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Monday, May 3, 2010
The Month in Rebuke - April Power!
Never mind. That's another rant for another day.
For now, join us as we look back with instant nostalgia at the opening weeks of the season, and study the lessons to be learned from April 2010.
The Jays Offense, or why OPS was invented
Through this weekend's games, the Jays sit in dead last in the American League in on base, with a skimpy .303 mark. On the other hand, the Jays sit just behind the Yankees in team slugging percentage, hammering the ball at a rugged .453 clip. Toss those two marks together, and the Jays sit sixth in the AL in OPS, at .756.
Going, going, A-Gon
No one exemplifies the Jays early season offense better than Alex Gonzalez. Through Sunday's game, Gonzalez had 29 hits, of which 19 were for extra bases (eight homers, 10 doubles and a triple), good for a .619 slugging percentage. At the same time, Gonzo has eeked out just three walks in 26 games so far, while striking out 28 times. So take Gonzalez's meager .303 on base, add it to the generous helping of slugicity, tally it all up, and he ends up sitting in 10th in the AL in OPS.
We believe in Vernon Wells...so far
Speaking of the OPS leaders in the AL, V-Dub sits comfortably in fifth amongst qualifiers with a 1.075 mark. Moreover, Vernon is posting stellar Sabermetrically-correct numbers as well, ranking third in Runs Created (25.2), fourth in isolated power (.360) and fifth in secondary average (.450).
It's been an outstanding start to the season, and we hope that people aren't going to get used to it or get cynical about any drop off in performance from here on out. Vernon has looked like a new man, both at the plate and in the field. Or maybe he just looks closer to what we want him to be.
Either way, there's a lot less chatter about his contract. Which is good, because that talk is both boring and depressing.
Or if counting stats are more your bag...
The Jays finished the weekend with the most homers (38) and total bases (397) of any American League club. Boom baby!
Goodbye, hello
Every time the Jays send a player off the to the glue factory or back to the minors, it's an opportunity to meet someone new. As the month closed, we saw Jeremy Accardo sent out of The Manager's sights, and Merkin Valdez passed through waivers to see if he can ever figure out how to get his vaunted "stuff" over the plate. The Jays also sent Edwin Encarnacion away to deal with his crappy wrist and to make room for productive players, and they let hispter oaf Brian Tallet look after his severe case of too-many-cutters on the DL as well.
In return, we got a couple of appearances in high five lines (and four at bats) from Jeremy Reed; a nastier, more focused Brett Cecil, who appears to be here to throw strikes and here to stay; Fred Lewis, who we've grown increasingly accustomed to seeing at the top of the order and who makes the lineup make sense; Josh Roenicke, who looks like a keeper so far; and Rommie Lewis, who sounds like a swell story of determination that we may or may not remember a couple of months down the road.
At some point in May, the Jays are going to have to make decisions on what to do with Tallet and E5, which will mean that someone gets bumped from active roster.
The diminishing power of the 'pen
We cam into the season thinking that the saving grace of this team would be the bullpen. The pen was deep enough so that the Jays could send any number of pitchers back to the minors for further seasoning, and good enough to boast four guys who have had a regular closer gig in the past few years. All good, right?
Yeah, not so much. At this point, the only cushion in discussing the bullpen's performance in April is that there was one team that was worse. But if we're going to lean on the Royals' lack of performance as some solace, we might just as well direct our attention towards the forthcoming ice dance season through the rest of the summer.
The pen has tossed batting practice to the tune of a 4.92 ERA, while the starters have managed to be close to a run better (3.98, fifth best in the AL).
We love our jarheaded closer
Signing Kevin Gregg elicited a fair amount of derision this winter, but the big man has been the - really sorry for this pun - saving grace of the relief corps. Take a gander at his 0.66 ERA and six saves in six opportunities to go along with his 14 Ks versus one walk and one earned run, and you may come to appreciate him as much as we do.
We could talk about the crowds...
...but really, let's wait until the nice days come, and we actually know how bad it is going to be. It sucks that the Jays might lose 30% of their attendance year-over-year, but we actually think that this season might be the bottom, and that small increases are possible in the next couple of years if the management plays things right. All a part of the building, we suppose.
Although those Blue Jays in suits commercials aren't helping.
In closing, your honour...
We got through our look back at the first month of the season, and we haven't mentioned Silver Sluggers Adam Lind (.770 OPS through Sunday) and Aaron Hill (.761 OPS in limited time). And yet, the Jays pull through it with an even .500 record.
So, we're not exactly breaking out the party hats. But we're still here, and vaguely optimistic for something better than misery from here on out. Which is the faintest of notions around which one can wrap them arms in a loving embrace, but in a season like this, it'll do.
12 comments:
- Darren Priest said...
You'd think the bullpen would come around, but that same logic means the bats have to get cooler.
I choose to believe Vernon Wells was playing hurt for a while and is too much of a man to make excuses. "This Things I Believe."*
*Really old Simpsons reference.
- May 3, 2010 at 6:09 PM
- J. Michael said...
Isn't it possible that the bullpen comes around and some of the bats cool, but Snider, Overbay, Hill, and (to some extent) Lind start to get some consistency?
Balance restored!
- May 3, 2010 at 6:34 PM
Cecil and Snidey are looking like the real deals tonight!
- May 3, 2010 at 9:21 PM
@The Ack: Tonight Snidey looked like the "big mashing middle of the order raker that every contending ballclub requires." Look out ... here comes a Sniderman!
- May 3, 2010 at 10:14 PM
- Gil Fisher said...
I saw R. Lewis pitch on the weekend and I'm not sure he isn't actually D. Purcey trying to pull a fast one on the Manager.
- May 3, 2010 at 11:12 PM
- The Ack said...
Snider's HR tonight terrified me. Holy fuck. He belted the piss out of that ball.
And Cecil was nothing short of boss. These are the games fans of a Rebuild savor.
- May 3, 2010 at 11:13 PM
Ha, "Hipster Oaf" is so very apt.
I'll go finish reading the rest of the post now.
- May 4, 2010 at 1:11 AM
- plain_g said...
buck's slugging percentage went from 293 to 554 in 4 games.
- May 4, 2010 at 10:07 AM
- brainiac said...
TONS of things to be exited about for the Jays - this year AND beyond.
Sniderman,Hill, Lind, Romero, Cecil all fantastic young players...the reemergence of Wells, Buck and A-Gon...
- May 4, 2010 at 10:28 AM
Great tweet on the pride of the Philadelphia Police Department. What a fat fuck.
- May 4, 2010 at 10:19 PM
- William J. Tasker said...
1. "Hipster Oaf" Ha! Hilarious.
2. Vernon Wells will not slow down. This is who he will be all season.
3. Don't like Freddie Lewis at the top of the order. Doesn't get on base enough. But don't know who to replace him with.
4. Gregg has been great. I think Piniella messed his mind in Chicago. He's much better than he was there.
5. Hill, Lind and Snyder are all on the upside and will be better from here on out.
6. On the flip side, Gonzalez isn't this good of a hitter.
7. Starters great. Releivers not so much. But it will get better in the bullpen now that Cito has seen what some can do and can't do. Or maybe that's giving him too much credit.
8. This is a fun team to watch. I wish Toronto would get behind them.
- May 5, 2010 at 9:14 AM
- Navin Vaswani (@eyebleaf) said...
I have my party hat. Got extras, too.
- May 5, 2010 at 12:36 PM


text:
Choice of carabiners for attaching the rope to the anchor
- Read the technical notice before viewing the following techniques.
- It is important to fully understand the information provided in the technical notice before using this complementary information
- Mastering these techniques requires training.
- Consult a professional before attempting to perform these techniques on your own.
Key issues and risks
At the anchor, carabiners stay in place over a long period of time; monitoring them during use is difficult or irregular.
Requirements and needs differ depending on the situations, and the equipment to be connected.
During installation, there are often several items to be attached to the carabiner. The anchor is not always easily accessible; installation must sometimes be done with one hand.
The most important risks to consider
Recommendation on carabiner and accessories
Why this choice?
• The SCREW-LOCK system facilitates installation, as it can be locked just once, at the end of the operation. The entire operation can be done with one hand. With an auto-lock, the sleeve must be operated at each opening/closing of the gate and two hands are required to attach an item
• The frame shape and material (aluminum or steel) must be chosen depending on the situation (industrial, heavy systems, sport or recreation, lightweight systems...) and on the equipment to be attached (one or more ropes, pulley, PAW...)
Precautions for use
• During installation, anticipate the situational risks and evaluate the possibilities of monitoring the connectors before and during use
• Do not leave a carabiner at the anchor without the ability to monitor it, if there is any risk of movement during use, cantilever loading or rubbing
• Once the installation is complete, verify that the connectors are correctly locked and positioned before using the system
• Whenever possible, back-up the system to avoid being dependent on the strength of only one carabiner
• Warning: the SCREW-LOCK sleeve can be opened by vibrations. During installation, be sure to rotate the carabiner so that gravity and vibrations tend to "close" the sleeve rather than "open" it

subset: commoncrawl


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In stock
3.50 mainland UK delivery charge Estimated 1-3 days delivery time We are happy to ship products wordwide Prices include VAT
Stay up to date with offers, products, promotions & more! (we never spam!)
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When exactly are supposed all explicit tasks tied to the current thread waited for?
Say is:
- Code: Select all
#include <omp.h>
#include <stdlib.h>
main (void)
int l = 0;
#pragma omp parallel reduction (+:l) num_threads (1)
#pragma omp task shared (l)
/* #pragma omp taskwait */
if (l != 1)
abort ();
return 0;
valid? I.e. is the point where all explicit tasks tied to the current thread after the last instruction in the implicit task, or later (e.g. after all reduction var merging, running destructors, etc.)?
Mandating it before might penalize even OpenMP 2.5 code or code that never uses tasks - as tasks can be created in other functions called from implicit task, not necessarily the implicit task itself,
this would mean the compiler needs to add before reduction merging code, lastprivate copying and running destructors probably a function call which would wait for all pending tasks. With
OpenMP 2.5 that wasn't necessary. Or is the above undefined and the above mentioned note applies in this case (and so the commented out taskwait is needed)?


text:
Posted 8 years ago
(76 items)
This is a Deco, 1920's Stewart-Warner speaker. I have been able to find similar speakers, the only difference is that they are not painted. I am unclear as to whether or not this was originally painted or if it was painted later. The other speakers I have seen appear to be gold or bronze in color, although I am unclear whether or not it is paint. On mine, the women's bodies appear to have had a silverish paint, but much of it is chipped. The border around it may have been a white paint. The metal underneath is a dark, tarnished silver. The paint on the dresses is almost entirely in tact. The piece in the center and the sides are painted black. The back has the same fabric covering and metal center piece, but is otherwise plain.


