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Non-Small Cell Lung Cancer Coverage from Every Angle
David S. Ettinger, MD
Afatinib (Gilotrif®)
Posted: Wednesday, May 10, 2017
Afatinib is an irreversible pan-ErbB inhibitor, including EGFR (ErbB1), developed to treat lung cancers of different types, including those with epidermal growth factor receptor (EGFR) mutations. The LUX-Lung series of studies1-3 have evaluated the efficacy and toxicities of afatinib in both treatment-naïve patients with metastatic disease and in those with previously treated non-small cell lung cancer (NSCLC). The promising results of some of these trials led to approval of afatinib by the US Food and Drug Administration in 2013 for patients with advanced NSCLC and EGFR exon 19 deletions or exon 21 (L858R) substitution mutations.4,5 Afatinib is commonly referred to as an EGFR tyrosine kinase inhibitor (TKI).
Approximately 15% to 20% of patients with NSCLC will be identified as having activating EGFR mutations in their tumors, and this percentage may be even higher among non-smokers with adenocarcinomas. For patients with EGFR-mutant tumors, targeted therapy can yield high response rates, long periods of disease control, and improved quality of life compared with chemotherapy.7,8
Although it is the most recently approved EGFR TKI for first-line treatment of metastatic NSCLC, afatinib is one of the best studied agents, with excellent comparative data versus both chemotherapy and other TKIs, said Gregory J Riely, MD, PhD, a lung cancer expert and associate attending physician at Memorial Sloan-Kettering Cancer Center in New York City.
Explaining Treatment Choice to Patients: Why Afatinib?
One of the newest issues to arise in clinical practice relates to questions from patients and families about immunotherapy and why an EGFR TKI is being considered instead of immunotherapy. "Media is saturated with advertisements for immunotherapy whereas there are few, if any, advertisements for EGFR TKIs. So, offering targeted therapy takes some explanation," Dr Riely observed. "I usually start with the relatively uncommon incidence of EGFR mutations in the general lung cancer population—ie, much of what patients know about lung cancer in general doesn't necessarily apply to their particular situation." According to Dr Riely, the key piece of information is that the response rate for patients with EGFR mutations who are treated with an appropriate EGFR TKI—such as erlotinib, gefitinib, or afatinib--is much higher than for those treated with immunotherapy. "I also point out that this is the beginning of our treatment plan…this is what we recommend to start with. Nevertheless, as treatment proceeds, we might decide to switch to a number of different options and immunotherapy may be a reasonable treatment down the road." Additionally, Dr Riely pointed out that some subset analyses from immunotherapy trials have shown that patients with EGFR mutations benefit less from immunotherapy than those with wild-type EGFR.9
Finding the Right Dose for Every Patient
There is a sense among community oncologists that afatinib may be more difficult for patients to tolerate than earlier generation sensitizing EGFR TKIs such as erlotinib or gefitinib, noted Lecia V. Sequist, MD, Associate Professor of Medicine, Harvard Medical School. This is not necessarily true, Dr Sequist pointed out, although successful treatment with afatinib may require a different approach by the medical team.
The challenge when initiating therapy, explained Dr Riely, is finding the right dose and managing the usual toxicities of EGFR TKIs in a proactive way. Most clinicians initiate treatment with the recommended starting dose but there are idiosyncrasies in the toxicities for every patient that may signal the need for dose modification. The rates of dose modification may be slightly higher in patients on afatinib, Dr Riely said, "but we can almost always identify a tolerable dose for every patient."
Confirming the notion that dose reduction is appropriate, "it's important for clinicians to know that about 50% of patients who start afatinib at the approved starting dose (40 mg) will ultimately benefit from dose reduction," Dr Sequist said. "I usually tell patients upfront, 'We're going to start with the approved dose but it's hard to predict side effects merely on the basis of body weight, age, gender, etc. Different patients metabolize the drug differently. Overall, there is a 50-50 chance that we will need to reduce the dose. So we will start here, but we will have a low threshold to dose reduce if you start having difficulty. Recent data confirm that outcomes on afatinib are equally good for patients who underwent dose reduction compared with those who did not.' "10
Treatment Choice and Molecular Typing
There are some provocative data to suggest that afatinib might have some benefits compared with other TKIs, but nothing conclusive, Dr Riely observed. For instance, in a head-to-head trial of afatinib versus gefitinib, those who received afatinib had better outcomes with regard to some endpoints, including progression-free survival (PFS) and time-to-treatment failure, compared with gefitinib.11 Nevertheless, there was no significant overall survival difference between the 2 therapies. According to analyses from 2 additional trials that compared afatinib with chemotherapy, afatinib shows an overall survival advantage for patients with the exon 19 deletion mutation in EGFR, but this effect was not seen in those patients with the L858R EGFR mutation.12 Neither gefitinib nor erlotinib have demonstrated an overall survival advantage versus chemotherapy for patients with any EGFR mutation subtype. "So, one of the common views is that afatinib is the preferred drug for patients with exon 19 deletions, although we don't really know if erlotinib, for instance, wouldn't be equally effective," Dr Riely pointed out. "The efficacy data are not sufficiently different that I would make treatment decisions based on molecular typing. Large bodies of data suggest that they're roughly the same."
Dr Sequist agreed that the data are not conclusive on this point. "My personal practice tends to be to favor afatinib in the case of exon 19 deletion, as well as for some specific other rare EGFR mutations, including G719X, L861Q, or L858RS768I," she said. Dr Sequist, whose clinical work is at the Massachusetts General Hospital Cancer Center in Boston, noted, "Those are specific mutations for which there are good efficacy data with afatinib."13,14 (Editor's Note: According to afatinib approval and prescribing information, "safety and efficacy of afatinib have not been established in patients whose tumors have other EGFR mutations" [other than exon 19 deletions or exon 21 (L858R) substitution mutations]).
Preventing and Managing Afatinib Toxicities
Illustrating his overarching attitude toward EGFR TKI-induced adverse effects, Dr Riely explained, "Most patients will have some degree of rash, but what I emphasize is that we need to find a tolerable level of rash. I explain that our goal is to continue the therapy for many months and even years. This side effect [eg, severe rash] is not something, therefore, that we want patients to 'tough out.' We need to find the right management strategy and the right dose."
With proper education of both the clinicians and patients, Dr Sequist observed, using afatinib is quite feasible. "I don't restrict the use of afatinib to any particular tumor criteria, gender, or age cut-off, but patients should have a good performance status and not be frail. Anectodally, I have the most trouble with it in very thin and petite older women (>70 yrs)."
The 2 most common adverse effects with afatinib –and all EGFR TKIs—are rash and diarrhea.
Treatment-related rash takes longer to develop and is slower to respond to intervention compared with diarrhea. It is important to address and control rash as early as possible, as soon as it is identified, by beginning topical agents and oral antibiotics. Although the rash is acne-like, patients should be informed that the rash is not acne and therefore it should not be treated with over-the-counter agents for acne, which can exacerbate the rash. Dr Riely described his approach, saying, "I usually give patients a prescription for a topical corticosteroid that they can fill as soon as rash starts. If the rash becomes significant, the patient is asked to come in for evaluation. If the rash is serious, we may consider a course of oral antibiotics, typically doxycycline or minocycline."
Dr Sequist advocates taking a more proactive strategy with respect to afatinib-associated rash by prescribing a course of prophylactic antiobiotics. "I start everyone who goes on afatinib on an antibiotic (minocycline, doxycycline, or ciprofloxacin), with instructions to begin the antibiotic about 4 to 5 days after the afatinib (to distinguish the cause of any nausea). This is not included in the PI," she noted, but "in my opinion, it should be a universal recommendation for patients to be on a concurrent antiobiotic for at least the first 4 to 6 weeks of afatinib treatment, as it really seems to help with rash," she said.
"I usually schedule a 'teaching session' with patients and instruct them to call us if they are having trouble at home on the medication rather than just waiting for their next scheduled appointment. I also schedule that first visit about 10 to 14 days after they've started afatinib because that's when the rash emerges and I can get a good visual assessment of how things are going," she said.
Some patients on chronic treatment with afatinib or any EGFR TKI, struggle with paronychia. In general, "they should be cautioned about having debriding procedures, which are often done at a podiatrists' office and can worsen the condition," Dr Sequist observed. Topical corticosteroid can be helpful and, in refractory cases, a dermatologist can perform an avulsion, removing the lateral edges of a toenail, which tends to be very successful but is a permanent alteration of the toenail.
"Holding" Drug is Often Best Advice
When a patient is struggling with an adverse effect of an oral drug—whether it is rash or diarrhea or mouth sores—sometimes the best thing to do when the symptom is first reported by phone, according to Dr Sequist, is to advise them to just "hold" the medicine.
If patients are having trouble with moderate symptoms when they first start afatinib, "I tell them to hold the dose for about 5 to 7 days. This is for those situations where the side effect is substantial enough to be uncomfortable but not serious enough to signal a medical issue." In some circumstances, it will be clear that dose reduction is required. Often, though, after about a week off medicine, Dr Sequist explains that patients can re-start without the same level of side effects occurring again. "The same dose is often better tolerated the second time around," she commented.
Our goal is to continue the therapy for many months and even years. This side effect is not something, therefore, that we want patients to 'tough out.' We need to find the right management strategy and the right dose.
Sometimes patients will modify oral regimens on their own, thinking that they've figured out a well tolerated schedule. Perhaps they take drug for 5 days and then take 2 days off. This is particularly the case when they've been on treatment for several months. After a period of time, the safety profile can change. "You might not get the acute symptoms like rash or diarrhea, but you'll see nail changes or stomatitis," Dr Sequist said. The clinician needs to ask at each visit whether the patient is taking pills every day. "Although 'stop dose and hold' is a great strategy for dealing with acute toxicities, a chronic pattern of holding doses is not generally a good long-term approach," she explained. Frequent cycling on and off medication can result in more rapid development of resistance.15 It is better to dose reduce to a more tolerable dose than to take the medication intermittently. If necessary, it is important to educate patients about the risks for resistance associated with intermittent dosing.
Future Approaches
One of the ongoing trials looking at optimal first-line treatment for patients with EGFR mutations is afatinib monotherapy versus afatinib plus cetuximab.16 A second-line trial that explored the combination in patients who had developed resistance to a TKI showed that those who received the 2-drug combination had a response rate on the order of 30% to 40%.17 The premise of the current trial is to determine whether the demonstrated effectiveness of afatinib plus cetuximab in the resistant setting will translate to the first line. In addition, although response rates with EGFR inhibitor TKIs in the first line may be as high as 60% to 70%, the duration of PFS is 12 months or less. The goal of using a combination regimen would be to extend the duration of the PFS.
A second issue that arises is how long to continue treatment with an EGFR TKI after disease progression. Oncologists frequently recommended continuing the EGFR TKI indefinitely and added different chemotherapy regimens over time, as needed. However, according to findings from the IMPRESS trial, which studied this approach, there was no value in continuing the TKI beyond progression, especially when a standard platinum-based chemotherapy doublet is initiated.18
To avoid the "flare" that occurs in about 25% of patients when they come off TKIs, Dr Riely recommended "a minimal wash out during the period before chemotherapy begins; it may even be ok to continue the TKI very briefly after chemotherapy is started."
Describing typical sequential treatment for EGFR-mutated advanced NSCLC, Dr Riely explained that most patients begin with a sensitizing EGFR TKI in the first line—typically afatinib, erlotinib, or gefitinib--and then move to a platinum-based doublet—typically carboplatin or cisplatin with pemetrexed—on progression.19 However, about 60% of patients with progression may have an acquired mutation in T790M; targeted therapy with osimertinib is recommended for these patients.20 Then, for third- line treatment, they might be offered either immunotherapy or docetaxel. "There's some evidence that, from an efficacy perspective, docetaxel is superior to immunotherapy in this setting but the toxicity profile for immunotherapy is easier. Many patients prefer, therefore, to try immunotherapy first," he said.
"One of my key messages to oncologists is that dose reduction is OK," Dr Riely concluded. "These agents were originally developed for use in patients with wild-type EGFR and were dosed at their maximal tolerable dose. We now know that lower doses of EGFR TKIs are likely to be just as efficacious in these patients. Identifying a tolerable dose where patients can live relatively normal lives with less rash and less diarrhea is the best approach," he observed.
Gregory J Riely, MD, PhD, disclosed no relevant relationships.
Lecia V. Sequist, MD, has disclosed that she has received consulting fees from AstraZeneca, Genetech, Ariad Pharmaceuticals, Inc, and Bristol-Myers Squibb.
Boehringer Ingelheim. LUX-Lung clinical trial programme. Available at: http://www.inoncology.com/pipeline/our-trials/our-trials/non-small_cell_lungcancer/lux-lung-programme.html. Accessed March 20, 2017.
Joshi M, Rizvi SM, Belani C, et al. Afatinib for the treatment of metastatic non-small cell lung cancer. Cancer Manag Res 2015;7:75-82.
Sequist LV, Yang JC, Yamamoto N, et al. Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J Clin Oncol 2013;31:3327-3334.
NIH. National Cancer Institute. FDA approval for afatinib dimaleate. Available at: https://www.cancer.gov/about-cancer/treatment/drugs/fda-afatinibdimaleate. Accessed March 20, 2017.
FDA approves afatinib. U.S. Department of Health and Human Services. U.S. Food & Drug Administration. Available at https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm592558.htm. Accessed March 20, 2017.
Boehringer Ingelheim Pharmaceuticals, Inc. Gilotrif (afatinib). Full Prescribing Information. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/201292s000lbl.pdf. Accessed March 14, 2017.
Sequist LV, Bell DW, Lynch TJ, et al: Molecular predictors of response to epidermal growth factor receptor antagonists in non-small-cell lung cancer. J Clin Oncol 2007; 25:587-595.
Moran T. Timing of epidermal growth factor receptor tyrosine kinase inhibitor therapy in patients with lung cancer with EGFR mutations. J Clin Oncol 2012; 30:3330-6.
Lee CK, Man J, Lord S, et al. Checkpoint inhibitors in metastatic EGFR-mutated non–small cell lung cancer—a meta-analysis. J Thorac Oncol 2016; 12:403-407.
Yang JC-H, Sequist LV, Zhou C, et al. Effect of dose adjustment on the safety and efficacy of afatinib for EGFR mutation-positive lung adenocarcinoma: post hoc analyses of the randomized LUX-Lung 3 and 6 trials. Ann Oncol 2016;27:2103-2110.
Paz-Ares L, et al. Afatinib (A) vs gefitinib (G) in patients (pts) with EGFR mutation-positive (EGFRm+) non-small-cell lung cancer (NSCLC): overall survival (OS) data from the phase IIb trial LUX-Lung 7 (LL7) [abstract]. Presented at the European Society for Medical Oncology (ESMO) 2016 Congress, October 7-9, 2016; Copenhagen, Denmark. # LBA43.
Yang JC, Wu Y-l, Schuler M, et al. Afatinib versus cisplatin-based chemotherapy for EGFR mutation-positive lung adenocarcinoma (LUX-Lung 3 and LUX-Lung 6): analysis of overall survival data from two randomized, phase 3 trials. Lancet Oncol 2015;16:141-151.
Helgener DF, Schumann C, Sebastian M, et al. Afatinib in non-small cell lung cancer harboring uncommon EGFR mutations pretreated with reversible EGFR inhibitors. Oncologist 2015;20:1167-1174.
Yang C-H, Sequist LV, Geater SL, et al. Clinical activity of afatinib in patients with advanced non-small-cell lung cancer harbouring uncommon EGFR mutations: a combined post-hoc analysis of LUX-Lung 2, LUX-Lung 3, and LUX-Lung 6. Lancet Oncol 2015;16:830-838.
Foo J, Chmielecki J, Pao W, Michor F. Effects of pharmacokinetic processes and varied dosing schedules on the dynamics of acquired resistance to erlotinib in EGFR-mutant lung cancer. J Thorac Oncol 2012;7:1583-159.
Afatinib dimaleate with or without cetuximab in treating patients with newly diagnosed stage IV or recurrent, EGFR mutation positive non-small cell lung cancer. Available at: https://clinicaltrials.gov/ct2/show/NCT02438722. Accessed March 20, 2017.
Janjigian YY, Smit EF, Groen HJM, et al. Dual inhibition of EGFR with afatinib and cetuximab in kinase inhibitor-resistant EGFR-mutant lung cancer with and without T790M mutations. Cancer Discov. 2014;4:1036–1045.
Soria J-C, Wu Y-L,Nakagawa K, et al. Gefitinib plus chemotherapy versus placebo plus chemotherapy in EGFR-mutation-positive non-small-cell lung cancer after progression on first-line gefitinib (IMPRESS): a phase 3 randomised trial. Lancet Oncol 2015; 16:990-998.
Ettinger DS, Wood DE, Aisner DL, et al. NCCN Clinical Practice Guidelines in Oncology Non-Small Cell Lung Cancer, v4.2017. Available at https://www.nccn.org/professionals/physician_gls/default.aspx. Accessed April 17, 2017.
Janne PA, Yang JC, Kim DW, et al. AZD9291 in EGFR inhibitor-resistant non-small-cell lung cancer. N Engl J Med 2015;372:1689-1699.
Managing Rash Linked to TKIs
Drug class/description
Irreversible pan-ErbB kinase inhibitor
FDA Indication/patient eligibility
First-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations as detected by an FDA-approved test.
Limitation of Use: Safety and efficacy of afatinib were not established in patients whose tumors have other EGFR mutations
Treatment of patients with metastatic, squamous NSCLC progressing after platinum-based chemotherapy
Recommended dose: 40 mg orally, once daily
Take afatinib at least 1 hour before or 2 hours after a meal
For renal impairment: 30 mg orally, once daily in patients with severe renal impairment (estimated glomerular filtration rate [eGFR] 15 to 29 mL/minute/1.73 m2). Has not been studied in patients with eGFR < 15 mL/minute/1.73 m2 or on hemodialysis
Common AEs (≥20%)
Diarrhea, rash/ acneiform dermatitis, stomatitis, paronychia, dry skin, decreased appetite, nausea, vomiting, pruritus
Warnings and Precautions*
Diarrhea may result in dehydration and renal impairment or failure.
Severe bullous, blistering, and exfoliating lesions occurred in 0.2% of patients.
Interstitial lung disease (ILD) occurs in 1.6% of patients.
Fatal hepatic impairment occurs in 0.2% of patients. Monitor with periodic liver testing.
Keratitis occurs in 0.7% of patients.
Embryo-fetal toxicity
*For recommended dosage modifications and discontinuation recommendations, see full Prescribing Information
Adapted from Full Prescribing Information.6
Accessed March 20, 2017

