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Are the effects of a non-drug multimodal activation therapy of dementia sustainable? Follow-up study 10 months after completion of a randomised controlled trial
Little is known about the long-term success of non-drug therapies for treating dementia, especially whether the effects are sustained after therapy ends. Here, we examined the effects of a one-year multimodal therapy 10 months after patients completed the therapy.
This randomised, controlled, single-blind, longitudinal trial involved 61 patients (catamnesis: n = 52) with primary degenerative dementia in five nursing homes in Bavaria, Germany. The highly standardised intervention, MAKS, consisted of motor stimulation, practice of activities of daily living (ADLs), and cognitive stimulation. Each group of 10 patients was treated for 2 h, 6 days a week for 12 months. Control patients received standard nursing home care. At baseline, at the end of therapy (month 12), and 10 months thereafter (month 22), cognitive functioning was assessed using the cognitive subscale of the Alzheimer's Disease Assessment Scale, and the ability to perform ADLs was assessed using the Erlangen Test of Activities of Daily Living.
During the therapy phase, the MAKS patients maintained their cognitive function and ability to carry out ADLs. After the end of therapy, both the control and the MAKS groups deteriorated in both their cognitive function (control, p = 0.02; MAKS, p < 0.001) and their ability to carry out ADLs (control, p < 0.001; MAKS, p = 0.001). However, in a confound-adjusted multiple regression model, the ability of the MAKS group to perform ADLs remained significantly higher than that of the control group even 10 months after the end of therapy (H0: βMAKS + βMAKS month 22 = 0; χ2 = 3.8568, p = 0.0496). Cohen's d for the difference between the two groups in ADLs and cognitive abilities 10 months after the end of therapy was 0.40 and 0.22, respectively.
A multimodal non-drug therapy of dementia resulted in stabilisation of the ability to perform ADLs, even beyond the end of therapy. To prevent functional decline for as long as possible, therapy should be performed continuously until the benefit for the patient ends. Follow-up studies on larger numbers of patients are needed to definitively confirm these results.
Trial registration
Alzheimer's dementia has been treated with drug therapy, non-drug therapy, and a combination of the two therapy types. In recent years, some studies have demonstrated the efficacy of non-drug therapy
Little is known about the sustainability of any of these therapeutic effects. Whereas it would be expected that the cognitive performance of Alzheimer patients who respond to drug therapy will inevitably deteriorate when the medication is withdrawn
In a blinded RCT design, we have demonstrated the efficacy of our multimodal activation therapy developed for institutionalised patients
Study design
Ten months after the end of our randomised, controlled, single-blind longitudinal trial of a multicomponent, non-pharmacological group therapy known as MAKS, we examined the efficacy of the therapy with dementia patients in five German nursing homes
Ninety-eight patients included in the original study fulfilled the following inclusion criteria: presence of primary degenerative dementia according to ICD-10 (F00, F03, or G30) and as confirmed by the attending physician; fewer than 24 points on the Mini-Mental State Examination (MMSE)
Figure 1
CONSORT flowchart
CONSORT flowchart.
The number of patients analysed consisted of the number eligible at each time point (Figure
The characteristics of the 52 patients who completed the follow-up analysis are summarised in Table
Treatment conditions
MAKS is a multicomponent group therapy consisting of tasks organised into three categories—motor stimulation (M), ADLs (A), and cognition (K)—preceded by a short introduction consisting of what we called a spiritual element (S). Each daily session began with this introduction, which lasted approximately 10 min and was designed to help the dementia patients feel part of the group. This was followed by about 30 min of motor exercises. After a 10-min break, the patients spent approximately 30 min completing a variety of cognitive tasks. This was followed by about 40 min of ADLs [for further information, see
The members of the control group received the standard care offered in each nursing home and were free to participate in any of the regular, non-MAKS activities offered at the nursing home. Patients in the control group participated in an average of two of these non-MAKS activities per week. Also, patients in the MAKS group were free to take part in these non-MAKS activities in addition to MAKS and did so once a week on average. The study did not interfere in any way with the patients' existing pharmacological treatment or nursing care.
Implementation of treatment
MAKS therapy was conducted in each nursing home by two therapists and one aide from Monday to Saturday from 9:30 am to 11:30 am for 12 months. The therapists were registered geriatric nurses. Each therapy group consisted of 10 dementia patients. Therapists and aides received a standardised handbook from the central study site describing in detail the steps to be taken on each day of therapy
Instruments and data recording
The cognitive and ADL-abilities of the patients were recorded by independent evaluators, who were blinded to treatment allocation and were not part of the nursing home staff. The patients were evaluated before the therapy commenced (baseline), at the end of the 12-month therapy (month 12), and 10 months after completion of the therapy (month 22), with all patients having the standard nursing home care during this latter period. Data were pseudonymised and submitted to the central study site.
Cognitive abilities were measured using the ADAS-cog
The ability to carry out ADLs was measured using the E-ADL test
Study coordinators recorded each patient's age, gender, educational attainment, family status, and nursing care needs at baseline. The nursing staff rated symptoms of depression among the patients at baseline using the mood subscale of the Nurses' Observation Scale of Geriatric Patients (NOSGER)
We also calculated the effect of any previous medical diagnoses on the mortality rate using the Charlson comorbidity index
Statistical analysis
We statistically analysed the data of all patients who completed the primary intervention period of 12 months either in the MAKS group or in the control group (n = 61). In the analysis of the follow-up data, we made attempts to record outcome variables for all patients who completed the intervention period and who were still alive 10 months after the end of therapy (n = 52). If more than 20% of the items on the ADAS-cog subscale or the E-ADL test were missing for any given patient (e.g. because of his or her refusal to complete the test), the score was calculated according to the expectation-maximum (EM) algorithm. Under these conditions, imputation at the 10-month follow-up was necessary in 4 cases. The scores for patients who died during the 10-month interim period without therapy (n = 9) were not imputed. The number of patients eligible for the analysis in the multiple regression models was 61 at the end of the therapy (at month 12) and 52 after the 10 months following the therapy (at month 22).
To describe the course, t-tests for dependent samples were calculated for both groups for the two time periods. The first period was the 12-month therapy period (from baseline to month 12), and the second period was the 10-month interim without therapy between evaluations (from month 12 to month 22). Model diagnostics of the differences revealed no deviation from a normal distribution. Cohen's d with pooled standard deviation
Differences between the groups were calculated with multiple analyses to adjust for possible confounders; multiple linear mixed models were computed. We computed two separate models, one for the E-ADL test score and one for the ADAS-cog score. For the analysis, we adjusted the score at months 12 and 22 for the baseline values (score at month 12 – baseline score, and score at month 22 – baseline score). We then built a variable that contains both measurements for each patient (where available) and used another variable to reflect the time of measurement ("repeated measurements"). We included the following independent variables: intervention group (MAKS vs. control), observation time (month 12 vs. month 22), age of the patient, medication score, NOSGER subscale mood, anti-dementia medication, and the interaction of the intervention group and observation time to account for possible changes of the group effect over time. The "nursing home" entered the model as a random effect. Model diagnostics revealed no substantial deviation from the model assumptions.
In a sensitivity analysis, we additionally included a random slope for time to account for possible non-systematic variations over time. For the analyses, we used the statistical software packages R
In the course of the 12 months of therapy, the cognitive and ADL-abilities of the patients in the control group (n = 30) decreased significantly (t-test for dependent samples; ADAS-cog: baseline, 35.6 ± 14.8 SD; at month 12, 40.8 ± 17.0, p = 0.039; E-ADL test: baseline, 24.3 ± 5.6; at month 12, 21.5 ± 7.4, p = 0.005). By contrast, these abilities of the MAKS group (n = 31) remained stable during this time (ADAS-cog: baseline, 32.6 ± 11.5; at month 12, 32.5 ± 15.3, p = 0.99; E-ADL test: baseline, 26.6 ± 5.1; at month 12, 26.3 ± 14.8, p = 0.72; see also
Figure 2
Median E-ADL test values over time
Median E-ADL test values over time. Median E-ADL test values in the groups MAKS and control over time together with the corresponding notched boxplots. Lower scores indicate greater deficits. Boxplots represent the distribution of raw data values. Non-overlapping notches are a (rough) indicator of significantly different medians [see
Figure 3
Median ADAS-cog values over time
