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One step closer to making Iowa history
You could say the state of Iowa is a little behind the curve when it comes to having female representation on a national level, but all of t…
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You could say the state of Iowa is a little behind the curve when it comes to having female representation on a national level, but all of t…
A 33-year-old Des Moines police officer accused of assaulting his former girlfriend has been fired.
A possible hotel development could bring with it some much needed space for conventions.
KIMT News 3 – A strong warning going out to parents with infants. Stop using the "Nap Nanny." It's an infant recliner that was sold betwe…
It's an issue that has many in one small town talking and plugging their noses.
Ernst secures GOP nomination to battle Bruce Braley in November.
Voters headed to the polls in Iowa to decide several primary races, including who will represent the Republican party in November's general …
One local group gathered earlier this week for their third annual picnic, but to them, it's about a lot more than food.
A Mason City house fire is out tonight but several pets were killed in the flames.
After an incident in Wisconsin over the weekend, there are new warnings to parents about monitoring what website their kids are visiting.
Work is underway to bring a popular north Iowa destination back to life.
Severe weather systems that moved through the area over the weekend put outdoor warning sirens to the test across north Iowa.
Perfect Circle is one of just three facilities in the country that grows organic tomatoes all year.
Road construction season is upon us, but the funding behind these projects is now a growing concern.
CLEAR LAKE, Iowa – Two men have been arrested after an argument apparently led to multiple assaults. The Cerro Gordo County Sheriff's Offic…
Polls open at 7 a.m. as Iowa voters decide a number of key primary election races
A self-made titan in the egg production industry, his son and the Iowa company they ran are expected to plead guilty to federal food safety …
The Mason City School Board continues to discuss the looming issue of budget cuts, but a meeting earlier this week carried with it a little …
Due to new guidelines, one local organization is looking to expand even more.
It's getting hot. The sun is starting to beat down, which means folks are heading outdoors for some fun in the sun.
It's a smelly situation and a local community is reacting.
It's never too late to think about learning a second language, and one study looks to show why it should be an option.
A new survey by the Organic Trade Association shows that more people are buying organic.
There is a new effort to bring out-of-state folks into north Iowa.
Money is going to be tight for one Iowa organization.
Polls will be opening up tomorrow for Iowa's primary elections and there is a new program that will help the check-in process go a little sm…
$6.8 million in fines for bribing inspector.
Minneapolis police are investigating the fatal shooting of a 17-year-old boy.
Des Moines police have charged a woman with murder in connection with the body of a man found at a motel in northern Des Moines.
Students from all over North Iowa tossed their hats in the air earlier this week celebrating their academic successes, and the severe weathe…


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Penn Control Plus Green Dot Tennis Balls 12 Can Case
Original Price:$43.95
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Penn's Control Plus Green Dot Balls are now available to purchase in a 12 can case (comprising of 3 balls per can). With their high visibility felt and speed reduction of 25% in comparison to regular balls, these tennis balls are great for junior players aged 11 and up and are particularly suited to full court play.
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Other tennis stuff we recommend:
Penn Quick Start Tennis 36' Red Felt Tennis Balls (12 Per Pack)
Penn 24 Tennis Balls Case Of Pressureless Tennis Balls
Pro Penn Marathon Regular Duty Tennis Balls Case
Tretorn Micro-X Pressureless Tennis Balls

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iPhone apps
Tracking Dog
Using the Tracking Dog, You can Protect your iPhone by GPS or alarm. You can find your girlfriend's present location or your child's present location1. GPS tracking app. 2. Only you will be able to deactivate alarming. 3. Stealth mode ….. Read more
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The G-overhangs of telomeres are thought to adopt particular conformations, such as T-loops or G-quadruplexes. It has been suggested that G-quadruplex structures could be stabilized by specific ligands in a new approach to cancer treatment consisting in inhibition of telomerase, an enzyme involved in telomere maintenance and cell immortality. Although the… (More)
Telomeres are known to prevent chromosome ends from being recognized as DNA double-strand breaks. Conversely, many DNA damage response proteins, including ATM, are thought to participate to telomere maintenance. However, the precise roles of ATM at telomeres remain unclear due to its multiple functions in cell checkpoints and apoptosis. To gain more… (More)
Telomere maintenance is essential to preserve genomic stability and involves several telomere-specific proteins as well as DNA replication and repair proteins. The kinase ATR, which has a crucial function in maintaining genome integrity from yeast to human, has been shown to be involved in telomere maintenance in several eukaryotic organisms, including… (More)
Functional telomeres are protected from non-homologous end-joining (NHEJ) and homologous recombination (HR) DNA repair pathways. Replication is a critical period for telomeres because of the requirement for reconstitution of functional protected telomere conformations, a process that involves DNA repair proteins. Using knockdown of DNA-PKcs and Rad51… (More)
DNA ligase I (LigI) plays a central role in the joining of strand interruptions during replication and repair. In our current study, we provide evidence that DNA ligase III (LigIII) and XRCC1, which form a complex that functions in single-strand break repair, are required for the proliferation of mammalian LigI-depleted cells. We show from our data that in… (More)
Glioblastoma multiforme is the most aggressive primary tumor of the central nervous system. Glioma stem cells (GSCs), a small population of tumor cells with stem-like properties, are supposedly responsible for glioblastoma multiforme relapse after current therapies. In approximately thirty percent of glioblastoma multiforme tumors, telomeres are not… (More)
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One Fisher Price Circus Birthday Lantern Garland. Each garland has six 4 x 5 inch accordion-style paper lanterns hanging from a beautiful 12 foot x .25 inch red satin ribbon. Each lantern is decorated with a 3.5 inch circus animal cutout. Hang your Fisher Price Circus Birthday Lantern Garland over the table, across the mantle, or anywhere you need unique pops of brilliant color.
This decoration is pretty enough to hang in a playroom or bedroom after your party.


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Lone Ranger
Posted in WB Cartoon Companion on March 22, 2004
Exceptionally popular character of radio, movies, and later television, from 1933 on. The opening, indelibly linked with the the theme song of the show, Rossini's William Tell overture, is to a certain extent spoofed in Buckaroo Bugs (Clampett, 1944). The Lone Stranger and Porky (Clampett, 1939) is probably the most detailed spoof of the show, though other cartoons, including The Film Fan (Clampett, 1939), Dripalong Daffy (Jones, 1951) also poke fun at the series. Fans of the series are spoofed in Thugs With Dirty Mugs (Avery, 1939) when the nogoodniks spin a safe dial, which turns out to be a radio dial, thus allowing the gang to tune into the show.
------------------------------- • Back to the Glossary • The Warner Brothers Cartoon Companion is © (copyright) 1996 E. O. Costello. All rights reserved.


