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Interbrand Breakthrough Brands: Recognizing Next-Generation, Disruptive Brands
Featured, Latest B2B News, Startups, Top News May 26, 2017May 26, 2017 B2BNN Newsdesk
Interbrand announced its second annual Interbrand Breakthrough Brands report in partnership with New York Stock Exchange (NYSE),Ready Set Rocket, and Facebook this week. The 2017 report recognizes 40 next-generation, disruptive brands that define progress and the potential to grow. The report complements Interbrand's annual Best Global Brands report, now entering its 18th year, by putting a spotlight on emerging brands—those that are affecting change and embodying growth.
"There are moments throughout the life of your business when you enter a new stage of growth," said Jez Frampton, Interbrand's Global CEO. "For Breakthrough Brands, it's realizing there's a gap or a need in the marketplace, and filling it. These brands are catalysts as they are not just setting new standards for other brands, they're breaking them."
After analyzing over 350 submissions from global influencers and open public submissions, 40 brands were selected as this year's Breakthrough Brands, each helping to illustrate key breaking insights. The report features brands to watch and incorporates a deep dive into growth and innovation across key global regions including EMEA, LatAm, North America, and Asia Pacific.
All 40 brands represent the next generation of brands; the startups, upstarts, challengers, problem solvers, innovators, and category creators. These brands join many of the 2016 brands that have shown stand out growth in the past year. Notable brands from the inaugural list include Casper, AWAY, Line, Venmo, Blue Apron, and iCarbonX.
This year's report divides the Breakthrough Brands into seven key insights:
The working future: An increased focus on individuals and what they need to be fulfilled within their careers and their lives especially as they become increasingly intertwined, such as Slack and General Assembly.
From lifehacking to better living: Brands that are looking to improve our lives by removing concerns, obstacles, and unnecessary interactions. The good life is not about more, but better; Thrive Global and Sea for example.
Not so artificial intelligence: Brands that are leading this charge—by both creating and harnessing these new tools—are going to dictate the future with this breakthrough technology; like Face++ and Clarifai.
Meaningful mobility: It's not about the journey or the destination, it's about fundamentally changing how we move people and things, with the aim of improving our environment, society, and lives through brands likeDidi and Ofo.
Funding change: The focus in finance is truly personal, as brands find breakthrough ways to align with individuals' values, and empower people to take greater control of their financial futures with brands like Square andWealthsimple.
Experiences on demand: Some brands make it easier to get what we want, others make it easier to find what we want, but all are helping us live an on-demand lifestyle, which is what brands like MikMak and Flipkart look to do.
Health in your hands: By leveraging tech innovation and pooling huge, previously unmanageable amounts of information, these new brands are improving the entire spectrum of care like Babylon and HumanCharger.
"Staying agile in the face of change means constant access to the latest breakthroughs, innovations and experiences," said Chief Communications Officer of Interbrand, Paola Norambuena. "These Breakthrough Brands are evidence of changing dynamics, and the insights they embody are ones that brands and businesses of every size need to understand and embrace."
"In a time when so many brands are doing so many great things, Breakthrough Brands must excel across the board. This requires authenticity, an optimized experience, and putting the customer first consistently," noted Alex Lirtsman, Co-Founder & Chief Strategist at Ready Set Rocket.
When selecting the brands to be featured in this report, these criteria were key:
Criteria & Methodology
Age: Is the brand 10 years or younger?
Change: Is the brand driving change by responding to a unique marketplace need, generating a new experience for consumers, disrupting an industry, adopting a new business model or developing a new technology?
Growth: Is the brand demonstrating its ability to grow? Is it operating as a successful business? Is it stretching into new product or service categories—or new geographies? Is it attracting top talent?
Buzz: Is the brand grabbing attention and gaining momentum?
Originality: Is the brand presenting a unique business model that challenges the traditional way of doing things?
"These next-gen brands represent the future. They are disruptive and defining, innovative and impactful," said Russ Rubino, VP of Marketing at Intercontinental Exchange. "In many ways, these young companies exemplify the NYSE's mission – to help great companies do great things by improving the lives of people and society with integrity, vision, humanity and impact."
To learn more about these insights and the brands highlighted in the second annual Interbrand Breakthrough Brands report, please visit interbrandbreakthroughbrands.com, where the report is available for download.
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IDENTIFYING BETTER OUTCOME MEASURES TO IMPROVE TREATMENT OF AGITATION IN DEMENTIA: A REPORT FROM THE EU/US/CTAD TASK FORCE
M. Sano1, M. Soto2, M. Carrillo3, J. Cummings4, S. Hendrix5, J. Mintzer6, A. Porsteinsson7, P. Rosenberg8, L. Schneider9, J. Touchon10, P. Aisen11, B. Vellas2, C. Lyketsos8, and the EU/US/CTAD Task Force members*
*E.U./U.S. CTAD TASK FORCE: Susan Abushakra (Framingham); Joan Amatniek (Princeton); Sandrine Andrieu (Toulouse); Randall Bateman (Saint Louis); Joanne Bell (Wilmington); Gene Bowman (Lausanne); Sasha Bozeat (Utrecht); Samantha Budd Haeberlein (Cambridge); Marc Cantillon (Livingston); Marither Chuidian (Aliso Viejo); Doina Cosma-Roman (Aliso Viejo); Anne De Jong-Laird (Wexham); Rachelle Doody (Basel); Sanjay Dubé (Aliso Viejo); Michael Egan (North Wales); Laura Eggermont (Utrecht); Phyllis Ferrell (Indianapolis); Erin Foff (Princeton); Terence Fullerton (New York); Sylvie Gouttefangeas (Suresnes); Michael Grundman (San Diego); David Hewitt (Wilmington); Carole Ho (South San Francisco); Patrick Kesslak (Princeton); Valérie Legrand (Nanterre), Stefan Lind (Valby); Richard Margolin (New York); Thomas Megerian (Aliso Viejo); Annette Merdes (Munich); David Michelson (North Wales); Mark Mintun (Philadelphia); Tina Olsson (Cambridge); Ronald Petersen (Rochester); Jana Podhorna (Ingelheim am Rhein); Stephane Pollentier (Ingelheim am Rhein); Rema Raman (San Diego); Murray Raskind (Seattle); Gary Romano (Beerse); Juha Rouru (Turku); Ivana Rubino (Cambridge); Ricardo Sainz-Fuertes (Wexham); Stephen Salloway (Providence); Cristina Sampaio (Princeton); Philip Scheltens (Amsterdam); Rachel Schindler (New York); Mark Schmidt (Beerse); Jeroen Schmitt (Lausanne); Peter Schüler (Langen); Märta Segerdahl Storck (Valby); Eric Siemers (Indianapolis); John Sims (Indianapolis); LeAnne Skordos (Cambridge); Bjorn Sperling (Cambridge); Reisa Sperling (Boston); Joyce Suhy (Newark); Serge Van der Geyten (Beerse); Philipp Von Rosenstiel (Cambridge); Michael Weiner (San Francisco); Glen Wunderlich (Ridgefield); Haichen Yang (North Wales); Jerry Yang (New York)
1. Mount Sinai School of Medicine, Bronx, NY, USA; 2. Gerontopole, INSERM U1027, Alzheimer's Disease Research and Clinical Center, Toulouse University Hospital, Toulouse, France; 3. Alzheimer's Association, Chicago, IL USA; 4. Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, Nevada, USA; 5. Pentara Corporation, Salt Lake City, UT, USA; 6. Roper St. Francis CBRT, Charleston, SC, USA; 7. University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; 8. Johns Hopkins University School of Medicine, Baltimore, MD, USA; 9. University of Southern California, Los Angeles, CA, USA; 10. University Hospital of Montpellier, 34025 Montepellier Cedex 5, and INSERM 1061, France; 11. Alzheimer's Therapeutic Research Institute (ATRI), Keck School of Medicine, University of Southern California, San Diego, CA, USA
Corresponding Author: Mary Sano, Mount Sinai School of Medicine, Bronx, NY, USA, mary.sano@mssm.edu
J Prev Alz Dis 2018;5(2):98-102
Published online March 21, 2018, http://dx.doi.org/10.14283/jpad.2018.15
For the second time in the past 3 years, the EU-US CTAD Task Force addressed challenges related to designing clinical trials for agitation in dementia, which is one of the most disruptive aspects of the condition for both patients and caregivers. Six recommendations emerged from the Task Force meeting: 1 – Operationalizing agitation criteria established by the IPA; 2 – Combining clinician- and caregiver-derived outcomes as primary outcome measures; 3 – Using global ratings to define clinically meaningful effects and power studies; 4 – Improving the accuracy of caregiver reports by better training and education of caregivers; 5 – Employing emerging technologies to collect near real-time behavioral data; and 6 – Utilizing innovative trial designs and increasing the use of biomarkers to maximize the productivity of clinical trials for neuropsychiatric symptoms.
Key words: Neuropsychiatric symptoms, agitation, dementia, Alzheimer's disease, clinical trials, NPS outcome measures.
Agitation and other neuropsychiatric symptoms (NPS) are the most disruptive aspects of dementia for both patients and caregivers. They are associated with worse quality of life (1), greater dementia severity, earlier institutionalization, and accelerated mortality (2, 3). Despite being a major driver of high cost care (4, 5), agitation and other NPS are poorly understood and inadequately studied. In a population-based study, agitation in dementia occurred in up to 40% of community-dwelling dementia patients and 80% of patients living in nursing homes (6). Cross-sectional studies show somewhat lower prevalence estimates (7). For persons with mild cognitive impairment (MCI) the prevalence of agitation is nearly as high, according to some studies (8). There are no approved pharmacological treatments for agitation in dementia in the USA and in Europe and Canada only short-term use of risperidone is approved for severe persistent physical aggression. Several medications with conventional and novel mechanisms of action are in development.
In 2014, the International Psychogeriatric Association (IPA) published provisional consensus definition for agitation in cognitive disorders for clinical and research use. According to this definition, agitation in dementia is characterized by emotional distress associated with the presence of at least one of the following: excessive motor activity, verbal aggression, or physical aggression. These symptoms must be severe enough to cause significant impairment in interpersonal relationships, social functioning, and/or the ability to perform or participate in activities of daily living. These symptoms must not be attributable to another psychiatric disorder, environmental or medical conditions, or the physiological effects of substance use (9).
