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1-Dec-2021
Digitising hospitals was the focus of NHS IT policy for twenty years. The job is still unfinished: so what are the options for trusts – and the integrated care systems that are planned to take over health tech strategy and funding next April? The Highland Marketing advisory board asked three leading chief information officers for their views
Covid-19 and the latest reforms of the NHS have focused attention on health tech to an unusual degree. The first few months of the pandemic saw a rapid roll-out of remote working, virtual clinics and digital-first primary care and triggered a lively political and media debate about their future role in healthcare.
Meanwhile, the health tech market has been focused on integrated care systems and the shared care records, data platforms, and apps they will need to join-up services, introduce population health management, and create a new 'offer' for places and citizens.
In the middle of all this, the digitisation of hospitals seems to be in danger of being overlooked. Which is odd, because for 20-years it was the focus of NHS IT policy, and it is still far from complete. In comments to the HETT show at Olympia, reported by the Health Service Journal, NHSX chief executive Matthew Gould around 10% of trusts remain "largely paper-based" while there are "a whole lot more that are only semi-digitised."
With the global digital exemplar programme wound down, the Unified Tech Fund planning to allocate the last of Jeremy Hunt's tech money by March, and ICSs due to take over IT strategy and funding in April, it doesn't look like there's a central strategy to improve things.
Yet, as the 'What Good Looks Like' document for ICSs acknowledges, there is a need to 'level up' trust electronic patient record provision, if hospitals are to work efficiently, support their staff, and feed into those shared care record and data platforms.
So, the Highland Marketing advisory board asked three leading chief information officers what their trusts are doing, to inform a debate about the challenges and opportunities ahead.
Big box? Best of breed? Ecosystem? Or new thinking?
Adrian Byrne, the chief information officer of University Hospitals of Southampton NHS Foundation Trust, started by challenging some of the terminology that is used around hospital systems.
Traditionally, he noted, people have contrasted 'big box' or single supplier with 'best of breed' models for rolling out EPR functionality, such as patient administration, order comms, e-prescribing and, more recently, e-noting and e-observations. But this may be unhelpful and outdated.
Unhelpful, because even the biggest of 'big box' EPRs don't do everything, so trusts are going to have to integrate them with other systems at some point; and the real question may be how much integration they want to handle.
"There seems to be an idea that it's 'go with one of the big boys' or 'let chaos reign', but I don't subscribe to that," Byrne said. "We are said to have a best of breed approach, but we want to integrate where we can and get down to as few systems as possible."
Outdated, because most of the current discussion about EPRs is focused on how they are evolving into platforms that can collect and then flow data into different systems, including patient-facing apps.
"I spoke to Will Smart [the former CIO of NHS England, who now works for Dedalus] a couple of weeks ago," Byrne said, "and he didn't want to talk about EPRs anymore. He wanted to talk about platform, flowing data, and patients: and I think that's right." (Highland Marketing also spoke to Will recently, and there's more on his views here).
Hospital IT is like an onion…
In practice, the basic distinction is well understood. Martin Sadler, the chief information officer at Sandwell and West Birmingham NHS Trust, said his organisation "put in an EPR 18-months ago" and "it has given us a platform to say: 'this is what we have done to the patient' and 'this is where they are in our system'."
Whereas Neil Perry, director of digital transformation at Dartford and Gravesham NHS Trust, said that in 2017, when his organisation refreshed its IT strategy, it first "decided what it wanted to do" and then decided that "best of breed was the way to get there, fastest."
But there was agreement between presenters and advisory board members that it is not enough.
Since then, his trust has adopted a modern approach to integrating data from its different systems and re-exporting it to apps that 'fill gaps' in its EPR functionality, working with an open platform from Alcidion.
However, there was agreement between presenters and advisory board members that an EPR, however, developed, is not enough.
Sadler said that while his trust had deployed Cerner Millennium, this was not the end of its IT strategy. Perry showed a slide that set out his strategy as an 'onion' with core functionality at its centre, and open, innovative systems for e-prescribing, analysis, and remote patient monitoring in the outer layers.
"An EPR is important, but to my mind, in our onion, it will be doing the core stuff and around the edge will be all the really exciting stuff: and that's more or less what Will says," he said.
Options, pros and cons
Bearing this in mind, the presenters and advisory board members felt there were pros and cons to the two approaches that less mature trusts will need to consider. A single supplier approach can get trusts a long way fast: one vendor pitches its system as "HIMSS 4/5 out of the box."
There is a perception that this makes 'big box' the preferred option for NHS England, which picked a lot of single supplier trusts for the GDE programme, and NHSX, which has structured the digital aspirant funding and the UTF around a PAS plus EPR modules approach.
It's also understood by boards. Neil Perry said one of his challenges was getting new leaders to understand his strategy. "You get the board asking why we don't have an EPR, or why we don't go and buy Cerner or Epic," he said. "Regulators can also be a challenge."
On the other hand, a single supplier approach is expensive. Sadler said his trust chose to retain its patient administration system and running Cerner Millennium still costs half his IT budget.
There is also a danger of trusts deploying their 'out of the box' EPR functionality and getting stuck at its level. The GDE programme was set up to take trusts in this position to the top of the HIMSS EMRAM maturity model and to create a 'blueprint' for others to follow.
It worked for the trusts involved; but many of Gould's "semi-digitised" hospitals will be running systems they got around the time of the National Programme for IT, with a bit of e-prescribing and e- observations, for which there has been national money.
So, perhaps the biggest argument for 'best of breed' these days is that it can encourage innovation. Perry said that as part of its 2017 strategy reset, his trust decided that "we didn't just want to be an early adopter, we wanted to be right on the left-hand side of the adoption curve, in the red zone, working with start-ups and innovators."
Byrne's team has developed its own technology, including the My Medical Record personal health record that is being quite widely adopted, particularly for prostate cancer follow-up (the Highland Marketing advisory board has been following the progress of MyMR, and there's more information here).
Parking the current lack of national focus, why haven't more trusts made similar progress? Board-level support and funding are definitely issues. Sadler said that in his previous CIO role, at young fashion website Missguided, his IT budget was 22% of turnover. The three presenters estimated their budgets at 2-4% and said they needed 6-10%.
But it's not just money. Cindy Fedell, a former NHS CIO who now works in Ontario, said people were also an issue. "You need a good CIO, who can understand strategy and understand their options," she said; arguing that more should be done to support professionalism and certification initiatives.
Then, there's local politics. James Norman, another former NHS CIO who now works for Dell Technologies, said when it comes to collaboration across a health economy, two of the potential reasons trusts go out to tender are that they've been formed in a merger, and it's easier to pick a "compromise" system than it is to get people to work with each other's IT, or they want to be on a different system to their neighbour/s to stop a merger happening.
Although Sadler said he'd have been happy to use a neighbour's technology; if they weren't trying to charge so much that it wasn't an option. "All of that needs to stop," Norman argued. "We should be working together as one NHS and sharing ideas and skills and systems."
ICSs: a chance to level up to where the best are now, not where the GDEs were five years ago?
In the absence of a national strategy, one of the questions for the future is going to be how integrated care systems approach the job of drawing up IT strategies for their trusts and patches.
Byrne argued there is a danger that some could be tempted to bring in management consultants who will advise buying a new kind of 'big box' – a single EPR for trusts, with a health information exchange / analytics package / patient portal attached.
Which, he argued, was likely to be a bad idea because it would mean swapping out one v1.0 system for another v1.0 system. As an alternative, he outlined a three-pronged approach.
First, a proper evaluation of the level of digital maturity that trusts have achieved for the money they have spent, to identify best-practice and where best to allocate 'levelling up' funds.
Second, ICS or ICP-led, system-wide procurements in areas where these make sense: pathology, imaging, areas like maternity that are not covered by EPR functionality and have a strong patient component. And third, system-wide integration of existing IT, so organisations can exchange messages with each other and with patient facing technology.
"I think it has to be an evolutionary approach," he said. "If people have some digital maturity, they should keep going, and keep thinking about how to build on those foundations. And it has to be clinically-led."
Nicola Haywood-Alexander, the CIO for the Lincolnshire integrated care system, said she was hoping to develop a strategy around this kind of idea. "I want to build up an architecture across the ICS," she said. "Instead of asking: 'does this hospital need an EPR' I want to ask: 'what do we need across the system?'
"That way, we can use investment to support new kinds of thinking. A lot of work that is done in hospital at the moment is going to be done in the community or homes in the future. So, we need to look at what works in hospital and ask how we can get it into the community or homes.
"Then, with a bit of luck, we can get the aspirants to where the best people are now, and not where the GDEs were five-years ago."
Highland Marketing's advisory board: Jeremy Nettle, former global advisor for Health Sciences, Oracle Corporation; Cindy Fedell, former chief digital and information officer at Bradford Teaching Hospitals NHS Foundation Trust; Andy Kinnear, former director of digital transformation at NHS South, Central and West Commissioning Support Unit; James Norman, healthcare CIO, EMEA, at DellEMC; Ravi Kumar, health tech entrepreneur and chair of ZANEC, and Rizwan Malik, divisional medical director of Bolton NHS Foundation Trust and managing director of South Manchester Radiology Highland Marketing is an integrated communications, PR and marketing consultancy with an unrivalled reputation for supporting UK and international health tech companies and healthcare providers, built over almost 20 years. Read more analysis and interviews on the Highland Marketing website, follow us on Twitter @Highlandmarketng, or get in touch on: info@highland-marketing.com


