text:
“If there’s one thing that can be said about the album, it is that it is brimming with emotion,” said guitarist Sam McGarrity. Boy, he wasn’t kidding. This emotional direction is a new concept for this group, but that doesn’t mean they still haven’t lost sight of their style. I only say this because as good as their first track sounds, it is very misleading in terms of the direction of the album. As for the rest of their work, it’s well orchestrated, produced perfectly and gives each member a chance to shine.
One of their most notable traits is their ability to build upon ideas while keeping things linear. With rock based bands, things can get a little repetitive. But The Nice Ones never get comfortable and can keep things interesting throughout the entirety of a track.
“Siren Song” is a surprising first start for the group. They’ve released two albums prior to this one and none of them are styled in the way “Siren Song” is, but loyal fans can rest assured that they haven’t lost their roots. With delicate instrumentation and Patrick Surdam’s fragile voice, the song acts as prelude which attests to McGarrity’s claim of the collection being full of sentimentality.
“Know Better” jumps right into their rock and roll style with the only similarity being Surdam’s voice. It’s a straightforward and completely contradictory song to the the prior track. It has a great instrumental hook in the chorus and, again, the group has done a stupendous job of building an arc worth waiting for. There’s plenty of highs and lows to keep thing interesting in an otherwise very rudimentary song.
“Good Kids” is dance worthy, glowing with positive energy and is a track that would be a tremendous hit in a live setting. The guitar hook is an ear worm, in a good way. And once again, they create an arc in their song that builds in a direction that a new listener would never expect. This is undoubtedly one of their key tracks.
Don’t be fooled, “Surfer Girl” is not what it seems. The tone switches back and forth several times and ends in a way that’s completely different than the intro in terms of instrumental and lyrical content. Surdam first speaks of a girl that he “thought of kissing” and ends the song talking about how he should have killed this girl when he had the chance. This one will be listed as another key track because of its contradictory style and, once again, the incredible rise and fall of emotion.
What I’m loving most about the album is how their songs never finish the same way they start. The only similarity is the key, and even that’s arguable. “John Honre Burns!” is one of the most dynamic tracks on the album and has an incredibly misleading intro. The only other time we hear the sultry riff of the intro is half way through the track when it repeats and that’s it. After the second verse, the feeling of rage grows exponentially until the end of the song when it comes crashing down.
Lastly is “Burn it Down,” the most anxious and chaotic track on the album. It leaves a bit of a bitter taste in the listener’s mouth considering what the tone was at the start of the album. It’s fast, rambunctious, but oddly good. McGarrity said this was an emotional track and anger is the emotion that this album was missing. Well, listeners will sure get their fill of anger with this one. It just isn’t a track most groups would place at the end of an album. Looking past that, it’s well orchestrated and a fun listen.
Although the album is “brimming with emotion,” it is a little sporadic. This isn’t an album that people will listen to from beginning to end; it’s too all over the place. I encourage people to riffle through the album to find something they like because there really is something for everyone.
Key Tracks: Siren Song, Good Kids, Burn it Down


