text:
Bioethics Training in Uganda: Report on Research and Clinical Ethics Workshops
- First Online:
DOI: 10.1007/s10730-010-9144-3
- Cite this article as:
- Griggins, C., Simon, C., Nakwagala, F.N. et al. HEC Forum (2011) 23: 43. doi:10.1007/s10730-010-9144-3
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This essay describes and critically evaluates a co-operative educational program to train Ugandan health care workers in bioethics. It describes one "bottom-up" effort, a week-long intensive workshop in bioethics provided by the authors to health care professionals in a developing country—Uganda. We will describe the background and circumstances that led to the organization of the workshop, and review its planning, design, curriculum, and outcome. We will focus especially on measures taken to make the workshop relevant for the audience of Ugandan professionals, and describe lessons learned after two presentations of the workshop. Finally, we will discuss the strengths and weaknesses of such a format, and its potential value in raising bioethical expertise in developing countries.
KeywordsAIDSInternational bioethicsUganda bioethicsAbortionAccess to healthcareBiomedical research
The volume of biomedical research being conducted in resource-poor countries has been steadily increasing, partially in response to the AIDS crisis in Africa and Asia, but also because of an ever-growing need for populations willing to participate in clinical trials of all kinds. Research is being sponsored not only by academic centers and non-government organizations (NGOs) from wealthy countries, but increasingly by the for-profit sector (primarily pharmaceutical companies). Whenever multinational research involves collaboration between a wealthy sponsoring country and a resource-poor host country, however, there is great potential for exploitation and harm. The reasons for this circumstance lie in the host countries' poverty and desperation for medical treatments, their lack of medico-legal systems to serve as watchdogs on powerful foreign entities conducting the research, and their lack of expertise with ethical issues which govern research (Macklin 2004; Simon et al. 2007; Benatar 2002). Also, fundamental differences in moral theory and sense of interpersonal relationships may make those in traditional cultures vulnerable to exploitation. Numerous regulations, laws, and standards have been written in an attempt to protect human subjects from harm, dating back to the Nuremberg Code and Declaration of Helsinki, but these are only as effective as the ethics review committees who are charged with interpreting them and utilizing them to monitor research.
One response to the problem of exploitation by powerful researchers has been to focus on capacity building within the resource-poor countries—raising local professionals' level of ethical expertise so that they can provide their own analysis and management of proposed research protocols. Although host countries have local ethics review boards, which must approve all research to be conducted within their borders, these boards operate at varying levels of sophistication. There is concern about their effectiveness in "pushing back" when powerful sponsors' ethics consultants have already approved research protocols. It is assumed that if a larger core of professionals were sufficiently trained in medical and research ethics, they could better articulate their country's morals and values, and more effectively protect their populations from harmful or exploitative research studies. Increased expertise in bioethics could strengthen resource-poor countries' positions when negotiating with foreign sponsors, companies, and NGOs desiring to conduct research in their communities, hospitals, and clinics.
Another reason for raising the level of bioethical expertise in resource-poor countries is the widespread availability, often for the first time, of treatments for infectious diseases like HIV. As these countries gain access to HIV treatments, facility with "implementation ethics" (Rennie & Behets 2006) becomes necessary. The implementation of treatment protocols raises significant ethical challenges with regard to screening for the virus and fair distribution of treatment resources.
Capacity building in resource-poor countries can be accomplished in a number of ways. One model, used by the NIH-sponsored Fogarty International Program, offers training grants to bring select individuals to developed nations to study bioethics in established centers and academic programs. Often structured assistance is available as these trainees return to their countries to serve on ethics review boards, assume leadership positions in research and health care, or set up educational programs of their own.
An alternative model of capacity building focuses on targeting larger groups of students and professionals in the developing country, providing briefer, less intense training but reaching a larger number of individuals. This "bottom-up" approach has been utilized by a number of academic research programs and NGOs, including Family Health International (http://www.fhi.org).
Both approaches—providing formal bioethics education in Western academic centers, or less intense training to a larger group in the host country—pose similar challenges. First, there is a danger of the "Western experts" (even with the best of intentions) imposing their own ethical viewpoint upon trainees whose culture may have quite different values, customs, and moral theories (Metz 2007). Second, the vast economic disparity between Western countries and those in the developing world results in widely different health care resources and systems, with widely differing problems. Western bioethicists, less familiar with the problems of extreme poverty, grossly underfunded health care systems, and full-blown epidemics of infectious disease, may lack the frame of reference that would most resonate with resource-poor professionals.
Finally, offering bioethics training to select health care workers or researchers may be relatively ineffective in bringing about real change for patients and research participants in resource-poor countries. As Ashcroft (2005) has suggested, such limited efforts may be simply a "moral fig leaf covering the structural violence in countries in transition" (p. 229). In other words, this type of education in bioethics may be simply misguided, serving only to appease Western audiences, and failing to address the true ethical problems facing health care and research professionals in developing countries.
This paper describes one "bottom-up" effort, a week-long intensive workshop in bioethics provided by the authors to health care professionals in a developing country—Uganda. We will describe the background and circumstances that led to the organization of the workshop, and review its planning, design, curriculum, and outcome. We will focus especially on measures taken to make the workshop relevant for the audience of Ugandan professionals, and describe lessons learned after two presentations of the workshop. Finally, we will discuss the strengths and weaknesses of such a format, and its potential value in raising bioethical expertise in developing countries.
Workshop Context
Uganda, an independent nation in eastern, sub-Saharan Africa, has a population of 32 million. A former British colony, it has had a relatively stable government since 1986 and enjoys friendly relations with the United States. The country is quite poor (ranked 149 out of 171 countries in per capita income) with 87% of Ugandans living in rural areas and surviving on subsistence agriculture. The literacy rate is 69%, and public education has only recently become mandatory through the 6th grade. English is the official language, although there are approximately 43 different ethnic groups within the borders of Uganda, many of whom speak their own language.
In 2007, Uganda had one physician for every 10,000 people. The national health care budget is just over $135 per person.
Like most sub-Saharan countries, Uganda has experienced HIV/AIDS in epidemic proportions. Some 132,500 new cases of HIV were reported in 2005; and in 2007, 940,000 adults were known to be living with AIDS. The average life expectancy is now 48 years (46 for males; 51 for females) (http://www.who.int/gho/countries/uga.pdf). There are 1,200,000 children orphaned as a result of AIDS living in Uganda. The health care system struggles to deal with the epidemic (as well as the related epidemic of TB); 50–70% of hospital admissions are AIDS-related.
Uganda, however, differs from most other sub-Saharan countries in that ever since the identification of the first AIDS case in 1982, it has been acclaimed as the African nation that has taken the most open and aggressive public health approach to dealing with the epidemic. As early as 1987, President Museveni urged Ugandans to become aware of the virus that causes AIDS and protect themselves from its transmission. This open stance by the government, with widespread public education in the media, is believed to be responsible for what is known as the "Ugandan miracle"—the reduction of the HIV infection rate from a high of 25% (at antenatal sentinel sites) to the current national rate of 5.4%.
Given its stability, well-established medical schools, and friendly stance towards the US, Uganda is the site of numerous Western-sponsored research efforts. Recently, Uganda has received large amounts of aid from the US government (through the President's Emergency Plan for AIDS relief) to provide HIV treatment to the population.
Like many African countries, Uganda is in transition from a traditional, rural and tribal-based society to a modernized, urban society. As a result, a majority of Ugandans seek treatment from both Western (modern) medicine and traditional healers when they become ill. The Western health care system can be described as two-tiered, with wealthier, insured Ugandans receiving care from private clinics and hospitals, and the majority treated in a system of government-funded hospitals and clinics.
