text:
Cantwell wins, as early Washington returns point to good night for Democrats
Schrier leads Rossi in 8th District vote
OLYMPIA, Wash. – The first round of election results from across Western Washington pointed to a good night for Democratic candidates even as outcomes were mixed for progressive initiatives.
Democratic Sen. Maria Cantwell won re-election, beating Republican challenger Susan Hutchison.
Cantwell easily outdistanced Hutchison, a former Seattle TV anchor and state GOP chairwoman.
Cantwell is a former tech executive who previously served one term in the U.S. House and six years as a state representative in the state Legislature. She will be serving her fourth term.
It's been nearly a quarter century since the GOP has captured a major statewide race in Washington.
The last time voters sent a Republican to the U.S. Senate was 1994, when Sen. Slade Gorton was re-elected to his final term before being ousted by Cantwell in 2000.
In the hotly contested 8th Congressional district that was expected to be a bellwether for the national mood, Democrat Kim Schrier led Republican Dino Rossi 53-47.
Republican U.S. Rep. Cathy McMorris Rodgers won re-election to the House in the 5th District, beating a strong challenge from Democrat Lisa Brown.
The district is centered in Spokane and has not elected a Democrat since former House Speaker Tom Foley last won in 1992. McMorris Rodgers won an open seat in 2004 and has generally cruised to easy victories since.
Two of the initiatives supported by many progressives were also off to big early leads, with I-1639 (gun control) ahead 60-40 and I-940 (law enforcement) up 59-41.
A measure to institute a carbon tax, I-1631, was down however, trailing 56-44. An initiative that proved confusing for some voters, I-1634, was winning, meaning cities across the state won't be able to tax certain food if it passes.
A look at Washington initiative results
Mother and daughter arrested for carjacking in Renton parking lot
State to begin work on diverging diamond interchange at I-90, SR 18


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June 21, 2013 / 12:05 AM / 6 years ago
Apple warns of "chilling effect" as antitrust trial ends
Nate Raymond
NEW YORK (Reuters) - Apple Inc, on trial for allegedly colluding to raise the price of e-books, said on Thursday an adverse ruling would have a "chilling effect" on how businesses investigate new markets.
An Apple logo is seen at the Apple Worldwide Developers Conference (WWDC) 2013 in San Francisco, California June 10, 2013. REUTERS/Stephen Lam
If Apple was found guilty, it would "send shudders through the business community" by condemning the ordinary negotiations that companies undertake to enter new markets, the company's lawyer, Orin Snyder, said on the last day of the trial.
"We submit a ruling against Apple on this record sets a dangerous precedent," Snyder said.
The U.S. Justice Department accuses Apple of conspiring with U.S. publishers beginning in late 2009 to increase the price of e-books in an effort to undercut the pricing established by then-dominant Amazon.com Inc. The publishers have settled with the government.
Throughout closing arguments Thursday, Apple found itself fighting back against tough questioning by U.S. District Judge Denise Cote.
At one point on Thursday, Cote asked if it was correct that Apple "understood publishers were willing to work together to put pressure on Amazon."
Snyder responded there was no evidence Apple understood the publishers were allegedly conspiring together before it proposed creating an online bookstore for its coming iPad. Apple had no idea the publishing executives were calling each other and having dinners together.
"There is no such thing as a conspiracy by telepathy," Snyder said.
For three weeks, the government has sought to show the popular iPad maker conspired with five of the biggest publishers to raise prices for new and bestselling books from the $9.99 set by Amazon.com.
Amazon.com, which at the time controlled up to 90 percent of the e-book market, had been buying books at wholesale and then selling them at times below its costs as it promoted its Kindle reading device.
Apple, by contrast, entered into so-called agency agreements in which publishers rather than Apple set book prices of up to $12.99 and $14.99, in a move the government contends enabled publishers to push back against Amazon.com's pricing.
Apple in exchange got a 30 percent commission from the publishers, who included Pearson Plc's Penguin Group, News Corp's HarperCollins Publishers Inc, CBS Corp's Simon & Schuster Inc, Lagardere SCA's Hachette Book Group Inc and Verlagsgruppe Georg von Holtzbrinck GmbH's Macmillan.
After signing the deals, the government said publishers pushed Amazon.com into the agency model, allowing publishers to increase prices, which shot up 9 percent industrywide, Mark Ryan, a Justice Department lawyer, said.
"Only a united industry front could move Amazon off its $9.99 price," he said.
Cote, who has said before the trial began that she thought the government would be able to show direct evidence Apple engaged in the conspiracy, also interrupted Ryan as he made his closing argument.
At one point, she asked Ryan how he responded to Apple's "argument that it didn't raise prices as the e-books would have been unavailable at any price."
Earlier Thursday, Snyder had argued that before Apple entered the market, publishers had begun withholding popular new titles from e-bookstores until the hardback version had been on sale for a number of weeks. Without Apple's entry, those titles would not have been available as e-books immediately, he said.
Ryan, who had earlier shown statistics that publishers withheld titles just 37 times in 2009, said he rejected Apple's argument. It was unclear how the future would have played out, he said.
"We don't know what course competition would have taken the industry on," Ryan said.
The Justice Department is not seeking damages against Apple. In a slide presented Thursday, the Justice Department said it wanted Apple to be prohibited from the agency model for two years and a five-year prohibition against the use of price-parity contract clauses at the center of the case, among other remedies.
Should the government prevail, a separate trial would be held on damage claims asserted by 33 state attorneys general whose case on liability was also being heard during the last few weeks.
The case is United States v. Apple Inc et al, U.S. District Court, Southern District of New York, No. 12-02826.
Reporting by Nate Raymond; Editing by Phil Berlowitz

redpajama_set_name: RedPajamaCommonCrawl


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Kyle Guy declares for NBA Draft
Closes door on return to Virginia
By Colin Cantwell | 04/16/2019
Junior guard Kyle Guy declared for the NBA Draft Tuesday afternoon. Richard Dizon | Cavalier Daily
Virginia junior guard Kyle Guy announced via Instagram April 16 that he would be joining teammates Ty Jerome and De'Andre Hunter in declaring early for the NBA Draft, before Mamadi Diakite did the same. Monday, Guy tweeted that he would be leaving his name in the draft, closing the door on returning to the Cavaliers for another season.
"I … set a goal for myself to play in the NBA," Guy wrote in his initial announcement. "I am diving in to this with two feet to achieve my dream but I will leave the option of coming back to school open."
However, in his follow-up tweet, Guy officially announced that he would no longer consider playing another year at Virginia.
"Saying goodbye twice is not easy," he wrote. "I am officially keeping my name in the draft. I know it's the right step after much prayer and thought with my family."
Guy was named Most Outstanding Player of the Final Four after hitting the winning free throws at the end of the game to beat Auburn then scoring 24 points in the national title game against Texas Tech. However, he does not appear in most mock drafts.
The draft will take place Thursday, June 20, at Barclays Center in Brooklyn, N.Y.
This article was updated with new information April 23.
By Jennifer Brice | 07/15/2019


