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Printable PDF
Vendor: Cisco
Certifications: Others Cisco Certifications
Exam Name: Implementing and Configuring SBYOD Using Cisco ISE v1.0
Exam Code: 648-266
Total Questions: 105 Q&As
Last Updated: Jul 11, 2020
Exam retired
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Waseem not to be underrated, Mthalane told
Boxing veteran Moruti "Baby Face" Mthalane has been warned by American boxing trainer Jeff Mayweather not to read too much into the professional boxing record of Muhammad "Falcon" Waseem, who will oppose Mthalane for the vacant IBF flyweight title at Axiata Arena in Kuala Lumpur, Malaysia, on Sunday.
Mayweather trains the 30-year-old Pakistani at the gym of his nephew Floyd Mayweather jnr in Las Vegas.
Jeff, 54, is the youngest of the three Mayweather brothers who are all former boxers. The others are Floyd Mayweather snr, 65, and 54-year-old Roger.
Jeff's charge, who has held the WBC Silver title, is undefeated in eight fights, with six knockouts.
Waseem is understood to have had more than 300 amateur fights and represented his country in 15 international tournaments including the Commonwealth Games.
Speaking through the Mayweather Boxing Channel, Jeff said: "Waseem is a phenomenal boxer. He is not a guy that I have to teach things. He knows how to fight. I am just fine-tuning things. Waseem is more than ready and excited. I expect [great] things from him."
Waseem said: "I am sure of a win. I had a tough camp under Jeff for 45 days. We enjoyed the camp and I am going to knock out Moruti."
Mthalane, 35, is a formidable former IBO champion with 24 knockouts in 35 wins against two losses. The boxer/fighter from Lindelani in Durban is trained in Johannesburg by successful trainer Colin Nathan.
Mthalane, Nathan, assistant trainer Vusi Mtolo and cut man Bernie Pailman have been in Malaysia since Sunday.
The IBF title that Mthalane and Waseem will be fighting for was vacated by Donie Nietes of the Philippines who moved up to the junior bantamweight division.
WBA welterweight champion Lucas Matthysse will defend against Filipino ring icon Manny Pacquiao in the main bout.
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subset: commoncrawl


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We all know that Santa Claus flies around the entire globe delivering to all the children of the world in a single night. NORAD even tracks the occasion to provide the proof, so we know it must be true. However have you ever wondered how Christmas is celebrated around the world, in all of those countries? Lucky for you, MANY people have created infographics to share that information, and we've collected them for you below :
Read more http://travel.gunaxin.com/christmas-around-world-infographics/178892


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Well, that last update was a disaster. Hopefully things pick up this time! Also, I hope we get a beta male soon because currently there is no one to succeed Cirnah and Aquila. Literally any healthy children would be welcome at this point. Seriously.
Cirnah has joined the learning room group, and Lyra has some sort of opinion on this. The death music is currently playing, which is not comforting.


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Manufacturing Plant of the FutureThe typical process control model that involves decision making for the process at the local or centralized level by PLCs (Programmable Logic Controller) or BPCS (Basic Process Control System) is quickly changing. These systems installed yesteryear were never intended to deal with or even realize the amount of data they would have access to in the near future. There are certainly newer ERP, MES and asset management systems that collect some of this data now, but the more critical challenge that local manufacturing facilities face is manpower. Because streamlining of costs and overheads has left many manufacturing facilities with just enough personnel to keep the plant running, facilities no longer have the extra time, personnel and resources required to analyze data. For this reason we are seeing third party companies, and even some of the larger process control vendors, offer leasing or annual agreements that involve collecting, storing, and analyzing all sorts of process data. This data is part of a larger predictive analytics strategy that can not only forewarn operators of impending problems to come, but is also being used to optimize the process itself. This type of cloud automation looks to gather as much data as possible to reduce operating expenditures and future capital expenditures for future plant builds.
So the challenge remains: how do existing and new manufacturing facilities find a cost effective way to get critical plant floor data up to higher level information systems? The answer is to take advantage of the digital HART data you already have installed but either didn't know it was there or couldn't afford the equipment upgrades to gain access to it.
This white paper, courtesy of Moore Industries, will outline how the flow of process and diagnostics data from smart HART digital field instruments can now be shared with mid and higher level control, asset management and data information systems without having to upgrade expensive process control interface equipment. Additionally, features and considerations of devices that enable this sharing of data will be reviewed and suggested.
Table of Contents
- Plant of the Future
- HART Protocol's Persistence
- HART Primer
- HART Revisions and Compliance
- HART Dynamic and Device Variables
- HART Hosts and Revisions
- HART Interface Options
- Employing the Extracted HART Data
- Cybersecurity Considerations
- Configuration of IIoT Devices
For more information, contact Arjay Automation, LLC. Call (800) 761-1749 or visit https://arjaynet.com.


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The S2S tool offers:
For the Coach:
Now also includes:
Readymade training sessions per age group
with selected favorite drills
Product upgrades are included in the price
Below you will find one of the totally 156 soccer skills that are presented in the S2S tool.
In the ARCHIVE we have selected 50 of the most fundamental skills and drills for youth and grassroots.
To find out more about all the features of the S2S tool, please click on DEMO.
To select the product version that suits you best, click on SUBSCRIBE.
Demonstration practice
When you subscribe, you will also find:
Drill practices, Game practices and Practice at home, as well as more general coaching points ("Secrets").
The players run into the scoring areas and finish. Cross the ball from various positions and from both sides. Two semi-active defenders to begin with, who mark the attackers in various ways. Swap roles.
The players practise running into the four separate scoring areas and sharing them amongst themselves.
Fully active defenders. Also practise with three and two attackers against the two defenders.


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This is one of the most important chapters in Scripture. It teaches us how the perfect world got to be what it is today. It lays the foundation on which the rest of Scripture is built, answers all modern philosophies, and forms the foundation for a true understanding of human nature and morality.
Verse 14 "You will crawl on your belly." We don't know what the serpent looked like before this or how God changed its body. The way he traveled formed a visual symbol of what would happen to Satan—he would eternally slither in the dust.
1. Satan tempted Adam and Eve through doubt and a twisting of scripture. How does he tempt us in the same way?
2. Perfection was gone. It was replaced by shame and the desire to cover up and hide. How did Adam and Eve show that sin dominated their lives?
3. God did not leave Adam and Eve in their guilt. Verse 15 is the first gospel promise. In this one short verse is found a wealth of good news. Where is Jesus in this verse?
4. Why did God drive Adam and Even from the Garden of Eden?
5. In what ways today do we experience the curse God put on Adam and Eve?
6. Why is death liberating for a Christian?


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Wolves turn down Nottingham Forest Bakary Sako bid
Wolves have turned down a bid from Nottingham Forest for winger Bakary Sako.
Head coach Kenny Jackett revealed after today's 3-1 win at Port Vale that the offer - believed to be for around £2.5m - was received and rejected in the last two days.
Sako was left out of this afternoon's Staffordshire derby because he didn't feel in the right frame of mind to play with speculation linking the former St Etienne wideman to the Championship club.
The bid is understood to have matched the eventual fee Fulham were prepared to pay earlier this summer, at least numerically, if not in method of payment.
But it is believed Wolves are still holding out for £4m.
Jackett said: "We had an offer two days ago from Nottingham Forest for which we turned down – it was nowhere near our valuation.
"I'm not going to disclose how much it is but it's an offer we've turned down.
"And as far as I'm aware, we're not close to agreeing a fee.
"He's not a player we're desperate to sell – we're not in that situation.
"But there is some speculation, he's aware of the interest and he wasn't in the right frame of mind to play today.
"Those are his words, not mine.
"So we'll see now what happens over the course of the weekend, but we're not desperate to sell him.
"We're not looking to do a deal necessarily, but if it comes at a decent level you have to think about it.
"But I've got assurances that should Tuesday morning come and he's still a Wolves player then he will be 100 per cent committed to the cause, as he has been so far because he's played very well.
"I'm hopeful that he will stay and contribute more."
Jackett said that he had spoken to Sako in the build-up to today's game and been made aware of the player's decision.
"We had a conversation during the course of the week and working with them every day, you get to read each other enough to talk honestly," he added.
"Today he wasn't with us and up to now, he's contributed very well in our season."
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Vision Rannari Running Line - a set of thin floating running lines to cover all your needs. All Rannari running lines have control markings at 5 m intervals. These running lines don't have any memory whatsoever so there's no need to stretch them before use. Built on our low stretch core. We have a small loop at the back and big loop at the front for smooth and easy attachment to your backing and shooting head. The big loop at the front helps threading spools through for changing fast between heads. Phthalate free.
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Graduate Electronics Design Engineer
North Devon
£20,000 – £28,000 + Holiday + Pension
Excellent opportunity to kick start your career in an exciting, challenging role that will continuously develop your skills.
On offer is the chance to work in a world renowned organisation with massive potential to progress.
Part of a larger group this highly revered organisation design and manufacture bespoke electronic components within a variety of high tech industries. They are currently und
Source: Local Jobs


