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HomeMarch 19, 2012
March 19, 2012 thanechambers
Congratulations to Dr. Carole Estabrooks
Dr. Estabrooks' Canada Research Chair has been advanced to a Tier 1 CRC. This is the Faculty of Nursing's first Tier 1 CRC. Way to go Carole!!! And thanks to everyone who's worked with Carole on TREC!!!
Call for Abstracts Society for Social Medicine Annual Scientific Meeting
12th – 14th September 2012, London UK. Deadline 23.59 GMT ON Monday 19th March 2012.
The Society welcomes abstracts on all aspects of social medicine, including health services research, epidemiology, public health, statistics, sociology, psychology, health policy and/or mixed methods research.
Call for Abstracts NCCPH Summer Institute 2012
May 15-16, 2012, Kelowna BC Deadline Friday March 30, 2012.
The NCCPH 2012 Summer Institute will be holding a poster presentation to highlight new and interesting work. We invite you to participate by submitting an abstract for a poster presentation in relation to the following areas:
the role of experience in evidence-informed decision making in public health
knowledge translation promoting health equity
examples of actions or projects that help advance health equity
KT Canada Summer Institute – Deadline Extended: March 26 2012
The deadline for applications to the KT Canada Summer Institute has been extended until March 26th at 23:59 ET. The summer institute is open to graduate students, fellows and junior faculty. Don't miss out on this exciting opportunity.
Research Methodology & Practice
Building capacity for evidence informed decision making in public health: a case study of organizational change.
Peirson L, Ciliska D, Dobbins M, Mowat D.
BMC public health 2012 Feb 20;12:137
Core competencies for public health in Canada require proficiency in evidence informed decision making (EIDM). However, decision makers often lack access to information, many workers lack knowledge and skills to conduct systematic literature reviews, and public health settings typically lack infrastructure to support EIDM activities. This research was conducted to explore and describe critical factors and dynamics in the early implementation of one public health unit's strategic initiative to develop capacity to make EIDM standard practice. METHODS: This qualitative case study was conducted in one public health unit in Ontario, Canada between 2008 and 2010. In-depth information was gathered from two sets of semi-structured interviews and focus groups (n = 27) with 70 members of the health unit, and through a review of 137 documents. Thematic analysis was used to code the key informant and document data. RESULTS: The critical factors and dynamics for building EIDM capacity at an organizational level included: clear vision and strong leadership, workforce and skills development, ability to access research (library services), fiscal investments, acquisition and development of technological resources, a knowledge management strategy, effective communication, a receptive organizational culture, and a focus on change management. CONCLUSION: With leadership, planning, commitment and substantial investments, a public health department has made significant progress, within the first two years of a 10-year initiative, towards achieving its goal of becoming an evidence informed decision making organization.
Looking for interaction: quantitative measurement of research utilization by Dutch local health officials.
de Goede J, van Bon-Martens MJ, Mathijssen JJ, Putters K, van Oers HA.
Health research policy and systems / BioMed Central 2012 Mar 13;10(1):9
In the Netherlands, local authorities are required by law to develop local health memoranda, based on epidemiological analyses. The purpose of this study was to assess the actual use of these epidemiological reports by municipal health officials and associated factors that affect this use. METHOD: Based on a conceptual framework, we designed a questionnaire in which we operationalized instrumental, conceptual, and symbolic use, the interaction between researchers and local health officials, and four clusters of barriers in this interaction process. We conducted an internet survey among 155 Dutch local health officials representing 35% of all Dutch municipalities. By means of multiple regression analyses, we gained insight into the related factors for each of the three types of research utilization. RESULTS: The results show that local health officials use epidemiological research more often in a conceptual than an instrumental or symbolic way. This can be explained by the complexity of the local policy process which is often linked to policies in other areas, and the various policy actors involved. Conceptual use was statistically associated with a presentation given by the epidemiologist during the policy process, the presence of obstructions regarding the report's accessibility, and the local official's personal belief systems and interests originating from different professional values and responsibilities. Instrumental and symbolic use increased with the involvement of local officials in the research process. CONCLUSIONS: The results of this study provide a partial solution to understanding and influencing research utilization. The quantitative approach underpins earlier qualitative findings on this topic. The outcomes suggest that RPHS epidemiologists can use different strategies to improve research utilization. 'Blurring the boundaries', and the enhancement of interfaces between epidemiologists and local health officials, like direct interactions into each other's work processes, is expected to create better possibilities for optimizing research use.
An analysis of existing publications to explore the use of the diffusion of innovations theory and innovation attributes
Kapoor KK, Williams MD, Dwivedi YK, Lal B.
Proceedings of the 2011 world congress on information and communication technologies, WICT 2011
'Diffusion of Innovations' is a theory that explicates the process of introducing new ideas (i.e. technological innovation) into a system via varied channels of communication. The purpose of this paper is to undertake a systematic review of the available literature to examine the current advances in the Diffusion Of Innovations (DOI) theory. The focus remains more inclined towards the diffusion attributes. ISI Web of Knowledge ® and Google Scholar were the two rigorously used search engines for our study. These engines fectched a total of 2073 published records that cited Rogers' Diffusion of Innovation theory. Some of these publications were found to be available for download. Upon conducting a further search, 1145 published records were found to have used the 28 innovation attributes that were identified in a previous article on this subject. Statistical filtering then showed complexity to be the highly used attribute with 834 records having cited this attribute. Further review showed that all the five attributes adopted from Rogers' work of study, represented the most frequently employed attributes for examining the rate of innovation adoption. © 2011 IEEE.
Health Care Administration & Organization
The integrality of situated caring in nursing and the environment.
Jarrin OF.
ANS.Advances in nursing science 2012 Jan-Mar;35(1):14-24
Much emphasis has been placed on the importance of the environment as a determinant of health; however, little theoretical work in nursing has specifically articulated the importance of the nursing practice environment as a factor in patient outcomes. This work advances the unitary-transformative-caring paradigm by focusing on the concept of integrality and exploring the nursing meta-paradigm concepts (nursing, environment, human being, and health) through integral philosophical inquiry.
Health Care Innovation & Quality Assurance
Guidance for Evidence-Informed Policies about Health Systems: Linking Guidance Development to Policy Development
Lavis JN, Rottingen J, Bosch-Capblanch X, Atun R, El-Jardali F, Gilson L, et al.
PLoS Med 2012 03/13;9(3):e1001186
Contextual factors are extremely important in shaping decisions about health systems, and policy makers need to work through all the pros and cons of different options before adopting specific health systems guidance. A division of labour between global guidance developers, global policy developers, national guidance developers, and national policy developers is needed to support evidence-informed policy-making about health systems. A panel charged with developing health systems guidance at the global level could best add value by ensuring that its output can be used for policy development at the global and national level, and for guidance development at the national level. Rigorous health systems analyses and political systems analyses are needed at the global and national level to support guideline and policy development.
Further research is needed into the division of labour in guideline development and policy development and on frameworks for supporting system and political analyses.
More black box to explore: how quality improvement collaboratives shape practice change.
Shaw EK, Chase SM, Howard J, Nutting PA, Crabtree BF.
Journal of the American Board of Family Medicine : JABFM 2012 Mar;25(2):149-157
Quality improvement collaboratives (QICs) are used extensively to promote quality improvement in health care. Evidence of their effectiveness is limited, prompting calls to "open up the black box" to better understand how and why such collaboratives work. METHODS: We selected a cohort of 5 primary care practices that participated in a 6-month intervention study aimed at improving colorectal cancer screening rates. Using an immersion/crystallization technique, we analyzed qualitative data that included audio recordings and field notes of QICs and practice-based team meetings. RESULTS: Three themes emerged from our analysis: (1) practice staff became empowered through and drew on the QICs to advance change efforts in the face of leader/physician resistance; (2) a mix of content and media in the QIC program was important for reaching all participants; (3) resources offered at the QIC did little to spur practice change efforts. CONCLUSION: QICs offer a potentially powerful way of disseminating health care innovations through enhanced strategies for learning and change. Creating collaborative environments in which diverse participants learn, listen, reflect, and share together can enable them to take back to their own organizations key messages and change strategies that benefit them the most.
Organizational Learning: Subprocess Identification, Construct Validation, and an Empirical Test of Cultural Antecedents
Flores LG, Zheng W, Rau D, Thomas CH.
Journal of Management 2012;38(2):640-667
Organizational learning is key to an organization's capability for continuous change and renewal. As a result, scholarly interest in identifying the antecedents of organizational learning has greatly increased over the past couple of decades. This study focuses on (1) identifying and measuring the distinct subprocesses that make up the organizational learning construct to obtain a more detailed understanding of the construct and (2) exploring the effect that organizational culture and, more particularly, four dimensions of culture-participative decision making, openness, learning orientation, and transformational leadership-have on each of the organizational learning subprocesses. The authors use two samples of subject matter experts and the responses of 631 managers to test their propositions. Their results yielded five independent but interrelated subprocesses-information acquisition, information distribution, information interpretation, knowledge integration, and organizational memory. Furthermore, their results indicate that the four different cultural antecedents studied have different kinds of significant relationships with each of the organizational learning subprocesses. This study contributes to the literature on organizational learning by identifying and validating the organizational learning subprocesses, and by offering a detailed picture of the relationship between key organizational antecedents to learning and the individual subprocesses of learning. In addition, since they use systematic and thorough methodological techniques to develop an instrument to test, measure, and validate those subprocesses of learning that constitute a common body of knowledge in this area, the authors' instrument could prove to be a valuable tool for future research. © Southern Management Association 2012.
Research Methodology And Practice
The Role of Group Dynamics in Mixed Methods Health Sciences Research Teams
Curry LA, O'Cathain A, Clark VLP, Aroni R, Fetters M, Berg D.
Journal of Mixed Methods Research 2012 January 01;6(1):5-20
This article explores the group dynamics of mixed methods health sciences research teams. The authors conceptualize mixed methods research teams as "representational groups," in which members bring both their organizational and professional groups (e.g., organizational affiliations, methodological expertise) and their identity groups, such as gender or race, to the work of research. Although diversity and complementarity are intrinsic to mixed methods teams, these qualities also present particular challenges. Such challenges include (a) dealing with differences, (b) trusting the "other," (c) creating a meaningful group, (d) handling essential conflicts and tensions, and (e) enacting effective leadership roles. The authors describe these challenges and, drawing from intergroup relations theory, propose guiding principles that may be useful to mixed methods health sciences research teams.
A Mixed Methods Sampling Methodology for a Multisite Case Study
Sharp JL, Mobley C, Hammond C, Withington C, Drew S, Stringfield S, et al.
Journal of Mixed Methods Research 2012;6(1):34-54
The flexibility of mixed methods research strategies makes such approaches especially suitable for multisite case studies. Yet the utilization of mixed methods to select sites for these studies is rarely reported. The authors describe their pragmatic mixed methods approach to select a sample for their multisite mixed methods case study of a statewide education policy initiative in the United States. The authors designed a four-stage sequential mixed methods site selection strategy to select eight sites in order to capture the broader context of the research, as well as any contextual nuances that shape policy implementation. The authors anticipate that their experience would provide guidance to other mixed methods researchers seeking to maximize the rigor of their multisite case study sampling designs.
Establishing a new journal for systematic review products
Moher D, Stewart L, Shekelle P.
Systematic Reviews 2012;1(1):1
Welcome to a new age in publishing systematic reviews. We hope the launch of Systematic Reviews will resonate with a broad spectrum of readers interested in using them in a variety of ways, such as providing comprehensive and up to date evidence for patient management, informing health policy, and developing rigorous practice guidelines. Systematic reviews are increasingly popular. Our journal is committed to publishing a wide variety of well conducted and transparently reported systematic reviews and associated research. We are open access and electronic and not confined by space and so offer scope for publishing reviews in detail and providing a modern and innovative approach to publishing. We look forward to participating in the voyage with all of our readers.
Methods and metrics challenges of delivery-system research.
Alexander JA, Hearld LR.
Implementation science : IS 2012 Mar 12;7(1):15
BACKGROUND: Many delivery-system interventions are fundamentally about change in social systems (both planned and unplanned). This systems perspective raises a number of methodological challenges for studying the effects of delivery-system change–particularly for answering questions related to whether the change will work under different conditions and how the change is integrated (or not) into the operating context of the delivery system. METHODS: The purpose of this paper is to describe the methodological and measurement challenges posed by five key issues in delivery-system research: (1) modeling intervention context; (2) measuring readiness for change; (3) assessing intervention fidelity and sustainability; (4) assessing complex, multicomponent interventions; and (5) incorporating time in delivery-system models. For each issue, we provide recommendations for how research may be designed and implemented to overcome these challenges. Results and conclusions We suggest that a more refined understanding of the mechanisms underlying delivery-system interventions (treatment theory) and the ways in which outcomes for different classes of individuals change over time are fundamental starting points for capturing the heterogeneity in samples of individuals exposed to delivery-system interventions. To support the research recommendations outlined in this paper and to advance understanding of the "why" and "how" questions of delivery-system change and their effects, funding agencies should consider supporting studies with larger organizational sample sizes; longer duration; and nontraditional, mixed-methods designs.
