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Elsie Meyer
Elsie Meyer, 71, of California, Mo., passed away peacefully on Saturday, December 21, 2019, at home surrounded by her family. Elsie was born on November 17, 1948, the daughter of Paul and Lucille (Comer) Yarnell. On December 2, 1967 she was united in marriage at First Baptist Church, Clarksburg, Mo., to Billy Joe Meyer, who survives of the home. Elsie graduated from Tipton High School in 1967. She was employed at Burger's Smokehouse and later as a cook at California Elementary School. She was of the Baptist faith and was currently attending the United Church of Christ in California, Mo. Elsie was an avid horse lover and she spent many years showing Appaloosa horses. In later years, she joined the Percheron Horse Association and enjoyed horse drawn farm work and carriage work. She was a member of the Missouri Draft Horse and Mule Association and was the 2017 Member of the Year. She thoroughly enjoyed the World Percheron Congress and she traveled all around the United States to attend these Congresses. For 51 years Elsie and Billy had camped at the Missouri State Fair where they would attend all the horse shows possible. They also liked to attend other state fairs across the United States making many friends along the way. Additional hobbies include camping, crappie fishing, attending all kinds of festivals and meeting her family and friends at Nic Nac Café. She was a member of the 'Breakfast Club and Thursday Night Supper Club' and was the driver for "Elsie's Oats Bus". Elsie is survived by her husband; daughter, Carla Meyer, Clarksburg, Mo.; son, Asa Meyer of California, Mo.; mother, Lucille Barbour of California, Mo.; grandchildren, Dakota (Sarah) Meyer of Colorado Springs, Colo., Casandra Rogers of Eldon, Mo., Brenden Lodato of Jefferson City, Mo.; one great-grandson, Anthony Meyer of Colorado Springs, Colo.; one brother, Russell Yarnell, California, Mo.; two sisters, Kathy (Larry) Murphy of California, Mo. and Sherry (Richard) Tuttle, Clarksburg, Mo.; one step-brother, Joe A Barbour and one step-sister, Pauline Klenz, both of Lomita, Calif.; one step-sister-in-law, Lois Ann Barbour of Granbury, Texas; one very special aunt, Lois Jean Heather; and many nieces, nephews and family and friends who were like family. She was preceded in death by her father; three brothers, Bobby Dean, Billie Don and Dennis Paul Yarnell; step-father, Virgil Barbour; one step-brother, Jimmie Barbour; and two step-sisters, Mae Gordon and Judy Blankenship. Elsie's kind heart and loving spirit touched the lives of many in her life. Visitation will be held on Friday, December 27, 2019 from 3:00 p.m. - 7:00 p.m. at Bowlin-Cantriel Funeral Service, California, Mo. Funeral Service will be held on Saturday, December 28, 2019 at 10:00 a.m. at the funeral home. Officiating will be Rev. Russell Cobb. In lieu of flowers, memorials are suggested to Hospice Compassus or Missouri Draft Horse and Mule Association, c/o the funeral home. The family would like to thank Hospice Compassus for their amazing help and support during Elsie's last few days. Arrangements are under the direction of Bowlin-Cantriel Funeral Service, California, Mo.

redpajama_set_name: RedPajamaCommonCrawl


The REI Flash 55 is a highly configurable, ventilated, roll top backpack that weighs 2 lbs 10 oz, but can be stripped down to 2 lbs 3 oz by removing several optional components. If you've never owned a backpack that's this lightweight, the Flash 55 is a good ultralight pack to cut your teeth on.
The REI Flash 55 Backpack is an ultralight, roll-top backpack with an optional top lid pocket. Weighing 2 lbs 10 oz, it has a ventilated back to help keep your shirt dry in warm weather and numerous pockets and straps, called "packmods", that can be removed or reconfigured to lighten it further, up to 7 oz. REI also added two additional side pockets to this year's model, in addition to two side water bottle sleeves, in order to provide more external storage. Sizing can be a little tricky though, since this new REI Flash 55 is only available in a limited number of fixed length torso sizes, unlike last year's model, which had an adjustable length frame. Make no mistake, the REI 55 is a true ultralight backpack and represents an exciting leap forward by the Co-op to make lighter weight backpacking more accessible and affordable. Plus, at $199, the price is right. A Women's REI Flash 55 Backpack is also available.
Note: A new REI Flash 45 is also available. While slightly lighter weight (2 lbs 7 oz), it does not have a roll top.
Materials: 100-denier ripstop nylon main body; 420-denier nylon bottom; steel frame.
The REI Flash 55 is an ultralight-style roll top backpack with an optional top lid. The advantage of using a roll top is that it lets you compress loads from the top in addition to the sides using compression straps. This is useful if your load expands and shrinks during a trip, like when you resupply your food in town on a thru-hike or section hike. The nice thing about having an optional top lid is that you can add it when it's needed, in cooler weather for example, to carry extra gloves, navigation gear, or smaller items that are handy to have easily accessible on longer hikes.
The Flash 55 top lid is also a floating lid, which is important because the pack has a long extension collar that extends above the top of the frame. Having a floating lid lets you raise its height, so it sits properly on top of your load. It also lets you wedge gear between the top of the main compartment and the bottom of the top lid, like a bear canister, tent, sleeping pad, etc, without having to put it into the main compartment. That greatly expands the pack's utility on more remote or technical trips.
The main compartment of the Flash 55 is huge and it will hold a lot of gear and food. It has a hydration pocket inside with a central hang loop, but the rest of the space is unstructured and the only accessible is from the top. REI also, in what may be a first, recommends lining the inside of the Flash 55 with a "trash compactor bag as a waterproof liner for your main compartment." Needless to say, a rain cover is not included with the pack.
The Flash 55 has a mesh front pocket that makes it easy to store damp or frequently accessed items, so you don't have to stop and open up your pack to access them or put them away. The top of that pocket also hooks onto a plastic dongle for added security. One concern I do have it on the durability of the mesh used on the front pocket and the side water bottle sleeves, discussed below. While the mesh holes are small to prevent snagging, I question its durability for long-term use and off-trail. Solid fabric pockets or pockets made with stiffer, heavier duty mesh are much more durable.
The Flash 55 has two mesh water bottle sleeves (located directly behind the hip belt pockets but attached to the pack sides) to make it easy to reach the bottles while you're wearing the pack. These were a feature on last year's model and proved popular with users. The bottles sleeves are sized for tall skinny soda or bottled-water bottles and its easy to pull them out or replace them while wearing the pack. While you can also fit a 1 liter Nalgene in the mesh sleeve and pull it out, getting it back in is difficult because the bottle diameter is wider. Both bottles sizes also have a tendency to pop out of the sleeves when you put the pack down or its falls over. The sleeves have snap closures in front to hold the bottles in place, but they're not totally effective, and they're difficult to re-snap closed when wearing the pack.
REI has also added to solid paneled side pockets behind the water bottle sleeves for holding gear and longer objects, like tent poles, chair kits, fishing poles, etc and lashing them to the side of the pack with a compression strap. It's an important enhancement, especially on a pack that will be used for longer distance trips. These pockets are not reachable when wearing the pack.
There are four additional pockets on the Flash 55, all of which are optional and can be removed. The floating top lid has an external top "Rainshield" pocket. That pocket is made with two layers of fabric and seam-taped, making it highly water-resistant. I hesitate to call it waterproof, because internal condensation is bound to make anything inside damp in prolonged rain. The top lid is attached by buckles and can be easily removed, as well as the straps holding it to the pack.
The hip belt pockets are sized to hold a SmartPhone.
The hip belt pockets are also easily removable. One is mesh-faced and other has a solid fabric front. They're large enough to hold an iPhone 6, a small point and shoot camera, or snack bars, but aren't what I'd call big. They're held on with a clever webbing strap/toggle system which holds them in place and prevents them from flopping as you bounce down the trail.
The Flash 55 also comes with a Rainshield shoulder strap pocket that's attached to the shoulder pads using the same webbing/toggle system used by the pockets. It's sized narrow for a Smartphone or a small camera. It snaps shut with a magnet, which always makes me leery on a backpack because it can interfere with a magnetic compass…but it'd be easy enough to cut out and replace with a velcro patch. It's constructed like the top lid, with two layers of fabric and seam-taped, making it highly water-resistant. This pocket is a real value-add and saves you the expense of buying a similar accessory pocket.
The Flash 55 includes a shoulder pocket sized for a SmartPhone or small camera.
The stock REI Flash 55 comes with an elaborate but easy to use compression and external attachment system. You can use it out the box, as-is, remove the numerous straps (without having to cut them off), or move them around any way you need.
All the packs straps are attached to the cord daisy chains so they can be moved or remove.
The four vertical corners of the pack have daisy chains loops running down them, implemented using cord, instead of traditional webbing. This is an increasingly common feature found on trail running backpacks, but it hasn't really caught on yet with mainstream backpacks.
All of the straps and attachment points on the pack are girth hitched to the daisy chain instead of being sewn into the pack seams. This lets you detach them, move them to a different location, or change their angles, as needed.
REI even includes a mesh sack with the Flash 55 so you can store the straps you've removed between uses, and not lose them. Directions for attaching the straps are printed on the outside. Thoughtful.
All of the removable straps and pockets weigh 7 oz total. If you're trying to reduce your pack weight, the biggest bang for the buck comes in removing the pockets (listed below), not the straps.
The problem with removing the side compression straps is that you often can't anticipate when you'll need them to lash gear to the side of the pack. If you remove the top lid, you can get rid of up to four straps, though I'd still recommend keeping two of them to hold down the sides of the roll top. There are a lot of variations possible, though.
The Flash 55 roll top can be buckled closed at the top or along the sides. Doing it along the sides prevents vegetation from getting caught in the pack, especially off-trail.
The REI Flash 55 is a ventilated backpack with a suspended mesh panel to help keep you cooler and your shirt drier in warm weather. The mesh is stretched across soft dorsal and lumbar padding and integrated with the pre-curved wings of the hip belt. This provides a comfortable back-hugging fit, but won't pull you backwards and off-balance, because the ventilation cavity is not as deep as that found on comparable packs, like the Osprey Exos.
The Flash 55 has a ventilated back to help keep your shirt drier.
The Flash 55's frame is a lightweight, 360 degree steel perimeter wire (not removable). It provides great torsional flex, so it moves with you, as well as the horizontal rigidity that is important for proper load lifter function and hip belt load transfer. The hip belt is sewn directly to the pack, so that the load is carried very close to your core muscles and hip girdle for maximum efficiency, while the soft lumbar pad and pre-curved hip belt wings grip the iliac crest. I'm really quite impressed with the hip carry on the Flash 55, which is comfortable and does not slip down.
The hip belt closes with pull forward straps for mechanical advantage, with a single central buckle. The hip belt pockets are positioned a little farther back on the hip belt than I'd like, so I can't see the zippers when I look down my sides, but whether they are for you will depend on your physical dimensions. I think the hip belt sizing for both the men's medium and large sizes is optimistic in the upper half of the sizing range, but your mileage will vary. However, if the front of the hip belt doesn't cover your hip bones, the pack isn't going to fit you (See How Should a Backpack Hip Belt Fit?).
If you remove the top lid, consider keeping two of the top lid straps to anchor the sides of the roll top.
The shoulder straps have a unisex S-shape, with a rail-based sternum strap. They're thickly padded and covered with a breathable mesh to wick away sweat. Both shoulder straps have elastic hose keepers as well as well a pair of short horizontal webbing straps to attach the Rainshield shoulder accessory pocket, which can be easily moved to the other shoulder strap. .
The sizing ranges for the men's Flash 55 pack are quite narrow in terms of torso lengths and hip belt sizes (see specs above), so I'd encourage you to try on a few different sizes to zero in on a comfortable fit. Based on the numbers, I should be able to use a Flash 55 in a medium, but the large size fits better, both in the torso and the hips. If you're between sizes, I'd definitely recommend sizing up.
The REI Flash 55 is a highly configurable, ventilated, roll top backpack that weighs 2 lbs 10 oz, but can be stripped down to 2 lbs 3 oz by removing several optional components. If you've never owned a backpack that's this lightweight, the Flash 55 is a good ultralight pack to cut your teeth on. Fully configured and out-of-the-box, with its top lid and full compression system, you can use it like your existing backpack as long as you don't exceed its maximum recommended load of 30 lbs or gear, water, and food weight. If you want to experiment with removing the lid and just using the roll top, or in removing components, you can do that when you're ready. Regardless, I think you'll still be impressed at how well the Flash 55 carries compared to a heavier weight backpack with a more substantial frame.
If you're a more experienced lightweight backpacker, switching to the Flash 55 can provide you with a lower cost way to reduce your pack weight than other comparable packs, with more features, and more flexibility. It's also a far better backpack in my opinion than an Osprey Exos 58 (see our review) and better than the Gregory Optic 58 (see our review) if you prefer a roll top. That's saying something, because these two packs are the industry leaders for sub 3 pound, ventilated backpacks at the $200 price point. My advice would be to try out the REI Flash 55 and compare them for yourself. This pack is a winner.
I've hiked 2+ thrus and have used a lot of low weight gear. I'm at the technical definition of UL, but have often needed to carry up to 30 lbs with food and water. Also, I have a somewhat-warranted distaste for REI (another story, I'll spare you…). And yet, though I have not used this pack, just considering the design, the assessment here seems spot on. Bring your gear to REI, put it in there, and try it on. If it fits you and your gear, go for it.
It's esp nice that it will let you continue to drop weight/features you don't need, as you become more experienced.
One note of caution… ventilation tends to be overrated as a spec. I tend to prefer designs similar to the one here, where it doesn't make any false promises about keeping your back from sweating. It just helps your shirt dry faster in the evening, when it cools off, IF you are still moving. If you make camp at 4pm, and that's before your body has stopped sweating, it won't gain you much. (And the other ventilated designs won't either.) So, while I offer my meager endorsement to this design, I caution low expectations for reduced back sweat.
Ventilation is overhyped. If you carried 30 pounds on your head (perfect ventilation) your back will still sweat.
If you want body-hugging, you'll need to look at internal-frame packs; they are intended to hug your back (sweating is accepted, here) and keep the load close to the center of gravity. If you want to see a good comparison of internal and external, take a hard look at the design elements of the Osprey Exos versus the Osprey Kestrel.
You mention you prefer it to the other similar price & weight ventilated, what do you think of it compared to the Crown 2 and Flex Capacitor?
I like the Granite Gear Crown 2 because it has an adjustable length hip belt and none of the fixed length hip belt sizing issues of the Flash 55. I also like the pockets / compression system / external attachment options on granite gear packs a whole lot – plus it has much bigger hip belt pockets. The crown 2 38 has actually turned into one of my favorite packs.
The Flex capacitor is a good pack, but not a roll top. I'll really like roll tops. Still its a far more durable pack than the Flash 55. Its a good pack if you beat your packs to death.
Different people have different needs and preferences for different trips and regions. Half the battle is figuring out what you need a pack to do. Picking one is pretty easy after that.
I really liked the Granite Gear packs I've owned (original Vapor Trail, a Nimbus, a couple of Vargas, and a crown VC.) They were great: the lightest, most comfortable pack I ever carried and very well built. They are internal frame, and very well-balanced.
The only reason I no longer use them is a Goldilocks story: the small ones are too small, and the large ones are too large. The largest load I carry now just fills a 45-50 liter pack nicely; the small GG packs are in the 35-40 liter range, and the larger packs are in the 55-60+ liter range. If they come out with a 45-50 liter range, I'll definitely be giving them s good, hard look.
"Half the battle is figuring out what you need a pack to do. Picking one is pretty easy after that." Could almost frame that.
Unfortunately I have a 19 inch torso and a 30 inch waist. Probably would not work for me.
I'm headed to a REI in a couple of weeks to try these on. It's possible that I might be able to use the small.
These REI UL backpacks are well made and a good deal for the money. I've owned the 1st two models with the Cruise UL 60 being the last. That was when I first got into UL backpacking. They served me well.
But when I tried an Osprey EXOS 58 I immediately sold my well-used Cruise UL 60 and got the EXOS. More comfortable overall, especially the cooler mesh trampoline back support.
Are those additional side pockets large enough to fit a thermorest z lite foam pad?
Hi Philip, this pack has a lot of foam (back panel, etc.). Does the foam used absorb water?
The foam itself doesn't but some will "stick" in the holes that pass through it by surface tension. All packs absorb some water, even DCF ones, in the shoulder straps and hip belts which are covered by fabric. If it rains, ah-hem, you're going to get wet from internal condensation even if you're wearing rain gear. I wouldn't worry about it too much.
I've read a ton of reviews on different packs lately, and this is the best review I've ever read, by a country mile.
Backpack reviews are a house specialty. Glad I could help.
I stopped at the REI in Ann arbor Michigan. They had a good supply of women's and men's. Despite my 30 inch waist the size small and medium both seem to fit well.
I loaded both the flash and the osprey Exos with 23 lb. For me the flash was much more comfortable. I noticed on the Exos that the shoulder straps we're very narrow really cut in and almost wanted to twist.
The frame on the flash is more flexible than the exos but still rather stiff. the one thing I noticed with the flash is that when I walked around it seemed to shift a little more side to side but not a lot.
Hey, Nate, I'm the same dimensions as you. I tried this pack on at REI today and liked it. Please update if you bought the Flash, which size you went with, and how it performed for you (with how much weight) in the field. Thanks.
Probably won't be getting until June. Will update for sure.
I'm torn between the REI Flash 55 and Osprey Levity 60 – any thoughts?
Get the flash. The side pockets on the Levity are unusable. The flash is a much better pack. Carries more, better, etc.
I'm planning a 6 day trip through europe over the summer and am looking for something versatile and light. The only comments I've heard against it are that it doesn't have as many compartments as the osprey so access to specific material is slightly more challenging. But this, I think is something that can be circumvented with a little bit of strategy. I also don't like the idea of the osprey weighing me down with pockets I will hardly use.
Do you feel comfortable strapping gear to the outside of the pack? Such as sleeping bag, etc.
Most definitely. It's easy to strap gear to the outside of the pack using their straps or elastic cord/cordlocks of your own design.
I went into REI today armed with my 20% coupon expecting to leave with the Flash 55. Unfortunately, neither the medium or large would fit me properly. I bought a Flash 45 in 2017 and I love it. The best pack I have ever owned. But, I would like something a bit larger for some extended trips I have planned. My 2017 version of the Flash 45 was completely adjustable, but, as Philip noted, the new version of the Flash 55 is not adjustable. I'm bummed out. That's progress I guess. The 2017 version of the Flash 45 has a floating lid so I am hoping I am going to be able to jam everything I need in there.
6 long strips of velcro, attached back to back, so you get one side fuzzy, and one side prickly. Un-stick the back panel that attached the straps to the pack, and "extend" the velcro attachment panel with the strips, so that the pack sits lower.
Made a world of difference for me.


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Home News Burkina Faso seeks help from international community to exit crisis
Burkina Faso seeks help from international community to exit crisis
DOUALA, Cameroon
Burkina Faso's self-proclaimed president invited the international community Thursday to help the country out of its crisis while pledging a return to normalcy in the wake of a coup.
"When the conditions are met according to the deadlines that our people will have sovereignly defined, I commit myself to a return to a normal constitutional life," said Lieutenant-Colonel Paul Henri Sandaogo Damiba in his first official address on national television.
Damiba led a coup Monday by a group of military officers called the Patriotic Movement for Safeguarding and Restoration (MPSR) that overthrew President Roch Marc Christian Kabore, the democratically elected head of state, who was enjoying a second term in the West African country.
For the new leader, the main priority in Burkina Faso "remains security."
Damiba said he wants to significantly reduce the areas under terrorist influence and the impact of violent extremism by restoring the will to fight with adequate means to the defense and security forces as well as to the volunteers for the defense of the homeland.
"This is a prerequisite for the gradual return of the public administration and the resettlement of internally displaced persons in their villages of origin," he said, calling on the international community to accompany the country in a rapid exit from the crisis.
He promised to respect human rights, ensure strict respect for an independent judiciary and to be tough on all those who are guided only by their selfish interests.
Damiba announced a draft roadmap that will be agreed with the nation's forces that he intends to federate.
He made the announcement in a context where the international community, the Economic Community of West African States (ECOWAS) and the African Union, of which his country is a member, have condemned the coup.
These communities as well as international leaders have called for a return to constitutional order, the release from detention of Kabore and the military's return to their barracks.
The advent of the MPSR was imposed in a country weakened by so many events and beset on all sides by radical armed groups, according to Damiba.
The situation has imposed on the army "an attitude that is imposed by its duty," he said.
The latest coup in Burkina Faso comes after the 2015 attempt against a transitional government and a few days after the arrest of a group of military personnel suspected of planning a coup but also following demonstrations by people dissatisfied with the security crisis's management after recurring attacks by terrorists leaving many civilians and military members dead.
On Sunday, a mutiny also broke out in the military barracks, creating a situation of uncertainty in the country.
While the African Union and ECOWAS condemned "an attempted coup" in their respective statements, the next day, the MPSR confirmed Kabore's overthrow.
The junta announced live on national television that it had suspended the constitution and dissolved the National Assembly. It also ordered the closure of the country's borders and imposed a curfew. A presenter read out a letter Monday evening on state television purportedly written by Kabore to announce his resignation.
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Interested in School of Media and Strategic Communications? Admissions officers are waiting to hear from you!
Oklahoma State University / School of Media and Strategic Communications is located in Stillwater, OK.


Communications today make it possible for us to be connected around the world in the click of an email or push of a mouse for an instant message. We can beam video to remote areas and catch events across the globe as they happen. Thus, our world has become an interconnected global community.
We have this vision that the children of the Azawak and the children in Montessori schools who are helping to bring them water can understand that they are connected and part of the global community.
Not everyone can go to the Azawak. And the children of the Azawak can't easily come here. But we can use technology for a really sweet purpose. We can demonstrate to children that what they do - their actions - bring a real smile.
In March, 2007, Ariane Kirtley hand-delivered gifts from the children in America to the children in Azawak. The following 13 minute video allows us to view that heart-to- heart sharing. Ariane and Moustapha tell the children and nomads about the children and teachers in the schools who are helping Amman Imman bring them water. Ariane hands them some of the rosemary that Odyssey Montessori upper elementary student Wyatt collected and sold. The girls wear the scarves that then 8 year old Catie McCoy knitted for them. She explains to them that students at Oneness-Family School and the Barrie School are making presentations and telling the world about their water problems. She shows them the cards from classrooms around the world that have pledge to help them get water. Ariane and Moustapha explain the different ways that children in America are helping.
The nomads smile. The children smile. We smile.
Simple giving. Modern technology. Global connections.
How lovely to see the children in this video, for they are many of the same children that Ariane photographed when she first went to the Azawak in 2005. We have seen them in many of her photos: Takat, Hassan, Abdoulaye, Moussa, Anaou, Rabbi, Mariama, Raichatou, Soutout, Mariama, Hazzi, Saleh.
Please share this video with all students, and let them know their hands can reach across the world and change lives!


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An individual's location history in the real world implies his or her interests and behaviors. This paper analyzes and understands the process of Collaborative Filtering (CF) approach, which mines an individual's preference from his/her geographic location histories and recommends locations based on the similarities between the user and others. We find that a CF-based recommendation process can be summarized as a sequence of multiplications between a transition matrix and visited-location matrix. The transition matrix is usually approximated by the user's interest matrix that reflect the similarity among users, regarding to their interest in visiting different locations. The visited-location matrix provides the history of visited locations of all users, which is currently available to the recommendation system. We find that recommendation results will converge if and only if the transition matrix remains unchanged; otherwise, the recommendations will be valid for only a certain period of time. Based on our analysis, a novel location-based accurate recommendation (LAR) method is proposed, which considers the semantic meaning and category information of locations, as well as the timeliness of recommending results, to make accurate recommendations. We evaluated the precision and recall rates of LAR, using a large-scale real-world data set collected from Brightkite. Evaluation results confirm that LAR offers more accurate recommendations, comparing to the state-of-art approaches.
Keywords: Recommendation, Collaborative Filtering, recommendation timeliness, location-based social networks, accurate recommendation.
Mathematics Subject Classification: Primary: 68T20, 68T37; Secondary: 68U01.
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Free calls to up to 55 internal or external numbers via 2-digit speed dial. Dedicated 'Taxi' button connects directly to a taxi dispatch. Poster directory can carry maps and other useful information.
The Infopoint Directory is our most comprehensive help point, offering free calls to up to 55 internal or external numbers.
Listed on the integrated poster directory, these services are accessed by entering a two-digit speed dial number. A dedicated, reconfigurable 'hot button' provides direct access to a featured service such as your nominated taxi operator.
Smart, vandal-resistant and very easy to use, the Infopoint Directory offers your visitors a clearly signposted means to connect with a wide range of services, 24 hours a day.
The A1-sized poster directory is designed and printed to your specifications.
It's large size means that the directory can also carry maps, site plans, advertisements and other useful information. Services can be displayed alphabetically, in display boxes and organised into categories.
Housed in a matching steel frame, the directory can be fitted to the left, the right or on both sides of the Infopoint unit.


The show was hosted on the 14th and 15th September and welcomed over 120 guests across both nights. Following the performances was the annual awards ceremony where students were given medals and prizes for the following achievements: Best Attendance, Most Determined, Great Achievement, and some slightly less serious awards such as: Ultimate Pole Kiss, Best Pole Face, Best Pole Bomb & Best Pole Homework.
This year also saw the surprise edition of the Mystery Box, the box was filled with over £50 of pole goodies and was given to one of the lucky performers (Sarah P) after she picked the winning pole move out of the hat at the end of Saturday's show!
"Our students always work so hard and we like to use the Showcase as an opportunity to reward some of our real 'stand out' students with achievement awards" Alex, Owner Stages Pole Fitness (pictured above, left).
The routines and song choices for performances were incredibly diverse this year, which gave the show a much wider variety and ensured that there was something to suit everyone's taste! The show kicked off with Alex's solo to Michael Buble's 'Cry Me A River' and ended with a all-cast group piece to 'The Greatest Show' from the recent film The Greatest Showman. In between were numbers such as Lady Gaga 'Telephone', Skillet 'Invincible', Christina Perry 'A Thousand Years', Meatloaf 'I Would Do Anything For Love' and many more!
"We had two wonderful evenings celebrating everything pole means to us and for me, celebrating our 5th birthday as a school made it something extra special. I don't know what I would do without Stages Pole Fitness, I love watching everyone build their strength and confidence - it gives me so much pride and joy. I hope everyone enjoyed the evenings as much as I did! Sadly, we will not be hosting a Showcase event next year (2019) due to the amount of work and time required. We do hope to make it a biennial event as it is wonderful for our students to have the chance to perform and awe-inspiring for friends & families to see what their loved ones can do. Watch this space." Alex.


We have a few training and health articles here on our Parrot Training page that will help you with training your bird.
Treat the bird like a 2 year old. You have to be sweet, gentle and FIRM to train a bird. If you take the mindset that YOU are top bird, then the bird will not train you, but you will train the bird.
The most important thing for training is gaining the bird's trust and respect. Work on not feeling frustrated or upset, because the bird will feel your tension and react to that.


Few shows are more set in their identity than Netflix's ridiculous, self-serious and often utterly audacious drama, which returns for a second on-brand season.
Is Netflix's The OA the most profoundly silly show on television or the most sillily profound show on television?
Premiering over two years after its first season launched as a mystery-shrouded stealth release, Brit Marling and Zal Batmanglij's mind-bending drama is hard to be ambivalent toward. Either you're like the characters within the show, willing to set aside preconceived conceptions of logic and narrative and reality to take a fantastical and wholly earnest leap into something much of the outside world would call lunacy, or you watched the first season with a growing sense of incredulity and frustration until the finale made your head explode, possibly with rage.
As difficult as it may be, I remain almost proudly in the middle about The OA even after watching the first six episodes of the second season, which takes several formal leaps forward, several storytelling leaps back, remains willfully confounding at every turn and is still capable of conceptual fits so head-scratchingly audacious that I'm able to admire and laugh at them at the same time. The only thing I'm sure of when it comes to The OA is that the process of watching and experiencing an episode is unlike the viewing of any other show on TV and, good or bad, there's value in that.
I'm still pissed off about the end of last season. No matter how you explain it or excuse it, a climax featuring the use of dimension-spanning interpretive dance to stop a mass shooting is fundamentally unearnable and I don't think the show came close. The second season picks up from that finale without dwelling on it, but also in the immediate aftermath. Kinda.
Because it wouldn't be The OA without initial disorientation, the premiere begins with the introduction of Karim Washington (Kingsley Ben-Adir), a Bay Area detective enlisted by a Vietnamese family to find a missing teenage girl. Karim's investigation leads him through a series of architecturally fascinating sections of San Francisco and into an underbelly of teens obsessed with an augmented reality puzzle-driven phone ap. The game offers potentially large prizes in crypto-currency and it may have ties to a Silicon Valley recruitment feeder. It also may be making players go mad or disappear.
It's a while before Prairie (Brit Marling) appears, having some sort of panic attack or spell on a ferry. See, in the aftermath of the shooting, Prairie's consciousness made a jump and she now finds herself back as Nina Azarova in a dimension in which Young Nina never got on that school bus, never had a near death experience, never went blind, never was adopted by Nancy (Alice Krige) and Abel (the late Scott Wilson, lovely in one scene), etc. The differences in this dimension are embodied by a really cheap gag showing that even though it was 2016 still, Joe Biden is president for reasons that are never even slightly explained, nor are there any other comparable big picture dimensional changes, which makes the Joe Biden joke extra odd.
Amid her disorientation, Nina/Prairie is quickly dispatched to a clinic on Treasure Island, where she encounters Dr. Percy (Jason Isaacs) and Homer (Emory Cohen) in very different situations, these involving research into stuff like lucid dreaming, shared delusions and other fun blither-blather that dovetail with the series' ongoing interest in Native American mysticism, talk of Original Angels and more.
Meanwhile, back in the original dimension, Steve (Patrick Gibson), French (Brandon Perea), Buck (Ian Alexander), Jesse (Brendan Meyer) and BBA (Phyllis Smith) are shattered by what they went through and for various reasons they're about to go on a road trip.
Oh and nobody does The Movements until the second episode, but plenty of people and things do The Movements, so if you're only watching The OA for The Movements, definitely prepare to be moved.
The idea of somebody trying to jump into this second season without having watched the first makes me laugh.
The first season was already structured as a bifurcated narrative — Prairie and the high school gang and Prairie and her captivity with Dr. Percy — so it isn't shocking that Marling and Batmanglij would want to raise the stakes with what is now a trifurcated narrative that's about a bifurcated timeline.
The trifurcated narrative, though, puts a lot of strain on viewer attention, or at least that of casual viewers, whom I've already said don't exist, so really I just mean, "Me."
The Karim storyline is solid in large part because the show's use of San Francisco locations is just terrific. Batmanglij and the other series directors are very clever when it comes to using actual landmarks like the 16th Avenue Tiled Steps, an assortment of distinctive properties and the natural geography of the area to give this season much more visual specificity than the more intentionally nondescript Everytown locations last season. If those settings lent the first season a disjointed Spielbergian flavor, there are more shades of Hitchcock to these episodes, specifically Vertigo, complete with Marling as a reasonable Hitchcock Blonde and the Prairie/Nina binary substituting for doppelgangers. Setting that aside, though, Karim's missing girl plotline is very nondescript and the early stages of Prairie's story put a lot of stock in audience investment in the Prairie/Homer relationship, which I didn't care about in the first season and definitely didn't take more interest in here.
The same is even truer of the return of the suburban kids now without Prairie (in their dimension) to steer them. Steve and Buck were, at best, half-developed characters in the first season and French and Jesse were even less than that, so asking them to carry a storyline on their own is immediately a questionable idea, made more so by how separate the writers keep those stories initially. The fourth and fifth episodes are where the San Francisco story begins building to a series of truly nutty revelations. I can't say with confidence that they're good revelations, but they're revelations that had me taking notes in all caps. Then the sixth episode goes over to the kids exclusively and all interest I had in the tail-end of the season vanished into the ether.
Even when I don't think The OA is all that good, which is often, I never doubt its sense of itself and all of the new casting in the second season matches instantly, with the possible exception of one piece of premiere casting that's so distracting Netflix has asked critics not to reveal it. Even in very brief appearances, actors like Melora Walters, Liz Carr and The Florida Project star Bria Vinaite add their particular versions of oddness to the mix. It's like how I still can't decide if Marling and Isaacs and Smith are giving traditionally "good" performances, but I know they're giving exactly the performances that The OA asks of them. Ditto with the intentionality of the far larger number of performances I'd call flat or monochromatic or traditionally "bad."
Those things that happen in the fourth and fifth episodes are really wild and not as alienating as interpretative dance at a mass shooting, and they're the sort of things that only The OA would do and that only The OA would do in complete, unironic seriousness. They're so unironically serious that one crucial and somewhat ridiculous scene is set to Live's "Lightning Crashes," possibly the most bizarrely self-aware rock song ever recorded and to have what's happening in that scene set to that particular song is the most OA thing The OA could possibly have done. And, let's be honest, everything The OA does is utterly and purely The OA, which is probably the most admirable thing about the show.
Premieres Friday, March 22 on Netflix.


Kadapa, Oct 30 (INN): The bodies of a woman and her son were retrieved from a well at Budvel, Kadapa district on Friday. According to Investigation officer Narayanaswamy, Komala (24) had married her lover Sadhanadhan five years ago against the wishes of their parents. The couple were residing in Keshavpatnam in Karimnagar district. Sadhanadhan was working as a supervisor in the Sakthi Seeds Company. The couple was blessed with one son Bunny (5). After the marriage, two cases were lodged against Sadhanadhan and were being heard at the Huzooranagar Court. Meanwhile, Komala started living with her parents.
She came to live with her husband after the lawyers worked out a compromise between both sets of parents nine months ago. Komala went missing on September 29, and her body was noticed by villagers in a well on the outskirts of the village on Friday. The villagers retrieved the bodies and alerted the police. Police registered a case and shifted to hospital for autopsy. Police suspect that financial problems and spats with her husband may have led to Komala killing herself, after throwing her son in the well. Further investigations are on.


text:
Hardy Horatius Graves
Biography Index || Navarro County - World War I
WORLD WAR I BIOGRAPHY
Pvt. Hardy H. Graves was born in Panola County County, Texas, May 2, 1895. He is the son of Mrs. S. M. Graves, of Kerens, and received his education in the public schools of Oklahoma. He entered the service October 4, 1917, with Company G. 357th Infantry, 90th Division, training at Camp Travis until May, 1918, when he sailed overseas for France. He participated in the activities of the 90th Division and after the armistice was signed was appointed and served as a Military Police.
History of Texas World War Heroes
Prairie Point Cemetery, Kerens, Navarro Co., TX
Photo submitted by Melba Love
Hardy H. Graves Dies Wednesday
Hardy H. Graves, 59, World War 1 veteran, died in the Memorial Hospital Wednesday afternoon of a heart attack.
Funeral services were incomplete early Thursday afternoon pending advices from a son in Germany.
Surviving are a son, Hardy G. Graves, U. S. Army, Germany; two daughters, Mrs. H. W. McCormick, Corsicana, and Mrs. Monia O'Quinn, Longview; two brothers, L. C. Graves, Powell and Johnny Graves, Kerens; and other relatives.
Graves served with the 36th Division in World War 1.
Corley will direct.
The Corsicana Daily Sun - Thursday, March 12, 1953
Submitted by Diane Richards


For the past two weeks, people have been entering our "Get Marooned" contest for an overnight trip for four to Big Splash in French Lick! Also included are hot breakfasts, waterpark passes, and games of mini golf and lazer tag at Shotz! We literally received HUNDREDS of entries, and we randomly selected a winner. To find out who it is, check out the latest KISS 106 commercial below!


1. Pre-register your animal. Good human!
The Good Human Pre-registration Program at the University of Illinois Veterinary Teaching Hospital provides peace of mind by preparing you to act if your animal has a medical emergency.
Registration is free and easy to do. Click the "Next" button to get started!


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Hines Names Leasing Agents for Its New Flagship Office Scheme in London's Covent Garden
Work has started on the transformation of Grainhouse, a former Victorian seed warehouse on Drury Lane, which will become the new European headquarters for Hines, while bringing 55,000 square feet of new prime office and retail space to the market
(LONDON) – Hines, the international real estate firm, has named Cushman & Wakefield and Colliers International as joint office leasing agents for Grainhouse, a premier new office property on Drury Lane in the heart of Covent Garden. Shelley Sandzer has been appointed as leasing agent for the 23,000 square feet of leisure and retail space.
The 91,000 square foot scheme was acquired off-market by the Hines European Value Fund 2 (HEVF 2) in March 2020. The Hines firm subsequently agreed to a 15-year pre-let on 36,000-square-feet across three floors of the five-level building, which will become the new headquarters for the Hines UK and European Region teams, who are both currently based at 5 Welbeck Street, W1.
There remains 32,000 square feet of office space to lease across two floors of the Grainhouse. The building is currently vacant and has planning consent for a landmark repositioning which will combine four interlinked period buildings to deliver one consolidated modern office environment, with street-level restaurant and retail amenities. The scheme has been designed by award-winning architects Barr Gazetas and is expected to be completed in Spring 2023.
Hines has commenced the refurbishment program, which incorporates the addition of a two-story roof extension across the site, with flexible office floorplates ranging from 6,650 to 15,800 square feet arranged around an atrium with character finishes including exposed concrete, steel and brickwork.
Health and wellbeing are a major focus of the scheme. The occupants of the building will have access to extensive external terracing and there will be areas on the roof that include native plant species and nest boxes. Spacious accommodation for secure bicycle storage and extensive shower and locker facilities will be provided.
Grainhouse will aim to reduce operational carbon through a variety of active and passive measures, as well as reducing embodied carbon by retaining as much of the original structure and materials as possible. The building has been designed to achieve BREEAM 'Excellent and WELL Platinum Certification, as well as meet enhanced digital connectivity standards with 'WiredScore Certified Platinum'.
Raj Rajput, Managing Director, Asset Management, Hines, said: "We have a huge opportunity and responsibility to re-shape, re-invent and breathe new life into a heritage building and transform it into a contemporary, future proofed workplace in the heart of London. We're looking forward to Grainhouse becoming our new home and are sure it will capture the imagination of occupiers."
James Campbell, Cushman & Wakefield, said: "This is an incredibly exciting project which we're delighted to be involved with. Occupiers love authentic buildings with outstanding amenities and Grainhouse squarely meets these criteria. We firmly believe that the best buildings in the best locations will continue to outperform. Its fantastic location in the heart of London's hospitality and entertainment core, and with Crossrail on the doorstep, will ensure Grainhouse is a huge success."
Tom Tregoning, Colliers International, said: "Grainhouse presents a rare opportunity for an occupier to find a building of such character with floor plates of this size in the heart of London. The compelling offer of contemporary workspace, in a reconfigured heritage building in such a tremendous location will attract strong interest from the occupier market."
Hines is a privately owned global real estate investment firm founded in 1957 with a presence in 240 cities in 27 countries. Hines oversees a portfolio of assets under management valued at approximately $160.9 billion¹, including $81.7 billion in assets under management for which Hines serves as investment manager, and $79.2 billion representing more than 172.9 million square feet of assets for which Hines provides third-party property-level services. Historically, Hines has developed, redeveloped or acquired approximately 1,450 properties, totaling over 485 million square feet. The firm has more than 180 developments currently underway around the world. With extensive experience in investments across the risk spectrum and all property types, and a pioneering commitment to ESG, Hines is one of the largest and most-respected real estate organizations in the world. Visit www.hines.com for more information.
¹Includes both the global Hines organization as well as RIA AUM as of December 31, 2020.
Since entering Europe in 1991, Hines has grown its European platform to include offices in 16 cities as well as a presence in 55 cities in 13 countries, with €22.7 billion of assets under management, including €19.8 billion for which Hines serves as an investment manager and €2.9 billion for which Hines provides third-party property-level services, in Austria, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Netherlands, Poland, Spain and the United Kingdom.
Visit www.hines.com for more information.
George C. Lancaster
Global Public Relations
erica.campbell@hines.com


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Satori Shakoor
1994-06-30 / American Way, Arts & Culture, Judith Binder, Performance
This video consists of two parts. The first is an interview with Satori Shakoor, a performer in the Los Angeles area with her own one-woman show. The second is said show, although unfortunately the recording of the show is not complete. Continue reading →
The Eighties in Retrospect: A Documentary
1979-01-01 / Uncategorized
"The 80s in Retrospect" is a mockumentary produced in 1979. The documentary "begins" in the middle of the footage (10:06), and features a series of mock commercials, scenes from a New Year party, a scene within a restaurant, and a soliloquy in a train station. The tone of the "documentary" shifts between comedic irreverence and earnest social criticism. The beginning of the footage (before 10:06) establishes the basic premise that polluted radio and television waves sent from Earth are being re-broadcast to Earth from a "space" Haight-Ashbury. The "documentary" footage, then, shows the "polluted" nature of television and radio media. Produced by The Anybody You Choose Video Group at Southern Illinois University Carbondale. Continue reading →
Burned out in Carbondale
Tongue-in-cheek polemic against a 1979 Chicago Magazine article about the failures and debaucheries of Southern Illinois University–Carbondale ("Burned Out in Carbondale"). The video takes the form of a 60 Minutes-esque investigation. It has several humorous segments and parodies, including rounds in a dilapidated library, an academic adviser who is actually a magician/diviner, and a woman who passes through a neighborhood bar (PK's) selling test answers. Continue reading →
Reverend Billy's Peace Revival
2003-3-8 / Outside Agitators
Reverend Billy and the Church of Stop Shopping stage a lengthy peace revival filled with song, dance, and sermons raging against American consumerism. Continue reading →
Media Burn by Ant Farm, 2003 edit
1975-7-4 / Ant Farm, Guerrilla TV, Outside Agitators, Performance, Roots of Video, Viewers Choice
A recent edit (2003) of Ant Farm's classic video art piece examining and satirizing the media, particularly the impact of television. On July 4, Independence Day, 1975, what a TV newscaster described as a "media circus" assembles at San Francisco's Cow Palace Stadium. A pyramid of television sets are stacked, doused with kerosene, and set ablaze. Then a modified 1959 Cadillac El Dorado Biarritz, piloted by two drivers who are guided only by a video monitor between their bucket seats, smashes through the pyramid destroying the TV sets. Continue reading →
[Wired In raw #101: Lily Tomlin #1]
1982-8-7 / American Way, Video Makers Choice
Raw footage for "Wired In," a never completed series on the technological trends and innovations of the 1980s. Lily Tomlin does multiple takes of a spoof PSA about Pac-Man addiction. Continue reading →
1982-8-7 / American Way, Viewers Choice
Raw footage for "Wired In," a never completed series on the technological trends and innovations of the 1980s. Lily Tomlin does multiple takes of a spoof PSA about Pac-Man addiction. She is also interviewed about her general feelings about technology. Continue reading →
[The 90's raw: John Simmons]
Eddie Becker, GDDF, NHPRC-2, THE 90's
Raw footage shot for the award-winning television series The 90's. Eddie Tape #64. John Simmons' gross national product, multiple takes of comedy routines based on Washington politics. Continue reading →


The U 67 tube microphone was the quintessential studio workhorse throughout the formative years of modern music.
The U 67 is a universal studio microphone suitable for all applications. Its smooth top-end with a subtle tube shimmer makes the U 67 an outstanding vocal microphone. Due to its essentially linear response in three polar patterns – omni, cardioid, and figure-8 – the U 67 is also a very versatile microphone for all kinds of instruments such as strings, woodwinds, brass, piano, drums, acoustic and electric guitar, bass guitar and upright bass.


text:
Q: Php Repeating Fetched Display in Loop I'm using php. I'm fetching two arrays with my table. I don't understand why it duplicates the table but it was able to display the values from the other query.
Here's the whole code:
    $select_department2 = mysql_query("SELECT DISTINCT work.`Department` FROM `work` INNER JOIN employee_leaves ON employee_leaves.ID_No = work.ID_No WHERE MONTH(employee_leaves.Date_Approved) LIKE '$month' AND Leave_Type LIKE 'Sick' AND Pay_Type LIKE 'Paid'");

while($row_department2 = mysql_fetch_array($select_department2))
{
   $dept = $row_department2['Department'];
}
   echo "
";
    echo "
";
        echo "Department	";
        echo "Name	";
        echo "Position	";
        echo "SL Balance	";
        echo "SL Retain	";
        echo "SL Convertible	";
    echo "
";

while ($row_id2 = mysql_fetch_array($select_id2)) {

   $select_record2 = mysql_query("SELECT DISTINCT employee_leaves.ID_No as leaveID, First_Name,Last_Name, Person_Type, Leave_Type, Special_Type, Position, Subject_Type, SUM(DATEDIFF(Leave_End,Leave_Start) + 1) as Total_Days
                                      FROM employee_leaves, person_details, work, person
                                      WHERE person.ID_No LIKE employee_leaves.ID_No AND person_details.ID_No LIKE employee_leaves.ID_No AND work.ID_No LIKE employee_leaves.ID_No AND (Leave_Status LIKE 'Approved' OR Leave_Status LIKE 'Extended') AND Leave_Type LIKE 'Sick' AND Pay_Type LIKE 'Paid' AND MONTH(Date_Approved) LIKE '$month' AND Department='".$row_department2['Department']."' AND employee_leaves.ID_No= '".$row_id2['leavesID_No']."'    ");

   $queryAllEmployees = mysql_query("SELECT person_details.ID_No as personID, Last_Name, First_Name, Position, Subject_Type, Department, Person_Type
                                    FROM person_details, work, person
                                    WHERE person_details.ID_No LIKE work.ID_No AND person.ID_No LIKE work.ID_No AND Department LIKE 'Humanities' AND Position != 'Academic Coordinator'
                                    ORDER BY Last_Name");

Here is the part where I echo the values from both queries:
$arrayRowA = array();
        $arrayRowB = array();
        while($row = mysql_fetch_array($select_record2)){$arrayRowA[] = $row;}
        while($row = mysql_fetch_array($queryAllEmployees)){$arrayRowB[] = $row;}

        // Loop through two arrays in a square way (every combination of both arrays)
        foreach($arrayRowA as $keyA => $objectA){
            foreach($arrayRowB as $keyB => $objectB){
                $leaveID        = $objectA['leaveID'];
                $Sick_First_Name = $objectA['First_Name'];
                $Sick_Last_Name = $objectA['Last_Name'];
                $Sick_Position = $objectA['Position'];
                $Sick_Subject_Type = $objectA['Subject_Type'];
                $Sick_Leave_Type = $objectA['Leave_Type'];
                $Sick_Special_Type = $objectA['Special_Type'];
                $Sick_Total_Days = $objectA['Total_Days'];
                $Sick_Person_Type = $objectA['Person_Type'];

                $personID       = $objectB['personID'];
                $Person_Type    = $objectB['Person_Type'];
                $First_Name = $objectB['First_Name'];
                $Last_Name = $objectB['Last_Name'];

                $Department = $objectB['Department'];
                $Position = $objectB['Position'];
                $Subject_Type = $objectB['Subject_Type'];
                $Person_Type = $objectB['Person_Type'];

                if ($Person_Type == 'Regular')
                  {
                    $Sick_Allowable_Days = 10;
                    $Sick_Remaining_Days = 10 - $Sick_Total_Days;
                  }else{
                    $Sick_Allowable_Days = 5;
                    $Sick_Remaining_Days = 5 - $Sick_Total_Days;
                  }

                echo "
";
                    echo "$Department	";
                    echo "$Last_Name, $First_Name	";
                    echo "$Subject_Type $Position	";
                    echo "$Sick_Allowable_Days	";
                    echo ($leaveID == $personID) ? "$Sick_Total_Days	" : "--	";
                    echo ($leaveID == $personID) ? "$Sick_Remaining_Days	" : "--	";
                echo "
";
            }
        }

A: I think you should try this:
$dept = array();
while($row_department2 = mysql_fetch_array($select_department2))
{
   $dept[] = $row_department2['Department'];
}

Then in the next loop use
    while ($row_id2 = mysql_fetch_array($select_id2)) {

   $select_record2 = mysql_query("SELECT DISTINCT employee_leaves.ID_No as leaveID, First_Name,Last_Name, Person_Type, Leave_Type, Special_Type, Position, Subject_Type, SUM(DATEDIFF(Leave_End,Leave_Start) + 1) as Total_Days
                                      FROM employee_leaves, person_details, work, person
                                      WHERE person.ID_No LIKE employee_leaves.ID_No AND person_details.ID_No LIKE employee_leaves.ID_No AND work.ID_No LIKE employee_leaves.ID_No AND (Leave_Status LIKE 'Approved' OR Leave_Status LIKE 'Extended') AND Leave_Type LIKE 'Sick' AND Pay_Type LIKE 'Paid' AND MONTH(Date_Approved) LIKE '$month' AND Department='".$dept[$i]."' AND employee_leaves.ID_No= '".$row_id2['leavesID_No']."'    ");

   $queryAllEmployees = mysql_query("SELECT person_details.ID_No as personID, Last_Name, First_Name, Position, Subject_Type, Department, Person_Type
                                    FROM person_details, work, person
                                    WHERE person_details.ID_No LIKE work.ID_No AND person.ID_No LIKE work.ID_No AND Department LIKE 'Humanities' AND Position != 'Academic Coordinator'
                                    ORDER BY Last_Name");
                                    $i++;

redpajama_set_name: RedPajamaStackExchange


To Cite: Safaeepour L, Mokhtari Nouri J, Moradian S T, Saied Ghiasi S M. The Effect of Family-Centered Care on the Duration of Weaning From Mechanical Ventilation in Coronary Artery Bypass Surgery Patients: A Clinical Trial Study, Crit Care Nurs J. 2017 ; 10(2):e10655. doi: 10.5812/ccn.10655.
Background: The use of nonpharmacological methods has been emphasized in the recent years. These methods are used to decrease the duration of weaning from mechanical ventilation after coronary artery bypass graft (CABG) surgery.
Objectives: The present study aimed at determining the effect of family-centered care on the duration of weaning from mechanical ventilation in patients undergoing CABG.
Methods: This clinical trial study was conducted in Jamaran Heart Subspecialty hospital in Tehran in 2016. Initially, convenient sampling method and random allocation were used by quaternary blocks to allocate patients into 2 groups of experimental and control, with 35 participants in each group. In the intervention group, the patients' family member chosen by the patient was entered into the ward during the weaning process. Patient's entrance time to the ward to extubation time was considered as the duration of weaning from mechanical ventilation in the 2 groups.
Results: Duration of weaning in the experimental group was 97 minutes less than the control group; in other words, the weaning duration of those in the control group was 1.4 times greater than those in the experimental group. This difference was statistically significant between the 2 groups (P = 0.05).
Conclusions: Family-centered care reduced the duration of weaning from mechanical ventilator in patients undergoing coronary artery surgery, which can remarkably decrease complications due to ventilation with positive pressure in these patients.
Copyright © 2017, Baqiyatallah University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
Cardiovascular diseases are the most common serious, chronic, and life-threatening diseases in the world (1). It has been estimated that the largest cause of worldwide death until 2020 would be coronary artery disease (2). American heart association (AHA) states that in the case of removing cardiovascular diseases, life expectancy would increase to 7 years in the United States. In England, cardiovascular diseases with 16 000 deaths per year is considered as the first cause of death. The growing trend of suffering from cardiovascular diseases is not specified to Western countries. In the study of Kita, it has been found that this group of diseases is increasingly growing in Japan as well (3). In a study in Finland, it was found that 9.1% of males and 4.9% of females were suffering from angina pectoris (4). Cardiovascular diseases in Iran, like many other countries, are the leading causes of death and the lost years of life (5). In addition, among the cardiovascular diseases, coronary artery diseases are introduced as the first and the most common cause of death (6).
No action like cardiac surgery could influence the quality of life of patients suffering from cardiovascular diseases. Cardiac surgery is the most common therapeutic intervention for ischemic disease and valve problems. It has almost been about 35 years since CABG is being performed in the medical centers of the world (1). The prevalence of this surgery in North America, Asia, West Europe, and other areas is 26.79%, 0.72%, 17, 94%, and 18.14%, respectively. Of the open heart surgeries, 60% are specified to CABG in Iran (7). Following CABG, patients are directly transferred to ICU and are being observed by an experienced nurse who has specific and enough skills and knowledge in caring for such patients until they come out of anesthesia, and reach adequate oxygenation and hemodynamic stability. After heart surgery, patients need meticulous monitoring in ICUs. Mechanical ventilation is one of the most common and most popular treatments in the period after surgery for all these patients (8). Patients undergoing mechanical ventilation experience many psychological and physiological negative complications (9, 10).
The process of weaning patients from mechanical ventilator in CABG patients, due to maintaining hemodynamic stability, is specifically important because inappropriate extubation could cause unpleasant complications (11).
Weaning from mechanical ventilator is one of the important processes of treatment in ICU because the process of weaning from mechanical ventilation allocates 40% of the whole duration of mechanical ventilation. Therefore, on time weaning from mechanical ventilation and extubation is clinically important (12).
In the recent years, nonpharmacological methods have been emphasized to decrease the duration of weaning from mechanical ventilator because one of the most important roles of nursing is early identification of physiological and psychological stresses (13). The presence of one member of the family as another nonpharmacological approach can control and decrease the physiological and psychological stress of the patients and their families (14). Family-centered care is not a new topic, but it is a growing philosophy and movement in a therapeutic care, resulting in improving quality of care and decreasing costs (15, 16). Family-centered care is has been indicated as one of the main implications of nursing in the 21st century, and its aim is to maintain the integrity of the patients' family and provide unique care for every patient (17, 18). In the family-centered education model, the active presence of the family is essential in assessing and diagnosing requirements and trainings because it is believed that illness of a family member results in the involvement of all the members of the family in the course of the disease cycle (19, 20).
The importance of this issue, insufficiency, and deficiencies of the family-centered nonpharmacological studies at the time of weaning from mechanical ventilator in ICU, encouraged the researchers to assess the effect of family-centered care on the duration of weaning from mechanical ventilator in CABG patients in ICU as a type of nonpharmacological intervention in these patients.
This was a clinical trial study documented in Iran clinical trials recording center with IRCT201609014299N4 code. The study population included all the patients' candidates for open heart surgery who were hospitalized in Jamaran hospital in Tehran from May 2015 to October 2016; they were transferred to ICU after undergoing open heart surgery by mechanical ventilator. Inclusion criteria were as follow: patient's willingness to participate in the study; age 18 to 75 years; performing heart surgery for the first time; nonemergency heart surgery; cardiac ejection fraction greater than 30% (EF > 30%); and lack of psychological problems. Exclusion criteria were as follow: bleeding more than 300 mL per hour; a need for surgical intervention; any type of neurological disorder after surgery; unusual events during surgery (such as pumping time more than 2 hours and severe bleeding during surgery); lack of hemodynamic stability during weaning; and compromising patient's health and the need for health team intervention; delay in weaning process based on the physician order; returning to the operating room; requiring tranquilizers and painkillers more than the current treatment protocols; having IABP (Intra-Aortic Balloon Pump) after surgery; rhythm dependence to pacemaker; coagulation problems; and receiving more than one type of inotrope, or receiving inotrope with an unusual dose after surgery. Number of the samples was calculated to be 64 by considering Alpha equals (5%), Beta (10%) and power (80%) using Altman's Nomogram and according to standard difference (21). Considering 10% sample loss, 70 individuals (35 in each group) were studied. Convenient sampling method was used initially based on the inclusion criteria, and then random allocation with foursome blocks was done for the 2 groups.
Data collection tools included a researcher-made sheet for collecting demographic features, 3 underlying diseases, underlying risk factors, and underlying factors related to heart surgery, and recording the sheet of weaning duration from mechanical ventilator, in which the duration of the patient's entrance to ICU to the time of extubation was recorded. The validity of the collection sheet was examined by 10 experienced instructors. For sampling, samples who met the inclusion criteria were selected and provided written informed consent a day before surgery. Then, one member of the family, who was preferred by the patient, was familiarized with the ward environment by the researcher and received some explanations about the patient's conditions (tracheal tube, mechanical ventilator, chest tube, and other cards). Moreover, entering time and ways of providing care to the patient in the ICU after the surgery were explained to the patient's entourage. Furthermore, the necessary training was provided by the researcher considering the following points: patient's entourage should stay somewhere that does not disturb the medical team or other patients, and only he/she has to pay attention to the patient; he/she has to talk to the patient and reassure the patient that the surgery has been performed successfully; he/she has to pay enough attention to the medical team recommendations; he/she should not intervene in the therapeutic routine actions; he/she has to go out of the ward if the medical team orders so; she/he may need to go out of the ward in the case of other patients' critical conditions; and physically, the patient should be in a corner of the ward where the entourage is in a relaxed condition to observe only his/her patient. One patient of the experimental group was being observed in every shift. The day after the surgery when the patients were transferred to ICU OH, the research process continued after the demographic information was filled out. Patient's entry time to ICU until his/her extubation was measured by a chronometer and documented. In the experimental group, after the patient's first inspiratory effort and if the patient's entourage had the inclusion criteria, the intervention would have been done, and the vital signs documented, and the patient's entourage would have entered to the ICU. In addition, in the control group, after the patient's entry to the ICU OH and in the case of meeting the inclusion criteria, the patient's vital signs were documented and only the usual cares were provided for the patient.
Measurement outcome in this study included the time of weaning from mechanical ventilator by chronometer (from the time of entering to the ward to the full extubation) based on minute. To avoid bias, patients and the staff, who were responsible for providing care and treating patients in ICU, did not know anything about the results of the actions and how the patients were categorized in the groups. Meanwhile, a nurse injected any type of painkillers or tranquilizers. In addition to documenting the drug dosage, the researcher documented the vital signs measurements at the already set times. In the case of any special condition for the patient, which has been explained in the exclusion criteria, the patient was excluded from the study, and special therapeutic actions were done according to the physicians and nurses' opinion of the related ward. Data were entered into SPSS Version 21 software. Independent t test was used for quantitative demographic information and chi-square test for qualitative demographic information. Kolmogorov-Smirnov one-sample test was used to verify data normality. Considering data normality, independent t test was used. Statistical significance was set at P ≤ 0.05.
Table 1 demonstrates the quantitative demographic features of the patients hospitalized in cardiac ICU in the 2 experimental and control groups. No significant differences were observed between the 2 groups in quantitative demographic features based on the results of the independent t test (P > 0.05).
Table 2 demonstrates the qualitative demographic characteristics of the hospitalized patients in cardiac intensive care unit in the 2 groups. The results of the Chi-square statistical test revealed no statistical differences between the 2 groups with respect to qualitative demographic characteristics (P > 0.05).
Table 3 displays the underlying diseases of the hospitalized patients in cardiac intensive care unit in the 2 groups. Chi-square statistical test results showed no statistical differences between the 2 groups in underlying diseases (P > 0.05).
Table 4 demonstrates the underlying risk factors of hospitalized patients in cardiac intensive care unit in the 2 groups. Chi-square statistical test results revealed no statistical differences between the 2 groups in underlying risk factors (P > 0.05).
Table 5 presents the underlying factors related to the cardiac surgery of the hospitalized patients in cardiac intensive care unit in the 2 groups. Independent sample t test results showed no statistical differences between the 2 groups in underlying factors (P > 0.05).
Table 6 exhibits the weaning time between the 2 groups. The mean and standard deviation of weaning time in the intervention group was less than that of the control group; in other words, the mean of weaning time in the control group was 1.4 times higher than that of the intervention group. Independent sample t test results showed statistical differences between the 2 groups in weaning time (P < 0.05).
The results of the present study revealed that family-centered care was useful in decreasing the duration of weaning patients from mechanical ventilation. Tables 1 and 5 present qualitative and quantitative demographic features, underlying diseases, and underlying risk factors related to heart disease of the patients participating in the study, which were homogeneous and were not significantly different from one another prior to the study.
Early weaning from mechanical ventilator is important in all the cardiac surgery units in the world because of some benefits such as faster recovery, faster discharge from ICUs, and preventing several complications of mechanical ventilation (12, 22). The results of the present study revealed that the presence of a member of the family could make a significant difference in decreasing the duration of patient's weaning from mechanical ventilator so the time in experimental group had decreased 97 minutes compared with the control group.
The results of this study were significant during weaning from mechanical ventilator, which could be due to the introducing and explaining the surgery process from the beginning of the study until ICU postdischarge because the patient's entourage, due to his/her friendly and emotional relationship with the patient, introduced the surgery process to the patient at home with the patient's comfort and tranquility in mind when the patient has not yet experienced pain or restlessness and has not learned the confounding factors. Safavi et al. by quoting from Hosseiny, stated that introduction process has a significant positive effect on patients before the surgery, which is inconsistent with the results of the present study (23). The same results were achieved in the study of Mary Beth Happ et al. In their study, with the aim of family presence and observation during weaning from mechanical ventilator, they found that family presence influenced the duration of weaning from mechanical ventilator (24).
In addition to the sessions of introducing the unit and process of the surgery, which could play an important role in the duration of weaning from the mechanical ventilator in the 2 groups, the same quantitative and qualitative demographic information, underlying diseases, underlying risk factors, and underlying risk factors related to heart disease of the patients prior to the study between the 2 groups could be another factor in confirming the effect of family member presence because the studies have shown that these factors can significantly influence the success rate of weaning from mechanical ventilator. Jalalian et al. had stated that they had 63% success rate in their study, and one of the causes of such high statistic was the similarity between demographic information and underlying factors and disease (25). In addition, in other studies, the success rate in weaning from mechanical ventilator was 38% to 70%; the authors believed that one of the causes of this success was the similarity between demographic information and lack of remarkable risk factors prior to the intervention (26).
The underlying diseases of the patients who underwent cardiac surgery and were hospitalized in the ICU are presented in Table 3. One of the causes of the high success in weaning from mechanical ventilator in the 2 groups is that these diseases were not significant in these 2 groups although the duration of weaning from mechanical ventilator in the experimental group was 1.4 time less than the control group. Studies have indicated that preoperative, transoperative, and postoperative variables are related to the prolonged mechanical ventilation time (27). Some studies have found that some demographic factors such as age (28), heart surgery, and underlying factors such as the number of heart surgery, and the amount of ejection fraction (29), and underlying diseases such as the history of mental disease, diabetes mellitus, and hyperlipidemia (30) can independently predict complications after heart surgery such as the longtime of weaning from mechanical ventilator.
Performing family-centered care had 97-minute effect on the duration of weaning from mechanical ventilator in the experimental group compared with the control group. In other words, patients in the experimental group were separated from mechanical ventilator 97 minutes earlier than patients of the control group. The weaning patients of the control group from the mechanical ventilator was totally 1.4 times of those in the experimental group. Moreover, the process of family-centered care is a process has to be started before the patient and his/her family's entry to the heart surgery process and should be continued after this process. Selecting a member of a family who has a more emotional and friendly relationship with the patient is helpful in conveying the necessary information to the patient because a member of the patient's family can convey the information with words more familiar to the patient and answer his/her questions. Similarity of qualitative and quantitative information, disease underlying factors, and heart surgery prior to the educational information can decrease complications caused by long time weaning from mechanical ventilator.
This article is the result of a MsC thesis of Baqiyatallah Medical Sciences University with the registration code of clinical trial center IRCT 201609014299N4. Also, we would like to extend our thanks to Jamaran Heart hospital staff for their assistance in this project.
Authors' Contribution: Leila Safaeepour: searching, data gathering, and writing the manuscript; Seyed Tayeb Moradian: data analysis. Jamileh Mokhtari Nouri, Seyyed Mohammad Saied Ghiasi: study design, data gathering, and writing the manuscript.
Funding/Support: All the research financial and material support was supported by Baqiyatallah University of Medical Sciences.