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Clay Staires
- Business Consulting
How you THINK is the most important thing about you! Living life day to day, year after year with the same struggles and difficulties can become incredibly tiresome and often leads us to think, ''I can't do this anymore!'' Your thoughts will always lead to your actions and your results. The KEY is learning how to think!
Clay Staires is an expert on personal and professional growth. For over 25 years he has been improving lives through helping people how to interpret their circumstances.
15 years of classroom teaching and coaching, 10 years of C-level leadership, 4 years of entrepreneurship, starting 5 companies in 6 years have equipped him with the experience. A failed marriage, losing a job, death of family members, loss of friends, living through the death of a dream has equipped him with the understanding. He has walked a journey of intentional development and has kept the map of success!
Clay speaks nationally on motivation, leadership, personal development and business management.
He lives in Skiatook, Ok with his wife Lisa and his two daughters Madison and Clare and their dog, Dolly. Clay has a passion for God and a compassion for others. His ultimate design is to help people move to their next level!
Clay is a Life Coach, Leadership Trainer, Business Consultant and Motivational Speaker.
Whom to Contact
- Clay Staires


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Real Estate Investing - Griffin Capital Asset Management - with Dr. Randy Anderson
Dr. Anderson, with a Ph.D in Finance, and President of Griffin Capital Asset Management, is focused on real estate investing, has a combination of real estate industry and academic experience, using research driven strategies, applying modeling, quantitative testing, and back testing in developing projects and investment vehicles, typically using REIT structures. In addition, they invest in real estate securities, looking always to diversify investors' portfolios in the real estate area. Listening to Randy is always a treat, educational and enlightening. To learn about real estate investing, listen to Randy.


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It's time to check up with our resident comic geek, GothamGal, for her take on her newest graphic novel read. Check out her thoughts on women in comics, the graphic novel writers she loves and much, much more, as GothamGal takes on DC Comics' Black Canary and Zatana: Bloodspell by Paul Dini and Joe Quinones.
I'm partial to strong female characters in comics—I really love the potential they bring as a role model to young girls.I love the idea of more younger girls being brought into comics—so we can get more amazing young women (and their ideas) IN the comic industry in the future and we don't get that issue where strong female comics get switched to a subpar creative team and then get axed (case in point: Batwoman). When I can find these strong-helmed female character-driven graphic novels, I scoop them up.
Black Canary and Zatanna meet when Zee is just a child and Canary is climbing up the mountains (and avoiding yetis), forging a friendship that allows Dinah to later introduce the magician to the JLA. And when Dinah's latest mission goes wrong, she turns to Zatanna to help her with a rogue, magic-using ghost. However, will these two ladies be able to pool their strengths and save the other women in the crossfire, or will Dinah end up killed by the spirit?
I loved reading this, it has a compelling story and really great characterizations of Zatanna and Black Canary.
Paul Dini is one of my favorite writers, and I jumped at the chance to read this when I saw his 'byline.' Mad Love is one of my favorites, and it was the first graphic novel I ever purchased (while in college). His style lends well to showing the lightness of even dark situations. Joe Quinones captures it very well.
Fans of either or neither fandom would be interested in reading this—I loved the panels featuring Green Arrow and the different flashbacks to JLA missions/interactions. It made sense, and added a universe continuity.
I picked this up at my local bookstore in hardcover, during a 'buy 2 get the 3rd free' event. I love that I picked this up, really enjoying the storyline and I recommend that you pick it up in your favorite format from your favorite retailer.


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August 02 , 2019
In July,13, the Canadian newspaper "WHEEL" published an article "Westlake passes the test with flying colours" on its print newspaper to recommend Westlake RP18 based on the good tire test result.
The article is written by Kevin "Crash" Corrigan, a member of the Automobile Journalists Association of Canada & the International Motor Press Association. He is a former licenced technician with over 40 years' experience in the auto industry. He had a tire test to test the tire performance and written the article:
Tires are tires, right?
They're something you need to replace on your vehicle to stay on the right side of the law, yes?
Yes well, some may view it that way but, when your life is traveling on just four small square patches of rubber that meet the road, I believe it's wise to do a little homework on the subject.
Should you buy the most expensive tires you can find?
If you're related to royalty or if you won last week's big lottery, then read through the reviews and purchase the best rubber available, no matter what the cost. I'd also recommend this approach if you own a high-performance vehicle that you regularly take to the racetrack. However, for most of us, we purchase what we can afford and what meets our personal needs. Obviously, the requirements of a long-distance highway commuter differ from those who use their vehicles few times a week to gather up groceries, with perhaps the occasional out of town trips.
If finances are tight, you may source a set of used tires online but let me provide you a warning on that – ALL tires have a shelf life, due to material deterioration over time. About 5-7 years tends to be the accepted average life of a set of tires. If you fail to notice the build date, those "bargain tires" could've been sitting in someone's garage from a vehicle sold off years ago and you'll have no idea of how those tires were treated. Thus, I encourage people to buy new rubber.
Fortunately, there are a few brands out there today which offer up-quality products at reasonable prices, which leads us nicely into my review of the Westlake Tire RP18.
The test
My test car was the 2019 Mazda CX3 AWD. This worked out well as I have driven it both on-road and under track conditions. I know how the vehicle behaves and feels with the original OEM tires.
The first thing I noticed was just how quiet these RP18s were although. The ride quality was equally impressive and certainly at par to what I have experienced from OEM fitment in the past.
I then tested the braking under severe conditions by employing high-speed full-wheel lockup on both asphalt and gravel roads. On both occasions, the vehicle tracked straight and true with zero drama. Standing start accelerating from both these tests saw the tires bite in and pull away with relative ease.
Later I headed for my favorite test location – a small, often uninhabited, country roundabout. Twice around a small roundabout tells me most of what I need to know regarding control & grip. There's a saying in racing that, "listen to what your tires have to say". Tires will readily supply you audible feedback when pushed to the limit in corners. They'll scream out to you if you push them hard enough!
Trust me when I say, not surprisingly for an old ex-rally driver, that I managed to get the RP18s to chatter away but I had to listen closely to hear their minor grumblings. I conducted the same test when evaluating new vehicles from the manufacturers and you'd be surprised how deafening some of those OEM tires can be.
My conclusion
I recommend caution when approaching the purchase of affordable tires. However, Westlake is not a new brand, having been used in Canada for many years. Westlake supports its products up with an impressive 80,000kms or 4 Year Warranty which, in many cases, is equal to or higher than some premium-priced brands.
The Westlake RP18 I tested is an all-season, general-purpose product. In my opinion, a set of RP18s should provide above average returns befitting most driver's requirements. For many today, there is often a case to be made for balancing budget with purchase price and, when you consider the price point of the Westlake RP18, there is a great deal of value for money on offer here.


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December 2004 LSAT Section 3 Question 8
Which one of the following most accurately describes the organization of the material presented in the passage?
Meckena on May 30, 2019
Why is A incorrect
2 Replies
Victoria on May 31, 2019Hi @Meckena-Hultin,
Right away, we can tell that E and C are stronger answer choices than A as the passage opens by discussing the Hippocratic oath and criticisms of it. The Hippocratic oath is not a general principle; rather, it is a code of conduct, as identified in Lines 1 to 6: "The moral precepts in the Hippocratic oath, which physicians standardly affirm upon beginning medical practice, have long been considered the immutable bedrock of medical ethics, binding physicians in a moral community that reaches across temporal, cultural, and national barriers." As the Hippocratic oath contains multiple moral precepts which are affirmed by physicians, we can tell that it is a code of conduct as opposed to a general principle even without any prior knowledge of what the Hippocratic oath is.
Secondly, criticisms of the Hippocratic oath are not made by the author of the passage; rather, criticisms that have been made by others are presented in the passage.
Finally, the last section of answer choice A does not mirror the final section of the passage. The author does not propose modifications to the Hippocratic oath. Instead, they dismiss the concerns regarding the oath's origins and authorship, arguing that the oath is continually written by those who critically appraise its content and judge it to express valid principles of medical ethics. The author then argues that the code is essential in assuring patients that physicians will pursue appropriate medical goals under generally accepted standards of professionalism. While the author does suggest that there should be adaptations at the oath's periphery, they point out that there is already a tradition of peripheral reinterpretation of the traditional wording. In this way, the author is defending the Hippocratic oath.
From our analysis of the passage, we can see that the author begins by presenting the Hippocratic oath, then presents criticisms that have been made by others, and ends with defending the origins, authorship, purpose, and continual reinterpretation of the Hippocratic oath. This organization is mirrored by answer choice E, making it the correct answer.
Hope this is helpful! Please let us know if you have any further questions.
Gabby on March 30 at 09:37PMHi, a passage such as this one with more than one viewpoints would be really helpful to have an example of notes that one would take to be able to answer questions quickly and correctly. I posted this on another message board, but haven't gotten any replies yet.


