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Rhyme's Reason is the second shifter romantic serial in the Dating a Werewolf Series (the first romantic serial was Rayne's Thunder). This serial has romance and a murder mystery unfolding within the pages of the story.
It is Rhyme's story to true love and you'll love getting lost in her diary entries as she figures out her emotions, overcomes an addiction, and seeks out a murderer that could very well be one of her bachelors.
Rhyme's Reason (Part One) Death of a Friend
Rhyme Manchester is the second in her family to take on the Mating Games. Despite the chaos that ensued for her little sister, Rayne, during her own games, Rhyme decides to give it a go. All three siblings only have one year to mate and marry and time is running out.
Logically, it makes perfect sense.
The problem is that Rhyme has never had the best emotional intelligence. Intelligence is her comfort zone and she will need to escape that tidy little box she has put her life into in order to find the love of her life.
When one of the ten contenders is murdered on the opening night of the games, Rhyme's reason flies out the window. What is worse, all signs point to multiple contenders in the competition for her heart as the potential killer. Will she be able to work through the clues to find the other half to her soul? And when she does, will that man be a murderer or will he be the next one murdered?
This is the first book in a six installment paranormal romantic murder mystery serial from the Dating a Werewolf Series. It contains a cliffhanger. The six installments will eventually be put into a single box set. The previous books in the Dating a Werewolf series were from Rayne's Thunder. It is not necessary to read Rayne's Thunder to know what is happening in the Rhyme's Reason serial. Thank you for joining Rhyme as she embarks upon her journey to love in part one of Rhyme's Reason.
Available on Amazon
Rhyme's Reason (Part Two) Men and Secrets
Rhyme is still reeling from the death of her friend, and ex-fiancé, Jackson, as this installment of the Rhyme's Reason series picks up again. She's never been more determined to find the killer, and bring him to justice for Jackson's, and her own, preservation. Gods forbid she falls for the murderer!
She hatches a plan to interrogate the men, and uses her mini-dates, and the help of the witches, to get to the bottom of the death of her friend. This puts her in unnecessary danger, and River isn't thrilled with her strategy, but he supports her the best he can.
Rayne and Storm return to the compound along with Simon and Chloe to plan a double wedding. One has a surprise, and another has unresolved feelings. Three of the nine men will not make the cut in this installment of Rhyme's Reason, and the other six will leave her head reeling with visions of romance, and possible happily-ever-afters.
Will her plan be successful? Will she find the killer? Will she find love? Check out this installment of Rhyme's Reason to find out.
Available on Amazon
Rhyme's Reason (Part Three)
Part Three is in final edits. It promises to be a little steamy as the competition for Rhyme's heart heats up. The remaining men battle for dates and the strongest will prevail. The question is if strength should be a high ranking factor for winning her love or should she choose on other merits.
Rhyme also takes in a stray witch friend and her bond with an old flame heats up.
The attacks on the compound and the competitors lead to a rivalry with another pack, one that promises to be explosive if relations are not repaired.
Check out this sneak peek of Rhyme's Reason (Part One)
Check out this sneak peek of Rhyme's Reason (Part Two)
Check out this sneak peek of Rhyme's Reason (Part Three)


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The Un-Carved Pumpkin
Pumpkins are hard to come by in London, since Halloween is a fairly new adopted American holiday over in the UK, and there isn't much room for a pumpkin patch in the city. Being relegated to smaller pumpkins found in the grocery store means that there isn't much surface area to carve out the traditional jack-o-lantern face — but we've got lots of alternatives.
On a positive note, it means there will be no possibility of stitches needed in the carving process, and I can get creative with some unique paint colors. Looking around the web, there are so many great ideas out there — here is a selection of my favorite ideas for un-carved pumpkins.
1. Decoupage a pumpkin with black and white line illustrations. DIY from Country Living.
2. A simple coat of paint can turn the usual into the unusual with just the right color. From Chatelaine.
3. Chalk paint adds a matte finish to give these pumpkins a modern touch. From The Perfectly Imperfect Blog.
4. Ombre and Neon keep pumpkins perfectly on trend for 2013. From Normann Copenhagen.
5. Show your state pride with a silhouette in traditional Halloween orange. Spotted on Formal Fringe.
(Images: as linked above)

subset: commoncrawl


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Series: None
Author: Lisa Colozza Cocca
Published: March 18, 2014 by Merit Press
Source: A copy was provided by the publisher via Netgalley. Thank you!
The eldest of ten children on a dirt-poor farm, Becky trudges through life as a full-time babysitter, trying to avoid her father's periodic violent rages. When the family's barn burns down, her father lays the blame on Becky, and her own mother tells her to run for it. Run she does, hopping into an empty freight car. There, in a duffel bag, Becky finds an abandoned baby girl, only hours old. After years of tending to her siblings, sixteen-year-old Becky knows just what a baby needs. This baby needs a mother. With no mother around, Becky decides, at least temporarily, this baby needs her. When Becky hops off the train in a small Georgia town, it's with baby "Georgia" in her arms. When she meets Rosie, an eccentric thrift-shop owner, who comes to value and love Becky as no one ever has, Becky rashly claims the baby as her own. Not everyone in town is as welcoming as Rosie, though. Many suspect Becky and her baby are not what they seem. Among the doubters is a beautiful, reclusive woman with her own terrible loss and a long history with Rosie. As Becky's life becomes entangled with the lives of the people in town, including a handsome boy who suspects Becky is hiding something from her past, she finds her secrets more difficult to keep. Becky should grab the baby and run, but her newfound home and job with Rosie have given Becky the family she's never known. Despite her guilt over leaving her mother alone, she is happy for the first time. But it's a happiness not meant to last. When the truth comes out, Becky has the biggest decision of her life to make. Should she run away again? Should she stay--and fight? Or lie? What does the future hold for Becky and Georgia? With a greatness of heart and a stubborn insistence on hope found in few novels of any genre, "Providence" proves that home is where you find it, love is an active verb, and family is more than just a word.My Review: This book, while not something I normally enjoy reading, caught my attention with the blurb and made me curious as to how this story would resolve. With the desire to find out how everything ended with Becky and the little baby Georgia, I jumped into and was immediately hooked by this novel.
The plot in this book, while slow moving, was something I found very interesting. I liked seeing the way that Becky fought for both her own survival and for Georgia's. She had to make some difficult choices and put the baby's safety and welfare over her own at times and I found her devotion and resolve to do the right thing wonderful.
Becky herself was a character I really liked. She was charming, polite, and caring to all those she came across. Her courtesy and manners immediately made me like her. She was strong and stubborn without being rude was a refreshing change from other YA protagonists I've come across in the past. She really wanted the best for all those around her and did her best to do the right thing. I loved her relationship with Georgia and how she grew so much from having the responsibility of raising a child all by herself. Georgia was a little ray of sunshine in this book and I liked seeing the way she lit up the page and all the other characters when she was around.
My biggest problem with this book was the ending. It nearly completely ruined the book for me. I closed it feeling unsatisfied and, frankly, cheated. There was no resolve and I was left with a bitterness toward more than a few characters and their actions and decisions. All of the lessons and themes this book had been building on were immediately ruined by the ending.
While the majority of the book was full of character growth, southern charm, and heart warming relationships, the ending left more than a little to be desired. Had Providence ended differently, I would have given this book a higher rating.
Three Cards