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(AP Photo/Gerald Herbert)
An aerial photo taken in the Gulf of Mexico shows the burning oilrig Deepwater Horizon, which collapsed and sank after an explosion caused by an oil 'blowout'
Robin Pagnamenta, Energy Editor, and Jacqui Goddard in Miami
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A team of engineers using an underwater robot was struggling last night to control one of the world's most challenging oil spills after an explosion ripped apart and sank a rig leased by BP in the Gulf of Mexico.
As fears grew for the safety of 11 workers still missing, BP and US officials were tackling what could be a major pollution incident using booms and dispersant chemicals.
The spill is being fed by an estimated 13,000 gallons of oil and gas that were pumping every hour from a pipe running up from an oil reservoir more than 2 miles (3km) beneath the seabed.
Deepwater Horizon rig, which had been drilling for oil at the time of the explosion on Tuesday night, collapsed and sank yesterday after being engulfed by a fire that had blazed for more than 36 hours.
Guy Cantwell, a spokesman for Transocean, the Swiss company that owned the rig, said that engineers were trying to cut off the uncontrolled flow of oil using a subsea robot. He said that the robot, equipped with cameras and remote-controlled arms, was being used to try to activate a device on the seafloor, 5,000ft (1,500m) below the surface, that is designed automatically to clamp shut over the base of a pipe that connects the rig with the seabed.
The robot was being deployed remotely from a ship close to the site of the disaster, 50 miles off the coast off Louisiana. If the effort fails the only alternative is to drill a "relief well" intersecting the original well. Mud and cement could then be injected inside to cap it. Such an operation, however, could take weeks or even months.
BP, Transocean and the US Coast Guard were planning to use booms, skimmers and chemicals to control what threatens to be a huge oil spill.
US regulators pledged to begin an investigation into the accident, which appears to have been caused by a "blowout" — an uncontrolled release of gas or oil that forced its way up the well pipe and caught fire, destroying the rig.
The majority of the 126 workers on board escaped unharmed but 17 were injured and 11 remain missing. BP said that all six of its staff, who had been overseeing the operation, were safe.
Last night survivors told of their desperate attempts to escape the fire. Chad Murray, 34, the rig's chief electrician, said that they had less than five minutes to leap from their stations or bunks and evacuate before the rig was enveloped by the fireball.
Jim Ingram said that he was getting ready for bed when everything suddenly went dark. He heard a thud that "kind of sounded like a crane operator that would have landed a load. On the second one, we knew something was wrong".


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I don't think I've ever had new year's resolutions, but my conversation with my friend today compelled me to define them. We were talking about how difficult it is for most artists to compose a cohesive whole from parts. That final step requires something more than just creativity. Read »
The expression "politically correct" has negative connotations. Why? Because a politically correct argument is logically correct without sufficiently matching the reality. In every instance, there is a degree of hypocrisy in it. Read »
Watching this documentary, "The Shock Doctrine", what struck me as the greatest problem is how much I don't know, and how it is not possible for us to know everything in order to make right decisions that are fair and just for all. All of us cannot spend full time learning what's happening in this world like Naomi Klein does. Doing our best isn't good enough to arrive at the correct answer because the world is a highly complex, ever-changing organism. Even Klein herself cannot have the right answer for everything. If each of us were responsible for having the right answer for every issue, we would all have to spend every waking moment learning about what's happening in the world and how everything works. Read »
Facebook is now under criticism for not blocking fake news sites, but this is a relatively minor problem compared to another problem that the platform inadvertently caused. What happened was similar to how a mob of cops behaves when one starts shooting; everyone panics and starts shooting also. The escalating fear fuels more bullets. And, when they finally run out of the bullets, and after the smoke clears up, they realize that they were just shooting at each other. I have a theory why this happens on Facebook and how we could potentially prevent it. Read »
Vote to win or vote for what you believe in? That is the question we can now revisit. People who voted for third party candidates were harshly criticized and ridiculed. Sanders' supporters were mocked and dismissed as "Bernie bros" because he was regarded at the time as not electable. Read »
This may ease your mind if you are worried about what Trump might do. This occurred to me while I was chatting with a room full of psychoanalysts. They were all very worried about Trump. I noticed at one point that they were taking everything Trump said quite seriously. What may be going on here is that some people are not used to how entrepreneurs talk. Read »
Now that Hillary Clinton conceded, let's seriously look at the apocalypse she predicted. Firstly, a sexual predator as president. We already had one, Bill Clinton. I think we had about an equal number of women come forward to accuse them of sexual misconduct. If it was not apocalypse then, it's not now. Read »
Trump supporters are like the third-class passengers on the lower deck of the RMS Titanic. They see the water leaking into the ship, so they are panicking. But the upper deck passengers, or the educated liberals in the urban areas, are oblivious to it. They are aware of the commotion in the lower deck but haven't bothered to look into what it's all about. Meanwhile, they are still debating among themselves whether the ship should turn left or right. Read »
The key takeaway from "Switched On" by John Elder Robison for me was that sympathy and empathy can contradict one another, although these two words are often used synonymously. Read »
With the rise of Donald Trump, there is now a growing concern about racism in the US. Vox has an interesting theory on the topic. They analyzed the recent data and argued that economic hardship does not explain Trump's popularity and the rise of racist sentiments. They are proposing that it's the other way around; that is, it's racism that is causing them to believe that they are experiencing economic hardship. Flipping them implies that racism has no cause. They are not looking for a different cause; they believe racism is the origin of the problem. In other words, some people are innately racist (like they are born racist) and Obama's presidency awoke their latent racist drive. Read »
Recently, one of my clients asked me to use less email and talk more on the phone or face to face. No Basecamp. No Slack. Just good ol' fashion phone or meeting. In this day and age when it is considered rude to call someone without first making an appointment through email, this was an interesting challenge. So I embraced the challenge to see what I would learn from this experience. Read »
"The question of what Donald Trump 'really believes' has no answer" is an interesting analysis, but I disagree with his conclusion. I think contrasting him with Hillary Clinton would shed further light on his theory. I think ALL politicians use words to DO things. That is an essential ingredient to make a politician. In the leaked emails of Clinton, she spoke about her "public" and "private" positions. The point she is trying to make is that what matters is achieving a particular end, so the means by which to achieve it is secondary. This is how all politicians operate, including Lincoln as she noted. Read »
Here is what I think is happening in this country, and why so many people are indeed voting for Trump. Most people are generous and tolerant of others as long as they are happy themselves and can afford to be so. In France, for instance, we are now witnessing blatant discrimination against Muslims. Their prejudice did not surface until recently with all the terrorist attacks, because France was peaceful enough and people were happy enough. Whenever we are happy ourselves we can afford to point our fingers at others and call them bigots and racists so we can feel good about ourselves. Read »
In the US, we have reached a point where every election is about voting for the lesser of two evils. We keep complaining about this situation but do nothing about it, either because we feel hopeless, or because we lack imagination. Read »
A lot of people seem to be un-friending Trump supporters on Facebook and keep complaining about Trump. Who are they exactly complaining to? This is a symptom of the troubling state of our democracy. The most urgent issue at stake is our political system itself. It's too outdated to address our modern problems. It needs an upgrade. Who we vote for is secondary to this problem. Read »
I woke up at 8:05am even though I had an appointment to see my friend Robert at 9 in the West Village. I quickly analyzed the likelihood of being able to get there in time. I needed to take a shower, get dressed, walk the dog, and get on the subway. On weekends (actually, today is Labor Day) the subway is unreliable, so I concluded that it's highly unlikely that I could get there in time. I emailed Robert to let him know that I was going to be late by about half an hour. Read »
Yesterday, my wife and I took our kid to an amusement park. We were with two other families who are more impulsive and happy-go-lucky than I am. They wanted to play on the beach first and then go to the amusement park later. I was concerned that it might start raining later. And if so, I figured, it would be better for us to go to the amusement park first, and then to the beach. I'm a control-freak, so I used my hyper-local weather app to check the probability of rain. It looked almost certain that it will rain later. As soon as I made my prediction, the weather became a lingering thought in my head. After the beach, the other families went on enjoying the amusement park despite the fact that ominous clouds were forming above us. I kept looking up and sure enough, it started raining. But fortunately, it drizzled for a while, so our kids were able to enjoy most of the rides. Towards the end, however, the rain became heavier. My wife and I had umbrellas, but the other families did not. They were getting soaked, but it didn't seem to stop them from having fun. We decided to go home. They went off to get hot dogs with their clothes drenched in the rain. Read »
The younger generations are generally savvier with the written forms of communication like texting, email, and social media, because they grew up with them. The older generations had to learn them as their second language. I'm wondering: Are the younger generations better at avoiding miscommunication when they use these digital mediums? Read »
My father often talks about death and dying. He jokes about it a lot with my daughter; like he might not be around when she visits him next time. Well, I've been the same way. The idea of death has been one of my favorite topics. I've read many books and articles on the topic, like "The Denial of Death" by Ernest Becker. I recently had the opportunity to spend two and half weeks with my parents, and what was interesting about observing my dad was that I could see, more objectively, my own attitude about death in him. Read »
Interestingly, popular video games emulate mundane aspects of everyday life that we dislike. For instance, Packman is about cleaning. I've heard that it's popular among women for that reason. FarmVille is about running a small business (farm). Minecraft is about sheer survival. Candy Crush is about pattern matching. It reminds me of matching pairs of socks after laundry. Read »


