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DianaHealth.com, an On-Line Database Containing Appraisals of the Clinical Value and Appropriateness of Healthcare Interventions: Database Development and Retrospective Analysis
Xavier Bonfill,
Affiliations Clinical Epidemiology and Public Health, Institute of Biomedical Research (IIB Sant Pau)-Iberoamerican Cochrane Centre, Barcelona, Spain, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
Dimelza Osorio ,
* E-mail: dimelza@cochrane.es
Affiliations Clinical Epidemiology and Public Health, Institute of Biomedical Research (IIB Sant Pau)-Iberoamerican Cochrane Centre, Barcelona, Spain, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, Ecuador, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
Ivan Solà,
Jose Ignacio Pijoan,
Affiliations CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain, Unidad de Epidemiología Clínica y Soporte Metodológico, UICEC de BioCruces-SCReN, Barakaldo, Spain
Valentina Balasso,
Affiliation Clinical Epidemiology and Public Health, Institute of Biomedical Research (IIB Sant Pau)-Iberoamerican Cochrane Centre, Barcelona, Spain
Maria Jesús Quintana,
Affiliations Clinical Epidemiology and Public Health, Institute of Biomedical Research (IIB Sant Pau)-Iberoamerican Cochrane Centre, Barcelona, Spain, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
Teresa Puig,
Ignasi Bolibar,
Gerard Urrútia,
Javier Zamora,
Affiliations CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain, Unidad de Bioestadística Clínica, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
José Ignacio Emparanza,
Affiliations CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain, Unidad de Epidemiología Clínica, Hospital Universitario Donostia, BioDonostia, San Sebastian, Spain
Agustín Gómez de la Cámara,
Affiliations CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain, Unidad de Investigación Clínica, Hospital Universitario 12 de Octubre, Madrid, Spain
Ignacio Ferreira-González
Affiliations CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain, Departmento de Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, Spain, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
Dimelza Osorio,
Javier Zamora
Xavier Bonfill Dimelza Osorio ... Ignacio Ferreira-González
To describe the development of a novel on-line database aimed to serve as a source of information concerning healthcare interventions appraised for their clinical value and appropriateness by several initiatives worldwide, and to present a retrospective analysis of the appraisals already included in the database.
Methods and Findings
Database development and a retrospective analysis. The database DianaHealth.com is already on-line and it is regularly updated, independent, open access and available in English and Spanish. Initiatives are identified in medical news, in article references, and by contacting experts in the field. We include appraisals in the form of clinical recommendations, expert analyses, conclusions from systematic reviews, and original research that label any health care intervention as low-value or inappropriate. We obtain the information necessary to classify the appraisals according to type of intervention, specialties involved, publication year, authoring initiative, and key words. The database is accessible through a search engine which retrieves a list of appraisals and a link to the website where they were published. DianaHealth.com also provides a brief description of the initiatives and a section where users can report new appraisals or suggest new initiatives. From January 2014 to July 2015, the on-line database included 2940 appraisals from 22 initiatives: eleven campaigns gathering clinical recommendations from scientific societies, five sets of conclusions from literature review, three sets of recommendations from guidelines, two collections of articles on low clinical value in medical journals, and an initiative of our own.
We have developed an open access on-line database of appraisals about healthcare interventions considered of low clinical value or inappropriate. DianaHealth.com could help physicians and other stakeholders make better decisions concerning patient care and healthcare systems sustainability. Future efforts should be focused on assessing the impact of these appraisals in the clinical practice.
Citation: Bonfill X, Osorio D, Solà I, Pijoan JI, Balasso V, Quintana MJ, et al. (2016) DianaHealth.com, an On-Line Database Containing Appraisals of the Clinical Value and Appropriateness of Healthcare Interventions: Database Development and Retrospective Analysis. PLoS ONE 11(2): e0147943. https://doi.org/10.1371/journal.pone.0147943
Editor: Xu-jie Zhou, Renal Division, Peking University First Hospital, CHINA
Received: September 8, 2015; Accepted: January 11, 2016; Published: February 3, 2016
Copyright: © 2016 Bonfill et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the paper and Supporting Information files.
Funding: This project received financial support from the EpiClin Programme of the Consorcio de Investigación Biomédica de Epidemiología y Salud Pública CIBERESP, a public institution from the Instituto de Salud Carlos III aiming to support research in Epidemiology and Public Health in Spain. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Healthcare systems worldwide must promote the most effective interventions and avoid those that are of low-value or inappropriate in order to face the challenge of remaining sustainable without jeopardising the quality of care [1–3]. Assessing appropriateness in health care involves three dimensions: 1. effectiveness, including the risk-benefit trade-off based on valid evidence; 2. cost-effectiveness, taking into account the available resources, and 3. characteristics, values and preferences of the individual, the community and society [4,5]. In recent years, the concept of value in healthcare, defined as outcomes relative to costs, has been introduced to better reflect whether a medical procedure is justified in the face of its benefits and costs [6]. Other authors have preferred the terms overuse or underuse to describe inappropriate interventions [7].
Using one term or another and applying a variety of methods, several researchers and clinical experts around the world have assessed or given their opinion about the appropriateness or the value of many healthcare interventions. Over the last years, a number of initiatives have been established to address this topic [8–14]. Information about these initiatives and their appraisals has been disseminated through different formats, such as research articles, letters, institutional reports and websites. Furthermore, the information is widely dispersed, making it difficult and inefficient for any potential user, either caregivers, policy makers, or patients, to form a complete view of what has been published on this topic. To solve these problems and to disseminate these initiatives and their results as widely as possible, we developed an on-line database that could serve as a fast, user-friendly, and constantly updated source of information concerning healthcare interventions appraised for their clinical value and appropriateness. In this article we describe the process of building the on-line database and we present the features of the website where it is hosted and the results of a retrospective analysis about the initiatives and the appraisals that were included in the website until July 2015.
In order to develop the database we established the following definitions:
Appraisal: any assessment or critical judgment about any healthcare intervention considered either as low-value, inappropriate or unnecessary, or valuable but underused, in the form of a clinical recommendation, literature review or an expert's analysis.
Healthcare intervention: any treatment (e.g. drug, surgery, procedure, therapy or counselling), any test (e.g. laboratory, imaging, or any diagnostic procedure) or any other action (e.g. educational or management strategy) used in any field of healthcare to improve health or to help with a particular problem.
Initiative: any collaborative effort to either appraise the appropriateness or the value of healthcare interventions or to collect clinical value and appropriateness appraisals.
The development of the on-line database started in Jun 2012. First, we searched the initiatives worldwide assessing the appropriateness or the value of healthcare interventions and their appraisals. We then defined and obtained the information necessary to build the database. Finally we designed the website where the database would be hosted, including a search engine to consult the database. The process to create the database ended in January 2014 with the launching of the website.
Search strategy and selection of references.
We searched the main worldwide initiatives that aimed to assess the appropriateness or the value of healthcare interventions and their appraisals by following medical news and article references, and by contacting experts in the field. We also searched articles related to the initiatives in MEDLINE (PubMed) using the strategy shown in Fig 1. The search was limited to articles published after June 2008 but no language restrictions were applied. Additionally, we used Google to search more information about the initiatives and about the authors of the appraisals.
Fig 1. Search strategy to identify initiatives.
https://doi.org/10.1371/journal.pone.0147943.g001
We selected any type of publication (e.g. research article, letter, review, etc) as long as it met all the following criteria:
The reference either contains a set of appraisals about low-value, inappropriate or unnecessary interventions or it is part of an established initiative according to the definition provided above.
The authors of the appraisal and of the initiative, if they are different, must belong to non-profit research or academic groups, such as scientific societies, or to governmental agencies or institutions.
We also searched for other appraisals published by the initiative but not included in the publication found with the search strategy.
Data extraction and database building.
A team of trained physicians retrieved the following information regarding the initiatives: institutions involved, country, year of launching, funding, aim of the initiative and methodology used to make the appraisal. The team also obtained the following information regarding the appraisals: initiative, publication year, type of intervention (e.g. diagnostic, pharmacologic or preventive), related specialties (e.g. anaesthesiology or cardiology), recommended action regarding the intervention (i.e. in favour or against its use), and keywords identified in the title. When appraisals were in languages other than English or Spanish and the titles clearly stated the population and the intervention, the team translated the title directly into English and Spanish with the support of a translator. If titles were not clear, they added a short explanation in English and Spanish.
The database was created after identifying, selecting, classifying and translating the appraisals.
Website design.
We designed and created the website with the help of a team of IT engineers. The design included a search engine to retrieve the appraisals from the database and other content such as a news section, a list of the authoring initiatives, and a section where users could suggest new content for the website.
The web app was developed in Hypertext Pre-processor (PHP) 5. We used the latest technologies in web development, such as Hyper Text Markup Language (HTML5), cascading style sheets (CSS3) and Asynchronous JavaScript-XML (Ajax). We also used MySQL 5 as a database management system in order to perform query optimization. The application was installed on a Linux server with redundant elements to ensure stability, and Secure Sockets Layer (SSL security).
Retrospective analysis
We analysed the initiatives and the appraisals included in the database until July 2015. Data for this analysis were obtained directly from the website. We described the following characteristics of the initiatives: researchers and institutions involved, country, year of launching or publication, type of initiative, terms used to describe their aims, and number and type of appraisals.
We analysed the appraisals included in the database according to the following characteristics: specialty, type of intervention concerned in the recommendation, and publication year. We also analysed the appraisals that had been published on selected topics and some findings of the database maintenance process.
Features of the on-line database
Fig 2 summarises the database development.
Fig 2. Process to create the on-line database www.DianaHealth.com.
The on-line database is hosted at www.DianaHealth.com in English, and also at www.DianaSalud.com in Spanish. The name of the website is an acronym that stands for its objective: Dissemination of Initiatives to Analyse Appropriateness in Healthcare (Divulgación de Iniciativas para Analizar la Adecuación en Salud). The database and the website where it is hosted are open access; they meet the Open Source Initiative criteria.
The website has seven sections: Initiatives, Search recommendations/analysis, News, Report a new recommendation or suggest a new analysis, Contact us, About us, and How to search.
The section Initiatives comprises a brief profile of each initiative which includes the following information: authors, year of launching, aim, and a link to its respective website.
In the section Search Recommendations/Analysis, users can consult the appraisals database through a search engine. The engine admits one or more of the following criteria: initiative, medical specialty, type of intervention, type of appraisal (high value or low value) or publication year. The search engine also admits specific free-text search terms related to any health problem or topic, such as, aortic aneurysm, epilepsy, bevacizumab, or vaccines. The search terms can be entered in either English or Spanish. After running a search, the list of results is displayed on the right. Each item in the list is an appraisal of the value or appropriateness of a given healthcare intervention. By clicking on any result, users can find additional information such as the authoring initiative, title, publication year, specialties involved, type of intervention, and a link to the original source where it was published. Furthermore, the search results can be exported into an Excel spreadsheet (*.csv) containing all this information.
The news section announces new initiatives and appraisals included in the website. It also posts events such as conferences and meetings on topics of interest, such as overdiagnosis, right care and clinical value.
In the section Report a new recommendation or suggest a new analysis, users can suggest the inclusion of new initiatives or appraisals not yet included in the database. In the section Contact us, users can find our e-mails to suggest improvements to the website and collaborative proposals. In the sections About us, and How to search we provide information about the operation of the website. Moreover, the website has Facebook and Twitter accounts to increase dissemination of the included initiatives and their appraisals.
The website is financially independent and not for profit. It does not receive financial support of any kind from the pharmaceutical or technology industries. It has been partially funded by the CIBERESP, a governmental research consortium in Spain (see the Funding section at the end of the article).
To keep the website updated, we identify new initiatives applying the same search strategy described in the methods, every one or two months. To keep the database valid, we check the sources where the included initiatives and the appraisals were identified every month or two, looking for modifications in the appraisals, such as withdrawals. Finally, to ensure that the links to the original sources are always functional, our IT engineers developed a system that automatically detects broken or misleading links to the original sources. The system generates a weekly report with the dysfunctional links, so we can fix them almost as soon as they change.
