This glossary explores commonly used health care quality improvement terminology.
Accountable Care Organization (ACO)—An accountable care organization is a group of health care providers (e.g. primary care physicians, specialists and hospitals) that have entered into a formal arrangement to assume collective responsibility for the cost and quality of care of a specific group of patients and that receive financial incentives to improve the quality and efficiency of health care.
Acute care—Acute care is short-term medical treatment, most often in a hospital, for people who have a severe illness or injury, or are recovering from surgery.
Admission or hospital admissions—Admission or hospital admissions is the process of being admitted to a hospital as a patient. The rate and quality of this process may be a good indicator of the local health system's performance and the effectiveness of health plans in managing care.
Agency for Healthcare Research and Quality (AHRQ)—The Agency for Healthcare Research and Quality (AHRQ) is the nation's lead federal agency for research on health care quality, costs, outcomes and patient safety. AHRQ is the health services research arm of the U.S. Department of Health and Human Services (HHS), complementing the biomedical research mission of its sister agency, the National Institutes of Health. The agency is home to research centers that specialize in major areas of health care research, including: clinical practice and technology assessment, health care organization and delivery systems, and primary care. AHRQ is a major source of funding and technical assistance for health services research and research training at leading U.S. universities and other institutions. As a science partner, the agency works with the public and private sectors to build the knowledge base for what works—and does not work—in health and health care and to translate this knowledge into everyday practice and policy-making.
Aligning Forces for Quality (AF4Q)—Aligning Forces for Quality (AF4Q) is a national program of the Robert Wood Johnson Foundation (RWJF) designed to help communities across the country improve the quality of health care for patients with chronic conditions such as diabetes, asthma, depression and heart disease. The premise of AF4Q is that no single person, group or profession can improve the quality of care without the support of others. AF4Q seeks to drive quality improvement by aligning key forces, including health care providers (physicians/physician groups, nurses, clinics), health care purchasers (employers and insurers) and health care consumers (patients).
Alliance for Specialty Medicine (ASM)—The Alliance for Specialty Medicine (ASM) is a nonpartisan coalition of 11 national medical specialty societies representing more than 200,000 physicians. ASM is dedicated to the development of sound federal health care policy that fosters patient access to the highest quality specialty care.
Ambulatory Care Quality Alliance (AQA)—The Ambulatory Care Quality Alliance (AQA) is a broad-based coalition of physicians, consumers, purchasers, health insurance plans and others who seek to improve health care quality and patient safety through a collaborative process in which key stakeholders agree on a strategy for measuring performance at the physician or group level; collecting and aggregating data in the least burdensome way; and reporting meaningful information to consumers, physicians and other stakeholders to inform choices and improve outcomes.
Ambulatory care—Ambulatory care is medical care provided on an outpatient basis—therefore, not requiring a person to be admitted to the hospital. Ambulatory Care is provided in physicians' offices, clinics, emergency departments, outpatient surgery centers and hospital settings that do not involve a patient staying overnight.
America's Health Insurance Plans (AHIP)—America's Health Insurance Plans (AHIP) is the national association representing nearly 1,300 member companies providing health insurance coverage to more than 200 million Americans. Member companies offer medical-expense insurance, long-term care insurance, disability-income insurance, dental insurance, supplemental insurance, stop-loss insurance and reinsurance to consumers, employers and public purchasers. AHIP's goal is to provide a unified voice for the health care financing industry; to expand access to high-quality, cost-effective health care to all Americans; and to ensure Americans' financial security through robust insurance markets, product flexibility and innovation, and an abundance of consumer choice.
American Academy of Family Physicians (AAFP)—The American Academy of Family Physicians (AAFP) is one of the largest national medical organizations, representing more than 94,000 family physicians, family medicine residents and medical students nationwide. Founded in 1947, its mission is to preserve and promote the science and art of family medicine and to ensure high-quality, cost-effective health care for patients of all ages.
American Health Quality Association (AHQA)—The American Health Quality Association (AHQA) is an educational, nonprofit national membership association dedicated to promoting and facilitating fundamental change that improves the quality of health care in America. AHQA represents Quality Improvement Organizations (QIOs) and professionals, sharing information about best practices with physicians, hospitals and nursing homes. Working together with health care providers, QIOs identify opportunities and provide assistance for improvement.
American Hospital Association (AHA)—The American Hospital Association (AHA) is a national organization, founded in 1898, that represents and serves all types of hospitals, health care networks, and their patients and communities. The AHA provides education for health care leaders and is a source of information on health care issues and trends. Through representation and advocacy activities, the AHA ensures that members' perspectives and needs are heard and addressed in national health policy development, legislative and regulatory debates, and judicial matters. Our advocacy efforts include the legislative and executive branches and include the legislative and regulatory arenas. Nearly 5,000 hospitals, health care systems, networks, other providers of care and 37,000 individual members come together to form the AHA.
American Medical Association (AMA)—The American Medical Association (AMA) helps doctors help patients by uniting physicians nationwide to work on the most important professional and public health issues. The AMA seeks to promote the art and science of medicine and the betterment of public health.
American Nurses Association (ANA)—The American Nurses Association (ANA) is the only full-service professional organization representing the nation's 2.9-million registered nurses (RNs) through its 54-constituent member associations. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.
Benefits—Benefits are the health care services or items covered by a health insurance company for its enrollees, as defined by the insurance plan.
Best practices—Best practices are the most up-to-date patient care interventions, which result in the best patient outcomes and minimize patient risk of death or complications.
Bundled payment—A bundled payments is a set, single payment for all health care services for an episode of care or a health condition, from care for a heart attack or knee replacement to a chronic condition such as diabetes. With bundled payments, health care providers are not paid for each service or procedure; they are instead rewarded for not only delivering the services but also for coordinating care and preventing duplicative or unneeded tests or treatments.
Care coordination—Care coordination occurs when different health care providers, such as primary care physicians, specialists and hospitals, communicate and collaborate on a patient's care and prevent duplicative tests and services. Medical homes and accountable care organizations are designed to promote care coordination for patients.
Center for Health Care Strategies (CHCS)—The Center for Health Care Strategies (CHCS) is a nonprofit health policy resource center dedicated to improving the quality and cost effectiveness of health care services for low-income populations and people with chronic illnesses and disabilities. CHCS works directly with states and federal agencies, health plans, and providers to develop innovative programs that better serve people with complex and high-cost health care needs.
Center for Health Improvement (CHI)—The Center for Health Improvement (CHI) is a national, independent, nonprofit health policy and technical assistance organization dedicated to improving population health and encouraging healthy behaviors. Since its inception in 1995, CHI has used evidence-based research to help public, private and nonprofit organizations strengthen their capacity to improve the quality and value of health care and enhance public health at the community level.
Center for Studying Health Systems Change (HSC)—The Center for Studying Health Systems Change (HSC) is a nonpartisan policy research organization located in Washington, D.C. HSC designs and conducts studies focused on the U.S. health care system to inform the thinking and decisions of policy-makers in government and private industry. In addition to this applied use, HSC studies contribute more broadly to the body of health care policy research that enables decision-makers to understand change and the national and local market forces driving that change.
Centers for Medicare & Medicaid Services (CMS) (formerly: Health Care Financing Administration: HCFA)—The Centers for Medicare & Medicaid Services (CMS) seeks to ensure effective, up-to-date health care coverage and to promote quality care for beneficiaries. Ultimately, CMS is working to transform and modernize the health care system.
Chronic care model—The chronic care model is a model developed by Edward Wagner and colleagues that provides a solid foundation from which health care teams can operate. The model has six dimensions: community resources and policies; health system organization of health care; patient self-management supports; delivery system redesign; decision support; and clinical information system. The ultimate goal is to have activated patients interact in a productive way with well-prepared health care teams. Three components that are particularly critical to this goal are adequate decision support, which includes systems that encourage providers to use evidence-based protocols; delivery system redesign, such as using group visits and same-day appointments; and use of clinical information systems, such as disease registries, which allow providers to exchange information and follow patients over time.
Chronic disease—A chronic disease is a sickness that is long-lasting or recurrent. Examples include diabetes, asthma, heart disease, kidney disease and chronic lung disease.
Clinical practice guidelines—Clinical practice guidelines are a set of systematically developed statements, usually based on scientific evidence, that help physicians and their patients make decisions about appropriate health care for specific medical conditions. Clinical practice guidelines briefly identify and evaluate the most current information about prevention, diagnosis, prognosis, therapy, risk/benefit and cost effectiveness.
Clinical quality measures—Clinical quality measures are criteria to evaluate the care provided to a patient, based on the treatments and tests the patient received compared to care that is proven to be helpful to most patients with a certain condition.
Comparative effectiveness research—Comparative effectiveness research compares multiple medications or treatments to determine which is most effective for different types of patients.
Consumer—A consumer is an individual who uses, is affected by, or is entitled or compelled to use a health-related service.
Consumer Assessment of Healthcare Providers and Systems (CAHPS)—The Consumer Assessment of Healthcare Providers and Systems (CAHPS) develops and supports the use of a comprehensive and evolving family of standardized surveys that ask consumers and patients to report on and evaluate their experiences with health care. These surveys cover topics that are important to consumers, such as the communication skills of providers and the accessibility of services. CAHPS originally stood for the Consumer Assessment of Health Plans Study, but as the products have evolved beyond health plans, the name has evolved as well to capture the full range of survey products and tools.
Consumer engagement—Consumer engagement is the situation in which consumers take an active role in their own health care, from understanding their own conditions and available treatments, to seeking out and making decisions based on information about the performance of health care providers.
Consumer-Purchaser Disclosure Project (CPDP)—The Consumer-Purchaser Disclosure Project (CPDP) is a group of leading employer, consumer and labor organizations working toward a common goal to ensure that all Americans have access to publicly-reported health care performance information. CPDP's shared vision is that with this information, Americans will be better able to select hospitals, physicians and treatments based on nationally standardized measures for clinical quality, consumer experience, equity and efficiency.
Consumer-driven (or directed) care—Consumer-driven (or directed) care is a form of health insurance that combines a high-deductible health plan with a tax-favored Health Savings Account, Flexible Spending Account or Health Reimbursement Account to cover out-of-pocket expenses. These accounts are "consumer-driven" in that they give participants greater control over their own health care, allowing individuals to determine on a personal basis how they choose to spend their health care account funds.
Coordination of care—Coordination of care comprises mechanisms that ensure patients and clinicians have access to, and take into consideration, all required information on a patient's conditions and treatments to ensure that the patient receives appropriate health care services.
Core measures—Core measures are specific clinical measures that, when viewed together, permit a robust assessment of the quality of care provided in a given focus area, such as acute myocardial infarction (AMI).
Data collection—Data collection is the acquisition of health care information or facts based upon patient and consumer race, ethnicity and language. Data Collection provides health care providers with the ability to perform benchmarking measures on health care systems to determine areas where improvement is needed in providing care.
Department of Health and Human Services (HHS)—The Department of Health and Human Services is the U.S. government's principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.
Disease management—Disease management is an approach designed to improve the health and quality of life for people with chronic illnesses by working to keep the conditions under control and prevent them from getting worse.
Disease registry—A Disease registry is a large collection or registry belonging to a health care system that contains information on different chronic health problems affecting patients within the system. A disease registry helps to manage and log data on chronic illnesses and diseases. All data contained within the disease registry are logged by health care providers and are available to providers to perform benchmarking measures on health care systems.
Disparities (in care)—Disparities in care are differences in the delivery of health care, access to health care services and medical outcomes based on ethnicity, geography, gender and other factors that do not include socioeconomic status or insurance coverage. Understanding and eliminating the causes of health care disparities is an ongoing effort of many groups and organizations.
Effective care—Effective care includes health care services that are of proven value and have no significant tradeoffs. The benefits of the services so far outweigh the risks that all patients with specific medical needs should receive them. These services, such as beta-blockers for heart attack patients, are backed by well-articulated medical theory and strong evidence of efficacy, determined by clinical trials or valid cohort studies.
Electronic Health (Medical) Record (EHR or EMR)—The Electronic Health (Medical) Record (EHR or EMR) is a computerized medical file that contains the history of a patient's medical care, commonly abbreviated as "EHR," in contrast to "PHR," which stands for personal health record., An EHR or EMR enables patients to transport their health care information with them at all times.
Emergency department—is the department within a health care facility that is intended to provide rapid treatment to victims of sudden injury or illness. Emergency Departments across the nation struggle with overcrowding, long patient wait periods and shortages of health care professionals.
Episodes of care—An episode of care is a concept that focuses on a health condition from its inception through evaluation and treatment as a means of measuring both the quality of care received and the efficiency of the care provided.
Evidence-based medicine—Evidence-based medicine is the use of the current, best available scientific research and practices with proven effectiveness in daily medical decision-making, including individual clinical practice decisions, by well-trained, experienced clinicians. Evidence is central to developing performance measures for the most common and costly health conditions. The measures allow consumers to compare medical providers and learn which ones routinely offer the highest quality, safest and most effective care.
Federally qualified health center (FQHC)—A federally qualified health center is a health organization that offers primary care and preventative health services to all patients regardless of their ability to pay for care. A FQHC must be a public or private nonprofit organization and meet specific criteria to receive government funding.
Fee schedule—A fee schedule is a complete listing of fees used by health plans to pay doctors or other providers.
Fee-for-service—Fee-for-service is an arrangement under which patients or a third party pay physicians, hospitals, or other health care providers for each encounter or service rendered.
Group health plan—A group health plan is a health plan that provides health care coverage to employees, former employees and their families, and is supported by an employer or employee organization.
Healthcare acquired infection (Hospital acquired infection)—Healthcare acquired infections are illnesses that patients get while receiving medical or surgical treatment. These infections can be caused by medical equipment, such as catheters and ventilators, complications from surgery, overuse of antibiotics, or a sickness caught from a health care provider.
Health Plan Employer Data and Information Set (HEDIS) Measures—The Health Plan Employer Data and Information Set (HEDIS) Measures are a set of health care quality measures designed to help purchasers and consumers determine how well health plans follow accepted care standards for prevention and treatment. Formerly known as the Health Plan Employer Data Information Set, health plans can receive accreditation on HEDIS measures from certain organizations, such as the National Committee on Quality Assurance.
Health Resources and Services Administration (HRSA)—The Health Resources and Services Administration (HRSA) is an agency of the U.S. Department of Health and Human Services and is the primary federal agency for improving access to health care services for people who are uninsured, isolated or medically vulnerable.
Health information technology (HIT)—Health information technology is a global term (which encompasses electronic health records and personal health records) to indicate the use of computers, software programs, electronic devices and the Internet to store, retrieve, update and transmit information about patients' health.
Hospital CAHPS (H-CAHPS or CAHPS Hospital Survey)—Hospital CAHPS (H-CAHPS or CAHPS Hospital Survey) is a standardized survey instrument and data collection methodology for measuring patients' perspectives of hospital care. While many hospitals collect information on patient satisfaction, there is no national standard for collecting or publicly reporting this information that would enable valid comparisons to be made across all hospitals. H-CAHPS is a core set of questions that can be combined with customized, hospital-specific items to produce information that complements the data hospitals currently collect to support improvements in internal customer service and quality-related activities.
Hospital Quality Alliance (HQA)—The Hospital Quality Alliance (HQA) is a public-private collaboration seeking to improve the quality of care provided by the nation's hospitals by measuring and publicly reporting on that care.
Hospital discharge—Hospital discharge is the process by which a patient is released from the hospital by health care professionals.
Hospital readmissions—Hospital readmissions of concern occur when a patient is released from the hospital and then must return within a short period of time to receive additional care for the same or a closely related health condition. Readmissions are often measured to determine the quality of care provided by a hospital and its affiliated physicians, because it indicates that a patient did not receive proper treatment or that care following the hospitalization was not properly coordinated.
Hospital referral regions (HRRs)—Hospital referral regions are used by the Dartmouth Atlas of Health Care to define regional health care markets. These regions are defined by where patients in surrounding areas are most often referred to for tertiary care. Each HRR contains at least one hospital that performs major cardiovascular procedures and neurosurgery. HRRs can cross state lines.
Improving chronic illness care (ICIC)—Improving chronic illness care (ICIC) is an organization that has worked for almost 10 years with national partners toward the goal of bettering the health of chronically ill patients by helping health systems, especially those that serve low-income populations, improve their care through implementation of the chronic care model.
Improving performance in practice (IPIP)—The improving performance in practice (IPIP) initiative is a project within the North Carolina Academy of Family Physicians. The program seeks to establish a designated Quality Improvement Consultant (QIC) to work onsite with the practice leadership team to develop a practice-specific redesign plan utilizing the resources of collaborating experts.
Informed decision-making (IDM)—Informed decision-making is a term to describe a process designed to help patients understand the nature of the disease or condition being addressed; understand the clinical service being provided including benefits, risks, limitations, alternatives and uncertainties; consider their own preferences and values; participate in decision-making at the level they desire; and make decisions consistent with their own preferences and values or choose to defer a decision until a later time.
Inpatient care—Inpatient care is the delivery of health care services to a person who has been admitted to a hospital or other health facility for a period of at least 24 hours.
Input—Input is the flow of patients into a medical facility, such as an emergency department.
Institute for Healthcare Improvement (IHI)—The Institute for Healthcare Improvement (IHI) is an independent nonprofit organization helping to lead the improvement of health care throughout the world. Founded in 1991 and based in Cambridge, Mass., IHI works to accelerate improvement by building the will for change, cultivating promising concepts for improving patient care, and helping health care systems put those ideas into action.