Reaching consensus on a definition of agitation in dementia represents an important step towards identifying new treatments since improved nosology can reduce heterogeneity in defining target conditions. These criteria need to be operationalized, so that the clinical characteristics can be aligned with what is understood about the biology and phenomenology of agitation in dementia. This will allow for the selection and assessment of measures that best capture clinically important outcomes. With this in mind, the European Union-North American Clinical Trials in Alzheimer's Disease Task Force (EU-US CTAD Task Force) focused its 2017 meeting in Boston, Massachusetts on finding the best outcome measure for agitation in dementia trials. This Task Force comprises an international collaboration of Alzheimer's disease (AD) investigators from industry and academia who meet yearly to review recent progress in developing effective treatments for AD, and reach agreement on common clinical trial approaches, while promoting collaboration and data sharing. The fact that the Task Force previously addressed some of the challenges in designing clinical trials for agitation and aggression only three years ago (10) attests to the importance of this issue.
Overview of Agitation in Dementia
In addition to the core symptoms, irritability, disinhibition, and aberrant motor activity are common. Moreover, agitation and other NPS fluctuate and overlap. For example, agitation overlaps with many other NPS, particularly depression, irritability, and anxiety, but also apathy (11). These fluctuating symptoms cluster into predictable groups with complex etiologies (12, 13). Caregivers often notice increased agitation in the late afternoon and evening, a phenomenon referred to as "sundowning" (even though it has more to do with fatigue and sensory experiences than with the sunset).
Biological mechanisms
Agitation may be due to underlying biological mechanisms or may be a consequence of delirium, environmental factors, medication, or caregiver and environmental interactions (14). Distinguishing the underlying factors that result in agitation – both biological and environmental — is important for treatment decisions. For example, sundowning may be associated with sleep disturbances, circadian rhythm disruption, or disorientation. If associated with circadian rhythm dysfunction, this symptom may be a target for chronobiologic treatments. Moreover, the underlying biology that disrupts behavior in persons with AD interacts with short-term and long-term environmental factors, medical comorbidities, etc, due to patient vulnerability.
The neurobiological mechanisms underlying agitation in dementia may differ from those that underlie agitation in other psychiatric diseases such as schizophrenia or major depressive disorder (15). These differences likely explain the fact that drugs used to treat NPS in depression and schizophrenia seem to be less effective in dementia leading to the need for novel approaches to treatment mechanism. Notably, the US Food and Drug Administration (FDA) recently approved pimavanserin for dementia-related psychosis in Parkinson's disease, and this drug is currently in clinical trials to treat both psychosis and agitation in patients with AD and in a trial for dementia-related psychosis in multiple types of neurodegenerative disorders. Pimavanserin is a selective 5-HT2A receptor inverse agonist. If treatment responsiveness emerges across dementia causes, this could open a new window into understanding the biology and treatment of some NPS.
Neurodegeneration disrupts brain circuitry, resulting in NPS. In agitation, at least two different circuits are disrupted (15). These may be the same circuits that are disrupted in dementia-related apathy, which could explain how apathy and agitation are closely linked (16). Further understanding of how these circuits are disrupted in different patients may provide clues about patients' differential response to treatment. Assessment of circuit function might also play a role as a biomarker to assess or predict treatment response.
Agitation in dementia is also associated with alterations in the function of serotonergic, noradrenergic, cholinergic, and dopaminergic neurotransmitters, related to neurodegeneration of associated brain nuclei (17). Neurodegeneration also contributes indirectly to the emergence of NPS by making patients very vulnerable to short-term and long-term environmental factors, or medical comorbidities, and other influences, such that patients express the impact of these in their behavior. Understanding the neurophysiological factors that underlie agitation in dementia should lead to more effective treatments.
With several medications with novel mechanisms in development, a question considered by the Task Force is whether treatment development should continue to focus on phenomenology or move towards targeting neurobiologic mechanisms. A focus on phenomenology may identify those more likely to respond to a specific treatment; however, the lack of attention to the complex mechanisms and genetic and environmental factors that contribute directly and indirectly to symptoms may ultimately lead to failure to identify underlying processes that need to be targeted in order to prevent these disabling NPS. For example, both affective and executive functions impaired in agitation, suggest that multiple neural circuits are disrupted. Citalopram primarily targets the affective phenotype (18).
Available treatments
Treatment options for NPS in AD have been disappointing. Antipsychotics, anticonvulsants, benzodiazepines, and antidepressants are frequently prescribed despite little evidence of efficacy and an increased risk of adverse side effects. Citalopram, a selective serotonin reuptake inhibitor (SSRI) is one apparent success story, since clinical trials showed that this drug reduces agitation without the negative side effects associated with other SSRIs (17). Worsening cognition and cardiac side effects were observed in some patients on citalopram, potentially limiting usefulness, although these side effects might be mitigated by using the S-enantiomer of racemic citalopram (19) A subgroup analysis investigating the heterogeneity of the treatment response concluded that patients with moderate agitation and lower levels of cognitive impairment were more likely to benefit from citalopram, while those with more severe agitation and greater cognitive impairment were at higher risk of adverse responses (20).
Assessing agitation in clinical trials
Choosing the best outcome measure for clinical trials is key to treatment development for NPS. Over time, different trials have used different outcome measures, as no gold standard has previously emerged. Instruments used to assess agitation in clinical trials include broad-spectrum scales such as the Neuropsychiatric Inventory (NPI) (21) and the clinician-rated NPI-C (22), the Neurobehavioral Rating Scale (NBRS), and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) (23); as well as agitation subscales of these instruments (NBRS, NPI, and NPI-C) or agitation-focused scales such as the Cohen-Mansfield Agitation Inventory (CMAI) (24).
The Neuropsychiatric Inventory (NPI) and its variants the NPI-Q and NPI-NH (for nursing homes), which is based on informant report, are widely used but may miss granularity as they are not designed for use as free-standing agitation instruments. The NPI-C, the clinician-rated form of the NPI (22) has a broader range that includes NPS characteristics of MCI and severe dementia, high inter-rater reliability, strong convergent validity for depression (assessed with the Cornell Scale for Depression in Dementia [CSDD]), psychosis (assessed with the Brief Psychiatric Rating Scale [BPRS]), apathy (vs. Apathy Evaluation Scale [AES]), and agitation/aggression (vs. the CMAI). The main strength of the NPI-C is that final scoring is based on experienced clinician ratings and not on subjective caregiver's input that include the so called "filter" whereby NPS reported to affect the patient reflect the caregiver's mental state instead (25). NPI-C has been translated into several languages offering advantages for international multi-site trials. Limitations of the NPI-C include its length as it has twice as many items as the NPI, and takes longer to complete, and it may be more costly as it must be administered by a skilled clinician. To date there is a lack of data concerning the agitation and aggression components of the NPI-C since this new measure has been rarely used in cohorts or trials. (Note: NPI-C was found to be feasible to use in a multi-center trial of scyllo-inositol for agitation but results have not been published).
Global scales have been widely used in clinical trials of treatments for NPS including agitation. The Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC), published in 1997 following a consensus process involving AD clinicians [26], has been modified for NPS trials (27, 28). The mADCS-CGIC uses an interview structure with worksheets to remind raters to evaluate specific NPS (e.g., depression, apathy, agitation) as well as the broader dementia. While its administration is less structured than a rating scale, this is intentional and allows the focus to be on "gestalt" of the NPS syndrome being rated. As such, it is less likely pick up trivial effects that are irrelevant to the clinical setting. In the Citalopram for Agitation in Alzheimer's Disease Study (CitAD), significant improvement compared to placebo was seen using two instruments as primary outcome measures — the mADCS-CGIC and the NBRS-A (17).
The CMAI is agitation specific and very detailed although it historically was developed for use in nursing homes. It covers a range of clinically-relevant agitation behaviors (not symptoms) and can usually be administered in 15-20 minutes. Drawbacks include its subjective nature, since it is administered to caregivers with no clinician input, and the observation that it focuses on the assessment of many behaviors seen in advanced dementia, typically not relevant to outpatients. In addition, questions remain about what is a clinically meaningful effect size on the CMAI. In CitAD, CMAI and the NPI were used as secondary outcome measures, enabling investigators to compare these measures in terms of sensitivity to change.
Evidence for a single construct vs. symptom clusters
CMAI calculates agitation scores using a diverse group of behaviors, which are grouped into symptom clusters. Although the manual states that it is not useful to add all categories to calculate a total score since different agitated behaviors occur under different circumstances and in different people, it also indicates that behaviors may be weighted according to disruptive impact and then combined (29, 30). The long version's 29-items tend to fit models involving 3-4 factors in principal component analyses: aggressive behavior, physically non-aggressive behavior, verbally agitated behavior, and/or hiding and hoarding. The question remains of whether symptom clusters provide more clinically relevant information for clinical trials than a total score calculated by summing all categories. Further, if a total score is used, should the factors be weighted differently? Weighting would have to be clinically determined and take into account the shape of behavioral trajectories and the clinical importance of behavioral changes.
