text:
Q: UWP Marquee Text Animation Is there a uwp version of marquee text animation.
And I want the same effect like WPF Marquee Text Animation.
When the pointer entered the grid item, marquee text start to animate.
When the pointer exited the grid item, marquee text stop to animate.

A: Here is a UWP version which I wrote based on the answer you provided from here. It's just a demo and you need to customize it yourself to meet your requirement.
Please create a usercontrol first and here is XAML code in the usercontrol:
     <Grid PointerEntered="Grid_PointerEntered" Width="265" PointerExited="Grid_PointerExited" x:Name="mygrid">
        <Grid.Resources>
            <local:NegatingConverter x:Key="NegatingConverter"/>
            <Storyboard x:Name="Storyboard1">
                <DoubleAnimation
                            Storyboard.TargetName="transferCurreny"
                            Storyboard.TargetProperty="X"
                            Duration="0:0:6" From="0"
                            To="{Binding Width,ElementName=canvas,Converter={StaticResource NegatingConverter}}"
                            RepeatBehavior="Forever"/>
            </Storyboard>
        </Grid.Resources>
        <StackPanel x:Name="mystack" Height="500" Background="AliceBlue">
            <StackPanel Orientation="Horizontal" x:Name="stack" Height="100">
                    <StackPanel.RenderTransform>
                        <TranslateTransform x:Name="transferCurreny" X="0"/>
                    </StackPanel.RenderTransform>
                <Canvas x:Name="canvas" Width="{Binding ActualWidth, ElementName=stack}">
                    <TextBlock Text="TestTesting" FontSize="25"  x:Name="txtKron" Canvas.Left="0"/>
                    <TextBlock Text="{Binding Text, ElementName=txtKron}" FontSize="25" Canvas.Left="{Binding Width, ElementName=canvas}"/>
                </Canvas>
            </StackPanel>
        </StackPanel>

    </Grid>

Here is the code behind:
     private void Grid_PointerEntered(object sender, PointerRoutedEventArgs e)
        {
            Storyboard1.Begin();
        }

        private void Grid_PointerExited(object sender, PointerRoutedEventArgs e)
        {
            Storyboard1.Stop();
        }

And the converter:
     public class NegatingConverter : IValueConverter
    {

        public object Convert(object value, Type targetType, object parameter, string language)
        {
            if (value is double)
            {
                return -((double)value);
            }
            return value;
        }

        public object ConvertBack(object value, Type targetType, object parameter, string language)
        {
            if (value is double)
            {
                return +(double)value;
            }
            return value;
        }
    }

And there is a portential problem. I will meet confict problem when I do not set the background of the above mystack stackpanel.

redpajama_set_name: RedPajamaStackExchange


text:
SpotlightCurrent AffairsHistory & CultureEnvironment & WildlifeIdentitiesTravelHealth & WellbeingEconomyArt
The GOYO Fitness Revolution
Team Roar
It's January. You know what that means? It means that practically every gym, jogging track, or bit of open lawn will be packed with joggers, lifters, and crossfitters, carrying yoga mats, earphones and a head full of dreams of six-packs. The top resolution for practically every new year, is to get fit or to lose weight. But only about half of these resolutions last past the first month. It's pretty hard to maintain the willpower and the consistency you need to do something as difficult as keeping fit ‒ unless, that is, you give yourself incentive and accountability by tracking your goals systematically. It's much easier to keep a resolution when you have concrete step-by-step goals and a way to track your progress. This is the reason why wearable fitness technology is so popular. Wearables provide a way to see where you stand in your fitness journey, set realistic goals, and scientifically track your progress using anything from the number of steps you take daily, to your heart rate and your sleep cycles.
Over the last few years, wearable tech has become increasingly popular. Hardware is becoming cheaper, tracking software is compatible with most devices, and the list of fitness functions are broader than ever before. But the majority of Western fitness device brands are still not affordable enough for the general user ‒ costing anything from a hundred to nearly two hundred and fifty dollars for some devices. That's not exactly pocket change for the average Sri Lankan.
Fitness ‒ Lankan Style
A new entrant, however, is trying to change all that. GOYO is a Sri Lanka-based brand looking to revolutionise the way we handle fitness in the island. They have developed a wearable device and an accompanying app to help you maintain a healthy lifestyle and benefit from it ‒ all with a Sri Lankan context (and budget) in mind. The app functions as a personal health advisor, motivating you towards achieving your daily goals. Through the app, you can set goals, track your stats, compete on a Leaderboard for bragging rights, accumulate badges, and maintain your own GOYO fitness profile. The app is available for both Android and iOS, so platforms are not a problem.
Probably the most fun and unique part of the app is the way it incentivises you to stick to your goals. GOYO partners with several local and international brands, so that when you complete a set task on your app, you get a chance to win rewards from GOYO partners. The rewards are all localised and available to anyone with a smartphone. You can get Instant Rewards for signing up and for completing non-challenge related goals. You also get Challenge Based Rewards for completing a challenge within a stipulated time period. Rewards could include discounts and special deals from partners ranging from restaurants to hotels, and travel to lifestyle products and services. What better way to keep to your goals than bribing yourself in true Lankan style.
The Wearable
The wearable connects directly to the app and can carry out a variety of functions. Image courtesy goyo.lk
The wearable itself is sleek and comes in a variety of colours to match your personality. The wearable connects directly to the app and has the hardware to carry out a variety of functions.
Calories ‒ Watch your weight by calculating the number of calories you burn daily.
Step counter ‒ Track the number of step you take
Distance tracking ‒ Know how far you walk in a day
Sleep tracking ‒ The device tracks your sleep patterns so you know how good your rest has been. A good sleep cycle is essential to staying fit.
Heart rate monitor ‒ Continuously measure your heart rate and track your cardio fitness levels during your exercise routines.
Stat display ‒ Get daily stat updates at a glance on the GOYO wearable screen.
Bluetooth connectivity ‒ Stay connected with the GOYO app on your smartphone via the wearable's Bluetooth connectivity. Then monitor all your stats through the app.
The GOYO launch is on the 21st of this month.
GOYO is launching their Sri Lankan fitness ecosystem on the 21st of January at the Arcade, Independence Square, from 4:00 p.m. onwards, at the GOYO Fitness Fiesta. At the event, you'll get to meet the GOYO Partners, engage in a range of fitness activities, win exciting gifts, meet famous personalities and get free advice from health and fitness professionals, along with a host of other fun stuff.
Also at the Fiesta are several Sri Lankan fitness celebrities. You'll get to meet the Natty Muscle SL team and find out everything you need to know about a fitter lifestyle. You can get fit with Yureni Noshika and get your Zumba on with Dharshan, proving that fitness can be healthy and a lot of fun in the process.
The GOYO Fitness Fiesta has several challenges you can complete to win exciting rewards as well. You can post a selfie from the event, hashtagging #GOYO, to stand a chance to win free wearables. You could also win 2 return air tickets from Colombo to Kandy or Sigiriya from Cinnamon Air, or test your strength in fitness challenges to win complimentary gifts. There will be instant rewards for anyone who attends the Fiesta as well, like an exclusive 20% discount on Fuze swimwear, by Rum Punch.
To take part in the GOYO Fitness Fiesta and join in the fun, register online at www.goyo.lk for your free invitation and access to many more rewards. You can also visit their Facebook page here to find out more about GOYO.

redpajama_set_name: RedPajamaCommonCrawl


Reporting directly to the Housing Manager, the selected applicant will be responsible for calling potential hosts to help in the recruitment of host families for this year. The role also includes attending host family recruitment events and street actions across Victoria and surrounding area, to promote hosting EF's international students. Position involves working evenings and weekends.
Participating in EF events, flyering and street action around Victoria and the surrounding area to recruit homestay hosts.


text:
Q: How to get the property name from default setter name? I am trying to figure out the original property name from the setter selector. For example I know that the setter is called setFoo: and would like to get foo. It should be a quite easy string processing task (remove set and change the first letter to lowercase) but I was wondering if there are any out of the box solution somewhere in the Objective-C runtime.
I would like to use it like this:
@interface MyClass : NSObject

@property (nonatomic, assign) BOOL foo;

@end

@implementation MyClass

@dynamic foo;

+(BOOL)resolveInstanceMethod:(SEL)sel
{
    const char* selectorName = sel_getName(sel);
    objc_property_t getterProperty = class_getProperty([self class], selectorName);
    objc_property_t setterProperty = class_getProperty([self class], getPropertyNameFromSetterName(selectorName));
    if (getterProperty) {
        // now I know that the property was declared and I should provide
        // the getter implementation
    } else if (setterProperty) {
        // I should provide the setter implementation
    }
}

@end


and his golfing caddy is the mack daddy.
and Dionne Warwick knows the way to San Jose Cuervo.
that was frigid enough to maker her shiver.
Burt Bacharach's dad was Curt Back O'rack.
He migrated here in a King Biscuit sack.
I'd prefer that it be the one belonging to Lolo Ferrari."


