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Home Open Access News Workplace News COVID-19 and the workplace of the future
COVID-19 and the workplace of the future
© Monkey Business Images
Here, PLACEmaking looks ahead to how the changes made to our ways of working during the COVID-19 crisis could decide the workplace of the future
The past 12 months have shown that the working world can adapt to crisis, and that solutions such as remote working can be adopted with little warning. But those reactive changes made in the face of the COVID-19 crisis could define the way we work in the future. Organisations big and small will be faced with questions over what lessons they choose to take forward after the crisis and the changes they choose to make in the coming months.
COVID-19 has proven that organisations cannot hope to simply apply 'sticking plaster' solutions onto old, out of date offices and expect them to meet new expectations for the workplace. Changes need to be more than mere cosmetic alterations to the status quo. Some of the benefits that emerged from the crisis will have long-term positive implications not just influencing the physical design of the workplace but could also alter how they operate. In the coming post-COVID period, some of the downsides to office-based working that were considered entrenched and inescapable may finally be confined to history. Long, costly commutes and the culture of unnecessary meetings and presenteeism may prove to be casualties of the new, forward-thinking way that organisations want to work. The agile working solutions brought about in the face of pandemic emergency could (and in many cases should) be replaced by new policies and practices much more suitable to the way we want to work in the future. In the wrong hands interpreting increased flexibility to dictating fixed days that employees must attend to the workplace is really missing the point. Enforced home working has demonstrated that people can work productively without managed presenteeism and constant supervision so a greater emphasis on staff choosing to balance time in and out of the office is called for (be it HQ or decentralised hub).
Different skillsets may become the new focus
Severing our ties to the traditional office and independence from the command and control of office management may result in us taking more responsibility for our own career development rather than being reliant on the opportunities (or lack thereof) that our current employer offers us. High-quality online skills development platforms and workshops which can be accessed by anyone, mean that we can take responsibility and agency over our own personal 'toolset' without being restricted by the prescriptive 'training' offered by the organisations that we currently work.
Alongside this, we could see a shift in the skillset potential employers will look for when it comes to hiring. There will, of course, always be certain industries and roles where focussed specialisation will take priority but we could also begin to see core skills such as adaptability, ability to switching to more agile working solutions and ability to pick up new skills becoming in increasing demand. As we've examined in a previous article the traditional workplace was already proving inadequate and out of sync with the needs of those entering the workforce, the COVID-19 crisis has in many ways highlighted these issues and made it clear that a different, more flexible way of working is not only possible, but also in many cases essential to organisational sustainability and operational survival.
Organisations will still need to fulfil their responsibilities to the people that work for themHow COVID-19 could change the way we look at offices and workspaces
For their part, organisations will need to remain focussed on their responsibilities to the talent they wish to attract and retain. People may start taking on personal responsibility for their career development but that does not mean that organisations do not have a responsibility to offer mentorship and well-being support, particularly for those new to the world of work or for those who are taking on new and unfamiliar job roles and responsibilities. As we traverse the post-pandemic working world, organisations choosing to rationalise their former office estate, need to take care to understand the sometimes abstract benefits of the informal and more social interactions in and around the 'office' and ensure these issues are not dismissed. The culture that defines an organisation is built by the people that work for it, and this cannot be expected to develop over Zoom or Teams. The financial argument for reducing the office estate and adopting remote working is a strong one (brought to the forefront by empty offices during lockdowns) but it cannot be the sole motivating factor in an organisation's decision for adopting different work styles and changing work patterns going forward.
Rather than simply being the same old offices but possibly smaller, the new office will need to be rethought of as a place that facilitates formal and informal mentoring and hosting opportunities for collaboration with wide networks of skills and experiences. For their part organisations will also need to make sure that their managers and supervisors balance their team's career development opportunities with equal career opportunities and benefits and rewards regardless of whether they are working remotely or in-office. We may no longer need the old office but we do need places that will host and facilitate important in-person interaction and, in direct response to the COVID-19 crisis organisations should begin to redesign the new office and consider it as a form of investment not only in real estate terms but as a place that hosts events for the people that form the core of any successful organisation and the culture that they create, nurture and sustain.
So how do we design the 'new office'?
The workplace we return to should not be a simply dusted down version of the pre-COVID 19 office we left last year. However frequently visited, the new office now has to change and the office of old is no longer fit for purpose. Organisations need to rethink the scale and distribution of their operational base, balancing the need for a city centre presence with locality-based drop-in work hubs that support now established home working patterns. However large or small their office estate is, its primary purpose is to invest in their collective culture, the well-being of their talent and positive connection with their customer base. Whether accessed physically or virtually or a combination of the two, the focus of the 'new office' must be on welcome and comfort, operated by customer-focused services and supported and enabled by intuitive, user-friendly technologies.
In place of bland, military-style harsh furniture layouts, people will want greater choice and the ability to create a space that works for them and they want a change of style, replacing glass, steel and concrete and in with smaller-scale offices and workplaces that are designed with character in place of corporate anonymity.
This moment in time is an opportunity to repurpose the new office, building on the unique experience of the last 12 months and embracing the opportunity to encourage a greater sense of collaboration with the people we work with. We need to create a new infrastructure of places, spaces, services and technologies that are focused from the point of view of the individuals and their needs.
PLACEmaking are workplace designers and change advisors.
Please note: This is a commercial profile
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Must Read >> How COVID-19 could change the way we look at offices and workspaces
Must Read >> Changing workplace landscape: How the COVID-19 pandemic has altered our way of working
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Boutique Fairs Singapore Is Back! Here's What To Expect
Ready your wallets
Therese Marie Lim , on 19 Apr, 2022
Payday may not be for another week, but we're sure you won't be able to resist indulging in a little bit of retail therapy at the Boutique Fairs Singapore 2022 or also known simply as "Boutiques". The highly anticipated event will be returning after a two-year hiatus and is set to take place at F1 Pit Building from 22 to 24 April — that's Friday to Sunday, so you basically have the whole weekend to visit!
The Boutique Fairs will showcase various local brands you'll surely love.
Now that in-person events are permitted, Boutiques is ready to showcase over 160 independent local brands, including beauty and lifestyle brands, women's and men's fashion and accessories labels, furniture and home decor lines, and more. Food and drinks will also be available at the event.
Singaporean brands at Boutique Fairs Singapore 2022
Like its previous iterations, Boutiques will bring together beloved and up-and-coming local brands under one roof. Each participating brand is carefully and expertly vetted by the event's founder Charlotte Cain, who has been organising Boutiques since 2002, so you can expect a great retail experience.
Brands that made the cut include well-known local fashion labels such as AKINN, LINGWU and Marilyn Tan Jewellery will be present at the upcoming Boutique Fairs Singapore. You can also look forward to exclusive collections and new launches from participating brands. kāi, influencer Christabel Chua's lifestyle brand, will be releasing its new drinkware range at the fair.
Christabel Chua a.k.a. bellywellyjelly teases kāi's drinkware collection. (Photo from: @bellywellyjelly)
You'll also be glad to know that up to 80% of the brands that will be featured this year are created with social responsibility in mind. Who's up for discovering new sustainable brands?
On top of that, visitors can also get to join curated experiences like live shoemaking demonstrations by artisanal footwear brand Palola, live typewritten poetry sessions by The Novel Encounter's founder Adam Tie and more.
How to join Boutique Fairs Singapore 2022
Boutiques will be selling limited tickets to control attendance and avoid overcrowding. There will be four-hour sessions across three days for a more breezy and intimate shopping experience. The tickets are available to fully vaccinated individuals for SGD5 each via the Boutique Fairs Singapore website. You can also buy tickets upon entry. However, there is no guarantee that there will be any left once you arrive so it's better to purchase ahead of time.
Want to go out after shopping? Check out these recommended rooftop bars and restaurants in Singapore.
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Hand In Hand Senior Specialty Services of the Berkshires, Inc is located at 88 Backman Avenue ,Pittsfield , MA / Massachusetts 01201. The assisted living facility service is rated for 3 seniors.
Hand In Hand Senior Specialty Services of the Berkshires, Inc is assisted living service for seniors. If you need help with your daily activities (ADLs), assisted living facilities are special facilities are what offer the medium service between independent living communities and nursing homes.
Hand In Hand Senior Specialty Services of the Berkshires, Inc offers assisted living and senior care in Berkshire .
Hand In Hand Senior Specialty Services of the Berkshires, Inc facility service is for 3 seniors.
Seniors and older adults in an assisted living facility like Hand In Hand Senior Specialty Services of the Berkshires, Inc usually need help with some basic daily needs. Assisted living facilities offer services like Independent Living, Personalized Assisted Living, and Memory Care for Alzheimer's and Rehabilitation, Dementia, and Skilled Nursing. You will also receive assisted care with medication, mobility, meal preparation, eating, bathing, dressing and housekeeping. You can also find offers like Continuing Care Retirement Communities where residents can live without moving if they need nursing care. Most of the facilities are providing rehabilitation, fitness, educational programming for seniors, and health services to seniors.
In general assisted living facilities like Hand In Hand Senior Specialty Services of the Berkshires, Inc require private pay in most cases. The assisted living is usually not covered by Medicare and Medicaid, exceptions can be met. What is the average price for assisted living and who pays for assisted living facilities are the general questions.
One-bedroom unit in an assisted living facility like Hand In Hand Senior Specialty Services of the Berkshires, Inc is $3,500, according to Cost of Care Survey by Genworth Financial Inc. That's $42,000 per year for the basic program.
Hand In Hand Senior Specialty Services of the Berkshires, Inc supports residents in Berkshire and the close by areas. Hand In Hand Senior Specialty Services of the Berkshires, Inc facility service is for 3 seniors. If you need more specific services like skilled nursing you should look for larger facilities like ……(larger) with a wider range of services.
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Scholarship students of Fundación A. Jean Brugger, finish intensive English course.
On December 12 a group of 16 young people, including 8 current scholarship students, 5 former graduates of Fundación A. Jean, and 3 other young people from San Juan del Sur, completed the four-month-long intensive English course at Escuela Adelante.
This project was part of the new Life Skills Program, an opportunity to strengthen and complement professional knowledge for the scholarship students and former professional scholars of Fundación A. Jean Brugger. This special project will develop greater professional skills and labor competency.
Our students are very excited and grateful for the opportunity they had to learn English, because they know the value of speaking English in San Juan del Sur, a tourist city. This will be of great help to their professional development.
Fundacion A. Jean Brugger congratulates all the young people who took advantage of and successfully completed this educational opportunity.
Finally, special thanks to Kathleen Brugger for promoting this educational initiative, and to all the donors who helped make the "Life Skills Program" possible.
We also thank the director of Escuela Adelante Jaime Hunter and Professor Hannah Zucker for their collaboration and interest in our students.


