text:
Gregory Palamas
Gregory Palamas (Greek: Γρηγόριος Παλαμᾶς; c. 1296 – 1357 or 1359)[3] was a Byzantine Greek prominent theologian and ecclesiastical figure of the late Byzantine period. A monk of Mount Athos (modern Greece) and later archbishop of Thessaloniki, he is famous for his defense of hesychast spirituality, the uncreated character of the light of the Transfiguration, and the distinction between God's essence and energies (i.e., the divine will, divine grace, etc.). His teaching unfolded over the course of three major controversies, (1) with the Italo-Greek Barlaam between 1336 and 1341, (2) with the monk Gregory Akindynos between 1341 and 1347, and (3) with the philosopher Gregoras, from 1348 to 1355. His theological contributions are sometimes referred to as Palamism, and his followers as Palamites.
Painting of Saint Gregory in Monastery of Vatopaidi, Mount Athos, Greece
Archbishop of Thessalonica, Church Father, Pillar of Orthodoxy
Melkite Greek Catholic Church[1]
Ukrainian Greek Catholic Church [2]
Canonized
1368, Constantinople by Patriarch Philotheos of Constantinople
Major shrine
Second Sunday of Great Lent
Long, tapering dark beard, vested as a bishop, holding a Gospel Book or scroll, right hand raised in benediction
Nilus Cabasilas, Nicodemus the Hagiorite, John Meyendorff
Gregory is venerated since 1368 as a saint in the Eastern Orthodox Church; some Byzantine Catholic Churches, which form part of the communion of the Catholic Church, also venerate him. (He has also been called a saint, and repeatedly cited as a great theological writer, by Pope John Paul II.[4]) Some of his writings are collected in the Philokalia, and since the Ottoman period, the second Sunday of Great Lent is dedicated to the memory Gregory Palamas in the Orthodox Church. The Byzantine Synodikon of Orthodoxy also celebrates his memory and theology while condemning his opponents, including some anti-Palamites who flourished after Gregory's death.
2 Monastic career
3 The hesychast controversy
3.1 Early conflict between Barlaam and Palamas
3.2 Triads
3.3 Role in the Byzantine civil war
3.4 Fifth Council of Constantinople
3.5 Gradual acceptance of the Palamist doctrine
5 Death and canonization
6 Hymns
Gregory was born in Constantinople around the year 1296. His father, Constantine, was a courtier of the Byzantine Emperor Andronikos II Palaiologos (1282–1328), but died when Gregory was still young. The Emperor himself took part in the raising and education of the fatherless boy and hoped that the gifted Gregory would devote himself to government service, but Palamas chose monastic life on Mt. Athos. Gregory's mother (Kalloni) and siblings (Theodosios, Makarios, Epicharis, and Theodoti) would also embrace monasticism, and the entire family was canonized by the Ecumenical Patriarchate of Constantinople in 2009.
Before leaving for Mt. Athos, Gregory received a broad education, including the study of Aristotle, which he would display before Theodore Metochites and the emperor.[5]
Monastic careerEdit
Despite the Emperor's ambitions for him, Gregory, then barely twenty years old, withdrew to Mount Athos in the year 1316 and became a novice there in the Vatopedi monastery under the guidance of the monastic Elder St Nicodemos of Vatopedi. Eventually, he was tonsured a monk, and continued his life of asceticism. After the demise of the Elder Nicodemus, Gregory spent eight years of spiritual struggle under the guidance of a new Elder, Nicephorus. After this last Elder's repose, Gregory transferred to the Great Lavra of St. Athanasius the Athonite on Mount Athos, where he served the brethren in the trapeza (refectory) and in church as a cantor. Wishing to devote himself more fully to prayer and asceticism he entered a skete called Glossia, where he taught the ancient practice of mental prayer known as "prayer of the heart" or hesychasm.
In 1326, because of the threat of Turkish invasions, he and the brethren retreated to the defended city of Thessaloniki, where he was then ordained a priest. Dividing his time between his ministry to the people and his pursuit of spiritual perfection, he founded a small community of hermits near Thessaloniki in a place called Veria.
He served for a short time as Abbot of the Esphigmenou Monastery but was forced to resign in 1335 due to discontentment regarding the austerity of his monastic administration.[6]
The hesychast controversyEdit
Main articles: Hesychasm, Palamism, and Hesychast controversy
See also: Theosis (Eastern Orthodox theology)
Hesychasm attracted the attention of Barlaam, a man who either converted to Orthodoxy or was baptized Orthodox[7][8] who encountered Hesychasts and heard descriptions of their practices during a visit to Mount Athos; he had also read the writings of Palamas, himself an Athonite monk. Trained in Western Scholastic theology, Barlaam was scandalized by hesychasm and began to combat it both orally and in his writings. As a private teacher of theology in the Western Scholastic mode, Barlaam propounded a more intellectual and propositional approach to the knowledge of God than the hesychasts taught.
On the hesychast side, the controversy was taken up by Palamas who was asked by his fellow monks on Mt Athos to defend hesychasm from the attacks of Barlaam. Palamas was well-educated in Greek philosophy. Gregory wrote a number of works in its defense and defended hesychasm at six different synods in Constantinople ultimately triumphing over its attackers in the synod of 1351.
Early conflict between Barlaam and PalamasEdit
Although Barlaam came from southern Italy, his ancestry was Greek and he claimed Eastern Orthodoxy as his Christian faith. Arriving in Constantinople around 1330, Barlaam was working on commentaries on Pseudo-Dionysius the Areopagite under the patronage of John VI Kantakouzenos. Around 1336, Gregory received copies of treatises written by Barlaam against the Latins, condemning their insertion of the Filioque into the Nicene Creed. Although this condemnation was solid Orthodox theology, Palamas took issue with Barlaam's argument in support of it, namely that efforts at demonstrating the nature of God (specifically, the nature of the Holy Spirit) should be abandoned, because God is ultimately unknowable and undemonstrable to humans. Thus, Barlaam asserted that it was impossible to determine from whom the Holy Spirit proceeds. According to Sara J. Denning-Bolle, Palamas viewed Barlaam's argument as "dangerously agnostic". In his response titled "Apodictic Treatises", Palamas insisted that it was indeed demonstrable that the Holy Spirit proceeded from the Father but not from the Son.[9] A series of letters ensued between the two but they were unable to resolve their differences amicably.
TriadsEdit
Icon of St. Gregory Palamas in the Metropolitan Cathedral named after him and where his relics are kept (on the left)
In response to Barlaam's attacks, Palamas wrote nine treatises entitled "Triads For The Defense of Those Who Practice Sacred Quietude". The treatises are called "triads" because they were organized as three sets of three treatises.
The Triads were written in three stages. The first triad was written in the second half of the 1330s and are based on personal discussions between Palamas and Barlaam although Barlaam is never mentioned by name.[9]
Gregory's teaching was affirmed by the superiors and principal monks of Mt. Athos, who met in synod during 1340–1. In early 1341, the monastic communities of Mount Athos wrote the Hagioritic Tome under the supervision and inspiration of Palamas. Although the tome does not mention Barlaam by name, the work clearly takes aim at Barlaam's views. The tome provides a systematic presentation of Palamas' teaching and became the fundamental textbook for Byzantine mysticism.[10]
In response, Barlaam drafted "Against the Messalians", which attacked Gregory by name for the first time.[11] Barlaam derisively called the hesychasts omphalopsychoi (men with their souls in their navels) and accused them of the heresy of Messalianism, also known as Bogomilism in the East.[9][12] According to Meyendorff, Barlaam viewed "any claim of real and conscious experience of God as Messalianism".[13][14][15]
Barlaam also took exception to the doctrine held by the hesychasts as to the uncreated nature of the light, the experience of which was said to be the goal of hesychast practice, regarding it as heretical and blasphemous. It was maintained by the hesychasts to be of divine origin and to be identical to the light which had been manifested to Jesus' disciples on Mount Tabor at the Transfiguration.[16] Barlaam viewed this doctrine of "uncreated light" to be polytheistic because as it postulated two eternal substances, a visible and an invisible God. Barlaam accuses the use of the Jesus Prayer as being a practice of Bogomilism.[17]
The second triad quotes some of Barlaam's writings directly. In response to this second triad, Barlaam composed the treatise "Against the Messalians" linking the hesychasts to the Messalians and thereby accusing them of heresy.
In the third Triad, Palamas refuted Barlaam's charge of Messalianism by demonstrating that the hesychasts did not share the antisacramentalism of the Messalians nor did they claim to physically see the essence of God with their eyes.[13] According to Fr. John Meyendorff "Gregory Palamas orients his entire polemic against Barlaam the Calabrian on the issue of the Hellenic wisdom which he considers to be the main source of Barlaam's errors."[18]
Role in the Byzantine civil warEdit
Although the civil war between the supporters of John VI Kantakouzenos and the regents for John V Palaeologus was not primarily a religious conflict, the theological dispute between the supporters and opponents of Palamas did play a role in the conflict. Steven Runciman points out that "while the theological dispute embittered the conflict, the religious and political parties did not coincide."[19] The aristocrats supported Palamas largely due to their conservative and anti-Western tendencies as well as their links to the staunchly Orthodox monasteries.[20] Although several significant exceptions leave the issue open to question, in the popular mind (and traditional historiography), the supporters of "Palamism" and of "Kantakouzenism" are usually equated.[21][volume & issue needed][22][full citation needed] Thus, the eventual triumph of Kantakouzenos in 1347 also brought with it the conclusive triumph of the Palamists over the anti-Palamists.
Fifth Council of ConstantinopleEdit
Byzantine Greek
Bishop and Monk
Philokalia
Theological work
Tradition or movement
Palamism
Asceticism, Mysticism
Notable ideas
Essence–energies distinction, Hesychasm, Theosis, Tabor Light
It became clear that the dispute between Barlaam and Palamas was irreconcilable and would require the judgment of an episcopal council. A series of six patriarchal councils were held in Constantinople on 10 June 1341, August 1341, 4 November 1344, 1 February 1347, 8 February 1347, and 28 May 1351 to consider the issues.[23] Collectively, these councils are accepted as having ecumenical status by Orthodox Christians,[24] some of whom call them the Fifth Council of Constantinople and the Ninth Ecumenical Council.
The dispute over hesychasm came before a synod held at Constantinople in May 1341 and presided over by the emperor Andronicus III. The assembly, influenced by the veneration in which the writings of Pseudo-Dionysius were held in the Eastern Church, condemned Barlaam, who recanted. The ecumenical patriarch insisted that all of Barlaam's writings be destroyed and thus no complete copies of Barlaam's treatise "Against Messalianism" have survived.[9]
Barlaam's primary supporter Emperor Andronicus III died just five days after the synod ended. Although Barlaam initially hoped for a second chance to present his case against Palamas, he soon realised the futility of pursuing his cause, and left for Calabria where he converted to the Roman Church and was appointed Bishop of Gerace.[11]
After Barlaam's departure, Gregory Akindynos became the chief critic of Palamas. A second council held in Constantinople in August 1341 condemned Akindynos and affirmed the findings of the earlier council. Akindynos and his supporters gained a brief victory at a council held in 1344 which excommunicated Palamas. However, the last of these councils, held in May 1351, conclusively exonerated Palamas and condemned his opponents.[11] This synod ordered that the metropolitans of Ephesus and Ganos be defrocked and jailed. All those who were unwilling to submit to the orthodox view were to be excommunicated and kept under surveillance at their residences. A series of anathemas were pronounced against Barlaam, Akindynos and their followers; at the same time, a series of acclamations were also declared in favor of Gregory Palamas and the adherents of his doctrine.[25] One notable opponent of Palamism was Nicephorus Gregoras who refused to submit to the dictates of the synod and was effectively imprisoned in a monastery for two years.
Gradual acceptance of the Palamist doctrineEdit
Metropolitan Church of Saint Gregory Palamas in Thessaloniki (arch. Ernst Ziller), where his relics are kept.
