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To evaluate the impact of rigorous WalkRounds on frontline caregiver assessments of safety climate, and to clarify the steps and implementation of rigorous WalkRounds.
Primary outcome variables were baseline and post WalkRounds safety climate scores from the Safety Attitudes Questionnaire (SAQ). Secondary outcomes were safety issues elicited through WalkRounds. Study period was August 2002 to April 2005; seven hospitals in Massachusetts agreed to participate; and the project was implemented in all patient care areas.
Prospective study of the impact of rigorously applied WalkRounds on frontline caregivers assessments of safety climate in their patient care area. WalkRounds were conducted weekly and according to the seven-step WalkRounds Guide. The SAQ was administered at baseline and approximately 18 months post-WalkRounds implementation to all caregivers in patient care areas.
Two of seven hospitals complied with the rigorous WalkRounds approach; hospital A was an academic teaching center and hospital B a community teaching hospital. Of 21 patient care areas, SAQ surveys were received from 62 percent of respondents at baseline and 60 percent post WalkRounds. At baseline, 10 of 21 care areas (48 percent) had safety climate scores below 60 percent, whereas post-WalkRounds three care areas (14 percent) had safety climate scores below 60 percent without improving by 10 points or more. Safety climate scale scores in hospital A were 62 percent at baseline and 77 percent post-WalkRounds (t=2.67, p=.03), and in hospital B were 46 percent at baseline and 56 percent post WalkRounds (t=2.06, p=.06). Main safety issues by category were equipment/facility (A [26 percent] and B [33 percent]) and communication (A [24 percent] and B [18 percent]).
WalkRounds implementation requires significant organizational will; sustainability requires outstanding project management and leadership engagement. In the patient care areas that rigorously implemented WalkRounds, frontline caregiver assessments of patient safety increased. SAQ results such as safety climate scores facilitate the triage of quality improvement efforts, and provide consensus assessments of frontline caregivers that identify themes for improvement.
WalkRounds were introduced in 1999 as a program for hospital leadership to sustain good relations with frontline caregivers, promote conversations to identify hazards, and gather information to enhance decision making around patient safety. In the wake of the IOM report (Institute of Medicine 1999), the demand for WalkRounds and other patient safety improvement efforts quickly outpaced rigorous research efforts, which resulted in widespread adoption of interventions with relatively little supporting evidence (Frankel et al. 2005; Haig, Sutton, and Whittington 2006). Not surprisingly, the extent to which health care leaders and managers reported that they are doing WalkRounds did not coincide with frontline caregiver's awareness of WalkRounds (Thomas et al. 2005).
To be effective stewards of limited patient safety resources, health care leaders must be informed consumers of available interventions, and select and rigorously implement these interventions. In our experience, few hospitals differentiate rounding to evaluate patient satisfaction, compliance with policies, or showcasing of excellent employees from WalkRounds that elicit caregiver concerns about patient safety, near misses, and adverse events. Even fewer rigorously compile the information elicited during WalkRounds, and fewer still embrace the wisdom of frontline caregivers by eliciting their assessments of patient safety relative to the WalkRounds intervention. Evaluating the impact of WalkRounds requires standardized and rigorous implementation of the program, and a validated tool to capture frontline caregiver assessments of patient safety, such as the safety climate scale of the Safety Attitudes Questionnaire (SAQ).
In high reliability (i.e., very safe) industries such as commercial aviation (Sexton and Thomas 2004) and nuclear power (Carroll 1998), safety climate is a proactive metric of safety that complements traditional retrospective metrics (e.g., number of fatalities and accidents). The specific aims of this study were to evaluate the impact of rigorous WalkRounds on frontline caregiver assessments of safety climate, and to clarify the steps and implementation of rigorous WalkRounds.
Seven acute care hospitals and one Ambulatory Center in Massachusetts were invited to participate in a prospective study of the impact of Patient Safety Leadership WalkRounds on safety climate. Because of resource limitations, we targeted a representative sample of health care facilities based on size (i.e., large, small) and scope (e.g., acute tertiary care institution to a small rural hospital) to capture unique issues in implementing our project. Each invited institution agreed to participate. Results of the Ambulatory Center will be presented elsewhere.
To participate, a hospital senior executive had to commit to championing the WalkRounds project and following the criteria outlined in the WalkRounds Guide (Table 1). The project period was August 2002 to April 2005. Participating sites began in staggered fashion in the summer and early fall of 2002 and assessed their safety climate at baseline and approximately 18 months after implementing the WalkRounds project. This was a hospital-wide effort supported by senior leaders and administration, with all clinical areas (e.g., pharmacy, intensive care unit, medical floor, etc.) in each hospital included in the project.
WalkRounds training was done on-site at each institution in a half-day session. This session included a 2-hour presentation of the Patient Safety Leadership WalkRounds project to senior leaders, quality and patient safety personnel, and clinical area managers/directors. Following this presentation, a subset of interested leaders who would shepherd the program forward were oriented to the underlying theories and concepts of WalkRounds, a framework and timeline for implementation, and a process to manage the data and provide feedback to those involved in rounds. The training also included recommendations for linking safety concerns identified during WalkRounds to the hospital's existing operations committee, which could ensure actions were taken and changes instituted. Hospital leaders were specifically instructed how to conduct weekly rounds, integrate rounds into their routine, and use rounds to surface and address concerns or defects related to patient safety. Investigators (A. F., M. P., S. P. G.) did on-site debriefings with those senior leaders who conducted weekly or bi-weekly WalkRounds on clinical floors. Thereafter, coaching calls were done every 2 months for 2 years with this core group of leaders.
Senior leaders targeted for inclusion in WalkRounds were the Chief Executive Officer, Chief Operating Officer, Chief Medical Officer, Chief Nursing Officer, or their equivalents. Other Board-level or senior clinical administrators were invited to participate, including Chief Financial and Chief Information Officers. The quality and patient safety personnel were charged with organizing the WalkRounds, and managing the database of safety concerns, recommendations, and actions taken to address the issues elicited through the rounding process. A Microsoft Access database was provided by the research team to manage the data.
This manuscript reports results from the safety climate domain of the psychometrically validated SAQ (Sexton et al. 2006). The six domains of the SAQ are safety climate, perceptions of management, teamwork climate, job satisfaction, stress recognition, and working conditions. A recent review of safety climate instruments in health care highlighted the SAQ as the leading instrument because it meets 22 of 23 essential criteria (e.g., content, validity, and reliability) (Colla et al. 2005). The safety climate scale is valid (Sexton et al. 2006), sensitive to interventions (Defontes and Surbida 2004; Thomas et al. 2005), and the attitudes elicited associated with patient length of stay and error rates (Pronovost et al. 2005). Safety climate scores vary widely among patient care areas within a given hospital. Therefore, we assessed safety climate at the patient care area level rather than the hospital level (Pronovost and Sexton 2005). The SAQ safety climate scale is calculated using seven items, each rated on a five-point scale from disagree strongly to agree strongly, including:
Safety climate scale scores were computed by taking the mean of the seven items for each respondent. Given the significant variability in safety climate scores among clinical areas, the longitudinal climate goal for a given unit is twofold: (1) improve your safety climate score by 10 points or more; or (2) maintain a positive safety climate consensus score of 60 percent or higher. In other words, the goal for a unit with good culture (60 percent or more of staff reporting good safety climate) is to maintain or improve it, whereas the goal for a unit with poor culture (<60 percent reporting good safety climate) is to improve it by 10 points or more.
All staff with a 50 percent or greater commitment to their patient care area for at least the 4 consecutive weeks before survey administration were invited to complete the SAQ regardless of their involvement in the WalkRounds project. This included staff physicians, registered nurses (RN), charge nurses, nurse managers, physician assistant/nurse practitioners, licensed vocational nurses (LVN)/licensed practicing nurses (LPN), hospital aides, physical therapists, occupational therapists, pharmacists, respiratory therapists, technicians, ward clerks/unit secretaries, medical administration, and other. Senior leadership (CEO, CFO, CNO, etc.) were not surveyed because the SAQ applies to clinical and nonclinical personnel more directly involved in the delivery of care to patients. Each participating patient care area administered the voluntary survey during preexisting staff meetings, with a pencil and return, sealable envelope to maintain confidentiality. Survey packets were hand-delivered to staff that were missed in preexisting meetings.
The criteria for inclusion of a patient care area in this analysis of safety climate were twofold: (1) the participating hospital was required to conduct weekly methodologically rigorous WalkRounds, according to the criteria outlined in Table 1 and (2) the patient care area needed a response rate of 50 percent or greater for baseline and post-WalkRounds administrations of the SAQ.
The percent positive, or "percent reporting good safety climate" for a patient care area was the percent of respondents in a care area with an average (mean of the seven items) safety climate scale score of agree slightly or higher. We adopted the convention of reporting percent agreement ("how good is the safety climate?") rather than means ("how average is the safety climate?") when presenting SAQ results to caregivers, managers, executives, and board members because percents are easier for these stakeholders to interpret (Pronovost and Sexton 2005). To test for improvement in safety climate assessments within patient care areas from baseline to post-WalkRounds, we used paired sample t-tests for each hospital to control for patient care areas nested within a hospital. Statistical analyses were performed using SPSS, version 13.0 (Chicago, IL).
Of seven hospitals, two underwent a change in leadership or had limited resources that precluded them from implementing WalkRounds, and one hospital implemented WalkRounds intermittently without a leader to drive the project. Four hospitals conducted rigorous weekly WalkRounds; two of these four complied with intensive collection and use of data. Results from these latter two hospitals are reported in this paper. Hospital A was an academic teaching institution, and hospital B a community facility; both had approximately 250 beds.
Two SAQ administrations with a 50 percent or higher response rate were completed in nine of 20 patient care areas in hospital A, and 12 of 24 patient care areas in hospital B; 21 units in total with ample response rates. In the 21 patient care areas, surveys were received from 790 of 1,265 (62 percent) at baseline, and 741 of 1,256 (60 percent) post-WalkRounds. Most respondents were female (74 percent baseline and 77 percent post) and RN (39 percent and 45 percent) (Table 2). Mean age was 39±12 at baseline and 40±12 post-WalkRounds, and years in same hospital 9.9±9.7 at baseline and 10.7±10.2 post.
Percent reporting positive safety climate across these 21 clinical areas at baseline ranged from 0 to 76 percent, and post-WalkRounds from 32 to 83 percent (Figure 1, Panel 1). At baseline, 10 of 21 care areas (48 percent) were below the 60 percent consensus safety climate score, whereas post-WalkRounds 3 care areas (14 percent) were below 60 percent consensus and did not improve their score by the minimum 10 points. Figure 1, Panel 2 shows how the safety climate scores changed for each caregiver type. RN perceptions improved from 57 to 70 percent reporting positive safety climate, whereas nurse managers/charge nurses decreased from 85 to 75 percent. Similarly, hospital aides, staff physicians, and respiratory therapists each improved the percent reporting positive safety climate by 10 points or more.
