Robert Winsor

Robert Winsor (May 28, 1858 – January 7, 1930) was a leading American financier, investment banker, and philanthropist who, as head of the Boston investment banking firm Kidder, Peabody & Co., was at the forefront of industrial consolidation during the period leading up to the Great Depression. After beginning his career at Kidder, Peabody in 1880 as a lowly clerk just out of college, Winsor was quickly promoted because of his business acumen, and was held in such great esteem by the 1920s that newspaper articles would refer to him as the "J.P. Morgan of Boston" and "one of the country's leading bankers."
Serving on the board of directors of several major corporations in various industries, particularly city railroads, mining, and utilities, Winsor was widely praised as a man of remarkable foresight, a man who had anticipated America's need for improved transportation, utilities, banking, and communications. Under Winsor's leadership, Kidder, Peabody developed from a local investment bank to one of the most powerful banking institutions in the world. He dominated his firm's operations until his sudden death in 1930, which nearly drove the firm out of business just after the Stock Market Crash.
Just after his death, a front-page story in the "Boston Sunday Post" declared Winsor “perhaps the greatest” of a group of same-aged business and political leaders (many of them classmates in the Harvard class of 1880), including Theodore Roosevelt, Josiah Quincy, Richard Saltonstall, Robert Bacon, and William A. Gaston, who had been responsible for building the country's banking, telephone, and transportation industries: “Winsor had the insight that saw the transportation needs of the last four decades. He saw the needs of and the demand for illuminating and heating gas. He saw the demand for communication... He grasped their importance and he...found the men to develop them. Not only did he find the men, but he found the money, millions of money, for the developments. Robert Winsor, self-effacing, publicity-shy, hiding his activities under a firm name, that of Kidder, Peabody & Company, was one of those extraordinary men whom professors of biological sciences will tell you happens only when nature wishes to create a Gladstone, a Wilson, or a Morgan.”
Childhood and education.
Robert Winsor was born in Salem, Massachusetts to Dr. Frederick Winsor, a Civil War surgeon descended from renowned shipbuilder Samuel Winsor, an early settler of Duxbury, Massachusetts, and teacher Ann Bent Ware, daughter of well-known Unitarian minister, professor and abolitionist Henry Ware Jr..
He was one of seven children, each of whom went on to great achievements — his brother Paul was chief engineer of Motive Power and Rolling Stock for the Boston Elevated Railway and was awarded a patent for a railway braking device he invented, sister Mary Pickard Winsor founded the Winsor School for girls in Boston, sister Elizabeth Pearson started the innovative Eliot-Pearson School for nursery school teachers at Tufts University, sister Annie Ware Winsor Allen founded the Roger Ascham School in White Plains, New York, sister Jane Gale directed the Friendly Society and founded the Toy Theatre in Boston, and youngest sibling Frederick Winsor founded the prestigious Middlesex School, of which he was headmaster for 37 years.
Robert Winsor grew up in a home that doubled as his mother's school, and was later educated at Phillips Exeter Academy, graduating from Harvard University in 1880. At Harvard, he played football (he was called "the prince of goal kickers") and was captain of the baseball team (famed for playing catcher against Yale without a mitt or mask, simply biting a piece of rubber between his teeth), but was by more than one account not the most rigorous of students.
Career.
Early years.
After graduation, Winsor joined the Boston investment banking firm Kidder, Peabody & Co. as a clerk, but was quickly recognized for his business acumen, earning the highest Christmas bonus in the company in his first year as a result of his success. He worked his way up to the title of partner in just 14 years (1894), and later senior partner, the title he held at his death. This role also had him director of the Kidder companies of Lowell, Springfield, and New Bedford, Massachusetts, Kidder-Peabody Trust Company, and divisions of Kidder Participations, Incorporated.
Settling in Weston.
Robert Winsor and his wife Eleanor settled in Weston, Massachusetts in 1883, buying a small plot of land at the corner of Boston Post Road and Hemlock Road where he built a simple shingle house (the first in Weston designed by a young architect named Samuel Mead). Over time, he would buy up adjoining properties, gradually laying out roads and building additional homes for his widowed mother and siblings and their families on a 472-acre estate called “Chestnut Farm,” the second largest holding in Weston, stretching from Wellesley to Summer Streets and cut through by Meadowbrook Road.
Railroad mergers.
Winsor's first triumph was as director of the Boston Elevated Railway (which later became the Metropolitan Transit Authority) in 1894. The firm had been started as a speculative enterprise by financier Charles Whittier, but was little more than a weak collection of electric railroads in Boston and Cambridge, Massachusetts; the dominant street railway firm in the city was West End Street Railway, controlled by Henry Melville Whitney. By 1895, Winsor on behalf of Kidder, Peabody was able to gain control of both companies, reorganizing them into one unified public transit system of subways and surface and elevated lines serving metropolitan and suburban Boston. He was later a major influence in the financing of the New Haven Railroad system.
Bank mergers.
During his early years as a partner with Kidder, Peabody, Winsor was also heavily involved in the formation of National Shawmut Bank of Boston in 1898–1899. A group of Massachusetts savings banks, dissatisfied with recent dividends on their shares in Boston's commercial banks, employed Kidder, Peabody to devise a consolidation plan; Winsor created a plan to merge nine of them into a syndicate headed by Kidder, Peabody to buy controlling shares in the banks, vote liquidation, and establish a successor corporation in which the savings banks would then invest. Although the plan drew protests both from the community and bank officials, Winsor moved forward, acquiring controlling shares to create National Shawmut Bank, which overnight became the largest bank in Boston, with twice the capital of the next largest bank.
Mining mergers.
In the years leading up to World War I, Winsor also helped engineer a number of acquisitions and mergers involving mining and natural resources. In 1899 he participated in the transfer of the Butte Coalition Mining Company and the Clark Montana Realty Company to the Amalgamated Copper Mining Company, controlled by Henry H. Rogers and the "Standard Oil Crowd." He continued to work with Amalgamated until its sale in 1910 to the Anaconda Copper Company. In 1901, Kidder, Peabody participated with J.P. Morgan in the formation of the United States Steel Company, with Winsor serving on the steel company's board.
With J.L. Richards, Winsor in 1905 brought together the Massachusetts Pipe Line Gas Company, the Bay State Gas Company of Massachusetts, and the Boston, Brookline, Dorchester, Jamaica Plain, Roxbury, and South Boston gas companies into the $15 million Boston Consolidated Gas Company. At the time of its incorporation, all but a small portion of its capital stock was owned by the Massachusetts Gas Company, which eventually acquired complete control. Winsor was also a director of the New England Coal and Coke Company, which supplied a large portion of the gas sold by the Boston Consolidated Gas Company. Beyond mining and energy, Winsor also aided in the financing of various other New England industries, including the American Felt Company, the Amoskeag Manufacturing Company, and the Mystic Steamship Company.
World War I and changing economic times.
During the war, Winsor led Kidder, Peabody in helping companies like AT&T and the Winchester Repeating Arms Company issue large numbers of bonds, and also participated in giving sizable loans to the Allies and Russia (a practice that banker Jacob Schiff, head of Kuhn Loeb, objected to). After 1919, Winsor became the leader of Kidder, Peabody's entire operation, and the man principally responsible for cultivating new business, organizing syndicates, and negotiating deals with other investment houses. Despite financial battles with J.P. Morgan, Winsor enjoyed a close personal relationship with the J.P. Morgan firm in New York, especially with his old Harvard classmate Robert Bacon and George Whitney, who had been a clerk with Kidder, Peabody.
But as the consumer-driven society exploded in the post-war years, Kidder, Peabody had trouble keeping up with the expansion, which was partly attributed to Winsor's autocratic leadership and inability or unwillingness to adapt to the changing times. Winsor would only leave Boston's State Street to travel to Kidder's New York office in the New York Stock Exchange Building once a week, and he still did not trust equities or the stock market, instead preferring to underwrite bonds, costing his firm both clients and millions of dollars in profit. (One exception was AT&T stock, which Winsor actively promoted; Charles Francis Adams wrote a letter to AT&T president Harry B. Thayer saying that he thought Winsor's firm had done a remarkable job of promoting the issue.)
Decline during the 1920s.
Winsor's power and prestige had hidden serious problems at Kidder, Peabody that came to a head during the 1920s. As the banking and securities markets changed rapidly, becoming much more fast-paced and competitive, older firms like Kidder, Peabody were now forced to fight for their share of the business against younger, more aggressive firms.
For the most part, Kidder, Peabody clung to its traditional conservatism under the leadership of Winsor, who by this time was one of the last of the older financiers still actively engaged in the securities business. Winsor still ruled his firm single-handedly, making practically all the major decisions without consulting advisers or divulging the firm's exact financial condition or issuing any year-end statements. The firm's position deteriorated throughout the 1920s, until its name no longer appeared among the ten leading houses.
The Willet v Herrick case.
Another factor in Winsor's downfall and failing health was his very prominent role as a defendant in the 'Willett v. Herrick and others' court case, which dragged on from 1921 through 1927, attracting as much attention in Boston as the simultaneous Sacco and Vanzetti murder trial. Although it was at its heart a simple civil suit, it involved a great deal of property and the reputations of some of Boston's most esteemed citizens, and like the Sacco/Vanzetti trial raised serious questions about the functioning of the Massachusetts courts.
In essence, George Willett, a successful self-made businessman and head of Willet, Sears & Co., felt he had been cheated out of his ownership of American Felt Company by a conspiracy of wealthy men. He in turn sued everyone involved (the richest, most prominent men in Boston) for damages to the tune of $15 million, the largest amount ever in a Massachusetts tort case. Robert Winsor was the oldest and most prominent defendant, and although Boston society found it difficult to believe the allegations against him, the jury disagreed, eventually awarding the plaintiff over $10 million. The ruling was eventually overturned on appeal, but the damage to Winsor's reputation, and failing health, was done.
The Stock Market collapse and Winsor's death.
When the stock market crashed, Kidder, Peabody's true financial condition was revealed to the world. Most of the firm's capital at that time was tied up in securities of companies it had financed and reorganized, whose value had plummeted so much with the crash that many were completely unsellable, effectively freezing most of Kidder, Peabody's assets. Although the firm survived the crash, the company's informal structure proved crippling as many of its senior partners decided to retire, taking their capital with them. Winsor only exacerbated the problem by using his own capital to pay back many investor losses himself.
Once the situation went public, depositors began to withdraw their funds, creating a crisis when the Italian government suddenly withdrew $10 million. When Winsor died of a heart attack on January 7, 1930, just three months after the crash, the firm was skating on the edge of bankruptcy and was forced to accept a $10 million bailout from J.P. Morgan to survive. It was not enough, and Kidder, Peabody was soon completely reorganized under new partners.
Legacy.
Although Winsor's activities in New England received the most publicity at the time, his contributions on the national scene had a more lasting importance. During the first two decades of the twentieth century he was recognized as one of a small handful of powerful bankers connected with the houses of Kidder, Peabody, J.P. Morgan, Lee, Higginson, Kuhn, Loeb, First National Bank and National City Bank, who made up the core of "finance capitalism." Individually and collectively the group had enormous financial power, working together in syndicates, floating the securities of the largest American corporations, marketing them through allied trust and insurance companies and banking correspondents throughout the world, or placing them on the New York Stock Exchange. They became the permanent financial agents of large corporations, handling not only their financial affairs, but arranging mergers, combinations, reorganizations, and communities of interest.
In this role, Winsor served as director, at one time or another, of:
Outside of the business world, Winsor was also a trustee of Phillips Exeter Academy, Middlesex School, and the Winsor School.
Careful development in Weston.
Over the course of his life, Winsor carefully developed his 472-acre “Chestnut Farm” estate, the second largest holding in Weston, from a collection of properties to a gentleman's farm to support his family, and eventually a neighborhood of lots for houses of various sizes and styles. To maintain the property's natural beauty even as it was subdivided, Winsor first had the land planned and designed by the Olmsted Brothers landscape design firm to ensure the rolling wooded landscape would be preserved. (The notes of Frederick Law Olmsted Jr. from their meetings states that “He wants to keep the place quiet and natural.”) He also offered some of his land to create a skating/swimming pond and relocate the Meadowbrook School and the Weston Golf Club (designed by Donald Ross), boosting the value of his property immeasurably. (His property was one of the first in the country to incorporate golf fairways as a selling feature for adjoining residential property.) The Weston Real Estate Trust was selective in its sales, keeping lots at two acres or larger (creating the protective zoning followed by the town to this day), and even organizing a competition for architects to design homes to be built on the land.
Building a Utopian Community at Woodbourne.
Before 1911, inspired by the plans of Edward Filene's "Boston-1915" project and others meant to address substandard housing and living conditions among the working class, Robert Winsor suggested the idea of building a "scientific, model residential enclave" for the conductors and motormen of his Boston Elevated Railway "as an alternative to the ills of urban housing and congestion," located "within fifteen minutes of the business center of Boston on a five cent fare." After studying several garden-based residential communities in London, Birmingham, Liverpool, and Germany, his hope was that such a community would serve as an “object lesson, which will lead others to make similar investments.”
On November 30, 1911, Winsor organized the Boston Dwelling House Company to develop a 30-acre site near the Forest Hills terminal “with the object of providing desirable, attractive, and sanitary homes at a moderate cost or rental for persons, desiring the same and for the purpose of acquiring the real estate." He put in place Henry Howard as president, his son and fellow Kidder, Peabody partner Robert Winsor Jr. as treasurer, and a board of directors that served as a list of the day's eminent political and social leaders: Robert Woods, William Henry Cardinal O'Connell, Frank A. Day, John Wells Farley, Frederick P. Fish, Bertha Hazard, Charles H. Jones, James Prendergast, James L. Richards, Mrs. Richard M. Saltonstall, Frederic E. Snow and Carl Dreyfus. Before building began, Winsor turned to landscape architects the Olmsted Brothers to design the tract; they delivered a plan similar to their work for Long Island's Forest Hills Gardens, also built near the railroad with naturalistic, winding streets that met in a large circle, which held a circular pool surrounded by larger public buildings. (The company, however, decided instead to go with another, cheaper designer, Robert Anderson Pope of New York, whose similarity to the Olmsted designs caused Frederick Law Olmsted Jr. to charge breach of contract.)
Although the development never met its goal of providing low-cost suburban housing for railroad workers (due to the quality of the construction and rising property costs, it quickly became an upper-middle-class neighborhood), the company sold off enough lots to make the development a marginal financial success. Some of the original plan and homes were lost, but the area in Jamaica Plain, now recognized as the Woodbourne Historic District with its old-growth trees, set-back model houses and harmonious curvilinear designs following the topography and landscape, remains a testimony to the housing styles, trends and idealistic development practices of the early twentieth century. The District is located in the northeast section of Jamaica Plain, encompassing Walk Hill Street, Bourne Street, Florian Street, Wachusett Street and Goodway Road.


