Your adult academic life will be defined by two of the most important exams: your SAT exam and your GMAT exam. You will spend quite some time properly preparing for these exams, but many of you are still unaware of how to manage the process itself. Fear not, because, in the following paragraphs, we will offer you some more information on these highly important tests.
You may be familiar with these tests, but if you're not, you must know that this is one of the two college admission tests across the US. SAT tests are standardized exams, as their name implies and they are designed to show schools how prepared are you for college. If you're applying for any college across the US, you will certainly have to take a similar test. In some cases, SAT scores account for as much as 50% of the final score, so you have to carefully prepare for yours. Below are some tips that will help you manage the whole process easier.
Get to know the logic behind the test. This is one of the most important things that you should get a hold of. After understanding how the test works, you will be able to structure your learning materials and resources more effectively, and even get enrolled in some SAT prep courses. This will help you enormously, in the long run.
Divide your learning materials depending on areas covered: reading, math and writing. If you attend specialized preparation courses or classes, you will receive all the needed learning materials, so you don't have to worry about that.
On the other hand, GMAT tests are specifically designed for those who plan on taking the MBA path. This test is a standardized test as well, a test that will show the preparedness of those taking it for the academic life at a Masters in Business Administration program. Thus, if you plan a business administration career, you most likely have to take this test. Some good tips to prepare for this test are as it follows.
Find a structured study plan and follow it rigorously.
Enroll in GMAT prep classes and courses. Make sure to select the course vendor with care. Only the most reliable ones out there will offer appropriate study materials and resources, so research your options well.
Follow the test prep advice that you'll receive in your prep classes. It will help you enormously, as you will receive insightful information on some of the best strategies to prepare for this highly important test of your adult life.
Finding reliable learning and study materials is one of the key steps to spotless scores in two of the most important exams of your adult academic life. Make sure that you research your options well when you decide that you need some extra help with your preparation. However, planning and an organized mind can go a long way when you prepare for similar tests. If it helps, invest in a planner and divide your learning activities in it.


Kelly Giles was raised on his family's corn, wheat, cattle and hay operation in Southwest Kansas and he continues the ranching tradition today with his son, Logan, building an Angus seed stock business and ranch near Canyon, Texas since 1999.
Kelly specializes in sculpturing land asset investments and working with buyers to find just the right property. Whether you are looking to purchase an operational unit, an income producing farm or ranch, a recreational property, or an executive estate, Kelly has the network to bring it to fruition. If you are considering a sale on a property, keep in mind that Kelly has an association of buyers searching for specific Ag Real Estate. Kelly is a member of the Realtor® Land Institute and the National Association of Realtors®.


Contemporary design matched with function. This multi-tasking neoprene case is perfect for those wanting something practical and simplistically styled. Having generous space for daily digital essentials, the case is fastened with an ergonomic handle, and is equipped with GRID-IT!® inside. The perfect solution for gamers on-the-go!
W:7.83" x D:0.98" x H:7.83"
W:7.32" x D:0.34" x H:7.32"


text:
package com.dropbox.djinni.ideaplugin.psi;

import java.util.List;
import org.jetbrains.annotations.*;
import com.intellij.psi.PsiElement;

public interface DjinniConstNamedValue extends DjinniNamedElement {

  @NotNull
  PsiElement getIdentifier();

  String getName();

  PsiElement setName(String newName);

  @Nullable
  PsiElement getNameIdentifier();

}

redpajama_set_name: RedPajamaGithub


text:
Intro/History
Intro History
Buntings Sparkers Restoration
General Communications HMS MercuryHMS GangesMinor Snippets
Communicator Publications Personal
Naval Artefacts - The Pussers Clock
Written by Godfrey Dykes
© RN Communications Branch Museum/Library
Just one of the pieces in my collection which are all certificated. This one is the Pussers (Royal Naval) clock which adorned the captain's bridge in our last battleship, HMS Vanguard. Our capital and major warships, including cruisers, were all capable of acting as a flagship* and thus had accommodation for an admiral and his staff which included an admiral's bridge, quite separate to that of the ship's or captain's bridge. Admiralty naval stores item number was 0552/461-9413.
My collection was purchased from Flemings of Southsea, Hampshire, UK over a period of approximately six years. Flemings (not to be confused with the naval tailors of the same name and same trading period although they were in Queens Street in nearby Portsmouth) were high profile buyers of ex-Admiralty equipments and everything they sold worked and was in excellent condition, often brand new. What they offered was sold on a 'first see-first buy' basis without privilege, pomp or circumstance! If you could pay the asking price, it was yours.
Talking about the Vanguard, I like this story about her which comes from the Times On-Line (Archive) of 1947. It was during the crossing-the-line-ceremony with the Royal Family embarked to South Africa, that the Captain of the ship standing with the King on the fo'c's'le, stopped looking at the two ends of a massive 28" hawser laying on the deck which the King was told was the 'main-brace'. "Well" said the King, "it's in a sorry state. You had better splice it", whereupon there was much jollity by her lower-deck crew members. It certainly was an occasion for God to Bless the King.
Portsmouth Dockyard Panic Stations
* In the 1970's (and at other times too) smaller ships were used as flagships and these included mainly the heavy destroyers, the GMD's (or DLG's) plus HMS Bristol a type 82 destroyer. However, I experienced several flagships whilst on the staff of Rear Admiral (Whisky - the admiral was a Scot) Wemyss {Rear Admiral Martin La Touche Wemyss} FOF2, and I can assure you that 'comfort and facilities' meant either the cruiser Tiger or Blake. Of the other big ships, LPD's, LPH's and fixed-wing Carriers, these acted as flagships to FOCAS (Flag Officer Carriers Assault Ships).

redpajama_set_name: RedPajamaCommonCrawl


Well, all of the quotes on my Movie List were finally identified. However, #2 on the TV list was not; no one even ventured a guess that came within miles of it.
I was actually pretty confident that it would not be identified, as only I and about three other people in the country ever watched this short-lived series.
"This man confuses me; kill him!": Spoken by the Supreme Gorgon to his minions about the dual-personalitied Gene/Jean, in the TV show "Quark", starring Richard Benjamin as Captain Quark, commander of a spacegoing garbage scow who kept getting involved in cosmic conflicts. A sort of attempt at "Galaxy Quest" well before its time, Quark was an SF comedy which had some really bright ideas but, in my opinion, overkill execution. The idea of a crew of misfits saving the world is not a new one, but you need a balance between the silliness of your crew and some seriousness to carry the plot along. Quark was far too overbalanced with silliness: Quark himself was the only straight man, an apparently quite intelligent and competent captain who somehow had been saddled with the worst crew ever assembled in one place: Ficus, the plant-man science officer who made Mr. Spock look like a raving hysteric; Gene/Jean, both male and female sets of genes and of personalities (Gene was a warmongering combat machine, Jean a pacifist); and a pair of beautiful identical twins (I think they were Betty and Betty, but I'm not sure after all these years) who were as I recall archetypes of Dumb Blonde.
Quark took jabs at Star Trek, Star Wars, and a host of other shows, books, and current ideas. It was a neat attempt, but doomed to obscurity. Galaxy Quest did it much better, many years later. I'm not sure such a thing COULD be done as a long-running series.


1 Oct 2015 . I was starting to find the maps on my RNS 510 were getting a bit out . firmware 5238 on any device from 2005 to October 2013 (with HDD). . You can get the download links from his site, but I'll reproduce the . November 9, 2015 at 2:45 pm . Tell me which can be placed navigation map now, or which.
19 Jan 2018 . The RNS 510 has NOTHING . Rns-510 navigation maps 2013 v9 + download links! - youtube Nov 17, 2011 Here is RNS-510 Navigation.
2 Mar 2016 - 6 min - Uploaded by Ankk VAGCOMInstallation de la cartographie 2016 (V13) sur le RNS-510. Retrouvez les codages Vagcom sur .
18 Nov 2011 - 4 min - Uploaded by Deividas A.Here is RNS-510 Navigation overview. You may download maps for this GPS system here .
12 Oct 2015 - 2 min - Uploaded by BSK GarageUSA Link for Maps Canadian Link for Maps . Just a Quick Video on how .


