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South African Journal of Economic and Management Sciences
On-line version ISSN 2222-3436
Print version ISSN 1015-8812
S. Afr. j. econ. manag. sci. vol.17 n.3 Pretoria Jul. 2014
Why is an ethical and integrated audit accreditation process required for Romanian hospitals?
Daniela-Tatiana AgheorghieseiI; Liliana IliescuII; Cristina GavriloviciII; Liviu OpreaII
I(Corodeanu); Center for Health Policy and Ethics, "Grigore. T. Popa " University of Medicine and Pharmacy, Iasi, Romania
IICenter for Health Policy and Ethics, "Grigore. T. Popa " University of Medicine and Pharmacy, Iasi, Romania
Nowadays, a third generation of ethics has come to the fore, whereby ethical issues are approached in an integrated manner, emphasising the management of ethics, which entails a cause-effect relation. One of its evaluation instruments is the ethical audit.
This paper presents the findings of research focused on 47 executives involved in the management of quality in Romanian hospitals. The research concerns, in particular, the relevance and the opportunity for an ethical audit and the assessment of its possible effects.
The data were gathered using a questionnaire.
The research shows that Romanian managers consider the introduction of the ethical audit within the accreditation process as being relevant and pertinent. They believe that ethical monitoring is beneficial for the activity of healthcare institutions, but also that these institutions are as yet not sufficiently prepared to implement ethical audits. This study might be useful for sounding an alarm bell or for suggesting a direction for the qualitative and quantitative improvement of accreditation criteria and for the management of change in healthcare institutions worldwide.
Key words: ethics in healthcare management, Romanian healthcare managers, ethical audit, accreditation
1 Introduction
Institutions in the healthcare system now have responsibilities beyond just patient rights or even the rights of employees. Their management as with any other organisation, is faced with the need to manage limited resources and competition. Moreover, healthcare institutions are subject to strong public scrutiny and must gain the trust and approval of accreditation bodies.
This article assumes that the world at large has entered the third generation of ethics and has made the transition to a higher level of ethical issues and methods of solving them. Our study presents the results of empirical research which aims to identify the opinions of executives involved in quality assurance in hospitals regarding the relevance of and opportunity for the introduction of the ethical audit within the accreditation system for hospitals in Romania.
It will add to the small body of studies in the field. We believe that our study could be useful for all countries wishing to strengthen public confidence in the health system by including ethical audits in accreditation criteria. Our research primarily conveys the message that managers involved in quality assurance in hospitals should be consulted, because they are the experts needed to support this process and provide information necessary for its implementation. Furthermore, the research highlights issues and questions that may be considered in consultation with managers.
2 Literature review
2.1 The multiple facets of ethics in the management of the healthcare system and its institutions
The principles, methods, strategies, instruments of ethics and good practices used in the management of hospitals and other healthcare units is a wide field of study, intensely analysed and debated in the scholarly literature from multiple points of view. Several issues have been analysed since the late 1990s: civic responsibility of the healthcare organisation (Hofmann, 1995); the evaluation of the ethical program (Neft-Smith, Scott, Edward & Fletcher, 1997); good practices in the ethics of hospital units (Cassidy, 1998); ethical leadership (Johnston, Cruess & Cruess, 2001; Dolan, 2004;) and the challenges raised by ethics and the responsibilities of leaders in the healthcare system (Squazzo, 2012); ethical dimensions in public healthcare policies (Roberts & Reich, 2002); ethics and the safety of hospitals (Weinstein, 2002) and ethics and patient safety (Lachman, 2008); challenges of ethical committees (Collier & Sandborg, 2006; Hogstel & Curry, 2004); the ethics of decision-making (Maddalena, 2007; Slosar, 2004); ethical transparency and economic medicalisation (Poitras & Meredith, 2009); the organisational costs of ethical conflicts (Nelson, Weeks & Campfield, 2008; Hofmann, 2012); and the ethics of decisions concerning the allocation of resources (Hofmann, 2011). The aforementioned issues have the commonality that if they are not considered properly, they can weaken quality of care and organisational performance. The numerous published studies show the complexity of the subject and the many ethical risks which might beset the proper functioning of the healthcare system. They also highlight the need for preparation and prevention, a willingness to approach them attentively, to analyse them according to their particularities, and to frame them optimally in the managerial process by finding adequate instruments for dealing with them. These articles also implicitly envisage the role, importance and structure of the ethical audit (Morrell, 2002; Kirkpatrick, Reamer & Sykulski, 2006). As Porter (1994:38) highlights, audit practices (and here we can include the ethical audit) have spread "due to changes in public sector management and new prominent ideals of quality, governance and accountability."
Another aspect which deserves full consideration is the inclusion of ethics within the accreditation system of healthcare units, highlighting thus the impact of ethics on stakeholders and on the quality of services provided. This would mean moving ethics from the abstract into reality, and rather than taking a declarative stance moving it to the implementation level. The fact that the accreditation process verifies whether the institution has a system for handling patient complaints does not fully demonstrate the functionality of the system. Only proper consultation of employees and patients regarding the ethical connotations of processes would show the ethical performance of an institution which differentiates it from other institutions.
Hoffman (1995) and Wu, Liao, Chiu, Lin and Yang (2011) debate the relevance of and the opportunity for the ethical audit within the accreditation process of hospitals). This article focuses on the latter aspect.
2.2 The third generation of ethics: the management of ethics and auditing
Towards the end of 1990s, Dr. Bart Colopy (in Cassidy, 1998) maintained that the ethical discourse had already entered the second generation of ethics. The first generation focused on the rights of patients, the quality of healthcare services and its effects, and on ethical issues related to decision-making involved in the choice of treatment regarding the assurance of life. For the author mentioned above, the second generation highlighted aspects of organisational and non-clinical ethics (ways of dealing with employees, allocation of budget, handling of conflicts of interests, prioritisation of certain healthcare services at the highest qualitative level for the patient, even in situations where this level is difficult to attain, etc.).
Apart from the economic pressures specific for a transition period, there are serious ethical dilemmas, rendered more urgent by the fact that one of the ethical responsibilities of organisations which provide healthcare services is taking the role of leadership in the improvement of healthcare in communities, in spite of financial difficulties and of the paradoxical situation that the problem of attracting resources from healthcare insurance is resolved by the high degree of employment in hospitals (Hofmann, 1995). Contemporary challenges for the worldwide management of the healthcare system are generated by diverse factors: technological; economic; socio-political; and cultural. According to the Joint Commission on Accreditation of Healthcare Organizations1 (1998:1), the necessity of dealing with moral issues was determined in the last 30 years by scientific progress in reproductive technology and by concern for the fragile medical state of new-borns and by the effects of technological development upon prolonging life expectancy. In addition morality was also determined by a wider awareness regarding the legal and moral rights of patients, including the right to self-determination, by a progressive change in vision regarding the financing of the healthcare system from "fee to service" to "managed care", by an enhancement of cultural, ethnic and spiritual diversity, by the rapid aging of populations which influenced the role of caretakers within the core family, and by a new philosophy concerning the meaning of "end-of-life care". These factors take different forms today, some of which are worrying for political decision-makers and leaders: the lack of resources; limited access to medical assistance for uninsured categories of the population,; the migration of doctors and of medical personnel; the internationalisation of access to healthcare; and political changes in general. Consequently, all these factors demand new visions and strategies, societal changes which bring about institutional modifications, and an approach at a superior level to ethical issues in the healthcare field. Apart from these high-level issues, there are also ethical dilemmas at an individual level which confront medical personnel, such as the case of doctors who must balance the obligation towards patients with their professional oath and with the obligation towards employers (Loewy, 1999), all with their own particular challenges.
These aspects, analysed in scholarly literature, are today presented in an integrated form, in a type of cause-effect relationship. If the first generation of ethics took into account patients' rights regarding access to healthcare services, today we have to deal with the problem of quality of this service and implicitly with the question of patients' perception of its quality. Therefore, the new orientation takes into account patients' opinions, either for the prevention, or for the improvement, through remedies, of medical services. There is, thus, the challenge of the evaluation of an ethical culture and values (orientation towards quality, excellence, listening and involving the patient, transparency, responsibility) which are predominant in an organisation, with reference to the satisfaction of patients. The latter is known as the third generation of ethics.
The third generation of ethics is responsible for the proper management of ethical behaviour, and applies to the managers who hold responsibility for observing ethical standards (Weber, 2001:13). The management of ethical conduct means the identification of risk areas so that the organisation is able to maintain a high degree of trust from the public, and so that it passes the test of accomplishing the accreditation standards required by external evaluators and can thus take an honourable place within the classification processes of hospitals. Apart from the aspects embodied by the previous generations, there is the additional need for a strong focus on the identification, through auditing, of the impact of initiatives deemed to establish an ethical climate and to prevent ethical risks within and outside the organisation (ethical culture and the satisfaction of patients, leadership, ethical climate and the satisfaction of employees). There is also the need for the voluntary use of managerial instruments which ensure both ethical behaviour within organisations and in their external relations, and the learning process (ethical policies, ethical programs, officer/ethical counsellor, ethical help lines, medical ethical committees, ethical codes, ethical quality management and ethical training). These instruments ensure integration and recognition within specific networks (ethical associations, partnerships with educational institutions), as well as the assessment of efforts and of the impact of these ethical measures (programmes that monitor the ethical climate, ethical audits). New requirements from the community, such as the fair handling of diversity, care for the environment, the involvement of the organisation in projects with a social responsibility, represent new challenges for organisations whose mission consists of providing healthcare. In order to deal with all these factors and requirements, the organisation needs an integrated system of ethical management which includes ethical vision, ethical competencies, instruments of planning, organising, leadership, decision-making and evaluation, access to networks, availability and capacity to learn and ethical training. The third generation of ethics also envisages the evaluation of integrity and the ethical reputation of an organisation (through the assessment of the degree of trust) and conformity with the institutional systems of accreditation (see figure 1).
Understanding this transition from the first generation of ethics to the third generation is extremely important for the acceptance of the role of the ethical audit in the ethics and quality management of hospitals, and of the introduction of this audit as an accreditation criterion. In other words, managers and responsible authorities could better realise the need to address ethical issues at a broader level, according to the current context in which their institutions operate. Pressures to reduce costs and focus on other priorities, lack of ethical skills (conducting an ethical audit would require "formal education or training related to professional ethics" (Reamer, 2007: 186)), but also lack of vision and indifference can block managers, causing them to stay at the stage of second generation ethics. This in turn may affect long-term organisational performance, especially in terms of public confidence.
2.2.1 The tools needed for managing ethical issues and risks: the relevance of the ethical audit
One of the instruments, which makes possible timely identification and dealing with ethical risks areas, with multiple advantages, is the ethical audit. According to Kaptein (1998:60), the ethical audit is a process which describes, analyses and evaluates the relevant aspects of the ethics in an organisation.
