text:
In geriatrics, we are at the very roots of medicine
Prof. MUDr. Eva Topinková, CSc., who had recently received the František Běhounek Prize for promotion and popularisation of Czech science in the European research area (ERA), has been at the helm of the Department of Geriatrics of the First Faculty of Medicine Charles University and General University Hospital in Prague since 2001. She emphasises that geriatrics is an immensely broad area with many so far unexplored corners, which includes topics ranging from epidemiology and preventive programmes of public healthcare though clinical practice all the way to experimental biogerontology.
The Department of Geriatrics at the First Faculty of Medicine and General University Hospital was created as the first of its kind in Prague. Is it still the only one?
Yes, our department was the first geriatric clinic in Prague but although that made it in a sense 'unique', we took no joy in that. There are three faculties of medicine in Prague and development of this area and training of medical students requires that a department specialising in geriatrics be established at each of them. That is why I was very pleased that last year, a Department of Internal Geriatric Medicine was created at the Second Faculty of Medicine in Motol. This is needed not only for patients – it is also necessary for successful further functioning of 'academic geriatrics' which enables a methodical development of this field and its scientific potential, including publication activity. It is the only way how we can implement geriatric knowhow also into other areas of medicine. Academic geriatrics needs the creation of further centres, scientifically erudite leaders, clinical studies, and projects that will produce more scientific results.
In one of the texts in our Number One you wrote that the First Faculty is freeing itself from traditionalism and is modernising in line with European trends. Does that also apply to the teaching of geriatric medicine here at your department?
Yes, but personally, I am no enemy of traditions. They are important: they facilitate continuity, stability, and feeling of security given by repeating things that worked well in the past. On the other hand, traditions actually do not allow change. I believe that it is necessary to follow up on the traditions of academic teaching, develop them, and adjust them in view of current needs, the needs of students, clinical practice, but also the needs of teachers. At the department, when developing new curricula, we took as our starting point the recommendations for Europe issued by UEMS, a geriatrics section for undergraduate teaching. As a representative of the Czech Republic, I participated in their development. We also published these recommendations in the journal of our association, just as we published an overview of contents of our specialisation training programme. Geriatrics is now included among the basic specialisations and the Geriatrics Department trains interns preparing for attestation and specialisation courses.
For some years now, the basics of geriatric medicine are included in the curriculum of medical and even of the majority of non-medical fields. What further changes to the better would you like to see in the training of future healthcare professionals?
I believe we managed to reach the goal we set ourselves almost twenty years ago together with the first head of our department, doc. Jiří Neuwirth. We wanted all students of medicine, physical, occupational, and nutritional therapy, as well as nursing students, to encounter in their studies something like 'geriatrics 101'. And this we managed, including the creation of instruction aids in Moodle. We would certainly welcome a return to full, in-person teaching without any Coved-related restrictions, a broader use of teaching materials from abroad – we are only just learning the Amboss program – and perhaps also a greater inclusion of the subject of aging into instruction in other fields taught here. It would be great to for instance include instruction in communication with older patients. To better understand geriatric diagnoses, one can also use the simulation centre – where students should try out for instance the weighted suits – to find for oneself how age changes the organism, its abilities, and its appearance. I find it surprising that for instance in pharmacology, students do not learn much about the notion of medications unsuitable in advanced age, that is, about the classes of medications which due to their pharmacokinetic or pharmacodynamic properties are not safe for older patients. these are for instance medications which significantly increase the risk of falling or those which have an anticholinergic effect. Those are not suitable for older people at all, because in advanced age the brain has low neurocognitive reserves, and the use of such drugs can have a negative impact on cognitive functioning or even cause a delirium.
How do you motivate medics to work in the area of geriatric medicine?
Our experience as well as one older questionnaire survey had shown that among students, only several percent are interested in working in geriatric medicine. This is caused by the not very positive attitude of current society to old people as well as by the still low prestige of this field, which tends to be viewed as uninteresting, lacking in action, and it is often misunderstood as amounting to long-term care for helpless seniors. We are trying to change this perception and show students that knowledge of geriatric medicine will help them take better care of patients in higher age groups even if they work in a different medical field. Perioperative care, safe prescription practices, comprehensive assessment of comorbidities, evaluation of cognitive abilities, and preventive geriatric medicine are areas where geriatric knowledge enables qualitatively better medical care.
What convinced you to choose geriatric medicine?
I must admit that I did not actually choose it. I was 'left' with a spot in the gerontologic group of Professor Pacovský at the Third Department of Internal Medicine of the Faculty of General Medicine (now the First Faculty of Medicine, note of the editor). But it turned out that there is much that is still unexplored and interesting in both gerontology and geriatrics, that it is an immensely broad field ranging from epidemiology and preventive programmes of public healthcare through clinical practice all the way to experimental biogerontology. Why is why I have been finding geriatrics so amazing for all those years. And another thing I find amazing is the fact that in caring for old people, we are at the very roots of medicine: helping, humane, and charitable.
Do you have some idea how many young physicians, now graduates from the medical faculties, want to focus on geriatric medicine?
Yes, in our professional association we keep track of the numbers of physicians who signed up for geriatrics and we follow them through their specialisation pre-attestation training. Our Department of Geriatric Medicine also serves as the clinical part of the Subdepartment of Geriatric Medicine of the Institute of Postgraduate Medical Education and holds accreditation for geriatrics.
In the Czech Republic, about ten physicians a year finish their specialised training in geriatric medicine, so that now there is over 200 of them working in Czechia. Should there be more?