text:
As a secular, non-sectarian, universal notion of art arose in 19th-century Western Europe, ancient and Medieval Christian art began to be collected for art appreciation rather than worship, while contemporary Christian art was considered marginal. Occasionally, secular artists treated Christian themes (Bouguereau, Manet) — but only rarely was a Christian artist included in the historical canon (such as Rouault or Stanley Spencer). However many modern artists such as Eric Gill, Marc Chagall, Henri Matisse, Jacob Epstein, Elizabeth Frink and Graham Sutherland have produced well-known works of art for churches.[1] Salvador Dali is an artist who had also produced notable and popular artworks with Christian themes.[2] Contemporary artists such as Makoto Fujimura have had significant influence both in sacred and secular arts. Other notable artists include Larry D. Alexander and John August Swanson. Some writers, such as Gregory Wolfe, see this as part of a rebirth of Christian humanism.[3] Christian Canvas Art
"Now I am sending Huram-abi, a skilled man, endowed with understanding, the son of a Danite woman and a Tyrian father, who knows how to work in gold, silver, bronze, iron, stone and wood, and in purple, violet, linen and crimson fabrics, and who knows how to make all kinds of engravings and to execute any design which may be assigned to him, to work with your skilled men and with those of my lord David your father. Bible Verse Wall Art
Huram also made the pails, the shovels and the bowls. So Huram finished doing the work which he performed for King Solomon in the house of God: the two pillars, the bowls and the two capitals on top of the pillars, and the two networks to cover the two bowls of the capitals which were on top of the pillars, and the four hundred pomegranates for the two networks, two rows of pomegranates for each network to cover the two bowls of the capitals which were on the pillars.read more. Share Your Faith Products
What does the Bible say about creativity? The very first verse of Scripture actually describes a creative act as "God created the heavens and the earth." Additionally, from Genesis, the Bible says, "God created man in his own image." This could be interpreted as we are creators just as God created us. We create relationships, art, homes, cities, nations and many more things including inventions even yet to be known! The creative spirit is certainly favored by God and our fellow man. Learn more from the collection of Bible verses about creativity below! Bible Verse Wall Art
Many are the plans in the mind of a man, but it is the purpose of the Lord that will stand. What is desired in a man is steadfast love, and a poor man is better than a liar. The fear of the Lord leads to life, and whoever has it rests satisfied; he will not be visited by harm. The sluggard buries his hand in the dish and will not even bring it back to his mouth. Strike a scoffer, and the simple will learn prudence; reprove a man of understanding, and he will gain knowledge. ... Bible Verse Wall Art
The son of a woman of the daughters of Dan, and his father was a man of Tyre. He is trained to work in gold, silver, bronze, iron, stone, and wood, and in purple, blue, and crimson fabrics and fine linen, and to do all sorts of engraving and execute any design that may be assigned him, with your craftsmen, the craftsmen of my lord, David your father.
In the four hundred and eightieth year after the people of Israel came out of the land of Egypt, in the fourth year of Solomon's reign over Israel, in the month of Ziv, which is the second month, he began to build the house of the Lord. The house that King Solomon built for the Lord was sixty cubits long, twenty cubits wide, and thirty cubits high. The vestibule in front of the nave of the house was twenty cubits long, equal to the width of the house, and ten cubits deep in front of the house. And he made for the house windows with recessed frames. He also built a structure against the wall of the house, running around the walls of the house, both the nave and the inner sanctuary. And he made side chambers all around. ... Bible Verse Wall Art
The porch which was in front of the house was as long as the width of the house, twenty cubits, and the height 120; and inside he overlaid it with pure gold. He overlaid the main room with cypress wood and overlaid it with fine gold, and ornamented it with palm trees and chains. Further, he adorned the house with precious stones; and the gold was gold from Parvaim.read more. Christian Gifts
He made an altar of bronze, twenty cubits long and twenty cubits wide and ten cubits high. Then he made the sea of cast metal. It was round, ten cubits from brim to brim, and five cubits high, and a line of thirty cubits measured its circumference. Under it were figures of gourds, for ten cubits, compassing the sea all around. The gourds were in two rows, cast with it when it was cast. It stood on twelve oxen, three facing north, three facing west, three facing south, and three facing east. The sea was set on them, and all their rear parts were inward. Its thickness was a handbreadth. And its brim was made like the brim of a cup, like the flower of a lily. It held 3,000 baths. ... Bible Verse Wall Art


Like many businesses Santander rely on the great people who work for them to help make the difference to their brand. However just saying 'we have great people who build excellent relationships with our clients' is just not strong enough with today's cynical audiences. Not only that but all banks can use that line and expect it to make them stand out.
Rather than just say it, Santander used their brand stories to evidence the great relationships they build with their clients.
A number of workshops and conversations later, and we were able to gather the business-centric stories needed to launch their two new corporate branches with a bang. Real, engaging and informative are just some of the words used to describe the stories told across two events attended by 150 of the top business leaders in each of Santander's two new city locations. The result – a chance to cut through the clutter with memorable stories that got people talking and helped Santander communicate with their audiences in a new and engaging way.


text:
Reading: The Southwest in the American Imagination: The Writings of Sylvester Baxter, 1881-1891, edit...
The Southwest in the American Imagination: The Writings of Sylvester Baxter, 1881-1891, edited by Curtis M. Hinsley and David R. Wilcox. University of Arizona Press, Tucson, 1996
Richard B. Woodbury
Department of Anthropology, University of Massachusetts-Amherst, Amherst, Massachusetts, US
Those interested only in the history of archeology may be disappointed in this volume, as it is less about the Hemenway Expedition as seen through Baxter's articles on it, than it is about his articles on Cushing at Zuni, as well as in southern Arizona, on Baxter himself (a fascinating person), and on how Baxter and his contemporaries shaped a late 19th century popular image of the Southwest However,this book maybe more important for its portent than its content.
It is the initial volume of a proposed multi-volume series, "Frank Hamilton Cushing and the Hemenway Southwestern Archaeological Expedition 1886-1889." The editors (actually, co-authors rather than only editors) have unearthed, to use an appropriate archaeological term a substantial amount of previously unexamined material relating to the Hemenway Expedition, completely controverting the negative (and, quite wrong) response that Frederick W. Hodge gave to Emil W. Haury's inquiry about records of Cushing's excavations.
How to Cite: Woodbury, R.B., 1997. The Southwest in the American Imagination: The Writings of Sylvester Baxter, 1881-1891, edited by Curtis M. Hinsley and David R. Wilcox. University of Arizona Press, Tucson, 1996. Bulletin of the History of Archaeology, 7(1), pp.4–7. DOI: http://doi.org/10.5334/bha.07103
Woodbury, R.B., 1997. The Southwest in the American Imagination: The Writings of Sylvester Baxter, 1881-1891, edited by Curtis M. Hinsley and David R. Wilcox. University of Arizona Press, Tucson, 1996. Bulletin of the History of Archaeology, 7(1), pp.4–7. DOI: http://doi.org/10.5334/bha.07103
Woodbury RB. The Southwest in the American Imagination: The Writings of Sylvester Baxter, 1881-1891, edited by Curtis M. Hinsley and David R. Wilcox. University of Arizona Press, Tucson, 1996. Bulletin of the History of Archaeology. 1997;7(1):4–7. DOI: http://doi.org/10.5334/bha.07103
Woodbury, R. B. (1997). The Southwest in the American Imagination: The Writings of Sylvester Baxter, 1881-1891, edited by Curtis M. Hinsley and David R. Wilcox. University of Arizona Press, Tucson, 1996. Bulletin of the History of Archaeology, 7(1), 4–7. DOI: http://doi.org/10.5334/bha.07103
1. Woodbury RB. The Southwest in the American Imagination: The Writings of Sylvester Baxter, 1881-1891, edited by Curtis M. Hinsley and David R. Wilcox. University of Arizona Press, Tucson, 1996. Bulletin of the History of Archaeology. 1997;7(1):4-7. DOI: http://doi.org/10.5334/bha.07103
Woodbury RB, 'The Southwest in the American Imagination: The Writings of Sylvester Baxter, 1881-1891, Edited by Curtis M. Hinsley and David R. Wilcox. University of Arizona Press, Tucson, 1996' (1997) 7 Bulletin of the History of Archaeology 4 DOI: http://doi.org/10.5334/bha.07103
Woodbury, Richard B.. 1997. "The Southwest in the American Imagination: The Writings of Sylvester Baxter, 1881-1891, Edited by Curtis M. Hinsley and David R. Wilcox. University of Arizona Press, Tucson, 1996". Bulletin of the History of Archaeology 7 (1): 4–7. DOI: http://doi.org/10.5334/bha.07103
Woodbury, Richard B.. "The Southwest in the American Imagination: The Writings of Sylvester Baxter, 1881-1891, Edited by Curtis M. Hinsley and David R. Wilcox. University of Arizona Press, Tucson, 1996". Bulletin of the History of Archaeology 7, no. 1 (1997): 4–7. DOI: http://doi.org/10.5334/bha.07103
Woodbury, R B. "The Southwest in the American Imagination: The Writings of Sylvester Baxter, 1881-1891, edited by Curtis M. Hinsley and David R. Wilcox. University of Arizona Press, Tucson, 1996". Bulletin of the History of Archaeology, vol. 7, no. 1, 1997, pp. 4–7. DOI: http://doi.org/10.5334/bha.07103


text:
using System;
using System.Collections.Generic;
using System.IO;
using Htc.Vita.Core.Interop;
using Htc.Vita.Core.Log;

namespace Htc.Vita.Core.Net
{
    /// <summary>
    /// Class BitsFileTransfer.
    /// Implements the <see cref="FileTransfer" />
    /// </summary>
    /// <seealso cref="FileTransfer" />
    public partial class BitsFileTransfer : FileTransfer
    {
        private Windows.BitsManager _bitsManager;

        /// <summary>
        /// Initializes a new instance of the <see cref="BitsFileTransfer" /> class.
        /// </summary>
        public BitsFileTransfer()
        {
            _bitsManager = Windows.BitsManager.GetInstance();
            if (_bitsManager != null)
            {
                _bitsManager.OnJobError += OnBitsManagerJobError;
                _bitsManager.OnJobTransferred += OnBitsManagerJobTransferred;
            }
        }

        /// <summary>
        /// Finalizes an instance of the <see cref="BitsFileTransfer" /> class.
        /// </summary>
        ~BitsFileTransfer()
        {
            _bitsManager?.Dispose();
            _bitsManager = null;
        }

        /// <summary>
        /// Converts from.
        /// </summary>
        /// <param name="data">The data.</param>
        /// <returns>Windows.BitsFileInfo.</returns>
        internal static Windows.BitsFileInfo ConvertFrom(FileTransferItem data)
        {
            return new Windows.BitsFileInfo
            {
                    LocalName = data.LocalPath.ToString(),
                    RemoteName = data.RemotePath.ToString()
            };
        }