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Tomorrow is Veterans Day which honors all our veterans. November 1 was All Saints Day to honor our loved ones who have passed. This painting is my mother's candle in the window of her church on All Saints Day in 2013. It is also in remembrance of my husband, Larry, who passed in 2016. The third candle is everyone else in my circle who has passed on. Most recently Jackie Biga...mother, teacher, friend.
Painting Your World And Mine
Sandra Wilkes Art
Sunday, November 11, 2018
Sunday, October 28, 2018
Easiest Way To Sell Your Art
Was I lucky? Oh, yes I was. Would I do it again? Oh, yes I would. In fact, I probably will. Try it. And please...keep it simple sweetie. That is the beauty of selling your art this way.
Saturday, February 3, 2018
Living In God's Abundance
Today's prompt was to create a self portrait illustrating what it would look like to live in God's abundance. My first thought was, "Boy, is that challenging!" For me to draw a self portrait we're talking maybe a month if I could even do it at all.....not a part of a day.
First, the message I got, which I know to be true, is I'm already living in God's abundance! So I knew what I wanted the portrait to look like. Then I found an app called Photo Sketch Maker and transformed two photo of my grandsons and me. It went from photo to portrait drawing in seconds. I was impressed. Someday I may try to paint it but for now, well....take a look. I live in this abundance of love in my arms! And I am so grateful.
Wednesday, January 31, 2018
Surviving Widowhood
Becoming a widow is on no one's bucket list or life plan.
Morbidly speaking, maybe it should be since it is inevitable that one of a partnership will go first. One goes. One stays. The one who stays has a lot of work to do. Emotionally and practically.
Maybe you've talked about it with your spouse. We did that. But once it happens in your life, you realize the scope of loss is beyond you. Like a tsunami of sorts. It knocks you off your feet. It threatens to drown you.
When it was my turn to walk this walk, my family, counsellors, and friends all threw me a rope. They put their arms around me and were there every way possible. Sometimes I let them in, and sometimes I just treaded water, gulped and sputtered all by myself.
Approaching the one year anniversary last summer, I proactively booked out June and July. Get away from that next wave which threatens to hit you. "You are so brave", they said. "I admire you." Well, I'll take it but, really, I'm on the defensive. Running away from it. I was getting the h____ out of Dodge before being submerged...again.
It's been 18 months now and I should have a grip on this, and most days I do. I go to sleep and wake up with prayers of gratitude on my lips. I am truly blessed in so many ways. My very best friend now is God. His spirit never leaves me in the cold, always there when I call, directing my path. Loving me.
And yet...still. A. Very. Hard. Walk.
Inspiration To Live Well Sandra Wilkes Art
Monday, December 4, 2017
Dog and Cat Paintings
But today it is all about this cat. I don't love him. I don't even know him, but he has made his way onto my canvas. I was drawn to these eyes and I wanted to preserve them. My first cat portrait and maybe my last. Hope you like him. He is in Oils, 11x14.
Sunday, January 8, 2017
Painting Out The Pain
If you are currently grieving like I am, how do you lose yourself? Is it through your work? A hobby? Is your diversion family and friends? Hopefully you can lose yourself in a healthy way instead of having yet another drink, a third bowl of ice cream or curling into a ball and thinking you can cry your grief away eventually. You can't.
I know what works for me. But just because I know doesn't mean that I do it. Knowing and doing are two different things. But if I do reach out and pick up a paintbrush, I can float away from that which hurts me. I can just let it go, or rather maybe it loosens it's grip on me and lets me go.
Soon I will finish the painting I've been working on with Sherry Hardage.
|Work In Progress. Not Use To Acrylics Yet. Learning About Them.
I hope you find your magic bullet for tazing grief so it will be powerless over you for awhile. It will come back but at least it will lay in a heap on the floor for awhile.


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Spyro the dragon
One of my favourite old video games and who better to try and build from it.
Surprisingly tanky, have had a platoon full of this bot and won in BA against a strong opposition.
Changed the tail to curve down wards to look more realistic and also tried to smooth out areas that needed to be smoothed.
Other art bots of mine are shown below
Dinosaur bots
Syntarsus- http://robocraftgarage.com/robot/glvxO134
Pteranodon- http://robocraftgarage.com/robot/ghiwPZ35
Tyrannosaurus rex- http://robocraftgarage.com/robot/ctvFO178
Triceratops- http://robocraftgarage.com/robot/bevCNRV6
Mega bots
Virgo Cluster- http://robocraftgarage.com/robot/gjrtuFIS
Xenon (mini mega)- http://robocraftgarage.com/robot/ghqtwyP6
Metal Gear Rex- http://robocraftgarage.com/robot/cftyIJT2
Dragon bots
Yellow/black dragon (flyable)- http://robocraftgarage.com/robot/almsxIU6
Purple/Green Dragon- http://robocraftgarage.com/robot/ciBQU249
Blue Dragon- http://robocraftgarage.com/robot/ghiLRTV7
Other good bots of my collection
Delorean- http://robocraftgarage.com/robot/uwALPS12
Mario on a bad day- http://robocraftgarage.com/robot/GIMOQ248
Pheonix- http://robocraftgarage.com/robot/gjnrGUW4
Robot Ratings
- 1 items