|Publication number||US6001082 A|
|Application number||US 09/026,937|
|Publication date||Dec 14, 1999|
|Filing date||Feb 20, 1998|
|Priority date||Feb 20, 1998|
|Publication number||026937, 09026937, US 6001082 A, US 6001082A, US-A-6001082, US6001082 A, US6001082A|
|Inventors||Thomas M. Dair, Maximillian Philip Burton, Marco Carroll Perry, David P. Farrage|
|Original Assignee||Becton Dickinson And Company|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (6), Referenced by (68), Classifications (12), Legal Events (5)|
|External Links: USPTO, USPTO Assignment, Espacenet|
1. Field of the Invention
The present invention relates to medication delivery pens having integral means for magnifying dosage numerals representing the dose being set by a user and, more specifically, a medication delivery pen having an integral magnifying pocket clip for magnifying the dosage numerals on the pen.
2. Description of Related Art
Hypodermic syringes are used to deliver selected doses of medication to patients. The prior art hypodermic syringe includes a syringe barrel having opposed proximal and distal ends. A cylindrical chamber wall extends between the ends and defines a fluid receiving chamber. The proximal end of the prior art syringe barrel is substantially open and receives a plunger in sliding fluid tight engagement. The distal end of the prior art syringe barrel includes a passage communicating with the chamber. A needle cannula may be mounted to the distal end of the prior art syringe barrel, such that the lumen of the needle cannula communicates with the passage and the chamber of the syringe barrel. Movement of the plunger in a proximal direction draws fluid through the lumen of the needle cannula and into the chamber. Movement of the plunger in a proximal-to-distal direction urges fluid from the chamber and through the lumen of the needle cannula.
Medication to be injected with the prior art hypodermic syringe often is stored in a vial having a pierceable elastomeric seal. Medication in the prior art vial is accessed by piercing the elastomeric seal with the needle cannula. A selected dose of the medication may be drawn into the chamber of the syringe barrel by moving the plunger a selected distance in a proximal direction. The needle cannula may be withdrawn from the vial, and the medication may be injected into a patient by moving the plunger in a distal direction.
Some medication, such as insulin is self-administered. The typical diabetes patient will require injections of insulin several times during the course of the day. The required dose of insulin will vary from patient to patient, and for each patient may vary during the course of the day and from day to day. Each diabetes patient will establish a regimen that is appropriate for his or her own medical condition and for his or her lifestyle. The regimen typically includes some combination of a slow or medium acting insulin and a faster acting insulin. Each of these regimens may require the diabetes patient to periodically self-administer insulin in public locations, such as places of employment or restaurants. The required manipulation of the standard prior art hypodermic syringe and vial can be inconvenient and embarrassing in these public environments.
Medication delivery pens have been developed to facilitate the self-administration of medication. One prior art medication delivery pen includes a vial holder into which a vial of insulin or other medication may be received. The vial holder is an elongate generally tubular structure with proximal and distal ends. The distal end of the prior art vial holder includes mounting means for engaging a double-ended needle cannula. The proximal end also includes mounting means for engaging a driver and dose setting apparatus as explained further below. A disposable vial for use with the prior art vial holder includes a distal end having a pierceable elastomeric seal that can be pierced by one end of a double-ended needle cannula. The proximal end of this prior art vial includes a plunger slidably disposed in fluid tight engagement with the cylindrical wall of the vial. This prior art medication delivery pen is used by inserting the vial of medication into the vial holder. A prior art pen body then is connected to the proximal end of the vial holder. The pen body includes a dose setting apparatus for designating a dose of medication to be delivered by the pen and a driving apparatus for urging the plunger of the vial distally for a distance corresponding to the selected dose.
The user of the pen mounts a prior art double-ended needle cannula to the distal end of the vial holder such that the proximal point of the needle cannula pierces the elastomeric seal on the vial. The patient then selects a dose and operates the pen to urge the plunger distally to deliver the selected dose. The patient then removes and discards the needle cannula, and keeps the prior art medication delivery pen in a convenient location for the next required medication administration. The medication in the vial will become exhausted after several such administrations of medication. The patient then separates the vial holder from the pen body. The empty vial may then be removed and discarded. A new vial can be inserted into the vial holder, and the vial holder and pen body can be reassembled and used as explained above.
The above described reusable medication delivery pen is effective and much more convenient for self-administration of medication than the hypodermic syringes using separate medication vials. However, the move to reduce the size of medication delivery pens has caused similar reduction in the size of dosage numerals used to set the desired dose on such pens. As a result, users with impaired vision have found it difficult to readily set the dose on such pens. Since it is particularly common among patients with diabetes to have complications of the disease causing impaired vision even more of a need has been found to address this problem. Some medication delivery pens have been made with limited magnification of the dosage numerals but the technique currently being used to magnify the dosage numerals leads to a medication delivery pen having an unacceptably large diameter or insufficient magnification. Hence, it is necessary to provides a medication delivery pen having integral magnification of the dosage numerals that provide sufficient magnification without adding an unacceptable increase in the diameter of the medication delivery pen or unnecessary bulk.
The present invention relates to a medication delivery pen that addresses the above-identified problem by incorporating means for magnification into the pocket clip of the medication delivery pen so that the pocket clip both provides means for magnifying the dosage numerals and functions as a clip for retaining the medication delivery pen in a user's shirt pocket. The present invention provides an improvement in user visibility of the dosage numerals since the magnification enlarges the image of each digit or font character of the dosage numeral and aides the vision of the user. The magnifying means is integrated into the pocket clip of the medication delivery pen such that the dosage numerals below the magnification means are sufficiently magnified.
Alternatively, if dosage numerals are displayed in multiple positions within the dosage display window on the medication delivery pen the entire clip can be made as a magnifier to provide magnification of a dosage numeral anywhere within the dosage display window. That embodiment provides an increase in magnification throughout the whole magnifier clip such that the digit found below the magnifier clip does not need to be stationery within the dosage display window of the medication delivery pen and is therefore free to move longitudinally, axially or rotationally and still be magnified by the magnifier pocket clip.
FIG. 1 is a perspective view of a medication delivery pen having a magnifier in a pocket clip according to the present invention.
FIG. 2 is a cross-sectional view of the magnifier in the pocket clip on the medication delivery pen shown in FIG. 1.
FIG. 3 is an elevational view of the magnifier in the pocket clip on the medication delivery pen shown in FIG. 1.
FIG. 4 is a perspective view of another medication pen having an alternative pocket clip magnifier according to the present invention.
FIG. 5 is a perspective view of yet another medication pen having an alternative pocket clip magnifier according to the present invention.
A medication delivery pen 10 having a pocket clip 15 including a magnifier 20 according to the present invention is shown in FIG. 1. Medication delivery pen 10 also includes a pen body assembly 30 with a shielding cap 35 removably attached thereto to cover a needle assembly (not shown) between uses of medication delivery pen 10.
Pen body assembly 30 includes a dose setting dial 31 that is used to set a desired dose to be injected by the user using medication delivery pen 10. Pen body assembly 30 also includes a window insert 33 mounted thereon having a cut-out or window 32 through which the user may view dosage numerals therein. Window 32 is disposed in insert 33 on the side of pen body assembly 30 to enable dosage numerals 40 to be visible by the user through window 32 and magnifier 20 as the user is setting the dose using dose setting dial 31. Dosage numerals 40, shown in FIG. 3, are used by the user to set the dosage desired for the next injection.
Rotatable dose setting dial 31 includes a knurled exterior surface to facilitate manipulation for setting the selected dose. FIG. 1 also shows an actuator button 34 that is used by the user when performing an injection after a desired dose has been set.
FIG. 2 shows a cross-sectional view of pocket clip 15 including magnifier 20. Pocket clip 15 is attached to pen body assembly 30 by extension 16 and extends in a distal direction to a distal end 17 having a foot 18 in pressure contact with or close proximity to the surface of pen body assembly 30. Magnifier 20, shown in FIG. 2, has an upper convex surface 21 and a lower concave or flat surface 22 that is positioned directly over window 32 at a predetermined distance to sufficiently magnify dosage numeral 40 within window 32. As shown in FIG. 3, when magnified by magnifier 20 dosage numerals 40 are sufficiently enlarged so that a user can easily read the numerals while setting a dose using dose setting dial 31.
An alternative embodiment is shown in FIG. 4 having a pocket clip 150 that extends over a longitudinally extending window 331 in pen housing 300. Pocket clip 150 includes a magnifying window 200 that extends the full length of window 331 so that if dosage numerals 40 appear anywhere within window 331 they will be properly magnified so to be easily seen and read by a user while setting a dose with medication delivery pen 10.
Another embodiment of a medication delivery pen according to the present invention is shown in FIG. 5 having a rotatable pocket clip 415 that extends over a rotatable display band 433 located on a pen housing 430. Display band 433 includes a window 432 for displaying the currently set dose. As a dose is being set and/or delivered, rotatable display band 433 rotates which causes window 432 to rotate about pen housing 430. In this embodiement pocket clip 415 is attached to pen housing 430 by an arm 416 that allows pocket clip 415 to rotate about pen housing 430. Pocket clip 415 is rotated about pen housing 430 until a magnifying window 420 on pocket clip 415 is positioned over window 432 so that the dosage therein is magnified so to be easily seen and read by a user setting a dose with the medication delivery pen. Alternatively, pocket clip 415 can rotate with window 432 during dose setting so that magnifying window 420 is always positioned over window 432.
While the present invention has been described with respect to a preferred and an alternative embodiment, it is apparent that various changes can be made without departing from the scope of the invention as defined by the appended claims.
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|U.S. Classification||604/207, 604/187|
|International Classification||A61M5/315, A61M5/31|
|Cooperative Classification||A61M5/31548, A61M2005/3125, A61M5/31525, A61M2005/3126, A61M2205/585, A61M2205/583|
|European Classification||A61M5/315E2B, A61M5/315D|
|Jul 9, 1998||AS||Assignment|
Owner name: BECTON, DICKINSON AND COMPANY, NEW JERSEY
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:DAIR, THOMAS M.;BURTON, MAXIMILLIAN PHILIP;PERRY, MARCO CARROLL;AND OTHERS;REEL/FRAME:009308/0891
Effective date: 19980616
|Apr 15, 2003||FPAY||Fee payment|
Year of fee payment: 4
|Jun 27, 2007||REMI||Maintenance fee reminder mailed|
|Dec 14, 2007||LAPS||Lapse for failure to pay maintenance fees|
|Feb 5, 2008||FP||Expired due to failure to pay maintenance fee|
Effective date: 20071214


text:
Refreshing watermelon dessert with flatbread
Portions: 4 persons | Preparation: 15 minutes
This tastes refreshing and really delicious. Simply cut the seedless watermelon into small pieces and enjoy with flatbread. In summer it is a fruity refreshment!
Please review recipe:
- 1 watermelon, small, seedless
- flatbread, for serving
- Half the seedless watermelon.
- Place the cut side on the cutting board and cut 1-2 cm apart down the board.
- Cut the melon slices in two or three times and arrange on a plate with cocktail umbrellas.
- The watermelon tastes fantastic with flatbread or baguette.
The watermelon tastes great with flatbread.
- cocktail umbrella

