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Curriculum Inventory Workshop
Terri Cameron, AAMC Valerie Smothers, MedBiquitous Ye Chen, University of Virginia James Galt, Rutgers Robert Wood Johnson Medical School Saniya Saifee, New York University School of Medicine
Workshop Objectives By the end of the workshop, participants should be able to: Describe and implement the CI Specification, Competency Framework, AAMC Business Rules, and Developer Resources Create XML code that includes PCRS to Program Competencies Mapping Create XML code that includes Event to Program Competency Mapping Create XML code that includes Sequence Block and Event Data Elements Upload a successful XML file to CI Staging
MedBiquitous Curriculum Inventory V1
Working Group launched in December 2010 Susan Albright and Marc Triola, co-chairs Charter: "to develop XML standards for the exchange of curriculum data for benchmarking and educational research." (Not just for AAMC Curriculum Inventory) Reasons for Undertaking Work: Enable local curriculum management systems to upload data to a central Curriculum Inventory Identify curricular trends Support curriculum benchmarking and reform
Curriculum Inventory Expectations Events Sequence blocks
Integration blocks A E B F C G D H I J K L M E O N C G S H I J P R Q 3 1 2 1 2 3 4 5 6 7 8 9 10 11 Competency framework
Events A curriculum is made up of many educational events
Events have metadata, descriptive information about the events IDs required! I A E J B F K C G L D H
Expectations Curricula may reference objectives , competencies, learning outcomes, or milestones. These are called competency objects. IDs required! 3 1 2 6 4 5 9 7 8 12 10 11
Competency Objects and Events
An event may be intended to address one or more competency objects (learning objectives, competencies, and milestones) A competency object may be associated with many events G 1 2 K 6 2
Sequence Blocks Events can be organized into blocks of instruction, called Sequence Blocks (think course/module/ year/phase/clerkship etc) A recurring event may be associated with more than one Sequence Block Sequence blocks may be associated with competency objects (competencies, objectives, etc) Sequence blocks have metadata, too IDs required! I A E J B F 2 1 K C A L G D H 7
Integration Blocks Curricular themes, or Integration Blocks, may apply to many sequence blocks, events, or objectives/ competencies and describe how the curriculum is semantically integrated. An event or block may link to many Integration Blocks and an Integration Block may link to many events, blocks or competency objects IDs required! A E B F C G D H I J K L 1 M E O N C G S H I J P R Q 3 2
Sequence Sequence blocks can be put together to form a the main structure of the curriculum (a sequence of courses, modules, phases, clerkships) A E B F C G D H I J K L 1 M E O N C G S H I J P R Q 3 2
Sequence Block Nesting
A E B F I J 1 2 Sequence blocks can be nested: a module or clerkship might be in a year which is within a phase and so on … Blocks will inherit any relations to competency objects from their sub-blocks No restriction on the number of nest levels Recursion explicitly forbidden A E B F I J 1 2 A E B F I J 1 2 A E B F I J 1 2
Types of blocks: ordered
Sequence=ordered Required=true - All sub-blocks within an ordered block happen with a prescribed sequence Block Required I A E J B F Block Required R C J D Q Z Block Required T A X Y M B
Types of blocks: unordered
- All sub-blocks within an unordered block happen for all students, but students may encounter them in a variable order Block Sequence=unordered Required=true Block Required A E B F I J Block Required C J Q Z R D Block Required A X M B T Y Block Required D K N S L C
Types of blocks: selectives
- Every student must participate in [specify number] of the blocks, and the order is variable Block Required = Required Order=Unordered Minimum=1 Block Optional A E B F I J Block Optional C J Q Z R D Block Optional A X M B T Y OR OR
Types of blocks: electives
- Students may or may not participate in any of the blocks Sequence Block Required = Optional Order =Unordered Minimum=0 Sequence Block Optional A E B F I J Sequence Block Optional C J Q Z R D Sequence Block Optional A X M B T Y OR OR
Types of blocks: parallel
- All sub-blocks within a parallel block happen at the same time, but are distinct educational units Sequence Block Required = Required Order = Parallel Sequence Block Required C J Q Z R D Sequence Block Required A E B F I J
Clerkships, required = Required, minimum = 2, maximum = 2
Level 1 Main Track, required = Optional, track = true Level 1 Common Clerkships, required = Required Med/Geri 1 84 days required in track Surg 1 56 days required in track NeuroScience 28 days optional Elective 21 days required Neurology 28 days required Pediatrics 1 42 days required in track Ambulatory 1 28 days required in track Anesthesiology 7 days required Psychiatry 28 days required Level 1 Ambulatory Track, required = Optional, track = true Option 1: This diagram shows two tracks for level 1 clerkships that show the varying lengths. The minimum maximum values of the "parent" block indicate that students must take two of the "child" blocks. Since Common Clerkships is required, that means that either the Main track or the Ambulatory track is required. We would need a new attribute called "required in track" to show that medicine, geriatrics, surgery and pediatrics are required in the track. The content for the tracks could be different (ie Surg 1 has different educational events than Surg 2). When researchers search for all surgery clerkships, they will see two clerkships of varying length with varying content, both marked required in track. The CIP search mechanism would need to understand the nuance of required in track when allowing users to construct search queries. QUESTION: Should we be able to say that a clerkship model is longitudinal? Is that mutually exclusive to integrated and rotation? Ob/Gyn 42 days required Med/Geri 2 63 days required in track Surg 2 42 days required in track Pediatrics 2 28 days required in track Ambulatory 2 77 days required in track
Level 2 Clerkships, July 4, 2011– April 27, 2012
Level 2 Clerkships Variable time, July 4, 2011 – April 27, order = unordered Level 2 Clerkships, second half of the year, January 1, 2012 – April 27, 2012 Subinternship required 28 days Emergency Med required 28 days Into to Internship required 14 days Anatomic Radiology Required 14 days or online course Critical Care Required 14 days This shows how you would model a course that can occur anytime during the second half of the year. Electives 147 days (21 are usually taken during level 1 and the rest during the level 2 variable time
Relates to other competency objects . . .
A competency object . . . Statement Competency Framework Relates to other competency objects . . . Learning Object Assess-ment Performance data Which can relate to external resources . . .