In hospital A, safety climate scale scores were 62 percent at baseline and 77 percent post-WalkRounds (t=2.67, p=.03). In hospital B, safety climate scale scores were 46 percent at baseline and 56 percent post-WalkRounds (t=2.06, p=.06). Four items in the scale significantly improved post-WalkRounds in hospitals A and B: feeling encouraged by colleagues to report patient safety concerns, knowing proper channels to direct patient safety questions, easily learning from the errors of others, and easily discussing errors that occur in their clinical area (Table 3).
There were two hospitals that did not conduct rigorous WalkRounds but collected safety climate data and met the 50 percent cutoff in a total of 18 clinical areas. The paired sample t-tests were not significant for this group overall or by hospital.
The issues raised during WalkRounds have a qualitative richness that is muted when attempting to quantify or categorize data. For example, in an inpatient psychiatric unit WalkRounds elicited that metal and glass objects continued to enter the unit on meal trays despite a surveillance mechanism. The solution was to change all utensils and cups to plastic and paper. On the same unit, inadequate information about a patient's assault history was identified, and resolved by establishing a screening log during crisis evaluations that was eventually added to the electronic medical record system. In an emergency room, adolescents testing positive for a sexually transmitted disease were uniformly lost to follow-up because this information was not provided to ambulatory clinics. As a temporary fix, residents in the ambulatory clinic were paged and the electronic medical record modified to enable consistent access to patient information.
Equipment/facility (hospital A 26 percent, hospital B 33 percent) and communication (hospital A 24 percent, hospital B 18 percent) were areas most often cited as safety concerns that could potentially harm a patient (Table 4). Typical examples for equipment/facility were:
Typical examples for communication were:
Frontline caregiver assessments of patient safety improved in both hospitals after implementing the WalkRounds project. This study builds upon previous WalkRounds research, which assessed safety climate among nurses present during the intervention (Thomas et al. 2005), by including all types of caregivers within a patient care area during WalkRounds. In addition, this study conducted WalkRounds weekly for 18 months, rather than monthly for 3 months.
We found that WalkRounds provided a formal structure and ongoing mechanism for caregivers to surface and address patient safety defects. In fact, the paired sample t-test results demonstrated significant improvement in the items that specifically dealt with discussing local patient safety concerns. Discussing and learning from errors, feeling encouraged by colleagues to report concerns, and knowing how to report concerns were themes from the four items that improved the most, and may be a result of senior leaders connecting with frontline workers to reveal and resolve concerns. In particular, improvement in the safety climate item "I am encouraged by my colleagues to report any patient safety concerns I may have," indicates that WalkRounds bolstered a shared sense of patient safety interconnectedness among the caregivers in a given patient care area.
The types of problems elicited during WalkRounds were influenced by the type of providers who participated. Nurses preferentially discussed operational problems, while physicians tended to focus on clinical decision-making issues. In both cases, the WalkRounds leader's skill in directing conversation and making participants feel safe determined whether the concerns elicited included a discussion of real adverse events.
Anecdotally, issues raised during WalkRounds fell into three categories; those that could be resolved locally, those that required cross-departmental collaboration, and those that required significant resources demanding new budget allocations. It is unlikely that the impact of organizational actions on perceptions of safety is directly related to these categories or to the cost or resource components of the action. Instead, a reasonably frugal action such as changing metal utensils to plastic may have an enormous impact on safety and perceptions of safety.
WalkRounds may empower caregivers with a stronger sense of responsibility for patient safety, coupled with a stable and predictable partnership with upper management to provide resources and remove barriers relevant to improve patient safety. Specific examples in two patient care areas with strong changes in safety climate scores support this suggestion. In one care area, the first WalkRounds elicited a discussion about poorly functioning wheelchairs that led to their replacement. In the second area, a serious adverse event was discussed during WalkRounds that led to a consensus that errors could be discussed in a supportive environment.
Analyses from other industries suggest that improving frontline assessments of safety increases actions that promote safety and minimize risk taking behaviors (Roberts 1990). The implication for health care organizations is that WalkRounds, by comparison to monies spent on other efforts to improve safety especially in the realm of informatics, is an inexpensive mechanism through which leaders can positively influence and document safety and quality over time. Moreover, WalkRounds in conjunction with a cultural assessment provides a clear picture of patient care areas with low safety climate scores that would benefit the most from WalkRounds. This is important given the limited resources for patient safety interventions. Using a validated cultural assessment tool, such as the SAQ , to diagnose strengths and weaknesses at the patient care area level is a powerful way to harness the wisdom and insights of frontline caregivers while helping direct the attention, resources, and responsiveness of hospital leaders to care areas that need it most. To be better stewards of dwindling resources and availability of leaders, the SAQ could be used to diagnose and triage assistance in the form of WalkRounds to units that need help.
Notable in this study is that only two of the seven hospitals were successful at broad and sustained implementation of WalkRounds. Commitment from leadership, a champion trained in quality or safety, and time and resources to manage the data and feedback are the three components that these two institutions had when compared with the other five hospitals. All three components appear to be necessary for success.
Similar to the lesson learned by the U.S. armed services after the Vietnam War, there is a significant difference in performance and outcome when using a mandatory draft versus a volunteer army. Most of our collective experience using WalkRounds and the SAQ has been with early adopters who were ahead of their contemporaries in thinking about and addressing patient safety defects. We have found that hospitals recruited to rigorously conduct WalkRounds or administer a cultural assessment survey have a significantly lower level of engagement and sustainment than hospitals who seek our guidance to conduct these interventions as a result of their own progressive thinking.
Albeit anecdotal, early adopters have consistently garnered higher levels of participation, more rigorous follow-through, and higher SAQ response rates than their recruited counterparts. For example, our study achieved a 60 percent response rate for the SAQ , whereas it typically garners a response rate of over 80 percent for hospital-wide (Pronovost and Sexton 2005). In this sense, our results may be an underestimation relative to the results achieved by some hospitals that chose to rigorously implement WalkRounds and refine the process on their own (Pronovost et al. 2005). In addition, hospital systems, such as Ascension, that were early adopters of safety culture assessment have garnered system-wide SAQ response rates of over 80 percent (across 60 hospitals and 24,000 respondents), and have integrated their results with decisions to choose patient safety interventions that are most appropriate for specific patient care areas (Rose et al. 2006). Unlike previous WalkRounds research that used an experiment/control group design, we chose a less sophisticated pre–post design, whereby each patient care area served as its own control. Prior work has demonstrated that control groups are easily contaminated by experimental group participants who float between patient care areas (Thomas et al. 2005). To compensate, we used a longer exposure period for WalkRounds (approximately 2 years) than previous work.
There were potential limitations to this study. First, detecting improvements in safety climate scores were limited by the small number of participating patient care areas, which resulted in statistical power limitations. Nevertheless, the separately conducted paired samples t-tests indicated significant improvement in safety climate scores for hospital A, and approached significance ( p=.06) for hospital B. Second, including only two hospitals limited our ability to generalize more broadly to hospital across the U.S. However, our sample did include an academic teaching and community facility. Third, a pre–post study design limited our ability to conclusively say that the WalkRounds caused the improvement in safety climate. While WalkRounds were the most visible effort during this period, the improvements might have been due to a more general temporal trend toward improved safety climate or other patient safety activities.
In conclusion, WalkRounds are not a patient safety panacea. Rather, they should be considered in the context of organizational readiness as a function of available leadership time, organizational resources, and patient safety-related priorities. The intent of WalkRounds is to implement a patient safety infrastructure that bridges the gap between leaders and frontline caregivers. The end result reported here is a significant improvement in frontline caregiver assessments of patient safety, and a narrowing of the apparent disconnect between RN and nurse managers/charge nurses. The spread and adoption of WalkRounds worldwide (Budrevics and O'Neill 2005; Verschoor et al. 2007) (http://www.npsa.nhs.uk/sevensteps) suggests that the process meets a need not yet met, which is eliciting caregiver concerns to identify local hazards within a framework that allows for the removal of barriers that impede actionable steps to make improvements. Assessing safety climate with the validated SAQ , affords leadership and frontline caregiver alike, the ability to empirically identify specific care areas that are struggling. In turn, WalkRounds can be implemented to identify and address local concerns, and track progress over time. Taken together, safety climate assessment and WalkRounds allow hospitals to diagnose, target, and treat the patient care areas in need of resources and leadership attention.
Joint Acknowledgment/Disclosure Statement: We would like to thank the Health Resources & Services Administration for the original WalkRounds grant, and the Health Research and Educational Trust for the opportunity to significantly refine the process and supporting materials related to WalkRounds. We would like to acknowledge Lou Woolf, Robert Norton, Alex Ferraro, Jennifer Costain, Eileen Sporing, James Mandel, and Sandra Fenwick for their participation in developing WalkRounds in their institutions, and Christine G. Holzmueller for her assistance in editing this manuscript. Dr. Eric Thomas was supported by AHRQ grant #1PO1HS1154401, and Dr. Bryan Sexton was supported by RWJ Foundation grant 58292.
Disclosures: Allan Frankel, Bryan Sexton, and Sarah Grillo are members of Lotus Forum Inc., a company dedicated to developing benchmark safety metrics for the health care industry.
Disclaimers: None.
The following supporting information for this article is available online:
Author matrix.
This material is available as part of the online article from: http://www.blackwell-synergy.com/doi/abs/10.1111/j.1475-6773.2008.00878.x (this link will take you to the article abstract).
Please note: Blackwell Publishing is not responsible for the content or functionality of any supplementary materials supplied by the authors. Any queries (other than missing material) should be directed to the corresponding author for the article.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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Sterling Silver Small Round Compassion Band
$ 125.00
This recycled sterling silver ring is engraved on the front in Tibetan with 'Karuna', for 'Compassion', and has the English translation inscribed on the inside of the ring. This ring inspires us to pray for all beings so that they may be free from suffering and the causes of suffering, and is a reminder to show kindness towards all. The ring measures approximately 1/8" in width and is available in sizes 5-8.