The bioethics workshop described here was first requested by a well-established, NIH-funded, HIV and TB research program based in Kampala, the capital of Uganda. The program, a collaborative effort between an American university and a Ugandan institution, has been in existence for nearly 20 years, and is currently conducting numerous clinical trials related to TB and HIV. The goal was to provide a service to the local professionals by offering a yearly workshop in research ethics. The Ugandan partners would be responsible for designing the educational effort and would choose the site each year.
Designing the Workshop
A major concern of the workshop organizers was that the educational offering not be inappropriately dominated by Western ideology, and that the structure and content be accessible and relevant to the Ugandan participants. To this end, all aspects of planning and execution were the result of close collaboration between the American and Ugandan partners. Several key decisions promoted the "Ugandanization" of the workshop.
Ugandan Leadership
The first of these decisions determined that the Ugandans should take the lead in designing the format, recruiting faculty, and selecting participants for the training. A 5 day, intensive workshop format was determined to be the most practical for the targeted audience of Ugandan health care professionals, who could be released from work duties for that length of time. The workshop would be repeated once each year. Because most of Uganda's ethics expertise is concentrated in the capital, it was decided that the workshops would be offered in the second largest city, where less formal ethics training has been offered. Participants would not be charged a fee to attend, nor would they receive any payment for their participation.
The Ugandan planners extended invitations to the first workshop to senior health care providers (physicians, nurses, pharmacists) in the local hospital, as well as to faculty and administrators in the local medical and nursing schools, and to individuals serving on research ethics committees (equivalent to American Institutional Review Boards). Because of favorable response to the first offering of the workshop, a number of professionals expressed interest in the second offering, and participants were selected from a pool of applicants. The selection process resulted in a more senior, established group of professionals in the first workshop, and a significantly younger group, more junior in their careers, in the second. No research ethics committee members were included in the second workshop. Attendance at each workshop was limited to 40.
International Faculty
Planners determined that an equal number of Ugandan and American faculty should be recruited. Ugandan faculty included a physician who had earned a Master's degree in bioethics in the U.S. through the Fogarty International Program. The American faculty, recruited from academic and hospital bioethics departments, came from a variety of academic backgrounds, including medical anthropology, clinical psychology, and philosophy. Local guest lecturers were included in both workshops.
Incorporating Clinical and Research Ethics into the Curriculum
Perhaps the most important decision made by the Ugandans planners was that the curriculum should include both research ethics and clinical ethics. This decision was based on the recognition that biomedical research in Uganda, as in many developing countries, is inextricably intertwined with the delivery of medical care. Public hospitals and NGO-sponsored clinics often deliver treatment as part of research protocols, and professionals and patients alike have difficulty discriminating between research and clinical care. Aware that most front line health care workers encounter patients who are enrolled in clinical studies, the planners realized that all Ugandan clinicians should be conversant in both research and clinical ethics in order to recognize the differences between them, and the difference in the ethical guidelines that govern each. They also realized that frontline health care workers who understand the ethical requirements of research are in an excellent position to note and report any unethical practices. Because of this dual focus, faculty experienced in both research and clinical ethics were recruited.
Designing a Relevant Curriculum
Although the American faculty was charged with planning the curriculum, the Ugandans made suggestions of desirable topics and made final alterations to the drafted plan. A list of topics covered in the curriculum is presented in Appendix 1.
A unique feature of the workshop was the faculty's high level of commitment to making the curriculum relevant to the Ugandan situation and culture. Multiple steps were taken to realize this commitment. American faculty familiar with African culture and the Ugandan health care system were recruited. Prior to the first workshop, they visited Ugandan hospitals and clinics in order to observe conditions and current initiatives such as the recently-inaugurated nationwide "Routine Counseling and Testing" program. They observed physician–patient interactions and interviewed physicians, nurses, administrators, and faculty members in order to learn of the typical ethical dilemmas faced by health care workers and researchers.
Examples of Ugandan Ethical Dilemmas
1. "We always have prisoners being brought into hospital for further management by doctors. But oftimes there may be no drugs and then patients are required to buy their own drugs; yet they may not easily access their relatives for help. So the patients are left helpless."
2. "My problem—why I came to hospital—is the abdominal problem which needs operation. (1) Why should I be asked to take an HIV test? (2) I have agreed and it's positive. Now you are asking for CD4 count—and it's low. Now you say the plan is: you can't operate because the CD4 is low. Why deny me treatment? Doctor's explanation: 'The prognosis may become worse'"
3. "Unconscious patient tested for HIV (for diagnostic purpose) and found positive. On improving, patient was counseled for testing and he refused completely. How would you disclose the results, as it was done without his consent? His wife (8 months pregnant) consented and was counseled for testing and she was negative."
4. "Breakdown during study—child: You are in the middle of an interview with an HIV orphan whose caretakers have consented to the study and he has also accepted to participate. He is 9 years old. All of a sudden he starts crying after questions concerning his late parents. He continues to cry without hope of ending soon. Do you go on with the interview? Do you stop? What can you do?"
5. "Fair Benefits: In a study of a contagious disease, only a few members in a home are eligible. They are enrolled, and they receive free full medical care and follow up. Along the way, other members of the family succumb to the disease/infection but still cannot be enrolled on the study. Is it fair for only some members to get free medical care? Shouldn't the uninfected members of the family be given free prophylactic care?"
6. "Abortion: Just recently I had a patient who was HIV+ and had an unwanted pregnancy. She really wanted to have an abortion. She called me specifically (I am her physician) to advise her. Personally, I value my religious beliefs and practices and they are against abortion. Abortion is illegal in this country but people do it anyway. So I couldn't tell her that. She badly needed my advice and I became speechless. How could I have handled her?"
Another pedagogical exercise was employed in each workshop, in part to deepen American faculty's understanding of Ugandan culture, but also to focus participants' attention on aspects of their culture that impact health care and participation in research. Small groups were asked to reflect upon Ugandan values and beliefs regarding a specific health-related topic, such as sexuality, birth control, substance abuse, or death. Topics with key observations are listed in Appendix 3.
Participants were also asked to focus on ethnic differences that might affect health care and participation in research. An exercise of this type is essential when teaching bioethics in an African nation like Uganda, which consists of 43 different ethnic groups—most of which have their own language, values, and traditions. Rivalries, prejudices, and misunderstandings exist among these groups, and impact physician–patient relationships, participation in research, and health care delivery. At least five Ugandan ethnic groups were represented among the workshop participants, and they appreciated an opportunity to talk in a formal and somewhat academic way about the ethnic differences and tensions between themselves and their patients.
Several changes were made after the first workshop to further customize the curriculum to the participants' experiences and needs. Small group projects were assigned during the second workshop, to be completed by the end of the week. The topics were gleaned from participants' own work experiences or research ideas, and are listed in Appendix 4. Presentation of the projects to the larger group on the last day of the workshop enabled faculty to assess the participants' learning and skills acquisition. Also during the second workshop, a condensed version of a research protocol originating in the US, which had been implemented in Uganda several years previously, was distributed with the Principle Investigator's permission, and a mock ethics review committee meeting was staged to illustrate the review process.
Finally, in order to heighten relevance, the faculty made a commitment to be flexible and responsive to the particular interests of the workshop participants. The curriculum was not only rewritten based on Ugandan faculty's input, but was revised nightly based on feedback from participants.
Lectures were presented in Power Point format, although a high level of interaction and discussion were encouraged throughout the workshops. Unfortunately, because access to computers and the internet is expensive and inconsistent, course materials and readings could not be distributed electronically. Instead, they were printed in the US prior to the workshop, shipped to Uganda, and distributed during the workshop.
Excellent attendance was maintained throughout the workshops, which is somewhat unusual for the Ugandan setting. Verbal and written feedback provided at the conclusion of the workshops was extremely positive. Participants reported that the content was relevant and applicable to their daily work. A number of participants felt that their careers would be enhanced by their participation, and at least one reported later that he had been promoted to a new position in part because of his attendance at the workshop.
