legislature considered various versions of the Florida Health Security Act.[26] These Acts would have enrolled Medicaid participants in managed care plans and would have used the savings to assist low-income Floridians in purchasing health care coverage.[27] These proposals did not pass in the Legislature and are still the subject of rancorous debate.[28]
Legislation also has been introduced in the Florida Legislature to limit severely the effectiveness of managed care plans in general, and HMOs in particular. During the 1995 session, legislation that targeted managed care plans included the Patient Protection Act,[29] the "Any Willing Provider" measure,[30] and legislation mandating direct access for patients to certain medical providers.[31] None of these bills passed the Legislature.[32] However, supporters indicate they will continue to fight for passage of these measures in the future.[33] A brief overview of some of the key provisions contained in this proposed legislation follows.
During 1995, more than twenty state legislatures considered bills designed to hinder managed care organizations.[34] Many of these bills were patterned after the American Medical Association's Model Patient Protection Act, which was drafted in 1994.[35] The provisions contained in Florida's version of the Patient Protection Act, House Bill 841 (the Act),[36] are representative of nationwide proposals attempting to restrict managed care and give more power to physicians and patients.[37]
The Act would have required managed care plans to provide prospective enrollees with detailed information on the plan's terms, conditions, and contracts with its providers.[38] Supporters of this provision contend that it would have put patients, rather than insurance companies, in control of care by providing them with additional information to enable them to make more informed choices when purchasing a health plan.[39]
Health maintenance organization proponents contend that the most useful information to the consumer is already presented to HMO enrollees with their member handbook[40] and that the Act could have required HMOs to provide volumes of material which would overwhelm potential enrollees.[41] For example, the Act might have been interpreted to require detailed lists of coverage provisions, benefits, and exclusions for each physician or provider in an HMO's network.[42] For large HMOs with many physicians and provider contracts, this provision alone would have required hundreds of pages.[43] The increased expense of furnishing this information to consumers would not have been matched by any additional value to the enrollee.[44]
Health maintenance organization representatives also are concerned that this provision would have been interpreted to require them to make available confidential information about the terms of their contracts with their hospitals and doctors.[45] Health maintenance organization representatives contend that much of this information is of little use to patients but could be used by competitors and adverse parties in contract negotiations.[46] These representatives argue that this information is proprietary and that making some of this information public would necessarily hinder future negotiations with providers; providing such information, which has no bearing on the quality of care, would thus increase the cost of providing care.[47]
The Act would have provided increased due process rights to physicians who were denied admittance to or terminated from a managed care plan.[48] It would have required each plan to establish a credentialing system for physicians[49] and would have allowed all physicians within a plan's geographic area to apply for the plan's credentials.[50] The Act also would have required HMOs to hire or contract with all qualified doctors who applied for credentials, even if the HMO had a surplus of doctors in relation to its number of patients.[51] These provisions of the Act would have placed severe restrictions on an HMO's ability to select its own physicians.[52]
Managed care opponents contend that this provision would have protected patients by removing the threat that an HMO could terminate a physician for economic reasons, or for having provided a patient with necessary care not authorized by the HMO.[53] This provision would have given physicians statutory job security not provided to any other profession.[54] Supporters of managed care view the measure as a virtual guarantee that every physician in Florida would have had an unprecedented right to obtain and keep a job.[55]
Furthermore, HMOs argued that they would have been prevented from quickly terminating doctors who were making mistakes.[56] Under the Act, an HMO could not have removed a doctor from its network unless the HMO had been able to prove the physician had caused "imminent harm to patient health[,] or [there had been] an action by the Board of Medicine or other government agency that effectively [impaired] the physician's ability to practice medicine within the jurisdiction," even if the HMO believed that the physician was not providing a suitable level of care.[57] Such a measure, HMO proponents contend, actually would have provided physicians with more protection than their patients.[58]
Health maintenance organization supporters also note that an HMO needs the ability to determine the number of physicians in its network.[59] One of the bedrock principles of managed care is that HMOs negotiate discounts with physicians in exchange for a certain patient volume.[60] Requiring an HMO to accept and retain all physicians who meet the credential requirements would eliminate an HMO's ability to provide its physicians with this volume. Thus, HMO supporters argue that the measure would have eliminated a provider's economic incentive to accept a lower rate and would have undermined one of the basic concepts of managed care.[61]
Supporters of the Act allege that HMO administrators, rather than the physicians, make the decisions regarding treatment of patients.[62] They believe that HMO employees may not always have the best interest of the patient in mind. Under the Act, only physicians would have been allowed to recommend denial of coverage or services or to make decisions about the necessity or appropriateness of treatment.[63] Any claimant who had a claim denied as "not medically necessary" would have been entitled to a due process appeal.[64]
Health maintenance organization proponents argue that this provision of the Act could have been interpreted to apply to two separate issues: treatment denial decisions and coverage decisions.[65] They note that HMOs already are required to have treatment denial decisions reviewed by a physician.[66] However, they are concerned that the Act would have been interpreted to apply to decisions concerning whether the treatment is covered under the HMOs' health plans as well.[67] This might have resulted in a requirement that all claims adjusters be licensed physicians.[68]