Lack of parental commitment to end child marriages and unavailability of education sponsorships are frustrating efforts to curb this practice in Machinga District, traditional leaders have said during a legal clinic organized by Zanzibar University Muslim Graduates (ZUMUGA) which aimed at sensitizing chiefs on legal matters Sunday at Nanyumbu.
The leaders, led by Senior Chief Kawinga, said the resistance to efforts to stop early marriages has led to some of the chiefs to come up with their own by-laws to deter the practice.
"I for one, I fine five chickens or K5,000 for every parent or guardian who resists this and because of that we are seeing so e change," he told the gathering of the Muslim alumni from Zanzibar University.
In his turn, Group Village Headman Kachara said chiefs are trying hard to prevent child marriages but parents and guardians are pulling down those efforts.
"As advised by our paramount chief not to tolerate child marriages in our respective areas, every chief is observing that, but the challenge has been the parents. They don't want to embrace change.
"When we try to end these marriages, they ask us why we are concerned as if they are our children," he said.
Group Village Headman Kafozi hinted that lack of academic sponsorships for girls who have completed their Standard 8 is also hampering efforts to end child marriages, saying parents don't see it fit to stop a child from early marriage when they know they can't afford secondary school fees.
"Much as we are ending these marriages, the problem here is that when these children pass their standard 8 examinations, they fail to go to secondary school because of financial reasons. As a result, parents feel it's a waste of time to stop them from marrying," he said.
ZUMUGA chairperson for Southern Chapter, Daniel Kamanga said the legal clinic included issues of child marriages, inheritance, crime and domestic violence.
"We came here to sensitise our chiefs on legal issues as you know Machinga is one of the districts affected by social injustice issues including albino killings. So we are also here to make an impact along those lines," he said.
Chairperson for Court Users Association in the area, Haji Balasani thanked ZUMUGA for the sensitisation, saying it would help to improve their service delivery.
At the meeting almost hundred traditional leaders were in attendance from Machinga District.


"Egad!!! I threw my back out again at the all night midget toss and brussel sprout buffet...It'll take me hours to drag myself to the computer to send out the topic..."
Brilliant! This is a regular occurence in my house - except I have two cats, so they work as a team; one sitting on you, the other staring at you and meowing!
haha, love this comic! It amazes me how many people wait with baited breath for the topic to appear. kinda sad?
hahahaha! I even called home this morning to ask my husband to check the site to see if the word had come in yet.
The cat is hilariously depicted. I'm intrigued what the 1st place trophy was awarded for.
Ha, ha. Don't forget the cold, wet nose to the eyeball trick.
bwahahahahaha!!!! baited breath. try WHERE IS THE FRAKKING FRIDAY TOPIC EMAIL?????
"Sugary" is one of my favorites too. Funny how it worked out because I hated the word!
heheheh... too funny. I kept watching my email friday morning going where IS THAT TOPIC!
Hey... midgets and brussel sprouts? Are you sure you weren't following me?
Great one, Brian. Hilarious as always.


I need some advise from those with experience on this component. We are facing soldering problem "pillow effect"(from cross section result)on this BGA. In the reflow profile point of view which area should we focused more? The soak time or the Total Time above liquiduos? btw, we use SAC305 solderpaste. Thanks in advance for any input.


Discovering the landscape: cut it out!
Over the past few years, my colleague Jen (Landscape Institute Archivist) and I have been working to integrate the library and archive of the Landscape Institute into the collections of the Museum of English Rural Life.
The LI collections are rich and varied, including material such as books, pamphlets, periodicals, press cuttings, minutes, membership lists, financial papers, Institute publications and a slide library.
Now the time has come for me to sort out the Landscape Institute cuttings collection.
In a library context a cuttings collection is most likely to include articles cut out of newspapers or other periodicals, or press cuttings. It is also likely that other types of ephemera will find their way into a cuttings collection, such as offprints (reprints of articles from editions of a publication), leaflets, advertisements, catalogues or posters.
A collection such as this arises from individuals cutting out relevant articles and compiling them. So they are a kind of personally (or institutionally) curated collection. A lot of us are likely to have done this ourselves – cutting out and keeping articles of printed material that have a personal connection or are of local interest.
Therefore we treat cuttings as a library collection, as they are culled from printed material.
The LI cuttings collection includes material from the 1960s to the early 2000s. It includes a lot of biographical articles on leading landscape architects, especially obituaries. This is alongside material on policy affecting the work of the landscape architect and features on particular parks, gardens and landscape projects.
Does the MERL Library hold any other cuttings?
Yes we hold a MERL Library cuttings collection which we still add to. This is in filing cabinets in the Reading Room and is organised in a sequence based on the MERL Library subject classification scheme.
Cuttings can be a problem for librarians! Their ephemeral and often flimsy nature can make their provenance difficult to attribute, while storage and organisation can also be a challenge.
Nonetheless, it is precisely the ephemeral nature of cuttings that make them so valuable to researchers. There is no better insight into contemporary views and public opinion on landscape architects and their projects than by reading what was being written about them at the time.
Of course, a lot of this material will now be available online or elsewhere. Still this collection is of historical interest in itself, as a record of what the Landscape Institute felt it was important to cut out and keep.
When will the cuttings be made available?
I am currently about 25% of the way through sorting the LI's collection of hundreds of cuttings! Thankfully I have a wonderful volunteer, Tina, who is going to help me with the project. Together we will be numbering, listing and repackaging the cuttings. I would hope that this project will be completed towards the end of the year, but please get in touch via merl@reading.ac.uk if you are interested in using the collection before then.
The MERL and Special Collections Open Access Library is now fully accessible again! In this library, which can be accessed from the Reading Room, you can find reference works relating to our Special Collections and to Samuel Beckett, as well as the library collection of the MERL, consisting of about 50,000 books, pamphlets and periodical volumes. We have been working hard to improve the layout of these collections to make it easier for you to quickly find the items that you need. We have also been able to create more space for future purchases and gifts.
We would like to thank our readers for their patience while the works were taking place.
In this post Amber Roberts, recipient of MERL's landscape academic engagement bursary talks about her work on our Michael Brown collection (Landscape Institute collections).
Michael Brown's work is unfortunately little known to today's landscape architects. Thanks to a generous research bursary from MERL I have been able to delve into his archive and begin to uncover Brown's idiosyncratic approach, his lost landscapes and his lost research.
The art and aesthetic delight of landscape must emerge out of solving down to earth problems elegantly and simply.
With this focus on the solution of 'down to earth problems', his work navigated the complex tensions of the profession that existed both then and now by advocating an objective, theoretical and interdisciplinary approach.
If spaces between buildings are to be used to their best advantage it is essential that methods of analysis and comparison be evolved which will enable the designer to analyse the functions and uses of external spaces very rigorously.
This approach is particularly evident in his work at Livingstone Road, London (1962 and later awarded a Civic Trust Award 1968) developed with the architects George, Drew and Dunn Partnership, a project that is due to be lost to a £300m regeneration project. By undertaking a disciplined survey and analysis of the site Brown identified key issues and opportunities that ranged from the particular microclimate of the site to cut and fill balance and pedestrian movement lines. Brown interwove this analysis with the 'Court House Concept' of his tutor McHarg to develop a series of spaces that were given careful detailing landform and levels to create a range of soft spaces.
Beyond the layout of the courtyard system of open space, Brown sought to foster a sense of ownership for the spaces among the new residents. This was a key approach of Brown's that he had begun to develop during his early British work with SPAN Housing. Brown himself became a resident of Fieldend and member of the Resident's Association for the upkeep of the landscape within the estate. The courtyards at Livingstone Road were each given a distinct character and function that was embellished with sculptures and wall panels and Brown actively promoted a resident's association for the scheme.
Overall Brown had a deeply personal and idiosyncratic approach to landscape, his publications and designs offered exemplary solutions responding to complex issues from housing and motorway design to the design of public squares. Each of which combined his joint skills in architecture, urban design and landscape. Brown's breadth of projects are testament to his rich and varied experience merging together disparate ideas and skills. This research on Brown will be presented with Lead Researcher Dr Luca Csepely-Knorr at the Society of Architectural Historians Conference in Glasgow next month.
Find out more about Amber's work or our Landscape Institute.