San Jose police officers on Thursday morning tased and arrested a man, who they said is a wanted felon.
The man — believed to be a transient — was stopped near Park Avenue and West San Fernando Street, close to Highway 87 and the Adobe headquarters. It remains unclear whether officers stopped him on foot or in a car, but the man was tased, loaded on a stretcher and taken into custody.
Police said that there is a $100,000 felony warrant out for his arrest. It is unknown what crime he is accused of committing.
Roads in the area were not closed.


text:
If You're a White Woman, You Might Not Live as Long as You Thought
The news is better for women of other races.
By Macaela Mackenzie
We consider ourselves pretty lucky to live in the year 2016. That's because tons of game-changing medical breakthroughs have afforded us the ability to live to a ripe old age. Across the board, people in the U.S. enjoy sky-high life expectancies that are only steadily increasing. That is, unless you're a white woman.
RELATED: The Life Expectancy Gap Between Rich and Poor Women Keeps Growing
According to the latest report from the Centers for Disease Control and Prevention (which covers changes in life expectancy rates from 2013 to 2014), the life expectancy for a white woman living in America just dropped from 81.2 years to 81.1.
That may seem like an insignificant amount (we're talking about a month here), but it could be part of a larger trend. This is the second time this particular demographic has seen a drop in life expectancy rates in the past decade—an anomaly in the upward trajectory we're used to seeing.
Sign up for Women's Health's new newsletter, So This Happened, to get the day's trending stories and health studies.
The news, however, is slightly better for women of other races. The life expectancy for Hispanic women rose from 83.8 to 84 years and stayed steady for black women at 78 years.
So why the drop in only one demographic? Experts speculate that the rise in prescription drug use among white women, smoking rates, and even things like a tough economy might be at play.
RELATED: It's Scary How Many Women Are Becoming Addicted to Prescription Painkillers
Of course, every individual is different, and average life expectancy rates are just that: an average prediction. Still, it's worth paying attention to see if this downward trend continues.
Macaela Mackenzie Macaela MacKenzie is a journalist covering women's equality.
Sia Opens Up About Her Mental Health And Relapse
People Swear By These SUPER Comfy Period Panties
Jamie Chung Got Real About Postpartum Depression
Amy Schumer On Endometriosis And Liposuction
Tess Holliday Pens A New Essay About Her Anorexia
Jenna Jameson Hospitalized With An Unknown Illness
'How Love Island Helped Me Realize I Had Lipedema'
What Kind Of Face Mask Does The CDC Recommend?
Here's How To Order Free COVID-19 Test Kits Online
Bella Hadid Gets Candid About Coping With Anxiety
The Best—and Worst—States to Live if You're a Woman
If You Live In One Of These States, You Might Be More Likely To Contract An STD
FYI Ladies: This Is How Long Ebola Can Live in Semen
If You're the Only Woman Up for a Job, You're Sh*t Outta Luck
9 Thoughts Every Woman Has Had At The Gynecologist
This Test Can Give You an Idea of How Long You'll Live


text:
Tag: imagination
Characters in movie
Your character should have a goal in the story. It can be long term or short term goal. While this character is trying to achieve this goal you need to add some spice. You need to some twist, drama , action or suspense to make this goal doable or not.
Ok writers let's get to work . 2014 is coming lets get some good movies on the big screen.
Qualities of a Producer
"Producers are highly self-motivated individuals, who have the final responsibility for all aspects of a film's production. It is mentioned the Producer monitors the film from birth to completion and beyond, starting long before the film-making process and continuing to talk about and sell the picture long after everyone else has gone on to other projects."
What is the job?
Their primary responsibility is to foster an environment in which the creative talents of the cast and crew can flourish – Producers are therefore ultimately accountable for the success of the finished film.
Pre-production – Producers typically select and bring together the key members of the creative team, including the Director, Cinematographer & Production Designer and potential key cast members. They assist the Executive Producers to raise finance for the production and, once the initial finance is in place, they select other key production office personnel as well as the essential Heads of Departments. Producers also approve locations, studio hire, the final shooting script, production schedule and budget. More time and money spent in pre-production can reduce time and money wasting in production.
Post-production and marketing – Producers are expected to liaise with the Director and post-production departments, including editing – both picture and sound, music and visual effects. The Producer will deal with the finance and distribution companies in planning the marketing and distribution of the finished film.
Please look for us soon www.mickiraproductions.com" in the near future. This is definitely us and an ideal goal for any producer with a great team.
Read more…. http://www.creativeskillset.org/film/jobs/production/article_3876_1.asp
Where do movies originate from
Film affects many lives in different ways. The film industry can control as much of its success because people try to relate to the storyline and see themselves in the storyline or a specific characters. Audience often choose a movie because they want it to make them feel a certain way. Since we as people are easily persuaded by media, we're safe to explore many situations that might be impossible or in some cases too overwhelming to face in the real world. Is this how Reality shows became so popular? Are people escaping their own reality through film or looking for help in their own situations?
"In some cases therapist are using movies as a therapeutic tool to help their clients to express their feelings." I find this statement interesting as I an employee at Mickira Productions is studying Sociology now in school. Some say they are finding that it is beneficial for some individuals that struggle with the ability to communicate their emotions and concerns. This technique is called Cinema Therapy or Movie Therapy. Many should know its a tool for help but not an answer to the patients issues.
I am sure many of us find it interesting how familiar some of these scripts and characters are to our own family. How often have you said "I could write a movie about our family?" Where do you think movies originate from?Hmm…p
What are some of your favorite family movies?
"are old movies more creative than new ones?"


text:
Sofija Mihajlovna Čiaureli, znana pod profesionalnim imenom Sofiko Mihajlovna Čiaureli (gruzijski: სოფიკო მიხეილის ასული ჭიაურელი, ruski: Софико Михайловна Чиаурели) (Tbilisi, 21. svibnja 1937. – Tbilisi, 2. ožujka 2008.) sovjetska i gruzijska je filmska i kazališna glumica. Dva puta je bila narodna artistkinja, 1976. godine narodna artistkinja Gruzijske SSR, a 1979. godine Armenske SSR. Smatra se da je bila muzom Sergeja Paradžanova. Imala je važnu ulogu u gruzijskome kazalištu u 20. stoljeću te je asocirana s dva najvažnija gruzijska kazališta: Gruzijskoga kazališta "Šota Rustaveli" u kojem je djelovala od 1964. do 1968. godine i Tbiliskoga narodnoga kazališta "Kote Mardžnšvili" u kojem je djelovala u dva navrata, od 1960. do 1964. i od 1968. do 2008. godine.

Životopis
Sofiko Čiaureli rođena je 21. svibnja 1937. u Tbilisiju, glavnome gradu Gruzijske SSR. Diplomirala je na moskovskome Svesaveznome državnome institutu kinematografije 1960. godine. Nakon završetka studija vratila se u Tbilisi. Od 1960. do 1964. godine bila je glumica u gruzijskome kazalištu "Šota Rustaveli", od 1964. do 1968. godine u Tbiliskome narodnoga kazališta "Kote Mardžanšvili", a od 1968. do svoje smrti 2008. godine ponovno u gruzijskome kazalištu "Šota Rustaveli".

Živjela je u Tbilisiju u kući svojih roditelja (danas Ulica Verike Andžaparizde 16, kuća-muzej Verike Andžaparide i Sofiko Čiaureli). Od 2003. godine bila je umjetnička voditeljica kazališta "Veriko".

Bila je delegatkinja 9. saziva Vrhovnoga sovjeta SSSR-a od 1974. do 1979. godine kao predstavnica južnoosetijske autonomne oblasti.

Godine 1975. bila je sutkinja na 9. Moskovskome međunarodnome filmskome festivalu.

Umrla je u rodnome Tbilisiju 2. ožujka 2008. godine u 70. godini života od duge i teške bolesti. Pokopana je u Didubenskome panteonu u Tbilisiju pored muža Koteja Mardžanova.

Obitelj
 Otac: Mihail Čiaureli
 Majka: Veriko Andžaparizde
 Braća: Otar i Ramaz Čiaureli
 Muževi: Georgij Šengelaja (s njim je imala dva sina: Nikolaj i Aleksandar Šengelaja), Kote Mardžanov
 Sinovi: Nikolaj i Georgij Šengelaja
 Unuci: Natalja i Georgij
 Georgij Danelija joj je rođak s majčine strane (Veriko Andžaparizde je sestra njegove majke)

Izabrana filmografija
 Hevrsurska balada (Хевсурская баллада, 1966.) ... Mzeqala
 Boja šipka (Цвет граната, 1968.) ... mladi pjesnik / pjesnikova ljubav / pjesnikova muza / pantomimičarka / anđeo / luda monahinja
 Ne žaluj (Не горюй!, 1969.) ... Sofiko
 Drvo želja (Древо желания, 1976.) ... Pupala
 Alibaba Aur 40 Chor (Приключения Али-Бабы и сорока разбойников, 1979.) ... Zamira, majka Ali Babe
 Potraži ženu (Ищите женщину, 1983.) ... Alisa Postic
 Legenda o Suramskoj tvrđavi (Легенда о Сурамской крепости, 1985.) ... Stara Vardo
 Milion u bračnoj košari as (Миллион в брачной корзине, 1985.) ... Valeria
 Ashug-Karibi (Ашик-Кериб, 1988.) ... Mama

Nagrade
 Narodna artistkinja Gruzijske SSR, (1976.)
 Narodna artistkinja Armenske SSR, (1979.)
 Najbolja glumica Svesaveznoga filmskoga festivala (1966., 1972., 1974.)
 Najbolja glumica Filmskoga festivala u Locarnu, (1965.)
 Državna nagrada SSSR-a (1980.)

Izvori

Vanjske poveznice
 Sofiko Čiaureli na IMDB-u
 Sofiko Čiaureli na Find a Grave-u
 Sofiko Čiaureli u Velikoj ruskoj enciklopediji

Gruzijski filmski umjetnici
Gruzijski scenski umjetnici
Filmski glumci
Kazališni glumci

redpajama_set_name: RedPajamaWikipedia


text:
La Asociación Psicoanalítica Estadounidense (American Psychoanalytic Association o APsaA) es una organización de psicoanalistas de los Estados Unidos que forma parte de la Asociación Psicoanalítica Internacional. En la actualidad tiene aproximadamente 3500 miembros.