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Actress and former Bond girl Michelle Yeoh was deported from Burma because she was on a government blacklist, according to one of the country's officials.
The official did not explain why the Malaysian Hollywood star was kicked out of the Southeast Asian country as soon as she arrived on June 22, The Associated Press reports. But Yeoh had just been to Burma in December to meet Aung San Suu Kyi because she is playing the pro-democracy leader in a new Luc Besson movie.
Suu Kyi spokesman Nyan Win confirmed that the "Crouching Tiger, Hidden Dragon" actress was not allowed to enter Myanmar, but said she did not know why.
"The Lady" is described as "an epic love story" about Suu Kyi, now 66, and her husband, Michael Aris. Suu Kyi, who was a major leader in Burma's democracy movement, was released last year after spending most of two decades in house arrest under Burma's military junta.
"People should know about her story because unfortunately I think a lot of people have forgotten or don't really understand what was going on because it's been 20 years," Yeoh told reporters in May about the "The Lady." The movie is due in theaters in October.
Luc Besson, known for directing thrillers like "Taxi," and "The Fifth Element," filmed the movie in neighboring Thailand.
Selected Reading: Michelle Yeoh IMDb, NobelPrize.org, Daily Mail


text:
Career Paths
Graduates of Peace, Justice, and Conflict Resolution are working in international aid and development impositions such as:
- Regional Advisor for Catholic Relief Services
- Deputy Country Manager for World Vision
- Program officer for Family Health International, and the Center for Disease Control
Graduates have obtained management positions such as:
- Project manager for NASA
- Consultant in program management
- Manager for the International Rescue Committee
- Program officer in the United Nations Development Program
Graduates are Training Professionals in conflict resolution, or are teaching at universities. Others have taken positions in labor-union-organizing and as corporate-compliance officers.
Conflict resolution is an expanding field. Opportunities include:
- School peer-mediation (useful together with teacher certification).
- Intercultural communication and diplomacy; race relations.
- Federal or state government alternative dispute resolution programs, such as the Federal Mediation & Conciliation Service.
- University or corporate dispute resolution offices.
- International Non-Governmental and Inter-governmental Organizations, including the World Bank's Post-Conflict Unit, that do international peace-building, humanitarian, and development work.
- For-profit dispute mediation groups (often useful together with a law degree).
- Policy research.
- Legislative lobbying, petitioning and protest action. and public education.
- University offices that handle conflict, such as the Dean of Students office.
- Peace-building specialists within US or inter-governmental relief and development organizations (prior experience via internships and language skills).
- The restorative justice field, including non-profit organizations, justice, or social service departments.
- Consulting about conflict, conflict assessment and forecasting.
- Multinational corporations and private investment firms concerned about conflict.
- Environmental and public-policy conflicts.
- Facilitation and dialogue.


text:
Video Lecture CA Final Financial Reporting New Syllabus PS Beniwal
Video Lecture CA Final Financial Reporting New Syllabus PS Beniwal
Product Description
- Format is Pen Drive/Download
- Duration is 230 Hours
- Validity for 12 Months
- Video Runs On Laptop
- No of Views is 2 Views per Lecture
About Faculty
CA Pardeep Singh Beniwal is commerce graduate from Kurukshetra University. He qualified Chartered Accountancy course in Nov 2007 and Associate Member in Nov 2008.
He passed in 1st attempt at PE-II (Scoring 85marks) & Final level. After Qualifying he was associated with S.C. Vasudeva & Co. Chartered Accountants, New Delhi to gain the expertise in the field of Risk Advisory, Assurance, Taxation and Auditing. He did various big audits such as IFFCO, IMCL, IREDA, IOCL, Bhusan Steel etc as team leader. He has the vast experience of the Accounting Standards issues.
He is awarded by VP of ICAI and Chairman of NIRC for, COMMENDABLE CONTRIBUTION IN ACTIVITIES OF THE PROFESSION as on 18th Feb 2012 in Hotel Lemerdian, New Delhi.
He has the vast experience of teaching and attended more than 25,000 students. He is the visiting faculty of ICAI. He is also the orientation faculty of ICAI at Vishvas Nagar. He is also GMCS Faculty of ICAI. His services in regards to orientation and GMCS classes are taken by Noida, Faridabad, Gurgaon, Karnal and Panipat Branches of ICAI. He was also the member of, Research Study Group of BoS of NIRC of ICAI 2010-11.
At present he is consultant and academician and teaching Accountancy at NIRC OF ICAI and MENTRO?S INSTITUTE OF COMMERCE


text:
Mr. Colloid: "Fine, except this morning I was hacking up some seriously disgusting greenish-black caked mucus gunk."
Dr. Grumpy: "I'm sorry."
Mr. Colloid: "Here's a picture of it."
A Blog detailing the insanity of my medical practice and the stupidity of everyday life.
Look on the bright side - at least it was only a picture.
Cell phone pics are great for documenting symptoms, but need to be saved for the appropriate specialist!
(Unless yak herders also specialize in pulmonology?)
Yeah, I wish people would realize just how grossed out we can get as well.
*note to self* do not read Dr Grumpys blog before or during breakfast
"I'll add you as a contact to my Flickr account. Make sure to check out the gallery for yesterday morning's turd. I think you'll be really impressed by the size."
Hair ball ?
It's only sputum, so unless sputum's your thing...don't fret!
At least we can't smell via internet...yet. That will really get me!
A long (long [long]) time ago I had a one day job installing stuff in a concrete basement that was really filthy, but I didn't notice it. The dust I was making + the dust I was stirring up all got breathed in.
The next day I was blowing this black goopy gunk out of my head. I panicked & went to an urgent care place.
I wait my turn and they look up my nose and say, "Looks fine to us." And I'm like, no, really, this thick black sludge was coming out. So they say, "Here's a tissue, blow your nose" and what comes out is definitely clear.
So I'm sitting there waiting for my "ok, you're done" paperwork, when I hear the idjits outside the room talking. And one says, in a loud voice, "Well, she might CLAIM it was black, but clearly she's lying."
So, I kinda feel for the guy. But, you know, I'm not insane enough that I would have done this. Or brought a sample. Yeeaugh.
kids should really be taught that hacking up anything - esp anything green or black is just bad.
Had a patient bring me an entire specimen jar of nasal mucus to ask me if I thought it could be CSF (cerebrospinal fluid). He must have been saving it up for weeks. But it was just ordinary snot.
I just had a patients son do this to me. I walked into her room and he says " Mom blew her nose and this big dark thing came out" then pulls a used tissue out of his pocket and opened it up to show me. Yeah she blew a booger out of her nose big deal. So he rolls the tissue back up and put it back in his pocket !!! I don't know what he s saving it for.
At least it was just a picture. I had a patient present me with a tic-tac container of sputum. I had to work very hard to maintain my composure because all I could think of was the Wayne's World line: "If you're gonna spew, spew into this!!"
I had a patient bring me a water bottle 1/4 full of mucous to show what he had been hacking up. Then he said, "Wait a minute, I got something for you doc..." and proceded to hoik up a big lugi into a kleenex to show me. And when he left, left his water bottle specimen on the floor in the exam room.
Oh and a different patient that handed the receptionist a pill bottle and went on to say it contained her urine specimen...
I can put myself in the guys shoes.
This guy just probably had a bad experience with a doctor that didn't listen to him as a patient and felt he needed to JUSTIFY his complaint.
if body juices scare you , dont be in health care - other than non invasive radiology....
Little Calf Creamery. Delicious homemade ice cream and food in Thousand Oaks!


text:
MelissaLouise74 necesitaba un nuevo diseño de logotipo y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 73 diseños de 15 diseñadores freelance.
LONGFORD & FRASER: The Leadership Academy for Boys is a exclusive, modern academy for boys in a large Australian capital city.
The curriculum promotes standards of excellence in life skill disciplines including:
Leadership, Self-Esteem, Emotional Resilience, Emotional and Social Intelligence, Respect for Women, Social Etiquette, Assertiveness, Honour, Integrity - together fostering the development of confident, young gentlemen, and the leaders of tomorrow.
For boys aged 6 to 12 years. (the age group may be extended with time)
Classes are held outside school hours.
You might describe it as a modern leadership academy.
Parents and grandparents who see a need for refinement of their son's social etiquette, emotional resilience skills and social skills beyond what their son is learning at school.
The target audience's income level is moderate to high.
The logo image needs to be bold,clean-line, outstanding, fresh, distinguished.
(no old-fashioned fonts)
It is an academy of substance. Think old English school or bank of repute.
eg: http://www.jws.com.au/ is an example - law firm in Australia.
The logo must attract the parents/grandparents, but also be attractive to the boys so that they will be proud to tell their friends that they are a student at LONGFORD & FRASER.
You may consider the style of a name plate on a door of a medical surgery with border(s),
Background colour of charcoal
eg: http://www.colorhunter.com/color/1D1D1D
eg: http://www.colourlovers.com/color/222222/
The accent colour is a vivid, fire-engine red
The text is white.
I am quite attached to this colour scheme but if you have other ideas I am willing and open to consider them.
However, I see red as the colour of courage and confidence. I see the charcoal as prestigious and strong.
The art needs to be in a vector format (Adobe Photoshop or Adobe Illustrator) layers intact so we can resize vector graphics without any loss of quality.
WINNER must provide:
a) A modifiable vector version of the logo in .ai, .psd or .eps (CMYK)
b) Web file format - .jpg (RGB)
Please do not use any stock images or clip art in the logo
We need full intellectual rights to the logo upon payment.
Warm wishes and grateful thanks in advance to all who participate.
Descubre cómo funciona un concurso de diseño u obtén más información sobre nuestros servicios de diseño de logo.