Business Rules Program-level competencies are required and must be mapped to PCRS using #related All competencies, including PCRS, program-level, sequence-block level, and event level competencies used in a <Relation> tag must have an <Includes> tag
Spec Required Elements
Curriculum Inventory ReportID Institution Program Title ReportDate ReportingStartDate ReportingEndDate Language Description Events Event Title EventDuration in hours and min Instructionalmethod (primary=true/false) or AssessmentMethod (purpose=formative/ summative) Expectations CompetencyObject identifier title Category * AcademicLevels Sequence * Vocab ids * - required by AAMC business Rules
SequenceBlock Requirements
Attributes: id, required Title Timing (either duration in days or start and end dates – clerkships must specify both) Level SequenceBlockEvent SequenceBlockReference
Matching Program Objectives to PCRS (Crosswalk)
2. Knowledge for Practice: Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care. 2.1 Demonstrate an investigatory and analytic approach to clinical situations 2.2 Apply established and emerging bio-physical scientific principles fundamental to health care for patients and populations 2.3 Apply established and emerging principles of clinical sciences to diagnostic and therapeutic decision-making, clinical problem-solving, and other aspects of evidence-based health care 2.4 Apply principles of epidemiological sciences to the identification of health problems, risk factors, treatment strategies, resources, and disease prevention/health promotion efforts for patients and populations 2.5 Apply principles of social-behavioral sciences to provision of patient care, including assessment of the impact of psychosocial and cultural influences on health, disease, care-seeking, care compliance, and barriers to and attitudes toward care 2.6 Contribute to the creation, dissemination, application, and translation of new health care knowledge and practices 2.99 Other knowledge for practice Demonstrate a broad working knowledge of the fundamental science, principles, and processes basic to the practice of medicine. 2.1 Understand the clinical relevance of scientific inquiry. 2.2 Apply this knowledge in a judicious and consistent manner to prevent common health problems and achieve effective and safe patient care. 2.3 Demonstrate the ability to evaluate emerging knowledge and research as it applies to diagnosis, treatment and the prevention of disease. 2.4 Utilize state of the art information technology and tools to retrieve, manage and use biomedical information in the care of individuals. 2.5 Utilize state of the art information technology and tools to retrieve, manage and use biomedical information in the care of populations. 2.6 Understand the indications, contraindications, and potential complications of common clinical procedures. 2.7 Perform the basic clinical procedures expected of a new PGY-1.
PCRS Mapping and Sequence Block or Event-level Competencies
Mapping of Sequence Block-level or Event-level objectives / competencies directly to PCRS is not allowed. Sequence Block and / or Event Objectives / Competencies, if mapped, are mapped to each other and to Program Objectives / Competencies
Competency Object Rules
<Competency Object> tags must be used to identify competencies, along with their <Category> (level) Program-level Sequence block-level Event-level Competency object URIs must be unique <Competency Object> tags must not be used to identify PCRS competencies
Competency Objects and the Curriculum Structure
All sequence block-level and event-level competencies must be referenced by at least one Sequence Block or Event (that was identified in the curriculum structure) Competency Framework Curriculum Inventory skos: narrower skos: related P2 S5 PCRS 6.99 PCRS 1.5 I The Sequence Block References the Program-level Competency P2 E J B P = Program Level Competency S = Sequence Block Level Competency E = Event Level Competency The Sequence Block References the Sequence Block-level Competency F S5 A
Circular References Relationships must not result in circular references. A circular reference occurs when a child element draws a hierarchical relationship to its parent that infers the parent is lower-level than the child. skos: narrower skos: related P2 S1 S2 PCRS 6.99 PCRS 1.5 P = Program Level Competency S = Sequence Block Level Competency E = Event Level Competency skos: narrower S3 Notes: – A c it is nonsensical because a higher level concept can't be a child of a narrower/lower level concept – e.g., the tire can never be the parent of the car. skos: narrower This relationship is not allowed because it creates a "Circular Reference" and violates a Business Rule. skos: narrower E4
Other notes Set the schema location to public copy: xsi:schemaLocation="http://ns.medbiq.org/curriculuminventory/v1/ Use namespace prefixes for competencies and competency framework Use AAMC ids for schools Competency Object identifiers must be URIs URLs do not have to be resolvable. As long as they uniquely identify, it will work. Add anchors to the URL so that each objective can be distinguished using the URL with the anchor included. Duration uses xsd format, for example, P40D, PT2H 1 week = 5 days
PCRS --Physician Competency Reference Set
"…a list of common learner expectations" What competencies schools are incorporating into their curricula; Where in their curricula schools are incorporating expectations and competencies; How schools are teaching and assessing competencies; and In what context and/or content competencies are being taught.
