text:
Event: Actress Neha Dhupia & actor turned director Saurabh Shukla promoted their upcoming film RAAT GAYI BAAT GAYI in a promotional event called 'Hangover Nights' in Mumbai.
Guest List: Neha Dhupia, Iravati Harshe, Rajat Kapoor, Saurabh Shukla, Suresh Menon
HOT and SEXY Poonam Pandey was snapped at Mirchi Music Awards.
Bollywood celebs Mahesh Manjrekar, Sudhanshu Pandey, Pallavi Joshi, Anjana Sukhani among others were snapped at Mirchi Music Awards 2017.
Bollywood celebs Varun Dhawan and Alia Bhatt promoted their upcoming film BADRINATH KI DULHANIA.
Bollywood actress Esha Gupta promoted her upcoming film COMMANDO 2.
Bollywood celebs Varun Dhawan and Alia Bhatt interacted with the media during BADRINATH KI DULHANIA press conference.


text:
I learned even more about sewing faux leather. I made a faux leather jacket two years ago with fabric I purchased from EOS. Most recently fabric from Mood.
Here are a few shots of the skirt on hanger.
|Front view of completed skirt|
|Back of skirt with exposed zipper|
|Close up of top stitching.|

domain: artistic


Shenzhen Geno Sound Technology Co., Ltd. is a high-quality manufacturer and supplier of advanced medical devices, and we are proud to present our latest product, the Portable Sonography. Our company is well-known for providing innovative and reliable medical equipment, and this product is no exception. This Portable Sonography device is designed to be compact and easy-to-use, offering unparalleled convenience and functionality to healthcare professionals. This device utilizes the latest technology to provide high-quality diagnostic imaging in a portable package. Its lightweight design makes it perfect for use in a variety of settings, including clinics, hospitals, and even homes. With its advanced capabilities and intuitive interface, the Portable Sonography is the perfect solution for professionals on the go. As a trusted company in the medical industry, we are committed to providing our customers with top-quality products that meet their exact needs. With the Portable Sonography, we have created a reliable and easy-to-use device that is sure to become an essential tool for healthcare professionals worldwide.


text:
Collected by Sara Moss
1048 E 2100 S #110, Salt Lake City, UT 84108, USA
Epic brewing opened the Annex pub last year in anticipation of the Sugar House boom. A roster of high-octane beers (the sour apple saison clocks in at 7.7 percent alcohol) and fortifying food (pastrami burgers, beer-can chicken) immediately turned...
1330 2100 S, Salt Lake City, UT 84106, USA
Once the site of Utah’s state prison, Sugar House Park is now a more wholesome place. In summer, the 110-acre tract holds free concerts and farmers’ markets; in winter, snow draws sledders and cross- country skiers from around the city. This...
2110 Highland Dr, Salt Lake City, UT 84106, USA
The Utah Brewers cooperative, a partnership between Wasatch Brewery and squatters craft beers, has an eye for where people drink. The latest proof: Wasatch Brew Pub, which serves playful beers (Polygamy Porter, anyone?) in a spot just off the new...
2212 S W Temple #14, Salt Lake City, UT 84115, USA
Thanks to loosened liquor laws, Utah’s distilling scene is flourishing—the Sugar House Distillery is the third small-batch distillery to open in the state in the last year. On an informal tour you can buy bottles of owner James Fowler’s vodka and,...
2165 S Highland Dr, Salt Lake City, UT 84106, USA
Utahns are deep into DIY and have a soft spot for anything vintage. Unhinged, which recently moved into a bigger, brighter sugar house location, sells it all, from scruffy overalls to leather satchels made by salt lake–based QP collections. This...
142 Calle Flamboyan, Vieques, PR 00765
Just sayin'... As far as beach bars go, this town's one-street scene is all bananas. After my trip, I called one of my awesome friends from college (go Providence!) who has frequented Vieques for work (lucky her), and when I told her how shocked I...
- 1 Travel News This Tiny Country Is Europe’s Fastest Growing Destination
- 2 Expat Life 11 Best Islands to Move to After Retiring
- 3 Travel News Why You Should Go to New York City This Winter
- 4 Where to Go in Winter 7 UNESCO World Heritage Sites You Need to Visit This Winter
- 5 Air Travel Another U.S. Airport Now Allows Non-Ticketed Visitors Through Security

domain: travel


text: Sonam Kapoor and Anand Ahuja's wedding festivities are ending with a bang! The couple's reception was at The Leela in Mumbai. Videos of Sonam Kapoor and Anand Ahuja cutting their gorgeous six-tier wedding cake are going viral. Sonam is seen feeding a piece of cake to Anand, who, in turn, feeds some to his in-laws Anil and Sunita Kapoor. the celebrations have surfaced on social media, and are already taking the internet by storm.

domain: news


text:
Free download Saavn Music & Radio for PC Windows or MAC from BrowserCam. Saavn Media Pvt. Ltd. published Saavn Music & Radio for Android operating system(os) mobile devices. However if you ever wanted to run Saavn Music & Radio on Windows PC or MAC you can do so using Android emulator. At the end of this article you will find our how-to steps which you can follow to install and run Saavn Music & Radio on PC or MAC.
We love listening to music, radio, and tunes everywhere and anywhere. There was a time when we used to play CDs on our CD players and had Walkmans around our neck every time. Today’s a much simpler time, a time where we have a world of music near our fingertips. Saavn is the best app for you to listen to songs, radio, podcasts, and the best part is that it’s for free. Saavn is a new way to listen to music. Here are some amazing reasons why Saavn Music and Radio is the best app for all your music needs. Whether you’re driving, riding the bus, or having a quiet evening at home - then this is the app for you.
Saavn Music and Radio have over 55 million songs across various genres from Hip Hop, Rap, EDM, R&B, and even the Classics. It’s a great app for everyone to use because it has a wide range of languages like Tamil, Telugu, Marathi, Kannada, Malayalam, Bengali, Gujarati, Rajasthani, Assamese, Bhojpuri, English, Marathi, and so on. This is the only app to have such a wide range of songs catering to diverse niches and languages.
Nowadays, it’s all about personalization and curated content. Saavn Music and Radio curates playlists based on your music preferences. It lets you discover new music from talented artists so that you can get the best of the niche you love. You also can access playlists that contain the top charts like the top 10 hip hop tracks, top 20 blues, and so on. With a wide range of curated playlists and radio stations, you can always have the best content to listen to.
Many of the shows and podcasts on Saavn aren’t just made for the sake of it. They’re made by professional artists so the content that’s there is genuine and original in all aspects. Saavn app also lets you download songs to your library so that you can experience this music even when you don’t have connectivity. With exclusive shows, original content and expert music, you can never go wrong with Saavn.
Saavn Music and Radio don’t compromise on quality. You can now explore quality songs and high-quality audio at 320kbps. You can enjoy all the personalized recommendations without any interruptions or limits. So, start listening now!
Let's find out the prerequisites to install Saavn Music & Radio on Windows PC or MAC without much delay.
Select an Android emulator: There are many free and paid Android emulators available for PC and MAC, few of the popular ones are Bluestacks, Andy OS, Nox, MeMu and there are more you can find from Google.
Compatibility: Before downloading them take a look at the minimum system requirements to install the emulator on your PC.
For example, BlueStacks requires OS: Windows 10, Windows 8.1, Windows 8, Windows 7, Windows Vista SP2, Windows XP SP3 (32-bit only), Mac OS Sierra(10.12), High Sierra (10.13) and Mojave(10.14), 2-4GB of RAM, 4GB of disk space for storing Android apps/games, updated graphics drivers.
Finally, download and install the emulator which will work well with your PC's hardware/software.
Follow above steps regardless of which emulator you have installed.

domain: hobby


This file is different from the
“shell.c” file that comes with the public-domain
version of SQLite. This shell.c has been enhanced
to make use of the encryption extension.
Dll(located in the install directory of the game) as Trojan. The “DLL not designed to run on Windows” error can stop you from adding third-party Windows software to your computer. If all else fails, you can install the missing DLL manually. Don’t worry; the above steps take little time; repairing takes a few seconds, so there should be no difficulty while repairing each package in your system.
Author Linda has been working as an editor at MiniTool for 1 year. As a fresh man in IT field, she is curious about computer knowledge and learns it crazily. Maybe due to this point, her articles are simple and easy to understand.
Fixing Device Manager error codes reinstalling driver
The really scary part is that if you download an infected DLL file, you risk—by the very nature of DLL files—giving that file deeper access than a regular infected file might get. DLL, short for Dynamic Link Library, is a type of file containing code and data that can be used by multiple programs at the same time. They are written in many languages, such as C, C++, C#, Delphi, Visual Basic, Visual Basic.Net, and so forth. And you’d better ask technicians for help or use professional and easy DLL file editor if you are a computer newbie.
- Trojans are malicious programs that can cause chain infections by installing other software of this kind.
- Drag the app from the Applications folder to the Trash (located in your Dock), then right click the Trash icon and select Empty Trash.
- The message might appear before or after a program is used, while a program is running, when Windows is started or shut down, or even during a Windows installation.
- DLL Tool focuses mainly on fixing the corrupted or missing DLL files instantly on your system.
Type in Y to schedule the volume to be checked the next time the system restarts. Keeping the drive in your Windows 10 computer error-free is essential to its performance. If you are experiencing issues opening files or applications, it may be time to check your drive for errors. Windows provides a utility tool known as chkdsk that can correct most errors on a storage disk. The chkdsk utility must be run from an administrator command prompt to perform its work. Hard drive data corruption occurs when a system cannot finish writing data to a file or when segments of the file become inaccessible.
Another thing worth noting is that restoring Windows 10 Registry Backup is not as easy as copying a file from one folder to another. If your computer with Windows 10 is turned on (online), you can’t replace the original registry files in the %windir%\System32\Config since they are locked by the operating system. Installed applications create many registry keys that are essential for their functionality. It is important to locate and delete entries of uninstalled software if they have not yet been removed before.
It tests if your endpoint can detect msvcr110.dll download when encryption is happening (like base on the files change pattern), but NOT to test if your endpoint can prevent it from start. Luckly, I found few brands can detect it, and one of them can stop ransomware encryption initiated from remote PC via file share and RDP as well.


