text:
Another dude you may or may not recognize. This is for those of you who wondered who I'd find next to do a sketch of, and is another of those sketches done in the cramped conditions of my airline seat after browsing through a magazine to find an interesting face. See the previous post on this practice. There's this series of print commercials for a watch or something similar that has served me well with well-lit faces, and so when I thumbed through this month's Hemispheres, I was quite pleased.
I did this one with a mechanical HB pencil, and it is quite incomplete… there's a bit of tinkering I could do with the modelling of the cheeks and around the eyes to bring his character out a bit more, but I decided to stop. Maybe later? We shall see. These are short practice runs in very non-ideal circumstances, and time is short this week…
On this day on Asymptotia...
- When Life Hands You Lemons... - 2014
- Crossings - 2014
- Crunch Time - 2012
- The Project - 4 - 2011
- The Hat - 2009
- Asymptotia Attacked! - 2008


text:
R is a PID with field of fractions K. $M \subseteq K$ is a fin. generated R-Submodule. I am trying to show M is in fact generated by one element.
Mathematics Stack Exchange is a question and answer site for people studying math at any level and professionals in related fields. It's 100% free, no registration required.
Sign up
Sign up
Here's how it works:
- Anybody can ask a question
- Anybody can answer
- The best answers are voted up and rise to the top
Consider a finite generating set and find a common denominator for its elements. Now, look at what you've got...
Alternatively, if $M$ is such a submodule, it has no torsion and we know from the structure theorem for f.g. modules over a PID that it must be free. Its rank can be computed by first tensoring with $K$ over $R$ and computing the dimension over $K$ of the resulting $K$-vector space. Because $M$ is contained in $K$, it is very easy to see that that dimension can only be $1$.
HINT $\: $ Fractions too have $\rm\: gcd\: \bigg(\!\!\dfrac{a}b,\:\dfrac{c}d\!\!\bigg)\ =\ \dfrac{gcd(a,b)}{lcm(b,d)}\ $ $\Rightarrow\:$ Bezoutness $\:\Rightarrow\:$ principality.

subset: commoncrawl


text:
This weekend I took part in a duathlon. That's the self-congratulatory part. But I didn't do the whole thing. That's the other part.
So what happened was this: A colleague had signed up to do it with a friend, with the friend biking 10km and my colleague doing the 5km walk. The friend backed out, and I backed in. Had I biked 10km before? No. Am I used to biking? Sort of, and where I live is moderately hilly. So I thought, why not. Continue reading


text:
Today on The Rise To The Top: The #1 Non-Boring Business Show: The husband and wife tag team of Joshua Sprague and France Morissette share how they turned a love for natural foods into a booming business with ideas and inspiration you can take away for your biz.
I use RISE partner Wistia for video hosting because they rock. Check 'em out.
Podcast: Play in new window | Download
Cookbook author, France Morissette, and her husband Joshua Sprague believe that healthy food should be uncompromising when it comes to flavor. They creatively explore the world of natural, whole foods, leaving no stone unturned in their quest to create mouth watering, flavor packed, whole food meals. Through stories, photos, and recipes, they're on a mission to help you eat healthy and enjoy every last bite in the process.
Make sure to check out Beyond The Peel and the Whole Food Revelation (their awesome product).
Ah, the holidays. You've got days off to spend time at home, travel or be with family. Problem is a pile of work is waiting when you get back! To help you stay on top of work AND enjoy the holidays, the solution is simple: Use GoToMyPC to access your computer from anywhere – your home, the in-laws, even an airport! Anywhere with Internet access. Get a FREE 30 day trial of GoToMyPC right now before the holiday break! Visit GoToMyPC.com, click the Try It Free button, and use promo code RISE.
You can join the 200,000+ The Rise To The Top enthusiasts by becoming a subscriber absolutely free.
Show the world you are fluff-free with an official fluff-free t-shirt!
Have you nabbed a copy of my book Smarter, Faster, Cheaper: Non-Boring, Fluff-Free Strategies for Marketing and Promoting Your Business? You can grab the first chapter for free right here, and you can buy it on Amazon or anywhere books are sold.


text:
Skydiving.com now has a network skydiving location serving Elsie and Perkins County in Nebraska. Call Skydiving.com at 1-800-617-7948 for details, free information and specials on skydiving in Elsie, NE today!
Popular Tags for Skydiving Elsie:
Skydiving Elsie, Skydiving in Elsie, Sky Diving Elsie, Skydive Elsie NE, Skydiving 69134, Elsie Skydiving, Skydiving Elsie Nebraska, Skydiving near Elsie, Skydiving in Elsie Nebraska, Elsie Sky Diving, Skydive 69134, Skydiving Elsie NE, Skydive Elsie, Skydiving Perkins County, Skydive in 69134, Skydiving NE, Sky Diving Elsie NE, Elsie, Nebraska
Sign up for our newsletter and receive updatesand specials on skydiving across America!


text:
Hot stuff this summer in Washington DC
August 2nd, 2013 by Liz Barron under Cross-cultural communications, Enjoying work, Executive Education, Global competencies, Leadership Development. 4 Comments.
Our theme was heat—the hottest week of the year in Washington DC, the U.S. IRS in real hot water, and white hot enthusiasm for a visit to America from our group of 42 Commissioners of Income Tax from the Indian Revenue Service. The group were here to learn about investigation techniques and use of technology. Smith faculty, former IRS Deputy Commissioner Mark Matthews, and many IRS executive and DC tax administration experts combined to share their knowledge of money-laundering, off-shoring, computer crimes and so on with our visitors.
Dr. Mike Faulkender led a spirited discussion on the tax-exempt targeting scandal and on the hearings to which Apple was subjected earlier this summer. In his estimation, Congress and bad law are the real villians in each case.
Dr. Peter Weiss led a workshop on data-mining. Dr. Anil Gupta widened the focus of the program, talking about Global Megatrends and the Changing Dynamics of the World Economy.
We visited the U.S. Capitol in the company of former Wisconsin Congressman Jim Moody. We sat around the board table at the Fed, and went to the Bureau of Engraving and Printing to see the new $100 bills being made.
At Brookings, Dr. Stephen Cohen signed copies of his new book about India and Pakistan–more heated discussion–and on the final morning new author Michael Pocalyko shared tips on spotting fraud, and signed copies of his thriller The Navigator.
Caela and I were treated to songs and poems in Hindi; given beautiful silk purses; and invited to visit everywhere from Agra to Bangalore to Lucknow and Goa. We will go. We want our own saris.
The Robert H. Smith School of Business at the University of Maryland, College Park uses its network and influence in the national capital area to provide a wide range of learning experiences for government and corporate groups from all over the world. Contact Liz Barron firstname.lastname@example.com or 301 405 5387 to plan your visit to the United States and to learn from Smith's faculty and expert contacts.


text:
Isaiah Afamefuna Ekejiuba (twitter: @Ekejiuba50)
Position: LB
Height: 6-4 Weight: 219 lbs.
Born: October 5, 1981
High School: Suffield Academy
College: Virginia (school history)
Weighted Career AV (100-95-...): 5 (9377th overall since 1950)
Promote your website or business by sponsoring this page for $5 on Pro-Football-Reference.com. Your message will replace this ad.
Output includes all games from 1920 to 2015.


text:
Karina Smirnoff has a great idea for the next season of "Dancing with the Stars" and it's something that fans may very well champion to happen. In an interview with OK! Magazine, posted on Monday, May 26, Karina said that for season 19 of the show, she wants to see the eliminated pro dancers serve as guest judges the week after they're eliminated.
She explained that it would be great for the show because as dancers themselves, the pros know what it takes and requires and so their criticisms are going to be very constructive. She said that while celebrity guest judges such as Abby Lee Miller and Donny Osmond are fun, having pros do some judging will be more beneficial to the teams. Karina revealed that she actually wanted to serve as a guest judge on the latest season but the show's producers wouldn't let her.
If Karina doesn't get her way with the pro dancers serving as guest judges the week after they're eliminated idea, she may very well get to judge in another, and much bigger, capacity. When told that judge Len Goodman made a comment that season 18 may be his last, Karina joked that she's going to send in her resume and absolutely campaign to get his job now.
Karina added that out of the three judges, which besides Len consists of Carrie Ann Inaba and Bruno Tonioli, Len is the only one who actually grew up in the ballroom world. She, as a ballroom person, would totally be right for the job.
While Karina Smirnoff has gone far on "Dancing with the Stars" in previous seasons, even winning season 13 with J.R. Martinez, she and her celeb partner Sean Avery were eliminated the second week in on the latest season. Her ex-fiance, Maksim Chmerkovskiy, eventually won the season with his celeb partner Meryl Davis.
Suggested Links
- 'DWTS' James Maslow and Peta Murgatroyd set the record straight
- Abby Lee Miller takes credit for Meryl Davis' and Maks Chmerkovskiy's 'DWTS' win
- 'DWTS' season 19: Maksim Chmerkovskiy a permanent judge and Derek Hough gone?
- The major actor 'DWTS' Karina Smirnoff wants to partner with
- Maksim Chmerkovskiy on why he left 'DWTS' and his new love of the show


text:
The American Way Comics Complete Series
Format Post in Technics
Shared By Guest
The American Way Comics Complete SeriesHi Dears! If You Want download The American Way Comics Complete Series after clicking On Download Link(In Code Section), Please Wait For 5-8 Second. Then You Can Click On Skip Ads! Button. Enjoy!! Code: The American Way is an eight-issue American comic book limited series produced under DC Comics' Wildstorm Signature imprint. The series debuted in April 2006, and was created by John Ridley and Georges Jeanty. The series represented a skewed parallel history of America, where the United States Government created its own super powered "heroes" and "villains". In the early 1940s, the United States government hatched a plan to create the Civil Defense Corps: a group of supposed "super-heroes" who could fight alien invasions, evil super-powered beings, and communism, all in front of an adoring public, courtesy of television. When an African-American hero named the New American is inserted into 1962′s premier superteam, the turmoil begins. Code:


text:
Louis Anthony Graziosi, 83, a long time resident of the Dover area died on Tuesday, November 6th at the Capitol Healthcare Services center. He was born January 2nd, 1929 in Jersey City to Louis and Maria Graziosi.
A dedicated and hard-working man, Louis was a proud member of the United States Air Force for over 23 years. It was his honor and pleasure to serve his country. After retiring from active military service, Louis worked as a Driver at Preston Trucking, and was also a self employed entrepreneur.
An avid outdoorsman, Louis loved hunting, fishing, and camping. He was also fond of talking to people and socializing. Louis could talk to anybody; his friendly demeanor, easy going manner, and welcoming presence allowed him to make friends with everyone he met. Louis belonged to Dover Masonic Lodge, the VFW, the Moose Lodge, the American Legion, and the Modern Maturity Center. Louis was a proud family man, who loved his family. He was a great husband and an amazing father.
He is survived by his spouse of nearly 64 years, Adelina Graziosi; as well as his daughter, Patricia Watts, and her husband, Richard of Ormond Beach, Florida, his granddaughter, Dr. Korashon Watts, PhD, and her husband, Damon Matlon, of Seattle, Washington. Louis' loss will be deeply felt by all of those who knew him; his spirit will always be with us, and his love we shall forever carry in our hearts. He is still well loved, and is deeply missed, and he will never be forgotten by those hearts he has touched. He will truly and sorrowfully be missed by all who knew and encountered him.
A memorial service will be held at Saint Andrews Lutheran Church at 11 am on Monday, November 12th.
In lieu of flowers the family request donations to the American Cancer Society, 92 Reads Way, Ste 205, New Castle, DE or the Delaware Hospice, 911 S. Dupont Hwy, Dover, DE. Letters of condolences can be sent via www.pippinfuneralhome.com.
Location, ST | website.com


text:
OK so we're going to do this for sure. We've gotten approval from our bosses to take the vacation time and everything! Now onto booking...
The girls will be 4.5 when we go, and we plan to do 3-4 days. Maybe 4 (get there on Sunday, rest/relax, then go on Monday, Tues, Wed, Thurs.)
I saw that Costco has some vacation options for DLR. We would ideally like to stay on-site in the most easily walkable hotel. I've been digging around on the overwhelming Disboards and it looks like the Grand Californian is the way to go in terms of quick, easy access to both DL and CA. Our girls don't nap (well, they do at school but not on weekends) right now, but they aren't kids with a lot of stamina and I imagine they WILL get tired and we would want to spend some time in the afternoon resting at the hotel, and to have to option to hit both DL and CA if we are able.
Anyway, opinions on whether the Grand Californian is the way to go would be appreciated! We are using going to use airmiles for airline tickets so we are willing to splurge on hotel to make this the easiest possible experience for us (the parents - LOL).
Anyway my main question is whether the Costco packages are good in terms of pricing. I just don't have time to really bargain-hunt for deals, but I don't want to pay top dollar either. I want a good middle ground of fair prices without having to spend hours and hours on disboards and elsewhere trying to get good deals. So...opinions on Costco?


text:
Announced on March 4, Northside Festival is returning in 2014, with over 90,000 folks who'll be attending venues in Williamsburg to Greenpoint, between the dates of June 12 through June 19, 2014. This is the sixth year Northside is bringing up-and-coming music, film and innovation. This is Brooklyn's largest festival.
Northside Music (June 12-15) will bring over 400 bands from Brooklyn and beyond for a showcase of what's next in music. This year's line-up includes Sharon Van Etten, Titus Andronicus, Beach Fossils, Courtney Barnett, Omar Souleyman, Dan Croll, Eagulls, Mas Ysa, Luke Temple, Laurel and more, with curated shows from such local media outlets and stores such as Pitchfork, BrooklynVegan, Sacred Bones Records, Captured Tracks, Ad Hoc, NYC Popfest, BreakThru Radio and The Deli Magazine. Two huge free shows will be held at a 6,000-capacity space in McCarren Park on June 14 and 15. For more of the lineup and further announcements, visit HERE.
Northside Innovation (June 12-13) is proud to present some of its most prestigious speakers yet, featuring: Chad Dickerson, Etsy; Kerry Trainor, Vimeo; Andy Dunn, Bonobos; Phin Barnes, First Round Capital; Jennifer Fleiss, Rent the Runway; Lockhart Steele, Curbed; Soraya Darabi, Zady; Mario Schlosser, Oscar; Amanda Peyton, Grand St., and many more to come! Check out an up-to-date list of speakers HERE.
Northside Film is excited to present Joana Vicente, Executive Director of IFP and producer of the films Enron: The Smartest Guys in the Room (2005), Coffee and Cigarettes (2003) and Welcome to the Dollhouse (1995) as the 2014 Northside DIY Film Competition jury chair! She'll be joined by Parker Posey, Ira Sachs (Love is Strange, Keep the Lights On), Matthew Grady (Factory 25) and Kentucker Audley (NoBudge Films, Sun Don't Shine). The open call for submissions has been extended until March 10 - for more information on how to enter, prize package information and more, click HERE.
Northside Film will also partner with top critics and film organizations to curate programs for 2014 including: BAMcinemaFest, BOMB Magazine, DCTV, Factory 25, Film Comment Selects, Filmwax Radio, IFC Films, IFP, indieWIRE, N+1FR (the N+1 Film Review), Reverse Shot, Shooting People, and more! More partners include Jameson Irish Whiskey, and will be introducing VH1 and Palladia as Platinum partners to the 2014 Festival. More details will be announced with their upcoming creative additives they'll be showcasing in June.
Early Bird Music Badges ($65), Innovation Badges ($245), Film Badges ($25), and Premium Badges ($275) are on sale now! Purchase badges HERE. Purchase single-show tickets HERE.
Follow and connect:


text:
I'm setting up a wordpress site for a friend who has some large audio files (around 150M). He's on a bad connection and it'll take him a while to upload those files using the normal wordpress upload tool. I'm looking for a tool that I can install on the server that allows uploads and is also fault tolerant (for example if you loses his connection, or power, or whatever it'll pick up where it left off). I realize normal web technologies probably don't do that, but perhaps flash or something similar will work. Any ideas?
I generally discourage uploading giant files through the browser, if possible; it just sucks. If going around WordPress a bit is an option, there's a plugin, Add From Server that allows for grabbing stuff that's already on the filesystem. So, have client ftp the files in(which gives you resuming etc. for free) and then import when ready through the WP admin.
since the site is hosted on ec2, I'm trying out s3browser. It's working great so far.


text:
If your child is a picky eater, it can be challenging to pack healthy lunches your child will eat. Picky eaters can also provide a challenge during mealtime at home.
We spoke with Sylvia Melendez-Klinger of the Grain Foods Foundation for tips to help picky eaters eat healthy lunches. Melendez-Klinger is a licensed and registered dietitian, certified personal trainer and founder of Hispanic Food Communications, a food communications and culinary consulting company based in Illinois.
Sylvia uses her in-depth culinary and cultural expertise to help an increasingly health-conscious Hispanic population learn new strategies for healthy living.
Examiner asks: How can parents help picky eaters eat healthy lunches?
Sylvia responds, "Picky eaters are a great concern to moms, but easing their worries doesn't have to be difficult. Let me share a few tips that will help ease the battles between you and your picky eater. This is coming not only from a dietitian, but from a mom of a recovered picky eater. Get creative and have some fun creating very tasty healthy food."
These tips from Sylvia will keep your kids wanting more and more healthy foods:
For a super easy colorful appetizer, mix 1 cup light cream cheese with 1/2 cup reduced fat mayonnaise and spread mixture on a serving platter. Layer salsa, chopped tomatoes and low fat shredded cheese for a real fiesta dip. Or make Sylvia's kids' favorite: layer your favorite pasta sauce with thin slices of low fat turkey sausage, cheddar Mozzarella cheese over the same cream cheese mixture.
Sylvia shares her family recipe for pleasing meatloaf. "Every winter I pull out my old fashioned (did I say super simple) meatloaf recipe that the aroma alone even makes our dog beg for leftovers. Just five ingredients: 1 pound ground turkey, 1 cup pasta sauce, 1 cup seasoned bread crumbs, 1 egg, 1/4 cup chopped onions and black pepper to taste. Mix well and place on a meatloaf pan or divide on a muffin pan. Bake at 350 degrees for 1 hour or 20 minutes for a muffin pan. While the meatloaf bakes on the upper rack, slice carrots and potatoes into thin coins, drizzle with olive oil and bake on a cooking sheet right on the bottom shelve of you oven also for 1 hour."
Sylvia suggests that families plan meals together. Sylvia says, "Sit down with your kids and plan a few meals together; they will be more inclined to eat something they help plan for the family. Also, take the family grocery shopping. Everyone can learn to read the nutrition labels and about the nutrients in each food or product."
When you teach kids how to cook, they are more likely to eat healthy foods. Sylvia shares, "I can't emphasize how important is to teach our kids, boys and girls, how to cook. Cooking is an art, which develops an appreciation for delicious healthy foods. If you are not skilled in the kitchen, take a class together in your community."
Eating dinner together at home will help your child become less picky. Sylvia says, "A shared dinner table can be a positive influence on shaping children's eating habits. Children who eat more family meals tend to consume less soda, fewer fried foods, and more fruits and vegetables." Citing a 2000 study by the Archives of Family Medicine, Sylvia tells us, "The table offer great benefits for everyone in the family; just keep your conversations positive."
Examiner asks: How should parents handle kids swapping lunches with friends?
Sylvia tells us, "I still remember my son giving away any lunch items he was not going to eat; he had a lot of friends during the lunch hour. Swapping lunches is a common practice among kids. As generous as this may sounds, kids today have many allergies and sensitivity to a number of foods, so is best to send small portions and try to provide foods your kids will most likely eat to avoid this food sharing." Many schools now have a firm no-swapping policy. If your school has this policy, reinforce this with your kids.
Examiner asks: What are the best protein choices for brown bag lunches?
Sylvia responds, "Here are my favorite top five protein sources: low fat yogurt, hard boiled eggs, mozzarella cheese stick, tuna fish with crackers or a handful of raw almonds or other favorite nuts." Sylvia recommends nuts for older kids.
Examiner asks: What foods help kids keep focused all day?
Sylvia tells us, "Studies have demonstrated that eating breakfast help kids stay focused during the day. A combination of at least three food groups will assure a well-balanced meal, which can provide the essential nutrients needed to keep kids focus during the day. For example: A simple and inexpensive meal with a cereal, low fat milk or yogurt and 1/2 cup of chopped fruit provides a nutritious meal."
Examiner asks: What other tips can you offer to help parents pack healthy, nutritious lunches?
Sylvia's response speaks to the worried parent in all of us. "Relax. Unless your picky eater is below the 25th percentile in the growth chart, you should relax a little and try to work in some of the tactics provided here, before you make them sit at the table for hours until they finish a few bites."
One more tip from a parent of formerly picky eaters. Being a picky eater doesn't last forever. Keep offering a variety of foods to your child and even the pickiest kids will eventually learn they like more than just hot dogs and mac and cheese.


