text:
Division Highlights
You may view earlier Division Highlights here.
- We are pleased to announce that Steve Mitchell, MD, has been appointed to the role of Medical Director of the Harborview Emergency Department (HMC ED). As you know, Dr. Mitchell has served in the role of Acting Medical Director of the HMC ED for the past several years and he has been exceptional in this role, assisting in the development of important collaborations, in the implementation of a number of process improvements, representing Emergency Medicine extremely well throughout the institution, and serving as a true champion for all of our missions. We have made tremendous progress over the past several years and much of this is as a result of his steady leadership and dedication. Steve is highly deserving of this appointment and we are truly fortunate to have him in this role as we move forward.
- WELCOME: Please welcome Nicholas (Nick) Johnson, MD; Andrew Latimer, MD; and Laura Welsh, MD, as the newest members of the Emergency Medicine family. Click here to learn more about them.
- Congratulations to Doug Franzen, MD, MEd, for his online curriculum that teaches the FAST Examination to medical students, as part of the CDEM online curriculum. Click here to You can visit the site at https://cdemcurriculum.com/fast-examination/.
- Another KUDOS to Dr. Franzen, who was selected as a special Peer Reviewer for the WJEM Education supplement. Doug was selected for this based on "recognition as a leader in Emergency Medicine education."
- Kudos to David Townes, MD, MPH, DTMH, and to Russ McMullen, MD, MPH, Msc, who provided presentations at the 17th Update for Travel Medicine and Global Health sponsored by the UW School of Medicine. Dr. Townes gave presentations on the topics of Complex Humanitarian Emergencies and High Altitude Medicine, while Dr. McMullen presented on the topic of Post-Travel Medicine: GI Case Studies.
WELCOME: Please welcome Nicholas (Nick) Johnson, MD; Andrew Latimer, MD; and Laura Welsh, MD, as the newest members of the Emergency Medicine family:
Nick Johnson received his medical degree from UCSF in 2010, after which he completed emergency medicine residency training at the University of Pennsylvania, where he also served as Chief Resident. While a resident, Nick received the Academic Excellence Award from the Emergency Medicine Residents' Association (EMRA) as well as the Penn Pearls Medical Student Teaching Award. Dr. Johnson's interest in critical care medicine became apparent during residency, where he served as Small Group Leader for the Reinventing Resuscitation Course and engaged in several research projects resulting in publications focused on pre-hospital care, acute lung injury, and ED factors associated with survival after sudden cardiac arrest. Following residency training, Nick was accepted into the highly competitive University of Washington Critical Care Medicine fellowship, where he has continued to be a stand-out. As a fellow, he was nominated as the Outstanding Consultant of the Year by the Division of Emergency Medicine; he has been recognized by our own residents as an exceptional teacher; and he has continued as an active and productive researcher. His two most recent publications are focused on factors influencing neurologic outcome following cardiac arrest.
Johnson NJ , Dodampahla K, Rosselot B, Perman SM, Mikkelsen ME, Goyal M, Gaieski DF, Grossestreuer AV. "The association between arterial oxygen tension and neurological outcome after cardiac arrest." Therapeutic Hypothermia and Temperature Management . 2016 Jul 6. [Epub ahead of print]. PMID: 27383062.
Johnson NJ , Rosselot B, Perman SM, Dodampahla K, Goyal M, Gaieski DF, Grossestreuer AV. "The association between hemoglobin concentration and neurologic outcome after cardiac arrest." Journal of Critical Care . In press. Accepted 8 July 2016.
Nick has served on the AHA council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation (3CPR) and Young Investigators' Section, as Vice Chair and Chair of the Critical Care Division of EMRA, and is currently Director of the Critical Care Fellowship Lab for Academic Life in Emergency Medicine Fellowship Incubator. Nick will split his clinical time between the HMC ED and the HMC ICUs. He has also been appointed as the Associate Program Director of the University of Washington Critical Care Medicine Fellowship for Emergency Medicine residency graduates. He will also serve on Critical Care Advisory Council at HMC as the HMC emergency medicine representative.
Andrew Latimer joins the UW Division of Emergency Medicine as our second EMS fellow. Dr. Latimer received his medical degree from the University of Michigan in 2012, after which he completed emergency medicine residency training at the University of Cincinnati. Andrew's interest in EMS began even before medical school, while he was an undergraduate at the University of Washington. During that time he worked as an EMT for Rural Metro Ambulance and for the Vashon Island Fire and Rescue with King County Fire District 13. He remained active in EMS while in residency, where he served as the Resident Assistant Medical Director for University of Cincinnati Air Care and Mobile Care, as Assistant Medical Director for Colerain Township Department of Fire and EMS, and as a SWAT Team Tactical Physician and Resident Medical Director for the Cincinnati Policy Department SWAT Team. Andrew has presented nationally at the Air Medical Transport Conference (AMTC) two years in a row and has been the recipient of the Jean Hollsiter Hollister EMS Award from the EMRA, as well as the MedEvac Foundation International Medical Transport Leadership Institute (MTLI) Scholarship. Most recently, Andrew was awarded the 2016 NAEMPS/Physio-Control EMS Fellowship.
Laura Welsh joins the UW Division of Emergency Medicine as a Medical Education Research Fellow; this is the fourth year of this fellowship program. Dr. Welsh received her Medical Degree from the University of Massachusetts in 2012, after which she completed emergency medicine training at the Harvard Affiliated Emergency Medicine Residency program, where she also served as Chief Resident. Laura's interest in and enthusiasm for medical education began to blossom during residency training. While at Harvard, she founded and served as Editor-In-Chief of the EMRA's EM Fundamentals (Emergency Medicine Residency Association), a resident guidebook addressing common chief complaints. She also participated in a medical simulation elective at Brigham and Women's Hospital, and later served as an instructor for medical students. She states that that the activity that was most influential in her decision to pursue a medical education fellowship was her role as cCo-Cchair of the Harvard EM Residency Curriculum Steering Committee. Most recently, Laura was selected for and attended the Harvard Macy's Program for Post-Graduate Trainees: Future Academic Clinician-Educators. On a national level, Dr. Welsh has been a Reviewer for MedEd Portal Publications and is currently serving as a Resident Member for the Individualized Interactive Instruction Task Force of the Council of Emergency Medicine Residency Directors (CORD).
Congratulations to Elizabeth Dorn, MD, DTMH, and Martin Makela, MD, who have been promoted to Clinical Associate Professor. Click here to learn more.
Congratulations to Raj Trivedi, MD, who was selected to serve on the HMC Medical Executive Board (MEB) as an At-Large Member. The MEB serves as the Board of Trustees Executive Committee of the Medical Staff, serving as liaison between the Medical Staff, Administrative Staff, the Board of Trustees, and the Dean of the School of Medicine. Dr. Trivedi has worked tirelessly as the Director of Quality Improvement and Patient Safety (QIPS) for the HMC ED, significantly enhancing our review processes. His efforts have resulted in the implementation of a number of important process improvement initiatives within the ED. Additionally, with his objective, detail-oriented, steady, and consistent approach, he has been highly effective in his advocacy for enhanced processes for emergency medicine patients across the broad range of disciplines within HMC. In his role as Director of QIPS, he has also provided excellent representation for Emergency Medicine at the Medical Quality Improvement Committee for Harborview Medical Center, as well as on the Trauma Council. Dr. Trivedi is highly deserving of this position and along with Steve Mitchell, MD, will represent our division well.
Congratulations to Lauren Whiteside, MD, MS; Rose Fernandez, MD; R4 (graduate) Justin Bammer, MD; and Graham Nichol, MD, MPH, for their recent publication, "Perception of the Risks of Ebola, Enterovirus-E68 and Influenza among Patients Presenting to the ED," in the Western Journal of Emergency Medicine. These authors surveyed ED patients to assess how public perception of influenza severity and risk of infection related to more publicized but less common emerging infectious diseases, such as Ebola Virus Disease (EVD) and enterovirus (EV-68). In this study, public perception of risk for these infectious diseases was discordant with the actual risks. Just as significant--despite appropriate concern for influenza--only 48% of study participants had received an influenza vaccine.
Kudos to Marie Vrablik, MD, MCR, who is a co-author on the publication, "Development of an Emergency Department Trigger Tool Using a Systematic Search and Modified Delphi Process," in the Journal of Patient Safety. This team of investigators sought to develop an ED trigger tool to improve the identification of adverse events in the ED and that might be used to direct patient safety and quality improvement.
Congratulations to Graham Nichol, MD, MPH, for his recent article in Resuscitation entitled, "Ischemia reperfusion injury as a modifiable therapeutic target for cardioprotection or neuroprotection in patients undergoing cardiopulmonary resuscitation." These authors provide an eloquent review of the cellular changes that occur with reperfusion and discuss pharmacologic and ischemic conditioning and the use of hypothermia for this setting.
Congratulations to Elizabeth Dorn, MD, DTMH, and Martin Makela, MD, who have been promoted to Clinical Associate Professor.
Dr. Makela: After graduating from medical school at the University of Washington in 1995, Dr. Makela went on to complete a Transitional Internship at Tripler Army Medical Center and then became a Naval Flight Surgeon. He completed residency in Emergency Medicine at the Naval Medical Center in San Diego in 2004, after which he continued to serve in the Navy including deployment to Iraq from 2006-2007 where he served as Officer in Charge of a Shock Trauma Platoon at Camp Fallujah. Dr. Makela received numerous awards for his dedicated service including the Bronze Star and the Navy Air Medal. Dr. Makela joined the UW Division of Emergency Medicine in 2008 and has served as Medical Director of the UWMC Emergency Department since 2011. Dr. Makela has been exceptional in this role, overseeing many operational and process improvement initiatives. Dr. Makela has received many awards since joining the UW faculty, both service and teaching related. He is a four-time recipient of the Golden Apple Award for Excellence in Teaching from the MEDEX Northwest program, an unprecedented accomplishment. He is also a recipient of the UW CARES award and the Patient Safety Hero Award, both from UWMC. Dr. Makela was named as a Seattle Magazine Top Doctor in both 2014 and 2015, and can be described as the consummate patient and safety/quality advocate. He is always ready to volunteer. On his own accord, he developed a program to deter and increase awareness of the dangers of binge drinking among our UW college students. On a yearly basis, he provides a "Binge Drinking Awareness" presentation to over 1,000 UW fraternity and sorority members.
