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A JURY has heard how a 33-year-old man "took advantage" of a drunk woman and raped her while she was asleep.
Yohannis Urrutia Castro, of Church Street, Watlington, went on trial at Oxford Crown Court yesterday.
He is charged with one count of rape allegedly committed on August 3 last year against a woman who cannot be identified for legal reasons.
Giles Curtis-Raleigh, prosecuting, said the woman could not remember most of what had happened to her because she had drunk heavily and taken cocaine during the evening.
He told the jury: "The crown says this man took advantage of a woman who was very drunk and absolutely fast asleep.
"She had no knowledge whatever of what he was up to so clearly had no ability whatever to consent."
The barrister said the defendant was discovered by a third party who claimed he was naked and having sex with his alleged victim.
Mr Curtis-Raleigh added that on the same evening another woman reported waking up with her underpants removed and Castro standing over her.
The barrister said: "This is particularly significant evidence showing the type of behaviour that this defendant was exhibiting that night towards young women."
He added that Castro had denied anything illegal had taken place during his police interview.
The trial is due to last four days.
Castro was released on bail.
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- GALLERY: Prince William proves a hit with young and old students on Oxford visit


text:
- $319,500
- Active
- Riverside Villas
- 2001 Faro Dr #24
- Austin, TX 78741
- 3 BD 3 BA 1692 Sq Ft 0.15 AC
- Residential
Enter your work address to calculate commute times to and from 2109 Maxwell Ln #a.
Remodel completed on Sep 16th! Gorgeous, updated condo w/quality modern finish out & packed w/upgrades including high quality porcelain wood look tile, granite counters, new cabinets, brand ss whirlpool appliances & breakfast bar in kitchen. The 2/1.5 has a great floorplan, gorgeous, shaded back yard, & includes 1-car carport. Title policy paid+$1K lender credit (& great rate) w/our preferred lender. Do not miss this property located minutes to downtown, airport, dining & shopping! Agent/owner.
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Property Listed by: Realty Austin
The information being provided is for consumers' personal, non-commercial use and may not be used for any purpose other than to identify prospective properties consumers may be interested in purchasing.
Based on information from the Austin Board of REALTORS® (alternatively, from ACTRIS) from December 4th, 2016 at 2:00pm CST. Neither the Board nor ACTRIS guarantees or is in any way responsible for its accuracy. The Austin Board of REALTORS®, ACTRIS and their affiliates provide the MLS and all content therein "AS IS" and without any warranty, express or implied. Data maintained by the Board or ACTRIS may not reflect all real estate activity in the market.
All information provided is deemed reliable but is not guaranteed and should be independently verified.

subset: commoncrawl


text: Q: Is it true I have to spend $20 to get iPhone 1.1.3 apps on my iPod? A: Yes, this is correct. Steve Jobs, or whoever, decided to rip us off. Q: Has 1.1.3 been jailbroken yet? A: Not quite yet. But I'm sure there are tons of people out there that are working very hard and attempting to "jailbreak" the 1.1.3 firmware. Q: Can I downgrade to 1.1.1 or 1.1.2? A: Yes, you sure can. There is a stickied thread in THIS section that will explain it. Q:Will your iPod brick if you update from a jailbroken 1.1.2(confirmed) 1.1.1(not confirmed) iPod? A:No, it will not..Proof? Just did it from a 1.1.2 jailbroken iPod(Mine-Exodus885) and updated to 1.1.3 Q: Will I be able to downgrade my 1.1.3 iPod using another computer with iTunes v7.5? A: So far, the answer is NO. (Needs confirmation) Q: Can i get the things that cost 20$ for free? A: No. Q: Are there any real (noticeable) benefits of upgrading to 1.1.3 apart from having the ability to pay for iPhone apps? A: "Not really... I updated it and everything looked the same except my 3rd apps were gone which I knew was gonna happen.... Only if you buy an $20 update you will get the iPhone apps, be able to arange icons and put your bookmarks on the screen... So if you are not buying $20 upgrade dont update...." Q: Will I be able to downgrade my 1.1.3 iPod using another computer with iTunes v7.5? A: So far, the answer is NO. (Needs confirmation) Q:Can you get the old iPod dock back if you upgraded to 1.1.3 without going back to 1.1.1 or 1.1.2? A:No, 1.1.3 is very limited in what you can change. In terms of the springboard (home screen) the only thing you can change is the order of apps on the screen. You can only do more advanced customization, like changing dock styles, with a jailbroken iPod and a modding application. Q:If I upgrade from a jailbroken 1.1.2 will it keep my settings? A:Yes! All the notes, mail settings, even your signature from your e-mail will remain the same. So there's no need to backup all those libraries. Q:Say you buy the $20 upgrade and then decide to downgrade and hack because the upgrade is not as great as you expected. Will you be charged another $20 if you upgrade again? A:SOMEONE CONFIRM ANSWER PLEASE. I don't want to put an answer until I know for sure. Q: Will you be able to share [yes, as in send it to others] the £12.99/ $20 "Software Upgrade"? A: The answer is YES! But, yeah, here's a big but... you wont be able to install it to other iPods! ATTENTION: ANY MORE IMPORTANT QUESTIONS? FEEL FREE TO POST IN HERE WITH A CORRECT ANSWER. AND IF YOU WOULD LIKE CREDIT FOR YOUR Q & A LET ME KNOW IN THE POST. NOTE: SEEING AS THE PROPER INFORMATION REGUARDING THE JAILBREAK OF 1.1.3 HAS BEEN CLEARLY STATED MULTIPLE TIMES ON THIS THREAD, ANY QUESTIONS POSTED CONTAINING QUESTIONS ABOUT TRICKING ITUNES TO GET THE FREE $20 APPS OR IF IT HAS BEEN JAILBROKEN YET WILL RESULT IN IMMEDIATE CLOSURE OF THREADS


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These are the words of our eldest (who is 4) who then proceeds to count past 10 all the way to 25 before becoming slightly lost and confused. I start making up crazy numbers just to play along "two hundred gazillions and thirty one" this goes back and forth for about 3 mins until we both fall about laughing at the kitchen bench. Our youngest (who is 3) can hear us laughing and comes barreling in from the lounge room not to miss out on this laughter fest going on in the kitchen. "Fifty two badillion" I continue, miss 3 joins in and takes it to another level "twenty dinosaur two" this sets off more fits of laughter and more crazy numbers. This carries on for 5 mins until the ruckus gets that loud that Dear Mum comes in wondering what we are all losing it about. I try to explain but get drowned out by miss 4 "poo poo toilet ten" I crack up laughing. Dear Mum chuckles to herself and walks away.
This is not a rare event in our house. When the girls are a little worked up we try and lighten the mood with silly things like this. It usually works, we can tell within the first 10 seconds wether it will change the mood or push them further the other way. On Tuesday I had a whole conversation with Miss 4 about socks that made no sense what so ever. It didn't even flow, but we were having fun and following along and that's all that matters. Having these unique conversations with my two daughters show me just how active their little minds are. I can almost see the cogs turning as they try to come up with the next funny number/object/comment. We are also getting the tall stories at the moment as well. You know the ones, I tackled a dinosaur at school today or there is a monster called George in their wardrobe.
We don't correct these conversations and say "that's untrue" as we see it's their imagination running wild. They are very creative with some of the things they come up with. They have however started to tell untruths when asked specifics about "who did that" or "what happened here". We always come down to their level and explain why it's wrong to lie and try to explain the difference. It's a work in progress. Is this the way to handle it??? Who knows. But they slowly seem to be getting it.
When I'm having a rough day I'll sometimes think about our nonsense conversations and say a ridiculous number out loud "fifteen poobum ten" and instantly feel better. I even throw it into a convo at work and get a chuckle from my coworkers who also have kids and know exactly where I am in life. So next time your having a tough time, count to 10 but don't stop there……. After 10 let your imagine run wild, trust me you will instantly feel better!!


