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Engage Blog: Christ-Centered Family Relationships during a Crisis
Makes You Think
Ron Welch,Professor of Counseling
It is said that a crisis brings out the best and worst in people. That certainly seems to have been proven true during the current COVID-19 crisis. We’ve seen neighbors going out of their way to help those in need in their communities, and we’ve seen people shoving others out of the way in stores to get to the last package of toilet paper. As restrictions are slowly lifted and life resumes some level of normalcy, what we will do differently in our family relationships as we move forward?
Most of us have spent recent weeks at home with family members either due to working from home or losing employment. There have been both positive and negative effects from this change, and we’ll look at both of these in this article. The primary goal of this piece, though, is to determine the “lessons learned” from this change to our routine and to identify the Christ-centered relationship guidance we can take with us into our family relationships after the crisis passes.
One of the most harmful effects of the stay-at-home experience has been the loss of social support systems. The church families we relied on for spiritual guidance and accountability, the friends and family we spent time confiding in and playing with, and our work colleagues we previously spent so much time with, were all kept “socially distant.” Loved ones who contracted the virus were facing serious and sometimes life-threatening illnesses and we weren’t allowed to see them. We faced new levels of social isolation.
On top of that, our carefully crafted rhythm of interacting with our spouses and children was rocked to the core, as those we love were suddenly around us 24/7. The increased “quality time” with our families that we have always wished for turned out to present some challenges, as well! School-age kids were home every day, college kids returned to live at home, and spouses we usually didn’t see during the day were competing for bandwidth for Zoom meetings (at least, those lucky enough to still have a job they could do from home). Completing work tasks seemed to take so much longer in this “new normal.”
Finally, and perhaps most destructively, many of us lost one or both of our primary family sources of income. The stresses of financial pressure led to strained relationships, frustration, and a sense of helplessness. Children from K-12 were required to learn in new ways and college-age students often faced simultaneous educational challenges and job loss. The future looked, and still looks, very uncertain.
In the midst of these challenging experiences, there were many positive effects of sheltering at home. There were opportunities for quality family time playing games, sharing family meals and devotionals, and actually talking with each other. Work schedules, for those fortunate enough to have a job, were more flexible and under our control. Technical skills doing our work online, learned out of necessity, helped us discover more effective and efficient systems for working in the future.
Through this storm, as with all storms, God has been right here beside us. While working with families during this time and watching those around me, I have come to believe that there are (at least) four lessons we can learn from this experience that will help us model Christ in our family relationships in the midst of this storm and in the calm that is sure to follow. This increased time with our families can be seen as an opportunity to make some permanent changes in our family relationships. These relationship changes can become a testament to our Christian faith long after the crisis is over.
Lesson #1 -Unselfishness is better than selfishness.
Ephesians 5:22 (NIV) says, “Wives, submit yourselves to your own husbands as you do to the Lord” and verse 25 says “Husbands, love your wives, just as Christ loved the church and gave himself up for her.” That’s pretty clear guidance to prioritize others over yourself. Pay attention to the people you are living with. Think about what they need before your own needs. Clean up the dishes so others don’t have to. Put your work on hold to go play with that beautiful child who is holding up the Frisbee with adoring puppy dog eyes. Take time to have a romantic lunch on the back porch with your loving spouse. Choose to love those around you first and worry about your own needs later.
Lesson #2 -Control your family schedule.
Control your weekly schedule -don’t let it control you. Ephesians 5:15-16 (NIV) says, “Be very careful, then, how you live -not as unwise but as wise, making the most of every opportunity, because the days are evil.” Consider taking control of your schedule by sitting down with the family on Sunday night before the week starts and planning out when you will have couple time, family time, conflict resolution time, and play time. In this crisis situation, with so many things changing, it is more important than ever to plan out your days and weeks. If your spouse’s name doesn’t appear in your calendar schedule for the week, something is wrong.
Lesson #3 -Set aside time for spiritual disciplines.
When your routine is upset, it is easy to let spiritual practices go as other demands take priority. Plan time in your week for family devotionals, participate with your family in a weekly church service in whatever format it is delivered, and maintain your small group participation. Perhaps most importantly, make time for God. Philippians 4:8 (NIV) encourages us to think on things that are true, noble, right, pure, lovely, admirable, excellent, and praiseworthy. Don’t minimize your personal prayer and Bible study time just because someone requests a Zoom meeting. Lock those times with God in first, and schedule everything else around them.
Lesson #4 -Stay positive.
Many families have found themselves complaining about the negative effects of the crisis instead of focusing on the positives. 1 Thessalonians 5:11 (NIV) says, “Therefore encourage one another and build each other up…;” Make sure you sit down with your family every day and thank God for the blessings you have. Thank God for the work you are still able to do, for the school progress the children are still able to make, and the time you have as a family. If you are unable to work right now or are dealing with the effects of the virus, take comfort in the promise that God has made that He is Immanuel and that He is with us in the midst of the storm.
Crises do, indeed, bring out the best and the worst of us. After 9/11, it was reported that church attendance surged, but that it then returned to previous levels only a year later. I want to challenge you and your family to not just return to the “old normal.” Let God use this time to strengthen your bonds with your children, enrich your marriage, and create new patterns that you can maintain in the future. If you do that, the legacy of this crisis will be that it brought out the “best in you” and resulted in a stronger, healthier, and Christ-centered family.
Dr. Ron Welch has worked in the field of clinical psychology for over 20 years, has been a licensed clinical psychologist since 1997, and holds a diplomate in professional counseling. Ron had maintained a private practice specializing in marriage and family work since 2004 before opening his Transformational Marriage™ practice in 2012. He earned his PsyD and MA in clinical psychology from Central Michigan University. Ron’s most recent book is10 Choices Successful Couples Make: The Secret to Love that Lasts a Lifetime.