Lessons Learned
Providing Bioethics Education to Frontline Health Care Workers in a Host Country is an Effective and Efficient Use of Resources
Directing ethics education towards frontline health care workers makes sense for a number of reasons. Participants in both workshops reported that they regularly encountered ethical dilemmas in their clinical work, and most had directly observed irregularities related to research participation. These frontline workers knew Ugandan patients well—their cultural tendency towards passivity, their lack of education, and their tradition of paternalism. They understood how easily patients, because of their great trust in physicians, could be manipulated and even deceived. Workshop participants were also aware of the Ugandan ethics review boards, which are seen as the protectors of human research subjects. They reported dysfunction in the system, including favoritism, nepotism, corruption, and review board "shopping" when protocols are rejected. These perspectives supported the organizers' assumption that educating frontline health care workers can enhance the level of monitoring and oversight, and provide valuable assistance to PIs, research teams, and even ethics review boards.
The appropriateness of educating frontline workers was also supported by their high level of motivation and engagement in the workshops and their willingness to disseminate the information to others. Verbal and written feedback indicated that the content was highly relevant to their work, and almost all participants demonstrated an excellent level of understanding and facility with ethical analysis by the end of the week. A number of participants shared formal and informal plans to educate others at their place of employment or in their educational programs following the workshop. At least one graduate from the first workshop returned as a "guest lecturer" for the second, and played a pivotal role in several discussions.
Careful Attention Should be Paid to Participant Selection and Group Dynamics During Ethics Training in Diverse Societies
Ethical discourse, or moral deliberation, is based on dialogue. It is rooted in the belief that each and every stakeholder has a uniquely valuable point of view, and that open discussion among stakeholders is essential to finding the optimal resolution to an ethical dilemma. This process of open dialogue between individuals of different ages, sexes, professions, levels of power, and social standing may be novel, challenging, and even upsetting for individuals from hierarchical societies such as those in Africa. Faculty learned that when teaching ethics in Uganda and possibly elsewhere in Africa, great care must be taken to facilitate open dialogue while simultaneously respecting the local culture. Faculty can accomplish this first by modeling cooperation between individuals of different sexes and professional disciplines. They can structure discussions in such a way that local elders and traditional leaders are honored, but participation by all is expected. They can also continually and explicitly point out the unique contribution of both sexes and all professional disciplines.
In observing the group dynamics in the two offerings of the workshop, it appeared that females, nurses, and younger professionals in the first workshop were inhibited by the presence of males, physicians, or "elders." The females (most of whom were nurses) rarely contributed to group discussions except when specifically encouraged by the faculty, or when required by the structured exercises. In contrast, participants in the second workshop, who were generally younger, more junior in professional standing, and less bound by traditional gender and professional roles, adapted more easily to open discussion. They were able to establish fluid dialogue among themselves, even when disagreement was evident. Modeling a free exchange of ideas appeared to be more successful when the majority of faculty was female rather than male, and when different disciplines (not just physicians) were represented.
An International Team of Faculty, Collaborating on Design and Presentation of an Ethics Workshop can be Highly Effective, and may be Preferable to Local Faculty Alone
Concern about cultural imperialism might suggest that Western faculty should play a less active role in the design and presentation of an ethics workshop in a developing country. However, the authors' experience suggests that an equal sharing between an international faculty is extremely valuable.
Throughout the workshops, constant comparisons of American and Ugandan culture were made by faculty. Rather than inhibiting the Ugandans, this continual juxtaposition of the two cultures seemed to help them see their own cultural values and beliefs more clearly. Hearing how Americans viewed an issue forced the participants to articulate what the Ugandan stance might be with regard to that same issue. The value of this cross-cultural discussion was such that, following the second workshop, the Ugandan organizers stipulated that American faculty should be involved in all future workshops, even if their own faculty should become sufficiently skilled to teach the workshops alone.
The multicultural nature of the faculty was key in provoking discussions that might not have occurred, or certainly would not have developed in the same way if only Ugandan faculty had been teaching. A prime example was the intense discussions that took place during the second workshop regarding homosexuality. The timing of the second workshop coincided with a sudden public discourse on homosexuality in Uganda, triggered by a lesbian couple who had very publicly "come out" and accused numerous individuals—including their physicians—of discriminating against them. Ugandan culture and religious teaching strongly condemn homosexual activity and the Ugandan participants and faculty were almost unanimous in supporting this view. The American faculty's perception of homosexuality as a human rights issue was challenging to the Ugandans, and faculty purposely returned to the issue throughout the week. The issue had implications not only for ethical clinical practice, but also for fair inclusion of all individuals in clinical research. While no agreement was reached, the quality and depth of the discussion most certainly would not have been the same had the American faculty not been present. The ongoing discussion demonstrated to the group that respectful dialogue can occur between thoughtful individuals with strongly differing opinions.
With the increase in multinational research involving subjects from resource-poor countries, the need for oversight and protection of vulnerable participants is greater than ever before. Regulations and standards that effectively address the power differential and economic disparity between researchers and desperate populations are constantly being re-evaluated and refined. But equally as important are thoughtful critics and effective ethics review boards—in both the sponsoring and host countries—who will be vigilant in upholding those standards. Therefore, raising the level of ethics expertise in resource-poor countries is vital if they are to do their part in strengthening ethics review committees, making their own voices heard, and "pushing back" in a meaningful way against potentially harmful research.
One way to raise the level of ethics expertise in developing countries is to expose front line health care workers to ethics education through brief training workshops, and in this paper, we have described our experience in offering such a workshop. After reflection, we believe that this experience has implications for the larger task of ethics capacity building in developing nations.
Overall, the experience suggests that a brief (1 week) intensive program for frontline health care workers is feasible, effective, and an efficient use of resources. Financially, the costs are minimal and can be easily included in the budget of multinational research organizations. The format is workable, as participants can be granted a leave from work and/or educational activities for this length of time without undue burden. The logistics of setting up such a workshop are facilitated if there is an ongoing collaborative relationship between the researcher's institution and the host country; an existing infrastructure greatly reduces the practical problems of communication between geographically-separated faculty and the staging of the workshop itself. However, even without a well-established infrastructure, researchers working with host countries could offer ethics training to those carrying out research protocols as well as frontline workers in the host institution.
We believe that the format described here is effective in accomplishing several goals. Recruiting frontline health care workers makes sense because they bring to the workshop a fairly astute awareness of the ethical problems that arise in local clinics and in research. With their experience as health care providers, they are able to reach a high level of sophistication and skill in a 1 week training session. In 40 hours, they are able to gain an appreciation for the similarities and differences between clinical treatment and research, and a solid understanding of the ethical principles that govern each of these endeavors. By the end of the workshop, participants can apply their learning to resolve ethical problems in their own clinics, and are capable of educating others about basic ethical issues.
Our experience suggests that a small team of faculty, but one diverse in gender, academic discipline, and cultural background, can be highly effective in educating professionals in a traditional culture. A diverse faculty can demonstrate the process of moral deliberation, which may be novel and even uncomfortable for professionals more familiar with a hierarchical or paternalistic approach to decision-making. A faculty made up of nurses, physicians, philosophers, and other professionals can underscore the value of hearing different opinions and different voices: women's voices, nurses' voices, minorities' voices, and voices from completely different cultures. Participants can experience open discussion of controversial and provocative issues that might not ordinarily be discussed in their culture.