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Design Participation as Insurance: Risk- Management and. End-users Participation in the Development of Information
- Rudolf Daniels
- 1 years ago
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1 Design Participation as Insurance: Risk- Management and End-users Participation in the Development of Information Systems in Healthcare Organizations Vivian Vimarlund Ph.D., Toomas Timpka M.D., Ph.D. MDA, Departments of Computer Science and Social Medicine, Linköping University, Linköping, Sweden. Address for correspondence Vivian Vimarlund, Ph.D. Department of Computer and Information Science Linköping University S Linköping Sweden Phone: Telefax:
2 Abstract By their indirect contribution to the attainment of the organizational goals, activities that prevent negative secondary effects from information system development in healthcare organizations can be regarded as sunk costs. In this paper economic theories and a case study are used to build a theoretical framework for analysis of when decision-makers should use end-user participation as a form of insurance for unforeseen consequences of the implementation of IT systems in healthcare organizations. The result suggests that to invest in broad design participation can be a productive activity that transforms potential current income into future benefits. Keywords: Health economics, health informatics, end-users participation, information system development, risk aversion. 2
3 1. Introduction Achieving a significant return from invested resources in Information Technology (IT) has been a continuing problem for today s organization [1]. In this respect, an alternative for a health care organization is to be poor today but have good future prospects. When purchasing a large, expensive item such as a Health Information System (HIS) which has not been produced in large quantities previously, there exist risks of cost-plus variety [2]. A HIS consumer agrees beforehand to reimburse the costs related to the acquired goods. However, nothing is usually decided about the unintended consequences that the implementation of a new system can have for the organization. A non-optimally designed HIS can lead to increased workloads and patient waiting time, and thereby reductions in the total service production [3]. In all, a healthcare organization may find the total effect of the changes that occur after the implementation of the new but noneffective system unacceptable. However, if the issues were clearly presented beforehand, decision-makers in healthcare would normally be willing to adopt measures to protect the organization from evident risks incurred by receiving non-optimal new systems. The ability to make effective decisions and buy the appropriate information system is closely related to the costs of acquiring information about the system s functionality and learning about the technical characteristics of the system [4]. Consequently, because the goals of healthcare organizations are to promote and restore health, activities that prevent negative secondary effects from information system development may be included in the total cost structure as sunk costs (a 3
4 cost incurred "in the past" that will not be affected by any present or future decision), in situations when they significantly contribute to the attainment of these goals. In the Scandinavian countries it has long been a tradition to incorporate end-users as key members of design teams and not see them merely as experimental subjects [5-8]. End-users participation in information system development is instead regarded as an important source of benefits, ranging from increased workplace democracy to that human-computer interaction issues are brought forward in the design process [8-9]. However, despite the increasing interest in end-users participation, few studies have discussed its economic consequences for healthcare. The aim of this paper is to explore the value of end-users participation in information system development projects. In specific, a formal theory is proposed for the planning of the use of such approaches in healthcare organizations. 2. Method Data were collected in a case study of the development of an information system in a small clinical setting. At the time of the study, the clinical unit provided case management for patients with multiple problems of medical, social and psychological nature. It only received its patients by referrals from other institutions, e.g., Primary Healthcare Centers (PCH), Social Insurance Offices, Occupational Healthcare Clinics, the Employment Exchange Office and Social Welfare Units. A participatory design method was used to develop the system. During 4
5 the initial phase of the development, the future end- users of the system: one physician, one psychologist, one social worker and one secretary, were allowed to actively influence the system design and test every new tool that was considered for implementation. The final HIS supported internal messages to individuals and broadcast file sharing, group and individual scheduling, and Internet mail [10]. Both qualitative and quantitative methods for data collection were used. For a period of two weeks, in face-to-face interviews, the healthcare team and the designers were asked about the system in use and about the main outcomes obtained from the participation process. In order to validate our results, one week after the first interview the members of the staff were individually given the opportunity to comment on the conclusions, which could be drawn from their interviews. Economic theories of industrial organizations, uncertainty, and consumer behavior were then used to interpret the collected data. 3. Case Study: Use of Working-Time in Design Participation 3.1. Findings: In the initial period, the clinical team acquired first-hand experience and information about the physical attributes of the information system. It also learned about the social significance of consuming the system and how the system might serve the needs of their clients. The endusers and designers discussed basic goals for the organization as well as the potential changes for teamwork that the system under design could support. At this stage, the outcome of the design was not seen to be the information system itself, but the value of its role in the production of healthcare 5
6 services. The new information system was seen as a tool for improving the quality of the service and, as such, a factor that would directly affect the service production possibilities at the clinic. Also, the requirements that were relevant for an improvement of the collaboration between the organizations the patient was involved with were established. Some of the effects pointed out by the work-team were: i) The possibility to improve communication with non-healthcare organizations, ii) The possibility to design the teamwork activities from a patient perspective, rather from that of a single service, iii) The possibility to create network structures that would allow creativity in production and processes, e.g., new forms of interaction and communication with patients and healthcare providers Comments: The information acquired during the design process allowed the clinical team to distinguish the functional value of the HIS, and to understand how it would help to easily integrate the healthcare professionals work tasks with each other. As previously found by Dobbs and Hills [11], experience with the application in the practice setting changed the clinical team s perception of the HIS. This in-depth experience may be the key factor for a high acceptance level of the changes that a new system inevitably is going to lead to for an organization. Moreover, the participation allowed the end-users to work closely with designers in their role as producers of modules, by supplying feedback to practical problems that arose during the design stage. This situation allowed the module producers to present broad specifications for the required module, while engineers developed the detailed specification. A system with these 6
7 characteristics was consequently considered to be of more value than any other potential systems without such attributes. This is due to the fact that the proposed solutions were seen to be more in accordance with the endusers own preferences [12-13]. The design process was also seen as an investment in human capital that should increase the effectiveness in the use of the systems and thus as a tool to manage the changes that technological innovations give to any organization A theory for Investments in Design Participation When a system development project is initiated, the final quality of the goods (i.e. the information systems) that will be available to the healthcare unit and the subsequent effects on the work-routines cannot be known with certainty. If the information system is not sufficiently appropriate, the economic effects on the organization are significant for two reasons. The first is the irreversibility involved in any investment [14] and the other is that clinical organizations can not raise unlimited resources to compensate for organizational failures. Consequently, when healthcare organization s managers fear negative secondary consequences of a HIS with regard to the clinical work flow, and if they can find a possibility of shifting these risks, they will engage in activities that allow them to be sure that the system will 1 The theory of economic growth signals four determinants of total output: growth in the labour force, investment in human capital, investment in physical capital and technological changes. Lipsey G, Courant PN. Economics.(11 th Edition). New York: Harper Collins College Publishers
8 be adapted to all aspects of their organization. The underlying logic for investing resources in design participation processes is the same as in choosing between ordinary commodities x and y within a single period of time. Just as individuals, organizations choose the level of investment that maximizes their well being, and borrow or lend resources to achieve a preferred time-pattern of consumption. Once the management has committed funds to a specific project, such as the development of a new HIS, it must forego other investment opportunities that might have been undertaken by using the same funds. Risk averse decision-makers calculate the present discounted value of the effects accrued over time to the unit, and predict the amount of resources they are willing to pay to acquire an insurance (such as design participation) that will protect the organization from future loses [15] e.g., decrease in service production. In such circumstances, the acquired insurance converts an uncertain outcome into a certain cost (the amount of resources the organization pays for allowing its personnel to actively participate in the development process). It follows that the organization is better off with an insurance if the possible future negative effect is severe or likely. The benefit for the buyer of the insurance who exchanges a risk-filled situation for a less risky one, is then substantially higher in terms of gain in private benefits or consumer surplus and wellbeing [16]. Consequently, healthcare decision-makers that want to prevent any negative secondary effects that affect the social or economic outcome of their organizations should be willing to actively contribute out-of pocket investments in 8
9 participation in order to screen out a high risk of obtaining a less appropriate system. Insert here text box 1 5. Discussion Organizations with utilitarian goals, such as healthcare organizations, always aim to maximize the utility of the production of services over time. They will therefore undertake policies that ensure optimal growth by adjusting a variable input factors, such as workforce, and means of production in the short run, and by choosing the method that will produce the best social and economic output in the long run. The results of our case study suggest that when time and effort are invested in allowing healthcare staff to participate in information system development processes, the benefits can well exceed the costs over the life cycle of the project. Because understanding the current process provides the basis for discussions regarding new alternatives (such as innovation of services, system capabilities, system costs, technical architecture), end-users participation in design can be the key positive influence on the quality of the service and thereby organizational effectiveness. In reverse, improved effectiveness stimulates productivity due to the fact that understanding the current process also provides the basis for decisions regarding new alternatives that can generate growth [17]. It is this association that makes design participation attractive for the healthcare organizations and for society as a whole. The central mechanism behind this is that learning-bydoing increases the accumulation rate of human capital for the organization 9