redpajama_set_name: RedPajamaCommonCrawl


The president of the Sports Bureau Pun Weng Kun believes that Hong Kong's recent FIA Formula E race will have a positive influence on the Macau Grand Prix.
"I think it is a good thing that the neighboring region is organizing a car race. It will generate more interest from people," he told the media at the Macau Grand Prix blessing ceremony which took place on Wednesday at the Macau Grand Prix Building.
Pun believes that Hong Kong Formula E will only serve to enhance the Macau Grand Prix atmosphere. "Whether it is local residents or tourists, they will be more interested to come watch the race," Pun pointed out.
According to Pun, the authorities are facilitating a smooth preparation for the local race to be held at the famed Guia Circuit. This year's budget for the event amounts to MOP200 million, the same as last year.
Tickets for seats located at the Lisboa Corner are nearly sold out. The president expects that this year's sales of Grand Prix tickets will remain similar to those of last year.
"To date, ticket sales are similar to the ones in past years. For some particular zones, there are almost no tickets left," informed Pun.
Last year, the International Automobile Federation's World Touring Car Championship (WTCC) dropped from the local race calendar. "Macau Grand Prix has always been a popular car race in the world, and Macau is well-known for organizing the car race," said Pun.
Pun advised that information concerning the participation of the WTCC in the 2017 Macau Grand Prix will be revealed before then.
The 63rd Macau Grand Prix will be held from 17th to 20th November.
The Formula 3 Macau Grand Prix will be a FIA Formula 3 World Cup race. The race will also feature the FIA GT World Cup for the second time.
Tickets are available for MOP50 for practice days on November 17 and 18. Ticket prices for race days on November 19 and 20 range from MOP130 to MOP550.