La ApsaA fue fundada en 1911. Tras el exilio durante el holocausto de varios psiquiatras judíos de renombre, la APsaA se convirtió en una organización psicoanalítica con una importante presencia en los años que siguieron a la segunda guerra mundial. Hasta la aparición de estudios que pusieron en duda la eficacia del psicoanálisis en la década de 1960 y la aparición de una variedad de psicoterapias nuevas y de tratamientos farmacológicos después de la década de 1970, el psicoanálisis ocupó un lugar predominante en la saludad mental, con una fuerte presencia en el ámbito académico y cultural en el que la APsaA y la API tuvieron una gran influencia.

No obstante, este florecimiento del psicoanálisis fue acompañado por políticas conservadoras en algunas áreas. Así, por ejemplo, hasta los inicios de los años 90, la APsaA impidió que aquellos que no fuesen psiquiatras, psicólogos homosexuales y los que no estaban dispuestos a aceptar la ortodoxia técnica formaran parta de la organización.

Muchas de estas restricciones fueron abandonadas posteriormente y la organización acepta en la actualidad a psicólogos y trabajadores sociales en mayores números, aunque son cada vez menos las personas que requieren la afiliación. La organización hace frente a desafíos significativos y dejó de ocupar un lugar tan notorio en lo que respecta a la salud mental. Mientras que las psicoterapias se volvieron cada vez más populares, la vigencia del psicoanálisis ha disminuido por diversas razones, que incluyen el costo y la duración de la terapia y la crítica de la comunidad científica por la falta de apoyo empírico de sus teorías y su efectividad.

Referencias

Véase también
Asociación Psicoanalítica Internacional
Psicoanálisis
Homofobia

Enlaces externos
 Sitio oficial de la Asociación Psicoanalítica Estadounidense
 Sitio oficial de la Asociación Psicoanalítica Internacional

Organizaciones profesionales
Asociaciones u organismos ligados al psicoanálisis


I know we have multiple threads going on right now but I just didn't think my question fit anywhere else.
I had planned to testify this year but the hearings being so early and spread out is really conflicting with some issues at work. I think I am only going to be able to take off one day.
Which hearing would my non-expert testimony be most beneficial? Which day or chamber would be the best use of time.
I will come down after work on every day I'm available.
Btw: I will still be doing the normal email bombs and I addressed 40 members of our club at last weeks meeting showing them how to use 2A Maryland, MSRP and MSI websites to learn about these bills and how to reach our legislators by email.
Very good post. We need a thread, that will help those of us who are testifying, get a plan of action on the facts we want to hit the dumbs hard with.


The line that extends along the margins of two sclerites where they are connected to each other by conjunctiva.
The line of separation is a line.
The line of separation is part of the integument.
line of separation by Miko, I. 2009. -2014 Curator. Hymenoptera Anatomy Ontology.
articular line by Ronquist, F., and G. Nordlander. 1989. Skeletal morphology of an archaic cynipoid, Ibalia rufipes (Hymenoptera: Ibaliidae). Entomologica Scandinavica, Supplement 33:1-60.


text:
we care.
Saxon Event Calendar
we cultivate.
We Are Saxon
Meet Your Advisors
The Saxon Way
we empower.
Return on Relationship
Managers and employees have different attitudes about their COVID workplace
Managers and employees have always had different attitudes about work, and the COVID pandemic has widened that gap even furthur. This divided workforce means most managers believe in the support their company provides, while fewer employees think their employer genuinely cares about them.
Seventy-seven percent of managers feel like their employer genuinely cares about their overall well-being, compared to only 55% of employees, according to a recent survey from Limeade, an employee engagement platform. Similarly, 78% of managers feel as though their employer has engaged in initiatives or offered services to support employee well-being since the start of COVID, compared to 66% of employees.
"This pandemic has not only added to stressors in our life, it's also taken away some resources we've all relied on, like spending time with loved ones, building relationships with coworkers, and getting to explore the world around us," says Reetu Sandhu, senior manager of the Limeade Institute. "You can see this in the drop that both groups report for their well-being."
Pre-pandemic, 96% of managers and 86% of employees said that they had favorable well-being levels, Limeade found. However, since the start of the pandemic, those figures have plummeted to 73% of managers and 59% of employees reporting positive well-being.
In a recent one-on-one interview, Sandhu shared what these discrepancies mean for employers and how companies can work to close the gap between employee and manager attitudes in the workplace.
How has the pandemic increased the disparity between managers and employees in the way they view their employers?
The pandemic has emphasized factors that have always been there. Consider power dynamics, for example. Managers are in a position of power that grants them additional permission to prioritize their well-being. This was evident in the findings too — 83% of managers felt comfortable asking for a day off to support their own well-being compared to just 68% of employees. If employees didn't feel adequately empowered, supported and even expected to prioritize their well-being before the pandemic, they're only going to continue to fall behind during the pandemic.
Why does this discrepancy exist in the first place?
Organizations haven't always recognized their role in employee well-being. Unfortunately, companies are only now facing the reality that factors such as power dynamics and organizational norms can have significant impacts on employees. Now, in the face of a pandemic, organizations are scrambling to find the answer. But we can't expect it to just happen — we need to really consider the employee perspective. Our study revealed that 70.8% of managers feel that since the outbreak of COVID-19, their one-on-ones with their direct reports have focused more on discussing their well-being at work. Only 33.6% of employees actually feel like that is the case.
This disconnect highlights that managers may not be equipped with the resources to lead these conversations, or perhaps there is a gap in trust present in these relationships for genuine conversations about well-being to occur. This isn't to say that managers do not care. We found that 84% of managers said they feel at least "somewhat" responsible for whether their direct reports experience burnout or not. Instead, it highlights that organizations are missing the mark in enabling both managers and employees to feel supported, cared for and safe to communicate honestly and openly about their experiences.
What can employers do to make all employees feel supported and cared for?
When employers invest in giving managers support, this pays out in dividends, as managers are then enabled to support their employees. Managers can think creatively about demonstrating care to their employees. This can include sending them a gift or a pick-me-up, asking intentional questions about how they or their families are doing, scheduling time for team connection and bonding where work is not an agenda item. Managers can declare a team well-being day, or celebrate the work that is being accomplished despite the tough times we are in. These seemingly small moments of care make an incredible impact on people.
It is very important that people feel as though they can speak openly about their work experience with HR and their managers. Managers, leaders and even peers need to establish trust within organizations and ensure that open communication is welcomed and not tied to any negative consequences. Then, and only then, will employees feel the safety and support they need.
Authentic care is the most impactful resource an employer can offer. Only when these efforts are genuine, will organizations see the direct benefits these offerings and open conversations have in supporting employee well-being. As a manager, don't just say you want your team to prioritize their well-being — hold them to it just as you would their performance. This communicates that you take it seriously and want to support in a serious way.
SOURCE: Schiavo, A. (28 December 2020) "Managers and employees have different attitudes about their COVID workplace" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/managers-and-employees-have-different-attitudes-about-their-covid-workplace
by 6dhannah
6 ways technology changed the workplace in 2020
Without technology, working remotely during a global pandemic wouldn't have been possible. But it also helped employers overcome unforeseen obstacles created by this new reality.
To help maintain social distancing, 42% of the U.S. workforce has been working from home, according to a study conducted by the Stanford Institute for Economic Policy Research. While working remotely has helped quell the spread of COVID, it's caused new challenges for the workforce: balancing work while caring for children or the elderly, deteriorating mental health, lack of opportunities to network — the list goes on.
Despite the promising news of vaccines pointing to changes in 2021, remote work is here to stay. Employers including Dropbox and Wikimedia Foundation have all announced options for employees to work from home permanently, and Wells Fargo and Apple have extended remote work until the summer.
Professional training and coaching:
BetterUp, a mobile-based professional coaching platform, is teaming up with NASA and the Federal Aviation Administration, in its first partnership with government agencies to provide their employees with personalized professional coaching.
In the coming months, the FAA and NASA will roll out BetterUp's professional coaching to supervisors and executives. At the individual level, employees will gain unlimited access to one-on-one professional coaching, accessible via any computer or smartphone. Employees will have access to a digital library that includes thousands of resources designed to reinforce coaching session topics.
"Our evidence-based coaching approach has been linked to significant behavioral gains in areas such as resilience, strategic planning, stress reduction, and the ability to lead teams," says Alexi Robichaux, CEO and co-founder of BetterUp. "Our goal with NASA and the FAA is to serve as a tool that will enable employees to better thrive as individuals and inspire others as leaders."
Telehealth:
Catapult Health launches new virtual program to improve access to preventive care
As the pandemic has triggered delays in both preventive and elective care, employers are turning to telehealth services to keep their workforce healthy and happy, and prevent the development of chronic disease.
Catapult Health, a provider of onsite and virtual preventive healthcare, has launched a new program called VirtualCheckup, through which employers can offer preventive care to their employees and family members anytime and anywhere.
"Over the past months, people are kicking the can on their chronic conditions," says David Michel, CEO of Catapult Health. "Individuals that we're seeing now have not been to their doctors in several months. They've been scared to go. So we're able to reach people where they are in this critical time and offer a solution that's very thorough and very simple for them to do."
Gamifying training, onboarding can help boost engagement for Gen Z
As young workers get more technologically advanced and the workforce continues to embrace remote work, training and onboarding processes are vital for getting employees up to speed. But 38% of HR professionals say that remote onboarding is harder than in-person onboarding, and only 9% say that it is easier, according to a recent survey by the HR Certification Institute and MindEdge Learning.
With remote work here to stay for the foreseeable future, tech will play an increasingly large role, says Matt Fairhurst, CEO of Skedulo, a software and workforce management company.
"It's about how to come up with and quickly implement really interesting technologies that help encourage the connectedness and engagement of employees," Fairhurst says. "Not as a method of discipline, but simply as a way to lean into the expectations that remote workforces have — which is an incredible desire for engagement and connectivity across the organization."
Virtual mental health care:
With stress, anxiety and burnout on the rise, employers are seeking new ways to support workers struggling with poor mental health during the coronavirus pandemic.
Lyra Health, a mental benefits provider, is adding the Calm app to their benefit offerings to help manage the added stress. Over 1.5 million employees will have access to the popular resiliency training app, as the new partnership expands mental health support to employees who may be resistant to more traditional modes of therapy.
"The urgency has never been greater than it is now to provide holistic mental health services," says Joe Grasso, clinical director of partnerships at Lyra Health. "It's a way to support people who maybe aren't ready to engage in therapy but want to dip their toe into some kind of wellness support."
Workplace safety:
New tool tracks COVID-19 geographical risk to pinpoint when employees can return to work
As new COVID-19 hotspots continue to pop up across the country, employers may be hesitant or unsure of how to proceed with potential reopening plans.
Health Advocate, a provider of health advocacy, navigation, well-being and integrated benefits programs, has launched a return-to-work solution called Return Navigator to help employers understand the critical components of how and when to return.
"For organizations planning the transition back to the workplace, safety and health are top priorities. However, it is challenging to determine the right timing and approach to have employees return," says Arthur Leibowitz, chief medical officer and founder at Health Advocate. "By combining these valuable tools, employers can make more informed decisions about developing and implementing their return-to-work strategy."
SOURCE: Webster, K. (23 December 2020) "6 ways technology changed the workplace in 2020" (Web Blog Post). Retrieved from https://www.benefitnews.com/list/6-ways-technology-changed-the-workplace-in-2020
Zoom meeting fatigue: How to maintain productivity in the grind of WFH
Let's face it: like everything else COVID-19, many leaders, their team members and clients are a little sick of Zoom meetings. What started as a useful tool — with a little bit of novelty — has now become yet another reminder of the grind that is just one part of the coronavirus pandemic.
The somber reality for many is that working-from-home will remain a reality for at least another three-to-six months. The very real challenge for leaders in small and large companies alike is keeping our work teams and clients engaged in what seems like an endless remote working model.
While there are many perks to working remote (no one misses commuting), what is lost is the physical connection needed to foster relationships among team members and clients. We have all come to recognize that those in-person meetings or deskside chats really did bring something important to a productive workplace.
Plus, mental health professionals have found that a lack of physical connection with co-workers can lead to feelings of isolation and disconnectedness. These psychological stressors can negatively impact team performance or a client relationship.
It is critically important that leaders recognize and find creative ways to overcome the not-so-virtual burnout to engage effectively with colleagues and customers, while also remaining productive. Here are just a few ways to foster personal connections and maintain workplace energy that are essential keys to overall business success.
Recreate your standing videoconference. Still running off the same meeting agenda and structure that has been in place since last March and April? It's time to retool the meeting and, literally, flip the agenda. Rotate meeting facilitators among team members. Incorporate some comic-relief like a video of the week or a rotating share of childhood photos or "hair fails." Changes can bring a fresh mindset when serious work is discussed.
Schedule meetings that aren't strictly about business. When we all worked in the office, we found time for breaks – whether that was the occasional pizza lunch, happy hour or just a conversation in the hall. So, schedule occasional meetings that have nothing to do with work, but instead focus on developing relationships and camaraderie by playing games such as Scattergories. Bring teams and customers together who share interests in movies, music, hobbies, outdoor activities or sports to compete for prizes – this can go a long way toward strengthening connections.
Bring back the deskside check-in. Not all meetings are created equal. While many organizations have successfully transitioned to virtual meetings, it has come at the expense of quick conversations in the kitchen or casual stopping by a client's office. Bring this back with 10-minute one-on-one check-ins on a singular topic at least once a week. And don't limit it to business matters only – the sky's the limit on what you and a colleague can chat about!
Bring back the phone call. It can be easy to unconsciously power through the day with little-to-no personal contact other than emails or text messages. Engaged managers should set aside time daily and weekly to reach out and connect with teammates and clients with a simple phone call. They don't have to be long – they should also sincerely ask this question: "how are you and how can I help?" This keeps the lines of communication open and demonstrates to team members and clients that their interests remain top of mind.
Set virtual "office hours." Professors regularly hold office hours where students are able to stop by to ask questions about an upcoming exam or a specific assignment. Why can't a similar concept apply to the workplace? Hosting regular "office hours," where clients and team members know they can pop into a Zoom room or chat via phone, eliminates confusion and boosts overall engagement. It also helps brokers continue to build out their business pipeline, especially as open enrollment season comes to a close.
The work-from-home environment isn't going away any time soon — in fact, it may not be until the second or third quarter of 2021 before a sense of normalcy reenters the corporate world. Until then, it's important that brokers do everything they can to foster engagement with team members and clients. It is a number-one priority for any top-performing team and broker.
SOURCE: Word, J. (28 December 2020) "Zoom meeting fatigue: How to maintain productivity in the grind of WFH' (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/zoom-meeting-fatigue-how-to-maintain-productivity-in-the-grind-of-wfh
The top tool for retaining your working parent population
When Allison Whalen returned to her job following her first maternity leave in 2017, she felt "completely overwhelmed" by the lack of supportive resources available to guide her through the leave and return-to-work process.
"I ended up getting through that first three months back at work and I realized there were about 50 things that I wish someone had told me before I'd even been on leave," says Whalen.
Whalen says she felt lost in understanding how much child care she would need before and after returning to the office, and felt left behind on her professional development.
After returning to work for a previous employer, Whalen knew something needed to change for working parents going out and coming back from leave. She started Parentaly a parental leave benefits company, in order to help employers streamline the process of getting new parents back to work.
Parentaly provides companies and workers with tools, coaching and resources that help working parents navigate the before and after of parental leave, without sacrificing their career and helping the organization retain its talent.
These benefits became even more critical during the pandemic. Whalen herself experienced her second maternity leave this summer, and having a plan for how she would navigate this time helped her stay productive. Remote work due to COVID was an added bonus for both her and her spouse, she says.
"My second maternity leave was a way better experience because I had made a plan that around six weeks postpartum, I wanted to start spending about two to four hours a week doing work," Whalen says. "That was possible because [my husband] wasn't commuting and he had breaks in between meetings where he could take a walk [with the baby]. We could plan because he was there."
While the pandemic has been a huge challenge for working parents, more flexible work arrangements have actually been beneficial to their overall productivity. Thirty percent of the working parents reported an increase in productivity during the pandemic, according to research from Rutgers University. Overall, 94% of employers say that even with employees working remotely, productivity was the same as or higher than it was before the pandemic, according to Mercer, an HR and workplace benefits consulting firm.
But flexible scheduling is just one part of the puzzle for employers wanting to support working parents. Companies that invest in employees and their families with benefits prioritizing their unique challenges see 5.5 times more revenue growth thanks to greater innovation, higher talent retention and increased productivity, according to research by Great Places to Work and Maven Clinic, a health services provider that supports women and families with their fertility, maternity, and pediatrics needs.
"So much of this comes down to productivity," Whalen says. "[It's about] how parents teach themselves to improve their productivity and then how the culture of the organization supports that productivity."
To keep employees engaged and committed to work while juggling their home responsibilities, paid parental leave is a key place to start when employers look to boost their benefits for working parents. Microsoft offered employee parents 12 weeks of paid time off in order to help them deal with COVID-related school closures. PwC also updated its child care benefits to help parents deal with working from home and virtual school.
While workplaces often focus on maternity leave benefits, it's critical they provide holistic support for parents at every stage of life, says Kate Ryder, founder and CEO of Maven Clinic.
"The best companies really look at parenthood as a journey. It's not just about the nine months of pregnancy," she says. "It's not just maternity, but it's fertility, return to work coaching [and] finding backup child care."
As employers look ahead toward 2021, it's critical they continue leading with empathy and understanding for working parents.
"The experience of being a working parent during COVID has been intensely difficult and stressful," Whalen says. "I am hopeful that this experience will result in some major improvements in the longer term for me, namely a reduction in volume and duration of work travel, increased flexibility to work from home, and improved child care benefits."
Whalen plans to encourage every employer she works with to provide more paid leave and greater flexibility and support when it comes to re-onboarding working parents coming back from leave. These actions now will benefit companies in the long-run.
"COVID has highlighted the importance of focusing on productivity over activity and so we are doing a lot of work focusing on how to work smarter, not harder," Whalen says. "The companies that will come out on top over the next one to two years are the ones that will continue to invest in developing and retaining top talent during and through this pandemic."
SOURCE: Schiavo, A. (22 December 2020) "The top tool for retaining your working parent population" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/parental-leave-and-other-family-planning-benefits-will-be-a-key-investment-in-2021
HR checklist: 5 things to-do before the new year
2020 has been… a year. But before HR professionals look hopefully to the future, they need to tie up loose ends to ensure their workforce starts the new year off on the right foot.
"This has been a strange year, and a stressful one for both employees and their companies," says Tauhidah Shakir, vice president of human resources and chief diversity officer at Paylocity, an Illinois-based HR software company. "Anything you can do to get ahead of things to wrap up this year is going to help alleviate that stress and get everyone off to a good start."
The pandemic has caused a lot of stress in the workplace. In November alone, 42% of Americans reported experiencing cases of anxiety or depression, according to the Centers for Disease Control and Prevention. As an HR manager, Shakir believes that staying organized, and helping employees through end of year changes will help alleviate stress for everyone. To help other employers cope with these unprecedented times, she created an end of the year to-do list to help other HR professionals stay on track.
Note last payroll date
"Keep an eye on the payroll process, and be sure to note the first day of the New Year falls on a Friday so it doesn't take you by surprise," Shakir says. "You have to make sure people are getting their sick and bonus time. Have it all plotted out so you're not rushing at the last minute."
"This isn't like any other open enrollment; HR needs to over communicate what benefits they're offering, and which ones are going to help their employees the most," she says. "We don't know how much things are going to change in the New Year; make sure employees are prepared by making them aware of any mental health, financial wellness and other benefits that can help."
"Since many of us are not all working in the same space right now, this is the perfect time to switch the workforce over to a completely paperless documentation process," Shakir says. "Email employees their end of year documents; it's going to be a lot less stressful than them waiting for it to come through the mail."
"This year presented a lot of challenges for everyone, and you're going to want to take any lessons learned into the New Year," she says. "You're looking for lessons learned, ways to improve to make benefits more accessible to employees. There's always room for improvement, so be sure to be open to what employees are telling you."
"A lot of employees are fatigued about working from home and feeling like they have no control right now," Shakir says. "Remember employees have a lot on their plate right now, especially with the winter holidays going on, so be kind and flexible about when they work so they can juggle all their responsibilities."
