text:
Bulgaria Links Hezbollah to Bombing of Israelis
SOFIA, Bulgaria — Hezbollah is behind an attack on a bus filled with Israeli tourists in Bulgaria last year, investigators said Tuesday, describing a sophisticated bombing carried out by a terrorist cell that included Canadian and Australian citizens.
February 5th, 11:05Current Location:sofia, bulgariaFeb 5, 12:40 PM EST
by Natalie de Vallieres and Biodun Iginla, BBC News
SOFIA, Bulgaria — Hezbollah is behind an attack on a bus filled with Israeli tourists in Bulgaria last year, investigators said Tuesday, describing a sophisticated bombing carried out by a terrorist cell that included Canadian and Australian citizens.
In the first major announcement in the investigation into the July 18 bombing that killed five Israelis and their Bulgarian driver, Interior Minister Tsvetan Tsvetanov said one of the suspects entered the country with a Canadian passport, and another with one from Australia.
"We have well-grounded reasons to suggest that the two were members of the militant wing of Hezbollah," Tsvetanov told the BBC's Natalie de Vallieres by phone after a meeting of Bulgaria's National Security Council. "We expect the government of Lebanon to assist in the further investigation."
Within hours, Lebanese Prime Minister Najib Mikati condemned the attack and said his country would cooperate fully.
Hezbollah, a Shiite militant group and political party that emerged in response to Israel's 1982 invasion of Lebanon, has been linked to attacks and kidnappings on Israeli and Jewish interests around the world.
The group has denied involvement in the Bulgaria bombing, and Hezbollah officials in Beirut declined further comment Tuesday when asked that question by a BBC reporter. Hezbollah officials as a rule leave it to their leader, Sheikh Hassan Nasrallah, to comment on security issues.
The bomb exploded as the bus took a group of Israeli tourists from the airport to their hotel in the Black Sea resort of Burgas. The blast also killed the suspected bomber, a tall and lanky pale-skinned man wearing a baseball cap and dressed like a tourist.
Although it was initially believed to be a suicide bombing, Europol Director Rob Wainwright told The Associated Press that investigators now believe the bomber never intended to die. He said a Europol expert who analyzed a fragment of a circuit board recovered from the scene determined that it was detonated remotely.
The investigators found no links to Iran, which Israel had accused of playing a role in the attack.
The findings increased pressure on Europe to declare Hezbollah to be a terrorist organization, as the United States and Canada do.
"The attack in Burgas was an attack on European land against a member of the European Union," Israeli Prime Minister Benjamin Netanyahu told the BBC's Nasra Ismail by phone. "We hope the Europeans learn the proper conclusions from this about the true character of Hezbollah."
The White House called on Europe to take "proactive action" to disrupt Hezbollah. Counterterrorism adviser John Brennan, who is President Barack Obama's nominee to run the Central Intelligence Agency, said Europe and other international partners should seek to uncover Hezbollah's infrastructure and disrupt the group's finances and operational network.
Canadian Foreign Affairs Minister John Baird went further.
"We urge the European Union and all partners who have not already done so to list Hezbollah as a terrorist entity and prosecute terrorist acts committed by this inhumane organization to the fullest possible extent," he told the BBC's Biodun Iginla by email, adding that Canada would work with Bulgarian authorities given the apparent involvement of "a dual national living in Lebanon."
Catherine Ashton, the European Union's top foreign and security official, told the BBC's Emily Straton that the EU needs to assess the implications of the investigation seriously but stressed that any decision on adding Hezbollah to the EU list of terrorist organizations would require a unanimous decision by the foreign ministers of the 27 EU countries, whose next scheduled meeting is Feb. 18. Such a move would freeze Hezbollah assets and cut off funding.
France and Germany, wary of coming under increased pressure to do so, had pressured investigators not to publicly name Hezbollah as responsible for the bombing, according to a U.S. official who spoke on condition of anonymity because he was not authorized to speak to the news media.
The investigators' reports offered the first glimpse at how the bombing was carried out.
Wainwright – whose organization helps coordinate national police across the EU, which includes Bulgaria – told the BBC in an interview that two counterfeit U.S. driver's licenses that were found near the bombing scene were made in Lebanon. The investigators, he said, found no direct links to Iran or to any al-Qaida-affiliated terror group.
"The Bulgarian authorities are making quite a strong assumption that this is the work of Hezbollah," Wainwright said. "From what I've seen of the case – from the very strong, obvious links to Lebanon, from the modus operandi of the terrorist attack and from other intelligence that we see – I think that is a reasonable assumption."
For Hezbollah, the accusation comes at a horrible time.
Despite its formidable weapons arsenal and political clout in Lebanon, the group's credibility and maneuvering space has been significantly reduced in recent years, largely because of the war in neighboring Syria but also because of unprecedented challenges at home.
Hezbollah still suffers from the fallout of a month-long 2006 war with Israel, in which it was blamed by many in the country for provoking an unnecessary conflict by kidnapping soldiers from the border area.
Since then, the group has come under increasing pressure at home to disarm, leading to sectarian tensions between Lebanese Shiite Hezbollah supporters and Sunni supporters from the opposing camp that have often spilled into deadly street fighting.
More recently, Hezbollah's support for the government of Syrian President Bashar Assad has proved costly to its reputation, and last week Israeli warplanes bombed what was believed to be a shipment of sophisticated anti-aircraft missiles headed to Hezbollah.
New troubles for Hezbollah could also add to Iran's international isolation. The Iranian regime is already under international sanctions for its suspect nuclear program, and has seen its position weaken due to its close ties with the Syrian regime. Its association with Hezbollah will likely further hurt Iran's international image.
Wainwright warned the attack, along with a wave of attacks against Israelis around the world in the past year, is an indication of a real threat to Israelis and Jews in Europe.
"Even if it's not Hezbollah, it has still obviously been carried out by an organization with some capability in the world, so the threat remains," Wainwright said. "I don't want to exaggerate the scale of that threat, but I think law enforcement authorities – government authorities – should take notice of this incident and prepare for the possibility at least of similar attacks in Europe."Tags: bbc news, biodun iginla, israel, natalie de vallieres, terrorism
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Jun 15 2013, 9:18pm CDT | by Luigi Lugmayr
Beijing, June 16 — A court in China has sentenced a man to life imprisonment for forging financial documents to get over 10 billion yuan (around $1.6 billion) from banks and companies.
Liu Jiyuan, 45, former president of an investment management company in Shanghai, was accused of swindling 10.13 billion yuan from several banks and enterprises between November 2008 to November 2010, Xinhua reported.
The court in Jinan in Shandong province said Liu forged seals of banks and companies, loan materials, certificates of deposit and telegraphic transfer as well as cheques.
Liu was also accused of pretending to be a bank staffer to illegally gather deposit from enterprises.
Over eight billion yuan has been retrieved after Liu's case was exposed.
Source: IANS
Luigi Lugmayr
Luigi is the founding Chief Editor of I4U News and brings over 15 years experience in the technology field to the ever evolving and exciting world of gadgets. He started I4U News back in 2000 and evolved it into vibrant technology magazine.
Luigi can be contacted directly at email@example.com. Luigi posts regularly on LuigiMe.com about his experience running I4U.
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subset: commoncrawl


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This coaching inn is situated beside the A10 on the Cambridge side of Ware. An adjacent modern annexe provides cottage-style rooms and a good array of modern facilities. Meals are taken in the inn whe...More about Feathers Inn
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Prepositions and Theology in the Greek New Testament: An Essential Reference Resource for Exegesis
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Product Description
Offered in the hope that it might encourage close study of the Greek text of the New Testament, its many features include the following:
- Coverage of all 17 'proper' and 42 'improper' prepositions
- Explores both literary and broader theological contexts
- Greek font---not transliteration---used throughout
- Comprehensive indexes to hundreds of verses, subjects, and Greek words
- Discussion of key repeated phrases that use a particular preposition
Product Information
|Format: Hardcover
Number of Pages: 192
Vendor: Zondervan
Publication Date: 2012
Availability: In Stock
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Publisher's Description
Prepositions are important in the exegesis of the Greek New Testament, but they are at the same time very slippery words because they can have so many nuances. While Prepositions and Theology in the Greek New Testament rejects the idea of a theology of the prepositions, it is a study of the numerous places in the Greek New Testament where prepositions contribute to the theological meaning of the text.
Offered in the hope that it might encourage close study of the Greek text of the New Testament, its many features include the following:
- Coverage of all 17 proper and 42 improper prepositions
- Explores both literary and broader theological contexts
- Greek fontnot transliterationused throughout
- Comprehensive indexes to hundreds of verses, subjects, and Greek words
- Discussion of key repeated phrases that use a particular preposition
Author Bio
Murray J. Harris is professor of New Testament Exegesis and Theology at Trinity Evangelical Divinity School in Deerfield, Illinois. Previously he was Warden of Tyndale House, a biblical research library in Cambridge, England. He presently resides in New Zealand.