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Links to news items about legal and regulatory aspects of Internet and the information society
GPL defenders say: See you in court
(CNET News)
A legal team enforcing the most widely used license in the open-source and free software movement has shown that it's not afraid to take its cases all the way to court. For years, violations of the General Public License, or GPL, have been met with quiet discussions to resolve compliance problems that can result when open-source software is used improperly. Now, however, the Software Freedom Law Center is taking a hard-line approach, filing a copyright infringement lawsuit against Monsoon Multimedia for allegedly failing to abide by requirements of the GPL.
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redpajama_set_name: RedPajamaCommonCrawl


Last years qualifiers keeping their hands on a 2001 Chevy Impala.
ST. GEORGE – Locals have been asking Cherry Creek Radio and Executive Auto Group to host another contest like they did last year. So to give back to the community together they have put forth their second contest in which the public can win a free car as easy as laying eyes on it – and one hand.
Here's the catch, 50 qualifiers over the age of 18 will be selected to keep their hand on a white 2001 Ford Explorer, with bells and whistles, for as long as they can. The person who keeps their hand on the car the longest will win the car.
Cheating, such as taping or gluing their hand to the car and sitting on or in the car, will not be allowed and will disqualify the contestant. So play it fair, it doesn't need to be that complicated. How hard can it be to keep a hand on a car? Or, the bigger question, how long does it take to keep a hand on a car and win?
Last year the contest went on for 96 hours.
During the contest there will be a 15 minute break every two hours – in the beginning. But as the contest progresses, the breaks will be further apart in hours.
Having friends and supporters may come in handy to help entertain and feed the qualifiers, though lunch and dinner will be provided. Be sure to tell an employer and friends if you are considering competing.
You can enter the contest in two ways: entering your name at remote broadcasts or by visiting Executive Auto located at 543 N. Bluff Street in St. George and dropping your name in the box. The names will be drawn every Wednesday through March 13. The contest will begin on March 20 at 5 p.m.
"Chances are we might start doing this every year" said Downward.
Last years qualifiers keeping their hands on a 2001 Chevy Impala. Photo curtesy of Rabbit Downward.
Sarafina has been studying film since she was 14, became a stage manager of a theater production at 15 and opened her own production company offering a variety of videography services at 16. Keeping abreast of the latest technology and growing her career is her passion. Born and raised in Southern Utah, Sarafina possesses a focused vision for bringing its news to the forefront in media that will engage the attention of her viewers.


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california punk
old school punk
Marc Bell (better known as Marky Ramone, born July 15 1956, in Brooklyn, New York) is an American drummer. He is perhaps best known for being the drummer for the highly influential punk rock group Ramones. Marc Bell started playing drums when he was 16, with his band Dust. He recorded two albums with the band." From a Dry Camel" one of the songs off their first album. Was listed in the top ten metal songs of all time. In the first edition of the Heavy Metal Almanac.The two albums made the charts in America. Read more about Marky Ramone on Last.fm.
Artisti simili
The Rumjacks


Our RiverMead reading partners joined us for this special event too. They enjoyed enjoyed every minute. After storytelling, our RiverMead reading partners had refreshments and read with students. This day was meaningful to all involved.
Inspired by Michael Daley, one of our first grade readers was brave enough to read a story to her entire class taking huge step toward reading independence! A proud moment!


Did you know that engagement with the arts makes you happier or that the main source of income to the arts per annum is consumer spending?
The arts are a big part of everyday life for Australians with high engagement levels and mostly positive attitudes to the arts and its impacts and benefits.
Aboriginal and Torres Strait Islander arts and cultures are a rich and unique part of Australian life and are increasingly understood, valued and lauded on the world stage.
The cultural economy is big business contributing significantly to the Australian economy.
Overall Art Nation is a very valuable resource for anyone working in the arts sector or with an interest in the arts, providing data at a national level in a form that is easily understood and quotable. It is also a work in progress, which is acknowledged and looks forward to what future reports might cover.
There are some fantastic new facts that we want to highlight that have come out of new research.
Engagement with the arts make you happier – Rachel Smithies' and Daniel Fujiwara's analysis on subjective wellbeing suggests that engagement with the arts correlates with higher life satisfaction – the amount of money required to produce an increase in life satisfaction equivalent to arts engagement is $4,349 per person per annum. Across the Australian population this is equivalent to $66 billion a year.
Lower attendance 20km out of Brisbane – Living in a regional location limits engagement with the arts less than might be expected. Though it turns out that if you look at attendance in capital cities, people who live within a 20km radius from the city centre (inner urban) have higher arts attendance than those who live outside this area (peri-urban) (74% vs 69%) nationally. The largest differences in attendance between inner urban and peri-urban areas are observed in Brisbane (75% vs 54%) and Sydney (76% vs 69%).
People with disability and people with low incomes are now just as likely to create art as Australians overall – Over the last four years there has been a big increase in creative participation in the arts by people with disability and people with low incomes. They are now just as likely to create art as Australians overall.
Women artists – Females accounted for less than a third of nominees for a selection of 21 major Australian arts awards open to both genders over the last three years and female artists earn half the median creative income of male artists, despite spending similar amounts of their time on creative practice (50% for males and 44% for females).
International arts tourism on the rise – Over the last four years, the number of international tourists to Australia has grown by 13 percent while the number of international arts tourists has increased 19 percent to 2.4 million in 2013–14. One in four international tourists visited a museum or art gallery in 2013–14 making it the most popular arts tourism activity. This level of engagement is similar to the UK and the USA (26% for Australia, 27% for the UK, 24% for the USA).
Aboriginal and Torres Strait Islander artists – Aboriginal and Torres Strait Islander peoples in remote areas have higher participation in arts and cultural activities. Those who do participate have markedly better physical and mental health and self-reported happiness and are more likely to complete secondary school and be employed.
Art production is the main source of commercial income for many remote communities with art centres. Between 2008 and 2012, remote Indigenous art centres generated around $53 million in art sales, with $30 million paid to artists. Nearly two thirds of artists who have received resale royalties are Aboriginal or Torres Strait Islander. The royalties generated by these Indigenous artists is close to $2.6 million which is almost half of the total royalties generated since 2010.
Cultural economy – A conservative estimate of the economic contribution of the arts is that the performing arts, music recording and publishing and arts education together contribute $4.2 billion (0.3% of GDP). This does not include the value of volunteer services which are estimated to be worth an additional $0.8 billion across arts and heritage organisations.
The main source of income to the arts is consumer spending. Australians spend almost $20 billion on cultural activities annually, which is four percent of their average weekly household expenditure. Most private support for the arts is from private donations, which continue to grow faster than corporate sponsorship and amount raised by artists through crowdfunding has more than quadrupled since 2011-12 to 2013-14 ($1.1m to $4.8m).
For more detail see Australia Council for the Arts, Art Nation: An Overview of Australian Arts 2015.
If you found this useful, you might like to have a look at Queensland's Arts in Daily Life data or see how funding outcome report data links to the bigger picture data collected by Australia Council and others in The rings of value.