domain: psychology


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You can add some gift cards to your PayPal account to use for purchases but not all gift cards are compatible.
Can I transfer iTunes card to PayPal?
Question: Q: Is it possible to transfer money from my iTunes card to my paypal/or bank? … You can’t redeem or return iTunes Gift Cards, Gift Certificates, and unused store credit balances for cash except as required by law.
Are Apple gift cards transferable?
You cannot gift your balance to someone else. However, you can put an UNUSED balance back to the original gift card. In contacting Apple for help, make sure you use the proper terminology for your issue.
How do I transfer Apple gift card to bank account?
Transfer in 1 to 3 business days
- Go to your card info: On iPhone: Open the Wallet app, tap your Apple Cash card, then tap the more button . …
- Tap Transfer to Bank. …
- Enter an amount and tap Next.
- Tap 1-3 Business Days. …
- Confirm with Face ID, Touch ID, or passcode.
- Wait for the money to transfer.
Can I apply a gift card to PayPal?
Yes. Anywhere in the U.S. where PayPal is accepted you can use prepaid gift cards that have a Visa®, MasterCard®, American Express®, or Discover® logo on it. … For PayPal members, you can simply add prepaid gift cards to your wallet then start using them during checkout – just like any other credit or debit cards.
Can you transfer iTunes money to Apple pay?
No, an iTunes Gift Card cannot be added to your Apple Pay Cash balance or used in any other way via Apple Pay. No, an iTunes Gift Card cannot be added to your Apple Pay Cash balance or used in any other way via Apple Pay.
How can I turn my iTunes gift card into cash?
You’re never going to get the face value of the card, but for popular cards, such as Target, Walmart and iTunes, you can get up to 92 percent of what it’s worth. Two sites specialize in selling unwanted gift cards: Cardpool and Raise. Cardpool buys directly from consumers. You can get an instant quote online.
Can you buy iPhone with Apple giftcard?
An Apple gift card is a perfectly valid form of payment towards the purchase of an iPhone.
Is Apple gift card same as iTunes?
Then use it to pay for Apple products, accessories, apps, games, music, movies, TV shows, iCloud, you name it. Apple Gift Cards are solely for the purchase of goods and services from the Apple Store, the Apple Store app, apple.com, the App Store, iTunes, Apple Music, Apple TV, Apple Books, and other Apple properties.
Can I use a Apple gift card for Apple Pay?
To add an APPLE STORE gift card to your wallet: Open the wallet app. This is the important part. … Only debit/credit and Apple Pay cash.
How do I gift Apple ID balance?
Email a gift card from your computer
- Open the iTunes Store in the Music app or the Book Store in Apple Books. …
- Under Quick Links, click Send Gift.
- Enter your recipient’s email address.
- Add a message.
- Click the amount that you want to gift, or click Other to enter a different amount.
How do I transfer app store credit to Apple pay?
How to quickly link your iTunes credit or debit card to Apple Pay
- Launch the Passbook app on an Apple Pay-compatible iPhone or iPad.
- Pull down from the top of the screen to reveal the plus sign — tap on the plus sign.
- Tap on Set Up Apple Pay.
- Log in to your iCloud account when prompted.
- Tap on Use Card on File with iTunes.
Can I transfer Amazon gift card to PayPal?
Re: Amazon.com Gift Card
However, a gift card can be added to PayPal by linking the card number in the Wallet section of the account. Once the card has been added as a debit/credit card, it can be used to pay for purchased completed using PayPal.16 мая 2016 г.
Can I convert a gift card to cash?
If you’re looking to get a fast payout for your gift cards, you can bring your cards to kiosks that offer instant money in exchange for the cards. Here’s a resource to help you find the nearest kiosk location, which are usually located inside of grocery, department or check-cashing stores.
Can I transfer money from a gift card to my bank account?
Yes, you can transfer money from most prepaid gift cards to your bank account using a service called CardCash. … It’s more expensive than just using the gift card or prepaid card to buy items. So make sure that it’s really the cash value that you want from the gift card.

domain: finance


MOSCOW, March 1 (RAPSI) – A bill on the simplified procedure of obtaining citizenship for residents of Crimea, who were outside the peninsula at the time of its reunification with Russia, has been submitted to the State Duma by a group of the country’s members of parliament, according to the lower house’s database.
Under the bill, citizens of Ukraine and stateless persons permanently residing in Crimea, who deregistered domicile before March 18, 2014, temporally departed from the peninsula “for work, education, medical treatment or personal reasons”, and did not receive a passport of a Russian citizen on return till now, would have a right to apply for citizenship using the simplified procedure.
Amendments are proposed to the federal law “On Citizenship of the Russian Federation”.
Crimea reunited with Russia following a referendum in March 2014. Over 96 percent of those who took part in the polls voted for joining Russia.