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goes plug-in
By Bruce Booth on 2019-09-30 - Bruce left the Daily Record three years ago after 23 years as a sub editor motoring writer to wind down a long career as a freelance motoring journalist. Still supplies new and used car columns as well as covering motorsport for the Record and for Eurekar
SOON, life will never be the same again for the legions of White Van Men and Women hard at work up and down the country, for the world's first one-tonne plug-in load-lugger is now ready to hit the streets, with deliveries in the UK starting before the end of the year.
Fittingly it is Ford which has won this highly-important race to deliver the first hybrid electric technology to the sector, just like its winning ways back in 1965 when it introduced the original Transit Van.
For 2019 however, the new Transit Custom Plug-in Hybrid offers the very best of both worlds by combining a pure electric driving capability of up to 35 miles, while being coupled with Ford's multi-award-winning three-pot, 1.0-litre EcoBoost petrol engine.
The Transit's front wheels are driven by the vehicle's 92.9kW electric motor powered by the van's 13.6kWh lithium-ion battery housed under the floor pan.
This gives the Transit a total range of around 310 miles, an overall fuel consumption figure of 91.7mpg and CO2 emissions of just 60g/km. To increase the range, just add petrol. Simple.
The net result is that van drivers will be able to carry out their work knowing that although they are behind the wheel of an electric vehicle, they will never run out of juice, yet will be able to enter the ever-expanding number of ultra-low-emission zones to pick-up and deliver knowing they comply with the law, thus avoiding any fixed penalties or nasty hidden charges.
Charging the new Custom Transit Hybrid is simplicity itself, the plug-in port located within the front bumper. To fully charge the battery takes just a little over two-and-a-half hours when plugged into a commercial type-2 AC vehicle charger.
Plug it into a typical domestic 240-volt 10-amp socket and even that takes less than four-and-a-half hours to fully charge the van.
Four distinct modes can be selected in order for the driver to choose when to used the battery power available. EV Auto provides the optimum efficiency according to whatever driving conditions pertain, while EV Now prioritises available battery power for emissions-free driving until the battery level reaches a minimum state of charge and the engine kicks back in.
EV Charge gives priority to the range-extending petrol engine which in turn will also charge the battery for use at a later time. EV Later also utilises petrol power while maintaining the battery level for later use.
However, savvy drivers will quickly cotton on to the fact that the battery is also topped up when decelerating and when under braking. This effect can be aided further by drivers who select Low as opposed to normal Drive via the gear selector.
Lifting off the accelerator pedal when in L mode increases deceleration thus increasing kinetic energy which is then recovered and stored wthin the battery for increased electric driving range.
Inside the new Hybrid Transit, driver comfort is the name of the game. Long gone are the harsh body-coloured painted metal dash and interior trim and vinyl seats.
This new Ford provides all the benefits for the driver that he or she would come to expect in any premium quality car.
Standard throughout each of the three trim levels comes Ford's SYNC 3 eight-inch touchscreen multimedia system, heated seats, leather-trimmed steering wheel, power mirrors ... heated of course, parking sensors front and rear, eight-way adjustable driver's seat and air conditioning.
Driver's will also love the abundance of chubby holes and bottle holders situated throughout the vehicle.
Other on-board features include 16-inch alloy wheels, cruise control with speed limiter, LED loading lights, a Thatcham alarm, heated windscreen and body-coloured bumpers,side mouldings and door handles. Options include sat nav, park assist, rear-view camera and lane assist.
With the battery hidden under the cargo floor, load volume remains at six cubic metres, while payload is also a healthy 1130kg, especially with such a small engine under the bonnet.
Prices for the Transit Custom Plug-in Hybrid range from £39,145 ex-VAT for Leader trim to £42,950 ex-VAT for top Limited spec. All come with Ford's standard eight year/100,000-mile warranty.
Van owners and drivers alike will be highly impressed by this new workhorse, those working in the executive shuttle business have not been left out, for also available to order now is the new Tourneo Plug-in eight-seater.
Sharing the same hybrid system as its Transit sibling, this luxury people-mover offers a pure electric range of up to 33 miles and fuel economy of up to 79.1mpg.
With its superb levels of comfort and refinement carried over from the current 2.0-litre diesel model, this new hybrid will soon prove a winner with operators and passengers alike.
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Botox is a leading cosmetic procedure designed to alleviate the appearance of dynamic wrinkles and the common signs of aging – helping to refresh your facial features and deliver a smoother and more youthful appearance in one or more areas of your face.
Kovak Cosmetic Center has been recognized by Allergan, the manufacturer's of Botox Cosmetic, as a Center of Excellence as well as Platinum Plus with Allergan's Partner Privileges program. Dr. Kovak has been training other physician's in the art of Botox Cosmetic for nearly twenty years.
Botox treatment is one of the most popular cosmetic treatments in the world; famed for its ability to reduce the signs of aging quickly and effectively in the majority of patients. In fact, in 2016, around 7 million Americans had type A botulinum toxin treatment, making it the top minimally-invasive cosmetic procedure in the USA, by a very large margin.
There are some very good reasons why Botox is such a popular treatment, undertaken by men and women from around the world. It's highly effective ability to soften wrinkles, improve frown lines, and revitalize facial skin, is one of the best ways to combat a lifetime's worth of facial contractions.
The right Botox treatment will alleviate the signs of years' worth of damage from lifestyles choices, the effects of the environment, and muscle contractions. Your face will feel much smoother as the presence of wrinkles and lines are reduced, and a natural healthy appearance will return to your skin.
What Do I Need to Know About Botox?
Many people are understandably skeptical about Botox at first, unsure of how much it can help to relieve the years of stress from their skin, or whether it's safe to use. As with all cosmetic procedures, it can help to understand more about the treatment, how it can benefit your skin, and whether it's suitable for you to use.
Botox can be used to treat some of the conditions that arise when a person suffers from a nerve disorder, like a condition in the eye muscle.
Botox is a vital treatment to help prevent the onset of chronic migraines.
Botox can help in cases where a person is suffering from hyperhidrosis or cervical dystonia.
The uses for Botox are continuously developing, with innovative studies into the highly versatile product being undertaken on a regular basis to examine the true potential of one of the most well-known forms of cosmetic treatment in the world. As more and more benefits of Botox are discovered, the cosmetic uses and revolutionary treatments continue to develop, enhancing the field of cosmetic practices even further.
Botox, whilst not a cure-all treatment, can help with a vast number of the common signs of aging. The cosmetic treatments involving the use of Botox are very diverse, helping to alleviate the signs of many common contour deficiencies and facial creases that have arisen due to lifestyle choices, such as smoking or increased sun exposure, and the varied signs of aging, that are different in every person.
Is Botox the Right Choice for Me?
Undertaking Botox Treatments in Chicago is a very personal decision, with many people choosing to have Botox treatment to improve the appearance of their skin and feel more confident in themselves. What holds some people back from having Botox treatment is the worry that the results won't look natural, or natural movement in their face will be seriously limited. If the Botox treatment is performed correctly, then there will be no severe facial restriction and the results will look and feel very natural.
While Botox does restrict some movement in the face, it's a restriction in the movement that is generally done unconsciously, like slight frowning, which can, overtime, contribute to the rapid appearance of skin aging and lines on the face. The end result of professional Botox treatment is much more natural than many people expect, and it is often very difficult to tell that a person has undergone any kind of Botox treatment. Your face will look very relaxed, healthy, and youthful.
Most Botox treatments in Chicago will start with identifying where the muscles that needed to be treated are; this is commonly achieved by the patient making different expressions. Once the physician has identified the areas, they will apply a cleanser to the area, and possibly an anesthetic if required.
The next step of the procedure is to inject the Botox into the marked areas on the face. The number of Botox injections depends on the patient, and the extent of treatment that they desire. Commonly, the area around the forehead and eyes are injected with Botox, and then any further areas at the patients request or physician's suggestion.
After the Botox has been injected, pressure will likely need to be applied to the area, to help prevent the skin from bleeding and stop bruises from forming. Then, the patient will need to sit for a few minutes and relax. The whole process is much quicker than many would expect, normally not taking much longer than 10 minutes.
What Symptoms Will I Experience After Botox Treatment?
Avoid exercise or any serious exertion.
Stay standing or sitting for up to four hours after the treatment.
Avoid certain medication like ibuprofen and aspirin.
Not over-tax the muscles in the immediate days after treatment.
A slight weakness in some areas of the face.
Directly after the treatment, or in the first few days, you could get a headache.
Nausea, lack of appetite, cough, fever, and other flu-like symptoms.
Redness and swelling around the treated area.
The development of an immunity to the effects of Botox – only when Botox is used on a very regular basis.
Trouble breathing in the instance of Botox treatment in the neck.
Difficult seeing, or problems with seeing normally in the instance of Botox treatment near the eyes.
Pain in the chest or prolonged illness.
There is a possibility that these symptoms may not appear straight away after Botox treatment, sometimes taking a few weeks to appear. If you do experience the very rare symptoms, then it is important to get into contact with your physician immediately.
After Botox treatment in Oakbrook, the change to your skin will likely become apparent after the first couple days, although it could take up to 10 days for you to really notice the difference. The quality of Botox treatment will largely depend on which clinic you visit. Not all Botox treatments are the same, as it is generally down to the practitioner to decide how much liquid to add to the Botox substance, normally it is between 2ml and 3ml.
Botox is a temporary adjustment to your appearance, so the results will eventually fade. The amount of time that the Botox will last differs from person to person, with a lot depending on how much Botox was initially used in the treatment. In some cases, the results could last as long as 6 months, and in other cases it could have faded after around 3 months. Slowly, as the activity in your muscles beings to increase, you will be able to notice the Botox wearing off.
Why Is the Kovak Cosmetic Center the Best Place to Go for Botox in Chicago?
If you're considering having a Botox treatment to rejuvenate your skin and the muscles in your face, then we highly advise that you get into contact with our team at the Kovak Cosmetic Center. Our years of experience performing high-quality and highly effective cosmetic procedures in all areas of cosmetic skin care, mean that we have an exceptional level of expertise performing the vastly popular Botox procedure.
From the initial consultation with one of our expert physicians or plastic surgeons in Chicago, we will be by your side through the treatment, helping you to decide which treatments will be the most beneficial to you, and where Botox can deliver the best results. Over the years, we have had chance to meet countless people who have benefited from the confidence boost and skin revitalization that professionally performed Botox can provide.
We always stay ahead of the curve at the Kovak Cosmetic Center, ensuring that our patients not only have access to the latest and most advanced procedures in cosmetic practices, but that our clinics in Chicago are full equipped with the best and highest quality equipment to deliver the kind of results that we know our customers have grown to expect from the Kovak Cosmetic Center. When you visit the Kovak Cosmetic Center, you can always be certain that not only will you receive the warmest of welcomes, but you'll be in a professional environment that truly caters to your needs and wellbeing.
If you would like more information about the Botox treatments available at the Kovak Cosmetic Center or learn more about the professional services that our team can provide, please don't hesitate in giving the Kovak Cosmetic Center a call today.