Median ADAS-cog values over time. Median ADAS-cog values in the MAKS and control groups over time together with the corresponding notched boxplots. Higher scores indicate greater deficits. Boxplots represent the distribution of raw data values. Non-overlapping notches are a (rough) indicator of significantly different medians
In the confound-adjusted multiple regression model with the random effect of "nursing home" (see Additional file
Additional file 1
Table S2. Fixed effects of mixed-effects model with E-ADL test as dependent variable and "nursing home" as random effect.
Click here for file
Figure 4
Estimated changes of E-ADL test score compared to baseline using a random effects model
Estimated changes of E-ADL test score compared to baseline using a random effects model. Higher scores indicate better abilities to perform ADLs. The solid lines represent effect estimates from a model with an interaction term for time and group, i.e. where the group effect can change over time. The dashed lines indicate a model without interaction. In this case, the group effect is forced to stay constant (as can be seen from the parallel dashed lines from month 12 to month 22).
In a sensitivity analysis, we additionally adjusted for a potential auto-correlation between the time points and thus included a random slope for time. In this case, the effect of MAKS therapy 10 months after the end of therapy was no longer significant (χ2 = 2.49, p = 0.116). Despite the lack of a significant difference in this case, the effect estimates revealed the same structure as depicted in Figure
As for the ADLs, we used a confound-adjusted model with a random effect of "nursing home" to evaluate the long-term effect of MAKS therapy on cognition (ADAS-cog; see Additional file
Additional file 2
Table S3. Fixed effects of mixed effects model with ADAS-cog as dependent variable and "nursing home" as random effect.
Click here for file
Figure 5
Estimated changes of ADAS-cog compared to baseline using a random effects model
Estimated changes of ADAS-cog compared to baseline using a random effects model. Higher scores indicate greater deficits. The solid lines represent effect estimates from a model with an interaction term for time and group, i.e. where the group effect can change over time. The dashed lines indicate a model without interaction. In this case, the group effect is forced to stay constant (as can be seen from the parallel, dashed lines from month 12 to month 22).
The sensitivity analysis with an additional random slope of time did not change the result (MAKS vs. control at month 22: χ2 = 0.88, p = 0.347).
The present study addressed whether the positive effects on cognition and the ability to carry out ADLs of a 12-month multimodal therapy of dementia patients are sustainable 10 months after the end of therapy. This study is thus one of the first RCTs to systematically examine the sustainability of the effects of a non-drug therapy in dementia patients. Our results using a confound-adjusted multiple regression model indicated that the positive effects of the group therapy (i.e. therapy group vs. control group) on the ability to carry out ADLs were indeed sustainable. This effect was still existent but no longer statistically significant when controlled for a random subject-specific slope. Such a finding is unique in the literature. To date, only two randomised studies have addressed the sustainability of non-drug therapy procedures on cognition and the ability to carry out ADLs, but in combination with cholinesterase inhibitors.
In a recent study on dementia patients living at home, Giordano et al.
Chapman et al.
In the main analysis, we found a long-term effect of the MAKS therapy on the ability to carry out ADLs but not on cognition. Future studies should test whether ADL training will preserve the self-reliance of the participating home residents more than that of the control group. This in turn would mean that ADLs are performed independently to a greater extent and are thus automatically trained further. By contrast, the long-term effect of MAKS therapy on cognitive functions is much lower. Here, the difference between the control group and therapy group was smaller 10 months after the end of therapy, and the effect of the therapy was no longer demonstrable in multivariate analyses. Compared to a strictly pharmaceutical therapy, a non-drug therapy thus appears to offer the potential of an effect that promotes independence in everyday living that lasts beyond the term of therapy, even if the positive effect on cognitive functions did not continue after therapy ended. Because the cognitive abilities as well as ADLs abilities were preserved in the MAKS group during therapy, a continuous therapy could perhaps stabilise both abilities even longer.
A limitation of the present study is the number of patients. After 22 months, only a relatively small sample number of patients remained (n = 52), owing in part to the high mortality rate in the age spectrum examined. The small number of cases is probably also the reason why the model in the sensitivity analysis with a random slope did not attain significance for the ability to carry out ADLs, especially since the variation of the measured E-ADL test scores increased over time (see Figure
One strength of the study is the strict RCT design used during the therapy phase. To our knowledge, our study is thus the first to examine the sustainability of an exclusively non-drug therapy of dementia after completion of the active therapy phase. Our method is also notable in that all dependent variables were recorded blindly by testing and not, as is often the case, by using outside assessment.
Our intensive multimodal therapy was elsewhere shown to be effective in the treatment of dementia with regard to both cognitive functioning and the ability to perform ADLs with greater effect sizes for patients with mild to moderate dementia
ADLs: Activities of daily living; RCT: Randomised controlled trial; ADAS-cog: Cognitive subscale of the Alzheimer's Disease Assessment Scale; MMSE: Mini-Mental State Examination; E-ADL: Erlangen Test of Activities of Daily Living; NOSGER: Nurses' Observation Scale of Geriatric Patients; EM: Expectation-maximimum; ROT: Reality Orientation Training; TFLS: Texas Functional Living Scale; NPI: Neuropsychiatric Inventory.
Competing interests
The authors declare that they have no competing interests. The research reported was funded by the German Ministry of Health (LT-Demenz-44-059), which had no role in designing or conducting the study; in collecting, analysing, or interpreting the data; or in preparing, reviewing, or approving the manuscript. The researchers acted fully independently of the sponsor.
Authors' contributions
All authors had full access to all of the data in the study. EG designed the study concept and obtained funding. KL and BH provided administrative, technical, or material support. KL and EG acquired data. All authors statistically analysed and interpreted the data, critically revised the manuscript for important intellectual content, and read and approved the final manuscript.
We thank all individuals who contributed to this study, especially the patients, the directors of the participating nursing homes, the nursing staff, the therapists, and the evaluators. We are grateful to the German Ministry of Health for funding. We thank Friedrich Mueller, former head of the Elderly Care Department of Diakonie Neuendettelsau, who took part in designing the study and collaborated in conducting the study; Dr. Christine Fiedler, PD Dr. Richard Mahlberg, Hans-Dieter Mückschel, and PD Dr. Martin Radespiel-Troeger, who acted as Data Monitoring and Safety Board members and who supervised the study. We thank Dr. Jane Zagorski for critically editing the English language of the manuscript.
Nonpharmacological therapies in Alzheimer's disease: a systematic review of efficacy
Dementia: Supporting people with dementia and their carers in health and social care
Nonpharmacological treatment of Alzheimer disease
Non-drug therapies for dementia: an overview of the current situation with regard to proof of effectiveness
Non-pharmacological, multicomponent group therapy in patients with degenerative dementia: a 12-month randomised, controlled trial
Effects of cognitive-communication stimulation for Alzheimer's disease patients treated with donepezil
Effects of cholinergic drugs and cognitive training on dementia: 2-year follow-up
Open-label, multicenter, phase 3 extension study of the safety and efficacy of donepezil in patients with Alzheimer disease
Assessing therapeutic efficacy in a progressive disease: a study of donepezil in Alzheimer's disease
Relearning face-name associations in early Alzheimer's disease
Effectiveness of procedural memory stimulation in mild Alzheimer's disease patients: A controlled study
Cognitive stimulation to improve cognitive functioning in people with dementia
The Danish Alzheimer Intervention Study: Rationale, Study Design and Baseline Characteristics of the cohort
Effects of multimodal non-drug MAKS therapy on Dementia symtoms and need for care in patients with degernative Dementia in the nursing home
"Mini-Mental State": a practical method for grading the cognitive state of patients for the clinician
A new rating scale for Alzheimer's disease
The Erlangen Test of Activities of Daily Living: first results on reliability and validity of a short performance test to measure fundamental activities of daily living in dementia patients
A new behavioral assessment scale for geriatric out- and in-patients: the NOSGER (Nurses' Observation Scale for Geriatric Patients)
A new method of classifying prognostic comorbidity in longitudinal studies: development and validation
Combination of intensive cognitive rehabilitation and donepezil therapy in Alzheimer's disease (AD)
Disease progression meta-analysis model in Alzheimer's disease
Effect of music therapy on anxiety and depression in patients with Alzheimer's type dementia: randomised, controlled study
Effects of community occupational therapy on quality of life, mood, and health status in dementia patients and their caregivers: a randomized controlled trail
Variations of box plots
Pre-publication history
The pre-publication history for this paper can be accessed here:


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According to prosecution, Jamsandekar was murdered at the behest of Gawli, who had, along with the co-accused, conspired to execute the Shiv Sena corporator
Mumbai: The special Maharashtra Control of Organised Crime Act (MCOCA) court on Friday convicted gangster turned politician Arun Gawli in the murder case of Shiv Sena corporator Kamlakar Jamsandekar, reports PTI.
The court also convicted eleven others accused while the sentence will be pronounced on 27th August.
One of the accused, Bala Surve, died during trial, while three accused were acquitted for lack of evidence.
Jamsandekar was shot dead in March 2008 at his Asalpha residence in suburban Ghatkopar. Gawli was arrested on 21 May 2008 and has been in custody since then.
On 7 October 2010, the court had framed charges against Gawli and other accused under MCOCA, sections 302 (Murder), 34 (common intention) and 120B (criminal conspiracy) of IPC, while Gawli and others had pleaded innocence.
According to police, the contract of killing Jamsandekar was allegedly given by accused Sahebrao Bhintade and Bala Surve, who were reportedly his (Jamsandekar's) rivals in construction business and the local politics.
The crime branch had said that the other reason why Jamsandekar was executed was that Bintade and Surve were eyeing a plot at Saki Naka in suburban Mumbai and Jamsandekar reportedly "refused to cooperate".
According to prosecution, Jamsandekar was murdered at the behest of Gawli, who had, along with the co-accused, conspired to execute him.
The chargesheet said that a sum of Rs30 lakh was paid to the Gawli gang for the job. The trial had commenced from October 2010.
Dr Swamy said the apex court has given its verdict on issues which he never raised and not touched on the important aspect of huge loss to the nation
New Delhi: Janata Party president Dr Subramanian Swamy on Friday said he will seek a review of the Supreme Court judgement dismissing his petition in the 2G spectrum case against Finance Minister P Chidambaram, reports PTI.
"I will seek a review of the judgement. I did not talk about conspiracy. I spoke about loss to the nation," Swamy said outside the Supreme Court shortly after his petition was rejected.
"It is a bad judgement. The Supreme Court never allowed me to complete my submissions," he told reporters.
He said the court has given its verdict on issues which he never raised and not touched on the important aspect of huge loss to the nation.
Government quickly came out in strong defence of Chidambaram. "Chidambaram has nothing to do with 2G case. Swamy is always involved in filing these kind of petitions. So, there is no ground for his petition. We will face him legally and politically if he tries to malign the Congress party," Minister of State in the PMO V Narayanasamy said.
Even if Subramanian Swamy files a review peition in the apex court, it will be dismissed as he has no case, the minister said.
While welcoming the apex court's verdict, Information and Broadcasting Minister Ambika Soni criticised Swamy's decision to file a review petition. "He (Swamy) is doing this to be always in the news. It's just wastage of court's time. Earlier also the court had dismissed his appeal against our party colleague (Chidambaram) on the ground that there is no evidence against him in the 2G case," Soni said.
Law Minister Salman Khurshid said, "I certainly can express great satisfaction on the judgement. I had great conviction from the beginning and the court has also accepted our arguments in the case."
He said that this was Swamy's second failed attempt to make Chidambaram a co-accused in 2G case. "I think that one should allow the Supreme Court to take a final call on something".
BJP leader Mukhtar Abbas Naqvi, however, said that the government should not be so happy as they got a reprieve in the case only on technical grounds.
"The whole Government is responsible for the 2G scam. If the Government has got relief in one case due to technical reasons, it doesn't mean the ministers are innocent".
We need to bring about the beneficial remedies in modern medicine into medical care that is inexpensive, safe and effective. But vested interests in modern medicine are scuttling every effort with an old but effective whip "there is no evidence base"
"The greatest truths are the simplest, and so are the greatest men"— JC & AW Hare
When one ponders over the multitude of risk factors in and around us in this hostile world, one wonders as to how we are alive at all. Medical claptrap informs us day in and day out about the multitude of potions—chemical drugs, surgeries, special foods, tonics, etc to keep us alive. The truth is that most, if not all, of those heavily advertised items damage the system further than helping us. The truth is that there is a very complicated, yet simple system inside each of the one hundred thousand billion cells inside the human body to compute all the internal and external inputs through multiple sources to eventually put in place two fascinating energy systems, a low energy and high energy systems, to keep us going.
Let us first examine this nature's computer inside every cell which existed for nearly a billion and half years before the first nerves ever appeared in a jellyfish. It took another half a billion years for cranial nerves and brain to appear in organisms including man. The myth that the brain and the nervous systems alone keep us going has to give place to a more holistic view that there are many other important systems that help keep man alive. Then we will progress further in our understanding of human physiology and pathology. Life is a complicated system of individual cell functions in the body in an interdependent manner to keep us alive and healthy. If the ten thousand odd proteins that are present inside each one of the trillions of cells in our bodies do not work well we will have disease states. For recovery from any illness, body cells will have to function normally again.
Our approach in the "so-called" evidence based modern medicine is to try and correct those changes (not knowing what they are) in disease states using chemicals or surgery. As a quick-fix, apparently, they help some people some times but all of them damage some part of the human system almost always, sometimes as late as five years after the event. One good example is a painkiller trasylol which is now known to kill the recipient as late as five years after he/she had it! What happened to another pain killer wyoxx is now common knowledge. These measures have now resulted in considerable misery for mankind. To quote the most authentic scientific body of the USA: "The National Academy's data attributes 100,000 deaths per year to physicians' errors, added to well over 100,000 deaths due to severe drug interactions and another 100,000 fatalities from hospital-based-infections. (For a detailed analysis, see Death By Medicine, by Gary S Null, et a)". This is from a country with less than one-third the population of India. Thank God, we do not have statistics like this for India.
What is the remedy? We must get to know the true physiology of cell function and try and see how we could restore that in the unlikely event of disease in a more natural way rather than inflicting chemical and surgical damage to the cells where possible. The fruitless research of modern medicine is based on statistical science and not true hard science. The "failure of millions of dollars spent on AIDS vaccine, failure of interferon as a wonder drug for cancer management with the latter still eluding a cure despite billions being wasted on cancer research and cancer screening (the latter has been shown to be useless and dangerous), and the ravages caused by drugs like Thalidomide and Thorazine," are there for all of us to see. Reports are pouring in now to show that Thalidomide was used in pregnant women in New Zealand those days as guinea pigs for testing the drug, resulting in many monsters being born there.
We need to arrange an urgent marriage between the beneficial remedies in modern medicine "like the excellent emergency care methods, brilliant surgical successes, time tested and harmless pharmaceuticals as also the newer life style changes" with the best and scientifically authenticated multitude of methods in many other systems of medicine into a judicious integrated system of medical care that is inexpensive, safe and effective under all circumstances. Unfortunately, the vested interests in modern medicine are scuttling every effort in this field by hitting those efforts with an old but, effective whip "there is no evidence base" in other systems of medical care. This is the biggest lie in the world.
Let us examine how we can use natural methods to get the damaged cells back to normalcy. The ten thousand odd proteins in each cell are functionally better than our supercomputers. They have two energy systems—the Low energy system and the High energy system. Initially, the proteins process all the information they collect from the body as also the outside world into a low energy information system which primes the other proteins to a high energy functional system that could power the body as a whole. In this milieu there are certain specific proteins that do the directing or chaperoning job very effectively. One such chaperone protein is the Heat Shock Protein, HSP 70. It is otherwise called Stress Responsive Protein (SRP 70) as it responds to every kind of stress in the cells.
The HSP 70 protein is supervised by the HSP 70 gene. HSP 70 protein could be re-primed by heating the cell to 47 degree centigrade but, that can never be done in the human body. The other method is to use some kind of natural energy to do the job. In health the cell uses the energy coming from the main source, sunlight, as also the magnetic energy generated by lightening throwing a halo of Schuman energy field around the earth. (Schumann effect) Since all proteins are but carbon, hydrogen, nitrogen and oxygen as in the DNA along with amino-acids that come from food. The electromagnetic energy used by the cell proteins which is then transduced to fire the mitochondria inside every cell to produce energy needed for life.
Glen Gordon was one of NIH's brilliant young scientists, 4th in hierarchy at one stage. He was a pioneer in this field of trying to regenerate the damaged (ischaemic) cells back to normal. This made the American Medical Association to file a law suit against him, which did not materialize at the end. He lost his entire grant support, though. He would not relent. He has come up with a small Pulsed Electro-Magnetic Field (PEMF) generator powered by a battery to stimulate and up-regulate the depressed HSP 70 protein and thereby regenerate the cells again. My own initial enthusiasm with this toy of his is exciting. This is not the right forum to disclose such serious research data as it has to be done through a recognized scientific publication. Nonetheless, the results are an opening for us to look more deeply into many such natural methods of making the sick cells (individuals) to regain their strength and health without any long-term detriment to the owner in the bargain.
The marriage between the best in both worlds, as suggested above, is our only solution in this dangerous state in which modern medical claptrap and statistical science have landed us. We need a holistic approach to human, nay, all problems of this world.
"And all the loveliest things there be
Come simply, so it seems to me"— Edna St. Vincent Millay
(Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS. He is also Editor-in-Chief of the Journal of the Science of Healing Outcomes, Chairman of the State Health Society's Expert Committee, Govt of Bihar, Patna. He is former Vice Chancellor of Manipal University at Mangalore and former professor for Cardiology of the Middlesex Hospital Medical School, University of London. Prof Dr Hegde can be contacted at [email protected])


