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Position: RB
Team: TB
College: LSU
Free Agency Roundup: Fournette Back With The Bucs & More
Roundup: Fournette Remains With Bucs; Watkins A Raven & More
Leonard Fournette Sidelined Early By Hip Injury
Leonard Fournette Continues To Downplay Weight Gain
Leonard Fournette Reportedly Tips Scales At 245 Upon Reporting To Camp
Trainer Says Talk Of Leonard Fournette's Weight Blown Out Of Proportion
Leonard Fournette Refutes Report He's 260 Pounds
Report: Bucs Not Happy With Nearly 260-Pound Leonard Fournette
Leonard Fournette Re-Signs With Buccaneers
Buccaneers Would Love To Have Leonard Fournette Back In Tampa
Leonard Fournette Visiting Patriots
Leonard Fournette Activated From IR; Bell Released To Clear Roster Spot
rec/yds
2022 16 20 189/668 3.5 3 73/523 7.2 3 227
2020 13 38 97/367 3.8 6 36/233 6.5 0 132
2019 15 13 265/1152 4.3 3 76/522 6.9 0 261
2018 8 38 133/439 3.3 5 22/185 8.4 1 120
2017 13 8 268/1040 3.9 9 36/302 8.4 1 230
2022 Stats | TB Week
TM Snap % - 87% 91% 61% 62% 82% 60% 72% 62% 29% - - 60% 47% 58% 60% 46% 5% 59%
rshYds 127 65 35 -3 56 63 19 24 19 57 - - 49 13 44 72 28 0 668
rushes 21 24 12 3 14 21 8 9 9 14 - - 10 4 10 20 10 0 189
rshTDs 0 0 0 0 1 0 0 1 0 1 - - 0 0 0 0 0 0 3
recYds 10 9 35 57 83 38 7 34 41 1 - - 32 33 30 90 19 4 523
Tar/Rec 2/2 4/2 6/5 7/7 11/10 6/6 3/2 3/3 7/5 1/1 - - 7/6 7/6 4/4 10/9 4/4 1/1 83/73
TM Tar% - 12% 15% 13% 22% 17% 6% 7% 13% 4% - - 13% 14% 10% 21% 10% 10% 13%
recTDs 0 0 0 1 1 1 0 0 0 0 - - 0 0 0 0 0 0 3
FScore 13 7 7 11 25 16 2 11 6 10 0 0 8 4 7 16 4 0 154
FS/PPR 15 9 12 18 35 22 4 14 11 11 0 0 14 10 11 25 8 1 227
Opp @ dal @ no gb kc atl @ pit @ car bal lar sea bye @ cle no @ sf cin @ ari car @ atl
TM Snap % 65% 49% 36% 82% 62% 63% 53% 61% - 65% 59% 81% 87% 80% 45% - - - 63%
rshYds 32 52 8 92 67 81 81 26 - 47 35 100 44 113 34 - - - 812
rushes 9 11 4 20 12 22 15 8 - 11 10 17 13 19 9 - - - 180
rshTDs 0 0 0 0 1 2 1 0 - 0 0 3 0 1 0 - - - 8
recYds 27 24 26 47 43 46 9 17 - 45 39 31 48 19 33 - - - 454
Tar/Rec 7/5 4/4 3/3 5/3 5/4 6/6 4/2 5/3 - 9/8 6/6 8/7 8/7 7/4 7/7 - - - 84/69
TM Tar% 16% 11% 6% 13% 12% 14% 11% 13% - 27% 13% 24% 16% 15% 16% - - - 14%
recTDs 0 0 0 0 0 0 0 0 - 0 0 1 1 0 0 - - - 2
FScore 5 7 3 13 17 24 15 4 0 9 7 37 15 19 6 0 0 0 186
FS/PPR 10 11 6 16 21 30 17 7 0 17 13 44 22 23 13 0 0 0 255
Opp dal atl @ lar @ ne mia @ phi chi @ no bye @ was nyg @ ind @ atl buf no @ car @ nyj car
TM Snap % 13% 43% 37% - 1% - 56% 73% 66% 36% 52% 56% - - 66% 32% 45% 43%
rshYds 5 103 15 - - - 50 52 0 19 17 10 - - 49 34 13 367
rushes 5 12 7 - - - 11 15 1 8 7 3 - - 14 9 5 97
rshTDs 0 2 0 - - - 0 0 0 0 1 0 - - 2 1 0 6
recYds 14 13 7 - - - 47 19 41 11 9 10 - - 16 32 14 233
Tar/Rec 1/1 5/4 2/2 - - - 7/6 6/3 6/6 3/2 4/1 3/3 - - 5/3 3/3 2/2 47/36
TM Tar% 3% 15% 6% - 0% - 17% 15% 16% 8% 9% 8% - - 12% 7% 5% 9%
recTDs 0 0 0 - - - 0 0 0 0 0 0 - - 0 0 0 0
FScore 1 23 2 0 0 0 9 7 4 3 8 2 0 0 18 12 2 96
FS/PPR 2 27 4 0 0 0 15 10 10 5 9 5 0 0 21 15 4 132
Opp @ no car @ den lac @ chi gb @ lvr @ nyg no @ car lar kc bye min @ atl @ det atl
rshYds 66 47 66 225 108 72 131 76 40 - 23 97 38 50 42 71 - 1152
rushes 13 15 15 29 23 20 29 19 11 - 8 24 14 15 15 15 - 265
rshTDs 0 0 0 0 1 0 0 0 0 - 0 2 0 0 0 0 - 3
recYds 28 40 26 20 29 46 14 60 32 - 34 62 53 13 31 34 - 522
Tar/Rec 6/4 6/4 8/6 3/2 7/4 6/6 2/2 7/7 6/5 - 7/7 12/9 11/9 6/3 7/5 6/3 - 100/76
recTDs 0 0 0 0 0 0 0 0 0 - 0 0 0 0 0 0 - 0
FScore 9 8 9 24 19 11 14 13 7 0 5 27 9 6 7 10 0 185
FS/PPR 13 12 15 26 23 17 16 20 12 0 12 36 18 9 12 13 0 261
Leonard Fournette 2022 Outlook
Fournette re-signed with the Buccaneers on a three-year, $21 million deal in March after ranking sixth among all NFL running backs with 1,266 yards from scrimmage last year. He averaged a career-best 4.5 yards per carry before being place on injured reserve with a hamstring injury in Week 15. After signing his second one-year deal with the Bucs last offseason, Fournette, 27, rushed for 812 yards and scored 10 total touchdowns. He also caught 69 passes for 454 yards. His best game came in Week 12, when Fournette, in addition to delivering a memorable halftime speech when the Bucs fell behind, rushed for 100 yards on 17 carries and had seven receptions for 31 yards. The last of his four touchdowns in that 38-31 victory was a 28-yard run with 29 seconds remaining. After backing up Ronald Jones for the majority of the 2020 season -- an experience that he and the coaching staff believe humbled him and helped prolong his career -- Fournette seized the opportunity when Jones suffered a broken finger, went on the reserve/COVID-19 list and suffered a quad injury in Weeks 15 and 16. Now, with Tom Brady back at the helm of this offense, Fournette's return is an ideal outcome for fantasy managers. Another top-10 finish is well within the range of possible outcomes. In fact, it's likely if Brady continues to lean on him as a receiver.
Fournette re-signed with the Buccaneers on a one-year deal worth up to $4 million. He arrived in Tampa via free agency following a surprise release from the Jaguars -- the team that selected him fourth overall in the 2017 NFL Draft -- just before the start of the regular season. He joined a crowded backfield on a team that was preparing to make a run at a title in its first year with Tom Brady under center, and managed to carve out a contributing role in the regular season, rushing 97 times for 367 yards and six scores, but also spending three weekends on the inactive list. But Ronald Jones suffered a broken finger in late December, went on the reserve/COVID-19 list and suffered a quad injury, forcing him to miss Weeks 15, 16 and the wild-card game at Washington. Fournette delivered 225 total yards and four touchdowns in that span, including 93 yards and two touchdowns against Washington, earning the nickname "Playoff Lenny" -- which ultimately morphed into "Lombardi Lenny." With the return of Fournette, the Bucs have all 22 offensive and defensive starters back from their championship team and fantasy managers have yet another split backfield to navigate.
Fournette's time in Jacksonville appeared to be at an end as trade rumors circulated prior to the NFL Draft. But nothing ever materialized and even though the team declined to pick up the fifth-year option on the former first-rounder's contract, everything appears to be pretty dandy in Duval. "I think the mindset is that we're going to go forward with Leonard on the team," GM Dave Caldwell said. Fournette's offseason has been intriguing. The running back racked up 1,152 yards on 265 carries and also enjoyed a breakout year in the passing-catching department, hauling in 76 receptions for 522 yards. That could change, however, with Chris Thompson on board. New OC Jay Gruden effectively used Thompson during their years together in Washington and could again. So how can Fournette improve? Positive touchdown regression. Per FantasyPros, there have been 372 running backs who've totaled at least 150 touches over the last 10 years. There are just 14 who found the end zone at a worse rate than Fournette did in 2019, as he scored just three touchdowns on 341 touches, or once every 113.7 touches. Doubling that touchdown total doesn't seem like even a slight reach.


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22 But now being made free from sin, and become servants of God, ye have your fruit unto holiness, and the end everlasting life.
23 For the wages of sin is death; but the gift of God is eternal life through Jesus Christ our Lord. (Romans 6:22-23 - - - in the Holy Bible)
Sanctify them through thy truth: thy word is truth. (John 17:17 - - in the Holy Bible)
Now Is Christ Risen
20 But now is Christ risen from the dead, and become the firstfruits of them that slept.
21 For since by man came death, by man came also the resurrection of the dead.
22 For as in Adam all die, even so in Christ shall all be made alive. (1 Corinthians 15:20-22 - - - in the Holy Bible)
Our Justification
20 He staggered not at the promise of God through unbelief; but was strong in faith, giving glory to God;
21 And being fully persuaded that, what he had promised, he was able also to perform.
22 And therefore it was imputed to him for righteousness.
23 Now it was not written for his sake alone, that it was imputed to him;
24 But for us also, to whom it shall be imputed, if we believe on him that raised up Jesus Christ our Lord from the dead;
25 Who was delivered for our offences, and was raised again for our justification. (Romans 4:20-25 - - - in the Holy Bible)
Understanding Good Friday
Understanding and fully appreciating the horror of Good Friday helps us understand and fully appreciate the justice of Mark 16:16.
