On 7 November 2018 a ceremony was held at Brompton Cemetery to remember those employees of His Majesty's Office of Works (HMOW) who died in World War 1. Over the last one hundred years the Royal Parks administered by HMOW has been split into The Royal Parks, Historic Royal Palaces and English Heritage, and it was representatives from these organisations, family descendants and student horticulturalists who paid their respects.
The ceremony started with the inauguration of the Chelsea Pensioners Battlefields to Butterflies meadow by the Reverend Steven Brokes at the Chelsea Pensioners Monument, which commemorates the 2,065 Chelsea Pensioners buried there. Around thirty Pensioners assisted students horticulturalists and children from the Isle of Wight in preparing the meadow.
A memorial plaque with the names of the 24 employees of The Royal Parks has been placed in the south east colonnade in the main avenue close by the Chapel. This was unveiled by; Loyd Grossman, Chairman of the Royal Parks Charity; Nicola Andrews, Palaces Group Director of Historic Royal Palaces; Toby Beasley, Head Gardener at Osborne House and; Cecily Ettringham a first year apprentice in The Royal Parks. The 10th Essex Living History Group provided the Guard of Honour and a bugler from the Welsh Guards sounded the Last Post and Reveille. The Blessing of the memorial plaque was given by the Reverend Canon Anthony Howe, Chaplain to the Chapel Royal.
The memorial plaque is to remain in the colonnade and its details placed on the Imperial War Museums' War Memorials Register.
Several press photographers were on site and ITV London News recorded Carol Meacher, the granddaughter of Arthur Berry a gardener at Hampton Court who was killed in 1918, and Loyd Grossman for an item in their evening news programme.


Interagency working between courts and mental health services: the Implications for interprofessional education and training.
Background/Rationale The prevalence of mental health issues in prison populations is exacerbated by ineffective screening for mental illness during earlier contact with the criminal justice system (CJS). Effective screening is reliant on cooperation between the CJS and mental health services. Interagency working has proved difficult in the past as might be expected of working between public services so distinct in expectations, priorities and working culture. Poor interprofessional working leads to court proceedings and public safety being compromised. Further, mentally disordered defendants face inappropriate imprisonment and fail to access community support/treatment. The aim of work is to explore the nature of interprofessional working at the interface of working between the CJS and the mental health services. Methods Data was collected through a cross sectional survey of court (n=479) and mental health workers (n=146). Results Attitudes towards defendants and willingness to work across agencies were comparable across agencies. Procedural expectations varied as did awareness, feelings of efficacy and levels of training that supports better interagency working. Conclusions We discuss the implication of findings for future interprofessional training needs of both court and mental health services. We compare and contrast these with current interprofessional education whose focus is almost exclusively on relationships between health and social care professionals.


Stay well nourished by eating and drinking enough – We can forget to stay hydrated while working in cold weather. However, did you know it is easier to become dehydrated in cold weather? Remember to drink plenty of water and eat a balanced diet. Dehydration can lead to fatigue, headaches, and other symptoms. It is important to stay alert on the job site.
Stay well rested – Make sure you are getting enough rest to be on the job. Unusual weather conditions can be dangerous and it is important to be alert.
Stay dry – Wet clothes are more dangerous in cold weather. If it is raining, make sure you have warm, water proof outerwear for such conditions. If you are going to be working outside for an extended period of time, consider packing a change of clothes.
Dress for the conditions – Layers are key! Dressing in layers helps "you to adjust to changing temperatures." Certain clothing items helps keep you warm such as hats, clothes, and scarves or some other type of neck covering. Layers is especially important in Southeast Texas where the temperatures can changes drastically from the beginning of the day to the evening.
Keep a cold weather safety kit in your vehicle – If you are going to be traveling, keep a cold weather kit in your car for the area. Some items like an emergency blanket, candles, and matches can be useful. The location makes a big difference as to what a vehicle kit should include.
As always, stay safe no matter the weather condition. Check ahead of time and prepare for the situation. It is always easier to be over prepared versus under-prepared.


(Reuters) -- U.S manufacturing grew in June at its slowest pace in 11 months and hiring in the sector slowed as overseas demand for U.S. products waned, an industry survey showed on Thursday.
The number of Americans filing new claims for unemployment benefits was also little changed last week, according to the U.S. Labor Department.
Financial information firm Markit said its U.S. "flash" manufacturing Purchasing Managers Index fell to 52.9 from 54.0 in May. The June reading was the lowest since last July although it stayed above 50, indicating expansion in activity.
For the second straight month, weaker demand from Europe and large emerging markets such as China dented sales. Markit said U.S. manufacturers reported the second largest decline in new export orders since September 2009.
The index's new orders component fell to 54.1 from 54.6.
Manufacturing has been one of the strongest links in an otherwise frail U.S. economic recovery, but Markit said weaker overseas demand may be starting to slow hiring in the sector.
The employment component fell in June to 53.1, reflecting the weakest rate of hiring in eight months. It stood at 54.3 at the end of May.


text:
Jane S. Shields
STAUNTON – Jane Oliver (Smith) Shields, 95, widow of Randolph Tucker Shields, of 31 Woodlee Road died Saturday, Oct. 25, 2014.
She was born Dec. 11, 1918, in Trenton, New Jersey, a daughter of the late John Holmes and Mildred (Oliver) Smith.
Mrs. Shields was a graduate of Newcomb College (Tulane) and Presbyterian School of Christian Education. She was a member of First Presbyterian Church, AAUW and many community organizations. Her lifetime interest in children's education led to her involvement in the founding of Community Child Care Center in 1971.
Family members include a son, Randolph Tucker Shields of Staunton; two daughters, Page Shields and husband, Joseph Sharrer, of Harrisonburg and Catherine Whittington of Charlottesville; a sister, Barbara Hull of Decatur, Georgia; and three grandchildren, Jane Kolb of New York City, and Thomas and Alex Whittington, both of Los Angeles.
A private graveside service will be at a later date.
Memorials may be made to the Community Child Care Center, 32 Park Ave., Staunton, VA 24401.
Henry Funeral Home is handling the arrangements.
Condolences may be sent to the family at www.henryfuneralhome.net.

redpajama_set_name: RedPajamaCommonCrawl


Located right on the much-beloved Plaza Trinidad in Getsemani, this is a great little spot for a corrientazo lunch that offers a little extra than the standard fare.
Sometimes, for example, they will have potato salad or borronjil (a kind of eggplant/platano smush) as a side. And instead of panela for your included drink, you might get lucky and arrive on the day they have watermelon juice.
There's a good range of mainly-meaty options that rotate frequently and sometimes get a bit adventurous. Most of the standard meats-based options are COP7000, but if you opt for the fish filete you'll pay 10,000COP. It's totally worth it. You'll receive a giant portion of fish fillet, battered in a salt and pepper spiced mix and shallow-fried to produce something that kind of reminds me of Cantonese style flounder. Which is to say it's very good. Plus it comes served with coconut rice- a coastal speciality and totally delicious.
Even the soup options vary (fish, triseca, hueso, pollo, patacones) and you might even be lucky enough to get mote de queso – a rich yam-based soup with chunks of cheese that's a speciality of the Atlantic Coast.
At night, the pizza oven gets cranked up, street tables and chairs come out and the cafe gets busy churning out light and crispy pizzas to the hungry plaza folk. They do pastas and burgers too, but I've only ever tried the pizza. Depending upon the toppings you choose, you can get a fairly giant pizza that would feed 2-3 people for around 14,000COP. I add my own dried chilli flakes to up the ante a little.
Lots of people arrive to Cartagena with the expectation that, as part of not-quite first-world Colombia, things are going to be cheap. 'Fraid not. Depending upon where you are coming from and how strong the currency you're converting is, things will be, for the most part, about the same price as in your first-world country (eating, drinking etc) or, even more expensive (accommodation, boating etc).
For most Colombians, lunch is the biggest meal of the day. So if you want to save money, take advantage of the competitive corriente pricing around town (more on corrientes next) and fill up at midday. The servings are so large you'll only need the lightest of dinners.
Corrientes are the daily meal option. At lunch they will usually consist of a soup to start; hueso (bone) or costilla (rib) are the most common and are made with potato and/or yuca, a chunk of bone with or without some meat attached (depending upon the generosity of your server) cilantro and maybe some other vegetables. You may also find pollo (chicken), pescado (fish) and patacones (plantain) options. If you're really lucky there might be mote de queso (a specialty soup with chunks of cheese and yam) or Modongo (hmm.. the less you know the better.. basically stomache lining/offal.. but mighty flavoursome).
The main plate will include your selected meat (carne [beef], cerdo [pork], pollo [chicken], lingua [tongue], higado [liver] or pescado [fish] being the main offerings) plus a varying combination of rice, lentils, beans, salad (always very basic - lettuce, tomato, onion), patacones and banana.
To drink, the usual offering will be aguapanela (brown sugar dissolved in water with lime juice), chicha (rice-based fruity cordial) or jugo (juice of the day). Corrientes are usually a lunch time thing, but a handful of places serve them up all night long too. Expect to pay from around COP$6,000 up to $15,000 depending upon the place and whether you choose the more expensive fish option.
Go to where the people are and you're more likely to find a better variety of good-valued meal options. Ludicrously high rental prices within the walled city makes it more difficult to find food for cheap, so head a little further out. Getsemani has a good offering of cheap eating to target both locals and backpackers. There's some good options around La Matuna aiming to capture the commercial/professional crowd of employees and even upmarket Bocagrande has some good lunch-time deals as the restaurants fight it out for tourist lunchtime trade.
Don't be scared to grab some food from the many street vendors, plonk yourself down on a bench and eat al fresco. After more than a year of living here and eating EVERYTHING offered on the street, I have never been sick once. You can pick up a styrofoam tray filled with lunch (rice, beans, salad, meat) for 4000 pesos from 12-2pm daily (popular options run out quickly so for more choice, eat earlier!) otherwise you can get all the street snacks I write about HERE throughout the day. Remember! You can also book in for my Street Food Tour!
I love Asian food and I cook a lot of it at home, paying a premium for my imported Oyster sauce because sometimes I just want those oriental flavours. But if you want to eat cheap you can't expect to eat the same way you do at home. People here don't really eat fresh, healthy protein-based salads, for example, so if that's what you are hankering for, you can find it, but expect to pay more. Eat what the locals eat and it will be cheaper. And apologies vegetarians - for the most part, Cartagena is very bad value for you.
OK! You're now ready for my list of cheap(er) restaurants. Go here.
Do you have any other tips to eat cheap around Cartagena?