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They are the perfect size for my 50lb dogs. Both dogs seem to enjoy them, and they are not small enough to be easily swallowed. I had smaller ones previously and my dogs would swallow them once they were softened from chewing.
I usually buy CET medium chews to clean my beagle's teeth, and they are a perfect size - not too big or small, and he can polish off the whole chew in one "sitting." I accidentally ordered the Dentahex chews when I needed replacements, instead of CET, and while I have no qualms about the quality, the chews are enormous. They are thick and tough and up to 6 inches in length (varies). Some of them are just too hard and big for my beagle to chew. When I reorder, I will go back to the CET brand.
This product is vet recommended. Its crunchy consistency allows small pieces to break off and be chewed by the pet, assisting digestion and greatly reducing the chance of gagging/choking. Additionally, there are very few additives in the product. These are the only treats that I give to my dogs.
The majority of orders will ship in 2 to 3 days.
RX orders can take longer due to get approval from your veterinarian and the pharmacy to approve.
Please contact us for updates about your order.
Rx = Prescription Item
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The Pharmacy will contact your Vet after placing the order and validate your order items. Approval based on the VET availability.
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PRESCRIPTION DRUGS ARE NOT RETURNABLE. VetDepot will not accept returns for refund or exchange on ANY prescription medication. State and Federal regulations prohibit us from accepting any prescription drugs returns, except when these drugs are subject to a recall.