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Season 19, Episode 16 Inspector Morse: The Wench Is Dead
First Aired: April 1, 1999
In Part 1 of the two-part "The Wench Is Dead," Chief Inspector Morse (John Thaw) becomes ill and lands in the hospital, where he becomes intrigued by a 140-year-old murder case. Millie: Lisa Eichhorn. Kershaw: Matthew Finney. Strange: James Grout.
Guest Cast
James Grout James Grout Strange
Matthew Finney Matthew Finney Kershaw
Cast & Details See all »
- Premiered: February 5, 1980
- Rating: TV-PG
- Premise: Whodunits, courtroom dramas and suspense tales make up this often brilliant anthology. It features adaptations of tales by myriad classic mystery writers, from Arthur Conan Doyle and Agatha Christie to Dick Francis and John Mortimer, with such notable figu… (more)
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Paul Wesley and Candice King reveal their favorite Stefan and Caroline moments of all time
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text:
Essential Information
Radiologists are medical doctors who interpret diagnostic images, such as x-rays, to diagnose disease and injury. Radiologists may be primary care physicians or consultants to other physicians. Radiologists must graduate from medical school before pursuing a radiology specialty. Doctors in these 4-year programs study all areas of radiology, including magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound. Further specializations are available through radiologist school residencies, including vascular, pediatric and neuroradiology. The successful completion of a radiology residency program qualifies doctors to become board certified radiologists.
A Doctor of Medicine (M.D.) is necessary for radiologist school residencies. Medical school application requires an undergraduate degree and MCAT scores. Residency programs use interview sessions to narrow down the competitive pool. In order to enroll in M.D. programs, students must have bachelor's degrees and extensive experience in pre-medicine subjects like biology and chemistry. Many programs also require interviews before being admitted.
Radiologist School Residencies
Radiologist school residencies incorporate patient care and research with technical and clinical training. Doctors learn using state-of-the-art equipment and are prepared for fellowship programs. Technologies covered include:
- Arteriogram
- Fluoroscopy
- Mammography
- Myelogram
- Nuclear medicine
- Ultrasound
Employment Outlook and Salary Information
Job growth for physicians and surgeons was anticipated to increase by 14% between 2014 and 2024, according to the U.S. Bureau of Labor Statistics (BLS) (www.bls.gov). Physicians practicing medical specialties, including radiologists, were expected to have especially good prospects. The median annual wage in 2015 for radiologists was upwards of $187,200.
Continuing Education Information
The American Board of Radiology (ABR) certifies radiologists upon the successful completion of written and oral exams. The board certification is good for ten years; radiologists then take a re-certification exam. Since technology changes, radiologists are expected to learn and improve their skills through personalized programs. Additional certifications exist for radiologists who choose to sub-specialize, and fellowships offer the extra training needed.
Aspiring radiologists need to have an undergraduate degree, pre-med courses, and competitive MCAT scores to enter into M.D. programs. After graduating from medical school, completion of a residency program in radiology is required for prospective radiologists to seek licensure to practice.


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SPECIAL OFFER & RENT REDUCTION Please call now for details! A stunning one bedroom modem style ground floor apartment, on the prestigious development at the old Wordsley Hospital site, near to Stourbridge.
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Roston Castings Limited is a ferrous and non-ferrous foundry which has been established since 1966. We manufacture Aluminium Die Castings, Prototypes and Tooling for many applications whether it be automotive, engineering or decorative. Situated in the Derbyshire Countryside, close to the Peak District, Roston has been supplying major companies for many years including the JCB Group for 25 years and Areva Transformers (formerly GEC) for 20 years.
Our aim is 'To Supply Economic Effective Solutions'


text:
Nannakuprematho release date confirmed for january13
Nannakuprematho release date confirmed for january13 . The movie even though said to release for sankranthi, there was no clarity on the release date of the movie.
Now with the release of new posters where it shows the movie coming on january13th has confirmed the release date.Now it is official confirmed and hence its a good news for all those people who are waiting for the movie.
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...I encourage you to give it a try. please contact me if you need help on Algebra 1, geometry and algebra 2 classes and tell me the topics you are having struggle on. Thank you! I am a certified high school math teacher.
Richardson, TXView Tutor
...I hold a 6th - 12th grade math Teacher certification for the state of Texas as well as a B.S. in Mathematics and an MBA, which involves Algebra 1. I love education and I am a lifelong learner myself, currently working on my Masters in Mathematics, including Algebra 2. I have taught Algebra 1, A...
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Reaction of hydrido[5,10,15,20-tetrakis(p-tolyl)porphyrinato]iridium(III) (Ir(ttp)H) (1) with 2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPO) (2) at room temperature gave a 90% yield of the unsupported iridium(II) porphyrin dimer, Ir(II)(2)(ttp)(2) (3). Kinetic measurements revealed that the oxidation followed overall second-order kinetics: rate = k[Ir(ttp)H][TEMPO], k(25 °C) = 6.65 × 10(-4) M(-1). The entropy of activation (ΔS(‡) = -25.3 ± 2.5 cal mol(-1) K(-1)) and the kinetic isotope effect of 7.2 supported a bimolecular associative mechanism in the rate-determining hydrogen atom transfer from Ir(ttp)H to TEMPO.
Department of Chemistry, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, People's Republic of China.
This article was published in the following journal.
Name: Inorganic chemistry
Pages: 9636-40
TEMPO-Mediated Aza-Diels-Alder Reaction: Synthesis of Tetrahydropyridazines Using Ketohydrazones and Olefins.
A novel, facile, and efficient method for the synthesis of tetrahydropyridazines by a one-pot tandem reaction of easily accessible ketohydrazones and olefins in the presence of 2,2,6,6-tetramethylpipe...
β-Hydride Elimination at Low-Coordinate Gold(III) Centers.
This article reports the first comprehensive study of β-hydride elimination at gold(III). The stability/fate of gold(III) alkyl species have been investigated experimentally and computationally. A se...
Parameterization of phosphine ligands reveals mechanistic pathways and predicts reaction outcomes.
The mechanistic foundation behind the identity of a phosphine ligand that best promotes a desired reaction outcome is often non-intuitive, and thus has been addressed in numerous experimental and theo...
Nickel-Catalyzed Asymmetric Alkene Hydrogenation of α,β-Unsaturated Esters: High-Throughput Experimentation-Enabled Reaction Discovery, Optimization, and Mechanistic Elucidation.
A highly active and enantioselective phosphine-nickel catalyst for the asymmetric hydrogenation of α,β-unsaturated esters has been discovered. The coordination chemistry and catalytic behavior of ni...
Rational Design in Catalysis: A Mechanistic Study of β-Hydride Eliminations in Gold(I) and Gold(III) Complexes Based on Features of the Reaction Valley.
β-Hydride eliminations for ethylgold(III) dichloride complexes are identified as reactions with an unusually long prechemical stage corresponding to the conformational preparation of the reaction com...
Physiopathology of Pulmonary Arterial Hypertension: Mechanistic Studies
The current aims to combine analysis of different inflammatory biomarkers and BMPR2 mutations, which are currently analyzed in each patient diagnosed with idiopathic or familial PAH, to es...
ADD-ON Study to Existing Hypoparathyroidism Studies
The purpose of this protocol is to add on additional exploratory studies to investigate changes in bone quality parameters with PTH(1-84) treatment of hypoparathyroidism. In addition to t...
Objective of the trial is to assess the safety and efficacy of Montelukast in treatment of Erythema Nodosum leprosum (ENL) reaction in multibacillary leprosy patients either in combination...
Systemic, Intrapulmonary and Pleural Inflammatory Reaction in Patients Undergoing Thoracic Surgery
Inflammatory reaction in different compartments of the body may have a negative effect on outcome. This study assesses the inflammatory reaction systemically, intrapulmonary and intrapleur...
Mechanistic Studies of Phase III Trial With BAF312 in Secondary Progressive Multiple Sclerosis
The primary goal of this study is to evaluate the effects of BAF312 (siponimod) on select immune and neuronal (nerve) cells by examining laboratory specimens (blood and/or spinal fluid) at...
Epidemiologic Studies
Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are CASE-CONTROL STUDIES; COHORT STUDIES; and CROSS-SECTIONAL STUDIES.
Cyclic N-oxide radical functioning as a spin label and radiation-sensitizing agent.
Cross-sectional Studies
Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.
Inflammation of an intervertebral disk or disk space which may lead to disk erosion. Until recently, discitis has been defined as a nonbacterial inflammation and has been attributed to aseptic processes (e.g., chemical reaction to an injected substance). However, recent studies provide evidence that infection may be the initial cause, but perhaps not the promoter, of most cases of discitis. Discitis has been diagnosed in patients following discography, myelography, lumbar puncture, paravertebral injection, and obstetrical epidural anesthesia. Discitis following chemonucleolysis (especially with chymopapain) is attributed to chemical reaction by some and to introduction of microorganisms by others.
Antibodies, Catalytic
Antibodies that can catalyze a wide variety of chemical reactions. They are characterized by high substrate specificity and share many mechanistic features with enzymes.
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Check in from 15h / Check out prior to 12h
Suburban Extended Stay Dayton-WP AFB: Find photos, reviews, information, amenities and compare prices for 2 stars hotels in Beavercreek, United States.
Suburban Extended Stay Dayton-WP AFB is located in Beavercreek and offers guests internet. It also provides a lift and a safe.
Hotel description
There are 100 rooms at Suburban Extended Stay Hotel Dayton Beavercreek, each providing all the necessities to ensure a comfortable stay.
Suburban provides breakfast every morning that guests can enjoy before heading out to explore the surrounding region.
James M. Cox Dayton International Airport is under a 30-minute drive from the hotel. Guests are able to visit Fairborn and Dayton, located within an easy drive of the property.
Hotel features
Pet Friendly
Elevator / Lift, Safe-Deposit Box
High-speed Internet
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text: Low-top croc-embossed leather sneakers in black. Round toe. Tonal lace-up closure. Adjustable Velcro strap with curved logo plaque at vamp. Logo plaque at padded bellows tongue. Signature zipper detailing at sides. Pull-tab at heel collar. Treaded rubber sole in black. Gold-tone hardware. Tonal stitching. Upper: leather. Sole: rubber. Made in Italy.