        /// <summary>
        /// Converts from.
        /// </summary>
        /// <param name="data">The data.</param>
        /// <returns>Windows.BitsJobPriority.</returns>
        internal static Windows.BitsJobPriority ConvertFrom(FileTransferPriority data)
        {
            if (data == FileTransferPriority.Foreground)
            {
                return Windows.BitsJobPriority.Foreground;
            }

            if (data == FileTransferPriority.High)
            {
                return Windows.BitsJobPriority.High;
            }

            if (data == FileTransferPriority.Normal)
            {
                return Windows.BitsJobPriority.Normal;
            }

            if (data == FileTransferPriority.Low)
            {
                return Windows.BitsJobPriority.Low;
            }

            return Windows.BitsJobPriority.Foreground;
        }

        /// <summary>
        /// Converts from.
        /// </summary>
        /// <param name="data">The data.</param>
        /// <returns>Windows.BitsJobType.</returns>
        internal static Windows.BitsJobType ConvertFrom(FileTransferType data)
        {
            if (data == FileTransferType.Download)
            {
                return Windows.BitsJobType.Download;
            }

            if (data == FileTransferType.Upload)
            {
                return Windows.BitsJobType.Upload;
            }

            if (data == FileTransferType.UploadAndReply)
            {
                return Windows.BitsJobType.UploadReply;
            }

            return Windows.BitsJobType.Download;
        }

        /// <summary>
        /// Converts from.
        /// </summary>
        /// <param name="data">The data.</param>
        /// <returns>FileTransferItem.</returns>
        internal static FileTransferItem ConvertFrom(Windows.BitsFile data)
        {
            if (data == null)
            {
                return null;
            }

            var localName = data.GetLocalName();
            if (string.IsNullOrWhiteSpace(localName))
            {
                return null;
            }

            var remoteName = data.GetRemoteName();
            if (string.IsNullOrWhiteSpace(remoteName))
            {
                return null;
            }

            try
            {
                return new FileTransferItem
                {
                        LocalPath = new FileInfo(localName),
                        RemotePath = new Uri(remoteName)
                };
            }
            catch (Exception e)
            {
                Logger.GetInstance(typeof(BitsFileTransfer)).Error(e.ToString());
            }

            return null;
        }

        /// <summary>
        /// Converts from.
        /// </summary>
        /// <param name="data">The data.</param>
        /// <returns>FileTransferPriority.</returns>
        internal static FileTransferPriority ConvertFrom(Windows.BitsJobPriority data)
        {
            if (data == Windows.BitsJobPriority.Foreground)
            {
                return FileTransferPriority.Foreground;
            }

            if (data == Windows.BitsJobPriority.High)
            {
                return FileTransferPriority.High;
            }

            if (data == Windows.BitsJobPriority.Normal)
            {
                return FileTransferPriority.Normal;
            }

            if (data == Windows.BitsJobPriority.Low)
            {
                return FileTransferPriority.Low;
            }

            return FileTransferPriority.Unknown;
        }

        /// <summary>
        /// Converts from.
        /// </summary>
        /// <param name="data">The data.</param>
        /// <returns>FileTransferProgress.</returns>
        internal static FileTransferProgress ConvertFrom(Windows.BitsJobProgress data)
        {
            return new FileTransferProgress
            {
                    TotalBytes = data.BytesTotal,
                    TotalFiles = data.FilesTotal,
                    TransferredBytes = data.BytesTransferred,
                    TransferredFiles = data.FilesTransferred
            };
        }

        /// <summary>
        /// Converts from.
        /// </summary>
        /// <param name="data">The data.</param>
        /// <returns>FileTransferState.</returns>
        internal static FileTransferState ConvertFrom(Windows.BitsJobState data)
        {
            if (data == Windows.BitsJobState.Acknowledged)
            {
                return FileTransferState.Acknowledged;
            }

            if (data == Windows.BitsJobState.Cancelled)
            {
                return FileTransferState.Cancelled;
            }

            if (data == Windows.BitsJobState.Connecting)
            {
                return FileTransferState.Connecting;
            }

            if (data == Windows.BitsJobState.Error)
            {
                return FileTransferState.Error;
            }

            if (data == Windows.BitsJobState.Queued)
            {
                return FileTransferState.Queued;
            }

            if (data == Windows.BitsJobState.Suspended)
            {
                return FileTransferState.Suspended;
            }

            if (data == Windows.BitsJobState.Transferred)
            {
                return FileTransferState.Transferred;
            }

            if (data == Windows.BitsJobState.Transferring)
            {
                return FileTransferState.Transferring;
            }

            if (data == Windows.BitsJobState.TransientError)
            {
                return FileTransferState.TransientError;
            }

            return FileTransferState.Unknown;
        }

        /// <summary>
        /// Converts from.
        /// </summary>
        /// <param name="data">The data.</param>
        /// <returns>FileTransferType.</returns>
        internal static FileTransferType ConvertFrom(Windows.BitsJobType data)
        {
            if (data == Windows.BitsJobType.Download)
            {
                return FileTransferType.Download;
            }

            if (data == Windows.BitsJobType.Upload)
            {
                return FileTransferType.Upload;
            }

            if (data == Windows.BitsJobType.UploadReply)
            {
                return FileTransferType.UploadAndReply;
            }

            return FileTransferType.Unknown;
        }

        private void OnBitsManagerJobError(string jobId)
        {
            NotifyJobError(jobId);
        }

        private void OnBitsManagerJobTransferred(string jobId)
        {
            NotifyJobTransferred(jobId);
        }

        /// <inheritdoc />
        protected override FileTransferJob OnGetJob(string jobId)
        {
            var bitsJob = _bitsManager?.GetJob(jobId);
            if (bitsJob == null)
            {
                return null;
            }
            return new BitsFileTransferJob(bitsJob);
        }

        /// <inheritdoc />
        protected override List<string> OnGetJobIdList()
        {
            return _bitsManager?.GetJobIdList();
        }

        /// <inheritdoc />
        protected override bool OnListenJob(FileTransferJob job)
        {
            var bitsJob = job as BitsFileTransferJob;
            return _bitsManager?.ListenJob(bitsJob?.GetInnerInstance()) ?? false;
        }

        /// <inheritdoc />
        protected override FileTransferJob OnRequestNewJob(
                string jobName,
                FileTransferType fileTransferType)
        {
            var bitsJob = _bitsManager?.CreateJob(
                    jobName,
                    ConvertFrom(fileTransferType)
            );
            if (bitsJob == null)
            {
                return null;
            }
            return new BitsFileTransferJob(bitsJob);
        }
    }
}


7th Annual Spaghetti Sauce Cook-Off and Silent Auction!!
What do I get for my $7.00?
The $7 per person will get you (1) one blue ticket good for a plate of spahghetti noodles and (5) blue tickets to be used to sample the sauce at any of the various chef contestant tables. You will also receive complimentary water or tea, bread and dessert.
When do I get the tickets I purchased?
Will-Call table at the entrance of the gym manned by parent volunteers.
All of the tickets will be sorted aphabetically by family name.
Just complete and pay through the online form below. Its that easy!!
and return your completed form, with payment, to the fron office.
The online ticket site is now closed.
There will be plenty of tickets to purchase at the door of the event! See you there!!!


From Odd to POD – we have it!
Hi I am Father Steve and I am here to make your shopping at The Rome Depot a blessed experience. Here at The Rome Depot – prices are so low you will feel like going to confession for stealing! All of our staff are professional and will greet you with a smile and a immaculate reception.
Whether you have been there from the cradle or are a convert we have shelves and shelves of everything you need to piously outfit yourself and your house.
From Alpha to Omega, if we don't have it we will order it.
Check our our daily specials below.
The ultimate in hi-tech cool Catholic gadgets. The iPope contains a 20mb hard drive with more than enough room to store all of the Pope's Wednesday audiences. Sign up with our new iHomilies service and download new sermons for only 99 cents with spoken encyclicals for only $4.99.
Sync up homilies on your home computer with the included USB (Ultra Sacramental Bus) cable. Our patented dial will have you selecting your favorite speech to listen to in no time. You can choose to listen by theological topic or random play.
You can't truly call yourself a Catholic Nerd unless you own a iPope. Get connected and be not afraid.
From our new line of G.I. St. Joe action figures we have Father Luke the chaplain. Your kids will have hours of fun saying Mass for the troops hearing confession in the field and giving Extreme Unction to fallen Joes. Includes kung-fu grip so that he never drops a Communion wafer.
Follow the Pope's advice and "breathe with both lungs" of the Church when you go scuba diving. One tank is filled with an oxygen/nitrogen mix of Roman air and the other an oxygen/nitrogen mix of Eastern air.
Introducing new dermatologist approved Chrism Oil for those with sensitive skin. Guaranteed to be hypo-allergenic. Also available with new fresh sacristy scent.
Lavabo -The first word of that portion of Psalm 25 said by the celebrant at Mass while he washes his hands after the Offertory, from which word the whole ceremony is named.
Do you still have palm branches from a Palm Sunday Mass 20 years ago and just don't think it is right to just toss them in the garbage. Do you have drawers full of worn out scapulars?
Normally blessed items should either be burned or buried to be properly disposed.
For big jobs we have the RD-500 Sacramental Flame Thrower. It is both fun and fast to dispose of your sacramentals. $349.99 while supplies last.
If you live in an apartment or somewhere with limited space the try the RD-250 propane sacrament elimination system safe for indoor use.
Do you have a small or big construction project and want your cement to be pious also. Introducing new Convert Cement which is made from sediment dredged from the Tiber River. Great for driveway construction so that every time you come home you will be crossing the Tiber.
This double reinforced steel entry door will give you all the protection that you need. This door will not only protect you against hurricanes and other storms, with the embedded St. Benedicts' medal it may also help to protect you from spiritual forces such as Satan (void where prohibited).
On the arms of the cross are the initial letters of a rhythmic Latin prayer: Crux sacra sit mihi lux! Nunquam draco sit mihi dux! (May the holy cross be my light! May the dragon never be my guide!).
Whether you are a closet Dominican or a full fledge book addict – we have just the books for you. Including Bibles, Catechisms, Spiritual Reading, Holy Cards, and Prayer Booklets. Each store has two full aisles reaching to the ceiling. Don't forget to stop by the bookshelf aisle for all the furniture needed to maintain your addiction.
During Easter Mass and at other times the People are sprinkled with Holy Water (aspersion).
We have just the equipment for every need.
We have available Holy Water Sprinklers & Pots.
Or to really soak down the congregation we now offer the heavy duty Holy Water Pressure Sprayer rated at 3000 psi. This will ensure that everybody in the congregation will be adequately sprinkled without you having to throw your arm out!
Not limited to just the Church, this Holy Water Pressure Sprayer will have your house spiritual and physically clean in no time.
You have seen those cheap foreign St. Joseph Statue Kits for selling your home in other Catholic Book stores. But why do things only with half measures? Our kits comes with a full 5′ foot statue of St. Joseph and a coupon to rent one of our post hole diggers. You will have St. Joseph buried upside down in no time and interceding to sell your house.
Do you have some heavy lifting to do?
Then do it in style by renting our Popemobile Forklift.
The person stationed in the bubble zone can easily see in all directions to act as a safety observer.
Besides, admit it – you have always wanted to be driven down the street in a Popemobile waving at passerbys.
Besides all the supplies and equipment you need we also offer you workshops to teach you how to do it yourself.
10:00 – 11:00 Build your own reliquaries. Learn how to custom make cases to fit those relics you have.
11:00 – 12:00 Build your own Prie-Dieu. This class will have you kneeling in no time.
12:00 – 1:00 Outfitting your home chapel. Learn what are the best woods to use and what materials are best to prevent fires started by votive candles.
Get your own Rome Depot credit card where rates are guaranteed not to be considered usury. Five percent of each purchase charged is donated to the poor.
All charges are forgiven during Jubilee Years.
In the meantime, nonpayment could lead to excommunication.
I nearly died laughing. What a great start to the day!
Just shared this with my dd – ROFL!!!
Hilarious – but then, I actually really liked the front door….
My goodness. I read most of this to my son, and he said "It's great being Catholic". I enjoyed it immensely. Thank you. Thank you.
What aisle is the pro-life stuff (table leaves, bunk beds, shed kits for all the bikes and stuff?) Also we need glue for our marriage and some fine and course sand-papal for some rough edges we have in our life!
Anyone with a blog or a website can add a link for The Popes Cologne and earn commissions.
Then sit back and receive commission checks for doing nothing !
I've got to share this with one of the Priests at my parish – I know he'd LOVE the Holy Water Pressure Sprayer!
I love it. I giggle, until I see something I actually really like….and would buy. I too think that the front door is great.
i think i just peed on my pants,giggling! will tell my friends about this hillarious site.
Too funny! Thank you for the laughter, it is much appreciated!
For the straight & narrow, i have applied for a patent for a spiritual GPS (God's Positioning System). This device will give out instructions for a route to heaven and it comes with a voice output from an auto recalculating subsystem that is activated when one strays from one of many designated routes to redemption, conversion and salvation. The feed comes from any one of many geo-synchronous spiritual satellites that have been calibrated according to the three paths of holiness: the purgative, the illuminative, and the unitive pathways.
Reading Supplies. Love books but the wife won't let me use the other bedroom for a library. She says "you got 'nough books already".
Our government's friendly EPA has released the latest rules for The Sacramental Destruction System.on its correct use so that a $10,000 fine or 50 years in Alcatraz can be avoided. The flame must not harm even just one blade of grass or leaf. Loss of home okay but no a helpless lovable plant.
Father Steve please had teacups 'cause I got rid of my coffee cups and of course Lipton tea bags.