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TNEA 2014 Random Number
TNEA 2014 Random Number is published by the Anna University today in the Anna University Counselling website. The random number assigning process was felicitated by the Minister of Higher Education Mr.Palaniyappan. The students can get their random number by entering the TNEA 2014 Application number to get the TNEA 2014 Random Number.
Along with the random number the student can know the details about the application form accepted state. Check the following link to get the Random Number


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Level: Advanced
Type: Classroom Training Course
ISPE CEUs: 2.0
|24-26 September
|Chicago, Illinois
|Norman Goldschmidt
This course will provide a detailed description of HVAC system fundamentals, including a discussion of primary system components such as fans, coils, humidifiers, and filters. Participants will receive an overview of critical parameters for products and processes that can be affected by HVAC, and explore the basic concepts of controlling these parameters using properly designed HVAC control systems. Participants will discuss what HVAC can and cannot do to maintain good manufacturing practices (GMPs) as they are addressed for facilities designed to manufacture bulk pharmaceutical chemicals (BPC), oral solid dosage (OSD) products, sterile products, and bulk biopharmaceuticals. HVAC systems for production laboratories and warehouse facilities utilized for the storage of product, raw materials, and components are also covered.
On completion of facility-specific systems, the requirements for commissioning and qualification are explored with emphasis on distinguishing between critical and noncritical parameters. Other course topics include HVAC controls, monitoring of critical parameters, and system construction. Dust collection systems and laboratory fume hoods are not covered, as these systems are addressed by other sources. The course concludes with suggestions for system maintenance.
Immediately apply the course learning objectives with the complimentary copy of the ISPE Good Practice Guide: Heating, Ventilation, and Air Conditioning.
Attendees will be provided with updates to course materials if GMPs or technology related to meeting GMPs change within 12 months of attending the course (e-mail address required).
Participants should be familiar with basic pharmaceutical product forms and GMPs.
This training course is of particular interest to existing and future members of the ISPE HVAC Community of Practice (COP).
ISPE will provide continuing education units (ISPE CEUs) for all North American seminars and courses, including educational programming at the ISPE Annual Meeting. CEUs are nationally recognized units of achievement designed for those individuals continuing their education in their chosen field or profession.
Delegates attending European seminars and courses will receive a Certificate of Attendance, as ISPE CEUs are currently not offered at European events. Verification of CEUs is based on attendance as well as satisfactory completion of all evaluation materials. Statements of credit will be sent via email within four weeks of evaluation materials. One hour of education programming equals 0.1 ISPE CEU credits.