We specialise in Aerospace CNC machining. Our team is determined to work effectively and adopt the most rational decision while working with complex tasks and solving problems. Our specialist teams have developed highest quality EU standard expertise in aircraft wheel and break MRO. We work with commercial and corporate aircrafts.
Part-145 Certificate ref.: LT.145.028
ISO9001:2015 Certificate no: EU.ISO9001.088 | EU.ISO9001.089
Get in touch
Impeccable business reputation has been built by the highest qualification employees - highly skilled professionals that are not afraid of complex and precision asking tasks.
Choose a reliable partner, get in touch:
CNC Manufacturing | Aviation | CNC Machining | CNC Manufacturing | CNC Milling | CNC Drilling | CNC Threading | CNC Grinding | Part-145 Welding | Aircraft Recycling


West End artists meet and greet in a truly inspiring space. Explore the Gesamtkunstwerk Exhibition and the building that will become a monument in our beloved West End. Engage in dialogue for WE Arts, an opportunity to explore and define the future of arts in the West End. Join us for music, wine and cheese, and great conversation. Complimentary parking provided in lot at Granville Street and Beach Ave.
The exhibition everyone is talking about.
Designed by the Bjarke Ingels Group, and produced by Westbank, the exhibition is an exploration of art, architecture, urbanism, sustainability, transportation, engineering, and landscape design.
Sunday, May 25th, 2014
5:30pm – 6:30pm
1460 Howe Street at Beach Avenue
RSVP by May 20th
Please share the invitation with friends, you must each RSVP to register
Space is limited to 200 lucky people


BOINC is a platform for distributed processing. For example, it takes a lot of processing time to sift through radio signals from the whole sky looking for possible alien signals, like it takes a lot of processing time to test various iterations of mathematical models to see what fits physics data the best. You can volunteer your PC to work for these projects when it is idle, and your PC is idle really, most of the time.
I volunteer for the following projects:
Einstein@Home - search for pulsars
LHC@Home - help develop particle accelerator physics
SETI@Home - search for alien radio signals
Cosmology@Home - match math models to physics data
As you may know, I have an awesome PC with 8 virtual cores and 6Gb RAM :_)
Here's a picture of BOINC using it hard.
You can see most of the processors are close to max (it often does max them all) and RAM usage dip suddenly as I logged on to actually use the machine.
Here's the BOIC control screen:
You can see the actual project tasks that are running, ready to run, finished and waiting for RAM allocation.
This is all very cool, but it also keeps my office toasty warm in the winter.
[update - Rosetta@Home also seems very worthy - thanks Rich]
Playing with Buck Converters
1 year ago


The Stinger Briefs come in a calm and serene olive green with dark red accents outlining your body like a silhouette. They are also made with a thick cotton blend that keeps these briefs snug and comfortable.
No matter the color, the front pouch or your Stinger Briefs perfectly packs away your accessories after and before play! No need to tuck anymore!
92% Cotton & 8% Spandex


text:
2020-01-21 16:58:30| digg
One of the things any CES veteran will tell you is that it's impossible to actually see all of CES. They're not kidding — it would be an overstatement to claim that CES takes over the entirety of Las Vegas, but it wouldn't be an egregious one.
2020-01-14 16:40:03| TIME Magazine Online: Top Business Stories
TIME spoke to Sony Electronics President Mike Fasulo at CES about what the Vision-S means for Sony's future.
2020-01-13 21:48:30| PR News Online
CES 2020 is in the books, but its implications will spread throughout the year. That will be the case for communicators, who saw plenty of opportunities to help new-age tech explain itself to the public. One of the big takeaways, and one likely to provide lots of work for communicators, is that technology has broken out and will be foundational to life, several communicators say. The post CES 2020: Communicators See Demand for Their Craft appeared first on PR News.
Sites :


text:
Thursday, February 14 15:56:17
Rangeland Foods has said it is to withdraw some batches of burger products which contained beef supplied from Poland that it produced for the catering and wholesale sectors.
This withdrawal comes after some batches of its burger product that tested positive in the UK for between 5pc and 30pc horse meat, according to the Food Safety Authority of Ireland (FSAI).
These products were sold to the catering and wholesale sectors and have been distributed to Ireland, the UK, Spain, France, Germany and The Netherlands.
The company, who are based in Castleblaney, Co. Monaghan, has contacted a number of its customers that would have received these implicated products and a withdrawal is now taking place. The FSAI says that if these suppliers have subsequently traded these products onwards to other food businesses, they are compelled to notify them to ensure that a swift withdrawal is undertaken across the market.
Rangeland Foods Ltd. has said it "regrets the inconvenience that this recall will have on its customers", but stated that "responsibility to the consumer for the safety and integrity of the food produced by Rangeland is central focus of its business."

domain: economics


text:
Video: THE EXORCIST - Trailer - HQ - (1973)
A teenage girl, horrifically disfigured, sits up in bed and projectile-vomits dollops of thick, green gloop onto the face of a priest. Then, in a stream of appalling profanity, the girl confirms what we already guessed: that she happens to be possessed by the Devil. As plot twists go, it's not exactly clever or sophisticated. But the scene is nonetheless hugely effective: this is, after all, one of the climactic moments of The Exorcist, which in turn is among the most terrifying and brilliantly-executed horror movies.

domain: entertainment


text:
Location visible to members
We are super lucky to have Guy Rigby; Partner of Smith and Williamson come to share his vast experience with us.
Smith and Williamson is the 8th Largest accounting firm in the UK and it's investment management business has around £12 billion funds under management and advice.
Guy has worked as a mentor and adviser to entrepreneurs for over 25 years, and buying and selling businesses and he is also the author of: "From Vision to exit. The Entrepreneurs Guide to Building and selling a business"
I've been "hunting" Guy for a while now to get him to speak for us and I'm really excited that we finally get the chance to pick his brain. This is the first time we have had an entrepreneur of this caliber and breadth of experience speak for us.
As a "warm up" to Guy I will also be sharing my "10 minute secrets to negotiation price down 10% or more"
Schedule for the night
6 Pm: Networking
7 Pm: Simple Negotiation Secrets. How to negotiate the price down on almost anything you buy by 10% or more. W Patrick Powers
7.15Pm: Building a Global Small Business W. Guy Rigby
8PM: Q and A
8.15 PM: More networking


text:
In this study, Ethanolic extracts of Allophylus cobbe showed effectiveness against various experimental animal models of pain and inflammation. Allophylus cobbe extract significantly inhibited the nociception produced by hot plate and inhibited the acetic acid-induced writhing significantly. Allophylus cobbe extract also significantly attenuated carrageenan-induced rat right hind paw oedema. Moreover, HPLC-DAD analysis of Allophylus cobbe extract confirmed the presence of anti-inflammatory phenolic compounds.
Earlier investigators suggested that acetic acid writhing and hot plate tests are used to evaluate peripherally and centrally acting analgesic drugs respectively (Kosteret al 1959; Williamsonet al 1996). Pain induced by thermal stimulus of the hot plate is specific for centrally mediated nociception (Amabeoku and Kabatende 2012). The ability of A cobbe extract to prolong the reaction latency to pain thermally-induced in mice by the hot plate suggests central analgesic activity.
The acetic acid induced abdominal constriction method is widely used for the evaluation of peripheral antinociceptive activity (Kosteret al 1959; Silva et al 2013). It is very sensitive and able to detect anti-nociceptive effects of compounds at dose levels that may appear inactive in other methods like the tail-flick test. Generally, acetic acid produced writhing or nociception by stimulating the production of prostaglandin (Satyanarayana et al 2004). Local peritoneal receptors are postulated to be partly involved in the abdominal constriction response (Correa and Calixto 1993; Mbiantcha et al 2011). The method has been associated with prostanoids in general, e.g. increased levels of PGE2 and PGF2α in peritoneal fluids as well as lipoxygenase products (Duarte et al 1988; Khan et al 2010). Therefore the results of the acetic acid induced writhing; strongly suggest that the mechanism of action of this extract may be linked partly to lipoxygenases and/or cyclo-oxygenases pathways. The extract at the doses tested was shown to possess anti-nociceptive activity evident in the nociceptive pain model, signifying it possesses both central and peripherally mediated activities.
Carrageenan is the phlogistic agent of choice for testing anti- inflammatory drugs as it is none antigenic and is devoid of apparent systemic effect (Lima et al 2007). Carrageenan model of inflammation is said to be biphasic. In the first phase, histamine, serotonin and kinnins will be released and form nonphagcytic edema in the first hour; while the second phase is attributed to the release of prostaglandins and lysosome enymes in the second to the third hour (Khan et al 2009; Muhammad et al 2012). A cobbe extract inhibited both the first and second phases of inflammation. The ability of the extract to inhibit carrageenan induced paw oedema suggests it possesses a significant effect against acute inflammation. The extract (250 mg/kg) also caused marked inhibition of carrageenan-induced hind paw oedema...

domain: biology


text:
To prevent an impending energy crisis this summer, private power producers in Bangladesh have requested $1 billion in foreign currency from the nation’s central bank. They plan to use the funds to import heavy fuel oil, as reported by Bloomberg.
The companies are looking for the banks to furnish them with dollars so they may issue letters of credit to buy gasoline from abroad, according to a letter the industry lobbying group, Bangladesh Independent Power Producers’ Association, sent to the central bank on Monday. From March through June, the private generators would require around $250 million a month to pay for the cargo.
The need comes as summer has arrived early in some areas of the region, requiring authorities and business organisations to take action to prevent blackouts when temperatures rise. The South Asian country’s second-largest source of energy after natural gas, heavy fuel oil, often known as bunker fuel, supplies a quarter of its electricity.
High fuel prices
Bangladesh’s economic difficulties have been exacerbated by high fuel prices and a reliance on imports, which jeopardises the country’s energy security. In order to irrigate the rice fields during the dry season and assist assure the country’s major staple grain supply, adequate electricity supplies would be essential.
According to the organisation, throughout the course of the four summer months, private electricity producers—who generate up to 45% of the country’s electricity—will need to import around 2.12 million tonnes of the fuel.
While goods would take 40–45 days to arrive, there is a pressing need to place shipment orders, according to Faisal Khan, head of the 46-member association.
Examining power producers
Besides irrigation, high temperatures are also likely to stimulate demand for power as citizens and companies increase the usage of cooling appliances.
“Bangladesh Bank is putting money into the market almost every day as needed.” The central bank will examine the power producers’ letter and determine whether their request is in accordance with the government’s current priorities, according to Mezbaul Haque, a spokesman for the central bank, in a phone interview.
Did you subscribe to our newsletter?
It’s free! Click here to subscribe!


text:
Hi, welcome to my portfolio!
My name is Natalie. I’m a writer and communicator with a passion for community-driven storytelling. I am hard-working, fast-learner dedicated to trying to improve the lives of others through words. In my free time I enjoy hiking, running and foraging for native plants and mushrooms.