Factor analyses from studies in different populations suggest that CMAI item scores do not cluster in a way that supports the use of factor (31). In different studies, different items "load" onto different factors and in some cases do not load at all or load on more than one factor (31, 32). If factor scores were to be used as separate endpoints, claims could be based on any one of those factors; however, this only makes sense if the different factors are independent, which is not the case. Since CMAI items as a whole represent a single construct (e.g., agitation, aggression), reflect aspects of the IPA provisional criteria, and have change scores consistent across factors (31, 32), it is most appropriate to combine them into a single total CMAI score. Separating factors may also reduce the power from the convergence of evidence across multiple domains. Change scores cluster to a greater extent than endpoint scores, and within each factor there are items that show significance while others do not, depending on the study (i.e., there is litle consistency across studies). For example, using data from a risperidone study, only change in "hitting behaviors" was significant in the physical aggression factor (33). Moreover, this study indicated that the biggest predictor of which items will show significance in treatment effects is how big the placebo effect is; thus signal-to-noise in the placebo group negatively predicts treatment effect (32).
To accelerate development of improved treatments for agitation, novel measures are needed to better capture behaviors that are of most concern to patients and caregivers. Operationalizing the IPA criteria is a needed first step, for diagnosis and to establish entry criteria for clinical studies. Some Task Force members advocated developing a single measure that reflects agitation as a unitary phenomenon. Since the development of new scales from whole cloth will result in additional regulatory challenges the consensus was that the best approach moving forward is to use existing datasets to construct an evidence-based single novel measure of agitation by selecting item subsets of existing scales (e.g., NPI-C or CMAI) that best reflect the IPA criteria and the situations in which agitation occurs. These data sets may include critical descriptors of setting, demographic or clinical characteristics, disease severity which could be used to improve sensitivity of outcomes for specific trials. [Recommendation #1].
The Task Force agreed that since clinician-derived and caregiver-reported assessments have overlapping strengths primary outcome measures in agitation trials should combine the two as is the case with mADCS or NPI-C, with secondary outcomes focusing on caregiver report alone, as with CMAI or NPI [Recommendation #2].
Further, global ratings should be used to define clinically meaningful effect sizes and to power studies [Recommendation #3]. This will mitigate concerns about defining meaningful benefit based on individual symptoms that are not relevant to the specific care setting. It will also streamline trials by supporting the use of smaller samples sizes and making "no-go" decisions easier.
Better engagement of caregiver-informants is critical to future treatment development [Recommendation #4]. Caregivers play an important role in the management of NPS. They not only feel the consequences of disruptive behaviors but may also be the cause of those behaviors. Giving caregivers a greater voice in management and treatment development should be coupled with efforts to improve data quality. To improve accuracy of caregiver reports it is essential to reduce the effects of inexperience and subjectivity (e.g., the caregiver "filter"). To this end, caregivers should be trained to understand what is meant by the term "agitation" and about the phenotype of individual symptoms which may provide data that is more valid and has less inherent variance.
Collection of near real-time data on agitation symptoms through briefer more frequent (e.g., daily) data collection contacts or caregiver diaries should be pursued. Technology may offer novel solutions for this objective, for example, by using digital assistants to remind people to submit assessments [Recommendation #5].
Critical improvements in clinical trial design should be implemented to ensure the provision of high quality care and to minimize placebo responses [Recommendation #6]. Trials should use systematic approaches to ensure that non-pharmacologic therapies have been considered prior to enrolling patients in medication trials (e.g, the DICE (Describe, Investigate, Create, Evaluate) approach (14)). Further, to exclude participants who do not need to be on medication, a placebo lead-in or withdrawal design should be considered. In clinical trials for severe agitation, there has been a strong bias for not selecting people who are easier to manage, although these patients may be less responsive to medication.
In the future, assessing levels of agitation or response to treatment could be improved through the use of biomarkers. The fact that agitation reflects multiple biological pathways suggests that multiple types of biomarkers – genetic, pharmacogenetic, proteomic, and performance – will be needed. In clinical and observational studies, these biomarkers will need to be validated in populations with a range of behaviors and in different settings.
Since agitation has multiple causes and mechanisms, there is no simple, single, or unique treatment. This observation demands that treatment development move towards better understanding the causes of agitation, including neurobiological factors, and the interaction with patient factors (e.g, dementia severity, co-morbidities), and environmental factors. Since different phenotypes may reflect different types of agitation addressing causes should precede treating the symptoms. Ultimately, the field should coalesce around the development of sequential algorithms that combine "eco-psycho-social" with pharmacologic treatments for agitation, and by extension for all NPS.
Acknowledgements: The authors thank Lisa J. Bain for assistance in the preparation of this manuscript. JC is supported in part by Keep Memory Alive (KMA) and NIGMS grant P20GM109025.
Conflict of interest: JC owns the copyright of the NPI. Other authors have no conflicts of interest with this paper. The Task Force was partially funded by registration fees from industrial participants. These corporations placed no restrictions on this work.
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17. Porsteinsson AP, Drye LT, Pollock BG, Devanand DP, Frangakis C, Ismail Z, et al. Effect of citalopram on agitation in Alzheimer disease: the CitAD randomized clinical trial. JAMA. 2014;311(7):682-91. doi: 10.1001/jama.2014.93. PubMed PMID: 24549548; PubMed Central PMCID: PMCPMC4086818.
18. Charu V, Rosenberg PB, Schneider LS, Drye LT, Rein L, Shade D, et al. Characterizing Highly Benefited Patients in Randomized Clinical Trials. Int J Biostat. 2017;13(1). doi: 10.1515/ijb-2016-0045. PubMed PMID: 28541924.
19. Ho T, Pollock BG, Mulsant BH, Schantz O, Devanand DP, Mintzer JE, et al. R- and S-citalopram concentrations have differential effects on neuropsychiatric scores in elders with dementia and agitation. Br J Clin Pharmacol. 2016;82(3):784-92. doi: 10.1111/bcp.12997. PubMed PMID: 27145364.
20. Schneider LS, Frangakis C, Drye LT, Devanand DP, Marano CM, Mintzer J, et al. Heterogeneity of Treatment Response to Citalopram for Patients With Alzheimer's Disease With Aggression or Agitation: The CitAD Randomized Clinical Trial. Am J Psychiatry. 2016;173(5):465-72. doi: 10.1176/appi.ajp.2015.15050648. PubMed PMID: 26771737.
21. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44(12):2308-14. PubMed PMID: 7991117.
22. de Medeiros K, Robert P, Gauthier S, Stella F, Politis A, Leoutsakos J, et al. The Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity of a revised assessment of neuropsychiatric symptoms in dementia. Int Psychogeriatr. 2010;22(6):984-94. doi: 10.1017/S1041610210000876. PubMed PMID: 20594384; PubMed Central PMCID: PMCPMC3314709.
23. Reisberg B, Borenstein J, Salob SP, Ferris SH, Franssen E, Georgotas A. Behavioral symptoms in Alzheimer's disease: phenomenology and treatment. J Clin Psychiatry. 1987;48 Suppl:9-15. PubMed PMID: 3553166.
24. Cohen-Mansfield J. Conceptualization of agitation: results based on the Cohen-Mansfield Agitation Inventory and the Agitation Behavior Mapping Instrument. Int Psychogeriatr. 1996;8 Suppl 3:309-15; discussion 51-4. PubMed PMID: 9154580.
25. Rosenberg PB, Mielke MM, Lyketsos CG. Caregiver assessment of patients' depression in Alzheimer disease: longitudinal analysis in a drug treatment study. Am J Geriatr Psychiatry. 2005;13(9):822-6. doi: 10.1176/appi.ajgp.13.9.822. PubMed PMID: 16166413.
26. Schneider LS, Olin JT, Doody RS, Clark CM, Morris JC, Reisberg B, et al. Validity and reliability of the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change. The Alzheimer's Disease Cooperative Study. Alzheimer Dis Assoc Disord. 1997;11 Suppl 2:S22-32. PubMed PMID: 9236949.
27. Schneider LS, Dagerman K, Insel PS. Efficacy and adverse effects of atypical antipsychotics for dementia: meta-analysis of randomized, placebo-controlled trials. Am J Geriatr Psychiatry. 2006;14(3):191-210. doi: 10.1097/01.JGP.0000200589.01396.6d. PubMed PMID: 16505124.
28. Sultzer DL, Davis SM, Tariot PN, Dagerman KS, Lebowitz BD, Lyketsos CG, et al. Clinical symptom responses to atypical antipsychotic medications in Alzheimer's disease: phase 1 outcomes from the CATIE-AD effectiveness trial. Am J Psychiatry. 2008;165(7):844-54. doi: 10.1176/appi.ajp.2008.07111779. PubMed PMID: 18519523; PubMed Central PMCID: PMCPMC2714365.
29. Cohen-Mansfield J. Assessment of disruptive behavior/agitation in the elderly: function, methods, and difficulties. J Geriatr Psychiatry Neurol. 1995;8(1):52-60. PubMed PMID: 7710649.
30. Cohen-Mansfield J, Marx MS, Rosenthal AS. A description of agitation in a nursing home. J Gerontol. 1989;44(3):M77-84. PubMed PMID: 2715584.
31. Rabinowitz J, Davidson M, De Deyn PP, Katz I, Brodaty H, Cohen-Mansfield J. Factor analysis of the Cohen-Mansfield Agitation Inventory in three large samples of nursing home patients with dementia and behavioral disturbance. Am J Geriatr Psychiatry. 2005;13(11):991-8. doi: 10.1176/appi.ajgp.13.11.991. PubMed PMID: 16286443.
32. Hendrix S, Brown BL, Cummings JL, Lyketsos C, Porsteinsson AP, Rosenberg PB, et al. Optimizing measurement of agitation and aggression in dementia. Alzheimer's & Dementia. 2017;13(7 supplement):P264.
33. Rabinowitz J, Katz I, De Deyn PP, Greenspan A, Brodaty H. Treating behavioral and psychological symptoms in patients with psychosis of Alzheimer's disease using risperidone. Int Psychogeriatr. 2007;19(2):227-40. doi: 10.1017/S1041610206003942. PubMed PMID: 16879763.
Copyright © 2012 - The Journal of Prevention of Alzheimer's DiseaseISSN 2426-0266

