Winners of this challenge created Model Privacy Notice (MPN) generators that produce a customizable MPN for health information technology (IT) developers, making it easier for consumers to see a product's privacy and security policies.
Jason Cronk and Professor Daniel J. Solove's generator features a side-by-side, live-updating view allowing application developers to see the MPN as they complete the app's sections. It also clearly shows the developer which sections are completed or require more information. The MPN most successfully combines the clarity and simplicity of a nutrition facts-type label with visual icons that aid comprehension of the privacy concepts. The first-place team, which was awarded $20,000, best specified which terms and language were changed to enhance consumer understanding.
1upHealth's team uses a side-by-side view that includes live checking of entered information to verify websites and phone number formats. The generated MPN allows for extensive customization, available in HTML, JSON, and Markdown formats. Detailed interviews and usability testing were held to receive consumer feedback. The second-place team was awarded $10,000.
MadeClear.io's generator features expandable headers allowing developers to easily see how far they have progressed in completing the MPN. The MPN uses alternating background images that help differentiate the sections and colorful icons that add context to the privacy language. The team's consumer testing included surveys completed by 30 individuals. The third-place submission was awarded $5,000.
The model privacy notice is a voluntary, openly available resource designed to help developers clearly convey information about their privacy and security policies to their users. Similar to the FDA Nutrition Facts Label, the MPN provides a snapshot of a company's existing privacy practices encouraging transparency and helping consumers make informed choices when selecting products. The MPN does not mandate specific policies or substitute for more comprehensive or detailed privacy policies, nor does it meet the Health Insurance Portability and Accountability Act (HIPAA) requirements for a notice of privacy practices.
ONC issued a request for information on March 1, 2016 asking the public what information about privacy and security practices health IT developers should disclose to consumers and what language should be used to describe those practices. ONC received thirteen submissions with broad stakeholder representation - from developer organizations representing over 5,100 members, provider organizations representing over 200,000 providers, and consumer organizations representing patients and consumers across the country. The challenge was launched in December 2016 and leverages updated MPN content developed by ONC, with feedback from the HHS Office for Civil Rights, Federal Trade Commission, and other private and public stakeholders.
A public webinar demonstrating the winning tools will be held on July 12 at 2:00p.m. EDT.
To access the 2016 MPN content, visit https://www.healthit.gov/sites/default/files/2016_model_privacy_notice.pdf.
Additional information about the MPN is available at https://www.healthit.gov/policy-researchers-implementers/model-privacy-notice-mpn.


Dated: May 3, 2013: Bangalore Sportz Blog talks about our academy.
We participated in TCS World 10K Run on May 19, Bangalore.
Dated: Nov 11, 2012, Fans of hockey covers the tournament.
© 2009 - 2017 Jude Felix Hockey Academy | All rights reserved.


Reader reviews and comments on Red River, plus links to write your own review.
Your Ancestors must be proud of you!
I've read both of your books. I was taken back in history and gone the journey with you and yours. I have never heard of the "Massacre" until I picked up Red River. Your books should be on everyone's personal bookshelf. I will share these with my children as their maturity level grows. I am telling everyone I know about Ms. L. "Ta-Taa-Mee" Williams.


Contact Alpine Dental Center Today!
Call Alpine Dental Center and speak to our Denver dentist Dr. Alan Gurman to schedule an appointment today! We are proud to serve families from Thornton and nearby areas as well!


text:
GB1 Characters, GB2 Characters, Minor character,
NYC Mayor
RGB NOW Comics Characters
Mayor Lenny
Real Ghostbusters Starring in Ghostbusters II: Part 3
Played By:
David Margulies
Mayor Lenny [1] (also known as Mayor [2], and The Mayor of NY [3]) was the Mayor of New York City who bailed the Ghostbusters out of jail to let them do their job and wipe out Gozer. After New Years Day 1990 and prior to the Thanksgiving holiday weekend in 1991, Lenny was succeeded as Mayor of New York City by Jock Mulligan.
In 1984, the Mayor bailed the Ghostbusters out of their jail cell, in which they were placed after the explosion at the Firehouse. Despite Walter Peck's accusations, he listened to Peter Venkman's argument that, if they could stop the impending threat, he would secure a re-election for himself. He gave them a military motorcade to get to Dana Barrett's apartment and had Walter Peck removed from his office.
Between 1984 and 1989, Lenny hired Jack Hardemeyer as his assistant. Jack jealously, yet needlessly, defended Lenny from the Ghosbusters, citing their association being harmful to the Mayor's run for Governor the following year. When the Ghostbusters were brought to Gracie Mansion, Lenny heard their latest claim but refused to help them. He returned to a party and was unaware Jack had the Ghostbusters committed to Parkview Psychiatric Hospital. As New Years approached, supernatural activity increased to unprecedented levels.
The next night, Lenny spent an hour in his room talking to the ghost of former mayor, named Fiorello La Guardia.[4] He returned to City Hall and told his team he had no choice but to call in the Ghostbusters and passed the order. Jack became alarmed. Lenny learned how Jack abused his power, fired him, and had him dismissed by force. They watched as day suddenly turned to night. Lenny, again, ordered someone to get him the Ghostbusters. Just as the Ghostbusters exited the Manhattan Museum of Art with Dana Barrett and Oscar, Mayor Lenny arrived on scene. Weeks later, he awarded the Ghostbusters with a Key to the City during a ceremony on Liberty Island.
Mayor Lenny was a reasonable politician who wanted to stop the crisis in New York at any costs. He listened to his advisers patiently for advice before calling the Ghostbusters. He was also a Catholic, and valued the advice of the Archbishop, whom he called "Mike."
Called "Lenny" by the Archbishop, his first name is presumably Leonard.
The Mayor was made to look like mayor of New York City at the time, Ed Koch. [citation needed]
David Margulies credits Bill Murray for suggesting the first name basis between Mayor Lenny and the Archbishop. [5]
Lenny is described as a "likeable Democrat and a man of the people - particularly the Irish, Italian and Jewish people." [6] [7]
In Ghostbusters: The Supernatural Spectacular:
The Mayor is referred to Hizzoner, New York slang for the Mayor. [8]
The Mayor recalls how he has impeccable visibility with the Carson show, the Letterman show, Donahue, Griffin, and Good Morning, America. He's also published a book, done cameos on Kate and Ali and Ryan's Hope, and there was a play about his life in development. [9]
The Mayor immediately dislikes Walter Peck who reminds him of his high school biology teacher. [10]
The Mayor's first name was Ed and he was a ward captain. [11]
After hearing Peter out, the Mayor muses to himself that Peter could be a dangerous opponent if he ever went into politics. [12]
In the Ghostbusters II August 5, 1988 draft, Lenny was no longer the mayor. The mayor is a man named Maury. [13]
The scene where Mayor Lenny mentions he had a discussion with the ghost of Fiorella La Guardia was a replacement scene done 4 weeks before Ghostbusters II's release because ILM could not do a ghost FX shot. [14]
The surname "Clotch" originates from the Ed Naha written novelization of Ghostbusters II. [15]
In Ghost Busted (manga), on chapter two, page 48, Jack refers to Mayor Lenny.
On page six of Ghostbusters Issue #4, Lenny is listed on Peck's speed dial.
Mayor Lenny was originally going to appear in Ghostbusters: The Video Game with Margulies set to reprise the role but Terminal Reality Creative Director Drew Haworth came up with a plan B to get Bill Murray on board by meeting with Brian Doyle-Murray. Margulies' contract was terminated. Doyle-Murray was hired to play the mayor. He was brought in to look at the game and his character. Doyle-Murray was skeptical they did this for all the actors. Terminal created a likeness of him. They talked to him about the game. He asked about his brother. Doyle-Murray liked the game. At the end of the meeting, he realized they wanted him to tell Murray he thought the game was good. Melchior admitted to the ulterior motives. Within two days, Bill Murray's attorney contacted Vivendi with news he agreed to reprise his role. [16]
This is also evident on page 20 of the October 8, 2007 third draft of the revised cut-scene script, where Peter refers to the Mayor as Lenny.[17]
Lenny appears on the back cover of Ghostbusters Volume 2 in a rendition of the scene he debuted in during the first movie.
Chapter 24: Biblical
Chapter 02: "World of the Psychic"
Chapter 19: Scaring the Straights
Chapter 21: Tenth Level of Hell
Chapter 28: World is Safe Again
Secondary Canon
Real Ghostbusters Starring in Ghostbusters II
Part 1 (referred to, but not seen)
↑ Archbishop (1999). Ghostbusters (1984) (DVD ts. 1:15:59). Columbia Pictures. Archbishop says: "How are you, Lenny?"
↑ Ghostbusters credits
↑ Ghostbusters II credits
↑ Mayor Lenny (1989). Ghostbusters II (1989) (DVD). Columbia Pictures. Lenny says: "I spent an hour in my room last night talking to Fiorello La Guardia, and he's been dead for forty years. Now where are the Ghostbusters?"
↑ Cross the Streams Episode 40, 27:16 to 27:45, 5/20/14
↑ Aykroyd, Dan & Ramis, Harold (1983). Ghostbusters (First Draft August 5, 1983) (Script p. 111). Paragraph reads: "He is a likeable Democrat and a man of the people - particularly the Irish, Italian and Jewish people."
↑ Shay, Don (November 1985). Making Ghostbusters, p. 156. New York Zoetrope, New York NY USA, ISBN 0918432685. Paragraph reads: "He is a likeable Democrat and a man of the people - particularly the Irish, Italian and Jewish people."
↑ Mueller, Richard (August 1985). Ghostbusters: The Supernatural Spectacular, p. 211. Tor Books, New York NY USA, ISBN 0812585984.
↑ Mueller, Richard (August 1985). Ghostbusters: The Supernatural Spectacular, p. 211. Tor Books, New York NY USA, ISBN 0812585984. Paragraph reads: "My visibility extends with impeccable clarity to the Carson show, the Letterman show, to Donahue and Griffin and Good Morning, America. I've published a book, done cameos on Kate and Ali and Ryan's Hope. They're doing a play about my life."
↑ Mueller, Richard (August 1985). Ghostbusters: The Supernatural Spectacular, p. 213. Tor Books, New York NY USA, ISBN 0812585984. Paragraph reads: "Hizzoner disliked him on sight. He looked like the mayor's high school biology teacher, and Hizzoner had flunked frog dissecting four times."
↑ Mueller, Richard (August 1985). Ghostbusters: The Supernatural Spectacular, p. 215. Tor Books, New York NY USA, ISBN 0812585984. Paragraph reads: "The prelate and the mayor were old friends from the days when they'd been priest and ward captain, Tim and Ed, but the formalities still had to be observed."
↑ Mueller, Richard (August 1985). Ghostbusters: The Supernatural Spectacular, p. 217. Tor Books, New York NY USA, ISBN 0812585984. Paragraph reads: "If this guy ever goes into politics, he could be very, very dangerous. I wonder if he's a Democrat."
↑ Aykroyd, Dan & Ramis, Harold (1988). Ghostbusters II (August 5, 1988 Draft) (Script p. 84). Peter Venkman says: "You got it, Maury."
↑ Naha, Ed (1989). Ghostbusters II, p. 18-19. Corgi Books, Great Britain, ISBN 0552135755. Paragraph reads: "Mayor Leonard Clotch wheeled around and, spotting Venkman, wiped a trickle of sweat from his upper lip and almost ran down the hall in the opposite direction."
↑ Playboy "The Untold Story of the Ghostbusters Video Game that was Almost a Masterpiece" 7/13/16
↑ Zuur Platten, John & Dille, Flint (2007). Ghostbusters: The Video Game (Revised Cut-Scene Script Third Draft October 8, 2007) (Script p. 20). Peter Venkman says: "Come on, Lenny, what gives?""
As seen in Ghostbusters
As seen in Ghostbusters II
Mayor Lenny as depicted in NOW Comics The Real Ghostbusters starring in Ghostbusters II part 3.
As seen on Ghostbusters Volume 2 TPB back cover
Retrieved from "https://ghostbusters.fandom.com/wiki/Mayor_Lenny?oldid=169258"
GB1 Characters