Health maintenance organization supporters further argue that this provision was unnecessary because all HMOs already are required to have grievance procedures through which HMO enrollees can challenge denial of authorization, and these grievance procedures provide a thorough review of all contested actions.[69] Under current law, these grievance procedures must be approved by the state[70] and meet national accreditation standards.[71] If the enrollee is not satisfied with the outcome of the HMO's grievance procedure, an independent statewide subscriber assistance program is available to review the denial.[72] This actually provides more safeguards for HMO enrollees, as such a statewide review of decisions is not always available for traditional indemnity policyholders.[73]
The Act would have granted physicians an exemption from antitrust laws in order to "combine into sufficiently large networks" to negotiate and compete with managed care plans.[74] The American Medical Association depicts the antitrust exemption as a way for physicians to "even the playing field" with insurers and HMOs.[75] However, insurers maintain that an antitrust exemption would cause boycotts and price-fixing by physicians.[76] They contend that this would be anticompetitive and result in increased health care costs.[77] Health maintenance organization proponents note that similar antitrust protections are not available for any other industry or employer group, and they question why only medical providers should obtain such protections.[78]
In addition, the Federal Trade Commission and the Federal Department of Justice already have developed health care provider antitrust "safety zones."[79] Health maintenance organization proponents contend that these safety zones should be given an opportunity to work and that the necessity of an antitrust exemption should be independently examined before carving out such exemptions for specific groups.[80]
One of the most controversial pieces of legislation directed at managed care would have required an HMO to allow any physician to become a service provider for the HMO so long as the physician agreed to accept the HMO's reimbursement rates and to comply with the HMO's guidelines.[81] Referred to as the "Any Willing Provider" measure, House Bill 541 reciprocally provided that enrollees in HMOs would be entitled at all times to "absolute choice" in the selection of their providers.[82] Health maintenance organizations would be "expressly forbidden" from requiring or coercing enrollees to use any provider other than one the enrollee selected.[83]
"Any Willing Provider" legislation defeats the entire concept of managed care. Health maintenance organizations and other managed care entities currently contract with only the number of physicians needed to serve their patients. By offering physicians an increased patient volume and a set income, HMOs are able to negotiate lower rates.[84] Requiring HMOs to allow any qualified physician to join the plan would drive up operating costs and reduce the HMO's bargaining power to negotiate physician fees. Cost savings generated by HMOs would be lost, and higher premiums would result.[85]
Finally, and perhaps most importantly, "Any Willing Provider" legislation could cripple the HMO's ability to ensure the quality of care provided by the physicians in its networks. While only minimal oversight is required in a traditional fee-for-service setting, HMOs are required to evaluate physicians' credentials before they are able to join the network and are required continually to monitor the quality of care provided once the physicians are members.[86] Health maintenance organization proponents argue that requiring HMOs to accept providers and making it difficult to terminate them from the HMO network will necessarily an hinder HMOs' ability to ensure high-quality health care.[87]
Another buzzword in the battle over managed care is "direct access." "Direct access" allows patients to receive services from certain health care providers without prior approval from their primary care physician.[88] Currently, HMOs operate under a "gatekeeper system," whereby the primary care physician, the "gatekeeper," usually must refer patients to a specialist before the HMO will cover the cost of the specialist's services.[89] The gatekeeper system assures that unnecessary services are avoided and that high-cost services are not overutilized by making one physician responsible for the coordination of the subscriber's treatment, medications, and other health care needs.[90] Health maintenance organization proponents argue that the gatekeeper's knowledge about the patient's medical history puts the gatekeeper in the best position to determine the most appropriate and cost-efficient care.[91]
House Bill 723[92] would have allowed HMO subscribers direct access to board-certified optometrists, ophthalmologists, and dermatologists under contract with the HMO.[93] The bill also would have prohibited HMOs from establishing disincentives to inhibit subscribers from seeking direct access to these three types of providers.[94] Allowing the patient direct access could have resulted in unnecessary utilization of these providers by HMO enrollees; such utilization would have increased health care premiums without necessarily increasing the quality of care.
Before legislation is passed which would, in many respects, eliminate managed care as a low-cost health care alternative, it is necessary to examine objectively the performance of HMOs and the care they provide. Supporters of the proposed curbs on managed care cite quality of care as one of the primary reasons such legislation is required.[95] Sponsors of these bills have attempted to link the cost savings HMOs generate to a decrease in the quality of the care provided to enrollees.[96] As one Florida Representative stated, "[A]ny time you squeeze price, squeeze price, squeeze price, quality is going to go down, go down, go down."[97] The Patient Protection Act itself cites that "potential and actual abuses by insurance companies and other managed care organizations, including making inappropriate decisions to refuse or terminate health care and other decisions which negatively affect patients' health," are evidence of the need for tough reforms which will protect patients from mistreatment.[98]
Recent studies, however, demonstrate that HMOs across the country are providing care which is not only of high quality but is, in many cases, better than the care provided to patients in non-managed care plans.[99] These studies have reviewed the quality of care provided in many settings and to many different types of patients.[100] Thus, the question arises whether there is a legitimate reason to pass legislation which would substantially alter, if not destroy, the managed care system.