Kallistos I and the ecumenical patriarchs who succeeded him mounted a vigorous campaign to have the Palamist doctrines accepted by the other Eastern patriarchates as well as all the metropolitan sees under their jurisdiction. However, it took some time to overcome initial resistance to his teachings. For example, the metropolitan of Kiev, upon receiving tomes from Kallistos that expounded the Palamist doctrine, rejected it vehemently and composed a reply in refutation. Similarly, the patriarchate of Antioch remained steadfastly opposed to what they viewed as an innovation; however, by the end of the fourteenth century, Palamism had become accepted there. Similar acts of resistance were seen in the metropolitan sees that were governed by the Latins as well as in some autonomous ecclesiastical regions, such as the Church of Cyprus.[26]
One notable example of the campaign to enforce the orthodoxy of the Palamist doctrine was the action taken by patriarch Philotheos I to crack down on Prochoros Kydones, a monk and priest at Mount Athos who was opposed to the Palamites. Kydones had written a number of anti-Palamist treatises and continued to argue forcefully against Palamism even when brought before the patriarch and enjoined to adhere to the orthodox doctrine. Finally, in exasperation, Philotheos convened a synod against Kydones in April 1368. However, even this extreme measure failed to effect the submission of Kydones and in the end, he was excommunicated and suspended from the clergy in perpetuity. The long tome that was prepared for the synod concludes with a decree canonizing Palamas who had died in 1357/59.[27]
Despite the initial opposition of some patriarchates and sees, over time the resistance dwindled away and ultimately Palamist doctrine became accepted throughout the Eastern Orthodox Church. During this period, it became the norm for ecumenical patriarchs to profess the Palamite doctrine upon taking possession of their see.[26]
Martin Jugie states that the opposition of the Latins and the Latinophrones, who were necessarily hostile to the doctrine, actually contributed to its adoption, and soon Latinism and Antipalamism became equivalent in the minds of many Orthodox Christians.[26]
According to Aristeides Papadakis, "all Orthodox scholars who have written on Palamas — Lossky, Krivosheine, Papamichael, Meyendorff, Christou — assume his voice to be a legitimate expression of Orthodox tradition."[28]
Interior of the Cathedral, Thessaloniki.
The reliquary of St Gregory Palamas inside the Cathedral.
Palamas's opponents in the hesychast controversy spread slanderous accusations against him, and in 1344 Patriarch John XIV imprisoned him for four years. However, in 1347 when Patriarch Isidore came to the Ecumenical Throne, Gregory was released from prison and consecrated as the Metropolitan of Thessalonica. However, since the conflict with Barlaam had not been settled at that point, the people of Thessalonica did not accept him, and he was forced to live in a number of places. It was not until 1350 that he was able to occupy the episcopal chair.[19] In 1354, during a voyage to Constantinople, the ship he was in fell into the hands of Turkish pirates; he was imprisoned and beaten. He was obliged to spend a year in detention at the Ottoman court where he was well treated.[19] Eventually his ransom was paid and he returned to Thessaloniki, where he served as archbishop for the last three years of his life.
Death and canonizationEdit
Palamas died in 1357/59. His dying words were, "To the heights! To the heights!" He was canonized a saint of the Eastern Orthodox Church in 1368 by Patriarch Philotheos of Constantinople, who also wrote his Vita and composed the service which is chanted in his honour. His feast day is celebrated twice a year on November 14, the anniversary of his death, and on the Second Sunday of Great Lent. The reason for his commemoration on the Second Sunday of Great Lent is because Gregory's victory over Barlaam is seen as a continuation of the Triumph of Orthodoxy (i.e., the victory of the Church over heresy) which was celebrated the previous Sunday.
Gregory's relics are kept in the Metropolitan Cathedral which is named after him. The Cathedral is in Thessaloniki, Greece.
HymnsEdit
Troparion (Tone 8)
O light of Orthodoxy, teacher of the Church, its confirmation,
O ideal of monks and invincible champion of theologians,
O wonder-working Gregory, glory of Thessaloniki and preacher of grace,
always intercede before the Lord that our souls may be saved.
Kontakion (Tone 8)
Holy and divine instrument of wisdom,
joyful trumpet of theology,
together we sing your praises, O God-inspired Gregory.
Since you now stand before the Original Mind, guide our minds to Him, O Father,
so that we may sing to you: "Rejoice, preacher of grace."
Patrologia Graeca vols. 150, 151.
Primary works translated into English
The Triads (Classics of Western Spirituality Series) (ISBN 0-8091-2447-5)
Philokalia, Volume 4 (ISBN 0-571-19382-X)
Saint Gregory Palamas: The Homilies, (The Complete Homilies Translated into English - Published in 2009) (ISBN 0977498344)
Homilies of Saint Gregory Palamas, Vol. 1 (ISBN 1-878997-67-X)
Homilies of Saint Gregory Palamas, Vol. 2 (ISBN 978-1-878997-68-5)
Treatise on the Spiritual Life (ISBN 1-880971-05-4)
The One Hundred and Fifty Chapters (ISBN 0-88844-083-9)
Dialogue Between an Orthodox and a Barlaamite (ISBN 978-1-883058-21-0)
Tabor Light
Gregory Acindynus
^ The Search For Sacred Quietude (melkite.org)
^ Second Sunday of the Great Fast Gregory Palamas (sspp.ca)
^ Rigo, A. (1989), "La vita e le opera di Gregorio Sinaita." Cristianesimo nella storia 10: 579–608.
^ Pope John Paul II, Homily at Ephesus, 30 November 1979, General Audience, 14 November 1990, General Audience, 12 November 1997, General Audience, 19 November 1997, Jubilee of Scientists
^ John Meyendorff, A Study of Gregory Palamas, trans. George Lawrence (London: The Faith Press, 1964), pp. 28-41.
^ Archbishop Chrysostomos, Orthodox and Roman Catholic Relations from the Fourth Crusade to the Hesychastic Controversy (Etna, CA: Center for Traditionalist Orthodox Studies, 2001), pp. 199‒232
^ The Ninth Ecumenical Council of 1341 condemned the Platonic mysticism of Barlaam the Calabrian who had come from the West as a convert to Orthodoxy. Of course the rejection of Platonic type of mysticism was traditional practice for the Fathers. But what the Fathers of this Council were completely shocked at was Barlaam's claim that God reveals His will by bringing into existence creatures to be seen and heard and which He passes back into non existence after His revelation has been received. One of these supposed creatures was the Angel of The Lord Himself Who appeared to Moses in the burning bush. For the Fathers of the Ecumenical Councils this Angel is the uncreated Logos Himself. (See John S. Romanides, Underlying Positions of This Website.)
^ Jugie, Martin (1940) "Barlaam, est-il ne catholique?." Échos d'Orient, 39 (197) : 100-125. Available on-line at: Persee.fr
^ a b c d Saint Gregory Palamas (1999). Dialogue Between an Orthodox and a Barlaamite. Global Academic Publishing. p. 3. ISBN 9781883058210.
^ Merriam-Webster's encyclopedia of world religions. Merriam-Webster, Inc. 1999. p. 836. Hagioritic Tome Palamas.
^ a b c "Gregory Palamas: An Historical Overview". Archived from the original on 2011-09-27. Retrieved 2010-12-27.
^ 1. His teaching about the light on Mt. Tabor, which he claimed was created. 2. His criticisms of the Jesus Prayer, which he accused of being a practise of the Bogomils; also charged it with not proclaiming Christ as God. Gregory Palamas: Historical Timeline, Appendix I: Timeline: Barlaam and the Councils of 1341 from Baron Meyendorff "Archived copy". Archived from the original on 2012-06-07. Retrieved 2012-06-20. CS1 maint: archived copy as title (link)
^ a b Palamas, Saint Gregory; Meyendorff, John (1983). Gregory Palamas. Paulist Press. p. 4. ISBN 9780809124473.
^ "accusing Gregory Palamas of Messalianism" (Antonio Carile, Η Θεσσαλονίκη ως κέντρο Ορθοδόξου θεολογίας -προοπτικές στη σημερινή Ευρώπη (Thessaloniki 2000, pp. 131-140), English translation provided by the Apostoliki Diakonia of the Church of Greece).
^ NOTES ON THE PALAMITE CONTROVERSY and RELATED TOPICS by John S. Romanides The Greek Orthodox Theological Review, Volume VI, Number 2, Winter, 1960-61. Published by the Holy Cross Greek Orthodox Theological School Press, Brookline, Massachusetts.[1]
^ Parry (1999), p. 231
^ 1. His teaching about the light on Mt. Tabor, which he claimed was created. 2. His criticisms of the Jesus Prayer, which he accused of being a practise of the Bogomils; also charged it with not proclaiming Christ as God. Gregory Palamas: Historical Timeline Appendix I:Timeline: Barlaam and the Councils of 1341 from Baron Meyendorff "Archived copy". Archived from the original on 2012-06-07. Retrieved 2012-06-20. CS1 maint: archived copy as title (link)
^ John Meyendorff. Byzantine Theology: Historical trends and doctrinal themes (Fordham University Press; 2nd edition, 1983, ISBN 978-0-8232-0967-5).
^ a b c Runciman, Steven (1986). The Great Church in captivity: a study of the Patriarchate of Constantinople from the eve of the Turkish conquest to the Greek War of Independence. Cambridge University Press. p. 146. ISBN 9780521313100.
^ Treadgold 1997, p. 815
^ Kazhdan 1991, p. 923
^ Jeffreys, Haldon & Cormack 2009, pp. 289–290 harvnb error: no target: CITEREFJeffreysHaldonCormack2009 (help)
^ Gregory Palamas: Historical Timeline Archived 2012-06-07 at the Wayback Machine
^ "Tradition in the Orthodox Church". Retrieved 2010-12-28.
^ Jugie, Martin. "The Palamite Controversy". Retrieved 2010-12-28.
^ a b c Jugie, Martin. "The Palamite Controversy". Retrieved 2010-12-28.
^ Crisis in Byzantium: The Filioque Controversy in the Patriarchate of Gregory II of Cyprus (1283-1289). St Vladimir's Seminary Press. 1997. p. 205. ISBN 9780881411768.
A Study of Gregory Palamas (ISBN 0-913836-14-1) By John Meyendorff Translated by George Lawrence (1964)
St. Gregory Palamas and Orthodox Spirituality (ISBN 0-913836-11-7) by Fr. John Meyendorff
Saint Gregory Palamas as a Hagiorite (ISBN 960-7070-37-2) by Metropolitan Hierotheos (Vlachos) of Nafpaktos
Introduction to St. Gregory Palamas (ISBN 1-885652-83-6) by George C. Papademetriou
Triune God: Incomprehensible but Knowable—The Philosophical and Theological Significance of St Gregory Palamas for Contemporary Philosophy and Theology by C. Athanasopoulos, 2015 (ISBN 978-1-4438-8055-8)
"The influence of Ps.Dionysius the Areopagite on Johannes Scotus Eriugena and St. Gregory Palamas: Goodness as Transcendence of Metaphysics", by C. Athanasopoulos, in Agnieska Kijewska, ed., Being or Good? Metamorphoses of Neoplatonism, Lublin: Catholic University of Lublin Press (KUL), 2004, pp. 319–341.
"Scholastic and Byzantine Realism: Absolutism in the Metaphysics and Ethics of Aquinas, Duns Scotus, Ockham and the critique of St. Gregory Palamas", by C. Athanasopoulos, in Verbum (the official Journal of the Institute of Medieval Philosophy, Department of Philosophy, University of St. Petersburg, Russia), Vol. 6, Volume Topic: Aristotle in Medieval Metaphysics, January 2002, pp. 154–165.
'St. Gregory Palamas, (Neo-)Platonist and Aristotelian Metaphysics: the response of Orthodox Mystical Theology to the Western impasse of intellectualism and essentialism' by C. Athanasopoulos in Divine Essence and Divine Energies: Ecumenical Reflections on the Presence of God in Eastern Orthodoxy, edited by C. Athanasopoulos and C. Schneider, James Clarke & Co, April 2013. (ISBN 9780227173862), pp. 50–67.
Treadgold, Warren (1997). A History of the Byzantine State and Society. Stanford, California: Stanford University Press. ISBN 0-8047-2630-2.
Kazhdan, Alexander, ed. (1991). The Oxford Dictionary of Byzantium. 1. New York: Oxford University Press. ISBN 9780195046526 https://books.google.com/books?id=F9qwtAEACAAJ. Missing or empty |title= (help) — "The Oxford dictionary of Byzantium: Aaron-Eski". The Oxford Dictionary of Byzantium. 2. New York: Oxford University Press. 1991. — The Oxford Dictionary of Byzantium. 3. New York: Oxford University Press. 1991. ISBN 9780195046526 https://books.google.com/books?id=OTxhtAEACAAJ. Missing or empty |title= (help)
Wikimedia Commons has media related to Gregory Palamas.
St Gregory Palamas Orthodox Icon and Synaxarion
International Conference on St Gregory Palamas, Thessaloniki 2012 with links to abstracts and reports from the Conference
Papers from the International Conference on St Gregory Palamas (Thessaloniki, Veroia and Mt Athos, 2012)
Palamas Seminar Meetings: Veroia, Greece 2015; Neamt, Romania 2016
Opera Omnia by Migne Patrologia Graeca with analytical indexes
Light for the World: the Life of St. Gregory Palamas (1296–1359) by Fr. Bassam A. Nassif
An Overview of the Hesychast Controversy
Melkite Greek Catholic Information Centre on St. Gregory Palamas
Excerpt from "Byzantine Theology, Historical trends and doctrinal themes" by John Meyendorff
Gregory Palamas at the Mathematics Genealogy Project
Retrieved from "https://en.wikipedia.org/w/index.php?title=Gregory_Palamas&oldid=1001023332"