Product Reviews
Timothy MillsAge: 55-65Gender: male5 Stars Out Of 5Prepositions and Theology in the Greek New TestameMay 1, 2013Timothy MillsAge: 55-65Gender: maleQuality: 5Value: 5Meets Expectations: 5For the person who is familiar with Greek, for the pastor using the Greek NT text for sermon preperation, this is a good resource for understanding the text. Sometimes the meaning is not clear because we miss the nuances contained in the prepositions. In the Lord's Prayer: "Protect us from evil;" in the Greek: "τοῦ πονηÏοῦ". The preposition makes it definate, and not relative; Satan not evil at large.
This is my second copy of the book, I left the first one behind in a hotel!


text:
Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians' decisions to honor or forgo previously established advance directives (ADs). In addition, physician views regarding legal risk, patients' ability to comprehend complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored.
Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents' perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test.
Three hundred eighty-eight of 951 surveys were completed (41% response rate). Eighty percent reported they were likely to honor a patient's AD despite its 5 year age. Fewer than half (41%) would honor the AD of a patient in ventricular fibrillation who had expressed a desire to "pass away in peace." Few (17%) would forgo an AD following a family's request for continued resuscitative treatment. A majority (52%) considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage (74%) disagreed that patients could not appreciate complexities surrounding their care while 69% agreed that costs should never impact a physician's decision as to whether to comply with a patient's AD.
Our findings highlight the impact, albeit small, external factors have on physician AD compliance. Most respondents based their decision on the clinical situation at hand and interpretation of the patient's initial wishes and preferences expressed by the AD.
Keywords:Advance directive; Physician decision making; Patient preference
Prior to the 1970s, medical care of the seriously ill was generally physician-directed by the ethical principles of beneficence and non-malfeasance [1]. Physicians (and other care providers) often provided treatments without first assessing patients' values or goals of care. This approach changed substantially following the highly publicized 1976 New Jersey Supreme Court decision of in re Quinlan, which held that a patient or his or her guardian had the right to refuse unwanted life-sustaining treatment even if doing so resulted in death. Public response to this case and subsequent cases [2-4] gave rise to the notion that patients ought to have a means of communicating their health care related values and goals in the event they are unable to communicate for themselves [5]. Indeed, following the Supreme Court's Cruzan decision, the Patient Self Determination Act (PSDA) was passed in 1990, requiring health care institutions that receive Medicare and Medicaid funding to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker [5,6]. All U.S. states and the District of Columbia have laws that recognize advance directives (ADs) [5].
Despite the transition from paternalistic decision making on the part of health care providers to decision making more centered on patient autonomy, the advent of ADs as a means of consistently and accurately reflecting patient wishes has been less successful [5-7]. Health care providers have struggled to align the importance of patient autonomy with treatments based on beneficial care [5,8-11]. When considering whether to provide life-supporting measures, physicians may be influenced by patient preferences, medical considerations and external factors [10-12]. External factors may include family wishes, financial considerations, physician characteristics and fear of legal liability [7-11,13-17]. Described as "interests of people other than the patient", these matters can lead to ethical conflicts involving patient care [7,10].
In this study, we evaluated the impact of these external factors and perceived patient preferences on physicians' decisions to honor or forgo previously established ADs. In addition, we explored physicians' views regarding legal risk, concerns over patients' ability to comprehend complexities involved with their care, and the impact of medical costs related to end-of-life care decisions.
Setting and participants
This study was approved by Mayo Clinic's Institutional Review Board. Each year, Mayo School of Continuing Professional Development conducts several comprehensive internal medicine continuing education courses. Attendees of two of these courses (Mayo Internal Medicine Board Review and Mayo Clinical Reviews), which were conducted in Rochester MN, were surveyed using a Scantron® survey based system. The survey instrument is in Additional file 1.
Additional file 1. Physician Questionnaire. Physician questionnaire including three patient oriented scenarios and general question set.
Format: PDF Size: 27KB Download file
This file can be viewed with: Adobe Acrobat Reader
Three scenarios based, in part, on previously court-litigated matters were employed to assess the impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation (Additional file 1). Scenario 1 presented respondents with an AD that had been signed in the past as the patient prepared for elective surgery and who, years later, presented with an acute unrelated problem.
"Scenario 1: A 62 year old patient with a history of hypertension and type 2 diabetes presents to the Emergency Department complaining of "not feeling well". His initial blood pressure reading by cuff is 240/110. Intravenous blood pressure therapy is provided by the Emergency Room staff after which he is transferred to a monitored hospital bed for close observation. Shortly following admission, the patient complains of a severe headache. Your work-up confirms that the patient has suffered a massive cerebral vascular accident (CVA). He is now is in severe respiratory distress. A trial of non-invasive ventilation has failed and the patient now requires intubation. An advanced directive signed by the patient 5 years ago prior to knee surgery indicates that the patient is "Do not resuscitate" (DNR) / "Do not intubate" (DNI)."
Scenario 2 aimed to assess the impact that illness acuity had on physician decision-making in the setting of an AD that reflected patient wishes to "pass away in peace".
"Scenario 2: A 65 year old patient with well controlled hypertension and who has signed an advance directive order stating a wish to "pass away in peace" arrives to the Emergency Department complaining of "chest pain". He is admitted to the cardiac telemetry unit pending a full work-up for cardiac ischemia. Shortly following arrival to the unit, he falls into ventricular fibrillation. A "Code" is called and upon your arrival to the bedside, the patient is apneic and requiring mask ventilation by the nursing staff."
Scenario 3 explored the influence of family demands that conflicted with a patient's AD had on decision making.
"Scenario 3: A 68 year old patient with hypertension, diabetes, end stage renal disease on dialysis and acute lymphocytic leukemia arrives to the Emergency Department febrile, tachypneic and hypotensive. He is transferred to the intensive care unit (ICU) you are covering and upon arrival becomes asystolic. The hospital electronic charting system shows that the patient completed and signed an advance directive indicating "Do not resuscitate" (DNR) / "Do not intubate" (DNI) wishes during a recent visit with his oncologist. The wife of the patient has demanded that you "disregard the advance directive and do everything you can to save my husband"."
A complete description of each scenario can be found in Additional file 1.
General questions were used to measure respondents' agreement with statements pertaining to perceptions of legal risk, concerns over patient knowledge of the idiosyncrasies involved with their care, and the impact that medical costs may have on compliance with patient preferences. A pilot study involving Mayo Clinic Department of Medicine staff physicians was initially undertaken to analyze the performance of both scenario-based and general question set design.
Statistical analysis
Responses which indicated "prefer not to answer" were treated as missing data. In addition to analysis using descriptive statistics, the responses indicating the strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Responses to questions 5–19 were also grouped into two levels, depending on the question: Very/somewhat likely and very/somewhat unlikely; Very/somewhat important and very/somewhat unimportant; Strongly agree/agree and Strongly disagree/disagree. These binary groupings were treated as categorical data for Chi-square and Fisher exact test analyses, as appropriate, depending on the numbers in each cell. A P-value of less than 0.05 was considered significant.
Overall, 388 surveys were completed by 951 attendees (response rate, 41%). The demographic characteristics (gender, age, type of service, years in practice) of respondents appear in Table 1. For the purpose of discussion of the results, Somewhat likely/Very likely and Somewhat unlikely/Very unlikely are reported as Likely and Unlikely, respectively. Similarly, we report Important and Unimportant, and Agree and Disagree.
Table 1. Demographics of Respondents
Scenario 1 (Old AD, used subsequently)
A majority (80%) of respondents reported they were likely to honor the patient's AD and not intubate the patient suffering from a massive stroke. (Table 2) Sixty percent of all respondents considered the age of the AD to be important in their decision making. This figure was even higher (69%) in those who were unlikely to adhere to the AD. (Table 3) About one-third (37%) of all surveyed reported fear of legal liability as a factor in their decision (P = 0.05). However, this figure did not vary among those who reported they would or would not comply with the patient's AD (P = 0.21). Physician age and number of years in practice did not influence answers provided to questions in Scenario 1, although older physicians were more likely to have a measured view of the importance of legal considerations with fewer responding "very important" or "very unimportant" to the consideration of legal liability (P = 0.03) (Table 4).
Table 2. Scenario responses including impact of advance directive characteristics on final decision making
Table 3. Influence of a variety of factors on the likelihood of compliance with advance directive
Table 4. Impact of respondent age and years in practice on the likelihood of compliance with advance directive
Scenario 2 (AD expresses wish to die peacefully, acute situation encountered)
Fewer than half (41%) of respondents reported they would honor the AD of a patient in ventricular fibrillation who had expressed a desire to "pass away in peace." (Table 2) A large majority (86%) considered it important that the patient's request did not mirror the acuity of the immediate condition requiring intervention. The results for Question 8 differed by gender, with female physicians more likely than male physicians to express uncertainty as to how they would proceed based on the information provided. (P = 0.01) Respondents older than age 50 years were more likely to consider the acuity of the condition as important. (P = 0.03; Table 4).