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YZ seat with WR tank??
Posted January 15, 2002 - 09:49 AM
Will the YZ seat work with the WR tank??
Thanks in advance, Ernie
Posted January 15, 2002 - 10:09 PM
Posted January 15, 2002 - 10:26 PM
stock seat would be cheap.
tall seat and graphics... Not sure. But I will say they look nice... especially the seat
Posted January 15, 2002 - 10:33 PM
Thanks for the quick responses. It figures that I need the seat too!!
What are you asking for the stock seat??
Posted January 15, 2002 - 11:03 AM
I have a WR426 that Im looking to do the conversion on myself...maybe we could work $omething out?
drop me a line if interested, my inet connection is here and there but i usually check the email at least once a day or so..
Posted January 15, 2002 - 12:57 PM
I will be keeping the stock YZ set up for when I moto (which is what I usually do). The WR tank and seat thing is for when my buddies and I go for cross country/trail/longer rides and the YZ tank capacity just is not enough.
Sorry for getting you excited, Ernie
Posted January 16, 2002 - 03:27 AM
or just let me know on a post.
Posted January 16, 2002 - 07:30 AM
Posted January 16, 2002 - 07:46 AM
Another option is to get the IMS YZ 3.2 gallon tank. This tank works with the YZ seat, has WR fuel capacity, and much better ergonomics than the WR setup. I just bought one for my WR from Baja Designs.
Posted January 16, 2002 - 08:43 AM
Posted January 16, 2002 - 10:44 PM
How you been?? How are the hoofs?? I posted a while back trying to check up on you but you never responded. I figured you either took your own life cause you couldn'd ride for a while or you were in TT denial.
I honestly never thought about the ergonomics. You guys make a great point. I'll have to check into the aftermarket tanks.
Thanks, Ernie
Posted January 17, 2002 - 05:22 AM
The tall Wr seat.... hummm... my cost was ...
100$ seat cover and graphics
50$ foam, and about 50 for the seat... plus 2 hours time to custom fit seat foam and cover...180$ and i guess I'd let it go.
There is like 4 " of foam (2 seats worth) in the rear 8" of the seat (extra tall)
I'll try to post a pic of my bikes!
Posted January 17, 2002 - 07:24 AM
Originally posted by crazyadam:
There is like 4 " of foam (2 seats worth) in the rear 8" of the seat (extra tall) I'll try to post a pic of my bikes!
That is a lot ot foam. Are you 7' tall or is that seat for Herman Munster?????
Posted January 17, 2002 - 08:16 AM
My shops scanner is broke, so no pic, but...
I cut the rear 6-8" off of the stock foam, cut at a large angle, or slope. then I glued it to the base, and put the tall foam over it. had to trim for the best fit, but it looks great! no lumps or wrinkles anywhere. from the fender to the top of the seat is about 3- or 4" instead of 2".
I've got long arms and legs.. and this is softer on my bony a$$, and makes it easier to stand... and a lot easier to let the seat bounce off of me in the serious rough stuff.
I did this to my YZ seat as well! my YZ seat is almost a straight line from the tank to the back of the seat.
I'll admit now that i did them so no one can borrow.. or test out my bike! even if they can start it !!!
Posted January 17, 2002 - 12:26 PM
The ankles are much better. Air cast is off. They hurt when it's cold. I can't run but I have been mtn and road biking alot. I'm going to Gorman this Sunday and try out the dirtbike on some trails. MX track soon. Are you going to the Supercross this Sat?
Think about the ergonomics on the WR tank. Thats why so many people have dumped the WR tank. The YZ or aftermarket big tank that fits a YZ seat is a huge improvement.
Let me know if you will be at the SX and we can hook up.
Posted January 17, 2002 - 02:35 PM
Not going to this weekends round but we are going to the Feb 2nd round. You gonna go to that one?? If so let me know. We are going to go early to watch practice and the qualifiers. We'll have the 5th wheel, bbq and......uh.......beverages.
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This is a semi-detached stone house. It´s located just 1 km from the sea. It has 4 bedrooms, 3 bathroom, flor heating and it´s air conditioned. It has a swimming pool and a basement. It´s just near the town center.
House POREČ Duplex stone house in Vabriga — for sale
435,000 €
Total area: 136 m² 2 separate bathrooms
- Land area: 524 m²
- Total rooms: 4
- Sea at 1,000 m
- Private car park


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Want to change your engine for faster winding, more torque ...?
Contact us
we can performRemanufactured * Your engine.
* According to availability, in exchange for an engine running condition.
|Mode Actife : Delivery scheduled between the 12/14/2016 and 12/19/2016


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This vintage, embossed postcard is a trade card advertising Fermentum Compressed Yeast from The Riverdale Distillery of Chicago. The colorful lithograph is rather complex with a bird, probably a robin perched on the branch of a rose. The background is divided into two sections. At the top it appears to be the snow capped roofs of a church perhaps and the bottom portion shows a quaint cottage along the snowy bank of a creek. On the back is information about the benefits of this "reliable" yeast.
The width varies but averages about 4 7/8" by 6 1/8" high and is nice condition with minimal wear. There is minimal edge wear and one lower corner is bent.
The pictures are not shown at actual size. Please refer to the description for actual measurements.
Don't forget to check out the other antique and collectible advertising in our shop!
This will be shipped by USPS First Class Mail. Combined shipping with other items can be arranged. Foreign shipping will be determined by the receiving country. Please read our home page regarding payment options and shipping policies. Thank you.
2 other shoppers have this item in their Cart or Wish List .
Christmas should be fun and stress free. We can help you by gift wrapping your purchase....just ask!
CHECK YOUR WISH LIST NOW! If one of our items are on it we may have offered you a special discount.


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text: What type of listing is this? For Sale What are you trying to sell/buy/trade? Olympus 17mm f 1.8 Brand New What are your prices? $335 shipped Where are you located? USA Where are you willing to to ship? CONUS Description I have a brand new olympus 17mm 1.8 black, that came kitted with my new cam. I wont be using this lens so here it is for sale. Comes with its original wraps. $335 shipped Personal/gift paypal, regular paypal add 3% Payment accepted Regular PayPal (buyer adds 3% for this option), Personal/Gift PayPal (violates PayPal policy and no buyer protection) Acknowledgement I have read and agree to the Buy and Sell rules.