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Welcome /
the lies: (my fiction) /
the truth: (essays & columns) /
Kiddie Cars
Trick or Treat in Cybertown
Music for People with Brains
My Last RaceChaser Column...
Contact Thom:
What have I done?!?
Photos and the Like
THE BLOG! /
Thom Ring
email@thomring.com
Just-released novel HENRY HITS THE BALL already received a FIVE-STAR review from Readers' Favorites.
Published the short-story collection GOODBYE AND OTHER STORIES. It was one of five finalists in the Next Generation Indie Book Awards-competition, the only finalist not published by an academic press. The collection includes the story WHATEVER YOU CAN PAY, which earned an Honorable Mention in Writers' Digest's annual writing competition, one of the most prestigious writing competitions in the country.
My short story, EYE CONTACT, published in The Quarterly, a New England literary magazine. It is included in GOODBYE AND OTHER STORIES.
Author of the middle-grade/young-adult novels THE RED RACECAR, DINOSAUR RACING and MOTOCROSS SUMMER, all of which BOYS READ! DINOSAUR RACING was chosen as Book of the Month by Readers' Favorite book reviews.
Authored the "first-chapter" books RACING JUNK, TURN RIGHT TO GO LEFT, AND GO FAST. BE SMART! written for newer readers.
Over 20 years as a syndicated columnist and reporter covering motorsports. Columns ran in a number of daily newspapers including: the Lowell, MA, Sun; Attleboro, MA, Sun Chronicle; Newburyport, MA, Daily News; Norwich, CT, Bulletin; Pawtucket, RI, Times; and Woonsocket, RI, Call.
Senior editor for Late Model Racer, a national magazine covering stock car racing.
Former publisher and editor of Shorttrack Magazine, which covered oval-track racing in New England.
Former Technical Editor and columnist for Trackside Magazine, which covered oval-track racing across the Northeast.
Served as New England Correspondent for Late Model Digest, a national weekly covering stock car racing.
Color commentator for Speedway Heat, which televised NASCAR's Busch North Series auto races. Have appeared on numerous television and radio shows as an expert on racing and/or safety-issues in the sport.
As a freelance writer, published in numerous magazines, including Stock Car Racing, Cycle, British Car, American Women Motorscene, Short Track Racing & Technology, Flat Out, Classic Bike Review, and, most recently, MOTIF magazine.
Served as consultant to Papyrus Games in developing shorttrack-racing computer-simulation.
Yes, there's a trend here. Follow it in the collection of my most interesting and noteworthy columns and articles: Ring Around Racing.
Former sportswriter for the Sun Chronicle.
Served as New England Correspondent and Goaltender Specialist for Just Hockey Magazine.
Have provided color-commentary for televised high school hockey as well as football.
Over 30 years helping people with disabilities return to employment, assessing their skills, analyzing jobs, and then marketing demonstrated-skills to employers as part of effort to develop suitable opportunities for them. Serve adults as well as teenaged students enrolled in the high-school component of the program.
As member of commission preparing materials used to market employment-services to employers, wrote chapters for the handbook Employing People with Disabilities.
Lead Teacher; Rhode Island Write on Sports, Bryant University campus. Write on Sports runs summer sports-writing camps for "underserved" middle-school students. Students create their own stories and video-features related to sports, doing research and then writing and revising under the guidance of experienced writers and teachers.
Created and maintained Mom N' Pop Culture blog on late, lamented Roadside Online website. It featured small local businesses that offered products and services consistent with traditional small-town commerce and values.
Member; the Association of Rhode Island Authors (ARIA)


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Please remember to inform the office, or Father Emmanuel, if you are going into the hospital and want a visit or prayers. The hospital will not do this for you since the privacy laws have been tightened. We will be glad to pray for you and your family members.
Catechetical Class is required; please inform Father Emmanuel well in advance.
All Catholics who have made a decision to enter into marriage must see a priest six months prior to the desired date of the marriage.
Please contact the Parish Office by 9:00 am Wednesday prior to the weekend you want your announcement published.


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Q: Pivot table with Apache Pig I wonder if it's possible to pivot a table in one pass in Apache Pig.
Input:
Id    Column1 Column2 Column3
1      Row11    Row12   Row13
2      Row21    Row22   Row23

Output:
Id    Name     Value
1     Column1  Row11
1     Column2  Row12
1     Column3  Row13
2     Column1  Row21
2     Column2  Row22
2     Column3  Row23

The real data has dozens of columns.
I can do that with awk in one pass then run it with Hadoop Streaming.  But majority of my code is is Apache Pig so I wonder if it's possible to do it in Pig efficiently.

A: You can do it in 2 ways:
1. Write a UDF which returns a bag of tuples. It will be the most flexible solution, but requires Java code;
2. Write a rigid script like this:
inpt = load '/pig_fun/input/pivot.txt' as (Id, Column1, Column2, Column3);
bagged = foreach inpt generate Id, TOBAG(TOTUPLE('Column1', Column1), TOTUPLE('Column2', Column2), TOTUPLE('Column3', Column3)) as toPivot;
pivoted_1 = foreach bagged generate Id, FLATTEN(toPivot) as t_value;
pivoted = foreach pivoted_1 generate Id, FLATTEN(t_value);
dump pivoted;

Running this script got me following results:
(1,Column1,11)
(1,Column2,12)
(1,Column3,13)
(2,Column1,21)
(2,Column2,22)
(2,Column3,23)
(3,Column1,31)
(3,Column2,32)
(3,Column3,33)

A: I removed col3 from id 1 to show how to handle optional (NULL) data
Id  Name    Value
1   Column1 Row11
1   Column2 Row12
2   Column1 Row21
2   Column2 Row22
2   Column3 Row23
--pigscript.pig
data1       = load 'data.txt' using PigStorage() as (id:int, key:chararray, value:chararray);
grped       = group data1 by id;
pvt         = foreach grped {
    col1        = filter data1 by key =='Column1';
    col2        =filter data1  by key =='Column2';
    col3        =filter data1  by key =='Column3';
    generate flatten(group) as id,
        flatten(col1.value) as col1,
        flatten(col2.value) as col2,
        flatten((IsEmpty(col3.value) ? {('NULL')} : col3.value)) as col3; --HANDLE NULL
};
dump pvt;

Results:
(1,Row11,Row12,NULL)
(2,Row21,Row22,Row23)

redpajama_set_name: RedPajamaStackExchange


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text:
Finlandia Prize for Fiction candidates 2012
23 November 2012 | In the news
The candidates for the Finlandia Prize for Fiction 2012 were announced on 15 November. They are Riikka Ala-Harja, Pirjo Hassinen, Heidi Köngäs, Ulla-Lena Lundberg, Aki Ollikainen and Juha Seppälä.
Their novels, respectively, are Maihinnousu ('The landing', Like), Popula (Otava), Dora, Dora (Otava), Is ('Ice', Schildts & Söderströms), Nälkävuosi ('The year of hunger', Siltala) and Mr. Smith (WSOY).
The jury – researcher Janna Kantola, teacher of Finnish Riitta Kulmanen and film producer Lasse Saarinen – made their choice out of ca. 130 novels. The winner, chosen by Tarja Halonen, who was President of Finland between 2000 and 2012, will be announced on 4 December. The prize, awarded since 1984, is worth 30,000 euros.
The jury's chair, Janna Kantola, commented: 'One of this year's recurrent themes is the Lapland War [of 1944–1945]. Writers appear to be pondering the role of Germany in both the Second World War and in contemporary Europe. Social phenomena are examined using satire; the butt is the birth and activity of extremist political movements. Economics, the gutting of money and market forces, are present, as in previous years, but now increasingly with a sense of social responsibility.'
Popula deals with people involved in a contemporary populist political party. Dora, Dora describes Albert Speer's journey to Finnish Lapland in 1943. Nälkävuosi depicts the year of hunger in Finland, 1868. Is takes place in the Finnish archipelago of the post-war years. Mr. Smith portrays greed and the destructive power of money both in Russian and Finnish history as well as in contemporary Finland. Maihinnousu, set in Normandy, depicts a child's serious disease in a family that is going through divorce.
Tags: literary prizes, novel
The Editors: The Finlandia Prize for Fiction 2012 (In the news)
The Editors: Finlandia Prize candidates 2011 (In the news)
The Editors: Finlandia Prize for Fiction 2013 (In the news)
Also by The Editors
Books from Finland to take archive form - 22 May 2015
In memoriam Austin Flint (1931–2015) - 2 April 2015
Fiat Lux! - 31 December 2014
To write, to draw - 18 December 2014
Archives open! - 12 December 2014
Soila Lehtonen is a journalist and theatre critic, and currently Editor-in-Chief of Books from Finland. She has edited a collection of writings about the city of Helsinki together with Hildi Hawkins, Helsinki: a literary companion (The Finnish Literature Society, 2000). Hildi Hawkins is a writer and translator, and the London Editor of Books from Finland. She is also the co-editor of things, a journal of writings about objects, their pasts, presents and futures.


What exactly is data mining in A strong best practice system enables organizations to put the latest medical evidence into Quality Process Improvement.
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hat are the implications of all this for Emory Healthcare? First, Emory Healthcare leadership is deeply committed to patient safety and minimizing medical errors.
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In case you somehow missed our big cover reveal, Portal 2 is set to drop this upcoming holiday season at full retail price. Even though the first game was just a few hours long, the sequel promises some extra content for your return through Aperture Science, most notably the inclusion of co-op.
While we won't reveal much more (be sure to read our 12-page story in our April issue) just know the original portal isn't the last time you'll see GLaDOS. There will also be surprising new characters and brand new areas of the Aperture Science Labs. The two-player co-op mode will feature its own campaign with two new playable characters. When it comes to these mind-bending puzzles, two brains are always better than one.
Be sure to regularly check in with our Portal 2 Hub for updates and exclusive content all month long.


text:
Nine arrested at Poor People's Campaign rally at the state Capitol
Arrests at Poor People's Campaign rally inside Pennsylvania Capitol
By Lasherica Thornton | Special to PennLive
Practicing civil disobedience, nine individuals of the Poor People's Campaign were arrested in the state Capitol Monday.
Each was issued a disorderly conduct citation for blocking entrance into the House chamber said Troy Thompson of the Department of General Services, which oversees the Capitol Police.
They sat in front of the House chamber doors with signs laying at their feet. Reporters with flashing cameras watched on as supporters sang "Whose side are you on?"
Poor People's Campaign rally at Pa. Capitol
Gallery: Poor People's Campaign rally at Pa. Capitol
The Poor People's Campaign has rallied at the Capitol for five consecutive weeks so far and will do so again next Monday before ending their six-week campaign. Monday, participants called for lawmakers to address inequality, demanding living wages, union rights and fully-funded anti-poverty programs.
Last week, 31 were arrested as a part of the Poor People's Campaign protests, in which they laid on the pavement and pretended to be dead, symbolizing people who have died due to lack of access to healthcare or clean water.