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Incoming Drama Major Alethea Shirilan-Howlett '24 Debuts First Full-Length Play on YouTube on Sunday
Friday, June 5, 2020, By Kelly Homan Rodoski
College of Visual and Performing ArtsDepartment of Drama
Growing up, Alethea Shirilan-Howlett '24, a senior at Jamesville-DeWitt (J-D) High School and an incoming first-year drama major (theater management track) in the College of Visual and Performing Arts, dreamed of being an actress. After attending a pre-college arts program at Brandeis University in July 2018, she was inspired to pursue playwriting.
That summer, Shirilan-Howlett spent time immersing herself in the music of and documentaries on the iconic 1960s folk rock group The Mamas and the Papas. "I was completely enthralled with the band story and decided I wanted to write a play about a band," she says. On Sept. 1, 2018, she put pen to paper.
Nearly two years later, her first full-length play, "No Exodus," will come to life for the public. Performed by the J-D High School Drama Club and directed by Shirilan-Howlett, the play's premiere will stream on YouTube on Sunday, June 7, at 7 p.m. (and will be available in the days following). Originally intended for a May unveiling on stage, the play has been transformed into a virtual performance due to the COVID-19 pandemic and the physical closure of public schools. Shirilan-Howlett and her colleagues have designated the play as a fundraiser for the CNY Arts Young Artists Scholarship Fund.
Kai Gesek as David
Set in Syracuse in the 1990s with flashbacks to the 1970s, the story takes place during a Passover Seder. It explores the relationship between a daughter, Ruth, and her mother, Wendy (a member of a band in the 1970s), and "examines the personal and cultural stakes of holding onto and letting go of the past and the stories we tell about it."
Writing the play was a labor of love for Shirilan-Howlett, who went through about 20 drafts before she declared it complete. Often when writing, she would step away for a walk and find herself typing ideas into her phone. "When I look at the final version, I see threads from that first draft," she says. "The draft process is all about layering in more threads."
She completed the play in November 2019 and worked with J-D Drama Club Director Jordan Berger to plan for a spring 2020 production. The nine-member cast was chosen and stage crew formed in early March. Shirilan-Howlett held the first read-through on March 11, and shortly thereafter, a friend in college called her to say that her school was moving online for the rest of the semester. By March 16, local schools had also moved online.
Then started the biggest challenge of all—moving from a stage to a virtual production. The play had been cast before school closed, so that critical element was taken care of. But now came the task of bringing it all together in an unfamiliar way. Shirilan-Howlett researched how other schools, colleges and theaters were delivering virtual performances, and she decided on Zoom as the platform and the highlighting feature to record student scenes.
Abby Morgan as older Wendy
"The experience of having to change formats unexpectedly has been eye-opening and frustrating at times, says Berger. "They've had to adjust to life at home recording these parts with audio, video, costumes, props, virtual backgrounds—even just worrying about which direction they are facing and the blocking is all so much removed from their comfort of being on a stage and performing."
Even though she would much rather be directing a stage production, Shirilan-Howlett found silver linings in preparing the virtual performance. Many of the cast members are experienced performers and are used to projecting out into the audience. The Zoom format has required them to transform big-stage energy into a small screen, resulting in nuanced facial expressions and acting choices that give the virtual performance its own unique flavor.
Quarantine also helped everyone to lean on each other. "We supported each other and gained so much as a cast," Shirilan-Howlett says. "It has been a true lesson in how art and connection transcend physical space."
Berger says it has all come together in a spectacular way. "The cast has put so much love and passion into this show, and it's been such a pleasure to work with talented and hardworking young people in this capacity with so many changes and uncertainty along the way," he says. "This is a student-run production through and through. I've been mostly on the sidelines, and it's so cool to see students taking on this project, embracing the process and taking charge."
Kai Gesek, a J-D senior and a seasoned performer, plays the role of David, Wendy's boyfriend and band mate, in the production. He says he enjoyed the experience of bringing the show to life: "Being able to experiment with formats along with my fellow actors and actresses has been unforgettable, to say the least. I would much prefer to have rounded out my senior year by performing this play live on stage, but I'm very happy with the final result."
Alethea Shirilan-Howlett
Gesek says the show would not be anything without Shirilan-Howlett. "When we all sat down for our first read-through of this show, I was in awe of how impactful the script was," he says. "It seemed to connect differently with every person in that room, and all of us were impressed with the sheer caliber of impact carried in the pages of the script. Alethea is a phenomenal writer and an amazing director. I cannot express how talented she is, simply because I can't figure out what words to use."
Meghan Culligan, a J-D freshman, plays a young Wendy. She has been in multiple musical productions, but this is her first play. "This whole experience has been really fun and a great way to keep my mind off of what's going on in the world right now," she says. "It was upsetting when we found out that we wouldn't be performing on stage, and I was unsure of how we would virtually perform, but it's been a lot of fun. And I think it looks great. It's really interesting to see how you can build a character and interact with other actors over a virtual platform."
Culligan says working with Shirilan-Howlett has been a great experience. "She is really good at having us understand our character's intentions and helping develop our characters," she says. "Alethea has definitely helped me improve my skills as an actress, and coming out of this I will have gained so many new acting skills from that I can use in the future."
Berger says he is grateful to be working with Shirilan-Howlett on her production. "Alethea didn't fret, complain or get down about our inability to get this in front of a live audience. She has stayed so positive throughout this entire process and worked hard from day one to ensure success," he says.
Shirilan-Howlett's skills in casting, directing, editing, publicity and leadership have impressed and inspired Berger along the way. "Alethea is a professional first and foremost and a leader of her peers the same age and younger—she's a superstar," Berger says. "I am so ecstatic that we've been able to bring her passion and work to life and that I could support her growth as a director."
This is not the first time that Shirilan-Howlett has found success with her work in the broader community. She was a finalist in Syracuse Stage's 2019 Young Playwrights Festival for her play "Viewer Discretion Advised." The play won first place in Princeton University's 10-Minute Play contest and was a winner in this year's The Blank Theatre Young Playwrights Festival in Los Angeles, where the winning plays are performed in weekend-long runs in professional theaters across the city and student playwrights are part of the production process. Shirilan-Howlett is currently working with a mentor, Hollywood screenwriter Robert L. Freedman, on preparing her play for production at a time to be determined.
And she is really looking forward to embarking on her new journey as a Syracuse University student in August. "I'm really excited about joining VPA," she says. "I felt so welcomed by the program and the faculty I met when I sat in on a theater management class. It seems like the theater community is really tight-knit, and I can't wait to be a part of it."
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When you weren't born frugal and you're not a natural saver, it's easy for you to believe that you may never have savings, or that you were not meant to live within your means. But that's not true. Sure, some behaviours are ingrained in you. And that's going to be hard to change. But, as with anything else in life, you CAN make that change if you want. If you are new to Frugal Living then you really don't have to stay in a financial mess, or feel lost when it comes to managing your money.
Whether you're twenty-one or sixty-one, starting to live a frugal lifestyle can be fun. It can also make a huge impact on your life – yes, no matter what are you are. But, one thing that may put you off from starting is knowing where to actually start in the first place. So let's take a look.
To start with, you need to get to grips with your spending. It's important here for you to make sure that you're aware of how you naturally spend your money. Assess your patterns. See where you're slipping up. Work out what kind of things are getting you in trouble. Just observe for a while so that you can get a sense of how things are.
Next, you're going to want to cut back. Now, there are many ways that you can look to save money in life. And you can do it in just about every area of life. Just make sure that you're begin brutal here. Because you're more likely to be cautious. Sure, make sure that you have the bases covered, but if you're throwing money away or you get no value from what you spend on, then it's time to cut back and cut out!
Next, you're going to want to make sure that you're driving down the price of the bills that you do have left. And to do that, it's going to help you to shop around. From the cheapest groceries to the best car insurance, there's always a best price. You just have to actively seek it out.
Then from here, it's important for you to be able to shop smart. Make sure that you're finding items that add value to your life and that you are happy with the price you're paying. Also shop consciously. Because it's quite often things like impulse buying that can let you down.
And then finally, when you know that you're being more conscious of your financial situation and you're managing things a lot better, you're then going to want to guide them. Because the thing about being smart with your finances. You want to have control. And to do that, you need to know where you're going. Sure, budgeting helps. But, it's goals that guide you. So, thinking about the financial goals you'd like to work towards, and then let them guide how you spend and save your money.