The goal of our efforts is not to attract as many physicians into our specialisation as possible. Geriatric medicine is not for everyone. As a field, it belongs to the large family of internal medicine but has overlaps into other areas as well: it touches for instance upon orthopaedics (in other countries, this subspecialisation is called orthogeriatrics), but also post-operative care and rehabilitation, specialisations in the area of disorders of vision and hearing, neurology, and psychiatry (states of deliria, dementia, disorders of behaviour in old age). That is why we do not want to educate just specialised geriatric physicians but also train specialists in other fields who will, based on some foundations in geriatrics, take better care of older patients. Each clinical area should cultivate its methods and specifics of treatment of older population. Right now, only a few recommended procedures take into account the specific aspects of aging and the fact that old patients have other comorbidities. The test of doctor's skill is to find, together with the patient, the patient's priorities and suitably modify the treatment, or, as we would nowadays rather say, individualise it.
The Department of Geriatric Medicine also functions as a guarantor of a non-professional study for students of the University of Third Age. What does this study involve?
The University of Third Age (U3V) opened at the First Faculty of Medicine in 1987, so this year we celebrate 35 years of activity. Right now, we have over 200 students who follow a four-term course in Human Biology and can also attend a course News in Medicine, in which we – thanks to help from the individual departments at the faculty – introduce each semester a different field. This academic year, we introduce new findings from oncology and addictology. And on a general level, how does education of in the 'third age' benefit its students? Studying in advanced age clearly has an important psychological effect. Some of our students are over eighty and many have been attending the course News in Medicine for over 10 years. Mental activity and the social nature of meeting in classes (recently unfortunately limited by the pandemic) have a favourable effect on the overall feeling of health and satisfaction with life. There are scientific studies which describe the positive impact of such activities on cognitive health.
Speaking of studies, your department has become, over the past twenty years, a renowned scientific partner of dozens of large European projects. Which of those resulted in key contributions to your field?
It is difficult to select just one or two projects. I remember the first project of the 5th framework programme of research and development of the European Commission AD HOC (2001–2004), which was I think also the very first large European project our faculty had acquired as part of this programme. It dealt with the issue of seniors in home care, clinical indicators of patients, indicators of quality of care, and the extent of care and services. Our department analysed pharmacotherapy and patients' adherence with treatment, and we published the results in JAMA, a highly prestigious journal. In 2005, we were the first in the Czech Republic to draw attention to the concept of unsuitable medications which carry increased risks for older patients. We are still active in researching this subject. I also remember the PREDICT project, which drew attention to the low representation of older persons in clinical studies and investigated barriers and ways of increasing their representation in clinical research. The results contributed to the creation of an expert groups for geriatric medicine adjoined to the European Medicines Agency. Scientifically most productive project with over 30 publication outputs in journals with impact factor was the SHELTER project of the 7th framework programme of the European Commission, which at that time followed the largest cohort of 5,000 patients in long-term care in eight European countries. From the past five years, I'd mention three large European projects focused on the study of seniors' frailty and sarcopenia. The SPRINTT project had proven the beneficial effect of directed physical activity and nutritional interventions in frail seniors and the MIDFRAIL project had shown improvements in physical fitness in older diabetics. The publication European consensus on the definition and diagnostics of sarcopenia has, as of today, 5,871 citations. Interesting were also the results of MPI–AGE project. It confirmed the contribution of MPI index to evaluation of frailty and prediction of mortality in a prospective study of hospitalised seniors and effectivity of interventions given their degree of frailty.
In your current scientific work also related to the Covid-19 pandemic?
Yes, we are now analysing the results of an international multicentric observational study MPI-COVID-19. It is a prognostic stratification of patients 65+ hospitalised with Covid-19 and an evaluation of effectiveness of intensive interventions using the MPI index. We are now also following, within the framework of international study EU-COGER, the effectiveness of post-Covid rehabilitation in geriatric patients.
You have recently received from the Ministry of Education the František Běhounek Prize for promotion and popularisation of Czech science in European research space. Which particular study or initiative in this area deserves, in your view, some special appreciation?
I am most honoured by this prize. It is an award not only for popularisation and promotion of Czech science but in effect a symbol of appreciation of the entire research field of gerontology and geriatric medicine. In addition to the abovementioned international research projects and grants, I have also been active in various international organisations for many years. For two terms, that is, eight years, I served as the general secretary of the International Association for Gerontology and Geriatrics IAGG for the European region and subsequently I was for four years president of the clinical section of IAGG-ER. I have also worked in the European Geriatric Medicine Society (EUGMS) and member of its academic board, and I have been serving for many years as a representative of the Czech Republic in the UEMS-Geriatric Medicine. I very much appreciate the opportunity of collaborating within the expert community with outstanding and important European geriatrists and gerontologists, and I value the support we receive in realisation of projects and educational activities from the faculty and the hospital. And I am most grateful to all my collaborators at the department and at other cooperation institutions, everyone who participates with me in promoting and developing geriatric medicine in our country and abroad.
Dr. Richter, head of the department, told me about you that you create at the department for your collaborators an 'anti-stress' environment. How do you do it?
Our aim is to make sure that people like working at our department and want to participate in its smooth operation. That is not a matter of course and I am trying to make sure that my colleagues know that I appreciate their work and respect them. I also honour the diversity of the team, where everyone can work on what they are interested in and what they find satisfying. I believe that it is important for the leader of a team to be authentic, so that the employees believe that what the leader does is seriously meant and that they are actually considered in the team leader's decisions.
klu
What Jednička means to me
Jednička in science


It performs the necessary dimensional checks during every phase of development, and the measurements required for the submission of PPAP files (and initials samples).