redpajama_set_name: RedPajamaCommonCrawl


text:
Morwell Advertiser (Morwell, Vic. : 1888 - 1954)
In: morning.
There was widespread regret when it became known that Mrs F. L. Grubb, nee Ruby Millicent, youngest daughter of the late Mr and Mrs G. Pentland,
Thu 5 Oct 1944 - Morwell Advertiser (Morwell, Vic. : 1888 - 1954)
Page 5 - OBITUARY
THE LATE MRS. MILLICENT GRUBB
There was widespread regret when
it became known that Mrs. F. L. Grubb,
nee Ruby Millicent, youngest daughter
of the late Mr. and Mrs. G. Pentland,
passed away suddenly at Morwell.
Mrs. Grubb, formerly of Cowes, Phillip
Island, had resided with her daughter
Mrs. J. Bolding jnr. at Chapel Street,
Morwell.
Her daughters, Beryl (Mrs. K. Hinde,
of Traralgon); Esme (Mrs. S. Living-
stone, of Traralgon); Lila (Mrs. J.
Murdock), whose husband is abroad
and Elaine (Mrs. J. Bolding, of Mor-
well) headed the guard of honor of
lady relatives and friends with their
floral tributes before the funeral cort-
ege left her sister's (Mrs. A. Brereton)
home at Traralgon for the last resting
place in that centre.
The pall bearers were Mr. Gordon
Pentland (brother) and three sons in
law. The many beautiful tributes,
donated to some degree, the loving es-
teem in which the deceased lady was
held. Of the late Mrs. Grubb, the
outstanding characteristics of radiant
personality, unselfishness, and courage,
inspired and made her beloved by all
who came in contact with her; and
her life is an indelible inspiration to
her devoted daughters and grand-
children so sadly bereft.
OBITUARY (1944, October 5). Morwell Advertiser (Morwell, Vic. : 1888 - 1954), p. 5 (morning.). Retrieved January 20, 2020, from http://nla.gov.au/nla.news-article66130650
"OBITUARY" Morwell Advertiser (Morwell, Vic. : 1888 - 1954) 5 October 1944: 5 (morning.). Web. 20 Jan 2020 <http://nla.gov.au/nla.news-article66130650>.
1944 'OBITUARY', Morwell Advertiser (Morwell, Vic. : 1888 - 1954), 5 October, p. 5. (morning.), viewed 20 Jan 2020, http://nla.gov.au/nla.news-article66130650
{{cite news |url=http://nla.gov.au/nla.news-article66130650 |title=OBITUARY |newspaper=[[Morwell Advertiser]] |location=Victoria, Australia |date=5 October 1944 |access-date=20 January 2020 |page=5 (morning.) |via=Trove }}
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Morwell Advertiser (Morwell, Vic. : 1888 - 1954), Thu 5 Oct 1944, Page 5 - OBITUARY


High levels of androgens These are sometimes called male hormones, though females also make them.
· There is no single test to diagnose PCOS. Your doctor will take the following steps to find out if you have PCOS or if something else is causing your symptoms.
· Medical history. Your doctor will ask about your menstrual periods, weight changes, and other symptoms.
· Physical exam. Your doctor will want to measure your blood pressure, body mass index (BMI), and waist size. He or she also will check the areas of increased hair growth. You should try to allow the natural hair to grow for a few days before the visit.
· Pelvic exam. Your doctor might want to check to see if your ovaries are enlarged or swollen by the increased number of small cysts.
· Blood tests. Your doctor may check the androgen hormone and glucose (sugar) levels in your blood.
· Vaginal ultrasound Your doctor may perform a test that uses sound waves to take pictures of the pelvic area. It might be used to examine your ovaries for cysts and check the endometrium This lining may become thicker if your periods are not regular.
Keep in mind that the menstrual cycle will become abnormal again if the pill is stopped. Women may also think about taking a pill that only has progesterone like Provera, to control the menstrual cycle and reduce the risk of endometrial cancer (See Does PCOS put women at risk for other health problems?). But, progesterone alone does not help reduce acne and hair growth.
Clomiphene) — the first choice therapy to stimulate ovulation for most patients.
Gonadotropins— given as shots, but are more expensive and raise the risk of multiple births compared to clomiphene.
Medicine for increased hair growth or extra male hormones. Medicines called anti-androgens may reduce hair growth and clear acne. Spironolactone (Aldactone), first used to treat high blood pressure, has been shown to reduce the impact of male hormones on hair growth in women. Finasteride a medicine taken by men for hair loss, has the same effect. Anti-androgens are often combined with birth control pills. These medications should not be taken if you are trying to become pregnant.


Come enjoy a tour specifically designed to get back in touch with your Albanian roots! This comprehensive tour of Albania also includes a night in beautiful Macedonia. Experience the vast history of Albania and immerse yourself in the rich culture of the Albanian people! This eleven day ten night tour departs on the May 14th and returns on May 24th.


Time dependence of the intensity (A), and the d-spacing (B) of the first order reflection of the rapidly formed H2 phase referring to the experiment given in Figure 4.
The solid red line shows the best single exponential fit to the data. The time constant, k, was determined to be 0.10±0.03 and 0.12±0.02 sec−1 for panels (A) and (B), respectively.


a short dubstep mix hope you enjoy!
Well... its kinda hard to give a review when its not your original work, if this is meant to be a mix of the dubstep songs you like then I suggest credited those artists who made the song. Plus the song cuts out at the 1 min mark. But all in all as said before I would recommend that you post up you original work.
I hope to see what hidden talents you may have.


text:
Mechatronics and Robotics Engineering is a unique program that brings together three engineering disciplines: computer, electrical, and mechanical engineering in one unique field
Engineering Databases: General
Engineering Databases: Materials
Using Knovel
Web of Science: Search Results
Web of Science: Create Alerts
Web of Science: Save Results
Standards and Codes
Welcome to the Mechatronics & Robotics Engineering Library Resources Guide
This is a guide of selected research sources for the Meachatronics & Robotics Engineering program available through Queen's University Library. Mecatronics and Robotics Engineering is an interdiscipliary program that spans in three engineering disciplines: computer, electrical, and mechanical engineering focusing on Automation, Robotics, Biomedical, Intelligent Systems. Please note that many resources are restricted to Queen's University affiliates. Please select the resources from the tabs on the left column.
Core MRE Collections
Engineering village provides access to key engineering literature and patent databases providing coverage from a wide range of trussted engineering resources
Web of Science is a multidisciplinary abstract and citation database of peer-reviewed literature, and provides both author and journal metrics (performance analytics) of the literature indexed in the database.
Knovel is a searchable database of more than 5,000 engineering and applied science handbooks and other reference works.
The IEEE Xplore digital library provides access to IEEE journals, transactions, letters, magazines and conference proceedings, IET journals and conference proceedings, and IEEE Standards.
AccessEngineering is an award-winning engineering references and teaching platform that delivers world-renowed, interdisciplinary engineering content integrated with analytical teaching and learning tools
SYNTHESIS is a database organized into series, with each series pertaining to a different topic in the field of engineering and computer science.
Scopus is the largest abstract and citation database, including peer-reviewed titles from international publishers, Open Access journals, conference proceedings, trade publications, quality web sources.
Next: Using Omni >>