text:
Evaluation of preoperative anxiety and fear of anesthesia using APAIS score
Fatma Celik1 &
Ipek S. Edipoglu ORCID: orcid.org/0000-0002-3510-59912
Preoperative anxiety is one of the most important problems for the patients, because it causes emotional and psychiatric problems as well as physical problems. It is crucial to detect the patient's existing anxiety to assist patients. Our primary aim in this study is to investigate how the patient's age, gender, the operation, surgical briefing, type of anesthesia recommended for the operation ahead, and patient's prior anesthesia experience affect the patient's anxieties. Our secondary aim is to reveal the causes of the patient's anxieties regarding anesthesia.
Our study was conducted as a prospective cohort study between May 2016–2017. Interviews with the patients were performed in the anesthesia clinic for preoperative examination. For the study, The Amsterdam Preoperative Anxiety and Information Scale (APAIS) has been used. The answers were evaluated in two scales: the anxiety score and the desire for information score. Answers to the statements were evaluated with Likert Scale. In addition, our patients were asked whether they had received prior anesthesia, if so, the type of anesthesia, whether they received surgical briefing and anesthetic method we recommended. We also asked our patients about the cause of their anxiety regarding the anesthesia.
A total of 637 patients were recruited to the study, after excluding the patients who do not meet the criteria for inclusion, and 499 patients were included. Between the age and desire for information sub-scores, a negative significant correlation was detected (r: − 0.241; p = 0.001). We found that the scores of graduates of university and higher were statistically significant than the primary school graduates (p = 0.003) and secondary school graduates (p = 0.034). Anxiety sub-scores of the patients who underwent general anesthesia were found to be significantly higher than the patients who underwent regional anesthesia (p = 0.029). Anxiety sub-scores of females were found to be significantly higher than the males (p = 0.001).
We think that being aware of the patients' anxiety and finding appropriate approaches for their anxieties can be valuable. APAIS is an effective method to measure patient anxiety and it might be beneficial to use during preoperative visits. Patient satisfaction and superior outcomes can be achieved in this way.
Trial registration ISRCTN43960422. Registered 19/02/2018—Retrospectively registered. http://www.isrctn.com/ISRCTN43960422
Preoperative anxiety is one of the most important problems for the patients, because it causes emotional and psychiatric problems as well as physical problems [1]. Anxiety is particularly important, because it has the potential to affect all aspects of anesthesia such as preoperative visit, induction, perioperative, and recovery periods [2, 3]. Perioperative anxiety is found to be correlated with increased autonomic fluctuations and increased requirement of anesthetic, elevated incidence of nausea and vomiting, and augmented pain during postoperative period [4,5,6]. As a result of these complications, it was reported that recovery period and the length of hospital stay were extended [4]. High levels of anxiety were seen in many patients during the preoperative period and all patients had different levels of anxiety. The exact etiology of anxiety can be due to anesthesia, surgery, and several other different reasons [7,8,9]. Thus, it is crucial to detect the patient's existing anxiety to assist patients. Many different approaches have been reported on this subject, but some of the methods are not practical to use and can be time consuming during the preoperative preparatory period due to non-specific questions [10]. In 1996, Amsterdam Preoperative Anxiety and Information Scale (APAIS) has been developed as a practical method [10, 11]. Preoperative anxieties of the patients scheduled for surgery can be evaluated using APAIS.
Our primary aim in this study is to investigate how the patient's age, gender, the operation, surgical briefing, type of anesthesia recommended for the operation ahead, and patient's prior anesthesia experience affect the patient's anxieties regarding anesthesia and surgery. Our secondary aim is to reveal the causes of the patient's anxieties regarding anesthesia if there are any.
This study was conducted as a prospective cohort study and was performed during the 1-year period between May 2016 and 2017. The study was performed on patients admitting to the anesthesia outpatient clinic for preoperative examination in Ahi Evran University's faculty of medicine. ASA I–III, adult patients who are scheduled to undergo elective surgery in our hospital and have adequate language skills for the interview were included in our study. Pediatric patients, patients who did not give consent, patients with mental retardation, Alzheimer's disease, dementia or psychiatric disorders, emergency, and ASA-IV patients were excluded from the study. Selection of patients was described in the flow diagram (Fig. 1). A written informed consent has been obtained prior to the interviews.
Interviews with the patients were performed when they came to anesthesia clinic for preoperative examination, under the supervision of a specialist anesthetist. The questioning was conducted before the premedication visit in the waiting room. The interviewer was a nurse who was totally blinded to our study. For the study, The Amsterdam Preoperative Anxiety and Information Scale (APAIS), which comprises six statements, has been used. The answers were evaluated in two scales: the anxiety score and the desire for information score. Anxiety score was obtained by calculating the total scores assigned to the expressions " I am worried about the anesthesic", "The anesthesic is on my mind continually", "I am worried about the procedure", "The procedure is on my mind continually", to measure the patient's level of anxiety regarding the anesthesia and surgery. Desire for information score is obtained by calculating the total scores assigned to the expressions "I would like to know as much as possible about the anesthesic " and "I would like to know as much as possible about the procedure "to measure the patient's level of desire for information regarding the anesthesia and surgery. Higher scores indicate higher levels of anxiety and desire for information. Answers to the statements were evaluated with Likert Scale. (1-Not at all…,5-Extremely). In addition, our patients were asked whether they had received anesthesia due to any reason, if so, the type of anesthesia, and whether they received surgical briefing. We also recorded which anesthetic method we recommended to the patient for the surgery they will undergo in the preoperative anesthesia clinic.
Then, we asked our patients about the cause of their anxiety regarding the anesthesia if there are any:
fear of death;
fear of waking up in middle of the surgery;
postoperative pain;
postoperative nausea, vomiting;
become permanently disabled;
experience of anesthesiologist;
fear of needle, intervention;
feeling pain during the surgery;
The patients were asked to select more than one cause if it is the case.
For the statistical analysis, NCSS (Number Cruncher Statistical System) 2007 (Kaysville, Utah, USA) program was used. When evaluating the study data, in addition to the descriptive statistical methods (mean, standard deviation, median, frequency, ratio, minimum, and maximum), when comparing quantitative data, for the variables that do not have normal distribution, Mann–Whitney U test was used to compare two groups. Kruskal–Wallis test was used to compare three or more groups and Dunn–Bonferroni as a post hoc test. To evaluate the correlation between the parameters, Spearman's correlation analysis was used. p value smaller than < 0.05 was considered significant.
The study was carried out in university hospital, within the period of 1 year. A total of 637 patients were recruited to the study, but after excluding the patients who do not meet the criteria for inclusion, 499 patients were included. Of these 499 patients, 47.9% (n = 239) were female, and 52.1% (n = 260) were male. The ages of the patients ranged between 18 and 92, and the mean age was 42.79 ± 14.75 years. In Table 1, demographic characteristics of the patients were presented, and most of the patients (45.2%, n = 225) were primary school graduates, which was the lowest level of education. In contrast, the ratio of the patients with the highest level of education, PhD, was 1.8% (n = 9).
Table 1 Demographic data
It was seen that the patients most frequently undergo septorhinoplasty, with 17.2% (n = 86). Due to the variety of operations performed in our hospital, we classified a significant portion (41.9%, n = 209) of the operations that our patients undergo under the title "other". It was found that 43.9% of our patients (n = 219) were operated under regional anesthesia. 62.9% (n = 314) of the cases had anesthesia experience, 72.6% (n = 228) of these cases had general anesthesia, 14.3% (n = 45) had regional anesthesia, and 13.1% (n = 41) had both general and regional anesthesia (Table 2). Only 59.7% of the cases (n = 298) received surgical briefing.
Table 2 Features of surgery and anesthesia distributions
Total APAIS score of the cases ranged between 6 and 30, and the mean was 14.50 ± 4.77. Anxiety scores of our patients ranged between 4 and 20, and the mean was 6.75 ± 3.73. The scores for the desire for information ranged between 2 and 10, and the mean was 7.75 ± 2.03. The distribution regarding "The Amsterdam Preoperative Anxiety and Information Scale (APAIS)" of the cases is given in Table 3.
Table 3 APAIS Scale distributions
After the interviews, it was found that of the 221 cases (44.3%) with anxieties regarding the anesthesia. Most of them, 41.2% (n = 91) were anxious about waking up during surgery, 49.8% (n = 110), and were anxious about postoperative pain. We demonstrated the other reasons of concerns in Fig. 2.
Anesthesia-related concerns
No statistically significant correlation was detected between the anxiety sub-scores in terms of age (p > 0.05). Between the age and desire for information sub-scores, a negative correlation statistically significant by 24.1% was detected (r: − 0.241; p = 0.001). Between the age and total scores, a negative correlation statistically significant by 18.1% was detected (r: − 0.181; p = 0.001) (Table 4).
Table 4 Association of demographic data and APAIS sub-scores and total score
Anxiety sub-scores of females were found to be statistically significantly higher than the males (p = 0.001). No statistically significant difference was detected between the desires for information sub-scores in terms of gender (p > 0.05). Total scores of female patients were statistically significantly higher than the scores of the male patients (p = 0.001) (Fig. 3).
APAIS sub-scores, total score, and their association with gender
No statistically significant difference was detected between the anxiety scores in terms of education-level sub-scores (p > 0.05). Statistically significant difference was detected between the scores of desires for information sub-scores in terms of education level (p = 0.001). According to the dual comparisons performed to detect the group causing the significant difference, it was found that the scores of primary school graduates are significantly lower than the scores of high school graduates (p = 0.003) and graduates of university and higher (p = 0.001) (p < 0.01). The scores of secondary school graduates were significantly lower than the graduates of university and higher (p = 0.031). Statistically significant difference was detected between the total scores in terms of education level (p = 0.001). According to the dual comparisons performed to detect the group causing the significant difference, it was found that the scores of graduates of university and higher were statistically significant than the primary school graduates (p = 0.003) and secondary school graduates (p = 0.034) (Fig. 4).
APAIS sub-scores, total score, and their association with level of education
Anxiety sub-scores of the patients who underwent general anesthesia were found to be statistically significantly higher than the patients who underwent regional anesthesia (p = 0.029) (Table 5).
Table 5 Association of anesthesia and surgical features and APAIS sub-scores and total scores
No statistically significant difference was detected between the desire for information scores in terms of the type of anesthesia (p > 0.05). Total scores of the patients who underwent general anesthesia were statistically significantly higher than the patients who underwent regional anesthesia (p = 0.045). No statistically significant difference was detected between the anxiety sub-scores in terms of anesthesia experience (p > 0.05). Desire for information sub-scores of the patients with no experience of anesthesia was statistically significantly higher than the patients with experience (p = 0.003). No statistically significant difference was detected between the total scores in terms of anesthesia experience (p > 0.05).
Anxiety sub-scores (p = 0.001), desire for information sub-scores (p = 0.001), and total scores (p = 0.001) of the patients anxious regarding anesthesia were found to be statistically significantly higher than the patients who do not feel anxiety (Table 6). Of the patients who had fear of death, anxiety subdimension scores (p = 0.001) and total scores (p = 0.001) were found to be statistically significantly higher than the patients who do not have fear of death. Of the patients who have the fear of waking up during the surgery, anxiety sub-scores (p = 0.013) and total scores (p = 0.009) were statistically significantly higher than the patients who do not have the fear of waking up. While there was no statistically significant difference in anxiety sub-scores and total scores in terms of postoperative anxiety (p > 0.05), desire for information sub-scores of the patients with postoperative anxiety was significantly higher than the patients who do not have the anxiety (p = 0.031). It is striking that the patients who have anxiety regarding nausea and vomiting did not have high anxiety sub and total scores. Patients who have fear of becoming disabled have a significantly higher anxiety sub-scores (p = 0.001) and total scores (p = 0.001) than the patients who do not have this fear. While no statistically significant difference was detected between the desire for information subdimension scores in terms of fear of becoming disabled, it is noteworthy that the patients with this fear have high scores (p > 0.05). The patients who have anxiety regarding the inadequacy of the anesthetist have statistically significantly higher anxiety sub-scores (p = 0.001), desire for information sub-scores (p = 0.046) and total scores (p = 0.002) than those who do not have this anxiety. While there is no statistically significant difference between the desire for information sub-scores and between the total scores in terms of the fear of needle or intervention (p > 0.05), anxiety sub-scores of the patients with this fear were statistically significantly higher than the patients who do not have this fear (p = 0.028). Anxiety sub-scores (p = 0.004) and total scores (p = 0.003) of the patients who have anxiety of feeling pain during surgery are statistically significantly higher than the patients who do not have this anxiety.
