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You may choose to sync certain our Services with information from other financial accounts. To sync your financial account information, we must access your online account with your financial institution. We will request your user name, password, and any other login data that you have set up with your financial institution to enable access. We use this information to update and maintain the account information you download, to assist with the download process, and to enhance the Services we may provide in the future.
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In accordance with applicable law, Tristan CPA and our service providers may use commonly-used tools to recognize your visit and track your interactions with our Services such as cookies, web beacons, pixels, local shared objects, and similar technologies (collectively, "Cookies"). Sometimes this tracking is necessary in order for us to provide you the Service you requested. Other times, we combine Usage Data collected from Cookies with that of other customers to improve your and other customers' experience. You have control over some of the Usage Data we collect from Cookies and how we use it. Information on changing your browser settings to opt out of Cookies can be found in your browser settings. If you opt-out and later delete your Cookies, use a different browser, or buy a new computer, you may need to renew your opt-out choices.
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b) Your Access Rights. As required by applicable law, you may contact us to confirm whether we maintain, or process on behalf of a third party, any of your Personal Information and to review it in order to verify its accuracy and the lawfulness of our processing of such Personal Information. Where you have determined that the Personal Information we collected about you is inaccurate or processed in violation of applicable law, you may also request that your Personal Information be corrected, amended, or deleted. Requests for access to your Personal Information and to have it corrected, amended, or deleted should be sent to info@tristancpa.com.
a) Constantly work to update our security practices to implement accepted best methods to protect your Personal Information, and review our security procedures carefully.
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In accordance with and as permitted by applicable law and regulations, we reserve the right to transfer your information, process and store it outside your country of residence to wherever we or our third party service providers operate.
7. HOW TO CONTACT US. If you have questions or comments about this Privacy Statement, please contact us. We want your feedback and comments.
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9. COLLECTION AND USE OF CHILDREN'S PERSONAL INFORMATION. We do not knowingly collect information from minors.
Our services are intended for and directed to adults. Our Services are not directed to minors and we do not knowingly collect Personal Information from minors.


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Tag: Al Lewis
Does ICD-10 Delay Create an Easy Opportunity for Coding Improvement?
Feb 16, 2012 • 4
By Al Lewis
Implementation of ICD-10s has been delayed "indefinitely." Rather than opine on whether that's a good thing or a bad thing, I will note that it creates an opportunity for a simple but powerful improvement in the value of the coding.
Caveat: I am not a coding expert (I don't even play one on TV) so there might be something wrong with this idea. The specific reason for the post is to find out whether there is some reason this can't be done, given the value of doing it. (I am so unfamiliar with coding that it is possible this is already being done and I'm the last guy to find out about it, in which case perhaps John and Matthew would be kind enough to remove it.)
Quite simply, how about adding an optional "R" for "rule-out" after the codes? For instance, today if a patient gets tested for diabetes and it turns out that he HAS diabetes, he gets coded "250" in the ICD-9s. Whereas if it turns out the patient does NOT have diabetes, he still gets coded "250." My proposal would code that (in ICD-9s) 250R.
By contrast, giving two opposite diagnoses the same code creates a cascading set of problems, in outcomes measurement, risk scoring, registries, disease management, reimbursement, and predictive modeling, problems that will be exacerbated as risk shifts down to the provider level and payors move to outcomes-based reimbursement.
Newt Gingrich Reveals His Inner Democrat
Jan 22, 2012 • 8
Perhaps Newt Gingrich's book Saving Lives & Saving Money has been quietly redacted of a few lines since its original 2003 printing, because otherwise a simple read of the copies now in circulation would find a blueprint for Obamacare just like the first printing did. I dusted off my old, autographed, copy and re-read it, and am providing some highlights for THCB readers.
Much of the book does propose market-based solutions, such as the use of disease management programs to "dramatically improve outcomes." However, the book also calls for bigger government, in the form of (1) drug coverage for seniors (since passed) and (2) a "tripling" of the National Science Foundation budget.
In addition to those two specific calls for increased government spending, the first printing contains language that might comfort Don Berwick more than Fox News, and not just because Dr. Berwick gets favorably mentioned twice.
Some samples:
P. 31: "The number of uninsured in America is a threat to our civilization."
P. 54 "Don Berwick[has] pioneered the translation of the teachings of quality experts such as Edwards Deming and Joseph Juran to the healthcare profession."
P 59 "It is justified to mandate the use of electronic systems to drag the medical system into the 21st century."
Reports of the Death of Disease Management Are Greatly Exaggerated
Jan 19, 2012 • 17
There have been unsavory rumors flying around the internet that disease management as practiced today may not be all that effective. I'm not going to reveal who started these rumors but her name rhymes with Archelle Georgiou. This person says disease management is "dead." Since there are still many disease management departments operating around the country apparently oblivious to their demise (and disease management departments are people too, you know), I suspect this commentator was using the word "dead" figuratively, as in: "The second he forgot the third cabinet department, Rick Perry was dead." (Another example of presumably figurative speech in the death category would be: "After he denounced gays while wearing the Brokeback Mountain jacket, you could stick a fork in him.")
And if the rhymes-with-Archelle commentator intends "dead" as a synonym for "not in very good shape," she certainly has a point. Not only does she have a point, but I would add more items to her list of reasons for the field's current troubles:
(1) The interval between diagnosis (the point where readiness to change is usually greatest) and successful patient contact can exceed three months;
(2) Predictive modeling "risk scores" that tell you only how sick someone was, dressed up as a "risk score," not how sick they will be, even though they aren't already high utilizers;
(3) Some interventions are so expensive that they exceed the cost of the disease;
Real Reform For Medicare Advantage
Medicare Advantage (MA) is stuck in a cycle in which the government wants to micromanage MA plans and cut their reimbursement to satisfy deficit hawks, while the health plan industry lobbies for exactly the opposite. The result is a negative-sum game, a stalemate that benefits nobody.
It turns out that this stalemate would be remarkably easy to overcome, in a way that makes money for the government, gives seniors a visibly better deal, reinvigorates the Medicare ACO, and entices many more members into MA. Since MA plans are held to quality standards far beyond what Medicare fee-for-service requires (remember, straight Medicare is a payment system, not an insurance plan), I am going to assert that the increasingly popular MA plan option – especially plans with high Star ratings – provides better care coordination for seniors than fee-for-service (FFS). The government recognizes this implicitly by initiating Medicare ACOs. ACOs are supposed to close that care coordination gap in FFS but it does not look like that is going to happen on a broad scale in the near future.
If one accepts the premise that more care coordination is a worthy goal, here's a better way of addressing that care coordination gap by getting more seniors into MA, rather than by setting up a parallel universe of ACOs…and do it in a way that clearly saves money for the government and seniors.
Start with the recognition that most 64-year-olds are already in an HMO or PPO. Today's sign-up procedure for Medicare acts as though neither innovation exists. A senior becomes eligible for Medicare and then (in competitive markets) gets deluged with offers to join one or another MA plan, which requires switching out of FFS — a model that, while called "traditional," is totally unfamiliar to patients coming out of commercial HMOs. These enticements to seniors are quite costly for the health plans, involving brokers, salespeople, advertising etc.
How about a system in which MA becomes an opt-out instead of an opt-in for 65-year-olds, meaning people would automatically start receiving their Medicare benefit through a health plan instead of FFS? As you read what follows, assume that MA would still be totally voluntary and that people who want the old-fashioned FFS can simply opt into it.Continue reading…
My Own Story of ALS
I would like to introduce our newest regular contributor, Al Lewis. Some of you might recall him from his guest-postings, sometimes offensive, usually controversial but always based on both fifth-grade arithmetic and principles of economics, two subjects that he respectively took in fifth grade and taught for two years at Harvard.
Al is asking for a tiny bit of help from us, which is to go to his ALS site and "like" it and maybe add a facebook comment. He is trying to get CMG Marketing (the official licensing contractor for Major League Baseball) to sell Lou Gehrig jerseys to raise money and awareness for ALS. Increasing the popularity of that site increases the likelihood of his getting CMG's attention with his fundraising idea. – Matthew Holt
It occurred to me that I have yet to post my own story in detail, and some of you asked me to do that after seeing my wedding photo.
Janet and I had dated for a while, and though we had broken up, we had become more like "besties" when she started to feel that something was amiss. I (and other close friends) took her to several doctors to try to discern what was wrong. I know many of you experienced the same thing with your loved ones, where you had to visit multiple doctors before getting a diagnosis. Then came the day — and no doubt you had a similar day too — when you finally get the definitive diagnosis. The Mass General neurologist, Dr. Cros, had very thoughtfully scheduled this visit as the last one of the day, so that the four of us there could be in his office into the evening, asking questions, holding back tears, cross-examining him to make sure we hadn't overlooked any possibility for treatment, even something in early-stage clinical trials, with mice even.
After that, we went about our lives. Of course I continued to be supportive as best friends would be. But I couldn't stand to watch her deteriorate in front of me like this. At one point her condition had declined so much that at her health club (Mt. Auburn) where she had been a member of for 20 years, someone asked what was wrong. About a day after I told the person at the front desk, the manager wrote back and said he was going to comp her membership for the rest of her life.Continue reading...
Time for Toto to Pull the Curtain Away from Patient-Centered Medical Homes
Apr 8, 2011 • 23
Patient-Centered Medical Homes in statewide populations have unstoppable momentum and major constituencies in support of them, so valid analysis of their outcomes is probably as futile as it will be unwelcome. However, the math speaks for itself, at least in the mother of all statewide medical homes, North Carolina Medicaid's Community Care Access Model.
I write this after having analyzed the actual data from this project's outcomes report, rather than the stated conclusion of the report, a conclusion that continues to be cited in support of the many states considering or implementing medical home models for their Medicaid populations.
The conclusion makes North Carolina looks like a huge win for PCMH: $300-million in reported savings. However, readers should have (but largely didn't) observe a number of curiosities about the data in support of that conclusion:
(1) Every element of resource use declined. People have to be getting their care from somewhere, but inpatient, ER, outpatient, physician, drug, and other expenses somehow all declined vs. trend.
(2) The decline in physician practice expense is especially counterintuitive: Why are the doctors so supportive if they are working harder but making less money?
(3) Even though somehow savings were shown in physician expense, per capita doctor visits did indeed increase. More concerning was that specialist visits –which are supposed to decline in a PCMH model – also increased.
(4) Inpatient expense fell 47%. This was achieved despite the fact that all the AHRQ's "Ambulatory Care –Sensitive Conditions" total to about 20% of admissions in most populations.
(5) The evaluators (William M. Mercer) are on record as saying that "choice [emphasis mine] of trend has a large impact on estimates of financial savings." Perhaps it is possible that Mercer, having given themselves this latitude, "chose" a trend that would make the study look good.
Those observations merely suggest that the study was done wrong. But one other "finding" invalidates the entire study: the 54% reduction in spending on babies under one year of age, accounting for the majority of the entire $300-milllion in spending. (Any nontrivial savings whatsoever in this category should have raised eyebrows since PCMH is mostly about managing chronically ill patients.) The components of spending in that category include physician expense, which should rise since doctors get paid more to be more accessible, and drug expense, which should rise for the same reason. This means that the entire 54% savings across the category must be concentrated in neonatal expense. Since neonatal expense is about half of total spending in the age category, it would have to decline by a mathematically impossible 100%+ in order for the category to average a 54% reduction.Continue reading…
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redpajama_set_name: RedPajamaCommonCrawl