This is a stunning late 1800's ormolu and jeweled powder compact with a pretty unused silk embroidered powder puff.
It features 4 emerald green colored stones, 4 pink stones, as well as 4 light blue stones that are all faceted bezel set stones are set on a gorgeous ormolu filigree lid.
It opens to a glass mirror, that has one small white spot. It has a metal mesh sifter net and a chrome powder plate cover that has holes for the dispensing of the loose powder you can add. The mirror has a tab to lift it up to reveal the rouge holder or a place for the handmade silk powder puff.
This compact is in fabulous condition, and the hinges and closure are in great working condition. It measures approximately 2 inches in diameter, and comes in a white organza gifting pouch.
A wonderful gift idea for the collector, and perfect for use with todays loose powder.
Consider visiting our shop for more antique and vintage powder boxes, compacts, and unique vanity pieces.


Cover up and stay comfortable in our blue midi swing beach dress. With tie-back shoulder straps and a tiered swing design, it's an easy to wear piece to effortlessly take you to the beach. 100% Viscose. Machine wash.


text:
December 7, 2018 Marilyn L. Davis
Best 1000 Words for the Image Contest: Traci Kenworth: The Curse
By: Traci Kenworth
Bailey was stuck inside the pages of a storybook. No matter what scenery she wandered into, she only escaped that story to be placed into a new one. How long had it been since she'd been home? Days? Months? Years? She couldn't tell if she aged to keep track of time.
Once, she'd glanced into the looking glass in Wonderland, but even that image had lied. She hung her head, fists clenched. Who had done this to her? And why? The fairy tales her mother had read her as a child spoke of spells and curses. Was that what this was?
She stared at the thick, clotted pages, its line of prose endless. Where would it take her now? A hint of dust clung to the book and made her sneeze. What if she tore the page? Would that seal her fate? Or break the tale?
She bent down near a spring and cupped her hands together while she caught some water. The clear, sweet taste refreshed her. The flow of the water as it splashed through the rocks on the bank calmed her thoughts. She was here. Best to enjoy her journey. Besides, if a curse had been cast, there existed a way to break it. Didn't all the books say so? The movies too?
Bailey pushed to her feet and smelled something peculiar. Wet. Damp. Like her grandmother's root cellar. She followed the scent. It got stronger as she headed in. The grass parted and she turned, putting her hands up as a lioness came into view.
The lioness stared at her a minute. She stared back. Sweat dripped down her back and legs. In storybooks, lions were either vicious or like gods. Which one was this?
The lioness broke the stare and motioned to a table set beside a small cottage. "Come. Have some tea."
Tea? With a lioness? Had anyone ever done this before?
"I won't bite," the lioness said.
"H-how can I be sure?"
"Why would I want to hurt you?" The lioness headed toward the table and took a seat at the head of it.
Bailey moved toward the table, her legs shaky. "I'm a girl. And you're a lioness."
"Yes, yes, I know that. But beyond that. Why would I?"
"Don't you eat humans?"
The lioness gagged on the tea she sipped. "Goodness, no. I'll be your guide, child."
"My guide?"
"To help you find your way home."
Bailey took a seat. "Then there is a way?"
"Oh, there's always a way. You just have to pay the price."
She leaned forward. "What price?"
"You must learn the secret of the storybook."
"That doesn't sound like a price."
"The price is in the doing. What will you give to go home?" The lioness reached for a raspberry scone.
The lioness savored a bite of the scone. "I would be careful with your answer. You just might find that everything is taken from you."
"But I'll be home?"
"If you learn the secret." She finished the last of the scone and gestured for Bailey to have one. "Oh, how delicious they are."
Bailey nibbled at hers. What was food when she could be home with her family? She pushed back from the table. "How do I begin?"
"You've been in the story world for a while. What have you learned?"
Bailey tilted her head. "I've learned to never follow a rabbit down a hole. Don't trust a flying monkey. That a prince can break a curse with a kiss." She sat straighter. "Is that it? Do I need to have a prince kiss me back home?"
"Those are good lessons, but not quite right. Think, my dear."
With a sigh, Bailey hugged herself. "I've learned that a beast can be tamed by love, wolves who disguise themselves as Grandmothers will be felled, and witches who eat children are to be avoided at all costs."
"You're clever but not thinking of your own story."
Bailey drew back. "My story?"
The lioness smiled. "Of course."
"But I don't have one."
"Oh, everyone has a story. They just have to solve the puzzle of it all."
She frowned. "The puzzle? But how can I solve it?"
"That is part of your journey."
"But where do I begin?"
"At the start, of course."
The beginning? But where was that? The lioness talked as if she should know this. The last thing Bailey remembered was Mother Goose and her struggle to feed all her children. Before then?
Did she have a family? She couldn't remember. Maybe she'd always been part of the fairy tales. She shook her head. No. There was Mother and Father. The twins and the baby. She belonged with them. In the land of?
Praege. Yes, yes. The beauty there was beyond words. Her house was gray with purple shutters. Her room, small and violet. She had lots of stuffed animals on her bed with a splurge of pillows. She could smell her mother's cooking pot roast with lots of carrots, potatoes, and celery. Her mouth watered in expectation. How did she get back there? She must solve the puzzle. What action would lead her home? She glanced past the fancy table and its teatime treats. If only she could see a clue.
"I don't see a way out."
"Then perhaps there's a way through." The lioness sets her teacup down. "How did you get here?"
"Through a mirror." She sat straighter. "Is that it? I must find the mirror, I came through to escape?"
She frowned. "It's not the looking glass. I saw that this morning and nothing happened when I held it. It has to be bigger. People sized. But where would such be?" Her gaze widened. "Maybe it's the Evil Queen's mirror. No, it's almost big enough, but not quite." She pushed her hair out of her gaze. She snapped her fingers. "The mirror in the hall with the three blind mice. That one's big enough."
"What brought you here?"
"I was—lonely. I saw the cat stalking the three mice and wanted to help."
"The mice or the cat?"
"The mice, of course. Just because they're blind doesn't mean they should suffer a nasty death."
"Why were you lonely?"
"My mother had grounded me. Too much daydreaming, she said."
"And have you learned?"
"Then you may go."
She stood.
"Oh, I didn't mean you had to leave here."
"But the mirror"
The lioness smiled. "The door home was in you all along."
A bright light spilled before Bailey. The pages of the book turned to home. She could see her mother in the kitchen. She rushed forward, leaving the fairy tales behind.
Traci Kenworth writes all genres of YA as well as the occasional historical romance. She lives in Ohio with her son, daughter, and four cats.
She has been writing since she was old enough to hold a pencil. It was through her writing that she was saved from a dark period in her life. She is forever grateful to God for this way out of the darkness and into the light.
Her experiences become a focal point for the heroes and heroines in her stories. They share a common trait with her; they are survivors. Their stories give the reader that most welcome gift – hope.
Some other things she enjoys: genealogy, riding horseback, and, of course, reading.
Follow Traci
Website: Where Genres Collide
While the Best 1000 Words for the Image Contest is winding down, Two Drops of Ink is always looking to publish the how-to that will help writers and bloggers improve their writing, poetry, short fiction, and memoir as it relates to the writer and blogger.
Want an additional platform for your writing? Then consider a guest post today.
Best 1000 Words for the Image Contest
Previous Best 1000 Words for the Image Contest: Rebecca Larsen: Nothing and Everything
Next Best 1000 Words for the Image Contest: J. Rohr: At Home in the Hideout
Laurie O says:
Nice job Traci! I loved the little nuggets of classic fairy tale references throughout your story. We can all relate to those.
Thank you, Laurie! It was fun to write!
Ann Satava says:
Did you find the link to vote, Ann? If you follow the 1000 words for the Image Contest link, you'll go to their page and you may have to sign up but if you do like the page, it'll help me with the votes! Thank you!
Traci, This was such a good story for that picture! I love fairy tale worlds, and the lioness was such a wise character. Always pointing out the truth but never giving the answer. But Bailey figured it out…as all main characters should. 🙂
Thank you so much, Michelle! Glad you liked it!
Great short story, Traci! Heading over to vote…
Thank you, Bette!
Check Out My Story on Two Drops of Ink! | Loleta Abi says:
[…] My Story, "The Curse" is up for a contest on Two Drops of Ink! Please vote, here's the link: https://twodropsofink.com/2018/12/07/best-1000-words-for-the-image-contest-traci-kenworth-the-curse/ […]
Thank you, Marilyn! I'm so happy you liked it!