New York Central MU Cars

The New York Central MU Cars were built for the New York Central Railroad in 1906–1929 when the New York Central began electrifying its lines for both the Hudson Division and the Harlem Division.
These were the first electric multiple units ever bought by the New York Central Railroad. They were retired between 1950-1973 by the ACMUs and M1A railcars.
History.
The first cars were built in 1906–1907 by American Car and Foundry Company and St. Louis Car Company, which together delivered 182 all steel MUs to the New York Central Railroad. They were built for the electrification of the Hudson Division north of High Bridge and the electrification of the Harlem Division north of Wakefield. The cars were numbered 4000–4173 featured arched stained glass windows located above each set of windows. The glass would be covered later on making it appear that the cars had small and low windows.
In 1910 and in 1913 both the Hudson and Harlem divisions were extended by a combined total of 36 miles. The Harlem line now went to North White Plains while the Hudson line went to Croton-on-Hudson. Additional MUs were ordered between 1913-1929, which totaled 164 that were ordered.
The MUs built from 1917-1929 had regular windows and no stained glass, so they looked like regular heavyweight coaches. This would give the New York Central a grand total of 353 EMUs, which were all motor cars as there was never any trailers ordered.
The New York Central had also purchased 21 combine/baggage MUs built from 1907 to 1910 that were used for the mail services as well as passenger service.
While some of the combines were exactly the same dimensions as the other MUs, the baggage version were notably shorter by 13 feet, compared with the regular MUs. All of these cars would continue service until the arrival of the first order of ACMUs in 1950.
Even though several of the worst cars were removed from service, the rest of the 1906/1907 MUs soldiered on until the next orders of ACMUs in 1962 and finally in 1965. All 1906 MUs were retired by 1963, while the remaining MUs from 1907-1913 and many 1920s era MUs were retired by 1965.
The remaining cars dating from 1924-1929 survived into the Penn Central era. They were built by Standard Steel and renumbered 1250-1296 to make room for other equipment that Penn Central inherited.
The 1200s were either painted in Penn Central's paint scheme or had the Penn Central logo plastered onto the cars. They were retired between 1971-1973 by the new M1A railcars, which also replaced most of the original ACMUs from 1950. After retirement many of these cars were scrapped.
Preservation.
Only three cars are known to survive into preservation.


Nashua River Rail Trail

The Nashua River Rail Trail is a paved mixed-use rail trail in northern Massachusetts and southern New Hampshire under control of the Massachusetts Department of Conservation and Recreation (DCR). It roughly follows the course of the Nashua River, passing through the towns of Ayer, Groton, Pepperell, and Dunstable, Massachusetts and ends about a mile across the New Hampshire state border in Nashua, New Hampshire. The trail is used by walkers, cyclists, inline skaters, equestrians, and cross-country skiers.
History.
Ayer was a major junction for both north-south and east-west rail lines during the rapid development of railroad transportation. The Nashua River Rail Trail sits on the former Hollis branch of the Boston and Maine Railroad, which follows an old Nashaway Indian trail. The line was originally part of the Worcester & Nashua Railroad that connected Worcester, Massachusetts and Nashua, New Hampshire, which was opened on July 3, 1848. The line was extended to Portland, Maine in 1874 and it became part of the Worcester, Nashua and Rochester Railroad connecting Worcester and points east to Canada's Grand Trunk Railroad via Portland, Maine.
The Boston & Maine Railroad took over the line in 1886 and called it the Worcester, Nashua & Portland (WN&P) Division. Between 1911 and 1912, a second track was added from Worcester to Nashua.
Passenger service on the line ended in 1934. After World War II, with the gradual decline of rail transportation, the line fell into disuse, and the last freight train ran on the line in 1982. Some concrete signal bases can still be seen, and railroad plates and ties can be found buried under the sand.
The DCR bought the Hollis Branch in 1987, and the trail was paved by Mass Highway between 2001 and 2002. The official opening and dedication was on October 25, 2002.
Features.
The Nashua River Rail Trail travels along a flat and scenic landscape with many opportunities to see wildlife. The trail passes wetlands, ponds, woods, swamps, and farmland where a variety of wildlife can be viewed, such as beavers, herons and swans.
At the Ayer trailhead, which is close to the Ayer commuter rail station offering access to rail service between Boston and Fitchburg, there is a 60-space parking lot with non-flush public toilets. There are several other parking lots along the trail, which crosses many roads and bridges. Trail users can stop for refreshments in nearby Groton Center or at a restaurant and ice-cream stand in Pepperell.
Free parking is available in Pepperell where the trail crosses Massachusetts Route 113 and at the Nashua trailhead at Yudicky Park.


Fred Gurley

Fred G. Gurley (1889 – July 4, 1976) was president and executive committee chairman of Atchison, Topeka and Santa Fe Railway.
Gurley began his railroad career in 1906 on the Chicago, Burlington and Quincy Railroad, where he worked his way up to become an assistant vice president. In 1939 he transferred to the Santa Fe as a vice president; he was elected president and executive committee chairman of the Santa Fe in 1944. On July 17, 1955, Gurley appeared on "Dateline: Disneyland"; the special broadcast of the opening of Disneyland. Gurley, along with Walt Disney and California Governor Goodwin Knight operated the inaugural running of the Disneyland Railroad; advertised at the time as the Sante Fe & Disneyland Railroad. Gurley retired in 1959, but stayed on as a director until 1964. At that time, he was named an honorary director for life by the railroad.