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Mumsnetters aren't necessarily qualified to help if your child is unwell. If you have any serious medical concerns, we would urge you to consult your GP.
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Johannesburg: An Indian family is playing monopoly when one brother exclaims that he has found a place where you can buy the president and land your airplane at a military base. The country is South Africa.
The sketch, on South African radio, refers to President Jacob Zuma's ties to the wealthy Gupta family and the landing of an Airbus carrying wedding guests at high-security Waterkloof airforce base near Pretoria.
Mr Zuma, whose son Duduzane is a director at the Guptas' Sahara Computers and Shiva Uranium, says he had no role in approving the use of the military facility and blamed lower-level officials, but many South Africans are sceptical.
''Zuma knows how it happened,'' said Sipho Radebe, 42, a delivery driver from Soweto township here. ''He has too close a relationship with this Gupta family.''
Groups ranging from opposition parties to the ruling African National Congress are united in their outrage over so-called Guptagate. The 2 million member Congress of South African Trade Unions, an ANC ally, called it ''an absolute insult to the people of South Africa''.
Mr Zuma, 71, has survived scandals before, including fathering an illegitimate child with a friend's daughter, the use of $US27 million in state funds to upgrade a private home and rape charges, of which he was acquitted in 2006. In December he strengthened his control over the party after easily defeating a leadership challenge from Vice-President Kgalema Motlanthe.
Mr Zuma has been a friend of the Guptas for about a decade, Sahara Computers managing director Atul Gupta said in an interview with Johannesburg's Daily Maverick in 2011.
Mr Gupta may be suspended from the ANC, BusinessDay reported on Thursday.
After their private jet touched down at Waterkloof on April 30, the wedding guests were driven in black BMWs fitted with flashing police lights to a three-day ceremony at the Palace of the Lost City in the Sun City casino and resort 150 kilometres to the west.
In the wake of the controversy, the government arrested 11 police officers and a reservist, and suspended the chief of state protocol, three senior military officers and a police major general.
''South Africans need to understand why and how a single family has come to wield such enormous power and influence over sections of government and its administration,'' said Neeshan Balton, executive director of the Ahmed Kathrada Foundation, a research centre promoting the values of the South African constitution.


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Two closed sections of the T'Railway Provincial Park reopen
Repairs have been completed to two more sections of the T'Railway Provincial Park that were damaged by heavy rains last October.
Opposition plans to submit amendments to bill creating independent appointments commission
The Newfoundland and Labrador House of Assembly is on Easter break for two weeks, but when MHAs return, Premier Dwight Ball can look forward to some suggestions on how to improve Bill 1.
Bill 1 is the new Liberal government's signature transparency and accountability policy — an independent appointments commission which Ball has promised will "take the politics out of government appointments."
Neither the Tories nor the New Democrats think Bill 1 lives up to the hype, but Tory MHA Steve Kent said the Opposition is going a step further — preparing a suite of amendments to the bill to fix some of its most glaring problems.
For starters, while the legislation calls on the appointments commission to submit three names to cabinet for final approval, Kent says the Tories will submit an amendment to rank those three names.
"If you truly want the best person for the job, then you should put a process in place that identifies the best person for the job. If you're selecting the next CEO of Nalcor, submitting three names without ranking and letting cabinet pick doesn't seem like a logical process at all," he said.
"Odds are, they won't in every case be three equally qualified people. Of course not."
The Tories also want to see an annual review of the independent commission to ensure it is respecting merit principles for its selection process, and they want to make sure the five-year review of the legislation is made public.
"Bill 1 calls for a review of the act every five years that would only be sent to cabinet," Kent said "So in the interest of openness and accountability, an amendment needs to be made so that the review will go not to cabinet, but to the speaker of the House for public release."
This will be an early test of how the Liberals conduct themselves in the House of Assembly.
Under the previous Tory government, accepting opposition amendments to legislation was a rarity, especially on significant matters of government policy.
In the first couple of weeks of Liberal control in the legislature, though, there have been signs that the current crowd plans to do things a bit differently.
And when Kent raised the possibility of proposing amendments to Bill 1 in question period earlier this week, Ball didn't exactly slam the door shut.
"We look forward to the debate on the independent appointments commission," Ball said. "We will certainly be entertaining — as we would completely expect that the members opposite would come with ways to improve that bill. If we see that during a good, robust debate there are ways to bring improvements to any piece of legislation, of course we'd consider all those things."
Kent said that even if the Liberals do entertain amendments, he's not optimistic about the appointments commission.
"Overall, it's ironic that this new entity is being named the independent appointments commission, because first of all, there's nothing independent about it, and secondly, it is not empowered to make appointments whatsoever," he said.
"I feel like in some ways, we'll be trying to put lipstick on a pig. This is flawed, poorly thought-out legislation, and it's simply window-dressing.
"It's simply about the Liberals trying to make good on an election promise that wasn't well thought-out."
firstname.lastname@example.com Twitter: TelegramJames