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Beyonce's Super Bowl 50 halftime performance was memorable for many reasons and one of those was her nearly falling while performing one of the many stunts she's known to do while on stage.
Well, knowing the Internet is a bunch of savages, it didn't take long for memes, GIFs and videos to drop placing her near fall among numerous hilarious backdrops. Perhaps the most famous of these was a video deeming her misstep as the "Beyonce bounce."
The video is set to R. Kelly's "Ignition (Remix)," but further remixed for him to repeat the word "bounce" as Bey moves across landscapes including past Macaulay Culkin in Home Alone, in replace of Super Mario and through jump ropes.
Y'all really never take breaks, huh? SMH. Watch the official "Beyonce bounce" video below.
BET.com is your No. 1 source for Black celebrity news, photos, exclusive videos and all the latest in the world of hip hop and R&B music.
(Photo: Christopher Polk/Getty Images)


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2872 History, philosophy & religion Large print books available
1. Gallipoli (Large Print Edition) - Alan Moorehead
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Ł34.99 Ł26.99 - Currently in stock
The classic and definitive history of the Gallipoli campaign with a new introduction by Sir Max Hastings. Moorehead, the finest war correspondent of his generation, recounts why the campaign was so important in the lessons it taught and why it continues to have such an emotional hold on the present day, particularly in Australia and New Zealand.
2. Gallipoli (Large Print Edition) - Alan Moorehead
Largeprint (Paperback) Our price: Ł24.99 - Currently in stock
The classic and definitive history of the Gallipoli campaign with a new introduction by Sir Max Hastings. Moorehead, the finest war correspondent of his generation, recounts why the campaign was so important in the lessons it taught and why it continues to have such an emotional hold on the present day, particularly in Australia and New Zealand.
3. The Saga of the 'Discovery' - Louis Bernacchi
Largeprint (paperback) Our price: Ł19.99 - Currently in stock
The story of Captain Scott's first expedition, by one who went with him. Louis Bernacchi's book Saga of the 'Discovery' is a comprehensive history of the fascinating ship which was built specifically for Antarctic exploration, and which was used intermittently for such purposes until the early 1930s, when she was given to the Boy Scouts Association...
4. A Spy Among Friends: Kim Philby and the Great Betrayal - Ben Macintyre
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Ł25.99 Ł12.99 - Currently in stock
Master storyteller Ben Macintyre's most ambitious work to date brings to life the twentieth century's greatest spy story.
5. An Introduction to Philosophy - George Stuart Fullerton
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Ł22.32 Ł10.99 - Currently in stock
6. Giant Print Centre-Column Reference Bible - NKJV - Thomas Nelson Publishers
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Ł34.99 Ł17.49 - Currently in stock
Self-pronouncing text. Center-column references and translation notes. Concordance. Stars marking messianic prophecies. Topical running heads. 8-page family record. 8 pages color maps. Red letter.
7. Gironimo!: Riding the Very Terrible 1914 Tour of Italy - Tim Moore
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Ł23.50 Ł11.75 - Currently in stock
History's most appalling bike race was an ordeal of 400-kilometre stages, cataclysmic night storms and relentless sabotage. Of the 81 who rolled out of Milan, only eight made it back. Committed to total authenticity, Tim acquires the ruined husk of a gearless, wooden-wheeled 1914 road bike, some maps and an alarming period outfit. What unfolds is the tale of a decrepit crock trying to ride another up a thousand lonely hills, then down them with only wine corks for brakes.
8. How to Create the Perfect Wife - Wendy Moore
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Ł19.99 Ł9.99 - Currently in stock
Thomas Day knew exactly the sort of woman he wanted to marry. Pure and virginal yet tough and hardy, she would live with him in an isolated cottage, completely subservient to his whims. As Day soon discovered, the woman of his dreams didn't exist in Georgian society. But rather than concede defeat, Day set out to create her.
9. In the Garden of Beasts - Erik Larson
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Ł23.50 Ł11.75 - Currently in stock
The extraordinary true story of intrigue and emerging terror at the American embassy in Berlin during Hitler's rise to ultimate power.
10. Is It True? The Facts Behind the Things We Have Been Told (Large Print 16pt) - Max Cryer
Largeprint (Paperback) Our price: Ł16.99 - Currently in stock
We can all remember the stories we were told as children: Santa Claus lives at the North Pole; St Bernard dogs carry brandy to help lost climbers; Lady Godiva rode naked through Coventry. They were great stories - and we believed them. But are they true? Max Cryer sets out to investigate the truth or otherwise of ideas and beliefs we may have always been told are true, but which on closer examination may not be. For example: Did Winston Churchill coin the term 'Iron Curtain'? 'OK' is an American expression, right? Tulips come from Holland, don't they? Did Sarah Palin say, 'I can see Russia from my house?' The subjects covered in this highly entertaining book are diverse, ranging from politics, science and social history, to language, music and the natural world. Max Cryer approaches each with an open mind, seeking to uncover the truth behind some of our most cherished beliefs. Be prepared for surprises.
11. Ninja - John Man
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Ł23.50 Ł11.75 - Currently in stock
From feudal Japan to 21st Century Hollywood, John Man reveals the reality behind one of the world's most enduring legends.
12. Our Church - Roger Scruton
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Ł10.49 Ł5.25 - Currently in stock
For most people in England today, the church is simply the empty building at the end of the road, visited for the first time, if at all, when dead. This title offers its sacraments to a population that lives without rites of passage, and which regards the National Health Service rather than the Church as its true spiritual guardian.
13. The Case for God - Karen Armstrong
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Ł18.99 Ł9.49 - Currently in stock
Here Armstrong argues that atheism has rarely been a denial of the sacred itself but has nearly always rejected a particular conception of God. She suggests that if we draw on the insights of the past, we can build a faith that speaks to our needs.
14. The Perilous Question: The Drama of the Great Reform Bill 1832 - Antonia Fraser
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Ł23.50 Ł11.75 - Currently in stock
International bestselling historian Antonia Fraser's new book brilliantly evokes a key period of political and social history: the passing of the Great Reform Bill of 1832.
15. The Prince, the Princess and the Perfect Murder - Andrew Rose
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Ł23.50 Ł11.75 - Currently in stock
The royal family's darkest secret and the establishment cover-up…
16. Twelve Steps to a Compassionate Life - Karen Armstrong
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Ł13.49 Ł6.75 - Currently in stock
From the spiritualities of world religions to the findings of contemporary neuroscience, the author argues that compassion is hardwired into our brains, yet is pushed back by our more primitive instincts for selfishness and survival.
17. 10 Issues That Divide Christians (Large Print 16pt) - Alex McFarland
Largeprint (Paperback) Our price: Ł19.99 - Click book title for availability and further details
Christians know there must be credible, biblical answers to society's toughest challenges, but is there a way to find these answers without advanced degrees in both biblical studies and political science? 10 Issues that Divide Christians, from best - selling Christian apologist Alex McFarland, is an in - depth but accessible exploration of hard questions facing our culture and the answers waiting in the pages of Scripture. Topics include homosexuality, the environment, war, abortion and the problem of evil. Each chapter also offers readers a resource list called ''''The Deep End of the Knowledge Pool'''' so they can dig deeper on one or more topics.
18. 10 Most Common Objections to Christianity (Large Print 16pt) - Alex McFarland
Largeprint (Paperback) Our price: Ł19.99 - Click book title for availability and further details
Society today has a growing number of objections and concerns regarding Christianity. Why does a loving God let bad things happen? Would God really send someone to hell? And why is Christianity right and other religions are in error? Many Christians hear objections to Christianity and have a crisis of faith. Enter Alex McFarland, a seasoned apologist who is ready to explore 10 common objections to Christianity. He offers straight answers that will give them confidence and understanding about their beliefs. After reading this book, all Christians will know how to effectively answer the most common objections to Christianity, why they believe what they believe and be prepared to defend their faith and worldview.
19. 100 Ways to Motivate Yourself Change Your Life Forever (EasyRead Large Edition) - Steve Chandler
Largeprint (Paperback) Our price: Ł19.99 - Click book title for availability and further details
In this first-ever paperback edition of his long-time best-seller, motivational speaker Steve Chandler helps you create an action plan for living your vision in business and in life. It features 100 proven methods to positively change the way you think and act - methods based on feedback from the hundreds of thousands of corporate and public seminar attendees Chandler speaks to each year.....STEVE CHANDLER is a keynote speaker and corporate leadership coach with a large number of Fortune 500 clients. He is also a popular convention speaker, (Arthur Morey of Renaissance Media said, ''Steve Chandler is the most original and inspiring figure in the highly competitive field of motivational speaking.'') Chandler's first book, 100 Ways to Motivate Yourself, was named Chicago Tribune's Audiobook of the Year in 1997. Chandler's books, now in seven languages, have also become best-sellers around the world. He can be reached at www.stevechandler.com.
20. 1001 Things You Should Know from the New Testament (Large Print 16pt) - Allen Ansdel
Largeprint (Paperback) Our price: Ł18.99 - Click book title for availability and further details
For curious readers of all ages, here is a new, fun, and thought - provoking way of looking at the Bible. This book guides readers in a treasure hunt with easy - to - find answers in every chapter of the New Testament. With no interpretation given and none required, it is a book people will buy for themselves, friends, and family.