A very personal story about her relationships including one with a young Haitian boy named Piti. A teenager when Julia and her husband, Bill, first met him in 2001, Piti crossed the border into the Dominican Republic to find work. Julia, impressed by his courage, charmed by his smile, has over the years come to think of him as a son, even promising to be at his wedding someday. When Piti calls in 2009, Julia's promise is tested.
Told with abundant humor and heart, Julia Alvarez's new Tia Lola story is the long-awaited sequel to How Tia Lola Came to Visit/Stay.
A powerful story that examines the special bond between mothers and daughters as it brings to life the story of Salome Urena, a memorable patriotic Dominican Republic Poet.
Julia Alvarez brings together 24 essays of rich and vivid recollections of her childhood and early adult years. They encompass her beginnings as a writer, the progress and her identity as a writer.
This is a story within a story of life's lessons and a search for identity. It is a humorous and creative tale of family life and the do's and don'ts of a novelist.


Last week, Mayor Landrieu and Sheriff Gusman announced their intent to add an additional building to the planned construction of the new jail - a move that violates both a 2011 City Council ordinance and the public's trust. As our elected officials surely remember, that ordinance, which passed unanimously in City Council with an outpouring of public support, limits the number of beds in the new jail facility to 1,438. As members of the Orleans Parish Prison Reform Coalition (OPPRC) we oppose the building of any additional jail beds beyond the agreed-upon 1,438 cap. To increase the size of the jail at this moment would not only be a blatant disregard of the democratic process, it would be a capitulation to the kind of racialized fear-mongering that has held this city hostage for far too long.
To be clear: the rate at which the city of New Orleans incarcerates is astronomically higher than any other place on earth. To fill a 1,438 bed jail, New Orleans would still need to incarcerate at a rate of double the national average in a country widely agreed to suffer from a crisis of over-incarceration. Although the city is proposing to use FEMA dollars to build the additional facility, the cost of maintaining it indefinitely into the future is one that will fall on taxpayers for generations to come.
Not only is incarceration at these rates unnecessary and costly to the city, it is also dangerous. In a report released on August 29th, the Metropolitan Crime Commission used a current population snapshot to suggest that the new jail will need to be at least 2,200 beds to serve New Orleans' needs. By treating the size of the prisoner population as fixed, the report forecloses meaningful discussion of reforming the wasteful and inhumane practices that drive up the population. Moreover, the report implies that the population currently incarcerated in Orleans Parish Prison (OPP) is made up primarily of violent offenders who, if released, would be a danger to public safety. This is absolutely and unequivocally false. In reality, the vast majority of OPP prisoners are pre-trial detainees who have not yet been convicted of any crime. Of those, many are charged with minor offenses such as drug possession. To paint young men convicted of marijuana possession as rapists and murderers is a deception that is not simply irresponsible: it costs lives.
Our city continues to incarcerate people not based on any danger they pose to the community, but based on their inability to pay bond. This leads to the disproportionate incarceration of poor people of color. About 84 percent of those incarcerated in New Orleans are African Americans. The average length of time spent waiting for trial is 69 days for African Americans and 38 days for whites.
It is long past time our city's governing officials committed to implementing the reforms needed to responsibly address the current crisis. While the current population at OPP is greater than the 1,438 projected by expert researchers during the planning of new construction, this in no way an indication that we need a bigger jail. Rather, it is a reminder that our city's criminal justice agencies must be held accountable to implementing policies that will reduce the jail population and increase public safety. Instead of considering the construction of new jail facilities, we urge the Mayor and City Council to consider the current practices of the courts, police, and District Attorney, and to make policy changes that promote pretrial release, diversion, and treatment over arrest and incarceration. We demand that the city fully fund the Pretrial Services program and that our judges be held accountable to making use of that program to make responsible and safe bond decisions. We also urge the city to invest in community-based treatment for people struggling with substance use and mental health issues, rather than building more jail beds for them.
We understand that the road to meaningful reform is long and hard, but we must begin the journey in earnest. Building a larger jail will not solve our city's problems. Let's start to talk about what will. As a contribution to that conversation, OPPRC plans to issue an open letter to Mitch Landrieu later this week.


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William Horace (Bill) Temple (28 November 1898 –  9 April 1988), nicknamed "Temperance Bill" or "Temperance Willie",  was a Canadian democratic socialist politician, trade union activist, businessman and temperance crusader. As a youth he worked for the railway. During World War I, and World War II he was a soldier in the  Royal Naval Air Service and the Royal Canadian Air Force. Between the wars, he was a salesman, and then he started a clothing import business. He became a socialist during this period, and joined the Co-operative Commonwealth Federation (CCF) when it was formed. He ran for political office many times for the CCF, both federally and provincially. The highlight of his political career was in 1948, when he defeated the incumbent premier of Ontario George Drew in his own legislative seat, in the electoral district of High Park, even though the premier's party won  the general election with a majority government. His tenure was relatively short, serving only one term, and was defeated in the 1951 provincial election, and went back into the clothing import business. In his later years, he successfully led the political fight to maintain the prohibition on selling alcohol in a section of Toronto's west end, winning three referendums in the 1960s, 1970s and 1980s. He died in the spring of 1988, a few months before another referendum on lifting the restrictions on alcohol in the area was again defeated, his "last" victory.

