text:
Linda Randall from Idea Girl Consulting shares Business Ideas For Kids -Ideas on how to start your own business and market yourself.
How to teach a child to manage their money and use a till at a yard sale. See how Maddie and Margot Bradshaw made countless bucks in the age of 12 promoting Snap Caps if she can do it then you are able to do it as well Art Eater – What to accomplish with your children art and the way to generate a revenue with it.
The story of Autumn de Forest an artist who at the age of eight sells several paintings for 250000.
Childrens Marketplace Study Instruments and Organization Guides. Run a Lemonade Stand or have a Bake Sale or Garage Sale to make some extra cash.
Jaden Smith – Star of Karate Kid – Will Smiths Son – Independence Day Movie Aug six 2011
Jaden is taking a number of his difficult attained money and developing a designer line of clothing for kids. He took in over 3000000 dollars in the age of 10 when he filmed the starring part in Karate Kid. Gambonia Jaden is now twelve ages outdated in 2011.
An inspiring story – JK Rowling and Harry Potter how it all began. July 11 2011
we can all discover some thing from a lady who did not consider NO for an answer.
In the event you think in yourself and what you do keep likely at it until you get to your aim. Here is surely an inspiring story of how JK Rowlings books Harry Potter got published.
Her manuscript was place into a slush pile from a Literary Agent and it fell into the garbage can.
her young daughter who was eight decades previous was sitting in her workplace and spotted the manuscript sitting within the rubbish can.
She pulled it out and study it.
The small lady loved it and begged for her mother to obtain it published…
and thats how harry potter was introduced to existence..
thanks to an authors creativeness that captured an incredible number of children teenagers and grownups.
Help Your Youngster Commence and On-line Retailer on Zazzle.com july six 2011
Among the ideas that i identified on the web was starting your personal on the internet retailer.
Your youngster can upload photos drawings as well as other inventive suggestions for t shirts mugs posters and all kinds of cool points they are able to create and provide.
Snap Caps – Bottle Cap Necklaces – Maddie Bradshaw twelve 12 months Outdated Millionaire By Linda Randall – May perhaps 21 2009
Imagine beginning your own enterprise at the age of 12 and inside a 12 months be a millionaire. Maddie Bradshaw is surely an inspiration to children and grown ups alike. She made some magnets for her locker at school and now sells them in shops.
Shes also designed the bottle cap necklace which can be nice since its interchangeable. Maddie and her sister whos only 9 decades old make their very own designs and their mother helped them obtain the organization heading. She does seminars on the best way to start off a company as being a child with only one idea. Congratulations Maddie I cant wait until you create a e-book about your good results. This is a great thought for publishers
Develop Your Concepts Into a Pastime By Linda Randall – Might 22 2009
Do you love creating crafts Do you have tips swimming inside your thoughts It is time to write those concepts down and start out generating them. The fantastic factor about hobbies is when you start off using it to create funds you are going to really get pleasure from your job. Most people do not like getting to go to work everyday to create a residing. I wager you listen to them complain about it all the time. But the rewards from making your own income are wonderful. You can do what ever you want travel get new apparel invest in toys or video games. The listing in endless so what kind of hobby are you currently thinking about Believe of one thing these days after which make it
Do What you Adore To perform Linda Randall – May perhaps 21 2009
When your considering of starting a hobby pick some thing that you genuinely like performing. If it turns out to become one thing marketable you would like to ensure you might delight in doing it a great deal. It can be boring and make you angry should you do not like performing the pastime.
Just how much Change Must Ive for my Lemonade Stand Cash Box
For any company venture its a great idea to possess at the least 50 pounds in money.
You would like to have mainly modest expenses and change for your clients.
You should also have a secure with a important so you can lock up the cash although serving customers.
When you reside in an location exactly where theres a problem with theft then it is greatest to wear a capital pouch about your waist and have several small alter purses for distinctive sorts of coins and expenses.
Its a great notion to possess a notepad as well as a pen to mark down how many products you marketed for your consumers.
Place a marking then cross it out once you attain five of them IIIII use or ——
Youngsters Can Benefit In Numerous From the Exact same Ways From Starting A Organization.
Maturity Accountability Dependability Frugality Communication Abilities Laptop or computer Skills Math Skills Self-management abilities like using care of a pet or home cleansing The meaning of a hard days work And most importantly the worth of the dollar. Though operating hard for a dollar maybe they will believe 2 times about asking you for funds for items they do not actually require.
Investigation And Find A Market To your Product Linda Randall – May well 21 2009
So you may have created a hobby and you get the concept to promote it to men and women. Very first you need to verify and see if its becoming made by somebody else. Then you need to see what type of potential it needs to be offered in shops. It is possible to ask your pals household plus the youngsters at college for his or her views. It is possible to appear up info on the net and see what textbooks are in the library about doing industry analysis for youngsters.


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Best for: Chronic tension headaches.
How it works: Tiny needles are inserted into specific points of the body; this can reduce muscle tension and encourages the release of painkilling endorphins, says Jill Blakeway, a licensed acupuncturist in New York City. Research suggests that, for some people, acupuncture may reduce tension-headache frequency by 50 percent or more.
Keep in mind: Studies show that you may need 10 treatments before you start experiencing relief.

subset: commoncrawl


text:
Super Mario Galaxy Credits (Wii)
Published by
Developed by
Also For
ESRB Rating
Critic Score
100 point score based on reviews from various critics.
User Score
5 point score based on user ratings.
Super Mario Galaxy Credits
Other Games
In addition to this game, the following people are listed as working on other games. No more than 25 people are listed here, even if there are more than 25 people who have also worked on other games.
Satoru Iwata, 291 other games
Shigeru Miyamoto, 185 other games
Jeff Miller, 155 other games
Leslie Swan, 150 other games
Nathan Bihldorff, 123 other games
William Trinen, 116 other games
Kōji Kondō, 96 other games
Hironobu Kakui, 84 other games
Charles Martinet, 83 other games
Tim O'Leary, 70 other games
Tsuyoshi Watanabe, 65 other games
Yusuke Nakano, 64 other games
Keizō Katō, 63 other games
Reiko Ninomiya, 52 other games
Yoshito Yasuda, 49 other games
Shinya Takahashi, 48 other games
Tomoaki Kuroume, 38 other games
Silke Sczyrba, 37 other games
Peter Swietochowski, 36 other games
Masato Kimura, 35 other games
Scot Ritchey, 34 other games
Takumi Kawagoe, 31 other games
Jasmina Libonati, 30 other games
Erik Peterson, 30 other games
Shigehisa Nakaue, 30 other games
People who have worked on this game have also collaborated on the creation of the following games:
The Legend of Zelda: Twilight Princess, a group of 60 people
Super Mario Galaxy 2, a group of 57 people
Donkey Kong: Jungle Beat, a group of 52 people
Super Mario 3D Land, a group of 44 people
Mario Kart Wii, a group of 38 people
Pikmin, a group of 32 people
The Legend of Zelda: Spirit Tracks, a group of 29 people
The Legend of Zelda: The Wind Waker, a group of 29 people
Super Mario Sunshine, a group of 28 people
The Legend of Zelda: Ocarina of Time 3D, a group of 27 people
Pikmin 2, a group of 25 people
Wii Sports Resort, a group of 24 people
Luigi's Mansion, a group of 24 people
Nintendogs, a group of 22 people
The Legend of Zelda: Phantom Hourglass, a group of 21 people
Animal Crossing: Wild World, a group of 21 people
Fire Emblem: Radiant Dawn, a group of 20 people
New Super Mario Bros. Wii, a group of 20 people
DK: Jungle Climber, a group of 20 people
Mario Kart: Double Dash!!, a group of 19 people
Mario Kart 7, a group of 19 people
Mario & Luigi: Bowser's Inside Story, a group of 19 people
Wii Fit, a group of 19 people
New Super Mario Bros. U, a group of 18 people
Animal Crossing: City Folk, a group of 18 people
Credits for this game were contributed by Alaedrain (3370) and MadEwokHerd (129)