Institute of Medicine (IOM)—The Institute of Medicine (IOM) is a nonprofit organization and honorific membership organization that works outside the framework of government to ensure scientifically informed analysis and independent guidance on matters of biomedical science, medicine and health. The Institute provides unbiased, evidence-based and authoritative information and advice concerning health and science policy to policy-makers, professionals, leaders in every sector of society and the public at large. IOM's book on quality and safety, Crossing the Quality Chasm: A New Health System for the 21st Century, partially funded by the Robert Wood Johnson Foundation, reported that a huge divide exists between the care we should receive and the care that we get. Crossing the Quality Chasm introduces the notion that health care needs to take a page from industry and use its engineering improvement methods to aim for top quality, efficiency and safety. The report lays out six goals that would become akin to a mantra for the quality improvement movement: care should be "safe, effective, patient-centered, timely, efficient and equitable." IOM's 2003 landmark report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care demonstrates the reality and effect of health disparities and quality-of-care differences for persons of racial and ethnic minorities.
Joint Commission (JCAHO) formerly: Joint Commission on Accreditation of Healthcare Organizations—The Joint Commission (JCAHO) is a private, nonprofit organization that evaluates and accredits hospitals and other health care organizations providing home care, behavioral health care, ambulatory care and long-term care services.
Meaningful use—Meaningful use is a qualification to receive federal funding for health information technology. For instance, if a health information technology (HIT) system is used in a meaningful way to provide better patient care, a health system can qualify to receive federal subsidies to help to pay for the technology.
Medical error—A medical error is a mistake that harms a patient. Adverse drug events, hospital-acquired infections and wrong-site surgeries are examples of preventable medical errors.
Medical home—A medical home is health care model that aims to provide structured, proactive and coordinated care for patients rather than episodic treatments for illnesses. In a medical home, the primary-care doctor operates as a "home base" for patients, overseeing all aspects of patients' health and coordinates care with any specialists involved in the patient's care.
Misuse—Misuse occurs when an appropriate process of care has been selected, but a preventable complication occurs and the patient does not receive the full potential benefit of the service. Avoidable complications of surgery or medication use are misuse problems. A patient who suffers a rash after receiving penicillin for strep throat, despite having a known allergy to that antibiotic, is an example of misuse. A patient who develops a pneumothorax after an inexperienced operator attempted to insert a subclavian line would represent another example of misuse.
Models of care—A model of care is a conceptual object or diagram that provides an outline of how to plan all current and future facility and clinical service. It is important that the Model of Care be designed and evaluated for its ability to be replicated within the health care system. Models of care can help guide and direct a patient's experience within a health care system.
Multi-disciplinary teams/multidisciplinary—Multi-disciplinary teams are health care teams made up of health care professionals as well as health educators or community leaders.
"Never-Events"—"Never-Events" are medical mistakes that should never occur under any circumstance.
National Committee on Quality Assurance (NCQA)—The National Committee on Quality Assurance (NCQA) The National Committee on Quality Assurance (NCQA) is a private, nonprofit organization dedicated to improving health care quality through measurement, transparency and accountability. NCQA has been a central figure in driving improvement throughout the health care system, helping to elevate the issue of health care quality to the top of the national agenda. The organization has helped build consensus around important health care quality issues by working with large employers, policy-makers, doctors, patients and health plans to decide what's important, how to measure it and how to promote improvement.
National Health Plan Collaborative (NHPC)—The National Health Plan Collaborative (NHPC) is a project bringing together 11 major health insurance companies, in partnership with organizations from the public and private sectors, to identify ways to improve the quality of health care for racially and ethnically diverse populations. Together, member health plans reach more than 87 million Americans.
National Institutes of Health (NIH)—The National Institutes of Health (NIH) is a part of the U.S. Department of Health and Human Services, the primary federal agency for conducting and supporting medical research. Helping to lead the way toward important medical discoveries that improve people's health and save lives, NIH scientists investigate ways to prevent disease as well as the causes, treatments, and even cures for common and rare diseases.
National Quality Forum (NQF)—The National Quality Forum (NQF) is a nonprofit membership organization created to develop and implement a national strategy for health care quality measurement and reporting. Established as a public-private partnership, the NQF has broad participation from all parts of the health care system, including national, state, regional and local groups representing consumers, public and private purchasers, employers, health care professionals, provider organizations, health plans, accrediting bodies, labor unions, supporting industries and organizations involved in health care research or quality improvement. Together, the organizational members of the NQF work to promote a common approach to measuring health care quality and fostering system-wide capacity for quality improvement. Quality improvement measures endorsed by the NQF are considered the gold standard.
National Strategy to Improve Health Care Quality (National Quality Strategy)—The National Quality Strategy is required by the Patient Protection and Affordable Care Act to establish national goals to guide federal and state efforts in identifying and implementing strategies for improving the quality of healthcare throughout the U.S. The U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality will administer the National Quality Strategy by proposing strategies for measuring the nation's progress, identifying areas for improvement, and providing annual updates to Congress and all Americans.
Office of the National Coordinator for Health Information Technology—The Office of the National Coordinator for Health Information Technology is a government organization that coordinates nationwide efforts to promote and implement the use of health information technology and electronic health records.
Outcome—Outcome is the result of a process, including outputs, effects and impacts.
Outcome of care measures—Outcome of care measures are criteria to evaluate the care provided to patients, based on the results of care, such as the percent of patients who died or were readmitted to hospitals following care.
Outpatient care—Outpatient care is medical or surgical care that does not include an overnight hospital stay.
Output—Output is the flow of patients out of a medical facility, such as an emergency department.
Overcrowding—Overcrowding is a situation experienced by many emergency departments across the nation where there are too many patients for the number of physicians available. This causes excessive time spent waiting for care, unhappy patients and poor-quality care provided to patients.
Overuse—Overuse describes a process of care in circumstances where the potential for harm exceeds the potential for benefit. Prescribing an antibiotic for a viral infection like a cold, for which antibiotics are ineffective, constitutes overuse. The potential for harm includes adverse reactions to the antibiotics and increases in antibiotic resistance among bacteria in the community. Overuse can also apply to diagnostic tests and surgical procedures.
Patient experience—The patient experience is comprised of research reports and administrative information that reflect quality from the perspective of patients by capturing observations and opinions about what happened during the process of health care delivery. Patient experience encompasses various indicators of patient-centered care, including access (whether patients are obtaining appropriate care in a timely manner), communication skills, customer service, helpfulness of office staff and information resources.
Patient flow—Patient flow is the movement of patients who seek care in an emergency department through the admission process. This is the process through which patients are granted entry for care at the hospital and seen by a physician.
Patient Protection and Affordable Care Act (PPACA)—The Patient Protection and Affordable Care Act is the full title of the comprehensive health care reform law enacted in March 2010.
Patient registry—A patient registry is a patient database maintained by a hospital, doctors' practice or health plan that allows providers to identify their patients according to disease, demographic characteristics and other factors. Patient registries can help providers better coordinate care for their patients, monitor treatment and progress and improve overall quality of care.
Patient safety—Patient safety is the measurement and prevention of harm caused to patients while they receive medical treatment.
Patient satisfaction—Patient satisfaction is a measurement designed to obtain reports or ratings from patients about services received from an organization, hospital, physician or health care provider.
Patient-centered care—Patient-centered care considers patients' cultural traditions, personal preferences and values, family situations and lifestyles. Responsibility for important aspects of self-care and monitoring is put in patients' hands—along with the tools and support they need. Patient-centered care also ensures that transitions between different health care providers and care settings are coordinated and efficient. When care is patient-centered, unneeded and unwanted services can be reduced.
Pay-for-performance (P4P)—Pay-for-performance (P4P) is a method for paying hospitals and physicians based on their demonstrated achievements in meeting specific health care quality objectives. The idea is to reward providers for the quality—not the quantity—of care they deliver.
Payers—Payers comprise the entity that assumes the risk of paying for medical treatments. Examples include uninsured patients, self-insured employers, health plans or HMOs.
Payment reform—Payment reform seeks to improve current mechanisms for reimbursing providers by including rewards for provider quality in the reimbursement mechanisms.
Performance measures—Performance measures are sets of established standards against which health care performance is measured. Performance Measures are now widely accepted as a method for guiding informed decision-making as a strong impetus for improvement.
Personal health record (PHR)—A personal health record (PHR) contains the medical and health-related background documents pertaining to a consumer.
Physician quality reporting initiative (PQRI)—The physician quality reporting initiative (PQRI) is authorized through the Medicare, Medicaid, and SCHIP Extension Act of 2007. It is a financial incentive for health care professionals to improve the quality of care that they provide.
Preference-sensitive care—Preference-sensitive care are treatments that involve significant tradeoffs affecting the patient's quality and/or length of life. Decisions about these interventions—whether to have them or not, which ones to have—ought to reflect patients' personal values and preferences, and ought to be made only after patients have enough information to make an informed choice. At times, the scientific evidence on the main outcome—survival—is quite good; in other cases, the evidence is much weaker.
Preventive care—Preventive care is health care services that prevent disease or its consequences. It includes primary prevention to keep people from getting sick (such as immunizations), secondary prevention to detect early disease (such as Pap smears) and tertiary prevention to keep ill people or those at high risk of disease from getting sicker (such as helping someone with lung disease to quit smoking).
Price transparency—Price transparency is the ability of consumers to know what it will cost to receive a given health care service at a variety of outlets.
Primary care—Primary care is basic or general health care traditionally provided by doctors trained in: family practice, pediatrics, internal medicine and occasionally gynecology.
Process improvement—Process improvement comprises techniques and strategies used to make the processes implemented to solve health care problems better. Process improvement can occur in emergency room or hospital settings, as well as in other health-system environments.
Process of care measures—Process of care measures are criteria to evaluate the care that patients receive, based on how often patients receive care that is recommended to give the best results for most patients with a particular condition, such as blood sugar tests, cholesterol screenings and eye exams for patients with diabetes.
Provider—A provider is a professional engaged in the delivery of health services, including physicians, dentists, nurses, podiatrists, optometrists, clinical psychologists, etc. Hospitals and long-term care facilities are also providers. The Medicare program uses the term "provider" more narrowly, to mean participating institutions: hospitals, skilled nursing facilities, home health agencies, etc.
Provider incentives—Provider incentives serve to induce or motivate the regulation of health care. Examples of incentives include monetary rewards for providers who meet specific benchmark standards for their patient care.
Public reporting—Public reporting makes information about physician and physician group performance available for consumers to use to compare the performance of local physicians/physician groups. The expectation is that a comparative public report of local physicians' performance in treating people with chronic illnesses will motivate and improve performance.
Purchasers—Purchasers comprise the entity that not only pays the premium for health care costs, but also controls the premium dollar before paying it to the provider. Included in the category of purchasers or payers are patients, businesses and managed care organizations. While patients and businesses function as ultimate purchasers, managed care organizations and insurance companies serve a processing or payer function.
Quality (of care)—Quality (of care) is a measure of the ability of a doctor, hospital or health plan to provide services for individuals and populations that increase the likelihood of desired health outcomes and are consistent with current professional knowledge. Good quality health care means doing the right thing at the right time, in the right way, for the right person and getting the best possible results. According to the mantra for the quality improvement movement, care should be "safe, effective, patient-centered, timely, efficient and equitable."
Quality (of life)—Quality (of life) is the amount of happiness and balance in an individual's life. Attention to good health will create a better quality of life.
Quality Alliance Steering Committee (QASC)—The Quality Alliance Steering Committee (QASC) is a broad-based coalition of physicians, consumers, purchasers, health insurance plans and others who seek to improve health care quality and patient safety through a collaborative process in which key stakeholders agree on a strategy for measuring performance at the physician or group level; collecting and aggregating data in the least burdensome way; and reporting meaningful information to consumers, physicians and other stakeholders to inform choices and improve outcomes.
Quality assurance (QA)—Quality assurance is a formal process of reviewing the quality of medical services provided by a physician or hospital and addressing any problems through corrective actions.
Quality improvement (QI)—Quality improvement (QI) is a term first coined in the private sector, when corporations began looking at ways to streamline and improve processes and systems. The most well-known example of quality improvement methodology is the "Six Sigma" method of change, developed by engineers at Motorola. In the health care context, the goal of quality improvement strategies is for patients to receive the appropriate care at the appropriate time and place with the appropriate mix of information and supporting resources. In many cases, health care systems are designed in such a way as to be overly cumbersome, fragmented, and indifferent to patients' needs. Quality improvement tools range from those that simply make recommendations but leave decision-making largely in the hands of individual physicians (e.g., practice guidelines) to those that prescribe patterns of care (e.g., critical pathways). Typically, quality improvement efforts are strongly rooted in evidence-based procedures and rely extensively on data collected about processes and outcomes.
Quality indicator—A quality indicator is an agreed-upon process or outcome measure that is used to determine the level of quality achieved. A measurable variable (or characteristic) that can be used to determine the degree of adherence to a standard or achievement of quality goals.
Quality measures—Quality measures are mechanisms used to assign a quantity to quality of care by comparison to a criterion.
Rapid cycle change—Rapid cycle change is a quality-improvement method that identifies, implements and measures changes made to improve a process or a system. At the onset, the team sets an outcome measure based on the system's goals. Improvement occurs through small, rapid PDSA (Plan, Do, Study, Act) cycles to advance practice change. This model requires targeting a specific area to change; planning changes on the basis of sound science, theory and evidence; piloting several changes with small patient groups; measuring the effects of changes; and acting according to the data. The fundamental concept of rapid-cycle improvement is that health care processes—once defined, in place and in effect—should be continually improved by instituting a constant cycle of innovations or improvements.
Report card—A report card is an assessment of the quality of care delivered by health plans. Report cards provide information on how well a health plan treats its members, keeps them healthy and provides access to needed care. Report cards can be published by states, private health organizations, consumer groups or health plans.
Resource use—Resource use is the amount of health care services used for a patient, including the number, cost and intensity of services provided.
Return on investment (ROI)—A return on investment (ROI) is the amount of improvement in care brought about by a certain investment. ROI can also refer to the theory that if you invest in health care quality now, then the quality of care for patients will improve in the future.
Right care—Right care is made up of the treatments that, according to evidence-based guidelines, are effective and appropriate for a given condition. Indicators used to define right care are often grouped into two categories: prevention and chronic care.
Self-management—Self-management is the ability of individuals to have the necessary knowledge, attitudes and skills to manage their health problems or disorders on a day-to-day basis. It is a skill that enables individuals, and their families, to make improved use of existing health services, as well as make choices surrounding health care providers, medication, diet, exercise and other lifestyle issues that protect or damage health.
Shared Decision Making—Shared decision making occurs when a patient and their health care provider openly communicate about the options, benefits, outcomes and risks of available treatment for a patient's health condition and reach a treatment plan based on the medical evidence, the patients' values and the doctors' advice.
Specialty care—Specialty care is health care focused on improving the well being of certain specialized categories of health, as opposed to general and overall health and well-being. To improve the quality of health care available to consumers and patients, providers must improve the quality and availability of primary and specialty care.
Standard of care—The standard of care is the expected level and type of care provided by the average caregiver under a certain given set of circumstances. These circumstances are supported through findings from expert consensus and based on specific research and/or documentation in scientific literature.
Standardized measures—Standardized measures are nationally recognized criteria for evaluating the quality of health care provided to patients. These measures are endorsed or developed by organizations, including the National Quality Forum, Ambulatory Quality Alliance, American Medical Association's Physician Consortium for Performance Improvement, specialty medical boards, national accreditors or government agencies.
Supply-sensitive care—Supply-sensitive care includes excess procedures, hospital admissions and doctor visits driven by the supply of doctors and hospital resources, rather than by need.
Throughput—Throughput is the ability of a medical facility, such as an emergency department, to complete a patient input and output cycle (i.e., to provide patients with the full cycle of care).
Transparency—Transparency is the process of collecting and reporting health care cost, performance and quality data in a format that can be accessed by the public and is intended to improve the delivery of services and ultimately improve the health care system as a whole.
Underuse—Underuse refers to the failure to provide a health care service when it would have produced a favorable outcome for a patient. Standard examples include failure to provide appropriate preventive services to eligible patients (e.g., Pap smears, flu shots for elderly patients, screening for hypertension) and proven medications for chronic illnesses (steroid inhalers for asthmatics; aspirin, beta-blockers and lipid-lowering agents for patients who have suffered a recent myocardial infarction).
Value-based purchasing—Value-based purchasing is a broad strategy used by some large employers to get more value for their health care dollars by demanding that health care providers meet certain quality objectives or supply data documenting their use of best practices and quality treatment outcomes.
Variation—Variation is an instance of change or deviation. There is unwarranted variation in the practice of medicine and the use of medical resources in the United States. There is underuse of effective care, such as the use of beta-blockers for people who have heart attacks and screening of diabetics for early signs of retinal disease. There is misuse of preference-sensitive care, such as the choice between mastectomy and lumpectomy for early-stage breast cancer. And there is overuse of supply-sensitive care, such as admitting patients with chronic conditions like diabetes to the hospital, rather than treating them as outpatients.
Work flow—Work flow is a repeatable pattern of activity enabled by the organization of resources, defined roles, and information into a process that can be documented and learned. Improvements in work flow for health care providers will lessen the burden of providing health care and will lead to greater quality health care overall.