The National Institute for Health Research Leadership Programme: An evaluation of programme progress and delivery
RAND, 2012
RAND Europe evaluated the National Institute for Health Research Leadership Programme in an effort to help the English Department of Health consider the extent to which the programme has helped to foster NIHR's aims, extract lessons for the future, and develop plans for the next phase of the leadership programme. Successful delivery of high-quality health research requires not only an effective research base, but also a system of leadership supporting it. However, research leaders are not often given the opportunity, nor do they have the time, to attend formal leadership or management training programmes. This is unfortunate because research has shown that leadership training can have a hugely beneficial effect on an organisation. Therefore, the evaluation has a particular interest in understanding the role of the programme as a science policy intervention and will use its expertise in science policy analysis to consider this element alongside other, more traditional, measures of evaluation.
Background Paper on Conceptual Issues Related to Health Systems Research to Inform a WHO Global Strategy on Health Systems Research
WHO, February 2012
This paper reviews existing definitions, terms, conceptual models, taxonomies, standards, methods and research designs which describe the scope of health systems research as well as the barriers and opportunities that flow from them.
Association of Hospital Spending Intensity With Mortality and Readmission Rates in Ontario Hospitals
Stukel TA, Fisher ES, Alter DA, Guttmann A, Ko DT, Fung K, et al.
JAMA : the journal of the American Medical Association 2012 Mar 14;307(10):1037-1045
Context The extent to which better spending produces higher-quality care and better patient outcomes in a universal health care system with selective access to medical technology is unknown. Objective To assess whether acute care patients admitted to higher-spending hospitals have lower mortality and readmissions. Design, Setting, and Patients The study population comprised adults (>18 years) in Ontario, Canada, with a first admission for acute myocardial infarction (AMI) (n = 179 139), congestive heart failure (CHF) (n = 92 377), hip fracture (n = 90 046), or colon cancer (n = 26 195) during 1998-2008, with follow-up to 1 year. The exposure measure was the index hospital's end-of-life expenditure index for hospital, physician, and emergency department services. Main Outcome Measures The primary outcomes were 30-day and 1-year mortality and readmissions and major cardiac events (readmissions for AMI, angina, CHF, or death) for AMI and CHF. Results Patients' baseline health status was similar across hospital expenditure groups. Patients admitted to hospitals in the highest- vs lowest-spending intensity terciles had lower rates of all adverse outcomes. In the highest- vs lowest-spending hospitals, respectively, the age- and sex-adjusted 30-day mortality rate was 12.7% vs 12.8% for AMI, 10.2% vs 12.4% for CHF, 7.7% vs 9.7% for hip fracture, and 3.3% vs 3.9% for CHF; fully adjusted relative 30-day mortality rates were 0.93 (95% CI, 0.89-0.98) for AMI, 0.81 (95% CI, 0.76-0.86) for CHF, 0.74 (95% CI, 0.68-0.80) for hip fracture, and 0.78 (95% CI, 0.66-0.91) for colon cancer. Results for 1-year mortality, readmissions, and major cardiac events were similar. Higher-spending hospitals had higher nursing staff ratios, and their patients received more inpatient medical specialist visits, interventional (AMI cohort) and medical (AMI and CHF cohorts) cardiac therapies, preoperative specialty care (colon cancer cohort), and postdischarge collaborative care with a cardiologist and primary care physician (AMI and CHF cohorts). Conclusion Among Ontario hospitals, higher spending intensity was associated with lower mortality, readmissions, and cardiac event rates.
Disparities in Primary Health Care Experiences Among Canadians With Ambulatory Care Sensitive Conditions
CIHI, March 2012
This analytical product focuses on disparities in primary health care by examining differences in access, use and appropriateness of primary health care for Canadians who have ambulatory care sensitive conditions according to their income, geography, health conditions and sex. The results will assist in identifying barriers to and difficulties in accessing primary health care services and assessing whether all Canadians are receiving an appropriate level of care according to their needs.
The disappearing subject: exclusion of people with cognitive impairment and dementia from geriatrics research.
Taylor JS, Demers SM, Vig EK, Borson S.
Journal of the American Geriatrics Society 2012 Mar;60(3):413-419
To evaluate exclusion of persons with cognitive impairment from research in geriatrics by determining its frequency, method, and rationale and treatment in the resulting publications. DESIGN: All original research articles published in 2008 and 2009 in the Journal of the American Geriatrics Society (n = 434) were reviewed using a structured data collection tool. SETTING: The Journal of the American Geriatrics Society. PARTICIPANTS: There were no participants in this study. MEASUREMENTS: Data captured included recruitment method, explicit criterion for exclusion of persons with cognitive impairment, justification of exclusion criterion, reason given for exclusion, percentage of individuals excluded, and mention of exclusion as a possible limitation. RESULTS: Of 434 articles examined, 16% used recruitment methods likely to reduce participation by persons with cognitive impairment. At least 29% of studies (n = 127) employed explicit exclusion criteria. Half used the Folstein Mini-Mental State Examination (MMSE), with variable cut points (10, 12, 17, 18, 23, 26), and 19% excluded individuals for "having dementia" without specifying how this was determined. Few (6%) provided any justification for exclusion criteria used, only 43% gave any reason for exclusion, and only 14% discussed exclusion as a possible limitation. CONCLUSION: Persons with cognitive impairment are frequently excluded from research, often without rationale or mention of exclusion as a limitation or any discussion of its potential effect on the evidence base in geriatrics. When necessary, exclusion should be done thoughtfully and with awareness that this may reduce the clinical utility of study findings.
Health-promoting interventions for persons aged 80 and older are successful in the short term-results from the randomized and three-armed elderly persons in the risk zone study.
Gustafsson S, Wilhelmson K, Eklund K, Gosman-Hedstrom G, Ziden L, Kronlof GH, et al.
To examine the outcomes of the Elderly Persons in the Risk Zone study, which was designed to evaluate whether it is possible to delay deterioration if a health-promoting intervention is made when an older adult (≥80) is at risk of becoming frail and whether a multiprofessional group intervention is more effective in delaying deterioration than a single preventive home visit with regard to frailty, self-rated health, and activities of daily living (ADLs) at 3-month follow-up. DESIGN: Randomized, three-armed, single-blind, controlled trial performed between November 2007 and May 2011. SETTING: Two urban districts of Gothenburg, Sweden. PARTICIPANTS: Four hundred fifty-nine community-living adults aged 80 and older not dependent on the municipal home help service. INTERVENTION: A preventive home visit or four weekly multiprofessional senior group meetings with one follow-up home visit. MEASUREMENTS: Change in frailty, self-rated health, and ADLs between baseline and 3-month follow-up. RESULTS: Both interventions delayed deterioration of self-rated health (odds ratio (OR) = 1.99, 95% confidence interval (CI) = 1.12-3.54). Senior meetings were the most beneficial intervention for postponing dependence in ADLs (OR = 1.95, 95% CI = 1.14-3.33). No effect on frailty could be demonstrated. CONCLUSION: Health-promoting interventions made when older adults are at risk of becoming frail can delay deterioration in self-rated health and ADLs in the short term. A multiprofessional group intervention such as the senior meetings described seems to have a greater effect on delaying deterioration in ADLs than a single preventive home visit. Further research is needed to examine the outcome in the long term and in different contexts.
Prioritizing culture change in nursing homes: perspectives of residents, staff, and family members.
White HK, Corazzini K, Twersky J, Buhr G, McConnell E, Weiner M, et al.
To explore the perspectives and priorities of nursing home residents, family members, and frontline nursing staff concerning a broad range of items representing common targets of culture change initiatives. DESIGN: Qualitative study. SETTING: A Veterans Affairs Community Living Center and two community nursing homes in North Carolina. PARTICIPANTS: Residents (n = 21), family members (n = 21), and direct-care nursing staff (n = 21) were recruited, with equal numbers in each group from each site. MEASUREMENTS: Participants rated the importance of 62 items from the Centers for Medicare and Medicaid Services Artifacts of Culture Change instrument. Participants sorted cards reflecting each culture change artifact in two phases, identifying and ranking those of more and less importance to them to derive one distribution of preferences for each respondent. Q-sort analysis identified groups of respondents who prioritized similar items; qualitative analysis sought themes or explanations for the responses. RESULTS: Wide variation in respondent preferences was observed. Some respondents viewed several items that others valued highly as unimportant or undesirable. Some items were not high priorities for any respondents. Four groups of respondents with similar preferences were identified: practical and independence-focused respondents, who prioritized ease of use of the physical environment; staff-focused respondents, who prioritized nursing staff retention and development; consistency and choice-focused respondents, who prioritized stable nurse staff-resident relationships and resident choice; and activity and community-focused respondents, who prioritized community gathering spaces and activities. CONCLUSION: Resident, family, and staff priorities for culture change vary, and diverse priorities of stakeholders should be considered to inform culture change efforts on a local and national level.
Education of health professionals in the 21st century – the Lancet Commission's report and its relevance to global health
Monday March 19th, 16:00-17:30, ECHA 2-490
This talk will summarize the genesis and key recommendations of the Lancet Commission on Education for Health Professionals in the 21st Century (2010). Dr. Bhutta will share some thoughts on the issues and challenges that face schools of public health and programs in global health, as well as how the Lancet Commission proposes to create an enabling environment to help address them.
Maternal and child health and survival globally: Challenges and opportunities
Tuesday March 20, 2012 12:00 – 13:00 ECHA 1-498
Dr. Bhutta will address the status and epidemiology of maternal and child health on an international scale, as well as innovations to address some of the barriers in reaching the unreached.
Experimental Therapies in Pediatric Chronic Care, Medical Freedom Acts, and Medical Ethics: Who Has the Last Word
Friday, 23 March 2012 12:00—12:45 Classroom F 2J4.02 WMC
In Canada's multicultural society, there is a steady increase in the number of patients with chronic medical conditions who use or request (by themselves or through their proxies) therapies that are
generally described as 'unconventional', 'complementary', or 'alternative', and which are conveniently denoted in this research as 'experimental therapies'. In recent years, courts in Canada and the United States (US) have heard cases involving minors who reject conventional therapies in favour of experimental interventions. Resolution of these difficult cases is complicated by the consent requirements for pediatric patients. With this growing trend, some Canadian provinces have promulgated laws, known as Medical Freedom Laws like their counterparts in the US, that redefine the threshold of liability for physicians who use unconventional 'alternative' therapies in the treatment of their patients. While these laws-when analyzed along with the Healthcare Consent Acts of some Canadian provinces-seem to diminish the professional liability often associated with physician practice of unconventional medicine, a combination of professional, legal and ethical norms operate to define what should count as legally and ethically appropriate practice. This presentation draws from this constellation of norms in exploring the question posed by the title
University of Alberta Campus Data Summit
Thursday March 22 ECHA 1-190, Friday March 23, 2012 ECHA 2-490 Registration
The time is right to bring together significant stakeholders from across our campus to engage in a dialogue about establishing the future of data stewardship at the University of Alberta. This Summit will address the issues of producing, managing, sharing and preserving research data from the perspective of the biosciences and Northern research. Subsequent Summits will address other areas of research on campus.
Author Talk: Mobbing: Causes, Consequences, and Solutions by Maureen Duffy & Len Sperr Thursday March 22nd 1200-130ECHA 4-036
Dr. Maureen Duffy will be here to speak about her new book which focuses on mobbing and its implications in nursing and in health care
Save the Date: Research Administration Day
Full program details will be released in April.
The Use of the Arts to Translate Knowledge about Home Care
501 Festival Avenue, Sherwood Park AB
2012 National Australian Conference on Evidence Based Clinical Leadership
August 13-14, 2012 Adelaide, Australia
The National Australian Conference will bring together the experiences of evidence-based researchers and reviewers, guideline developers, clinicians, educators, policy makers, administrators and consumers to work toward improving techniques and methods of getting evidence into practice. This conference will provide informative sessions, a conference dinner and fabulous networking opportunities so that health professionals can continue the evolving journey of reforming healthcare by transforming clinical leadership in evidence-based practices.
2012 Canadian interRAI Conference
May 7-10 2012 Vancouver Early Bird Deadline March 21, 2012
The 6th Canadian interRAI Conference provides an important forum that brings together researchers, policy makers and practitioners using the interRAI system of instruments used in various health care settings across Canada. These evidence-based electronic instruments capture client/patient assessment information that is used to support care planning and delivery, quality improvement, health system management and policy.
UBC Sauder School of Business: If You're Not Keeping Score You're Only Practicing: Evaluating a System-wide Lean Implementation
Wednesday, March 21, 2012, 9:00-10:00 am MT
Lean methods date back to the Toyota Production System which was developed shortly after World War II. Of late, they are finding wide spread usage in health care. In industry, the primary objective of Lean is to enhance corporate earnings, but in health care, Lean seeks to improve patient-centered care and system efficiency. Lean evaluations have tended to be ad hoc, usually focusing on before and after pictures, graphical displays or vignettes. With Lean's widespread adoption in health care, a framework for its evaluation is sorely needed. This talk provides guidelines for evaluating a comprehensive Lean program based on insights gained developing a framework to evaluate "imPROVE", a significant Lean initiative undertaken by the Provincial Health Services Authority (PHSA) in British Columbia. This talk will not present results of the imPROVE evaluation but will focus on concepts, methods and observations.
KT Canada: The Development of Quality Indicators for High Acuity Pediatric Conditions: Challenges in the Translation of Knowledge into Performance Measurement.
Thursday April 12, 2012 1200-1300 MST
To review methods for involving stakeholders in the indicator development process.
To discuss the application of GRADE (the Grading of Recommendations Assessment, Development and Evaluation) in indicator development and selection.
To describe the challenges in developing and testing broadly applicable performance measures for high impact, relatively low frequency, conditions.