Obviously, there are many shortcomings to a brief educational model such as described here. Time limitations restrict the number of topics that can be addressed, and the depth in which they can be discussed. However, 40 hours of training in bioethics is more than is offered to most health care workers, even in resource-rich countries. A judicious use of time, exclusive focus on topics relevant to the host country, and provision of supplementary reading materials are clearly necessary, especially when both research and clinical ethics must be presented. Our experience has also taught us that sufficient time must be allowed for discussion of post-workshop implementation if participants are expected to train others or apply their new skills in their work. Building networks to support post-workshop communication is also important.
A second criticism of an ethics workshop for frontline workers is that awareness of ethical problems is being sharpened in individuals who must then return to environments that lack mechanisms for addressing these problems. Participants reported an increased ability to analyze ethical dilemmas, consider options, and recommend solutions. However, they expressed frustration that they had no real power to carry out those solutions or affect change. Participants who observed irregularities in research or in the functioning of ethics review committees not only feared retribution for speaking up, but usually could not even identify individuals or groups to whom they could make such reports. Clinical dilemmas sparked the same frustration. Participants reported great moral distress when they had to "ration at the bedside" or watch vulnerable patients like prisoners, or patients without families be denied treatment. They wished for hospital policies that would address these problems and relieve them of this burden. Obviously, making organizational change is well beyond the scope of the faculty and most of the participants in a workshop format. Educational efforts of this type clearly have to be part of a larger strategy that focuses on administrative and organizational change. Otherwise workshops of the type described here can indeed be considered window-dressing, or "moral fig leafs."
A third problem is common to any educational effort offered by a Western faculty to a developing country audience. Presenting Western moral theories, or even "mid-level" principles such as beneficence, nonmaleficence, autonomy, and justice, may be inappropriate or even disrespectful of a developing country's own moral framework. For example, authors such as Metz (2007, 2010) have described an "African moral theory" based on principles such as harmony, communality, and solidarity. While there are certainly commonalities between Western and African ethics, African principles may lead Ugandan physicians or researchers to very different conclusions or actions from their American colleagues. (This was quite obvious when workshop discussions turned to the topic of duty to warn partners and family of a patient's HIV infection). It is important that the faculty from the host country be well-versed in their own moral tradition and be able to "translate" or compare and contrast their principles with those presented by the Westerners.
A final problem is that much of Western academic bioethics is, simply put, irrelevant to resource-poor countries. One of the authors (F.N.), a Ugandan faculty member educated in the United States through a Fogarty International training grant, expressed his frustration by saying to his American colleagues: "yours is a bioethics unconstrained by poverty." What he meant, of course, was that much of Western bioethics is pre-occupied with problems that are totally irrelevant in impoverished countries: issues surrounding esoteric, cutting-edge technologies, physician-assisted suicide, and futile treatments at the beginning or end of life. Well aware of this circumstance, faculty excluded these topics from the curriculum.
However, what the resource-poor audience needed was expertise in the ethics of poverty, resource distribution, epidemics, gender inequality, government corruption, and wartime casualties—the areas in which Western bioethicists are the weakest, and to which bioethics as a discipline has devoted the least amount of research and scholarship. Participants needed to analyze the ethics of colonialism, the ways it has shaped the African psyche, and how it impacts relationships with foreign researchers today. They needed to discuss how ethics can respond to government corruption, and what professionals' responsibility is when all the funds for patient meals have been "diverted" and there is no food in the hospital for 3 days. Granted, these problems, which fall under Paul Farmer's label of structural violence (Farmer 2005), are not being totally ignored. They are being studied by a subgroup of internationally-oriented bioethicists. However, as a discipline, bioethics is still woefully unsophisticated in these areas.
It is naïve to think that any one type of intervention can impact global health care, or meet even a single country's needs for ethics education. The question is whether a workshop such as the one described here can be an effective part of a larger strategy to raise ethical expertise in a resource-poor country. We believe that it can be, provided that the educational effort is responsive to the country's realities and needs, focuses on both clinical and research ethics, and teaches skills that can be applied by participants in their environments. Finally, the training should be repeated often enough and long enough in one geographic area so as to "saturate" the area's pool of health care workers. A critical mass of frontline workers conversant with basic research and clinical ethics can be a key factor in protecting human participants in research by keeping ethics review boards aware of problems and promoting ethical practices in health care systems.


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The Minnesota Senate will not act to ban assault weapons or high-capacity ammunition clips this year, a DFL leader said Monday.
Sen. Ron Latz, DFL-St. Louis Park, who is chairing the Senate's gun hearings this week, said he will focus on closing the loopholes in background checks and leave the issue of banning weapons or ammunition to Congress.
"The assault weapons ban and high-capacity magazine ban proposals are highly divisive," said Latz, chairman of the Senate Judiciary Committee. Legions of concerned gun owners turned out for three days of hearings on gun issues last week, and Latz said such bans also do not have strong support from law enforcement.
On the other hand, he said, the idea of filling loopholes in background checks has strong public and police support, and he believes it can pass this year.
"Law enforcement does have broad consensus in favor of universal background checks, closing loopholes in existing statutes," he said. "I want to focus on what has broad public support."
The bans introduced in the House by Rep. Alice Hausman, DFL-St. Paul, were opposed by the National Rifle Association, the state's Gun Owners Civil Rights Alliance and dozens of gun owners who felt the bills would violate their constitutional rights. They questioned how the weapons would be defined and what would happen to those who own them now.
Support came from Protect Minnesota, a gun-control organization, and former Minneapolis Police Chief Tim Dolan. But the Minnesota Police and Peace Officers Association, which represents rank-and-file police officers, threw its support behind universal background checks rather than the guns and magazine bans.
"We always suspected this was the strategy from the minute this started, " said Rep. Tony Cornish, R-Vernon Center, leader of the gun-owners-rights position at the Legislature. "I don't think they thought they had the votes."
He said he remains opposed to the background checks plan out of fear that it would lead to a gun registry that could be used for confiscation.
Rep. Michael Paymar, DFL-St. Paul, chairman of the House Public Safety Finance and Policy Committee, told gun-control advocates at the Capitol Monday that he will push ahead with the background-checks measure. Paymar said "universal background checks will be the centerpiece of our bill" but banning weapons or magazines would face "much more opposition."
Latz's committee scheduled hearings at the Capitol for noon and 6 p.m. on Thursday and noon Friday. Bills pending before his panel include trying to prevent people with severe mental issues from obtaining weapons and changing the way felons get their rights to purchase weapons restored.
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Classic Seashore Rental-225 Grant Surfside Cottage
From $727 / night
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Description from the owner
Description from the owner
Bedrooms: 9/
Bathrooms: 6/
Sleeps: 22/
Type: House
Book this 9 bedroom, 6 bathroom house in Cape May today! A total of 22 people can sleep here comfortably.
Guests can enjoy a hot tub, deck, and outdoor grill among other amenities offered by this rental.
Travelers are sharing their opinions on this property. It has an overall rating of 4/5 thanks to 1 review.
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Wigan 1 Bournemouth 1: Young pretenders fight back to save Martinez's blushes
Wigan manager Roberto Martinez rejected any suggestion he had shown disrespect to the FA Cup after seeing his side fight back to snatch a replay against their League One opponents.
Bournemouth led through Eunan O'Kane's fine strike just before half-time but were pegged back when Jordi Gomez fired in the rebound after his penalty was saved by Shwan Jalal.
Leveller: Jordi Gomez scored in the second half to rescue a draw for Wigan against Bournemouth
Match facts
Wigan: Pollitt, Boyce, Golobart, Figueroa, Stam, Fyvie (McArthur 79), Jones (Dicko 78), Redmond (Henriquez 46),Gomez, Boselli, McManaman.
Subs Not Used: Al Habsi, Espinoza, Kiernan, Campabadal.
Goals: Gomez 70.
Bournemouth: Jalal, Francis, Elphick, Cook, Daniels, McQuoid (Pitman 88), O'Kane, Arter, Pugh, Tubbs (Fogden 66), Hughes (Partington 90).
