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Q: Can I wrap up 'Power Automate flow' into a file? I want to create a 'Power Automate flow' and wrap it up into a file so I can execute the automation by simple calling that file. Is that possible ?

A: It is not exactly like running a file. But you can trigger flows by using a hyperlink from the When an HTTP request is received
https://manueltgomes.com/reference/power-automate-trigger-reference/when-an-http-request-is-received-trigger/
That might be an option. It is a premium action though.


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Later developments in the various Buddhist traditions led to new innovations in yogic practices. The Theravada school, while remaining relatively conservative, still developed new ideas on meditation and yogic phenomenology in their later works, the most influential of which is the Visuddhimagga. The Indic meditation teachings of Mahayana Buddhism can be seen in influential texts like the Yogācārabhūmi-Śāstra (compiled c. 4th century). Mahayana meditation practices also developed and adopted new yogic methods, such as the use of mantra and dharani, pure land practices which aimed at rebirth in a pure land or buddhafield, and visualization methods. Chinese Buddhism developed its own methods, such as the Chan practice of Koan introspection and Hua Tou. Likewise, Tantric Buddhism (also Mantrayana, Vajrayana) developed and adopted tantric methods, which remain the basis of the Tibetan Buddhist yogic systems, including the Six yogas of Naropa, Kalacakra, Mahamudra and Dzogchen.[251]
The chronology of completion of these yoga-related Early Buddhist Texts, however, is unclear, just like ancient Hindu texts.[85][86] Early known Buddhist sources like the Majjhima Nikāya mention meditation, while the Anguttara Nikāya describes Jhāyins (meditators) that resemble early Hindu descriptions of Muni, Kesins and meditating ascetics,[87] but these meditation-practices are not called yoga in these texts.[88] The earliest known specific discussion of yoga in the Buddhist literature, as understood in modern context are from the later Buddhist Yogācāra and Theravada schools.[88]
In the modern bodybuilding industry, the term "professional" generally means a bodybuilder who has won qualifying competitions as an amateur and has earned a "pro card" from their respective organization. Professionals earn the right to compete in competitions that include monetary prizes. A pro card also prohibits the athlete from competing in federations other than the one from which they have received the pro card.[12] Depending on the level of success, these bodybuilders may receive monetary compensation from sponsors, much like athletes in other sports.

redpajama_set_name: RedPajamaCommonCrawl


In a kingdom at the bottom of the sea, King Triton's youngest daughter Ariel yearns to have her questions about the human world answered as she grows bored with her watery home. When she saves the handsome and human Prince Eric from drowning, Ariel begins to discover her own voice with the help of her friends – even after the conniving sea witch silences her.
Based on a fairy tale by Hans Christian Andersen, musical extravaganza The Little Mermaid receives the brilliant Nashville Children's Theatre treatment during a fall/winter run, Nov. 8 through Dec. 23.
Like to catch a performance as our guest? We're giving away a pair of tickets to the Friday, Nov. 9, 7 p.m. show — enter through this form, and we'll choose and announce a random winner that morning.
Need another date, or prefer to make sure you're in the house? Tickets are on sale now via nashvillechildrenstheatre.org.
Entrants agree to join the East Nashvillian newsletter. There is no purchase necessary to enter. Entries are limited to U.S. residents at or over the age of 18. Enter through this form. Sweepstakes entries must be received by Friday, Nov. 9, 2018, at 10 a.m. Prize includes two tickets to the Nashville Children's Theatre production of The Little Mermaid, valued at $16 apiece. Odds of winning depends on the number of eligible entries. Winner will be selected at random and notified via email; winner must reply within 2 hours or forfeit the prize, after which a new random winner will be chosen. The East Nashvillian maintains the right to publicize the names of winners. Void where prohibited.