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En el año 2019 se cumplen 25 Años del Indice UV, sin embargo el Cáncer de la Piel sigue siendo el Cáncer más común en los Estados Unidos
IRS Promueve Preparación para Desastres y Semana de Preparación para Huracanes
Declaración del Tesoro sobre la Restauración de la Democracia Venezolana
IRS Provee Consejos de último minuto a Contribuyentes; Recursos para Prórrogas, Pagos y Acuerdos de Pagos a Plazos
Con la Fecha Límite para Presentar Impuestos que se Aproxima, el IRS dice que cerca de 50 Millones todavía Necesitan Presentar
Contribuyentes Reciben Reembolsos más Rápidos con Depósito Directo
IRS.gov: Mejor Lugar para Obtener Consejos y Recursos de Ultimo Minuto sobre Impuestos
IRS: Apresurarse a Presentar la Declaración de Impuestos puede Generar Errores, use E-file y Solicite una Prórroga si es Necesario
Se Acerca Plazo de Impuestos: IRS Aclara Cinco mitos Acerca de Reembolsos
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IRS Expande Exención de Multas para Aquellos cuya Retención de Impuestos y Pagos de Impuestos Estimados no Fueron Suficientes en 2018; Umbral Clave Reducido a 80 por Ciento
Guía de la Temporada de Impuestos: Ayuda con Impuestos está a un Clic de Distancia en IRS.gov
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Guía de la Temporada de Impuestos - - Ayuda Gratuita de Preparación de Impuestos Disponible en Persona y en Línea
El IRS les Recuerda a Miembros de las Fuerzas Armadas de los EE.UU. de Ayuda Tributaria Especial
Guía de la Temporada de Impuestos - - Contribuya a una Cuenta IRA antes del 15 de Abril para Reclamarlo en su Declaración de Impuestos de 2018
Guía de la Temporada de Impuestos - - Publicación del IRS Ayuda a Pequeñas Empresas, Trabajadores autónomos a Comprender lo Nuevo en Impuestos
Más Personas Presentan su Declaración de Forma Gratuita a Través de Free File
Publicación de la Propuesta Presupuestaria de la EPA para el Año Fiscal 2020
IRS - - Elija un Preparador de Impuestos cuidadosamente - - Fraude de Preparador de Impuestos Figura en la Lista de Estafas Tributarias la Docena Sucia
Queda Solo Un Mes Para Solicitar Préstamos de Desastres de SBA
Be Ye Holy
15 But as he which hath called you is holy, so be ye holy in all manner of conversation;
16 Because it is written, Be ye holy; for I am holy. (1 Peter 1:15-16 - - - in the Holy Bible)
Righteous Judgment
Judge not according to the appearance, but judge righteous judgment. (John 7:24 - - in the Holy Bible)
President Donald J. Trump visited the Republic of Korea (R.O.K.) June 29–30. During this visit, President Trump and R.O.K. President Moon Jae-in affirmed the unbreakable bond between our two countries and committed to further strengthen our bilateral relationship. Both sides reaffirmed that the strong U.S.-R.O.K. alliance is the linchpin of peace and security in the Indo-Pacific. The two leaders also took steps to deepen security, economic, scientific, health, and cultural cooperation in the region.
Commitment to Peace
President Trump and President Moon emphasized the need to continue close coordination on North Korea. Both sides reaffirmed their commitment to achieving the final, fully verified denuclearization of North Korea and to the full implementation of UN Security Council resolutions regarding North Korea.
While in Korea, President Trump met with North Korean Chairman Kim Jong Un at the DMZ, where they agreed to resume working-level negotiations between the United States and North Korea. President Trump remains committed to achieving the goals he and Chairman Kim set at the Singapore Summit: transforming U.S.-DPRK relations, building lasting peace, and complete denuclearization of the DPRK.
Deepening Cooperation in the Indo-Pacific
President Trump and President Moon explored ways to deepen cooperation between the U.S. Indo-Pacific Strategy and the R.O.K. New Southern Policy.
President Trump and President Moon committed to jointly advance good governance and transparency, rule of law, sovereignty, a rules-based order, and market economic principles in the Indo-Pacific.
Meaningful cooperation—in development assistance, energy and digital network security, maritime law enforcement capacity building, and natural disaster resiliency—will address emerging challenges and make the U.S.-R.O.K. alliance more robust and adaptable.
The United States and R.O.K. share a principled approach in supporting the centrality of ASEAN and related regional institutions.
The leaders reiterated their commitment to the sovereignty and economic independence of the countries of the Mekong region, including through the Lower Mekong Initiative, R.O.K.-Mekong, Friends of the Lower Mekong, and other complementary regional initiatives. Both sides welcomed U.S.-R.O.K. cooperation in the Mekong, including in the areas of transboundary water governance, women's empowerment, and digital economy.
The United States and the R.O.K. share goals on encouraging an open and innovative environment for a thriving regional digital economy. For example, the United States promotes an open, interoperable, reliable, and secure Internet, encourages private sector engagement in the digital economy, and strengthens regional cybersecurity capability and capacity through programs such as the Digital Connectivity and Cybersecurity Partnership and the U.S.-ASEAN Smart Cities Partnership.
Alliance Forged in Blood
As the linchpin of peace and security in the Indo-Pacific, the U.S.-R.O.K. alliance supports peace on the Peninsula and in the region.
The United States and the R.O.K. highlighted their robust military sales partnership, including the recent acquisition of 40 F-35A Joint Strike Fighters to bolster U.S.-R.O.K. combined defense.
President Trump and President Moon affirmed plans to continue to strengthen alliance defense and deterrence capabilities through the R.O.K.'s acquisition and development of highly advanced military assets.
The two leaders acknowledged the importance of exercises and training programs to maintain combined U.S.-R.O.K. military readiness and support peace and stability on the Korean Peninsula. The United States and the R.O.K. agreed to coordinate with Japan on trilateral security cooperation, including information sharing, high-level policy consultation, and combined exercises.
Mutually Reinforcing Prosperity
President Trump has worked diligently to improve the trade relationship between the United States and the R.O.K.
Last year, President Trump and President Moon welcomed significant improvements to the United States–Korea Free Trade Agreement. The updated deal secured key improvements that preserve and grow jobs in America's auto industry.
The R.O.K. is one of the United States' closest trading partners, with more than $130 billion in two-way goods trade and nearly $35 billion in services in 2018 alone.
The goods and services trade deficit with the R.O.K. dropped by more than 20 percent in 2018.
U.S. exports of autos, agricultural products, fuel, and chemicals to the R.O.K. grew last year.
The R.O.K. is a major source of foreign direct investment in the United States.
U.S. subsidiaries of R.O.K. firms supported nearly 52,000 U.S. jobs, contributed $1.1 billion to U.S. research and development, and are accountable for $14.2 billion in U.S. exports of goods from majority-owned U.S. affiliates, as of 2016.
South Korean investment continues to grow and is the 13th fastest growing source of investment. Since President Trump's visit in 2017, R.O.K. firms have announced and brought into operation several multi-billion dollar investment projects in the United States.
In May 2019, Lotte Chemical USA and Westlake Chemical Corporation held an opening ceremony for their $3.1 billion joint-venture ethylene facility and Lotte Chemical's ethylene glycol production facility in Lake Charles, Louisiana.
In May 2019, LG Electronics opened its $360 million washing machine factory in Clarksville, Tennessee.
In March 2019, SK Group broke ground on a $1.67 billion electric vehicle battery plant in Jackson County, Georgia.
In February 2019, Hanwha Q Cells announced that it has brought its 3.8 gigawatt solar panel factory in Dalton, Georgia online.
In August 2017, LG Electronics announced plans to establish a $25 million factory for advanced electric vehicle components in Hazel Park, Michigan.
In January 2017, Hyundai Motor Co. and affiliate Kia Motors announced plans to invest $3.1 billion in the United States by 2021.
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Riding High
When you are riding high, take a look and see whose horse you are on.
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8 Let all the earth fear the Lord: let all the inhabitants of the world stand in awe of him. (Psalm 33:8 - - - in the Holy Bible)
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OnePlus confirms 5G-ready Smartphone for 2019
By Vaibhav Jain on June 28, 2018
News OnePlus
Founder and CEO of OnePlus Pete Lau at Mobile World Congress Shanghai announced that the company could launch a 5G-ready OnePlus device as early as next year.
The announcement came during the conversation about OnePlus's product and community philosophy. Lau revealed that the relationship between Qualcomm and OnePlus is leading the brand becoming one of the first 5G Smartphone maker.
OnePlus didn't confirmed that the phone getting 5G support will be the OnePlus 7 or its T variant. OnePlus usually launches two flagship phones for a year and the company has already announced the OnePlus 6 which is likely be succeded by the OnePlus 6T. So, the OnePlus 7 might be the first Smartphone to see the light of 5G.
OnePlus has already sold more than a million units of the OnePlus 6 in 22 days. What you think about the OnePlus 7?


Locally made, high quality bicycle bags and panniers made for active lifestyles, urban commuters and avid adventurists. Featuring backpacks, duffels, hip packs and assorted bicycle accessories, North St. Bags has a solution for every storage-on-the-go need.
Ready to shop? Everything in this guide comes from Portland-based makers, and most of these goodies can be found at Made Here PDX. Happy holidays!


