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Tag Archives: Purple Hearts
Injury In the Line of Duty…or not?
By: T F Stern
T F Stern's Rantings
When an individual puts on a uniform in the service of his community or country, either as a fireman, police officer or military serviceman we recognize the uniform perhaps more than the individual. If they get injured while in our service it's our moral duty to take care of them.
An article at the Fox News website by Catherine Herridge, Fort Hood shooting victim denied benefits, despite Purple Heart decision pointed out that a military board has denied benefits to a soldier who was shot during the Ft. Hood terrorist attack.
You may recall the Obama administration pressured the military into calling the shooting "work place violence" rather than classifying the shooting as a terrorist event "even though the evidence showed Hasan was emailing the Al Qaeda cleric Anwar al-Awlaki prior to the attack".
But that's not all…the administrators of our military, those charged with looking after our servicemen who put the uniform on each day in defense of our nation took it a step further.
"MAJ Hasan has been charged with criminal activity, but has not been adjudicated a terrorist. Therefore, the clear preponderance of evidence does not support that the injuries sustained were the direct result of armed conflict," the letter said.
I wonder what planet these administrators are from; really! Getting shot six times isn't the result of armed conflict? Must have been one heck of a game of Tidily Winks those soldiers at Fort Hood were playing.
Putting aside whether or not the injuries were the result of an attack carried out during war time, on foreign soil or our own should not matter… shouldn't a member of our military be taken care of if he/she fell off a loading dock while pealing potatoes assigned to KP duty? (I know, soldiers no longer are required to perform KP; pick some similar mundane chore like slipping down on a wet floor while cleaning the head)
There you go, soldier; we don't have to pay for your injuries because you can't prove they happened as an act of war. Chew on that for a while …
Of course there are two sides to every coin; taking into account the numerous attempts to feign injury in order to collect a fat Workman's Compensation package. Sometimes it works, sometimes it doesn't.
A friend of mine worked for the U.S. Postal Service as a criminal inspector. One of his jobs was investigating individuals who were collecting disability from the government, folks suspected of being less than honest about their injuries. He told me about folks who claimed they were too injured to work collecting full benefits that showed up each month in their mail box. The only problem was these folks were fit as a fiddle and off working 'cash jobs' that went as unreported income when they were supposed to be at home in their sick bed.
I wish there were more inspectors catching free loaders; but that goes against current policy under the Obama administration. Truth be known, I think there are bonuses set aside for the more creative free loaders.
Talk about free loaders and spending taxpayer money, what about this?
"The director of the Philadelphia VA regional benefits office was paid $288,000 in "relocation payments" to move the 140 miles from Washington, D.C. to her new home last year".
"Federal regulations allow for the reimbursement of relocation expenses including the "costs of house-hunting, moving, terminating leases, and a per-diem rate for meals and temporary housing for an employee and his or her family," the spokesman said."
I'm so happy to know the VA administrators are able to take care of themselves; but isn't their job to take care of military personnel who need medical treatment? (Sounds like they have their priorities messed up)
I remember one police officer who fell out of his chair at the station and collected full disability benefits for about a year; that's full pay with benefits, tax free because it was carried as Injury on Duty. (not making this up folks; this actually happened)
Back in the 70s an off duty uniformed Houston Police Officer was injured while working traffic at the Astrodome, an extra-job where his salary was furnished by the Astrodome. Long story short; he was seriously injured by a vehicle while working traffic; but the City denied his request for Injury on Duty status.
The City of Houston claimed that at the time of his injuries his actual employer was the Astrodome and refused to pay while he was out of work. Eventually the courts convinced the City of their responsibility because the officer was directing traffic and wearing a uniform which represented his authority, authority which could only be given by the City of Houston.
More recently another Houston Police Officer, Jason Roy, survived a roll over accident during a chase. His promised benefits have been denied after being disabled with a broken neck, making him unable to perform as a police officer.
'"The City of Houston is cooperating fully and is not contesting Officer Roy's medical condition. The case is moving through the process dictated by the state. The next scheduled hearing will occur in mid-November. The decision as to whether benefits are granted is made by the Worker's Compensation Division of the Texas Department of Insurance, not the city," city of Houston Director of Human Resources Omar Reid."
This means there's a bureaucrat stationed somewhere along the chain of command to deny benefits; either at the City, State or Federal level of government. Somebody is employed in a position of authority to ignore benefits promised, ignore right from wrong and to limit final responsibility in favor of saving the taxpayers money.
I would hope our military service men and women would be treated better; but our government is run by folks who have lost their compass as to what's right and wrong. Injury on Duty means nothing to administrators and bureaucrats whose sole purpose in life is to screw over those who've earned these benefits.
Posted in 2nd Amendment, Authors, Constitution, History, Military, Politics, Survival, T F Stern, Terrorism	| Tagged Barack Obama, Catherine Herridge, Fox News, Ft. Hood, Guns, Islam, Jihad, Military, Muslims, Politics, Purple Hearts, T F Stern, Terrorism, Terrorists, Texas, War	|


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Q: How to write block definition using properties? I am writing a class for getting image from Photos Library.
I want one single method that will return selected image from library.
So i started writing a class named MediaBrowser.
I used block that will give selected image. But I am confused where to write block definition. Please correct the code if i am going wrong.
In MediaBrowser.h
@interface MediaBrowser : NSObject

typedef UIImage* (^MediaBrowserCompletionHandler)(void);

+ (id)sharedInstance;
- (BOOL)startMediaBrowserFromViewController:(UIViewController*)controller
                          completionHandler:(MediaBrowserCompletionHandler)completion;
@end

In MediaBrowser.m
@interface MediaBrowser () <UIImagePickerControllerDelegate, UINavigationControllerDelegate>
@property (nonatomic, strong) MediaBrowserCompletionHandler completionHandler;
@end

@implementation MediaBrowser

static MediaBrowser *sharedMediaBrowser = nil;

+ (id)sharedInstance
{
    if (nil != sharedMediaBrowser) {
        return sharedMediaBrowser;
    }
    static dispatch_once_t onceToken;
    dispatch_once(&onceToken, ^{
        sharedMediaBrowser = [[MediaBrowser alloc] init];
    });
    return sharedMediaBrowser;
}

- (BOOL)startMediaBrowserFromViewController:(UIViewController *)controller completionHandler:(MediaBrowserCompletionHandler)completion
{
    self.completionHandler = [completion copy];
    if (([UIImagePickerController isSourceTypeAvailable:UIImagePickerControllerSourceTypeSavedPhotosAlbum] == NO)
        || (controller == nil))
        return NO;

    UIImagePickerController *mediaUI = [[UIImagePickerController alloc] init];
    mediaUI.sourceType = UIImagePickerControllerSourceTypeSavedPhotosAlbum;

    // Displays saved pictures from the Camera Roll album.
    mediaUI.mediaTypes = [[NSArray alloc] initWithObjects:(NSString *)kUTTypeImage, nil];

    // Hides the controls for moving & scaling pictures, or for
    // trimming movies. To instead show the controls, use YES.
    mediaUI.allowsEditing = NO;
    mediaUI.delegate = self;

    [controller presentModalViewController:mediaUI animated:YES];
    return YES;
}

// UIImagePickerControllerDelegate

- (void)imagePickerController:(UIImagePickerController *)picker didFinishPickingMediaWithInfo:(NSDictionary *)info
{
    NSString *mediaType = [info objectForKey: UIImagePickerControllerMediaType];
    UIImage *imageToUse;

    // Handle a still image picked from a photo album
    if (CFStringCompare ((CFStringRef) mediaType, kUTTypeImage, 0) == kCFCompareEqualTo) {
        imageToUse = (UIImage *) [info objectForKey:UIImagePickerControllerOriginalImage];
        // Do something with imageToUse
        if (self.completionHandler) {
            // Pass here UIImage
            self.completionHandler();
        }
    }

    [picker dismissModalViewControllerAnimated:YES];
}

@end

A: I figured out the answer. I wanted to send selected image from UIImagePickerController to the calling class. I was writing wrong block. See corrected code below.
In MediaBrowser.h
block declaration shoudld be :
typedef void (^MediaBrowserCompletionHandler)(UIImage *selectedImage);

And in MediaBroser.m
Calling block should be :
if (self.completionHandler) {
     self.completionHandler(imageToUse);
}