We have the power to save ourselves, but only if we wake up and notice that the house is on fire before we are consumed by it.
We need to talk about the fact that complicit conservatives are allowing white supremacists and other right-wing radicals to gaslight the country. Here's how it works.
The right-wing media ecosystem functions as an ideology-laundering operation for white supremacist ideas, incrementally funneling them from the margins into the mainstream.
Right-wing media personalities give airtime and legitimacy to crazy conspiracy theories, absurd spins on hot-button issues and blatant lies, exposing them to a wider audience and desensitizing people to the implications of white supremacist ideas.
Opportunistic politicians pick up on the themes, pandering to the far right with dog-whistles - slogans and policy positions that seem innocuous to bystanders but speak directly to white supremacists in language they understand.
So they say things like "freedom of speech" when they mean licence to engage in hate speech that threatens violence and terrorism against vulnerable communities; or "securing our borders" when they mean keeping out people who are non-white.
Under this cover of legitimacy, the white supremacists start coming out into the open, testing the waters, making increasingly public, inflammatory statements that build on the legitimacy granted to them by pandering politicians and media personalities.
The conservative establishment mostly turns a blind eye to this, recognizing that a nontrivial portion of their political base are racists, bigots and chauvinists. They may occasionally denounce a statement that goes too far but they mostly stay silent.
Conservative politicians pander to racists in increasingly brazen ways, winking to the base while continuing to insist publicly that they are not racist and denounce racism.
So you have, for example, Ontario PC leader Doug Ford personally appointing an anti-Semitic, Islamophobic misogynist to represent the PC Party in London West, a man who argued students should be allowed to debate whether the Holocaust happened.
The Holocaust may be a perfect case study in how hate-laundering works, because the lie - a canonical white supremacist tenet - already has incremental iterations ranging from full denial through downplaying the scale, questioning the details, and creating uncertainty.
Defending having students debate whether the Holocaust happened based on "free speech" grounds is a huge propaganda victory for white supremacism. It's the thin edge of a gruesome wedge that allows Nazi ideology to seep into the mainstream.
The white supremacists are traveling down that "free speech" wedge (and the "border security" wedge, and the "political correctness" wedge, and others) and incrementally getting their ideas into the mainstream. Suddenly they seem to be everywhere.
And it can happen very quickly. If someone had warned in October 2016 that a Trump administration would forcibly remove 13,000 children of asylum seekers from their parents and put them in cages, no one would take them seriously. That was just two years ago.
The white supremacists have already succeeded in getting their ideas into the mainstream and are coming right out into the open. Here's where things get interesting: they insulate themselves from singling-out by wrapping themselves in the broader conservative movement.
White supremacist ideas have so permeated the mainstream of conservative thought that white supremacists just point to the proliferation of racist ideas as proof that they're not really racist, or else everyone must be racist.
The white supremacists are openly gaslighting the mainstream: Look at these libtard snowflakes: whenever they see someone saying something they disagree with, they get triggered and accuse the person of being racist.
When I realized that the neo-Nazi who ran for mayor of Hamilton had a Twitter profile, I trolled through his feed to try and get a sense of what he was putting out. I was shocked - not because it was particularly outrageous but because it was so samey.
The neo-Nazi's twitter feed looked pretty much indistinguishable from the feeds of just about every single right-wing identity politics troll I've already encountered. It was actually rather on the banal side compared to some I've seen.
During the recent municipal election campaign, lots of right-wing trolls came at me about my support for Hamilton's light rail transit (LRT) project. I couldn't help but notice the strong correlation between their vitriolic opposition and their support for the white supremacist who ran a high-profile mayoral campaign in Toronto.
When I pointed out that they were endorsing and retweeting a white supremacist, they invariably denied it, insisting that the accusation was a hit-job from a lamestream media that was afraid of free speech.
When I pointed out that she had literally gone on a neo-Nazi podcast to praise her hosts and the organizers of the hate march in Charlottesville, they fell back on the claim that her words were taken out of context.
If I continued to push back, they ended up ignoring or blocking me. Their feeds, you should understand, were filled with hatred toward liberals and refugees and full of paranoid conspiracy theories. There was no getting through to them in just 280 characters.
Earlier I mentioned Premier Doug Ford personally nominating a bigot as his party's candidate in London West. This summer, he posed for a photo with the white supremacist Toronto mayoral candidate at his annual "Ford Fest" campaign event.
There is no way on earth that he did not know who she was, this prominent conservative who has been to six Ford Fests and was a high-profile correspondent on "The Rebel", a right-wing conspiracy laundering website. Yet it took him several days to issue a mild denunciation that finally mentioned her name, albeit in passing. He knows her supporters are a nontrivial share of his own base.
The white supremacist mayoral candidate ended up finishing in third place with 25,667 votes or 3.4 percent of the total votes cast. Think about that: more than twenty-five thousand people in Toronto voted for a white supremacist who has warned about "white genocide" and proudly recited the "Fourteen Words" white supremacist slogan.
The neo-Nazi mayoral candidate in Hamilton didn't do as well, coming in seventh place (out of 15), pulling in just 706 votes or 0.51 percent of the total. But we shouldn't be too comforted, as he basically ran no campaign. A charismatic, media-savvy white supremacist may do better.
So we have a media ecosystem incrementally laundering white supremacist ideas into the mainstream and radicalizing angry men, abetted by conservative politicians who either fail to speak out or actively dog-whistle and pander to white supremacists.
This allows the white supremacists to gaslight liberals and progressives by claiming that when we name them as white supremacists, we are just attacking people whose ideas about "free speech" and "secure borders" we don't like.
If you point out that a racist dog-whistle is racist, the gaslighting response is to accuse you of being the racist for seeing racism in the message.
Federally, we may be tempted to feel relief that the anti-immigrant MP who denounced multiculturalism decided to leave his home in the Conservative Party of Canada and form his own party, but we should not confuse his ambition with his erstwhile party's principles.
In the wake of a terrible week in which American right-wing terrorists sent mailbombs to politicians and reporters, murdered two people for being black in Kentucky and murdered eleven people for being Jewish in Pittsburgh, our CPC leader decided it was a good time to attack the media.
His MPs have long been accusing mainstream journalists of being "Liberal reporters" and "spin tools" and even "fake news" (ugh), and now he has come out swinging in a party fundraising appeal taken right from the Trump playbook.
And Andrew Scheer was supposed to be the nice one.
We don't have to guess what happens when right-wing parties keep winking to bigots, chauvinists, misogynists and white supremacists who are being radicalized by a parallel universe of right-wing propaganda. When you feed the beast, the beast gets bigger.
And if the party that has been feeding the beast happens to gain power, the beast has a nasty habit of breaking its chains and taking over. At the risk of Godwining this essay, I'm sure von Hindenberg thought he could control Hitler.
Or if you prefer a (slightly) less hot analogy, I'm sure Paul Ryan and Mitch McConnell thought they could control Trump.
When white supremacists take over a party and the party takes over a country, we end up with fascism. We've seen this movie before, and in fact it is currently playing in various theatres around the world. We know how the story ends.
I'm not being hyperbolic when I say we need to stamp out white supremacism if we want to save the body and soul of our country.
Right-wing terrorism has been increasing steadily in the USA and Europe over the past several years. We are by no means immune to this trend in Canada.
Hate crime researcher Dr. Barbara Perry reports that there are 130 active hate groups in Canada right now, up 30% in just the past three years. Right-wing terrorists aren't just "crazy people" - they are radicalized in a media swamp of right-wing propaganda that is reaching into the mainstream.
Right wing terrorists are not isolated loners, or at least they're not just isolated loners. They are also active members of radicalizing communities that are part of the larger continuum of incremental hatred-laundering.
When politicians blow racist dogwhistles, right-wing terrorists get the message. As Democratic Florida gubernatorial candidate Andrew Gillum famously said of his GOP challenger, "I'm not calling Mr. Desantis a racist. I'm simply saying the racists believe he's a racist."
Likewise, Doug Ford had the full support of Canada's white supremacists, who heard his racist dog-whistles loud and clear.
Across the border, it's no coincidence that the right-wing terrorist who sent bombs to George Soros, Hillary Clinton and CNN had a van festooned with Trump logos. Trump has been relentlessly, shamelessly fomenting hatred against these targets for years.
A social media photo from mid-2015 showed the same van with no stickers affixed yet. The bomber was radicalized to violence by the Republican presidential candidate's hate-fueled presidential campaign.
Amazingly, before the man charged with sending the bombs was arrested and reported, right-wing pundits were falling over themselves to accuse Democrats of a "false flag operation" - of sending bombs to themselves in order to make conservatives look bad. That is an extremely crazy conspiracy theory but some extremely high-profile conservatives helped circulate and amplify it before the truth came out.
The anti-Semitic terrorist who committed mass murder against the Tree of Life Jewish synagogue in Pittsburgh was radicalized in part by paranoid conspiracy theories about the caravan of refugees fleeing from violence who are slowly making their way through Mexico.
His attack targeted the Synagogue for being Jewish, and also for the connection to HIAS, the Hebrew Immigrant Aid Society, which is the oldest and one of the largest refugee settlement organizations in the world.
So the threat from right-wing radicalization is twofold: there is the risk of increased terrorist attacks against vulnerable groups, and also the risk that the far right will take over the conservative party and win election, turning the country toward fascism.
Again, conservative politicians who believe they can activate the base with dog-whistles while remaining in control are deluded. Sooner or later, a charismatic figure emerges from the base and takes over the party. Most voters don't even notice until it's too late.
And conservative politicians who believe they can't afford to disavow and cut off the base are really just admitting that their own policy ideas, designed to pander to the far right, are too extreme for genuine mainstream acceptance.
Most worrying are the conservative politicians who are just terrified of the right-wing base as I am, but who have convinced themselves that the best thing they can do to protect the centre is to mollify and contain the radicals by throwing them some red meat from time to time to keep them happy. As if feeding the beast somehow won't make it bigger and stronger.
Liberal democracy is not a law of nature or even a fundamental principle of psychology or sociology or political science. It is nothing more than an agreement among a large group of people about a set of principles by which we are willing to be bound.
The Charter of Rights and Freedoms is not a magical scroll; it cannot save our liberal democracy from our own indifference. In Ontario we have a Premier who brags about his willingness to invoke S.33 of the Charter, which grants him the power to violate our rights.
Helpful article. I can think of lots of examples of extreme responses to liberal viewpoints (gaslighting is the term you use) on Twitter and in the media these days. I've even seen a Republican campaign attack ad on a US TV station that painted a certain Democrat candidate as an "extreme liberal" and "dangerous socialist"
I am not expecting to be labeled as a bleeding heart, wasteful liberal idiot, liberal f**tard or any number of other weak and despised things just because I publicly air an opinion and disagree with something I see as hateful or unjust. As you are helping us understand is that this is an attempt to shut people up or shout them down. The whole idea of this "gaslighting" process is to move people away from reasonable discourse and discussion and understanding and to replace it with divisions, name-calling, and polarization of people into disparate groups.
'They' are ALL lying to us at the top of the pyramid . We are decaying mentally, physically and spiritually on a rapid pace. . 'Heads they win, tails we lose' . What is good, beautiful, spiritual, love - is being flipped on its head and promoted as bad. And what is bad, ugly, perverted, ungodly - is being promoted as good. . As above, so below. . Detoxify your pineal gland and see through the illusions. . Sacred geometry, numerology and the stars shine their way. . Knowledge is power.
Life is genuinely harder for too many people, much harder than it was 40 years ago, how it got so much harder for so many people is the question.
The Bolsonaro victory has caused many people to start to pay attention to the manipulation of the collective psyche that the fascist right has been perfecting since the time of Dr. Goebbels. It is time to do an asset mapping of the right wing. They are fortunate to have Evangelicals in their camp. This group is the most effect cadre for causing the undermining / main weakness of the progressive forces: The religious right believes that they are all one big family in Christ - and this attitude enables their ranks to act in an egalitarian/comradery kind of social system. The opposite of the way progressives are hamstrung by status hierarchy, and choosing to find fault with any aspect of someone's ideological purity. This judgementalism does not happen on the Nazi right. They are willing to tolerate any flaw - so long as their ultimate goal of power and control of the instruments of governance remains their undivided focus. Many of them have read about Schopenhauer's concept of the collective will as examined in MEIN KAMPF. It is likely this has been Trump's bedside reading.
After decades of being a political junkie, I see only one way to mobilize a critical mass of activism to put the public interest in control of this problem. Only by a willingness on the part of grassroots, authentic citizens' group agencies and networks, to become active in the implementation of the 17 Sustainable Development Goals for 2030, can we advance the policies that will enable our economy and political system to be taken forcefully from the toxic hands of neoliberalism, and restored to enable the purpose of democratic processes to resume. We will have to understand that social psychology demonstrates that if 3.5% of a population is able to learn a technology of problem-solving, that this group can infuse through the rest of society. In the case of the 17 SDGs, this will enable those who are aware and trained to help the rest of society overcome ideological incoherence. For further details on this, watch the videos from Prof Jeffrey Sachs on Youtube from the Sustainable Devt Academy, and if you want to become part of the group implementing the SDGs, take a look at the course that Prof Sachs teaches on EdX.
The Munk debate was a bizarre exchange between a neocon and a fascist. There were no "good guys" on that stage.