Our Metrology department also performs periodic audits of products required by the Quality system.
As an industrial partner MICROTECHNIC is involved in the approval of parts and assemblies products.
We provide project management for the achievement of certification tests specified in customer's specifications.
We have the experience to realize many tests required by the automotive industry: aging tests , strength or endurance , etc.
Additionally we design and manufacture assembly machines. We are also developing equipments specially adapted for testing.


text:
Jump to Content: Welcome to the virtual world of Georgia Tech
Jump to Footer Navigation: Accessibility | Contact Us | Legal & Privacy Information | Technology
Assistance Navigation:
GT >> College of Engineering >> School of Industrial and Systems Engineering >> ISyE Personal Web Site
· Faculty Home
· Courses
· Publications
· Research
· Software
Optimization Software at Georgia Tech
Semidefinite Optimization: First-order algorithms
SDPLR v0.130301 (March 13, 2001)
SDPLR is an ANSI C package developed S. Burer, C. Choi and R.D.C. Monteiro for solving general semidefinite programs (SDPs) using a nonlinear, first-order algorithm that is based on the idea of low-rank factorization. A specialized version of SDPLR is also available for solving specially structured semidefinite programs (SDPs) such as the MaxCut SDP, the Minimum Bisection SDP, and the (unweighted) Lovasz Theta SDP. The details of the algorithm used by SDPLR can be found in the technical report "A Nonlinear Programming Algorithm for Semidefinite Programs via Low-rank Factorization" written by S. Burer and R.D.C. Monteiro.
Link for downloading
Download the technical report in PDF format
Email Sam Burer with questions or comments
DSA-BD v0 (September 22, 2011)
DSA-BD is a MATLAB package developed by C. Ortiz, R.D.C. Monteiro and B.F. Svaiter for solving general semidefinite programs (SDPs) using a block-decomposition first-order method, which is a special case of the hybrid proximal extragradient (HPE) method, a framework of inexact proximal point methods introduced by B.F. Svaiter and M. Solodov. Several ingredients are introduced to speed-up the method in its pure form such as: an aggressive choice of stepsize for performing the extragradient step; use of scaled inner products in the primal and dual spaces; dynamic update of the scaled inner product in the primal space for properly balancing the primal and dual relative residuals, and; proper choices of the initial primal and dual iterates, as well as the initial parameter for the primal scaled inner product. The subroutines for most of the algebraic operations (SDV, matrix-vector multiplication) use a LAPACK implementation coded in C. The details of the algorithm used by DSA-BD can be found in the technical report "Implementation of a block-decomposition algorithm for solving large scale conic semidefinite programming problems" written by R.D.C. Monteiro, C. Ortiz and B.F. Svaiter.
This code was developed under the support of the grants: NSF CMMI-0900094 and ONR N00014-11-1-0062
Email Camilo Ortiz with questions or comments
2EBD-HPE v0.2 (July 31, 2012; last update: May 31, 2013)
2EBD-HPE is a MATLAB package developed by C. Ortiz, R.D.C. Monteiro and B.F. Svaiter for solving two-easy-block structured convex optimizations problems (including SDPs) using a block-decomposition first-order method. The 2EBD-HPE method contains two important refinements from a computational point of view, namely: an adaptive choice of stepsize for performing an extragradient step; and the use of a scaling factor to balance the blocks.The details of the algorithm used by 2EBD-HPE can be found in the paper "A first-order block-decomposition method for solving two-easy-block structured semidefinite programs" by R. D. C. Monteiro, C. Ortiz and B. F. Svaiter.
AAmethod v0 (August 31, 2012)
The AA method is a new accelerated variant of Nesterov's method for solving a class of convex optimization problems, in which certain acceleration parameters are adaptively (and aggressively) chosen so as to: preserve the theoretical iteration-complexity of the original method, and; substantially improve its practical performance. The details of the algorithm used by the AA method can be found in the paper "An adaptive accelerated first-order method for convex optimization" by R. D. C. Monteiro, C. Ortiz and B. F. Svaiter.
Combinatorial Optimization: Continuous heuristics
CirCut v1.0612 (June 12, 2001)
CirCut is a Fortran 90 package for finding approximate solutions of certain binary quadratic programs, currently including the Max-Cut and the Max-Bisection problems. An introduction to the details of the algorithm behind CirCut can be found in the technical report "Rank-Two Relaxation Heuristics for Max-Cut and Other Binary Quadratic Programs" written by S. Burer, R.D.C. Monteiro, and Y. Zhang.
Email Yin Zhang with questions or comments
Max-AO v0.120301 (March 12, 2001)
Max-AO is an ANSI C package for heuristically solving the (unweighted) maximum stable set and maximum clique problems. The details of the algorithm behind Max-AO are available in the technical report "Maximum Stable Set Formulations and Heuristics Based on Continuous Optimization" written by S. Burer, R.D.C. Monteiro, and Y. Zhang.
Click for downloading
Renato D.C. Monteiro, Georgia Institute of Technology
Yin Zhang, Rice University
Sam Burer, University of Iowa
Accessibility | Contact Us | Legal & Privacy Information | Technology | Giving to Tech
©2003 School of Industrial and Systems Engineering
This site is available to any internet device, but really looks best in a modern graphical browser that supports web standards.

redpajama_set_name: RedPajamaCommonCrawl


Barcelona deny reaching agreement for transfer of PSG's Adrien Rabiot ESPN FC; Argentine soccer chief says Messi devoted to national team Hoy Los Angeles... So, here's the guide to where to play soccer in Barcelona that I wish I'd had a few years ago! I've tried to answer every question I can think of to get you started playing ASAP. I've tried to answer every question I can think of to get you started playing ASAP.