Early life
Temple was born in Montreal in 1898, and was one of five children. His father was a railway conductor, and the family moved with him to Toronto in 1909. After completing grade 8, due in part to his father's alcoholism, he took a job as an office boy with the Grand Trunk Railway for $5 a week.

Military career
At the age of 17 Temple went to fight  in World War I, joining the Royal Navy Air Service as a fighter pilot before transferring to the Royal Air Force, where he destroyed three Royal Air Force planes and no enemy ones.  In 1942, during World War II, he was a flying officer on intelligence operations for the Royal Canadian Air Force stationed in Sydney, Nova Scotia and Gander, Newfoundland.

Young adulthood
After World War I, Temple was treated as a war hero by his employer. The Arrow Shirt Company president met Temple's train in Montreal, where he promoted him to travelling salesman for the company's Winnipeg office.

It was in Winnipeg where Temple – who had been a staunch Conservative, supporting Prime Ministers Sir Robert Borden and Arthur Meighan – was captivated by the speeches of local socialist clergyman and politician J. S. Woodsworth, and became a socialist in 1921.  Temple would regularly encounter Woodsworth, then a member of parliament in Ottawa, on train trips for his sales job. Arrow moved him and his wife Mary Temple to Regina, Saskatchewan where he met Major James Coldwell, who at the time, was the principal at the school that she taught at. Coldwell was the leader of the Independent Labour party (ILP), and Temple would drive him to political rallies and events during this period.  Another important socialist figure that he met at this time, was Clarence Fines, an assistant principal at Coldwell's school. They would go door-to-door to raise money for the ILP.  Fines would later become the finance minister in Tommy Douglas's Saskatchewan government during the 1940s and 1950s. Temple joined the Co-operative Commonwealth Federation (CCF) when it was formed by Woodsworth and his followers in 1932.

Great Depression
When Temple was transferred by Arrow to Kitchener, Ontario in 1933, he became president of the local CCF organization.  His employer disapproved of Temple's socialist activism and told him to choose between politics and his job. Temple chose politics, putting himself out of work when the Depression was at its worst. Temple borrowed $5,000 from his sister and went to England, where he obtained samples of cashmere sweaters, Dack slacks and Burberry coats, and returned to Canada to find retail outlets. His import business continued until the war, when he enlisted in the RCAF.

Political career
In 1943, Flying Officer Temple, took leave, to become the Ontario CCF's candidate in the west-end Toronto constituency of High Park in the provincial election. He was narrowly defeated by George Drew, leader of the Ontario Progressive Conservative Party, by a mere 400 votes. Drew became Premier of Ontario as a result of the election.

Temple ran in the June 1945 federal election as the CCF candidate in High Park. He placed third. Undeterred by his previous electoral defeats, he ran again in the High Park constituency,  this time at the provincial level, in the 1948 Ontario election. Temple castigated Drew for softening Ontario's liquor laws, claiming the Premier was the captive of "liquor interests" due to the government's decision to allow liquor sales in cocktail bars.  While Drew's party swept to victory across the province, Drew himself was defeated by Temple, and decided to resign as premier and move to federal politics.

He continued to hound Drew after being elected. In the fall of 1948, Drew become the leader of the federal Progressive Conservatives. He needed a seat in the federal parliament and contested a by-election in the Ottawa-area electoral district of Carleton in order to win a seat in the House of Commons.  The federal Co-operative Commonwealth Federation (CCF) was determined to defeat him, so they ran Eugene Forsey as their candidate.  Temple was brought up from Toronto to appear at a political meeting in Richmond, Ontario's Town Hall, where Forsey and Drew were speaking. He accused the Tory leader of being "a tool of the liquor interests" and also made suggestions about Drew's sobriety.  Throughout the evening Drew grew more red-faced and explosive, every time Temple spoke. Finally, after Drew misheard Temple calling him dishonest, the two men were restrained before they could come to physical blows with each other.  A riot was barely averted, and the meeting had to be terminated. However, on 20 December 1948 Drew soundly defeated Forsey, and went on to sit in Parliament.

As a Member of Provincial Parliament (MPP), Temple fought for temperance and for housing for World War II veterans.  He was elected CCF Caucus chairman shortly after he defeated Premier Drew. His temperance crusades in the legislature put him at odds with the party establishment, including national secretary, David Lewis. The following year, he was not re-elected Caucus Chairman. Temple remained in the Ontario legislature until his defeat in the 1951 election. After his defeat, he returned to the clothing import business until his retirement in the late 1960s.

Temple remained an activist in the CCF. In the early 1950s he was a leader of the "Ginger Group", a group of dissident CCFers who argued that the party's poor performance in the 1951 provincial election was due to the party moving away from taking clear socialist stands on issues and instead focussing too much on organizational issues. The group opposed what they saw as the "bureaucratization" of the CCF with salaried organizers and a greater emphasis on fundraising taking the place of grassroots volunteers and political education and discussion. Temple and his supporters also argued that power was being increasingly concentrated in the hands of the party executive instead of the grassroots resulting in the squelching of democratic discussion and grassroots policy development and sought to rectify this by curtailing the powers of the provincial secretary. On 12 April 1952, at the 18th annual provincial convention, Temple nearly ran for leader against Ted Jolliffe but withdrew at the last minute allowing Jolliffe to be acclaimed. Temple then ran for party president against establishment candidate Ted Isley, but was defeated 112 to 85. Temple and one other member of the Ginger Group, True Davidson, were then subsequently elected to the executive as vice-presidents.

He remained a member of the CCF's successor, the Ontario New Democratic Party, for much of his life but resigned from the NDP in 1987, stating that he "cannot possibly accept the liquor policy of the party."

Temperance crusader
He acquired the nickname "Temperance Willie" while serving in the RCAF. His anti-liquor attitudes formed in his early years as a result of his father's alcoholism as well as his Methodist upbringing and experiences in the military. He admitted to having a few drinks during World War I, "Of course I've had a drink, you cannot go through two world wars without taking a drink," he told the Globe and Mail but added "I think I had a few on Nov. 11, 1918, but I don't really remember having any since."

After his political defeat, he remained active in West Toronto where he founded the Inter-Church Temperance League. When the community joined the city of Toronto in 1909, it did so on condition of remaining a "dry" district where alcohol sales were prohibited, as they had been since 1904. Temple and his Temperance League fought for half a century to maintain that regulation despite attempts by the city to reverse it. Over the years, several plebiscites were held on allowing alcohol sales, and Temple and his supporters successfully fought against permitting alcohol sales in referendums held in 1966, 1972, 1984. He died several months before a 1988 plebiscite, but had already begun the campaign, and his supporters credited him with their victory. It was not until after Temple's death that neighbourhoods in the area finally voted to allow alcohol sales beginning in 1994 in the St. Clair West area, and ending in The Junction in 2000, when the last dry region in west Toronto became wet.

Trade unionism
Temple was also a supporter of trade union rights throughout his life, and walked on countless picket lines. In the fall of 1973, during a strike by the independent Canadian Textile and Chemical Union at Artistic Woodworking in North York, while on the picket line, he was arrested and charged with assaulting a police officer. When Temple's case was brought to trial, the officer who had allegedly been assaulted (who was twice Temple's size and more than half his age) claimed in testimony that he had smelled alcohol on Temple's breath. This caused more offence to Temple than the claim that he had committed an assault, and a long series of character witnesses testified that Temple had never consumed anything stronger than ginger ale as long as they had known him. The charges were dismissed.

Religion
Temple was raised a Methodist and was a member of the United Church of Canada, where he attended every Sunday, although in the latter years of his life he said his religious views were probably closer to the Unitarian Church.

Personal life
Temple was predeceased by his son, William Price Temple; who was hospitalized for over four months, in and out of a coma, and finally succumbed to an undiagnosed brain-disease on 21 August 1956. His wife, Mary Temple, served for a period as an alderman on the Toronto City Council for Ward 7 from 1959 to 1969, and had previously served as a school trustee for the ward.  She also served as Chair of the Toronto School Board in the 1950s.