domain: food


The National Disability Insurance Agency released its first quarterly report since the beginning of the national rollout. The report shows that the scheme now has almost 37,721 participants with $3.3 billion committed in participant plans.
This latest report has significantly changed in structure. In this article we have picked out six of the most significant lessons that providers can learn from the data.
1. Participant satisfaction has dropped.
It probably comes as no surprise to anyone that participant satisfaction with the NDIS has dropped in the last quarter, with 85% of participants rating their experience as “good” or “very good”, down from 95% since the beginning of trial. Fewer people are answering this survey at all, which would suggest that this number may be even lower in practice.
2. Participants are being rated by their “level of function”.
The new quarterly report includes data that distributes participants on a 1-15 scale of “level of function”. This is the first we’ve heard of this scale and it’s frankly a bit shocking to see. We are speculating that this 15 point scale may be linked to the NDIA’s infamous reference packages, using participants’ “level of function” as a key indicator of their package size. Specifically with relation to the ECEI approach, the report states, “The first plan process is a method for better aligning the level of function and need with support packages for participants when they first enter the Scheme.”
3. Adjustments to the categorisation of disability groups gives some new insight.
This report has changed the categorisation of disability groups, merging all the intellectual disability groups and separating out some physical disabilities. This new categorisation puts the total number of participants approved in Q1 with Intellectual Disability and Autism at 66.6%.
The separation of some groups now gives us specific insight on participants with ABI, Spinal Cord Injury and Stroke. For example, we can now see that participants with Spinal Cord Injury have the largest average package cost, at over $100,000. This is close to double the expected package cost for this group.
4. Data using the new Price Guide shows the scale of each support category.
This report is the first to give insight into the amount that will be spent on each support category using the Price Guide released in July 2016. This is significant because this Price Guide was the first to separate out (amongst others) Support Coordination & Plan Management.
Extrapolating these numbers out to full rollout, this could mean that the Agency will spend $770 million on Support Coordination. This spend is higher than we would have predicted, and puts Support Coordination in the top 4 largest categories by spend. Given that the national budget for LACs is $550 million and with such significant crossover between the stated roles of Support Coordination and LACs, the amount of funding allocated to Support Coordination may indicate a failure of LACs to fulfil some of their key plan implementation functions.
5. Some key pieces of information are missing.
Despite the excitement at the inclusion of data just described, there were some notable absences in this latest report. In contrast to earlier Quarterly Reports, this report does not include data on:
The proportion of participants who are self-managing their funds
Complaints by type and outcome
Data on the characteristics of the entire NDIS cohort, including trial. Almost all graphs refer only to participants entering the Scheme in Q1.
6. Bilateral targets for plans are not being met – by a long way.
The original target for the number of approved plans in Q1 was 20,264. In the wake of the GPD (Great Portal Disaster), this was halved to just over 10,000. The final number of plans approved in Q1 was 7,440, falling fairly significantly short of even the reduced target.
This shortfall speaks to the contradicting pressures that LACs and Planners are experiencing – on the one hand to create fantastic plans in a way that actively engages the participant and on the other, to push through plans at twice the rate of what was already an unreasonable timeline. This is inevitably resulting in inconsistent plans, meaning that pre-planning is more important than ever. See Sally’s recent article for some great pre-planning tips.
The greatest planning squeeze is being felt in NSW, where the timeline to full rollout is a mere two years (one year less than every other state). While most other states have met or nearly met their revised targets, NSW is understandably lagging behind, making up almost all of the national shortfall.


text:
My goal was to walk every public street in the city of Seattle. Four years after starting I have logged 2,722 miles and completed the goal. The orange and red areas on the map reflect the neighborhoods I walked. Brown areas represent some private roads and properties I did not walk.
A list of some of my favorite discoveries and an index of walks by neighborhood can be found in the March 2015 posts and in the very bottom post June 8, 2010.

domain: geography


What's All This Then?
Wednesday, April 19, 2006
RUMSFELD SHOULD GO - AND TAKE HIS ARROGANCE WITH HIM!!
If the International Olympic Committee ever decides to add "Exercise in Arrogance" as a competitive sport, the United States would have to be one of the front runners to win gold - either in the individual or team competitions. The Muslim world would have some favored entries to be sure. Osama Bin Laden and the al Qaeda team of course - and Iran’s Mahmoud Ahmadinejad who would be a natural selection based on his thumb to nose attitude towards the United States and his grand Israel destruction plan.
But the favorite would have to be our own Donald Rumsfeld - who’s name alone is fast becoming a Thesaurus alternative for pomposity and disdain. In defending himself against relatively mild criticism from a half dozen retired generals along with the likes of John McCain, he is now floating the idea that the criticism stems not from his mishandling of the Iraq adventure but from resentment at changes that he has introduced during his five years on the job. And some people are buying into at least some of that nonsense. Witness the lead editorial in today’s Chicago Tribune.
But is that really why the generals are calling for his resignation? Think about it. This is the man whose response to looting in Iraq after we had toppled Saddam Hussein was that "freedom is messy." This is the man whose answer to a soldier in Iraq who asked why he had to scrounge for scrap metal to protect his vehicle was "As you know, you go to war with the Army you have. They’re not the Army you might want or wish to have at a later time." This is the man who told us that he knew where the weapons of mass destruction were. "We know where they are" he said. "They're in the area around Tikrit and Baghdad and east, west, south and north somewhat." This is the man who revealed the clarity of his thinking with his comment that " Reports that say that something hasn't happened are always interesting to me, because as we know, there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns -- the ones we don't know we don't know." Now why wouldn’t you want someone like that leading you into battle?
This is the man who showed his respect for the opinions of others by saying "Secretary Powell and I agree on every single issue that has ever been before this administration except for those instances where Colin's still learning." And when Army Chief of Staff , General Eric Shinseki testified that several hundred thousand troops would be needed to control conditions in post war Iraq, this was the man who said "The idea that it would take several hundred thousand U.S. forces I think is far off the mark." Shortly after which, General Shinseki was gone - and we all know what conditions prevail in Iraq today.
In defending himself with his usual arrogant flair, Rumsfeld wanted us all to know that "The fact that two or three or four retired people have different views, I respect their views. But obviously out of thousands and thousands of admirals and generals, if every time two or three people disagreed we changed the secretary of defense of the United States, it would be like a merry-go-round."
Well nobody is suggesting that "every time two or three people disagreed we changed the Secretary of Defense." I don’t think that there’s ever been a situation where retired generals have called for a Secretary to resign in a time of war. And you’ll note that Mr. Rumsfeld forgot to mention that among those "two or three people" were the generals actually involved in conducting the war in Iraq and Afghanistan. It’s a little like Scooter Libby saying that out of hundreds of prosecuting attorneys, only Patrick Fitzgerald who brought an indictment before a grand jury. As the average pre-teen of today would say Dah??
What the secretary didn’t forget was where to go to put out his defense. To Rush Limbaugh - whose right wing radio program just happens to be on the armed forces network that can be heard by our troops in Iraq. It’s an appropriate combination. Limbaugh the distorter - (and I’m being kind with that description) - coupled with the frequently incomprehensible Rumsfeld.
According to one web site listing a bio of our esteemed Secretary of Defense "The cantankerous Rumsfeld has charmed the Washington press corp with his microphone skills." I agree that he at times can exhibit charm, but all too often words cascade from this charmer’s mouth that I believe more accurately reflect the inner being of the man. Arrogant. Disdainful. Dismissive of opinions that differ from his and obsessed with the conviction of his own rectitude that blinds him to the potential dangers of some of his decisions.
At the very least, if the man is a patriot, he should resign if only to remove himself as an issue in the problems we are facing in Iraq and Afghanistan and in the so called war on terror - if it ever gets re-launched against those who attacked us. It would send the right message to everyone. To our enemies. To our military personnel. That we have leaders who are willing to accept responsibility, to admit that no one individual is indispensable and who will step aside and allow new ideas to enter the arena for the good of the nation.
But having watched the guy for lo these many years - I'm not holding my breath.


text: Lake view, level terrain, great building location with village utilities. Village maintained roads and year round accessibility. The lot faces south for awesome solar gain with any type of construction. This is one of the larger lots at .68 of an acre. Located on the corner, there is great flexibility as to location of a home and garage or turn the house to make the best lake views.