The following section of this Article will focus upon medical literature comparing the treatment provided by HMOs to the treatment provided by traditional fee-for-service plans in the following areas: preventive care and health promotion in general, early diagnosis of diseases, care of the elderly, care of children, care in acute situations, and efficiency in medical treatment. It also will address comparative data relating to survival and mortality rates.
There is general agreement that one of the most effective and affordable means of providing quality health care is to make available, and encourage the use of, preventive care and health-promotion services. Research shows that HMOs are more effective at providing preventive care and health-promotion services than traditional fee-for-service indemnity plans. A recent literature analysis of managed care performance since 1980 published in the Journal of the American Medical Association cites six studies which have found that HMO plan enrollees receive more preventive tests, procedures, examinations, and health-promotion services than indemnity plan enrollees.[101]
Among the six reviewed studies, one published in the Annals of Internal Medicine compared the quality of care provided to patients with common ambulatory conditions in an HMO setting with care provided in a traditional fee-for-service setting.[102] The authors found that HMO patients were more likely to undergo screening for breast cancer and cervical cancer and had better blood pressure control than fee-for-service patients.[103] The study also found that HMO patients were equally as likely to undergo screening for colon cancer as fee-for-service patients.[104] Interestingly, the authors' initial hypothesis was that financial incentives to limit treatment in a network model HMO would reduce the number of services provided to HMO patients and potentially reduce the quality of care received.[105] However, they determined from their data that HMO patients "received equal or better quality of care than fee-for-service patients treated by the same physicians" for the treatment of uncomplicated high blood pressure "and for the provision of preventive services to middle-aged women without chronic diseases."[106] The authors concluded that "incentives for physicians to limit the use of medical services did not compromise the quality of ambulatory care" received by HMO patients.[107]
Researchers with the Centers for Disease Control and the National Center for Health Statistics reached a similar conclusion in a cancer screening study of women.[108] In this study, female HMO enrollees aged fifty to sixty-four were found to receive more mammographies, clinical breast exams, and Pap tests than women with fee-for-service coverage.[109] Using data from the 1992 National Health Survey, the authors of this study found that among women aged fifty to sixty-four with twelve years of education or less, 62.8% of female HMO enrollees had received a mammogram within the year preceding this study, compared with only 48.1% of women with fee-for-service coverage.[110] Almost 71% of the total HMO enrollees had recently received a clinical breast examination and nearly 63% had received a Pap test within the past year.[111] In comparison, less than 64% of women with fee-for-service coverage had received a clinical breast exam in the past year, and only 56% had received a Pap test in the past year.[112] For all women aged sixty-five and older, use of mammography and Pap testing was approximately 13% higher for HMO enrollees than for women with fee-for-service coverage.[113]
As these representative studies indicate, HMO patients are more likely to receive preventive care and screening than patients with fee-for-service coverage.
For many diseases, the effectiveness and degree of treatment vary depending upon the stage of the disease at the time of diagnosis. An earlier diagnosis means easier and more successful treatment. Thus, the quality and the cost of care are directly related to the extent of the disease at the time of detection.
Recent research indicates that HMOs provide superior cancer screening and preventive services than fee-for-service providers. For example, a study published in the American Journal of Public Health compared the stage of cancer diagnosis in Medicare beneficiaries enrolled in HMOs to the stage of cancer diagnosis in fee-for-service patients.[114] This study found that providers diagnosed HMO enrollees with melanoma, female breast, cervix, and colon cancer at significantly earlier stages in the disease.[115] The largest differences were found in women with cervical cancer and in patients with melanoma.[116] Health maintenance organizations diagnosed 58% of enrollees with cervical cancer at the "in situ," or local stage, as opposed to regional or distant stages.[117] Only 38.8% of fee-for-service patients were diagnosed at this local stage.[118] In melanoma patients, 39% of HMO enrollees were diagnosed when the cancer was at the local stage, compared to only 23.8% of fee-for-service patients.[119]
The research indicates that the earlier diagnosis of these cancers may be attributable to HMO coverage of screening procedures such as mammographies, Pap tests, fecal occult blood tests, and physical examinations.[120] However, in most cancers that lack these routine screening procedures, the researchers still found no difference in the stage of diagnosis between HMO and fee-for-service patients.[121] These cancers studied include prostate, rectum, buccal cavity and pharynx, bladder, uterus, kidney, and ovary.[122] Thus, the research indicates that HMO providers diagnose cancers at a stage which is at least equal to, and sometimes significantly earlier than, the stage of diagnosis for fee-for-service patients.