10 [18-19]. We further found that effects of design participation not only can induce a better understanding of an organizations needs in the production of the system, as argued by Greenbaum [20], but it can also increase the interpersonal or social interdependence among individuals. The main yield of these effects is a broader scope for productivity improvement [17]. Further, in every economic system, there is a responsible agent upon whom the burden of any given risk falls in the first instance. Healthcare organizations, due to their responsibility as agents for patients, and as representatives for their stakeholders (who are themselves largely risk averse), are always likely to behave in a risk averse manner [21]. In making choices, these organizations always wish to be efficient by using no more input than necessary. Because the development processes of HIS necessarily involve changes that take place over time and involve numerous actors [22] it seems rational that healthcare organizations should adopt approaches that diminish or at least divide risks of obtaining an inappropriate HIS. Consequently, if it is possible to use design methods that will decrease the risk for negative unforeseen secondary consequences, these methods will be preferred, even if this implies increased short-run costs during the requirement specification process. Decision-making, whether or not of an economic nature, always involves assumptions about the future. The purpose of adopting a new plan of action, such as introducing an information system, is to make the future different and presumably better. To make an optimal choice in economic terms, it is essential to predict, with the least possible uncertainty, the effects that this 10
11 choice will have on the future evolution of the economic unit in question. If any organization worries about risk it will pursue safer lines of activity even though these suggest fewer short-term benefits. The organization has to decide what to consume, how to employ the resources it has, and how much to save so as to acquires more resources [23]. On occasions, organizations save in order to produce new resources for themselves in-house. More often, however, organizations save by physically acquiring new resources (such as new technology), making capital investments in order to create and exploit profit opportunities in the future [14]. As saving increases future income, the decision to consume today or to save, such as to decide between direct investments in new ready-made products or design participation, is a productive activity that transforms potential current income into future income. Hence, if a healthcare organization makes wrong choices in this decision-making, its survival may be threatened, whereas if it makes a shrewd estimate of the future effects of an investment, it may be rewarded with large or at least improved benefits and with new sources of competitive advantage. Acknowledgements The Swedish Board for Technical and Industrial Development NUTEK/VINNOVA supported this work through the MTO program. References [1] Landauer TK. The Trouble with Computers, Usability and Productivity. Cambridge, MA: MIT Press
12 [2] Arrow KJ. The Economics of Information. Cambridge, MA: The Belknap Press of Harvard University Press [3] Vimarlund V, Ljunggren M, Timpka T. Implementation of Computer-Based Patient Records in Primary Care: The Societal Health Economic Effects. In: Cimino JJ (Ed.). Proceedings of AMIA Annual Fall Symposium; 1996 Oct Washington D.C. Philadelphia: Hanley and Belfus, Inc p [4] King N, Anderson N. Innovation and Change in Organizations. London: Routledge [5] Abowd G, Beale D, Dix A, Finley J. Human Computer Interaction. Prentice Hall International [6] Mundford E, Henshall D. Participative Approach to Computer System Design. London: Associated Business Press [7] Naschold F, Cole RE, Gustavsen B, van Beinum H. Constructing the New Industrial Society. Stockholm, Sweden: The Swedish Centrum for Working Life [8] Timpka T et al. Action Design Version 2.0 CEC/AIM DILEMMA Deliverable DO4. Linköping, The MDA- group. Linköping University, [9] Sjöberg C, Timpka T. Participatory Design of Information Systems in Health Care. Journal of the American Medical Informatic Association 1998; 5: [10]Hallberg N, Timpka T. Quality Function Deployment (QFD) for 12
13 Developing Customized Social Medical Service. Scandinavian Journal Social Welfare 1997; 6: [11]Dobbs M, Hill MB. Technical Innovation and The Demand for Goods. Scottish Journal of Political Economy 1984; 31(2): [12]Becker GS. Accounting for Tastes. Cambridge, MA: Harvard University Press [13]Frey BS. Not just for the Money. Cheltenham, UK: Edward Elgar Publishing [14]Dixit AK, Pindyck S. The Options Approach to Capital Investments. In: Brown JS (Ed.). Seeing Differently: Insights on Innovations. Boston, MA: A Harvard Business Review Book [15]Cooter R, Ulen T. Law and Economics. New York: Harper Colins Publishers [16]Evans R. Strained Mercy. The Economics of Canadian Healthcare. Toronto and Vancouver: Butterworth & Co. Canada Ltd [17]Yang X. (Eds.). Increasing Returns and Economic Analysis. New York: McMillan Press Ltd 1998.p [18]Lucas RE. Making Miracle. Econometrica 1993; 61: [19]Arrow KJ. The Economic Implications of Learning by Doing. Review of Economic Studies 1962; 29: [20]Greenbaum J. A Design of One s own: Towards Participatory Design in the United States. In: Schuler D, Namioka A (Eds.). Participatory Design 13
14 Principles and Practices. New Jersey: Lawrence Erlbaum Associated, Inc p [21]Hopkins A, Gabbay J, Neuberger J. Role of users of health care in achieving a quality service. Quality in Health Care 1994; 3: [22]Perez C. Structural Change and the Assimilation of New Technologies in the Economic and Social System. Future 1993; 15(5): [23]Hirshleifer J, Glazer A. Price Theory and Applications. (5 th Ed). New Jersey: Prentice Hall Inc
15 Text box 1 The reasons why decision-makers should be willing to invest in a "participation insurance" during IS development Risk averse decision-makers are always willing to pay for the reduction of risk just as they are willing to pay for more tangible commodities. Assume that any loss that can occur as a consequence of the implementation of a new system (e.g. changes in work routines, decrease in productivity due to a non-optimal use of the new system, lack of specific knowledge for using central functions, non-optimal system design etc) can theoretically be expressed in terms of a monetary equivalent. In such circumstances, when investing in development of an IS, decision-makers contemplate an uncertain future in which a specific negative effect may or may not occur. Probabilistic methods are often used in decision analysis to determine expected costs and benefit as well as to assess the degree of risk in particular projects. In such situations, when estimating the benefits and costs, it is common that decision-makers attempt to obtain the expected or average values of different events that might or not occur and affect the final outcome of the product. The benefits and costs associated with these different events can therefore be estimated and the expected benefits and costs calculated as the sum over all possible events of the resulting benefits and costs multiplied by the probability of occurrence of a particular event, such as, non-desirable organizational and economic effects. m E [ B ] = ( B ) Pr q t t/q q=1 Eq.1 q = 1, m m E [ C ] = ( C ) Pr q t t/q q=1 Eq.2 q= 1, m 15
16 Where q= 1, m, represents possible events, (B t\ q ) and (C t\ q ) are benefits and costs respectively in period "t" due to the occurrence of "q". Pr q is the probability that "q" occurs, and E [B t ] and E [C t ] are respectively expected benefit and cost in period "t". Hence the expected net benefit in period "t" is given by E[NBt] = E[Bt] -E[Ct] Eq.3 Let now the probability of occurrence of the unforeseen effects after the implementation of the IS be as already indicated "q", and non-occurrence of such effects be "1-q". Assume also that the chances of the negative effect occurring are believed to be 100 q out of 100. If the negative effects do occur, the consequences (non-desirable effects on the production of health services, and consequently unhealth for the patients) can be judged by the decision-makers as equivalent to a loss of N. Moreover, an organization s well being (WB) during the future in question will be related (positively) to the development of an optimal system, which is expected in the absence of negative effects. Thus, the influence of the negative effect N is thus equivalent to a reduction in well being equal to (WB-N). If we now use U (WB) with probability 1-q to express the utility of the organizations well being with an appropriate system, then we can describe the utility of a non-optimal system over the future period as U (WB-N) with probability q. If for instance q=0.5 there is 50% chance of that either WB or WB-N occur. Representing this expected level as E(U) (expected utility), we obtain: E(U)=U(WB) (1-q)+U(WB-N)q Eq.4 The decision-maker, in such circumstances may be confronted with the subject choice among alternatives with different expected benefits of levels of risk and confronted with a choice between the certain value of the IS and a gamble with possible uncertain outcomes. 16
17 Decision-makers that wish to avoid risk so as to avoid the possibility of losses might in such circumstances, select a project with a lower risk of losses. Consequently, in situations of high risk for obtaining a non-optimal IS, a second best allocation of the capital investment will be preferred (investing in participation). Even if this action affects the total amount of consumption of resources (time, personnel involvement, and or money) that is available in the short-run, the decision-maker will chooses the riskless solution to maximize the expected utility of the IS. This preference results in a willingness to take risk premium e.g. participation insurance, that will ensure that the final benefits outcome will exceeded their cost, reflecting in this manner an adjustment of the rate of returns for the perceived risk 17
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Eric Morken
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Eric Morken is the sports and outdoor editor at the Echo Press and Osakis Review newspapers in Douglas County, MN. Follow him on Twitter at echo_sports.
Contact Email
- Member for
- 4 years 2 months
Author Content
BOYS BASKETBALL Alex vs. Big Lake, 7:30 p.m. Osakis at Browerville-EV, 7:30 p.m. Brandon-Evansville at Ortonville, 7:30 p.m. WCA vs. Battle Lake, 7:30 p.m. Parkers Prairie at Sebeka Tourney, TBD...
BOYS BASKETBALL Parkers Prairie at Sebeka Tourney, 5 p.m. Minnewaska at Pequot Lakes, 7:15 p.m. GIRLS BASKETBALL Parkers Prairie at WDC, 7:30 p.m. NORDIC SKIING Alex at Brainerd, 10 a.m...
The Alexandria girls hockey team suffered its second loss of the season in a 4-1 defeat versus Rogers at home on Friday night. The Royals (8-4, 5-1 Mississippi 8) scored three opening-period goals to put the Cardinals (9-2, 5-0 CLC) in an early hole and sophomore Paetyn Levis posted a hat trick on the night to lead the way. "The first period was a big struggle for us this game," Alexandria head coach Blair Hovel said. "We went into the game without Kristin Trosvig.
The Alexandria dance team went to Sauk Rapids-Rice to take on the Central Lakes Conference field in an invite last Friday and came home sixth in kick and eighth in jazz. All the CLC teams were in attendance for the meet as Sartell won the kick and the jazz to sweep the competition. St. Cloud Tech was second in both and Sauk Rapids-Rice was third in kick, while Brainerd was third in jazz. "The kick team had a great performance and came in sixth place beating Willmar and St. Cloud Apollo," Alexandria head coach Christine Reilly said of her team.
The Alexandria boys hockey team fell 6-1 on the road against East Grand Forks on Saturday evening. The Cardinals' (2-4-1, 2-2-1 CLC) lone goal came five minutes into the third period by Wyatt Wittenburg, assisted by Noah Hittle and Nate Folsom. The Green Wave (7-3-1, 1-0-1 Mariucci) got on the board early with goals by Nick Derrick at 5:52 and Hunter Olson at 16:59.
The Alexandria girls basketball team welcomed a 4-2 Big Lake team to town on Friday to test itself out of conference play. The Cardinals were up to the challenge as...
BOYS BASKETBALL Alex at Detroit Lakes, 7:30 p.m. Brandon-Evansville at Kimball Tourney 6 p.m. WCA vs. Morris Area, 5 p.m. GIRLS BASKETBALL WCA vs. Morris Area, 3:30 p.m. BOYS HOCKEY...
The Minnewaska boys basketball team improved to 7-1 by holding off Montevideo (4-3) in a West Central Conference showdown on Thursday. The Lakers shot 54 percent (20-37), including 5-of-8 from three. They also went 12-of-14 from the free throw line to secure the win. The Thunderhawks shot 19-of-45 from the field but hit just 9-of-19 free throws. Matt McIver led three players in double figures for Minnewaska with 20 points.
The Alexandria boys basketball team snapped a two-game skid in the Central Lakes Conference by beating Sartell-St. Stephen 72-55 on Thursday. The Cardinals (5-3, 2-3 CLC) shot 51 percent from the field (27-52), including 24-of-36 from inside the arc. Alec Wensman had a team-high 17 points to go along with six rebounds, two blocks and two assists. Alexandria had five players with at least seven points. Jaran Roste had 11 points, 10 rebounds, four assists and three steals.
The Alexandria wrestling team held off a late charge by St. Cloud Tech-Cathedral on Thursday night by getting a big pin from Quintin Kluver-Longfellow at heavyweight that secured a 39-32 victory. Tech scored 18 points over the final three matches before the heavyweight bout as Drew Kiffmeyer won by forfeit at 182 and Cole Schreder (195, 3:43) and Tyler Hugg (220, 1:18) each won by fall. That set the stage for Kluver-Longfellow, and he delivered against Micah Mangel.