Mindful Self-Compassion (MSC) is an empirically supported 8-session program designed to cultivate the skill of self-compassion.
MSC is based on the groundbreaking research of Kristin Neff and the clinical expertise of Christopher Germer.
MSC teaches core principles and practices that enable participants to respond to difficult moments in their lives with kindness, care and understanding.
Attending the MSC program can assist in transforming your relationship with yourself through the notion of 'attending and befriending'. This is quite a different approach than the usual one taken in our busy lives of the 'subtle aggression of self-improvement' (Bob Sharples). The formal and informal practices taught in the MSC program are intended as a way of developing a mindful, warm and kind friendliness to one's self.
The three key components of self-compassion are: self-kindness, a sense of common humanity, and balanced, mindful awareness. Kindness opens our hearts to suffering, so we can give ourselves what we need in those difficult times. Common humanity opens us to our essential interrelatedness, so that we know we aren't alone, and we understand the fact that being human means making mistakes and having our glitches. Mindfulness opens us to the present moment, so we can get a wider / clearer picture of our experience, thus learning to accept it with greater ease. Together they comprise a state of warm-hearted, connected presence.
Take time to practice and integrate each session. Each session building upon the next, with the week in between being a fruitful part of the program itself.
MSC can be experienced in an intensive format, with the 8-sessions occurring over consecutive days including the extra retreat session. The group deeply connects and the immersion itself can deepen understanding.
Due to work or family commitments the intensive training may work better for some, it allows participants to fully immerse themselves in MSC. There are options of retreat style residential MSC intensives or non-residential. Please scroll down to see options of intensives with Tina Gibson in 2018.
"I am passionate about creating and teaching compassion-based mindfulness to people of all ages and all walks of life. I believe that all things are truly workable, and that there is a lot more right with people than wrong with them, no matter how stuck they might feel. At Adelaide Mindfulness we creatively deliver our teachings with heartfelt presence, humour and authenticity. We are committed to assisting people to care for themselves and each other in a sustainable way - benefiting our community and our world. So start your journey of greater awareness and compassion here, in this very moment."
If you are worried about the costs of a program or workshop please get in touch with Tina to discuss flexible payment plans, our aspiration is that MSC be available to all who seek it.
"A great introduction to mindfulness whether you have previous experience with meditation and would like to take it deeper or if it is all new to you.Very welcoming, informative and helpful for everybody"
"During and since completing the course I am experiencing "untangling" and a greater view within and outward"
"Fantastic program. I would highly recommend for anyone"