Group portrait of members of the 20th Battalion. These soldiers enlisted between July and August 1915 and trained in Egypt from December to April 1916. They were then sent to the Western Front. Standing, from left: 2362 Pte Charles Hendry Elliott, a labourer from Waverley, NSW, formerly of London, England. Pte Elliott returned to Australia in September 1918; 2926 Pte Eric Austin Tate, a farmer from Kangaroo Valley, NSW. He was promoted to sergeant in August 1917 and killed in action at Passchendaele, Belgium on 9 October 1917, aged 26. Sitting, from left: 2648 Pte Donald Davidson a labourer from Bullaworrie, NSW, formerly of Aberdeen, Scotland. He was promoted to corporal on 6 November 1916 and killed in action at Flers, France, on 15 November 1916, aged 25; 2822 Corporal Edmund Smith, a plasterer from Haberfield, NSW. He was killed in action at Bullecourt, France, on 2 May 1917,aged 24; 2777 Pte a butcher from Rozelle, NSW. Pte Prentice returned to Australia on 13 April 1919. Pte Tate wrote on the back of the photograph that the group were 'tent mates'.


Embracing technology doesn't have to be a headache! Discover new tools to manage your business more efficiently, including tablets, phones, automation and cloud services. From reporting to booking to marketing, this workshop explores harnessing the power of technology to empower your daily operations and keep clients coming back for more!
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Biel and Timberlake Marry
Posted by Suzanne Cooper on Oct 19th, 2012
Justin Timberlake and Jessica Biel, who have been together since 2007 and engaged since December 2011, married under the stars in southern Italy in front of 100 of their family and friends. Biel called the event, "a total fantasy experience."
They were spotted in Italy earlier in the week and threw a party for guests at the Borgo Egnazia resort near Bari, Italy. The candlelit nondenominational ceremony was officiated by the couple's close friend, director Bill Purple.
"It's great to be married, the ceremony was beautiful and it was so special to be surrounded by our family and friends," the couple said in a statement.
Timberlake, 31, became known in the boy band N'Sync before breaking off to a successful solo music career. The singer-actor has since appeared in several movies, including "The Social Network" and "Trouble with the Curve."
Biel, 30, began her screen career in the TV series "7th Heaven" and then moved into movie roles with "Texas Chainsaw Massacre," "New Year's Eve," and "Total Recall."
Defying tradition, Biel wore a custom petal pink and white strapless Giambattista Valli gown and carried a bouquet of chamomile, ranunculus, and ruscus. Timberlake sported in a traditional Tom Ford tuxedo that he had a hand in designing.
Timberlake played the guitar and serenaded his bride as she walked down the aisle with a song he wrote specifically for their big day and for her. "I figured if there was something I was going to be able to offer, it would be to sing her down the aisle. Grown men were weeping. Hopefully it's because I didn't sound bad," Timberlake said.
About the tears she shed as she started her walk down the aisle, Biel said, "I was about to stand up in front of my friends and family and bare my soul for the person I love. It was terribly emotional."
The couple read vows that they wrote themselves and exchanged gold rings from Leor Yerushalmi of the Jewelers of Las Vegas that they helped design. Their first dance was to Donny Hathaway's 1971 rendition of "A Song for You." Timberlake said about the song, "It happens to be one of my favorite songs of all time, and Jess's as well."
The guest list included close friends Jimmy Fallon, Andy Samberg, Timbaland, and Beverley Mitchell. Notably, not invited to the ceremony were Timberlake's N'Sync band mates.
After the ceremony, the celebration moved to an al fresco bar for cocktails and hors d'oeuvres such as lobster in turnip tops and mini caprese salads. A four-course dinner featuring steak and sea bass was served. The meal ended with affogato, a scoop of ice cream topped with a shot of espresso.
Timberlake said, "To hear all of our family and friends cheering at extremely loud, inappropriate decibel levels, that became the pinnacle of the ceremony. It felt perfect. It felt like everything came together."
Photos of the wedding were sold to People magazine for a reported $300,000.
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Provider Status Bill Focuses on Underserved, Earns NACDS' Backing Bipartisan House bill seeking to designate pharmacists as healthcare providers in Medicare leverages pharmacists' education and training
Arlington, Va. – Bipartisan legislation was introduced in the U.S. House of Representatives today that would designate pharmacists as healthcare providers under the Medicare program. The bill would amend The Social Security Act of 1935 to enable pharmacists to work to their full capability by providing underserved patients in the Medicare program with services not currently available to them.
H.R. 4190, introduced by Reps. Brett Guthrie (R-KY), G.K. Butterfield (D-NC) and Todd Young (R-IN), would elevate pharmacists' ability to help patients achieve success in their healthcare. Specifically, Medicare patients could have enhanced access to pharmacy services including immunizations, diabetes screenings and self-management education, cardiovascular screenings and behavioral therapy within the scope of state laws under this new bill.
"The provider status designation will amplify pharmacists' ability to do what they do best – serve patients and help them on the road to better health," said NACDS President and CEO Steven C. Anderson, IOM, CAE.
"We applaud the leadership of Reps. Guthrie, Butterfield and Young in introducing this bipartisan, commonsense legislation," said Anderson. "As one of the most trusted healthcare professionals, pharmacists are extremely valued by patients in the greatest of need. From helping patients take their medications effectively and safely, to providing preventive services, pharmacy services help keep people healthier and reduce costs."
The U.S. healthcare system is on a transformational path and it is becoming increasingly challenging to ensure access to affordable, quality patient care – especially for the medically underserved, including senior, residents of public housing, persons with HIV/AIDS, as well as rural populations and many others. The national physician shortage, at a time when health insurance coverage is expanding, could further complicate healthcare access.
In recent years, pharmacists have played an increasingly important role in the delivery of healthcare services. Pharmacists now commonly provide immunizations and medication therapy management (MTM) services. They are also developing new and innovative approaches through medication synchronization programs, identifying and treating medication adherence issues, and working to have the ability to provide simple medical testing services.
However the lack of pharmacist recognition as a provider by third party payors – including Medicare and Medicaid – has limited the number and types of services pharmacists can provide, even though fully qualified to do so.
Today's pharmacists spend more than six years obtaining professional education to receive their degree and license. In addition to providing safe access to prescription medications, pharmacists provide one-to-one, face-to-face to counsel patients about the importance of taking those medications as prescribed. They also administer vaccinations – including flu shots, provide preventive health tests and offer educational programs and services to help patients manage diseases and chronic conditions.
Many patients in the Medicare Part B program also rely on their pharmacists to provide durable medical equipment and other supplies to help them manage chronic diseases or conditions.
"Retail pharmacies are oftentimes the most readily accessible healthcare provider. Research has shown that nearly all Americans (89%) live within five miles of a community retail pharmacy," said Anderson. "Combined with their expertise and training, pharmacists as healthcare providers can serve their patients to their full capabilities.
"Expanding the role of pharmacists to meet the demands of more than 30 million newly uninsured patients can only help alleviate the increased need for healthcare services. And we are hopeful that this legislation is the first step towards the ultimate goal of achieving success for patient health."
By NACDS.org Staff|2017-06-16T14:36:05-05:00Mar-11-14|Categories: Press Release|Tags: MTM, Pharmacy_Value, Vaccinations|
NACDS represents traditional drug stores, supermarkets and mass merchants with pharmacies. Chains operate over 40,000 pharmacies, and NACDS' over 80 chain member companies include regional chains, with a minimum of four stores, and national companies. Chains employ nearly 3 million individuals, including 157,000 pharmacists. They fill over 3 billion prescriptions yearly, and help patients use medicines correctly and safely, while offering innovative services that improve patient health and healthcare affordability. NACDS members also include more than 900 supplier partners and over 70 international members representing 21 countries.
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Very few people that get Denmark homeowners insurance actually end up finding the best rates available. They will typically go with what their current insurance provider has for them, usually bundling that in order to get a discount. However, you can find several different Wisconsin companies that will charge far less than what your existing insurance policy actually offers. In fact, they may even give you more coverage for less money, but you have to obtain home insurance quotes on the web that can lead you to these exceptional deals.
The speed at which the policy will go into effect is usually quite fast. If you are coming up on your next payment with your current insurance provider, it will likely start on the same day so that you do not lose any coverage. Also remember that discounts can also be achieved by paying your premiums annually instead of making monthly payments. These are just a few other things to consider if you are looking for a way to save money on your Denmark, Wisconsin homeowner insurance policy.
Possessing house owner's insurance policies is definitely a smart idea. Catastrophes typically come about unexpectedly and can end result in enormous expenditures, and probably the reduction of your home. Possessing home owner's insurance policies will help you protect the price of everything from a burst pipe, to fire harm. home owner's insurance will help you to repair or rebuild your home quickly.
There are two significant things that you can guarantee are carried out to support reduced your insurance coverage expenses. Initial of all, have a security technique mounted. It can decrease your insurance policy rates by a number of percentage factors. Nevertheless, keep in mind to speak to your company and provide proof of the new set up ahead of anticipating to see a adjust. In addition, smoke alarms can save you on rates. This strategy can decrease your yearly expense up to 10 %.
Just before setting up a pool or getting a trampoline, be sure to verify with your insurance business to see what influence this will have on your rates. Some businesses will charge as a lot as ten% more to insure a home with a pool, trampoline or other possibly harmful gear on the home.
You can conserve 1000's of pounds and years of payments by creating your house payment on a bi-weekly basis, as an alternative of month-to-month. Inquire your home holder about environment you up on this payment plan. Considering that there are 52 months in a 12 months, you will end up producing an additional few of payments with out breaking the bank or your spending budget.
If you have house insurance policy and also have a dog, make positive that you search for plan possibilities that go over men and women who may be attacked by your pet. It really is a strange and backwards planet at times, but an intruder can actually sue you if your dog assaults him. Yeah, it's insane, but which is why they have these protection choices.
If you have any spare cash in a financial savings account, use it to pay off your house. When you possess your home outright your once-a-year home insurance policy premiums can drop dramatically as insurance coverage businesses tend to believe that house-owner's are much more most likely to get care of and secure their house.
Buy a burglar alarm with central monitoring to preserve money on your home owner's insurance policy. Most insurance coverage businesses will low cost your coverage value by up to 5 per cent if you can show proof of a centrally monitored alarm program. The cost you pay out for the insurance policies may really nicely be offset by the low cost on your insurance policies rates.