text:
Link Building techniques for blogs
View Single Post
Newbie Member
Getting quality links is the only way to improve your PageRank. Quality meaning links that carry weight. The more quality links you get the higher your PageRank will be. Apparently I can't link you an article but there are plenty of them out there. Just be careful because there are a lot of self-proclaimed "gurus" who have absolutely no idea what they are talking about.
Also, there is a great website that I like using that will both track your rankings and will keep track of your links. It also shows how much link juice each link has. Check out sheerseo.
One thing to keep in mind...not all links start with a large amount of "link juice". It takes time, to get quality links. Your content will determine how often your page is linked to. If you have good content, people are more likely to link to your content and that will generate quality links.


text:
"Bachelor" star Juan Pablo may have been the must-have contestant after people fell in love with him on Desiree Hartsock's season of "The Bachelorette." He was eliminated rather fast, but women around the country remembered him. But it may be the last time that producers will let the country decide who they want on the show, because Juan Pablo quickly became the most-hated man in the country during his season.
According to a new Wetpaint Entertainment report published on May 1, "Bachelor" star Juan Pablo hasn't reached out to Chris Harrison after filming his dramatic finale episode. In fact, he hasn't really talked to anyone with relation to the show. "I haven't talked to him," Chris tells Parade magazine when asked if he has talked to Juan Pablo since the dramatic "After the Final Rose" special. Of course, Sean Lowe was shocked that Juan Pablo would be so rude to Harrison after he got everything from the show.
Even though he hasn't reached out, Harrison does follow him in the press and he knows that Juan Pablo and Nikki Ferrell are indeed still together. "I know they're together. They're doing well," Chris says of the couple, citing producers and other folks on the show as his insiders. "That's the ironic thing in all of this," he adds. "The ultimate goal is to have a relationship and they do."
It sounds like there are no hard feelings anymore, as Harrison did his job; he made sure that Juan Pablo found love and found a partner. But he is still questioning whether Juan Pablo 'loves' Nikki and has told her. Juan Pablo has said that he doesn't want to "force fall in love" with Nikki. "Has he told her he loves her? I don't know, I hope so by now, but I don't know if he has, and I don't think he has," Chris says.
It sounds like Juan Pablo won't be reaching out to get any favours from Harrison or the "Bachelor" family anytime soon. What do you think of him now?


text:
Moll Flanders
by Daniel Defoe
Moll Flanders Section 3 Summary
Drapers and Captains
- Moll jumps back in time a little to note that after she and Robin first get married they set up house in London. When Robin's brother eventually gets married, too, Robin goes to the wedding in the country and Moll stays in London by herself.
- She's sad about the elder brother getting married, but she feels better when she remembers she w is youthful, pretty, fairly well-off, and (once Robin dies) unattached. In short: many men are interested in her.
- And once Robin dies, they become even more interested in her because she has money. Moll is careful, though, and doesn't fall for anyone initially. She's hoping for a bigger and better match.
- One of these suitors is the brother of her new landlady. He's a "linen-draper" (228). Wait a minute, that's a job?
- Unfortunately, she lets herself down and gets tricked into a relationship with this linen-draper guy. She's so intent on avoiding becoming someone's mistress that she ends up marrying the draper, who she thinks is a gentleman (and, no, not just the kind that holds the door for you – the kind that has money).
- But the draper is only interested in Moll for her money and tries to spend it as quickly as he can. He definitely doesn't live up to the reputation Moll thought he had. He spends all of his and Moll's money on foolish extravagances, including a trip to Oxford.
- A little more than two years into their marriage, Moll's husband gets caught by the police for all of his excessive debts. When Moll visits him in jail, he tells her to save herself and to take whatever money she can from their quarters and get out. That's precisely what she does.
- And that's the last we see of Husband #2, because soon after this he escapes to France, leaving many of the bills unpaid.
- Moll's husband sends her a couple of letters from France, including one in which he includes some money to pick up some holland fabric he had pawned. She's able to live off the money she makes from selling the fabric for a little while.
- Still, things have gotten dire. She has much less money than she used to and is technically still married, even though her husband is clearly out of the picture. She's alone and in trouble.
- Her solution? She gives up her old identity, of course. Changing her name to Mrs. Flanders, Moll moves to the "Mint," where people often go to evade debts collectors.
- Here, Moll becomes very popular, even though she isn't sleeping with anyone. Pretty soon, though, she gets bored. She thinks the people around her sin too much.
- So she decides to get out and moves in with a friend, also a widow, for six months. Then the widow gets married again and Moll's on her own once more.
- Meanwhile, Moll figures out that money matters in marriage more than anything else. Men can be picky and women are supposed to be grateful for all offers they receive. This doesn't quite seem fair.
- An example comes in the form of a girl Moll knows, who's been jilted after questioning her suitor. Moll advises her to act more like a man and protect herself in matrimonial negotiations. So, following Moll's advice, the girl spreads a rumor that the man who dumped her was a big jerk. And that gossip becomes a powerful weapon. Soon, none of the other women in the area will let the man court them, because of the nasty rumor they've heard.
- The girl tricks the man into falling back in love with her and teases him severely before finally taking him back.
- The man undergoes a complete moral change and becomes humble and nice. And it's all because of Moll's advice. The girl's able to manage her money wisely and even keep some of it out of her new husband's hands.
- Moll takes this opportunity to remind readers of the importance of women's rights. She says women should get to take more time in figuring out whom they might like to marry. Hear hear.
- Of course, despite all these noble thoughts about rights, Moll's situation is still pretty unfortunate. She still doesn't have much money and so no one wants to marry her. This is one situation where gossip clearly won't help.
- Moll decides she has to start over somewhere else again, with yet another identity.
- Luckily, she has a friend who can help. This friend, a former widow, helps her with both money and advice. The widow and her husband pretend Moll is their cousin and take her into town with them. They fool people into thinking Moll has more money than she does.
- Moll wants a man who thinks she has a lot of money and won't question her about her fortune too much, so she selects a captain as her new target.
- At some point in their courtship, the new lovebirds write poetry to each other on her window, using his diamond ring. Moll confesses she doesn't have much money and he says he'd marry her anyway – he thinks she's testing him and is secretly rich. Perfect.
- They decide to get married, and she continues to deceive him about her financial status. Moll tricks the poor guy into promising to love her whether she's really rich or really poor.
- He tells her he's pretty well off and has all this property in Virginia. He ends up not minding all that much when Moll reveals her truly poor status, and they are soon married. (This is Husband #3, just in case you want to keep track.)
- By the time she finally tells him how much money she really has, he's relieved because it's actually a little more than he was led to expect. She gives him a little money at a time, before saying that she has run out.
- This prompts Moll's new husband to say that he should go to Virginia by himself in order to keep their expenses low. But Moll wants to go with him, and we can't forget that this is a woman who knows how to get her way.
- Sure enough, they're soon on their way to America. The journey seems arduous but Moll doesn't talk about it very much. When they get to Virginia, they move in with her husband's mother.
- Everything goes well… until it doesn't.
- Moll's mother-in-law tells them about how many of the people in Virginia are former English criminals who've been exiled and were previously servants or slaves. But in the new world, they can work their way up to a fresh start. As it turns out, the mother-in-law is one of these very criminals she's describing. Hmm. That sounds vaguely familiar…
- Over time, a curious Moll asks more questions about her mother-in-law's past and learns the mother-in-law was in – you guessed it – Newgate prison. Gasp.
- Moll freaks out when she learns the mother-in-law's real name. Moll doesn't tell her mother-in-law the problem, but as soon as she can be alone she faces facts: her mother-in-law is actually her mother, and her husband is her brother. Pause for appropriate disgust.
- Horrified, Moll simply cannot continue with daily life: she's been sleeping with her brother and she's currently pregnant with their third child. She becomes paralyzed with indecision.
- She carries on for three years feeling like an immoral criminal, but hey, at least they don't have any more kids.
- Meanwhile she learns more about her mother-in-law/mother, and feels like they have both been living like whores.
- Then everything falls apart: Moll and her husband start to fight a lot, and she arranges to return to England by herself. She can't bear to act as his wife anymore, but, even with all of the arguing, she has a really hard time convincing him to release her from their marriage.
- She decides she'll have to abandon her family because of her secret, and her poor husband can't understand why she wants to leave.
- When she stops sleeping with him altogether, he calls her crazy for it. Finally she decides she has no choice but to tell him a bit about their real relationship. But, before she can, he starts threatening to put her in a madhouse, which freaks Moll out.
- They have a huge fight. She says they're not legally married, but doesn't say why, and he becomes severely ill. He assumes that Moll has another husband who's still alive – which is technically true, but is not the problem she has with him – and tells his mother about it.
- Moll is forced to tell their mother the real secret. At first they fight about it, but then they make up in an attempt to resolve the larger issue of incest. If the truth comes out it will destroy all of them. What in the world should they do?
- The mother thinks Moll should just act like it's not true, and pretend she never found out her husband was actually her brother. But Moll thinks this is disgusting, and we totally agree.
- Moll says she should return to England by herself, if her mother will give her some money, and then once she's gone her mother can tell her husband/brother the truth.
- Meanwhile, the poor, in-the-dark husband keeps bringing up the madhouse because she won't tell him what's really going on. So their mother finally persuades the husband to ease up on Moll, but Moll knows she has to tell him the truth before she gets pregnant with a fourth child.
- So, even though her mother doesn't want her to, Moll finally decides to tell her husband the truth. First she makes him promise he won't think the secret is her fault, that he'll never tell anyone but his mom, and that he won't let his emotions get the best of him.
- He promises.
- So Moll finally tells him they are siblings. Big moment, folks.
- He is beyond horrified and eventual tries to "fix" the problem by offering to kill himself. Well, bud, that's a little extreme. A more practical Moll manages to get him in a better mood, but he still tries to commit suicide twice. Luckily, he's unsuccessful.
- He does become ill all over again, though, and Moll decides it's a good time to head back to England. He's weaker now, after all, so Moll will have an easier time convincing him this is the right way to handle the situation.
- They agree to call each other brother and sister, and Moll tells him he should spread the word that she's died, and then he can get married again.
- The husband agrees to speak well of her in her absence, although Moll makes an aside to the reader that, later, we'll find out that wasn't exactly what he ended up doing. Hmm. We wonder what she means by that.
People who Shmooped this also Shmooped...