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John Holbrook mailed me that he had written some articles that might interest us (poster and readers of Fratello :-)). The first one is an article about watch polishing with the help of this magical stuff from Cape Cod.
John also writes for watch magazines in the US. He did a review of a nice Panerai for InSync here (it is a PDF!). And for Chronos, you can find a complete Holbrook report if you click right here. The Holbrook report contains a lot of different watches. Different brands and styles, certainly worth checking out!
Have fun!
Robert-Jan Broer
Founder & Editor at Fratello Watches
Robert-Jan Broer, born in 1977, watch collector and author on watches for over a decade. Founder of Fratello Watches in 2004.
Latest posts by Robert-Jan Broer (see all)
- Keep Track Of The Value Of Your Watch Collection - Jul 28, 2017
- Introducing The Dark Sea 500m From Undive Watches - Jul 26, 2017
- Speedy Tuesday – A Fan Talks About His Speedmaster Transitional From 1968 - Jul 25, 2017


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New care models
This report looks at the different approaches being taken by MCP and PACS vanguards to contracting, governance and other organisational infrastructure. It focuses on developments at five sites: Dudley; Sandwell and West Birmingham (Modality Partnership); Salford; Northumberland; and South Somerset (Symphony Project).
Key findings
- Many of the vanguard sites would like to bring together the budgets for core primary care services and other local services, but it seems unlikely that GPs will give up their core General Medical Services or Personal Medical Services contracts in the immediate future.
- Many of the sites would like to bring together the budgets and contracting for some health and social care services, but only a small number have made substantial progress in incorporating social care.
- Many commissioners plan to contract with a single provider or entity to hold the budget and oversee or deliver a broad range of services, although most are still deciding which organisation or partnership should do this.
- Commissioning and developing new care models involves risks as well as opportunities, underlining the importance of how these models are governed, their organisational form and how risks are shared.
- Building and strengthening collaborative relationships is just as important as focusing on the technical elements of integrated care.
Policy implications
Successful care models are based on trusting relationships and collaborative organisational cultures, often developed over time, which enable clinical teams as well as organisational leaders to work together effectively. The challenge now is how to build clinical collaboration and system leadership in a statutory context that was not designed for this purpose.
The vanguards have shown just how important it is to build collaborative relationships between the organisations and leaders involved in developing new care models. Delivering results will take time, but there needs to be a focus on the relational elements of new care models as well as the technical elements.
Keep up to date
Subscribe to our email newsletters and follow @TheKingsFund on Twitter to see our latest news and content.
interested of york
It is unfortunate that you chose the acronym PACS which to a large number of doctors means Picture Archiving and Communication System aka the thing that you look at your radiology on!
This report is disappointing, as it seems to focus on the problems, but is not surprising, as the old block contacts are hard to shift, despite banner headlines in 2006 ending them. I have proposed a solution of NKICE recommended Mindfulness Based Cognitive Therapy (MBCT) 8 week courses, which teach patients and service users self care, see www.sectco.org.uk. I am trying to introduce this into Locally Commissioned Services with clusters of GPs in Brighton and Hove, which is the worst CCG in the country, but aims to be the best.
Don,t MCP's offer a vehicle for real integration and investment in community services at a time when the other structures are showing signs of crisis---a new model and structure we could all get behind Whilst governance and accountability may be complex issues don't they require some robust support in order to make a mark. They need for existing provision to work with this is also critical. Views on this would be appreciated