Set up a security method in your home that is monitored by a central monitoring station, and you will help save about five percent on your house insurance coverage. You will probably have to supply evidence to your home insurance business to get the discount, but that is as straightforward as sending them a copy of your checking invoice.


We call our national parks our national inheritance. We call them our nation's gems – our legacy for future generations. We talk about the places they protect and the stories they preserve so that we never forget, never take for granted the struggles it took to forge this nation of ours.
Of the many narratives that have shaped our collective heritage, that of our armed forces stands apart.
Our military history is made up of tales of extraordinary heroism, determination, and sacrifice. These tales are interwoven into the National Park System – not only in battlefield and military parks, but also into our nation's most iconic gems like Yosemite National Park and Golden Gate National Recreation Area.
In fact, if you were to examine the list of most-visited sites in the National Park System, you'd find a popular – and moving – place where you can learn about the courage and service of our military women and men at the Vietnam Veterans Memorial.
Located on the northwest corner of National Mall and Memorial Parks, the Vietnam Veterans Memorial is an exceptional national park site where you can pay tribute to the men and women who served and who lost their lives during the Vietnam War. Within the site, visitors have the opportunity to honor the names of the fallen who are inscribed on the Memorial Wall, visit the Three Servicemen statue, look upon the Vietnam Women's Memorial statue, and reflect at the In Memory plaque.
Having welcomed over 5.5 million people last year, our veterans' stories continue to resonate with visitors at this national park site. Their grit and sacrifice continue to inspire us to give thanks for their service and to never take for granted the cost of our freedom.
The next time you have the opportunity to visit the Vietnam Veterans Memorial, let these fascinating facts help guide you through the powerful stories and symbolism enshrined within this national park.
The design for the memorial was determined through a nationwide competition.
Of the over 1,400 submissions, Yale architecture student Maya Lin's design was chosen by the committee.
The Memorial Wall was dedicated on Veterans Day of 1982.
70 separate panels make up each of the walls of the 'v' shape.
One end of the memorial wall points toward the Washington Monument, while the other points to the Lincoln Memorial.
The two 200-feet-long walls contain more than 58,000 names.
The names are listed in chronological order by date of their casualty and begin and end at the origin point, or center, of the memorial where the two walls meet.
Having the names begin and end at the center is meant to form a circle – a completion to the war.
By including the names of all those who were killed or missing in action, the memorial conveys just how overwhelming the casualties were during this war.
Visitors can see a reflection of themselves in the names on the black granite walls, connecting the living to those lost.
The statue was unveiled on Veterans Day of 1984.
It honors those who fought and returned from the war by showing them standing, keeping watch over the wall.
Artist Frederick Hart used patina to give the bronze statue some color variations.
The servicemen depicted in the sculpture stand seven feet tall upon a base that is one foot tall.
The three figures represent a Hispanic man, an African American man, and a Caucasian man – ethic groups that were heavily represented in the war's combat forces.
The Vietnam Women's Memorial statue was unveiled on Veterans Day of 1993.
Former Army nurse Diane Carlson Evans led the efforts to recognize the bravery of the nearly 11,000 women who volunteered.
Evans was the first woman in U.S. history to lead an initiative to create a national monument in D.C.
Artist Glenna Goodacre composed a scene of a "moment in crisis" to capture the range of emotions women faced in fulfilling their duties.
The bandage on the wounded soldier's face is meant to help visitors see themselves as him, and connect with the comfort and care women provided.
On Veterans Day of 2004, the In Memory plaque was added to the memorial site.
It is located at the northeast corner of the memorial plaza surrounding The Three Servicemen statue.
It is meant to recognize the soldiers whose life was cut short as a result of their service in the war, but whose names were not eligible for inscription on the Memorial Wall.
The causes of death that were attributed to their service in Vietnam included PTSD-related illness, Hodgkin's and Parkinson's, exposure to chemicals such as Agent Orange, and cancer.
The Vietnam Veterans Memorial is one of many sites in the National Park System that preserve and honor the contributions of our military women and men. Visit the battlefields, military parks, historic sites, and memorials that stand as reminders of their sacrifice, learn about their struggles and experiences defending our values, and give thanks for their valor.
I am unaware of any records of visitors that are kept. However, I do know that, in the American History Museum on the mall, they have a room that is filled with items that have been left at The Wall. It is a rotating display. Meaning that the items there are changed from time to time to reflect newer items that are left there. I also know that all of those items are kept, and logged, by the Smithsonian for future reference.
Someone above made reference to one war being "...useless..." and another as "...needed...". I submit to you that no war is needed or useless, rather, some wars are necessary while others are/were unnecessary.
The comment has been made that "nobody cares except those of us who served in Vietnam (and their families)" That is simply not true. I am 48 years old and was blessed not to lose any loved ones in the Vietnam War. However, I made a trip to D.C. and at the top of my list was to go to the Wall to pay my respects. Perhaps I am not indicative of others in the country who are not directly impacted by this terrible war, but I think there are more of us than you think out there -not as many as there should be, unfortunately...but still more than you think. I was raised (and raised my son) to appreciate those who gave of themselves to preserve my way of life. To those taken too soon and those still with us (from this and all wars our country has been involved with) - Thank you for your service! It IS appreciated. And, thank you to the loved ones left behind -your sacrifices have not been forgotten.
As an Active Duty servicewoman, I take pride in knowing that those that came before me, made it easier for me to serve and be proud. I didn't play a role in Vietnam, but I made it a point to re- enlist near the wall to say thank you and that I will carry the baton. We care, so don't be so cynical. I've and was told personal stories about how the reception of returning servicemen, so I see your point in that context, but you all are Never obscure or forgotten.
My active duty Navy grandson went last year. I was opposed to the war, but not to the people who were actually doing the fighting, most of them only a few years older than me. I cried for these fallen, and only wish they would have been the last to fall in battle. Much love and respect for all Veterans, these especially whose brothers and sisters in arms were not treated right upon return. "Love the sinner,hate the sin" for me translated to " Hate the war,love those who bravely fought" Still wishing we could find a better way to resolve differences.
I am a Vietnam Veteran having served there 1968 and 1969. I appreciate it when folks say to me "Thank You For Your Service".....and I thank THEM for thanking ME....and usually ask them to add "AND WELCOME HOME" when they address a Vietnam Veteran because WE did not get the "Welcome Home" that today's Veteran get.
As a Social Studies teacher, I diligently teach about Vietnam to my students as advised by the Vietnam Veterans Memorial Fund curriculum Echoes from the Wall. I was finishing my first grade year in 1975. I never served. I have a love for teaching, and one of the things I teach is about how important it is to remember all veterans who served. Vietnam veterans deserve to be treated with the same dignity as all other veterans. I work hard to instill the importance of keeping the memory alive. Thank you to all veterans who served!
Today is election day, I VOTED today, because of the men that I served with in Vietnam that never made it home. Vietnam was not a nice place to be in 1968 / 1969, and to come home and have the things that were said and done to us as Veterans of war, is to this day still hard for me to think that people would do that to Us. We did what our Country asked us to do ( Drafted) and not old enough to vote, but we did what was asked.


text:
"In the hospital, there will be nobody to pamper me": a qualitative assessment on barriers to facility-based delivery in post-Ebola Sierra Leone
Stefanie Theuring ORCID: orcid.org/0000-0002-5372-79031,
Alimamy Philip Koroma2 &
Gundel Harms1
Reproductive Health volume 15, Article number: 155 (2018) Cite this article
Sierra Leone has one of the highest maternal mortality rates in the world. Encouraging the use of skilled birth attendance in health facilities is an important step in the endeavor to increase the number of safe deliveries. However, public trust in health facilities has been greatly damaged during the Ebola epidemic outbreak in Sierra Leone in 2014/2015, and little is known about external and intrinsic barriers to facility-based delivery (FBD) in the country since the end of the Ebola epidemic.
We conducted a qualitative study on FBD in Princess Christian Maternity Hospital, Freetown, which is the national referral maternity hospital in Sierra Leone. We performed six focus group discussions with providers, pregnant women and recent mothers surrounding experiences, attitudes and behaviors regarding FBD and potential barriers. Discussions were tape recorded, transcribed and evaluated through content analysis.
Women in our study were overall technically aware of the higher safety linked with FBD, but this often diverged from their individual desire to deliver in a supportive and trusted social and traditional environment. Close relatives and community members seemed to be highly influencial regarding birth practices. Many women associated FBD with negative staff attitudes and an undefined fear. Logistic issues regarding transportation problems or late referral from smaller health centers were identified as frequent barriers to FBD.
More supportive staff attitudes and acceptance of an accompanying person throughout delivery could be promising approaches to increase women's confidence in FBDs. However, these approaches also imply revising health systems structures, like staff working conditions that are conducive for a friendly atmosphere, sufficient space in delivery wards allowing the women to bring a birth companion, or like the establishment of a reliable peripheral ambulance system to ensure transportation and fast referral.
Plain English summary
Background: Sierra Leone is one of the countries in the world where most women die when giving birth. Assistance of skilled health workers in health facilities increases safety for mothers. However, after many people died in hospitals in Sierra Leone during the Ebola outbreak in 2014/2015, trust in health facilities decreased. Although the Ebola outbreak ended, there might still be barriers to facility-based delivery (FBD).
Methods: Our aim was to find out what people think of FBD in Freetown, Sierra Leone. We conducted six group discussions in Princess Christian Maternity Hospital with staff, pregnant women and recent mothers on experiences, attitudes and behaviors regarding FBD and potential barriers.
Results: Women in our study were overall aware of FBD being safer than home deliveries. At the same time, they often expressed a desire to deliver in a familiar social and traditional environment. Close relatives and community members often influenced where and how women want to deliver. Many women feared that staff might treat them badly in hospitals and that they might die there. Transportation to hospital from home or from other health centers was named as a problem.
Conclusions: Women might be convinced to use FBD if staff would treat them in a more supportive way and if they could bring a trusted person to stay with them during delivery. This means that hospitals need to improve some conditions, like motivating the staff or offering an ambulance system to ensure transportation even from far away.