No dogma, no canon. Just common sense.
The FORTAC method of teaching isn't to just teach you what to do, or to just teach you what to think. We're here to teach you what options you have, to teach you how to think. Not necessarily what the answer is, but how to find the answer.
Instead of focusing on trying to adapt rigid doctrine to flexible situations, we present principles, fundamentals that work across the board, so that you can apply them to your problems as needed. Ralph Waldo Emerson said it well, "As to methods there may be a million and then some, but principles are few. The man who grasps principles can successfully select his own methods. The man who tries methods, ignoring principles, is sure to have trouble."


text:
Talk Nerdy UK
Who are 'Talk Nerdy To Me'?
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Like this and want more? Why not subscribe to their podcast on iTunes or Podomatic? Or why not head over to the all new and improved www.talknerdy.uk to download and/or stream the latest podcasts?
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This is about a history you might never know if I did not relate it to you. It is a bespoke story and one that reveals the very heart of this remarkable company.
ITI founder Devan Shah grew up in comparative privilege in southern India in the city of Coimbatore, acquiring an easy familiarity with many of India's religious traditions and languages. Summer vacations from school were spent high in the cool Nilgiri mountains near Coonoor on the tea estate managed by his older sister's husband. In college, he took a degree in business, and dutifully but swiftly climbed the rungs of the tea profession, starting as an assistant to a South India tea broker. Then, like many other Indian professionals in his mid-20's, he emigrated to the USA to start a new life.
The American tea trade in 1989 was sleepy, just barely beginning to wake up to its potential. Though Devan thrived in the electronics import-export business, he knew inside himself this was not right livelihood for a born tea man. In 1990– the same year he married Reena Mahesh of Los Angeles– he started India Tea Importers. Let the record show I have been a witness from the beginning. I got to taste the first six chests of tea Devan imported while they were stacked in his father in–law's garage. That was in LA, but we'd met in New York thanks to Madhavan Nambiar, then NY Director of Tea Board of India. Upon learning he was from the Nilgiris, I showed him the Nilgiri tea sample I'd newly received, as it happened, that very hour. Nobody in America, I included, knew anything whatever about South India Tea. In ten minutes time, I had learned so much about that tea sample from Devan's expert professional analysis that on the spot I asked him to be my teacher.
Devan's first years in business seemed to me, frankly speaking, scary as a rollercoaster, maybe not truly dangerous but full of dramatic ups and downs. Meanwhile, I was far from the only person Devan was educating about tea. Right from the outset, he grasped that those who benefit the most from the tea business are those who contribute the most to tea culture. Devan Shah has played a decisive role in developing America's tastes in tea. For example, before he started, there was no ready to drink chai sold in the US. Oregon Chai—America's first chai—was made with Devan's support and credit using his tea. From then on most ready to drink chai sold in the US were made using Nilgiri teas that ITI imported and supplied. Chai is now a category unto itself, of course, but Devan and ITI have paved the path from Oregon Chai to the Oprah Chai Tea of today.
ITI has consistently created markets for tea where there were no markets previously. Reflecting its expanding horizons, India Tea Importers, in 2000 was re-christened International Tea Importers. Having become a major importer of organic and fair trade teas as well as conventional teas from every producing country, today ITI is even able to offer the rarest examples of China Tea. ITI was the first to mass market White Tea and first to import China Yellow Tea into the US.
Besides supplying America's burgeoning tea businesses, no company has exceeded ITI's contribution to America's developing tea culture. In 2005 Devan was invited to serve as International Juror at India's first-ever tea competition, the Golden Leaf India Awards held, as it happened, at the Nilgiri hill station town Coonoor, his old summertime home place. In 2014, Devan received the John Harney Lifetime Achievement Award, when he was just in his early 50's. In America, there is simply nobody who has done more than Devan Shah and his company, ITI, to create the Tea Renaissance blossoming all around us today. Moreover, none of us in the world of tea would be where we are today were it not for Devan. We are all in his debt.
Devan inspired and educated multitudes in the love of tea and the business of tea—his daughter Bianca second to none among them. From an early age she has absorbed her father's teachings in both the arts and the businesses of tea. After tragedy struck in April 2016 with the unexpected passing of our beloved Devan, one can say that his ultimate and lasting gift to the tea trade was to personally groom a successor who is equal parts talented and determined to carry out her father's vision for what the tea industry is still yet to become. Having known her all her life, I can attest that Bianca is every inch her father's daughter. You will find her more than dutiful in upholding Devan's high standards both in tea quality and in business relations. Devan's legacy is in good and trustworthy hands I can assure you. ITI supports tea promotion and education efforts as a matter of company policy.
ITI was World Tea Expo's first Platinum Sponsor and has remained a Platinum Sponsor ever since. From the beginning, ITI has been the Specialty Tea Institute's (STI) single largest supporter of educational classes and seminars. Among numerous other contributions to tea culture, ITI is the founder of a number of tea festivals including the Los Angeles International Tea Festival. The company is also publisher of the books by James Norwood Pratt. JNP's classic work, The Tea Lover's Treasury, widely considered the work that launched the Tea Renaissance, is now updated and expanded in a 30th Anniversary Edition as The Ultimate Tea Lover's Treasury. Internationally, JNP's Tea Dictionary has become an indispensable tool of the world-wide tea trade. The next Tea Society title will be W.H. Ukers' Romance of Tea with an introduction, annotations and an epilogue by James Norwood Pratt. ITI specializes in servicing clients of all sizes and provides in-house flavoring and blending-to-order. ITI's deep experience and up-to-date knowledge of the tea industry enables us to deliver the right teas for our customers in quantities ranging from two to two thousand pounds.


Giving of our _ _ _ _, our treasure, and our talents.
I don't take enough time to spend with God.
There, I said it. It's out in the open now. Whew!
Now we know that Satan can't actually make us do anything, he, after all, was conquered by our Lord and Savior Jesus Christ. He does, however, retain the power to tempt us to do all sorts of bad things. The crux being, as I've pointed out above, we can get busy doing many good things as well as bad. The point is, all of the things we do are distractions. They are distractions from being in a personal relationship with God.
Whatever word or term you use, there must be more of it set aside for growing in our relationship with our creator. He, after all, has created all of this thing we call time.
This convicting illuminated the hope that I alluded to earlier. I had the power to make my own decisions. I chose right then to grow and mature in my spiritual formation and set upon asking God for his help in this quest. You see, while you may have the blessing of free will, nothing is possible without God. With his help, I have embarked upon a series of practices that include; getting up at 5:00 am for an hour spent in the Word and intercessory prayer, meeting with and absorbing spiritual formation practices from other pastors, devotional readings from the saints that came before us, and I regularly pray throughout my day with a small leather notebook filled with the names of those for whom I pray (You'll not find me without this important journal of praises and concerns). This list is not all-inclusive, nor is it an attempt on my part to "earn grace," but merely tools to recognize the grace that is already being poured out in my life.
You're probably thinking, "But Jason, you just listed all kinds of new demands on your time!" and you'd be half right. With the insight and strength gained during these times of devotion, I am better equipped to face my day and the challenges that it will present. I'm also more willing to say, "I'm sorry, I'm going to have to decline" to new requests and more accepting of less than perfect scores on coursework.
While I did add spiritual practices to my schedule, I now do not consider this a demand at all, but an invitation… an invitation to grow in my relationship with Christ.
This is an invitation that is open to all.
Every good relationship we have, or have had in the past, requires time spent with the other person. Real time. Real sharing. Real emotions. Real… love.
Please don't neglect the most important relationship of your life.
It's hard to believe that my first Finals Week is almost upon me. It seems like it was just a few weeks ago I was tackling my first assignments. For the past few days, I've been reflecting on the astonishing new revelations I've experienced over the last twelve weeks. I've learned many concepts and details about the love of Christ that were unfamiliar to me. But along with this new knowledge about God, I've also had manifestations of self-examination that reveal my strengths and weaknesses, or as we call them in seminary… growth edges.
I know I've spoken of this in the past, but if I was forced to use one word to describe seminary it would be "transformational." Everyone I had spoken to who has attended used this word in describing the experience, now I see what they meant. The first twelve weeks have fundamentally transformed my relationships with God and the people I call friends and family. Because I am more fully coming to understand how freely God loves me, I can more effectively embody that in my love for others.
Preparations for finals week at the graduate level, from what I can see so far, differs from that of the undergrad system that my daughter Isabel is experiencing. I don't have facts to memorize; I have papers to write. Long papers… very long papers. I'm finding that the length of the papers is the biggest challenge, but probably not in the way you imagine. If I have a paper that is required to be 9-12 pages my difficulty is not getting at least nine pages, it's keeping the paper under 12 pages. I have so much that I want to say about God that I find it difficult to be bound by maximum page lengths. I remarked to one of my professors that I needed to write a book.
None of this transformation has been easy. When is radical change ever easy? There are two things that have lessened the difficulty found in this process. First and foremost is my God, through the work of the Holy Spirit, has given me intelligence I do not possess. He has given me wisdom I have never had. Jesus has provided to me patience and a work ethic for my classwork that has not been demonstrated in my life to this point (though I have preached it to my children for years).
Catch all that? Now you see why I have a quickly expanding list of new vocabulary words contained within a notebook in my pocket!
My daughters Isabel and Emma have been a huge help as well. Isabel is kind enough to proofread her dad's papers, though not so kind that she doesn't end up putting red ink all over them! I suspect she's enjoying repaying my years of editing her work. Emma is always quick to provide a hug and words of encouragement to me. At random times, she will just walk up and wrap her arms around me, and it just makes me melt.
To expand on the second "thing," I'd like to add that my friends and supporters have been phenomenal in their inquiries about my well-being. Your questions and concern about my workload and life are very humbling to me as well as uplifting in my spiritual growth.
Classes officially end on December 18th, but preparations have already begun. Some of the multi-part finals that are required have already been completed. This weekend I will be working on the remainder of the assignments with the goal of having them submitted early while also completing the normal weekly assignments.
It may all sound overwhelming, but it isn't. I am more relaxed now than I have been throughout this entire endeavor. I know that I am loved by God, by my wife, my children, my family, and my friends.
With God, all things are possible. Without Jesus, I would still be wandering in the wilderness of the world.


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Sixers Select Ben Simmons With First Overall Pick
The Philadelphia 76ers have made Ben Simmons the franchise's first No. 1 overall pick since selecting Allen Iverson 20 years ago.
By Derek Bodner·	 6/23/2016, 7:46 p.m.
The Philadelphia 76ers made official what has long been expected: Ben Simmons is the first overall selection in the 2016 NBA draft.
Simmons has long been rumored to be the guy the Sixers were targeting after the team won May 17th's NBA lottery. Simmons averaged 19.2 points, 11.8 rebounds, 4.8 assists, and 2.0 steals per game during his only season at LSU.
"I'm happy to be part of the family now. It's a weight off my chest," said Simmons after a selection that had become a foregone conclusion. "I've been looking forward to this day for a while, so I'm glad I've made history, not only for myself but my family and Australian basketball."
Simmons grew up in Newcastle, Australia, before coming to the United States in 2013 to attend Montverde Academy in Montverde, Florida, the same school Joel Embiid attended. Simmons has another connection to the Sixers in head coach Brett Brown, who coached Simmons' father, Dave, while in Australia.
Simmons will carry the weight of a struggling Sixers franchise on his shoulders, although he has help in potential reinforcements like Embiid. The two could form an intriguing power forward-center combination — if Embiid were able to get and stay healthy. Embiid has missed the last two seasons while trying to recover from a navicular bone fracture in his right foot.
In addition, the Sixers also have big men Jahlil Okafor and Nerlens Noel — at least for now. Bryan Colangelo has been rumored to be shopping both of them in search of acquiring another top draft pick.
Simmons is an electric player, with incredible athleticism for his size, the ball handling ability of a guard, and elite court vision and passing ability. He will need to work on his outside shot, as he attempted just 3 three-point shots on the season and shot just 67 percent from the free-throw line.
Asked after the draft about what work lies ahead, Simmons spoke not as the draft's most highly touted prospect but as a player about to embark on his rookie season: "Everything, from eating right to getting my body right for 82 games, to dribbling, to shooting, just everything. I think everything really needs to be worked on because you're going to that next level where guys have been in the league for 10-plus years, so they have a lot of experience."
Simmons spoke of the work ahead in Philly, and his childhood adoration of Allen Iverson. "A lot of people don't know that I actually had a poster of AI when I was young. It was a big, diamond-cut poster of him with the braids. … I used to have the cornrows when I was younger."
You can read more about why Simmons should have been the No. 1 selection in the draft from our big board.
Later Picks
With the 24th pick in the first round, the Sixer selected 6'7″, 205-pound French small forward Timothe Luwawu, who has the chance to be a really solid two-way role player. Standing 6'7″, with very good athleticism and an improving outside shot, that potential is there.
And with the 26th pick, the Sixers selected 6'7″, 185-pound Turkish shooting guard Furkan Korkmaz. The 18-year-old Korkmaz is one of the youngest players to see significant Euroleague playing time. Perhaps most notably, he is an Anadolu Efes teammate of Dario Saric, who — in a world without Joel Embiid — would be the team's biggest unicorn: He, like Embiid, is consistently on the verge of maybe, possibly, potentially, theoretically joining the 76ers after they acquired his rights on draft night 2014.
Derek Bodner covers the 76ers for Philadelphia magazine. Follow @DerekBodnerNBA on Twitter.
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The winners of the 64th Evening Standard Theatre Awards have been announced, with Ralph Fiennes and Sophie Okonedo taking home the top acting prizes.
Watch the highlights.
Red carpet glitz and glamour.
The star-studded ceremony, co-hosted by Idris Elba, Claire Foy, Evening Standard owner Evgeny Lebedev and Dame Anna Wintour, took place at Theatre Royal, Drury Lane, with Phoebe-Waller Bridge as the evening's presenter.
Ralph Fiennes and Sophie Okonedo took home the top acting prizes for their performances as passionate lovers divided by politics in Antony and Cleopatra at the National Theatre, while Matthew Lopez's epic two-parter The Inheritance was named as Best Play.
The ceremony featured performances from some of the West End's most popular shows.
All photos were taken by Dave Bennett.
A glamorous,
star-studded evening
High-profile
celebrity attendance
Event sponsors.
Theatre Awards 2017.
The annual awards took place on Sunday 3 December. Marking their 63rd year, the awards were co-hosted by the ESI Media's owner, Evgeny Lebedev, American Vogue editor-in-chief, Dame Anna Wintour, Cate Blanchett and Lin-Manual Miranda. Phoebe Waller-Bridge was on presenting duties.
The big winner from the night was Jez Butterworth's 'The Ferryman' scooping three awards including Best Play, Best Director and Best Emerging Talent.
The event was sponsored by Qatar Airways and Michael Kors.


Continuing Training Block 4, Officer Safety with Handling Difficult People (Elective Module Hours). Eight (8) hours of security officer training credit. Classes are offered Monday thru Saturday from 9:00 am - 4:00 pm. Classes are self-study and facilitated by an instructor & comply with the Skills Training Requirements for Security Guards (AB 2880).
Information on the Continuing Training Requirements (AB 2880). Every newly licensed security guard must complete 32 hours of additional training. Sixteen (16) hours must be completed within 30 days from the day the registration is issued, or within 30 days of starting employment. The remaining 16 hours must be completed within the first six months from the day the registration is issued, or within six months of starting employment. Eight (8) hours of Continuing Education training is required every year after the first.
The classroom training will take place at The Loss Prevention Group, 524 7th Street, Oakland (between Washington & Clay and a few blocks away from the 12th Street Downtown Oakland BART Station).
Continuing Training Date 1 * Select Monday, 4/22/19, 9:00 a.m. Tuesday, 4/23/19, 9:00 a.m. Wednesday, 4/24/19, 9:00 a.m. Thursday, 4/25/19, 9:00 a.m. Friday, 4/26/19, 9:00 a.m. Saturday, 4/27/19, 9:00 a.m. Monday, 4/29/19, 9:00 a.m. Tuesday, 4/30/19, 9:00 a.m. Wednesday, 5/1/19, 9:00 a.m. Thursday, 5/2/19, 9:00 a.m. Friday, 5/3/19, 9:00 a.m. Saturday, 5/4/19, 9:00 a.m. Tuesday, 5/7/19, 9:00 a.m. Wednesday, 5/8/19, 9:00 a.m. Thursday, 5/9/19, 9:00 a.m. Friday, 5/10/19, 9:00 a.m. Saturday, 5/11/19, 9:00 a.m. Monday, 5/13/19, 9:00 a.m. Tuesday, 5/14/19, 9:00 a.m. Wednesday, 5/15/19, 9:00 a.m. Thursday, 5/16/19, 9:00 a.m. Friday, 5/17/19, 9:00 a.m. Saturday, 5/18/19, 9:00 a.m. Monday, 5/20/19, 9:00 a.m. Tuesday, 5/21/19, 9:00 a.m. Wednesday, 5/22/19, 9:00 a.m. Thursday, 5/23/19, 9:00 a.m. Friday, 5/24/19, 9:00 a.m. Saturday, 5/25/19, 9:00 a.m. Tuesday, 5/28/19, 9:00 a.m. Wednesday, 5/29/19, 9:00 a.m. Thursday, 5/30/19, 9:00 a.m. Friday, 5/31/19, 9:00 a.m.