Table 6 Association of anesthesia-related concerns and APAIS sub-scores and total scores
In our study, we aimed to evaluate patient anxiety using APAIS scale and to reveal the causes of fear in patients with anxiety regarding anesthesia. APAIS is a suitable tool to measure anxiety score, as its anxiety and desire for information sub-scores reveal important information on anesthesia and surgery [12]. At the same time, as it is planned with far-reaching answers, quickly performed and easy to understand, APAIS is a scale widely well known by patients and doctors [12]. These are the reasons why we preferred APAIS over State–Trait Anxiety Inventory, (STAI).
In this study, we found a negative correlation between the age and desire for information. We found that as our patients get older, their desire for information decreases (r: − 0.241; p = 0.001). Similar to our study, a comprehensive study which investigated all patient groups found that older patients have less anxiety [13]. Taşdemir et al. [7] also reported that elderly patients have lower anxiety scores in preoperative period. In another study, it was proposed that the reason behind this is the possible fatalistic viewpoint of the elderly patients and the efficient use of the communication instruments by the youngsters and the subsequent high probability of accessing bad outcomes/experiences on health [14]. There are studies in the literature, which report different results, on the correlation between anxiety and age [13].
Analysis of anxiety scores showed that females have higher anxiety scores than males. In the literature, there are many studies that corroborate the results of our study [13, 15]. The authors think that this is because traditionally, males cannot easily express their weaknesses [15]. However, there are studies that report different results on the correlation between gender and anxiety [10]. Experimental studies suggested that the fluctuations in estrogen and progesterone levels can be the source of mood and anxiety disorders and the cause of the difference in female patients [16].
We found that the desire for information scores increases statistically as the level of education increases. In the literature, there are conflicting results on this subject. While some of them reported an increase in the anxiety with education, some reported a decrease [17]. In the study that included 592 patients, Cauomo et al. [18] found that anxiety scores increased with increased education levels. They suggested that the reason behind this was that educated patients can express themselves better and they had higher awareness on anesthesia and surgery [18].
We found that patients scheduled for general anesthesia have statistically higher anxiety scores than patients scheduled for regional anesthesia. The potential reason behind this can be that with regional anesthesia, patients think that they will be awake during the operation and thus will have consciousness of the surroundings. Similarly, general anesthesia can increase the patient anxiety, as the patients think that they will not have control and will be at the mercy of the healthcare staff during the operation.
As expected, we found that the patients with no previous experience of anesthesia have higher desire for information scores. Similar to our study, there are studies reporting that the previous surgery experience decreases the anxiety levels [18, 19]. The correlation between previous anesthesia experience and anxiety was shown in the literature [1]. Differences between the studies can be due to the positive or negative personal experiences of the patients.
Patients who had anxiety of anesthesia most frequently had the fear of postsurgical pain (n = 110), followed by waking up during the surgery (n = 91). We found that anxiety of death came only the third (n = 59). Similar to our study, a recent survey study showed that the fear of pain was the most important cause of anxiety [20]. In another study with 800 patients by Sheved et al. [13], similar results were reported on fear of pain. The survey studies by Burkle et al. [17] showed that the fear of death was the biggest cause of anxiety. They also reported that the fear of death decreases with increasing age. The difference between the aforementioned studies and our study is that the questionnaires in those studies do not include "pain during perioperative period" option included in our study. As expected, fear of needle or intervention ranked the fourth, with 25.3% of the patients. We found that 22.6% of our patients were anxious about feeling pain during the surgery, 18.6% were anxious about becoming disabled, and 17.2% were anxious about postoperative nausea and vomiting. The reason that caused the least amount of anxiety was the inadequacy of the anesthetist (n = 17). Information on the factors that affect anxiety may reduce preoperative anxiety [21]. Studies on anesthesia-induced anxiety report various results that are close to each other. In a study with 100 patients by Matthias et al., it was found that "awareness" during anxiety is the most important cause of anxiety. It was followed by the surgical outcome, postoperative pain, waiting for the surgery, and being at the mercy of the healthcare personnel [21]. In another study, the authors reported that the causes of anxiety are, respectively, waiting for the surgery, being at the mercy of the healthcare personnel, surgical outcome, and awareness [22]. We think that these small differences between the studies may be caused by some sociological differences between the countries.
In our study, using APAIS, we also investigated the causes of anxiety regarding anesthesia. In our study, both the anxiety scores and desire for information scores of the patients who felt anxious regarding anesthesia were statistically significantly higher than the patients who did not feel anxious. Patients who had fear of death had statistically significantly higher anxiety scores than the patients who did not have this fear. Patients who had fear of waking up during surgery had statistically significantly higher anxiety scores than those who did not have this fear. Desire for information scores was significantly higher in patients anxious about postoperative pain than the patients who did not have this anxiety. Anxiety scores of patients who had fear of becoming disabled were statistically significantly higher than those who did not have this fear. Anxiety scores and desire for information sub-scores of patients anxious about the inadequacy of the anesthetist were statistically significantly higher than the patients who did not have this anxiety. Anxiety sub-scores of patients who had fear of needle or intervention were significantly higher than patients who did not have this fear. The anxiety subscale scores of the patients who had anxiety of waking up during the surgery were statistically significantly higher than the patients who did not have this anxiety. Among all these causes, we failed to detect a correlation between anxiety and nausea and vomiting. As a result of our findings, we demonstrated the subjects that the patients with anxiety regarding anesthesia would like to receive real information about, or the subjects those patients are anxious about. Thus, we think that it would be appropriate to explain these subjects carefully to the patients prior to the surgery.
Many studies used STAI test for the evaluation of anxiety, but we chose APAIS, because APAIS is much easy to use for both patient and the doctor, which have fewer questions, and it is as reliable as any other test. Studies investigated to evaluate anxiety with STAI or other tests, but they are hard to use for clinical routine, because they are not practical. APAIS is both reliable and practical [1]. It is a tool that has the capacity to differentiate between patient's anxiety and desire for information. Anesthesiologists can enhance patients' anesthetic experience, depending on the patients' answers, like placing emphasis on management of perioperative time or just giving a much more detailed information about the operation that the patients are going to have [1]. Therefore, APAIS may be a useful tool for the routine use in the preoperative visits [1]. The point of our study that differentiates from other studies was additionally we asked the patients their anesthesia-related concerns and we lightened the association of anesthesia-related concerns and APAIS. It is necessary to intervene if patients show higher anxiety, because perioperative anxiety is associated with increased autonomic variations and increased anesthetic requirement and augmented postoperative pain [4,5,6]. As a result of these complications, many authors reported extended recovery period and the length of hospital stay [4]. Therefore, it is critical to reduce the anxiety of the patients. In the literature, there is plenty of evidence that demonstrates the preoperative information as playing a crucial role to diminish perioperative anxiety [23]. When an anesthesiologist detects patients with high anxiety, they should use audiovisuals, psychoeducational information, and preoperative nursing visits to reduce it. These interventions have shown to reduce anxiety and deliver supplementary information to the patients [23]. We can achieve improved results for patients when they have lower levels of anxiety.
The first limitation of our study is that it was a monocentric study. If the study could be performed in a multicentric manner, its efficacy, and the patient population, it included would have been higher. Another limitation was that we could not include patients hospitalized in the wards and only included the patients who came to our anesthesia clinic.
In conclusion, we think that being aware of the patients' anxiety and finding appropriate approaches for their anxieties can be valuable. APAIS is an effective method to measure patient anxiety and it might be beneficial to use during preoperative visits. Patient satisfaction and superior outcomes can be achieved in this way.
APAIS:
Amsterdam Preoperative Anxiety and Information Scale
ASA:
American Society of Anesthesiology
Buonanno P, Laiola A, Palumbo C, Spinelli G, Terminiello V, Servillo G. Italian validation of the Amsterdam preoperative anxiety and information scale. Minerva Anestesiol. 2017;83(7):705–11.
Laufenberg-Feldmann R, Kappis B. Assessing preoperative anxiety using a questionnaire and clinical ratings: a prospective observational study. Eur J Anaesthesiol. 2013;30(12):758–63.
Gras S, Servin F, Bedairia E, Montravers P, Desmonts JM, Longrois D, et al. The effect of preoperative heart rate and anxiety on the propofol dose required for loss of consciousness. Anesth Analg. 2010;110(1):89–93.
Pokharel K, Bhattarai B, Tripathi M, Khatiwada S, Subedi A. Nepalese patients' anxiety and concerns before surgery. J Clin Anesth. 2011;23(5):372–8.
Maranets I, Kain ZN. Preoperative anxiety and intraoperative anesthetic requirements. Anesth Analg. 1999;89(6):1346–51.
Van Den Bosch JE, Moons KG, Bonsel GJ, Kalkman CJ. Does measurement of preoperative anxiety have added value for predicting postoperative nausea and vomiting? Anesth Analg. 2005;100(5):1525–32.
Taşdemir A, Erakgün A, Nuri Deniz M, Çertuǧ A. Comparison of preoperative and postoperative anxiety levels with State-Trait Anxiety Inventory Test in preoperatively informed patients. Turk Anesteziyoloji ve Reanimasyon Dern Derg. 2013;41(2):44–9.
Jlala HA, French JL, Foxall GL, Hardman JG, Bedforth NM. Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia. Br J Anaesth. 2010;104(3):369–74.
Shafer A, Fish MP, Gregg KM. Preoperative anxiety and fear: a com- parison of assessments by patients nad anesthesia and surgery residents. Anesth Analg. 1996;83:1285–91.
Mohd Fahmi Z, Lai LL, Loh PS. Validation of the Malay version of the Amsterdam preoperative anxiety and information scale (APAIS). Med J Malaysia. 2015;70(4):243–8.
Moerman N, Oosting H. The Amsterdam Scale (APAIS). Anesth Analg. 1996;82:445–51.
Berth H, Petrowski K, Balck F. The Amsterdam Preoperative Anxiety and Information Scale (APAIS)—the first trial of a German version. GMS Psycho Soc Med. 2007;4:1–8.
Shevde K, Panagopoulos G. A survey of 800 patients' knowledge, attitudes, and concerns regarding anesthesia. Anesth Analg. 1991;73(2):190–8.
Aykent R, Kocamanoğlu İ, Üstün E, Tür A, Şahinoglu H. The reasons and evaluation of preoperative anxiety: a comparison of APAIS and STAI scores. Turkiye Klinikleri J Anest Reanim. 2007;5(1):7.
Mavridou P, Dimitriou V, Manataki A, Arnaoutoglou E, Papadopoulos G. Patient's anxiety and fear of anesthesia: effect of gender, age, education, and previous experience of anesthesia. A survey of 400 patients. J Anesth. 2013;27(1):104–8.
Weinstock LS. Gender differences in the presentation and management of social anxiety disorder. J Clin Psychiatry. 1999;60:9–13.
Burkle CM, Mann CE, Steege JR, Stokke JS, Jacob AK, Pasternak JJ. Patient fear of anesthesia complications according to surgical type: potential impact on informed consent for anesthesia. Acta Anaesthesiol Scand. 2014;58(10):1249–57.
Caumo W, Schmidt AP, Schneider CN, Bergmann J, Iwamoto CW, Bandeira D, Ferreira MB. Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand. 2001;45(3):298–307.
Badner NH, Nielson WR, Munk S, Kwiatkowska C, Gelb AW. Preoperative anxiety: detection and contributing factors. Can J Anaesth. 1990;37(4):444–7.
Nagrampa D, Bazargan-Hejazi S, Neelakanta G, Mojtahedzadeh M, Law A, Miller M. A survey of anesthesiologists' role, trust in anesthesiologists, and knowledge and fears about anesthesia among predominantly Hispanic patients from an inner-city county preoperative anesthesia clinic. J Clin Anesth. 2015;27(2):97–104.
Matthias AT, Samarasekera DN. Preoperative anxiety in surgical patients: experience of a single unit. Acta Anaesthesiol Taiwanica. 2012;50(1):3–6.
Kindler C, Harms C, Amsler F, Ihde-Scholl T, Scheidegger D. The visual analog scale allows effective measurement of preoperative anxiety and detection of patients anaesthetic concerns. Anesth Analg. 2000;90:706–12.
Vergara-Romero M, Morales-Asencio JM, Morales-Fernández A, Canca-Sanchez JC, Rivas-Ruiz F, Reinaldo-Lapuerta JA. Validation of the Spanish version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Health Qual Life Outcomes. 2017;15(1):120.
Both authors participated in the design of this study, and FC collected data and analyzed data. ISE wrote the manuscript. Both authors revised it critically for important intellectual content. Both authors read and approved the final manuscript.
The data sets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Ethics committee approval for our study was obtained from the ethics committee of Ahi Evran University on 27/04/2016 (study no: 2010-05/04).
Institutional funding from Ahi Evran University Medical Faculty clinical investigations.
Department of Anesthesiology and Intensive Care Medicine, Ahi Evran University Medical Faculty, Kirşehir, Turkey
Fatma Celik
Department of Anesthesiology, Suleymaniye Obstetrics & Pediatrics Training and Research Hospital, Istanbul, Turkey
Ipek S. Edipoglu
Correspondence to Ipek S. Edipoglu.
Celik, F., Edipoglu, I.S. Evaluation of preoperative anxiety and fear of anesthesia using APAIS score. Eur J Med Res 23, 41 (2018). https://doi.org/10.1186/s40001-018-0339-4
APAIS
Fear of anesthesia