Temple died on 9 April 1988, at the Queensway General Hospital, after a short illness at the age of 89.

References

Footnotes

Bibliography

1898 births
1988 deaths
Canadian socialists
Canadian Christian socialists
Ontario Co-operative Commonwealth Federation MPPs
20th-century Canadian politicians
Canadian temperance activists
Trade unionists from Ontario
Methodist socialists

redpajama_set_name: RedPajamaWikipedia


text:
Tag: FDA
FDA Releases Updated Working Model for Software Precertification Program
The U.S. Food and Drug Administration (FDA) recently released "A Working Model v.1.0" for its Software Precertification Program, which is aimed at organizations that design, test and monitor software products used for medical purposes ("Software as Medical Device" or "SaMD" products). The goal of the Software Precertification Program is to encourage innovation in digital health technologies by streamlining regulatory approaches while ensuring patient safety and device effectiveness.
Continue reading "FDA Releases Updated Working Model for Software Precertification Program"
Written by: Svetlana Lyapustina
Tags: digital health, FDA, Medical Devices, pharmaceutical, Software Precertification Program
FDA Expands Big Data Use with Sentinel System
The U.S. Food and Drug Administration (FDA) is increasing its capability to harness the power of big data – or more specifically of the "real world evidence" (RWE) – to assess the safety of medical products that are approved for the U.S. market. To that end, FDA is expanding its Sentinel System so that by the end of 2023 it would represent "a transformative, multi-purpose national data and scientific resource center for evidence generation that a wide array of stakeholders use to inform all aspects of healthcare decision making," according to the recently released Sentinel System Five-Year Strategy.
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Category: Health Care, Pharma/Life Sciences
Tags: Big Data, data mining, FDA, machine learning, patient privacy, Sentinel System
New Handbook Provides Guidance to Healthcare Delivery Organizations on Preparation and Response to Medical Device Cybersecurity Incidents
Recently, the MITRE Corporation, in collaboration with the U.S. Food and Drug Administration (FDA), announced the release of the Medical Device Cybersecurity Regional Incident Preparedness and Response Playbook. The Playbook was designed to provide "tools, references, and resources" for Healthcare Delivery Organizations (HDOs) to better prepare for and respond to medical device cybersecurity incidents.
Continue reading "New Handbook Provides Guidance to Healthcare Delivery Organizations on Preparation and Response to Medical Device Cybersecurity Incidents"
Written by: Peter Baldwin
Category: Health Care, Privacy
Tags: cyberattack, cybersecurity, FDA, HDO, Healthcare Delivery Organizations, medical device
US FDA Approaches to Artificial Intelligence
Artificial Intelligence (AI) can be employed in a health care setting for a variety of tasks, from managing electronic health records at a hospital, to market research at a benefits management organization, to optimizing manufacturing operations at a pharmaceutical company. The level of regulatory scrutiny of such systems depends on their intended use and associated risks.
In the U.S., for medical devices using AI, one of the key regulatory bodies is the Food and Drug Administration (FDA), especially its Center for Devices and Radiological Health (CDRH). CDRH has long followed a risk-based approach in its regulatory policies, and has officially recognized ISO Standard 14971 "Application of Risk Management to Medical Devices." That standard is over 10 years old now, and therefore is currently undergoing revisions – some of which are meant to address challenges posed by AI and other digital tools that are flooding the medical-devices arena.
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Tags: AAMI, AI, American Association of Medical Instrumentation, artificial intelligence, British Standards Institute, BSI, CDRH, Centers for Devices and Radiological Health, FDA, Federal Trade Commission, FTC, ICH, IMDRF, International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use, International Medical Device Regulators Forum, International Organization for Standardization, ISO, National Institute of Standards and Technology, National Science Foundation, NIST, NSF
FDA Approves Software Application That Alerts Providers of Potential Stroke in Patients
On February 13, 2018 FDA approved a software application with clinical-decision support capability, in this case alerting providers of a potential stroke in patients. The system, "Viz.AI Contact," is developed by a US/Israeli company named Viz.ai, which uses artificial intelligence and machine deep learning for analyzing medical images. Earlier in January, this system also received a CE Mark from the European authorities.
Stroke is caused by an interrupted blood supply to the brain; for example, due to a blood vessel's rupture. Stroke is among leading causes of mortality and long-term disability in the U.S. and other countries. The Viz.AI Contact system analyzes brain computed tomography (CT) scans, identifies a suspected large vessel blockage, and sends a text notification to the health care specialist.
Continue reading "FDA Approves Software Application That Alerts Providers of Potential Stroke in Patients"
Tags: artificial intelligence, FDA, Internet of Things
FDA Approves First Digital Pill
The U.S. Food and Drug Administration has approved the country's first drug with a digital ingestion tracking system.
Abilify MyCite is a pill that digitally tracks whether patients have taken the medication. The pill contains a sensor that, once ingested, sends a message to a patient's wearable patch, which then transmits the information to a smartphone application. This voluntary process allows patients, caregivers, and physicians to track this information through a web-based portal if the patient has given consent. Experts believe that such digital devices could have a positive impact on public health by addressing a longstanding problem; in this case, that patients do not take their medicines as prescribed.
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text:
Francis Riendeau for Les 3 sex*/Infographics by Marion Bertrand-Huot
Article • XX(X) Movies: A Look at Feminist Pornography
Michelle Bergeron Deschênes | étudiante M.A. clinique en sexologie à l'UQAM; Alexandra Fournier | candidate M.A. en sexologie à l'UQAM et Myriam Pomerleau | sexologue et psychothérapeute
The text below is from the Avant-garde magazine from Les 3 sex* published in paper format in april of 2019 and then in electronic format in may of 2019. For more information on the magazine or to get a copy, click here.
☛ Cette chronique est aussi disponible en français [➦].
Translated by Audrey Morabito
Swollen breasts, wet vulvas, panting. Ejaculation. Full mouths, hungry tongues, luscious lips. Ejaculation. Dilated anus, oiled butt cheeks, spanked ass. Ejaculation. On all fours, on your knees, bound. Ejaculation. Teacher, schoolgirl, cowgirl. Cumshot.
Shocking? For most, this scenario is nothing new. Whether we accept it or not, sexuality is slightly coded and stereotypical (Boisvert, 2017). In fact, for the past fifteen years, pornography has been part of the Western sexual norm. That is to say that it has become an important cultural influence in the lives of many in this society (Lavigne, 2009; Paveau, 2014). How does feminist pornography fit into this taboo yet ubiquitous phenomenon? How can the feminine impose itself in a universe created by men and for men (Williams, 1989)?
Straight Mainstream Pornography
Straight mainstream porn looks to sell 'real' sex, as opposed to simulated sexual relationships found on TV. It aims to generate quick arousal responses by showing the "best angles" and the "best positions" so that spectators can see everything (Lavigne, 2009). A lot of emphasis is put on penetration close-ups and the visibility of male ejaculation, as an indication that a sexual act has indeed taken place (Williams, 1989). This means that porn has been built around a very limited sexual script, in which the male orgasm is principal, relegating female pleasure as a mere afterthought. Boisvert (2017) appropriates the concept of the cumshot to the idea that sexual desire is first and foremost something that originates from man to be thrust onto woman. As porn is a cultural scenario prescribing certain sexual acts (Gagnon, 2008), the representation of heterosexual encounters would encourage that female desire stay within the limits of sexual stereotypes (Boivert, 2017).
Regardless of the scenario, this type of pornography constrains its protagonists to their sexual function: it puts foward a sexuality that is stripped of social relationships (Wadbled, 2012).
The proposed script is so rigid that it leaves very little room for spontaneity and for the development of intimacy between the actors (Taormino, 2013a). Everything is orchestrated: actions and reactions interact and are chosen based on the nature, gender and social role assigned to the characters (Wadbled, 2012). Penetration being the ultimate goal of the scene, foreplay intended for female pleasure is usually neglected (Taormino, 2013a). This type of pornography tends to remain indifferent to sexual diversity and is usually limited to heteronormative scripts (Smith, 2015).
What About Feminist Porn?
The feminist movement in pornography responds to the desire of promoting positive female sexuality that transgresses the dominant male system (Kurnet, 2014; Laprade, 2016; Paveau, 2014). It is in the mid 80s that pornographic film actresses like Annie Sprinkle, Veronica Vera, Candida Royalle, Gloria Leonard and Veronica Hart proposed to reclaim and revolutionize the scripts of mainstream straight pornography, in order to create an alternative and feminist genre (Penley et al., 2013). Feminist porn became a critique of the pornography made for men and by men, and a militant act of resistance that seeks to have women regain power over their sexuality (Glick, 2000).
Behind the staging and production of feminist videos, are erotic and political motivations (Lavigne and Le Blanc, 2017). The Feminist Porn Award (Kunert, 2014; Penley et al., 2013) recognizes three criteria for judging the feminist nature of a film:
A women's implication in the creative process
An authentic representation of female pleasure
Challenging the stereotypical representation of sexuality and gender as proposed by mainstream straight porn
Feminist porn therefore becomes a genre that recognizes the existence of a female audience, but also of anyone that does not feel represented in mainstream straight porn (Penley et al., 2013). To do this, it wishes to show sexual scenarios, bodies and erotic experiences that are too often ignored (Lavigne and Le Blanc, 2017) without stigmatizing practices responding to more traditional scripts. Feminist pornography is said to put forth more manifestations of sexual agency than straight mainstream porn (Fritz and Paul, 2017), which in turn contributes to reinventing sexual scripts of passive women into liberated and positive female sexuality (Kunert, 2014). Amongst the other key factors of the genre, great importance is given to consent, desires, chemistry between the actors and actresses, better working conditions as well as the representation of both exciting and educational scenes (Taormino, 2013b). This industry promises women in control of their fantasies, authentic desire, and real female orgasms (Penley et al., 2013).
Ultimately, feminist pornography is a type of critical commentary of an industry originally produced by and for heterosexual men (Kunert, 2014). The objective, however, remains the same: to show real sex that involves showing a specific vision of its multiple expressions and configurations.
The Sex Wars