Since its launching in January 2014 until July 2015, we identified 23 initiatives (Tables 1, 2 and 3) and included 2940 appraisals of healthcare interventions from 22 initiatives in the database. The appraisals from one initiative (the ACR Appropriateness Criteria [14]) have not yet been included in the database. None of the 22 initiatives included until July 2015 was identified through the option "Report a new recommendation".
Table 1. Characteristics of the initiatives aimed at reducing low-value or inappropriate healthcare interventions included in DianaHealth.com until July 2015.
Results are shown in order of year of launching.
The 23 initiatives were: eleven campaigns gathering clinical recommendations from scientific societies, five sets of conclusions from literature review, four sets of recommendations from guidelines, two collections of articles on low clinical value in medical journals, and an initiative of our own (Tables 1, 2 and 3). These initiatives came from scientific societies, governmental health institutions, and universities from high-income countries. All the initiatives but one were launched in the last decade, and they were all still active at the time of inclusion. Two initiatives, the Right Care Alliance from the US [36] and the Right Care programme from UK [37], were not included as such in DianaHealth.com since they do not provide appraisals of the clinical value or appropriateness of any particular intervention. However, they were included in the DianaHealth.com news section. The US Right Care initiative is an interesting network of healthcare professionals and citizens who promote avoidance of overuse in medicine through educational materials and other resources. The UK Right Care programme focuses on describing variability in clinical practice and compiling local examples of commissioning innovations.
The terms used by the included initiatives to describe their aims were varied. For example, Elshaug et al [12], Prasad et al [13], and the Spanish initiatives 'Essencial' [24] and 'Compromiso por la Calidad de las Sociedades Científicas' [25] refer to "low-value practices." The US Choosing Wisely [9], the Canadian Choosing Wisely [10] and the Australian Choosing Wisely [34] described the interventions as "unnecessary." Other initiatives did not use a specific term but referred to interventions that "should be discontinued or not used routinely" (Do not Do [8]), or to practices "that confer no benefit but have true risks" (Less is More [21]).
Most of the initiatives (15 out of 23) presented their appraisals as clinical recommendations (in favour or against the use of a given intervention), either evidence-based or based on expert consensus while eight initiatives did not provide recommendations: six of them provided evidence-based assessments, and two initiatives were topic collections and article series from two medical journals respectively, gathering articles of different types (original investigations, reviews, and letters) that appraise the value or appropriateness of healthcare interventions (Tables 1, 2 and 3). Four of the Choosing Wisely initiatives and Essencial, in addition to providing clinical recommendations, also developed informative materials to facilitate doctor-patient communication in order to improve appropriateness.
As for the 2940 appraisals included in the database, most of them were about low value or inappropriate interventions (96%, n = 2830). The rest (4%) were about appropriate interventions. We also included these appraisals in the website. Table 4 shows some characteristics of the appraisals included in DianaHealth.com by July 2015.
Table 4. Characteristics of the appraisals included in DianaHealth.com until July 2015.
Table 5 shows an example of the number of appraisals retrieved by the search engine using three keywords: cancer, pregnancy and heart disease. Another example of the options of the search engine is shown in the S1 Appendix. This is an Excel spreadsheet obtained when selecting Vascular Surgery in the field of medical speciality (n = 73 appraisals). The search engine also allows users to identify common or similar appraisals provided by different initiatives, and contrast them. For example, the use of images for low back pain in the absence of red flags was analysed in 22 appraisals against this practice, provided by 11 initiatives (Choosing Wisely from US, Canada, and Australia; Smarter Medicine, Doing more does not mean doing better; Do Not Do; Compromiso por la calidad de las Sociedades Científicas; Essencial; Less Is More; SemFYC recommendations; and Elshaug et al.).
Table 5. Example of the number of appraisals retrieved by the DianaHealth.com search engine in July 2015 (n = 2940), on three different health topics.
The results are classified according to the initiative.
After several updating processes, we observed that the initiatives updated their contents at different intervals. For instance, Less is More and Too Much Medicine posted new items weekly (sometimes daily), Choosing Wisely and Essencial published new recommendations every one or two months, and the Prescrire Initiative published a new report after a year [28]. Furthermore, we observed that some appraisals of some of the initiatives have been withdrawn by the authoring initiative, for instance, some appraisals from the NICE Do not Do recommendations database.
During the updating processes, we also identified new initiatives. In the last updating, we identified two Choosing Wisely-like new initiatives from UK [38], and Germany [39], but we were unable to identify any appraisal.
Principal findings
We have developed a website named DianaHealth.com, an on-line database of appraisals about healthcare interventions considered low value or inappropriate in clinical practice. The website is open access, independent and constantly updated. It is available in English and Spanish and has a search engine to retrieve the appraisals using one or more search criteria.
Up to July 2015, the database included 2940 appraisals from 22 initiatives. Most of the initiatives (n = 11) were campaigns gathering clinical recommendations from scientific societies, outside the context of a clinical practice guideline document. The rest of initiatives were sets of conclusions from literature review (n = 5), sets of recommendations from clinical practice guidelines (n = 3), collections of articles on low clinical value in medical journals (n = 2), and an initiative of our own. The appraisals were mostly recommendations on pharmacological and diagnostic interventions, made by clinical experts from 22 initiatives of different kinds. Most appraisals were from scientific societies.
Strengths and weaknesses of this project
DianaHealth.com contributes to disseminating initiatives and their results, facilitating the search for information about appropriateness in healthcare. The website is user-friendly because no registration is required and the initiatives and appraisals are accessible with a few clicks. Since its contents are available in English and in Spanish, DianaHealth.com makes the information accessible to people in many countries. Finally, the exportable format to a comma-separated values file (CVS file) allows users to make further analyses related to their interest, for example, identifying interventions that have been appraised by more than one initiative and may have more consensus regarding their low value.
We have identified the following weaknesses. First, some initiatives might not have been detected since we did not carry out a systematic search. However, the most well-known initiatives worldwide have been included and the website allows the inclusion of new initiatives at any moment. Second, new appraisals might not be available in DianaHealth.com until one or two months after they are published in their original sources. Third, the nature of the appraisals is diverse; for instance, some are evidence-based clinical recommendations, and others are a judgment of one or two experts, which might have an impact on the quality of the appraisals. DianaHealth.com provides links to the information published in a variety of sources, but the responsibility for their quality rests entirely on the authors, since we do not have the resources to assess the soundness of the appraisals included in the website. Finally, the impact assessment of DianaHealth.com is still limited. Even though we have received positive comments through the website's contact service, its Facebook, and Twitter accounts, we do not yet have any statistics of usability, or other feedback.
Strengths and weaknesses in relation to other studies and databases
As far as we know, the DianaHealth.com project is unique. We have not found any other databases that collect the main initiatives and appraisals about clinical value and appropriateness from recent years in a single site. Some of the websites of the initiatives included in DianaHealth.com [8,9,24] provide tools to search their appraisals, but these tools offer few options and allow somewhat limited searches.
Several of the initiatives included in DianaHealth.com have been referenced by other authors. For instance, Hurley [40] wrote an interesting article describing the Choosing Wisely-like initiatives, but did not mention other initiatives pursuing the same objective.
Implications for clinicians and policymakers
The information collected in DianaHealth.com promotes awareness of initiatives concerning inappropriate or low-value interventions. Identifying and decreasing these interventions is crucial to improve the quality and sustainability of healthcare systems. Despite the importance of these appraisals, however, some caution is necessary before applying any of them to a particular setting because certain aspects analysed when conducting the appraisals (such as, cost or necessary resources for implementation), might differ between countries, between health systems, or over time. Moreover, patients' values and preferences must always be taken into account.
Future actions
The database has short and long-term objectives: to expand the contents of the database by including references containing a single appraisal, searching other databases beyond MEDLINE, and including the terms disinvestment and de-implementation in the search strategy; to increase the database audience, making its contents available in other languages other than English and Spanish; and to measure the impact of the database by implementing quantitative indicators, such as the number of visits. It would also be of interest to find effective ways to present the appraised interventions to patients and to assess the impact of the appraisals on the use of the interventions in the clinical practice. Finally, it would be useful to have a search filter in Medline and other databases to identify literature about low-value or inappropriate interventions.
S1 Appendix. Excel spreadsheet obtained when selecting Vascular Surgery in the field of medical speciality (n = 73 appraisals).
https://doi.org/10.1371/journal.pone.0147943.s001
This project is led by a research group from the Clinical Epidemiology Department of the Hospital de Sant Pau and the Iberoamerican Cochrane Centre, based in Barcelona, Spain. They have had the support of other associated partners pertaining to CIBERESP: Hospital Ramón y Cajal, Hospital 12 de Octubre, Hospital Universitario de Donostia, Hospital Universitario Cruces, Universidad Miguel Hernández, Hospital Universitario Vall d'Hebron.
We want to thank Karla Salas, Eva Madrid, Cinthya Agüero, Paulina Fuentes, Valentina Duarte, Juliana Castillo, Manel Quevedo, Hector Pardo and Aleix Bonfill for their support during the website development. We also wish to thank Antonio Segura-Hernández and his colleagues from ISISLAN for all their support in the website development, Andrea Alepuz and Maria Victoria Leo for their support in the translation of the website and its contents, and to Carolyn Newey for advice with the English. Dimelza Osorio is a PhD candidate in Methodology of Biomedical Research and Public Health at the Universitat Autònoma de Barcelona, Spain.
Conceived and designed the experiments: XB DO IS JIP. Performed the experiments: XB DO VB MJQ. Analyzed the data: DO. Contributed reagents/materials/analysis tools: XB. Wrote the paper: XB DO IS JIP VB MJQ TP IB GU JZ JIE AGC IFG.
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34. ChoosingWiselyAustralia.org.au. [Internet]. NPS MedicineWise: Choosing Wisely Australia. [cited 2015 Jul 30]. Available: http://www.choosingwisely.org.au/about-choosing-wisely-australia.
35. Tokuda Y. Current Status of Choosing Wisely in Japan. General Medicine. 2015; 16: 3–4.
36. Lown Institute. [Internet]. The RightCare Alliance. [cited 2015 Jul 30]. Available: http://lowninstitute.org/take-action/join-the-right-care-alliance/.
37. Rightcare.nhs.uk. [Internet]. National Health Service: The Right Care Programme. [cited 2015 Jul 30]. Available: http://www.rightcare.nhs.uk/.
38. Malhotra A, Maughan D, Ansell J, Lehman R, Henderson A, Gray M, et al. Choosing Wisely in the UK: the Academy of Medical Royal Colleges' initiative to reduce the harms of too much medicine. BMJ. 2015; 350:h2308. pmid:25985331
39. Association of the Scientific Medical Societies in Germany. [Internet]. Choose Wisely Together. [cited 2015 Jul 30]. Available: http://www.awmf.org/en/health-care/gemeinsam-klug-entscheiden.html.
40. Hurley R. "Can doctors reduce harmful medical overuse worldwide?" BMJ 2014; 349: g4289. pmid:24993249
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We took the city out of Hack Your City this week, collecting reader tips on Yellowstone National Park. You can read all the best comments in the Staff tab under the original post. We've collected highlights below.
"Leave camp inhumanly early to start your day," says Slacklinejoe in a great overview comment about optimizing your visit. "Some of the best wildlife experiences and stunning views happen before most folks have rolled out of their tent/RV/whatever, and getting golden hour shots will set your photos apart from the crowd." Sounds worth it even if you're not taking photos. "Like I'm talking 6 am early," says Rebecca.
Dress for the cold, says everyone. "Bring a hat/mittens/jacket suitable for 30s-40s temps no matter what time of year you come," says DaveSs, in another great overview comment. They recount a snowy June visit, followed by a week with highs in the 80s.
"If you fly into Bozeman, you'll have two options for entering the park: West Yellowstone (West entrance) or Gardiner (North entrance). Choose based on what you intend to see first," says Tim, explaining the advantages of each at the start of a lengthy guide to the park. Other tips include handling a bear attack, lodge recs, and a suggested itinerary.
"Keep weed on the DL. It is federal land, federal laws. I knew of a few people who got popped," says BobJerryPhil.
And be careful! People die in the park from falling off ledges, into running water, or into boiling springs, say several readers.
Yellowstone is big. "No matter where you stay, you are going to have to travel long distances on slow, crowded roads to get to all of the various sights/hikes/locations," says Sneeje. So be patient and don't try to do it all at once. "Each corner of the park can easily fill a whole day, especially if you like to hike," says MonkeyT.
Reservations fill up quickly, so plan ahead. But, says MC63i, keep checking them for cancellations. They also suggest eating at the diner counters in souvenir shops to avoid long waits at restaurants.
"Don't stop in the friggin' road for a picture," says Vlachen.
"Absolutely no selfies 10ft away from a bison," says DaveSs.
"The Lonestar Geyser is a short hike/bike from the trail, and is much more dramatic and satisfying than Old Faithful," says monkeyhumper.
"Some of the less popular geyser loops like Painted Pots are just as freaking awesome as anything else," says Rebecca.
And multiple commenters recommend the less crowded Grand Teton National Park just south of Yellowstone. "They have ranger-guided wildlife 'hunts' in the evenings," says RgbyRef. "If you plan to make a trip of two nights I recommend camping in GTNP, leave the camper, and drive early to yellowstone for a day trip," says RCJ.
That's it for this week! Go read all the tips in the original thread, and leave yours below. Come back Monday to hack an actual city. Aaand the island nation around it.