text:
How I approach my research
Planning to use this page to document my research strategies. Thoughts and links for those of you who want to do a bit of digging yourselves and an aide memoire to myself when I get stuck.
Genealogical Proof Standard
I wish that I had paid more attention to genealogical proof standard when I first started my research. This would have saved me time that has been wasted climbing the wrong tree on a couple of occasions. I am gradually working through and checking source documentation and challenging some of the conclusions I have previously drawn. Even now, I still find the urge to push on and come back to the documentation later is strong. I should really slow down and pay more attention to the following standards:
- Reasonably exhaustive search
- Complete and accurate citation of sources
- Analysis and correlation of the collected information
- Resolution of conflicting evidence
- Soundly reasoned, coherently written conclusion
Sources – Who, What, When, Where
Writing source citations in approved format takes time and practice. Even a citation in the wrong format is better than no citation at all. As a minimum the citation should cover who, what, where and when. One of my next tasks is going to be to review my direct line ancestors and check and update my citations using these questions. The "when" question is particularly useful in determining whether new records may have become available which could give additional confirmation or raise questions about the validity of earlier conclusions.


text:
Sharon Osbourne isn't holding back in her criticisms over Susan Boyle's looks.
In an interview earlier this week on "The Opie & Anthony Show" on Sirius Satellite Radio, Sharon offered a mouthful about Susan's looks when she talked about seeing a picture of the "Britain's Got Talent" star next to her rock 'n' roll husband.
VIEW THE PHOTOS: Wild & Wicked: Hot Shots Of The Fiery Sharon Osbourne
"There's this great picture of Susan Boyle, smiling, looking like a slapped a** next to Ozzy," Sharon said as the DJs burst into laughter.
When asked if she loved the Scottish singer, Sharon said she did, packed with another insult about the woman's face.
VIEW THE PHOTOS: Keepin' It Real With TV's Hottest Reality Stars!
"I like everybody to do well, even someone that looks like a slapped a**," she said in a clip posted on YouTube. "It's like God bless her. You go girl. She does look like a hairy a**hole."
When the hosts brought up Sharon wrapping up her own statement about Susan with "God bless her," Sharon added another barb.
"You do, you just want to say God Bless and here's a Gillette razor," she said.
VIEW THE PHOTOS: Susan Boyle
"But he gave her the talent. He really did," Sharon added. "He hit her with the f***ing ugly stick.
Related Content from AccessHollywood.com:
PLAY IT NOW: Sharon Osbourne Says Kelly Is In It To Win It
PLAY IT NOW: Sharon Osbourne Turns On The 'Charm' At Access
MORE ACCESS ON THESE TOPICS: Sharon Osbourne - Susan Boyle - TV - Reality TV - Celebrities


text:
foodcube necesitaba un nuevo diseño de papelería y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 16 diseños de 11 diseñadores freelance.
FoodCube Australia requires a fresh and innovative business card design.
FoodCube Australia
The business card is being designed in order to convey personal contact details to third parties to FoodCube Australia. The design should subtly communicate the product, as described below; and inform in a simple, clean and effective manner only relevant information. The design should be unique and attention grabbing - in order to engage the receipient, and encourage the business card to be future referenced, due to its effective design.
FoodCube Australia is a Hot Food Vending business, introducing into the domestic and global marketplace a unique range of hot food vending machines. The range includes a French Fries FoodCube, which instantly fries French Fries, fresh in 90 seconds; along with a Toasted Sandwich FoodCube, which produces freshly toasted sandwiches in just one minute. The units have been around for 4 years.
- • The business card should contain: contact details - telephone number, email address, mailing address, website - lay these out in a template format, into which these details can be dragged and dropped
• name
• logo
• space on the reverse side for a tag line and two small product images
- clutter


text:
Most medical school faculties are not well versed in the fundamental changes taking place in the nation's health care system, which makes it difficult for them to adequately prepare medical school students and residents for practicing in the changing health care environment. That was a central theme that emerged from a primary care policy forum held here recently by the American Board of Family Medicine.
Larry Green, M.D., founding director of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, says primary care residency programs are working to change to better meet the needs of an evolving health care system.
"If we are going to talk about innovation and change, we often have to change the faculty, because their natural inclination is to teach what they have been doing their whole careers and what they were taught," said George Thibault, M.D., president of the Josiah Macy Jr. Foundation, who spoke as part of a three-member panel. "That is different from what we want to transform the health care system into," he added.
Thibault said transformation of the health care system requires transformation of the educational process, a goal that can only be attained by having teachers in place to train students and residents about new and emerging health care payment and delivery models. "If we are going to have a reformed health care system, we need to pay attention to the workforce -- not just the numbers of the workforce, but the composition of the workforce," said Thibault.
- The ability to change the nation's health care system will require a primary care workforce that is trained in team-based and collaborative care, said three speakers at a recent American Board of Family Medicine policy event.
- Most medical school faculties are not trained in new and innovative health care models, making it difficult for them to properly train a primary care workforce to meet the needs of an evolving health care field.
- The speakers cited examples of how public and private partnerships are working to train a workforce that meets the needs of the health care system and the community at large.
What medical school professors teach is an accumulation of their work and educational experiences, he noted. "They can't teach what they don't know. We talk about new models of clinical education (moving) out of the academic center and into the community. It is integrated rather than fragmented. Those experiences were not the experiences faculty had when they were working."
Thibault also addressed interprofessional education, saying that most faculty members did not receive their training in an interprofessional setting. "They didn't learn from other faculty and leaders in other professions."
Moreover, most medical school faculties are unfamiliar with online learning and other technologies. "We want to and need to develop future leaders and innovators in education," said Thibault. But, he added, changes in medical school education will succeed only if entire faculties buy into the process. "The redesign of the education system and the redesign of the delivery system are only sustainable if they become the standard way we do business," Thibault noted.
Thibault and the two other speakers on the panel, Barbara Brandt, Ph.D., director of the National Center for Interprofessional Practice and Education, and Larry Green, M.D., professor and Epperson Zorn Chair for Innovation in Family Medicine and Primary Care at the University of Colorado, Denver, pointed out that medical education is undergoing fundamental changes in some parts of the country to better align with changes taking place in the health care system as a whole.
"There are physicians all across this country who are doing their (best) to change the training programs," said Green, who was the founding director of the AAFP's Robert Graham Center for Policy Studies in Family Medicine and Primary Care. In fact, he added, the three main primary care residencies -- family medicine, internal medicine and pediatrics -- are all engaged in efforts to redesign their residency training programs to achieve better health care.
As an example of the changes occurring within medical education, Thibault described a primary care faculty development initiative spearheaded by the American Board of Family Medicine, the American Board of Internal Medicine and the American Board of Pediatrics to develop some common goals and competencies around curriculum development.
The initiative, funded by the Josiah Macy Jr. Foundation, the Health Resources and Services Administration (HRSA) and private foundations, has identified particular skills or competencies needed for the primary care workforce of the future. These include
- teamwork,
- change management,
- leadership,
- population management and
- clinical microsystem skills.
Brandt, meanwhile, said the push to develop competencies for interprofessional education is exemplified by the National Center for Interprofessional Practice and Education. The center is funded by HRSA and private foundations, making it a true public and private partnership. One of the main goals of the center is to transform the siloed U.S. health care system into one that engages patients, families and communities in collaborative, team-based care, said Brandt.
To achieve this goal, the center will create and test new health care organizations and structures while training a workforce that operates in team-based delivery systems to improve health care quality, safety and access.
"We really do not have a lot of evidence as far as what works in training and education for this type of practice," said Brandt. "That is going to be one of the marks of distinction of this particular national center."
The ultimate goal, Brandt said, "is better alignment of the health care system and higher education."
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See how Sally Massagee and her doctors tried to stop muscles from growing all over her body on an "AC360°" special investigation, tonight 10 p.m. ET
(CNN) -- As a wife and mother to five children, Sally Massagee had always led an active lifestyle. She ran her own successful CPA firm in her hometown of Hendersonville, North Carolina, and loved to cook and play tennis with friends.
But in her late 40s, that all changed. Massagee's muscles began growing out of control.
"Everyone assumed that I spent a whole lot of time in the gym," she says. "One doctor said how many hours a day do you spend in the gym?"
But Massagee didn't work out at the gym, nor was she taking steroids. As her muscles continued to grow, they also started to harden like rocks underneath her skin, causing excruciating pain. Long gone were the days of running and playing tennis. Even basic activities like walking and standing soon became unbearable.
"I couldn't reach up to fold over the turtleneck on my sweater," she says. "I couldn't reach my ears to put on earrings."
In 2006, with her family's support, Massagee began to search for help. She headed first to Duke University Medical Center. For two years, she saw doctor after doctor and had test after test, but no one at Duke could figure out what was happening to her body.
For Massagee's husband, Buddy, the mystery was bewildering. "Duke's about as high as it gets on the notches in the Southeast," he says. "And when Duke tells you they don't know what it is and they don't have any more ways or ideas for guessing or testing what it is, it's a scary thing."
After Duke came up empty, Massagee applied to the the Mayo Clinic in Rochester, Minnesota. But they rejected her because she did not have a diagnosis.
With her physical capabilities slipping away, Massagee, 53, thought there was nowhere else to turn. "I felt certain that if there wasn't a diagnosis, I felt that it was pretty certain that it would kill me," she says.
In 2008, she got a glimmer of hope. She was told about a new program at the National Institutes of Health that takes on the rarest of undiagnosed cases. With a referral from her endocrinologist from Duke, she was accepted into the Undiagnosed Diseases Program.
"There just aren't words for how excited I was," Massagee says, "that there was a hope ... that someone would be able to find out what was wrong. And I remember Buddy saying in the process, if anybody can figure it out, I think these folks can; I think if there's any hope, this is it."
After the work at UDP, Massagee had a long and nerve-wracking wait.
Finally, in May last year, she got the call she'd hoped for -- the mystery was solved.
In her case, abnormal proteins which normally attack the organs, were attacking her skeletal muscles.
Although the mystery was solved, Massagee's story was far from over.
Her diagnosis gave her hope that she'd survive. It also meant enduring a grueling new chapter of her life with no guarantees how that would end.
Watch Anderson Cooper 360° weeknights 8pm ET. For the latest from AC360° click here.