A: typedef UIImage* (^MediaBrowserCompletionHandler)(void);

@interface MediaBrowser : NSObject

@property (nonatomic,copy) MediaBrowserCompletionHandler handler;

@end

A: This should be fine.
typedef UIImage* (^MediaBrowserCompletionHandler)(void);

@interface MediaBrowser : NSObject
....
@end

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Axiom Exergy, ( Stanford/UC Berkeley, now Axiom Cloud) is developing the Refrigeration Battery, an energy storage system for supermarkets and refrigerated facilities that can provide baseload shifting (approximately 100 kW for 6+ hours) away from on-peak hours. The Refrigeration Battery can reduce the peak demand of a supermarket (in kW) by up to 40%. The company will proceed with a major pilot with a major grocery chain to validate the technology.
Energy Adaptive Networks (Caltech, now PowerFlex EDF Renewables) is tackling the growing problem of managing energy distribution on the grid, as more electric vehicles make charging demands on the network. The EAN system consists of open-source chargers with real time sensing and communication capability, online optimization algorithms that compute, minute by minute, the optimal charging rate for every EV in the parking structure, and management software that oversees the charging operation in a garage and includes mobile apps to interact with users and payment systems. The Rocket Fund will enable expansion of a network of 50 EV chargers, under testing in the Caltech parking facilities.
Fluency Lighting Technologies (UC Santa Barbara) offers next generation lighting options with an innovative laser stimulated phosphor light engine for outdoor lighting that provides strong pinpointed light. Testing shows potential savings of 45% less energy, and 60% overall cost savings. The Rocket Fund will enable the purchase of key equipment for conducting a pilot program, in partnership with the National Science Foundation.
Keewi (Stanford), is developing a comprehensive hardware and software system for tackling a major challenge in energy efficiency: plug load energy use. The system provides a hardware and software combination that not only measures current and voltage use ( as well as human proximity) but also incorporates remotely controlled devices linked up to a user –friendly software interface that can be monitored online.
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Richard J. MacGregor Sr.
December 31, 1940 ~ December 10, 2021 (age 80)
CHICOPEE – Richard J. MacGregor Sr., 80, of Claire St. in Chicopee was called safely home on Friday, Dec. 10, 2021 at Baystate Medical Center. Richard was born in Ludlow on December 31, 1940, a son of the late Robert and Angela (Giroux) MacGregor. Richard served as a Master Sergeant with the Army National Guard for 22 years before being honorably discharged in 1991 and had previously served with the US Army from 1961 to 1962. Richard worked at Kollmorgen (now L3), as a quality assurance manager in the optical division in Northampton over 24 years, retiring in 2005. He had previously worked as a machinist for Chicopee UniRoyal Tire in Chicopee for 13 years. Richard was very active in his community through the Shriners. He was a member of the Ludlow Brigham Lodge of Masons, the Melha Shrine, ROJ Springfield Court 144 and the Order of "Q". He was a very proud member of the Melha Highlanders and the Legion of Honor. He was a longtime member of the Union Church of Christ in Ludlow. He loved woodworking, golf and watching his many grandkids compete in numerous sports – his favorite place was cheering from the sidelines. He especially enjoyed just spending time with family and friends. Richard was predeceased by his loving wife of 40 years, Anne-Marie (St. Onge) MacGregor and his brother-In-Law Albert St. Onge Jr. He leaves his three sons; Richard J. Jr. and his partner Tonya Sargalski of Windsor, CT, Michael D. and his wife, Anne of Hampden, and James R. and his wife Melissa of Arlington, VA. Richard leaves the joys of his life, his incredible grandchildren; Robert, Caitlin, Richard III, Matthew, Daniel, Elizabeth and Alexander MacGregor. He was their biggest fan and champion. He also leaves his dear brother, Robert MacGregor of Ludlow and his dear Sister-in-Law Sr. Rita St. Onge, SASV, of Marlborough and many nieces, nephews, cousins and dear friends.
The family will receive friends on Thursday, December 16, 2021 from 9:00 to 11:00 a.m. at Tylunas Funeral Home, 159 Broadway St., Chicopee. A Funeral Service will be conducted at the Funeral Home at 11:00 a.m. with Pastor Jeffrey K. Erb, Celebrant. Burial will follow in Fairview Cemetery in Chicopee.
Memorial contributions may be made in Richard's memory to Shriner's Children's Hospital, Springfield Unit , 516 Carew Street, Springfield, MA 01104.
To send sympathy gifts to the family or plant a tree in memory of Richard J. MacGregor Sr., please visit our tribute store.
Chicopee, MA 01020
Funeral Home Service
Interment with Military Honors.
Abbey Memorial Drive
Chicopee, MA
Shriners Hospital c/o Springfield unit
516 Carew Street, Springfield MA 01104


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Ombamnesty Effect on American Workers Is Considered (Weakly)
The Contra Costa Times immigration reporter tried his liberal best to present both sides of the Obamnesty, including the downer of more workers being unleashed on jobless citizens. (California statewide unemployment in May was 10.8 percent, so joblessness is a big concern here.)
But Matt O'Brien's questionable attempt at "fair and balanced" was neither. The piece starts out with emotional stories from several young illegals and their dreams for the future. One version in the San Jose Mercury posted a sympathetic photo of one, Fiona Cruz.
For the other side, the reporter interviewed CIS's excellent researcher Steve Camarota, and cited a couple relevant quotes. But O'Brien followed Camarota's reasonable analysis with an immediate refutation beginning: "Those are assumptions many economists don't hold. . ."
However, the most egregious element was the omission of young citizens who already struggle to find jobs. Why are their dreams for the future not considered worthy? How hard would it have been for the reporter to go to a local campus or unemployment office to find Americans who cannot find work?
The media constantly barrages the public with tearful stories of illegal aliens, as in this case. But young Americans, whose parents have obeyed the law and paid the taxes, are not even an afterthought to liberal journalists.
For that reason, I propose a new visa category for journalists to increase diversity in the newsroom and educate current scribblers about what the rest of America faces. Fifty thousand new journalist immigrants should do nicely for a start.
Immigration reprieve means thousands of new workers in California, By Matt O'Brien, Contra Costa Times, June 19, 2012
As thousands of young illegal immigrants consider openly applying for work permits under a new Obama administration directive, they dream of jobs they could never find in the shadows.
Eduardo Ruiz, of San Jose, has worked in a South Bay market since he was a teenager, but the trained artist wants to animate 3-D movies and open his own studio. Fiona Cruz, of Daly City, earned a biotechnology degree at UC Davis but is blocked from working in a science lab. Alameda's Ju Hong bussed tables at a sushi restaurant to pay his UC Berkeley bills but would rather be drafting better government policies.
An estimated 350,000 children and young adult immigrants in California and more than 1 million nationwide could qualify for protection from deportation and temporary work permits through the new federal relief initiative announced Friday, according to the Migration Policy Institute.
How their arrival into the formal job market will affect California's economy and employment is a mystery to many economists because nothing quite like this has ever happened before.
Many of those eligible are already working, but only because their employers don't know or care that they are here illegally.
Giving them legal work permits — renewable every two years — will open up previously unattainable careers to people like Ruiz, Cruz and Hong.
"My dream is to start my own studio. I'll have to hire people. That's job creation, an investment," said Ruiz, a 29-year-old about to graduate from San Jose State. "There will be a lot of young people graduating, starting businesses, and that will create jobs," he said.
Not everyone is as optimistic.
The relief measure could also flood the California job market with newly legal workers competing for scarce jobs with other workers, especially native-born Americans who never went to college, said Steven Camarota, research director of the Center for Immigration Studies in Washington, D.C., which seeks to reduce immigration.
"The benefit to the illegal immigrant himself might be significant," Camarota said. "But that raises other concerns. Unemployment is so bad at the bottom end of the labor market."
Well-paying fields that weeded out illegal workers because of strict background checks — such as in security or parcel services — could suddenly get more competitive, he said.
Statewide unemployment was 10.8 percent in May. More workers "could mean higher unemployment, longer bouts of unemployment, lower wages, lower benefits," Camarota said.
Those are assumptions many economists don't hold since most studies show illegal immigrants have a trivial effect on other workers, said UC Berkeley economist David Card.
"For various reasons, however, the spillover effects of immigration capture a disproportionate share of attention, particularly from critics of immigration," Card said in an email.
The directive's biggest effect will be on the beneficiaries themselves "who in the best case might be able to apply for better jobs," he said.
Immigrant advocate Reshma Shamasunder is among those who believe empowering undocumented youths with legal jobs and freedom from deportation benefits the broader community.
"They'll be able to make money and increase their ability to buy a home, buy products," said Shamasunder, director of the Oakland-based California Immigrant Policy Center. "Young people are very smart investments for California."
Biotechnology major Cruz graduated from UC Davis in 2009 and aimed for a career in stem cell research or regenerative medicine. Unable to work in those fields, she chose activism after U.S. Immigration and Customs Enforcement sought to deport her to the Philippines.
The 24-year-old won a deportation reprieve earlier this year but has not been able to work.
The directive the Department of Homeland Security issued last week applies to illegal immigrants under 30 who came to the United States before they turned 16. They must either be high school graduates, currently in school or military veterans.The government won't begin taking applications until mid-August.
Hong, 22, graduated from UC Berkeley in May worried about his future. The South Korea native is a longtime "Dreamer," part of a national network of undocumented student activists who have been fighting for a federal Dream Act giving them a path to citizenship.
This short-term administrative directive doesn't do that, but Hong said it is an important step.
"I never thought the Obama administration would allow Dreamers to have work permits," Hong said. "It's a huge victory."
The political science major imagines one day working for the government, the same one he grew up fearing would deport him.