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OBJECTIVE The orexigenic gut hormone ghrelin and its own receptor can be found in pancreatic islets. blood sugar tolerance was assessed as the blood sugar disappearance continuous (Kg) from 10 to 30 min. Outcomes The three ghrelin infusions elevated plasma total ghrelin concentrations to 4-, 15-, and 23-flip above the fasting level, respectively. Ghrelin infusion didn't alter fasting plasma insulin or blood sugar, but weighed against saline, the 0.3, 0.9, and 1.5 nmol/kg/h doses reduced AIRg (2,152 448 vs. 1,478 2,889, 1,419 275, and 1,120 174 pmol/l) and Kg (0.3 and 1.5 nmol/kg/h doses only) significantly ( 0.05 for everyone). Ghrelin infusion elevated plasma growth hormones and serum cortisol concentrations considerably ( 0.001 for both), but had no influence on glucagon, epinephrine, or norepinephrine amounts (= 0.44, 0.74, and 0.48, respectively). CONCLUSIONS That is a solid proof-of-concept research displaying that exogenous ghrelin decreases glucose-stimulated insulin secretion and glucose disappearance in healthful humans. Our results raise the likelihood that endogenous ghrelin includes a function in physiologic insulin secretion, which ghrelin antagonists could improve -cell function. Ghrelin provides gained considerable interest during the last 10 years for its exclusive function in regulating mealtime craving for food and lipid fat burning capacity, aswell as brief- and long-term energy homeostasis (1C3). It's the just known circulating aspect that promotes diet and increases fats mass. Ghrelin is certainly secreted mainly Mouse monoclonal to CD19.COC19 reacts with CD19 (B4), a 90 kDa molecule, which is expressed on approximately 5-25% of human peripheral blood lymphocytes. CD19 antigen is present on human B lymphocytes at most sTages of maturation, from the earliest Ig gene rearrangement in pro-B cells to mature cell, as well as malignant B cells, but is lost on maturation to plasma cells. CD19 does not react with T lymphocytes, monocytes and granulocytes. CD19 is a critical signal transduction molecule that regulates B lymphocyte development, activation and differentiation. This clone is cross reactive with non-human primate in the tummy and proximal little colon, and stimulates growth hormones (GH) secretion (4C6), furthermore to its influence on energy stability. In healthy topics, plasma ghrelin amounts rise steadily before foods and fall to a nadir within one hour after consuming, with adjustments in plasma amounts during meals differing two- to threefold (7C8). Under pathologic circumstances associated with serious malnutrition and fat loss, such as for example anorexia nervosa (9), cancers, or cardiac cachexia (10C11), plasma total ghrelin amounts are elevated up to threefold weighed against healthy people. Besides its popular results on nourishing behavior, fats mass, and GH secretion, ghrelin has been implicated in the legislation of blood sugar homeostasis (12C13). The GH secretagogue receptor (GHSR)-1a, also called the ghrelin receptor, is certainly broadly distributed and continues to be localized towards the hypothalamus, pituitary, liver organ, adipocyte, and pancreas (14C15). Both ghrelin and GHSR are portrayed in individual and rat pancreatic islets on both – (16C17) and -cells (18C19), and ghrelin is certainly stated in a book endocrine islet cell buy 177931-17-8 type that stocks lineage with glucagon-secreting cells (20C21). Pancreatic ghrelin cells can be found as the predominant cell enter fetal individual islets, and appearance in the pancreas during advancement considerably precedes its incident in the tummy (20). In pet mutant models, an early on stop in the differentiation of insulin-producing cells network marketing leads to a massive upsurge in ghrelin-producing cells, recommending a developmental hyperlink between ghrelin and insulin (22). In vitro, ghrelin inhibits glucose-stimulated insulin secretion within a dose-dependent way from cultured pancreata (23), isolated buy 177931-17-8 pancreatic islets (19,24), and immortalized -cell lines (19,21), recommending that it works on cells to do this impact. In experimental pets, both ghrelin released from pancreatic islets and exogenous ghrelin inhibit glucose-stimulated insulin secretion (16,24C26). Targeted gene deletion of ghrelin increases blood sugar tolerance and augments insulin secretion in mice, recommending a feasible physiologic function which could end up being mediated by results on islet function (27). In keeping with these results, ghrelin gene deletion was proven to prevent blood sugar intolerance induced with a high-fat diet plan, an environmentally-induced style of hyperglycemia (26). Jointly, these results indicate the potential of ghrelin blockade to avoid both genetically (gene)- and environmentally (high-fat diet plan)-induced blood sugar intolerance. The result of ghrelin on insulin secretion in human beings is questionable. Intravenous shot of ghrelin reduces plasma insulin and boosts blood glucose in a few studies, recommending inhibition of insulin secretion (12,28). Nevertheless, this finding is not universally noticed (29), which is unclear whether such results take place at physiologic or just pharmacologic dosages of ghrelin. Prior research performed in human beings primarily evaluated the influence of ghrelin on -cell function in the fasting condition, and there is certainly little details on the result from the peptide on activated insulin release. As a result, the function of ghrelin in the legislation of blood sugar homeostasis in human beings remains poorly grasped. In this research, we determined the result of ghrelin on glucose-stimulated insulin secretion and blood sugar tolerance. We infused acyl-ghrelin, the bioactive endogenous ligand from the GHSR-1a, at adjustable doses with the purpose of increasing plasma total ghrelin level to physiologic (significantly less than twofold), supraphysiologic (two- to threefold) and pharmacologic (a lot more than threefold) amounts. An intravenous buy 177931-17-8 blood sugar tolerance check (IVGTT) was performed at regular condition plasma ghrelin amounts to look for the influence on glucose-stimulated insulin secretion and.
Tag: Mouse monoclonal to CD19.COC19 reacts with CD19 (B4)
Background The duration of prior hormonal treatment can predict responses to
Background The duration of prior hormonal treatment can predict responses to subsequent therapy in patients with metastatic castration-resistant prostate cancer (mCRPC). (COU-AA-301, = 78 [7%] COU-AA-302, = 44 [4%]); castrated individuals received preceding AR antagonists (COU-AA-301, = 1015 [85%]; COU-AA-302, = 1078 [99%], 15.7 mo or 16.1 mo median duration, respectively). Final result measurements and statistical evaluation Cox model was utilized to obtain threat ratio and linked 95% confidence period with statistical inference by log rank statistic. Outcomes and restrictions Clinical advantage with AA was ABT-378 noticed for Operating-system, rPFS, and PSA response for pretty much all quartiles with GnRHa or AR antagonists in both COU-AA-301 and COU-AA-302. In COU-AA-301, sufferers with an extended length of time of prior endocrine therapy tended to possess greater AA Operating-system, rPFS, and PSA response advantage, with lead-time chemotherapy bias possibly impacting COU-AA-301 outcomes. Time-to-castration-resistance had not been captured. This evaluation is limited being a post-hoc exploratory evaluation. Conclusions In the COU-AA-301 and COU-AA-302 research, AA produced scientific benefits irrespective of prior endocrine therapy length of time in sufferers with mCRPC. Individual overview Metastatic castration-resistant prostate cancers patients derived scientific benefits with abiraterone acetate irrespective of preceding endocrine therapy duration. = 191)= 87)= 174)= 109)= 191)= 91)= 195)= 89)= 155)(= 95)(= 179)(= 85)(= 167)(= 82)(= 170)(= 82)General success = 119)= 133)= 145)= 137)= 127)= 127)= 139)= 130)= 138)(= 134)(= 132)(= 132)(= 138)(= 131)(= 132)(= 141)General success 0.05; simply no multiplicity adjustments had been designed for this hypothesis producing post-hoc evaluation. An connections check was performed to assess if the Mouse monoclonal to CD19.COC19 reacts with CD19 (B4), a 90 kDa molecule, which is expressed on approximately 5-25% of human peripheral blood lymphocytes. CD19 antigen is present on human B lymphocytes at most sTages of maturation, from the earliest Ig gene rearrangement in pro-B cells to mature cell, as well as malignant B cells, but is lost on maturation to plasma cells. CD19 does not react with T lymphocytes, monocytes and granulocytes. CD19 is a critical signal transduction molecule that regulates B lymphocyte development, activation and differentiation. This clone is cross reactive with non-human primate aftereffect of abiraterone acetate was reliant on prior endocrine ABT-378 therapy length of time. This evaluation was performed for GnRH ABT-378 agonists considering that nearly all patients received preceding GnRH agonists (Supplementary Desk 2). 3. Outcomes 3.1. Individual characteristics Individuals received prior endocrine therapy with GnRH agonists (COU-AA-301, = 1127 [94%]; COU-AA-302, = 1057 [97%]) and/or orchiectomy (COU-AA-301, = 78 [6.5%]; COU-AA-302, = 44 [4.1%]) (Fig. 1). Pure androgen receptor antagonists (COU-AA-301, = 1015 [85%]; COU-AA-302, = 1078 [99%]) had been also found in COU-AA-302. In COU-AA-301, the median length of prior GnRH agonist and androgen receptor antagonist publicity was 45.1 mo and 15.7 mo, respectively. Median durations of prior GnRH agonist and androgen receptor antagonist publicity in COU-AA-302 had been 36.7 mo and 16.1 mo, respectively. These durations represent the length of prior endocrine therapies, not really a single contact with one type of manipulation. 3.2. Results Overall success was improved in the abiraterone group versus the prednisone group in every quartiles of length of previous endocrine therapy researched in COU-AA-301 (Desk 1 and Supplementary Fig. 1) and everything except quartile 3 in COU-AA-302 (Desk 2 and Supplementary Fig. 2). Nevertheless, there have been inconsistencies across quartiles in demonstrating a substantial treatment advantage with abiraterone acetate with this post-hoc exploratory evaluation. In both tests, individuals who experienced an extended length (quartile 4 equals the longest length) of prior endocrine therapy got a longer general survival, whether assessed against quartile publicity of GnRH agonists or androgen receptor antagonists. This is observed no matter task with few exclusions for both abiraterone and prednisone organizations. Radiographic progression-free success was considerably improved in the abiraterone group versus the prednisone group in individuals for those quartiles of prior GnRH agonists or androgen receptor antagonists treatment in both COU-AA-301 (Desk 1 and Fig. 2) and COU-AA-302 (Desk 2 and Fig. 3). The PSA response proportions had been also superior in addition to the type and duration of prior endocrine therapy (Supplementary Fig. 3). Outcomes from an connection evaluation to examine if the aftereffect of abiraterone acetate was reliant on prior endocrine therapy length weren't significant in both COU-AA-301 and COU-AA-302 for both general success and radiographic progression-free success (Desk 3). Evaluation by GnRH agonist quartiles yielded related results, with non-e of the connection tests on result measures displaying significance. Desk 3 Interaction evaluation of abiraterone acetate treatment and prior endocrine therapy duration for general success and radiographic progression-free success in COU-AA-301 and COU-AA-302 worth? ?Overall success? ??Treatment0.1? ??Length of time0.009? ??Treatment duration0.4? ?Radiographic progression-free survival? ??Treatment0.0006? ??Length of time 0.0001? ??Treatment duration0.7COU-AA-302?Parametervalue? ?General success? ??Treatment0.4? ??Length of time0.002? ??Treatment duration0.6? ?Radiographic progression-free survival? ??Treatment 0.0001? ??Length of time0.04? ??Treatment duration0.7 Open up in another window Treatment with abiraterone acetate and prednisone was well tolerated by sufferers, as previously reported for both COU-AA-301 [9,10] and COU-AA-302 [8,11,16]. 4. Debate The clinical advantage of abiraterone was preserved irrespective of type and length of time of prior endocrine therapy at almost all quartiles analyzed, as proven in.


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"An Inspector Calls" was written by JB Priestley in 1945. It begins as a classic detective thriller, but later as it unfolds it can also be interpreted as a morality play. "An Inspector Calls" is set in the imaginary North Midlands industrial town, Brumley. It was set before the First World War in 1912.
During this time, Britain was a capitalist country. Capitalism is an economic system based on private wealth such as ownership of businesses, factories and transport services. Priestley, however, was a socialist. He believed in a political system that aimed to create a society with no class system. During Priestley's life, he saw a great many changes. He joined the army when war broke out in 1914. He saw death, hatred and blood in the trenches then narrowly escaped death when a shell exploded next to him. The war in 1914 mixed upper and lower classes together, demolishing the divide between them.
No matter what class soldiers came from, they all worked together to fight for their country and Priestley believed that this should apply to everyday life, everyone should be responsible for each other.
In this essay I will outline how the Inspector influences the development of the play, influences the characters and the audience and what he represents.
In "An Inspector Calls", the Inspector represents the new socialist way of thinking, which was Priestley's way of thinking. The Inspector is a puppet that Priestley uses to express his opinions of society and capitalism. The Inspector was created as a socialist with the same political views of the class system. This theme of socialism versus capitalism is explored in more depth as the play develops. The Inspector?s socialist ideals can be seen throughout the play as he speaks to the characters. One speech in particular, found...