Until the mid 80s, the feminist movement was largely against pornography (Lavigne, 2014). The dominant discourse maintains that pornography is not only a symbol or an illustration, but the very foundation of female oppression (Segal, 1998; Williams, 1989). In that sense, it is imperative to oppose and censor its different representations (Segal, 1998).
Faced with this position, dissident voices of feminist activists raise the controversial idea that pornography may be, on the contrary, an opportunity to defend the rights of women (Laprade, 2016). This is the beginning of the 'sex wars', in which an ideological gap exists between anti-pornography feminists and anti-censorship feminists (Kunert, 2014). If the desire to "decolonize women's sexuality" (Lavigne, 2014, p.37) is a shared interest by both groups, the means to achieve it are not unanimous.
The Point of View of Anti-Pornography Radical Feminists
The critiques from these feminists are based on the belief that pornography seeks above all to subordinate, objectify and dehumanize women (Dworkin, 1981; MacKinnon, 1985). They see pornography as a representation of coercion and sexual violence which, in the form of propaganda, incites men to use violence against women (Dines, 2010; Dworkin, 1981; MacKinnon, 1985). The words of activist Robin Morgan illustrates this point well: "Pornography is the theory, and rape the practice" (cited in Williams, 1989). Faced with the inherently bad nature of pornography, these feminists try to abolish it through legal means. However, the injunctions submitted to some supreme courts in the United States have been rejected or judged unconstitutional (Bourcier, 2011). In this legislative battle, anti-pornography radical feminists create an unlikely alliance with conservative and religious lobbyists, as their common goal is to condemn and censor pornography using the power of the law (Kunert, 2014).
What do Anti-Censorship Feminists Think?
This movement was first led by lesbians as well as former pornographic film actors (Glick, 2000; Kunert, 2014). For members of the anti-censorship movement (or sex-positive movement), the anti-pornography discourse reinforces the basic concept that female sexuality is "soft", non-violent and stripped of power dynamics, which only has the effect of maintaining stereotypical gender roles that encourage the subordination of women (William, 1989). Expression and creation in pornography are seen as preferable to legal remedies aimed at censorship which only regulate and confine female sexuality more (Segal, 1998; Williams, 1989). This is why they propose showing female pleasure as an alternative way to incite social change (Glick, 2000). They promote sexual scripts that have been rethought and reinterpreted (Kunert, 2014).
Today, the critiques formulated by the Queer movement take certain ideals from the sex-positive movement which aims to reclaim this pornographic genre. Indeed, these critiques invite us to reflect on the symbols, the agency, the performance, and the deconstruction of sexual norms, as well as question the various identity categories (Laprade, 2016). In fact, Judith Butler's works on feminism has inspired feminist pornography in the search for this type of change (Laprade, 2016). According to Butler (2005), it is not possible to free yourself from power, but only possible to destabilize it. According to this theory, the political transformations desired by feminist pornography can only take place in a subversive repetition of the dominant categories of mainstream straight porn. It is in this context, that pornography can aspire to be diverse and offer a better representation of sexuality to sexual subcultures (Lust, 2010).
Is Porn for Women the Same Thing?
Without being mutually exclusive to feminist pornography, pornography for women only responds partially (sometimes not at all) to the criteria for feminist work. In fact, many films identified as "porn for women" are essentially directed and marketed by the same production companies that share the mainstream straight market (Smith, 2015). The films are usually addressed to women and heterosexual couples and show actors and actresses that respond to the habitual codes of the industry, but in a context where the sexual practices are usually less aggressive, more sensual and romantic (Feminist Porn Award, 20118). In those very specific cases, the expression "porn for women" refers to a sub-category of mainstream straight porn (Fritz, 2015), which, rather than varying the representations of female sexuality as does feminist pornography, reaffirms the principles of its most popular form. The expression "porn for women", however, can be used by feminist platforms, hence the confusion and the interchangeable use of both terms.
Let the Pleasure Begin…
Limited to mainstream straight pornography, feminist pornography invites itself to the bedroom. It calls on marginalized communities, but also all of those who don't identify with mainstream straight pornography, to rethink the norms and dominant conventions of the industry. The new directors and actresses argue that it is possible, by repetetively broadcasting new videos, to progress towards a deconstruction of social codes and conventions of mainstream straight pornography. Regardless of its motivations, whether political or erotic, the fact remains that pornography's main essence is to arouse the person who watches it.
Feminist Pornography Sites
By Alexandra Fournier (inspired by: https://feministporn.org)
Afourchamberedheart.com
Located at the crossroads between pornography and art, this independant project aims to explore the aesthetic and conceptual potential of porn.
BrightDesire.com
The original content of producer Ms Naughty, named Indie Porn Icon in 2017, in diverse formats : films, photographs, documentaries, fiction, articles and more.
LustCinema.com
Large selection of films focusing on aesthetics and visual quality. The XConfessions series shares testimonies from members who share their deepest fantasies.
Lustery.com
A platform allowing couples to share their amateur videos. It focuses on emotions and intimacy by showing real partners.
A go to reference in terms of independent genres, this platform proposes one of the largest collections of feminist, indie and queer films.
One of the authors of this text, Alexandra Fournier, is currently recruiting participants for her master's thesis on adult women's experiences with feminist pornography. For all the details click here or contact Alexandra here.
Boisvert, L. (2017). Le principe du cumshot. Les désirs des femmes sous l'emprise des clichés sexuels. Montréal: VLb éditeur.
Bourcier, M.-H. (2011). Queer Zones 3. Identités, cultures et politiques. Paris: Éditions Amsterdam.
Butler, J. (2005). Trouble dans le genre : le féminisme et la subversion de l'identité. Translated by C. Kraus. Paris: Éditions La Découverte.
Dines, G. (2010). Pornland: How Porn Has Hijaclœd Our Sexuality. Boston, MA: Beacon Press.
Dworkin, A. (1981). Pornography: Men Possessing Women. New York, NY: Perigee. Translated by Dufresne, M. (2006). Le pouvoir. Nouvelles Questions Féministes, 18(3), 94-104.
Feminist Porn Award (2018). What is the difference between Feminist, Ethical and Female-Friendly Porn. http://www.feministpornawards.com/what-is-feminist-porn/difference-feminist-ethical-female-friendly-porn/
Fritz, N. (2015). From Cum Shots to Cunnilingus, the agentic and objectifying scripts of feminist and mainstream pornography [Doctoral dissertation, Indiana University].
Fritz, N. and Paul, B. (2017). From orgasms to spanking: A content analysis of the agentic and objectifying sexual scripts in feminist, for women, and Mainstream pornography. Sex Roles: A Journal of Research, 77(9-10), 639-652. DOI 10.1007/s11199-017-0759-6
Gagnon, J. (2008). Les scripts de la sexualité : essais sur les origines culturelles du désir. Paris, FR: Payot.
Glick, E. (2000). Sex Positive: Feminism, Queer Theory, and the Politics of Transgression. Feminist Review, 64, 19-45. DOI 10.1080/014177800338936
Kunert, S. (2014). Les métadiscours pornographiques. Questions de communication, 26, 137-152. https://www.cairn.info/revue-questions-de-communication-2014-2-page-137.htm
Laprade, B. (2016). Des Feminist Sex Wars au matérialisme performatif : relecture de la pornographie et du BDSM. Cahiers de l'IREF, collection Agora, 7, 95-105.
Lavigne, J. (2009). Sexualité et photographie : Transgression féministe et ratification de la norme pornographique comme pratique artistique. Protée, 37(1), 25-34. DOI 10.7202/001306ar
Lavigne, J. (2014). Baiser la norme pornographique, ou quand la porno féministe, queer et lesbienne est un mode d'Action féministe / The Feminist Porn Book: The Politics of Producing Pleasure. Tristan Taormino (dir.), City University of New York, « Feminist Press », 328 p. Spirale, 247, 37-38. https://www.erudit.org/en/journals/spirale/2014-n247-spirale01137/71099ac.pdf
Lavigne, J. and Le Blanc Elie, M. (2017). L'autopornographie comme témoignage sexuel? In Nengeh Mensah, M. (dir.), Le témoignage sexuel et intime, un levier de changement social (p.67-75). Montréal: Presses de l'Université du Québec.
Lust, E. (2010). Good Porn: a woman's guide. Berkeley: Seal Press.
MacKinnon, C. A. (1985). Pornography, civil rights, and speech. Harvard Civil Rights Civil Liberties, 20(1), 10-68.
Paveau, M. A. (2014). Sluts and goddesses. Discours de sexpertes entre pornographie, sexologie et prostitution. Questions de communication, 26, 111-135. https://www.cairn.info/revue-questions-de-communication-2014-2-page-111.htm?contenu=resume
Penley, C., Shimizu, C. P., Miller-Young, M. and Taormino, T. (2013). Introduction: The Politics of Producing Pleasure. In Taormino, T., Penley, C., Shimizu, C. P. et Miller-Young, M. (dir.), The Feminist Porn Book: The Politics of Producing Pleasure. New-York, NY: The Feminist Press at CUNY.
Segal, L. (1998). Only the Literal: The Contradictions of Anti-pornography Feminism. Sexualities, 1(1), 43–62. DOI 10.1177/136346098001001003
Smith, A. W. (2015). Whose Porn is it Anyway: Rhetorically Exploring the Differences Between Mainstream and Feminist Internet Pornography [Doctoral dissertation, Michigan State University]. https://d.lib.msu.edu/etd/2368
Taormino, T. (2013a). Calling the Shots: Feminist Pom in Theory and Practice. In Taormino, T., Penley, C., Shimizu, C. P. and Miller-Young, M. (dir.), The Feminist Porn Book: The Politics of Producing Pleasure. New-York, NY: The Feminist Press at CUNY.
Taormino, T. (2013b). Tristan's films. http://puckerup.com/feministpom/tristans-films/
Wadbled, N. (2012). Que doit-on voir dans la pornographie? Reproduction et reconnaissance de la représentation des genres. Entrelacs. Cinéma et audiovisuel, 9. DOI 10.4000/entrelacs.355
Williams, L. (1989). Hard Core. Power, Pleasure, and the "Frenzy of the Visible". Berkeley, CA: University of California Press.
Bergeron Deschênes, M., Fournier, A. and Pomerleau, M. (2020, April 20). Films XX(X) : regard sur la pornographie féministe. Les 3 sex*. https://les3sex.com/en/news/1191/article-xx-x-movies-a-look-at-feminist-pornography
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He came in and looked at 640-916 Book Yang s sullen voice from behind the metal armor See the Houren under 640-916 Exam Demo the genius Then he hugged his fist and swept a circle I have seen adults I am waiting for you Yang An sullenly said in a high sitting Are you Introducing Cisco Data Center Technologies, 640-916 Ebook | Duangtawan Hotel Chiang Mai a woman who has recently harassed the safflower club 640-916 Exam Engines I saw his eyes look at Hong Xuejiao, Hong Xuejiai immediately said The woman with scars on her face is the prostitute of Weiwu Bofu, Ning Jimei Cisco CCNA Data Center, Updated 640-916 Exam Dump The boy in law is also a bachelor Qi Yu Hou Ye, there is no harassment under the subordinates, it is true pursuit I can t easily see a top eyed, Hou Ye, you know me too.
There were no two figures in the room.