SOURCE: Webster, K. (16 December 2020) "HR checklist: 5 things to-do before the new year" (Web Blog Post). Retrieved from https://www.benefitnews.com/list/hr-checklist-5-things-to-do-before-the-new-year
5 tips for a work-from-home holiday
Unfortunately, this holiday season will not offer a respite from the pandemic. Vaccination and a return to normalcy are on the horizon, but they won't arrive before the end of the year. In fact, the cold temperatures and increase in travel during the holidays are forcing experts to urge caution and predict the worst. Under these circumstances, holiday work gatherings are foolish and even keeping the office open feels unwise. That doesn't mean, though, you have to shut down the holiday spirit.
You already have the tech in place for a remote holiday experience. You've gotten used to Zoom, even if you're not in love with it. When you know how to lead in a work-from-home environment, emceeing a party is no biggie. Is it as fun as a party in the flesh? Probably not, but it can still be fun all the same. Here are a few tips to ensure you do just that.
Prioritize safety
This tip is a no-brainer if there ever was one. The advice from experts is clear: You should not host an in-person gathering for your holiday party. It's just that simple. As Thanksgiving showed, some people simply cannot resist getting together with their families during this time of year. While you won't be able to enforce prudence in your team member's personal lives, you can surely do so when it comes to company parties. No matter how much you love your annual gathering, no matter how much you've been looking forward to it, you just can't have it as you normally would.
Keep mandatory events brief
At this point, we all know how real Zoom fatigue is. It's one thing when we have to stay in meetings all day for work purposes. However, making people wait on-screen for hours during optional activities is akin to cruel and unusual punishment. To avoid this fate, front-load important games, events, and announcements on the party schedule. Over time, the party should get more formless, allowing people an easy escape if they don't want to hang out for too long. In other words, don't make it like a wedding where everyone needs to wait four hours between the ceremony and the food.
Prioritize interactivity
There are a whole host of ways to bring partygoers together across physical space. From games that work well over Zoom to sending cocktail kits to your team, there's a method of group interaction that will delight your team members. I would recommend not doing anything that's too onerous on the team members themselves. For example, it's better for you to send gifts to the team than to try to organize a virtual Yankee Swap. The latter may be a good idea in theory, but it will run into snags if everyone fails to mail their gifts on time. You'll find more success if you handle that stuff yourself. Also, don't forget to tell team members to expect a piece of mail, lest they open it before the party and ruin the surprise.
Consider alternative ways to say thanks
One upshot of not having an in-person party is that you'll save a ton of money. Consider doing something with this to benefit your team and community. Maybe you want to make a charitable donation on behalf of your firm. Perhaps you'd like to offer some precious extra time off to the folks who've given their all during an incredibly difficult year. Whatever route you choose, these gestures will surely make a real difference in people's lives.
Keep the spirit alive
The holidays, we're often told, are defined by the spirit of generosity and warmth more than by any event or gift. This year will put that maxim to the test unlike any other. Sure, things look a little differently this year, but we can all adapt, overcome, and still partake in the most wonderful time of year.
SOURCE: Vetter, A. (16 December 2020) "5 tips for a work-from-home holiday" (Web Blog Post). Retrieved from https://www.benefitnews.com/list/5-tips-for-a-work-from-home-holiday
5 ways HR can help millennials be smarter than their parents about retirement
Getting younger employees to save for retirement is right up there with getting a finicky child to eat their vegetables. Sure, it's good for them, but it's not always what they want.
Participation rates and average deferral rates in voluntary enrollment plans for workers younger than 35 are well below those of other age groups, indicating that HR teams may need to take extra steps to reach this segment of their employee base, according to data from Vanguard, a leading 401(k) provider.
HR professionals are uniquely positioned to best assist younger workers. The best tack for HR experts to take with millennials in regard to retirement saving is to point out some of the mistakes their parents' generation has made in that area.
These five points listed below can help your younger workforce be better retirement savers than those in their parents' generation.
Help employees understand the destination
When it comes to saving for retirement, a lot of older workers are clearly lost. Younger workers have an opportunity to do a better job of staying on track.
Vanguard's data show the average 401(k) participant within 10 years of retirement age (i.e., between ages 55 and 64) has a plan balance of just $69,097.
That may not provide much help over a retirement of 10 or 20 years.
Caution young staff members that one reason older workers are so badly behind in retirement saving is that they haven't checked first to see where they're going.
A MoneyRates retirement plan survey finds that 71% of workers within 20 years of retirement age still have not done a calculation of how well their savings will hold up over their retirement years.
Encourage your workforce to determine what enough savings is. Inform your staff that it only takes a few minutes to use a retirement calculator to see how much to put aside to meet savings goals. That way, your employees will know where their retirement plan is heading.
Educate employees on how to get debt under control
Saving for retirement is undermined when employees are also building up debt at the same time.
Stress that debt costs more than retirement investments are likely to earn, a dollar in debt can more than counteract the benefit of a dollar in savings.
According to the Federal Reserve's Survey of Consumer Finances, the typical household still has $69,000 in debt by the time the head of that household is within 10 years of retirement.
Notice that this figure almost exactly matches the previously-mentioned amount that the average 401(k) participant in that age group has. In other words, debt can effectively wipe out a person's 401(k) savings.
So, your team's first step toward educating workers about building a more secure retirement should be to do something many in their parents' generation failed to do: get debt under control.
Teach employees how to spread savings to make the burden lighter
Retirement saving is a big job, but younger workers have something very important on their side: time. Emphasize that spreading retirement savings out over 25 to 40 years makes the job much easier.
It gets tougher if young workers do what many of their parents' generation have done--wait and then try to catch up in the last ten years or so until retirement.
The golden rule: Don't leave free money on the table
When employers provide a 401(k) match, all staff should understand there's a direct financial incentive to start saving now. Every time employees put money into their 401(k) plan, the employer kicks in some on their behalf.
If employees don't contribute money into the plan, they don't get this money from the employer. There's no going back in future years and reclaiming that extra money the employer would have put in on the worker's behalf.
The only way not to miss out on this free money is to contribute each and every year— and to contribute enough to get the maximum employer match available.
Show employees the benefits of saving
A dollar saved today can equal $10 at retirement age.
Saving money is hard work, but HR professionals can show their employees that it gets easier when they let their investments do the work for them.
The investment returns earned become much more powerful when compounded over a long period of time. Compounding means earning a return not just on the original money invested, but also on the returns earned in other years.
Younger workers must recognize that a dollar invested today could be worth much more than a dollar invested toward the end of their career.
There are many people of older generations who would be a lot better off today if they absorbed each of these five lessons when they were younger.
SOURCE: Barrington, R. (14 October 2020) "5 ways HR can help millennials be smarter than their parents about retirement" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/ways-hr-can-help-millennials-be-smarter-than-their-parents-about-retirement
New financial benefits give small business employees early wage access
Mandatory quarantines and business closures during the coronavirus pandemic have taken a particularly large financial toll on small businesses, forcing many employers to reduce wages and health coverage.
Sixty-five percent of small businesses said they were either extremely concerned or very concerned about how the coronavirus will affect their business, according to a survey by Freshbooks. In addition to financial pressure, small business employers are also tasked with providing benefits that will support struggling employees.
"COVID-19 just exacerbated what was going on in the market and put even more pressure on small companies and their employees," says Emily Ritter, head of product marketing at Gusto, a payroll and employee benefits platform for small businesses. "Employees across America are living paycheck-to-paycheck and the stress of that can be expensive for households."
Gusto has launched a new set of health and financial wellness benefits to provide employees with early access to earned wages, medical bill reimbursement and a savings account.
These financial tools are especially beneficial as healthcare costs drive many employees into debt, Ritter says. According to a Salary Finance survey, 32% of American workers have medical debt, and 28% of those who have an outstanding balance owe $10,000 or more on their bills.
"Financial health and health coverage is so inextricably linked, which has come into the limelight with COVID-19," Ritter says. "We're seeing that small group health insurance is something that is really important, so if we can help small businesses help their employees with health bills, that's another component of financial health."
Gusto's new benefit offering allows employers to contribute to employees' monthly health insurance costs. Contributions can vary from $100 to amounts that would cover an employee's entire premium. The contributions are payroll-tax-free for the business and income-tax-free for employees, and employers also have the flexibility to adjust their contribution at any time.
"A large portion of American workers say that they wouldn't be able to handle the financial implications of a large injury or illness, and of course illness is top of mind in the midst of a global pandemic," Ritter says. "So it was really important for us to show up with these solutions."
Additionally, Gusto has launched Gusto Cashout, which gives workers early access to earned wages without any fees, helping them avoid having to turn to payday loans, overdraft fees or credit card debt between paychecks. With a new debit card function and cash accounts — which also provide interest — workers can put aside savings straight from their paychecks, helping them better navigate short-term emergencies and unexpected expenses.
Even before coronavirus, less than half of adults living in the U.S. had enough savings to pay for a $1,000 emergency expense, according to a Bankrate.com study, and 50% of employees said they live paycheck to paycheck, a CareerBuilder survey found.
"We're really trying to help people be prepared in those rainy day moments and avoid the debt cycle that happens," Ritter says. "Because this product is free [for our clients' employees] and the wages come out of their paycheck on payday, there is no continuous debt cycle that happens with a payday loan."
Fifty-one percent of Americans feel at least somewhat anxious about their financial situation following the coronavirus outbreak, according to a recent survey from NextAdvisor, and nearly three in 10 Americans' financial situation (29%) has been negatively impacted since the pandemic began.
Providing employees with financial wellness resources and other support can help small business owners build a more efficient and competitive business, despite the challenges faced during COVID, Ritter says.
"It's a win win for their employees and for their business," Ritter says. "When employees are more financially stable, they're able to show up more effectively at work."
SOURCE: Nedlund, E. (13 October 2020) "New financial benefits give small business employees early wage access"(Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/news/new-financial-benefits-give-small-business-employees-early-wage-access
How benefit advisers can hold healthcare plans accountable for their prices
Brokers and consultants already know that much of the growth in health benefit costs is not driven by insurer and TPA rate increases, but rather by the increase in the price and volume of healthcare services. While some of these costs are due to growing survivability rates for serious diseases and therapeutic improvements, much are avoidable, such as expenses associated with unnecessary care and unnecessarily expensive care. Evidence of variability of costs is found in the fact that unit cost and utilization can vary wildly from health system to health system, even within the same market.
Read more: 4 drivers of healthcare costs — and what advisers should do
Just because macro healthcare economics is the primary driver of overall health costs, doesn't mean that health plans are powerless to control price increases. Even though health plans can and do negotiate rates directly with health systems in their networks, too often they don't do everything they can to offer exceptional value to their customers. They don't ask the right questions of health systems, they don't practice thorough utilization management, and they don't contract exclusively with providers who focus on high-value care. In other words, they don't work hard enough to eliminate unnecessary costs or to bring prices down. Instead, they treat them as a given and pass those costs on to their customers.
Navigating these economic realities is challenging, and employee benefit advisers have their work cut out for them as they try to find the health plans that offer the most value for their clients. In order to discern which health plans offer the best bang for member bucks, benefit advisers need to understand the economics of healthcare today, and in particular, the economics of the market in which they operate. They can do this by asking hard questions of health plans and digging into data in order to determine healthcare cost and utilization differences between networks in their area.
Too often, benefit advisers take the whole healthcare market as a given, especially due to the popularity of broad preferred provider organization (PPO) networks, which include almost every system in an area. But the reality is that economics vary dramatically from system to system, so employee benefit advisors need to understand local economics in order to effectively evaluate network differences and find value. They can do this by:
Heavily and skeptically questioning carriers and TPAs to understand their networks and participating providers. Examples of questions to ask include: Tell me your opinion about different health systems in your network? How much do negotiated fees vary for outpatient services, professional services, etc.? Why is a specific expensive provider part of your narrow / high-performance network?
It's also important to ask when a contract with a specific health system is up and if it will be renegotiated soon, since a new contract could include very different rates from the current one. Note that some of the time, carriers will discuss rates as a function of Medicare, but because Medicare DRG rates can vary dramatically from hospital to hospital, an adviser needs to understand Medicare base rates.
Analyzing claims. Every adviser has plenty of these available to them, and they should be analyzing those claims to determine which providers are lower cost and which are higher cost. In particular, it's important to look at outpatient rates, facility rates, and professional rates, by specialty. It's also important to compare the same diagnosis codes across providers. For example, claims could reveal that a hypothetical Dr. Jones operates on 100 patients out of 100, while a hypothetical Dr. Smith operates on only 50 patients out of 100 with the same condition. To figure out why this discrepancy exists, we would have to dig deeper since some doctors or practices may cater to only high-risk patients. Claim data can help shed light on health plan information that is not typically available to the public as health plan rates are often proprietary but appear on claims.
Taking all of these steps will help benefit advisers achieve something essential: holding health plans accountable for their prices. If a health plan doesn't aggressively hunt for high value providers and reward them, you should ask why. And if you don't like their answer, you probably identified a plan that isn't a good fit for your clients because it doesn't deliver on what matters most: quality care offered at an affordable price without compromising coverage.
SOURCE: Cohen, A. (04 November 2020) "How benefit advisers can hold healthcare plans accountable for their prices" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/how-benefit-advisers-can-hold-healthcare-plans-accountable-for-their-prices
Employees are stressed caring for aging parents. How can employers help?
As many employees are caring for parents and close relatives, a balancing act on both physical and mental well being has impacted their work productivity. Read this blog post to learn more.
A growing number of employees are caring for aging parents, parents-in-law and relatives while working full time. One report puts the number of employees caring for aging family members at one in six, while other sources put the number even higher — 73% of employees caring for older family members, with 80% of those employees reporting that they struggle to balance their work and caregiving responsibilities.
This balancing act not only has an impact on employees' physical and mental wellbeing, it also has a significant impact on their employers. But researchers at Harvard Business School found that many employers are not aware of the extent to which caregiving responsibilities are affecting employee performance, productivity and costs.
Only 24% of employers surveyed said caregiving affected employee performance compared to 80% of employees who said it impacted their productivity. One report calculated the cost of lost productivity due to employee caregiving at $33.6 billion per year. The researchers also found that employees were leaving their positions due to caregiving responsibilities, which increased turnover costs. And those who stayed on the job experienced higher rates of absenteeism and presenteeism.
Support strategies for employee caregivers
Employers can offer several resources and benefits to help reduce the stress and physical and mental health impact on employees who are caring for aging family members. These strategies can also decrease the negative effect that caregiving can have on productivity and costs.
Flexible schedules and remote work options: Offering flexible schedules and the option to work from home can help employees fit caregiving responsibilities, like taking family members to doctor's appointments, preparing meals and helping with other activities of daily living into their day with less stress and less missed work time.
Eldercare information and referral resources: These services can help employees find eldercare in their community, connect with other caregivers for support and advice, and learn about financial, health, legal and housing issues they may face as they provide care for aging family members and plan for the future.
Self-care resources for caregivers: The stress of caregiving can increase the risk of health problems including heart disease, diabetes, migraine headache, gastrointestinal problems, substance misuse, anxiety and depression. Employers can help employees better manage stress by offering access to free stress management resources including exercise and meditation classes, caregiver support groups and referrals to online and in-person mental health providers.
Medical second opinions: Managing the healthcare for an aging family member living with complex or serious medical problems such as dementia, cancer and heart failure can be especially difficult, stressful and time-consuming for employees. Access to second opinions can help employees make informed choices about their family member's care and provide peace of mind about their decisions.
Specialist guidance and support: Employers can offer access to navigators and advisors who can help employees ensure that their aging family members' healthcare is coordinated to lower the risk of medical errors, inappropriate care and missed follow-up care. These services can also ensure that their medical records are reviewed and consolidated, which is especially important when people see several physicians. Navigation and advisory services can help employees research medical treatments for their family member, find and connect with experienced specialists and build a plan to address the potential progression of their family member's health issues. Advisors can also help with appointment scheduling, insurance issues and problems with medical bills, all of which can be exceptionally time-consuming and frustrating tasks.
Expand telehealth access: By expanding employees' telehealth benefits to include aging parents and parents-in-law, employers can make it easier for employees to be involved in their family member's care, even if they don't live nearby. Telehealth can also make getting care easier for family members because they don't need to arrange transportation to appointments.
Subsidize back-up care: Consider providing employees with subsidies to help pay for in-home back-up care for aging family members. With this safety net in place, employers can decrease the number of hours employees are absent from work due to caregiving responsibilities.
SOURCE: Varn, M. (28 October 2020) "Employees are stressed caring for aging parents. How can employers help?" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/employees-are-stressed-caring-for-aging-parents-how-can-employers-help
© 2020 Saxon Financial Services. All rights reserved.
Phone: +1 (513) 573-0129 | Toll-Free: +1 (800) 847-1733 | Fax: +1 (513) 774-0252
Copyright © 2020 Saxon Financial Services Communication regarding securities is strictly intended for individuals residing in the states of AL, AZ, CA, DC, FL, GA, IA, IL, IN, KS, KY, MD, MI, NC, NJ, NM, NV, NY, OH, PA, SC, SD, TN, TX, VA, WA, WV. Securities offered through Cambridge Investment Research, Inc., a Broker/Dealer, Member FINRA / SIPC. Investment Advisor Representative, Cambridge Investment Research Advisors, Inc., a Registered Investment Advisor. Cambridge and Saxon Financial Services are not affiliated. Not NCUA insured, not credit union guaranteed, may lose value. No offers may be made or accepted from any resident outside the specific state(s) referenced. Cambridge does not provide tax advice.


Wait, no no. Carbs are friends AND food!
Who here has ever been afraid of carbs? (I, for sure, was! A long time ago, I ain't ashamed to admit it!) But I'm here to tell you today, there's no need to fear the carb.
Let's start with, what actually is a carbohydrate? It is simply a macronutrient in your diet, yielding 4 calories per gram (which is the same amount as protein). Carbs are the main energy source in your body, being broken down in glucose and glycogen, fueling both daily activities and muscle contraction during workouts. Carbs can be broken down into two categories: simple and complex. Simple carbs are easily digestible, causing a quick burst of energy and just as quick of a decrease, and include foods such as refined grains and sugars. Complex carbs are harder to digest, being higher in fiber leading to a more gradual energy spike with little to no crash. Complex carbs include foods such as whole grains and vegetables. Both types of carbs are absolutely ok in your diet! Be sure to have a balance though, and, as long as you hit your fiber and don't go over your carb goals, have some chips.
How many carbs do I need? This is a tricky one. With the craze of the ketogenic diet, the low carb fans are coming back. The ketogenic diet is one that consists of >10% of total calories coming from carbs, 20% coming from protein, and 70% coming from fats. In terms of weight loss, according to the NSCA, keto and normal diets are pound for pound, so it's really up to you. However, the recommendation for carbs in the everyday diet is between 45-60% of total calories. I personally prefer a range between 35-50% of total calories coming from carbohydrates for both myself and clients. The lower end of the range of carbs is for more aggressive fat loss, but I tend to keep my clients around 40%.
Weight loss comes from a calorie deficit, no matter how much of your diet comes from carbs. Protein helps to keep your muscle mass during times of dieting, so that is non-negotiable in terms of keeping in your diet. The rest is up to you, and your personal preferences.
Long story, short: don't be afraid of carbs. They're good for you. Just don't overdo the sugar, and eat your fiber, and you can absolutely incorporate carbs into your diet, while still reaching your goals.