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text:
Fantasy & Other Worlds
The Storm in the Barn
By Matt Phelan
Candlewick, 2009
Suggested Ages: 10 and Up
Starting with the reality of the Dust Bowl in Kansas in 1937, The Storm in the Barn is a graphic novel (meaning big comic book) about a boy named Jack and his family's struggles to survive the drought and keep their farm. Bullied by the bigger boys, Jack doesn't try to fight back. Upon seeing a looming dust cloud, the other boys retreat to the safety of the general store, but Jack tries to outrun it, heading for his neighbors' recently abandoned barn. When he finds the door locked, he runs for home, where the town doctor is attending to Jack's sickly older sister, Dorothy. Dust pneumonia is what she has, and she spends her days in bed, under mosquito netting to keep out the dust, reading books to Jack and their little sister, Mabel, about another Dorothy, the one who left Kansas for Oz.
Though the doctor worries that Jack has what he calls "dust dementia," and Jack's own father finds the boy useless, Jack has one supporter—Ernie, the owner of the general store, who tells him Jack tales to bolster his confidence. (What are Jack tales? They're stories from English and then American folklore about an ordinary hero named Jack. You know at least one of them: "Jack and the Beanstalk.") With the dust storms getting worse, the people turn to superstition, nailing dead rattlesnakes to fences to bring on rain and clubbing jackrabbits to death. At night, Jack sees light glaring from the barn, and the next day, he is able to get inside, where he finds an inexplicable puddle of water on the floor. It's there that he will encounter the all-powerful King of Storms, whom he must defeat, just like Jack in tales of old, to bring the rains back to the wasted farmland.
If this title gets your young reader asking questions about the dust bowl, you might check out some of the startling photographs in Albert Marrin's Years of Dust: The Story of the Dust Bowl and in Martin W. Sandler's The Dust Bowl Through the Lens. Children who have never heard any stories about that stalwart fellow, Jack, (other than that one about the beanstalk), will delight in Richard Chase's classic American folklore collection, The Jack Tales, which he compiled and published in the early 1940s, and Ray Hicks's The Jack Tales. For real atmosphere, play some songs from Woody Guthrie's "Dust Bowl Ballads," which you can find at Amazon.com.
Reviewed by : JF.
Themes : CARTOONS AND COMICS. FAMILY LIFE. GRAPHIC NOVELS. HISTORICAL FICTION.
Baum, L. Frank. The Annotated Wizard of Oz: The Wonderful Wizard of Oz. Norton, 2000.
Chase, Richard. The Jack Tales. Houghton Mifflin, 1943.
Curtis, Christopher Paul. Bud, Not Buddy. Delacorte, 1999.
Freedman, Russell. Children of the Great Depression. Clarion, 2005.
Hesse, Karen. Out of the Dust. Scholastic, 1997.
Hicks, Ray. The Jack Tales. Callaway, 2000.
Marrin, Albert. Years of Dust: The Story of the Dust Bowl. Dutton, 2009.
Recorvits, Helen. Goodbye, Walter Malinski. Farrar, 1999.
Sandler, Martin W. The Dust Bowl Through the Lens: How Photography Revealed and Helped Remedy a National Disaster. Walker, 2009.
Tan, Shaun. The Arrival. Scholastic/Arthur A. Levine, 2007.
Wood, Don. Into the Volcano: A Graphic Novel. Scholastic/Blue Sky, 2008.
"Children can read this as a work of historical fiction, a piece of folklore, a scary story, a graphic novel, or all four."
JF.
CARTOONS AND COMICS. FAMILY LIFE. GRAPHIC NOVELS. HISTORICAL FICTION.
Reviewed by: JF.
Themes: CARTOONS AND COMICS. FAMILY LIFE. GRAPHIC NOVELS. HISTORICAL FICTION.