We're thrilled to announce the launch of NCARB Blog , a social hub where emerging professionals, educators, and practitioners can come together to explore industry trends. Updated weekly, NCARB Blog is your destination for the latest news about licensure, innovations in education, cutting-edge technology, and more—from people like you.
In addition to updates about the National Council of Architectural Registration Board's (NCARB) programs and initiatives, the blog will feature guest posts from industry experts and emerging professionals. Through our online community, readers will have access to exclusive videos, photo galleries, and interviews. Plus, you'll find tips and insight you can't get anywhere else.
In the coming months, we have an impressive lineup of guest bloggers who will touch on everything from diversity in the profession, to budgeting for the Architect Registration Examination® (ARE®), to navigating the Intern Development Program (IDP).
It is with great pleasure that we invite you to explore the NCARB Blog—just one of the many resources we've developed to help aspiring architects achieve their career goals over the last few years. Check back often for your weekly dose of architectural-related news, inspiration, and conversation.
If you're interested in becoming a guest blogger for NCARB, please contact us at blog@ncarb.org and review our Blog Guidelines.


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Titanfall Frontiers Edge Revealed
Home Articles Video Games
by James Gough
in Video Games
Developer Respawn have today announced the name and some basic details for the second Titanfall DLC pack – it's going to be called Titanfall Frontier's Edge and was officially announced on the official Titanfall website. Frontier's Edge will be made up of three new maps for Titanfall, promising to push "the battle to the furthest reaches of the universe".
The three new maps for Titanfall will be named Dig Site, Haven and Export. There are no images or video footage of the new levels as of yet, but Respawn will likely release details in a similar manner to the last DLC pack; by releasing a video and screenshot pack for each map over a period of time prior to the release.
Dig Site is described on the official announcement post as an "isolated mining outpost", Haven is described as an "exclusive beach resort" and Export is a "mining hub on the side of a mountain".
Titanfall Frontier's Edge will be available for "free" as part of the Titanfall Season Pass, or $9.99 as a standalone pack.
Just in case you've been living under a rock, have only recently picked up an Xbox One or have general curiosity, Respawn also provided a brief recap/overview of Titanfall.
Set in the near future on a distant frontier torn apart by war, Titanfall drops players in the middle of a conflict between the Interstellar Manufacturing Corporation (IMC) and the Militia. The action is rapid and varied – featuring parkour-style wall running and massive double jumps. The freedom to shift back and forth between pilot and titan allows players to change tactics on the fly, attacking or escaping depending on the situation and extending the action vertically to new heights.
We'll keep you updated on Frontier's Edge and any other Titanfall updates as they are announced.
Tags: dlcRespawntitanfallXboxXbox One


Who Are You Looking For In Queenstown, Maryland?
Run a search by name for anyone in Queenstown, Maryland & get free white pages information instantly. Queenstown, Maryland white page directory listings include full name, phone number and address.


When children or adults afflicted with autism spectrum disorders, Down's syndrome, Alzheimer's disease, dementia, or other cognitive disorders wander from the safety of their caregivers, your Sheriff's Office is called to action.
Because of the outstanding involvement and cooperation of Lions Clubs throughout Erie County, local law enforcement agencies and the Sheriff's Office have another great tool to help us find and rescue your loved ones more quickly with the Project Lifesaver program. A search that previously may have taken days can now be successfully concluded quickly—potentially saving lives and thousands of taxpayer dollars.
Project Lifesaver clients will receive a plastic bracelet containing a water-resistant radio transmitter. Each participant's transmitter is assigned a radio frequency that is unique both to them and their geographical area. The bracelets may be worn on the client's wrist or ankle.
When a Project Lifesaver client is discovered to be missing, the caregiver reports the situation to the Sheriff's Office via the Erie County 911 system. Trained deputy sheriffs or local law enforcement officers will respond to search for the missing Project Lifesaver client using the program's radio frequency tracking receivers.
Be known to wander from his or her caregiver, or the potential client's behavior causes the caregiver to believe that the potential client will wander in the future.
Immediately notifying the Erie County Sheriff's Office via 911 if a Project Lifesaver client is discovered missing.
For more information, or to enroll an individual in the Erie County Project Lifesaver program, please contact Pam Straziuso at 419-271-6844, or by e-mail at straziusoteacher@aol.com or Deputy Ron Schnittker at 419-625-7951 Ext. 6141, or by e-mail at rschnittker@eriecounty.oh.gov.
There are costs associated with participating in the Project Lifesaver program. Donations are needed to supply bracelets and to provide financial support for those that do not have the financial resources to participate in the program, but who have loved ones who could benefit from program participation.
To learn how you or your organization can become involved in our program as a sponsor, please call Mike Karniotis at 419-366-5567 or by e-mail at ekarniotis@bex.net.