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Welcome to the Savoy Park Hotel
On your arrival you'll immediately feel welcome and at home. The Savoy Park Hotel has been under the stewardship of the Henderson family for over fifty years. You'll experience genuine hospitality, friendly, professional service and excellent fresh homemade food.
The minute we arrived at the Hotel, we felt very well looked after. The staff were so accommodating and nothing was a problem to them. Your attention to detail was extremely welcome. We owned a hotel for 21 years and I have now found out how my customers felt with the service you and your staff afforded us.
Fantastic Ayrshire wedding venue! As a guest at a friends wedding I can say that the staff at The Savoy Park Hotel certainly know how to host a fantastic wedding celebration! The hotel building and gardens are lovely, the service was beautiful and the food amazing. Highly recommended hotel in Ayr!
Stayed here for my brothers wedding. Nothing was too much trouble. Room was spotless, spacious & comfortable (room 15). I am vegetarian and was made separate buffet food without even asking, thank you. Food delicious, as was breakfast, staff were excellent and friendly. Made our family wedding and stay a wonderful day!
Weddings at the Savoy Park
The happiest day of your life should be somewhere special. We believe the Savoy Park is the perfect setting for your wedding day. By working together, our organisation & planning will ensure that you will have a fantastic day. You can be confdent that your wedding day will be a wonderful occasion to look forward to & look back on with fond memories. We are happy to accommodate any special arrangements, considerations & wishes you have for your day no matter how big or how small. If it's important to you, then it's important to us.FIND OUT MORE
Stay with Us
Snug in your bedroom, relax and freshen up in your en-suite bathroom. Call home from your room phone or check your e-mail. If you wish you can order a meal in the comfort and privacy of your own room. You can make tea or coffee anytime with your room tea service. Parents can enjoy peace of mind with the baby listening service after the children have tired themselves out in the garden.
Full Scottish Breakfast is included in all of our bedroom rates.BOOK NOW
Our Room Types
Classic Twin - From £65.00
Superior Twin - From £75.00
Classic Double - From £70.00
Superior Double Ensuite - From £75.00
Executive Double Ensuite - From £85.00


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1Cup1Coffee.com > Physics > Rubble Trouble: New York
Rubble Trouble: New York
Date added: Aug 02, 2011
- In the puzzle game Rubble Trouble: New York you need to demolish the right buildings using a variety of tools to demolish with. Use bombs, hammers, bullets and other devices. Make sure you destroy the right buildings.
- Mouse to use explosives/weapons.
WASD/arrow keys to pan map.
R to restart.
- Mouse to use explosives/weapons.
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5 comments for Rubble Trouble: New York
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September 1st, 2011 1:18 PM
meow on
September 2nd, 2011 11:09 AM
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roboto on
September 9th, 2011 11:10 AM
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Leamington Priors Club
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apartment in Lynchburg, VA you can be a star! The 2013 Lights, Camera, Lynchburg! video competition is now underway and prizes totaling more than $4000 will be awarded.
This year's theme is The HEART of Lynchburg. The city of Lynchburg has something to offer people of all ages! There are different types of art and it includes a range of activities, creations and modes of expression including music, drama, literature, film, sculpture, paintings, dance and even food. Lynchburg invites you to submit videos showcasing the Lynchburg art scene as you see it.
The deadline for entries is November 1. Videos must be between one and three minutes in length and can be submitted in one of the following categories:
- Amateur, ages 18 and below
- Amateur, ages 19 and above
- Top of the Class (for school groups, community center groups and non-profit groups ages 18 and below)
- Professional, ages 19 and above
There will be a panel of judges who will determine the winners of the Amateur, Professional and Top of the Class categories, while the Viewers' Choice Award will be determined by an on-line public poll.
Winners will be announced during an awards ceremony on Friday, December 6.
So get out those video cameras and become the next star of the Lynchburg entertainment scene!
See more at: http://www.lynchburgva.gov/videocontest