Ignition User Defined Types (UDTs) are a powerful tool for consistently modelling pieces of equipment that are replicated throughout a system. For example a pump may have multiple variables such as pressure, temperature and flow, and by creating a UDT definition for that pump we can then replicate every instance of that pump in the system.
A UDT definition also flows directly through our Cloud Injector Modules allowing for dynamic system modelling within your Bigdata platform.
In this tutorial we will explain how the data in a UDT is represented when using MQTT Transmission and MQTT Engine along with best practices for managing UDT definitions.
- Have completed the Getting Started: Two Ignition Architecture tutorial
- Have installed and configured a second Edge device pointing to the Ignition Distributor gateway
Creating and Publishing a UDT
Step 1 - Open Designer sessions
Open three separate Designer sessions and connect to each of the three instances of Ignition:
- Edge1 running MQTT Transmission
- Edge2 running MQTT Transmission
- Ignition running MQTT Engine
In the Tag browser, set the Column selection to include Value and Data Type. Your designer views will look similar to the views below:
Step 2a - Create a UDT definition on Edge1
From the Designer pointing to your Edge1 instance create a new UDT with the following properties:
- Name: Pump
Add a Memory Tag member to the Pump UDT with the following properties:
- Name: Pressure
- Value: 123
Add a second Memory Tag to the Pump UDT with the following properties:
- Name: Flow
- Value: 50
Step 2b - Create an instance of the UDT on Edge1
Under your device PLC1, create an instance of the UDT "Pump" with the following properties:
- Name: Stream1
Your designer view connected to Edge1 will now look like this:
Step 3 - Publish the newly added UDT instance
On the Edge1 Ignition instance UI, navigate to the MQTT Transmission Transmitters settings by selecting Config > MQTT TRANSMISSION > Settings and selecting the Transmitters tab.
Edit the Example Transmitter and ensure that the Convert UDTs parameter is deselected. This will enable the UDT Definition to be included as part of the BIRTH and disable the UDT member tags from being converted to normal tags before publishing.
From the Designer pointing to your Edge1 instance force a refresh by switching the provider to MQTT Transmission and selecting the Refresh click box under Transmission Control. This Boolean control will automatically deselect once the BIRTH has been published.
From the Designer pointing to your MQTT Engine instance, you will now see the tag Stream1 with a data type of Pump published from the Edge1 device:
and can see the Pump UDT Definition in the UDT Definitions tab:
From the Designer connected to the Edge1 instance, make changes to the Stream1 tag Flow and Pressure member tags and see the data published and displayed on the MQTT engine instance of Designer.
Now we have our UDT defined we can replicate this across our other edge devices.
Replicating a UDT across other Edge devices
Step 1 - Export/Import the Pump UDT definition
Following the instructions Ignition Importing and Exporting Tags, select the UDT Definition to export from the Edge1 device and import to the Edge2 device
Step 2 - Create a new instance of the Pump UDT on Edge2 and publish
The name of the instance does not have to be different as the tag path of group/edge/device will fully define the data.
Your Designer views will look similar to the ones below:
You cannot have UDTs definitions with the same name and different tag members within the system. The MQTT Engine will ignore any new UDT definitions received that share the same name as the first recorded UDT definition.
This means that if you are updating a UDT, you cannot simply add or remove a tag member from the UDT and force the refresh to publish a birth certificate as the MQTT Engine will ignore the revised definition.
The recommended method is to create a new UDT definition on the Edge device that inherits from the existing UDT definition. This is done by setting the property Parent Data Type of the new UDT definition to the existing UDT definition. This will allow you to manage versioning for your UDT definitions and prevent published data being ignored by MQTT engine.
In the example below, we have created a new UDT named Pump1 with the inherited tags from Pump and added a new memory tag of Temperature.
Once the new definition is created, you can create an instance on the edge device and force the refresh. The new UDT definition will be recorded by MQTT engine and the data processed correctly without impacting the data published from other edge devices. The system can run like this indefinitely with the updated definition imported into any other locations that need to use that new definition.
Changes made at an edge device to UDT definition member tags are not propagated through the system. You will see that any tag instances of that UDT at the edge device will reflect the changes, but the recorded definition for the UDT at engine will not change nor will tag instances for other edge devices using that definition.
If you make any change to an existing UDT definition you will need to also:
- Delete the UDT definition at the MQTT Engine
- Delete all instances of tags using the UDT definition at MQTT Engine
- Note: If using MQTT Engine 4.0.16 and newer, this step is no longer required
- Delete the stale variant of the UDT definition in all edge devices through out the system
- Export the updated UDT definition from the edge device and import into all other edge devices
- Force a refresh at each edge device
UDT Collision Detection
UDT collision detection is now available in MQTT Engine module 4.0.16 and newer and uses the MD5 sum of the UDT to detect differences.
If a collision is detected, a warning will be logged and you can see the detail by setting the com.cirruslink.mqtt.engine.gateway.sparkplug.SparkplugBPayloadHandler to TRACE.
This detail will show the UDT definition at MQTT Engine and also the UDT definition published in the NBIRTH message. The offending edge node can be identified from the NBIRTH message.
- Add additional Edge devices to the system using the same UDT.
- Create nested UDTs to build local systems.


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Cam Jansen: The Mystery of the Monster Movie #8
- Your price$4.99
You'll see how many points you'll earn before checking out. We'll award them after completing your purchase.
The Cam Jansen books are perfect for young readers who are making the transition to chapter books, and Cam is a spunky young heroine whom readers have loved for over two decades. Now the first ten books in the series have updated covers that bring new life to these perennial best-sellers. Old fans and new readers will love Cam's cool, modern look!
- Penguin Young Readers Group, July 2004
- Download options:
- EPUB 2 (Adobe DRM)
You can read this item using any of the following Kobo apps and devices:

domain: literature


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On December 15th, 1988, Keith Richards and his incomparable band, The X-Pensive Winos, played the Hollywood Palladium. It was the penultimate show in a 12 city US tour and a night both band and audience will never forget. Now this legendary concert is available for the first time as a limited edition box set.
Across all formats – Boxset, CD, 2LP vinyl & digital – Keith Richards leads his absolutely smokin’ band through one classic after another including his landmark solo tracks ‘Take It So Hard’, ‘Make No Mistake’, to Stones classics ‘Happy’ and ‘Connection’. Exclusive to the Boxset and Digital formats are 3 previously unreleased tracks ‘Little T&A’, ‘You Don’t Move Me’ and the Lennon-McCartney penned hit ‘I Wanna Be Your Man’.
Listen to ‘Little T&A’, below:
“The real stuff,” is how Keith Richards describes The X-Pensive Winos.
“I wish to thank all the guys in this crazy beautiful band. Something to love. I know I do.”
Keith had assembled the core of this band throughout 1987 and ’88 during the ‘Talk Is Cheap’ sessions. For this first ever live solo Keith Richards tour, the stellar line-up was a who’s who of the finest musicians on the planet: guitarist Waddy Wachtel (Everly Brothers, Fleetwood Mac, Linda Ronstandt, Stevie Nicks), drummer Steve Jordan (long time Keith collaborator), bassist Charley Drayton, keyboard player Ivan Neville (Rolling Stones collaborator), singer Sarah Dash, and on saxophone, the inimitable, late great, long time Rolling Stones sideman Bobby Keys.
Live At The Hollywood Palladium comes as a special deluxe box set, presented in a matching folio, wrapped in a black cotton replica of the tour shirt sold that night, complete with a satin VIP pass on top, also including an impeccable all-new essay ‘The Loosest Tight Band You’ve Ever Heard’ by renowned rock writer David Fricke. It comes as a reissue after the original album was released due to popularity of the bootlegs.
Pre-Order Live At The Hollywood Palladium here
‘Live at the Hollywood Palladium’ Tracklisting
Take It So Hard
How I Wish
I Could Have Stood You Up
Make No Mistakes
Time Is On My Side
Whip It Up
I Wanna Be Your Man (Box Set and Digital Only)
Little T&A (Box Set and Digital Only)
You Don’t Move Me (Box Set and Digital Only)
Super Deluxe Box Set:
The remastered album on 2 180g LPs
10” vinyl of 3 unreleased bonus tracks (I Wanna Be Your Man, Little T&A, You Don’t Move Me) *Exclusive to this box set only*
Remastered CD of original album
DVD of original concert film *Exclusive to this box set only*
40 page, hardback book with David Fricke essay featuring a new interview with Keith, plus extensive rare and unseen photos from Keith’s archives
Reproductions of archival materials from the tour including:
Tour press release
Keith’s handwritten setlist
Hand-drawn band dressing room sign
Tour itinerary Press photos
VIP & backstage passes
Keith’s custom Hollywood Palladium plectrum
Promotional wine label & bag given away at the show . . . and more!
Other formats available include:
1CD remastered album
2LP 180g remastered album
2LP 180g Limited Edition Red remastered album Digital

domain: entertainment


FLCC men even mark
The Finger Lakes Community College men's soccer team evened its record at 4-4 with a home shutout against Erie Community College Monday, 3-0.
Jerry Orr struck first only one minute into the game, while Chad Hallsted and Rob Wheeler contributed the other two goals. Coy Mason, Josiah Travis and Casey Venets combined for eight saves for FLCC.
FLCC coach Gene Wild said that his team played well and added, "hopefully they'll continue to improve with each game."
FLCC 3, MVCC 1
In Canandaigua, FLCC pulled off an impressive win over Mohawk Valley Community College
Nikki McGraw scored two of FLCC's goals, with assists from Amanda Butcher (Greece Arcadia). Heather Green (Marcus Whitman) added the game winning goal, with an assist by McGraw. Brittany DeBole blocked 12 of 13 shots against her in goal.
Mohawk Valley is ranked second in the country. With the big win, FLCC is now 7-0.


One should always begin at the beginning, at least that’s what they say – with the Walco F110E Series Friction Feeder at the head of your mailroom equipment, you’ll look forward to starting your mailing processes over again and again. If there was a universal piece of mailing equipment every mailing business should have, this would be it.
It’s an innocent enough piece of equipment, essentially just a chute and some belts, but the amount of time and effort a Walco F110E Series Friction Feeder can save you can be stupendous. Instead of having to manually feed and straighten the mail that goes into your system, this fancy bit of mailroom equipment will do all that for you – you just need to sort it and drop it in the feeder. You can integrate it anywhere in your system or use the Walco F110E alone with postage equipment.
When it comes to beginnings, the Walco F110E Series Friction Feeder will always be there to start whatever mail process you need started. But that’s not all, it also has these incredible features:
Optional components are available, including an articulating acceleration assembly that separates pieces within the feeder, a remote speed POT that moves the speed control closer to conveyor speed controls and speed following, which allows the feeder to follow transport belt speeds with one central control.
If you’re ready to simplify your mail’s beginning, it’s time to take a closer look at the Walco F110E Series Friction Feeder.
Stephen W (NC) 7/10/2018 11:08 AM
This is how a feeder should be built. We haven’t replaced a single bearing or shaft. In the same timeframe, we’ve rebuild our S############## 3 times and our S########### 4 times. We could have purchased 2 more F110E for what we spent on the S############## or the S###########. Not to mention the downtime. I showed the invoices to the owner on a Friday, and the production manager quit on Monday. Guess who is the new production manager! I feel bad for him, but this is just a sample of the bad decisions he made. Like recently purchasing a used Secap Jet1. Turns out, it’s no longer supported so we can’t get parts
The F110E is a Beast!
Marc (PA) 9/1/2016 4:25 PM
We’ve had the F110E friction feeder for 2.5 years now. We have a SureFeed, Straight Shooter and a StreamFeeder. The Walco not only feeds better, it’s a lot more durable! We haven’t changed a single part on it yet! The other feeders would need belts and separators and far too often, bearings and shafts. Saving up for the Walco VF200 vacuum feeder.
Built like a tank!
Bill M (Bensalem, PA) 4/21/2014 1:48 PM
We have a Surefeed feed, a Stream Feed, and a Straight Shooter. Thank you Walco for finally getting it right! They guys actually fight over who is going to get the F110 to run their job with. So we will be buying another one or 2 as soon as the others throw another bearing. I’ve had it with buying bearings and shafts for the other feeders! Never again! The Walco sets up easy and feeds a lot more consistently.
Want more durability and productivity? Vacuum Friction Feed? Check out the Walco VF200 High-Speed Commercial Vacuum Friction Feeder