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Stations List - Page 1
Details of over 46190 stations worldwide, including mmsi of the stations and stations positions on the map.
MMSI 3669142
EPFD
Last Update Jan 31, 2023 12:58 PM
First Seen Dec 12, 2018 12:01 PM
EPFD Surveyed
Last Update Dec 17, 2022 10:25 AM
Last Update Nov 28, 2019 10:01 AM
EPFD GPS
Last Update Jul 23, 2019 3:48 PM
Last Update Dec 8, 2022 11:05 AM
Last Update Jan 30, 2023 4:37 PM
Last Update Feb 24, 2022 8:31 AM
Last Update Dec 12, 2018 12:01 PM
Last Update Dec 6, 2022 2:48 PM


As the world's population grows, so does the rate of global urbanization and development. What is built on the land directly correlates to the impacts on ecological systems and to the health, safety and welfare of our communities.
Far too often, however, land and building projects are designed without regard to their harmful impact on scarce resources, ecological systems or the quality of life in the community. With land as a crucial component of the built environment, the SITES v2 Rating System provides a systematic and comprehensive set of guidelines and benchmarks that help elevate the value of a landscape. Providing a framework to help plan, design, develop and maintain landscapes, the SITES v2 Rating system helps projects to avoid, mitigate and even reverse detrimental impacts of built landscapes.
By aligning land design and development practices with the functions of healthy ecosystems, the SITES program demonstrates how developers, property owners, landscape architects, planners and more have the power to protect, restore and enhance ecosystem services. Elements of the SITES v2 Rating system can help professionals create spaces that are healthier and safer for their communities.
The goal of this credit is to increase users' ability to understand and access outdoor spaces by incorporating elements of accessibility, safety and wayfinding into the site design. Studies have shown that providing optimum site accessibility, safety and wayfinding in an integrative design approach creates a sense of security, connection, social interaction, and quality of life improvement through the reduced fear of crime and ease of navigation. These features also attract a higher and broader spectrum of customers to businesses contributing to a vibrant economic community.
The goal of this credit is to provide economic and social benefits to the local community. This starts with identifying the needs and desires of site users and stakeholders during the pre-design stage. Providing free public access to on-site events, facilities, amenities or programming are some of the ways the project gives back to its community and addresses social equity.
Experiences provided by nature are inherently restorative. Mental fatigue and stress caused by noise or long periods of focus can result in irritability, loss of productivity or anxiety. This credit addresses those issues by providing accessible, quiet outdoor spaces and unobstructed views of vegetation, to capitalize on the restorative benefits of these natural connections.
This credit aims to provide opportunities for on-site physical activity. According to the Centers of Disease Control and Prevention, daily moderate activity decreases the incidence of chronic diseases such as diabetes and heart disease. Physical activity and exercise can also improve mental health by reducing feelings of depression and anxiety, reducing stress and promoting psychological well-being.
Projects earning this credit strengthen community and encourage social connections by providing spaces that support the interaction of people. Elements like seating, games, wireless access, food concessions, picnic spaces, outdoor auditoriums, playgrounds or farmers markets can all contribute to promoting social interactions and connections.
Any site has the potential to improve the health and well-being of its users with the guidance in the SITES v2 Rating System.
Learn more about SITES at the ASLA Annual Meeting and Expo, hosted October 19–22 in Philadelphia.


This is a set of 5 free title generators for you to use in your projects.
All 5 titles have adjustable title text and optional Build in/ Build out switches.
Consider a $1 price to help support me and my future lessons.
I make these in my personal time outside of work, because I want to help as many people as I can with the basics for free.
By donating- it means that I will likely offer more items for free in the future.


text:
Trump IS Nick Fuentes
Who's the happiest guy in America this week?
Nick Fuentes. In a matter of days, he's gone from total obscurity to the most famous person in the country. Everybody's talking about him!
Until he had dinner with Trump, literally, no one had ever heard of him (except various "hate watch" groups scamming money out of the perpetually alarmed). That's not for lack of trying on Fuentes' part. He was doing anything he could think of to get people to notice him.
You say praising Hitler will get me in the news? Watch this!
[Twenty researchers at People for the American Way earnestly type up reports titled, "The Dangerous Rise of Far-Right Extremism," then blast them to the Upper West Side.]
Serendipitously, Donald Trump is also desperate for attention. As president of the United States, he used to brag to anyone who would listen about the important people who called him. (You know, the way a lot of serious adults do.) Rupert Murdoch calls me every day!
He proudly produced the letters he'd exchanged with North Korean leader Kim Jong Un to journalist Bob Woodward, telling him the letters were "soooo top secret," and asking Woodward (again, a JOURNALIST) (for The Washington Post!), "Don't say I gave them to you. OK?"
A friend in deed: New evidence reveals incredible aid Lyndon Johnson lent the Jews
Talking About Kanye West, Nick Fuentes, Milo With Joseph Cotto (12-6-22)


text:
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text:
Мателіка () — муніципалітет в Італії, у регіоні Марке, провінція Мачерата.

Мателіка розташована на відстані близько 160 км на північ від Риму, 60 км на південний захід від Анкони, 35 км на захід від Мачерати.

Населення —   (2014).
Щорічний фестиваль відбувається 16 вересня. Покровитель — Sant'Adriano.

Демографія

Сусідні муніципалітети

 Апіро
 Кастельраїмондо
 Черрето-д'Езі
 Езанатолья
 Фабріано
 Ф'юміната
 Гальйоле
 Поджо-Сан-Вічино
 Сан-Северино-Марке

Див. також
 Список муніципалітетів провінції Мачерата

Примітки

Муніципалітети провінції Мачерата

redpajama_set_name: RedPajamaWikipedia


Boeing [NYSE: BA], the Air Traffic Alliance, Airservices Australia and Qantas Airways have agreed to conduct flights to demonstrate a concept to vastly improve aircraft arrival efficiency.
The agreement, signed today at the Air Traffic Control Maastricht conference, calls for air traffic control to send the approaching aircraft electronic arrival clearance instructions -- eliminating the need for the usual multiple voice communications. Electronically linked data then guide the aircraft on a steady descent along the most efficient path.
The aircraft, on scheduled Qantas flights, will operate under these instructions from beginning of descent, about 140 miles from the airport, until landing 28 to 30 minutes later.
Ideally, this concept will allow engines to remain just above idle, compared to the common "stepped" approach using alternating power increases and decreases.
"Tailored arrivals will provide for vastly more efficient aircraft arrivals while saving fuel, reducing emissions, minimizing noise and increasing safety," said John Hayhurst, president, Boeing Air Traffic Management. "This highly specialized international team brings the wide breadth of knowledge and experience essential for improving the air transport system worldwide."
The arrivals also have the potential to reduce flight-crew and air-traffic-control workload.
"These demonstration flights will provide the technical data to support broader research into four-dimensional operations, the fourth dimension being time. That will add the advantage of more accurately defining optimal flight paths between different points," said Lionnel Wonneberger, AT Alliance president. "The effort will also allow us to deliver and quantify benefits using existing air and ground equipment."
The demonstration will involve approximately 100 flights using Qantas Boeing 747-400s and Airbus A330s at Sydney and Melbourne international airports. The flights are expected to begin in March and continue for approximately six months.
Qantas flight crews and Airservices Australia's air traffic controllers will constantly evaluate each flight during arrival, switching immediately to routine operations if needed.
After assessing results, the participants will decide whether to continue in-service operations, conduct additional flights or both.
Australia was chosen to demonstrate the concept, as Airservices Australia's air traffic control system is the only system currently capable of supporting such a trial in domestic airspace.
Boeing, which developed the concept, is the project coordinator in partnership with the AT Alliance. Airservices Australia will provide ground equipment and operations experience, and Qantas will provide the pilot training and aircraft, which will use existing equipment for the demonstration.
The Air Traffic Alliance is a grouping of EADS, Airbus, and Thales, combining leading industry forces to accelerate the evolution of ATM systems though the integration of air, ground, and space expertise. The Alliance is working to bring mutual benefits to passengers, airspace users, air traffic service providers and airports, while improving safety and security in a more efficient air transport system.