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|Message view
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|dean gaudet <dgaudet-list-new-ht...@arctic.org>
|Re: http://dev.apache.org/devnotes
|Tue, 02 Jan 2001 18:07:45 GMT
On Sun, 31 Dec 2000 firstname.lastname@example.com wrote: > > Brian, please add Dean to the APR group. > > > > > is there a module that does both of these? (if not, why not?) > > > > > > No, because the last time we used modules to do stuff like this, we had > > > all sorts of headaches > > > > huh, such as? > > Try checking out apache-1.3 and then httpd-docs-1.3. The httpd-docs-1.3 > checkout should be horribly broken. no, apache-1.3 is horribly broken, httpd-docs-1.3 looks to be fine. % cvs -d dev.apache.org:/home/cvs checkout apache-1.3 ... cvs server: existing repository /home/cvs/apache-1.3/htdocs does not match /home/cvs/httpd-docs-1.3/htdocs cvs server: ignoring module htdocs-1.3 % cvs -d dev.apache.org:/home/cvs checkout httpd-docs-1.3 ... no error % that's because you guys left the /home/cvs/apache-1.3/htdocs directory. assuming you guys copied all the RCS files from apache-1.3/htdocs to httpd-docs-1.3/htdocs to preserve history then you can just delete apache-1.3/htdocs. and the best option would have been to leave the htdocs directory right where it was, and make httpd-docs-1.3 a subdirectory of apache-1.3. which would have let all developers with existing checked out trees continue to function with zero knowledge of the change, and zero extra work. (this is obviously what i would have preferred, considering i already had a tree with changes checked out... instead i just gave up on the changes because i ran out of time trying to figure out wtf was wrong.) > The reason is simple. APR is a brand new project, and a good number of > the Apache developers have never committed code to APR, and have never > expressed interest in touching it. When we created APR, I didn't want to > weight APR too heavily with httpd developers, because it shouldn't be just > an httpd thing. the problem for me is that i now only contribute every N months when i get an afternoon that i'm otherwise not doing much on, and every N months i have to see what you guys have changed with just the source control (nevermind the code itself, that part i find way easier to grok changes to once i figure out how to get it). once i get through that part my spare time has run out. this is just the first time i'm complaining, 'cause i actually ran into this frustration a few months ago as well and just gave up that time. net progress: 0 contribution. call me a whiner if you want, but reorganisations generally suck ass, and for the most part, it's been reorganisations (of cvs, of directories, of names, ...) which have deterred me from being interested in continuing contribution to apache. maybe if the anon-CVS thing just works from here on out to infinity i'll just try that next time. (as you can see i tried the old unprivileged developer access -- /from-cvs/... but obviously that too needed reorganisation!) really sure you missed me eh? :) -dean
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By Alistair Gretarsson
THATTA, Pakistan, 19 October 2010 – When the floods hit the town of Belosheher in Pakistan's southern province of Sindh last August, Haleema Gafoor, 20, was in the final weeks of her pregnancy. With waters quickly submerging their home, she and her family had no choice but to flee.
|VIDEEO: UNICEF reports on the long-term, sustainable solutions to improve the health and well-being of women and children in Pakistan in the wake of the floods. Watch in RealPlayer
"When the flood waters came and we left our home, I was so pregnant and in so much pain that I was sure that I would die on the road," said Ms. Gafoor.
Ms. Gafoor and her husband finally managed to get space on a bus coming to the district's main town of Thatta. When they arrived, a local landlord allowed them to camp on his land in a vacant lot between a few houses in the centre of town.
Across Pakistan, the flood waters are now finally receding and people are returning home, often to heavily damaged or destroyed houses and devastated livelihoods. Many have been surviving in hastily built camps for weeks on end and, in some cases, for months. The long journey of rebuilding lives has just begun for most and the needs are still immense.
Mobile outreach
In conditions like these, pregnant women are particularly at risk.
The Maternal, Newborn and Child Health (MNCH) programme is a government-run programme, supported by UNICEF, which provides essential care to women during pregnancy and birth and to both mother and child in the first weeks of life. Here in Thatta, three tented MNCH centres have been set up to provide these essential services to those who have fled the flooding and are living in the surrounding camps.
|© UNICEF/Pakistan/2010/ZAK
|'Lady Health Worker' Asma Farooq gives ante-natal check-ups to a group of women in Thatta, in Pakistan's Sindh province.
Many women, however, are either unaware of these services or are unable to make the journey to the tented MNCH centres. To extend the reach of these services and to ensure that all pregnant get the care they need, UNICEF is supporting mobile outreach teams.
Each team includes one doctor, a lady health worker and a community midwife. They seek out women who are pregnant or have recently given birth and provide them with essential ante-natal, peri-natal and neo-natal care. When necessary, the team refers the patient to the nearest hospital, but distances are long and sometimes there simply isn't enough time for referral.
Birth in a tent
It was one of these teams that met Ms. Gafoor during one of their routine rounds of the camps. During an ante-natal check-up, the team, led by Dr. Rehana Rafique Memon, advised Ms. Gafoor to alert them when she was going into labour.
Yet when the day came and Ms. Gafoor called the MNCH team for help, she was already very close to giving birth. She was rushed to the tent where, within half an hour and on a simple rope bed, she gave birth to a baby girl. She named her daughter Lalee, after her grandmother.
The challenges to delivering essential services to those affected by the flooding will continue to grow in the coming months as more people return home, causing a geographical spread of those in need. The Government of Pakistan, UNICEF and the humanitarian community are rapidly scaling up early recovery efforts across the country to respond to the changing nature of this emergency.
Meanwhile, UNICEF is working to build services to reach even more people than before the floods with life-saving health, nutrition, sanitation and education services. UNICEF works on long-term, sustainable solutions to improve the health and well-being of Pakistan's women and children now and into the future.
Pakistan flood crisis 2010
Photo essay: Pakistan's children after the floods
UNICEF supports transitional schools
with video
Health centres fight malnutrition
with video
Rebuilding a school damaged by floods
with video
Improved health care for mothers and newborns
with video
Press release: Pakistan flood survivors struggle to restore their lives
Ejaz's story: After the floods, hope remains
with video
Mobile clinics reduce malnutrition in flood-hit region
with video
Providing education in flood-hit areas
with video
Supplies amidst harsh winter
with video
Families face increasing challenges
with video
Six-month update
with video
Malnutrition crisis, six months on
with video
Strategic plan tackles malnutrition
Back to school in Swat
with video
Millions brace for winter
with video
Child-friendly centres in north-west
with video
Malnutrition in Pakistan's flood zone
with video


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|Grzegorz Kossakowski <gkossakow...@apache.org>
|Re: Make status code attribute of seriailzers expandable
|Fri, 30 Mar 2007 12:09:19 GMT
Ard Schrijvers napisał(a): > Hello, > > >> Don't you have two distinct pipelines for rendering pages with forms >> included and without? I don't details of your use case but IMO it is >> good practice to have two distinct pipelines and decide in flow which >> one should be used. >> > > we rely on repository sources where the customer (the cms user) defines wether or not a form is on the page, so, no...we cannot know in our main pipeline what the headers should be > I see, it's classical example of situation where conditional (condition based on processed content) pipelines would be very helpful. Unfortunately, we don't have them (yet?). > >> Nevertheless, if you know in flow how headers should be set, why don't >> set them there? >> > > Then they only are set on the pipeline calling this flow, and according [1] these are lost in the main pipeline > COCOON-1619 is not bug IMO. It's just part of contract that internal pipelines are serve some data and do not interfere with original request. I think that was valid design decision at the time whole stuff was created. Now, the same problem applies for postable sources and servlet services. I've been thinking about it for a while and came to conclusion that information about result of processing (status code, various http headers) should be collected from all internal requests and even from pipeline components, prioritized and then information put into HTTP response should be calculated from these collected parts. Priorities would be assigned automatically based on simple rules like: when main pipeline and internal pipeline want to set the same header, main wins; when pipeline and pipeline's component want to set the same header, component wins etc. It's important at design level, see my comment here: https://issues.apache.org/jira/browse/COCOON-2009#action_12475631 Current situation where all components and pipelines have write access to whole environment is really bad because leads to the situation described in comment above. What do you think? -- Grzegorz Kossakowski http://reflectingonthevicissitudes.wordpress.com/
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text: Could DraftKings, FanDuel joining forces help sports betting? By SBR Tuesday, June 14, 2016 Share with: Daily fantasy betting giants DraftKings and FanDuel are discussing a possible merger, according to Bloomberg.com and multiple media sources. The fantasy sports operators have been in and out of court for one reason or another since the insider trading scandal first exploded during football season last year. New York's Attorney General Eric Schneiderman famously declared fantasy sports as illegal gambling back in November of last year. The AGs in Idaho and Texas were not far behind and also ruled that DFS is considered unlawful gambling. Not every state is in agreement; in fact Mississippi legalized daily fantasy sports last month. The dynamic duo joining forces would allow them to pool their resources as they battle the legality of their games in court against states like Idaho, New York, and Texas. Many in the sports betting industry as well as the political spectrum have pointed out that fantasy sports gambling is not far removed from betting on individual games, and that there is a great deal of hypocrisy in daily fantasy sports receiving an exemption from the Unlawful Internet Gambling Enforcement Act of 2006 (UIGEA). "It's a distinction without a difference," quipped New Jersey State Senator Raymond Lesniak during an interview with SBR. The daily fantasy sites have argued that they are perfectly legal thanks to the UIGEA carveout, but that hasn't stemmed the flow of opposition at the state level. In theory, DraftKings and FanDuel merging would allow the two to stop spending money competing vs. one another and focus solely on winning in court. The longer there is a debate about fantasy vs. sports betting the better, as common sense dictates that at the end of the day, gambling is gambling, and Americans want to be able to legally bet whether on the performance of athletes or the outcome of a straight-up match.