text:
(Louisville, KY) – The National Stem Cell Foundation and the National Multiple Sclerosis Society announced today they will partner on two research projects focused on myelin repair and regeneration. Myelin is the insulation around nerve fibers attacked by the immune system in MS, resulting in the inability of nerve cells to talk to each other and leading to progressive loss of function. Other demyelinating diseases that will benefit from this research include a number of rare genetic disorders that affect children and young adults.
The $1 million dollars in joint funding will be split between research projects at Stanford University in Stanford, California and the Uniformed Services University of the Health Sciences in Bethesda, Maryland.
Dr. Paula Grisanti, Chair of the National Stem Cell Foundation said, “The National Stem Cell Foundation is delighted to partner with the National Multiple Sclerosis Society in funding such promising research. It is our goal to fund collaborations that will accelerate the development and availability of stem cell therapies with the greatest potential for immediate impact. These research projects have the potential to restore function and improve the lives of patients and families in need worldwide.”
The research team at Stanford University, led by Marius Wernig, Ph.D., is devising ways to program skin cells to produce myelin-producing cells that can repair or replace damaged myelin. If the research is successful, the patient’s own skin cells could be used for transplantation, eliminating the risk of rejection.
The research at the Uniformed Services University of Health Sciences in Bethesda, led by Regina Armstrong, Ph.D., is finding ways to induce myelin repair by increasing the number of cells in the brain that make myelin. Dr. Armstrong is working with a molecule called “Sonic Hedgehog,” known to multiply cell division and increase the number of myelin-producing cells.
“Both these projects have the potential to make promising headway in the quest to restore function in people with MS and other demyelinating disorders,” said Dr. Bruce Bebo, Executive Vice President of Research at the National MS Society. “This innovative partnership with the National Stem Cell Foundation will bring more resources to speed this priority area of research so that people with MS and other demyelinating disorders can live their best lives.”
About the National Stem Cell Foundation
The National Stem Cell Foundation is a non-profit organization supporting adult stem cell research and clinical trials with the potential to treat or cure conditions and diseases affecting people worldwide. NSCF supports collaboration and information sharing wherever possible and seeks to engage researchers, clinicians and industry in the effort to move promising research into therapies for people in need. For more information, visit www.nationalstemcellfoundation.org.
About The National Multiple Sclerosis Society
The National MS Society addresses the challenges of each person affected by MS by funding cutting-edge research, driving change through advocacy, facilitating professional education, collaborating with MS organizations around the world, and providing programs and services designed to help people with MS and their families move their lives forward. The National MS Society is committed to achieving a world free of MS. For more information, visit www.nationalMSsociety.org.

domain: medical


text:
Market Square Park
Get your bearings with a bird’s-eye view (or at least 1002ft of it) by climbing the elevator of the JPMorgan Chase Tower to the Sky...
In an 1860 building, this intimate downtown place claims title to the 'oldest bar in Houston.' Expect well-priced wines by the glass and...
Locals flock here at lunchtime to chow down on great Cajun gumbos and jambalaya, but don't discount the appeal of daily changing...
Market Square Park information
You’ll notice how the 19th-century buildings on Market Sq, the historical center of Downtown, sharply contrast with their modern surroundings. A few restaurants line the square and there's a cafe in the park. In summer the small green space plays host to concerts and outdoor movies.

domain: geography


text:
reporting mark: N/A
railroad class: N/A
There are currently 3 Michigan Transit Museum radio scanner frequencies from Michigan in our database.
Mount Clemens station is a historic railroad depot located at 198 Grand Street in Mt. Clemens, Michigan. Young Thomas Edison learned telegraphy at this station. The building was listed on the National Register of Historic Places in 1981 as the Grand Trunk Western Railroad, Mount Clemens Station and designated a Michigan State Historic Site in 1973.


Replacement Bumper Pad Clips
These metal clips are for our aftermarket replacement bumper pads (see related products below). If you are looking for the plastic clips to fit an original (OEM) pad strip, see the related items list below.
Available in a pack of 8 (front bumper) or pack of 10 (rear).
Check out our article: Vanagon Bumper Pad Clips Explained