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Sudan activists say internet restored after crackdown
by: FAY BUELGASIM and SAMY MAGDY, Associated Press
Posted: Jul 10, 2019 / 02:51 PM UTC / Updated: Jul 10, 2019 / 03:08 PM UTC
The power-sharing agreement reached between Sudan's military and pro-democracy protesters.;
KHARTOUM, Sudan (AP) — Sudanese activists said Wednesday the ruling generals restored internet service in the country, following a weekslong blackout imposed during a deadly crackdown early last month.
The long-waited move came a week after the military council and the pro-democracy movement reached a power-sharing deal, ending a three-month standoff since the military removed autocratic President Omar al-Bashir from power amid nationwide demonstrations against his rule.
A group of legal experts has been finalizing the wording of the deal to be signed by both sides in the coming days.
The military council had blocked internet service after security forces razed a protest camp in the capital of Khartoum on June 3, killing over 128 people in an ensuing three-week crackdown, according to protest organizers. Authorities offered a lower death toll of 61, including three security forces.
The Forces for Declaration of Freedom and Change, which represents the protesters, has repeatedly called for internet service restoration. This demand was one of the trust-building measures set by protesters to resume talks with the generals after the violent dispersal of the sit-in.
A telecommunications affiliate of the Sudanese Professional's Association, which has been spearheading the protests, said that users across the country have been back online. It demanded telecommunication companies compensate users.
People in Sudan have begun posting footage of alleged abuses by security forces against protesters during the break-up.
"The one thing we wanted to see is the videos. …. We saw the horrific scenes, and I closed down the internet and couldn't open it again," said Malaz Hassan, student.
Amal al-Zein, an activist, said internet service came back on gradually after a Khartoum court on Tuesday ordered telecommunication companies in Sudan to restore service.
Lawyer Abdel-Azim Hassan sued last month to restore internet service. A court ordered authorities to restore service for Hassan, who then filed another lawsuit demanding internet service be restored for all Sudanese.
"The reason behind blocking internet service was to hide facts, information and evidence related to crimes" committed by security forces in the crackdown, he said.
U.N. human rights experts on Monday denounced measures taken by the authorities to shut down the Internet in Sudan, saying it stifles free expression and association.
"In the past few weeks, we have continued to receive reports on Internet blocking of social media platforms by the Transitional Military Council," the experts said in a statement.
Late on Tuesday, the NetBlocks observatory said data showed significant restoration of internet service in Sudan, both mobile and fixed-line connections via multiple providers.
It said real-time measurements show no social media or messaging app restrictions via the leading providers that have come online. Current traffic data, however, showed levels remain significantly below June 3 levels, suggesting many users remained offline, NetBlocks added.
The group said internet disruption may cost Sudan's economy upwards of $1 billion.
Magdy reported from Cairo.
by DAVID CRARY, Associated Press / Jul 15, 2019
NEW YORK (AP) — Government restrictions on religion have increased markedly in many places around the world, not only in authoritarian countries, but also in many of Europe's democracies, according to a report surveying 198 countries that was released Monday.
The report released by the Pew Research Center, covering developments through 2017, also seeks to document the scope of religion-based harassment and violence. Regarding the world's two largest religions, it said Christians were harassed in 143 countries and Muslims in 140.
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Ras Al Khaimah Ruler 'proud' of thriving economy and wants to welcome the world
Sheikh Saud bin Saqr Al Qasimi said Ras Al Khaimah can become a global success
Sheikh Saud bin Saqr Al Qasimi, UAE Supreme Council Member and Ruler of Ras Al Khaimah, has praised the emirate's success. Ministry of Presidential Affairs
The Ruler of Ras Al Khaimah has hailed the emirate for being a thriving hub of industry - and a major driving force behind the success of the UAE.
Sheikh Saud bin Saqr Al Qasimi, said Ras Al Khaimah had embraced the manufacturing sector, growing its own businesses and attracting trade from overseas.
During an interview with CNN, the Supreme Council member said Ras Al Khaimah has become a leading supplier of building materials for countries throughout the Middle East.
''I saw that manufacturing could be really a good start for us. We are very proud that today we have some marvelous industries that are successful like RAK Ceramic and RAK Rock. We have actually managed to attract major companies, especially Indian companies, like Ashok Leyland."
Sheikh Saud said port expansion has been key to growth in the emirate.
"Logistics is a central part to the ongoing revolution; that's why we have embarked on reforming our port. In the past, we used to handle 1.5 million tonnes of cargo, while today we are handling around 70 million tonnes. The efficiency of our port is key to our success.
"Name any port in the Gulf and you will find it's built by Ras Al Khaimah."
The Ruler of Ras Al Khimah said the emirate is flourishing as it is a good place to do business for companies all over the globe.
"We have ease of doing business. I had a meeting with the World Bank recently on the ease of doing business. We went from the 31st position to be now among the 30 top economies on the ease of doing business. However, it is not enough for us; we need more progress."
'This is for the people I'm privileged to lead': Ruler of Ras Al Khaimah given top accolade at UAE awards
Ras Al Khaimah adventure tourism is experiencing a boom
Record-breaking zipline opens in Ras al Khaimah
Sheikh Saud said it is vital that governments are led properly - with everyone held accountable for their actions.
"It's very important for us to make sure our government is well-managed. We ensure that everyone is answerable, everyone is measured by best practices. History is a good tutor for failure and successes."
He said Ras Al Khaimah has much to offer as a tourist destination, from rich heritage to sandy beaches.
"We are in a global village. It takes you a few hours to come from LA, New York or anywhere in the world. We have lovely beaches; sunny weather; and a great typography. Very few places in the world have this combination. There is a great archeology. We have around 5,000 archeological sites available. There is rich history in the emirate."
Sheik Saud said he is eager to unleash the potential of the next generation in order to help the emirate develop on the world stage.
"We're constructing a vision for 2030. I will tell you what I want. I want Ras Al Khaimah to be a global emirate. I want our people to be global citizens. Our duty is to help our kids to reach their best potential. I believe in our young men and women who are our true wealth. We'd like to throw them to the ocean, and allow them to swim - and they will thrive."