Step 1: Match Competencies
PCRS Step 1: Match Competencies
Step 2: Create XML File
<CompetencyObject> </CompetencyObject> <CompetencyFramework> <cf:Includes> </cf:Includes> <cf:Relation> </cf:Relation> </CompetencyFramework> </Expectations> Insert one of your program competencies
<lom:lom> <lom:general> <lom:identifier> <lom:catalog>URI</lom:catalog> <lom:entry>http://libraries.rutgers.edu/rwj/RWJMS_Competencies2.html#V.A.2.b</lom:entry> </lom:identifier> <lom:title> <lom:string>Students will convey information honestly and tactfully; will engage in truthful interactions with patients, peers, and in professional work. </lom:string> </lom:title> </lom:general> </lom:lom> <co:Category term="program-level-competency"/> </CompetencyObject>
<Expectations> <CompetencyFramework>
<cf:Includes> </cf:Includes> </CompetencyFramework> </Expectations> Insert one of your program competencies Insert one PCRS
<cf:Includes> <cf:Catalog>URI</cf:Catalog> <cf:Entry>http://libraries.rutgers.edu/rwj/RWJMS_Competencies2.html#II.B</cf:Entry> </cf:Includes> <cf:Includes> <cf:Catalog>URI</cf:Catalog> <cf:Entry>https://services.aamc.org/30/ci-school-web/pcrs/PCRS.html#aamc-pcrs-comp-c0108</cf:Entry> </cf:Includes>
<CompetencyFramework> <cf:Relation> </cf:Relation> </CompetencyFramework> </Expectations> Show the relationship between your program competency & PCRS
<cf:Relation> <cf:Reference1> <cf:Catalog>URI</cf:Catalog> <cf:Entry>http://libraries.rutgers.edu/rwj/RWJMS_Competencies2.html#I.C.2.d</cf:Entry> </cf:Reference1> <cf:Relationship>http://www.w3.org/2004/02/skos/core#related</cf:Relationship> <cf:Reference2> <cf:Entry>https://services.aamc.org/30/ci-school-web/pcrs/PCRS.html#aamc-pcrs-comp-c0108</cf:Entry> </cf:Reference2> </cf:Relation>
Lessons Learned Some benefit to moving a bit slow
Having more than one person understanding the specifications is important Humans are not the weakest link Networking is vital Carving out dedicated time is crucial Explaining the big picture to faculty is important Developing a functioning end product is vital Developing tools not just a product is key for the future
Show Events Mapping in XML File
Ye Chen
XML File Structure <CurriculumInventory > <ReportID> </ReportID><Institution></Institution> <Program> </Program><Title> </Title> <ReportDate> </ReportDate> <ReportingStartDate> </ReportingStartDate> <ReportingEndDate> </ReportingEndDate> <Language> </Language> <Description> </Description> <Events> <Event> </Event> </Events> <Expectations> <CompetencyObject> </CompetencyObject> <CompetencyFramework> </CompetencyFramework> </Expectations> <AcademicLevels></AcademicLevels> <Sequence> <SequenceBlock > </SequenceBlock> </Sequence> </CurriculumInventory>
Events and Competencies
Event (E1): White Coat Ceremony Event (E2): Orientation Lecture Event (E3): Peds Part 1 Event (E4): Peds Part 2 Describe the three functions List the organization, Gather, synthesize, and organize patient information. Professionalism Perform all medical, diagnostic
Repeat the same format for other 4 competencies
List All Competencies <Expectations> <CompetencyObject> List competencies </CompetencyObject> <CompetencyFramework> </CompetencyFramework> </Expectations> <CompetencyObject> <lom:lom> <lom:general> <lom:identifier> <lom:catalog>URI</lom:catalog> <lom:entry>http://nosuchdomain.edu/program_competency/1</lom:entry> </lom:identifier> <lom:title> <lom:string>Professionalism</lom:string> </lom:title> </lom:general> </lom:lom> <co:Category term="program-level-competency"/> </CompetencyObject> This value will be refered in several places (event, include, and relationship) Repeat the same format for other 4 competencies
Show the relationships among competencies
<Expectations> <CompetencyObject> List competencies </CompetencyObject> <CompetencyFramework>Show relationships</CompetencyFramework> </Expectations> Include all program level competencies, include sequence block level competencies and event level competencies if they have mappings with other competencies. other information for competencyFrameWork <lom:lom>------</lom:lom> <cf:Includes> <cf:Catalog>URI</cf:Catalog> <cf:Entry>http://nosuchdomain.edu/program_competency/1</cf:Entry> </cf:Includes> <cf:Includes> <cf:Catalog>URI</cf:Catalog> <cf:Entry>http://nosuchdomain.edu/program_competency/2</cf:Entry> </cf:Includes> <cf:Includes> <cf:Catalog>URI</cf:Catalog> <cf:Entry>http://nosuchdomain.edu/course_competency/3</cf:Entry> </cf:Includes> <cf:Includes> <cf:Catalog>URI</cf:Catalog> <cf:Entry>http://nosuchdomain.edu/event_competency/4</cf:Entry> </cf:Includes>
Show the relationships among competencies (cont.)
Describe the three functions Gather, synthesize, and organize patient information. program level comptetencies to PCRS…….. Professionalism <cf:Relation> <cf:Reference1> <cf:Catalog>URI</cf:Catalog> <cf:Entry>http://nosuchdomain.edu/program_competency/1</cf:Entry> </cf:Reference1> <cf:Relationship>http://www.w3.org/2004/02/skos/core#narrower</cf:Relationship> <cf:Reference2> <cf:Catalog>URI</cf:Catalog> <cf:Entry>http://nosuchdomain.edu/course_competency/3</cf:Entry> </cf:Reference2> </cf:Relation> <cf:Relation> <cf:Reference1> <cf:Catalog>URI</cf:Catalog> <cf:Entry>http://nosuchdomain.edu/course_competency/3</cf:Entry> </cf:Reference1> <cf:Relationship>http://www.w3.org/2004/02/skos/core#narrower</cf:Relationship> <cf:Reference2> <cf:Catalog>URI</cf:Catalog> <cf:Entry>http://nosuchdomain.edu/event_competency/4</cf:Entry> </cf:Reference2> </cf:Relation>
Map event to competencies
Only show the direct mappings. Non direct mapping is taken care by the relationship. Event (E1): White Coat Ceremony Event (E2): Orientation Lecture Event (E3): Peds Part 1 Event (E4): Peds Part 2 Describe the three functions List the organization, Perform all medical, diagnostic <Event id="E1"> <Title>White Coat Ceremony</Title> <CompetencyObjectReference>/CurriculumInventory/Expectations/CompetencyObject[lom:lom/lom:general/lom:identifier/lom:entry='http://nosuchdomain.edu/event_competency/4']</CompetencyObjectReference> <InstructionalMethod primary="true">IM013</InstructionalMethod> </Event> /CurriculumInventory/Expectations/CompetencyObject[lom:lom/lom:general/lom:identifier/lom:entry= ] 'http://nosuchdomain.edu/event_competency/4' inside <Event id="E2"><Event id="E3">, there should be <CompetencyObjectReference> with different entry value.