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The global liquid milk replacers market size is expected to grow from USD 188 million in 2018 to USD 243 million by 2023, at a Compound Annual Growth Rate (CAGR) of 5.3% during the forecast period. The major driving factors in the liquid milk replacers market are increasing consumption of dairy products and the adoption of precision nutrition technique.
The major liquid milk replacers vendors include Liprovit, BV (Netherlands), Calva products LLC (US), PETAG Inc. (US), Cargill (US), Archer Daniels Midland Company (ADM) (US), CHS Inc. (US), Land O’Lakes Inc. (US), Glanbia Plc (Ireland), Nutreco N.V. (Netherlands), and Lactalis Group (France). These players have adopted various growth strategies such as expansions, acquisitions, and new product launches to expand their presence in the global liquid milk replacers market. Expansions has been the most dominating strategy adopted by major players from 2014 to 2018. This has helped them to innovate their offerings and broaden their customer base.
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In line with the rising importance of the liquid milk replacers, Cargill has established its presence in diversified feed markets; this has helped it to minimize risks and dependency on any particular business segment. The company has a strong product portfolio and brand image, which enables it to strengthen its position in the market. It has strong R&D capabilities, which provide it with a strategic advantage over its competitors. The company is focusing on R&D to meet the demands of the feed industry. The company focuses on obtaining market-driven solutions to meet the increasing demand for milk replacers and other feed products. It is involved in various strategic growth initiatives such as expansions and investments. For instance, Cargill opened a new animal nutrition technology application center in Izmir, Turkey, in January 2016, to aid the increase in local awareness for calf milk replacers.
Nutreco N.V. focuses on catering not only to the milk replacers market but the overall feed industry. The company leads in terms of operational and financial strength and has focused on growing within the milk replacers market through both organic and inorganic means. It has expanded its product portfolio and geographic reach through new product launches, expansions, investments, and acquisitions. For instance, in 2017, Sprayfo altered the composition of its products in the above product range to reduce the usage of chemicals to a minimum level. In 2016, Trouw Nutrition (Netherlands), a subsidiary of Nutreco (Netherlands), opened a new Calf & Beef Research Facility close to Boxmeer (Netherlands) to meet the demand for milk replacers in animal nutrition applications.
By type, the medicated segment is expected to be the faster growing in the market during the forecast period.
The medicated segment is projected to grow at the higher CAGR between 2018 and 2023. Medicated liquid milk replacers provide various health benefits and improve the performance of infant livestock. These milk replacers are mainly fed to infant livestock that has physical and nutritional deficiencies, weaknesses, or diseases; and requires an enhanced nutritional diet. This has led livestock rearers to use medicated liquid milk replacers.
By livestock, the calves segment is growing at the fastest rate during the forecast period.
The calves segment, by livestock, is projected to be the fastest-growing store type in the global market. Calves are born with only the abomasum, i.e., the fourth stomach functioning; and their digestion is only dependent on the enzymes existing in the abomasum. For this reason, infant animals are fed with high-quality milk replacers, as they fulfill their nutritional needs and boost their immunity toward diseases. Liquid milk replacers for calves are nutritious concentrate mixes and contain nutrients such as protein, fats, vitamins, and minerals in the optimum required ratio to ensure optimal growth.
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Europe is projected to account for the largest market size in the liquid milk replacers market during the forecast period.
Europe is estimated to account for the largest share of the market in 2018. The consumption of liquid milk replacers in this region is majorly driven by the rising demand for milk and milk products among consumers. According to the Joint Research Center of European Commission, about 12.4% of the entire milk production in the region is used for general consumption; with 36.1% being used for cheese production, 28.7% being used for butter, and 11.5% for cream. This leaves about 20% of the produced milk available for young livestock consumption, providing a huge market opportunity for milk replacers. Milk replacers also form an important dietary input for livestock fattening purposes, wherein they constitute the major feed products and account for a majority of the feed cost for young livestock meant for slaughter. Milk replacers are majorly produced in countries such as France, Germany, Italy, the Netherlands, and Belgium; and are traded throughout the region.


Jun 15 - Jan 1 2021
Ruschestraße 103, Haus 1, Lichtenberg
Few moments in history stick in the mind with quite as much meaning as the fall of the Berlin Wall. It was the end of one world, the beginning of another, the final dying embers of communism giving way to a new era of freedom, or something along those lines. This open-air exhibition on the site of the former Stasi headquarters is especially poignant, as it focuses on those East Germans who defended themselves and their freedom in the face of totalitarianism. This exhibition features a huge range of photographs, posters and documents, along with many films, telling the tale of that fateful time. An audio guide is available at the visitors centre to accompany visitors through the exhibition.


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The 53-year-old, who hosts 'Daybreak' as well as her own show straight afterwards, has been married to cameraman Steve Smith since 1992 reveals that her career hasn't interfered with their bedroom time.
"You just make time - weekends and afternoons!" Kelly told Star magazine during a recent interview. "That's a very important part of any relationship."
The mother-of-one went on to say that the pair no longer go on date nights, but they do spend weekends together and go and watch the football for a bit of romance.
You just make time - weekends and afternoons! That's a very important part of any relationship.
Kelly, who helped launch GMTV back in 1993, went on to insist that ‘Daybreak’ is “better than it’s ever been."
"It's all statistics,” she stated. "My 8.30am show is up year-on-year, and from 7.30am onwards, it's better than it's ever been. We still have a long way to go, but we’re heading in the right direction.
“We’re getting there but it won’t change overnight. It’ll be a year before we can fully turn it around.”