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Veterinarians in Claiborne County, MS
Comprehensive list of Claiborne County, Mississippi based veterinary clinics and animal hospitals offering advanced medical diagnostics or pet treatment. Find a veterinarian for your dog, cat or other pet.
Claiborne County, MS
Business Listings
Give your pet the finest care possible-bring them to Canton Road Veterinarian Hospital. We provide preventative medicine, blood work, tiny animal surgery, pet grooming and boarding, and general medicine. Though she specializes in cats and dogs, our veterinarian can handle other tiny animals. Contact us to schedule an appointment.
Where you and your pet become members of our family when you walk through the door! Ridgeland Pet Clinic is a solo veterinary practice where we pride ourselves on our personalized care, friendliness, and compassion. We are a tiny, family-operated clinic, and we evaluate your trust in us! We will treat your pets as if they are our own.
Routine elective surgery spay, neuter, declaw, etc. Internal medicine arthritis, diabetic patients, kidney disease, liver disease, etc. Our mission is to keep your pet healthy, and both you and your pet cheerful with a knowledgeable and friendly team. The aforemention areas of practice are performed by a general practitioner veterinarian with no board certification and in no way imply specialization,
For over 30 years, the doctors and team at the Animal Medical Center of Hattiesburg have offered pets with individualized comprehensive health care plans and pet owners in South Mississippi with exceptional client service. We are pleased to provide dog training through Hub City Dog Training at Animal Medical Center. We are providing a 6 week course in basic dog obedience, and will aid.
Whether your pet requirements professional medical care or grooming services, rely on the veterinarians at Advanced Pet Care. We supply a range of pet care services from animal boarding to pet grooming at sensible prices, plus we supply on-site medical services including orthopedics and dentistry.
Our doctors and team of South Mississippi Veterinary Clinics are dedicated to delivering a consistently superior program of wellness for our patients. We value compassion for our pets and lasting relationships with our customers. These values will remain key to our continued efforts to serve our community and their pets.
PDA's enable us rapid access to the information that we need throughout the day. They are relatively inexpensive and provide a way for us to carry electronic books, databases, programs and much more in our pocket. They are wonderful new tools for our profession. The Plumb's Veterinary Drug Handbook sixth edition has been released for PDAs! The iPhone and iPod Touch version is available.
Meridian Animal Clinic is a complete service tiny animal veterinary clinic and hospital. We have been servicing the Meridian area since 1974 providing routine wellness care as well as advanced medical, surgical, diagnostics and therapeutics for pets of all ages.Our licensed veterinarian, Dr. A.G. Harrell, III, strives to perform superior medical treatment, combined with compassion for both pets and
At Seal-Laird Veterinary Hospital we understand how important your companion animal or huge animal is to you. That is why we are committed to delivering the finest care possible. We supply over 86 years of combined experience to supply the best quality veterinary solution to all our customers and patients. We have on-site, diagnostic imaging equipment to help in the diagnosis of many disorders.
- The people here are very friendly, knowledgable, and competent. They always have the Hill's
Dr. Joey Kaletsch is the owner of our hospital. He graduated from Louisiana State University in 1999. After selling the Animal Hospital of Diamondhead he opened Beatline Oaks Veterinary Hospital. With his effort, you and your pet will receive exceptional medical care and customer service. Dr. Joey Kaletsch worked eight years for the Police Department.
We're situated in Gulfport, Mississippi and are a complete service veterinary hospital whose main mission is to supply gentle, optimal care for pets who are considered part of the family. Our practice was begun in 1995 by Dr. Mike Anderson who continues as owner today and works daily to insure your pet receives the finest care possible and works daily to insure you receive exceptional customer service.
Welcome to Northwood Hills Animal Hospital Dedicated to delivering the best healthcare for your pet. Northwood Hills Animal Hospital has been delivering gentle, compassionate care for your special companions since 1984. Our experienced and friendly team supplies complete medical, surgical, and dental services for pets. We even have an on-site lab, so testing is completed in-house.
We treat tiny animal and exotics. Contact us for your after hour emergencies. We are no longer able to take wildlife due to lack of resources and unsafe release sites. Please give us a call, and see how we can serve your pet's requirements!
Dr. Larry Anthony, Dr. Daniel Shy and the dedicated team at Starkville Veterinary Hospital are dedicated to treating your pet with kindness, compassion and high-quality veterinary medicine. We supply 24hr emergency medical care. Our mission is to treat every customer as though they are family and every pet as if he or she is our own.
The Gulf Coast Veterinary Hospital was set up to supply quality after hours emergency and critical care for your pet when your regular Doctor is not available. A veterinarian and team will be there during Hospital Hours. Your phone call will alert them to your pet's condition so that they may prepare in advance for your arrival.
BIENVILLE ANIMAL MEDICAL CENTER is a complete-service veterinary medical facility, situated in OCEAN SPRINGS, MS. We are dedicated to promoting responsible pet ownership, preventative health care and health-related educational opportunities for our customers. BIENVILLE ANIMAL MEDICAL CENTER strives to provide excellence in veterinary care to OCEAN SPRINGS, MS and surrounding areas.
Magnolia Mobile Veterinary Services supplies house calls for your pets. Dr. Odile Holahan's clinic supplies full pet care in a twenty-six foot commercial vehicle designed and equipped for veterinarians. The self-contained clinic enables physical exams, vaccinations, lab work, surgery, and dental cleaning in a comfortable atmosphere.
Our aim at the Animal Clinic of Columbus is to supply best quality veterinary medicine and surgery to our patients and friendly courteous service to our customers. We believe that preventative care and regular check ups are the key to ensuring optimal health and lifespan of a pet.
We encourage you to browse through our web pages, learning more about our hospital and team. We have included information to assist you and your pet. Personally, I have always felt that the finest doctor in the world is the Veterinarian. He can't ask his patient what is the matter--He's got to just know.
Our Mission To supply superb service for our customers and compassionate care for our patients at all times. Clinic Services We are a complete service veterinary clinic delivering everything necessary for maintaining a healthy and cheerful pet. Immunizations and Preventative Care Learn More Annual vaccinations, heartworm prevention, flea and tick prevention, geriatric screens, dental cleaning, etc.


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In addition to hosting a wide range of pre-existing software on TACC systems, TACC staff members actively develop new software and improve current software. To learn more about the software TACC is developing, please click on the title below.
Visit the Software page to view a list of all software available for use on TACC's systems.
Abaco (Actor Based Containers) is a functions-as-a-service platform based on Linux container technology and the actor model for concurrent computation.
Joe Stubbs
The IO service API enables the asynchronous movement of file data into and out of the CyVerse cyberinfrastructure.
Rion Dooley
The amask tool exposes process masks (affinity) of an application within a parallel environment, so that users can determine the cores/hardware-threads where each process is allowed to run.
Kent Milfeld
DisplayCluster is a software environment for interactively driving large-scale tiled displays. The software allows users to interactively view media such as high-resolution imagery and video, as well as stream content from remote sources such as laptops / desktops or high-performance remote visualization machines.
Gregory D. Abram
Two-pronged approach: GraviT will replace the OpenGL pathways commonly used for visualization with a high-performance, open-source ray tracing engine that can interactively render on both a CPU and on accelerator architectures; GraviT will provide a direct interface to a high-performance distributed ray tracing engine.
Paul A. Navrátil
ICAT assists users in modifying, compiling, and optimally running their applications on HPC platforms equipped with the Intel Knights Landing (KNL) processors.
Ritu Arora
Idev creates an Interactive DEVelopment environment on a compute node from the user's login window.
Kent Milfeld
An Interactive Parallelization Tool (IPT) for assisting domain-experts and students in efficiently parallelizing their existing C/C++/Fortran applications is being developed in this project.
Ritu Arora
The launcher is a framework for running large collections of serial or multi-threaded applications, known as High Throughput Computing (HTC), as a single multi-node parallel job on batch-scheduled High Performance Computing (HPC) systems.
Luke A. Wilson
A Lua based module system that easily handles the MODULEPATH Hierarchical problem.
MPE is a library for extending Processing sketches to multi-node tiled displays. This library makes it possible to render interactive Processing sketches across distributed computing systems on many displays.
Heri Nieto
OpenMFA is a set of custom Linux Pluggable Authentication Modules (PAM) built to provide multi-factor authentication capability that does not interfere with common data transfer protocols (SCP, SFTP, rsync, etc.), provides a mechanism for specific accounts or IP ranges to be exempted, supports SSH public key authentication as a first factor, and is built to support opt-in or mandatory deployments designed for the transitioning of large user bases.
W. Cyrus Proctor
The pylauncher is a customizable launcher utility that provides base classes and routines that take care of most common tasks
Victor Eijkhout
REMORA (REsource MOnitoring for Remote Applications) provides a simple interface to gather important system utilization data while running on HPC systems.
Sanity Tool includes a group of generic and machine-specific tests that are used to evaluate the correctness of a user's account configurations.
This project develops a dynamic ray scheduling algorithm that effectively manages both ray state and data accesses.
Paul Navrátil
Shell Startup Debug is used to trace the behavior of the startup scripts on your system.
The main purpose of this project is to provide convenient tools for HPC users and administrators with easy-to-use SLURM interface or commands.
An infrastructure for the low-overhead collection of system-wide performance data that integrates information from a variety of sources.
Bill Barth
The Texas Pandemic Flu Toolkit is a collection of tools for forecasting and simulating flu pandemics, as well as optimizing health resources across the state. These tools are made available via a web-based interface, where users can compute new models and interactively visualize results using a variety of methods.
Paul A. Navrátil
A tool that allows supercomputer support staff to collect and understand job-level information about the libraries and executables that end-users access during their jobs.


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JOKER in 70mm
Buy Tickets
Drafthouse News
Terror Tuesday and Weird Wednesday are back.
Our longest-running programming series are bringing cinephile culture into the Virtual Cinema space.
Make Your Own Vegan Buffalo Cauliflower | #AlamoAtHome
Curb your cauli-cravings and prepare one of our most sought after recipes in your own kitchen.