Sierra Leone is not only one of the poorest countries in the world; it is also one of the most dangerous countries when it comes to delivering a baby, with a maternal mortality rate of 1360/100.000 births as of 2015. [1] Despite strong efforts to improve health services´ accessibility and availability, e.g. by establishing a peripheral health unit network or reducing financial barriers by introducing the Free Healthcare Initiative for pregnant and lactating women in 2010 [2, 3] immense gaps in the country's health system in terms of quality of care and patient safety remain a problem. Furthermore, the largely inadequate obstetric care offered by an already weak health system in Sierra Leone has been further compromised during the Ebola epidemic with approximately 10 000 cases between 2014 and 2015, forcing many hospitals to close down or reduce their activity to prevent Ebola transmission or because of staff shortages. [3, 4] Many women in the Ebola outbreak-affected countries including Liberia, Sierra Leone and Guinea are likely to have died due to the reduced access to appropriate care during childbirth, and many more to have lost their trust in the reliability and safety of health services during the virus outbreak [3]. While before 2014, facility-based deliveries (FBD) in Liberia were rising up to an all-time high, after the Ebola epidemic, FBDs decreased by up to almost 80%. [5] In Sierra Leone, before 2014, only about half of deliveries were facility-based [6]. A report assessing changes in health services utilization in the early phase of the Ebola outbreak showed that service uptake was seriously compromised with a one-third decline in facility-based deliveries already by September 2014, mostly as a result of women's fear and lack of confidence in health services [7, 8]. Since the Ebola outbreak ended, there is uncertainty whether the public trust in health institutions has been restored, and to date, research regarding the ongoing potential intrinsic and extrinsic barriers to FBD is scarce in this post-outbreak population. This study aimed at capturing the current situation regarding attitudes of patients and providers on FBD in Freetown, Sierra Leone.
We conducted a cross-sectional qualitative assessment based on six Focus Group Discussions (FGDs) to identify common attitudes, perceptions and behaviors with respect to FBDs, with the goal to design further formative research to increase institutional delivery rates. Our study was located in Princess Christian Maternity Hospital (PCMH) in Freetown, Western Area of Sierra Leone. PCMH is the national referral maternity hospital in the country, with a capacity of about 140 beds and approximately 5700 deliveries in 2016. PCMH is the only facility providing Comprehensive Emergency Obstetric and Neonatal Services in the Western Area, comprising of about 1.5 million inhabitants. [9]
Study procedures
Within PCMH, we conducted two FGDs with health care providers, two FGDs with pregnant women from the ANC ward, and two FGDs with mothers who were waiting for hospital discharge after delivery. This mixture of groups was supposed to offer insight into a wide range of perspectives from different positions. FGD participants were recruited purposively; recruitment criteria included belonging to one of the three target groups, the person not being involved in any medical procedure at the time of recruitment, and willingness to participate. An information sheet on study participation was read out to all participants, and they gave written informed consent by signature or fingerprint. We recruited five to seven participants for each FGD, based on the assumption that a rather small group size can create an encouraging atmosphere for each individual to engage in the discussion [10]. The number of FGDs was subject to data saturation, which was achieved after six groups as we observed reiterating discussion contents and no new information being brought up within those target groups. A local study nurse moderated the FGDs in English and Krio, using a previously prepared discussion guide. The discussion guide comprised questions surrounding general attitudes towards home delivery, institutional delivery, traditional birth attendants (TBAs), perception of barriers to facility-based deliveries, and own experiences with delivery (patients, as well as providers who had previously given birth) or working at the delivery ward (staff). The discussion sessions were located in a privacy-offering counselling room of PCMH and lasted for about 60 min each, a time seeming appropriate for within-group data saturation. For women who spoke in Krio, the study nurse translated questions to Krio and answers to English immediately. Statements of FGD participants were subject to probing and respondent validation. Discussions were audio-taped; in addition, an observing person took notes. This was supposed to support data interpretation, e.g. to capture group dynamics or for the case of affirmation of a statement through body language. We asked each of the participants to fill in a form for basic demographic information before the discussions started. The participants received a refreshment and a small financial compensation for their time spent. The six FGDs were conducted in October 2017.
We performed a both tape-based and note-based constant comparison analysis of the data, with an abridged, partly (for key statements) verbatim transcription of audiotapes by one researcher. The data went through a three-step process of inductive coding performed by one researcher (the first author), including initial open coding, axial coding, i.e. grouping and linking identified codes within categories, and selective coding, i.e. deriving themes from the identified categories. [10] The coding procedure involved iterative reading of transcripts and notes combined with writing analytic memos to reflect on the emerging concepts. The content analysis was performed manually.
Thirty-five women took part in our six focus groups; 13 providers and 22 patients. The average age in the provider groups consisting of female nurse/midwives was 43 years, the majority of providers were Christian (9/11; 2 missing data), the minority Muslim (2/11).
Among the patient groups, the average age was 26 years (n = 19, 3 missing data). Three quarters of clients were Muslim (15/20, 2 missing data) and one quarter was Christian (5/20). The majority was married (14/17, 5 missing data). Average travel time to the hospital among the patients was 70 min (n = 16, 6 missing data). As their occupation, most patients stated they were students or petty traders. Among the participants from the group of recent mothers, the majority had been referred to PCMH for some pregnancy or birth complication.
General views on FBD
The common understanding among all participants, both patients and providers, was that FBD would generally provide best medical care and least health risk for mother and baby.
"I think it will be safer for me to deliver in the hospital." (Pregnant woman, FGD3)
"If you come to the hospital, they will know how your baby is, they will know what to do. They will do a scan." (Pregnant woman, FGD3)
"In case of any problem or complication, specialists are available who can help." (Pregnant woman, FGD3)
"I think that is the right way, to deliver in the hospital, because there you can get best medical care." (Pregnant woman, FGD4)
"Home delivery is very risky. (If not going to a health facility), you end up losing the baby and even your own life." (Recent mother, FGD6)
"If you go to the central hospital, and you are delaying and you cannot push, we have a mechanism, the vacuum; we will use it to lift this baby from you. We have so many facilities. (…) If the baby is not responding well, we have a good resuscitation center." (Health provider, FGD1)
However, contradicting to the positive attitudes participants were describing, at the same time they expressed a general concept of fear, wariness and mistrust regarding health facilities. Most women reporting FBD experiences mentioned an initial fear of going to hospital for delivery, especially for surgery. Reasons remained opaque, but it was vaguely implied that fear was justified. It appeared as if going to the hospital was widely equated with having to die there.
"I was frightened, because I never wanted to go to that theater again." (Recent mother, FGD6)
"They told me I am going to need an operation, I feared. (…) I put everything to god." (Recent mother, FGD6)
"Why are women afraid of the hospital? (…) They have their reasons." (Recent mother, FGD6)
"Some women don't want to be referred to hospital. They think it's the end of their lives." (Recent mother, FGD5)
"When Ebola was there, women would not come to hospital, because they said if you come, you will be infected, you will die. Because so many people had Ebola. They are afraid of this." (Health provider, FGD2)
"Most of the (women) will always say, when you go to PCMH to deliver, you die." (Health provider, FGD1)
"Some of the women will tell them (smaller health centers), please don't refer me, I don't want to go to PCMH, I don't want to die." (Health provider, FGD1)
Attitudes and behavior of delivery staff
Women who had experienced FBD confirmed predominantly positive experiences, having perceived staff as encouraging and supportive.
"They took good care of me, they talked to me, advised me and encouraged me." (Recent mother, FGD6)
"I was giving the nurses a hell of a time. (…) The nurse that night, I congratulate her. She went up and down. Four doctors I think she called for me." (Recent mother, FGD6)
"They are gentle (…) I would still come to this hospital" (Recent mother, FGD5)
"I like the way they took care of me. Staff encouraged me when I was crying, as I was a (primipara), so they encouraged me a lot." (Pregnant woman, FGD3)
"They only gave the best care to me. They were so close and monitoring everything. They encouraged me so much." (Pregnant woman, FGD4)
However, women also reported a number of negative experiences, including communication problems, being neglected by hospital staff, or certain undesirable health workers practices during delivery, like lithotomy position.
"There was a very long delay. (…) I told (the nurse) to do something. She insisted on what she thinks was best. (…) I was admitted on Monday, I went into labor on Tuesday, but C/S was only done on Saturday. (…) (The baby) was alive when I was admitted, but she was born dead." (Recent mother, FGD5)
"I went to a health center closeby; I was thinking that the nurses were very wicked. They just placed me here, nobody talked to me, nobody looked at me, for about ten hours." (Health provider, FGD2)
"I was in pain, I wanted to go to the toilet. Nobody came to me to help, so I myself went to the toilet, and I felt something was coming out, I called the nurses: `come, look at my baby!` I said, `you people are sitting there, talking, talking, talking, and I delivered my baby by myself.´ They were sitting outside the room; after the examination, they just forgot about me." (Health provider, FGD2)
"Some of the nurses we talk to…there's so many attitudes when you are in labor. You may have some kind of behavior that the nurses will not like. But they have to be patient because we are in labor. Their boss should tell them to be patient with us." (Pregnant woman, FGD3)
"The majority of us don't know how to deliver in a bed. We are not used to that. We prefer to deliver on the ground, that is better for us. (…) When you go to the hospital, the nurses will just leave you on the bed. (…) I would like to deliver on the floor. The bed is too high, and we are in a form of fearness." (Pregnant woman, FGD 3)
"All they wanted to do was a vaginal examination. I refused vaginal examination. The area was already sore." (Health provider, FGD2)
The problem of negative staff attitudes possibly deterring women from approaching PCMH was particularly expressed by the providers themselves, who argued that a lack of motivation in underpaid and overworked nurses and midwives would substantially contribute to unfavorable working attitudes of staff.