Dr. Dorn: Dr. Dorn graduated from the University of Washington School of Medicine in 1995. During medical school, she was awarded the Lyons Fellowship for Retinal Research within the Department of Biostructure at the UW and conducted and performed retinal research from 1992-1995. Following medical school, Dr. Dorn completed a medical/surgical Internship at Virginia Mason Medical Center, where she "got the bug" for emergency medicine. She then completed emergency medicine residency training at Alameda County Medical Center (Highland) in Oakland, California. Dr. Dorn remained as faculty in Oakland, working at both Kaiser Oakland and at Alameda County Medical Center until 2003, when she moved back to Seattle and worked as an emergency physician at Providence Hospital (now Swedish Cherry Hill) for several years before joining the UW faculty full-time. Dr. Dorn has been a tremendous member of the Division of Emergency Medicine where she is an enthusiastic and beloved teacher. Dr. Dorn consistently arrives at her ED shifts prepared to provide a mini lecture for all ED learners, always being intentional about bringing residents and medical students into interesting cases. Dr. Dorn has been a consistent and highly valuable contributor to many of our ED initiatives. She has been the editor of the HMC Wiki since 2013 and an OCCAM (Online Clinical Care Advisories & Messages) Editor since 2015. Dr. Dorn also shares her medical expertise globally. She has been active in international health efforts since 1989. Most recently, she has served as the Education and Medical Care Director with the Global Health Ministry in Escquipulas, Guatemala, since 2010. In that role she works with and trains health care providers in coordination with local physicians. She has helped lead the efforts to provide primary care and access to tertiary care for a network of rural villages in the province. Also as part of this program, she has developed a wound care clinic that facilitates telemedicine review of cases. As of 2013, she also began working with the University of San Carlos to bring medical students to this rural region in need.
Kudos to Adeyinka Adedipe, MD, who was nominated to the Alpha Omega Alpha Honor (Medical) Society (AΩA) by the medical students of the University of Washington School of Medicine. Dr. Adedipe was selected based on "his high academic achievement and demonstration of leadership, professionalism, research, teaching and service."
Congratulations to Marie Vrablik, MD, MCR, and Rose Fernandez, MD, who were awarded a grant from the Washington State Safety and Health Investment Projects. Their proposal, "Preventing Violence against Emergency Department Healthcare Workers: A Prospective Needs Assessment to Inform Effective Intervention," addresses a significant national safety issue. Drs. Vrablik and Fernandez will conduct a four-site (Harborview Medical Center, University of Washington Medical Center, Valley Medical Center, and Providence Regional Medical Center -Everett) prospective assessment of violence against providers and health care workers in the ED and the impact on the victims.
Congratulations to M. Kennedy Hall, MD, MHS, for his publication, "Impact of Point-of-Care Ultrasonography on ED Time to Disposition for Patients with Nontraumatic Shock," in the American Journal of Emergency Medicine. This was a retrospective study that evaluated the effect of the use of POCUS on time to disposition request, using data from four emergency departments in Connecticut.
Kudos to Sachita Shah, MD, for her publication, "Focused Cardiopulmonary Ultrasound for Assessment of Dyspnea in a Resource-limited Setting," in Critical Ultrasound Journal. The authors assessed the accuracy of emergency providers in performing cardiopulmonary ultrasound (CPUS) after a training intervention in a limited-resource setting.
Congratulations to Jeff Riddell, MD, for his recent publication in the Annals of Emergency Medicine entitled, "Alternatives to the Conference Status Quo: Addressing the Learning Needs of Emergency Medicine Residents." Dr. Riddell and his co-authors "describe the design and implementation of structural changes to a residency's didactic conferences using methods based in educational theory and derived principles, and detail the experience of a four-year emergency medicine residency program piloting a new curriculum to better adapt conference education to the learning needs of its residents."
Congratulations to Alisha Brown, MD, and Jeff Riddell, MD, who have completed the University of Washington Teaching Scholars Program. Drs. Brown and Riddell continue their work focusing on the use of social media as an educational tool.
A special recognition to the EM Ultrasound team and Amy Morris from PCCM. As a team, they were significant contributors at the recent American Society of Echocardiography Annual Convention held at the Washington State Convention Center. Drs. Adeyinka Adedipe, M. Kennedy Hall, Brandon Backlund and Sachita Shah provided several lectures and hands-on instruction at this conference.
Please congratulate Stephen Morris, MD, MPH; R3 Marlee Hahn, MD and R3 Brandy Cluka, MD, on their publication, "A Multisource Derivation of Guidelines for Education and Screening for Human Trafficking in the Emergency Department." Their article addresses an significant international public health issue and proposes a series of guidelines for an emergency medicine curriculum in identifying victims of human trafficking.
Kudos to Stephen Morris, MD, MPH, and Elizabeth Dorn, MD, DTMH, for their publication, "Emergent Radiation Therapy As Definite Airway Management for Dyspnea with Mediastinal Mass" in the American Journal of Emergency Medicine. Drs. Morris and Dorn describe a case where a patient with a large mediastinal mass with respiratory compromise was successfully treated with steroids and emergent radiation therapy, thus avoiding intubation.
Congratulations to many of our EM faculty, who will be teaching Intersession courses for the School of Medicine in the upcoming academic year. For a complete list of the approved courses, click here.
Kudos to Jamie Shandro, MD, MPH, who was selected by the UW School of Medicine Class of 2016 as the recipient of the Clinical Distinguished Teacher Award. This award is presented to two UW clinical faculty members and one basic science faculty member as recognition of their exemplary teaching. Dr. Shandro will receive her award at the 67th Annual Physician's Oath and Hooding Ceremony at Benaroya Hall on Friday May 27, 2016.
Congratulations to Kathy Jobe, MD, on her recent PRAISE Award. PRAISE Award winners serve as role models, setting a valuable example in excellent communication to their fellow physicians. The PRAISE Award is given quarterly to physicians, PAs and ARNPs who meet or exceed the UW Medicine goal for patient satisfaction scores.
Congratulations to Lauren Whiteside, MD, MS, on her recent acceptance into the Missouri Institute of Mental Health (MIMH), VA, and National Institute on Drug Abuse (NIDA)-funded Implementation Research Institute fellowship through the Center for Mental Health Services Research (CMHSR), at Washington University's George Warren Brown School of Social Work. Dr Whiteside will participate as a scholar in drug abuse. You can read more about the Implementation Research Institute here.
Congratulations to Marie Vrablik, MD, MCR, who has now completed the University of Washington and Seattle Children's Certificate in Patient Safety Program. Dr. Vrablik's project for this program was entitled "Time and Workflow Barriers to Obtaining a Spine MRI from the Emergency Department." Co-authors of this project include Steve Mitchell, MD; Tak Watase, MD; Karl Jablonowski, MS; and Ken Linnau, MD.
Kudos to Doug Franzen, MD, MEd, who has now completed his year as president of the Clerkship Directors in Emergency Medicine (CDEM). CDEM is an academy representing the interests of undergraduate medical educators in emergency medicine.
Congratulations to Alex St John, MD, MS, and Nathan White, MD MS, who had two proposals selected for funding by the Defense University Research Instrumentation Program (DURIP). The award, entitled "An Integrated Coagulation Testing System for Military Health Research," will further the Division of Emergency Medicine Research Laboratory (EMRL) capabilities in the study of trauma-induced coagulopathy. The award, entitled "An Advanced Ultrasound System for Military Health Research," will allow the pursuit of two additional lines of trauma resuscitation research.
Kudos to Herbie Duber, MD, MPH, who is co-investigator of two new grants. The first, "Methodologies to Enhance Understanding of HIV-Associated Social Determinants," is a novel approach to social determinants for HIV using a big data approach. The second, "Implementation of the Global Fund's Programmatic Quality Assurance and Improvement," is a project designed to implement a QI program for Global Fund programs in countries of interest.
Congratulations to David Townes, MD, MPH, DTMH for being featured as a panelist at the 13th Annual Western Regional International Health Conference, which was held in April at the University of Washington. Dr. Townes contributed to the discussion with a presentation entitled "Where Minds and Money Meet: The Policies and Economics of Health Aid in All Forms: How to Strive for Effective Investment to Improve Health."
Congratulations to Josh Jauregui, MD; Medley Gatewood, MD; Jon Ilgen, MD, MCR; and Jared Strote, MD, MS, for their original research study, "Emergency Medicine Resident Perceptions of Medical Professionalism," which was recently published in the Western Journal of Emergency Medicine.
Kudos to Nathan White, MD, MS; Xu Wang, MD; Alex St John, MD, MS, and the entire lab team for their recent article, "Post-Translational Oxidative Modification of Fibrinogen is Associated with Coagulopathy after Traumatic Injury," which was published in Free Radical Biology and Medicine.
Congratulations to Lauren Whiteside, MD, MS, who is co-author of the article, "An Effectiveness-Implementation Hybrid Trial Study Protocol Targeting Posttraumatic Stress Disorder and Comorbidity," in the journal Implementation Science.
Kudos to Kennedy Hall, MD, MHS, who is co-author of the article, "Despite Federal Legislation, Shortages of Drugs Used in Acute Care Settings Remain Persistent and Prolonged," recently published in Health Affairs. This article was covered by the Health News from NPR: Shortages Grow For Lifesaving ER Drugs, Study Finds : Shots - Health News : NPR
Congratulations to Matt Valento, MD, for his publication, "A Retrospective Study of Clinical Effects of Powdered Caffeine Exposures Reported to Three US Poison Control Centers," in the Journal of Medical Toxicology.
Kudos to Rose Fernandez, MD, who is the recipient of the 2016 Academy for Women in Academic Medicine (AWAEM) Award for Outstanding Achievement in Research. "The AWAEM Research Award recognizes a woman faculty member whose outstanding achievements have promoted research and scholarly discovery in Emergency Medicine (EM). Accomplishments of the winner of this award should have had significant impact on advancing knowledge about a focused area of Emergency Medicine." Dr. Fernandez's research and contributions in the area of medical education/simulation and patient safety have been many and significant, bringing her national recognition. She has served as Inaugural Chair of the SAEM Simulation Academy from 2009-2011, and she was former chair from 2011-2012. She has been a member of the National Patient Safety Foundation and the Emergency Medicine Patient Safety Foundation since 2009. Dr. Fernandez has also been an Ad Hoc Reviewer on the Special Emphasis Panel for the US Agency for Healthcare Research and Quality (AHRQ), for the US Army Medical Research Materiel Command Medical Training and Health Information Sciences Research Program, and for the Department of Defense Medical Research and Development Program. She also serves on the Editorial Board of Simulation in Healthcare, and is Deputy Editor of Teaching and Learning in Medicine. She is author of several high-impact publications and has been an invited speaker at numerous national conferences focused on simulation in medical education, effective teamwork, and patient safety.
Congratulations to Tak Watase, MD MBA, and Melissa Halliday, DO, who are the recipients of the UW PRAISE (Patient Reported Assessment in Satisfaction and Excellence) Award. PRAISE award winners serve as role models, setting a valuable example in excellent communication to their fellow physicians. The PRAISE Award is given quarterly to physicians, PAs and ARNPs who meet or exceed the UW Medicine goal for patient satisfaction scores. Recipients have been rated among the top in the nation for their listening and communication skills.