text:
The Walking People
Keane, Mary Beth
Greta Cahill never believed she would leave her village in the west of Ireland until she found herself on a ship bound for New York, along with her sister Johanna and a boy named Michael Ward. Labeled a "softheaded goose" by her family, Greta discovers that in America she can fall in love, raise her own family, and earn a living. Though she longs to return and show her family what she has made of herself, her decision to spare her children knowledge of a secret in her past forces her to keep her life in New York separate from the life she once loved in Ireland, and tears her apart from the people she is closest to. Even fifty years later, when the Ireland of her memory bears little resemblance to that of present day, she fears that it is still possible to lose all when she discovers that her children--with the best of intentions-- have conspired to unite the worlds she's so carefully kept separate for decades. A beautifully old-fashioned novel, The Walking People is a debut of remarkable range and power.
Publisher: New York, New York : Houghton Mifflin Harcourt Publishing Company, p2010.
Characteristics: xxi, 392 pages ;,24 cm.
Read more reviews of The Walking People at iDreamBooks.com
Tjad2L Jul 09, 2019
Great story! MB Keane has such an ability to draw out her characters. I loved everything about this book.
lilypad_1 Sep 20, 2013
Fabulous read, great description of daily life in Ireland in the 1960's. Also, insightful into the life of immigrants living in New York in the 1970's. Characters seem so alive they could be aunts, uncles, cousins, sisters.
Author also wrote "Fever" about Typhoid Mary which is also excellent.
Women — Ireland — Fiction.
Irish Americans — Fiction.
Family Secrets — Fiction.
New York (N.Y.) — Fiction
Ireland — Fiction
Domestic Fiction.

redpajama_set_name: RedPajamaCommonCrawl


7 Im gonna tell ov teh kindnesez ov teh lord, Teh deedz 4 which he iz 2 be praisd, Accordin 2 all teh lord has dun 4 us— Yez, teh lotz da gud things he has dun 4 da houz ov israel, Accordin 2 his compashun an lotz da kindnesez.
8 He sed, "surely they r mah peeps, Sons hoo will not be false 2 me"; An so he became their savior.
9 In all their distres he 2 wuz distresd, An teh angel ov his presence savd them. In his luv an mercy he redeemd them; He liftd them up an carrid them All teh dais ov old.
10 Inn bwingen manee kittehs tah gloary, its watz fitin dat Ceiling Cat, who haz maids evahweefi, shuld purrfekt salfaeshun bie sufahwen.
11 Dee kittehs dat maek dem kittehs holey an dah kittehs dat arr maid holey arr inz dah saem famawee. Soo Jebus no iz ashaimd tah call dem bwoatas.
12 Him sayzes, "Ai willz say my naim tah mi kittehs; en dah pwescense of dah kittehs ai wilz sing yuz prayzes."
13 An agan, "Ai willz puts my twast en hims." An agan himz says, "Hee am ai, an dah kittehs Ceiling Cat haz given tah mee."
15 an fwee dah kittehs hoo arr en caiges bi der feerz of def.
16 Foe hims no hewps dah birdcats, buh Abraham's kittehs.
17 Caz of dis himz hads tah bee maid liek us kittehs en evahwee way, so dats hims may bee ah faiful kitteh tah Ceiling Cat, an dat himz mite atoan fur dee invisible errors of dah kittehs.
18 Caz him himzself sufahd wen himz wah temptaed, hims iz abah tah helpz dose hoo arr bein temptaed. Srsly!
13 And wen dey were gone teh hover d00dz of teh Ceiling Cat appeareded to Jozif and sayed "Hai, get up nao, and taek kitlin and mudder into Eejippt0rz, and stay dere till I sez, cos Herrot is lukin for teh kitlin and him gonna pwn him!"
15 and stayed dere til Herrot was "lol *dead*", so ting wud be liek teh profet sayed wen he sayed "Out of Eejippt0rz I done called mah son"
16 B4 he dyd, Herrot, wen he saw teh wies men was lollin at him, was rlly ticked, so him goed owt and pwned all teh kitlins dat woz in Beetleham, and teh beaches round dere, dat was under 2, cuz teh kitlin he waanted to pwn was dat age.
18 In Romma dere was a mew herd, crine vaerdy sadly, Raychul crine for her kitlins, and wud not be comfortd, cuz dey iz gon.
20 sayin "Hai, j00 can go hoem nao, Herrot am dead, lol"
21 And him went home to Izreal wit teh kitlin and him mudder.
23 and him moved into Nazref, so teh profets wud be rite wen dey sed "Ppl gonna call him a Nazreem"
This is a fun concept and I love the LOLcats. Thank you for the link to Kitty Limericks. I hope to start blogging there again soon.


text:
Patrick Kane May Not Play In Game Three
Quenneville calls him a game time decision
By Tom Fornelli • Published April 20, 2009 • Updated on April 20, 2009 at 4:00 pm
While the Blackhawks have a nice two-game lead in their first round series against the Calgary Flames tonight, they'll be facing a new challenge. For the first time this postseason they'll have to play a game without the United Center faithful standing behind them and cheering them on.
Instead they'll be facing a crowd that's every bit as raucous as the Chicago faithful at Calgary's Pengrowth Saddledome, the "C of Red." Also, let's not forget that the Flames weren't exactly easy to beat at home this season, posting a 27-10-4 record, though two of those losses did come to the Hawks.
Oh, and as if winning in Calgary wasn't hard enough, now the Hawks face the possibility of being without Patrick Kane, who missed this morning's skatearound at the Saddledome. Coach Joel Quenneville said that Kane was "resting" and that whether he plays or not will be a game-time decision.
No doubt what the young Kane is resting from are all the bumps and bruises that the Flames have administered to him every chance they get. While Kane is a very adept playmaker on the ice, his size has been an issue in the first two games as he's been pushed around by the bigger Flames throughout the first two games.
Still, even though Kane hasn't been as effective in the postseason as he was during the regular season, he's still a key cog to the Blackhawk machine. His play during five-on-five action has suffered, but he's still a key part of the Hawks power play and his playmaking skills would no doubt be missed if he doesn't suit up.
If Kane doesn't play, Colin Fraser will dress in his place and Martin Havlat can probably expect a even more attention from the Flames after the whistle than he got in game two on Saturday night.
Along with writing for NBCCHICAGO.com, Tom Fornelli can also be found contributing at FanHouse, SPORTSbyBROOKS, and his own Chicago sports blog Foul Balls.


text:
Unlocked Sony Xperia XZ3 Available For Purchase In The US
Android Headlines Alexander Maxham Oct 17, 2018
Android Headlines Oct 17, 2018
Alexander Maxham Oct 17, 2018 Read Source
In short: The Sony Xperia XZ3, announced at IFA back in early September, is now available for purchase in the US. The Sony Xperia XZ3 is available in three colors: black, forest green and white silver. Sony outfitted the Xperia XZ3 with an OLED display, which is the first time an Xperia smartphone has had an OLED panel. This is actually a p-OLED panel, so it is likely being made by LG. There is a 6-inch Quad HD+ (2880×1440 resolution) display here, and it is also curved. So that the display actually melts into the sides of the device, making the device actually feel smaller than it is, and look nicer as well. Internally, the Xperia XZ3 has all of the specs that you would expect from a 2018 flagship. That includes a Snapdragon 845 chipset, with 4GB of RAM and 64GB of storage. There is also a micro SD card slot available for expanding storage on the Xperia XZ3, for those that might need a bit more storage on their device. That is all powered by a 3300mAh capacity battery.
Sony's Xperia XZ3 is more than just the specs though. There's a lot more to this device than just that. Sony not only drastically improved the display here, but they also kept the stereo front-facing speakers – all without doing a notch, take that Pixel 3 XL. The bezels here are still pretty sizable, but compared to other Sony smartphones, they are actually quite small. Sony touts that these speakers are now larger, thus provide even better sounding and louder audio for watching movies and playing games. Speaking of playing games, Sony took the vibration motor from its DualShock 4 controllers and put it in the Xperia XZ3 (it was also in the Xperia XZ2 earlier this year), so you're getting some really good vibration here, which enhances the gaming experience and multimedia consumption as well. Of course, we can't forget about the fact that Sony has Android 9 Pie running on the Xperia XZ3, making it one of the few devices that have launched with Android Pie pre-installed (only other devices to do this are the newly announced Huawei Mate 20 series, and the Pixel 3, Pixel 3 XL). Sony's skin is also pretty light, so you're getting an almost stock Android experience here.
There's also a 19-megapixel camera on the back of the Xperia XZ3, like Google, Sony is also sticking with just one camera on the back of its smartphones. This sensor is a pretty good one, and does provide some great looking images. It has also been used on the past few Sony flagships. But a feature that this camera has that others don't, is the ability to do 3D pictures. So it can take a 3D scan of an object or even yourself, and create a 3D picture that you could use in a video game, like Grand Theft Auto. Obviously this isn't a feature that you are going to use all the time, but it is still pretty neat to have, to say the least. Sony also has a fingerprint sensor around back now, just below the camera. It's no longer in the power button, so it will actually work in the US.
Background: Sony likes to release two flagships each year, and they usually aren't big upgrades over each other, and that's because they are only about six months apart. The smartphone industry does move fast, but not quite that fast. However, this time around, the Xperia XZ3 is a much bigger upgrade over the Xperia XZ2. Which makes it more of a worthwhile purchase, especially seeing as it does have that OLED display here, which Sony says is one of the best on the market – though the Pixel 3 XL currently has the best display, according to DisplayMate.
In the past, Sony has been pretty slow to offer its devices in the US. This was likely partly due to the fact that it was only offering them unlocked and not through any carriers. In other markets, that's not a big deal, but in the US it basically means that your phone won't sell well. In the US, many still head to their carriers to buy a new phone, whether that's in person or on their website. And most unlocked smartphones do not work on all of the US carriers – largely skipping out on Sprint and Verizon due to them being CDMA. Sony used to take months to bring their devices to the US, launching their "current" flagship about a month before the next flagship is being announced. Which caused a lot of people to not buy it, and wait for the next big thing. Now, Sony is launching smartphones in the US within a few weeks of Europe and India, which is a big improvement, and definitely necessary.
Impact: The Xperia XZ3 is now available for $899. And unfortunately, the offer to get the Xperia Ear Duo for free expired when pre-orders ended yesterday, so you won't be able to get the Xperia XZ3 and Xperia Ear Duo for $899, which was a really incredible deal. Especially considering the Xperia Ear Duo are $279 by themselves. But you can still purchase the Xperia Ear Duo in black, forest green and white silver. All three have a black front, and that has been the new trend the past couple of years, likely because of more companies pushing mobile virtual reality using your smartphone, and black bezels makes it easier for to not get distracted while using your phone for virtual reality.
Surprisingly, the Xperia XZ3 is not certified to work on Verizon. This is a surprise seeing as other Sony smartphones have worked on Verizon in the past, leaving Sprint as the only carrier that its smartphones didn't work on. But for the Xperia XZ3, we're looking at just AT&T and T-Mobile support. Of course, MVNO's that run on those networks will also be supported. That includes Straight Talk, Simple Mobile Metro by T-Mobile, Cricket and others. It's the vast majority of carriers in the US, but unfortunately the largest carrier is left out. That's not a huge surprise, seeing as this only being sold as unlocked. It also wouldn't be a huge surprise to see Verizon announce today or later this week, that the Xperia XZ3 is compatible with its network. You can pick up your Xperia XZ3 from Amazon using the links below.
Buy the Sony Xperia XZ3
The post Unlocked Sony Xperia XZ3 Available For Purchase In The US appeared first on AndroidHeadlines.com |.


text:
Archives - Vulnerabilities Assessments
18 July 2011 FSB Plenary meets in Paris, France
At its meeting in Paris today, the FSB assessed vulnerabilities affecting the financial system and the progress of initiatives in a variety of policy areas to address them. The meeting also approved the finalised arrangements for the establishment of Regional Consultative Groups to broaden the range of countries involved in the FSB's work.
Content Type(s): Plenary Meetings, Press, Press Releases Source(s): FSB, RCGs Policy Area(s): AAQ, EMDEs, Implementation Monitoring, LEI, Non-bank financial intermediation, OTC Derivatives, SIFIs, Vulnerabilities Assessments
16 May 2011 Public responses to April 2011 note Potential Financial Stability Issues Arising from Recent Trends in ETFs
Public contributions received on the FSB's note on ETFs published on 12 April 2011. The FSB and its member authorities and standard setting bodies are continuing to monitor developments in the ETF market closely, and will use the feedback received as an input for their work.
Content Type(s): Publications, Responses to Consultations Policy Area(s): Vulnerabilities Assessments
11 April 2011 FSB seeks feedback on Potential Financial Stability Issues Arising from Recent Trends in ETFs
The FSB seeks feedback on its note on recent developments in the ETF markets. Comments should be sent to fsb@bis.org by 16 May 2011.
Content Type(s): Press, Press Releases Source(s): FSB Policy Area(s): Vulnerabilities Assessments
11 April 2011 Potential Financial Stability Issues Arising From Recent Trends in Exchange-Traded Funds (ETFs)
This paper highlights a number of recent developments related to certain types of ETFs that pose concerns to financial stability. Feedback on the note should be sent to fsb@bis.org by 16 May 2011.
Content Type(s): Consultations, Publications Source(s): FSB Policy Area(s): Vulnerabilities Assessments
11 April 2011 Financial Stability Board publishes a note on financial stability issues from exchange-traded funds (ETFs)
5 April 2011 FSB Plenary meets in Rome, Italy
At its meeting in Rome today, the FSB assessed vulnerabilities affecting the financial system, and made decisions needed to progress major initiatives to strengthen the resiliency of the financial system.
Content Type(s): Plenary Meetings, Press, Press Releases Source(s): FSB Policy Area(s): Compensation, Data Gaps, Implementation Monitoring, Information Exchange, Non-bank financial intermediation, OTC Derivatives, SIFIs, Vulnerabilities Assessments


text:
Q: How to fork a Framework Library After downloading the Android Source Code using the repo command as suggested on the page:
repo init -u https://android.googlesource.com/platform/manifest