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Competent sysadmin with php experience required to finish project (DNS proxy with bind and squid)
- Status Closed
- Budget N/A
- Total Bids 7
Project Description
I hired a freelancer to create a DNS proxy system (like [url removed, login to view]), and what I received was a hack-filled and broken system. Over the last few months, I've been working with my friend who's a sysadmin to rewrite the project properly and we finally have a proper backbone to work with. Everything works great. The only problem is my friend works full-time at an ISP so his time is very limited and doesn't have the time to finish the remaining tasks:
- need NHL gamecenter live added to the proxy (may or may not need the method below for netflix)
- in order for netflix to work, for each https server we allocate an ip address like this:
iptables -t nat -I PREROUTING -d ${Y} -j DNAT --to-destnation ${X}
iptables -t nat -I POSTROUTING -d ${X} -j SNAT --to-source ${Y}
(if you don't have a 100% grasp on what were doing here, you're not the one for this project. We already did it for one of the SSLs but we need a few more for it to work on mobile devices)
- we setup denyinfo to redirect to a renewal page when the service is suspended but for some reason it's crashing bind so troubleshooting is required here. It's been temporarily commented out.
Bonus: the original freelancer created a php snippet in WHMCS to activate the customer's ip address and do a couple other things. It was written like crap and needs to rewritten. I wasn't planning on including this as part of the project because as I understand sysadmin and php are different things, but if you can do it, it'll be considered. If you're able to write a proper WHMCS module that's even better.
The entire project is about 95% complete so unreasonably high offers will be rejected immediately.
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The Red Roosterby Michael Wallace
Of all the desperate women in German-occupied Paris, Gabriela Reyes is the least likely to scratch out her survival as a whore for a Gestapo agent. After fascists murdered her mother and brother and tortured her father in an insane asylum, she hates the Germans as much as she fears them. But when she discovers the man responsible for destroying her family, she decides to become his mistress to try to free her father and avenge her family.
Helmut von Cratz is a war profiteer using his wealth to undermine the Third Reich and is one meeting with an American agent away from ending the German occupation of France.
But Gabriela's sudden appearance as Colonel Hoekman's mistress jeopardizes Helmut's careful plans. Now he must decide: will he abandon his plans, or will he sacrifice yet another woman to the German war machine?
Editorial Reviews
Product Details
- 9781481927468
- Publisher:
- CreateSpace Publishing
- Publication date:
- 01/12/2013
- Pages:
- 340
- Product dimensions:
- 5.50(w) x 8.40(h) x 0.60(d)
- Age Range:
- 1 - 17 Years
Meet the Author
I've trekked across the Sahara on a camel, ridden an elephant through a tiger preserve in Southeast Asia, eaten fried guinea pig, and been licked on the head by a skunk. In a previous stage of life I programmed nuclear war simulations, smuggled refugees out of a war zone, and milked cobras for their venom. I speak Spanish and French and grew up in a religious community in the desert.
Customer Reviews
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A fast moving plot with rather typical characters found in historical fiction: a strong female protagonist , a handsome war time German entrepreneur playing both sides, and the evil officer with a sadistic love of torture. The historcal setting creates a satisfying backdrop for the rather stereotypical plot and characters. The theme involving the lenghts one will go to survive is carefully integrated into the lives of the characters and provides a unifying thread .
The characters were easy to get caught up in and root for or against. The writing was effortless and a joy to follow. The book was a great value, 850 pages of intrique. This author is one to watch.
It's not your standard 'war' story. But a human story set in the times of the war.
enjoyable read, highly recommend
I really liked this book. I didn't like the characters so much at first but they grew and changed and by the end I liked them a lot. And the evil ones I despised. I thought the story was very good and it seemed to me that it could have been a true story rather than fiction. I would recommend this book for people who want to remember how awful world war II Nazi Germany was.
A very good WW11 page turner of trying to outwit the Gestapo in occupied France. Characters well portrayed and believable. Highly recommended
If you love stories about WWII, especially in Germany, you will like this one. It keeps you guessing right up to the end. Highly recommend it!!
Fast paced plot with creative twists, this book will be difficult to put down. Historically accurate, the side plot showed how difficult life in occupied France was for the torn citizens. Survival is a tough road, the choice made are not always the ones people would make during times of prosperity and peace. Wallace's novel gives a good feel for how people made do in the worst of times. I will absolutely read more from this author.
I would like to see Barnes & Noble add whether books are first or third person. I do not like first person books and when I purchase one in Nook, I am stuck when I discover it is now what I wanted.