text:
Don Cooper Phelps (Dopey)
Position: HB-DB
Height: 5-11 Weight: 185 lbs.
Born: January 7, 1924 in Richmond, KY
Died: June 11, 1982 in Frankfort, KY
High School: Danville
College: Kentucky (school history)
Drafted by the Cleveland Browns in the 5th round (65th overall) of the 1950 NFL Draft.
Weighted Career AV (100-95-...): 0 (15060th overall since 1950)
Output includes all passing, rushing, and receiving plays.See all Don Phelps Super Bowl plays using the Super Bowl Play Finder


text:
When it comes to accepting a challenge, many teens are literally risking their lives to gain YouTube fame. An article posted February 22 by WCSC Live5 tells of a 15-year-old South Carolina teen who is lucky to be alive.
Shawn Stillinger, a Charleston, South Carolina teen decided to accept a challenge involving a homemade blow dart. Shawn tilted the blow dart up to shoot it out of a tree, and the dart somehow went into his throat.
Shawn's mother, Tara Chavis, told WCSC News
"He was scared and I think he realized then what he did wasn't really worth what he was feeling right at the moment."
Shawn's primary concern, after hearing his throat would have to be cut open, was whether a surgeon wouldn't be able to remove the dart.
Shawn was sent to two hospitals, and neither was able to remove the dart. Dr. David Gudis, Doctor of Otolaryngology from the Medical University of Charleston was able to access his airway using endoscopic technology.
This procedure didn't require cutting into Shawn's throat. For those teens eager to perform the eating dart stunt, keep in mind Dr. Gudis cautions people can die from foreign objects getting stuck in their airway.
A video, which can't be embedded on Examiner, can be viewed here.
It's an important part of growing up to consider the consequences of a dare. Don't perform stunts that have the potential to kill you. When in doubt-don't.
To the parents out there, it pays to read up on the latest YouTube dares being marketed toward teens.


text:
ATLANTA — Supermarkets planning to survive the present economic downturn would be wise to avoid middle-market positioning, said an A&P executive in an address here. "There's been a big shift among retailers to get out of the middle," said G. Robert James, vice president, strategy and insights, A&P. "One-size-fits-all doesn't really fit anywhere in the industry." James made his remarks in a keynote address at the Category Management Association conference, in which he focused on the ...
REGISTER TO VIEW THIS ARTICLE - Register for a Free Account
Why Register for FREE?
Registering for content on Supermarket News will give you INSTANT access to invaluable articles and media content that industry professionals rely on. You will have access to our special reports, feature articles, and industry analysis. It's FREE, easy and quick. What are you waiting for! In addition you will also receive complimentary access to the SN salary survey data tables.
Click here to read the FAQ page if you have any questions (opens in a new window)
Attention Paid Print Subscribers: While you have already been granted free access to SN we ask that you register now. We promise it will only take a few minutes! Or visit your profile and add your print magazine account number and zip code.


text:
From Medscape Education Oncology
"Metastatic Castration-Resistant Prostate Cancer: New Targets, New Therapeutic Approaches"
Drs Logothetis, Beer, De Bono, et al in presentation and panel discussion.
Lots of Q&A with some intersting discussion of Cabo... CME presentation.
Nice vid! The era of chemotherapy for prostate cancer sounds like it's over, and future patients will be put on a specially tailored schedule of targeted drugs.


text:
Pop princess Britney Spears is flattered that country superstar Miranda Lambert uses her as inspiration to work out harder.
Spears took to Instagram to praise Lambert for her recent 45-pound weight loss. "So flattered by this @MirandaLambert!" Britney wrote. "You look amazing!!"
Spears was responding to a comment Miranda had made in a recent Women's Health magazine interview, where Miranda said she pictures Britney's fit body in her mind as inspiration to run faster during her workouts. "I can picture Britney's body and I'm like, 'Faster!'" said Lambert.
Portion-Controlled Diet and Circuit-Training Workouts
Miranda 30, is in the best shape of her life after reportedly losing 45 pounds through diet and exercise. Lambert said she lost the weight ahead of her 30th birthday (in November 2013) because she wanted to turn over a new leaf as she entered a new decade.
The blonde beauty said her junk-food diet during her 20s resulted in dramatic weight fluctuations, but she decided once and for all to take charge of her health.
Lambert, whose favorite snack is Cheetos, credited a portion-controlled diet and rigorous cardio and fat-burning circuit-training workouts for her unbelievable transformation.
Miranda said she tries not to get discouraged by the numbers she sees on the scale, saying constantly weighing yourself is an exercise in torture.
Slammed Weight-Loss Surgery and Anorexia Reports
Miranda, who's married to fellow country superstar Blake Shelton, made headlines after debuting her dramatic weight loss at the 2013 CMA Awards. She was shocked at the amount of attention she received after the weight loss, because she didn't think anyone would notice. Unfortunately, some of the attention wasn't positive.
Lambert recently slammed rumors that her weight loss was due to plastic surgery. A furious Miranda denied she underwent weight-loss surgery, and underscored that she had slimmed down the "good old-fashioned" way: through diet and exercise.
"I DID NOT have surgery to lose weight," she blogged. "That is ridiculous. I lost my weight the healthy and good-old fashioned way. Watching what I eat and working out with my trainer Bill Crutchfield."
Lambert also vehemently denied rumors she's suffering from the eating disorder anorexia after debuting her dramatically thinner frame. Miranda, who has sold more than five million albums, recently dropped her fifth album, Platinum.
Suggested Links
- Blake Shelton weight loss was due to Miranda Lambert 'divorce starvation diet'
- Tim McGraw is ripped to shreds at 48: His Paleo diet and CrossFit workout
- Sexy Shania Twain, 50, reveals low-carb vegetarian diet and yoga workout tips
- Demi Moore bikini body secrets: Raw vegan diet, yoga and Pilates workouts
- Dr. Oz reveals inexpensive anti-aging wrinkle creams and weight loss secrets


text:
San Diego Opera Maestro remembered
Edoardo Müller was willing to send a message in opera
Garrett Harris 4 p.m., June 27
Genre: Electro | DJ
No shows scheduled | Post a show | View show history
Inception: San Diego, 2005
Influences: MSTRKRFT, the Kills, Crystal Castles, the Antlers, Ghostland Observatory, LA Riots, the Villains, Tronik, Youth, Friendly Fires, the XX
DJ Edgartronic - aka Edgar Nuñez - spins his own remixes, along with cult 1980s and modern electro-house and offbeat Europop. He has held several residencies, the most noteworthy being Boombox Thursdays at the Air Conditioned Lounge, which ran for over a year. He was nominated Best DJ at the 2008 and 2009 San Diego Music Awards.
As of 2010, Nuñez works as a Web developer by day and a DJ by night. "One of my first DJ gigs was at Scolari's," he says. "It had its good times and its bad." He has also hosted Analogic Nights, a dance music radio show at online radio station X1FM.