Hofmann (1995) defines the ethical audit from the perspective of guaranteeing to stakeholders the implementation of the mission originally assumed by the organisation, "even in the most difficult times". Also the ethical audit is "...a practical and valuable instrument in evaluating whether the organization complies with its standards and expectations" (Hofmann, 2006), which in unfavourable contexts, implies taking risks and facing a large range of potentially negative consequences. Wiley (1995, as cited by Menzel (2007:72)) considers that the ethical audit has the role of improving the organisation's performance. In the wake of evaluations, the audit offers management certain focal topics such as: the climate; the working environment; and the codes and consolidation of ethical policies of the organisation.
The ethical audit is based on a process of analysis and is a true mechanism of dialogue and of gathering suggestions for improvement. It generates trust regarding external stakeholders, guaranteeing to them that the organisation fulfils its economic, social and environmental obligations (Garcia-Marza, 2005). The ethical audit makes it possible to apply ethical issues to professional practices, to survey and evaluate, where necessary, the adequacy of these practices, and to monitor the application the quality assurance strategy (Reamer, 2007). It also represents a barometer of organisational well-being by compiling a list which verifies the degree of conformity to ethical standards, written or unwritten (Schlegelmilch, 1998:128). It evaluates the fidelity of the organisation towards the values, mission and the ethical code as declared and assumed initially by the organisation. It also assesses aspects regarding the way in which the organisation respects its internal and external stakeholders and their moral and legal rights (employees, patients, clients, providers, volunteers, community). The audit is also part of the construction and the maintenance of ethical climate, it makes place for ethics in communication and leadership and develops practices for financial management, marketing and funding.
Ferrell, Ferrell and Fraedrich (2012:244245) and Menzel (2007:72) focus on a long list of benefits of the ethical audit. It has a preventive and proactive character because it makes it possible to track actions and behaviours which are mistaken, which produce ethical risks and crises within the organisation in real time. In this way, the audit minimises the potential costs of ethical conflicts and of unethical conduct. This type of audit motivates and assures the perception of an ethical climate and promotes satisfaction among employees. It protects the image and the good reputation of the organisation by avoiding uncontrolled situations and ethical risks which might compromise it. The internal audit cements good practices within organisations, boosting trust and good public opinion as well as credibility with financial institutions.
In this context the relevance and structure of the ethical audit used both in the management of the quality of hospitals and in the accreditation process are discussed next.
3 Methods
3.1 Research aim
Our research aim is to identify the opinion of hospital executives (involved in quality assurance) regarding the relevance of and the opportunity for the introduction of the ethical audit in the accreditation process of Romanian hospitals.
This research primarily took as its starting point the work of Wu et al. (2011) who studied the problem of including the ethical audit within the accreditation process of hospitals and their optimal structure, using a valid sample of 90 hospital managers in Taiwan. Also the work of Landman, Mouton and Nevhutalu (2001) from the Ethics Institute of South Africa, which shows the results of the ethical audit (conducted based on a questionnaire) at the Chris Hani Baragwanath Hospital was a cornerstone in supporting our approach. In Romania we have no similar studies related to consulting hospital managers involved in quality assurance on the integration of ethical audits into institutions' accreditation criteria.
3.2 Research method and tools
Our method for gathering the data was an inquiry based on a questionnaire including two parts and with a total of 59 items (including biographical data of respondents).
The questionnaire was chosen as the method of data collection because hospital managers involved in quality assurance who participated in the research are from hospitals across the country. Under these conditions, the research would have involved high costs and time constraints if not for the questionnaire. As Pienaar (2010:182) highlights, "In organisational research, ... business ethics, ... transgressions of organisational standards are sensitive". Also, as stated by an expert in research methodology (Chelcea, 2001:255), "the questionnaire is indispensable for knowledge of the phenomena of consciousness, constructed and mediated by language (knowledge, opinions, beliefs)."
3.2.1 The design of the questionnaire and its distribution
In the first part of the questionnaire (whose analysis and results are the subject of this article, see table 5 below), 20 questions related to the expressed opinions regarding the relevance of and the opportunity for introducing the ethical audit within the accreditation process of Romanian hospitals were formulated.
The second part of the questionnaire was comprised of questions related to aspects which would be adequate for the structure of an ethical audit, and which might be monitored in the course of the accreditation process of Romanian hospitals. Within the present paper we limit our research to the analysis of the answers obtained in the first part of the questionnaire. The second part of the questionnaire was the subject of another analysis, the results of which have already been published.
The questionnaire was examined by eight specialists who have an academic interest in healthcare ethics.
The questions were formulated so as to present multiple choices and an ordinal scale of response of the "Likert type" (1 - complete disaccord, 6 - complete accord). One of the questions was open-ended.
The questionnaire was formatted and distributed with the help of the "googledocs" application.
3.2.2 Research subjects, sample method and characteristics of the sample
In order to achieve the research objective, we applied a non-randomised sampling method called logical sampling. The questionnaire was applied online between January and July 2012 to 150 executives, all members of the target group within the framework of a European project on the topic of the management of quality in healthcare in Romanian institutions. They were informed during project meetings of the purpose of the questionnaire, and about the importance of the ethical audit for the quality assurance process.
The main reason for the selection of this target group was that its members are involved in hospital quality assurance, and as suggested by Porter (1994:1), the audit is part of the process "audit and other quality assurance initiatives". In addition "many audits, such as medicine, are conceived primarily as internal reviews to improve decision-making...intended to support rather than to discipline" (Porter, 1994:4). Ethical audit is a tool for monitoring the application of the quality assurance strategy (Reamer, 2007). Managers involved in quality assurance are those that provide the foundation for the quality of decisions by improving procedures and preventive controls. They know in detail all the strengths and weaknesses of the organisation's activities (are "the key informants"), and are the ones that provide all the necessary documentation for institutional accreditation given existing data. They are the closest to the "ethical audit", because they are the ones who know all the details of all organisational work processes.
The valid sample is represented by 47 subjects, which constitutes a response rate of 29 per cent from the analysed population.
The distribution of respondents according their gender, level of studies, type of education and age is presented below (in tables 1, 2, 3 and 4).
A percentage of 89.4 of the executives work for institutions which are publicly-funded, while the rest come from institutions funded from mixed resources. Of these institutions, 25.5 per cent are emergency hospitals, 17 per cent have a general profile, and 17 per cent provide medical services for patients who are chronically ill. In an equal percentage, 8.5 per cent are respondents from county hospitals and municipal hospitals respectively, 6.4 per cent are from academic hospitals, and 4,3 per cent from clinical units. A percentage of 40.4 are from institutions that have under 200 beds, 34 per cent have between 200 and 500 beds, and 25.5 per cent have over 500 beds.
3.2.3 Data analysis
The gathered data were analysed with the aid of the statistical program SfinxPlus2, under the licence of use for Alexandru Ioan Cuza University, Iasi, Romania. The following methods and tests of analysis were put to work: analysis of frequencies; calculation of means and of standard deviations; and correlation tests.
3.3 Research hypothesis
Based on the literature we formulated the following hypotheses: 1) executives from Romanian hospitals consider that the introduction of an ethical auditing would be relevant and welcome within the accreditation process of hospitals (Hofmann, 1995; Wu et al., 2011; Morrison, 2011); 2) they consider that the implementation of an ethical audit within the accreditation process would have a beneficial role regarding the activity of Romanian hospitals (Hofmann, 1995; Wu et al., 2011; Morrison, 2011); 3) they think that managers and healthcare institutions from Romania are not sufficiently prepared for the implementation of an ethical audit (Reamer, 2007); and 4) in their opinion, there is a strong correlation between the role of ethical auditing and the consolidation of the public's trust in the capacity of hospitals to provide medical service of superior quality (Domingo Garcia-Marza, 2005; Menzel, 2007).
4 Results
The averages of the answers for the 20 variables (related to each of the questions) which we will analyse further (from a total of 58 for the entire questionnaire) vary between 5.70 and 3.43, with the total average being 4.79 (Table 5).
Analysis of the answers given emphasises that the most important and essential aspects for the management of healthcare institutions are: concern for quality (N = 42; 89.4 per cent); efficiency (N = 20; 42.6 per cent); and good relations between patients and institutions (N = 18; 38.3 per cent). A percentage of 78.7 (N = 37) of the questioned executives completely agree that respect for ethical principles represents an essential aspect of the management of healthcare institutions (M= 5.70; σ=0.66). A percentage of 66 per cent of respondents (N = 31) agreed completely that quality assurance must be related to ethics (M=5.55; σ=0.75). These answers concur with the best-known ethical theories (Morrison, 2011:230). For example, the Kantian vision is that concern for quality constitutes a moral duty, even a categorical imperative and that all human beings are worthwhile and deserve quality services. In turn, the supporters of utilitarianism would consider lack of quality in services as an adverse consequence for individuals, as well as for the organisation, which translates into low satisfaction or outright dissatisfaction, or low wages and has adverse legal implications. Finally, Rawls' theory of justice argues for the importance of the interest of the community and of the organisation. The relationship between the two variables (that ethical principles represent an essential aspect of quality assurance management) is highly significant and has a positive correlation coefficient of 0.83 (Ecart-type of regression coefficient = 0.094). In this case, the former explains 69 per cent of variance in the latter. These results are possibly justified by the fact that respondents are people involved in quality management of the institutions where they work.
A percentage of 57.4 (N = 27) of participants are in complete agreement that the accreditation process of hospitals should include the management of ethical values and organisational ethics, that is policies should be formulated and instruments introduced that support ethical standards (M = 5.34; σ=1.03). The correlation coefficient between the management of ethical values and organisational ethics within the accreditation process and the inclusion of the ethical values within the accreditation process is +0.88. The first variable accounts for 76 per cent of variance in the second variable (Ecart-type of the regression coefficient - 0.076). Nevertheless, only 12 respondents (25.5 per cent) expressed complete agreement and 19 agreement (40.4 per cent), that in their institution there is on-going concern for the implementation of ethical values.
Over half of the respondents (N = 30; 63.8 per cent) are in complete agreement with the introduction of ethical standards within the accreditation process of hospitals (M=5.40; σ=1.08).
Concerning the introduction of ethical audit within the accreditation process, 53.2 per cent (N = 30) expressed complete agreement, and 31.9 per cent (N = 15) agreement (M=5.26; σ=1.09).
A high percentage of 57.4 (N = 27) expressed complete agreement regarding the beneficial role of ethical monitoring in management of Romanian healthcare institutions (M=5.38; σ=0.97). The same percentage of respondents confirm that it would be beneficial to introduce ethical auditing for the accreditation process to increase performance of healthcare institutions (M=5.28; σ=1.08).
A percentage of 46.8 respondents (N = 22) expressed complete agreement that they would be available to participate in the process of ethical auditing, while 31.9 per cent (N = 15) expressed agreement (M=5.09; σ=1.21). There is strong dependence between the variable (availability to participate) and the introduction of ethical auditing within the accreditation process with a correlation coefficient of +0.70 (Ecart-type of the regression coefficient -0.095). The first variable explains 49 per cent of variation in the second variable. As far as concrete advantages are concerned, 68.1 per cent of respondents (N = 32) showed complete agreement that public trust would be consolidated if hospitals provide superior quality medical services (M=5.36; σ=1. 11). A percentage of 34 per cent completely agreed, while 34 per cent agreed that integration of the ethical audit into accreditation criteria would improve the classification of hospitals (M=4.89; σ=1.09). Inclusion of ethical audits might contribute to a more efficient allocation of resources (36.2 per cent accord or agreement and 34 per cent total accord or agreement; M=4.79; σ=1.32). (Inclusion of the ethical audit in the accreditation process explains 61 per cent in the consolidation of public trust (correlation coefficient +0.78, ecart-type of the regression coefficient - 0.095).