redpajama_set_name: RedPajamaCommonCrawl


text:
Afghanistan won by 134 runs in a one-sided match, 7th consecutive win against Scotland
Afghanistan beat Scotland by 130 runs in the 17th match of the T20 World Cup. Playing first after winning the toss, Afghanistan made 190/4. Najibullah Zadran scored (59) off 34 balls. Scotland had a target of 191 runs to win the match, but the entire team showed a shameful game and were all out for 60 runs in a game of 10.2 overs.
Not a single player from Scotland could show the courage to stand on the wicket. Four players got out for 0 and returned to the pavilion. This was Afghanistan's 7th consecutive win against Scotland in T20 Internationals. In the victory of the team, Mujeeb ur Rahman took 5 wickets while performing a memorable performance.
Chasing the target, Scotland got off to a good start. In the first three overs, the team scored 27 runs for no loss. Mujeeb Ur Rahman got the first blow to the team by dismissing Kyle Coetzer (10). On the very next ball, Mujeeb got Callum McLeod for 0, giving Afghanistan a second breakthrough. Mujeeb could not take a hat-trick but in the same over, he dismissed Richie Berrington for 0. In the very next over, Naveen-ul-Haq sent Matthew Cross to the pavilion for zero.


Displaying entries 23081 – 23120 of 23240.
Coll, Keith USS McCandless (FF 1084) YN3 Personel Jul 1977 – Jul 1979 Anyone who remembers having to get your ID's and update your page 2's had to visit my office.
Collins, Brenson "Radar" Gauntlets (VAQ 136) YN3 squadron Sep 8, 1995 – Jul 13, 1997 Never wanted to leave Japan I had so much fun!!!
Colon, Emilio USS Downes (FF 1070) YN3 X Jan 1984 – Apr 1987 Good times and Bad times. Met some very good people and some not so good. All and all, it was an experience that I will never forget.
Comer, Joseph USS South Carolina (CGN 37) YN3 X 1981 – 1983 Served in the Engineering Log Room and Ship's Office.
Comola, James Paul USS Corregidor (CVE 58) YN3 A Mar 1951 – Sep 1952 From Great Lakes direct to CVE58. Served thru 8-52. Left for NAVCOM 4, Tripoli, Libya. Handled personnel records and all other correspondence out of Engineering Office.
Conen, John USS Brooke (DEG 1) YN3 Ships Office 1973 – Re-enlisted on the USS Missouri when the ship was in dry dock in Bremerton Washington.
Connors, Bob USS Puget Sound (AD 38) yn3 Captain's Office Mar 1969 – Jul 1970 Worked in the Captain's Office with Chief Bill Baldwin. Great Chief and had a great time. Also worked with Personnel Office & Chief Walsh & crew member's Bates, Hanson.etc We also had Chief Warrent Officer Larson.
Contreras, Benito USS Independence (CV 62) YN3 X-1, CCC, X-2 Nov 14, 1994 – Dec 9, 1997 I grew up on this ship. I had many great memories that I will never forget. From drinking my 1st beer at the A Club to getting drunk for my last port visit in Pusan Korea in 97. INDY you will be missed.
Cook, Dan USS Hassayampa (AO 145) YN3 X 1966 – 1967 Made one WESTPAC in 1966. We was the only ship at the time that had a female officer on board. I remember long hot sweaty hours of unreping day and night. And who could forget all the great times at Olongapo City!!
Cook, Mike USS Yellowstone (AD 41) YN3 and R-6 Sep 1, 1984 – May 1, 1988 Thanks to the crew for making it a great tour! I'm retired now and still one original ballcap from those days. Retired now and think of the times regularly.
Cooper, Don USS Canisteo (AO 99) yn3 admin 1978 – 1982 I was onboard for about 3 years. I had a drinking problem ans was cort martialed and sentenced to the grig for 2 months. I regret my actions and would love to hear from anyone who remembers me both positively or negatively.
Copper, Heath USS Champion (MCM 4) YN3 Deck/Admin 1994 – 1996 Best group of people i have very meet. Looking back now some of you that I drank with I wonder how we ever made it back to the ship.
Corey, Rollie USS Lipan (ATF 85) YN3 Ships office Apr 1971 – 1972 I was on board also for the long trip from Nam to pearl towing the pier, the fire when we left and how everybody was happy because we got to go back to subic one last time, I believe it took us about 2 mo.
Corpus, Jose USS Benjamin Stoddert (DDG 22) YN3 ADMIN Mar 1967 – Oct 1968 Retired YNC(SW). Great ship, great shipmates.
Cortese, George USS Molala (ATF 106) YN3 Admin Apr 1976 – Jun 1979 The Best Ship ever always talk about it. met someone that was on the ship from vietnam war.
Cotter, Dennis P. USS John F. Kennedy (CV 67) YN3 Engineering Nov 1970 – Jun 12, 1974 Was yeoman for the Commander of the Engineering Dept.
Crane, Royanthony Aka Mutt USS Constellation (CV 64) YN3 Legal 1997 – 1998 Looking to contact old shipmates.
Craven, Chuck USS Southerland (DD 743) YN3 X-NAV Nov 11, 1971 – Jun 10, 1975 While in the yards in Long Beach the SOUTHERLAND football team was undefeated until we played the Marines. We had such a tight crew it was so much fun being on the ship with all my shipmates.
Crocker, Jeff USS Enterprise (CVN 65) YN3 First Lieutenants and Captains Office Feb 14, 1978 – Aug 12, 1981 Westpac 78 then to Bremerton. Good times, great friends. Worked for CWO Tato and Capt Kelly.
Croeber, Paul USS Chikaskia (AO 54) YN3 2nd 1961 – 1963 Deck force, then 1st Lieutenant's or deck yeoman.
Croley, Mark (Swampgrass) USS Scott (DDG 995) YN3 ADMIN Jul 1990 – Mar 1994 Still prefer syrup and biscuits.
Cronk, Donald R. USS Enterprise (CVN 65) YN3 2nd Lt Office Apr 27, 1965 – Mar 27, 1968 Picked up the E in Nothfork Va as an E2. Made YN3. Worked in First Lt Office. Also G Division.
Cruz Jr, Guadalupe USS David R. Ray (DD 971) Yn3 NX Nov 1979 – May 1983 I was on Westpark back in 1980, then went to Seattle WA for dry dock. I live in San Antonio tx. Feel free to contact me on my sadab5001.lc@gmail.com.
Culver, Jeremy "bubba Tex" USS Scott (DDG 995) YN3 Admin Jul 1995 – Dec 11, 1998 I miss the good ol times onboard.