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Little Caesars Is Making a New Lasagna Pizza
Some may say that pizza is perfect just the way it is, no need for improvements. But it looks like Little Caesars would disagree. The fast food pizza purveyor is rolling out a new type of pizza like none you’ve tasted before, though the jury’s still out on whether that’s a good thing or not.
The chain recently started testing a Lasagna Pizza that combines everything you love about lasagna, with everything you love about pizza. Sounds like the perfect carb hybrid, right? According to the company’s website, the frankenpizza is made with a toasted Parmesan- breadcrumb crust topped with “meaty” marinara sauce, Italian sausage, mozzarella, muenster, ricotta and, of course, mini ribbon pasta. Yes, they went there, and put noodles on top.
It has 2,740 calories, 5,780mg of sodium, and 308g of carbs, so… uh… maybe don’t mention it to your doctor or trainer or, well, anyone for that matter.
This pizza is certainly not for the faint of heart -- or the lactose intolerant -- but if you’re feeling up to the challenge, Little Caesars’ Lasagna Pizza is being served Hot-N-Ready from 4pm to 8pm at participating locations in Georgia, West Virginia, and Ohio. You can tackle this cheese and carb monstrosity for $9, according to a report by Chew Boom.
Little Caesars has yet to disclose whether the new Lasagna Pizza will be making its way to more cities, so you’ll just have to wait and see. And maybe preemptively go the gym forever.

domain: news


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£159 – 2-Night Berkshire Mini Break w/Afternoon Tea & Wine
Save up to 62% on a mini break at Donnington Grove Hotel and Country Club in Berkshire. With this 2-night stay, you'll get daily breakfast, afternoon
Our Deal Experts research, evaluate and test thousands of deals to find those with true value. We recommend only the very best deals whose price and availability we can confirm. We never publish a deal we wouldn't book ourselves.
When You Can Go
Valid 15 Apr-31 Jul

domain: travel


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Mainstream Records was founded by legendary jazz producer Bob Shad in 1964. Previous to that Shad worked with Savoy Records and launched Time Records in the mid 50s.
His new label was a bit different. It was pretty contemporary. He worked with many jazz musicians that were perhaps a bit past their peak but still had something to say. Kats like Shelly Manne, Roy Haynes, Harold Land, and even Sarah Vaughn cut albums for Mainstream. He also worked with a lot of journeyman jazz musicians that had signficant careers playing with some of the major names of the period. Shad basically gave these musicians an opportunity to express their own voice. Later on Mainstream crossed over into the rock field producing the first album from Big Brother & The Holding Company as well as The Amboy Dukes. Plenty of collectible psych albums were released on the imprint as well.
Shad’s grandson is movie producer/comedian Judd Apatow. Along with his sister he is curating and mining the Mainstream catalog.
At the moment our primary focus is on the period of the early 70s when Shad was encouraging his jazz artists to plug in. There were some simply incredible albums released on the label that are frequently overlooked in the used bins. Huge mistake. If you are a fan of soul jazz, spiritual jazz, electric jazz, or kosmigroov - there were some phenomenal choices courtesy of Mainstream Records.
We are offering a selection of CD reissues from Japan that we think deserve your attention. Here’s one:
Curtis Fuller was a well regarded trombonist who spent many years playing with Art Blakey's Jazz Messengers. He also played with Miles Davis, Count Basie and many others. Crankin' was the second of two albums he cut for Mainstream and they were unlike anything else he recorded.
This is lethal modal/hard bop electric jazz. Fuller's band is ridiculous: Lenny White on drums, Stanley Clarke on electric bass, George Cables on electric piano, Bill Hardman on trumpet, Ray Morris on tenor sax, and Bill Washer on guitar. Everyone shines and Washer plays some out of this world guitar leads. George Cables is a gold badge of honor - you see an album with George Cables playing electric piano grab it. Bill Hardman was a great trumpeter that also played with Art Blakey. He cut great albums for Muse and Strata-East. What can you say about the rhythm section? Its amazing of course. Fuller plays his butt off - he takes the trombone to places you never thought possible.


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text:
Objective—To evaluate survival time of dogs with
idiopathic Fanconi syndrome.
Animals—60 dogs with idiopathic Fanconi syndrome.
Procedure—Data were collected by means of questionnaires
distributed to owners and veterinarians of
dogs with idiopathic Fanconi syndrome and by examination
of medical records when accessible.
Questionnaires and records were reviewed for criteria
used in diagnosis, treatments administered, survival
time, and subjective owner perceptions regarding
their dogs' general condition.
Results—58 of the dogs were Basenjis. Fifty-seven
dogs (95%) were reportedly managed by use of a single
therapeutic regimen. Median survival time after
diagnosis of Fanconi syndrome was 5.25 years; median
estimated lifespan was calculated to be between
11.3 and 12.1 years. Owners of 28 of 29 (97%) dogs
still alive at the time of the study subjectively
assessed their dogs' general condition as good to
excellent. Seizures or other neurologic dysfunction
was reported for 11 dogs.
Conclusions and Clinical Relevance—Results suggest
that expected lifespan for dogs with idiopathic
Fanconi syndrome was not substantially reduced,
compared with expected lifespan for unaffected dogs,
and that affected dogs generally had a good to excellent
quality of life, as subjectively assessed by their
owners. What effect the treatment regimen had on
survival time or lifespan could not be determined,
given the small number of dogs managed with other
methods. The high percentage of dogs with neurologic
abnormalities was a concern, but whether this
was related to Fanconi syndrome or represented a
breed-related predisposition to neurologic disease
could not be determined. ( J Am Vet Med Assoc 2004;225:377–383)

domain: pet


The city that brought microtransit to rural America
Rodger Lentz, Chief Planning and Development Officer for Wilson, North Carolina, reveals why a small city 40 miles east of Raleigh is investing in the future of transportation.
An introduction to on-demand transportation
The global transportation market is ripe for redevelopment, with intense traffic congestion and outdated or overwhelmed infrastructure — both physical and digital — requiring new solutions that radically rethink transportation. Thankfully, a number of leading cities are rapidly adapting to meet these challenges using on-demand transportation.