Subs Not Used: James, Demouge, McDermott, Fletcher.
Booked: Pugh,McQuoid.
Goals: O'Kane 41.
Att: 8,199
Ref: Robert Madley (West Yorkshire).
Wigan's second string were knocked
out of the Capital One Cup by League Two Bradford in October and they
were second best for long periods yesterday at the DW Stadium.
But Martinez, who made nine changes
from the side beaten 4-0 by Manchester United on Tuesday, said this was
the kind of test his young players needed.
He said: 'We need to be brave enough and patient enough to give them opportunities and everyone showed they were ready.
'I do show the Cup a really good respect. The games are competitive, games of real high intensity. Unless youngsters play in competitions like this, we'll never accelerate their development. Bournemouth deserved the draw.'
Bournemouth saw Marc Pugh booked for
a dive in the area and Matt Tubbs go close before they went ahead four
minutes before half-time.
O'Kane allowed a pass from Harry
Arter across his body before thumping home. Martinez threw on Angelo
Henriquez at the interval and the Manchester United striker, 18, headed a
Dave Jones free-kick against the bar.
In front: Bournemouth's Eunan O'Kane opens the scoring at Wigan
With just over 20 minutes remaining, Wigan finally equalised when Maynor Figueroa was held in the area by Simon Francis.
Gomez's penalty was saved by Jalal but the Spaniard stabbed in the rebound.
Bournemouth manager Eddie Howe said: 'We're a bit disappointed. The lads were brave and played some excellent football.'
Get in: O'Kane (left) celebrates with team-mate Marc Pugh after opening the scoring at Wigan
Second chance: Jordi Gomez missed a penalty (above) but was on hand to slam home the rebound (below)
Getting acquainted: Wigan Athletic's new signings Angelo Henriquez (right) and midfielder Roger Espinoza
Better things to do? Wigan's FA Cup clash with Bournemouth didn't exactly capture the imagination
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refugenoun [ C or U ]uk /ˈref.juːdʒ/ us /ˈref.juːdʒ/
C2 (a place that gives) protection or shelter from danger, trouble, unhappiness, etc.:
These people are seeking/taking refuge from persecution.
(Definition of "refuge" from the Cambridge Advanced Learner's Dictionary & Thesaurus © Cambridge University Press)
(Definition of "refuge" from the Cambridge Academic Content Dictionary © Cambridge University Press)
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the person who sits in the back of a rowing boat and controls its direction


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Science, Society, and the Arts (ad hoc)
Science, Society, and the Arts Planning Committee (SSA) (ad hoc, 2015-2017) plans the March 3-5, 2017, SSA7 multi-disciplinary conference involving Washington and Lee students in the presentation of their academic achievements before an audience of their peers and the faculty. Conference participants may make oral presentations of research papers on traditional academic-conference-style panels, deliver research results in poster sessions, or present creative work. Students may also choose to participate in colloquia organized around common readings proposed by interested students and faculty.
Matt Tuchler, Chair
Appointed Members
Melina Bell, Associate Professor of Philosophy
Michelle (Mikki) Brock, Assistant Professor of British History
Lynn Chin, Assistant Professor of Sociology
Stephan Fafatas, Lawrence Associate Professor of Accounting
Peter Jetton, Senior Director of Law Communications
Julie Knudson, Director of Academic Technologies
Fred LaRiviere, Associate Professor of Chemistry
Jemma Levy, Assistant Professor of Acting and Directing
Helen MacDermott, Office Manager, Center for Global Learning
Tom Marcais, Technology Integratiion Specialist
Kishanthi Vinayagamoorthy, Associate Professor of Law
David Pfaff, Integrative and Quantitative Science Center Coordinator
Matt Tuchler, Associate Professor of Chemistry
Ellen Kanziger '18U
Kathryn (Kate) Sarfert '17USkyler Zunk '19
Ellen Kanziger '18U


text:
Foursquare © 2016 Lovingly made in NYC & SF
The Fish Market Restaurant
Seafood · $$
105 King St
"Fresh oysters, spiced shrimp, chowder and good beer selection. What the Fish Market has done well for decades. When in doubt keep it simple."
Blackwall Hitch
Seafood · $$$
5 Cameron St (North Union Street)
"Great food, great location, and great service! Loved the fish & chips and my dining companions loved their soft shell crab and scallops and risotto."
Indigo Landing Restaurant
1 Marina Dr
"Fabulous view of DC and National Airport right on the Potomic River. Love this place - try their seafood cobb - it's yummy. Better seating if you make reservations. Great place for meeting too. They h"
Killer E.S.P.
Coffee Shop · $
1012 King St
"Espresso drinks are, as they say, killer. Don't miss out on the fantastic cold brew. Say hi to Buddy, the shoppe's dog. Enjoy the Cali-inspired space."
Murphy's Grand Irish Pub
Irish · $$
713 King St (btwn N Columbus & N Washington St)
"mmmm. lovely shepherd's pie and beer. at night, they also have live music (at least on the weekends). it's very inviting and a nice place to spend a low-key evening."
New American · $$$
1120 King St
"The vegetarian tasting menu with wine pairings was fantastic. /recommend."
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11 Teacher-Approved Crafts for School
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Cute Clip on Animals
By: ZiggityZoom
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Click here to view your Craft Projects.
These clip-on animals are great for little kids going back to school. Not only are they quick and easy to make, but it makes it easy to identify your child through all the other kids.
- Plastic clips or small beaded chains
- Glossy photo paper 8 ½ x 11 in. (any paper may be substituted)
- Laminating sheets
- Hole punch or Grommet tool
- Scissors
- Print sheet of Ziggity images on the glossy photo paper.
- Place printed paper between two pages of plastic laminate.
- Press pages firmly together.
- Carefully cut out Ziggity animal images, leaving some excess laminate around edges. (Parental assistance may be required.)
- Using either a grommet tool or hole punch, make a hole in the top of each animal, about ¼ in. from the top.
- Attach a plastic clip or metal, beaded chain to each Ziggity animal.
For more cute kids crafts go to ZiggityZoom.com
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|By Business Wire
Article Rating:
|November 5, 2012 03:02 AM EST
Moxie Software, Inc., the leading provider of customer-centric enterprise social software, today announced a partnership with Microsoft Corp. to pursue a joint, go-to-market strategy offering Spaces by Moxie™ within Microsoft Dynamics CRM.
As part of the partnership, Moxie Software™ will provide Microsoft Dynamics CRM with comprehensive, multi-channel and knowledge base solutions for delivering superior customer experiences. Offered on premises or in the cloud, Moxie Software's Knowledge Spaces™, Email Spaces™, Chat Spaces™, Web Self-Service Spaces™, CoBrowse Spaces™ and Social Media Spaces™ are immediately available to work with Microsoft Dynamics CRM.
Customer Benefits:
Spaces by Moxie enables Microsoft Dynamics CRM customers to provide differentiated and personalized customer experiences at scale. The combined solution allows customers to:
- Use Microsoft Dynamics CRM as the single source of truth for all customer and interaction data.
- Benefit from a single agent desktop that seamlessly works with multi-channel interactions to contact and case records within Microsoft Dynamics CRM.
- Automatically search the knowledge base from within the case record for faster case resolution.
- Publish information from the case record into the knowledge base as knowledge articles to improve effectiveness of the knowledge base.
- Proactively engage customers on the website via rules driven chat and create lead/case records within Microsoft Dynamics CRM where appropriate.
- Ensure accurate data by allowing agents to update Microsoft Dynamics CRM from within the agent desktop.
More details about the partnership can be found here.