Event and SequenceBlock
Curriculum Inventory Event and SequenceBlock Saniya Saifee NYU School of Medicine
Event Event contains sub elements that describe a single education or assessment event
Event-Subelements Event Title EventDuration Description Keyword CompetencyObjectReference ResourceType ID InstructionalMethod AssessmentMethod 0..∞ Required Optional
Event XML <InstructionalMethod primary="true"> IM013
<Events> <Event id="E1"> <Title>White Coat Ceremony</Title> <EventDuration>PT2H</EventDuration> <Description>First year students are given </Description> <Keyword hx:source="MeSH" hx:id="D010817"> <lom:string>Physician-Patient Relations</lom:string> </Keyword> <Interprofessional>false</Interprofessional> <CompetencyObjectReference>/CurriculumInventory /Expectations/CompetencyObject[lom:lom/lom:general/lom:identifier/lom:entry='http://nosuchdomain.edu/zxcvb'] </CompetencyObjectReference> <InstructionalMethod primary="true"> IM013 </InstructionalMethod> </Event>
Competency Object <Expectations> <CompetencyObject> <lom:lom> <lom:general> <lom:identifier> <lom:catalog>URI</lom:catalog> <lom:entry>http://nosuchdomain.edu/ event_competency/4 </lom:entry> </lom:identifier> <lom:title> <lom:string>Describe the three functions of the medical interview </lom:string> </lom:title> </lom:general> </lom:lom> <co:Category term="event-level-competency"/> </CompetencyObject> </Expectations>
Events-checklist An event must have at least one instructional OR assessment method. An event can only be reported if we can report timing. An event may have multiple instructional or assessment methods, but if it's an instructional session, only one method can be primary. All assessment methods must be marked as formative or summative. Within <Event> tags, the <AssessmentMethod> and <InstructionalMethod> tags must reference a unique ID from their respective vocabularies
SequenceBlock Events Sequence Block B A B A D D When F 1 F E E I
G F H E D I A B G F H E D I When 1 Combined 2 3 Events Sequence Block Expectations
Title Timing Level ClerkshipModel CompetencyObjectRef… ID Required 0..∞ ID 0..∞ SequenceBlockEvent Required 1..∞ SequenceBlockReference Optional
Timing Timing Date StartDate EndDate Duration
SequenceBlockEvent required SequenceBlockEvent EventReference
StartDate EndDate required
AcademicLevels <AcademicLevels> <LevelsInProgram>2</LevelsInProgram> <Level number="1"> <Label>Year 1</Label> <Description>Preclinical</Description> </Level> <Level number="2"> <Label>Year 2</Label> </AcademicLevels>
Sequence Block <Sequence> <SequenceBlock id="e" required="Required"> <Title>Introduction to Medicine</Title> <Timing><Duration>P1M</Duration></Timing> <Level> </Level> <SequenceBlockEvent required="true"> <EventReference> </EventReference> </SequenceBlockEvent> </SequenceBlock> </Sequence>
Nested SequenceBlock <SequenceBlock id="c" required="Required">
<Title>Year 1</Title> <Timing> <Duration>P12M</Duration> </Timing> <Level> </Level> <CompetencyObjectReference> /CurriculumInventory/Expectations/CompetencyObject [lom:lom/lom:general/lom:identifier/lom:entry= 'http://nosuchdomain.edu/course_competency/3'] </CompetencyObjectReference> <SequenceBlockReference> </SequenceBlockReference> </SequenceBlock>
SB-checklist A SequenceBlock (Year, course, module) can only be reported if it has at least one "valid" event. The id attribute in the SB must be unique. SB should not be associated with a level number that has not been defined in <AcademicLevels> The <Timing> subelement of <SequenceBlocks> tags with a ClerkshipModel attribute must specify <Dates> and <Duration>
Is this a valid Event? <Event id="E2"> <Title>Orientation Lecture</Title> <EventDuration>PT4H</EventDuration> <Description> Faculty discuss what the students are to expect in the coming year. </Description> <InstructionalMethod primary="true">Lecture </InstructionalMethod> </Event>
It is not a valid event <Event id="E2"> <Title>Orientation Lecture</Title> <EventDuration>PT4H</EventDuration> <Description> Faculty discuss what the students are to expect in the coming year. </Description> <InstructionalMethod primary="true">Lecture </InstructionalMethod> </Event> IM013
Best Practices and project insights
Saniya Saifee NYU School of Medicine
Process followed Software program that creates XML Curriculum
Management System (CuRIE) <CurriculumInventory> …….. …. </<CurriculumInventory Validate XML against XSD CI Portal Send XML AAMC Business rules errors Refactor And repeat
Lessons learned -1 <CurriculumInventory> ….
"Including ALL Academic levels, courses, events, Expectations in your first attempt while uploading file on CI portal" </CurriculumInventory> "Including ONE Academic levels, courses, events,
Create a checklist of minimum requirements
Lesson learned -3 Create a checklist of minimum requirements
Lesson learned -3
Keep doing frequent and repeated submission
Lesson learned - 4 Keep doing frequent and repeated submission
CI Process Validate XML against MedBiq CI Standard Upload to CI
Successful submission results in 'Submitted Status' Log into School Portal Download and Review Verification Report Download results in 'Review Status' Reject or Verify Data Rejection returns Status to 'No Response' Verification results in 'Verified Status'
Resources Curriculum Inventory Implementers' Listserv: Competency Framework Specs and Schemas: AAMC Curriculum Inventory Developer Resources: https://www.aamc.org/initiatives/cir/about/349624/fordevelopers.html Physician Competency Reference Set URIs: https://www.aamc.org/external/348732?url=https://www.mededportal.org/icollaborative/resource/793 SKOS: Simple Knowledge Organization System MedBiquitous: Curriculum Inventory Working Group: Competencies Working Group:
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Plastic Spoon Lamp
DIY Yarn Chandelier | Got some yarn lying around? Here's a perfect project for you. #DiyReady www.diyready.com
DIY beautiful cardboard lamp...this is soooo sweet...not great instructions, but hopefully you get the general idea....I think I would cover the "agons" with tinfoil or gold wrapping paper (or both..or even some other coloured foil wrap) but isn't this sweet!1
Diy ombre mirrors made out of spoons
Pinspire - Pin de Flavia AG.GO:te quedas en las pulseras con chapas o vas mas alla??? ideas no faltan!