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text:
Learn how to approach verbal ability questions
Directions from questions 1 – 5 : Read the passage carefully and choose the correct answers to the related questions:
The Great Pyramid at Giza is one of the world's most amazing landmarks. Rising high above the Sahara Desert in the Giza region of northern Egypt, the Great Pyramid stands some 450 feet into the burning desert sky and occupies of an area of 13 acres. The rough climate of the Sahara has actually caused the pyramid to shrink 30 feet from its original height. The pyramid was such an amazing feat of engineering, that it remained the tallest structure in the world for over 3800 years. The entire was originally faced with polished limestone to make it shine brilliantly in the sun.
Most Egyptologists, scientists who study ancient Egypt, agree that the Great Pyramid was built around 2560 BC, a little more than 4,500 years ago. It took tens of thousands of workers twenty years to build. The pyramid contains over two million stone blocks. Although most of the blocks weigh two or three tons, some weigh up to 80 tons.
The Great Pyramid of Giza was ordered built by the Pharaoh Khu-fu as a magnificent tomb. His vizier (advisor) Hemon is credited with being the pyramid's architect. Khufu's pyramid is actually part of a complex of pyramids that includes the Pyramid of Khafre, the smaller Pyramid of Menkaure, a variety of smaller pyramids and structures, and the Great Sphinx. The Great Pyramid of Giza is the last remaining of the Seven Wonders of the World
Which of these does not house the Great Pyramid ?
Southern Egypt
Northern Egypts
Sahara Desert
Except for option 2, all have been mentioned in the first line.
How many stone blocks constitute the pyramid
more than two million
Answer: Option C.
Refer to third line of second Paragraph. "the pyramid contains..............".
. Most of the blocks in the pyramid weigh about tons.
Two or three
Refer to last line of second Paragraph: Although most of the blocks weigh two or three tons, . .. . .
Which of the following definitions best describes the meaning of "complex" in the passage?
Refer to second line of third paragraph:Khufu's pyramid is actually part of a complex of pyramids - thus Group is the correct answer.
Which of the following is false
The Great Pyramid is the last of the Seven Wonders of the World.
Khufu was Hemon's vizier and architect.
The Pyramid took tens of thousands of workers about twenty years to complete it.
Hemon was Khufu's vizier and architect
Khu-fu was the Pharaoh and Hemon was his vizier.refer to first few lines of last paragraph.
. This watch (a) / is superior and (b) /more expensive than that watch (c) /No error (d)?
The correct phrase is superior to..
This town isn't very well known (a) / and there isn't much to see, (b) so a few
tourists come here, (c) / No error (d)
In front of the word a few, we need to add the word only.
Directions from questions 8-9 : Correct the Highlighted parts
All human beings are vulnerable to greed and temptations?
are vulnerable for
have vulnerability of
were vulnerable at
No correction required
Answer: Option D.
How did the burglar got into the bank is a mystery.?
Hyperventilated
Because of the word did , the next verb will be in present tense.
Complete the sentence
Both by ________ and by gender, American painter Mary Cassette was an ________ , because her artistic peers were French men.
background, amateur
citizenship, intellectual
nationality, anomaly
style, advocate
The key words are French and men. It is thus clear that the blanks should have words which surround nationality and Mary Cassette being an exception


The Issue of Adequacy in the Financing of Public Education: How Much Is Enough?
Publications, Institute for Research on Educational Finance and Governance, School of Education, CERAS Building, Stanford University, Stanford, CA 94305 ($1.00).
Note: Some pages may reproduce poorly due to marginal legibility of original document.


Redmond, WA – Current Redmond Artist-in-Residence, Maja Petrić, has transformed her art studio into a gallery. The grand opening of the space, located at 16528 Cleveland Street, Building D, Redmond, WA 98052, takes place on Friday, February 22 from 6:00 p.m. to 9:00 p.m. The exhibit will showcase existing Lost Skies artworks from her AIEye series and opportunities for attendees to participate in the development of new, Redmond specific AIEye artwork. The new artwork will debut as a part of So Bazaar this summer. On-going, drop-in hours at the gallery will be Monday and Thursday's from 3:00 p.m. – 8:00 p.m.
In Lost Skies, Maja seeks to capture people's perspective on climate change and engage their connection with nature. To achieve this all-encompassing collective gaze, Maja partnered with artificial intelligence (AI) scientist Mihai Jalobeanu. Together, they created a system, AIEye, that is designed to process vast numbers of images that document the manifold of people's visions of nature and create one image that represents all the collected images. Human hands alone could not possibly accomplish this processing, meaning, Lost Skies would not be possible without AI.
Maja Petrić is a new media artist. She received a Ph.D. from the University of Washington and a Master's Degree from New York University. She taught at the University of Washington, Complutense University of Madrid, Technical University of Madrid, and European Institute of Design. She directs and teaches the graduate program Creative Lighting at the European Institute of Design in Madrid, Spain. She has exhibited internationally, and her art is represented by Winston Wächter Fine Art Gallery in Seattle.
The Redmond Artist-in-Residence Program stimulates cultural vibrancy in Downtown Redmond's parks and challenges residents to become an active participant in civic life and cultural advocacy. For more information about Maja Petrić's work, please visit Redmond.gov/artistresidence.
For questions and more information contact Lisa Maher, Communications & Marketing Manager, at lmaher@redmond.gov or 425-556-2427. This press release is available on www.redmond.gov.


text:
Driving Investment Returns Through Talent Management
Top 50 U.S./Americas
Executive Search Review
About Hunt Scanlon Media
Newswire Archive
Leadership Reports
2020 Next-Gen Leaders Report
2020 Diversity, Equity & Inclusion Report
2020 Executive Recruiting State of the Industry Report Part Two: Forecast & Recovery Strategies
2020 Executive Recruiting State of the Industry Report: Adapting in Uncertain Times
PE Report 'Driving Investment Returns Through Talent Management'
Private Equity Recruiting Report Bundle
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Pivot Management Partners Names Leader of Collegiate Sports Recruiting Practice
June 29, 2018 – Executive search specialist for the sports and entertainment market Pivot Management Partners (PMP) has expanded with the addition of Peter Roby as senior client partner to lead its recently launched collegiate sports practice. The practice will focus on searches for athletic directors, coaches and senior professional positions on behalf of universities and NCAA conferences.
"In everything he has done in his career, coach Roby has left an indelible stamp of integrity and done things the right way for the right reasons," said Scott Gilly, PMP's founder and CEO. "We are thrilled to count Peter among our senior leadership team."
In addition to Mr. Gilly, Mr. Roby is also reuniting with another former Harvard basketball player and team captain, Neil Phillips, the senior client partner leading the firm's diversity and inclusion initiatives.
"Peter's presence strengthens our ability to deliver real impact for clients in helping them define and pursue their diversity interests by focusing intently on their culture, a climate of honest discourse, and clear, results-oriented initiatives – something Peter has done at every institution he has been associated with in his career," said Mr. Phillips.
Mr. Roby said he was excited about his new role and the colleagues he will be working with. "Today's marketplace for the best talent is too competitive not to use the highest level professionals available," he said. "The opportunity to help build upon the great work that Scott and Neil are doing, along with the rest of the team at Pivot, is a very special opportunity for me."
Collegiate Sports Veteran
"Mr. Roby's mission-driven commitment to leadership development, equal opportunity, and maintaining the integrity of college sports are among the core values that motivate his work with PMP," the firm said. "Having led one of the most diverse, respected and impactful careers in collegiate sports, Mr. Roby's extensive relationships across the sports industry will benefit clients in PMP's collegiate sports practice and beyond."
Sports and Entertainment Expansion Elevating Search Business
Over the last quarter century, the sports sector has grown into a formidable global industry. Historically, professional sports teams operated on a relatively modest level, with league officials, team owners, managers, and coaches surrounding themselves with people they knew and trusted from their own small worlds. College sports teams relied on in-house search committees and word-of-mouth recommendations. Much of that has forever changed.
Teams with tremendous followings like the Dallas Cowboys, Real Madrid and Manchester United have seen their valuations soar into the billions of dollars. That's attracted search firms – big time. Seasoned recruiters now provide strategic planning advice, in addition to talent identification services, with the capability of applying their findings to speed along the process in the hunt for talent. Here's some further reading from Hunt Scanlon Media.
Mr. Roby completed his 11-year tenure as athletic director at Northeastern University, as well as his five-year appointment to the 10-member NCAA Division 1 Men's Basketball Committee responsible for selecting and seeding the men's tournament field. In 2007, he was named one of the 100 Most Influential Sports Educators in America by the Institute of International Sport.
Related: Executive Search Gets 'On the Ball' In Sports Recruitment
Previously, Mr. Roby served as head coach of the Harvard University men's basketball program, vice president for U.S. marketing at Reebok, and director of Northeastern's Center for Sport in Society. Earlier in his career, he was an assistant coach at Stanford University, Dartmouth College and the U.S. Military Academy at West Point. He currently serves on the Knight Commission on Intercollegiate Athletics, and continues to play a significant role in the NCAA Pathway Program.
Headquartered in New York, Pivot Management Partners is a retained executive search firm focused on the complete sports & entertainment ecosystem. It specializes in a secure and confidential search process, helping to shape the leadership teams of both established and emerging organizations in the world of sports & entertainment, including professional sports franchises and league offices, university athletic departments and NCAA conferences, as well as the growing array of agencies, brands, sponsors, and content, technology and media companies in the industry.
Related: Executive Recruiters Continue Their Expansion into the Sports Industry
Mr. Gilly, who founded the firm in 2015, draws upon a deep network of extensive industry relationships, and more than 20 years of "front-line" experience as a labor-employment lawyer, trusted advisor, and senior executive. He works closely with clients to identify, acquire and onboard top-tier executives that fit the corporate culture and working environment they are joining.
Prior to founding PMP, Mr. Gilly built a labor-employment law practice, first at Morgan Lewis & Bockius and then as founding partner of his own law firm. He has two decades of training and advocacy experience advancing workplace diversity, inclusion and harassment prevention, as well as advising and counseling many high-profile senior executives and businesses, including professional sports leagues and media-entertainment companies.
Related: Executive Recruiters Prove Invaluable to Thriving Global Sports Sector
Contributed by Scott A. Scanlon, Editor-in-Chief; Dale M. Zupsansky, Managing Editor; Stephen Sawicki, Managing Editor; and Andrew W. Mitchell, Managing Editor – Hunt Scanlon Media
Vector Talent Resources Appoints Leader of Executive Search Division
Major, Lindsey & Africa Finds General Counsels for Elanco Animal Health and American Tire Distributors
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Please note: When ordering a zBar you will actually receive a doubleZ bar. Along the underside is a fold line and you simple snap the excess away to create the zBar. This is easy and you should have no trouble doing so.
The Posh has a self-adhesive cover strip which hides the screws. All Fittings supplied.