This page should be read alongside the page managing medication in care homes.
Care homes have a duty of care to the people they look after. This includes making sure the home has enough of the correct medication at the right time for all individuals. It is not acceptable to give the GP or pharmacy being closed as a reason for someone you provide care for running out of medication. Out of hours GPs or pharmacies are available.
If you have a problem and need to access prescriptions or pharmacies outside normal working hours you can find out of hours medicines on the NHS websiteExternal link.
A care home must be able to give evidence that they have been proactive in addressing any concerns or issues with medication. The care home should keep copies of what has been done to remedy any issues. For example, you should keep copies of any emails to pharmacies if there are any issues, such as the wrong medication being received.
A short and useful overview of giving medication from the NHS is available in the medicines tips for carers External link page.
Always follow the doctor's instructions about when and how someone should take medication.
does the medication have to be taken a certain way, for example only with water? Where the prescripition allows you should offer the person their preferred drink to take their medication. If you are in doubt about which drinks you can offer with medication with consult with a pharmacist.
does the person have any temporary swallowing or mouth problems?
PRN (also known as 'as required medication') can cause difficulties. PRN medications should have a personalised medication administration plan in place. Some things to consider are if medication is prescribed as "take for pain" and the individual can't speak, how do you know when to give the medication? You could try to find out how the person expresses pain, for example do they rock, or hold their stomach?
Some medication must be given at certain times. This must be taken into account and clear guidance must be available should the individual refuse, or the time interval be missed. If medication is prescribed to be taken before or after food then this must be adhered too.
Taking medication and not drinking enough during the day is not good for the body. People taking medication need to ensure that they are drinking regularly. Make sure that each person is drinking 6-8 glasses per day using a 250ml mug or glass.
Remember that foods high in water, like fresh fruits, vegetables and some dairy products can be an important part of a person's fluid intake.
More information is available on our helping people to drink enough to stay healthy page.
Something often not considered is what to do with pre-existing medication when someone becomes sick. Sometimes this is referred to as the 'sick day rules'. For example, if someone develops vomiting this can impact on their normal medication. Many health care professionals provide advice to such patients that certain drugs should be temporarily stopped during acute inter-current illnesses, particularly where there is disturbed fluid balance. This advice is commonly described as 'sick day rules' or to take a 'drug holiday'. You should get advice from a GP or pharmacist if the person you care for becomes sick to see if their medication needs to change.
The CQC provide information on a range of topics on their medicines and adult social care services page.
The legal position on who can administer what in care homes is explained in this article External link by Croner-i.
NICE guidelines on managing medicines in care homes External link .


We have lost an essential bulwark against foul, reactionary and proto-fascistic politics, writes Joyce McMillan.
When I survey the current grim state of European and US politics, it's surprising how often my mind drifts back to a single day in April 2010, when one mainstream leader of a Western democracy came to grief in a manner that somehow seems to sum up the key political dilemma of our times. I'm talking, of course, about former Prime Minister Gordon Brown, and his ill-fated encounter, during the general election campaign of 2010, with a woman called Gillian Duffy, a lifelong Labour supporter who, during a walkabout in Rochdale, offered various thoughts about problems of crime and employment in her home town, and then moved on to the subject of "all these Eastern Europeans" – a problem of "too many people", she said, mostly coming here just to claim benefits.
Her exchange with the Prime Minister was brief, and was of course followed by one of the most excruciating gaffes in British political history; back in his car, and unaware that his lapel microphone was still switched on, Gordon Brown described her as "some bigoted woman", and then watched over the next few hours as what was left of his political career went up in smoke.
The consensus about what had happened was instant and absolute. Gillian Duffy was not a bigot, the consensus said, and Gordon Brown was wrong to use the word about her. She was just a woman trying to raise legitimate concerns about immigration; and the fact that Britain's political elite tended to dismiss such concerns as racism or bigotry signalled only the extent to which they were out of touch with ordinary people and their problems.
And over the next few years, not only in the UK but beyond, that consensus became part of a growing received wisdom which argued that anti-immigrant views must be heard, and that not to hear them and act on them is damaging to democracy, demonstrating contempt for those on the sharp end of the social changes brought by mass migration. If the phrase "legitimate concerns" was used once – by politicians of right, left and centre – it was used a thousand times; and the idea seemed to be that if the issue of immigration was freely discussed, then new and rational policies could be put in place, that would reassure the public and reduce tensions.
What is becoming increasingly evident, though, is that it hasn't worked out like that. On the contrary, it seems that the more mainstream politicians move to accommodate and respond to anti-immigrant feeling, the stronger it becomes, and the more extreme in its demands. All across Europe and the United States, since the early years of this decade, politicians of the far right from UKIP to the German AfD have felt emboldened to make their case with a new and militant self-righteousness; and mainstream political parties – from the Conservativews in the UK to the US Republicans – have not been slow to make sharp rightward moves in response.
In that time, the British Labour Party has become so afraid of popular anti-immigrant feeling that it now dare not even oppose the looming disaster of Brexit; and Europe has become a continent of wealthy nations that would rather stand by and watch a huge, quiet holocaust on its southern borders – with almost 3,000 people each year dying in the Mediterranean in desperate efforts to reach our shores – than step up to our obligations in terms of the rights of refugees, and of common humanity.
So it is perhaps, in the light of this experience, time to think again about exactly what we mean when we talk about the "legitimate concerns" of those who do not like immigration. Poor or overpriced housing, overcrowded schools and a struggling health service are 'legitimate concerns', for example; but the idea that those problems are exacerbated by immigration, rather than often helped by a powerful wave of well-trained workers from other countries, has never been anything more than a lie, peddled by certain sections of the media.
Subject "legitimate concerns" about immigration to a fact-check, in other words, and they often tend to melt down to this: that some people don't like people from other countries and cultures coming to live in their midst, tend greatly to overestimate both their numbers and the threat they pose, and often don't bother to check their hostile assumptions against the facts, or to get to know people from other countries and cultures before judging them; and that, let's face it, is a fairly good working definition of bigotry, xenophobia, or racism.
All of which suggests that the uncomfortable truth we perhaps now have to face is that Gordon Brown was not necessarily wrong to detect an element of bigotry in Gillian Duffy's views; and that the 50-year consensus that kept open hostility to foreigners and racial minorities out of our mainstream political discourse, not only in the UK but across Europe and north America, was perhaps an essential bulwark against the kind of foul, reactionary and proto-fascistic politics that is being unleashed now. Times have changed, of course; and under 21st century conditions, political and media establishments can no longer easily conspire, as they could in the 1960s, to silence disruptive or shocking views.
Yet history still reminds us that the fact that views are held by large numbers of people does not necessarily make them right, or even defensible. There was a right answer for Gordon Brown to have given Gilliam Duffy in Rochdale that day; he could have issued a comradely challenge, asking her if it was really the European migrants themselves who bothered her, or issues like housing, health services and low pay. As the reaction to Gordon Brown's comment showed, though, challenging voters on their opinions, however ill-founded, has become one of the great taboos of modern marketing-driven political culture; and seems set to remain so, despite mounting evidence that in the effort to give the people what they want – or, if you like, to reflect their "will" – the present generation of Western politicians may have embarked on a very dangerous path indeed, and one that ends only in violence, and despair.