IDEAS and DECOR: Make A Cloud :)
iemo[イエモ] | リフォーム&インテリアまとめ情報
Valentine idea - tin can and clothespin vase
I'll have to find out if local shoe stores will give me shoe boxes, I want about 100. ~Ariel


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David Bowie | Michael Jackson | George Michael | Whitney Houston | Prince | Game of Thrones | Ennio Morricone | J.S Bach
Gregory Scott violinist | Alex Dineen Guitar | Dan Peate Bass Guitar | Ruby Grace Moore Cello | Jon Needham Drums | Ali Roocroft Keys
Guest appearance from West End Singing Star Chris Barton
Tickets: £24 - £19
(All ticket prices include booking fee).
A concert packed full of show stopping hits from the world's best-loved icons, performed by violin showman Gregory Scott and performers from the Royal Northern College of Music. Guest appearance from West End Singing Star Chris Barton.
As heard on Classic FM, Manchester born violin showman Gregory Scott has performed with Bryan Ferry, kd Lang and as a soloist with the Hong Kong Philharmonic Orchestra. Greg's debut album "DUEL" reached Number 1 in the UK Classical Charts.
West End Singing Star Chris Barton was a finalist in BBC Any Dream Will Do, Andrew Lloyd Webber's search for a Joseph. West End credits include Hairspray, Joseph, The Sound of Music and Starlight Express.
The Dancehouse Theatre
10 Oxford Road
0161 237 9753


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Starting a Small Farm Business
2/21/2017 6:00 pm - 8:00 pm
Price: 00.00
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The Arkansas Tech Small Business and Technology Development Center presents "Starting a Small Farm Business" from 6-8 p.m. on Feb. 21 at the Pope County Extension Office in Russellville.
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There is irregular wavy contour of the liver with, no definite focal lesion seen.
Splenomegaly is noted with large number of varices and dilated veins seen at the gastroesophageal junction and in the splenorenal region (spleno-renal shunt). Dilated portal vein, splenic vein as well as the left ovarian vein down to the pelvis where tortuous dilated parauterine vessels are seen. Findings are in keeping with portal hypertension.
Congested mesenteric vessel mostly secondary to the above mentioned portal hypertension.
Dilated IVC seen with patent IVC and hepatic veins, with multichamber cardiomegaly seen in the imaged chest.


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At Cushnie Et Ochs, models had high shine hair which - for most hair types - can only be recreated with a run over with a pair of straighteners.fitflops women's walk star 3 chocolate Search forum Search Go Advanced Search Post New Thread 1 2 3 6 Last 3048 Skip to page: Close Filter the discussions shown below&hellip. "The Institute's analysis of the implications of Brexit for the Scottish economy leads to the conclusion that it is difficult to imagine that it would help improve Scotland's competitive position with respect to our trade with the EU.
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Bosnian Rainbows Album Stream
Just skimming it you can tell this isn't great
gotta jam but yeah zavalaz record will shit on this god damn it omar
Omar dun fucked up
It's better than I expected, but still shit compared to Mars Volta. I hope Zavalaz will slay this.
Digging: The Black Angels - Death Song
cedric was mvp on noctourniquet so yah high hopes
Pretty much what I expected, a step above his solo albums, but not much more than that... Seriously, you ditched TMV for THIS?!
This was quite lackluster and highly uninspired compared to Omar's output on previous efforts. Some track were pretty good, but I just couldn't dive into the rest.
listened to this once and wasn't really feeling it. torn maps is actually one of the best tracks here
Digging: King Gizzard and The Lizard Wizard - Murder Of The Universe
It's definitely way better than I was expecting
God, this album is boring...
I guess we know who came up with the awesome song names for TMV
Is ok, they're coming to my country soon enough, maybe their act will be interesting
Pretty bog standard
You guys seriously need to give this a chance, it's not that bad. A solid four.
I'm on "Worthless" and it's an awesome track.
Average album but they kick ass live
"not that bad" sounds like a 3
fairly disappointed. Some good songs but also several really boring ones. 3.5
There are some absolutely killer tracks here, it is at least on par with Noctourniquet (and I consider that to be an above average TMV record)
The only reason people don't like this is that they where expecting another TMV this is great for what it is.
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Unformatted text preview: Chapter 8 Inductive Reasoning ANSWERS TO EXERCISES Exercise 8.1 1. Target group : people in this country; sample : adults in New York and San Francisco; relevant property : being "pro-choice" in the abortion debate. The argument is weak because the sample is not representative. 2. Target group : people in general; sample : people on the street who have been questioned by TV reporters; relevant property : being fed up with celebrities who voice their opinions. The argument is weak. The sample is not representative and is also probably too small. 3. Target group : medical treatments; sample : two cases in which proposed treatments turned out to be ineffective; relevant property : treatments turning out to be worthless. The argument is weak. The sample is too small. 4. Target group : students at this university; sample : first-year students at this university; relevant property : being against such a militant policy. The argument is weak because the sample is both too small and not representative. 5. Target group : American adults; sample : several thousand gun owners; relevant property : being opposed to gun-control laws. The argument is weak. The sample is not representative. 6. Target group : future Buffalo winters; sample : the past twenty Buffalo winters; relevant property : Buffalo's receiving several feet of snow. The argument is strong. 7. Target group : crimes committed in Chicago; sample : Chicago crimes reported in newspapers; relevant property : crimes committed by racial minorities. The argument is weak because the sample is not likely to be representative. Newspaper reports of crimes might not reflect the actual incidence of crimes. 8. Target group : dentists; sample : dentists who suggest that their patients chew gum; relevant property : recommending Brand X gum. The argument is weak because the sample is not representative. 9. Target group : water in the Charles River; sample : two hundred samples of water taken from many sites all along the Charles River; relevant property : concentrations of toxic chemicals. The argument is strong. 10. Target group : children; sample : children reported by the news media to have been abducted in the past year; relevant property : being abducted. The argument is weak. The sample is not representative (and probably too small) because reports of the news media are not likely to reflect the true incidence of abductions. 11. Target group : university fraternities; sample : at least two fraternities involved in illegal activity; relevant property : illegal activity involving fraternities. The argument is weak. The sample is much too small. 12. Target group : Americans; sample : adults with an annual income of $48,000 to $60,000; relevant property : being happy and satisfied with one's job. The argument is weak because the sample is not representative. (Middle-income workers are likely to have attitudes toward job satisfaction that are different from those of workers in other income brackets, especially lower ones.) income brackets, especially lower ones....