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Composition | John Snow Labs
FHIR Composition Resource
Electronic Health Records Exchange Through FHIR
Processes Data
Processes Information
Processes Documentation
FHIR Smart
Smart on FHIR
The Composition Resource is a set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle.
A Composition is a basic structure from which FHIR Documents – immutable bundles with attested narrative – are built. A single logical composition may be associated with a series of derived documents, each of which is a frozen copy of the composition.
A Composition is a structure for grouping information for purposes of persistence and attestability. There are several other grouping structures in FHIR with distinct purposes:
The List resource – enumerates a flat collection of resources and provides features for managing the collection. While a particular List instance may represent a "snapshot", from a business process perspective, the notion of "list" is dynamic – items are added and removed over time. The List resource references other resources. Lists may be curated and have specific business meaning.
The Group resource – defines a group of specific people, animals, devices, etc. by enumerating them, or by describing qualities that group members have. The Group resource refers to other resources, possibly implicitly. Groups are intended to be acted upon or observed as a whole (e.g., performing therapy on a group, calculating risk for a group, etc.). This resource will commonly be used for public health (e.g., describing an at-risk population), clinical trials (e.g., defining a test subject pool) and similar purposes.
The Bundle resource – is an infrastructure container for a group of resources. It does not have narrative and is used to group collections of resources for transmission, persistence or processing (e.g., messages, documents, transactions, query responses, etc.). The content of bundles is typically algorithmically determined for a particular exchange or persistence purpose.
The Composition resource – defines a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. The Composition resource provides the basic structure of a FHIR document. The full content of the document is expressed using a Bundle containing the Composition and its entries.
The Composition resource organizes clinical and administrative content into sections, each of which contains a narrative, and references other resources for supporting data. The narrative content of the various sections in a Composition are supported by the resources referenced in the section entries. The complete set of content to make up a document includes the Composition resource together with various resources pointed to or indirectly connected to the Composition, all gathered together into a Bundle for transport and persistence. Resources associated with the following list of Composition references SHALL be included in the Bundle:
– Composition.subject
– Composition.encounter
– Composition.author
– Composition.attester.party
– Composition.custodian
– Composition.event.detail
– Composition.section.author
– Composition.section.focus
– Composition.section.entry
Other resources referred to by those resources MAY be included in the Bundle at the discretion of the authoring system as documented in the system's operation definition (such as $document operation), or as specified by any applicable profiles.
Fast Healthcare Interoperability Resources (FHIR) is a draft standard describing data formats and elements (known as "resources") and an application programming interface (API) for exchanging electronic health records. The standard was created by the Health Level Seven International (HL7) health-care standards organization.
Its goal is to facilitate interoperation between legacy healthcare systems, to make it easy to provide healthcare information to healthcare providers and individuals on a wide variety of devices from computers to tablets to cell phones, and to allow third-party application developers to provide medical applications which can be easily integrated into existing systems.
FHIR provides an alternative to document-centric approaches by directly exposing discrete data elements as services. For example, basic elements of healthcare like patients, admissions, diagnostic reports and medications can each be retrieved and manipulated via their own resource URLs (Uniform Resource Locators). FHIR was supported at an American Medical Informatics Association meeting by many EHR (Electronic Health Record) vendors which value its open and extensible nature.
John Snow Labs; Health Level Seven International;
FHIR, HL7, Medical Terminology, Processes Data, Processes Information, Processes Documentation, Health Information Exchange, Electronic Health Records, FHIR Smart, Smart on FHIR
FHIR Composition Resource, Electronic Health Records Exchange Through FHIR
Concept_Name Name of the concept in the FHIR structure string required : 1
Computer_Ready_Name A Computer-ready name (e.g. a token) that identifies the structure - suitable for code generation. Note that this name (and other names relevant for code generation, including element & slice names, codes etc) may collide with reserved words in the relevant target language, and code generators will need to handle this. string -
Type The type the structure describes. string -
Dollar_Ref The Dollar_Ref ($ref) string value contains a Uniform Resource Identifier (URI) which identifies the location of the JSON (JavaScript Object Notation) value being referenced. string -
Description A free text natural language description of the structure and its use string -
Items The value of the keyword should be an object or an array of objects. If the keyword value is an object, then for the data array to be valid each item of the array should be valid according to the schema in this value. string -
Enum The enum is used to restrict a value to a fixed set of values. It must be an array with at least one element, where each element is unique. string -
Required The value of the keyword should be an array of unique strings. The data object to be valid should contain all properties with names equal to the elements in the keyword value. string -
Const The value of this keyword can be anything. The data is valid if it is deeply equal to the value of the keyword. string -
Concept Name Computer Ready Name Type Dollar Ref Description Items Enum Required Const
Composition resourceType This is a Composition resource Composition
Composition id #/definitions/string The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Composition meta #/definitions/Meta The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Composition implicitRules #/definitions/uri A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Composition _implicitRules #/definitions/Element Extensions for implicitRules
Composition language #/definitions/code The base language in which the resource is written.
Composition _language #/definitions/Element Extensions for language
Composition text #/definitions/Narrative A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Composition contained array These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. {'$ref': '#/definitions/ResourceList'}
Composition extension array May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. {'$ref': '#/definitions/Extension'}
Molecular Biology Research Technique Concepts and Types
Research Activity Relationships
Occupational Activity Concepts and Types
Machine Activity Concepts and Types
FHIR Definitions Data Package


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Ilhéus do Prata é um distrito do município brasileiro de São Domingos do Prata, no interior do estado de Minas Gerais. De acordo com o Instituto Brasileiro de Geografia e Estatística (IBGE), sua população no ano de 2010 era de 610 habitantes, sendo 302 homens e 308 mulheres, possuindo um total de 354 domicílios particulares. Foi criado em 9 de abril de 1891.

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 Distritos do Brasil

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Distritos de São Domingos do Prata

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Dorse Kelly process all new CPM employees' benefit enrollment make sure all paperwork is properly completed to process their bi-weekly payroll. She's been employed with Chicago Public Media for over 33 years and has no desire to retire yet! She loves to travel and will be spending Thanksgiving 2015 in Hawaii.


This patented system is much safer, faster and more cost effective than any other used on mine-sites today, reducing downtime by up to 80% and costs up to 75%. It is the way of the future.
It is difficult to understand just how good this system is until you've experienced the difference for yourself. No company that has used Pakka Jacks has ever returned to the old systems.
The Pakka Jacks system is a game changer, a revolutionary new approach that has been tested and refined for over ten years in some of the toughest mine conditions in the world. In that time it has been adopted by most of the major mining companies in the country.
This is no longer just a really good idea, it is the benchmark, internationally in terms of safety, cost and machine availability.
This is the future. If you want to be a part of it, give us a call.
If this system just improved safety by a large margin, which it does, it would be amazing. The fact that it does this while slashing costs and downtime is the stuff of legend.
It is also the only system in Australia that meets the current Workcover regulations.
The Pakka Jacks system achieves the same results as current methods with less workers, in much less time and without the use of multiple cranes. Standard machine maintenance projects can realize savings in the order of half a million dollars. Over 90% of all Pakka Jacks projects have achieved savings greater than 50% compared with old methods.
The different approach utilized in the Pakka Jacks system radically changes the way maintenance projects are handled. Standard jobs can be reduced from 9 days to 2. This is not an improvement of 10%, or even 20%, which would normally be incredible. This is an improvement of 78%, or 7 days. That's 168 hours of extra machine availability.
Safer, faster and more cost effective - the Pakka Jacks system radically improves all aspects of on-site machine maintenance.
This is one of the most awkward, and important aspects of dealing with large machine maintenance. Pakka Jacks are the only lifting system where the load isn't suspended at any point, it is always supported.
The unique self-packing mechanism means that the load, using a Pakka Jacks system, is always supported, at every stage of the lift. This means that the area under the load can be accessed at any stage.
This single benefit has enormous ramifications for maintenance work. Work site safety is greatly enhanced while making the work much easier and faster.
Many mine maintenance procedures currently employ dual or multiple cranes. This is expensive, complex and has a high degree of risk.
There has been a lot of attention recently on the dangers associated with multiple crane lifts. They are intrinsically complex and high risk. They are also expensive, particularly when you take into consideration the additional safety allowance (reserve capacity) required for each additional crane.
The Pakka Jacks lifting system takes multiple cranes out of the equation. There is, in fact, very little craneage required at all. An additional advantage is that the Pakka Jacks system can operate in weather extremes where cranes are unusable.
Recent failures have made multiple crane lifts a hot topic.
The Pakka Jacks system has been designed to handle side-loading, a critical safety feature on work-sites exposed to high winds, blasting and variable ground conditions.
Both the system design and the lift units themselves contribute to a side loading capacity that has been independently certified to meet all relevant standards. So the Pakka Jacks system is just as safe as the stands you use every day.
Compared to current systems, which have little or no inherent side loading capacity, this is actually an enormous benefit, greatly reducing risk of injury or catastrophic failure.
Hydraulic injection is horrific, both on the personal and commercial levels. The Pakka Jacks system has been specifically designed to guard the operator against this in all aspects.
Features like an enclosed control console, completely separating the operator from the hydraulic lines, and fully enclosed high pressure hydraulics in the lifting units, mean that workers are far better protected from risk of hydraulic injection.
Hydraulic pressure is only present during the relatively brief period of active lifting or lowering. At all other times, the high pressure hydraulic system is inactive, and the Pakka Jacks units function purely as certified stands. This effectively removes all risk of hydraulic injection for the majority of the maintenance period.
We take hydraulic injection seriously. The whole system has been specifically designed to minimize all risk in all situations.
Standard procedures are commonly completed in less than a quarter of the time, often with reductions of 7 days or more.
On most mine sites around the world today, this would be regarded as pure fantasy. On the mine sites that have utilized the Pakka Jacks system it is just regarded as jaw-droppingly good.
With the Pakka Jacks system, there is no longer any need to sequentially remove major components, one of the biggest factors contributing to maintenance duration.
When downtime is costed at $1K per hour or more, every day has a huge impact on running costs and overall site profitability. Seven days of downtime translates to 168 lost hours and has a big impact right along the work stream. When this downtime is a result of breakdown, rather than scheduled maintenance, the losses are even greater.
Another benefit of reduced downtime, and reduced maintenance cost, is that it allows for maintenance to be performed more regularly. This translates into greater machine availability, longer machine life and much greater throughput and profitability.
With less labor, minimal craneage and taking only a fraction of the time, cost savings of over half a million dollars are common, for single maintenance procedures.
In over 90% of actual cases, cost savings greater than 50% were realized, compared to previous procedures. In some cases, the costs were reduced by over 75%.
To be really clear on this; you pay less than half the money for a job that takes only a quarter of the time, with greater safety - and you get the same result as you did the old way.
If you're still doing it the old way, you need to give us a call.
Improved safety at half the cost and in a quarter of the time - with the same result. Why haven't you called us yet?
Having a single operator controlling the entire lift, with excellent visibility and the choice of full automatic or manual control is a vast improvement on other current methods.
Compared to multiple cranes and manual packing, or any other current method, the operator of the Pakka Jacks system has far more control.
The control console can also communicate securely online, allowing remote users to check diagnostics, change settings or just monitor the lift.
Complete QA audits can also be delivered for the entire lifting operation.
Greater control means improved safety, flexibility and efficiency.
Mining work-sites recently came under Australian Workcover regulation. This has immediate implications for maintenance work on vehicles, all of which are met by the Pakka Jacks system.
The Pakka Jacks system is the only Workcover approved, self-supporting jacking system in Australia. Given that Australian standards are some of the toughest in the world, we are very confident that the Pakka Jacks system should meet or exceed current requirements in mine sites across the globe.
All of these benefits flow from the fact that the patented Pakka Jacks system is a new way to perform an old task.
This system is so much better than current methods, it almost seems unfair to compare results (but we're still going to do it).
The game has changed, and it's all good news. Worker safety has improved, machine availability has increased and costs have been slashed.
Join some of the world's leading mining companies and get the same advantage they already enjoy on their sites. Give us a call.
The Pakka Jacks system changes the game in terms of safety, machine availability and costs. To get back in the game, you need to call us.