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Raineys Trio returns
Local tour stops included
The Raineys Trio compromised of Laura Rainey, James Rainey and Berdella McGrew.
GALLIPOLIS — The James Rainey Trio returns to Gallia over the Independence Day week holiday.
The James Rainey Trio is a national singing group that was formed in 2009. With their humble beginnings, from the small town of Gallipolis, the trio started out on a journey that would just continue to grow. Original members were James, his wife Laura, and Randy Shafer.
Their first CD together was "A Country Christmas, Swan Creek Valley Style." A release profiling the Rainey Trio said, "The trio began to see God move in a mighty way in their services and knew this is where and what God would have them do. They would use a wonderful pastor and man of God to sing bass when he was available to do so, Pastor Rick Towe, from New Life Church of God. Towe sang on their first national release with the the Raineys entitled, 'Gettin' Ready Today.' The group has since relocated to Swansea, Ill., where James and Laura serve as worship ministers at Christ United Church of Christ in Belleville, Illinois."
The multi-talented Berdella McGrew of Flora, Ill., with her alto voice now joins the Raineys to complete the trio. The group keeps a busy schedule doing church services, revivals, recreational festivals, and more. They have recorded over eight album projects, their newest being, "Higher Ground."
James owns a full-time recording studio, Declaration 212 Productions, and produces many gospel artists, as well as The trio's projects. James also keeps a busy schedule playing for the nationally-known solo artist, Jonathan Wilburn. He appears at NQC, Dollywood, Silver Dollar City, The Branson Belle, and many more events across the country.
James has been involved in full-time gospel music since he was 14 years-old. He has traveled with the many groups: including The Gospel Harmony Boys, The Plainsmen Quartet, The Hoppers, The Greenes, The Singing Americans,The Blackwood Quartet, and The Stamps Quartet. He has co-produced the national release, "Heartbeat," "Jesus Hold My Hand," "The Writer," and co-wrote the national hit, "Angels on Board" with the Singing Americans. He is known for his instrumental work across the county, but is nationally know for the kid's song, "God Can Use Me."
This tour back to Ohio includes the Gallipolis River Recreation Gospel Day, Wednesday July 3, 10 a.m. to 3 p.m., with the group taking the stage at 1 p.m. On Wednesday evening, join them at 7 p.m. at College Hill Church, Mason County, W.Va. with Rev Josh Searls. On Saturday July 6 at 6 p.m. join them in service with Pastor Greg Sears , Pastor Rick Towe and the Congregation of the New Life Church of God. Sunday morning, the trio will be with Pastor Jamie Fortner and the congregation of the Puritan Freewill Baptist Church at 10:30 a.m. Sunday evening at 6 p.m., they will be with the congregation of Addison Freewill Baptist Church and Pastor Rick Barcus, rounding out the trip back home.
https://www.mydailytribune.com/wp-content/uploads/sites/42/2019/07/web1_IMG_8573-1-.jpgThe Raineys Trio compromised of Laura Rainey, James Rainey and Berdella McGrew. Courtesy photo
Hi! A visitor to our site felt the following article might be of interest to you: Raineys Trio returns. Here is a link to that story: https://www.mydailytribune.com/news/41715/raineys-trio-returns