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Defence Bank marches forward with its best result yet.
... Defence Bank marches forward with its best result yet. Navigate to...
Defence Bank records net profit after tax of $13.9m for FY 2020/21, up by 38%.
Deposit growth of 5.7%, total deposits of $2.3b.
Lending growth of 8.0% with total loans of just under $2.5b at 30 June 2021.
Capital adequacy reaches a four year high at 16.0%.
Loan delinquency rate remains low, at just 0.08%.
Return on assets is 0.49%, with return on equity at 7.11%.
Defence Bank today recorded a 38% increase in profit, fuelled by record lending.
"Our people led and technology-enabled strategy has delivered these results for our members," Defence Bank CEO David Marshall said.
"We've invested in our team and in digital advancement to foster effortless banking, allowing our people to deliver an authentic, easy-to-navigate, personalised banking service.
"We have provided stability, consistency and convenience to our members against the backdrop of uncertainty and rapid change caused by the COVID-19 environment.
"Our fundamentals are strong, our return on assets is 0.49%, our return on equity sits at 7.11%, and our net interest margin has lifted from 1.84% in FY 2019/20 to 1.98% in FY 2020/21.
"Total deposits have grown by 5.7% to $2.3B for FY 2020/21.
"We have responded to our member's appetite for banking that's convenient, requires minimal effort, and is compatible with their busy daily lives.
"Members love our Defence Bank app, as shown by a rating of 4.8 out of 5 in both the Apple and Google stores, well ahead of our competitors.
Feedback like this from our members is so important and we have thousands of members happy to recommend Defence Bank and telling us it's easy to bank with us. Defence Bank recorded an average Net Promoter Score of +40 and a Member Effort Score of 82% during the year, well ahead of the big four.
"Defence Bank is extremely well capitalised, recording capital adequacy of 16%, the highest for the bank since 2017. Our inaugural $15M subordinated notes transaction and $300M capital relief public RMBS transaction both added significantly to this result.
Our cost to income ratio has also improved, moving from 73% to 69% in 12 months."
During FY 2020/21, Defence Bank reached $3Billion in assets, and received a rating of Baa1 | Stable | P-2 from Moody's Investor Services due to strong asset quality, good capitalisation and profitability. The recognition from Moody's provides a dual rating for the Bank, with a rating of BBB |Positive|A2 re-confirmed by S&P Global Ratings during the financial year.
Marshall said while uncertainty remains in the COVID-19 environment, Defence Bank is well placed for continued growth and refuses to use Covid as an excuse not to do so.
"We expect continued demand for all of our products and services.
"This includes continued demand for home loans, particularly from younger members. We remain prudent lenders who want to get more Australians into homeownership but not by getting them in over their heads. Our overall loan delinquency remains very low, at just 0.08%.
"As regulators take a renewed focus on serviceability, Defence Bank is well placed to easily meet these and any further requirements.
"Our focus continues to be on accelerating improvements in our member experience with more digital banking investment a key priority over the next 12 months."
Download the Defence Bank Annual Financial Report 2020/21.
You may also enjoy reading...
Defence Bank reaches three billion in assets.
Defence Bank has reached a historic milestone by recording $3 billion in assets, surging by a billion dollars in only four years.
Defence Bank members benefit from strong half-year result.
Defence Bank today announced a strong half-year result that continues to support record investment in new products and services for Members.
Defence Bank 2020 Annual General Meeting.
In light of the global outbreak of COVID-19, and current guidance and restrictions on travel and public gatherings the Defence Bank 2020 Annual General Meeting will be held online as a virtual meeting on Monday, 23 November 2020 at 1000hrs AEDT.


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Treating and caring for patients with fungal diseases is becoming an increasing economic burden. Estimated numbers of patients who will need expensive antifungal drugs for some of the life-threatening fungal illnesses are summarised here.
A case of pulmonary cryptococcoma due to in the United Kingdom.
Read more about A case of pulmonary cryptococcoma due to in the United Kingdom.
Read more about Development of an adaptable headspace sampling method for metabolic profiling of the fungal volatome.
Pathophysiological aspects of Aspergillus colonization in disease.
Read more about Pathophysiological aspects of Aspergillus colonization in disease.
Manchester Fungal Infection Group, National Aspergillosis Centre, Mycology Reference Centre all carry out research programs.


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Cowan Court
Johan Dehlin
6a architects have emerged as a leading architectural practice in the UK, with a particular reputation for working in sensitive historic environments and exemplifying a high level of craft in all their work.
In 2008, 6a won a competition for a new student residence within the Churchill College at the University of Cambridge. Built in 1959, the original buildings were a result of one of the most high-profile architecture competitions of its time, won by architect Sheppard Robson (against the likes of Alison and Peter Smithson). The 10 brick courts are now Grade II heritage-listed, remaining one of the most important examples of English Brutalism and a flagship project of the architect.
Cowan Court respectfully reinterprets Robson's original design, an echo of its robust materiality and form. The new 68-room hall of residence mimics the floor plan of the existing courts – a solid square block punctured by a central courtyard. The cloisters that surround the internal courtyard act as the main circulation space, creating a social core. This inner sanctuary is given a special treatment, lined with light raw oak that contrasts with the rough, recycled timber cladding elsewhere. The courtyard is densely planted with birch trees, creating an inviting shared space where students can gather and study. The private rooms then turn themselves out to views over Churchill's landscape, creating a clear distinction between communal and private life.
Robson's original facades of brick and concrete are transferred into timber. Their board-marked concrete formwork is mirrored by the recycled-oak cladding, reading like an inversion or mold of the original. Its blackened finish matches the tones of the weathered brickwork; although easily read as a contemporary addition it somehow looks as if it has aged with its neighbors.
The box bay windows of the original courts are continued, but in reverse — flush with the façade and providing deep window seats within the thickly insulated walls.
Although directly informed by its brutalist counterparts, Cowan Court displays a sensitivity and softness that contrasts with the surrounding built fabric. The timber cladding, while speaking to the brick and concrete, provides a quality of warmth, unlike its antecedents. The sharp square form of the original courts is also subtly altered – each façade is slightly concave like the entasis of a classical column, only revealed when the sun's direct light casts a shadow of its soft bow. While sitting comfortably amongst its rugged neighbors, there is a delicacy and tenderness to Cowan Court in its simple but refined materiality and detailing.
Cowan Court's choice of materiality addresses the pressing environmental issues of our time, boasting an ambitious environmental strategy, using reclaimed timber, passive ventilation, triple glazed windows, a high-level of insulation as well as utilizing solar electricity and rainwater collection.
Cowan Court while in direct conversation with the surrounding college has its own contemporary voice – an innovative addition to the progressive college that was founded as a memorial to Sir Winston Churchill in the 'white heat of technology' of the early 1960s.
David Grandorge
6a Architects
Country and City
More architecture
Søholm: Nordic modernism on the Øresund seaside
Kamelia House: Urban community for seniors
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Are you still playing Warcraft? It seems there are very few vegetarians that play the game. It would be great to find others and start vegetarian Guild!
Never met a veg character in game but that was almost 8 years ago!
Mages, by default, are vegan.
I suppose this is why I have so many mages, across numerous realms.
I would love to play again, but am so busy. My husband got the Frozen Throne and is a lvl 60 something gnome mage on Suramar server (Vishvakarma).
Nice to meet you veggiefrog!
It's been so long since I've played but I think the Alliance will more likely to be veg especially if you want to be veg in game. In the Horde, the Undead can eat corpses and the Orcs don't seem very veg friendly to me. The Nightelves and Dranei seem more meditative.