Kudos to Amber Sabbatini, MD MPH, and colleagues for their recent article, "Transitional Care Clinics [TCC] for Follow-Up and Primary Care Linkage for Patients Discharged from The ED" (Elliott K, W Klein J, Basu A, Sabbatini AK, Am J Emerg Med. 2016 Mar 15). Dr. Sabbatini and coauthors evaluated the patient factors associated with completion of a follow-up transitional care clinic visit (using the HMC After Care Clinic program) and the impact of completion of such a visit on subsequent ED use. Their data demonstrated a reduction in ED use in the subsequent year by those patients who completed these appointments, suggesting a role for TCC in ensuring better continuity and access to necessary health care.
Congratulations to Herbie Duber, MD, MPH, for his recent publication, "Evaluating Facility-Based Antiretroviral Therapy [ART] Program Effectiveness: A Pilot Study Comparing Viral Load Suppression and Retention Rates" (Duber HC, Robert A, Ikelezi G, Fullman N, Gasasira A, Gakidou E, Levine A, Achan, Trop Med Int Health. 2016 Mar 21). Dr. Duber and co-authors assessed the use of cross-sectional viral load measurements among HIV-infected patients receiving ART as an additional measure of facility performance. Their data showed a lack of correlation between various outcome measures, suggesting the need for additional research to evaluate ART program effectiveness at health facilities in sub-Saharan Africa.
Kudos to Kennedy Hall, MD, for two recent publications:
- In the article, "Prediction of In-hospital Mortality in Emergency Department Patients with Sepsis: A Local Big Data-Driven, Machine Learning Approach," published in Academic Emergency Medicine (Taylor RA, Pare JR, Venkatesh AK, Mowafi H, Melnick ER, Fleischman W, Hall MK. Acad Emerg Med. 2016 Mar; 23(3): 269-78), Dr. Hall and his co-authors demonstrate how machine learning might be used to better predict hospital mortality related to sepsis as compared to traditional clinical decision rules. This article was highlighted in the UW Daily and the UW Health Sciences News Beat.
- In the article, "Cost-effectiveness of the Cardiac Component of the Focused Assessment of Sonography in Trauma Examination in Blunt Trauma" (Hall MK, Omer T, Moore CL, Taylor RA. Acad Emerg Med. 2016; Apr; 23(4): 415-23), Dr. Hall and colleagues use decision analysis to evaluate the cost effectiveness of the cardiac component of the FAST exam in the evaluation of hypotensive and normotensive blunt trauma patients.
- Dr. Hall and team (Applied Physics Lab and Urology) were also featured on the Applied Physics Laboratory website for their novel stone-pushing technology.
Kudos to the following faculty and residents who submitted proposals for the recent UW Medical Student Intersession program. Kudos as well to Doug Franzen, MD; Jon Ilgen, MD; and Jamie Shandro, MD, for coordinating this process.
- Michael Vrablik, MD – "Emergency Medicine Point-of-Care Ultrasound"
- Matthew Valento, MD - "Electrons to the Emergency Department: The Cellular Biology of Poisons"
- David Townes, MD; Herbie Duber, MD; Stephen Morris, MD; Jeremy Hess, MD; and Sachita Shah, MD – "Introduction to Humanitarian Emergencies"
- Jared Strote, MD; EM3 Bjorn Watsjold, MD – "Ethics in Emergency Medicine"
- Jeff Riddell, MD; Alisha Brown, MD; Annie Chipman, MD; Joshua Jauregui, MD – "The Physician Online: Mindful Use of Digital Media"
- Joshua Jauregui, MD; Jamie Shandro, MD - "Resuscitation"
Kudos to Martin Makela, MD, who was recently selected as a "2016 UWMC Patient Safety Hero," an award given to UWMC faculty and staff who "go above and beyond for patient safety and wellness." Dr. Makela is one of 13 individuals who will be honored at the 2016 UWMC Patient Safety Heroes celebration on March 15, 2016.
Congratulations to Alisha Brown, MD, who won the Best Faculty Discussant Award in her category at the March annual meeting of the Emergency Medicine Council of Residency Directors (CORD), held this year in Nashville.
Kudos to Fiona Gallahue, MD, FACEP, who was once again elected to the CORD Board of Directors. Dr. Gallahue has served the organization for many years. Her leadership, passion, and dedication to residency education will continue to be a great asset to CORD as they continue to advance emergency medicine education into the future.
Congratulations Lauren Whiteside, MD, MS, who is co-Investigator on the grant, Helping Individuals with Firearm Injures: A Cluster Randomized Trial, whose aim is to test the effectiveness of a multicomponent intervention aimed at reducing mortality and morbidity among patients who present to Harborview Medical Center with a gunshot wound. This project is funded through the City of Seattle, the U.S. Department of Justice, and the Center for Gun Responsibility. The Primary Investigator is Ali Rowhani, MD, from the UW Department of Epidemiology. Other Co-investigators include Fred Rivara, UW Department of Pediatrics, and Kevin Haggerty, UW School of Social Work.
Kudos to David Townes, MD, MPH, DTM&H, who was featured in UW Medicine INSIGHT. Dave gave a heartfelt interview in Teaching Moments: An Interview with David Townes.
Congratulations to Amber Sabbatini, MD, MPH, whose article, "In-Hospital Outcomes and Costs among Patients Hospitalized during a Return Visit to the Emergency Department," was recently published in JAMA. Dr. Sabbatini and her colleagues used data from the Healthcare Cost and Utilization Project to evaluate clinical outcomes and costs for adult patients who were hospitalized when returning after a previous ED visit. Data from their study contradict the presumption that these patients would have worse outcomes and greater costs of care. This study has significant implications for future quality measures. Dr. Sabbatini's article was featured in UW Health Sciences' Newsbeat with an editorial discussing the implications of the study.
Kudos to EM4 Hayes Wong, MD, and Steve Mitchell, MD, for their publication, "Survey of Ebola Preparedness in Washington State Emergency Departments," in Disaster Medicine and Public Health Preparedness. This study evaluated the perceived challenges and attitudes of Washington State ED medical directors in developing EVD preparedness programs for their hospitals.
Congratulations to Steve Mitchell, MD, for his publication, "Head-Elevated Patient Positioning Decreases Complications of Emergent Tracheal Intubation in the Ward and Intensive Care Unit," in Anesthesia-Analgesia. Investigators performed a retrospective study which demonstrated that, in emergent situations, back-up head elevated positioning was associated with a decrease in complications related to tracheal intubation. Dr. Mitchell's manuscript won the Article of the Month award for the journal.
Kudos to Amy Betz, MD, for her two recent publications in emDocs: (1) "Maximizing the 'Safe' Discharge," and (2) "Unexplained Abnormal Vital Signs on Discharge / Unexplained Deaths after Discharge: What Can We Do Better?" Congrats to Dr. Betz, who continues to push us to provide safer care for our patients through transitions of care.
Congratulations to Adeyinka Adedipe, MD, on his promotion to Associate Professor. Dr. Adedipe joined the UW Division of Emergency Medicine in 2008 and has been instrumental in the development of Point of Care Ultrasound within the ED, has developed a rigorous educational and QA program, and has effectively represented Emergency Medicine institution-wide through his work on the Institute for UW Simulation and Interprofessional Studies Point-of-Care Ultrasound Committee. Dr. Adedipe served on the UW School of Medicine Curriculum Renewal Committee's Subcommittee on Career Exploration and Focus, and he currently serves on the Editorial Board of the Journal of Emergency Medicine and Critical Care. He is also an Associate Member of the Harborview Injury Prevention and Research Center. Dr. Adedipe was the recipient of the Service Excellence Award from UWMC in 2009, received the UW Medicine PRAISE Aware in 2014, and was named a Top Doctor in the Seattle Metropolitan Magazine in 2014.
Congratulations to Medley Gatewood, MD, on his promotion to Associate Professor. Dr. Gatewood joined the UW Division of Emergency Medicine in 2005 as an Acting Instructor and was appointed as Assistant Professor in 2008. He has served as the Director for Quality Improvement and Patient Safety (QIPS) for the UWMC ED since 2009. Dr. Gatewood has facilitated the development and implementation of a number of process improvement projects including those related to management of the acute stroke patient, sepsis, and STEMI. Dr. Gatewood's scholarship has also been focused in the area of quality, most recently being published in the BMJ of Quality and Safety for his article entitled, "A Quality Improvement Project to Improve Early Sepsis Care in the Emergency Department." He has received the UWMC ED Teacher of the Year for Madigan – University of Washington Affiliated Residency in Emergency Medicine in 2005 and 2006 and the UWMC ED Teacher of the Year Award for the UW EM Residency program in 2013. He was rated as a "Top Reviewer" of over 700 peers by the Western Journal of Emergency Medicine and named one of Seattle's Top Doctors in Seattle Metropolitan Magazine in 2013 and 2014.
Congratulations to Jon Ilgen, MD, MCR, on his promotion to Associate Professor. Dr. Ilgen came to the UW Division of Emergency Medicine in 2010 following completion of his Emergency Medicine Education Research Fellowship at Oregon Health and Science University (OHSU). While at OHSU, he completed a Master's in Clinical Research and was part of an AHRQ T32 Research award investigating an online diagnostic reasoning assessment tool. Since joining the UW Division of Emergency Medicine, Dr. Ilgen has continued to follow his passion for medical education research with a specific focus on the development and promotion of diagnostic reasoning skills and the study of assessment tools to measure educational outcomes. His publications appear in medical education high-impact journals such as Medical Education and Academic Medicine. Two of his manuscripts have been cited as among the year's best emergency medicine education research publications in Academic Emergency Medicine Journal. He has been an Associate Editor of the Journal of Graduate Medical Education since 2014 and was recently appointed as an Associate Editor of Academic Emergency Medicine Education and Training. In addition to these scholarly pursuits, Dr. Ilgen has been a superb educator and mentor for students, residents and fellows. He is the founder and Director of the UW Division of Emergency Medicine Medical Education Research Fellowship and in this role has provided exceptional mentorship and guidance to the fellows.
Congratulations to EM1 Ben Friedman, MD; EM1 Rachel Harper, MD; Ari Glucksberg, ARNP; and Jared Strote, MD, MS, for their recent publication, "In the Limelight," in the Journal of Emergency Medicine. Discussed is a case of phytophotodermatitis.
Congratulations to EM2 Andrew Lim, MD; Melissa Halliday, MD; and to our colleagues in Pulmonary and Critical Care (Kristina Rudd, MD) and the Department of Laboratory Medicine (John Hess, MD) for their case report, "Hepatic Abscess-Associated Clostridial Bacteraemia Presenting with Intravascular Haemolysis and Severe Hypertension," in BMJ Case Reports.
Congratulations to Stephen Morris, MD, MPH, for his publication, "Emergency Medicine Resident Rotations Abroad: Current Status and Next Steps," in Western Journal of Emergency Medicine, Volume 17, Issue 1, 2016. Dr. Morris' article evaluates content and didactic training for EM resident rotations in global health.
Kudos to Fiona Gallahue, MD, for her publication, "Handoff Practices in Emergency Medicine: Are We Making Progress?" in Academic Emergency Medicine. Dr. Gallahue's article looks at the state of handoff training within Emergency Medicine residency training programs in the United States.