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Jim Ott
Born Milwaukee, Wisconsin, June 5, 1947; married; 2 sons, 1 grandchild. Graduate Milwaukee Washington High School, 1965; B.S. University of Wisconsin–Milwaukee, 1970; M.S. University of Wisconsin–Milwaukee, 1975; J.D. Marquette University, 2000. Full-time legislator. Former broadcast meteorologist and instructor at University of Wisconsin–Parkside. Served in US Army, 1970–73; Vietnam veteran. Member: State Bar of Wisconsin; American Meteorological Society; Mequon/Thiensville Noon Rotary; Mequon/Thiensville Chamber of Commerce; American Legion; Ozaukee County Republican Party; North Shore Branch Milwaukee County Republican Party; Lumen Christi Catholic Church (past parish council president). Recipient: National Weather Service Public Service Award 2006; Archbishops Vatican II Service Award 1999; Vietnam Campaign Medal and Meritorious Unit Citation; Emerging Political Leaders Program; BILLD Leadership Fellow; MADD Legislator of the Year2016, 2015, 2013; Wisconsin Chiefs of Police Association True Friend of the Law Enforcement Community 2016; Trout Unlimited recognition 2015; MMAC Champion of Commerce 2016, 2015. Elected to Assembly since 2006. Additional appointments, 2017: Judicial Council; Miller Park District Board of Directors (appointed by governor).


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I was told about a fun website for Christmas by a blogger friend at Parsimonious Pash.
There is a man in Michigan that owns reindeer and 3 times a day from the day after Thanksgiving till Christmas eve, he dresses up as Santa and feeds his reindeer live on a camera. You can also watch the reindeer at any time as well.
The website is Reindeercam.com
Imagine the delight your child will get when they see Santa and his reindeer live on camera! You can even add your child to the "nice list" and donate funds to keep Santa's reindeer fed as well as write letters to Santa. The cam is even available as an app for smartphones and tablets. Make sure you check out the FAQs section as well for some laughs and some interesting info about reindeer. I found out they live in such cold conditions as -80 F!
I really think this is an amazing website. I had fun watching the Reindeer myself! The Reindeer Cam is on 24 hours a day and even has night vision.