There is also a strong, positive dependence between the variable regarding the beneficial role of the introduction of ethical monitoring in the management of Romanian healthcare institutions and the variable regarding the introduction of ethical auditing within the accreditation process. The correlation coefficient is +0.87 (ecart-type of the regression coefficient - 0.083), with the former variable explaining 75 per cent of the latter's variation.
A matter of concern is the perceived preparedness of managers for elaborate ethical policies. Responses were rather heterogeneous: 4 respondents (8.5 per cent) completely agreed that they are sufficiently trained, 11 (23.4 per cent) agreed, and 12 (25.5 per cent) were in partial agreement. A similar answer was given to the question regarding the extent to which Romanian hospitals are prepared for ethical auditing: the greatest number of those questioned (N = 16.34 per cent) only partially agreed with this statement, and only 4 completely agreed (8.5 per cent). For dependence between the variables (managers are prepared for elaborate ethical policies and (healthcare institutions are prepared for an ethical audit) there was a significant and positive relationship, the correlation coefficient being +0.79 (Ecart-type of regression coefficient - 0.088), the former explaining 62 per cent of the latter's variation.
Related to the above questions is the following one regarding the problem of whether managers receive sufficient support and resources for implementing elaborate ethical policies and standards at the institutions they lead. Fourteen respondents (29.8 per cent) expressed partial disagreement (M=3.43; σ=1.26). Thirteen (27.7 per cent) expressed partial agreement on whether managers are sufficiently competent for this task. Only 3 (6.4 per cent) expressed their complete agreement. Logically, a big number of respondents (N = 30; 63.8 per cent) consider that managers need supplementary preparation in order to be able to elaborate ethical policies and standards for the institutions that they lead (M=5.51; σ=0.75).
Over half of the respondents (59.6 per cent; N = 28) completely agreed that the managers of hospitals should be consulted with regard to the introduction of ethical audits among the criteria of the accreditation process (M=5.19; σ=1.31). A percentage of 46.8 per cent (N = 22) and 31.9 per cent (N = 15) expressed complete agreement and agreement for taking part in an ethical audit.
5 Discussion and research limitations
The consultation of executives regarding the introduction of the ethical audit among the evaluative criteria of the accreditation process of hospitals certainly represents an important step for the assessment of their availability to involve themselves and the institutions they lead in such a process.
The research shows that over half of the managers are in complete agreement with the introduction of ethical standards within the accreditation process of hospitals. This shows that they consider the introduction of the ethical audit within the accreditation process as being relevant and pertinent and that ethical monitoring is beneficial for the activity of healthcare institutions. As can be seen from their responses, the most important gain is the consolidation of public trust regarding access to medical service of superior quality. These ethical audits also allow for proper classification of hospitals and for better allocation of resources according to ethical efforts by organisations. The results are all the more convincing, because participants involved (quality management at institutions) draw a clear line between abiding by ethical principles and quality assurance. The findings therefore support the introduction of ethical auditing within the accreditation process, which in turn improves the quality of medical services.
Among the problems identified by executives, is the insufficient preparation and training of managers for conducting ethical audits. The solution to this challenge is supplementary training for managers.
Findings of this research demonstrate that Romanian healthcare institutions are only partially prepared for ethical evaluation, and a strong concern for ethical values is not manifest.
The idea of defining ethical requirements for healthcare institutions through the accreditation is also expressed by Morrison (2011: 239). Ethical auditing would guarantee standard requirements. If only a few healthcare institutions which are really concerned with the championing of ethical values apply audits, their effect would not be capitalised and would only have a limited sphere of impact. Ethical audits are costly (which implies legal justification for the resources involved) and in order to reach an adequate degree of objectivity, they must be handled by external specialists. Many hospital managers do not appreciate the advantages of ethical audits especially given the pressure of lack of resources and the absence of managerial contractual obligations. In this context, the problem of integrating ethical auditing into the accreditation process of healthcare institutions arises. There are many beneficial effects through the "forced" implementation of this instrument. Adding criteria to the accreditation process requires consistency and realism.
The actual accreditation standards proposed by the National Commission of Hospital Accreditation (CoNAS2) in Romania might add to the list of verification for the presence or absence of stricter managerial and performance aspects, but their foundation has a basis of respect towards ethical values. By taking into account ethical audits, it might be possible to offer concrete answers concerning the preoccupation with ethical values when utilising certain instruments. Questions that could be asked are the following:
- What are the ethical values that should be taken into account to support the mission of each hospital?
- What are the ethical values that could be developed to satisfy the patient and what are the results of these values?
- What are the mechanisms for the implementation of ethical policies (ethical programmes, ethical codes, training modules on ethical themes);
- What are the components of organisational structure (ethical committees and commissions, ethical lines, ethical counsellors) with responsibilities in ethical monitoring and which of these could be addressed by patients and employees when faced with ethical dilemmas and problems?
- How can work climate be characterised from an ethical point of view and what is its relationship with the employee's performance?
- What are the ethical aspects endorsed within public relations strategy?
- To what extent does the strategic plan take into account the activity's effects upon the environment?
- What are the ethical values which sustain the functionality of the communication system, etc.?
Healthcare authorities have a picture of what is going on at the macro-level of the healthcare system and have useful and necessary information for high-level decision-making processes. Integration of the entire healthcare system transforms the ethical audit into a control instrument, but also into an instrument of classification of healthcare units. Mandatory ethical audits within the accreditation system lead to a more efficient allocation of resources. Implicitly, institutions would be more motivated to increase their performance in order to be granted greater access to resources.
As Loewy (1999) argues, each system has unique ethical problems, and each country's healthcare system is marked by its own values and societal structures.
The main limitation of this research is that a small sample of subjects was used, which does not make it possible to generalise results.
The relatively small research sample, might designate this study as being a pilot. However, this is the first study of its kind in Romania and is an initial step to creating awareness for hospital managers (especially those involved in quality assurance) that their institutions may be subject to audits of ethics in the accreditation process. In spite of this limited character, the study might be useful for sounding an alarm bell or for suggesting a direction towards the qualitative and quantitative improvement of accreditation criteria and towards the management of change in Romanian healthcare institutions and worldwide. This change would consolidate fidelity towards each organisational mission, benefitting all categories of stakeholders.
6 Conclusion and further research
Research shows that managers are open to the idea of introducing the ethical audit as an institutional accreditation criterion. Managers used in this study could be the first group of sup-porters to recommend to the responsible authorities the introduction of ethical auditing in hospitals. At the same time, it is important to remember that preparation is needed in this area.
Ethical auditing is a proactive process, which aims at improving the ethical performance of healthcare institutions.
Through auditing, every healthcare institution might convey to its (internal and external) stakeholders a message about its ethical preoccupations with respecting moral values, about its constant efforts made in order to provide medical services at the highest level of quality, gaining in this way their trust and support.
From an economic point of view, the results of an ethical audit might contribute to the classification of healthcare units in order to obtain a fair allocation of resources, which would create a competitive framework and ensure their progress and improvement.
Future research could aim at including a larger number of subjects. To have a complete picture, a future study should follow the integrated opinion of hospital managers, employees, the authorities that are responsible and interested in accreditation of hospitals, patients and lastly the community.
This paper is part of broad research developed within the framework of the European project entitled "Studii postdoctorale in domeniul eticii politicilor de sanatate" (POSDRU/89/1.5/S/61879).
Authorship Statement
All authors contributed equally to this paper.
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HOGSTEL, M.O. & CURRY, L.C. 2004. Ethics committees in long-term care facilities, Geriatric Nursing, 25(6):364-369. [ Links ]
JOHNSTON, S.E., CRUESS, S.R. & CRUESS, R.L. 2001. Ethical leadership in modern medicine. Canadian Journal of Administrative Sciences, 18(4):291. [ Links ]
JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS 1998. Ethical issues and patient rights: across the continuum of care. Oakbrook Terrace, IL, USA. [ Links ]
KAPTEIN, M. 1998. Ethics management: auditing and developing the ethical content of organizations. Dordrecht, Netherlands: Kluwer. [ Links ]
KIRKPATRICK, W.J., REAMER, F.G. & SYKULSKI, M. 2006. Social work ethics audits in health care settings: A case study. Health & Social Work, 31(3):225. [ Links ]
LACHMAN, V.D. 2008. Patient safety: The ethical imperative, Dermatology Nursing, 20(2). [ Links ]
LANDMAN, W.A., MOUTON, J. & NEVHUTALU, K.H. 2001. Chris Hani Baragwanath Hospital Ethics' Audit. Ethics Institute of South Africa. Research Report no. 2. Available at: http://ethicssa.intoweb.co.za/UserFiles/ethicssaintoweb.co.za/CHBHFinalReport.pdf [accessed 2012-05-01]. [ Links ]
LOEWY, E.H. 1999. Health-care systems and ethics: What can we learn? Health Care Analysis, 7:309-320. [ Links ]
MADDALENA, V. 2007. A practical approach to ethical decision-making, Leadership in Health Services, 20(2):71-75. [ Links ]
MORRISON, E. 2011. Ethics in health administration: a practical approach for decision makers. Sudbury, MS: Jones and Bartlett Publishers. [ Links ]
MENZEL, D.C. 2007. Ethics management for public administrators: Building organizations of integrity. Armonk, NY: M.E. Sharpe. [ Links ]
MORRELL, C. 2002. Ethical audit. Nursing Children and Young People, 14(7):3. [ Links ]
NEFT-SMITH, G., SCOTT, SPENCER, EDWARD M. & FLETCHER, J.C. 1997. Ethics program evaluation: The Virginia Hospital Ethics Fellows Example, part II. HE CForum, 9(4):375-388. [ Links ] NELSON, W.A., WEEKS, W.B., CAMPFIELD, J.M. 2008. The organizational costs of ethical conflicts. Journal of Healthcare Management, 53:1. [ Links ]
PIENAAR, J. 2010. Ethics in economic and management sciences: a researcher's resource. SAJEMS, 13(2):177-189. [ Links ]
POITRAS, G., MEREDITH, L. 2009. Ethical transparency and economic medicalization. Journal of Business Ethics, 86:313-325. [ Links ]
PORTER, M. 1994. The audit explosion. London: Demos. [ Links ]
REAMER, F.G. 2007. Conducting an ethics audit. Social Work Today, 7(1). Available at: http://www.socialworktoday.com/archive/EoEJanFeb07.shtml [accessed 2012-05-14]. [ Links ]
ROBERTS, M.J., REICH, M.R. 2002. Ethical analysis in public health. THE LANCET, 359. [ Links ]
SQUAZZO, J.D. 2012. Ethical challenges and responsibilities of leaders, Healthcare Executive, 27(1):32. [ Links ]
SCHLEGELMILCH, B.B. 1998. Marketing ethics: an international perspective. London: International Thomson Business Press. [ Links ]
SLOSAR, J.P. 2004. Ethical decisions in health care. Health Progress, 85(1):38. [ Links ]
WEBER, L.J. 2001. Business ethics in healthcare: beyond compliance. Bloomington: Indiana University Press. [ Links ]
WEINSTEIN, H. C. 2002. Ethics issues in security hospitals, behavioral sciences and the law. Behav. Sci. Law, 20:443-461 WU, [ Links ] M.H., LIAO, C.H., CHIU, W.T., LIN, C.Y. & YANG, C.M. 2011. Can we accredit hospital ethics? A tentative proposal. Journal of Medical Ethics, 37(8):493-497. [ Links ]
Accepted: December 2013
1 The Joint Commission on Accreditation of Healthcare Organizations (JCAHO/JACHO) (now Joint Commission) is "... a private non-governmental agency that establishes guidelines for the operation of hospitals and other health care facilities, conducts accreditation programs and surveys, and encourages the attainment of high standards of institutional medical care..." (http://medical-dictionary.thefreedictionary.com/Joint+Commission+on+Accreditation+of+Healthcare+ Organizations).
2 The National Commission of Hospital Accreditation (CoNAS) in Romania has among its main responsibilities: the approval of a hospital accreditation; the approval of procedures, standards and methodologies for accreditation of hospitals; the proposal of strategies to improve the quality of hospital services (http://www.conas.gov.ro/despre.html).