domain: celebrity


text:
In the beginning the author familiarizes us with the topography and climate of the Punjab. Then, Mr Singh, himself a Sikh, dwells into ancient history about the Mohenjo Daro, Indus valley civilizations, whose cradle was the Punjab. Singh, claims that this ancient civilization was later wiped out by the Aryans invaders. The Aryans, bought the Vedic religion to the fore in India and till date are the dominant force in India. The aboriginals were marginalized and the tribals in India today are decedents of the aboriginals. Although after almost 2600 years, anyone claiming that Aryans are still outsiders, and trying to drive political mileage out of it is are just being plain silly. Hinduism, while a great religion has had too many problems, the major one being the caste system, the social hierarchy in which the Brahmins take the top spot(incidentally the same people who came up with the caste system) and Shudhras at the bottom, who were not only given menial jobs but were discriminated and persecuted for centuries. Even in modern day India, this rigid and evil structure persists which the upper casts still exploit.
15th April 1469, Guru Nanak, born into a middle class, hindu, Bedi family was spiritually inclined from an early age. The young Guru could hold his own against erudite theologians. He was married at an early age, 12, child marriage was common in those days. Nanak even had two sons and was later convinced by his sister to find regular employment. Soon, He had his epiphany, and announced to the world his encompassing philosophy where he repeated several times he was "neither a Hindu nor a Muslim". Thus, a new monotheist religion was born. Inspired from the Sufi and Bhakti movements. Nanak used the local language, Punjabi, to spread his word. Guru Nanak, also traveled the world to spread his religion. An anecdote from one of his travels goes something like this: Nanak was travelling in the middle east and was somewhere near mecca, when he got tired and fell asleep. A zealous Muslim started shouting at him; pointing out that his feet were pointing towards Mecca, on hearing this Nanak went back to sleep, the Muslim enraged moved Guru Nanak's feet to a different direction, to his astonishment Mecca moved to where the Guru's feet were, wherever the zealot tried to move the Guru's feet mecca also moved. The Guru pointed out that God was everywhere.
Guru Nanak's small religion had found many patrons amongst the Punjabi speaking population, he pitched the idea of an omnipotent, omnipresent, and formless god. After Nanak's death there were 9 more Gurus, all from the mercantile Khatri caste.
2. Guru Angad - who was an ardent follower of Nanak, he spent his life in fortifying the edifice of the Sikh Church that Guru Nanak had built. He also tactically handled Sri Chand, who was a son of Guru Nanak and had declared himself as the heir.
3. Guru Amar Das - Guru Angad, following the tradition of Guru Nanak choose not one of his sons as the successor but one of his pious disciples, Guru Amar Das. Guru Amar das created the practice of Langar, which meant a communal feast for the poor and the needy. He also had copies of the hymns of Nanak and Angad created in Punjabi which for the local peasent population was legible rather than the Arabic Koran or hindu texts written in the complex Sanskrit.
4. Guru Ram Das - Son-in-law of Guru Amar Das, further composed more hymns.
5. Guru Arjun- youngest of the three sons of Guru Ram Das. Arjun was one of the most important Sikh Gurus, he commissioned the sacred Guru Granth Sahib, holy text of the Sikhs. He also created "Golden Temple" at Amritsar. Here the author notes how Golden temple was similar to what Mecca was to Muslims, and Benaras to Hindus; while in monotheist religions it is acceptable, even crucial to have a pivotal church/mosque/temple, in a polytheist religion like Hinduism it is impossible to have one center of power. For e.g. my family are pious Hindus, but none has ever visited Benaras, nor they have any desire to do so. Back in the 17th century, when the secular king Akbar died, Jehangir took his place, Jehangir was worried about the rise of Guru Arjun and had him tortured. The Guru's body could not withstand the sadistic torture. On May 30, 1606 during an intermission in his torture sessions the Guru was allowed to wash up in a nearby river; The Guru's weakened body could not withstand the current and was drowned.
6. Guru Hargobind - The people were shocked by the mistreatment meted out to Arjun. before he died Guru Arjun proclaimed his son, Hargobind, as the next guru. Hargobind called to arms. He created a private army to defend not just the Guru but Hindus and Sikhs.
7. Guru Hari Rai - An uneventful tenure, where more and more people were lured to Sikhism. Guru Hargobind did not find either of his living sons to be worthy of being declared a Sikh guru so the loyal grandson, Hari Rai was given the top job.
8. Guru Hari Krishen - Was the youngest Sikh guru only 5 years old when he became one, few people think that nepotism was at full display when Hari Rai choose one of his sons that too only a 5 year old boy, Hari Krishen, died only 2 years later because of chicken pox, majority of his guruship being spent under the supervision of the fanatic, odious, genocidal Mughal ruler Aurangzeb.
9. Guru Teg Bahadur - who was the son of Guru Hargobind was put at the helm of Sikhism, so as to avoid the fiend Aurangzeb from ruling Sikhs by a proxy. Teg Bahadur was captured and his head was severed by the order of the perfidious Aurangzeb.
10. Guru Gobind Singh - Was just a 9 year old boy when his father was executed. He was the last Sikh guru and he more than anyone gave the Sikhs their identity. Guru Gobind Singh was a brilliant military commander, a towering personality and a man with magnetic charisma. His entire family was murdered by the Mughals, his innocent sons were walled alive! Guru Gobind Singh gave Sikhs the five emblems and the Khalsa. He was responsible for turning Guru Nanak's religion into a militant fighting unit. He was murdered by two pathans in his tent. Guru Gobind Singh was the last Sikh guru and after him he proclaimed only the Guru Granth Sahib shall be worshiped.
Guru Gobind Singh appointed an ascetic name Lachman Das as his successor. This man was later known as Banda Bahadur. Why this Hindu ascetic was chosen over other Sikh millitary commanders and leaders? remains a mystery till today. Maybe, Guru Gobind Singh was an excellent judge of character; perhaps we will never know. The author provides his own flimsy theories in the footnotes which I daresay seem to discredit the Rajput hindu credentails of this braveheart.
Banda went on to lead the Sikhs from one victory to another, decimating the mughal forces. 5 years after Wazir Khan had murdered the sons of Guru Gobind Singh, Banda beheaded Wazir Khan. Thus in 1710 he avenged the last Sikh guru. Banda's victories made him seem indestructible to the Mughals and Sikhs; he was revered by the Sikhs, he also acclaimed himself as the 11th Guru. Banda managed to set up his own empire and won large swathes of land. Banda's reign came to end in 1715, when he was captured and put in an iron cage. He was asked to accept Islam, on refusal he was inhumanely tortured and executed in Delhi.
The author who is a self confessed Gandhi Nehru acolyte tries to paint Banda as a villain and intolerant. The fact remains that Banda gave the Mughals a taste of their own medicine. He should be revered by the larger Indian community like Maharana Pratap and Shivaji, who also fought against the religion of Arabs. Banda was perhaps the greatest Sikh of all time after the Gurus, even more than Maharaj Ranjit Singh.
Banda's death is also a death sentence for this book. The author takes the reader to such heights with his fascinating tale that it is difficult to reemerge after that. The rest of the book painfully details the several invasions of Ahmed Shah Abdali, and its effect on the Sikhs. The book also takes us through how the Sikh power started to ascend as the Mughal and Afghan powers started to descend. The book concludes with a blow by blow account of the greatest Sikh empire under Maharaja Ranjit Singh. The author leaves no stone unturned to sing encomiums about Ranjit Singh.
All in all this is a good introduction to Sikh History, I would not be interested in reading volume two which chronicles the Sikh religion from 1839-2004, for three reasons.
a) I'm not intrested in this era of Sikh history
b) Author seems biased towards his own religion and never shares any negatives about his brethren, if you can call people who lived 500 years ago as brethren.
c) The book was more like a text book i.e. too many dates, names and details around topography.
3 stars out of 5. I would recommend if you are a history buff.

domain: history


They just don’t advertise it.
Or, they really aren’t meaning to use it like a blog, but it seems to have been around since last November, just nobody noticed it. It is called Out of the Blue, and it seems to be a basic install of Word Press onto the wa-democrats.org site.
Comments are turned off, but it certainly seems like someone is intending on building some sort of blog.
This is ironic given Ken’s suggestion last month.
I found it by following the link for the site’s RSS feed from the front page. So, they could just be using the WordPress install to produce an RSS feed, which wouldn’t be that bad of an idea. But, if they did want to transition Out of the Blue into a real deal blog, they could.