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1. Applicability
These general terms and conditions of sale (hereinafter the "General Terms and Conditions") apply to all agreements concluded between BT Belgium B.V. with an office at Middenweg 8 bus 10, 3930 Hamont-Achel, Belgium (hereinafter the "Seller") and the Consumer. Consequently, the Seller only concludes agreements under current conditions to the exclusion of all other conditions. These conditions apply to both sales and installation of the sold goods. If the Consumer does not agree with certain conditions, he must inform the Seller of this within seven working days after receipt of the General Terms and Conditions. These conditions are irrefutably deemed to have been brought to the notice of the Consumer before the conclusion of the agreement. By ordering, the Consumer accepts these conditions.
The Consumer has the right to withdraw from the agreement without penalty and without giving any reason within 14 (fourteen) calendar days from the day following the delivery of the product. To make use of the right of withdrawal, the Consumer must inform the Seller about this by means of a clear statement by letter to BT Belgium B.V. Middenweg 8 box 10 in 3930 Hamont-Achel, Belgium or email to info@cemabearing.be. The Consumer shall immediately return the goods to the Seller within 14 (fourteen) calendar days after the date on which the Consumer informed the Seller about the withdrawal from the agreement. In the event of a return, the Consumer must send the goods in unopened packaging and in unused condition accompanied by a copy of the proof of purchase to the following address: BT Belgium B.V. Middenweg 8 box 10 at 3930 Hamont-Achel, Belgium. If the Consumer revokes the agreement, the Seller shall refund all payments received from the customer to the customer immediately and at the latest within fourteen (14) days after the date on which the Seller received the notice of cancellation of this agreement. For this refund, the Seller will use the same means of payment as the Consumer in the original transaction, unless expressly agreed otherwise with the Consumer; under no circumstances will the Seller charge the Consumer for this refund. The Seller may refuse the refund until the goods have been returned.
3. Quotations / offers
Offers and promotions of the Seller are not binding until they, after acceptance by the Consumer, are in turn confirmed by the Seller. Pictures, size and weight statements, etc., which the Seller provides in catalogues, website, advertising material or otherwise, are not binding for him and are only intended to give a representation of the offered article. Deviations in any form do not give the Consumer the right to refuse the goods, to omit payment or to claim compensation. An agreement is only final when the Seller has accepted the order in writing and the Consumer receives an order confirmation. After the agreement has been concluded, the Seller will not be able to unilaterally change the essential characteristics of the product or service for the Consumer. This also applies to the use that the Consumer envisaged, at least insofar as he communicated this to the Seller and the seller accepted this, or in the absence of such specification, the use was reasonably foreseeable.
4. Deliveries
The goods are sent at the risk and danger of the recipients, even if these are delivered carriage paid. Subject to the explicit and written agreement of the Seller, the goods will be delivered at the place of destination indicated in the Seller's order form. The time of delivery is determined by mutual agreement between the Seller and the Consumer. If the day of delivery cannot yet be precisely determined at the time of sale, an approximate period will be established, with the exact date subsequently being determined by mutual agreement. The Seller will only be obliged to deliver the ordered products on every working day between 8 a.m. and 6 p.m. at the agreed delivery address. The Consumer guarantees appropriate reception and permanence on the agreed date. The Seller cannot unilaterally determine or change the delivery term. The number and condition of the products must be checked at the time of delivery. All visible defects must be reported to the seller. Accepting a shipment without written comments to the address of the seller counts as an irrefutable presumption that the delivered goods were free from visible defects. The Consumer will specifically mention any damage to the packaging. This provision does not affect the Consumer's rights with regard to the agreement as stipulated in art. 1649 bis et seq. BW.
The Seller gives a warranty on his products for a period of 2 years. The warranty commences on the day of purchase and only applies to the first user of the product concerned. Warranty means: exchanging for the same product, repair or refund of the purchase price. The form of warranty is at the discretion of the Seller. The warranty becomes void if the product is installed, modified, or used in violation of the instructions or is used improperly or improperly. The warranty also lapses if the Seller is not informed of the defect of the product within 30 days after the defect was discovered. The Consumer acknowledges having been informed by the Seller of the necessity to have the installation of the products done only by skilled specialists. The warranty does not cover normal operational wear, destruction, damage or destruction of the product due to force majeure or environmental effects, or due to improper use. The granting of a guarantee does not lead to an extension or to the resumption of the guarantee period. The buyer is not entitled to claim a refund for the costs incurred in removing or reinstalling the product covered by the warranty. The Seller is not liable for accidental damage, indirect damage or consequential damage. If you have a warranty claim, please contact the Seller: BT Belgium B.V. Middenweg 8 bus 10, 3930 Hamont-Achel, Belgium. When the product is returned, it must be accompanied by a copy of a proof of purchase. The costs of the return shipment are for the account of the buyer. The costs of return to the buyer are for the account of the Seller. The risk during the transport of the relevant product from the buyer to the Seller and back is borne by the buyer. The Seller makes no guarantees as to the usability and suitability for a particular purpose of use or suitability for any other purpose. We are also not responsible for any other information about properties, descriptions or statements related to the product.
The indicated price is the total price to be paid by the Consumer, including the value added tax and the costs of all services that must be paid by the Consumer. However, this does not include: the transportation costs as well as the installation cost of the product.
7. Payment terms
Except for distance sales, all invoices of the Seller are cash and therefore immediately payable on the date of the invoice. In the event of non-payment, the Consumer will owe interest by operation of law and without prior notice of default, in proportion to the annual statutory interest rate from the due date and a compensation of 10% on the total invoice amount and with a minimum of EUR 100. Equivalent compensation will come to the Consumer if the seller fails to fulfill his obligations. In case of purchase, an invoice will be sent to the Consumer by e-mail. If no e-mail address has been provided, the invoice will be made available upon delivery or sent via traditional mail. Except for distance purchases and without prejudice to the option of requesting payment of a deposit, the Seller has the right to demand payment either prior to delivery or at the time of delivery. In the aforementioned cases, the seller is still entitled to unilaterally demand additional payment guarantees, advances or guarantees before delivery. If the Consumer renounces the conclusion of the agreement, the seller has the right to keep the amounts paid. However, the Consumer has the right to receive an equivalent amount of compensation from the seller if the seller renounces the conclusion of the agreement. The Seller expressly retains ownership of all delivered goods in this respect, even if these have been placed, until the day of full payment of principal, interest, compensation and costs. All movable property placed by the Seller is irrefutably deemed not to be permanently attached to the yard and therefore to be removable. Cross-border payment orders are only considered fulfilled if any additional transfer costs have been paid by the Consumer.
The Consumer and Seller are obliged to execute the agreement unless in case of force majeure. In the event of a breach of contract, one party owes the other a flat-rate fee equal to 10% of the total price. Force majeure exists in the case of, but not limited to, war, national or international conflicts, strike, lockout, lack of transport equipment or raw materials and fire. The execution of the agreement will be suspended in the event of continuous and uninterrupted force majeure for its duration. This for a maximum duration of six months. If the force majeure still exists after this period has expired, the agreement will be terminated by operation of law without one party owing any compensation to the other.
9. Invalidity
Should one of the clauses of the General Terms and Conditions be declared null and void, this invalidity will not affect the validity of the other clauses and the Seller and the Consumer will endeavour to immediately and in good faith negotiate a valid clause with the same economic effect. If a clause or a part of it would in any event be in conflict with any provision of mandatory law, the latter provision will automatically replace the conflicting provision.
10. Applicable law
The General Terms and Conditions and any agreement to which the General Terms and Conditions apply are governed by Belgian law. The competent court is appointed according to art. 624 of the Judicial Code. The legal language is the consumer's mother tongue. The parties undertake, under penalty of inadmissibility of instituting a claim with the exception of protective measures, to organize a meditation in advance with equally shared costs.