Going on almost five years on air, Ryan has the number one rated radio lifestyle show in the Bay Area. You can hear him every Saturday from 5-7pm. You can also stream live on iHeart Radio. Guests have included, Rachel Ray, Todd English, Sunny Anderson, Daniel Boulud, Genevieve Gorder, John Gidding, to Sabrina Soto.


text:
ResourcesVacuum
How To Test A Vacuum Tube
Remember the story of Wilhelm Röntgen discovering X-ray using vacuum tube? Much like the widespread use of x-ray, after the invention of the tube by Marconi, in the early twentieth century, the vacuum tube was an essential element in every electric element built to receive and transmit electric signals and data in the form of radio signals. A vacuum tube, as you may already know, is a near-vacuum electric tube that controls the flow of electricity in between its two electrodes.
In the vacuum tube, the filament attached to the cathode heats up when current flows through it. The heated up cathode then emits electron that runs straight to the anode due to the attraction of charges. Despite its being old fashioned these days, many hobbyists and enthusiasts still use vacuum tubes to conduct experiments with. But many a time, grids break down, the filament sags or burns. Hence comes the knowledge of how to test a vacuum tube without a tester, if you don't own any. Or how to test a vacuum tube with a multimeter.
Firstly, in order to know to detect the problem, you'll need to know the model of the tube and its specifications.Some models are best for cleaning stairs and some may be used to clean used to clean wet carpets wet carpets while others might be used in a generalized way. You need to know the construction procedure and the mechanics behind it to fully identify the problem with your tube. Has the glass envelope burst? Has one of the pins shorted out, and melted off? There might be a gas buildup in the gas envelope but the tube may still light up, although it won't function. Or maybe, like all other products, your tube has worn off. The proper reason may only be revealed through proper knowledge of the ratings and pin diagram of your vacuum tube.
Go to the manufacturer's site and download the specification of the tube. Once you know which pin is which, you're ready to carry out the test.
The second thing you'll need to test your tube is a multimeter, of course. If you have spare functioning tubes and a radio, you can also utilize those to test your vacuum tube.
The best tube tester is the socket or circuit for which it was intended. If your main circuit is working you can use it to test the tubes. Does the circuit function when the different tubes are put inside it? If your tube doesn't power up the circuit, then it's not functioning.
Another basic method is to measure the current using the multimeter (Ammeter in this case) when the heater is powered and a low voltage is applied between plate and cathode. Connect the positive of the multimeter to the cathode of the tube and the negative to the anode. Point the multimeter's controlling needle to the Ampere section of the ring and notice if there is any current flow across the tube.
If you're suspecting a filament burn, use your multimeter (ohmmeter in this case) to check between each two pins with a resistance between them. This is what drives a functioning filament. If there is no resistance between any two pins, the cause might be it's a malfunctioning tube.
In short, the best way to test your tube is to study about it and know how it works. The more you know, the more likely you'll find out about where to look despite the absence of a tube tester.
If you want to clean your home using high pressure water, a pressure washer can help you to do so.
The Top 10 Best Rimfire Scope Reviews
How to Get into A Kayak: Described in Just 5 Nice and Easy Steps
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2019 © Ten Reviewed. All rights reserved.


If you suffer from the above symptoms, you are not alone. BPH is one of the leading reasons for men to visit a urologist.
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Dr. Kenneth Choi came to Tucson in 1986, from Flagstaff to attend the University of Arizona undergraduate program, and received his medical degree in 1994. Dr. Choi's focus in the practice is microscopic surgery, pediatric urology, erectile dysfunction, penile prosthesis placement and incontinence surgery. He is one of the most experienced urologists in Arizona with implantation of genitourinary prosthetic devices.
Dr. Mitzi Barmatz is board certified with the American Board of Urology. She received her medical degree from the University Of Colorado Health Sciences Center. Dr Barmatz has held several positions at Northwest Medical Center throughout her career including Section Head-Department of Urology and Chief of Staff. She also served on the Board of Trustees.
Dr. Wright received his Bachelor's degree from Brigham Young University in Business with an emphasis in Information Systems. Dr. Wright's clinical interests include general urology, particularly stone disease and treatment of voiding dysfunction and prostate enlargement, including laser therapies.
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If you want to learn more about the Urolift procedure, you can visit Urolift's website to view information about the procedure, patient testimonials and much more.


text:
white house correspondents' dinner 2014 May 3, 2014
Mark Leibovich Is Glad That the White House Correspondents' Dinner Is Looking More B-List
By Katie Van Syckle
Photo: Andrew H. Walker/2014 Getty Images
New York has the Met Ball, L.A. has the Oscars, and Washington has the White House Correspondents' Dinner. But D.C. might be the only town where a partygoer enjoying cocktails in the shadow of the Washington Monument will also tell you that the whole thing is a bunch of corporate- and celebrity-driven drivel that takes everyone away from their otherwise Very Important Jobs.
In years past, Tom Brokaw and Christopher Hitchens have proudly played the event's party pooper. This Town author Mark Leibovich is the latest to criticize the weekend of passed plates, free champagne, tough doors, Hollywood types, and unexplainable lighting decisions.
Daily Intelligencer caught up with Leibovich last night at the New Yorker party at Washington's W Hotel. He's on a paperback tour for This Town, and still hopes that D.C. will get over its decadence.
"I would hope that it would be some kind of pivot point in which Washington maybe collectively comes to a point of self-awareness that maybe this looks awful, maybe it's excessive, maybe two or three or dozen parties, after parties, brunches are not necessary," Leibovich told Daily Intelligencer.
"Basically, this is just part of the disconnect between the self-celebration of Washington and the revulsion that people outside of it feel for the major institutions here, i.e. the media, i.e. Democrats, Republicans, Congress, lobbyists, whatever. And the disconnect between incredible prosperity and wealth and, frankly, decadence that has grown up here in the last couple of decades, and the very real economic struggles that the country has had in the last six years."
Leibovich said this would probably be his only party this weekend. (He explained that he was not invited to the tony Tammy Haddad brunch after the event made an appearance in the book.) But he told us what to expect: "One thing that you always at a weekend like this is, 'Oh, I can't believe we are all back here again,'" Leibovich says. "There's a grudging acknowledgment of the soul-crushing sameness of these weekends… But this looks a little more B-listy than it's been in the last decade. So that's a good sign."
white house correspondents' dinner 2014
Mark Leibovich: WHCD Is Looking More B-List


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Meet England fans who face the World Cup gatecrashing their weddings – and plan to alter speeches and have frie. – It'd be 'andy if England could wrap things up in 90 minutes, so Jo and Andy don't have to delay the speeches The couple from .
Live traffic news for Aylesbury, 24 hours a day, from AA Roadwatch. Call 84322 – 'theAA' on your mobile or 0906 88 84322 from a land line for the latest travel news.
Jobs in Domremy André was born on March 14, 1929, in Domremy, SK, to Joseph and Antoinette (nee Dupas . where he worked as a telegraph operator for Canadian National Railway. This job took André to many different p.
It's one of London's truly great bars, hotel or otherwise. Purists like to hate on vodka . The base for their martini is a peculiar wheat-based vodka called aylesbury Duck, which has a full-bodied t.
The #1 Best Value of 54 places to stay in Aylesbury. Free Wifi. Free Parking. Five Arrows Hotel. Show Prices. #2 Best Value of 54 places to stay in Aylesbury.
Aylesbury (/ e l z b r i / AYLZ-br-ee) is the county town of Buckinghamshire, England.It is an ancient market town with several historic pubs, is home to the Roald Dahl Children's Gallery and, since 2010, the 1,200 seat waterside theatre.
Travel to Guernsey Getting to Guernsey couldn't be easier when you travel with Condor Ferries. You can pack everything you need and travel in the comfort of your own car, allowing you to make the most out of your holiday in Guernsey. . Check in when traveling to Jersey by car is just one hour before .
Budget hotel in Aylesbury. This 19th century lodge brings together traditional, rustic charm, with plenty of 21st century comforts. With a wide variety of attractions and glorious landscape on the doorstep, this bed and breakfast hotel in Aylesbury is the perfect place to stay if you're looking for a comfortable nights sleep, great food, fine .