"It is the attitude of health workers that is not correct. Some of the women will say, ´I don't want to go to this facility to deliver because the nurses don't treat me fair, when I go they shout at me.´ (…) The nurses are stressed." (Health provider, FGD1)
"The salary is very low. It is not encouraging. (…) So we are short of staff. This is the reason why most of us will get annoyed with the patients. (…) I perform three deliveries and I am overworked. I'm stressed with my empty pockets. And when you come around with your own problem, you don't want the problem of others, it just gets me mad." (Health provider, FGD1)
"There is a shortage of health workers. We are dealing with so many patients. So some women may even refuse to come another time, because they say `if I go there, I will stay a long time`. The work is too much for us and there is no motivation. We are working for 24 hours, covering three shifts sometimes. That may lead you to maybe talk a bit hard to the patients." (Health provider, FGD2)
Inhibiting staff attitudes also appeared in the context of the consistently mentioned problem of late referral from smaller health centers to hospitals in emergency cases. Hospital staff described health workers of smaller health centers as often ignoring their limits or overestimating their skills, and thereby causing a delay in referring the patient to hospital.
"The health workers there will be on their limit, but they don't want the community to see: this health worker doesn't know her job. (…) If you check our (PCMH) maternal mortality, you will see that most of the (referred) cases come in as `death on arrival´. (…) So now as a midwife or nurse (…) when you see that this particular case, you should not handle it, you should refer earlier." (Health provider, FGD1)
"This (late arrival in hospital) can be the fault of colleagues. Sometimes they hold on to these patients for quite long beyond their limits. By the time they refer the patients, by the time they get here if the distance is too long, they come here already obstructed." (Health provider, FGD2)
Role of trusted person/TBAs
As a logical addition to perceived negative attitudes and communication problems with hospital staff, women repeatedly articulated their desire to have a person of trust around when it comes to delivery, like a relative or a TBA. Since delivering woman are usually not allowed to bring an accompanying person into the delivery ward, they fear being unattended and left alone. This imagination causes discomfort and hesitance to choose FBD in many pregnant women despite their knowledge that it is the safer option.
"I will be more comfortable to deliver at home. I am afraid that in latency phase, they will admit you and leave you alone. I am afraid to be alone, I want to deliver at home so I can be with the same midwife." (Pregnant woman, FGD3)
"I am not certain where to deliver, I am having fear. I will have someone at home to pamper me, in the hospital, there will be nobody to pamper me." (Pregnant woman, FGD3)
"(Pregnant women) believe in what older women are telling them, giving them information, helping them at home." (Pregnant woman, FGD4)
"People believe they should deliver at home rather than in hospital, because their grandparents have done it, their great-grandparents were doing it, so they prefer to do it." (Health provider, FGD1)
The large influence of women's trusted social environment also caused delay in hospital referral in some cases where an emergency occurred. When asked why they did not approach the hospital immediately when noticing danger signs, women referred to trusted people in their family/community who advised them, often based on wrong concepts of the symptoms.
"Elder people are experienced. This was my first own pregnancy, so I don´ t have any idea about that. So I took the idea of them. (…) They gave treatments to me." (Recent mother, FGD5)
"I had swollen feet. (My people) said that maybe it is because it is a male child. One day a nurse was passing by. She said: this is a danger sign, go to hospital on Monday. Unfortunately, I was convulsed before Monday. (…) I was having the idea that my feet were swollen because I was having a male child." (Recent mother, FGD5)
From the close social environment, especially husbands seemed to be highly influential on the place of delivery. Reports on partner support with respect to FBD were divergent, including both encouraging and inhibiting attitudes. However, participants described women as generally not authorized for such decision-making without the partner and having to wait for his approval, even in emergency cases.
"My husband also advised me to go to the hospital. Going to the hospital is the best thing." (Pregnant woman, FGD4)
"I asked him why his wife doesn't deliver in hospital; he told me categorically that whenever his wives, because he has several wives, come to the hospital to deliver, they will advise them on family planning. (…) He believes when you advise his wives (on family planning), they will go out with another man." (Health Provider, FGD1)
"The women don't have a right to their own opinion. (…) The nurse will tell them ´I have to refer you to another level, where they will continue your treatment`, the woman will say `I want to wait until my husband comes`. (…) The women don't have a right to make their own decision." (Health provider, FGD1)
"They said she was waiting for the husband. (…) Just as I'm telling you about this knowledge that you should go earlier and save your own life, not your husband's life, but your own life! She will prefer sitting at home waiting for him." (Health provider, FGD1)
TBAs were characterized to have an important role as trusted and respected persons, often with a family bond, whom many women prefer to FBD because of tradition and belief.
"TBAs are in the community, they are very close to the patients. Sometimes these TBAs are women's mothers, or mothers-in-law. So they are trusting them more than the nurses in the hospital." (Health provider, FGD1)
"TBAs, the women know them for a long time, so they think they will be handled with care and treated better. (…) Also, some of them are their relatives, so they trust in them more than in nurses." (Health provider, FGD2)
"They are the people that are respected in the community. Most of the nurses, they are just young girls. TBAs, maybe she is my mothers or grandmothers age, so they are most trusted." (Health provider, FGD2)
At the same time, participants discussed that TBAs are often lacking medical competencies, and they described the resulting skepticism. Officially, TBAs have no permission to perform deliveries under threat of penalty charge, but recent efforts strived for integrating TBAs into the formal health system. Discussants however agreed that women would never reveal to a health facility if they had been with a TBA, so no one would know or charge a fine.
"TBAs are not trained to a level to attend to complications" (Health provider, FGD2)
"I do not trust them 100% (…) For them, they don't know how to do. They just say the baby is fine." (Pregnant woman, FGD3)
"I am not comfortable with the TBAs because they don't know where the baby lays and how to handle complications." (Pregnant woman, FGD3)
"It was decided to let TBAs join our health workers in the hospital setting. (…) They sent out a call to the TBAs: the greater the number of patients you bring to the hospital (for delivery), the higher they pay you. (…) So the TBA will encourage women to come to the hospital." (Health provider, FGD2)
Travel distance/transportation
Participants frequently expressed long travel distance to PCMH as an important obstacle. It was stated that many women have no means of transportation, especially when labor starts during the night. The failure to approach a health facility for delivery was also perceived as a consequence of poverty and the inability to pay for transportation. Oftentimes, TBAs remain the only accessible option of any skilled attendance in the absence of transportation to a health facility.
"Most pregnant women do not come to the hospital because of transport, because they are living at a distance." (Pregnant woman, FGD4)
"At longer distance, pregnant women will not have transport. Poverty plays a big role to get to the hospital." (Pregnant woman, FGD4)
"Patients go home first to raise money. They are coming here, they don't know anybody, for transport, for food, they need money to take care of themselves. These are very poor patients. Even the blood transfusions have to be paid." (Health provider, FGD2)
"There are places that are not motorable and are far away from any health center. So most of these people now will prefer to go to the TBA." (Health provider, FGD1)
In some cases, PCMH staff had contributed to the transportation barrier to FBD by sending a delivering woman back home because she was not far enough progressed in labor. Staying closer to the hospital around the due date was discussed as an option.
"I came in labor, but it was the latency phase, they returned me back home. Then later, labor progressed in the middle of the night, so I was unable to come back to the hospital, because I was living out of Freetown. (…) I went to a retired midwife and delivered at home because of the distance." (Pregnant woman, FGD3)
"If I lived far off, I would think about a relative that stays very close to the health facility, so about one or two weeks before my delivery time, I go closer to the health center and stay with my sister who is already there. So by the time of contractions, I don't need to delay by getting to the health facility (…) It would ease so many problems." (Health provider, FGD2)
"In PCMH, there is a waiting room. But sometimes the patients refuse to stay, because if they have their farm work to do, they will not leave it there, so they refuse to stay. Also this waiting area is only for women with high risk pregnancy, so the others have to go home." (Health provider, FGD2)
The participants did not consider the ambulance system as helpful to facilitate transportation because of lack of sufficient ambulance cars. Even if women have a possibility to go to PCMH by car, public transport or ambulance, they mentioned that heavy traffic in Freetown would not permit easy access to the hospital.
"Ambulance is there, but there is no fuel, the relatives need to provide fuel, and they don't have the money. Also, the ambulances only cover the district headquarters. They are not in the villages." (Health provider, FGD2)
"That is another problem. Most of the times these (smaller) health centers don't have an ambulance. So the time they will call for an ambulance, you think of the traffic, you think of the poor road network, the condition of the patient should have gone worse. Most of these patients are dead on arrival" (Health provider, FGD1)
This qualitative assessment aimed at reflecting patients´ and providers´ current frames of mind regarding institutional delivery in a setting characterized by extreme poverty, high maternal mortality and ongoing recovery from a major health system collapse during the Ebola outbreak. We observed heterogeneous perspectives on FBD, and identified several intrinsic as well as extrinsic barriers, which were largely concurring with outcomes from a recent systematic review of qualitative evidence on facilitators and barriers to FBD in low- and middle income countries [11].
Overall, study participants expressed a general agreement on health facilities being the safest and most reasonable option for delivering a baby. This confirms earlier findings from Tanzania, where women were highly knowledgeable about the fact that complications during delivery are best manageable at health facilities [12]. Bohren et al. likewise endorsed that health facilities were usually perceived as providing high quality care [11].
At the same time, and somewhat contradictory, the strong perception of advantages of FBD stood alongside a frequently expressed fear of hospital admission and preference for home delivery. This discrepancy, largely acting between the poles of rationality and emotionality, represents a major intrinsic conflict in the context of FBD. The underlying scheme is also transferable to what Bohren et al. have described as an "intersection of traditionalism and modernity" [11]. While "modernity" equates to decision-making in favor of high-standard medical care and obstetric technologies based on the rationale that this will result in increased safety and survival, the "traditionalism" aspect is strongly linked to the influence of a woman's social and cultural environment and the desire to be accompanied and emotionally supported by a trusted person. An event like the Ebola outbreak is likely to increase emotions like fear and mistrust in authorities, and thereby counteracts allegedly rational arguments for institutionalized health care, as also suggested in a systematic review on effects of Ebola on health care utilization [4]. Other studies corroborate the general relevance of our finding that familiar support and care during home delivery might outweigh reasoning for FBD for many women [13, 14].