Where could Barcelona FC play if Catalonia secedes?
FC Barcelona could play in the Premier League if Catalonia wins Sunday's referendum for independence from Spain, the region's sports minister has said.
16 hours ago · Philippe Coutinho reacts during the La Liga match between Sevilla CF and FC Barcelona at Estadio Ramon Sanchez Pizjuan on March 31, 2018 in Seville, Spain.
Senior Mamelodi Sundowns authorities drove by Yogesh Singh are as of now in Spain concluding an arrangement that will see the Spanish mammoths and as of late delegated class champions FC Barcelona come back to South Africa to play against the Brazilians.
Watch live online free stream Getafe - Barcelona on PC and mobile (iPhone, iPad and Android). Watch Getafe - Barcelona live streaming HD video free online. Livescore and highlights for this match are updated live during the match.
So, here's the guide to where to play soccer in Barcelona that I wish I'd had a few years ago! I've tried to answer every question I can think of to get you started playing ASAP. I've tried to answer every question I can think of to get you started playing ASAP.


text:
8 arrested after several middle and high school students showed up to school on drugs
October 14, 2021 at 7:08 pm EDT
8 arrested after several middle and high school students showed up to school on drugs The middle and high school students were all taken to the hospital. The number of students and their current condition is unknown.
POLK COUNTY, Ga. — Eight people are behind bars and three more are wanted after authorities say they sold THC-laced gummy candies and vapes to underage students.
School administrators and parents noticed several students were intoxicated and incoherent at school, so they contacted Polk County Drug Task Force agents.
The middle and high school students were all taken to the hospital. The number of students and their current condition is unknown.
Investigators found that three convenience stores in the area were illegally selling products containing THC.
Channel 2 investigative reporter Chris Jose found that one of the stores involved had a sign on the door that read. "Due to a family emergency, we will be closed until further notice."
The stores were identified as American Dream Convenience, Sunoco and Chevron. All three businesses are located on North Main Street.
Cedartown Police Chief Jamie Newsome said students at Cedartown Middle School and High School were taking so many of the laced gummies, their teachers became concerned for their health.
"They eat five or six gummies before gummy number one has taken effect and then you're having some medical emergency," Chief Newsome said.
Newsome said the investigation into the convenience stores began last school year.
Eight of the eleven suspects were arrested Tuesday. They were identified as:
Jagrutiben Patel, 32
Chiragkumar Patel, 37
Melody Harding, 59
Jorge Cervantes, 42
Heather Ballew, 34
Edwin Cruz, 28
Luis Nunez Pisano, 21
Guadalupe Nunez Pisano, 24
Melody Harding Suspect in drugs arrest (Polk County Sheriff's Office)
The identities of the three people wanted has not been released.
Investigators were able to recover large amounts of THC vapes, THC gummies, schedule I drugs and money.
Jose says the candy laced with THC looks just like any other bag of candy, and with Halloween around the corner, parents should keep a close watch on what their kids are eating.
These cases are being prosecuted by the Tallapoosa Judicial Circuit's District Attorney's Office.
Police make major drug bust at South Fulton bar 7 people were arrested in the raid.
UGA students, fans react to arrest of former star quarterback Stetson Bennett


Arjun Kapoor has given many movies after debuting with Ishaqzaade with Parineti Chopra and received positive reviews. But the movie 2 States alongside Alia Bhatt has given him the fame and appreciation for his hard work and talent. Rather than that Arjun is working for social causes and one of them is Gender Equality. Also, he has done a movie on the same too with Kareena Kapoor in Ki and Kaa.
Talking about Arjun's working with his father Boney Kapoor- they had already done work in Tevar starring Arjun and Sonakshi Sinha but somehow the movie didn't go well at the box office as expected when the producer like Boney work with such a talented actor and son Arjun.
Being an actor Arjun realized that sometimes things didn't work out so he does not regret anything and said, "Sometimes, films come with their own destinies. Timing kabhi kabhi galat ho jaati hai. I feel Tevar came at a time when people were exhausted with that genre. If the masala genre gets repeated too many times, it will give you a feeling of eating out every day. After a point, you get bored [of eating out] and enjoy it only once in a while".
Describing Baaghi 2 as a "well-packaged masala film" that has come "after a long time", Arjun said a film has to be served "at the right time, in an accurate portion and presented in the correct manner". "That year, by the time we came with Tevar, eight to ten films had already delivered the same thing [masala film]. In isolation, there's nothing wrong with the film. It was made for a certain audience but that audience wasn't in the mood to watch it as they had watched the same kind of thing too many times," he added.
"You always learn and grow. There's no point crying over the past. Now, when we work together, we will be more careful about things. So let's look ahead. Hopefully, I will give him his career's biggest hit," Arjun concluded.


Plaintiff Patricia Marie Geibig ("Plaintiff") brings this action under 42 U.S.C. §405(g), challenging a final decision of Defendant Commissioner denying her application for Widow's or Widower's Insurance Benefits under Title II of the Social Security Act. The parties have filed cross motions for summary judgment. For the reasons set forth below, Defendant's Motion for Summary Judgment [Dock. #21] is DENIED, Plaintiff's Motion for Summary Judgment [Dock. #16] is GRANTED to the extent that the case is remanded for further administrative proceedings.