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About Kevin Tolman
Path of Least Resistance / Autumnal Equinox - 2010
Acrylic & Mixed Media On Canvas, 30 x 72 in.
Born in Detroit, Michigan in 1949, Kevin Tolman attended classes at the Detroit Institute of Arts and Cass Tech as a youth, and he is a graduate of the Art School of the Society of Arts and Crafts, in Detroit. In 1981 he moved to the Ramah Navajo Reservation in western New Mexico. Feeling at home in the Southwest, he later settled in a north valley area of Albuquerque, building an adobe house and studio in 1987. In 1990 he spent a year painting in Arraiolos, a small hill town in central Portugal, and in the years since he has continued to work when traveling in Europe, Mexico, and most recently, South America.
For over four decades, Kevin Tolman has been exhibiting his work in galleries, museums, and universities across the United States, where his paintings are included in numerous private, corporate, and public collections. His work has also been exhibited internationally in Canada, Mexico, Germany, France, England, and Portugal. A Tolman canvas is included in the Albuquerque Museum's permanent collection, and his work now hangs in the collections of the New Mexico State Capitol, and the University of New Mexico.
Tolman works in a variety of mediums including drawing in pencil and caran d'ache, and painting with acrylic, collage and mixed medias on canvas or paper. These are abstract works primarily influenced by the natural world and much informed by a sense of place. He does no preparatory drawings prior to starting a painting. These works are created slowly in layer after layer, and it is by taking risks and paying attention to the chance circumstances that arise during this process that each piece is allowed to reveal it's individual direction and character. The artist can often be found working under the trees at a large easel next to his studio near the Rio Grande.


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By 97.1FM The Drive | September 17, 2021
ABBA's 'Gold' returns to 'Billboard' top 40, thanks to new singles & album announcement
PolyGram/Universal
ABBA's Gold is has caught a second wind, rising back up the charts for the first time in three years.
Gold: Greatest Hits, the popular compilation album by the Swedish pop group, soared up the Billboard 200 chart from #114 to #34 on the survey dated September 18.
According to the outlet, the album moved 15,000 equivalent album units in the U.S. for the week ending September 9, a 61% jump, as per MRC data. Part of that includes 5,000 units in physical album sales, which allows it to climb the Top Album Sales chart from the 33rd spot to the 11th, as well.
ABBA's climb up the charts comes after the quartet dropped two new singles — "Don't Shut Me Down" and "I Still Have Faith In You" — earlier this month. Additionally, they announced a new album, The Voyage — their first in 40 years — as well as a special production to open in London next year featuring digital avatars of the group's members performing their legendary songs.
Gold: Greatest Hits, which was originally released in 1992, last saw the top 40 in August 2018, when it peaked at #25. That was likely due to the release of the movie Mamma Mia! Here We Go Again, which features the group's songs.
All in all, the album has spent an impressive 168 weeks on the Billboard 200 chart in total since its release.
The Voyage is scheduled to be released on November 5.
The Drive Holiday Plaid Hoodie Sweatshirt
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The British team did well in the first round of the Men and Women events at the World Mind Sports Games.
All three women and three of the four men won. Chong Han and Vanessa Wong are the top team players with a chance of medals. Only Andrew Simons lost his game by 7.5 against a Brazilian 3d.
Last updated Wed Oct 25 2017. If you have any comments, please email the webmaster on web-master AT britgo DOT org.