I wake up wondering once again, as so often, how the little horse got on the boat in the first place, let alone why it voyaged so far: who let it on, was there no-one to lead it off, by its halter, for example, back onto dry land, to its own pastures, that were maybe not so green, but familiar, at least? Why was it by the pier, near the harbour even? I suppose horses do live by the seaside, it is not unheard of, but it vexes me. A horse belongs onshore, as far as I'm concerned, in my inexpertise.
I try to think this through and come up with several potential scenarios, none of which satisfies as an explanation. Perhaps the little horse accidentally strayed onto a cargo ship and was mistaken there for one of the ones that were actually being exported, by coincidence, just then. Maybe it wasn't so much a coincidence, maybe the horse got friendly with, even enamoured of, one of the horses that—very possibly against their own will or better instinct—were being embarked right now and just followed it, in equine loyalty and affection.
Perhaps it was being sold: it could simply be that it was 'mine'—as in the person writing the song, thus narrating the story and lamenting the absence of 'my' little horse, wishing it back—only by extension, and really it belonged to the family or to my father, and he, for reasons best known to him (but there are many imaginable: economic hardship, disaffection with the beast, or having gambled it away to a foreign sailor, notwithstanding the riddle as to what a sailor, of all people, would do with a pony – maybe sell it on?…), had exchanged it for goods or money, or forfeited it; and now, as I sit here on my own watching the waves roll in from afar, it has long since sailed away, right over the ocean, over the sea.
Then suddenly it hits me, out of the blue. It has all been a misunderstanding. Where I went to school, in Basel, we had an annual 'bazar'. I can't be sure any more was it at this bazar, which everybody pronounced 'bahtzar', and which happened a few weeks before Christmas to raise funds for the school, or was it at the summer fete, which happened every year in the summer, probably just before the big holidays, to the same end, or both, but there was a little patch of wood in the school grounds where sometimes, not always, some generous soul would bring along a couple of ponies, so the children could go pony riding for a franc or two. This was almost the only occasion that ever presented itself to me to see, or think of, or hear about, ponies. Even though they spelt 'Pony' the same as in English, just with a capital for being a noun, everybody called a pony 'es Bonny', pronouncing it with an at best half committed P and without the prerequisite diphthong, making it sound exactly like 'Bonnie'. For years—years!—I would stand in class amongst my gschpänlis and intone with devotion a plea for someone, anyone really, to bring back, bring back, oh bring back my little horse to me. And for years—years!—I could not fathom why the little horse had ever gone away, there just seemed to be no plausible explanation for this. And now—now!—it turns out there didn't ever need to be.


for $279,900. The lot size is 0.5 Acre(s).
LAKEFRONT LOT!! Boat slip must be purchased for $70k (not included in price). Soft, rolling topo. Hard woods. On Cul-De-Sac. Owners' plans have changed. Rare opportunity to buy lake front living in Marina Bay.