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I saw this on another blog today and thought it would be a lot of fun to share here and to learn about some of my readers. I feel like you guys know a lot about me or more about me than I know about you. I would like to know more about my readers. 🙂 So, I will start with this list and then you can copy & paste your answers in the comments section. 🙂
I Am – a strong woman, wife & mother
I Want – to have completed a marathon by this time next year.
I Have – two beautiful children & a loving husband.
I Wish – the economy was in a better place.
I Hate – cancer
I Fear -death…dying before my kids.
I Hear – the news…storms are on the horizon
I Search – for new gluten-free foods all the time!
I Wonder – what the world will be like in 25 years.
I Regret – some of the things I did 15 years ago. If I went back to change them though, my life would be different today.
I Love – my family
I Ache – for those in pain
I Always – kiss my kids & hubby good night before bed.
I Usually – talk to my sister at least once a day
I Am Not – the type of person to be late..punctuality is one of my biggest OCD habits! LOL!
I Dance – with my daughter
I Sing – whenever the mood strikes me.
I Never – say never
I Rarely – watch TV during the day or summer.
I Cry – too much! LOL! I am very emotional.
I Am Not Always – the most organized, though I try.
I Lose – my keys in my large purse all the time
I'm Confused – when I have to help my son with his algebra! LOL!
I Need – a good massage from my hubby.
I Should – get up & change my laundry.
I Dream – of opening my own gluten-free restaurant/bakery one day.
I hope– that my kids have a good school year…they start next week.
I feel– for my sister….she is having a rough pregnancy with twin boys.
I appreciate-all my friends, family & readers. 🙂
What lessons have you learned this year? I can do anything that I want to do if I put my mind to it. Attitude is the key. A positive attitude can change your whole experience. Why be miserable when you don't have to be?
Now, here is a blank copy for you to cut & paste. You can fill as much of this out as you want or as little. I can't wait to read more about you all!
I Am –
I Want –
I Have –
I Wish –
I Hate –
I Fear –
I Hear –
I Search –
I Wonder –
I Regret –
I Love –
I Ache –
I Always –
I Usually –
I Am Not –
I Dance –
I Sing –
I Never –
I Rarely –
I Cry –
I Am Not Always –
I Lose –
I'm Confused –
I Need –
I Should –
I Dream –
I hope-
I feel-
I appreciate-
What lessons have you learned this year?
I finally found the very elusive PB & J Lara Bar!!! WOOOHOOOO!!! Thanks to Raisin Rack for having it in stock, as well as every other Lara Bar flavor. They rock!! As a matter of fact, I have all 3 new flavors in the house right now! I will try them all and then report back.
I am going to dinner tonight at a new restaurant. This place is new to me, not new. They supposedly have a gluten-free menu. I am super excited & can't wait to report back to you guys!
2 of the 3 winners of the Fiber One giveaway have not contacted me. Elissa & Marybeth, please email me at email@example.com to claim your prize! If I don't hear back by midnight on Friday, I will choose 2 more winners.
When I went into my daughter's school today, I saw a Celiac.com print out sitting on the desk in the office. I asked the secretary if she has Celiac. She told me that she didn't, but a student does. Also, they think her daughter may have Celiac. She is in college & has been having all kinds of issues. I told her a little about the testing & gave her the link to my blog. If you are reading, I hope your daughter can get to feeling better! Please let me know if I can help!
Have a great night.
Filed under: Family, Gluten-Free, Gluten-free Products | 9 Comments »


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Andy King / AP
Snow-covered trees are seen outside the Mall of America Field at the Hubert H. Humphrey Metrodome before an NFL football game between the Minnesota Vikings and the Chicago Bears on Sunday.
Updated at 10:11 p.m. ET: A potent winter storm pounded the Upper Midwest and Northern Plains on Sunday with heavy snow and strong winds, making traveling treacherous and prompting airlines to cancel scores of flights.
The heaviest snowfall was expected from eastern South Dakota through southern Minnesota. Forecasters said up to 16 inches was possible in the hardest-hit areas, including up to a foot in and around Minneapolis.
A record snowfall of 10.2 inches was set at Twin Cities, MN on Sunday. The old record of 7.4 inches was set in 1961.
The snow, coupled with winds gusting as high as 40 mph, could produce whiteout conditions "making travel nearly impossible," the National Weather Service said in a statement.
Minnesota State Police said more than 300 car crashes were reported from 9:30 p.m. Saturday to noon Sunday, none of them fatal.
NBC's meteorologist Dylan Dreyer reports.
And it wasn't just the snow that was a threat. The weather service said temperatures were expected to plummet behind the system to well below zero over western Minnesota, with wind chill readings as low as 20 to 30 below.
"Travel will be very difficult and stranded motorists risk getting frostbite or hypothermia due to the frigid wind chill late this evening and tonight," the weather service said.
Watch the most-viewed videos on NBCNews.com
More than 150 flights at Minneapolis-St. Paul International Airport were canceled due to the storm, airport spokesman Pat Hogan told The Associated Press.
Delta Air Lines said snow and icing conditions prompted it to cancel about 90 flights on Sunday.
The southern branch of the storm was expected to dump heavy snow in the Central to Southern Rockies, according to The Weather Channel's Tom Niziol. "As the system continues south, snow will also spread southward across the mountains of New Mexico from Taos through Sante Fe where over a foot of snow is likely for this area," he said.
Snow, strong winds and cold air were also expected to hit the Great Lakes region late Sunday night into Monday.
More content from NBCNews.com:
- Breezy Point residents meet for first time since Sandy destruction
- US Supreme Court to take up same-sex marriage issue
- Advocates on both sides hope for Supreme Court clarity on same-sex marriage
- Boy, 7, accidentally shot dead by dad outside gun store, police say
- Video: Mayor trying to live on food stamps provides progress report
- Parents plead for release of former Marine held in Mexico
- Video: Forensic artist helps solve 12,000 cases
Follow US news from NBCNews.com on Twitter and Facebook


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To Unravel Boston Bombing Plot, Investigators Pressure Suspects' 'Inner Circle'
To find out whether the Boston Marathon bombing suspects had ties to a terrorism network or anybody else was involved in last month's deadly plot, federal authorities appear to be putting intense pressure on friends of surviving suspect Dzhokhar Tsarnaev and his brother Tamerlan Tsarnaev's widow, Katherine Russell.
Investigators have found explosive residue in the kitchen and bathtub of Tamerlan's home in Cambridge, Mass., according to NPR. This suggests that pressure cooker bombs used in the April 15 attack were at least partly made in the apartment where the slain suspect lived with his 24-year-old wife and child.
Since the bomb exploded during the Boston Marathon, killing three people and injuring more than 260 others, Russell has been living with her parents in North Kingstown, R.I.
While she is assisting investigators, it is learnt that she may not be fully cooperating yet, which has led federal agents to keep an eye on her. They follow her in unmarked vehicles whenever she leaves her parents' house, according to The Associated Press. "It seems to me they don't believe her yet," David Zlotnick, a professor of law at Roger Williams University and former federal prosecutor in the District of Columbia, was quoted as saying.
Authorities say Russell spoke to her husband by telephone after news channels showed his picture as a suspect following the attack. However, Russell's lawyer, Amato DeLuca, has told AP that the last time she saw him was before she went to work on April 18.
Law enforcement officials have met Russell for many hours over the past week, according to DeLuca, who had earlier said his client had no reason to suspect her husband before the bombings.
A key goal of the investigators at this point is "to figure out if she has knowledge of how he became radicalized, who he spoke to, how he may have learned to make the bomb and whether there are others out there who share his views," Ron Sullivan, a professor and director of Harvard's Criminal Justice Institute, was quoted as saying.
Sullivan believes investigators will likely succeed in pressuring Russell to fully cooperate because she is the mother of a young daughter, and would not want to be "deemed as a pariah or ostracized by the whole country."
Authorities have charged three friends of younger brother Dzhokhar, who are from the University of Massachusetts Dartmouth and all 19 years old, for allegedly covering up for the suspect – which could also be a means to force Russell to cooperate, experts believe.
Two of Dzhokhar's friends, identified as Dias Kadyrbayev and Azamat Tazhayakov from Kazakhstan, were arrested for obstruction of justice by removing a backpack with fireworks and a laptop from Dzhokhar's dorm room. The other student, identified as Robel Phillipos, was charged with lying to federal agents about their visit to the dorm room. If convicted, they could get five or more years in federal prison.
The three students have pleaded innocence. Zlotnick says the charging of Dzhokhar's friends suggests authorities could take a similar action on Russell, which forces her to cooperate.
"I think it's to find out ... are there other tentacles here?" seconded Nancy Gertner, a former federal judge in Massachusetts and a professor at Harvard Law School.
Dzhokhar was recently moved from a hospital to a prison medical facility, and faces a potential death sentence if convicted of the terrorism plot.
NPR has reported that Dzhokhar told the FBI that he and his brother initially planned to explode bombs on the 4th of July in Boston, but they changed their plan after they were able to make the bombs well before the target date.