The Future of Gaming: DLC
We take a look at the future of gaming in three parts: 3D, Social Gaming, and DLC.
Where does the future of gaming lie? Will we all be rocking games in 3D? Will all our game purchases be over the Internet? And will social games take over from more "core" titles? In this three-part feature, GameSpot looks at three topics that promise to change the way we play games. Presented over the course of three weeks, The Future of Gaming will look at the rise of 3D titles, the increasing importance of downloadable content, and social gaming's impact on the games industry. Contributing to the feature are some of the biggest names in games development, who all share their thoughts, aspirations, and reservations about the impact of these three topics in the years to come. The second topic presented is The Future of Gaming: DLC.
Read The Future of Gaming: 3D here.
The Game Awards 2023 Recap 12 Minutes Of Ultrawide Avatar: Frontiers Of Pandora Gameplay Fortnite - Rocket Racing Official Launch Trailer Like a Dragon: Infinite Wealth - Kiryu's Bucket List Story Trailer Guilty Gear -Strive- Elphelt Valentine Gameplay Starter Guide The Best Game Awards 2023 Trailers Devil May Cry: Peak Of Combat | V | Releases on Jan 10. 24 | Showcase Brief #2 Every Reveal at The Game Awards 2023 in 21 Minutes FINAL FANTASY XVI | DLC Trailer THE FINALS | Season 1 Launch Trailer Monster Hunter Wilds - Official Reveal Trailer GUILTY GEAR -STRIVE- | Elphelt Valentine Gameplay Reveal Trailer
Downloadable content (DLC) has become a vital part of the games industry. The ability to digitally distribute content directly onto consoles and PCs is changing the way developers make games and the way consumers play them. Where once upon a time downloadable content meant a new gun or two, a different-coloured pair of pants, or a multiplayer map five or six months after launch, DLC is no longer an afterthought--it is now seen as continuous, upgraded game content that more often than not takes the shape of fully realised add-on episodes that extend the life and gameplay hours of the original title. With an increasing number of AAA titles now receiving postlaunch DLC support, game developers have had to reevaluate the early planning stages of any titles they seek to make.
The transition hasn't happened without controversy. Many gamers have criticised the DLC model as a way for publishers to make more money from a single product. Some have also called into doubt the motivations of developers, who are seen to be deliberately leaving out game content in order to release it after the initial game, and at significant cost to the consumer. Both Microsoft and Nintendo have come under fire in the past for their currency system models, which trade real money in return for a certain number of points that can be used to buy games and items through Xbox Live and the Wii Shop Channel. Even free DLC has earned its fair share of criticism, with some accusing publishers of deliberately leaving out certain features of a game in order to extend the marketing life of a title after release.
Whatever its past problems, it's looking more certain that DLC is here to stay. Aside from extending the life of a game, developers have found that releasing downloadable content gradually allows them to spend less time and planning in the development stage, meaning it is likely that consumers will no longer have to wait three or four years for a AAA title to arrive. It also allows developers to gather and implement feedback from gamers, making DLC content more polished and in line with what the community wants.
So where does the future of DLC lie? Will an increasing number of titles be split up into various parts? Will all games one day be distributed as episodic content? And will gamers get on board with the economic implications of such a model?
Extending the life of games
At this month's GDC Europe in Cologne, the game industry service Electronic Entertainment Design and Research (EEDAR) presented new information about the continued growth of digital downloads. Despite worldwide game sales now exceeding US$50 billion annually, EEDAR found that most consumers purchase only two to three games per year, a significant drop from the previous average of six to eight titles per year. However, in the DLC field, EEDAR found that 2009 was the biggest year on record in the industry for downloadable content sales, a trend that is expected to continue to rise through to 2011 and beyond as longer development cycle games come to market. EEDAR also revealed that regardless of cost, 28 percent of gamers do not check for the availability of DLC, while 22.5 percent actively seek it out before launch.
Developers are unanimous that DLC is the future. Some see it as an opportunity to extend the life of games; others believe it's a way to deliver better quality titles in a shorter amount of time. Medal of Honor executive producer Greg Goodrich sees DLC as an opportunity for developers to reach out to players.
"DLC is a vital part of any project. I think that for a long time, game developers were reaching out to people once every one or two years. Now, this gives us a way to extend the life of a franchise and continue the game experience in between the major releases."
Warhammer 40,000: Space Marine producer Raphael van Lierop thinks DLC allows players to live longer in the gameworlds they love.
"When you really love a game, you want to live in that world as long as you can. We've all played games where we didn't want the experience to end. DLC is a great way to extend the life of a game and allow players who love that game to keep playing in that world. I also think DLC extends the value of the product--from a developer's point of view, rentals and resales are harmful to developers, and I think it's great if we can give people who bought our games more of a reason to hold onto them. DLC is a great evolution for our industry, and I hope it continues to develop further and further."
Obsidian's creative director on Fallout: New Vegas, Chris Avellone, sees developers prepping for DLC a lot earlier in the game-making process.
"I see DLC following the same model as it has been doing. I imagine this is because it has been so successful, meaning it will be started a lot earlier in the development process. I think it's a great way to introduce episodic content in a title and thus give it more life, bridging the gap between big releases. The development process is so long, so this appeals to both players and developers. It's also exciting because it allows developers to create further stories in a particular gameworld."
The DLC controversy
In March 2009, Capcom drew the ire of some gamers when it announced that it would be charging US$4.99 for the Resident Evil 5 Versus mode DLC, which allows up to four players to compete in two different competitive game types. Many felt Capcom had no right to charge a fee for a gameplay mode that is now the standard in most titles, and were vocal in their demand that the publisher relent and give gamers what they had already paid for. In response, Capcom remained adamant that the Versus mode remained "above and beyond" the initial scope of Resident Evil 5, making the US$4.99 price tag justified.
The controversy over DLC comes down to value versus cost. For example, many gamers found the US$2.50 price tag slapped on the infamous horse armour DLC for The Elder Scrolls IV: Oblivion laughable; the same goes for the two "missing" chapters in Assassin's Creed II, which gamers accused Ubisoft of taking out of the original game to release as paid DLC down the track (which is exactly what happened).
It has also been revealed that DLC pricing is also a matter of dispute between publishers and developers. In its April 2007 issue, Game Informer revealed that Microsoft was forcing developers to release priced DLC even when it was the latter's wish that the DLC be free, spurred by a dispute between Microsoft and Gears of War developer Epic Games. After speaking to industry contacts about the process that developers go through to get their content on Xbox Live Marketplace, Game Informer also found instances when DLC had to be delayed due to developers refusing to accept Microsoft's pricing.
Some developers recognise that a balance has to be struck when it comes to the cost and value of DLC. Spec Ops: The Line lead designer Cory Davis believes DLC is viewed in a very different way by developers and consumers.
"DLC from a consumer perspective is very different from DLC from a developer's perspective," Davis said. "Some things are just not going to be possible to do in DLC depending on the game you're making. When I see DLC today I want to see more expansion packs rather than just a few new weapons or a skin for a character. The strongest DLC we've seen expands the narrative and allows players to experience more of that game's universe in a deeper way. That's what we should be shooting for as developers--giving really valuable DLC to players."
"I think it's going to step away from little trinkets and bonus packs and properly branch between game series. Developers will start trying to make DLC more meaningful via proper chunks of game. That's where the future is headed."
Ghost Recon: Future Soldier producer Stuart White believes DLC will allow developers to take into account how consumers feel about a title.
"DLC is going to get a lot bigger. It's a great move for both consumers and developers--we'll spend less time worrying about shipping content upfront and more time on tweaking the game according to player response."
Helping out indies
A lot of developers also see DLC as a way to give small, independent studios a better chance at selling their games, meaning a more diverse games industry in the long run.
Twisted Pixel lead designer Dan Teasdale says some small studios simply wouldn't survive without the downloadable content avenue of distribution.
"I think DLC has a massive future. It means developers can keep working on content nonstop, and it's also a good way for smaller studios to get noticed without having to sign a huge publishing deal. I think giving a voice to developers who have amazing ideas and want to get them out there to a big audience."
Mike Fegan from Trickstar Games in Melbourne is a firm believer in the future of DLC and its impact on the industry.
"DLC is the first time where we can see content creators moving up the food chain from a business perspective. In our case, it gives us the chance to make the games we want and the ability to publish them ourselves on Wii Ware, PSN, and XBL. We're confident that DLC and digital distribution will grow dramatically over the next few years."
Platinum Games studio founder and
"For a developer that is unable to sell games directly to consumers, the concept of DLC is great. I think 10 years from now, a point is going to come where DLC is going to be the primary form of game delivery, and that is exciting." Will DLC change the future of games? Let us know by leaving your comments below! Make sure you check back next week for The Future of Gaming: Social Games.
The products discussed here were independently chosen by our editors. GameSpot may get a share of the revenue if you buy anything featured on our site.