text:
Mihai Sandu-Capră (n. 1 iulie 1956, com. Drăgușeni, județul Suceava) este un politician român, fost membru al Parlamentului României, ales pe listele PSD. În cadrul activității sale parlamentare, Mihai Sandu-Capră a fost membru în grupurile parlamentare de prietenie cu Statul Plurinațional Bolivia, Republica Panama, Republica Libaneză, Republica Polonă, Republica Turkmenistan, Republica Finlanda.

Nașteri în 1956
Deputați români 2004-2008
Politicieni români din secolul al XXI-lea
Membri ai Partidului Social Democrat

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Justice League may have been a steaming pile of failure for Warner Bros., but not everything sucked about it. The film ended on a really high note, with the return of Jesse Eisenberg's Lex Luthor as he takes the initial steps into forming his Injustice League. Surely they wouldn't ignore that storyline going forward, right?
I love it when actors as journalists if we can pull any strings to make something happen. No. No we can't.
It isn't clear where Luthor could resurface. I'd like to think he'd show up in Aquaman, perhaps to recruit someone like Black Manta to his side. And then again in Wonder Woman 2 in hopes of luring Cheetah to the team. To me this makes perfect logical sense, which means we'll probably see them do something completely different.
Eisenberg added that his role in Justice League, which we are pretty certain was shot early in Zack Snyder's time on the project, wasn't cut at all. "Actually, on the contrary, they added some stuff,", he said in response to a question about it.
I don't know what they could've added to what is a really brief cameo. Maybe he meant they added scenes to the whole movie, not just his scene?


LobotoME has a line of planners for everything from road trips to meal planning.
Heather Stuart is one organized mama.
Any occasions, events and appointments the Wauwatosa mother of three hasn't tapped into her iPhone she can find on the color-coded paper calendar on her desk (husband = blue, youngest daughter = pink).
If the info's not there, check the family calendar on the refrigerator. Oh, and her iPhone also synchronizes with her computer.
"I'm a freak," Stuart said, laughing.
This is what happens when list-makers go digital. If one calendar is good, then three must be better - which means the information could be anywhere. Without a level head and a lot of patience, keeping up with the calendar can become its own chore.
Thanks to several new organizers created by moms, for moms, blending paper and digital doesn't have to be twice the work.
Amy Knapp started making paper calendars in her hometown of Kalamazoo, Mich., because she couldn't find one that made sense for a schedule that included taking care of a daughter who would have lifelong disabilities.
Business calendars with small spaces and an hourly timeline didn't work for Knapp. So she introduced a calendar with a layout that suited her, covered the entire academic year and included a perforated list for groceries.
More recently, Knapp premiered a digital calendar that blends with those she offers in paper form, available at www.familyorganizer.com.
The need for functional planners that take into account family needs is borne out by the stories behind the products. Nina Restieri started www.momAgenda.com because she couldn't find a calendar to suit her family's requirements.
Jenny Newcomer was a work-from-home mom who "had a million different lists going on."
"I was always losing track of something," she said.
She wanted an organizer that would encompass everything in her life, from her to-do list to meal planning.
Newcomer, of Durango, Colo., designed one for herself and gave copies to friends. That morphed into a business called LobotoME notepads and planners, available at www.lobotome.com.
The momMe calendars have spaces for busy parents to set up "me" time. The OrganizeMe planners have a less-feminine look. Both come in a bound pack of 60 sheets, so pages can be torn out and carried along.
Another company, the Milwaukee-based online store Lifephoto.com, offers photo calendars that can be preprinted with reminders for family vacations, day trips, school exams and holiday events, said company spokesman Cindy Berg.
Tracie Stier-Johnson juggles calendars for five people. The Racine mother of four keeps an electronic calendar by iPhone tied to her computer at home, which automatically puts events into her digital calendar. But as the former owner of Broadway Paper, the Third Ward store, she also knows the benefit of writing things down. Plus, her paper calendar allows her to go into more detail for specific events.
Stier-Johnson, a photographer, tries to fill out her week-at-a-glance calendar each Sunday so she can see what's going on in the week ahead.
"But I find by the end of the year my paper calendar falls to the wayside, and I rely more on my electronic calendar," she said.


much love, illy: in etsy news: little miss momma feature and shop update!!!!
Oh, you always have the coolest items in your shop!! Congrats on the update!
You are too sweet with your super nice comments--right back at ya! And guess what? I went to USC too! Fight on!


Join us for These Upcoming Modular Courses!
A detailed examination of the books of Job, Proverbs, Ecclesiates and the Song of Songs.
An examination of what constitutes Christian leadership, how leaders are developed and how leadership styles are engaged. In this practicum course, students will also be expected to engage the practice of leadership in local ministry. The goal of this course is to take leadership out of the realm of theory and focus on the practical applications of leadership within local ministry.
An introduction to the rational defense of the Christian faith including both the identification of evidence or grounds for Christian belief as well as evidence against non-Christian beliefs. We will also consider the biblical grund of apologetics, different models of apologetics, and the specific apologetic challenges of modernism and postmodernism.
A study drawing on the biblical and theological resources of the Christian tradition for the development of Christian ethical reflection and the formation of Christian character in a post-Christian context.
All courses are available for audit (for half price) if space is available. Also, graduates with a degree from Taylor Seminary are entitled to return to take one course each academic year at no cost (except for fees).


जॉयचंदी पहाड़ Railway station is situated in Raghunathpur, West Bengal. Station code of जॉयचंदी पहाड़ is JOC. Here are some trains that are passing through जॉयचंदी पहाड़ railway station like South Bihar Exp, South Bihar Exp, Tata Asn Exp, Tatanagar Exp, Guwahati Express, Guwahati Ms Exp, Dibrugarh Exp, and many more.