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The other day I was watching one of those commercials for some medication, where a bee or a butterfly or a ladybug tells me how to get more sleep or be less depressed -- and after the obligatory listing of what said drug may cause, I realized I already have most of those side effects, simply from being a parent.
Which is why I'm suggesting kids come with a warning label ... you know, so there are no surprises? Maybe we could redesign those generic hospital blankies into big soft yellow swaddlers with a list on the back in bold black writing and send new parents home with one.
I think it should say something like this:
Warning, Children May Cause ...
Memory Loss: You will be able to sing every word to the theme song of The Facts of Life, but you may find yourself shampooing a second time because you can't remember whether you already did it before you conditioned.
Panic Attacks: Never had them before? Try leaving your child on the first day of school or running late to your child's first recital ... how about losing him/her for a whole five minutes at Barnes & Noble (I called a Code Adam on that one) ... I'm not even including visits to the ER.
More from The Stir: 20 Signs You're Ready to Have a Baby
Restlessness: Expect to be aware of every sound in your home, keenly aware. You will know the blip of the monitor, a faint cough, the beep of the fridge, the pacing of the dog that needs to go out, the buzz of the timer on the dryer, the bing of the smoke detector running low on battery, the wooosh of a toilet being flushed rooms away, the scratchy gulp of a child with impending strep, the crackle of a crib being climbed ... And those sounds will be amplified as if you have some sort of sonar -- then try to fall into a deep sleep. (PS: Your mate will not hear any of them.)
Hallucinations: As a fun addition to your sonar hearing, you will hear and see things that aren't there. Do not expect to shower, dry your hair, vacuum, just chill, or sleep without being convinced someone is crying, calling your name, or has fallen or is out of bed. You will check more than someone with OCD checks the oven. Oh, and you'll check that too.
Twitching: For the first eight months after my son was born, my eye twitched so much -- 17 creepy men in grocery stores turned me down. Puh-lease, don't flatter yourselves men, if I were hitting on you, I wouldn't wink while covered in spit-up!
Sleeplessness: You will be somewhat alert from the time your children need feedings every hour or two, until they have a curfew ... maybe longer.
Weight Gain: This is simple math: Add in eating everyone's leftovers and then subtract the time you have left for consistent workouts. Multiply that times pie and eat it.
Irritability: When you're on three hours of sleep and you've spent your day cleaning pee, doing the thousandth load of laundry, finally getting out to run an errand (but realizing you forgot your wallet), waiting in the car until your child wakes from an impromptu nap, and trying to remember how to do algebra -- how could you not explode when your husband says "Hi"? Add in working from home and a Caillou marathon for good measure.
Confusion: There will be times when you cannot remember your age, where you left your glasses (they're on your head), where you left your cellphone (you're talking on it), what's going on in a conversation that YOU initiated, or your husband's name (until you've called him every name you know, including the dog's). That is normal.
Bruising: Be prepared to get kicked in the nose or teeth, take a wiffle bat to the groin, have a finger jammed in your ear, or a ball flung at your skull -- just cuz.
Dizziness: So, you've recently realized that since having kids, you can no longer go on spinny things, ride facing the wrong way in a vehicle, or turn in a circle without feeling queasy? Bwahahaha -- your kids will want you to swing them in circles (faster), spin with them until they fall, and accompany them on Tilt-a-Whirl and Mad Hatter's Tea Party type rides until they're too embarrassed to be seen with you in public ... good luck.
Sexual Dysfunction: Expect some changes to your sex patterns -- where, when, how often, how long, and what types of things you'll choose in lieu of sex (like sleep or a shower, or a game of Words With Friends).
Brain Fog: Expect to have a clouded hazy vision of your children growing up. As much as you try to savor each year, each age, your memories of those times will feel as if they've been smeared with Vaseline. (Let's hope the brain fog covers the guilt you'll feel after not keeping a perfect baby book.)
More from The Stir: 25 Crazy Signs That Say You Are DEFINITELY a Mom
Shortness of Breath: Chase me Mommy, catch me Mommy, throw me Mommy, carry my bike home Mommy, flip me Mommy, give me a piggy back ride Mommy, spin me around Mommy, build me a fort Mommy, juggle me in one hand with the cat and the dog in the other Mommy ...
Numbness and Cramping: There will be times when your child falls asleep on you or near you, and though you can no longer feel your extremities, you will not move a single cell. For cramping: Escaping the room of a lightly sleeping child by inching out over the course of an hour ... then see a chiropractor.
Heartache: There will many times when your little one enters a new phase of independence and self-reliance -- this is a good thing -- but it will make you feel surprisingly sad. As much as you love seeing your child grow up, it is inexplicably crushing when you realize that a phase has ended.
Well, I'll start printing the blanket ...
PS: I'm thinking we could put this on condom boxes too. I mean, if you're not trying for a baby, this is a lot scarier than a warning about STDs, don't you think?
Image via JennyFromTheBlog/TheSuburbanJungle


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ORGANIZER: Newcor Commercial
EVENT: The Pink 5k
The "COR" Team Newcor Commercial wrote -
Join together with your friends and family to honor a survivor, support a current patient and and celebrate our own survivor, Krissie Vanyo. Please join us in winning the fight against breast cancer. Open to all ages! Best dressed costume contest to be awarded to best team and best individual!
Location: Creekside Park, The Woodlands, Texas
5k Start Time: 8:30 a.m.
1 mile Start Time: 9:00 a.m.
Packet Pickups at Luke's Locker on June 18 & 19th. 7:00 a.m. day of registration.
Download the "Join Our Team" Eblast to sent to family, friends, co-workers!
Participants are invited following the races join us in the Rob Flemming Park for a family friendly PinkFest including great music, bounce houses, post-race breakfast, face painting and more.
Find out more about sponsorship opportunities here!
Together we can PRESS Forward in the fight against breast cancer. We can inspire hope. We can nurture healing. We can renew lives.
Did you know?
- 1 in 8 women will be diagnosed with breast cancer
- Healthy diet & exercise routine can reduce the chance of breast cancer by nearly 40%
- When caught early, breast cancer has a 98% survival rate
- Nearly 85% of women diagnosed with breast cancer DO NOT have a family history
- Over 2 Million women in the US have been diagnosed and treated for breast cancer
The Breast Cancer Charities of America is the new voice of breast cancer. We are passionate, filled with energy and a vision and will not stop until breast cancer is no longer a life-threatening disease.
To learn more about the Breast Cancer Charities of America visit, iGoPink.org


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Carpeting Photo Gallery
Brand Overview
STAINMASTER® Carpet
Profile | Website | Catalog | Design Tools | Warranty | Green
MASTER® carpets are designed for the way you live. From easy-to-clean carpet that's perfect for families to extra durable carpet options that can take the abuse your pets dish out, we have a carpet for you. If your family includes a four-legged friend, be sure to check out our STAINMASTER® PetProtect® carpet and cushion system. And if you have kids in your home, you'll want a durable carpet to stand up to your active lifestyle—STAINMASTER® Active Family™ carpet.
product catalog >>> Product Visualizer >>>
Mohawk Carpet
Profile | Website | Catalog
More than anything, carpet manufacturers like Mohawk have your specific lifestyle in mind. That's why we innovated the softest, most family-friendly and pet-friendly carpets ever. Our carpet stands up to high-traffic wear and resists life's spills and stains like never before. With so many colors and textures to choose from, there's no reason to put off buying new carpet. With Mohawk, you're sure to find carpeting that suits both your lifestyle and your budget.
product catalog >>>
Caress Carpet by Shaw
Profile | Website | Video
Caress is backed by Shaw Floors 20-year warranty with stairs included, offering lifetime stain & soil protection, including all pet stains. Caress has been reimagined to offer the best in style and design. All the softness you love...now in your carpet.
Shaw Carpet
Profile | Website | Catalog | Design Tools | Warranty
Like you, Shaw Floors is passionate about creating beautiful homes founded on innovative design and lasting function. We know that a beautiful room doesn't happen by accident. Shaw offers more than 25,000 carpet styles and colors. That means your ultimate carpet choices will always reflect your own, unique vision.
product catalog >>> Product Visualizer >>>
Anderson Tuftex Carpet
Profile | Website | Catalog
Tuftex Carpets of California, Shaw Floors premier residential brand, is known for its innovative design, color, quality, and care for the environment.
product catalog >>>
Karastan Carpet
Profile | Website | Catalog | Video | Warranty | Clean
Karastan carpets are known for artistry, innovation and craftsmanship. Our sophisticated carpet styles range from traditional to contemporary looks and work great in today's home, home office or business environment. Selecting the right carpet is hard work. At Karastan, we can make your choice a little easier.
product catalog >>>
Shaw ClearTouch Carpet
Profile | Website
Shaw is pleased to introduce a line of carpets featuring the company's new ClearTouch® BCF PET with recycled content.
Commercial Brands
Philadelphia Commercial
Profile | Website | Catalog | Green
Philadelphia Carpets is Shaw's oldest and broadest product line. Philadelphia offers a broad selection of carpets designed for today's busy lifestyles that are both beautiful and affordable.
product catalog >>>
Mohawk Commercial Flooring
Profile | Website | Green
Believe in Better. It's Mohawk Commercial Flooring's commitment and relationship to our customers. Our entire company is designed to support you at every step of your journey. Learn more about Mohawk Group. Karastan, Durkan, Mohawk
Patcraft Commercial Carpet
Profile | Website | Catalog | Green
Patcraft is recognized throughout the carpet industry as aleader in innovative design with a tradtion of integrity and superior service for more than 50 years.
product catalog >>>
From sumptuous pastel plush to rugged berber tweeds, carpet is a universally popular floor covering, Broadloom has long been synonymous with comfort and luxury, but in today's eclectic room schemes, carpeting is just one of numerous soft options for a high-fashion floor.
Whether you choose a room-size loose-laid or wall to wall permanently installed over a cushion, this soft floor covering, offers many practical advantages. Broadloom's sweep of color and underfoot comfort gives any room-even sparely set ones-a more "furnished" feeling. Colors can work magic, too. For example, a light hue visually expands a small space, and a dark one cozies up a large room. Carpet in a sunny color can visually warm a room short on natural light. Before you buy carpets, study samples at home, and remember that the color of a room-size carpet will be more intense than the samples.
Advantages of Carpeting
Materials and construction give carpeting inherent virtues that may suit your decorating needs.
- Broadloom absorbs sound, an appealing feature for condominiums, town houses, and homes with high ceilings.
- Yarn construction and surface texture add soft contrast to a room's angular architecture.
- As versatile camouflage, broadloom goes over any existing floor, with no need for a new sub-floor, and it hides uneven surfaces and existing floor damage.
- Today, carpet is available with soil, stain, odor, and static-resistant features, and manufacturing techniques have increased its durability and cleanability.
Education Links
Learn More
At Clark Dunbar Carpet we believe an educated consumer is our best customer.
- Carpet Guide: How to Choose Carpet Color, Style & More | Karastan
- Karastan Carpets - KEEPING YOUR FLOOR BEAUTIFUL
- Live Beautifully Interior Design & Home Decor Blog | Karastan
- How to Clean a Carpet, Carpet Cleaning Tips, Care for Carpeting | Mohawk Flooring
- Mohawk Carpet Installation
- EverStrand - Eco Friendly Carpet
- SmartStrand - The Best Carpet for Pet Owners Yet.
- Monawk's Air.o - Pure Peace of Mind. Hypoallergenic Soft Flooring
- Wear-Dated Carpet - Highest Quality, Longest Lasting Beauty
- Mohawk Forever Fresh - Starts Clean - Stays Clean


