9And Jesus went on to say, "And so I tell you: make friends for yourselves with worldly wealth, so that when it gives out, you will be welcomed in the eternal home. 10Whoever is faithful in small matters will be faithful in large ones; whoever is dishonest in small matters will be dishonest in large ones. 11If, then, you have not been faithful in handling worldly wealth, how can you be trusted with true wealth? 12And if you have not been faithful with what belongs to someone else, who will give you what belongs to you?
14When the Pharisees heard all this, they sneered at Jesus, because they loved money. 15Jesus said to them, "You are the ones who make yourselves look right in other people's sight, but God knows your hearts. For the things that are considered of great value by human beings are worth nothing in God's sight.
1616.16: Mt 11.12–13"The Law of Moses and the writings of the prophets were in effect up to the time of John the Baptist; since then the Good News about the Kingdom of God is being told, and everyone forces their way in. 1716.17: Mt 5.18But it is easier for heaven and earth to disappear than for the smallest detail of the Law to be done away with.
1816.18: Mt 5.32; 1 Cor 7.10–11"Any man who divorces his wife and marries another woman commits adultery; and the man who marries a divorced woman commits adultery.
19"There was once a rich man who dressed in the most expensive clothes and lived in great luxury every day. 20There was also a poor man named Lazarus, covered with sores, who used to be brought to the rich man's door, 21hoping to eat the bits of food that fell from the rich man's table. Even the dogs would come and lick his sores.


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Walter E. Williams, Black Voice of Libertarian Economics, dead at 84
zengernews
Walter E. Williams, a prominent African American economist, scholar, professor and syndicated columnist, died Dec. 2 after teaching a class at George Mason University, where he was the John M. Olin Distinguished Professor of Economics.
Considered by his admirers to be a voice of economic rationality, he was among the few prominent African American economists who pushed back against the grain of politics, including welfare, the minimum wage and even tax policy that redistributes money from the so-called 1 percent to the poor.
Despite his advanced age, Williams was neither retired nor retiring. He enjoyed teaching, and he loved stimulating people to think differently.
Williams grew up in Philadelphia's hardscrabble public housing projects. He worked as a taxi driver before being drafted into the army, worked as a probation officer, and put himself through college, earning a Ph.D. at UCLA in 1972.
While serving in the army in Korea, he registered with his new unit as a "Caucasian," explaining that he didn't mark "Black" because he didn't want to be assigned to all the worst jobs on base. In 1963, when he was still in Korea, Williams wrote to President John Kennedy to ask whether "Negroes" should "be relieved of their service obligation or continue defending and dying for empty promises of freedom and equality," in reference to racism in the military and the government.
Prior to being transferred to Korea, he was court-martialed — and acquitted — for stirring up the ranks with provocative statements about race.
Walter E. Williams, John M. Olin Distinguished Professor of Economics, George Mason University gave a public lecture titled "The Role of Government in a Free Society" on September 19, 2013, at Texas Tech University. (WikiMedia Commons)
After teaching from 1973 to 1980 at Temple University in Philadelphia, Williams moved to George Mason University in Fairfax, Virginia. Walter E. Williams was known for challenging his students and audiences to think critically and question widely held assumptions about the impact of government interventions on behalf of the poor, especially minimum wage laws and their impact on minorities. He argued that the effect of the minimum wage, regardless of the intentions behind it, is "to cut off the bottom rungs of the economic ladder for the most disadvantaged worker and lower the cost of discrimination."
In a 1977 study for the Joint Economic Committee of Congress, he demonstrated that the rise of minimum wage laws ran in parallel with dramatic increases in youth and black unemployment rates, which were higher in 1970 than in 1940.
"No matter what answer we give to explain this trend, the one that we cannot give is one that asserts that society in general has become more racially discriminatory over this period," he said. Williams returned to that theme in a 2011 study published by Stanford University's Hoover Institution Press, "Race and Economics: How Much Can Be Blamed on Discrimination?"
"Free-market resource allocation, as opposed to allocation on political grounds, is in the interests of minorities and/or less-preferred individuals," Williams wrote.
In his 1982 book "The State Against Blacks," Williams cited historical evidence showing that many state interventions were in fact racist, crafted to harm black workers who were in competition with whites. The Davis-Bacon Act of 1931, which mandated "prevailing wages" for public works projects, excluded black workers from competing with whites. That was the point, Williams argued.
Democratic Rep. John J. Cochran of Missouri noted in congressional debate at the time that he had "received numerous complaints in recent months about Southern contractors employing low-paid colored mechanics getting work and bringing the employees from the South." The law was passed with the explicit intention of excluding "colored workers." Williams was among only a handful of public intellectuals to publicly revisit the Davis-Bacon Act .
Williams was critical of government overreach across the board and opposed socialism, redistributive taxation, the war on drugs and military conscription. He was a self-described libertarian, and his autobiography, "Up From the Projects," recounts his "many achievements that would have been unfathomable by his ancestors, underscoring his belief that, unlike so many other societies around the world, in America one needn't start out at, or anywhere near, the top in order to eventually reach it," the book's back cover states.
His legacy includes the thousands of students whom he taught over a 53-year academic career. Many became economists themselves, guaranteeing that hard questions, logic and evidence will continue to be uncomfortable, but still respected.
Williams was predeceased by his wife of 47 years, Connie Taylor Williams.
(Edited by Judy Isacoff and David Matthew)
The post Walter E. Williams, Black Voice of Libertarian Economics, dead at 84 appeared first on Zenger News.

redpajama_set_name: RedPajamaCommonCrawl


For your mobile site, it's important to come up with ways to convey your information in as few words as possible. Mobile device screens are small, so droning on and on about a product just to get more keywords in is annoying to readers. Brevity is the crux of mobile marketing communications.
Craft a mission statement more for your purpose than anything if you want to stay on track in social mobile marketing. You will be less likely to stray into unproductive strategies if you give yourself a clear reminder of your principles.
A business' customer base usually stays the same unless it's market changes. However, you must always realize that customers may leave due to things occurring outside the range of your market. If you want to remain competitive, you must make sure you are offering the most current in terms of technology.
Bringing in profits with mobile marketing is definitely effective with the correct approach. It allows you to tap in to the millions of potential customers that communicate primarily with their phones. The two options mentioned are both great ways to market your business. Take your marketing closer to where your customers are located.
You might already be aware of the option of offering free apps to clients, but you might not realize that it's also quite easy to make the applications yourself If your business designs it's own app, you can step up your mobile marketing campaign and compete with the big boys. You are merely limited by imagination, as there are a lot of items you can include in your app.
A mobile marketing campaign can boost your business and draw in lots of customers, but only if it is entirely compatible with all mobile platforms. Your efforts must work on as many popular devices as possible, or you'll risk losing customers.


At times it must be difficult to be a wedge designer at TaylorMade. Probably like Victor Valdes at Barcelona. With the huge success of the M3/M4 drivers, irons and Spider putters its easy to overlook the great wedges produced this year. The TM milled wedges have a great classic look, soft feel and have some simple yet effective bounce and grind options. Given the somewhat complex nature of other wedge lines this could be very attractive to those wanting a great less fuss purchase. Usual lofts are available and the dynamic gold wedge shaft just adds to the simplicity of the selection process. Also, be sure to check out the different finishes.
JamGolf are also proud to exclusively offer the TaylorMade blackout wedge. Like the black limited edition P790 TaylorMade have made the milled wedge with all its benefits but in a ridiculously cool finish.
Wedges are personal and there are some technical factors at play so don't hesitate to call, e-mail or webchat us with your questions.


Journal of Scalable Computing (Thompson Reuters and Scopus indexed), to be published in Volume 18, issue 4, December 2017.
* All papers will be peer-previewed by at least two reviewers.
* There is NO publication fee.
Deadline extended to June 1st.
This special issue is a chance for researchers, academics, and industries to debate the different issuesrelated to the latest challenges, technologies, solutions, techniques and fundamentals pertaining to communication, computing, networking, control in CPS. People who work in the area of design, testing,and implementation of all types of cyber physical systems and any other related area from industry and academia are welcome to submit their paper..
Applications of CPS on e-Health, life sciences, energy, and smart cities.
Safety-critical, dependable, fault-tolerant cyber-physical systems.
Simulation and visualization of CPS.
Testing and Validation of CPS.


text:
Ezra Swerdlow (March 2, 1953 – January 23, 2018) was an American film producer and production manager.

In 1980, he served as a unit manager on the Woody Allen film Stardust Memories. He co-owned Schindler/Swerdlow Productions in New York.

Filmography
He was a producer in all films unless otherwise noted.

Film

Production manager

Second unit director or assistant director

As an actor

Location management

Thanks

Television

References

External links

1954 births
2018 deaths
American film directors
Place of birth missing
People from Long Island
Neurological disease deaths in Massachusetts
Deaths from motor neuron disease

redpajama_set_name: RedPajamaWikipedia


text:
Gareth Bale To Remain FIFA 14 UK Cover Star
September 2, 2013 by Adam Neaves
Many have wondered if the FIFA 14 UK Cover Star will change in light of Gareth Bale's switch to Spanish giants, Real Madrid.
EA have come out and confirmed that Gareth Bale Will indeed stay as the UK cover star. In a statement to the guys at Eurogamer, an EA spokesman stated:
Gareth Bale remains the FIFA 14 UK cover star alongside Lionel Messi, In light of his recent transfer we are working closely with his management and we will have an update soon.
Are you happy that Gareth Bale will remain as the UK cover star for FIFA 14? Let us know your thoughts via the comment section below.


Your NRD shares the cost with landowners for the construction of several conservation measures including terrace systems, grassed waterways, and erosion control dams. Our cost share rate for the construction of terraces, waterways, etc. is currently 75%.
2019 tree orders have ended. 2020 orders will start in November, 2019!
Recently, your NRD has begun an active and growing program to cost share with landowners the expense of capping old, unneeded wells. Up to 75 percent of the cost for capping wells is available by contacting your Papio-Missouri River NRD.


text:
M&M'S Brand Makes Halloween And Christmas Sweeter With Costumes And Decor From Gemmy Industries
prnewswire M&M's	 October 1, 2015
MOUNT ARLINGTON, N.J., Oct. 1, 2015 /PRNewswire/ — Now fans of M&M'S® Brand Candy can enjoy their favorite treats in new and exciting ways during the Halloween and Christmas seasons. In addition to eating the delicious chocolate candy, fans can wear them as Halloween costumes and display them as Christmas decor, thanks to a licensing agreement between Mars Retail Group and Gemmy Industries.
M&M'S® Chocolate Candies aren't just for handing out at Halloween — they also make terrific costumes. Make a colorful entrance at any Halloween party by portraying confident M&M'S® Brand Character Red or lovable M&M'S® Brand Character Yellow. Each costume set costs $30 at select major retailers nationwide and includes an inflatable costume, white gloves, fan and battery pack. The costume is comfortable, and it inflates quickly and easily.
During the Christmas season, M&M'S® Brand is the most-purchased chocolate brand for gifting, stuffing stockings and filling candy bowls, according to the 2014 Christmas Beacon Report. Now consumers can extend their love of the M&M'S® Brand into their holiday decorations. They'll find two sweet selections starring the M&M'S® Brand Character Red at select major retailers nationwide. A 20-inch-tall Red is dressed like an elf, and he can stand and greet guests with a smile. Pair him with the 12-inch tall M&M'S® Brand Character Red, who is dressed like Santa Claus and performs a hilarious side-stepping dance to the song "Sexy and I Know It." They'll both add comfort and joy to the holiday season. The porch greeter costs $19.94, and the side stepper costs $16.92.
"M&M'S® Brand Chocolate Candies have been family favorites for generations, especially during the holidays and seasonal celebrations," says John Capizzi, general manager of Licensing for Mars Retail Group. "We're pleased to offer M&M'S® Brand fans these festive items from Gemmy Industries, an innovator in entertainment and seasonal decor."
"At Gemmy, we develop fun, interactive items with an eye on pop culture icons," says Jason McCann, President of Gemmy Industries. "From past experience with Mars Retail Group, we know that the M&M'S® Brand and the M&M'S® Brand Characters are a hit. Shoppers will be thrilled to see these new items on the seasonal shelves."
food /
RDIF and Italy's Inalca announce joint investments in Russian beef production industry
Trattoria Sabbia di Mare Seafood Restaurant in Bologna
Paolo Zannoni: Chairman of Autogrill
‹ Launching Weiwanjia: Strategic Step for Jebsen Group	› De'Longhi Multifry, The Ultimate Multi-Cooker, Is Now Available Just In Time For The Holiday Entertaining Season


text:
NM Boys Take BGM Crown
BROOKLYN – North Mahaska placed five runners in the top 10 at BGM Sept. 21 to run away with the team cross country title. The boys scored 32 points to easily outdistance Montezuma in second with 82 and GMG in third with 141. North Mahaska girls ran well but did not have enough runners to compete as a team.
Lane Harmon took third to lead the Warhawks finishing the 5K distance in 19 minutes 6.59 seconds. Anthony Goemaat and Nate Sampson placed fifth and sixth respectively in 19:37.66 and 19:56. 04. Brayden Veiseth was eight in 21:15.85 and Grant Smith took 10th in 21:44.73. Andy Knockel finished 20th with a time of 24:20.14 but did not figure into the team score.
All four girls placed in the top 20 with Natalie LaRue leading the way in fourth place in 24:36. Addie Schilling placed 11th in 26:15, Claira Bacon was 19th in 29:42 and Kelsey Comstock was 20th in 30:36.
In the junior varsity boy's race, North Mahaska's Garrett Lamb placed sixth in 25:02 and Beau Simmons was 10th in 27:17.
NM's junior high boys also had a strong afternoon. Asher DeBoef finished sixth in 10:17.67Ben Yang was ninth with a time of 10:35.77, Mitchell Kincaid 19th in 11:31.42; Larry Mohr, 34th in 15:16.88; and Bronson Edwards-Hinton, 38th in 16:56.97.
Allie Veiseth and Emmerson Jedlicka led the junior high girls placing second and third respectively. Veiseth finished in 11:43.18 and Jedlicka ran 11:47.56. Alu Steil was tight behind in fourth in 12:11.63 and Fallen Rivera was 30th in 19:04.23.
Jean Knockel	on September 24, 2020 at 7:09 am
Very happy for the team. Did not feel it was necessary to single out one kid and say they did not figure into the team scoring, I think everyone contributes in some way on a team and that was embarrassing to him Thank you


text:
Q: Optional Relational Filters Let's say I have the following design:
Tables:
video_games
A list of all known video games
video_game_modes
A list of game modes for each video game.
For example:

*

*Game = League of Legends

*Game Mode = Ranked

another_table
What is the cleanest design for if another_table can reference both a video_game and a video_game_mode but video_game_mode is optional?
I could easily understand if all video_games had at least 1 blank video_game_mode as you would just reference that in another_table.

A: You can reference both in your new table (another_table) and have a foreign key to both video_games and video_game_modes.  Just make the column that references video_game_mode nullable.  You can then put a constraint to force unique against video_game and video_game_mode if your intent is to have one row per video game and mode combination.
If it's one-to-many from video_games to video_game_modes, you could add a constraint that both game and game_mode could not be populated simultaneously (enforce that one or the other is null).  Then if the game does not have any game modes, you can still reference the game directly, and foreign keys could be used to protect data integrity.

redpajama_set_name: RedPajamaStackExchange


Temple Beth El is a member congregation of the United Synagogue of Conservative Judaism, (www.uscj.org), observing Traditional Judaism within the framework of modern living. Through religious services, religious school and adult education, the congregation strives to develop a sense of family and community among members and to encourage growth and understanding of Jewish identity.
As Conservative Jews, our philosophy is to remain committed to the Halacha, Jewish law determined by our tradition, while also allowing for change and growth. This differs from the Reform approach, which views ritual law as a matter of personal choice, and the Orthodox approach, which adheres to a stricter interpretation of Jewish law. In Conservative Judaism, all decisions of Jewish law are not made by the individual. Instead they are determined by the Committee of Laws and Standards of the Rabbinical Assembly of America. The Religious Committee of Temple Beth El, along with the Rabbi, periodically reviews issues of law and practice as they arise.


Jon Ballard's poetry and fiction have appeared in over fifty journals since 2006, including Cimarron Review, Flint Hills Review, The Valparaiso Poetry Review, New Mexico Poetry Review, Fifth Wednesday Journal, Blue Earth Review, The MacGuffin, Boxcar Poetry Review, Connecticut River Review, and Broadsided.
He is the author of five poetry chapbooks: Lonesome (Pudding House, 2007), Sad Town (Maverick Duck Press, 2007), Trees Make You Think of Other Things (Foothills Publishing, 2008), Such Small Rain (Pudding House, 2009), and most recently, Somewhere Between (Finishing Line Press, 2013).
He received an MA in English from Oakland University, and works as an adjunct writing instructor at Oakland Community College. Currently he lives in Michigan.
Visit Jon at: www.jpballard.com. Year of the Poets is his first novel.


Logan City Council will move to adopt a new infrastructure charges policy in hopes of boosting job creation, hotel development and small businesses.
Council said that from March 1, 2017, eligible developments in parts of the city that they have targeted for commercial growth will receive the benefits of this new economic incentive plan.
Planning and Development Chairperson Cr Russell Lutton said the new charges policy was designed to remove impediments to commercial investment in Logan.
"Areas like Springwood and Beenleigh will become Logan's commercial centres as our city grows so if Council is serious about attracting investment then we need to offer financial incentives where we can for people to do business here," he said.
Under the policy, new hotel developments that achieve a 4 or 5 star rating could seek to have their infrastructure charges deferred.
New non-residential developments in certain parts of the city could also avoid the charges altogether if the development is within an existing building.
"The City of Logan would love to attract brand-name hotels recognised by Star Ratings Australia to boost short-term accommodation options for the city," Cr Lutton said.
"If we've got more high quality hotel options, it gives our city a better chance of attracting and hosting events that draw people from interstate and overseas.
"Hotel developments not only drive jobs growth during construction, they also deliver a flow-on effect by encouraging investment in smaller businesses that support their operations.


text:
Infinity War at the Federalist
May 9, 2018 / DBreitenbeck
A new Federalist article is up, this one based off of Avengers Infinity War and talking about some of the same things I've been writing about recently.
In other words, Thanos is a classic student of Thomas Malthus: a believer in the threat of overpopulation, only on a universal scale and with a blend of Marxist utopianism. He points to poverty, hunger, and environmental devastation as proof of his theory and boasts that in worlds he has "balanced" (by conquering and massacring half the population) no one goes hungry. He believes that his efforts are necessary to create the best life possible for the most people, and he believes it so strongly that he is willing to do quite literally anything to achieve it.
Yet, though he is a monster, Thanos is also, for lack of a better word, a very human character. He does terrible things, but we see he feels the horror of them, and he carries himself at all times like a man bearing a tremendous burden. When the other characters reject his arguments, he doesn't fly into a rage, but only shakes his head in sad frustration that he can't make them understand. Again, he genuinely believes in what he is doing and thinks that he is the only one with the knowledge and will to do what has to be done. He feels he has been given a tremendous responsibility and must do whatever it takes to carry it out.
Thus, Thanos has a similar mindset to the Marxists and other leftists of the past century or so: he has a clear idea of the state of affairs that he is aiming to achieve, which he believes will eliminate the suffering he sees around him under the current system and save the world from a greater disaster down the road. Most importantly, he believes that anything and everything can be justified if it forwards this goal. The "agenda," the final utopian state to be achieved, is more important than anything happening now, just as Marxists believed that "truth" and "justice" meant anything that forwarded the revolution.
Links, Movies
Marvel, Sharing a link, The Federalist
← How I Would have Written 'Black Panther'
A Startling Conclusion →
2 thoughts on "Infinity War at the Federalist"
Please add the phrase "based off of" to your list of things that are wrong in and of themselves and which should never be permitted under any circumstances. Thanks.
That said, thanks for the article. After seeing the film it struck me how obvious it is that abortion apologists routinely use Thanosian logic, but you're right: it's broader than that.


Home Page \ Design and manufactures \ why screenline?
Designed and manufactured in italy. Lowest total cost of ownership. Best service and support.
Technological excellence, productive excellence, quality excellence. We have been on the world market since 1985 as videoprojection screen manufacturers.
We have always developed our products starting from our customers' experience and needs. The curiosity that always accompanies the presentation of new ScreenLine products allows us today to be present in four continents with a widespread distribution. The products we propose always become a term of comparison in the videoprojection field and we constantly improve and enrich.
Objects full of passion that conquer the heart of those who own them and the head of those who use them: the quality marked Screenline.
Screen designers and manufacturers of Italy.


text:
Tag: verse novel
A review of Cloudless by Christine Evans
The voice of the playwright is obvious in Christine Evan's verse novel Cloudless. A rich blend of characterisation, setting, and powerful thematic weaving from poem to poem, the novel takes us deep into the heart of working class Perth in the 1980s. Each of the eight key voices who make up the story are on the cusp of something: their lives about to change.
A review of Vanishing Point by Jeri Kroll
At no point does the book lose its dramatic momentum. In fact, so compelling is the plot at times that it takes some effort to slow down and read the poems fully as poetry should be read, rather than racing on to see what happens. Vanishing Point is quick and easy to read, but the poems repay second and third readings where the complexity of the work begin to unfold. Diana's self-awareness grows viscerally and sensually as she comes to accept the sensations of her adult body through the final section.
A review of Magellenica by Justin Lowe
There's a freshness to this form of novel, and Lowe handles it well, but I still feel like I've been left with a snapshot rather than a story. Nevertheless, as a portrait of both a post-WWI veteran, an image of cricket at its most exciting period in Australia, and a portrayal of Sydney in the 20s, this is a lovely, evocative book, full of rich imagery and sensual moments.
A review of El Dorado by Dorothy Porter
Once again, Porter succeeds in that impossible juggling act of narrative and poetry. Even for the most casual of reader, El Dorado reads easily as a fast paced, intense and psychologically satisfying thriller. For those who want more than simply a quick escape, El Dorado explores complex topics of childhood innocence and guilt; love and hatred; desire and psychosis with the kind of taut intensity that only poetry can provide.


text:
Константин Александрович Лебедев (20 марта 1920; Коломна, Московская губерния — 9 января 2018) — советский и российский языковед, специалист по Афганистану.

Биография
Константин Александрович Лебедев в 1942 году окончил Московский институт востоковедения (МИВ) и с 1943 года начал преподавать там язык пушту. Потом в 1943—1949 годах Лебедев — преподаватель афганского языка (пушту) и литературы, в 1949—1954 годах — заведующий кафедрой языка пушту и литературы МИВ. После присоединения МИВ к МГИМО в 1954 году продолжил преподавание в новом институте до 1985 года, работая на кафедре арабского, персидского и афганского языков (данная кафедра была в 1962 году преобразована в кафедру языков стран Ближнего и Среднего Востока). В 1981—1996 годах Константин Александрович работал заведующим кафедрой иранской филологии Института стран Азии и Африки при МГУ имени М. В. Ломоносова, в 1996—2012 годах — профессором на той же кафедре.

Известен благодаря своему вкладу в русскую афганистику (был знатоком языка пушту). Автор 110 научных трудов. Автор или соавтор множества русско-пушту и пушту-русских словарей и учебников пушту. Считался главой московской школы преподавания пушту. Перевел ряд афганских народных сказок.

Литература

- Карманный русско-афганский словарь. М. 1961.
- Карманный пушту-русский словарь. М. 1986.

Примечания

Ссылки
 Ушел из жизни К. А. Лебедев

Востоковеды России


text:
Stephen Hair & Brian Jensen in Theatre Calgary's A Christmas Carol (2019-20). Photo by Trudie Lee.
An adaptation of Charles Dickens' classic novella, by Geoffrey Simon Brown
Christmas Eve, 1843. Marley is as dead as a doornail.
Scrooge is forced to confront the impact of his life as he follows the spirits of Christmas past, present and future through his city on a cold winter's night.
As timeless as it is fresh; a faithful rendition of a beloved story and a message of connection in an increasingly individualized world.
"Theatre Calgary has pulled out all the stops and spared no expense or talent to create its most spectacular A Christmas Carol in 33 years...None of these wonderful effects and frivolity would matter a wit if they didn't have a strong script to hold it all together and that is what Geoffrey Simon Brown has provided in his adaptation of Charles Dickens' beloved novella. The action moves swiftly and smoothly from scene to scene and Brown has made certain there are moments of pathos and introspection to balance the humour and spectacle."
The Calgary HeraldLouis B. Hobson
Production Details
49 Characters played by 23 actors
15 adults (7 Men, 5 Women, 3 Any gender)
8 children (4 boys, 4 girls)
120 minutes (one intermission)
Premiere production by Theatre Calgary (Calgary) December 2019
Upcoming production by Theatre Calgary (Calgary) December 2020
The cast of Theatre Calgary's A Christmas Carol (2019-20). Photo by Trudie Lee.
More Plays by Geoffrey Simon Brown
Michael Mysterious
License this play? Contact


Do Homosexuals Prey on Others?
Give a homosexual five minutes and he will assure you that homosexuals do not prey on others, and if he will lie about that, he will lie about other things also!
There is nothing gay with the homosexual way! Perversion is not normal, acceptable behavior. God created male and female and everyone knows how they are supposed to interact. Any deviation is a threat to civilization.
Well, it's time for someone to say it, so I will: Homosexuals are dangerous people. My critics will say that homosexuals are no better or worse than other people; however, that is a fairy story! Homosexuals make up less than 3% of the American population yet they have perpetrated about 68% of all serial killings in the last 30 years!


Congratulations to Cory on his promotion to Job Captain and for recently passing his NCARB exams to become a Registered Architect! And welcome to Heather and Dalia, joining our team as Architectural Designers in the Providence and Boston offices! Read below to learn a bit more about Cory, Heather and Dalia!
Click here to learn more about Cory, Heather & Dalia!


Thirty-two year old Telford Work moved to the Palisades in March 1926 as director of public relations for the Pacific Palisades Association. A journalism graduate from the University of Southern California who had assembled a small chain of local newspapers near Fresno, Work became editor of the "Progress." On May 4, 1928, he launched The Palisadian, an 8-page weekly tabloid that sold for five cents a copy. "It is with the confidence that an alert, constructive-spirited newspaper, distinctive in format and devoting itself resolutely in its news and editorial columns to making Pacific Palisades the business, banking, school and religious center of the north shore section…will meet with a hearty welcome from the residents of Pacific Palisades and the surrounding sections that the publisher herewith presents the first issue of The Palisadian," Work wrote in his front-page introduction. The lead story announced that $1 million was being spent to pave Marquez Avenue (now Chautauqua) and plant trees along the community's link with Santa Monica Canyon.
On September 7, 1934, Work sold The Palisadian to his friend Clifford D. Clearwater, who in 1922 had been one of the first settlers in the community with his young wife, Zola. In fact, the first of their three children was the second child ever born in the Palisades.
Although untrained as a journalist (his previous jobs included delivering the mail by horseback as the town's original postal carrier), Clearwater had natural talents that enabled him to serve with distinction as editor, publisher, photographer, and civic leader until his death in 1956.
When Clearwater died of a heart attack in 1956 at the age of 59, his widow Zola took over as editor and publisher. By 1960 she was ready to retire and sell her newspaper to "crosstown" rivals Charles Brown and William Brown, twin brothers who in 1954 had acquired the Pacific Palisades Post, a separate publication that was established in 1950. The Browns immediately consolidated both papers into one operation at 839 Via de la Paz, where two years earlier they had built their own printing plant. The plant enabled the Browns to publish their paper in a broadsheet format (today's standard newspaper format), as opposed to The Palisadian's smaller tabloid size.
Thirty-three year old Alan Smolinisky purchased the Palisadian-Post, Post Printing and the building located at 839 Via de la Paz on December 5, 2012. Smolinisky, a graduate of Palisades High and the University of Southern California, is a dedicated newspaper enthusiast who spends 4-5 hours per day reading. Smolinisky wrote a Viewpoint titled 'Why I Bought the Palisadian-Post' in the December 7, 2012 issue of the newspaper explaining his love of the town and its only newspaper. He and his wife, Caroline, a native of Indiana and a fellow USC graduate, live in the Huntington Palisades with their children, dogs and newspapers. "I love that the Post has always been family-owned," Smolinisky said.


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Process evaluation of integrated diabetes management at primary healthcare facilities in Pakistan: a mixed-methods study
Muhammad Amir Khan, John D Walley, Saima Ali, Rebecca King, Shaheer Ellahi Khan, Nida Khan, Faisal Imtiaz Sheikh and Haroon Jehangir Khan
Muhammad Amir Khan
Chief Coordinating Professional, Association for Social Development, Islamabad , Pakistan
John D Walley
Professor of International Public Health, Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds , UK
Saima Ali
Research Coordinator, Association for Social Development, Islamabad , Pakistan
Lecturer, Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds , UK
Shaheer Ellahi Khan
Assistant Professor, Humanities and Social Sciences Department, Bahria University, Islamabad , Pakistan
Nida Khan
Project Coordinator, Association for Social Development, Islamabad , Pakistan
For correspondence: nidakhan@asd.com.pk
Faisal Imtiaz Sheikh
Haroon Jehangir Khan
Director, NCD & Mental Health, Directorate General of Health Services, Punjab , Pakistan
Background Integrated care for diabetes and associated conditions at primary level health facilities can make care available to a much larger population, especially in rural areas.
Aim This process evaluation was to understand how the authors' integrated care was implemented and experienced by the care providers and patients, and to inform modifications prior to province-wide scale-up.
Design & setting The mixed-method study was conducted as part of a cluster randomised trial on integrated diabetes care at 14 public health facilities.
Method The care practices were assessed by analysing the routine clinical records of 495 registered patients with diabetes. Then semi-structured interviews with service providers and patients were used to understand their respective care experiences. A framework approach was applied to analyse and interpret the qualitative data.
Results The intervention and the study were implemented as intended under routine conditions in rural health centres. Key service processes effectively delivered included: skill-based training; screening and diagnostic tests; treatment card records; and the additional case management as per desk guide, including monitoring progress in glucose and weight at follow-up consultations, and mobile phone calls to help adherence. However, social and cultural factors affected clients' ability to change lifestyles, especially for women. The intervention effect was limited by the short study follow-up of only 9 months.
Conclusion Integrated diabetes care was feasible, both for providers and patients, and potentially scalable at primary care facilities under routine conditions in Pakistan. Additional operational interventions are required for sustained drug supplies, supervision, in-service training, and to address the social challenges to healthy activity and eating, especially for women.
The delivery of integrated diabetes care at public facilities has never been evaluated in Pakistan. The process evaluation of early implementation was to help understanding and refining of the delivery of care tasks in routine healthcare settings.
To achieve better coverage, early diagnosis, and continuity of care, the World Health Organization recommends1 integrated delivery of diabetes care at primary and secondary level health care; implying delivering diabetes care as part of routine outpatient and community-based care. The challenge is how to achieve this in resource-poor settings. Pakistan has the seventh highest burden of diabetes mellitus in the world.2 The burden of disease is expected to increase if adequate control measures are not taken.3 High diabetes prevalence poses a challenge to economic development4 and to the quality of life of the population.5
In Pakistan, integrated diabetes care is to be delivered by medical and allied staff already working at health centres and sub-district hospitals. These publicly funded health facilities provide free-of-charge basic clinical and diagnostic services to defined catchment populations. However, lack of contextualised programme guidelines and tools to diagnose, treat, and educate patients with diabetes results in widely varied and poor quality care provision and an inadequate patient response to the care.6
To address the varied quality of care, the Provincial Non-Communicable Disease (NCD) Programme and partners developed three products by adapting international best practice guidelines.7–11 These are: a case management desk-guide; a lifestyle modification counselling tool; and a training package for care providers. The products were aimed at enhancing the diabetes care practices and achieving better glycaemic control. In light of other reported experiences,12 this study's enhanced care intervention covered the screening, diagnosis, prescription, education, and follow-up of patients with diabetes.
The trial design and findings are to be published in this journal (in press).13 The key trial finding was that the enhanced care intervention improved the glucose control results. The enhanced care patients achieved a higher proportion of desirable blood glucose level of HbA1c ≤7%, and a higher mean patient difference between their baseline and end-line HbA1c. However, after adjusting for between-cluster variation, the intervention effect has a 17% probability of being by chance (P = 0.17).
Process evaluation of complex intervention is important to understand how context, issues of fidelity, and participant interactions with, and responses to, the intervention affect outcomes.14 This process evaluation uses quantitative and qualitative methods in a sequence15 to: assess fidelity to the planned intervention by exploring how it was implemented; explore the ways in which providers and patients experienced the intervention; and inform modifications to the intervention before scaling.
Routine clinical care data (quantitative) were used to assess the fidelity to the care protocols (intervention). The qualitative interviews were designed to explore the ways in which providers and patients responded to, and interacted with, the intervention.16 The data collection and analysis were organised around five key intervention components:
patient identification and diagnosis;
treatment and record-keeping;
lifestyle modification;
patient follow-up and referral; and
material inputs for patient care (see Box 1).
A pragmatic approach to the research17 was adopted, through which the authors aimed to make informed policy and practice recommendations for the NCD Programme in Punjab province. Box 2 shows the logic model for the intervention.
Care task
Screening and diagnosis 1. Number of patients with diabetes registered, as percentage of overall outpatient attendance2. Number and percentage of patients examined for baseline clinical and laboratory, and age/anthropometric measurements Patient's and provider's experiences, as well as practice deviations and reasons for:
identifying and examining patients who are overweight or symptomatic of diabetes mellitus
conducting clinical and laboratory exams, and diagnosis
Prescriptions 3. Number and percentage of patients prescribed as per guidelines for diabetes and/or hypertension:
without comorbid condition
with comorbid condition (renal insufficiency; pregnancy)
4. Number and percentage of uncomplicated patients prescribed drugs without trying a lifestyle change 5. Number and percentage of patients prescribed preventive treatment Patient's and provider's experiences, as well as practice deviations and reasons for:
prescribing, as per guide
trialling lifestyle changes before drugs
prescribing preventive drugs
Lifestyle modification 6. Recording of smoking status and staff response Patient's and provider's experiences, as well as practice deviations and reasons for:
counselling patient (with pictorial tool) for lifestyle change and smoking cessation
estimating and use of 'target weight' for patient counselling
Follow-up and adherence 7. Number and percentage of patients adhering to follow-up visits (in first 9 months) 8. Number and percentage of patients examined (clinical/ laboratory) on follow-up visits 9. Number and percentage of patients referred for expert check-up and/or complication and/or severe drug reaction Patient's and provider's experiences, as well as practice deviations and reasons for:
patient adherence to follow-up visits (include retrieval)
staff adherence to care during follow-up visit
referrals (for example, side effects)
Material inputs Patient's and provider's experiences, as well as practice deviations and reasons for:
maintaining uninterrupted inputs
coping with input gaps and/or challenges
Box 1. Selected care tasks and key indicators
Intervention inputs
Intervention process and actions
Practice change
Health outcome
Case management desk guide and lifestyle counselling tool
Training of doctors and allied staff (on full care package)
Supplement drugs, equipment and supplies (digital blood pressure apparatus, glucometer, and strips)a
Recording formsa
Screen/diagnosea
Prescribe anti-diabetic drugs
Identify co-morbid condition and treat
Counsel for lifestyle modification
Follow-up care, including retrieval
Providers practise programme protocols to:
Screen, diagnose, treat, counsel, follow-up, and report as per programme protocol
Patients practise:
Follow-up visits
Lifestyle changes (as counselled)
Patients gets:
Screened and diagnosed as per programme protocol
Prescribed right drug/ dose
Counselled for lifestyle change
Followed-up and treated for continued care
Reduction (0.5%) in mean HbA1c
Increased proportion achieving HbA1c <7%.
Reduction in complications related to diabetes
aInputs/ practices kept same in intervention and control arms.
Box 2. Logic model for the intervention
Care providers used chronic disease cards to record clinical care data for the trial patients at 14 public health facilities. The quality of data were ensured, by programme and research staff providing additional training to providers on record-keeping, conducting careful monitoring of data completeness, and by querying any data that appeared implausible. The patient disease card data, collected from October 2014–August 2016, were entered into SPSS (version 17.0). Data were single entered and the quality was assured by data-entry checking at regular intervals to minimise error rates.6 The frequency distribution of the data were analysed and cross-tabulated by sex, and by intervention and control.
A preliminary analysis of the quantitative data, collected up to that point, was performed in January 2016. This preliminary analysis was used to identify protocol deviation, and inform the design of semi-structured interviews with care providers and patients at selected intervention sites.
Facility and participant selection
Four facilities that deliver primary health care — two rural health centres and two urban sub-district hospitals — were randomly selected to understand intervention delivery and experience in rural and urban settings. At each facility, one doctor and one clinic assistant were interviewed.
The facilities were organised into two pairs; one rural health centre and one sub-district hospital per pair. The quantitative data were used to purposively sample patients. In one pair, eight patients (four per facility) were selected according to their adherence to follow-up visits (≥6 follow-up visits in 9 months). Of the four patients in each facility, two (one male and one female) had adhered to follow-up visits and the other two (one male and one female) had not. In the second pair of facilities, another eight patients (four per facility) were selected according to the extent of diabetes control (fasting blood glucose [FBG] ≤125 or random blood glucose [RBG] ≤200). Of the four patients in each facility, two (one male and one female) had controlled their blood sugar levels and the other two (one male and one female) had not (see Figure 1).
Figure 1 Sampling for interviews. RHC = rural health centre. THQ = Tehsil headquarters.
All patients who met the criteria described above were identified from the routine data. Patients from the list of those who met the criteria were randomly selected and the clinic assistant was requested to contact them to arrange an interview. With health facility staff facilitation, all potential participants agreed to be interviewed.
Semi-structured interviews were conducted with providers and patients from April–July 2016. The interviews were conducted using Skype call technology and lasted for around 30 minutes. The interviews were conducted in a segregated space to ensure confidentiality and the interviewee was assured that the data would be kept confidential and anonymous. All interviews were recorded. A research assistant was also present at the clinic, to assist the patient with the required technology. An Islamabad-based female member of the research team with experience of qualitative interviewing conducted all the interviews in Urdu. Providers and patients were located within the health facilities in locations that provided confidentiality. The technology was set up by members of the field research team, while the interviewer was located in Islamabad. This format was adopted owing to time and budget constraints for the care providers and the research team, issues concerning the safety of researchers and participants during the data collection period, and gender-related access and adherence issues. Participants provided consent to the interviews verbally and this was recorded.
The transcripts were anonymised and identification keys kept separate from the data. The researcher who collected the data transcribed it in Urdu. Then another researcher checked the transcripts, while listening to the recording. A framework approach was used to analyse the data.18 Two members of the team familiarised themselves with the data by reading the transcripts, and identified initial codes. They developed a thematic framework, which was based on five a priori intervention components and emergent issues, and applied it to the data19. At this point, data that were included from the transcripts were translated into English by the researcher who collected and transcribed the data, and the quality of the translations were checked by other members of the research team (further information available from the authors on request).
The trustworthiness of the data was ensured by triangulating it from different sources; for example, providers and clients. During the writing process, key findings and quotations were continuously checked against the original transcripts to ensure consistency. Ongoing discussion and agreement by the research team framed the analysis process.
The quantitative and qualitative data were analysed and the findings were integrated. In some cases, the research team had further queries and re-contacted responders in the qualitative study by telephone.
The major findings are presented below, under five key task categories.
Screening and diagnosis of diabetes
Between 0.05% and 0.1% of outpatients were diagnosed as having diabetes across the intervention and control piloting sites. This was lower than might be expected.20 The data is not available to estimate the proportion of outpatients who were screened, tested and found to have high blood glucose levels.
About 60% of the diagnosed patients were overweight. This suggests that, as proposed, patients were screened on the account of appearance (of being overweight) and symptoms of diabetes. One of the responding doctors summarised his experience as follows:
'Patients do report with different set of symptoms and signs, therefore we rely on a range of indications for diabetes.' (Doctor RHC)
At the time of diagnosis 417 (84%) patients were administered both RBG and FBG; the remaining (16%) patients were administered only one of the two tests (RBG 5%; FBG 11%). A total of 2–3 consecutive facility visits were required for a patient to get examined and diagnosed. The facility staff and patients did not report any financial or social constraint to coping with this requirement:
'The doctor got a few tests done for diagnosing my diabetes, for which I visited the facility three times. I did not pay any fee for these tests.' (Female patient THQ)
The definition and understanding of FBG testing was found to vary among patients; for example, some patients reported taking a cup of tea (but no breakfast) before coming for the FBG testing.
Urine protein testing was used to screen patients for renal impairment. Urine protein was found to have been tested for all 495 diabetes patients. A total of 192 (39%) of the patients were found to have some degree of proteinuria: 134 (27%) had mild proteinuria; 58 (12%) had moderate or severe proteinuria, which is associated renal compromise.
The facility staff indicated that the use of dipstick made the urine-protein screening more feasible and quicker for staff and patients. Neither staff nor patients reported any financial, social or logistic constraints in getting the urine tested. For example:
'Urine dipstick is more manageable for our situation, i.e. heavy patient load.' (Allied staff THQ)
The core demographic measures (age, sex) and clinical parameters (for example, weight and blood pressure) were found recorded for all registered patients. The data show that about 60% of the registered diabetes patients were women. The facility staff and patients reported no social and/or logistic constraint in: (a) getting a patient clinically examined and recorded; and (b) patients' sharing their phone numbers, when the purpose was explained to them. However, most female patients shared the phone numbers of their male family members (husband, son, and so on) for the facility records:
'Female patients usually prefer sharing the phone number of a male family member; as this is socially more acceptable [in this cultural setting].' (Allied staff RHC)
When asked about the possible reason for more female patients, the facility staff mentioned minimal opportunity cost (that is, lost earning) as a main reason for more female patients, rather than more women suffering from the disease.
All patients were found to have been prescribed medication at the time of diagnosis; no patient was given lifestyle modification trial before prescribing the drugs. Prescribing drugs at diagnosis seems to stem from patient expectation and the provider's routine, which is to prescribe everyone at the time of diagnosis:
'It is difficult to inform a patient about diagnosis and not prescribe any medicine; the patient is likely to switch to another source of medical care.' (Doctor RHC)
Table 1 shows that the intervention-site patients were more often prescribed the correct medicine, as per programme protocols (namely, that metformin should be prescribed as first-line drug, unless associated with protein in urine), compared with the control sites: 49% and 131% more often among patients without and with proteinuria respectively.
Table 1. Prescriptions for diabetes
Variation in prescription practice seems to be a blend of medical and non-medical considerations. Non-medical reasons for drug preferences were provider preference, patient profile, and drug cost and availability. Some of the prescription variations reflect more the provider's perceived balance between the medical and non-medical considerations:
'Some patients do prefer taking expensive medication (by multinational pharmaceutical companies) or medicine being used by other family member or friend.' (Doctor RHC)
At time of registration, around 10–12% of patients with diabetes were labelled hypertensive and prescribed antihypertensive drugs, whereas another 12–13% were found with raised BP but not labelled and not treated for hypertension. Interviews with staff indicated inconsistencies in labelling a patient with coexisting diabetes and hypertension, and also in recording antihypertension drugs, especially if not provided from the facility drug stock:
'Patient records are sometimes used as evidence of drugs dispensed by the facility; so we tend to record only the drugs provided from the facility stock.' (Doctor RHC)
Table 2 shows that the majority of eligible patients were not prescribed any preventive drug (a statin and/or aspirin unless a contraindication), even when available in the facility stock. Interviews with doctors at intervention facilities indicated the challenge of selecting eligible patients for prescribing preventive treatment. Some also suggested considering universal prescription of preventive drugs, with as few exclusions as possible:
Table 2. Preventive medication
'Heavy outpatient load makes it difficult to apply any complex care protocol such as eligibility for preventive medication.' (Doctor THQ)
The average reported duration of lifestyle counselling session at the time of registration was about 10 minutes, whereas subsequent counselling sessions were shorter, at around 5 minutes. Women were reported to show more interest in lifestyle counselling, including weight reduction.
At the time of registration, around a quarter of male patients and 5% of female patients were reported smokers. At the time of outcome measurement, 9 months after registration, only one smoker reported having quit smoking. Staff and patients indicated that staff prioritised counselling on diet and exercise, with less attention to smoking cessation.
Comparing weight at registration and the sixth follow-up visit, the intervention was found to have maintained or reduced the body weight of 69% of patients, while 31% of patients showed an increase in body weight. The change in weight indicates some possible lifestyle changes involving diet and/or exercise. The concept of target weight was also reported to be well perceived by staff and patients, as it set a clear target for weight change.
Patients reported challenges in managing their daily walk (30 minutes) owing to lack of access to a walking place and difficulty in finding time from other responsibilities. Women also reported an additional cultural challenge to their walking practices of needing a male member to accompany them. Some women managed by walking within their household boundaries, such as in courtyards and roof-tops.
Data suggest that the change of diet was a complex social phenomenon, rather than just a matter of health need or priority. The ability to change the family dietary practices seems to be associated with who in the household has suggested the dietary change. Male wage-earners were more likely to get the family diet changed compared with a female homemaker or an older person. A few women also reported managing their salt and/or oil reduction by taking their portion out, then adding salt or oil to the food for the rest of the family members. One commented:
'My mother-in-law decides the menu and recipe for family meals; any dietary change without her consent is not easy.' (Female patient THQ)
Follow-up and adherence
Patients at intervention sites adhered more to the first eight monthly follow-up visits (75%; n = 1507/2000) as compared with the control sites (44%; n = 862/1960). This difference seems more marked during the first five monthly follow-up visits, and becomes less pronounced in subsequent months (see Figure 2).
Figure 2 Patient attrition in intervention and control arms
Interviews with staff and patients indicated free drugs and tests to be the incentives for patients' continued facility visits:
'I come to the health centre to get free examination and drugs.' (Patient RHC)
The intervention sites implemented a three-tray system, whereby patient treatment cards were moved to the next tray when they attended, while those not attending remained and were made a phone recall contact. The better adherence to follow-up visits at intervention sites indicates the value of this patient adherence monitoring and retrieval system. The allied staff reported no challenge in their reminding male and female patients about their follow-up visit. However, staff suggested using standardised messages for typical scenarios, such as reminders to patients with delayed follow-up visit, and reminders for lifestyle changes:
'Useful application of mobile technology for patient adherence may be sustained and possibly expanded for other disease conditions.' (Paramedic THQ)
Many individuals faced the challenge of being consistent in attending, taking life-long medication and lifestyle change. More than half of the interviewed staff and patients mentioned patients using supplementary care from traditional and/or faith-based sources in the hope of finding a cure, rather than accepting the explanation of their diagnosis and the prospect of lifelong treatment:
'On my friend's suggestion, I did try water from a holy spring in hope of getting cured.' (Patient THQ)
The review of more than 2350 patient follow-up visit records, showed universal staff adherence to the clinical assessment (for example, BP, weight) and blood glucose testing requirements. However, the staff did indicate the importance of uninterrupted supplies (for example, glucose testing strips) and equipment maintenance (for example, BP apparatus, weighing scale, and so on) for them to be able to examine patients properly. No patient reported any significant financial or social challenge in attending their follow-up appointments.
During the first 9 months of treatment, 41 patients (8%) visited a secondary level hospital; 19 (46%) of these visits were for cardiovascular disease-related conditions; and 34 (83%) were admitted for 1 or more nights. Seventeen (41%) of the 41 reported visits were made to a public hospital, and 24 (59%) were made to a private hospital. When a patient has a severe medical condition, the doctor and the patient's family judge which hospital and when to attend, taking into account financial and other considerations. Even referral for a routine specialist examination (for example, an eye examination) at a hospital can be a challenge, which may result in lower patient compliance:
'It took three hospital visits for me to get checked by eye specialist, because I went without prior information and appointment.' (Patient THQ)
Material inputs
Project records and staff interviews show that the drugs, laboratory supplies, and equipment were effectively channelled through the respective provincial programme and district offices. The facility staff and patients did not report any complaints regarding distribution, quality, or use of programme provided drugs and supplies. However, the facility staff mentioned the challenges of maintaining equipment and non-inclusion of the cholesterol-lowering drug (statins) in the list of drugs for the public facilities to purchase.
Overall, the intervention components were found to be feasible to implement for the providers and were acceptable to patients. The intervention led to improved prescribing practice and better attendance for follow-up visits. The data on lifestyle counselling and change were inconclusive and need further emphasis in future. Two important health system factors that helped to make the diabetes care available and affordable for patients were use of the chronic disease card, and regular supply of free drugs and tests.
The intervention showed improved patient glucose control outcomes, although this was not statistically significant after adjusting for cluster effects and potential confounding variables. A limiting factor on the size of effect may be the reduction of follow-up from 18 to 9 months, which was owing to operational and time-constraints. The results need to be assessed again with a longer treatment follow-up and refinements made following a process evaluation of the intervention.
A pragmatic approach to data collection was adopted, which had both strengths and weaknesses. The strengths were that, by utilising routine data, data collection costs were minimised and the quantity of data available for analysis was maximised. However, there were some variables that were not available such as education level and occupation. There is a lack of literature evaluating the use of Skype interview in applied health research, such as participant discomfort with technology, or technical failure. However, the authors' experiences were broadly positive and utilisation of Skype technology allowed them to conduct the research according to the planned protocol and with an expert interviewer.
The international guidelines21 recommend FBG as an essential test for diagnosis and follow-up of diabetes. The present study indicates that testing FBG is feasible at the time of diagnosis. However, FBG testing during the follow-up seems to add to the patient and staff efforts without necessarily adding to the quality of clinical care. Global literature suggests that RBG can be used as a reasonable test to check the glycaemic control of undertreatment of patients in resource poor settings.22–24 Therefore, the authors recommend the use of RBG (instead of FBG) to simplify the follow-up requirements for patients and staff, without compromising the quality of care.
This study showed that using a dipstick for testing proteinuria is feasible for primary healthcare settings. This seems in-line with experiences elsewhere; for example, Patel et al 25 stated that urine dipstick is feasible and reduces staff workload in routine primary care. Given that 40% of patients with diabetes had some degree of proteinuria, and the degree of proteinuria does affect the prescription, the authors recommend universal urine dipstick testing of patients with diabetes at primary healthcare facilities.
This study found more diagnoses of diabetes among women than men. One explanation could be higher prevalence of diabetes in women than men. The literature suggests occupation, education, socioeconomic status, marital status, obesity, and increased waist circumference to be the major reasons for possible high prevalence among females.26–29 However, another plausible explanation is higher service utilisation among women.30–31 In this case, the data were inconclusive as to why more women than men were diagnosed.
Prescription variation among intervention doctors indicates that, in addition to guideline and training, staff enhanced supervision is needed to achieve universal adherence to the prescription protocols. The literature shows evidence of doctors: (a) advocating specific brands of medicine in response to promotion by pharmaceutical companies;32–34 and (b) prescribing drugs in response to patient preferences, such as drug cost and perceived quality.35–36 In the present study, the availability of drugs influenced the staff and patient response, and the authors recommend programme measures to ensure supply of essential drugs at public health facilities.
The very low prescription of preventive medicine, even when made available, indicates the need to simplify the prescription protocols. The recent literature also proposes universal prescription of preventive medicine, with some exclusion criteria.37 The authors recommend adapting the protocols for prescribing preventive medication, in line with criteria-based exclusion approach.
The authors found helpful, as reported elsewhere,38–40 the use of mobile phone to remind patients about their follow-up appointments. Nevertheless, 25% of patients still did not adhere to their follow-up appointments. The King's Fund11 reported similar challenges of chronic disease patients' non-adherence to the follow-up visits. Others report higher adherence to the follow-up visits when patients were offered transfers to another health facility of their choice or convenience41–42 and prescription refills.43 The authors recommend that the NCD programme contextualise and evaluate such innovations for potential future scaling.
Lifestyle change is a complex sociocultural phenomenon that is mediated by family, community, and gender dynamics.44 This study found that women faced greater challenges than men in making changes to their diets and physical activity levels.39,40,45,46 This could relate to a number of sociocultural factors; for example, decision-making power, gendered division of labour, and traditional home-based roles.47,48 However, most literature relates to high-income settings, and interventions often rely on behaviour change techniques43–45 that have emerged out of Euro-American psychological theory. The authors recommend research to understand how to modify the lifestyle of patients with diabetes in developing country settings, with interventions focusing on both individuals and communities.
Implications for research and practice
By utilising mixed methods for a process evaluation, the authors were able to develop an in-depth understanding of the perceptions of providers and patients of what was delivered, to whom, and why. Some challenges were identified relating to continued diabetes care and lifestyle modification, and the authors have proposed recommendations for better diabetes care in Pakistan.
This study shows that integrating diabetes management into routine primary care is feasible and acceptable. Integrated diabetes and related disease care can lead to improved assessment, diagnosis, prescription practices, and adherence to follow-up appointments in a low-income country setting, with promising results. The authors recommend service delivery refinement and continued research for achieving optimal diabetes care.
The study was funded by the Department for International Development, UK (reference number: COMDIS-HSD RGNUID 480650)
This study has ethical approval from the University of Leeds Research Ethics Committee (reference number: HSLTLM11019) and the Pakistan National Bioethics Committee (reference number: NBC: 90) on 30 April 2012.
The authors would like to acknowledge Farooq Manzoor, director of NCD control programme, Punjab, for facilitating this study.
Accepted July 2, 2018.
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Muhammad Amir Khan, John D Walley, Saima Ali, Rebecca King, Shaheer Ellahi Khan, Nida Khan, Faisal Imtiaz Sheikh, Haroon Jehangir Khan


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New National Director of Multicultural and Cross Cultural Ministry
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Apwee Ting, Multicultural and Cross Cultural Ministry
Rev Dr Apwee Ting from Dandenong Uniting Church has been appointed as the new National Director of Multicultural and Cross Cultural Ministry.
Rev Dr Ting is the first person from an Indonesian background to be appointed to a senior national role in an Australian mainstream Christian Church.
As the Minister at Dandenong Uniting Church in Victoria, Rev Dr Ting brings with him a wealth of experience in multicultural ministry.
The Dandenong region is one of Australia's most culturally diverse and multifaith communities due to the recent influx of new migrants and refugees to the area. Ensuring that different groups are connected and working together is a key aspect of Rev Dr Ting's ministry in Dandenong.
Rev Dr Ting has a rich theological understanding of intercultural ministry, having completed his PhD in 2005 at STTIP Jakarta (Sekolah Tinggi Teologi International Philadelphia). His thesis examined cross-cultural ministry as the fulfilment of the church's missional mandate.
This year marks the 30th year since the Uniting Church declared itself to be a multicultural church. Rev Dr Ting hopes to bring this spirit of intercultural unity to his new role.
"I strongly feel the hands of God, friends and communities supporting and encouraging me to take this important role. I feel so grateful and humbled by this opportunity and will give myself as a servant to all," he said.
"I look forward to working closely and constructively with my colleagues in Synods, National Conferences, Presbyteries and congregations."
One of Rev Dr Ting's priorities will be developing more culturally accessible resources for ministry including a publication that uses images of seasonal fruit to explain biblical and theological teachings.
"In this age of rapid global migration, of people and of ideas, churches need to re-discover the art of cross cultural ministry in order to fully engage with their missional mandate. I'm glad to say the UCA is at the very front of this ministry."
UCA President Rev Prof Andrew Dutney has warmly welcomed Rev Dr Ting's appointment.
"Apwee Ting brings a wealth of experience in working cross-culturally in congregations and a deep understanding of the UCA's overseas church partnerships," Rev Prof Dutney said.
Rev Dr Ting will officially commence his new position in July this year.
You can read the full media release on the Uniting Church National Assembly website.
The gift of being UnitingWorld National Director
Presbytery on show
Yurora – National Christian Youth Convention (NCYC)
Theological diversity within a multicultural church
New UnitingCare director


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Playwright, Author, Lyricist
Musicals, Plays
Comedy, Jukebox/Revue, Romance, Farce, Historical/Biographical, Horror
playwright lyricist author Tony nominee drama desk award writer
About Joe DiPietro
Born in Teaneck, New Jersey in 1961, Joe DiPietro is an American playwright, lyricist, and author. Joe attended Rutgers University in 1984 with a Bachelor's Degree in English. His best known works include *All Shook Up*, *I Love You, You're Perfect, Now Change* , and Memphis. I Love You, You're Perfect, Now Change ran for 12 years Off-Broadway at the Westside Theatre. Although DiPietro made his Broadway debut with All Shook Up in 2005, it was Memphis in 2010 that won him critical acclaim. Winning the 2010 Tony Award for Best Musical, Memphis ran for three years at the Shubert Theatre. DiPietro's next Broadway success would come with Nice Work If You Can Get It, earning him a Tony Award nomination for Best Book of a Musical and winning the Drama Desk Award for Best Book of a Musical.
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Auditons for AMDA (Washington) Washington, DC
The 39 Steps McLean, VA
Vanya and Sonia and Masha and Spike Baltimore, MD
seven methods of killing kylie jenner
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What an honor to have Jayne's Robe featured in my hometown newspaper. My journey has taken me all over the world to learn and refine my craft as a designer, but nothing makes me prouder than my deep roots back to DuBois, Pennsylvania (or as we say "P-A").
My parents remain active members of their local community and their work continues to inspire our family to give back. Please check out the news article about Jayne's Robe in the DuBois Courier Express.