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Friday, August 15, 2003 - Hopes run high in Denver that Jake Plummer can do for the Broncos what Brian Griese could not. Hopes run high in Chicago that Kordell Stewart can do for the Bears what Jim Miller could not. Hopes run high in Arizona that Jeff Blake can do for the Cardinals what Plummer could not.
Broncos prepare to trade Dalton - Denver Post - Adam Schefter
Friday, August 15, 2003 - Training camp ended early and abruptly for defensive tackle Lional Dalton, not unlike his career with the Broncos. Coach Mike Shanahan instructed Dalton to skip all practices while the team attempts to trade him, something it expects to do within a week.
Beuerlein ready to start - Denver Post - Patrick Saunders
Friday, August 15, 2003 - Steve Beuerlein is a backup quarterback with a golden arm and a starter's mentality. That's a comforting thought for the Broncos should Jake Plummer ever get hurt this season.
Dove Valley Days - Denver Post - Patrick Saunders
Friday, August 15, 2003 - For the second day in a row, veteran wide receiver Ed McCaffrey hauled in a long pass from quarterback Jake Plummer. And for the second day in a row, cornerback Lenny Walls was the victim.
Heavy burden: Dalton shown door - Rocky Mountain News - Lynn DeBruin
August 15, 2003 - Lional "Jelly" Dalton thought he was on a roll after losing 36 pounds this off-season. He was, as the Denver Broncos decided to roll him right out the door. The man brought in 18 months ago to add beef to the Broncos' defensive front officially went on the trading block Thursday. If Dalton can't be traded, he expects to be released.
Middlebrooks: sound body, peace of mind - Rocky Mountain News - Lee Rasizer
August 15, 2003 - Willie Middlebrooks knows many Denver Broncos observers boil down his career to simple terms: He's a No. 1 pick, who hasn't played for two years. Therefore, he's a bust. To him, it's fuzzy math.
A must-see: Snake vs. Slash - Rocky Mountain News - Lynn DeBruin and Lee Rasizer
August 15, 2003 - The marquee for Saturday night's preseason game reads like some B-rated flick: Slash vs. Snake. On one side is Kordell "Slash" Stewart, looking for a fresh start with the Chicago Bears after eight roller-coaster seasons with the Pittsburgh Steelers.
Broncos camp report, August 15 - Rocky Mountain News - Lee Rasizer
August 15, 2003 - Jake Plummer seemed a little scattershot with his passing early in camp, throwing in the direction of his targets but not putting the ball in optimal spots for the receivers. But the quarterback has looked crisp this week, especially throwing the deep ball.
Broncos want to trade Dalton - Daily Camera - Barney Hutchinson
August 15, 2003 - The Broncos had a good reason for holding out defensive tackle Lional Dalton from both the morning and afternoon practices Thursday. They are trying to trade him. Broncos head coach Mike Shanahan confirmed that after Thursday's afternoon training camp session at Dove Valley.
Plummer set to take advantage of scrambling - Daily Camera - Barney Hutchinson
August 15, 2003 - The innocent bystanders hanging around the Denver Broncos offense during preseason camp have to act a little more lively this summer. Heads up, guys, you never know when No. 16 will break the pocket.
Shanahan: Broncos Plan to Trade Dalton - DenverBroncos.com - Andrew Mason
Aug. 14, 2003 - The Broncos are shopping Lional Dalton. Following the afternoon practice, Head Coach Mike Shanahan confirmed that the team is looking to trade the defensive tackle, who joined the team via free agency in 2002 and had been running with the first team through most of camp. However, since returning from Houston, second-year man Monsanto Pope, who started one game last year, had received the bulk of the first-team work.


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款式: 34777136 颜色:
FP One
以现代风格诠释的古旧饰物。FP One是独家自营品牌。
Pretty, but not wearable
I bought this set because it looked absoluetely stunning and I thought I could wear it around and enjoy myself while wearing it. It was really heavy looking on. I bought in the navy blue and the fabric for the shirt was not what I expected and the skirt was really really long. I bought a medium. The top fit but the skirt was a little loose. I took it in. I wear the set because I didn't want to return it, but I don't wear them together because it doesn't look right on me.


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Collecting Strategies: The Financially Painless Way To Collect Gold Coins
By Al Doyle for CoinWeek....
The appeal of gold is universal, and it has nothing to do with the state of one's finances. A desire to own the metal coupled with a small budget can be especially frustrating, but there are ways to play the gold game without large sums of cash.
Even though it hasn't been used as daily spending money for close to 100 years, a wide selection of smaller gold pieces have been struck in recent years. How does a person build a collection? Consider these options.
One-ounce rounds are for the investor market, and the second most popular size in modern gold coinage is the 1/10-ounce version. Although premiums above melt value are higher on smaller coins, they provide the average working person with a way to accumulate gold one or two pieces at a time.
The American Eagle will be the choice of many small gold shoppers, and it offers several collecting options. First struck in 1986, the series has been issued on a continuous basis, making it ideal for a date set. Annual proofs are a second path for the diehard Eagle enthusiast. Roman numerals marked the date until 1991. There are no high-priced keys, but the 1991 will cost a little more than later issues. While many dealers stock silver Eagles by date, few professional numismatists do the same with the complete run of 1/10-ounce gold Eagles.
Canadian Maple Leafs have a worldwide following, and this series of 24-karat gold pieces stretches back to 1982. How does a person fill dates in a series that tends to be sold randomly by bullion dealers? You might have to attend a large show and sort through batches of "Maples". Only three 1/10-business strike Eagles (1988, 1991 and 2007) sport mintages of less than 200,000, but it's a totally different story north of the border.
Collectors who like rarity and a challenge will find it in the 1/10 ounce Leafs. Annual production ranged from 21,300 to 63,470 from 2000to 2008, with the low points coming in 2007 and 2003 (26,940). It's clear that the Royal Canadian Mint was more focused on one-ounce units for the investment market. Mintage numbers were under 100,000 in 2010 and 2012.
The original mass-market gold coin - the Krugerrand - is sometimes overlooked or taken for granted in a 21st century bullion market full of newer choices. The smallest K-rand debuted in 1980, and the 21st century includes a run of low-mintage dates
Chinese Pandas and Austrian Philharmonics are other well-respected options with a track record of regular issues. Because of their popularity in the jewelry trade as well as with the general public, 1/10 Pandas tend to command higher prices than the competition. The 2006 Philharmonic features a mintage of 39,892. The musical instruments on the reverse are one of many examples of the tasteful and talented artistry that is a trademark of the Austrian Mint.
The choices don't end with the big five. Check out the various 1/10-ounce gold coins produced by Mexico, Australia and the Isle of Man. Recent 1/10-ounce (0.1005 ounce, to be exact) Britannias are made exclusively for the collector market, as annual mintage numbers in the low four figures will attest.
A person doesn't have to be confined to one series of modern gold. Go ahead and play the type set game by obtaining as many different designs as possible. There's another way to derive satisfaction from small gold even if your holdings lack some of the scarcer dates. As one friend vividly described it, having a handful of 1/10-ounce gold coins "makes you feel like a low-budget King Midas." At today's spot prices, working up to becoming a minor league Midas is also much less expensive than it would have been a year or two ago.