text:
New Utrecht High School
Grades: 9-12
Lots of sports and a wide range of course offerings
Overcrowding; some kids get lost in the shuffle
New Utrecht High School in Bensonhurst serves a wide-ranging population that includes high achievers in the honors track, new immigrants learning English and students with special needs. It is one of New York City's largest high schools. Students speak more than 30 languages, including Spanish, Chinese, Arabic, Urdu and Italian.
Most students graduate on time, and the number of graduates ready for college-level work is above the citywide average. Teachers say the school is safe and orderly, though numbers are rising and the school is crowded. Most teachers report they would recommend the school to other families, according to school surveys.
Perks of this big school include a football field and a swimming pool. Students may participate in a talent show, a fashion show, a spring musical and a Chinese New Year celebration. The school has more than 30 academic, social and cultural clubs. The foreign language choices are Italian, Mandarin and Spanish.
The well-kept building has a wood shop, two gyms and a swimming pool. A newer wing houses a cafeteria and classrooms. The school has a small business operation, where students learn the facets of operating an actual business and enter into competition with other schools.
Students with good standardized test scores and grades and attendance in middle school may apply to the Honors Academy, which has a focus on humanities, math and science.
The school also offers programs in Medical Billing and Coding, Travel and Tourism, and Law. Teens participate in internships and job shadowing at places like the Justice Resource Center and Maimonides Hospital. Another program offering is the Academy of Art and Design.
In a partnership with Kingsborough Community College, more than half of New Utrecht students take college-level courses by the time they graduate. The program helps kids stay focused on going to college, critical in a community where many parents may not have finished high school.
Despite the range of offerings at this large school, some kids get lost in the shuffle. More than half miss more than 18 days of school. Students have the same guidance counselor all four years, to develop positive relationships with staff and improve attendance, according to the yearly plan. The school is overcrowded and some kids complain about bullying, safety and respect among students.
College acceptances include New York University, SUNY Binghamton, Amherst College, Cornell, Fordham, Middlebury College, Niagara University and the University of Houston.
ADMISSIONS: Zoned neighborhood school. Students from outside the zone may apply for special programs and most are admitted according to the educational option formula, designed to attract a mix of children of different abilities. Honors Academy students are admitted based on grades, attendance and standardized test scores. (Lydie Raschka, web reports, April 2018)
How many students graduate in 4 years?
How many students graduate with test scores high enough to enroll at CUNY without remedial help?
How many students take a college-level course or earn a professional certificate?
How many graduates stay enrolled in college for at least 3 semesters?
This school offers Transitional Bilingual Education in Chinese.
How many students with disabilities graduate in 4 years?
How many English language learners graduate in 4 years?
Programs & Admissions
From the 2021 High School Directory
Medical Professions & Health Careers
Admissions Method: Ed. Opt.
Combines academics and hands-on experience to develop candidates interested in health career professions. Program highlights include Billing & Coding certification, senior year internship opportunities, and a certificate of completion in Health Informatics & Health Assisting.
Academy of Legal Studies
Introduction to Legal Studies, Constitutional Law, Criminal Justice, Criminology, Public Speaking & Debate, Moot Court/Mock Trial, Legal Writing, and Senior Internship.
Academy of Hospitality & Tourism
Helps students chart career paths in one of the world's largest industries, from hotel management to sports entertainment and event management; includes the study of geography, economics, and world cultures.
Academy of Art & Design
A discipline-based art program with courses in: Drawing, Digital Design, Fashion Illustration & Construction, Painting, Photography, and Sculpture. Individualized mentoring and portfolio development for students who intend to pursue studies in fine arts.
Admissions Method: Screened
Provides students of outstanding ability and potential with an enriched, challenging, college preparatory program that emphasizes humanities, mathematics, and science.
Academy of Business and Technology
An interdisciplinary program combining business and technology courses with a real hands-on working experience. The curriculum includes courses such as Computer Applications, MOS Certification, Visual Basics, and Entrepreneurship -all directed towards completing professional and academic certifications.
New Utrecht High School D75 Inclusion Program
Admissions Method: D75 Special Education Inclusive Services
Admissions Method: Zoned Guarantee
Comprehensive academic program.
Arabic, Italian, Mandarin, Spanish
Advanced Placement (AP) courses
AP Macroeconomics, AP United States History, AP Drawing, AP Physics 1, AP Environmental Science, AP Computer Science Principles, AP Biology, AP Psychology, AP English Language and Composition, AP English Literature and Composition, AP Human Geography, AP Statistics, AP World History: Modern, AP Computer Science A, AP Chinese Language and Culture, AP Calculus AB, AP Microeconomics, AP Italian Language and Culture, AP Spanish Language and Culture, AP Calculus BC, AP U.S. Government and Politics, AP Chemistry
Boys PSAL teams
Badminton, Baseball, Basketball, Bowling, Football, Handball, Soccer, Swimming, Tennis, Volleyball, Wrestling
Girls PSAL teams
Badminton, Basketball, Bowling, Flag Football, Handball, Soccer, Softball, Swimming, Tennis, Volleyball
Read about admissions, academics, and more at this school on NYCDOE's MySchools
Bensonhurst (District 20)
Trains: to 79th St
Buses: B1, B4, B64, B8, X28, X38
Maureen Goldfarb
Natalie Tang
Fort Hamilton High School
8301 Shore Road
Franklin Delano Roosevelt High School


text:
/ Aaron Nola was the man Gabe Kapler wanted on the mound
Aaron Nola was the man Gabe Kapler wanted on the mound
It was the right move.
Nola stuck out nine in seven splendid innings http://www.bengalscheapshop.com/cheap-au...ley-jersey , Nick Williams hit a two-run homer and the Philadelphia Phillies beat the Baltimore Orioles 4-1 Wednesday to sweep a two-game interleague series.
Nola (11-2) gave up one run and seven hits to win his fifth straight decision.
He escaped a jam on his 103rd pitch when second baseman Cesar Hernandez made an outstanding, over-the-shoulder running catch on Machado's shallow fly to right with two outs and runners on first and third.
"That's awesome," Nola said of the play.
Kapler, who was heavily criticized for pulling Nola after 68 pitches in the season opener at Atlanta, visited the mound before letting his ace face Machado with a 2-1 lead.
"We knew he was the best option," the first-year manager said. "He always makes us feel confident."
Nola said he would've lobbied to stay in but didn't have to say anything other than he felt fine.
"I want to go deep in the game," he said. "I want to get through that inning."
After five consecutive losing seasons Renell Wren Jersey , the Phillies are on the rise under Kapler. They pulled within 1 1/2 games of NL East-leading Atlanta and moved 10 games over .500 for the first time since finishing the 2011 season with a franchise-record 102 wins.
"It's a nice milestone, one we can celebrate," Kapler said.
Making his second career start and third appearance, Orioles right-hander Yefry Ramirez (0-2) retired 13 of his first 14 batters before running into trouble in the fifth. Ramirez gave up two runs – one earned – and one hit in five innings.
"I was really proud of Yefry. You couldn't ask for much better," Orioles manager Buck Showalter said.
Williams connected off David Hess in the seventh, sending a 409-foot shot into Philadelphia's bullpen in right-center and extending the lead to 4-1.
Victor Arano tossed two scoreless innings for his first career save.
Ramirez didn't allow a hit until Scott Kingery ripped a one-out double to left in the fifth. Williams, who walked http://www.bengalscheapshop.com/cheap-au...dan-jersey , advanced to third on the hit.
Jorge Alfaro followed with a grounder down the first-base line. Chris Davis moved a few steps to his left, took his eyes off the ball to look at Williams running halfway down the line, and the ball knuckled under his glove. Both runners scored on the error.
Adam Jones lined an RBI double to left-center in the third, giving the Orioles a 1-0 lead.
WELCOMING MANNY
For the second straight day, fans clapped each time Machado was introduced. They also chanted "We want Manny!"
The three-time All-Star is set to become a free agent after the season and the Phillies are among the teams interested in acquiring him before the non-waiver trade deadline on July 31 or signing him in the offseason.
Machado told reporters before the game he wants to play shortstop wherever he goes and he wouldn't be surprised if Philadelphia aggressively pursued him. Phillies team president Andy MacPhail held the same position in Baltimore when the Orioles selected Machado No. 3 overall in the 2010 amateur draft.
Orioles: OF Joey Rickard was recalled from Triple-A Norfolk to replace OF Colby Rasmus, who was placed on the restricted list before Tuesday night's game.
Phillies: RHP Jerad Eickhoff was scheduled to throw another live batting practice at Single-A Clearwater. Eickhoff has nerve issue in fingers and hasn't pitched this season.
Orioles: RHP Andrew Cashner (2-8, 4.48 ERA) starts the opener of a four-game series at Minnesota on Thursday night. Cashner had a 3.21 ERA in five starts in June but didn't earn a win.
Phillies: Nick Pivetta (5-7 T.J. Hockenson Jersey , 4.66 ERA) takes the mound at Pittsburgh for the start of a three-game series on Friday. Pivetta earned the win in a scoreless inning of relief in Philadelphia's 13-inning victory over Washington last Sunday.
The Buffalo Bills are known as the team that always managed to "choke". Time and time again, fans are disappointed with the pathetic management and lack of discipline on the team. This article shows some of the Bills biggest mistakes, which cost them years of potential success.It is important for readers to understand that teams do not necessarily have a first round pick every season. This means, that various years are not included in this article. Notably, like many other NFL teams, Buffalo scouts missed out on some great talent in drafts. In other cases, Bills fans were hoping that they would select one player http://www.lionscheapshop.com/cheap-auth...vai-jersey , but management makes a risky decision and chooses someone else. Having watched a significant amount of Bills games in my life, I can tell you this; they are poorly coached every year. The Bills often lack discipline. With the right coaching and players, Buffalo could be a respected franchise, like many other organizations. As of right now, they are one of the joke teams of the NFL, a team that does not have a shot at doing anything special. While Rex Ryan is no longer the head coach in Buffalo, fans will have to hope the team can finally buckle down and focus on football. If the organization could get a playoff berth Will Harris Jersey , it would mean a lot to fans.Note: The Bills did not have a first round pick in 2015 or 2005.


The Musculoskeletal, Oral and Skin Sciences (MOSS) IRG will consider research applications that address structural systems that are prerequisite for physical form, mechanical function, movement, and integrity of the body.
These structural systems and their components are the basis for the organization of the study sections of this IRG and are described according to the following topical areas: skeleton, spine, bone, connective tissue, extracellular matrix, and their related diseases/disorders; dental/oral and craniofacial and their related diseases/disorders; skeletal muscle, limb, and their related diseases/disorders; joints and their related diseases/disorders, including rheumatic diseases; skin and its related diseases/disorders. Autoimmune diseases are specifically included. For these topical areas, the studies considered range from molecular genetics and stem cell research to animal models and clinical trials. For each major topical area, the research applications may include studies of: basic biology, including growth, development, maturation, and aging; biomaterials for prostheses/orthotics and implants; pathogenesis and therapeutics; physical rehabilitation; exercise; mechanobiology/biomechanics; injury and repair, including adaptation, plasticity, degeneration, and regeneration; diagnostic markers and biomarkers; cell and gene-based therapies; and clinical outcomes and trials.


Launched in 1998, the S-TYPE road the crest of the wave of retro design that had arguably been kickstarted by Volkswagen's reboot of the Beetle. It was made at Jaguar's Castle Bromwich facility in Birmingham, was styled by Geoff Lawson in 1995, and was greeted by a mixed reaction from the press and buyers. It was based on the Jaguar DEW platform/Ford DEW platform, which was shared with the Lincoln LS.
The first S-TYPEs were disappointing to drive, but the 2003 facelift really improved the car's dynamics and interior. Subsequent models (X202, X204, and X206 introduced running changes that improved the overall appeal of the car, which actually ended up being an excellent buy, especially in V6 diesel form. Replaced by the XF in 2007, which carried over much of the S-TYPEs understructure.