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VIDEO: Auto Express gives us a look around the BMW iX3
Home » Models » BMW i » VIDEO: Auto Express gives us a look around the BMW iX3
May 1, 2018 / 2 minutes read
The BMW iX3 Concept recently debuted at the 2018 Beijing Auto Show and it gave us a glimpse at the beginning of BMW's future electric product offensive. It's a very important car for BMW, as it's going to be the brand's first mainstream fully-electric car. The BMW i3 was the brand's first-ever EV but it was a bit of an niche vehicle, designed primarily to be a funky, electric alternative to most city cars. This BMW iX3, though, is going to be a mainstream EV that will be able to act as a daily driver and primary vehicle to many customers and families.
In this new video from Auto Express, we get a bit of a look around the BMW iX3 in Beijing and we get to see what it looks like in the flesh, rather than in heavily edited photos on the internet. And in this video, it looks better than we expected.
Based on the current BMW X3, the new iX3 will be a traditional SUV. It's basically an electrified version of the BMW X3, just with some styling and powertrain changes. It looks similar to the X3 but it obviously has a new grille design, new front bumper and a new rear diffuser. It looks good and is very obviously a high-tech EV. However, it doesn't look too overly funky or weird, like the i3 is. But it isn't as bland or boring as a Tesla Model 3. It's a good combination of funky EV styling and normal car looks.
The BMW iX3 will have an electric powertrain developed by BMW and it will make 270 hp and have a total range of 249 miles. The latter is an impressive figure for an SUV and it's far more than enough for almost anyone on a daily basis. What's more, BMW claims that it will be able to charge almost 100 percent of its battery in just 30 minutes, thanks to 150 kW charging.
It's an interesting and impressive car, the BMW iX3 and if it drives anywhere near as well as the new X3 does, it's going to be a homerun. We can't wait to see the final production version, which we don't think will change much from this concept.
VIDEO: Listen to the S85 V10 Engine in all its Glory
More from BMW i
16 responses to "VIDEO: Auto Express gives us a look around the BMW iX3"
Hockenheim silver is so sexy /s
Scott Campbell says:
Great looking vehicle. Should be a real home run for BMW. 50 KW DC fast chargers are very rare in the USA. Porsche and BMW keep talking about all these super fast chargers but where are they and when will they be built. With the EV's larger batteries most people charge at home. When it comes to traveling cross country, flying is faster.
Sander says:
50kW dc chargers are the norm in Europe and soon that will be 350kW:
https://insideevs.com/first-public-175-kw-chargers-350-kw-from-spring-2018-now-open-in-europe/
https://electrek.co/2018/03/02/ultra-fast-electric-vehicle-charging-network-fastned-europe/
"We can barely keep up now. If you haven't been following, Europe is
completely onboard now with the 'ultra-fast' 350 kW charging technology
even before any electric car can actually take advantage of all that
And for the USA: https://arstechnica.com/cars/2018/04/electrify-america-will-deploy-2000-350kw-fast-chargers-by-the-end-of-2019/
"The charging sites will be in 17 metropolitan areas and on highways in 39 states."
athbr says:
There are thousands of 50kW chargers in the US. What are you talking about? The first of the 150/350kW chargers just opened. Go to plugshare and filter the "orange" CCS chargers.
CDspeed says:
The back end is awful, it's almost design-less, and the front is pretty plain but still has a bit of that awkward look from the ICE Model. BMW looked strong in the EV game when they launched the i3 and i8, but it's been messy ever since. They finally have a good base for an electric SUV but it looks odd, and it's built nowhere near the European Union. ( not that I have a problem with Chinese built cars, but it's a German brand for crying out loud.)
disqus_NdrthOMZ62 says:
BMW are a German brand with more than 2 dozen factories around the world for crying out loud, their largest in America, more to come. They have been co-producing in China for years, export 5 Series from there. Minis from The Netherlands, X3 from South Africa, soon 3 Series from Mexico.
johnbl says:
I'll stick with the X…
Alexander S says:
2020 or 2021 is a little bit late for BMW…Should bring it in 2019. Or at least make more range in 2020 than now…
Guillaume Perret says:
Sorry but I dont get the concept of building an electric SUV with conventionnal design.
Why the long hood ? Hope there is a trunk on the front if no more engine !
Jag is definitly onto something with the I-Pace. It is different but still looks like a Jag (ok… SUV…). BMW should look at them and not make extreme diesgn like i3 or very dull like this new iX3
BR117 says:
BMW said that they got feedback where customers said they want EVs that look like cars in the current lineup, which means customers wanted cars that follow conventional design with the traditional proportions and overall look. As an X3 owner, I'm very happy they made the iX3 look just like a normal X3 (especially the current G01 that has an awesome design) vs. changing the proportions like Jaguar did with the I-PACE. Even if the I-PACE interior is more space efficient and a longer hood doesnt make much sense and such practically, I do not like the look of the I-PACE. The proportions seem very strange to me visually, looking more like a hatchback than an SUV. I'd much rather they made the I-PACE look like an F-PACE, imo. I know you and other folks will disagree, but BMW is doing it right. Change one variable at a time and gauge customer response.
They might be right indeed, let's see what the market will do :-)
But I hope they will make something useful out of this long front space. But even as a "frunk", because SUV is higher, it wouldn't be practical at all.
What about space for a real spare wheel for example ???? that would be a nice "new" feature !
If they could make a 7 seaters out of a X3-like SUV instead, I am sure the market would respond well !
Yeah, the market and customer response should heavily dictate their decisions. I definitely agree that the frunk is very weird when you consider the size, hood length, and SUV height for sure, but until they get tcustomers get used to EVs, this is probably the best until they can try more 'radical' redesigns. I just hope they get it done a lot better than the I-PACE.
As for 7-seater, since I feel the X7 is coming out and the I have a strong feeling the Chinese will really like this one in particular, and since the Chinese like EVs, I'd definitely expect a 7 seater X7 EV with an iX7.
I am living in Munich ,here we don't call a X7 a SUV but a supertanker :-)
Horatiu B. says:
I'm in one right now :) it's big
Matt Stokes says:
Since the X3 will continue to be offered with Petrol, Diesel and Hybrid power trains, the body still needs to have an engine compartment. With this being the case, it is more cost effective and easier to scale up production, rather than develop a new vehicle from the ground up.
Hugo Becker says:
A Kia grille? ;-)