Congratulations to Graham Nichol, MD, MPH, on being named by ThomsonReuters, a global news and information company, as among the most influential scientists of 2015. See the UW Health Sciences and affiliated researchers on HSNewsBeat.
Jeremy Hess, MD, MPH was recently appointed as the Co-Director of the UW Center for the Health and the Global Environment (CHanGE). The Center for Health and the Global Environment, among other things, "collaboratively develops and promotes innovative approaches to understanding and managing the risks of global environmental change." You can read more about CHanGE by clicking here.
Dr. Hess is also is co-author of two recent publications:
- Vins H, Bell J, Saha S, Hess JJ. The mental health outcomes of drought: A systematic review and causal process diagram. International Journal of Environmental Research and Public Health. 2015, 12(10): 13251-13275. doi: 10.3390/ijerph121013251.
- Hess JJ, Wallenstein J, Ackerman JD, Akhter M, Ander D, Keadey MT, Capes JP. Scribe impacts on provider experience, operations, and teaching in an academic emergency medicine practice. Western Journal of Emergency Medicine. 2015, 16(5): 602-601. doi: 10.5811/westjem.2015.6.25432
Dr. Hess presented at the Annual Conference of the International Society for Exposure Science in Henderson, Nevada, in October. His presentation was entitled, "Assessing Heat Exposure in Ahmedabad, Gujarat, India: A work in Progress."
Kudos to Herbie Duber, MD, MPH, who will be serving as the Principal Investigator on the HeartRescue Evaluation Project in China and India, sponsored by Medtronic Philanthropy. Dr. Duber will be leading the evaluation component of the Global HeartRescue program. RTI, an international organization collaborating with the University of Illinois Chicago, the University of Arizona, and other China- and India-based implementation partners, will be initiating interventions aimed at improving STEMI (heart attack) and OHCA ("out-of-hospital cardiac arrest") care in cities within those countries. The University of Washington's Department of Global Health / Institute for Health Metrics and Evaluation will evaluate the impact of those interventions and help implementers identify an appropriate path forward for more geographically widespread improvements in STEMI and OHCA care. The project is anticipated to run through 2019.
Kudos to Jeremy Branzetti, MD, and to a former EM faculty member, Dave Lu, MD, for their recent publication in the Western Journal of Emergency Medicine, "Impact of Burnout on Self-Reported Patient Care among Emergency Physicians."
Kudos to Doug Franzen, MD, MEd, for his publication, "Mind the Gap: The Bumpy Transition from Medical School to Residency" in the December 2015 issue of the Journal of Graduate Medical Education. The article addresses the challenges of developing an educational continuum from undergraduate medical education to graduate medical education for students and resident trainees.
Congratulations to Jared Strote, MD MS, who was awarded a grant from the Medic One Foundation to support his project, "Law Enforcement Calls for Emergency Medical Services Assistance: Defining the Patient Population."
Kudos to Graham Nichol, MD MPH, who was quoted in the New York Times about CPR Survival Rates. Click here to see the article.
Congratulations to Medley Gatewood, MD, for his recent publication in BMJ Quality and Safety, "A Quality Improvement Project to Improve Early Sepsis Care in the Emergency Department." This paper describes the results of the sepsis intervention implemented at UWMC.
Kudos to Kennedy Hall, MD, for two recent publications in Academic Emergency Medicine, both from the Academic Emergency Medicine (AEM) Consensus Conference: "Emergency Department Diagnostic Imaging: The Journey to Quality" and "Comparative Effectiveness Research: Alternatives to "Traditional" Computed Tomography Use in the Acute Care Setting."
Congratulations to Amber Sabbatini, MD, MPH, for her recent publication in Academic Emergency Medicine and from the AEM Consensus Conference, "Optimizing Patient-Centered Communication and Multidisciplinary Care Coordination in Emergency Diagnostic Imaging: A Research Agenda."
Kudos to Fiona Gallahue, MD, and Amy Betz, MD, for their article, "Ready for Discharge? A Survey of Discharge Transition of Care Education and Evaluation in Emergency Medicine Residency Programs," published in the Western Journal of Emergency Medicine.
Congratulations to Nathan White, MD MS; Alex St. John, MD; Xu Wang, MD; and Esther Lim, BS, for their publication, "Self-propelled Particles That Transport Cargo through Flowing Blood and Halt Hemorrhage," in the October 2015 edition of Science Advances.
The UW Division of Emergency Medicine had a strong presence at the American Heart Association (AHA) Resuscitation Science Symposium in Orlando in November, 2015. Kudos to the following EM participants and their presentations/achievements:
- Graham Nichol, MD, MPH: "Cardiac Resuscitation Systems of Care."
- Michael Sayre, MD, panel discussion moderator, "Resuscitation Guidelines 2015."
- Nathan White, MD, MS: "Platelet Force Measurements Are Predictive of Triage Category and Blood Transfusion after Trauma," with UW co-authors Esther Lim, BS; Xu Wang, MD; & Diana Chien, BS.
- Nathan White, MD, MS: "Personalized Hemorrhage Resuscitation."
- Matthew Gittinger, MD; Sarah M Brolliar, BS, MPH; Graham Nichol, MD, MPH; and Rosemarie Fernandez, MD: "Impact of an Automated Chest Compression Device on Team Communication during Simulated Cardiac Arrest Resuscitations - A Pilot Study."
- Heemun Kwok, MD, MS: "A Method for Real-Time CPR Detection from the Thoracic Impedance Signal."
Kudos to Melissa Halliday, DO, who is a recent recipient of the UW Medicine PRAISE Award. The PRAISE Award —"Patient Reported Assessment In Satisfaction and Excellence"— recognizes physician excellence in patient communication and leadership and is presented biannually to UW Medicine healthcare providers for meeting or ranking above the 80th percentile in their listening and communication skills.
Kudos to Graham Nichol, MD, who is featured in the UW Health Science News Beat and is first author on the November 9, 2015, NEJM article, "Trial of Continuous or Interrupted Chest Compressions during CPR." Co-authors of this landmark article include Dr. Tom Rea, UW Division of General Internal Medicine, and Dr. Peter Kudenchuk, Division of Cardiology.
Kudos to Herbie Duber, MD, MPH, for his recent three publications, two of which are focused on antiretroviral therapy and the third on the global burden of disease. You may view the articles on antiretroviral therapy here and here, and the global burden of disease here.
Kudos to Betty Chen, MD; Steven Bright, MD; Amit (Raj) Trivedi, MD; and Matt Valento, MD, for their publication in Clinical Toxicology, "Death Following Intentional Ingestion of E-Liquid," an interesting discussion on nicotine toxicity and the potential increase of abuse with the introduction of e-cigarettes.
Kudos to Matt Valento, MD, for his publication, "Digoxin-Specific Antibody Fragment Dosing: A Case Series" in the most recent American Journal of Therapeutics. The article offers a retrospective analysis of digoxin poisoning and empiric dosing of digoxin-specific antibody fragments. Dr. Valento was also an invited expert panelist at the North American Congress of Clinical Toxicology (NACCT), which held its 2015 meeting in San Francisco from October 8-12, 2015.
Congratulations to Heemun Kwok, MD, MS, who has been selected as a methodologist for the American College of Emergency Physicians (ACEP) Clinical Policies Committee which is responsible for the publication and dissemination of clinical policies that shape the practice of Emergency Medicine. Dr. Kwok joins an elite group of methodologists/researchers in this role.
Kudos to EM2 Paul Charlton MD, Annie Chipman MD MS, and Kat Comstock RN, Rose Fernandez MD, Elizabeth Rosenman MD, and the ISIS Staff for their submission, "Seeing Red - Navigating the Combative Patient: An Innovative De-Escalation Curriculum for the Provider," which was accepted for presentation at the International Meeting on Simulation in Healthcare 2016.
Congratulations to Joshua Jauregui MD, who from October 6-9, 2015, will be presenting as a Visiting Scholar at the Center for Health Education Scholarship at the University of British Columbia. His presentation, "Faculty Re-entry and Sustainable Success: What Happens Next?" discusses how faculty members form their identities as clinical educators and how institutions can better support them. You can see more information here.
Kudos to Emily Junck MD and Rich Utarnachitt MD MS for their BMJ Case Reports publication, "Ruptured Intercostal Artery Pseudoaneurysm: A Rare Cause of Acute Back Pain," which reviews this rare diagnosis.
Congratulations to Michael Sayre MD, Andrew McCoy MD, and Anders Conway MA for their publication in Prehospital Emergency Care entitled, "Impact of Building Height and Volume on Cardiac Arrest Response Time."
Congratulations to Rose Fernandez, MD, and Steven Mitchell, MD, whose submission entitled, "Danger, Will Robinson: Using Simulation to Identify High-Risk PPE-Related Occupational Activities - Bringing FMEA to Life," was accepted for presentation at the International Meeting for Simulation in Healthcare. While the topic is highly relevant to the development and implementation of Ebola patient care training, the methodology can be applied to any healthcare process.
Kudos to Betty Chen, MD, and Matt Valento, MD, whose submission, "Laboratory Abnormalities Following an Unintentional Pediatric Riveroxaban Ingestion," was accepted for presentation at the 2015 North American Congress of Clinical Toxicology (NACCT). Dr Valento will also serve as an expert panelist at this meeting.
Congratulations to Lauren Whiteside, MD, MS, who has received a K-23 Career Development Award from the National Institutes of Health (National Institute on Drug Abuse, NIDA). Dr. Whiteside's project for this award is entitled, "A Longitudinal Collaborative Care Model for Patients with Prescription Opioid Misuse Utilizing the Emergency Department for Care." This K-23 proposal will inform, refine, and pilot a collaborative-care model built from the chronic disease management framework to decrease rates of prescription opioid misuse among patients in the ED while addressing health services needs and comorbidity. Patients with substance-use problems utilize the ED for care more often than patients without these needs do, thus making the ED a critical and innovative location to initiate such a model of care. Dr. Whiteside's primary mentors for this award include Doug Zatzick, MD (Professor, UW Department of Psychiatry & Behavioral Sciences, Harborview Injury Prevention and Research Center) and Dennis Donovan, PhD (Professor and Director, Alcohol & Drug Abuse Institute, UW Department of Psychiatry).
Kudos to Annie Chipman, MD, MS, who is a recipient of a 2015 WGEA (Western Group on Educational Affairs, affiliated with the AAMC) Mini-Grant Program Award for her proposal, "Do You Remember That Patient? Exploring the Educational Value of Telephone Follow-Up in Graduate Medical Education and Beyond."
Congratulations to Jason Heiner, MD, for his two recent publications: "Female with Leg Lesion" in the August addition of Annals of Emergency Medicine. Featured in the same edition is an additional article dedicated to this diagnosis. The second is "Elderly Woman with Abdominal Pain: Bedside Ultrasound Diagnosis of Diverticulitis," in the Western Journal of Emergency Medicine.