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Definition, Etiology, Pathogenesis Top
Pulmonary embolism (PE) refers to the occlusion of the pulmonary artery or some of its branches by an embolus. The embolus may be formed by thrombi (the most frequent cause of PE; these usually originate from deep veins of the lower extremities or the pelvis, less commonly from veins of the upper parts of the body; this type of PE is a clinical manifestation of deep vein thrombosis [DVT]), or occasionally by amniotic fluid, air (during insertion or removal of a central venous catheter), fat (after a long bone fracture), tumor cells (eg, renal cancer), or a foreign body (eg, material used for embolization procedures).
Risk factors for PE are the same as in the case of DVT (see Deep Vein Thrombosis). In approximately a half of all cases no risk factors are identified (idiopathic PE).
Complications of PE (their severity depends on the size of the embolus and individual cardiovascular reserve):
1) Ventilation-perfusion mismatch leading to impairment of gas exchange and subsequent hypoxemia (it may be aggravated by a shunt of poorly oxygenated blood from the right to the left atrium via a patent foramen ovale).
2) An increase in pulmonary vascular resistance (aggravated by vasoconstriction due to hypoxemia) results in increased right ventricular afterload, right ventricular dilation, a decrease in left ventricular filling, a reduction in cardiac output, hypotension/shock, and impaired coronary blood flow, eventually leading to acute ischemia and injury to the overloaded right ventricle. Impairment of coronary blood flow may cause myocardial injury or even a transmural myocardial infarction with normal coronary arteries, and irreversible progressive right ventricular failure is one of the major causes of death. In patients with heart failure, occlusion of even a small proportion of the pulmonary artery branches may result in shock, whereas in young and otherwise healthy individuals, a substantial occlusion of the pulmonary vascular bed may cause only minor clinical symptoms. Emboli in the peripheral branches of the pulmonary arteries may lead to lung infarcts and focal atelectasis. An increase in right atrial pressure may cause opening of the foramen ovale (this is anatomically patent in approximately a third of the healthy population), thus allowing a venous thrombus to pass and embolize into the systemic circulation (paradoxical embolism). After hemodynamic stabilization, a gradual recanalization of the pulmonary arteries takes place; in rare cases, the emboli do not dissolve despite adequate treatment and slowly undergo organization, which may lead to the development of chronic pulmonary hypertension.
Clinical Features and Natural History Top
1. Symptoms often have a sudden onset and include dyspnea (in ~80% of patients), chest pain (~50%; usually with features of pleural pain, less commonly resembling coronary pain [10%]), cough (20%, usually dry), less frequently collapse or syncope and hemoptysis.
2. Signs: More than half of patients develop tachypnea and tachycardia. In the case of right ventricular dysfunction, the signs include dilation of the jugular veins, a loud pulmonary component of the second heart sound, sometimes a tricuspid regurgitation murmur, hypotension, and signs of shock.
3. Natural history: Symptoms of DVT occur in an approximately one-fourth of patients. Mortality in untreated PE depends on the clinical severity of the disease (see Diagnostic Workup, below) and is up to 30%.
Diagnosis Top
1. Blood tests: Increased serum D-dimer levels; in the majority of patients with high-risk or intermediate-risk PE, elevated levels of cardiac troponins and/or natriuretic peptides (B-type natriuretic peptide [BNP] or N-terminal pro–B-type natriuretic peptide [NT-proBNP]) are seen, which are indicative of right ventricular overload.
2. Electrocardiography (ECG): Tachycardia; supraventricular arrhythmias as well as nonspecific ST-segment and T-wave changes (typically inverted T waves in leads III and V1-V2) may also occur. Rare features include SIQIIITIII syndrome, right axis deviation, and incomplete or complete right bundle branch block. In patients with PE causing hemodynamic instability, negative T waves in leads V2 to V4 and sometimes up to lead V6 are often observed.
3. Chest radiographs may reveal enlargement of the cardiac silhouette, pleural effusion, elevated hemidiaphragm, dilation of the pulmonary artery, atelectasis, and parenchymal opacification.
4. Computed tomography angiography (CTA) allows for an accurate assessment of the pulmonary arteries from the pulmonary trunk to the segmental arteries. Multislice CT (MSCT) also includes the subsegmental arteries (the clinical significance of isolated thrombi in these arteries is controversial). Additionally, CTA reveals interstitial pulmonary lesions.
5. Echocardiography: In patients with high-risk or intermediate-risk PE, this may reveal right ventricular dilation and thinning of the interventricular septum. A characteristic finding is a hypokinetic right ventricular free wall with preserved apical contractility, as well as dilation of the inferior vena cava due to right ventricular failure and right atrial hypertension. Transesophageal echocardiography allows for the visualization of the pulmonary arteries up to the proximal parts of the lobar arteries and thus detects emboli more effectively than transthoracic echocardiography.
6. Ultrasonography of the deep veins of the lower extremities: Compression ultrasonography (CUS) and/or ultrasonography of the entire venous system of the limb may reveal thrombosis.
7. Other studies: Pulmonary ventilation-perfusion (V/Q) scintigraphy is performed less often because of its limited availability and the advantages of CT angiography. However, V/Q scintigraphy provides less radiation exposure than CT angiography and is a first-line test during pregnancy; moreover, it should be considered in women of child-bearing age or other patients who do not have concomitant lung pathology (which can lead to indeterminate test results). Pulmonary angiography is used rarely because of its invasiveness.
A patient with suspected PE requires a rapid diagnostic workup. The management strategy depends on the patient's condition and the availability of diagnostic studies.
1. Evaluate the risk of early death:
1) High-risk PE: Symptoms of shock or hypotension (systolic blood pressure [SBP] <90 mm Hg or SBP fall by ≥40 mm Hg lasting >15 minutes, if not caused by arrhythmia, hypovolemia, or sepsis).
2) Non–high-risk PE: No manifestations of shock or hypotension.
a) Intermediate-risk PE: Features of right ventricular dysfunction (observed on echocardiography or CTA; elevated BNP/NT-proBNP levels) or positive markers of myocardial damage (increased levels of troponin T or I). The risk is additionally increased if the features of right ventricular dysfunction and myocardial damage occur simultaneously.
b) Low-risk PE: Absence of the above-mentioned features of right ventricular dysfunction and markers of myocardial damage.
2. Evaluate the clinical probability of PE (eg, using the Wells score [Table 3.19-13] or the modified Geneva score [Table 3.19-14]) in a patient with non–high-risk PE. In patients with suspected high-risk PE, the clinical probability of PE is usually high. Diagnostic tests can also be used to consider an alternative diagnosis, for instance, ECG may be used to assess for an acute coronary syndrome or acute pericarditis and a chest radiograph may be used to assess for pneumonia or pneumothorax. The exclusion of alternative diagnoses can increase the clinical probability for PE, which requires specific diagnostic testing.
3. Diagnostic tests in patients at high risk with suspected PE: Figure 3.19-3. To confirm the diagnosis, perform an urgent CTA or a V/Q lung scan. If CTA or a V/Q scan is unavailable, or if CTA cannot be performed due to the patient's condition, bedside echocardiography may be helpful in providing indirect evidence for PE (eg, dilated right ventricle, increased pulmonary artery pressure).
4. Diagnostic tests in patients not at high risk with suspected PE: Figure 3.19-4.
1) Patients with a low clinical probability of PE: Measure the D-dimer level using a high-sensitivity (~95%) or moderate-sensitivity (~85%) assay. A normal D-dimer level is sufficient to exclude PE and further investigations and treatment are not necessary. If the D-dimer level is elevated, perform CTA; a negative CTA result excludes PE and allows for the safe discontinuation of anticoagulant treatment.
2) Patients with an intermediate clinical probability of PE: Measure the D-dimer level using a high-sensitivity (~95%) assay. A normal D-dimer level is sufficient to exclude PE and further investigations and treatment are not necessary. If the D-dimer level is elevated, perform CTA; a negative CTA result excludes PE and allows for the safe discontinuation of anticoagulant treatment.
3) Patients with a high clinical probability of PE: Measurement of D-dimer levels is not recommended and CTA should be performed. In patients with an indeterminate CTA result, consider a V/Q scan or bilateral CUS to assess for DVT.
The diagnosis of PE in non–high-risk patients is confirmed by a thrombus observed in CTA and extending to the level of the segmental arteries. If the embolism is limited to a single subsegmental artery and there is no evidence of thrombosis elsewhere (eg, lower limb DVT), anticoagulant therapy may not be warranted.
5. Diagnosis of PE in pregnancy: The measurement of D-dimer levels is of limited value because these may be elevated due to pregnancy, particularly in the second half of pregnancy. If the D-dimer is negative, there is insufficient evidence that it can be used to exclude DVT without further diagnostic imaging. The initial diagnostic test is lower extremity venous ultrasonography, because the diagnosis of DVT is sufficient to start anticoagulant therapy without further diagnostic testing for PE. Diagnostic tests involving ionizing radiation should only be performed in pregnant women with normal bilateral lower limb venous ultrasonography. A V/Q scan and CTA can be done during pregnancy, but V/Q scanning is suggested as an initial test because it has been better studied and there is more radiation exposure to the mother with CTA.
Pneumonia and pleurisy, asthma, chronic obstructive pulmonary disease, pneumothorax, acute respiratory distress syndrome, heart failure, acute coronary syndrome (eg, in the case of ST-T changes in a patient with chest pain), intercostal neuralgia and other causes of chest pain; and in the case of high-risk PE, also cardiogenic shock, cardiac tamponade, and aortic dissection.
Severe heart failure and exacerbation of COPD are risk factors for VTE and may coexist with PE.
Treatment Top
Treatment of High-Risk Pulmonary Embolism
Treatment of high-risk PE: Figure 3.19-3.
1. Start symptomatic treatment:
1) Treat hypotension/shock as in patients with right ventricular failure (see Acute Heart Failure). Note that intensive fluid resuscitation may have harmful effects due to an increase in right ventricular overload.
2) Depending on the presence and severity of respiratory failure, administer oxygen and consider indications for mechanical ventilation.
2. IV unfractionated heparin (UFH): Administer UFH immediately at a loading dose of 80 IU/kg (up to 5000 IU) as an IV bolus provided that anticoagulant treatment is not contraindicated (see Heparins).
3. Thrombolytic therapy: Thrombolytic therapy is suggested if not contraindicatedEvidence 1Weak recommendation (benefits likely outweigh downsides, but the balance is close or uncertain; an alternative course of action may be better for some patients). Low Quality of Evidence (low confidence that we know true effects of the intervention). Quality of Evidence lowered due to the risk of bias and imprecision. Kearon C, Akl EA, Comerota AJ, et al; American College of Chest Physicians. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):e419S-94S. doi: 10.1378/chest.11-2301. Erratum in: Chest. 2012 Dec;142(6):1698-1704. PubMed PMID: 22315268; PubMed Central PMCID: PMC3278049. (see ST-Segment Elevation Myocardial Infarction) (most contraindications are relative in the case of life-threatening PE, particularly when immediate embolectomy is not possible). Early confirmation of PE using imaging studies is indicated, but in critically ill patients the decision to use thrombolysis can be made solely on the basis of the clinical features suggestive of PE. In some patients, bedside cardiac echocardiography may provide indirect evidence to support a diagnosis of massive PE (right ventricular dilation, elevated pulmonary artery pressure, paradoxical septal motion). In patients with cardiac arrest, the immediate administration of 50 mg of IV alteplase and starting cardiopulmonary resuscitation may be life-saving. Thrombolytic therapy is most effective when administered within 48 hours of the onset of PE symptoms, but may have beneficial effects even after 6 to 14 days.
Dosage of thrombolytic agents:
1) Streptokinase:
a) Accelerated regimen (preferred): 1.5 million IU IV over 2 hours.
b) Standard regimen: 250,000 IU IV over 30 minutes followed by 100,000 IU/h.
2) Recombinant tissue plasminogen activator (rtPA) (alteplase):
a) Standard regimen: 100 mg IV over 2 hours.
b) Accelerated regimen: 0.6 mg/kg (maximum, 50 mg) over 15 minutes.
4. If the patient has not received heparin prior to the administration of the thrombolytic agent, administer IV UFH 80 IU/kg (up to 5000 IU) and then start a continuous infusion of UFH at a rate of 18 IU/kg/h (up to 1300 IU/h) while monitoring the activated partial thromboplastin time (aPTT). If a loading dose of UFH has been used before the thrombolytic agent, you may continue the UFH infusion together with an infusion of the thrombolytic agent or start UFH after the discontinuation of the agent. Evidence is lacking in regards to whether UFH should be continued during the concurrent administration of thrombolytic therapy; it is suggested that UFH not be coadministered during thrombolytic therapy.
5. Once thrombolytic treatment has been discontinued, with the patient stabilized while still receiving heparin, start long-term anticoagulation with a VKA or direct oral anticoagulants (DOACs) following the same principles as in DVT (see Deep Vein Thrombosis).
6. In the case of contraindications to anticoagulant treatment in patients at high risk of PE recurrence, ie, with extensive proximal DVT, consider placement of an inferior vena caval filter. The filter is inserted via the femoral vein or the internal jugular vein and placed in the inferior vena cava, below the ostia of the renal veins. This treatment is sometimes also indicated in selected patients with severe pulmonary hypertension (to protect against even a minor PE episode, which in this situation could be life-threatening) or after pulmonary embolectomy. If the risk of bleeding has decreased, start anticoagulant treatment and remove the filter. Do not place the inferior vena caval filter in patients receiving anticoagulant treatment.
7. If thrombolytic therapy is contraindicated or has been ineffective (hypotension or shock persist), as well as in the case of a mobile thrombus in the right ventricle or right atrium (particularly passing through the foramen ovale), consider pulmonary embolectomy (surgical removal of the thrombus from the pulmonary arteries, performed using extracorporeal circulation). In the case of a thrombus located proximally in the pulmonary arteries, you can also consider percutaneous embolectomy or fragmentation of the thrombus using a catheter. Such interventions should only be considered in experienced specialized centers.
Treatment of Low-Risk Pulmonary Embolism
1. In all patients with suspected PE, start anticoagulant treatment while still waiting to perform diagnostic tests if the results cannot be obtained within 24 hours. In patients with a high or intermediate clinical probability of PE, start anticoagulant treatment immediately, without waiting for the results of diagnostic tests.
2. Anticoagulant treatment regimen: see Deep Vein Thrombosis.
Treatment of Intermediate-Risk Pulmonary Embolism
The treatment is the same as in patients with low-risk PE, but in patients with right ventricular overload and myocardial dysfunction it should be started in a clinical setting with continuous monitoring of heart rate and blood pressure. In case of clinical deterioration, start "rescue" thrombolytic treatment, and if this is contraindicated, perform embolectomy or percutaneous intervention, depending on the clinical setting and availability.
Treatment of Pulmonary Embolism in Pregnancy
1. Non–high-risk PE: see Deep Vein Thrombosis.
2. High-risk PE: If this is life-threatening for the pregnant patient, consider thrombolytic therapy (it may cause bleeding into the placenta and lead to miscarriage). Pulmonary embolectomy is also associated with a high risk for both the child and the mother.
3. Do not use DOACs in pregnancy.
See Deep Vein Thrombosis. While continuing treatment with heparin, consider switching from UFH to LMWH or fondaparinux.
Prevention Top
1. See Primary Prevention of Venous Thromboembolism.
2. Prevention of recurrent VTE: see Deep Vein Thrombosis.
Tables and FiguresTop
Score (original)
Score (simplified)
Predisposing factors
History of DVT or PE
Recent surgery or immobilization
Symptoms: Hemoptysis
Heart rate >100 beats/min
Signs and symptoms of DVT
Clinical assessment: Alternative diagnosis less likely than PE
Clinical probability (3 levels; original score)
Low clinical probability: Total score 0-1
Intermediate clinical probability: Total score 2-6
High clinical probability: Total score ≥7
Clinical probability (2 levels; original score)
PE not likely: Total score 0-4
PE likely: Total score >4
Clinical probability (2 levels; simplified score)
PE not likely: Total score 0-1
PE likely: Total score ≥2
Adapted from Thromb Haemost. 2000;83(3):416-20 and Thromb Haemost. 2008;99(1):229-34.
DVT, deep vein thrombosis; PE, pulmonary embolism.
Score (original)
Score (simplified)
Predisposing factors
Age >65 years
Previous deep vein thrombosis or pulmonary embolism
Surgery or fracture in the past month
Active malignant condition
Unilateral lower limb pain
Heart rate 75-94 beats/min
Heart rate ≥95 beats/min
Pain on deep venous palpation of the lower limb and unilateral edema
Clinical probability (3 levels; original score)
Low clinical probability: Total score 0-3
Intermediate clinical probability: Total score 4-10
High clinical probability: Total score ≥11
Clinical probability (3 levels; simplified score)
Low clinical probability: Total score 0-1 points
Intermediate clinical probability: Total score 2-4 points
High clinical probability: Total score ≥5 points
Clinical probability (2 levels; original score)
Pulmonary embolism unlikely: Total score 0-5 points
Pulmonary embolism likely: Total score ≥6 points
Clinical probability (2 levels; simplified score)
Pulmonary embolism unlikely: Total score 0-2 points
Pulmonary embolism likely: Total score ≥3 points
Adapted from Arch Intern Med. 2008;168(19):2131-6 and Ann Intern Med. 2006;144(3):165-71.
Figure 3.19-3. Management algorithm in patients with high-risk pulmonary embolism.
Figure 3.19-4. Management algorithm of non–high-risk pulmonary embolism.