text:
|Property type
|Minimum Stay
|5 - 7 nights
every night. Full kitchen. Each bedroom has a full bathroom en suite. Villa can accommodate up to 10 people. Beautiful gardens and great breezes. All rooms have ceiling fans. Located 1 mile from the center of Negril and the best 7 mile beach in the Caribbean. Walking distance to the famous Ricks Cafe. Maid service and cooking services provided at an additional fee. Airport transfers and tours available at an additional fee.
Love this place. Have stayed here before. I could sit on the porch, forever. Good working kitchen in a house that has all the amenities we need. Love swimming in this spot. Not a spot for timid swimmers. We usually rent a car for our stays on the West end of Negril, and this house has room to park and close the gate. Security is fine. Would happily stay again.
A group of 6 of us recently stayed here in february of 2016. From the moment we arrived, the place and the people, were above and beyond our expectations making it an amazing and unforgettable trip. Not only was the villa itself clean, spacious and welcoming, the view spectacular, and the fishing, swimming and snorkeling amazing, but the workers were friendly, inviting, open to share in conversation and made the place feel safe and welcoming throughout as well as added so much to our overall vacation. Fabi will always be a part of and shared in many of our memories. Billy was very helpful with our booking and stay and ensured everything was organized and ready for our arrival and departure. The cliffside is truly an amazing place to stay and we hope that our travels will bring us back. Thank you to Billy, Fabi, Ronald and Runkin for having us and making our trip truly spectacular!
Excellent stay! Friendly people. View is unbeatable. Fabi is there in the day for your safety, to garden and just make you feel at home, anything you need just ask. Rankin and Ronald(spelling?) rotate night shift safety, they are also great for conversation, information and history. You can't beat the location, the people, the area. Thanks, One Love
My family and I could not have chosen a better place to vacation! Not only was the property itself beautiful, but it was a reasonable distance from any excursions or activities in Negril. The villa is located on the rocky cliffs of the West End, making it well within walking distance to Rick's Café, 3 Dives Grill, etc. and only a five minute taxi ride to the beach. Our gardener, Fabi, took care of most of our needs. He was able to answer any questions about the logistics of local life and even grilled us a banquet of fresh seafood in our backyard! Polly, the housekeeper, cooked us a traditional Jamaican breakfast on our first morning and kept the house feeling and looking clean throughout our stay. When darkness fell, Randkin and Ronald, the night guards, were always available for late-night conversations about Jamaican culture (and a card game or two). Between Fabi and the night guards, someone was always around (night or day) to answer any questions we had. We never felt anything but completely safe and comfortable throughout our stay. The villa itself was spacious and beautiful, boasting three separate bedrooms each with its own bathroom. Perhaps the best part was the back porch complete with chairs, tables, a day bed, and an amazing view of the rocky west coast. With a ladder in place, my family and I could privately snorkel and cliff jump whenever we pleased! Billy was very responsive to our inquiries and could always be reached. Overall an unforgettable experience! Our only heads up: the locals can be a bit noisy at times.
Please read and confirm your review for Property #150015 below.
Best Wishes,
Reviews Team
Our family of six adults gathered at the Villa for a week over the Christmas holidays. The location simply could not be beat. We spent a good part of every day swimming and snorkeling in the beautiful cove and along the rocky coastline all the way up past 3 Dives. Underwater was like being in a fish tank and the caves and rocks were full of things to explore. Early mornings were best before the wind kicked up. The ladder into the water made it easy to get in and out but my sons still insisted on jumping from the rocks occasionally! The plaza area was fabulous for daily sunbathing and evening cocktails for the sunset and stargazing. We ate dinner every night on the spacious veranda as well as catching a nap there occasionally. Although the interior furnishings are a bit worn the house was clean and equipped for our stay and once there, you realize that it fits well the Negril casual lifestyle. Besides I spent very little time inside the house. Beds were comfortable, there was plenty of water for showers, and towels and supplies. There is some noise and late parties in the neighborhood but only once did it get a bit out of hand (at 3 am) and Rodney (night security) took care of it for us. We cooked most of our meals at home with just a few trips to the Icon grocery or L&M convenience store down the street. We made a trip to the Negril Fish Market for lobster and snapper and Fabi helped to grill the fish outside. It is also a short walk to many of the local food spots, like Samsura (very nice but a bit pricey) or 3 Dives (do not miss the jerk chicken with bammy!), or DBar or Erica's, and it is only a nice 15-25 minute walk to Rock House or to experience the craziness of Rick's. Our rental car fell though so Fabi set us up with the greatest cab driver (Bobby) who ended up almost serving as our personal tour guide. He took us on trips to the market, YS Falls, Blue River, Beach, and even joined us for dinner at a few great local eateries (Cloggy's in Blue River was amazing fish). Billy, the owner, was responsive and helpful in every way. We had a wonderful vacation and truly hated to leave.
"We had a party of five - three men in their sixties and two young men in their twenties - and we couldn't have picked a better location. We liked being on the cliff road and having access to the sea for snorkeling. The grounds are beautiful and the house is spacious. Ian, the night security guard, and Fabi, the gardener, helped make our vacation fun, safe, and interesting. We didn't make use of the maid service or cooking, so we can't comment on that. We made breakfasts every morning - we got juice from the stand across the street and cooked our own pancakes and eggs. We also prepared some of our own lunches. The food in the neighborhood is great - I highly recommend the jerk chicken at Three Dives (skip the lobster). The neighbor resort (Samsara) has a great happy hour special from 4:00 pm until 7:00 pm. Two for one on all rum drinks and I recommend trying the Banana Daiquiri. The owner responded promptly to every inquiry (via email and telephone). It was a pleasure doing business with him. One warning - for those of us who are used to American showers and toilets, the water pressure is lower."
90 Min from Montego Bay Airport, 20 Min by Air to Negril.
|Rate Period
|Weekend Night
|Monthly *
Low Season
Apr 15 2017 - Dec 15 2017
5 night minimum stay
Jul 25 2017 - Jul 31 2017
7 night minimum stay
Flat fee
High Season
Dec 16 2017 - Apr 14 2018
5 night minimum stay
My Standard Rate
5 night minimum stay
|Notes: Rates are based on 4 guests; add $50 per night, per additional guest
|Additional Persons/Night
|Refundable damage deposit
|Cleaning Fee
$400/night $2400/week
$300/night $2000/week
Weekly rate in US dollars: Low - $2000 High $2400
Dates available: Year Round
* Approximate monthly rate. Actual rate will depend on the days of the month you stay.


text:
Administration of Symantec eDiscovery Platform 8.0 for Users: 250-412
Braindump2go Engine Features
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Braindump2go Practice Exams for Cisco Specialist Certifications 250-412 are written to the highest standards of technical accuracy, using only certified subject matter experts and published authors for development.
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Downloadable, Interactive 250-412 Testing engines
Our Administration of Symantec eDiscovery Platform 8.0 for Users Preparation Material provides you everything you will need to take a Cisco Specialist Certifications 250-412 examination. Details are researched and produced by Cisco Certification Experts who are constantly using industry experience to produce precise, and logical.
- Comprehensive questions and answers about 250-412 exam
- 250-412 exam questions accompanied by exhibits
- Verified Answers Researched by Industry Experts and almost 100% correct
- 250-412 exam questions updated on regular basis
- Same type as the certification exams, 250-412 exam preparation is in multiple-choice questions (MCQs).
- Tested by multiple times before publishing
- Try free 250-412 exam demo before you decide to buy it in Braindump2go.com
- 640-864
- Designing for Cisco Internetwork Solutions (DESGN)
- 642-770
- Operational Foundations for Cisco Service Provider Core Networks (OFCN)
- 640-461
- Introducing Cisco Voice and Unified Communications Administration v8.0 (ICOMM)
- 642-437
- Implementing Cisco Voice Communications and QoS v8.0 (CVOICE v8.0)
- 642-447
- Implementing Cisco Unified Communications Manager, Part 1 v8.0 (CIPT1 v8.0)
- 642-457
- Implementing Cisco Unified Communications Manager, Part 2 v8.0 (CIPT2 v8.0)
- 642-427
- Troubleshooting Cisco Unified Communications v8.0 (TVOICE v8.0)
- 642-467
- Integrating Cisco Unified Communications Applications v8.0 (CAPPS v8.0)
- 642-067
- Advanced Routing and Switching for Field Engineers (ARSFE)
- 642-655
- Wide Area Application Services for Field Engineers (WAASFE)
- 646-046
- Advanced Routing and Switching for Account Managers (ARSAM)
- 646-656
- Cisco Wide Area Application Services for Account Managers (WAASAM)
- 642-062
- Routing and Switching Solutions for System Engineers (RSSSE)
- 642-654
- Wide Area Application Services for System Engineers (WAASSE)
- 642-681
- Cisco Advanced Wireless LAN for System Engineers (AWLANSE)
- 642-631
- Cisco Advanced Wireless LAN for Field Engineers (AWLANFE)
- 646-671
- Advanced Wireless LAN for Account Managers (AWLANAM)
- 642-374
- Cisco Express Foundation for Systems Engineers (CXFS)


text:
[Date Index]
[Thread Index]
[Author Index]
Re: mathematica log sessions
it is already on you Mathematica installation.
Look at
that generate a Mathematica notebook from a kernel session.
If you don't like to use the Frontend to see the results later,
the package may give you some ideas how to make a text log.
It is extensively described in "Programming in Mathematica" 3th Edition
by Roman Maeder,
Hope that helps
Ela Parmar wrote:
> how do I keep a log of a mathematica session under unix?


text:
Hey so I know what I am about to ask is a sacrilege but I have to ask.
I just bought a '10 WRX and I want to make sure I keep it clean. I would love to hand wash and detail the car however I live in Maine and this morning it was a balmy 25 degrees, so washing outside is not possible.
How much damage would an automatic car wash cause? I know it will remove salt and road grime, but does it cause too much paint/car damage? If so, whats the best way to protect the car/paint from road junk?
Thanks for any help


text:
Leah Prisuta - Basketball
Junior - Forward Beaver Falls, PA
HS: Riverside
Leah Prisuta has been selected as the female student-athlete of the week. Prisuta helped lead Geneva to its first conference victory of the season with a 16 point effort in a win over Bethany last Wednesday. On Saturday, Prisuta posted her first double-double of the season with 11 points and 11 rebounds in Geneva′s heartbreaking 57-56 overtime loss to Chatham.
Matt Lorello - Basketball
Senior - Forward
HS: Mohawk Bessemer, PA
Matt Lorello has been selected as the male student-athlete of the week. Lorello posted 19 points in a loss at Washington & Jefferson and then scored 25 points in Geneva′s overtime victory against Thiel on Saturday. For the week, Lorello was 16-21 (76.2%) from the field. Against W & J, Lorello pulled down a team best eight rebounds and against Thiel he had three blocks in the victory.
© 2017 Geneva College | All rights reserved


text:
Of the 83 funds tracked by CAPS, only a J Rothschild fund managed by Global Asset Management gained in 2001, improving by nearly 13%.
GAM stayed away from volatile equity markets, keeping more than a quarter of assets in cash and bonds, said CAPS' Alan Wilcock. Most funds maintained an equity balance of more than 80% at the end of the year.
Other funds rounding out the top five produced negative returns, but outperformed the FTSE All-Share index, which fell by 13.3%. Phillips & Drew, the fund manager that underperformed in the late 1990s, placed two of its funds in the top five.
The most successful funds tended to favour old fashioned value shares rather than growth stocks. 'The winners all had good stock selection and a highyield bias,' said Wilcock.
Such a strategy vindicates the theories of former P&D investment boss Tony Dye, who questioned the longevity of the technology boom. Dye was ousted in early 2000.
But axing a senior manager may not help a fund's long-term performance, said CAPS chief executive Fred Settelmeyer. He claimed managers should not be judged on only one or two years' performance, adding: 'A good manager this year could be the worst next year.'
Under-performing managers should be compared only to others using a similar strategy, and evaluated over the longer term. Actively managed funds marginally outperformed the index trackers, falling in value by 13.1%.
Active funds have come under scrutiny for charging higher fees, yet failing to better the performance of the trackers.
- More about:
- Bonds
- Bonds And Funds
- Debt Market (bond Market)
- Nm Rothschild
- Stock And Equity Market And Stock Exchange


text:
28 CATHOLIC PATRON SAINT MEDALS cRUCIFIX CROSSES CHARMS
- Sold for: Start Free Trial or Sign In to see what it's worth.
- Item Category: Fraternal, Political, Organizations
- Source: eBay
- Sold Date: May 08, 2011
- Channel: Auction House
Catholic Treasure ChestTruly unique Catholic items at bargain prices ! ******************************* Catholic treasures...medals, crosses, charms and more...! Don't miss out ! ************************* Unique mixed lot of Catholic of 28 Catholic religious medals, Crosses, Crucifixes and charms ... ******************************** This lot is a unique collection of 28 Catholic holy medals, crosses, crucifixes, rosary centers and charms... some hard to find and not often found...some vintage style///. When I had my Catholic Treasure Chest business in full swing several years ago, I was always on the lookout to find Catholic treasures and sought out the most unique, unusual and rare finds... I eventually built up a wonderful selection of many Catholic medals ...Jesus, Our Lady and many patron Saint medals. I am now clearing some inventory and have included some new addtions in with this lot ! I offer this lot of 28 patron saint medals, crosses, crucifixes and charms in various shapes and sizes for your consideration. A mixture of oxidized silver, bronze, copper as well as enameled over color vintage images...2 of the medals are aluminum...... most of the medals have a jump hoop so they may be attached to your ... read more


text:
Complimentary Consultation
It is important to feel you have control over your future. At LifeStyle Financial and Tax Advisors, we offer our experience and expertise to help you design your own plan for financial independence.
Contact us to schedule a free, introductory financial consultation! Call us at (763) 496-1232 or connect with us online by filling out the form below!