Armour Refrigerator Line

The Armour Refrigerator Line (ARL, one of the Armour Car Lines) was a private refrigerator car line established in 1883 by Chicago meat packer Philip Armour, the founder of Armour and Company.
To get his products to market, Armour followed the lead of rivals George Hammond and Gustavus Swift when he established the "Armour Refrigerator Line" in 1883. Armour's endeavor soon became the largest private refrigerator car fleet in America. By 1900, the company listed over 12,000 units on its roster (one-third of all the privately owned cars in the country), all built in Armour's own car plant.
One of the Armour Car Lines' subsidiaries was dedicated to produce hauling. In 1919 the Federal Trade Commission ordered the company's sale for antitrust reasons. On March 18 of the following year the new entity, to be known as Fruit Growers Express (FGE), would take with it 4,280 pieces of rolling stock, repairs shops at Alexandria, Virginia and Jacksonville, Florida, and numerous ice plants and other facilities scattered throughout the East Coast.


Americus, Preston and Lumpkin Railroad

The Americus, Preston and Lumpkin Railroad was a historic, narrow gauge railroad in the state of Georgia in the United States.
It was chartered in 1884 and started operations the next year between Americus and Richland. It eventually operated from Louvale to Abbeville.
In 1888, it was reorganized as the Savannah, Americus and Montgomery Railway.


Westchester branch

The Westchester branch was a rapid transit line which was part of the Chicago "L" system from 1926 to 1951. The branch served the suburbs of Forest Park, Maywood, Bellwood, and Westchester, and consisted of nine stations. It opened on October 1, 1926 and closed on December 9, 1951.
Operations.
The Westchester branch was long, and originated from the Garfield Park Branch at the Des Plaines station in Forest Park, Illinois. Initially the line terminated at Roosevelt Road near Bellwood Avenue. On December 1, 1930, service was extended to Mannheim/22nd. Service on the Westchester branch ended on December 9, 1951, and was replaced by the Westchester bus route (now Pace Route 317), which largely mirrored the route of the Westchester branch, though the bus route only extended as far south as Canterbury Street.


Vermilion Valley Railroad

The Vermilion Valley Railroad is a short-line railroad that operates across the Indiana-Illinois state line, connecting the Flex-N-Gate Corporation facility west of Covington, Indiana with CSX Transportation in Danville, Illinois. The line is owned by the FNG Logistics Company , a subsidiary of auto parts manufacturer Flex-N-Gate, its primary customer. Operations by the VVRR, owned by the Indiana Boxcar Corporation until 2019 and the Midwest and Bluegrass Rail since, began in 2003 after CSX abandoned the ex-New York Central Railroad line.
History.
The line was completed in 1869 by the Indianapolis, Crawfordsville and Danville Railroad, and later became part of the Pekin-Indianapolis line of the Peoria and Eastern Railway, a New York Central Railroad subsidiary. Successor Conrail abandoned the portion between Olin and Crawfordsville by 1985, and in 1999 the remaining pieces were conveyed to New York Central Lines LLC for operation by CSX. CSX filed with the Surface Transportation Board for abandonment between Danville and Olin in 2001, since there had been no traffic for the past three years. Flex-N-Gate Corporation submitted an offer of financial assistance and bought the line through newly created FNG Logistics Corporation in December 2002. The Vermilion Valley Railroad began operating the line in April 2003.


Brainerd Subdivision

The Brainerd Subdivision is a rail line owned and operated by BNSF Railway (Burlington-Northern Santa-Fe). It runs from Staples, Minnesota to Duluth, Minnesota.
It is about 150 miles (241 km) from Staples, Minnesotato Duluth, Minnesota.
It was built and owned by Northern Pacific Railway. (finished building all rail about 1911)
In 1970, the Northern Pacific merged with other railroads to form the Burlington Northern Railroad, but then in 1996, merged with Atchison, Topeka and Santa Fe Railway (ATSF) to form BNSF Railway.
The rail line gets about 8-12 trains daily, most of which are coal.
Railyard.
The Brainerd Sub has one railyard, and is very small.
Most of the yard is MOW Equipment, because of BNSF Brainerd Shops.
The railyard also has a small line that leads to Brainerd Industrial. (Not 100% active anymore, and streetruns before getting to the Park)


Pacific series (railcar)


Stuart Threipland

Stuart Threipland MD, FRCPE (18 May 17161805) was a Scottish physician. He was the son of Sir David Threipland, the second baronet of Fingask and, like his father, was an active Jacobite. After qualifying MD from the University of Edinburgh in 1742 he became a fellow of the Royal College of Physicians of Edinburgh (RCPE) two years later. In 1745 he joined Prince Charles Edward Stuart in the Jacobite rising. He became physician-in-chief to the prince and stayed with the army throughout the campaign. After the Jacobite defeat at Culloden in April 1746 he went into exile in France but was able to return to Scotland under the Act of Indemnity (1747). When his father died in 1746 he succeeded to become "de jure" the third baronet of Fingask but was technically unable to use the title which had been forfeited by his father because of his support for the Jacobite cause. He practised as a physician in Edinburgh and was elected president of the RCPE in 1766. In 1783 he was able to buy back most of the family estates in Fingask and Kinnaird which had been confiscated from his father in 1715.
Early life.
He was born in Fingask Castle to Sir David Threipland, Bart. (1666–1746), second baronet of Fingask, Perthshire, and his wife Katharine (née Smythe). At the time the castle was occupied by Hanoverian troops, and his father was in hiding nearby. His father had been an active supporter of the 1715 Jacobite Rising, during which he had been captured by the government army but had escaped and gone into hiding. His family estates were confiscated, and he was stripped of his baronetcy. Stuart Threipland studied medicine at the University of Edinburgh and in 1737 became one of the founder members of the Medical Society of Edinburgh, later the Royal Medical Society. He graduated as a Doctor of Medicine in 1742, and in 1744 he became a fellow of the Royal College of Physicians of Edinburgh (FRCPE) and began practice as a physician in the city.
Service in the 1745 Jacobite Rising.
Threipland came from a staunchly Jacobite family, and his forename, spelt "Stuart", was a mark of the family's devotion to that cause. When Prince Charles Edward Stuart raised his standard at Glenfinnan on 19 August 1745, he and his brother David joined his army. David Threipland died of a gunshot wound at the Battle of Prestonpans in September 1745. Stuart Threipland remained with the prince throughout the campaign becoming his physician-in-chief. He was with the Jacobite army as they marched south as far as Derby, remaining with them on the retreat north into Scotland, and he was present at the Battle of Culloden. After the defeat at Culloden he went into hiding with the prince in the Highlands of Scotland. On one occasion they hid in a cave in Badenoch, where Threipland cared for another Jacobite fugitive and doctor Archibald Cameron of Locheil, who was later captured and hanged at Tyburn for his part in the rising. Assuming the disguise of a Presbyterian minister Threipland reached Edinburgh. There he changed his disguise to that of a printer's devil or apprentice and made his way to England. From there he escaped to France, where he joined Prince Charles Edward in exile in Paris.
Later life.
He was able to return to Scotland in 1747 or 1748 under the Act of Indemnity of 1747. He resumed his practice as a physician in Edinburgh and was elected president of the Royal College of Physicians of Edinburgh on 4 December 1766. When his father died in 1746 he became d"e jure" the third baronet of Fingask but was technically unable to use the title during his lifetime. He lived at Fountain Close, close to the site of the first Hall of the Royal College of Physicians, and from 1771 in Chessel's Court in the Canongate. In later years he spent his summers at his villa at Moredun, south of Edinburgh and the winter months at his apartment in Horse Wynd, off the Canongate. Later he stayed at the Bishop's Land, a large dwelling in the High Street. His practice was a successful one and enabled him in 1783 to buy back most of the family estates in Fingask and Kinnaird that had been confiscated in 1715.
He died at Edinburgh in 1805.
Family.
He married his first wife, Janet Sinclair, in 1753, and after her death he married Janet Budge-Murray in 1761. When Stuart Threipland died in 1805, Patrick, the eldest of their six children, inherited the baronetcy, and the title was formally restored in 1826 by Act of Parliament.
Threipland's medicine chest.
The medicine chest is thought to have been given to Threipland by Prince Charles Edward Stuart. The later provenance of the chest has been documented. Threipland donated it to the surgeon Alexander Wood (1725–1807), and his son Dr George Wood left it to a Dr John Smith. He presented it to the RCPE. It is 10 inches square. The chest contains 147 preparations, most of which are in glass bottles. These include "gums, ointments, powders, balsams and pills". When the chest was in use medicine was dominated by the theory of humours. This involved the use of purgatives, emetics, and enemas, and many of the preparations in the chest are intended to produce such effects. Most of the preparations are vegetable-based, but the increasing use of chemically based drugs in the mid-18th century is demonstrated by the presence of "borax, potassium acid tartarate, dilute sulphuric acid, calamine, zinc oxide and lead acetate". In addition to the drugs, there were compartments for mortar and pestle, scales with weights, scissors, forceps, spatula, suturing needles, paper, and pens.


Pubocervical ligament

The pubocervical ligament is a ligament connecting the side of the cervix to the pubic symphysis.
The collagen in the pubocervical ligament may be reduced in women with vaginal prolapse.


Wilhelm Kiesselbach

Wilhelm Kiesselbach (1 December 1839 – 4 August 1902) was a German otolaryngologist born in Hanau.
From 1859 he studied medicine at the universities of Göttingen, Marburg and Tübingen. In 1877/78 he worked as assistant under Wilhelm Olivier Leube in the polyclinic at the University of Erlangen. In 1880 he obtained his habilitation and in 1888 became an associate professor. He was director of otolaryngology at the university clinic in Erlangen from 1889 to 1902.
His name is associated with the eponymous Kiesselbach's plexus, which is the site where the anterior ethmoid artery, greater palatine artery, sphenopalatine artery and
superior labial artery anastomose in the anteroinferior part of the nasal septum.
Written works.
He also edited the section on diseases of the nose and pharynx for Penzoldt-Stintzing's "Handbuch der Therapie".