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MANHATTAN — Dean Wade's time away from the basketball court because of an injured foot may soon come to an end.
The senior forward is expected to return to Kansas State's lineup within the next 10 days, coach Bruce Weber said Thursday. There's a chance he will even be ready to play for the Wildcats in their next game, an 11 a.m. tip at Iowa State on Saturday.
"I don't want to say yes or no, but we are moving forward," Weber said. "Hopefully, if there is no major setback here in the next week or 10 days we hope to have him back."
That is excellent news for the K-State basketball team, which has struggled without its best player during the past six games.
Wade, the Big 12 Preseason Player of the Year, hasn't suited up for the Wildcats since he tore a tendon in his right foot during a victory over Georgia State on Dec. 15. He left the court and needed crutches to walk to the locker room. Weber said Wade would need anywhere from three to eight weeks to recover.
The Wildcats have looked lost on offense without him. They started 0-2 in Big 12 play and struggled mightily shooting the ball before storming back from a 21-point deficit to beat West Virginia on Wednesday.
Wade was averaging 13.6 points and 7.8 rebounds before his injury. Those numbers rank second and first on the team, respectively.
It appears he is nearly ready to join the starting lineup. Wade has returned to practice and looked fine walking in street clothes before games.
"He is going to practice a little bit today and then we will just see how he does," Weber said. "That is kind of our next step. He has done workouts, he has done running, he has done walking, he has done jumping in the water. So now get him on the court and let him practice a little bit."
K-State plays at Iowa State on Saturday, at Oklahoma on Wednesday and then returns home for a clash with TCU at Bramlage Coliseum on Jan. 19.
Wade could be a candidate to play in any of those games, but the Wildcats are unlikely to rush him back into action before he is fully ready. He has a history of foot injuries and missed the majority of last year's NCAA Tournament with a stress fracture in his left foot.


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The seniors in our society hold a privileged place and deserve special care. They, like all the others, are on a hunt for cheap car insurance that will help them to save their monthly premium. In the State of Georgia, there are multiple issues that need the attention of elders before they apply for a particular insurance. The main issue with the insurance company is high risk factor of senior citizens than the younger ones. The younger citizens are at a relative advantage as compared to the older ones because of less risk value.
The car insurance companies tend to hesitate while risking a big premium on a potentially risky applicant. Georgia cheap car insurance is no longer an issue for the old people because they have a separate ministry looking after their affairs. The insurance rates offered by this company are way lesser as compared to the other companies in the US market.
If you follow certain tips, it will definitely help you save a huge premium and you can benefit from these ideas. While crossing a road intersection, try your level best to keep off from an accident. The best way to stay away from the accident is to stop at each intersection irrespective of presence of traffic signal. Make it a thumb rule to halt at the intersection even if there is no traffic passing by. If you are the holder of Georgia cheap car insurance, they have a special training package in place for you people.
Their training classes are meant to teach you to drive safe from accidents. Looking ahead of the intersection is another helping aid that gives you a better decision time. Keep your wits about while driving on a busy road as the cars can bump in from any direction without any prior indication. Always give a margin of error to the opposing driver as he may not drive up to your expectations.
One thing more that is not covered in most of the auto insurance in Georgia is the defiance of traffic laws. If you have violated a traffic law which is intentional breaking of the law, the insurance company will not be able to finance your losses. But in case of Georgia car insurance, you are legally covered if you have insurance already. But to be on the safer side, you must stay on the right side of the highway.
Try and follow the prescribed speed limits of the normal roads and interstate highways, because if you will defy any of these, your insurance company will not be able to help you. Now it is about time that you should buy yourself a best insurance plan. Georgia auto insurance offers you an easy way to find out a best deal for you. Just enter the ZIP and compare the prices / rates of various companies and customize the insurance package for yourself. You just need to get online to do that, leave the rest to customer support department.


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"People think a soul mate is your perfect fit, and that's what everyone wants. But a true soul mate is a mirror, the person who shows you everything that's holding you back, the person who brings you to your own attention so you can change your life. A true soul mate is probably the most important person you'll ever meet, because they tear down your walls and smack you awake."Thanks, Tom. You are mine and I will forever be grateful.
~~ Elizabeth Gilbert, Eat Pray Love
Keep smacking me awake, lover.


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Christmas and New Year in the Cotswolds
On this page you will find information on seasonal events taking place in the Cotswolds. From Christmas Markets to New Year Balls.
From Christmas packages at Cotswold Hotels to places to have your Christmas meal.
Christmas shoppers will be able to enjoy free parking to attend Christmas lights switch-ons and celebratory events in line with the following arrangements:
Saturday 26 November
Moreton-in-Marsh: free parking all day at Old Market Way car park.
Cirencester: free parking after 3 pm at all CDC car parks in town.
Thursday 1 December to Saturday 3 December
Tetbury: free parking at all CDC car parks in town after 4pm on 1 December until 6 pm on 3December.
Friday 2 December
Chipping Campden: free all day at Market Square
Bourton-on-the-Water: free parking after 3 pm at Rissington Rd car park (donations to local charities will be accepted on the day).
Friday 9 December
Stow-on-the-Wold: free parking from 3 pm at Maugersbury Rd car park.
Cllr Chris Hancock, CDC Cabinet Member for Enterprise and Partnerships, said:
"Waiving charges for Christmas light switch-ons and other festive events should save money for the many families across the District who plan to travel by car to enjoy one of more of these spectacles. We also hope that it will encourage people to arrive earlier and boost trade in local shops.
"We are already operating a 'free after 3pm' scheme every day at the Brewery and Forum car parks in Cirencester, and Christmas shoppers can also benefit from free parking on Saturdays, Sundays and Bank Holidays at the Council's Trinity Road headquarters (GL7 1PX) and also at the St James's Place offices (GL7 1FP)."
Quick Links
Corinium Hotel & Restaurant
New Year's Eve Gala Dinner & Dance
Join our popular annual celebration and make a night of it. £120 per person inclusive dinner, accommodation & breakfast. For further information and all bookings, please contact Tim on 01285 659711.
12 Gloucester Street, Cirencester, GL7 2DG
Other Information
Follow Us On Twitter
We have an active Twitter account where you can keep up to date with what's going on in the Cotswolds.
So if you have a Twitter account, you can follow us by going to http://twitter.com/cotswolds
More Adverts


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I know that New Englanders will all tell me that the only place for leaf peeping is in the northeast, but California has it's own special fall season. Instead of all the leaves turning and falling at once, they change by variety by week. So each week, while walking the dog, I will discover a new tree is losing it's leaves. This one is pure fireworks. The photo doesn't do it justice.
Posts Tagged 'Walking the dog'
24 Nov
Fall foliage
13 Jul
Letting go
Tonight I took off my shoes and walked the dog barefoot. The cement is
warm where the sun kissed it.
It feels so good. I wonder why I haven't done this before.