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Marketing Insider
The award-winning Marketing Insider offers timely advice, tips and tools to help small and mid-sized business marketers take a more strategic approach to your promotional activities. Download each issue or view them as a flipbook.
2019 Issue 3
Are you looking to add a little Marketing Magic into your strategy? Download this edition of Marketing Insider to learn how to transform customer feedback and enhance the customer experience.
View Flipbook Download
2019 Issue 2
By some estimates, people today see 5,000 or more messages daily. Dive into this edition of Marketing Insider to learn how a multi-channel marketing strategy can help you increase the number of messages you send so that it's more like to stick.
View Flipbook Download
2019 Issue 1
Learn the difference between brand, purpose, vision and mission and how employee engagement is tied to trust and more in this edition of Marketing Insider.
View Flipbook Download
2018 Issue 3
Learn how to get more value from typical marketing activities and motive your team in the coming year in this new issue. And see how you can better integrate a direct mail campaign with digital advertising and social media.
View Flipbook Download
2018 Issue 2
Do you know the key to keeping your best customers? Marketing expert, Ruth P. Stevens addresses these issues in this edition of Marketing Insider.
View Flipbook Download
2018 Issue 1
Managing a critical asset like your brand is a shared responsibility across an organization. In this issue of Marketing Insider, we're taking a closer look at a universal business marketing objective: increasing brand awareness.
View Flipbook Download
2017 Issue 3
See how you can enhance your understanding of your key buyers, so that you can meet them where they are on their journey.
View Flipbook Download
2017 Issue 2
Even the smallest organizations can be big innovators. Learn manageable ways to make day-to-day improvements that all contribute to better results.
View Flipbook Download
2017 Issue 1
Discover new ways to target key prospects – and customers who are ripe for additional business – with cut-through-the-clutter tactics, and learn how to save time and money in the process.
View Flipbook Download
2016 Issue 3
Take a closer look at some of the ways in which you can tap promotional products to increase the impact of traditional direct mail communications, improve brand recall and leave positive impressions about your company.
View Flipbook Download
2016 Issue 2
How can you reach your target audience in a way that's personal, memorable and has the ability to make someone feel special? Learn more about the power of a tried-and-true channel: direct mail.
View Flipbook Download
2016 Issue 1
We're taking a look at a few of the ways in which your customers and prospects may be exposed to your business and how shifting your perspective to theirs can be eye-opening. Discover the small details that can make a big impression.
View Flipbook Download
2015 Issue 3
An outcome of your business planning process ought to be a marketing plan that outlines the components you need to advance you toward your company vision and goals. Bring focus to your objectives.
View Flipbook Download
2015 Issue 2
We are breaking down top content marketing tactics that you may or may not employ. Is it time to get started? Or get better at what you are doing? Get fresh insights into top content marketing activities.
View Flipbook Download
2015 Issue 1
While the desired outcome is quite different – buy vs. give – many of the challenges and preferred communications channels are the same for nonprofit and for-profit organizations. Get tips in choosing yours.
View Flipbook Download


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Site plan. Click to enlarge.
When the new property owner purchased the gas station at Coronel Francisco Soares St., in Nova Iguaçu, Rio de Janeiro, in 2007, he unknowingly bought its environmental liabilities, too.
The typical fuel station supplies gasoline, diesel, ethanol, and natural gas to its customers. It had been revitalized in 2002, but that work did not address the property's tanks, fuel spills, underground soils, or groundwater. The new owner hired Consultoria Saneamento e Meio Ambiente Ltda. (CSM) to remediate contamination issues at the site.
CSM cleaned and degassed the underground tanks and installed a pump-and-treat system, but the technology was not lowering the benzene, toluene, ethylbenzene, and xylene (BTEX) levels to the State Environmental Institute of Brazil (INEA) standards for soil and groundwater. These standards (listed in the table) are equal to or more stringent than U.S. maximum contaminant levels in groundwater. In soil, the Brazilian standards are equal or more stringent than U.S. standards, which vary by state.
In June of 2008, CSM and the new property owner asked Grön Environmental for assistance. The new cleanup team shut down the pump-and-treat system and activated the S-200 bioremediation process, which was patented by James Lynn in 2001. Gron is the representative and distributor of the S-200 OilGone products in Brazil. The firm used existing wells and added a few more well points to inject S-200 into both the soil and groundwater. Grön uses the process developed in Spain with adaptations for its sites.
The S-200 process is a bioremediation accelerator that binds with hydrocarbon pollution; it exponentially increases the population of hydrocarbon-degrading indigenous bacteria which, in turn, eliminate the hydrocarbon pollution.
Groundwater BTEX chart. Click to enlarge.
This process was fully tested by the Spanish government and universities during the Prestige tanker spill off the Galatian coast of Spain in late 2002 through 2003. It is the improved second generation version of the bioremediation process used to clean 70 miles of coastline impacted by the Exxon Valdez tanker incident.
Three months after startup at the Nova Iguaçu gas station, the team took soil and groundwater samples, which showed reduced BTEX levels. Within six months, the results were below INEA compliance levels. In April 2009, new sampling and analysis confirmed completion of work at the site.
Soil BTEX chart. Click to enlarge.
S-200 is on the U.S. Environmental Protection Agency's National Contingency Plan (NCP) Product Schedule. This listing does not mean that EPA approves, recommends, licenses, certifies, or authorizes the use of S-200 on an oil discharge. This listing means only that data have been submitted to EPA as required by subpart J of the NCP, Section 300.915. The data submitted exceed the testing criteria for the bioremediation effectiveness test and therefore qualifies S-200 to be listed on the product schedule.
The S-200 process, which costs about US$50,000 for one year of groundwater cleanup, can save significant amounts of money when compared to pump and treat, soil vapor extraction, and chemical oxidant technologies. The quick turnaround also allows for a faster property sale without deed restrictions or other legal hurdles.


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BLONDIE Union City Blue (UK limited 4-mix blue vinyl 12" includes Diddy's Power and Passion Mix, Jammin' Hot's I Can't Believe It's Not Diddy Mix, Vinny Vero's Turquoise Mix and Burger Queen Peroxide Powder Mix, picture sleeve 12CHS5027)
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Woman lights car on fire at Daytona Beach gas station
Witnesses say woman poured gas on car, lit it on fire
DAYTONA BEACH, Fla. – People ran for their lives when a woman lit her car on fire at a busy gas station, nearly causing the place to explode, police said.
It happened at the BP gas station at 971 West International Speedway Boulevard in Daytona Beach.
Eyewitnesses who couldn't believe what they were seeing. They said the woman pulled up to the pump, poured gas on her car, and then lit it on fire -- with her pets trapped inside.
"I think she was trying to kill us all," said Edna Sandrus, who was one of two clerks on duty. "All I know was I had to shut that valve off or this whole place was going to blow up."
It began when the woman paid $20 for gas, then stole a lighter. The view from store security cameras shows one clerk, Craig Walker, try to wrestle a lighter from the woman's hands.
The woman managed to grab another lighter from inside her car, lit the gas she had poured over her car, and then a ball of flames engulfed the car and shot as high as the pumps.
A stranger tackled the woman, covered her on the ground, and probably saved her life. Meanwhile, Walker ran away just in time.
One man saw what happened and ran to rescue those pets while others ran for their lives. The man at the pump next to her ran so fast, he ran out of his shoes to escape the pending explosion, said witnesses.
Police identified the woman as Alexandra Barnes of West Palm Beach and said she kept saying she was God. Even after being saved, witnesses said Barnes wasn't done risking other people's lives.
"The only thing she did say was her babies were in the car. So the boy from next door assumed that she had kids in the car, so he ran to the car with it on fire and there was dogs in there," said Sandrus.
After John Bracy saved her dogs, witnesses said she scooped them up and ran into the busy road, sat down in oncoming traffic and waited to get hit by cars.
Bracy's boss, Rafael Rivera, said Bracy is a hero.
"He's a little bit crazy but you know some people would stand there and watch and others would jump into action and that's exactly what he did and I'm proud of him," Rivera said.
Police took her away in handcuffs and she'll be mentally evaluated, but people who witnessed the ordeal are just happy nobody was hurt -- or worse.
"I never thought I would experience that working here," said Walker.
Both the woman's dogs were taken to the Humane Society. They were not injured.
The state fire marshal will determine if Barnes will be charged.
Copyright 2013 by Post-Newsweek Stations. All rights reserved. This material may not be published, broadcast, rewritten or redistributed


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Bing Crosby Memorabilia
Visit the house where this famous entertainer grew up. View approximately 200 items of Bing Crosby memorabilia, including the duplicate Oscar he won in 1944 for "Going My Way." There are 22 gold and two platinum records from such titles as "White Christmas," "Silent Night," and "Swinging on a Star." Also displayed are movie stills and photographs, record albums, books, and sheet music. There are many trophies and awards he received over the years from various organizations. There are items from the Crosby Research Foundation, such as the "Trip Trap," a mousetrap that the foundation invented. There is also a health device that Crosby endorsed called "Stretch to Your Health with the Stars." This represents just a portion of the total Crosby Collection materials. Hours are weekdays, 9 a.m.-4:30 p.m. and Saturdays, 1-4 p.m. Free parking behind the house.
- Where:
- Crosby House, 508 E. Sharp Ave., Spokane, WA
- City:
- Spokane
- Neighborhood:
- Logan neighborhood, Northeast Spokane
- Cost:
- Free
- Phone:
- (509) 313-3847
- Email:
- firstname.lastname@example.com
- More like this:
- Art


