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Viewing: Maritime History
July 6, 2017
Port Noarlunga Anchor's Anniversary
The 'big' anchor at Port Noarlunga reef has been there as long as I have known, but only just. It was apparently placed in position at the reef just under two weeks before I did my first dive there. It was years before I got to see it though. It was Sunday 22nd January 1978 when divers moved the anchor from where it had been buried in sand to a rocky area where it would be seen more by divers….
Posted in Dive Reports, Maritime History | By Steve Reynolds
May 10, 2017
Normanville Jetty and Hotspot
David Muirhead says that the Normanville jetty is "a pretty poor excuse for a jetty". "I have, however, found some surprisingly good photographic subjects on the piles at high tide, which is all the more titillating given the entire jetty can be above the water mark," he says. (The present jetty is the second Normanville jetty. The first one was a short distance to the south of the current one but, after severe storm damage, it was decided that repairing…
Posted in Bony fishes, Dive Reports, Jetties, Maritime History, Syngnathids | By Steve Reynolds
May 3, 2017
The Rescue of Australian Prisoners of War following US attack on Japanese ships during WWII
In 1944, hundreds of Australian and British prisoners of war (PoW) held by the Japanese were briefly held at the River Valley Road Camp in Singapore. They were then going to be sent to Japan to work in coalmines there. A convoy of eight vessels with PoW onboard left Singapore on 6th September 1944. The vessels in the convoy comprised of the 10,000-ton Kachidoki Maru (formerly the American ship President Harrison), two oil tankers, two cruisers, a corvette, another small…
Posted in Maritime History | By Steve Reynolds
April 30, 2017
South Australians onboard the final voyage of the Titanic
I had a bit of a surprise when I visited the cemetery at the Aldinga Uniting Church recently. I had gone there to photograph the Star of Greece memorial there. Star of Greece memorial (Taken by Steve Reynolds) I found a couple of graves in the name of McRae near the memorial. What caught my eye was a headstone for the McRae family with a reference to the Titanic. The headstone for the McRae family (with a reference to the…
Posted in Maritime History | By Steve Reynolds
April 13, 2017
Update on the wreck of the AV Ulonga
This photo of the AV Ulonga at the North Parade Wharf in Port Adelaide was posted on the Facebook page for The South Australian Ketch Fleet recently: – The Ulonga at Port Adelaide circa early 1960s (Source: https://www.facebook.com/234583500036716/photos/a.237879926373740.1073741831.234583500036716/775086302653097/?type=3&theater ) It came with these details: – "Three mast auxiliary schooner "Ulonga", at North Parade Wharf, Port Adelaide, sometime in the very early 1960's. The bow of the ship near her bow belongs to the schooner "Coringle", also engaged in the same…
Posted in Maritime History, Shipwrecks | By Steve Reynolds
February 28, 2017
"My Wheels" At Second Valley
I love to see "my wheels" when I dive at Second Valley jetty. It's great when I come across them during my dives there. I'm talking about large cartwheels and 'truck sets' that are in the bay between the jetty and 'boat shed island'. I described these wheels in my articles titled "The Existence of an 'Underwater Trail' at Second Valley Jetty", "The Various 'Jetties' at Second Valley" and "More About the Wheels at Second Valley" in our 2011 Journal….
Posted in Dive Reports, Jetties, Maritime History | By Steve Reynolds
December 8, 2016
The unveiling of Reg Sprigg's dive chamber at the Patawalonga, Glenelg North, SA
A long list of lucky events led to me attending the recent unveiling of Reg Sprigg's dive chamber at Glenelg North (with my wife Noeleen). The dive chamber has been positioned adjacent to the Buffalo replica on the banks of the Patawalonga. Our Patron, Scoresby Shepherd had suggested that I try to get approval to attend the official unveiling. An email request to a namesake sealed the deal for Noeleen & I to attend the event. A good crowd had…
Posted in Equipment, Events, Maritime History | By Steve Reynolds
October 9, 2016
The Exposed Remains of the Original Port Willunga jetty & the Wreck of the Ida
The Star of Greece Café is close to a shipwreck, and it's not the wreck of the Star of Greece! The wreck of the Ida is down on the beach below the café. The wreck isn't always visible as she is usually buried in the sand on the beach. She is said to have been "driven ashore about 100 yards south of the jetty". Not the old jetty mind you. She is located mid-way between the old jetty and the…
Posted in Maritime History | By Steve Reynolds
October 6, 2016
Sue Simmonds recently sent me the following email message regarding her late father's love of the Shandon: – "Hi Steve, The "Shandon" was dad's favourite ship, he loved sail and was probably born fifty years too early. I've also attached a photo of the "Shandon" taken from the "Mount Stewart" off the Coast of Chile in 1918 as mentioned in the story, also a copy of a sketch that Dad did of the "Shandon" plus the letter from the Master…
Posted in Maritime History | By Steve Reynolds
September 9, 2016
Follow-up on the Schooners Lemael & Booya
I had previously written a series of articles regarding a number of sailing ships, but two in particular – the Booya and the Lemael. The series started with "Cyclone Tracy Shipwrecks" in our April 2005 newsletter (No.320). This was followed by "More About the Booya" in our July 2005 newsletter (No.323). The third article was titled "The Wreck of the Schooner Lemael" and it was published in our June 2007 newsletter (No.344). The final one in the series (until now)…
Posted in Maritime History, Shipwrecks | By Steve Reynolds


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This week we begin our second round of case studies! We will talk about how humans use energy, though our discussions will mostly revolve around one of the biggest controversies of our time, "peak oil." What is peak oil? Is it a myth? How much energy do we really use, and what is the most sustainable way to plan for our energy future?
The Game Plan
- The background of our energy case studies…
- Opinions vs. Facts
- Energy Case Studies
In Class Resources
Additional Resources
- Google's Public Data Explorer
- History of Energy Use in the United States
- The Independent: Oil Supplies are Running Out Fast
- MIT Faculty Newsletter: Solving the Energy Problem
- The Myth of Peak Oil

subset: commoncrawl


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Rate of fatal work injuries rises with age
August 17, 1999
Workers age 65 and over had the highest workplace fatality rate of any age group in 1997. There were 13.8 fatalities per 100,000 workers among those who were 65 years old and over, compared to an overall rate of 4.7 fatalities.
[Chart data—TXT]
The occupational fatality rate rose with each age group. The youngest workers shown in the chart, age 16 to 17, had the lowest rate, at 1.5 fatal injuries per 100,000 workers. For the next group, 18 and 19 year olds, the rate was nearly twice as high (2.8). With each successive group the rate increased, with the biggest change occurring between 55-to-64 year olds and those 65 and over. Differences in industries and occupations accounted for some of the variation in risk among age groups.
These data are a product of the BLS Safety and Health Statistics Program. Additional information is available from "Fatal Workplace Injuries in 1997: A Collection of Data and Analysis," BLS Report 934.
Bureau of Labor Statistics, U.S. Department of Labor, The Economics Daily, Rate of fatal work injuries rises with age on the Internet at https://www.bls.gov/opub/ted/1999/aug/wk3/art02.htm (visited August 23, 2017).
Recent editions of Spotlight on Statistics
Women in the workforce before, during, and after the Great Recession
A look at trends and projections in the labor force participation of women from the 1950s to 2024.
Employer-sponsored healthcare coverage across wage groups
A look at the relationship between employee wages and access to, participation in, and costs of employer-sponsored medical, dental, and vision care benefit plans.
Sports and Exercise
A look at participation and time spent in sports and exercise activities.
Women at Work
A look at women's labor force participation and earnings, how women spend their time and money, the nature of fatal work injuries, and labor force projections for the future.


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Accession Number : ADD001889
Title : Technique for Fabricating Vacuum Waveguide in the X-Ray Region.
Descriptive Note : Patent,
Corporate Author : DEPARTMENT OF THE NAVY WASHINGTON D C
Personal Author(s) : Anderson,John P
Report Date : 08 Jul 1975
Pagination or Media Count : 3
Abstract : This invention pertains to a method of fabricating vacuum waveguides in the x-ray region. It comprises the following steps: (a) Selecting an optically flat substrate; (b) Depositing a film of metal on the substrate; (c) Photoetching a line corresponding to the width of the waveguide in the metal film; (d) Selecting a parylene pellicle; (e) Depositing a metal film on one side of the pellicle; (f) Depositing a film perpendicular to the length of the waveguide on the opposite side of the pellicle; (g) Placing the pellicle in fixture which applies slight pressure to the pellicle (stretching the pellicle over the substrate); and, (h) Evacuating the fixture.