text:
Chiropractic & Manual Therapies 2018 (Dec 18); 26: 50 ~ FULL TEXT
Michelle M. Holmes, Felicity L. Bishop, David Newell, Jonathan Field, and George Lewith
Department of Psychology,
University of Southampton,
Southampton, SO17 1BJ UK.
BACKGROUND: Patient-reported outcome measures (PROMs) are widely available for use in musculoskeletal care. However, there is little research exploring the implementation of PROMs in clinical practice. This qualitative study explored chiropractors' views on PROMs to identify any barriers and facilitators to implementing PROMs in chiropractic care and the training needs of chiropractors regarding the use of PROMs.
METHODS: A qualitative study of chiropractors' views on PROMs was undertaken as part of a larger project to address the feasibility of conducting a randomised controlled trial of PROM use in chiropractic clinics for patients with low back pain. Contact was made with chiropractors working in chiropractic companies with multiple clinic sites. Semi-structured interviews were conducted with eight chiropractors, either face-to-face at their place of work or over the telephone. The interviews were transcribed verbatim and analysed using thematic analysis. The data were coded inductively by two authors.
RESULTS: Chiropractors discussed their knowledge and engagement with PROMs in clinical practice, identifying reasons for their use, such as understanding clinic performance, clinical practice, and research. They also discussed how they used PROMs within their clinical practice and the benefits of using them with individual patients, for example during the consultation, identifying yellow flags, and tracking patient progress. Chiropractors voiced concerns about patient engagement with PROMs, questioning if patients find them burdensome, and the appropriate PROMs to use with patients with pain. Finally, chiropractors acknowledged the organisational barriers and facilitators to using PROMs within their practice, such as busy practices, electronic systems, and use of reception staff.
CONCLUSIONS: Using participating chiropractors' views of PROMs, the study identified barriers and facilitators to implementing PROMs in chiropractic care, such as clinician knowledge, engagement, and organisational concerns and identified the potential training needs of chiropractors regarding PROMs. The results from the study suggested chiropractors use PROMs with their individual patients, but PROMs should be meaningful to patients and chiropractors to improve engagement.
KEYWORDS: Clinical practice; Implementation; Musculoskeletal care; Patient-reported outcome measures; Qualitative research
From the FULL TEXT Article:
Patient-reported outcome measures (PROMs) are instruments and questionnaires which can be used to collect patients’ perceptions and views on their own health. [1-4] Data are provided exclusively by the patients, typically through paper questionnaires, electronic devices, or interviews, and amount to a numerical score. [5-7] PROMs were developed for their use in randomised-controlled trials to provide a comprehensive assessment of patient experience of illness and treatment. [8-10] The use of PROMs has since been incorporated into clinical practice to evaluate health care, increase knowledge of patients’ disease trajectories, and evaluate the effectiveness of treatments.  Their use is increasingly recommended in day to day clinical practice.
Since their development, research has been conducted to identify the impact of PROMs when used in clinical practice. Literature indicates that PROMs may impact clinically and psychologically on patients when used in clinical practice. One review of PROM research suggested that using PROMs may influence detection of psychological problems and facilitate communication between healthcare professionals and patients.  Three reviews, examining evidence from RCTs or controlled trials, identified that PROMs may improve the process and outcome of care. [1, 13, 14] This included improvements in health status and functional status as well as increased diagnosis and use of health services, with improvements in patient-clinician communication and patient satisfaction.
Although PROMs are increasingly being used to collect patient outcomes, with a NHS report in 2008 highlighting the importance of using PROMs to measure patients’ perspective on their care , there is currently little research on the implementation of PROMs in clinical practice. For PROMs to be correctly and appropriately utilised in clinical practice it is essential to understand the implementation.
Despite the availability of musculoskeletal PROMs, there has been very little published research in the context of musculoskeletal care and PROMs, with just three studies exploring how PROMs can be used in clinical practice. [15-17] Much of the literature examining the barriers and facilitators to successful PROM implementation has focused on oncology, palliative care, or mental health settings. One systematic review examined issues of implementation with allied health professionals.  These authors identified four potential factors affecting implementation:
clinician knowledge and perceived value of PROMs,
practical barriers, and
clinician concerns and consideration of patient benefit.
A recent feasibility study identified that implementing a web-based PROM for a UK cohort of chiropractic practitioners was achievable and could generate information useful for patients, clinicians, and policy makers.
Chiropractors are increasingly encouraged to use PROMs within their practice , however it is currently unknown how many chiropractors do so. A survey of 62 chiropractors found that although visual analogue scales and numeric rating scales are commonly used, chiropractors only occasionally use condition-specific PROMs (such as the Oswestry Questionnaire) and generalised PROMs (such as the SF-36).  Bussičres et al.  suggest that effort should be placed on addressing this knowledge-to-practice gap and improve implementation of PROMs in clinical practice.
It is necessary to further explore the barriers and facilitators of using PROMs within the specific context of chiropractic care to ensure successful implementation. It is important to understand patients’ and clinicians’ views on using PROMs and the values of implementation. Greenhalgh et al.,  identified that further research is required to examine how PROMs are supported in different healthcare professions, the needs of healthcare professionals aiding their use of PROMs in clinical practice, and the place of training on utilising PROMs data. This article describes a qualitative study of chiropractors’ views on PROMs, undertaken as part of a larger project to address the feasibility of conducting a randomised controlled trial of PROM use in chiropractic clinics for patients with low back pain. The findings from this study will inform a future randomised controlled trial. The aim of this qualitative study was to identify any barriers and facilitators to implementing PROMs in chiropractic care and the training needs of chiropractors regarding the use of PROMs.
A qualitative study was conducted interviewing chiropractors to explore their views on using PROMs in clinical practice. Participants were recruited within the South of England using convenience sampling. The South of England is home to over 1.7 million people, with over 1 million people of working age. Over 3 months, three different chiropractic services with multiple clinics (1–5) were approached. These were identified by the study team through conversation via professional networks and groups, but not by MMH, as clinics currently using PROMs. The practices are located in residential areas of large towns (population of 20,000-100,000) and smaller market towns (population of 1000-20,000). Recruitment took place simultaneously with transcription and analysis. Over the 3 month recruitment period, all chiropractors working within these practices were invited for interview (n = 40). Chiropractors received an email invitation to the study, explaining the purpose of the study and the procedures involved in participating. Recruitment continued until data saturation was reached (no new themes were generated from the data), this was assessed by two authors. This study received ethical approval and research governance approval from the University of Southampton (ID: 20715). All participants provided informed consent to participate in the interviews. Additionally, the data collected fit with the Data Protection Act of 1988 and the Data Policy of the University of Southampton. [23, 24]
Data collection and analysis
This research adopted a pragmatist philosophy and approach, using a qualitative methodology to allow for exploration into stakeholders subjective evaluations of using PROMs in clinical practice. [25, 26] Semi-structured interviews were conducted with participants following an interview guide (see Table 1). Interviews allow for participants to express themselves, giving individuals a chance to tell the story of their experiences. [27, 28] Interviews were conducted in private, either face-to-face at their place of work or over the telephone. The telephone interviews did not differ in content or length to those undertaken face-to-face. The interviews were undertaken by the lead author, who has previous experience in qualitative projects, as part of her PhD project. MMH is not a chiropractor but has clinical experience (previously worked for 5 years as a massage therapist), with no previous relationship to the participants. The research topic and how the study had arisen was explained to participants, and that the researcher was independent of their clinic and employers. Interviews were audio recorded and field notes were made during and immediately after the interview.
The interviews were transcribed verbatim and input into the computer-assisted qualitative software NVivo (version 10) for analysis . The data were analysed using thematic analysis following the steps set out in Braun and Clarke :
1) the data were coded inductively,
2) codes were examined for patterns and refined,
3) relationships and refined patterns between codes were identified and themes were developed, and
4) themes were described with representative data to support the theme.
This allowed for a thorough exploration and detailed description of chiropractors’ experiences and views of using PROMs. [30, 31] The initial coding was conducted by one author [MMH], with refinement and grouping into higher-level categories by discussion of coding between two authors [MMH and FLB]. Quotes have been selected to best describe the findings, with pseudonyms given to participants. The study has been written up according to the consolidated criteria for reporting qualitative studies.
Eight chiropractors participated in an interview (4 males, 4 female). Chiropractors were based at four different clinics (chiropractors per clinic: 1,2,2,3), however many worked in more than one clinic within one chiropractic service or had their own separate private practice. For the interviews, 7 were completed face-to-face and 1 via telephone. The interviews had an average time of 31 min.
The interviews aimed to explore chiropractors’ views on the use of PROMs in clinical practice. This aimed to identify any barriers and facilitators to implementing PROMs in chiropractic care and the training needs of chiropractors regarding the use of PROMs. The analysis identified five themes. The following sections describe each theme with example quotes from participants.
Clinician knowledge and engagement with PROMs
Chiropractors discussed clinician knowledge and engagement with PROMs. All chiropractors had used PROMs at some point during their practice. Half of the chiropractors used PROMs routinely within their practice, with four rarely using PROMs. Use of PROMs was varied amongst the chiropractors, some used electronic systems where PROMs were completed by patients before their clinical appointment, with others using a paper system filled in by patients at each visit. PROMs specifically mentioned included the Bournemouth Questionnaire , Patient Specific Functional Scale , Roland-Morris Questionnaire  and the Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire.  Choice of PROMs and process was also influenced by their clinic, for example the PROMs procedures within the chiropractic company they were employed at differed from their practices as an individual practitioner.
Most of the chiropractors were positive about using PROMs. They stated many reasons and benefits for using PROMs in their practice. Many chiropractors spoke about using the data for audits and for feedback: to understand personal and clinic performance, to compare practitioners and practices, and to improve practice. The data were thought to be useful to understand overall progress and satisfaction for groups of patients. “obviously it helps you to see how your doing, as well, overall, across lots of different patients. And.. yeah sort of how your clinic is performing so it’s just making sure the patients are happy with other aspects of their care.”
Chiropractors also thought the data were necessary to collect for research purposes, to legitimise their practice and was important for the profession. However, one chiropractor cautioned that valid reasons to collect data are required:
“what you don’t want to be doing is just gathering loads of data.. so you can say how wonderful you are.
There is an element of that.. so as a profession we can say how wonderful we are. And we are doing for
it ourselves, we aren’t really doing it for the patients in that case”
Chiropractors were concerned over patient engagement, some believed that the data were only meaningful if all patients completed the questionnaires, and that they would need to significantly improve completion rates to be able to benefit from collecting data. Some chiropractors stated that many patients wouldnot report feeling dissatisfied and as a result were concerned that the data they received were positively-skewed. One chiropractor thought that those who are satisfied are more likely to complete PROMs and report a positive result. Chiropractors suggested that patients might not want to offend their chiropractor, or disappoint them, and therefore report improvement.
“My gut feeling is that people that don’t complete are the people that aren’t happy with what you’ve done.
So it’s immediately biased.”
There were mixed responses to using PROMs within every day clinical practice. Some chiropractors thought it was beneficial to them, progressing as a chiropractor and improving their practice. Some chiropractors used PROMs as a tool, in combination with discussion and physical examination, to make a clinical decision: “I have looked at data and then changed my practice, possibly because I was thinking that.. ‘that patient is not getting any better, what is happening?’ err.. looked at the data to see if that could help me at all, tried a completely different approach with the patient”
Others did not use it within their practice, preferring to ask their patients personalised questions within the clinic to build rapport with patients: “I’m too old to be that interested in learning new things from questionnaires, I’ve had a lot of experience in practice, and if I want to learn something it won’t be by using questionnaires.”
Some chiropractors lacked clarity on the details of their clinic’s procedure relating to PROMs, especially when done via an electronic system. For example, there was uncertainty on the timing of follow-up PROMs: “I think they get it at three months, or do they get it at four weeks. I think they get it at four weeks” – Cameron. Others did not know whether the PROMs they used had been validated or empirically tested and therefore appropriate for use in practice. Others were unclear over what populations the outcomes were validated. PROMs are inherently subjective, there-in lies their value, however many chiropractors perceived this subjectivity as a weakness, voicing concerns that PROMs are open to interpretation and questioning the value of the data in clinical practice.
“It’s even more subjective and open to interpretation. I mean the BQ [Bournemouth Questionnaire] and getting
them to grade things on 1 - 10 is fairly subjective anyway. When you say “how do you feel, are you very much
improved or just much improved?” You know you can go to a smiley face system can’t you.”
Participants believed that, in general, chiropractors might not have any previous knowledge on PROMs. In the interviews, chiropractors were asked about training on PROMs. Training on PROMs delivered via the internet, with e-resources and a physical guide was seen as acceptable by chiropractors: “I do think that many practices can benefit”
They suggested highlighting the benefits of using PROMs and the simplicity of the process. “So assuming everybody knows absolutely nothing about them and saying ‘this is what they are, this is why they are useful, this is how it can help you’ erm.. is probably the way to go.”
Use of PROMs for individual patients
Chiropractors discussed their use of PROMs throughout the treatment process with patients. PROMs were used from the first consultation to look at the patients’ story. They identified that sometimes the information they received from PROMs differed from patients reporting during the initial visit. One chiropractor stated PROMs enabled chiropractors to see things from the patient’s perspective.
“I do think.. the longer you’re out in practice, either the more you pick up on things and use it, or the more
settled to your routines you become and maybe forget the importance about the psychological aspect of the care,
because you get so.. so sort of swaddled in your own routine, that you forget about renewing yourself. I think
this sort of feedback is useful for renewing us, if we choose to use it actively.”
Chiropractors also talked about being able to identify ‘yellow flags’ by using PROMs. This triggered chiropractors to reassure the patient, educate them about recovery, and discuss self-management. One chiropractor stated that PROMs affected the management plans of his patients: “For me it’s about identifying those that are at risk of not.. not responding as you would expect them to and then being able to intervene a lot earlier”
Chiropractors also used PROMs at follow up to track patients and identify any improvements. They were also used to identify patients who were not progressing. One chiropractor discussed how they used the PROMs to follow up a patient: “I think they’d put that it hadn’t improved. So I phoned and err.. yeah we had a discussion about it, and they just started coming back”
Chiropractors also mentioned discussing PROMs with patients and visually showing them their progress.
“I did do a guy this morning, literally like that.. cos he was chronic and erm.. he’d had pain for three years,
and I started seeing him about six months ago, and he came in for a sort of final check-up, cos I think there’s
an argument for doing check-ups on people with chronic problems, and he hadn’t been for three months, and he’s
pretty good, he’s almost fine really. And I pinged up his little graph and said ‘look, there you are’ and he went
‘oh, yeah, that’s loads better isn’t it’ so for him, it was really neat.”
This visual depiction, and showing patients their improvement after a change in behaviour, was seen as positive reinforcement “cos they can physically.. go.. ‘oh last time I remember the last time I filled that in I was 8 and now it’s only a 4’”
Chiropractors also believed that PROMs improved patient adherence for treatment and self-care exercises “for patient compliance.. if a patient is.. that is the advantage if the patient sees or remembers what they’ve done, then they themselves can see improvement”
Chiropractors also thought that PROMs may improve the patient-clinician relationship.
“So for the majority of patients I feel like it makes them, feel like we are really interested, like we want to
know everything. Especially if they can fill it out at home, and then when they come in for the initial like
consultation, I’ve already looked at it, and have some insight into their pain. I think it’s really good, and I
think they feel.. kind of reassured by it.”
Chiropractors also identified using PROMs to change treatment for their patients: “I know I’ve ended care for patients because it hasn’t seemed to be helping, but I’ve continued care but in a different way. Erm.. because maybe it was maybe more appropriate to.. to refer to someone else”
Despite chiropractors identifying how they might discuss PROMs, many chiropractors reported not discussing PROMs with their patients. This was often in cases where patients were improving. Practitioners would also not talk to patients about anxiety and depression unless they scored highly. Several chiropractors thought discussing PROMs may only be beneficial for certain patients, such as with chronic patients. “I suppose it gives me a handle on the psychosocial stuff and the barriers, and the chronic ones. And therefore I might tweak them more psychosocially, or more in terms of exercise and something different, from just treating.”