At least one critic of managed care has expressed concern that HMOs may be insensitive to patients with special needs, such as the elderly.[123] While it would seem that the supposed financial incentives to limit treatment in HMOs would be especially strong among high-cost enrollees such as the elderly, current research indicates otherwise.[124] A recent study published in the Annals of Internal Medicine compared the health and functional status of elderly Medicaid recipients in prepaid plans to the status of elderly patients enrolled in traditional fee-for-service Medicaid.[125] The authors of this study found that elderly patients enrolled in prepaid plans reported better general health and well-being scores than those enrolled in fee-for-service plans.[126] The study reported no differences between the two insurance groups as to number of deaths, the proportion in fair or poor health, physical functioning, activities of daily living, visual acuity, blood pressure, or diabetic control.[127] The authors concluded that "there was no evidence of harmful effects of enrolling elderly Medicaid patients in prepaid plans, at least in the short run."[128]
Another study found similar results when it compared the quality of care received by elderly patients with high blood pressure in Medicare HMOs to those in fee-for-service plans.[129] Of 685 elderly hypertensive patients studied, those enrolled in HMOs were more likely than those in fee-for-service plans to have their medications, alcohol history, and smoking history documented.[130] These HMO patients were three times more likely to have their orthostatic blood pressures checked both at their initial visit and in follow-up visits.[131] The authors also found "significant differences" between the two settings in referrals to sub-specialists.[132] Medicare HMO patients were more likely to receive a funduscopic examination and more likely to be referred to an ophthalmologist for examination.[133] Cardiac examinations were "consistently more frequently evaluated" in the Medicare HMO patients than in the fee-for-service patients.[134]
Hypertensive patients enrolled in Medicare HMOs also were significantly more likely to undergo screenings of electrolytes and renal parameters and tests for diabetes mellitus, and they were more likely to receive a chest roentgenogram.[135] While this study found that the Medicare HMO patients received fewer medication adjustments in response to new mental status changes and were less likely to have electrolytes monitored if they were on diuretics,[136] the authors concluded that elderly hypertensive patients in Medicare HMOs received "equal or better quality of care for most criteria," compared with those in fee-for-service settings.[137]
Children comprise another segment of the population that is particularly vulnerable to inadequate care.[138] Research conducted in response to this concern demonstrates that children enrolled in HMOs receive care which is at least comparable to the care received by children enrolled in fee-for-service plans.[139]
In a study conducted in conjunction with the RAND Health Insurance Experiment, 693 children ranging in age from newborn to thirteen were randomly assigned to either a staff model HMO or to one of several fee-for-service plans.[140] A comparison of the two groups found no difference in total health expenditures or in individual health outcomes.[141] However, children assigned to an HMO had a 40% greater number of routine preventive examinations and had a 50% greater number of office visits than children assigned to a fee-for-service plan.[142] The authors concluded that these results indicate that "no serious negative health effects exist for children receiving care in the staff model prepaid group practice compared to those receiving fee-for-service care."[143]
Additional concerns about HMO coverage may arise in acute care settings; these concerns include accessibility of HMO enrollees to medically necessary acute care and the quality of care HMO enrollees receive in these acute situations. However, recent research shows HMO enrollees actually may receive superior care in acute situations, compared to patients with fee-for-service insurance.