text:
Hearing Transcript on Servicemembers' Seamless Transition into Civilian Life–The Heroes Return.
Printed for the use of the Committee on Veterans' Affairs
SERIAL No. 110-7
For sale by the Superintendent of Documents, U.S. Government Printing Office
CORRINE BROWN, Florida
STEVE BUYER, Indiana, Ranking
Malcom A. Shorter, Staff Director
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records of the Committee on Veterans' Affairs are also published in electronic form. The printed hearing record remains the official version. Because electronic submissions are used to prepare both printed and electronic versions of the hearing record, the process of converting between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process is further refined.
March 8, 2007
Servicemembers' Seamless Transition into Civilian Life—The Heroes Return
Chairman Harry E. Mitchell
Prepared Statement of Chairman Mitchell
Hon. Ginny Brown-Waite, Ranking Republican Member
Prepared Statement of Congresswoman Brown-Waite
Hon. Cliff Stearns, a Representative in Congress from the State of Florida, statement
U.S. Department of Veterans Affairs:
Michael J. Kussman, MD, MS, MACP, Acting Under Secretary for Health, Veterans Health Administration
Prepared Statement of Dr. Kussman
Shane McNamee, MD, Director, Hunter Holmes McGuire Richmond Veterans
Affairs Medical Center, Richmond, VA
Prepared Statement of Dr. McNamee
Steven G. Scott, MD, Medical Director, Tampa Polytrauma Rehabilitation Center,
James A. Haley Veterans' Hospital, Tampa, FL
Prepared Statement of Dr. Scott
William F. Feeley, MSW, FACHE, Deputy Under Secretary for Health for Operations and Management, Veterans Health Administration
Prepared Statement of Mr. Feeley
Edward C. Huycke, MD, Chief Department of Defense Coordination Officer, Veterans Health Administration
Prepared Statement of Dr. Huycke
Ira R. Katz, MD, PhD, Deputy Chief Patient Care Services Officer for Mental Health, Veterans Health Administration
Prepared Statement of Dr. Katz
U.S. Government Accountability Office, Cynthia A. Bascetta, Director, Health Care
Prepared Statement of Ms. Bascetta
Lain, Kimberly, Millersville, MD
Pearce, Kathy, Mesa, AZ
Sullivan, Paul, Cedar Park, TX
Walter Reed Medical Center/Bethesda Naval Hospital:
Kathy Dinegar, Social Worker Liaison for Seamless Transition
Sherry Edmonds-Clemons, Social Worker Liaison for Seamless Transition
Letter dated March 7, 2007, from U.S. Department of Veterans Affairs Secretary Nicholson to Congresswoman Ginny Brown-Waite, regarding the ability of DoD and VA to provide world-class health care to servicemembers and veterans
U.S. Government Accountability Office Letter dated June 30, 2007, from Cynthia A. Bascetta, Director, Health Care, to Congressman Michael Bilirakis, regarding Transition of Care for OEF and OIF Servicemembers (GAO-06-79R)
U.S. Government Accountability Office Report entitled, "Vocational Rehabilitation—More VA and DoD Collaboration Needed to Expedite Services for Seriously Injured Servicemembers," dated January 2005 (GAO-05-167)
Response to Questions for the Record from Paul Sullivan, Cedar Park, TX, and former Project Manager for the U.S. Department of Veterans Affairs, dated March 27, 2007 [The exhibits submitted by Mr. Sullivan are being retained in the Committee files]
Thursday, March 8, 2007
U. S. House of Representatives,
Subcommittee on Oversight and Investigations,
Committee on Veterans' Affairs,
Washington, DC.
The Subcommittee met, pursuant to notice, at 3:43 p.m., in Room 334, Cannon House Office Building, Hon. Harry E. Mitchell [Chairman of the Subcommittee] presiding.
Present: Representatives Mitchell, Space, Walz, Rodriguez, and Brown-Waite.
Also Present: Representatives Filner, Hare, Buyer, Bilirakis, and Lamborn.
Mr. MITCHELL. Welcome to the Oversight and Investigations Subcommittee of the Committee on Veterans' Affairs March 8, 2007, hearing entitled, Servicemembers' Seamless Transition into Civilian Life—The Heroes Return. I want to thank everyone for being here today. Two weeks ago, the American people learned that some of the most seriously wounded warriors were recovering in dilapidated conditions at the Walter Reed Medical Center, supposedly the Army's premier medical facility.
These conditions are absolutely unacceptable and the American people are rightly outraged. Sadly, it appears the buildings are just the tip of the iceberg. Reports have been filtering in about a labyrinth of bureaucratic red tape our returning soldiers are having to navigate to get the basic health care benefits they need and deserve. These problems have a direct impact on these men and women as they transition from the military's health care system to the VA. We have a responsibility to investigate how issues at the Department of Defense affect soldiers as they become veterans. We have a responsibility to make sure that the Department of Veterans Affairs is doing its job to make the transition as easy as possible.
I am not convinced the that U.S. Department of Veterans Affairs (VA) is doing its part. Last night, ABC News reported that a proposal to keep seriously wounded vets from falling through the cracks of the bureaucracy was shelved in 2005 when Jim Nicholson took over as VA Secretary. I am deeply troubled when wounded soldiers say in news reports that the VA has made them feel horrible. That is unacceptable and embarrassing and the American people deserve answers. Today, we hope to get to some of them. In today's hearing, we will hear from witnesses who have seen and experienced firsthand the difficulties veterans face when they transition from the DoD health care system to the VA. Their stories are compelling, and I am eager to learn how the VA is responding to their concerns as well as the health care needs of their fellow veterans who have taken time to come to observe our hearings.
In particular, I would like to recognize Specialist Greg Williams, Corporal Noel Santos, Sergeant Frank Valentine, Staff Sergeant Danny Vega. We are honored to welcome these young heroes here today. At this time, I ask unanimous consent that Mr. Filner, Mr. Buyer, Mr. Hare, Mr. Lamborn, and Mr. Bilirakis be invited to sit at the dais for the Subcommittee hearing today. Hearing no objections, so ordered.
[The statement of Chairman Mitchell appears in the Appendix.]
Mr. MITCHELL. Before I recognize the ranking Republican member for her remarks, I would like to swear in all of our witnesses. And at this time, if you would please stand, we will swear you in.
[Witnesses sworn.]
Mr. MITCHELL. Thank you. Now I would like to recognize Ms. Brown-Waite for her opening remarks.
Ms. BROWN-WAITE. I thank the Chairman. And I apologize both to the Chairman and to the members for my tardiness. It was an issue relating to a sexual predator in my district who was found guilty yesterday, and I was speaking to the family and to some members of the press about it. And I thank the gentleman for yielding. The Committee on Veterans' Affairs has been conducting oversight reviews of the seamless transition issue for our Nation's servicemembers for the past several Congresses.
In the last Congress alone, the Committee and its Subcommittee held 10 hearings on the transition of our servicemembers. I believe that I speak for all of us when I say that this is a top priority issue, that despite our best efforts has not always been entirely resolved. Congress codified the concept of DoD/VA sharing, now known as seamless transition, in 1982, with the passage of the Veterans Administration and the Department of Defense Health Resources Sharing an Emergency Operation Act. This Act created the VA Care Committee to supervise and manage opportunities to share medical resources. Now, 25 years later, we are still discussing this issue. Some progress has been made in the area of transitioning servicemembers back to the workforce.
Last Congress, Public Law 109-461 was enacted which included various transition assistance initiatives ranging from health care needs to education and employment needs. During the last Congress, members and staff from the Committee conducted numerous field and site visits at the VA and military treatment facilities and military bases to review efforts on the seamless transition, and held oversight hearings in May and September of 2005. The transition and integration back into civilian life should be transparent and effortless for our servicemembers.
However, this apparently does not always seem to be the case. More often than not, the handoffs have been fumbles. In a GAO report prepared for this Subcommittee on June 30, 2006, it was found that the VA has taken many aggressive actions to provide timely information to OEF and OIF servicemembers and their families, especially in their critical time of need. The report also noted the positive steps taken to increase the awareness training and sensitivity of staff and medical providers on the needs of OIF and OEF servicemembers and veterans. The report also found the VA continues to have problems assessing real-time medical information from DoD treatment facilities. Mr. Chairman, I ask unanimous consent that a copy of this report be inserted in the official hearing record, and I will be happy to hand that to you.
Mr. MITCHELL. So ordered.
[The referenced GAO Report entitled, "Vocational Rehabilitation—More VA and DOD Collaboration Needed to Expedite Services for Seriously Injured Servicemembers," (GAO-06-79R), appears in the Appendix.]
Ms. BROWN-WAITE. I appreciate that.
We know that we have witnesses from Walter Reed Army Medical Center, and I want to make it clear that today's hearing is not about the conditions at Walter Reed, but about the transition of our servicemembers and how they are making it from DoD to VA care, how the process works, are there any gaps in care, and is VA getting the information that it needs from DoD in a timely manner to ensure the continuity of care for these new veterans, so that waiting periods for care do not extend for months after separation from active duty. And why to this day is information on DoD personnel being cared for at the VA's polytrauma centers still not being electronically transmitted? Is there a difference between DoD electrons and VA electrons? Again, Mr. Chairman, I thank you and I yield back the balance of my time.
[The statement of Congresswoman Brown-Waite appears in the Appendix.]
Mr. MITCHELL. Thank you. At this time, I am asking members to submit their opening statements. We have 13 people on three panels that we are going to hear today. So it will take quite a while. If you could submit them for the record, I would appreciate that.
We will now proceed to panel one, we are pleased to welcome Dr. Michael Kussman, the acting Under Secretary of Health for VA. Dr. Kussman has had a long and distinguished military career beginning with his service in the 7th Infantry Division in Korea. He has held leading medical positions at multiple facilities while on active duty, such as serving as commander of the Walter Reed health care system.
As the Director of Health care at the GAO, Ms. Cynthia Bascetta provides our Subcommittee with a major service not only in her ability to provide independent assessment of VA program performance, but also to place the performance of VA's seamless transition programs in a historical context. As many of you are aware, last night, Mr. Paul Sullivan appeared on ABC News to discuss a data tracking system, which would have made the seamless transition of new veterans much more efficient. We are pleased to welcome him here today to answer questions and share his knowledge and experience on this issue.
Finally, Private First Class Kimberly Lain who has recently gone through the transition process to the VA from the Walter Reed Medical Center is here to share her experiences with us.
Mr. MITCHELL. Dr. Kussman, if you would please. If everyone could please, in front of you is a little clock with a green light, a yellow light and a red. And if we could keep that, keep it in line with that, I would appreciate it. Dr. Kussman?
Dr. KUSSMAN. Good afternoon Mr. Chairman and members of the Subcommittee. I would like to submit the written record for the record if that is okay, Mr. Chairman. Thank you for this opportunity to comment on VHA's seamless transition efforts. Before I begin, however, let me address an issue with which was discussed in the news media last night. In 2003, VA developed a contingency tracking system to meet the Veterans Benefits Administration, not the VHA's immediate need to track their benefits, assistance activities in support of seriously injured servicemembers as they transition from MTFs to our health care facilities.
The VA employees who worked on the system hoped that it would evolve to meet the VHA. Unfortunately, it could not meet VHA's needs or even all of VBA's needs without additional development costs, and in February 2005, our Department decided to consider other ways to accomplish this task.
Because VHA's case management needs were not met by the system, we developed our own tracking system which is known as the MTFs to VA. Last summer, we were briefed on DoD's joint patient tracking application, or JPTA system, which provides a great deal of information on the progress of seriously injured veterans through DoD's health care system.
Together, DoD and VA realized that enhancing DoD system was our best option, providing both departments with a much better tool to track case management issues. DoD provided us with the capability to look at their records towards the end of last year, and earlier this month, we developed the ability to enhance the system to enable VA case managers to add their own notes and information about phone calls they have made to patients.
Our vision is to create a continuous clinical record of transfers and case management activities for all seriously injured patients as they progress through both DoD and VA systems of care. VHA will continue to use the MTF to VA system until JPTA can create such a record for seriously injured patients.
One other thing, before I leave this subject, contrary to what was erroneously reported last evening, the decision to use one system which was felt better met our needs over another one was made appropriately at the administrative level. This was a programmatic decision and not one made by the Secretary. VHA's efforts to create a seamless transition for men and women as they leave the service and take up the honored title of veteran begins early on. Our outreach network ensures that returning servicemembers receive full information about VA benefits and services.
In each of our medical centers and benefits offices now has a point of contact designed to work with veterans returning from service in Operation Enduring Freedom and Operation Iraqi Freedom. VHA has coordinated the transfer of other 6,800 injured or ill active duty servicemembers and veterans from the Department of Defense to the VA.
Our highest priority is to ensure that those returning from the global war on terror who transition directly from DoD military treatment facilities or MTFs to VA medical centers continue to receive the best possible care available anywhere. This month, we are attempting to call each of these severely injured servicemembers and veterans to see if they need additional support. And we are directing facilities to provide OIF/OEF care coordinators at each facility.
VA social workers benefits counselors and outreach coordinators advise and explain the full array of VA services and benefits to servicemembers while they are still being cared for by DoD. These employees assist active duty servicemembers as they transfer to VA medical facilities from MTFs.
In addition, our social workers help newly wounded soldiers, sailors, airmen, and marines and their families plan a future course of treatment for their injuries after they return home. Currently, VA social work and benefits counselors are located at 10 military treatment facilities. One important aspect of coordination between DoD and VA to a patient's transfer to VA's access to clinical information. The Bi-Directional Health Information and Exchange, BHIE, allows VA and DoD clinicians to share text space clinical data in a number of sites, including Walter Reed and National Naval Medical Center and the two military treatment facilities that refer them, they are the two military treatment facilities that refer the majority of polytrauma patients to the VA.
Mr. Chairman, case management for our patients begins at the time of transition from the military treatment facility and continues as their medical and psychological needs dictate. Patients suffering severe injuries or those with complex needs receive ongoing case management at the VA facility where they receive most of their care. VHA has recently determined that every medical center will have a full-time case manager for OIF/OEF veterans needs and we are in the process of hiring a hundred new OIF/OEF veterans to serve as ombudsmen to support severely wounded veterans and their families.