Suprangular

The suprangular or surangular is a jaw bone found in most land vertebrates, except mammals. Usually in the back of the jaw, on the upper edge, it is connected to all other jaw bones: dentary, angular, splenial and articular. It is often a muscle attachment site.


Articular disk

The articular disk (or disc) is a thin, oval plate of fibrocartilage present in several joints which separates synovial cavities. This separation of the cavity space allows for separate movements to occur in each space.
The presence of an articular disk also permits a more even distribution of forces between the articulating surfaces of bones, increases the stability of the joint, and aids in directing the flow of synovial fluid to areas of the articular cartilage that experience the most friction.
The term "meniscus" has a very similar meaning.


Stephen A. Appelbaum

Stephen A. Appelbaum (1926–2000) was an American psychologist. He received his PhD from Boston University and the Bruno Klopfer Award in 1985.


National Health Service (England)

The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the Brazilian Sistema Único de Saúde. Primarily funded by the government from general taxation (plus a small amount from National Insurance contributions), and overseen by the Department of Health and Social Care, the NHS provides healthcare to all legal English residents and residents from other regions of the UK, with most services free at the point of use. Some services, such as emergency treatment and treatment of infectious diseases, are free for most people, including visitors.
Free healthcare at the point of use comes from the core principles at the founding of the National Health Service. The 1942 Beveridge cross-party report established the principles of the NHS which was implemented by the Labour government in 1948. Labour's Minister for Health Aneurin Bevan is popularly considered the NHS' founder, despite never formally being referred to as such. In practice, "free at the point of use" normally means that anyone legitimately and fully registered with the system (i.e., in possession of an NHS number), available to legal UK residents regardless of nationality (but not non-resident British citizens), can access the full breadth of critical and non-critical medical care, without payment except for some specific NHS services, for example eye tests, dental care, prescriptions and aspects of long-term care. These charges are usually lower than equivalent services provided by a private provider and many are free to vulnerable or low-income patients.
The NHS provides the majority of healthcare in England, including primary care, in-patient care, long-term healthcare, ophthalmology and dentistry. The National Health Service Act 1946 came into effect on 5 July 1948. Private health care has continued parallel to the NHS, paid for largely by private insurance: it is used by about 8% of the population, generally as an add-on to NHS services.
The NHS is largely funded from general taxation, with a small amount being contributed by National Insurance payments and from fees levied in accordance with recent changes in the Immigration Act 2014. The UK government department responsible for the NHS is the Department of Health and Social Care, headed by the Secretary of State for Health and Social Care. The Department of Health and Social Care had a £110 billion budget in 2013–14, most of this being spent on the NHS.
History.
A. J. Cronin's controversial novel "The Citadel", published in 1937, had fomented extensive debate about the severe inadequacies of healthcare. The author's innovative ideas were not only essential to the conception of the NHS, but in fact, his best-selling novels are said to have greatly contributed to the Labour Party's victory in 1945.
A national health service was one of the fundamental assumptions in the Beveridge Report. The Emergency Hospital Service established in 1939 gave a taste of what a National Health Service might look like.
Healthcare prior to the war had been an unsatisfactory mix of private, municipal and charity schemes. Bevan decided that the way forward was a national system rather than a system operated by local authorities. He proposed that each resident of the UK would be signed up to a specific General Practice (GP) as the point of entry into the system, building on the foundations laid in 1912 by the introduction of National Insurance and the list system for general practice. Patients would have access to all medical, dental and nursing care they needed without having to pay for it at the time.
In the 1980s, Thatcherism represented a systematic, decisive rejection and reversal of the post-war consensus, wherein the major political parties largely agreed on the central themes of Keynesianism, the welfare state, the mixed economy, supplies both of public and private housing, and close regulation of the economy. There was one major exception: the National Health Service, which was widely popular and had wide support inside the Conservative Party. In 1982, Prime Minister Margaret Thatcher promised Britons that the NHS is "safe in our hands."
Organisation.
The NHS was established within the differing nations of the United Kingdom through differing legislation, and such there has never been a singular British healthcare system, instead there are 4 health services in the United Kingdom; NHS England, the NHS Scotland, HSC Northern Ireland and NHS Wales, which were run by the respective UK government ministries for each home nation before falling under the control of devolved governments in 1999. In 2009, NHS England agreed to a formal NHS constitution, which sets out the legal rights and responsibilities of the NHS, its staff, and users of the service, and makes additional non-binding pledges regarding many key aspects of its operations.
The Health and Social Care Act 2012 came into effect in April 2013, giving GP-led groups responsibility for commissioning most local NHS services. Starting in April 2013, primary care trusts (PCTs) began to be replaced by general practitioner (GP)-led organisations called clinical commissioning groups (CCGs). Under the new system, a new NHS Commissioning Board, called NHS England, oversees the NHS from the Department of Health. The Act has also become associated with the perception of increased private provision of NHS services. In reality, the provision of NHS services by private companies long precedes this legislation, but there are concerns that the new role of the healthcare regulator ('Monitor') could lead to increased use of private-sector competition, balancing care options between private companies, charities, and NHS organisations. NHS trusts responded to the Nicholson challenge—which involved making £20 billion in savings across the service by 2015.
Core principles.
The principal NHS website states the following as core principles:
The main aims of the additional principles are that the NHS will:
Structure.
The English NHS is controlled by the UK government through the Department of Health and Social Care (DHSC), which takes political responsibility for the service. Resource allocation and oversight was delegated to NHS England, an arms-length body, by the Health and Social Care Act 2012. NHS England commissions primary care services (including GPs) and some specialist services, and allocates funding to 211 geographically-based clinical commissioning groups (CCGs) across England. The CCGs commission most services in their areas, including hospital and community-based healthcare.
A number of types of organisation are commissioned to provide NHS services, including NHS trusts and private sector companies. Many NHS trusts have become NHS foundation trusts, giving them an independent legal status and greater financial freedoms. The following types of NHS trusts and foundation trusts provide NHS services in specific areas:
Some services are provided at a national level, including:
Staffing.
In the year ending at March 2017, there were 1.187 million staff in England's NHS, 1.9% more than in March 2016. There were 34,260 unfilled nursing and midwifery posts in England by September 2017, this was the highest level since records began. 23% of women giving birth were left alone part of the time causing anxiety to the women and possible danger to them and their babies. This is because there are too few midwives. Neonatal mortality rose from 2.6 deaths for every 1,000 births in 2015 to 2.7 deaths per 1,000 births in 2016. Infant mortality (deaths during the first year of life) rose from 3.7 to 3.8 per 1,000 live births during the same period. Assaults on NHS staff have increased, there were 56,435 recorded physical assaults on staff in 2016–2017, 9.7% more than the 51,447 the year before. Low staffing levels and delays in patients being treated are blamed for this.
Nearly all hospital doctors and nurses in England are employed by the NHS and work in NHS-run hospitals, with teams of more junior hospital doctors (most of whom are in training) being led by consultants, each of whom is trained to provide expert advice and treatment within a specific speciality. From 2017, NHS doctors must reveal how much money they make from private practice.
General practitioners, dentists, optometrists (opticians) and other providers of local health care are almost all self-employed, and contract their services back to the NHS. They may operate in partnership with other professionals, own and operate their own surgeries and clinics, and employ their own staff, including other doctors etc. However, the NHS does sometimes provide centrally employed health care professionals and facilities in areas where there is insufficient provision by self-employed professionals.
Note that due to methodological changes, the 1978 figure is not directly comparable with later figures.
A 2012 analysis by the BBC estimated that the NHS across the whole UK has 1.7 million staff, which made it fifth on the list of the world's largest employers (well above Indian Railways). In 2015 the Health Service Journal reported that there were 587,647 non-clinical staff in the English NHS. 17% worked supporting clinical staff. 2% in cleaning and 14% administrative. 16,211 were finance staff.
The NHS plays a unique role in the training of new doctors in England, with approximately 8,000 places for student doctors each year, all of which are attached to an NHS University Hospital trust. After completing medical school, these new doctors must go on to complete a two-year foundation training programme to become fully registered with the General Medical Council. Most go on to complete their foundation training years in an NHS hospital although some may opt for alternative employers such as the armed forces. Most NHS staff, including non-clinical staff and GPs (although most GPs are self-employed), are eligible to join the NHS Pension Scheme—which, from 1 April 2015, is an average-salary defined-benefit scheme. Among the current challenges with recruiting staff are pay, work pressure, and difficulty recruiting and retaining staff from EU countries due to Brexit. and there are fears that doctors could also leave.<ref name="Guardian20/5/2017">NHS chief tells ministers: face up to the pay crisis "The Guardian"</ref>
In March 2021, the Department of Health and Social Care made a non-binding recommendation that NHS staff in England should receive a 1% pay rise for 2021–2022, citing the 'uncertain' financial situation and the current low inflation. This is estimated to cost £500 million a year, as almost half of the NHS's budget goes on staffing costs (at £56.1 billion). The Trades Union Congress estimated that nurses' pay would be £2,500 less than in 2010, paramedics' pay would be £3,330 less and porters' pay would be £850 less due to inflation. The Royal College of Nursing has criticized the pay rise, calling it 'pitiful' and said that nurses should be getting 12.5% more; it has also agreed to set up a £35m fund to support members in the even of a strike. Other unions have threatened strike actions and warned that the proposal could lead to staff quitting their jobs, worsening staffing issues. The Labour Party similarly criticized the proposal as 'reprehensible' and claimed that it goes against a government 'promise' made in 2020 to give NHS workers a 2.1% pay rise, which was voted for in a long-term spending plan in January 2020 but the Department of Health considered to be not legally binding. Prime Minister Boris Johnson has defended the 1% pay rise, stating that the government is giving workers "as much as we can" in light of the COVID-19 pandemic and that he was "massively grateful" to the health and social care workers. Secretary of State for Health and Social Care Matt Hancock and Secretary of State for Education Gavin Williamson have similarly argued that the decision was due to an assessment of what was affordable due to the pandemic and that NHS staff was excluded from a wider public sector pay freeze. The Review Body on Doctors' and Dentists' Remuneration, an independent review body, is expected to make its own recommendations on NHS salaries in May 2021, which may differ from the Department of Health's recommendation. Shadow Secretary of State for Health and Social Care Jon Ashworth has clarified that Labour would "honour whatever the review body recommends".
2012 reforms.
The coalition government's white paper on health reform, published in July 2010, set out a significant reorganisation of the NHS.