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E-Mini futures options are futures contracts that are traded electronically through the Chicago Mercantile Exchange. The "E" comes from the fact that they are traded electronically, using online resources, and the "Mini" part of the name is due to the fact that these contracts are a fifth of the size of regular S&P futures contracts. Many traders prefer these to other forms of trading, and they are popular in other markets as well as the S&P 500.
The Standard and Poor's e-mini futures contract is a group of stocks from S&P's 500 large-cap benchmark stocks. Stocks used to make up the e-mini contract are selected for their industry, size and liquidity. These options tend to trade very quickly in the electronic market. Since an e-mini is a futures contract, the e-mini option covers a period of three months, and a new contract is established at the end of that time. Contracts end in March, June, September and December.
A single E-mini futures contract for the S&P 500 has a value that is 50 times the current value of the S&P 500 stock index. If the stock index has a value of 1,000, for example, an E-mini would be valued at $50,000. A buyer can purchase a contract for a tenth of its face value, so by investing only $500 the trader can control options worth 10 times that amount. He can make or lose money this way, depending on how the day's trading goes.
The term "tick" is used to describe the change in value of an e-mini option. A tick is the smallest increment of movement for an E-mini, and each tick is worth $12.50. Four ticks together equal a single point, so the value of a point is $50. Daily market changes typically amount to about 15 or 20 points, or 60 to 80 ticks, for a total fluctuation of about $750 to $1,000. This can be up, for a profit, or down, for a loss, and there can be days when the fluctuation is far more than 80 ticks.
Trading e-mini options is far more affordable for individual investors than full options are, allowing people to work on their own instead of as part of a trading group. These futures options also have the advantage of being much more liquid than the larger options, so investors don't need to tie up their money any longer than they want to. Many people find it appealing that S&P E-mini options can be traded 24 hours a day instead of being limited to traditional trading hours. For such people, these hours are an additional incentive to buy E-minis.
Photo Credits
- Jupiterimages/Photos.com/Getty Images