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Mitt Romney has put the Middle East back into the election debate on foreign policy, which is where it deserves to be. His speech at the Virginia Military Institute last week was more considered than the off-the-cuff remarks at the notorious 47 percent dinner where he saw "no way" for there to be a peace settlement with the Palestinians.
Read Full Article »


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For some reason people send me mail messages and while I see the mail showing up in gmail when I check the time when they send it is always like 15 minutes before. ( This usually happens with important messages from clients not with standard messages that notify you when you sign up to some website)
Important message are delivered with huge delay, crap semi spam message are instantaneous
Anyone have experienced something like this? 15 minutes to deliver a mail is an eternity in this digital age.
Not even trying to contact google we know they don't answer, hope to find a solution here if exist.
Actually, Gmail delivers emails extremely fast, in my opinion. Other providers are having quite some trouble receiving or delivering emails fast to Gmail.
just happened half an hour ago and the person have gmail also.
maybe the NSA is intercepting my mail. NSA get off the line you douche and let me use gmail as it should
Yep, reviewer should to approve your mail
Are you using the web client, or some third party client like Thunderbird or Mail.app? The delay might be between Gmail and your client, in that case..
the normal webpage. I just leave the tab open. I even force it to update itself and no message, and then you see the message pop up but if you check the time when it was sent (6 minutes ago or 14 minutes ago)
Can be a problem with firefox, maybe?
I believe the time shown next to your email is the send time (the one in the header provided by the outgoing mail server), not the receive time. So the delay isn't necessarily on gmail's end. Most likely either the server sending the email encountered a delay, or there was some sort of delay en route. You can take a look at the original content of the email to see when the actual 'received' timestamp was, which is when it was delivered to Google's servers.
I think the fact that some emails show up instantaneously while others are delayed suggests that the issue is more likely with those sending servers than with the receiving server.
yes, but the sender have gmail I've checked. So is strange.
I'm running some tests now. I will keep chrome and firefox open at the same time on the mail page and see if they behave differently.
doru said
just happened half an hour ago and the person have gmail also.maybe the NSA is intercepting my mail. NSA get off the line you douche and let me use gmail as it should
Actually, yep!
If I send any mail from
me @icloud @yahoo my server to gmail, they get there instantly. If I send any from @gmail to @icloud @me @yahoo they have a ~1/15 minute lag Other servers have issues with GMail sometimes, but it's chaotic. Sometimes it works like a charm, other times it's snail mail.


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We're sorry, this listing is off the market. Try these listings instead:
Full-Service Landscape Business New Orleans #328453 posted Apr 9, 2013
- New Orleans, Louisiana, United States
- $1,650,000
This full-service landscape business for sale is located in the large metropolitan city of New Orleans, Louisiana. For over 14 years this company has built, designed, and maintained landscapes of all types for its long list of loyal clients. The business has an experienced staff who know the industry...
Home Inspection - Nationally Franchised Business #281033 posted Feb 2, 2012
- New Orleans, Louisiana, United States
- $35,000
This nationally franchised business for sale is an established home inspection company. It is nationally renowned and one of the fastest growing home inspection companies today. The well-known national franchise began offering its top-of-the-line home inspection services 18 years ago and now has over...
Premium Interior Decorating Business #263856 posted Oct 14, 2011
- Baton Rouge, Louisiana, United States
- $350,000
For over 5 years, this prosperous interior decorating business has the track record and proven success that keeps it amongst the best in the industry. Business focuses on custom window treatments such as custom draperies, shades, blinds, etc. as well as bedding, rugs, furniture, art, and accessories...
Did you know that social networking is a great way to buy a business? Sign up now and we'll show you how.
Disclaimer: DealStream has not independently verified any of the information in this listing and makes no warranty as to its accuracy or completeness.


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Originally posted on Fox Sports West | Last updated 6/18/13
NEW YORK (AP) -- The game between the Los Angeles Dodgers and New York Yankees has been postponed by rain, delaying the renewal of their old October rivalry. The game was called Tuesday night about 30 minutes before the scheduled first pitch. It will be made up as part of a day-night doubleheader Wednesday, with start times of 1:05 p.m. and 7:05 p.m. A star player and fan favorite when he was captain of the Yankees, Dodgers manager Don Mattingly was back in the Bronx to face the team that passed him over when it hired Joe Girardi as skipper in 2007. The two-game series marks the Dodgers' first trip to Yankee Stadium since clinching the 1981 World Series. Hyun-Jin Ryu had been set to pitch for Los Angeles against Phil Hughes.
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Linus Torvalds on the Near Future of the Linux Kernel
Talking in an interview with InformationWeek Linus Torvalds revealed what features and functions we can look forward to from the Linux kernel in the near future, what direction development will take, and what his views are on the continual accusations by Microsoft.
The focus of next year's work will be improving hardware support, said Torvalds, with work being put into drivers and porting to other platforms. He identified graphics and WLAN drivers as former weak spots with the situation currently improving and likely to continue doing so next year.
What Torvalds is really excited about is the use of solid state disks (SSD) which he anticipates will help to reduce latency in data access, thus having a huge positive impact on the Linux kernel's latencies. Although virtualization is not one of his favorite topics, Torvalds doesn't deny that much has been going on in that field.
Torvalds sees Linux's strength of Linux compared to Windows less in a specific area than in the flexibility of Linux. Virtualization is a good example of this that shows the validity of various different approaches, according to Torvalds. At the same time it demonstrates the true strength of the Open Source model versus single-vendor models.
Asked to comment on Microsoft's claims that Linux infringes on Microsoft patents, Linus Torvalds response showed that he was fairly confident that there was very little to support the accusations.
Issue 201/2017
Buy this issue as a PDF
GitHub Announces Open Source Friday Program
They encourage people to take time out and work on open source projects on Friday.
System76 Announces Their Own Distro, Pop!_OS
Pop!_OS is based on Ubuntu and uses the Gnome stack.
Linus Torvalds Talks About His Motivation
He never tires of working on the Linux kernel.
Debian 9 Stretches Its Wings
The new release of Debian has a very strong focus on security.
Trojan Turns Raspberry Pi into a Cryptocurrency Mining Device
Two trojans in the wild are targeting Linux machines.
Fedora 26 Beta Comes with New Features
The workstation comes with the latest Gnome desktop environment and support for many application build systems.
Raspberry Pi Foundation Merges with CoderDojo Foundation
The two foundations join forces to expand their efforts to reach young people.
Samba Security Hole Patched but Risk is Bigger
Millions of devices that use Samba Server are vulnerable to attacks.
Red Hat Announces OpenShift.io
Red Hat takes its IDE online.
Microsoft Bakes Linux into Windows Server
Microsoft is slowly becoming a Linux vendor.