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Q: Can android friends list include non app user friends? Going off my last question Is there a work around(permission) to get friendPickerFragment to show all friends?, I noticed that when I go on my tinder profile, I can see a list of my friends. Based on the new upgrade to graph v 2.0, does that mean all of these friends(35+) use tinder, or did tinder find some workaround - taggable friends to show these friends even though they do not use tinder?(Profile -> My Friends)

A: From my many, many, many google searches and questions and what not, i've come to the following conclusion:
There is no way to get the entire Facebook friend list if you make an application right now.
The reason some apps are still able to get the full friend list, is that they were created prior to 31th May 2014 (Not 100% sure on the date, but around that time), so they were allowed access to the "old" API (The old API allows you to get a full friend list) until some time during the summer of 2015. This was done to allow them time to transistion to the new API (The new API only allows you to get a list of people that use your application, which is bullsh*t to be honest).
Sorry.

redpajama_set_name: RedPajamaStackExchange


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Home / Opinion /
BREAKING! Baloch leader tells India Sati peeth Hinglaj Temple in Pakistan is in a bad shape
27 October, 2019 02:21:16
Hinglaj is an important Hindu pilgrimage site known for its famous Sati peeth in Balochistan province of Pakistan. It is about 250 km north of Karachi. It is believed by Hindus that during the Tandava Dance of Lord Shiva, when Vishnu's Chakra had cut the body of Sati into pieces, the vermillion coloured head of Sati had fallen in Hinglaj. Hinglaj is also an extremely arid region and the name of Hinglaj lends itself to the Hingol river, the largest in Balochistan and the Hingol National Park which at 6,200 square kilometers and is the largest in Pakistan.
Since it is located in a desert which is called Maru in Sanskrit, the shrine is often referred to in holy texts as "Marutirtha Hinglaj" which means Hinglaj, the Shrine of the Desert. Recently Baloch leader Hirbayar Marie was at Kamakhya where it is believed Ma Sati's vagina had fallen. The leader depicted how no money is being spent on the upkeep of the temple and as a result the old structure is in a dilapidated state.
Swami Vivekananda as a Women Activist
Swami Vivekananda: The socialist who did not follow Marx
Swami Vivekananda could relegate Gods of his religion for greater cause of India
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Increasing customer connections through distribution system expansions and customer lateral construction.
Increasing system capacity through expansion of existing treatment systems or inclusion of new treatment systems.
Addressing water quality or regulatory requirements with new treatment technologies, unit processes, or equipment.
With an aging infrastructure, the repair and replacement (R&R) of existing equipment and systems is key for long term achievement of quality and capacity goals. For this reason, West Basin's capital improvement program includes an R&R component intended to extend the useful life of existing facilities and equipment.
Feasibility Studies – Feasibility studies are undertaken in order to assess the practicality of the proposed project. In general, these studies will assess five areas of feasibility; technical feasibility, economic feasibility, legal feasibility, operational feasibility, and schedule feasibility.
Once a project has been identified as feasible, it may move into the design phase. The designers will define the project through detailed specification documents and construction drawings. The final deliverable from the design phase is the Ready-To-Advertise bid package. This package is a complete design (design analysis, specifications, and drawings,) including annotated design submittal review comments that answer and/or incorporate review comments resulting from the review of the final design submittal.
Construction, alteration, demolition, installation, or repair work done under contract and paid in whole or in part out of public funds.
It can include preconstruction and post-construction activities related to a public works project.
For a full definition of public works refer to Labor Code section 1720.
Anyone working on a public works project must be paid prevailing wages as determined by DIR. Projects of $30,000 or more must meet DIR's apprenticeship requirements. Failure to comply with public works requirements can result in civil penalties, criminal prosecution, or both.
New pipeline alignments and customer laterals are necessary to expand the system.
Within each of West Basin's treatment facilities, there are more than 30 discreet treatment systems dedicated to producing West Basin's five designer waters. Treatment plant expansions range from the addition of new unit process for redundancy or reliability, or a wholesale facility expansion intended to increase the treatment capacity of the system.
Because West Basin has a substantial range of assets of varying ages, repair and rehabilitation projects are a critical part of ensuring the health and longevity of West Basin's infrastructure. These types of projects can include, but are not limited to simple replacement or repair for equipment such as pipes, pumps, tanks, instrumentation, or treatment process elements.
After the repair or refurbishment, the remaining useful life of the existing asset must be extended by at least Three years.
When the above conditions are not met, the cost of repair or refurbishment will be considered as operations and maintenance expenses.


The Chart of the Day belongs to Harvard Bioscience (HBIO). I found the scientific instrument stock by using Barchart to sort today's Top Stocks to Ownlist first by the highest Weighted Alpha, then I used the Flipchart feature to review the charts for consistent price appreciation over the last 6 months. Since the Trend Spotter signaled a buy on 3/27 the stock gained 15.53%.
Harvard Bioscience develops, manufactures and markets tools used in drug discovery research at pharmaceutical and biotechnology companies, universities and government laboratories.
Earnings estimated to increase 66.70% this year, an additional 30.00% next year and continue to compound at an annual rate of 10.00% for the next 5 years.


In describing the basic basics for fire, many talk about the fire tetrahedron. In other words, besides the original fire triangle of fuel, heat and o2, they add the fourth essential of chemical reaction. Fire starts use all four! It is necessary for all of us to understand the part each of these plays in producing fire in order that we can put it to use in possibly lighting our fire pit and preventing or extinguishing excess fires. For example , to put out a grease fire to the stove, turn off the cooker (removing the heat) and cover with a lid (removing the oxygen that passes the fire). This will likewise benefit those contemplating buying a fire pit, helping them to choose fire pits are best for them.
Toutlemaghreb - Effective communication methods in an organization. Effective communication in an organization increases productivity, decreases employee turnover and improves office atmosphere whether a supervisor or regular employee at the organization, the. Effective organizational communication: a key to employee. Effective organizational communication: a key to employee motivation and performance interscience management review imr issn: 2231 1513 volume 2, issue 2, 2012 82 in 1950's, research on the effects of feedback on employee performance and climate research was initiated the problem of upward communication distortion was the focus. Effective organizational communication strategies. Effective organizational communication individuals who are influential within organizations know the importance of strong communication skills this seminar is designed to teach practical skills and techniques to make communicating with others more effective. The "four be's" of effective organizational communication. And then there is the matter of consistency; since managers have different communication styles and approaches, information flow can vary significantly across departments and locations where employees work despite these variations in communication preferences and practices, there is a straightforward path to improved organizational communication. Running head: effective organizational communication. Effective organizational communication affects employee attitude, happiness, and job satisfaction 2 according to the u s bureau of labor statistics 2012 the unemployment rate was at an all time high in 1983 at 10 4% and fluctuated at lower levels over the next seventeen years until 2010 when it rose to 9 7%. Effective organizational communication. They receive the message and decode it for an effective communication to take place, it is necessary that the recipient of the message understands the message the way the sender intended both the sender and the recipient do have important roles to play in completing the process of effective communication 13. 15 strategies for effective communication in an organization. Effective communication in an organization is always important no matter what the operational scale of a company is, it can succeed and overcome all sorts of internal misunderstandings as well as external operations only with successful communication strategies such is the importance of communication in an organization. Managing organizational communication shrm online. Communication is a vital management component to any organization whether the purpose is to update employees on new policies, to prepare for a weather disaster, to ensure safety throughout the. What is organizational communication? introduction to. As you now know, communication study is deeply entrenched in the oral rhetorical traditions of ancient rome and greece similar to the many of the early concepts that shaped the discipline, some of the founding principles of organizational communication originated in the east. Effective communication brings successful organizational. Organizational communication, organizational change, communication objectives, business organizations abstract the purpose of this paper is to recognize and discuss the significance of effective communication during the process of managing changes in organizations.