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Bloom Fuel™ 0-0-2 represents an entirely new method of feeding aimed at pushing plants into the flowering stage. This 100% organic, transition product is designed to reduce the vegetative stage of growth and switch the plants over to the flowering stage. As the plant switches stages, Bloom Fuel™ helps to create multiple flower sites with more lateral branching by providing just the right balance of energy and nutrients.
This item is sold individually. The case size is listed for your convenience for instances where you wish to order in case quantities.
— Ships from H: WA, CA, CO, MI, TN, PA, FL USA.

subset: commoncrawl


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Marijuana refers to the dried leaves, flowers, stems, and seeds from the hemp plant Cannabis sativa, which contains the psychoactive (mind-altering) chemical delta-9-tetrahydrocannabinol (THC), as well as other related compounds. This plant material can also be concentrated in a resin called hashish or a sticky black liquid called hash oil.
Marijuana is the most common illicit drug used in the United States. After a period of decline in the last decade, its use has been increasing among young people since 2007, corresponding to a diminishing perception of the drug's risks that may be associated with increased public debate over the drug's legal status. Although the federal government considers marijuana a Schedule I substance (having no medicinal uses and high risk for abuse), two states have legalized marijuana for adult recreational use, and 21 states have passed laws allowing its use as a treatment for certain medical conditions (see "Is Marijuana Medicine?", below).
Marijuana is usually smoked in hand-rolled cigarettes (joints) or in pipes or water pipes (bongs). It is also smoked in blunts—cigars that have been emptied of tobacco and refilled with a mixture of marijuana and tobacco. Marijuana smoke has a pungent and distinctive, usually sweet-and-sour, odor. Marijuana can also be mixed in food or brewed as a tea.
THC's chemical structure is similar to the brain chemical anandamide. Similarity in structure allows drugs to be recognized by the body and to alter normal brain communication
When marijuana is smoked, THC rapidly passes from the lungs into the bloodstream, which carries the chemical to the brain and other organs throughout the body. It is absorbed more slowly when ingested in food or drink.
However it is ingested, THC acts on specific molecular targets on brain cells, called cannabinoid receptors. These receptors are ordinarily activated by chemicals similar to THC that naturally occur in the body (such as anandamide; see picture, above) and are part of a neural communication network called the endocannabinoid system. This system plays an important role in normal brain development and function.
The highest density of cannabinoid receptors is found in parts of the brain that influence pleasure, memory, thinking, concentration, sensory and time perception, and coordinated movement. Marijuana overactivates the endocannabinoid system, causing the "high" and other effects that users experience. These effects include altered perceptions and mood, impaired coordination, difficulty with thinking and problem solving, and disrupted learning and memory.
Marijuana also affects brain development, and when it is used heavily by young people, its effects on thinking and memory may last a long time or even be permanent. A recent study of marijuana users who began using in adolescence revealed substantially reduced connectivity among brain areas responsible for learning and memory. And a large long-term study in New Zealand showed that people who began smoking marijuana heavily in their teens lost an average of 8 points in IQ between age 13 and age 38. Importantly, the lost cognitive abilities were not fully restored in those who quit smoking marijuana as adults. Those who started smoking marijuana in adulthood did not show significant IQ declines.
Marijuana use may have a wide range of effects, particularly on cardiopulmonary and mental health.
Marijuana smoke is an irritant to the lungs, and frequent marijuana smokers can have many of the same respiratory problems experienced by tobacco smokers, such as daily cough and phlegm production, more frequent acute chest illness, and a heightened risk of lung infections. One study found that people who smoke marijuana frequently but do not smoke tobacco have more health problems and miss more days of work than those who don't smoke marijuana, mainly because of respiratory illnesses. It is not yet known whether marijuana smoking contributes to risk for lung cancer.
Marijuana also raises heart rate by 20-100 percent shortly after smoking; this effect can last up to 3 hours. In one study, it was estimated that marijuana users have a 4.8-fold increase in the risk of heart attack in the first hour after smoking the drug. This risk may be greater in older individuals or in those with cardiac vulnerabilities.
A number of studies have linked chronic marijuana use and mental illness. High doses of marijuana can produce a temporary psychotic reaction (involving hallucinations and paranoia) in some users, and using marijuana can worsen the course of illness in patients with schizophrenia. A series of large studies following users across time also showed a link between marijuana use and later development of psychosis. This relationship was influenced by genetic variables as well as the amount of drug used, drug potency, and the age at which it was first taken—those who start young are at increased risk for later problems.
Associations have also been found between marijuana use and other mental health problems, such as depression, anxiety, suicidal thoughts among adolescents, and personality disturbances, including a lack of motivation to engage in typically rewarding activities. More research is still needed to confirm and better understand these linkages.
Marijuana use during pregnancy is associated with increased risk of neurobehavioral problems in babies. Because THC and other compounds in marijuana mimic the body's own endocannabinoid chemicals, marijuana use by pregnant mothers may alter the developing endocannabinoid system in the brain of the fetus. Consequences for the child may include problems with attention, memory, and problem solving.
Additionally, because it seriously impairs judgment and motor coordination, marijuana contributes to risk of injury or death while driving a car. A recent analysis of data from several studies found that marijuana use more than doubles a driver's risk of being in an accident. The combination of marijuana and alcohol is worse than either substance alone with respect to driving impairment.
Many have called for the legalization of marijuana to treat conditions including pain and nausea caused by HIV/AIDS, cancer, and other conditions, but clinical evidence has not shown that the therapeutic benefits of the marijuana plant outweigh its health risks. To be considered a legitimate medicine by the FDA, a substance must have well-defined and measurable ingredients that are consistent from one unit (such as a pill or injection) to the next. As the marijuana plant contains hundreds of chemical compounds that may have different effects and that vary from plant to plant, and because the plant is typically ingested via smoking, its use as a medicine is difficult to evaluate.
However, THC-based drugs to treat pain and nausea are already FDA approved and prescribed, and scientists continue to investigate the medicinal properties of other chemicals found in the cannabis plant—such as cannabidiol, a non-psychoactive cannabinoid compound that is being studied for its effects at treating pain, pediatric epilepsy, and other disorders.
The amount of THC in marijuana samples confiscated by police has been increasing steadily over the past few decades. In 2012, THC concentrations in marijuana averaged close to 15 percent, compared to around 4 percent in the 1980s. For a new user, this may mean exposure to higher concentrations of THC, with a greater chance of an adverse or unpredictable reaction. Increases in potency may account for the rise in emergency department visits involving marijuana use. For frequent users, it may mean a greater risk for addiction if they are exposing themselves to high doses on a regular basis. However, the full range of consequences associated with marijuana's higher potency is not well understood. For example, experienced users may adjust their intake in accordance with the potency or they may be exposing their brains to higher levels overall, or both.
Contrary to common belief, marijuana is addictive. Estimates from research suggest that about 9 percent of users become addicted to marijuana; this number increases among those who start young (to about 17 percent, or 1 in 6) and among people who use marijuana daily (to 25-50 percent).
Long-term marijuana users trying to quit report withdrawal symptoms including irritability, sleeplessness, decreased appetite, anxiety, and drug craving, all of which can make it difficult to abstain. Behavioral interventions, including cognitive-behavioral therapy and motivational incentives (i.e., providing vouchers for goods or services to patients who remain abstinent) have proven to be effective in treating marijuana addiction. Although no medications are currently available, recent discoveries about the workings of the endocannabinoid system offer promise for the development of medications to ease withdrawal, block the intoxicating effects of marijuana, and prevent relapse.
Research shows marijuana may cause problems in daily life or make a person's existing problems worse. Heavy marijuana users generally report lower life satisfaction, poorer mental and physical health, more relationship problems, and less academic and career success compared to non-marijuana-using peers. For example, marijuana use is associated with a higher likelihood of dropping out of school. Several studies also associate workers' marijuana smoking with increased absences, tardiness, accidents, workers' compensation claims, and job turnover.
Learn More:
DrugFacts - Is Marijuana Medicine? - Click Here
Research Report Marijuana Abuse - Click Here
Statistics & Trends - Click Here


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Chateau Pavie 2005 . St. Emilion. owc. Bottle (12). ... (Total: 12 Btls. )Click the image to load the highest resolution version.
DescriptionChateau Pavie 2005
St. Emilion
Bottle (12)
"Very dark. Refreshing, savoury, leathery nose, though the oak is a bit obvious. Pretty angular on the finish at the moment but pretty impressively long. I do wish the proprietor would submit Pavie for blind tasting during the primeurs sessions; I'm sure I would score it higher if he did. Post Pavie 2003 saga, tasting at the château is hardly a relaxed, dispassionate experience. The favourite of the group when scores were averaged." (17.5pts JR, Aug 2009)
"Dense, opaque purple to the rim, with a gorgeously promising nose of blackberries, cassis, graphite and cedar wood just beginning to emerge, it tastes more like a three-year-old than wine that is already a decade old. This beauty is intense and full-bodied, with magnificent concentration, a majestic mouthfeel and a total seamless integration of tannin, wood, alcohol, etc. Beautifully rich, full and multidimensional, this is a tour de force in winemaking and certainly one of the top dozen or so 2005 Bordeaux." (100 pts. Robert Parker, Wine Advocate #220, Aug. 2015)
"Opaque purple in color, it is beyond belief in extract and concentration, but perfectly balanced and pure, with the oak well-integrated. Massively concentrated, and still a baby, this wine tastes more like it's two to three years old than one that's been around for a decade. Intense notes of grilled meats, spice box, cassis, black cherry, licorice and graphite arepresent in abundance. Enormously endowed, but with superlative purity and balance, this is the greatest Pavie in the early Perse era, starting in 1998." (100 pts. Robert Parker, Wine Advocate #219, June 2015)
"Pavie's 2005 exhibits a thick-looking purple color to the rim as well as an exquisite perfume of blueberry and blackberry liqueur, unsmoked cigar tobacco, crushed rocks, damp earth, and hints of truffles and incense. The vineyard's limestone soils have provided massive concentration, a laser-like precision, fresh, zesty acidity, and massive tannin. Despite the wine's enormous concentration and intensity, there is a lightness to its style...As they say, the truth is irrefutable - this is one of the world's most outstanding wines, and the 2005 Pavie should take its place among the greatest achievements of Bordeaux in the last 50 years." (98+ pts. Robert Parker, Wine Advocate #176, Apr. 2008)
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'Explore' word challenge
The Kinston Toastmasters Club held its second meeting for December at the Kinston Public Library on Dec. 17.
Elwood Hill, one of the club�s vice presidents-membership, led in the Pledge of Allegiance, and Robyn Jones, the club�s vice president-public relations, gave the invocation. Jones was also the toastmaster of the evening.
As grammarian, Victoria Thigpen challenged the club to use the words �explore� (meaning �to investigate�) and �implore� (meaning �to appeal, beseech, or beg�), both derived from a Latin root meaning �to drink or cry.�
Eugene Kupstas gave the first speech of the evening, fulfilling the seventh or �Research Your Topic� assignment from the basic Competent Communicator manual. His title was, �Some Things You Might Not Know about Thomas Jefferson.� Thomas Jefferson was born in 1743 to Peter Jefferson, who produced the first accurate map of Virginia. In 1760, Thomas enrolled at William and Mary College in Williamsburg and met many leaders of that day, men who gave their names to Virginia counties. In 1776, Benjamin Franklin and John Adams asked Jefferson to draft the Declaration of Independence. In 1781, Jefferson, then governor of Virginia, was warned by Jack Jouett, a very brave horseman, about the march of the British army on Charlottesville, where he lived and where the Virginia legislature had fled for safety. From 1785 to 1789, Jefferson was involved in the social life of Paris, France. In 1799, he organized the Republican opposition to President John Adams, and became President himself soon afterwards. Ron Michalowicz evaluated this speech.
Elwood Hill gave the next speech, �Talking about Family History.� He detailed the descent of his family from Nathan Hill, who moved from Greene County to Deep Run in the early 1800�s and started Deep Run Free Will Baptist Church. One ancestor in this line fought for the South in the Civil War. His grandfather, Jasper Hill, was born to a farming family in 1888. The family once lived in a two-room house. One ancestor could not read or write; another served on a school board despite having only a very few years of formal education himself. Nettie Jean Hill evaluated this speech.
Robyn Jones gave a module, �Evaluate to Motivate� from the Successful Club Series. Everyone benefits from an evaluation: the speaker, the audience, and the evaluator. To make an evaluation effective, talk with the speaker beforehand; show interest; personalize your remarks; evaluate the speech, not the person; promote self-esteem; and avoid being disingenuous or a phony. Use a simple evaluation structure, such as evaluating the structure, content, and delivery; or remarking on the pluses and the minuses. Use the sandwich method, in which praise comes before and after the constructive criticism. Take two or three minutes to give your evaluation; talk about only a few things, and organize your evaluation into an opening, a body, and a conclusion.
Thigpen was topic master, and asked Jones and Elwood Hill whether buying a lottery ticket in hope of winning gives one a sense of power or takes it away. Jones feels that it would be yielding that power, and Hill believes that the only people getting any money are those who started the lottery. Neither has ever bought a lottery ticket.
Thigpen then asked Nettie Jean Hill and Kupstas whether people should work for money or for learning. Hill believes that we should work for both, and give something of value. Kupstas thought back to his jobs at Smithfield Packing and a Christian school, and thought that we should bring as much of ourselves as we can into our jobs, and learn the details of the job. Neither believes that we should work for just a paycheck.
Michalowicz was asked which is more valuable, the value you can give to another person or a chest full of money. He answered that giving value to someone else is more valuable. Now that he is retired, he does much more volunteer work. Loyalty is low among workers nowadays, but he is giving back what he has learned.
Michalowicz was also the overall evaluator.
The club will hold its next regular meeting on Jan. 7. Kupstas will be toastmaster, Michalowicz will be topic master and overall evaluator, and both Jones and Thigpen will give speeches. Members are invited to participate in the regular meetings, and participants are heartily invited to become new members. A friendly, encouraging environment is to be found there. More information may be found on the Internet at www.toastmasters-nc.org. The club website is http://962.toastmastersclubs.org.


