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# Piping and Hydrogen
# Which piping and tubes should I use for connecting modules?
For the water piping we use John Guest components as they are easy to source and cheap, but it is no requirement to stick with this brand. The hydrogen piping must be stainless steel, we use Swagelok tube fittings, as they are easier to tighten than thread fittings. From the water trap (on floor of container) a vent line with an inner diameter of 10 mm or more must go up into a safety area, different from the safety area the purge line goes into (could be at two opposite sides of the container for example).
# What is the AEM technology?
Enapter’s core product is the standardized and stackable anion exchange membrane (AEM) Electrolyzer. Electrolyzers use electricity to split water (H2O) into hydrogen (H2) and oxygen (O2) through an electrochemical reaction. At the heart of the Electrolyzer sits the electrolytic stack. The stack is made up of multiple cells connected in series in a bipolar design. Enapter's unique technology relates to the special design and operation of these cells, each comprising a membrane electrode assemble (MEA) made from a polymeric AEM and specially designed low-cost electrodes. The anodic half-cell is filled with dilute KOH (alkaline) electrolyte solution; the cathodic half-cell has no liquid and produces hydrogen from water permeating the membrane from the anodic half-cell. oxygen is evolved from the anodic side and transported out from the stack through the circulating electrolyte. The hydrogen is produced under pressure (typically 35 bar) and already extremely dry and pure (about 99.9%). Using Enapter’s auxiliary Dryer module, hydrogen is delivered at 99.999% purity. As hydrogen is generated, the anodic half-cell side is topped up with distilled water or purified tap/rainwater.
# What is the difference between Proton exchange membrane (PEM) and anion exchange membrane (AEM)?
Proton exchange membrane Electrolyzers (PEM) use a semipermeable membrane made from a solid polymer and designed to conduct protons. While PEM Electrolyzers provide flexibility, fast response time, and high current density, the widespread commercialization remains a challenge largely due to the cost of the materials required to achieve good lifetimes and performance. Specifically, the highly acidic and corrosive operating environment of the PEM Electrolyzer cells calls for expensive noble metal catalyst materials (iridium, platinum) and large amounts of costly titanium. This poses an insurmountable challenge to the scalability of PEM Electrolyzers.
The anion exchange membrane Electrolyzers use a semipermeable membrane designed to conduct anions. They are a viable alternative to PEM with all the same strengths and several key advantages that lead to lower cost:
AEM electrolysis works in an alkaline environment, where less expensive non-PGM1 catalysts have high stability. Therefore, PGM catalysts are not required.
Due to the less corrosive nature of the environment, stainless steel can be used instead of titanium for the bipolar plates.
AEM Electrolyzers can tolerate a lower degree of water purity, which reduces the complexity of the input water system and allows for the use of filtered rain and tap water. De-ionized water is not required.
# What is the difference between the traditional alkaline and AEM Electrolyzers?
Traditional liquid alkaline Electrolyzers have been on the market for quite a while and are relatively cheap. However, they are comparatively poor at responding to fluctuating power supply, and so it is difficult and costly to efficiently pair them with renewable energy sources. Traditional liquid alkaline Electrolyzers operate with highly concentrated electrolyte solutions and at low pressure. They require additional purification and compression steps to produce high quality gas at a higher output pressure. This is only cost-effective for centralized and monolithic multi-MW projects.
The AEM Electrolyzer builds on advantages from traditional alkaline Electrolyzers, but avoids its weaknesses:
AEM electrolysis works in a highly diluted alkaline environment and is therefore much safer to handle.
The AEM Electrolyzer can use similarly cost-efficient materials while making much purer hydrogen at higher efficiency.
The AEM Electrolyzer can fully ramp and is ideal to link up with variable renewable energy sources.
# What are the advantages of AEM over PEM and alkaline?
AEM electrolysis combines the benefits of PEM and traditional alkaline.
Flexible operation, safe due to the separation of H2 and O2
Low stack material cost
Low Balance of Plant (BOP) complexity and cost
High purity hydrogen production (highest efficiency compared to PEM and traditional alkaline)
# Where are the Electrolyzers made?
At the moment, all production takes place in Italy.
# Is your system CE certified?
The EL2.1 is CE certified.
No, our system is not designed to be installed in an ATEX area. During normal operation, there is no leakage of any hydrogen or oxygen gases from the system. The product gases are only released from the designated interfaces (H2 outlet, O2 vent, and H2 purge) that have to be correctly managed during the on-site installation. It is the project developers/installers responsibility to ensure that the area where the electrolyzers are installed must never contain any explosive atmospheres during any time of regular operation. An appropriate safety concept must be in place to mitigate the risks of any failures that could result in leakage of flammable gases. Such a safety concept could involve, for example, hydrogen sensors, forced ventilation, or natural ventilation.
# Is the pipeline in accordance with any certification?
We make all our hydrogen piping in accordance with ASME B31.12 for hydrogen piping and pipelines. All the European guidelines refer to the ASME, which is something like a “gold standard” for anyone working with hydrogen.
# Is an oxygen concentration sensor in the hydrogen needed on the tank/vessel/cylinder? Could there be a case where oxygen from the Electrolyzer comes in, resulting in an explosive atmosphere?
No, due to the differential pressure operation of the stack (H2 at 30 bar, O2 at atmosphere), it is not possible for meaningful concentrations of O2 to get out from the H2 outlet into the tank.
# Can the system itself introduce in the lab an ATEX area surrounding the Electrolyzer (implying specific requisites for other equipment installed)? Is it necessary to have the H2 outlet with a weldable connection, as to avoid the formation of a potentially dangerous (ATEX) zone in the area surrounding the system?
The Electrolyzer normally has a standard ¼” Swagelok bite-type Stainless Steel connector for the hydrogen outlet piping. The outlet pipe is protected internally by relief and check valves from any gas flow backwards into the machine from the external tank/H2 distribution lines. We don’t believe it is necessary to weld the connection to avoid ATEX – it is quite typical to have these Swagelok connections in gas piping in laboratories. However, this may change with local rules and regulations.
The only thing to note in terms of safety areas is that the Electrolyzer system has two outlets that need to be connected to a safe area without any ignition sources. The first is the oxygen vent, which consists of 250NL/hr of oxygen gas at atmospheric pressure and may also contain some water and a very small percentage of hydrogen. The other is the hydrogen purge pipe, from which the Electrolyzer releases the pressurized hydrogen gas after a system shutdown – here, it releases about 10NL of hydrogen gas at 35 bar into the atmosphere within about 2 seconds.
1: Platinum Group Metals
2: ATmospheres EXplosible

domain: chemistry


text: On October 25, 2021, the Government of Ontario introduced Bill 27, Working for Workers Act, 2021 in the Legislative Assembly. If passed, Bill 27 would create significant new employer obligations and rights for workers in Ontario. The government has also proposed an hourly minimum wage increase to $15. How will these changes affect businesses? To help us clarify the legalities is Jonathan Borelli. Jonathan is a labour lawyer with Mississauga based law firm Keyser Mason Ball.

domain: news


text:
Actress Salma Hayek posted a photo of herself on Instagram with a colorful rainbow painted on her face. Why?
Salma captioned the unusual pic: ‘I painted this rainbow on my face because many people are using rainbows to symbolize unity and hope, and to thank the #NHS and all the health workers around the world for their courage and endurance.’
But this new rainbow initiative also provides meals for hungry families since for each tagged post, ‘@yumi will donate a month’s worth of meals to @FeedingAmerica to help support families in need. ‘

domain: sociology


Thursday, May 19, 2016
Review Thursday: Rubicon Stuart
The second of 4 reviews to come from the Rubicon tanks that I received from Jamie. Speaking with Jamie about it, it seems that this kit is at the behest of the community. Something that had a bit more variety than the ones that exist from other companies today, and Rubicon listened!
I will preface this one with.. I love this kit. But let me go into detail on why.. and understand that now I am looking at how to put more of them into my lists moving forward :D
Am also going to say that this is the only kit that I do not have from Warlords already to compare against.
Right away we can see this to be a simpler kit as there are only 2 sprues, the instructions, and transfers.
Right away for some reason I switched up to build the turret first. I had the option for a closed hatch,but decided to keep it open. I like the idea of a commander sticking out of it. Something of the light tanks having someone popping out of them is always fun, and you see them a lot in the photos.
The gaps though on the top there will be needing some filling. Probably the only part I am not the happiest about to be fair. But a simple fix all the same.
The tracks were pretty straightforward to assemble as well. I like that there is so much details even on the inside sections which will never be seen, but add so much to the kit. It is why I love this kit the most out of the 4 ( shhh forget this point when I write up the next 2 :) ). But I will explain on why I love it the most after the next parts are shown..
But seeing each section of the track undercarriage, with each going together really easy. Hardest part is probably the end spoke gears, and that was based on how they were attached to the sprues. But a sharp knife can cut them clean.
The parts for the lower half of the tank fit like a glove, and the lower section is there for if you want to take it as a kangeroo recce instead of the turret variety. Allowing you to put some models standing up perhaps there?
But at this point I was seeing that I could keep the tracks off for a bit until I got the top part done and if I could paint it in sub-assembly pieces.
All together... many little pieces requires for the front of the hull there. Everything was a bit snug overall, but fit nicely overall.
But this is what I love about this kit so much is that the pieces all are able to work separately, allowing for the chance to paint each section with greater detail. Something that the other kits might take a liking to actually and make it so that some truly great paint jobs can be made from them ( not mine, but maybe Jamie's? ). But also means that you can paint the inside sections for the variants easy enough, and enhance the quality of the piece quite a bit!
The only thing I have not assembled so far however is the Kangeroo variant ring that consists of an HMG and 3 MMGs. Might have to check the rules on how that might work out, and if it is any good in game.
Here it is sitting beside the Crusader from the same company. However if I were to do a comparison to the Warlords version I would have to say categorically that this one will win out.
Why? Well cause with, again, the variants of it gives it more flexibility. But when looking at the costs of it, you can get it for 18 gbp at North Star Figures or get the static resin copy from Warlords for 21 gbp. Seems like a no brainer for me here.. and one that I suspect you will see more of these gracing my desk in the near future. Just have to figure out how to use these vehicles, and where to use them in a tank wars list ;)
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9) Protecting and Houses The Artwork
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I’m which have a challenge. I’d received a photo album to possess X’mas present and all sorts of the fresh sleeves was torn away from the center binder. So what can I actually do?
It’s great that you’ve gotten a photo album record given that a xmas present. I’m thinking exactly what you received might be an excellent D-ring photo album record album in which you’ll have to open up the three bands for the binder and you may insert the new page protectors (plastic material arm) on the step three exposed bands and video her or him personal to hold this new page protectors.
You will have to carry out photo album pages and you can input per style towards the all the web page protectors. Every page protectors can hold a couple pages/pictures, back and front.
You will find videos I’ve found where you could go through the different types of photo album records and you may pick one which your has available. Pledge it will help!
I’m trying to make a photo album out-of photographs of myself and you may my personal spouse, and i also want suggestions for this because really we have little idea exactly what I’m doing hahah.

domain: hobby


text:
Unfinished Peace – Victims and Survivors Issues
Members of the Victims and Survivors Forum will discuss the Stormont House Agreement and the dilemma of meeting individual victims needs while also working for the ‘greater good’. They will also address the strength of working together – no matter who they are and no matter who harmed them. Chair: Judith Thompson, Victims Commissioner.
Supported by Healing Through Remembering and the Commission for Victims and Survivors NI


Download Hotkid – Star Lomo MP3 Audio
Nigerian talented singer and songwriter, Hotkid has released a new single titled Star Lomo.
This is a follow-up to his previous single titled Oga Mi Sir and it is available for download on this platform.
Listen and Download below
Hotkid – Star Lomo
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on line 691
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text:
The History of Gun Control in America
From the Sullivan Act in the early 20th Century to the Assault Weapons bans of today
Since 1911, politicians and activists have tried to pass laws restricting access to guns, thinking that this will somehow take them out of the hands of criminals.
It is the contention of this article that the majority of gun control supporters in this country are under the mistaken assumption that taking guns away from law-abiding citizens will somehow reduce crime. They seem to believe that banning guns somehow takes them out of criminals hands. In our research on the subject, we found that this is anything but the case.
The History of Gun Control in America is a lengthy one, so we have condensed it as well as we could possibly manage. We'll discuss the major incidents throughout the history of both the United States and the world that have shaped gun control over the years. In writing this novella, it became apparent just how bizarre some of these events were and stranger still occasionally was the reaction by the people and legislators — and what they thought that the proper course of action was to respond to these events.
At times, this brief history seems like a fictional tale of lawmaking gone wrong. Although it is 100% true, many readers have made comments like, "Why did they possibly think that would work?"
But relax and sip your favorite brew as you go through these pages. Some parts may anger you, but the last chapter is well worth the wait. The end is far rosier than the journey to get there, as the Twenty-First Century has seen unprecedented gun rights bloom throughout this great nation, as well as the resulting drop in crime that any country with expanding freedom inevitably enjoys.


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Born in 1947 in Blackpool, Prior spent her teenage years in St. Albans where, in the early '60s, she befriended a small crew of musicians who had coalesced to form a scene around the Cock Pub. Among them were Donovan Leitch and a fingerpicking guitarist named Mac MacLeod; Prior and MacLeod briefly formed the folk duo Mac Maddy. By 1966, she had begun working with another musician from the St. Albans scene, Tim Hart, and together they recorded a pair of traditional albums called Folk Songs of Olde England, Vol. 1 and 2. Their powerful vocal blend and Hart's acumen on a variety of folk instruments earned them some attention around the London scene and in late 1969 they were approached by former Fairport Convention bassist Ashley Hutchings, who was looking to start a new folk-rock band.
Steeleye Span made their debut in 1970 with Hark! The Village Wait, an album which introduced their intricate vocal blend and often hard-driving instrumental take on traditional U.K. fare. While the band's membership would shift a number of times throughout their many decades together, it was Prior's distinctive voice and infectious charisma that remained constant through nearly every phase of their career. Although she and Hart recorded one more outing as a duo -- 1971's enchanting Summer Solstice -- Steeleye Span went on to become one of Britain's most visible and commercially successful groups of the folk-rock boom, landing a surprise hit with their a cappella rendering of the late renaissance piece "Gaudete" and later with 1975's more pop-driven "All Around My Hat." By the latter part of the '70s, Prior had wed Steeleye Span bandmate Rick Kemp and begun to branch out on her own, first collaborating with fellow folk singer June Tabor on 1976's highly regarded Silly Sisters album, then launching a solo career with 1978's Ian Anderson-produced Woman in the Wings. A second album, Changing Winds, appeared later that same year, making use of what had turned into a contentious Steeleye Span hiatus.
Prior and the rest of Steeleye Span were convinced to reunite in 1980 for their 11th studio outing, Sails of Silver, after which they essentially became a part-time touring band for the first half of the '80s. Prior and Kemp raised a family together, touring here and there and recording 1982's Hooked on Winning and Going for Glory as the Maddy Prior Band. Unlike most of Steeleye Span's output throughout the years, her solo albums were focused more intently on original material. This trend continued when they reunited for 1986's Back in Line, which included the Prior/Kemp original "Lanercost." That same year, Prior began working in an early music consort called the Carnival Band and they recorded A Tapestry of Carols, the first of many collaborations devoted to ancient music. In 1988 she and Tabor briefly resumed their partnership as Silly Sisters with No More to the Dance, followed in 1989 by another Steeleye Span album, Tempted Tried.
Heading into the '90s, Prior continued to maintain a busy schedule, releasing a duo album with Kemp, Happy Families, as well as another solo album in 1993's Year. In between these were two more outings with the Carnival Band, which at this point had become her more dominant project. Following two more mid-'90s Carnival Band releases, Prior experienced some difficulties with her vocal range, causing Steeleye Span to re-enlist another founding member, Gay Woods, to join her as co-vocalist. The 1996 album Time marked the two singers' first appearance together since the band's 1971 debut. Not long after its release, Prior shocked fans and left Steeleye Span, who opted to carry on with Woods acting as lead singer on their next two albums. Free from commitments to her longtime band, Prior began touring annually with the Carnival Band around Christmas time and devoted herself to recording a pair of ambitious solo albums in 1998's Flesh and Blood and 1999's Ravenchild, each one dealing in mythology and produced by Nick Holland and multi-instrumentalist Troy Donockley.
Following 2000's live album Ballads and Candles, Prior resumed her intensely creative solo run in the studio with Holland and Donockley, first issuing 2001's song cycle Arthur the King, then 2003's Lionhearts. She also found time for another Carnival Band release and a 2002 album called Under the Covers with her daughter, Rose Kemp, and friend Abbie Lathe which was credited to Maddy the Girls. She rejoined Steeleye Span in 2004 after eight years away, and recorded They Called Her Babylon as well as their first Christmas album, Winter. Throughout the remainder of the decade, Prior managed an astonishingly prolific output, recording two more albums with Steeleye Span, three with the Carnival Band, and another with Maddy the Girls, all the while helping to run the Stones Barn Arts Centre in Cumbria which she founded in 2003. Following 2007's live DVD The Quest, she recorded the more traditionally minded solo outing Seven for Old England in 2008, which heavily featured former Steeleye Span bandmate, accordionist John Kirkpatrick and his son Benji.
Early in the next decade, Prior formed a new trio with Carnival Band fiddler and piper Giles Lewin and accordionist Hannah James. Minimalist in set-up, but bolstered by strong playing and Prior's still-agile vocals, the trio recorded 3 for Joy in 2012. A year later, Steeleye Span enjoyed their first chart placement in decades with Wintersmith, an ambitious conceptual album on which they collaborated with fantasy writer Terry Pratchett. After another outing with the band, 2016's Dodgy Bastards, Prior resumed her trio work with Lewin and James for 2017's Shortwinger. Celebrating the 50th anniversary of her longtime band, Prior and Steeleye Span headed out on a major tour of England in 2019. ~ Timothy Monger, Rovi
The only App that can give you results through singing and humming search!

domain: entertainment


text:
WWE Roadblock: End of the Line Full Movie On XMovies8: Roadblock: End of the Line was a professional wrestling pay-per-view (PPV) event and WWE Network event produced by WWE for the Raw brand and the new cruiserweight-exclusive brand, 205 Live. It took place on December 18, 2016, at the PPG Paints Arena in Pittsburgh, Pennsylvania.
IMDB Rating: 5.9/10
Director: Kevin Dunn
Released Date: 18 December 2016
Time: 90 min


As Newcastle enters the Christmas period a strange calm has lowered over Tyneside. Registering four consecutive wins would typically arouse the kind of giddy excitement and anticipation expected only for Christmas day itself. But while various paper based outlets are poking thoughts of another European campaign, the caution amongst supporters is more palpable.
Any given man who enjoys a cautious bet on soccer would have taken the quartet of league fixtures falling from a desperately lacking loss to Sunderland as seven points at best; many viewing that as an optimistic prospect itself. However, the bizarrely erratic performances stretching from August have settled sharply to a smoother more disciplined format where grinding out results has been the order of the day. Whether by design or accident, the strategy has concluded a round of fixtures with a healthy points tally (and healthy squad) to take into the fast flowing Christmas period.
Although players and management alike deserve plaudits for this – some individually, and collectively – the period has also benefited richly from fortunate circumstance needed when attempting to build form – something that deserted NUFC for pretty much the entirety of the season previous. Indeed it may be the events of last season still fresh in the mind that have kept attitudes cautious – or perhaps it’s that despite the comfort of a points tally better than the reigning champions, after a third of the season, the football played hasn’t been exactly been emphatic. A goal difference of +1 is the lowest by comfortable margin to all other teams in positive figures – the problems of scoring goals may have been mostly solved by Loic Remy, but frequently conceding them remains an issue that should not be ignored, even if the results are favourable.
And why not? Should constructive criticism of a winning side be denied simply because the result was 3pts? The win at Tottenham could still be fully enjoyed with a frank and brutal assessment once the day had past of why Tim Krul had so many saves to make – whilst equally appreciating the cutting counter attacks made in the first period that lead to the winning goal. Without honest appraisals of wins as well as defeats we restrict ourselves to at most half of what we could learn – and even if the there is nothing to be gained – an opposition simply too good for us, or a bad day at the office, at least the exercise of review has been conducted with proactive intent in mind.
Even with this mentality however, there is obviously a limit to what this squad can achieve, realistically. The argument that on our day we can take any team at home has weight, although can be misleading in terms of ability when considering the same boost of motivation and effort is what facilitates cup upsets. However, with the team now looking far more settled and solid (if not spectacular), Alan Pardew has a platform to build from with January approaching – and in patches of the team some very real ability. The 442 system stuck with recently may be tied together somewhat loosely – relying up the fitness of Shola Ameobi and the improvisation of Sissoko and Gouffran as wingers – but the important fact is it is a system that is working with more consistency than has been seen of late.
Pardew has made no secret of his preference to play 442, and although this stubbornness has caused us problems before, now is his perfect time to take the successes of our recently starting XI and buying the correct players to improve it. This may mean sacrificing assets such as Papiss Cisse and Hatem Ben Arfa, who would very likely move on to play well elsewhere – and in the latter’s case be very unpopular – but best for the club if the finances were properly invested (a big if). Ultimately genuine rather than accidental progress is more likely to come down to the willingness of Mike Ashley to loosen his highly restrictive grip upon the club – but beyond that, being honest with ourselves wouldn’t be the worst place to start.


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A subanalysis of a successful algorithm-driven primary care–based diabetes disease management program examines the relationships among patient characteristics, labor inputs, and improvement in A1C level.
To examine the relationships among patient characteristics, labor inputs, and improvement in glycosylated hemoglobin (A1C) level in a successful primary care—based diabetes disease management program (DDMP).
We performed subanalyses to examine the relationships among patient characteristics, labor inputs, and improvement in A1C level within a randomized controlled trial. Control patients received usual care, while intervention patients received usual care plus a comprehensive DDMP.
The primary outcome was improvement in A1C level over 12 months stratified by intervention status and patient characteristics. Process outcomes included the number of actions or contacts with patients, time spent with patients, and number of glucose medication titrations or additions.
One hundred ninety-three of 217 enrolled patients (88.9%) had complete 12-month followup data. Patients in the intervention group had significantly greater improvement in A1C level than the control group (−2.1% vs −1.2%, P = .007). In multivariate analysis, no significant differences were observed in improvement in A1C level when stratified by age, race/ethnicity, income, or insurance status, and no interaction effect was observed between any covariate and intervention status. Among intervention patients, we observed similar labor inputs regardless of age, race/ethnicity, sex, education, or whether goal A1C level was achieved.
Among intervention patients in a successful DDMP, improvement in A1C level was achieved regardless of age, race/ethnicity, sex, income, education, or insurance status. Labor inputs were similar regardless of age, race/ethnicity, sex, or education and may reflect the nondiscriminatory nature of providing algorithm-based disease management care.
(Am J Manag Care. 2010;16(1):42-48)
Incorporation of a diabetes disease management program (DDMP) into the primary care setting can aid in addressing diabetes care disparities, reflecting the nondiscriminatory nature of algorithm-based care.
More than 20 years ago, the US Department of Health and Human Services issued their Report of the Secretary’s Task Force on Black and Minority Health.1 This study documented many health disparities and sparked efforts to improve the health and healthcare of vulnerable populations and to raise awareness and concern for health disparities research.2-4 Disparate trends in care across various groups have been noted, including racial/ethnic minorities, as well as women, children, older adults, and other potentially vulnerable populations. Despite this research and advocacy, health disparities persist across a wide spectrum of disease processes, clinical settings, and populations within the United States. According to the 2007 National Healthcare Disparities Report,5 some disparate trends are improving, such as rates of cholesterol control among racial/ethnic minorities; however, many are in major need of improvement, particularly in the areas of diabetes care and chronic disease management.
The Agency for Healthcare Research and Quality (AHRQ) has identified several priority groups that serve as targets for health disparities research and quality improvement. These groups include racial/ethnic minorities, persons with low incomes, women, children, older adults, those with disabilities, and rural inhabitants.5,6 In general, members of these priority groups along with those who have less education and no private insurance are more likely to receive poorer quality of care and to experience greater barriers in terms of access to care compared with their respective counterparts.5 For example, compared with white patients,7 Hispanic and lower-income patients with diabetes mellitus are less likely to receive the recommended services for diabetes care such as timely measurement of lipid levels and glycosylated hemoglobin (A1C) levels, and black patients have higher rates of many of the complications of diabetes such as admissions for lower extremity amputations.8 Although studies performed by Trivedi et al9 and by Chin et al10 have demonstrated that quality improvement measures can lead to reduced disparities in some diabetes-related processes of care, it has been more difficult to influence outcome measures such as attainment of goal blood glucose control (as measured by A1C level).11 Findings from recent studies9,12 have also suggested that disparities in diabetes care may be related to patient characteristics, provider characteristics, or system-level factors.
Disease management programs have been shown to be successful in improving care for patients with diabetes,13-17 and there is growing interest in the usefulness of such models in addressing healthcare disparities.12,18,19 However, little is known about the specific effect of disease management programs on disparate trends and particularly on their ability to provide unbiased care and to improve patient outcomes equally across priority groups. Results of a successful primary care—delivered algorithm-based diabetes disease management program (DDMP) have been previously reported.16 Evaluation of this program within a randomized controlled trial demonstrated significant improvements in A1C level, blood pressure, aspirin use, patient satisfaction, and other measures.16 The program was also found to require modest labor inputs.16,20,21 In the present study, we performed a subanalysis of this program to examine the relationships among patient characteristics, labor inputs, and improvement in A1C level, with a particular focus on evaluating the potential usefulness of programs such as this to influence the care and outcomes for patients considered to be within an AHRQ-defined priority group and for patients with less education or no private insurance.
We performed a randomized controlled trial of a DDMP among 217 patients with type 2 diabetes mellitus and poor glucose control (A1C level ≥8%) in an academic primary care practice. Details of the trial have been previously published.16,20,21 Patients in the intervention group received care from their primary care provider supplemented by a DDMP. The program included intensive management from clinical pharmacists and from a diabetes care coordinator who provided diabetes education, applied algorithms for treating glucose level abnormalities and decreasing cardiovascular risk, used an electronic registry to proactively identify patients in need of additional care, and addressed barriers to care. Treatment algorithms provided guidance on when to contact patients and information about titration or addition of new medications for glucose control and cardiovascular risk reduction. Control patients received a one-time disease management session from pharmacists, followed by usual care from their primary care provider. The primary outcome was improvement in A1C level over 12 months. The study was performed and subsequently analyzed with approval from the University of North Carolina at Chapel Hill and Vanderbilt University institutional review boards. Written consent was obtained from all study participants.
To estimate resources required for the DDMP, the study team documented process measures for all intervention patients. These “labor inputs” included the following: (1) minutes spent by the disease management team in direct contact with a patient or in activities related to patient care, (2) number of contacts with a patient, and (3) number of patientspecific glucose medication titrations or additions. These measures captured the labor of the DDMP and did not include any actions taken by the patient’s primary care providers.
All analyses were performed using commercially available statistical software (Stata 8.0; StataCorp LP, College Station, TX), and a 2-sided significance level of 5% was used for statistical inference. Baseline differences between intervention and control groups were determined using Wilcoxon rank sum test for continuous outcome variables and X2 test for categorical outcome variables. We examined the relationship between patient characteristics and improvement in the median A1C level using multivariate quantile regression analysis. Quantile regression modeling was chosen for this subanalysis because we report the median changes for each outcome of interest. The median reporting was required because of additional data stratification and subsequent changes in sample sizes. This should be contrasted with how the program was evaluated in previous publications.16,21 For each patient characteristic (age, race/ethnicity, sex, education, income, and nsurance status), we performed a separate model that included the study status, the patient characteristic in question, and an interaction term to evaluate the potential modifying effect of intervention status and the patient characteristic in question on change in A1C level. Patient characteristics were dichotomized based on priority criteria of the 2007 National Healthcare Disparities Report5 (with age dichotomized at 65 years [older adults], race/ethnicity as white vs nonwhite, and household annual income at $10,000). Education was dichotomized at less than high school and insurance as private versus nonprivate. We used Wilcoxon rank sum test to examine the relationship between each of the labor inputs (median time spent with patients, median number of actions or contacts with patients, or median number of glucose medication additions or titrations) and each of the aforementioned patient characteristics. We also used Wilcoxon rank sum test to analyze the relationship between each of 3 labor inputs and attainment of goal A1C level (≤7%) at 12 months of follow-up. Finally, we examined the relationship between each of 3 labor inputs and improvement in the median A1C level using multivariate quantile regression models for each labor input, with each model adjusting for the aforementioned patient characteristics.
From February 2001 to April 2002, 217 patients were enrolled. Complete follow-up data were available for 193 patients (88.9%) at 12 months. Baseline demographics revealed diversity, with substantial sociodemographically vulnerable participants having poor diabetes control. Most nonwhite participants were African American. Intervention and control patients generally had similar characteristics (). The A1C levels improved significantly more for intervention than control patients during the trial (). From baseline to 12 months, control patients had a median 1.2% decrease in A1C level, whereas intervention patients had a median 2.1% decrease (difference, 0.9%; 95% confidence interval, 0.6%-1.3%; P = .007).
There was no significant difference in improvement in the median A1C level when stratified by age, race/ethnicity, sex, income, or insurance status (Figure and ). There was slightly greater improvement in the median A1C level among women compared with men (−1.2% vs −0.5%) and among those with less than a high school education compared with those with at least a high school education (−1.1% vs −0.8%). Results of multivariate quantile regression analysis did not reveal any significant interaction effect on improvement in A1C level between participants’ intervention status and each of the respective patient characteristics of interest.
Among intervention patients, there were no differences in labor inputs (median time spent with patients, median number of actions or contacts with patients, or median number of glucose medication titrations or additions) when stratified by age, race/ethnicity, sex, or education (). The disease management team had significantly more contacts and spent more time with patients having a household annual income less than $10,000 or no private insurance. There were no observed differences in each of 3 labor inputs when stratified by patients obtaining the goal A1C level of 7% or less at the end of the trial. In multivariate analysis, there was no significant relationship between each of 3 labor inputs and improvement in the median A1C level when adjusted for age, race/ethnicity, sex, education, income, and insurance status.
In this subanalysis of our DDMP, a successful reduction in blood glucose (A1C) level was achieved irrespective of race/ethnicity and other important sociodemographic factors. Our findings were not influenced by the observed differences at baseline in terms of age and insurance status between the control and intervention groups. Also, none of the priority sociodemographic factors analyzed had a significant modifying effect with DDMP participation on improvement in A1C level. The time spent by the disease management team for intervention patients was provided similarly regardless of age, race/ethnicity, sex, or education. Improvement in A1C level did not require additional labor inputs compared with patients who did not show significant improvement when adjusted for patient characteristics. Our findings suggest that DDMPs may serve as a tool for providing equal quality of care and for addressing the current disparate trends in care often experienced by many of the AHRQ priority groups with diabetes.
The etiology of racial/ethnic and other socioeconomic disparities in diabetes and other chronic illness care is likely multifactorial. Disparities in provider behavior may be an important component. Sequist and colleagues22 recently conducted a provocative study in which they reported on variations in diabetes-related outcomes at the level of individual physicians. They examined a 14-site primary care group practice that used an integrated electronic medical record system and found significant within-physician variation between the percentages of white and black patients who were able to achieve recommended levels of glycemic, blood pressure, and lipid control. Patient sociodemographic factors accounted for a relative range of 13% to 38% of the observed racial/ethnic differences, whereas within-physician effects (ie, racial/ethnic disparities observed within the same physician panel) accounted for 68% to 75% of the observed differences. A study by Schulman and colleagues23 that surveyed 720 physicians eliciting recommendations regarding cardiac catheterization found that sex and race/ethnicity independently influenced how physicians managed their patients, with many physicians surveyed being less likely to recommend needed catheterizations among women or nonwhite patients.
One reason for the success of our program in improving care regardless of socioeconomic status may be the ability of disease management to eliminate potential disparities in provider-level behavior. The nondiscriminatory nature of providing algorithm-based care may serve as a means by which health systems could ensure delivery of effective and unbiased care, while accounting for and addressing the frequent special needs that arise when caring for traditionally vulnerable patient populations. As we observed in our program, this could be achieved through management practices that allowed for patient-centered approaches to care as individualized needs become evident (described herein). The use of a team approach to care with midlevel providers and a care coordinator working together with primary care physicians may also help to prevent provider-level disparities.
Our disease management team spent slightly more time among patients with lower income or no private insurance. This additional time may have been related to addressing economic barriers to attaining medications and other clinical care. More research is needed to better understand the resources required to achieve successful outcomes across all priority groups. In the present analysis, we also found that women and participants with less education showed slightly greater benefit from the intervention. Greater improvement in glycemic control among patients with less education and among women is more likely to reflect differences by intervention status rather than by education or sex. This was supported by the absence of an interaction effect between these variables and patient status with A1C level and should be contrasted with the previously reported analysis showing that patients having lower literacy had significantly more improvement in glucose control compared with those having higher literacy.20 Significant improvement in glycemic control based on literacy level may have been related to the fact that our intervention included several approaches to address literacy, including the use of simplified communication, the “teach back technique” for confirming patient understanding, lowerliteracy materials, and a care coordinator who confronted many social barriers.20 An approach in which individualized physician care of patients with diabetes is supplemented with an adequately tailored and focused chronic DDMP may be an important approach in eliminating disparate trends.
Several limitations were inherent in our study. Our sample size was small, and we may have lacked adequate power to detect differences based on patient characteristics alone. In addition, our documented labor inputs characterize time spent with patients by the disease management team and do not include time spent by primary care providers or the patients or utilization of clinical services or other resources. Furthermore, the time spent by the management team included some actions that were considered “outside” of the algorithm, such as discussion of certain medication changes with providers. As previously reported,21 discussion with providers was required for 112 of 500 drug titrations and for 233 of 348 new drug additions. The time required by such actions would be difficult to predict if our program was repeated. The generalizability of our findings is also reduced by the fact that our study was conducted at a single-site academic institution and did not have adequate representation of several racial/ethnic minorities such as Latinos. Furthermore, our participants at entry had poorly controlled diabetes, and it is arguable that the magnitude of our findings would be lessened if repeated in a population with better baseline control. Finally, although we believe that the algorithm-based care was a major factor contributing to the balanced improvement in A1C level across the priority groups, it remains a possibility that our findings were influenced by regression toward the mean or by the fact that our study did not find many clinically significant racial/ethnic disparities on baseline evaluation of our study population. One may argue that, if such disparities were in fact observed, our results may have differed in their magnitude. There may be other factors associated with the intervention that could have contributed to the similar improvements. For example, we focused on patient self-management skills and provided assistance with obtaining medications. These efforts combined with aggressive treatment using algorithmbased care might have had synergistic effects among certain individuals.
We do not go so far as to suggest that our program has eliminated racial/ethnic disparities but are confident that none were created among participants who received our intervention. A disease management program integrated into primary care can be a successful model for improving care among vulnerable patients with significant barriers. Emphasis on algorithm-based treatment and on team approaches to care can result in improvements regardless of race/ethnicity, sex, education, or other characteristics and represents an important tool for addressing healthcare disparities. Future research about the role of disease management to address health disparities in diabetes and other chronic illnesses is clearly indicated.
Author Affiliations: From the Division of General Internal Medicine (ROW), Meharry Medical College, Nashville, TN; the Division of General Medicine and Epidemiology (DAD, RMM, MPP), and the Division of Pharmacy Practice and Experiential Education (RMM), University of North Carolina at Chapel Hill; and the Division of General Internal Medicine and Public Health (CYO, RLR), Vanderbilt University Medical Center, Nashville, TN.
Funding Source: This study was completed with support from the Robert Wood Johnson Clinical Scholars Program, the University of North Carolina (UNC) Program on Health Outcomes, the UNC Division of General Internal Medicine, the Vanderbilt Center for Health Services Research, and the Vanderbilt Diabetes Research and Training Center (P60 DK020593), by grant NCRR NIH 5R25RR017577 from Meharry CRECD program (Dr White), and by grant R25RR017577-08S1 from ARA Supplement (Dr White).
Author Disclosure: Dr Rothman reports serving on the Clear Health Communication Fellowship Advisory Board for Pfizer, Inc. The other authors (ROW, DAD, RMM, CYO, MPP) report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.
Authorship Information: Concept and design (DAD, RMM, MPP, RLR); acquisition of data (DAD, RMM, MPP); analysis and interpretation of data (ROW, DAD, MPP, RLR); drafting of the manuscript (ROW, CYO, RLR); critical revision of the manuscript for important intellectual content (ROW, DAD, CYO, MPP, RLR); statistical analysis (ROW, RLR); provision of study materials or patients (RLR); obtaining funding (RLR); administrative, technical, or logistic support (RMM, MPP); and supervision (RLR).
Address correspondence to: Richard O. White, MD, Division of General Internal Medicine, Meharry Medical College, 1005 Dr DB Todd Jr Blvd, Nashville, TN 37208. E-mail: firstname.lastname@example.org.
1. Task Force on Black and Minority Health. Report of the Secretary’s Task Force on Black and Minority Health. Washington, DC: US Dept of Health and Human Services; 1985.
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3. Betancourt JR, Maina AW, Soni SM. The IOM report Unequal Treatment: lessons for clinical practice. Del Med J. 2005;77(9):339-348.
4. Nickens H. Report of the Secretary’s Task Force on Black and Minority Health: a summary and a presentation of health data with regard to blacks. J Natl Med Assoc. 1986;78(6):577-580.
5. Agency for Healthcare Research and Quality. 2007 National Healthcare Disparities Report. Rockville, MD: US Dept of Health and Human Services; 2008.
6. Nelson A. Unequal treatment: confronting racial and ethnic disparities in health care. J Natl Med Assoc. 2002;94(8):666-668.
7. Cheng EM, Chen A, Cunningham W. Primary language and receipt of recommended health care among Hispanics in the United States. J Gen Intern Med. 2007;22(suppl 2):283-288.
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9. Trivedi AN, Zaslavsky AM, Schneider EC, Ayanian JZ. Trends in the quality of care and racial disparities in Medicare managed care. N Engl J Med. 2005;353(7):692-700.
10. Chin MH, Cook S, Drum ML, et al; Midwest Cluster Health Disparities Collaborative. Improving diabetes care in Midwest community health centers with the Health Disparities Collaborative [published correction appears in Diabetes Care. 2004;27(8):2099]. Diabetes Care. 2004;27(1):2-8.
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12. Peek ME, Cargill A, Huang ES. Diabetes health disparities: a systematic review of health care interventions. Med Care Res Rev. 2007;64(5 suppl):101S-156S.
13. Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003;348(5):383-393.
14. Knight K, Badamgarav E, Henning JM, et al. A systematic review of diabetes disease management programs. Am J Manag Care. 2005;11(4):242-250.
15. Norris SL, Nichols PJ, Caspersen CJ, et al. The effectiveness of disease and case management for people with diabetes: a systematic review. Am J Prev Med. 2002;22(4 suppl):15-38.
16. Rothman RL, Malone R, Bryant B, et al. A randomized trial of a primary care—based disease management program to improve cardiovascular risk factors and glycated hemoglobin levels in patients with diabetes. Am J Med. 2005;118(3):276-284.
17. Wagner EH, Glasgow RE, Davis C, et al. Quality improvement in chronic illness care: a collaborative approach. Jt Comm J Qual Improv. 2001;27(2):63-80.
18. Cavanaugh K, White R, Rothman R. Exploring disease management programs for diabetes mellitus: proposal of a novel hybrid model. Dis Manage Health Outcomes. 2007;15(2):73-81.
19. Littenberg B, MacLean CD. Mandated diabetes registries will benefit persons with diabetes. Arch Intern Med. 2008;168(8):797-799, 802-803.
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domain: literature


text:
A single, moderate workout may immediately change how our brains function and how well we recognize common names and similar information, according to a promising new study of exercise, memory and aging. The study adds to growing evidence that exercise can have rapid effects on brain function and also that these effects could accumulate and lead to long-term improvements in how our brains operate and we remember.
Until recently, scientists thought that by adulthood, human brains were relatively fixed in their structure and function, especially compared to malleable tissues, like muscle, that continually grow and shrivel in direct response to how we live our lives. But multiple, newer experiments have shown that adult brains, in fact, can be quite plastic, rewiring and reshaping themselves in various ways, depending on our lifestyles.
Exercise, for instance, is known to affect our brains. In animal experiments, exercise increases the production of neurochemicals and the numbers of newborn neurons in mature brains and improves the animals’ thinking abilities. Similarly, in people, studies show that regular exercise over time increases the volume of the hippocampus, a key part of the brain’s memory networks. It also improves many aspects of people’s thinking.
But substantial questions remain about exercise and the brain, including the time course of any changes and whether they are short-term or, with continued training, become lasting.
That particular issue intrigued scientists at the University of Maryland. They already had published a study in 2013 with older adults looking at the long-term effects of exercise on portions of the brain involved in semantic-memory processing.
Semantic memory is, in essence, our knowledge of the world and culture of which we are a part. It represents the context of our lives — a buildup of common names and concepts, such as “what is the color blue?” or “who is Ringo Starr?”
It also can be ephemeral. As people age, semantic memory often is one of the first forms of memory to fade.
But the Maryland scientists had found in their earlier study that a 12-week program of treadmill walking changed the working of portions of the brain involved in semantic memory. After four months of exercise, those parts of the brain became less active during semantic-memory tests, which is a desirable outcome. Less activity suggests that the brain had become more efficient at semantic-memory processing as a result of the exercise, requiring fewer resources to access the memories.
Now, for the new study, which was published in April in The Journal of the International Neuropsychological Society, the scientists decided to backtrack and parse the steps involved in getting to that state. Specifically, they wanted to see how a single workout might change the way the brain processed semantic memories.
So, they recruited 26 healthy men and women aged between 55 and 85, who had no serious memory problems and asked them to visit the exercise lab twice. There, they rested quietly or rode an exercise bike for 30 minutes, a workout the scientists hoped would stimulate but not exhaust them.
Afterward, the volunteers lay inside an M.R.I. brain scanner and watched names flash across a computer screen overhead. Some of the names were famous, such as, say, Ringo Starr, while others were lifted from the local phone book.
Famous names are an important element of semantic memory, and the volunteers were asked to press one key onscreen when they recognized celebrities’ names, and a different key when the name was unfamiliar. Meanwhile, the researchers tracked their brain activity over all, as well as in the portions involved in semantic-memory processing.
The scientists had expected that the areas needed for semantic memory work would be quieter after the exercise, just as they were after weeks of working out, says J. Carson Smith, an associate professor of kinesiology and director of the Exercise for Brain Health Laboratory at the University of Maryland School of Public Health, who oversaw the new study.
But that is not what happened. Instead, those parts of the brains most involved in semantic memory fizzed with far more activity after people had exercised than when they had rested.
At first, the researchers were surprised and puzzled by the results, Dr. Smith says. But then they began to surmise that they were watching the start of a training response.
“There is an analogy to what happens with muscles,” Dr. Smith says.
When people first begin exercising, he points out, their muscles strain and burn through energy. But as they become fitter, those same muscles respond more efficiently, using less energy for the same work.
The scientists suspect that, in the same way, the spike in brain activity after a first session of biking is the prelude to tissue remodeling that, with continued exercise, improves the function of those areas.
Our brain’s memory centers become, in other words, more fit.
This study is short-term, though, and does not show the intervening steps involved in changing the brain with regular exercise. It also does not explain how activity alters the brain, although Dr. Smith believes that a surge in certain neurotransmitters and other biochemicals after workouts must play a role.
He and his colleagues are hoping to examine those issues in future studies and also zero in on the best types and amounts of exercise to help us maintain our memories of that genial Beatles drummer and all the other touchstones of our pasts.B:
今天排列期开奖结果查询【简】【政】【本】【来】【不】【想】【掺】【和】【自】【己】【儿】【子】【婚】【礼】【的】，【谁】【知】【道】【简】【易】【说】，【父】【子】【一】【起】【结】【婚】【挺】【好】【的】，【洛】【星】【也】【赞】【成】。 【简】【政】【和】【林】【阿】【姨】【的】【婚】【礼】，【简】【易】【和】【洛】【星】【的】【婚】【礼】，【就】【放】【在】【了】【同】【一】【天】。【但】【是】【地】【方】【不】【一】【样】。 【洛】【星】【和】【简】【易】【相】【识】【到】【现】【在】，【已】【经】【十】【几】【年】【了】，【从】【初】【中】【开】【始】。【洛】【星】【在】【乎】【的】【也】【不】【是】【个】【形】【式】，【而】【是】【简】【易】【这】【个】【人】，【婚】【礼】【怎】【么】【样】【她】【并】【不】【关】【心】，【都】【是】【简】【易】
【乔】【思】【慕】【懒】【懒】【的】【靠】【在】【沙】【发】【上】，【玩】【着】【手】【里】【的】【书】，“【说】【说】【看】。” “【侯】【旭】【尧】【在】【林】【总】【离】【开】【后】【拿】【出】【手】【机】【看】【信】【息】，【看】【到】【信】【息】【后】【有】【些】【愤】【怒】，【接】【下】【来】【就】【是】【我】【们】【大】【家】【看】【到】【的】，【田】【银】【不】【小】【心】【扑】【掉】【了】【云】【翔】【手】【里】【的】【老】【鼠】。”【不】【知】【道】【是】【巧】【了】【还】【是】【侯】【旭】【尧】【运】【气】【不】【好】，【顾】【黎】【昕】【原】【本】【低】【头】【一】【直】【在】【处】【理】【公】【司】【的】【事】，【刚】【好】【那】【个】【时】【候】【抬】【头】【就】【被】【他】【看】【见】。 【乔】【思】【慕】
【其】【余】【没】【瞧】【见】【过】【的】【人】【仅】【会】【觉】【的】【江】【采】【兮】【厉】【害】，【真】【真】【的】【是】【太】【厉】【害】【啦】，【这】【全】【都】【是】【怎】【作】【到】【的】【呀】。 【自】【然】，【江】【采】【兮】【的】【控】【冰】【术】【缓】【缓】【提】【升】【后】，【有】【一】【类】【是】【随】【着】【肯】【定】【的】【时】【刻】【会】【消】【失】【的】，【便】【似】【是】【江】【采】【兮】【对】【这】【后】【门】，【那】【便】【是】【会】【消】【失】【的】【控】【冰】【术】，【可】【这】【般】【的】【控】【冰】【术】【消】【耗】【的】【体】【力】、【内】【力】【更】【是】【多】。 “【江】【小】【姊】【果】【真】【不】【是】【简】【单】【的】【人】【物】！”【林】【书】【发】【出】【这】【般】【的】【感】
【兽】【神】【的】【表】【情】【像】【吃】【了】【谷】【道】【热】【肠】【一】【样】【难】【受】。 【他】【本】【以】【为】【自】【己】【拿】【出】【的】【是】【双】【鬼】【王】【炸】，【可】【以】【横】【扫】【一】【切】，【结】【果】【对】【面】【直】【接】【将】【四】【张】【玉】【皇】【大】【帝】【甩】【在】【他】【脸】【上】。 【这】【尼】【玛】，***【就】【算】【了】，【还】【在】【线】【印】【卡】。 【要】【点】【脸】【好】【么】？ 【自】【己】【丢】【出】【去】【的】【不】【过】【是】【蕴】【含】【有】【一】【丝】【丝】【上】【位】【神】【规】【则】【的】【魂】【血】，【对】【方】【直】【接】【丢】【出】【了】【蕴】【含】【有】【一】【丝】【丝】【世】【界】【规】【则】【的】【能】【量】【体】。
“【医】【生】，【你】【帮】【我】【看】【看】【我】【的】【腿】，【可】【以】【吗】？”【一】【位】【年】【轻】【小】【伙】【子】【一】【瘸】【一】【拐】【地】【走】【进】【了】【德】【华】【医】【院】。 【沈】【君】【怀】【看】【了】【眼】【手】【腕】【上】【的】【手】【表】，【再】【看】【了】【看】【那】【人】【的】【腿】，【说】【道】：“【进】【来】【吧】，【顺】【便】【把】【门】【带】【上】。” “【你】【这】【腿】【疼】【了】【有】【多】【久】【了】?”【沈】【君】【怀】【轻】【轻】【敲】【打】【了】【几】【下】【问】【道】。 【年】【轻】【小】【伙】【子】【嘶】【了】【一】【口】【气】，【如】【实】【说】【道】：“【也】【有】【一】【两】【个】【星】【期】【了】【吧】。” 今天排列期开奖结果查询“【我】【说】【的】【你】【都】【听】【懂】【了】【吗】？【盖】【姆】【奇】【奇】？”【邦】【奇】【冲】【着】【盖】【姆】【奇】【奇】【说】【道】。 【盖】【姆】【奇】【奇】【瞪】【着】【小】【圆】【眼】【睛】，【歪】【着】【脑】【袋】【想】【了】【一】【下】，【然】【后】【快】【速】【地】【点】【了】【点】【头】： “【要】【去】【找】【彩】【色】【的】【石】【头】，【很】【多】【的】【彩】【色】【石】【头】，【黑】【色】【的】【石】【头】、【红】【色】【的】【石】【头】、【绿】【色】【的】【石】【头】！”【盖】【姆】【奇】【奇】【复】【述】【了】【一】【遍】【重】【点】。 【盖】【姆】【奇】【奇】【加】【入】【邦】【奇】【的】【部】【落】【之】【后】【表】【现】【不】【错】，【这】【个】【土】【著】【地】【精】
【玄】【都】【点】【了】【点】【头】，【稽】【首】【道】：“【弟】【子】【受】【教】。” 【他】【又】【看】【着】【老】【子】【道】：“【巫】【族】？【老】【师】，【巫】【族】【如】【何】？” 【老】【子】【见】【徒】【弟】【问】【了】，【也】【不】【隐】【瞒】【道】：“【巫】【族】【不】【在】【轮】【回】【之】【中】，【故】，【不】【受】【轮】【回】【之】【厄】，【不】【受】【轮】【回】【之】【厄】，【故】，【不】【在】**【之】【中】，【不】【在】**【中】，【故】【无】【忧】，【无】【损】。” 【玄】【都】【愣】【了】【一】【下】，【喃】【喃】【道】：“【如】【此】【说】【来】，【巫】【族】【岂】【不】【是】【不】【惧】【此】【劫】【了】，【巫】
排 列 5开 奖 结 果 今 天 2019-04-26 07:59:27
排 列 3开 奖 结 果 今 天 2019-12-09 00:27:23
版 权 所 有 ，未 经 书 面 授 权 禁 止 使 用 Copyright BC.杀手 1997-2019 by heimao all rights reserved

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text:
To take stress off the damaged Delaware River Bridge, engineers are literally jacking up the 1.2 mile-long span by installing extra supports as they work to permanently fix a fracture in the structure.
Eight, 80-foot tall jacking towers will be installed under the bridge next week, Carl DeFebo, a spokesman for the Pennsylvania Turnpike Commission, said Friday.
The towers will shore up the 135-foot high bridge, which connects the Pennsylvania and New Jersey turnpikes by spanning the Delaware River, after a large vertical crack was found in a truss a week ago. The bridge is jointly owned by the Pa. Turnpike Commission and N.J. Turnpike Authority.
The fracture was discovered on the Pennsylvania side of the bridge by an inspector who was reviewing a contractor's paint job. Officials immediately shut down the bridge, which carries an average of 42,000 vehicles a day.
The truss is on the underside of the bridge in an area holding up the road deck.
DeFebo said engineers are still trying to figure out what caused the fracture and when the break happened. He estimates they'll need an additional week to come to a conclusion.
Breaking news and the stories that matter to your neighborhood.
In addition to the support towers, electronic monitors to detect stress on the bridge will be installed, DeFebo said.
The bridge will remain closed in the meantime. Approach roads leading to the bridge, like the 5.7-mile N.J. Turnpike's Pearl Harbor Extension are also shut down.
DeFebo did not have an update on when the span may reopen, but officials previously said the shut down would last at least two weeks.


When you are looking to get a new CPU, it can be tough to determine what you need to have since all of a sudden, words like cores and clock speeds are getting thrown at you. We’ll skip over the technical speak to assist you determine what kind of AMD CPU you need. One of the much better attributes to AMD processors is that they have integrated graphics which give you speeds often double what you get from an Intel processor.
The core i5 line of processors comprise three lines of processors such as the core i5 7xx, core i5 7xxS and core i5 6xx series. Clocking frequencies of these processors are from two.4 GHz to 3.33 GHz but it could be augmented with the new Turbo Enhance technology from Intel. Some of the i5 processors feature four cores with four threads even though some come with 2 cores and 4 threads. But practically all of them have an 8MB L3 cache, Intel HD graphics and Intel Intelligent Cache technology.
Roni: I’m a longtime believer in just developing your personal pc from components. Even though I am at the moment running a Dell Core i7 920 12 GB RAM and it’s bulletproof, I’ve had excellent luck with element PCs. So as long as your components are top quality, there is no reason to shell out the extra bucks to get a Sony IMHO. For that reason, any of the i7 or i5 series, with at least four GB RAM will take care of all your requirements and then some.
GEN three motherboards are compatible not only with PCI-e three., but also forwards compatible with Ivy Bridge processors. You can anticipate to pay a tiny premium for these motherboards, so you will have to establish whether forward compatibility is crucial to you. If you’re the sort that likes to build their rig from the ground up each and every time, then I suggest going with the more affordable motherboards as PCI-e three. is not readily offered at this time.
CPU improvements are difficult basically simply because processors are serial computer systems. They are meant for tasks that are serial, so never benefit from several cores (most of the gains come from escalating the frequency). The sole causes GPUs keep acquiring more rapidly at their pace is simply because they keep increasing the core count, which is straightforward to do.


text:
The parents of two young people killed by immigrants are leading an effort to repeal California's "sanctuary state" policy and criminalize officials who obstruct federal law.
"You're already here illegally," said Don Rosenberg, whose son Drew was hit on a motorcycle by an unlicensed driver who had been granted temporary immigration status to remain in the U.S. in 2010. "You already have no right to be here. Why are we bending over backwards for someone who commits more crimes on top of that?"
Senate Bill 54, which restricts the ability of local law enforcement to help the federal government enforce immigration violations, prompted the U.S. Department of Justice to sue California last month and survived an early referendum attempt that failed to qualify.
Now a group called Fight Sanctuary State is taking another shot at the law and announcing a new ballot measure initiative Wednesday to delete sections of the government code related to SB 54 and another law that penalizes employers who give federal immigration authorities access to employee records or buildings without a warrant.
The initiative, which likely would not appear on the ballot until 2020, goes a step further to require state and local law enforcement to notify federal authorities when they have an undocumented immigrant in custody.
The measure would also impose criminal penalties and fines on government officials who obstruct federal immigration enforcement, prohibit the Department of Motor Vehicles from issuing licenses for undocumented immigrants and require voters to provide proof of citizenship to register.
Sen. Kevin de León, D-Los Angeles, on his way to a West Covina City Council meeting to defend the bill he authored, said the restrictions on rights of undocumented immigrants under the initiative suggests the "ghosts of Prop 187 are being brought back to life." The 1994 initiative, which was overturned by the courts, eliminated public services for undocumented immigrants.
“It is clear that Donald Trump’s clarion call to pit neighbor against neighbor dividing our communities is being answered," he said. "They won’t be successful in California. As the most diverse state in the world, California knows better. "
Rosenberg is joined in the effort by Agnes Gibboney, who has said her son Ronald DaSilva was shot and killed more than a decade ago by an undocumented immigrant. Fight Sanctuary State reported less than $3,500 in contributions in 2017, and Rosenberg said they plan to rely on volunteers to gather signatures until they raise more money.
"We’re going to need millions of dollars, and that’s what we’re looking at raising," he said.


text:
This is where the iPad mini shines. It's lighter than the regular iPad and slips easily into the large hip pocket in coats and tunics. There's also a market for those who can come up with accessories and apps for medical staff. Cases need to look medical and protect well, including from chemicals. Email and messaging apps specifically designed for in-hospital use should also be popular.
5/31/13 at 10:51am


text:
Custom-built rear rack designed specifically for Aventon Sinch and Sinch Step-Through ebike models. Haul your groceries and other essential items on your journey safely.
This rear rack is made for Sinch and Sinch Step-Through ebikes only. Be sure to select the correct model rack for your Sinch ebike frame; For example, the Sinch Step-Through rear rack is only compatible with the Sinch Step-Through ebike.
- Sturdy aluminum construction
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- Load Capacity: 50lbs
The rack was easy to install and only took a few minutes. It is probably not recommended that children ride on the rack, but one of our great-grands did for 1/2 a mile with no issues.
Thank you for leaving a review! We appreciate the time!
Very easy to install
Nice- Thank you for the review, Marcia!
Awesome! Thank you for the review, Robert!
A great addition! I also got a weatherproof bag and use it for, lock, lights, etc. a must get.
Hi there- glad to hear that you love the rear rack! Thank you!
Aventon Rear Rack - Sinch
Thank you for leaving a review!


text:
seabag n : a cylindrical drawstring bag used by sailors to hold their clothing and other gear
A duffel bag (or duffle bag) or gym bag is a large cylindrical bag made of cloth with the closure at the top, often also referred to as a kit bag
The name comes from Duffel, a town in Belgium where the thick cloth used to make the bag originated. Nowadays a Duffel Bag typically refers to the specific style of bag, though the phrase may also be used to refer to any large generic holdall or a bag made of thick fabric.
It is often used to carry luggage or sports equipment by people who travel in the outdoors. Duffel bags are often used by military personnel. When used by sailors, they are sometimes called seabags in this capacity.

domain: travel


TigerNet is the oldest and largest Clemson Community online with 131k members and 20M forum posts.
|ESPN: ACC Helmet Stickers|
From Heather Dinich of ESPN:
Clemson quarterback Tajh BoydTajh Boyd
RS So. Quarterback
#10 6-1, 225
View Full Profile: There were plenty of stars for the Tigers in their 59-38 win over North Carolina, but Boyd orchestrated all of it with a school-record and career-high five touchdown passes and another rushing touchdown. His six touchdowns tied Woody Dantzler’s record for touchdown responsibility set in 2001 against NC State. Boyd completed 27 of 46 passes for 367 yards and rushed 11 times for 8 yards.
Wake Forest receiver Chris Givens
NC State cornerback David Amerson
Florida State’s running game
|Send Feedback to TigerNet Staff: Email | Comment||
- Swinney addresses SC's racial slur accusations
- WATCH: Awkward exchange between Muschamp and Swinney
- Fox Sports analyst: "Clemson is a fraud"
- Muschamp didn't like Clemson celebrating seniors during 4th quarter
- WATCH: Watson, Gallman, Williams say goodbye to Clemson fans
- ESPN analyst Booger picks a fight with Clemson fans
- ESPN analyst says Bentley will outplay Deshaun Watson
- WATCH: Boulware with epic rant on South Carolina
- Clemson jumps up in latest AP Poll
- Swinney sends plea to Clemson fans about ACC title game


I have developed around 150 jobs for a big project, most of them are reading information from Oracle and then loading the data into HDFS (Staging Area), now I do not want to continue doing the same thing over and over again.
I am looking for a way to have1 job that does everything since the tasks is repetitive, and then using some sort of metadata to achieve the goal of loading the data to early stages.
If there are no major transformation involved then there are multiple ways to design this job.
Introduction to Talend Open Studio for Data Integration.
Practical steps to developing your data integration strategy.
Create systems and workflow to manage clean data ingestion and data transformation.


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If you’ve been to the arena you’ve seen the huge ring at the bottom of the center video screen advertising LifeLock. LifeLock is a company that provides identity theft protection, which is certainly important, unless of course, you have no identity. I thought about that a few weeks ago while I was having one of those “Why aren’t the Bobcats a bigger deal?” conversations with a fellow fan. This was again thrown in my face, or so I thought, when I went to NBA.com to check the box score. Check out the video.
I’m sensitive ok? I thought the man said “To the Hornets in Charlotte.” I went to NBA.com rather than my usual ESPN.com, see if you can see why. NO ONE HAS CORRECTED IT! This tweet by AP beat writer covering the ‘Cats Mike Cranston: Still happens nightly RT @HawksPRGuy: GAME TIME! #Hawks #Hornets. When Coach Brown, let’s say left the team, I was watching Dan Patrick’s radio show and they literally had a joke call-in segment to have people name 2 Bobcats players. His point was that by firing Coach Brown, the ‘Cats were removing the one guy that mattered as far as identity. Very funny, Bob Costas still owns you.
So worse than the confusion of national and out of town media, the Bobcats have little to no identity on the court. I have this sense that I never know exactly what we’ll see night in night out. Look at the final scores: 87, 100, 83, 92, 81, 94, 96. The leading scorer has been somewhat consistent however, who it is would probably surprise casual fans. DJ Augustin has been outstanding, truly, and I’m not looking for a diamond in the rough, he’s been a good point guard. You expect the Bobcats’ leading scorer to be either Stephen Jackson or Gerald Wallace, the all-star from last season.
So, last night, coming into a game against Atlanta, who has been top 4 in the East the last few years, coming off a huge loss, embarrassing really, they looked like the Bobcats against Boston or something. It was a trap. Then add to that fact that if you can be sure of one thing on this team, Stephen Jackson’s issues with referees and the referees are Steve Javie and Eli Roe….Jack is going to be outside of his own mind.
So there was the setup, how did it go? Atlanta jumped out to a 9-0 lead, Charlotte came back to actually lead 29-24 at the end of the first quarter. That can be attributed to Stephen Jackson hitting two threes and Kwame Brown playing solid. They erased the lead, took one of their own behind solid play. Second quarter was more of the same. What gave the Bobcats hope was, of the strong players Atlanta has, Marvin Williams and Al Horford didn’t make the trip, then in the 2nd quarter Joe Johnson caught the full brunt of Gerald Wallace and was hobbled. So the 5 point halftime lead looked good and looked like with Johnson likely out, a cruise to the win. Wrong. The Bobcats had one of their standard 3rd quarters.
Gerald Wallace was asked about the third quarters after the game he simply said “I don’t know. I’ve been trying to figure that out all season.” 32-18, and that’s about all she wrote, yeah the Bobcats lost the fourth quarter by another 7 but that third did them in. It’s disappointing. I don’t know what it is about coming out of the break.
Coach Silas said it had to do with Atlanta’s zone defense, he also said they didn’t do many of the things they went over in shoot around very well. Then he said that they just passed the ball around the perimeter. All true! I hate to watch the ball go round and round the three point line unless you’ve got some hot shooters, which the Bobcats don’t. Boris Diaw was the best shooter at 5-7 last night, 7 shots was nothing when you look at Jack’s 14. It’s frustrating, but they keep saying “it happens” or “it’s a long season.” Is it so much to ask for a win every night accompanied by 3-8 amazing dunks? Come on!
Going west this week is going to be tough, not just on the Bobcats but on me. I’m going to do my best to stay up and interested, in a few cases well past midnight. The records out there are tough but the teams often aren’t a reflection on those records. Let’s hope for the best, even without Tyrus Thomas and coming off a loss that leave many looking for that identity.


Desperate for attention? Tara Reid posts racy naked picture of herself in a hammock as she wishes her fans 'Happy New Year'
She is currently enjoying a New Year break in Tulum on the Yucatan Peninsula in Mexico but Tara Reid is doing her best to make sure that no one forgets about her while she is away.
The 39-year-old American Pie actress has been posting a string of pictures on her Instagram page, the latest showing her completely naked with nothing but her arms to protect her modesty.
In the picture, Tara smiles happily at the camera with one arm covering her breasts.
Scroll down for video
Racy: Tara Reid wished her fans a Happy New Year by posting this racy naked snap of herself on Instagram
It is the latest in a host of images she has posted as she waved aside criticism over her slim figure with captivating bikini snaps.
Earlier in the week, Tara elicited many oohs and ahhs as she took to the natural swimming pool of Ceyote wearing just a scanty green print bikini and Aztec jewelry.
'Catch me if you can': Tara Reid elicited a wave of oohs and ahhs from her social media followers by posting pictures of her underwater sea adventure in Tulum on the Yucatan Peninsula of Mexico
'I'm a mermaid,' the American Pie star captioned one underwater photo of herself, her blonde hair fanning out behind her and golden skin shimmering.
Tara, who jetted down to the exotic location with her boyfriend for the NYE celebration, included another close-up photo of her swimming her way through the natural rock formations.
'Tarafish catch me if you can,' she flirted in the caption, adding: 'Cenote was amazing. More pics to come. Happy new year!'
Rock-hard abs: The 39-year-old actress displayed her svelte figure in a green print bikini during her trip to Cecote, a natural underground swimming hole
Mermaid swim: Tara dove right in and took to the water like a mythical mermaid
'One of my personal favorites,' Tara quipped alongside a snap that showed her with eyes wide open and floaty hair.
'Caves are so beautiful in Tulum. I love it. Wish you were all here with me,' she gushed.
Tara clung to her beau among the rugged rocks for yet another photo, writing: 'My amazing boyfriend who I adore. Thank you for making my New Years. You are wonderful.'
Romantic interlude: The American Pie star was joined by her boyfriend on her underwater excursion
'One of my personal favorites': Tara quipped alongside a snap that showed her with eyes wide open and hair fanning out behind her
'First day of the new year and I love it! And I love you!' Tara captioned a picturesque snap of the resort's lush green landscape and beach.
Tara's exotic underwater excursion caused one fan to write, 'You're so pretty' while another ventured, 'Awesome' and a third chimed in, 'Beautiful.'
She later posted an Instagram snap of herself at a dinner table with a glass of red wine in front of her.
She's happy: Tara posted an Intagram snap of herself on New Year's Day and wrote she was happy
'I'm so happy,' she wrote in the caption.
Earlier in the week, Tara attracted comments of concern regarding her weight after sharing a set of bikini-clad pictures taken on the beach.
One follower wrote: 'Can we just look at how skinny she is!?'
Underwater acrobats: The slender blonde assumed a variety of bathing beauty poses like this one
Lush landscape: Tara shared a view of the resort's emerald-green lawn and beach lounging area
Another chimed in: 'Tara, please look after yourself. I write this without jealousy or hate, just genuine concern.
'Your figure resembles that of someone underfed in a lot of these pics. Your timetable may be gruelling but please take time out to look after your health. You've so many fans and we're all here to support you.'
'Yes, I also think Tara is dangerously skinny,' another responded.
'Too skinny': The actress garnered comments of concern regarding her weight in an earlier set of bikini snaps like this one, which caused one follower to write: 'You're too skinny'
Sun bathing: Tara was spotted wearing a different bikini on December 30
Svelte: She displayed her thin frame in a multicolored two-piece bathing suit
Posing for a future Instagram photo? Her boyfriend snapped a picture of his beloved using a cell phone
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Production Designer Stuart Craig Featured in The Telegraph
Feb 20, 2010
Thanks to our Order Partner RupertGrint.net
we can let you know about a new article in The Telegraph about Stuart
Craig, the production designer on the Harry Potter films. The interview
covers Craig’s daily routine, his favourite props, favourite film and
even has a small picture of a map of Hogwarts drawn by J.K.Rowling, the
“first document from the very first day of the very first
coming-together of the book, the author and the movies, more than 10
The production designer also briefly mentions “Harry Potter and the Deathly Hallows” throughout the article, such as when he talks about the “new Snitch that miraculously opens up to reveal the Resurrection Stone” created for the seventh film. Quotage:
The last time I cried was a few days ago when we filmed the death of Alan Rickman’s character, Snape. It’s quite difficult to cry in rushes – where we watch the previous day’s work – but he is an extraordinary actor and he dies an extremely good death. I don’t cry out loud, I have to say, but I do get a wet cheek.
[On life after Harry] I really am glad to have worked on the Potter films and in 10 years it has never seemed repetitive. After it all comes to an end, and I’m at home, I’m sure I’ll be grumpy for a few weeks because people won’t be interested in what I think any more. But I’m sure I’ll get used to that.

domain: artistic


text:
Celebrate Safely this Independence Day by Protecting Yourself and Others from COVID-19
The Iowa Department of Public Health released this press release late Thursday evening:
Tama County Public Health wants you to have a fun and safe holiday weekend, and do your part to limit the spread of COVID-19.
“Celebrating the Fourth of July may feel a little different this year with COVID-19 considerations, and we want to remind everyone to follow some simple tips to enjoy Independence Day safely,” said Shannon Zoffka, Executive Director Tama County Public Health. “There are measures every Iowan can take to protect themselves and those they love from getting sick over this special holiday weekend. We have seen an increase of cases this week, so it is important to be cautious and always stay home if you are not feeling well, even with mild illness.”
Simple steps for protecting yourself and others from COVID-19:
The best way to prevent illness is to avoid being exposed to this virus. The virus is thought to spread mainly from person-to-person between people who are in close contact with one another (within about 6 feet).
Avoid close contact and social distance by putting 6 feet of distance between yourself and people who don’t live in your household including in public places like bars and restaurants.
If you’re traveling, watch for local virus activity where you are going. Find travel considerations here.
Take extra precautions if you are at higher risk for severe illness.
Cover your mouth and nose with a cloth face cover when around others, especially when other social distancing measures are difficult to maintain.
Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing. Avoid touching your eyes, nose, and mouth with unwashed hands.
Cover coughs and sneezes.
Clean and disinfect frequently touched surfaces daily.
Monitor your health daily and be alert for symptoms. Watch for fever, cough, shortness of breath, or other symptoms. Stay home if you are sick and follow CDC guidance.
“This holiday weekend, we encourage all Iowans to celebrate safely and responsibly by following these tried and true public health measures that stop the spread of COVID-19 and other viruses,” said Zoffka. “We each have a responsibility to keep our friends, families and communities safe. By following these simple measures, we will protect the health of all Iowans and keep our state on the right track.”
Reviewing fireworks safety and food safety tips can also keep you and your community healthy as you celebrate this holiday weekend. For more information on COVID-19 safety visit www.coronavirus.iowa.gov


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AAMAL COMPANY SERVICE AND TRAINING PROFESSIONAL DEVELOPMENT.
Aamal Company was established in Syria in 2009 and performed its activities till 2013. In 2013 the Headquarters was moved to Turkey
1 – TRAINING
2 – Oilfield Services Industry
3 – Trading (Import, Export)
AAMAL Ltd. continues to grow ever day thanks to the confidence our clients have in us. We cover many industries such as oil gas, energy, business services, consumer products.

domain: economics


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Day five on my month-long Romantic Novelists Association feature. Each day in February I will have a different author on the blog, talking to me about their books. It is to help celebrate the sixtieth birthday of the RNA and to raise awareness of how it might be a great fit for you if you are an author. I hope you enjoy the features over the next few weeks. Be sure to give the authors a follow on social media and add the books you fancy from the selection of great authors to your own TBR.
💫Romantic Novelists Association
The Romantic Novelists’ Association was founded in 1960 to both celebrate, and demand respect for, romantic fiction. Founder members included Denise Robins, Barbara Cartland, Elizabeth Goudge, Netta Muskett, Catherine Cookson and Rosamunde Pilcher. The first President of the Association, Denise Robins, noted that although romantic fiction gave great pleasure to many readers, the writers almost felt they had to apologise for what they did. The RNA was going to put a stop to those apologies and, instead, celebrate and promote romantic authorship.
In 1966, an early Vice President of the association, Elizabeth Goudge, commented that ‘As this world becomes increasingly ugly, callous and materialistic it needs to be reminded that the old fairy stories are rooted in truth, that imagination is of value, that happy endings do, in fact, occur, and that the blue spring mist that makes and ugly street look beautiful is just as real a thing as the street itself.’
Today, the RNA continues to support and champion the authorship of romantic fiction that shows the value of imagination and the possibility of a happy ending and also celebrates the broader spectrum of romantic fiction that explores the more challenging aspects of relationships and human experience.
I write romance with a twist of mystery under the overall banner of ‘the past is never dead’. I’ve been a member of the RNA since late 2016 and am published by Sapere Books. Although I’m Welsh I live in Cornwall, with my husband of almost twenty-five years.
💫 Another You: A haunting love story reaching back to the Second World War
Sometimes the hardest person to save is yourself…
Marie Johnson fell in love with The Smugglers pub when she first moved to Dorset with her husband, Stephen.
But when Stephen’s wandering eye caused the breakdown of their marriage, and the costs of running the pub started to mount, Marie felt her dreams crashing down around her.
With local celebrations planned for the 60th anniversary of D-Day, Marie is hopeful things will turn around.
But she could never have predicted the ways her life will soon be changed forever.
A charming American soldier walks into Marie’s life, but it becomes clear nothing is really as it seems…
Why is Marie suddenly plagued by headaches? Is her American soldier everything he seems to be?
Or could the D-Day re-enactments be stirring up something from the past…?
ANOTHER YOU is a moving saga of family life in the 21st century which draws on the horrors of combat, both in modern times and the Second World War. It is a heart-warming tale of one woman’s fight to reclaim her identity and discover what really matters to her.
Can you tell us a little about your publishing journey, please?
A series of ups, downs and sideways moves! My first book, The Cheesemaker’s House, was a finalist in a national TV show’s search for a novelist, but even so I ended up publishing it independently because most publishers seem scared of ghosts… at least where romantic fiction is concerned. However the book went on to win another award and through that I was signed to Endeavour Press (who went into liquidation) before finally finding a home at Sapere Books.
Can you tell us how you became involved with the Romantic Novelists Association and what it means for you to be part of it?
The first thing I did once I had a publishing contract in my hand was join the RNA. At that point they didn’t accept indie authors (even ones who, like me, had sold thousands of books) and that put me off a bit, but everyone told me I should join so I did. I’ve never looked back. I’ve made so many friends and it’s brilliant to have a warm blanket of support behind you. In order to give something back I’m part of the team running the RNA’s new Facebook group for authors, bloggers and readers, The Romantic Fiction Book Club.
What was the inspiration behind your latest release?
Studland Bay in Dorset. It is a beautiful place, almost magical in the way it feels cut off from the world. Another You started life as a short story based around a local ghost but turned into something completely different. It really took off when I began to work on the character of Marie, a chef in her early forties stuck in an abusive marriage, whose life begins to change when she meets a mysterious soldier on the cliffs.
Do you find it hard to let your characters go when you finish writing the book?
Yes. When you’re writing you live and breathe them, becoming emotionally caught up in their lives. I don’t feel a character is really working for me until I begin to do this and it can be something of a rollercoaster. Very often their stories continue in my head, long after the final chapter of the book until I can slowly let them go.
What was your favourite read of 2019?
It was a very close call between Julie Cohen’s Louis and Louise and Elizabeth Buchan’s The Museum of Broken Promises, but in the end the latter won out. It’s set in present day Paris and Prague in the 1980s and Buchan’s writing creates a tapestry of detail so rich and wonderful I found myself holding my breath as the story tipped into second, third and fourth gears and became unputdownable.
Do you read other romance authors and who would you recommend?
Yes, I do. I think it’s important to read within your genre and it helps I’m a total sucker for a great love story. What I’m not so keen on are books that seem formulaic, where the famous man and the ordinary woman get together after falling out half a dozen times. While I understand the need to escape I prefer my fiction to be relatable so for readers who agree with me I’d recommend Tracy Rees, Claire Dyer, Elizabeth Buchan and Liz Fenwick.
Was there a point in your life that a book helped you get through, if so which one?
When things are tough I tend to turn to writing rather than reading.
Is there anyone that you would like to mention and thank for their support of your writing?
If I did it would probably read like an overlong Oscar list because different people have helped at different times. However my mother was my biggest encouragement and support although she didn’t live long enough to see me land a publishing deal. And my husband has always been there quietly in the background, making sure I have the space and time I need to write.
If you had the power to give everyone in the world one book, what would it be and why?
Good question, and not an easy one to answer, because so few books are genuinely relevant across cultures. Perhaps one about the power of kindness, because that’s so important and pretty universal.
What are you working on now?
I have just finished the first draft of what will be my third book for Sapere. It’s a dual timeline set in Cornwall in 1815 and 2015 and strongly features a man who talks to ghosts, although it is in no way a conventional spooky story. The idea came to me when I met someone who does claim to have this gift and I’m writing the novel with his blessing.
Lastly, do you have any questions for your readers?
Most of my books have some sort of ghostly element, although almost always there is more than one way of interpreting events, so I’d love to know how much belief in life beyond the veil my readers actually have.
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Here is a handy link tree with all my social media. Why not follow me on Twitter, Goodreads and Instagram.
💫 Final Thoughts
Thank you to Jane for taking part in my special feature.