text:
Q: SCons: how to debug what action does? I'm trying to understand why Sphinx builder for SCons doesn't work.  The essential part of the code that I want to debug boils down to this:
SCons.Action.Action('$SPHINXCOM', '$SPHINXCOMSTR')

I know that in theory, $SPHINXCOM should expand to $SPHINXBUILD $_SPHINXOPTIONS ${SOURCE.attributes.root} ${TARGET.attributes.root}, but since SCons never seems to run this action, I can never trace what was it thinking it should run.
Trying to navigate SCons' own code is a road to hell... it's completely opaque, with dozens of delegations and guesswork and so on... After hours of trying, I still cannot find the code that is supposed to run when this action is evaluated, or whatever the correct term is... but at some point the methods of the action start returning empty string, at which point it seems to stop.
By reading through the --help options, I cannot see anything that would increase verbosity or print any more diagnostic messages than what is already printed (there isn't really any logging in the code anyway, so there seems to be nothing to print anyway).  I would be happy to find the code that executes the action, so that I would know at which point the action does have to have to produce any non-null values in its methods...  I'd be grateful if anyone could point me to that code.

Just to give you a taste of what is going on with this Action thing.  My findings so far are as follows:

*

*Action calls two helper methods conditioned on the type of arguments, which in my case seems to delegate the work to ActionBase class.

*ActionBase, after inspecting the types of arguments (all of which are passed through **kw, i.e. anonymously) seems to then delegate the work to ActionAction class.

*ActionAction class then inspects the arguments, which have now been altered by the previous inspections, and calls CommandAction class to deal with the input.

*CommandAction now again delegates to Action.

*Action now received the same basic info in the arguments, but it's formatted differently: instead of the second argument being a string, it is a dict with a single key in it.

*Action now delegates to _Action...

Somewhere around that point the methods of "action" object start returning empty string where a I'd expect to see the generated command.  Given the overall structure and smell of the code, I think I only scratched the surface of this devious delegation scheme, but I don't have enough of inside knowledge to cut through all of it to the place, where "action" methods are really accessed.  If I knew where that happens, I'd be able to find a way to structure the arguments to Action in such a way that they make it in one piece to that place.

A: Note that SCons runs in two phases: a "parse" phase, and a "build" phase. The call trace that you describe above is from the "parse" phase. This is where the SConstructs get read and digested. In this phase, SCons simply keeps track of which source and target nodes are required (get defined) by the different Builder calls like "env.PDF("test.ltx")". For a target node, like "test.pdf" in this example, it also registers the Environment to be used ("env" here). In Builder::_execute an instance of the class Executor gets registered with each target, keeping track of which Builder actions have to get triggered.
But it doesn't execute the required single Actions right away! This will only happen later, in the "build" phase, when SCons detects that the target "test.pdf" is indeed not up-to-date.
Then, Task::execute (in Taskmaster.py) gets called, which invokes the Node::build() method of the target node. There the registered Executor gets called and expands the Actions in Executor::execute_action_list().
Remark: Take into account that the string '$SPHINXCOM' gets substituted with the variables as being set for the current Environment. So, you don't have to manipulate the arguments given to the Action constructor, but the variables in the used Environment for getting the output you need.
I hope this helps you further. ;)

redpajama_set_name: RedPajamaStackExchange


TV From family reunions to soaring dragons, the season eight premiere of GoT delivered some key moments fans have been waiting a long time to see. Spoiler warning.
TV Want to join the Game of Thrones bandwagon but think you don't have time? Think again. Here is how you can watch the new season.
TV Game of Thrones' final season is here today — so get your tips in to the GoT Challenge now. Predict who will make it through and you could win an Iron Throne.


As we're sure you know, Easter is just around the corner. It's a fun and chocolately time of year! It also supplies us with an extra-long weekend and lines up with school holidays, meaning a lot of us are hitting the highways or jumping on a plane.
We're sure it promises to be a great time away!
While planning all the fun you're going to have, we think it's important to also take some time to plan and prepare for your trip (especially if you're driving long distances), to help ensure you have a safe and happy holiday. So, we've put together this holiday safety guide to help you on your way!
Depending on what you have planned, there might be some specific things to consider when planning, booking or while away on your holiday. We figured holiday planning is stressful enough, so we've collected some great tips and advice for a safe and happy holiday, for a range of holiday plans!
Hitting the Highway? Stop here first.
It's likely that you would have heard many, if not all, of these tips before – but it doesn't make them any less true or important. If you're hitting the road for a decent period of time it's important to consider all these tips (and others you may have come across), to be sure that you travel safely and enjoy your time on the road!
Make sure you check your tyres, oil and other fluids, and make sure your car is up to date on its services. Breaking down isn't just annoying, it can be dangerous depending on where it happens and how far away help is, not to mention the innate dangers that come with standing on the side of a highway.
It's important to plan out your trip, including rest stops, sightseeing and fuel. Rest stops are important for everyone – they can help keep passengers and kids happier, and allow the driver a chance to relax, or ideally an opportunity for drivers to switch over. General advice is to stop every 2 hours for at least 15 minutes. If you're on a longer trip you may also need to plan where you're staying overnight or various sightseeing stops along the way.
Depending on where you're travelling, it can be a fair distance between service stations, so you should know roughly where you will be filling up if you're taking roads less travelled.
Probably one of the harder ones at times, as we all know some drivers on our roads can be rude and dangerous when it comes to how they operate on the road. Unfortunately, this can be part and parcel of using our roads, and as difficult as it can be at times it's important to just let this slide, drop back and avoid these drivers or even pull over for a quick break – driving angry is never a good idea.
And as with every list of driving tips, we include following the road rules – don't speed or drive under the influence and look up the road rules for any other states you might be travelling through.
Hopefully, these tips and your own good judgement will keep you and those you're travelling with safe on our roads over the Easter period, but unfortunately accidents do happen. If the worst happens on our roads, you can chat to an expert lawyer at any point during the Easter period, or any time during the year – give us a call here or find out more about car accident claims here.
Boarding a Boat? Check these out before you pull up anchor.
Depending on your level of boating experience, these tips may be ones you're familiar with or completely new to you – either way it's worth familiarising yourself with these recommendations to ensure you approach any time out on the water safely.
Just like heading out on a road trip, it's important to make sure your boat is prepared and ready for the journey. This includes all your safety equipment, extra fuel, food and fresh water.
The equipment you will be required to carry on-board will depend on whether you're heading out on enclosed or to open waters – check out the QLD regulations here.
This is probably the most important consideration before heading out on the water. You should always check forecasts and tides (find all the relevant QLD links and phone numbers here) before you head out, and keep a regular eye on these while you're out – getting caught off-guard in bad weather can be deadly.
It's important to know your limitations if you're the skipper, don't attempt anything (such as a bar crossing) that you're unfamiliar with – especially with a boat-load of family and friends aboard.
If possible, try to avoid alcohol completely, as the sun and water can exacerbate its affects, but if you are planning to drink remember at least 1 licensed skipper must have a blood alcohol level of under 0.05 at all times. Carry lifejackets for everyone and ensure everyone wears one whenever you think there may be a heightened risk – they save lives and prevent unnecessary tragedy.
Hopefully these tips keep you safe and happy while out on the water. Should the worst happen you can speak to our expert team at any time (call us here) and you can find out more about boating accident claims here.
Flying Afar? Check-in here first.
The advice here is a little different, given you're not in control of your mode of transport, but there are certainly still some important tips for safe and happy travel when you're jumping on a plane. Many of these are ones you may have heard before, but they're still as important as the first time you heard them!
Smart Traveller is something you should be checking before you plan out your next overseas adventure – it advises you of any safety concerns or issues that may affect your travel plans. You should check this for all areas you're looking to travel to, and pay attention to any issues that may impact your travel insurance.
Speaking of travel insurance, make sure you have yours sorted!
Travel insurance is something that we believe is important for every trip overseas, making sure that if worst happens; you aren't left stranded in a foreign country or with a huge medical bill.
You should make sure you're familiar with your itinerary, including flight times, gate numbers, and terminals (some large airports have multiple terminals and travel between these can be upwards of 20 minutes).
You should also be familiar with any visa requirements that the country you are travelling to may have, as well as any restrictions on what you can bring into the country (for example, codeine is illegal in Indonesia).
You should practically prepare for your flight and time away, including having all your devices, chargers and adaptors, comfort items for travel, any medication you may need (that you have a letter from your doctor for if needed) and other things to keep you entertained and comfortable on the flight.
Lastly, here's 50 more tips for a 'perfect' flight!
Hopefully you have a safe and happy flight, and enjoy your time away – whether it's overseas or within Australia, however if the worst does happen you can find out more about accidents and injuries that occur on a plane here, and accidents and injuries that occur overseas here.
You can also reach our friendly team here.
Lastly, are you one of the hard working people staying behind and working through the Easter Holidays? If so, thank you! We know holidays wouldn't be possible without any of you – thanks for keeping everything running, we hope you get some time off soon!
If you are heading away, we hope these tips help you with your planning and keep you and those with you safe and happy for this trip (and any others you may be planning!).