Descriptors : *Patents, *Waveguides, *Vapor deposition, *Plating, X rays, Vacuum chambers
Subject Categories : Physical Chemistry
Test Facilities, Equipment and Methods
Distribution Statement : APPROVED FOR PUBLIC RELEASE


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bbesore Review
Very nice desk at reasonable price
This desk an attractive solid wood item. It was easy to assemble (and I'm not very handy) and fits perfectly in a small corner of a guest bedroom.
- How did the color on site compare with the actual product? match
- Please tell us about the quality of the product. nicely made
- How accurate was the on site description of the product? very
Was This Review Helpful?


text: I'm going into ninth grade this year and I'm playing football. in 7th and 8th grade i had to play wide receiver even though i really wanted to play quarterback. I can throw a football 50 or so yards but ever since i entered the 7th grade i can't throw a football more than once before i get severe pain in and around my elbow. what is going on??


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- Trending Now: More Trending:
- Svengali syzygy hegemon repugnant white nationalist, white supremacist
commendatory letter
Definition of commendatory letter
: a letter of commendation; specifically : a letter of introduction testifying to an individual's good standing in a church and given by a bishop to a traveling member of his diocese or to a cleric transferring to another diocese
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|The first picture of my Mini after getting it in November of 2006.
Saturday night I ran a quick errand. Little did I know that it was the last time I would be driving my beloved Mini Cooper. The transmission died as I was exiting a parking garage at Hollywood & Highland. I was hurrying because I didn't want to pay more than the already overpriced $2. Later, the mechanic would estimate that a new transmission would cost around $7,000. With not even seven hundred dollars in the bank, seven thousand was going to be impossible.
While the Mini is obviously just a car, it has however, been a dependable friend throughout my five years in Los Angeles. I could always count on my 'Silver Bullet' to be there for me and get me where I needed to go. It was security. It was freedom. It was also the first thing in my entire life that I handled completely on my own from the initial purchase to payments and insurance to gas and repairs. I was always proud that regardless of my money troubles over the years, I managed to remain responsible in my decision to buy and care for it.
I bought the silver 2003 Mini Cooper slightly used from a Lexus dealer in November of 2006. I had just moved to Los Angeles in September to focus on acting and comedy while finishing my library degree. I'd been driving a rental car while I figured out if I wanted to stay. After swearing that I would never do PR again after 2003, I caved and accepted a position working for a man who was paying me a ridiculous amount of money to take him to red carpet events so he could be "famous." I hated it, but I was making good money and knew it was temporary until I got a librarian job.
I remember that first test drive in the Mini. It was dark, probably around eight at night, and I was speeding down the PCH. The windows were down, the sunroof was open, and the whole time I was thinking, I did it. After leaving NYC in 2004 confused and disappointed, I spent the next 2½ years repairing myself and getting out of debt. I had accomplished a great many things and was enjoying the moment. I knew the car was just the beginning of the many successes I would find in LA. I knew this time, I would find lasting success and happiness because I was a different person now. I was grounded. I had experience. I was going to be a librarian who told jokes.
That Mini took me to places I never imagined: countless jobs that didn't last; auditions where I didn't get the part; comedy performances where nobody came; and moved me in and out of five different residences. There were several road trips too, the most important being in November of 2009 when my brother and I drove it back to Florida so I could finish my Masters degree, where a year later, my dad and uncle would then drive it back to Los Angeles, because I was too busy with jobs to do it myself. The battery would die along the way, perhaps an indicator that trouble was on the horizon.
I met the love of my life in that Mini, where two years later he would also break my heart, ironically just before he was going to drive it across the country without me. It was like the Mini knew before I did that my relationship was really over, and the time spent repairing myself hadn't made a difference to him. Perhaps one day when my heart heals, I will once again be open to driving in the carpool lane. Sometimes traffic is easier to take when you have someone to ride with, but until then I will enjoy cutting off men in Porsches. I mean, if you are going to get in an accident, make it a possible love connection, right?
So you can see that the Mini was never just a car to me. It was a symbol of freedom and protection. I call it the 'Silver Bullet,' not because I like Coors Light, but because I kind of thought of the Mini as my protection against the many monsters in Los Angeles. No matter how many times they tried to take me down, I could fight them off by putting up the windows and taking a few deep breaths. The Mini was also my way out. When things would get to be too much, I would drive down to San Diego or over to Big Bear and see friends who would tell me I was strong and should keep fighting.
Sadly, the damages to the Mini are just too large for me to repair this time. Like that car, I will finally admit that I too am broken. The body looks good but under the hood is years of wear and tear, resulting in a much bigger problem that can't be fixed so easily. At this point in my life, I just can't afford any more bumps in the road no matter how clear that street seems to look on certain days.
It's like when you are on a road trip and you know you should stop for gas but keep telling yourself that if you can make it 10 more miles, you get the exit with the Wendy's. Then you see a sign for an In-N-Out, which is only 20 more miles, even better, you think. Then there's a sign for Red Robin in just 40 miles? Jeez, you are caught up in so many reasons why you should keep going that you ignore the reasons you shouldn't – YOU ARE OUT OF GAS!
Most of the time, your procrastination doesn't really change the course of your trip in a major way, but once in awhile fate steps in and your car slows to a stop. You are now in the middle of nowhere and there are coyotes approaching the vehicle. You kick yourself for liking hamburgers and seeing the signs but not paying attention to what they were really saying. A burger would be awesome but there is no guarantee you will ever taste them. And of course, sometimes in life, we just run out of gas.
Had it been another nail in the tire, a dead battery, or coolant hose, I would fix it and probably continue down this same road that I have been driving for the past five years. Seriously, this road has a ton of potholes but I keep driving and buying tons of crap I don't need from stupid gift shops thinking it is going to make the trip more exciting so when I finally get to my destination I am going to look fabulous! Listen, nobody needs 75 T-shirts when you never leave the car.
Anyway, I think my Mini is trying to help me one last time. It is saying STOP.
Without a transmission, a car cannot go backwards or forward, it just sits in neutral until somebody is annoyed and pushes you out of the way. You can make the decision to remain in the car knowing that you won't be going anywhere, or you can turn the car off, open the door, and get out. I am choosing to get out while I still have the strength to continue the journey on foot, or bus, or rickshaw, or whatever.
As usual I have no idea where I am going. It might be a rest stop, it might be a racetrack, and it might be back to NYC, a place I have always regretted leaving (that also doesn't require a car. Hmmm.) What I do know is this - the higher power I am trusting to take the wheel of my life will not leave me stranded on the side of the road. That's why I have AAA (and something called faith.)
***In addition to the Mini, my library studies were the only other stable thing I had during my time in Los Angeles. I thought of quitting on numerous occasions, even took a semester off or two, but it was in graduating with that Masters degree that gave me the confidence to try Los Angeles this second time. I think it is fitting that my Mini was in Florida so I could drive it to graduation - probably the most important trip of my life. I am therefore thankful that the two things that cost me the most money – my car and my Masters degree - ended up paying off in some great adventures and many life lessons. Plus without them, I doubt I would have lasted this long. I also want to mention that while a car only loses value over time, a college degree will do the exact opposite. Invest in your mind and you will truly have the freedom to go anywhere…
|Taking the Mini down Lombard Street
in San Francisco, November 2008.
|My brother and I just before we drive the Mini
back to Florida, November 2009.
|Using the Mini to move out of a bad living
situation, November 2010.
|The Mini's transmission dies and is hauled
to the garage, December 2011.


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Explore self-published books, artist editions and recent publications from independent publishers with a focus on photography at the Warte für Kunst. kijk:papers will be accompanied by book launches, artist talks and presentations.
Thursday June 04, 2015 /// 3:00 – 10:00 pm
3:00 pm /// We're open
You're welcome!
4:00 pm /// Talk with Hanna Zaenker, Sabine Niggemann and Natalie Richter
Hanna Zaenker, Sabine Niggemann and Natalie Richter studied photography at the Folkwang University of Arts, Essen. During the talk they will present recent publications.