The decision to defibrillate the patient or not was independent of the fear of legal liability (P = 0.07). (Tables 3 and 4) The fear of legal liability was not influenced by gender, age, practice type or duration of practice.
Scenario 3 (Family in conflict with patient's stated preferences)
In the hypothetical case of the critically ill patient with leukemia, three-fourths of respondents (74%) reported that they would honor the AD despite the spouse's request for continued resuscitative care. (Table 2) Among those who would not adhere to the AD, 78% considered the spouse's demand important to their decision. (Table 3) Respondents older than 50 years were more likely (59% versus 49%, P = 0.01) to be influenced by the wife's request than respondents age 50 years and younger. (Table 4) Similarly, 60% of those physicians in practice for more than 15 years reported the spouse's request as important to their decision compared with 46% of those with less experience (P = 0.01). (Table 4) Overall, fear of legal liability was important to more of the respondents (53%) than noted in either of the other two patient scenarios (P < 0.01). (Table 3) Although a higher percentage of respondents were influenced by a fear of liability amongst those who would not honor the AD (63%) compared with those who would (50%), the difference was not statistically significant (P = 0.42). (Table 3) The fear of legal liability was independent of age or years of practice (Table 4).
Two questions are common to each of the three scenarios. Questions 5, 8 and 11 concern the likelihood of honoring the advance directive. Questions 7, 10 and 13 ask about the legal fears of the decision. Of the 388 respondents, 312 stated that they were likely or very likely to honor the advance directive in Scenario 1. Of these, only 139 were also likely/very likely to honor the advance directive in Scenario 2, and only 108 were also likely/very likely to honor the advance directive in Scenario 3. Thus, 108 of the 388 respondents (28%) answered consistently across scenarios regarding their likelihood of honoring the advance directive. Although the fear of legal liability was very important or important to 37%, 41% and 53% of respondents for Scenarios 1, 2, and 3, respectively, only 39 respondents (10% of the total), consistently answered that the fear of legal liability was (very) important in each Scenario. There was similar scenario-dependency for (very) unimportant, with only 15 of 388 respondents (4%) minimizing legal concerns in all scenarios.
General questions
Table 5 shows the results of the general (non-scenario-based) questions. The responses to this set of general questions were not impacted by demographic factors (gender, age, years in practice).
Table 5. Respondent level of agreement with general topics involving advance directives
The results of our survey suggest that physician adherence to ADs is situation-specific, and that in rapidly reversible conditions (i.e. Scenario 2) physicians believe their judgment supersedes previously-specified patient instructions. The fear of legal action did not appear to be a major factor in the compliance or non-compliance with ADs, except in the case of Scenario 3 in which there was family disagreement with patient wishes.
Although ADs may not offer the results initially envisioned by those who advocated for their existence, they nonetheless may provide a valuable, societally-acceptable approach to communicating one's desires regarding end-of-life care goals and preferences [5]. Similar to other reports [5,7-9,11,15], our study found that despite knowledge of their existence, physicians do not consistently honor patients' ADs. In our survey, the temporal remoteness of the AD and the reversibility of the immediate condition appeared to hold greater relevance for clinicians' decision making.
A majority of physicians surveyed would refuse to provide emergency care to a patient who completed an AD before undergoing a previous routine surgical procedure (Scenario 1) but would deliver treatment in a case where the AD reflected a patient's wish to pass away in peace (Scenario 2). Like physicians and other health care providers, courts have been confronted with disputes over the appropriateness of providing emergency treatment to patients who have previously requested limits to their care through ADs [5]. One representative Ohio court judgment held that an earlier decision by a patient to forego life-saving measures could carry over to an emergency condition only after it was determined that the patient had both knowledge and understanding of how the two settings may differ [18]. By example, the court acknowledged the difference between a terminally ill patient who had previously requested to die in peace and now suffers injuries sustained in an automobile accident and the treatment of an emergency condition developing from their terminal condition. In line with this judicial reasoning, respondents we surveyed appeared to be concerned that the request to "pass away in peace" in Scenario 2 was effectively different from the condition that brought the patient to the hospital that day.
Legal concerns influencing decisions on advance directives
Over half (52%) of the respondents in our study agreed that the risk of liability was lower when maintaining someone alive against their wishes than in mistakenly failing to provide resuscitative efforts. Prior reports also suggest that the risk of legal liability may influence a practitioner's decision regarding end-of-life care and resuscitative efforts [15,19]. In a survey of emergency medicine physicians, 58% of respondents stated that their decisions regarding resuscitation were largely influenced by fears of litigation or criticism [15]. Although 80% admitted legal concerns should not influence physician decision-making regarding resuscitation, 92% reported that the present legal environment did influence their practice [15].
Although claims have been filed against hospitals and physicians alike for damages arising from delivery of care against the express wishes of patients, it should offer comfort to providers that courts have struggled when deciding if and how to award compensation for "continued living" [5,19]. In Anderson v. St. Francis-St. George Hospital, Inc, a patient, who had provided clear instructions upon admission to the emergency room to forgo extraordinary life-sustaining treatment, sued for damages resulting from a stroke sustained following cardiac defibrillation for ventricular fibrillation [5,19-21]. The Anderson court held that such damage awards were unavailable unless the patient could show that "defibrillation itself caused or contributed to [his] stroke in any way other than simply prolonging his life " [5,21]. Instead, damages would only be awarded for direct injuries resulting from resuscitation efforts such as burns due to defibrillation.
When confronted with a spouse's wishes that conflict with those provided by the patient's AD, over half of respondents (53%) considered the threat of legal liability as important or very important to their decision. The fear of liability was more prevalent than expressed in the two prior patient scenarios (37% and 42%, respectively). Furthermore, a majority of those failing to honor the AD in Scenario 3 were strongly influenced by the spouse's request for continued care (77%) and potential risk of future liability (63%). Our results remain in line with other reports suggesting that due to the limited number of cases filed against practitioners for failing to abide by a patient's AD, along with the courts' general unwillingness to award damages for continued life, practitioners often consider the risk of mistakenly failing to deliver treatment greater than providing care against the wishes of patient or surrogate [5].
With many confounding factors influencing physician decisions to honor or forego patient ADs, some have advocated that a better means of ensuring physician compliance with patient wishes is to limit legal liability to only those instances where intentional disregard for the instructions provided in the AD occurs [5]. Despite proposed benefits, only 56% of respondents agreed with this approach to balancing liability. The majority of respondents (74%) disagreed that the complexity of medical care should limit the level of patient participation in decisions at the end-of-life. Perhaps this strong view among those surveyed could help explain why a standard of liability limited to the intentional disregard for patient wishes alone did not gain greater support.
Family influence on physician compliance with advance directives
Almost three-quarters of physicians surveyed (74%) in our study stated they would continue to honor an AD despite the spouse's request to the contrary. However, among those who reported that they would not comply with the patient's AD (17%), a large majority (77%) considered the spouse's demand important or very important in their decision. Demands for care by the family that are at odds with those expressed by patient's AD, have been considered the leading cause for physician noncompliance with ADs [6]. However, the general lack of spousal influence on those we surveyed may reflect problems others in the past have highlighted [1]. Family members and surrogates often fail to accurately predict a patient's treatment wishes by overestimating the patient's desire for continued treatment [22].
Older (over 50 years of age) physicians and those with more practice experience (>15 years) were more influenced by the spouse's demand than their younger colleagues. Prior studies suggest that physician age may impact the level of influence a family's appeal has on physician practices [13]. Hinkka et al. reported that while family requests had a greater initial influence on younger physicians' care decisions, any age-specific trends tended to fade with the introduction of an AD [13]. As those we surveyed were aware that an AD existed, any bias on the part of younger physicians to respect family requests may have been nullified.
Limitations of care
At our institution, and in many other institutions, there is a distinction between "comfort measures only" and a desire not to undergo cardiopulmonary resuscitation (i.e. to be "Do Not Resuscitate/Do Not Intubate" [DNR/DNI]). In the former, all treatment measures that are not intended to alleviate discomfort are discontinued, except for the use of opiates, benzodiazepines, anti-sialogogues and nursing cares are continued to maximize comfort. This practice is consistent with the thoughts of the 67% of respondents who disagreed or strongly disagreed with the statement that "comfort measures only should allow physicians to continue life support measures." (Table 5) In contrast, when a patient has made a decision to not be resuscitated or intubated (i.e. they are DNR/DNI), but hasnotdecided to be "comfort measures only", this can still be consistent with aggressive therapy directed towards a patient's goals of care (i.e. chemotherapy, radiation, antibiotics, pressors, etc.) [23-27]. Withholding treatment at the end-of-life does not necessarily suggest that all care should be discontinued and patients who are DNR/DNI do not necessarily wish to forego ICU care. Several states have enacted laws ensuring end-of-life care and surrogate-decision making occurs in line with a patient's expressed wishes to promote a patient's dignity [22]. Practitioners should be aware that the blurring of lines between treatment and comfort measures not only stands at odds with patient autonomy and the right to decision making, but comes with some additional (while rare) legal risk [5]. For example, a Michigan court awarded damages to the family of a patient who awoke from a coma but remained in a vegetative state after a hospital provided care in excess of the patient's health care proxy requests for comfort measures only [5].
Costs of care
Two-thirds of those we surveyed (69%) agreed that costs should never impact a physician's decision as to whether to comply with a patient's AD. According to a recent report released by the Agency for Healthcare Research and Quality, 1% and 5% of the population accounted for 22% and 50% of health care expenditures respectively (using 2009 data) [28]. Forty-percent of health-care costs involved care delivered to patients 65 years of age or older. Our results appear in line with prior surveys of physicians finding that a majority object to the use of cost-effectiveness data to determine the benefit of treatment provided to patients [29]. Others have suggested that physicians may be unwilling to enter the controversial domain they believe better belongs to politicians, administrative bodies and health care advocates [29].
Our study has methodological limitations. Given that 41% of surveys were returned, our results may not be generalized to all clinicians who are commonly confronted with the issue of deciding on whether to follow or forego patient ADs. Another potential limitation of our study is that those surveyed were not asked if they are commonly confronted with issues related to patient advance directives during their normal course of daily practice, although in general, many of the general internists who attend these meetings are hospitalists and commonly address these issues.
Clinicians may be faced with instances where providing care to patients is inconsistent with the desires expressed in an AD. This study set out to explore clinician compliance with patient AD's and to determine whether particular external factors may influence decisions to either honor or forego pre-set directives. When confronted with a specific patient scenario, most of the provider decisions in our study were influenced by the entirety of the clinical situation (e.g. temporal remoteness in relation to the AD and the reversibility of the immediate condition) rather than a literal application of the AD. Furthermore, most clinician decisions were made without concern for legal liability or influenced by demands by families to continue care. Our findings confirm that a majority of clinicians appreciate that while a patient may wish to forego end-of-life treatment, this does not equate to sparing comfort care measures. Also, most clinicians we surveyed agreed that their treatment decisions should not be influenced by the monetary cost required in providing this care.
Until a more reliable system can be developed that enables a patient's desires to be fully expressed under a multitude of unique clinical scenarios, physicians will be required to interpret, as they did in our study, the interaction between a patient's immediate medical condition and their prior requests as documented through ADs.
Competing interests
All authors: No financial or non-financial competing interests.
Authors' contributions
CB conceived of the study, participated in its design and coordination and helped to draft the manuscript. MK participated in the design of the study, performed the statistical analysis and helped draft the manuscript. PM participated in the design of the study, coordinated survey logistics and helped draft the manuscript. KS participated in design of the study and helped draft the manuscript. CH participated in the design of the study and helped coordinate survey logistics. All authors read and approved the final manuscript.
Source of funding
All authors and manuscript preparation: Departmental and Institutional resources.
Luce JM: A history of resolving conflicts over end-of-life care in intensive care units in the United States.
Crit Care Med 2010, 38(8):1623-1629. PubMed Abstract | Publisher Full Text
Lynch HF, Mathes M, Sawicki NN: Compliance with advance directives. Wrongful living and tort law incentives.
J Leg Med 2008, 29(2):133-178. PubMed Abstract | Publisher Full Text
Bergman-Evans B, Kuhnel L, McNitt D, Myers S: Uncovering beliefs and barriers: staff attitudes related to advance directives.
Am J Hosp Palliat Care 2008, 25(5):347-353. PubMed Abstract | Publisher Full Text
Hardin SB, Yusufaly YA: Difficult end-of-life treatment decisions: do other factors trump advance directives?
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Perkins HS, Bauer RL, Hazuda HP, Schoolfield JD: Impact of legal liability, family wishes, and other "external factors" on physicians' life-support decisions.
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Smith DG, Wigton RS: Modeling decisions to use tube feeding in seriously ill patients.
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Hinkka H, Kosunen E, Metsanoja R, Lammi UK, Kellokumpu-Lehtinen P: Factors affecting physicians' decisions to forgo life-sustaining treatments in terminal care.
J Med Ethics 2002, 28(2):109-114. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Howe EG: When family members disagree.
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Mebane EW, Oman RF, Kroonen LT, Goldstein MK: The influence of physician race, age, and gender on physician attitudes toward advance care directives and preferences for end-of-life decision-making.
J Am Geriatr Soc 1999, 47(5):579-591. PubMed Abstract
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Estate of Leach v. Shapiro, 469 N.E.2d 1047 (Ohio Ct. App. 1984)
Waisel DB, Burns JP, Johnson JA, Hardart GE, Truog RD: Guidelines for perioperative do-not-resuscitate policies.
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Lens V, Pollack D: Advance directives: legal remedies and psychosocial interventions.
Death Stud 2000, 24(5):377-399. PubMed Abstract | Publisher Full Text
Anderson v. St. Francis-St. George Hosp., Inc, 671 N.E.2d225 (Ohio 1996)
Surrogate selection: an increasingly viable, but limited, solution to intractable futility disputes.
Website: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1551979 webcite. Accessed 1/25/2012
Swetz KM, Lyckholm LJ, Smith TJ: Maximal medical therapy and palliative care can work together: when are advanced care measures appropriate?
J Hosp Med 2009, 4(7):453-456. PubMed Abstract | Publisher Full Text
Levy M, Tanios MA, Nelson D, Short K, Senechia A, Vespia J, Hill NS: Outcomes of patients with do-not-intubate orders treated with noninvasive ventilation.
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Cohen RI, Lisker GN, Eichorn A, Multz AS, Silver A: The impact of do-not-resuscitate order on triage decisions to a medical intensive care unit.
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Lund CR, Samant R: Interpretation of do-not-resuscitate (DNR) orders among oncology health care professionals and the potential for these orders to influence care for medical issues unrelated to resuscitation. (abstr 9078).
Kennedy K: 5% of patients account for half of health care spending.
USA Today
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Pre-publication history
The pre-publication history for this paper can be accessed here:


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text: The next Brussels Cartoon and Animation Film Festival will take place February 20-March 3, 2001. The festival is seeking submissions from your recent works in any categories of animation, from traditional animation to mixed media techniques. There is no distinction for formats or running time. Programming categories include: short films, feature films and tributes & retrospectives. There is no entry fee. The deadline for submissions is November 1, 2000. The 2001 edition will be the occasion to celebrate the 20th anniversary of the festival and everybody is invited to the party! The Brussels Cartoon and Animated Film Festival is one of the top festivals on the international cartoon and computer-generated images circuit. It features 150 to 200 films, plus premieres, original retrospectives, exhibitions, workshops and "making of" programs, and welcomes a host of top-ranking guests. The festival is also hosting Anima 2001, a 4-day industry event with various conferences, screenings and panel discussions. Plus, to celebrate its 20th anniversary, the Festival will present a special exhibition on the Folimage Studio. Plenty of surprises will be in store! For more information contact Folioscope at: rue de la Rhétorique 19, 1060 Bruxelles, Belgium; Tel.: ++ (32)2 534-4125; Fax: ++ (32)2 534-2279; E-mail: email@example.com. Entry forms are now available on the festival web site.


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State of the Housing Market
Industry leaders and experts testified on the current condition and challenges facing the housing market.
People in this video
- Mark A. Calabria Director Cato Institute->Financial Regulation Studies
- David Crowe Chief Economist and Senior Vice President National Association of Home Builders
- Jeffrey Lubell Executive Director Center for Housing Policy
- Ron Phipps First Vice President National Association of Realtors
- Susan M. Wachter Professor University of Pennsylvania->Wharton School of Business
- Tim P. Johnson U.S. Senator [D] South Dakota
- Bob Menendez U.S. Senator [D] New Jersey
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- Richard C. Shelby U.S. Senator [R] Alabama
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text: Brand: Elomi Style: EL8485 Sizes: M, L, XL, 2XL, 3XL, 4XL Fabric Content: Blend Elomi Imogen Brief Style EL8485. Dark and indulgent, the new Imogen collection is crafted in a Marquisette fabric (looks like silky tulle) with black floral embroidery, laid over a honey colored shell. It has beautiful braid effect trim and a sheer organza bow added to refine the finishing touches. The brief is in a mid rise design and can be beautifully coordinated with any of the Imogen bras and accessories.


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The reason Italians voted for Berlusconi
What on earth are the Italian people thinking? That's been the view of many in response to the strong showing of a dangerous comedian (and also Beppe Grillo) and the total rejection of Mario Monti in this week's general elections.
Don't they know that it was the heroic Monti that saved Italy from a bond market revolt in 2011 with his austerity and structural reforms? Don't they know that it was Berlusconi (right) that led Italy into the mire in the first place?