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Identifying relative efficacy of components of prehabilitation in adult surgical patients: protocol for a systematic review and component network meta-analysis
http://orcid.org/0000-0002-8543-1859Daniel I McIsaac1,2,3,
http://orcid.org/0000-0001-5662-8647Brian Hutton2,3,
Areti Veroniki4,
Marlyn Gill5,
Laura Boland6,
Karina Branje1,2,
Alexa L Grudzinski1,
Emily Hladkowicz1,2,
Julia Shaw1,2,
Chelsia Gillis7
The Prehabilitation Knowledge Network Authorship Group
1Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada
2Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
3School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
4Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
5Patient Partner, Calgary, Alberta, Canada
6Centre for Practice-Changing Research, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
7Department of Human Nutrition, McGill University, Montreal, Quebec, Canada
8NA, Ottawa, Ontario, Canada
Correspondence to Dr Daniel I McIsaac; dmcisaac{at}toh.ca
Introduction Prehabilitation is a high-priority intervention for patients, the public, clinicians and health systems. However, existing knowledge syntheses are generally low quality and do not provide insights regarding the relative efficacy of different prehabilitation components (eg, exercise, nutrition, psychosocial or cognitive interventions). The objective of the planned review is to evaluate the relative efficacy of different prehabilitation components to inform current care, implementation and future research.
Methods and analysis We will perform a systematic review and component network meta-analysis (CNMA). We will use a peer-reviewed search strategy to identify all randomised trials of prehabilitation in adult surgical patients from Ovid Medline, Embase, the CINAHL, PsycINFO, Web of Science and the Cochrane Central Register of Controlled Trials, along with grey literature. All stages of the review and data extraction process will be performed in duplicate, following recommended best practices. To compare the relative efficacy of different prehabilitation components (prespecified as exercise, nutrition, psychosocial or cognitive interventions), we will use CNMA, an extension of network meta-analysis that allows estimation of the contributions to efficacy of each component of a multicomponent intervention through direct and indirect comparisons. We will use additive CNMA models for critical outcomes (postoperative complications, patient-reported recovery, physical recovery and length of stay); standard care will be the common reference condition. Pre-specified sensitivity and subgroup analyses will be conducted.
Ethics and dissemination This review of published data does not require ethical review. Results will be disseminated via scientific conferences, peer-reviewed publications, social and traditional media and via our research network to target partners and organisations.
Quality in health care
A prespecified protocol based on best practices for systematic review and meta-analysis will guide conduct of the study.
All stages of the study will be done in collaboration with patient and knowledge user partners so that findings will be co-produced in an integrated knowledge translation framework.
Component network meta-analysis will allow comparison of the relative efficacy of different prehabilitation components, even when multiple components are delivered simultaneously.
If assumptions underlying component network meta-analysis are not met, we may be unable to estimate relative efficacy of different components.
Globally, >300 million surgical procedures are performed each year.1 2 These surgeries mostly occur on a planned (also referred to as 'elective') basis,3 meaning that wait-times can be positively leveraged to optimise patient status prior to surgery. Patient optimisation is critical in supporting high value surgical care as adverse postoperative events that matter to patients and the healthcare system are common.4 Complications such as cardiopulmonary events, infections and major bleeding occur in 10%–20% of patients.5–7 Impaired functional recovery or new clinically significant disability develop in more than one in five surgical patients; such adverse events are even more common among older patients and those with poor baseline health.8–12 Effective strategies to improve outcomes for the millions of people having surgery each year are urgently needed.
Prehabilitation is a process undertaken in advance of surgery, which has the specific intent of improving an individual's functional, physiologic, cognitive and/or mental health status through targeted interventions.13 14 Patients, the public and international specialty societies identify prehabilitation as a high priority intervention, including multiple James Lind Alliance priority setting partnerships.15–17 However, despite the face validity and enthusiasm for prehabilitation interventions, a recently completed umbrella review of 55 prehabilitation systematic reviews found that existing evidence synthesis is insufficient to inform practice.18 Several key knowledge gaps preclude translation of current evidence into practice. First, existing systematic reviews have major methodological shortcomings; 51 of 55 prehabilitation reviews synthesised in a recent umbrella review were rated as low quality.18 19 Second, prehabilitation interventions are heterogeneous, as they may consist of different components, including exercise, nutrition, psychosocial and cognitive interventions, or combinations thereof.18 Existing prehabilitation reviews have typically focused only on single component interventions, or pooled all types of prehabilitation components or interventions together. This means that patients, clinicians, researchers and health system planners are unable to determine what specific components, or combinations of components, contribute the most to prehabilitation efficacy and deserve the greatest focus in implementation and future research. Understanding how the current evidence network can be leveraged to detect differences between the effects of interventions and their individual components would help to address these important gaps.
Component network meta-analysis (CNMA), an extension to network meta-analysis, allows estimation of separate effects for each component of a multicomponent intervention through direct and indirect comparison, even when these are delivered in combination.20 21 We propose a CNMA based on an up-to-date, high-quality systematic review, to address important knowledge gaps in the prehabilitation evidence base. Our objective is to estimate which prehabilitation components contribute the greatest efficacy in improving critical outcomes, including postoperative complication rates, patient-reported recovery, physical recovery and length of stay in adult patients preparing for surgery.
This study will be a systematic review with CNMA. The study began in March 2022 and has an anticipated end date of March 2023. This protocol has been prepared in consideration of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines, the PRISMA extension for network meta-analysis and specific considerations for CNMA.22–24 Methods for the review are directly informed by the Cochrane Handbook and Methodological Expectations of Cochrane Intervention Reviews.25 26 Findings will be reported according to PRISMA guidance.23 27 28 Any deviations from our prespecified methodology will be described in the final report (with rationale).29 The protocol has been submitted for registration to the International Prospective Register of Systematic Reviews (PROSPERO).
This review will be conducted and co-produced with partners using an integrated knowledge translation (IKT) framework.30–32 Specifically, patients who will be impacted by the research and knowledge users who will implement evidence in practice have been, and will continue to be, regularly engaged through meetings, surveys and one-on-one discussions. A start-up meeting occurred 3 June 2022; mid-study, postsynthesis and wrap up team meetings will also be held to ensure meaningful input can be obtained throughout the course of the study. Patient and public involvement will be reported according to the Guidance for Reporting Involvement of Patients and the Public-2 checklist.33
Intervention definition
A prehabilitation intervention is intended to improve physical, physiological, cognitive or psychosocial function and to correct deficiencies in these domains in advance of surgery.13 14 We will define and operationalise the following working definition of prehabilitation based on consistent descriptions of prehabilitation provided in the literature: a unimodal intervention consisting of exercise (eg, aerobic, strength or flexibility focused interventions), nutrition (eg, advice, supplementation or other interventions to improve oral or enteral macro or micronutrient intake), cognitive (eg, interventions to improve or maintain cognitive function) or psychosocial (eg, interventions to improve mood, affect or motivation) training or a multimodal intervention that combines exercise, nutrition, cognitive and/or psychosocial training with or without other interventions, undertaken for seven or more days before surgery.13 34–36 No limitations will be placed on duration, location or supervisory approaches to the prehabilitation intervention. For the purposes of CNMA, intervention components will be classified as: exercise, nutrition, cognitive or psychosocial. The reference category will be standard care, which is the most common comparator in existing randomised trials and meta-analyses of prehabilitation.18
Selection criteria will be informed by our population–intervention–comparator–outcome question. We will include randomised trials addressing a population of adults (>18 years; provision of paediatric surgical care is substantively different from adults) undergoing major elective surgery where participants were exposed to a prehabilitation intervention prior to surgery compared with individuals receiving standard care or a different prehabilitation intervention (eg, another prehabilitation intervention consisting of different components) reporting prespecified outcomes (see the Outcomes section).
Studies evaluating isolated preoperative risk factor management (eg, smoking cessation, anaemia treatment, medication management in isolation) or interventions applied immediately (<7 days) before surgery (a time frame consistent with enhanced recovery after surgery)37 38 will be excluded to be consistent with accepted definitions of prehabilitation.18 No language exclusions will be applied. Quasi-experimental and other non-randomised designs will be excluded.
Consultation with partners (patients, clinicians, health system leaders and scientists) and a recent umbrella review performed by our team informed prespecification of outcomes.18 This led to the choice of critical and exploratory outcomes that are prioritised by knowledge users and that will be adequately reported in prehabilitation trials. Critical outcomes include: (1) a composite of any postoperative medical or surgical complications during the index hospitalisation or within 30 days (a core outcome in surgery and perioperative medicine)39 40 as it is a key step on the causal pathway between prehabilitation and improved recovery after surgery,10 and is the most commonly reported outcome in prehabilitation RCTs36; (2) patient-reported recovery (eg, disability or quality of life; most distal reported measure up to 90 days after surgery); (3) physical recovery (eg, 6 min walk test, short physical performance battery; most distal reported measure up to 90 days after surgery) and (4) length of hospital stay (LoS). Exploratory outcomes will be organised per the Institute for Healthcare Improvement Triple Aim domains, and will include health (non-home discharge, mortality), experience (pain, satisfaction) and resource use (costs).36 41 42 These exploratory outcomes will be analysed if adequate data and resources are available.
Our search strategy (online supplemental file 1) has been developed with our team's information specialist, and has undergone the Peer Review of Electronic Search Strategies review process with a second, independent information specialist.43 Grey literature sources will be searched.26 44 We will translate and apply our search strategy to Ovid Medline, Embase, the CINAHL, PsycINFO, Web of Science and the Cochrane CENTRAL Register of Controlled Trials. We will assess reference lists of included trials and related reviews to identify citations missed by our search.
Study review and selection
All stages of the review will be conducted in duplicate by two independent reviewers using Distiller SR (Evidence Partners, Ottawa, Canada). At each stage of the review, the first 50 citations will be assessed, followed by a meeting of reviewers with study leads to review decisions, identify any issues related to disagreements and/or interpretation of selection criteria, and recalibrate reviewers' approaches as needed. The first stage will include title and abstract review. After full text review by two independent authors, any conflicts will be resolved through consensus in a meeting between study leads and reviewers; reasons for exclusion at full text review will be documented and provided in the final publication.