text:
How A Love of Gin Made a Festival
A small village in East Yorkshire may seem an unlikely spot for a gin festival, but Bubwith isn't your average village – it's full of gin lovers!
The higher-than-average concentration of people who enjoy the vogueish drink is all down to the Jug and Bottle – a destination deli and off license at the heart of village life. Not only do the locals enjoy a wide selection of unusual and small batch gins thanks to the well-stocked 'Jug', but they are also well-educated about the history and types of gin thanks to a regular small gin tasting events and popular monthly pop-up bars.
All of this is down to Jug and Bottle owner and gin-enthusiast Louise Smith who picked up on the emerging trend for new gins early on and started dedicating more and more shelf space to it as it grew in popularity. She now stocks over 100 varieties, many of them from Yorkshire, and is always on the lookout for new and interesting varieties to share with her large group of local gin enthusiasts.
It was after attending several large gin festivals that Louise decided that she wanted to do her own festival, right at home in Bubwith. She says "The larger festivals have lost their appeal. The last one I went to didn't have great gins, lacked atmosphere and didn't really learn much from the event. I came away very disappointed. I want this festival to be a journey of discovery. It will be a smaller venue, great atmosphere, a bit quirky and plenty of new gins to the market, both in brands and in expressions. Ultimately I want people to come and discover their favourite new gin!"
After enlisting the help and support of her network of gin-loving friends, Louise's dream of her own gin festival is becoming a reality, with Bubwith's first Gin Festival taking place in March. And it's shaping up to be a great night for gin lovers.
The Jug and Bottle Gin Festival will be warm and intimate and defiantly Yorkshire! There will be 30 gins, carefully chosen to showcase popular trends and new introductions to the market. Tickets include a welcome G&T, hot food, a commemorative glass and live music from local recording artist Helen Chambers. Hooting Owl from Barmby Moor and Sing Gin from Kettlesing will be there talking about their Yorkshire gins and providing samples to try. There will also be the new 4 seasons gins from Rock Rose.
One might argue that gin is a kind of social glue in Bubwith – and anything that brings people together and gets them talking has got to be a good thing!
Bubwith Gin Festival | Saturday 23rd March | 7.30pm | The Bubwith Centre
Tickets from The Jug & Bottle or online at www.jugandbottle.co.uk/events
Louise Smith | e: info@jugandbottle.co.uk | m: 07776 095143


Diana is a type of a house with a loft. This is one of the model units you can choose from of Ecoverde Sierra located at Barangay Indahag, Cagayan de Oro City. The location is very close to Indahag Elementary School and High School.
Elisse is a rowhouse in Ecoverde Sierra, Indahag, Cagayan de Oro City. It is close to Indahag Elementary and High Schools.
Claire- 2 Storey House Ecoverde Sierra located in Barangay Indahag, Cagayan de Oro City. It has 3 bedrooms and 1 toilet & bath (with 1 provision for another toilet & bath). It is close to Indahag Elementary and High Schools.
Bianca 2 Storey house in Ecoverde Sierra has 3 bedrooms and 2 toilet & bath. It is located at Barangay Indahag, Cagayan de Oro City very close to Indahag Elementary and High School.
2 Storey Single Detached House (Andrea) of Ecoverde Sierra, Indahag, Cagayan de Oro City. It has a floor area of 65sqm and lot area of 75sqm. It is composed of 4 bedrooms and 2 toilet & bath.
2 storey house with parking space located at Adelaida Park Residences, Upper Balulang, Cagayan de Oro City.
House and Lot for sale in Macasandig, Cagayan de Oro City.
2 storey house Xavier Estates with 4 bedrooms and 3 toilet & baths. The master's bedroom has own toilet & bath and a balcony.
Feleize is a single attached bungalow house located at Fatima West Plain Subdivision. It is the most affordable unit in the subdivision.


Rhubarb is one of those funny New England fruits- like gooseberries or husk cherries- that sound adorable and quaint to the uninitiated, rather like something our grandparents might've made into a buckle or a fool. Then there are the devoted fans who know: there are few things better than an ice-cold slice of rhubarb pie. We have two rhubarb plants in our gardens- they've been here way longer than any homeowner- and every year we look forward to the first rhubarb pie of the season the way others look for the first robin sighting or the first blooming lilacs.
Rhubarb and I go way back. My mom used to make rhubarb pie when I was growing up, which is kinda weird, since we lived in the suburbs. I used to think she picked it from a plant in the backyard like we do now, but she recently told me that no, she bought it at the market- the plant we had was too sour, even for rhubarb. No matter. I still have my Mom's recipe, complete with her perfect five-minute Cuisinart crust, and I make it every year with an almost religious devotion: for me, eating that first bite of rhubarb sweet-sour pie is reliving a moment of childhood happiness.
So of course, as soon as the stalks were up from the ground this spring, I set my sights on dear old rhubarb pie for our May monthly dessert. It almost came to a food fight though: our eleven year old wanted Coconut Vanilla Pudding Cake and our six year old has her heart set on a batch of sugar cookies. Nurturing my inner tyrant, I decided that since neither of those choices was seasonally dependent, plus the fact that I had the distinct advantage of being the one who would actually make the dessert, rhubarb would prevail. Caesar lives.
The funny thing about so many pies is how much better they can get after a day of sitting in the refrigerator, getting chilled and letting all those sweet and sour and buttery flavors rest and meld together. Rhubarb pie is a classic example of this: out of the oven it is really, really good. Our of the fridge the next day? Ridiculous. Amazing.
Something was amiss. At first I couldn't put my finger on it, and finally I realized it was this… this taste in my mouth… like the aftertaste you get from drinking a diet soda. Bleh! What was that? Then I knew: it was the sugar. Sugar and I, it seems, are now like old friends who haven't seen each other in so long that when they get together it's fun, but… a little awkward.
Nobody is more surprised than me about this turn of events. I expected a lot of things in our Year of No Sugar project: to gradually lose cravings for sugar (which I have), perhaps to lose a few pounds (which I haven't), to notice sugar's effects much more dramatically (which I have). For some reason, though, I didn't expect to lose my taste for sugar itself. Does this mean (shudder) no more enjoying treats… ever?
Meanwhile, I've been exploring the online work of Australian author David Gillespie, author of Sweet Poison, who I am going to insist on mentioning repeatedly until you go out and buy his book, because he's a freakin genius. (If you do buy his book, be sure it is by Gillespie; in America there is a book by the same name by Dr. Janet Hull which focuses on the evils of aspartame).
It was in Gillespie's book that I first heard about the possibility of using dextrose as a sweetener. Dextrose isn't fructose; it is recognized by the body as glucose, which means your body knows what to do with it. Could this be? I wondered. Could we really have a dessert that didn't have sugar in it or taste like bananas? And was actually good? I fairly salivated at the prospect.
Spurred on by what is left of my sweet tooth, I tackled David's online recipe for "Strawberry Ricotta Cheesecake." I was fully prepared to be deeply disappointed. I reminded the kids this was "an experiment" and might not be as wonderfully delicious as the name might suggest. But it did look pretty great in the oven, rising and browning just a bit on the top… and the smell was a warm, faint strawberry-inflected sweetness, distinctly dessert-y.
One bite, however, and my skepticism evaporated. In it's place appeared surprise. Also, delight. I smiled big. I looked around and saw that the kids were smiling big too- in between big bites of white fluffy dessert- dessert that contained no fructose… effectively no added sugar. And it was GOOD! Really good!
If this was a made-for-TV movie, this would be the exact moment that the soundtrack featuring the Hallelujah chorus would break in, playing jubilantly over jump-cuts of us stuffing our faces with the fluffy treat. I couldn't stop exclaiming how good it really was! I mean, it wasn't S-W-E-E-T !!!… but it was quietly sweet- which at this point seems to be what we really prefer anyway. We all polished off our plates. The kids immediately were getting ideas: could we make ice cream with dextrose? How about sugar cookies?
Although I am old enough to be suspicious of anything that promises to be a panacea, I can't help but wonder: would it work- and equally important, would it be heresy- to attempt a dextrose rhubarb pie?
yes I use dextrose to sweeten rhubarb, you need a generous amount though!
I thought I'd have to give up rhubarb… I have 2 varieties in my garden, one red stemmed that needs far more sweetening than the one with half green half pink stems. Great relief that I can still make my rhubarb cake, which is an almost custardy/eggy cake with chunks of rhubarb through it.
What a relief! Don't suppose you'd be willing to part with that Rhubarb Cake recipe…?
Beat butter and sugar till pale and fluffy. Add eggs a little at a time beating well after each addition.
If mixture starts to curdle add a tbsp of the flour. Add the vanilla. Then fold in the flour adding enough milk to give the batter a reluctant dropping consistency. Scrape into a buttered 20cm springform cake tin.
Toss the rhubarb over the top of the cake mixture. Bake 40mins 190 degrees Celcius.
The rhubarb sinks into the cake as it cooks with some pieces sticking out the top and looking rather rustic. When a skewer inserted into the middle comes out clean it is cooked.
Cool cake in the tin, then carefully remove from the ring and base. Dust with icing sugar if liked, before serving with whole Greek yogurt or freshly whipped cream. A brilliant eggy cake that straddles cakedom and custard! Can be used as a blueprint for other fruit topped cakes.
I've made this many times, it's a keeper! Hope you like it. I love all Diana Henry's cookbooks.
so why is Dextrose ok to use? Isn't dextrose a form of glucose?
Pricilla- What I've been told by folks who know more than me about how the body works is that your body runs on glucose, and yes, dextrose is glucose.
What you need to worry about is fructose- that is the stuff your body doesn't know what to do with and treats like a toxin.
I got the idea to use dextrose in cooking from David Gillespie in his book Sweet Poison- an excellent read if you want to learn much more about how the body's biochemistry functions, and exactly why it is that fructose is so bad for you.
You are currently reading A Year Of No Sugar: Post 53 at Eve O. Schaub.