Friday June 05, 2015 /// 2:00 – 10:00 pm
2:00 pm /// Signing & booklaunch with Daniela Risch (DE)
Daniela Risch will launch her recent publication 'vanishing into thin air' (2015) during kijk:papers. Her self published book comes with a poem by Ulrike Almut Sandig. Daniela Risch studied at the Ostkreuzschule for Photography Berlin (Prof. Ute Mahler), the Academy of Media Arts, Cologne and the Folkwang University of Arts, Essen. In 2014 she was granted with a scholarship of the Stiftung Kunst & Kultur, Dresden.
3:30 pm /// Sarah Pedde (DE) presenting her work 'Handlungen für ein zersplittertes Bild – Archiv der Gesten'
Sarah Pedde studied photography at the University of Applied Sciences Bielefeld, Faculty of Art and Design and will start her studies in Visual Arts in Vienna from on autumn 2015. In her work she focusses on transfering and handling of images into different materials and media. At present she is engaged in art history publications and their transfer into sculptural.
6:00 pm /// Harvey Benge (NZ/FR) presenting his photobook work
"My interest lies in the strange anthropology of cities, observing and making photographs of the unusual and overlooked in the human landscape where nothing is as it seems. I make photographic series which evolve into bookworms." Harvey Benge lives and works between Auckland (NZ) and Paris (FR). He conducted workshops at the AUT University, Auckland and the Lichtblick School, Cologne, in colaboration with artists like Pieter Hugo, Rineke Dijkstra, Antoine d'Agata and Lewis Baltz. His list of bookworks meanwhile counts more than 40 titles.
7:30 pm /// Tommaso Tanini and Marco Paltrinieri (IT) on Discipula Editions and their recent publication 'H. said he loved us'
Discipula Editions, founded by M.F.G. Paltrinier, Mirko Smerdel and Tommaso Tanini, can be seen as a collaborative research platform operating in the field of photography and visual culture. "As a means through which to bring art projects outside more conventional and institutional spaces and to question the distinctions between creation and production, Discipula is committed to designing, self publishing and distributing its works as limited edition books and other printed matters."
Saturday June 06, 2015 /// 2:00 – 10:00 pm
3:00 pm /// talk with Jan Kiesswetter, Alina Schmuch and Jan Wenzel (DE) / spector books
6:00 pm /// talk with Lotte Reimann (DE/NL)
Lotte Reimann studied photography at the University of Applied Sciences Bielefeld, Faculty of Art and Design and the Gerrit Rietveld Académie, Amsterdam. She had been supported by notable institutions such as Kunststiftung NRW, Stiftung Kunstfonds and the Mondriaan Fonds. Her works 'Jaunt' (2014), 'Bis morgen im Nassen' (2013) and 'Guffaw' (2011) are either self-published or cooperations with Art Paper Editions (BE) and RVB Books (FR). During her lecture she will especially focus on the handling of found footage material in relation to her artistic work.
7:30 pm /// Sven Lindhorst-Emme (DE) presenting his work as a bookdesigner
Sven Lindhorst-Emme works as a freelance graphic designer and teacher for communication design at the Lette Verein Berlin. His work specially focusses on the conception and the design of photobooks. With 'Beyond Cold War' (2014), 'Dear Clark' (2013), 'Be good' (2012) and 'Beyoğlu Blue – Purple Edition' (2010), four of his works will be on view at kijk:papers. Sven Lindhorst-Emme will talk about his work on these 4 projects (among others) and his very own approach to designing photobooks.
Sunday June 07, 2015 /// 1:00 – 5:00 pm
1:00 pm /// black coffee with malenki.net
Katrin Kamrau and Robert Schlotter introducing the platform for photographic editions malenki.net and their project kijk:papers. Everybody is welcome for a fresh black coffee.


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Check Out the Magnetic Platform
May 31, 2013
WOW Why didn't I think of this?
Can't wait to play with mine when it comes next week.
WOW Why didn't I think of this?
Can't wait to play with mine when it comes next week.
Today we unveil the new catalog at 2 p.m. eastern time. A few more hours to wait but I wanted to share the cover with you and my new video series "What's Up With Stampin' Up!?" Where ever Friday I will share new product. Today after 2 p.m. it will be the last time you can order from all three catalogs the Spring, 2012-2013 retiring items and the new 2013-2014 plus there is special
25 percent off three of our greeting sets!
No limits and get them on any order type (workshop, customer, demonstrator, or online).
Dates: May 31-June 30, 2013
I'll upload pics of sets once the shopping cart opens up today at noon (MT) These are all in the current catalog too.
SASSY SALUTATIONS Page 39 of the new catalog
#126707 Clear Mount Reg.17.95 now 13.46
#132070 Wood Mount Reg. 23.95 now 17.96
SWEET ESSENTIALS Page 41 of the new catalog
#126457 Clear Mount Reg.14.95 now 11.21
#132085 Wood Mount Reg. 23.95 now 17.96
PETITE PAIRS (one of my most used sets!) Page 73 of new catalog
#122497 Clear Mount Reg. 20.95 now 15.71
#128706 Wood Mount Reg. 28.95 now 21.71
Remember a $50 on-line order and I will send you the new catalog.
Okay my last farewell post to the retiring Stampin' Up! stamp sets and accessories. Love this card done with the Bordering on Romance Stamp Set and my favorite verse set Curly Cute. Check out the Designer Frames Folder to highlight the flowers. Next post will be new items from the 2013-2014 Stampin' Up! Catalog. Have yours? If not go place that $50 order so you can receive your catalog in the mail.
DO NOT MISS TOMORROW May 31, 2013 NEW VIDEO SERIES
As I show you fun new products each week in this new series.
Okay Baja Breeze and Elements of Style Stamp Set retiring is really hard to take. Blue is my favorite color, and Baja Breeze well love it, but all good things come to an end at some point in the stamping world to make room for bigger and better things. Have you seen the new 2013-2014 Catalog? Don't forget to get that $50 order placed in my on-line store today and get Elements of Style Stamp Set or the many other items that are soon to be retired.
Watch new video series starting May 31, 2013--What's up with Stampin' Up!? Unveiling what's new with Stampin' Up! in the new Stampin' Up! Catalog. You don't want to miss.
Saying final goodbye to Curly Cute Stamp Set is hard, as I love this verse set along with the Bordering on Romance Set. This card we did at my retirement party. Wisteria Wonder should be a retiring color but will become a new standard color in the new catalog. Don't have your new catalog remember a $50 order in my on-line store and you get one mailed right to you. The 3/8" Ruffed Ribbon will be retiring so make sure you get that on your order soon.
Watch new video series starting May 31, 2013--What's up with Stampin' Up!? Unveiling what's new with Stampin' Up! in the new Stampin' Up! Catalog. You don't want to miss.
As I say my finally farewell to Manhattan Flower Embossing Folder, I am announcing a new video series starting Friday. "What's up with Stampin' Up!?" Don't worry every Tuesday I am committed to the Creative Fold Videos, but now on Friday I will do a new video series of "What's Up with Stampin' Up!" introducing the new with Stampin' Up!. Like the new title? It was my darling husband's idea for the name. Don't have the new catalog that we can start ordering from on Friday? Place a $50 order at my on-line store at the top of this blog and I will send you a copy. Until Friday happy stamping.
Why is it so hard to say goodbye to some stamp sets? French Foliage is one of the sets. Guess me loving fall is part of the reason, but I truly love this set. Do you have in your stamp collection? If not you only have a few short days to add it as it is retiring along with Vintage Wallpaper Folder. Don't forget if you order $50 or more in my on-line store I will send you the new 2013-2014 Stampin' Up! Catalog.
The Blossom Builder Punch will soon be retired and we used at my Retirement Party to create this card. First we punched out 2 sizes of petals and ran the smaller one through the Polka Dot Embossing Folder and the large petals through the Petals-a-Plenty Embossing Folder. We used a circle punch for the base to attach our flower petals to made it easier to form our flower. The Top Note Bigz Die was used for the background and the already retired Embossing Folder Elegant Bouquet Folder. That is why with Stampin' Up! accessories if there is something you want you better get now, because accessories are only available while supplies last. Another item retiring at the end of the month is the 5/8" Flower Trim found in the Occasions Catalog. Gosh I am going to hate to see that retire as I love it, it adds no bulk to your cards, so no added postage is needed when sending through the mail. The Designer Paper and Ink used is the Island Indigo, which is an In Color that should be retiring but instead is part of the color refresh.