Data will be extracted using a form specifically designed for this review following a piloting exercise by the review team. Key to the implementation of CNMA as our analytical approach, we will collect full descriptions of comparator conditions (eg, standard care, other prehabilitation interventions). All data will be extracted in duplicate; disagreements will be resolved by reviewers through cooperative review of the primary source with a study lead. A full description of all anticipated data points is included in online supplemental file 2. Sample size, population characteristics and missing data will be collected for each trial. For binary outcomes, we will collect the 2×2 table, event rates and/or effect measures (eg, ORs or risk ratios) along with a measure of uncertainty (eg, 95% CIs, p values). For continuous outcomes we will collect means and SD, and/or effect estimates such as mean differences along with their 95% CIs and p values. Any missing data will be sought directly from study authors.
Assessment of bias in included studies
The Cochrane Risk of Bias 2 tool will be applied in duplicate to each included RCT45 to assess within-study bias of the included evidence. Where >10 studies are available in a meta-analysis, funnel plots and Egger's test will be used to assess for possible publication bias and small-study effects.46
Assessment of certainty of evidence
We will use the GRADE working group classification to assess the certainty of evidence for each outcome,47 including modifications specific to certainty assessment in network meta-analysis.48 This will allow us to categorise evidence as high/moderate/low/very-low certainty, which will be reported using appropriate statements.49
Intervention effect estimates
Pooled effect estimates will be reported as odds ratios (binary outcomes), mean differences (continuous outcomes on a single scale (eg, LoS)) or standardised mean differences (SMDs) (continuous outcomes on multiple scales (eg, functional recovery)); point estimates along with 95% CIs will be reported. Where SMDs are calculated from different scales that capture related conceptual outcomes (eg, patient-reported recovery via quality of life or disability scales), directionality will be standardised prior to analysis. Where multiple scales that reflect functional recovery are reported within a single included study, we will preferentially select for pooling generic (vs disease specific) scales to enhance generalisability, and quality of life (vs other concepts) scales, as our previous work demonstrates that quality of life is reported far more frequently in prehabilitation studies than related measures like disability.18 Where continuous outcome measures are not reported as means and SD, we will use the methods of Wan and colleagues to estimate means and SD from reported measures such as medians and IQR or overall ranges.50 Effect estimates derived from cluster randomised trials will be pooled using the reported effect adjusted for clustering, or if not available, a corrected estimate accounting for an estimated design effect.51
Data syntheses and analyses
Our approach to analysis will follow previous recommendations, whereby sequential and complimentary techniques will be used to estimate the pooled effects of prehabilitation and its components.20 52
Pairwise meta-analysis
Pairwise meta-analysis will first be used to estimate whether any prehabilitation intervention, or prespecified components (exercise, nutrition, psychosocial or cognitive) improve critical outcomes compared with standard care or comparator interventions (separately). All meta-analysis models will use random effects, as existing knowledge suggests that assumptions for fixed-effect meta-analysis will not be met (in particular due to heterogeneity related to different surgical procedures).18 We will use the Hartung-Knapp-Sidik-Jonkman method to derive appropriate CIs.53 Between-study variance will be estimated using the restricted maximum likelihood method and its 95% CI using the Q-profile approach.54–56 We will also calculate the I2 statistic to quantify the percentage of variability due to between-study heterogeneity rather than random error. If substantial heterogeneity exists, sources will be explored using subgroup analysis and meta-regression, based on prespecified postulated effect modifiers (type of surgery, age, type of prehabilitation, baseline functional status).
Assessment of assumptions for NMA and CNMA
We will assess for transitivity (the assumption that two components can be validly compared via a common control condition) both visually and statistically. Visual evaluation will be conducted via assessment of the distribution of effect modifiers in tabular and graphical presentations across treatment comparisons. We will visually inspect similarity of the distribution of the following effect modifiers: type of surgery, age, baseline functional status, comorbidity or American Society of Anesthesiologists' Score, presence of cancer, presence of malnutrition. Statistical assessment of transitivity will involve a global assessment of consistency using the design-by-treatment interaction model,57 and a local assessment through the node-splitting approach.58 For the CNMA, we will assess the additivity assumption using the method of Rücker et al based on the difference in Q statistics between the additive CNMA and standard NMA model.24
Network meta-analysis
Next, we will conduct a standard NMA, also referred to as a full interaction model in CNMA,20 and generate network plots to visually explore the available evidence base. We will perform a random-effects NMA assuming a common between-studies variance (
) across the whole network, using the restricted maximum likelihood method.59 We will estimate summary effect measures (ORs, mean differences, weighted mean differences) along with 95% CIs and 95% prediction intervals. To assess the magnitude of heterogeneity, we will compare the estimated
with an empirical distribution for dichotomous data.60 We will obtain a treatment hierarchy using P-scores, which take values between 0 and 1, and which is based on the estimated treatment effects and their associated uncertainty.61
Component network meta-analysis
We will use an additive CNMA model to evaluate the influence of the individual components, where each component has its own effect, and the total effect of an intervention will be equal to the sum of the relative component effects. It should be noted that common components in comparisons of interventions cancel out (ie,
is identical to the effect of
Model implementation
All analyses will be performed in the R programming language (R Foundation for Statistical Computing, Vienna, Austria). We will fit pair-wise meta-analysis models in R using the meta package,62 and will conduct all NMA, CNMAs, design-by-treatment interaction models, node-splitting models, subgroup and sensitivity analyses in R using the netmeta package.63
If adequate data are available and network geometry is not substantively changed, we will re-estimate our additive CNMA models limited to low risk of bias trials only.
While we have prespecified, based on our prior umbrella review, exercise, nutrition, psychosocial and cognitive interventions as the components that we will compare using CNMA, theoretically each component can be further subdivided. If adequate data are available, we will explore CNMA analyses by subcomponent (eg, exercise: aerobic, strength, other; nutrition: supplementation, counselling, other; psychosocial: anxiety reduction, mood stabilisation, other; although ultimately some subcomponents listed here may require further merging or disaggregation based on their distribution between studies) to further refine our understanding of intervention component efficacy. If missing data are present and unaccounted for in primary reports, we will complete sensitivity analyses using appropriate techniques to impute missing values and assess consistency between primary and imputed results.
Results will be disseminated through presentations at scientific conferences and submission of peer-reviewed manuscripts. Using our IKT approach, we will also perform targeted dissemination to partner organisations and via our investigator network. Social and traditional media will also be used to spread results to a larger audience. Ethics approval was not required, as this study does not require participation of human subjects.
CNMA requires specific assumptions and acknowledgement of limitations. Assumptions underlying CNMA are similar to those of network meta-analyses,64 and will require assessment prior to analysis. Because network comparisons (direct and indirect) depend on a common reference condition (ie, standard care), detailed description of standard care conditions in existing trials will be described to allow meaningful clinical interpretation of results. Should assumption-violating differences between RCTs be identified, we will incorporate baseline risk meta-regression (ie, control rate meta-regression) in our analyses.65 Some indirect (ie, via the standard care reference condition) comparisons may not be possible due to a lack of relevant RCT comparators. We have defined our components as exercise, nutrition, psychosocial and cognitive. However, we recognise that these components could be subdivided further, and have therefore prespecified exploratory investigation of subcomponents (eg, strength vs aerobic exercise) should adequate data be available. Sparse data can also limit the power to detect meaningful differences, especially in CNMA models with interactions and for meta-regression.20 66 67
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. Methods to estimate the between-study variance and its uncertainty in meta-analysis. Res Synth Methods 2016;7:55–79.doi:10.1002/jrsm.1164pmid:http://www.ncbi.nlm.nih.gov/pubmed/26332144
Langan D,
Jackson D, et al
. A comparison of heterogeneity variance estimators in simulated random-effects meta-analyses. Res Synth Methods 2019;10:83–98.doi:10.1002/jrsm.1316pmid:http://www.ncbi.nlm.nih.gov/pubmed/30067315
Viechtbauer W
. Confidence intervals for the amount of heterogeneity in meta-analysis. Stat Med 2007;26:37–52.doi:10.1002/sim.2514pmid:http://www.ncbi.nlm.nih.gov/pubmed/16463355
White IR,
Barrett JK,
. Consistency and inconsistency in network meta-analysis: model estimation using multivariate meta-regression. Res Synth Methods 2012;3:111–25.doi:10.1002/jrsm.1045pmid:http://www.ncbi.nlm.nih.gov/pubmed/26062085
Dias S,
. Checking consistency in mixed treatment comparison meta-analysis. Stat Med 2010;29:932–44.doi:10.1002/sim.3767pmid:http://www.ncbi.nlm.nih.gov/pubmed/20213715
Whitehead A
. Borrowing strength from external trials in a meta-analysis. Stat Med 1996;15:2733–49.doi:10.1002/(SICI)1097-0258(19961230)15:24<2733::AID-SIM562>3.0.CO;2-0pmid:http://www.ncbi.nlm.nih.gov/pubmed/8981683
Turner RM,
Davey J,
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. Predicting the extent of heterogeneity in meta-analysis, using empirical data from the Cochrane database of systematic reviews. Int J Epidemiol 2012;41:818–27.doi:10.1093/ije/dys041pmid:http://www.ncbi.nlm.nih.gov/pubmed/22461129
. Ranking treatments in frequentist network meta-analysis works without resampling methods. BMC Med Res Methodol 2015;15:58.doi:10.1186/s12874-015-0060-8pmid:http://www.ncbi.nlm.nih.gov/pubmed/26227148
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. How to perform a meta-analysis with R: a practical tutorial. Evid Based Ment Health 2019;22:153–60.doi:10.1136/ebmental-2019-300117pmid:http://www.ncbi.nlm.nih.gov/pubmed/31563865
Schwarzer G,
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. Meta-Analysis with R. Springer International Publishing, 2015.
Donegan S,
Williamson P,
D'Alessandro U, et al
. Assessing key assumptions of network meta-analysis: a review of methods. Res Synth Methods 2013;4:291–323.doi:10.1002/jrsm.1085pmid:http://www.ncbi.nlm.nih.gov/pubmed/26053945
Sutton A,
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. NICE DSU technical support document 2: a generalised linear modelling framework for pairwise and network meta-analysis of randomised controlled trials, 2011. Available: http://www.nicedsu.org.uk
Melendez-Torres GJ,
Bonell C,
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. Emergent approaches to the meta-analysis of multiple heterogeneous complex interventions data collection, quality, and reporting. BMC Med Res Methodol 2015;15:1–7.
Hempel S,
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. Risk of bias: a simulation study of power to detect study-level moderator effects in meta-analysis. Syst Rev 2013;2:107.doi:10.1186/2046-4053-2-107pmid:http://www.ncbi.nlm.nih.gov/pubmed/24286208
Twitter @bh_epistat
Collaborators Prehabilitation Knowledge Network: Shamsuddin Akhtar, Marlis Atkins, Sylvie Aucoin, Rebecca Auer, Carlota Basualdo-Hammond, Paul Beaule, Mary Brindle, Gregory Bryson, Franco Carli, Antoine Eskander, Dean Fergusson, Julio Fiore Jr., Alan Forster, Melani Gillam, Leah Gramlich, Jayna Holroyd-Leduc, Timothy Jackson, Rachel Khadaroo, Manoj Lalu, Cameron Love, Guillaume Martel, Colin McCartney, Dolores McKeen, Amanda Meliambro, Husein Moloo, Ronald Moore, John Muscedere, Julie Nantel, Stephane Poitras, Celena Scheede-Bergdahl, Risa Shorr, Monica Taljaard, Tom Wallace, Duminda Wijeysundera.
Contributors DIM is the principal investigator. DIM, MG, LB, BH, AV, CG, KB, ALG, JS and EH were involved in the conception and design of the study. DIM wrote the initial draft of the protocol and this manuscript. All authors provided critical input regarding the design of the study. DIM, BH, and AV designed the data analysis plan. All authors revised the protocol critically for important intellectual content and approved the final version to be published. DIM, MG, LB, BH, AV, CG, KB, ALG, JS and EH agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors, including the Prehabilitation Knowledge Network, have critically reviewed and approved the final protocol.
Funding This work was supported by The Canadian Institutes of Health Research (179837).