A 1994 study published in the New England Journal of Medicine found that patients with acute appendicitis who had fee-for-service coverage were more likely to suffer a ruptured appendix, which is associated with elevated mortality, than those patients enrolled in HMO plans.[144] The researchers suggested that "insurance-related delays in seeking medical care"[145] might be responsible; they noted that "[d]eductibles and higher co-payments in fee-for-service plans may contribute to delays by patients in seeking care."[146] Furthermore, they commented that "large staff-model HMOs often provide urgent care facilities that are separate from the hospital emergency room; such facilities may increase the likelihood of an early evaluation for abdominal pain."[147]
Additional research demonstrates that HMO members are actually more likely than fee-for-service patients to be admitted to a hospital in some acute situations.[148] A 1994 study of 3,006 patients who sought treatment at a hospital emergency department for acute chest pain found that HMO patients were more likely to be admitted to the hospital than patients in other insurance groups.[149] These results were true for patients at low risk and medium risk of acute myocardial infarction.[150] For patients at high risk of acute myocardial infarction, where the decision to hospitalize is less discretionary, hospital admission rates did not differ.[151] The "percentage of patients who suffered acute myocardial infarction and who were inadvertently discharged from the emergency department" also was the same for HMO patients and other patients.[152]
In their study, the authors acknowledged that salaried HMO primary physicians, "although at minimal direct financial risk, certainly would not receive financial rewards for hospitalizing their patients."[153] They noted that their explanations were uncertain for why they had found "unexpectedly higher"[154] admission rates for HMO patients with chest pain.[155] They contend the unexpected results suggested that "[o]rganizational factors beyond financial incentives ... may exercise a more powerful influence on physicians' decision making, potentially leading to increased hospitalization of HMO patients."[156]
A driving force in health care today is elimination of waste while maintaining quality. Research indicates that HMOs are highly effective in achieving this goal. The Journal of the American Medical Association published a comprehensive review of studies conducted since 1980 comparing managed care with indemnity plans; it found that, in eighteen of twenty comparisons from nine different studies, HMO plans used 22% fewer procedures, tests, or treatments that were considered expensive and/or had cheaper alternatives.[157] At the same time, sixteen studies conducted since 1980 have shown either better or equivalent quality-of-care results for HMO patients compared to fee-for-service patients. These studies reviewed a broad range of medical conditions, diseases, or interventions, including congestive heart failure, colorectal cancer, diabetes, hypertension, colon cancer, and cerebrovascular accident.[158]
One such study compared clogged artery treatment decisions for Medicaid patients, patients covered by fee-for-service plans, and patients enrolled in HMOs. This 1988 study found that fee-for-service patients were approximately 2.3 times more likely than HMO patients to undergo coronary bypass surgery or angioplasty than Medicaid patients, while HMO patients were only about 1.5 times more likely to undergo coronary bypass surgery or angioplasty than Medicaid patients.[159] However, mortality rates for HMO patients were slightly lower than those of fee-for-service patients; the lower mortality rates suggest that some of the coronary bypass surgery may have been unnecessary, which may have increased patient mortality.[160] The authors noted that the rate at which discretionary procedures were performed on HMO enrollees was lower than that on patients with fee-for-service coverage and suggested that this indicated "a more appropriate use of procedures in HMOs."[161]
At least one other study appears to indicate that HMOs provide more effective and efficient care. This study, comparing the treatment and mortality risk of prostate cancer patients covered by fee-for-service plans to such patients enrolled in HMOs, found that the HMO patients were less likely to receive surgery, but more likely to receive radiation therapy, than patients in fee-for-service settings.[162] Mortality risk was also lower for the HMO patients than for the fee-for-service patients, especially in low-income patients.[163] The authors stated that the finding of less frequent surgery, but more frequent radiation therapy, was consistent with previous findings that HMOs favor outpatient care.[164] However, the authors stated that the results of their study "contradict the belief that HMOs undertreat their patients" and "should encourage policy makers to continue viewing the HMO as a desirable alternative to traditional fee-for-service plans, particularly for low-income persons."[165]
The ultimate indicators of the quality of health care coverage are survival and mortality rates. Again, research suggests that survival and mortality rates for HMO patients are at least equal to, if not better than, the rates for fee-for-service patients. Coverage of preventive services, such as cancer screening, appears to have a positive effect on the stage at which cancer is diagnosed; early detection is "strongly associated" with survival and mortality rates.[166] Furthermore, a study comparing the treatment and survival of prostate cancer patients in HMO and fee-for-service settings found that the mortality risk was lower for HMO patients than for patients with fee-for-service plans, with the difference being greatest among patients with low incomes.[167] The authors noted other research indicating that treatment in an HMO setting also may increase survival rates for low-income patients with other cancers.[168] From their own research and available literature, the authors concluded that HMOs "enable persons predisposed to seeking appropriate care to do so," and that HMOs "promote access to basic medical services"; these factors "appear conducive to survival."[169]
A year-long study comparing the health status outcomes of elderly Medicaid recipients enrolled in fee-for-service plans to those enrolled in prepaid plans also documented equally favorable survival rates for managed care enrollees.[170] In a study of 800 Medicaid beneficiaries aged 65 or older, there was no difference in the number of deaths between those enrolled in fee-for-service plans and those who received prepaid care.[171]
Proponents of anti-managed care legislation argue that the quality of care HMOs provide is, or will be, poorer than the quality of care provided in the traditional fee-for-service settings. However, as shown by the research cited in this Article, the quality of care in an HMO setting is often equal to or better than that provided in a traditional fee-for-service setting. Additionally, HMOs provide this equivalent or superior medical care at a lower cost.
Managed care plans tend to offer better access to screening and preventive care services. Thus, they are better at keeping their enrollees healthy, and their physicians are often able to diagnose conditions at an earlier, more manageable stage. For these and other reasons, managed care plans can be more efficient and effective than fee-for-service plans. The studies clearly indicate that HMOs are a viable means for providing low-cost, quality health care.