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are new doctors safe to practise?
- Jack Porter
- 3 years ago
- Views:
1 Be prepared: are ew doctors safe to practise?
3 Cotets What we foud 02 Why we ve writte this report 04 What is preparedess ad how ca it be measured? 06 How well prepared are medical graduates? 08 How has preparedess chaged? 14 Does preparedess vary betwee medical schools? 18 I what ways are ew doctors poorly prepared? 24 What makes a ew doctor prepared? 36 What could happe ext? 46 Evidece used for this report 47 Refereces 49 Geeral Medical Coucil 01
4 What we foud The good ews is that very few graduates from UK medical schools are very poor at medical practice. But there are low-level cocers about a sizeable umber of ew doctors ad aroud oe i te feels poorly prepared for begiig their medical career. I some respects, the problem is wider tha this. Oe i te ew UK medical graduates feels poorly prepared. 02 Geeral Medical Coucil
5 More graduates are prepared for begiig their medical careers Positively, there are some idicatios that preparedess is improvig. This follows major chages i medical educatio some of them liked to our 2009 publicatio Tomorrow s Doctors, which sets out what is expected of ew graduates ad the stadards of teachig, learig ad assessmet i UK medical schools. Preparedess varies betwee medical schools ad aspects of practice There are major differeces betwee medical schools i the preparedess ad subsequet progressio of their graduates. Variatio is t ecessarily a bad thig, as log as it does t compromise the care patiets receive, but substadard pockets of medical educatio must be improved. The root causes are various. The level of preparedess is affected by the characteristics of the studets that medical schools select, by udergraduate curricula icludig the opportuities for gaiig cliical experiece, by the supervisio ad support give to ew graduates ad by the cliical eviromets i which they fid themselves. How we ll tackle the issue We will work with medical schools, postgraduate traiig bodies, employers ad idividual doctors, both ew ad well established, to address the shortcomigs ad make sure that patiets get the doctors they eed. Preparedess is ofte poor i certai aspects of practice. We eed to improve the competece of ew doctors i prescribig; the early maagemet of emergecy patiets (especially whe o call); some practical procedures; ad, loosely, resiliece, professioalism ad employability. Graduates sometimes acquire specific skills i the abstract, but ca t put them ito practice while uder the pressures of the day-to-day cliical eviromet. Geeral Medical Coucil 03
6 Why we ve writte this report We regulate medical educatio ad set the outcomes ad competecies that ew graduates eed to show. We also quality assure medical educatio to see how our requiremets are beig met we do this by collectig iformatio from doctors i traiig ad from the orgaisatios ivolved, ad by visitig the sites where educatio is delivered. I 2009 we published the latest versio of Tomorrow s Doctors, which icludes the outcomes for graduates ad the stadards that medical schools eed to achieve. This followed a major review, which icluded research we commissioed 1 ad full cosultatio with medical schools, employers ad others. 04 Geeral Medical Coucil
7 Assessig the impact of Tomorrow s Doctors We have ow reviewed the impact of Tomorrow s Doctors to see what we ca lear. The review gives us a base of evidece for future work to make sure that our regulatio is effective ad focused. It gives us a startig poit for reviewig the outcomes for graduates. It also helps us to cosider the case for fudametal chages to regulatio, which icludes a proposal to abolish the year of provisioal registratio after graduatio. Also, should we itroduce a licesig examiatio for doctors wishig to practise i the UK? I reality, it is hard to reach firm coclusios about the impact of Tomorrow s Doctors. It did t come ito force util the academic year , so ew graduates received much of their medical educatio uder the previous versio. Also, other major chages have bee itroduced, so it is t possible to sigle out the ifluece of Tomorrow s Doctors cofidetly. Therefore, this report focuses o how well prepared medical graduates are to become safe doctors i traiig. We cosider how preparedess has chaged, how it varies betwee medical schools ad i what respects graduates have appeared particularly well or poorly prepared. We also make some suggestios about factors that may ifluece preparedess, icludig the impact of Tomorrow s Doctors. Our ew stadards for medical educatio Separately, we have bee reviewig our stadards for the delivery of educatio ad traiig, coverig both udergraduate ad postgraduate stages. Iformatio has bee shared betwee the two complemetary reviews. Tomorrow s Doctors will be replaced by a ew set of stadards for the delivery of educatio ad traiig, alogside a stad-aloe set of curricular outcomes to be achieved by graduates. Geeral Medical Coucil 05
8 What is preparedess ad how ca it be measured? We take a wide view o what makes a ew graduate prepared for medical practice. I this report, we use preparedess to cover all the attributes that we should expect of ew graduates which iclude: professioalism employability competece readiess fitess for purpose fitess to practise. There are tesios to bear i mid. O oe had, it is importat to be reasoably precise about the skills we expect ew graduates to demostrate; o the other had, we must ot overlook their overall capability. O oe had, ew graduates eed to be able to cotribute to patiet care from day oe; o the other had, they eed to be istilled with the values ad habits to sustai a career over decades. O oe had, they still have much to lear ad are eterig a ew stage of traiig i which they should be properly supervised ad supported; o the other had, they are ow employees ad their patiets are waitig ad eed safe treatmet. Usurprisigly, it is particularly difficult to defie a precise boudary betwee beig prepared ad ot. Employers may say substatial umbers of ew graduates have ot bee properly prepared for their resposibilities. A smaller proportio of graduates may agree that they do ot have all the skills they eed to cope with the demads upo them this may be atural ad reasoable, or reflect poor support ad supervisio. Much smaller umbers will be idetified formally as doctors i difficulty ad will be carefully moitored through the Foudatio Programme. Eve smaller umbers will be referred to us, ad could have their registratio erased or compromised as a result. These differet thresholds reflect the rage of expectatios that face graduates, but do t stop us idetifyig areas of cocer that eed to be addressed. 06 Geeral Medical Coucil
9 Various mechaisms cast light o graduate preparedess Surveys of ew doctors ad their traiers These ca be large-scale ad methodologically soud, but ca be iflueced by factors such as respodets age, sex ad workig eviromets. Where there are differeces betwee the perceptios of the ew doctors ad their traiers, the ew doctors ted to have a more positive view of their ow preparedess. Other assessmets ad moitorig These should be robust, but i some cases are restricted to small umbers of graduates. Direct evidece o the safety or quality of patiet care delivered by ew doctors This is very valuable, but ca be very limited. By combiig sources ad types of evidece, we ca build up a picture of graduate preparedess. Feedback from employers ad other orgaisatios This gives a importat perspective, but may ot be scietifically robust. Examiatios Exam results should be reliable ad valid, but focus o limited competecies at a specific poit. Geeral Medical Coucil 07
10 How well prepared are medical graduates? A log-ruig study ito preparedess by Goldacre ad colleagues foud that 53% of 2008 graduates ad 49% of 2009 graduates agreed that their medical school had prepared them well. 2 Several idicators are available from more recet surveys of traiers ad doctors i their first year of foudatio traiig (F1 doctors or F1s). What do F1 doctors thik? 69.9 % 74.4 % agree or strogly agree that they are adequately prepared for my first foudatio post. 9.2% disagree or strogly disagree. agree or strogly agree the skills I leared at medical school set me up well for workig as a foudatio doctor. 8.5% disagree or strogly disagree % 24.5 % feel forced to cope with cliical problems beyod your competece or experiece o a daily or weekly basis. say they sometimes or defiitely get very frighteed or paic feeligs for apparetly o reaso at all. 08 Geeral Medical Coucil
11 92.2 % of F1s uderstad what is expected of them. 7.8% do ot. What do traiers thik? Clare va Hamel has surveyed traiers to fid out what they thik about the preparedess of the F1 doctors they trai. They thik % of F1s ever fail to cope with the trasitio from medical school; 23.9% sometimes fail; 4.4% defiitely fail % 66.8 % of F1s uderstad what is expected of them. 7.8% do ot. of F1s ever seem overly axious; 28.6% sometimes seem overly axious; 4.6% defiitely seem overly axious % of F1s ever fail to cope with the trasitio from medical school; 23.9% sometimes fail; 4.4% defiitely fail % Geeral Medical Coucil 09
12 Preparedess ad employmet A 2009 survey of employers foud that: iterviewees were kee to say that some juior doctors are excellet ad some respodets thought that stadards were geerally improvig. The message from may respodets was, however, that juior doctors are geerally ot meetig the eeds ad expectatios of the curret NHS. 3 A similar picture was reported more recetly i the idepedet Shape of Traiig review. We heard from some employers that they were cocered that may doctors whe leavig medical school are ot fit to take up their Foudatio Programme posts. 4 As stressed by the ew qualitative research by Morouxe ad colleagues, which we commissioed, difficulties i perceived preparedess ofte relate to aspects of the workig eviromet, icludig: How may graduates formally cause cocer? The umbers of graduates who are formally recogised as causig particular cocer are much smaller tha you might expect from the reports of employer opiio. We refuse provisioal registratio to very few UK graduates: four i 2010 two i 2011 four i 2012 two i Some applied agai ad were the awarded provisioal registratio. the challeges of a high-volume time pressured workload, ofte with iadequate levels of staff. Traiees may feel prepared for situatios whe all goes to pla, but uprepared whe exposed to high volumes of work which demad prioritizatio ad multi-taskig; or ucertai thresholds (ot kowig whe to refer to seiors); iadequate team-workig; or whe seiors are ot easily accessible. 10 Geeral Medical Coucil
13 There were doctors i the Foudatio Programme i 2012/13 14,975 was the total of doctors o the programme i Foudatio Programme doctors did ot complete their year of traiig i F1 doctors (3.2%) ad 296 doctors i the secod year of traiig (F2 doctors or F2s) (3.0%). Amog the F1 doctors, 0.7% were i less tha full-time traiig, 0.8% had more tha four weeks absece, 0.9% wet ito exteded or remedial traiig, 0.1% were dismissed, 0.6% resiged ad 0.2% did ot complete for some other reaso doctors did t complete Foudatio Programme traiig 235 doctors did t complete foudatio year 1 There were 378 Foudatio Programme doctors i difficulty i F1 doctors (2.6%) ad 185 F2 doctors (2.4%). Of the 378, 135 were siged off as fit to cotiue traiig i the ormal way, but 187 were forced to repeat at least some of their Foudatio Programme traiig, 36 resiged or were released, ad there were 20 others doctors did t complete foudatio year 2 Geeral Medical Coucil 11
14 18 F1 doctors ad 13 F2 doctors were referred to us that year. 2.5% of UK graduates from 2012 were still provisioally registered i March 2014 (97.5% had secured full registratio). Graduates ca retai provisioal registratio loger tha the ormal year for a rage of reasos. 1.1% of F1 doctors ad 1.0% of F2 doctors received a usatisfactory outcome i their Aual Review of Competece Progressio (ARCP) i % The rate of usatisfactory ARCP outcomes icreases i later stages of traiig, where the impact of udergraduate educatio will be less up to 25.1% i core traiig ad 14.0% i higher traiig. of doctors who graduated i 2012 were fully registrated by March Geeral Medical Coucil
15 How does preparedess affect patiet safety? It is difficult to assess the impact of graduate preparedess o patiet care. However, oe study idetified a 6% icrease i deaths amog patiets admitted at the poit whe ew graduates eter the NHS ad most other doctors i traiig chage posts. Surveys by two medical royal colleges foud that more tha four i five respodets believed that patiet care suffers durig this chageover period. 7 The risks to patiet safety i the chageover period relate to the mass movemet of doctors i traiig ito ew roles, ot oly the itroductio of ew graduates. However, accordig to the report of the ew qualitative research by Morouxe ad colleagues: F1 doctors felt uprepared for the step chage i resposibility, the workload, the degree of multitaskig, decidig who ad whe to ask for help, uderstadig how the hospital works (which varied by hospital) ad dealig with uderperformace of other team members. Deaths icrease whe o cosultats are preset There is o doubt that patiets are more at risk whe cosultats are scarce or abset. May reviews have foud that patiets suffer whe there is a delay i ivolvig cosultats ad the icreased death rate for hospital patiets at weekeds has bee attributed to lower cosultat ivolvemet. 8 While this evidece demostrates the beefits of cosultat-delivered care, it also idicates the dagers that result from relyig upo doctors i traiig who are ot appropriately prepared for the practice they eed to deliver. Preparedess eeds to be improved The overall picture idicates that there is room for progress. Employers have cocers about the preparedess of ew graduates ad a small miority of ew graduates appear to regard themselves as geerally poorly prepared. Their traiers share a similar view. All but a tiy umber of UK graduates obtai GMC registratio, ad aroud 3% have formally recogised difficulties while they are i the Foudatio Programme, or do ot make progress at the usual rate. But the picture looks more worryig whe we look at particular aspects of preparedess ad variatios betwee medical schools. Geeral Medical Coucil 13
16 How has preparedess chaged? Past research The research by Goldacre ad colleagues shows that ew doctors reported a geeral tred of improvig preparedess before the 2009 versio of Tomorrow s Doctors. The percetage of graduates who agreed that they had bee well prepared icreased from 36% for 1999/2000 to 50% for 2002 ad 58% for 2005, before fallig back to 49% for Those who disagreed fell i each of those cohorts from 41% to 31%, 21% ad 16% respectively. 9 A 2012 literature review by Talletire ad colleagues reported a less clear-cut picture. They foud that sice 1993, graduates perceptio of their ow preparedess: Research we commissioed The rapid review by Morouxe ad colleagues did t fid strog evidece of chage followig the publicatio of Tomorrow s Doctors i However, more recet cohorts of graduates were better prepared tha previous cohorts. The ew qualitative research idicates areas of possible improvemet. Some iterviewees, icludig other healthcare professioals ad patiet represetatives, oted a improvemet i the commuicatio skills of F1s. Iterviewees also felt that recet graduates were more orieted towards multi-professioal team workig. improved for practical procedures ad team workig showed little chage for acute care, commuicatio ad ethics declied for prescribig. Other professioals saw little chage i preparedess i commuicatio, ethics, prescribig ad practical procedures, but a declie i preparedess for acute care Geeral Medical Coucil