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- Fall '11
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Pyrophosphate formation from phospho(enol)pyruvate adsorbed onto precipitated orthophosphate: A model for prebiotic catalysis of transphosphorylations
- Received:
- Cite this article as:
- Hermes-Lima, M. & Vieyra, A. Origins Life Evol Biosphere (1989) 19: 143. doi:10.1007/BF01808148
- Citations
- 43 Downloads
It has been postulated that adsorption and surface catalysis, as well as repeated drying and wetting cycles, were essential in the synthesis, interconversion and co-evolution of phosphorylated molecules, including 'energy-rich' compounds. We have investigated the formation of pyrophosphate from phospho(enol)pyruvate and orthophosphate. The reaction occurred within hours at 37°C, required the adsorption of phospho(enol)pyruvate onto sedimented phosphate, exhibited Michaelian-like behavior and showed positive cooperativity with respect to divalent cation concentration. Thus in 'mild', near-equilibrium conditions, the de-solvated surfaces of phosphate crystals can catalyze the formation of pyrophosphate with a kinetic behavior similar to that found in contemporary enzymes. The experimental system we describe may represent a model for the prebiotic catalysis of transphosphorylations.


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Director, Digital Advertising Solutions
Michael Page
jobsDB ref: JSG400003003183688
EA License No. 98C5473
Employer Ref. 3924448/001
Our client is an established and very successful, global company with APAC headquarters based in Singapore. Globally known in the Media & Entertainment industry, they are now looking to recruit a Director, Digital Advertising Solutions to replace a recent internal transfer.
Client Details
Our client is an established and very successful, global entertainment & media company with APAC headquarters based in Singapore. Globally known in the industry, they are currently rapidly expanding and are looking to capitalize on this success to invest in digital solutions in Asia. Due to their rapid growth, they have been promoting their best talents across APAC region. Hence they are now looking to recruit a Director, Digital Advertising Solutions to replace a recent internal transfer
Reporting to the Senior Vice President, Digital of their most mature business, this role works in close partnership with Sales, Product, Content, Production and Marketing team. The key objective is to assist Sales team by ideating, planning and delivering the best in class digital and sponsorship solutions on company's web and mobile platforms in Asia.
Besides the advisory responsibility, this role will:
- Support Sales team to grow digital advertising and sponsorship revenue in Asia
- Create and develop digital sponsorship solutions working closely with Sales, Product, Content, Production and Marketing teams.
- Lead the complete project life cycle to guarantee the delivery of solutions on time and on target.
- Demonstrate Return on Investment by providing thorough analysis to clients
- Masters or Bachelors Degree preferably in Advertising, Business or Communication.
- Minimum 7 years experience in delivering digital advertising solutions
- Experience in the Broadcasting industry as well as a genuine passion about Entertainment & Culture
- Expertise in developing digital media and advertising solutions, video solutions being a must.
- Knowledge of traditional and online platforms.
- High level of energy and ability to execute whilst addressing a wide range of clients of products.
- Candidates who have agency background will be highly preferred
Job Offer
The company has a proven track record rewarding successful individuals with attractive career progression.
To apply online please click the Apply button below. For a confidential discussion about this role please contact Nicolas Mochot (Lic No: R1762864) on +65 6416 9853.
About Michael Page
As part of PageGroup, Michael Page is a leading professional recruitment consultancy specialising in the recruitment of permanent, contract and temporary positions on behalf of the world's top employers. PageGroup operates through 155 offices in 35 countries worldwide. First established in London in 1976, we've been bringing jobseekers and employers together for more than 30 years. London listed, we opened our first Asian office in Hong Kong in 1994 and currently we have offices in all major business hubs across the APAC region, including Australia, Singapore, Tokyo, Malaysia, India, Taiwan, Shanghai, Beijing, Shenzhen, Guangzhou, Pudong and Suzhou.
So if you're looking to take your career to the next level, visit www.michaelpage.com.sg
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Books booklist
This year, are you focusing on fostering persistence, motivation and resilience in your students? Then you have to check out our list of 12 amazing read-alouds for teaching growth mindset.
Image via http://grangergrades.tumblr.com/post/146495729270/260616-a-new-addition-to-my-bujo-pages-i.
50 books every child should read by age 16, a book list for kids of all ages
Movies Based on Books 2017 -- I always find that the best movies are based on books. I mean, it must be a great story to be made into a movie, right? Okay, the books are usually better but it's so much fun to give it the benefit of the doubt. Some movies can really surprise you, like The BFG and The Hunger Games. It's a new year and that means lots of new movies to watch and books to read. Here's a list of books to read before you watch the movie.
These books about libraries would make perfect gifts for the bookworm in your life!
I don't think I could survive without books. As I've said, I love challenging myself too, and I think this is a great idea to encourage yourself to step outside of your comfort zone and discover some new favourites to read!
If you love Beauty and the Beast, check out these 14 retellings and themed novels.
If you love the Harry Potter books, check out these books to read based on your Hogwarts House!
These biggest book club books from the past decade are definitely books worth reading. Must add to your 2017 reading list!
Top 50 children's books about nature :: nature study for kids


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Ruling says hospital can't force anti-psychotic drug on patient after questionable schizophrenia diagnosis
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Joseph Brean
Wednesday, Jul. 31, 2013
A recent judgment against Toronto's Saint Michael's Hospital clarifies what kind of evidence to prove a person's incapacity will withstand legal scrutiny, and it reinforces a patient's right to refuse medication. National Post files
Nearly four years after staff at Toronto's Saint Michael's Hospital started slipping an anti-psychotic drug into a woman's orange juice while treating her for lupus, Ontario's highest court has tossed aside the ruling that allowed her to be drugged against her will, in part because the psychiatrist who diagnosed her with schizophrenia admitted he was "making parts of [her symptoms] up."
In a sharply worded ruling, the Court of Appeal said there was "no evidence" the woman ever agreed to medication, and overturned the Consent and Capacity Board's "unreasonable" finding that the woman was mentally incapable of doing so.