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El Badi Palace Architecture, Marrakesh, Morocco
El Badi Palace Architecture, Marrakesh, Morocco, 2016–04-21.
The El Badi Palace and sunken gardens are a short walk from Bahia, within the old, towering Medina walls of the Mellah.
Commissioned by the Arab Saadian sultan Ahmad-al-Mansur and completed in 1593, the complex took 25 years to build and is considered to be some of the finest examples of Saadian architecture in Moroco.
A ruined palace, the site is often being renovated and restored, but remains to be many peoples favourite Marrakesh palace experience.
- Filename
- AK6A0438.jpg
- Copyright
- Chris Griffiths
- Image Size
- 3840x5760 / 2.7MB
- Contained in galleries
- El Badi Palace - Marrakesh - Southern Morocco


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SwedArt Reindeer Leather Bracelets From Lapland, Sweden
Description: SwedArt's stunning reindeer leather bracelets from near the Arctic Circle in Lapland, Sweden, adorn the wrists of fashion minded men and women in 32 countries as well as countless celebrities. Skilled artisans from the 10,000 year old indigenous Sami culture of reindeer herders have been creating these beautiful bracelets for centuries. SwedArt offers traditional designs as well as contemporary designs. The handmade jewelry is still made with the ancient techniques and materials of the Sami – vegetable tanned reindeer leather, hand carved antler buttons and a unique spun pewter and silver wire. Over 100 styles and 50 colors can be seen in the product Galleries on www.swedart.com and www.swedart.etsy.com, www.facebook.com/swedart as well as on www.pinterest.com/swedart. Please email [email protected] to place orders for immediate delivery from Boston or place an order in SwedArt's Etsy Store.
Price: $59.00 to $150.00


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Here are my picks from the nursing literature over the past few months. SJO and CHOC employees have access to the full text of many of these articles through the Burlew Medical Library.
1. Nursing research in theory and practice - is implementation the missing link?
Severinsson, Elisabeth;
Journal of Nursing Management, 2012 Mar; 20 (2): 141-3
2. Promoting nursing research and innovation by staff nurses.
Syme, Rachel; Stiles, Carla;
Applied Nursing Research, 2012 Feb; 25 (1): 17-24
Abstract: Promoting nursing research participation is challenging. Since the creation of an internal fund for research and innovation, 11 projects have received funding with a doubling of staff participation. The success of this novel funding opportunity highlights the need for this type of support and demonstrates success in promoting nursing research.
3. Demystifying nursing research terminology: Part 2.
Welford, Claire; Murphy, Kathy; Casey, Dympna;
Nurse Researcher, 2012; 19 (2): 29-35
Abstract: Aim To provide an explanation of the research methodologies and strategies available. Background There are numerous research methodologies and strategies. The literature is ambiguous in relation to research terminology and this often leads to confusion about which methodology or strategy to adopt. Data sources A review of the most up-to-date literature. Discussion The most commonly adopted methodologies and strategies are discuss Conclusion Part 1 (Welford et al 2011) of this two-part paper explained the research paradigms and the rationales for choosing particular paradigms. Part 2 provides an explanation of the methodologies and strategies available to the researcher. Implications for practice/research This paper will be particularly useful for novice researchers or doctoral students.
4. A taste of nursing research: an interactive program introducing evidence-based practice and research to clinical nurses.
Brown, Christine R; Johnson, Ann S; Appling, Susan E;
Journal for Nurses in Staff Development, 2011 Nov-Dec; 27 (6): E1-5
Abstract: Developing and implementing a program to introduce clinical nurses to research and evidence-based practice (EBP) should spark interest and participation. In this article, the authors describe and evaluate a staff development initiative not only to introduce the principles of EBP and research but also to give nurses the opportunity to participate in the research process and development of EBP questions.
5. Nursing research week: promoting staff nurse awareness of research activities through a week long celebration.
Weitzel, Tina; Robinson, Sherry;
Journal for Nurses in Staff Development, 2011 Nov-Dec; 27 (6): 280-4
Abstract: Nursing Research Week was developed and implemented by staff nurses who comprise the Nursing Research Council of a Midwest hospital. Multiple activities based on the literature and designed to appeal to staff nurses with diverse interests and knowledge of research were included. The process of development of the activities and the participants' evaluation are shared.
6. Spotlight on Outcomes. Data-Driven Decision Making: A Nursing Research and Evidence-Based Practice Dashboard.
Mick, JoAnn;
Journal of Nursing Administration, 2011 Oct; 41 (10): 391-3
7. Implementing Evidence-Based Practice in the Reality of Clinical Practice.
Rycroft-Malone, Jo;
Worldviews on Evidence-Based Nursing, 2012 1st Quarter; 9 (1): 1
8. Factors Influencing Advanced Practice Nurses' Ability to Promote Evidence-Based Practice among Frontline Nurses.
Gerrish, Kate; Nolan, Mike; McDonnell, Ann; Tod, Angela; Kirshbaum, Marilyn; Guillaume, Louise;
Worldviews on Evidence-Based Nursing, 2012 1st Quarter; 9 (1): 30-39
9. Effectiveness of organisational infrastructures to promote evidence-based nursing practice.
Foxcroft D; Cole N;
Cochrane Database of Systematic Reviews, 2012 (2)
Abstract: Background:; Nurses and midwives form the bulk of the clinical health workforce and play a central role in all health service delivery. There is potential to improve health care quality if nurses routinely use the best available evidence in their clinical practice. Since many of the factors perceived by nurses as barriers to the implementation of evidence-based practice (EBP) lie at the organisational level, it is of interest to devise and assess the effectiveness of organisational infrastructures designed to promote EBP among nurses.; Objectives:; To assess the effectiveness of organisational infrastructures in promoting evidence-based nursing.; Search methods:; We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, LILACS, BIREME, IBECS, NHS Economic Evaluations Database, Social Science Citation Index, Science Citation Index and Conference Proceedings Citation Indexes up to 9 March 2011.; We developed a new search strategy for this update as the strategy published in 2003 omitted key terms. Additional search methods included: screening reference lists of relevant studies, contacting authors of relevant papers regarding any further published or unpublished work, and searching websites of selected research groups and organisations.; Selection criteria:; We considered randomised controlled trials, controlled clinical trials, interrupted times series (ITSs) and controlled before and after studies of an entire or identified component of an organisational infrastructure intervention aimed at promoting EBP in nursing. The participants were all healthcare organisations comprising nurses, midwives and health visitors.; Data collection and analysis:; Two authors independently extracted data and assessed risk of bias. For the ITS analysis, we reported the change in the slopes of the regression lines, and the change in the level effect of the outcome at 3, 6, 12 and 24 months follow-up.; Main results:; We included one study from the USA (re-analysed as an ITS) involving one hospital and an unknown number of nurses and patients. The study evaluated the effects of a standardised evidence-based nursing procedure on nursing care for patients at risk of developing healthcare-acquired pressure ulcers (HAPUs). If a patient's admission Braden score was below or equal to 18 (i.e. indicating a high risk of developing pressure ulcers), nurses were authorised to initiate a pressure ulcer prevention bundle (i.e. a set of evidence-based clinical interventions) without waiting for a physician order. Re-analysis of data as a time series showed that against a background trend of decreasing HAPU rates, if that trend was assumed to be real, there was no evidence of an intervention effect at three months (mean rate per quarter 0.7%; 95% confidence interval (CI) 1.7 to 3.3; P = 0.457). Given the small percentages post intervention it was not statistically possible to extrapolate effects beyond three months.; Authors' conclusions:; Despite extensive searching of published and unpublished research we identified only onelow-quality study; we excluded many studies due to non-eligible study design. If policy-makers and healthcare organisations wish to promote evidence-based nursing successfully at an organisational level, they must ensure the funding and conduct of well-designed studies to generate evidence to guide policy.
10. Clinical nurse specialists shaping policies and procedures via an evidence-based clinical practice council.
Becker, Elaine; Dee, Vivien; Gawlinski, Anna; Kirkpatrick, Theresa; Lawanson-Nichols, Mary; Lee, Betty; Marino, Christina; McNair, Norma; Melwak, Mary A.; Purdy, Isabell; et al.;
Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 2012 Mar-Apr; 26 (2): 74-86
Abstract: In the practice of nursing, organizations with progressive evidence-based practice programs implement structures and processes whereby nurses are engaged in the review of existing research and in the development of clinical practice documents to better align nursing practices with the best available scientific knowledge. At our academic hospital system, clinical nurse specialists (CNSs) took the lead to help transform a traditional nursing policy and procedure committee into a hospital-wide, staff-represented Clinical Practice Council (CPC) that ensures evidence-based nursing practices are reflected in the organization's nursing practice documents for the provision of patient care. Clinical nurse specialists function as mentors and cochairs who are dedicated to ensuring that nursing practice is supported by the latest evidence and committed to guiding staff nurses to continually move their practice forward. The success of the CPC is due to the leadership and commitment of the CNSs. This article describes the structure, process, and outcomes of an effective CPC where CNSs successfully engage frontline clinicians in promoting nursing care that is evidence based. Clinical nurse specialist leadership is increasingly made visible as CNSs effectively involve staff nurses in practice reforms to improve patient outcomes.
11. Does evidence-based nursing practice increase ROI?
Schifalacqua, Marita MacKinnon; Soukup, Maurita; Kelley, Wanda; Mason, Alison Rich; American Nurse Today, 2012 Jan; 7 (1): 32-3
Abstract: A quality-improvement initiative quantified return on investment (ROD from cost avoidance for five healthcare-acquired conditions.
12. Examining Nurses' Attitudes Regarding the Value, Role, Interest, and Experience in Research in an Acute Care Hospital.
Riley, Joann Kay; Hill, Ambrosha N; Krause, Kori B; Leach, Laura B; Lowe, Timothy J; Journal for Nurses in Staff Development, 2011 Nov-Dec; 27 (6): 273-9
Abstract: This study examined nurses' attitudes regarding the value of and their role, interest, and experience in research in an acute care hospital. A correlational design explored the relationship between attitudes about nursing research, involvement, educational background, and experience. The results indicated an increasing level of value and interest in research for those nurses with greater educational attainment, certified specialty, previously taken research course, research experience, and a nursing position in education. The findings suggest that additional education and guided projects are needed for those nurses with little or no previous research experience.
Thursday, March 29, 2012
Danielle's Picks from the Literature - March 2012
Posted by Danielle Linden, MLIS, AHIP at 10:14 AM 1 comments
Labels: Libraries/Literature
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