Over the next couple days I want to share some of the cards we made during my Stamp-a-Stack of retiring stamp sets. This card was done with the Best of Everything Stamp Set. Since I own this set in clear, we were able to color the design in with the Stampin' Write Markers and stamp it once, verse and branch together. Doesn't get easier than that. Don't have this set? You need to hurry as it will retire soon. Remember you can order 24/7 online here.
Another card I received from Jill Olsen using the Tasteful Trim Bigz XL Die for the Big Shot and the soon to be retired Print Poetry Designer Series Paper. Jill had sent me a similar card a year or so ago. I loved the look showcasing several different papers, so I did a YouTube Video showing how to do this technique with the release of last year's In Colors watch here. I may need to do this to spotlight the new in colors this year, that will be released on May 31. Watch for exciting new product base class samples in the coming days. The words come from the stamp set Curly Cute which is a retiring stamp set. Check out all the retiring items here, and make sure you get them for your stamp collection before they are gone for good.


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- Another round! Ephrata Brewfest back for second year
- This summer, at the movies…
- Easter Egg Hunt List
- Irish dance showcase at Warwick High School
- Roots and Blues 2017
- Reel Reviews: 2017 Oscar picks
- 'American Idiot' at EPAC
- Warwick grad producing 'Million Dollar Quartet' at Dutch Apple
- 'Somewhereville Station' revisits the 50s and 60s
Sweigart's Market owner dies at 98
John J. Sweigart, 98, formerly of Denver, passed away Wednesday, May 18, 2011 at United Zion Retirement Community in Lititz.
Born in Denver, he was the son of the late Scott S. and Ida E. (Hartman) Sweigart. He was the husband of the late Lillie M. (Hertzog) Sweigart, who passed away in 2004.
John was the oldest and longest living charter member of Trinity United Methodist Church in Denver, where he had served as a Sunday school teacher for many years.
John was a former volunteer for Red Cross and traveled locally and nationally to assist in disaster relief. He was chaplain at Ephrata Community Hospital and also volunteered in other capacities. He was a former Denver Lions Club member and past president. He was the last of his Denver High School Class of 1931.
John and his wife owned and operated Sweigart's Market for 35 years. He was also a counselor and business manager at the United Methodist Church Camp in Mt. Gretna.
He is survived by his two children: Harold J., husband of Virginia A. Bard, of Fort Mill, S.C.; and Eileen J., wife of John W. Schindewolf, of Cheshire, Conn.; numberous grandchildren; great-grandchildren; and great-great-grandchildren.
Funeral services were held May 23 at United Zion Retirement Community with the Rev. Ethan L. Levengood officiating. Interment took place in Fairview Cemetery.
In lieu of flowers, memorial contributions in John's memory may be made to the charity of your choice.
Arrangements were made by Roseboro Stradling Funeral & Cremation Services Inc. Online condolences can be sent to roseborostradling.com.
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Wendy Stauffer says:
Amy Wells says:


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Each state demands that drivers carry responsibility automobile insurance in case they're revealed to be responsible in a vehicle accident. The Post Office UK offers customers a quote on travel insurance in just 15 seconds and their policies have won many awards and much recognition form within the travel industries, they even promise to pay off claims fully within five days. Hi, an Indian travel agent said I could get a one way flight to India (Bangalore), but i really got the feeling he just wanted to make a sale. Individual health insurance would be a financial impossibility, costing about 60 dollars a month- a whopping $720 a year for each partner. Carriers do not support the idea of the dual-SIM phone This is because it makes it easier for consumers to swap to different companies.
Since the fact that your car is more likely to be hit only means that someone else will be responsible for the bill you only have to ensure that you have the added coverage to make up any difference that their insurance policy will not cover. The pyramids, for one, were built centuries prior to the Hyksos invasion, and there is, of course, no direct connection between the Cairo Museum and either of these cultures. Therefore being alert and having full information about the policy would be the best solution of you not having types of frauds from any one. Rejections are cause by things like submitting incorrect policy numbers, enrollee numbers, patient birth dates, or sending the claim to the wrong insurance company.
Backpacker holiday insurance covers you with the expenses which may occur to you during the travel like lost baggage, cancellation of trips or sometimes flights, accidents and unexpected or uncertain events which may happen during your journey. After the application is received and accepted by a travel company, a company recruiter will usually contact you over the phone or by email to talk about your destination preferences and the availability of work in those specific locations. Other tourism trends include celebrity tourism, where tourists will do leisure activities which involve showbiz events and some popular film sites, educational tourism, where people travel to gain knowledge overseas about the different cultures and ideas to gain more insight. It is crucial to maintain liability vehicle insurance in the event of an accident.
Once-a-year insurance plan for instance is a insurance policy that may be opened up as well as maintained quite easily without continual phone calls and time invested being concerned about discounts and short comings. Schengen Visa will allow anyone including Filipinos to travel and visit 22 European countries and 3 non-European in just one visa. The amount will vary from policy to policy therefore it is important to take note of the deductible which will have to be paid before the insurance company pays anything.
Take over-the-counter anti-inflammatory medication, such as ibuprofen, when you travel. Cover for such events allows the largest companies to recoup losses ranging from about $250 million to $1 billion, according to Russell Kennedy, a divisional director at insurer Brit. Meanwhile, coverage for medications, which may cost consumers hundreds of dollars every month, is no different in the diabetes plans from that in other gold plans. In order to deal with them efficiently and return home safe, it is important to have an adequate backpacking travel insurance cover. Chi-squared tests and generalized estimating equations, a type of multivariate analysis, were used to test for associations between density level, travel distance, other patient characteristics and receipt of RT. And if you're a frequent traveller, our annual travel insurance may suit your needs.
The underwriters of the insurance companies, that sell these Travel Medical Insurance are usually rated by independent rating companies, that determine financial strength of these Underwriters. A broad form policy must meet the Insurance Services Organization (ISO) requirements to provide additional protection against financial loss as a result of specific conditions. Your travel agent will either be able to match it or tell you why you're setting yourself up for a scam. Trip cancellation insurance generally covers such things as recouping your money if you have to back out of a trip, depart early, or if your travel provider goes out of business or claims bankruptcy.
You are automatically covered for up to $3,000∞ rental car insurance excess on the International Premium Plan. Most of the time, travel insurance can be arranged with your travel agent, and it can cover you up until the trip is over and you return to your place of origin. The Financial Conduct Authority (FCA), set up in 2013 to crack down on customer rip-offs, said its study of 15 unnamed insurance companies and their agents found widespread examples of poor practise. Beginning January 1, 2014, most people will be required to maintain health insurance, and individuals who do not obtain health insurance will have to pay a penalty under the federal Patient Protection and Affordable Care Act of 2010. They have to negotiate the terms of insurance policy with the insurers to get the best deal for their clients. The remaining six percent bought travel medical insurance, medical evacuation insurance or both.
Noncompliance has been the norm for a huge segment of the small business community as a whole and vending companies are a big segment of that noncompliance number. This means a quick response from the K & R insurance provider is one of the most helpful aspects of any policy. It is important to read all of the literature on the policy before deciding to go with this plan. Hindi po pagsinabing Georgia is Georgia in USA may Georgia pong country and hindi po sya masyadong pinapasyalan kasi hindi safe sa mga babae.Ganun din mo yung mga nasa list ng Africa. I used to use foreign currency TCs when you could purchase them fee-free at the AAA office.
If you need help comparing policies or just need a rundown of how this type of insurance works, consider using sites like Squaremouth and InsureMyTrip. To apply for a special annual health insurance card, you need to present a letter of admission from the school you are going to attend, a copy of your birth certificate and a letter requesting extended insurance coverage. Life insurance comes in different types, e.g. Mortgage Protection, Level Term, Convertible Term, Whole of Life, Section 60 Life Cover and serious illness cover. For nonemergency care overseas you may be covered but probably will have to call your insurance company or HMO in the United States for all for treatments that need to be authorized.
However, if you tripped over your own feet in a museum and smashed a £1,000,000 vase while on holiday, insurance payouts would be necessary to cover the costs over the £500 excess that you would pay. Worldwide travel insurance coverage may not be necessary in countries where health care is the responsibility of the government. Here are some of the most common millennial misconceptions about car and health insurance , as well as a few tips for getting the facts straight. The insurer should choose a suitable policy which takes into account such as theft, but other events such as: fire.