The white paper, "Equity and excellence: liberating the NHS", with implications for all health organisations in the NHS abolishing primary care trusts and strategic health authorities. It claimed to shift power from the centre to GPs and patients, moving somewhere between £60 to £80 billion into the hands of clinical commissioning groups to commission services. The bill became law in March 2012 with a government majority of 88 and following more than 1,000 amendments in the House of Commons and the House of Lords.
Funding.
The total budget of Department of Health in England in 2017/18 is £124.7 billion. £13.8 billion was spent on medicines. The National Audit Office reports annually on the summarised consolidated accounts of the NHS.
The population of England is ageing, which has led to an increase in health demand and funding. From 2011 to 2018, the population of England increased by about 6%. The number of patients admitted to hospital in an emergency went up by 15%.  There were 542,435 emergency hospital admissions in England in October 2018, 5.8% more than in October 2017. Health spending in England is expected to rise from £112 billion in 2009/10 to £127 billion in 2019/20 (in real terms), and spending per head will increase by 3.5%.
However, according to the Institute for Fiscal Studies (IFS), compared to the increase necessary to keep up with a rising population that is also ageing, spending will fall by 1.3% from 2009–10 to 2019–20. George Stoye, senior research economist of the IFS, and said the annual increases since 2009-10 were "the lowest rate of increase over any similar period since the mid-1950s, since when the long-run annual growth rate has been 4.1%".<ref name="Guardian3/5/2017"></ref> This has led to cuts to some services, despite the overall increase in funding. In 2017, funding increased by 1.3% while demand rose by 5%. Ted Baker, Chief Inspector of Hospitals has said that the NHS is still running the model it had in the 1960s and 1970s and has not modernised due to lack of investment. The British Medical Association (BMA) has called for £10bn more annually for the NHS to get in line with what other advanced European nations spend on health. In June 2018 ahead of the NHS' 70th Anniversary then Prime Minister Theresa May announced extra funding for the NHS worth an average real terms increase of 3.4% a year, reaching £20.5 billion extra in 2023/24.
The commissioning system.
From 2003 to 2013 the principal fundholders in the NHS system were the primary care trusts (PCTs), that commissioned healthcare from NHS trusts, GPs and private providers. PCTs disbursed funds to them on an agreed tariff or contract basis, on guidelines set out by the Department of Health. The PCTs budget from the Department of Health was calculated on a formula basis relating to population and specific local needs. They were supposed to "break even" – that is, not show a deficit on their budgets at the end of the financial year. Failure to meet financial objectives could result in the dismissal and replacement of a trust's board of directors, although such dismissals are enormously expensive for the NHS.
From April 2013 a new system was established as a result of the Health and Social Care Act 2012. The NHS budget is largely in the hands of a new body, NHS England. NHS England commission specialist services and primary care. Acute services and community care is commissioned by local clinical commissioning groups (CCGs) led by GPs. From April 2021 all CCGs have become part of Integrated Care Systems.
Free services and contributory services.
Services free at the point of use.
The vast majority of NHS services are free at the point of use.
This means that people generally do not pay anything for their doctor visits, nursing services, surgical procedures or appliances, consumables such as medications and bandages, plasters, medical tests, and investigations, x-rays, CT or MRI scans or other diagnostic services. Hospital inpatient and outpatient services are free, both medical and mental health services. Funding for these services is provided through general taxation and not a specific tax.
Because the NHS is not funded by contributory insurance scheme in the ordinary sense and most patients pay nothing for their treatment there is thus no billing to the treated person nor to any insurer or sickness fund as is common in many other countries. This saves hugely on administration costs that might otherwise involve complex consumable tracking and usage procedures at the patient level and concomitant invoicing, reconciliation and bad debt processing.
Eligibility.
Eligibility for NHS services is based on having ordinary resident status.
Prescription charges.
 the NHS prescription charge in England was £9 for each quantity of medicine (which contrasts with Scotland, Wales and Northern Ireland where items prescribed on the NHS are free). People over sixty, children under sixteen (or under nineteen if in full-time education), patients with certain medical conditions, and those with low incomes, are exempt from paying. Those who require repeated prescriptions may purchase a single-charge pre-payment certificate that allows unlimited prescriptions during its period of validity. The charge is the same regardless of the actual cost of the medicine, but higher charges apply to medical appliances. Pharmacies or other dispensing contractors are reimbursed for the cost of the medicines through NHS Prescription Services, a division of the NHS Business Services Authority. For more details of prescription charges, see Prescription charges.
The high and rising costs of some medicines, especially some types of cancer treatment, means that prescriptions can present a heavy burden to the primary care trusts, whose limited budgets include responsibility for the difference between medicine costs and the fixed prescription charge. This has led to disputes whether some expensive drugs (e.g., Herceptin) should be prescribed by the NHS.
NHS dentistry.
Where available, NHS dentistry charges were: £20.60 for an examination; £56.30 for a filling or extraction; and £244.30 for more complex procedures such as crowns, dentures or bridges. As of 2007, less than half of dentists' income came from treating patients under NHS coverage; about 52% of dentists' income was from treating private patients. Some people needing NHS dental care are unable to get it.
NHS Optical Services.
From 1 April 2007 the NHS Sight Test Fee (in England) was £19.32, and there were 13.1 million NHS sight tests carried out in the UK.
For those who qualify through need, the sight test is free, and a voucher system is employed to pay for or reduce the cost of lenses. There is a free spectacles frame and most opticians keep a selection of low-cost items. For those who already receive certain means-tested benefits, or who otherwise qualify, participating opticians use tables to find the amount of the subsidy.
Injury cost recovery scheme.
Under older legislation (mainly the Road Traffic Act 1930) a hospital treating the victims of a road traffic accident was entitled to limited compensation (under the 1930 Act before any amendment, up to £25 per person treated) from the insurers of driver(s) of the vehicle(s) involved, but were not compelled to do so and often did not do so; the charge was in turn covered by the then legally required element of those drivers' motor vehicle insurance (commonly known as "Road Traffic Act insurance" when a driver held only that amount of insurance). As the initial bill went to the driver rather than the insurer, even when a charge was imposed it was often not passed on to the liable insurer. It was common to take no further action in such cases, as there was no practical financial incentive (and often a financial disincentive due to potential legal costs) for individual hospitals to do so.
The Road Traffic (NHS Charges) Act 1999 introduced a standard national scheme for recovery of costs using a tariff based on a single charge for out-patient treatment or a daily charge for in-patient treatment; these charges again ultimately fell upon insurers. This scheme did not however fully cover the costs of treatment in serious cases.
Since January 2007, the NHS has a duty to claim back the cost of treatment, and for ambulance services, for those who have been paid personal injury compensation. In the last year of the scheme immediately preceding 2007, over £128 million was reclaimed.
From April 2019 £725 is payable for outpatient treatment, £891 per day for inpatient treatment and £219 per ambulance journey.
Car park charges.
Car parking charges are a minor source of revenue for the NHS, with most hospitals deriving about 0.25% of their budget from them. The level of fees is controlled individually by each trust. In 2006 car park fees contributed £78 million towards hospital budgets. Patient groups are opposed to such charges. (This contrasts with Scotland where car park charges were mostly scrapped from the beginning of 2009 and with Wales where car park charges were scrapped at the end of 2011.)
Charitable funds.
There are over 300 official NHS charities in England and Wales. Collectively, they hold assets in excess of £2 billion and have an annual income in excess of £300 million. Some NHS charities have their own independent board of trustees whilst in other cases the relevant NHS trust acts as a corporate trustee. Charitable funds are typically used for medical research, larger items of medical equipment, aesthetic and environmental improvements, or services that increase patient comfort.
In addition to official NHS charities, many other charities raise funds that are spent through the NHS, particularly in connection with medical research and capital appeals.
Regional lotteries were also common for fundraising, and in 1988, a National Health Service Lottery was approved by the government, before being found illegal. The idea continued to become the National Lottery.
Outsourcing and privatisation.
Although the NHS routinely outsources the equipment and products that it uses and dentistry, eye care, pharmacy and most GP practices are provided by the private sector, the outsourcing of hospital health care has always been controversial. The involvement of private companies regularly draws the suspicion of NHS staff, the media and the public.
Outsourcing and privatisation has increased in recent years, with NHS spending to the private sector rose from £4.1 billion in 2009–10 to £8.7 billion in 2015–16. The King's Fund's January 2015 report on the Coalition Government's 2012 reforms concluded that while marketisation had increased, claims of mass privatisation were exaggerated. Private firms provide services in areas such as community service, general practise and mental health care. An article in "The Independent" suggested that the private sector tends to choose to deliver the services that are the most profitable, additionally because the private sector does not have intensive care facilities if things go wrong.
Sustainability and transformation plans.
Sustainability and transformation plans were produced during 2016 as a method of dealing with the service's financial problems. These plans appear to involve loss of services and are highly controversial. The plans are possibly the most far reaching change to health services for decades and the plans should contribute to redesigning care to manage increased patient demand. Some A&E units will close, concentrating hospital care in fewer places.<ref name="BBC17/11/2016"></ref> Nearly two thirds of senior doctors fear the plans will worsen patient care.
Consultation will start over cost saving, streamlining and some service reduction in the National Health Service. The streamlining will lead to ward closures including psychiatric ward closures and reduction in the number of beds in many areas among other changes. There is concern that hospital beds are being closed without increased community provision.
Sally Gainsbury of the Nuffield Trust think tank said many current transformation plans involve shifting or closing services. Gainsbury added, "Our research finds that, in a lot of these kinds of reconfigurations, you don't save very much money – all that happens is the patient has to go to the next hospital down the road. They're more inconvenienced... but it rarely saves the money that's needed." By contrast, NHS England claims that the plans bring joined-up care closer to home. Senior Liberal Democrat MP Norman Lamb accepted that the review made sense in principle but stated: "It would be scandalous if the government simply hoped to use these plans as an excuse to cut services and starve the NHS of the funding it desperately needs. While it is important that the NHS becomes more efficient and sustainable for future generations, redesign of care models will only get us so far – and no experts believe the Conservative doctrine that an extra £8bn funding by 2020 will be anywhere near enough."
NHS policies and programmes.
Changes under the Thatcher government.
The 1980s saw the introduction of modern management processes ("General Management") in the NHS to replace the previous system of consensus management. This was outlined in the Griffiths Report of 1983.
This recommended the appointment of general managers in the NHS with whom responsibility should lie. The report also recommended that clinicians be better involved in management. Financial pressures continued to place strain on the NHS. In 1987, an additional £101 million was provided by the government to the NHS. In 1988 Prime Minister Margaret Thatcher announced a review of the NHS. From this review in 1989 two white papers "Working for Patients" and "Caring for People" were produced. These outlined the introduction of what was termed the "internal market", which was to shape the structure and organisation of health services for most of the next decade.