This review of the objective medical literature indicates that there is no legitimate reason to eliminate HMOs as a health care alternative. Studies demonstrate that increased enrollment in managed care plans is beginning to slow the runaway increases in health care costs. However, physicians and others have proposed, and continue to propose, legislation that strikes at the foundation of HMOs and managed care plans. The authors believe the proponents of such legislation are either not aware of these objective studies or may have been unduly swayed by anecdotal evidence of abuse. After an analysis of proposed anti-managed care legislation and a thorough review of the available literature, the authors conclude that legislation which seeks to eliminate the very concepts on which managed care is based is unnecessary and will deprive Florida citizens of their ability to choose this option for high-quality, low-cost health care.


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Make your animations "look" right by creating smooth motion, with these software-agnostic tricks from animation expert George Maestri.
Learn how to use the extensive range of tools in 3ds Max to render out elements for compositing in After Effects.
Achieve a richer, more dynamic look for your Flash-based animation by incorporating hand-drawn animation techniques.
The founders of Tiny Inventions explain how their (tiny) two-person animation studio evolved and share the process behind their film Between Times.
Learn to rig and animate a 3D robotic arm in CINEMA 4D.
This course offers intermediate and advanced Flash designers a step-by-step guide for creating full-featured facial rigs in Flash Professional.
Breaks down the process of creating, rigging, and animating the arm of a character in an opening title sequence in After Effects—a task traditionally performed using rigging or skeleton tools available in 3D programs.
Introduces the skills needed to create photorealistic 3D creatures for film, video, and game production.
Create and animate highly controllable characters using After Effects.
Discover how to import layered files and paths from Illustrator into After Effects, animate flat vector artwork in both 2D and 3D space, and output your animations.
Teaches you how to use Illustrator's tools and features to prepare 2D files for animation in Adobe After Effects.
Use nested symbols and motion and shape tweening to create believable characters in Flash.
Shows how to master the new Motion Tween model and the Motion Editor to control easing and effects.
Follows the creation of a short animated film, from storyboard through final output, using After Effects CS3.
"The quality of the videos and teaching is excellent and rarely a week goes by when I do not sign in and learn something new." —Brian L.
more from our members »


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Welcome to Our Site
Welcome to the online home of Antioch Baptist Church in Timberlake, NC. Our hope is that your visit to this site will be both useful and enjoyable as you find out about who we are, where we have come from, and what things God continues to do in our church family. Be sure to check back regularly for new updates to the site. This website has been built with you in mind - if you have any questions, comments or concerns, please don't hesitate to let us know. So go ahead, start browsing!
A Word From Our Pastor
I just wanted to take this opportunity
to welcome you to our
little corner of the World Wide Web, and encourage you to look through
our site and learn more about our "little country church on the move"-
we are a relatively small country church bursting at the seams, with a
genuine desire to Glorify GOD. Please feel free to contact us by any of
the methods made available on the site and we will respond as quickly
as possible. We would also like to welcome you to our Church and family
as we seek to fulfill our vision of "Growing the Christian Family at
Home and Abroad." God Bless You!
- Dr. M. David Chambers
New! Video Podcast
Looking for a more convenient way to watch Antioch services? Try the new video podcast! Each 30 minute episode contains a special music selection as well as the message. It works great with most smartphones and tablets (also works with standard browsers) and has better video quality than the Watch page. Try it out today by clicking here to access subscription links for your podcast viewer or here if you use iTunes.
Youth Page
Check out the Youth Page! It's up at http://antiochlit.wix.com/home.


text:
The popularity of the iPod is creating a backlash of resentment as the iPod becomes too ubiquitous to be chic.
The Zandl Group, a New York-based trends forecaster which regularly interviews a panel of 3,000 consumers aged 25-35, recently picked up its first significant criticisms. 'The iPod is far and away the most popular tech gadget with our panellists - however, for the first time we are hearing negative feedback about the iPod from some panellists,' said the organisation's spokeswoman, Carla Avruch. 'Panellists cite that the batteries are not replaceable, so when they die the entire player must be replaced,' she said. 'We have heard from some conspiracy theorists that the batteries are made to die soon after the warranty ends.
Certainly other companies can develop devices that equal or surpass the iPod in functionality. The technological challenges are not very high.
Sales have peaked.
From its launch five years ago its sales graph showed a consistent upward curve, culminating in a period around last Christmas that saw a record 14 million sold. But sales fell to 8.5 million in the following quarter, and down to 8.1 million in the most recent three-month period.
Apple may have saturated its target market. However, the success of the iPod might have spawned so many competitors that the peak might be due to sales by the competition. Anyone know of a source for industry sales of MP3 players?
Mac Daily News thinks the original article paints far too pessimistic a picture.
This is a semi-annual article that's dusted from time to time for republication. The formula: Ignore cyclical holiday buying patterns to show "declines" in iPod sales, dig up some out-of-context focus group lines that iPod is "losing its cool," and insert this year's "threats" to iPod+iTunes (oh, David, basic iPod FUD 101: you forgot "iPod scratches," dummy).