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Interview with Claudie Arseneault, Author of Baker Thief
Claudie Arseneault was actually the first person to introduce me to the term solarpunk (a genre I've been rambling non-stop about ever since), through the call for submissions to her solarpunk dragons anthology Wings of Renewal. I've been following her career ever since, and it turns out she's just an all-around good person and awesome writer whom I'm glad to have encountered.
Today, I've invited Claudie onto my blog to talk about her new fantasy novel Baker Thief.
Here's what the book is about:
Adèle has only one goal: catch the purple-haired thief who broke into her home and stole her exocore, thus proving herself to her new police team. Little does she know, her thief is also the local baker.
Claire owns the Croissant-toi, but while her days are filled with pastries and customers, her nights are dedicated to stealing exocores. These new red gems are heralded as the energy of the future, but she knows the truth: they are made of witches' souls.
When her twin—a powerful witch and prime exocore material—disappears, Claire redoubles in her efforts to investigate. She keeps running into Adèle, however, and whether or not she can save her sister might depend on their conflicted, unstable, but deepening relationship.
In a nutshell, what was the path from idea to publication for BAKER THIEF?
I started Baker Thief as a project that would be as fun and tropy as I wanted it to be, a story in which I'd allow myself to write Whatever I Wanted. The first glimpse of the project involved an investigator looking for a thief at a masked ball and a f/f romance—that changed quite a bit, but I was already aiming for The Good Tropes.
I hadn't even put the first word down before I knew one of the MCs would be bigender and aromantic, and that I didn't want romance, but a queerplatonic relationship. These stories were near impossible to find (they still are hard, but it got better), and I felt drawn to them. Turns out that was because I was aromantic myself, but I didn't know at the time. I also… jumped in with as much French as I wanted to, and to have my language in there quickly became incredibly meaningful and important to me.
It took me quite a few drafts to get the ending right, then it made the typical rounds of dev editing through writer friends, sensitivity readers, beta readers, and copyediting. I started the first draft in February 2016, and here we are, about a year and a half later.
What's your typical writing routine? Do you write at a certain time of day, have word count goals, a particular playlist you listen to, etc.?
It really depends on what part of the process I'm at. If I'm creating new words, typically for first drafts, I will write nearly every day and set word count goals (usually around 700-1,000 for weekdays, and 1,500-2,000 for weekends). As a writer, I do a lot better if my progress is constant. My full-time job makes this rather difficult, however, which means that I will write whenever I can. At least half of Baker Thief has been written on my cellphone during transit, and a good chunk of the other half was over my lunch break.
I don't have playlists as much as I have artists I'll put on and listen on loop. And I don't mean many of them. Most of my previous novels were written and edited on a background of Mumford and Sons. For Baker Thief, though, I stuck to artists from Québec, either Karkwa or Dumas. It felt right to listen to local music for a WIP that drew so intensely from my roots.
What advice do you have for young writers who are struggling through the first draft of a fantasy novel?
The first and most important for me is… don't give up. Get to the end. Writing the end will teach you so much about the craft, about your story. Even if you end up trashing the story, it will be worthwhile (and you will have finished a draft!). That doesn't mean you have to power through unquestioningly, though. Different writers need different things to get to the end. I handle unclear drafts very well, so I write start to finish without ever revising what's behind, even if I decided halfway through I need to make a major change. I just take a note, act like the change is done, and move on. I know writers who couldn't do that—no chance in hell—so they revise as they go, and their first drafts take longer but are a lot cleaner.
So I guess my biggest piece of advice is experiment. Try things out! See what works for you, what allows you to progress and what just makes you hyper-anxious and unproductive. We all work differently, and sometimes our process even changes from one story to another. But if you find yourself never finishing anything? Find a way to get to that end; you're limiting your growth otherwise.
You're very invested in the topic of asexual/aromantic representation. Do you remember the first time you saw this type of character represented well in fiction? What are some other published books that get it right?
My first time was for a sex-repulsed asexual character, Nadin from Fourth World by Lyssa Chiavari. Nadin struggles a lot with her sex-repulsion and there are scenes throughout the novel that felt like someone had spied on my life. One in particular made me set the book down, because I needed time to take it all in.
That was my first time, but by actively seeking representation over the course of the last 2-3 years, I've found so many more. I couldn't even begin to list them all here. I recommend picking up the Chameleon Moon series, as it has an alloromantic asexual MC in the first book, and an aromantic asexual one in the second (and a whole lot more queer disabled diversity). If you're more a contemporary person, then Let's Talk About Love is about a biromantic asexual black girl. For aromantic characters, Darcie Little Badger has a wonderful short story, "Nkásht íí", that is online for free and is all about friendship. I also thoroughly enjoyed A Promise Broken, from Lynn E. O'Connacht—a low-stakes fantasy of manners about a girl grieving and her aroace uncle.
As I said, there are many more out there! You can check out Penny Stirling's list of aromantic or asexual fiction that's free online, Queer Books for Teens recommendations for aromantic and asexual, or even access my database which has a record of all the aro or ace fiction I could find, with tags and filters to make it easier to narrow down on what you really want.
How have your own baking adventures informed the development of BAKER THIEF?
Not in major ways. I was already well into the novel by the time I got really into baking, and I'd done my fair share of research before. It did change the way I described it—the details, basically. It's just not the same until you have both of your hands in the dough and your lower back kinda hurts from all the kneading and you got flour over your clothes again because you keep forgetting an apron.
Do you have any readings or signings coming up? Where can readers find you, online or off?
I don't have a lot of in-person stuff coming up, but I attend Can*Con every year, and I expect to be at Sirens Con this year, too! October is my convention month, haha. I am much easier to find online, however. I tweet at ClH2OArs and my website is at claudiearseneault.com. You can also support me more directly on Patreon.
Claudie Arseneault is an asexual and aromantic spectrum writer hailfing from Quebec City. Her love for sprawling casts invariably turns her novels into multi-storylined wonders centered on aromantic and asexual characters. Her high fantasy series, City of Spires, started in February 2017. Her next book, Baker Thief, features a bigender aromantic baker and is full of delicious bread, French puns, and magic.
Claudie is a founding member of The Kraken Collective and is well-known for her involvement in solarpunk, her database of aro and ace characters in speculative fiction, and her unending love of squids. Find out more on her website!
Story Behind the Story: Under a Rock
Like a lot of writers, I have many random notes for story ideas, most of which go nowhere or sit in a notebook for years before they actually become a story. "Under a Rock" started as one of those: I had the idea of an inexplicable gigantic tooth showing up in someone's backyard, and them charging admission to see it, a la "A Very Old Man With Enormous Wings." I plucked the idea out of my notebook after seeing an anthology call that had something to do with sharks and dinosaurs; I decided the giant tooth I'd imagined could be a cosmic-sized version of either. After looking into the anthology a bit more, I discovered it was actually a revenge market, something put together to get back at/make fun of some other editor or author. These happen from time to time as manifestations of publishing world drama—the recent Cocktales and The Cocky Cockers anthologies which were reacting to the CockyGate "trademark" fiasco are prime examples. But considering I didn't know or have any stake in whatever this shark-related drama was, I decided to just be grateful for the prompt that helped me get this idea on paper, and submit it elsewhere.
I wrote this story just after I quit my "day job," which I'd been working at the same time I took over management of World Weaver Press, and I was feeling pretty stretched thin and out of touch with the rest of the world. This was one of the first stories I'd written in nearly a year. All of that exhaustion and disconnection got poured into this story, the sense that remarkable things were happening all around me and I couldn't even look up to witness them. I guess "Working Like a Dog" and "Brain Child" have similar themes—I'm just not a writer who deals well with the drudgery we so often need to pay our bills.
The character in this story ends up at home from her overbearing job because she's suffering from a cold. It was a convenient way to take her out of her element, but it was also an idea I'd been wanting to explore for a while. Protagonists are usually healthy and ready to run, or else they're suffering from some sort of severe trauma or disease. So much of my life has been spent in sniffles, or in not-great-but-not-fatal health, so I gave my character a cold to see how she'd face this adventure with a tissue in her hand.
Here's an excerpt of "Under a Rock":
A giant dinosaur tooth sat smack in the middle of our un-mowed back lawn. Truly giant: a good eight feet tall, and twelve or more from root to tip.
"Who put this here?" I yelled. The strain on my throat brought on a coughing fit.
"What?" Abby yelled back.
I recovered and went back to the living room so I wouldn't have to yell again. "Who put that thing back there?"
"No one," she said. "It just showed up."
"Giant dinosaur teeth don't just show up in people's yards."
She gave me a look like I'd just said the Earth was flat. "Yeah, they do."
"No, they don't."
"Oh," she said. "Are you one of the shark people?"
"The what?"
"Most people think they're dinos, but there are some people who insist they're the right shape for sharks."
"A bit big for a shark, don't you think?"
She shrugged. "That's why more people think they're dinos."
"Want to tell me what the hell is going on?" That sent me into another coughing fit. Abby looked curiously at me.
"You really don't know? Have you been living under a rock?"
Read the rest of the story at Silver Blade Fantasy Magazine: www.silverblade.net/2018/06/under-a-rock/
Interview with Joanne Merriam, editor of Broad Knowledge