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OAHU HAWAII WORKSHOP | July 2nd, 2016
Sale price
Regular price
I am passionate about what I do because I simply love what I do. I am taking all my talents, technically, artistically, and business-wise and creating one amazing workshop that covers it all. I wanted to create a workshop retreat that is refreshing, inspiring and a place for photographers to come and learn. This workshop will only have THREE (only TWO seats left!) seats available to insure everyone who comes will get lots of 1:1 attention to learn from me directly.
Expect to learn A TON! This will be an ALL-DAY comprehensive workshop that will teach you the in-depth principals of working with clients and creating the most stunning portraits. During this one day workshop I will cover all aspects of running a successful business, working with clients, as well as creating your dream business. We will spend the entire day going over material and will spend a large portion of this day traveling around the island shooting beautiful portraits in the most amazing locations. I'm seriously so excited for this workshop and will be keeping this very small and private to allow us to explore and create something amazing together.
We will start of by going over everything I do that makes my business successful. We will have plenty of time to cover all questions. There will be a focus on the business aspect, including a marketing portion and how to find your dream clients. Lets face it, running a business is not easy these days and it's so important to be business savvy in todays world. I'll teach you all my little tricks and tips i've learned along the way and you'll see how applying these steps to your own business will be a huge game changer.
I'll be there to show you what I do at my sessions, how I get my clients comfortable, what camera settings I'm using & you will be there to shoot right by my side. We will cover using natural lighting, posing, how to capture details and emotion while shooting. I will also go over different natural lighting techniques; such as those very airy backlit images I love creating. You will be shooting through out the workshop and are welcome to use any of the images for your portfolio.
It would take a full day to edit the entire gallery so i've decided that everyone who attends will also receive a full recording of me editing a complete gallery with the images taken at the workshop. The great thing about this is that you'll be able to re-watch the video as many times as you need, pause, and work on your own images at your own page long after the workshop is over.
After we get done shooting we will head to dinner and will spend the rest of the evening together as a group.
If this sounds like something you want to be apart of (I'm hoping it is!) book your spot. Remember, they are limited spots available . It's important for me to keep the workshop classes small and personal. I want to be able to give each of the attendees' 1:1 attention. Most of all I want you to leave this workshop feeling inspired to bring your business and portraits to the next level.
Please bring your DSLR as well as a prime lens such as the 50mm lens or 35mm and memory cards. You should know how to shoot in manual mode and have a basic understanding of post processing. If you have a laptop please bring it!
I will be doing A LOT of talking, so get ready to take notes!
July 2nd, 2016
Oahu Hawaii


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Course Grants
The course award program was intended to stimulate the development and implementation of courses, or course segments, in analytic theology at divinity schools and departments of theology and religious studies. The program provided awards to faculty members who developed and taught courses of one of the following two types:
- Revised Required Courses—supplementing an existing, required graduate survey course that does not currently contain a segment on analytic theology with one.
- New Courses in Analytic Theology—development of a new course dedicated to analytic theology.
Past Winners
The Analtyic Theology course award program has closed.


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Allerdale Borough Council is being recommended to choose Tesco as the preferred bidder to build on the Cloffocks in Workington.
The council's Workington Town Centre Task Force Group made the recommendation after looking at bids from a number of major retailers.
Potential development partners were asked to produce bids to meet a number of criteria including helping with the regeneration of the town.
Leisure developments
Council leaders Jim Musgrave said: "We are delighted to recommend Tesco as the preferred developer.
"Looking at the whole package they offered, it best met our needs regarding regeneration of the area and linkages to the town centre.
"The preliminary decision needs to be confirmed after further negotiations on some items that need to be addressed."
The council says the sale of the Laundry Fields site would raise more than £7m and it hopes the money will go towards improvements to housing and leisure developments.


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It's not all the time that you find yourself in need of a replacement Strut Mount to repair your vehicle. Anyone who operates a Chevrolet knows that when it comes to maintaining their car, truck, or SUV only the absolute best replacement parts will do. When your Chevrolet Suburban 2500 rolled off the assembly line, it was destined for a person with discerning taste who values long-lasting quality in their automobile. Obviously, you didn't buy your Suburban 2500 unless you knew that you wanted performance and good looks both rolled up into one automobile.
The performance of your car or truck is the result of an evolved suspension. Your vehicle's MacPherson strut suspension reduces vehicle weight and improves maneuverability of the wheel carrier, as opposed to having a shock and upper control arm. At the top of the your strut is your Chevrolet Suburban 2500 strut mount, and it consists of a metal sleeve inside a rubber or urethane bushing which provides a means for the strut to fasten to it and pivot as well. It is this pivot that the strut mount provides that allows your wheels to change location and orientation a few degrees so it can accommodate changes in the road. This adaptability was never seen before the strut mount, and your Chevrolet Suburban 2500 owes its comfortable ride to it.
Given all the hassles associated with performing maintenance on your car or truck, let www.carpartsdiscount.com be the number one store you go to make purchasing it easy. Ordering new Chevrolet parts from www.carpartsdiscount.com means you are getting the best deal on the highest quality original and aftermarket replacement Suburban 2500 parts on the internet. At Car Parts Discount, we have live customer service members here with enough expertise to help you select the correct Chevrolet Suburban 2500 part for your needs. Just choose your year from the list below to find the right Chevrolet Suburban 2500 Strut Mount for your 2013, 2012, 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2003, 2002, 2001, 2000 model.