In England, the National Health Service and Community Care Act 1990 defined this "internal market", whereby health authorities ceased to run hospitals but "purchased" care from their own or other authorities' hospitals. Certain GPs became "fund holders" and were able to purchase care for their patients. The "providers" became independent trusts, which encouraged competition but also increased local differences. Increasing competition may have been statistically associated with poor patient outcomes.
Changes under the Blair government.
These innovations, especially the "fund holder" option, were condemned at the time by the Labour Party. Opposition to what was claimed to be the Conservative intention to privatise the NHS became a major feature of Labour's election campaigns.
Labour came to power in 1997 with the promise to remove the "internal market" and abolish fundholding. However, in his second term Blair renounced this direction. He pursued measures to strengthen the internal market as part of his plan to "modernise" the NHS.
A number of factors drove these reforms; they include the rising costs of medical technology and medicines, the desire to improve standards and "patient choice", an ageing population, and a desire to contain government expenditure. (Since the National Health Services in Wales, Scotland and Northern Ireland are not controlled by the UK government, these reforms have increased the differences between the National Health Services in different parts of the United Kingdom. See NHS Wales and NHS Scotland for descriptions of their developments).
Reforms included (amongst other actions) the laying down of detailed service standards, strict financial budgeting, revised job specifications, reintroduction of "fundholding" (under the description "practice-based commissioning"), closure of surplus facilities and emphasis on rigorous clinical and corporate governance. Some new services were developed to help manage demand, including NHS Direct. The Agenda for Change agreement aimed to provide harmonised pay and career progression. These changes have given rise to controversy within the medical professions, the news media and the public. The British Medical Association in a 2009 document on Independent Sector Treatment Centres (ISTCs) urged the government to restore the NHS to a service based on public provision, not private ownership; co-operation, not competition; integration, not fragmentation; and public service, not private profits.
The Blair government, whilst leaving services free at point of use, encouraged outsourcing of medical services and support to the private sector. Under the Private Finance Initiative, an increasing number of hospitals were built (or rebuilt) by private sector consortia; hospitals may have both medical services such as ISTCs and non-medical services such as catering provided under long-term contracts by the private sector. A study by a consultancy company for the Department of Health shows that every £200 million spent on privately financed hospitals will result in the loss of 1000 doctors and nurses. The first PFI hospitals contain some 28 per cent fewer beds than the ones they replaced.
The NHS was also required to take on pro-active socially "directive" policies, for example, in respect of smoking and obesity.
Information technology.
In the 1980s and 90s, NHS IT spent money on several failed IT projects. The Wessex project, in the 1980s, attempted to standardise IT systems across a regional health authority. The London Ambulance Service was to be a computer-aided dispatch system. Read code was an attempt to develop a new electronic language of health, later scheduled to be replaced by SNOMED CT.
The NHS Information Authority (NHSIA) was established by an Act of Parliament in 1999 with the goal to bring together four NHS IT and Information bodies (NHS Telecoms, Family Health Service (FHS), NHS Centre for Coding and Classification (CCC) and NHS Information Management Group (IMG)) to work together to deliver IT infrastructure and information solutions to the NHS in England. A 2002 plan was for NHSIA to implement four national IT projects: Basic infrastructure, Electronic records, Electronic prescribing, and Electronic booking, modelled after the large NHS Direct tele-nurse and healthcare website program. The NHSIA functions were divided into other organisations by April 2005.
In 2002, the NHS National Programme for IT (NPfIT) was announced by the Department of Health. It was widely seen as a failure, and blamed for delaying the implementation of IT in the service. Even in 2020 it appeared most of the 1.38 million NHS computers were still using Windows 7, which was released in 2009, and additional support had to be arranged by Microsoft until 14 January 2021 before the migration to Windows 10 could be completed. NHSX, the organisation set up to manage NHS information technology was supervising the migration, and has the power to impose sanctions on laggards.
Despite problems with internal IT programmes, the NHS has broken new ground in providing health information to the public via the internet. In June 2007 www.nhs.uk was relaunched under the banner "NHS Choices" as a comprehensive health information service for the public now known simply as "The NHS Website".
In a break with the norm for government sites, www.nhs.uk allows users to add public comments giving their views on individual hospitals and to add comments to the articles it carries. It also enables users to compare hospitals for treatment via a "scorecard". In April 2009 it became the first official site to publish hospital death rates (Hospital Standardised Mortality Rates) for the whole of England. Its "Behind the Headlines" daily health news analysis service, which critically appraises media stories and the science behind them, was declared Best Innovation in Medical Communication in the prestigious BMJ Group Awards 2009. and in a 2015 case study was found to provide highly accurate and detailed information when compared to other sources
In 2012, NHS England launched the NHS Apps Library, listing apps that had been reviewed by clinicians.
In 2018, the NHS announced they would abandon the name NHS Choices, and in future, call the site the "NHS website". This coincided with the launch of the NHS app.
Eleven of the NHS hospitals in the West London Cancer Network were linked using the IOCOM Grid System in 2009. This helped increase collaboration and meeting attendance and even improved clinical decisions.
Smoking cessation.
One in four hospital patients smoke and that is higher than the proportion in the general population (just under one in five). Public Health England (PHE) wants all hospitals to help smokers quit. One in thirteen smoking patients was referred to a hospital or community based cessation programme. Over a quarter of patients were not asked if they smoke and nearly three quarters of smokers were not asked if they wanted to stop. Half of frontline hospital staff were offered no training in smoking cessation. Smoking patients should be offered specialised help to stop and nicotine replacement. There should be dedicated staff helping patients to quit. Seven tenths of smokers say they want to stop and those offered help are four times more likely to stop permanently. PHE claims smoking causes 96,000 deaths per year in England and twenty times the number of smoking related illnesses. Frank Ryan, psychologist said, "It's really about refocusing our efforts and motivating our service users and staff to quit. And of course, whatever investment we make in smoking cessation programmes, there's a payback many times more in terms of the health benefits and even factors such as attendance at work, because it's workers who smoke [who] tend to have more absent spells from work." The numbers of smokers getting help to quit has fallen due to cuts in funding for smoking cessation care though the National Institute for Health and Care Excellence recommends such help. Smoking is the greatest cause of avoidable illness and death in England, costs the NHS £2.5bn a year and the economy £11bn.
Public satisfaction and criticism.
A 2016 survey by Ipsos MORI found that the NHS tops the list of "things that makes us most proud to be British" at 48%. An independent survey conducted in 2004 found that users of the NHS often expressed very high levels of satisfaction about their personal experience of the medical services. Of hospital inpatients, 92% said they were satisfied with their treatment; 87% of GP users were satisfied with their GP; 87% of hospital outpatients were satisfied with the service they received; and 70% of Accident and Emergency department users reported being satisfied. Despite this some patients complain about being unable to see a GP at once when they feel their condition requires prompt attention. When asked whether they agreed with the question "My local NHS is providing me with a good service” 67% of those surveyed agreed with it, and 51% agreed with the statement "The NHS is providing a good service." The reason for this disparity between personal experience and overall perceptions is not clear; however, researchers at King's College London found high-profile media spectacles may function as part of a wider 'blame business', in which the media, lawyers and regulators have vested interests. The survey found that most people believe that the national press is generally critical of the service (64% reporting it as being critical compared to just 13% saying the national press is favourable), and also that the national press is the least reliable source of information (50% rating it not very or not at all reliable, compared to 36% believing the press was reliable) . Newspapers were reported as being less favourable and also less reliable than the broadcast media. The most reliable sources of information were considered leaflets from GPs and information from friends (both 77% reported as reliable) and medical professionals (75% considered reliable).
Some examples of criticism include:
Quality of healthcare, and accreditation.
There are many regulatory bodies with a role in the NHS, both government-based (e.g., Department of Health and Social Care, General Medical Council, Nursing and Midwifery Council),and non-governmental-based (e.g., Royal Colleges). Independent accreditation groups exist within the UK, such as the public sector Trent Accreditation Scheme and the private sector CHKS.
With respect to assessing, maintaining and improving the quality of healthcare, in common with many other developed countries, the UK government has separated the roles of suppliers of healthcare and assessors of the quality of its delivery. Quality is assessed by independent bodies such as the Healthcare Commission according to standards set by the Department of Health and the National Institute for Health and Clinical Excellence (NICE). Responsibility for assessing quality transferred to the Care Quality Commission in April 2009.
A comparative analysis of health care systems in 2010 put the NHS second in a study of seven rich countries. The report put the UK health systems above those of Germany, Canada and the US; the NHS was deemed the most efficient among those health systems studied.
700 hospital patients suffered harm in serious incidents due to treatment delays in part of 2015–16, 1,027 hospital patients suffered similar harm in 2016-17 and this rose to 1,515 in 2017–18. Norman Lamb blames understaffing. NHS Improvement stated during 2017-18 the NHS was short of 93,000 staff, which included 10,000 doctors and 37,000 nurses.
Performance.
In 2014 the Nuffield Trust and the Health Foundation produced a report comparing the performance of the NHS in the four countries of the UK since devolution in 1999. They included data for the North East of England as an area more similar to the devolved areas than the rest of England. They found that there was little evidence that any one country was moving ahead of the others consistently across the available indicators of performance. There had been improvements in all four countries in life expectancy and in rates of mortality amenable to health care. Despite the hotly contested policy differences between the four countries there was little evidence, where there was comparable data, of any significant differences in outcomes. The authors also complained about the increasingly limited set of comparable data on the four health systems of the UK. Medical school places are set to increase by 25% from 2018.
A report from Public Health England’s Neurology Intelligence Network based on hospital outpatient data for 2012–13 showed that there was significant variation in access to services by clinical commissioning group. In some places there was no access at all to consultant neurologists or nurses. The number of new consultant adult neurology outpatient appointments varied between 2,531 per 100,000 resident population in Camden to 165 per 100,000 in Doncaster.
In 2019, "The Times", commenting on a study in the "British Medical Journal", reported that "Britain spent the least on health, £3,000 per person, compared with an average of £4,400, and had the highest number of deaths that might have been prevented with prompt treatment". The "BMJ" study compared "the healthcare systems of other developed countries in spending, staff numbers and avoidable deaths".
Mental health services.
The NHS provides mental health services free of charge, but normally requires a referral from a GP first. Services that don't need a referral include psychological therapies through the Improving Access to Psychological Therapies initiative, and treatment for those with drug and alcohol problems. The NHS also provides online services that help patients find the resources most relevant to their needs.