Joanne Merriam is the publisher of Upper Rubber Boot Books, a fantastic independent publisher who has brought you amazing books such as Sunvault: Stories of Solarpunk and Eco-Speculation and Choose Wisely: 35 Women Up to No Good. Now Joanne is running a Kickstarter to get two new anthologies off the ground. Broad Knowledge features a story by my good friend and Clarion classmate Vida Cruz, as well as stories by Wendy Nikel and Aimee Ogden, two authors I've been lucky enough to work with through World Weaver Press. Sharp and Sugar Tooth looks pretty awesome too, featuring some familiar names that always deliver amazing stories: Catherynne M. Valente, Alyssa Wong, Damien Angelica Walters, Caroline M. Yoachim, and many others.
Check out my interview with Joanne Merriam, and then support the Kickstarter here:
https://www.kickstarter.com/projects/1431077765/135809732?ref=489967&token=55a135c1
Sarena Ulibarri: Your description for these anthologies says they focus "on 'bad' women, and 'good' women who just haven't been caught yet." This reminds me of that famous quote about "well-behaved women rarely make history." What made you want to publish stories about this kind of character?
Joanne Merriam: That description is defining 'good' and 'bad' in reference to what we expect women to be, and I'm really fascinated by social expectations and how people structure their lives to adhere to or challenge them. The women in these anthologies appear to be doing everything 'right' while getting their own way, or decide they won't be held back by others' expectations, or, tragically, try to adhere to or challenge expectations and pay a terrible price for it.
I hope that the breadth of stories will collectively show different ways of being, and open up a mental space for thinking about their own options for our readers (whether or not they're women), in addition to entertaining them.
SU: Can you give a couple of teasers about some of the stories we'll find in BROAD KNOWLEDGE and SHARP & SUGAR TOOTH?
JM: Broad Knowledge includes a scientific paper written by a researcher who contracts Innsmouth Fish-man Syndrome, an article for biblical scholars on a seraph's visit to Earth, an in-depth ethical discussion for journalists covering a woman who has been quarantined on a military base so her ideas don't spread to the general population, and a series of newspaper headlines and excerpts covering the invention of time travel—but the story that's probably the most fun, and also possibly the darkest, is "Mary in the Looking Glass," about the legendary horror figure Mary Whales, and her ex-lover.
Sharp & Sugar Tooth features the ritual consumption of funerary meat, poison as a replacement for war, chefs who heal society one meal at a time, alien biomes which entirely consume their hosts, and women turning into chocolate, honey, pastry, fish food, and apple-bearing trees. I'm particularly taken with Jasmyne J. Harris' "What the Bees Know About Discarded Girlish Organs," in which part of romance is being eaten by your partner, and what happens when people split up before the process is completed. It's really haunting.
SU: You are editing BROAD KNOWLEDGE, while SHARP & SUGAR TOOTH is being edited by Octavia Cade. Did the two of you take different approaches to curating these books?
JM: Yes, I think so. Octavia is quite brilliant! She struck me as very deliberate and careful and thoughtful about how she structured the book, both in selecting stories and in ordering them, to fit a kind of overall narrative arc. I took a more topic-oriented approach to ordering, and am perhaps not as smart, but I'm always saved by the amazing writers who send in their stories and make me look really good as an editor.
SU: How do these two anthologies differ from CHOOSE WISELY, the first anthology you did of "Women Up to No Good"?
JM: The main difference is the theme, of course: Choose Wisely is all about choices, while Broad Knowledge is about (you guessed it) knowledge, and Sharp & Sugar Tooth about food and consumption. They are also more diverse: Choose Wisely has more white authors, and more Americans, than either of these anthologies, and that's reflected in the stories in these anthologies being more varied and reflecting more of our world.
SU: You have some excellent writers lined up in these two anthologies. As an editor/anthologist, how do you go about reaching out to writers to ensure a diverse table of contents?
JM: I use social media extensively to reach communities I'm not a part of. For calls for submissions, I post, where appropriate, on the FB groups Call For Submissions; Calls for Submissions (Poetry, Fiction, Art); Open Call: Science Fiction, Fantasy & Pulp Markets; Open Submission Calls for Horror/Paranormal/Mystery/SciFi Writers; Call For Submissions : QUILTBAG; Asian Science Fiction & Fantasy; Feminist Science Fiction; The State of Black Science Fiction; Women of Color Writers' Community; and WOMPO (Women's Poetry Listserv). I also tag writers who I'm interested in seeing work from, and post using hashtags like #diversesff on Twitter and Tumblr, and note the call for submissions in my emailed newsletter, which goes out 2-3 times/year. I'm also on Duotrope, so people who use that to search for markets will find our listings.
When I'm selecting stories, I try to read blind by saving all of the stories under their titles and removing author identities. Of course, it's never entirely blind because I can recognize some writers' voices, but I make the attempt, which means that I have to address diversity in my submissions pool before I get to that largely-blind selection stage. Midway through my submissions period, I'll go quickly through the submissions I've received to get a sense of who is submitting, just looking at names, and faces where gmail has included a photo, so I can see if I need to work harder to get the word out to certain communities. It's necessarily an incomplete and uncertain process, so I try to err on the side of assuming I need to do more work. I try to do this at least a month and preferably longer before submissions close, so people have time to respond to renewed calls for submissions.
SU: What's the process a story goes through between the time it is accepted and the time it is published in an Upper Rubber Boot Books anthology?
JM: External editors have their own editorial processes, but for me there's editing and proofreading with an outside proofreader, and then there's all the stuff that goes into making the books themselves. So I go through any edits with the authors (reading closely, sending suggestions for changes), and possibly rewrites if they're required, and then I figure out what order the stories should go in (usually I try a bunch of different orders until I settle on something that feels right), then create an html file of the stories, which will eventually be part of the ebook (I make the html file first then create the print book file from it so that any errors in the html will get caught). Then I do the formatting for the print files, then send those to the authors to double-check.
Check out some excerpts from these anthologies below, and support the Kickstarter until June 30, 2018 by clicking here.
Interview with Jennifer Lee Rossman, author of Anachronism
Full disclosure: Jennifer Lee Rossman is one of the authors I work with through World Weaver Press. We've been lucky enough to snag short stories from her for Glass and Gardens: Solarpunk Summers and Mrs. Claus: Not the Fairy Tale They Say, and she'll have a science fiction novel that is fun and heartbreaking in all the right ways coming out with us in early 2019.
Then again, she's got stories all over the place these days, so other publishers are clearly catching onto her talent! I invited her onto my blog to tell us a bit more about her awesome time travel novella, out now from Kristell Ink.
Here's the description of Anachronism:
It's the same old story: Time traveler meets girl, time traveler tells girl she's the future president, time traveler and girl go on a road trip to prevent a war...
Petra Vincent is at the end of her rope — or rather, the edge of a bridge. Her world is falling apart around her and she sees no way out of the meaningless existence the future has in store. But when stranded time traveler Moses Morgan tells her that she will one day lead the country out of the rubble of a nuclear civil war as President of the United States, she's intrigued — and when another time traveler starts trying to pre-emptively assassinate her, she realizes Moses might be telling the truth...
Anachronism is a time-traveling, adventure-filled novella with a whole bagful of danger, twists, and snarky banter.
Sarena Ulibarri: In a nutshell, what was the path from manuscript to publication for ANACHRONISM?
Jennifer Lee Rossman: When I wrote ANACHRONISM, I had never been published and, quite frankly, had no clue what I was doing as far as publishing was concerned. I wrote my query letter in about five minutes and proceeded to send it to every publisher that came up in my "sci-fi novella publishers" Google search (typos and all and, in one case, I managed to send two copies of my query letter in one email).
By some miracle, it worked, and Kristell Ink's amazing editor Kate Coe has helped me polish the manuscript and guide me through the confusing world of proof copies and promotion. It's been a long process, but holding an actual book full of my words is the best feeling.
SU: Without too many spoilers, how does time travel work in your novella? Are there limitations and constraints your time traveling characters have to work within?
JLR: Moses doesn't like to give a lot of information about the intricacies of the science involved in time travel, but he does say that paradoxes are possible. There is nothing stopping you from going back in time and killing your ancestor, but it might make your ancestor pretty mad.
SU: What books, authors, or films most influenced you when writing ANACHRONISM?
JLR: The writing style has been compared to Douglas Adams, but that wasn't really a conscious decision. I was really inspired by roadtrip buddy movies. I love the dynamics (and hilarity) that arise when you stick two people in a car and force them to get along, and getting to add sci-fi and save-the-world elements made it really fun to write.
SU: What's your typical writing routine? Do you write at a certain time of day, have word count goals, a particular playlist you listen to, etc.?
JLR: I write whenever I can, usually listening to 70s and 80s music. I try to write at least one page every time I'm on the computer, which sometimes results in short paragraphs and a lot of dialogue.
SU: What advice do you have for young writers who are struggling through the first draft of a science fiction novel?
JLR: Find other writers in your genre, whether that means a critique group at your library or a couple nerdy people on Twitter who will laugh along with you when you realize you accidentally stole half of your plot from Star Wars.
SU: What are you working on now? And where can readers find you, online or off?
JLR: I'm trying to rewrite a series of novellas I wrote when I was nineteen. They are... not well written, but I think they're fixable. And a bunch of people on Twitter have somehow convinced me to write a book about werewolves in wheelchairs. Called Chairwolves.
I also have a novel, Jack Jetstark's Intergalactic Freakshow, coming out next year with World Weaver Press. The editor is a really nice lady named Sarena Ulibarri, and she definitely did not force me to say that.
I blog at jenniferleerossman.blogspot.com and Tweet @JenLRossman, and you can find my stories in these anthologies on my Amazon page: amazon.com/author/jenniferleerossman
Jennifer Lee Rossman is a science fiction geek from Oneonta, New York. When she isn't writing, she cross stitches, watches Doctor Who, and threatens to run over people with her wheelchair. Her work has been featured in several anthologies and her novel, Jack Jetstark's Intergalactic Freakshow, will be published by World Weaver Press in 2019.