What these questions miss is the divergence between calm in the financial markets last year and the parlous condition of the Italian economy.
True, Monti's austerity measures helped his compatriot, Mario Draghi at the European Central Bank, to pledge to backstop the Italian bond market last summer, which has reduced Italian borrowing costs from emergency levels.
But those same measures have also, directly, sent the Italian economy reeling as this chart, using IMF data, shows:
As this shows, when Monti slashed the structural deficit in 2011 and 2012 by around 2.8% of GDP, he sent the country into a severe recession.The Italian economy shrank by 2.2% last year. The European Commission expects it to fall by a further 1% this year. Unemployment has shot up from 8.4% in 2011 to 10.6%. Joblessness is expected to hit 12% in 2014 by the Commission.
Most of the Monti labour market reforms were necessary. Indeed, Italy needs more of them. But with external demand weak, this was no time for Rome to raise taxes. As Wolfgang Munchau has pointed out, Italy needed reforms alongside measures to sustain demand. Germany and the European Commission, with their balanced-budget obsession, insisted that Monti perform both at the same time. With predictably dire results.
So if people are scratching their heads over why the Italian people have voted for Silvio Berlusconi and Grillo in large enough numbers to deny the centre-left/Monti bloc a workable majority they should consider the real economy, rather than the bond markets – and also bear in mind that those two politicians alone explicitly challenged the Brussels/Berlin dogma which presents immediate and deep austerity as, in all circumstances, the elixir of recovery.Tagged in: Beppe Grillo, Silvo Berlusconi
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Survivor 26: Fans vs Favorites Discussion
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May 13 2013, 06:56 PM
Spot's Meow
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Location: California
Re: Survivor 26: Fans vs Favorites Discussion
A great ending! I have been a big Cochran fan since the first time he played (you can go back and read that thread as proof, others didn't like him but I stuck by him!). I knew he had the potential to be a really amazing player.
The reunion show was a bit strange. They've often shown past Survivors in the audience, but I'm not sure why we had to interview them so often this time. Rudy's interview was...awkward. As well as the interview with that little girl.
I didn't even realize until more than halfway through that the pre-jury Survivors weren't on the stage as they usually are after the vote is read. You know, I think it really speaks to how awesome and crazy this season was that two of the most controversial players that would have been the whole story on a more boring season, Shamar and Brandon, weren't even mentioned in the reunion and yet they were not lacking for material.
Sherri continued to be a non-entity. Did Jeff even ask her any questions after the vote was read? The jury basically ignored her and then she verbally assaulted the one person who did address her (Eric).
And somehow, even with half the cast not on stage, there still wasn't enough time for questions.
By the way, what the hell was Eddie talking about when he said he would use the money for a bar/dog park? That was so strange.
So it looks like the rumors about the next season of Survivor are true. Basically a "blood is thicker than water" theme of castaways playing with family members. Actually what I've heard is that it will be returning players with a family member. Haven't they tapped that well dry by now? I saw a completely rumored list of returnees and it included Kat and her cousin; I had totally forgotten about that creepy incestuous relationship.
I guess we'll see what happens next season!
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Nurgle Sorceror and Construct by FalassionWatch
©2013-2015 Falassion
A Chaos Sorceror model converted with a Nurgle icon on the top of his staff and a fairly robust friend to do the lifting.
I love it totally, this style is so interesting and it is so cool, great work, so sweet, i totally love it god dammit, yes! ^^
Where did the construct come from, looks awesome
love the paint on the sorceror. nice job!
Great textures on the Big dude! great job!
awesome pint job.


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See photos of BACONFEST MKE 2015>>
See photos from BACONFEST MKE 2015>>
Wisconsin's own award-winning Patrick Cudahy presented 102.9 THE HOG's 4th annual BACONFEST MILWAUKEE 2015 at our brand new location – the Event Center inside Potawatomi Hotel & Casino!
HOG Heads devoured unique bacon creations along with some classic favorites prepared by Southeast Wisconsin's best chefs and restaurants! Plus, appearances by Bob & Brian, Joe & Borna, Mindy Novotny, Rock Girl Amanda, and lots more!
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Trek to Lignon Hill
Lignon Hill gives you a 360degree view of Legaspi City, which includes, of course Mayon Volcano . The tricycle we rented was only allowed up to the gate at the bottom of the hill. So it was a 45-minute trek for us, which includes a few minutes of rest in between. Going up, we felt that the road never ended. We huffed and puffed all the way, and swore to start exercising when we got back to Manila. What made it worse was the realization that if we rented a van, we would have skipped the aching legs, as we saw them going straight to the peak. But, then, we never dwell on the negative (and was also on a budget), so we set the thought aside. There was a zipline, but wasn't available when we went there. I'm not sure why, it could be that they open late or maybe because we came on a weekday. There are stores on the peak which sell food, drinks and ice cream. :-) Get ready with your P5 coins to be able to use the viewer for a closer look of Mayon Volcano and the port area. You can also see the airport runway from the hill. When we went there, we were fortunate to see an aerial show of around 8 small planes (probably a practice routine). Entrance fee is P30.00
- Budget Travel
Chill at the Embarcadero
Good food, good view. It's modern Legaspi. This commercial center located at the Legaspi Harbor. We weren't able to enjoy all that it could offer since we only passed there to eat, but they have a variety of activities to keep you busy. There's a 350-meter zipline from a lighthouse, kart race, segway.
- Backpacking
Visit the Cagsawa Ruins
The Cagsawa Church, built around 1724, was buried when Mayon Volcano erupted in 1814. The bell tower is the most preserved part of the church. The remaining walls of the church can give you an idea on how big it was, and its basic structure. Looking around the vicinity, there were big boulders scattered, which were testament of how strong the eruption was, moving tons of stones just like marbles.
- Backpacking
- Family Travel
- Budget Travel
Our Lady of the Gate Parish Church
The Church was built in 1773 by Franciscan missionaries at the time when Daraga was still part of Cagsawa. Technically, the style is Baroque but there's also a bit of renaissance Gothic in there too and it's famous because it's the only one of its kind in the world built from black volcanic rock.
Unfortunately, in an effort to protect the crumbling facade, the front of the Church, with exception of the belfry, has been covered in lime, turning it completely white! In a very unpopular move with the general public, the Church has unfortunately lost that famous black volcanic facade it was famous for.
The Church's facade carries the Franciscan Order coat of arms, images of Franciscan saints and an image of Our Lady of the Gate. The engravings throughout the entire façade including those on the belfry are pretty much all that is left of any historical relevance after the bombings during World War II. Inside, the Church is very simply laid out with little in the way of remaining relics or decoration to be seen.
There is a lovely little cafe that can be accessed from the grounds affording the most incredible views of Mt Mayon. We watched the sunset over a few drinks and snacks.
Please see the Travelogues for more photos of Mayon and the surrounds.
Ligñon Hill & Nature Park
A must do if staying in Legaspi, Ligñon Hill is well worth the visit. It is one of the best places to see Mt Mayon in all its glory along with beautiful 360degree views of the entire region. The 143m high cinder-cone hill is located 11km southeast of the volcano and is the highest location in Legaspi, towering over Legaspi Airport. The Philippine Institute of Volcanology and Seismology (Phivolcs) has a permanent station up here with which to observe Mayon.
I understand that due to the popularity of this place, there are developmental improvements being made with regard to eateries, entertainment & activity facilities and also improved protection of the nature reserve itself.
The early morning is the best time to see Mayon before the clouds set up home over the volcano's summit or, in the eveningtime for the sunset and city lights. Also, it is less humid and hot at these times.
There are multiple activities available such as zip lining, paintballing, ATV off-roading and biking through dry gullies at the foot of Mayon.
Alternatively, sit down with a cold drink/ snack and enjoy the beautiful views!
Please see my Travelogues for photos of the beautiful views of Mayon
Malilipot Busay Falls
This cute little waterfall is tucked away in the forested foothills of Mt Mayon near the little town of Malilipot. We had just finished a trek through the Mayon foothills so we were shattered already and just needed to rest somewhere cool and refreshing! The entry fee was minimal.
These Falls are quite high - initially descending from a height of 250m over 7 stages of mini-falls and pools until the last 40m cascade drops into a small and shallow pool at the very bottom. Since this is the one near the carpark and the most accessible of them all, it is also the most popular.
The pool is lovely, the water cool, clear and clean and the sound of rushing water is all around. It's a tiny piece of perfected, untouched paradise. We were fortunate enough to not have to share it with anyone else at the time we were there!
If you are a keen hiker, then the option to hike up to the start of the waterfall is an available option. Apparently it's quite treacherous, steep and slippery - especially during the wet season (which is most of the time!). If we hadn't hiked Mt Mayon, we could have done this instead.
Well worth a visit!
Hoyop-Hoyopan Limestone Caves
We found out about these caves through local knowledge. Located in the village of Cotmon in Camalig (not far from Daraga), it is about 30mins drive from Legaspi. On the drive we stopped numerous times to ask for directions as sign-posting around here isn't great!