Jeddah, Al Kandarah intro. Jeddah is one of the most important cities in Saudi Arabia. It is situated upon the Red Sea coast, and therefore has grown into an important port city of the oil trade of the country. There are many thousands of visitors, from both domestic and international destinations, that flock to this resort town each week. The city centre is home to many fabulous hotels, including the Al Kandarah hotels. In addition to the these, this district is also the location of the famous Jeddah Clinin Hospital. Not far from the district is the Jeddah corniche, which stretches along the waterfront area of the city. It contains many interesting sites, including the Ata Allah Theme Park and the Al-Shalal Theme Park, which are two of the most visited attractions by family-travellers in the city. One of the best aspects about staying here is its central location to almost anywhere in city. This is great for tourists and short-stay visitors.


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No question, Nevada's golf courses are as challenging as they are spectacular. And without doubt, this is due in no small part to the state's daunting landscapes and sheer physical beauty.
Throughout the southern desert, seas of green caress the rocky terrain. Breathtaking oasis, pleasantly warm in winter, and designed by the game's finest - Dye, Stamps, Palmer, Fazio, to name but a few. Within a two hour drive of Las Vegas you'll find 50 of these masterpieces. Among them, championship courses like the Tournament Players Club at Summerlin and The Canyons, home of the PGA's Las Vegas Invitational.
Farther north, in, on and around the majestic mountains and pristine lakes, you'll find another 50 courses, all as magnificent as they are challenging. Take the Montreux Golf and Country Club, for example, a private paradise and home of the Reno-Tahoe Open. Or the Edgewood Tahoe, where the American Century Celebrity Golf Championship is played. These are no ordinary courses. They are man-made works of art, painstakingly designed to complement Mother Nature's own miracles. And don't miss The Divine 9 around Carson City, each course more heavenly than the next.
No matter if it's north or south, public or private, Nevada's golf courses are simply some of the finest in the land. In fact, Golf Digest names 5 Nevada courses in its list of America's 100 Greatest Public Courses. And Golf Week has 5 Silver State locations on its list of America's Top 100 Resort Courses. That's a lot more than our fair share. And let's not forget one of the real perks of playing golf in Nevada. Besides the magnificent courses themselves, there's just so much else to do here once the round's over. From the undivided pampering of some of the world's leading spas to the bright lights and non-stop action of the night, there's a lot more to a Nevada golf vacation than just golf.
It is Nevada, after all !!


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GP's Classic Steel #98- 1984 250MX Shootouts
Tony Blazier January 7, 2015 0 3
For this installment of our classic shootout rundown, I thought we would take a look back at the 250 class of 1984.
The early 80's were an exciting time to be a motocross enthusiast. Motocross technology was moving at an incredible pace and bikes were often being completely redesigned after only ONE YEAR on the market. Can you imagine that today, now that some bikes go half a decade with only small refinements? In the early eighties, change was the norm and complete redesigns were the order of the day. Within the span of three short years, the average 250 MX machines morphed from a simple air-cooled, dual-shocked sled, to a linkage-suspended, liquid-cooled, disc-braked Supercross weapon.
Of course, the flip side of this breakneck pace was the fact that if you were stuck racing a two-year old bike, you were likely left sucking rocks and castor oil. Power plants, suspension and overall design were moving at the speed of light, and this put an incredible strain on the smaller manufacturers. Brands like Can-Am, M-Star (Maico) and Husqvarna were making a valiant attempt to keep pace, but by 1984, the writing was on the wall. The Japanese had set their sights on motocross dominance, and the Old World brands looked to be going down for the count.
For this installment of the test roundup, we are going to look at the shootout results from Motocross Action, Dirt Bike, Dirt Rider and MOTOcross magazine. These were the premier MX focused enthusiast magazines in 1984 and they give us a good cross section of the editorial opinions of the day.
So let's step into the Way Back Machine one more time and take a look at the 250 motocross class of 1984.
It is pretty telling that in the four shootouts I looked at in 1984, only the ever-inclusive Dirt Bike Magazine even tested bikes other than the Big Four. MXA, Dirt Rider and MOTOcross magazine all included the Suzuki, Yamaha, Kawasaki and Honda in their tests, but drew the line at the Euro brands. In addition to the usual suspects, Dirt Bike threw in the KTM, Husky and M-Star for good measure.
None of the 1984 250 class were perfect, but MXA came to the conclusion that one machine stood head and shoulders above the rest.
While the 250 shootout garnered top billing on the cover of the March '84 issue, I bet most of us teenage moto heads were more interested in the "Pit Tootsie" fashion guide of page 74
Dirt Rider magazine was still fairly new in 1984, and their 250 shootout showed that they were still working out the kinks. It was by far the most brief of the four wrap-ups and extremely light on any details. No-pictures, virtually no info and buried in the back of the mag like an afterthought, this shootout garnered a big boo from a fourteen year old Blaze.
1984 Honda CR250R Shootout Ranking –
MXA: 1st
Dirt Bike: 3rd
MOTOcross: 1st
Dirt Rider 2nd
Overview- For 1984, Honda round-filed their class winning 1983 CR250R and spec'd a virtually all-new machine. The '84 CR featured Honda's first production "Power Valve" (dubbed ATAC for Automatic Torque Amplification Chamber) and their first application of a disc brake for the front. New bodywork mimicked the look of the works RC Factory bikes and gave the CR the sleekest lines in the 250 class.
On the track, the CR's new motor romped on the competition with a broad powerband and blistering performance. It was by far the fastest bike of '84 and head-and-shoulders above the other bikes in stock trim. Unfortunately, the Honda's suspension was not nearly as effective as the motor and the Red Rooster ranked near the back of the pack in suspension performance. Handling continued to be good overall, with a sharp feel in the turns and a vicious headshake under deceleration.
Reliability was also a Honda bugaboo in '84, with cracked pistons (MXA recommended buying pistons in six-packs), seized crank bearings and broken wheels a major problem. Overall, the Honda was a blazing fast bike, with sano looks and crummy suspension (stop me if you have heard this before). MXA and MOTOcross thought the Honda was best, largely due to its pony prowess, but Dirt Bike and Dirt Rider were less enamored with its propensity to deliver sore wrists, bruised backsides and pricey repair bills.
1984 Suzuki RM250 Shootout Ranking –
MXA: 3rd
Dirt Bike: 1st
MOTOcross: 2nd
Dirt Rider: 3rd
Overview – Another all-new bike for '84, the RM250 adopted the looks of the 1983 RH works bikes and added a new coat of bright blue paint to spruce things up. The new bike sported a completely redesigned chassis and a second generation of Suzuki's award winning Full-Floater rear suspension system. In the motor department, the new bike improved slightly on the mellow (slow) '83, with a wide spread and pleasant delivery, but no overabundance of thrust. It was an easy to ride power plant, but in no danger of out dragging the torquey Yamaha or blistering Honda. By far the new RM's greatest virtue was its suspension, which continued to lead the class by a wide margin. In Dirt Bike's view, this suspension advantage and ease of use outweighed its power deficit. For MXA, Dirt Rider and MOTOcross (who almost picked the RM tops) the RM's excellent suspension was just not enough to overcome its uninspired power plant.
1984 Yamaha YZ250 Shootout Ranking –
MXA: 2nd
Dirt Bike: 2nd
MOTOcross: 3rd
Dirt Rider: 1st
Overview – A very solid effort for 1984, the YZ was actually good enough to beat out the works bikes of the competition for the 1984 250 National Motocross title. When you consider that Rick Johnson accomplished this feat on basically a stock YZ, with an Öhlins shock, Simons fork and a porting job, it is even more eye opening. In stock condition, the YZ provided a brutal low-end delivery and burly midrange blast. It was the fastest bike out of turns, but once past the midrange, the YZed threw out the anchor. Revving it out only made it go slower, and its cranky transmission made selecting the next cog a chore. The Yamaha handled well, with excellent turning manners and a light feel, but its confused suspension package hindered its performance in the rough. Fork performance was particularly abysmal and more akin to an undersprung pogo stick than a high-tech suspension component. For most of the magazines, the woeful fork performance, cantankerous trans and lack of top-end were enough to knock the YZed out of the top spot. Only Dirt Rider picked it as champ, and only after their CR blew up one too many times.
1984 Kawasaki KX250 Shootout Ranking –
MXA: 4th
Dirt Bike: 5th
MOTOcross: 4th
Dirt Rider: 4th
Overview – The 1984 Kawasaki KX250 certainly does not stand as a high water mark for the green brand. The KX finished last in the three all-Japan shootouts and even got beat out by one of the Euro's in the Dirt Bike contest. The last of the fender-plated Kwackers, the '84 KX was burdened with a tall and tippy chassis no one liked and awkward ergonomics that appeared to be designed for Andre The Giant. The bike was clumsy in the corners and by far the hardest of the Nipponese machines to negotiate through the turns. Suspension performance was sup-par, with both ends bottoming out with a mighty thud on anything bigger than a Wrigley's chewing gum wrapper. Its motor offered decent pull, but the powerband was narrow and hard to use. On the plus side, it did have the most powerful front brake in the class and a trick Euro-style fender brace, so there's that. Thankfully, better days were ahead for Team Green.
1984 KTM 250 MX Shootout Ranking –
MXA: N/A
MOTOcross: N/A
Dirt Rider: N/A
Overview – In 1984, the KTM 250 actually had a lot going for it. It was the lightest bike in the test at a feathery 213 pounds (no small feat considering the seat was constructed from industrial grade concrete) and over the course of seven months it proved the most reliable. Quality components were used throughout and the KTM's forged pistons lasted four times that of the cast-formed Japanese competition (ten times in the case of the grenade-prone CR). Power was solid and plentiful (second only to the CR in max output), but the delivery was too slow and enduro-like for most rider's tastes. The chassis was stable and great for high-speed off-road use (the frame and basic motor were shared across the MX and off-road line), but it felt long and was less enthusiastic in the turns. The suspension was the exact opposite of the mushy Kawasaki, with too much spring rate and too heavy of damping at both ends. Action was brutally harsh and the KTM was rated the worst of the six bikes tested. With some suspension tuning, the KTM made a great off-road mount, but as a motocross machine, it needed a little work.
1984 M-Star 250 SuperCross Shootout Ranking –
Overview – Here we have one of the last gasps of a once proud brand, the 1984 M-Star 250 SC (almost comically, the "SC" stood for Supercross, a discipline this bike was not likely to ever experience). In the early eighties, Maico fell on hard times in America and abroad. Product quality issues led to diminishing sales and a string of costly lawsuits crippled the German manufacturer's finances. As a result, Maicowerk AG filed for bankruptcy in 1983. This understandably left the U.S. distributors less than enthused and when the Maisch brothers in Germany tried to bring back a restructured Maico in 1984, they met with push back from their former partners. The distributors wanted the money they felt they were owed and refused to let Maicos be sold in the US (the distributors owned the rights to the name in America). As a result of this legal wrangling, Maico sought new distributors and was forced to sell the new bikes as a "M-Star" in America.
In every other country around the globe, the Maicos remained Maicos, but in the good old USA, we got M-Stars, go figure. As for the quality of the new 250 "SuperCross", it was actually a pretty decent bike overall. The '84 250 SC was Maico's, huh…I mean M-Star's, first attempt at a liquid-cooled 250 and pretty solid for a first effort from a bankrupt manufacturer. There was no power valve or fancy disc brakes, but the SC featured single shock suspension and modern look. The motor put out a pleasant spread of ponies that pulled well from the midrange up, but the low-end response was pretty poor and bike required a 125-style aggressiveness to keep it on the pipe. In most situations, the M-Star demanded either its rider to be a gear lower than the others, or be willing to fry the clutch mercilessly to get the German percolating.
In addition to its lethargic low-end, a grim set of Maico (M-Star?) designed 42mm forks, a poorly set up Öhlins shock and a girthy 231 pound fighting weight (18 pounds porkier than the KTM!) held the Teutonic terror back in the final rankings. In the end, it was only better than one machine in the test.
1984 Husqvarna CR250 Shootout Ranking –
Overview – Much like its European brethren, Husqvarna was struggling to keep pace with the Japanese in 1984. A full five years after the debut of Kawasaki's Uni-Trak rising rate, single shock suspension, the Husky was still making due with seventies-era dual shocks in '84. They actually worked pretty well (better than the M-Star, Honda, or KTM's shocks actually), but they gave the bike a very antiquated look and wide layout. Liquid cooling finally made its debut in 1984 on the Hooska, but the new motor still pumped out very old-school dose of ponies. Like the M-Star, the Husqvarna was badly overweight (despite its lack of a beefy swingarm or linkage) and was only one pound lighter than the gravitationally challenged German.
On the track, the Swede was the slowest bike in the test by a Nordic mile and incapable of out pulling a well-tuned KX125. It was slow to rev and happier plowing through pine trees than blasting berm shots. The suspension was good, if a bit soft and the bike handled well, as long as turns were not in your vocabulary. Like the KTM, it made a much better off-roader than MX racer and unfortunately, was no threat to the cutting-edge bikes from Japan in 1984.
BTOSports.com Observations from Anaheim 1
Just Short Vol.4 #1
frank Emerson says:
I am rebuilding a 84 Husky I hope it's not as slow as the shootout says it is. It is factory ported with a pipe, and vforce reed cage, so I hope for some power gains. I have a gold valve, along with heavy springs for the forks. I will have Clark Jones rebuild the shocks , with the heavy progressive springs. So bye May I while have it out at REM.
Rolf says:
Hey Frank, was wondering how your Husky turned out and did you manage to get some power gains?
GREG MAGGIO says:
Hate to say it, but the RM seems to me the best,,good across the board, that is unless you have a sponsor, or lots of throw around money for maintenance..


Yesterday I had an OB appointment. I am at the point where I have to go in every two weeks. Anyway, I decided to just drag Orion along. The nurse checked my blood pressure and listened to the babys heart beat. After she left, Orion climbed up on the table and lifted his shirt up. He wanted to listen to "his baby" too. When I told him we couldn't, because the nurse took the listener, he was not discouraged. He pointed to the arm casty thingy, and lifted his shirt sleeve up, and said "arm." He was still up on the table when the doctor walked in. I made him get down, and I hopped up so that the doc could measure me. Orion then climbed up, so that he could be measured. The doctor was very nice and measured his tummy too.
On the way out to the car, Orion tripped and chipped a tooth. I felt so bad. In the car he kept saying "tongue, teeth, lips." I don't know if he was saying that to express that they hurt, to to let me know that they all felt a little funny. I tried to get a decent picture of his tooth, but he didn't want to smile. I am sure that at some future date, there will be a toothy picture of him, and you all can see the chip then.
Today, was kinda a rough day. It started out good. I did my visiting teaching first thing this morning, which was nice. Although, I must admit that after reading the message, I didn't really feel qualified to teach on it. I am lucky to skim through my scriptures everyday. To actually study them and take something away, is a rare occurrence. (Mostly because when I am awake enough to study, Orion is awake too.) After lunch, it was supposed to be nap time. The key words there are supposed to be. Since Orion has been able to climb out of his crib, I have been giving him the choice to either lay in his bed, or to lay on mommys bed. He has been choosing my bed for the last little while. Which hasn't been to bad. He lays down, and snuggles up next to me, holds my hand, and goes to sleep. After he is asleep, I drift off myself and take a nap. Today however . . . After an hour of him playing on my bed and threatening him with his bed, I finally had enough and just picked him up and took him to his room. On the way in, I tripped on a toy and fell on my knees. Luckily, I didn't drop Orion or fall on him or my stomach (the baby). But WOW do my knees hurt now. The right is even a little swollen and bruised. When I could, I stood up and put Orion in his crib, and walked out and shut the door. He cried and cried and cried and cried for about an hour. By this time, I was sure that if he just came and lay with me for a few minutes, he would be out. No luck, he played on my bed for another 20 minutes. By this time, I was way tired, and had no patience. I took him back to his crib, and shut the door again. He cried for a little bit, and then just played in his room until I told him he could come out. But neither one of us got a nap today. At about 3pm I decided to be productive and while Orion played outside, I swept, mopped, vacuumed, did the dishes, started dinner, and then cleaned the bathroom. By this time though, Orion was clingy and whinny and just being difficult. I was so glad that Phil came home from work early. After dinner, Orion went down with Philip to watch Cars, while I did dinner dishes. I went down shortly after to find Orion playing with my Stampin Up Chalk. He was covered in green, along with our chair. That was the last straw for me. I took him upstairs for a bath, crying the whole time. After his bath, I sent him back down, but was still weepy. I thought I would just sit and read the Ensign for a few minutes, to help me calm down, and get a grip on my emotions. Wouldn't you know it, but my wonderful visiting teacher showed up with a homemade loaf of bread right then. Unfortunately I didn't have it together enough at that point to not just cry. I'm sure she thought things were a lot worse then it really was. I was just so moved that she was thinking of me. Anyway, Orion is now in bed, asleep, and it was fairly painless to get him there. I am curled up in bed watching Dancing with the Stars, and writing an insanely long blog post. I can't decide if I should just turn in after my show is over with, or if a nice warm long bath is in order. I have been cramping a lot since I fell, but the baby has been super active, so I am assuming that all is well.
Here's to hoping that tomorrow is better! And a HUGE thanks to Janice. The bread was delicious.
When I was pregnant with Mordecai my OB would measure Emily's tummy too, and she would put the gel on her tummy and hit the Doppler with her ring so there was a sound. I miss her!!! Also Mordecai has a chipped tooth too. We really are family. Which tooth did he chip? Mordecai's is HIS right incisor. I have no idea where he lost it though.
I sure hope tomorrow goes better! I totally FEEL you on the bad day thing.
I'm sorry Hannah! I'm glad that your visiting teacher came over and brought you some bread! It's always nice to get something you don't expect, even if it's just a visit. I wish I was closer and could help. I'm sure tomorrow will go better!
Oh, Hannah! I'm so sorry you had such a day. I hate days like that. They always seem to happen on the no nap days. I'm quite impressed with how productive you were able to be though. How do you do it? You are truly wonderful, Hannah! Love you!