text:
Q: Optimize c# foreach complexity Alright so I`m doing a particular case here and I need to pass through a treeview with many foreaches.
After realising my code is not working properly in memory wise I decided to rewrite the code to LINQ. I have managed to get rid of the first foreaches but at the end, I cannot get rid of the signalUI foreach because it needs the Typeof(SignalUI) properties. These being said I don`t know how to do the LINQ for 2 lists at the same time.  I have tried working with JOINS but had no results.
 private void signalUITextBox_textchanged(object sender, EventArgs e)
        {
            for (int j = 0; j < _numberOfSelectedSlaves; j++)
                if (_currentNode.Parent.Parent.Text == mas.Slaves[j].Name)
                {
                    int counter = 0;
                    foreach (FrameUI frame in mas.Slaves[j].FrameList)
                    {
                        int signalcounter = 0;
                        if(_currentNode.Text == mas.Slaves[j].FrameList[counter].FrameName)
                        foreach (SignalUI signalui in frame.SignalList)
                        {
                            foreach (Control i in this.Controls)
                            {
                                if (i is TextBox)
                                {
                                    var txtbox = (TextBox)sender;
                                    if (txtbox.Name == i.Name)
                                    {
                                        foreach (var k in typeof(SignalUI).GetProperties())
                                            if (signalui.SignalName + k.Name == txtbox.Name)
                                            {
                                                mas.Slaves[j].FrameList[counter].SignalList[signalcounter].SetProperty(k.Name, Convert.ToString(txtbox.Text));
                                            }
                                    }
                                }

                            }
                                signalcounter++;
                        }
                        counter++;
                    }
                }
        }

        private void signalUCheckBox_textchanged(object sender, EventArgs e)
    {
        var SlaveQuery = mas.Slaves.Where(slave => slave.Name == _currentNode.Parent.Parent.Text).First();
        var FrameQuery = SlaveQuery.FrameList.Where(frame => frame.FrameName == _currentNode.Text).First();
        var chkbox = (CheckBox)sender;
        var ControlQuery = this.Controls.OfType<CheckBox>().Where(control => control.Name == chkbox.Name).First();

    }

EDIT: Thanks for help. Following below answers i managed to remove all the nested loops
        private void signalUITextBox_textchanged(object sender, EventArgs e)
    {
        int j;
        int signalcounter = 0;
        int counter = 0;
        var txtbox = (TextBox)sender;
        var properties = typeof(SignalUI).GetProperties();
        var SlaveQuery = mas.Slaves.Where(slave => slave.Name == _currentNode.Parent.Parent.Text).First();
        var FrameQuery = SlaveQuery.FrameList.Where(frame => frame.FrameName == _currentNode.Text).First();
        for (j = 0; j < _numberOfSelectedSlaves; j++)
            if (_currentNode.Parent.Parent.Text == mas.Slaves[j].Name)
                break;
        foreach (FrameUI frame in mas.Slaves[j].FrameList)
        {
            if (_currentNode.Text == mas.Slaves[j].FrameList[counter].FrameName)
                break;
            counter++;
        }
        foreach (SignalUI signalui in FrameQuery.SignalList)
        {
            var prop = properties.FirstOrDefault(p => signalui.SignalName + p.Name == txtbox.Name);
            if (prop != null)
            {
                mas.Slaves[j].FrameList[counter].SignalList[signalcounter].SetProperty(prop.Name, Convert.ToString(txtbox.Text));
            }
            signalcounter++;
        }

    }

A: As a general rule: Pull repeated calculations that always yield the same result within each loop iteration out of the body of the loop and to them once. The structure of your code will simplify, declutter, and you effectively reduce its inherent complexity.
The outline of your code will look like this:
private void signalUITextBox_textchanged(object sender, EventArgs e)
{
    // build a list of textboxes, but…
    // in fact, you don't need this at all if you care only of 'sender' as a TextBox
    var textBoxes = this.Controls.OfType<TextBox>().ToList();

    // hence:
    if (!(sender is TextBox)) return;
    var txtbox = (textBoxe) sender;

    // build a list of properties (hint: reduce the list further, if you can)
    var properties = typeof(SignalUI).GetProperties();
    // in addition, a dictionary may come handy: .ToDictionary(p => p.Name);

    // the rest of the code seems cluttered and unnecessarily complex, too,
    // but hard to refactor without detailed knowledge of your data structures
    for (int j = 0; j < _numberOfSelectedSlaves; j++)
    {
        if (_currentNode.Parent.Parent.Text == mas.Slaves[j].Name)
        {
            int counter = 0;
            foreach (FrameUI frame in mas.Slaves[j].FrameList)
            {
                int signalcounter = 0;
                if (_currentNode.Text == mas.Slaves[j].FrameList[counter].FrameName)
                    foreach (SignalUI signalui in frame.SignalList)
                    {
                        // find the matching property
                        var prop = properties.FirstOrDefault(p => signalui.SignalName + p.Name == txtbox.Name);
                        if (prop != null)
                        {
                            mas.Slaves[j].FrameList[counter].SignalList[signalcounter].SetProperty(prop.Name, Convert.ToString(txtbox.Text));
                        }
                        signalcounter++;
                    }
                counter++;
            }
        }
    }
}

Three nested loops less.