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Selena Gomez usually flirts with ultra feminine hair styles and leaves her endlessly long and hopelessly glossy hair to fall into place via textured ponytails and chic chignons but she made a slightly different mane move on Sunday evening.
For the Oslo leg of her Stars Dance Tour the songstress stormed out onto the city's Spektrum stadium sporting a new 'do. Her dark hair was given a new look as a half halo braid was plaited at her crown.
The plait acted as a hair band that allowed a little height at the crown and left the rest of her locks to fall freely. To complete the look Selena stuck to a more natural approach to her makeup allowing her lips to take centre stage with a muted red shade worn over them.
Her fashion didn't disappoint either as the singer looked white hot in high-waisted shorts and a sheer top in the same shade. Sitting pretty at the end of her toned legs were heeled black lace-up ankle boots that added a monochrome finish to things.
When she's not stirring up a hair storm on stage, Selena appears to be influencing fellow celebrities too. After heading to the MTV VMAs in an exposed Versace corset bra Lady Gaga emerged a few days after wearing a replica of the top - and looked just as hot.
We think we'll be trying out Selena's half braid soon!
What do you think of Selena's latest hair look? Let us know below or tweet us @Cosmopolitan.co.uk

domain: celebrity


Seattle, WA – The Seattle Kraken fell to the playoff bound Los Angeles Kings, 5-3, on April 27th at Climate Pledge Arena. A five goal second period saw the teams tied at three heading into the third period, with the Kings able to close the door late. Considering that their playoff spot was locked up prior to this matchup, Los Angeles rested several starters. This included Anze Kopitar, who saw his 281 consecutive games played streak end. Kopitar’s was the fifth-longest active streak in the NHL.
A wild second period was the defining frame in this contest. After the opening 20-minutes only saw one goal, scored by Jared McCann with about a minute left, the offense exploded. The Kraken opened up the second frame with a Ryan Donato goal, dangling around Kings netminder Jonathan Quick. While Seattle scored first and dominated the games total shots, Los Angeles went the quality over quantity route. The Kings scored goals from Gabriel Vilardi and Trevor Moore in a time span of a little under four minutes. While Jordan Eberle was able to answer the Kings with his own goal 14:29 into the second period, Trevor Moore answered back two minutes and 41 seconds later. It was the same old story for Seattle from their past three games, a collapse in the second period thanks to sloppy puck play and poor defense. Kraken head coach Dave Hakstol would speak on his team’s flaws.
“We were poor defensively, point blank. Through the first period, you could see indications of it. There were outnumbered rushes that got to our blue line that we were able to kill and catch by that point in time, second period that started to catch up to us. Once you look at really each of the goals, we allowed the puck to the inside. In order for that to get there, our coverage down low…… was soft,” Hakstol remarked.
Seattle had one final golden opportunity with a five on three situation. With a little under nine minutes left, Kings Gabriel Vilardi was given a double minor for high sticking on Jared McCann. Around the six-minute left mark, Los Angeles’ Philipp Danault was given a minor for hooking on Ryan Donato. The Kraken had an opportunity served to them on a platter, and while they did put shots on Kings netminder Jonathan Quick, Seattle had nothing to show for that opportunity. With that failed power play, the Kraken have only converted one of thirteen power plays in their past two games. In the four-game losing streak that they’re currently in, Seattle is two for sixteen. Alternate captain Jordan Eberle reflected on the teams struggles on special teams.
“He (Jonathan Quick) was good, he made some solid saves. We had a couple good looks, wasn’t as good as it should have been. You get a five on three there to try and tie the game up, you gotta score to give your team a chance. Definitely a frustrating one,” Eberle stated.
Seattle has looked better as a team down the stretch of the second half of this season, but this four-game stretch has been disappointing. While there have been good moments, the second period collapses and abysmal power play are reminiscent of the Kraken in the first half of the season. Let’s hope, for the fans sake and for monument carried into next seasons sake, that the Kraken can finish the season on a high note.
The Kraken get a rebound opportunity this Friday, April 29th against the San Jose Sharks. It’s the final home game of their inaugural season, and the second to last game as a whole. San Jose, who will also miss the playoffs, are led by young forward Timo Meier. Puck drop is at 7PM PST inside of Climate Pledge Arena.


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The number of disordered eating cases in adolescent athletes and the female participation in sports that require body exposure and emphasize agility, beauty and leanness of movements, such as dancing, gymnastics, long-distance running and also tennis, have increased in recent years. Disordered eating can lead to serious health complications such as menstrual irregularities and bone demineralization, featuring the Female Athlete Triad. Therefore, to identify vulnerable groups and the best way to track them, it became extremely necessary to describe and confront recent data on the presence of disordered eating and its complications, covering energy availability and Female Athlete Triad spectrum, in young female athletes and control subjects. (Gabriela Morgado de Oliveira Coelho, Female athlete triad-disordered eating and its complications in female athletes: An update).
Open access to the scientific literature means the removal of barriers (including price barriers) from accessing scholarly work. There are two parallel âroadsâ towards open access: Open Access articles and self-archiving. Open Access articles are immediately, freely available on their Web site, a model mostly funded by charges paid by the author (usually through a research grant). The alternative for a researcher is âself-archivingâ (i.e., to publish in a traditional journal, where only subscribers have immediate access, but to make the article available on their personal and/or institutional Web sites (including so-called repositories or archives)), which is a practice allowed by many scholarly journals.
Open Access raises practical and policy questions for scholars, publishers, funders, and policymakers alike, including what the return on investment is when paying an article processing fee to publish in an Open Access articles, or whether investments into institutional repositories should be made and whether self-archiving should be made mandatory, as contemplated by some funders.
Last date updated on April, 2021