One chiropractor also said discussion was down to their personal rapport with the patient:“So for example, if I’ve got a builder in, who’s talking about football, or rugby, I’m not going to ask him.. I’m not going to start talk about emotions and stuff like that”
Patient engagement with PROMs
Chiropractors voiced views on patient engagement with PROMs. Charlotte felt that for patients: “This is just a pain, literally”; she along with other chiropractors expressed that PROMs were bothersome for patients, stating that patients do not enjoy completing a large volume of paperwork. Some chiropractors reported comments from patients, asking them to stop sending the questionnaires, although one chiropractor did state this was a small minority of patients. Chiropractors also had concerns that it might put off patients coming back to the practice, due to the paperwork involved “I mean the more questionnaires you give people, the more annoyed they are going to be with questionnaires”
Participants did acknowledge some barriers to patients completing PROMs, such as: email and computer access, IT skills, literacy, age, and time. Chiropractors stated that some patients might be too busy to fill them in. Some chiropractors believed that you cannot change patient engagement with PROMs “there’s a small minority that kind of just can’t be bothered to do it, and are just not interested”
However, many participants had ideas to improve patient engagement. Chiropractors explained that most patients come in for treatment and are not necessarily expecting to fill out a form, and they do not understand why they are filling in the questions. One method recommended to improve engagement, was to explain to patients that completing the questionnaires is a component of their care and explain its inherent value. For example: “this a positive thing as part of your management plan, which gives us information about how you are improving”
Chiropractors also suggested reception staff may have to explain this to patients, as they often explain and provide the questionnaires to patients in advance of their appointment with the chiropractor.
“I think it totally hinges on how you explain it to the patient and the way that they.. that initial conversation
and how it’s explained initially will probably determine whether that patient stays with that or not. The better it’s
explained and the more they understand it, the better their compliance will be later down the line.”
Types of PROM constructs
Chiropractors discussed some of the PROMs currently used in clinical practice for low back pain. Chiropractors also expressed wanting to focus more on a functional scale rather than a pain or quality-of-life scale. Although chiropractors acknowledged the need to know how much pain patients are in, several expressed concerns about getting patients to routinely quantify their pain. One chiropractor expressed that this might remind patients of their pain. “I always think ‘we keep going back to the pain’ and really we don’t want them to focus on the pain.”
Several chiropractors commented that these pain scores might have a negative effect for the patient.
“By always focusing on how much things hurt, and how difficult it is to do things, and how bad it’s been,
for that kind of patient.. you’re perhaps, kind of, maintaining them in that, sort of, slightly negative spiral.”
Chiropractors often chose to focus on functional outcomes, changing the focus to a patient’s abilities rather than their pain.
“I work both here and in a private practice, tried different things in both places, and really ended up with..
the same thing overall.. going with measures of what they feel they can achieve and do. In my opinion I feel
that’s what matters in the end.”
Some chiropractors also had concerns about questionnaires that used the word ‘depressed’. Noting that although this was pertinent for some patients, this may not always be appropriate.
“It says something about.. yeah.. ‘how depressed have you been feeling?’ and she was like ‘I didn’t think
I was supposed to be depressed with back pain’. And it hadn’t even crossed her mind”
Organisational barriers and facilitators
Chiropractors discussed the organisational barriers and facilitators to implementing PROMs within routine clinical practice. Chiropractors also voiced concerns about practicalities and human error. Chiropractors often spoke about forgetting to look at the data and that PROMs did not come to mind easily. It was an active task to remember to look at PROMs during follow-up treatments. They also discussed their busy practices and that time was an important factor.
Chiropractors expressed that in practice they are trying to be efficient, on time, so they do not keep the patients waiting, and this can restrict their use of PROMs within treatment sessions.
“I do think time pressure, is a big limitation, forgetting and then sometimes you think.. ‘oh I forgot on that one
patient, or no I’m just going to leave that one patient out, I need to get on to the next one’ - that’s the challenge.”
One debate was the best medium to use for PROM collection, to use paper or via an electronic system. One chiropractor highlighted that results were easier to view and use when on the computer. The computer system they used generated patients’ results into a graph, which would be time consuming to do if PROMS were paper-based. However, some chiropractors had difficulties with using the electronic system “You can sit there for ages trying to figure out”
One chiropractor had issues with the electronic system not functioning correctly. However, using a paper version often required more administrative time for both the reception staff and the chiropractor. One key message was that all data should be on the same medium. One practice used paper clinic notes and an electronic system for PROMs, which was deemed to be inconvenient. Chiropractors within this clinic spoke about the difficulties switching between the two systems when the clinic is busy, and PROMs often got forgotten.
One key facilitator in the collection of PROMs was reception staff. All chiropractors spoke very highly of their reception teams. Some chiropractors noted it was a joint effort, with reception staff explaining the importance of PROMs to patients and chasing patients for follow-ups. One chiropractor, who did not have the support of a reception team, noted that this would improve data collection. However, other chiropractors saw PROMs as mainly an administrative task that they did not get involved with: “I just leave it to the receptionist to do all that”
This study aimed to explore chiropractors’ views on the use of PROMs in clinical practice. In order to address the knowledge-to-practice gap of using PROMs, it is essential to understand the implementation process.  Five themes relating to the chiropractors’ use of PROMs were developed during the analysis. The findings of the qualitative interviews and existing literature should be considered for chiropractic practices contemplating implementing PROMs into their clinical practice. Antunes et al.  previously conducted a review of barriers and facilitators of implementing PROMs in the palliative care setting. The review suggested a series of steps that need to be taken prior to implementing PROMs in clinical practice, this included: selection of outcome measure, decision of application of measure, and clinician education. The findings of this study have identified a series of barriers and facilitators to implementing PROMs in chiropractic care and the training needs of chiropractors regarding the use of PROMs.
Chiropractor preference and selection of PROMs
Within the interviews, chiropractors stated a preference for functional scales, which focus on a patient’s functioning rather than pain levels, with chiropractors finding them meaningful for their clinical practice. These preferences will need to be addressed, both in selection and practitioner education on appropriate measures, for PROMs to be successful in clinical practice. One systematic review has similarly identified that PROMs must be appropriate for successful implementation and use in clinical practice , suggesting PROMs must be clinically meaningful for chiropractors to engage with them. Clinicians in mental health settings also suggested that PROMs must be of clinical value in order for clinician engagement.
Application of PROMs
Although two chiropractors suggested issues with an electronic PROM system this was preferred over a paper-based system. In a study to assess the feasibility and acceptability of PROMs with patients with rheumatoid arthritis, patients’ perceived a web-based PROM as easy, and reported willingness to fill in the questionnaires at home.  During the feasibility study interviews, IT skills, literacy, age, and time were suggested as barriers to completion. However, as these are chiropractors’ perceptions on barriers, further research is needed to explore patients’ views on completion of PROMs.
A commentary by Chang  also identified that unsuitable or poorly designed electronic PROM software is a barrier to successful implementation. Some chiropractors felt that PROMs were an administrative task and so it is necessary to ensure both a conducive environment and improve knowledge of the use of PROMs to improve engagement. This could be addressed by ensuring computerised PROMs are designed to be easily used in busy practice settings and providing training on PROMs to clinicians.
Interviews also explored how to improve patient engagement. Two reviews previously identified that co-operative colleagues and staff encouragement facilitated patient engagement and the use of PROMs in clinical practice [18, 37]. Chiropractors suggested that reception staff could explain to patients that PROMs are a valuable part of their care. This may increase fidelity to PROMs in clinical practice.
Clinician education and implementation
The qualitative interviews identified that chiropractors often had a lack of knowledge and engagement with PROMs, despite using them in clinical practice. It is also acknowledged in the findings that chiropractors’ attitudes and beliefs around the consultation process may influence their use of PROMs, with some chiropractors explicitly rejecting the use of PROMs, despite clinical procedures. Antunes et al.  and Duncan and Murray  also identified clinicians’ lack of knowledge and education was a significant barrier to PROM use. Literature suggests that educating clinicians on the purposes of PROMs and the benefits of using them may be beneficial. [18, 37, 38]
An additional barrier may be chiropractors’ confidence in managing the issues identified by using PROMs. A systematic review found that whilst physiotherapists feel confident with the mechanical treatment of low back pain, many feel unprepared to treat the cognitive, social, and psychological factors that contribute to recovery.  Therefore, training should include both how to identify these factors using PROMs and how to manage these factors within their clinical domain.
Chiropractors indicated that training would be acceptable and would improve knowledge and engagement with PROMs in clinical practice. It is important that training should also include the use of PROMs for clinical audit, feedback, and research purposes. Understanding the multitude of ways PROMs can be used within clinical practice may improve uptake and engagement.
Generally, the results suggest that clinician training, selection of PROMs, and organisational barriers should be considered when implementing PROMs in clinical practice. However, the sampling of participants may limit the transferability of the results. Socioeconomical region of the clinics and details on the experience and training of the sample were not collected. It is therefore not possible to compare the chiropractors to the wider profession. The findings also only represent the views of chiropractors who have volunteered to take part in research and therefore may not be representative of the population. These findings also do not include the patient perspective of PROMs. While the sampling may limit the transferability, this study provides an insight into PROMs use in chiropractic practice.
Recommendations for research
Further research in this area should consider the views of patients completing PROMs in chiropractic practice. Patients’ views will provide necessary insight into the process and benefits of implementing PROMs into clinical practice. Additionally, as interviewees spoke about how they use PROMs with individual patients, research should also explore how PROMs may potentially affect the process and outcomes of patient care when used clinical practice. A recent review of PROMs examining their use with individual patients found PROMs could influence the clinician-patient relationship, consultation discussions, and decision-making around treatment.  Not all patient populations benefit from PROMs completion, with a review of PROMs in psychological care for those with common mental disorders, finding no difference in treatment outcome and limited evidence in improving patient satisfaction.  Further research is required to understand which healthcare services PROMs should be incorporated into and how this may impact patients. The findings from this study will inform a future randomised controlled trial to explore the clinical and psychosocial effects of PROM use in chiropractic care.
Chiropractors are increasingly using PROMs in their clinical practice. The aim of this qualitative study was to examine the views of chiropractors on using PROMs. Exploring chiropractors’ experience of using PROMs, this study identified how clinician knowledge and engagement and organisational barriers and facilitators affect implementing PROMs in chiropractic care, such as choosing the appropriate PROMs and systems to use in their practice. Chiropractors also identified possible training needs of chiropractors regarding PROMs, with training including the process and benefits of using PROMs in clinical practice. The results from the study also demonstrated the necessity of ensuring PROMs are meaningful to patients and chiropractors. It is clear there are differing views and engagement with PROMs within clinical practice; in addition, future research must consider patients’ views on completing PROMs and how it affects the process of clinical practice and outcomes.
The authors would like to thank all the participants in the study who were interviewed.
The study forms part of MMH’s PhD project funded by the University of Southampton, AECC University College, the Royal College of Chiropractors and Southampton Complementary Medicine Research Trust.
PROMs = patient-reported outcome measures
All authors contributed to the planning and design of the study. MMH conducted and transcribed the interviews. MMH developed an initial coding manual, with two authors contributing to the final analysis. All authors were major contributors in the write up of the study. MH, DN, JF read and approved the final manuscript.
Valderas JM, Kotzeva A, Espallargues M, Guyatt G, Ferrans CE, Halyard MY, et al.
The impact of measuring patient-reported outcomes in clinical practice: a systematic review of the literature.
Qual Life Res. 2008;17(2):179–193.
Dawson J, Doll H, Fitzpatrick R, Jenkinson C, Carr AJ.
The routine use of patient reported outcome measures in healthcare settings.
Measuring patient-reported outcomes: moving beyond misplaced common sense to hard science.
BMC Med. 2011;9:86.
Fitzpatrick RM, Davey C, Buxton MJ, Jones DR.
Evaluating patient-based outcome measures for use in clinical trials.
Health Technol Assess. 1998;2(14)
Department of Health .
Guidance on the routine collection of Patient Reported Outcome Measures (PROMs).
Devlin N, Appleby J.
Getting the most out of PROMs: putting health outcomes at the heart of
NHS decision-making. London. 2010.
Appleby J, Devlin NJ.
Measuring NHS Success: can patients’ views on health outcomes help to manage performance?
London: King’s Fund; 2005.
Greenfield S, Nelson EC.
Recent developments and future issues in the use of health status assessment measures
in clinical settings.
Med Care. 1992;30(5 Suppl):Ms23–Ms41
The assessment of disability: from first to future principles.
Br J Rheumatol. 1983;22(3 Suppl):48–58.
Toward an understanding of patient outcome measurement.
Arthritis Rheum. 1983;26(6):697–704.
Greenhalgh J, Dalkin S, Gooding K, Gibbons E, Wright J, Meads D, et al.
Functionality and feedback: a realist synthesis of the collation, interpretation and utilisation of
patient-reported outcome measures data to improve patient care.
Health Serv Deliv Res. 2017;5(2):1.
Greenhalgh J, Meadows K.
The effectiveness of the use of patient-based measures of health in routine practice in improving the
process and outcomes of patient care: a literature review.
J Eval Clin Pract. 1999;5(4):401–416.
Espallargues M, Valderas JM, Alonso J.
Provision of feedback on perceived health status to health care professionals:
a systematic review of its impact.
Med Care. 2000;38(2):175–186.
Marshall S, Haywood K, Fitzpatrick R.
Impact of patient-reported outcome measures on routine practice: a structured review.
J Eval Clin Pract. 2006;12(5):559–568.
Stratford PW, Binkley JM.
Applying the results of self-report measures to individual patients:
an example using the Roland-Morris questionnaire.
J Orthop Sports Phys Ther. 1999;29(4):232–239.
Hvitfeldt H, Carli C, Nelson EC, Mortenson DM, Ruppert BA, Lindblad S.
Feed forward systems for patient participation and provider support: adoption results from the original
US context to Sweden and beyond.
Qual Manag Health Care. 2009;18(4):247–256.
Thigpen C, Shanley E.
Clinical assessment of upper extremity injury outcomes.
J Sport Rehabil. 2011;20(1):61–73.
Duncan EA, Murray J.
The barriers and facilitators to routine outcome measurement by allied health professionals
in practice: a systematic review.
BMC Health Serv Res. 2012;12(1):96.
Newell D, Diment E, Bolton JE.
An electronic patient-reported outcome measures system in UK chiropractic practices:
a feasibility study of routine collection of outcomes and costs.
J Manip Physiol Ther. 2016;39(1):31–41.
The role of patient questionnaires.
Chiropractic report. 2012.
Hinton PM, McLeod R, Broker B, MacLellan CE.
Outcome measures and their everyday use in chiropractic practice.
J Can Chiropr Assoc. 2010;54(2):118
Bussieres AE, Al Zoubi F, Stuber K, French SD, Boruff J, Corrigan J, et al.
Evidence-based Practice, Research Utilization, and Knowledge Translation
in Chiropractic: A Scoping Review
BMC Complement Altern Med. 2016 (Jul 13); 16 (1): 216
Data Protection Act of 1998. 1998.
University of Southampton .
University Ethics Policy. Southampton, Services RaI. 2013.
Denzin NK, Lincoln YS.
The SAGE handbook of qualitative research. 4. USA: SAGE; 2011.
Qualitative researching. London: Sage; 2002.
Research methods in health. 3. England: Open University Press; 2009.
Wilkinson S, Joffe H, Yardley L.
Qualitative data collection: interviews and focus groups.
In: Marks DF, Yardley L, editors. Research methods for clinical and health psychology.
London: Sage Publications Ltd; 2004. pp. 39–55.
NVivo qualitative data analysis software. 10th ed:
QSR International Pty Ltd; 2010 [Online].
Braun V, Clarke V.
Using thematic analysis in psychology.
Qual Res Psychol. 2006;3(2):77–101.
Vaismoradi M, Turunen H, Bondas T.
Content analysis and thematic analysis: implications for conducting a qualitative descriptive study.
Nurs Health Sci. 2013;15(3):398–405.
Tong A, Sainsbury P, Craig J.
Consolidated criteria for reporting qualitative research (COREQ):
a 32-item checklist for interviews and focus groups.
Int J Qual Health Care. 2007;19(6):349–357.
Bolton JE, Breen A.
The Bournemouth Questionnaire: A Short-form Comprehensive Outcome Measure.
I. Psychometric Properties in Back Pain Patients
J Manipulative Physiol Ther 1999 (Oct); 22 (8): 503-510
Patient specific functional scale.
Aust J Physiother. 2007;53(1):65–66.
Roland M, Morris R.
A study of the natural history of back pain: part
I: development of a reliable and sensitive measure of disability in low-back pain.
Gummesson C, Atroshi I, Ekdahl C.
The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire:
longitudinal construct validity and measuring self-rated health change after surgery.
BMC Musculoskelet Disord. 2003;4(1):11.
Antunes B, Harding R, Higginson IJ.
Implementing patient-reported outcome measures in palliative care clinical practice:
a systematic review of facilitators and barriers.
Palliat Med. 2014;28(2):158–175.
Introducing the routine use of outcomes measurement to mental health services.
Aust Health Rev. 2001;24(1):43–50.
Koevoets R, de Glas NA, Le Bourlout C, Huizinga TW, Allaart CF, Dougados M, et al.
Autonomous online health assessment questionnaire registry in daily clinical practice.
Patient-reported outcomes measurement and management with innovative methodologies and technologies.
Qual Life Res. 2007;16(SUPPL. 1):157–166.
Synnott A, O’Keeffe M, Bunzli S, Dankaerts W, O’Sullivan P, O'Sullivan K.
Physiotherapists may stigmatise or feel unprepared to treat people with low back pain and psychosocial
factors that influence recovery: a systematic review.
J Phys. 2015;61(2):68–76
Gilbody SM, House AO, Sheldon T.
Routine administration of health related quality of life (HRQoL) and needs assessment instruments to
improve psychological outcome--a systematic review.
Psychol Med. 2002;32(8):1345–1356.