Kudos to Elizabeth Dorn, MD, DTMH, for her publication, "Electrical Storm - Brugada's Syndrome - A Case Report and Literature Review" found in the August edition of Journal of Emergency Medicine and Critical Care.
Congratulations to Steven Mitchell, MD, for his recent publication, "Core Curriculum Illustration: Pediatric Traumatic Spondylolisthesis of the Axis," in Emerg Radiol. 2015 Jul 2. [Epub ahead of print]
Congratulations to Joshua Jauregui, MD, who was selected as one of the winners of the WGEA (Western Group on Educational Affairs) 2015 MESRE Award for Excellence in the category of Outstanding Oral Presentation of Education Research in Medical Education. These awards are given to investigators of outstanding oral presentations with strong methodologies and potential for making an impact in their field of study. The oral presentations are judged based on strength of the design, organization of the content, clarity of the delivery, time management and the use of audio or visual aids.
Congratulations to Rose Fernandez, MD (Principal Investigator), and Elizabeth Rosenman, MD (Co-Investigator), who have been awarded a grant from the Department of Defense for their proposal, "Development of an Integrated Team Training Design and Assessment Architecture to Support Adaptability in Healthcare Teams." This grant is funded through the Congressionally Directed Medical Research Program (CDRMP) and will focus on the identification and development of methods of simulation training that will optimize adaptive team performance and mitigate teamwork-related threats to patient safety.
Congratulations to Jon Ilgen, MD, MCR, who is Co-Investigator of a 2015 Medical Education Research Grant from the Royal College of Physicians and Surgeons of Canada. The grant is entitled, "Examining Errors Related to Pattern Recognition." His collaborator and the PI of this award is Dr. Jonathan Sherbino from Hamilton, Ontario, Canada.
Congratulations to Marie Vrablik, MD, who was recently named a recipient of the PRAISE award at HMC. PRAISE awards are given biannually to physicians/providers who rank in the 80th percentile or higher in their listening and communication skills.
Congrats to Betty Chen, MD, who was featured on a clip on King 5 News focused on shellfish poisoning. Watch it here.
Kudos to Anna Condino, MD who was selected as the University of Washington's Resident Liaison for the WA-ACEP Board of Directors! As a non-voting member of the BOD, Dr. Condino will have the opportunity to participate in important discussions related to advocacy, legislation and policy. She will also be representing the interests of Washington State emergency medicine residents, and will participate in the National ACEP Board meeting and the ACEP Advocacy and Leadership conference. Thank you to Dr. Hayes Wong who was our first-ever liaison and set the bar high. We have every confidence that Dr. Condino will be an excellent ambassador for our program.
Congratulations to Alex St. John, MD who was awarded the Emergency Medicine Foundation Research Grant for his proposal entitled, A damage control resuscitation cocktail for polytrauma with hemorrhagic shock and traumatic brain injury. Alex will use this award to continue focused study in basic and translational science of hemostasis, hemorrhagic shock, and traumatic brain injury.
Alex St. John, MD is also the recipient of the UW PRAISE AWARD. The PRAISE Award is given quarterly to physicians, PAs and ARNPs who meet or exceed the UW Medicine goal for patient satisfaction scores. PRAISE stands for Patient Reported Assessment In Satisfaction and Excellence. The PRAISE award is presented biannually to UW Medicine healthcare providers for ranking in the 80th percentile or higher on their listening and communication skills.
A very well-deserved and special congratulations to Dr. Sachita Shah who has been promoted to Associate Professor, effective 7/1/2015. Please click here for more details.
Congratulations to Jason Heiner, MD, Joshua Villarreal, PharmD, and Jared Strote, MD, MS, for their article, "Loperamide dependence and abuse," published in the BMJ Case Rep. Kudos also go to Ryan MacDonald, MD, Madigan Army Medical Center rotating Emergency Medicine R3 resident, who is first author of the article.
Kudos to David Townes, MD, MPH, DTMH, who continues to be significantly involved in humanitarian work for disasters. As described in this UW Medicine article, Dr. Townes wears many hats related to humanitarian emergencies, including coordinating a public response for the CDC, providing technical advice for the Office of Foreign Disaster Assistance (OFDA) at the United States Agency for International Development (USAID), and advising the U.S. government and others how best to respond to international disasters.
Congratulations to Heemun Kwok, MD, MS, for his clinical paper, "Adaptive rhythm sequencing: A method for dynamic rhythm classification during CPR," published in Resuscitation. Dr. Kwok and his team are developing improved technology to more accurately identify cardiac rhythms during CPR.
Kudos to Steven Mitchell, MD for his recent case report, "Core curriculum illustration: blunt cerebrovascular injury," in Emergency Radiology. This case report includes a discussion of the diagnostic challenges and criteria for blunt CVI.
Kudos to EM4 Rebekah Heckmann, MD; Alex de la Fuente, MD; and Jason Heiner, MD for their publication, "Pediatric urinary retention and constipation: vaginal agenesis with hematometrocolpos," published in the Western Journal of Emergency Medicine: Integrating Emergency Care with Population, 16(3).
Health in Complex Humanitarian Emergencies (September 14-18, 2015): A course co-chaired by David Townes, MD, MPH, DTMH, Associate Professor. Interested in working in humanitarian emergencies and international disaster response? This is an important course to learn more about response to humanitarian emergencies and natural disasters. This will be the Fourth Annual Course at the UW. UW staff and faculty may take it free of charge. Click here for more details.
Kudos to Patrick Maher and Jared Strote for their publication, "Case Report: Civilian use of a conducted electrical weapon," in the American Journal of Emergency Medicine.
Congrats to Medley Gatewood, Jared Strote, Bill Shuman and our colleague from Madigan, Lindsay Grubish for their article, "The use of model-based iterative reconstruction to decrease ED radiation exposure," also published in the American Journal of Emergency Medicine.
Congratulations to Jon Ilgen, MD, MCR, for his recent article, "Disrupting Diagnostic Reasoning: Do Interruptions, Instructions, and Experience Affect the Diagnostic Accuracy and Response Time of Residents and Emergency Physicians?" published in Academic Medicine [Acad Med. 2015; 90: 511-517).
Congratulations to EM3 Hayes Wong, MD, who was recently awarded the 2015 Global Opportunities Health Fellowship from the University of Washington. The purpose of the UW Global Opportunities Health (GO Health) Fellowship is to provide financial assistance to a graduate student, professional student, or medical resident at the University of Washington so that they may gain valuable international fieldwork experience in global health. Hayes' work will focus on evaluating the implementation of the Foreign Medical Teams Initiative during the Ebola response and other humanitarian emergencies at the World Health Organization in Geneva, Switzerland. Kudos and congratulations to David Townes, MD, MPH, DTMH, who has been Hayes' primary mentor.
The UW Division of Emergency Medicine was well represented at the recent UW Medicine Regional Sepsis Conference, held on March 6, 2015 at Harborview Medical Center. The aim of the conference was to explore cutting-edge developments in sepsis care by discussing recent studies and international guidelines. There were five EM faculty presenting, including: Adeyinka Adedipe, MD; and Brandon Backlund, MD: "Measuring Fluid Responsiveness," and Daniel Henning, MD; Tak Watase, MD; and Richard Utarnachitt, MD: "Sepsis Chameleons."
Congratulations to Herbie Duber, MD, MD, MPH, FACEP, first author of a manuscript published in PLOS ONE, "Uptake of WHO Recommendations for First-Line Antiretroviral Therapy [ART] in Kenya, Uganda, and Zambia." The study looked at guideline adoption of ART and patient- and facility-related determinants of their use.
Kudos to EM3 Emily Junck, MD, and Sachita Shah, MD, for their recent publication in BMJ Case Reports, "Phlegmasia Cerulea Dolens in a Teenage Boy Found to Have Factor V Leiden."
Congratulations to Fiona Gallahue, MD, FACEP, Associate Professor and Residency Program Director, who was recently elected to the Board of Directors of the Council of Emergency Medicine Residency Directors (CORD). CORD is a scientific and educational organization whose mission is to be integral to the advancement of emergency medicine education. Dr. Gallahue is the inaugural Program Director of the University of Washington Emergency Medicine Residency Program, and her scholarly work has been in the areas of care of the abused patient and learner evaluation.
Kudos to EM2 Adrienne Hughes, MD; EM3 Jodie Totten, MD; and Jared Strote, MD, MS, for their recent publication, "Delayed Diagnosis of Gastric Outlet Obstruction from Bouveret Syndrome in a Young Woman," in the Western Journal of Emergency Medicine.
Kudos to Nathan White, MD, MS, and his team of investigators and collaborators from the UW Departments of Bioengineering and Molecular Engineering and Sciences Institute and the Department of Chemical Engineering. Dr White's team has developed a synthetic, injectable hemostatic polymer ("PolyStat") that mimics Factor XIIIa-mediated fibrin stabilization, resulting in a significant reduction in hemorrhage volume and improved survival for those treated with this agent. Their work has recently been published in and is featured on the cover of Science Translational Medicine [LW Chan, X Wang, H Wei, LD Pozzo, NJ White, SH Pun, "A Synthetic fibrin cross-linking polymer for modulating clot properties and inducing hemostasis." Sci Trans. Med. 7,227ra29 (2015). Locally, the interview and story can be found on King5 Health Links.
Congratulations to Joshua Jauregui, MD, whose abstract, "The Faculty Reentry Project: Understanding the Factors That Effect Sustainable Faculty Success after Participating in a Longitudinal Faculty Development Program," was accepted for presentation as an oral abstract at the 2015 WGEA/WGSA/WOSR Regional Conference in April. The WGEA, WSGA, and WSOR are all professional organizations within the Association of American Medical Colleges (AAMC), a non-profit association that represents US & Canadian medical schools.
Kudos to Herbie Duber, MD, MPH, who is an invited speaker at the global oncology symposium, Making Cancer a Priority in Global Health, scheduled for March 31, 2015, at the Fred Hutchinson Cancer Research Center in Seattle. His talk is entitled, "What Global Oncology Can Learn from the Experience of HIV Treatment." Click here for more information about the symposium and agenda.
Kudos to Jeremy Branzetti, MD, Associate Program Director of the UW Emergency Medicine Residency Program, who was recently named recipient of the 2015 Council of Emergency Medicine Residency Directors (CORD) Faculty Teaching Award. Dr. Branzetti was recognized for his contributions to the education of emergency medicine residents. Nationally, Dr. Branzetti also serves as the Chair of the Four Year Program Community of Practice.
Congratulations go to Rose Fernandez, MD, who is a recent grant recipient from the Washington State Department of Labor and Industries' Safety and Health Investment Projects (SHIP) grant program. Her grant, "Personal Protective Equipment [PPE] Training for Health Care Workers Treating Patients with Highly Contagious Infectious Diseases," will evaluate training and the impact of using extensive PPE when treating patients with high-risk profile diseases (such as Ebola).