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Convene 8 PC Patio Sofa Set | Espresso/Mocha
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Offering durability, stability and healthy support for years to come, this furniture will help to organize your patio decor and bring functionality with personal style and beauty. Standing on aluminium frame each piece from this collection is outfitted with plush and soft upholstered seat cushion.
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ERIC Number: ED344464
Record Type: RIE
Publication Date: 1989
Pages: 19
Abstractor: N/A
Reference Count: N/A
Chinese Passives: Transformational or Lexical?
Zhang, Jiuwu; Wen, Xiaohong
Analysis of Chinese passive constructions indicates two types. The first is a verbal or syntactic passive because it is derived through a transformational rule. The second is a lexical passive that has certain properties in common with the predicate adjectives in both Chinese and English and is derived through the semantic function and in lexical causative-inchoative constructions. (Author/MSE)
Descriptors: Chinese, Classification, Contrastive Linguistics, English, Grammar, Language Research, Linguistic Theory, Semantics, Syntax, Verbs
Publication Type: Opinion Papers
Education Level: N/A
Audience: N/A
Language: English
Sponsor: N/A
Authoring Institution: N/A
Identifiers: Passives
Note: In: Kansas Working Papers in Linguistics, Volume 14, Number 1; see FL 020 157.


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04/13/2008Provided by Citysearch -
I love Aqua Marina, its a very small restaurant but its a great escape from the rest of the eateries in the neighborhood. There aren't many places that can offer this cuisine in a more upscale atmosphere while offering very affordable prices. I love the pasta, i highly recommend the penne a la vodka, it is simply delicious. They have great daily, lunch and early bird specials! If you live in the neighborhood this place is a must!


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Soap & Glory™ Mini Clean, Girls™ Creamy Body Wash
Rub a handful of Clean, Girls™ onto slightly damp skin until it forms a thick, luxurious lather, and then rinse. Dry off, and follow with moisturiser if you feel you must. (Clean, Girls™ has a moisturising matrix built-in, so some girls dew and some don't).
You might be witty, charming, sassy and fabulous, but there's nothing quite as nice as being Clean, Girls™.
Polyquaternium-10, Phenoxyethanol, CI 77891 (Titanium Dioxide), Cocamidopropyl Betaine, Acrylates/Palmeth-25 Acrylate Copolymer, Glycol Distearate, Glycerin, Parfum (Fragrance), Coco-Glucoside, Methylisothiazolinone, PEG-40 Hydrogenated Castor Oil, Sodium Chloride, Dipropylene Glycol, Sodium Laureth Sulfate, Mica, Citric Acid, Glyceryl Oleate, Limonene, Glyceryl Stearate, Butylphenyl Methylpropional,Hydroxyisohexyl 3-Cyclohexenecarboxaldehyde, Orchis Mascula Extract, Lactic Acid, Sodium Hydroxide, Tetrasodium EDTA, Disodium Phosphate, Alpha-Isomethyl Ionone, Citrus Reticulata Peel Oil, Vanilla Planifolia Fruit Extract, Benzoic Acid, Linalool, Alcohol, Isopropyl Alcohol, Coumarin, Citronellol, Sodium Acetate, Aqua (Water)
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I would once again like to welcome from Buyers Meeting Point to share information of this week's events and news from the world of purchasing Kelly Barner.
NOTE: In this week 's guest sound bite, we 'll hear a new clip from Pamela Eason, CEO of the Womens ' Business Enterprise National Council as she discusses the importance of reinforcing with middle managers the need for supplier diversity
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Brandforce is one of Northern Europe's biggest and most experienced operators within license production and distribution of the market's best known and most popular original brands in footwear and fashion clothing. Want to successfully offer fashionable and original designer labels to your customers? Brandforce offers you fast, direct and easy access to a large inventory and a beautiful showroom with a wealth of up-to-date footwear and clothing merchandise from today's top brand names.
We always have the latest in polos, t-shirts, sweatshirts, sweatsuits, jeans, socks and underwear in our own Brands - Pringle, REDGREEN SPORTSWEAR, MELKA, Foot Warmers, Vinson.
Welcome to BRANDFORCE – we look forward to showing you our large selection
BRANDFORCE was founded in 2000 by managing director Heine Østergaard, who sought to establish a network of professional buyers, innovative manufacturers and effective partners with a keen eye for spotting today's trends in the market for footwear and fashion clothing.
Since then, the company's success and significance on the market has grown, and since 2002 we have been greeting customers and business partners at our modern facilities in Svenstrup, close to Aalborg.
With 16 service-minded and experienced staff members – as well as an always up-to-date inventory and well-furnished showroom – BRANDFORCE offers customers and partners fast and direct access to a large assortment of the newest trends within footwear and fashion clothing.
Our inventory, service and logistics facilities enable us to satisfy any special requests you may have with regard to the packing and labelling of your goods. All our merchandise is approved by leading legal experts and may be sold in the EU – and BRANDFORCE always guarantees 100% authenticity.
BRANDFORCE is a financially strong company, which provides a good basis for serious, long-term collaboration. We have an AAA internationally recognised rating for credit worthiness and financial capacity.
Welcome to BRANDFORCE Fashion – we look forward to showing you our large assortment and many great deals!
The brand Foot Warmers is established in the year 2010. The Foot Warmers thermo socks will keep your feet warm and they feel so pleasant and soft that you'll never wish to take them off again. The socks will secure support, comfort and an optimal fit for sport, leisure and domestic comfort. They are available in various sizes and fits – both for children and adults. The models are available both with and without the advanced non-skid ABS technology that makes them well suited for indoor activities. The Foot Warmers socks are tested and the results are marvelous – Foot Warmers socks are more than 3 times warmer than regular cotton socks.
Careza is fashionable fitness and running sportswear which is designed with focus on energizing colours, functionality and comfort during your work out or running session.
No matter if you are in the gym, out running or being sporty in the outdoor, you will be amazed by Careza Sportswear, which will help you sharpen your look while working hard on your goals and keeping the right spirit of training in mind.
The Brand Vinson is another initiative of BRANDFORCE - it has been registered since 1971 and has been delivering high quality clothing products ever since. Vinson wants to deliver high quality to reasonable prices and make all kind of clothing from underwear to outerwear.
Brandforce is well-known for manufactoring menswear og sportswear. The sportswear is inspired by the Vinson mountain. You go to the Vinson mountain to find a beautifull and peacefull place where trekking an unbelieveable experiences are an everyday happening. This mountain every year challenge people around the world.
Ed Hardy is authentic clothing, which represent a cool and rough attitude and lifestyle. The brand and its styles are inspired by the artwork of the tattoo legend Don Ed Hardy, who has been a pioneer within the tattoo artistic world.
The Ed Hardy brand is well-known world-wide and with its very recognisable clothing and accessories for both men and women, it has become a much loved brand among celebrities as well. fast and easy delivery and absolute high quality – at prices that allow you to be more competitive while increasing earnings.
Transforming the design core of REDGREEN into a sportswear collection for men and women, the redgreen universe is extended to the moments of life when leisurewear is called for.
While the collection is linked by design and fashion references to redgreen´s maritime history, Redgreen sportswear is not made exclusively for a maritime lifestyle per se, but can be worn, enjoyed and experienced by anyone who loves the freedom of life outdoors.
In the design process, care is taken to ensure optimal fit and wear, making each individual style a special treat and an extension of the experience of outdoor sports, activities or leisure.
For over fifty years Melka has been focusing on designing clothes in a high quality and with a great fit. From jackets to underwear, the Melka collections always aim to have full attention to the design, details and a perfect fit, so we can guarentee an impeccable outfit.
Melka is all about taking care of old Swedish heritage and we hope our customers want to embrace the heritage of Melka as well.
Umbro is a well-known international brand within the sportswear and football equipment industry. The brand combines its heritage in sports tailoring with modern football culture to create iconic sportswear and football clothing.
The company was founded by Harold Humphreys, along with his brother Wallace in a small workshop in Wilmslow, Cheshire, inspired by the growing interest in football witnessed nationwide. The name "Umbro" is a quasi-portmanteau inspired from Humphreys Brothers Clothing.
Brandforce ApS - Lansen 15 - DK-9230 Svenstrup J
+45 96 32 10 80 - Fax +45 98 38 33 62


