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Travelers are exposing their data on public networks
While aware of the risks, U.S. travelers are not taking the necessary steps to protect themselves on public Wi-Fi and are exposing their data and personal information to cyber criminals and hackers, according to AnchorFree.
The PhoCusWright Traveler Technology Survey 2013 polled 2,200 U.S. travelers over the age of 18 revealing new insights into travelers’ online behavior and their understanding of cyber risks.
It is estimated that 89 percent of Wi-Fi hotspots globally are not secure. The increased use of smartphones and tablets to access unsecured public Wi-Fi hotspots has dramatically increased the risk of threats. Travelers were three times more likely to use a smartphone or tablet than a laptop to access an unsecured hotspot in a shopping mall or tourist attraction, two times more likely in a restaurant or coffee shop and one and a half times more likely at the airport.
“In the age of tablets, smartphones and ubiquitous hotspots, many travelers don’t realize that they are unsuspectingly sharing sensitive information with others on public Wi-Fi,” said David Gorodyansky, CEO of AnchorFree. “It’s troubling that while most travelers are concerned about online hacking, very few know how, or care enough, to protect themselves. Looming threats — from cyber thieves to malware and snoopers — are skyrocketing on public Wi-Fi and travelers need to be vigilant in protecting themselves.”
Further to this point, a striking 82 percent of travelers surveyed reported that they suspect their personal information is not safe while browsing on public Wi-Fi, yet nearly 84 percent of travelers do not take the necessary precautions to protect themselves online.
The top three concerns cited when using public Wi-Fi are the possibility of someone stealing personal information when engaging in banking or financial sites (51 percent), making online purchases that require a credit or debit card (51 percent) and making purchases using an account that has payment information stored (45 percent). Travelers were less concerned about using email or messaging services on public Wi-Fi (18 percent).
“Consumers underestimate their exposure to risks when connecting to public Wi-Fi,” said Robert Siciliano, personal security and identity theft expert. “While credit card fraud is considered a traveler’s most significant risk, consumers should be aware that there are many levels to protecting personal data online – a compromised email account puts other accounts at risk, including credit cards, and provides hackers with a wealth of information they can use to steal your identity.”
Cyber-security threats are not the only issues people face while traveling. Thirty-seven percent of international travelers —which equates to 10 million U.S. travelers annually— encountered blocked, censored or filtered content including social networks (40 percent) such as Facebook, Twitter and Instagram during their trip.
Top websites that were also blocked include video and music websites such as Hulu and YouTube (37 percent), streaming services such as Pandora and Spotify (35 percent), email (30 percent) as well as messaging sites such as Skype and Viber (27 percent).
To avoid the threat of hacking and cyber attacks, more than half of travelers (54 percent) try not to engage in online activities that involve personally sensitive information while one in five (22 percent) avoid using public Wi-Fi altogether because they believe their personal information is at risk.


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North Suburban Family Day Care Association
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Charlotte H Meyer
C-O IRIS KAITSCHUCK
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Korean Air and Delta’s joint venture will help Incheon increase its transit traffic and boost the Seoul hub’s standing
The newly approved profit sharing joint venture between Korean Air and Delta Air Lines will give customers seamless access to more than 290 destinations in…..
Asia Blue Swan Special: Korean Air-Delta JV set to boost tourism but may impact capacity elsewhere in Asia
Delta Air Lines and Korean Air are moving towards implementing their JV. Korea has given clearance to the partnership, adding to pre-existing US approval. Korean…..

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text:
In this paper, after a summary of explanations of why child psychotherapy is important in 0 to 3 years of age group, some different psychotherapy approaches will be introduced. The paper will be focus on psychoanalytic / psychodynamic models; however, other approaches will be described. Every approach will be examined in theoretical and practical aspects.
The very beginning years of human life attracts the attention of researchers in recent years. Especially in the period of 0-3 years of age, brain development is very fast and also the basis of the characteristic features is discarded.
Through the psychotherapy practices with adult patients, the importance of early childhood times on mental health began to understand more. Today we know that early childhood experiences have power to affect rest of one’s life in physical, emotional, cognitive or social areas (Movder, Rubinson & Yasik, 2009). Therefore, in the early years of childhood, therapeutic interventions are quite valuable to minimize the risk factors of future problems.
The main goal of this paper is to make a summary about different approaches in early childhood psychotherapies. Although there are hundreds of different therapy techniques in the literature, this paper will only focus on some of the technique which use in 0- to 3-year-old-children.
Psychotherapy in 0- to 3-year-old-children: from past to present
The therapeutic work with children had begun with the case of Little Hans who had been analyzed by Freud (1909). Hans was five years old when Freud started to treat him. On the other hand, a two and three-quarters-year-old patient Rita, was treated by Klein (1960). This was the first case study in 0 to 3 years of age group.
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At the beginning of the therapeutic work with children, it was known the effect of the psychoanalytic ideas. Later, child psychologists, who work with different schools, developed different approaches and different techniques. Some of them were non-directive and took the child to the center. Others were directive and focused on parent-child relationship. In this paper, I will focus to psychoanalytic / psychodynamic theory based approaches. And then, I will shortly mention some other approaches.
Psychoanalytic Play Therapy
This therapy approach is based on Freud’s classic psychoanalytic thoughts. Anna Freud (1946 as cited in Astramovich, 1999) and Melanie Klein (1960) established the framework of this therapy technique. They stayed loyal to the some of the basic concepts of psychoanalysis such as unconscious materials and defense mechanisms. But still there were some differences between them.
According to Klein (1960), children play purely symbolic games. In this regard, child’s play is similar to “free association” in adults and must be analyzed and interpreted by the therapist. Klein stated that even little children have insight capacity; therefore she found it important to interpreting the child. In her view, interpreting the unconscious symbols and metaphors will help the child to understand his or her real feelings. So that the anxiety level of the child will decrease. She also mentioned about the transference process in children. When she began to treat her two and three-quarters-year-old patient Rita, she was going her home and playing with her toys in her room. But then, she thought that this process may not let the transference occur, and consequently she proposed to analyze child in consulting room, not in the child’s house. (Klein, 1960)
Anna Freud (1946) thought different from Klein in some matters. She brings two main objections to Klein’s methodology. Firstly she mentioned about the issue of “free association”. According to Freud, child’s play cannot think as a version of free association in adults. She believed that a child’s play is not always symbolic; it could be a replaying of real events. She also thought different in transference process. In terms of her point of view, the child’s interest to the therapist can be seen as an affectionate attachment rather than transference (Freud, 1946).
According to Astramovich (1999) toys and child’s play are tools to get unconscious material. The therapist tries to make the unconscious processes conscious, and to gains insight into the child. Therefore, the therapist should be empathic and encourage the child to develop a transference relationship. The main goal of this technique is to foster the awareness of wishes and conflicts; and help to children to improve tolerance to their own feelings.
Child-Centered Play Therapy (CCPT)
CCPT was developed by Virginia Axline (1947) who was student of Carl Rogers. This approach based on Rogerian view. Axline gave place to some of the basic concepts of humanistic theory such as unconditional positive regard, genuineness and empathic understanding. Although Axline herself did not work with the 0 to 3 years of age group, CCPT is used for this period. In a study (Frick-Helms, 1997) 2.8 year old child was treated with this approach.
According to Axline (1947) this is a child-led, nondirective approach. It has two main purposes: to help for change and to increase the self-determination of the child. There are no diagnostic interviews before the treatment. Past is past and the child will tell his or her story when the time comes. Therefore, CCPT therapist does not focus to interpreting the child. In play room, the child is free to do what he or she want. The therapist follows the child; accommodates child’s steps and not try to lead to the child or not hurry up to solve the problems. The therapist must be vigilant and tender to the child’s requirements. Acceptance and understanding of the child is crucial. When the child realizes that he or she accepted by the therapist, it increases the self confidence of the child. (Axline, 1947)
CCPT also focuses the recognition of the child’s real self. Moustakas (1959 as cited in Astramovich, 1999) mentioned that the lack of recognition of the real self shows negative effect on children and thus, children can not reveal their potentials. The therapist’s task is to help the child for realization his or her own real self. This process will bring emotional insight to the child.
Jungian Analytic Play Therapy
This approach is based on Carl Gustav Jung’s theoretical view about human psychology. Jung (1954 as cited in Robson, 2010) believed that we all have two types of unconscious: personal and collective. And both of them have archetypes which contain ideas, images, voices and etc. In his point of view, the therapist should provide a reliable environment to the child for playing and revealing the unconscious material. Then the therapist interprets the play and that gives a chance to therapist to promote the child through a healing process (Robson, 2010).
There is not enough information about the practice of this approach with 0 to 3 years of age group. However, I can mention about a kind of Jungian sandtray therapy technique called as “sandplay therapy” which is suitable for every age period. I will touch on this subject later in “sandtray therapy” chapter.
Psychoanalytic Parent Infant Psychotherapy
The foundations of this approach come from psychoanalytic theory. It is a version of psychoanalytic play therapy for 0 to 2 years of age period. Therefore, some changes are made.
According to Baradon (2005) one of the changes is the position of parents in the therapy process. Unlike classical psychoanalytic view, parents have crucial position in this approach. The therapist tries to support parents to enable better relation with the infant, to enable emotional regulation of both themselves and their infants. Also this approach more focused on the infants to support their development. Positive attachment behaviors, baby’s coherent sense of self, potential developmental risks, separation and individuation process are worked with parents and infants together. (Baradon, 2005)
Baradon also mentioned that, in this approach, the relationship between parents and their infants is seen as patient. The therapist tries to establish a laborsaving environment for the therapy and leans on the relationship. Transference and counter-transference processes; defense mechanisms and resistance are taken into consideration by the therapist. The therapist also procures guidance to parents about the care of the baby. Other important features of this method are assessment and observation of the infant. Psychoanalytic Parent Infant Psychotherapy may use in group settings. It also should be noted that each session is videotaping in this approach. (Baradon, 2005)
Filial Therapy (FT)
This approach was developed by Drs. Bernard and Louise Guerney in the late 1950’s. According to Drewes (2009) FT is a kind of multi theoretical psychoeducational approach which exploits other approaches such as family therapy, play therapy and cognitive-behavioral therapy. In this technique, the therapist teaches and guides parents as they learn how to play their children. FT is suitable for children 2-12 years of age. It is also useful in group settings. Individual parent sessions generally continue between 15 to 20 one-hour sessions. And group sessions meet for two hours between 10 to 20 weeks.
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Drewes also mentioned that FT practice begins with an intake session. Then the therapist observes the family while they are playing together. This observation process takes about 20 minutes. Right after the observation, the therapist talks with parents about the play and tell them the FT method. Then the therapist plays with the child in a non-directive way in order to teach to parents how to play. Meanwhile, parents watch the therapist. Towards the end of the session the therapist and parents discuss about the child’s play. The therapist listens to parents empathically and answers their questions (Drewes, 2009).
When the training period starts, the therapist trains to parents about playing skills. Parents learn four basic skills: structuring the play, empathic listening, child-centered imaginary play and limit-setting skill. Later, the therapist acts like a child and parents play with the therapist. Parents are encouraged to show what they learn about the play. The therapist gives them feedbacks. After that, parents play with their own children with the supervision of the therapist. Finally, towards the end of the treatment, parents practice the play in the home settings. (Drewes, 2009).
Theraplay (Attachment-Enhancing Play Therapy)
Theraplay is a short-term therapy approach which is based on attachment theory (Booth & Jernberg, 2010). It is appropriate to children from eighteen months to twelve years. The core aim of this approach is to improve a safe, compatible, playful relationship between a child and his or her parents.
According to Booth & Jernberg (2010) the treatment plan of theraplay practice is generally for eighteen to twenty-four sessions. Every treatment plan includes; assessment, treatment and checkup phases. In assessment phase, the child’s behaviors and the parents’ attitudes are assessed by the therapist. In the first treatment phase there can be one or two therapists. If there are two therapists, while one of the therapists is playing with the child; the other one, the interpreting therapist, works with parents. In the beginning of the treatment parents do not join to play sessions. They watch their child from two-way viewing mirror with the interpreting therapist or they watch from videotape after the session (if there are not two therapists). The interpreting therapist talks about the rationale of the theraplay, the problem areas of the child, wishes, concerns and expectations with parents. In the second treatment phase, after observing process, parents play with the child in theraplay room. In this phase, four basic skills are taught to parents: structuring, challenging, intruding and/or nurturing. After a termination session, the checkups phase comes. Checkup sessions are made quarterly in first year and annual thereafter. (Booth & Jernberg, 2010)
Watch, Wait and Wonder (WWW) / Infant-Parent Psychotherapy (IPP)
I will introduce these two approaches as together because both of them were developed by same team at the Hincks-Dellcrest Children’s Mental Health Centre (Toronto, Canada). WWW and IPP are effective on infants and based on psychodynamic principles such as “unconscious”, “transference”, “countertransference” and “potential space” ( Tuters, Doulis & Yabsley, 2011). Also these concepts are considered in conjunction with the attachment theory.
One of these two approaches is WWW. First W tells to parents “watch” the play of the infant! What is the infant doing? Second W tells to parents “wait” the infant’s play. Don’t hurry! Let the infant take to lead in the play! And third W tells to parents “wonder” about the infant’s play. What is the infant trying to tell you? The infant’s play is seen as “potential space” between the infant and the parent ( Tuters et al., 2011). There are two basic principles of WWW. To accept the leadership of the infant in the play and to accept that the play has a symbolic meaning. Every WWW session has two parts. In first part, the infant plays and the parents are asked to play with the infant on the floor. In play, leadership must be in the infant and the parents should follow the child. In second part the play and the thoughts and feelings of parents are discussed with the therapist.
Infant-Parent Psychotherapy (IPP) approach is similar to WWW. Their basic principles are same, but there are some little differences between them. In IPP, in order to show the effect of parent’s unresolved past issues, the therapist is more active in play. And also countertransference process is more considered in IPP (Tuters et al., 2011).
The Developmental, Individual-Differences, Relationship-Based (DIR) Approach
This approach was developed by Stanley Greenspan and it provides a multi-dimensional system in order to assess and support of infants and children with different developmental characteristics (Greenspan & Wider, 2006). It is especially effective for children who have autism spectrum disorder, down syndrome, learning disorders and developmental disorders. However, DIR approach is suitable to define the child’s and family’s features.
According to Greenspan (2006) the “D” expresses developmental levels. It gives an idea about that question: “Where is the child in developmental continuum?” The “I” expresses individual differences. It emphasizes biologically based capacities such as auditory processing, motor planning and etc. And the “I” expresses relationship. It calls attention to the relationship between the child and the parents. DIR approach benefits from floortime, which is a kind of play technique, so as to practice the model. Floortime is performed with little children on the floor. Taking into account the children’s individual differences, floortime supports their developmental levels relationship skills. (Greenspan & Wider, 2006)
This approach was developed by Dr. Susan McDonough so as to understand mother-infant relationship through the interactive play experience. It aims to consolidate the relationship between infant and the mother and to increase the mother’s enjoyment from interactions with the infant (Balbernie, 1998). Core concepts of this approach are “therapeutic alliance” and “strengths of the family”. According to Balbernie (1998) the model focuses on strength features of the family system and tries to consolidate them. The mother’s past is not analyzed. Transference dynamics are considered but there is no fully interpretation. Treatment phase contains 5-12 sessions. Videotape is used in this approach.
Ecosystemic Play Therapy (EPT)
This approach was developed by O’Connor who emphasizes the importance of the children’s whole ecosystem. According to O’Connor (1997) EPT is a multi theoretical approach. It is not based on only one perspective. The main aim of the EPT is to promote the child’s abilities in order to cope with their needs. The basic role of an EPT therapist is to replace the core beliefs of the child with a functioning way. And also, the therapist tries to make the system to be more responsive to the requirements of the child. (O’Connor, 1997)
Caregiver-Toddler Play Therapy
This approach deals with disturbed relationship between the caregiver and the toddler. According to Schaefer & Kelly-Zion (2008), the main goal is to improve this disturbed relationship with the play. There are three constituent in this approach. First, the therapist establishes a “simultaneous relationship” with the toddler and the caregiver. Second, the therapist is able to “speak for the child” and that supports the communication between the toddler and the caregiver. And third, the therapist guides to caregiver for teaching relational skills. In the beginning treatment, the therapist is very active, but then the caregiver is expected to be more active. (Schaefer & Kelly-Zion, 2008)
It is a Jungian version of “Sandtray Therapy” which is developed Dr. Margaret Lowenfield. A Jungian therapist, Dora Kaff, adapted Sandtray Therapy to a Jungian perspective and she called this new version as “Sandplay Therapy”. According to Zhou (2009) this is an expressive therapy which is appropriate for all ages. This approach helps to emerge nonverbalized emotions. In this technique, children play with sand, water and little miniatures. The symbols in the play reflect personal and collective unconscious and with the help of the therapist the ego of the child is restructured (Zhou, 2009).
If we consider human life such as a building; 0 to 3 years period correspond to foundation of it. And if this foundation is not strong enough; this building encounters with the risk of falling down. Today, although preventive approaches has already started to gain importance, in some cases, more serious interventions are needed. Child psychotherapies in 0 to 3 years of age group meet this need.
The main goal of this paper was to mention different psychotherapeutic approaches which use in 0 to 3 years of age group. It is impossible to mention all approaches therefore I have tried to describe most known and most effective approaches. However, psychotherapy world is not static, in time, different new approaches will emerge.
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"We are excited to announce that a University of Kentucky recruit will be joining both UL and IU's entire recruiting classes in this year's game," said Keith Conrad, the event's recruiting chair. "It will be great to have all three fan bases back in Freedom Hall supporting their newest additions. Cardinal fans should be ecstatic to see what Coach Pitino has labeled as the most talented recruiting class he has assembled during his tenure at the University of Louisville."
The Basketball Classic is presented by Papa John's, with Contributing Sponsor Horseshoe Foundation of Floyd County. Media Sponsors are 99.7 DJX, B96.5 FM, and SLAM Magazine. Supporting Sponsor: Dick's Sporting Goods.
First held in 1973, the Kentucky Derby Festival Basketball Classic has featured such players as Jamal Mashburn, Moses Malone, Rex Chapman, Pervis Ellison, Isiah Thomas, Dominique Wilkins, Darrell Griffith, Derek Anderson, Anfernee Hardaway and Michael Beasley, among many others.


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As part of LKYCIC’a 10th anniversary event, LKYCIC’s distinguished visiting fellow Professor Ricky Burdett from the London School of Economics (LSE) presented a public lecture on ‘Shaping Cities in an Urban Age’. He provided insights
LKYCIC is pleased to announce that Dr Belinda Yuen has been appointed to Milan Pact Awards 2022 evaluation committee by city of Milan. She is also science reviewer in WWTF- Vienna Science and Technology Fund (Austria) in field of public health.
Business Times published an opinion piece written by HASS head Prof Lim Sun Sun, NUS' Dr Sreeja Nair and LKYCIC research fellow Dr Gayathri Haridas on the need to provide more support for vulnerable workers so lifelong learning can yield payoffs.

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Himachal Pradesh is dotted with a number of scenic hill stations, which are extremely popular as summer holiday destinations. Shimla and Manali are two of such places, which do not have natural beauty in abundance but also have a number of tourist attractions. Opt for a Magnificent Shimla Manali tour, a well-planned itinerary by Indian Holiday, offering the best of these places. This tour of 5 nights and 6 days lets you explore Kufri, Solang Valley, Rohtang Pass and other famous tourist attractions. Treat your eyes to the picturesque beauty spread all around.
What is included in the tour
- Full Sightseeing as per itinerary
- All Hotels Accommodation
- Meals (MAP) Breakfast & Dinner
- Local Transport (Personal Cab)
- Airfare/train fare
What is NOT included in the tour
- Any meals other then those specified in 'Cost Includes'
- Expenses of personal nature such as tips, telephone calls, laundry, liquor etc.
- Guide & Entrance fees during sightseeing
- Service tax of the hotel And GST Taxes
- Any other item not specified in 'cost includes'
- Short trip to Kufri
- A leisure walk at Shimla and Manali Mall Roads
- Sightseeing in Manali including Hadmiba Devi Temple and Tibetan Monastery
- Day's excursion to Solang Valley and Rohtang Pass
Day 01: Arrival at Delhi
Welcome to Delhi: - Beautiful Himachal tour will start with your arrival at Delhi the capital of India. Get grand reception at airport arrival by Trojan Holidays representative. Later, get transfer to the hotel.
Day 02: Delhi - Shimla (380 kms/ 08hrs)
Travel by surface from Delhi to Shimla
Shimla: former summer capital of British India & now a capital of Himachal Pradesh, set amidst the snow capped shivalik mountain ranges offering some stunning views of the mighty Himalayas, it is surrounded by pine deodar, oak and rhododendron forests. Towards the north lie the snow-covered high-ranges, while the valleys breathe whispering streams and swaying fields. Shimla offers a variety of shopping, sport and entertainment activities.
Day 03: Shimla -Kufri-Shimla (24 kms.)
After breakfast visit to half day city tour visiting Indian Institute Of Advanced Studies, Sankat Mochan Temple and Jakhu temple,
Afternoon visit to excursion tour of Kufri & Chail,
Kufri :a popular ski resort in winters, which offers some stunning mountain views , Later drive to Chail:The Chail Palace is well known for its architecture. The cricket ground and a polo ground which is there at an altitude of 2,444 m was owned by erstwhile royal family of Patiala. It is the world's highest cricket ground. In 1891, Maharaja Bhupinder Singh of Patiala incurred the rage of Lord Kitchener. It led to the restriction of his entry into the summer capital, Shimla. This incensed the Maharaja and he vowed to build a new summer capital for himself. So he rebuilt the place (Chail) as per his requirements. There we will visit the Palace of former Maharaja of Patiyala.
Later back to hotel. Overnight stay at hotel at Shimla.
Day 04: Shimla – Manali (280 kms/ 7 hrs)
After breakfast check out from hotel ,drive to Manali,
Manali : at the northern end of the Kullu Valley in Himachal Pradesh, is a hill station situated at a height of 2050 m (6398 ft) in the Himalayas. Situated on the Beas river (Vyaas in Hindi) and near its source, it is a popular tourist spot for Indians in summer and a magical, snow-covered place in winter. A staging point for a number of treks (Beas Kund, Chandrakhani Pass) and sports such as white-water rafting, Manali is also on the road to Ladakh via the valley of Lahaul and Spiti and rohtang pass which is main attraction near Manali.
Arrive at Manali and check in the hotel,Rest of the day is at leisure to visit the local markets overnight stay at hotel at Manali.
Day 05: Manali
After breakfast visit to city tour. Visiting Hadimba temple, the 450 years old Hadimba Devi Temple, the oldest temple in Manali, Vashisht Temple, Manu temple and picturesque Naggar Valley. Evening you can enjoy at mall road, later back to hotel, Free for leisure. overnight stay at hotel at Manali.
Day 06: Manali - Rohtang Pass – Manali (Snow Point)
After early breakfast visit to excursion visiting Kothi Gorge, Gulaba, Marhi, Rohtang Pass (Upto Snow Line in case Rohtang is closed due to snow fall) Carry warm clothes like hand gloves, muffler, sweater, shawl, socks & sports shoes etc. Enroute overcoats and shoes are available on hire. Please note thatRohtang Pass (altitude 3940 mts.) is actually 51 kms. far from Manali, due to heavy snow covering the road, this pass is not accessible during heavy snow fall for Snow Point, and Solang Valley. Later back to hotel. Evening free for leisure, overnight stay at hotel at Manali.
Day 07: Manali – Dharamshala (200 kms/ 5 hrs)
After breakfast check out from hotel then drive to Dharamshala.
Dharamshala: This is a hill station lying on the spur of the Dhauladhar range about 17 kms north- east of Kangra town. This hill station is wooded with oak and conifer trees and snow capped mountains enfold three sides of the town while the valley stretches in front. The snowline is perhaps more easily accessible at Dharamshala than at any other hill resort and it is possible to make a day's trek to a snow-point after an early morning's start. Dharamshala is also the headquarter of the Kangra district.
Arrive at Dharamshala, check in to hotel, Rest of the day free for leisure . overnight stay at hotel in Dharamshala.
Day 08: Dharamshala – Mcleod Ganj – Dharamshala
After breakfast visit to Baijnath temple, one of the 12 Jyotirlingas also, Visit the Tibetan monastery in Maclodganj (upper Dharamshala) a seat of Tibetan spiritual leader Dalai Lama later visit Palmpur Tea Eatates, etc. later back to hotel. Rest of the day free for enjoy at mall road, overnight stay at hotel in Dharamshala.
Day 09: Dharamshala – Dalhousie (180 kms/ 04 hrs)
After healthy breakfast in the morning check out from the hotel and transfer to Dalhousie by Road.
Dalhousie: is a beautiful, quiet and peaceful small town of North India, famous among the honeymooners. Away from the maddening crowds of plains, Dalhousie is surrounded with attractive cottages, villas, sky touching deodar and pine trees and evergreen ornamental shrubs that makes it one of the most preferred tourist’s destinations in Himachal Pradesh.
On arrival at Dalhousie, check in to hotel. Evening free for leisure. Overnight stay at hotel at Dalhousie.
Day 10: Dalhousie
After breakfast visit to scenic walk to the Satdhara (seven springs) said to contain mica and medicinal properties (4 kms/1 hr), Martyr’s memorial at Panchpula (five bridges), and Shubhash Baoli, later back to hotel, evening enjoy at mall road. Overnight stay at hotel at Dalhousie.
Day 11: Dalhousie – Chandigarh (320 kms/ 07 hrs)
After healthy breakfast in the morning check out from the hotel and proceed to Chandigarh reach Chandigarh in the afternoon and check in at the hotel. Evening proceed for the sightseeing tour of Chandigarh city. Come back to the hotel. Overnight stay at the hotel.
Day 12: Chandigarh - Delhi (250 Kms/ 05 hrs)
After breakfast check out from hotel, drive towards Delhi. Arrive Delhi in the afternoon and proceed to airport to board your flight back to home. Tour ends with sweet memories.

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Happy Hump Day, Friends! I am so glad to be sharing another DT card for the Midweek Magnolias. Our new challenge this fortnight is...
Share some of your “Love” theme projects with us for a chance to win a Mystery Prize from Magnolia Sweden.
My card features “I Give You My Heart Tilda Duo” from the Lovely Duo collection. I used some brand new papers from Pebbles "We Go Together" collection which are perfect for St. Valentine’s Day. The color palette is pink, muted red, gray, and aqua which is one of my favorite color combos for a "LOVE" theme. I used up some of my old red Bazzill Bling card stock and fabulous New Aqua American Crafts card stock.
The new Oh-La-La DooHickey Die Club Kit works marvelously with my theme and all the pretty flowers from Magnolia’s new collection adds to the luscious design.
Here’s a close up of Tilda colored with Copics to match all the pretty elements I used for my card.
Stamps – Magnolia: I Give You My Heart Tilda Duo
DPs/CS – Pebbles: We Go Together; Bazzill: Red Bling; AC: Aqua CS
Dies – MagnoliaOh-La-La DooHickey Club Kit: Heart Doily, Flower Flourish, Love Tag; Spellbinders: Large Oval and Large Oval Scallop
Flowers – Magnolia; Wild Orchid Crafts
Ribbon/Lace – HOTP: Aqua Sheer; JoAnn’s: Lace
Ink – Tsukineko: Memento Tuxedo Black; Ranger: Frayed Burlap DI
Other –Recollections: Flat back Pearls
Copics – Skin: E35, E11, E00, E000, R20, R30. Hair: E29, E25, E31. Apparel/Other: BG13, BG32, BG11, W5, W3, W1, W0, W00, R14, R12, R11.
I hope I've inspired you to join us for the challenge. Have a great week.
Hello, Magnolia Friends. Today
is Team B’s turn to share some inspiration for the current challenge…
IS IN THE AIR*****
This challenge will run until January
My designer papers are from Pion
Design’s My Precious Daughter collection. I love the
pretty pink papers and love theme design. They are so easy to dress with a vintage
shabby chic style as I've done here. I used The Paper Company ivory card stock
for my base.
I colored Tilda with Copics to
coordinate with my papers. I added a bit of glitter bling with Stickles to Tilda’s
wings and the hearts I stamped randomly around the frame.
The new Oh-La-La DooHickey Die Club kit
is perfect for a Valentine’s theme card. I cut several of them for this card
which include the Eiffel Tower, Heart Flourish and Love Key all covered with Embossing
Powder for that metallic effect.
Here’s a close-up of Tilda.
Leave a comment on any of the
DT’s blogs and/or the Challenge blog for a chance to win a weekly prize from
Magnolia-licious. The winner is announced every week during the “W”ednesday
Come and join us for the
challenge and you may have a chance to win a Surprise from the Magnolia-licious store. As long as you follow our rules and theme you will be entered in the
random winner draw at the end of the challenge. Good Luck!
Magnolia: You are my Valentine Tilda, Arrow and Hearts
DPs/CS – Pion Design:
My Precious Daughter; The Paper Company: Ivory
Oh-La-La DooHickey Club Kit: Heart Flourish, Eiffel Tower, Heart Key, Love
Birds Tab; Marianne Design: Large Oval by Petra LR0240
Flowers – Wild
Ribbon/Lace – The Ribbon
Girl: Vintage Seam Binding
Tsukineko: Memento Tuxedo Black, Cocoa; Ranger: Pumice Stone DI
Other – Prima:
Shabby Chic Treasures Door Locks; Ranger: Pink Taffeta Stickles, Gold Embossing
Powder; Stampendous: Shabby Pink Frantage Embossing Enamel; Sprinkle &
Sparkle: Firecracker Red Embossing Powder; Recollections: Flat back Pearls
Skin: E35, E11, E00, E000, R20, R30. Hair: E47, E44, E43, E42. Apparel: R85, R83,
R81, RV00, Other: E44, E43, E41. BKGD: W5, W3, W1 W00, 0.
Thanks for stopping by. Have a
Happy New Year, Friends! I am finally back to crafting after such a nice long break for the Holidays. The Midweek Magnolias are looking forward to a creative year and I hope you are too.
We have a new challenge which is our first of 2015 and we are showing off our...
Share some of your new crafty tools and supplies for a chance to win a Mystery Prize from Magnolia Sweden.
My card features “Christmas Kitchen Tilda” from the Waiting for Christmas collection. I used some new papers from Maja Designs and colored Tilda with Copics to coordinate with my embellishments.
This Magnolia image can be used for just about any type of card as she is so versatile. This is a Birthday card that I made for my granddaughter, Isabel, who celebrates her 10th Birthday in a couple weeks.
I used new die cuts from the Oh-La-La DooHickey Club Kit collection as well as some fabulous Joy Crafts dies which create the perfect Birthday theme.
Here’s a close up of Tilda.
I hope I’ve inspired you to join us for the challenge. Have a great week.

domain: artistic


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Submitted to: Journal of Soil and Water Conservation Society
Publication Type: Abstract Only
Publication Acceptance Date: 7/1/1998
Publication Date: N/A
Technical Abstract: The Journal of the Soil and Water Conservation Society is a very diverse journal. To maintain this diversity, and to provide for needs in the next millennia, SWCS must attract the best scientists in natural resources research. In the coming decades, world population will grow by 3 billion people, about the same number as world population increased by in the last half of the 20th century. To meet the needs of the earth's population, agricultural production must increase dramatically. There will be several major technological revolutions that will help meet these needs, and SWCS and the Journal must be important in bringing the fruits of these revolutions to providing the natural resource base that will supply the populations needs. To meet the challenges in the next millenia, SWCS and the Journal must provide opportunities for a diverse mixture of scientists to participate in setting the agenda for the society and the journal and a focus must be on international activities.

domain: agronomy


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If you find the perfect cabinets, but they don't come in your desired finish, a simple coat of paint can help transform cabinets that are almost right into cabinets you'll love. Particle board and MDF, two common materials for stock cabinets, are susceptible to water and have a shorter life span than plywood and wood. I sometimes chuck the jig's drive adapter in my drill press and use the jig in cabinet hardware columbus ohio the drill press for better downward pressure. This urban row-house kitchen makes the most of the space with tall maple cabinets and dual-height countertops, as seen on HGTV's Bang for Your Buck. A 3 drawer bedside table will help you keep your bits and pieces safe, while a deep 2 drawer option will provide space for bigger items. This kitchen remodel was designed with the help of the cabinet experts in our Columbia, Md showroom. Great for wet bars , boardrooms ,hiding collections , TV concealment, security, Pantry, Master closet and anywhere regular cabinet doors are in the way. how to build a filing cabinet out of wood How to human body angstrom Weatherproof outside TV Watching TV Plans to build outdoor tv cabinet outdoors lets you enjoy nature without wanting your favored shows.
If you want to update the style of your kitchen without a dramatic white kitchen cabinet refacing change or are simply looking to refresh your cabinets, cabinet redooring white kitchen cabinet refacing may work for you. This is a video I took after completing my job doing a complete kitchen out of Teak for my daughter and son in law's home. To distinguish between the variety of table or cabinet styles, and also the different wood finishes available, a 5 letter Ref Code was introduced:
With Annie Sloan, I could do a section of 8-12 cabinets at a time, and by the time cabinet hardware columbus ohio I was done with a coat on all 8, the first one was just about dry and ready for a second coat.
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When you look cabinet stain or glaze the glass, you will see the cabinet color continue rather than seeing the typical plywood interior. Buying a TV lift means that you need to ensure that the lift itself is the correct size for its application, and to ensure that the TV will fit well into the lift. If they are finished well then they should hold up. Conjure a seafaring adventure with a Royal Naval Porthole Mirrored Medicine Cabinet from Restoration Hardware Cast alumunim and a round form give this piece industrial style, and it's perfect for displaying in multiples. All hazardous substance cabinets supplied by Storage N Stuff Limited are manufactured in 0.9mm and 1.2mm mild steel providing a fire resistance of 30 minutes, with fully welded seams throughout, doors are reinforced to prevent distortion and are fitted with a two point locking handle with two keys.
The main feature is the solid oak face frame and doors; these are pretty good quality for the price and they accept stain well. And for petite niche, we offer small wine cabinets, corner wine cabinets and wooden wine rack or wrought iron wine bottle rack for ample entertaining savvy. It's important to keep in mind that the perfect kitchen for you is based on your family's needs and how you work in the kitchen. Pair these options with light colored cabinets and a muted paint palette for the walls, creating a stunning kitchen design scheme. This double pantry has a clean, white finish which has purifying qualities and will be a never-let-it-go addition for your kitchen, medical cabinet or other place. Contact your local Tailored Living designer to discuss maximizing your business space with custom commercial cabinets, unique office designs and industrial floor coverings. This toaster-oven-size unit lacks advanced features, but it has the same brilliant GE user interface and a top reputation in its class. If your granite is white with a gray grain, reverse that scheme on the backsplash. This means that the door sits in front of the cabinet and covers almost all of the cabinet. Allow the stain to soak into the wood sawstop cabinet vs contractor saw five minutes and then wipe it off with a clean rag. Gel stains work well in creating other faux finishes, too, such as sponging and stenciling. Whatever you do, do not paint a part of the cabinets and leave another part stained Cherry.
This traditional kitchen looks great with its blue painted island with white quartz countertop and matching white cabinetry. Our setup was about $1,200 how to make roll out cabinets the cabinets and about $950 for the solid-surface top with molded bowl. You may find it easier to work with a gel stain and be sure to rub it in evenly. It also means our kitchen cabinet repair and restoration services cost up to 30 percent less than our competitors.
© Copyright 2015 i dont want to discuss it

domain: design


text:
Kid-Friendly Fun in Luxembourg Gardens
While researching our trip to Paris, the theme I saw time and again, was that Paris was family-friendly because of its numerous parks. There are small ones where you’d least expect them (next to Notre Dame). Or parks with fountains, tennis courts, cafes, and breathtakingly beautiful ones — like Luxembourg Gardens.
Luxembourg Gardens is an absolute must-see when traveling with children. A vast space where children can run free is priceless. And for several Euros (per child and activity) you can also entertain them with sailing miniature sailboats on the pond in front of Luxembourg Palace, watching a puppet show, or riding the old fashioned merry-go-round. We chose to save those activities for another day. Instead we spent our limited time (and Euros) in the fenced in, and oh-so deluxe, playground.
We spent our morning climbing the Arc de Triomphe, and arrived at Luxembourg Gardens in the afternoon. The moment we stepped through the gates, the kids forgot their tired legs, let go of our hands, and ran. They chased each other, jumped in piles of leaves, all while making their way to the main attraction.
We were in Paris during the Parisians fall vacation, which meant this playground was bustling with children. Our kids immediately joined the fun. Ada came running over, hopping with excitement and said, “Mom! I said Bonjour! to a girl, and she said it back, but then she kept talking, and I couldn’t understand her! So we kept see-sawing.”
Along with see-saws, this park has a climbing structure that mimics the shape of the Eiffel Tower; wooden trains to climb in and on; ropes to trek across and climb up and… I’ll just let the pictures speak for themselves:
Ada’s favorite was the zip line, which she rode countless times. Each time, she patiently waited in a long line of older kids, stepped up to the platform, grabbed onto the rope and took off at a crazy speed. Her smile grew wider with each ride.
The kids played to their heart’s content.
As the afternoon sun lowered behind the trees (which would be ideal in summer heat), and the rain sprinkled off and on, a chill crept underneath my wool coat that I couldn’t shake. Aaron bought me tea from the snack bar, which I hugged in my hands; I blew on the steam hoping to defrost my cheeks. But it was no use. I was freezing and yearned for the sun. Thankfully we were all ready to explore more of the gardens (and hopefully warm up).
Once the kids finally stopped moving, they realized just how tired they were. And who can blame them? Climbing several hundred steps, walking the Parisian streets, and running through Luxembourg Gardens for several hours tends to catch up on you when you least expect it.
We knew we had only scratched the surface of what Luxembourg Gardens has to offer. And I hoped that we’d spend another afternoon here sailing boats and watching a puppet show. But with only a few days left on our trip, we still had more of Paris to discover. And tomorrow, we’d get to see her from splendid heights at the top of the Eiffle Tower.


VATH Mercedes-Benz A45 AMG
VATH has unveiled their tuning program for Mercedes-Benz A45 AMG. The ultra-hot hatchback was unveiled back in 2013 and since then several tuning companies developed styling packages for it. VATH offers both - styling and performance upgrades for the A45 AMG.
The exterior features a full aerodynamics package consisting of modified front and rear bumpers, new side skirts and a huge rear wing. There are also new VATH logos as well as decals and red brake calipers. The tuning company fitted the A45 AMG with a set of new three-part forged wheels – 8.5J x 20" fitted with 225/30 R20 tires at the front and 9.5J x 20" with 265/25 R20 at the rear. Another set is also available – one-piece rims – 8.5J x 19" and 9.5J x 19" with 235/35 R19 and 255/30 R19, respectively.
The A45 AMG is powered by a 2.0 liter turbocharged four-cylinder petrol with 360HP (265 kW) at 6,000RPM and 450Nm (332 lb-ft) of torque at 2,250RPM. 0-100 km/h in 4.6 seconds and a top speed of 250 km/h (155 mph) - electronically limited. The engine is mated to an AMG SPEED SHIFT DCT 7-speed sports transmission with three driving programs, double-declutching function and Race Start. VATH offers a tuning package boosting the engine to 425HP (312 kW) and 515Nm (381 lb-ft) – an increase of 65HP and 65Nm. The result is thanks to an ECU re-map, a custom down pipe and 200 cells VA-stainless steel catalyst.
Other highlights include sport coilovers (-20 to -65 mm ride height); sports exhaust systems; big brake systems; and exclusive interior equipment.
All parts have MOT-approval.


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© Oncology Nursing Society. Unauthorized reproduction, in part or in whole, is strictly prohibited. For permission to photocopy, post online, reprint, adapt, or otherwise reuse any or all content from this article, e-mail email@example.com. To purchase high-quality reprints, email firstname.lastname@example.org.
February 2014, Supplement to Volume 18, Number 1
Translating Research on the Distress Thermometer Into Practice
Susan S. Tavernier, PhD, APRN-CNS, AOCN®
Distress is commonly experienced by people with cancer. The National Comprehensive Cancer Network (NCCN) developed a guideline for screening and managing distress in 1999 and has updated the guideline on an annual basis ever since. Using the five-phase framework for translational research, this article summarizes research findings related to the guideline and associated distress thermometer for each phase of translational research. The NCCN Distress Management Guideline is a useful tool to screen for and manage distress. However, additional research is needed, particularly in the areas of impact on outcomes of importance to patients.
Distress is a universal experience; however, the degree to which it is experienced, the duration, and the subsequent response to the distress varies widely. People living with cancer often have clinically relevant levels of distress requiring interventions for effective management (Carlson, Waller, Groff, Giese-Davis, & Bultz, 2013; Cohen, 2013; Kendall, Glaze, Oakland, Hansen, & Parry, 2011; Mitchell, Hussain, Grainger, & Symonds, 2011; Roerink et al., 2013; van’t Spijker, Trijsburg, & Duivenvoorden, 1997; Zabora, BrintzenhofeSzoc, Curbow, Hooker, & Piantadosi, 2001; Zwahlen, Hagenbuch, Jenewein, Carley, & Buchi, 2011). Despite the widespread incidence of cancer-related distress, data indicate that clinicians are not familiar with valid and reliable tools to screen and assess for distress in their patients. In addition, the implementation of such tools in the clinical setting is limited (Jacobsen & Ransom, 2007; Pirl et al., 2007; Tavernier, Beck, & Dudley, 2013).
Assessment of cancer-related distress is best conducted using validated measures (Oncology Nursing Society, 2013). However, using an instrument congruent with the conceptual definition of distress is important. In addition, short, inexpensive measures easily completed by the patient, which also are incorporated into the electronic medical record, are ideal (Mitchell, Vahabzadeh, & Magruder, 2011). Although many instruments are used in research to measure distress, they are not always amenable to implementation in routine oncology practice. In addition, many instruments assess constructs related to distress such as depression, symptom severity, or unmet needs, but not the global construct of distress. Several excellent reviews of the psychometric properties of such instruments are available (Mitchell, 2010; Vodermaier, Linden, & Siu, 2009; Ziegler et al., 2011), particularly the comprehensive data supplement to the review by Carlson, Waller, and Mitchell (2012).
The purpose of this article is to review research using the National Comprehensive Cancer Network® ([NCCN®], 2013) Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Distress Management and the distress thermometer. The American College of Surgeons (2012) Commission on Cancer will require routine screening of distress for all patients for healthcare agencies seeking accreditation beginning in 2015. Acknowledging the need for interdisciplinary collaboration for optimal management of distress, oncology nurses have the opportunity to demonstrate leadership in the selection, implementation, and evaluation of tools for assessing distress (Vitek, Rosenzweig, & Stollings, 2007). In addition, oncology nurses are well positioned to develop and evaluate interventions for improving outcomes related to distress management (Fitch, 2011).
The Distress Thermometer
The NCCN Guidelines for Distress Management was first published in 1999. The authors purposefully used the term distress to reduce the social stigma associated with other more common terms associated with psychosocial problems (i.e., depression, anxiety, and maladjustment). The NCCN (2013) defines distress as
A multifactorial unpleasant emotional experience of a psychological (cognitive, behavioral, emotional), social, and/or spiritual nature that may interfere with the ability to cope effectively with cancer, its physical symptoms, and its treatment. Distress extends along a continuum, ranging from common normal feelings of vulnerability, sadness, and fears to problems that can become disabling, such as depression, anxiety, panic, social isolation, and existential and spiritual crisis (p. DIS-2).
The NCCN (2013) recommends screening for distress using a tool such as the distress thermometer, a single-item tool asking people to score how distressed they have been over the past week on a picture of a thermometer using a scale from 0 (no distress) to 10 (extreme distress) located at the top (see Figure 1). The person also completes a 39-item problem list, marking “yes” or “no” if the problem was experienced in the past week.
Overall, studies support the validity of the distress thermometer as a measure of cancer-related distress in adult and pediatric populations. Studies most often test construct validity of the distress thermometer with the Hospital Anxiety and Depression Scale (HADS), using HADS to determine specificity and sensitivity for identifying clinical cases. The distress thermometer was adapted and tested using English and Spanish versions in a pediatric oncology sample (Patel et al., 2011). A Danish version demonstrated validity in a study involving women with newly diagnosed breast cancer (Bidstrup et al., 2012). Validity is further supported in patients with advanced cancer (Ryan, Gallagher, Wright, & Cassidy, 2012) and family members of patients with cancer (Zwahlen et al., 2011). One limitation to validity studies is the predominance of studies occurring outside of the United States. Although a systematic review of cultural equivalence supports reliability, sensitivity, and specificity of the distress thermometer across languages and countries of study origin, Kayser, Acquati, and Tran (2012) identified the need for determining conceptual validity among immigrants and minority racial and ethnic groups within the United States.
Translation of the Distress Guideline Into Practice
Khuory et al. (2007) described five phases of translational research. The first phase (T0) focuses on a basic research question: “Do people with cancer experience distress?” T1 research is targeted toward a specific group: “What is the association between distress and people receiving cancer treatment?” The third translational research phase (T2) synthesizes research primarily for the goal of developing an evidence-based guideline. This level of research requires the use of valid measures of distress as well as support for interventions to decrease distress. The scope of the psychometric evidence is well presented in meta-analyses and systematic reviews of the measures used to assess distress and related concepts (i.e., anxiety and depression) (Carlson et al., 2012; Mitchell, 2010; Vodermaier et al., 2009; Ziegler et al., 2011).
Interventions to reduce distress are tested during the T2 phase of translational research. The NCCN Guidelines for Distress Management guideline provides a decision tree for referral based on the source of distress: physical, mental, social, spiritual, family, or practical problems. Therefore, interventions are targeted at the source of distress. Interventions to reduce distress related to physical symptoms are extensive and beyond the scope of this article, but more information can be found via the Oncology Nursing Society’s Putting Evidence Into Practice (PEP) guidelines, the NCCN’s Guidelines for Supportive Care, the Cochrane Review database, the National Guideline Clearinghouse, and the Joanna Briggs Institute, to name a few.
Interventions evaluating the efficacy of social interventions to reduce distress are inconclusive because of the poor quality of studies (Faller et al., 2013). Interventional research to alleviate cancer-related distress from spiritual sources is understudied. Published reports are primarily of qualitative design and in the area of palliative or end-of-life spiritual care. Care focusing on relationships and communication is viewed by patient participants as facilitators of spiritual care (Edwards, Pang, Shiu, & Chan, 2010).
A meta-analysis of randomized, controlled trials of psychological interventions for emotional distress concluded that interventions had a positive effect on reducing distress (Faller et al., 2013). The effect of the intervention was stronger in those with breast cancer or those who had metastatic disease. Most significantly, the investigators found that those interventions occurring during a longer period of time had a higher degree of sustained outcomes (Faller et al., 2013). Other studies support those conclusions (Carlson, Groff, Maciejewski, & Bultz, 2010; Franchi et al., 2013).
The fourth phase of translational research (T3) sometimes is referred to as dissemination, diffusion, or implementation research. In this stage, research focuses on using a guideline in the real-world setting. The research addresses the challenges of implementation because of the differences between the highly controlled environment in which research is conducted and the complexities of the clinical setting (Cochrane et al., 2007).
Three studies reported the diffusion of the NCCN Guidelines for Distress Management into practice. One study reported the uptake of the Guideline by NCCN institutions, with about half of the responding institutions routinely screening for distress, most using a tool other than the distress thermometer (Jacobsen & Ransom, 2007). A second survey of 448 oncologists found that 65% routinely assessed for distress, but only 14% used a validated instrument, and only 33% were at least somewhat familiar with the guideline (Pirl et al., 2007). The third study surveyed Oncology Nursing Society members (N = 420) working in ambulatory settings and reported that 38% of nurses were not at all familiar with the NCCN Guideline for Distress Management, and only 30% used a tool to assess for distress (Tavernier et al., 2013).
Suggestions have been made that distress should be considered as the “sixth vital sign” (Bultz & Carlson, 2005; Holland & Bultz, 2007). Feasibility of patients completing the distress thermometer digitally, using a tablet, is supported (Carlson et al., 2010), as is completion via telephone (Hughes, Sargeant, & Hawkes, 2011). The acceptability and usability of the distress thermometer adapted for pediatric patients experiencing cancer was not supported because the source of distress often was unable to be determined, and nonsignificant differences in the quantity of services were noted (Patel et al., 2011).
Translational research studies examining the process or outcomes of implementing the NCCN Guideline for Distress Management or distress thermometer include evaluating the impact of screening on referrals, trajectories of distress, and barriers to adoption. An observational study cautiously concluded that when nurses were educated on the use of the distress thermometer, referral rates to psychosocial oncology services were higher and more accurate (Grassi et al., 2011). In a large (N = 505) Canadian study involving patients with a distress thermometer score greater than 4, investigators found that 24% of the patients accessed at least one support service; and, of the 24%, the majority accessed an average of three services (Waller, Williams, Groff, Bultz, & Carlson, 2013). Participants who were older, female, or had a lower education level were less likely to self-refer themselves despite high levels of distress. A study in Japan found that patients experiencing severe distress had sustained distress if they had high-intensity scores on pain, fatigue, or appetite loss when compared with those who had low distress (Yamaguchi et al., 2012). However, distress levels were observed to be variable on repeated assessments, causing concern for over-referrals based on a single score (Carlson, Waller, Groff, Giese-Davis, et al., 2013; Yamaguchi et al., 2012).
Perceived barriers to adopting the distress thermometer or guideline include time, concern about inability to respond to increased demand for referrals, lack of knowledge about how to screen and manage distress, and no perceived benefit of screening (Absolom et al., 2011; Clark et al., 2012; Hughes et al., 2011; Oktay, Nedjat-Haiem, Davis, & Kern, 2012; Tavernier et al., 2013). Conversely, successful implementation, although reported primarily in case study or quality improvement projects, occurred when the implementation process had clear aims, regular data reporting, clinician comfort with introducing the distress thermometer, was perceived as beneficial to patient care, and was representative of team stakeholders in the planning and evaluation of the process (Absolom et al., 2011; Dudgeon et al., 2012; Hammonds, 2012; Oktay et al., 2012).
The fifth phase of translational research (T4) concerns the impact of a practice on populations. Because the goal of cancer treatment is to improve quality of life and/or increase longevity, an example of a research question related to the new American College of Surgeons standard is, “Does screening for distress improve the quality of life and/or survival of patients with cancer?” The impact of screening with the distress thermometer on overall survival of cancer has not been explored. Screening using the distress thermometer followed by individual triage in patients with lung cancer led to fewer reports of pain and problems with coping and family conflict compared to those receiving usual care or screening alone (Carlson, Waller, Groff, & Bultz, 2013). Screening has been found to reduce the time to referral (Thewes, Butow, & Stuart-Harris, 2009).
Research is one component of evidence-based practice, with the primary goal being the improvement of patient care outcomes (Titler, 2011). Translational research related to the NCCN Guideline for Distress Management and distress thermometer exists for all five phases, albeit sparse for the T4 phase. The distress thermometer is a quick, valid indicator of the degree to which a patient is distressed by cancer and its treatment. Oncology nurses able to articulate the research evidence are better prepared to be engaged and assume a critical role in the decision making and implementation (Scott & McSherry, 2009) of an institution’s approach to meet the Commission on Cancer standard.
Understanding that the distress thermometer is designed to screen for distress and is not a diagnostic tool is critical. Although the validity of the distress thermometer has been supported primarily using the HADS, the distress thermometer is not a diagnostic tool for depression or anxiety. When a patient is identified as having significant distress using the distress thermometer, additional assessment must occur to determine the source of distress. Additional assessment guides the appropriate referral or intervention. Using the distress thermometer should occur within those parameters and, as outlined in the NCCN Guidelines, a more in-depth assessment should be made for patients reporting levels of distress above established cutoff points.
Extensive research regarding the need to screen for cancer-related distress and the validity, feasibility, and acceptability of the distress thermometer exist. Although no significant intervention research findings for physical sources of distress have been noted, a need exists for research evaluating the efficacy of interventions related to the social, spiritual, and practical issues identified by the distress thermometer. Oncology nurses using the distress thermometer and the associated NCCN Guideline for Distress Management are encouraged to share the experience and to assist others attempting to integrate its use into routine care.
Implications for Practice
Ø Use the distress thermometer from the National Comprehensive Cancer Network to assess patients for distress.
Ø Assess a patient’s distress level on a routine basis because distress is influenced by many variables.
Ø Perform a follow-up assessment on patients reporting high levels of distress to ensure appropriate referral or intervention.
Absolom, K., Holch, P., Pini, S., Hill, K., Liu, A., Sharpe, M., . . . Palliative Care Research. (2011). The detection and management of emotional distress in cancer patients: The views of health-care professionals. Psycho-Oncology, 20, 601–608.
American College of Surgeons. (2012). Cancer program standards 2012: Ensuring patient-centered care. American College of Surgeons Commission on Cancer. Retrieved from http://www.facs.org/cancer/coc/programstandards2012.pdf
Bidstrup, P.E., Mertz, B.G., Dalton, S.O., Deltour, I., Kroman, N., Kehlet, H., . . . Johansen, C. (2012). Accuracy of the Danish version of the “distress thermometer.” Psycho-Oncology, 21, 436–443. http://dx.doi.org/10.1002/pon.1917
Bultz, B.D., & Carlson, L.E. (2005). Emotional distress: The sixth vital sign in cancer care. Journal of Clinical Oncology, 23, 6440–6441. http://dx.doi.org/10.1200/jco.2005.02.3259
Carlson, L.E., Groff, S.L., Maciejewski, O., & Bultz, B.D. (2010). Screening for distress in lung and breast cancer outpatients: A randomized controlled trial. Journal of Clinical Oncology, 28, 4884–4891. http://dx.doi.org/10.1200/jco.2009.27.3698
Carlson, L.E., Waller, A., Groff, S.L., & Bultz, B.D. (2013). Screening for distress, the sixth vital sign, in lung cancer patients: Effects on pain, fatigue, and common problems—Secondary outcomes of a randomized controlled trial. Psycho-Oncology, 22, 1880–1888. http://dx.doi.org/10.1002/pon.3223
Carlson, L.E., Waller, A., Groff, S.L., Giese-Davis, J., & Bultz, B.D. (2013). What goes up does not always come down: Patterns of distress, physical and psychosocial morbidity in people with cancer over a one-year period. Psycho-Oncology, 22, 168–176. http://dx.doi.org/10.1002/pon.2068
Carlson, L.E., Waller, A., & Mitchell, A.J. (2012). Screening for distress and unmet needs in patients with cancer: Review and recommendations. Journal of Clinical Oncology, 30, 1160–1177.
Clark, P.G., Bolte, S., Buzaglo, J., Golant, M., Daratsos, L., & Loscalzo, M. (2012). From distress guidelines to developing models of psychosocial care: Current best practices. Journal of Psychosocial Oncology, 30, 694–714. http://dx.doi.org/10.1080/07347332.2012.721488
Cochrane, L.J., Olson, C.A., Murray, S., Dupuis, M., Tooman, T., & Hayes, S. (2007). Gaps between knowing and doing: Understanding and assessing the barriers to optimal health care. Journal of Continuing Education in Healthcare Professions, 27, 94–102. http://dx.doi.org/10.1002/chp.106
Cohen, M. (2013). The association of cancer patients’ emotional suppression and their self-rating of psychological distress on short screening tools. Behavioral Medicine, 39, 29–35. http://dx.doi.org/10.1080/08964289.2012.731440
Dudgeon, D., King, S., Howell, D., Green, E., Gilbert, J., Hughes, E., . . . Sawka, C. (2012). Cancer Care Ontario’s experience with implementation of routine physical and psychological symptom distress screening. Psycho-Oncology, 21, 357–364.
Edwards, A., Pang, N., Shiu, V., & Chan, C. (2010). The understanding of spirituality and the potential role of spiritual care in end-of-life and palliative care: A meta-study of qualitative research. Palliative Medicine, 24, 753–770. http://dx.doi.org/10.1177/0269216310375860
Faller, H., Schuler, M., Richard, M., Heckl, U., Weis, J., & Küffner, R. (2013). Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: Systematic review and meta-analysis. Journal of Clinical Oncology, 31, 782–793. http://dx.doi.org/10.1200/jco.2011.40.8922
Fitch, M.I. (2011). Screening for distress: A role for oncology nursing. Current Opinion in Oncology, 23, 331–337.
Franchi, G., Bulli, F., Muraca, M.G., Maruelli, A., Grechi, E., & Miccinesi, G. (2013). Impact of a psycho-oncological rehabilitation intervention on psychological distress: The experience of CeRiOn (Oncological Rehabilitation Centre) Florence 2007–2010. Supportive Care in Cancer, 21, 2381–2386. http://dx.doi.org/10.1007/s00520-013-1803-x
Grassi, L., Rossi, E., Caruso, R., Nanni, M.G., Pedrazzi, S., Sofritti, S., & Sabato, S. (2011). Educational intervention in cancer outpatient clinics on routine screening for emotional distress: An observational study. Psycho-Oncology, 20, 669–674.
Hammonds, L.S. (2012). Implementing a distress screening instrument in a university breast cancer clinic. Clinical Journal of Oncology Nursing, 16, 491–494.
Holland, J.C., & Bultz, B.D. (2007). The NCCN guideline for distress management: A case for making distress the sixth vital sign. Journal of the National Comprehensive Cancer Network, 5, 3–7.
Hughes, K.L., Sargeant, H., & Hawkes, A.L. (2011). Acceptability of the distress thermometer and problem list to community-based telephone cancer helpline operators, and to cancer patients and carers. BMC Cancer, 11, 46. http://dx.doi.org/10.1186/1471-2407-11-46
Jacobsen, P.B., & Ransom, S. (2007). Implementation of NCCN distress management guidelines by member institutions. Journal of the National Comprehensive Cancer Network, 5, 99–103.
Kayser, K., Acquati, C., & Tran, T.V. (2012). No patients left behind: A systematic review of the cultural equivalence of distress screening instruments. Journal of Psychosocial Oncology, 30, 679–693. http://dx.doi.org/10.1080/07347332.2012.721489
Kendall, J., Glaze, K., Oakland, S., Hansen, J., & Parry, C. (2011). What do 1,281 distress screeners tell us about cancer patients in a community cancer center? Psycho-Oncology, 20, 594–600. http://dx.doi.org/10.1002/pon.1907
Khoury, M.J., Gwinn, M., Yoon, P.W., Dowling, N., Moore, C.A., & Bradley, L. (2007). The continuum of translation research in genomic medicine: How can we accelerate the appropriate integration of human genome discoveries into health care and disease prevention? Genetic Medicine, 9, 665–674. http://dx.doi.org/10.1097GIM.0b013e31815699d0
Mitchell, A.J. (2010). Short screening tools for cancer-related distress: A review and diagnostic validity meta-analysis. Journal of the National Comprehensive Cancer Network, 8, 487–494.
Mitchell, A.J., Hussain, N., Grainger, L., & Symonds, P. (2011). Identification of patient-reported distress by clinical nurse specialists in routine oncology practice: A multicentre UK study. Psycho-Oncology, 20, 1076–1083. http://dx.doi.org/10.1002/pon.1815
Mitchell, A.J., Vahabzadeh, A., & Magruder, K. (2011). Screening for distress and depression in cancer settings: 10 lessons from 40 years of primary-care research. Psycho-Oncology, 20, 572–584. http://dx.doi.org/10.1002/pon.1943
National Comprehensive Cancer Network. (2013). NCCN Clinical Practice Guidelines in Oncology for Distress Management [V.2.2013]. Retrieved from www.nccn.org/professionals/physician_gls/f_guidelines.asp#supportive
Oktay, J.S., Nedjat-Haiem, F.R., Davis, C., & Kern, K.C. (2012). Distress screening: Experiences of oncology social workers. Journal of Psychosocial Oncology, 30, 652–666. http://dx.doi.org/10.1080/07347332.2012.721490
Oncology Nursing Society. (2013). Implementing screening for distress: The joint position statement from the American Psychosocial Oncology Society, Association of Oncology Social Work, and Oncology Nursing Society. Oncology Nursing Forum, 40, 423–424.
Patel, S.K., Mullins, W., Turk, A., Dekel, N., Kinjo, C., & Sato, J.K. (2011). Distress screening, rater agreement, and services in pediatric oncology. Psycho-Oncology, 20, 1324–1333.
Pirl, W.F., Muriel, A., Hwang, V., Kornblith, A., Greer, J., Donelan, K., . . . Schapira, L. (2007). Screening for psychosocial distress: A national survey of oncologists. Journal of Supportive Oncology, 5, 499–504.
Roerink, S.H., de Ridder, M., Prins, J., Huijbers, A., de Wilt, H.J., Marres, H., . . . Netea-Maier, R.T. (2013). High level of distress in long-term survivors of thyroid carcinoma: Results of rapid screening using the distress thermometer. Acta Oncologica, 52, 128–137. http://dx.doi.org/10.3109/0284186x.2012.723822
Ryan, D.A., Gallagher, P., Wright, S., & Cassidy, E.M. (2012). Sensitivity and specificity of the distress thermometer and a two-item depression screen (Patient Health Questionnaire-2) with a “help” question for psychological distress and psychiatric morbidity in patients with advanced cancer. Psycho-Oncology, 21, 1275–1284.
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Susan S. Tavernier, PhD, APRN-CNS, AOCN®, is an assistant professor in the School of Nursing at Idaho State University in Meridian. The author takes full responsibility for the content of the article. The author did not receive honoraria for this work. The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the author, planners, independent peer reviewers, or editorial staff. Tavernier can be reached at email@example.com, with copy to editor at CJONEditor@ons.org. (Submitted September 2013. Accepted for publication September 15, 2013.)
Key words: distress; translational research; evidence-based practice

domain: psychology


text:
There's a scene in Blue Valentine (out Dec. 31) in which a young couple, played by Michelle Williams and Ryan Gosling, teeter into love, aided by an impromptu ukulele serenade and soft-shoe. It's one of those magic movie moments wisely featured in the trailer for the film capturing the heady rush of early infatuation. And it's what makes sequences of the same couple's marriage falling apart all the more painful to watch. ''I feel like the audience is divided between people who've had their heart smashed into smithereens and people who haven't,'' says Williams. When she hears that it took this reporter three days to recover emotionally from the film, she exclaims, ''Oh, good!''
Since its premiere at January's Sundance Film Festival and subsequent acquisition by The Weinstein Company, Blue Valentine has generated a groundswell of buzz for its unblinkingly honest (if not always pretty) portrait of a marriage, not to mention its two stars' performances. But last month, in a move that could jeopardize its box office and awards prospects, the MPAA slapped the film with a dreaded NC-17 rating, apparently for a graphic scene of Gosling's character performing oral sex on Williams'. (A rep for the MPAA declined to comment.) ''We're going to have to overturn this,'' says TWC co-chair Harvey Weinstein, who adds he has no intention of cutting the scene and has already assembled a team of lawyers to prep a formal appeal. ''How did Piranha 3D get an R and Blue Valentine get an NC-17?'' asks Weinstein, citing the August horror film released by TWC's own Dimension label. ''If [Piranha 3D] got an NC-17, I'd be the first going, 'All right, we gotta cut some of that stuff.' It's ridiculous a penis is coughed up by a piranha! They show more in four scenes than we show in [all of Blue Valentine], and ours is a serious love story,'' he says. ''I don't understand it.'' The actors are similarly flummoxed. ''It's devastating news,'' says Williams, ''because it makes the film sound tawdry or seedy when it hopes to be the exact opposite.''
Fighting the MPAA is just the latest bump in the road for a film that's taken writer-director Derek Cianfrance (Brother Tied) 12 years to make. Williams came aboard in 2003, just as she was ending her six-season run on Dawson's Creek (see below). ''[The script] attached itself to me and became a part of me. It filled up the room that I lived in, filled the head that I walked in,'' says the 30-year-old actress, who earned an Oscar nomination for 2005's Brokeback Mountain. Gosling, also 30, signed on a couple of years later when Blue Valentine producer Jamie Patricof who also produced Half Nelson, the 2006 indie for which Gosling picked up his own Oscar nod handed him the script and declared it would be the actor's next movie. ''I read it and I agreed,'' says Gosling. ''Though it wasn't my next movie because it took another four years.'' He pauses. ''Derek has a fascination with time it's in everything that he does. He makes a six-hour chicken it has to take six hours to make. If it's five hours, it's not even worth eating. He believes that time makes things better.''


Brainomix and Nanoflex Robotics have announced today that they have been awarded a grant via the ‘UK—Switzerland Bilateral: Collaborative R&D [research and development]’ programme, under which the companies will work together to jointly develop an integrated remote diagnosis and treatment platform for stroke, powered by artificial intelligence (AI).
The grant, administered by Innovate UK and Innosuisse—the respective innovation agencies of the UK and Switzerland—has awarded Brainomix £400,000 and Nanoflex CHF400,000.
Starting in 2024, the two companies will collaborate to create an AI-assisted magnetic navigation system for robotic surgical tools. The project will leverage Brainomix’s AI-enabled diagnostic imaging capabilities and Nanoflex’s precise magnetic navigation technology to create an assisted-navigation feature for interventional devices, such as catheters, as they move through the vascular network of a patient.
“We are grateful for the support of Innovate UK to fund our work with Nanoflex Robotics,” said George Harston, chief medical and innovation officer at Brainomix. “The project aims to leverage the power of artificial intelligence to enhance Nanoflex Robotics’ cutting-edge magnetic robotic navigation system to be the first system worldwide to enable remote thrombectomy, thus transforming stroke treatment options and helping improve outcomes for patients.“
“Time is critical when it comes to treating stroke patients,” added Christophe Chautems, chief technology officer at Nanoflex. “Every delay in removing a blood clot reduces the chance of post-stroke functional independence. By enabling increased and earlier access to mechanical thrombectomies through our remote robotics platform, we hope to give more people a greater chance to live independent lives after stroke.”
Nanoflex’s first product will be a mobile robotics system that utilises ultra-flexible guidewires to allow for direct steering of the tip. This gives physicians precise control and dexterity over a range of complex interventions.


text:
Coffee travel around South – East Asia
When I was travelling around Asia, I spoke with many local baristas. I also used the chance to participate in various coffee brewing workshops.
I am amazed, how baristas in Asia generally have a strong desire to really understand the complex processes of coffee growing, harvesting, processing, roasting, brewing and tasting. They want to know, how one process has a causal effect on the other processes. Many Asian baristas enjoy tasting coffee knowledgeably. It brings them happiness to understand why for some brews the most notable flavor is blueberry or dark chocolate.
During my coffee workshops in Chiang Mai, Thailand, I did not learn any brewing recipes that I would always follow once being back in Europe. Instead, we exchanged our ideas and philosophies why we like to drink coffee.
My teachers explained to me how the process of brewing works. Before we started the brewing process, we decided what style of coffee we want to make and we also got to know our coffee beans and the chemistry of our brewing water. My teachers recommended me different grind sizes for various brewing methods. I also learned what goes on, when water passes through the coffee grounds. My teachers helped me to understand, how flavors are distracted from the coffee grounds into the water.

domain: chemistry


text:
Located in Canberra, Red Cedars Motel is near the airport and near a metro station. The area's natural beauty can be seen at Commonwealth Park, while Australian War Memorial and National Gallery of Australia are cultural highlights. Looking to enjoy an event or a game while in town? See what's happening at Canberra Stadium or Manuka Oval. Spend some time exploring the area's activities, including winery tours.
This smoke-free motel features laundry facilities, free newspapers and barbecues. Free WiFi in public areas and free self parking are also provided. Other amenities include a reception hall. All 30 rooms provide fridges, coffee makers and TVs. Guests will also find showers and ironing boards. Change of towels is available on request
Red Cedars Motel offers 30 forms of air-conditioned accommodation with an iron/ironing board. Fridges and coffee/tea makers are provided. Bathrooms include a shower. Change of towels and change of bedsheets can be requested.
Cleaning and safety practices
Enhanced cleanliness measures
Disinfectant is used to clean the property
High-touch surfaces are cleaned and disinfected
Sheets and towels are washed at 60°C or hotter
Follows the industry cleaning and disinfection practices of Safe Travels (WTTC - Global)
Protective shields in place at main contact areas
Guest rooms kept vacant for 24 hours between stays
Social distancing measures in place
Temperature checks given to staff
Hand sanitiser provided
This information is provided by our partners.
Available in some public areas: Free WiFi
Parking and public transport
Free uncovered self-parking on site
Wheelchair-accessible parking available
Free newspapers in reception
Change of bedsheets (on request)
Change of towels (on request)
Front desk (limited hours)
If you have any requests for specific accessibility needs, please contact the property using the information on the reservation confirmation received after booking.
The front desk is open daily from 7:30 AM - 8:00 PM
If you are planning to arrive after 9 PM please contact the property in advance using the information on the booking confirmation
Front desk staff will greet guests on arrival
Staffed front desk
Pets not allowed (service animals welcome)
Service animals are exempt from fees
Children and extra beds
Children are welcome
Rollaway/extra beds are not available.
Cots (infant beds) are not available
You need to know
Extra-person charges may apply and vary depending on property policy
Government-issued photo identification and a credit card, debit card or cash deposit may be required at check-in for incidental charges
Special requests are subject to availability upon check-in and may incur additional charges; special requests cannot be guaranteed
This property accepts credit cards; cash is not accepted
This property reserves the right to pre-authorise the guest's credit card prior to arrival.
We should mention
This property welcomes guests of all sexual orientations and gender identities (LGBTQ friendly)
Property is also known as
Red Cedars Motel Watson
Red Cedars Motel
Red Cedars Watson
Red Cedars Motel Motel
Red Cedars Motel Watson
Red Cedars Motel Motel Watson
Frequently asked questions
Yes, Red Cedars Motel offers free cancellation on select room rates, because flexibility matters! Please refer to Red Cedars Motel cancellation policy on our site for more details about any exclusions or requirements.
As of 18 Jun. 2021, prices found for a 1-night stay for 2 adults at Red Cedars Motel on 25 Jun. 2021 start from AU$113, including taxes and fees. This price is based on the lowest nightly price found in the last 24 hours for stays in the next 30 days. Prices are subject to change. Choose your dates for more accurate prices.
No, only service animals are welcome at the property.
Self-parking is free at this property.
Check-in is from 2 PM - 9 PM. Late check-in is available during limited hours.
Checkout is at 10 AM.
Located in Watson, this motel is within 1 mile (2 km) of EPIC and Kamberra Function Centre. Mount Majura is 2.5 mi (4 km) away.
Very comfortable room with good kitchenette and bathroom (noisy fan though). Importantly, the air conditioner and the TV were really good and the room painting, carpet and bed coverings were clean and comfortable.


text:
Across from monuments and trees honoring slain teen Hillary Norskog and victims of the 1995 Oklahoma City bombings, another plaque until Monday lay in near obscurity on the grassy memorial hill outside the Palos Hills Police Station.
That plaque, donated by a city alderman, was supposed to be a simple memorial to Robert Brian Flewwelling, who died in 1994.
But on Monday only a hole in the ground in front of a sapling remained after Mayor Gerald Bennett ordered the plaque removed, saying that he and the City Council were unaware of the honoree's 1984 conviction for contributing to the sexual delinquency of a child.
Bennett said there is no formal procedure for checking the backgrounds of those being honored by memorials in the city, but that may soon change.
"This is a little bizarre, this situation," said Bennett. "We just accept the tree from someone who wants to donate the tree.
"It'll (the procedure) change in the future. We'll have to come up with something."
Ald. Pauline Stratton said she was "outraged" when she learned of Flewwelling's conviction.
"I just thought it was a real bad reflection on the city and especially with the police department," she said.
Stratton said she believed that someone should have known of Flewwelling's past because the officers who arrested him in December 1984 are still on the police force.
But Police Chief Paul Madigan said Monday that the police department was not involved with the installation of the plaques.
"We don't know a lot about this," he said. "This was a political thing."
The memorial was donated by Ald. Andy Galatte, who employed Flewwelling as a landscape designer with Galatte's company, Galatte Landscaping, at 8200 W. 111th St., Palos Hills, according to Galatte's son, Joe.
Andy Galatte was on vacation Monday and unavailable for comment.
Flewwelling's was one of five plaques placed on a hill just east of the police department. A memorial to Hillary Norskog, a Palos Hills teenager who was brutally slain in July 1993, and victims of the Oklahoma bombing were also donated by Galatte, Bennett said.
Flewwelling was 31 in June 1984 when he and another Palos Hills man, Robert Zaitz, were convicted of forcing a 15-year-old boy to perform and participate in oral sex. Flewwelling pleaded guilty in January 1985. He was fined $90 and sentenced to six months of court supervision, according to court documents.
Zaitz was convicted of four counts of contributing to the sexual delinquency of a minor and sentenced to 40 years in prison, according to court documents.
Joe Galatte, who said he along with his father was friends with Flewwelling, said he only recently learned of the conviction. Nonetheless, he said it doesn't change the way he feels about his friend.
"He was a pretty good guy," he said. "I don't even know if (the charges were) true. I wasn't there. If someone wants to dedicate a plaque to him, let him."

domain: law


text:
“Patently Apple has discovered that Apple Inc has recently acquired thirty-two new patents and/or patent applications covering such matters as playlists, music kiosks and possibly finance, fitness and shopping apps, too,” Jack Purcher reports for Patently Apple.
“The transaction took place earlier this month. The patents hold promise and may even assist Apple in one of their current legal cases,” Purcher reports. “Today’s report generally covers the patents that were acquired by Apple and points to a twist in the process of how Apple came across these patents.”
Purcher reports, “At the end of the day, our report could have been titled: Apple Acquires Patents: The Good, the Bad and the Ugly.”
Much, much more in the full article here.