—Michael Marshall Smith Grow your ideas in style Scrivener is a powerful content-generation tool for writers that allows you to concentrate on composing and structuring long and difficult documents. While it gives you complete control of the formatting, its focus is on helping you get to the end of that awkward first draft. Your complete writing studio Writing a novel, research paper, script or any long-form text involves more than hammering away at the keys until you're done.
Write, structure, revise Scrivener puts everything you need for structuring, writing and editing long documents at your fingertips. With access to a powerful underlying text engine, you can add tables, bullet points, images and mark up your text with comments and footnotes. Editing - Jeni Chappelle.
Free 10-page sample edit For all editing services (please note: this does not include the manuscript assessment), you'll receive an annotated manuscript with my notes.
I use the Track Changes feature in Word so you can accept and reject edits individually, and you'll always know what I've changed. All page estimates are based on the standard: 250 words per page. Developmental and content editing Developmental editing focuses on the elements of storytelling and can take place at any point in the writing process. Copyediting and proofreading. Guest Post: How I Went From Writing 2,000 Words a Day to 10,000 Words a Day - SFWA. By Rachel Aaron When I started writing The Spirit War (Eli novel #4), I had a bit of a problem. I had a brand new baby and my life (like every new mother's life) was constantly on the verge of shambles. The 12 Stages of Physical Intimacy – What Are They? MASTER LIST of Gestures and Body Language! Hey there!
Lots of writers liked my list of facial expressions, so I thought I would do a companion post about gestures and body language. Describing these can help readers visualize a scene and get a feel for the characters, and again, they can set up lines of dialogue so you don't have a string of he said, she said, he asked, she exclaimed, etc., running down the page. How to Rock Your Story's Tension. Photo cred: © Sergei Zolkin via Unsplash Today we're talkin' tension.
No matter your story's plot or genre, you need to know how to nail tension in your fiction. Why? For starters, tension occurs every time a hero and a villain come in contact. And trust me, that needs to happen in your story. The Writers Alley: How To Write A Kissing Scene...Valentine Edition. The Kiss...the moment when lips meet, when senses are heightened, when hearts meld.
It is a magical thing, because women loved to be kissed They want to be wanted, desired, loved. When writing romance, the kiss is of the utmost importance. How to Write in Deep POV + get inside the mind of your character. Photo cred: © Paolo Imbag via Unsplash This post is part of the HOW TO WRITE A STORY guide series.
16 Observations About Real Dialogue. 8 Tips for Awesome Dialogue. Dialogue is one of the most important and also one of the most difficult aspects of a story.
That is because dialogue is such a common occurrence in readers' lives. Just as badly done animation of people is creepy, badly written dialogue comes off as fake and vaguely menacing. There is nothing worse to read than a cliché-ridden, stilted, and obviously forced line of dialogue. From the dime store novels of the past to Harlequin romances of today, you can find examples of bad dialogue everywhere. But what is good dialogue? 1. Emotional Looking Glass: See How Your Body Reacts to Feelings. 21 Writing Prompts for Setting a Scene in Your Novel.
Sure, there's the action–but what about all the extra bits meant to flesh out your story? While I don't encourage overwriting for the sake of word count, meaningful details can help you establish setting and atmosphere. Last week, I sat down with John Banville's Booker Prize winning novel, The Sea–a book that features prose I admire–and took careful notes about how the author managed to effectively set certain scenes. How to Make Your Book Play Out Like a Movie.
By Jody Hedlund, @JodyHedlund Recently I received a reader email that said this: "My friend gave me one of your books and I devoured it in two days . . .
The scenes play out like a movie in my head, and I felt the characters were all real people!" The scenes play out like a movie. Dramatica - The Next Chapter in Story Development. Kami McArthur, How to Win Writing Contests—and Big Publishing Contracts. Utah Valley Writers. Posted on November 1, 2014 by Michael Gordon Leave a Comment Aaaaaand . . .
Commence NaNoWriMo! Good luck to everyone doing it. I've won two years straight and here's what I can tell you. NaNo is NOT about getting large chunks of time to write. As far as this year, in case you're wondering. eReader interactive infographic. 5 Ways To Shorten Your Short Stories. Ever wonder why all short stories are called short, when in fact some of them are medium-length and some are long? These days, many editors of literary journals, especially online literary journals, are putting increasing emphasis on short short stories—that is, short stories that don't exceed about 3,500 words.
Word count matters to editors. Setting: Using Scene To Enrich Your Writing. In both fiction and nonfiction, the setting is the general background against which your story takes place—the physical location and time period, both of which influence your characters and plot. So how can a creative writer use setting and scenery to further offset, augment, or reflect the action of the plot? Although we're going to be exploring this issue in terms of fiction, these techniques work for nonfiction as well. These craft techniques work in all genres: poetry, stories, personal essays, memoir, and books. Short Story Shortcuts: 4 Techniques For Making A Big Impact In Few Words. To successfully write short fiction, you need to make a big impact in as few words as possible. So every choice you make as an author needs to be deliberate, every character needs to act with purpose, and every word needs to pack a punch.
When less is definitely more, focusing on certain details can help imbue your short story with lots of color, meaning, and subtext—without superfluous words. Four Small Ways To Pack Big Meaning Into Short Stories 1. Character Gestures – When you're writing with a word count restriction, you want to show your characters' personalities without using too much dialogue. 2. 3. Active Voice Versus Passive Voice. Today's topic is active voice versus passive voice. 25 Editing Tips for Tightening Your Copy. The 200 Most Common Redundancies. Nuts and Bolts: "Thought" Verbs.
The Art of Brevity: 5 Powerful Techniques to Cut the Fluff from Your Fiction. Save the Cat!® National Novel Writing Month. Nano-104230.pdf. The Crash: Braving Your Second Draft. Hemingway. #Women Are From Venus, Men Are Annoying — A Guest Post. By Rob Preece While sitting at an autographing at the Romantic Times Convention several years ago, a woman hurried up to my table.
Beta Reader Questionnaire. Over the course of the last couple years, I've learned a lot about having those awesome people called beta readers. Five Common Problems I See In Your Stories. Short Stories: 10 Tips for Creative Writers. LESLIE LEYLAND FIELDS: 9 Woes of the Writing Life. Writing Empathetically vs. Sympathetically and Sentimentally. Tips for writing book reviews. 5 Ways to Get Rid of Your Damn Empty Modifiers. Written? Kitten! Write or Die 2. 25 Insights on Becoming a Better Writer. 7 Things Dungeons & Dragons Taught Me About Storytelling. Aliventures — Writing, blogging, and self-publishing.
Daily Writing Tips. 5-Step Secret To Great Fiction. Novel Writing Tips & Fundamentals – Storyfix.com. Writing Essentials. 100 Little Ways You Can Dramatically Improve Your Writing. The best writer's resources on the web - Writer's Knowledge Base. 25 Things Writers Should Stop Doing. Kurt Vonnegut's 8 Rules For Writing Fiction. Pixar's 22 Rules of Storytelling. Passionate Reason the blog of author L.E. Henderson: How I Lost My Guilt and Became Addicted to Writing. Telescopic Text © Joe Davis 2008.


Northfield A have started to close the gap on their rivals at the top of Division 2 of the Cleveland & District Summer Table Tennis League as they scored a maximum 10-0 victory over Ormesby G. Although being 10-0 the match was closer than the scoreline suggests.
Tom Webster, Gary Whittle and Lee Russell all scored hat tricks for Northfield. Two of the sets, the doubles, Tom Webster and Gary Whittle beat Olly Flight and John Daley was by a narrow margin of 11-8 in the decider after the Ormesby players led by 2 games to 1. Olly Flight took Lee Russell to 5 games after leading 2-0.
With the intention of gaining honours, Nunthorpe B kept up their momentum with a 9-1 victory over Ormesby F Wheelers with hat tricks from Barbara Kearney, Bob Evans and Trevor Teasdale. The doubles was the only game won by Ormesby.
Beaumont Nomads B also kept their interest in the title with a 10-0 victory over Ormesby H with Sam Hugill, Bruce Lowther and Jane Lynas all unbeaten. This victory was a true reflection of the score line.
Nunthorpe B still lead the division with 113 points from 15 matches. Beaumont are second with 112 from 16, but the strong favourites are Northfield with 111 from 13.
Westbourne B are outsiders with 110 from 16 after they had dropped 4 points to Ormesby E winning only 6-4, mainly due to hat tricks from Ormesby Cadet Eve Witterick. Lee Kelly and Andy Greason won 2 each for Westbourne B.


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Stenoma dryaula is a moth of the family Depressariidae. It is found in Paraguay and Brazil (Amazonas).

The wingspan is 14–15 mm. The forewings are whitish ochreous, the dorsal half slightly brownish tinged. There is a moderate brown median streak from the base to the apex, the upper edge somewhat mixed dark fuscous, the lower rather suffused. The second discal stigma is black, the plical also but smaller and sometimes obsolete. There is a marginal series of black dots around the apical part of the costa and termen. The hindwings are light grey.

References

Moths described in 1925
Taxa named by Edward Meyrick
Stenoma

redpajama_set_name: RedPajamaWikipedia


Established in 2002, using skills developed with 40 years experience in design and construction Thomas Pierce Architecture LLC creates memorable innovative environments. Beyond Bricks and Mortar, components of success for us include developing relationships with our clients, responding to fiscal restraints, emphasizing sound environmental practice and the integration of an extensive palette of materials to fulfill and elevate the owner's vision into built reality.
Award winnning Built Projects have exceeded 70,000 Sq Ft in scope.
Sucessful projects developed which have exceeded 250,000 Sq Ft. Innovative metal building design.
We have provided architectural services for all scales of residential projects, from feasibility reports for room additions and renovations, to luxury residences exceeding 22,500 Sq Ft in scope. Our main emphasis is providing appropriate, quality design services with good stewardship to meet the specific needs of the client.
We actively participate and are commited to improving the social, economic and environmental well being of our community.


From the start of one's medical education, the importance of obtaining a complete medical history is emphasized as an essential tool for patient care, and family medical history (FMH) is often included within the construct of a complete medical history. However, while the requirements and utility of FMH are well-defined for certain specialties, such as medical genetics  , these same aspects are considerably less clearly defined for FMH in primary care  . One reason to account for this is best stated in the National Institutes of Health State-of-the- Science Conference Statement on Family History and Improving Health: "Family history was a core element of clinical care long before the evidence-based medicine paradigm was even proposed  ." In other words, it has been considered to be a requirement of inquiry with little proof of why that is the case or what is to be included.
Review of the literature is of little help. In regards to the assessment of utility of FMH, few studies have shown the direct effect of obtaining FMH on improving patient outcome   . What is more, these studies have been disease-specific and their results, therefore, cannot be extended to primary care where FMH could be utilized in the assessment of any number of diseases or conditions.
All that can really be stated with confidence is that the most accurate information is obtained when soliciting the FMH of patients' first-degree relatives, when compared to obtaining FMH relating to family members of a higher degree. More accurate information is also obtained when asking patients to recall specific diseases in their FMH, as they are better able to rule out disease (i.e. provide a negative family history), rather than recall its presence (i.e. provide a positive history)  .
For these reasons, it is evident that, within the context of primary care, the requirements of FMH, and its utility, lack establishment and warrant further investigation. What is more, given that there are no universally established guidelines for what is to be included in FMH, it is also unclear what healthcare practitioners of a typical primary care practice should include when inquiring about FMH. Thus, the objectives of this study were to assess the practices of a representative primary care practice (the Queen's Family Health Team, QFHT) in order to determine if: 1) FMH is regularly acquired, 2) the methods of acquisition of FMH results in the greatest yield of accurate information (i.e. FMH for first-degree family members), 3) the acquisition of a generalized FMH could result in alteration of patient management at a primary care level for a variety diseases and 4) what the perspectives of healthcare practitioners in primary care are in regards to the acquisition and utility of FMH to determine if there is any disparity between the self-report of practices and what is documented in patients' records.
The study was conducted at the two sites of the Queen's Family Health Team (QFHT) in Kingston, Ontario.
Participants for the study were selected from patients scheduled for appointments at the QFHT between May and July 2011. Patients were contacted by phone one week prior to their appointments and, if they agreed to participate, were requested to arrive 30 minutes earlier than their scheduled appointment times in order to be interviewed. Participants were informed that they would be asked about their FMH and that their electronic medical record (EMR) would be reviewed. Patients were only excluded from the study if they were under 25 years of age at the time of their scheduled appointment.
Ethics approval of the study was obtained from the Queen's University Health Sciences & Affiliated Teaching Hospitals Research Ethics Board.
When a scheduled participant arrived for his/her appointment, an interview was conducted focusing on the health of his/her first-degree relatives (i.e. mother, father, siblings and children). The interviews conducted focused on first-degree relatives as past research has shown that patient memory of FMH is most accurate for first- degree family members  . Each interview was conducted by the same investigator and followed a similar construct (Table 1). Patients were first asked whether any of their first-degree relatives had a history of a selected set of diseases (cardiovascular disease, diabetes, cancer, asthma, atopy, chronic obstructive pulmonary disease, dementia, mental health conditions, hearing loss, vision loss, and/or obesity). Specific diseases were asked about directly as evidence has shown that patients more accurately report negative history, or the absence of disease in family members, rather than the presence of disease  . As there is little information regarding what should be inquired about regarding family medical history during a standard primary care visit  , the diseases directly asked about were chosen based on discussion between the investigators of this study, as well as questionnaires commonly used for similar studies, such as the Family Healthware Screening Tool developed by the Centers for Disease Control and Prevention  .
The medical history of each first-degree family member was then reviewed similarly through patient interview, inquiring if any significant medical history had been missed (other conditions, hospitalizations, surgeries, cause of death, etc.). As well, the current age of each first-degree relative was obtained, or the age deceased.
Once an up-to-date FMH was obtained by interview, each participant's EMR was reviewed, noting the FMH present on file prior to the start of the study. The FMH on file was identified as "Empty" if the family history field contained no information, "Incomplete" if the field contained any information regarding the patient's FMH and "Complete" if there was some documentation of the health of every first-degree family member. If the family history field of the EMR had been populated prior to the start of the study, the date it was last updated was also noted (3 months prior to the start of the study, 12 months prior to the start of the study, or later).
Table 1. Format of patient interview. Each patient was asked if any first-degree relative had any of the conditions listed in the table. They were asked to specify which relative(s) and the age(s) of onset. Following this line of questioning, patients were then asked to state the current age, or age deceased, of each first-degree relative and to state any other medical conditions these family members' had that they may not have mentioned previously.
The FMH obtained by interview was analyzed to determine whether the participants had a significant family history of coronary artery disease (CAD), diabetes mellitus type II (DMII), substance abuse (SA), colorectal cancer (CRC), polyps, and/or cancers associated with hereditary non-polyposis colorectal cancer (HNPCC-as- sociated cancers). These varied conditions were selected as they are commonly dealt with in primary care, and guidelines for their diagnosis and treatment vary depending on the presence of significant family medical history  -  .
Patients were considered to have a significant family medical history of coronary artery disease if they had a first-degree relative with premature CAD (a male relative younger than 55 years and/or female relative younger than 65 years) as these patients are to be considered to have double the calculated 10-year CAD risk according to Canadian Cardiovascular Society guidelines  .
Any patient with a first-degree relative with a history of DMII was considered to have a significant family medical history, as the 2008 Clinical Practice Guidelines from the Canadian Diabetes Association considers a first-degree relative with DMII to be a risk factor that would warrant screening for DMII in individuals younger than 40 years of age and/or more frequently than every three years, which is standard for those considered to have a baseline risk  .
Any patient with a first-degree relative with a history of SA was considered to have a significant FMH, as any history of SA increases the predicted likelihood of opioid abuse by the patient if prescribed opioids for chronic pain, as established using the Opioid Risk Tool (ORT)  . The data collected by interview was further analyzed to categorize the particularly kind of SA present in the patient's FMH, as risk of aberrant use of opioids varies with the type of SA. What is more, risk is compounded if there is a FMH of a combination of prescription drug use, illegal drug abuse and/or alcohol abuse  .
Finally, a patient was considered to have a significant FMH of CRC, polyps or HNPCC-associated cancers if they had one or more first-degree relatives with any of these conditions. HNPCC-associated cancers included: endometrial, small bowel, ureter, kidney/transitional cell, skin, ovarian, pancreatic, gastric, primary brain, and primary hepatobiliary cancers. First-degree FMH of these conditions were considered significant as presence of these conditions stratifies the patient at an increased risk for CRC and, as such, screening tests, such as colonscopy, should first be performed earlier than the standard age of 50 years  .
To obtain healthcare practitioner (HCP) perspectives, an online survey was circulated to the clinical staff of the QFHT. The survey asked about their FMH-taking behaviours, their opinions regarding the utility of FMH in primary care and ways in which the acquisition of FMH can be improved upon at the QFHT.
A total of 83 patients met the inclusion criteria and agreed to participate in the study. Their ages ranged from 25 - 86 years (median: 63 years). Fifty-seven of the participants (68.7%) were female (Table 2).
Thirty-five of the 83 patient records reviewed (42%) contained no documentation of the FMH in the allotted section of the EMR. Fifty-one percent (n = 42) contained some documentation of the patient's FMH, but did not list the health of every first-degree relative of the patient. Only 7% (n = 6) of the patient records reviewed were considered complete in that there was some documentation of health for each first-degree relative of the patient (Figure 1).
Thirty of the 48 records (63%) that had some documentation of FMH, whether considered "complete" or "incomplete", were last updated more than one year prior to the start of the study. Thirteen (27%) were updated within the last 12 months, and only 5 records (10%) were updated in the last three months (Figure 2(a)). In other words, of all 83 records reviewed, only 22% (n = 18) had the FMH updated in the past year (Figure 2(b)).
Table 2. Characteristics of the patient population. Any patient coming in for a scheduled appointment at the Queen's Family Health Team (QFHT) between May and July 2011 was eligible to participate in the study, provided they were above the age of 25. A total of 83 patients participated in the study.
Figure 1. Family history documented on EMR prior to start of study. Each participant's electronic medical record (EMR) was reviewed to determine the completeness of the documented family medical history (FMH) on file prior to the start of the study. The documented FMH was considered "Empty" if there was no documentation of FMH in the allotted section of the EMR, "Incomplete" if there was any documentation of the patient's FMH in the allotted section of the EMR, and "Complete" if there was some description of the health of each first-degree relative of the patient in the allotted section of the EMR.
Figure 2. Time period in which family history was last updated on the EMR. The patient's electronic medical record (EMR) was reviewed to determine when the documented family medical history (FMH) was last updated: in the past 3 months (February 2011 or later), in the past 12 months (May 2010 to February 2011) or more than one year ago (prior to May 2010). (a) Only includes records that had some documentation of the patients' FMH (described in Figure 1 to be "Incomplete" or "Complete"); (b) Includes all patient records reviewed, including those that did not contain a FMH for the patient.
Reviewing the FMH obtained by interview for significant medical history of CAD, DMII, SA, CRC, polyps or HNPCC-associated cancers, it was found that 56 of the 83 participants (67%) had a significant family medical history for at least one of these conditions. Twenty-seven percent of patients (n = 22) had a significant family history of CAD, 29% of patients (n = 24) had a significant family history of DMII, 37% of patients (n = 31) had a significant family history of SA, and 22% of patients (n = 18) had a significant family history of either CRC, HNPCC-associated cancer or polyps (Figure 3(a)).
Figure 3. Significant family history. Review of the patient's interviews for a significant family medical history (FMH) of coronary artery disease (CAD), diabetes mellitus type II (DMII), substance abuse, colorectal cancer (CRC), polyps, or cancers associated with hereditary non-polyposis colorectal cancer (HNPCC-associated cancers). (a) Overview of significant family history. A description of how FMH was considered to be significant can be reviewed in the Methods section of this paper; (b) Significant family history of substance abuse. Further categorization of the substance abuse present in each patient's FMH to specify whether history of alcohol abuse, illegal drug abuse and/or prescribed drug abuse were present; (c) Significant family history of colorectal cancer or HNPCC-as- sociated cancer. Further categorization of the history of CRC, polyps or HNPCC-associated cancer in each patient's FMH.
The data regarding SA was further categorized to explore the prevalence of different forms of SA in the family histories of the participants. It was noted that 35% of participants (n = 29) had a significant family history of alcohol abuse, 7% of participants (n = 6) had a significant family history of illegal drug abuse, and 1% of participants (n = 1) had a significant family history of prescription drug abuse (Figure 3(b)).
The data regarding significant family history of CRC or another HNPCC-associated cancer was also subdivided in order to determine the presence of both groups of conditions individually, and to determine the number of participants that had more than first-degree relative with either of these conditions, as this information is required when assessing a patient's risk of CRC  . Seven percent of participants (n = 6) had one or more first degree relatives with a history of CRC, 17% of participants (n = 14) had a history of the HNPCC-associated cancers (excluding CRC) and 10% of the participants (n = 8) had more than one first-degree relative with a history of CRC and/or HNPCC-associated cancer (Figure 3(c)).
Of the 42 HCP respondents to the survey, 16 were staff physicians (38%), 20 were residents (48%), 2 were nurse practitioners (5%) and 3 were nurses (7%) at the QFHT (Table 3). Eighty-six percent of those that responded (n = 36) stated that they do regularly inquire about the FMH of their patients, while 14% (n = 6) stated they do not (Figure 4(a)). To better understand what clinicians considered to be regular inquiry, the HCP were asked how often they inquire about FMH. The majority, 64% (n = 27) stated that they inquired about a patient's FMH at every periodic health examination. Twenty-four percent (n = 10) responded that they inquire about FMH when they considered it clinically appropriate, 12% (n = 5) stated they did so when a new problem presents, 10% (n = 4) inquire about FMH at the initial patient visit, 5% (n = 2) at most or all patient visits, and 2% (n = 1) whenever time allows (Figure 4(b)).
Regarding the utility of the FMH, all HCP responded that they considered it to be useful when making clinical decisions, but 40% stated that they only found it useful "some of the time" (Figure 5(a)). When prompted to discuss what determines whether they will inquire about FMH in order to assist in clinical decision making, their answers suggested that it often depends on the perceived utility of FMH, such as if knowledge of the FMH affected their screening, investigation or management of a patient. Some also responded that they would inquire if they noted FMH was not already present on the EMR or to assess risk. Other reasons HCP considered it important to obtain FMH were: to further understand the patient's environment and how it may affect his/her health (64%, n = 27), to determine the patient's familial risk for particular conditions (95%, n = 40), and to counsel patients on preventative measures they can take to benefit their own health (79%, n = 33) (Figure 5(b)).
When asked to consider barriers to inquiring about FMH, the most common reasons were lack of time (45%, n = 19) or that patients do not come in frequently enough (31%, n = 13). Other reasons were that HCP were unsure what to ask due to lack of clear recommendations (14%, n = 6), concern that the focus of the visit may be lost (10%, n = 4), concern that the patients may not know their family medical history well (10%, n = 4), concern that it may cause the patient unnecessary worry (2%, n = 1), and that it is often forgotten about in the context of investigating an acute condition (2%, n = 1). It should be noted that 36% (n = 15) felt that they do not experience barriers when asking about family medical history (Figure 6).
In terms of what HCP stated they asked about when inquiring about FMH, the majority stated that they ask about the specific health issues of each family member (62%, n = 26), as well as targeted questions relating to the patient's current health status (64%, n = 27). Half of the respondents (n = 21) stated that they inquire about the general health of the family of the patient (Figure 7(a)).
When asked to elaborate regarding which family members the HCP specifically ask about, the majority (64%, n = 27) stated that they inquire about first-degree relatives, including children. Five respondents (12%) stated that they asked about first-degree relatives but excluded children, 12 respondents (29%) stated that they regularly inquire about the health of second-degree relatives and none stated that they regularly ask about the health of third-degree relatives (Figure 7(b)).
Differing from what the HCP stated that they included when inquiring about a patient's FMH, the HCP were asked what they think should be included in a complete FMH. The majority agreed that the FMH pertaining to a patient's current conditions should be present (67%, n = 28), the positive and negative history for conditions known to have increased familial risk (74%, n = 31) and the current age or age deceased for each first-degree relative of the patient (55%, n = 23) should be included (Figure 8).
Table 3. Characteristics of the respondents of the healthcare practitioner online survey. Healthcare practitioners working at the Queen's Family Health Team (QFHT) were requested to complete an online survey regarding the acquisition and utility of family medical history (FMH). The demographics of the respondents are shown here.
Figure 4. Insight into the regularity of inquiry of family medical history by healthcare practitioners. The following graphs elucidate at what times family medical history (FMH) is solicited by healthcare practitioners' (HCP) from their patients. (a) Proportion of healthcare practitioners surveyed that regularly inquire about family medical history. Self-report; (b) Times at which the healthcare practitioners surveyed inquire about patients' family medical history. Self-report.
Figure 5. Utilities of family medical history. Healthcare practitioners (HCP) were asked to respond to whether they find family medical history (FMH) useful when making clinical decisions and if there are other utilities to the FMH obtained. (a) Proportion of healthcare practitioners that consider family medical history useful in clinical decision making. Self-report; (b) Utilities of family medical history. HCP were asked to consider specific reasons they find FMH to be useful in clinical care.
though one respondent did comment that a patient-filled questionnaire would not allow for the same HCP-di- rected patient-specific questioning that would be most useful clinically.
Figure 6. Perceived barriers to inquiring about family history. Healthcare practitioners were asked to consider reasons they may find it difficult to discuss family medical history (FMH) with their patients, or to note if they feel they do not have difficulty discussing FMH.
Figure 7. Content of family medical history obtained by healthcare practitioners. Healthcare practitioners (HCP) were asked to self-report what specific information they solicit from their patients when obtaining family medical history (FMH). (a) Healthcare practitioner focus when inquiring about family medical history. Self-report; (b) Family members inquired about by HCP when obtaining family medical history. HCP were asked to report which relatives they regularly requested information about when obtaining FMH from their patients.
Figure 8. Healthcare practitioner opinions regarding what should be included in the documented family history of a patient. Healthcare practitioners were asked what they thought should be included in a standardized family medical history.
mented and, when it is present, it is rarely complete, meaning that it does not contain health information for each first-degree relative of the patient. This is disparate with the majority of the HCP surveyed agreeing that FMH should include reference to both the positive and negative history for conditions with increased familial risk for first-degree relatives. As well, results of this study also showed that a standardized method of acquiring a general FMH, could lead to alteration in patient care for a variety of diseases (CAD, DMII, SA and CRC).
The findings of this study can be interpreted many ways. In regards to the opposing findings of the self-re- ported acquisition of FMH by the HCP surveyed, and the lack of FMH documented in patients' records, one explanation is that HCP are simply not inquiring into patients' FMH, despite reporting otherwise. However, a more likely explanation is that information is being obtained, but not documented, which is particularly worrisome given the evolution of primary care.
In the previous construct of primary care in which a single physician was responsible for a patient and had sole access to a patient's record, methods of documentation and decision to omit information was less of an issue in that the physician was aware of his or her own practices. However, in the newer constructs of primary care, such as the family health team  , any number of HCP could be reviewing and updating a patient record. As such, it becomes essential that information in patient records be clearly documented such that it is recognizable and useable by all who access it. Thus, if this study shows anything in regards to the acquisition of FMH, it is that more standardized documentation of the acquired information is necessary.
In regards to what information must be included in a FMH in primary care, previous studies have provided little recommendation  . However, after developing a standardized framework to obtain a general family history for the purpose of this study, using the knowledge that negative family history and information regarding first-degree relatives is most accurate  , it has been shown that such a framework could yield a significant family history for a variety of diseases leading to the alteration of their management in primary care. Thus, it is the opinion of the authors of this report that this framework could be utilized broadly in primary care settings and for future studies of the utility of FMH in primary care.
While this study has given some insight into the acquisition and utility of family history there are limitations. For one, the study was essentially a pilot study; using a simple, cross-sectional design, focusing on a non-ran- domized subset of patients at a single center. As well, while the four disease guidelines used to assess FMH  -  did show utility of FMH to patient management in primary care, these guidelines were merely representative of the wide breadth of guidelines available that should be reviewed in order to better determine which diseases should be asked about directly when obtaining FMH.
In conclusion, this study showed that obtaining a standardized FMH can result in altered patient management in a primary care setting. However, at least for the representative practice site assessed in this study, there is a high degree of variability in terms of the documentation of FMH despite many agreed-upon beliefs regarding what should be included in a standardized FMH. Considering all this, future study topics could include: expanding a study like this to multiple centers to confirm the results obtained here, a qualitative study involving the interview of a variety of HCP to fully elucidate how FMH is currently used in primary care and the reasons for the wide variability in documentation, and, most importantly, the development of a family history framework that could be used in a randomized control trial to assess whether its use leads to improved patient outcome in primary care. Only then can the use of FMH truly be considered evidence-based.
The authors would like to thank Jyoti Kotecha from the Centre for Studies in Primary Care for her review of the data and recommendations regarding the direction of the project, as well as Danyal Martin from the Department of Family Medicine for her logistical assistance.