Itrrrs important exposure for legal reasons in addition to suggests the money all of the insurance provider will pay in the circumstance for physical injury or simply property damage attributable to manner of an advert truck or van on the illustration showing a good car accident. U K Insurance Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. In exchange for the payment of a premium, the insurance company promises to provide compensation in the event of certain occurrences. A decent cheap family travel insurance policy is a vital purchase families travelling on a budget.
For general Manulife Travel Insurance inquiries, please continue to call 1-800-565-2338. You may have read enough about pre-existing conditions for visitors , and yet may not have found a visitor insurance plan, which actually covers pre-existing conditions. According to American Cancer Society, Medicare Part B and most insurance companies reimburse at least a part of cost associated with chemotherapy. Because if these companies can't make money in non-hurricane years the odds increase dramatically that they will not be able to build up enough cash to pay your claim after a major Florida hurricane. Please note that the cost of travel insurance is also dependent on the state of health care and access to medical services in the country you are planning a trip. If you are going away for a longer period, a gap year or backpacker policy may be more suitable. Seniors, or their children, may know that funerals can cost $8 – $10 thousand dollars these days!
Many of the people who get Access America travel are getting it because they are going on a cruise. Many people out there are having insurance for their car even when they are not having their driving license. Uber and Lyft are the best-known services, but other players include Sidecar , Wingz , Summon and Hailo In Europe, there's also LeCar, SnapCar , BlaBlaCar , Djump , Heetch and Uber has several slightly different services: It still operates its limo-style UberBLACK, which requires drivers to have a commercial chauffeur license and insurance. Credit insurance is basically a type of coverage that is created to pay off the minimum monthly payment of your credit card, should you not be in a position to make these minimum payments. For comprehensive information on insurance cover and reimbursement, refer to reliable online resources.
In most countries they don't admit people into a hospital without any proof of a medical insurance. In addition, a Google employee is licensed to sell insurance on behalf of CoverHound, a San Francisco-based company that pulls insurance options from the largest carriers. It's especially very important for pregnant mothers to continue to keep you and your unborn baby safe, sound and worry-free with travel insurance protection. As a broker, we compare quotes from several insurance compagnies to find the best fit for YOUR needs. There are several options to choose from depending on your travel frequency, type of holiday, places of interest, duration of your holiday and certain other facts. Nowadays, one can get a free cruise through a number of ways and some of these ways are not even considered as travel secrets. There are many ways on how to promote your insurance sales one way is advertising.
Your insurance companies may already cover you for certain things that you are unaware of, such as theft, while you are on vacation. If your food allergy is particularly bad, make sure to express this in their language. Some companies may limit the number of annual trips, whilst others may have no limit at all. Kung meron po kayong kakilala na tagadto sa UAE, better ask them na ikuha kayo ng visa sa mga travel agencies. The tax code says you can deduct the cost of purchasing and maintaining your car, to the extent you use that car for business purposes.
As laid out in the terms of the life insurance policy the policyholder has to pay a set of payments known as a premium and in turn the insurer will compensate the policy beneficiary in the event of insured's accident or death. Instead, your goal should be to target those types of insurance which the big insurers don't target directly and which have a sizeable market in Australia. Policy interventions for incentivizing providers to accept public insurance could improve access for the publicly insured.
GENERAL EXCLUSION: Any claim resulting from you travelling in, to or through a country or area included on the list of Do Not Travel countries provided by the Australian Government through the Department of Foreign Affairs and Trade – or those countries subject to an embargo from the UN Security Council or from any other international organisation to which Australia belongs, as well as events occurring in any international conflicts or interventions involving the use of force or coercion. From Chicago to Washington DC travel by either train or plane yesterday, today, and tomorrow will be horrendous in many places throughout our nation. But the drawback of shunning the traditional package holidays is that travel insurance policies may not cover all aspects of an individually booked trip, says M&S.


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Practicing in the Appellate Courts is for the purpose of reviewing trial court judgments to correct of errors committed by the trial court, development of the law, achieve a uniform approach across courts, and the pursuit of justice, more generally. Appellate courts are not a forum to make a new case, but instead they determine if the rulings and judgment of the court below were made correctly.
Palisades, formerly known as Sneden's Landing and then Rockland, is a hamlet in the Town of Orangetown Rockland County, New York, United States located north of Rockleigh and Alpine, New Jersey; east of Tappan; south of Sparkill and west of the Hudson River. The hamlet has no mayor, nor any official legislative bodies. It does, however, have its own library, and post office, with the zip code 10964. It is almost entirely residential with the exception of a small industrial area section on the Tappan border. The area commonly referred to as Snedens Landing, is located within the eastern portion of Palisades between US Route 9W and the Hudson River. The hamlet has a registered historic district known as the Closter Road - Oak Tree Road Historic District. The district comprises the area from the north side of Closter Road and south side of Oak Tree Road approximately 1/2 mile west of US Route 9W in Palisades. The hamlet's significant institutions include an IBM conference center, the Lamont-Doherty Earth Observatory, and a well-regarded nursing home. It is the southernmost community in Rockland County. Sneden's Landing is mentioned in Alec Wilder's song, "Did You Ever Cross Over to Sneden's?", one of Mabel Mercer's signature pieces.
Appellate Law Lawyers In Palisades New York


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This article made me question my frequent use of static utility methods:
Here are a couple of the excerpts I liked from the article:
The basic issue with static methods is they are procedural code. I have no idea how to unit-test procedural code. Unit-testing assumes that I can instantiate a piece of my application in isolation. During the instantiation I wire the dependencies with mocks/friendlies which replace the real dependencies. With procedural programing there is nothing to "wire" since there are no objects, the code and data are separate.
Lets do a mental exercise. Suppose your application has nothing but static methods. (Yes, code like that is possible to write, it is called procedural programming.) Now imagine the call graph of that application. If you try to execute a leaf method, you will have no issue setting up its state, and asserting all of the corner cases. The reason is that a leaf method makes no further calls. As you move further away from the leaves and closer to the root main() method it will be harder and harder to set up the state in your test and harder to assert things. Many things will become impossible to assert. Your tests will get progressively larger. Once you reach the main() method you no longer have a unit-test (as your unit is the whole application) you now have a scenario test. Imagine that the application you are trying to test is a word processor. There is not much you can assert from the main method.
The Sunburned Surveyor
Thursday, January 15, 2009
2 comments:
- Larry D. Becker said...
I seems like more of a critique of procedural programming than static methods. No one wants to go back to the bad old days, but the excesses of object oriented programming are just as bad. Everyone has seen cases of "over design" of classes where they attempt to put in every possible feature. I suspect the answer, as usual, lies somewhere in the middle. Static methods have their place.
- Eron Hossain said...
Java language was discovered by James Gosling of Sun Micro systems in 1991. Although C, C++ like programming languages were present in the market but due to fix platform constraint, web developers were unable to develop high end applications. See more programming assignment help
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Ideas for the House
12 Pins0 Följare
Even if you don't have a backyard or a spacious kitchen, you can have an herb garden using mason jars!
Mason jar chandelier.
Packing crate book shelves. I need three or four of these to fill a wall and I will probably still have books left over.
mason jar chandelier
Lola bikes and coffee | Selectionneurs. Cool bike mounting idea for when I get my own place.
Lampen gemaakt van keukenraspen
Industrial Lighting With Black Enamel Dome Shade and Reproduction Twisted Wire on Etsy, $172.00
wine boxes bookshelf


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|Publication number
|Publication type
|Application number
|Publication date
|Feb 2, 2010
|Filing date
|Apr 26, 2005
|Priority date
|Apr 26, 2005
|Fee status
|Also published as
|Publication number
|James R. Thacker, Carla M. Woods, Sridhar Kothandaraman, John D. H. King, Kerry Bradley
|Original Assignee
|Boston Scientific Neuromodulation Corporation
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (52), Referenced by (21), Classifications (5), Legal Events (5)
|External Links: USPTO, USPTO Assignment, Espacenet
The present invention relates to tissue stimulation systems and more particularly to evaluating stimulation therapies and patient satisfaction with stimulation therapies.