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Relationship between Motor Symptoms, Cognition, and Demographic Characteristics in Treated Mild/Moderate Parkinson's Disease
Jay S. Schneider ,
* E-mail: jay.schneider@jefferson.edu
Affiliation Dept. of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, PA, United States of America
Stephanie Sendek,
Chengwu Yang
Affiliation Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA, United States of America
Jay S. Schneider,
Jay S. Schneider Stephanie Sendek Chengwu Yang
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Although Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized primarily by motor symptoms, PD patients, at all stages of the disease, can experience cognitive dysfunction. However, the relationships between cognitive and motor symptoms and specific demographic characteristics are not well defined, particularly for patients who have progressed to requiring dopaminergic medication.
To examine relationships between motor and cognitive symptoms and various demographic factors in mild to moderate, PD patients requiring anti-PD medication.
Cognitive function was assessed in 94 subjects with a variety of neuropsychological tests during baseline evaluations as part of an experimental treatment study. Data were analyzed in relation to Unified Parkinson's Disease Rating Scale motor scores and demographic variables.
Of the UPDRS subscores analyzed, posture/balance/gait was associated with the highest number of adverse cognitive outcomes followed by speech/facial expression, bradykinesia, and rigidity. No associations were detected between any of the cognitive performance measures and tremor. Motor functioning assessed in the "off" condition correlated primarily with disease duration; neuropsychological performance in general was primarily related to age.
In PD patients who have advanced to requiring anti-PD therapies, there are salient associations between axial signs and cognitive performance and in particular, with different aspects of visuospatial function suggesting involvement of similar circuits in these functions. Associations between executive functions and bradykinesia also suggest involvement similar circuits in these functions.
Citation: Schneider JS, Sendek S, Yang C (2015) Relationship between Motor Symptoms, Cognition, and Demographic Characteristics in Treated Mild/Moderate Parkinson's Disease. PLoS ONE 10(4): e0123231. https://doi.org/10.1371/journal.pone.0123231
Academic Editor: Krystof Bankiewicz, University of California at San Francisco, UNITED STATES
Received: November 9, 2014; Accepted: March 2, 2015; Published: April 23, 2015
Copyright: © 2015 Schneider et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Data Availability: Data cannot be made publicly available due to ethical restrictions. A de-identified dataset will be made available upon request from the corresponding author.
Funding: The research was supported by National Institutes of Health grant NS038681 (www.nih.gov). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized primarily by motor symptoms including bradykinesia, resting tremor, rigidity, and postural instability. However, it has become increasingly apparent that PD patients, at all stages of the disease, can experience cognitive dysfunction. Although there is heterogeneity to the clinical presentation of cognitive impairment in PD in general [1] and particularly earlier in the disease process, the cognitive impairment in PD often involves executive function, attention, visuospatial function and working memory, suggesting a frontal or fronto-striatal nature to these cognitive deficits [2,3,4,5].
Several studies have examined relationships between motor symptoms and cognitive functions in PD and in general, such studies have reported that bradykinesia and rigidity are correlated with at least some types of cognitive impairment while tremor is less likely to correlate with cognitive impairment [6,7,8,9]. For example, Huber et al. [10] compared levodopa-treated patients (Hoehn and Yahr stage 2–3) with tremor predominant disease to those with bradykinesia/rigidity dominant disease and found only the latter group to exhibit memory, visuospatial, and executive function deficits. Further, they found that age of onset of PD had little influence on neuropsychological performance when overall effect of age was controlled for [10]. However, these and similar findings are difficult to interpret since patients were tested while medicated and the effects of dopaminergic medications on cognition are varied and may affect individual cognitive symptoms differentially [11].
To overcome this potential problem with the interpretation of data obtained from medicated patients, other studies examining the relationship between motor symptoms and cognition in PD have utilized newly diagnosed, drug naive (de novo) patients [12,13]. In one such study, bradykinesia was associated with working memory and mental flexibility, whereas axial signs were associated with episodic memory and visuospatial function [13]. These authors suggested that slow movement and inflexible thinking may be controlled by a dopaminergic network different from networks involved in tremor and/or rigidity, since after controlling for age, sex, and education, no association was found between cognitive performance and tremor and rigidity [13]. However, a caveat of these studies is that cognitive deficits may be subtle in newly diagnosed, drug naive PD patients [14,15] and it may be difficult to relate cognitive functioning to other variables in this population, depending in large part on what types of cognitive assessments are performed and how sensitive they are to detecting subtle cognitive deficits in this population.
Although there are obvious merits to examining the relationship between cognitive and motor symptoms in de novo PD patients without having to account for the potential complicating factor of medication effects, it is also important to examine these relationships in more advanced patients who require medication as the relationship between cognitive and motor symptoms may change as the disease progresses. The purpose of the current study was to examine the relationship between motor and cognitive symptoms and various demographic factors in mild to moderate, PD patients requiring anti-PD medication and examined in a practically defined off period.
Participants and Ethics Statement
These data were collected during baseline assessments performed as part of a study examining long-term effects of GM1 ganglioside treatment on PD (ClinicalTrials.gov NCT00037830). The study was approved by the Division of Human Subjects Protection at Thomas Jefferson University and written informed consent was obtained from all subjects prior to enrollment. Subjects were men or women between 39 and 85 years of age with a diagnosis of idiopathic PD consistent with the UK PD Society brain bank PD diagnostic criteria. Inclusion criteria included "off" Unified Parkinson's Disease Rating Scale (UPDRS) motor score between 10 and 40, "off" Hoehn and Yahr staging of 1.0 to 3.0, Mini Mental State Exam (MMSE) score ≥ 25, and Beck Depression Inventory (BDI-II) score ≤ 10.
Procedures and Data Collection
All subjects were assessed while in a practically defined "off" period prior to taking that day's first dose of anti-PD medication and at least 12 h after the last dose of levodopa (or 24 h after the last dose of dopamine agonist). Pre-morbid full scale IQ (FS IQ) was estimated using the National Adult Reading Test (NART). Motor function was assessed by two independent observers, using the UPDRS part III (motor score). The motor score used in the analysis was the average score from the two observers. Inter-rater reliability was assessed using Pearson linear correlation coefficient for each pair of raters and inter-rater reliability was high (median correlation coefficient was 0.94 for UPDRS motor scores). Additionally, a rigidity sum was computed as the total of UPDRS items 22a-e; a bradykinesia sum was computed as the total of UPDRS item numbers 23a-b, 24a-b, 25a-b, 26a-b, and 31; an axial sum (posture/balance/gait) was computed as the total of UPDRS item numbers 27–30; a tremor sum was computed as the total of UPDRS item numbers 20a-e and 21a-b; a speech and facial expression sum was computed as the total of UPDRS item numbers 18 and 19.
The following tests were used to assess neuropsychological functions:
Brief Test of Attention (BTA).
assessed auditory attention and requires no motor response, making it useful for assessing attentional/working memory deficits in subjects with motor/dexterity impairments. The subject listens to progressively longer series of lists containing letters and numbers on an audio tape and after each list is heard, the subject must report either the number of letters or numbers that he or she heard. The total number of correct responses (out of a maximum score of 20) was recorded.
Controlled Oral Word Association Test (COWAT).
assessed verbal fluency or the spontaneous production of words beginning with a given letter of the alphabet (letters F, A, S were used) within a limited time period (60 secs.). The total number of words produced (adjusted for education) was recorded.
Wisconsin Card Sorting Test (WCST).
assessed set shifting and cognitive flexibility (executive function). A computerized version of the WCST was used. On this test, a stimulus card is presented on the lower portion of the computer screen and the subject is asked to match that card to one of the four cards on the upper portion of the screen. The subject is not told how to make the match but the computer provides feedback as to whether the match is right or wrong. Number of perseverative errors; number of nonperseverative errors; number of categories completed; number of trials to complete first category were recorded.