text:
define(["jQuery"], function (jQueryDashed){

"use strict";

(function($){

    //Do something

})(jQuery);
return app;
});


text:
module Streem
  class Pipe

    def initialize(&action)
      @outstreem = nil
      @action = action if block_given?
    end

    def terminal?
      @outstreem.nil?
    end

    def <<(data)
      data = @action.call(data) if @action
      @outstreem << data if @outstreem
    end

    def |(outstreem)
      raise RuntimeError.new('already connected') if @outstreem
      raise RuntimeError.new('cannot connect a streemer') if outstreem.is_a?(Streem::Streemer)

      @outstreem = factory(outstreem)
    end

    private

    def factory(pipe)
      pipe.is_a?(Proc) ? Pipe.new(&pipe) : pipe
    end
  end
end


text:
"Night Journey to the Palace of Roses," pen & ink drawing, 2.5" x 5" on heavy artist's stock.
Inspired by the films of Czech director Karel Zeman, this series of pen and ink drawings attempts to capture some of the mystical fantasy atmosphere of "The Fabulous Adventures of Baron Munchausen" (1961-62) and "The Fabulous World of Jules Verne" (1958). The latter film won the Grand Prix prize at the World Exposition EXPO58 in Brussels. These films offer a wondrous sense of fantasy and incredible adventure, with magnificently decorated sets, elaborate costumes, live action, and superlative animation. I first saw these films on American television in the early 1960's and never could forget those indelible images which Karel Zeman incorporates into his marvelous productions. There is a kind of poetry in Zeman's magical storytelling, like moments of visiting the Moon to meet Cyrano de Bergerac, Tonik, Baron Munchausen and several astronauts. We further get to meet Princess Bianca, General Ellemerle, the military Adjutant and even the Sultan in a series of fantastic episodes brimming with mystery, action, adventure and sheer imaginative fun. I have titled my drawing "Night Journey to the Palace of Roses," presented here in a series of variations produced via Google's Picasa 3 photo editing software.
These versions of "The Fabulous Adventures of Baron Munchausen" and "The Fabulous World of Jules Verne" can be found on several websites. Both are English-dubbed versions of the original Czech-language films. The best versions however can be found at the Karel Zeman Museum in Prague, Czechoslovakia, in restored condition with superior audio-visual quality. The Museum can be found at www.muzeumkarlazemana.cz/en
Here are some passages from "The Rubaiyat of Omar Khayyam," translated by Edward FitzGerald (1809-1883) based upon quatrains written by Omar Khayyam (1048-1122), a Persian mathematician, astronomer and philosopher. From the First Edition (1859):
Awake! for Morning in the Bowl of Night
Has flung the Stone that puts the Stars to Flight:
And Lo! the Hunter of the East has caught
The Sultan's Turret in a Noose of Light.
From the Fifth Edition (1889):
Wake! For the Sun, who scatter'd into flight
The Stars before him from the Field of Night,
Drives Night along with them from Heav'n , and strikes
The Sultan's Turret with a Shaft of Light.
These remarkable verses generate spectacular images in an exquisitely poetic manner, somewhat reminiscent of the dreams, visions and artistic majesty one may find in the films of Karel Zeman.
The First and Fifth Editions of "The Rubaiyat of Omar Khayyam," translated by Edward FitzGerald in a superb Dover Thrift Edition.
An artistic impression of the forest groves which once stood at the west end of Baltusrol Avenue in Springfield, New Jersey in the Fifties and Sixties. The pen & ink drawing is 3" in diameter on artist's stock.
An improvisation based upon childhood memories of playing with my cousins Sharon and Kerry in Springfield, New Jersey at the western edge of Baltusrol Avenue where once there was a large forest with rocks, a stream and a stone bridge. Although my family did not live in Springfield, we often visited there allowing Sharon and Kerry to show me so many of the local attractions and scenery. I once stayed at my aunt and uncle"s house for a week affording plenty of time to explore the forested area adjacent to the neighborhood. My dad and I helped to extend Sharon and Kerry's house toward the back with a new kitchen and renovated dining room. So we were there for many weekends both working and relaxing. My cousins invited me to attend the Strawberry Festival in the springtime, held at Jonathon Dayton High School. We also saw the fireworks display in July and attended birthday parties, anniversaries and outdoor picnics at the Baltusrol Avenue address. In the years from 1955 to 1965 I came to love the forested area, the rock formations and the lyrical stream which meandered through the forest realms just a short walk from my relative's home. Sometime around the late 1960's or early 1970's this area changed drastically with the introduction of a new highway system which obliterated the forest and permanently altered the landscape which we as children had so dearly loved. This music is dedicated to my cousins Sharon and Kerry and to my Aunt Lill and Uncle Del for their warmth, hospitality and generosity of spirit in sharing their home and neighborhood with me. It is an improvisation which celebrates the innocence of children and the playfulness of the creative mind. This music reflects upon the pageantry of outdoor activities, the dance of one's inner spirit, and the breathless beauty of taking delight in four changing seasons.
Both the artwork and the video recording above are reflections based upon my memories of a now vanished forest which once stood near the home of my aunt, uncle and cousins. The present views of this area are captured via Google Earth and show the relative development of highways, neighborhoods, asphalt streets and concrete bridges, all expected elements of urban modernization (or "progress"). You would not ever know today what once was there if you had never seen the forest which enveloped this area back in the 1950's and 1960's. Perhaps this kind of development is symptomatic of many areas due to population density and the necessity of arterial roadways to alleviate traffic congestion. But it is a sad loss to those of us who love the green belt areas and hold fond memories of this particularly lovely woodland retreat. On my You Tube channel I have posted a series of accordion improvisations entitled "Baltusrol Impressions" which further explores my memories and reflections of this now vanished forest.
Invitation to Imagination - Tales of a Fantast
"Journey to a Gilded Palace" - pen and ink drawing on artist's stock, 2.5" x 5", inspired by "The Fabulous Adventures of Baron Munchausen" (1962), a film by Karel Zeman.
There are some very evocative scenes in "Baron Prasil" by Czech director/ filmmaker Karel Zeman (1910-1989). In the United States this film was released as "The Fabulous Adventures of Baron Munchausen." Live action is combined with animation in a wonderfully inventive and charming manner. We travel to the Moon in order to meet the Baron (Milos Kopecky) as well as Cyrano de Bergerac (Karel Hoger) and a host of beguiling characters such as Tonik (Rudolf Jelinek) and the Princess Bianca (Jana Brejchova) in a series of romantic adventures. The artistic quality of this film is outstanding, with sets that sparkle via imaginative detail and design. We manage to see flying machines, sailing ships, giant fish, sea battles, land battles, castles, ornate palaces and places of exquisite beauty. Some scenes are tinted, others have a monochromatic appearance or selective use of color. The set of drawings in this post have been largely influenced by both this film and Karel Zeman's "The Fabulous World of Jules Verne" (1958), aka "The Deadly Invention" or "An Invention for Destruction."
A full color version of my pen and ink drawing illustrating the use of pointillism or stippling technique.
A blue tinted version of the original full color drawing, effects taken from Picasa 3 editing program.
This effect from Picasa 3 is titled "Polaroid" and gives a snapshot frame of the original drawing.
This effect gives a glow or luminous quality to the original drawing. Picasa 3 is a free photo editing program recommended by Kim Komando, "America's Digital Goddess."
Here is the original drawing placed on my work table with an artificial rose for inspiration. I love the light coming in through the north-facing window. Here I can work up until 6 PM without light fading significantly.
This image shows the rose taped to the work table just above the drawing.
I find that listening to music is a therapeutic asset while drawing or painting for hours on end. Classical music is my preferred choice for inspiration, but jazz can also become a great source of ideas.
Music has always been a favorable companion to my artwork. In the studio I am presently using the Model One AM/FM radio made by Tivoli Audio, hooked up to a Terk external amplified antenna. Over the years I have always been impressed by the audio designs of Henry Kloss (1929-2002). Kloss helped to found Acoustic Research, then went on to form KLH (along with Malcolm S. Low and Josef Anton Hofmann), Advent, Cambridge Soundworks, and Tivoli Audio. Most of Henry's designs are still held in high regard today including the Model 88 clock radio from Cambridge Soundworks and his Tower loudspeakers. There was a time when I enjoyed reading the three prominent audio magazines of the early hi-fi era: "Stereo Review," "High Fidelity," and "Audio." Later on I subscribed to "Stereophile Magazine" published by J. Gordon Holt in Media, Pennsylvania. Many of these publications gave rave reviews to the electronics and loudspeakers designed by Henry Kloss.
One of the most endearing aspects of the art of Karel Zeman is his use of music in the soundtracks prepared for his films. There is a lovely music score composed by Zdenek Liska in "Baron Prasil" with Frantisek Belfin conducting the Filmovy Symfonicky Orchestra. This music adds layers of charm and mystique to the action on the screen, blending a sense of orchestral enchantment to the artistic merits of the story. In one of the film's most evocative scenes, Baron Munchausen calls himself a "Fantast," a visionary or dreamer. Perhaps this is also a tale of the artist who brings forth imaginary worlds and invites an audience to willingly embark upon a similarly fantastic journey.
Adventures in Pen & Ink Paradise
Color Pen and Ink Drawing, 5" x 5" on artist's board, inspired by Science Fiction and Fantasy themes.
Georges Seurat and Pointillism
I have always loved the distinctive style of French Post-Impressionist painter Georges Seurat (1859-1891), noted for his use of Pointillism (also known as Divisionism or chromoluminarism). Seurat's "A Sunday Afternoon on the Island of La Grande Jatte" (1884-1886) remains a favorite for its remarkable colors, texture, size and conception. Chromoluminarism is characterized by the use of small juxtaposed dots of color which interact optically to produce a vibrant purity and recognizable texture throughout. In Pointillism the use of dots of paint does not always focus upon the separation of colors. Much of the color theory behind these concepts began with French chemist Michel Eugene Chevreul, American physicist Ogden Rood and French art critic Charles Blanc, inventor of the color wheel. Ogden Rood spoke of purity, luminosity and hue in his work on the nature of colors. The idea is to entice the eye of the beholder to do the mixing and blending of light, color, line and texture. In the case of the above drawing, of course I am using color pen & ink instead of paint, but the technique remains the same.
Influences and the Evolution of Technique
I first learned the technique of "stippling" while attending Drew University in Madison, New Jersey during Botany courses taught under Doctors Robert Zuck and Florence Zuck in the late 1960's. Stippling involves the technique of painting, engraving or drawing by means of dots or small touches. Such methods can be very time consuming but the results merit a fine degree of accuracy and sometimes a lovely sense of natural texture. Over and over again one can visualize the fantastic design and detail of nature, to begin to comprehend the marvelous components of life we see in a typical day. Our Botany courses taught us to value the act of keen observation and to thoroughly follow through on representational drawings.
Another influence in this style of drawing may be seen to be inspired by the Scottish botanist Robert Brown (1773-1858), noted as the inventor of "Brownian motion." Brownian motion has been defined as the erratic random movement of microscopic particles in liquid or gas, as a result of continuous bombardment from molecules of the surrounding medium. This gives the artist an idea that colors may be reacting to one another in various particles of light, that one may attempt to understand the often unseen forces of nature such as humidity, air currents, gravity or electromagnetic fields. So there remains a swirl of sometimes invisible phenomena which the artist desires to illustrate through his use of manifold points and dots of color.
In High School Physics class I remember learning about vectors and the idea of visually representing direction and magnitude via mathematics and physics on a graph. Mr. Fields taught us to determine the position of one point in space relative to another by designing a visual chart which quantified both magnitude and direction. An example of a vector is velocity which describes how fast something is moving and in what direction it is going. When I think of such momentum or force fields, I can visualize the effect of sunlight on a natural landscape and imagine how an artist might illustrate such effects via painting or drawing in swirls or dots of color.
The animated films of Czech Filmmaker Karel Zeman (1910-1989) also have exerted an enormous impression on my artwork beginning in the 1960's when I first saw his remarkable work. "The Fabulous Adventures of Baron Munchausen" (1961) aka "Baron Prasil" and "The Fabulous World of Jules Verne" (1958) are prime examples of Zeman's genius. You often cannot tell what is live action and what is animation in a Karel Zeman film, for everything is wrapped in a decorative atmosphere of wondrous fantasy. The stories are inventive, featuring a sense of childlike imagination and special effects which are often disarming in their enchantment and cinematic charm. "Off On a Comet" (1967) and "The Stolen Airship" offer similar tales of adventure and imaginative journey through time and various landscapes.
Sepia tone instead of color. Digital variation through Picasa 3.
Blue tint instead of full color.
Almost like a night scene instead of daylight.
Reverse image.
Another reverse image with unusual color effects.
Picture of the studio with the drawing on my artist's desk.
Northern light is best for drawing and painting. It is the most even throughout the day.
The set of color pens in my studio.
The Sharpie permanent markers come in an ultra fine point set of 24 pens. The Bic Mark-it pens are labelled fine point but offer a wider imprint in a set of 36 colors. You can use both sets to delineate a scene, with the bold points to add dramatic color and the ultra fine points to add fine detail, dimension and subtle textures throughout.