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SC&RA STS Symposium Review
With important global transportation issues, North American harmonization, safety and permitting topics on the agenda, the 2019 Specialized Transportation Symposium convened in Houston in February to a record attendance. Nearly 600 people attended the annual event that assembled a veritable Who's Who of the specialized transportation industry, including business and governmental leaders, permitting officials and many others who work in the heavy haul services and support realm.
New this year was the opportunity to sign up for one-on-one meetings with state permit officials and concurrent conference tracks on safety and permits.
"This new format gave attendees the ability to follow different tracks that better suit their business interests," said SC&RA Transportation Vice President Steven Todd. "This added a lot of value to the symposium, giving companies that sent two people or more the opportunity to leave with much more information and perspectives. The interactive format of each track encouraged best practices and practical application of tactics to everyday issues."
Federal Motor Carrier Safety Administration's (FMCSA) Larry Minor updated attendees on the proposed rules relating to hours-of-service and discussed how these changes may impact the heavy haul sector.
Engaging speakers
A highlight of the symposium was a presentation by former Navy SEAL Kevin "Dauber" Lacz. A co-star of the movie American Sniper, Lacz wowed the audience with combat lessons that can be applied to the business world.
"Life begins at the edge of your comfort zone," Lacz said. Receiving two standing ovations, the young combat veteran is the author of "The Last Punisher," his true account of his 2006 deployment with SEAL Team Three's Charlie Platoon with American Sniper Chris Kyle in Iraq.
For the first time, the American Association of State Highway and Transportation Officials (AASHTO) Freight Management Group conducted its annual meeting in conjunction with the SC&RA Specialized Transportation Symposium. This was hugely beneficial for STS attendees who could network with state and governmental officials from their respective regions.
AASHTO is a nonprofit, nonpartisan association representing highway and transportation departments in the 50 states, the District of Columbia and Puerto Rico. It represents all transportation modes and its primary goal is to foster the development, operation, and maintenance of an integrated national transportation system.
In the presentation Perspectives from Global Corridors, experts from around the world shared snapshots of specialized transportation concerns in Europe, Asia Pacific, Central America and Oceania. The panel included Jonathan Bhana-Thomson, chief executive, New Zealand Heavy Haulage Association; Steven Dunnewijk, general manager, Mammoet; André Friderici, director of Friderici Special SA and European Association of Abnormal Road Transport and Mobile Cranes; and Mathias Rehe, President, Daco Heavy Lift De Centro America.
Millennial hires
One of the most interesting panel presentations at this year's event addressed a key human resource issue across the specialized transport sector. Attracting and Retaining the Next Generation of Talent featured Kevin Kwateng, director of Heavy Haul Operations, Transport Bellemare International; Larry Wainscott, practice leader, Global Executive Solutions Group; and Nathan Barnhart, project sales representative, Barnhart. The panel, moderated by SC&RA's Director of Membership Jason Bell, discussed different recruitment trends and what works and doesn't work when hiring millennials.
The STS Exhibit Center showcased 56 companies.
The 2020 Specialized Transportation Symposium will be held February 18-21, 2020 at the Sheraton Charlotte Hotel in Charlotte, NC.
Exemplary drivers
Two heavy haul drivers were named SC&RA Drivers of the Year at the 2019 Specialized Transportation Symposium. Clay Bonnet of Berard Transportation and David Collins of Perkins STC accepted the award that is given for exemplary safety, integrity, talent and teamwork.
From left, David Collins of Perkins STC and Clay Bonnet of Berard Transportation were named SC&RA Drivers of the Year.
Clay Bonnet began his career with Berard in 1984 as a driver/rigger. Having never had a DOT recordable incident, Bonnet is a versatile driver. One of his greatest moves was a flawless trip in Texas last year hauling a 300,000-pound column that measured 16 feet high, 14 feet wide and 200 feet long. Bonnet serves as Berard's mentor for all new hires, riding along with each of them to evaluate their driving habits. In addition, he leads all pre-trip/pre-job safety briefings with third parties.
David Collins has been driving professionally for more than 20 years. He too has never had a recordable DOT incident. He began his career as a heavy haul driver with Perkins in 2011. He has pulled a variety of equipment, carrying an assortment of cargo including industrial boilers, Class 7 hazardous material, tanks, generators and transformers. In 2018, Collins pulled several engines with a gross weight of over 1.3 million pounds on the Perkins 400-ton dual-lane suspension beam trailer through the upper peninsula of Michigan, a project that was a year in the making. He serves as subject matter expert on Perkins' patented quantum trailer.
North America Conferences & Events Crane & Specialized Transport
Graham Brent announces retirement
Graham Brent will step down in the summer of 2022.


text:
How the UK's controversial anti-gay anti-test law could affect LGBT people in the UK
The UK's anti-bullying law has been condemned as a "gag law" that will cause a major disruption to LGBT people and their families.
But it's not just LGBT people who could suffer if this new law is enforced.
Many others could also lose their jobs and housing if the law is implemented, and the government could face legal action if it were to fail to comply.
What are the tests?
The new law allows the police to request information about people's sexuality and sexual orientation from anyone, including those living in foster care.
Anyone with an opinion that could be used in the law could also be investigated, and a public statement that "an opinion on homosexuality is contrary to the best interests of children" could be interpreted as a warning to anyone who disagrees.
People living with a mental health condition can also be questioned about their sexual orientation.
A police officer could also demand information from someone who "has recently experienced or experienced sexual contact with another person of the same sex", which could be an assault charge.
The law does not mention homosexuality or gender identity in its definition of "sexual orientation".
The government says it's a "legitimate and proportionate response" to those who are "being discriminated against in the workplace, housing, education and health services".
It has said the law "is about protecting children from bullying".
What do gay people think?
Some LGBT people are concerned about the new law, but others say it could actually be good for them.
"I think it is really good," says Jamie Wilson.
"[The law] might allow people to be more assertive about expressing their sexuality, which could allow more people to come out and be themselves."
But Jamie says he's "not in favour of making people uncomfortable".
"If they are being discriminated against, they should be able to come forward and speak about it," he says.
Jamie says he doesn't think the new legislation is likely to stop people from coming out, but he hopes that the law can help.
"The laws are just starting to come into place, but we should be talking about what can and can't be done about it now," he adds.
If you or someone you know needs help, contact the Samaritans on 08457 90 90 90 or visit their website.
Posted in: Properties Filed under: antigen test, gay test, purity test, rapid test
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text:
Development of Mental Health Indicators in Korea
Psychiatry Investig. 2012;9(4):311-318
Psychiatry InvestigJournal ArchivePsychiatry Investig. 2012;9(4)
Publication date (electronic) : 2012 November 14
doi : https://doi.org/10.4306/pi.2012.9.4.311
Hyeree Han1, Dong Hyun Ahn2, Jinhee Song1,3, Tae Yeon Hwang4, Sungwon Roh1,5
1Department of Mental Health Research, Seoul National Hospital, Ministry of Health and Welfare, Seoul, Republic of Korea.
2Department of Psychiatry, Hanyang University College of Medicine, Seoul, Republic of Korea.
3Department of Social Welfare, Catholic University of Korea, Bucheon, Republic of Korea.
4WHO Collaborating Center for PSR and CMH, Yongin Mental Hospital, Yongin, Republic of Korea.
5Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Correspondence: Sungwon Roh, MD, PhD. Department of Mental Health Research, Seoul National Hospital, Ministry of Health and Welfare, 398 Neungdong-ro, Gwangjin-gu, Seoul 143-711, Republic of Korea. Tel: +82-2-2204-0292, Fax: +82-2-2-2204-0280, swroh@korea.kr
Received 2012 May 17; Revised 2012 July 19; Accepted 2012 August 05.
Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea.
This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries.
We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders.
Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation.
Keywords: Mental health; Mental health indicator; Development
According to the results of an epidemiological survey on mental disorders, the lifetime prevalence of mental disorders - the percentage of population experiencing one or more mental disorders through life - in Korean adults (at the age of 18-64) is as high as 27.6%.1 Throughout the world as well, 120 million people are suffering depression and less than 25% of them are known to get adequate treatment.2 Moreover, social and economic burdens caused by mental disorders are increasing steadily, and according to the Global burden of disease project of the World Health Organization (WHO), mental disorders such as depression, alcohol use disorder, bipolar affective disorder and schizophrenia are included in the 20 major causes of disability. In particular, unipolar depressive disorder, which makes the biggest contribution to disease burden among mental disorders, ranked third in terms of contribution to disease burden in 2004 and is expected to be first in 2030.3 What is more, mental disorders show early onset age and cause high indirect expenses resulting from the reduction or loss of productivity at workplaces, and consequently they impose high economic burdens on society compared to physical diseases. Nevertheless, mental disorders are generally overlooked by policy makers due to lower mortality than physical diseases and social prejudice against mental disorders.
In order to reduce the serious social and economic impacts of mental health problems, it is necessary to survey the general status and level of mental health of the corresponding country and to monitor the trend of change periodically. Particularly in these days, statistical data are used in setting the priority of national policies or evaluating national projects and therefore it is necessary to create various mental health indicators through statistical surveys or reports and to utilize them in policy making. That is, mental health indicators are essential for monitoring people's mental health status in a country, developing mental health policies, and evaluating the performance of such policies. In addition, mental health indicators are required for comparison and benchmarking among countries.
Developed countries have developed mental health indicators systematically based on theoretical grounds as national projects not only for surveying people's mental health status and monitoring its trends but also for providing scientific grounds to policy makers and monitoring the processes and outcomes of policies. On the contrary, few mental health indicators have been developed in Korea. As to statistical data and indicator-related studies in Korea, epidemiological surveys on mental disorders and surveys on disabled persons are conducted in every five years and these surveys cover part of population with mental disorders. In addition, the National Health and Nutrition Survey collect data on mental health such as activity restriction caused by mental disorder, stress awareness level, depression and suicide impulse, and on drinking and smoking. Except these surveys, there are few national projects for monitoring mental health in Korea.
This study was conducted in order to review the current state of mental health indicator development in international organizations and major foreign countries and, based on the results, to develop and propose mental health indicators that can determine and monitor the current level of mental health in Korea, set the priority of promotion or resource allocation in projects to improve mental health, and enable international comparison.
Concept of mental health indicator
Mental health is one's state of well-being that enables the person to display his/her abilities, to cope with daily stress, to work productively and to contribute to community. Mental health in such a positive sense becomes the base of well-being and effective roles for individuals and community. In a positive sense, mental health may involve both health and diseases and, accordingly, everybody desires mental health and feels subjective health regardless of whether he/she has a mental disorder.4
Health indicators are scales not only on the health status of a population group but also on the general level or characteristic of all relevant items including health policy, healthcare system, healthcare resource, natural environment, size and composition of population, and people's perception and value of health.5 That is, they express the quantitative and qualitative aspects of health by comprehensively indicating systems and statuses related to a population group's health promotion and prevention of diseases.6
Accordingly, 'mental health indicators,' which combines the two concepts, are scales showing people's mental disorders as well as their positive mental health including subjective wellbeing and expressing the quantitative and qualitative state of policies and services promoted to solve mental health problems, to promote mental health and to prevent mental disorders. That is, these indicators are used to measure various aspects of mental health system like population groups' need of mental health services (e.g., the percentage of population belonging to vulnerable groups), resources invested in mental health service systems (e.g., the number of mental health professionals per 100,000 persons, and the percentage of budgets for mental health promotion programs in budgets for general health promotion), quality of service activities including the ways of delivering protection (e.g., the annual number of mental inpatients per 100,000 persons), and the effect of mental health services in service consumers (e.g., annual suicide rate, symptom reduction, disability level, quality of life).7
Indicator development in international organizations and other developed countries
Recently, several international organizations promoted indicator development projects. The Organisation for Economic Co-operation and Development (OECD) conducted the Health Care Quality Indicators Project, through which it defined mental health as one of the five priority areas, reviewed indicators in the member countries, and developed internationally comparable indicators on the quality of mental health.8 WHO performed a indicator development project for evaluating mental health policies and services usable in underdeveloped countries in order to solve the problem that over 24% of 202 areas, including the member states, associated members, territories, and areas, did not have systems for collecting and reporting mental health information and that mental health evaluation and monitoring tools used in developed countries are not applicable to developing and underdeveloped countries in terms of objective, scope, structure and contents.9 The European Union (EU) also promoted the Mental Health Information and Determinants for the European Level (MINDFUL) project based on previous projects for improvement in mental health information and comparison among its member countries with the object of expanding the scope of mental health monitoring systems so that they comprehend not only negative mental health but also positive mental health, mental health promotion, and mental disorder prevention.10
Among individual countries, the U.S., Australia, the U.K., Scotland, etc. have developed indicators in order to monitor the performance and services of mental health. The U.S. developed indicators on the performance of mental health services to meet consumers' needs actively,11 and Australia developed indicators on the performance of mental health services in public sectors in connection to the strategic directions of national mental health plans and characteristically it included indicators related to safety.12 In the U.K., mental health indicators have been used in evaluating the performance of the Mental Health Trust since 2001,13 and the indicators were designed jointly by the government, the Commission for Health Improvement, and the Ministry of Health. Developed indicators aim to help people understand the performance of community health services and to provide information easily and conveniently, and every year new indicators are developed in the process of setting the goals of the National Health Service in order to reflect changes timely and evaluate performance properly.14 Scotland gives national priority to mental health promotion and promotes national visions such as people's mental health, quality of life, welfare, and social integration of those with mental disorders or mental health problems. Moreover, it has defined the concept of mental health in two aspects, namely, mental health problems such as anxiety and positive mental health such as satisfaction with life and positive relations with others, and developed mental health indicators focusing on the measurement of positive mental health.15 Table 1 summarizes the current state of indicator development in international organizations and major countries as presented above.
Indicator development of international organizations and other countries
The characteristics of mental health indicator development in foreign countries are as follows. First, the objectives of mental health indicator development reflect each country's national mental health strategies and aim at measuring and monitoring the performance of current national mental health policies for mental health promotion. In case of international organizations, indicators are developed mainly to compare the quality of mental health among countries. Second, most countries are making efforts to build up a comprehensive frame including the performance of mental health policies, the provision of services, each population group's current mental health status, etc. in order to measure the performance of mental health services. Third, the concept of mental health is being expanded so that it connotes not only mental disorders but also personal protection factors of positive mental health such as resilience, self-esteem and self-efficacy. Fourth, with regard to the contents of indicators, consumers' viewpoint emphasizing consumers' experience in provided mental health services is being introduced in addition to the current state of mental health like mental disorders and the contents of mental health services. Introducing these kinds of indicators will contribute to changing mental health services consumer-centered. Fifth, indicator systems for inter-regional comparison and frameworks for standardized measurements are being developed. Sixth, the development of mental health indicators does not take place in a short period but goes through long-term refinement and revision.
Principles of developing mental health indicators in Korea
This study attempted to develop indicators that reflect the current state of mental health in Korea, the objectives of national policies and people's needs of mental health, and are internationally comparable. In addition, indicators were developed with the object of enhancing quality of mental health, improving mental health facilities and personnel, upgrading the quality of mental health service, respecting the human rights of people with mental disorders, and using limited mental health resources efficiently and effectively.
For the development of mental health indicators in Korea, we made an effort to include mental health indicators of Health Plan 201016 and the National Mental Health Commission report17 (Table 2). Health Plan 2010 was a national plan intended to improve the accessibility of mental health service, the level of national mental health and the quality of life of people with mental disorders. The National Mental Health Commission developed some indicators to assess community mental health services.
Mental health related indicators in Korea
In developing indicators, we focused on adults and the scope of indicators comprehended mental health problems including mental disorders, resources including manpower, facilities and finance, mental health services, risk and protection factors, etc. Moreover, the scope of mental health services was divided into five domains, that is, mental health status, mental health factor, mental health system, mental health service, and the quality of mental health services so that it includes prevention, treatment, continuous management and early interventions, and divided again into 21 subdomains according to the nature of indicators (Table 3).
Expert survey results of mental health indicator categories
'Mental health status' covers positive mental health and mental health problems including mental disorders, and 'mental health factor' covers personal factors and environmental factors that may affect mental health. 'Mental health system' includes indicators related to mental health resources and covered policies and plans related to mental health, organizations and human resources involved in mental health services, and budgets and finance. 'Mental health service' comprehends all mental health activities conducted in the area of mental health including services for the prevention, treatment, and rehabilitation of mental disorders, and 'Quality of mental health' includes indictors to measure whether mental health services enhance the level of mental health and whether such services are provided based on evidence.
By reviewing indicators developed in Korea and major foreign countries presented above, we collected around 600 indicators. Then, in consideration of their redundancy and availability, the principles of indicator development in this study, and the indicator system, we reduced them into 22 indicators on mental health status, 8 on mental health factor, 29 on mental health system, 38 on mental health service and 27 on the quality of mental health services, so a total of 124 indicators in the 1st questionnaire.
Expert questionnaire survey
We conducted the 1st and 2nd questionnaire surveys with experts recommended by academic societies related to mental health in Korea. In detail, we recruited 19 participants who have expertise in the area under investigation from the following societies: Korean Neuropsychiatric Association, Korean Society of Clinical Psychology, Korean Association of Mental Health Social Workers, and Korean Academy of Psychiatric and Mental Health Nursing.
The purpose of the surveys was to collect the experts' opinions on the fitness of mental health indicators developed by the authors. Based on the results of the 1st questionnaire survey, the 2nd questionnaire was developed through adding new indicators and revising the terms of indicators. The 1st questionnaire survey presented each expert indicator categories and 124 indicators developed by the authors, and had them rate the importance of each indicator domain/subdomain and item on a 5-point scale. Then, the importance of the indicator categories and items was assessed by the mean score and the proposed indicators were revised.
Indicator categories
In the results of the questionnaire survey on the suitability of indicator category, adequacy was high in order of mental health system, mental health service, mental health status, the quality of mental health services, and mental health factor among the 5 higher domains. Among the subdomains, those belonging to mental health system such as policies and plans, organizations, finance, and human resource, and those belonging to mental health service such as early interventions, treatment and rehabilitation attained a high score, showing high consistency with the results on the fitness of the 5 higher domains. In the questionnaire for assessing the importance of individual indicators, 40 out of the 124 indicators got a mean score of 4 or higher.
We developed the 2nd questionnaire containing a total of 127 indicators by revising terms and adding new indicators based on experts' opinions collected in the 1stt questionnaire survey. The 2nd questionnaire survey presented the results of the 1st survey and the revised questionnaire. As in the 1st questionnaire survey, the respondents rated the importance of each indicator category and item at a 5-point-scale, and then the fitness and importance of the indicator categories and individual indicators were assessed by the mean score. In the 2nd questionnaire survey, the suitability of mental health system and mental health services was also rated high and this result was mostly consistent with the results on the subdomains. To put it concretely in the results on the subdomains, 'policies and plans,' 'organizations,' 'human resources' and 'finance' belonging to mental health system, and 'early interventions' and 'treatment' belonging to mental health service showed high importance (Table 3).
Mental health indicators
In the results of expert survey on individual indictors, the number of indicators scoring 4 or higher was 59 out of 127, which was 19 larger than that in the 1st survey. Among the top 30 indicators based on the mean score, 10 belonged to 'mental health system' and this is considered to suggest the importance of resources such as policies, organizations, human resources and finance in understanding the current situation of mental health and making related policies in Korea. Moreover, indicators in the subdomain of 'mental health problem' ranked high. In particular, 'suicide rate' ranked first probably because of the rapidly increasing number of suicides. Besides, the annual prevalence of mental disorders, depression and alcoholism was found to be an important indicator. It is also considered necessary to measure social and economic burdens caused by mental disorders including socioeconomic expenses resulting from mental disorders and suicides (Table 4).
Thirty key mental health indicators
As a preliminary study for developing mental health indicators that reflect the current situation of Korea, this study reviewed mental health indicators in Korea and other countries and proposed individual indicators in the domains of mental health status, mental health factor, mental health system, mental health service, and the quality of mental health services.
These indicators include the objectives of mental health suggested in national health policies such as Health Plan and the objectives of national mental health plans suggested by the National Mental Health Commission. Moreover, we aimed to develop indicators that can assess the current situation of mental health, suggest the future directions of policies, and monitor the quality of current mental health services and evaluate its trend. In particular, we included equality as a quality indicator in order to measure difference in the quality of mental health among areas and ultimately to spot inequalities among areas and redistribute resources in this age of decentralization. What is more, we tried to develop internationally comparable indicators by including mental health indicators used in international organizations such as WHO and OECD and foreign countries.
Various socioeconomic changes such as economic crisis, unemployment and poverty experienced by our society are becoming the risk factors of mental health causing chronic mental disorders as well as depression, suicide, stress and addiction. Mental health services for solving these problems are faced with diverse challenges in addition to their traditional tasks like chronic mental disease patients' returning to community, higher effectiveness of treatment services, human rights promotion, and enhanced quality of life. Although the mental health system of Korea has achieved quantitative expansion steadily including the increase in the number of mental health institutions and community mental health centers since the Mental Health Act in 1995, it is still incompetent to cope with various mental health problems.17 In this situation, it is considered very desirable to conduct research for developing mental health indicators that represent the current state of mental health and mental health system and the quality of mental health services comprehensively.
As the indicators developed in this study targeted only adults not children, adolescents or elderly people, however, further research is required on the tasks below for the use of the results of this study. First, we need to obtain the values of the indicators using the indicator calculation models in order to monitor the current situation of mental health in Korea and improve the unmet needs. That is, by monitoring changes in the calculated values of the indicators, we may be able to evaluate the performance of government policies and monitor the trends of mental health. In other words, we can lay the base for a system to monitor national mental health policies through assessing the level and performance of mental health policies according to the directions and objectives of national mental health policies and through periodically monitoring national mental health policies for providing information necessary in policy making. Second, we need to accumulate indicators continuously and analyze them periodically, and utilize the results as materials for effective policy making. Third, we need to regularize national surveys with annual refinement of the developed mental health indicators and to develop standardized questionnaires for the surveys. Fourth, future studies developing dimensional mental health indicators are warranted because it is also important to measure the status of mental health not only categorically but also dimensionally.
The ultimate objectives of the development of mental health indicators are to find unsatisfactory parts or new needs by surveying the current state of mental health and mental health services, to reflect them in policies for high-quality mental health services, and ultimately to enhance people's mental health level. The mental health indicators proposed in this study are expected to be useful tools contributing to improving people's mental health by assessing the performance of mental health policies in connection to mental health problems and services, analyzing trends in mental health problems and mental health policies over time, and providing high-quality mental health services.
This study was conducted with the support of Lee Si-Hyung Social Psychiatry Research Fund of the Korean Foundation of Neuropsychiatric Research (DHA and SR) and the National Center for Mental Health Research and Education of Seoul National Hospital (HH). The authors would also like to acknowledge the contributions of the participating experts: Jeongyee Bae, RN, PhD, Inje University; Yong-Mae Baek, PhD, Catholic University of Daegu; An Kee Chang, MD, Seoul National Hospital; Duk Hee Chun, PhD, Tongwon College; Duck-Gyu Kang, PhD, Haein Mental Health Center; Donghyeon Kim, MD, Choongmoosarang Hospital; Sun Ah Kim, RN, PhD, Yonsei University; Yoon Kim, MD, PhD, Seoul National University; Jong-Eun Lee, RN, PhD, Inha University; Jonggook Lee, MD, Yong-In Mental Hospital; Woo Kyeong Lee, PhD, Yong-In Mental Hospital; Yu Jin Lee, MD, PhD, Gachon University; Kyoung A Nam, RN, PhD, Ajou University; Jong-Woo Paik, MD, PhD, Kyung Hee University; Yongjin Seo, MD, Yong-In Mental Hospital; Jun Mo Sung, PhD, Korea Nazarene University; Hae-Joo Yoon, MA, Seoul National Hospital.
1. Cho MJ. The Epidemiological Survey of Mental Disorders in Korea 2011. Seoul: Ministry of Health and Welfare.
2. 10 facts on the global burden of disease Accessed May 7, 2012. Available at: http://www.who.int/features/factfiles/global_burden/en/index.html.
3. World Health Organization. The Global Burden of Disease: 2004 Update 2008. Geneva: World Health Organization.
4. Herrman H, Saxena S, Moodie R, eds. Promoting Mental Health: Concepts, Emerging Evidence, Practice 2005. Geneva: World Health Organization.
5. World Health Organization. Constitution of the World Health Organization 1948. Geneva: World Health Organization.
6. Yoon CK, Yoon BJ, Lee JH, Kim YS. A study on development of health indicator system in Korea. Korean J Health Policy Adm 2003;13:44–66.
7. World Health Organization. Mental Health Policy and Service Guidance Package: Mental Health Information Systems 2005. Geneva: World Health Organization.
8. Hermann R, Mattke S. Members of the OECD Mental Health Care Panel. OECD Health Technical Papers NO. 17. Selecting Indicators for the Quality of Mental Health Care at the Health Systems Level in OECD Countries 2004. Paris: Head of Publications Service, OECD.
9. Saxena S, Lora A, van Ommeren M, Barrett T, Morris J, Saraceno B. WHO's Assessment Instrument for Mental Health Systems: collecting essential information for policy and service delivery. Psychiatr Serv 2007;58:816–821. 17535942.
10. MINDFUL-Mental Health Information and Determinants for the European Level Accessed May 8, 2012. Available at: http://info.stakes.fi/mindful/EN/frontpage.htm.
11. Mental Health Statistics Improvement Program's Consumer-Oriented Mental Health Report Card Accessed May 8, 2012. Available at: http://www.mhsip.org/reportcard/.
12. National Mental Health Performance Subcommittee. Key Performance Indicators for Australian Public Mental Health Services: Technical Specification Summary 2008. Canberra: Department of Health and Ageing, Commonwealth of Australia.
13. Department of Health. NHS Performance Ratings: Acute Trusts, Specialist Trusts, Ambulance Trusts, Mental Health Trusts 2001/02 2002. London: Department of Health Publications.
14. Commission for Health Improvement Accessed May 8, 2012. Available at: http://www.chi.nhs.uk/Ratings/Trust/Overview/mht_overview.asp.
15. Parkinson J. Establishing a Core Set of National, Sustainable Mental Health Indicators for Adults in Scotland: Final Report 2007. Edinburgh: NHS Health Scotland.
16. Suh MK, Kim HR, Suh T, Sun WD, Shin YJ, Choi EJ, et al. Establish of New Health Plan 2010 2005. Seoul: Korea Institute for Health and Social Affairs, Ministry of Health and Welfare.
17. National Mental Health Commission. 2007 National Mental Health Commission Report 2008. Seoul: Ministry of Health, Welfare and Family Affairs.
OECD: Organisation for Economic Co-operation and Development, WHO: World Health Organization, AIMS: Assessment Instrument for Mental Health Systems, EU: European Union, MINDFUL: Mental Health Information and Determinants for the European Level, MHSIP: Mental Health Statistics Improvement Program, NHS: National Health Service


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Q: Scroll visible content in JPanel How can I move the visible part of JPanel? I mean I have a set of tabs that can be dynamically created and closed (similar to browser tabs) and at some point there might be too much of them to be visible so I'd like to add buttons to move the view left and right. I thought about adding a JScrollPane with setHorizontalScrollBarPolicy=HORIZONTAL_SCROLLBAR_AS_NEEDED but it results with quite ugly... scroll. How can I create just buttons to manipulate the visible part of the panel?
The code responsible for the tabs is pretty much something like this:
private JPanel tabsPane;

private JComponent createItemsPane() {
        tabsPane = new JPanel();
        tabsPane.setOpaque(false);
        tabsPane.setLayout(new BoxLayout(tabsPane, BoxLayout.X_AXIS));
        return tabsPane;
    }

public void addTab(TabCaption item) {
        tabsPane.add(item);
    }

Alternatively, I'd like to move the change the visible part so that selected tab is always displayed...

A: If you don't want the scrollbars to show, you can the the vsb and hsbPolicy accordingly. Then, add a bunch of buttons for manipulating the JViewPort of the JScrollPane:
JPanel comp = new JPanel();
comp.setLayout(new GridLayout(1, 20));
for (int i = 0; i < 20; i++) {
    comp.add(new JLabel(String.format("  %d", i)));
}

JScrollPane scroll = new JScrollPane(comp, JScrollPane.VERTICAL_SCROLLBAR_NEVER, JScrollPane.HORIZONTAL_SCROLLBAR_NEVER);
BiConsumer<Integer, Integer> setview = (x, y) -> {
    Point p = scroll.getViewport().getViewPosition();
    scroll.getViewport().setViewPosition(new Point(p.x + x, p.y + y));
};
JButton left = new JButton("<");
left.addActionListener(e -> setview.accept(-10, 0));
JButton right = new JButton(">");
right.addActionListener(e -> setview.accept(+10, 0));

JFrame frame = new JFrame();
frame.setDefaultCloseOperation(JFrame.EXIT_ON_CLOSE);
frame.setLayout(new BorderLayout());
frame.add(scroll, BorderLayout.CENTER);
frame.add(right, BorderLayout.EAST);
frame.add(left, BorderLayout.WEST);
frame.pack();
frame.setVisible(true);

The Frame starts with size large enough, but if you shrink the window you can use the buttons to scroll. You might also want to disable or hide the buttons depending on the current viewport.

redpajama_set_name: RedPajamaStackExchange


text:
Find a Doctor/Pediatrics/TX/Houston
Dr. Gina Stephen, MD
Languages supported at her practice: English
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Dr. Stephen's Background
Dr. Stephen, MD is a practicing Pediatrician in Houston, TX. She completed a residency at New York Methodist Hospital. She currently practices at Pediatrics of Greater Houston PLLC and is affiliated with The Woman's Hospital of Texas. Dr. Stephen accepts multiple insurance plans including Aetna, Humana, and Imagine Health - SmartCare. Dr. Stephen also practices at Pediatrics of Greater Houston Kingwood in Kingwood, TX.
Dr. Stephen, MD is a practicing Pediatrician in Houston, TX. She completed a residency at New York Methodist Hospital. She currently practices at Pediatrics of Greater Houston PLLC and is affiliated...Dr. Stephen, MD is a practicing Pediatrician in Houston, TX. She completed a residency at New York Methodist Hospital. She currently practices at Pediatrics of Greater Houston PLLC and is affiliated with The Woman's Hospital of Texas. Dr. Stephen accepts multiple insurance plans including Aetna, Humana, and Imagine Health - SmartCare. Dr. Stephen also practices at Pediatrics of Greater Houston Kingwood in Kingwood, TX. More...Less
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Iran military advisory presence in Iraq, Syria aimed at fighting terrorism: Shamkhani
Tuesday, 22 May 2018 5:07 PM [ Last Update: Tuesday, 22 May 2018 5:21 PM ]
Secretary of Iran's Supreme National Security Council (SNSC) Ali Shamkhani
A senior Iranian official says legitimate governments of Iraq and Syria have called for Iran's military advisory presence in their countries in order to help them fight terrorism.
Secretary of Iran's Supreme National Security Council (SNSC) Ali Shamkhani made the comments on Tuesday after US Secretary of State Mike Pompeo said on Monday that Washington will increase the financial pressure on Iran by imposing the "strongest sanctions in history" on the Islamic Republic if Tehran refuses to change the course of its foreign and domestic policy.
PressTV-US warns Iran of 'strongest sanctions in history'
The US secretary of state says Washington will impose the strongest sanctions in history against Iran.
Speaking weeks after the United States' move to pull out from a nuclear agreement Iran signed with major powers in 2015, he laid out 12 tough conditions for any "new deal" with Tehran. The conditions included withdrawal of Iran's military advisors from Syria and the Islamic Republic's respect for the Iraqi government's sovereignty.
Shamkhani said the world confirms that Iran has played a leading role in preventing the expansion of Daesh in Iraq, Syria, Lebanon and even Europe.
"The ire of the US and this country's allies, who were the main creators and sponsors of Takfiri terrorism and the final losers of this battlefield, is understandable," the SNSC secretary added.
He emphasized that the "futile" US efforts to limit the Islamic Republic's strength indicates Washington's weakness and is a clear indication of Iran's power in domestic and foreign arenas.
Elsewhere in his remarks, the senior Iranian official said the Islamic Republic's enrichment right has been officially recognized in the United Nations Security Council Resolution 2231.
The continuation of Iran's nuclear program has been outlined in the international nuclear agreement, Shamkhani said, adding, "This dossier has been closed and the nuclear negotiations will never be open again under any conditions."
He noted that US President Donald Trump made the decision to pull Washington out from the nuclear deal as he imagined that he could impose his conditions on Europe and win the support of the American people but neither Europeans nor other countries backed him.
The US president announced on May 8 that Washington was walking away from the nuclear agreement, officially known as the Joint Comprehensive Plan of Action (JCPOA), which was reached between Iran and the five permanent members of the UN Security Council - the US, Britain, France, Russia and China - plus Germany.
Trump also said he would reinstate US nuclear sanctions on Iran and impose "the highest level" of economic bans on the Islamic Republic.
Iran has said it would remain in the JCPOA for now, pending negotiations with the other signatories in the coming weeks before making a final decision on its future role in the agreement. Tehran wants the Europeans to give it clear-cut guarantees about fulfilling their obligations if it remains in the accord.
After the US secretary of state demanded broad changes in the course of the Islamic Republic's foreign and domestic policy, Iranian President Hassan Rouhani said later on Monday that the United States cannot make decisions for Iran and other independent countries.
PressTV-World never accepts US deciding for all: Rouhani
The Iranian president says the United States cannot make decisions for Iran and other independent countries in the world.
"All world countries want independence in their decisions and perhaps Americans are able to advance their agenda in some places through pressure, but logic does not accept them making decisions for the world," Rouhani said.
Russia's Permanent Representative to the Vienna-based International Atomic Energy Agency (IAEA) Mikhail Ulyanov also said on Tuesday that Washington's recently-outlined demands of Iran are nonsensical because they left no chance for clinching any new deal.
PressTV-Pompeo's demands of Iran 'nonsense': Russian envoy
Russia's envoy to the IAEA says Washington's demands of Iran are nonsensical because they left no chance for clinching any new deal.
"That's nonsense, nothing can be agreed on this basis," Ulyanov said from Vienna in a video conference.
Iran Iraq US Syria Ali Shamkhani
Iran decries political abuse of plane crash
Ayatollah Khamenei: US disgraced after assassination of top general
Iran lays victims of plane crash to rest


A powerful blast rocked a busy market Monday, February 4 in the Somali capital, which is regularly targeted by Al-Shabaab, police said.
Mohamed said the market was near Mogadishu's municipality buildings.
"The blast occured close to Mogadishu mall and it has caused death and destruction. Nine civilians were confirmed dead and several others are wounded," police officer Ahmed Moalin Ali said.
Earlier Monday, a gunman shot Maltese national Paul Anthony Formosa, manager of the port of Bossasso in semi-autonomous Puntland state for P&O Ports, a subsidiary of the Dubai-based DP World.
The Dubai government confirmed the death in a statement on Twitter and said the circumstances of the incident was being investigated.
"Three other employees have been injured in this morning's incident, and all are currently receiving medical treatment," the statement said.
The group also claimed responsibility for the car bomb in Mogadishu, via a statement on a pro-Shabaab website.
Al Shabaab jihadists seeking to topple the internationally-backed government regularly carry out attacks in the Somali capital.
The al-Qaeda affiliated group was largely driven out of Mogadishu in 2011 and has lost many of its strongholds, but it retains control of large rural swathes of the country and continues to wage a guerrilla war against the authorities.
On January 16, Al Shabaab attacked an upmarket hotel complex in the Kenyan capital Nairobi, killing 21 people during a day-long siege.
This story was updated throughout the day on February 4, 2019.


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Episode 265: Leah Gilliam
Tagged as:	artist, brooklyn, design strategist, filmmaker, Girls Who Code, Leah Gilliam, Lesberation, New York City
https://dts.podtrac.com/redirect.mp3/audio.simplecast.com/7beb800e.mp3
Leah Gilliam is a force. As an award-winning artist, she uses technology to tell stories, bring awareness to issues, and to ask questions about important topics. And as a design strategist, she lends her expertise with building inclusive spaces to organizations like Out in Tech and Girls Who Code, where she currently serves as VP of strategy and innovation. Did I mention she's also a creator who has made everything from 16mm films to interactive installations to board games?
Like I said, Leah Gilliam is a force.
We sat down to talk about how she first got involved in design strategy, and from there we explored her work as an artist and a teacher, and dove into topics surrounding creativity, finding balance, solving projects, and the notion of a Black queer design aesthetic. I'm so grateful to have the opportunity to share Leah's story and her work with you, so make sure you take a listen!
Leah Gilliam on Wikipedia
Leah Gilliam on Twitter
Leah Gilliam at Out in Tech
Episode 250: Julian Alexander
Tagged as:	brooklyn, creative director, entrepreneur, GRAMMY, graphic designer, Julian Alexander, new york, School of Visual Arts, Slang Inc., SVA
https://dts.podtrac.com/redirect.mp3/audio.simplecast.com/7a6fef01.mp3
For our 250th episode, I'm so honored to bring you this conversation with creative director, graphic designer, and entrepreneur Julian Alexander. Julian may be most well known for designing the album cover for 50 Cent's Get Rich or Die Trying, and his design work on the Miles Davis box set The Complete Jack Johnson Sessions even earned him a GRAMMY for art direction! Even with those huge accolades under his belt, Julian is a really humble guy, and I think that really comes through in the interview.
We talked about how he got his start in design, his time as a design director for Sony Music, and I asked how his career changed for him after winning the GRAMMY. We also discussed the relationship between design and music, some of his current projects through his studio Slang Inc., and gave some really great advice for designers of all levels. Julian is a true champion for design and designers, and I'm so glad to be able to share his story with you all.
Cheers to 250 episodes of Revision Path!
Slang Inc.
Slang Inc. on Instagram
Julian Alexander on Discogs
Episode 249: Mikell Fine Iles
Tagged as:	Bloomberg, brooklyn, Clark Atlanta University, design director, JWT, Mikell Fine Iles, New York City, Noise, San Francisco
https://dts.podtrac.com/redirect.mp3/audio.simplecast.com/c30fdc4e.mp3
There's no single way to becoming a designer these days, which I suppose is one of the most interesting things about this industry. Mikell Fine Iles, for example, grew up in San Francisco around art and design, went to Clark-Atlanta University for school, studied more design in Denmark, and worked for agencies Noise and JWT before his current position at Bloomberg as design director. And there's more!
We started our conversation talking about Mikell's day-to-day work at Bloomberg, and from there talked about his time in Atlanta as a student and young professional, discussed what HBCUs can do to prepare the next generation of designers, and he talked about his time studying design in Denmark! Mikell's talent, drive and hustle have really helped propel him to success.
Mikell Fine Iles' Website
Mikell Fine Iles on LinkedIn
Episode 240: Jonathan Jackson
Tagged as:	brooklyn, creative director, Jonathan Jackson, Kent State University, New York City, partner, WeShouldDoItall, WSDIA
https://dts.podtrac.com/redirect.mp3/audio.simplecast.com/f92d6f4c.mp3
"WeShouldDoItAll isn't just a name — it's a way of life." And let me tell you, Jonathan Jackson was not kidding when he said that. As creative director and partner of the award-winning, Brooklyn-based studio, he and his team have done all kinds of work from websites to fashion to large scale exhibitions. And there's even more!
Jonathan talked to me about his early days at Kent State University, and how his love for architecture planted the seed for what would become WSDIA. We also spent a good bit of time going over how he runs the studio, covering everything from dealing with clients to balancing incoming projects. Jonathan has a lot of great advice for everyone from studio owners to up and coming designers, so this is an interview where you'll definitely want to take notes!
WeShouldDoItAll on Twitter
WeShouldDoItAll on Instagram
WeShouldDoItAll on Facebook
Episode 194: Datrianna Meeks
Tagged as:	brooklyn, Datrianna Meeks, general assembly, howard university, New York City, product designer, School of Visual Arts, Spotify, SVA
https://dts.podtrac.com/redirect.mp3/audio.simplecast.com/67489.mp3
Datrianna Meeks has been on our radar since we first profiled her back in 2015 as part of 28 Days of the Web. Since then, she's been making some tremendous strides in her career, leading up to her current position as a senior product designer at Spotify.
Our conversation started off with Datrianna walking us through a typical day at work, and we spoke about the NYC design and tech scene and about her inspiring design journey. She's also a podcast fanatic, so we also talked about #AmpedBrunch, an event she recently hosted for women of color in podcasting. Datrianna is really carving out a space for herself in this industry, so keep an eye out for her!
Datrianna Meeks on 28 Days of the Web
Datrianna Meeks' Website
Datrianna Meeks on Twitter
Revision Path is also sponsored by Hover. Visit hover.com/revisionpath and save 10% off your first purchase! Big thanks to Hover!


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Le pont de Thorp Arch (en ), aussi appelé pont de Boston Spa (Boston Spa Bridge) est un pont voûté qui traverse la Wharfe et relie les villages de Thorp Arch et de Boston Spa dans le Yorkshire de l'Ouest, en Angleterre. Il est classé monument de Grade II.

Historique
Le pont est ouvert en 1770.

Description
Le pont est fait de  taillé.

Il comporte cinq portées à voûtes, dont deux se trouvent aujourd'hui sur le cours de la Wharfe. La voûte centrale est pourvue de becs surmontées de parapets avancés au niveau du tablier.

Notes et références

Thorp Arch
Thorp Arch
Thorp Arch
Thorp Arch
Monument classé de Grade II dans le Yorkshire de l'Ouest
Transport dans le Yorkshire de l'Ouest
Thorp Arch

redpajama_set_name: RedPajamaWikipedia


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Last edited by Zolot
5 edition of Rifleman Costello found in the catalog.
Rifleman Costello
The adventures of a soldier of the 95th (rifles) in the Peninsular & Waterloo Campaigns of the Napoleonic Wars
by e costello
Published November 10, 2005 by Leonaur Ltd .
Battles & campaigns,
Biography: historical,
European history: c 1750 to c 1900,
Military - Aviation,
Biography / Autobiography,
Personal Memoirs,
Military - Napoleonic Wars,
Biography & Autobiography-Military,
Biography & Autobiography-Personal Memoirs
The Recollections of Rifleman Harris is a memoir published in of the experiences of an enlisted soldier in the 95th Regiment of Foot in the British Army during the Napoleonic greggdev.com eponymous soldier was Benjamin Randell Harris, a private who joined the regiment in and served in many of the early campaigns in the Peninsula greggdev.com the mids, Harris was working as a cobbler in Author: Benjamin Randell Harris. Photo cover of Chuck Connors and Johnny Crawford. The Gold Hat starring Lucas McCain, Mark McCain, Sam Barnaby (rancher), Billy Barnaby, Dave Slater, Owens (lawyer), and Hired Gunmen, script by Eric Freiwald and Robert Schaefer, art by Warren Tufts; Lucas and Mark approach the ranch house of a friend, when they are shot at by the owner.
This book aims to present Costello's story in a comprehensive and comprehensible way. Everything that can be done has been done to ensure that your progress with Ned Costello through the major events of his life is a lot smoother for you as a reader than it was for him as a rifleman. Find nearly any book by Eileen Hathaway. Get the best deal by comparing prices from over , booksellers. used books, rare books and new books › Find signed collectible books: 'Costello: The True Story of a Peninsular War Rifleman' More editions of Costello: The True Story of a Peninsular War Rifleman: Costello: The True Story of.
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Rifleman Costello by e costello Download PDF EPUB FB2
Rifleman Costello book. Read 2 reviews from the world's largest community for readers. THE ADVENTURES OF A SOLDIER OF THE 95TH (RIFLES) IN THE PENINSULAR 4/5. Aug 24, · This book of Costello s narrative in its unedited and unabridged form the whole Rifleman.
It is not a facsimile all the typesetting is new, clean and legible. It forms part of a series of accounts by rifleman published by Leonaur who Rifleman Costello book offer other Napoleonic history greggdev.com book is one of several in our Eyewitness to War series.5/5(4).
Apr 05, · Buy Rifleman Costello - The Adventures of a Soldier of the 95th (Rifles) in the Peninsular & Waterloo Campaigns of the Napoleonic Wars by E Costello (ISBN: ) from Amazon's Book Store. Everyday low prices and free delivery on eligible orders/5(12). Nov 01, · Rifleman Costello: The Adventures of a Soldier of the 95th (Rifles) in the Peninsular & Waterloo Campaigns of the Napoleonic Wars.
An excellent book, that provides a great insight to those who fought in Rifle regiments during the Napoleonic war.
Well worth picking up, especially if you're a fan of Bernard Cornwell's Sharpe series of books. 5/5(1). Costello: The True Story of a Peninsular War Rifleman [Eileen Hathaway] on greggdev.com *FREE* shipping on qualifying greggdev.com: Eileen Hathaway.
The Rifleman book. Read 14 reviews from the world's largest community for readers. #1 New York Times bestselling author and decorated war veteran Oliver /5. Feb 26, · While Mark goes hunting for Old Spike, Lucas goes hunting for a mortal enemy who showed up in North Fork - the enemy used to be a good friend.
Nov 30, · Rifleman Costello by E Costello,available at Book Depository with free delivery worldwide. Rifleman Costello: E Costello: We use cookies to give you the best possible experience.4/5(23). Told in his own words, he takes the reader through vibrant images of Napoleonic battlefields, of officers, soldiers, comrades and camp followers as well as his constant enemies - Napoleons French Army This book has been previously publised under the title 'Rifleman Costello the Adventures of a Soldier of the 95th(Rifles) in the Peninsular.
The Rifleman is an American Western television program starring Chuck Connors as rancher Lucas McCain and Johnny Crawford as his son Mark McCain.
It was set in the s in the fictional town of North Fork, New Mexico Territory. The show was filmed in black and white, in half-hour greggdev.com of episodes: (list of episodes).
Jul 02, · Rifleman is a thrilling story of a young man in extraordinary circumstances. Yet what makes Gregg's story so enthralling is how he was shaped by his wartime experiences and primed an eventful - and dangerous - life behind the Iron Curtain. Rifleman is an outstanding book that deserves to become a classic'" – Lloyd Clark, author of Arnhem.
The action-packed classic television series about a widowed rancher, Lucas McCain (Chuck Connors), raising his son, Mark (Johnny Crawford), in New Mexico. This western series aired on ABC from and is a classic in the genre for its high production standards, character-driven plots, moral lessons and A-list guest stars.
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More information. Saved by. Feb 26, · It's a big day for North Fork - the first railroad train is coming to their new station. Riding as passengers are the McCains and a Japanese nobleman and his servant who are visiting the West to.
Thomas Plunket (–) was an Irish soldier in the British Army's 95th Rifles regiment. He served throughout the Peninsular War and later in the Waterloo Campaign of He is remembered for killing a French general during the Peninsular War with an extremely long range rifle shot, then killing the general's aide-de-camp, who had gone to his side to render aid, with greggdev.comance: United Kingdom.
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Whether they have appeared one time only or times, they are just as important as the main characters and/or anyone else involved in The greggdev.com is just a small tribute to those great many characters actors. Oct 24, · Buy Costello: The True Story of a Peninsular War Rifleman First Edition by Edward Costello, Eileen Hathaway (ISBN: ) from Amazon's Book Store.
Everyday low prices and free delivery on eligible orders.5/5(1). Costello E-rifleman Costello Book New. The American - $ The American Rifleman Goes To War Nra Guide Book Joseph Boxley Roberts Euc. Lord Of - $. Rifleman Costello: The Adventures of a Soldier of the 95th (Rifles) in the Peninsular & Waterloo Campaigns of the Napoleonic Wars.
Saved from This book will forge you into the person you always wanted to become, physically, mentally, spiritually. Absolute must read.Get this from a library! Costello: the true story of a Peninsular War rifleman ; including Adventures of a soldier.
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greggdev.com - Rifleman Costello book © 2020


This year princesses decided to spend their summer exploring south! Looks like somebody's going to get country-styled! Good old bouffant wings, shiny buckles and cowboy boots. Do you like this style as much as Anna and Merida do? They are a country gals at heart and they surely want to get the look and the style of a country pop diva. Let's get through all of their chic and highly feminine wardrobe featuring lovely printed dresses, shirts, tops, jeans, vests, boots and cowgirl hats. Any stylish city girl could learn some amazing style tips from this country cuties! It's fashion time, y'all!


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o Please write your mobile phone numbers, camping pitch number or Hotel on the paperwork on your stable door.
o Mares and geldings may share a box. It is not allowed for mares and stallions.
o If you want wood shavings in your box instead of straw, this can be ordered when registering the pony.
If it is not you will receive an additional charge of 350 kr. / 46 euro.
REMEMBER – fork – brush – feed bucket – water bucket – hay / wrap.
1 box woth 1 pony 1.300 DK/ 173 euro.
1 box with 2 ponies 1.500 DK / 200 euro.
1 box with 1 pony 800 DK / 106 euro.
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Shavings instead of straw 250 DK / 33 euro.
Then 100 DK/ 13 euro. per. new bale of shavings.


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