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GCC entertainment projects need 'designed-in' security
'Designing-in' contemporary security theories and technologies will lead to the development of safer entertainment and leisure projects in the GCC
Crowds, public, and space, for the public at large, conjure images of openness, freedom of movement, and limitless fun. In the Middle East, we see crowded public spaces all around us – from stunning shopping malls and high-end restaurants, to extravagant hotels and a variety of public events venues.
What we rarely think of as we enjoy these crowded public spaces are the security risks associated with them. We try not to imagine how our open, free, and fun areas could be compromised by such risks.
Security risks are very real today, but are such attacks preventable? Could we lessen the impact when they do occur?
Creating security within crowded and public spaces requires a number of things, and it starts with an acceptance that this is a shared challenge that requires a collective response.
Security is achievable with a holistic and considered approach. Let's use a stadium as our protected space to illustrate some of the different ways we can address security.
There is nothing worse than arriving at a stadium for an event and being confronted with a queue, or a rule regarding what you can or cannot bring inside. Security of public spaces will only work if we adopt an 'in it together' approach. This means not only promoting the requirements of security, but also, for example, encouraging people to leave larger bags at home.
We must push these messages on social media platforms, and also provide clarity on the reasons for the measures. The public will buy-in to initiatives if they can see a clear and justified reason for doing so. Just turning up at the stadium to be refused large bags will not help champion security initiatives amongst the public. Obtaining buy-in is key.
We also need to take a step back when we look at the space we are trying to protect. How do we expand the idea of a protected perimeter, and at what point do we stop?
In the stadium example, the venue itself is the object in need of protection. However, that doesn't mean we discount what we see as the immediate public space surrounding it, where large numbers of people still congregate. Nor should we ignore the extended public space and approaches, or the 'last mile' as it is commonly referred to.
This is typically uncontrolled, and often a poorly defined area where a crowd gathers ahead of the main event, or the exit route when the event is concluded. Each layer of space contributes to the protective layer we can build around our crowded spaces.
By understanding the requirements for security in these areas, we can begin to look at ways in which we can protect these spaces and provide information to assist in the protection of the inner layers of the venue. Simple measures such as 'spotters', or crowd-control personnel can – and should – be trained to identify suspicious behaviour, and to promote security messages to the public, contributing to the 'buy-in journey', promoting a secure space for all.
Technologies can also be used in these spaces to identify anomalies, known persons of interest, and to provide some early warning signs of a security threat through stand-off screening.
These elements only work when we consider the 'so what?' aspect. What must we do if we identify something suspicious? Protection of space means ensuring that a well-considered concept of operations has been prepared, and that procedures to deal with the out of the ordinary are not only in place, but are fully understood by the team.
If we move parking facilities away from a stadium to provide a larger stand-off area, then have we considered the other security risks that come from movement of people in and out of the venue? The security team responsible for the venue or event must think through these questions and scenarios.
A holistic security approach is vital to ensure that correct preventative measures and procedures are in place, and that this strategy is tested with major simulated exercises to identify any broken links in the chain. It has never been more important to protect our crowded spaces.


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|In stock
Perfect for newborns, the close cuddle of Moby Wrap will help you bond your little one - even when you're on-the-go. This wrap offers an easy-to-use, hands-free way to evenly distribute baby's weight across your back and hips, making for a comfortable carry and hassle-free adventures. It's made from a soft, breathable, blended fabric, and comes in fashionable solids and trendy prints, making it the perfect, one-size-fits-all solution for any parent or caregiver.


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Manuel Mendive: Nature, Spirit, and Body—Featuring Photographs by John Rowe opened on July 25, and will be on view until November 4, 2018, at the Bronx Museum of the Arts (located at 1040 Grand Concourse, Bronx, New York).
Description: Over the last fifty years, Cuban artist Manuel Mendive has developed a sophisticated and pointed examination of the influence of African oral-based traditions on Cuba through the experimental lens of contemporary art. His multidisciplinary work, in particular performances, has become a vehicle for exploring the intersections between art, religion, philosophy, politics, ethics, and anthropology. At the Bronx Museum, Mendive will present a new body of works focused on his continued visual interpretation of narratives of Yorùbá-Lucumí culture and wisdom literature, extending to the universal ideas and relationships between humans and nature.
Conceived as a cohesive group of paintings and sculptures, the overall installation suggests a passage to the heart of all living things. Steeped in ancient African wisdom and modern philosophical constructs, Mendive's artworks invite the viewer to be immersed in a universal search for identity and interconnectedness.
Born on December 15, 1944 in Havana, Cuba, Mendive studied at the San Alejandro Academy of Plastic Arts in Havana. His works are in the collections of the National Museum of Fine Arts in Havana, the Museum of Modern Art in Paris, and the Ethnographic Museum of Budapest, among others.
John Rowe has spent over two decades documenting people and cultures worldwide, and his work has been published by National Geographic, NBC News, CNN, Al Jazeera, The Guardian, L'Oeil de la Photographie, and The Explorers Journal, among others.
Click here to listen to the Manuel Mendive Elegy by Orlando Ferrand in English.
Click here to listen to the Manuel Mendive Elegy by Orlando Ferrand in Spanish.
[Image above: Manuel Mendive, "Fragmento de un paisaje / Fragment of a Landscape" (detail), 2017.]
Source: http://www.bronxmuseum.org/exhibitions/manuel-mendive-nature-spirit-and-body


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MacDonald gears up for ParaPan-Am Games
Tillsonburg's Tyson MacDonald will be representing Canada when he swims at his first Para-Pan American Games in Lima, Peru, August 25th-31st.
"I'm so ready for it," MacDonald smiled. "Ever since Trials, I've increased my training. This is some of the hardest training I've ever done, but also some of the best training I've ever done. Some of my swims at Provincials at the start of July were faster than some of the swims I had – rested – at Trials. So to me that was a really good sign heading into the summer.
"As the days get closer, it is really getting exciting. The realization that I am part of Team Canada has started to sink in, and that's just upping the excitement."
MacDonald, 22, who qualified for the Lima 2019 ParaPan-Am Games at the Canadian Swimming Trials in April, will be competing at what is expected to be the largest ParaPan-Ams ever with a record 1,850 athletes, including approximately 144 Canadians in 13 sports.
Before swimming at Trials, MacDonald needed his S14 classification (swimmers deemed to have some form of intellectual disability, supported by documentation from several experts), which he received after competing in Melbourne, Australia in February 2019.
"That went great, I got classified there," said MacDonald. "The swimming went well, the experience was awesome. That was kind of my first taste of being part of what Team Canada is like because all the coaches were there and the support staff."
In Australia he was able tap into resources that wouldn't be available to most club swimmers.
"So that was really exciting and I've built off of that since."
The Trials were a 'taper-focus' meet, and after qualifying in Toronto he went back into heavier training, including a 10-day trip to Spain at the end of April for a Swimming Canada camp, paid by Team Canada.
"The reason why they selected Spain is that it has a similar climate to what Peru will be like when we are there. It gave us a chance to swim outside, and just get into a new climate. Language is similar in Spain as in Lima, I guess, in some sections. So it was a number of factors, availability for instance.
"It gave us an opportunity to work directly with the coaches that are going to be coaching us directly in Lima… to get to know our coaches and train with swimmers in my classification, around the same age."
MacDonald, who grew up swimming competitively in Tillsonburg, then Brantford, is a currently member of the Wilfrid Laurier University team. But Canada, he said, represents something new.
"Now we have team goals, team expectations. It's a totally different competition, which is exciting. Change is good. Having the Spain Performance Camp, and having a few days in Montreal before we fly to Peru, just to regroup and gather after nationals, having that time together will be a good opportunity for us to get fired up, I'm sure."
His goal in Peru is to earn second-swim Top 8 opportunities.
"As I've always said, once you get a Top 8 you've got a lane, you've got a shot at a medal. I haven't set high expectation goals yet just because I'm waiting to see what the rankings look like going in. Then I can kind of zone into that a little bit better. My general thinking is to make second swims."
Earning some lifetime bests, while achieving Top 8 second swims would be even better.
"That would be a great day."
A condensed competition, MacDonald, who will be 23 at the Games, will not have a lot of time for sight-seeing – he's there to compete and support Team Canada.
"If you're not racing, you're in the stands cheering and watching. If you are racing, you're in race prep mode. And there's a recovery part, too. For me, I have one day off pretty much in the middle of the schedule, so for that day I'll be very low key, in the water doing a light practice, then staying off my feet, staying hydrated and well nourished."
His ParaPan-Am events will be 100 metre breaststroke, 200m freestyle, and 100m backstroke. Canada also has a 4x100m S14 mixed freestyle relay, which includes MacDonald. His final event will be 200m Individual Medley.
MacDonald leaves for Peru (via Montreal) August 15th, but before that he is competing in the para category at Nationals in Winnipeg, August 6-12.
"Pretty much the entire month of August I'm home a couple of days," he laughed. "It's quite a busy turnaround, lots of travel."
After the ParaPan-Am Games, MacDonald plans to return to Wilfrid Laurier for his fifth year of eligibility, while continuing to swim the varsity circuit, including OUA Championships.
"Once that's done I'll jump into final preparations for Para Olympic Trials in April 2020," he said, setting his sights on the 2020 Summer Paralympics in Tokyo.
"That will be a big one," he nodded.
After 2020 Trials, it's 'wait and see.'
"It's kind of we'll see what happens and go from there."