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Development of a scalable and extendable multi-dimensional health index to measure the health of individuals.
ABSTRACT: BACKGROUND:For population health management, it is important to have health indices that can monitor prevailing health trends in the population. Traditional health indices are generally measurable at different geographical levels with varied number of health dimensions. The aim of this work was to develop and validate a scalable and extendable multi-dimensional health index based on individual data. METHODS:We defined health to be made up of five different domains: Physical, Mental, Social, Risk, and Healthcare utilization. Item response theory was used to develop models to compute domain scores and a health index. These were normalized to represent an individual's health percentile relative to the population (0 = worst health, 100 = best health). Data for the models came from a longitudinal health survey on 1,942 participants. The health index was validated using age, frailty, post-survey one-year healthcare utilization and one-year mortality. RESULTS:The Spearman rho between the health index and age, frailty and post-survey one-year healthcare utilization were -0.571, -0.561 and -0.435, respectively, with all p<0.001. The area under the Receiver Operating Characteristic curve (AUROC) for post-survey one-year mortality was 0.930. An advantage of the health index is that it can be calculated using different sets of questions and the number of questions can be easily expanded. CONCLUSION:The health index can be used at the individual, program, local, regional or national level to track the state of health of the population. When used together with the domain scores, it can identify regions with poor health and deficiencies within each of the five health domains.
SUBMITTER: Yap CW
Exploring the relationship between national economic indicators and relative fitness and frailty in middle-aged and older Europeans.
Project description:on an individual level, lower-income has been associated with disability, morbidity and death. On a population level, the relationship of economic indicators with health is unclear.the purpose of this study was to evaluate relative fitness and frailty in relation to national income and healthcare spending, and their relationship with mortality.secondary analysis of data from the Survey of Health, Ageing and Retirement in Europe (SHARE); a longitudinal population-based survey which began in 2004.a total of 36,306 community-dwelling people aged 50 and older (16,467 men; 19,839 women) from the 15 countries which participated in the SHARE comprised the study sample. A frailty index was constructed as the proportion of deficits present in relation to the 70 deficits available in SHARE. The characteristics of the frailty index examined were mean, prevalence of frailty and proportion of the fittest group.the mean value of the frailty index was lower in higher-income countries (0.16 ± 0.12) than in lower-income countries (0.20 ± 0.14); the overall mean frailty index was negatively correlated with both gross domestic product (r = -0.79; P < 0.01) and health expenditure (r = -0.63; P < 0.05). Survival in non-frail participants at 24 months was not associated with national income (P = 0.19), whereas survival in frail people was greater in higher-income countries (P < 0.05).a country's level of frailty and fitness in adults aged 50+ years is strongly correlated with national economic indicators. In higher-income countries, not only is the prevalence of frailty lower, but frail people also live longer.
Factors Associated with Utilization of Primary and Specialist Healthcare Services by Elderly Cardiovascular Patients in the Republic of Serbia: A Cross-Sectional Study from the National Health Survey 2013.
Project description:The European Health Interview Survey (EHIS) is run every 5 years to examine how people experience and rank their health, how they care about their health, and to what extent they use the healthcare services. We identified the sub-population of special interest, i.e., cardiovascular disease (CVD) patients older than 65 years, in this cross-sectional study from the Serbian national survey of population health (2568 persons from a total of 15,999 subjects surveyed). We performed univariable and multivariable logistic regression analysis to assess the correlation between the healthcare system utilization and identified demographic, geographic, socio-economic, and self-rated factors. The most important factor for the utilization of the primary and the specialist healthcare services by elderly CVD patients is the region where one lives (Southern and Eastern Serbia OR = 2.44, 95% CI = 1.58-3.77/Belgrade OR = 1.75, 95% CI = 1.32-2.30). Age is another factor, where the 65 to 74 years old CVD patients utilize healthcare services the most. Higher education (OR = 1.80, 95% CI = 1.31-2.47), being a part of the highest Wealth Index group (OR = 1.62, 95% CI = 1.10-2.40), having very poor health status (OR = 3.02, 95% CI = 1.41-6.47), and presence of long-term illness (OR = 1.49, 95% CI = 1.16-1.92), play an important role in the utilization of the specialist care only.
Measuring Frailty in Medicare Data: Development and Validation of a Claims-Based Frailty Index.
Project description:Background:Frailty is a key determinant of health status and outcomes of health care interventions in older adults that is not readily measured in Medicare data. This study aimed to develop and validate a claims-based frailty index (CFI). Methods:We used data from Medicare Current Beneficiary Survey 2006 (development sample: n = 5,593) and 2011 (validation sample: n = 4,424). A CFI was developed using the 2006 claims data to approximate a survey-based frailty index (SFI) calculated from the 2006 survey data as a reference standard. We compared CFI to combined comorbidity index (CCI) in the ability to predict death, disability, recurrent falls, and health care utilization in 2007. As validation, we calculated a CFI using the 2011 claims data to predict these outcomes in 2012. Results:The CFI was correlated with SFI (correlation coefficient: 0.60). In the development sample, CFI was similar to CCI in predicting mortality (C statistic: 0.77 vs. 0.78), but better than CCI for disability, mobility impairment, and recurrent falls (C statistic: 0.62-0.66 vs. 0.56-0.60). Although both indices similarly explained the variation in hospital days, CFI outperformed CCI in explaining the variation in skilled nursing facility days. Adding CFI to age, sex, and CCI improved prediction. In the validation sample, CFI and CCI performed similarly for mortality (C statistic: 0.71 vs. 0.72). Other results were comparable to those from the development sample. Conclusion:A novel frailty index can measure the risk for adverse health outcomes that is not otherwise quantified using demographic characteristics and traditional comorbidity measures in Medicare data.
Association Between Dysphagia and Inpatient Outcomes Across Frailty Level Among Patients???50 Years of Age.
Project description:Frail patients may have heightened risk of dysphagia, a potentially modifiable health factor. Our aim is to examine whether the relationship between dysphagia and adverse health outcomes differs by frailty conditions among inpatients???50 years of age. Medical or surgical hospitalizations among patients???50 years of age in the Healthcare Cost and Utilization Project's National Inpatient Sample from 2014 through the first three quarters of 2015 were included. Adverse outcomes included length of stay (LOS), hospital costs, in-hospital mortality, discharge status, and medical complications. Dysphagia was determined by ICD-9-CM codes. Frailty was defined as (a)???1 condition in the10-item Johns Hopkins Adjusted Clinical Groups (ACG) frailty measure and a frailty index for the (b) ACG and (c) a 19-item Frailty Risk Score (FRS) categorized as non-frail, pre-frail, and frail. Weighted generalized linear models for complex survey designs using generalized estimating equations were performed. Of 6,230,114 unweighted hospitalizations, 4.0% had a dysphagia diagnosis. Dysphagia presented in 3.1% and 11.0% of non-frail and frail hospitalizations using the binary ACG (p?<?0.001) and in 2.9%, 7.9%, and 16.0% of non-frail, pre-frail, and frail hospitalizations using the indexed FRS (p?<?0.001). Dysphagia was associated with greater LOS, higher total costs, increased non-routine discharges, and more medical complications among both frail and non-frail patients using the three frailty definitions. Dysphagia was associated with adverse outcomes in both frail and non-frail medical or surgical hospitalizations. Dysphagia management is an important consideration for providers seeking to reduce risk in vulnerable populations.
Obesity and 1-year outcomes in older Americans with severe sepsis.
Project description:Although critical care physicians view obesity as an independent poor prognostic marker, growing evidence suggests that obesity is, instead, associated with improved mortality following ICU admission. However, this prior empirical work may be biased by preferential admission of obese patients to ICUs, and little is known about other patient-centered outcomes following critical illness. We sought to determine whether 1-year mortality, healthcare utilization, and functional outcomes following a severe sepsis hospitalization differ by body mass index.Observational cohort study.U.S. hospitals.We analyzed 1,404 severe sepsis hospitalizations (1999-2005) among Medicare beneficiaries enrolled in the nationally representative Health and Retirement Study, of which 597 (42.5%) were normal weight, 473 (33.7%) were overweight, and 334 (23.8%) were obese or severely obese, as assessed at their survey prior to acute illness. Underweight patients were excluded a priori.None.Using Medicare claims, we identified severe sepsis hospitalizations and measured inpatient healthcare facility use and calculated total and itemized Medicare spending in the year following hospital discharge. Using the National Death Index, we determined mortality. We ascertained pre- and postmorbid functional status from survey data. Patients with greater body mass indexes experienced lower 1-year mortality compared with nonobese patients, and there was a dose-response relationship such that obese (odds ratio = 0.59; 95% CI, 0.39-0.88) and severely obese patients (odds ratio = 0.46; 95% CI, 0.26-0.80) had the lowest mortality. Total days in a healthcare facility and Medicare expenditures were greater for obese patients (p < 0.01 for both comparisons), but average daily utilization (p = 0.44) and Medicare spending were similar (p = 0.65) among normal, overweight, and obese survivors. Total function limitations following severe sepsis did not differ by body mass index category (p = 0.64).Obesity is associated with improved mortality among severe sepsis patients. Due to longer survival, obese sepsis survivors use more healthcare and result in higher Medicare spending in the year following hospitalization. Median daily healthcare utilization was similar across body mass index categories.