Each VA NC also has a designated point of contact to coordinate activities locally for OIF/OEF veterans and to ensure the health care and benefits needs of the returning servicemember and veterans are fully met. VA has distributed specific guidance to field staff to ensure that the roles and functions of the points of the contact and case manager are fully understood and that proper coordination of benefits and services occur at the local level. To ensure that all eligible veterans are aware of the services they are entitled to, VA's developed a vigorous outreach education and awareness program for our returning veterans and their families.
To allow us to provide coordinated transition services and benefits for National Guard and Reservists, a memorandum of agreement was signed with the National Guard in May 2005. Similar memorandums are under development with the United States Reserve and the United States Marine Corps. These new partnerships will increase awareness of and access to VA services and benefits during the demobilization process as former servicemembers return to their local communities.
VA is also reaching out to returning veterans whose wounds may be less apparent. VA's a participant in the DoD's post-deployment health risks and assessment program. We provide information about VA care and benefits, enroll interested Reservists and Guardsmen in the VA health care system and arrange appointments for referred servicemembers.
As of December 2006, an estimated 68,800 servicemembers were screened under the provisions of this program resulting in more than 17,000 referrals to the VA. Finally, VA provides outreach to our newest veterans through our readjustment counseling service, commonly known to veterans as the Vet Centers Program. Vet centers were created by Congress as the outreach element in VA's health administration. The approximate number of OIF/OEF combat veterans served by vet centers today is 180,000. Vet centers have provided bereavement services to the families of over 900 fallen warriors. VA plans to expand the Vet Center Program. We will open 15 new vet centers and eight new vet center outstations at locations throughout the Nation by the end of 2008. At that time vet centers will total 232.
We also expect to add staff to 61 existing facilities to augment the services they provide. Seven of the 23 new centers will be opened during calendar year 2007. Mr. Chairman, this concludes my presentation. At this time I would be pleased to answer any questions that you may have. Thank you.
Mr. MITCHELL. Thank you, Dr. Kussman, for your presentation.
[The statement of Dr. Kussman appears in the Appendix.]
Mr. MITCHELL. The others are here just for questions. We will not have an opening statement. But I do have some questions I would like to ask of you to start with. I am going to ask about the complaint system that is in place that the VA has. When a patient approaches the VA with a complaint about treatment they have received, how is that complaint handled?
Dr. KUSSMAN. Sir, there would be multiple ways. We have patient advocates at every facility. There are signs up that tell the patients that if they are unsatisfied with what they have they can go to the patient advocate. They could call the IG, they could call our Office of Medical Inspection. They could go directly to the hospital director or they could send an e-mail directly to me, which people do, as well as the Secretary.
Mr. MITCHELL. And is there someone who follows up with this after they have made a complaint?
Dr. KUSSMAN. Yes, sir. Personally, if it is to me.
Mr. MITCHELL. And to follow up with this, the follow-up, who follows up with the facility to make sure that they correct whatever is wrong? Does anybody follow up? Because it seemed to me, you know, when we hear about Building 18 and some other buildings out there—I am sorry, that was Walter Reed, not under your control. But let's say that there was a facility that someone complained about, is there anybody who follows up with the facility?
Dr. KUSSMAN. Yes, sir. Our assistant, I mean, our Deputy Under Secretary for Operations and Maintenance, Mr. Bill Feeley, is responsible for the upkeep and the services at all the facilities and through him and the hospital directors we would be sure that things were corrected. We also have a lot of inspection teams that come and visit us. If there was an issue like that, not only the joint commission, but we have what we call our own supports, there are a mini joint commission that we do on ourselves. The IG comes and reviews us with their CAP reports. We have other outside agencies that review, CARF which reviews rehabilitation centers. So there is a lot of review and follow up if there is identified a deficiency in any of our facilities.
Mr. MITCHELL. What kind of records do you keep on patients' complaints?
Dr. KUSSMAN. Again, I think that would be at the facility level. But we also have very elaborate patient satisfaction surveys that are done when patients come in, they fill out a form, and those are reviewed and kept that, I believe at the facility. They are tracked at the facility as part of the performance measures for the leaders of the facilities to be sure, but we also have the University of Michigan do a consumer satisfaction review service every year, and thank goodness every year that we have done very well on that is a customer satisfaction, and have actually been 10 points higher than civilian facilities.
Mr. MITCHELL. What is the process you use for taking valid complaints and taking corrective action?
Dr. KUSSMAN. Well, as I said, sir, hopefully that would be handled at the facility level, that if somebody raised a complaint about something, that through the patient advocate or anybody else who took the complaint, the facility director and associate directors would act on that. If the patient doesn't get satisfaction, it could be raised through the division level or to the central office through an 800 hotline call to the Secretary, the IG, or the Office of Medical Inspection.
Mr. MITCHELL. How often do you review these surveys or these complaints? Are they done every day? Once a month? Every three months? How often do you review these complaints or these satisfaction surveys? Once a year?
Dr. KUSSMAN. The survey, the large survey, as I mentioned from the University of Michigan, is done once a year, but other surveys are done on a rotating basis. The IG does—rotates through our facilities.
Mr. MITCHELL. Besides surveys about satisfaction, what about complaints about service or the care they are getting? How often are those reviewed and are there records of those?
Dr. KUSSMAN. Well, as I said, I think it depends on whether the complaint got up to the central office or not, but the complaints are generally handled at the local level if they can be handled. If the individual doesn't get satisfaction, it would bubble up, but that is an ongoing thing. They review those complaints and see if there is any pattern.
Mr. MITCHELL. If a patient doesn't feel they have gotten satisfactory compliance or haven't had their complaint satisfactorily answered, what happens then?
Dr. KUSSMAN. Well, I would encourage them and they would be encouraged to take it to the higher level. They can come to the division or they can come to the central offices if they don't get satisfaction. That is our job, to take care of veterans and if they are not satisfied with what they want, we would encourage them to call us.
Mr. MITCHELL. Do you have any idea about how many complaints you might get a month?
Dr. KUSSMAN. No, sir, but I can go back and ask and get it to you.
Mr. MITCHELL. All right. Thank you. I yield my time.
Mr. BUYER. Mr. Chairman, I ask for a parliamentary inquiry.
Mr. MITCHELL. Yes.
Mr. BUYER. My inquiry is that the witnesses sitting with the Acting Under Secretary, the individuals sitting there, are they witnesses or are they sitting there in an individual capacity?
Mr. MITCHELL. Mr. Buyer, they were sworn in. So they are here to answer questions as we try to further this.
Mr. BUYER. Further parliamentary inquiry. Is it the intention of the Chairman to follow rule XI of the House Rules when it comes to the rules and procedures of the Committee?
Secondly, Mr. Chairman, in the 15 years I have been here in Congress, I have never seen a committee or a subcommittee ever treat an official of the Administration without respect and dignity of their position and station. And I have been here through Republican and Democratic administrations. This is a very curious manner in which you are treating the Under Secretary of Health for the VA. So I, again, ask you, is it the intention of the Chairman to follow the rules and protocols of the House under rule XI?
Mr. MITCHELL. We will take a five-minute recess on that.
Mr. MITCHELL. We will reconvene. Mr. Buyer recommends that having Mr. Sullivan and Ms. Lain appear with Dr. Kussman on the panel does not show proper respect. So, we will ask Ms. Lain and Mr. Sullivan if they would step down and join the second panel. If you would do that, please.
Mr. SULLIVAN. Yes, Mr. Chairman.
Mr. MITCHELL. That's the only way I guess we can get proper respect. Thank you.
Mr. BUYER. I thank the Chairman.
Mr. MITCHELL. Ms. Brown-Waite?
Ms. BROWN-WAITE. I would address this to Dr. Kussman. Today I received a letter from Secretary Nicholson addressing what the VA has done and what they are doing, and what they're going to do in the future to ensure that the wounded veterans receive everything that they need as a transition from DoD medical facilities to the VA. If you would please talk about that, I'm sure that you were involved in that letter. Is that correct?
Okay. If you would just please discuss that, and I think that every member here does plan, you know, holding the Secretary's feet to the fire to make sure that those promises made in the letter, and I think everyone received one, I think the Chairman received a letter today, that that really does take place. I think regardless of the party affiliation, every member here wants to make sure that our veterans are well taken care of, and in response to the Chairman's question about what happens when the number of complaints pile up, I can just tell the Chairman that I'm aware of at least one hospital administrator who was removed from that post in my district, and I am sure that the freshman members here will learn and that we will be also contacted when the VA is not responsive.
The families and/or the veterans and military people won't hesitate to also let us know. So if you would just elaborate a little bit on that letter, I would appreciate that very much.
Dr. KUSSMAN. Congresswoman, I don't have the letter right in front of me, so I didn't have it memorized, but obviously I am aware of the content of the letter. We believe very strongly in our responsibility to veterans and their families for care, and I believe that we have done that, as mentioned with the satisfaction surveys that we have. But I believe this was just another way of energizing and reminding our people and our facilities of our obligation to do the things that we need to do. We are hoping we will accept responsibility when things don't go well, and we pledge to fix them when they're not, and so we want to be sure that we've assessed everything that we are doing, and be sure that we can raise the bar as appropriate.
Ms. BROWN-WAITE. You know, when I first ran for office, I thought it was a really good idea to virtually have the veterans be able to go to non-VA hospitals. I really thought that was a good idea until I really got to know the veterans population both in my district and the organizations that are represented up here. And I learned what a very high satisfaction level that the clear majority of veterans have and also the very good survey results that the virtual—the customer satisfaction survey that takes place. I know I don't have a VA hospital in my district.
I have three great ones around me, and we're going to hear later from the head of the polytrauma unit there. But I get great results and the veterans who aren't happy also contact us, you know, I would be interested in the number of complaints. I think maybe we should—every member should have that information available, and how many of them were resolved. You know, so that we can also assure the veterans that if they do have a question, or a complaint, that their complaint is taken seriously, and is resolved.
Dr. KUSSMAN. Yes, ma'am.
Ms. BROWN-WAITE. Mr. Chairman, I would also request that Secretary Nicholson's March 7 letter addressed to me and to you regarding the VA's efforts to ensure the seamless transition into the VA system from DoD, that that can be also submitted for the record.
Mr. MITCHELL. Without objection, so ordered.
[The March 7, 2007, letter from Secretary Nicholson appears in the Appendix.]
Ms. BROWN-WAITE. I appreciate that. In the letter it also said that every VA medical center now has specialty PTSD treatment capability. Would you elaborate a little bit on that? And how recent is it that the PTSD treatment availability has been available?
Dr. KUSSMAN. Thank you for the question. The VA, as you know, has been the leader in the treatment evaluation and research of PTSD ever since the diagnosis was first used in 1980, and we have a national center in White River Junction and other research sites that are seen as international resources for the treatment research and evaluation of PTSD. We, in 2004, developed a very thorough and elaborate mental health strategic plan to look at where we were at the time and what are the things that we could do better. And one of those things we realized that we could do better was to be sure there was PTSD treatment teams at all our facilities and there are over 200 of them and that is more than just our facilities, because as you know, we have about 155 hospitals. We've also put PTSD treatment teams in large clinics as well to meet the needs of people who have PTSD or are being looked at for PTSD. And so this is really part of our mental health strategic plan to enhance the services available.
Ms. BROWN-WAITE. I thank the Doctor, and I yield back the balance of my time.
Mr. MITCHELL. Thank you, and just one follow-up question real quick. What is the waiting time for a person to receive treatment in these centers?
Dr. KUSSMAN. Sir, obviously our goal, first of all, if anybody has urgent or emergent care, they get in right away. Our goal is that if it is not urgent or emergent the person should be seen within 30 days of the request.
Mr. MITCHELL. How long?
Dr. KUSSMAN. 30 days.
Mr. MITCHELL. Thank you. Mr. Space?
Mr. SPACE. Thank you, Mr. Chairman. I understand that Ms. Bascetta is available for questioning?
Mr. MITCHELL. Right.
Mr. SPACE. I hope I have pronounced your name correctly.
Ms. BASCETTA. Bascetta.
Mr. SPACE. Thank you. And I apologize.
Ms. BASCETTA. That's okay.
Mr. SPACE. Ms. Bascetta, you, in your work for the GAO, obviously have invested many hours in researching, in documenting matters concerning seamless transition. My question is to what extent—I am assuming you have made recommendations. And I am curious to what extent those recommendations have been followed, and if there have been matters that you have recommended, issues that you have suggested that have been ignored.
Ms. BASCETTA. I wouldn't say that the VA has ignored any of our recommendations in this regard. I can't say, however, that the two departments working together have followed our recommendations so far to the extent that we'd want them to. And the one that I'm most concerned about is that VA and DoD do a better job collaborating on rehabilitation so that veterans or servicemembers, for that matter, who need services get them as early as possible. Our work has shown that if there is a delay in getting rehabilitation, there can oftentimes be deficits that can't be made up. And one of our most significant concerns is that, of course, all veterans start in the DoD system. And if they don't work together early, meaning that DoD at times would have to let VA in early, it could happen that when VA has a veteran arrive for care in their system, you know, there could be deficits that VA can't make up.
I'd also say that with regard to the seamless transition, it remains a work in progress rather than a fully implemented reality, but I think that because of the complexity of the process, there will always be room for continuous improvement. When we reported on it in 2006 to this Committee, we did not make recommendations because in the course of our work when we found problems to VA's credit, they corrected them while we were completing our work. Most of those were problems with regard to individual patients. So we would have to do more work at this time to look systematically to reassess how well it is working.
[The statement of Ms. Bascetta appears in the Appendix.]
Mr. SPACE. Thank you. Have you made specific recommendations concerning the fashion in which these delays can be eliminated, specifically with respect to rehabilitation? And if so, can you provide us with a copy of those specific recommendations?