The Caves are a multi-level cavernous system of natural limestone featuring the usual sights such as stalactites, stalagmites, quartz crystalline, lots of colour and water. It was discovered during the Japanese occupation when the guerillas used the network as a base in the region. Since then, the caves have become a popular and easily accessible tourist site. More serious cavers can discover the more treacherous parts of the system which apparently take 11 hours to discover if you have all the necessary gear with you.
There is always a cool breeze to be felt whilst walking through the upper levels of the cave system which means that the natural ventilation is good and the caverns don't stink. The name 'Hoyop-Hoyopan' is derived from the word "hoyop" which means 'blow'.
The caves are situated on private land but the family that own the place know them well and provide very well informed and educational guided tours. The caves are lit with incandescent lights and the guide also carries a torch for the darker bits.
Since the system does have a history of guerilla movement, concrete steps and raised pathways were installed so that residents could get about easily and quickly. These days, this makes movement a much easier affair when visiting with the main risk reduced to being aware of slippery surfaces. With exception of one really narrow passage that involved a level of contortionism, moving around the cave was easy and relatively safe!
The guide was fabulous and friendly, with interesting little stories about certain stalactites, stalagmites and the quartz crystalline. Very well informed, he could answer most questions thrown at him about the formation of the caves, to the war-time history to folklore. He told us that the locals keep an eye on the water level in the underground lake and that if it drains rapidly then you know that the volcano is about erupt...!
Also, people have been known to shelter here during bad typhoons and cyclones.
We walked around for about 40 mins looking at the gorgeous colours and shapes before leaving by a side exit which afforded a gorgeous view of Mt Mayon. Since the caves are so well-lit, you can really see the colours which is a little unusual in caves.
The cost isn't too bad - a couple of hundred pesos for the parking, tour and lights. Obviously this is more if you want to partake in more serious caving.
There are a few more photos in my Travelogues
Cagsawa Ruins
These ruins are the remnants of a Franciscan church built in 1724 during the Hispanic occupation, which was later destroyed by a violent volcanic eruption in Feb 1814. They are considered a symbol reflecting the dangers of living near an enormous, active volcano and are one of the biggest tourist attractions in this region.
The eruption is said to have killed about 1,200 people in the area and actually buried the town of Cagsawa (among others) under several hundred million cubic meters of ash. It is said that hundreds of Cagsawa residents sought refuge in the church, but were killed by either pyroclastic flows or lahar. The proximity to the volcano meant that any chance of survival was extremely low. These days, only the belfry remains standing and the area is protected by government. Apparently, in the past, there was more left of the structure but cyclones and earhquakes have left their legacy since.
Survivors chose to resettle in Daraga and remain in the locality rather than leave and set up somewhere else. We were told by locals that people wanted the ruins excavated so that bodies could be recovered and returned to their families for formal buriel but the government refused. This place therefore remains very important to many families in this region.
We visited on a dark, cloudy, gloomy day which added to the general atmosphere of the place. It was a unique experience
I have posted photos in my Travelogues...
- Castles and Palaces
- Historical Travel
- Museum Visits
A day out on a fishing boat...
Thanks to the suggestion made by our friends who live here, we were able to hire a local fishing boat to take us to the coral reefs in the Albay Gulf for a spot of snorkelling.The boat resembled a catamaran and must have been about 35 foot long. This was a working boat weighing in at few tonnes so although it wasn't fitted with any luxuries (such as ladders to get in and out!), there was a 5-man crew in attendance. No sails but entirely motored, the boat did have a powerful engine that got us there and back in one piece.
It didn't strike me as difficult to arrange to one of these excursions. Our friend entered a cafe, asked someone (in English) and then we were guided to someone's house and within half an hour it was arranged! We would leave at 7am and return by lunch time.
People here live on the water and their livelihoods are derived from the sea. They know the water very very well and are good judges with regard to swift weather changes. When fishing, these boats are taken out to quite a distance, are strong and sturdy and are managed by skilled crew.
We didn't go too far and stayed within the relative safety of the Albay Harbour. The captain knew of good snorkelling areas and thanks to his knowledge, we saw numerous varieties of fish, starfish and coral in crystal clear urchin-infested waters. The captain had offered to take us to a sandy beach island for a walk around but we opted to stay in the water as long as we could. Instead, we stopped at a little bay for a half hour coconut pit-stop before making our way home.
From when we had left at 7am, we had watched clouds build up far in the distance. As it got darker and the lightening started flashing with distant rumbles of thunder, our crew went into a huddle, had a talk and decided the excursion was over and we needed to leave asap. We had been quite keen to visit an island with some caves but by this stage they refused to even entertain the idea because of the time vs the building storm. They didn't think we'd get home in time to beat the storm that was swiftly moving in. I, for one, wasn't keen to be out there in a storm! It had rained every day that we'd been here so this wasn't unexpected.
Full power on, we motored back to Legaspi, enjoying the motion, wind, sea-breezes and views. It had been a really fabulous few hours!
Well, shortly after we got home, the storm hit land and it was a big one! The wind screamed and howled rattling everything, rain pouring for ages, the lightening and thunder just horrid! And down there in the harbour we could see our boat hopping and bouncing all over the place!
I have posted photos of our day out in my Travelogues:
Read more: http://members.virtualtourist.com/m/145713/154a73/#ixzz1s4Oz8jQE
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Francis_Scott_Key 3 years, 8 months ago on Businessman Gieryic cited for code violations
Businessman Gieryic cited for code violations
It is a sad day in America when the government prohibits the Star-Spangled Banner from being flown over private property. This is not some communist country like China or North Korea; so why is the City of Albany acting like it is? I wish Mr. Gieryic the best of luck in his fight to overturn this outrageous law. He just picked up another customer. May the Star-Spangled Banner forever wave over the land of the free and the home of the brave!


text:
Constitution, Miranda, and Constelation Class
View Single Post
November 2 2012, 12:56 AM
Location: United Kingdom
Re: Constitution, Miranda, and Constelation Class
Fires spreading that fast through a ship that size means the fire must have been spreading through some of the mechanical ducts of the ship, in close proximity to the plasma lines, and threatening to reach weapons storage, engineering in short order.
Obviously it didn't, but staying aboard would have risked the entire crew on the that gamble, they were under fire and didn't have time to get the panicking crew to fire control stations or environmental control.
They probably assumed that either the ship had been destroyed, the fire consumed it and all but destroyed it or it had been captured, either way there was no point returning.
"But there's no sense crying over every mistake. You just keep on trying till you run out of cake."
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The headlines that mattered yesteryear.
1942—Nightclub Fire Kills Hundreds
In Boston, Massachusetts, a
in the fashionable Cocoanut Grove nightclub kills 492 people. Patrons were unable to escape when the fire began because the exits immediately became blocked with panicked people, and other possible exits were welded shut or boarded up. The fire led to a reform of fire codes and safety standards across the country, and the club's owner, Barney Welansky, who had boasted of his ties to the Mafia and to Boston Mayor Maurice J. Tobin, was eventually found guilty of involuntary manslaughter.
1934—Baby Face Nelson Killed
In the U.S., killer and bank robber Baby Face Nelson, aka Lester Joseph Gillis, dies in a shoot-out with the FBI in Barrington, Illinois. Nelson is shot nine times, but by walking directly into a barrage of gunfire manages to kill both of his FBI pursuers before dying himself.
1922—Egyptologists Enter Tut's Tomb
British Egyptologists Howard Carter and Lord Carnarvon become the first people to enter the tomb of Pharaoh Tutankhamun in over 3000 years. Though sometimes characterized as scholars, Carter and Carnarvon were primarily interested in riches, and cut up Tut's mummy to more easily obtain the jewels and gold affixed to him.
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text:
Ilford 6.5x9 is available only in Europe - it is not imported in the USA. Two years ago I tried to order some through Freestyle during Ilford's 'special order' offer but was told that the 6.5x9 would not be available for export.
I stocked up during a recent stay in Europe.


text:
Joel Berger
- Website: github.com/jberger
- About: As I delve into the deeper Perl magic I like to share what I can.
Recent Actions
Posted I'm Thankful for Perl to Joel Berger
These last few years have been just astonishing and so much of it is due to Perl and the Perl Community. In 2013 I ended my 8 year graduate experience (where I learned a lot of Perl) by defending my
Commented on Calculating U.S Federal holidays with Time::Moment
Looks great!...
Posted Anonymous Classes With Private Data to Joel Berger
A long while back (I'll find the reference if I can) Stevan Little, author of Moose, commented that part of what he wanted for a p5mop was the ability to have truly private data in classes. Much in the way Perl 6 has
$!dataattributes that are simply private…
Commented on A Basic Challenge
I thought you might say that, and IMO, that's more preprocessor than C++ anyway. What would be cool would be implementing a DSL or even a p6 grammar that does it directly....