A long summer of tough commutes for Metrorail riders will start June 4 with 13 straight days of single-tracking in one section, the agency said as it revealed its updated SafeTrack maintenance plan Thursday.
The first project will be single-tracking on the Orange and Silver lines between Ballston and East Falls Church starting June 4 and ending June 16.
That means reduced service for the entire Orange and Silver lines, and a severe impact west of the Ballston station.
The next projects may be among the most disruptive in all 15 projects of the entire 10-month rebuilding plan: The complete shutdown of segments of track on the Orange, Silver, Blue and Yellow lines.
Starting June 18, the Orange, Silver and Blue lines will be shut down between Eastern Market and the Minnesota Ave. / Benning Road stations. Two stations will be closed: Stadium-Armory and Potomac Ave. That will last until July 3.
July 5, the Yellow and Blue lines between Reagan National Airport and Braddock Road will be shut down until July 11. And beginning July 12, the Yellow and Blue lines will be shut down between Reagan and Pentagon City.
Metro will provide shuttle buses during the shutdowns, but the transit agency said any travelers should consider alternative travel options.
And the disruptions don't end there: SafeTrack requires five separate shutdowns of sections of the system and 10 spans of single-tracking.
The dates stretch through the summer, the school year and into 2017, though Metro is pausing the massive maintenance work for big events including Wreaths Across America at Arlington National Cemetery and for the presidential Inauguration.
SafeTrack is Metro's massive overhaul of its rail system. The plan has been championed by new General Manager Paul Wiedefeld, who has said that he wants Metro to prioritize safety over service.
Wiedefeld has also said he will not reduce fares during the maintenance.
Wiedefeld had rolled out an earlier version of the plan -- only to have to revise it after federal transit officials demanded immediate fixes to some sections of track.
It's clear that SafeTrack will have a huge impact on Metro riders for most of the next year. In addition to the 15 projects that Metro detailed Thursday, stations will close at midnight to allow for more repair time.
But SafeTrack follows a series of serious safety breaches on the Metrorail system. In January 2015, a Metro rider died in a smoke-filled car near the L'Enfant Plaza station.
An investigation revealed that Metro regularly sent trains full of passengers into smoky tunnels to investigate the smoke.
A string of nonfatal but still serious service and safety problems followed, including the recent fireball that erupted at the Federal Center SW station.
Continuous single tracking between East Falls Church and Ballston. Reduced service at most stations; severe impact West of Ballston.
Line segment shutdown between Eastern Market and Minnesota Ave/Benning Road. Reduced service at all Orange, Silver and Blue line stations.
Two stations closed: Stadium-Armory and Potomac Ave.
Free shuttle buses run between Eastern Market and Minnesota Ave. / Benning Road with stops at Stadium-Armory and Potomac Ave.
Line segment shutdown between National Airport and Braddock Road. Reduced service at all times at many stations, primarily Yellow and Blue lines in Virginia.
Line segment shutdown between National Airport and Pentagon City. Reduced service at all times in many stations, primarily Yellow and Blue lines in Virginia.
Continuous single-tracking between East Falls Church and Ballston. Reduced service at all Orange and Silver line stations.
Continuous single tracking between Takoma and Silver Spring; reduced service at most Red Line stations.
Continuous single tracking between Shady Grove and Twinbrook. Reduced service at Shady Grove and Rockville stations.
Continuous single tracking between Franconia-Springfield and Van Dorn St. Reduced service at Franconia-Springfield and Van Dorn St. only.
Continuous single tracking between Vienna and West Falls Church. Reduced service at Vienna and Dunn Loring stations only.
Line segment shutdown between NoMa and Fort Totten. Reduced service at most Red Line stations.
Continuous single tracking between West Falls Church and East Falls Church. Reduced service at all Orange and Silver line stations.
Continuous single tracking between Greenbelt and College Park. Reduced service at Greenbelt station only.
Line segment shutdown between Pentagon and Rosslyn. Reduced service at all Blue Line stations.
Continuous single tracking between Braddock Rd and Huntington / Van Dorn Street. Reduced service at all Yellow and Blue line stations.
Normal Service Jan. 14-22 for the Inauguration.