Plaintiff applied for benefits on September 19, 2014, alleging disability as of September 19, 2009 (Tr. 123-124). Upon initial denial of the claim, Plaintiff requested an administrative hearing, held May 2, 2016 in Livonia, Michigan (Tr. 20, 35). Administrative Law Judge ("ALJ") Henry Perez, Jr. presided. Plaintiff, represented by attorney Elizabeth Warren, testified (Tr. 38-50), as did Vocational Expert ("VE") Annette Holder (Tr. 50-54). On June 1, 2016, ALJ Perez found that Plaintiff was capable of performing her past relevant work as a cashier (Tr. 28, 30). On October 7, 2016, the Appeals Council denied review (Tr. 1-6). Plaintiff filed suit in this Court on December 8, 2016.
Plaintiff, born August 21, 1962, was 53 at the time of the administrative decision (Tr. 30, 124). She completed 12th grade and worked as a retail clerk and laborer before the alleged onset of disability (Tr. 151). She alleges disability as a result of bipolar disorder, Post Traumatic Stress Disorder ("PTSD"), Attention Deficit Hyperactivity Disorder ("ADHD"), depression, herniated spinal discs, a hernia, asthma, vertigo, arthritis, Carpal Tunnel Syndrome ("CTS"), hypertension, prior substance abuse, and a hearing impairment (Tr. 149).
Her former work included a job as a shipping supervisor, requiring her to lift up to 35 pounds and stand or walk most of the day (Tr. 40). She also worked at a pharmacy as "a cashier and general help" worker, requiring her to work at the register and straighten shelves (Tr. 40-41). The pharmacy job required her to lift up to 35 pounds (Tr. 41).
Plaintiff's low back and neck pain was becoming progressively worse (Tr. 41). She was unable to turn her neck to the left or raise her left arm (Tr. 42). In spite of pain medication and injections, she experienced level "six to seven" pain on a scale of one to ten (Tr. 42). The pain was exacerbated by damp and cold weather (Tr. 43). Due to the lower back condition, she experienced lower extremity symptoms (Tr. 43). Epidural injections improved the condition (Tr. 43). She otherwise coped with the condition by taking Ibuprofen, using a heating pad, icing her back, using BenGay, taking mineral baths, and stretching (Tr. 44). She spent 60 to 70 percent of her time addressing symptoms (Tr. 44). Physical therapy improved her range of neck motion (Tr. 44-45). She was unable to lift more than 10 pounds, stand for more than five minutes, sit for more than 20 minutes, or walk for more than one quarter of a mile (Tr. 45, 50). After standing or walking, she required time to sit or lie down (Tr. 46).
Plaintiff lived in a ground floor apartment with her boyfriend, noting that she changed to a ground floor apartment because she was unable to walk up stairs (Tr. 46). Her household chores were limited to wiping off the sink, putting dishes in the dishwasher, and wiping down the shower after bathing (Tr. 47). She cooked on an occasional basis (Tr. 48). She spent most of the day watching television (Tr. 48). She experienced concentrational problems due to both pain and bipolar disorder (Tr. 48). Her bipolar episodes were characterized by depressive episodes during which she became lethargic and reclusive (Tr. 49). She became frustrated during manic phases because her desire to be productive was hampered by physical problems (Tr. 49).
In March, 2014, Plaintiff was advised to get wrist splints (Tr. 535). The following month, she was referred to physical therapy for chronic neck pain (Tr. 537). In June and August, 2014, Plaintiff sought urgent treatment for back pain (Tr. 529, 531). August, 2014 psychological intake records state that Plaintiff's former substance abuse and anxiety issues were complicated by chronic pain (Tr. 416). The same month, Tendai K. Thomas, M.D. noted Plaintiff's report of ongoing "aching, burning, and sharp" back pain (Tr. 513). In September, 2014, Plaintiff reported that she experienced lower extremity numbness (Tr. 376). Imaging studies of the chest were consistent with COPD (Tr. 382). Counseling notes state that her dose of Abilify was increased (Tr. 421). In October, 2014, Dr. Thomas prescribed physical therapy for cervical and lumbar spine pain and radiculopathy of the upper and lower extremities (Tr. 329, 500, 502). Plaintiff reported "pins and needles" pain of the neck and shoulders (Tr. 330). Therapy records state that she attributed the spinal problems to motor vehicle accidents, falls, domestic abuse, and manual labor (Tr. 336). The following month, Plaintiff reported an improvement of symptoms of 75 percent but noted "consistent" pain at the "seven to eight" level (Tr. 337). Plaintiff reported chronic back pain to Dr. Thomas (Tr. 497). An MRI of the cervical spine from the same month showed "mild flattening of the spinal cord" at ¶ 5-C6 and C6-C7 (Tr. 373). An MRI of the lumbar spine showed "severe disc space narrowing and degenerative end plate change of the L5-L1 level" (Tr. 374). She was diagnosed with mild to moderate lumbar spondylosis (Tr. 375).
In March, 2015, Plaintiff reported increasing anxiety (Tr. 424). She was prescribed Neurontin along with psychotropic medications (Tr. 425). In June, 2015 epidural injections, physical therapy, and home exercises were recommended (Tr. 372). Counseling records state that Plaintiff's psychological condition had improved (Tr. 431). Dr. Thomas' records from the same month note that the back condition was "severe" and "worsening" (Tr. 490). September, 2015 records note Plaintiff's report of ongoing lumbar spine and left shoulder pain (Tr. 360, 470). The same month, she sought emergency treatment for a shoulder injury (Tr. 557). Dr. Thomas noted a history of radiating musculoskeletal back pain (Tr. 474, 479, 484). She exhibited reduced range of lumbar spine motion (Tr. 361). Epidural injections were administered without complications (Tr. 362). Counseling notes state that she was medication compliant but reported sleep disturbances (Tr. 432).