Ruff-Light Trail Learning Test (RULIT).
assessed visuospatial learning and memory. This test does not require good motor control or drawing skills and is designed to minimize or eliminate verbal mediation for successful task completion. Subjects are presented with a stimulus card that contains a complex configuration of circles that are interconnected by lines. The subject begins at the START circle and uses an index finger to trace a line connecting the circles from the START to the END. At each circle (or step) along the trail, there are three to five choices for the next step, but only one choice is correct. The subject is given immediate feedback as to whether their choice was correct, and the subject keeps making choices until the correct choice is made. This process continues through the 15-step trail. Successive trials are administered until the trail is recalled without an error on two consecutive trials. Immediate memory is analyzed by the number of steps correctly completed in Trial 2. Learning is analyzed by the number of trials needed to master the task (total correct)). Long-term (delayed) memory is assessed by having the subject retrace the trail after a 60-minute delay and the number of steps correctly completed was recorded.
Conditional Associative Learning Task.
assessed learning of arbitrary associations between a set of stimuli and a set of responses. The conditional associative-learning task required subjects to learn, with immediate correction, spatial locations associated with specific stimuli. Four disks and four blank cards are placed are placed in front of the subject. The subject is instructed that each card is associated with only one of these disks and that they need to learn the associations. The experimenter points to a disk and the subject must point to a card and the subject is provided feedback as to whether they have made a correct association. There is a maximum of 3 errors allowed per trial. If 3 errors are made, the administrator shows the subject the correct response. The number of trials to criterion (out of a maximal score of 68) were recorded.
Stockings of Cambridge.
This test of fronto-executive function assesses planning and problem solving ability and is part of the Cambridge Neuropsychological Test Automated Battery (CANTAB), a computer/touch screen-based cognitive assessment system. In the "plan and move" condition, subjects had to move three colored circles in the lower half of the screen to match a given pattern in the upper half of the screen. The difficulty of the task increased as the number of moves needed to complete the task increased from two to five. Subjects are instructed to wait to begin moving balls until they have planned their moves. In a second condition that controls for motor performance, the "follow" condition, is administered. Subjects are simply required to follow moves made by the computer. By subtracting response times in the "follow" condition from those in the "plan and move" condition, it is possible to separately measure planning and movement times [16]. The number of moves to solution of the problem, the proportion of problems solved in minimum number of moves, the initial thinking time, and the subsequent thinking time were recorded.
Spatial Working Memory.
This task, also from the CANTAB battery, is a self-ordered spatial search task in which the subject must search for (and find) blue tokens that are hidden inside of colored squares on the screen. The number of items to be searched increases as the task progresses from 2 items to 8 items. Once a blue token had been found within a particular box, that box would not contain another token, as every box was used only once. The test begins with a number of colored boxes shown on the screen and the subject must touch the boxes using a process of elimination, to find one blue 'token' in each of the boxes and use them to fill up an empty column on the right hand side of the screen. The number of boxes is gradually increased, until it is necessary to search a total of eight boxes. The color and position of the boxes used are changed from trial to trial to discourage the use of stereotyped search strategies.: For sets of length 4, 6 and 8 boxes, the number of between errors (a subject returns to open a box in which a token has already been found) were assessed.
Univariate analyses of motor symptoms (M) as measured by the UPDRS part III (motor) scores, cognition (C) as measured by cognitive assessment instruments described above, and demographic characteristics (D) were performed. These included summarizing categorical variables with frequencies and percentages and continuous variables with means, standard deviations, medians, and the interquartile ranges. The distribution of continuous variables was checked using box plots, histograms, and normal probability plots. For demographic variables, comparisons were made between treatment groups using a two-sample t-test with means for continuous variables and using a Chi-square test with percentages for categorical variables. An exact test was used when cell counts were too small for the Chi-square test to be valid. In order to explore relationships between Motor (M) symptoms, Cognition (C), and Demographic (D) variables, Pearson or Spearman correlation coefficients were calculated for each pair of variables. A p-value less than 0.05 was taken to indicate a statistically significant relationship between the corresponding pair of variables interrogated.
Table 1 shows the demographic characteristics of the sample population (N = 94). This group of PD patients generally had relatively short duration of disease (average 3.0 ± 2.7 years), did not have dementia (based on MMSE criteria), did not have clinical depression (based on BDI-II scores) and were highly educated (average 16.4 ± 3.1 years of education). Relationships between motor symptoms (assessed during a practically defined off period) and demographic features were explored and results showed that all UPDRS subscores (i.e., bradykinesia, posture/balance/gait, speech/facial expression, tremor) with the exception of rigidity were significantly positively correlated with disease duration (Table 2). With the exception of posture/balance/gait, none of the UPDRS subscores were correlated with age at diagnosis and with the exception of rigidity, none of the UPDRS subscores were correlated with MMSE score. None of the UPDRS motor subscores were correlated with years of education, estimated full scale IQ or BDI-II score (Table 2).
PowerPoint slide
Table 1. Subject Demographics and Baseline Characteristics.
https://doi.org/10.1371/journal.pone.0123231.t001
Table 2. Correlations Between Off-Period UPDRS Scores and Demographics [r (p value)].
Relationships between performance on neuropsychological tests and demographic variables (Table 3) and performance on neuropsychological tests and UPDRS components (Table 4) were examined. Auditory attention, assessed with the BTA (number of correct responses), was correlated with MMSE score and FS IQ and negatively correlated with age. Verbal fluency, assessed by performance on the COWAT, was correlated only with MMSE score and FSIQ. Visuospatial learning and memory, as assessed by the RULIT, showed visuospatial learning ability to be positively correlated with MMSE score and negatively correlated with age Immediate and delayed visuospatial memory performance were both negatively correlated with age and immediate memory was also negatively correlated with BDI-II score. Planning and problem solving ability showed relationships with age and education; relationships between cognitive flexibility and age, MMSE score, and education were detected; spatial working memory performance (number of errors made) was correlated with age (i.e., worse performance with increasing age).
Table 3. Correlations Between Neuropsychological Performance and Demographic Variables [r (p value)].
Table 4. Correlations Between Neuropsychological Performance and Off UPDRS Motor Scores [r (p value)].
Performance on the COWAT was not correlated with any UPDRS measures. Brief Test of Attention performance was negatively correlated with bradykinesia, posture/balance/gait/, and rigidity. Conditional associative learning ability (trials to criterion) was correlated only with bradykinesia (i.e., more trials to criterion (worse performance) correlated with higher (worse) bradykinesia scores. Visuospatial learning (RULIT, number correct responses) was negatively correlated with bradykinesia, speech/facial expression, and posture/balance/gait. Immediate visuospatial memory was negatively associated with posture/balance/gait and speech/facial expression while delayed visuospatial memory was also negatively correlated with bradykinesia. Planning and problem solving ability showed minimal relationships with motor function. The number of categories completed on the WCST was negatively correlated with all UPDRS subscores except tremor. The number of errors made during performance of the spatial working memory task at all levels of task difficulty were primarily correlated with posture/balance/gait (i.e., worse performance associated with worse pasture/balance/gait scores). The relationships between neuropsychological test performance (correlation coefficients) and "off" UPDRS motor scores are shown in the heat map in Fig 1.
Fig 1. Heat map showing the relationships between cognitive test performance (based on correlation coefficients) and subscores from the Unified Parkinson's Disease Rating Scale (UPDRS) motor scales.