domain: literature


text:
Here is the summary of the book:
Cassandra Clare’s Mortal Instruments series, epic urban fantasy set in a richly imagined world of shadowhunters, vampires, werewolves, fairies, and more, has captured the imaginations and loyalty of hundreds of thousands of YA readers. Originally a trilogy (City of Bones, City of Ashes, City of Glass), the series has extended to six titles, plus a prequel trilogy, the Infernal Devices, and a planned sequel series, the Dark Artifices. A feature film is planned for 2013. Shadowhunters and Downworlders, edited by Clare (who provides an introduction to the book and to each piece), is a collection of YA authors writing about the series and its world.
Case study...thats what this is....a stack of well researched and well worded case study essays into the realm of Cassandra Clare's Nephilim, From the likes of Holly Black, Kate Milford, Diana Peterfreund, Sara Ryan, Scott Tracey, Robin Wasserman, Kendare Blake, Gwenda Bond, Sarah Rees Brennan, Rachel Caine, Sarah Cross, Kami Garcia, Michelle Hodkin and Kelly Link, comes a true delicacy that gives a new meaning to every shadowhunter book Ms. Clare has written and published so far..... Although in question we are still taking about the Mortal Instruments series here.
There are the reasons why humor and sarcasm makes the best weapon for Jace. There is the reason why Malec is what it is. There is the reason for Clary to adopt art as her ultimate weapon. There is the reason why the best friend never gets the girl....and so many more. Each of these renowned authors bring their own taste to the table (the book), providing what they saw in all such situations as they read each of Ms. Clare's books.
"Shadowhunter fans? Don't miss out on this.....its the one for you"

domain: library


To see how food waste affects your wallet, our water supply, the demand for oil, and the environment, check out this awesome infographic: http://colorado.doortodoororganics.com/blog/?p=1833
Volunteers gleaning with the Society of Saint Andrew delivered 3300 pounds of broccoli today.
Would we like 32 dozen eggs from free-range chickens? Of course! But since the eggs were in far-away Palatka, instead of rescuing them, we suggested they be donated to one of our recipient groups located in Palatka. Bread of Life, a group that cooks lunch for 100 or so every day of the year, was delighted to get this wonderful, protein-rich food. Best of all, the farmer indicated that she would be donating eggs regularly.
the Time-Union published a wonderful article about Food Rescue and Waste Not Want Not! http://jacksonville.com/entertainment/food-and-dining/2012-01-19/story/nonprofit-volunteers-help-rescue-food-needy.


text:
MIAMI—Miami-based Trust Hospitality has revealied that the former Islamorada Resort will complete its top-to-bottom transformation in December and change its name to Amara Cay Resort. Included in the resort’s rebranding is a new website that is now accepting reservations for travel beginning on Jan. 1, 2015.
“We are thrilled to introduce the new Amara Cay Resort to the Islamorada community and to travelers from around the world,” said Kara Lundgren, GM of the Amara Cay Resort. “This property has been a Florida Keys staple since the 1970s, and we are eager to preserve those memories while also elevating our guest experience to the highest levels. The new look and feel of the resort will echo the authentic feel of the island lifestyle our guests treasure.”
Amara Cay Resort’s 110 guestrooms and suites feature designs incorporating natural elements such as wood, rattan and dark tile. Each guestroom has a newly extended balcony with views of the Atlantic Ocean and the surrounding Florida Keys. The new guestrooms incorporate environmentally responsible elements such as LED lighting, improved thermostats, upgraded sinks and showers, and impact-resistant glass.
Amara Cay Resort will also open Oltremare Ristorante, a Mediterranean-inspired Italian restaurant, which will feature a 60-seat open setting that will flow into the lobby.
“The future is bright for the Islamorada Resort Company,” said Patrick Goddard, president & COO of Trust Hospitality. “The rebranding and multimillion-dollar renovation of Amara Cay Resort is just the beginning. It’s a new and exciting era for Islamorada, and we are thrilled to be a part of changing the landscape for locals and travelers alike.”