But cell phones are beginning to get built-in MP3 players. Cell phones have already caused a peak in PDA (personal digital assistant) sales. Apple is responding by planning to bring out an iPod model can play downloadable movies. But when walking around people have less time to watch movies than to listen to music or converse on a phone. Though I can imagine people watching part of a movie or a favorite TV show when on a work lunch break or while stuck in a car waiting to pick up a kid from school or sports practice.
Are there better portable music players for MP3, WMA, and other formats? Anyone have suggestions on better value propositions or more richly featured portable music devices?
Apple will be far from first in the paid video download business. Amazon has begun a movie download service that can only work with Microsoft Windows XP PCs.
While Amazon's service carries thousands of TV shows and movies from more than 30 studios and networks here and abroad, it has many of the same prohibitive features that impede other movie-download services.
With a typical DSL/cable home Internet connection, it takes 55 minutes to download a hourlong TV episode and one hour and 50 minutes to download a two-hour movie, although Amazon has a feature that allows customers to watch a video during the process.
The Amazon Unbox video player works solely on Microsoft's latest operating system, Windows XP not on Macs or older versions of Windows. The system is not compatible with the iPod, the center of a technological ecosystem that Apple strictly controls.
You could download a video onto a laptop and then watch it on an air flight instead of the standard in-flight movie - at least until anti-terrorism measures lead to a ban on carry-on laptops.Posted by Randall Parker at September 10, 2006 05:50 PM
Don't make to much of the Amazon/M$ movie DL deal. Amazon unbox works with Tivo S3.
I dont think its that the ipod is losing popularity I think that its because practically EVERYONE has one. When the ipods first came out everyone went bananas to get one, now that everyone has one, its harder to sell them.
Seems unfair that the Instapundit would link a 2 year old post that only shows up how wrong it was.
I think he owes you a link to something more current, where events at least haven't been proven you wrong yet.
I bought a Sandisk Sansa Clip mp3 player. It's just as good as Apple's player. It's significantly cheaper. And it has more features(fm radio, voice recording). How many mp3 players do people really need? I guess when the battery dies, you need to get a new one.
OR, it could be that because of the drawbacks....and the enormous expense, people are now buying alternatives to the Ipod...personally, I've bought 3 sansa mp3 players (one ea for myself, the wife, and my son)...they've all lasted far beyond the warranty period...while my daughter & step daughter's Ipods have BOTH been replaced twice each...battery and storage issues...
I won't buy and Ipod, nor any related products for this reason...batteries just don't last, nor does the storage system...
QUOTE: "batteries just don't last"
Nonsense. I've had excellent luck with my iPod batteries. And after a couple years, when they do decline, I've replaced them myself cheaply. If you're reasonably handy with a small screwdriver (or have a friend who is), it's no big deal.
QUOTE: "the enormous expense"
Laughable. Compare equivalent players, and you'll see that iPods are competitively priced.
QUOTE: "people are now buying alternatives to the Ipod"
"Wishful thinking" for an iPod hata. iPod market share has been stable or rising.
that is not true for today because ipod is still popular although it has already many rivals.


text:
HARRISON, N.Y. – President Obama's motorcade will take him through Purchase on Friday afternoon to attend one of two Westchester fundraisers, which could spell trouble for those looking to get away ...
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I was gonna make a g@y joke , butt fuck it.
Why are girls still surprised when this happens?
We think that we got over it during the sleepover years.
Bi the way, how was it?
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28,161pages on
this wiki
this wiki
|Music by
|Stephen Lawrence
|Lyrics by
|Mark Saltzman
| SJL Music Co.
Sesame Street Inc.
|Episode 2176
NTV is a Sesame Street MTV parody channel all about the letter "N", with Nora Nicks as the host. The channel featured Nick Normal and the Nickmatics singing "The Letter N", which was described to be their latest hit song.
In the group's performance of "The Letter N", Nick Normal sings about his Friday afternoon, and the events that happened (featuring black and white flashbacks), which all involve words beginning with "N": Nothing, Never, and No, eventually leading to a giant letter "N" appearing at the end of the video.
- The song features MTV-style captions that refer to "N Records" at the beginning of the music video.
- The song was also used in a 1991 episode, where Maria and Big Bird were watching NTV in the Fix-It Shop.
- Online


text: The annual smAlbany Business Expo and Social Media Conference is July 17 at the College of Nanoscale Science and Engineering. The event was founded by Liberteks, a Guilderland computer store. This year it has been organized by SEO Web Mechanics of Altamont. The free conference starts at 7 a.m. http://smalbany.org/


text:
August 2, 2015
RENO, NV - Washoe County Sheriff's deputies are looking into the theft of more than a hundred dollars in donations stolen from the Nevada Humane Society over the weekend.
The burglar broke through a double-paned window on the clinic side of the building.
Deputies don't know whether the burglar tried to take medications, but two donation jars containing more than 100 dollars were taken. Those funds are used to fund the spaying and neutering of animals for families who can't afford it. No animals were harmed.
It's estimated it will cost at least a thousand dollars to replace the window.