text:
SailNet Community (http://www.sailnet.com/forums/)
- News Feeds (http://www.sailnet.com/forums/news-feeds/)
- - Sailing On Ice? Yeah, That's A Sport. (http://www.sailnet.com/forums/news-feeds/84567-sailing-ice-yeah-39%3Bs-sport.html)
Sailing On Ice? Yeah, That's A Sport.
Imagine racing over a frozen lake on a wind-powered sled, hitting speeds that top 40 miles an hour. That's what ice sailors all around the world do just about anywhere water freezes. In the U.S., Lake Champlain has emerged as one of the country's best ice sailing venues.
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text:
Congressional Actions Related To The Creation Of Museums In The Washington, Dc Area
P.L. 95-596 – Joint resolution to initiate preliminary studies for the restoration and renovation of the Pension Building in Washington, DC, to house a Museum of the Building Arts, and for other purposes (November 4, 1978).
P.L. 96-515 – Title III of the National Historic Preservation Act-To authorize and direct the Secretary of Interior and the Administrator of the General Services Administration enter into a cooperative agreement with the Committee for a National Museum of the Building Arts, Inc. for the operation of a National Museum for the Building Arts in a Federal Building located in the block bounded by Fourth Street, Fifth Street, F. Street and G street (the Pension Building)
( December 12, 1980).
P.L. 101-185 – To establish the National Museum of the American Indian within the Smithsonian Institution (November 28, 1989).
P.L. 103-98 – To authorize the Board of Regents to plan, design, construct and equip additional space at the East Court of the National Museum of Natural History (October 6, 1993).
P.L. 103-151 – To authorize planning, and construction of the West Court of the National Museum of Natural History (November 24, 1993).
P.L. 103-337 – (Section 1067) (Defense Authorization Act of 1994) – To transfer property to the General Services Administration for the purpose of establishing a National Museum of Health and Science (October 5, 1994).
P.L. 104-222 – To authorize construction of the Smithsonian Institution National Air and Space Museum Dulles Center at Washington International Airport (October 2, 1996).
P.L. 105-240 – Making continuing appropriations for the fiscal year 1999. This incorporated the District of Columbia Appropriations Act, 1999, which provided for the "establishment and operation of a Museum of the City of Washington, D.C. at the Carnegie Library at Mount Vernon Square, $2,000,000, to remain available until expended, to be deposited in a separate account of the Society used exclusively for the establishment and operation of such Museum" (January 27, 1998).
P.L. 106-492 – To establish the National Law Enforcement Museum on Federal land in the District of Columbia (November 9, 2000).
P.L. 106-522 – Provides for "a Federal payment to the Federal City Council for the establishment of a National Museum of American Music, $250,000, to remain available until expended: Provided, That such funds shall be used for the costs of activities necessary to complete the planning phase for such Museum, including the costs of personnel, design projects, environmental assessments, and the preparation of requests for proposals: Provided further, That such funds shall be deposited into a separate account of the Federal City Council used exclusively for the establishment of such Museum". (November 22, 2000).
P.L. 107-106 – To establish the National Museum of African American History and Culture Plan for Action Presidential Commission to develop a plan of action for the establishment and maintenance of the National Museum of African History and Culture in Washington D.C. (December 28, 2001).
P.L. 107-224 – To authorize the Secretary of Transportation to carry out a project for the construction of a plaza adjacent to the John F. Kennedy Center for the Performing Arts. This plaza will allow the Kennedy Center to construct a museum of performing arts on top of the planned plaza. (September 18, 2002).
P.L. 108-81 – To reauthorize the Museum and Library Services Act. Amends 20 U.S.C. 9172 (1)), to include museum sites. (September 25, 2003).
H.R. 1012 – Carter G. Woodson Home National Historic site Establishment Act of 2003 – Directs the Secretary of the Interior to establish as a unit of the National park system the Carter G. Woodson Home National Historic Site in the District of Columbia (Passed by House May 2003 and Senate November 2003; Authorizes Appropriations).
H.R. 3491 – To authorize the National museum of African American History and Culture (Passed by House and Senate November 2003 – awaiting President's signature).


text:
Foreign Secretary David Miliband has rejected calls for a Labour leadership contest.
On the BBC's Politics Show, he said Fiona MacTaggart was right to say revitalising Labour was "a huge task", but that he absolutely was not in favour of a challenge to the leadership.
What are these?
E-mail this to a friend


text:
GREELEY, Colo. – The Northern Arizona men's basketball team could not overcome 23 turnovers as Northern Colorado posted a 76-68 victory at the Butler-Hancock Pavilion Thursday night.
"(The turnovers) were more on us," said Head Coach Jack Murphy. "Northern Colorado is a good team and they are well coached. They do not put a lot of pressure on you. A lot of the turnovers were unforced and uncharacteristic of how we have been playing lately. It is not indicative of the team that we have."
UNC improved to 6-9 in Big Sky play, while the Lumberjacks dropped to 6-9 and 9-16 overall.
The Bears got the bulk of their scoring from their top three players with a combined 62 points by Derrick Bardin, Tevin Svihovec and Tate Unruh. Svihovec had a game-high 24 points, going 9-for-13 from the field with three triples in the contest. Barden had 21 points and Unruh added 17 points.
The Lumberjacks closed to within four points with six minutes left in the game but Svihovec scored seven straight points including two three-pointers to push the lead back to nine points. The Lumberjacks never got any closer.
Gabe Rogers led the Lumberjacks with 23 points on 7-of-15 shooting from the field.
"Gabe is an outstanding player and it is well-documented how much we rely on Gabe and what a great roll he has been on lately," said Murphy. "He has been playing at an all-conference level and I think he is one of the best scorers in the league."
Freshman guard DeWayne Russell added 15 in the loss. Senior guard Stallon Saldivar added seven points and five assists before leaving the game with an injury.
NAU shot 56 percent for the game but UNC recorded the 23 turnovers with the help of 14 steals.
The Bears led by nine at the half 35-26 with the help of 14 NAU turnovers in the first half. The Lumberjacks came out of the locker room with a 9-0 run to tie the game at 35. The Bears then responded with an 8-0 run to go back up 43-35.
"What we did to get back in the game is we executed," said Murphy. "We executed offensively and defensively and were able to turn them over and go get scores. When they went on their run, unfortunately, we reverted back to a couple of turnovers and poor execution. In a game like this on the road with high stakes involved, you have to have your focus and execution for 40 minutes to come out with a victory. We just did not have that tonight."
The Lumberjacks travel to Grand Forks, N.D., for a Saturday afternoon game against North Dakota.
"We have to be mentally ready to play, individually and as a group, doing your job and understanding your roles," said Murphy. "I think we will have a much better showing on Saturday."
Tipoff is at 1:05 p.m. against North Dakota and the game can be heard on the Lumberjack Radio Network on 105.1 The Big Talker, online or via the Big Talker mobile app. Fans can also catch the game on Big Sky TV.


text:
"I can't say anything negative," said Thomas. "We came here very much under-rated but it was a great game.
"Australia stuck it together for the 80 minutes, we had just one lapse in defence and they won.
"We believe in ourselves. Australia starved us of ball in the first half but we came back into it."
The late try denied Thomas a dream victory on a day when he became Wales' most-capped player with 93 caps.
After the final whistle, Thomas ran over to give his shirt to Australia attack coach Scott Johnson, who was Wales' skills coach from 2001 until last year.
"It is a memorable day for me and I probably would not have been around if it was not for Scott," added Thomas.
"He has given me a lot of inspiration. He has been a shining light for me and if anyone deserves the shirt, he does."
Australia skipper Phil Waugh admitted that there was a "feeling of relief" after the game.
"The guys hung in there after a slow start and we did reasonably well," he said. "We knew it was going to be tough.
"We had a huge amount of possession in the first half but tries turn games and to get to half-time five points down was a good effort after the Welsh tries.
"There was some rustiness in the first half, some simple mistakes, and we dropped a lot of balls. Hopefully we can work on that and a win by a bit more in the second Test in Brisbane."
Wallabies coach John Connolly feels that the nature of the win will be a big benefit to his side.
"Digging ourselves out a hole like that will give this team a lot of confidence," said Connolly.
"We made a lot of mistakes and helped their cause a lot, but it's never easy to come back from 17-0 down so I was proud of them."
Connolly's Wales counterpart Gareth Jenkins added: "Of course we're disappointed we didn't win but at the end of the day we showed we were competitive.
"We were ridiculed with the team we brought here but were justified in doing that."


text:
PBS NewsHour full episode Dec. 30, 2015
Video duration: 53:41Expires: 01/29/16Video has closed captioning.
Wednesday on the NewsHour, Bill Cosby is charged with sexual assault, stemming from a 2004 allegation. Also: Espionage amid Israel's lobbying of Congress over the Iran deal, lawmakers make compromises to finish out 2015, the biggest scientific breakthrough of 2015 raises questions and taking control back from the food industry over what we eat.


text:
There's something a bit smug about this lo-fi music doc, which pivots on a surprise manslaughter charge (levelled against the lead singer of heavy-metal rockers, Lamb of God, whilst the band were mid-way through a European tour in 2012). Randy Blythe finds himself accused of pushing a Czech fan from the stage, at a gig in 2010. An ex-alcoholic, Blythe seems a nice bloke, and appears truly sorry about the young fan's death. But when he holds forth on "core values" and "personal responsibility", (and pals like Slash and Slipknot's Corey Taylor pop up to extol his virtues), the project feels like a press release.
It's far more interesting to watch Blythe, in the Prague court room, wearing a stricken expression and smart clothes. He's a performer desperate to prove his emotions are for real. You can see the strain on his face (he's in his early forties but could be 60). His fresh-faced devotees don't seem to care; their willingness to worship at his angst-ridden feet tells a story all in itself.
- More about:
- Cinema
- Rock Singers