Kudos to Heemun Kwok, MD, MS, who is a grant recipient from the State of Washington Life Sciences Discovery Fund, established in 2005 by the Governor and the Washington State Legislature to improve the health and economic wellbeing of the State's residents. His grant, "Transforming the Paradigm of Sudden Cardiac Arrest Resuscitation: Patient-Specific Treatment through Innovative Technology," will fund the creation of a software product that will guide the best course of treatment for the individual patient during continuous CPR. Dr. Kwok is co-investigator of the grant.
Kudos to Michael Vrablik, DO, for his article, "The Diagnostic Accuracy of Bedside Ocular Ultrasound for the Diagnosis of Retinal Detachment: A Systematic Review and Meta-analysis," published in the Annals of Emergency Medicine 65 (2015), 199-203.
Kudos to Jon Ilgen, MD, MCR, for his three articles: "Now You See It, Now You Don't: What Thinking Aloud Tells Us about Clinical Reasoning" in the Journal of Graduate Medical Education, December 2014; 783-785; "A Systematic Review of Validity Evidence for Checklists Versus Global Rating Scales in Simulation-Based Assessment" in Medical Education 49 (2015), 161-173; and "Disrupting Diagnostic Reasoning: Do Interruptions, Instructions, and Experience Affect the Diagnostic Accuracy and Response Time of Resident and Emergency Physicians?" in Academic Medicine, (ePub ahead of print) Jan 2015.
Congratulations to Johsua Jauregui, MD, who was appointed as co-lead of the Scholarship Core of the UW's Center for Leadership and Innovation in Medical Education (CLIME). CLIME was established to promote scholarship and professional development for educators across UW Medicine.
Congratulations to Jon Ilgen, MD, MCR, who was appointed as CLIME'S Associate Director.
Kudos to Jason Heiner, MD, who was recently named a Fellow of the Academy of Wilderness Medicine.
Congratulations to Tak Watase, MD, MBA, whose article, "Educating Emergency Medicine Residents in Emergency Department Administration and Operations: Needs and Current Practice," was recently published in The Journal of Graduate Medical Education (December 2014: 770-773).
Kudos to EM3 Emily Junck, MD, for being acknowledged for her "52 articles in 52 weeks," a list of classic practice-changing Emergency Medicine articles, in Skeptics Guide to Emergency Medicine. Click here for the link. Congratulations Emily!
Kudos to David Townes, MD, MPH, DTMH, who will be panelist/moderator for "Ebola in 2015—and Beyond," a panel discussion sponsored by the World Affairs Council (based in Seattle) and scheduled for January 22. Details: Date: Thursday, January 22, 2015. Time: 7:00pm to 8:00pm; wine reception beginning at 6:30pm. Location: The Landing at Northcut, 5001-25th Avenue NE, Seattle, WA 98105. Click here to register.


text:
There is a thin border between some so-called solutions and addiction. When an individual crosses the border and becomes addicted to the solution is a thing of mystery. Cutting is an example of this. People turn to cutting because they want a release from their anger, frustration, depression or other negative emotions. When cutting is not checked or curbed, some people become addicted to this and get so habituated that they need to do it every day for fun and excitement. Cutting is a habit that is rooted in some sort of psychological disorder or distress.
Many teenagers start cutting themselves after a severe breakup or an emotional upheaval. They use cutting as a stress buster. Severe depression also triggers cutting. We may not understand the trauma an individual is facing and they cannot speak easily about it. Cutting is their way of telling us that they need our help. Most people like to be in control of their destiny and when things don't shape up as they wish they become frustrated. Emotional distress is something that everyone cannot handle in a matured way and this is especially true for the teenagers. They have just started learning about emotional complications and to cope they choose cutting.
Cutting is also a way through which people seek attention. It is also a way through which people manipulate others to give them the attention or love they want. Cutting can become an obsession in many and most people tend to hide the cut marks. Some believe that cutting gives them control over themselves and they can manipulate the blood flow and the amount of pain the cuts cause. It also stems from a masochistic mentality. Some people associate cutting with love. They try to show their passion for their lover by cutting their hands and inflicting pain to themselves.
Related Articles
Why Do Men Admire Kim KardashianDecember 11, 2015
Why Do People Light Up Christmas TreesDecember 09, 2015
Why Do People eat wild turkey on ThanksgivingNovember 26, 2015
Why Do Some Men Take Part in MovemberNovember 17, 2015
Why Do Business persons Wear NecktiesNovember 13, 2015
Why Do Girls Go Crazy for Nail ArtOctober 31, 2015
Why Do Rappers Talk About IlluminatiApril 22, 2014
Why Do Asylum Seekers Come To The UKApril 22, 2014
Why Do Hamsters Lose Their FurApril 03, 2014
About Author
(0) Readers Comments
Leave a Reply
Why do men wear thongs
June 10, 2013
Why do kids stutter
June 20, 2013
Why do people believe in Bigfoot
June 22, 2013
Why do plants need air
March 29, 2013
Why do people preach what they don't practice
June 05, 2013
Why Do People Use Cloud Storage
September 17, 2016
Why Do People Take CAT Exam
September 14, 2016
Why do we celebrate earth day
April 22, 2016
Why Do We Stay Healthy by Eating Honey
January 08, 2016
Why Do Some Men Take Part in Movember
It is a very good thing my brother did it and has continued to grow it
Why do spacers hurt so much
I've got these spacers in right now and they are very painful! One of
Why do computers only use binary data
Hi Anupam, I'm 13 and I am really interested to learn how computers
Why do plants need sunlight
very helpful for my science project thank you
Why do organisms reproduce
good .need improvement

subset: commoncrawl


text:
Newegg.com - A great place to buy computers, computer parts, electronics, software, accessories, and DVDs online. With great prices, fast shipping, and top-rated customer service - once you know, you Newegg.
If you are reading this message, Please click this link to reload this page.(Do not use your browser's "Refresh" button). Please email us if you're running the latest version of your browser and you still see this message.
Newegg.com - Computer Parts, Laptops, Electronics, HDTVs, Digital Cameras and More!
Showing Results: Most Recent
This review is from: Lenovo Laptop IdeaPad Y570 (08622KU) Intel Core i7 2nd Gen 2630QM (2.00 GHz) 6 GB Memory 750 GB HDD NVIDIA GeForce GT 555M 15.6" Windows 7 Home Premium 64-bit
Pros: -Really awesome design and lightweight
-EPEAT Energy Saver and Battery saver programs
-Switching between graphics is convenient and saves battery when not gaming
-Price on Newegg is a steal
Cons: -A LOT of crapware
-RIC Utility makes songs skip (common problem among Ideapad models)
-The gloss finish makes it a magnet for dust
-Screen does not support 1080p resolution, but it isn't noticeable
Other Thoughts: This laptop is a serious step up from my 2009 Toshiba Satellite A665. It's GeForce 555M rips through any game I put up on it and it's i7 processor can handle a ton of work. Simply put, this laptop is a monster, in a good way. Once you clear out the useless programs and turn on that GPU to power and performance, this thing really shines. It isn't that bad on the wallet either for a laptop of this caliber. It doesn't come with 8GB RAM or one of the higher level graphics cards but it still manages to DO WORK.
P.S Get rid of RIC asap! It tends to skip songs and make enjoying media a hassle.


text:
Must Read Super Espresso Machine Review
- Comparison, Video, Best Price, Winner Product INCLUDED
BY Kenneth Wilson, DEC 12, 2015 11:00 AM
Wake up and smell the beans!
Read on for the best information and reviews on Espresso machines, where to buy and how to select the best coffee makers in the industry.
Read before you plan to buy a coffee maker or regret later...
Planning to buy an espresso machine this season? Have a look at all these amazing options you can choose from, and make the best decision according to the features and prices.
Before starting with the detailed review I would like to brief you with Top 3 Super Espresso Machines that were ranked best in 2015.
Cuisinart DGB-700BC Brew Coffeemaker
797 Customer Reviews
- Fully programmable machine.
- Brews up to 12 cups of coffee.
- Easy Brew pause and strength selector functions.
- LCD Display Available.
- Three year limited warranty.
- Price is slightly on the higher side.
Delonghi Pump Espresso And Cappuccino Maker
124 Customer Reviews
- Self-priming operation.
- Dual filter holder.
- Easy choice options for ground espresso, or E.S.E pods.
- Easy to clean.
- No power/water indicators.
- Lacks the auto shut feature.
Lello Ariete 1375 Cappuccino & Espresso Maker
373 Customer Reviews
- Stainless steel body.
- 950 Watts espresso machine.
- Large cup warming area.
- One year limited warranty.
- Available at Reasonable Prices
- Water leaks sometimes.
- Hard to manage the water tank.
A true coffee addict will understand the need for a good espresso machine in their household, and will keep these simple yet effective points in mind when selecting one.
It may be as simple as selecting one from the store and getting it home; but then again, if you are a coffee nerd, you will not just make the purchase based on the basics.
There Are 4 Different Types Of Espresso Machines:
- Manual
- Semi - Automatic
- Fully Automatic
- Super Automatic
Before making the purchase, you need to ask yourself a couple of very important questions like whether you want your coffee machine to only make espressos or cappuccinos as well?
How often is the machine going to be used and how many drinks are you going to make in a single go?Is the machine cost and energy efficient, because that some machines require more power than the others.
This is why you need to decide what type of coffee machine best suits your requirements.
What To Look For In A Good Espresso Machine?
- A Machine That Is Easy To Clean
- A Machine That Looks Attractive
- Something That Can Be Operated Easily, And You Can Adjust The Dials, Water Levels And Levers Easily
- A Machine That Doesn't Use Up Too Much Electricity
- Enough Place For Warming Cups
- Heat Retention Quality
- Consistently Pressured Pump, 9 Bar Mostly
- Consistent Brewing
- Production Of High Quality Steam, At The Right Angle, Using The Right Pressure
Now that we know how to choose a good machine, lets see what exactly a mind-blowing cup of coffee has to be like:
What Are The Components Of A Perfect Espresso?
Crema, body and heart, are the three layers of espresso:
- Crema: A golden brown colored foam, forms the top layer of the espresso, and contains the finest flavors and aromatics of the espresso.
- Body: This is the mid-layer of the shot, and is characteristically a caramel brown shade.
- Heart: The innermost layer of the espresso is also known as its heart. This part is usually a deep shade of brown, and bitter, to counter with the sweetness of the aroma of the espresso!
What Should The Ideal Espresso Taste Like?
Most of us casual coffee drinkers don't even know what an ideal espresso shot is supposed to taste like. The commercial coffee that we enjoy at famous joints isn't half as good as a traditional cuppa!
Have a look at some of your best options for that Perfecto Espresso Shot:
This fully automatic espresso machine is easy to use and affordable, providing you the perfect brew each time.
- Fully programmable machine that can brew up to 12 cups of coffee in one go ·
- Grind-control function+ built in Burr Grinder ·
- Easy to clean ·
- Brew pause and strength selector functions ·
- LCD display for better understanding·
- Three year limited warranty.