Commented on A Basic Challenge
I see https://metacpan.org/pod/Language::Basic and https://metacpan.org/pod/Inline::Basic on CPAN already. I'm sure that someone could implement either a source filter or something else on top of those, but in essence, its been done long ago :-)...
Posted YAPC::NA 2015 Wrap-up and More New (PSGI!) Modules to Joel Berger
I was lucky enough to be able to attend YAPC::NA 2015 in Salt Lake City, this year.
Commented on Bounty for fixing CPAN modules
I believe I suggested bounties in a previous post actually. I think that sounds like a great idea, at least as a pilot program....
Commented on An example using Mojo::DOM for rewriting HTML
Hi, I'm not at all sure what you are attempting to do and the comment system of this site does not make it very conducive to technical discussion. I would recommend asking a question on StackOverflow and include the Perl...
Posted New CPAN Modules to Joel Berger
I have found myself in a bit of a CPAN exuberance these last few months. While I have released several new modules, I haven't found time to announce them individually. Here then is a joint announcement of what I've been doing on CPAN lately.
Commented on Term::ReadLine::Gnu Unicode Hell
is it possible that you are not decoding your json as it comes in? In JSON::Tiny you probably should be using decode_json rather than from_json (which you might be, but without seeing the code I don't know)....
Commented on Alien::Base past, present and future (upcoming change in behavior)
Two quick clarifications, its "Berger" and I'm still involved, though Graham certainly is doing the lion's share of the work....
Posted Come to MojoConf and tell us something cool! to Joel Berger
Maybe you are already registered for this year's MojoConf in New York City (June 4th-6th) or maybe you are still thinking about it. Either way, a great way to introduce yourself to the Mojolicious…
Commented on Non-blocking Mojolicious apps are even easier now!
The subs (steps) are invoked in order, waiting for preceding steps to complete. You can also start multiple "simultaneous" non-blocking actions in each step in which case all of these must complete to move to the next step....
Commented on File::Which, pwhich and App::pwhich
I'm curious, I was told that IPC::Cmd::can_run was also useful as a portable "which" and it is core since 5.9.5; can I ask for an opinion between these?...
Commented on A Year of CPAN Uploads
Commented on Writing XS Like a Pro - The INTERFACE Keyword
Both your module and its code look very nice! I'm looking forward to using it!...
Commented on GSoC 2015
Mojolicious is in! Come on people think!...
Commented on A survey of table rendering packages
If Text::CSV counts, you might also be interested in Tie::Array::CSV (my own). Then again, I'm not sure I would count it....
Commented on My Attempt at CPAN PR Challenge for 01/2015
A fine start, and you have already learned a lot! Keep it up!...
Commented on The sad story of pseudohash criticism
At risk of jumping in to a battle I barely understand, my understanding of the talk was criticizing and lamenting the loss of time and productivity that could have gone to other efforts (perhaps even to your suggestion). I don't...
Commented on You have nothing to lose but your chains!
Yes indeed. Thanks. Fixed....
Posted You have nothing to lose but your chains! to Joel Berger
Perhaps a misleading title. Seeing as this is not a political blog but a Perl one, I'm going to talk about method chaining, not worker's unions.
Method chaining is the practice of consecutively calling methods on the return of a previous method. This comes in primarily two flav…
Commented on Method::Signatures : Some relief for MooseX::Declare users
Hi Phil, since I wrote this, there have been other improvements, mostly in the Perl core itself. With these improvements that allowed MooseX::Declare to work, albeit with some scary side effects, newer modules can do similar things in a much...
Commented on I want Package BLOCK syntax return 1.
The class doesn't need to return 1, the file/module does. These are separate tasks and though they are commonly seen together are fully unrelated....
Commented on We are all Perl's ambassadors...
I really like the ++ on Metacpan. It enforces the old adage "if you can't say anything nice, don't say anything at all". Might not be as useful for long-form reviews, but I know that if I see a module...
Commented on So I went to Mongolia and rode a Camel
Very cool! Thanks for sharing!...
- Posted Mojolicious: Do It For The Candy! to Joel Berger
Commented on Urging users with good test suites to test-drive latest DBIx::Class trial
I won't say it's substantial, but my Galileo CMS is on cpan and uses DBIC. It's mostly just basic CRUD tho. Still another data point is good right? https://github.com/jberger/Galileo...
Commented on Rewriting Pod::Readme
The major reason I find for replicating my pod as my README.pod (`podselect lib/MyModule.pm > README.pod`) is that GitHub displays a README.pod on its front page. That is plenty worth the (autogenerated) replication in my mind....
Commented on Try rakudobrew and play with concurrency
Jonathon gave a surprise talk at MojoConf, the topic of which was of course the benefits that p6 would have for a non-blocking web framework like Mojolicious and I have to admit, it was the first time that I got...
Comment Threads
rockyb commented on
A Basic Challenge
I don't know how others feel, but both of these while having some coolness isn't as direct or cool as how you do this with C++. Doing something not as good, albeit a long time ago isn't the same thing, IMHO.
rollbear commented on
A Basic Challenge
Hullo all,
I don't generally write in Perl, so in many ways I don't belong here. But I was made aware of this challenge, and since I'm the one guilty of the C++ stuff, I thought I'd introduce myself. Hi there!
Are you sure you want to show that Perl can be an even weirder language than C++ is?
I understand the spirit. I did this in part because I was amazingly bored, and in part because an ex-colleague complained about having inherited code that reminded him of BASIC. The combination of the two made horns grow on my forehead, and they weren't the BSD type.
Makoto Nozaki commented on
Bounty for fixing CPAN modules
As a start, I have made a list of ideas I gathered and also added a link to BountySource. Feedback will be welcomed!
Henryk Paluch commented on
A Simple Mojolicious/DBI Example
For Unicode support there are few fixes needed:
use Encode; plugin Charset => {charset => 'utf-8'};
modify / method to:
any '/' => sub { my $self = shift; my $rows = $self->select; # convert utf-8 octets -> unicode for my $Item ( @{ $rows } ){ map { $_ = decode('utf-8',$_) } @{ $Item }; } $self->stash( rows => $rows ); $self->render('index'); };
Best regards
—Henryk Paluch
collin commented on
Calculating U.S Federal holidays with Time::Moment
This is awesome! There is also Bank::Holidays on the CPAN, which is limited to the five years the Federal Reserve posts on their site. Full disclosure: I am a contributor to that module.
About blogs.perl.org
blogs.perl.org is a common blogging platform for the Perl community. Written in Perl and offering the modern features you've come to expect in blog platforms, the site is hosted by Dave Cross and Aaron Crane, with a design donated by Six Apart, Ltd.


text:
Worse idea: licking cactus goop or frog juice?
Turi recalls when her own curiosity with a cactus led to an embarrassing call to the doctor, and why she doesn't sympathize with people who take psychedelic drugs.
She is terrible, send her back to the west coast. And that is a polite comment
Comments are closed.


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If Not Wonder Woman...Then Who?
I kinda get the feeling Wonder Woman isn't gonna connect with the masses and maybe not a character that works(live action)...so is there another lady in the DCU that could swoop in with a live action movie and become queen?
My top contender is Zatanna. Magic seems to be in now with all these witch movies coming out. :p
Re: If Not Wonder Woman...Then Who?
Re: If Not Wonder Woman...Then Who?
^ That belt/chestplate is just odd.
If Halle Berry didn't taint it too much I could see a Catwoman film working.
Re: If Not Wonder Woman...Then Who?
As nice as that pic is and as much as I LUV Supergirl, I'd like to see something that isn't close to Superman or even Batman with Catwoman, Batgirl...even Batwoman.
Other than Zatanna, Stargirl also works with me. :)
Re: If Not Wonder Woman...Then Who?
Whenever I'm watching the Lying Game, and I'm always watching The Lying Game and those stupid Twins mummy enters the camera frame, my heart skips a beat because that's frakking Supegirl.
You want off kilter?
How about Mary Marvel?
That way the token girl introduces the rest of the boys (and the tiger) who then have a walk on in the Justice League movie.
But as long as I can't get my mind off Supergirl...
Looking through all that, the one thing that did leap out at me, although I don't find her attractive, her face is squished up like a pitbull, but chicken of the sea stupid is almost indistinguishable from naive and innocent.
Jessica is apparently trying to get herself on a sitcom at the moment... Although she is hardly a girl anymore.
32 (Wikipedia.) is a Superwoman, not a Supergirl.
Although if she's bending steel in her bare hands, no one is likely to call her on it.
Re: If Not Wonder Woman...Then Who?
It really has to be Wonder Woman--everyone else is either a derivative of Superman or Batman or is unknown outside of comic book geekdom (if audiences can't connect with Wonder Woman, how can they possibly connect with lesser-known characters?).
A case could be made, however, for a studio to make those lesser-known characters household names, but that involves them taking a bigger financial risk...
Re: If Not Wonder Woman...Then Who?