Ms. BASCETTA. I can submit our report for the record. The recommendation was a conceptual one that the two departments collaborate to come up with a plan and an agreement as to when it would be appropriate for VA to have data about servicemembers. And that through the course of them working out the details early intervention could become a reality.
[The GAO report (GAO-05-167) reference by Ms. Bascetta appears in the Appendix.]
Mr. SPACE. Thank you. I yield back the balance of my time.
Mr. MITCHELL. Thank you. Mr. Buyer?
Mr. BUYER. Mr. Chairman, I will follow the protocols of the Committee and I will go at the end of the sitting members of the Committee for questions. Thank you.
Mr. MITCHELL. Thank you. Mr. Walz.
Mr. WALZ. Thank you, Mr. Chairman. And thank you, Dr. Kussman, for being here. Ms. Bascetta, I appreciate the opportunity to speak with you, and I want to thank you for the work you've done for our veterans. I said I do think that is critically important that we keep that in mind, and having spent a lot of time in our polytrauma center in Minneapolis, I know the quality of care and the professionalism there is something that I am very proud of.
My constituents demand that we get this right and we're here today to question and to look ahead and I think that is a healthy exercise, I think it is one we need to do and we can get this right. We must get it right. I would associate myself with the ranking member Ms. Brown-Waite when she said, that this is a priority. This is one that we have to get right. I feel it is a moral imperative to take care of our wounded warriors when they return home, but I also think that it is a national security issue.
We need to make sure this is part of what we're doing so soldiers know they're being taken care of. Results matter in this, and it is one of these situations that I think we have to shoot for. You're right, it is always going to be a continuing process. But this is a zero sum proposition. One mistake is too many in this. One soldier left untreated is too many.
And I think all of us agree with that, and the goal is to try to get it to zero. If we ever get there, we must continue to try. So just a couple of questions, Mr. Kussman. How long have you been with the VA—I'm not sure if I got that—have you been working in your current position, sir?
Dr. KUSSMAN. In my current position? Since 12 August 2006.
Mr. WALZ. How long have you been with the VA in general, Dr. Kussman.
Dr. KUSSMAN. I first came to the VA on 24 September 2000.
Mr. WALZ. Very good. My first question on this is do you believe there were substantial changes made or substantial preparations made starting in about March of 2003 when this current conflict in Iraq got started? Were there preparations made for the influx of wounded veterans that we would see?
Dr. KUSSMAN. We always, sir, are ready to take whatever we need. I think that the thing that surprised everybody was the type of injuries that we were seeing, not necessarily the volume, although no one could predict how long the war was going to go on, and that is a different issue. But what we have seen is that there are certain signature injuries of this war. One is PTSD, particularly for the National Guard and Reserves because I am not trying to minimize the active component, but they do have a cocoon around them, and in my previous life I appreciated that. But what do you do with the people who then, when they get discharged, don't have that same type of cocoon?
The other thing is because of the body armor and the far-forward surgical care, servicemembers are surviving with much more complicated wounds. So that was one of the things that drove us very quickly to build on our four TBI centers that we have in Palo Alto, Minneapolis, Tampa and Richmond. And we have two of the directors here that will be on a follow-up panel. We put in place there, the full multidisciplinary approach for things, not just TBI. But TBI is another signature injury that is occurring, partly because I think when we went into the war, we thought that we would see the more traditional types of casualties, gunshot wounds, shrapnel, the usual thing.
The enemy is taking a different tact in using IEDs and car bombs that create blast injuries, and one of the blast injuries among others is the traumatic brain injury which is—not to minimize it, it is head rattle that occurs inside the helmet, the brain floats and things in the brain, it is not locked in. So there is a whole spectrum of mild to moderate traumatic brain injuries to severe traumatic brain injuries.
Mr. WALZ. And just using the last bit of my time, do you feel like we're prepared for the large number that are going to be diagnosed as we start to check everyone now the traumatic brain injury? Sometimes it's not so visible, vision, different things like that, and PTSD. Do you feel like we're prepared? And you are absolutely right, in my former life, it was 24 years in the National Guard. And I know when they go out to rural Minnesota, it is a lot different than when we're on an active military base. Are we prepared for these soldiers today, tomorrow and 5 years and 50 years down the road?
Dr. KUSSMAN. Sir, as you know, I can't read a crystal ball, but I think right now we put in place the procedures and processes that we can take care of this group of patients. As you know, of the 613,000 servicemembers that have transitioned out of the active component since the OIF/OEF started, some are active component people who have left, others are transitioned back to the National Guard or Reserve or just get out of that as well. We've seen 205,000 of those people with a myriad of differing complaints. We see—we project that number—that was out at the end of FY 06. We project that number in FY 08 to be 263,000.
We project that we will see 5.8 million veterans. So it is a relatively small number of our total force, but they have certain needs, and we believe with our four polytrauma centers, our 17 additional level two centers and teams and all our facilities, we are ideally poised to be able to take care of the patients as they transition out.
Mr. WALZ. Thank you. And I yield back, Mr. Chairman.
Mr. MITCHELL. Mr. Rodriguez?
Ms. BASCETTA. Mr. Chairman, may I add something? I'm sorry.
Mr. MITCHELL. Go ahead, ma'am.
Ms. BASCETTA. I would just like to elaborate a little bit on what Dr. Kussman said. And that is, we did some budget work for this Committee last year and reported in September 2006 that one of the factors that caused one of the problems in VA's budget estimation was underestimating the cost of serving veterans returning from Iraq and Afghanistan. And part of that was due to the fact that their data largely predated the conflict. But the other part was—and I can't make this point too strongly—that they have had trouble getting data from DoD that they need for planning purposes. So it is another example of the need for these two agencies to work together.
Mr. MITCHELL. Thank you. Mr. Rodriguez?
Mr. RODRIGUEZ. Thank you very much. I wanted to follow up with the GAO. And you answered one of my questions because I recall some time back, we pushed an effort in terms of trying to get both the active-duty soldier and the VA working together more and it seems based on the GAO report that there are still some serious problems in communication and, in fact, some even questioning the part of the DoD about the fact that they have concerns that they might even provide services to them while they're still in the military. And I was wondering, why would they be concerned about that?
Ms. BASCETTA. They told us—and this was about a year and a half ago now—that they were concerned about their retention goals.
Mr. RODRIGUEZ. They were concerned about their retention goals?
Ms. BASCETTA. Yes.
Mr. RODRIGUEZ. And not necessarily concerned about their health, I gather.
Ms. BASCETTA. They didn't say that.
Mr. RODRIGUEZ. They didn't say that.
Ms. BASCETTA. They were worried about VA coming in too early and giving servicemembers the idea that they might want to leave the military. And our concern was that these servicemembers needed rehabilitation from VA, from DoD, from the private—
Mr. RODRIGUEZ. Whoever can provide it, I agree.
Ms. BASCETTA. So they could fully recover both medically and vocationally and have the option to, you know, work to their fullest potential, either in the military or in the private sector, in the civilian sector and many of them, I think, might have opted to stay in the military and many are because it is their career, and they're dedicated to it. Others have told us that they don't want to leave the military because their families need health care, health insurance.
Mr. RODRIGUEZ. And I know that doesn't have anything to do with VA, but you also, in the GAO report, talk about our military soldiers having difficulty paying, or when creditors go after them, when they're unable to get their loans, unable to buy a car, and mainly, because they're being harassed by credit agencies and going after them for fees?
Ms. BASCETTA. Yes, sir. There are long-standing problems with the military pay system that have not been fixed. And it aggravates an already antiquated system. If I might add too, there are other problems that we noted in the course of the seamless transition work. It was done for the VA Committee. So we didn't report these findings in the report, and we didn't make recommendations to DoD because they weren't within the scope of our reporting. But some of them had to do with other bureaucratic problems that the family members and the servicemembers get caught up in.
For example, in one case, a disabled servicemember was to be discharged from a PRC to a VA nursing home. And DoD refused to pay to have the wheelchair transported. It didn't fit in the ambulance, and they refused to have it transported separately until a cost analysis could be done. They told the VA social worker that would take several weeks. The VA social worker, to her credit, found donated post funds, not appropriated funds, and used them to have the wheelchair shipped to the nursing home so the servicemember would not be confined to his bed.
Mr. RODRIGUEZ. My God. You know, and I know that, you know, I had left for 2 years from Congress, but I remember prior to leaving, we were working hard at trying to establish a system where the soldier automatically leaves the military and can be picked up as quickly as possible. Now you also mention that the VA is still having difficulty getting the prognosis and diagnosis, and the medical history, because it isn't electronically done?
Ms. BASCETTA. That's correct.
Mr. RODRIGUEZ. What can we do from the VA perspective in terms of trying—because that is part of—you know, and the other part, and I know you have only been there a short time and I know the responsibility falls with all of us. I don't like the idea of coming down—this I am referring to the administration—firing the commander at Walter Reed who has only been there for 6 months when in all honesty, that responsibility falls with all of us in ensuring that they have the resources that are needed, and I know that we haven't provided that, and I know that with a large number, some 23,000 soldiers that are coming back seriously injured, we need to beef up on funding. I was pleased to see on the CR, that $3.6 million, and I want to get your feedback on it, and we're hoping to add some additional supplemental funding, but not only to the VA, but also to the active soldier.
And in saying that, we had talked about seeing how we can, you know—and maybe you can guide us from the VA perspective. What do we need to do to make sure that we accomplish that goal that when that soldier leaves the military and the VA picks him up, how can we make sure we don't have to reduplicate everything and retest everything in terms of the soldier?
Dr. KUSSMAN. Sir, is that a question to me?
Mr. RODRIGUEZ. Yes, sir.
Dr. KUSSMAN. We are working very closely with DoD, particularly with the more seriously injured people. And let me just add to what Ms. Bascetta said. The two health care systems, by their nature, have been complementary, that the VA does some things and DoD does others. I mean, we don't do pediatrics and things of that sort. She is exactly right, that when people have multidisciplinary problems, you need to get at them all quickly because you can then lose some momentum with one thing if you are only focused on one. So we have moved to put a blind rehabilitation specialist into Walter Reed, a spinal cord specialist coming out of the Washington VA, because those are the two things that—
Mr. RODRIGUEZ. If I can, what else do we need to do to try to correct some of those things that were mentioned by the GAO from the VA perspective?
Dr. KUSSMAN. Well, I think that we have done a lot of the things that the GAO mentioned, and Ms. Bascetta said that. What we did is we realized that we have those four wonderful centers that we have, and I think they're state of the art and multidisciplinary, but people leave those centers. They don't live near there, so we put 17 additional—there are really 21 level II sites, one for each of our divisions. But the 17 are additional. The four that we already have in VISNs, we didn't see any reason to duplicate on top of the level I. So there is a total 17 new, but a total of 21 centers as well as putting resources at our facilities to try to provide the full depth and breadth of services close as we could.
Mr. RODRIGUEZ. Did I hear you saying that we don't need to do anything else, that you have established the things that are there in order for us to—for the service person to be able to be picked up? Is that what I am hearing?
Dr. KUSSMAN. We can always do better. We appreciate your assistance.
Mr. RODRIGUEZ. The question is how can we do better? What do we need to do to help to you do better? Because apparently we're not doing—
Mr. MITCHELL. Mr. Rodriguez, your time has expired.
Mr. RODRIGUEZ. Thank you.
Mr. MITCHELL. Thank you. Mr. Buyer?
Mr. BUYER. Thank you very much. Ms. Bascetta, I was sitting here trying to think how many years we have been on this issue. I can't even remember. It has to go back 12 or 13 years. It is not nice to talk about age with a lady, but it has been a long time. I can't even begin to count the number of GAO studies you've done and supervised over the years. You know, this is 20-plus years in the making, trying to get DoD and VA to coordinate and cooperate.
And Dr. Kussman, I've got history with you too, even back when I was on the Armed Services Committee and you were a commander at Walter Reed, which a lot of people may not even realize, back in the 90s. And you know what—pardon?
Mr. FILNER. Now we know who is responsible.
Mr. BUYER. Well, if you want to know who is responsible, let's go back and do a little history. I remember—let's do this, Dr. Kussman, because you were a senior officer then in the medical corps. In the 1990's, we would come out of two rounds of base closures, back then the defense budgets were about $270 billion, and we were doing everything we could to try to downsize everything from wings and ships and divisions, and were trying to make it work, and then that is when I had the supervision over the military to help the delivery system.
So what was the response? The response was that if we had less dollars, we'd create centers of excellence. Remember? So we created Brooke, Bethesda, and Walter Reed as centers of excellence because there weren't enough dollars to go around out of those budget years to fund all of those hospitals at all the ports or all of the bases and forts. So we create the three centers of excellence. And we had this belief coming out of the first Gulf War that, gee, we weren't going to have as many wounded, we wouldn't be in a continuous war for a long period of time. It was challenging for me when Walter Reed came out on the BRAC. I was pretty surprised by that. I knew it was an aging facility. But at a time of war, for us to put one of our centers of excellence on the BRAC was bothersome to me.
Now I no longer had served on the Armed Services Committee, so I have a void in my background in intellect here as to exactly what happened and transpired over the last 5 years. But even to say we're going to transition it all over to Bethesda is a pretty heavy burden. So as we had a surge of wounded and other than hospitals were not able to accept those capacities, we had a problem.
And I also, then, add to this Congress, GAO, and Inspectors General have put a lot of pressure on commanders of bases that have been BRAC'ed about what monies you are going to spend on facilities that are about to be closed. And so, what an untenable and difficult position we put a commander in at Walter Reed by squeezing him from both ends. We're going to maintain the standard and quality of care, and at the same time, by golly, you'd better be careful what dollar you spend, and the worst, horrible things that happened is, I can almost see an individual thought they would make a well-intentioned decision by saying, let's keep these unmar