- Product Dimensions: 13.1 x 10 x 18.1 inches ; 12.8 pounds
Now, let us look at the Pros and Cons for this coffee maker:
The Good Stuff:
- Grind-control function+ built in Burr Grinder increases the quality and taste of the brew each time.
- The machine is fully programmable, so you can completely customize the functions to make the sort of coffee you like.
- The strength selector function means you can choose how strong you want your coffee to be.
- It can make up to 12 cups at a time, so the machine is basically equipped to meet bulk requirements.
The Bad Stuff:
- Price here is the only disadvantage, as it is slightly more towards the expensive scale.
4.5/5 Stars
An efficient espresso machine that has dual function and doesn't blow holes in your pocket.
- Dual filter holder,
- Awesome swivel jet frother for creamier coffee
- Easy to clean.
- Product Dimensions: 8 x 11 x 10 inches; 6.7 pounds
The Good Stuff:
- It is easy to clean and you don't need to struggle much with disassembling, cleaning and reassembling the parts of this espresso machine.
- The self-priming operation means you won't have to wait for the perfect cup of coffee, in terms of boiler and element reaching the right temperature.
The Bad Stuff:
- Lack of indicator buttons for water and power.
- Doesn't have the auto-shut button.
4,4/5 Stars
Heavy duty coffee maker packed with string of features best use, reasonably for priced!
- Stainless steel body.
- 950 watts cappuccino/espresso machine
- 1-year limited warranty.
- Brews 5-6 cups in a single go.
- Product Dimensions: 9.2 x 9.5 x 12.5 inches
The Good Stuff:
- Large cup warming area, which means more coffee at a time.
- Uniform and constant pump pressure with the help of the thermo block 15-bar pump.
- It also has a removable water reservoir, which you can fill as and when required.
The Bad Stuff:
- The water tank has been reported to be troublesome sometimes.
- There have been reports of water leaks from the unit as well.
4.2/5 Stars
The best one-cup coffee maker, true value for money, available with regular and bold brew options.
- Can handle up to 14 ozs. single serve packs, with ground coffee.
- Available with bold or regular brew options.
- Single serve cup can be made in travel mugs or regular coffee cups.
- Product Dimensions: 12.4 x 8.3 x 14.2 inches ; 5.3 pounds.
The Good Stuff:
- This espresso maker offers maximum brewing flexibility options.
- It can be used with K-cups of any variety, and this makes it truly functional.
- It is compact and portable, which means you can take it anywhere you like.
The Bad Stuff:
- It is a single cup espresso maker, hence holds only 10oz of water, so needs refilling each time.
- Tends to make some noise towards the end of the brewing cycle, accompanied with steam.
4.1/5 Stars
Heavy duty stainless steel, easy to clean cost effective espresso machine.
- Perfect espresso temperature with the help of thermo block heating.
- 15-bar thermo block pump.
- 1 year limited warranty.
- Product Dimensions: 12 x 12 x 15 inches
The Good Stuff:
- Froth enhancer for the perfect creamy cup each time, dual wall filter system, for additional fine ground beans.
- Easy to clean espresso machine, it has a removable grid and drip tray.
The Bad Stuff:
- It tends to make a noise louder than most other espresso machines available in this segment.
- The knob is comparatively hard to twist, making it a problem.
4.0/5 Stars
Fully automatic, easy to use, espresso machine for the best brew each time.
- Hassle free, one touch operation.
- LCD display for better understanding.
- Large water tank + easy empty tank detection.
- 15 bar pressure pump.
- Easy to use frother.
- Product Dimensions: 14 x 9.5 x 15 inches ; 17 pounds
The Good Stuff:
- The drip tray is easy to remove and clean which makes the espresso maker easy to maintain.
- 2 years worldwide warranty available with this espresso maker, making it a gadget for long-term use.
- The unique design and the large bean hopper works to keep the coffee beans fresh.
The Bad Stuff:
- The machine can be noisy at times and this may be a problem.
- The price may be on the heavier side, as compared to other machines available in the same league.
3.9/5 Stars
High power, stainless steel, efficient espresso maker
- It is equipped with dual spouts for brewing two cups of coffee at a time.
- 15 bar pump and back pressure adapter.
- Used with ground espresso as well as pods
- Product dimensions: 16 x 15 x 19 inches
The Good Stuff:
- Removable/adjustable drip tray, so the machine is easy to maintain
- Steam wand/frother for better crema, so you get a nice froth on your coffee each time
- Impeccable engineering means this is a machine you can count upon to last you for years.
The Bad Stuff:
- The machine tends to drip water, after the functioning of the pump is complete.
- The water heating may be slow as compared to other options in this league
3.8/5 Stars
Espresso maker with hot water dispenser, easy to use, cost effective.
- Coffee maker and hot water dispenser
- Around 14oz brew, in travel mugs or any coffee cup
- Product Dimensions: 11.1 x 15 x 12.6 inches ; 4.8 pounds
The Good Stuff:
- Water heating shuts off automatically after 176 degree f) for 30 minutes.
- Can be used for making other hot beverages besides coffee too.
- LCD display for better understanding.
The Bad Stuff:
- The machine turns too hot if left on for too long.
- It makes only 2 cups of coffee for every 14 oz. of water, whereas other machines of the same league make more.
3.7/5 Stars
Single serve espresso maker, with hot water dispenser.
- Best for single cup brews, compact in size
- Hot water buttonCharcoal water filter
- Product dimensions: 12.6 x 12.2 x 9.5 inches ; 8.6 pounds
The Good Stuff:
- Takes less than 2 minutes to prepare the brew, so you get your coffee quick!
- Coffee filter reusable; which means you don't have to change it each time.
- 3 year warranty, so you can bank upon this appliance to last you long.
The Bad Stuff:
- Price may be slightly on the higher side, for single serve machine.
3.6/5 Stars
Fully automatic, well equipped espresso machine that is reasonably priced.
- One touch control for single or double shots
- Removable milk containers
- It includes single/double shot filters, coffee recipes, measuring cups and so on
- Product dimensions 12 x 14 x 12.2 inches ; 9 pounds
The Good Stuff:
- Removable and easy to clean drip tray, making it possible for you to maintain the machine easily.
- It has an automatic milk frothier, so helps you in getting the perfect creamy coffee every time.
- Adjustable cup tray, so you can easily put any coffee mug beneath it
The Bad Stuff:
- The two brewing spouts are far away from each other, so there is need for special attention when placing your cups under it.
- The specifics are not mentioned well on some parts and this might lead to confusion.
3.5/5 Stars
And The Winner Is..?
For this part of the review, it's important to make a very clear recommendation. Keep in mind that people like options, but what they respond to are clear directions.
Ideally, there should be one clear winner in your roundup and you can recommend that above all other solutions. If there is more than one recommended solution, draw very clear lines around the products and explain clearly whom each one is for. Make it as easy as possible for your readers to pick the solution that is right for them.
Winner Product Of 2015
Cuisinart DGB-700BC Grind-and-Brew 12-Cup Automatic Coffeemaker, Brushed Chrome/Black
- Reasonably priced
- Brews 12 cups of coffee at a time
- Easy to clean, fully programmable
- Warrantied product
Some basic pointers to keep in mind when tasting the perfect brew!
- It should be full bodied, and should have a rich flavor profile, that is distinct; like a strong fruity, floral or chocolate flavor!
- One should make sure that the brew is never smokey, burnt or sour in taste.
- The trick is to let the coffee flavor grow on you; you may not like what you taste at first, but when you've had a couple of sips, and a couple of shots, the flavor will grow on you; so you basically have to find your blend!
Final Brewing Thoughts :
So basically, you need to find an espresso machine that suits your requirements to perfection, in terms of usage, price, and energy consumption, type of brews it produces and whether it can handle making loads of coffee in peak hours.
Why Spend That Much For A Simple One Ounce Coffee?
For most of us, coffee is something very basic and functional and we wouldn't know the fuss about the right grind and roast and brew if it hit us in the face. .
However, once you've fallen in love with the perfect espresso, you will do anything it takes to find the right crema, mouth feel and color to your cup. It is definitely worth spending that much when it's not just coffee, but magic in your cup every morning!


text:
MBA C-Suite Co-op
The Drexel LeBow C-Suite Co-op™ builds on the internship experience by providing students the opportunity to work directly with the highest level leaders at the top companies in the area.
The full-time Drexel LeBow MBA program includes a required experiential component during the summer term, after the first nine months of academic study. One of the options for fulfilling this requirement is the C-Suite Co-op™. Students are selected through a rigorous assessment, competitions, interviews and selection process – a learning experience on its own. After the organization match is made, students will work directly with these well-known and successful leaders on key projects within that organization.
Full-time MBA students compete for coveted C-Suite Co-op™ positions, where they work at the highest levels at firms such as Agile Therapeutics, Cisco, FMC, NBC Universal, World Trade Center of Philadelphia and other leading American corporations — all while still earning their MBA.
The networking opportunity plus practical experience can boost students' resumes and change the course of their career.
"I can think of no better way to introduce students to the realities of the business world," says SAP co-CEO Bill McDermott. "As the need for real talent deepens in business, the program provides an opportunity for substantial knowledge growth – for the student and for SAP."


text:
No harm in looking. New #jobs
Sildenafil 10mg Tablets
Avoid drinking alcohol while you're taking prednisone Maintain the price cialis medication within a place where Cialis Tadalafil Tablets others cannot be able to it Cialis is needed to help remedy these conditions: , BPH affects over fifty percent that face men in their s in addition to being many as percent in men over the age of , the agency said Future studies is going to be required to further define the drug s role and the optimal duration to prevent decrease of sexual function after treatment And doctors should counsel these patients about safe sex practices, i was told that impotence problems, said Sidney Taurel, Lilly chairman and buy tadalafil cialis chief You ought not make use of this medication if you are allergic to prazosin or similar medicines for example alfuzosin Uroxatral, doxazosin Cardura, silodosin Rapaflo, tamsulosin Flomax, or terazosin cheap viagra without a prescriptiongeneric 10mg cialis Hytrin Tend not to begin tadalafil canada 20mg to use a fresh medication without telling your medical professional Unless you employ a dose-measuring device, ask your pharmacist first ource: However, this does not necessarily indicate no interactions exist feeling just online purchase of viagra like you might conk or Caregivers may suggest waiting to own test until after baby exists nausea, upper stomach pain, itching, decrease of appetite, dark urine, clay-colored stools, jaundice yellowing of the skin or eyes There was clearly no difference in the average Sildenafil 10mg Tablets myocardial performance index improvement between the right ventricular dominant subgroup and also the non-right ventricular dominant subgroup, indicating a bonus no matter what ventricular structure Taking Stendra which has a cialis online sale nitrate medicine for heart problems or cardiovascular disease may cause extreme and high lowering in blood pressure xerostomia or an agonizing taste in your mouth Searching for name generic cialis answers? or go join the to touch base with others who have similar interests Keep your medication inside a place Buy Viagra Generic where others cannot arrive at where to buy cialis online it Provigil may make certain types of family planning pills less efficient, which will cause an unplanned pregnancy Measure the liquid using a special dose-measuring spoon or medicine cup, avoid a regular table spoon Also called: Adcirca, Cialis Enter a drug name and choose a drug through the list Peyronie&rsquo s disease, angulation, cavernosal fibrosis -- Fastest Shipping! or a history of prolonged viagra 20 mg side effects erections .