Former FBI director James Comey spoke highly of his deputy Andrew McCabe's integrity, both in public and in multiple private conversations with President Trump, displaying what looks to be poor judgment of McCabe's character now that the former FBI deputy director has been referred for criminal prosecution for allegedly lying to federal investigators.
Others in the media and in Congress jumped to McCabe's defense when he was fired, claiming it was a purely political and vindictive move. That too, has been shown to be wrong, as McCabe has been referred to a federal attorney for federal prosecution based on the Justice Department inspector general's findings that McCabe leaked to the press and lied about it.
Comey repeatedly assured Trump in private conversations that he could trust McCabe, who he referred to as "true professional" and an "honorable person." When McCabe was removed from his post in January — following months of attacks for perceived conflicts of interest from Trump and Republicans, and in the midst of the IG investigation into the FBI's handling of the Clinton email case — Comey publicly defended and praised McCabe's honor.
The comments have not aged well. The IG found McCabe broke FBI rules by leaking a story to The Wall Street Journal in order to defend his own interests. He authorized an agent to refute reports he prematurely shut down the Clinton Foundation investigation. McCabe then told Comey he did not authorize the leak or know where it came from, and similarly lied to federal investigators, including under oath, the IG found. These findings prompted Attorney General Jeff Sessions to fire McCabe.
The findings also contrast sharply with the way Comey and other allies have characterized McCabe.
Trump brought up McCabe's reliability in their second private conversation together, and again in other conversations, in which Comey recounts he assured Trump he didn't have to worry about McCabe in particular, or about leaks from the higher-ups in the FBI.
Here's what others had to say of McCabe, both when he was removed from his post in January and later when he was fired.
Several Democrats offered to hire McCabe after he was fired, to save him from losing his government benefits. They apparently got the idea from Andrea Mitchell, NBC's chief foreign affairs correspondent, who described herself as a McCabe supporter.
"If a friendly member of Congress hired him for a week he could possibly qualify for pension benefits by extending his service the extra days," she tweeted.
Former CIA Director John Brennan wrote an indignant defense of McCabe when he was fired, taking aim at Trump in a tweet.
Following the release of the IG report and Comey's memoir, in which he recounts his time at the FBI, Comey has not disputed the that allegations McCabe lied to him. "It's not okay," he said on "The View" about the finding McCabe illegally leaked.
McCabe maintains his firing was politically motivated, and is reportedly looking to sue for defamation, wrongful termination, and other possible claims. His lawyer said McCabe was "upset and disappointed" by some of the things Comey said.