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Immersive MD program fosters systemic change
First cohort of Population-based Urban and Rural Community Health students become doctors
The first year of medical school brings lots of excitement for new students: getting to know professors and peers, taking foundational courses on core pharmacology concepts, and exploring the campus. For one group of School of Medicine Class of 2021 graduates, the first year also involved figuring out how to afford a month’s worth of meals and bus tickets for a family of three or four on an impossibly tight budget.
“The poverty simulator threw us into real-world situations in our introductory weeks at UMass Medical School,” said Poornima Manikantan, MD’21. The Longmeadow native graduated with the inaugural class of students in the Population-based Urban and Rural Community Health (PURCH) track. “It was an opportunity to simulate the difficult decisions that many community members face daily.”
In line with the PURCH mission, the simulation is an interactive, interprofessional educational experience in which students truly learn what it means to be a member of a family living at or below the poverty line that illuminates some of the many social determinants of health that impact their patients.
“You’re assessing how to get to work, pick up your kids from school, receive health care and buy groceries all without having access to transportation,” said Dr. Manikantan, now in her internal medicine residency at Stony Brook University Hospital in New York. “If you can’t make ends meet, you have to navigate the possibility of your house being foreclosed or checking your family into a homeless shelter. You make tough decisions, such as not getting groceries one week, then find ways to get services that could be of assistance.”
“It is a simulated month that takes place within a few hours where students navigate different social services and challenges,” said Justin Ayala, undergraduate education program coordinator for PURCH. “It recreates some of that anxiety that folks feel on an everyday basis in low resource communities. This can help our learners see and feel the lived experience of the patients that they may be interacting with.”
In the PURCH track, offered at the UMMS-Baystate campus in Springfield, students learn primary and sub-specialty care of patients within a population-health framework. Participants complete their preclinical and basic science courses in addition to program-specific courses such as Determinants of Health and Doctoring & Clinical Skills. In their third-year, students complete clinical rotations at Baystate Medical Center. The PURCH curriculum prepares students to practice medicine in diverse urban and rural communities, with a focus on underserved populations and analysis of social determinants of health. The 2021 PURCH cohort comprised six men and nine women, including 11 Massachusetts residents.
The program augments the MD track with additional emphasis on patient-centered, community-based care and innovative, immersive learning experiences. PURCH prepares students to manage the health of both individuals and populations.
“PURCH highlights ways to establish cultural and structural change. It enhances the student experience in learning about their community and how that knowledge influences everything from how they talk to their patients to understanding their community partners,” said Sarah McAdoo, MD, director of the PURCH population health capstone course.
Kevin White, MD’21, was the first student accepted to PURCH when it was launched in 2017. He was born at Baystate Medical Center in Springfield in 1995, and now, Dr. White is beginning his internal medicine residency at Walter Reed National Military Medical Center in Maryland. Inspired by the tradition of military service in his family, White is also a lieutenant in the U.S. Navy. Although he is far from home, he credits PURCH for the opportunity to train in the community that raised him.
“In first grade, I remember the school counselor asking what we wanted to be as adults. I would say I wanted to be a doctor,” White said. “My mother is a medical assistant, always helping others and putting people before herself. I wanted to be just like her.”
White was able to pursue that vision when he enrolled in PURCH after graduating from UMass Amherst. He was introduced to the UMMS environment when he participated in the BaccMD Pathway, an undergrad program that provides students from backgrounds underrepresented in medicine the opportunity of provisional acceptance to the School of Medicine.
“As I went through the program, I gradually became more interested in medicine. It brought together some of the qualities that I really aspire to emulate as a physician. PURCH definitely helped me solidify my interests in working with urban-rural community health populations. Springfield is extremely diverse, with vast Hispanic, African-American and Asian populations,” he said.
The PURCH curriculum focuses on cultivating physicians who are team-oriented, excellent diagnosticians, self-reflective, empathetic and leaders who can be led. Students in the program strive to exemplify those characteristics.
“PURCH is not just a track, it’s also a state of being,” said Kevin Hinchey, MD, senior associate dean for education at UMMS-Baystate. “It encompasses the essence and traits of what it means to be a doctor. Our goal is to teach our students to find and maintain humility and understanding while working with their patients.”
“On the surface of the water, we have all of our classes and academic work that outlines our responsibilities as providers,” said Rebecca Blanchard, PhD, assistant dean for education at UMMS- Baystate. “But underneath that water, deep down is the outreach and connection to the community. That’s what will really mold the physician.”
Colton Conrad, MD’21, moved to Springfield from North Carolina when he matriculated at UMass Medical School. From the minute he toured Baystate Medical Center, he knew it would be a great place to learn. Dr. Conrad is now serving his residency in emergency medicine at Baystate, which was his top choice. Like White, he was intrigued by the novelty of the program.
“I was really excited to be a part of a new program and be one of the first to step into the field with this specific training,” said Conrad. “I’ve been able to develop a better understanding of patients on a deeper level than their illnesses or ailments. They’re not just patients, they’re people living in a community,” said Conrad, noting that is his responsibility as a physician to meet his patients where they are.
Courses taken in the PURCH track provide the same information, build the same skills and develop the same competencies as the traditional MD curriculum, but PURCH focuses on a commitment to underserved populations. Courses bring real patient experiences to life both inside and outside the classroom, putting students in the shoes of people for whom they will care. The courses also show students the complexity of the human anatomy through the lens of other trades and professions.
“A car mechanic came in on our first day of classes,” said Conrad. “They taught us how they do a diagnosis and history of a car’s maintenance . . . asking questions like, ‘When did the problem start? What does it sound or feel like to you?’ The analogy was super insightful, especially walking into med school on day one.”
“PURCH unites people who are oriented around social determinants of health and finds avenues to provide care in a way that is cognizant of all of the other drivers that impact health outcomes, such as housing instability, internet access and food insecurity,” said Amanda Whitehouse, MD’21. Alongside her former classmate Conrad, Dr. Whitehouse is also beginning her career as a physician at Baystate Medical Center, in pediatrics. She taught for Teach for America before enrolling in medical school and believes firmly that education is critical in shaping the doctors of tomorrow.
“There is so much to be aware of as a clinician. You truly take on the role of an educator,” she said. “Medicine and teaching are synonymous, and I feel that PURCH puts us in the shoes of both the learner and the teacher. We learn from our patients as they do from us.”
An asset of the PURCH education is the collaboration with lay faculty, a diverse group of community members who are passionate about shaping the education of future providers. The community faculty live in Western Massachusetts and represent organizations that collaborate with PURCH and Baystate on the goal of developing culturally humble physicians as community advocates. They help augment curricula and teach by hosting student learning experiences and serving as standardized patients, a role for which they are trained to act as patients with specific medical conditions in simulated office visits where students interview and examine them.
Both the PURCH students and community faculty said this experience is invaluable and instrumental to structural change.
“Students participated in many moments where they were able to engage directly with families,” said Jenise Katalina, healthy families resource specialist at The Children’s Trust and former vice president of family services at Square One in Springfield. Square One provides a range of education and support services to help families grow cognitively, emotionally and socially. “I believe that we cannot create systemic change and address the needs in our community without an interdisciplinary approach. Not only did this program provide an opportunity to connect students with the community that they will be working in, but it also provided me and my organization with the opportunity to learn more about the medical schooling process and move our work forward with another lens on our work.”
“I remember showing the students my community when we went on a food desert tour,” said Charlie Holmes, leader of Springfield’s Service Employees International Union, and a standardized patient and community faculty member. “We developed a strong bond with this hands-on experience. It so much touched my heart when I saw the students volunteering in my community.”
Kathryn Norman, MD’21, chose PURCH after graduating from Harvard and working for the Centers for Disease Control and Prevention through the Public Health Associate Program in California for two years, where she developed a love for local health policy. Now an internal medicine resident at Beth Israel Deaconess Medical Center, Dr. Norman credits PURCH for immersing her and her peers in Springfield-based volunteer projects over the years, exposing them to the lifestyles and environments of their patients.
“I took part in a neighborhood workday through Revitalize CDC, a community development coalition. We went out and did some painting and gardening. I was painting a fence and a woman in her 50s, who was also painting, started chatting with me and shared how she had a personal connection to Baystate Medical Center in her family. I remember her saying how amazing it was to see a medical center grow and bring in students who were not part of Baystate, but who were coming out and learning about the community because they truly wanted to be there. It stuck with me,” Norman said. ■