redpajama_set_name: RedPajamaStackExchange


text:
Maze soft
Sheet Metal Fabrication – Innovative and Useful
Sheet metal fabrication operations are varied and complex. Each stage of the operation performs a specific task and also causes certain chemical and physical changes in the metal. The finished product can be iron, steel, aluminum, copper, or a combination of various metals and alloys. Skilled craftsmen perform a series of operations, resulting in a finished product that can truly be a work of art.
Each operation is carried out according to drawings prepared by engineers and draftsmen according to customer's drawings and specifications.
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Braking is the bending of a flat metal part at specific locations to shape a specific structure. The CNC equipment moves the stops to the correct size and instructs the operator to use the correct punch and punch.
Welding is the connection of metal parts to each other using electric welding with wire, rod, and other methods.
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But even with all this high tech, all metallurgical companies still require highly trained people to access the most difficult-to-reach weld spots that a computerized mechanical welder cannot access, and to form parts with double or multiple curvatures that they cannot be done without personal skill, eyes and human hand. The best sheet metal manufacturers are those who combine the best of modern technology with the most skilled metalworkers who can still work wonders with sheet metal that no machine can do today.
Sheet metal fabrication is a complex set of operations that produces a portion of everything that people use in their daily lives. Automobiles, houses, airplanes, kitchen equipment, sports cars, and toys are just a few of the products that use this manufacturing method. This business is an art form and you can create incredibly beautiful and complex designs.
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text:
NEGOTIATING HEALTH: patients' and guardians' perspective on "failed" patient-professional interactions in the context of the Swedish health care system
Roland Koch1Email authorView ORCID ID profile,
Stefanie Joos1 and
Elsa-Lena Ryding2
Received: 1 October 2017
Sweden has a largely tax-funded health care system that aims at providing equal access for everyone. However, the individual's perception and experience of the health care system remains a relevant topic for researchers. The aim of this study is to learn the patient's perspective on how patients and professionals negotiate in the social context of the Swedish health care system.
Eight essays that had spontaneously been contributed to a medical writing contest were analyzed using narrative methods. Narratives were defined as a sequence of clauses that correspond to an order of events in the narrator's biography. The analysis comprised a three-step process. First, the essays were read and narratives were extracted. Second, an agency analysis was performed. Third, an analysis of social positioning was employed.
The Swedish health care system provides the social context and background for negotiations between patients and professionals. The narrators position the protagonists of the illness narratives as either patients or guardians of underage patients. The protagonists meet health care representatives in negotiation situations. Due to the lack of emotional connection between the negotiating parties, impossible situations arise. False promises are made which ultimately result in the patients' suffering. Thus, all negotiations failed from the narrators' perspective.
The narrators invited their audience to solve negotiation situations differently. This study discusses some actions that may help navigate negotiation situations: Health care providers should acknowledge the patient's or guardian's social position and dilemma, allow emotions, involve all parties in the decision-making process and manage expectations. Writing competitions may provide a tool for experience-based assessment of health care systems.
Professional-patient relations
The Swedish health care system is largely tax-financed. In 2015, Sweden's health expenditure ranked 5th in the European region. The health expenditure share of the country's gross domestic product was 11,1%. 83,6% of the total health expenditure was financed from public sources. Health care is culturally considered a joint effort in Sweden. Swedish health care prioritizes patient empowerment, respect for the individual and providing health care for everyone on equal terms [1].
However, personal experiences of individuals within the Swedish health care system may diverge from the established goals of the system. A continuing interest in the study of narratives within the context of Swedish health care demonstrates this: Håkansson et al. studied homeless peoples' experiences within a shelter that provides lodging and health services. They established that the perception of illness is relative to the social circumstances in which the experience takes place [2]. In the context of sick leave and return to work, people suffering from mental illness feel stigmatized relative to those who have been absent with somatic illness [3]. Marttila et al. demonstrated that people receiving social assistance show resilience and agency, although facing multiple and complex adversities [4].
These three studies emphasize patient self-management in the social context of the Swedish health care system. Negotiations, defined as discussions aimed at reaching an agreement [5], are a recurring element in stories about illness experiences [3, 6]. According to Arthur Frank, three sub-genres of illness stories are known: Restitution, quest and chaos narratives [7].
The study of stories (narratives) and acts of storytelling (narration) generates diverse material for psychological, socio-anthropological and linguistic studies [7–12]. The storyteller (narrator) arranges past experiences into a meaningful sequence. This sequence is then presented to an audience. Thus, narration is both communication and social interaction [13, 14]. Often, the narrator creates a self-image (narrative identity) through which she re-lives and re-enacts past experiences. Characters appearing in the narrative are positioned by the narrator to negotiate social positions [15]. Narratives act as meaning-making devices, allowing the narrator to make sense of past events and realign them to her personal biography and self-concept [16].
Narration is inseparably interwoven with the narrators' social reality and cultural background. The analysis of stories (narrative analysis) is thus suited to research personal experience in the sociocultural context. In summary, narratives are complex and intersubjective constructs of experience. They are used by narrators to negotiate social positions [17]. The WHO has acknowledged that narration is important to understand cultural aspects of health and health policy making [18].
The aim of this study is to learn the patient's perspective on how patients and health care providers negotiate differences in the social context of the Swedish health care system.
The source of our study material are contributions to the 2016 medical writing contest ("skrivaretävling" [19]). This contest is hosted biannually by the Swedish Balint society (SFMP). The competition usually invites medical professionals (nurses, doctors, social workers) to write a self-reflective essay on a personal patient-health care provider experience.
In the 2016 competition, however, the jury found nine contributions that were written from a patient's perspective. A brief request revealed that the authors were indeed patients. They had found the competition advert on the internet. Since this was unexpected and provided a unique occasion to study spontaneous narratives about patients' perspectives, one of the jury members (ELR) decided to initiate this exploratory study. Inclusion and exclusion criteria as applied to the material are shown in Table 1.
• Essay author identified herself as a patient
• Narrative was written from a patient and/or guardian perspective
• Written consent
• Essay author identified herself as a medical professional
• Concerns about safety or discomfort
• Request of legal release clause
• Request of payment
We contacted the nine authors and explained the study goal and ethical principles for voluntary participation. Eight of the nine authors gave their written consent to participate. Thus, eight essays were included in the study. The essay authors were then asked to provide information about their gender, age and profession.
To ensure participant safety and to enrich the credibility of our findings, a member check was planned. A member check is a qualitative research technique in which a summary of the findings is presented to the participants. Participants' reactions and feedback to the results is then obtained. None of the eight participants withdrew their consent after the member check. Their feedback is included in the discussion section.
All participants were middle-aged, working Swedish women. Their professions were stated as: Airport control officer, author, business consultant, police officer, teacher, teaching assistant, university professor. One participant did not provide information about her profession.
Narrative Analysis reconstructs the inner logic of stories in order to analyze how individuals build and experience their social reality. It examines three basic questions [11, 20]:
What is being told?
How is it told?
Why is it told in that way?
While the first analysis step requires a dedicated reader with an open mind, the two subsequent steps ask for a more empirical and structured approach. Following the three basic questions, the analysis process lasted from 01/2016 to 08/2017. RK had most experience in this analysis method and thus performed all three analysis steps. Between each step, a two-three month pause was planned.
Step 1: Getting to know the texts and finding narratives
First, two authors (RK and ELR) read printouts of all essays alone. During reading, spontaneous thoughts and feelings were noted by hand. The two authors then discussed their thoughts and findings. During this discussion, possible topics emerged. RK characterized the stories according to Frank's definitions of illness narratives. RK and ELR then extracted narratives from the essays based on Labov's definition of a narrative. According to Labov's linguistic definition, a narrative is a sequence of clauses that correspond to an order of events in the narrator's biography [8]. Episodic narratives were collected into "vignettes" [9]. This provided a framework for the following analysis steps.
Step 1 thus helped getting acquainted with the material and the narrators. It allowed us to approach the question: "What is being told?"
Step 2: Agency analysis
Second, RK analyzed narrative agency. Basically, a narrator directs the characters of her story. She uses stylistic elements such as dramaturgy, choice of genre and language to attribute (or deny) power to her characters. By examining the degree to which characters in a narrative are able to influence their lives or the lives of other characters, the narrator's view of her own impact on the fate of her characters become clear. This allows researchers to understand the narrator's concepts of control, responsibility and autonomy [15].
Methodologically, step 2 focused more on the second question: "How is it told?" All three authors discussed the results of this analysis step. Several topics and points of interests arose that needed further explaining.
Step 3: Analysis of social positioning
Third, RK performed a positioning analysis. Narration is a real-time act of constructing and negotiating social positions between narrator and audience through the attribution of features, characteristics, intentions and roles. The narrator actively positions her characters towards each other. She also positions herself to her story and towards the audience. Positioning analysis thus offers insights into the narrator's social stance and her sociocultural background [21].
In this analysis step we could integrate results from the first two analysis steps into the social context of the writing competition. In short, the results of the final analysis step answered the question "Why is it told in that way?". The results were discussed in the study group and later in an interdisciplinary qualitative research workshop group that consisted of social and medical scientists.
For the sake of readability, only the final results (step 3) are presented.
All of the following text examples have been translated from Swedish. Replacements, insertions or clarifications use square brackets. Table 2: Overview of the narratives contains information about the heterogeneity within the narratives in greater detail.
Overview of the narratives
Patient or Guardian to Patient
Acute or chronic disease
Inpatient or Outpatient setting
Middle-aged Woman
Guardian to a young girl
Several doctors
Several weeks
Middle-aged Man
Guardian to an adolescent girl
Several doctors & psychotherapist
Middle-aged Women (Group)
Saleswomen in hospital context
Less than one hour
Adult man
One Doctor
Adult, no gender specified
Nurse, other Patients
It became clear during the first readings that seven narratives were about negative experiences of patient–health care provider encounters. Following Frank's classification of illness narratives, the narratives were identified as quest narratives. In quest narratives, the protagonist confronts a series of challenges. The goal of the quest is to preserve or to gain health. In the study material, these challenges were presented as negotiations between health care providers and the protagonists.
The narrators chose tragedy as their narratives' genre: The narrators slowly built up conflicts and tension in the negotiation situation. The tension ultimately resolved in a climax, which led to a negative ending. This ending often meant a negative impact on patients' health and well-being. Narrators staged conflict between characters. They used emotional language with poetry-like verses and metaphors to create an emotional undertone in the narratives. The following first excerpt shows the closing paragraph of a narrative. The story was about an adolescent girl with a presumed neuropsychiatric condition. She was accompanied by her parents, mainly her mother, during several appointments with child psychiatry staff. The story was told from the perspective of the mother.