text:
- Home
- Evidence-Based Medicine for Pharmacists in the Patient-Centered Medical Home (PCMH)
- Slide Presentation in Text Format
Evidence-Based Medicine for Pharmacists in Patient-Centered Medical Home
Slide Presentation in Text Format
Monday, December 13, 2010
11:00-12:30pm, ET
- On the top of the slide are the logos for the Department of Health and Human Services and the Agency for Healthcare Research and Quality (AHRQ).
Slide 2
Development and Support
- This Web conference was developed by the Agency for Healthcare Research and Quality's (AHRQ) Effective Health Care Program with assistance from the American Pharmacists Association.
On the bottom of the slide is the logo for the Effective Health Care Program and the American Pharmacists Association.
Slide 3
Accreditation and CPE Information
- The American Pharmacists Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education (CPE). This Web conference, Evidence-Based Medicine for Pharmacists in the Patient-Centered Medical Home, ACPE #202-999-10-270-L04-P, is approved for 1.5 hours of CPE credit (0.15 CEUs).
- To obtain CPE credit for this Web conference, participants must participate in the entire Web conference and complete the online evaluation by December, 27, 2010. A voucher code and further instructions will be provided during the Web conference. In order to complete the online activity evaluation form, participants will need to have a valid Pharmacist.com user name and password. A Statement of Credit will be automatically generated upon achieving these requirements.
Slide 4
Accreditation and CPE Information
- Target Audience: Pharmacists
- ACPE Activity Type: Knowledge-based
- Learning Level: Level 1
Slide 5
Learning Objectives
After participating in this Web conference, pharmacists will be able to:
- Define the tenets of the patient-centered medical home and AHRQ's role.
- Describe the various patient-centered medical home models and list the numerous roles for pharmacists in a PCMH.
- Discuss successful implementation strategies and potential barriers to the PCMH.
- Recognize the Effective Health Care Program as an evidence-based resource for pharmacists.
Slide 6
Sarah J. Shoemaker, Ph.D., Pharm.D., R.Ph., Moderator
Health Services and Policy Researcher
Abt Associates, Inc.
Cambridge, Massachusetts
Janice L. Genevro, Ph.D., MSW, The Patient-Centered Medical Home (PCMH) and AHRQ
Lead, Primary Care Implementation Team
Center for Primary Care, Prevention, and Clinical Partnerships
Rockville, MD
Images of Dr. Shoemaker and Dr. Genevro are on the left side of the slide next to their name and title.
Slide 7
Stephanie M. Hammonds, Pharm.D., The Role of Pharmacists in the Medical Home
Office of Pharmacy Affairs
Healthcare Systems Bureau
Rockville, MD
Karen Williams, Pharm.D., M.B.A
Branch Chief for Quality Improvement (QI)
Office of Pharmacy Affairs
Rockville, MD
Images of Dr. Hammonds and Dr. Williams are on the left side of the slide next to their name and title.
Slide 8
Vince Willey, Pharm.D., The PCMH in Practice: The Pharmacist Experience
Associate Professor
Philadelphia College of Pharmacy
Philadelphia, PA
Scott R. Smith, Ph.D., R.Ph., M.S.P.H., How AHRQ's EHC Program can support the Pharmacist's Role in the PCMH
Director of Pharmaceutical Outcomes Research Programs
Center for Outcomes and Evidence
Rockville, MD
Images of Dr. Willey, and Dr. Smith are on the left side of the slide next to their name and title.
Slide 9
Sarah J. Shoemaker, Pharm.D., Ph.D., R.Ph., has no financial interests or relationships to disclose.
Janice L. Genevro, Ph.D., M.S.W., has no financial interests or relationships to disclose.
Stephanie M. Hammonds, Pharm.D., has no financial interests or relationships to disclose.
Karen Williams, Pharm.D., M.B.A., has no financial interests or relationships to disclose.
Vincent Willey, Pharm.D. has recently received research/grant support from AstraZeneca.
Scott R. Smith, Ph.D., R.Ph., M.S.P.H., has no financial interests or relationships to disclose.
Slide 10
AHRQ and the Medical Home: Building a Blueprint
Janice L. Genevro, Ph.D., M.S.W.
Center for Primary Care, Prevention,
& Clinical Partnerships
Slide 11
AHRQ Mission Statement
To improve the quality, safety, efficiency, and effectiveness of health care for all Americans
Slide 12
What AHRQ does
- Generates New Knowledge
- Synthesizes Evidence
- Supports Implementation
Slide 13
Primary Care
AHRQ recognizes that
the Nation's primary care system
is foundational to achieving
high-quality, accessible, efficient health care for all Americans.
Slide 14
The Medical Home
AHRQ believes that the primary care medical home, also referred to as the patient-centered medical home (PCMH), advanced primary care, and the healthcare home, is a promising model for transforming the organization and delivery of primary care.
Slide 15
The Medical Home
- A medical home not simply a place but a model of primary care that delivers care that is:
- Patient-centered
- Comprehensive
- Coordinated
- Accessible, and
- Continuously improved through a systems-based approach to quality and safety
Slide 16
AHRQ's Definition of the Medical Home
- Key components
- Patient-centered: Relationship-based with an orientation toward the whole person
- Comprehensive Care: Team-based care that includes providers from multiple disciplines, including pharmacy
- Coordinated Care: Clear, open communication and transfers of accountability, especially during care transitions
- Superb access to Care: Responsive to patients' preferences regarding access
- Systems-based approach to quality and safety: Commitment to quality and quality improvement
- Health IT, workforce development, and payment reform are critical to achieving the potential of the medical home
- Full version is available at www.pcmh.ahrq.gov
Slide 17
AHRQ and the Joint Principles Closely Aligned
- Patient-centered
- Comprehensive
- Team-based care
- Coordinated
- Accessible
- Quality and safety
- Health IT
- Workforce development
- Payment reform
- Personal physician
- Physician directed practice
- Whole person orientation
- Care Coordination
- Health IT
- Quality and safety
- Enhanced access
- Payment
Slide 18
AHRQ PCMH Research
- Retrospective Evaluations
- Health Partners (Minnesota)
- WellMed (Texas)
- Mixed Methods Evaluations
- Transforming Primary Care Practice
- 14 2-year awards
- $600K per study
- Awarded summer 2010
- Transforming Primary Care Practice
- Establishing a Research Agenda
- Co-funded with CWMF and ABIMF
- Collaboration of SGIM, STFM, APA
- Results published June 2010 in JGIM
Slide 19
Information for Decision Makers
- Foundational White Papers
- Necessary but Not Sufficient: The HITECH Act's Potential to Build Medical Homes
- Engaging Patients and Families in the Medical Home
- Integrating Mental Health into the Medical Home
- Address Policy and Research Issues
Slide 20
Coming Soon!
More White Papers and Briefs
- Planned white papers for 2011:
- Analysis of PCMH outcomes
- Exploration of PCMH within the larger health care system
- Upcoming series of briefs on the status of primary care in the US
- Includes new analysis of the primary care workforce
Slide 21
Database of PCMH Literature
- Database of published literature on the medical home
- Over 500 citations
- Searchable by PCMH domain, policy relevance, and outcomes
- Includes a section on foundational documents and articles
Slide 22
Implementation Projects
- Toolkit on integrating the Chronic Care Model in safety net settings
- Visit: http://www.ahrq.gov/populations/businessstrategies/
- Companion toolkit on utilizing practice coaching
- Currently conducting field evaluation
- National expert working group on using practice facilitators and practice coaching
- Launching winter 2010
Slide 23
Implementation Projects
- Building a PCMH Information Model
- Describe the PCMH in terms of the information flows and interactions between and among patients/consumers and other PCMH stakeholders
- Develop new 'functional use cases'
- Examine current standards and existing 'technical use cases' in relation to the PCMH
- Identify gaps
- Began Summer 2010
Slide 24
Online PCMH Resource Center
On the slide is a screen image of the Patient Centered Medical Home Resource Center Web page on the Agency for Healthcare Research and Quality Web site.
Slide 25
- Targeted towards meeting the needs of Policy Makers and Researchers
- Includes:
- AHRQ definition of the medical home
- Searchable article database
- Foundational white papers
- Will continue to grow and expand
Please visit and help us spread the word!
Slide 26
Principles for Pharmacists' Services in PCMH
- Developed by 9 pharmacy organizations
- Essential principles:
- Access to pharmacist services
- Patient-focused collaborative care
- Flexibility in PCMH design
- Development of outcome measures
- Access to relevant patient information
- Effective health information technology
- Aligned payment policies
Principles for Inclusion of Pharmacists' Clinical Services in the Patient-Centered Primary Care Medical Home. (March 2009). http://www.accp.com/docs/misc/pcmh_services.pdf
Slide 27
Delivering Better, Safer Care in Communities Nationwide: The PSPC Performance Story
Stephanie M. Hammonds, Pharm.D.
Office of Pharmacy Affairs,
Slide 28
How Reliable is our Care?
A Function of System and Culture
Patient Safety and Clinical Pharmacy Services Collaborative (PSPC) Aim
|1: million
|-Custom-crafted processes
|-Standard process
-Safety drills
|-Loss of individual identity
-Defer to expertise
-Safety Culture
|-Each Doc writes unique orders
|Multi-disciplinary rounds
Protocols for high risk meds
|-Anesthesia safety
-Airline industry
Autonomy Teamwork Highly Reliable Org's
Slide 29
Let's Improve Health Outcomes!
A Decade of "Calls for Action"
Primary Care Status Quo:
- Physicians Rx patients, w/o collaboration
- Accept Rx errors as ok, or not my problem
- Tolerate non-adherence, poor outcomes
Calls us to lead "Significant Change",
Target: Chronic Disease via Primary Care
Slide 30
PSPC Aim
To save and enhance thousands of lives a year by:
1. Achieving optimal health care outcomes
2. Eliminating adverse drug events
3. Increasing clinical pharmacy services
Slide 31
PSPC Teams are Transforming and Improving Quality Delivery Systems
This slide is a visual of how PSPC is working to improve the overall delivery system. PSPC focuses on comprehensive primary care including transitions of care. The PSPC aims to integrate clinical pharmacy services into the patient-centered health home.
On the left there is a traditional model which indicates that is not powerful enough to significantly improve outcomes, particularly for complex patients. In an ideal world everyone would have a primary care physician.
Slide 32
Models for Medical Home
"Doc alone with an Rx pad"
This slide shows the traditional model of care that is available. The traditional model only covers basic episodic care, which leads to status quo outcomes.
Slide 33
Models for the Medical Home
Systems/Teams for Better Outcomes
This slide shows the advanced model. This model illustrates that there needs to be a way to minimize the old standard of care, which is only visiting the doctor in his or her office. The advance model shows that there are three levels that need to work together to result in better outcomes. These three levels work to close the outcomes gap.
- Doctors office ó Basic Care, Episodic
- Expanded Medical Home ó Preventive Planned Care
- Comprehensive Health Home: Community Health Centersó Disparity
Slide 34
The "3T's" Road Map to Transform US Health Care
The "How" of High-Quality Care
This is a diagram of the three Ts of transforming healthcare.
Slide 35
Acquiring and Advancing Knowledge to Achieve Better Outcomes
This is another diagram of the three Ts of transforming healthcare. One example illustrates an ace inhibitor. T1 represents the basic biomedical research; someone discovers the chemical compound that can inhibit the angiotensin converting enzyme. However, without the next step one will not be able to impact public health. T2 is in the middle and has an image of a funnel that represents the clinical research trials that will eventually be marketed. T3 shows that despite the clinical research, there is a huge backlog in systems-based performance improvement, which is leading to patients falling through the cracks. This is represented by the boat neck on the diagram. Currently, PSPC is at the boat neck. The average patient in the PSPC population takes at least eight prescription drugs and has five chronic conditions, and sees multiple providers.
Slide 36
Health Status Breakthroughs in High-Risk Patient Populations
The PSPC high-risk patient population is characterized by:
- 8 drugs per patient
- 5 chronic conditions per patient
- 3 providers per patient
The soundtrack for our patient's health care stories?: Scary Music
30% of PSPC teams' total patients are in this high-risk population
Slide 37
Health Status Breakthroughs for Multiple Populations of Focus (PoFs)
On this slide there is a pie chart showing the distribution of Teams by PoF. The pie chart is divided into Anticoag (15%), Asthma (8%), BP (5%), Diabetes (54%), HIV/AIDS (13%), LDL (5%).
For each of these POFs, teams are working to bring patients from health status out of control to under control.
Slide 38
Imagine a future when:
- Are in proactive, comprehensive medical homes
- Receive indicated planned/preventive care
- Understand what each med is intended to do
- Safely use indicated Rx to achieve those goals
- Are in a world class community of practice Health Professionals
- Work collaboratively, with joy
PSPC is doing this, and WILL BLOW THE DOORS
Slide 39
A Map on the Road to Improvement
"Change Package"
- Details the leading practices that together address the Aim and Goals of the improvement process.
- Developed by harvesting lessons from high performing organizations that have achieved outstanding results.
- Reviewed and vetted by a panel of national experts.
- Serves as the catalogue of leading practices that teams adapt and use to accelerate the improvement process.
Slide 40
The PSPC Change package is organized into five strategies to achieve results
This slide has a pyramid with the top of the pyramid labeled as Patient Centered Care, the middle portion labeled Safe Medication Uses System, and the bottom portion labeled Integrated Care Delivery. The free space on the left side of the pyramid is labeled Leadership Commitment, and the free space on the right side of the pyramid is labeled Measurable Improvement.
Slide 41
Institute for Healthcare Improvement (IHI) Breakthrough Model for Improvement
This graph shows IHI methodology and how improvement cycles help with the acceleration to move further and faster than the status quo drift.
Slide 42
PSPC Performance Story
Patients with Health Status Out of Control
September 2009 (Baseline)
This slide shows a bar graph. Each bar graph represents the patient in the team populations shown on slide 37. 100 percent of the patients had the status Out of Control.
Slide 43
Patients with Health Status now
"Under Control" vs. "Out of Control"
Through PSPC 2.0 (12 Months)
This slide is a graph of the teams shown on slide 42. On this graph it is clear that patients receiving care from their respective teams showed dramatic improvements.
Slide 44
Health Status Breakthroughs
In just 12 months, 54% of patients brought their health status under control
Slide 45
Patient Safety Breakthroughs
Teams are working to drive rates of