In October, 2015, James Moravek, M.D. noted Plaintiff's report of continuing left shoulder pain despite the use of Oxycodone and Norco (Tr. 509). He recommended physical therapy, reduction of narcotic medication use, and icing (Tr. 510). October, 2015 therapy records note the diagnosis of impingement syndrome of the left shoulder (Tr. 341). Discharge records note that Plaintiff's shoulder pain was reduced to a "two" out of "ten" (Tr. 353).
Plaintiff reported "no improvement" in a psychiatric medication review of February, 2016 (Tr. 438). In April, 2016, Dr. Thomas completed a medical source statement stating that due to chronic neck and low back pain with radicular symptoms, Plaintiff was unable to stand or walk for more than 15 minutes or sit for more than 30 (Tr. 556). Dr. Thomas found that she was limited to standing or walking for 60 minutes in an eight-hour workday (Tr. 556). He limited her to lifting only 10 pounds on an occasional basis and only occasional pushing or pulling (Tr. 556). He found that she would be required to take unscheduled work breaks due to fatigue and poor motor strength (Tr. 556).
In December 2014, Thomas Martin Horner, Ph.D. performed a consultative psychological examination on behalf of the SSA, noting Plaintiff's report of a 2011 hospitalization after a drug overdose and Post Traumatic Stress Disorder ("PTSD") as a result of her husband's 2009 suicide (Tr. 305). She reported that she last worked in 2003 at a pharmacy as a cashier and "straightening shelves" (Tr. 305). She left due to back and emotional problems (Tr. 305). She admitted to a history of alcohol and Vicodin abuse (Tr. 306). Plaintiff reported that she used braces for CTS at night (Tr. 307). Dr. Horner found that Plaintiff was "not a shirker by nature or by attitude" (Tr. 308). He found her capable of coping with ordinary work stresses but noted that her work abilities could be complicated by the physical conditions (Tr. 308).
The same month, Adam McKenzie, D.O. examined Plaintiff on behalf of the SSA, noting Plaintiff's report of spinal disc problems diagnosed in October, 2014 (Tr. 310). Plaintiff reported that she experienced radiating pain in all extremities (Tr. 310). She reported symptoms of CTS but stated that she never wore wrist braces (Tr. 310).


Mercy wrote: I SOOOOOO want to go through MFW K with my daughter when she reaches that age, but I can't stop her from learning how to read. It's almost a battle for me, because she LOVES learning. And since she knows all of her letters and sounds, she's now begun sounding things out. (because she's in the bathtub and sees on the shampoo the word "KIDS" and asks how to spell that). Just an example, but she does it constantly. So, I'll say it slowly to show her how to sound it out. Now, that's all she's doing is going around sounding things out.
How can you NOT teach when they apparently are ready?
I have the book I used to teach my son to read. Would it really be so bad if I picked up the book and worked a little bit here and there with her?
It's not that I don't want to "let her be young" - it's just killing me that I can't meet her where she's at. Does that make sense?
I'd just like to get some closure in my mind about what to do with her.
Anyone out there with some good ideas?
By the way, she knows all of her colors, shapes, numbers to 10, she's working on her own to write, she can write her own name, etc. We've done the patterns, lacing, etc. She's really mastering all those preschool skills very quickly. I promise I'm not doing anything except just "being there" for her when she's interested in something.
She's at a point, the next step is reading, writing and cutting skills. HELP!
Thanks again for giving me a place to "talk."
Maybe some of the more experienced mom's will give some more helpful advice, but from my limited experience, you should definately still plan on doing MFW K if you are wanting to do that - no matter where your child is on the reading spectrum. It's just so wonderful. The unit studies such as Apples, Insects, Jewel, and so on can be done separately from the phonics portion if your child is beyond the MFW phonics instruction by that time.
You could make that choice when you get to the beginning of Kindergarten and see where your child is. Maybe the phonics lessons would still be enjoyable as a review, or maybe you would simply use another phonics along with MFW-K units. I think both ways could work well. I have done it both ways (using MFW phonics with the units, and another phoincs with the units) and both ways worked well.
Hope this helps. I think the curriculum is enjoyable for any child ages 4-7.
Hi Mercy :) It is a joy to have a little one who loves to learn! I have one, too! My two cents would be to change her definition of what "school" is for now. Do still answer her questions about sounding out, etc, but introduce her to lots of different activities and play.
It will be a little work (I am doing this, too), but to me it's worth it. I am introducing different kinds of arts & crafts, different toys, different ideas, different books. Steering away from the ABCs, 123s, shapes, colors, etc. Doing a little of that, but that isn't our focus.
My 2 year old is doing science, music, Bible, read alouds, etc - along with his older sister. I used "days of the week boxes" from Upon Our Hearts this year - and that has been a hit! I am planning for them again next year.
I also have purchased several toddler activity idea books - there are lots of great ones out there! And they are filled with ideas that are easy on mom and geared just for the little ones.
He is curious about everything and wants to "do just what sissy is doing" in school. Part of his training has been learning that some school they do together and some is just for him/her. After he adjusted his ideas, he likes that!
I agree that you should do MFWK for K. It is just an excellent program - so rich and so fun. We loved it!
I have a great learner as well. I just can't keep up sometimes. Go to the library and read to her lots, go on nature walks and let her draw the things she sees. If she has a particular interest let her dive into that. ALso clay, cornstarch and water (great for non allerigic kids take a little corntarch and water and mix it til it a little thick when you jab your finger in it it will not breakthrough but when you do it slowly it will). Play. Play. and more play. Have her tell you stories and you tell stories. You make up a line and then let her make up a line (they can get very silly).