17 Results from aual surveys of doctors i traiig Recet quatitative surveys of ew doctors suggest a cotiuatio of the improvemet reported by Goldacre ad colleagues. I our 2009 atioal traiig survey, ew doctors were asked: Do you feel that you were adequately prepared for your first F1 post? 54.3% of UK F1 doctors said they were, but 33.0% disagreed. UK graduates who say they felt prepared for their first F1 posts % 58.8% 61.8% I 2012, F1 doctors were asked to respod to the statemet: Before commecig my first foudatio post I felt prepared for the role. For 2013 ad 2014, the statemet was tweaked to: I was adequately prepared for my first foudatio post. I 2014, 69.9% agreed ad 9.2% disagreed. Possibly the much lower percetage i 2012 relates to our ot usig the qualified phrase adequately prepared that year ad askig how the graduates felt before their first post % 70.2% 69.9% Geeral Medical Coucil 15
18 New doctors were also asked: I this post how ofte did you feel forced to cope with cliical problems beyod your competece or experiece? The same questio has bee used each year from 2009 ad shows a cosistet patter of major improvemet up to 2012 ad a less clear picture sice the. A further survey of F1 doctors by Clare va Hamel idicates improvemet i their overall preparedess betwee 2012 ad However, sigificat chages were ot foud i the proportio of F1 doctors with serious axiety or i relatio to prescribig ability. How ofte have F1 doctors felt forced to cope with cliical problems beyod their competece or experiece? Never Rarely Mothly Weekly Daily % 41.1% 20.9% 26.0% 4.4% % 44.2% 20.2% 22.8% 3.9% % 47.8% 18.8% 18.4% 2.9% % 49.0% 17.8% 11.2% 1.3% % 47.6% 18.3% 12.1% 1.7% % 46.4% 17.5% 11.5% 2.1% 16 Geeral Medical Coucil
19 Fewer doctors i difficulty Also, the proportio of formally recogised doctors i difficulty i the Foudatio Programme has declied from 4.6% i 2010 to 2.6% i 2013 for F1 doctors. Ad from 4.2% i 2010 to 2.4% i 2013 for F2 doctors. 11 Proportio of doctors i traiig formally recogised as doctors i difficulty Idicatios of a overall improvemet i preparedess There has bee improvemet i the views ew doctors hold of their ow preparedess, both before ad sice the 2009 publicatio of Tomorrow s Doctors. This is probably due to a rage of factors, which could iclude chages i udergraduate educatio, i the Foudatio Programme or i the support available from employers F1 3.4% 4.6% 3.7% F2 4.2% Also, fewer ew graduates are formally recogised as havig difficulty, which suggests better preparedess at the weaker ed of the spectrum (assumig there has bee a reasoable cosistecy i the threshold for beig recogised as i difficulty) % 2.6% 2.4% 2.5% However, Talletire ad colleagues suggest decliig preparedess from I ay case, the evidece is partial ad we do t have cosistet data over time o the views of traiers ad employers, let aloe more objective evidece o chages i preparedess. Geeral Medical Coucil 17
20 Does preparedess vary betwee medical schools? Variatio betwee medical schools i the iterests, abilities ad career progressio of their graduates is ievitable ad ot i itself a cause for cocer. However, uderstadig the extet of variatio i some aspects of preparedess ca highlight problematic issues across medical educatio ad determie whether they are tied to particular locatios perhaps with causes that ca be idetified ad addressed. Evidece from surveys The rapid review by Morouxe ad colleagues foud six studies suggestig differeces betwee schools ad two suggestig o differeces. I particular, the reports from Goldacre ad colleagues have documeted a rage across schools i the perceptio ew doctors have of their preparedess. The rapid review cocludes: there is compellig evidece to suggest that medical school does make a differece i terms of self-reported preparedess. More recet survey evidece supports this coclusio, such as resposes to our 2014 atioal traiig survey. There was a wide variatio betwee medical schools i the ew doctors who cofirmed: I was adequately prepared for my first foudatio post. This agreemet raged from 60.7% to 85.0% (those disagreeig raged from 2.4% to 12.5%). There were five uiversities or medical schools where more tha 80% of graduates said they were adequately prepared; seve with 70 79% of graduates prepared; ad the other 17 with 60 69% of graduates prepared. 18 Geeral Medical Coucil
21 We ca also look at resposes to the questio: I this post how ofte have you felt forced to cope with cliical problems beyod your competece or experiece? At oe istitutio, 30.7% of graduates aswered ever. At the other extreme, there was oe school where that respose was give by oly 17.9% of graduates. How have perceptios of preparedess chaged over time? Usig resposes to our 2014 atioal traiig survey, we ca also cosider the variatio betwee schools i how their graduates perceived preparedess has chaged over time. O feelig they have obtaied the skills to set them up for practice, the percetage agreeig or strogly agreeig varied across schools from 61.8% to 96.6%. Statistical aalysis of the va Hamel survey of ew doctors i 2013 foud o sigificat differeces betwee medical schools i either the mea axiety score or the percetage with serious axiety. But for a overall preparatio questio ad for early all the specific preparatio domais, there were highly sigificat differeces betwee the medical schools. Also, there were sigificat differeces betwee the schools for all the measures of prescribig ability. At oe school, the umber of graduates regardig themselves as prepared icreased by 134.7% betwee 2009 ad 2014 (from 31.4% to 73.8%). There was also a school with a 75.2% icrease. At the other extreme were two schools with decreases i graduates declared preparedess, of 4.3% ad 10.8% (although chages i the questio asked may have cotributed to these treds). We ca also look at the chage i the graduates copig beyod their competece betwee 2009 ad If we look at those aswerig daily or weekly, all medical schools seem to have improved. The best improvemet was oe medical school with a fall of 79.6% (from 39.7% of graduates to 8.1% sayig they have to cope beyod their competece daily or weekly). At the other extreme was a school with a fall of 30.8% over that period. Geeral Medical Coucil 19
22 ARCP outcomes The ARCP outcomes data also reveal variatios betwee medical schools. For higher traiig, with a UK figure of 14.0%, the rage was from 5.8% (leavig aside some schools with very small umbers of graduates covered by our data) to 19.2%. I the first year of the Foudatio Programme (F1), usatisfactory outcomes raged from 0.0% amog graduates from some schools to 3.6% for graduates from oe school. The overall UK figure was 1.1%. I the secod year of the Foudatio Programme (F2), the rage was from 0.0% for some schools to 2.5% for oe school. The overall UK figure was 1.0%. For core traiig, with a overall UK figure of 25.1%, the rage was from oe school where 5.4% of graduates i the programme achieved usatisfactory outcomes, to aother where 36.7% received usatisfactory outcomes. I iterpretig these figures, it s importat to bear i mid: the impact of the educatio provided by the medical school is likely to be highest o Foudatio Programme outcomes ad lowest o higher specialty traiig traiig programmes vary hugely i their rate of usatisfactory outcomes, so a apparetly good result for a medical school may be largely due to its graduates eterig traiig programmes where it is relatively rare to receive a usatisfactory outcome. For example, some programmes tie ARCP outcomes to passes i examiatios. 20 Geeral Medical Coucil
23 medical schools vary i the time that their graduates spet i traiig programmes durig , the period covered by this data, ad the loger they were i programmes, the more opportuities they had to receive a usatisfactory outcome. It is possible to adjust the figures to take accout of the differeces betwee the schools i the atioal traiig programmes their graduates wet ito durig the period of our data. Takig this approach, oe school has 8.4% fewer usatisfactory outcomes tha you would expect give the spread of their graduates across the various traiig programmes. At the other extreme are three schools with 3.1% more usatisfactory outcomes tha you would expect. Foudatio Programme data We ca also cosider the spread of medical schools i relatio to the selectio of their graduates ito the Foudatio Programme i % of applicats were allocated oe of their top five choices. The rage across the medical schools was from 81.8% at oe school up to four schools all at more tha 99%. 12 Lookig at the results from the situatioal judgemet test, which is scored out of 50, the averages for the various UK schools raged from 37.3 to The average for EEA graduates was 33.3 ad for other iteratioal graduates So the average results for the UK medical schools i the situatioal judgemet test vary by less tha 8%. Nevertheless, variatios i idividuals performace are see as substatial eough to justify their beig used as a major compoet i rakig for etry to the Foudatio Programme. 13 We ca also look at the umbers of Foudatio Programme doctors i difficulty. At oe extreme is oe medical school with more tha 4% of its graduates i difficulty. There are also schools with fewer tha 1% of their graduates i that positio. Agai, this suggests oly a limited variatio betwee schools, give the small umbers of graduates officially i difficulty from ay oe school. The rage is arrower still if you oly cosider the doctors i difficulty who are ot siged off as fit to cotiue traiig i the ormal way. Geeral Medical Coucil 21
24 There s some variatio i graduates who remai provisioally registered There is also variatio i the umbers of graduates from each school who take loger tha usual to obtai full registratio. Lookig at the 2012 graduates who were still provisioally registered i March 2014, there were five medical schools with fewer tha 1% provisioally registered, icludig two with oe at all. There were six schools with more tha 4% of their graduates still provisioally registered, icludig oe with 8%. This ca be for a rage of reasos, ot all liked to the doctors preparedess. Choice of specialty varies betwee medical schools Medical schools also vary substatially i the specialties that their graduates apply to. For example, lookig at first roud applicatios i 2012 ad 2013, o average 24.3% of doctors i the Foudatio Programme made a applicatio to Core Medical Traiig. However, the UK medical schools raged from oe where 16.1% of graduates i the Foudatio Programme applied to Core Medical Traiig to aother where 53.0% did so. O average, 37.0% of doctors o the Foudatio Programme applied for GP traiig, varyig from 17.4% of graduates from oe school to 48.0% at the high ed. We ca also look at our data o specialist ad GP registratio. It takes several years to complete traiig as a GP or a specialist ad the period of traiig varies substatially. So we eed to go back a few years to obtai figures that give a true compariso i relatio to the fial destiatios of graduates. 22 Geeral Medical Coucil
25 We have chose to look here at the destiatios of graduates from the five years For example: The percetage of medical graduates becomig GPs raged from 17.1% at oe uiversity to 46.8% at aother. The rage for aaesthesia was from 3.7% of graduates from oe uiversity up to 9.9% at aother. For the physicias, the uiversities raged from 9.0% of medical graduates up to 29.2%. Ad for the surgeos, the rage was from 5.1% up to 13.8%. Clearly, this is takig us some way from preparedess at the poit of graduatio. But we ca see the substatial variatios betwee medical schools i relatio to specialisatio of their graduates, whether or ot this is desirable. O the oe had, the patter ca be see as resultig from competitio for places i specialty traiig ad as reflectig the relevat ad relative stregths of the graduates applyig ad progressig. O the other had, the medical schools producig large umbers of GPs are helpig to address a key area of cocer i medical staffig. The specialties most valued by studets or doctors i traiig may ot be the most valuable to the NHS. Are some medical schools better tha others? There are major differeces betwee medical schools i the preparedess ad subsequet careers of their graduates. Clearly, evets later i a doctor s career will ted to be less closely attributable to their udergraduate educatio. I ay case, this iformatio is ot sufficiet to demostrate that some schools are better tha others. That depeds o the criteria you use, ad ot least whether it is relevat to cosider the value added by the medical school takig ito accout the potetial of the studets they erol. Also, there is room to debate whether the variatio betwee schools i graduate preparedess is a problem ad, if so, how it could be tackled. For example, a atioal licesig examiatio might reduce variatio i preparedess by prevetig some very poor graduates from practisig ad possibly by ecouragig more uiformity i udergraduate curricula. Geeral Medical Coucil 23
26 I what ways are ew doctors poorly prepared? The research we commissioed Morouxe ad colleagues rapid review of the academic literature sice 2009 foud: research suggestig that ew doctors are reasoably well prepared for history-takig ad performig full physical examiatios, but less so for prescribig, cliical reasoig ad diagosis, ad the early maagemet of emergecy patiets variatio reported o competece i practical procedures mixed fidigs o team-workig ad commuicatio with colleagues ad patiets some evidece that ew doctors are poorly prepared for dealig with error ad safety icidets ad that they lack uderstadig of the cliical eviromet Morouxe ad colleagues also carried out ew, origial research. I this, data from iterviews with ew doctors ad others, ad from diaries kept by ew doctors, were mapped agaist the outcomes of graduates set out i Tomorrow s Doctors. The researchers foud that some ew doctors fid traslatig scietific kowledge ito cliical practice challegig, but uderstadig huma structure, fuctio ad pathological mechaisms provides cofidece for decisio makig. Others thought that they are geerally poorly prepared to look beyod the biomedical aspects of a patiet s coditio. The research also shows that graduates are cofidet i speakig with patiets for history takig, to summarise patiets histories, to explai examiatio fidigs, ad to commuicate these to seior staff. But they are less prepared for the high umber of patiets to examie. mixed evidece o professioalism. 24 Geeral Medical Coucil
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text:
This site is a collection of stories from people who self-identified as former members or regular attenders of Mars Hill Church through answering a standard set of questions. Stories were first collected in the fourth quarter of 2015, approaching a year after the closure of the church.
This project is an attempt to capture the imprint the church left on actual people and how they are processing the experience.
Former members and regular attenders are welcome to
participate HERE and read the FAQ HERE
To those who have already done so, thank you.
This site is not intended to set down a definitive or comprehensive history of Mars Hill. Content posted here is assumed to be the opinion of those responding and should be read as such. Names and contact information were not required to participate. Any contact information provided has been removed. Responses were only edited for spelling.
Mars Hill Was Us is licensed under