Thanks man, full song is free to download here on Newgrounds!
poor animation... Could be better than this.
After looking at your submissions, I'd have to disagree. Saying something negative that is true is fine, but don't go turning Fox News on all of us.


You must agree to the terms before submitting this form.
I would like to be informed by Bosch Security Systems, Inc. via email or telephone call about my registration for the Customer Care Portal.
I can withdraw this consent at any time by emailing Security.Marketing@us.bosch.com.
* Read more about our Data Security Policy.


text:
About the Tuupala school building process
Markku Pääkkönen, Project Manager 2014–2018
Tuupala school was an interesting project
Tuupala school has been an interesting project in every way. I have been in the field for 35 years but built using concrete. The technique in wood construction was new to the designers, constructors, and contractors, and we faced new challenges every day. The floor structures were challenging, mostly because we had to solve the vibration between each floor of the building. We solved problems with teamwork, and it is safe to say that the outcome speaks for itself.
Weather protection is
The best thing that has happened in the construction in years
The major differences between building with concrete and wood are the lightness of wood in the installation phase as well as the finished surface of the solid wood panels. The construction site was protected from weather, and the building process was unbelievably quiet.
Weather protection is the best thing that has happened in the construction business in years. It should be used in every form of construction, not just when using wood. The project documents state that we must follow the dry chain at the construction site. The CLT panels are delivered to us protected and we unload them covered as well. The construction site was covered by 60 000 m3 of tenting, which provided us with great and safe working conditions.
We discussed carbon binding a lot, and its meaning has only grown since the project. The building stores a lot of carbon, and if it will ever be torn down, it can be repurposed. This was an ecological solution and an answer to the challenges public construction face.
Ecological factors, architecture, and acoustics make this a special place we are happy to introduce to everyone.
Antti Karsikas, Architect
Interesting project for an architect
It certainly aroused my interest and curiosity because CLT solid wood panels were not that known material in public construction at the time. Since the first CLT factory in Finland was set up in Kuhmo, it really was inspiring considering the materials would be manufactured locally using local wood. Designing was just as interesting and exciting bearing in mind that no other architect had not designed a CLT building on this scale. I felt like I had to dive in at the deep end from the beginning.
Solid wood is a
Lighter material
I was positively surprised by the process of building with solid wood. It is lighter as a material which made acoustic planning challenging. The building process itself was more comparable to a traditional element construction and we were able to apply similar rules throughout that process.
The serene atmosphere in the school building is intentional and it is more distinct in open learning environments such as this. Students and the various school activities naturally create a lot of sounds so the foundation itself needs to be peaceful and quiet. When the lobby is untouched and nearly sacred, there are no stimuli to make any additional noise.
There is so much public discussion about carbon binding in construction that this building keeps feeling relevant. Ecological factors and indoor air quality in public construction are constantly relevant topics. This school reflects the values of our architect office as well as my personal principles. In addition to the high-class architecture, this building is ecological, healthy, and local. I personally like to highlight the environmentally friendly characteristics.
Heikki Ainasoja, Structural Designer
CLT as the construction material on this scale was new
Starting this project we knew that using solid wood would bring us a whole new set of challenges to the structural design process. We faced a lot of surprises and while the main areas were well under control, we were fighting small battles from beginning to end. The final product is a team effort and we can be proud of it.
I joined as the structural designer through public bidding. At that point, this was meant to be a concrete school but once the plans changed we were able to adjust our bid to reflect wood construction.
One of the main requirements for a successful project on this scale is
There are not many large public buildings made of wood in Finland which is why my initial thoughts were a little skeptical, but we still wanted to be a part of the project. While we were experienced in wood construction, CLT as the construction material on this scale was new to us.
The scale of structural design in wood buildings is much broader than in traditional construction, where you can rely on standardized structural systems and solutions. Compared to concrete construction we had to start over and the number of details made the planning process more arduous than normally.
The biggest challenges wood brought to the planning process were acoustics and fire safety. The building is class B1, which means that in 60 minutes, the wood can burn about 50 mm unless the wood structure is protected from all sides. That required about 100 mm additional width on each side of the structures.
One of the main requirements for a successful project of this scale is strong teamwork among all parties in the project. Based on the user feedback it is safe to say we were successful. Wood as the dominant material makes the atmosphere special and it is always great to come back here.


We were women of leisure today. Had a nice and simple breakfast at Monamie on the way out of town, with two cups of GOOD coffee. Yum. Since we only needed to go a short (relatively) way today there was lots of lingering and on my part, lolly gagging.
We leap frogged with a woman named Blue Yonder for much of the day but she went on a few miles beyond our stopping point. Here are BY and Tidy Camper at lunch.
And here again stepping over one of the anti-bike/motorcycle contraptions.
The day was pretty uneventful and our total miles ended up being 14 miles. We got into camp about five and fiddled about till dusk.
Today was the first day we've hiked without Dirty Girl as she left yesterday for a five day accupuncture training in Portland. So it's just the two of us to get into trouble. I'm sure we'll manage.
Tomorrow it's a short day of ten miles and a stay over at Casa de Luna. This spot couldn't be more different than the Saufleys and it should be an interesting cultural experience. A full report will be forthcoming.


5 books Creative Director & Founder, Mandy, has recommended in our newsletters!
With summer in full swing, there's nothing we love more than to kick back and relax with a great book in one hand and a glass of something cold in the other.
The Republic of Gilead offers Offred only one function: to breed. If she deviates, she will, like dissenters, be hanged at the wall or sent out to die slowly of radiation sickness. But even a repressive state cannot obliterate desire – neither Offred's nor that of the two men on which her future hangs. Now a hit TV show, The Handmaid's Tale is brilliantly conceived and executed, with a powerful vision of the future which gives full rein to Margaret Atwood's irony, wit and astute perception.
Anita Desai is amongst our greatest and most insightful writers. On the occasion of her 80th birthday, The Complete Stories gathers together the short story collections Diamond Dust and Games at Twilight and the novellas of The Artist of Disappearance, with a new preface from the author. From the icy suburbs of Canada to the overcrowded B&Bs of Cornwall, via the hill towns and cities of India, Anita Desai observes human behaviour unflinchingly but not unkindly, recognising our ordinariness and our strangeness, and capturing both with quiet precision.
The Idiot sees Selin, a tall, highly strung Turkish-American from New Jersey turns up at Harvard and finds herself dangerously overwhelmed by the challenges and possibilities of adulthood. She studies linguistics and literature, teaches ESL and spends a lot of time thinking about what language – and languages – can and cannot do. Along the way she befriends Svetlana, a cosmopolitan Serb, and obsesses over Ivan, a mathematician from Hungary. The two conduct a hilarious relationship that culminates with Selin spending the summer teaching English in a Hungarian village and enduring a series of surprising excursions.
At the age of thirty-six, on the verge of completing a decade's training as a neurosurgeon, Paul Kalanithi was diagnosed with inoperable lung cancer. One day he was a doctor treating the dying, the next he was a patient struggling to live. Kalanithi died while working on this profoundly moving book, yet his words live on as a guide to us all. When Breath Becomes Air is a life-affirming reflection on facing our mortality and on the relationship between doctor and patient, from a gifted writer who became both.
How do you remember the summers of your childhood? For Laurie Lee they were flower-crested, heady, endless days. Summer: Vintage Minis is an evocation of summer like no other - a remote valley filled with the scent of hay, jazzing wasps, blackberries plucked and gobbled, and games played until the last drop of dusk. Lee's joyful and stirring writing captures the very essence of England's golden season. Selected from the book Cider with Rosie by Laurie Lee.