Have fun enjoy this time and if she is asking you how to say something answer her. My DD started reading at just before 4 years of age and I did not teaching how to read (all on her own) so sometimes it just happens (enjoy it because many struggle with reading).
Quinne~ You hit it right on the button! See, I've called "character training" school, housework school and of course school stuff school, but never PLAY school! I need to rework the definition of school in my mind. It all seems sort of simple and silly now that I didn't see that before...oh well.
Mike~ I love the idea of telling stories together!! I started just recently stretching my own creativity by trying to tell misc. bible stories to her. I'm not the most engaging, vibrant story teller, but it's been fun to try. I love the idea of taking turns to make stories up. Very neat! And, great reminder to play with clay. Playdo gets old so quickly, it's fun to try new things.
ShanMom~ I am really looking forward to trying K! I know I'll love it because I love the heart that the Hazell's have. They have blessed our home abundantly! I would just love to go through K without skipping anything. Who knows where we will be by that time...either way, I think I'll take your advice and do it regardless of whether she's reading or not.
Thank you so much for your thoughts everyone! I guess I'll have to sit down and try to plan our school a little different, thinking ahead to find ways to include more activities and crafts,etc.. Making time for play right now seems a little difficult with the new baby, but we'll get there. Projects just seem to be going by the wayside so easily. Changing my mind a little though on what school is will really help me to make the time for more play.
By the way Quinne, I love the idea of the "days of the week boxes!" I've tried something similar and I think I'm just a little too disorganized for that. I can't seem to keep up with them. I work better with "grab that thing off the shelf and play with it." LOL.
I am glad the others chimed in. I was seeking to give you a completely unbiased view earlier, but I will now share that I wish I had waited to start a phonics program with my son, and simply did other things to satisfy his craving to put words together...and followed the MFW plan as is. Mainly, because it is simpler for you when you can follow MFW (or whatever you are using) the way it was intended too. Hope this helps.
My DD was just like that. We found this book at the library and loved it so much we purchased our own.
It says "For ages 2 to 6"
Simple Art materials and household items are used (like paper plates, muffin papers, toilet paper rolls, cotton balls...) to create animals for each letter, from Allan the Alligator, to Nellie the Newt, to Zelda the Zebra. Each animal will take on a character of its own as they create their Alphabet Zoo. You also Create Make-and-touch letters - Bumpy Bs, Fluffy Fs, Quilted Qs and Zig-zag Zs. Other actvities include playing ABC games, going on letter hunts, doing silly ABC fingerplays, and reading rebus picture sentences.
We did one letter a week. We kept all of our creations in a notebook with page protectors and made a special "ABC book" my Littles are proud of to this day.
I am so not one that likes to get out a lot of stuff for messy crafts. This was simple easy and wonderful times spent together.
When we did this book with my son, DD remembered enjoying it so much she wanted to do it again with him. She was in 2nd grade...! My littlest one is 2 now and I look forward to using it with her before doing MFW-K.
Lynnette: Wife and Mother by the will of God.
Mercy, I'd just like to offer a little hug and say that you're not "pushing her" if you're letting her set the pace. Answering questions is not pushing. I know that you know that, but I just wanted to say it. It's a delicate balance when you've got a curious little learner -- you know what she's capable of, yet not wanting her to get so far ahead so early.
I read, read, read to my dd as a baby and toddler because I thought that's what a mom was supposed to do, and having unchecked PPD, staying at home snuggled up reading was wonderful to me! I never "taught" my dd to read, she just started trying to read by herself at age 2. I would help her sound out a word if she didn't know it, but it wasn't like a school lesson or anything. She was reading independently at 3.5, and she continues to love books!
We didn't start MFWK until she was almost 5, and it was a perfect fit for her. She already knew her letters - upper and lowercase, she could read at a 2nd-3rd grade level, and could add 2-digit numbers (without carrying). And MFWK was still a perfect fit for her -- because she was 5yo, and it is written for 5yo's, whether they are advanced or not. Lots of other moms on this board have taught MFWK to a child that is already reading well. There's lots of ideas for you when you get there.
I just want to encourage you to continue pre-school activities with your little princess, continue to read to her and let her try if she wants to, but don't be afraid that she's going to "outgrow MFWK before she's old enough to do it," because that's not going to happen. HTH.
Lynnette~ I just checked and my library has this book! What a great suggestion.
Cyndi~ That is exactly what I needed to hear. Thank you. Really. I am so glad you wrote in because I have had a fear that if she progressed...K wouldn't really be a good fit anymore. Yes, I've read that others have done it, but I kept feeling like they didn't really get all they could out of it. Now I can see that it really will be ok. Your words refreshed me. Keeping a balance is very difficult. I did push my son and I don't want to travel down that road again. I want to always enjoy my children first and foremost.


text:
Chinese Leader Hails Strong Ties With Russia
Russian President Vladimir Putin (right) meets with his Chinese counterpart Xi Jinping in Moscow.
China's President Xi Jinping, on a visit to Russia, has hailed the strong partnership between the two countries.
Meeting with Prime Minister Dmitry Medvedev on March 23, Xi said the results of his visit had far exceeded his expectations.
In a speech to Russian students, he said strong Chinese-Russian ties are a guarantee of the strategic power balance in the world.
He also warned against foreign interference in the affairs of other nations.
The visit to Russia is Xi's first foreign trip since he became president last week.
During talks with President Vladimir Putin on March 22, Xi said they had agreed "to strengthen mutual support."