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Abraham Lincoln – a tribute on his birthday
An evening pause: On Lincoln's birthday, a tribute.
An evening pause: On Lincoln's birthday, a tribute.
For the next week my posting might be lighter than usual. Today I am heading to Israel to visit family and do a bit of sightseeing. Whether I have sufficient access to the internet to keep up with events as well as continue to post will not be clear until I get there and get settled in.
In the meantime, I will also be celebrating my sixtieth birthday while in Israel. If you have been a regular reader of Behind the Black and would like to help me celebrate this milestone with a donation to the website, I would be most grateful. The tip jar is located at the bottom of the right column, just below the search box.
Happy 100th birthday to Milton Friedman!
Go to the link to watch some wonderful video clips of Friedman clearly and with good humor explaining the benefits of freedom and capitalism. However, for me my favorite Milton Friedman quote is without question this one, on the real way to change Congress:
I do not believe that the solution to our problem is simply to elect the right people. The important thing is to establish a political climate of opinion which will make it politically profitable for the wrong people to do the right thing.
Actual video below the fold.
» Read more
An evening pause: On George Washington's birthday, an excerpt of a speech by David McCullough from September 27, 2005. As McCullough notes, even King George III himself knew the measure of the man. "He will be the greatest man in the world."
Behind the Black officially premiered July 1, 2010, and has been up and running now for twenty months. I make it a point to post often and regularly on issues of space, science, technology, politics, and history, subjects that interest me personally. Except for one short period a year ago when family matters kept me away from the computer for several days, I have managed to update the webpage frequently every day during that entire time.
Because of this, traffic to the site has steadily grown. For this I thank you, my readers, especially those who love to add their own two cents to the webpage in the comments. While I certainly do not agree with all those who comment, I very much appreciate the open and intelligent nature of the discussion.
During that time I have resisted begging for contributions. Though I added a tip jar link to the webpage about three months ago (located in the right column below the search box), I have made very little note of it because shilling for dollars seems crass, and I feel that if I am doing a good job people will naturally look for it in order to donate to the webpage to keep it going.
However, today is my birthday, so I feel I have the right to do some self-promotion. Moreover, for the past fifteen years I have made my living as a freelance science writer. The business, however, is changing, and I am finding that I am becoming increasingly reliant on the income I make from at my own website over that earned by selling articles to magazines.
Thus, if you are a regular reader of Behind the Black, please consider giving the website a donation, no matter how small. Not only would I appreciate it greatly, it will help make it possible for this website to continue and grow.


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Thursday, December 16, 2010
Virgin Galactic Aims At Orbital Flights
Not satisfied with the firm's plans to provide suborbital space tourism flights, Mojave-based Virgin Galactic said Thursday that it is now supporting work by Sierra Nevada Space Systems and Orbital Sciences, on commercial space vehicles to support orbital flights. Virgin Galactic said it is hoping to allow fare-paying passengers to experience safe, orbital space flight. Sierra Nevada Space Systems and Orbital Sciences are both working on reusable vehicles aimed at providing privately-operated, crew vehicles to deliver astronauts to orbit for NASA, via NASA's Commercial Crew Development Program (CCDEV2). Virgin Galactic said it is proposing to market seats on those vehicles to the public, as well as the its existing customers, who have already put down deposits to take trips on Virgin Galactic's suborbital vehicles to space. Financial details of the support for the firms was not details.


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Author | Abhinn Shreshtha | Friday, Aug 07,2015 7:58 AM
The first stage of the Phase III auctions seem to be winding down after 9 days of rigorous activity. Delhi just has a single bid of Rs 138 crore at the end of Day 9. Ahmedabad, Bhubaneshwar and Bangalore saw no new bids on Day 9. Mumbai has two active bids of just over Rs 91 crore for its two frequencies at the end of Day 9.
The north-east region was quiet with Guwahati not seeing any new bids for its single frequency, the provisional winning price for the city now stands at just over Rs 1.63 crore. Lucknow saw two bids for its 3 frequencies with the provisional winning bid at just over Rs 14 crore (approx). Pune also saw two bids with the highest being Rs 33.77 crore. Nagpur and Kolhapur both have one bid each of around Rs 7 crore. Nasik has two bids for its 2 frequencies for around Rs 2 crore.
Jodhpur did not see any new bids yesterday while Jaipur is still in demand with 3 bids for its single frequency and the provisional winning price at Rs 19 crore now (approx). Udaipur saw no new bids, as has been the case for the past few days. Kanpur now has 2 bids for its 3 frequencies of around Rs 8 crore. Patna has one active bid of Rs 17.89 crore.


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White Chocolate Cake
Baking By Lenette Updated 1 Aug 2008 , 3:47pm by angkimbrell
I do all my baking from scratch and tried Rose Levy Berabaum's white chocolate whisper cake.
I had the darned-est time with this recipe. I made cupcakes, some came out okay and many were crumbly. I weighed the ingredients and followed the recipe to the letter. Usually her recipes come out good for me.
Any suggestions?
Do you have a tried and trued scratch white chocolate cake recipe to share?
I made the one from Dede Wilson's book a couple times but it always sinks in the middle.
I need another option. TIA!
. . . I'll be interested in watching the replies you get for this one . . . yummo . . . can't wait for the best white chocolate scratch cake . . . bring it on . . .
Here's one from allrecipes
From recipezaar
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text: 1Vice Sportsbook completes move to RDG Corp By SBR Wednesday, February 10, 2016 Share with: Sportsbook Review reported two weeks ago that online sports betting site 1Vice (SBR rating C) announced it would be reassumed by RDG Corp. The move was scheduled for after Super Bowl 50 and took place last night. Players who have experienced issues logging in or accessing their betting accounts are encouraged to write to firstname.lastname@example.com. The online sportsbook has asked players to clear their cache and cookies before attempting to log-in. The sportsbook's manager Griffin released an email to all 1Vice players explaining the decision to move back under RDG Corp, which is most known for brands Bet33 and AmericasBookie. 1Vice Griffin: "After reviewing our current business model, it has become apparent that we have made some wrong decisions, regarding bonuses, promotions, and player risk management. After the Superbowl, the 1Vice brand, will be moving to the RDGCorp Solution, as well as, revamping our business model, to mirror OTHER successful RDG Brands. During this transition we will be auditing accounts, and closing accounts that do NOT fit our NEW business model, and making arrangements to settle those accounts in a timely manner. We are excited about this change, and with the support of RDG Corp, will can ensure the success of 1Vice, and improve the already high quality of service our clients already enjoy." Players in need of assistance with the online betting site are encouraged to submit a sportsbook complaint form.


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Who is Bernie Sanders?
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- If you live in Travis County, you can text 'Register' to 48683 – a voter registration card will be mailed to you. Re-register as many times as you need.
- Visit feelthebern.org to learn where Bernie stands on over 50 issues & help by printing some flyers!
This was created & paid for by grassroots volunteers with no official relation to Bernie Sanders' campaign (Bernie 2016) or berniesanders.com


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Science Center NEMO
NEMO Science Museum is a science center in Amsterdam, located at the Oosterdok. It was built on top of the IJ-tunnel that connects the center of Amsterdam with the north of the city. The striking building, designed by Italian architect and engineer, Renzo Piano, opened its doors in 1997. Some say the shape of the building mimics the appearance of a large boat, but others suggest that it's actually a reflection of the tunnel it was built upon.