Plagiocephaly

Plagiocephaly, also known as flat head syndrome, is a condition characterized by an asymmetrical distortion (flattening of one side) of the skull. A mild and widespread form is characterized by a flat spot on the back or one side of the head caused by remaining in a supine position for prolonged periods.
Plagiocephaly is a diagonal asymmetry across the head shape. Often it is a flattening which is to one side at the back of the head and there is often some facial asymmetry. Depending on whether synostosis is involved, plagiocephaly divides into two groups: synostotic, with one or more fused cranial sutures, and non-synostotic (deformational). Surgical treatment of these groups includes the deference method; however, the treatment of deformational plagiocephaly is controversial. Brachycephaly describes a very wide head shape with a flattening across the whole back of the head.
Causes.
Slight plagiocephaly is routinely diagnosed at birth and may be the result of a restrictive intrauterine environment giving a "diamond" shaped head when seen from above. If there is premature union of skull bones, this is more properly called craniosynostosis.
The incidence of plagiocephaly has increased dramatically since the advent of anti-sudden infant death syndrome recommendations for parents to keep their babies on their backs.
Data also suggest that the rates of plagiocephaly are higher for twins and multiple births, premature babies, babies who were positioned in the breech position or back-to-back, as well as for babies born after a prolonged labour.
Diagnosis.
A developmental and physical assessment performed by a physician or a pediatric specialist is recommended. Often imaging is obtained if the diagnosis is questionable to see if the baby's sutures are present or not. If the sutures are not present, craniosynostosis may be ruled into question.
It is also common for an infant with Positional Plagiocephaly to have misaligned ears (the ear on the affected side may be pulled forward and down and be larger or stick out more than the unaffected ear).
Prevention.
Prevention methods include carrying the infant and giving the infant time to play on their stomach (tummy time), which may prevent the baby from progressing into moderate or severe plagiocephaly.
Letting babies crawl may also prove to be crucial in preventing plagiocephaly as it strengthens babies' spine and neck muscles. Crawling also boosts gross and fine motor skills (large and refined movements), balance, hand-eye-coordination and overall strength.
Treatment.
The condition may improve to some extent as the baby grows, but in some cases, home treatment or physical therapy treatment can improve the shape of a baby’s head.
Early interventions (based on the severity) are of importance to reduce the severity of the degree of the plagiocephaly. Diagnosis is most commonly determined through clinical examination.  In order to assess the severity of the condition and determine the best course of treatment, practitioners often use the Plagiocephaly Severity Scale. This is a scale that can help practitioners evaluate the condition in a standardized way.
The course of treatment is typically based on the age of the child when the diagnosis  is made in conjunction with the severity of the diagnosis. If a diagnosis of mild to moderate plagiocephaly occurs before four months of age, repositioning therapy may be helpful. If the diagnosis is determined to be severe, practitioners will likely prescribe a cranial molding orthosis (helmet), which has the best results when prescribed between five to six months of age.
Repositioning.
Initially, treatment usually takes the form of reducing the pressure on the affected area through repositioning of the baby onto their abdomen for extended periods of time throughout the day.
This may include repositioning the child's head throughout the day so that the rounded side of the head is placed against the mattress, re-positioning cribs and other areas that infants spend time in so that they will have to look in a different direction to see their parents or others in the room, re-positioning mobiles and other toys for similar reasons, and avoiding extended time sleeping in car-seats (when not in a vehicle), bouncy seats, or other supine seating which is thought to exacerbate the problem. If the child appears to have discomfort or cries when they are re-positioned, a neck problem should be ruled out.
Helmets.
High quality evidence is lacking for cranial remolding orthosis (baby helmet) for the positional condition and use for this purpose is controversial. If conservative treatment is unsuccessful, helmets may help to correct abnormal head shapes. These helmets are used to treat deformational plagiocephaly, brachycephaly, scaphocephaly and other head shape deformities in infants 3–18 months of age by gently allowing the head shape to grow back into a normal shape. This type of treatment has been used for severe deformations.
Prognosis.
Preliminary research indicates that some babies with plagiocephaly may comprise a high-risk group for developmental difficulties. Plagiocephaly is associated with motor and language developmental delays. While developmental delay is more commonplace among babies with plagiocephaly, it cannot be inferred that plagiocephaly is the cause of the delay.
Etymology.
Ancient Greek πλάγιος ("plagios") 'oblique, slanting', from PIE "plag-" 'flat, spread', from *"plak", and Modern Latin "cephal-" 'head, skull, brain', (from Greek κεφαλή) together means 'flat head'.


James B. Bradley

James Bray Bradley (November 19, 1858July 4, 1940) was the Michigan Auditor General from 1905 to 1908.
Early life.
Bradley was born on November 19, 1858 in Middlebury Township, Michigan to parents Albert B. and
Jerusha Louise Bradley.
Education.
Bradley graduated from Rush Medical College in 1886.
Career.
Bradley worked as a physician and surgeon in Grand Rapids, Michigan. Bradley was elected to the position of Michigan Auditor General in 1904, and served from 1905 to 1908. Bradley was a candidate in the Republican primary for the 1908 Michigan gubernatorial election. Bradley was a presidential elector from Michigan in 1928.
Personal life.
Bradley married Jennie Frost in 1885. After Bradley was widowed in 1913, he remarried to Pearl Parshall on October 12, 1915. Bradley was a member of the American Medical Association, the Knights Templar, the Shriners, the Knights of Pythias, and the Maccabees. Bradley was Freemason. Bradley was Methodist.
Death.
Bradley died in Eaton Rapids, Michigan on July 4, 1940.