I was able to compile the whole project without issue using make.
What I would like to do is compile my own fork of android.media.MediaPlayer, but I am lost as to how to set up the build.
I tried using ndk-build in /frameworks/base/media/libmedia, and got the following output:
Android NDK: WARNING:/home/user/android/WORKING_DIRECTORY/frameworks/base/media/jni/Android.mk:media_jni: non-system libraries in linker flags: -lpthread
Android NDK:     This is likely to result in incorrect builds. Try using LOCAL_STATIC_LIBRARIES
Android NDK:     or LOCAL_SHARED_LIBRARIES instead to list the library dependencies of the
Android NDK:     current module
[armeabi] Compile++ thumb: audioeffect_jni <= android_media_AudioEffect.cpp
/home/user/android/WORKING_DIRECTORY/frameworks/base/media/jni/audioeffect/android_media_AudioEffect.cpp:22:23: fatal error: utils/Log.h: No such file or directory
compilation terminated.
make: *** [/home/user/android/WORKING_DIRECTORY/frameworks/base/media/obj/local/armeabi/objs/audioeffect_jni/android_media_AudioEffect.o] Error 1

How could I compile a .jar that contained libmedia and android.media.MediaPlayer so that I could simply drop it into a project and use that instead of the default android.media.MediaPlayer?

redpajama_set_name: RedPajamaStackExchange


Wool Tops :: Tops Merino Dyed 22 mic. :: Black 22mic tops B110, 50gr.
Home/Wool Tops/Tops Merino Dyed 22 mic./Black 22mic tops B110, 50gr.
Black 22mic tops B110, 50gr.
Minimum quantity for "Black 22mic tops B110, 50gr." is 2.


text:
Q: Helper Classes for DelayedJob in Rails In order to start delayed_job's on a schedule you need to have helper classes with a perform method that delayed_job can call. These need to be defined before any of the classes that use them to create scheduled delayed_jobs are called. All very short, and many of them in my case. For example:
class AccountUpdateJob < Struct.new(:account_id)
  def perform
    acct = Account.find(account_id)
    acct.api_update
  end
end

I'm doing this in a file called "dj_helper_classes" in the initializers folder. Is that the right thing to do?

A: I keep mine in lib/jobs, one file per class.  So, your example would be in lib/jobs/account_update_job.rb
module Jobs
    class AccountUpdateJob < Struct.new(:account_id)
        def perform
          acct = Account.find(account_id)
          acct.api_update
        end
    end
end


Career Development Having trouble choosing a specialty? Learn about family medicine, and what it has to offer.
So, you want to be a doctor? You've started medical school, and the medical world is your oyster. You've made a lot of good decisions to get here, but there's another important decision lying in store. What kind of doctor do you want to be?
As a medical student, choosing a specialty is perhaps one of the toughest decisions you'll ever make. Your curiosity about the human body is limitless, so why limit yourself to one particular organ or system? If this sounds like you, family medicine is the answer.
Family physicians care for people of all ages and genders, and focus on maintaining ongoing patient-physician relationships. They know patients' health history and provide comprehensive, integrated and coordinated care. Family physicians conduct approximately 1 in 5 of the total medical office visits in the United States each year — more than any other medical specialty.
A typical day for a family physician may include delivering a baby and caring for the new mother, performing a sports physical on a teen, and helping patients manage chronic health conditions such as diabetes, high blood pressure, asthma and arthritis. With a focus on prevention, family physicians empower patients to take charge of their health. They also perform minor surgeries and procedures such as colonoscopies, endoscopies, IUD placement, colposcopies, skin biopsies, suturing lacerations, vasectomies and more.
One of the unique aspects of family medicine is that it offers a high degree of flexibility compared to other medical specialties. Because family physicians are needed everywhere, they have the option to choose to work in urban or rural settings, to pick their practice environment and scope of practice, and to pursue different career paths, such as public health, teaching or research. These options enable a manageable and rewarding balance with family life and personal interests.
Because they are in great demand, the future looks bright for family physicians. According to research done by the Robert Graham Center, the United States will need nearly 52,000 more primary care physicians by 2025. For the last 10 years, family medicine has been the most recruited specialty in the United States.
Medical students are eligible for free membership in the American Academy of Family Physicians. AAFP members have access to exclusive web content, including the medical journals American Family Physicians and Family Practice Management.


For the first time, in all the flights I booked online with Cebu Pacific, I made an error in filling out one of the more important details – the passenger name. Ack! And if the same thing happened to you and like me, you found out the mistake after verifying your credit card details, chances are, you felt a lot like I did. It was a silly mistake but I did have my reasons. I was in a hurry to get the flight booked. You see, the first attempt I booked for this flight, Cebu Pacific's website gave the error prompt and I had to do the process over again. When the blanks were filled in for me on my next attempt, I was careless and did not double check and only made sure I got our travel dates right.
The day the hubby acquired my middle name. My bad!
While I could have panicked and worried that I might have to buy a separate ticket for the hubby again and end up wasting money, I collected myself and called the Cebu Pacific hotline 702-0888. Turned out Cebu Pacific actually has allowance for this particular silly mistake that some of their passengers are bound to make at one time or another.
1. Go to http://www.cebupacificair.com/Pages/fee-summary.aspx 2. Scroll down to Name Change Fee – (NC) 3. Click on the pro-forma affidavit (name correction of same person) 4. Have the form printed and filled out (no need to have it notarized) 5. Email namechange@cebupacificair.com with the Booking Reference No. as Subject. Attach with the email the scanned copy of the filled out Pro-forma Affidavit and the scanned government issued ID of the passenger. Indicate within the email the travel dates.
Chelsea said that upon submission of the needed requirements, I can follow up with them after 24 hours. Turned out I did not need to follow up with them since I received a reply and an itinerary receipt with the hubby's name corrected in less than three hours.
Thank you for sharing your experience with Cebu Pacific name change.
It was perfect solution to my predicament.
pa help nmn kc nagkamali ako ng input ng JR…dpat ang JR nasa kasunod ng first name pro ang nagawa ko ung JR nasa surename ko nailagay…ano dpat ko gwin pra maaus?
Hello po! Need help po, Ang friend ko ang nag book ng flight q this morning lang, then she send me the booking reference for me to pay without knowing na mali pala yung apelyedo q. Instead na Christine Panganiban only appear as Christine Pa. Anu po ba dapat gawin aside sa tawagan ang hotline nla? Wla po ksi kming landline eh. Thank you po! More Power!
Year 2016 month of May and I end up on this blog because I too did a mistake.
An friend ask me to buy her a one way ticket from Taipei to Manila.
I key-in her surname instead of her family name.
I was so stressed with the mistake and scan through CEBU PAC website for solution.
It was an international call and I dialled many times and waited for two minutes at a time until I hang-up and called again and for seems eternity someone replied.
so there hotline would be available 24 hours a day in a quick response.
Anyway the one who answered the phone told me to prepare two documents .
There was no Pro forma Affidavit required.
Now my problem is , my friend didnt have her MC so right now I am sending Cebnamechange mail if I can use another Identification that will show three names .
Family name, First Name, and Surname.
It was this ID that I got confused that I key-in the first name and surname.
Still waiting for reply .
Hi! Was the email cebnamechange@cebupacificair.com given to you? Have they replied to you yet? I am in the same predicament at the moment and waiting for a reply.
Hi! Need help. Since i cannot call the hotline,might as well ask here. What if there was a missing letter in the name. Like lacking "n". My 6 mo. son is Siegmunnd,and my aunt input Siegmund which contain one "N" only. What do I do?
Please help me po ngayon ko lang na check na mali ang na encode ko sa name ni PERIWENKLE CASTA . nagkamali ako na insted PERIWENKLE, PERIWINKLE sana OR Instead of WE dapat "WI". Gamit ko Credit Card ko para ito sa pamangkin ko na ang flyt ay sa April 15 @ 3:15 PM Manila to Roxas City. Please po tulungan nyo naman ako na e consider, clerical error lang po.
Hi I need help I booked the ticket for my daughter but I was wrongly type the last name..It is supposed FAZRINA SHAREEN SHEIKALIE not SHEICKALIE..Hoping for your kind and immediate respond regarding this matter. Thank you..
Hello..i need help.have some error in my itinerary.i call the customer service many times but no one answer..my problem is all about my name in my itinerary it was belenda olivarez prado…instead of belenda prado olivarez is the correct..pls help me..it doesn't matter when i check in?
Last December 26, 2016, I booked a ticket for my 2 sisters and myself. One of my sisters names was misspelled. I typed MA NELLA TAN instead of MARIA NELLA TAN, which is the name in her passport. What do I do to correct our ticket. Please advise asap. Thank you very much.
tatangpin po ba ang greencard niya? sa passport niya kasi is family name namin bahian pero nalagay ko po ay nelson last name ng asawa niya. sa greencard po nag appear yung nelson kaso sa passport niya is bahian. please po need advise. flight ref number po ay LDRZMD. pwede po ba palitan ng apilyido?
I have failed filling out my middle name does this matter? My flight details doesn't match my passport due to locking of my middle name.Please help me. Thanks!
Pa help pls..my frnd ask me to book his sister a ticket and i was mistake typing her surname.. what will i do?
hi, so sorry but i book a flight for the three of us..my daughter and my mom whose age is 73, but sadly she cant make it on saturday flight so i tried calling the customers hotline to help me book a trip for a regular fare inbehalf of the slot of my mom for my cousin,but i was confused how come they book me the same name of my mom insted of my cousin?pls help me…..
My name was miscorrectly spelled. From Emelie to Emelia..What should I do?
please change the surname of my wife:s name from Fe Alma Durs to Fe Alma S. Durano our flight is on Sept 4, 2017 with Booking Reference no W7W9WL. Thank you very much for your kind assistance,..
hi mam please help me also dahil nag kamali yong boyfriend ko pag sulat ng pangalan ko instead of Leil ,ni lagay niya duon ay Liel yun lang ,may problem pa ba jan?
hello.. pano po if ever nag kabaliktad and surname sa first name.. japanese kc sya kaya lagi po nauuna ang last name kaya nag kamali po sya ng book my ways pa po ba maayos?