text:
Q: CSS - sticky table headers I have a code pen here  - Code
It's a table in a container, the table is bigger than the container.
When scrolling left to right the table and the headers move
When scrolling up and down I need the header to be sticky and the content to move underneath.
It sort of works here - Code
but I lose the widths of the columns and the table.
How do I make the headers sticky but keep the width of the table
body{
  background: grey;
  font-family: sans-serif;
}
.page{
  background: white;
  width: 1200px;
  margin: 0 auto;
}
.table-con{
  overflow: scroll;
  max-width: 1200px;
  height: 500px;
}

table{
  /*table-layout: fixed;*/
  border-collapse: collapse;
  width: 1500px;
}

thead th:first-child{
  width: 20px;
  padding: 0;
}

thead th{
  text-align: left;
}

thead tr{
  border-bottom: 1px solid #444;
}

tbody td{
  border-bottom: 1px solid #aaa;
}

tbody tr:nth-child(even) td:not(:first-child){
  background: yellow;
}

tbody td:first-child{
  background: none;
  border: none;
  padding: 0;
}

th, td{
  padding: 10px 5px;

   &:first-of-type{
    padding-left: 20px;
  }

  &:last-of-type{
    padding-right: 20px;
  }
}

A: Hi Please refer below code hope it will helpful to you.

html, body{
  margin:0;
  padding:0;
  height:100%;
}
section {
  position: relative;
  border: 1px solid #000;
  padding-top: 37px;
  background: #500;
}
section.positioned {
  position: absolute;
  top:100px;
  left:100px;
  width:800px;
  box-shadow: 0 0 15px #333;
}
.container {
  overflow-y: auto;
  height: 200px;
}
table {
  border-spacing: 0;
  width:100%;
}
td + td {
  border-left:1px solid #eee;
}
td, th {
  border-bottom:1px solid #eee;
  background: #ddd;
  color: #000;
  padding: 10px 25px;
}
th {
  height: 0;
  line-height: 0;
  padding-top: 0;
  padding-bottom: 0;
  color: transparent;
  border: none;
  white-space: nowrap;
}
th div{
  position: absolute;
  background: transparent;
  color: #fff;
  padding: 9px 25px;
  top: 0;
  margin-left: -25px;
  line-height: normal;
  border-left: 1px solid #800;
}
th:first-child div{
  border: none;
}

            Table attribute name

Table attribute name

            Value

Value

            Description

Description

          align
          left, center, right
          Not supported in HTML5. Deprecated in HTML 4.01. Specifies the alignment of a table according to surrounding text

          bgcolor
          rgb(x,x,x), #xxxxxx, colorname
          Not supported in HTML5. Deprecated in HTML 4.01. Specifies the background color for a table

          border
          1,""
          Specifies whether the table cells should have borders or not

          cellpadding
          pixels
          Not supported in HTML5. Specifies the space between the cell wall and the cell content

          cellspacing
          pixels
          Not supported in HTML5. Specifies the space between cells

          frame
          void, above, below, hsides, lhs, rhs, vsides, box, border
          Not supported in HTML5. Specifies which parts of the outside borders that should be visible

          rules
          none, groups, rows, cols, all
          Not supported in HTML5. Specifies which parts of the inside borders that should be visible

          summary
          text
          Not supported in HTML5. Specifies a summary of the content of a table

          width
          pixels, %
          Not supported in HTML5. Specifies the width of a table


After installing the path to the object folder and the tileset folder you have to relaunch Flame.
And don`t forget to click on "new map" after restart.
I wasted 1 hour to solve the problem the first time-just because i didn`t click on "new map".
hello montetank i already do what you recommended but somehow the FlaME said "couldnt find the file" or "couldnt open the file"
The reason is: In the archive tilesets is an folder with the same name. And in Objects is an Object-folder. I had the same problem. Here the path, where i put my folders.
BTW-Don`t forget to read the guide.


Rugby artificial grass needs to be tough and designed to enhance players' performance and last for years but in order to do this regular maintenance needs to be invested in to ensure that hard falls and heavy tackles don't rip the seams and cause a health and safety issue resulting in an unusable pitch.
Outdoor rugby pitches cannot avoid the bad weather therefore it is important to make sure that the life of the pitch is maximised and drainage doesn't get clogged up! Unfortunately, contaminants can penetrate into artificial turf surfaces from air born particles and other items that are not supposed to be on the surface such as leaves and litter. Power sweeping and specialist de-compaction can be outsourced to STM to remove the smallest of particles and help with cleaning your artificial turf if you are having problems with drainage of the artificial turf.
If you are unsure about which one your surface requires browse to our preventative maintenance section or contact us.
Rugby pitches need to withstand hard landings and that is why we have worked with International Rugby Federation approved rugby turf to make sure that we know what is expected of rugby turf to provide the best possible result for you and your pitch.
Rugby pitch infill is exceptionally important and should always be monitored. This is because it acts as a support mechanism for the artificial grass and protects the grass (obviously very important with rugby!) Gradually over time, infill can move towards the edges of the rugby pitch to the areas that are not used as much so it is important to redistribute the infill back to its initial state.
STM do this by using a specialist machine to help move the sand infill. There are also other benefits of making sure that your sand and rubber infill is monitored regularly. Remember there will be tonnes of sand in your rugby pitch and these act as a shock absorber in rugby as the sand will take the brunt of the fall therefore not damaging the yarn.
Did you know that if you have one tear in your rugby pitch, and sand infill gets into the seam, the abrasiveness of the sand can lead to further seams coming away. TIP: make sure that you have seams repaired as soon as possible!