Green denotes a significant negative correlation, red denotes a significant positive correlation and black denotes no significant correlation. The intensity of the color reflects the strength of the correlation.
https://doi.org/10.1371/journal.pone.0123231.g001
Non-motor aspects of PD have received increasing attention recently and in particular, it is appreciated that cognitive changes are relatively common in non-demented PD patients [17]. Although the relationships between motor dysfunction and cognition have been investigated previously in PD patients, most studies have examined these relationships in newly diagnosed, drug naïve patients [13] or in more advanced patients in the medicated state, with neuropsychological testing performed in the "on" condition [6]. In the current study, patients requiring anti-PD medication were studied, neuropsychological testing was performed in a practically defined "off" condition, and motor function was assessed in an "off" condition.
For the most part, motor function assessed in the "off" condition correlated primarily with disease duration. Neuropsychological performance primarily was related to age, MMSE score, or education, with disease duration, BDI-II score or FS IQ having little relationship to neuropsychological test results. When the relationships between neuropsychological performance and motor function were examined, it is interesting that tremor was mostly unrelated to neuropsychological outcomes, similar to what has been noted in other studies that examined an earlier PD population [13]. Also, in newly diagnosed, drug naïve PD patients, bradykinesia was negatively associated with tests considered to have executive demands, such as the WCST (categories completed) [13]. In the present study, bradykinesia was also negatively associated with the number of WCST categories completed, reflecting a problem with cognitive flexibility.
Of the UPDRS subscores analyzed, posture/balance/gait was associated with the highest number of adverse cognitive outcomes followed by speech/facial expression, bradykinesia, and rigidity. The relationships between cognitive outcomes and posture/balance/gait scores support the observations that PD patients with a posture instability gait difficulty (PIGD) subtype may have accelerated cognitive decline and an increased risk for developing dementia [18].
No associations were detected between any of the cognitive performance measures and tremor. This lack of association between tremor and cognitive function has been described in other studies [9,10,19] and further suggests that tremor likely results from dysfunction of neural circuits and neurochemical systems that may be distinct from those that underlie cognitive function. In contrast, associations between different aspects of visuospatial function (performance of RULIT task, conditional associative learning, and spatial working memory) and posture/balance/gait were significant, suggesting potentially overlapping processes involved in these functions. In a retrospective analysis of established, non-demented PD patients, it was noted that patients with MCI had higher postural instability and gait disorder subscale scores than cognitively intact patients, suggesting and association of these motor symptoms with increased cognitive dysfunction [20]. Similarly, early stage, drug naïve PD patients were found to have associations between visuospatial function (and episodic memory) and severity of axial symptoms [13]. The findings that these associations span different stages of the disease and are found in early, unmedicated patients as well as in more advanced patients take on particular significance since others have reported that patients whose motor symptoms are prominently characterized by posture and gait disturbances, motor symptoms that are traditionally less responsive to dopaminergic therapy, have increased risk for developing dementia [18,21].
The current study has several potential limitations. The motor function data reported in this paper was the result of clinical assessments and thus relied on clinical judgement of the investigators rather than objective assessments of motor function. However, as described previously by us [22], subjects were observed by two independent raters to improve the precision of this measure. There is also the possibility that some of the neuropsychological measures may have been directly affected by impaired motor function. We think motor disability was unlikely a significant contributing factor to the neuropsychological test results since most tests relied on verbal responses, had no particular timing component that would adversely impact performance, or had built in controls for motor performance. Since this study utilized subjects already receiving anti-PD medications, including levodopa, results obtained during a practically defined "off" period may have been complicated by any potential long duration response to levodopa, and such effects could have contributed to the current findings. However, to the best of our knowledge, long duration effects of levodopa on cognitive function, as assessed in this study, have not been reported. Lastly, because of the number of comparisons made, some of the findings reported here may be not be true associations. We did not correct for multiple comparisons as we wanted to minimize the chance of falsely excluding potentially true relationships, although possibly at the expense of reporting an occasional spurious association. However, we believe that findings related to the lack of any associations of cognitive data with tremor and associations of cognitive data with posture/balance/gait in particular are true as multiple associations within a given cognitive test were found and were all in the same direction. Nevertheless, additional studies may be warranted to confirm our results.
Our findings suggest that in PD patients who have advanced to requiring anti-PD therapies, there are salient associations between axial signs and different aspects of cognition, and particularly with visuospatial learning and memory suggesting involvement of similar circuits in these functions. Associations between executive functions and bradykinesia also suggest involvement similar circuits in these functions. Age appeared to be the demographic factor most associated with neuropsychological test performance. The more information we gather about possible relationships between demographic factors, cognition, and motor function, the better we might be able to understand the origins of and perhaps predict the course of different cognitive and motor symptoms in PD.
This research was supported by NIH grant NS038681.
Conceived and designed the experiments: JSS. Performed the experiments: JSS SS. Analyzed the data: CY. Wrote the paper: JSS CY.
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19. Portin RJ, Kiovussalo A, Laihinen AO, Rinne UK (1989) Cognitive deficits, motor disability and duration of illness in early Parkinson's disease. Journal of Clinical and Experimental Neuropsychology 11: 369.
20. Sollinger AB, Goldstein FC, Lah JJ, Levey AI, Factor SA (2010) Mild cognitive impairment in Parkinson's disease: subtypes and motor characteristics. Parkinsonism &Related Disorders 16: 177–180.
21. Verbaan D, Marinus J, Visser M, van Rooden SM, Stiggelbout AM, Middlekoop HA, et al. (2007) Cognitive impairment in Parkinson's disease. Journal of Neurology, Neurosurgery, and Psychiatry 78: 1182–1187. pmid:17442759
22. Schneider JS, Gollomp SM, Sendek S, Colcher A, Cambi F, Du W (2013) A randomized, controlled, delayed start trial of GM1 ganglioside in treated Parkinson's disease patients. Journal of the Neurological Sciences 324: 140–148. pmid:23199590
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AP Muncipal Teachers Transfers Guidelines and instructions AP GO.506 & 507 Released : GOVERNMENT OF ANDHRA PRADESH G.O.RT.No. 506 Dated: 16-05-2018.
on Municipal Teachers' Transfers-2018 (Phase-II) – Orders – Issued.
on Municipal Teachers' Transfers-2018 (Phase-I) – Orders – Issued.
In pursuance of the orders issued, lifting of ban on transfers vide reference 2nd read above, the Director of Municipal Administration, A.P., Guntur has submitted on transfer and posting guidelines / instructions vide letter in the reference 3rd read above based on the representation of various Teachers and Teacher Unions to effect the Municipal Teacher Transfers 2018 to the various categories of Teachers working in the Municipal Management under Spouse, Mutual, Inter Management/District/Inter district and request transfers.
A. Applicability : Transfers shall be applicable to all categories of Teachers working in Municipalities / Corporations as per Service Rules, 2016 i.e. Gr.II Head Masters, School Assistants, Specialist Teachers, PSHMs, Secondary Grade Teachers and other equivalent categories working in all Municipal / Corporation Primary / Upper Primary/ High Schools in the State.
The Municipal Teacher who have completed a minimum period of service for 3 years (as on 30th April, 2018) in a ULB is eligible for Transfer.
b. Spouse cases : Husband and Wife cases (only Municipal Teachers shall be shifted following the prescribed procedure). Teacher whose spouse belongs to State Government or Central Government or Public Sector undertaking by Govt. or Local Body or Persons working in the Institutions against the Aided post category in AP and working in the same District / Outside District may opt for transfer. Once the facility is utilized, the next request can be made only after eight years. The concerned HoD/Appointing Authorities shall issue the Service Certificate in respect of spouse working within/outside the AP State, as the case may be.