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Jul/2019
FANBOY'S HOME
Fantastic Fest Film Review: 'Apostle'!
by Gumbercules9000 on Sep 24th, 2018
Easily my favorite movie of Fantastic Fest so far, Apostle is the type of movie that will stay with you hours after watching it. Gareth Evans wrote and directed this disturbing tale of Thomas (Dan Stevens) who infiltrates a religious cult on a remote island in order to rescue his kidnapped sister. Any further descent into the plot would ruin surprises that were a joy to discover during the movie. Evans' ability to depict brutality and rage is second to none. What's that? You haven't seen The Raid or its sequel? Go watch those then come back to this review.
Dan Moran's Top Films of 2018 and his Award Nominations!
by Gumbercules9000 on Dec 30th, 2018
This year I saw 102 new movies in 2018. That number is actual movies released in 2018. I count Netflix and streaming movies released this year because that is where we are heading but the majority of the 102 was in movie theaters. I decided not to rank my top movies this year because at the end of the day the difference between #10 thru #3 is usually based on my mood when I write the list. So I just put my top movies in ABC order.
My Bloody Podcast #22 – Fantastic Fest 2018 and Halloween 2018!
Here is the super spectacular 22nd episode of our horror podcast under the MULTI-MEDIA MEN banner called 'My Bloody Podcast', where the show is related to all things HORROR! Here on this new show, Preston Barta from Fresh Fiction and the Denton Record-Chronicle and I talk about everything we love about horror movies, tv shows, and horror themed music.
http://boomstickcomics.com/wp-content/uploads/2018/09/my-bloody-podcast-22.mp3
Fantastic Fest 2018 First Wave of Motion Pictures Announced!
by Gumbercules9000 on Aug 1st, 2018
Fantastic Fest is one of the events that is pure bliss for any fan of genre cinema. If you love horror, sci-fi, foreign, action, and even adult-oriented movies from the 1970s, then Fantastic Fest is the place to let that freak flag fly high and be with like-minded individuals that truly appreciate the art of movies. All of the madness and fun will take place in Austin, TX starting on September 20th and run for 10 days at the Alamo Drafthouse on South Lamar St. This year, which is the 14th annual festival of Fantastic-ness, captures the essence of the Korean movie scene with a ton of cool films being showcased from Korea, both new and old. This is something you won't want to miss.
The first wave of movies has been announced, including the World Premiere of the WWII horror movie called 'OVERLORD' from J.J. Abrams. In addition to that film, Fantastic Fest will host Gareth Evans' horror movie 'APOSTLE'. Gareth gave us the amazing films 'THE RAID' AND 'THE RAID 2', so you can expect some insane fight scenes and horrific imagery. Alos, a film called 'THE NIGHT COMES FOR US', which stars the badass from those 'RAID' movies will be shown, meaning Iko Uwais will stun us once again with his amazing physical skills. If you were a fan of 'THE GREASY STRANGLER', the director of that movie Jim Hosking has a new film called 'AN EVENING WITH BEVERLY LUFF LINN', which is being described as a David Lynch meets John Waters type of movie. You had me at Greasy Strangler.
Lastly, there are some vintage films coming through from AGFA (American Genre Film Archive), one of which has peaked my interest from the title alone – 'MARY JANE'S NOT A VIRGIN ANYMORE'. I have high hopes for this one. Below is the list of films with cast and crew info, along with a brief synopsis. Enjoy and hope to see you all there.
'Fantastic Fest' Second Wave of Programming Looks Fan-Freaking-Tastic!!!
by Red Zeppelbon on Aug 26th, 2015
Hey guys, Jana here,
'Fantastic Fest' has released their 2nd wave of programming with a huge roster that would work as an entire film fest on its own! Add it to the first wave programming seen here, and by Jupiter's Cock, it's going to be exciting!!! There will be advance screenings of 'The Martian', 'High-Rise', 'Green Room', and 'The Keeping Room'.
"This is a big year for genre cinema. We're exceptionally proud to honor incredible filmmakers and welcome back some of Fantastic Fest's favorites," said Tim League, Fantastic Fest and Alamo Drafthouse CEO/Founder.
Sticking true to Fantastic Fest's penchant for chaos and explosive events, they welcome Itchy-O to Austin for the first time. A blazing, 32-member aural assault from the darkest depths of Colorado, Itchy-O is a wholly immersive, musical experience on a massive scale. Said festival director Kristen Bell, "We cannot wait for them to unleash their percussive mayhem on our audience as hysteria has a welcome home at Fantastic Fest."
See below for the full lineup of newly announced film titles for Fantastic Fest 2015. Final wave of titles to be announced shortly.
Film Review: "Son of God"
by Woozie on Feb 27th, 2014
Suzanne L., Here…
Whether you believe or do not believe, most people can agree that the story of Jesus is very powerful. A man who sacrifices his life by a going through a terrible death in the hopes that his act will save humankind from the grave – it is automatically filled with drama and meaning. Unfortunately, the latest film to try to capture the power of this story, Son of God, fails in so many ways. From the acting to the scripting to the special effects and staging, this is one story of the Gospel that should be skipped.
Boomstick Comics » Blog Archive Mary Poppins Returns: Film Review! - Boomstick Comics on *UPDATED* BLURAY/DVD RELEASES FOR THE 1ST WEEK IN NOVEMBER
Linda Fitzgerald on Film Review: 'Venom'!
Gumbercules9000 on An Evening With Beverly Luff Linn Interviews at Fantastic Fest 2018!
Rocky Balboa on An Evening With Beverly Luff Linn Interviews at Fantastic Fest 2018!
Jack Burton on Fantastic Fest Film Review: 'Hold the Dark'!
Video Newscaster:
[TV news anchor reporting] Once again, the L.A.P.D. is asking Los Angelenos not to fire their guns at the visitor spacecraft. You may inadvertently trigger an interstellar war.
Independence Day (1996) The Movie Quotes
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Important update on Feline Panleukopaenia Virus (FPV)
Friday, 10 February 2017 at 4:18
Important update on Feline Panleukopaenia Virus (FPV) (also known as feline parvovirus or feline enteritis)
As confirmed by the University of Sydney, there is an outbreak of FPV in Sydney that has already killed dozens of cats and kittens, and has led to the temporary suspension of cat admissions and adoptions at Blacktown Pound.
What is FPV?
FPV is a largely fatal viral infection that has rarely been seen over the past 40 years thanks to effective vaccination – the standard F3 vaccination covers FPV. However, kittens are at high risk until their vaccination schedule is complete. Adult cats require boosters.
If you own a cat, please make sure their vaccinations are up-to-date.
If you are a pensioner or on a low-income, please phone our welfare office on 02 9519 7201 for a referral to a vet who will offer discounted vaccination.
Loss of appetite, lethargy, vomiting, diarrhoea (often with blood present) and general depression can all be signs of FPV. Young kittens and unvaccinated cats are most at risk. If you have any concerns about your cat, see your vet as soon as possible.
Cat Protection
At Cat Protection, all cats and kittens over 4 weeks are vaccinated on admission with a live F3 vaccine, and continue to receive vaccinations according the schedule while they are in our care.
We also faecal test every kitten on admission and of course, all cats and kittens are health checked by a vet. We have stringent infection controls in place.
At Cat Protection, we have been closely monitoring the health and progress of the kittens in our care and are very excited to announce we are resuming kitten adoptions.
As a precaution we are asking anyone who has a cat or cats at home to bring along a copy of their cat's current vaccination certificate. This new measure is to highlight the importance of vaccination for all cats and kittens and safeguard against the spread of FPV.
We have many beautiful adult cats and kittens in our adoption centre who would love to find their forever homes. We also have kittens available at Concord Veterinary Hospital and Divine Creatures.
Sadly, we have had four fatal cases of FPV (representing only about 2% of our feline population in January-February) over the past week and none prior to that. All four were kittens and had only had initial vaccinations or were too sick to even be vaccinated on entry. All were provided with dedicated and compassionate veterinary care, and we thank everyone who did everything possible for them.
We are working with our vets and the University of Sydney's Professor Vanessa Barrs to ensure that, through research, these cats will help cats of the future.