Rams News · Feb 4 Dance Marathon Crushes Goal!
Congratulations to Ladue Dance Marathon for another successful event!
Ladue Dance Marathon is a 6-hour celebration of the year-long fundraising efforts of Ladue students on behalf of the Children's Miracle Network in support of our two local children's hospitals, St. Louis Children's and SSM Health Cardinal Glennon Children's Hospitals.
The main goals of the event (and all the work that goes into it) are to raise awareness of the mission of the Children's Miracle Network and to support that mission with financial donations. These funds support children in the hospital by helping to pay for everything from sophisticated equipment to art therapy.
Click the link below to see the final reveal of donations raised.


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Jonathan Leko: Striker wasn't himself after Kiko Casilla racism, says Charlton boss Lee Bowyer
Charlton manager Lee Bowyer says striker Jonathan Leko "wasn't himself" after being racially abused by Leeds goalkeeper Kiko Casilla.
Casilla was given an eight-match ban on Friday after being found to have used racist language towards West Brom forward Leko, then on loan at Charlton, during a Sky Bet Championship match on September 28.
Following the ruling, Leko revealed his frustration at how long it had taken for a hearing to take place, and also his disappointment at a lack of support from the Professional Footballers' Association (PFA) and anti-racism bodies, including 'Kick It Out'.
"You can see he wasn't himself, because he's a bubbly lad, he's a young lad, very confident, and he was a bit quiet for a while after," Bowyer said. "But then us as a group, we got him through that, and then he started to become himself again.
"But the most important thing now is that it's been dealt with and we can all move on. In an ideal world, for us – and I guess Leeds would say the same – it should have been dealt with quicker. I don't think it's been fair on both clubs and all players involved for it go on as long as it did.
"It's too long. To have something like that holding over you is difficult, and for a young player as well. It's not a nice thing to have to carry."
Along with urging the game's governing bodies to "look into their own processes", Leko admitted that he would "think twice" in future about reporting such an incident, due to the level of stress the process has caused him.
The PFA issued a public apology to Leko on Wednesday, explaining that they had contacted Charlton and having not heard back "wrongly assumed" that the player didn't require their support.
Leko returned to West Brom from Charlton after injuring his anterior cruciate ligament at the end of December, but Bowyer has remained in contact with the 20-year-old.
"Us as a football club have been there supporting him from day one," Bowyer said.
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The ATTD Yearbook addresses a growing interest in the development of new and advanced technologies and devices for the treatment of diabetes which has resulted in numerous manuscripts in medical journals relating to this topic and it summarizes, in a critical way, the most important articles in the field of diabetes technology and treatments.
The content of the ATTD Yearbook 2019 will be available free on line via the ATTD2020 website as from the start of the ATTD 2020 meeting. However, if you wish to pre-order a printed copy for EURO 65 you may do it during the registration process.
The 10TH YEARBOOK ON ADVANCED TECHNOLOGIES & TREATMENTS IN DIABETES reflects the recent innovations in the treatment of diabetes, combining a selection of the most relevant published data from the very broad field with short key leaders' opinions. The ATTD2018 yearbook summarizes the most important articles in the field of diabetes technology, published during the period between July 2017 to June 2018.
Mary Ann Liebert, Inc. is the publisher of the ATTD Yearbook and Conference Abstracts.
Please click here to download the ATTD 2018 Yearbook.