Cialis Professional 20mg
Lowest Price For Brand Cialis
Dosage Cialis
Fast Generic Cialis
Dosage Cialis 36
Viagra Generic Canada
Cost Of Viagra Per Pill
Viagra Viagra Canada
50 Mg Viagra
Generic Viagra From India
Buy Cialis Paypal
Buy Tadalafil


text:
East Union (1-1) caps its nonleague schedule this Friday at Dino Cunial Field where it will face its stiffest test so far in Modesto Christian (2-1).
Manteca High's sophomores racked up more than 500 total offensive yards and rolled to a 40-0 win over host Los Banos on Friday night in non-league play. It was Manteca's first shutout of the season.
The East Union freshmen did not give up a score until late in the game Thursday and crushed visiting El Capitan-Merced 39-7 in non-league play at Dino Cunial Field..
RIPON – Michael Ysit doesn't run in an offense that affords him the opportunity to touch the ball 30 times every game.
A game played primarily in the hands of its quarterbacks was decided by the foot of Joshua Gonzalez.
LOS BANOS - Joe Menzel's Colin Kaepernick impersonation wasn't pretty. Nor did it count.
SACRAMENTO – Lathrop threw punches with Capital Christian for four quarters Friday night.
LODI – Despite a 37-8 non-league loss at Tokay, Weston Ranch displayed effort throughout the game.
RIPON – Spencer Hower pushed himself around the skate park, building speed and confidence as he went.
East Union and Sierra both rebounded from tough losses last week with resounding wins.
The Sierra freshmen could not find the end zone Thursday and could not keep host Central Catholic out of it as the Raiders rolled to a 33-0 non-league win at David Patton Memorial Field.
DeleteJacari Thompson intercepted a Liberty Ranch pass on the game's opening drive and returned it for a Lathrop touchdown as the junior varsity Spartans posted a 26-9 non-league road win on Friday night.
Manteca football coach Eric Reis wanted the ball in the hands of quarterback Joe Menzel. Simple as that.
LATHROP - It is evident that Lathrop has made strides to be a more competitive football team.
LINDEN – So far, so good.
Page 32 of 56
It was the year of the quarterback for Manteca city schools this fall, and that was reflected in the All-Valley Oak League voting.
Menlo-Atherton players sprinted off Coach Parks Field to celebrate with fans following their 49-21 win over Manteca in the CIF State Division III-AA Northern California ...
Menlo-Atherton is not the same team Eric Reis saw last year.
Friday night will be a homecoming of sorts for Manteca High senior Joel Olmos.
Undefeated Northern Section powerhouse Sutter (13-0), Central Section Division II champion Sanger (13-0) and perennial Santa Rosa-based contender Cardinal Newman (12-1) were thought to be ...
STOCKTON - Everyone gets knocked down.
Placer coach Joey Montoya knows what his team is up against on Saturday.
Thanksgiving came a day early for the Buffaloes.
Jeff Harbison's last game as Sierra head football coach may have been a loss, but he'll be remembered for the many firsts the ...
Page 1 of 1
Contents of this site are © Copyright 2017 Manteca Bulletin - All Rights Reserved
Privacy policy and Terms of service | Contact Us


text:
Resources for Self-Represented Litigants
This portal provides information on what is expected of you, and instructions to be followed, if you bring your own application for leave to appeal or if you have been named as a respondent on an application for leave to appeal.
- Are you a self-represented litigant who wants to apply for leave to appeal?
- Are you a self-represented litigant who has been named as a respondent on an application for leave to appeal?
Leave to Appeal Assistance Project
- Consult the Law Help Ontario site if you are appealing a case from Ontario, or inquiring about where you may apply for free or low-cost legal services.
- If you are seeking leave to appeal a case to the Supreme Court and wish to apply for help from the Supreme Court of Canada Leave to Appeal Assistance Project, download the application form from the Law Help Ontario website. If you are appealing from outside Ontario, you may still apply for assistance and efforts will be made by Pro Bono Law Ontario (PBLO) which is administrating the Supreme Court of Canada Leave to Appeal Assistance Project, to refer you to local services.
- To obtain information on how you can find a lawyer or where you can get free or low-cost legal services, consult the Public Legal Information and Education Sites page.
- Date modified:


text:
Amateur Surgeon 2 levels 7-9 Tips and Strategies
- App name: Amateur Surgeon 2
- Developer: [adult swim]
- Genre: Adventure
- Release: Nov 8, 2010
If you are stuck on Amateur Surgeon 2 levels 7-9 you came to the right place. Below you will find a video walkthrough and some written tips that will guide you through that level. Have fun and enjoy this great game.
levels 7-9 Walkthrough
This page contains Amateur Surgeon 2 video walkthroughs for iOS (iPhone/iPad) called "act 1 Миссии 7-9" and has been uploaded on Максим Тарасов official channel at Feb 2, 2013.
Still need help with this level? Here you can ask questions and discuss with other Amateur Surgeon 2 users.
Hit like if this helped you!
Stuck on some levels in Amateur Surgeon 2? This walkthrough can help you finish the game.


text:
how to make gulp alive spray download free En8Y full file
== Search results for how to make gulp alive spray ==
Searched file: how to make gulp alive spray
*Filename: how to make gulp alive spray.zip
*Year: 2015
*Total Downloads: 153451
*Uploaded: 02/26/2015 11:10:24
*Type: WinZip
*Supported OS: All
== Searches related to how to make gulp alive spray: ==
02/26/2015 11:10:24
Shop the Shop department for Berkley Gulp! Alive Freshwater Spray Attractant today from Bass Pro Shops, your #1 source for quality.Gulp! Alive! Attractants are available in many popular prey scents and flavors. Simply spray any bait to make it taste and smell like live bait. Berkleyジェイソン・フェリス(フィールドスタッフ) ガルプ!アライブ!アトラクタントスプレーは、めちゃ臭いですネ(笑)。5/19/2012 · http://fishingfanatic.us Another great day using the NXT (5-6 wt) flyrod and 1-inch Gulp Alive minnows in Chartreuse!1/20/2009 · Keith walks you through all the benefits and positives of Berkley Gulp Alive!Simple homemade magnesium oil made with magnesium chloride flakes helps improve sleep and stress levels.The NEW Berkley Gulp! Alive is the next generation in Gulp! scent and attractant technology. Now that technology is available in a spray bottle.手持ちのルアーがパワーアップ!トリガー式スプレーボトルのガルプ!ジュースです。gulp! alive! attractant spray (ガルプ!11/19/2005 · 1) Get some grape juice. 2) Mix the grape juice with 2 parts water. (The less water, the stronger the wine. Use all grape juice if you want it really strong)We're trying to help everyone on the planet learn how to do anything. Join us. How to
how to make gulp alive spray
== Related Links: ==
custom server programs motley crue 10 seconds mp3 pga tour 06 ps2 cheats golf packages of the carolinas cypress hill lyrics taxi driver Deep Purple Made In Japan Deluxe Edition renew driver license online texas how to get your mcse one stop adult program empire 3 crack songs that express individuality ncaa football rulebook acrobat security cracker the secret 2013 progressive car insurance full cover game cash prize i fucked my daughter' games star wars bsn nursing schools with accelerated programs how to get rid of mouth numbness Chak De India 2007 how to list book chapter on cv Believe s03e01 -french theoretical geomorphology pdf greenlight go beyonce mp3 return of the dozen download nvidia geoforce4 mx4000 specifications navy seal workout book book by chance fat leslea newman malware programs closing access is denied


text:
You have no items in your shopping cart.
Looks like we can't meet you here!
Your current browser is out of date. Please update to the newest version of your browser clicking here or meet us in a different browser. See you there!
Price includes Rs 150 for personalization
Enter up to eight characters to personalise your product
Please use A-Z characters only
Personalise it with a colour of your choice
Pick where your personalisation would appear
The Onyx Black Exquisite Leather Watch and Cufflink Case is crafted with premium leather to keep your watches and cufflinks looking as good as new. Now store, protect, carry and display your favourite accessories with ease!
Please note:
Please note:1) Due to the color settings of your monitor ( or the handheld device screen) the colors shown in the photographs may slightly vary from the product in your hand.
2) Personalization may add upto 3-5 business days to the delivery timeline.
Be it for a quick trip or a planned tour abroad, you always want to make sure that you are dressed right for the occasion. But your best attire is incomplete without the perfect accessories. The compact travel-friendly Onyx Black Excuisite Watch and Cufflink Case comes with easy to store compartments for your best-loved watches and sleek slots to hold your favourite cufflinks in place. Now spruce-up easily even when you are on the move.
Good looks often fade away, but you won't have to worry about that when it comes to this exceptional Watch and Cufflink Case. Crafted with premium leather, the elegant case will age gracefully but keep your watches and cufflinks looking as good as new. With the soft velvet interior to protect your watches & links and the see-through window that displays your watches beautifully, the Exquisite Leather Watch and Cufflink Case not only looks good but feels great too.
A bad choice of accessories can ruin your entire outfit. With the Onyx Black Exquisite Watch and Cufflink Case, store your cufflinks along with the watches that complement them the best. The case is not only easy-to-store but also easy-to-use with its magnetic snap button and see-through window for a quick glance. Now with all your favourite accessories in one-place, suit-up with ease!


text:
Number Must Commence With A Zero, Contain Only Numbers, Must Not Include Any Spaces, and Must Be 10 to 13 Digits In Length.
Have you received unwanted or unsolicited calls from this number? If so, why not tell us about it. By completing our very simple form below, your comment will be added to our extensive Reverse Telephone Number Directory for others to view.
crork service seo
Posted: 10 November 2015
ePaJ5G well clear their motive, and that is also happening with this article
Posted: 16 October 2015
AnZ00g Great, thanks for sharing this post.Really looking forward to read more.
alex crork
Posted: 03 September 2015
MSd4EP Thanks for sharing, this is a fantastic article.Much thanks again. Much obliged.
Posted: 22 March 2015
I have been surfing on-line more than three hours lately, but I never discovered any fascinating article like yours. It's lovely price sufficient for me. In my view, if all website owners and bloggers made good content material as you probably did, the net might be much more helpful than ever before.
crorkz linkz
Posted: 15 January 2015
czld8a As I web-site possessor I believe the content material here is rattling wonderful , appreciate it for your efforts. You should keep it up forever! Best of luck.
(0121) 2135610, 0121 2135610, 01212135610
Copyright © ReverseNumber.Co.Uk. All Rights Reserved.
Home | Terms of Service | Privacy Policy | Latest Comments | Full Directory | Contact Us