potential adverse drug events (pADEs) and adverse drug events (ADEs) to ZERO
Average team improvement through PSPC 2.0
- pADE rates fell 60%
from an average of 0.86/pt to 0.34/pt
- ADE rates fell 49%
from an average of 0.12/pt to 0.06/pt
Slide 46
PSPC Potential Impact at full scale up
CHC patient population expected to reach 40 million
- Extrapolating from PSPC Data:
- 12 million patients will need CPS
- 5.4 million potential ADEs avoided
- 720,000 actual ADE's prevented
- Savings Generated:
- $8.7K/ preventable ADE
Slide 47
|Number of…
|PSPC 3.0 (as of 11/1/10)
|37 inc. PR
|41 inc. DC and PR
|43 inc. DC and PR
|Community Health Centers
|Colleges/Schools of Pharmacy
Slide 48
PCMH in Practice: The Pharmacist Experience
Vincent Willey, Pharm.D.
Associate Professor of Pharmacy
Philadelphia College of Pharmacy
At the bottom of the slide there are logos for Quality Family Physicians and the Philadelphia College of Pharmacy.
Slide 49
Presentation Overview
- Our PCMH practice
- Pharmacist consultation
- Patient scheduling and referral
- Patient visit flow
- Physician perspective
- Implementation challenges
Slide 50
Practice Background
- Three fulltime physicians
- Privately owned practice
- 9 staff
- Medical assistants
- No nurse practitioners, physician assistants or nurses
- Practice started in 1999
- Electronic medical record since inception
- Phlebotomy on-site from national lab provider
Slide 51
Pharmacist Consultation
- Collaboration with the Philadelphia College of Pharmacy
- Pharmacists currently 2 full days per week
- One full day and two half days
- Pharmacists currently 2 full days per week
- Started in July 2009
- One pharmacist at one day per week
- Started in July 2009
- Second pharmacist added in January 2010
- Two half days per week
- Second pharmacist added in January 2010
Slide 52
Pharmacist Consultation Area
- Specific patient education area
- Not an exam room
- Table and chairs to facilitate more relaxed atmosphere and more than one person
- Significant others
- Group visits
- Table and chairs to facilitate more relaxed atmosphere and more than one person
Slide 53
Patient Scheduling
- Pharmacists' schedule maintained in the same system as the physicians
- Receptionists make appointments
- Majority of patients specifically referred by the physician
- One hour for new patients
- Half an hour for follow-ups
Slide 54
Patients Currently Referred
- Metabolic syndrome
- Diabetes
- Hypertension
- Dyslipidemia
- Most have multiple or all 3 conditions
- ADHD/depression/anxiety/bipolar disorder
- Others
Slide 55
Future Expansion of Patients
- Asthma
- Smoking cessation
- Anticoagulation management
- Pain management
- "Complex" medication regimens
Slide 56
Patient Visit Flow- Initial Visit
- Medication review
- Update current list
- Especially inquire regarding OTC and alternative meds
- Update current list
- Review indications
- Do they know why they are taking each?
- Review indications
- Assess adherence
Slide 57
Patient Visit Flow- Initial Visit
- Introduction
- Who and what I do
- Not just about medications
- What do they want to get out of the session
- Disease state education
- Review of lab parameters and goals
- Use EMR to show graphs for trends
- Why we care about these numbers
Slide 58
Patient Visit Flow- Initial Visit
- Diet review
- Current diet
- ADA reducing calories and fat slide deck
- Food labels
- Basics regarding fat, cholesterol and sodium intake
- "Good" fats vs. "Bad" fats
- Calorie goals
- Livestrong.com and calorieking.com
- Excellent source for non-food label foods
- Diary log
- Livestrong.com and calorieking.com
- 3 to 5 specifics items to work on
Slide 59
Patient Visit Flow- Initial Visit
- Vitals
- Weight
- Blood pressure
- Review recommendations with physician
- Medications
- Lab testing
- Screening
- Foot exam
- Retina exam
- Physician completes each visit with the patient
- Enacts accepted recommendations
- Reinforces key points with patients
Slide 60
Patient Visit Flow- Initial Visit
- Typically 4 to 6 weeks after initial visit
- Tailored to the individual patient
- Review dietary changes
- Weight
- Review medication changes
- Problems
- Adherence
- Assess any new labs
- Blood pressure
- Exercise
- Reinforce initial education
- Review dietary changes
- Visit schedule individualized after 1st follow-up
Slide 61
- Pharmacist writes note directly in the patient's electronic chart
- Created specific "pharmacist" note template
- Update medication lists
- Note forwarded to physician for review and signoff of recommendations
Slide 62
Physician Perspective
So what is the physician thinking about when I approach them to collaborate in a PCMH?
Slide 63
Primary Care Physician Current Business Model
- Fee for service vs. capitation
- Payer mix
- Medicare
- Medicaid
- Commercial insurers
- Payer bonuses – HEDIS reporting
- Utilization
- Quality
Slide 64
Primary Care Physician
"Hot Buttons"
- Control
- Type A personalities
- Dedication to patients
- Liability
- Creating more work
- Follow-up
- Breaks in communication
- Not receiving consult notes back after referrals
Slide 65
Primary Care Physician
"Hot Buttons"
- Finances
- Referring to the pharmacist can't be a negative financially
- Reimbursement for "medical home" services
- How can that be split between physician and pharmacist to provide the enhanced services required
- Optimal practice size
- How many physicians/patients need to support a pharmacist
- Physician Schedule
- Mondays and Friday usually worst
Slide 66
Why a Pharmacist?
- Complementary skill sets
- Physician diagnoses
- Pharmacist as medication expert
- Pharmacist also can perform lifestyle modification and disease state management
- Negatives
- Don't associate pharmacists with this type of role
- Cost – pharmacists are expensive
- Non-conventional billing compared with nurse practitioners and physician assistants
Slide 67
Bumps in the Road
- These patients tend to be non-compliant
- Lifestyle and medications
- High cancelled appointment rate – 20%
- Bad for the patient
- Bad for the business model when paid on a fee-for-service basis
- Integration of the services with existing practice and staff
- Staff education
Slide 68
Bumps in the Road
- Discussions with local commercial insurers
- Payment to pharmacist as a provider
- Adequate reimbursement rates
- Timing of office visit with physician to close out the visit
- Need to have billing under the pharmacist
- Selective use of physician at time of the visit vs. mandatory due to billing
Slide 69
Key Takeaways
- Medical practice models are changing
- Pharmacists can be a key contributor to direct patient care in a PCMH
- Need to be appropriately aggressive in stating our value to the PCMH
- Understand what we can do
- Understand the physician perspective
- Succinctly articulate our value proposition
Slide 70
Supporting the Pharmacist's
Role in PCMH:
AHRQ's Effective Health Care Program
Scott Smith, Ph.D., R.Ph., M.S.P.H.
Center for Outcomes and Evidence
Slide 71
AHRQ's Effective Health Care Program
- Created in 2005, authorized by Section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003
- AHRQ shall conduct and support research on:
- "the outcomes, comparative clinical effectiveness, and appropriateness of health care items and services (including prescription drugs)"
- Goal: to provide patients, clinicians and policy makers with reliable, evidence-based healthcare information
Slide 72
Comparative Effectiveness Research
- Focuses on patient-centered outcomes
- Unbiased and practical, evidence-based information
- Compares drugs, devices, tests and surgeries, and approaches to health care
- benefits and harms
- what is known and what isn't
- Descriptive, not prescriptive
On the right bottom corner of the slide is a balance with the words benefits and harms on it.
Slide 73
- "Comparative"
- Need to think about what the available options are
- Placebo is not sufficient
- "Effectiveness"
- Vs. Efficacy
- What happens in the "real world"?
Slide 74
Patient Protection and Affordable Care Act
- Section 6301: Patient-Centered Outcomes Research
- Name change: Comparative Effectiveness Research = Patient-Centered Outcomes Research
- Patient-Centered Outcomes Research Institute
- Independent, nonprofit Institute with public- and private-sector funding
- Sets priorities and coordinates with existing agencies that support patient-centered outcomes research
- Prohibits findings to be construed as mandates on practice guidelines or coverage decisions and contains patient safeguards
On the right side of the slide there is an image of an office building.
Slide 75
Understanding Uncertainty About Decisions
This slide has a diagram which is taken from The New England Journal of Medicine. Panel A represents how everyone is trained to think about interventions. The author's argue that interventions are made to depict thresholds and a "one-size-fits-all" approach; however, there's a threshold which the net benefits outweigh the risk. If one is able to see that threshold through lab tests or some kind of other clinical diagnostic measure, then they can automatically recommend care. Below certain thresholds, care is often discouraged. The second part of the diagram shows model B which has a large gray area that represents small benefit or uncertain net benefit, labeled Discretionary Care. This area asks clinicians to defer to patients about their preferences about care, and whether a certain benefit is important to them. The main purpose of this diagram is to recognize that different decisions have different evidentiary needs. This is what the Effective Health Care Program works to address.
Quanstrum KH, Hayward RA. Lessons from the mammography wars. N Engl J Med. 2010 Sep 9;363(11):1076-9.
Slide 76
|Patient decision
|Should I take raloxifene, alendronate, or calcium and Vitamin D to prevent osteoporosis?
|Drug coverage
|Which bisphosphonate drugs should be included on a drug formulary?
|Clinical practice guidelines
|When should therapy for low bone density be initiated?
|Health plans and insurers
|Should we reimburse for follow-up assessment of bone density on treatment, and how often?
|Health system policies
|Should we institute primary care-based ultrasound screeening of osteoporosis
See Atkins, D. Creating and Synthesizing Evidence With Decision Makers in Mind. Med Care 2007;45: S16–S22
Slide 77
Keeping the Patient at the Center
- Patients are more involved in their care.
- Each patient is different.
- Patients need reliable, relevant, and understandable information.
Slide 78
Effective Health Care Program
- Evidence synthesis (EPC program)
- Systematically reviewing, synthesizing, comparing existing evidence on treatment effectiveness.
- Identifying relevant knowledge gaps.
- Evidence generation (DEcIDE, CERTs)
- Development of new scientific knowledge to address knowledge gaps.
- Accelerate practical studies.
- Evidence communication/translation (Eisenberg Center)
- Translate evidence into improvements
- Communication of scientific information in plain language to policymakers, patients, and providers.
Slide 79
Available AHRQ Products
There are images on the slides of available AHRQ products. These products include Research Reviews, New Research Reports, Technical Briefs, and Summary Guides.
Slide 80
Examples of Comparative Effectiveness Systematic Reviews
- Comparative Effectiveness of First and Second Generation Antipsychotics in the Adult Population
- Evaluation of Effectiveness and Safety of Antiepileptic Medications in Patients with Epilepsy
- Comparative Effectiveness of Pharmacologic Therapies for the Management of Crohn's Disease
- Effectiveness of Screening and Treatment of Subclinical Hypo- or Hyperthyroidism
- Diagnosis and Comparative Effectiveness of Treatments for Urinary Incontinence in Adult Women
- Comparative Effectiveness of Multiple Daily Injections or Insulin Pump Therapy with or without Continuous Glucose Monitoring for Diabetes
Slide 81
Examples of AHRQ Technical Briefs
- Wheeled Mobility (Wheelchair) Service Delivery
- Multidisciplinary Pain Programs for Chronic Non-Cancer Pain
- Particle Beam Radiation Therapies for Cancer
- Percutaneous Heart Valves
- Neurothrombectomy Devices for Treatment of Acute Ischemic Stroke
- Use and Safety of Positional MRI in the Management of Patients with Musculoskeletal Pain
Slide 82
Examples of New Research
- CER of treatments for open-angle glaucoma (National Registry)
- CER of clinical management strategies in end-stage renal disease (Large US cohort of dialysis patients)
- Evaluating the effects of drug-eluting and bare metal stents
- Evaluating outcomes of PET Scanning using the NOPR Registry
- The Impact of Intensive versus Usual Glucose Control in Individuals with Type 2 diabetes
- ADHD and Risk of Sudden Cardiac Death
- CER of treatments for heart failure
Slide 83
In the Pipeline
- More than 100 topics
- Evidence Synthesis
- Future Research Needs
- Original Research
- Methods Research
Slide 84
Effective Health Care Program Translation Products
This slide has images of Effective Health Care Program's products.
Slide 85
Consumer Guides
- Key Messages from EHC Reports
- Written in plain language (approx. 8th grade level) and with audio files
- Created with input from end-users
- Actionable – written to inform decisions with emphasis on benefits and harms
- Spanish translations available
- Cost information provided
Slide 86
Consumer Guides
- Paired with clinician guides to promote shared decision making
- Guides available in
- Online
- Audio podcasts
- Spanish translations
On this slide there are images of available consumer guides. Also, there is an image of a widget for the Healthcare 411 RADIO Podcast.
Slide 87
Important Role of Outside Input-Get Involved
- Nomination of research topics
- Input on research questions
- Comment on draft reports
- Focus test translation products
- Comments on overall program direction and quality improvement
Slide 88
Shared Perspectives on Comparative Effectiveness
- Comparative effectiveness should be a public good that:
- Gives health care decision makers – patients, clinicians, purchasers and policy makers – access to the latest open and unbiased evidence-based information about treatment options
- Informs choices and, where possible, is closely aligned with the sequence of decisions patients and clinicians face
-The Right Treatment for the Right Patient at the Right Time
Slide 89
What can comparative effectiveness research do for you?
- Help make decisions more consistent, transparent and rational
- Clarify nature of disputes over practice and policy
- Help inform quality improvement efforts
- Help patients make decisions about their own care
Slide 90
How to Access Products
AHRQ Website: www.effectivehealthcare.ahrq.gov
- Full reports and summary guides for patients and clinicians
- Opportunities to nominate research topics or comment on research questions and draft reports
- Audio files
- Spanish translations for consumer guides
- CE Activities
- Faculty slides
AHRQ Publications Clearinghouse:
1 (800) 358-9295
Requests for FREE, printed summary guides
Slide 91
How to Stay Informed
- EHC Program website:
- EHC Program newsletter, Comparative Effectiveness News
Slide 92
Slide 93
How to Obtain CPE Credit
- Note the voucher code: EMB123
- Go to www.pharmacist.com/education
- Go to Online CPE Quick List and click on "Evidence-Based Medicine for Pharmacists
in the Patient-Centered Medical Home"
- Log in using your Pharmacist.com user name and password
- Complete the evaluation to gain immediate access to your Statement of Credit