text:
Institutional open access agreements
Narrative medicine educational project to improve the care of patients with chronic obstructive pulmonary disease
Antonietta Cappuccio, Alessandro Sanduzzi Zamparelli, Massimo Verga, Stefano Nardini, Alessandro Policreti, Pasquale Alberto Porpiglia, Silvia Napolitano, Maria Giulia Marini on behalf of the Words of Breath Group
ERJ Open Research 2018 4: 00155-2017; DOI: 10.1183/23120541.00155-2017
Antonietta Cappuccio
1Fondazione ISTUD, Milan, Italy
ORCID record for Antonietta Cappuccio
Alessandro Sanduzzi Zamparelli
2Dept of Clinical Medicine and Surgery, Section of Respiratory Disease, University Federico II, Naples, Italy
Massimo Verga
3Antismoking Centre, ASST Santi Paolo e Carlo, Milan, Italy
Stefano Nardini
4Pulmonary and TB Unit, General Hospital, Vittorio Veneto, Italy
Alessandro Policreti
5Medical Dept, Novartis Farma, Origgio, Italy
Pasquale Alberto Porpiglia
Silvia Napolitano
Maria Giulia Marini
Personal details and profile of the 74 physicians who wrote parallel charts
Female 42 (31)
Male 58 (43)
Age years 52 (31–69)
Professional years 23 (5–40)
Northern Italy 45 (33)
Central Italy 27 (20)
Southern Italy 28 (21)
Working in a hospital 47 (35)
Working in local public healthcare facilities 41 (30)
Working in a private clinic 9 (7)
Working as a private practitioner 3 (2)
Respiratory diseases 86 (64)
Internal medicine 14 (10)
Data are presented as % (n) or mean (range).
Characteristics that influenced the narrative style chosen by pulmonologists
"Core" parallel charts "Contingent" parallel charts "Moral" parallel charts
Charts 150 153 59
Northern Italy 39 (64) 49 (80) 12 (20)
Central Italy 46 (45) 32 (32) 22 (22)
Southern Italy 41 (41) 41 (41) 17 (17)
Working in a hospital 38 (66) 48 (84) 14 (26)
Working in local public healthcare facilities 43 (62) 37 (54) 20 (29)
Working in a private clinic 57 (17) 30 (9) 13 (4)
Working as a private practitioner 45 (5) 55 (6) 0 (0)
Age years
30–39 47 (21) 44 (20) 9 (4)
40–49 44 (46) 46 (48) 10 (10)
Data are presented as n or % (n).
Number of characters and time spent writing the parallel charts
Characters n
≤1000 1 (2) 24 (36) 10 (6)
1001–2000 31 (43) 50 (76) 39 (23)
>3000 36 (54) 7 (11) 29 (17)
Time spent writing min
<30 28 (27) 54 (71) 33 (15)
>60 39 (52) 23 (31) 37 (17)
Personal details of the patients described in the parallel charts and their influence on the narrative style
Easy Difficult Easy Difficult Easy Difficult
Total at the beginning 65% 35% 72% 28% 26% 74%
Emotions at first visit (n=93) (n=51) (n=101) (n=38) (n=14) (n=39)
Positive 16% 6% 19% 11% 29% 5%
"During the visit, the patient appeared to me serene, optimistic and open to an exchange of views"
"The patient is very hopeful and full of trust"
Fear and pain 57% 34% 62% 29% 50% 26%
"He told me he was afraid that at 48 he was already a finished man"
"He seemed tired, rigid, not in his usual mood. His way of dressing appeared unkempt, sloppy and a bit messy, not impeccable as usual"
Anger and neglect 7% 28% 5% 24% 0% 59%
"The patient, at the beginning of the visit, was serene, because he was convinced he was not ill, but that his problems were normal for smokers and that I would have told him that he was fine"
"He was very aggressive and angry about his disease, and he criticised all the people he was talking about, but he was actually angry with himself"
Submission and shame 20% 34% 16% 37% 21% 10%
"There was a certain resignation about him, knowing that he had smoked for years"
"She seemed tired, physically and morally, confused and resigned"
Smoking at first visit (n=96) (n=50) (n=109) (n=41) (n=11) (n=43)
Yes 56% 84% 59% 80% 55% 84%
Nonsmoker/already quit 44% 16% 41% 20% 45% 16%
Pulmonologists' personal decisions and emotions as described in the parallel charts, and their influence on the narrative style
Easy Difficult Evolved Easy Difficult Evolved Easy Difficult Evolved
Total 65% (n=98) 2% (n=3) 33% (n=49) 72% (n=110) 11% (n=16) 17% (n=26) 24% (n=14) 46% (n=27) 31% (n=18)
Reasons that led to therapy change
Illness-oriented 52% 0% 71% 40% 0% 35% 50% 28% 60%
"The change of therapy, combined with encouragement, was the change the patient needed to get out of the spiral of anxiety that enslaved him"
"If we try to give you another bronchodilator instead of cortisone, it will be like having a car with two engines"
Disease-oriented 48% 100% 29% 60% 100% 65% 50% 72% 40%
"A proper diagnosis through anamnesis and spirometry. Therefore, initiated therapy recommended by the international COPD guidelines"
"I explained to him that, after seeing the spirometry results, he could not fail to follow my advice and that I would facilitate his tasks with a simpler, but still effective therapy"
Physicians' emotions after communication of therapy change
Satisfaction and trust 55% 33% 37% 51% 15% 24% 55% 19% 8%
"I felt happy seeing that in a few minutes the husband, in front of the opportunity to modify a therapy that was not objectively optimal, returned to smile, with a much less concerned expression"
Anger and discomfort 5% 67% 37% 3% 62% 14% 27% 5% 46%
"I felt the patient distant and unwilling to follow the directions given, especially for what concerns the behavioural changes. It seemed that she did not care about her health"
"Almost helpless … I thought it was a failure"
Duty and responsibility 40% 0% 37% 46%% 23% 62% 18% 76% 46%
"I felt I was responsible for his happiness"
"I felt obliged to help him and make him change his mind"
Smoking cessation strategies
Reprimands 24% 100% 35% 67% 75% 54% 80% 90% 89%
"I ask him if he still smokes and he answers yes. AT THIS POINT, I burst out and I rebuke him because he KEPT SMOKING. I added that it's not right that I and others have to sustain healthcare expenditure while he continues to be addicted to nicotine"
Compromise 57% 0% 48% 27% 25% 38% 20% 10% 11%
"I also took the opportunity to remind her of the damage of cigarette smoke and how she had been good recently, in reducing the daily number of cigarettes"
Counselling 19% 0% 17% 7% 0% 8% 0% 0% 0%
"During my next visit, I tried to make the patient feel at ease, in order to better understand the stressful situations that led her to her compulsive desire of smoking"
COPD: chronic obstructive pulmonary disease.
Results of healthcare relationships in terms of therapy, activities resumed, pathway of care and adherence, their correlation to the narrative style, and the type of relationship established
Physicians' impression on how patients lived the therapy
Negatively 4% 100% 7% 7% 75% 9% 0% 61% 17%
"A disaster, a bigger challenge for her, a defeat"
Positively 64% 0% 54% 58% 25% 74% 60% 39% 61%
"I think the patient experienced care in an authentic way, knowing that there are not many other possibilities that effective … so, all in all, he was grateful to the scientific world"
"But when he realised its immediate effectiveness and ease, he strongly adhered to the therapy"
As a liberation 32% 0% 39% 35% 0% 17% 40% 0% 22%
"I was glad that an elderly widow had come back to plan a six-month summer vacation in advance. The therapy has restored her confidence"
"In my opinion, the patient has experienced cure as a new opportunity to live his life"
Resumption of the activities interrupted due to disease
No 8% 33% 2% 7% 36% 4% 15% 56% 7%
"I knew he had abandoned the therapy I had prescribed because the results were probably not the expected ones"
Yes 47% 33% 44% 39% 29% 64% 38% 6% 46%
"Thanks to the new therapy, he regained his desire to live, made of small but important things: meeting friends, talking to the newsagent, sometimes playing bowls, feeling alive again"
"Working continuously, without frequent breaks, he can meet his deadlines and can continue to play soccer"
Yes, with some limitations 45% 33% 53% 54% 36% 32% 46% 39% 47%
"He is a demanding person. He cannot do things that maybe other people of his age without COPD could do. But let's not let it go … do not ever say it"
Thinking back to the pathway of care, I think …
It was difficult 1% 33% 16% 0% 14% 5% 14% 40% 8%
"The path has been slower and fuller of obstacles than I had expected at the beginning"
Something could be improved 15% 33% 11% 22% 36% 18% 57% 25% 31%
"I think it's also necessary to have a psychological support for family members"
I did my best 48% 0% 27% 52% 36% 27% 14% 15% 46%
"I think the path of the patient is very satisfactory for the results obtained, which of course must be maintained"
Listening to the patient is the 35% 33% 46% 26% 14% 50% 14% 20% 15%
key for success
"Understanding her biggest concern and sharing it with her motivated the patient to follow the cure prescribed, also ensuring a continued adherence"
Yes 100% 67% 97% 98% 64% 100% 100% 44% 100%
Lessons acquired by physicians when writing and how they relate to the narrative style
From this experience, I've learned …
To be perseverant 13% (n=16) 12% (n=15) 16% (n=6)
"I have learned that even slight improvements need to be pursued to improve the quality of life of each individual!"
"You have to wait patiently for the result"
New aspects of COPD 16% (n=20) 28% (n=35) 13% (n=5)
"Too many times we focus only on the superficial and mainly clinical aspects; in the case of a COPD patient, smoking is often a hint, a sign of other types of discomfort"
"The pharmacological prescription alone, if not accompanied by proper education, is unlikely to succeed"
The importance of true 72% (n=90) 60% (n=75) 71% (n=27)
"From the relationship with this patient, I learned that we must first cure the wounded soul of the lion, and only then intervene on the pathology"
"That very often the quality of life and the resumption of a previously lost activity is much more important to the patient than having improved functional parameters or laboratory data"
"We physicians are focused on the perfect diagnosis, but in this relationship I learned that often the patient makes the diagnosis, we are the translators of expressions and clues. As investigators, we can find the solution among the smallest clues, those hidden in the heart of the people"
Appreciation of the educational project in relationship to the narrative style
The project influenced my daily practice
Yes, partially or entirely 85% (n=113) 83% (n=112) 60% (n=28)
"This approach has greatly improved my relationship with patients, making me understand that empathy associated with drug therapy can be useful in treating not only the disease but also the person"
"Yes! I am more confident about the good performance of my prescriptions"
No 0% (n=0) 5% (n=7) 17% (n=8)
"I'm not used to writing parallel charts. I don't know how to describe my feelings, I honestly don't really like it"
I already applied this approach 15% (n=20) 12% (n=16) 23% (n=11)
"I like to think of my patients not just as clinical cases, I think I do this every day. Sure, writing is another thing, but I'm still motivated"
Writing the parallel chart …
Was beneficial and liberating 38% (n=43) 12% (n=15) 38% (n=12)
"It was liberating, almost therapeutic"
"Satisfied and accomplished"
"Interested in applying a methodology that I have not used to date"
"The narration has put me at the patient level, a parallel level, but with meeting points. It does not exist in geometry but in reality, it does!"
Made me reflect 33% (n=38) 31% (n=39) 13% (n=4)
"By concentrating on the patient's experience, the doctor is obliged to expose himself as a person, sympathetic with the subject visited, because he is subject to the same psycho-social and affective dynamics"
"It caused me not to run, but to think and rethink, he brought back the focus on the man, rather than on the patient"
Made me feel complete 23% (n=26) 10% (n=13) 38% (n=12)
"A useful moment of reflection. Often in the hospital you feel a machine that has to "crunch" visits. Thanks to writing the parallel charts I felt human once again"
"I felt helpful and positive, happy with my work and the relationship I can build with several patients. Watching such situations makes us realise how important the emotional aspects of our profession are and I hope that other colleagues who are less interested in this aspect will see the improvements that this approach can make to people's lifes"
Was demanding 6% (n=7) 5% (n=6) 13% (n=4)
"I have struggled a bit to detach myself from the scientific methodology I'd been using for years, but it was a great challenge and I hope I can do a decent job"
Vol 4 Issue 2 Table of Contents
You are going to email the following Narrative medicine educational project to improve the care of patients with chronic obstructive pulmonary disease
Antonietta Cappuccio, Alessandro Sanduzzi Zamparelli, Massimo Verga, Stefano Nardini, Alessandro Policreti, Pasquale Alberto Porpiglia, Silvia Napolitano, Maria Giulia Marini
ERJ Open Research Apr 2018, 4 (2) 00155-2017; DOI: 10.1183/23120541.00155-2017
COPD and smoking
Endobronchial autologous BM-MSCs in IPF patients
Effect of β-blockers on the risk of COPD exacerbations
Recurrence of symptoms after childhood LRTI
Show more Original articles
Admissions following first exacerbation-related hospitalisation
Improving the wellbeing of caregivers of patients with COPD
Arterial remodelling in smokers, and patients with small airway disease and COPD
Show more COPD
About ERJ Open Research


357 SOUTH BREWSTER RD is Block 126, Lot 30 in Buena Boro, Atlantic County.
The Deed for 357 South Brewster Rd is filed with the County Clerk in Book 5480 on Page 115.
This property is partially within the A Zone (within floodplain). Approximately 0.01 acres (0.32%) of the property is within this zone.
View the list of properties within 200 feet of 357 SOUTH BREWSTER RD. Useful for determining certified mailing lists when applying for a variance or permit.
FRANDINO, JOHN DAVID & MARGARET M.


We are migrating our project from Spring 3.1.0 to Spring 5.1.3 But we observerd that pacakge org.springframework.ejb.support has been discontinued in 5.1.3 There are classes like org.springframework.ejb.support.AbstractStatelessSessionBean that we are using. I tried searching for its replacement in Spring 5.1.3 but couldn't find any good article on to tackle this issue. Can anyone provide some guidance on what is the replacement for this package, especially org.springframework.ejb.support.AbstractStatelessSessionBean.java in Spring 5.1.3?
I tried looking at the documentation available online. But couldn't find any helpful article.
It seems there is no replacement, and that makes sense to be honest. I found https://docs.spring.io/spring/docs/3.2.4.RELEASE_to_4.0.0.M3/Spring%20Framework%203.2.4.RELEASE/org/springframework/ejb/support/AbstractStatelessSessionBean.html which mentions that the class is to support EJB 2.x beans. Those should no longer be used anywhere that is not ancient legacy code, and even in Spring 3.2 this class and all other classes / interfaces in the same package were deprecated; see https://docs.spring.io/spring/docs/3.2.4.RELEASE_to_4.0.0.M3/Spring%20Framework%203.2.4.RELEASE/org/springframework/ejb/support/package-summary.html.
You probably have to rewrite some code this time. Since you're going up two major versions, that shouldn't come as a surprise though.
TilesConfigurer is deprecated? How to use tiles 2.2 in spring MVC 3.1?