This is even more the case when women were having bad experiences with inattentive, careless or even rude health staff at the hospital. Unfavorable attitudes of staff were subject to a number of studies in the context of FBD [15,16,17], and are a constant emerging theme when describing experiences with FBD, ranging from verbal abuse and ignorance to even physical abuse like slapping. A recent study from rural Sierra Leone observed that poor women were particularly prone to unsupportive staff attitudes, with health facilities structurally reflecting social power imbalances within a society [2]. Oyerinde et al. [16] argued that humanized care based on women's dignity during delivery is one of the major determinants of patient satisfaction with maternity services and vital for the public perception of FBD, while a study in Benin concluded that it could even positively influence the progress of birth, like less need of medication [18]. Several studies confirm our finding that patients and especially providers accuse the health system to be responsible for overloaded staff and unbearable working conditions, resulting in a climate of demotivation, frustration and harshness [15]. In any case, respectful and attentive staff attitudes are crucial when aiming at building confidence among delivering women in an institutional environment where they do not know anyone and are in a state of fear. To compete with the trusted social environment of a woman during home delivery, health service implementers need to recognize the pertinence of this topic, and consequently address unfavorable working conditions of staff as well as increase their social and communicative skills in stressful situations. The option of allowing an accompanying person into delivery wards to support a woman throughout the process of giving birth, as it has been practiced in European countries for several generations, could be a worthwhile consideration to improve FBD attractiveness [15, 19, 20]. Continuous emotional support and advocacy may result in increased feeling of control and competence in the delivering woman, with multiple potential benefits. As a Cochrane trial review on the topic showed, one-to-one birth companionship of any person, including unskilled family members, was not only associated with fewer negative views on delivery of the women, but also with improved birth outcomes, like more spontaneous deliveries and less pain medication. [20] In many resource-poor health settings including PCMH, allowing additional persons´ presence in delivery wards is challenging because of restricted space conditions. However, given the importance of this theme and the simplicity of this no-cost measure, health decision makers should take into serious account how this could be realized and included into health policies.
Long distance to the hospital and lack or unaffordability of transportation was among the strongest extrinsic barriers women mentioned for FBD. Poor geographic access and prohibitive costs of transportation are a key barrier for seeking institutional, particularly emergency obstetric care in the sub-Saharan African Region and have been recognized as such for a long time. [2, 11,12,13, 21, 22] Yet, to date, little innovative thought has been conceded to the question of how delivering women in these resource-poor and often secluded settings can reach a health facility at the right time [23]. As it stands, ambulance systems are not a reliable nor affordable option in our Sierra Leonean setting as well as in many similar other ones. Recent research on a free ambulance system in Ethiopia has shown that its uptake halved pregnancy-related mortality in the related districts, strongly suggesting that this could be a highly valuable strategy if further pursued [23]. Ways to establish free, continuously and widely available ambulance systems covering remote areas should be included as a priority issue into health strategic plans with the goal of reducing maternal mortality.
This is one of the first studies after the 2014–2015 Ebola outbreak that looks into perspectives on FBD in Sierra Leone. A limitation of our study is the restriction to participant recruitment from only one health facility, PCMH. Further assessments should involve different facility types including private clinics and peripheral health units, and should also be conducted in other parts of the country including non-urban settings, to be able to generalize our results. Also, we cannot entirely exclude response bias given the FGDs were conducted within the hospital setting; however, all participants were assured that nothing they would discuss would be later attributed to them personally, and our findings generally suggest that there was no shyness among participants to express critical opinions. Logistic constraints of the study setting did not allow for conducting FGDs with home-delivering women directly in their communities or with other influential groups including TBAs and elderly people, nor for comparing experiences of PCMH clients to women having delivered in a facility allowing birth companions in the delivery ward. These aspects could have broadened our spectrum of findings, and further research in this regard would certainly be valuable.
In conclusion, women in our study setting were aware of the higher maternal and newborn safety linked with FBD, but this often diverged from their individual desire to deliver in a supportive and trusted social and traditional environment. In this desire, they seem to be highly susceptible to the influence of close resource persons like husbands or elder family members. Logistic issues with long travel distances and late referral from smaller health centers appeared as another frequent problem for FBDs. Accommodating delivering women's emotional state of insecurity and fear by more supportive staff attitudes and the possibility of an accompanying person at her side throughout the process of giving birth could be promising approaches to increase confidence in health institutions. However, these approaches also imply revising health systems structures, like working conditions of hospital staff conducive for a friendly atmosphere, like sufficient space in delivery wards allowing the women to bring a birth companion, or like the establishment of a reliable peripheral ambulance system. In Sierra Leone, where more women die during childbirth than in virtually any other country, it should be a primary goal of health policy makers to mitigate the barriers to FBD in every possible way, and further implementation research assessing effectiveness of the different approaches would be highly desirable for the future.
WHO, UNICEF. UNFPA, World Bank Group, and United Nations population division, maternal mortality estimation inter-agency group. Maternal mortality in. 1990-2015;2015 http://www.who.int/gho/maternal_health/countries/sle.pdf. Accessed April 18, 2018.
Treacy L, Bolkan HA, Sagbakken M. Distance, accessibility and costs. Decision- making during childbirth in rural Sierra Leone: a qualitative study. PLoS One. 2018;13(2):e0188280. https://doi.org/10.1371/journal.pone.0188280.
Orya E, Adaji S, Pyone T, Wurie H, van den Broek N, Theobald S. Strengthening close to community provision of maternal health services in fragile settings: an exploration of the changing roles of TBAs in Sierra Leone and Somaliland. BMC Health Serv Res. 2017;17:460.
Brolin Ribacke KJ, Nordenstedt H, Höijer J, Molnes R, Froseth TW, et al. The impact of the West Africa Ebola outbreak on obstetric health Care in Sierra Leone. PLoS One. 2016;11(2):e0150080. https://doi.org/10.1371/journal.pone.0150080.
Lori JR, Rominski PJE, Munro ML, Williams G, Bell SA, et al. A case series study on the effect of Ebola on facility-based deliveries in rural Liberia. BMC Pregnancy Childb. 2015;15:254. https://doi.org/10.1186/s12884-015-0694-x.
Statistics Sierra Leone and ICF International. Sierra Leone Demographic and Health Survey. In: Key findings. Rockville, Maryland, USA: Statistics Sierra Leone and ICF International; 2013. p. 2014. https://dhsprogram.com/pubs/pdf/SR215/SR215.pdf. Accessed April 18, 2018.
UNICEF. Sierra Leone Health Facility Survey. Assessing the impact of the EVD outbreak on health systems in Sierra Leone. 2014:2014 https://www.unicef.org/emergencies/ebola/files/SL_Health_Facility_Survey_2014Dec3.pdf. Accessed April 17, 2018.
VSO International. Exploring the impact of the Ebola outbreak on routine maternal health services in Sierra Leone. 2015. https://www.vsointernational.org/file/554/download?token=74820Ho8. Accessed April 17, 2018.
Princess Christian Maternity Hospital. 2016 annual report of PCMH activities. Freetown, 2017.
Onwuegbuzie AJ, Dickinson WB, Leech NL, Zoran AG. A qualitative framework for collecting and analyzing data in focus group research. Int J Qual Meth. 2009;8(3).
Bohren MA, Hunter EC, Munthe-Kaas HM, Souza JP, Vogel JP Gülmezoglu M. Facilitators and barriers to facility-based delivery in low- and middle-income countries: a qualitative evidence synthesis. Reprod Health. 2014;11:71.
Women´s Dignity, Care International Tanzania. We have no choice. Facility-based childbirth: The perceptions and experiences of Tanzanian women, health workers, and traditional birth attendants. Dar es Salaam, Tanzania: Women´s Dignity and Care International; 2008.
Wilunda C, Scanagatta C, Putoro G, Takahashi R, Montalbetti F, Segafredo G, Betran AP. Barriers to institutional childbirth in Rumbek North County, South Sudan: a qualitative study. PLoS One. 2016;11(12):e0168083. https://doi.org/10.1371/journal.pone.0168083.
Shiferaf S, Spigt M, Godefrooij M, Melkamu TM. Why do women prefer home births in Ethiopia? BMC Pregnancy Childb. 2013;13(5) https://doi.org/10.1186/1471-2393-13-5.
Bohren MA, Vogel JP, Tuncalp Ö, Fawole B, Titiloye MA, Olutayo AO. Mistreatment of women during childbirth in Abuja. Nigeria: a qualitative study on perceptions and experiences of women and healthcare providers Rep Health. 2017;14:9. https://doi.org/10.1186/s12978-016-0265-22017.
Oyerinde K, Harding Y, Amara P, Garbrah-Aidoo N, Kanu R, Oulare M, et al. A qualitative evaluation of the choice of traditional birth attendants for maternity care in 2008 Sierra Leone: implications for universal skilled attendance at delivery. Matern Child Health J. 2013;17:862–8. https://doi.org/10.1007/s10995-012-1061-4.
D'Ambruoso L, Abbey M, Hussein J. Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana. BMC Public Health. 2005;5:140. https://doi.org/10.1186/1471-2458-5-140.
Fujita N, Perrin XR, Vodounon JA, Gozo MK, Matsumoto Y, Uchida S, Sugiura Y. Humanised care and a change in practice in a hospital in Benin. Midwifery. 2011;28(4):421–8.
Gebrehiwot T, Goicolea I, Edin K, San Sebastian M. Making pragmatic choices: women's experiences of delivery care in northern Ethiopia. BMC Pregnancy Childb. 2012;12:113. https://doi.org/10.1186/1471-2393-12-113.
Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2013;7 CD003766.
Gabrysch S, Cousens S, Cox J, Campbell OMR. The influence of distance and level of care on Deliveryin rural Zambia: a study of linked National Data in a geographic information system. PLoS Med. 2011;8(1): e1000394). https://doi.org/10.1371/journal.pmed.1000394.
Panciera R, Khan A, Rizvi SJR, Ahmed S, Ahmed T, Islam R, Adam AM. The influence of travel time on emergency obstetric care seeking behavior in the urban poor of Bangladesh: a GIS study. BMC Pregnancy Childb. 2016;16:240. https://doi.org/10.1186/s12884-016-1032-7.