text:
NEW YORK — Sally Ride, the first American woman to fly in space, died Monday at her home in San Diego. She was 61.
The cause was pancreatic cancer, according to an announcement by her company, Sally Ride Science. Ms. Ride, a physicist, flew on the shuttle Challenger on June 18, 1983, and on a second mission in 1984. She was also, at 32, the youngest American in space. Ms. Ride later became the only person to sit on both panels investigating the catastrophic shuttle accidents that killed all astronauts on board: the Challenger explosion in 1986 and the Columbia crash in 2003.
Ms. Ride was finishing studies at Stanford — degrees in physics and astrophysics (as well as English) — and looking for a job when she saw a newspaper advertisement that said NASA was accepting astronaut applications. She looked at the qualifications and said, ''I'm one of those people,'' she told The New York Times in 1982.
She applied, and made the cut. ''The women's movement had already paved the way, I think, for my coming,'' she said.
By the time she began studying laser physics at Stanford, women had already broken through into the physics department, once a boys' club. And when she applied to the space program, NASA had already made a commitment to admit women.
But there were still rough spots. Speaking to reporters before the first shuttle flight, Ms. Ride — chosen in part because she was known for keeping her cool under stress — politely endured a barrage of questions focused on her sex: Would spaceflight affect her reproductive organs? Did she plan to have children? Would she wear a bra or makeup in space? Did she cry on the job? How would she deal with menstruation in space?
CBS News reporter Diane Sawyer asked her to demonstrate a newly installed privacy curtain around the shuttle's toilet. On ''The Tonight Show,'' Johnny Carson joked that the shuttle flight would be delayed because Ms. Ride had to find a purse to match her shoes.
At a NASA news conference, Ms. Ride said: ''It's too bad this is such a big deal. It's too bad our society isn't further along.''
The Soviets had already sent two women into space. One was welcomed aboard a space station by a male cosmonaut who told her the kitchen and an apron were ready for her.
In her early days at NASA, Ms. Ride trained in parachute jumping, water survival, and acclimatization to weightlessness and the huge G-forces of a rocket launch. She learned to fly a jet plane. She also switched from physics to engineering and helped to develop a robotic arm for the space shuttle. The Challenger commander, Robert Crippen, chose her for the 1983 mission in part because of her expertise with the device. She was part of a crew of five that spent about six days in space, during which she used the arm to deploy and retrieve a satellite.
At Cape Canaveral, many in the crowd of 250,000 that watched the launch wore T-shirts that said, ''Ride, Sally Ride'' — from the lyrics of the song ''Mustang Sally.''
The next day, Gloria Steinem, then editor of the magazine Ms., said, ''Millions of little girls are going to sit by their television sets and see they can be astronauts, heroes, explorers, and scientists.''
When the shuttle landed, Ms. Ride told reporters, ''I'm sure it was the most fun that I'll ever have in my life.''
Her next mission, in 1984, lasted about eight days. She was on the roster for another shuttle flight, but then, on Jan. 28, 1986, the Challenger blew up, 73 seconds after taking off.
'She inspired generations of young girls to reach for the stars and later fought tirelessly to help them get there.'
As part of the accident-investigation panel appointed by President Ronald Reagan, she asked tough questions. The group learned from testimony and other evidence that there had been signs of trouble on earlier Challenger flights, but that they had been dismissed as not critical. Ms. Ride told a colleague it was difficult not to be angered by the findings.
One witness was Roger Boisjoly, an engineer who had worked for the company that made the shuttle's rocket boosters and who had been shunned by colleagues for revealing that he had warned his bosses and NASA of potentially fatal flaws in the boosters' seals. Afterward, Ms. Ride, widely considered to be reserved and reticent, hugged him. She was the only panelist to offer him support, and Boisjoly, who died in February, said her gesture had helped sustain him during a troubled time.
In 2003, after sitting on a shuttle-disaster panel for the second time, Ms. Ride said in an interview with The Times that part of the problem at NASA was that people had forgotten some of the lessons learned from the Challenger accident. But she also said: ''I flew the shuttle twice. It got me home twice. I like the shuttle.''
In 1987, Ms. Ride led a study team that wrote a report advising NASA on the future direction of the space program. The team recommended an outpost on the moon, though not a ''race to Mars.'' But Mars should still be the ''ultimate objective,'' the group said. In the report, Ms. Ride wrote that a lunar outpost would combine ''adventure, science, technology, and perhaps the seeds of enterprise.''
She also noted darkly that the United States had ''lost leadership'' to the Soviet Union in a number of aspects of space exploration.
The same year, Ms. Ride retired from NASA and became a science fellow at the Center for International Security and Arms Control at Stanford University. In 1989, she became a professor of physics and director of the California Space Institute at the University of California San Diego.
She also developed a passion for trying to interest young people, especially girls, in science, math, and technology. She wrote six science books for children, including one that explained how to make a sandwich in space. (She advised eating it fast, before it floated away.) In 2001 she started a company, Sally Ride Science, to ''make science and engineering cool again,'' as she put it, by providing science-oriented school programs, materials, and teacher training.
Ms. Ride was known for guarding her privacy. She rejected most offers for product endorsements, memoirs, and movies, and her reticence lasted to the end. At her request, NASA kept her illness secret.
In 1983 Susan Okie, a longtime friend and a journalist, wrote an article in The Washington Post in which she described Ms. Ride as elusive and enigmatic, protective of her emotions. ''During college and graduate school,'' Okie wrote, ''I had to interrogate her to find out what was happening in her personal life.''
Okie quoted Ms. Ride's younger sister, the Rev. Karen Scott, a Presbyterian minister, as saying, '' 'Closeness' is not a word that is often used to describe relationships in our family.'' Ms. Ride always needed to be in control, her mother told Okie.
In a statement, President Obama said Ms. Ride was ''a national hero and a powerful role model.''
''She inspired generations of young girls to reach for the stars and later fought tirelessly to help them get there by advocating for a greater focus on science and math in our schools,'' he said. ''Sally's life showed us that there are no limits to what we can achieve.''
In 2003, Ms. Ride told The Times that stereotypes still persisted about girls and science and math — for example the idea that girls had less ability or interest in those subjects, or would be unpopular if they excelled in them. She thought peer pressure, especially in middle school, began driving girls away from the sciences, so she continued to set up science programs all over the country meant to appeal to girls — science festivals, science camps, science clubs — to help them find mentors, role models, and one another.
''It's no secret that I've been reluctant to use my name for things,'' she said. ''I haven't written my memoirs or let the television movie be made about my life. But this is something I'm very willing to put my name behind.''
Ms. Ride married a fellow astronaut, Steven Hawley, in 1982. They decorated their bedroom with a large photograph of astronauts on the moon. They divorced in 1987.
Ms. Ride leaves her partner of 27 years, Tam O'Shaughnessy; her mother, Joyce; and her sister, Scott, who is known as Bear. (O'Shaughnessy is chief operating officer of Ms. Ride's company.)