One example of a stimulation system is a spinal cord stimulation system ("SCS"). Spinal cord stimulation is a well accepted clinical method for reducing pain in certain populations of patients. An SCS system typically includes an Implantable Pulse Generator (IPG) or a radio-frequency (RF) transmitter and receiver, electrodes, electrode leads, and when necessary, lead extensions. The electrodes are implanted along the dura of the spinal cord, and the IPG or RF transmitter generates electrical pulses that are delivered, through the electrodes, to the dorsal column and dorsal root fibers within the spinal cord. Individual electrode contacts (the "electrodes") are arranged in a desired pattern and spacing in order to create an electrode array. Individual wires within one or more electrode leads connect with each electrode in the array. The electrode leads exit the spinal column and attach to one or more electrode lead extensions, when necessary. The electrode leads or extensions are typically tunneled around the torso of the patient to a subcutaneous pocket where the IPG or RF-receiver is implanted.
Spinal cord stimulators and other stimulation systems are known in the art. For example, an implantable electronic stimulator is disclosed in U.S. Pat. No. 3,646,940 issued Mar. 7, 1972 for "Implantable Electronic Stimulator Electrode and Method" that provides timed sequenced electrical impulses to a plurality of electrodes. As another example, U.S. Pat. No. 3,724,467 issued Apr. 3, 1973 for "Electrode Implant For The Neuro-Stimulation of the Spinal Cord," teaches an electrode implant for the neuro-stimulation of the spinal cord. A relatively thin and flexible strip of physiologically inert plastic is provided as a carrier on which a plurality of electrodes are formed. The electrodes are connected by leads to an RF receiver, which is also implanted.
In U.S. Pat. No. 3,822,708, issued Jul. 9, 1974 for "Electrical Spinal Cord Stimulating Device and Method for Management of Pain," another type of electrical spinal cord stimulation device is taught. The device disclosed in the '708 patent has five aligned electrodes, which are positioned longitudinally on the spinal cord. Electrical pulses applied to the electrodes block perceived intractable pain, while allowing passage of other sensations. A patient operated switch allows the patient to adjust the stimulation parameters.
An SCS system treats chronic pain by providing electrical stimulation pulses through the electrodes of an electrode array located at the distal end of a lead placed epidurally next to a patient's spinal cord. The combination of electrodes used to deliver stimulation pulses to the targeted tissue constitutes an electrode configuration. In other words, an electrode configuration represents the polarity, being positive, negative, or zero, and for certain SCS systems with such capabilities, relative percentage of the current or voltage provided through each of the electrodes. Electrode arrays used with known SCS systems may employ between 1 and 16 electrodes on a lead. Electrodes are selectively programmed to act as anodes, cathodes, or left off, creating an electrode configuration. The number of electrodes available, combined with the ability to generate a variety of complex stimulation pulses, presents a huge selection of electrode configurations and stimulation parameters (together referred to herein as "stimulation sets") to the clinician. When an SCS system is implanted, a procedure is performed to select one or more effective stimulation sets for a particular patient. Such a session of applying various stimulation parameters and electrode configurations may be referred to as a "fitting" or "programming" session. Additionally, a series of electrode configurations to be applied to a patient may be organized in a steering table or in another suitable manner.
Other parameters that may be controlled or varied in SCS are the frequency of pulses provided through the electrode array, pulse width, and the strength (amplitude) of pulses delivered. Amplitude may be measured in milliamps, volts, etc., as appropriate, depending on whether the system provides stimulation from current sources or voltage sources. With some SCS systems, the distribution of the current/voltage across the electrodes (including the case of the pulse generator or receiver, which may act as an electrode) may be varied such that the current is supplied via numerous different electrode configurations. In different configurations, different combinations of electrodes may provide current (or voltage) in different relative percentages of positive and negative current (or voltage). Moreover, there may be some electrodes that remain inactive for certain electrode configurations, meaning that no current is applied through the inactive electrode.
Therefore, an "electrode configuration" refers to a polarity and/or to a relative distribution of current or relative magnitude of voltage applied through the electrodes of the electrode array. Electrodes may be positive, negative, or turned off, such that a subset of anodes and cathodes are created within the electrode array. A polarity of each electrode may be a positive or negative "1" or a fraction thereof. For example, one electrode of the electrode array may have a polarity of negative "1" (cathode), while another electrode may have a polarity of positive "1" (anode).
Alternatively, a polarity may be spread out among different electrodes, for example, such that one electrode has a polarity of +0.75, while the other electrode(s) have +0.25. This distribution is known as polarity "distribution" or "percentage" among the electrodes of an electrode array. In the above examples, if an electrode has a polarity of negative 1, it is a cathode with 100% of the negative polarity distribution. If an electrode has a polarity of +0.75, it is an anode with 75% of the polarity distribution (with one or more additional electrodes accounting for the remaining 25% of the positive polarity distribution). Thus, a numerical value may be easily associated with a polarity distribution. In the case of current-controlled electrodes, in this example 75% of the anodic current would emanate from the first anode and 25% of the anodic current from the remaining anode(s). In the case of voltage-controlled electrodes, in this example the voltage magnitude of the first anode (e.g. +3.0 volts or 75%) would be three times that of the other anode(s) (+1.0 volts or 25%). The electrode configuration, along with pulse frequency, pulse width, and pulse amplitude of the voltage/current applied to the selected electrodes may be referred to as a stimulation set.
In order to test the effectiveness on a particular patient of various stimulation parameters and electrode configurations (i.e., parameters sets), it is necessary to provide a series of stimulation parameters in a systematic method. Several such systems exist including the systems disclosed in U.S. Pat. No. 6,393,325, incorporated herein by reference in its entirety, wherein a patient may direct the movement of the stimulus current through a suitable interface. Another method of testing the effectiveness of various stimulation parameters is disclosed in U.S. application Ser. No. 11/026,859, incorporated herein by reference in its entirety. In this Application, during a fitting session with a patient, a clinician uses navigation with two parameter tables to step through and optimize stimulation parameters.
In tissue stimulation applications, various stimulation sets may change the character and success of the patient's experience with the therapy. It would be useful to the clinician to be able to quickly determine the patient's satisfaction with a particular stimulation set for both clinical tracking as well as future programming and adjustment to the stimulation therapy. In previous tissue stimulation systems, patients may have been asked to evaluate the effectiveness of the various stimulation sets that are applied. While the clinician may have sought patient feedback in past systems, a system of evaluating stimulation sets, including evaluations that are not based on memory but are based on more quantitative data, scoring stimulation sets and organizing patient satisfaction is needed.
What is needed is method of creating a patient database including tested stimulation sets and associated feedback on these stimulation sets. Once created, this database may be used in future stimulation sessions, in order to provide the most effective stimulation sets to the patient to meet therapeutic objectives. Additionally, there is a need for evaluating the stimulation set based on patient feedback and/or on frequency of use. Additionally, there is a need for a way to evaluate patient-experienced pain both before and after stimulation pulses are applied to the patient. The associated pain level should be stored in the database in addition to the other patient feedback on the tested stimulation sets.
Embodiments of the present invention describe a tissue stimulation system and devices and methods for programming the stimulation system. The stimulation system may have an implant device comprising an implantable pulse generator having an implantable electrode array connected thereto, the implantable pulse generator having electrical circuitry therein that generates electrical stimulation pulses. This invention is also applicable to a system having an external transmitter that transmits the energy for pulses to an implanted receiver that receives the energy for the pulses and sends the pulses to the electrodes implanted adjacent the tissue to be stimulated.
One embodiment is a tissue stimulation system comprising: (1) a pulse generating device for generating electrical stimulation pulses, wherein the electrical stimulation pulses are defined by a stimulation set; (2) at least one implanted electrode for delivering the electrical stimulation pulses generated by the pulse generating device; (3) a database which stores one or more stimulation sets and an associated frequency of use for each of the stimulation sets; (4) means for selecting a stimulation set from the database; and (5) a programmer capable of communicating with the pulse generating device in order to program the pulse generating device to generate electrical stimulation pulses in accordance with the selected stimulation set.
The database of the stimulation system may store patient information, clinic information, and tissue stimulation device information. A level of patient satisfaction before and after the stimulation pulses are applied to the patient may be recorded in the database. The database may also store any associated patient feedback with the stimulation sets. Patient feedback may be generated using an interactive display screen. A visual analog scale may be used to evaluate the stimulation sets. Patients may also provide verbal feedback. Objective criteria such as perspiration, muscle tension, respiration rate, heart rate may be used to evaluate stimulation sets and thus generate a score for the set. A score may be calculated for the stimulation set based on one or more of frequency of use and patient feedback.