This list ranks countries by their annual beer consumption per capita. The Irish and Germans may think they're the heaviest drinkers, but they're not. That honor goes to the Czechs. Beer is the most popular, widely consumed alcoholic beverage in the world, and third most popular beverage overall behind water and tea - meaning there are lots of biggest beer drinking countries. Beer may also be the oldest alcoholic beverage, with references to it found within some of humanities earliest known writings. Countries with high consumption of beer per capita likely have a culture that has been making brew for a long time.
What countries drink the most beer? What's the average beer consumption of the country you're from? Today, regional beers are distributed and enjoyed world wide... And judging from this list, some countries enjoy their beer more than others, landing them a spot on this list of beer drinking countries.


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Cleaner air
Mapping air pollution
Mapping pollution
East Oakland
Air pollution and health in East Oakland
EDF deployed Google Street View cars equipped with Aclima's environmental sensing platform to collect data in a 6 square mile area in the easternmost part of Oakland for a year between 2015 and 2016. The resulting map shows elevated levels of air pollution in many parts of East Oakland.
Air quality data from Google/Aclima; analysis by Apte et al / EDF. Colors on the map do not correlate to colors on the Air Quality Index.
From the map, you can see that I-880 (Nimitz Freeway), a major transportation route serving the Port of Oakland and Oakland International Airport, features significantly higher levels of air pollution. Not surprising, when considering that the I-880 corridor carries the greatest volume of truck traffic [PDF] in the Bay Area region and among any highway in California. The stretch of I-880 shown here sees on average 200,000 vehicle trips per day [PDF].
Other areas of East Oakland with elevated levels of pollution include the busy road corridors shown below, where a number of commercial and industrial facilities are close to residential areas and public spaces. Our map echoes the findings in a 2010 community-based participatory research study [PDF]by Communities for a Better Environment, which found high levels of air pollution along the same roadway, with measurements higher than state and federal standards. The study area is densely populated and includes many places where vulnerable populations gather [PDF], such as schools, senior centers and hospitals, as shown in a 2008 baseline by CBE.
East Oakland's freight corridor, busy roadways and industrial sector have contributed to elevated levels of air pollution, and residents experience some of the highest asthma hospitalization rates compared to the rest of the region, according to a 2016 report by Alameda County Public Health Department.
In an effort to better understand how changes in pollution levels within even small areas could impact health, EDF partnered with Kaiser Permanente and combined our mapping data with electronic health records. We found in a 2018 study that differences in air pollution within neighborhoods or even city blocks can increase risks of heart attack and deaths from heart disease in the elderly.
As in West Oakland, a large percentage of the communities in East Oakland are both low-income and of color. These individuals and families bear a disproportionate burden of environmental impact, resulting in worse health outcomes. East Oakland has higher death rates due to heart disease, stroke and lung cancer than both Oakland and Alameda County. And life expectancy in East Oakland is seven years shorter than the more affluent residents in the Northern area of the city. (Alameda County Public Health 2016 report) While these health outcomes are related to multiple factors, studies have shown that exposure to high levels of air pollution -- from motor vehicles, refineries and other sources -- increases death rates associated with coronary and lung diseases. Our findings, coupled with existing research, highlight the need for stricter regulations to protect the health of communities most impacted by poor air quality.
You can help: Make your voice heard!
Everyone deserves to breathe clean air, and you can make a difference by advocating for common-sense solutions to reduce levels of harmful air pollution.
If you live in Oakland, connect with local groups like Communities for a Better Environment, which can help you take action on issues that affect your health and environment.
Find a clean air advocacy group working near you. For example, Moms Clean Air Force, a national group of more than a million parents, organizes communities to protect clean air and our kids' health in 20 states.
Explore this project
Methodology and data
About the partnerships
Modeling with collected data
Catherine Ittner +44 (0)75 1037 6417 (office)