text:
Wired Magazine's recently issue talks about radical transparency as a new trend in the industry. However, I think this is more of a buzzword-rallying-piece rather than more well-known customer-driven innovation business concept. Industry congnoscenti, Patricia Seybold aptly describes some of the goals, issues and processes involved in her book last year Outside Innovation (see my book list). I stil have to find time to finish reading the last chapters of it but I think it does a great job presenting the topic in a more useful manner.
Wired's Radical Transparency piece vs Patricia Seybold's Outside Innovation
rawn 100000R0P5 Tags:  innovation 2,401 Views


text:
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Subscribe to or Download Our Weekly Bulletin
Submitted by cooladmin — Wed, 02/24/2010 - 12:37 AM — Last Updated: Thu, 06/22/2017 - 4:17 AM
Recent weekly bulletins from COOL are available here for the current calendar year. Prior years, including 2016, are under "News - Schedules >> Bulletin Archives" from the drop down menu . Please note that in order to view a church bulletin, you will need the Adobe Acrobat Reader . If you do not have it on your computer, you must first download it and install it. You can download the reader for free by clicking on the 'Get Acrobat Reader' button on the right.
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Attached Files:
Catholic News
- The tale of Fr. Brochero: Gaucho priest, devil's worst nightmare
- This beautiful church was a gift from Slovakia to Icelandic Catholics
- What does it mean to be a 'pro-life' police officer?
- Judge halts deportations of Chaldean Christians to Iraq
- Francis urges Serrans to 'keep moving forward' promoting vocations
- How Catholic culture can thrive on the internet
- US Senate healthcare bill 'unacceptable as written', bishops warn
- How the Church is helping Christians return to Aleppo
- A doctor prescribed a procedure, but insurance offered death
- Dating apps and the death of romance – what's a Catholic to do?
- Be bold, Pope urges members of Serra International
- US Senate health-care bill is 'unacceptable,' says bishops' spokesman
- Illinois bishop bars Communion, funerals for same-sex married couples
- Patriarch to consecrate Lebanon, Middle East to the Immaculate Heart of Mary
- Pope calls on priests to show apostolic zeal, denounce evil
- Leading exorcist appeals for improved seminary formation
- Community of at Sant'Egidio brokers Central African Republic accord
- Federal court blocks deportation of Iraqi Christians
- Trump administration issues new letter on transgender students
- USCCB: prayer, solidarity following London mosque attack
- Angelus Address: On the Life of the Missionary Disciple
- Witnesses of Providence
- 'The Sacred Heart Isn't a 'Holy Card' for Devout, But the Heart of Our Faith,' Says Pope
- Pope: We Must Have Courage, Even If We Stumble and Sometimes Fail
- Pope's Words on Friendship to 'Serra International'
- Academy of Sciences: A President Expert in Food Security
- On the Feast of Saints Peter and Paul: Five New Cardinals by the Pope's Side
- INTERVIEW: 2018 Synod: All Young People Are Invited to Be Involved, says Sister Nathalie Becquart
- 'While Christ Is the Cornerstone, We Are Living Stones Close to Him,' Says Pope
- Pope's Morning Homily: A Good Shepherd Gives His Life for His Sheep
- King and queen of Holland visit the pope, and give him tulips for the Vatican Gardens
- Pope at Santa Marta: The true significance of I care is helping others
- Fr. Zollner on clerical sex abuse: Our goal is for victims of abuse to feel listened to
- Pope Francis will not go to South Sudan, but launches 3 big projects in the area
- Pope Francis greets Jerry Jones and National Football League's Hall of Fame Delegation
- Pope: All are called to be saints if they maintain an open heart
- Pope Francis explains in the General Audience that everyone can aspire to be saints
- LIVE: General Audience with Pope Francis
- "The Christians of Iraq return good for evil, and have no desire for revenge"
- Pope's trip to highlight the example of two misunderstood priests
- Pope's Wednesday Audience: "Tribulations are part and parcel of evangelization"...
- Chasing Ernest: A journey to South Georgia to retrace the steps of Ernest Shackleton...
- Why Phoenix's flights can't take off in extreme heat...
- Bracing for the next news story: Was Bernie Sanders actually pushing 'secular humanism'?
- Decide now whom you will fear: A homily for the 12th Sunday of the Year...
- Springfield Bishop Thomas Paprocki decrees: No Communion or funeral rites for same-sex couples...
- Did Jesus really rise from the dead? ...
- The symptoms of dying (which you're going to do someday, so go to confession)...
- A good eggsplanation of why bird eggs are shaped like eggs...
- Why Syria's Christians oppose efforts to depose Assad...
- This Canadian pro-life activist's talk at Google headquarters was a hit
- Pope Francis salutes Lithuania's first Soviet-era martyr
- Pope prays for victims of landslide tragedy in China
- Pope says persecution is the risk of being a missionary
- Pope uses common veneration of relics to foster relations with Orthodox
- Circle of Protection mobilizes to change nation's budget priorities
- Under the radar: South Sudan needs media attention, immediate action
- Judge blocks deportation of Chaldeans and other Iraqis
- A doctor prescribed a procedure, but insurance offered death
- Bishop: 'Fundamental defects' persist in Senate's version of health bill


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Russert: Giuliani will get support in FL from "people who still have memories of September 11th"
Research ››› ››› JOHN DELICATH
During MSNBC's January 19 coverage of the Nevada caucuses and the South Carolina Republican primary, while discussing Republican presidential candidate Rudy Giuliani's chances of winning the upcoming Florida primary, NBC Washington bureau chief Tim Russert predicted that Giuliani will get support from "ex-New Yorkers and people who still have memories of September 11th." In assuming that "people who still have memories of September 11th" will support Giuliani, Russert echoed a tendency by many in the media to tout Giuliani's actions as mayor of New York City on September 11, 2001, without mentioning that his performance before, during, and after the terrorist attacks has been questioned and criticized.
From the 6 p.m. ET hour of MSNBC's coverage of the January 19 Nevada caucuses and the South Carolina Republican primary:
CHRIS MATTHEWS (host of MSNBC's Hardball): Who is McCain's base? I mean, if he does begin to look like the leader of this party, what's his base?
RUSSERT: Veterans. Certainly he's proving that in South Carolina throughout this campaign, in terms of getting them out. A hard line on foreign policy. His position in favor of the surge has won him support with that particular community. But you go to Florida in a four-way race, Chris, evangelicals go to Huckabee. Rudy, I guess, ex-New Yorkers and people who still have memories of September 11th. How does it divide up?
I think money will be important. Mitt Romney has his own money, and you can't underestimate that. I read one of the stories today that Rudy Giuliani was calling for people to come make phone calls on his behalf, but bring your own cell phone, which I interpreted to be perhaps a shortage of money. So, you pick it in Florida. Who knows? But what I do know is, if you win Florida, going in to Super Tuesday, you really do have a lot of free media momentum on your side.
- Network/Outlet
- Person
- Tim Russert
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- Rudy Giuliani, 2008 Elections
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text:
Each passing day in Syria offers new evidence that Muslim clerics are preachign holy war, not only against the regime of Bashar al-Assad, but against Syrian Christians. Thousands of Christians have fled their homes, some leaving the country, while others seek haven in border areas that allow quick departure to Lebanon of Turkey. A war that began seeking to end brutality has become brutal.
Christians refugees in the border village of Qa described to German reporters their terror at the prospect of a successful overthrow of Assad. They described how husbands, sons, and relatives had been murdered by religious rebels. Leila Khouri, who came from the town of Qusay, described the horror awaiting Christians: "they sermonized on Fridays in the mosques that it was a sacred duty to drive us away. We were constantly accused of workign for the regime. And, Christians had to pay bribes to the jihadists repeatedly to avoid getting killed."
The tragedy of Sryia is to drive out one tryant and replace him with religious ones. In Iraq most Christians have fled for their lives, we fear a similar end awaits Syrian Christians.