text:
I'm listening to the doctor so keeping it brief .... First Blogoversary (delayed due to Lent) Candy.
Closes midnight on Friday 30th April - winner posted on Sunday 2nd May - rather than leave this post at the top, I will put on a sidebar link to it.
In the candy is:


text:
Store: AppliancesConnection.com – Online Appliances Shop
Coupon Code: SAVE15 – Use Coupon
Expiry: 2011-08-31
Details: Save $15 on Appliance Purchases over $999 at AppliancesConnection.com. And Use Coupon Code: SAVE15 at checkout.
This Coupon has expired on 2011-08-31 as per our database.
Use it on your own Luck.
Use it on your own Luck.


text:
The team were in Skreen on Tuesday night where a strong cold breeze blew towards the Templeboy end. Missing Paul Flynn, Thomas Howley and Niall Judge, the lineup was young but all gave a good account of themselves.
For the first two quarters we played with the wind but the dominant Pats midfield still held sway and at the halfway point we trailed 8 v 6 with some notable scores being achieved with lads kicking off their weaker foot.
In the third quarter we were whitewashed by the stronger Pats team who scored from all positions of the field. In the fourth quarter we showed better ability and teamwork and got up the field for a couple of scores.
Team: John Hallinan, Dáire Barrins, James Boland, Fergal Boland, Brian Mahoney, Micheál Cahill, Ódhrán Quinn, Danny O'Hora, Colm Naughton, Óisín Flynn, Kenneth Flynn, James Tully
POSTSCRIPT: Thankfully a St.Pats official officiated at the game as Coiste na nÓg Contae Sligigh, would not agree to sanction the fixture as it had been moved from the previous week. Thanks to St.Pats for the game and the official for his unbiased refereeing
News/Match Reports >