A's father and I walk the corridors of the Child Psychiatry Clinic on either side of A; alone; finely crushed glass in our veins. Intolerable pain for every drop of blood fighting its way through the heart. (S25)
Four major categories emerged that contributed to this negative outcome in patient-health care provider negotiations:
Disrupted patient-health care provider relationship
The protagonists scrutinized health care providers' words and actions. This created a tense atmosphere in which the care provider's best intentions risked being disregarded or misinterpreted. The following example shows one narrator's interpretation of basic hygiene rules. She used the example to illustrate the emotional detachment of health care providers. She positioned herself as a caring mother who is the expert on her child:
Does [the doctor] see the child at all? Or is she just afraid to become infected? She touches the child with rubber gloves. She is so sure of the diagnosis: A common gastroenteritis. Why does that woman not listen to a mother's worries? Does she not know what it is like to be awake at night? (S14).
The last question especially challenged the moral and emotional position of the physician. In the mother's eyes, the physician did not understand the difficulties of tending a sick child. A conflict of roles was also present: The narrator expected that a female doctor should understand her as a woman.
The interpersonal positions and relationships were especially complex in the narratives that involved parents, children and health care providers. Since the health care providers invested a lot of energy in the patient, the guardian character often felt disregarded.
Guardians were conflicted: On the one hand, they depended on the health care provider's expertise and did not want to disturb the diagnostic process. On the other, they wanted their own needs to be fulfilled. For example, they wanted to be involved as experts on their children. This conflict might have contributed to the protagonist's increasing frustration, which was reflected in the dramatization of the narratives.
In the following example, the protagonist's daughter, who was the patient in this narrative, felt that a doctor's apology was acceptable. However, the protagonist himself, the father, was dissatisfied and remained unforgiving towards the physician. Forgive physician. Forgiveness had to be provided by the daughter:
"I want to offer you an apology"[, the doctor said]. N sees B [his daughter] nod. He bites his tongue. He does not want to tell the doctor about the missed delivery at work and how his boss treated him because of that. He forces himself to say:
"So what do you think, B?"
"It's all right, dad", she says, "it's all right".
Well, it had better be. (S17).
Care providers were perceived as representatives of "the system", not as individuals. However, because the health care providers were accessible during the negotiations, the protagonists' (and narrators') frustration was mainly directed at them. The stories contained generalizations of negative experiences, as the following excerpt illustrates:
Two small words [Title of narrative].
This is how Swedish doctors have marked me.
"Unwashed, sober."
This was written in my medical record nearly ten years ago. (S23).
The description of the patient as "unwashed, sober" was made by a single physician in the medical record. The narrator, who in this case identified with the protagonist by using a first-person narration, however, generalized this as "Swedish doctors" (plural) having marked her. This demonstrates that one single failed patient-health care provider interaction may change a patient's position towards the health care system in general.
Difference in social position
The protagonists were characterised as people with low self-esteem. Negative experiences within the health care system were associated with negative consequences for the protagonists. Past trauma (both physical and psychological) still influenced protagonist behaviour and attitudes as reflected in the narrative. This is a recurring topic in the narratives:
He could not win arguments; Not against doctors. If he could, he would not have to walk around with his bad leg. He would at least have obtained an examination at that time (S17).
The protagonists remained at a disadvantage during the negotiations. In contrast, the health care providers navigated "the system" freely. Health care providers' advantage in knowledge, legal power and the support of a larger group led to a better social position. From the patients' perspective, providers granted or declined health care services, as the following example illustrates:
A[Mother]:: "Okay, I'm coming right now."
B[Nurse on the phone]: "We can offer you an appointment at eight."
A: "Now!"
B: "Eight o' clock."
A: "I'm coming now! Let me just put some clothes on the kids".
B: "But you will have to sit in the waiting room for several hours till it's eight!" (S36).
In another example, the guardian assisted her child in communicating with a psychiatrist and a psychologist. The stigma involved with being mentally ill or being the parent of such a child was tangible as an awkward feeling of shame. Patient and parent were excluded from the group of health care providers. The health care providers remained "professional" by refraining from any emotional response:
"Our test results show that there are major difficulties, much more pronounced than in the preceding tests" [the psychiatrist says].
A [The daughter] interrupts:" No cows inside, moo! "and laughs heartily.
Her father and I join in the laughter.
The psychiatrist looks at me questioningly: "What did she say?"
"It's a joke. A has difficulties saying 'shoes', she says 'cows'. So we tell her that cows say 'moo', it's called 'shoes'". ["Shoe" and "Cow" sound similar in Swedish].
The psychiatrist and the psychologist look puzzled. They do not smile.
"Yes, as I was saying" [the psychiatrist continues] (S25).
The feeling of shame arose when the health care providers did not laugh with the family. The laughter would have relieved the awkward tension. Instead, shame and anger arose. The topic of stigmatization remained hidden. This contributed to the negative spiral of anger, shame and frustration which ultimately led to a failure of the negotiation.
Circumstances influencing negotiations
At times, the course of negotiations was influenced by circumstances beyond the control of the protagonist or the health care system representative. In the following instance, a single mother was speaking on the phone with an oncology nurse. Parallel to this very serious phone call, she had to take care of her two children that were fighting in the adjacent room. This excerpt also serves as an example on how appointments are handled in the Swedish health care system: Generally, patients call an automated phone centre, type in their phone number and later receive a call-back appointment. That return call might occur at a bad time:
A [Mother]: "But why this evening? Why the rush?"
Directed at the adjacent room, she bellows: "Be quiet now, I'm having a phone call!! And it's important!!!"
B [Nurse on the phone]: "We had a free appointment there. Furthermore, we quickly need to see if it's just picture artefacts or... something else." (S36).
The nurse was keen on delivering the best care possible. She had the best intentions. The narrator positioned the mother in a situation where she had a disadvantage. Taking care of her children left no time for reflection. The possibility of a serious illness caused her an enormous amount of stress and fear. This is an example of how narrators opposed medical care to the emotional and social needs of the individual.
In another narrative, there was no negotiation at all because the doctors did not wait for the father's consent to decide upon the discharge of a seventeen-year old girl from the surgical ward:
But the doctor had already been there, had decided. And there were others that needed the bed. (S17).
The last passage illustrated that the needs of many were more important than the need of the individual. The doctor's argument "There were others that needed the bed" was accepted as a fact. However, in the continuation of the story, the premature discharge led to severe complications for the patient. Following the arguments of the narrator, there are situations where the needs of many lead to severe suffering for the few. This story's narrator clearly rejected the notion.
Unrealistic expectations
Narrators used health care providers' promises in a satirical fashion: All negotiations ended with a negative outcome. To make a promise in that context had to seem cynical. Below are some examples of narrators' use of expectations and promises.
Woman: "Everyone, I understand you have breast cancer?"
Some of the women nod embarrassedly.
"All of you will feel so much better when you see how much healthier you look after having used these products". (S26).
The narrator of the above example opposed breast cancer to the use of beauty products. The text was entitled "look good, feel better". This positioning was a clear statement against a superficial and emotionally detached health care system.
She [the mother] sees the ribs sticking out on the child.
That physician understands: You can go crazy when the stomach flu never gets better!
He had small kids once, too. But on fluid replacement every tenth minute even cholera patients survive.
She feeds the little girl with a spoon every tenth minute, but it does not get better. […] She cannot stand it any more! (S14).
This doctor's use of communication techniques and empathy had no influence on the position of the narrator. The mother did as she was told, but the promised positive result did not occur. Instead, the child's condition worsened. The mother's disappointment added to her frustration, which in turn was expressed in the dramatization of the overall narrative.
Negative case analysis
One story was considered - although brilliantly written - a negative case because of its clearly fictional character. The story was about a patient in a closed psychiatry ward. There were no negotiations in the story. The hero had no specified gender, but we assumed he was male. He had a pocket watch through which he could manipulate time.
Being a great listener, he knew almost everything about the staff members and the other patients. He acted as a counsellor to other patients and staff. The story ended when he decided to die. He then used the clock to speed up time. Before that, he wrote a to-do-list to his nurse:
I write some lines to the nurse:
1. Leave your disgusting husband.
2. Get a different job.
3. I know you have little time. Thus, I want you to have my pocket watch. It is of utmost importance that you turn the upper two dials one click in the direction of the sun before wearing it. (S28).
The decision was always the patient's. The story had a high degree of agency because the patient remained the master of his own fate at all times (even when forcibly restrained to the bed). Thus, the story provided the antithesis to the other narratives that were based on personal experience. It represented a utopia about the patient being in control. Everybody else, including medical staff, was positioned as a prisoner of the system. Changing jobs or dying were the only ways to escape this situation.
The findings provided new insights into failed interactions between health care providers and health care seekers in the Swedish health care system. Negotiation was the main topic of the interactions. In the narrated situations, the protagonists faced nearly impossible odds. Most negotiations failed from the narrators' perspective. As a consequence, the protagonists and/or their protégés suffered. With the exception of the above-mentioned negative case, these quest narratives only featured tragic heroes.
The writing competition was intended for health care providers. Regardless, arguably privileged middle-aged Swedish women decided to send their contributions. Returning to the basic questions of narrative analysis, one asks: Why tell that specific story in that way in that specific context?
Why do patients contribute to a medical writing contest?
Tavernier et al. demonstrated that young adults that adolescents whose narratives included meaning-making in regard to critical life events scored better at well-being tests. Meaning-making in stories is thus correlated with well-being [22]. Little or no meaning-making or self-reflection could be seen in the stories of this study. Narratives from objectively more exposed groups of Swedish people [2, 3] contained clearer testimonies of agency and self-management than the stories analysed here.
Our participants might have written the essays with the intent to criticise the health care system. All authors - working middle-class Swedish women - had full access to health care and social benefits. Their main criticism was the lack of emotional response in negotiation situations.
This criticism was expressed by the extensive use of negative emotional language in the narratives. We demonstrated that patient-health care provider interactions sometimes become negotiations. Negative emotions can have a negative impact on negotiations [23].
Illness is associated with stigma. In the narratives, stigma was strongly associated with shame. Our findings demonstrated that shame can be experienced by patients and by parents or guardians of sick children. Despite the health care providers' best effort to act "professionally", the parents in the narratives felt excluded from patient-care provider relationship. This in turn contributed to parents' feelings of helplessness and frustration. It also increased patients' and parents' dependency on the health care system. In their study on the stigma of substance use, Chang et al. reflected [24]:
According to Bourdieu, habitus comes from individual experiences, but since individual experiences are structured by our social position, one cannot separate habitus from an individual's structured experiences as a member of various social groups. That is, our everyday actions today are shaped, though not determined, by our structured, stratified pasts. And in the field of health care, where differences and inequalities are worked out in clinical interactions underpinned by specific norms and rules, substance use stigma is produced, exacerbated and negotiated (page 18).
The narrators chose to end their narratives with the protagonist's negative feelings. These feelings arose as a result of the failed negotiations. The protagonists' future remained unclear to the audience. Implicitly, the audience (i.e. the writing competition jury, an audience of presumed health care providers) were prompted to find a better way. The open ending of each story allows different ways to read the story. This is called "subjunctivity" [17]. Wanting to change that outcome motivated us to conduct this study in the first place. It was a typical "doctor's reflex" to a patient's plea.
In summary, the patients saw the writing competition as a means to publish their stories. They knew that their stories would reach health care representatives who were interested in the emotional aspects of patient-health care provider interaction.
Why did the contributors choose negotiations as a topic?
The narrators focused on negative health care experiences and the impact of those experiences on the individual. Since the narrators identified with the protagonists, patients or their guardians were cast as heroes. This automatically put the health care representative in the role of the antagonist.
A narrative researcher always becomes part of narration because he or she is a recipient of the narrative [20]. This is especially true for illness narratives [25]. Therefore, we compared our findings with other studies on negotiations in health care.
Stoddart observed meetings between community nurses and patients. She then held semi-structured interviews with both negotiation parties and asked them about the relationship [26]. The material was qualitatively analysed with grounded theory. She identified three core aspects of negotiation: Navigation, socio-cultural characteristics and power and control. She came to similar conclusions: Observed negotiation situations and narratives of such situations share common elements. Narratives and narrative analysis, however, emphasize subjectivity. If personal experience and social position are the main point of interest, narrative analysis seems to be the most fitting research method.
Nilsen studied doctors' negotiation strategies in assessing sick leave in patients. He first held focus groups and then analysed the material with systematic text condensation [27]. Participating physicians expressed the need to balance biomedical issues and their responsibility towards society. They felt that they were "street-level bureaucrats". The findings of our study show the perspective of the health care seekers. The narrators felt no special responsibility towards society. On the contrary, a repeating and seemingly futile struggle to "get what they needed" is a recurring topic of the narratives. The needs of the individual were repeatedly opposed to the needs of many. This contrast is a challenge for health care providers, who need to balance the patient's emotions and individual social position with society's needs. Indeed, one GP in Nilsen's study reflected (Page 42):
"When I deal with long-term sick leave for conditions I don't quite understand, I always talk to the patient about his work, his marriage, his children and his financial situation. A lot of trouble lies hidden here".
Mustafa examined general practitioners' (GP) use of negotiation strategies when they met patients that expected antibiotic treatment [28]. The study was based on thematic analysis of semi-structured interviews. GPs reported that if they learned and managed patients' expectations, negotiations had a more positive outcome.
In another study that used a quantitative approach, Raieli studied parents', children's and doctors' expectations in situations where the treatment of the child's headache was indicated [29]. Patients' or guardians' expectations differed from those of the paediatrician. For example, paediatricians expected that fear of a brain tumour was more important to patients and parents than the acute management of pain. The opposite was the case. Both studies conclude that patient expectations must be obtained and managed.
Our study showed that unclear expectations or false promises disappoint patients. The negative experience resulted in the loss of trust in the health care system. Trust modulated patient behaviour, as other studies have shown [30]. If a patient had too little trust in health care, he or she withheld vital information or postponed seeking help even though symptoms had worsened. Patients were also at risk of generalizing disappointing experiences. A single negative experience that perhaps was derived from a failed relationship with a health care provider shaped their view on the health care system as a whole. To manage expectations is a way to manage patients' trust in the health care system.
Negotiations provided the narrators with a stage. There, the narrators directed complex dramatic plays that featured conflicting emotions and social roles. In all narratives, the negotiations' negative outcome was used as the central dramatic element.
In summary, negotiation situations were a fitting stage for the narrators' point. Addressed at the audience of health care providers, the narrators declared: "There is something wrong with the system – do something".
Due to analysing eight narratives from a highly selective source (a medical writing competition), the scope of this exploratory study in terms of sample size and depth is somewhat limited. The "interview question" basically was the advert of the writing competition [19]: "the essay should reflect ethical and cultural aspects of patient-care provider relationships in clinical encounters". This frame allowed enough freedom to tell a story [7]. In contrast to a more conclusive research approach, several questions remained open. At the same time, we established that writing competitions are a viable data source in health care research.
All study participants were middle-class working Swedish women. Thus, less privileged groups and men were not represented. On the other hand, we discovered a complex interplay of roles and emotions in the context of the Swedish health care system. Our approach biased the sample towards persons with above average communication skills. Much reflection on patient-health care provider relationships was done implicitly by the use of language and characters. Thus, the selection of persons with the skills to articulate their experiences benefitted the purposes of this study. For less articulate persons, interview studies seem to provide better study opportunities, because the interviewer can engage in a dialogical narration of the story [2, 7, 20].
The material was derived from spontaneous contributions. This provided an honest insight into what Swedish women with negative health care experiences spontaneously considered important to tell an audience of health care providers. The material is diverse enough to research interactions in different settings (in-patient, out-patient) and different types of disease, like chronic and acute illness.
Even under the limitations of a somewhat biased and limited sample, the findings were credible. This aspect is very important in narrative research according to the quality recommendations on narrative research by Greenhalgh [31] and Loh [32].
The triangulation of analysis methods in the three-step analysis process helped maintain a breadth of perspective: Agency analysis identified that the narrated interactions were indeed negotiations. After integrating this aspect in the analysis, several narratives could be understood much better. Positioning analysis helped discover the health care system critique. This allowed the analysis of another narrative, which at first was regarded as a negative case. Furthermore, study material and results were presented to experts (sociologists and fellow GPs) in a qualitative methods workshop. Their feedback confirmed that we were on the right track.
During member check, we asked the participants to provide feedback about our findings. They recognized the problem of different positions in power. When phone calls were involved, they added that this power is often misused to keep patients away from vital doctor time. Unnecessary waiting for the doctor (or the absence of doctors in general) was seen as a consequence of how the Swedish health care system works today. Furthermore, they agreed that patients and guardians wanted to be recognized as experts on their own body (or the body of their protégé). Their feedback puts the above-mentioned sample bias into perspective: Even though the narrators were arguably privileged, literate and well-spoken, power-play occurred. The resulting negative emotions sabotaged the outcome of negotiations. Thus, the member check added to the credibility of our findings.
Lastly, our own background as doctors heavily influenced the interpretation of the findings. Reading the patient's narratives triggered countless experiences with patients. Many stories that dwelled within us resonated with the analysed narratives. On the one hand, this limited our objectiveness. On the other, it contributed to our findings' credibility and possible application in practice. We believe that social scientists and physicians should cooperate on medical narrative research topics and look forward to an exchange about that.
All analysed stories challenged the audience to find a more patient-centred approach in dealing with negotiation situations. We conclude that a disrupted patient-health care provider relationship, difference in social position and mismanaged expectations contribute to the failure of patient-health care provider negotiations. In turn, a better management of expectations and the acknowledgement of emotional and social aspects of patient-health care provider interaction may provide a key to improve patient experience.
A writing competition invites patients or their guardians to share their experiences. We would like to continue this line of research and implement writing competitions as a tool to obtain tacit knowledge of health care system users. Based on our experiences with this exploratory study, we would like to design a more conclusive study, which focuses on some of the open questions of our findings. A comparison of patient experience in different health care systems seems especially tempting.
Personal experience and patient participation should play a larger role in the quality assessment of health care systems and in the research of patient-health care provider communication.
(Sxx):
Writing Contest Submission number xx (Reference to narrative)
SFMP:
Svensk förening för medicinsk psykologi (Swedish Balint society)
We humbly thank the essay authors for their participation in conducting this study and for allowing us to learn from and share their experiences. We also like to thank Andrew Dickinson, MBChB, for proof-reading this manuscript. We thank Christine Preiser, MA, sociologist (Coordination Centre for Healthcare Research, Tübingen University) for her feedback on the presentation of our methodology.
The datasets generated during the current study are not publicly available to safeguard participants' confidentiality but are available from the corresponding author on reasonable request.
ELR had the initial idea for the study, selected the material following inclusion and exclusion criteria and corresponded with study participants. She also performed analysis step 1 in collaboration with RK. RK performed all three analysis steps and wrote the draft of the article. JS commented on the article and provided her experience in the publication of scientific research. RK and ELR equally contributed to discussions about emerging themes and findings from 2016 onward, JS joined the discussions in 2017. All authors read and approved the final version of the manuscript and are accountable for the work presented.
The planning on recruitment, data collection and analysis was based on an ethics committee consultation from an earlier study (Regional ethics review board of Linköping University, dnr 2014/391–31), which had the same study design and material (writing contest submissions). The stories had already been submitted as anonymous transcripts, e.g. names and places used had already been changed by the original authors. Thus, the study was exempted from requiring ethics approval under local guidelines according to the regional ethics review board of Linköping University.
The principles of the declaration of Helsinki [33] were followed. Written consent to participate has been obtained from the patient authors.
None of the authors have any competing interests to report.
Institute for General Practice and Interprofessional Care, University Hospital of the Eberhard-Karls-University, Osianderstr. 5, 72076 Tübingen, Germany
Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, 171 77 Stockholm, Sweden
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Saint-Etienne won 1-0 at former champion Montpellier on Friday to move provisionally into sixth place in the French league.
Courbis took the reins on Monday following the resignation of Jean Fernandez but he could not inspire HSC to victory as a goal from Max Gradel handed the visitors all three points.
The 60-year-old saved Montpellier from relegation to the French third division towards the end of the 2006-07 season but, after leading the club into Ligue 1, he had to make way for title-winning boss Rene Girard in order to complete a two-year prison sentence for his role in a corruption scandal concerning former club Marseille.
And it looks like he will face another relegation battle with his side just five points above the drop-zone after nine league games without a win. Franck Tabanou had the first effort of the night as he was found by Francois Clerc but could only fire into the side-netting.
The midfielder was enjoying a lively start and saw a volley saved by Geoffrey Jourdren before he shot wide in the 29th minute.
Benjamin Corgnet then fired over the bar in the dying moments of the half and Montpellier will have been grateful to get in level at the interval. Jourdren was called on to make a save from Corgnet in the 47th minute before the home side eventually found their feet and Morgan Sanson missed the target from 25 yards.
Souleymane Camara saw another effort go wide for Montpellier before St Etienne got the goal they deserved with 15 minutes to play. Brandao crossed into the area where Faouzi Ghoulam flicked the ball on towards Gradel at the far post and the Ivorian volleyed home.
Camara headed inches over the bar in the closing stages as the visitors searched for a second but one was enough to move them up to fourth ahead of the rest of the weekend's games.
The Associated Press was used in this report.