text:
NAR has a wealth of resources to help agents, brokers, and associations better understand and educate each other about the safety risks they face.
From planning your safety strategy to extensive safety resources including apps, products, and educators, NAR has many useful items for all real estate professionals including regularly-scheduled safety webinars, numerous articles organized by category, videos, and a safety alert program.
NAR further offers the Safety Matters: Safe Business = Smart Business course free of charge to state and local REALTOR® associations. More information on the course and how to license it can be found here.
Information about NAR's Safety Program Reimbursement Grant for Associations is also available.
If you need assistance or have suggestions, please email email@example.com.
Safety Topics
We've already done the research for you. References (formerly Field Guides) offer links to articles, eBooks, websites, statistics, and more to provide a comprehensive overview of perspectives. EBSCO articles (E) are available only to NAR members and require a password.
"Working in real estate involves risk and, unfortunately, that risk takes many forms. As an industry, we collectively work very hard to promote safety awareness among our members. We are fully committed to educating REALTORS® about potential threats and providing them with resources to protect themselves."
– 2015 NAR President Chris Polychron
Source: Statement from NAR 2014 President Elect Chris Polychron on Beverly Carter Tragedy (National Association of REALTORS®, Sep. 30, 2014)
Top 10 Real Estate Agent Safety Tips
- Careful with personal info
- Verify customer information
- Enlist a coworker
- Announce your showings
- Scout locations early
- Keep phone in hand
- Keep customer in sight
- Pay attention to exits
- Take a self-defense class
- Trust your gut
Source: House Hunt Network (House Hunt, Jun. 17, 2014)
REALTOR® Safety Forms, Guides, Handouts & Videos
2018 Member Safety Report (National Association of REALTORS®, Sep. 10, 2018) The goal of the report is to measure and understand the scope of the problem, so that real estate professionals can develop the resources, programs, and technologies they need to keep themselves safe.
REALTOR® Safety (National Association of REALTORS®)
3-Hour Safety Course for REALTOR® Associations (National Association of REALTORS®)
- This course is an essential primer on how real estate professionals can limit risk to preserve safety and facilitate positive business outcomes.
- Available classroom materials for this course will allow REALTOR® associations to submit the course to their respective state licensing authority for CE approval. Please note that CE approval is not guaranteed.
- Materials for a 1-hour presentation are also provided.
REALTOR® Safety Forms: More Than Just Space Filler (National Association of REALTORS®, Aug. 26, 2013)
REALTOR® Safety Materials (National Association of REALTORS®)
The REALTOR® Guide to Safety — The Real Estate Guide to Safety gives you practical advice about how to increase your awareness of surroundings and what might be suspicious. This guide will help you be better prepared to protect yourself, other agents, and your clients in highly vulnerable situations.
REALTOR® Safety Tips Card —This handy wallet-sized, laminated card includes three easy, practical tips to keep on hand as a regular reminder of simple ways to stay safe on the job. The card includes space for important phone numbers to keep on hand such as an in case of emergency contact number, a non-emergency number for police and others.
The Safety Minute:01 — The Safety Minute:01 provides safety and security fundamentals in the post 9/11 world.
Episode 1: Why REALTORS® are targeted (REALTOR®SafetyFirst.com)
General Safety Tips
5 common real estate safety myths (REALTOR® Magazine, Apr. 6, 2017)
4 ways male agents put themselves in danger (REALTOR® Magazine, Jan. 24, 2017)
Local Realtor association aims to better protect industry members from foul play (Nooga, Sep. 1, 2016)
Keeping you and your agents safe (REALTOR® Magazine, Aug. 2016)
Common practices that put you in danger (REALTOR® Magazine, Jul. 2016)
Ohio real-estate agents getting phone apps for personal safety (The Columbus Dispatch, Jan. 20, 2016)
14 simple steps for safeguarding your office (La Porte County Association of REALTORS®)
Safety Tips for Commercial Professionals
Safety (Charlotte Region Commercial Board of REALTORS®, 2017)
7 Dangerous Practices You Think Are Safe (REALTOR® Magazine, Oct. 1, 2017)
REALTOR® Safety Matters for Commercial Professionals (National Association of REALTORS®, Jul. 31, 2015)
Rural Safety Tips (National Association of REALTORS®, Jun. 3, 2015)
eBooks & Other Resources
The resources below are available for loan through Member Support. Up to three books, tapes, CDs and/or DVDs can be borrowed for 30 days from the Library for a nominal fee of $10. Call Member Support at 800-874-6500 for assistance.
Be a Hero (Kindle, eBook)
7 Safety Habits That Could Save Your Life (eBook)
Be Alert, Be Aware, Have a Plan (eBook)
Dangerous Personalities (Kindle, Audiobook, eBook)
The Fence (Kindle, eBook)
Fight Back (Kindle, Audiobook, eBook)
The Gift of Fear (New York, NY: Random House, 1997) HV 7431 D35
Health & Safety at Work Essentials (Audiobook, eBook)
No Second Chance (Audiobook, eBook)
Safety at Work (Audiobook, eBook)
Staying Alive (Kindle, Audiobook, eBook)
Stay Safe (Kindle, Audiobook, eBook)
Strong on Defense: Survival Rules to Protect You and Your Family from Crime (New York, NY: Simon & Shuster, 1996) HV 7431 St8 M31
The Tao of Survival (Kindle, Audiobook, eBook)
Workplace Safety (Kindle, eBook)
Have an idea for a real estate topic? Send us your suggestions.
The inclusion of links on this page does not imply endorsement by the National Association of REALTORS®. NAR makes no representations about whether the content of any external sites which may be linked in this page complies with state or federal laws or regulations or with applicable NAR policies. These links are provided for your convenience only and you rely on them at your own risk.


text:
Neptune: 04:00 UT (June 26, 2011)
The semi-major axis of Neptune's orbit about the Sun is 30.06 astronomical units (roughly 2.8 billion miles or 4.5 billion kilometers).
Neptune has a diameter of roughly 30,800 miles (49,600 kilometers) at the equator.
This image was created from HST data from proposal 12675: K. Noll, Z. Levay, M. Livio, C. Christian, H. Bond, L. Frattare, M. Mutchler, T. Borders, and W. Januszewski (Hubble Heritage Team/STScI).
F467N (46nm), F631N (63nm), and F845M (84nm)
NASA, ESA, and the Hubble Heritage Team (STScI/AURA)
This image is a composite of many separate exposures made by the WFC3/UVIS instrument on the Hubble Space Telescope using three different filters. The color results from assigning different hues (colors) to each monochromatic image. In this case, the assigned colors are:
Blue: F467N (46nm)
Green: F631N (63nm)
Red/orange: F845M (84nm)


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In January and February 2018 we traveled to South America mainly to explore the flora and volcanoes of Central Chile. As has become our habit we took our Advanced Elements kayaks with us. The Sport version has become our favourite for long haul travel. At 16kg and packed in a bag, it can be transported at no extra cost on planes and thereafter buses. In Chile we then traveled in hired cars. We could choose the smallest and cheapest vehicles, as the kayaks fit easily into a small car together with camping gear. In this way we could not only explore the forests and country with its volcanos, deserts and forests, but the kayaks gave us an extra dimension with the huge range of lakes, estuaries and fjords that Chile has.
John Shipton, 2018.


text: hearingOS is the worlds leading Hearing Aid App Hear everything clearly -hearingOS will support your hearing. Whether young or old, you can benefit from smart algorithms that process and improve external audio for your ears. Better speech understanding and intelligibility -hearingOS uses state of the art Artifical Intelligence to suppress noise and increase speech intelligibility. -Signals are amplified through the smart algorithm amplifier while noise is suppressed. Works with Wireless & Wired Earphones -Supports almost all headphones that can be connected through Bluetooth or a Cable, including Apple Airpods. Adjusts to your ears -Move the colored dots around on the slider and instantly notice the difference. Every person and every situation is different. hearingOS is the #1 hearing aid app,audio booster,sound amplifier,hearing helper,listening device on the iOS App Store. Privacy Policy & Terms of Service can be viewed here: http://www.hearingos.com/tos. SUBSCRIPTION - PRICES AND CONDITIONS HearingOS is available for free download. All users are invited to take a 7-day trial week. If you want to continue using hearingOS, we offer you an automatic extension: EUR $ 2.49 / week ($ 9.99 / month) Your credit card will be debited within your iTunes account after the order confirmation has been received. The subscription will be extended if you do not disable it at least 24 hours before the renewal date. There is no price increase on an extension. The length of the subscription is 1 month at a price of $ 9.99 for US users. The subscription is auto-renewable but can be cancelled at any time. Subscriptions can be managed in the iTunes account settings and the automatic extension can be deactivated. After purchase, no reimbursement can be made for a non-utilized portion of the period.