By Tess Egginton for East Midlands Business Link Magazine.
The fifth Institute of Directors (IoD) East Midlands Women as Leaders Convention took place on Friday (29 March) at the Crowne Plaza Hotel, Nottingham.
Charlotte Valeur, Chair of the IoD, headlined the event as keynote speaker, joined by some of the region's top leaders, who shared inspirational stories with delegates at the lunchtime event.
Opening the convention, Ron Lynch, IoD East Midlands Regional Director, said a few words. In his speech Ron outlined the importance of running events that will have an impact on society and improve diversity, which indeed, as Ron said has many benefits. Ron noted: "We know that diversity on the board brings many benefits.
Louise Third MBE of Integra Communications Ltd, the host of the event for the second year – a PR and communications consultant specialising in business growth – then took over the mic to introduce Charlotte Valeur, Chair of the IoD.
She continued: "We want to be in a place where we have respect for everybody and space for everybody […] that is what I work towards, equality for all so we can all be who we are and bring to the table who we are no matter what it is.
She went on to discuss how in the top levels it is important to have diversity – not just gender diversity – but all diversities as represented by our population.
She suggested that leaders consider and commit to value words: "Make a social contract with yourself where you say 'my values are…'. If you have a LinkedIn profile put in your values in the top line, so that is what people see when they see your name and your face. Then you make a contract with the world.
"Leadership needs to be based on values that you find in your heart. Once we do that it will trickle down in our society." As for Charlotte, she noted that her value words are collaboration, honesty and trust.
After a Q and A with Charlotte and a break for lunch, Louise introduced the next section of the event, the panel.
Caroline said: "Those leaders that actually care about who follows them and why, and those people that aren't following them and why are very wise.
"Leadership for me […] is that actually I need all of my team with me. We need to be shoulder to shoulder, and you have a responsibility to make sure their talents and skills are given the opportunity to shine. I have the opportunity to lead those people down a particular path.
Lisa Wainwright, Technical Director for International Volleyball (FIVB) and a member of the International Basketball Federation (FIBA) Governance Commission, spoke next. Reflecting on values, Lisa talked about the importance of integrity. She said: "Being an authentic leader is about being honest about who you are.
One of the key points that Karen made was the importance of visible leadership. She said: "Being visible is hard in a big corporate environment.
"I put time in my diary each week to do that. I get out there and talk to the people.
Karen concluded her time with the audience by saying that as a leader you must be yourself, be visible, listen to what people say, do not be afraid to challenge people and have difficult conversations, but equality give lots of praise.
Bill Skelly, Chief countable of Lincolnshire Police spoke next. Exploring two areas of being a leader: the already touched upon importance of authenticity and compassion.
Bill also highlighted that his value words, as initially brought into the convention's conversation by Charlotte, are truth, justice, duty.
In regard to compassion Bill noted that empathy and action are compassion.
He went on to say: "The effect you have as a leader on people's lives is massive and if you demonstrate that compassion then they will follow you." Closing his speaking time, Bill highlighted that authenticity and compassion are not just words but verbs, they are activities to be done, so one must actually go and do them.
The penultimate panel member introduced was Susan Hallam MBE, of Hallam Internet, who discussed leadership in a small business environment. She talked about how leadership evolves in oneself and how leadership is something one can learn as one goes along.
Complimenting Charlotte's speech, Susan brought up the importance of North Star principles, knowing your values and staying true to them in the in turbulent times of change. Susan also touched upon innovation and being open to ideas. She said that the big thing about leadership she learned in the realm of innovation was to be able to ask for help and get advice you need from other organisations. She noted that one must continue to develop leadership skills and not be afraid to say that we need to develop these skills.
Melanie also noted the importance of reading how people are feeling and to tapping into those feelings, as well as the importance of being authentic and opening oneself up, being available for people and challenging people.
A Q and A with the panel followed covering topics from loneliness as a leader, to balancing family and success, and the question of whether men find authenticity more difficult than women.
-Saying yes even though it might not work.
The afternoon finished with words from Gary Smith, IoD Regional Chairman, who pulled out key themes from the day including authenticity and the important of followers.