text:
Atlantic Avenue Tree
Belarusian Church
Until Fri Dec 5 2014
- Free
Not yet rated
Time Out says
Mon Nov 29 2010
You'll be inspired to deck your Brooklyn halls when you see this tree and window display centered around Atlantic Avenue through the ages. On Dec 5, the tree will be set aglow, the winner of the annual holiday window competiiton will be announced, and Rolie Polie Guacamole, and kids from P.S. 38 and 261 will perform. Keep an eye out for Santa plus some guest speakers, and be sure to bring a wrapped book or toy to donate to children living in the nearby Gowanus Houses and Independence Towers.
CommentsAdd +
Venue details
Belarusian Church 401 Atlantic Ave
Boerum Hill
New York
- Cross Street:
at Bond St
- Transport:
Subway: A, C, G to Hoyt–Schermerhorn; 2, 3, 4, 5 to Nevins St
Belarusian Church
- 401 Atlantic Ave
Boerum Hill
New York
- 40.439685,-74.364598
- 401 Atlantic Ave
- Belarusian Church
- Event phone:
- Event website:
- Categories:
Things to Do. Kids activities & themes
- Good for:
- Event type:
Seasonal traditions
- Date Time Price information
Wed Dec 26 20128:00am


text:
Deathspank - Reviews @ VideoGamer, IGN, Eurogamer
View Single Post
July 14th, 2010, 20:00
I watched a video of this with dialog between an orphan girl and the main character, where he buys her a pony, etc. The dialog and voice acting seemed slow paced and plodding which killed any humor it might have had. It desperately needed quicker pace and better direction. Really unimpressive. And that's a clip they released to promote the game!
A whole game of lame comedy like that combined with fetch quests and Diablo hack and slash is a complete turn off for me.
Keeper of the Watch
Join Date: Jan 2010
Location: Downtown Chicago, IL
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text:
Editors' Note: Download.com has chosen not to provide a direct-download link for this product and offers this page for informational purposes only.
|Video Software
|Video Capture Software
Publisher's Description+
macVCR allows you to record what happens on your computer screen to a Quicktime movie which you can then replay later at your leisure. macVCR doesn't require any form of installation, just double click the Icon and the program will launch.
- Specify Recording Length or Operate Manually
- Live Camera Feed Option
- Magnify Area at Cursor
- Date and Time Overlay Option
- Adjustable Compression Quality
- Enhanced Area Selector with Snapshot
- Adjustable Output Resolution
- Choice of Codecs
- Resolution Presets
- Performance Adjustment
- Support for Multiple Monitors
- Unlimited User Presets
- Record a Selected Region of any Monitor
- Incorporates Speech Feedback
- Export to Windows Media, iPhone, Apple TV, AVI and Many More
- Low Disk and CPU Usage
- Trial Version (90 Seconds Recording) Available for Download
- Manual supplied as a PDF
What's new in this version:
- Now CodeSigned for OSX Mountain Lion GateKeeper
- Japanese Encoding Option
- Bug Fix when Displaying Annotation
- Key Combination Help Displayed
- Both Intel Only and Universal Binary Supplied


text:
i have a set of 4 Motegi MR7's that are 16x7.
they are multi-pattern wheels, one is 4x100, but i don't know the other one.
Price : $275 O.B.O, seriously, make me some offers, i'm really looking to get rid of these quickly, so i will consider any offer.
will also trade for a set of Scroth 3-point harness', or stock MK2 3-point seatbelts.
located in SNH.
PM me for more details/pics/anything, or email email@example.com


text:
"Me" will be used as the reference point to search from.
Please provide a postal code or a city, or select a city from the directory.
We are your one-stop shop for Repairs, Unlocking, Accessories and Refurbished Phones. Why buy a new cell phone or tablet computer when you can Repair or Unlock the one you already have? samsung screen repair We specialize in Environmentally Savvy Solutions for your Cell Phone that are easy on your pocket.
Located at 1321 Kingsway in Vancouver, Megatronic Cell Phone Services is a local business included in the cell phones - service & repair category of Canpages website.
Feel free to call 604-872-2355 to get in contact with Megatronic Cell Phone Services that is located in your neighbourhood. Or, simply add this business to your business favorites list.
Finally, feel free to send this profile page to your friends by clicking on Facebook or Twitter links.


text:
Shatabdi Express trains are a chain of superfast trains in India that link Metro cities with other prominent cities for pilgrimage, tourism, or business. Shatabdi Expresses are only day-trains and they come back to the originating station on the same day. Shatabdi are the fastest and prestigious trains of the Indian railways.
Shatabdi Express trains operate over short distances while Rajdhani Expresses cover long-distance trains linking the nation's capital New Delhi to the capitals of other states. Bhopal Shatabdi Express (2001) is the fastest train in India which operates at the speed of 160 km/h.
The first Shatabdi train was inaugurated in the 1988 to memorialize the centenary of Pandit Jawahar Lal Nehru's Birthday by Madhav Rao Scindia who was the minister for railways. It ran from New Delhi to gwalior, later extending up to Bhopal junction.
The average speed of Bhopal Shatabadi is about 93 km/h between the originating and the destination stations running at the speeds at 150 km/h. The Shatabdi Express receives the priority in comparison to other trains and usually given platform no 1 at the most stations. Swarna Shatabadi Express is regarded as the most luxurious of the Shatabdi Express trains of India.
In addition to luxurious Shatabdi trains the Indian Railways also added an economical priced version Jan-Shatabdi Expresses, which are non air-conditioning and reasonably priced.
Gharib Rath (chariot of the poor) introduced by Railway Minister Lalu Prasad Yadav are fast trains similar to Rajdhani and Shatabdi trains which are completely Air-Conditioned and available at lower fares. These trains have proved to be highly successful and give stiff competition to low cost airlines operating on long-distance routes.
Express travelers are served with breakfast, snacks, coffee or tea, meals, a glass of canned juice and a litre of water bottle. Installation of on board entertainment systems have is being done on some of these trains where the passengers can avail the facility of watching movies and tv serials via satellite.
Some of the famous Shatabdi trains include Bhopal Shatabdi, Kanpur & Aligarh Lucknow Swarna Shatabdi, Kalka Shatabdi, Amritsar Shatabdi, Ajmer Shatabdi, Dehradun Shatabdi, etc


text: I got lucky this morning and bagged my 2nd Maine snow goose in two years. The bird today was a juvenile from this past breeding season. It was mixed in with a flock of 40 or so Canada's and stood out like a sore thumb. It wasn't getting out alive! Funny thing is the last snow I shot was just down the road from this one. Guess it's my lucky spot! My buddy dropped a Canada out of the same flock that was an absolute monster. It was all of 13lbs I'd say. All in all a pretty good hunt. At one point we had 200 Canada's working the spread at once. Always exciting when you have that many birds at once! Here's a few pics. You might need to open them in a new tab to see them fully.


text: While I applaud the bus driver for stopping the hit & run driver...I will say that bikes are a HUGE pain in the a$$. I live in an area that is VERY popular with bikes...rural and gorgeous. But, being rural, there are lots of roads with 1 lane in each direction and no-passing zones. It is not uncommon to have a bike with 20+ cars lined up behind it. SO frustrating. I know they have a right to be on the raod, but do it smartly. If there is a line of cars behind you, pull over and let them pass. And for God's sake, don't ride 2-3-4 bikes wide.


text:
Hyatt $25 Gift Card
Reward Item Information
Low Price Guarantee On All Products!
$25 Hyatt Gift Card
Discover a place that opens your eyes. Hyatt believes a great hotel should offer more than a good night's sleep. It should create an environment that awakens your senses. It's one of the many intangible qualities you'll experience at every Hyatt.
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Come enjoy the many experiences Hyatt has to offer. Which destinations calls to you?
Hyatt Gift Cards are as easy to use as a credit or debit card, for payment towards lodging or dining at Hyatt Hotels & Resorts in the U.S., Canada or the Caribbean. The cards can also be used at any Hyatt operated restaurant or lounge without having to be guest of the hotel. If registered as a guest of the hotel, the recipient can also use the card to cover other Hyatt services charged to the room. Cards do not expire.
Subject to availability. Please call Lynda at ACityDiscount on 404-752-6715 ext 100 to confirm that your dates are available, before booking.


text:
Moscow (CNSNews.com) - Russia's next president looks set to be a close and longtime ally of Vladimir Putin, after the majority United Russia party and three minor parties on Monday named Dmitry Medvedev as their candidate in the election next March.
Putin promptly backed the choice of Medvedev, who is currently first deputy prime minister. The pro-Kremlin United Russia, which easily won recent parliamentary elections with Putin topping its list, will formally approve the candidate at a party congress on Dec. 17.
With the support of Putin and United Russia, Medvedev is regarded a shoo-in for the presidency. United Russia and its allies now control more than two-thirds of the seats in the State Duma, parliament's lower house.
Medvedev, 42, has been a close ally of Putin's for 17 years, having earlier served as head of the presidential administration and head of Putin's election campaigns.
As chairman of the board of Russia's natural gas monopoly, Gazprom, he is widely seen as a business-friendly candidate.
Alexander Shokhin, head of the country's leading business lobby, the Union of Industrialists and Entrepreneurs, said Medvedev was one of those people around Putin who advocates favorable conditions for business.
His candidacy would end allegations of a "velvet reprivatization" campaign in Russia, Shokhin said.
In his capacity as first deputy prime minister, Medvedev in recent months was in charge of social issues and "national priority" programs including housing and healthcare. He has also been a vocal advocate of mortgage lending.
Alexander Lebedev, a business tycoon turned Duma deputy, described Medvedev as a "very good choice," adding that he has an impressive track record in social and economic matters.
Russian pundits don't expect significant political changes in Russia after the election next March. Putin's team will retain power, said the Kremlin-connected political analyst, Gleb Pavlovsky.
Even Medvedev's opponents conceded that his nomination was consistent with the Kremlin's policies.
Communist Party head Guennady Zyuganov, who also plans to run for president, said Medvedev's candidacy was to be expected, given the fact he has been Putin's right-hand man.
Alexey Malashenko, an analyst at the Carnegie Endowment in Moscow, predicted that the new president would be unable to take any independent measures. He would continue Putin's policies, while Putin retains the real power, Malashenko said.
But television presenter Sergei Dorenko, a former Putin loyalist who is now a Communist supporter, believes there will be a style change, at least. Medvedev will not call his opponents "jackals," he said, in reference to Putin's recent attacks against his political opponents and their alleged Western backers.
Presidential candidates have until Dec. 23 to declare their candidacy. The poll is scheduled to take place on March 2, with the new president to be inaugurated in May.
The Russian constitution requires Putin to step down when his second consecutive term ends in May.
Putin, 55, has repeatedly said he will neither violate nor amend the constitution to allow him a third consecutive term, but many analysts expect he will find other ways to dominate Russian political life. Some expect that he may stand again in 2012, if not before, should circumstances allow.
Make media inquiries or request an interview about this article.
Subscribe to the free CNSNews.com daily E-Brief.
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Winemaker Baby Bodysuits are an Idakoos specialtiy! Idakoos has many things to offer. Whether you want to get a Winemaker Baby Bodysuit for a special occasion, give a Winemaker Infant Bodysuit as a present or need to represent with a funny Winemaker Baby Romper during Holidays or Family and Friends get-togethers, Idakoos is sure to have the right Winemaker Baby Bodysuit for you! Even if it turns out you can't find the right Winemaker Baby Creeper with the perfect design for all those babies in your family and friends circle; Idakoos offers all of its children's Winemaker Baby Bodysuits as Winemaker Baby Bodysuits. Personalize any Winemaker Baby Snapsuit the way you want to ensure the perfect gift.
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