Keep A Breast Foundation

The Keep A Breast Foundation (KAB) is a 501(c)(3) non-profit organization focused on breast cancer prevention and education, based in Los Angeles, California, United States. The organization was founded by Shaney jo Darden and Mona Mukherjea-Gehrig in 2000, officially gaining NPO status in 2005. KAB first gained national prominence with their “"i love boobies!"” bracelets, which were the focus of a U.S. federal court case. Promoting breast cancer prevention via means of education and early detection remains a key focus of KAB's campaigns.
Programs.
Check Yourself!
The CYS program creates and distributes breast health education through printed materials, blogs, and the Check Yourself! App.
Check Yourself's primary focus is raising awareness on the importance of doing a monthly breast self-check. With 40% of diagnosed breast cancers being self-detected, KAB believes that establishing what is “normal” for you is an important step to knowing your body.
In 2018, over 160,000 CYS cards were distributed globally.
Treasured Chest.
This program supports women diagnosed with breast cancer or testing positive with the BRCA1 or BRCA2 gene with an opportunity to create their own breast cast. TCP kits have been sent out to all 50 states, with a large portion of them having gone out to women under 40.
Non-Toxic Revolution.
The NTR mission is to inform, educate and inspire young people to revolt against the dangers of toxic chemicals in their environment and food supply, especially those linked to the development of breast cancer. Its aim is to focus on prevention as a means to maintain long-term health and well-being. Non-Toxic Revolution also provides alternative choices so that young people everywhere can make smart changes.
Campaigns.
i love boobies!
In 2008, KAB released their “"i love boobies!"” shame-free breast awareness message. This message was designed to take a positive approach to breast cancer dialogue. It particularly resonates with young people and encourages them to be open and active about breast cancer prevention.
"i love boobies!" is focused on sparking dialogue among young people about breast cancer and breast health. Many different kinds of "i love boobies!" merchandise has been made to further this cause, and revenues from this merchandise fund KAB programs and campaigns, broaden its reach and in the past, provide grant money supporting important studies.
School controversy.
The "i love boobies!" bracelets were created by the Keep A Breast Foundation in 2004. The Foundation created and sold a series of one-inch wide silicone rubber bracelets, emblazoned with the slogan "i ♥ boobies! (Keep A Breast)" to raise money and create a conversation about breast cancer among young people. The positive and upbeat awareness-raising campaign was designed to make young people feel comfortable talking about a subject that is otherwise fearful and taboo.
As the bracelets became a fashion craze among teenagers, many school districts began to ban the wearing of these bracelets as the slogan conflicted with school dress codes that prohibit the wearing of any item that includes sexually suggestive language or pictures.
A dispute over such a ban reached the U.S. Court of Appeals for the Third Circuit. A panel of three of its judges heard the case, and it was then taken up to be re-heard by all 14 judges en banc. The court ruled 9-5 that the school's ban on the bracelets violated the students' right to free speech because the bracelets were not plainly offensive or disruptive and were speech conducted to raise awareness of a social issue. The U.S. Supreme Court later declined to take up the case.
DIY Action.
The DIY Action campaign was created for people that wish to start their own fundraiser benefiting The Keep A Breast Foundation. KAB provides educational materials and awareness merchandise, and the events range anywhere from skateboarding and music events, to cook offs and birthday parties.
#checkyourselfie.
This campaign was created to share the message of breast self-checks with friends and followers via social media platforms. It is meant to encourage people to download the KAB Check Yourself! App, since this has become such an effective way to reach teens and young adults. This app is free to download to phones and devices. It shows and explains how to do a self-check and lets users set a monthly reminder for future checks.
Fit 4 Prevention.
Fit 4 Prevention is a national movement to raise awareness about breast cancer prevention through fitness and wellness. The goal of F4P is to inspire people to reduce their risk of cancers by adopting a healthier, more active lifestyle. KAB works with studios, gyms and individuals around the country to raise funds and increase awareness for The Keep A Breast Foundation and their mission.
Past campaigns.
Imagine If... was a support program intended for young people to share their feelings concerning what the world would be like if there were no cancer. It was part of the Keep A Breast Traveling Education Booth and traveled on music tours, festivals and events around the world. Participants wrote down their response on a small whiteboard, took photos with their Imagine If... response and then shared the photos on the internet and social media.
"This is My Story" is a campaign that gave people a chance to share the impact breast cancer had on their lives through writing or video. Videos and written testimonies were shared on KAB's YouTube Channel, as well as their website and social media platforms.
Breast cast exhibitions.
Keep A Breast founders developed a technique for creating breast casts at the start of the organization in 2000. The result was a white plaster/gauze cast that can be customized by artists. The first breast cast auction was in 2000. Some past breast cast exhibitions include: "Tokyo LOVE show, Keep A Breast PDX, American Rag X LAB Art, Bare Minerals, Bordeaux Love, and Snow Show."
Warped Tour.
Keep A Breast first went on Vans Warped Tour in 2001, and participated each year through 2018, which was the last Vans Warped Tour. This tour was KAB's largest outreach platform, and helped the organization to grow. On this tour, KAB had a tent filled with educational materials and merchandise, as well as volunteers and employees to help educate and provide support for anyone interested. Many of the bands on Vans Warped Tour are Keep A Breast supporters. Through KAB's work with Vans Warped Tour, they were able to take part in several music compilation collaborations featuring many artists they met over the years on tour.
Celebrity involvement.
Many professional athletes, celebrities, artists and well-known individuals have been involved with The Keep A Breast Foundation. Pro surfers Lisa Anderson and Layne Beachley, burlesque stars Dita Von Tesse and Catherine D’lish, musicians Iggy Pop, Kim Gordon of Sonic Youth, Mark Mothersbaugh of DEVO, Katy Perry and Tom Delonge of Blink 182 and Angels & Airwaves, and artists Shepard Fairey, Mike Giant, Ed Templeton and Dalek to name a few of the big names that have been supporters and contributed to KAB.
Partnerships.
The Keep A Breast Foundation partners with many different companies and organizations to help further their reach. Some of these partnerships are for the month of October, which Keep A Breast refers to as Breast Cancer Prevention Month and some go year round. The support these partnerships offer include product collaborations, outreach, advertising, special events and promotions. A few of KAB's partners have included Rastaclat, HUF, True&Co., Valiant Entertainment, and S.W. Basics.
In October 1, 2019, Thrive Causemetics donated 100% of its profits to Keep A Breast Foundation, and donated $5 for every repost on Instagram of a certain image with the hashtag #thrivecausemetics for the rest of October.
Global.
The Keep A Breast Foundation, as stated in its mission, “is a global non-profit organization 2.” KAB has had affiliates in Japan, Canada, Europe, Mexico and Chile. Currently, Keep A Breast Europe is active and has a headquarters in Bordeaux, France, which was developed by Lorene Carpentier, the organizations Global CEO.
Founder.
Shaney jo Daren is the Founder and CCO of The Keep A Breast Foundation. Shaney jo was born in Fullerton, CA and was grew up in Southern California. She began her career in fashion design, which she did predominantly in the action sports industry. In 2008, she quit her job and began focusing on Keep A Breast full-time, shortly after moving the foundation out of her home, and into an office in Carlsbad, CA. Shaney jo did a TEDx talk in 2011 concerning The Keep A Breast Foundation and the “"i love boobies!"” bracelet controversy.


Paul Frick

Paul Joseph Frick is an American psychologist and the Roy Crumpler Memorial Chair in psychology at Louisiana State University (LSU), as well as a professor at the Learning Sciences Institute of Australia at Australian Catholic University. He is known for his research on psychopathy and antisocial behavior in children, which he has been studying for over twenty years.
Biography.
Frick was educated at Louisiana State University and the University of Georgia. While still training to become a family therapist, he changed his mind after deciding that treatments for child aggression were not effective enough, so instead he chose to study the causes of such behavior. Before joining the faculty of LSU in 2015, he was a University Distinguished Professor of psychology at the University of New Orleans, where he was chair of the psychology department from 2007 to 2015. He was the president of the Society for the Scientific Study of Psychopathy from 2009 to 2011, and editor-in-chief of the "Journal of Clinical Child & Adolescent Psychology" from 2007 to 2011. Since 2018, he has been editor-in-chief of the "Journal of Abnormal Child Psychology". In 2015, he received the Robert D. Hare Lifetime Achievement Award from the Society for the Scientific Study of Psychopathy.


La Jolla Institute for Immunology

La Jolla Institute for Immunology is a non-profit research organization located in La Jolla, California. It is located in UC San Diego’s Research Park. The Institute researches immunology and immune system diseases. The Institute employs 23 faculty members and more than 300 employees. Dr. Mitchell Kronenberg has served as its president and scientific director since 2003. The institute was founded in 1988.
La Jolla Institute for Immunology is a collaborative research organization that has forged many partnerships within the research community in San Diego, across the United States, and abroad. The institute's biomedical research facility covers 145,000 square feet inclusive of specialized research rooms suited for all aspects of molecular and cellular biology.
History.
La Jolla Institute for Immunology was established in 1988 by a coalition that included Makoto Nonaka, the Institute's founding president, and Kimishige Ishizaka, the Institute's first scientific director.
In 1989 the Institute began its laboratory operations with the arrival of two immunologists, Kimishige Ishizaka and Teruko Ishizaka, from Johns Hopkins University in Baltimore, Maryland. The Ishizakas were co-discoverers in 1966 of the IgE (immunoglobulin E) protein, a molecule that induces allergic reactions in the human body. In 1991, Kimishige Ishizaka was appointed president and scientific director of the institute and served in the role until his retirement in 1995.
In 1995, Howard Grey joined La Jolla Institute of Immunology as president and scientific director. During the next several years, the Institute recruited prominent faculty members and formulated a program to accelerate the commercial development of LJI's research and drug discoveries. In 1996, the Institute moved from its initial location on Torrey Pines Road in La Jolla to a new purpose-built facility on Science Center Drive on the Torrey Pines Mesa.
In 2003, Mitchell Kronenberg was appointed president and scientific director. That same year, the Immune Epitope Database (IEDB) was established and launched. The database was designed and developed by the La Jolla Institute under a competitive contract from the National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH. In 2012, the NIH renewed their contract with the Institute for a further seven years.
In 2006 the Institute opened a new research facility located in the new UC San Diego Science Research Park. In 2011, the Institute opened the RNAi Center for Identifying Genetic Triggers of Disease. The center's goal is to propel scientific efforts to pinpoint the specific genes involved in causing immune diseases, cancer, and other diseases using RNA interference (RNAi) technology. That same year, the La Jolla Institute and Immunology became the fifth collaborating organization to join the Sanford Consortium for Regenerative Medicine.
In 2013 La Jolla Institute extended its partnership with the Japanese pharmaceutical company Kyowa Hakko Kirin. The six-year agreement continues a research alliance that began in 1988. In 2015 the La Jolla Institute for Immunology announced its affiliation with the UC San Diego Health System.
In 2018, the La Jolla Institute for Allergy and Immunology changed its name to La Jolla Institute for Immunology to reflect its current focus.
In 2020, scientists at the institute formed a Coronavirus Task Force in response to the COVID-19 pandemic. At the same time, the institute became the home of the Coronavirus Immunotherapy Consortium (CoVIC), a research collaboration to test antibodies against the novel coronavirus, SARS-CoV-2, led by structural virologist Erica Ollmann Saphire.
Scientific activities.
Scientists at La Jolla Institute for Immunology study the fundamental workings of the immune system. This includes studying the cells driving allergies and autoimmune diseases, as well as the cells that aim to fight cancers and infectious diseases. The institute is made up of three centers: the Center for Autoimmunity and Inflammation, the Center for Cancer Immunotherapy and the Center for Infectious Disease and Vaccine Research.
Scientists at LJI also lead research into genomic sequencing of immune cells and high-resolution imaging of virus/antibody interactions through cryo-electron microscopy. The institute is home to the Immune Epitope Database (IEDB) and the DICE (Database of Immune Cell Expression, Expression of quantitative trait loci and Epigenomics).
Scientists at LJI, in collaboration with researchers at the J. Craig Venter Institute, were the first to publish an analysis of potential SARS-CoV-2 epitopes vulnerable to the human immune system. Since then, COVID-19 research at LJI has shed light on how both CD+8 and CD+4 T cells respond to the SARS-CoV-2 virus. These findings can inform vaccine efforts. Scientists at the institute have analyzed mutations in the SARS-CoV-2 virus. Additional COVID-19 projects at the institute include research to understand how the virus affects white blood cells called monocytes and research into Multisystem inflammatory syndrome in children (MIS-C).
Researchers at LJI have established several international research partnerships, including research collaborations in Nepal to study flavivirus infection and collaborations in Sierra Leone to study hemorrhagic fever viruses.


Epicondyle

An epicondyle () is a rounded eminence on a bone that lies upon a condyle ("epi-", "upon" + "condyle", from a root meaning "knuckle" or "rounded articular area"). There are various epicondyles in the human skeleton, each named by its anatomic site. They include the following: