The National Evidence-Based Practice Conference will highlight strategies for applying evidence to meet complex health needs, innovative strategies for care across the continuum, network with EBP experts and enthusiasts and learn cutting edge information to apply in a wide range of settings. A variety of clinical issues will be discussed based on abstracts accepted for podium or poster presentations. This program is designed to guide your journey to improved evidence-based care.


text:
jdbraytonauthor
If Charlie Don't Surf, Then Faulkner Don't Tweet
ABOUT EYE SKIN the new novel
About J.D. Brayton
AUTHOR'S FORWARD- EYE SKIN
DUCKS AND MONKEYS from EYE SKIN
The Taphophile Chronicles #5- The Frasers
April 23, 2018 UncategorizedJ.D. Brayton - Author
The Frasers-
The Husband and Wife Sculptors of Rock Creek Cemetery
James Earle Fraser –Frederick Keep Monument. 1920
Laura Gardin Fraser – Hitt Memorial, 1931
The world renown sculptor James Earle Fraser, and his wife, Laura Gardin Fraser, a great sculptor in her own right, are an interesting study in how marriage and the arts can co-exist and even flourish in the spirit of collaboration.
James Earle Fraser was a student of Augustus Saint Gaudens; his best known works in Washington, D.C. are:
"Music & Harvest" "Aspiration & Literature"(The Arts of Peace) – on the Arlington Memorial Bridge.
The John Ericsson Memorial, in East Potomac Park near The Lincoln Memorial- comemorating the Swedish-American inventor of the screw-type propellor and designer of the USS Monitor Iron ship.
The Alexander Hamilton statue at the Commerce Department.
The Second Division Memorial, The Ellipse.
The Robert Todd Lincoln sarcophagus in Arlington Cemetery and a score more installations in the National Capitol area.
His best known sculpture-The End Of The Trail-an evocative and graceful statue of a Native American brave slouched on horseback wearied by war and loss, holding a battle lance is one of the most copied pieces of "Western Frontier" art. Fraser himself complained that he should have gotten a copyright on the image, as everyone who used it for calendars and reproductions have made more money off this work than he ever did. Still, if counterfeit exposure is any corelation to the axiom 'imitation is the sincerest form of flattery'— this piece serves as an illustration. Because of wartime scarcity of bronze this great piece was never actually cast from the plaster in Fraser's lifetime. It began to degrade and was saved and is now being preserved and exhibited in the entrance of the Oklahoma Museum.
Fraser's famous design of the so-called 'Indian Head-Buffalo Nickel' is iconic. Fraser's father—an executive in the trans-continental railroad—was one of the party sent to The Black Hills of Dakota to find and bury the remains of George Armstrong Custer's 7th calvary after the military disaster at the Little Big Horn. Fraser was exposed to the terrible consequences of the Native American wars, as his art illustrated. This great drama still remains unresolved, if not largely forgotten, in the history taught in the United States today.
His internship to Augustus Saint Gaudens is yet another example of how a pupil can flourish and indeed stand shoulder to shoulder with a former mentor. Augustus Saint Gaudens (sculptor of the Adams Memorial in Rock Creek Cemetery) was so sought after that he couldn't fill all his orders or requests— hence all the commissions he was unable to complete he handed to James E. Fraser, his brightest pupil.
Laura Gardin Fraser was James Fraser's student at The Art Students League in New York City, where they met and later married. All great artists have mentors – in this case the love, talent and mutual respect grew into a lifelong love and commitment to the art of neo-classical sculpture. She gained much, both by her time as Fraser's student, and by Augustus Saint Gauden's mentorship. Their marriage was indeed a mutual collaboration, though James E. Fraser may have attained greater stature in the decidedly male dominated world, Laura worked as an artist worthy of respect and and merit. The Frasers remained a truly great creative couple for life. By the efforts of Laura Gardin Fraser, and the many great female sculptors and artists of the late 19th and early 20th century, the social barriers have all but been eliminated in the world of art—where true equality has always been at the avant-gaarde of history.
← Scenes from STORMY-The Movie	Excerpt from EYE SKIN- →
Monthly Ravings
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redpajama_set_name: RedPajamaCommonCrawl


text:
var expect = require('expect.js');
var Cookie = require('../index');

describe('Cookie', function() {

    describe('get', function() {

        document.cookie = '_sea_test_1=1';
        document.cookie = '_sea_test_2';
        document.cookie = '_sea_test_3=';
        document.cookie = '_sea_test_4[t]=xx';

        it.skip('should return the cookie value for the given name.', function() {

            expect(Cookie.get('_sea_test_1')).to.equal('1');
            expect(Cookie.get('_sea_test_2')).to.equal('');
            expect(Cookie.get('_sea_test_3')).to.equal('');
            expect(Cookie.get('_sea_test_4[t]')).to.equal('xx');

        });

        it('should return undefined for non-existing name.', function() {

            expect(Cookie.get('_sea_test_none')).to.equal(undefined);

        });

        it('should throw error for invalid name.', function() {

            expect(function(){ Cookie.get(true); }).to.throwError();
            expect(function(){ Cookie.get({}); }).to.throwError();
            expect(function(){ Cookie.get(null); }).to.throwError();

        });

    });

    describe('set', function() {

        it('should set a cookie with a given name and value.', function() {

            Cookie.set('_sea_test_11', 'xx');
            expect(Cookie.get('_sea_test_11')).to.equal('xx');

            Cookie.set('_sea_test_12', 'xx', { expires: -1 });
            expect(Cookie.get('_sea_test_12')).to.equal(undefined);

            Cookie.set('_sea_test_13', '2', {
                expires: new Date(2099, 1, 1),
                path: '/'
            });
            expect(Cookie.get('_sea_test_13')).to.equal('2');

            Cookie.remove('_sea_test_14');
            Cookie.set('_sea_test_14', '4', {
                domain: document.domain,
                path: '/',
                secure: true
            });
            expect(Cookie.get('_sea_test_14')).to.equal(undefined);

        });

    });

    describe('remove', function() {

        it('should remove a cookie from the machine.', function() {

            Cookie.set('_sea_test_21', 'xx');
            Cookie.remove('_sea_test_21');
            expect(Cookie.get('_sea_test_21')).to.equal(undefined);

            Cookie.set('_sea_test_22', 'xx', {
                expires: new Date(2099, 1, 1),
                path: '/'
            });
            Cookie.remove('_sea_test_22', {
                path: '/'
            });
            expect(Cookie.get('_sea_test_22')).to.equal(undefined);

        });
    });

});

redpajama_set_name: RedPajamaGithub


Honestly, it doesn't look pretty in my eyes (yet), but it works and eliminates the disadvantages mentioned above. With some help of Expression.Evaluate, we could further clean it up to match the magrittr-style for example, but I've been warned to use this function, so not sure what to prefer at the end.
So the first 2 arguments are swapped and 2 additional curly bracket-pairs are needed.
I think that "piping" is what the PQ GUI is all about. Each step effectively pipes the result of the previous step to the next one. "let" makes things explicit, and the unnesting makes the code readable, as opposed to Excel formula language (and thank you DAX team! for adding similar syntax).
Trouble ensues when you resort to the (so-called) Advanced Editor.
The more I tweak the M, the easier it is to lose all of the steps. But damn, it's great to have those steps; for testing and for maintenance, etc..
There's just a natural tension between what Microsoft has invented in the PQ GUI along with the demands of a hand-written functional language program. I'm impressed with what they've come up with so far and am anticipating what the "real IDE" will be.
It's a difficult problem, and the various other places that Power Query is sure to show up in will add other difficult requirements for the IDE (e.g. when will be be able to emit multiple outputs from a single query?).
In the meantime, I've been trying to evolve a coding style that leverages today's GUI and also accommodates hand-coded M.
The GUI will show and resolve the step, but won't walk into the nested let. This is often good enough though — maintainers can examine the result of the "subprogram" in the GUI.
Note: You can also include steps anywhere in-between which are not referenced elsewhere in the query. The GUI will show them. This is useful for adding (sort of) unit tests, or debugging steps, or sanity checks.
Sometimes I add a couple of steps at the top for navigating #shared that "exist" only in the PQ GUI and are there for the developer (me).
I beg forgiveness if you do all these things already too, but I haven't seen any discussion of these ideas elsewhere. (And thanks for the link to Kim Burgess's work!).
Thank you very much for this detailed response, this is an interesting perspective.
Are you a developer/programmer by trade or do you come from the Excel-world?
I'm a developer who works with end users enough to have learned Excel programming along the way (often the "last mile" and/or the first one for many systems in my experience). A friend, who's lucky enough to be doing DAX these days, pointed me to your helpful blog. Thanks.
Thank you! The reason why I asked is that I expect developers to be more comfortable with long code than Excel-users.
So I still try to use as little words/expressions in my code to make it look less intimidating.
Thanks for the cools tricks around lazy evaluation, I'm still not utilizing them to the full extend. Just recently saw Marcel Beug using "empty steps" as comments which can be seen in the Query Settings: https://youtu.be/ZvP8SoIz3VE?t=405 . Finding that very cool as well.
So I've wrapped the m-tools repo code into a library which I hope I can extend and include in my projects.


text:
The Trump of Pahrump, the Unholy Trinity and Other Dystopian Tales
by Jim Miller on October 22, 2018 · 0 comments
in Under the Perfect Sun
Screen grab from Diamond Theft video via YouTube
The Trump of Pahrump is dead.
Yes, the world's most famous brothel owner, Dennis Hof, left this world peacefully last week in bed at the Love Ranch only hours after celebrating at his birthday party/campaign rally. The event was held to aid Hof in his quest to secure a seat in the Nevada state legislature as a Republican, a race he was heavily favored to win. Hof is best known for his HBO reality TV show about the Moonlight Bunny Ranch and his biography, The Art of the Pimp, which gleefully riffs off of the title of the President's paean to himself.
Just hours before his untimely demise, Hof was cheerfully holding court at an event that featured the trio of porn star Ron Jeremy, Americans for Tax Reform founder Grover Norquist, and Sheriff Joe Arpaio. To top it all off, they were joined by Fox News talking head Tucker Carlson, who offered birthday wishes to America's Pimp by video feed. It was a good night for Hof who, despite the uncomfortable facts that he is both now dead and accused of rape by several former employees, is still a sure bet to win the election in his heavily Republican district largely populated by good Christian folks committed to Making America Great Again.
Hunter S. Thompson famously referred to his legendary trip in Fear and Loathing in Las Vegas as "a savage journey into the heart of the American Dream," and just as his drug-fueled epic captured the capitalism-on-acid that was Sin City in the early seventies, the story of Hof's birthday party might be the purest distillation of the essence of Trump-era Republicanism that one could find. Here Hof's vulgar empire built on the sad commodification of human intimacy and the objectification of women with a menacing undercurrent of sexual violence is joined by the Unholy Trinity of the MAGA moment.
Jeremy, a pathetic, waning, white male porn star turned reality show oddity is the embodiment of the degraded hucksterism that sells the vicious hatemongering and authoritarian cruelty of Sheriff Joe and the dog-eat-dog, Social Darwinist economics of the radical libertarian right that Grover Norquist has infused into the DNA of the contemporary Republican Party. It's a fun mix ready-made for broadcast over Fox News to keep us all distracted while they shrink government down to the size where it can be drowned in a bathtub as the world ends.
Not with a bang but a whimper–or perhaps a shudder, to paraphrase Eliot.
If this sounds too hyperbolic, consider that this surreal turn of events took place just as Senate leader Mitch McConnell was doing the rounds calling for cuts to the "entitlement programs" of Social Security and Medicare to help deal with the huge deficit that is emerging in the wake of Trump's massive tax cuts for the rich and corporations–denying the connection all the while. Then there are the Republicans who voted to end health care coverage for people with pre-existing conditions campaigning as if they had saved said healthcare protections.
And if that seems as obscenely dishonest as the President's cover story for the torture and murder of a Washington Post journalist by the Saudis (all in the service of an arms deal), then you probably loved hearing Trump's and some southern senators' climate change denial in the wake of the devastation wrought by Hurricane Michael.
This coming alongside their refusal to acknowledge the science brought to us in a UN report informing the world that we have about ten years left to stop the worst-case scenarios of catastrophic climate change which could end up spurring a mass extinction of plant and animal life and putting millions of people at grave risk.
"As if the earth under our feet were an excrement of some sky/and we degraded prisoners/destined/to hunger until we eat filth," as William Carlos Williams once put it.
One might humbly hope that the current horrifying state of affairs would be enough to get people of good conscience to vote in the coming midterms. But even that is not a certainty as the worst remain full of passionate intensity and the "best" we can muster frequently lack all conviction.
Yet unlike Yeats in his famous poem "The Second Coming," we don't need to wonder what rough beasts are slouching toward Bethlehem to be born. They're staring us right in the face.
Now is not the time to let the perfect be the enemy of the good. Let's vote and keep fighting for something better like our lives depend on it—because they do.
Older Article: Ocean Beach Mainstreet Association Celebrates 40 Years
Newer Article: OB Town Council Meets Wed., Oct.24


text:
Home/Gossip/Bus With Passengers Bursts Into Flames on Nairobi-Mombasa Highway
Bus With Passengers Bursts Into Flames on Nairobi-Mombasa Highway
A bus with passengers burst into flames along the Nairobi-Mombasa highway heading to Mombasa from Nairobi.
In a video shared by Sikika Road Safety on Friday, December 9, the vehicle was parked on the side of the road near a ditch as it was consumed by the fire.
The accident occurred at 2:25 am on Friday morning, December 9, at Mtito Andei, Makueni County.
According to the reports, all the passengers were evacuated to safety before the fire spread.
The bus wreck after a fire on the Nairobi-Mombasa highway on Friday, December 9, 2022
Sikika Road Safety
"We tried to put off the fire with water but our efforts bore no fruits," stated one of the passengers.
Following the unprecedented accident, area residents helplessly watched from a distance as the bus was reduced to ashes.
"This is terrible," noted another passenger as he recorded the ordeal.
From the one-minute video, other road users carried on their journey without offering assistance. Notably, no casualties were reported from the accident.
The cause of the fire was unascertained. However, some passengers claimed it began at the front of the vehicle.
In November 2022, the National Transport and Safety Authority (NTSA) announced that the number of victims of road accidents from January to October 30, 2022, increased to 17,550 from 16,642 in 2021.
NTSA further indicate that accidents occurred mostly from Friday to Sunday between 5 pm and 10 pm due to reduced law enforcement, driver fatigue, and high volumes of traffic.
Accidents, it added, can be curbed through the reduction of wreckless driving and other human errors.
An NTSA official marshalls traffic at a past accident scene
NTSA
accident fire fire.
Radio Africa Announces Mass Layoff in Restructuring Plan
Wetangula's Ally Trounces Ruto Candidate in Bungoma Senatorial Race
4 Uhuru's Mega Projects That Were Altered by Ruto Regime
Where Are They Now: Inside Mutahi Kagwe & Other Uhuru CS's Private Lives
Revellers Throng Kitengela Club Inside Airplane After Launch
EPRA Issues Guidelines for Refilling LPG Gas Affecting All Consumers


Two videos showing an edited set of Super-8 films shot in Vietnam in 1971. The conversion to video and the added narration was done around 1995.
A video made from Super-8 films shot in Quang Tri and Phu Bai, Vietnam in 1971. This includes a drive through Hue to Phu Bai and a helicopter flight back to Quang Tri over the same route.
Part 2 of the original Super-8 films showing Da Nang and Saigon, Vietnam in 1971.


text:
Az aurotioprol az arany vízoldható komplexe, melyet reumaellenes szerként használnak, intramuszkuláris (izomszövetbe adott) injekció formájában alkalmazva.

Jegyzetek

Fordítás

Aranyvegyületek

redpajama_set_name: RedPajamaWikipedia


text:
Dolphins Change Their Calls To Be Heard Over Rising Ocean Noise
Barbara MoranTwitter
In this 2011 photo, Kibby, an Atlantic bottlenose dolphin, is shown at the Dolphin Research Center in Grassy Key, Fla. (Wilfredo Lee/AP)
As speedboats and cargo ships continue to make the world's oceans noisier, bottlenose dolphins are adapting their calls — making their whistles simpler, shorter and higher frequency — to compensate.
"They're really having to simplify what they say," says Helen Bailey, a marine biologist with the University of Maryland Center for Environmental Science, and an author on a paper last week in Biology Letters that explains the phenomenon. "They're probably also sharing less information, because they're just trying to be heard over the noise."
Marine mammals communicate mainly through sound, and use whistles to greet each other, share information about food, and talk to their calves. Bailey says that constant, high levels of background noise may not only hamper their ability to communicate, but also lead to chronic stress. "If you're living by a noisy road, that can be quite stressful," she says, "and so we're concerned."
Bailey and her colleagues collected sound from an area about 20 miles off the coast of Ocean City, Maryland, to gather baseline data on a proposed wind farm site. The area has heavy boat traffic from both shipping and recreational vessels, similar to most coastal areas near busy ports.
Her research adds to a growing body of evidence that ocean background noise is affecting marine animals — not just mammals, but other creatures like lobster and cod, as well.
"Those fish are listening," says Leila Hatch, a marine ecologist at Stellwagen Bank National Marine Sanctuary, off the coast of Boston. She and her colleagues have been recording and measuring the underwater soundscape at the sanctuary for more than a decade. Hatch calls the area a "highly trafficked environment," crossed by cargo and tanker ships heading to Boston, fishing vessels, whale watching charters, and recreational and research boats. Boat propellers leave trails of bubbles, which create a background hum when they burst. The hum has increased substantially over recent decades, says Hatch: "The levels of human-induced noise and the rise of those levels is problematic for animals."
Hatch and her colleagues have mostly focused on the effects of noise on the endangered right whale — they estimate a 70 percent loss in the amount of ocean where the whales can hear each other during their spring foraging months. But lately they've also been looking at Atlantic cod, which use low-frequency calls during spawning, and other animals like lobsters and crabs.
"There are a variety of different critters — both marine mammals and some of the essential keystone species of this area — that we have questions about," Hatch says.
In 2016 the National Oceanic and Atmospheric Administration released its "Ocean Noise Strategy Roadmap," which offered goals and recommendations to reduce the impact of noise on marine animals.
Bailey, for one, thinks new laws are in order. "Just as we have regulations about cars and their emissions," she says, "we need to be thinking about sound emissions. As humans we already have regulations about what sounds you can be exposed to, for how long … but we're not putting any of that protection into place for the ocean.
"The chronic sound, the boat noise, is going on all the time," she adds. "If we could make that quieter, that would make a huge difference."
As Right Whale Population Plummets, Focus Turns To Their Falling Birth Rates
Study: Underwater Noise Hurts Whale Communication
Barbara Moran Twitter Correspondent, Climate and Environment
Barbara Moran is a correspondent on WBUR's environmental team.


text:
Ennemis intérieurs est un court-métrage français réalisé par Sélim Azzazi, sorti en 2016.

Synopsis
Années 1990. Un Algérien, né en Algérie française, vient déposer une demande de naturalisation. Son interrogatoire par un inspecteur, lui-aussi d'origine algérienne, va bientôt ressembler à un duel entre deux visions de la nation.

Fiche technique
 Titre original : Ennemis intérieurs
 Réalisation : Sélim Azzazi
 Scénario : Sélim Azzazi
 Décors : Françoise Arnaud
 Costumes : Émily Cauwet-Lafont
 Photographie : Frédéric Serve
 Son : Pascal Jacquet
 Monteur son : Sélim Azzazi
 Montage : Anita Roth, Charlotte Soyez
 Musique : Sélim Azzazi
 Production : Benjamin de Lajarte, Sélim Azzazi, Frédéric Serve
 Société de production : Qualia Films
 Société de distribution : Qualia Films
 Pays d'origine :
 Langue originale : français
 Format : couleur — 2,35:1 - Son Dolby 5.1
 Genre : drame
 Durée : 27 minutes
 Dates de sortie : France :

Distribution
 Hassam Ghancy : Le demandeur de nationalité française
 Najib Oudghiri : L'interrogateur
 Stéphane Perrichon : Le gardien de la paix
 Nasser Azazi : Le père
 Amine Brossier : Le fils
 Nicolas Pouillot : un policier dans le couloir
 Franck Gonzales : un policier dans le couloir

Distinctions

Nominations
 Oscar 2017 : Oscar du meilleur court métrage en prises de vues réelles

Liens externes

Film français sorti en 2016
Court métrage français
Film tourné à Lyon
Film dramatique français
Film se déroulant dans les années 1990
Prix du public de la compétition nationale du festival du court métrage de Clermont-Ferrand


Honda Civic Mk4 GPS tracking device for free. How to track & trace Honda Civic Mk4 ?
How to track your favourite Honda - model Civic Mk4 in realtime for free ?
Civic had a very wide range of engines from 1.2 to 1.6 SOHC VTEC DOHC. The base model Civic was the fourth generation model 1.2 SOHC, jednogaźnikowy, however inaccessible European and American market. On the European market the basic model was 1.3 SOHC jednogaźnikowy. Other engines available in the fourth generation was 1.4 dwugaźnikowy 90 hp and the 1.5 engine with two-point injection PGM-Fi. The 1.5 designation D15B2 wore and had, like the 1.4 dwugaźnikowa 90 horsepower. This engine was the most common in the total Civicu 4Gen in both Europe and the USA. His counterpart from multiple injection PGM-Fi was a unit with a capacity of 1.6 liter SOHC.


Gloucester's own talented acoustic duo, Alexandra & Josh, joins Feather & Wedge for an evening of incredible acoustic music. With vocals by Alexandra Grace and guitar by Josh Cominelli, their set list includes blues, folk, jazz standards, indie pop and original music. Don't miss the chance to hear this multi-talented young duo.


Ceramic thin tire decals, wishing bottles, necklaces, sweaters, chains, vintage perfume bottles, corks, pendants.Various colors, styles.
Seeking the best bottle chain with good quality and affordable prices from DHgate Australia site. We provide a variety of cross heart chain online supplied by reliable sellers around the world. Helping you step by step of finding cheap free rings chains is what we aim for. Enjoy exploring our range of beaded chain clasps shop and find the prism bead chain for sale from au.dhgate.com with free delivery to Australia.


It can happen to you. Your child will be lying on the floor in the middle of the supermarket having a full-blown meltdown. You will get judgmental or sympathetic looks from other shoppers, depending on their experiences. You shouldn't feel guilty, though; tantrums are more complicated than a spoiled child being told they can't have a toy. So what causes them and what can you do to deal with them?
A tantrum happens when a child is overwhelmed by emotion and doesn't have any other way of releasing it. Small children don't have the life experience to distinguish between major life events and the small things like having to wait for something. Sometimes a tantrum can be caused by a child trying to cope with too much stimulation or change; this is particularly true for children with autism. The cause could be as simple as tiredness, hunger, jealousy, lack of stimulation, or the need for attention or reassurance. Children are also sensitive to their environment and will pick up on any stresses at home, even if they don't understand the cause of them.
To deal with a tantrum effectively you need to decide whether a tantrum is caused by anger or distress. If the screaming and kicking is caused by anger, then you need to distance yourself a little. Don't reward bad behaviour with a bribe to be good. Be firm and clear about how you expect them to behave. If it's safe to ignore the attention-seeking behavior (for example, by walking away), then do so, but stay in sight so they don't feel abandoned. You also need to allow them to have some dignity when they capitulate and change their behavior. Praise their good behavior and don't ridicule them for their actions.
If the tantrum is triggered by distress, you need to give them reassurance. A cuddle works better than words; showing them you're accepting their feelings as genuine, giving them the security of physical contact and helping them regain control. A distraction can often help; singing to them, telling them a favorite toy wants a hug or giving them something to play with can all work.
Small children are prone to tantrums and sometimes you have to wait it out since they're too distressed to be calmed down right away. If you take a consistent approach, stay calm and accept it as a natural stage of your child learning to control their emotions, you'll find you can both survive the experience. And as for the judgmental passers-by? Just wait until they have their own tantrum-throwing child to deal with.


Make your first stop for ceramic tile your last.
Howland Floor Covering has some of the world's finest ceramic and porcelain tile fashions. You'll also find all the accessories needed to make your project perfectly personal and unique. We carry Sonoma Tilemakers, Artistic Tile, Ceramic Tile Trends, Pratt & Larson, Oceanside Glass, Crossville/Sideview Glass, Encore, Walker Zanger, and Marazzi. Tile can add sophistication, dimension and texture to any room, from traditional to modern, imported to domestic, ceramic tile offers endless possibilities. Tile offers durability, low-maintenance, beauty, quality and value to floors, walls, and countertops.
Natural – perfect anywhere you want soft, blending colors and texture.
Things to keep in mind when shopping for ceramic tile: If your room is small, use larger tiles to create a more open appearance with less grout lines to break up the space. Be aware, there are color variations in ceramic tiles ranging from moderate to high. Slate and Marble are natural products and this variation will create a wonderful look in your room. Your room deserves the very best.
Knowing which ceramic product is best for a particular room and the activity in that room, can help you shop wiser and that is what Howland Flooring Covering is here to help you with. We can help you save money in the long run because unwise buying decisions can lead to costly replacement.


Winter is never the most fun season to be a car owner. You're buying snow tires and making sure to drive extra carefully — and it's cold!
At least keeping the car in the garage helps you avoid having to scrape snow and ice off your car, but can it really make a huge difference in other ways, too? It can, and here's why.
Winter temperatures can get so low that your car locks can actually freeze. And, if a layer of ice forms, your doors can freeze shut, too. There are a lot of precautions you can take to prevent this, but one of the easiest is keeping the car in the garage. It's not exposed to the elements, and the temperature in an enclosed building is warmer, even if your garage isn't heated.
If you don't have keyless entry, there's a chance that you could break your car key off in the door lock while trying to get it open. That's not a good situation to be in.
Car batteries don't do well in extreme temperatures — be it hot or cold. However, their capacity gets drastically reduced in cold temperatures, especially if you have an older battery. There's also an increased draw on the battery from accessories, as your headlights and wipers are usually on more often during the winter season.
One of the biggest issues, though, is that the demand on the battery to get the car started can be even higher than normal. Motor oil gets thicker when it's colder, meaning the engine is more difficult to turn over, and your battery struggles more. Even though it's still cold in a garage, any extra bit of warmth can help.
All of the scraping and snow clearing when a car is left outside is exhausting. You have to plan ahead and make sure you have enough time to get all the scraping or clearing accomplished and get your car warmed up. Even if it doesn't snow, you still have to allow some extra time if you want your car to be warmed up and ready before you're halfway through your commute.
Keeping the car in the garage helps you avoid all of that hassle. In addition to it being better for your car, it's also better for you. You can save those spare minutes and spend them on getting ready or doing other tasks instead of worrying about your car. More coffee, anyone?
Having insulated garage doors can give a boost to all of the benefits that come along with keeping your car indoors. They make it warmer than normal garage doors, blocking out more of the cold and almost guaranteeing that the temperature in your garage won't get below freezing. This is good news for your car's battery and fluids.
An extra perk is that it can help save you money. If you have an uninsulated garage attached to your house, the temperature discrepancies are going to impact the room that garage is attached to, making the heating system work harder to make sure those areas are warm. An insulated garage helps even that out — a good bonus!
Keeping your car in the garage this winter is a no-brainer. Help keep your car running smoothly, while also saving time in your day that would otherwise be spent on clearing snow. That's what a garage is meant for.


Sharon Mehlman and Angelo Paparelli spoke at the Federal Bar Association's Immigration Seminar held on May 17-18, 2013, in Memphis, Tennessee, on "Worksite Enforcement: Criminal and Civil Litigation." Ms. Mehlman also spoke on "Worksite Enforcement: Representing the Employer in an ICE Audit." Mr. Paparelli also spoke on "Worksite Enforcement: Counseling Corporate Compliance."


A blog from a post on agency workers at Social Care Experts blog is discussed.
Several blogs related to social workers in Great Britain are presented.
Several blogs related to social care sector is discussed including the stigma related to dementia, future of social care and plan to lure back retired social workers in Great Britain.
A blog is presented in response to a debate on the issues concerning forced adoption.
Several blogs and videos are presented including a blog on sheltered housing, artist Kim Noble's video about his experience of life on a mental health ward and another video of the British government's campaign to recruit more social workers.
Several blogs related to social work including former British Prime minister Margaret Thatcher's social engineering policy, Phone hacking and forums, are presented.


text:
Baseball Preview: Ohio State Takes On Vanderbilt In Nashville Regional To Begin NCAA Tournament
By Colin Hass-Hill on May 31, 2019 at 1:52 pm @chasshill
Credit: Ohio State Athletic Department
The Bucks are hot, as Andrew Magno has said. But can they stay hot?
Ohio State made a miraculous Big Ten tournament run as a seventh seed, becoming the lowest-seeded team to ever claim the championship, which meant it earned an automatic bid into the NCAA tournament. Andrew Magno earned most outstanding player of the conference tournament honors, and Seth Lonsway, Griffan Smith, Dillon Dingler, Brady Cherry and Dominic Canzone also made the all-tournament team.
Now with a shot to play in the NCAA tournament, the Buckeyes once again find themselves as significant underdogs. They earned the fourth seed in the Nashville Regional, which includes No. 1 seed Vanderbilt, No. 2 seed Indiana State and No. 3 seed McNeese.
Vanderbilt (49-10, 23-7) Nashville, Tennessee 7 p.m. ESPN2
Ohio State will open the Regional by facing the Commodores, the No. 2 overall seed in the NCAA tournament. The game will begin at 7 p.m. Friday, and it will be broadcasted on ESPN2.
"When you come to Ohio State, you want to win a championship," Canzone said. "Dog piling at the end in Omaha has always been a dream. That dream came true, but we have a lot more work to get back there. I don't think we care who we play. If we play our game, we can compete with anybody in the country. We're ready."
The Nashville Regional
The NCAA baseball tournament opens with 16 Regionals, which are hosted by the top-16 seeds in postseason play. One team advances from each Regional, meaning the 16 teams that moved on will participate in Super Regionals hosted by the top-eight remaining seeds.
Here's the setup of the Nashville Regional. It is a double-elimination format.
Game 1: No. 2 Indiana State vs. No. 3 McNeese at 1 p.m.
Game 2: No. 1 Vanderbilt vs. No. 4 Ohio State at 7 p.m.
Game 3: Loser of Game 1 vs. Loser of Game 2 at 1 p.m.
Game 4: Winner of Game 1 vs. Winner of Game 2 at 7 p.m.
Game 5: Winner of Game 3 vs. Loser of Game 4 at 3 p.m.
Game 7 (if necessary): Winner of Game 4 vs. Winner of Game 5 at 7 p.m.
Ohio State vs. Vanderbilt
Though Ohio State has won 11 of its last 13 games, it's running into one of the best teams in the country on Friday.
Vanderbilt, an SEC power with 13 NCAA tournament appearances in a row and three College World Series appearances, has a 49-10 record this season. Greg Beals, Ohio State's head coach, has never won more than 44 games in a season.
The Commodores, who have the benefit of hosting the Nashville Regional, have a 28-5 home record this season, and they're riding a nine-game winning streak. Most recently, they knocked off Auburn, Mississippi State, LSU and Mississippi on their spotless run to win the SEC tournament championship.
Ohio State, though, just entered enemy territory and pulled out a postseason win. Nebraska hosted the Big Ten tournament, and the Buckeye beat the Cornhuskers, 3-1, on Sunday to win the title.
"We just played in front of 17,000 (fans) for a B1G Championship," Magno said. "We've played high caliber teams before. We played Oregon State a lot the past few years. You can't hype it up. Any team can be beat any day."
Ohio State's Garrett Burhenn and Vanderbilt's Drake Fellows are expected to face off as starting pitchers on Friday.
Burhenn, who has a 6-3 record, maintains a 3.53 ERA, the best among Ohio State's starting pitchers. He has thrown 66 strikeouts in 86 2/3 innings, allowing 28 walks and 89 hits. Opponents have hit .271 against him, and he has allowed three home runs.
Fellows hasn't lost this season, holding an 11-0 record. He has a 4.05 ERA with 108 strikeouts in 91 innings. He has allowed 83 hits and 36 walks.
The winner of this game will play the winner of Indiana State-McNeese at 7 p.m. Saturday. The loser will face the loser of Indiana State-McNeese at 1 p.m. Saturday and will be one loss away from elimination.
Credit: Ohio State Athletic Department.
What To Know About Ohio State
Despite at RPI in the 100s, a .500 regular season conference record and the necessity to win the Big Ten tournament to even earn a bid into the NCAA tournament, Baseball America listed the Buckeyes as one of the two most dangerous No. 4 seeds.
Ohio State went on an absolute tear to end the season. It dropped a game to Minnesota in the Big Ten tournament, but otherwise beat Michigan, Maryland, Minnesota and Nebraska en route to winning the title. None of those victories came by more than two runs.
Dominic Canzone leads the Buckeyes' offensive effort. He's one of two players on the team, which has a .268 combined batting average, to hit better than .300 this season. The Big Ten player of the year candidate has hit .350 with 15 home runs and 42 RBIs. He also has 17 doubles and nine stolen bases with a .445 on-base percentage, all of which are team highs.
Brady Cherry, another middle-of-the-order bat, has hit 15 homers and 49 RBIs while hitting .308. Catcher Dillon Dingler hits .291 with a .399 on-base percentage.
Burnhenn will combat Vanderbilt's offensive prowess on the mound Friday night. Ohio State also heavily relies on Magno (2.20 ERA in 57 1/3 innings) out of the bullpen. He's the only reliever with a sub-4.00 ERA.
What To Know About Vanderbilt
Few teams in the country can score quite like Vanderbilt.
The Commodores rank fifth in the country and first in the SEC with 8.5 runs per game, trailing only New Mexico State, Arizona, Penn and Central Michigan. For comparison, the Buckeyes average 5.6 runs per game, which is 169th in the nation.
Pick almost any offensive stat, and you'll find Vanderbilt in the top 10.
Batting average: .319, fourth in the country
Slugging percentage: .521, fourth in the country
Hits: 664, fourth in the country
Doubles: 143, fourth in the country
On-base percentage: .417, seventh in the country
J.J. Bleday, a projected top-10 pick in the 2019 MLB Draft, leads the nation with 26 home runs. The powerful corner outfielder hits .357, has a .467 on-base percentage and a .752 slugging percentage. He also has 11 doubles, 67 RBIs and a team-high 48 walks.
Austen Martin leads the SEC with a .414 batting average. He has 18 doubles, four triples, six homers, 36 RBIs and 17 stolen bases. He also has a 33-to-28 walk-to-strikeout ratio. Four other Commodores with at least 30 starts — Stephen Scott, Cooper Davis, Ethan Paul and Philip Clarke — bat better than .300.
Vanderbilt's pitching staff has a combined 3.80 ERA, which is the 35th-best in the country.
Mason Hickman (2.20 ERA in 73 2/3 innings), Patrick Raby (2.90 ERA in 91 innings) and Kumar Rocker (4.14 ERA in 71 2/3 innings) are the Commodores' starting pitchers, along with Fellows, the starter on Friday. Tyler Brown (2.01 ERA in 40 1/3 innings), Jake Eder (2.97 ERA in 33 1/3 innings) and Ethan Smith (3.30 ERA in 30 innings) are among their top relievers.


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05 August 2017 Venue Highbury Stadium Attendance
English Football League - League One
Match preview: Fleetwood v Rotherham
Fleetwood Town return to Highbury on Saturday as they open the new Sky Bet League One season against Rotherham United (3pm k/o).
The Cod Army created history last term, finishing fourth in the league standings before narrowly losing in the play-offs against Bradford City.
Rotherham – who will see Paul Warne start his first full campaign as full-time first team manager – have had success over pre-season with a highlight being their 4-0 win against Barnsley. The Millers were relegated from Sky Bet Championship last time around.
After a disappointing season, the South Yorkshire side will be hoping to bounce back and gain promotion at the first attempt. New signing David Ball, who has scored six goals in pre-season for his new club, will be looking to score against the club who he had five successful years with.
Town have a full squad to select from, with a host a new signings including Lewie Coyle and Conor McAleny pushing to make their competitive debuts for the club.
The Millers are set to name a former Fleetwood front two – with Ball and Jamie Proctor set to the lead the line at Highbury.
Ex-Town striker Ball is no stranger to Cod Army fans after spending five years with the club before signing for Rotherham in the summer.
The attacker started his career at Manchester City scoring a memorable goal to secure victory in the 2008 FA Youth Cup final against Chelsea. He later signed for Peterborough United in 2011 and made over 40 appearances before moving on-loan to Rochdale.
On the 23rd July 2012, Ball signed for Fleetwood Town and enjoyed a five-year spell at the club with the highlight being his goal against Preston North End and it being nominated for FIFA Puskas Award in 2015, as well as being a key member of the side that won promotion from Sky Bet League Two.
In June 2017, the 27-year-old signed for Saturday's opponents Rotherham United on a two-year deal after leaving the Fylde Coast side in the summer.
Tickets are still available for the match at Highbury, but ONLY for home fans, as the away allocation is sold out.
Home fans can buy tickets from the ticket office, or by calling 01253 775080.
Watch exclusive interviews with head coach Uwe Rosler and defender Lewie Coyle below for FREE.
Team news: Rotherham United (H)
Uwe Rosler has named his side to face Rotherham United this afternoon at Highbury.
Report: Fleetwood Town shine on opening day of the season
Fleetwood began their Sky Bet League One campaign in the best possible fashion with a fine victory over Rotherham United at Highbury.
Conor McAleny scored twice on his competitive debut with two brilliant finishes in game that was pulsating from start to finish.
The former Everton attacker was one of four new signings in the starting line-up, alongside Lewie Coyle, Kyle Dempsey and Jordy Hiwula.
League newcomers United were quick out the blocks at Highbury and applied early pressure to the Cod Army back line, but it was to be Town who would create the first clear cut chance. After a smart break away move, McAleny fired just over from 30 yards.
The hosts gave the visitors a scare minutes later as Jordy Hiwula broke through the defence and slotted past Rotherham keeper Richard O'Donnell, only to be denied a debut goal by the offside flag.
The offside flag was to deny the opening goal again, this time for the away side, as Lee Frecklington received the ball from a corner and his low drive from outside the area looked to have take a deflection and was duly ruled out.
McAleny's impact on the game was clear, and it was the new man who gave Town the lead. After receiving the ball on the right, Bobby Grant played a low cross into the area and McAleny neatly struck the ball past O'Donnell.
The hectic opening twenty minutes calmed after the goal, but the contest remained an end-to-end one. Chances were few and far between as the game began to even out and there was little to suggest there was to be a second goal in the half.
However, further great chances did come and Town could have extended their lead as Town peppered the Yorkshire side's goal. As Cian Bolger flicked a header from Alex Cairn's goal kick goal-wards, Hiwula took down the ball neatly and struck the post. From the rebound, the ball fell to Kyle Dempsey who tested the palms of O'Donnell.
The final action of the half was again a Town chance, as Bobby Grant flicked a neat ball just over the bar.
The second half began with the same ferocity as the first with both sides competing end-to-end. Will Vaulks was the first to test the reflexes of Cairns, who parried his 25 yard effort.
Rotherham grew in confidence, causing Rosler's men problems defensively, but the Millers were reduced to try long-range efforts. Former Town striker David Ball's curling effort on the edge of the box was well saved by Cairns.
Much like the opening stages, Fleetwood continued to look impressive on the counter attack, with Amari'i Bell's cross just a slight touch away from doubling lead. Moments later it was déjà vu, this time Hiwula needing the touch to guide in from McAleny's offload.
With play firmly with the home side, Town soon doubled they lead they perhaps deserved. With the debutant causing problems for the Rotherham defence, McAleny soon had the ball in the net for the second time as he cut in from the left and fired past O'Donnell to complete a stunning move.
The Town fans behind the goal quickly ramped up the decibel level with an electric atmosphere now engulfing Highbury, helped by a healthy number of boisterous Rotherham fans.
Most of the attacking play was with the visitors but a resolute Cod Army continued to frustrate their opponents. Ashley Hunter and Devante Cole were introduced to the action, with the latter replacing the impressive McAleny, who received a standing ovation from the three sides of home fans.
In the dying embers of the game, Cole could have ended the tie but brilliant closing down from Joe Mattock prevented him from firing past O'Donnell.
This was to be the final action of an impressive win for the Cod Army, who begin the season with a blistering win.
FTFC XI: Cairns, Coyle, Bell, Eastham, Pond ©, Hiwula (Hunter), Dempsey, McAleny (Cole), Grant, Bolger, Glendon (O'Neill).
Subs not used: Neal (GK), Burns, Rodgers, Schwabl.
RUFC XI: O'Donnell (GK), Emmanuel, Mattock, Vaulks, Ajayi, Forde (Newell), Frecklington ©, Proctor, Ball (Moore), Taylor (Williams), Ihiekwe.
Subs not used: Bilboe (GK), Potter, Purrington, Yates.


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Klitschko's Heavyweight Reign Ends
Ukrainian Wladimir Klitschko in an October 2013 fight in Moscow.
Britain's Tyson Fury has defeated Wladimir Klitschko of Ukraine to become world heavyweight boxing champion.
The 27-year-old Fury won the titles of the three most important ranking organizations -- the IBF, WBO, and WBA -- in front of 45,000 spectators in the football stadium in Duesseldorf, Germany, late on November 28 after a unanimous points win over Klitschko, 39.
Klitschko's defeat, his first in 11 years, ended the Ukrainian's nine-and-a-half-year reign as heavyweight champion.
"It is still early and I have to process things but there will definitely be a rematch," Klitschko said after the fight.
He has held the IBF belt since 2006, the WBO title since 2008, and the WBA crown since 2011.
Klitschko's older brother, Vitali, a former heavyweight boxing champion, is currently the major of Kyiv.
Based on reporting by AP and Reuters


The Ways and Means Committee can get anyone's taxes including the POTUS. I guess don't run for POTUS if you can't stand the heat. No one made Trump run- he has to follow precedent and the rules/ laws of the Ways and Means- he isn't a King. He promised to release his taxes he didn't.
https://youtu.be/1qKd9fDLku8. The honourable Adam Schiff speaks and he speaks with honour, integrity and control. THIS is the behaviour of a person that I would gladly tell me kids to follow as an example of good leadership. History will remember his words.
Since Trump is the only POTUS who has a record of hiring illegals for his resorts and golf courses because they are cheap labor- why not have them bused to Mar-a-lago and his other golf courses? Trump's solution is to dump them in the US since he has no solution, so he actually wants illegals here.
So,the only POTUS who married to non-Americans & had those wives sponsor their non- American relatives for citizenship is concerned about unqualified nonproductive people coming into our country? Ivana was a skier/ Melania a lingerie model- yeah we really need more of those in the US, not laborers.
Today one of Donny's supporters was interviewed about not getting a big refund like she was used to-complaining that she thought Trump's tax cut was going to help the middle class.What did Fox tell these voters?All the rest of cable news apparently knew Trump was giving tax breaks to the rich only.
Your sister the judge has the right idea- she didn't want her taxes investigated and be embarrassed as a judge- so she retired. If you won't turn over your taxes as required - you should follow suit- just quit. That way you won't embarrass your country or family.
said candidate Donald Trump. But now Wikileaks is not his "thing". RIGHT.


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Sinn Féin Budget 2021
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Lisanelly offer vision of the future for education - Ruane
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Sinn Féin Education Minister, Caitríona Ruane, has said that the former military site at Lisanelly, Omagh, presents a unique opportunity for education.
The Minister was speaking during a visit to the former MOD site, where the development of an educational campus has been proposed.
The Minister said:
"Lisanelly presents a unique opportunity to turn this site into a new source of hope and achievement for the future. There is widespread support to develop a shared educational campus, which could contain schools from a wide range of sectors. A shared campus opens up many possibilities to share resources, which can only benefit the children and young people attending the schools.
"I would commend the work done to date by the Chamber of Commerce, Omagh Council and the Lisanelly Schools Working Group, which is chaired by local church leaders.
"We have six schools expressing an interest in relocating to Lisanelly, and in most cases this could free up important regeneration sites in the town of Omagh itself. The development of an educational campus here could provide first class educational facilities for more than 3,000 pupils in a more co-ordinated and effective way than is possible now. School projects can be developed and delivered together, with facilities planned in a way that allows schools to collaborate and share in delivering education.
"I have previously stated the need to reform education and Lisanelly can offer a real vision for the future of how education can be delivered. All our children and young people deserve to be offered the best educational opportunities in the best surroundings.
"There are a number of stages to go through to make this project a reality and I will work closely with Ministerial colleagues to discuss the obvious merits of the proposals. There are many interests in Lisanelly and by taking a cross-departmental and cross-agency approach we can make this happen for Omagh." ENDS
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Gayle James is a wedding photography studio formed by Gayle Chan and James Lee. Founded in 2010, nothing inspires or amazes us more than the beauty and power photography has to tell stories.
We know capturing weddings are a huge responsibility, so you can entrust one of the most important milestones of your life with us. With a combined 3 decades of experience in the prospective fields originating from architecture and graphic design, photography has always been a passion and much loved creative medium we know we'll love for the rest of our lives. Our brand of photography style can be described as honest & creative reportage delivered with a dreamy aesthetic. Coming from creative and design backgrounds, we focus on capturing the story of your precious wedding day, letting the most emotionally captivating moments shine through, whilst ensuring it is always accompanied with a intimate and honest visual style. Every wedding is unique and happens in such a short space of time, so our mission is to capture the essence of your day so you can re-live it for a lifetime. Our approach is to let the day unfold naturally without getting in the way. Our job is to make you feel relaxed and enjoy the day. You're at your best when you feel comfortable, which is why our belief is a great photographer needs to work within any environment they find themselves in.
Congratulations on your engagement! We're sure you've got a million things flying through your head right now, and plenty of important decisions to make along the way to your perfect wedding day. Your wedding day is undoubtedly one of the most significant days in your life. The memories of the day will fade, but your photos will remain. So investing in the right photographer who will treat your wedding with the utmost respect, care and diligence is important.
We're designers as well as Photographers so the eye of composition and story-telling is key.
Don't get a photographer via Groupon PLEASE!
Candid couple shot in a favourite location within the venue. This one is usually framed for a lifetime.
A challenging one was being asked to photograph the best men and bridemaids dancing around the couple and capture the mood.
The most stylish umbrella you can afford to buy. Rain is great, it adds drama and a beautiful quality to photos, but in real-life can be a bit messy!
I was frustrated with just working in my design background. I first picked up a camera when I went to my friend's wedding and got hooked!


Feel that, Susan Sarandon? It's called backlash. The Oscar-winning actress backtracked on her controversial comments from a Monday, March 28, interview with MSNBC — during which she suggested that Donald Trump would make a better president than Hillary Clinton — after several of her Hollywood peers, including Debra Messing and Jamie Lee Curtis, called her out on Tuesday.
Scream Queens star Curtis, 57, took to Twitter to respond to Sarandon's interview with Chris Hayes on Monday. During the sit-down, 69-year-old Sarandon, a staunch Bernie Sanders supporter, remarked, "Well, you know, some people feel Donald Trump will bring the revolution immediately. … If he gets in, then things will really explode."
Curtis wasn't the only one to call out Sarandon for the remark. "The idea that Susan Sarandon wud say that NOT supporting Hillary in a HRC/Trump race is a legitimate choice for Democrats, is insane," Mysteries of Laura star Messing, 47, wrote on Tuesday night, which warranted another response from Sarandon.
To drive her point home, Sarandon pinned a tweet on her verified page, which has more than 350,000 followers, in which she disputed a report by The Hill.
Watch her appearance on MSNBC above.


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Broadway On My Mind
LAVA Broadway on My Mind walking tour #6 February 23rd 2014
Join us as we restart the post-Salon walking tour series with the new year. February will bring John Parkinson back into focus as we take a stroll down "Parkinson Alley," that stretch of West 5th Street stretching from Spring through Broadway and Hill which is thick with examples of this iconic Los Angeles architect's work. And who better to help us parse the landscape than Parkinson's advocate, Stephen Gee, whose book, Iconic Vision: John Parkinson, Architect of Los Angeles is the definitive survey of this seminal Los Angeles designer and builder? In addition to Stephen, the tour will be hosted by, Richard Schave.
Youtube Channel link for Broadway On My Mind Walking Tour February 2014
After his undergraduate studies in art history at UC Santa Cruz, Richard Schave set out to explore the American interior as an itinerent brick mason. His return to his native Los Angeles coincided with a renewed acquaintance with Kim Cooper, a once-detested academic colleague who would become his bride. Together, fusing scholarly research with new digital tools, they launched the 1947project time travel blog, along with In SRO Land, and On Bunker Hill, as well as the Esotouric tour company. With the success of Kim's True Crime tours, Richard developed a series of Literary and California Culture excursions. Richard is a dedicated preservationist, and the host of the LAVA Sunday Salon and the LAVA Literary Salon series, named Best L.A. Literary Salon by Los Angeles Magazine. He also curates an ongoing series of forensic science programs at Cal State Los Angeles. Richard is also a reader at the Huntington Library.
« LAVA Sunday Salon January 2014	» LAVA Sunday Salon February 2014


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Tales From the Dispensary: "While 4/20 Was Great, as a Business Owner, I'm Actually Looking at Green Friday"
4/20 sales hit new records this year, but there's another day you should be watching for even bigger profits…
April 20 (4/20) is a day that cannabis businesses, consumers, and investors alike look forward to all year long.
It's the unofficial cannabis holiday that draws millions of shoppers to dispensaries across the country to take advantage of deals and giveaways. This year was no different.
For example, on April 20, 2021, Planet 13 Holdings Inc. (OTC: PLNHF) recorded its highest single-day sales record as customers flocked to its Las Vegas superstore to celebrate and spent $543,000.
Ayr Wellness Inc. (OTC: AYRWF) hauled in a total of $1.24 million across its six-state footprint.
Now, those are both great companies.
But if you're just looking at those single-day sales from other companies you were on the fence about buying, you're not getting the full picture of the impact 4/20 has on cannabis businesses – or the industry as a whole.
Because while the 4/20 hype suggests it's the biggest cannabis sales day of the year, what most people in the business don't talk about is the "4/20 hangover." They'll also bury the fact that those numbers from April 20th can be inflated because of discounts that brought in a lot of people but will hurt the bottom line.
That's why I wanted to bring you this first-hand report from dispensary owner Charlie Delvalle, who was on the ground at his Hashstoria stores.
Because there's actually an even more important day that you should be looking forward to as the most profitable day of the year that will really add to the bottom line…
Get the truth about 4/20 cannabis sales in Charlie's boots-on-the-ground report below:
Learn How to Start Making Money From Cannabis Today With This Winning Stock Portfolio That's Bursting With Profit Potential
Our NICI Membership subscribers just had the chance to cash out for a triple-digit return on a single trade after our initial buy recommendation 11 months ago. With four of our NICI Membership model portfolio positions up over 100% (and one as much as 335%), plus five more raking in double-digit gains over the last 18 months on average, you simply can't afford to miss out on any more of these real-time profit alerts. Find out how you can get in on the next round of profits right here.
One response to "Tales From the Dispensary: "While 4/20 Was Great, as a Business Owner, I'm Actually Looking at Green Friday""
Linda Dyson says:
How do I get into the cannabis Stoke Market?


They have release_32 in svn. I don't know they might be released, though.
And, could you suppress generating refs/heads/svn-tags and prune them for now?
>>> I can't find any release_32 branch at http://llvm.org/git/llvm.git or http://llvm.org/git/clang.git.
>> really bad job here.
>> I'm going to work on this tonight.


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Un sensor de impacto, detector de choque o monitor de impacto es un dispositivo que indica si se ha producido un choque físico o un impacto. Por lo general, tienen una salida binaria (go/no go) y, a veces, se denominan dispositivos de sobrecarga de choque. Los detectores de golpes se pueden utilizar en envíos de artículos valiosos frágiles para indicar si puede haber ocurrido una caída o impacto potencialmente dañino. También se utilizan en cascos deportivos para ayudar a estimar si puede haber ocurrido un impacto peligroso.

Por el contrario, un registrador de datos de choque es un sistema de adquisición de datos para el análisis y registro de pulsos de choque.

Descripción general
Los choques e impactos a menudo se especifican por la aceleración máxima expresada en g-s (a veces llamadas fuerzas g). La forma del impulso de choque y, en particular, la duración son igualmente importantes.  Por ejemplo, un impacto corto de 1 m/s 300 g tiene poco potencial de daño y no suele ser de interés, pero un impacto de 20 m/s 300 g puede ser crítico. Dependiendo del uso, la respuesta a esta sensibilidad de tiempo de un sensor de impacto debe coincidir con la sensibilidad del elemento que está destinado a monitorear.

La ubicación de montaje también afecta la respuesta de la mayoría de los sensores de impacto. Un impacto en un elemento rígido, como un casco deportivo o un paquete rígido, puede responder a un impacto de campo con un pulso irregular que, sin un filtrado adecuado, es difícil de caracterizar. Un choque en un artículo acolchado generalmente tiene un impulso de choque más suave y, por lo tanto, respuestas más consistentes del detector de descargas.

Los choques son cantidades vectoriales en las que la dirección del choque es importante para el elemento de interés. Los sensores de impacto también pueden ser muy sensibles a la dirección de la descarga de entrada.

Se puede evaluar un sensor de impacto:

•	Por separado en una prueba física de laboratorio, tal vez en una máquina de choque instrumentada.

•	Montado en su elemento previsto en un laboratorio de pruebas con accesorios controlados y choques de entrada controlados.

•	En el campo de entrada con impactos incontrolados y más altamente variables.

El uso de métodos de ensayo adecuados y protocolos de verificación y validación es importante para todas las fases de la evaluación.

Tecnología
Se encuentra disponible una amplia variedad de tecnologías que van desde simples indicadores analógicos hasta componentes electrónicos más sofisticados. Por lo general, un dispositivo proporciona una indicación óptica de un evento desencadenado, pero a veces se pueden proporcionar señales eléctricas:

 sensores como acelerómetros y sistemas microelectromecánicos asociados
 sistemas de masa-resorte que pueden ser activados por un impacto
 bolas magnéticas que se pueden desprender de un soporte
 interrupción de la tensión superficial de un líquido
 rotura de un componente frágil de bajo costo con una fragilidad conocida

Monitoreo de envíos

Se puede montar un sensor de impacto en un paquete (interior o exterior) o directamente en el producto que se envía. El montaje en el paquete generalmente se realiza para detectar una manipulación excesiva, como alturas de caída elevadas, mientras que el montaje en el producto se realiza para indicar más de cerca el daño del producto.

Algunos envíos necesitan más de un detector de impactos para monitorear mejor todas las direcciones de los impactos. Los artículos grandes o largos a veces tienen detectores de impacto en ambos extremos del contenedor de envío.

El sensor de impacto indica si es probable que las mercancías en tránsito hayan estado sometidas a condiciones potencialmente dañinas. Según estos datos, las opciones pueden ser:

 Si no ha habido un choque inusual, continúe usando el envío como está, sin una inspección especial
 Si se han producido riesgos potencialmente dañinos, inspeccione minuciosamente el envío en busca de daños o realice una calibración adicional antes de su uso
 El destinatario puede optar por negociar con el transportista, el remitente o el proveedor o incluso rechazar un envío en el que los sensores indiquen un daño severo

Los golpes y los impactos no son los únicos peligros que pueden causar daños; la vibración, los pinchazos, la compresión, etc. también pueden causar daños pero no activarían un sensor de impacto.

Impacto a personas

Los equipos de protección personal, como los cascos, a veces están equipados con monitores de impacto.  Estos están destinados a ayudar a saber si ha ocurrido un impacto excesivo y ayudar a dirigir el descanso o la atención médica necesarios. La investigación continúa, incluidos protectores bucales especializados para ayudar a clasificar los impactos en la cabeza.

Los sensores de colisión de los cascos de ciclismo pueden detectar una colisión y pedir ayuda. Los sensores de caída están disponibles para las personas mayores para pedir ayuda cuando se detecta una caída.

Otros usos
Un uso relacionado de un sensor de impacto es por ejemplo, el sensor de la bolsa de aire del automóvil. Estos sofisticados sensores se utilizan para activar el sistema de bolsas de aire de protección que se utilizan en los vehículos actuales.

Los sistemas de protección activa del disco duro detectan los impactos en las computadoras portátiles para ayudar a minimizar los daños causados por caídas.

Algunas balizas de localización de emergencia, como los transmisores de localización de emergencia, se activan debido a un choque o impacto específico.

Interpretación
Los sensores de impacto se utilizan para indicar si se ha producido un impacto significativo: esto ayuda a determinar la necesidad de acciones de seguimiento. La variabilidad siempre está presente y debe tenerse en cuenta en el análisis:

 Los sensores de impacto tienen alguna variación en la respuesta a las descargas en condiciones controladas de laboratorio.
 Las personas responden de manera individual a los impactos. Lo que podría causar lesiones a una persona podría no ser tan grave para otra.
 Los artículos frágiles y los productos envasados responden con variaciones a los choques de laboratorio uniformes.
 Los choques de campo son muy variables.

Por supuesto, es mejor cuando el detector de golpes indica correctamente cuándo es probable que haya daños o lesiones y cuándo no. Es muy posible tener señales falsas positivas cuando se activa un detector de choque pero no hay daño en un producto o no hay lesiones a una persona. Asimismo, también son posibles falsos negativos.

Los sensores de impacto están diseñados para indicar un solo choque o impacto severo. En algunos casos, una serie de choques menores pueden causar daños o lesiones, pero no activarían un sensores de impacto.

Véase también

 Errores de tipo I y de tipo II
 Embalake
 Criterio de lesión encefálica
 Casco de fútbol americano
 Sistema de telemetría para impactos en la cabeza
 Matriz de confusión

Referencias

Bibliografía
 DeSilva, C. W., "Vibration and Shock Handbook", CRC, 2005,
 Harris, C. M., and Peirsol, A. G. "Shock and Vibration Handbook", 2001, McGraw Hill,
 Yam, K.L., "Encyclopedia of Packaging Technology", John Wiley & Sons, 2009,

Instrumentos de medición
Embalaje
Cascos


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Tag: infection control (Page 1 of 2)
January 10, 2022 / Delta Dental
Monitoring sterilizer functionality is crucial for every office. If your California-based practice has a quality assessment (QA) review coming up, you'll want to be absolutely certain that you're properly spore testing all sterilizers on a weekly basis. Improperly sterilized equipment is one of the most common reasons for QA non-compliance.
Spore testing, or biological monitoring, remains the best assurance that sterilization equipment is functioning and that your office is performing instrument processing procedures correctly. Spore testing assesses the killing of highly resistant Geobacillus and Bacillus spores. Inactivation of these microorganisms strongly implies that other potential pathogens in the load have been eliminated.
Here's a checklist of important points to keep in mind to make sure your practice is safe and compliant when it comes to spore testing sterilizers.
Spore test all sterilizers
You must test all sterilizers present in your sterilization area. If a sterilizer is not currently being used, or is considered a back-up, it still must be spore tested at least weekly. To remain in compliance, store out of use or broken sterilizers away from the sterilization space in your practice if you are not conducting weekly spore testing on them.
Spore test at least once a week
California Code of Regulations states: "Proper functioning of the sterilization cycle of all sterilization devices shall be verified at least weekly through the use of a biological indicator (such as a spore test). Test results shall be documented and maintained for 12 months."
In addition, the Centers for Disease Control and Prevention and the American Dental Association both recommend sterilizers be monitored at least weekly with biological indicators.
Retain records of spore testing for at least a year
With mail-in services, recordkeeping is done by the monitoring service. During a QA review, the examiner reviews records related to spore testing, so be sure to have them on hand for at least the past 12 months.
Remove any sterilizer with a positive test
If a positive test is reported on a sterilizer, immediately retest the sterilizer using the same cycle that produced the positive result. The sterilizer must be removed from service until you get a passing result from the retest. Most failed spore tests are due to operator error, so a passed retest confirms that the sterilizer is safe to use. Remember to document both the failed test and the passing retest in this scenario.
If the retest confirms a positive spore growth, then the sterilizer must remain out of service and all instruments that were sterilized by that machine must be recalled from use and re-sterilized through a different sterilizer to confirm that they are safe for patient care. The broken sterilizer must be inspected, repaired and re-challenged by passing three consecutive spore tests taken on three fully loaded cycles prior to returning the sterilizer to service.
During a QA review, it is not uncommon for an auditor to see failed spore testing results. A failed spore test will not cause a failure of the QA review so long as the office followed and documented the proper protocols after a failed spore test to ensure safe care for patients.
Do not substitute other forms of testing for spore tests
Spore testing is the standard for assuring proper sterilization of dental instruments. Mechanical or chemical indicators can help with the detection of procedural errors or malfunctions, but they do not verify sterility, and they do not replace the need for weekly spore test.
How to tackle antibiotic overprescription
September 13, 2021 / Delta Dental
In 2019, American health care providers of all specialties wrote a total of 251.1 million antibiotic prescriptions — that's enough for three-quarters of Americans to receive at least one. That number wouldn't necessarily a problem if all of the prescriptions were necessary and prescribed within guidelines set by health care associations, but that isn't always the case. In fact, nearly a quarter of prescriptions are most likely unnecessary, according to a cross-sectional study.
And, unfortunately, dentists are some of the top antibiotic prescribers in the United States.
Why antibiotic stewardship is important
Being thoughtful when prescribing antibiotics is part of a practice called antibiotic stewardship. Antibiotic stewardship is an effort to improve how antibiotics are prescribed and used. The goal is ultimately to treat infections more efficiently and to combat antibiotic resistance.
The most dangerous result of antibiotic overprescription is antibiotic resistance. When germs are exposed to antibiotics but not killed, they evolve and develop resistance to drugs. Those resistant germs cause infections that are difficult, if not impossible, to treat and can increase the mortality rates of once treatable infections.
When antibiotics are prescribed improperly, patients may have to deal with the adverse physical effects of antibiotic treatment for no reason. Common adverse effects include nausea, abdominal pain and vomiting, and they happen in almost 10% of patients. Even more, antibiotics can be a financial burden. Without insurance coverage, the average cost of generic antibiotics is about $43 for a 500mg dosage.
The dentist's role in overprescription
According to surveys of antibiotic prescriptions in the U.S., dentists write one in 10 antibiotic prescriptions. In a study done on prescription rates in Australia, England, the U.S. and British Columbia, dentists in the U.S. were found to be the most prolific antibiotic prescribers. American dentists prescribed twice the amount of antibiotics that Australia, the least prolific, did per 1000 population. Studies reveal that almost 81% of antibiotics prescribed by dentists are used against stewardship guidelines.
Antibiotics are a vital tool in dental health, especially when treating patients with comorbidities that can increase the danger of an infection, like heart disease. The American Heart Association recommends that only patients at the highest risk for adverse outcomes from infections should be prescribed antibiotics. They should absolutely be prescribed when necessary. But before you prescribe, take a moment to consider whether antibiotics are necessary.
There isn't a "one size fits all" approach to managing antibiotic use. The reason antibiotic overprescription is so prevalent is also the reason it's difficult to change: medical decision-making is incredibly complex. To tackle overprescription in your own practice, you can:
Use guidelines from the Centers for Disease Control and Prevention or the American Dental Association to reduce any prescription uncertainty.
Include information for your patients about practices like watchful waiting, which is when you give a written prescription but ask your patient to delay filling it in case they feel better.
Include materials around your office that inform patients about the dangers of not taking their full antibiotic prescription.
Use the tips above to be antibiotic aware and to inform your colleagues and patients about the importance of antibiotics stewardship.
Common questions your patients may have about the COVID-19 vaccine
March 3, 2021 / Delta Dental
As the COVID-19 vaccine is becoming more accessible throughout the country, you may find more of your patients talking about it and asking questions. Unfortunately, there's a lot of conflicting and inaccurate information being spread through various media channels. Staying on top of the truth can be a full-time job, but here's a list of common questions and some points you can bring up in case your patients come to you with concerns about the vaccine.
Is the vaccine safe?
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Concerns about catching COVID-19 from a vaccine shot. There is no live virus used in the vaccines, so people who receive them can't contract COVID-19.
Concerns about the vaccine damaging cells' DNA. mRNA vaccines don't alter cell DNA. Instead, they teach cells how to make a protein, which generates an immune response that will help cells target similar proteins in the COVID-19 coronavirus.
Concerns about the vaccines being developed recklessly or too quickly. The vaccines have been tested on tens of thousands of patients. Pfizer and Moderna have published ingredient lists for their vaccines, and the mRNA technology used to make the vaccines has been in development for over 30 years.
I've heard reports of people having aches, chills and other symptoms after getting vaccinated. Is this an issue?
No. Some people who have gotten the vaccine have reported muscle pain, chills and headaches, but that is not unusual for vaccines. These are part of the body's normal immune response. But if you've had an allergic reaction to vaccines in the past (which is due to the ingredients used in the vaccines), then you should first consult with your health care provider.
Should I still get a vaccine if I've had COVID-19 previously?
Yes. It's not clear if having contracted COVID-19 previously grants long-term resistance and immunity, like chicken pox does. Even for those who have been infected previously, the CDC still recommends getting vaccinated.
COVID-19 doesn't seem that deadly. Should I get a vaccine if I'm not in a high-risk category?
Yes. It's true that as a percentage, most people who contract COVID-19 don't die from it. Still, there can be serious long-term consequences such as lung, heart or brain damage. And even someone who doesn't get seriously ill can still spread the disease among others who are more vulnerable. Getting a vaccine helps you protect not just your family and loved ones, but also society as a whole. These are important reasons to get the vaccine.
Once I've been vaccinated, do I still need to wear a mask or socially distance?
Yes. Even if a person has been vaccinated, that doesn't mean that he or she can't still spread the virus. It takes at least 10 days for the body to develop antibodies, and the number of antibodies present only goes up with more time. Additionally, research hasn't conclusively determined if the vaccines prevent asymptomatic infection and spread (although it is likely that they do). Wearing a mask and socially distancing are also good behaviors to model for those who haven't been vaccinated yet. By getting vaccinated and following other preventive measures, you can do your part to end the pandemic sooner!
I've heard that the vaccine contains a chip inside that lets the government and corporations track people who get vaccinated. Is this true?
No. Some syringe makers include a microchip within the label of their syringes so that health care providers can track the shipping history and origin of doses of vaccine, but there is no chip in the vaccine itself.
I heard that the vaccine targets a protein that occurs naturally in pregnant women and can cause fertility issues. Is this true?
No. An amino acid sequence is shared between COVID-19 and a placental protein found in pregnant women, but the sequence is too short to trigger an immune response by itself. COVID-19 vaccines won't cause fertility issues in women.
For further information on key facts about the vaccine and how you can play a role as a trusted health care provider, please consult the American Dental Association's COVID-19 vaccine page.
Dentists and the COVID-19 vaccine: what to know
After a somewhat rocky start, the COVID-19 vaccine rollout seems to be progressing favorably for dental professionals. Most states now consider dentists to be essential health care workers eligible for priority vaccination, and many states now allow dentists to administer the vaccine to their patients.
Most dentists can get the vaccine
Most states now include dentists as essential health care workers eligible for their first phase of vaccination, according to the most recent information complied by the American Dental Association (ADA).
Currently, more than half of states place dentists in the highest priority tier, 1a, for immunization.
Several states, including Florida, Minnesota, and Nevada, also include dentists in their first phase of immunizations, but give counties the discretion to prioritize them higher or lower within that phase.
Other states, including Colorado, Louisiana and North and South Dakota, include dentists in their first phase of immunizations but place them in a lower-priority tier than other essential health care workers.
Only a few states don't consider dentists to be essential workers. Oklahoma classifies dentists as part of a group of "allied health fields and general outpatient health service priority groups" that will be eligible for the vaccine as part of the state's second phase of immunizations. Texas, meanwhile, has not yet determined where dentists will fall within its immunization plan.
Some dental staff can also get the vaccine — and may be required to do so
Several states, including Arkansas, Georgia, Iowa, New York and Wisconsin, consider dental office staff such as dental hygienists to be essential health care workers eligible for priority vaccination.
Dental practice owners may also be able to require their staff to receive the vaccine. There are some important caveats to consider, though. For instance, if your practice has 15 or more employees, a vaccination requirement must accommodate disabilities, including pregnancy-related issues, under the Americans with Disabilities Act, and must respect staff members' religious beliefs. You may also be required to pay for the vaccinations.
Despite these challenges, it might be an option worth pursuing. A recent survey found that 64% of patients who were hesitant to return to their dental office would be willing to do so if the entire staff had received the COVID-19 vaccine.
Many dentists can administer the vaccine
Currently, dentists in at least 20 states can administer the COVID-19 vaccine. It's worth noting, however, that not all these states will necessarily allow dentists to vaccinate patients in their dental offices.
For instance, the California Dental Association says it's unlikely that dentists in the state will be able to administer vaccines from their dental offices because of storage requirements, billing issues and space requirements for patients who need to be monitored after they receive the vaccine. More likely, they say, is that dentists will be able administer the vaccine at hospitals or through government vaccination programs, such as mass vaccination sites.
In New York, dentists can administer the vaccine only at sites overseen or approved by the state or a local health department and supervised by physicians, physician assistants or nurse practitioners.
Members of your staff may also be able administer the vaccine. For instance, California and some other states will allow dental hygienists to do so.
To help you determine your state's rules about administering the vaccine, the ADA has created an interactive map with the latest updates.
In eligible states, dentists and dental hygienists who wish to administer the vaccine may also have to complete training beforehand. The ADA has compiled a state-by-state guide that includes information about the vaccine, educational resources and training.
Finally, the ADA is also requesting that the federal government grant liability protection to dentists who administer the COVID-19 vaccine.
Return to Care supplemental reimbursement program extended through 2020
October 9, 2020 / Delta Dental
To help you continue to provide care to your Delta Dental patients during the ongoing COVID-19 pandemic, we're extending the Return to Care supplemental reimbursement program through December 31, 2020.
As a network dentist, you'll receive a $10 supplemental reimbursement for performing qualifying evaluation or consultation codes. The program launched June 22 and was later extended to October 20.
The latest extension to December 31 is meant to offer you additional support and help you adjust to the new conditions as you prepare for 2021. There are no other changes to the program that is currently in place.
For more details on the supplemental reimbursement program, please see the complete FAQ.
As before, to receive the reimbursement, you must participate in one of the following networks and treat an eligible patient covered by one of these Delta Dental plans:
DeltaCare® USA
Delta Dental PPO™ and DPO in Texas (see applicable Delta Dental companies below)
Delta Dental Premier® (see applicable Delta Dental companies below)
Delta Dental Federal (Legion), Medicare Advantage
Applicable Delta Dental companies include Delta Dental of California, Delta Dental Insurance Company, Delta Dental of Pennsylvania, Delta Dental of the District of Columbia, Delta Dental of Delaware, Inc., Delta Dental of West Virginia, Inc. and Delta Dental of New York, Inc.
The Medi-Cal Dental, CDPHP (NY Medicaid) and HSCSN (Washington, D.C. Medicaid) networks are not eligible for this reimbursement.
Reopening: A success story from Modesto, California
The coronavirus pandemic has been difficult for everyone, but it has been particularly tough on the dental industry. In mid-April of this year, for instance, almost 95% of dental practices reported being either closed completely or open only for emergency patients, according to an American Dental Association (ADA) survey. Most practices reported that their practice volumes were less than 5% of usual, and collections were also down dramatically.
While the pandemic continues, many practices have been able to reopen successfully. And their patients are returning. But reopening hasn't been without its struggles.
Dr. Ray R. Rodig, DDS, owner of the Vintage Dental practice in Modesto, California, talks about the process of reopening, some of the challenges — both expected and unexpected — and offers some tips and best practices for others in the same situation.
For how long was your practice closed?
Almost 11 weeks.
When did you reopen?
Why did you decide upon that date?
We had done all of our research into what would keep our patients and team members healthy and safe at the office. We had a couple of "practice runs" the week before to work out our new patient flow to make sure it was workable, safe, complete and comfortable for patients and team alike. While hard to get, we had all the PPE we needed, our air purifiers and sneeze guards were in place — we were ready to go back to work, and the ADA said it was safe.
What challenges did you face initially?
The fear and uncertainty of both patients and team members — some patients are still not comfortable returning and have appointed out into November and December. There's also a balancing act with moving our patients through the office, making sure there's no "traffic jams" — no one coming in contact with each other in the office. And finding and ordering PPE was very difficult. Thank goodness for our local Stanislaus Dental Society! They really helped and kept us in the loop.
Which was the most difficult to address?
Some people — very few — are just put off by having to wear masks. We explain that they'll only need them entering and leaving the office and that we'll even provide them, but some folks just don't want to accept this. We're patient and understand completely, but we just need to keep everyone safe. No exceptions.
Did you encounter any challenges that you weren't expecting or that surprised you?
The heat and stress of wearing the extra PPE really surprised us. Just breathing takes so much more energy — learning to breathe with N95s, wearing both scrubs and full-length gowns together. It creates a lot of heat and stress that we didn't even think about before we started back.
Which challenges have been resolved and which are ongoing?
The biggest challenge we seem to have is letting our operatories sit empty for five minutes. We need a bit more time to turn over the operatories now, which creates a scheduling issue. We've resolved this by revamping the schedule, but it continues to evolve daily, as no day is ever the same, and turning over the operatories and taking the extra time to complete a thorough sterilization is a challenge.
I'd also say closing our reception area has been a real process. It's yet another scheduling issue involving the flow through the office, but our patients understand what we're doing and why, so it's really become a non-issue.
And we're getting used to the hot PPE, but I'm sure hoping this doesn't become the "new normal." It's sure hard to visit with our patients now.
How did your staff react to returning to work? Did any refuse?
Thankfully, our team was ready to come back to work — not one person refused. Some voiced safety concerns in our team Zoom calls prior to reopening, but we answered their concerns, and everyone came back.
What additional precautions have you had to take in your office?
We closed our reception area, and our patients must call and wait in their cars for their appointments — this was very odd for us since we like to visit with our patients, but they seem to understand. We also don't allow extra persons to come with them unless they have appointments, too. All patients need to answer a series of questions, sanitize their hands and have their temperature taken before we'll take them to their operatory. Temperatures of all team members are taken as they enter and as they leave each day.
Our team members in the back office wear two masks (one being an N95), a face shield, scrubs and a full-length surgical gown, and most like to wear bouffant caps. Before COVID, we only wore level 3 masks, face shields and lab coats.
We have limited the use of the cavitron, and have external vacuum machines to help suction any aerosols away while in treatment or hygiene; we use Isolites as well.
Our front team wears masks and are stationed behind large sneeze guards, and they're constantly sanitizing all pens, files, countertops, etc. There's hand sanitizer everywhere. The office is fogged daily, and we have air purifiers in every operatory.
Additionally, we started using a COVID-19 testing program weeks ago through Pathnostic. We have kits on hand, and if someone isn't feeling well, has a cough or fever, or has come in contact with someone they think (or know) has been ill or had COVID-19, we have kits in the office that are simple to use, comfortable, and we get results back in a couple of days.
I highly recommend these for safety and peace of mind, and they're not scary, painful tests. There's no cost to the office or the person being tested. We've tested team members, family members, friends, patients — and everyone is surprised at how easy they are to do, and how fast we get the results back. It's comforting to know we can find out quickly if there's a problem.
Have you had to discontinue use of certain equipment or purchase new equipment?
We have limited the use of cavitrons — the hygienists have external suction machines to limit aerosols in addition to air purifiers in their operatories, so we leave it up to the hygienists to decide whether to use it. As far as equipment is concerned, we have really only purchased air purifiers for each operatory and a fogger we use daily at this point. Our office has always been very sterile and safe, so we didn't have to change or add much.
What kinds of additional expenses have you faced as a result?
The professional installation of sneeze guards was a bit pricey but certainly necessary, and the cost of PPE went through the roof — that's quite an expense right there.
How do ask your patients to prepare for a visit?
Our front office will call our patients the day prior to their appointment and ask all the same questions that we will ask when they arrive for their appointment. We don't want them to show up and not be able to see them due to travel, or fever, or coming in contact with someone who may be sick. We ask that they wear a mask, arrive at the time of their appointment, call us from their car when they arrive, and we call them back to let them know when to come inside.
What do ask your patients to do when they arrive?
Our reception area is locked; when they call to let us know they've arrived, we let them know that we will call them back when they can enter. Once their assistant or hygienist is ready, we call and ask them to come on in. Our team opens the door, so patients don't have to touch the door handle.
How have your patients responded?
Some have been a bit confused at first, but 99.99% of our patients are happy we're working hard to keep them safe and healthy. The .01% that are unhappy about wearing masks are still appreciative of our efforts. Some are pretty amazed at all the precautions we take and have taken some of our ideas to implement in their homes.
Have your patients had any concerns? How have you addressed them?
Their concerns seem to center around safety. Once we walk them through the process over the phone, they understand that each patient is carefully screened and put through the same process they're going through, as well as our team members. Most are confident by the time they get here and are definitely confident when they leave.
What is your current situation in terms of patient volume? Collections?
We were very surprised at how busy we were right from time we reopened and we've continued to stay busy — new patients, patients coming back for treatment diagnosed prior to closure, past patients with new treatment needs — people seem to be excited to be able to get back to keeping their teeth healthy. Our collections have exceeded our expectations, as has the patient attendance. We were pleasantly surprised.
How has this changed since you initially opened?
Our patient flow is much more of a rhythm now — at first it was disconcerting implementing all the new steps, but now it's a habit and much easier. I'm also blessed with a great team and great patients.
What advice do you have for other dentists in a similar situation?
I'd say everything can be really overwhelming at first, but as the old saying goes, "How do you eat an elephant? One bite at a time." Do your research, figure out what works best for you and your team, find out what is working for other professionals in your local dental community and emulate them.
We thought it would be very hard to reopen, and while it seemed very challenging at the beginning, it became easier sooner than we anticipated. And let your patients know what you're doing to keep them safe — they'll appreciate that.
Is there anything you'd caution other dentists about or recommend that they look out for?
I'd make sure that your team knows how important it is to everyone that they practice social distancing in the office.
We protect ourselves from our patients, but once the PPE comes off and we're with our "office family" we can't forget that we need to keep our distance from each other. This isn't the easiest thing to do — we have staggered lunches, plenty of room in our breakroom and wear masks when not eating.
And remind your team about social distancing and wearing masks away from the office. We need to protect each other.


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