text:
GUERLAIN Lingerie de Peau BB Cream SPF 30
49 reviews
73% would repurchase
Package Quality: 4.7
Price: $$$$
Package Quality: 4.7
Price: $$$$
INGREDIENTSTitanium Dioxide 3.55%: Sunscreen. -Octinoxate 3.74%: Sunscreen. -Oxybenzone 1%: Sunscreen.
Start your review
on 9/23/2014 12:20:00 PM
Age: 36-43
Skin: Combination, Fair, Warm
Hair: Blond, Other, Other
Eyes: Blue
It most likely should be called a foundation (as well as moisturizing version of it) rather than a daily BB cream. Nice texture but pretty heavy for my liking. Stays on pretty well but doesn't melt into the skin completely and is noticeable if looked up close. Light is looking white-ish on faces with pink undertones.
on 8/8/2014 1:12:00 PM
Age: 30-35
Skin: Acne-prone, Fair, Not Sure
Hair: Brunette, Other, Other
Eyes: Blue
I generally use Skin 79 BB cream (orange bottle) religiously - however I picked this up at the Duty free in Oslo as I was truly blown away by the texture. No foundation/bb cream has astounded me the way this one has. The colour (1 light) matches my NW120 skin perfectly, causes no breakouts, nor highlightlights any flakes or dry spots. It hasn't caused any excess oiliness and while glowy - it doesn't look greasy. The smell is nice, a hint of rosewater - though I would prefer if were free of unnecessary irritants like fragrance, however - nothing is perfect. In conjunction with a good skincare regime, this can really make your complexion appear radiant, even if you have big pores and fine lines, without highlighting said imperfections. I rarely write reviews anymore but I simply had to speak out and pray, as always (and oft in vain) that Guerlain does not discontinue this wonderful product.
on 5/7/2014 1:40:00 AM
Age: 19-24
Skin: Acne-prone, Fair-Medium, Not Sure
Hair: Brunette, Other, Other
Eyes: Brown
lets start off with saying that this is my first BB cream that i have bought. At first, I was so impressed with how it just glided on and how breathable it felt compared to foundations and the result was definitely glowy I would say, does not turn matt. I absolutely loved it! But then it ALL went down hill, after 4 hours my skin was super super oily everywhere! (i have oily tzone) and it was melting off! I got it in medium and I would say that it also oxidized a bit, turning it a slightly orange during the day. I loved the whole concept of a BB cream and will still be on the hunt for a perfect one. But for now, I only use it when I know I am going to be out for a short while. Plus do not like that it comes in only LIGHT and MEDIUM, i am definitely in-between and it would be too expensive to buy both and mix them, not worth it!
on 3/5/2014 10:44:00 AM
Age: 30-35
Skin: Dry, Fair, Not Sure
Hair: Blond, Other, Other
Eyes: Green
I am fair with freckles, meaning I have pink undertones with warm accents. A true neutral. This makes finding base products tricky because I can't really cover my freckles and look natural and I like coverage for my problem areas. Usually this means heavy reliance on concealer and a tinted moisturizer but smashbox discontinued my fave tm and I started looking elsewhere. I bought this on a whim and I have mixed emotions about it. The thing is that even on my dry, sensitive uneven skin this looks AMAZING and keeps looking better for about 6-8 hours. Then it FAILS hard and immediately. My skin looks dry and irritated. It's the perfume and the chemical SPF. It's not a bb cream. It's not nourishing or protective. It has an SPF and some moisturizers but it is chock full of irritants. As an aesthetician I know that prolonged use of such irritants damages you skin in the form of sun damage and inflammatory responses. That being said as a sheer glowy foundation for short periods it's spectacular looking. I love the way my skin looks with this on which is why I kept it. I have since also purchased the dior nude bb cream and although that too is fragranced I find it much better for the daily use I was intending. This I will use on occasion only. Bottom line is that it's a beautiful sheer foundation with a unique finish that should be worn only on occasion if at all. I won't repurchase because of the overwhelming fragrance and the itch I have to put up with while it's settling. The dior leaves my skin looking better when I take if off.
on 1/26/2014 9:58:00 PM
Age: 36-43
Skin: Normal, Medium, Not Sure
Hair: Brunette, Other, Other
Eyes: Brown
I love this BB cream it's simply the best, only thing is its not really moisturizing so you should definitely apply your serum and a bit of moisturizer to your face first before applying bb cream. The coverage is perfectly natural for those whom are looking for a natural, and radiant look. I also apply some translucent powder over or foundation powder with a brush. Also the price point is fairly reasonable considering you don't need much, I was amazed how I only need to use a very small amount every time. Try it, you will love it!!!
on 1/13/2014 12:54:00 AM
Age: 30-35
Skin: Dry, Fair, Not Sure
Hair: Black, Other, Other
Eyes: Brown
This is a fantastic product. It looks way better than all of the Korean or American BB creams I've used so far. It gives out a very dewy finish but not oily. The longer you wear it the better you look with this product. My only negative comment about this is it only comes in two shades light and medium. Even the light shade is too dark for me. I use it when I want to look like i have a slight tan on.
on 1/12/2014 8:47:00 PM
Age: 44-55
Skin: Combination, Fair-Medium, Cool
Hair: Brunette, Curly, Coarse
Eyes: Blue
My daughter is a cosmetician at Shoppers and I get lots of samples. I love Guelain as I'm a one line women, using Neostratra skin care and Guerlain cosmetics( Gosh being my second favourite). I was using Kibo and Dermaglow but Shoppers stop selling them so I find lines that I can get my daughters 30% discount. I use Guerlains foundation, 02 beige clair, Parure De Lumiere and it is a very fine foundation, it gives you a hint of dewy colour. 2 weeks ago my daughter gave me a sample of Guerlains BB cream and at first I thought that the coverage was too heavy as my skin is really good. But I started noticing as the day went on, it changed into the most perfect movie star glow and I thought wow..you look beautiful. The secret it to apply it with a brush after a primer and blend well. You will be amazed. I will use my Parure De Lumiere as under eye concealer as it is now I realized the perfect shade for my under eyes..Oh what fun
Seriously, I can't makeup(haha) what one I like better. The BB or PDL. The PDL melts into my skin but doesn't last as long as the BB but the BB is heavier than I prefer but prefer dosen't mean it doesn't look good. Oh well..
on 12/26/2013 5:30:00 AM
Age: 30-35
Skin: Normal, Fair-Medium, Neutral
Hair: Brunette, Wavy, Fine
Eyes: Brown
This is an excellent bb cream. The texture is very creamy & lovely, and the pigment is much more than I expected in a western brand's bb cream. It feels very comfortable & light on the face. I can tell I'm wearing it, so it doesn't feel like nothing at all, but it isn't heavy in the slightest. On my normal to dry skin, it has excellent wear time--10+ hrs! It offers amazing coverage for a (again, western) bb cream. I'd say that it's comparable, coverage-wise, to a medium coverage foundation. However, it has the consistency of a facial moisturizer or cream--it's quite hydrating. I'll admit I'm a huge fan of Korean & Japanese bb creams (although their shade selection in most brands for medium to darker skintones sucks). However, I don't care the heavier coverage that the Korean bb's offer on an everyday basis because I simply don't need it. (I do however need a *great* concealer for my raccoon eyes lol). Since I love second skin-like, sheer/light coverage products, the western bb's have grown on me very much even though at first I resented that they weren't "real bb creams". They now definitely have a big place in my makeup collection, & I've since accepted that there are western bb creams and eastern bb creams. Variety is the spice of life, right?
I LOVE Guerlain's Teracotta, & Four Seasons Bronzers, but I had never tried any of their base products for some reason. I'm NC35 in the summertime & I wear this in medium, which suits me quite well. In the dead of winter, when I'm more of an NC25-30, the medium shade is too dark. There are only 2 shades that I'm aware of--light & medium, so def go to a counter or Sephora & try it first if you can. Sephora is awesome with offering samples. If you fit into the limited shade range, and you aren't super oily, I would suggest trying this bb. If you are super oily, this probably won't be your BFF. Guerlain claims the shades are "self-adjusting," but take that with a grain of salt because the "self-adjusting" claims that cosmetic companies make are total BS. As much as these companies claim that their base products have "magic" self-adjusting pigments, there is no such thing. Some makeup seems to self adjust just because it blends in well enough with your skintone, oxidizes enough to match you decently, or it has such little pigment that it simply disappears lol. Makeup simply cannot magically decide what your skin tone is, and adjust accordingly.
At $51, sure this product's expensive, but it's Guerlain, so that's a given. It also smells divine. As with any base product, prepping your skin first helps it to apply even more beautifully. However, if you're pressed for time, this could definitely take the place of your moisturizer, unless you're very dry. Also, you need much less of this than your average bb cream, & if you can apply it with a brush (such as one similar to the RT Expert Face or Buffing brush, or any of the Sigma F80's), that's the application method I'd recommend. A Beauty Blender works great too (I much prefer the original Blender to imitations, there is a big difference). The Beauty Blender is especially useful if you don't need as much coverage because
you can wet it to thin out the coverage. If applying with your hands, be sure to take a minute to blend it really well. It's not a total slap on and go type of product, because it has more pigment than the typical bb. Overall, I'm quite happy with this product & I think it's definitely worth trying out.
on 11/14/2013 7:10:00 AM
Age: 19-24
Skin: Very Oily, Fair, Neutral
Hair: Blond, Straight, Fine
Eyes: Hazel
I wish there was a shade "light" with a yellow undertone too! This one has a strong pink undertone. Light: for those that are NW20 or less.
I wear MUFE HD in 120. I am more on the neutral side, but have a yellow undertone. Lioele Beyond the Solution fits me okay (I don't feel embarrassed of the color on my face :P).
I wish Guelain worked on me because I really liked everything but the color, which slightly oxidized to a little deeper beige color, what didn't flattered my fair yellowish complexion.
This one is has a consistency comparable to an Asian BB cream, or more to a medium coverage foundation. It spreads easily, the coverage is medium to full, and it covers most imperfections. The lasting power is also very good, and with just one powdering, it stayed matte for 7 hrs. You don't need to blot a lot, if you want, then 1x every 5, 6 hrs (oily & combo skin!).
I really don't understand why Guerlain thinks every woman in Europe has a pink/beige undertone? I have their Parure Extreme in 02 Clair Beige (I was told it looked perfect on me. Mental Note: never believe to a pushy SA. Later I found out PE is being replaced with TdP). The color is dark and too beige for my skintone. What I want to say is that they make excellent foundations (and this BB), with creamy, easy spreadable, medium/full coverage, long lasting and optical complexion correcting features, but without too much colors to pick from.
If you have a pink undertone, and fair skintone: I hate you.
Price: If you can afford this BB cream, and the color matches you: go for it. It's one of the best here on the market. + Dior
on 9/1/2013 12:07:00 PM
Age: 36-43
Skin: Combination, Other, Not Sure
Hair: Brown, Other, Other
Eyes: Hazel
I really had high hopes for this product after reading all the rave reviews here. This was my first BB cream, but unfortunately the color is a tad too dark. In summer I could get away with it but the fact I don't have a tan doesn't help. I put this on over my serum but I wasn't thrilled with the results - it gave more coverage than I wanted (I was looking for a second skin effect not a foundation), it didn't have the lasting power I sought (by noon my face was shiny), I expected it to be a bit more matifying (I used Mac face powder and it looked ok for the first hour or so), and I got some pimples in places I don't normally get
Now I'm seeking to give this to a friend as I wasn't given a sample to try out before I bought.
Popular BB Creams
Popular BB Creams


text:
Florida State head basketball coach Leonard Hamilton announced that junior forward Chris Singleton underwent successful surgery on his right foot on Monday. The procedure was performed by team orthopedic surgeon Dr. Bill Thompson of the Tallahassee Orthopedic Clinic. Singleton's rehabilitation will begin immediately and will be overseen by the Florida State athletics training staff. No timetable has been established for his return to the court.
Singleton (Canton, Ga./Dunwoody) has played in all 25 of the Seminoles' games this season and is averaging 13.8 points, 7.1 rebounds and 2.1 steals per game.
Florida State, the second winningest program in the ACC in the last three seasons, is 18-7 overall and in third place in the ACC standings with an 8-3 record. The Seminoles travel to play at Wake Forest on Saturday in a game that will be televised by the ACC Network.