text:
Spring Break is here! And the city is abounding with activity "24- 7- 365". We have art celebrating popular culture in Harlem. Ballet, modern and more throughout the city. Blockbuster and Indie film share the silver screen, jazz to Motown grooves Midtown and the world's most exotic cars hit the westside. Here are a few of the many events happening in the city that never sleeps guaranteed to keep you Out and About.
Constantin Brancusi ( at the Guggenheim Museum) produced an innovative body of work that altered the trajectory of modern sculpture. During this period, Brancusi lived and worked in Paris, then a thriving artistic center where many modernist tenets were being developed and debated. He became an integral part of these conversations both through his relationships with other artists, such as Marcel Duchamp, Fernand Léger, Amedeo Modigliani, and Henri Rousseau, and through his own pioneering work.
One Planet One Future (461 West Street) spreads awareness on the effects of climate change through accurate documentation and informed discussion. Our permanent exhibitions serve as centers for education, collaboration, and community. Gallery Hours are from Tuesday to Saturday, 12 – 7 pm
Harlem Postcards, an ongoing project at the Studio Museum in Harlem, invites artists of diverse backgrounds to reflect on Harlem as a site of cultural activity, political vitality, and creative production.This season we are pleased to feature postcard images created by Diedra Harris-Kelley, Marilyn Nance, Gordon Parks, and Andre Wagner. Each photograph has been reproduced as a limited-edition postcard available free to visitors at Carnegie Hall's Judy and Arthur Zankel Hall through March 24, 2018.
Award-winning South African choreographer Dada Masilo/The Dance Factory returns to the Joyce Theater April 3 through 8th. This time Masilo presents a torrid retelling of the tragic-romantic ballet, Giselle. By setting the work in rural South Africa, Masilo imbues this version with African rituals and ceremonies as she highlights the themes of betrayal, heartbreak, grief and revenge present in the classic tale.
DADA MASILO / THE DANCE FACTORY (ZA) Giselle
Dance Theatre of Harlem's 2018 New York City season, April 4th, 6th and 7th at New York City Center promises to be a thrilling evening of 21st century ballet. Highlights include the New York premieres of acclaimed choreographer Darrell Grand Moultrie's Harlem on My Mind; This Bitter Earth, the breathtakingly elegant work by Christopher Wheeldon, set to the music of Dinah Washington and Max Richter; George Balanchine's beloved Valse-Fantaisie; and, live music & guest artists from Collage Dance Collective, under the leadership of former DTH dancer Kevin Thomas, will accompany the revival of the legendary choreographer Geoffrey Holder's masterwork Dougla.
The Movement with Billy Porter
Everything Is Imaginable (World premiere) is Jack Ferver's interdisciplinary performance work presented April 4 through April 7 at New York Live Arts 219 West 19th Street. Everything Is Imaginable, juxtaposes the lives, virtuosity and fantasies of its five queer performers. In turns manic and poetic, the work addresses ideas of genre, sexuality, success, friendship, and loss. Ferver is joined by American Ballet Theater principal James Whiteside, principal dancer with Martha Graham Lloyd Knight, dancer and costume designer Reid Bartelme, and Broadway actor Garen Scribner.
Jack Ferver: Everything Is Imaginable (World premiere)
In Tyler Perry's Acrimony a faithful wife, tired of standing by her devious husband, is enraged when it becomes clear she has been betrayed.
Tyler Perry's Acrimony
Tomb Raider Lara Croft, the fiercely independent daughter of a missing adventurer, must push herself beyond her limits when she finds herself on the island where her father disappeared.
Bombshell: The Hedy Lamarr Story at the The Jacob Burns Film Center, 364 Manville Road Pleasantville, N.Y. Starlet and screen siren Hedy Lamarr was actually so much more. From her 1933 role in an erotic film to her multiple inventions—including a radio-controlled torpedo signal that could not be tracked and the cellular technology now used in WiFi—Lamarr lived a very full life. Alexandra Dean's eye-opening documentary portrait weaves together rare recordings and interviews with excerpts from Lamarr's own diary to reveal this genius of science and film. Narrated by Susan Sarandon and voiced by Diane Kruger.
Bombshell: The Hedy Lamarr Story
Amateur Night At The Apollo, 253 West 125th Street, on Wednesday April 4, 7:30pm. A brand new line-up of contestants competes for the chance to perform during the April 11th Show Off and move on to Top Dog on May 16th. It all leads to the chance of winning the title of Super Top Dog and a cash prize ($5,000 in the Child Star category and $20,000 in the Adultcategory) on November 21st!
Chick Corea has joined the Jazz at Lincoln Center Orchestra with Wynton Marsalis (at Jazz at Lincoln Center on Thursday April 5, 8pm)– a group he calls "the greatest big band on the planet" – to perform transformative new iterations of his music. Now, for the first time, they're joining forces to explore the work of another master pianist and composer: Thelonious Monk, the high priest of modern music.
A Decade Of Soul: Classic Soul & Motown Revue featuring Bruce "Big Daddy" Wayne & Special Guest Prentiss McNeil of The Drifters at B.B. King Blues and Club & Grill at 237 West 42 Street on April 6 and April 7. A musical journey taking you back in time! Back to when Berry Gordy's Motown label and his studio band the Funk Brothers and Stax record's Booker T and the MG's were the proponents of what came to be known as a historical style of music. "Soul Music" A trip back to when King and Smash records gave us "The Godfather of Soul" while the Columbia and Atlantic label brought us "The Queen of Soul".
Valerie Simpson, Songwriter, recording artist, entrepreneur, and restauranteur can now add Broadway thespian to her impressive list of accomplishments. On March 12, 2018 Simpson made her Broadway debut as Matron "Mama" Morton in Broadway's longest running musical Chicago. For her six-week run (through April 22) Simpson is flanked by a talented cast of Broadway veterans including: Amra- Faye Wright as the Vaudeville villainess Velma Kelly, Bianca Marroquin– the murderous ingénue Roxie Hart and Chaz Lamar Shepard as brash barrister Billy Flynn.
The revival of Once On This Island opened on December 3, 2017 at the as Tonton Julian, Kenita R. Miller as Mama Euralie, Alex Newell as Asaka, Merle Dandridge as Papa Ge, Quentin Earl Darrington as Agwe, Lea Salonga as Erzulie and David Jennings as Armand. Directed by directed by Michael Arden and choreographed by Camille Brown.
The Kooples (150 Greene Street) Sample Sale on Sunday April 1. So after prancing down Fifth Avenue in your Easter bonnet head to the Soho. The details regarding this French clothier's blowout are sparse, but shop, shop, shop: You'll probably find dreamy Parisian street-chic pieces like silk dresses and casual- cool crewneck T-shirts for men and women marked up to 70 percent off.
The New York International Auto Show at Jacob Javits Convention Center (11th Ave. (btwn 34th & 40th St.) through Sunday April 8. The annual Auto-fest returns to New York with the latest and greatest on two and four wheels. A great afternoon for the entire family.
The New York International Auto Show
The Orchid Show at the New York Botanical Garden in The Bronx (2900 Southern Blvd.) is now in its 16th year, this mesmerizing show displays thousands of orchids in geometric, illuminated sculptural presentations. Catch special Orchid evenings for dancing, music and drinks among the flowers.
We look forward to see you Out and About
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Out & About NYC Magazine was founded to offer the arts and lifestyle enthusiast a fresh new look at New York City. We will showcase the established and the emerging, the traditional and the trendy. And we will do it with élan, and panache with a dash of fun.
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Tagged A Decade Of Soul: Classic Soul & Motown Revue, Alysha Deslorieux, Amateur Night At The Apollo, Amedeo Modigliani, Amra- Faye Wright, Andre Wagner., Art, B.B. King Blues and Club & Grill, Bianca Marroquin, Bombshell: The Hedy Lamarr Story, Broadway, Bruce "Big Daddy" Wayne, Camille Brown, Chaz Lamar Shepard, CHICAGO, Chick Corea, Christopher Wheeldon, Circle in the Square Theatre, Collage Dance Collective, Constantin Brancusi, Dada Masilo/The Dance Factory, Dance Theatre of Harlem, Darrell Grand Moultrie, David Jennings, Diane Kruger, Diedra Harris Kelley, Dougla, Everything Is Imaginable, Fernand Léger, Geoffrey Holder, George Balanchine, Giselle, Gordon Parks, Guggenheim Museum, Hailey Kilgore, Harlem on My Mind, Harlem Postcards, Hedy Lamarr, Henri Rousseau, Isaac Powell, Jack Ferver, Jacob Javits Convention Center, James Whiteside, Jazz at Lincoln Center Orchestra, Joyce Theater, Kevin Thomas, Lara Croft, Lea Salonga, Lloyd Knight, Marcel Duchamp, Marilyn Nance, Martha Graham, Matron "Mama" Morton, Michael Arden, musical, New York Botanical Garden, New York Live Arts, Once On This Island, One Planet One Future, Out and About NYC Magazine, Phillip Boykin, Prentiss McNeil, Quentin Earl Darrington, Roxie Hart, Studio Museum in Harlem, Susan Sarandon, The Drifters, The Jacob Burns Film Center, The Kooples, The New York International Auto Show, The Orchid Show, This Bitter Earth, Tomb Raider, Tyler Perry's Acrimony, Valerie Simpson, Valse-Fantaisie, Velma Kelly.
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