Red velvet cake is much more than vanilla cake tinted red. This recipe produces the best red velvet cake with superior buttery, vanilla, and cocoa flavors, as well as a delicious tang from buttermilk. My trick is to whip the egg whites, which guarantees a smooth velvet crumb.
This is my forever favorite red velvet cake recipe. I published it on my blog a few years ago and decided it's time for clearer recipe instructions and a video tutorial. Many of you love this recipe too, so let's roll up our sleeves and rev up our mixers!
Red velvet cake is the queen of all layer cakes. The "I can't quite put my finger on the flavor" cake. It's the sweet marriage of buttermilk and vanilla with a little cocoa for good measure. She's tall, dramatic, and completely covered in silky cream cheese frosting. This is my best red velvet cake.
These 4 flavors are essential to the perfect red velvet layer cake. Not only is the flavor outstanding, red velvet cake's texture is worth writing home about. It's dense and soft with a moist and velvety crumb. However, the absolute best part about red velvet cake is the cream cheese frosting. Slathered on thick, my cream cheese frosting recipe is delicately sweet and undeniably creamy.
I use specific ingredients, certain amounts, and unique mixing techniques to produce my best red velvet cake recipe. Begin by whisking the dry ingredients together, then beat together the wet ingredients. We'll combine the two, add buttermilk and tint the batter red. More on food coloring below.
Cake Flour: I highly recommend that you use cake flour. Cake flour is much lighter than all-purpose and the perfect base for a light, soft-crumbed cake texture. Like I mention above, red velvet's texture is important to the authenticity of the flavor. You will thank me for the recommendation after you taste how incredibly soft this cake is! It's the texture you find at professional bakeries.
Unsweetened Cocoa Powder: 2 Tablespoons is plenty for a little cocoa flavor without overpowering the vanilla and butter flavors.
Butter & Oil: What sets red velvet cake apart from chocolate is its buttery flavor. With only butter, we risk a dry cake. With only oil, we lose the butter flavor and softness that comes with creaming butter & sugar together. So all that's to say, use both butter and oil. Moist texture, soft and cakey texture, buttery flavor. Boom.
Buttermilk: Buttermilk is tangy, creamy, and makes baked goods extremely moist. You can't make delicious red velvet cake without it! Additionally, buttermilk helps activate the baking soda to leaven the cake.
What about the food coloring? Red velvet cake wouldn't be red without food coloring. I recommend gel food coloring because the color is concentrated, so you need less of it. For natural coloring, use beet powder. If you don't want to use food coloring, leave it out! The cake will have the same flavor and be a lovely shade of cocoa.
I add one simple step to this red velvet cake recipe and it guarantees the BEST texture.
Whip the egg whites separately, then fold into the batter.
This cake recipe requires 4 large eggs. Separate the eggs before starting. Beat the egg yolks with the wet ingredients, then beat the egg whites into fluffy peaks and fold them in last. Beating the egg whites incorporates air and promises a velvet-rich texture.
In my opinion, cream cheese frosting pairs best with red velvet's flavor and this frosting recipe is really simple. You need block-style cream cheese, butter, confectioners' sugar, a splash of milk, vanilla extract, and a pinch of salt to offset the sweetness. It glides on seamlessly and is silky smooth. If you're looking to pipe decoration with this cream cheese frosting, chill it in the refrigerator for 20 minutes. This guarantees the creamy frosting will hold its shape.
This recipe converts even red velvet skeptics. I should know because I used to be one!
Preheat oven to 350°F (177°C). Grease two 9-inch cake pans, line with parchment paper, then grease the parchment paper. Parchment paper helps the cakes seamlessly release from the pans.
Make the cake: Whisk the flour, baking soda, cocoa powder, and salt together in a large bowl. Set aside.
Using a handheld or stand mixer fitted with a paddle attachment, beat the butter and sugar together on medium-high speed until combined, about 1 minute. Scrape down the sides and up the bottom of the bowl with a rubber spatula as needed. Add the oil, egg yolks, vanilla extract, and vinegar and beat on high for 2 minutes. (Set the egg whites aside.) Scrape down the sides and up the bottom of the bowl with a rubber spatula as needed.
With the mixer on low speed, add the dry ingredients in 2-3 additions alternating with the buttermilk. Beat in your desired amount of food coloring just until combined. I use 1-2 teaspoons gel food coloring. Vigorously whisk or beat the 4 egg whites on high speed until fluffy peaks form as pictured above, about 3 minutes. Gently fold into cake batter. The batter will be silky and slightly thick.
Divide batter between cake pans. Bake for 30-32 minutes or until the tops of the cakes spring back when gently touched and a toothpick inserted in the center comes out clean. If the cakes need a little longer as determined by wet crumbs on the toothpick, bake for longer. However, careful not to overbake as the cakes may dry out. Remove cakes from the oven and cool completely in the pans set on a wire rack. The cakes must be completely cool before frosting and assembling.
Make the frosting: In a large bowl using a handheld or stand mixer fitted with a whisk or paddle attachment, beat the cream cheese and butter together on medium-high speed until smooth, about 2 minutes. Add the confectioners' sugar, cream/milk, vanilla extract, and a pinch of salt. Beat on low speed for 30 seconds, then increase to high speed and beat for 3 minutes until completely combined and creamy. Add more confectioners' sugar if frosting is too thin, more milk if frosting is too thick, or an extra pinch of salt if frosting is too sweet.
Assemble and frost: Using a large serrated knife, slice a thin layer off the tops of the cakes to create a flat surface. Discard or crumble over finished cake. Place 1 cake layer on your cake stand or serving plate. Evenly cover the top with frosting. Top with 2nd layer and spread remaining frosting all over the top and sides. I always use an icing spatula and bench scraper for the frosting. I used Wilton piping tip #12 for decoration around the top.
Refrigerate cake for at least 30-60 minutes before slicing. This helps the cake hold its shape when cutting.
Cover leftover cake tightly and store in the refrigerator for 5 days. Frosted cake or unfrosted cake layers can be frozen up to 2-3 months. Thaw overnight in the refrigerator and bring to room temperature before decorating/serving.
Make Ahead Instructions: The cake layers can be baked, cooled, and covered tightly at room temperature overnight. Likewise, the frosting can be prepared then covered and refrigerated overnight. Let the frosting sit at room temperature to slightly soften for 10 minutes before assembling and frosting.
Cake Flour: For best texture and taste, I strongly recommend cake flour. If you absolutely cannot get ahold of it, a mix of all-purpose and cornstarch is fine. Sift together 2 and 2/3 cups (333g) all-purpose flour + 1/3 cup (40g) cornstarch and use this instead of cake flour. Sifting them is imperative. Measure 3 cups AFTER sifting and use in the recipe instead of cake flour.
Vinegar: The vinegar helps brighten the red color. Don't get scared, a touch of vinegar is normal in red velvet desserts! You can't taste it.
Why is everything at room temperature? When everything is near the same temperature, they mix together easily, evenly, and produce a uniform texture. It's important!
Food Coloring: The amount of red food coloring is up to you. I tested with varying amounts. To get the dark red color you see here, use about 2-3 Tablespoons of liquid food coloring or 2 teaspoons gel food coloring. Dye the batter until you are pleased with the color. Use beet powder for a natural alternative or leave the food coloring out completely.
Buttermilk: Buttermilk is a key ingredient and flavor in this recipe. Use low fat or full fat. If you don't have buttermilk, you can make your own sour milk. To do so, add 1 teaspoon of fresh lemon juice or white vinegar to a liquid measuring cup. Add enough regular milk (whole milk is best) to make 1 cup. Stir the two together and let sit for 5 minutes before using.
Sheet Cake: This batter fits nicely into a 9×13 inch cake pan or 12×17 inch sheet pan. Same oven temperature. Bake for about 40-45 minutes or 20-25 minutes, respectively. Keep your eye on the cake and use a toothpick to test for doneness.
3 Layer Cake: Divide the batter between 3 9-inch cake pans. Bake for about 22-25 minutes.
Bundt Cake: This cake batter fits into a 10-cup or larger bundt pan. I'm unsure of the exact bake time (likely around an hour), but use a toothpick to test for doneness. Same oven temperature.
Need something smaller? Here are my red velvet cupcakes!


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Q: check first with timestamp? do i save some time when having a timestamp and only ask the operation isCancelled every 50 msec?

A: isCancelled is a pretty simple BOOL flag, so checking it on each iteration of even a very tight loop doesn't incur a real performance penalty. I think you'll find the overhead of setting up a mechanism to check isCancelled periodically will actually perform worse.


Next Wednesday -April 19 2017- will be SAS day. Free access will be provided to anyone with a valid SAS email address and LinkedIn profile. Observe what the Greedometer algos are quantifying. Use the contact form to inquire.


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