Comments about the Partnership:
"We understand the need for businesses of all sizes to deliver scalable and personalized experiences," said Craig Dewar, Director, Microsoft Dynamics CRM Product Marketing. "Moxie's multi-channel and knowledge base solutions coupled with Microsoft Dynamics CRM capabilities empower our customers to provide a great customer experience. Having the right tools not only means enabling high productivity for customer care teams but, more importantly, it means transforming the workforce into a market intelligence network."
"Moxie's partnership with Microsoft validates our strategy of delivering superior customer experiences by enabling social knowledge and multi-channel communications across the enterprise," said Tom Kelly, president and CEO of Moxie Software. "This partnership gives Microsoft Dynamics CRM customers access to a comprehensive market offering for customer service and sales."
"The partnership between Microsoft and Moxie Software is just one of those partnerships in the industry that makes complete sense to me," said Paul Greenberg, president of The 56 Group, LLC. "Each of them fully complements the other, they are located in the same city and both of them are quality companies who have the right ideas on how to partner. I've had the opportunity to work with both of the companies individually and they both have been honorable, which bodes well for the partnership too. While I don't often endorse partnerships, I like this one, strength to strength."
About Moxie Software, Inc.
Moxie Software provides the only customer-centric enterprise social software suite that enables companies and organizations to effectively connect employees, customers and partners to engage in business, share knowledge and collaborate. Spaces by Moxie is a comprehensive solution that powers more than three billion social interactions per year for leading organizations in consumer services, financial, healthcare, high-tech and media and entertainment. Moxie Software's customers are able to innovate faster, improve operational efficiencies and provide superior customer experiences. To learn more about Moxie Software, visit www.moxiesoft.com.
Moxie Software, Spaces by Moxie, Knowledge Spaces, Email Spaces, Service Chat Spaces, Sales Chat Spaces, Web Self-Service Spaces, CoBrowse Spaces and Social Media Spaces are trademarks of Moxie Software, Inc. All other company and product names mentioned are used only for identification purposes and may be trademarks or registered trademarks of their respective companies.
With so much going on in this space you could be forgiven for thinking you were always working with yesterday's technologies. So much change, so quickly. What do you do if you have to build a solution from the ground up that is expected to live in the field for at least 5-10 years? This is the challenge we faced when we looked to refresh our existing 10-year-old custom hardware stack to measure the fullness of trash cans and compactors.
Aug. 30, 2016 02:30 AM EDT Reads: 1,851
The emerging Internet of Everything creates tremendous new opportunities for customer engagement and business model innovation. However, enterprises must overcome a number of critical challenges to bring these new solutions to market. In his session at @ThingsExpo, Michael Martin, CTO/CIO at nfrastructure, outlined these key challenges and recommended approaches for overcoming them to achieve speed and agility in the design, development and implementation of Internet of Everything solutions wi...
Aug. 30, 2016 02:00 AM EDT Reads: 2,220
Cloud computing is being adopted in one form or another by 94% of enterprises today. Tens of billions of new devices are being connected to The Internet of Things. And Big Data is driving this bus. An exponential increase is expected in the amount of information being processed, managed, analyzed, and acted upon by enterprise IT. This amazing is not part of some distant future - it is happening today. One report shows a 650% increase in enterprise data by 2020. Other estimates are even higher....
Aug. 30, 2016 01:30 AM EDT Reads: 3,043
Why do your mobile transformations need to happen today? Mobile is the strategy that enterprise transformation centers on to drive customer engagement. In his general session at @ThingsExpo, Roger Woods, Director, Mobile Product & Strategy – Adobe Marketing Cloud, covered key IoT and mobile trends that are forcing mobile transformation, key components of a solid mobile strategy and explored how brands are effectively driving mobile change throughout the enterprise.
Aug. 30, 2016 01:30 AM EDT Reads: 384
With over 720 million Internet users and 40–50% CAGR, the Chinese Cloud Computing market has been booming. When talking about cloud computing, what are the Chinese users of cloud thinking about? What is the most powerful force that can push them to make the buying decision? How to tap into them? In his session at 18th Cloud Expo, Yu Hao, CEO and co-founder of SpeedyCloud, answered these questions and discussed the results of SpeedyCloud's survey.
Aug. 30, 2016 01:15 AM EDT Reads: 2,317
Today we can collect lots and lots of performance data. We build beautiful dashboards and even have fancy query languages to access and transform the data. Still performance data is a secret language only a couple of people understand. The more business becomes digital the more stakeholders are interested in this data including how it relates to business. Some of these people have never used a monitoring tool before. They have a question on their mind like "How is my application doing" but no id...
Aug. 30, 2016 01:00 AM EDT Reads: 1,932
DevOps at Cloud Expo, taking place Nov 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 19th Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The widespread success of cloud computing is driving the DevOps revolution in enterprise IT. Now as never before, development teams must communicate and collaborate in a dynamic, 24/7/365 environment. There is no time to wait for long dev...
Aug. 29, 2016 10:00 PM EDT Reads: 2,487
Identity is in everything and customers are looking to their providers to ensure the security of their identities, transactions and data. With the increased reliance on cloud-based services, service providers must build security and trust into their offerings, adding value to customers and improving the user experience. Making identity, security and privacy easy for customers provides a unique advantage over the competition.
Aug. 29, 2016 08:30 PM EDT Reads: 2,440
Qosmos has announced new milestones in the detection of encrypted traffic and in protocol signature coverage. Qosmos latest software can accurately classify traffic encrypted with SSL/TLS (e.g., Google, Facebook, WhatsApp), P2P traffic (e.g., BitTorrent, MuTorrent, Vuze), and Skype, while preserving the privacy of communication content. These new classification techniques mean that traffic optimization, policy enforcement, and user experience are largely unaffected by encryption. In respect wit...
Aug. 29, 2016 08:15 PM EDT Reads: 1,872
SYS-CON Events announced today that StarNet Communications will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. StarNet Communications' FastX is the industry first cloud-based remote X Windows emulator. Using standard Web browsers (FireFox, Chrome, Safari, etc.) users from around the world gain highly secure access to applications and data hosted on Linux-based servers in a central data center. ...
Aug. 29, 2016 08:00 PM EDT Reads: 917
SYS-CON Events announced today that 910Telecom will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. Housed in the classic Denver Gas & Electric Building, 910 15th St., 910Telecom is a carrier-neutral telecom hotel located in the heart of Denver. Adjacent to CenturyLink, AT&T, and Denver Main, 910Telecom offers connectivity to all major carriers, Internet service providers, Internet backbones and ...
Aug. 29, 2016 07:00 PM EDT Reads: 1,980
Traditional on-premises data centers have long been the domain of modern data platforms like Apache Hadoop, meaning companies who build their business on public cloud were challenged to run Big Data processing and analytics at scale. But recent advancements in Hadoop performance, security, and most importantly cloud-native integrations, are giving organizations the ability to truly gain value from all their data. In his session at 19th Cloud Expo, David Tishgart, Director of Product Marketing ...
Aug. 29, 2016 06:45 PM EDT Reads: 846
StarNet Adds Secure Remote Linux and Unix Desktops to X-Win32 | @CloudExpo @XWin32 #Cloud #Linux #Security
StarNet Communications Corp has announced the addition of three Secure Remote Desktop modules to its flagship X-Win32 PC X server. The new modules enable X-Win32 to safely tunnel the remote desktops from Linux and Unix servers to the user's PC over encrypted SSH. Traditionally, users of PC X servers deploy the XDMCP protocol to display remote desktop environments such as the Gnome and KDE desktops on Linux servers and the CDE environment on Solaris Unix machines. XDMCP is used primarily on comp...
Aug. 29, 2016 06:15 PM EDT Reads: 800
Almost two-thirds of companies either have or soon will have IoT as the backbone of their business in 2016. However, IoT is far more complex than most firms expected. How can you not get trapped in the pitfalls? In his session at @ThingsExpo, Tony Shan, a renowned visionary and thought leader, will introduce a holistic method of IoTification, which is the process of IoTifying the existing technology and business models to adopt and leverage IoT. He will drill down to the components in this fra...