text:
HomeNews & Social MediaHainan NewsHK chief executive Leung Chun-ying recalls fruitful trip to Hainan
HK chief executive Leung Chun-ying recalls fruitful trip to Hainan
Hong Kong will enhance its role as a channel bringing capital, talent and technology into the mainland from all over the world. Photo: AFP
I attended the Pan-Pearl River Delta Regional Co-operation and Development Forum (PPRD Forum) in Hainan on November 30 and December 1. It was the first time I attended the PPRD Forum and also my first major visit outside Hong Kong since I took office as chief executive. The trip proved fruitful. In particular, we achieved encouraging results in promoting Hong Kong's role in the further development of the PPRD region by making more effective use of the PPRD co-operation platform and leveraging our unique advantages.
The PPRD Forum, launched in 2004 and held for the eighth time this year, is an important platform for regional co-operation in which Hong Kong participates. The "9+2" provinces/regions in the PPRD account for one-third of the country's population and gross domestic product, representing a huge potential market. The provinces/regions differ in their state of development. Some of them are situated near the coast and were among the first to implement the policy of reform and opening up, while some are inland provinces endowed with rich natural resources and cost advantages. By bringing their qualities into play and enhancing co-operation, these provinces/regions can promote the modernisation and development of the PPRD region, presenting new opportunities for Hong Kong's economic development.
When exchanging views with the leaders of the PPRD provinces, I emphasised the unique role that Hong Kong could play, pointing out that our extensive international connections could support their development strategy of speeding up the link-up with the rest of the world, which would in turn create career development and business opportunities for Hong Kong people and enterprises in various sectors. I also made reference to the dedicated chapter for Hong Kong and Macau in the National 12th Five-Year Plan, in which the central authorities clearly expressed its support for Hong Kong in consolidating and enhancing our status as an international financial, trade and shipping centre. In this consolidation and enhancement process, there would be ample scope for co-operation between Hong Kong and the PPRD provinces.
In the early stages of the country's economic reform and opening up, Hong Kong acted as a major source of capital, talent and technology – resources that were needed for the mainland's development. Some 30 years on, the national development has now entered a new stage in which Hong Kong will enhance its role as a channel bringing capital, talent and technology into the mainland from all over the world while also introducing mainland enterprises, products and services to the global market. The PPRD provinces can make good use of Hong Kong's international network to implement the national development strategy of "going out" and "bringing in".
For instance, mainland enterprises intending to expand overseas may seek professional advice from more than 70 foreign law firms in Hong Kong – firms that have the advantage of being conversant with the laws of their respective countries. Hong Kong is also a place where global investors and service providers like to congregate. Boasting over 20 foreign chambers of commerce and 1,200 regional headquarters of overseas enterprises, Hong Kong is a convenient place for mainland enterprises to source capital, talent and technology from the rest of the world and identify foreign business partners.
My views received a positive response from the leaders of the PPRD provinces. They look forward to deepening co-operation with Hong Kong and Macau, and especially to achieving a win-win situation by complementing our respective strengths and capitalising on the advantages of "One Country, Two Systems". They fully agreed that Hong Kong, with its international connections and as a channel for capital, talent and technology, will continue to contribute substantially to the further development of the PPRD.
During the forum I had bilateral meetings with the leaders of Hainan, Yunnan, Guangxi, Sichuan and Fujian to explore areas for closer co-operation. Regarding Hainan, where tourism is growing rapidly, we can deepen our co-operation in the development and promotion of multi-destination itineraries and cruise products. For Yunnan, we can help export its products to the international market, building on our increasingly close business and trade ties. For Guangxi, the "front porch" of the Asean-China Free Trade Area, Hong Kong can serve as an intermediary to help it attract more investment and go global.
For Sichuan, we can further enhance exchange and co-operation on various fronts, with our close relationship fostered through the reconstruction works after the earthquake. With Fujian, we can explore the feasibility of mutually extending the pilot implementation of measures under the Economic Co-operation Framework Agreement and the mainland and Hong Kong Closer Economic Partnership Arrangement.
The new SAR government and I attach great importance to Hong Kong's economic development. Only by achieving a relatively high and sustainable rate of economic growth can we solve Hong Kong's deep-seated problems. To this end, we will pursue further economic development by seeking change while maintaining stability and being appropriately proactive. We will also make good use of the mainland's support while continuing to engage ourselves globally.
Enhancing co-operation with the PPRD provinces is both in line with my proposal to strengthen internal diplomacy and conducive to Hong Kong's economic development. Building on the foundation laid at this forum, particularly the understanding reached with some provinces, my colleagues and I will endeavour to help Hong Kong businesses and professionals increase their participation in the development of the PPRD while also benefiting from a closer relationship with the region as a whole.
Leung Chun-ying is the chief executive of Hong Kong.
SOURCE: scmp.com
Previous news: Hainan Airlines among Chinese companies creating new jobs in Europe
Next news: HK, Macau & 9 mainland provinces to hasten S. China Sea development