text:
Caudovirales - dsDNA Viruses - dsDNA Viruses (2011) - ICTV
ICTV 9th Report (2011)
dsDNA Viruses (2011)
dsDNA Viruses Caudovirales
Wikis - Title
Caudovirales
Taxonomy - Then and Now
-dsDNA Viruses
+Adenoviridae
+Ampullaviridae
+Ascoviridae
+Asfarviridae
+Baculoviridae
+Bicaudaviridae
-Caudovirales
+Myoviridae
+Podoviridae
+Siphoviridae
+Corticoviridae
+Fuselloviridae
+Globuloviridae
+Guttaviridae
+Herpesvirales
+Iridoviridae
+Ligamenvirales
+Mimiviridae
+Nimaviridae
+Papillomaviridae
+Phycodnaviridae
+Plasmaviridae
+Polydnaviridae
+Polyomaviridae
+Poxviridae
+Rhizidiovirus
+Salterprovirus
+Tectiviridae
Order Caudovirales
Chapter Version: ICTV Ninth Report; 2009 Taxonomy Release
The order consists of the three families of tailed bacterial viruses infecting Bacteria and Archaea: Myoviridae (long contractile tails), Siphoviridae (long non-contractile tails) and Podoviridae (short non-contractile tails). Tailed bacterial viruses are an extremely large group with highly diverse virion, genome and replication properties. Over 4500 descriptions have been published (accounting for 96% of reported bacterial viruses): 24% in the family Myoviridae, 62% in the family Siphoviridae and 14% in the family Podoviridae (as of November 2001). However, data on virion structure, genome organization and replication properties are available for only a small number of well-studied species. Although extensive horizontal gene transfer between bacterial cells and viruses has obscured phylogenetic relationships amongst some tailed viruses, particularly those which are temperate, enough common features still survive to indicate their fundamental relatedness. Therefore, formal taxonomic names are used for Caudovirales at the order and family level, but only vernacular names at the genus level. Since publication of the Eighth Report, some taxonomic revision of the family Podoviridae has been accomplished based on genome information. This has led to the introduction of subfamilies to accommodate the wealth and diversity of bacterial viruses being discovered.
Virion properties
The virion has no envelope and consists of two parts, the head and the tail. The head is a protein shell and contains a single linear dsDNA molecule, and the tail is a protein tube whose distal end binds the surface receptors on susceptible bacterial cells. DNA travels through the tail tube during delivery (often called "injection") into the cell being infected. Heads have icosahedral symmetry or elongated derivatives thereof (with known triangulation numbers of T=4, 7, 13, 16 and 52). Capsomers are seldom visible: heads usually appear smooth and thin-walled (2–3 nm). When they are visible, morphological features (capsomeres) on the surface of the head commonly form 72 capsomers (T=7; 420 protein subunits), but known capsomer numbers vary from 42 to 522. Isometric heads are typically 45–170 nm in diameter. Elongated heads derive from icosahedra by addition of equatorial belts of capsomers and can be up to 230 nm long. DNA forms a tightly packed coil (without bound proteins) inside the head. Tail shafts have six-fold or (rarely) three-fold symmetry, and are helical or stacks of disks of subunits from 3 and 825 nm in length. They usually have base plates, spikes, or terminal fibers at the distal end. Some viruses have collars at the head–tail junction, head or collar appendages, transverse tail disks, or other attachments.
Physicochemical and physical properties
Virion Mr is 20–600 ×106; S20,w values are 200 to >1200S. Both upper limits may be underestimates, since these properties have not been determined for the largest tailed viruses. Buoyant density in CsCl is typically about 1.5 g cm−3. Most tailed viruses are stable at pH 5–9; a few are stable at pH 2 or pH 11. Heat sensitivity is variable, but many virions are inactivated by heating at 55–75 °C for 30 min. Tailed viruses are rather resistant to UV irradiation. Heat and UV inactivation generally follow first-order kinetics. Most tailed phages are stable to chloroform. Inactivation by nonionic detergents is variable and concentration-dependent. Some virions are sensitive to osmotic shock, and many are sensitive to Mg+ chelators.
Virions contain one molecule of linear dsDNA. Genome sizes are 18 to >500 kbp, corresponding to Mr values of 11 to >300 ×106. DNA content is 45–55% of the virions. G+C contents are 27–72% and usually resemble those of host DNA. Some viral DNAs contain modified nucleotides which partially or completely replace normal nucleotides (e.g., 5-hydroxymethylcytosine instead of cytosine), and/or are glycosylated or otherwise modified.
There are 7–49 different virion structural proteins. Typical head shells are made up of 60T molecules of a single main building block CP and 12 molecules of portal protein through which DNA enters and leaves, but they can also contain varied numbers of proteins that plug the portal hole, proteins to which tails bind, proteins that bind to the outside of the CP shell (decoration proteins) and other proteins whose roles are not known. Non-contractile tails are made of one major shaft or tube protein and contractile tails have a second major protein, the sheath protein that forms a cylinder around the central tube. Tails also have small numbers of varied specific proteins at both ends. Those at the end distal from the head form a structure called the tail tip (Siphovirus) or baseplate (Myovirus) to which the tail fibers are attached. The tail fibers bind to the first-contact receptors on the surface of susceptible cells. Fibers or baseplates may include proteins with endoglycosidase or peptidoglycan hydrolase activity that aid in gaining access to the cell surface and entry of DNA into the cell. Most virions carry proteins that are injected with the DNA, such as transcription factors, RNA polymerase and others with poorly understood functions.
No well-characterized virions contain lipid.
Glycoproteins, glycolipids, hexosamine and a polysaccharide have been reported in certain virions but these are not well-characterized.
Genome organization
The linear dsDNA genomes encode from 27 to over 600 genes that are highly clustered according to function and tend to be arranged in large operons. Complete functional genomic maps are very diverse and available for only a relatively small number of tailed viruses. Virion DNAs may be circularly permuted and/or terminally redundant, have single stranded gaps, or have covalently-bound terminal proteins. The ends of these linear molecules can be blunt or have complementary protruding 5′ or 3′ ends (the "cohesive" or "sticky" ends, which can base-pair to circularize the molecule). Prophages of temperate tailed viruses are either integrated into the host genome or replicate as circular or linear plasmids; these linear plasmids have covalently-closed hairpin telomeres.
In typical lytic infections, after entering the host cell, viral DNA may either circularize or remain linear. A few viruses use terminal proteins to prime DNA replication and package progeny viral DNA (ꨡ29 and its relatives) or replicate DNA by a duplicative transposition mechanism (Mu and its relatives). Gene expression is largely time-ordered and groups of genes are sequentially expressed. "Early genes" are expressed first and are largely involved in host cell modification and viral DNA replication. "Late genes" specify virion structural proteins and lysis proteins (Figure 1). The larger tailed viruses have gene expression cascades that are more complex than this simple scenario. Transcription often requires host RNA polymerase, but many tailed viruses encode RNA polymerases or transcription factors that affect the host RNA polymerase. Translational control is poorly understood and no generalizations are possible at the present state of knowledge. All tailed viruses encode proteins that direct the replication apparatus to the replication origin, but this apparatus may be entirely host-derived, partly virus encoded, or entirely virus encoded. DNA replication is semi-conservative, may be either bidirectional or unidirectional, and usually results in the formation of concatemers (multiple genomes joined head-to-tail) by recombination between phage DNAs or by rolling circle replication. Progeny viral DNA is generated during virion assembly by cleavage from this concatemeric DNA: (i) at unique sites to produce identical DNA molecules with either cos sites or blunt-ended, terminally redundant termini, (ii) at pac sites to produce circularly permuted, terminal redundant DNAs, or (iii) by a headful mechanism to produce terminally redundant, circularly permuted DNAs.
Figure 1. Flow chart of tailed phage replication. The chart depicts the replication of "typical" virulent phages such as Enterobacteria phage T4 (T4), Enterobacteria phage T7 (T7), and the temperate phages.
Virion assembly and DNA packaging
Assembly of virions from newly made proteins and replicated DNA is complex and generally includes separate pathways for heads, tails and tail fibers. Coat protein shells, called procapsids or proheads, are assembled first, and DNA is inserted into these preformed proteinaceous containers. Assembly of procapsids is poorly understood, but often utilizes an internal scaffolding protein which helps CP assemble correctly and is then released from the shell after its construction. In many, but not all, tailed viruses, proteolytic cleavages (by host or virus-encoded proteases) of some proteins accompany assembly. Virus-specific DNA is recognized for packaging into procapsids by the terminase protein. One end of the DNA is then threaded through the procapsid's portal structure, and DNA is pumped into the head by an ATP hydrolysis-driven motor that is probably made up of the two terminase subunits and portal protein. Unless unit length DNA molecules are the substrate for packaging (such as with Phi29), when the head is full of DNA a "headful sensing device" recognizes this fact and causes the terminase to cleave the DNA to release the full head from the unpackaged remainder of the DNA concatemer. The terminase subunits are usually released from the virion after DNA is packaged. Filled heads then join to tails and tail fibers to form progeny virions. Some viruses form intracellular arrays, and many produce aberrant structures (polyheads, polytails, giant, multi-tailed, or misshapen particles). Progeny viruses are liberated by lysis of the host cell. Cell lysis is caused by phage-encoded peptidoglycan hydrolases; but lysis timing is controlled by holins, phage encoded inner membrane proteins that allow the hydrolases to escape from the cytoplasm.
Antigenic properties
Viruses are antigenically complex and efficient immunogens, inducing the formation of neutralizing and complement-fixing antigens. The existence of group antigens is likely within species or genera.
Biological properties
Tailed-viruses are lytic or temperate. Lytic infection results in production of progeny viruses and destruction of the host. Phages adsorb tail-first to specific proteins or polysaccharides on the host cell outer cell surface. In a few cases the primary adsorption sites (receptors) are flagella or pili. Upon adsorption to the outside of the cell, virions undergo complex and often poorly understood rearrangements which release the DNA to enter the cell through the tail. Cell walls are often locally digested by a virion-associated peptidoglycan hydrolase and viral DNA enters the cytoplasm by as yet unknown mechanisms. In some cases DNA entry is stepwise and transcription of the first DNA to enter is required for entry of the rest of the DNA. Empty virions remain outside the infected bacterium, however most viruses inject specific proteins with the DNA. Temperate viruses can, upon infection, either enter a lytic growth cycle (above) or establish a lysogenic state (below). Physiological factors in the cell can affect the decision between these two pathways.
All three-tailed virus families include genera or species of temperate viruses. Viral genomes in lysogenized cells are called "prophages". Prophages are either integrated into host cell chromosomes or persist as extrachromosomal elements (plasmids). Integration is usually mediated by recombinases called integrases. The most common are in the tyrosine-active site class and some are in the serine-active site class. For the Mu-like viruses, integration is accomplished by transposases. Integrated prophages typically express only a very small fraction of their genes. The genes that are expressed from the prophage are called "lysogenic conversion" or "cargo" genes, and their products usually alter the properties of the bacterial host. Among these genes is the prophage repressor gene, whose product binds operators in the prophage genome to keep the lytic cascade of gene expression from initiating. Plasmid prophages typically express many of their early genes, some of which are involved in replication of the plasmid (which can be circular or linear). Prophages can often be induced to initiate a lytic growth cycle; DNA damaging agents such as ultraviolet light or mitomycin C cause many prophages to induce.
Host range
Tailed viruses have been found in over 140 prokaryote genera representing most branches of the bacterial and archaeal phylogenetic trees. The host specificity of these viruses can vary widely; some can infect members of multiple genera, but perhaps more common (especially in the host family Enterobacteriaceae, where the most varieties have been studied) are viruses that are specific for particular isolates or groups of isolates of closely related host species.
Transmission in nature
Virions are typically carried and transmitted in aqueous environments, although a few are stable to drying. Virus genomes can be carried as prophages inside host bacteria. Such lysogenic bacteria can induce release of virions, either spontaneously or in response to specific environmental signals.
Tailed phages are the most abundant type of organism on Earth; the current best estimates are 1031 particles in our biosphere. If all these phages were laid end to end the line would extend for 2×108 light years. Data from genome sequence analyses imply that these viruses can move around the globe on a time scale that is short relative to the rate at which they accumulate mutations. They have a worldwide distribution and presumably share the habitats of their hosts. An important habitat is inside lysogenic bacteria as prophages.
Phylogenetic relationships within the order and the perils of mosaicism
The recent availability of high-throughput DNA sequencing has led to a dramatic increase in the number of complete genome sequences that are available for members of the Caudovirales. At the latest count 101 myoviruses, 91 podoviruses and 244 siphoviruses are listed in the RefSeq Genomes section of NCBI. The new data substantially enrich our appreciation of the genetic structure and diversity of the global Caudovirales population and of the evolutionary mechanisms within that order. The new data also substantially complicate considerations of how best to represent these viruses in a coherent and easy to use taxonomy.
The hallmark of the genomes of these viruses is that they are genetic mosaics, a property that becomes apparent when two or more genome sequences are compared. The modules of sequence that constitute the mosaic are typically individual genes, but they can also be parts of genes corresponding to protein domains, or small groups of genes such as prohead assembly genes. The mosaicism is evidently the result of non-homologous recombination during the evolution of these viruses. The novel juxtapositions of sequence produced in this way are spread through the population and reassorted with each other by means of homologous recombination. Regardless of mechanism, the overall result is as if each phage had constituted its genome by picking modules from a menu, choosing one module from each of perhaps fifty columns, each of which has alternative choices.
While there is no doubt that recombinational exchange has muddied the relationship between certain phages, recent whole genome comparative proteomics revealed that in many cases clear phylogenetic relationships exist even though DNA sequence similarity is small. Using CoreGenes, a BLASTP-based comparative genomic tool, all fully sequenced members of the Podoviridae and Myoviridae were analyzed. From these studies it was possible to identify high level relationships between phages that shared ≥40% homologous proteins distributed over the length of their genomes (representing phage within the same genus) and lower level relationships in which only 20–30% of the proteins were significantly (BLAST score ≥75) similar. This has led, for example, to the creation of three distinct genera within a new subfamily (Autographivirinae) for phages previously known as the "T7 superfamily" and has helped classify or re-classify many other members of the families Podoviridae and Myoviridae. While this approach has significantly reduced the number of unclassified viruses, there are still many that remain genomic orphans. It has not yet been possible to place certain phages which are clearly related but only at a low level. For example, the myoviruses that infect Prochlorococcus and Synechococcus possess a set of genes which they share with T4-like phages but score very low in CoreGenes. Higher-level relationships will therefore have to be addressed in the future. The tentative classification of phages based purely on morphological grounds and minimal sequence analysis should be discouraged in favor of full sequence analysis on genomes that have been carefully annotated.
In the current ICTV taxonomy, presented here, the division of the order Caudovirales into three families is based solely on tail morphology: members of the family Siphoviridae have long non-contractile tails, Myoviridae have long contractile tails, and Podoviridae have short tails. As might be expected from the discussion above, this hierarchical division of phages on the basis of one character leads to many examples of inappropriate divisions of other characters. One well-known and easily illustrated example of this is shown in Figure 2, comparing phages lambda and P22. These two phages are considered by many phage biologists to be closely related, because they share genome organization (including regulation and layout of transcription and functional order of genes), temperate lifestyle, a number of similarities of gene sequences and they can form viable hybrids. Despite these similarities, they are classified into different families (Siphoviridae and Podoviridae for lambda and P22, respectively) based on their differences in tail morphology. It may be arguable whether the similarities between these two phages are enough for them to be classified in the same family, but it is in any case clear that P22 is much closer to lambda than it is to most other members of the family Podoviridae, such as phages T7 and N4, which have essentially no similarity to lambda in sequence, genome organization, or lifestyle.
Where mosaicism is extensive, ICTV will have to come to terms with the fact that not all phages will be simply classifiable in a straightforward hierarchical manner. Because of this, the ICTV considers the taxonomy of this group to be provisional, and this is the reason that the names of the genera are in a non-official vernacular format. Discussions are ongoing both within the ICTV and in the virology community at large, and there may well be significant changes to the Caudovirales taxonomy in the future, in response to our new understanding of the biology.
Figure 2. The mosaic relationship between the genomes of phages P22 and lambda. The circular maps are opened for linear display between the lysis and head genes. The genes in each genome are represented by rectangles. P22 genes that have sequence similarity to lambda genes are connected by light gray trapezoids. The thin arrows represent transcription of the early operons and thick arrows transcription of the late operons. The circular phage genomes are opened at their attachment (att) sites for insertion of the prophage into the host chromosome in lysogens. DNA packaging initiation sites (called pac and cos in P22 and lambda, respectively) are also indicated below the maps.
Similarity with other taxa
Tailed bacterial viruses resemble members of the family Tectiviridae by the presence of a dedicated structure for DNA injection, but differ from them by the permanent nature of their tails and lack of a lipid bilayer. Tailed viruses resemble viruses belonging to the family Herpesviridae in morphogenesis (use of scaffolding proteins, packaging of DNA into preformed shells, maturation of procapsids by proteolytic cleavage, and capsid conformational change) and overall strategy of replication. In addition, temperate tailed phages and members of the family Herpesviridae are able to establish latent infections.
Derivation of names
Caudo: from Latin cauda, "tail".
Myo: from Greek my, myos, "muscle", referring to the contractile tail.
Sipho: from Greek siphon, "tube", referring to the long tail.
Podo: from Greek pous, podos, "foot", referring to the short tail.
Ackermann, H.-W. (2009). Phage classification and characterization. Methods Mol. Biol., 501, 127-140.
Casjens, S. (2005). Comparative genomics and evolution of the tailed-bacteriophages Curr Opin. Microbiol., 8, 451-458.
Hatfull, G.F., Cresawn, S.G. and Hendrix, R.W. (2008). Comparative genomics of the mycobacteriophages: insights into bacteriophage evolution. Res. Microbiol.. 159, 332-339.
Glazko, G., Makarenkov, V. and Mushegian, A. (2007). Evolutionary history of bacteriophages with double-stranded DNA genomes. Biol. Direct., 2, 36.
Lavigne, R., Darius, P., Summer, E.J., Seto, D., Mahadevan, P., Nilsson, A.S., Ackermann, H.W. and Kropinski, A.M. (2009). Classification of Myoviridae bacteriophages using protein sequence similarity. BMC Microbiol., 9, 224.
Lavigne, R., Seto, D., Mahadevan, P., Ackermann, H.W. and Kropinski, A.M. (2008). Unifying classical and molecular taxonomic classification: analysis of the Podoviridae using BLASTP-based tools. Res. Microbiol., 159, 406-414.
Lima-Mendez, G., Van Helden, J., Toussaint, A and Leplae, R. (2008). Reticulate representation of evolutionary and functional relationships between phage genomes. Mol. Biol. Evol. 25, 762-777.
Rohwer, F. and Edwards, R. (2002). The Phage Proteomic Tree: a genome-based taxonomy for phage. J. Bacteriol., 184, 4529-4535.
Susskind, M.M. and Botstein, D. (1978). Molecular genetics of bacteriophage P22. Microbiol. Rev., 42, 385-413.
Lavigne, R., Molineux, I.J. and Kropinski, A.M.
The authors acknowledge the contribution to the Eighth ICTV Report of Casjens, S.R. and Hendrix, R.W.