domain: library


PVC (Polyvinyl chloride) Chemical Compatibility Chart: Check the chemical compatibility of Polyvinyl chloride / PVC with various chemicals, solvents, alcohols and other products. Shop PVC Please Note: The information in this chart has been supplied by reputable sources and is to be used ONLY as a guide in selecting equipment for appropriate chemical compatibility.
De belangrijkste leverancierslanden of -regio''s zijn china, Japan en Taiwan, China, die respectievelijk 99%, 1% en 1% voorzien van flexibele hittebestendige slang. U kunt de veiligheid van producten waarborgen door een selectie te maken bij gecertificeerde leveranciers, wder 466 met ISO9001-, 284 met Other-, 93 met ISO/TS16949-certificering.
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24/2/1981· Moreover, a sulfuric acid concentration exceeding 60% will lead to an unstable anodizing operation which sometimes includes surface-burning. The incorporation of the oxalic acid additive into the electolyte solution in an amount in excess of 10% is extremely disadvantageous because the excessive oxalic acid precipitates, while an amount less than 2% will lead to an unstable operation …
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Sulfuric Acid Mixed Sulfuric Acid and Nitric Acid Sulfuric Acid and Ferrous Sulfate Concentration, Temperature, Length of M% F Exposure 245 220 2 yr AlSl Type of st,nl:,,s -__- 316 316 Type Expel of iure 99.6 55-75 .02-0.3 20 10 20 5 25 10 Field Field 1082 hr
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TR-60D (100-99) Rev.∅ 08/16/04 Page 3 of 19 1.0 DISCUSSION These tables list the chemical compatibility chart of various elastomer materials commonly used for o-ring. This data has been compiled from literature published by various material suppliers. It
1/3/2020· Flexible supercapacitor, by virtue of its high power density, long cycle stability and high safety, can be considered as an attractive energy storage device , , . As there is no interaction between electrode and electrolyte, the flexible supercapacitor is easily damaged due to structural misalignment under external deformation  ,  .


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CBS goes the distance with The Ellen Show
BY Advocate.com Editors
November 15 2001 1:00 AM ET
Variety reports that fresh from her triumphant gig as host of the Emmy Awards, Ellen DeGeneres has received a full-season pickup from CBS for The Ellen Show. While the show remains CBS's lowest-rated series, the ratings did go up slightly last week for its first post-Emmy broadcast. The Ellen Show has been racking up positive reviews, and CBS executives are said to be pleased with the show's creative direction.
- WATCH: Gay Couple Assaulted at Dallas BBQ in Chelsea
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- Drag Race's Trixie Mattel: 'I Actually Thought I Would Win'
- Meet the Same-Sex Couple Who Made Dodger Stadium Swoon
- POLL: Americans Prefer Gay President to Evangelical or Tea Partier
- Op-ed: The Dire State of Louisiana LGBTs


Ray Kiracofe sat quietly as he listened for 10 minutes as a former ROTC student detailed the impact of his inappropriate touching on her life.
“I know I’m forever scarred for this,” the former Socastee High School student said Monday in an Horry County courtroom.
She spoke of the shame she felt at the hands of her Air Force ROTC instructor during her senior year. She lost all hope and prayed for death to take the pain away. Those feelings dissipated over time and now the victim says her optimism is returning.
“I view every day as a new beginning,” she said, her hands slightly shaking as she read from a prepared letter, “and a chance to do something great.”
Judge George McFadden — who needed a break after hearing statements by the victim and her mother — commended the victim for speaking and said she is an inspiration to men and women. McFadden is an out-of-county judge, but heard pleas in Horry County on Monday. The Sun News does not identify the victims of crimes with a sexual element.
McFadden placed Kiracofe, 69, on five years’ probation for his guilty plea to assault and battery second-degree.
Assistant Solicitor O’Bryan Martin said Kiracofe was a Socastee High ROTC instructor. He had inappropriate contact with the student that included touching and kissing.
Kiracofe has no criminal history and the action did not progress to sexual assault, which is why Martin said the state recommended probation.
Defense Attorney Preston Brittain said Kiracofe was willing to pay any amount to help the victims, including medical bills or other costs, to rectify his assault.
“My client is ashamed and sorry for his actions,” Brittain said.
For months after the assault, the victim said she felt like the life was drained from her body; she was hopeless and depressed. She convinced herself that nobody cared for her.
“I felt so taken advantage of and manipulated,” she said.
The victim’s mom said that when her daughter came home from ROTC during freshman year she was excited. Kiracofe told the mom at one point that he loved the victim and viewed her as a daughter.
After the assault, the victim became withdrawn and removed all the ROTC accolades in her room. She also had to remove herself from college for a stretch to deal with the impact of the incident.
“I was supposed to protect my daughter,” the mother said, taking a moment to collect her thoughts amid tears. “I let her down.”
The mother called Kiracofe a disgrace and said he failed to live up to the Air Force ideals of integrity, service to others and excellence.
“He should not be allowed to wear the uniform of the U.S. Air Force again.”