redpajama_set_name: RedPajamaCommonCrawl


text:
Q: How can I finish my Python subprocess before continuing? This script creates a progress bar when copying a folder.
I need to figure out how to make the copyObjFile function complete before the script continues (and displays the "Done!" message).  However, the "Done!" message is currently being displayed before the copy operation completes.  How can I make it wait?
import sys
import os
import subprocess
from PySide2 import QtGui, QtCore, QtWidgets

class FileCopyProgress(QtWidgets.QWidget):
   def __init__(self, src=None, dest=None):
      super(FileCopyProgress, self).__init__()
      self.src = src
      self.dest = dest
      self.build_ui()

   def build_ui(self):
      hbox = QtWidgets.QVBoxLayout()
      self.pb = QtWidgets.QProgressBar()
      self.pb.setMinimum(0)
      self.pb.setMaximum(100)
      self.pb.setValue(0)

      hbox.addWidget(self.pb)
      self.setLayout(hbox)
      self.setWindowTitle('File copy')

      self.auto_start_timer = QtCore.QTimer()
      self.auto_start_timer.timeout.connect(lambda: self.copyfileobj(src=self.src, dst=self.dest, callback_progress=self.progress, callback_copydone=self.copydone))
      self.auto_start_timer.start(2000)
      self.show()

   def progress(self, curr, tot):
      percentage = int((float(curr) / float(tot)) * 100)
      self.pb.setValue(percentage)
      app = QtWidgets.QApplication.instance()
      app.processEvents()

   def copydone(self):
      self.pb.setValue(100)
      self.close()

   def copyfileobj(self, src, dst, callback_progress, callback_copydone, length=8*1024):
      numFiles_total = 0
      for root, dirs, files in os.walk(src):
         numFiles_total += len(files)
      self.auto_start_timer.stop()
      # COPY FILE
      p = subprocess.Popen(['robocopy', src, dst, '/E', '/MT:16'], shell=True, stdout=subprocess.PIPE)
      numFiles_curr = 0
      while True:
         line = p.stdout.readline()
         if not line:
            break
         myLine = line.strip()
         if '%' in myLine:
            numFiles_curr += 1
            print('Progress: ' + str(numFiles_curr) + '/' + str(numFiles_total))
            callback_progress(curr=numFiles_curr, tot=numFiles_total)
         sys.stdout.flush()
      callback_copydone()

class Window(QtWidgets.QDialog):
   def __init__(self):
      super(Window, self).__init__()
      self.initUI()

   def initUI(self):
      vlayout_base = QtWidgets.QVBoxLayout()
      self.setLayout(vlayout_base)
      button = QtWidgets.QPushButton('Copy File')
      button.clicked.connect(self.doStuff)
      vlayout_base.addWidget(button)

   def doStuff(self):
      self.copyFile()
      self.messageDialog('Done!', 'message')

   def copyFile(self):
      source = r'/Users/asdf/Downloads'
      destination = r'/Users/asdf/Temp'
      ex = FileCopyProgress(src=source, dest=destination)

   def messageDialog(self, msgText, windowTitle=None):
      # SHOW MESSAGE BOX
      msgBox = QtWidgets.QMessageBox()
      msgBox.setModal = True
      if windowTitle:
         msgBox.setWindowTitle(windowTitle)
      msgBox.setText(msgText)
      msgBox.exec_()

def main():
   app = QtWidgets.QApplication(sys.argv)
   w = Window()
   w.show()
   sys.exit(app.exec_())

if __name__ == '__main__':
   main()

A: It looks like you are missing a wait:
# in: copyfileobj definition

p = subprocess.Popen(['robocopy', src, dst, '/E', '/MT:16'], shell=True, stdout=subprocess.PIPE)

status = p.wait()

redpajama_set_name: RedPajamaStackExchange


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Enjoy the concert of classical music in a beautifully decorated baroque concert hall with impressive 17th-century painted stucco ceilings at Lobkowicz Palace in Prague Castle! Popular chamber classical music concerts are performed in the original musical salon of the palace.
Professional musicians, including members of the Czech Philharmonic Orchestra, play a selection of the world's most celebrated pieces of classical music.
With the "Concert + Museum" ticket, you can enjoy a classical music concert and visit a unique art collection in the Lobkowicz Palace Museum. The tour is audio guided, and you can look forward to seeing musical instruments, original scores and manuscripts from Beethoven and Mozart, paintings by famous masters such as Canaletto, Brueghel the Elder and Velázquez, fine porcelain, ceramics and rare decorative arts dating from the 16th to 20th centuries and more.
Starts at 1:00 PM every day. The concert hall is open 15 minutes before.
We recommend to arrive 40 minutes before the concert starts because of the security check-in spots within the Prague Castle area! We recommend to use the entrance near the tram stop Prague Castle (street intersection Marianske hradby and U Prasneho mostu). Here is the shortest security check queue. Additionally, you can come here by taxi or use car parking.
By purchasing a ticket, you will receive a 10% discount to The Lobkowicz Palace Café with its spacious balcony and a spectacular view of Prague.


ShareCenter Network Storage with 2 drive bays and support service mydlink DNS-320L is a handy solution for the sharing and implementation of backing up your important data by creating a personal "cloud".
ShareCenter Network Storage with 2 drive bays and support service mydlink DNS-320L is equipped with file-Web-server that lets you download documents, photos and other multimedia files, regardless of your location. After setting the ShareCenter benefit from the convenient Web-based user interface to browse the list of available files. You can also use the mydlink mobile application to connect to and play music, view videos and photos directly on your mobile device.
directly on the Smart TV. Also, streaming video, photos, music can be performed remotely via a mobile device.
Installing drives in the DNS-320L is not difficult - just remove the cap and insert a 3.5 "hard drives SATA. Click on the latch to get access to the drive enclosure, and then install them. Convenient USB-port on the back of the ShareCenter can be used or to share a house or office to USB-printer, or to connect an external USB-drive to perform backups at the touch of a button. You can also connect an uninterruptible power supply (UPS) to monitor battery level, and ensure data integrity in case of power failure .
ShareCenter supports hard drives in four different configurations (Standard, JBOD, RAID 0, RAID 1) in order to select the best of them, depending on your requirements. In Standard mode creates two separate hard disks available. JBOD combines both drives into one volume. RAID 0 combines both drives in a striped array for maximum performance using a compound Gigabit Ethernet. In RAID 1, the contents of one hard drive is duplicated on the other, providing maximum reliability. If one drive fails, the other will continue to operate separately as long as there is no replacement of a failed drive. The data is automatically copied to the new disk, allowing the array ShareCenter return to full level of protection, while maintaining the integrity of the files.
For users interested in reducing electricity bills and saving the environment, the products D-Link Green ™ provides environmentally friendly alternatives without compromising performance. The device uses the power management features hard drive and control the fan speed to reduce energy consumption, minimize noise and extend the life of hard drives.


How to have normal and shared Dropbox folders in sync with ownCloud.
tl;dr legal – understand and apply opensource licenses, for humans.
Apache, PHP, MySQL slow under Windows 8. How to fix.
Starting from today, I will point out interesting git commits for my projects, using Standard Theme's Link posts. My first git announcement is regarding two new features for mbpfan. The micro-posts let you download latest mbpfan-git release by clicking on the post title. I might use this system to report interesting things I find around, as well.