Designed and Manufactured in New Zealand DMXking brings high quality products within your reach. Protocols include Art-Net I, II & 3, sACN E1.31, RDM E1.20 and Enttec Pro Compatible.
On this page you will find a variety of products based on Art-Net and sACN Protocols.


text:
John Hamilton Mortimer
British, English
Photo credit: Towner
Self Portrait in Character c.1775–1778
John Hamilton Mortimer (1740–1779)
(b Eastbourne, Sussex, 17 Sept. 1740; d London, 4 Feb. 1779). English painter and etcher. He studied under Hudson and became a lifelong friend of his fellow pupil Joseph Wright. His work included portraits, similar in style to those of Wright and conversation pieces in the manner of Zoffany, but he was at his best in historical and imaginative subjects. Among these were pioneering scenes from medieval British history, but he found his true bent in the 1770s with pictures showing the exploits of soldiers and banditti in the 'savage' style of Salvator Rosa (Bandit Taking Up his Post, c.1775, Detroit Inst. of Arts). Many of his paintings have disappeared and are now known only through engravings. Mortimer led an eccentric and disorderly life, but he became more settled after marrying in 1775 and his early death cut short the career of one of the most individual British painters of his generation.
St Paul Preaching to the Ancient Britons John Hamilton Mortimer (1740–1779)
Wycombe Museum
Dr Philip Hayes John Hamilton Mortimer (1740–1779)
New College, University of Oxford
The Honourable John Hastings John Hamilton Mortimer (1740–1779)
Chequers Court
John Frederick Sackville (1745–1799), 3rd Duke of Dorset, and Mr Ralph Petley of Riverhead John Hamilton Mortimer (1740–1779)
National Trust, Waddesdon Manor
Thomas Le Blanc John Hamilton Mortimer (1740–1779)
Jack Broughton, the Boxer John Hamilton Mortimer (1740–1779)
A Man and a Boy Looking at Prints John Hamilton Mortimer (1740–1779)
To have and to hold: a visual history of handbags
Lucy Ellis
Oxford Dictionary of National Biography
Biography on Wikipedia
Hatton Gallery
Hunterian Museum
Lady Lever Art Gallery
National Trust, Upton House
The Courtauld, London (Samuel Courtauld Trust)
Wadham College, University of Oxford
Do you know someone who would love this resource? Tell them about it...
https://batch.artuk.org/discover/artists/mortimer-john-hamilton-17401779 Copy


Whether you are a tourist or traveling on business, Huaqi Hotel Harbin is a great choice for accommodation. It is only 6.9 km from Harbin Railway Station and 42.7 km from Harbin Taiping International Airport. With its good location, the hotel offers easy access to transportation links and neighboring key destinations.
All rooms here are well equipped with domestic/international direct-dial telephone, air conditioning, free toiletries, electric kettle, slippers.
Opened in 2005, the hotel houses 618 rooms and suites.
Tip: Free Wifi is provided on floors 26-34.


Elegant Moroccan style tile patterning decorates white glass shade of this gorgeous contemporary cylinder accent lamp.
With a modern cylinder shape, this beautiful white glass accent lamp handsomely refreshes exotic, other worldly style. The lamp features a beautiful Moorish tile pattern that offers texture. Stands on a metal base.
Overall: 11" high. Glass is 10" high x 4 1/2" wide. Metal base is 5" wide.
Uses one maximum 60 watt standard base bulb (not included). On-off in-line cord switch.
White glass cylinder accent lamp from 360 Lighting.
Moorish tile pattern on the glass.
Metal base in a silver finish.
Needed a small discreet lamp for the top of a cabinet (hutch) for movement sensor bulb.
I have paraplegia and need an easy to reach on/off switch for my bedside table lamp. This lamp meets that need, and also has a pretty glass pattern which, according to reviews, still gives off a fairly bright illumination. It's small footprint will be helpful as well, I hope. We'll see.
Perfect for vanity in bathroom !
Needed more lighting in kitchen. Perfect for counter.
I have one already and wanted a pair. It is contemporary, simple, unobtrusive, decorative and has a glass shade which is easily cleaned. As a retired senior I believe that it is priced reasonably.
Looking for two small lamps that I can put on my new makeup table. With two 60-watt bulbs should be enough light. Hope these lamps will provide the light I need.
I like this lamp because it is unique and I like to decorate outside the box.
It fits really nicely in an unusual setting. Also nice price, thank you!
To replace a similar lamp that has broken.
2 Questions- 1) How far down the cord from lamp is the switch? & 2) Is the cord white?
BEST ANSWER: The switch from the base measures 16.5" and features a clear cord.
Can a bulb that gives off a fire flame appearance be used in this lamp?
Yes, I purchased this lamp for use with the "flame bulb" and it works perfect, the bulbs wattage is not harmful to the lamp or a fire hazard, however I only use it as a 'night-lite' in the bedroom.
Is there an on/off switch on the cord, or is there a switch on the base?
BEST ANSWER: The on off switch is on the cord. The lamp is great and when lit casts a nice pattern on the wall.
I was looking for inexpensive lamps to provide extra lighting in a bedroom, as well as a lamp that could lighten up a dark corner in my dining room. I am very happy with my purchase. The lamp fits fine on a 6" wide shelf in my dining room and has made a big difference. I'm using another one as a bedside lamp. I also appreciate the glass shade which is frosted with a design on it that's not too fru-fru.
These were exactly what I was looking for and could not find anything similar in my area. I have them on top of a tall entertainment center. With low wattage bulbs they give me the light I want to relax in the evening without turning on lamps.
Great design. Just the right amount of light for a small dining room. If needed, I can move from room to room!
I wanted a soft light for my bedroom. This is a pretty design, but the light that it emits is more Industrial & starck. You can see the bulb through the cylinder once it's on. And when I walk around in the room, I have this shadow. It is not a soft light..the cylinder does not filter at all.
Great for adding bit of light in small dining area or on nightstand.
These small table lampsavailable here as a handy set of 2 lampsare operated via a handy on-off touch feature.


text:
Benefice of North Waltham, Steventon, Ashe and Deane
St. Michael's, North Waltham
St. Nicholas', Steventon
Holy Trinity & St. Andrew, Ashe
All Saints', Deane
Helplines and Support Agencies
Home > Churches > St. Nicholas', Steventon
The Parish Church of Steventon is St Nicholas, situated some distance away from the village at the top of a small country lane opposite the site of the old manor House. St Nicholas was originally built around the year 1200 and, apart from some limited 13th, 15th and 19th century alterations, has stayed much the same since it was first built. The church is used regularly for worship and is well known for its associations with Jane Austen, born in Steventon in 1775, being the single most important building left standing in Steventon which relates to her. Her father George Austen, two of her brothers James and Henry, and her nephew William Knight were all Rectors of Steventon. Jane was baptized in St. Nicholas.
Some restoration work was carried out in Victorian times including the stained glass windows and much of the roof structure was rebuilt. The pews, pulpit, organ and choir stalls were added and the church was redecorated internally. The spire was also added. Recent renovation has lovingly restored some of the William Morris style decoration to the chancel arch and highlighted some Medieval wall paintings.
The church community plays an active part in local community life, including Steventon Players, Singers, and Strummers. There is an annual village fête, monthly coffee morning s, and seniors' Christmas lunch. The boundary between 'church' and 'village' activity is often hard to discern. To nurture the Jane Austen heritage, villagers meet and greet many visitors to the church encouraging community involvement. In 2017, church and village commemorated the 200th anniversary of her death with a festival of various events raising funds for the church and drawing church and village closely together.
Latest News for steventon
Saint Nicholas Steventon Group Visits
Church Opening (St. Nicholas)
United Benefice Rogation Walk
Church Warden Vacancy
Church Opening (All Saints)
OK, I'm happy with this


text:
Q: Android WebView не работает корректно С сервера приходит ссылка на эквайринг сбербанка, при открытии заполняю форму но оплата не проходит.
webView.getSettings().setJavaScriptEnabled(true);

В чем может быть проблема?
Если заполнять через браузер компьютера, то все проходит успешно

A: удалось решить проблему добавив эти настройки
webView.getSettings().setJavaScriptEnabled(true);
    webView.getSettings().setLoadWithOverviewMode(true);
    webView.getSettings().setUseWideViewPort(true);
    webView.getSettings().setAllowFileAccess(true);
    webView.getSettings().setAllowContentAccess(true);
    webView.getSettings().setAllowFileAccessFromFileURLs(true);
    webView.getSettings().setAllowUniversalAccessFromFileURLs(true);
    webView.getSettings().setDomStorageEnabled(true);

redpajama_set_name: RedPajamaStackExchange


text:
Q: No onTap response in flutter class _MainTestState extends State<MainTest> {
  void setstateham() {
    setState(() {

    });
  }
  @override
  Widget build(BuildContext context) {
    final double tophe = MediaQuery.of(context).padding.top;
    final pro = Provider.of<Pro>(context);
    US(context);

    GlobalKey<CircularMenuState> key = GlobalKey<CircularMenuState>();

    return Scaffold(
      backgroundColor: pro.mainColor,

        body: SingleChildScrollView(
            child: Container(
      padding: EdgeInsets.only(top: tophe),
      child: Stack(
        children: [

This is the top part of the widget containing the setState refresh function.
Container(
            margin: EdgeInsets.fromLTRB(305.w,23.h,0,0),
            width: 80.w,
            height: 80.h,
            child: CircularMenu(
              toggleButtonSize: 25.0,
              toggleButtonColor: pro.backColor_jinblue,
              toggleButtonIconColor: Colors.white,
              startingAngleInRadian: 0.45 * 3.14,
              endingAngleInRadian: 0.95 *  3.14,

              key: key,
              items: [
                CircularMenuItem(

                  icon: Icons.settings,
                  onTap: () {
                    pro.changeMainColor();
                    print('click1');
                    setstateham();
                  },
                  color: pro.backColor_jinblue,
                  iconColor: Colors.white,
                ),
                CircularMenuItem(
                  icon: Icons.info_outline_rounded,
                  onTap: () {
                    pro.changeMainColor();
                    print('click2');
                    setstateham();
                  },
                  color: pro.backColor_jinblue,
                  iconColor: Colors.white,
                ),
                CircularMenuItem(
                  icon: Icons.invert_colors,
                  onTap: () {
                    pro.changeMainColor();
                    print('click3');
                    setstateham();
                  },
                  color: pro.backColor_jinblue,
                  iconColor: Colors.white,
                ),

              ],
            ) ,
          ),

onTap is unresponsive code
Performing hot reload...
Syncing files to device SM N971N...
Reloaded 1 of 775 libraries in 1,197ms.
I/ViewRootImpl@7cd6bbe[MainActivity]( 3299): ViewPostIme pointer 0
I/ViewRootImpl@7cd6bbe[MainActivity]( 3299): ViewPostIme pointer 1
I/ViewRootImpl@7cd6bbe[MainActivity]( 3299): ViewPostIme pointer 0
I/ViewRootImpl@7cd6bbe[MainActivity]( 3299): ViewPostIme pointer 1
I/ViewRootImpl@7cd6bbe[MainActivity]( 3299): ViewPostIme pointer 0
I/ViewRootImpl@7cd6bbe[MainActivity]( 3299): ViewPostIme pointer 1
I/ViewRootImpl@7cd6bbe[MainActivity]( 3299): ViewPostIme pointer 0
I/ViewRootImpl@7cd6bbe[MainActivity]( 3299): ViewPostIme pointer 1

When the button is pressed, the setState or print itself in the onTap does not proceed, it just pops up the ViewPostIme that the touch is somewhere on the screen. When I touch the circlemenuitem in the emulator on the pc, the ViewPostIme pointer doesn't even come up and there is just nothing.
If you make another button and put it onPressed it works. If I create another widget and try onTap, there is no response as well.