Godefay H, Kinsman J, Admasu K, Byass P. Can innovative ambulance transport avert pregnancy–related deaths? One–year operational assessment in Ethiopia. J Glob Health. 2016;6(1). https://doi.org/10.7189/jogh.06.010410.
Many thanks are owed to Ms. Margaret T. Sesay, the study nurse in PCMH conducting the FGDs, and to all the study participants in PCMH, Freetown.
This study was conducted with support of the ESTHER-clinic partnership program of the German Agency for International Cooperation (GIZ) and the Federal Ministry for Economic Cooperation and Development, who had no influence on the design of the study, on collection, analysis, and interpretation of data, and on writing the manuscript.
The datasets used and analysed during the current study are available from the corresponding author on reasonable request.
Institute of Tropical Medicine and International Health, Charité- Universitätsmedizin, Augustenburger Platz 1, 13353, Berlin, Germany
Stefanie Theuring
& Gundel Harms
Department of Obstetrics and Gynecology, Princess Christian Maternity Hospital, Freetown, Sierra Leone
Alimamy Philip Koroma
Search for Stefanie Theuring in:
Search for Alimamy Philip Koroma in:
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ST contributed to this research by designing the study, participating as an observer in FGDs, transcribing audio tapes, analyzing the data and writing the manuscript. APK contributed by designing and planning the study and preparing data collection. GH contributed by designing and planning the study. All authors read and approved the final manuscript.
Correspondence to Stefanie Theuring.
Permission to conduct this assessment was granted by the PCMH executive board. This was a preparatory assessment for further formative research on increasing FBD rates, so need for further ethical approval was waived at this stage. All information resulting from the discussions was treated strictly confidential, and data was anonymized during transcription and analysis procedures. Participants were free to choose which questions they wanted to answer or discuss, they were not pressurized to give any statement and they could withdraw their data at any moment without negative consequences for their treatment in PCMH.
Theuring, S., Koroma, A.P. & Harms, G. "In the hospital, there will be nobody to pamper me": a qualitative assessment on barriers to facility-based delivery in post-Ebola Sierra Leone. Reprod Health 15, 155 (2018) doi:10.1186/s12978-018-0601-9
Facility-based delivery
Post-Ebola
Qualitative study
Ebola research highlights


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Q: Link posted by facebook graph api doesn't show title, thumbnail I use facebook graph api to publish a link to group.
It works occasionally, many times the title, description and thumbnail won't be displayed.
But with that same link if i post by facebook, it works normally.
The link is tested with debugger tool.
Not sure any way to preload the link or guarantee all meta data will be published correctly through graph api?

redpajama_set_name: RedPajamaStackExchange


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The creators of Wild Arms and Shadow Hearts announce two spiritual successors
adminon August 26, 2022 Leave a Comment on The creators of Wild Arms and Shadow Hearts announce two spiritual successors
And since it is better not to count on Sony (randomly) to finance a Japanese RPG, it is without the help of any publisher that Akifumi Kaneko and Matsuzo Machida founded the studios Wild Bunch Productions and Yukikaze with the ambition of giving birth to RPGs. role. worthy successors to Wild Arms (whose license is still inactive at Sony) and Shadow Hearts (whose rights are held hostage by a company that doesn't even make video games anymore).
Two rooms, two environments, therefore, with on the one hand the luminous Armed Fantasia: To the End of the Wilderness whose title is a more than sustained reference to Wild Arms, and on the other Penny Blood whose sinister cachet resonates to the tone of Shadow Hearts, a trilogy whose highlight remains the excellent second episode, Shadow Hearts: Covenant.
To get people talking about these projects, Kaneko and Machida have teamed up to make this joint announcement and, more rarely, to set up a joint Kickstarter campaign. Thus, nostalgic fans of the two sagas will be able to join forces to raise the boat and give more possibilities to see the light of these projects. Kaneko and Machida admit it, this Kickstarter call was strongly inspired by the successful passages of Bloodstained and especially by Eiyuden Chronicle, heir to Suikoden that will see the light of day next year, not without having seduced the publisher 505 Games in passing.
The two teams are hoping for at least $750,000 to start producing a PC version of each of the games, but additional tiers will need to be monitored to guarantee ports for PlayStation 5, Xbox Series, and Nintendo's next console. Generally speaking, the additional levels will benefit both games simultaneously, gaining additional content as the Combo Gauge increases. Backers will also have the opportunity to get both games at an attractive price thanks to the early bird combo.
The Kickstarter campaign will be available soon, but the Gematsu site has had the opportunity to prepare an interview with those responsible for these projects, which are still in the prototype phase, if you ever expected a launch window or even a different gameplay. to that. small clip
Armed Fantasy: To the End of the Desert
With its ambient sauce western fantasy, armed fantasy do not fool anyone about your intentions to arouse the interest of those nostalgic for Wild Arms, a saga whose first episode recently appeared in the PlayStation Plus Premium catalog but whose descendants are not known since Wild Arms XF in 2007 on PSP. These images suggest a trio of protagonists, the Pathfinders, who rely on their arsenal called ARM (Ether reaction maximizer) to cleanse the Anomalies plaguing the lands of Londenium. Expect a gigantic world map filled with things to do, fast-paced turn-based combat, puzzles, and all kinds of vehicles to explore on land, sea, and sky. Exploring the dungeons will take advantage of gadgets specific to each character on the team to progress.
"When I was developing Wild Arms 4, various circumstances forced us to remove the world map entirely. The frustration I felt at that time still lives in my heart today. That's why I want to include the best possible high-quality world map in this new title.commented Akifumi Kaneko, who is not the only former Wild Arms executive on the Wild Bunch Productions team.
blood penny
A true UFO in the JRPG scene even in its time when the genre abounded, Shadow Hearts is a series with an imprint that will not be easy to update in a new license, but what a good bet from Matsuzo Machida, director of the trilogy released on PS2. Inscribed in the gothic horror genre against a backdrop of nightmarish imagery, blood penny follows the story of Matthew Farrell, a 28-year-old New York City private eye embroiled in a dark international investigation during the turbulent 1920s. Unlike the others, Matthew is gifted with cursed powers inherited from his father and the used to hunt all kinds of monstrosities. Here there is no fictitious world and above all a strong taste for traveling inherited from Shadow Hearts, since it is about touring the American, European and Asian continents.
"Along the way, he will meet those who fight for revenge, those who seek to use aberrant horrors for their own gain, and those who simply wish to destroy. Penny Blood tells the story of a man who must become what he seeks to defeat.", we can read. The fights will combine traditional turns with a system that will ask the player to react quickly"to maximize attacking potential and keep players on their toes in every match", which reminds Shadow Hearts' Wheel of Judgment as a happy coincidence. Not to spoil anything, composer Hirota Yoshitaka is already confirmed with the compositions that already promise to be oppressive, but that his colleague Akari Kaida (Fire Breathing) 3 ) will be softened with a good dose of jazz.Finally, the illustrator Miyako Kato will also ensure the artistic affiliation with Shadow Hearts.
#creators #Wild #Arms #Shadow #Hearts #announce #spiritual #successors
CategoriesScience and TechnologyTagsannounceArmscreatorsHeartsShadowspiritualsuccessorsWild
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I decided to hire Ben Perlmutter after a friend, who was going through a similar situation, referred him. I was detained for driving under the influence on the freeway in the beginning of January. To be completely honest I felt like my world was literally falling apart. I worked so hard to get where I am and felt like I threw that all away in one night. Ben was truly honest, extremely helpful and understanding. He always kept me in the loop of what was going on through phone calls and text ( I was constantly working and barely had time to meet in person which was truly helpful!). He also took care of my dmv hearing, where my license was NOT suspended! I had my court date in mid April. Ben was able to lower the charge from a DUI to a wet and reckless, no community service and no license suspension. The outcome was actually jaw dropping especially with the evidence brought forth against me. I do have to pay a fine and go to classes for 3 months however, my license was never suspended and I was not charged with a DUI. Overall I'm extremely happy with the outcome. I definitely recommend hiring Ben. The outcome would have been completely different if I didn't hire him. I am extremely thankful and happy.
Me and my husband were sued in a breach of contract lawsuit that caused us intense anxiety for about a year until we hired David and Ben. We were so afraid of hiring a lawyer because we didn't want to pay even more money than the high amount we were already being sued for, but David and Ben told us to rest assured that they were going to take care of the case in the most cost-effective way possible. They got to work on the case IMMEDIATELY and turned everything around for us. They called and texted us EVERY time something happened in the case just to keep me informed on every detail. I never had to contact them even once to find out what was going on with the case--this is important to me because my last lawyer was bad at following up. In the end the case settled for much less money than what the plaintiff was asking for (and less than what me and my husband rightfully should have paid). Hiring David and Ben was the best decision. They made one of the most stressful experiences of my life stress free. 100% I would hire them again and recommend everyone I know to them.
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I read the letter but skipped the comments. Her eyes are haunting in that picture in the Times.
Depending on where you are, the comments can be wonderful; I was reading through ONTD, and nearly everyone was supporting her and rallying around her. The vicarious vitriol was also lovely. I made the mistake of reading on Awards Daily, which is primarily an Oscar site, so I don't know why I was surprised that they made it all about the Oscars and Cate Blanchett's chances, etc., but they did. And that wouldn't have even been that bad, but the misogyny and victim blaming and down-right accusations of lying were enough to make me literally sick to my stomach.
I read a bit on this around the net today, the blogs I normally read, as well as some of the older articles from around the time of the custody battle. It was just awful how many pro/con comments fell onto the male/female axis. I don't know what is true, but personally haven't been able to stomach Allen since his marriage to Farrow's daughter Soon-Yi (I think maybe she changed her name?)The heart does what the heart does but you don't have to act on it. Self-denial is the right choice in some cases. There was a case in my immediate family of false accusation of child sexual abuse so I know what kind of hell it puts a family through. But I do believe there are more actual cases than false accusations. More's the pity.
I never liked his movies much, though I went through a phase in college of dressing like Annie Hall. So it's not a problem for me to just not watch him.