text: Vendeur: missfrankiecat (1.079) 99.6%, Lieu où se trouve: London, Lieu de livraison: GB et de nombreux autres pays, Numéro de l'objet: 222318233337 One of these - the diamonte studded with blue bell - was actually rather expensive when new. The bead work is on a woven elastic braid that you can push the buckle through at any point for an exact fit. It is for a small cat - total length just over 9". The other collar is just a basic blue glitter band - up to 12.5" and well used. Please look at the detailed photographs which are part of this description. Please note that I will try to post as soon as possible but I frequently travel to work and may not be able to post until the first Saturday after your payment has cleared. Therefore if very swift turnaround is required please message me prior to purchase so that I can advise when I will be able to mail that week. I only send signed for or Special Delivery depending on item value and postage/packing costs reflect this. I do not personally mail overseas but am signed to the eBay Global Postal Scheme. Therefore please do not message me requesting a lower postage cost than that set by eBay for international sales.


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Tuesday February 21, 2017 | Campus Closed Today
Snow Day
Due to weather and road conditions, the Incline Village Campus is closed today.
Enjoy the powder!
Due to weather and road conditions, the Incline Village Campus is closed today.
Enjoy the powder!
Welcome to SNC Tahoe, a small liberal arts college in Incline Village, Nevada on the shores of Lake Tahoe.
We invite you to join our top ranked programs and enjoy life at a world-class destination. Hope to see you soon!
Follow us on Instagram Like us on Facebook See Our Viewbook
Scholarships: all international students are considered for merit-based scholarships. The scholarship amount depends on your academic record. The maximum scholarship award for international students is $4500 per year. Contact Admissions for more information at email@example.com or 866.412.4636.
Early Start Scholarship: an Early Start scholarship is available toward the tuition of the online university class "US Academics and Culture". Contact Tara at email@example.com for information.
Cost: see Tuition and Fees for an outline of all costs. Campus housing and meal plan ("Room and Board") are required for all new international students. Health insurance that will cover you in the US is also required.
DO NOT use the Freshman or Transfer Cost Calculators. They are for US students only.
There is no fee to apply to SNC Tahoe.
The minimum TOEFL score for new international students is 59. If you have a lower score, contact Chris at email@example.com for options.
Your school transcript must be officially evaluated by one of these companies: International Education Research Foundation; AACRAO; World Education Services
Applications are accepted on a rolling basis, although we strongly recommend that you complete your application as early as possible. You will usually receive a decision within two weeks of completing all your application requirements.
Chris Anderson
International Programs and ELL Coordinator
Email address for digital documents: firstname.lastname@example.com.
Mailing address for official transcript(s) and other documents:
Admissions Office | Sierra Nevada College | 999 Tahoe Boulevard | Incline Village, NV 89451-9500
Fax: 775.831.6223
College Board CEEB Code for SNC: 4757
"This class has helped me prepare for the U.S. university. I have more confidence in myself because now I know what to expect in the U.S. university and cultures."
– Student in Japan, 2016
ELEC 110 U.S. Academics and Culture is a self paced online university class for international undergraduate students. Learn key strategies to succeed in U.S. academic systems, improve communication skills, adjust to US culture, and to build professional networks. Graduates receive three college credits from SNC and "Conditional Admission". The academic credits can also be transferred to other US colleges and universities.
Get a special scholarship for this class. Email firstname.lastname@example.com for details.
Once accepted and enrolled, I-20 forms are mailed to you for Visa applications and U.S. entrance. When you have your I-20, make an appointment with the nearest U.S. embassy or consulate to apply for your student visa. In some countries it may take several months to get your visa, so apply as soon as possible.
For more information, please contact the Admissions Office at firstname.lastname@example.com or 866.412.4636.