Frailty Phenotype and Healthcare Costs and Utilization in Older Women.
Project description:OBJECTIVES:To determine the association of the frailty phenotype with subsequent healthcare costs and utilization. DESIGN:Prospective cohort study (Study of Osteoporotic Fractures (SOF)). SETTING:Four U.S. sites. PARTICIPANTS:Community-dwelling women (mean age 80.2) participating in SOF Year 10 (Y10) examination linked with their Medicare claims data (N=2,150). MEASUREMENTS:At Y10, frailty phenotype defined using criteria similar to those used in the Cardiovascular Health Study frailty phenotype and categorized as robust, intermediate stage, or frail. Participant multimorbidity burden ascertained using claims data. Functional limitations assessed by asking about difficulty performing instrumental activities of daily living. Total direct healthcare costs and utilization ascertained during 12 months after Y10. RESULTS:Mean total annualized cost±standard deviation (2014 dollars) was $3,781±6,920 for robust women, $6,632±12,452 for intermediate stage women, and $10,755?±?16,589 for frail women. After adjustment for age, site, multimorbidity burden, and cognition, frail women had greater mean total (cost ratio (CR)=1.91, 95% confidence interval (CI)=1.59-2.31) and outpatient (CR=1.55, 95% CI=1.36-1.78) costs than robust women and greater odds of hospitalization (odds ratio (OR)=2.05, 95% CI=1.47-2.87) and a skilled nursing facility stay (OR=3.85, 95% CI=1.88-7.88). There were smaller but significant effects of the intermediate stage category on these outcomes. Individual frailty components (shrinking, poor energy, slowness, low physical activity) were also each associated with higher total costs. Functional limitations partially mediated the association between the frailty phenotype and total costs (CR further adjusted for self-reported limitations=1.32, 95% CI=1.07-1.63 for frail vs robust; CR=1.35, 95% CI=1.18-1.55 for intermediate stage vs robust women). CONCLUSION:Intermediate stage and frail older community-dwelling women had higher subsequent total healthcare costs and utilization after accounting for multimorbidity and functional limitations. Frailty phenotype assessment may improve identification of older adults likely to require costly, extensive care.
Assessing Global Frailty Scores: Development of a Global Burden of Disease-Frailty Index (GBD-FI).
Project description:Frailty is an independent age-associated predictor of morbidity and mortality. Despite this, many countries lack population estimates with large heterogeneity between studies. No population-based standardised metric for frailty is available. We applied the deficit accumulation model of frailty to create a frailty index (FI) using population-level estimates from the Global Burden of Disease (GBD) 2017 study across 195 countries to create a novel GBD frailty index (GBD-FI). Standard FI criteria were applied to all GBD categories to select GBD-FI items. Content validity was assessed by comparing the GBD-FI with a selection of established FIs. Properties including the rate of deficit accumulation with age were examined to assess construct validity. Linear regression models were created to assess if mean GBD-FI scores predicted one-year incident mortality. From all 554 GBD items, 36 were selected for the GBD-FI. Face validity against established FIs was variable. Characteristic properties of a FI-higher mean score for females and a deficit accumulation rate of approximately 0.03 per year, were observed. GBD-FI items were responsible for 19% of total Disability-Adjusted Life Years for those aged ?70 years in 2017. Country-specific mean GBD-FI scores ranged from 0.14 (China) to 0.19 (Hungary) and were a better predictor of mortality from non-communicable diseases than age, gender, Healthcare Access and Quality Index or Socio-Demographic Index scores. The GBD-FI is a valid measure of frailty at population-level but further external validation is required.
One-year costs of medical admissions with and without a 30-day readmission and enhanced risk adjustment.
Project description:BACKGROUND:To overcome the limitations of administrative data in adequately adjusting for differences in patients' risk of readmissions, recent studies have added supplemental data from patient surveys and other sources (e.g., electronic health records). However, judging the adequacy of enhanced risk adjustment for use in assessment of 30-day readmission as a hospital quality indicator is not straightforward. In this paper, we evaluate the adequacy of risk adjustment by comparing the one-year costs of those readmitted within 30 days to those not after excluding the costs of the readmission. METHODS:In this two-step study, we first used comprehensive administrative and survey data on a nationally representative Medicare cohort of hospitalized patients to compare patients with a medical admission who experienced a 30-day readmission to patients without a readmission in terms of their overall Medicare payments during 12 months following the index discharge. We then examined the extent to which a series of enhanced risk adjustment models incorporating code-based comorbidities, self-reported health status and prior healthcare utilization, reduced the payment differences between the admitted and not readmitted groups. RESULTS:Our analytic cohort consisted 4684 index medical hospitalization of which 842 met the 30-day readmission criteria. Those readmitted were more likely to be older, White, sicker and with higher healthcare utilization in the previous year. The unadjusted subsequent one-year Medicare spending among those readmitted ($56,856) was 60% higher than that among the non-readmitted ($35,465). Even with enhanced risk adjustment, and across a variety of sensitivity analyses, one-year Medicare spending remained substantially higher (46.6%, p < 0.01) among readmitted patients. CONCLUSIONS:Enhanced risk adjustment models combining health status indicators from administrative and survey data with previous healthcare utilization are unable to substantially reduce the cost differences between those medical admission patients readmitted within 30 days and those not. The unmeasured patient severity that these cost differences most likely reflect raises the question of the fairness of programs that place large penalties on hospitals with higher than expected readmission rates.
The patterns of health care utilization by elderly Europeans: frailty and its implications for health systems.
Project description:To examine the patterns of health care utilization by the elderly and test the influence of functional decline.We used the three regular waves of the SHARE survey to estimate the influence of frailty on health care utilization in 10 European countries. We controlled for the main correlates of frailty and unobserved individual effects.The frail elderly increase their primary and hospital care utilization before the onset of disability. Multimorbidity moderates the effect of frailty on care utilization.The prevalence of frailty is high in most countries and is expected to increase. This renders frailty prevention and remediation efforts imperative for two complementary reasons: to promote healthier aging and to reduce the burden on health systems.
Do healthcare needs-based population segments predict outcomes among the elderly? Findings from a prospective cohort study in an urbanized low-income community.
Project description:BACKGROUND:A rapidly ageing population with increasing prevalence of chronic disease presents policymakers the urgent task of tailoring healthcare services to optimally meet changing needs. While healthcare needs-based segmentation is a promising approach to efficiently assessing and responding to healthcare needs at the population level, it is not clear how available schemes perform in the context of community-based surveys administered by non-medically trained personnel. The aim of this prospective cohort, community setting study is to evaluate 4 segmentation schemes in terms of practicality and predictive validity for future health outcomes and service utilization. METHODS:A cohort was identified from a cross-sectional health and social characteristics survey of Singapore public rental housing residents aged 60?years and above. Baseline survey data was used to assign individuals into segments as defined by 4 predefined population segmentation schemes developed in Singapore, Delaware, Lombardy and North-West London. From electronic data records, mortality, hospital admissions, emergency department visits, and specialist outpatient clinic visits were assessed for 180?days after baseline segment assignment and compared to segment membership for each segmentation scheme. RESULTS:Of 1324 residents contacted, 928 agreed to participate in the survey (70% response). All subjects could be assigned an exclusive segment for each segmentation scheme. Individuals in more severe segments tended to have lower quality of life as assessed by the EQ-5D Index for health utility. All population segmentation schemes were observed to exhibit an ability to differentiate different levels of mortality and healthcare utilization. CONCLUSIONS:It is practical to assign individuals to healthcare needs-based population segments through community surveys by non-medically trained personnel. The resulting segments for all 4 schemes evaluated in this way have an ability to predict health outcomes and utilization over the medium term (180?days), with significant overlap for some segments. Healthcare needs-based segmentation schemes which are designed to guide action hold particular promise for promoting efficient allocation of services to meet the needs of salient population groups. Further evaluation is needed to determine if these schemes also predict responsiveness to interventions to meet needs implied by segment membership.


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