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DevOps at Cloud Expo – being held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA – announces that its Call for Papers is open. Born out of proven success in agile development, cloud computing, and process automation, DevOps is a macro trend you cannot afford to miss. From showcase success stories from early adopters and web-scale businesses, DevOps is expanding to organizations of all sizes, including the world's largest enterprises – and delivering real results. Am...
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Internet of @ThingsExpo, taking place November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 19th Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The Internet of Things (IoT) is the most profound change in personal and enterprise IT since the creation of the Worldwide Web more than 20 years ago. All major researchers estimate there will be tens of billions devices - comp...
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[session] Architecting for the Cloud By @RagsS | @CloudExpo @IBMBluemix #Cloud #Docker #Microservices
As the world moves toward more DevOps and Microservices, application deployment to the cloud ought to become a lot simpler. The Microservices architecture, which is the basis of many new age distributed systems such as OpenStack, NetFlix and so on, is at the heart of Cloud Foundry - a complete developer-oriented Platform as a Service (PaaS) that is IaaS agnostic and supports vCloud, OpenStack and AWS. Serverless computing is revolutionizing computing. In his session at 19th Cloud Expo, Raghav...
Aug. 29, 2016 02:00 PM EDT Reads: 1,012
Data is the fuel that drives the machine learning algorithmic engines and ultimately provides the business value. In his session at Cloud Expo, Ed Featherston, a director and senior enterprise architect at Collaborative Consulting, will discuss the key considerations around quality, volume, timeliness, and pedigree that must be dealt with in order to properly fuel that engine.
Aug. 29, 2016 12:45 PM EDT Reads: 2,030
There is growing need for data-driven applications and the need for digital platforms to build these apps. In his session at 19th Cloud Expo, Muddu Sudhakar, VP and GM of Security & IoT at Splunk, will cover different PaaS solutions and Big Data platforms that are available to build applications. In addition, AI and machine learning are creating new requirements that developers need in the building of next-gen apps. The next-generation digital platforms have some of the past platform needs a...
Aug. 29, 2016 12:15 PM EDT Reads: 849
19th Cloud Expo, taking place November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA, will feature technical sessions from a rock star conference faculty and the leading industry players in the world. Cloud computing is now being embraced by a majority of enterprises of all sizes. Yesterday's debate about public vs. private has transformed into the reality of hybrid cloud: a recent survey shows that 74% of enterprises have a hybrid cloud strategy. Meanwhile, 94% of enterpri...
Aug. 29, 2016 12:00 PM EDT Reads: 3,202


text:
- //Home
- //Music
- //Blogs
- //Mixed Media
- //John Foxx
Electro pioneer John Foxx has joined forces with animator Ian Emes to create the video for "Flightpath Tegel," one of the tracks from his new release, D.N.A. (out on October 11th). Foxx, a visual artist as well as a musician, takes his abiding fascination with film to its logical conclusion on a CD/DVD package that also includes a collaboration with director Macoto Tezka. In the wake of recent projects with Alex Proyas and designer Jonathan Barnbrook, Foxx's exploration of the possibilities of audiovisual work continues to bear rich fruit.
We all know how critical it is to keep independent voices alive and strong on the Internet. Please consider a donation to support our work as independent cultural critics and historians. Your donation will help PopMatters stay viable through these changing and challenging times where costs have risen and advertising has dropped precipitously. We need your help to keep PopMatters strong and growing. Thank you.
Young the Giant "Something to Believe In" (live) (premiere) // Music
Eli Paperboy Reed "My Way Home" (premiere) // Music
Paper Bird "Make My Dreams Come True" (Hall & Oates Cover) (premiere) // Music
The Specter of Multiplayer Hangs Over 'Door Kickers'
// Moving Pixels
"Door Kickers is not a multiplayer game, but for a while there, I couldn't tell the difference.READ the article


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Soulard Farmers Market
Anheuser-Busch Brewery
The world's largest beer plant, the historic Anheuser-Busch Brewery, gives marketing-driven tours. View the bottling plant and...
Meaning 'peace' in Sanskrit, Shanti is the Bohemian heart of Soulard. It hosts a popular Tuesday open mike and folk-bluegrass-rock acts...
Bogart's Smoke House
The soul of Soulard? The smoky meats here draw lines of people who tear into all the standards plus specialties such as prime rib....
730 Carroll St · interesting places nearby
Soulard Farmers Market information
A local treasure with a range of vendors selling regional produce, baked goods and prepared foods. Picnic or snack yourself silly. Dating to 1779, it's pretension-free.


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They appear after shark attacks, marathons, earthquakes and even terrorist attacks like the one in Paris last year. And they have appeared en masse most recently in images of migrants and refugees attempting deadly crossings of the Mediterranean Sea ...
The flu outbreak is hitting Maryland and the rest of the country hard.
Get the primer on the flu and what you can do to prevent it.
Eating things such as chicken soup, garlic and fruits and vegetables is not just an old wise tale when it comes to fighting colds and flu.
A scientific survey found 71% of gas pump handles and 68% of corner mailbox handles were highly contaminated with germs most associated with a high risk of illness.
Mark Baum believes the relentless EpiPen price hikes are "shameful" and his company is plotting a $100 alternative for the lifesaving allergy treatment.
The U.S. Department of Agriculture has temporarily closed six offices in five states after receiving several anonymous threats, USDA spokesman Matthew Herrick said Tuesday.
Zika continues its march around the world.
Any infant exposed to the Zika virus in utero should have their hearing tested after birth, no matter how normal they may appear, the Centers for Disease Control and Prevention announced Tuesday.
Some doctors may be milking their better-insured patients.
Fifteen more cases of locally-transmitted Zika virus have been confirmed in Singapore, the city-state's Ministry of Health (MOH) said late Monday.
With 41 cases confirmed early the same day, the total number of Zika virus infections in Singapore has ...
The president granted on Tuesday commutation of sentence to 111 individuals.
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We stayed there for one night only, however, the experience was great. Very helpful and attentive staff, clean room, perfect location right in the heart of Darling Harbour, as well as a nice swimming pool. We can really recommend staying there!
- Reservation Options:
- TripAdvisor is proud to partner with Booking.com, Hotels.com, Expedia, Hotwire, Orbitz, Agoda, Travelocity, Priceline, Odigeo and HotelTravel.com so you can book your Adina Apartment Hotel Sydney, Harbourside reservations with confidence. We help millions of travelers each month to find the perfect hotel for both vacation and business trips, always with the best discounts and special offers.
- Also Known As:
- Medina Grand Harbourside Sydney
- Medina Grand Harbourside Hotel Sydney


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JC Penney collecting used prom dresses
Now through April 2, JC Penney stores are collecting used prom dresses to donate to girls who need them.
Donors wlll get a 20% coupon to be used for a new dress for each used dress that is donated.
- Two new Ross Dress for Less stores set to open Saturday
- Meijer store in Sussex to open Tuesday
- National Business Furniture grand opening set for June 14
- Men's retailer Richard Bennett Tailors moving to Brookfield Square from Mayfair
- Bon-Ton Stores Inc. planning to sell, lease back three more stores
- Hallmark aiming for another touchdown: Packer Jordy Nelson is 2016 Keepsake ornament
- Wisconsin's first Akira store opens Friday at Brookfield Square
- Downtown Boston Store's new furniture department debuts Thursday
- Meijer partners with Froedtert & Medical College of Wisconsin network
- Fox Bros. Piggly Wiggly lands meat contest awards
Retail Business News
Retailers look to high tech to engage visitors to their store
The store, that basic building block of commerce, is emerging as a high-tech laboratory.