So far, nothing else appears to be missing. Deputies are reviewing surveillance video to get a better idea of who may have been involved.
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text:
With or Without Names, St. Louis Archdiocese's "Matrix" of Sex Offenders Leaves Questions
Note: There seems to be some problems with the third-party provider RFT used to upload the matrix. We are working to resolve the issue.
Download a copy or click the link for a larger view.
St Louis Archdiocese Child Abuse Spreadsheet by chad_garrison5721
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help me please... i dont know what to answers.
This is a discussion on What is RECURSION in MATHEMATICS? within the C Programming forums, part of the General Programming Boards category; help me please... i dont know what to answers....
help me please... i dont know what to answers.
f(x) = f(x2) + a
Manasij Mukherjee | gcc-4.9.2 @Arch Linux
Slow and Steady wins the race... if and only if :
1.None of the other participants are fast and steady.
2.The fast and unsteady suddenly falls asleep while running !
Last edited by King Mir; 10-03-2011 at 05:14 AM.
It is too clear and so it is hard to see.
A dunce once searched for fire with a lighted lantern.
Had he known what fire was,
He could have cooked his rice much sooner.


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Women's Brooks Dyad 8Item #BRK1139
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Nice shoe that will be used for walking and all day comfort. Just need to re-order in the wide width, also available from RRS via drop ship from Brooks.
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With other vendors in the past, the CMA had not experienced the type of project and event management partnership they desired. In bluemedia, they found a company that would proudly take ownership of its objectives and timelines. bluemedia would go on to develop a production plan that easily met sponsor/CMA deadlines as well as quality […]Read More
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Sit back and watch in awe as bluemedia helps to transform the University of Phoenix Stadium from an Arizona Cardinals facility into a Fiesta Bowl facility in less than 12 hours' time. Go behind the scenes and see for yourself how over 2 miles of banner material and 250 separate pieces of signage were used […]Read More
MTV2 recently stopped by our shop to see how we design / print, and install graphics for their show Burnout. Andy Salcido walked Clay Millican through our 55,000 sq/ft facility showing him each step of the process needed to create & produce our amazing vehicle graphics. Clay seemed most impressed with our HP Turbojet printer […]Read More
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Bluemedia helps Circle K take on thirst… Blue wrapped fourteen 28′ Trailers and eight 32′ Trailers along with a Tanker to promote Circle K's famous Thirst Buster. With great creative and amazing reproduction, thousands of commuters will find themselves uncontrollably in need of a ginormous .79 cent ice cold Thirst Buster.Read More
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Check out the new UTV we designed and wrapped for our friends over at the Tilted Kilt and Weller Racing.Read More
To communicate their "farm fresh" approach Sony recently recycled cast-off advertising banners into a collection of jeans. Called the "Recycle Project Jeans," the concept used ads which were displayed on the side of their building, in turn hanging and selling the upcycled product on that same wall. Sony, recognizing that (much like wine or sushi) […]Read More


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Jone's column was accepatable up until the point he took the unfounded cheap shot at Knight.
Geez, just what was that all about???? And just what is the story with Flounders? Is he full time or part-time? If he isn't writing about PSU football, which isn't often, just what else does he do at the Patriot?
Good decision BOT. All those that are frothing at the mouth for blood from Penn State are just going to have to begin to become more rational and control their emotions.
Barack Hussein Obama's socialist policies will only continue to contribute to the worsening of our country's economic situation.
Just how many writers and bloggers do PennLive and The Patriot have? It seems about every other day
another one of them is writing a column giving us their opinion about how they think we should view Joe. What is that saying about "beating a dead horse"?
Gettysburg's Susan Star Paddock says gambling is an inappropriate activity.
The biggest scandal in college sports history? Not even close. In a very real sense the scandal had almost nothing to do with any college sports program. It was about one person, Sandusky, who was a long time retired emplyee of a program. Nothing more.
Being accosted by a criminal is a terrible thing to have to endure. But being abused by overzealous law enforcement personnel or unethical members of the judicial system for me is far, far, far worse. One can very sadly be easily railroaded by the latter with almost no recourse.
Really? And again just why was Juan Williams fired?
Yes, yes, yes. yes!!!!!
Well lets put as a solution raising my taxes again way, way, way down the list of possible solutions that are considered.
Just a terrible, terrible article. Just who at PENNLIVE approved it? Agree, take Flounder off the Penn State beat now.
He put off telling us where we all knew he stood on the issue as long as he could.
Well, he certainly got his fifteen minutes of fame over with early on in life.
Gettysburg's own Susan Star Paddock prays for the souls of these people, these gamblers.
"One Term Tommie". Gov, you will never be able to live down having done wrong to JoePa.
Ganim, just can't accept your not reflecting his actual job titile.
One could surmise that maybe PennLive is obsessed with Penn State.
Notre Dame has been largely irrelevant in college football for almost a generation.