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Home>All Posts>Reviews>Blu-Ray / DVD Reviews>'Cloverfield' Films on 4K...
'Cloverfield' Films on 4K, 'Jawbone,' 'Dog and Pony Show,' More on Home Entertainment
Blu-Ray / DVD ReviewsNews Angela Dawson|January 20, 2018	|1
CLOVERFIELD 4K ULTRA HD. (DVD Artwork). ©Paramount.
Producer J.J. Abrams' and director Matt Reeves' monster hits "Cloverfield" and "10 Cloverfield Lane" arrive on 4K Ultra HD for the first time ever Tuesday Jan. 23 from Paramount Home Media Distribution.
Celebrating its 10th anniversary this year, the groundbreaking sci-fi actioner "Cloverfield" thrilled critics and audiences alike with its shocking, first-person video account of a horrifying attack on Manhattan by an unknown and seemingly unstoppable unexplained force. Filled with action and spectacle, the film offers an eye-popping experience in a 4K Ultra HD/Blu-ray Combo Pack. The Blu-ray features more than an hour of bonus content including commentary by director Matt Reeves, a making of featurette, deleted scenes, alternate endings and more.
"10 Cloverfield Lane," the 2016 sequel, delivers suspense and memorable performances by John Goodman and Mary Elizabeth Winstead as survivals of a supposed apocalyptic attack. The 4K Ultra HD/Blu-ray Combo Pack includes commentary by director Dan Trachtenberg and producer Abrams, plus seven featurettes exploring the production and its connection to the original "Cloverfield (bonus features on Blu-ray).
Ian McShane, Ray Winstone, and Johnny Harris star in the hard-hitting action-thriller "Jawbone," arriving on DVD, Digital, and On Demand Tuesday Jan. 23 from Lionsgate.
The stakes are high in this poignant tale of friendship, forgiveness, and salvation as former prizefighter Jimmy McCabe, played by Johnny Harris, reenters the ring for the fight of his life. In this engrossing action-thriller, retired prizefighter Jimmy McCabe (Johnny Harris, "RocknRolla") steps back into the ring decades after his stardom as a boxing teen have faded. Jimmy tries to regain his magic by training hard and fighting tough. But to earn real money, he must take part in a savage, unlicensed match that could end his career — and his life. Also starring Ian McShane ("American Gods") and Ray Winstone ("The Departed"), "Jawbone" reveals that our most brutal battles are with ourselves.
With performances and music by The Jam's Paul Weller, the "Jawbone" DVD includes a making-of featurette and will be available for the suggested retail price (SRP) of $19.98.
"A Dog and Pony Show" arrives on DVD, Digital and On Demand Tuesday Jan. 23 from Lionsgate. Starring Mae Whitman, Ralph Macchio and Academy Award winner Mira Sorvino ("Mighty Aphrodite"), this tale of two best friends—a circus dog and a pony—is filled with valuable life lessons. This family comedy tells the story of Dede, a famous performing circus dog who gets left behind when her show leaves town. She's discovered by Billy, a lonely city kid who's just moved to a ranch nearby. Billy decides to adopt the vain and arrogant dog, and brings her to his farm where there are eccentric critters, including a sleep-deprived rooster, a gassy cow, and a hypochondriac horse. Dede has to outwit the bumbling thieves from a rival circus who are plotting to kidnap the priceless pooch.
Approved by the Dove Foundation for all ages, "A Dog and Pony Show" will be available on DVD for the suggested retail price of $19.98.
Kurtis Spieler's spine-chilling "The Devil's Well," on DVD Tuesday Jan. 23 from Wild Eye Releasing.
Karla Marks mysteriously vanishes while conducting a paranormal investigation with her husband into the Devil's Well, an underground location reported to be a gateway straight into hell, and the site of ongoing strange phenomenon. A year after her disappearance, a group of investigators go back to uncover the truth about Karla, and are faced with evil forces greater than they ever imagined.
Winner of the Gold Award at the Spotlight Horror Film Awards, and featuring a superb line-up including Bryan Manley Davis ("Sheep Skin"), Chris Viemeister ("Bridge and Tunnel"), David Alexander ("Thelema the Equinox Diaries"), Kristen Seavey ("Nightwing: Escalation"), and Anne-Marie Mueschke ("Siberia"), "The Devil's Well" is full to the top brick with bloodcurdling chills.
Tags:10 Cloverfield Lane, A Dog and Pony Show, Cloverfield, Ian McShane, J.J. Abrams, Jawbone, Matt Reeves, Mira Sorvino
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GOP After Trump
Coronavirus tests are supposed to be free. Some Texans are still being saddled with large bills.
Congress directed most insurance companies to cover test costs for insured patients in March, and has promised to reimburse providers for testing those who are uninsured. But experts say there are gaps in the protection that can leave patients surprised with bills.
by Shannon Najmabadi May 13, 2020 9 AM
Mark Sonego sought a test for the new coronavirus in March. "I was nervous, like, 'Geez do I have this thing?'" he said. Credit: Robin Jerstad for The Texas Tribune
As the coronavirus spreads across the state, The Texas Tribune is covering the most important health, economic and breaking developments that affect Texans, every day. Watch our Texas unemployment tracker, use our explainer on the coronavirus for essential information, and visit our map tracker for the number of cases, deaths and tests in Texas.
The symptoms hit Pamela Shaw in mid-March. She was coughing and couldn't get enough air. She felt achy. It was unlike any cold or flu she had ever experienced.
Worried, she called a hospital hotline to see if she could get tested for the new coronavirus, and the woman who answered the phone insisted she call an ambulance and go to the emergency room.
All Shaw wanted was a coronavirus test. Instead, she got a battery of screenings to rule it out, she said — and later a bill for at least $1,440.
"It would have been so easy just to give me a test right then," said Shaw, 61, an Elgin resident. "I was there. I was having symptoms."
Tests for the virus, which typically involve a painful swab up the nose, are often advertised as free. Congress directed most insurance companies to cover test costs for insured patients in March and has promised to reimburse providers for testing those who are uninsured.
But experts say there are gaps in the protection, including for people like Shaw, who sought a test early in the pandemic, or those who went to a doctor and left without being screened for the virus. Not only could they be on the hook for the cost of the visit, like a co-pay or emergency room facility fee, but also any diagnostic procedures used to check for ailments besides COVID-19.
With a nationwide shortage of test supplies, clinicians have been encouraged to rule out illnesses, like the flu, before testing for the coronavirus.
That's what happened to Shaw.
When she arrived at St. David's hospital in North Austin on March 17, she was whisked into the emergency room, where she got a flu test, an X-ray of her lungs and an electrocardiogram, or EKG, to check her heart, she said. Her test came back negative and her scans were normal, but the doctor told her she couldn't get a coronavirus test and discharged her with several prescriptions, she said. Shaw spent the next 10 days recovering and wondering what a coronavirus test would have shown.
She received one bill for physician services that says she owes $1,370 for the emergency department visit and $72 for the EKG. Her online claims show the ambulance and medical facility, both in network, charged $2,736 and $10,583, respectively; the insurance plan paid $982 and $173, and she may owe $246 and $2,458.
"The whole uncertainty of it is stressful," Shaw said. "I mean there's already enough stress."
Contacted by a Texas Tribune reporter for comment, UnitedHealthcare, Shaw's insurance company, said it would be "reprocessing these COVID-19 related claims under her plan" based on changes it made in March, which include "retroactively waiving cost share back to early 2020."
Ken Mitchell, chief medical officer for St. David's HealthCare, said given Shaw's "medical assessment and improvement in symptoms while at the hospital, she did not meet the criteria for testing," which at the time was very limited and being administered by the local health authority with direction from the Centers for Disease Control and Prevention.
Read the full statement from St. David's HealthCare.
(38.9 KB) DOWNLOAD
Patients confused
The protections passed by Congress prevent testing costs for most people, and some insurers have said they'll cover more services than required by the legislation. But health insurance experts say patients are facing a disjointed health care bureaucracy made even more complicated by the changing guidance and the limited availability of tests.