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- Most Auspicious
- Inauspicious
- Good
- Most Auspicious
Day Choghadiya
04:47 - 06:38Shubh06:38 - 08:28Rog08:28 - 10:19Udveg10:19 - 12:09Char12:09 - 13:59Labh13:59 - 15:50Amrit15:50 - 17:40 Kaal VelaKaal17:40 - 19:30 Vaar VelaShubh
Night Choghadiya
19:30 - 20:40Amrit20:40 - 21:50Char21:50 - 22:59Rog22:59 - 24:09Kaal24:09 - 25:19Labh25:19 - 26:28Udveg26:28 - 27:38Shubh27:38 - 28:47Amrit
Auspicious work is absolutely prohibited in the Rahu Kaal. See today's Rahu period, the right time of the beginning and the end, and the ways to avoid it.
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mPanchang introduces you to Weekly Choghadiya and Choghadiya Table
Choghadiya is the Vedic Hindu Calendar. Whenever we want to check the auspicious time to start anything new, we refer to the Chogadia. Clock (Ghadi) is the method which is utilized for calculating time equivalent to 24 minutes roughly. Four Ghadi is referred as Chaughadia which constitutes 96 minutes, most of the choghadiya represents 96 minutes. This is also known as Choghadiya Table which is mainly referred to check an auspicious date for traveling purposes.
Get to know today's choghadiya or aaj ka choghadiya on mPanchang.
To use the choghadiya table in a more simplified manner, we consult it to check the Shubh Muhurat before starting a fresh work. Amrit, Subh, Labh and Char are the four most popular Choghadiya. We too have bad Choghadiya which can be referred as Udveg, Kaal and Rog. These bad Choghadiya need to be avoided while making a major decision.
Every hour of each day is associated with a planet's movement which makes it auspicious or inauspicious accordingly. In simple terms, every day has some good time durations and bad time durations. These auspicious or inauspicious phases are determined with Choghadiya or a Choghadiya Table. Choghadiya can be classified into - Day Choghadiya i.e. the duration between sunrise and sunset and Night Choghadiya i.e. the duration between sunset and sunrise next day.
It is basically a form of Hindu Calendar which is used to find out the auspicious hours of a day. Initially, a Choghadiya Table was used to find out about Travel Muhurat but now with its simpler form. which is easy to understand, it is used for almost every important event or occasion.
At mPanchang, you can check daily as well as weekly Choghadiya.
Choghadiya - The Name
The term Choghadiya is a combination of two words - Cho, i.e. four and Ghadiya, i.e. Ghati. Each Ghati, as per Hindu time, is equivalent to 24 minutes. There are 30 Ghatis from Sunrise to Sunset which is divided by 8, so, there are 8 Day Choghadiya Muhurat and 8 Night Choghadiya Muhurat. 1 Choghadiya is equivalent to 4 Ghatis which is approximately 96 minutes. So, one Choghadiya lasts for about 1.5 hours.
Types Of Choghadiya
In Hindu Vedic Astrology, there are seven types of Choghadiya
- Amrit, Shubh, Labh - These three time periods are the most auspicious durations and all important events should be commenced during these phases.
- Char - It is considered as a good Choghadiya
- Udveg, Kaal, Rog - These are the inauspicious time durations and every auspicious work should be strictly avoided during these phases.
What are Vaar Vela, Kaal Vela, Kaal Ratri?
Vaar Vela, Kaal Vela and Kaal Ratri are those times during a day on which no auspicious work should be done. Any auspicious work if commenced during these timings will not be successful. Vaar Vela and Kaal Vela are prevalent during the day whereas Kaal Ratri is prevalent during night time.
What to do if auspicious Choghadiya Muhurat coincides with inauspicious times of Vela, Kaal or Ratri?
In Hindu Astrology, it is advised that no auspicious work should be done during Rahu Kaal, Vaar Vela, Kaal Vela or Kaal Ratri. Even if these timings coincide with the most auspicious Choghadiya Muhurat, it is always better to postpone the work.
How is good Choghadiya and bad Choghadiya determined?
Whether a Choghadiya is auspicious or inauspicious is determined by the influence of the planet on it at that particular time. If the planet is malefic, it is bad Choghadiya and if the planet is benefic, it is good Choghadiya.
It also depends on the weekday as the first Choghadiya of the day is associated with the ruling planet or deity of the day. So,
Sunday - Sun
Monday - Moon
Tuesday- Mars
Wednesday - Mercury
Thursday - Jupiter
Friday - Venus
Saturday - Saturn
So, the first and last Muhurat of the day are influenced by the Lord planet of the weekday and then followed by the rest of the planets.
Amrit Choghadiya is the time under the influence of Moon. Moon is considered a benefic planet in Hindu Vedic Astrology. So, Amrit Choghadiya is regarded as a highly auspicious time in Hindu Astrology. This time is considered beneficial for all types of occasions or works.
Shubh Choghadiya is the time under the influence of Jupiter. In Hindu Astrology, Jupiter is a benefic planet and this is why is considered to be a Shubh Muhurat. Shubh Choghadiya is often referred for all auspicious occasions especially for determining marriage dates and conducting marriage ceremonies.
Labh is a Choghadiya time under the influence of Mercury. Mercury is regarded as a beneficial planet, thus the duration under its influence is considered auspicious. It is an auspicious time but is an exceptionally fruitful time if one wants to start any new learning or acquire new skills or start an education or a course.
Char Choghadiya is associated with the planet Venus. Hindu Astrology considers the influence of Venus quite auspicious. So, the time under its influence, known as Char or Chanchal is often considered for auspicious works. Venus is the planet of movement, so, people look at Char Choghadiya to determine the best time to travel.
Udveg Choghadiya is the time under the influence of Sun. Sun, in Hindu Vedic Astrology, is a malefic planet and has adverse effects. So, all the auspicious work and new starts are avoided during Udveg. However, Udveg Choghadiya is considered to be beneficial in government related matters.
Kaal Choghadiya is associated with the planet Saturn. In Hindu Astrology, Saturn is believed to be a malefic planet and the time which is under its influence is known as Kaal Choghadiya. No auspicious work should be done during this time. However, if there is any work that results in accumulation of wealth or is related to the same, it can be performed during this time.
Rog Choghadiya is associated with the planet Mars. According to Hindu Vedic Astrology, Mars is not regarded as a beneficial planet. This planet has a negative energy, thus, no auspicious work is done during the time under its influence. Rog Choghadiya is the time which is under the influence of Mars. However, it is a time which is often recommended at the time of War or if one wants to defeat their enemy.
mPanchang provides you Daily Choghadiya as well as Weekly Choghadiya along with accurate information on Vaar Vela, Kaal Ratri and Kaal Vela. Our astrologers advise you to use the Daily Choghadiya table to find out about the Shubh Muhurat in a day. Performing each important work with reference to Choghadiya is a way to assure success and prosperity in every endeavor you undertake.


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This word is used in skateboarding when a trick is pulled off that was very smooth and easy looking. Like it took no try what so ever.
That Tre to lip slide was so buttery assed, You could of been on the phone when you did it.
by J-Paul July 10, 2008
buy the domain for your foodie site


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Carrie Underwood Heads to Haiti for Mission Trip
Carrie Underwood is taking time away from her life as a country superstar to help others, going on a mission trip in Haiti.
The singer apparently crossed from the Dominican Republic into Haiti on Wednesday (June 18). One of the girls on the trip, Rhae Lauren, posted the above photo on Instagram, saying, "The girls of the trip getting ready to cross the D.R. (Dominican Republic)/Haiti boarder this morning. Excited for our first day. So proud of everyone and how much we were able to accomplish! @danitaschildren#haiti#dentalmissiontrip."
It seems this mission trip is focused on dental work, and it's through Danita's Children, a nonprofit that rescues, loves and cares for orphaned and impoverished kids. The founder, Danita Estrella Watts, began the organization in a small home that housed 14 children, but it's since grown to accommodate more than 100 orphans. Danita's Children also provides school for over 300 children and serves more than 18,000 meals per month. In addition to all of that, the charity operates a medical center and hospital.
The gold-hearted Underwood appears ready to work in the photo, sporting a casual long-sleeved shirt, aviator sunglasses and holding a backpack. Certainly, the presence and helping hands of all those women will bring smiles to the faces of the Haiti residents.
But the 'American Idol' winner isn't the only country star who has invested her time in helping Haiti. Brad Paisley helped install water pumps in the country last February, Hillary Scott of Lady Antebellum helped open an orphanage and Laura Bell Bundy threw a 24-hour dance marathon with the proceeds going to a nonprofit that feeds Haitian orphans.
Best of 2014 in Country Music (So Far!)


text: Chinese Woman in Trade Secrets Case Seeks Release July 17, 2014 03:18 AM Tweet TAGS: Marketing, Overseas December 18, 2014 By Associated Press Email A woman from China awaiting trial in Iowa on charges she conspired to steal trade secrets from U.S. seed corn companies is asking the government to release her on bond so she can travel to California and to her homeland. Mo Yun, 42, is in Des Moines free on bond under very strict supervision awaiting a detention hearing scheduled for Thursday in federal court. Mo is the wife of Shao Genhou, chairman of Beijing Dabeinong Technology Group Co., known as DNB Group. He is on Forbes magazine's list of world billionaires with a net worth estimated at $1.4 billion. He has not been implicated in the conspiracy. Mo's arrest was the latest development in a case U.S. Attorney Nicholas Klinefeldt announced in December in which six employees of DBN or its subsidiaries were alleged to have stolen patented seed corn from fields in Iowa and Illinois and shipped it to China to try to reproduce its traits. Court documents indicate the intellectual property loss to the companies, including Pioneer Hi-Bred and Monsanto, has been estimated at $15 million. Mo Yun was added to the case in an indictment filed July 2, after Mo was arrested during a trip to Southern California with her children. Mo's attorney, Terry Bird of Los Angeles, said Mo should be allowed to travel to China to be with her family for limited periods of time, and to travel to Los Angeles where her lawyers are based and where her children can more easily visit. Federal prosecutors oppose allowing her to travel to China. An indictment filed in December listed six men as part of the conspiracy, including Mo's brother, Mo Hailong, also known as Robert Mo. He is the only one of the original six to be in custody. The others remain fugitives, court documents said. The updated indictment filed this month said federal agents heard some of the men discuss in January 2007 how Mo Yun was in charge of the operation and the hope was to gather 1,000 samples of corn hybrids. The court document said in 2008, Yun told her brother how happy the company was with the seeds being collected and explained how they were testing the seeds' DNA. In court documents, Bird blasted the government for the way Yun was arrested at Los Angeles International Airport on July 1. Bird said Mo, her 12-year-old son and 5-year-old daughter arrived in the U.S. on June 25 for a vacation to Disneyland. On July 1, as Mo and her children waited for the airplane to take them back to China, a customs agent arrested her and told her she either had to let her children fly alone or let them be taken into the custody of customs agents. "She made the gut-wrenching decision to have them fly home without her, a decision made that much harder by the fact that her 5-year old daughter was clinging to her, crying inconsolably, and had to be pulled away to be put on the plane," Bird wrote. Bird said the government's indictment against Mo "has got to be one of the thinnest reeds I've seen in over 40 years of practice." Klinefeldt's spokesman, Kevin VanderSchel said he couldn't respond to Bird's comments on the strength of the government's case. Bird said prosecutors heard she was in the U.S. and hastily drew up the criminal complaint. He alleges her arrest is the U.S. government's attempt to pressure her to give up information about the case. "This is a squeeze play. That's what's really happening," Bird told U.S. District Judge Michael Wilner during a July 3 detention hearing in Los Angeles, according to the hearing transcript. "These allegations reflect the slimmest of connections and, in fact, do not reflect or reveal any criminal intent or act on their face." Back to news