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World Youth Day memories: Cologne 2005
While the World Youth Day 2008 in Sydney is over already and I was reading the different media coverage on the event, my thoughts went back 8 and 3 years frequently over the last days. Some flashbacks and thoughts to share....
When you are regularly getting together with people you've met in Rome 2000 and you know the persons working at the episcopal youth organisation planning the World Youth Day tour for the Flemish delegation, it seems obvious that you go to the next World Youth Day . But when you are already 28, working, in a relationship, it becomes a bit less obvious as well. And yet it takes place in Cologne at 3 hours from where you live. Surely you cannot miss it.
So I joined the Flemish delegation with another 100 of us just for the closing weekend of the World Youth Day in Cologne. In the days before I left, I followed closely all media news on the event from home. It was very frustrating to see how the way journalists approached the pelgrims over and over again: we got to see protesters distributing condoms, they questioned youth about the pope and his visions on gay marriage, female priests, etc... This is getting so old. You either agree , partially agree or disagree with the Vatican and for western Europeans it's usually the latter. But it's so frustrating that focus in the media always goes to the same 5 or something controversial issues when covering the catholic religion. Yeah sure, condoms, ....that nicely brings the essence of the Christian faith. That surely is what the World Youth Days are all about. Grrr what a narrow-minded approach in its own.
Friday 19 August, Cologne
We got on the busses on Friday afternoon on a grey cold August day and drove to Cologne. As we only joined for the last 3 days (2 nights) we were hosted in a schoolbuilding unlike the majority of the Flemish delegation who was staying in host families in a parish at the edge of Cologne. As a matter of fact, the majority of all pelgrims at the World Youth Day was staying with German families. I find that very impressive and doubt somehow that the Belgians would manage/be willing to do so. Thumbs up for the German hospitality!
In contrast with Rome where the public life had completely disappeared , Cologne still seemed to continue its day-to-day activities with the pelgrims mingling in between. The traditional Road of the Cross on Friday evening was taking place in the neighbourhood where we staying together with other groups hosted in neighbouring parishes. While Germans were glancing at us from behind every window, we walked in a slow solemn march through the city towards a park for a short celebration. I felt their eyes peaking at my back while we were staring closely in the candle we were holding and shielding from the drippling rain and while were trying to sing our songs a little more firmly.
Saturday - Sunday 20/21 August 2005
This morning we had celebrated a last Eucharist with the hosting parish and all the host families. Even though I had not been in one of them, I could feel the warmth that had surrounded them all week. What a great community.
After the long goodbyes we all gathered in busses to drive to our assigned parking lot...in the middle of nowhere in the fields out of Cologne. On the highways we saw bus karavans going in all directions but luckily no traffic jams got generated. From the parking lot we started our hike towards Mariënfield where the night wake would be held by Pope Benedict XVI. Some other thousand of pelgrims from all nationalities had to leave from the same parking lot and we all hiked in long rows of singing, chatting, ...people through the fields. From across the fields and trees we could see other lines of people waving flags , praying out loud, ... coming nearer to us until roads merged in bigger and bigger groups.
When we arrived at Marienfield at our "entry gate", we saw people from all sides arriving and filling the location. Flags everywhere, all going to the same central point. Somehow I wondered if the arrival of a Crusade would have looked like that. (or any other big invading army). But this army was singing, laughing, having fun.
We installed ourselves in our designated sector and I find a little big of space to unroll my sleeping bag next to a Mexican (who still sends me an e-mail now and then of which I don't understand a single word), a group pelgrims from Strasbourg France and an American family. Later on I heard that each pelgrim had 0.7 square meter....I had exactly the room for one sleeping bag while using my backpack as pillow. If you wanted to go somewhere, you had to jump from sleeping bag to sleeping back. So at each walkway, you saw people taking off their shoes and tiptoeing on their socks over the other people's belongings gently. It was noted in the press afterwards that this clearly was not a rock concert crowd as they had never seen youngsters being so respectfull for each other. (I read similar press comments about Sydney this year: the city would have first been a bit reserved or even hostile against this invasion of pelgrims but slowly the friendly happy open pelgrims would have won the sceptic's heart...I am not surprised.)
The crowd didn't overwhelm me as much as in Rome: first of all I had expected it to be huge, secondly it was less than half the crowd as in Rome (800000 people slept there at night, the closing Eucharist was attended by 1.2 million people).
However this time my pelgrimage was not preceded by an exhausting week, so I could pay much more attention to the service, the texts , the vigil, etc (in Rome I had dozed off by the end of the evening and was woken up by the fireworks at midnight :p). This time I truly was curious to "meet" the brand new pope Benedict XVI. As was the habit with his predecessor, the crowd started scanding his name upon his arrival: "Beneditto". He waved it away, but still seemed to enjoy it very much. Whenever he mentioned the previous pope John-Paul II he got a huge applause...and I started to have a feeling that he mentioned John-Paul II quite often (on purpose?). Other than that he didn't allow much spontaneity in his teachings. They all seemed well prepared and structured and whenever the crowd interrupted something he sayd by applause or scanding or so...he simply paused until we were quiet again and then continued where he had left off. No spontaneous jokes in between....only heavy theological explanations. Although good, ...it was heavy to listen to.
I remember the weather predictions to be quite desastrous for the weekend: cold and rainy. I was equipped with a big plastic to use as a shield if necessary. But somehow the clouds remained in a big circle around Marienfield with an opening above ourselves. While that weekend there were inondations in Belgium (border at 30 min drive from Marienfield!)....we stayed dry and even got some sunshine. I have pictures of the clouded sky making a big curve around us with a nice blue whole above us......I don't know what to think about that phenomenon to be honest, but it sure struck me.
Rome 2000 was overwhelming and I remember mainly the friendships I made and the international meetings with the other pelgrims. Cologne 2005 had much more focus on the content for me. I am really greatful to have been able to participate twice. And from now on I follow the current participants with all my heart and thoughts during the next World Youth Days. I hope it is as powerful for them as it was for me.
Up to 2011 in Madrid!