text:
The Coburg Football Club has once again demonstrated its strong playing list retention with the re-signing of 27 players of it’s list of 42 from the 2022 VFL season.
Headlining the list of re-signings are Ryan Exon who commences the season on 106 VFL games and Jesse Corigliano who enters his 9th season as a Coburg player and on 80 VFL games.
Ryan Exon and Jesse Corigliano.
Luke Bunker, Harry Nolan and Mitch Podhajski all come back in 2023 with over 50 VFL games now under their belts and Charlie Thompson, Nathan Boucher, Luke Nelson and Braedyn Gillard are players that have between 29 and 50 VFL games worth of experience and are ready to take another big step forward in 2023.
Luke Bunker and Charlie Thompson
Mitch Podhajski and Harry Nolan
Players who joined the club in 2022 and have re-committed for 2023 are Jonothan Marsh, Sam McLarty, Flynn Gentile, Josh Watson, Edyn Sibbald, Lachlan Walker, Harry Andronaco, Tom Jepson, Trent Warren, Max Thompson and Alex Lukic.
Alex Lukic and Edyn Sibbald
Flynn Gentile and Max Thompson celebrate a goal vs Sydney
Also re-committed for 2023 are Josh D’Intinosante, Josh Kemp, Ryan Sturgess, Jhye Baddeley-Kelly, Ben Jepson, Aaron Clarke, Tom Mckenzie and Ben Reddick.
Jhye Baddeley-Kelly and Aaron Clarke
Upon the news of these re-signings, Coburg CEO Sebastian Spagnuolo said “Having at least 27 players from 2022 keen to re-sign for 2023, and hopefully more positive news to come soon, is testament to the environment being created by Andrew Sturgess and his support staff aswell as the work being done by the on field leadership group in 2022.
Over the coming weeks and months our attention will turn to improving the playing list for season 2023 but that process will be built upon a solid foundation of player retention which always makes recruiting easier and allows us to be more targeted.
We are grateful for the commitment of our playing group and we look forward to seeing them return for preseason in November hungrier and ready to go again on our quest for success.”
The club will soon make announcements of new players that are joining the football club in the leadup to the 2023 season and the best place for all news is our Facebook and Twitter accounts so please ensure that you have liked and followed the club’s accounts.
You can also head to www.coburgfc.com.au for more club information.