Meaning and origin of the English baby name Liberty. Meaning of Liberty. What does Liberty mean? Liberty origin. Information about Liberty.
Meaning of Liberty, Information about First Name Liberty, English Origin Names, Choose babynames from thousunds of names data base from various regions and coutries.


As a child, I experienced Heritage Park as a place of make-believe. Last fall, I saw the park as a storied landscape of a different kind. I had just put the finishing touches on my book Calgary through the Eyes of Writers and was looking for literary connections between the works of poetry and prose I'd collected in the book, and the Park's exhibits.
Here are a few of the many literary links I discovered, and recently shared at the Park's Speaking of the Past lecture series.


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Yоu hаvе read іt іn thе рареrѕ, ѕееn іt with televisions, еnсоuntеrеd іt on the web, аnd you exactly knоw what ѕоlаr еnеrgу will be. But іf you аrе still dоubtful аbоut thе еffісіеnсу оf thе photo voltaic роwеr уоu ѕhоuld undoubtedly nееd tо rеаd the following rеаѕоnѕ whу уоu ѕhоuld іnѕtаll ѕоlаr раnеlѕ for hоmе use.
With the cost оf еlесtrісіtу bіllѕ соnѕtаntlу іnсrеаѕіng, mаnу persons аrе lооkіng for сhеареr аltеrnаtіvеѕ. Sоlаr роwеr іѕ the main mоѕt useful fоrm of rеnеwаblе electric power уоu can gеt thеѕе dауѕ. In reality, ѕunlіght іѕ аmоng thе fеw frее things we tend to get іn lіfе. You can easily uѕе іt so that you can роwеr уоur household аt lіtеrаllу not any expense. After panels are іnѕtаllеd, you actually саn ѕtаrt ѕаvіng оn уоur еlесtrісіtу bill right away. Bаѕісаllу, аll уоu currently have tо dо is ѕеt them on аnd you can еnjоу frее еlесtrісіtу for аt the very least 25 to 30 уеаrѕ!
Thе vаluе оf уоur Family home is going to greatly іnсrеаѕе іf уоu have ѕоlаr energy іnѕtаllеd. In respect tо a study, a hоmе'ѕ vаluе іѕ raised by $20 fоr еvеrу $1 rеduсtіоn іn аnnuаl еnеrgу cost savings. Sо for еxаmрlе, іf you actually wіll save $1,000 with your own yearly еnеrgу, your family home value wіll аlѕо іnсrеаѕе by $20,000. A residence with ѕоlаr panels is going to аlѕо sell twісе аѕ quickly as nоn-ѕоlаr hоmеѕ аt a hіghеr price.
If the panels make grеаt аmоunt оf еnеrgу mоrе thаn уоu will be able to еvеr соnѕumе, you can ѕеll thе еxсеѕѕ electric power to сеrtаіn corporations. Yоu саn feed the actual excess еlесtrісіtу bасk through thе роwеr grіd іn a роlісу саllеd "nеt metering." Consequently іnѕtеаd оf ѕtоrіng them straight into a bаttеrу ѕtоrаgе ѕуѕtеm, the utіlіtу company will certainly сrеdіt you fоr vоltѕ of unuѕеd роwеr аt whісh уоu are usually paid out еіthеr mоnthlу or annually. Mоѕt ѕtаtеѕ іn thе US have got nеt metering bіllѕ thаt rеquіrе utіlіtу companies tо purchase bасk еxсеѕѕ еnеrgу for thе very same rаtе уоu buу роwеr through thеm. Get in touch with уоur utіlіtу соmраnу bеfоrе proceeding аnу furthеr.
Glоbаl warming іѕ nоw swiftly bесоmіng a awful реrіl to humаn bеіngѕ. Inѕtаllіng ѕоlаr раnеlѕ fоr your personal household іѕ a superb wау to раrtісіраtе іn keeping оur Mоthеr Nature. Sіnсе these kind of panels carry on tо рrоduсе electric power frоm a nаturаl ѕоurсе, there іѕ simply no сhаnсе оf emitting аnу damaging toxins or possibly mоnо саrbоn through thіѕ concept. Whеn thе еnvіrоnmеnt is clean, уоur health and wellness wіll bе totally safeguarded.
In order to рrоmоtе thе uѕе involving solar panels fоr propertys, thе gоvеrnmеnt оffеrѕ income tax rewards of 30 percent аѕ a lосаl іnсеntіvе fоr раnеl installation. Fоr instance, уоu ѕреnt $10,000 on a new раnеl аrrау аnd tооk аdvаntаgе оf thе tаx сrеdіt you actually саn greatly reduce уоur fеdеrаl tаxеѕ оwеd bу $3,000. Yоu саn аlѕо сhооѕе tо have thе tаx сrеdіt off thе total cost for уоur раnеl іnѕtаllаtіоn. Evеn іf уоu'rе lіvіng in a mаjоr mеtrороlіѕ mаjоr роwеr fаіlurе may ѕtіll transpire. Aѕ long аѕ thе sun іѕ uр and also ѕhіnіng, the actual solar раnеlѕ wіll continue on to рrоduсе electrical power. Wіth thаt іn mіnd, installing solar panels for hоmе usage is certainly lіkе уоur protection toward futurе rіѕіng еnеrgу prices аnd оthеr unсеrtаіntіеѕ.


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Die Biliong ist eine Axt, die auf Malaysia benutzt wird. Sie dient als Werkzeug und Waffe.

Geschichte
Die Biliong wurde auf Malaysia als Kriegswaffe und als Schnitzwerkzeug entwickelt. Sie wird bis heute benutzt.

Beschreibung
Die Biliong wird aus einem Stück Hartholz gefertigt. Der Stiel der Axt hat am oberen Ende einen verbreiterten Kopf, in dem ein Zapfenloch eingearbeitet ist. Das Zapfenloch dient dazu, die Klinge fest aufzunehmen und sie trotzdem beweglich zu halten. Die Klinge wird an dem Kopf des Stieles zusätzlich durch eine leicht zu öffnende Wicklung aus Pflanzenfasern gehalten. Durch Lockern dieser Wicklung ist es möglich, die Klinge im Zapfenloch zu drehen. Steht die Klinge quer zum Stiel, kann man sie als Schnitzwerkzeug verwenden. Steht die Klinge im geraden Winkel zur Klinge, kann man sie als Streitaxt benutzen. Die Klinge selbst ist flach ausgeschmiedet und besitzt eine lange Angel. Die Klingen- und Stielform variiert von Ort zu Ort. Am hinteren Teil des Axtkopfes werden oft farbige Haarbüschel zur Dekoration angebracht.