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This course is the 3rd EBU Academy Master Class dedicated to Instagram. This time, there will be a special focus on the Stories.
Instagram continues its progression as the fastest rising social platform and claims more than one billion monthly active users. The platform is most successful with the 18-34 age group, which is precisely the demographic that Public Service Media has the most difficulty reaching.
This Master Class details the algorithm and functionalities of the platform, explores the specifics of the Stories format, a key element to be considered by a publisher when developing its social media strategy.
This Master Class builds on previous, highly rated, Master Classes and reviews learnings from successful publishers of Stories. It shares best practice from strategizing to hands-on production techniques.
SkillAudience Digital newsgathering Editorial Innovation Mobile Social Storytelling Strategy
05 - 06 nov. 2018
EBU Headquarters
L'Ancienne-Route 17A
Le Grand-Saconnex, Geneva
Date limite d'inscription
04 nov. 2018
Détails concernant l'inscription
The price includes tuition, course materials and coffee breaks. It does not include any other meals, travel or hotel costs.
Payment and cancellation policy
EBU Academy does not make hotel reservations. However, we have negotiated competitive rates with some of the hotels near the venue and the city centre. Please contact the hotel of your choice directly.
Hotels offering special rates for the EBU/Eurovision (pdf)
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Artificial Intelligence (AI), once the domain of low budget futuristic sci-fi movies and TV shows with farcical special effects (think "I, Robot" or Dr Who circa 1970s "I am a Dalek" and don't laugh) is now a reality. AI has arrived. Take a look around you. Self scan tills in the supermarkets, voice activated gadgets, Apple's Siri, driverless cars, AI assisted surgical procedures and Google's increased focus on machine learning. AI is pervading our every day humdrum almost by stealth.
The Moral Grey Zone Of Leadership
The leadership moral grey zone. Or, more plainly, the tolerance of unethical leadership behaviour has a huge impact upon businesses, their people and, ultimately their success. If you've ever worked in a dysfunctional organisation where unethical practices are the accepted norm or bullying, gossip and favouritism is rife, you'll be familiar with the grey zone.
Whether you're part of a start up or an established business, your choice of leader (and the systems that support them is the bedrock of success). In spite of more immediate short term wins, there's no longevity for a leader in the moral grey zone. The grey zone leader may appear to be achieving results, but they're not sustainable. Think Siemens former CEO and Chairman, Heinz-Joachim Neuberger and Johannes Feldmeyer, fined for bribery. Or the arrest of Bruno A Kaelin Head of Corporate Compliance at Alstom following investigations into his alleged role in a bribery slush fund. One of the most infamous moral grey leaders was Kenneth Lay of Enron, convicted of 6 counts of fraud. His unethical behaviour resulted in the downfall of the company. Often tolerated, morally grey leadership wreaks lasting damage.
What does it look like?
Research from Knoll, Lord, Peterson and Weigelt ( 2016, Journal of Applied Psychology, 46) identified two factors necessary for predicting unethical behaviour;
- Moral disengagement
- Situational strength
So what does this look like in practice? The researchers found that for leaders to engage in unethical behaviour, for example (if indeed you do need an example).
Bullying, marginalising, spreading rumour, preferential treatment of 'favourite' staff, manipulating information, cheating, lying or using the workplace to enhance personal relationships or social status
They have to morally disengage their own moral compass, or ignore societal norms to enter into the above.
Can you spot them?
Surprisingly, yes. There are telltale signs. The research found that leaders in the grey zone typically;
- Have Low Levels of Emotional Intelligence. Grey leaders focus on the task and the results they want rather than their behaviours or how they get there. Self awareness and self regulation is usually low in unethical leaders. They are unable to heed internal clues and cues that their behaviour is unacceptable. They are also unable to recognise that such behaviours are shunned by wider society. They are oblivious to their behaviours and may even believe they are role modelling.
- Reduced Self-Organisation. When we operate effectively as human beings our values and systems are congruent. The lack of alignment that unethical behaviour produces is easily tolerated by grey leaders. When behaving unethically, they don't feel dissonance between the beliefs they hold or espouse and their actions.
- Decreased Self Regulation. Unethical leaders display behaviours that lack impulse control, shouting, swearing, lying, bullying, creating a culture lacking in transparency, resulting in mistrust. Take time to reflect upon the worst office despot you've worked with and anyalse their behaviour, an ability to control themselves is usually in short supply. They are reactive, mercurial, the organisational grenade without a pin and more than just a little bit scary to be around.
- Lack Authenticity: They don't know who they are or they are pretending to be something they're not with a compelling variety of 'Game faces.' An individual's level of authenticity is a significant predictor of unethical behaviour. High levels of authenticity are the armour against unethical leadership. People with high levels of authenticity have greater self awareness and self regulation. They are not driven by ego and status and place more emphasis on listening, learning and developing. They possess a congruence between their values and their actions and when they don't they feel it.
The 4 Step Predictive Process
To disengage morally is a four step process. If you're leading a business you may recognise the telltale signs in your own behaviour (don't beat yourself up, you can change it). If you're responsible for L & D these are the stages of moral disengagement to watch out for;
- Creating a story. This is characterised by 'everyone else is doing it' or 'just this once'. A reconstruction that enables the unethical behaviour to flourish. It creates a reality where the behaviour is no longer immoral. The narrative is always creating justification for the behaviour e.g. 'It's not against the law'
- A reduction in accountability. Grey leaders place less emphasis on their own agency a more on the responsibility of colleagues by blaming others, organisational culture, systems and processes.
- They deny the result or pass the buck. Unethical leaders either deny or do not recognise the consequences of their behaviour. They are also adept at passing the buck.
- Victim perception. They will downplay their impact upon others or mentally reduce the status of those falling foul of their actions. Perceptions such as 'They're not important anyway' 'They don't matter' 'They wouldn't have a job without me' scenarios are common. Unethical leaders often push the blame onto their victims, absolving themselves of all responsibility.
Is it their fault or are they misunderstood?
The researchers found another significant factor affecting the moral grey zone, situational strength.The cues and systems provided by an organisational culture will either support or discourage unethical behaviour. The people, the culture, reward systems, processes to ensure compliance, actions, punishments (or lack of) all come together to form psychological impetus for ethical or unethical behaviour. Organisational systems and structures often support unethical behaviour. You might not be approving it but are you tacitly saying it's wrong?
Reflect on our checklist to see if you are supporting the development of unethical behaviour
- A lack of authenticity
- Your organisation places emphasis on task completion above all else
- Your business has considered objectives but not behaviours
- You do not explicitly disapprove of unethical practice
- Your systems promote a lack of ethics and may even reward them
- You recognise a narrative pattern that always seeks to blame others or justify behaviours
- You identify behaviours that fail to recognise the consequence of actions
- There is a narrative about how the impact of victims is negligent or it is their fault.
To learn more about selecting leaders or developing a workplace culture that promotes ethical behaviours contact us at firstname.lastname@example.com or join one of our Leadership programmes. We offer espresso bitesize, half day, one day, conference or bespoke sessions.
What's Your Moonshot?
Are You Shooting For The Moon?
Maybe you've thought about your core values, your mission statement or your vision but what about your moonshot? Yes, your moonshot. Mission, values and vision can often sit on a shelf gathering dust with barely anyone other than the people who came up with them knowing what they are. A moonshot is different.
Originating from the Apollo and Soviet lunar programmes aiming to land humans on the moon, the term is now common business parlance. A moonshot is a long term business goal, an audacious ambition or innovative project. Google subsidiary, X, the company's research lab refer to their most ambitious projects as moonshots. Led by Astro Teller, or "Captain of Moonshots" X works firmly in the future rather than the present. Think AI, Google Brain, the driverless car, Project Loon or Project Calico researching life extension. Like Google X the moonshot is firmly focused on the future, the art of possibility, of what could be rather than what is. A moonshot is something to aim for. It inspires your organisation at every level.
Moonshots are bold. They look beyond strategy towards the future. They are extraordinary projects or proposals that fulfil the following criteria;
- It addresses a problem, a big one
- It proposes a radical solution
- It utilises innovative thinking & technology
Teller takes the moonshot one step further by;
- Addressing the hardest part of the project first. This is a kind of natural selection, culling unsuitable projects in this phase. Teller describes this as identifying the Achilles heel early on rather than wasting time and money only to discover it later.
- Rewarding failure. We know from the work of Carol Dweck that learning by failure is the way to go. When a project is killed off in the culling phase, staff are rewarded. Failure is celebrated rather than brushed under the carpet.
Moonshots are game changers. They design the future rather than simply following the herd. So if you're a business, start up or tech company looking to innovate, forget business as usual and follow our 6 step plan.
- Identify the problem – think huge ideas rather than bitesized.
- Along with your big idea there needs to be the potential to overcome the problem (this part is mission impossible rather than mission tricky)
- Form a team of committed, motivated, collaborative experts.
- Work out what the most difficult aspect of the project is and set to work.
- Foster a growth mindset. Learn from and celebrate failure.
- Get buy in to the project at every level of your business.
- Get to work and reach for the stars.
Want to find out more about innovation, moonshots, growth mindset or anything else involved in reaching for the stars? Contact us at email@example.com we'd love to hear from you. Check out our creativity and innovation training on our courses page to find out more.


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Run Time Error: This indicates that an external routine could not access a GT.M database library routine because it did not call the GTM$INIT library routine first. The GTM$INIT library routine initializes the GT.M run-time environment.
Action: Call GTM$INIT or a GT.M M routine before calling any other database access library routine.


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Posted: January 21; Updated: January 24
Tens of thousands are expected to march in New York on Saturday in solidarity with the Women's March on Washington simultaneously taking place in the nation's capital.
The marchers, who are joined by activists both around the country and around the world, are promoting the rights of women, the LGBTQ community, workers, environmental issues, racial inequality and more.
Plans for the marches began the day after Donald Trump was elected president in November, following a contentious campaign in which he vowed to eradicate President Barack Obama's Affordable Care Act, defund Planned Parenthood, enforce stronger immigration laws and withdraw from the Paris Climate Agreement.
The New York event kicks off at 10:30 a.m. at Dag Hammarskjold Plaza on 47th Street between 1st and 2nd avenues with a Facebook Live salute with marchers in London. A rally with speakers will follow, and the march is set to get underway just before noon.
Marchers will travel south in staggered groups from the plaza to 42nd Street and head west past Grand Central Terminal to 5th Avenue. They will then turn north and continue to the end of the march route near Trump Tower at 721 5th Avenue.
Guest speakers, music and more will take place throughout the afternoon.