text:
- Binuclear cobalt phthalocyanine supported on manganese octahedral molecular sieve: High-efficiency catalyzer of peroxymonosulfate decomposition for degrading propranolol. [Journal Article]
- STSci Total Environ 2019 May 31; 686:97-106
- Propranolol (PRO) is widely detected in the aquatic environment and proved to be detrimental to multifarious aquatic organisms. In view of some virtues of sulfate radicals than hydroxyl radicals, adv…
Propranolol (PRO) is widely detected in the aquatic environment and proved to be detrimental to multifarious aquatic organisms. In view of some virtues of sulfate radicals than hydroxyl radicals, advanced oxidation technologies that involve the activation of peroxymonosulfate (PMS) have stimulated wide-ranging research on the PRO removal. In this paper, a composite (C2NOMS-2) of amino-functionalized manganese octahedral molecular sieve (NOMS-2) and binuclear cobalt phthalocyanine (Co2CPc) was synthesized easily, and utilized as a catalyzer for PMS to degrade PRO in water. The apparent rate constants of PRO degradation by PMS with C2NOMS-2 as a catalyst was found to be higher than with NOMS-2, Co2CPc and the composite of uninuclear cobalt phthalocyanine (CoCPc) and NOMS-2. The catalytic ability of C2NOMS-2 was investigated under various reaction conditions: catalyst dosages (0.5-2.0 g/L), PMS doses (50-500 mg/L), initial pH (5-11), reaction temperature (20-35 °C), and natural water constituents (Cl-, HCO3-, and sodium huminate). Radical scavenging tests and electron paramagnetic resonance spectroscopy showed that 1O2 was the most critical reactive oxygen species, and conceivable mechanisms of PMS activation with C2NOMS-2 were proposed established on the curve estimation of high-resolution XPS spectra, revealing that the generation of reactive oxygen species was mainly resulted from the cycles of Mn3+/Mn4+, Co3+/Co2+ and surface lattice oxygen/surface adsorbed oxygen. The intermediate products of propranolol degradation were identified by LC-MS/MS. Cycling experiments and ion dissolution detection suggested that C2NOMS-2 could maintain satisfactory stability in an aqueous system.
- Enhanced decolorization of methyl orange by Bacillus sp. strain with magnetic humic acid nanoparticles under high salt conditions. [Journal Article]
- BTBioresour Technol 2019; 288:121535
- In this study, magnetic humic acid (MHA) nanoparticle was prepared and confirmed the enhancement on reduction of azo dyes under high salt concentration. The anaerobic growth of the strain Bacillus sp…
In this study, magnetic humic acid (MHA) nanoparticle was prepared and confirmed the enhancement on reduction of azo dyes under high salt concentration. The anaerobic growth of the strain Bacillus sp. on quinones makes the biogenic hydroquinone feasible, and the latter was proven to reduce the azo dyes stoichiometrically. This in-situ reversibly oxidation and reduction of MHA acts as electron shuttle to catalyze the biotic reduction of the azo dyes. The biodegradation efficiencies in batch experiments and sequencing batch reactor with MHA were increased by 1.5-2.5 times as compared to that of control without the catalyzer. Moreover, the negligible leaching of HA under various environmental conditions suggests the robustness of the coating of HA on Fe/O surface. These results indicated that the as-prepared MHA could be used as redox mediator to accelerate the extracellular electron transfer, which is of great environmental significance for the removal of hazardous compounds.
- Thiol-click photochemistry for surface functionalization applied to optical biosensing. [Journal Article]
- ACAnal Chim Acta 2019 Jul 04; 1060:103-113
- In the field of biosensing, suitable procedures for efficient probes immobilization are of outmost importance. Here we present different light-based strategies to promote the covalent attachment of t…
In the field of biosensing, suitable procedures for efficient probes immobilization are of outmost importance. Here we present different light-based strategies to promote the covalent attachment of thiolated capture probes (oligonucleotides and proteins) on different materials and working formats. One strategy employs epoxylated surfaces and uses the light to accomplish the ring opening by a thiol moiety present in a probe. However, most of this work lies on the use of thiol-ene photocoupling chemistry to covalently attach probes to the supports. And thus, both alkenyl and thiol derivatized surfaces are assayed to immobilize thiol or alkene ended probes, respectively, and their performances are compared. Also, the effect of the number of thiols carried by the probe is analyzed comparing single-point and multi-point attachment. The performance of the analogous tethering, but onto alkynylated surfaces is also carried out, and the sensing response is related to the surfaces hydrophobicity. A newly developed reaction is also discussed where a fluorinated surface undergoes the covalent immobilization of thiolated probes activated by light, creating small hydrophilic areas where the probes are attached, and leaving the rest of the surface highly hydrophobic and repellent against protein unspecific adsorption. These mixed surfaces confine the sample (aqueous) uniquely on the hydrophilic spots lowering the background signal and thus increasing the sensitivity. These probe immobilization approaches are applied to fluorescence microarray and label-free nanophotonic biosensing. All the exposed reactions have in common the photoactivation of the thiol moieties, and give rise to quick, clean, versatile, orthogonal and biocompatible reactions. Water is the only solvent used, and light the only catalyzer applied. Thus, all of them can be considered as having the attributes of click-chemistry reactions. For these reasons we named them as thiol-click photochemistry, being a very interesting pool of possibilities when building a biosensor.
- Construction of an ultrasensitive electrochemiluminescent aptasensor for ractopamine detection. [Journal Article]
- AAnalyst 2019 Apr 08; 144(8):2550-2555
- In this study, an ultrasensitive electrochemiluminescence (ECL) aptasensor based on Ru(bpy)32+-doped silica nanoparticles (Ru@SiO2 NPs) coupled with gold nanoparticles (Au NPs) was developed for the …
In this study, an ultrasensitive electrochemiluminescence (ECL) aptasensor based on Ru(bpy)32+-doped silica nanoparticles (Ru@SiO2 NPs) coupled with gold nanoparticles (Au NPs) was developed for the determination of ractopamine (Rac). TPrA is used as the coreactant, the Ru@SiO2 NPs serve as the ECL luminophores, and the Au NPs work as a catalyzer in the redox reaction as well as the carrier that immobilizes the aptamer. Meanwhile, the complete incorporation of the Ru@SiO2 NPs and Au NPs increases the localized surface plasmon resonance (LSPR) probability, thus promoting ECL emission. The ractopamine (Rac) target molecules are specifically captured on the electrode surface by aptamer recognition. The ECL signal is quenched by energy transfer from the luminophore to benzoquinone compounds, which are oxidative products of Rac from the electrochemical scanning process. The proposed ECL aptasensor exhibits ultrahigh sensitivity and excellent selectivity for Rac detection. The linear response ranged over Rac concentrations from 1.5 × 10-12 M to 1.5 × 10-8 M with a detection limit of 4.1 × 10-14 M (S/N = 3). The detection recovery of Rac in real meat samples confirmed the satisfactory performance of the method. This study describes a versatile ECL aptasensor based on the combined functions of luminous nanospheres and Au NPs, indicating its potential application for the ultrasensitive analysis of targets in diverse systems.
- Photoelectrochemical platform for MicroRNA let-7a detection based on graphdiyne loaded with AuNPs modified electrode coupled with alkaline phosphatase. [Journal Article]
- BBBiosens Bioelectron 2019 Apr 01; 130:269-275
- In this work, a photoactive material, Graphdiyne (GDY) loaded with AuNPs (AuNPs-GDY), was successfully synthesized. The fabricated material made use of the natural band-gap structure of GDY, which co…
In this work, a photoactive material, Graphdiyne (GDY) loaded with AuNPs (AuNPs-GDY), was successfully synthesized. The fabricated material made use of the natural band-gap structure of GDY, which could produce hole-electron pairs and the plasmon resonance effect of AuNPs to obtain a high photoelectrochemical (PEC) response. AuNPs-GDY PEC response changed with the mass ratio of GDY to tetrachloroauric acid. When the mass ratio of GDY to tetrachloroauric acid was 1:2.5, AuNPs-GDY exhibited the best PEC performance. Thus, the best one was selected as the photoactive material to establish a PEC biosensor for microRNA detection. The PEC biosensor used the alkaline phosphatases as catalyzer to generate ascorbic acid in situ, which provided a low background signal and a high PEC response. The cancer marker, MicroRNA let-7a, was chosen as a target model. Under optimal condition, potential 300 mV and pH 8.0, the PEC biosensor had a detection limit of 3.3 × 10-19 M and a good linearity with microRNA let-7a concentration ranged from 1.0 × 10-18 M to 1.0 × 10-10 M. This PEC biosensor opened a promising platform using GDY to fabricate analytical method and detect microRNA at ultralow levels for diagnoses.
- Catalytic Performance of Nitrogen-Doped Activated Carbon Supported Pd Catalyst for Hydrodechlorination of 2,4-Dichlorophenol or Chloropentafluoroethane. [Journal Article]
- MMolecules 2019 Feb 14; 24(4)
- Nitrogen-doped activated carbon (N-AC) obtained through the thermal treatment of a mixture of HNO₃-pretreated activated carbon (AC) and urea under N₂ atmosphere at 600 °C was used as the carrier of P…
Nitrogen-doped activated carbon (N-AC) obtained through the thermal treatment of a mixture of HNO₃-pretreated activated carbon (AC) and urea under N₂ atmosphere at 600 °C was used as the carrier of Pd catalyst for both liquid-phase hydrodechlorination of 2,4-dichlorophenol (2,4-DCP) and gas-phase hydrodechlorination of chloropentafluoroethane (R-115). The effects of nitrogen doping on the dispersion and stability of Pd, atomic ratio of Pd/Pd2+ on the surface of the catalyzer, the catalyst's hydrodechlorination activity, as well as the stability of N species in two different reaction systems were investigated. Our results suggest that, despite no improvement in the dispersion of Pd, nitrogen doping may significantly raise the atomic ratio of Pd/Pd2+ on the catalyst surface, with a value of 1.2 on Pd/AC but 2.2 on Pd/N-AC. Three types of N species, namely graphitic, pyridinic, and pyrrolic nitrogen, were observed on the surface of Pd/N-AC, and graphitic nitrogen was stable in both liquid-phase hydrodechlorination of 2,4-DCP and gas-phase hydrodechlorination of R-115, with pyridinic and pyrrolic nitrogen being unstable during gas-phase hydrodechlorination of R-115. As a result, the average size of Pd nanocrystals on Pd/N-AC was almost kept unchanged after liquid-phase hydrodechlorination of 2,4-DCP, whereas crystal growth of Pd was clearly observed on Pd/N-AC after gas-phase hydrodechlorination of R-115. The activity test revealed that Pd/N-AC exhibited a much better performance than Pd/AC in liquid-phase hydrodechlorination of 2,4-DCP, probably due to the enhanced stability of Pd exposed to the environment resulting from nitrogen doping as suggested by the higher atomic ratio of Pd/Pd2+ on the catalyst surface. In the gas-phase hydrodechlorination of R-115, however, a more rapid deactivation phenomenon occurred on Pd/N-AC than on Pd/AC despite a higher activity initially observed on Pd/N-AC, hinting that the stability of pyridinic and pyrrolic nitrogen plays an important role in the determination of catalytic performance of Pd/N-AC.
- Catalyst-Assisted Solution-Liquid-Solid Synthesis of CdS/CuInSe2 and CuInTe2/CuInSe2 Nanorod Heterostructures. [Journal Article]
- ICInorg Chem 2019 Jan 07; 58(1):695-702
- Axial nanowire heterostructures composed of cadmium sulfide (CdS)/copper indium diselenide (CuInSe2) and copper indium telluride (CuInTe2)/copper indium diselenide (CuInSe2) were synthesized by a sol…
Axial nanowire heterostructures composed of cadmium sulfide (CdS)/copper indium diselenide (CuInSe2) and copper indium telluride (CuInTe2)/copper indium diselenide (CuInSe2) were synthesized by a solution-liquid-solid (SLS) method with the catalyzer of bismuth nanocrystals. Electron microscopy and diffraction studies show CuInTe2 and CuInSe2 segments growing along the  direction with a clear epitaxial interface between them. In CdS/CuInSe2 nanorod heterostructures, CuInSe2 and CdS segments grow along the  and  direction, respectively, with an obvious epitaxial interface between them. Energy-dispersive X-ray spectrometry demonstrates the alloy-free composition modulation in two nanorod heterostructures. In CuInTe2/CuInSe2 nanorod heterostructures, Te and Se are localized in CuInTe2 and CuInSe2 segments, respectively. Cu/In/Se and Cd/S are localized in the CuInSe2 and CdS sections of the CdS/CuInSe2 nanorod heterostructures. This research confirms that the SLS mechanism provides a general alternate technique to prepare multicomponent axial 1D heterostructures that have been difficult to generate by using either catalyst-free solution-phase synthesis or vapor-liquid-solid growth.
- Fabrication of Uniform Gold Nanopatterns on Graphene by Using Nanosphere Lithography. [Journal Article]
- JNJ Nanosci Nanotechnol 2019 May 01; 19(5):2851-2855
- In this study, we have realized controllable fabrication of gold nanopatterns on pristine monolayer graphene by using nanosphere lithography, in which polystyrene (PS) spheres are used as templates. …
In this study, we have realized controllable fabrication of gold nanopatterns on pristine monolayer graphene by using nanosphere lithography, in which polystyrene (PS) spheres are used as templates. With this method, periodically ordered triangular Au nanopatterns are uniformly formed on graphene surface. Micro-Raman spectroscopy shows that these sacrificial PS templates have no obvious effect on graphene surface structure while the subsequently formed Au nanopatterns are found to enhance Raman intensity of G and 2D bands by surface plasmon resonance. The compressive stress introduced in the metal deposition process leads to an obvious blue shift of 2D band. Besides, the metal-induced doping effect reduces the intensity ratio between 2D and G bands. This uniform arrangement of metal nanostructure is expected to grow other nanomaterials or used as Raman enhancement substrate in biomedicine, catalyzer and optics areas.
- Alkaline Hydrothermal Synthesis, Characterization, and Photocatalytic Activity of TiO₂ Nanostructures: The Effect of Initial TiO₂ Phase. [Journal Article]
- JNJ Nanosci Nanotechnol 2019 Mar 01; 19(3):1511-1519
- One-dimensional (1D) titanate nanostructures were synthesized by hydrothermal route, using commercially available TiO₂ (P25) and anatase powders as precursor materials and strong NaOH solution as cat…
One-dimensional (1D) titanate nanostructures were synthesized by hydrothermal route, using commercially available TiO₂ (P25) and anatase powders as precursor materials and strong NaOH solution as catalyzer. The prepared titanates were calcined, followed by protonation to produce TiO₂ nanostructures having enhanced photocatalytic and photovoltaic properties. The synthesized TiO₂ 1D nanostructures were characterized using field-emission scanning electron microscope, high-resolution electron microscope, X-ray diffraction analysis, and UV-Vis photospectroscopy to understand the effect of initial TiO₂ phase on morphological and crystallographic features, and bandgap. Methylene blue degradation test was applied to evaluate the photoactivity of the products obtained after different stages of the process. The findings indicate that 1D TiO₂ nanostructures form by different mechanisms from dissolved aggregates during hydrothermal process, depending on the crystal structure of the initial precursor used. Photocatalytic test results reveal that protonated titanates have considerable adsorption capability, while photocatalytic degradation depends on TiO₂ transformation.
New Search Next
- Cooperative Action for Molecular Debromination Reaction on Cu(110). [Journal Article]
- JAJ Am Chem Soc 2018 Nov 21; 140(46):15631-15634
- Copper is the paradigmatic catalyzer of the Ullmann cross-coupling reaction. Despite this, its role in the reaction is still under debate. Here, we shed light on the mechanistic steps of debrominatio…
Copper is the paradigmatic catalyzer of the Ullmann cross-coupling reaction. Despite this, its role in the reaction is still under debate. Here, we shed light on the mechanistic steps of debromination, characterizing a prototypical molecule, namely 4,7-dibromobenzo[ c]-1,2,5-thiadiazole (2Br-BTD), deposited on a Cu(110) surface. By means of scanning probe techniques and first principle calculations, we demonstrate the oxidative addition of Cu atoms leading to a -C-Cu-Br metal-organic complex. The scission of the strongly bound bromine atoms requires the cooperative action of neighboring complexes resulting in the formation of Cu-coordinated BTD structures.

domain: chemistry


text:
Dealing with heartbreak is surely never easy. Most people do not know how to deal with heartbreaks that they do extreme measures just to heal their broken love.
Just like any other teenager, this young girl experienced broken love. But what’s really alarming is the fact that she decided to lock herself in her apartment room for 5 months.
The situation gets worse when the owner of the hostel smell something bad coming from her room. They hurried to tell the police and as they opened the door, they were shocked and disgusted.
It turns out that the room of the girl was full of rubbish andher own body odor adds to the bad smell that started to linger outside.
According to reports, the owner of the hostel already noticed that the girl rarely gets out and only orders food to meet with her daily needs. Her real situation was busted only when a person nearby smell something coming from the woman’s room.
The woman was allegedly abandoned by the love of her life. Right then, she locked herself in the room and only did a few moving and eating for the last five months.
What the police saw inside was really disturbing, knowing that she is a fine and very young lady. The room was full of rubbish, they couldn’t even push the door easily. They also saw a girl… a slim girl, rather… on the bed… sitting down… with puffy eyes and messy hair. She also occasionally wipes her hand and phone.
The Innkeeper said that the woman was truly devastated upon losing her love. The couple dated for years but the guy left her, making her feel depressed and lose herself in the midst of all the heartache she felt.
But the police who came to the rescue were enthusiastic enough to change the mood in the room. They cleaned the room and threw faithful words towards the girl.

domain: psychology


text:
MANILA - It's the last Battles performance for Bamboo's Kamp Kawayan, and he picked two young artists with unique vocals to compete against each other.
AJ Yape and Zam Lago performed Ben&Ben's "Araw-Araw", adding their own flavor to the song.
Though both earned praises for their performance, it was Lago who made it to the next round.
None of the other coaches used their "steal" privilege, which means Yape is eliminated from the competition.
The new "The Voice Teens" episode aired on the Kapamilya Channel, which is mainly available through cable providers such as Sky, and was streamed online on YouTube.
It airs at 7:30 p.m. on Saturdays and 7 p.m. on Sundays.