You're all putting too much emphasis on the character and not enough on the actor who's cast in the role. We already have a successful superheroine type heading up a movie franchise: Jennifer Lawrence in The Hunger Games. Get someone like that for Wonder Woman, Zatanna, Catwoman, Ms. Marvel, whoever you like, and it'll be a hit. Superheroine characters aren't all that different from one another.
And Halle Berry hasn't tainted Catwoman for good. I'm sure the general audience has long since forgotten that. People don't care enough about popcorn movies to remember them for long. If George Lucas didn't kill Star Wars dead with those horrible prequels, then Catwoman is still perfectly viable. Let's see, who could be Catwoman...Kerry Washington is pretty popular nowadays, isn't she?
Re: If Not Wonder Woman...Then Who?
The only female character of any consequence that is not part of one of the families and yet is still interesting would be Zatanna. The magic angle definately works. If the proposed JL: Dark ever gets made, she would certaonly be worth having a standalone movie.
As for the others...aside from the fact that we a not likely to get a superhero movie with a female lead for a while...but the pickins are slim
Supergirl...derrivative of Superman...he would have to get a SERIES of movies before she would even get one
Batgirl...derrivative of Batman...Batman, Robin and probably Nightwing are more likely to get a movie first.
Batwoman...even less likely than Batgirl.
Catwoman...this could work, but only AFTER another Batman reboot.
Mary Marvel...not a chance in hell. Mary is much less interesting that Billy. She is not really a stand alone character anyway.
Re: If Not Wonder Woman...Then Who?
Catwoman is still perfectly tainted.
I saw Jennifer's snl a couple days ago.
Not a lot of range.
After surviving two Fantastic Four movies, I think Kerri knows better than to stick a cape on no matter how much money they give her.
Re: If Not Wonder Woman...Then Who?
Re: If Not Wonder Woman...Then Who?
And it's not all-important that the character have a lot of name-recognition value, as long you make a good movie.
Blade and The Mask and Hellboy and Men in Black were all pretty obscure comic books. Didn't hurt the movies any.
So why not try the Huntress or the Valkyrie or Modesty Blaise or somebody, as long as you keep the budget under control?
Re: If Not Wonder Woman...Then Who?
Re: If Not Wonder Woman...Then Who?
Zatanna may indeed be coming to the big screen, though not as a solo character. She's one of the supernatural characters in the so-called "Justice League Dark" project that Guillermo Del Toro is in talks to develop.
As for other DC female characters, I think Big Barda has a lot of potential, but she'd kind of have to be part of the whole Fourth World thing. Power Girl might work, if you could come up with a good origin story that wouldn't drag in all the continuity baggage. And though I haven't read anything involving her, I've heard a number of things about a character called Manhunter, a lawyer who takes on a superhero persona. I can see how that could have TV-series potential -- what network exec doesn't love lawyer shows? Not sure about movies, though.
Re: If Not Wonder Woman...Then Who?
Anne's Catwoman, didn't make sense and faded into the background of an awful and disjoint movie.
I had forgotten that Batman Rises had happened.
Bandaid on a bullet hole.
She was going to be like his nurse?
10 years of Batman had turned Christian Bale in Mr Burns.
All he could do with that beautiful woman is ask her to rub ointment on the sore places.
Manhunter was cancelled in 2008 Christopher. It was a good book with dangerously sexy covers but couldn't find an audience. Although if you want to talk about baggage... She's wearing a Darkstar (space cop rival to the green lanterns) uniform which is broken or she can't turn on to give her some Supermanlike powers, Jeanpaul Valleys' psycho Batman Gloves, and a boom stick (battlestave) that used to belong to a former lad named Manhunter...
The covers are like porn made specifically for Deadpool.
Re: If Not Wonder Woman...Then Who?
Most of the reviews I've seen agree that Hathaway's Selina was the best thing about The Dark Knight Rises even when they found the rest of the movie flawed. She's certainly the best live-action screen Catwoman since Julie Newmar.
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Team Kolby supporting diabetes research!
Is this photo a winner?
Similar Photos: charity | participant teams | world diabetes day | basketball | jdrf walk | jdrf | jdrf walk to cure diabetes | nieceDesign Your Own Enter the Contest
comment by Guest - Dec 11, 2013 - back to the top
What wonderful support Kolby has making life better for her and all dibetics.


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Khan it be true? Pacquiao vs. Amir in April?
Sure, word has it that Amir Khan might face Manny Pacquiao in April…but is there actually something substantial to this rumor?
Sure, word has it that Amir Khan might face Manny Pacquiao in April…but is there actually something substantial to this rumor?
With Manny Pacquiao rumored to be considering an opponent for his final fight, who should get the job?
Who would have thought Manny Pacquiao's loss to RING welterweight champion Floyd Mayweather Jr. would be the start of weird things to come? 'Pacman' is now facing a class-action suit filed in the state of Nevada.
By leading his Philippine Basketball Association team to victory on Wednesday, WBO welterweight titlist Manny Pacquiao took a risk himself by entering the fray as a player.
As much as he seemingly wants a Floyd Mayweather Jr.-Manny Pacquiao bout to become reality, Top Rank's Bob Arum is equally frustrated when it comes to getting anyone to listen regarding negotiations.
Floyd Mayweather Jr. and Manny Pacquiao had an hour-long meeting at Pacquiao's hotel on Tuesday night following their brief courtside discussion at a basketball game. Pacquiao adviser Micheal Koncz's opinion now? "I believe that the fight is going to happen."
Manny Pacquiao could pursue a May 30 clash with Amir Khan if Floyd Mayweather Jr. does not sign to face him by the end of January, said the Filipino boxer's adviser, Michael Koncz.
Manny Pacquiao could pursue a fight against Amir Khan if Floyd Mayweather Jr. does not agree to face him by his end-of-the-month deadline, the Filipino icon's adviser, Michael Koncz, told RingTV.com on Tuesday.
Manny Pacquiao has agreed to his side of the terms for a May 2 fight with Floyd Mayweather Jr., the Filipino fighter's promoter, Bob Arum, and his adviser, Michael Koncz, have informed RingTV.com.
Manny Pacquiao was updated this morning on ongoing negotiations for a potential May 2 bout with Floyd Mayweather Jr., according to Pacquiao's adviser Michael Koncz.
According to insiders, undefeated pound-for-pound superstar Floyd Mayweather Jr. wants to meet Manny Pacquiao in the ring and supposedly, plans are already in play.
In Lem Satterfield's latest notebook, the question is asked: Will other fighters follow Canelo Alvarez's example and move from Showtime to HBO?
Despite recently signing a contract extension with Top Rank Promotions, Manny Pacquiao's future options just might have slightly improved with Bob Arum burying the hatchet with Oscar De la Hoya.
After Floyd Mayweather's grueling victory over Marcos Maidana on Saturday, the demand for a showdown against Manny Pacquiao rings loudly from two heavyweight legends.
Could we possibly see a Sergio Martinez-Manny Pacquiao showdown? Should the middleweight champion defeat Miguel Cotto on June 7, Lou DiBella says it might become a reality.
Manny Pacquiao is currently negotiating a contract extension with his promoter, Top Rank, which would entail five fights through 2016, Top Rank CEO Bob Arum confirmed to RingTV.com on Monday.
Manny Pacquiao says that a bout with Floyd Mayweather Jr. could not happen until 2015 if Mayweather is not willing to work with Pacquiao's promoter, Bob Arum.
Manny Pacquiao is familiar with the top two candidates to be his next opponent, having lost by split-decision to Tim Bradley in 2012 and having sparred many rounds with Ruslan Provodnikov.
The United States Court of Appeal for The Fifth Circuit has dismissed a $1 million lawsuit that was filed by Imperial ED against Manny Pacquiao. The suit was described as "frivolous" by the fighter's advisor, Michael Koncz.
Reports that Manny Pacquiao owes $18.5 million in unpaid taxes to the IRS are incorrect, and "the recent stories contain serious errors," according to an attorney for the eight-division titlewinner.


text:
eggplant silk jersey 'Hagen' trapeze dress
designer's notes
You'll scream "Golly!" when you slip into the contemporary chic dresses of Jay Godfrey.
color: Eggplant / Teal Mid-weight pleated silk woven Halter neck On seam pockets at a-line skirt Concealed rear zip Fully lined Contemporary fit Size 2 measures approximately 22'' long from natural waist, 34'' at bust, and 36'' at hip; may vary by size 100% Silk; Dry Clean; Imported; style# 323051501


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Future - Neva End (Remix) Feat. Kelly RowlandSat, Nov 24, 2012 Videos, R&B Music VideosComments
"He's such a pleasure to work with you," says Kelly about Future. "I love his style. I love the fact that he's so refreshing, bringing something so cool and extraordinary to music."
"Neva End (Remix)" is the first single from Future's forthcoming album 'Pluto 3D', due out November 27. The set is a re-release of his debut album with three new songs.


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