"It certainly is a forceful ruling," said Anita Szigeti, lawyer for the woman, Amy Anten. "It's important for her personally. In my respectful submission, it's also very important — and the court appears to have agreed by considering the matter on its merits — to give the Consent and Capacity Board, and also the first appellate level of reviewing court, some guidance on how to really weigh the evidence that goes to the heart of the Charter-protected right of the person against forced treatment."
The judgment clarifies what kind of evidence to prove a person's incapacity will withstand legal scrutiny, and it reinforces a patient's right to refuse medication, which the Supreme Court of Canada upheld in 2003.
Ms. Szigeti also said despite that top-level legal guidance, a "pervasive paternalism" has revealed itself in medical institutions, such that now it is "absolutely commonplace for a physician to just give his or her opinion" that patients cannot make choices about their own treatment.
"You risk rubber-stamping a physician's finding of incapacity, without ultimately a shred of evidence to support it," she said.
The new ruling, released on Monday, found the anti-psychotic schizophrenia drug Risperidone appears to have been administered without Ms. Anten's knowledge in orange juice "to improve her compliance" with the treatment regime. It was later injected with her knowledge.
It finds that Dr. Shree Bhalerao, a psychiatrist at Saint Michael's Hospital, gave "confusing" testimony about his initial exam of her, and could not justify his decision to re-categorize her psychosis as schizophrenia, based on a sketchy history. The court was particularly critical of his explanation that the medical team "tried our best to assure her that [her delusions about people attacking her] weren't happening, but again, I mean it's her word against ours and we tried our best to alleviate that by using that kind of floor [sic] of medications."
'You risk rubber-stamping a physician's finding of incapacity, without ultimately a shred of evidence to support it'
Ms. Anten, whose age is not specified but is older than 40, testified she did not believe she was ill when she was hospitalized in November 2009.
"I feel numb mentally and physically," she testified. "I feel more angry and more depressed and I do start feeling as if people are harming me. Although I did before, but it appears from what [Dr. Bhalerao] said that I was being given medicine before I even realized it. So it could be as a result of this medicine entirely that I have made such, um, made such admissions that people were harming me but there was a particular patient who was here and she left recently about a half a week ago, and I believe she was harming me while I was sleeping."
The ruling criticized the Consent and Capacity Board for finding that, as a result of her illness, Ms. Anten was unable to appreciate that medication would benefit her, and that she was unable to compare her fears of side-effects with "the fact that without treatment the psychosis would continue unabated," as the board put it.
"There was no evidence to support such a finding," the court concluded. "To the contrary, while there was unchallenged evidence from [Ms. Anten] of the side-effects of treatment, [Dr. Bhalerao] offered no evidence of any benefit."
The court declined to order a new hearing, because Ms. Anten has been the subject of subsequent capacity hearings, with various outcomes. "In these circumstances, nothing would be gained by ordering a new hearing," wrote Justice Marc Rosenberg for a three-judge panel.
Dr. Bhalerao's counsel declined to comment.
National Post
Posted in: News Tags: Canada, Doctors, Health Care, Hospitals, St. Michael's Hospital
Self-diagnosis on Google, other websites the first line of medical care for more than half of Canadians: poll
Definition of 'health care' at centre of dispute as health authorities defy B.C. Alzheimer's patient's living will
Immigration, lack of sunshine cited as possible culprits behind eyebrow-raising spike in Canadian schizophrenia cases


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I really enjoyed staying here. The rooms were super nice, and the amenities were great. The staff was very helpful and attentive. Ordered room service, and the food was excellent! The only drawback was that they didn't have an airport shuttle, so we had to take a cab to the airport.
- Official Description (provided by the hotel):
- When you arrive at the Washington Marriott Wardman Park, you'll find a charming neighborhood in the heart of Washington, DC filled with amazing restaurants and quaint shops. Just a few steps away, you'll discover the funky stores and ethnic cuisine of Adams Morgan or the exciting night life of Dupont Circle. Head north to hear the sounds of animals coming from the National Zoo. Or venture into the hotel's natural surroundings to enjoy a quiet hike or invigorating run through Rock Creek Park. With a Metro stop just outside the doors and area airports close by, it's a premier city destination just two Metro stops from everything DC has to offer. We believe that brilliant meetings begin with brilliant space and offer an astounding 195,000 square feet of versatile space that can be customized for groups of all sizes. It's an unmatched place to meet where accommodating venues and equally helpful planners can bring any groups unique ideas to life. ... more less
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Discover a selection of top forums shurtugal forums on the internet. Come to share your passion on forums shurtugal forums and meet other fans of shurtugal forums. Then, why don't you create your own forum of shurtugal forums ?
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Home of the Amiibo training community + the Fustic Crew
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#1 chat rap forums an all-age forums and chat room aimed at the hip hop crowd. Home of the ballers, pimps, playas, thugs, gangstas, and much much more.
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To be part of, and expand on my Vision Board
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The official hip hop forum for I2G
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Welcome to Googles Club, an awesome site to talk about webkinz googles or just hang out with your friends! We've got a chatbox, forums and more!
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We are Xbox 360 and PS3 modders! We love to have fun and make people smile with mods!
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A forum mainly for the Medieval Text RPG game and other games resurrected from the old Runescape Forums, but there are other mini forums as well to keep you members occupied.
This is the Coriolis Gaming Official Forums


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We are chiefly engaged in the manufacturing and supplying Marjoram Herb all across the country. The Marjoram Herb is cold-sensitive perennial herb and undershrub, with flavors of pine and citrus. Used for culinary purposes, the Marjoram Herb can be provided either dry or green.
Siddhesh Agro
Upendra Nagar, Room No. 63, Senapati Bapat Marg, Dadar West, Maharashtra - 400028, India
The company is counted among the leading Manufacturers, Exporters and Suppliers of Marjoram in Mumbai. The Marjoram, offered by the company, is known for its super-fine quality and can be availed at the market leading prices. Having numerous uses, Marjoram is widely demanded across the globe. Details Marjoram is also known as Sweet Marjoram, Knotted, Pot or Winter Marjoram. It is available in dried leaves or ground.