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Important system announcements may be displayed below the login button on this page. Please scroll down to read these important announcements.
Information for students in on-line, hybrid and web enhanced courses offered by Rowan College at Burlington County can be found at http://rcbc.edu/distance-education
You can reset your RCBC Blackboard password at any time using the "Forgot Your Password?" link on this page. Please use the Username Option not the Email Address Option. For password reset instructions visit http://rcbc.edu/distance-education/reset-your-password
Blackboard (only) help is available 24/7/365 by visiting https://rcbc.edusupportcenter.com
The Blackboard helpdesk can not assist with RCBC WebAdvisor or Email.
Welcome to the Blackboard e-Education platform—designed to enable educational innovations everywhere by connecting people and technology.
Dear Students:
The RCBC Office of Distance Education creates student login accounts in batches about once every four hours. Although you may already be able to access the Blackboard system, you will not be able to see or access your course until the day it is officially scheduled to start.
If the official start date of your course has already passed, and you registered at least eight (8) hours ago and you are still unable to login or see your course:
First try to login using the instructions at http://rcbc.edu/blackboard. If that does not work, make a note of the exact step in the instructions where you ran into the issue, and the exact wording of the error message you receive. Then please contact the Office of Distance Education by email to email@example.com or by calling extension 3250 at (609) 894 9311 or (856) 222-9311. Our office hours are 9:00 am to 4:45 PM, Monday-Friday.
For evening, weekend and holiday technical support:
Technical support (for the Blackboard system only) is available 24/7/365 at https://help.edusupportcenter.com/shplite/rcbc/home or by calling (855) 699-0729. Please note that our 24/7 helpdesk does not create student accounts, but can assist you in troubleshooting and resolving most other technical difficulties with Blackboard.
We wish you success in your RCBC studies! Have a great semester.
Office of Distance Education
Rowan College at Burlington County
500 College Circle
TEC Room 102
Mount Laurel, NJ 08054
(609) 894-9311 x1790


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This module provides a generic interface to a message queue. Message queue implementations must implement the Dancer2::Plugin::Queue::Role::Queue role, which defines the interface to abstract the specifics of the backend....CROMEDOME/Dancer2-Plugin-Queue-0.006 - 26 Jan 2016 01:01:18 GMT - Search in distribution
- Dancer2::Plugin::Queue::Role::Queue - Dancer2::Plugin::Queue implementation API
- Dancer2::Plugin::Queue::Array - Single-process, in-memory queue
- Dancer2::Plugin::Queue::Role::Test - A Test::Roo::Role for testing Queue backends
This module implements a Dancer2::Plugin::Queue using MongoDBx::Queue....DAGOLDEN/Dancer2-Plugin-Queue-MongoDB-0.003 - 10 Mar 2013 02:40:42 GMT - Search in distribution
This module implements a Dancer2::Plugin::Queue using IO::Iron::IronMQ::Client....MIKKOI/Dancer2-Plugin-Queue-IronMQ-0.002 - 14 Apr 2017 18:25:29 GMT - Search in distribution
This Task installs Dancer2, optional engines, templates and assorted modules that are not included in the Dancer2 core distribution. It is based heavily on the awesome Task::Dancer distribution by Sawyer X and ambs. If you've written anything relatin...CROMEDOME/Task-Dancer2-0.06 - 09 Nov 2015 03:59:38 GMT - Search in distribution
This plugin helps you display temporary messages, so called "flash messages". It provides a "flash()" method to define the message. The plugin then takes care of attaching the content to the session, propagating it to the templating system, and then ...ESAYM/Dancer2-Plugin-FlashNote-0.02 - 18 Apr 2017 17:42:41 GMT - Search in distribution
Dancer2 aims to keep the core as small as possible, but there are a growing number of useful plugins to add helpful features. This document provides a quick summary of some recommended plugins. Plugins Dancer2::Plugin::Adapter Wrap any simple class a...CROMEDOME/Dancer2-0.205001 - 11 Jul 2017 13:04:56 GMT - Search in distribution
BIGPRESH/Dancer-Plugin-Database-Core-0.20 - 01 Sep 2016 09:01:53 GMT - Search in distribution
A very simple plugin for Dancer2 to process CAPTCHA.I needed this for my other project (in-progress) available on github <https://github.com/Manwar/Dancer2-Cookbook>. The core functionality of the plugin is supported by GD::SecurityImage....MANWAR/Dancer2-Plugin-Captcha-0.11 - 24 Apr 2017 13:51:07 GMT - Search in distribution
This module provides two methods "get_csrf_token()" and "validate_csrf_token($token)". Master token stored in session. CSRF tokens generated using master token and page uri....JUMPERCC/Dancer2-Plugin-CSRF-1.01 - 25 Dec 2016 11:17:57 GMT - Search in distribution
Provides an easy way to obtain a connected DBI database handle by simply calling the database keyword within your Dancer2 application Returns a Dancer::Plugin::Database::Core::Handle object, which is a subclass of DBI's "DBI::db" connection handle ob...BIGPRESH/Dancer2-Plugin-Database-2.17 - 13 Aug 2016 13:01:45 GMT - Search in distribution
This module makes easy to obfuscate internal IDs when using them in a URL given to users. Instead of seeing <http://example.com/item/42> users will see <http://example.com/item/c98ea08a8e8ad715> . This will prevent nosy users from trying to iterate a...SHARDIWAL/Dancer2-Plugin-EncryptID-0.03 - 30 Jul 2016 09:34:21 GMT - Search in distribution
[The Dancer2 plugin was contributed by Andrew Beverley] This module provides easy access to the extensive logging facilities provided by Log::Report. Along with Dancer2::Logger::LogReport, this brings together all the internal Dancer2 logging, handli...MARKOV/Log-Report-1.21 - 03 Jul 2017 13:33:02 GMT - Search in distribution
A flash is session data with a specific life cycle. When you put something into the flash it stays then until the end of the next request. This allows you to use it for storing messages that can be accessed after a redirect, but then are automaticall...SHARDIWAL/Dancer2-Plugin-Flash-0.03 - 30 Jul 2016 05:38:19 GMT - Search in distribution
This is an honest attempt to make Dancer::Plugin::Res to be Dancer2 friendly. It should behave same as it's twin as nothing has changed in functionality. I needed a Dancer2 compatible version of Dancer::Plugin::Res for my other work available on gith...MANWAR/Dancer2-Plugin-Res-0.07 - 23 Sep 2016 09:25:33 GMT - Search in distribution
A very simple plugin for Dancer2 for chaining routes.I needed this for my other project (in-progress) available on github <https://github.com/Manwar/Dancer2-Cookbook>....MANWAR/Dancer2-Plugin-Chain-0.08 - 17 Sep 2016 06:26:51 GMT - Search in distribution
- Dancer2::Plugin::Chain::Router - Helper package for Dancer2::Plugin::Chain.
This plugin will allow you to retrieve a text file using Dancer2 and display it in an html page. Also, it will save the edited file to it's location on the server. It's designed to be flexible and unobtrusive. It's behavior is customizable through Da...JACKB/Dancer2-Plugin-EditFile-0.005 - 18 Feb 2017 11:38:23 GMT - Search in distribution
This plugin gives you the ability to do A/B testing within Dancer2 easily, using <http://sixpack.seatgeek.com/>. It handles the client_id transparantly through Dancer2's Session plugin....BLOM/Dancer2-Plugin-Sixpack-0.03 - 30 Dec 2015 10:29:12 GMT - Search in distribution
This plugin can be used to verify if routes that are used as Github webhook payload URL use the correct secret....DSONNTAG/Dancer2-Plugin-Github-Webhook-0.01 - 01 Jan 2017 14:48:20 GMT - Search in distribution
VANHOESEL/Dancer2-Plugin-HTTP-Bundle-0.02 - 09 Dec 2015 21:28:49 GMT - Search in distribution
VANHOESEL/Dancer2-Plugin-HTTP-Caching-0.01 - 21 Nov 2015 17:14:38 GMT - Search in distribution


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Copy the jailbreak file, paste on USB and then install jailbreak to your PS3 console.
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