The various types of patent infringement occur when a person or business uses parts of a patented idea, method, or device without permission. Patent infringement is also known as patent violation or even stolen ideas. It could involve either using or selling the patented invention or idea. Before you can sue someone for patent infringement, you must figure out who is at fault. It's not always as obvious as you might think. Understanding the different types of patent infringement helps to determine who is accountable.
Making, using, selling, trying to sell, or importing something without obtaining a license from the patent holder is considered direct patent infringement. The offender must complete this act willfully and within the United States.
Indirect infringement includes contributory infringement and inducement to infringe a patent. Under these terms, even if a company isn't the one that originally infringed on the patent, that company can still be held accountable for patent infringement.
This type of infringement involves the purchase or importation of a part that aids in creating a patented item. To prove contributory infringement, one must show that the component's main use would be to create a patented item. A generic item that has other uses usually doesn't qualify in proving contributory infringement.
This occurs when a person or company aids in patent infringement by providing components or helping to make a patented product. It occurs through offering instructions, preparing instructions, or licensing plans or processes.
Willful infringement exists when a person demonstrates complete disregard for someone else's patent. Willful infringement is especially damaging to defendants in a civil suit. The penalties are much higher, and typically defendants must pay all attorney and court costs if they are found guilty.
To prove literal infringement, there must be a direct correspondence between the infringing device or process and the patented device or process.
Even if the device or method doesn't exactly infringe a patent, a judge might find in favor of the patent holder. If the device does basically the same thing and produces the same results, it could be an infringement.
Sometimes the end user is not even aware that he or she is using a patented item unlawfully. Other times, there are too many people using the item to sue all of them. Rather than suing end users, it might be best to sue those who are knowingly trying to infringe on a patent.
Only exists in the United States. In other countries, designs aren't patented.
In the United States, patents protect companies from losing billions of dollars to competitors. For example, a patent protected the creators of the drug Lipitor, which resulted in 12.7 billion dollars in sales.
Patents exist all over the world, but the laws vary by country. For example, in India, a patent gives the owner power over everything about that idea or object.
The patent office issues patents, but it does not enforce them. That job is left up to you. The first step is typically to ask the infringing person or company to stop. If that doesn't work, the next steps depend on the country. In Canada, for example, most patent cases take place in the Superior Court of the Provinces or in the Federal Court.
It's important for you and your company to watch your competitors to make sure no one is infringing on any of your patents. Some people choose to hire a third party to do this.
It's also important to watch upcoming technology. You can save time and money by stopping any patent infringement attempts before they are completed.
If you believe someone is infringing your patent, proving it is a two-step process.
The defense typically will challenge the patent's validity. The capabilities, rules, and regulations vary by country.
The defense may try to prove that the original patent was not valid based on a previous idea or patent. It could be considered invalid because of a failure to include every inventor in the patent.
Several strategies are necessary and important to win a patent infringement lawsuit.
Patent infringement means unauthorized use of a patent. "Use" may sound like a simple term. Unless you are specifically trained in patent infringement, it's not easy to define.
According to 35 U.S.C. 271(a) (2000), "[Whoever] without authority makes, uses, offers to sell, or sells any patented invention, within the United States or imports into the United States any patented invention during the term of the patent therefore, infringes on the patent."
In the past, courts have defined the term "use" liberally. This has made patent infringement difficult to prove.
The nature of the claim determines how the courts handle a case. It's much different for a process or method versus an apparatus.
An apparatus claim involves the physical item and not necessarily what it can do. Owning or possessing the object is not always patent infringement.
There are fewer limitations when claiming patent infringement on methods than on apparatus claims.
Infringement on a method has a smaller scope than infringement on an apparatus.
Joy Technologies, Inc. versus Flakt, Inc.
The federal government disagreed that the sale of an industrial plant that the defendant created to use a patented system was patent infringement. If the process was later performed, it could be patent infringement. The sale of the equipment was not considered infringement until the equipment was actually used.
NTP, Inc. versus Research in Motion, Ltd.
The Federal Circuit made it clear that the infringer must sequence the steps exactly for patent infringement to exist. In this case, if the infringer did even one step of the process outside of the United States, the court did not consider the method patent infringement. When the system isn't used in its entirety, it's not infringing on the patent. However, the court did find infringement when the infringers used the system completely within the United States.
The courts decided that infringement only occurs when the system is used and the invention put into service. The infringing party must apply the system or method to cause the end product to benefit the user.
Judging patent infringement is a two-step process.
When someone is found guilty of patent infringement, the penalties typically include monetary relief to the patent holder. The most important of these is compensatory damages. These cover the patent owner's lost profits because of the patent infringement. The amount of these damages is set after the value of the patent has been determined. Damages may also include the actual money received by the infringer.
The patent holder is also eligible to receive court costs and attorney fees that were paid to take the infringer to court.
If a defendant is found guilty of deliberate infringement, the patent holder is eligible for increased damages. These damages can be up to three times the normal compensatory damages. These damages can only be claimed from the date the patent is issued, and the claim can only go back six years prior to the filing of the infringement claim.
Injunctions are another type of penalty for patent infringement.
For infringement disputes in India, the court levels start with the District Court, then move up to the High Court, and finally the Supreme Court of India. These disputes are handled similarly to those in the United States. After the filing of a suit, a hearing is held where the district court reviews the evidence.
If the case deals with both invalidity and infringement, it is heard by the high courts. Furthermore, a specialized board, the Intellectual Property Appellate Board, hears all the appeals related to patent infringement.
Spending money to avoid patent infringement could save you or your company a lot of money in the future. There are many reasons to avoid a patent infringement lawsuit.
Lawsuits are expensive, but patent lawsuits tend to cost even more than traditional ones. Many cost over a million dollars in legal fees alone. If you are the defendant and lose, you may be required to pay court costs and the legal fees of the person who accused you of patent infringement.
If you are sued for patent infringement, you pay with both your time and your money. Even though the lawyers do most of the work, you will still spend a lot of time appearing in court and working with the lawyers to attempt to prove your innocence.
The accuser may ask for a preliminary injunction that could hurt your business even before the judge gives the verdict. Specifically in India, to get an injunction, the accuser must prove that the claim has validity, there is irreparable damage involved, and that the accuser will be greatly inconvenienced if it is not granted.
The owner of the patent may also go after your customers. Even if you have not knowingly committed patent infringement, you could lose customers and damage your reputation during the process.
If you are found guilty of patent infringement, you typically will have to start completely over in your process for your product or idea. You will lose valuable time and money. Finding alternatives from the beginning could be much cheaper.
Don't wait until you've already created a product to try to find relevant patents. You may want to consider outsourcing this step to experts who know how to find relevant patents for specific designs or ideas.
Intentionally ignoring others' patent information won't save you in court. In fact, it will probably cause you more problems.
Once you have found all the relevant patents related to your product, it's time to send them to a lawyer for review. Since this process can be costly, make sure you do an initial review to pull out any patents that have expired. Also, find out if the patent owner has paid all maintenance fees, or if any of the patents aren't actually applicable to your product.
A utility patent normally expires after 20 years. A design patent usually expires after 14 years. There are typically maintenance fees associated with patents, and if they aren't paid, the patent is no longer valid. Don't waste your money by having your lawyer review patents that have expired.
Before you send any patents to your lawyer, you should realize that internal communications about patents are not always covered under attorney-client privilege. Be cautious about what you say during these communications.
If there is any question that you could be infringing on a patent, it's best to work with your patent attorney immediately. Request a preliminary patent infringement review. This is not a formal opinion, and it costs less than a full review.
If it is necessary, the next step is a formal patent infringement check by your patent attorney. Your attorney will check the USPTO and look for any validity concerns with the patent. Although a formal review is more expensive, it's much cheaper than being sued for patent infringement.
If patent infringement is possible, then it might be worth the time to prove any further validity issues. These might include earlier technology or other patents which would discredit the patent.
Myth: We won't get sued.
Reality: It's not worth the risk.
Patent lawyers are marketing and doing the homework for businesses, making lawsuits more accessible. Even small companies are at risk of being sued.
Myth: We know every patent in the industry.
When people feel that they are experts in their field, they assume that if there is a related patent, they already know about it.
Reality: It's impossible to know every patent.
There are some times when infringement is permissible or at least excusable. If the patent holder intentionally delays bringing a suit against the infringer, the infringer could win the case. There are four other times when infringement is permissible.
If you get sued for patent infringement, it could cost you a great deal of money. you could see big costs. If someone copies or steals parts of your patents, those court costs can also be high.
If you could be at risk for being on the offense or defense of patent infringement, then you may need to consider patent infringement insurance.
Most of the time, patent infringement insurance is not worth the investment. There are high costs associated with the insurance, including insurance premiums and copays. The money you spend on insurance is usually better spent on developing technology or investing in your company.
For example, patent insurance usually costs between 2 and 5 percent of the amount of coverage. If you want a million dollars in coverage, it could cost up to 50,000 dollars. You might also have to pay a copayment of 15 to 25 percent of any lawsuit award covered by the insurance. That means if the suit costs one million dollars, you will still owe up to 250,000 dollars.
Defensive patent insurance requires a strict process for approval. The insurer will look closely at your patent portfolio for conflicting patents. If there is any chance you could be sued for patent infringement, they won't cover you. These disadvantages are also true for offensive patent insurance.
Some Comprehensive General Liability Insurance may offer types of insurance that cover aspects of patent infringement, such as intellectual property infringement.
Patent infringement is a complicated part of the legal system. It's important to work with an attorney, whether you are on the defensive or the offensive end of patent infringement. You can post your legal need here, whether it is a patent infringement or another business legal need, and you will instantly receive free custom quotes from the top 5% of lawyers on UpCounsel. Our lawyers come from some of the most prestigious law schools such as Berkley, Yale and Harvard.