Note: This is to upgrade a 700 MHz server only! For customers to upgrade from 550 MHz to 900 MHz, please use the ProLiant 8000 Pentium III Xeon 550 MHz to 900 MHz Processor Upgrade Kit (PN 231092-B21).
Note: This processor option kit (PN 175810-B21) supports the ProLiant 8000 and the ProLiant 8500 servers.
Note: This processor option kit (PN 146170-B21) supports the ProLiant 8000 and the ProLiant 8500 servers.
Note: This processor option kit (PN 146169-B21) supports the ProLiant 8000 and the ProLiant 8500 servers.


Competing in the NPC is a motivation for me to keep my mind, body & attitude positive and focused. It is a sport that many people can't understand and is not for everyone to understand, just respect it. For me its the drive that keeps me going. Always having a plan and always having a goal allows me to to stay motivated DAILY in both my personal and professional life. This lifestyle is path that leads me to constant challenges that once I over come them, they make me stronger and better at everything in my life.


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These limitations of liability apply even if MyUnversityMoney has been expressly advised of the potential loss.
matter which it would be illegal or unlawful for MyUnversityMoney to exclude or limit, or to attempt or purport to exclude or limit, its liability.
[You accept that, as a limited liability entity, MyUnversityMoney has an interest in limiting the personal liability of its officers and employees. You agree that you will not bring any claim personally against [NAME'S] officers or employees in respect of any losses you suffer in connection with the website.] [Without prejudice to the foregoing paragraph,] you agree that the limitations of warranties and liability set out in this website disclaimer will protect [NAME'S] officers, employees, agents, subsidiaries, successors, assigns and sub-contractors as well as [NAME].


Corticosteroids in pulmonary tuberculosis. Idiopathic Pulmonary Fibrosis; IV: The clinical and radiographic manifestations of pulmonary tuberculosis are often slow to resolve despite fully effective antimicrobial chemotherapy. In the s, the recognition that lung damage in tuberculosis TB is mainly due to a prolonged host inflammatory response led to a series of controlled clinical trials of adjunctive corticosteroids administered during the early phase of TB chemotherapy. Receive exclusive offers Lung penetration of methylprednisolone updates from Oxford Academic. Home Publications Conferences Register Contact.
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New Delhi: Seven people were killed as the nine coaches of the New Farakka Express derailed near Raebareli in Uttar Pradesh. The injured have been admitted to the hospital. The UP government has announced an emergency aid of Rs. 2 lakh for the family of the deceased and Rs. 50,000 for those who have seriously injured.


Man Utd supporters were furious after seeing former Liverpool FC midfielder Philippe Coutinho score a wonder goal in the Champions League.
Manchester United supporters are furious by the amount of space Philippe Coutinho was allowed when scoring for Barcelona on Tuesday night.
The former Liverpool midfielder netted a sensational goal to give Barcelona a three goal lead at the Nou Camp in the Champions League quarter-final, but supporters think it was unacceptable to concede.
Although the Brazil international did superbly well to find the back of the net from distance, many fans feels that United should have done their homework on Coutinho to prevent him scoring such a trademark goal.
The 26-year-old scored countless times for Liverpool by cutting onto his stronger foot from distance before smashing the ball into the far corner of the net.
Coutinho's goal marked the end of a torrid night for United fans, and after the game they hammered their defence for conceding such an inevitable effort.
Messi cutting in from the right. Coutinho cutting in from the left. Shock.


I want to share some of my pictures I took of a very talented young woman's creative flare. My darling friend Meg had a tea party and the way she set up her table was so magical that I could not help but take my camera out and document it!
Ah dearest pips! It pays off to read your friend's blog 🙂 you made my day.
lots of love my Meg!


text:
from evy import patcher
from evy.patched import asyncore
from evy.patched import asynchat
from evy.patched import socket
from evy.patched import thread
from evy.patched import threading
from evy.patched import time

patcher.inject("test.test_asynchat",
               globals(),
               ('asyncore', asyncore),
               ('asynchat', asynchat),
               ('socket', socket),
               ('thread', thread),
               ('threading', threading),
               ('time', time))

if __name__ == "__main__":
    test_main()

redpajama_set_name: RedPajamaGithub


Food parcels sent from Australia are handed out to OAPs in Holborn, London.
Unissued / unused material - location and date unclear or unknown.
Holborn, London. Food parcels sent from Australia are handed out to OAPs in Holborn.
CU a food parcel showing the contents. CU Mr Martin and Mrs Cox handing out parcels to Old Age Pensioners. VS Old men and women arriving to receive their food parcels. MS Exterior view of Holborn town hall. CU Norman A Martin, Agent General for Victoria, Australia who helped to present the parcels of food sent from Australia. CU Mrs Cox, the Lady Mayoress of Holborn who also helped in the distribution. VS Old men and women receiving their gifts.
Liverpudlian parade of shire horses in bridles decorated with flowers and bells.
Lady Mayoress of Ramsgate names hovercraft 'Swift'.
American newsreel about election of mayor in Berlin - start divide into East and West.
Life saving demonstration is held in Brighton, Sussex.


Regarded as one the world's leading premium lifestyle brands, Tommy Hilfiger has been delivering superior styling, quality and value to consumers worldwide for more than 25 years. The founder, Tommy Hilfiger –a self-taught designer and entrepreneur- has built a brand that essentially is a celebration of classic American style; this approach has proved so successful that in less than two decades, the company grew from a single line into a global business that encompasses a wide range of products among them: menswear, womenswear, swimwear, shoes, handbags and other accessories. In 1999, Tommy Hilfiger started designing and selling watches, a passion he inherited from his father, who was a watchmaker. The watch collection is just as successful as the other product lines and remains true to Tommy's design philosophy of "Fresh American Style."
Masters In Time is official dealer of Tommy Hilfiger watches, Masters In Time therefore sells only original Tommy Hilfiger watches, with full warranty of the watch brand itself. All Tommy Hilfiger watches on Masters In Time are in stock. The watch you order will be shipped on working days.


Endometriosis – Women are breaking the silence on this disease!
Physiotherapy can help with Bladder Pain Syndrome.
Listen to the "Life Matters" interview with Dr Susan Evans, Endometriosis Specialist Gynaecologist.
This eBook will help you to learn more about pelvic pain.
Home of the national centre for pelvic pain research.
What are the really important factors to address in management?
The booklet contains information about bladder and bowel control during pregnancy and after childbirth, and explains the role of the pelvic floor muscles and how to exercise them.
There is no doubt about it – pregnancy is physically demanding! Regular exercise is an essential way of helping your body cope with the increased demands on your joints, muscles, heart and lungs.
The Pregnancy Pelvic Floor Plan smart phone app was developed in conjunction with The Pregnancy Centre and with input from women who are currently pregnant or have recently had a baby.
The Continence Foundation of Australia has developed a free, safe-exercise app to enable people at risk of pelvic floor dysfunction to continue to exercise without putting additional pressure on their pelvic floor.