text:
ANDY FARRELL, the Lancashire captain, has already acknowledged that Yorkshire will be able to field a formidable pack for the Origin match at Odsal next month. Two of the young contenders for prop positions for the White Rose meet at club level tonight when Leeds Rhinos and Castleford Tigers do battle at Headingley.
Andy Lynch, of the Tigers, and Ryan Bailey, the teenage Rhinos prodigy, are very much in the thoughts of Graham Steadman, the Castleford and Yorkshire coach, as he looks to finalise his selection for a match that is designed as an international proving ground.
Bailey, 19 and


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Books and Movies blog is hosting this year's Ireland Reading Challenge. To participate, you just have to commit to reading books about Ireland and/or by Irish authors sometime in 2011. I have a whole month of Irish reading planned for March, 2011, so this challenge is perfect for me. Among the things I'd like to read are:
The Matchmaker of Kenmare, by Frank Delaney,
Skippy Dies, by Paul Murray,
The Dork of Cork, by Chet Raymo,
The Midnight Choir, by Gene Kerrigan,
The Outside Boy, by Jeanine Cummings, and more.
I have a small stash of Irish books just waiting for something like this; I'm going to read as much as I can in March but I'm sure I'll be reading all year long here and there.
I'm so excited to be participating! Thanks to Books and Movies for hosting


text:
Sit, stay, save 20% sitewide. 24 hours only. Use code GOFETCH20
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text:
Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
To the Editor: Dr Green and colleagues1 discuss 3 cases described as reversible myelosuppression
that may be associated with linezolid treatment. Pharmacia, which manufactures
linezolid, asked independent hematologists to review the histories and bone
marrow pathology of the first 2 cases. The third case was not reported to
us as of March 14, 2001.
Arellano FM. Linezolid and Reversible Myelosuppression. JAMA. 2001;286(16):1973-1974. doi:10.1001/jama.286.16.1969
© 2017


text: Anyone who has ever been into London's West End will have come across those people whose entire job is to stand on the same spot all day holding a sign that advertises the local Subway, English classes or the classic, a Golf Sale. As humiliating and depressing as that job may be, nothing could be worse than the poor guy who I saw on Saturday on Tottenham Court Road. He was having to stand handing out leaflets while wearing a backpack with a pole attached and a working LCD screen hanging above his head!!! He also had a smaller LCD straped to his chest. Presuming the backpack contains some kind of powerpack, I'm sure his back appreciated it! Sadly I had no camera on me at the time.


text:
Another interesting article about GMOs has been making the rounds today. This one was written by Dr. Charles Benbrook, Chief Science Consultant for The Organic Center. This publication is an updated version of a report that The Organic Center published in 2009. The new version has been published in "Environmental Sciences Europe" and can be downloaded […]
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