text:
Women's basketball falls short in quarterfinal
Sam Santill/ Gannon Sports
Emma Wright and Gannon's women's basketball team came just short in the NCAA Division II Atlantic Regional, falling to Shepherd, 93-89.
Timothy Corso, Staff Writer
The Gannon University women's basketball team fell 93-89 to Shepherd in double overtime in its NCAA Division II Atlantic Regional tournament opener Friday in Glenville, W. Va.
The loss ended the Knights' season and left them with a 24-7 mark while Shepherd lost to host Glenville State, 82-70, the following night in a tournament semifinal game.
The Knights held a slim 89-88 lead with 58 seconds left in the second overtime when Shepherd went on a 5-0 run to end the game and send the Rams to the next round.
Shepherd guard Abby Beeman tallied seven of the Rams' 12 points in the second extra period to give them the surge they needed.
Beeman finished the night with a near triple double, tallying 34 points, 13 assists and eight rebounds. In addition, Beeman swiped eight steals.
For the Knights, "25" seemed to be the magic number Friday night, as Emma Wright and Sam Pirosko each scored 25 points to lead the team.
Gannon also had 25 turnovers, which was a big contributor to the loss.
Those turnovers helped the Knights squander a 19-point lead they held in the second quarter.
While the Knights led 43-31 at the intermission, Shepherd quickly cut into that deficit.
The Rams went on an 18-4 run in the first half of the third quarter to take a 49-47 lead.
But Gannon stormed back and carried a 59-54 lead into the final frame.
After a pair of late free throws by Tori Obenrader gave the Knights a 75-72 lead with 52 seconds left, Beeman would split a pair of free throws to make the lead 75-73.
Following a Sydney Mitchell turnover, Beeman missed a jumper in the paint, but the Knights' failure to box out came back to bite them as Sydney Clayton put the second-chance layup in to tie the game at 75-75 with 15 seconds left.
The Knights allowed seven offensive rebounds in the contest.
Coach Cleve Wright called a timeout with 14 seconds left to draw up a final play to win the game for Gannon.
However, no shot was taken as an Emily Poling turnover sent the game into overtime.
A similar event happened at the end of the first overtime when Pirosko turned the ball over with a second left, which sent the game to the final overtime.
Emma Wright said in a postgame interview posted on the Gannon athletics website that the game showed just how much fight the Knights had in them all season.
"Any day of the week we want a different outcome, just for each other," she said. "When I look to the girl to my right, I just want it for her. And I know all of our team wants that too, so I think that's what the worst part is.
"But I am proud of what this team gave this year, and I wouldn't want to stand next to any other team or be in any other locker room, and I know every other girl in there would say the same thing."
Wright's coach – and father – Cleve Wright said afterward he was proud of his team.
"I'm proud of what they accomplished," he said. "I'm proud of who they are."
"Lots to build on for the future."
TIMOTHY CORSO
Gannon athletics
A View from the Sidelines
A Look into Women's Diving and Swimming
Ahrens joins cross country coaching staff
Baseball double header has positive turnout
Men's soccer dominates start of season
Women's soccer starts season with strong squad