This Cycling Holiday explores the second section of the Camino Frances / French Way by Bike, the most traditional of all the pilgrim routes to Santiago de Compostela and the best known internationally. The route, which was established in the late 11th century reaching the tomb of St James the Great, crosses the North of the Iberian Peninsula, through the Basque Country, Navarra, La Rioja, Castilla y Leon and Galicia regions of Spain. Nowadays, cycling on the Camino has become an incredibly popular way of enjoying this once-in-a-lifetime journey to Santiago de Compostela.
Starting from Burgos, medieval city and home of a UNESCO World Heritage cathedral, this section of the French Way by Bike offers some of the best historical and cultural vestiges of the whole Camino Frances. It passes through Leon and the vast Castilian Plateau (Approx. alt. 900m) before reaching another medieval bastion – the buzzing city of Ponferrada. The mostly flat and gentle terrain makes it accessible to any cyclist with an average level of fitness.
Rates include*: Accommodations in hotels and guesthouses. All breakfasts and 2 dinners. Luggage transferred from hotel to hotel. Bike rental and breakdown insurance, Detailed Cycling Notes. Map.
Burgos still preserves important vestiges of its medieval splendour and the city boasts a masterpiece of Spanish Gothic architecture: the Cathedral of Burgos (a UNESCO World Heritage Site). Aside from a visit to the historic quarter, you can take an interesting walk along the banks of the Duero and Arlanza rivers.
All day long, you will notice the influence of the Camino de Santiago as there is not a single village we cross that does not have obvious references to it.
During this stage, we have a good understanding of the popular meaning "Castilla es ancha" (castilla is wide). Crop fields give patches of beautiful color to the agricultural landscape all year round. The first half of the day is mainly flat and it gets a bit more undulating on the second half to Sahagun.
Today we cycle through the colorful Castilian meseta or plateau. The landscape here seems endless as we pass over the flat terrain of the area, affording great views over the surrounding agricultural area. We finish the day in the vibrant city of Leon.
This is probably one of the flattest cycling days of the entire Camino Frances, but as we are on a high plateau, it still offers some great views and you will see Astorga down in the valley long before reaching it! In Astorga, take some time to visit the Episcopal palace, the cathedral, and the old city walls.
The last day of this section is definitely the most difficult, but also, the most rewarding one! We can enjoy spectacular views as we climb up to 1500m above sea level to reach the famous Cruz del Hierro (the Iron Cross). The natural scenery and towns with rich history make this the best way to finish the section, before reaching Ponferrada: a city with a lively, and very pretty, medieval center.
Transfer: Santander Distance: 2 hrs 15 min.


text:
Income Tax Return: TDS
Income Tax Return: Be prepared to pay double TDS if you don't file it by June 30
by Editor - June 20, 2021
Some taxpayers may have to pay TDS deducted at source at higher rates starting from July, if a taxpayer has not filed TDS in the last two years and the TDS deducted in each year exceeds Rs 50,000.
So Income Tax Department will charge more while filing Income Tax Return ITR from July 1, In Budget 2021, a new section 206AB was introduced to deduct TDS at higher rate on cases having fixed nature of income.
Abhishek Soni, Co-Founder and CEO, Tax2Win said, where the return of income has not been filed in the last two years and the TDS deducted in each year is more than Rs 50,000. twice the rate specified under the relevant section/provision or b) twice the applicable rate/rates or c) the rate of five per cent, Soni explained.
The Central Board of Direct Taxes (CBDT) has extended the deadline for filing income tax returns for the financial year 2021. The last date for filing Tax Deduction at Source (TDS) for the fourth quarter of the financial year 2020-21 has been extended. June 30, as per the circular. Earlier the due date for filing TDS was 31st May.
Sujit Bangar, Founder, TaxBuddy.com, said, "This is a big relief for those deducting TDS as these returns involve a lot of records and data to be reported correctly. Accordingly, the due date for issue of Form 16 has also been extended from June 15 to July 15.
Vivek Jalan, Partner, Tax Connect Advisory Services LLP said that the new income tax return e-filing portal may have a new facility to check whether the individual has filed the return earlier.
Under the new section 206AB, for specified persons who have not filed ITR for the last two years, a higher TDS is to be deducted by the payer. It is expected that there is going to be a new facility in the new tax portal for the deductor to check whether the deductor has filed his last two ITRs or not,
Jalan said – In the absence of such facility, it may not be possible to implement the new section 206AB, it is important to note that such facility is already there in the GST portal to check GSTR compliance, now in the form of ITR. For this, the income tax portal is also expected to have this facility, he added.
The new rule will not apply in these cases
However, the newly applicable section 206AB will not be applicable for TDS deducted under section 192 for withdrawal from salary or provident fund under section 192A. TDS on winnings under section 194B or 194BB by way of card game, crossword, lottery, puzzle or any other game and horse race will not come under the purview of the new section. It will not be applicable for TDS on income against investment in Securitization Trust u/s 194N and cash withdrawal exceeding Rs.1 crore under section 194N.
If you are deducting TDS on Salary Income (192), Lottery (194B), Horse Racing (194BB), PF (192A), Trust Income (194LBC), and Cash Withdrawal (194N), the provisions of this section will not apply. Also, it is not applicable for NRIs who do not have any permanent establishment in India, said Abhishek Soni.
Tags Income Tax Return: TDS


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Why is Manitoba the polar bear capital?
Why is Manitoba known for polar bears?
Is Manitoba known for polar bears?
What city is considered the polar bear center of the world?
Why is Churchill Manitoba famous?
How many polar bears are in Manitoba?
Which province has the most polar bears?
What latitude is Churchill Manitoba?
Is it safe to walk around Churchill?
What is special about Churchill Manitoba?
How come that you can find polar bears in Churchill Manitoba so far away from the North Pole?
Are there grizzly bears in Manitoba?
Why are there no roads to Churchill?
Where is Churchill buried?
Can you drive from Winnipeg to Churchill?
From July to November, about a thousand migrate to Churchill, earning it the nickname the "polar bear capital of the world." Here, the planet's largest land carnivores spend the summer and await winter, when the bay freezes and they can perch on the ice and hunt for ringed seals. …
Churchill is one of the best places in the world to see polar bears because it lies within the natural habitat of a healthy population of polar bears. In the winter months, the bears are feasting on seals on the ice of Hudson Bay. … See polar bears up close in Churchill, located in northern Manitoba.
Manitoba, in the heart of Canada, is also home to one of the world's few human settlements where polar bears can be observed in the wild. Thousands of people from across the globe descend on the town of Churchill in Manitoba, which is famous for its polar bear population.
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Playful and curious, belugas are fun and extremely social creatures. Not just a whale sanctuary, Churchill is the undisputed capital of polar bear country! Polar bears invade the town for a six-week period in fall and early winter.
It is most famous for the many polar bears that move toward the shore from inland in the autumn, leading to the nickname "Polar Bear Capital of the World" that has helped its growing tourism industry.
The estimated polar bear population in the western Hudson Bay area is 935. Manitoba is committed to taking action to protect this vulnerable, irreplaceable species.
Ontario is home to the southern-most population of polar bears in the world. Climate change is considered the greatest threat to the long-term survival of these bears.
Visiting Churchill: the Polar bear capital of the world
Canada itself is home to roughly 17,000 polar bears out of 25,000 worldwide, and by far the best place to see them is Churchill, in northern Manitoba. Their presence here, on the edge of Hudson Bay, is almost guaranteed every year.
If walking is absolutely necessary, stay on the main streets of Churchill – never walk in dimly lit areas. During the active polar bear season, mid-summer to freeze-up, the Polar Bear Alert phone line is monitored 24 hours-a-day.
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Welcome to the polar bear capital of the world.
But take another look and you'll see Churchill is a one-of-a-kind Manitoba destination. Lying along the migration path of polar bears and beluga whales, Churchill draws wildlife enthusiasts from all over the globe. Fall is prime time to see polar bears in Churchill.
Unlike other water sources, the Hudson Bay is a freshwater bay making it one of the first areas to freeze over. Positioning themselves near Churchill's bay will give this polar bear population a key advantage as they have earlier access to a plentiful food source.
You might be surprised to learn that grizzly bears live in Manitoba. These majestic creatures, with a characteristic hump on their backs, can grow up to three metres long from head to tail, weigh upwards of 700 kilograms and run up to 55 km/hour.
Churchill, a community of about 900 people, is about 1,000 kilometres north of Winnipeg. It became a fly-in only community after flooding damaged the Hudson Bay Rail line in about 24 places. Omnitrax, the company that owns the railway, said it could take until spring 2018 to repair the line.
Winston Churchill is buried, alongside other members of the Churchill family, at St Martin's, Bladon, just outside Blenheim Palace grounds.
If driving from Winnipeg, you will head north on Highway 6 to Thompson to catch the overnight train to Churchill (there are no roads to Churchill, meaning it's only accessible by train or plane!). Thompson is roughly a 760 km journey north of Winnipeg with many gorgeous sites along the way.
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Monitoring, Learning and Evaluation Community of Practice (MLE CoP) started in 2015, with 16 members, drawn from five different organizations. Since then, the membership has grown to 35. The CoP members have diverse backgrounds: agricultural economics, value chains, gender, M&E, public health and agronomy. Its activities and discussions have emphasized building the collective capacity of the members, harmonizing members' approach to monitoring, evaluation and learning and standardizing M&E methods. The 2016 CoP meeting held on 27- 29 April 2016 in Kigali, Rwanda, focussed on harmonizing strategies for household and yield data collection and the use of digital/mobile devices for data collection.
Christine Bukania spoke with some participants of the meeting to find out how their participation in the CoP was helping to build their MLE capacity.
These individual voices were echoed by the very positive collective evaluation of the meeting by the participants. Majority of participants identified learning and networking, in their end-of-meeting evaluation, as two of the aspects they liked most about the 2016 meeting and requested that more time be dedicated to the next MLE CoP meeting.