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Kbradley needed a new logo design and created a contest on 99designs.
A winner was selected from 292 designs submitted by 65 freelance designers.
Partners in Wealth Preservation
We are changing our name from Kelly Financial Group to
Partners in Wealth Preservation. Our website is http://www.kellyfg.com.
The new name reflects our defensive investing strategy
• Buy and hope is no longer an option
• Financial independence does not happen by accident
• Conservative is always in fashion
Our ideal clients, those who receive maximum benefit from our services are:
Conservative, trustworthy, individuals and business owners, CEO's, retired or nearing retirement with defined goals and a clear sense of what is important to them.
Enjoyable to work with and desiring freedom to pursue a higher quality of life.
Seeking a trusted advisor that will help them make smart choices about their money.
Capable of delegating with investable assets of >$500,000 or a net worth of $1 million+.
We need a logo that reflects our conservative values and is symbolic of stability and our ability to help people plan and realize the retirement they've dreamed of.
Existing logo is attached.
Find out how a design contest works or learn more about our logo design services.


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"With the number of people in fields harvesting and with the drought conditions we've experienced here in Ohio, we expected attendance to be off significantly, but it wasn't," says Craig Fendrick, manager of Ohio State University's Farm Science Review. Attendance at this year's show in London, OH, was the third highest in the show's 37-year history, with 140,460 tickets sold.
The show's 585 exhibitors were displaying everything from combines to shoe polish. The hottest sellers? Items costing less than $30,000, such as tractors under 100 hp. "But even exhibitors of the big-ticket items said they had enough folks who were interested to make it worthwhile for them to be there," Fendrick says.
Here's a look at some of the new products unveiled at this year's show.
Front-mount injector
Instead of mounting this toolbar behind the tank, Clymer/Clark put it in front to give you better visibility of your liquid nitrogen applications. The new RCF 1000 front-mounted coulter injection applicator is available with up to 17 coul-ters and a bigger tank to cover more acres. Three tank sizes are available: 750, 1,000 or 1,600 gal. The tank bottom is contoured and fully drainable to prevent algae from growing on the bottom. Suggested list price: around $17,000. Contact Clymer/ Clark Inc., Dept. FIN, 407 E. Washington St., Box 266, Pandora, OH 45877-0266, 419/384-3211.
Articulated loader
This German-made, articulated loader used in mills and foundries and for construction and landscape for years is now making its debut in agriculture. "It's the most popular thing on this lot. We are already running out of literature," says Jack Furay, Furay Distributing Company, after only the first day of the show. "Dairy farmers want it to move silage, hay and manure."
The Coyote uses half the fuel of a regular front-end tractor loader, offers more capacity than a skid steer, yet is safer and longer-lasting and requires less maintenance, Furay says. It features a Deutz, air-cooled engine. Everything in the front end is within reaching distance so parts are easy to work on. It even comes with a tool set. The 38-hp loader shown here is one of 16 models in the series. Prices range from $25,000 to $70,000. Contact Furay Distributing Co., Dept. FIN, Box 88, Lewis Center, OH 43035, 740/548-4689.
Place starter right
J.S. Ag Innovations says that its new liquid fertilizer placement disc for Case IH planters (800 series or newer) gives the yield benefits of starter fertilizer without the effects of germination burn. The blade places liquid fertilizer 1 in. off to the side of the seed trench and just below the seed. "The farmer who tested it had a 4- to 5-bushel yield increase," says company representative Jeff Schultz. "He put part of the fertilizer on at planting and side-dressed later." One bolt connects the disc to the existing factory cast bracket on the planter. Suggested list price: $35 to $40/kit, which includes 9-in. blade assembly and metal application tube. Contact J.S. Ag Innovations Inc., Dept. FIN, Box 125C, Ewing, MO 63440, 800/400-2610.
Fast fill seed
Fill a planter with seed in only 15 min. without having to move a wagon around with this new central-fill auger system designed for Kinze planter models 2600 or 3600. It fills up to 24 seed boxes at once. "Otherwise you would have to fill each box individually with bags or a wagon auger," says Kasco president Phil Kaster. The system bolts on to your planter. An auger run by hydraulics fills the main line. Holes are cut on the hopper lids for the grain to drop in. Suggested list price: $5,500 for complete unit with hydraulics. Contact Kasco, Dept. FIN, 170 W. 600 N., Shelbyville, IN 46176, 317/398-4636.
Bend steel cold
This new cold bender uses the down force from your 20-ton shop press to bend up to 1/2-in.-thick steel for any repairs that require a bent piece of metal. "Otherwise you would have to heat the steel with a torch and bend it with a sledge hammer," says Gene Shoup. "But the bend is not as accurate as what you get with this." Suggested list price: $225. Contact Shoup Mfg. Co., Dept. FIN, 145 S. West Ave., Kankakee, IL 60901, 800/627-6137.
Chop stalks fast
Finely chop corn stalks and bean, wheat and sunflower stubble to leave an even residue on top of your conservation tillage acres with this new stalk chopper by Hawkins Manufacturing. It features a five-blade reel front and six blades in back to ensure the proper blade overlap for good chopping.
"You can cover a lot of acres fast," says company representative Neil Junckin, who says you can drive 10 mph or faster with this design. The 8-row, 30-in. model featured here requires a 3,640-lb. tractor. A double-welded, 7 x 7-in. frame provides for added strength. Choose between a straight cut or angle cut for more aggressive chopping. Suggested list price: $8,275. Contact Hawkins Mfg. Inc., Dept FIN, 2120 E. 4th Ave., Holdrege, NE 68949, 308/995-4446.
Longer-wearing seed tube protector
RK Products designed a new seed tube protector to keep planter opener discs from squeezing in on the seed tubes of current John Deere and Kinze planters. It features a floating graphite block nestled in a steel holder bracket that is mounted to the shank assembly. The graphite lasts twice as long as a planter's original protector, according to the company. Price: around $15. Contact RK Products, Dept. FIN, 3802 Jean St., East Moline, IL 61244, 800/580-6818.
Norwegian chopper
This new multipurpose, self-loading Kverneland KD 832 bale chopper can chop, spread and feed both dry and high-moisture haylage. "Most others aren't self-loading and they can process one or the other very well, but at a very expensive price," says company representative Mark Neely. "This one does it all." The chopper handles both round bales up to 4 x 5 ft. and large or small square bales. It is equipped with a fan that can blow straw up to 59 ft. for bedding. You can control all these functions from the seat of your tractor. Suggested list price: approximately $14,000. Contact Norcan Farm Equipment, Dept. FIN, Box 2409, Youngstown, OH 44509, 800/233-0815.


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NZ Mainzeal assets to be auctioned off
Property Here - Tuesday, April 23, 2013
Assets belonging to failed construction company Mainzeal - including everything from toilet blocks to tower cranes - are being put under the hammer.
Turners Auctions said it had been asked by the receivers of Mainzeal Property and Construction to carry out a mass sale of the company's assets.
Jason Tredgett, a senior valuer and auctioneer, said most items, including power cables, office furniture, hand tools, ladders and shipping containers, would go on the block at a series of auctions around the country next month.
All heavy machinery, such as tower cranes, scissor lifts and building hoists, was open for tender, Tredgett said.
"The receivers asked us to go to the market and bring back the right price."
PwC partners Colin McCloy and David Bridgman would make the final call on whether those tenders were acceptable, Tredgett said. "We're just the party that gets the best offers."
McCloy confirmed that Turners was undertaking a tender and auction process but said any overall valuation of the assets was commercially sensitive.
"The objective is to sell the plant and equipment and generate funds for the receivership process," McCloy said.
Mainzeal Property and Construction was New Zealand's third-largest construction firm when it went into receivership on Waitangi Day, leaving workers and subcontractors locked out of about 40 worksites.
McCloy and Bridgman were appointed as receivers to the group in February and the company was placed into liquidation later that month.
According to the receivers' first report, Mainzeal owes $11.3 million to its only first-ranking secured creditor, Bank of New Zealand.
Unsecured trade creditors are owed about $70 million, not including payments and invoices for January and February.
Employees are owed $5.2 million and the Inland Revenue Department is probably owed $600,000, the report indicated.
This month the receivers cut Mainzeal's full-time staff numbers from 500 to just 14.
Mainzeal's key assets are listed with a book value of $111.4 million, of which $71 million is related party receivables, $21.2 million contract receivables, fixed assets $12.3 million and residential properties $5.9 million.
Tenders for Mainzeal's assets close on May 9 at 4pm. Auctions are to be held in Palmerston North, Hamilton, Christchurch, Auckland and Wellington, starting on May 1 and ending on May 29.


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Find hotels in Rochester using the list and search tools below. Explore our guide for inexpensive and discount hotel/motel rates in or near Rochester, MI for your upcoming personal or group trip. Discover the best Rochester Michigan hotel/motel rooms. Review the Rochester hotel list below to find the perfect lodging. We also have a map of the Rochester hotels. Booking 5+ Rooms? Find Rochester Group Hotel Deals
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