domain: news


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@ChrisPerkinsDnD I wish we had some proper dragonlance draconian stats, though! Suggestions? I've been running DL in 5e!
— Susi Stuart (@susistuart) September 3, 2015
Chapter 8 of the DMG can help. Try using hobgoblin stats for baaz draconians, adding wings & turn-to-stone ability. https://t.co/a2FBCA7aWb
— Christopher Perkins (@ChrisPerkinsDnD) September 3, 2015

domain: hobby


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I am installing a baseboard heater in a room , with a 220V line coming out of the wall. I also added a thermostat switch right to the unit of the baseboard
(not a wall mount switch) as far as the wiring goes through the thermostat switch which has 2 wires coming off it, it requires that a hot wire be connected specifically to one of the wires.
My problem is, on a standard 110v i know black is "HOT" and white is "neutral".
But this 220v line that i have has a "black" wire , "Red" wire and a ground.
so what would be considered as my "Hot" wire, The Black or the Red?

domain: design


Join Isabella Taylor on an adventure to inspire young children to follow their dreams in the series Inspired By.
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‘Vampire Diaries’ Kat Graham Wearing Stella & Dot Necklace
Even more celebs are walking the red carpet in their fabulous Stella & Dot jewelry. The beautiful Kat Graham, star of the CW’s ‘The Vampire Diaries,’ was recently seen wearing the Somervell Necklace while at a GQ event in Los Angeles last week. The necklace features a faceted triangular glass crystals sparkle in this quintessential laying necklace. It transitions beautifully from day to night. Plus, you can add to several of our statement necklaces for that touch of sparkle!


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The Fayetteville Arsenal
, North Carolina
was built in 1838
because during the War of 1812
the United States government realized that the existing distribution of weapons and ammunition factories was not adequate for the defense of the country. A program was begun to provide more Federal arsenals which would be distributed so that no area of the country would be too far away from an arms depot. Bladen County Representative James McKay
introduced House Resolution #374 for inclusion of an arsenal at Fayetteville.
The cornerstone for the Arsenal was laid April 9, 1838. It was constructed of brick and stone and at each of the four corners of its massive walls was an octagonal tower. Entry into the Arsenal was controlled by use of massive iron gates. Workshops
, quarters and other buildings in the Arsenal were constructed of brick and wood.
When North Carolina seceded from the Union, Governor Ellis commissioned Warren Winslow to bring about the peaceful, if possible, surrender of the Arsenal at Fayetteville. General Walker Draughon, then in command of the North Carolina Militia, was given the order to take possession of the Arsenal.
He mobilized the Fayetteville Independent Light Infantry (FILI) (the oldest private military organization in the State, having been organized in 1793) under the command of Major Wright Huske, and the LaFayette Light Infantry, commanded by Capt. Joseph B. Starr. Other troops were used as well, and the total number of troops... Read More


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Collaboration industry expert, Ruben Romero, brought on as Managing Director of TAD Associates, West
November 7, 2017 —
TAD Associates is excited to welcome Ruben Romero as Managing Director for the West Coast. The addition of Romero fulfills TAD Associates’ long held ambition of a bi-coastal presence.
“I was attracted to TAD’s ability to view AV and other technology as a holistic part of its clients’ strategy,” said Romero. “I believe that technology should be a tool and a platform for experiences and collaboration. TAD Associates’ principles fall squarely in line with those beliefs.”
Romero brings to TAD 15 years…
TAD ASSOCIATES LAUNCHES UPDATED WEBSITE AND LAUNCHES A NEW BLOG
New York — October 5, 2017 — TAD Associates, a leader in strategic technology and design consulting, is excited to announce its redesigned website which showcases some of the phenomenal changes they’ve experienced this year.
The site tadassociates.net is the most recent update in an exciting year of growth and expansion for the firm, which has included new offices in Texas and California, the promotion of Rob Badenoch to Partner, and the creation of a digital content design offering and managed services. …
TAD specializes in creating functional, innovative and modern spaces by connecting Technology, Architecture and Design.


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Looking for easy Valentine crafts? These colorful paper heart spinners are a great way to practice cutting on a line and bilateral coordination skills!
Finding fun ways to practice scissor skills can be tough – it’s easy for kids to get frustrated and when they get frustrated, often they struggle with attention and effort. Practicing cutting on straight lines can be especially repetitive!
Today, we’re sharing an awesome way to put those cutting skills into action to create a fun, colorful heart spinner! This easy Valentine craft is perfect for the classroom, the therapy room, or home!
Easy Valentine Crafts: Heart Spinners
What you’ll need:
Yarn (2 pieces, each about 12″ long)
What to do:
Draw lines to create five 1″ strips of paper. Have kids cut on each line. Next, have kids cut all of the strips of paper in half – except one! So they’ll end up with 8 small strips and 1 long strip.
Fold the short strips into heart shapes and staple them along the long strip of paper in a row (see the video for a demonstration).
Trim off the top of the long strip of paper.
Punch holes at both ends of the craft. String a piece of yarn through each holes and tie knots to make a loop and keep them in place.
Check out the video below:
Hold the ends of the pieces of yarn – one in each hand with the hearts stretched out in between. Swing the hearts around gently to twist the pieces of string around themselves. Then, pull gently on both ends and watch the hearts spin!
How to change it up:
-My youngest kiddo made his spinner with only 3 hearts on it because he doesn’t sit for art projects for too long! It still worked great and looked cute!
-These can be rainbow colored like in the pictures/video or you can simplify by using just one piece of paper and cutting it into strips to make a spinner that is all one color.
For Virtual Sessions:
This craft is great for virtual sessions as long as there is a parent/caregiver who can help with the stapling! Try showing the video and pausing it to let the child complete each step along the way!
We hope you like this fun and easy Valentine craft! If you make your own heart spinner, we’d love to see!
Post a video or picture on Instagram (@insptreehouse) or Facebook and tag us!

domain: artistic