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To help achieve the goals you have in mind, whether you wish to improve the quality of your life or better cope with life's difficulties, I offer many years of experience and a collaborative, non-judgmental approach. My orientation is wholistic–mind, body, and spirit–in order to help you with the areas in which you want to focus. I use a variety of treatment modalities, including cognitive-behavioral therapy, mindfulness, and solution-focused therapy.
I am a Licensed Professional Counselor (LPC). My undergraduate degree, a Bachelor of Arts in psychology, was earned at at Lakeland University in Sheboygan, where I was awarded the Psychology Student of the Year. I also have a Master of Science degree in educational psychology, with emphases in community counseling and school counseling, from UW–Milwaukee. Having lived in Wisconsin since childhood, I chose to remain here for my education and to live the good life. I am Wisconsin through and through.
Having worked in a number of settings, including outpatient mental health, university counseling, school counseling, and in-home autism treatment, I have broad experience as a counselor and therapist. These varied experiences have all enriched my career; however, my heart lies as an outpatient psychotherap ist, so this is where I'll stay.
Maintaining a strong community and professional presence has always been important to me. I am currently serving as Past President on the Board of Directors for Mental Health America in Sheboygan County, have been a member of the American Counseling Association since 1988, and actively participate in the Sheboygan County Chamber and the Plymouth Chamber of Commerce.
On a personal level, balance in my life ensures my own mental health. Quality relationships with my family and friends, a healthy and active lifestyle, a strong spiritual connection, and a good book reflect my top priorities. The more of these that I can accomplish in the surroundings of nature, the better!


This collection features images of the five presidents of Governors State University: William E. Engbretson (1969-1976), Leo Goodman-Malamuth (1976-1992), Paula Wolff (1992-2000), Stuart Fagan (2000-2006), and Elaine P. Maimon (2007-today).
Questions about this collection? Contact: GSU Library Digital Collections at opus@govst.edu.


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My relationship with Mina began when I was under contract for a house I was about to purchase. I reached out to her to set up an appointment for an estimate for a kitchen and bathroom renovation. She responded immediately, came out within a few days to perform a walk-through (at no charge), and brainstormed ideas with me on the spot related to the projects I had in mind in addition to other ideas around the house to help me as I embarked on furniture shopping, etc. Unfortunately that contract fell through and we moved on from that house, but I had to have Mina be a part of my next home in some way. It turned out the next house we moved forward with was in desperate need of a kitchen reno - so I called Mina once again. She provided a walk-through, designs and an estimate (very fair by the way) within a week - and the rest is history. Check out the amazing transformation in the pictures below. Mina is a bulldog in the project management sense - as a contractor, she runs a tight ship and demands perfection. She hired her own crew and was on-site everyday to ensure all was well. She stayed well within budget and the project was finished a few days earlier then what she estimated. I had entered this project with a pretty good idea of exactly what I wanted from a design standpoint - but I couldn't have pulled this off without her design advice. She gave great suggestions on materials and how to save money in addition to what would be worth investing in. The entire process was seamless, and she even returned to our house a few weeks after when we had an issue with one of our open shelves - she brought in a carpenter and fixed the issue for us with no charge. She absolutely went above and beyond, and I can't wait until I can hire Mina Herrera Design for another project. I highly recommend her. Thank you, Mina!
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Mina Herrera Design remodeled my mom's kitchen, it looks absolutely beautiful, they did all the cabinets and put granite counters it looks amazing! Mina is a responsible person and all her designs are really beautiful i'll highly recommend her.
Thanks Mina for helping remodel my kitchen and bathroom. Thanks also for the all the design ideas for the exterior of the home. Thanks for everything really without your help it would never have been done.
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Load your family into the 2018 Nissan Murano. With less than 30,000 miles on the odometer, this 4 door sport utility vehicle prioritizes comfort, safety and convenience. Smooth gearshifts are achieved thanks to the 3.5 liter 6 cylinder engine, and for added security, dynamic Stability Control supplements the drivetrain. Nissan prioritized comfort and style by including: 1-touch window functionality, power front seats, a built-in garage door transmitter, an automatic dimming rear-view mirror, an outside temperature display, blind spot sensor, and remote keyless entry. Nissan ensures the safety and security of its passengers with equipment such as: dual front impact airbags with occupant sensing airbag, front side impact airbags, traction control, brake assist, anti-whiplash front head restraints, a panic alarm, and 4 wheel disc brakes with ABS. When road conditions become unpredictable, rely on all wheel drive to maintain outstanding control. This vehicle has achieved Certified Pre-Owned status, by passing Nissan's comprehensive certification process, including a comprehensive 156 point inspection! Our knowledgeable sales staff is available to answer any questions that you might have. We are here to help you.


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Home - The Real Beauty Queen
The Real Beauty Queen
Som Kanika / Khmer Times No Comments Share:
With her innate passion to become a beauty queen, Kha Annchhany did all her best to get what she has always dreamed of. She joined Miss Cambodia in 2017 and was named 4th runner up. This feat has paved the way for her to represent the Kingdom of Wonder in the international pageant stage – Miss Asia Pacific International 2018.
The competition was held in the city of Manila, Philippines on October 4, where 50 candidates competed for the cove-ted crown. Established in 1968, Miss Asia Pacific International evolved over the decades to include candidates from more countries, having originally gathered only representatives from Asia and Oceania.
Cambodia's Kha Annchhany and Colombia's representative for Miss Asia Pacific International 2018. Supplied
Annchhany reached the final rounds of the competition. Although she was not able to bring home the crown for Cambodia, she said, "becoming one of the contestants standing on the same stage with other beautiful girls from around the world, is already one my biggest achievements in life." She said she will forever look back to the day she represented her country in the best way possible.
"In the competition, there were many contestants from diverse countries, with different cultures, traditions and education. I needed to challenge myself to break through the language barriers. I pushed myself to adapt to the different environment setting and culture. There was some sort of culture shock, but I easily managed to overcome it."
And even with the huge responsibility she had to carry on her shoulder while representing the country, Annchhany said she gained tons of learning and experiences that she can now use to improve herself as a person and as a beauty queen.
"With the interactions I had with the other contestants, I learned about their cultures and traditions; their dances and sports and lifestyle. I realised that we're all different, but we're all determined to represent our countries well. There were contestants coming from Muslim countries. They had to go through more complicated processes but they were able to follow their dreams of becoming beauty queens. With that, I am more inspired to fulfill mine as well. Standing with them on the same stage was really unforgettable."
Now that the competition is over, Annchhany believes that her journey has not ended yet; and she knows that she will be going through hurdles as she continues to become part of the list of Cambodia's beauty queens. She said she finds strength from the support her family and relatives are giving her.
"Their strong belief in me has become my source of motivation to enter in this industry with confidence. I'm blessed to get their encouragement, because my parents' support plays an important role in helping me to achieve this big dream."
To all those young Khmers who share the same dream, Annchhay said, "Believe in yourself and follow your dreams despite the difficulties that you are facing and may face in the future. However before becoming who I am today, there were many setbacks that held me down, but I overcame them all because I believed in myself and in my capabilities. You should do the same."
REUTERS/Beawiharta
Asia-Pacific air passenger traffic up
Jacksons International Airport May 2015. wikimedia/Nick-D
PNG airport gears up for upcoming APEC summit
An airplane ready to land in Phnom Penh International Airport. KT/Chor Sokunthea
Three new airlines to join buoyant sector
KT/Say Tola
The road to the crown
Tags: Kha Annchhany, MANILA, Miss Asia Pacific International, Miss Cambodia
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