Literatur
 George Cameron Stone, Donald J. LaRocca, A Glossary of the Construction, Decoration and Use of Arms and Armor: in All Countries and in All Times, Verlag Courier Dover Publications, 1999, ISBN 978-0-486-40726-5
 John Frederick Adolphus McNair, Perak and the Malays: "sārong" and "krīs.", Verlag Tinsley brothers, 1878
 Diagram Group, The New Weapons of the World Encyclopedia: An International Encyclopedia from 5000 B.C. to the 21st Century, Verlag St. Martin's Press, 2007, ISBN 978-0-312-36832-6
 Hugh Low, Sarawak its inhabitants and productions: being notes during a residence in that country with His Excellency Mr. Brooke, Verlag Adamant Media Corporation, ISBN	 978-1-4021-9043-8
 Robert L. Winzeler, The architecture of life and death in Borneo, Verlag University of Hawaii Press, 2004, ISBN 978-0-8248-2632-1

Weblinks
 Biliong bei Internet Archives. PDF-Datei hier einsehbar
 Biliong bei Go Antiques

Axt
Asiatische Waffe (historisch)

redpajama_set_name: RedPajamaWikipedia


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This week I had the opportunity the trek up north to Silicon Valley to attend Yahoo's Hadoop Summit 2010. I love Silicon Valley. The few times I've been there the weather was perfect (often warmer than LA), little to no traffic, no road rage and people overall seem friendly and happy. Not to mention there are so many trees it looks like a forest!
The venue was the Hyatt Regency Great America which seemed like a very posh business hotel. Walking into the lobby and seeing a huge crowd of enthusiasts and an usher every two steps was overwhelming!
A user's click streams are mapped to latent interests, similar to mapping words to interests in topic models like LSA and LDA. Yahoo uses Hadoop to recompute a user's profile every five minutes.
Yahoo Mail receives 40% less spam than Hotmail and 55% less spam than Gmail (this surprised me). Hadoop is used to train the spam detection model.
Yahoo also discussed Hadoop Security, feature to integrate Hadoop with Kerberos to provide secure access and processing of data that is sensitive to business. Hadoop Security is currently in beta in the Yahoo distribution of Hadoop. Perhaps the biggest impact of Hadoop Security is that businesses can now colocate business sensitive data without worrying about unauthorized prying eyes. Yahoo's distribution of Hadoop with Security can be downloaded from Github.
Yahoo also introduced Oozie, an open-source workflow system for managing Hadoop jobs including HDFS, Pig and MapReduce. Oozie seems similar to Chris Wensel's (@cwensel) Cascading system. Oozie is open-source and can be downloaded from Github.
Yahoo's transparency and contributions to the Hadoop and open-source community are very empowering. This quote sums it up well: "Hadoop is the technology behind every click on Yahoo!" In addition to Hadoop, Yahoo has open-sourced a project from the Inktomi days called Traffic Server and the Subversion repository is here. Yahoo also suggested that they will be moving on to a new venture: public cloud computing and storage, which would be a competitor to Amazon Web Services as well as Google Storage and a Google cloud computing solution that may or may not have already been announced (there were plans or rumors of a Google cloud computing service, but I cannot find any references to it).
Surprisingly, most of the focus on cloud computing, particularly Amazon Web Services, was on Elastic MapReduce rather than EC2. Amazon pre-announced several new features.
Bootstrapping actions allow the user to specify certain operations to occur before the map/reduce process begins. If you want to install some Python package that does not exist on Elastic MapReduce, use a bootstrap action. The speaker used installing a newer version of R as a use case! Bootstrap actions are not new, but new enough to be mentioned..
Users will be able to shrink or expand the size of the cluster or the HDFS in Elastic MapReduce, making it truly, well, elastic.
Newer versions of Hadoop (0.20), Pig and Hive will, or have been, installed.
Users will now be able to bid for extra capacity at a lower cost using spot instances, which have been available for EC2 for some time.
Cloudera had announcements of its own. Cloudera Desktop, a unified user interface for users and operators of Hadoop clusters as described by the developers, has been open-sourced and renamed HUE. You can download HUE from Cloudera's GitHub repository. Cloudera will also offer monitoring, configuration support for its enterprise users via Cloudera Enterprise.
Over lunch I met up with Jakob Homan (@blueboxtraveler) from Yahoo and then with Charlie Glommen (@radarcg) from TouchCommerce. It is always great to meet fellow tweeters in person. I must say the lunch was awesome – the best risotto I have ever tasted! Anyway, we then broke off into three tracks: developer, applications, and research. I spent most of my time in the research track. The first three sessions were about working with large graphs, and I wished I had seen them BEFORE struggling so much with a large graph in my Master's thesis.
First up was Jimmy Lin (@lintool) from University of Maryland. He introduced some large graph design patterns (slides) that can decrease running time by 70%. His method involves using message passing where computations are performed at each vertex and partial results are passed along the edges as messages. The first design patter was im-mapper combining to make local aggregation more efficient. The second design pattern, smarter partitioning creates more opportunities to create local aggregation by using range partitioning instead of hash partitioning. The final design pattern was called "Schimmy" which was named after the developers and is essentially a merge join between messages and graph structure. More information can be found in Schatz and Lin's paper. Lin also commented on that fact that current Algorithms courses focus on serial algorithms and that there are many things that one must take into account when developing parallel algorithms. Lin has written a book to introduce students and other users to the MapReduce way of thinking. It is available online for free.
Partition the graph (the first map operation).
Summarize the connectivity in each partition (first reduce operation).
Combine all of the small summaries (the second map operation).
I also attended a talk on set similarity joins by Chen Li (UC Irvine) where he suggested that minhash does not find all similar items because it is probabilistic (I somewhat disagree, but that's just the facts). The materials for his research, including source code, is on here. I also attended "Exact Inference in Bayesian Networks using MapReduce" (slides) by Alex Kozlov of Cloudera. At this point, my brain was becoming more inefficient at absorbing knowledge! During this session I finally got to meet Flip Kromer (@mrflip) from Infochimps, Anand Kishore from Yahoo (@semanticvoid) and Pete Skomoroch (@peteskomoroch) from LinkedIn, which lead to me also meeting Florian Leibert (@floleibert) from Twitter.
I then decided to switch tracks and I attended a presentation (slides) of Cascalog by developer Nathan Marz (@nathanmarz). Cascalog is a very expressive querying language for Hadoop. It is based on Clojure, a Lisp dialect written on top of the Java Virtual Machine, and its syntax is very similar to Datalog (or Prolog). In some ways, its simplicity to import a file and run a job on it seems to parallel R. I can't wait to dive into this some more! I also attended Jerome Boulon's (Netflix) talk on Honu, which is a large scale streaming data collection and processing pipeline (slides).
. Alas, here I am on my way back to Southern California.
The slides for Hadoop Summit 2010 tracks are now available. Videos should be available in a week.
To leave a comment for the author, please follow the link and comment on their blog: Byte Mining.


Providence Christian Academy accepts international students with a F1 visa.
Room and Board is available upon request (English speaking host families). More information is available in regards to home stay fees. If interested, please contact the office.


Native to Brazil and Bolivia, the fruit of the Bati plant produces a beautiful oil that is rich in both Oleic and Linoleic fatty acids.
It makes a wonderful natural emollient and is said to have healing and anti-inflammatory properties. An exotic ingredient for creams, lotions and other personal care products.


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Dennis Rodman: 'Obama can't do s–t'
Alex Dickinson
Social Links for Alex Dickinson
North Korean leader Kim Jong Un and former NBA star Dennis Rodman watch North Korean and U.S. players in an exhibition basketball game at an arena in Pyongyang, North Korea. AP
Bad boy former NBA star Dennis Rodman has launched a profanity-laden rant against Barack Obama over the president's failure to get on with North Korean dictator Kim Jong Un.
"We got a black president (who) can't even go talk to (Jong Un) … Obama can't do s—, I don't know why he won't go talk to him," Rodman told TMZ.
"Obama? F— him!"
Rodman told the gossip website he would return to North Korea on August 1 in an attempt to sway Jong Un in releasing US citizen Kenneth Bae.
Bae is a tour operator who was arrested in the troubled dictatorship in November. North Korea's Supreme Court sentenced him last week for unspecified "hostile acts" against the state. In a Foreign Ministry statement on Sunday, North Korea said the 44-year-old Washington state man entered the country with a disguised identity.
"I'm going to try and get the guy out," Rodman said of Bae. "It's going to be difficult."
Earlier this week, Rodman took to Twitter to say he would ask Jong Un to "do me a solid and cut Kenneth Bae loose".
The former San Antonio Spurs and Chicago Bulls star sparked controversy in February when he visited North Korea, and sat next to Kim as they watched an exhibition basketball game.
His trip came at a time of high tension between Pyongyang and Washington and was not endorsed by the U.S. State Department.
With Associated Press
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Colton Haynes Thanks Fans For 'Unbelievable Love' After Coming Out Gay
Actor Colton Haynes on Friday thanked his fans for their "unbelievable love and support" after he came out gay.
On Thursday, Haynes, who is best known for his roles as Jackson Whittemore in MTV's Teen Wolf and Roy Harper/Arsenal in The CW's Arrow, gave his first interview in which he discussed his sexual orientation.
(Related: Colton Haynes officially comes out gay.)
Haynes told Entertainment Weekly that "acting 24 hours a day is the most exhausting thing in the world."
In an Instagram post, Haynes thanked his fans for their support.
"I can't thank y'all enough for the unbelievable amount of support & love you've been sending my way," Haynes wrote. "Special thanks to Entertainment Weekly, @yutsai88 and Marc Snetiker for such a beautiful article."
He concluded his post with a quote from Ben Lorry's Stories for the Nighttime and Some for the Day: "There once was a man who was afraid of his shadow … he met it … now he glows in the dark."