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Q: WatchKit didReceiveApplicationContext not being called I can't get didReceiveApplicationContext to be called.  Any ideas?
InterfaceController:
import WatchKit
import Foundation
import WatchConnectivity

class InterfaceController: WKInterfaceController, WCSessionDelegate {

    @IBOutlet var colorLabel: WKInterfaceLabel!

    private let session: WCSession? = WCSession.isSupported() ? WCSession.defaultSession() : nil

    override init() {
        super.init()
        session?.delegate = self
        session?.activateSession()
    }

    override func awakeWithContext(context: AnyObject?) {
        super.awakeWithContext(context)
    }

    func session(session: WCSession, didReceiveApplicationContext applicationContext: [String : AnyObject]){
        let colors : String = applicationContext["color"] as! String
        colorLabel.setText(colors)
        NSLog("session did receive application context")
    }

}

I've been following along with this tutorial: http://www.kristinathai.com/watchos-2-how-to-communicate-between-devices-using-watch-connectivity/
No NSLog or setting of the colorLabel happens.  No idea what I'm missing.  Thanks!

A: I had the same problem. In my case it helped to just close both simulators and then run the Watch scheme. This opens up both simulators again in connected state.
Hoping it helps!

A: I copied the above code into a new watch app and it works fine.  The error must lay on the sending side. Are you certain the code in the iOS app is being called?  I presume you are using Xcode and two simulators, one for the iOS app and one for the WatchApp.
The code on the iOS side is not run unless you open the app on the phone simulator.  Where and how on the iOS side are you issuing the updateAppContext call?
In my test, this is all that I added to my ViewController.swift on the iOS side (This code will not be triggered until I start the iOS app on my iPhone.)
override func viewDidLoad() {
    super.viewDidLoad()
    // Do any additional setup after loading the view, typically from a nib.
    let session = WCSession.defaultSession()
    session.delegate = self
    session.activateSession()
    do {
        try session.updateApplicationContext( ["color" : "Red" ])
    } catch _ {

    }
}

A: For me, when doing some testing/debugging i tried to fire updateApplicationContext in AppDelegate. This caused the didReceiveApplicationContext not being called.
Moving this logic to a later point, like in a UIViewController made it work for me at least.

A: Check the session to make sure its isPaired and watchAppInstalled properties are both YES. It seems like updating the shared context while these are NO will not work.
I was having this issue. Made a change to not update the context when either condition was NO. Added an implementation of sessionWatchStateDidChange:, and if both conditions were YES, updated the context. It worked.
I suspect this in combination with another issue where the phone will not send the context if the data is not different causes the "never updating" issue. A workaround of passing a "uuid" did help but I suspect the above is a better fix.

A: This seems to be a typical 'development phase' problem!
The WCSession.defaultSession.applicationContext is buffered on the iOS device, so it is only transferred to the watch (extension) once if it doesn't change.
This lead to the strange finding, that watch extensions 'didReveiveApplicationContext:' seems not to be called, when WCSession.defaultSession.updateApplicationContext is called in the iOS app again. (Try to call WSSession.defaultSession.receivedApplicationContext in the extension to find, that the earlier transferred context is in fact available)!
In test situations, it is very helpful to add a 'changer' object to the context dictionary (like an UUID object, or - maybe even better - a NSDate.date). This will ensure, that the context has changed (compared to the buffered one) and gets transferred again (leading to a call to didReceiveApplicationContext) :-)
NSError*    error = nil;
[WCSession.defaultSession updateApplicationContext:@{ @"yourKey"       : @"your content",
                                                      @"forceTransfer" : NSDate.date }
                                             error:&error];

And: Don't forget to remove this in the production version of your app, as - of course - this leads to unneeded data transfer between your app and your watch extension!
PS: The checked answer solves this problem by creating a new app. And flushing all buffers this way...

A: In my case, I used the following code to send my application context:
    do {
        try session.updateApplicationContext(applicationContext)
    } catch let error {
        throw error
    }

and neither didReceiveApplicationContext was called, nor an error was thrown.
My problem was that applicationContext contained a custom object, whereas only property list items are allowed.
The strange point is that no error was thrown.


Many NHS organisations are exploring the possible service and financial benefits of new models for the provision of pathology services.
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An English district general hospital needed to upgrade its pathology services and invest in new equipment. As part of that exercise, it agreed in principle to the reorganisation of its pathology services with a neighbouring district general hospital. It agreed to pool workforce assets and investment, to free up property in one of the Trusts to allow more cost-effective investment in equipment at the other Trust, to create a shared workforce to minimise cost and maximise expertise, and finally to be able to offer a more cost-effective, responsive service to external users of pathology services in primary care.
Conducting due diligence and providing other areas of project support.
A teaching hospital in Wales: we helped the hospital from start to finish with the procurement of two separate but parallel services (biochemistry and haematology) together worth £48 million over an initial 8 year period, which resulted in major savings for the hospital as well as securing a high level of service provision.
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Read our blog post for our advice on utility rooms - everything you need to know.
Wanting larger kitchens has been the kiss of death to the laundry/utility room, but they still very much have their place. If you've got a utility room, you will consider yourself very lucky. If you haven't, don't dismiss the possibility of clawing back some space to create one. It might feel like a waste but it actually frees up your living space and makes it more efficient to live in; consequently, it's a huge selling point in a family house. Ideally, a utility area houses the washing machine, dryer, ironing board, a sink and drying pulley. It also has storage space for cleaning utensils, mops, vacuums, vases and other household necessaries, well away from the food preparation areas.
It doesn't need to have great head height or be beautifully finished - an unconverted basement is a good location as long as it's not too damp and you provide good ventilation. You won't regret it. This is the engine room that keeps the rest of a house running smoothly and tidily, and if you have the space it's well worth creating one.
If you can make it work, fit a laundry chute in the bathroom. It is fantastic feature and a great timesaver for people with busy lives. There's an old-world glamour to chucking your laundry into the bathroom chute, even if you have to sort it yourself at the other end! You need free space between the floors without plumbing, wires or other obstructions. You can hide the chute ends in cupboards, with a big laundry basket at the bottom. Perhaps this is a little impractical for the majority of homes though.
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