text:
[ Post a Response | Norman Dunn's 'Hebburn and our Neighbours Forum' ]
Rules! No Politics,swearing,derogatory remarks or we delete. Anyone sharing our content on Face Book must credit 'Hebburn and our Neighbours'.
Re: They think they it's all over. For Lilian
Posted by Liz Dance on November 28, 2021, 10:00:17, in reply to "Re: They think they it's all over."
It all takes time to recover Lilian especially when we are older but once Eric is in his own surroundings I am sure he, and you, will feel much better.
They think they it's all over. - Stan Wears November 24, 2021, 13:54:29
Re: They think they it's all over. - Brian November 24, 2021, 14:39:15
Re: They think they it's all over. - Sheila November 24, 2021, 17:29:40
Re: They think they it's all over. - Allan Campbell November 24, 2021, 14:41:40
Re: They think they it's all over. - Geoff November 24, 2021, 15:26:31
Re: They think they it's all over. - Malcolm November 24, 2021, 15:30:33
Re: They think they it's all over. - Jimmy November 24, 2021, 15:43:19
Re: They think they it's all over. - Flora November 24, 2021, 16:55:25
Re: They think they it's all over. - Stan Wears November 24, 2021, 18:45:39
Re: They think they it's all over. - Davy November 24, 2021, 18:42:48
Re: They think they it's all over. - LIlian November 25, 2021, 16:37:39
Re: They think they it's all over. - John Shearer November 25, 2021, 18:09:23
Re: They think they it's all over. - fir Lilian - Liz Dance November 25, 2021, 18:28:19
All the best to you and Eric Lillian - Linda Smith in NZ November 25, 2021, 19:16:09
Re: All the best to you and Eric Lillian - Lilian November 25, 2021, 20:03:05
Re: All the best to you and Eric Lillian - Norman Dunn November 26, 2021, 8:51:06
Re: They think they it's all over. - Tom Barker November 26, 2021, 16:36:00
Re: They think they it's all over. - Bill Wallace November 26, 2021, 22:13:12
Re: They think they it's all over. For Lilian - Liz Dance November 28, 2021, 10:00:17
Re: They think they it's all over. For Lilian - Stan Wears November 28, 2021, 11:58:14
Recommended Local History websites. www.donmouth.co.uk,www.gatesheadeast.co.uk


text:
Treatments for broken kneecaps in adults
Broken kneecaps (patella fractures) account for 1% of all fractures. There are many treatments for these fractures and they can be treated with surgery or conservatively (any treatment where surgery is not used). Conservative interventions can be cast immobilisation, brace, immobilisation by traction and others. Surgery can be open or percutaneous (through a needle), can use metallic or non-metallic implants, and the implants can be wires, screws or plates.
Aim of review
This review aimed to evaluate the effects of different methods for treating kneecap fractures in adults, with or without surgery. The main outcomes we were interested in were patient-rated knee function, pain and complications.
Search results and quality of the evidence
We searched the scientific literature up to May 2014 and found five relevant studies with a total of 169 participants. Participants in these studies were aged between 16 and 76 years. There were 68 females and 100 males; the gender of one participant was not reported. Two studies were conducted in China, and one each in Finland, Mexico and Turkey. All five studies compared different types of surgery or surgical devices. Thus, we found no studies comparing different types of conservative treatment or surgery versus conservative treatment.
The five studies made three comparisons. We judged the evidence available for each comparison was of very low quality. This was because all the trials had design flaws that put them at high risk of bias and the studies were also too small.
What the included studies found
None of the studies reported on health-related quality of life, return to previous activity or cosmetic appearance.
Two studies comparing biodegradable (non-metallic) versus metallic implants found little difference in outcomes (knee pain, adverse events and function) between the two groups. Neither study reported on patient-rated function.
One study compared patellectomy with repositioning of a tendon with simple patellectomy (kneecap is removed) for treating complex kneecap fractures. It found that tendon repositioning resulted in more participants reporting better knee function and fewer participants with pain and limited knee function. One participant had an adverse event.
Two studies found that novel methods of percutaneous fixation (surgery using small incisions to insert the fixation devices) resulted in less knee pain and fewer adverse events (mainly relating to the fracture fixation materials) than open surgery (involving wide incisions). Neither study reported on patient-rated function.
Overall, the evidence is very low quality and is insufficient to draw firm conclusions about the best method of treatment for kneecap fractures. Treatment options must be chosen on an individual patient basis, carefully considering the relative benefits and harms of each intervention and patient preferences. Further research is warranted and should be preceded by research to determine which questions should be prioritised.
There is very limited evidence from RCTs about the relative effects of different surgical interventions for treating fractures of the patella in adults. There is no evidence from RCTs evaluating the relative effects of surgical versus conservative treatment or different types of conservative interventions.
Based on very low quality evidence, biodegradable implants seem to be no better than metallic implants for displaced patellar fractures; patellectomy with vastus medialis obliquus advancement may give better results than simple patellectomy for comminuted patellar fractures; and two novel methods of percutaneous osteosynthesis may give better results than conventional open surgery. However, until conclusive evidence becomes available, treatment options must be chosen on an individual patient basis, carefully considering the relative benefits and harms of each intervention and patient preferences. Further randomised trials are needed, but in order to optimise research effort, these should be preceded by research that aims to identify priority questions.
Fractures of the patella (kneecap) account for around 1% of all human fractures. The treatment of these fractures can be surgical or conservative (such as immobilisation with a cast or brace). There are many different surgical and conservative interventions for treating fractures of the patella in adults.
To assess the effects (benefits and harms) of interventions (surgical and conservative) for treating fractures of the patella in adults.
We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (2 May 2014), the Cochrane Central Register of Controlled Trials (The Cochrane Library, 2014, Issue 4), MEDLINE (1946 to April Week 4 2014), Ovid MEDLINE In-Process & Other Non-Indexed Citations (2 May 2014), Embase (1980 to 2014 Week 17), LILACS (1982 to 2 May 2014), trial registers and references lists of articles.
Randomised controlled trials (RCTs) or quasi-RCTs that evaluated any surgical or conservative intervention for treating adults with fractures of the patella were eligible for inclusion. The primary outcomes were patient-rated knee function and knee pain, and major adverse outcomes.
At least two review authors independently selected eligible trials, assessed risk of bias and cross-checked data extraction. Where appropriate, results of comparable trials were pooled.
We included five small trials involving 169 participants with patella fractures. Participant age ranged from 16 to 76 years. There were 68 females and 100 males; the gender of one participant was not reported. Two trials were conducted in China and one each in Finland, Mexico and Turkey.
All five trials compared different surgical interventions. Two trials compared biodegradable versus metallic implants for treating displaced patella fractures; one trial compared patellectomy with advancement of vastus medialis obliquus versus simple patellectomy for treating comminuted patella fractures; and two trials compared percutaneous osteosynthesis (both procedures were 'novel' and one used a new device) versus open surgery for treating displaced patella fractures. All the trials had design flaws, such as lack of assessor blinding, which put them at high risk of bias, potentially limiting the reliability of their findings. No trial reported on health-related quality of life, return to previous activity or cosmetic appearance.
Very low quality evidence from two trials (48 participants) comparing biodegradable versus metallic implants indicated little difference between the two interventions at two-year follow-up in the numbers of participants with occasional knee pain (1/23 versus 2/24), incurring adverse events (3/24 versus 1/24) or with reduced knee motion (2/23 versus 2/24). Neither trial reported patient-rated knee function scores. In one trial, as per routine practice, metallic implants were removed one year after surgery (four participants). The other trial did not report on this aspect.
Very low quality evidence from one trial (28 participants) indicated that compared with simple patellectomy, patellectomy with advancement of vastus medialis obliquus surgery for treating comminuted patella fractures resulted in more participants with a 'good' result based on a subjectively rated score (12/12 versus 11/16; risk ratio (RR) 1.42, 95% confidence interval (CI) 1.01 to 2.01), fewer participants experiencing knee pain (5/12 versus 13/16; RR 3.11, 95% CI 1.01 to 9.60) and more participants with unlimited activity and no loss in quadriceps strength at four-year follow-up. The only adverse event reported was a patellar tendon subluxation in the simple patellectomy group.
Neither trial comparing percutaneous osteosynthesis (using novel devices or methods) versus open surgery reported on patient-rated knee function scores. Very low quality evidence from two trials (93 participants) showed that percutaneous osteosynthesis improved knee pain measured using visual analogue scale (0 to 10 where 10 is worst pain) at one month (mean difference (MD) -2.24, 95% CI -2.80 to -1.68) and at up to three months (MD -1.87, 95% CI -2.45 to -1.29). This effect did not persist at six months (very low quality evidence from one trial). Very low quality evidence from the two trials showed significantly fewer participants with adverse events (loss of reduction, infection, hardware complications, delayed wound healing) after percutaneous surgery (8/47 versus 28/46; RR 0.28, 95% CI 0.14 to 0.55). Very low quality evidence from the two trials indicated better clinician-rated knee function scores after percutaneous fixation at two to three months and 12 months follow-up; however, the between-group difference was not clinically important at 24 months. Very low quality evidence showed a lower incidence of hardware removal in the percutaneous group at two years; however, the results in the two trials were heterogeneous and the reasons for removal were not given in detail.
Treatments for broken ankles in children
Surgery or non-surgical treatment for broken heel bones
Interventions for treating defects of the joint surfaces of the ankle bone in adults
Surgical interventions for treating distal tibial fractures (breaks of the lower end of the shin bone) in adults
Treatments for breaks in the lower part of the thigh bone in adults
Orthopaedics & trauma > Fractures > Bones of appendicular skeleton
Orthopaedics & trauma > Fractures > Leg, knee & ankle fractures
Sayum Filho J, Lenza M, Teixeira de Carvalho R, Pires OGN, Cohen M, Belloti J
Bone, Joint and Muscle Trauma Group
Sayum Filho J, Lenza M, Teixeira de Carvalho R, Pires OGN, Cohen M, Belloti J. Interventions for treating fractures of the patella in adults. Cochrane Database of Systematic Reviews 2015, Issue 2. Art. No.: CD009651. DOI: 10.1002/14651858.CD009651.pub2