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text:
Q: Unity sprite flip goes out of camera bounds I'm trying to flip a sprite when arrow keys pressed but they somehow goes out of the boudnds of the camera. It seems to me the whole camera is flipped instead of the sprite. What is the right way to approach this.
I'm trying to flip when user press the left / right arrow key. Below is my code.
using System.Collections;
using System.Collections.Generic;
using UnityEngine;

public class Player : MonoBehaviour
{
    public float speed;
    public float input;
    Rigidbody2D rb;
    Animator anim;
    // Start is called before the first frame update
    void Start()
    {
        rb = GetComponent<Rigidbody2D>();
        anim = GetComponent<Animator>();
    }

    private void Update ()
    {
        if (input != 0) {
            print("is running");
            anim.SetBool("isRunning", true);
        } else {
            print("is not running");
            anim.SetBool("isRunning", false);
        }

    if (input > 0) {
            transform.eulerAngles = new Vector3(0,0,0);
        }else if (input < 0){
            transform.eulerAngles = new Vector3(0,180,0);
        }
    }

    // Update is called once per frame
    void FixedUpdate()
    {
        input = Input.GetAxis("Horizontal");
        rb.velocity = new Vector2(input * speed, rb.velocity.y);
    }
}

this is the screenshot from the scene / game

Any help is appreciated. Thanks.

A: You should change the scale instead of rotation.
using System.Collections;
using System.Collections.Generic;
using UnityEngine;

public class Player : MonoBehaviour
{
    public float speed;
    public float input;
    private Rigidbody2D rb;
    private Animator anim;

    private void Start()
    {
        rb = GetComponent<Rigidbody2D>();
        anim = GetComponent<Animator>();
    }

    private void Update()
    {
        if (input != 0)
        {
            print("is running");
            anim.SetBool("isRunning", true);
        }
        else
        {
            print("is not running");
            anim.SetBool("isRunning", false);
        }
        if (input > 0)
        {
            transform.localScale = new Vector3(1, 1, 1);
        }
        else if (input < 0)
        {
            transform.localScale = new Vector3(-1, 1, 1);
        }
    }

    private void FixedUpdate()
    {
        input = Input.GetAxis("Horizontal");
        rb.velocity = new Vector2(input * speed, rb.velocity.y);
    }
}

redpajama_set_name: RedPajamaStackExchange


text:
Q: Creating transparent Forms (or Activities?) in Firemonkey Delphi for Android I want to create a transparent activity (or should I call it Form?) in Delphi (FMX) for Android, like this user does in his video.
Is it possible to do it with Delphi?
Thank you


text:
import("sqlbase.sqlobj");
import("etherpad.globals");

function run() {
  if (globals.isProduction()) {
  	// use pt-online-schema-change
  	return;
  }
  sqlobj.createIndex ('pad_access', ['hostUserId', 'type']);
}

redpajama_set_name: RedPajamaGithub


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Are you concerned about the security of your financial information? With rising instances of debit card fraud and data breaches, it's an understandable concern. But the good news is, there are several steps both you and your banking institution can take to make sure your money is safe from fraud. First, let's take a look at the different types of fraud you can encounter.
Debit and credit card fraud occur when someone steals your card number and information or attempts to use your card without permission. This type of fraud usually happens because of theft or ATM Skimming, which we'll talk more about below.
Phishing occurs when someone contacts you and solicits personal, private, and/or financial information under the guise of a legitimate and familiar company. As more awareness about phishing has increased, scammers have become even more clever. It's important to be on guard and never give out your financial information to anyone unless you are 100% certain of his or her identity.
Identify theft occurs when someone steals personally identifying information about you, such as a social security number, and then uses that information to open accounts or make purchases. This type of fraud takes a major toll on a person's life and is difficult to recover from, so it's important to take as many preventative steps as possible to protect yourself.
A Skimming device is a card reader attached to an ATM or point-of-sale device (such as a gas station pump), which disguises itself as part of the machine. These devices are used to save debit and credit card information, including the PIN number, so that it can be replicated for theft. While these types of fraud are on the rise, there are actions you can take to keep your information secure.
Use Online Banking – Online banking is the safest way to keep track of your financial information. Not only does it eliminate a paper trail with personally identifiable information, this convenient option is protected with layers of security for your protection. You can enhance this security by creating strong passwords that you frequently change.
Safe Card Habits – The first step to keeping your debit card safe is to memorize your PIN number and never write it down or give it away. When making purchases, use the credit option as frequently as possible to avoid typing in your PIN. Finally, if your wallet or purse is ever stolen, immediately contact your banking institution.
Protect Documents – Use paperless billing and keep your financial documents organized in a secure location, and make sure to shred any documents you no longer need.
Monitor Your Accounts – The easiest and safest way to keep track of your accounts is to use online banking.
Be on Guard For Phishing – While phishing emails have become more cunning, there are still a few key signs to look out for.
Look out for spelling and grammar mistakes – Many phishing emails have errors in spelling and grammar. Since they often impersonate large, trusted companies and organizations, you can be certain that if there are major spelling and grammatical issues, it's a scam.
Don't believe threats – Many phishing scams scare users with threats saying their accounts will be closed or blocked. Trusted companies will typically send official letters in the mail for any serious issues.
Use Wi-Fi Securely – If possible, use your cellphone as a Wi-Fi hotspot. Otherwise, if you must use public Wi-Fi, be sure to only sign on to trusted networks, like those operated by large companies, such as Starbucks or your local library. If possible, don't look at personal or financial information while signed on to a public Wi-Fi.
Create Strong Passwords – Make sure your passwords are hard to guess by making them long and with a combination of letters (both upper and lower case), numbers, and symbols. Never write your password down. Instead, use a password manager.
Off colors – Some skimming devices are hard to detect, but if the slot where you insert your card is a wildly different color than the rest of the machine, it's probably an attached device.
Misaligned graphics – ATMs are well-designed machines, so if you see words, arrows, or other graphics that are misaligned or overlapping, the machine has probably been tampered with.
Loose parts – Skimming devices have to be installed on point-of-sale or ATM machines, so when you use an ATM, check for loose parts. Pull at the card reader and the keyboard to make sure it's not loose or wiggly. If it is, don't take the risk; avoid using the machine.
Use a Chip Card – Chip cards are far safer than cards with magnetic strips. Many ATM and point-of-sale machines now use chip reading technology.
How Does Your Bank Protect You From Fraud?
Fraud Monitoring – Most banks monitor for suspicious transactions and will either deny or hold questionable transactions until you can verify them.
EMV Chip Technology – Europay, Mastercard and Visa (EMV) chip technology is the global standard for card security. This chip makes cards more difficult to successfully counterfeit.
Anti-Skimming Technology – If you've recently visited an ATM and noticed you no longer insert your card via the short edge, you've encountered ActivEdge technology. This complex piece of technology prevents skimming by making it extremely difficult for scammers to install skimming devices.
Owned by Members – Credit unions are owned by their members. That means, if you bank with a credit union, you're not just a customer, you're an owner.
Less Fraud Means Better Rates – Earnings are always given back to credit unions in the form of dividends. This means that members receive lower loan and higher savings rates.
Save Money by Reducing Fraud – Better rates and protected financial information mean members not only feel secure, they save money, too.
Learn more about the steps Community First is taking to protect you against fraud.
Also, be sure to follow our 13 quick tips to protect yourself from identity theft during the holidays by downloading our Identity Theft Protection Guide.