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College of Business Names 2016 Alumni Fellow
Jan Lewis was recently selected as 2016 Alumni Fellow for the College of Business. Jan Lewis is a Tax Partner with Haddox Reid Eubank Betts PLLC in Jackson, MS. Her responsibilities include income and estate tax planning, research, and compliance for individual and business clients. Her areas of practice include healthcare, oil & gas, construction and real estate. Lewis is a native of Jackson, MS, and a 1985 summa cum laude graduate of MSU. She is a member and past chairperson of the Richard C. Adkerson School of Accountancy Advisory Board at MSU. She was chosen as MSU Beta Alpha Psi Alumnus of the Year in 2000. Lewis was recognized at the MSU Alumni Fellows Awards Banquet on Friday, November 4, 2016.
COB's Gamma Iota Sigma Recently Honored at the GIS International Conference for 2015-16 Academic Year!
Congratulations to the Pi Chapter of Gamma Iota Sigma who were recently recognized during the Gamma Iota Sigma International Conference in Columbus, Ohio, taking home awards for community service, membership development, and public relations for the 2015-2016 academic year! More than 500 students and advisors were in attendance at the conference and 60 organizations participated in the sessions and career fair.
MSU Launches Innovative Executive Mentoring Program
The Center for Entrepreneurship and Outreach (CEO), housed in MSU's College of Business, is launching an innovative mentoring program with state's top business developer. Glenn McCullough, Jr., executive director of the Mississippi Development Authority will be the center's first executive in residence, providing one-on-one mentoring opportunities to the more than 100 student start-ups! The inaugural session is scheduled for Wednesday, Sept. 14, from 1:30 – 3:00 in the CEO, located in Suite 101 in McCool Hall on the MSU campus.
Adkerson School of Accountancy Ranked Third in the 2016 CCH Public Accounting Report!
Congratulations to the Richard C. Adkerson School of Accountancy, as they are now ranked 3rd in the nation for both undergraduate and graduate accounting programs (with 15 or fewer full-time faculty) in the the latest Commerce Clearing House Public Accounting Report. A division of the Wolters Kluwer tax solutions firm, CCH has published annual rankings of the nation's best college accounting programs for almost 30 years.
Horne, LLP Generously Supports the Adkerson School of Accountancy
The College of Business' Adkerson School of Accountancy recently received a $75,000 charitable contribution from Horne, LLP, a three-year pledge to support three areas of focus: undergraduate scholarships, graduate scholarships and the newly-created Horne Strategic Initiative Fund, which will provide a source of flexible funding for high impact programs and needs of the nationally ranked Adkerson School of Accountancy.


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Hotels in Vernegues
Hotel reservation
Hotel rooms in Vernegues
There are not so many hotel rooms in Vernegues, just 3, still everyone can find an offer to suit his choice. The most common offers in this city are hostels, they count 1 out of 3, and their prevalent location is central district. According to our practice, it is the most profitable to book a hotel in the east of Vernegues, as it is the location of the hotels with optimal cost and quality offers along with the cheap hotels. Taking into account the small size of the city, there is no need to dwell hotel reservation on the location: the road to the city center would take less then half an hour, so one can book a hotel in any district of Vernegues. The most populated with hotels district of Vernegues is the south, 33% of cheap hotel rooms are concentrated here. However, even those who want to live in the center can choose from 1 variants of hotel rooms. Vernegues is a truly multifaceted city, here everyone can find a hotel of his choice: a business person, a young couple or a family with little children. The view to pool from the hotel room can serve as a pleasant addition to the journey. Apart from all these, hotels in Vernegues offer their customers pets allowed, business centre, bar and swimming pool. Take a look at our selection of the cheap hotel rooms in Vernegues to make a well-informed choice for your reservation!
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Hotels in Vernegues are spread around the city within the distance of 2.9 kilometers, while 1 hotels are located directly in the city center. The most popular accommodations in Vernegues is
Appartement les Balcons d'Azur
located in a 0.3 kilometers from the city center.
The best hotels are here and now. Try them!
All cities in France


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From young children to
older adults, people of all ages will find opportunities to enjoy the outdoors
in Lakewood. Whether your interest is in finding the neighborhood playground, a
space to hold the company picnic, or retreating to nature, we have an
adventure waiting.
Urban and Regional Parks
staff manage and care for the beautiful parks and open space in our city,
Cold Full Moon Guided Night Hike
Leave those flashlights at home for this unique hiking adventure. You will be guided by a park naturalist along the park's trails and surrounding green spaces. Wear comfortable hiking shoes, dress for weather conditions and bring water. These hikes are designed for the whole family, but each will average an hour and a half of walking on uneven terrain. Meet at the Bear Creek Lake Park Visitor Center unless otherwise noted. No dogs please.
$2/person, park entrance fee is waived
Registration deadline: Dec 12
Celebrate the first day of winter with us. We will go on a short night hike and then gather around the campfire for a marshmallow roast and celebration of the winter solstice that will include the traditional burning of the yule log. Please bring your ow mug to enjoy a hot beverage. No dogs please.
Registration deadline: Dec 16


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"Occupancy sensors are one of the most effective means to meet lighting control energy code requirements and achieve substantial energy savings with a typical payback period of three years or less," said Scott Jordan, Square D lighting control product marketing manager. "These new non-obtrusive occupancy sensors give designers another option to optimize the sensors' coverage patterns, especially in corridor areas."
The three available models can be used to support specific application requirements. For example, the PIR device provides line-of-sight motion detection and is best-suited for areas like corridors and aisle ways. It is available with three interchangeable lenses to create custom coverage patterns:
- Wide-angle lens: 2,500 square feet at an 8-foot mounting height
- Long-range lens: 102 linear feet at a 10-foot mounting height
- High-bay lens: 54 linear feet at a 30-foot mounting height
With a 180-degree field of view and up to 1,000 square feet of coverage area, the ultrasonic occupancy sensor is ideal for multistall restrooms, open office areas and stairwells — primarily daylit spaces with obstructions in both commercial and residential applications and without flat ceilings that require greater minor motion coverage.
The dual-technology version employs both PIR and ultrasonic technologies, and provides the greatest sensitivity to motion in large areas with obstructions, such as classrooms, conference rooms, large meeting rooms or other spaces where minor motion coverage is critical. It employs PIR technology to detect major motion, and once lighting has been turned on, a combination of PIR and ultrasonic technology detects minor motion to keep lighting on while areas remain occupied.
For more information about Schneider Electric, visit www.squaredlightingcontrol.com.