text:
Das Fest der Rosella è un film muto del 1919 prodotto e diretto da Friedrich Zelnik.

Trama

Produzione
Il film fu prodotto da Friedrich Zelnik per la Berliner Film-Manufaktur GmbH.

Distribuzione
Uscì nelle sale tedesche nel 1919.

Note

Collegamenti esterni

redpajama_set_name: RedPajamaWikipedia


Vinoteque was a wine bar where you could enjoy tapas and wine while listening to live music. Thus the use of gestalt - the negative space between the jugs creating a wine glass, and the jug also representing a guitar. The colors are reminiscent of white and red wines.


text:
namespace iTin.Export.Model
{
    using System.Collections.Generic;
    using System.Linq;

    using ComponentModel.Writer;
    using Helpers;

    /// <inheritdoc />
    /// <summary>
    /// </summary>
    public partial class BehaviorsModel
    {
        #region constructor/s

        #region [public] BehaviorsModel(ExporterModel):
        /// <inheritdoc />
        /// <summary>
        /// Initializes a new instance of the <see cref="T:iTin.Export.Model.BehaviorsModel" /> class.
        /// </summary>
        /// <param name="parent">The parent.</param>
        public BehaviorsModel(ExporterModel parent)
            : base(parent)
        {
        }
        #endregion

        #endregion

        #region public methods

        #region [public] (void) Execute(IWriter, ExportSettings): Executes defined behaviors
        /// <summary>
        /// Executes defined behaviors.
        /// </summary>
        /// <param name="writer">Writer to use.</param>
        /// <param name="settings">Writer settings.</param>
        public void Execute(IWriter writer, ExportSettings settings)
        {
            var behaviors =
                this.Where(behavior =>
                    behavior.GetType() != typeof(TransformFileBehaviorModel)
                    && behavior.GetType() != typeof(DownloadBehaviorModel));

            foreach (var behavior in behaviors)
            {
                behavior.Execute(writer, settings);
            }

            var downloadBehavior = Get<DownloadBehaviorModel>();
            downloadBehavior?.Execute(writer, settings);
        }
        #endregion

        #endregion

        /// <inheritdoc />
        protected override void SetOwner(BaseBehaviorModel item)
        {
            SentinelHelper.ArgumentNull(item);

            item.SetOwner(this);
        }

        #region [public] {static} (T) Get<T>(this List<T>) where T : IBehavior : Returns specified behavior
        /// <summary>
        /// Returns specified behavior.
        /// </summary>
        /// <typeparam name="T">Behavior type</typeparam>
        /// <returns>
        /// Specified behavior.
        /// </returns>
        public T Get<T>() where T : IBehavior
        {
            return GetRange<T>().FirstOrDefault();
        }
        #endregion

        #region [public] {static} (List<T>) GetRange(this List<T>) where T : IBehavior: Returns an enumerator to a field list containing only those who meet the condition of type
        /// <summary>
        /// Returns an enumerator to a field list containing only those who meet the condition of type.
        /// </summary>
        /// <typeparam name="T">Behavior type</typeparam>
        /// <returns>
        /// Enumerator that contains list of fields that meet the condition.
        /// </returns>
        public List<T> GetRange<T>() where T : IBehavior
        {
            return this.Where(behavior => behavior.GetType() == typeof(T)).Cast<T>().ToList();
        }
        #endregion
    }
}

redpajama_set_name: RedPajamaGithub


In case you didn't notice it, there has been an increase in the price of Cisco written exams.
Q. What exactly is the price adjustment being made at this time?
A. As of June 24, 2008, the price of the CCNA comprehensive exam #640-802, the single exam option for achieving CCNA certification, will be $250 USD, the professional-level Composite exam #642-892, will be $300 USD and the CCIE written exams will be $350 USD or the local currency equivalent in all regions. All other exam prices still apply. For more information, contact Pearson VUE at www.pearsonvue.com/cisco.
Q. Will the price be adjusted in all worldwide locations?
A. Yes, the price will be adjusted in all regions. Cisco Certified Learning Partners in some areas may include the exam along with a training course for a single price.
Q. How can I find out the local currency price for exams?
A. All prices cited are in U.S. dollars. For details about local currency pricing in the country where you take an exam, contact Cisco's authorized test delivery partner, Pearson VUE.
Q. Will the price to Networking Academy students also be changed?
A. Consistent with our past years strategy, Cisco will provide financial assistance to Cisco Networking Academy students in the form of discounts to help defray the cost of key certification exams.
Q. Will the price increase impact the Cisco CA employee discount?
A. CA employee voucher program will not change ($50USD).
Q. Why is the price being adjusted at this time?
A. Our market analysis indicates the price of these exams are out of line with the market value it provides and with other IT certification exams at the Associate, Professional and Expert level. Cisco Career Certifications is one of the industry's most recognizable and highly valued programs for IT professionals. Achieving either a CCNA, Professional or Expert certification validates knowledge and hands-on skill with the world's leading networking solutions.
I read almost 10 times the last QA, but i couldn't think of any no-money-included relationship between exam price and exam market value. Does a higher priced exam (alone by itself) make it a higher valued exam?
In my opinion, every manufacturer establishes a price for its exam based on the desire of people who want to have have their certification. Cisco is a huge name in the networking business and has to set a fair price, considering others check their prices and use them for their own certifications. Unfortunately, the current raise of prices has a more economical reason than a performance one. USA is in recession and so they have to ask more of the people wanting to get CCNA, CCNP or any other piece of paper. Taking into consideration the increasing number of people in Asia getting certified, Cisco's income will increase for sure. At around the same time, another competitor, Juniper has announced another free certification and this is how Cisco reacts. I, for one, won't be tempted to get more from Cisco, because of this new price. The jobs in networking are still scarce and many employers, even if they ask for certifications, don't understand the value of it. Now, with the same amount of money you can become MCSA and not CCNA. I don't know how's the situation in other countries but in mine, MCSA is better paid than CCNA. So, good luck Cisco with this new path you are taking.
The new triple -paper only- CCNA will surely make Cisco richer. Maybe they found an easy way to increase their revenue.
what is current and latest price updates for cisco exam for each paper of ccnp?
Nice Post! It will really boost our confidence level. I think the best way to study and prepare for exam is to connect with some online exam preparing sites, which will frequently send you data according to you desire exam.
It is an excellent opportunity for all those students who want to prepare themselves within short period of time.