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PCMag Asia Buying Guides Spring PC Buying Guide Website & App Building Tools Web Hosting
Need to establish an online presence for yourself or your business but have no idea where to start? This primer will teach you how to create a website—small or large—in no time flat.
By Jeffrey L. Wilson
Stop whatever you're doing and ask yourself this simple question: "Do I need a website?" If your response was anything other than "yes," you need to think again. It doesn't matter if you're the head of a multinational corporation who employs thousands of people or a local mom-and-pop shop from around the way, you need a website to help potential customers find you online. If you have a business, failure to establish an online home is lost revenue. You don't want that.
Fortunately, there is a vast number of web hosting services at your disposal. Choosing one is the tricky part, as it depends both on the quality of the service and its ability to match your needs. The Best Web Hosting Services is an excellent place to start, as it highlights our 10 favorite web hosts.
As far as actually doing the nuts and bolts building and design of your site, you also have plenty of options. You can hire someone to design and code a website, or you can try your own hand (if you're a novice, The Best Courses for Learning How to Build Websites is an excellent starting point). You can use an online service to create web pages, or build it offline using a desktop software tool. Or, if you're a coding dynamo, use a plain text editor to create a site from scratch. How you mix and match these decisions depends on your skills, time, budget, and gumption.
If you're ready to get going, this guide will introduce you to the services and software that can get you started building your own website, even if you have no experience. Keep in mind, none of these tools will give you an idea for a winning website—that's on you. They also won't make you a web designer, a job that's distinct from building a site. Still, these services and software will ease some of the headaches that come from a lack of extensive expertise in CSS, FTP, HTML, and PHP. Let's get started.
Blogging For Fun and Profit
A blog, a shortening of the antiquated-on-arrival word "weblog," is a unique website subset that you may recognize from its familiar layout. Typically, new content resides at top of the page and older posts are revealed as your scroll down. If you need to quickly build a simple website, starting with a blogging service is a great way to go.
The major player in the blog game is WordPress, a content management system (CMS) that powers millions of websites, including The New York Times, Quartz, and Variety. WordPress-powered sites are incredibly easy to set up, customize, and update—ideally on a daily basis. You aren't required to learn fancy-schmancy FTP tricks (though you can certainly use them if you like), and there are ridiculous numbers of free and paid WordPress themes and WordPress plug-ins to give your website a pretty face and vastly expanded functionality. Check out How to Get Started With WordPress to learn everything you need to know about the CMS, including the differences between WordPress.com and WordPress.org. Though WordPress dominates the blogging space, it isn't the only blogging CMS of note.
Yahoo's Tumblr is another incredibly popular blog platform that lends itself to shorter, more visual posts. You can, however, find themes that give your Tumblr site a more traditional website's look and feel. Google's Blogger features tight integration with Google AdSense, so making extra pocket change is a snap. Newer blogging services, such as Anchor, Feather, and Medium, stress writing and publishing more than intricate design, but they're incredibly simple to update.
These services can host your content on their servers free of charge, but in exchange for that zero cost, your online destination will have a less-than-elegant domain, such as jeffreylwilson.tumblr.com. That might be fine for a personal blog, but it will look too low-rent for a business that wants people to trust it enough to pay for whatever it's selling.
If you prefer a more traditional URL, you'll need to purchase one from the likes of GoDaddy or Namecheap. Domain name pricing can range from extremely cheap to extremely expensive, depending on whether or not domain squatters are looking to flip a valuable piece of online real estate. You'll want to get something short, but evocative and catchy. For more, please read How to Register a Domain Name.
Depending on the hosting service, you may need to download the CMS and upload it to your own hosted platform if you wish to use a domain you purchased elsewhere.
If you're concerned about how your site will look on mobile devices, don't fret. Sites created on these blogging platforms typically include mobile-friendly responsive design versions, so that they're well formatted for smartphones and tablets.
Build Your Personal Online #Brand
Blogs are swell, but sometimes you need a simple place to park your persona on the internet for branding purposes. In this case, you can just get a nameplate site, or as we prefer to think of them, a personal webpage (rather than a multipage site). Instead of linking internally to your store or other pages of note as you would with a more traditional web page, a personal site usually has links that go elsewhere—to your social networks, wish lists, playlists, or whatever else is linkable.
About.me is an example of a nameplate service. You simply upload one big photograph as the background for your personal webpage, then artfully overlay information and links to create your digital nameplate. These free sites help you pull images from your social networks or from a hard drive, then provide the tools to make the text and links work unobtrusively, though it really behooves you to check out other personal pages for an idea of what works.
These services typically offer a premium tier that grants more hosting flexibility. For example, About.me's $8 per month premium package removes the company's branding and gives you the ability to connect your site to an externally purchased domain.
Artists with major portfolios to show off shouldn't feel left out. There are a number of personal page/site builders, including BigBlackBag and SmugMug, that display your work just as well, or better, than Flickr or Instagram can.
Stepping Up to Self-Hosted Services
When it's time to go beyond the blogs, beyond the online resumes, beyond the page of links, which service do you turn to for a full-blown site that gives you the flexibility to build nearly anything you desire? There's no lack of them, but three of our favorites are DreamHost, HostGator, and Hostwinds, well-rounded services that feature numerous hosting types and tiers.
You can get started for roughly $10 per month for shared or WordPress hosting if your website doesn't require much server horsepower. As your business expands, however, your website may need greater horsepower. That's when you should look into cloud, VPS, and dedicated hosting. These levels of services are for when you really need a web host that offers lots of storage, a significant amount of month data transfers, and numerous email accounts.
See How We Test Web Hosting Services
Even if you don't sign up for those web hosts, you should look for services that offer similar features. You'll want a WYSIWYG editor that lets you adjust every page and add images, video, and social links. Plunking down a few extra bucks typically nets you robust ecommerce and search engine optimization (SEO) packages for improved Bing, Google, and Yahoo placement. Most advanced web hosting services include at least one domain name, free of charge, when you sign up.
How to Build an Ecommerce Website
Before we move on, we should discuss integrating ecommerce into your website. If you plan to sell a product or service, this is an essential part of the website building process that cannot be ignored. Thankfully, most web hosting services offer a variety of different bundled software and integrations.
Things to look for as you vet hosts for ecommerce include drag-and-drop store builders, Secure Socket Layer (SSL) software for safeguarding financial transactions, and email marketing plug-ins, so that you don't have to work with an outside vendor to promote your business. There's nothing wrong per se with using an unconnected marketing service, but anything that adds convenience means more time to spend on the rest of your business. For more in-depth advice on getting started selling online, you should consider our story on the 6 Factors Companies Need to Consider When Choosing a Web Host.
Website Builders Build Websites
There's another relatively fast way to get your website online: website builders. These are standalone services featuring drag-and-drop tools and templates that let nonexpert, would-be webmasters get up and running quickly. Some advanced web hosts also offer their own sitebuilders or integrate functionality from one of the standalone services.
While the best of them offer surprising amounts of flexibility, they also impose stringent enough restrictions to page design that you shouldn't be able to create a really bad looking site using one of these services. Typically you can get a Mysite.servicename.com style-url with no commerce abilities for free from one of these services; you have to pay extra for a better URL and the ability to sell. One issue to consider is that if you eventually outgrow one of these services, it can be hard to export your site to a full scale advanced web hosting like Dreamhost or Hostgator. If you know that's where you are eventually going, it may be better to skip the sitebuilder step.
None gets the job done better Editors' Choice award-winning Wix, though Gator and GoDaddy have very compelling offerings. It has a drag-and-drop interface, and all elements of the site are customizable. It doesn't cost a cent to get started with Wix, but you'll want to go premium, starting at $5 per month for a domain and scaling upward to $25 per month for unlimited monthly data transfers and 20GB of storage.
DIY: Website Creation Software
For years Adobe Dreamweaver has been synonymous with web page creation. It's gone from being a creator of HTML pages in a WYSIWYG interface to being able to handle programming pages in Cold Fusion, JavaScript, PHP, and other formats. Its liquid layout lets you see how pages look at different browser and screen sizes—even on smartphones and tablets. It's about as code-heavy as you want it to be.
Dreamweaver is available as part of the Adobe Creative Cloud subscription service. You can get a standalone version of Dreamweaver CC for $31.49 per month, or as part of Adobe's All Apps suite, which includes Illustrator CC and Photoshop CC, starting at $79.49 per month.
If you're on a Mac, however, there's another option: RapidWeaver. This WYSIWYG webpage editor has full code access and FTP support for uploading pages. There are plenty of built-in templates to get started, all for the one-time price of $84.99. On Windows there are numerous choices. Xara Web Designer, for example, starts at $49.99 and promises you don't need to know HTML or Javascript to create sites based on the company's templates.
Press Publish
Sure, there are more advanced hosting topics to consider, such as domain name servers and multi-cloud connectivity, but this guide is meant to introduce you to the basics. Whether you decide to build a website yourself or hire coding experts to do the dirty work is up to you. For now, rest easy knowing you have the information to get started in taking your business online.
For further reading on getting the most out of your business website, check out 10 Easy But Powerful SEO Tips to Boost Traffic to Your Website, Building an E-Commerce Website: 8 Technical Aspects You Need to Understand, Processing Payments on the Web: 7 Things to Consider, and 6 Surefire Ways to Market Your New E-Commerce Website.
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About Jeffrey L. Wilson
For more than a decade, Jeffrey L. Wilson has penned gadget- and video game-related nerd-copy for a variety of publications, including 1UP, 2D-X, The Cask, Laptop, LifeStyler, Parenting, Sync, Wise Bread, and WWE. He now brings his knowledge and skillset to PCMag as Senior Analyst.
When he isn't staring at a monitor (or two) and churning out Web hosting, music, utilities, and video game copy, Jeffrey mentors, practices Jeet Kune Do, blogs, podcasts, and speaks at the occasional con. He also collects vinyl and greatly enjoys a craft brew.
You can a find Jeffrey online at jeffreylwilson.net, or send him a tweet at @jeffreylwilson
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Not selling or buying your home?
A home warranty plan is a service agreement that provides protection against the cost of unexpected service repairs or replacement of the property's major mechanical systems and appliances, such as your furnace, boiler or heat pump, air conditioning or evaporative cooler, whole house fan, water heater, electrical, plumbing, garage door opener, sump pump.
A home warranty plan can also cover items such as a gas fireplace, hot tub, pool, septic tank, well pump, and more.
Blue Ribbon Home Warranty plans offer upgrades that can be added to our comprehensive plans. This makes it easy for you to customize the plan you want in order to get the protection you need for your home.
Choose a plan that best fits your needs, starting at $18.75 a month. Blue Ribbon Home Warranty, Inc., offers a plan for every household budget, and if you cannot find what you are looking for, ask us and we will see what we can do to help you.
There are plenty of reasons for adding a Blue Ribbon Home Warranty to your home, here are just a few.
Do you know that routine periodic home maintenance will cost on average 1% - 3% of the purchase price of your home per year? No matter how conscientious, many things in the house don't last forever and eventually, will need replacement or repair. The cost of fixing or replacing your home's major mechanical systems, appliances, gas fireplace, hot tub, pool, well and septic tank increases at an average of 10-20%? Most repair companies charge a service fee just to show up at your door.
A Blue Ribbon Home Warranty will help you keep repair costs down for good. Plus, it can increase the value of your home, condo, townhouse, manufactured home, mobile home, duplex, triplex, four-plex, and other multi-family residential properties.
If you have a problem with an appliance or mechanical system in your home, who is going to fix or replace it?
Are you sure you are getting the BEST price and service?
Is it being FIXED properly?
Are you sure, you are hiring a Company that will stand behind their promises? What about when it comes time to RENEW? Do they drastically increase their prices or change the coverage policy in the middle of your term?
Is the home warranty company, locally owned, or are they based out of state? What are their credentials, credit standings, and are the members of the Better Business Bureau? How long have they been in business?
You have asked about the quality of their contractors, but what about the quality of the products too?
WE HAVE THE ANSWERS! We will pay to repair or replace your home's mechanical systems, appliances, and specialty items such as Gas Fireplaces, Hot Tubs, Pools, Well pumps, Septic tanks regardless of their age.
Looking for a Colorado REALTOR or real estate professional in YOUR area?