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|Home | About | Journals | Submit | Contact Us | Français
Guidelines recommend advanced care planning for terminally-ill patients with less than one year to live. Few data are available about when physicians and their terminally-ill patients typically discuss end-of-life issues.
National survey of physicians caring for cancer patients about timing of discussions regarding prognosis, DNR status, hospice, and preferred site of death with their terminally-ill patients. We used logistic regression to identify physician and practice characteristics associated with earlier discussions.
Among 4,074 respondents, 65% would discuss prognosis "now" (patient has 4–6 months to live, asymptomatic). Fewer would discuss DNR status (44%), hospice (26%) or preferred site of death (21%) "now", with most physicians waiting for patient symptoms or until there are no more treatments to offer. In multivariable analyses, younger physicians more often discussed prognosis, DNR status, hospice, and site of death "now" (all P<.05). Surgeons and oncologists were more likely than noncancer specialists to discuss prognosis now (P=.008), but noncancer specialists were more likely than cancer specialists to discuss DNR status, hospice, and preferred site of death "now" (all P<.001).
Most physicians report they would not discuss end-of-life options with terminally-ill patients who are feeling well, instead waiting for symptoms or until there are no more treatments to offer. More research is needed to understand physicians' reasons for timing of discussions and how their propensity to aggressively treat metastatic disease influences timing, as well as how the timing of discussions influences patient and family experiences at the end of life.
Prior research has demonstrated large variations in the costs and aggressiveness of care delivered to patients with cancer and other chronic illnesses at the end of life.1–3 While such variation is not explained by variations in patients' preferences for end-of-life care,4 it could be explained in part by physicians' propensity to discuss end-of-life options with their terminally-ill patients. Patients whose physicians discuss end-of-life options sooner might be more knowledgeable about strategies to improve the quality of the end of-life experience and more interested in pursuing them based on this knowledge. Moreover, for patients who may prefer to avoid aggressive care at the end of life, physicians who discuss end-of-life options sooner might better understand these preferences and may be more likely to act on them.
National guidelines recommend advance care planning for patients with terminal illness and life expectancy of 1 year or less.5, 6 Important components of such advance care planning include clear and consistent discussions about prognosis, information about advanced directives and exploration of the "do not resuscitate" (DNR) option, information about palliative care options including hospice, and elicitation of patients' preferences for site of death.5 California recently enacted legislation requiring doctors to counsel patients whose prognosis is less than a year about hospice and palliative care.7
Few data are available about when physicians and their terminally-ill patients typically discuss end-of-life issues. We surveyed physicians caring for cancer patients to describe their reports of the timing of discussions about prognosis, DNR status, hospice, and preferred site of death with their terminally-ill patients. We then assessed physician demographic, professional, and practice characteristics associated with their reports of the timing of these discussions. Finally, we assessed whether physicians who were more knowledgeable or comfortable addressing end-of-life issues were more likely than other physicians to discuss these topics while patients were still feeling well.
This study is part of a large multi-regional study examining processes and outcomes of care for a population-based cohort of cancer patients conducted by the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium.8 The cohort includes more than 10,000 patients diagnosed with lung or colorectal cancer during 2003–2005 living in Northern California, Los Angeles County, North Carolina, Iowa, or Alabama, or who received their care in one of 5 large health maintenance organizations (HMOs) or 10 Veterans Affairs Health Care System sites. Data were collected from patient (or surrogate) interviews, medical records, surveys of patients' physicians, and surveys of informal caregivers. The study was approved by the human subjects committees at all participating institutions. This analysis uses data from the physician survey only.
As described previously,9 we surveyed physicians identified by patients participating in the CanCORS baseline interview as filling one or more key roles in their care, including providing surgery, chemotherapy, or radiation therapy (or discussing these treatments for patients who were not treated); referring patients to these key providers; helping to make treatment decisions; or knowing if the patient had symptoms related to their cancer or its treatment. Of 6,871 physicians whose contact information was verified, 4188 (61.0%) responded.
To assess timing of discussions about end-of-life issues, physicians were asked: "Assume you are caring for a patient who is newly diagnosed with metastatic cancer, but is currently feeling well. You estimate that the patient has 4–6 months to live. When, in the course of the typical patient's illness, are you most likely, for the first time, to discuss the following with this patient or family? (1) prognosis, (2) DNR status, (3) hospice, (4) preferred site of death." Response options were "now", "when the patient first has symptoms", "when there are no more non-palliative treatments", "only if the patient is hospitalized", and "only if the patient or family bring it up". At the time of the survey administration, national guidelines5, 6 recommended discussion of these topics with terminally-ill patients having a life expectancy of 1 year or less.
In addition, we asked physicians how strongly they agreed or disagreed with the following statement:10, 11 "I feel knowledgeable enough to discuss options for end-of-life care with my cancer patients and their families." Response options were strongly agree, somewhat agree, neither agree nor disagree, somewhat disagree, strongly disagree. Physicians also provided information about the number of terminally-ill patients they cared for in the past year and personal and practice characteristics.
We excluded 114 physicians who did not respond to all 4 questions regarding discussions about end-of-life issues. We used multiple imputation to impute missing data for remaining items.12, 13 Item nonresponse was <2–3% for most variables, but was 7% for the proportion of patients enrolled in managed care.
We described physicians' reports of discussing prognosis, DNR status, hospice enrollment, and preferred site of death. We used Chi-square tests to compare reports of discussing each option "now" by physician characteristics. We used logistic regression to identify physician factors associated with having discussions "now". Independent variables that we believed may be related to timing of discussions included self-reported physician specialty (surgeon, medical oncologist, radiation oncologist, non-cancer specialist [predominantly primary care physicians, gastroenterologists, and pulmonologists, <1% were geriatricians and <0.1% were palliative care specialists]), age (<40, 40–49, 50–59, ≥60 years), sex, race/ethnicity (white, Asian, black, Hispanic, other), board certification, U.S./Canadian medical graduate, practice site (office, hospital), teaching involvement (none, 1–5 days/month, >5 days/month), proportion of patients in managed care (quartiles), number of terminally-ill patients cared for in the past year (quartiles), and study site. We calculated adjusted rates of discussing options "now" for each physician characteristic using a standardized regression approach.14
In a second set of models, we included variables reflecting whether physicians felt knowledgeable enough to discuss end-of-life options with their patients. Responses were categorized as strongly agree, somewhat agree, or other responses.
We conducted two sensitivity analyses. First, we changed the dependent variables in the models to "when the patient first develops symptoms" or "now" versus other options. Second, we repeated all analyses after restricting the cohort to physicians caring for at least 2 terminally-ill patients in the past year (95% of physicians), since some physicians (particularly non-cancer specialists) may have cared for cancer patients who did not die.
The mean age of the 4,074 physicians was 50.1 (SD 9.8), 82% were male, 22% were surgeons, 13% medical oncologists, 6% radiation oncologists, and 59% non-cancer specialists. Characteristics of the cohort are included in Table 1.
The Figure depicts physicians' reports of when they would discuss prognosis, DNR status, hospice, and preferred site of death with their terminally ill patients, by specialty. Overall, 65% of physicians would discuss prognosis "now", while 15% would have this discussion only if the patient/family brings it up. Forty-four percent would discuss DNR status "now" with 18% waiting for the patient to have symptoms and another 26% waiting until there were no more nonpalliative treatments. Approximately one-quarter (26%) of physicians would discuss hospice "now" with 16% waiting for symptoms and 49% waiting until there are no more nonpalliative treatments. Finally, 21% would discuss preferred site of death now, with 24% having this discussion only if the patient/family brought it up. Surgeons and medical oncologists were most likely to discuss prognosis "now", whereas noncancer specialists were most likely to discuss the other topics now.
In multivariable analyses, surgeons and medical oncologists were more likely than noncancer specialists to report discussing prognosis "now" (P=0.008), but noncancer specialists were more likely than cancer specialists to discuss DNR status, hospice, and preferred site of death "now" (all P<0.001) (Table 2). Younger physicians were more likely to report discussing prognosis, DNR status, hospice, and preferred site of death "now" (all P<0.05). Female physicians were less likely than male physicians to report discussing prognosis "now" (P=0.05) and physicians with more terminally-ill patients were more likely than others to report discussing prognosis (P=0.003) and DNR (P=.04) "now". Asian physicians were less likely than other physicians to report discussing prognosis "now", and Hispanic physicians were most likely to discuss DNR status "now". Physicians in office-based (vs. hospital) practices were more likely to report discussing hospice "now" (P=.007). Physicians with the most patients in managed care were most likely to discuss DNR status and hospice "now" (both P=.02). Discussion of all treatment options were highest in the Veterans Administration and the HMO sites and were generally lowest in Los Angeles County and Alabama.
In a second set of multivariable models that included physicians' reports of whether they felt knowledgeable enough to discuss end-of-life options with their terminally ill patients, physicians who strongly agreed (55% of physicians, OR=1.89, 95% CI 1.55 to 2.30) or somewhat agreed (30% of physicians, OR 1.44, 95% CI 1.18 to 1.76) were more likely than other physicians to discuss prognosis "now". Physicians who strongly agreed they were knowledgeable to discuss end-of-life options were also more likely to discuss DNR status (OR 1.94, 95% CI 1.58 to 2.37), hospice (OR 1.59, 95% CI 1.27 to 2.00), and preferred site of death (OR 1.60, 95% CI 1.27 to 2.05) "now". In all cases, addition of these variables to the base models did not influence the associations in Table 2.
When we restricted the sample to physicians who reported that they would discuss prognosis "now" to assess how often these physicians would use the discussion or prognosis as an opportunity to discuss other topics "now", 57% also reported that they would discuss DNR status "now", 36% that they would discuss hospice "now", and 30% that they would discuss preferred site of death "now".
In sensitivity analyses, we repeated analyses based on whether physicians discussed end-of-life issues "now" or "when the patient develops symptoms" vs. other responses, and associations were generally similar (data not shown). Likewise, when we restricted the cohort to physicians caring for at least 2 terminally ill patients in the past year our results were similar.
In this large survey of physicians caring for cancer patients who practiced in various locations across the United States, we found that many physicians report not discussing end-of-life options with terminally-ill patients while they are still feeling well, instead waiting for onset of symptoms or until there are no more non-palliative treatments to offer. A significant minority of physicians reported they would discuss prognosis or preferred site of death only if the patient or family brought it up. Younger physicians and physicians who were not cancer specialists reported discussing end-of-life options sooner than older physicians and cancer specialists, as did physicians caring for patients in HMO or VA settings, compared with physicians whose patients were identified from population-based settings.
Although guidelines recommend advance care planning for terminally-ill patients with a life expectancy of 1 year or less, a minority of physicians in our study reported that they would discuss DNR status, hospice enrollment, or preferred site of death with patients who had 4–6 months to live and were feeling well. There are several potential explanations for this finding. Physicians may disagree with the guidelines (which are based primarily on expert consensus due to limited data), may be unaware of the guidelines, or may agree with the guidelines but still delay discussions that may be difficult.
Few data are available about the benefits of advance care planning on patient- and family-centered measures.15 Although seriously ill patients, families, and physicians may agree about the importance of preparation for the end of life16 and value good communication about end-of-life care,17 little is known about patients' preferences regarding timing of discussions about end-of-life topics. Some reports suggest that patients prefer early discussions. For example, outpatients have suggested that advance care planning should occur when they are well, although ideally after the physician knows the patient.18
Nevertheless, not all patients want to discuss end-of-life issues early. An Australian study of metastatic cancer patients found that only 59% wanted to be told how long they had to live when first diagnosed.19 Indeed, some older individuals of certain ethnic groups do not believe patients should be informed that they have incurable cancer.20 Uncertainty also exists about preferences for timing of discussions about DNR status. Some evidence suggests that most patients want to discuss DNR status with their physicians.21–23 However, in the SUPPORT study, only 23% of patients had discussed DNR status with their physicians, and of those who had not, only 42% wished to discuss their preferences.24 A small study of hospitalized cancer patients found that only 9% had discussed advance care preferences with their outpatient oncologist and only 23% of the remaining patients reported wanting to do so, although 58% of patients supported policies requiring housestaff to discuss advance care preferences at hospital admission.25
Some physicians who are aware of the guidelines for advance care planning for terminally-ill patients may delay end-of-life discussions because they fear that discussing death early in a patient's terminal course may be associated with less hope and poorer outcomes.26, 27 However, studies examining outcomes following end-of-life discussions have demonstrated no harm or positive outcomes.28, 29 Other physicians may have difficulty with end-of-life discussions because they perceive discussing end-of-life issues as an admission of failure to cure a patient's cancer.30, 31 Additional training may benefit physicians who felt less knowledgeable discussing end-of-life options, since they were less likely to report having these discussions early.
Our finding that many physicians reported waiting until there are no more nonpalliative treatments available before discussing end-of-life issues suggests that some physicians favor providing treatment for terminally-ill patients before discussing end-of-life issues. This is consistent with the willingness of many terminally-ill patients to undergo therapy despite a high treatment burden or a high likelihood of an undesirable outcome.32, 33 However, physicians likely vary a great deal in their assessments of the availability of nonpalliative treatments and the number of regimens indicated,34 and waiting until all possible treatments are exhausted may delay discussions until it is too late for patients' preferences and values to be addressed. In one study, only 41% of seriously-ill patients who expressed a preference for comfort care believed that their medical care was consistent with that preference.35 Given that use of chemotherapy at the end of life is increasing,3, 36 even for cancers generally considered unresponsive to chemotherapy,36 excessive treatment might delay discussions of end-of-life issues unnecessarily. Nevertheless, some physicians may defer hospice discussions because hospice care typically limits access to medical treatments.37
Some physicians may delay discussions of end-of-life issues because they are uncertain about the accuracy of their estimates for life expectancy. Physicians consistently overestimate survival for terminally-ill cancer patients, although their predictions are highly correlated with actual survival and have discriminatory ability even when inaccurate.38 Still, even after formulating survival estimates (accurate or not), physicians often have difficulty communicating them, frequently providing intentionally inaccurate estimates or no estimates at all.39 Yet, discussions of prognosis may be important, since terminally-ill cancer patients' own estimates of prognosis are typically more optimistic than physicians' optimistic predictions.40, 41 Patients' beliefs about prognosis influence their treatment preferences,40 and may influence patients' likelihood of initiating discussions about goals when physicians do not. Such delays could contribute to unrecognized wishes. For example, patients who express a preference to die at home are more likely to die at home than similar patients with wishes that are not expressed.42, 43
Although nearly two-thirds of physicians reported they would discuss prognosis "now", among this group, only half reported they would also discuss DNR status "now", and only one third would discuss hospice or preferred site of death "now". This finding suggests that discussions of prognosis are not synonymous with advance care planning. Physicians may instead be using discussions of prognosis to initiate discussions about potential treatments.
Our finding that younger physicians were more likely than older physicians to discuss end-of-life options with their patients may reflect greater awareness of guidelines44 or more emphasis on palliative care issues during their medical training. Alternatively, physicians who are older may have more experience with difficult end-of-life conversations and be more skeptical about the potential benefits. Our finding that physicians in HMO or VA settings reported having end-of-life discussions sooner than physicians of patients in population-based settings may reflect a less-intensive approach to end-of-life care in these managed care models of care. Alternately, it may reflect the ability of integrated organizations to influence behavioral norms. Other evidence suggests greater hospice use in managed care systems45 and less intensive end-of-life care for cancer patients in the VA versus fee-for-service Medicare settings.46 The geographic variations we observed for the population-based sites is consistent with other studies demonstrating large variations in care, particularly for situations where few data are available to guide treatment recommendations.1, 47
Our analysis is strengthened by the large, geographically diverse sample of physicians from multiple disciplines who care for cancer patients. Nevertheless, our findings should be interpreted in light of several limitations. First, our vignette had a limited list of response options to learn when physicians would likely discuss end-of-life issues with a terminally ill patient, and responses to this vignette may not reflect reality. Our response options, for example, did not include an option such as "at the next visit, but before symptoms develop", which may have been a choice of physicians who may want to establish more of a relationship with their patients before discussing sensitive end-of-life issues.48 Second, as CanCORS participants are not a national sample and our survey is subject to nonresponse bias, we cannot be certain that the physicians in our sample were representative of physicians caring for cancer patients nationally or in the regions studied. In addition, physicians' responses may have been influenced by social desirability bias; but the low prevalence of "now" responses suggests that social desirability was not the main determinant of responses. Finally, we surveyed only physicians and thus do not know the role of non-physician providers in initiating end-of-life discussions with terminally ill patients.
In conclusion, despite guidelines recommending discussion of prognosis, DNR status, hospice, and preferred site of death with terminally-ill patients while they are still feeling well, our findings suggest that different types of physicians have very different views regarding the appropriate timing of these discussions. More research, both quantitative and qualitative, is needed to understand physicians' reasons for timing of their discussions, the role of physicians' propensity to aggressively treat metastatic cancer on the timing of discussions, and patients' preferences for timing and how timing influences patients' and families' experiences at the end of life. Education and patient, physician, and institutional interventions may be necessary to increase advance care planning for terminally-ill cancer patients. Programs such as the Education for Physicians on End-of-Life Care-Oncology (EPEC-O)49, 50 provide a promising model for influencing behavior change.
Funding: This work of the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium was supported by grants from the National Cancer Institute (NCI) to the Statistical Coordinating Center (U01 CA093344) and the NCI-supported Primary Data Collection and Research Centers (Dana Farber Cancer Institute/Cancer Research Network U01 CA093332, Harvard Medical School/Northern California Cancer Center U01 CA093324, RAND/UCLA U01 CA093348, University of Alabama at Birmingham U01 CA093329, University of Iowa U01 CA01013, University of North Carolina U01 CA093326) and by a Department of Veteran's Affairs grant to the Durham VA Medical Center U01 CDA093344 (MOU) and HARQ 03-438MO-03).
Investigators from the National Cancer Institute and the Department of Veterans Affairs participated in this study's design and data collection but not the analysis, interpretation of findings, reporting of this work or the decision to submit the article for publication.
Financial Disclosures: None of the authors have any potential conflicts of interest or financial disclosures to report.
The authors would like to thank Robert E. Wolf, M.S., and Yang Xu, M.S. for expert programming assistance and Yulei He, Ph.D. for assistance with the multiple imputation.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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New Jersey Superior Court, Law Division
Decided: June 21, 1983.
T & M HOMES, INC., A NEW JERSEY CORPORATION, PLAINTIFF,v.THE TOWNSHIP OF PEMBERTON, THE ZONING BOARD OF ADJUSTMENT FOR THE TOWNSHIP OF PEMBERTON, DEFENDANTS
Haines, A.j.s.c.
[190 NJSuper Page 638]
T & M Homes sues the Township of Pemberton and its Zoning Board of Adjustment for compensatory and punitive damages claimed to result from the denial of a variance application. The suit is based upon the Civil Rights Act of 1871, 42 U.S.C. § 1983, constitutional violations being alleged. The Township moves for a partial summary judgment dismissing the claim for punitive damages. I reach the conclusion that the motion should be granted.
Under Newport v. Fact Concerts, Inc., 453 U.S. 247, 101 S. Ct. 2748, 69 L. Ed. 2d 616 (1981), the court held that "[b]ecause absolute immunity from such damages obtained at common law and was undisturbed by the 42d Congress, and because that immunity is compatible with both the purposes of § 1983 and general principles of public policy, . . . a municipality is immune from punitive damages under 42 U.S.C. § 1983". [at 271, 101 S. Ct. at 2762] The policy reasons set forth by the Court were:
(1) Punitive damages are a form of retribution the ill effects of which should be visited upon the wrong-doer, not the taxpayers; (2) the purpose of retribution is not served by permitting punitive damage awards against a municipality which cannot formulate the necessary intent to take the actions upon which damages are based; (3) deterrence, an important purpose of punitive damages, is not furthered by an award against a municipality; and, (4) the salutary effect occasioned by the imposition of such damages is far outweighed by their effect upon municipal resources. [at 266-271, 101 S. Ct. 2759-2762]
Fact Concerts did not decide whether a municipality could waive its immunity from punitive damages. The Township of Pemberton has agreed to hold harmless all of the individual members of its appointed boards from compensatory and punitive damage claims based upon constitutional violations. Plaintiff
[190 NJSuper Page 639]
argues that this agreement, effectively shifting ultimate liability to the municipality, constitutes a permissible waiver of immunity with respect to the present punitive damage claims.
The question is one of power. Do municipalities have the power to waive immunity from punitive damage claims? In my opinion, they do not. New Jersey municipalities have only such powers as are delegated to them by statute. West Point Island v. Dover Twp., 54 N.J. 339, 346 (1969). No statutory authority authorizes a municipality to waive its immunity from punitive damage claims. N.J.S.A. 59:10-4, part of our Tort Claims Act, is the only indemnification statute in point. It authorizes indemnification of "local public employees consistent with the provisions of this act." The Act, N.J.S.A. 59:10-1 expressly prohibits payment of punitive damages. Public policy is opposed to such waiver. The reasons are given in Fact Concerts. In addition, New Jersey does not permit a tortfeasor to shift the burden of punitive damages to an insurer. Variety Farms v. N.J. Mfrs. Ins. Co., 172 N.J. Super. 10, 24-25 (App.Div.1980). An indemnifying municipality is no different than an insurer in present circumstances.
Pemberton's indemnification ordinance, insofar as it refers to punitive damages, is unauthorized and therefore invalid.
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Yesterday I bought a book of Irish fiddle sheet music and started learning this song - way above my skill level? Probably, but I've been having fun dinking around with the first line before it gets to the mess of triplets. Anyway, I found this video on YouTube and wanted to share the song for those like me who've never heard it before. Also because check out the bow hold of the fiddler on the right. It's like he's basically holding it with two fingers. Plus his bow almost looks like a baroque bow to me - doesnt it look like it bends convex instead of concave? Crazy. But great song.
Yes that is an unusual looking bow and bow hold. How does he put enough pressure on it? Oh yea, pretty song too.
Opportunity is often missed because it wears suspenders and looks like hard work.
maybe the bow bending the other way puts enough of a tension on it that it doesn't require a lot of pressure to vibrate the strings? Take my word with a grain of salt since i really don't know anything about why a bow is shaped the way it is. lol. really neat though.
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President Muhammadu Buhari on Tuesday assured Nigerians that the nation would soon get out of recession and become great again.
Speaking during the grand rally of the All Progressives Congress (APC) for the Edo State governorship election scheduled to hold on Saturday, President Muhammadu Buhari on Tuesday, assured Nigerians that the nation would soon get out of recession and become great again.
Buhari, who had earlier paid a courtesy visit to the palace of the Edaiken N'Uselu and crown prince of Benin Kingdom, Eheneden Erediauwa, where he extolled the contributions of the former Oba of Benin, said the youth had a critical role to play in uniting the nation.
"We are a nation of great human and natural resources, especially the youth. Please, sit down and reflect and remember what I said 30 years ago. We have no other nation like Nigeria. We must all remain and salvage it together.
"I assure you we are going to get out of our economic doldrums. We are almost out of our insecurity problems and we are going to make Nigeria great again. We are going to be very proud of our country once again and our resources will not be for nothing; we will continue to be," Buhari said.
The APC rally, which was held under tight security at the Samuel Ogbemudia Stadium, was witnessed by APC governors, former and servicing National Assembly members, leaders of the party, including the National Chairman, Chief John Odigie-Oyegun, and serving ministers.
"Remember What I Said 30 Years Ago"? – Read What President Buhari Told Nigerians In Benin on Naijaloaded |/a>.


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https://www.myhrtoolkit.com/wp-content/uploads/2014/10/social-s.jpg 229 254 Bob Teasdale https://www.myhrtoolkit.com/wp-content/uploads/2015/09/myhrtoolkit-hrsoftware-logo1-300x78.png Bob Teasdale2014-10-21 09:07:202015-06-26 09:11:45How does HR use Social Media
How does HR use Social Media
Social Media in HR doesn't have to be a bad thing, there are many ways in which HR Managers can use social media.
Understanding the way empolyees use tools such as social media can encourage engagement and help them feel part of the company, and brand. HR managers can embrace social media for team building, recruiting, onboarding and even training.
When asked, most HR professionals feel that their use of HR will increase next year, so how does HR use Social Media?


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CANARA BANK RTGS HO Branch in BELGAUM - Address, IFSC, MICR Code
CNRB0005336MICR Code
MALLAPURA S AContact
CANARA BANK MAIN ROAD MALLAURA S A GOKAK BELGAUM MALLAPURA S A KARNATAKA 591101City
What is IFSC Code of CANARA BANK situated at MALLAPURA S A- RTGS-HO?
IFSC Code of CANARA BANK situated at MALLAPURA S A - RTGS-HO is
What is the meaning of IFSC Code, MICR Codes in Banking industry?
IFSC or Indian Financial System Code is the code allocated to all banks branches. Bank branches use this code to participate in RTGS and NEFT transactions.
What is the significance of IFSC Code and how we can use it?
IFSC Code is a 11 digit code and we can use this code to communicate between different branches of different banks. Upon receiving the request for fund transfer it is easy for a bank to identify the payee branch. First four characters are code of bank, last six digits are branch code and fifth character is left 0, for any future use.


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Machu Picchu & the Sacred Valley: 2-Day Tour from Cusco
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