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We are offering Marjoram Oil is one of the most popular essential oils. Highly used in cosmetics as well as aromatherapy for treating several problems. Marjoram Oil has been traditionally used in making perfumes due to its aroma. The oil is very useful in aromatherapy and many aromatic preparations are made using Marjoram Oil. Marjoram Oil blends well with many other essential oils including Clary Sage, Geranium, and
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Deals in Thyme Natural Herbs, Marjoram Herb, Sage Herb, Snow Peas
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Post your Buy Requirement
Deals in Ch-5 Jowar, Cinnamon and Pepper, Singhara Trapa Bispinosa Singada, Garlic Powder / Granules, Fresh Triphala, Cabbage Granules, TRIGONELLA FOENUM GRAECEUM, Sona Masoori White Steam Rice, Spring Onion Flakes, Ilaichi Green, Cabbage Flakes, Pistacia Lentiscus, Oregano Flake, Punica Granatum Peels, Vallerian Wallichii, gurmar Patta, Dry Whole Ginger, Milky White Jowar, Apium Graveolens, Kokam Seed
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Added: Monday, February 22, 2010
Diamond And Claudia In Fuck Toy Sexcapade
This blonde and brunette lesbian combo loves getting their pussies hammered with various fuck toys. Watch Diamond and Claudia Adkins as they lusciously tongue lap on each others' horny bushes and then slam them with these glorious toys, making them gush out their delectable cunt juices.
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official flyer!
official flyer!
Happy Birthday to this cool guy 💞🎉🎈
Balance and Composure//August 20,2014//Slims SF
Jordan gave me his set list…
Chiodos 05-07-14
Got that setlist from tonight's show at slims.
So, I went to the best concert I have ever attended on Tuesday. At Slim's in SF I saw Hank Green and the Perfect Strangers, Driftless Pony Club, Harry and the Potters, Rob Scallon and Andrew Huang and it was AMAZING. Such great energy, and I made like 5 instant friends at the concert (but, alas, I forgot to get their contact info! Sadness!
But at the concert they had awesome merch, including this poster by hugscream! I loved it so much I went and framed it, and now it has a proud place on my wall!
Charli XCX @ Slim's
by Daniel Kielman
Music bloggers! I need to find a few locals that want to blog about music for the Slim's Presents site and our little Tumblr page here. If you're interested, PM me here, tell me about yourself, where you live, why you want to blog for us and what kind of angle you'd want to cover with your posts. Link to some of your writing, if available. We'll hook you up with free tickets to shows, exposure for your writing, access to interviews and other cool stuff.
Feel free to pass it on!
October 25th @ Slim's in San Francisco, CA
Andrew McMahon in the Wilderness 10•17•14
I can't believe this night just happened.
10 year anniversary Beer Commercials Tour | Minus the Bear killed it last night
From Indian Lakes, Blondfire, and Relient K were absolutely astounding. General admission concerts are always the best.


text:
FiltersShow / Hide
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- Location: Anywhere in the UK
Radius: ... miles
'Joe Wells is a skilled jokesmith who threads great gags through intelligent political material that, whilst razor-sharp, is never particularly angry or dark. As the first gross gags open up into smarter, topical ones it's clear that this is a tightly-structured, well thought-out set. Excellent jokes and sly political comment wrapped tightly in a neat parcel which delivers regular, powerful laughs from a delighted audience. He spins new life out of easy targets like bankers and the BNP with some wonderful imagery' (British Comedy Guide)
'Highly original, inspired and suitably different from the rest of the crowd… brilliantly crafted jokes' (Comedy Central).
'A star of the future... some of the most surprising and thought-provoking material coming from any comedian in his early 20s' (The Guardian).
'A real venom in his delivery seemed to communicate that the numerous laughs that he manages to obtain are just positive collateral to the message he is trying to portray' (Broadway Baby).
See more info at joewells.org.uk
Image © Joe Wells
Joe Wells tour dates listed on Ents24.com since May 2008.
12 Joe Wells Tour Dates
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May 2017
Saturday (Late Show) Stand Up Comedy:
Gabriel Ebulue, Jeff Innocent, Joe Wells
Top Secret Comedy Club (WC2B 5PD)
From: £14.40
June 2017
International Comedy Edinburgh Previews:
Nick Revell, Joe Wells
Kings Head Crouch End (N8 8AA)
From: £7.70
International Comedy Edinburgh Previews:
Joe Wells, Gareth Richards
Kings Head Crouch End (N8 8AA)
From: £7.70
Monkey Business Comedy Club:
Abandoman, John Gordillo, Joe Wells
Martin Besserman
Cafe Rouge Hampstead (NW3 1QE)
From: £16.50
July 2017
Edinburgh Previews:
Carey Marx, Joe Wells
The Caroline Of Brunswick Pub (BN1 4SB)
From: £3.30
August 2017
September 2017
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- Friday 21st Apr: Joe Wells to appear at Hideaway, London in May
- Tuesday 18th Apr: Joe Wells to appear at Backyard Bar, London in June
- Thursday 6th Apr: Joe Wells announced 2 new tour dates
- Tuesday 4th Apr: Joe Wells announced 2 new tour dates
- Thursday 23rd Mar: Joe Wells to appear at Wivenhoe Town Cricket Club, Colchester in August
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Zach Holland Na Am Music Review #19 Group #2 Songs from Spirit: Power and Prayer in the Columbia Plateau Chapter 8 focuses on the fieldwork aspect of the study. The study's fieldwork focuses on traditional ceremonies and using song as the driving force for power. Dr. Hamill wanted to gain a better understanding if the power of song was being lost and forgotten overtime similarly to native language. To get the best understanding the field study was conducted at the "most visible and frequent ceremony held today in the Columbian Plateau," the Washat. Dr. Hamill brings up the point that his tools as an ethnomusicologist are recording technologies and the written word. Both of these techniques are frowned upon and take away from the authenticity of the ceremony. As I have learned in class, these techniques take away the power of the song as most of these songs are learned through visualizations and passed on through memorization. Dr. Hamill seems to be stuck between a rock and a hard place with his religious
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This note was uploaded on 02/06/2012 for the course MUS 265 taught by Professor Staff during the Spring '11 term at Washington State University .
- Spring '11
- Staff
- Music
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