Another embodiment is a method of evaluating stimulation sets comprising: (1) applying electrical stimulation pulses to a patient, wherein the electrical stimulation pulses are generated by a pulse generating device and are defined by at least one stimulation set; (2) determining a frequency of use for each applied stimulation set; and (3) retrievably storing the frequency and the associated stimulation sets in a database.
The database may be used to select stimulation sets for future stimulation sessions. An updatable score may be calculated for each stimulation set based on both frequency of use and patient feedback. The database may be updated based on frequency of use. Patient feedback may be generated using, e.g., a visual analog scale.
Another embodiment is a method of determining patient satisfaction with a stimulation set, the method comprising: (1) determining a patient's level of pain before applying electrical stimulation pulses to a patient; (2) applying electrical stimulation pulses to the patient, wherein the electrical stimulation pulses are generated by a pulse generating device and are defined by at least one stimulation set; (3) evaluating the applied stimulation sets, wherein the evaluation includes determining the patient's level of pain after applying the electrical stimulation pulses and determining a frequency of use for each applied stimulation set; and (4) retrievably storing the evaluation and the associated stimulation sets in a database.
The levels of pain may be determined using a visual analog scale. A score may be generated for each stimulation set with the following equation:
score=(10−VAS)+(use percentage/10),
wherein VAS is a value from 1 to 10 indicating a level of pain experienced while the electrical stimulation pulses are applied according to the stimulation set, and wherein the use percentage is a value representing frequency of use for the stimulation set. This score may be stored in the database with the associated stimulation set.
The above and other aspects of the present invention will be more apparent from the following more particular description thereof, presented in conjunction with the following drawings wherein:
It is to be understood that this invention is not limited to the particular devices, compositions, methodologies or protocols described, as these may vary. It is also to be understood that the terminology used in the description is for the purpose of describing the particular versions or embodiments only, and is not intended to limit the scope of the present invention which will be limited only by the appended claims.
It must also be noted that as used herein and in the appended claims, the singular forms "a", "an", and "the" include plural reference unless the context clearly dictates otherwise. Thus, for example, reference to an "electrode" is a reference to one or more electrodes and equivalents thereof known to those skilled in the art, and so forth. Unless defined otherwise, all technical and scientific terms used herein have the same meanings as commonly understood by one of ordinary skill in the art. Although any methods, devices, and materials similar or equivalent to those described herein can be used in the practice or testing of embodiments of the present invention, the preferred methods, devices, and materials are now described. All publications mentioned herein are incorporated by reference. Nothing herein is to be construed as an admission that the invention is not entitled to antedate such disclosure by virtue of prior invention.
The various components of an exemplary SCS system may include an implantable pulse generator (IPG) and programmer used with such system. Implantable components may include an implantable pulse generator, one or more electrode arrays, and (as needed) one or more extensions to connect the array(s) to the IPG. Such implantable components, external devices and circuitry are more fully described in U.S. Pat. No. 6,622,048. Alternatively, a system comprised of an implanted RF receiver and external transmitter, as a pulse generating device in place of an IPG, may be used.
A programming system may include, as described in U.S. Pat. No. 6,622,048, a clinician programmer coupled to a directional device. The clinician programmer typically interfaces with a patient hand-held programmer (HHP) in communicating with the implanted pulse generator. However, other types of communication links between the clinician programmer (i.e., the programming computer) and the IPG may be utilized. Programmers may be in the form of a conventional PC, a laptop, a PDA, a monitor, a hand-held device, and any other suitable computing means.
The electrical stimulation pulses applied to a patient are defined by a stimulation set, comprising an electrode configuration and pulse stimulation parameters.
A flow chart representing one embodiment of a method of recording, evaluating, scoring, storing, and retrieving stimulation sets and their use is depicted in
Applied electrical stimulation pulses are evaluated for therapeutic effectiveness at step 12. Many types of evaluations exist, such as verbal communications or a numerical ranking. A clinician, patient, and/or program may evaluate the stimulation set. In patient evaluation, for example, the patient may be prompted to answer questions in order to evaluate the stimulation sets. These patient comments may be recorded to a computer database. Such questioning may be oral or may be automated using a suitable user interface.
In another patient evaluation, the patient may be asked to rank the associated stimulation set while the stimulation pulses are being applied to the patient, using a discrete scale, such as A-F. Alternatively, stimulation sets may be evaluated by the user after a fitting or programming session, wherein a batch of stimulation sets has been tested on a patient. Stimulation sets may be scored according to objective criteria. Objective criteria include measurements of various physiological parameters of the patient, such as perspiration, muscle tension, respiration rate, heart rate, and the like.
Evaluation information may take into account pre-treatment and post-treatment patient information. Determining patient satisfaction in the absence of stimulation therapies provides a baseline for interpreting patient feedback after stimulation pulses are applied. For example, a patient may be asked to identify a level of patient satisfaction or well-being before the stimulation session begins. After stimulation pulses have been applied to the patient, his/her satisfaction level may be determined again. The change in patient satisfaction, if any, may be used to evaluate specific stimulation sets.
Patient satisfaction is commonly represented by a reduction in the sensation of pain. Therefore, a patient may be prompted to select a pain level experienced in the absence of stimulation, a pain level while various stimulation sets are applied, and a pain level after stimulation sets have been applied.
Pain levels or other patient sensations may be evaluated by a patient using a discrete scale, such as 1-10, or A-F, etc. These scales may be incorporated visually into a suitable user interface. Interfaces may include, but are not limited to, display screens, handheld devices, monitors, laptops, and PDAs. The interfaces may be interactive, such as a touch screen. The user may use a mouse, joystick, or stylus for in connection with the interface for the input of patient feedback.
An example of one such user interface would be a display screen incorporating a graphical display of a visually continuous scale. A user would be prompted to identify along the continuum a ranking associated with a particular level of satisfaction. For example, a visual analog scale ("VAS"), such as the one depicted in
Once evaluations have been collected for a stimulation set, a score may be generated for each stimulation set at step 13 in
A score for a particular stimulation set may also be indicative of its frequency of use. This frequency of use may be patient-specific or may be grouped according to clinic location, according to specific patients having similar diseases or conditions, or across any number of patients. If a patient uses particular stimulation set(s) a majority of the time in his/her therapy sessions, this use percentage is likely indicative of the effectiveness of this stimulation therapy. This use percentage may be used to generate a score for the stimulation sets—the more frequently used stimulation sets having higher scores. Frequency of use may be a separate score for each stimulation set. Alternatively, the frequency of use may also be weighted according to any algorithm to obtain a total score for each stimulation set.
In addition to scoring the stimulation sets by frequency of use, patient feedback may be used to score the stimulation sets. For example, a VAS or some other means of determining a score for the stimulation set from patent feedback may be used alone, or in combination with other factors to generate a total score for the stimulation set. One example of creating a total score for a stimulation set would be to sum together the VAS score with the percentage of use. VAS score is inversely proportional to patient well-being, while percentage of use is directly proportional. Therefore, one simple algorithm for generating a score for a stimulation set is:
total score=(10−VAS)+(use percentage/10),
wherein a maximum score a stimulation set may have is 20.
For example, if a stimulation set has a VAS score of 4 and a percentage use of 10%, then a combined total score would be "7" (6+10/10). But if a stimulation set has a VAS score of 7 and a percentage use of 10%, then a combined total score would be "4" (3+10/10). Therefore, the higher the total score, the better the stimulation set. Other algorithms may also be used.
Since a score may be proportional to percentage of use, means for tracking the percentage of use for each stimulation set during therapy sessions and a means for updating the score based on this tracking may be useful. This tracking may be accomplished with any suitable database or software. Again, this tracking of percentage of use may be patient-specific or may be grouped according to patient groups.
Once evaluated, patient feedback and the associated stimulation set may be organized and stored in an appropriate database at step 14. The database may store the stimulation sets and patient feedback, including verbal comments and VAS score. Additionally, the database may store the one or more scores determined for each stimulation set. This score may be indicative of one or more of the patient feedback and the frequency of use. The database may also include patient satisfaction information in the absence of stimulation therapy. As explained above, the patient's sensation of pain before stimulation provides a baseline for determining the effectiveness of the stimulation therapy. Finally, the database may include information regarding patient satisfaction after specific therapies have been applied.