Lorena Ros — Creative stories to destigmatize and educate on all issues of mental health.
A Photojournalist Since 2001, Lorena Ros has been published globally including in Newsweek, Time and El Pais and is a regular contributor for The Sunday Times Magazine and the Saturday Telegraph in the UK. She has also worked extensively with Ngo's (Soros, Human Rights Watch, Doctors of the World). In 2011-12 she created and conducted photographic workshops for inmates in Spanish women's prisons with the support of the Audience Engagement Grant from OSI and La Caixa Foundation. In 2008, Ros received the Getty Grant for Editorial Photography.
Lorena recently became a mother; she lives with her baby daughter and her filmmaker partner between Barcelona and Mumbai.


text:
Is it time to reinvent the Irish birth cert?
Updated / Monday, 15 Nov 2021 12:32
'The inability to ascertain full and accurate birth certificate results in data gaps for LGBTQ families'
Opinion: the document's data and design needs to undergo significant transformation to reflect changes in Irish family structure
By Páraic Kerrigan and Amber L. Cushing, UCD
Birth certificates and the data that they gather play an important role in providing complete and accurate information on demographics, especially by linking people as families and identifying a person's origins. While countries around the world have modified the structure and practices surrounding the ways in which they document the event of birth and associate children with parents via the birth certificate, Ireland's birth certificate has remained largely unchanged since it was introduced under Victorian law in 1864.
The structure of the birth certificate, as it currently stands is orientated around normative categories of gender and sexuality, and accordingly, does not allow for the fluidity and multiplicity of gender and sexual identities that characterize the lived experience of many parents. This issue is particularly pertinent for LGBTQ families, who are often faced with more acute inequalities due to the structure of the birth certificate. This often renders LGBTQ parents invisible in the eyes of the state, and sometimes their children.
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From RTÉ Radio 1's Drivetime, Kathleen Funchion, Sinn Fein spokesperson for Children and Chairperson of the Children's Committee, talks bout new birth cert legislation
In 2020, we conducted a series of research interviews with LGBTQ parent families across Ireland and with Irish LGBTQ parents who have left the State due to current birth registration law. We wanted to find out about their experience with the Irish birth certificate and birth registration process, and how they think the birth certificate needs to be changed.
Many of these LGBTQ parents saw the birth certificate as an exclusionary tool that failed to gather accurate data about an LGBTQ parent family. Participants spoke to the fact that only one parent can be listed on birth certificate in most cases, due to the fact that the default fields of information (currently the standard is one "mother" and one "father" only) on the birth certificate cannot recognize same-sex parents. Many gay fathers noted how difficulties emerge with attempting to recognize only a father in their instance as Irish birth certificates require a mother,.
For all LGBTQ parents, children who are donor-conceived and born outside of Ireland to same-sex parents cannot be legally connected to both parents, often leaving one of the parents in limbo. There are many more permutations and variations of these cases, but exclusions such as these created significant vulnerabilities for both parent and child. It means the unnamed partner on the birth certificate does not have any legal role in making decisions for the child, particularly as it pertains to healthcare.
From RTÉ One's Six One News, same-sex couple legally recognised on twins' birth certs
The inability to ascertain full and accurate birth certificate results in data gaps for LGBTQ families. This leads to demonstrable negative effects when some of these families attempt to access services of the state, such as social welfare like the universal Child Benefit monthly payment. Some families have had to engage in legal battles to ascertain full rights for accessing the Child Benefit for monthly payment, resulting in a significant economic costs as a result of legal fees.
Some LGBTQ parents have had difficulties obtaining Irish passports for their children, largely related to the issue that a child can only obtain Irish citizenship by having an Irish citizen mother or father listed on the child's birth certificate. In cases where an Irish citizen was not the birth mother or genetic father, the second parent is not listed on the birth certificate, limiting a child's entitlement to Irish citizenship.
Some progress has been made in making the birth certificate more inclusive for LGBTQ parent families. The Children and Family Relationships Act legislates that if a child is born through assisted reproduction, both parents can now be on the birth certificate. However, this only applies if the parents are two women who conceive through an Irish fertility clinic and the child must have been born in Ireland. This change is very narrow and still excludes many families. Our preliminary data suggests that this process requires LGBTQ parents to engage in additional information management and documentation not required of heteronormative family structures, leading to unequal access to a birth certificate.
Many LGBTQ parents saw the birth certificate as an exclusionary tool that failed to gather accurate data about an LGBTQ family
The birth certificate and how it is structured is not just an issue that effects LGBTQ-parent families. Minister for Children, Equality, Disability, Integration and Youth Roderic O'Gorman is currently attempting to make a concession on a bill to give adopted people access to birth certificate and other personal information. While adopted people are significantly impacted by a lack of access to birth information, LGBTQ parents, as well as donor conceived children and children born via surrogacy are also impacted by the framework in which birth information is recorded on birth certificates in the Republic of Ireland.
What is clear is that birth certificate data and design needs to undergo significant transformation to take account of the diversification of family structure, particularly as it relates to LGBTQ families. This can come down to changing the field of information on the birth certificate to be more inclusive, such as changing "mother" and "father" to "parent 1", "parent 2" and perhaps allowing for additional parents to be listed, as is allowed in the Canadian Province of British Columbia. The process of collecting birth information and the design of the birth certificate must be reconsidered to enable a more accurate and fuller representation of LGBTQ families in Ireland, especially as the number of LGBTQ-parent families begin to increase in numbers.
Dr. Páraic Kerrigan is an Assistant Professor in the School of Information and Communication Studies at UCD. His first book, LGBTQ Visibility, Media and Sexuality in Ireland was published this year. He is a former Irish Research Council awardee. Dr. Amber L. Cushing is a Lecturer and Assistant Professor at the School of Information and Communication Studies at UCD. She is a former Irish Research Council awardee
Irish Research Council


text:
US: Columbia - Two police officers sentenced for using excessive force against a woman.
WASHINGTON—Franklin Brown, 35, and Eric Walters, 39, both former police officers with the city of Marion Police Department in Marion County, South Carolina, were sentenced to serve 18 months and one year and one day in prison, respectively, today in federal court in Florence, South Carolina, by U.S. District Court Judge R. Bryan Harwell for repeatedly tasing a former local female resident during the course of her detainment. For both defendants, three years of supervised release will follow the prison sentences and they each face a $100 special assessment. Brown and Walters previously pleaded guilty to violating the victim's civil rights during this incident.
According to court documents, on April 2, 2013, in the course of detaining the victim, Walters tased the victim causing her to fall to the ground and injure her head. Once she was on the ground, Walters continued to tase the victim multiple times. Brown subsequently arrived on scene and proceeded to tase the victim as she was seated on the curb, restrained in handcuffs and surrounded by law enforcement. Walters and Brown admitted there was no legitimate law enforcement purpose for repeatedly tasing the victim as she did not pose a threat to the officers.
"The defendants abused their authority as law enforcement officers by repeatedly tasing a defenseless, compliant victim," said Principal Deputy Assistant Attorney General Vanita Gupta of the Civil Rights Division. "Today's sentence is a reminder that this type of abusive and dishonorable behavior will not go unpunished."
"I thank the Marion Police Department, the FBI and the Civil Rights Division," said U.S. Attorney Bill Nettles of the District of South Carolina. "Due to their collective efforts in concert with our office, the officers in this case were brought to justice."
Today's sentence resulted from the investigative work of the FBI's Myrtle Beach Division. The case is being prosecuted by Trial Attorneys Henry Leventis and Nicholas Murphy of the Civil Rights Division, and Assistant U.S. Attorney John Potterfield of the District of South Carolina.


Initial briefing began in April 2003 for the remodelling of this 30-bedroomed sheltered housing scheme to provide Extra Care accommodation and new communal facilities. Working within Darlington Borough Council's Partnering Framework, Phil Newbold, Senior Associate at Dewjo'c Architects, managed the consultation, design and construction phases of this £2.4m project on a tight programme and with very challenging logistics.
New Teaching Block at Dixons City Academy, Bradford.