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Adding a New Layer: 20th Century Heritage in Worcestershire – Health and Welfare
Over the past two years Worcestershire's Historic Environment Record has been working to identify, record and better understand the significance of 20th Century buildings and public places across the County. Many more await discovery and assessment!
Funded by Historic England, this project has also aimed to strengthen the public's awareness and appreciation of 'everyday' 20th Century heritage, its conservation, value and significance.
From County Small Holdings and Schools to Village Halls and National Chain Stores, this blog will – over the next couple of months – explore the diverse range and legacy of our 20th Century heritage and celebrate the extra layer of richness it brings to both our lives and landscapes.
20th-century buildings related to health and welfare—including hospitals and clinics—reflect substantial advances in medical practice and progressive attitudes towards social care. Before 1900 healthcare was largely provided by charities, poor relief, Local Government or unregulated private practice. Almhouses, charitable housing for the poor, survived into the early 20th-century and Voluntary Hospitals, which included Cottage Hospitals in smaller towns and rural areas, provided acute as well as specialist care. Mid to late Victorian hospitals were generally based on Paris' Lariboisiere pavilion plan, with inter-linked wards, corridors and service pavilions intended to combat the air-borne spread of disease (Historic England 2017, 6).
At the turn of the 20th-century the health of the nation was a primary concern of government and the 'value' of a healthy population widely recognised. The 1919 Ministry of Health Act established a government Minister for Health with responsibility over sanitation, health care and disease, while the 1921 Public Health (tuberculosis) Act obliged County and Borough councils to provide care services for tuberculosis patients. From 1934 subsidised milk was first made available for British school children.
The 20th-century was increasingly marked by the development of a looser approach to planning, to benefit as much as possible from light and air, and innovative site and building types such as open-air hospitals – further adapting the tradition set by convalescent hospitals, asylums and children's homes set in restorative open spaces. Areas were increasingly needed for research, teaching and new technology, and for housing nurses.
The Lucy Baldwin Maternity Hospital, in Stourport on Severn, was largely funded by philanthropist Julien Cahn. The hospital was officially opened in 1929 by Stanley Baldwin, the then prime minister, in honour of his wife Lucy Baldwin, a well-known writer and activist for improved maternity care. The site was absorbed within the NHS after 1948. After becoming semi-derelict, the site was demolished in 2012 and redeveloped for housing. © Jeremy Bolwell and licensed for reuse under this Creative Commons Licence.
The impact of two World Wars, and the profound affect war had had on society's attitudes towards fairness, equality and compassion, invigorated calls for a universal system of health and welfare care, which can be dated back to the 1909 Minority Report of the Royal Commission on the Poor Law. While the 1942 Beveridge Report—or Social Insurance and Allied Services Report—is reputed to have been the blueprint for the British welfare state, it was the unexpected Labour victory in the 1945 General Election that finally drove through reforms for universal education, social welfare and the National Health Service (NHS).
The now demolished Ronkswood Hospital in Worcester opened in 1941 as a temporary hutted hospital to treat both service and civilian casualties. It was later used by the Ministry of Pensions, as a Pensions hospital. By 1952 Ronkswood Hospital had been absorbed within the NHS and had become part of Worcester Royal Infirmary. At the same time the hospital expanded to accommodate a large maternity unit, with an ante-natal clinic and classrooms. The hospital's water tower (above) was the last building on the site to be demolished prior to its re-development for housing © Copyright Chris Allen and licensed for reuse under this Creative Commons Licence.
The NHS was launched on 5th July 1948, by the then Health Secretary, Aneurin Bevan, in Manchester. The establishment of the NHS was by no means universally accepted, with many doctors opposing the idea of becoming employees of the government. In compromise, General Practitioner surgeries were permitted to remain private businesses and hospital consultants authorised to continue private treatment (see Cabinet Papers: Origins of the NHS for further details). Rather than initiating a wave of new building the NHS generally absorbed existing Voluntary and Local Authority-owned Hospitals. Maternal and child health and welfare became a top priority of the newly formed NHS. This led to changes in maternity care policy and practice which resulted in the growth of hospital deliveries, as opposed to home births, and the rise of community clinics that delivered immunisation programmes, maternity care and school medical services.
The 1959 Mental Health Act took steps to reform mental health services, and community care. By the mid-1960s, rising demand as well as the development of new technologies, lead to a period of growth in new hospital buildings, clinics and health education. Single speciality hospitals went out of fashion in favour of District General Hospitals, which provided an array of diagnostic and therapeutic services, and Modernist, progressive designs, as pioneered by Continental architects like Le Corbusier and Walter Gropius, were widely adopted, their modular construction and use of electric lighting facilitating wider, deeper, taller buildings that symbolised the modernity of the healthcare found within it (Hughes 2000, 21). Increasing pressures to reduce public spending led to large scale re-organisation of the NHS from the 1970s and the growth of the private health system.
Moor Street clinic in Worcester was built in the Modern style in the mid-1960s as a school clinic, complete with an audio clinic, minor ailments clinic and rooms for doctors, dental surgery, remedial teachers and speech therapy. The building now provides Family Planning and Sexual Health services.
Despite the Master Plan for Redditch New Town incorporating a 40-acre site at Woodrow for the development of an 850 bed General Hospital, the inhabitants of Redditch had to wait until 1986 before the Alexandra Hospital officially opened. At the same time the late Victorian Smallwood 'Cottage' Hospital, which had been predominately funded by local needle manufacturer and philanthropist Edwin Smallwood, became an NHS Clinic called Smallwood House (Webster, 2016, 77–82). © Chris Allen and licensed for reuse under this Creative Commons Licence.
Clubs and societies developed as a distinctive characteristic, at all levels of society, over the 20th-century. Women's Institutes, Working Men's and Ex Service-Men's Clubs (the British Legion was formed in 1921) followed in the footsteps of institutes, but little is known about the architecture of clubs, including those of the Scouting Movement (formed 1910) and other organisations developed for the welfare of boys and girls. Most were built in a domestic or vernacular style; the largest Working Men's clubs being sometimes executed in a neo-Georgian style. From the 1950s Youth clubs were often part of planned housing developments and promoted by the National Council of Social Service (founded 1919, now the National Council for Voluntary Organisations).
Working Men's Club in Callow End.
Health and Welfare Buildings: Listing Selection Guide (2nd ed. 2017)
Hughes, J 2000 'The matchbox on a muffin: the design of hospitals in the early NHS'. Medical History 44, 21–56
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Adding a New Layer: 20th Century Heritage in Worcestershire – Public Utilities
Over the past two years Worcestershire's Historic Environment Record has been working to identify, record and better understand the significance of 20th Century buildings and public places across the County. Many more await discovery and assessment! Funded by Historic England, this project has also aimed to strengthen the public's awareness and appreciation of 'everyday' 20th...
Adding a New Layer: 20th Century Heritage – Agriculture & Subsistence
From the 1870s British farming faced depression. Caused by a catastrophic fall in grain prices – a consequence of increasingly cheap imports, particularly from America – the British farming industry did not fully recover until after the Second World War. As arable land was laid down to pasture, dairy farming, buoyed by increasing demand in...
Adding a New Layer: 20th Century Heritage in Worcestershire – Industrial and Maritime


text: Q: Snapping and Tracing using QGIS When I split features or split parts, and using Enable Tracing, all I have is an uncontrolled snap to other existing features boundaries. As I start tracing it always go through anywhere in the map. Every time it connects to the other edge of polygon as you've seen in the image.