Therefore, stimulation sets may be tracked, scored, stored, organized, updated, and retrievable for each patient. Such organization may be through any suitable computer system, employing, for example, any suitable memory device, computation device, database, user interface, communication connections and/or software. In such a manner, a patient's satisfaction with stimulation sets may be tracked over various stimulation treatment sessions. Various reports may be generated from the described database, including patient satisfaction reports generated over a period of time.
By storing the score and/or usage associated with stimulation sets, this score and/or usage is easily retrieved from the database upon subsequent patient follow-ups at step 15 in
As another example, a stimulation set may initially be found to have a VAS score of 4. Upon presentation at follow-up, the patient may rank this same stimulation set as having a VAS score of 6. The system, recognizing this difference in patient evaluation from day-to-day, may then select different stimulation sets that have a VAS score of less than 6 for use.
The evaluation information may be used to create a patient profile, which may be retrievable from a database and used for each stimulation session. Patient satisfaction information, such as a VAS score in the absence of therapy, may be included in the profile. Other recorded information may also include general information and information related to specific therapy sessions. Such information may include the stimulation sets applied to the patient, including any identified bounds or preferred parameters, any scoring of these parameters, the date, the patient information, the clinic, the attending clinician, the stimulator hardware used, and any other information related to the patient, stimulation and therapy.
During an initial programming session or at subsequent sessions, the stimulation sets may be displayed to the user along with any associated feedback, scores, and/or usage. The graphical displays may be used in any phase of a stimulation session to convey stimulation parameters to a user. The VAS, scores, usage, and/or total scores may be readily displayed to the patient to ease selection of effective stimulation parameters. Alternatively, during evaluation, the patient may not be able to see previous scores/usage for a particular stimulation set, allowing for objective evaluation.
Upon subsequent patient evaluation sessions, the database tracks any changes to the stimulation set scores/usage, at step 16 in
While the invention herein disclosed has been described in relation to pain therapies, it is not limited to such use. For example, patient feedback and satisfaction may be evaluated and stored for treatment of other conditions, such as, for example, peripheral vascular disease, congestive heart failure, angina, motor disorders, and urinary incontinence. For these other conditions, rating systems are known, such as, for example, Fontaine rating for peripheral vascular disease, the NYHA classifications for congestive heart failure and angina, the UPDRS, Hoehn and/or Yahr in motor disorders, and bladder capacity in urinary incontinence. As such, patient satisfaction based on any of these or other scales may be used to evaluate the electrical stimulation pulses delivered to the patient. As explained above, these evaluations may be stored and organized within a database associated with the stimulation sets. These scales may be incorporated into a suitable user interface, such as a touch screen as explained in relation to the VAS, in order to efficiently interpret patient feedback.
While the invention herein disclosed has been described by means of specific embodiments and applications thereof, numerous modifications and variations could be made thereto by those skilled in the art without departing from the scope of the invention set forth in the claims. For example, the methods discussed above are not limited to spinal cord stimulation systems and may be used with many kinds of stimulation systems such as, but not limited to, those described above, cochlear implants, cardiac stimulation systems, peripheral nerve stimulation systems, muscle tissue stimulation systems, brain stimulation systems and microstimulators.
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Owner name: ADVANCED BIONICS CORPORATION, CALIFORNIA
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Russia has warned the US-led coalition combating in Syria that it'll view its plane as targets, after a Syrian army airplane was shot down.
The coalition stated it had shot down the Syrian SU-22 after it bombed US-backed rebels in Raqqa province on Sunday.
Russia, Syria's most important ally, stated it was additionally halting communication with the US geared toward stopping air incidents.
Syria condemned America's "flagrant assault", saying it might have "harmful repercussions".
"Any plane, together with planes and drones belonging to the worldwide coalition working west of the Euphrates river, can be tracked by Russian anti-aircraft forces within the sky and on the bottom and handled as targets," the Russian defence ministry stated.
It denied the US had used a communications channel earlier than the SU-22 fighter bomber was downed.
The memorandum of co-operation with the coalition geared toward stopping air incidents and guaranteeing flight security was ending as of Monday, the defence ministry added.
The downing of a Syrian warplane by a US jet threatens to attract Washington additional into the Syrian combating.
The US has already attacked pro-government forces on the bottom after they entered an exclusion zone designed to guard US personnel coaching and advising anti-government rebels close to Syria's border with Iraq.
Now Washington is extending this safety to forces that it backs who're engaged within the offensive in opposition to Raqqa. These native, tactical steps inevitably may have strategic implications creating an extra supply of friction between Washington and Tehran.
Iran's focus is more and more on the border area between Syria and Iraq. The battle for management of this important territory is changing into ever extra harmful.
Iran's personal missile strikes in opposition to what it says are IS targets underscores Tehran's willingness to behave in defence of its personal pursuits in Syria.
The co-operation had been halted after the US launched 59 Tomahawk cruise missiles at Syria's Shayrat airbase in April in response to a suspected chemical weapons assault on a rebel-held city in Idlib province.
However the US and Russia had agreed to renew communications final month.
The SU-22 fighter bomber was engaged by an F/A-18E Tremendous Hornet after it had dropped bombs close to the city of Tabqa in Raqqa province on Sunday afternoon, the Pentagon stated.
It's believed to be the primary air-to-air kill of a manned plane by a US army jet for the reason that Kosovo marketing campaign in 1999.
The US-backed Syrian Democratic Forces (SDF) had been working within the Tabqa space.
The SDF have been combating Islamic State militants as a part of a drive to retake town of Raqqa, the IS stronghold additional to the east.
An announcement from the US-led coalition's Operation Inherent Resolve stated pro-government militiamen had attacked SDF models, driving them from the city of Ja'Din.
The US-led coalition performed what it stated was a "present of power" – a reported buzzing of the pro-government troops by jets – to cease the assault after which referred to as Russia to attempt to "de-escalate the state of affairs and cease the firing".
Nonetheless, the SU-22 dropped bombs on SDF positions a number of hours later, the coalition stated, and "in accordance with guidelines of engagement and in collective self-defence of coalition-partnered forces [the plane] was instantly shot down".
Makes an attempt to warn the airplane away utilizing an emergency radio frequency failed, the US Central Command stated.
The coalition assertion added: "The demonstrated hostile intent and actions of pro-regime forces towards Coalition and accomplice forces in Syria conducting legit counter-Isis [IS] operations is not going to be tolerated."
The coalition, it added, did "not search to battle the Syrian regime, Russian or pro-regime forces partnered with them, however is not going to hesitate to defend coalition or accomplice forces from any menace".
The Syrian military stated its warplane had been on a mission in opposition to IS when it got here beneath hearth, in line with state tv.
It stated the incident would have "harmful repercussions" on efforts to battle terrorism.
A military assertion stated the pilot of the airplane was lacking.
Though that is the primary time the coalition has shot down a Syrian jet, there have been an growing variety of incidents between the 2 sides:
- Earlier this month, the US shot down a pro-Syrian government armed drone after it fired at coalition forces close to the al-Tanf border crossing, between Syria and Iraq
- In Might, US-led coalition plane bombed a convoy of pro-Syrian government forces who had been reportedly transferring in direction of a base at al-Tanf being utilized by insurgent fighters and Western particular forces
- In September 2016, US-led coalition planes targeting IS positions instead killed Syrian troops. The US expressed "remorse" for the incident, which Russia stated left 62 Syrian troops lifeless
In a separate incident on Sunday, Iran's Revolutionary Guards stated that they had launched a number of missiles from Iran into japanese Syria, concentrating on IS fighters.
The Guards stated that they had fired mid-range ground-to-ground missiles from western Iran concentrating on "the headquarters and assembly place and suicide automotive meeting line" of "IS terrorists" in Deir al-Zour province.
A "massive quantity" of militants had been killed and tools and weapons had been destroyed, the Guards stated.
The missiles had been apparently in response to an IS-claimed attack on the Iranian parliament earlier this month which killed greater than a dozen folks.
"The spilling of any pure blood is not going to go unanswered," a Guards assertion stated.
Iran has been a key ally of President Assad, sending army advisers and hundreds of "volunteer" troops.