Russian and Chinese officials signed a raft of agreements, including a deal on Russian oil deliveries and a memorandum on building a new gas pipeline to China.
Based on reporting by Reuters, AFP, and Interfax


text:
Report: Cyberpunk Development Didn't Really Start Until 2016
The Great AMD/Nvidia GPU Shortage Won't Get Better Any Time Soon
Published 5 days ago: January 13, 2021 at 1:05 pm -
Filed to:amd
ces 2021gpusnvidia
Image: Alex Walker (Kotaku Australia)
wasHave you tried to buy an Nvidia GPU or AMD GPU recently, only to be hit with pre-order buttons and "stock not available" nightmares? Well, expect the misery to carry on for at least a couple more months.
As good as the new line of GPUs and silicon has been over the last couple of months, actually buying them — a console, CPU, GPU — has been practically impossible. It's been so bad that companies have formally apologised, multiple times, and there's been no prospect of a respite any time soon.
But even those who were patiently waiting for PC gaming upgrades — since users at least have some clarity on when those might arrive in the country — will have to be supremely patient. At the annual CES Tech Investor Forum this year, Nvidia's chief financial officer Colette Kress offered more bad news.
Q: But the problem is that given all of this strong demand, and I just checked, like for example, some of the retail sets at Best Buy today, I still can't get an RTX 3070, RTX 3080, RTX 3090, your latest RTX 3060 Ti. I still can't get it. It's sold out everywhere. And so, can you give us an update on supply availability? Are the constraints more focused on wafer supply or advanced packaging and substation supply? And more importantly, when does the NVIDIA team expect the situation to improve?
Nvidia's Colette Kress: Thanks for that question. So in order to talk about supply, we first have to discuss the demand. We did have an exceptional overall holiday season. Gaming demand is off the charts. Our overall Ampere architecture and ray tracing are really a true success. This demand has remained stronger for longer. Okay? So, supply does remain tight at this time. We expect the overall channel inventories, meaning the inventories that are with our AIC partners as well as in our e-tail and retail channels will likely remain lean throughout Q1. Our overall capacity has not been able to keep up with that overall strong demand that we have seen.
As a reminder: Nvidia's fiscal first quarter ends on April 28 each year, which is a miserably long wait. And what's not helping is that the vast majority of Nvidia's gaming base aren't even RTX card owners. Kress revealed that the amount of concurrent users on Steam has grown by 40 percent year over year, and with more gamers looking for upgrades — and more people getting into gaming because of COVID — that just adds even more pressure onto an already-too-thinly-stretched supply chain. Some users have suggested that cryptocurrency miners might be adding to the problem, but Kress said Nvidia would revive their line of CMP graphics cards — basically GPUs without video ports that are dedicated for mining — if demand reached that point.
AMD hasn't been quite as open about their supply troubles, but the news isn't good on that front either. In a roundtable interview with journalists, AMD CEO Lisa Su said the company would no longer be phasing out their RX 6000-series reference designs:
We are committed to keeping GPU pricing as close to our suggested retail pricing as much as possible, because it's the only way to be fair to the users. Normally when we have GPU launches, our own branded cards are available initially but then fade away for our partners to pick up. This time around we're not phasing out our RX 6000 series, enabling us to sell direct to customers as low as possible. We're encouraging partners to do the same. Not only tariffs, but the COVID environment has increased shipping and freight costs, which are hard to avoid.
AMD originally told the Australians at Hardware Unboxed that third-party RX 6000-series cards would be sold at MSRP prices "within 8 weeks". But if AMD isn't going to phase out their reference designs, that's an indication that they're not expecting partners to fall in closer to MSRP at all. And given that AMD's own supply issues aren't about to go away any time soon — remember, they're having to balance production of their own 7nm CPUs and GPUs alongside the 7nm SOC solutions for the PlayStation 5 and Xbox Series X, which are equally impossible to buy — it's no surprise that the AMD CEO didn't specify how long this situation would persist for.
The one small hope is that consumers at least have more alternative options for GPUs now, even if they can't buy the card they initially want. That doesn't solve a lot of issues when everything is out of stock all at the same time, but as more shipments trickle into the country over the coming weeks and months, it's at least something. I'd argue the best option at this stage is probably just to hold off as long as possible until the value-per-dollar comes back into line with the original MSRP pricing.
More From Kotaku Australia
Nvidia Cards Are Getting Resizable BAR Support Very Soon
CES 2021 Has Been A Big Year For AMD Gaming Laptops
Don't Buy AMD's Radeon 6900 XT For Gaming
Some Australians Still Won't Get Their RTX 3080 Cards Until February
Alex Walker is the editor of Kotaku Australia and is known for his work covering video games, industry issues, technology and esports. He has written for ABC Technology & Games, games.on.net, PC Powerplay, Techly, Gizmodo Australia, Lifehacker Australia and more.
morkai says:
Mhmm. I got up at 1am on launch day for a 6800XT. Managed to checkout a reference design MSI card with Scorptec. Not long after this was cancelled and refunded, but I was offered the chance to get my name down for a partner card when they became available.
Subsequently got my name down and paid for a Sapphire Nitro+ 6800XT at Scorptec.
The order status has been "awaiting stock availability" since 30/11 and I'm not expecting that to change anytime soon.
dekaboko says:
I ordered an EVGA rtx 3080 on launch day. I just got an ETA of 1/2/21. lol You will be waiting.
Pandacles says:
i managed to get a 3070 mid december from pc case gear, and currently scorptec has quite a few different 3070s in stock available not no 80s