text:
This message was edited 1 time. Last update was at 04/25/12 07:58 PM
This message was edited 1 time. Last update was at 05/08/12 03:00 PM
windweaver wrote:Cinebar,
It looks like there are a lot of Simmers who like the idea of having our ts2 style restaurants back. I sure hope this thread makes an impression in our favor to the Sims Team!
I'm keeping my fingers crossed.
Jazmyne4u2 wrote:Signed!
I honestly would LOVE to have our sims go shopping again! They should make like a clothing store for like prom dresses and wedding dresses too! That would be cool.
©2016 Electronic Arts Inc. All rights reserved.
All trademarks are property of their respective owners.
Legal Notices
Terms of Service
Privacy and Cookie Policy
Online Safety
Contact Us
Product EULAs and Other Disclosures


text:
Join or Sign In
I learned to sew from my Mother and sewed my own doll clothes, even making up my own patterns. Mom turned to quilting when she retired and asked me to finish her last quilt which got me started quilting. I also crochet and love to learn new patterns - scarves are perfect for this.
Take Craftsy with you!
Craftsy Apps for iOS and Android. Read more »


text:
Photography: Logan Cole Makeup: Amy Clarke
Monthly Archives: November 2012
My beautiful sister-in-law-in-law (that was not a typo!) Rebeccah was married to Spencer at Green Olive Ranch. Their wedding was so "them". I love every detail and thought they put into their special day. I was so happy to do her "Tangled" inspired hair. Gorgeous Bride + Rapunzel + Daisies = Happy Hair Stylist!!! Thanks […]
no comments
Photography: Trevor Hoehne Make Up: Amy Clarke Styling: Summer Watkins Production/Set Design: Jessie Simonson
show 1 comment
Anyone who knows me know how much I love 31 Bits! Needless to say, I was overwhelmed when they told me they wanted do a feature on me and the beauty school in Kenya. The 'underlying rhythm' that drives 31 Bits to help women in Uganda, is the same rhythm that has motivated me to […]
no comments
31 Bits Fall/Winter Collection is here! I love being able to do hair and have fun with my Bits family! And this is why I love 31 Bits…. Over the last four years, 31 Bits has grown to working with 110 women in Northern Uganda. It didn't take us long to realize these women didn't […]
no comments


text:
Let $S$ be a symmetrix $n \times n$ matrix. (Remember that means $S^t = S$). Let $v$, $w$ be eigenvectors of $S$ for eigenvalues $\lambda$, $\mu$ respectively. Suppose $\lambda \not= \mu$. Show that $v \cdot w = 0$.
Hints give:
- In other words, the eigenspaces of symmetric matrices are perpendicular to each other.
- Use a: Where you let $x, y \in \mathbb{R}^n$. Verify that $(Sx) \cdot y = x \cdot (Sy)$. Answer: I verified that they do equal.


text:
Master Zionosis
I'm not sure if this is the right place for this, i think it is. Anyway I read a thread a little while ago about the new ranking system and how many posts are needed for the next rank, I've searched for a while and I can't find it, if someone could point it out for me please.
Thank you :)
Thank you :)