All sorts of things are bubbling up — from exotica such as holograms and virtual reality to more-prosaic but potentially more-useful technology — as legacy retailers seek to merge their physical outposts with the online world.
The transformation has chains making major investments, and Menomonee Falls-based Kohl's Corp., one of the Milwaukee area's largest employers, is no exception.


text:
Posts Tagged 'Star Trek'
Chris is mixing it up! "It's not really a traditional style 'Ask Roger Anything' question, but can you do a post on George Takei?"
To be honest, when you asked the question, I didn't have all that much to say. Subsequently, there's been a bit more.
Let me start with the original Star Trek (1966-1969). I was not a big fan, but my father was. Read the rest of this entry »
I received one of those recorded scam IRS phone calls this month, threatening to put me in jail. Mine came from the Syracuse, NY area from a known scam phone number.
2015 Was Hottest Year in Recorded History.
No boots on the ground… What does it mean?
Abortion Is as Old as Pregnancy: 4,000 Years of Reproductive Rights History.
No relation: The Green brothers explain January 1 and Oregon "militia" Read the rest of this entry »
In light of Leonard Nimoy's death on February 27, a not-unexpected event which nevertheless saddened me greatly, a couple family recollections.
When I was a teenager in Binghamton, NY, my father was a big fan of Star Trek, airing on NBC-TV in 1966-1969. He watched it every week, barring some meeting conflict. I'd wander into the living room, watch a scene or two, and walk away, bemused.
Read the rest of this entry »
New album from Rebecca Jade & The Cold Fact the debut release from San Diego-based eclectic soul/funk band. RJ is my niece, my sister Leslie's daughter.
From NBC San Diego: "Not everything on April Fool's Day was a joke. Rebecca Jade & the Cold Fact released their self-titled debut and it's no laughing matter. Channeling everyone from Candi Staton and Betty Davis to Morcheeba and Brightback Morning Light, these 12 tracks of soul and funk are stunners. Do yourself a favor and pick up a copy."
Another review.
In this picture, she's the one in the blue dress.
After watching this video, I'm even more convinced than I was before: Daylight Saving Time is a waste of time. Having tried to schedule a phone call from the UK at a point when the US is in DST and the UK has NOT yet moved to British Summer Time, I know of which the speaker is talking about.
Read the rest of this entry »
When I was in fifth or sixth grade, I learned the word vulcanization. It had to do with a heat process involving the manufacturing of rubber tires, usually involving adding sulfur to the mix. The word was derived from Vulcan, the Roman god of fire, from which the word volcano also evolved.
Thus, I was somewhat confused when I started watching the original Star Trek television series. I was not a big enthusiast initially, but my father was. The first officer was a character named Spock, not to be confused with the then-famous pediatrician Dr. Benjamin Spock. Read the rest of this entry »


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Hotels near Beaulieu Vineyard
Search hotels near Beaulieu Vineyard in Napa
Trending now in Napa
Hotels within 3 miles of Beaulieu Vineyard
- Most bookedHarvest Inn by Charlie Palmer
136 people looked at this hotel in the last hour
Most recent review
"Loved most things about the property. It is a beautiful spot just south of downtown St. Helena, perfect for touring Napa. The grounds are beautiful, with lush landscaping everywhere. The staff was very helpful. The hotel has been recently updated, and is a very tasteful blend of the old and t..."
A Traveller, Aug 2016, US
21 people looked at this hotel in the last hour
Most recent review
"Everything was beyond our expectations! Friendly staff, great service, special attention, fantastic room, amenities, grounds and surroundings. Worth every penny! "
A Traveller, Jul 2016, CA
14 people looked at this hotel in the last hour
Most recent review
"This was in the middle of everywhere we were traveling in Napa and was such a cozy place that made you feel like you were at home. "
A Traveller, Jul 2016, US
Hotels within 4 miles of Beaulieu Vineyard
61 people looked at this hotel in the last hour
Most recent review
"The hotel is old world charm - could use some updates, but everything was very clean and people were delightful. You felt like you were entertaining in your own home."
A Traveller, Jul 2016, US
29 people looked at this hotel in the last hour
Most recent review
"The rooms were super spacious and clean. Beds were comfy. Bathroom was huge for a hotel bathroom. Very nice! Fireplace was a lovely addition, if it had been cooler we would have used it!"
A Traveller, Aug 2016, CA
28 people looked at this hotel in the last hour
Most recent review
"Linda, the inn keeper is awesome. Great room and fabulous breakfast/ very nice hot tub an added bonus. I would definitely recommend the Oleander House. We have stayed in downtown Napa before, but check out Yountville- you won't be disappointed. Very quaint town😄"
A Traveller, Aug 2016, US
26 people looked at this hotel in the last hour
Most recent review
"Great value for a small very clean comfortable room with continental breakfast. I really like this 50's style hotel. The room is small however quality of bathroom, bed, wifi, and cable tv great!"
A Traveller, Aug 2016, US
19 people looked at this hotel in the last hour
Most recent review
"Every aspect exceeded our expectations which were high after reading the other great reviews. Staff was wonderful and room was clean and big with very high, vaulted ceilings. We were on the parking lot side but still had a great view - tons of trees and vines everywhere. Great shower pressure. ..."
B, Jun 2016, US
Hotels within 5 miles of Beaulieu Vineyard
17 people looked at this hotel in the last hour
Most recent review
"We had 2 rooms. Apt over garage with washer dryer was a treasure. My room in main house was charming quiet & comfy. TV & AC good. Best breakfast out of 8 places we stayed. Great redwood out front. "
D, Jul 2016, US
16 people looked at this hotel in the last hour
Most recent review
"An excellent experience! Definitely will book it again."
A Traveller, Jan 2016, US
Map of hotels near Beaulieu Vineyard
- Napa Valley Wine Train
- Robert Mondavi Winery
- Oxbow Public Market
- Domaine Carneros
- Uptown Theater
- Stags' Leap Winery
- Napa Golf Course at Kennedy Park
- Napa Premium Outlets
- Napa Valley College
- Westwood Hills Park
- Black Stallion Winery
- Artesa Winery
- Balloons Above the Valley
- Ceja Vineyards
- Darioush Winery
- Hess Collection
- Clos Du Val Winery
- Napa Opera House
- Di Rosa
- Napa Symphony
Hotels in Napa near Beaulieu Vineyard
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LM has worked its way over Mullan Pass and will soon meet counterpart ML in Avon nearing sunset. The day started with the previous LM here at sunrise.....
The ML glides along in the rain with a relatively short train.
Wasn't expecting this to emerge....but there you go, even in a sea of orange, a surprise can happen.
The revised west portal of the Mullan Tunnel resembles an excavation site.....which, in some respects, it was.
The ever-changing BNSF roster still gets my hopes up when I hear certain number series over the scanner....pretty much everything I used to know has moved on, either in numbering or off the roster... (more)
The new & improved west portal of Mullan Tunnel, combined with new & improved GE models dominating the roster, have reduced the famous scenes of exhaust until the helpers emerge.
Having passed a coal train stopped in the siding at Austin, the helper set is sent back "light" to assist the train which has now stalled.
A westbound loaded tank train heads west up the 2.2% slope of Mullan Pass. From this spot you can see 3 levels of track; Skyline Trestle, the approach to Weed, and Austin. On the far horizon is He... (more)
A CSX heavy GEVO lifts a manifest up the 2.2% grade over Greenhorn Trestle. Foreign Power is fairly common on the MRL and BNSF northern lines.
Beautiful things like this happen to me all the time. What was just supposed to be a laid back half-day of trains before other local activity yielded "the" train of the trip.
#841 is headed out past West Livingston in order to back down the main and access the R-Y Branch. These two empties will be swapped for two loads.


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