Under recent legislation, the steps a doctor takes to rule out the coronavirus — from blood tests to listening to a patient's heart — should be covered if a COVID-19 screening is also ordered, said Sabrina Corlette, founder of the Center on Health Insurance Reforms at Georgetown University.
"That's the good news. The bad news is that if you get all those services but a COVID test is not ordered or administered, then none of it's required to be covered," she said.
It's a situation many people may have found themselves in, particularly early in the pandemic, as lack of testing capacity meant some patients with COVID-like symptoms were denied tests and guided to isolate at home unless their condition worsened, Corlette said.
The fast-moving directives can leave patients confused about what they owe.
Take Mark Sonego. The same week he was furloughed from his job in furniture sales, he called his doctor, wheezing and feverish. The doctor's office was closed, and the woman who answered the phone told him to go to a San Antonio emergency room and urgent care center, where he had his nose and throat swabbed and a CAT scan taken.
"I was nervous, like, 'Geez do I have this thing?'" Sonego said.
The doctor said he had bronchitis and didn't test him for the coronavirus. He paid $379, but this month got an explanation of benefits from his insurance that says he may owe $6,331 after discounts and reductions. That includes a $495 deductible or copay on the CAT scan.
"Back on March 22, there weren't many options; I didn't know where to go," Sonego said.
But after being contacted by a reporter, the medical facility he went to said Sonego should, in fact, owe nothing.
The facility expects his insurance to adjust the claim based on the recent legislation and has issued him a refund.
"The amount billed to insurance was in accordance with fair health standards," the statement from Spectrum Healthcare says.
Read the full statement from Spectrum Healthcare.
The insurer, Blue Cross and Blue Shield of Texas, said it does not comment on individual members' cases out of respect for their privacy.
"We understand how freestanding emergency room (FSER) charges for services can be costly and frustrating for patients," a spokesperson, Laura Tolley, said in a statement. "Our members and patients shouldn't have to worry about a surprise bill, particularly during an emergency."
Read the full statement from Blue Cross and Blue Shield of Texas.
Patients who think they have been incorrectly billed can file appeals or call their insurers to find out what's covered.
"Going to be mistakes made"
There is no guaranteed protection for those screened for the virus before federal legislation was enacted March 18, though some insurers volunteered to cover the cost of testing in early March. Short-term or other bare-bones insurance plans have been urged to cover testing costs but are still not required to. And patients who are tested out of their insurance networks may receive balance bills — or the difference between what the provider charges and the insurer pays.
Stacey Pogue, a senior policy analyst at the Center for Public Policy Priorities, a left-leaning think tank, said patients might receive bills due simply to human error in responding to quickly changing directives during a global pandemic.
"There's just going to be mistakes made, there's going to be COVID tests administered that were coded wrong … and there's going to be insurers that changed their policy but did not process a medical bill or claim correctly," said Pogue, who focuses on health policy issues. And "just because your insurance company by law is required to cover it with no cost sharing, there is nothing that prohibits the provider from sending you a bill and asking you to pay up front."
Tamara Stephney estimates she's already paid several hundred dollars since she began to feel ill in late March. In quick succession, Stephney's daughter, two sons and the girlfriend of one of her sons — all adults who lived with her in Dallas — also became feverish and sick.
Stephney was eager to get tested, and not just because one of her kids sleeps in the same room as she does. She helps lead an organization that offers health care to people with HIV, an immunocompromised population that would be particularly vulnerable to the virus.
"I needed to know unequivocally that I either had it or I didn't," Stephney said.
Her daughter, who tested positive, was able to get screened at a site offering free tests to people with symptoms. Stephney, who didn't have a fever, was turned away.
But she felt sure she had the virus. It was like someone was sitting on her chest. She had no sense of smell. Walking to the mailbox down the street left her winded. It was debilitating and scary for Stephney, who was used to working out vigorously with cardio and weights three days a week.
Ultimately, she found an out-of-network doctor who gave her a flu test and a coronavirus test that came back positive, she said. It cost some $300, after the office visit, medications and a chest X-ray she got when her symptoms didn't improve, she said.
"One of my concerns is just … who's supposed to be responsible for these medical bills? I've already spent $100 on that one visit. The other bills haven't started rolling in yet, but they will," Stephney said. "I understand why they wanted to rule out the other things, but I just wanted the COVID test."
It "burned a hole in my pocket"
In one respect, Shaw, Sonego and Stephney are fortunate: They have health insurance. In Texas, there are approximately 5 million residents without it, amounting to 18% of the population, the highest uninsured rate of any state.
The federal government is reimbursing some medical providers for testing or treating those without insurance. But it's unclear how patients can get their money back if they were tested in February, March or most of April, before the reimbursement program was announced.
Texas officials also requested Medicaid funding to cover uninsured patients' doctor visits associated with COVID-19 testing. It had not been approved as of Monday.
These measures could help a patient like Hannah Nichols, who does not have health insurance and came down with a fever several weeks ago. Her employer, a home improvement store, told her she would need to be tested before returning to work, and she said she went to Austin Regional Clinic in April and was billed $222 for a coronavirus screening. Now, she's not sure if she'll get her money back.
It "really burned a hole in my pocket," Nichols said. A spokesperson for the clinic said it is enrolling in a provider relief program and "will reach out to our patients who have reimbursable claims to provide refunds or waive charges."
There are other ways to get free tests, but they can be hard to find or to access.
The federal government is reimbursing providers for testing uninsured people through a national disaster medical system.
There are also free government-supplied testing sites scattered across the state. But due to the short supply of tests, especially in March, the sites prioritized people with symptoms and are limited to those able to drive to one of the designated locations.
"Just immense uncertainty"
Coronavirus expenses are not just a concern for patients.
A consulting firm hired by America's Health Insurance Plans, a trade association, found COVID-19 testing and treatment could cost insurers $56 billion to $556 billion over the next two years. There isn't legislation requiring insurers to cover coronavirus treatment with no out-of-pocket costs to patients. But some have promised to waive copays and deductibles, and the federal government has tried to protect patients from being balance billed for their care.
Jamie Dudensing, chief executive officer of the Texas Association of Health Plans, said the test costs could become expensive.
"What happens when someone needs to test every day?" Dudensing asked, referring to workplaces that might require it for employees.
Premiums may rise as a result, with one March estimate out of California projecting they could increase more than 40% in the absence of federal action.
For those without insurance, Congress has sent health care providers relief funds that are supposed to be used, in part, to pay for the cost of treating the uninsured.
Wendy Netter Epstein, a law professor and faculty director of DePaul University's Jaharis Health Law Institute, said there's little clarity about how much of the funds will be dedicated to it.
"From a provider perspective, there's just immense uncertainty," she said.
Disclosure: The Texas Association of Health Plans and the Center for Public Policy Priorities have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.
Texans still clamoring for coronavirus tests as state promises availability will skyrocket
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Coronavirus test results in Texas are taking up to 10 days