The Washington Cider Week posts continue! The previous week brought me to Seattle Cider and the Burgundian (Eden & Alpenfire event ) on Thursday night to kick off Washington Cider Week, and Cider Summit Seattle 2015 on Friday & Saturday (see post 1 for tasting notes and post 2 about the event & photos). This week brought me to Capitol Cider for a tasting event with Bill Bradshaw and nine Washington cideries (Tues Sept 15 2015, covered here), and to the Schilling Cider House for the 2 Towns tap night (Thurs Sept 17 2015, covered soon).
I had been to Capitol Cider once before, but it was probably over a year ago. I really didn't like that first visit much at all, as nothing really went well, from the food (it was early lunchtime on a weekend but they mostly had brunch items, not lunch), to the service (grumpy bartender), to the cider (didn't like anything I tried, and the bartender wasn't too forthcoming with samples; I would have preferred a flight, which they now offer).
Much has changed there since then! Their service was good this time (I give them some slack as they had to give everyone a few handouts and 9 different ciders! in addition to taking any other orders). Their bottle list has much improved / expanded. However, unfortunately it is mostly just a list (they only have the smaller bottles in some fridges literally at floor level near the entry). As it is a printed list, it easily gets out of date (both times I bought bottles they only had half of what I wanted, although I was requesting more rare & special release selections). However, Capitol Cider isn't really my sort of scene. Getting there & parking is a nightmare for one. The Schilling Cider House is honestly more my style, plus they have more taps (32) and a larger bottle selection (which you can see and look at the labels).
Bill Bradshaw is a cider expert who hails from the UK and has written several books about cider, among other things. This special event was a guided tasting through ciders from nine Washington cideries. Dave White from Whitewood Cider apparently helped Bill Bradshaw choose the cideries, although I'm not sure how the ciders got chosen (it didn't appear Bill, Dave, or the cideries themselves chose the cider selections, so it may have been availability / mostly what they already had on tap). [The cidermakers chose the ciders poured, although there was some confusion from one of the cideries as far as their selection.] They are for the most part some of the more traditional cideries in WA. For $30, I got a flight of nine ciders (probably a 3 or 4 oz pour each), plus a full glass of the cider of my choice. I unfortunately had to drive, so I made due with my flight (finishing my favorite ciders and leaving the rest) and a couple tastes afterward, but no full glass of cider. Most of the cideries had one or more cidermakers on hand who came up on the stage and explained about their chosen cider.
They were also selling Bill's books, he was signing autographs, and many of the cideries brought some bottles which they opened after the event and poured tastes. During the event there was a slideshow of Bill's photos. They also played the teaser for a documentary titled 'Cider Hunters' that he and Pete Brown (co-author of World's Best Ciders) are fundraising for, about the history of cider in the U.S. Cider is "the drink that built America". He described how it disappeared, breweries moved in, the craft beer movement started in the '80s, and now we are in the age of craft cider, built from the beer explosion. Throughout the event there was some discussion on whether cider is more similar to wine or beer. It depends on who you ask. Bill seemed to lean towards beer, but I'd probably lean more towards wine as scientifically speaking cider is a type of fruit wine, although the ABV of most ciders is more similar to beer than wine.
The event was also unfortunately at 6pm on a weeknight, which is late for me as I go to work at 6am. So, I didn't get to stay too long after they were done with the guided tasting a bit after 8pm. I was surprised there were still some empty seats, as I had expected this to easily sell out (I purchased my ticket a few days in advance over the phone to ensure I wouldn't get turned away). Considering that almost all of the 9 cideries were represented and that many brought more than one person, plus the Capitol Cider folks and such, there were almost as many folks that were working the event as attending the event! They were setting up live music and it looked like the party kept going after I left. The event was held in Capitol Cider's basement bar area, which has a small stage, tables, bar height tables, a bar, pool tables & such, and restrooms.
I had an awesome time! Many of the cidermakers I had been chatting with the previous week were there. I also hadn't previously tried 6 out of the 9 ciders they were pouring, which is quite good odds as they are all local. I tried to take some photos, but the lighting was pretty horrible. Click to biggify.
Upon sitting down I spotted a clipboard full of menus. They had menus for their cider tap list, beer & regular cocktails, cider cocktails, cider flights, food, and a cider bottle list! I focused on photographing the cider stuff. Weird angles to avoid glare; sorry. Their food menu (gluten free restaurant by the way) is on their website. I ate some pho before the event as I wasn't sure if it would work well to try to eat dinner during it, and their menu is a bit fru-fru for my liking. That was a good call as its difficult enough to taste cider and take notes! I did however order some creme brulee, which was pretty disappointing, as it was almost half fruit, small, and expensive.
Now, on to the nine ciders of the night! They were tasted in an order to try to minimize the effect the last would have on the next, not in the numerical (alphabetical) order. I believe that all the ciders which were on their tap list were tap pours, and the remaining two (Nashi and Westcott Bay) were bottle pours. I really enjoyed hearing about the ciders as I was tasting them. They also took audience questions / comments.
(6) Tieton Ciderworks Sparkling Perry, 5.5% ABV. I hadn't tried this one before, but have tried a number of varieties from Tieton. Its part of their "top shelf ciders" along with the Cidermaker's Reserve (which I've reviewed), available in pretty 500ml bottles. Craig Campbell, a grower at Tieton's orchard (and the one who started Tieton with his wife), was the presenter. It is made from 11 varieties of perry pears grown in their orchard (which is the largest cider apple & perry pear orchards in Washington, but still small by orchard standards). Craig noted that pears are much more difficult to grow and press into juice than apples. This perry was made using a French keeving technique, where it is slow fermented with wild yeast for 5 months. He said this method can calm some of the tannins of the perry pears. Craig also noted that this perry was just bottled/kegged in May, and may taste even better after bottle aging for 1-2 years. On the drier side of semi-sweet. Mild tartness, bitterness, and tannins. Medium bodied. Unique strawberry notes. I would have liked more carbonation, but I imagine my sample may have sat for a bit / not been able to be poured correctly due to the size. Pretty tasty!
(5) Nashi Orchards Issho Ni "Together" Cider, 6.9% ABV. This was my first time trying anything from Nashi Orchards, although I have one of their perries at home. Jim Gerlach, owner and cidermaker, was there to present. This is one of the few (two?) ciders that Nashi Orchards makes; they specialize in perry. Their orchard is full of asian pear varieties and they pride themselves in using traditional cidermaking methods. This cider was made using apples from the Vashon Island community, which included a lot of crabapples and heirloom apple varieties. It was dry fermented and not backsweetened. Smells like English cider, of rich bittersweet apples. On the drier side of semi-dry. Moderate to high tannins and bitterness. Mild tartness. I liked the bark better than the bite on this one (smelled better than it tasted). It was a bit too high in tannins & bitterness for my liking, likely from the high crabapple content. I imagine like most ciders, if I was having a full glass, I would have liked it better (vs. having a tasting glass).
(7) Snowdrift Dry, 7.6% ABV. I've tried a number of Snowdrift cider varieties; my favorites so far are Red (made from red fleshed apples) and Cornice (barrel aged). This one was presented by someone from Capitol Cider, but Snowdrift sent along some notes. It was commented that they have a small orchard and cidery which is ideally located in East Wenatchee, with its hot summers and cold winters, ideal for cider apples which thrive with temperature variations. Their orchard is mostly Yarlington Mill cider apples, but they have over 40 apple varieties. They noted this cider won an international contest, which is rare for a PNW cider (vs. a UK cider). Semi-dry. Clean plain apple scent. Low in tannins, bitterness, acidity, and tartness. Some citrus notes, but I otherwise didn't pick up much. Smooth. The alcohol is well hidden. I found it kinda boring, but a very solid selection.
(2) Dragon's Head Traditional, 6.9% ABV. This is the variety I tried at Cider Summit. I also have a bottle of their Wild Fermented at home. Wes Cherry (co-owner with his wife) presented. They are from Vashon Island, where they grow over 70 varieties of cider apples, mostly English and some French. They moved their cidery from the Seattle area 5 years ago to start the orchard. This year was their first significant harvest from their own orchard. This cider underwent malolactic fermentation (which is when malic acid is converted to lactic acid, and can often be considered a fault but some cidermakers desire it) which was arrested to retain some residual sweetness and give some butterscotch notes. Semi-dry. Higher acidity. Citrus and fruity notes. Low to moderate tannins and bitterness. Mild tartness. I really enjoyed this cider. Probably as it had a little more complexity to it and didn't go too overboard on tannins and bitterness.
(8) Westcott Bay Semi-Dry, 6.8% ABV. This was my first time trying any ciders from Westcott Bay. Presented by Capitol Cider. Westcott Bay has their own cider orchard in the San Juan Islands which dates back to the 1870s. They re-planted in the mid 1990s and released their first cider in 1999. They make more traditional apples using cider apple varieties such as Kingston Black, Yarlington Mill, Dabinett and Sweet Coppin. Semi-sweet. Similar to English cider. Bitter finish, but still only mild to moderate. Moderate tannins. Bolder flavor. I really enjoyed this cider. I like ciders like this which have a bold flavor profile without being too bitter or too high in tannins.
(1) Alpenfire Simple Cider, 6.9% ABV. I've had a number of ciders from Alpenfire, but hadn't even heard of this one (it looks like it may be tap only at this time?). I particularly like their Apocalypso and Spark! ciders. Presented by Nancy Bishop. They described themselves as a more traditional cidery whose ciders tend to be higher in tannins. They planted their cider apple orchard in 2003, then needed to learn how to use it, and get people to buy their ciders! This variety is their least traditional cider, made from basic heirloom and dessert apples. It is sweeter and described as having some honeysuckle aromas, and was lightly oak aged. On the sweeter side of semi-sweet. Slightly hazy. I picked up some honey, pear, and mild herbal notes. No significant tannins, bitterness, acidity, tartness, etc. I thought it was rather complex for a simple cider! I really enjoyed it.
(4) Liberty Ciderworks Abbess, 7.6% ABV. I've had a number of ciders from Liberty. Presented by Rick Hastings. This is a newer cidery from Spokane, open about a year and a half, and they currently produce 7,500 liters a year. Unlike many of the cideries featured, they don't have their own orchard. However, they have found ways (probably at great expense) to obtain cider apples, primarily from three different orchards, including from Garfield WA. They also use a lot of crabapples. They aim to keep the apple centric, and don't plan to do flavored ciders; their Turncoat Dry Hop cider and this one is as flavored as they get. I particularly like their Manchurian Crabapple and English Style ciders. Rick commented the Spokane cider market is growing slower than Seattle, but is still growing. Liberty was tasting their new Abbess variety, with gin botanicals. Made from Empire, Macintosh, and Manchurian Crabapples. Its been out for about a month in their tap room and has been popular. English cider scent with a hint of botanicals. On the drier side of semi-dry. Bold flavored. A hint of botanical flavor. Significant tartness, bitterness, and tannins. I'm not a huge fan of this one, but it didn't have any faults and is a solid selection.
(9) Whitewood Cider Kingston Black, 9.7 ABV. I had tried this cider at Cider Summit, but didn't mind having it again in the least, as it was one of my favorites! I've only tried Whitewood's Summer Switchel and this one, but look forward to trying some others. Presented by Dave White. Whitewood released their first ciders in 2013, so this is their third season. Dave aims to make more traditional ciders, with heirloom & cider apple varieties. He noted their Southsounder cider is made from apples within 20 miles of Olympia. This Kingston Black cider was made with champagne yeast, but Dave hopes to eventually make a wild fermented batch. It is 80% Kingston Black and 20% Cornish [Porter's] Perfection, much to Dave's disappointment. He aimed to make a single varietal, but apparently the Kingston Black apples were sliding around too much during pressing or something, as they were sweated to bring out more flavor. Doing an almost single varietal Kingston Black cider must have been very expensive, as they are rare. He noted some Woodinville Whiskey was added to the barrel before aging. [The barrel was from Wishkah River Distillery in Aberdeen, WA.] I don't like aged spirits, but love the flavor in a cider. This cider was taken out of fermentation in early 2014 and barrel aged until just recently. Dry. Whiskey and vanilla notes. Rich bold flavor. Very smooth, with hidden ABV. Low to moderate bitterness. Yum!
(3) Finnriver Fire Barrel, 6.5% ABV. I've tried a large number of Finnriver ciders, and even tried this variety quite awhile ago. I remembered really looking forward to it but being disappointed. I bought another bottle recently as so many folks enjoy this cider, and I wanted to give it another chance, as my palate has changed. So, here will eventually be a full review of it here. Presented by Eric Jorgensen, a co-founder. They were described as a small organic farm which started selling cider in 2010. Eric thinks they were the least traditional of the nine cideries present. However, he described this as their most traditional cider, as it is made from cider apples. They started a second orchard three years ago and aim to remain sustainable and organic. This cider recipe was original produced by Drew Zimmerman, who sold the rights when he retired. It is made from Kingston Black, Yarlington Mill, and Dabinett cider apple varieties. This cider is no longer aged in Kentucky whiskey barrels though, as they aim to keep it more local, instead using UT or WA barrels. This cider has inspired Finnriver to take on other barrel aging projects. They mentioned they are barrel aging a small batch of their Black Currant cider, which sounds awesome, as that is one of my favorites of theirs, along with Honey Meadow. Very smooth. On the sweeter side of semi-dry. Mild barrel notes. Bold flavor. Moderate tannins, bitterness, and acidity. I was surprised with how much I enjoyed this cider, in contrast to my memory from awhile back. I look forward to drinking the bottle I have at home!
I was interested in buying four bottles to take home from Capitol Cider, but they only had two of the ones I wanted, Virtue The Mitten and AeppelTreow Appely Doux. I had heard of both but didn't know they even sold them in WA! I had been wanting to try The Mitten ever since I got into cider; it often makes top cider lists. Note that the prices shown on their bottle list below are to drink there, but you get a 25% discount to take home. That brings their prices just a bit over local bottle shops for most ciders. The cost to drink a bottle is much less of a markup than most wine lists. However, with all those ciders on tap, why would you want to? They initially forgot to apply the 25% discount (they were very busy and I was asked them to go to the back and find specific bottles), so I was very glad I checked my receipt.
Unfortunately the cider list was stapled at the top, so even taking it off the clipboard I couldn't get good photos. The angles are again to avoid glare from overhead lighting. Impressive bottle list! However, the win still goes to the Schilling Cider House in Fremont, as you can look at the actual bottles.
I got my new copy of World's Best Ciders (which I reviewed here recently) autographed by Bill Bradshaw, and even got to chat with him for a few minutes.
Stay tuned for the last but not least Washington Cider Week event post, from the 2 Towns night at the Schilling Cider House! Like Cider Says on Facebook for the latest info.