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Moral poseurs and the reality that kills them 12
It is peculiarly horrible to die in some grotesque manner at the hands of Islamic murderers who kill in the name of Allah – as, it is reported, Kayla Mueller probably did. She was an American woman who went to the battlefields of the Middle East to"help" people, some of them Islamic murderers who kill in the name of Allah.
She was a member of an organization called the International Solidarity Movement (ISM), whose mission is described by Discover the Networks:
Radical, anti-Israel organization that recruits Westerners to travel to the Holy Land to obstruct Israeli security operations
Justifies Palestinian terrorism against Israeli civilians
Supports the Palestinian "right of return"
Supports boycott, divestment and sanction campaigns against Israel
According to Israel's Ministry of Foreign Affairs, some ISM activities are carried out "under the auspices of Palestinian terrorist organizations"
A senior IDF officer says ISM is "a pro-Palestinian organization, set up by Palestinians, funded by Palestinians and linked to Palestinian terror"
Co-founder Huwaida Arraf has acknowledged that ISM cooperates and works with Hamas, Islamic Jihad, and the Popular Front for the Liberation of Palestine
… From its inception, ISM realized that if any of its volunteers were to be arrested, injured, or killed in the course of their activities in the West Bank or Gaza, such events could be exploited as major propaganda victories for the PLO. As ISM leader George S. Rishmawi once put it: "When Palestinians get shot by Israeli soldiers, no one is interested anymore. But if some of these foreign volunteers get shot or even killed, then the international media will sit up and take notice."
One of ISM's most well-known activists was the late Rachel Corrie, a 23-year-old volunteer who, in March 2003, was crushed beneath an Israeli bulldozer in Rafah when its operator failed to see her trying to block the destruction of a tunnel through which Hamas and Islamic Jihad terrorists were receiving smuggled weapons.
Another high-profile casualty was Tom Hurndall, a British-born ISM volunteer who was shot in the head by an Israeli solier during a firefight between the IDF and Palestinian terrorists on April 11, 2003. Hurndall's life was initially saved by a four-hour emergency surgery, but he spent the next nine months in a coma and then died on January 13, 2004.
Both Corrie and Hurndall were lionized as martyrs by pro-Palestinian activists and media outlets. …
For comment on how misplaced such lionizing is, see our post, No, the name's not Rachel Corrie, March 10, 2010.
In 2004, ISM operative Abe Greenhouse said that the International Solidarity Movement was using Gaza and the West Bank not merely as venues for its anti-Israel activism, but also as training grounds for anti-American campaigns that the American Anarchist Movement was planning to stage along the U.S.-Mexico border.
A Front Page article traced the connection between ISM and the London bombings of 7/7/2005:
Among the less publicized details of the July 7th London bombings is the connection of … Muhammad Sadique Khan to the preeminent group of the pro-terrorist "solidarity" movement, the International Solidarity Movement.
Israel National News reports on the life and death of Kayla Mueller:
The myth that she was a wonderful altruistic young woman should be exposed. This is another Rachel Corrie propaganda story in the making, and the western media is falling for it again, or embracing it on purpose.
Kayla Mueller was a member of the International Solidarity Movement (ISM) who spent at least two years working with that terrorist support group. She was involved in demonstrations against the Jews in Sheikh Jarrah (part of East Jerusalem) after a 20 year long court decision recognized the Jews' legal rights to homes they were chased from in earlier wars launched by the Arabs. She also participated in demonstrations to interfere with the IDF demolishing the homes of terrorists and suicide bombers after the courts okayed the demolitions.
Just as with Rachel Corrie, the press tries to paint Kayla as a selfless volunteer helping poor Arab refugees. She may have helped injured Arabs in "refugee" camps, but she was working to support the goals of Palestinian irredentists and to interfere with the IDF on behalf of terrorist groups.
As an ISM activist she was a tool for the worldwide jihad. …
First, she lived and rioted with other ISM activists with an Arab family that refused to vacate a home they were squatting in after a legal case that took 20 years established it was stolen from the Jewish owners. …
She was also a human shield in support of terrorists. …
Another ISM strategy is to try and disable Israeli security tactics. One of the newer ones is to try and suggest that when the IDF uses tear gas to avoid lethality in controlling weekly Arab rioters, the gas is really deadly and must be stopped altogether. The real reason for this inversion about tear gas is the Palestinians and their ISM lackeys hope they can make it impossible for the IDF to control the weekly riots such as in Bi'ilin, riots Kayla was a part of.
[She wrote:] " … The nature of impermanence is our greatest ally and soon the rules will change, the tide will turn and just as the moon waxes and wanes over this land so too the cycles of life here will continue. One day the cycle will once again return to freedom."
Freedom? For whom? Another Arab dictatorship. Arabs who are Israeli citizens are free, but Kayla wanted the "free" Palestinian-state-to-be from the "river to the sea" as a good ISM activist. Her writings suggest the classical thought processes of pampered American student "radicals" and "revolutionaries" who can't get enough of supporting dictatorships and terrorists overseas as liberation movements, the complete opposite of what they are.
"Oppression greets us from all angles", she wrote. "Oppression wails from the soldiers radio and floats through tear gas clouds in the air. Oppression explodes with every sound bomb and sinks deeper into the heart of the mother who has lost her son. But resistance is nestled in the cracks in the wall, resistance flows from the minaret 5 times a day and resistance sits quietly in jail knowing its time will come again. Resistance lives in the grieving mother's wails and resistance lives in the anger at the lies broadcasted across the globe. Though it is sometimes hard to see and even harder sometimes to harbor, resistance lives. Do not be fooled, resistance lives," Kayla concluded in her letter.
This certainly doesn't sound like a tireless "aid worker". Instead, it connotes a supporter of Palestinian Arab terrorist groups. …
Kayla Meuller made it clear she was involved in the weekly riots in Bi'ilin. She wrote of … several members of the same [Arab] family whom she roomed with dying. Rachel Corrie did the same thing, creating a story for the ISM of protecting an Arab family from IDF bulldozers. One family daughter Kayla guested with died in her own home, not at a demonstration. The fact was the woman was very ill, with leukemia and other internal infections. As in good ISM tactics, her corpse then became another propaganda tool. But like any good ISM activist, Kayla Mueller didn't let this stand in the way of her propaganda letter home:
"And now just today, the daughter of the Rahmah family, Jawaher, has been asphyxiated from tear gas inhalation. Jawaher was not even participating in the weekly demonstration but was in her home approximately 500 meters away from where the tear gas canisters were being fired (by wind the tear gas reaches the village and even the nearby illegal settlement often). There is currently little information as to how she suffocated but the doctor that attended her said a mixture of the tear gas from the IDF soldiers and phosphorus poisoned her lungs causing asphyxiation, the stopping of the heart and death this afternoon after fighting for her life last night in the hospital. The following is a clip from today showing hundreds of Palestinians, Israelis and international activist carrying her body to her families (sic) home where they said their final goodbyes."
The IDF doesn't use phosphorous in the West Bank. The ISM always claims it does. It's good for propaganda. …
Kayla Mueller came from Prescott, Arizona where she once volunteered at a women's shelter. … She chose to take the ISM's revolutionary path and to embrace part of the worldwide jihad and she died for it … She sought "freedom" working to support fascist groups that provide just the opposite for their people and she paid the ultimate price for that choice.
We think it is appropriate to quote (as we have had occasion to do before) some lines from Joseph Conrad's scornful portrait of privileged women in his story The Informer. (What he says applies equally well to men from the same secure Western backgrounds.)
For all their assumption of independence, girls of that class are used to the feeling of being specially protected, as, in fact, they are. This feeling accounts for nine tenths of their audacious gestures. …
She had acquired all the appropriate gestures of revolutionary convictions – the gestures of pity, of anger, of indignation …
She was displaying very strikingly the usual signs of severe enthusiasm, and had already written many sentimental articles with ferocious conclusions.
Perhaps she thought the jihadis would love her. Should love her. Should be grateful to her. It was not fair that after all she'd done for them, they killed her.
Why had she not discovered that the ideology of Islam, which holds that it is good and right to subjugate women, cut off limbs, stone adulterers to death, burn up fellow Muslims, throw homosexuals from high buildings, decapitate prisoners, keep slaves, bury children alive, has nothing in it that would prompt its devotees to value a stranger's self-sacrificing service given with a friendly smile in a spirit of sweetness and light?
Could it be because intense moral conceit makes the mind it conquers impervious to reality?
Posted under Anti-Semitism, Arab States, Commentary, Ethics, Islam, Israel, jihad, middle east, Muslims, Palestinians, Terrorism, United States by Jillian Becker on Wednesday, February 11, 2015
Tagged with Abe Greenhouse, IS/ISIS/ISIL, Kayla Mueller, Rachel Corrie, the International Solidarity Movement (ISM), Tom Hurndall
This post has 12 comments.


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New Study Links Stress and MS, but the Association May Not Be Causal
Jared Kaltwasser
A new study finds people who go on to be diagnosed with MS are more likely to have experienced a significant stressful life event, but the author cautions against jumping to cause-and-effect conclusions.
A new study is lending more credence to the theory that multiple sclerosis (MS) may be linked in some way to stress, although the authors caution that it is exceedingly difficult to tease out whether the link is merely an association or whether stress might play a causal role.
The latest findings on the MS-stress connection were published in the European Journal of Neurology. Investigators from Sweden's Karolinska Institute used data from questionnaires given to 2,930 people with MS and 6,170 controls to see whether any patterns could be found in terms of the occurrence of major life events and the onset of MS. The questionnaires focused on lifestyle environmental factors and, in particular, on 10 specific life events, such as loss of a loved one, unemployment, or the breakup of a marriage or long-term relationship. If a survey respondent said they had experienced one of those events, they were asked to indicate when it happened and how important the event was when it occurred. The investigators only included events in their analysis if the event happened prior to the onset of MS symptoms. Controls were matched to patients with MS based on age, sex, and residential area.
The results showed a statistically significant correlation. Patients who had undergone one of the key life events had an increased risk of MS ranging from 17% to 30%. The authors found the link between stressful life events and MS was higher for women in many cases and that the stressful event typically happened within 5 years prior to the onset of MS symptoms.
Xia Jiang, Ph.D., the corresponding author and colleagues, noted that the subject of MS and a possible link to stress has been studied quite a lot, although many of the studies have been small and had design flaws, which, among other things, have led to selection bias.
Furthermore, the results of the studies have been mixed; for example, the results of two major studies by Danish researchers that were published in 2014 showed that, on the one hand, children whose parents got divorced had a higher risk of MS as adults while on the other, adults who who had gone through a divorce or other stressful events did not have a higher risk of MS.
Related: A Differing View: The 'Inside-Out' Explanation of How Multiple Sclerosis Occurs
Jiang told Managed Healthcare Executive the topic of stress and MS is controversial partly because inferring causal relationships from the associations shown in observational studies is problematic.
"For example, in retrospective studies, recall bias is a problem," she said. "MS patients (or anyone who unfortunately gets ill) would be more likely to seek a reason for their disease, so they may recall and report their life events or other relevant events to a greater extent than healthy individuals."
Prospective studies are also present issues, she said, because the neurological changes in a patient might start years before symptoms of MS are identified, and those changes might lead to negative impacts on the patient's lifestyle and stress level.
"Stress and MS are both brain-related, [so] it's difficult to prove causality," she said. "The two conditions might exacerbate each other, or there might be a reciprocal relationship."
Indeed, though her study found a notable association between MS and stress, Jiang said it's far too soon to draw conclusions about the nature of the apparent correlation or what implications such a link might have for patient care.
What they can say, however, is that there seems to be enough evidence to warrant additional study.


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