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|Name Christopher Blasdel||Role Writer|
|Books The shakuhachi: A Manual for Learning, The Single Tone: A Personal Journey Into Shakuhachi Music|
Albums Striking Light, Striking Dark, Navarasa
Education Tokyo University of the Arts, University of Tokyo
Similar People Goro Yamaguchi, Mark Izu, Kaoru Kakizakai, James Nyoraku Schlefer, Watazumi Doso
Born 1951 (age 70), Canyon, Texas, United States
Ayuo, Christopher Yohmei Blasdel - Drink Down The Sun And Moon from OUTSIDE SOCIETY
Christopher Yohmei Blasdel (クリストファー遙盟、 born 1951 in Canyon, Texas) is a shakuhachi performer, researcher and writer specializing in the music of Japan and Asia. In 1972, while on foreign study in Tokyo, he was introduced to the Kinko Style shakuhachi master (later designated "Living National Treasure") Goro Yamaguchi, whom he studied with until Yamaguchi’s death in 1999. In 1975, Blasdel began learning Aikido under Yasuo Kobayashi and performing with the butoh dancer Akira Kasai at his studio, Tenshikan. Blasdel presently holds a 4th degree black belt in Aikido.
- Ayuo Christopher Yohmei Blasdel Drink Down The Sun And Moon from OUTSIDE SOCIETY
- shirabe for shakuhachi and cello
In 1978, Blasdel entered the Musicology Faculty at Tokyo National University of Fine Arts (Geidai) with a scholarship from the Japanese government. He studied traditional Japanese and Asian music under the pioneering ethnomusicologist Fumio Koizumi and the Noh scholar Mario Yokomichi. He studied the ancient Myôan Style shakuhachi from Chikugai Okamoto and ensemble techniques from shamisen/koto master and Living National Treasure Kunie Fujii and gagaku ryûteki flute under Sukeyasu Shiba. Blasdel graduated from Geidai with an MFA in 1982. In 1984, he received his shihan master teaching license and professional name, Yohmei, from Yamaguchi—the first of only two non-Japanese ever accredited by Yamaguchi.
Blasdel began working part-time at the International House of Japan in 1988 as advisor to their arts program and curator of the Japan-US Friendship Commission Creative Artists’ Exchange Program. In 2005, he was promoted to Artistic Director of the International House. He taught Japanese music at International Christian University from 2001 to 2006 and at Temple University, Japan campus from 2002. He also taught as guest professor at Earlham College in 1988 and Chulalongkorn University in Bangkok in 1991.
Blasdel is the senior artistic advisor to the annual Prague Shakuhachi Festival. He also co-organized the Boulder World Shakuhachi Festival in 1998 and the World Shakuhachi Festival, Sydney in 2008. He was featured in the Sarawak Rainforest World Music Festival in 2004 and numerous other festivals and concert tours introducing Japanese music to the world. To date he has made a total of eight CDs of classical and contemporary shakuhachi music. He has added shakuhachi music to live readings of such distinguished poets as John Logan, Kenneth Rexroth, Sam Hamill, Makoto Ooka and Leza Lowitz.
His publications in English include The Shakuhachi, A Manual for Learning originally published in 1988 by Ongaku no Tomo-sha, the first book on shakuhachi technique and history in the English language published by a major publishing company (later re-written and published by Printed Matter Press in 2008). In 2006, Ongaku no Tomo-sha published the Japanese version of this manual. In 2005, Printed Matter Press published his semi-autobiographic account of his life in Japan The Single Tone, A Personal Journey into Shakuhachi Music.
His Japanese publications include Shakuhachi Odessei—Ten no Neiro ni Miserarete (「尺八オデッセイ—天の音色に魅せられて」Kawade Shobo Shinsha, 2000, translated and adapted into English as The Single Tone). This work was awarded the Sixth Rennyo Prize for Non Fiction in 1999.
Christopher Yohmei’s website
The International House of Japan, Inc. website
Aikido Kobayashi Dojo website
Prague Shakuhachi Festival
Japan Times Review of The Shakuhachi--A Manual for Learning
Japan Times Review of The Single Tone—A Personal Journey into Shakuhachi Music

domain: artistic


Here’s a challenge: build your own Hyperloop pod prototype and test it at Elon Musk’s SpaceX headquarters in California. Who said engineering can’t be fun? Engineering students from the University of Edinburgh who were accepted to participate in the exciting SpaceX Hyperloop Pod competition used thermal imaging and measurement technology from FLIR to make sure their prototype was ready for the race.
Travelling from city to city at 700 miles per hour in an underground vacuum tube seems futuristic to some of us, but not to entrepreneur Elon Musk. The forward-thinking CEO of Tesla and SpaceX sees this as the next step in mass transportation technology. Hyperloop is Musk’s concept of electrically propelled pods travelling autonomously through a near-vacuum tube. The pods will be able to reach speeds comparable to aircraft and could see a journey such as Edinburgh to London shortened to 50 minutes.
A yearly competition draws many engineering teams from around the world to the SpaceX headquarters in California. There, SpaceX challenges the teams to develop their own Hyperloop pod prototype and test it in a mile-long vacuum tube.
One of the engineering teams that joined the 2018 competition is Hyped, a student society at the University of Edinburgh. The team consisting of more than 100 members has been focusing both on the technical and commercial development of Hyperloop. Their designs have already seen success in two international competitions.
In the 2018 competition, the Hyped team wanted to push the boundaries of the Hyperloop technology in a new prototype that featured magnetic levitation, electrodynamic (Halbach) wheels for propulsion and high-speed braking, emergency pneumatic brakes, and a carbon composite pressurized vessel.
Efficient power management
“As a student society, our budgets and capabilities are rather limited,” says Daniel Toth, Head of Power at Hyped. “The first time we can actually test our prototype on a larger scale is at the SpaceX facilities. So, it is very important that we can thoroughly test every individual component well in advance, starting with smaller test setups, but then gradually increasing the size of our tests.”
Toth heads the group involved with power management (battery packs and related electronics), usually an area of expertise where things heat up before they break. Next to a lot of simulation work, the Hyped team also performs destructive tests of components to discover the performance limits of their designs.
“With electrical components and battery packs, heat usually indicates that something goes wrong, so it is only logic that thermal imagers are part of our toolkit,” Toth explains. “Thermal imaging is an ideal technology to see weak points in the design and it enables us to see where we can make improvements. Electronic components will also behave differently in a vacuum, because there is no air cooling. It’s important to test these conditions very thoroughly.”
Thermal imagers and clamp meters
The Hyped team has been using a Flir E4 thermal imaging camera and a Flir CM275 clamp meter with thermal imaging. “We found that the Flir CM275 clamp meter is great for quick scanning and diagnostics, while the Flir E4 thermal camera was handier for longer and more comprehensive inspections that involved more people,” says Toth.
The power of the Flir CM275 clamp meter lies in the fact that it combines two modes of operation that work well together. Through Infrared Guided Measurement (IGM™), the CM275 provides a reliable way to identify hot spots and overloaded circuits from a safe distance. With the clamp meter’s wide range of functions and accurate temperature readings, users can confirm their findings.
“Even in thermal imaging mode, you can still use the meter readings, so having both in one device is very efficient,” says Toth. “To me, it is much more reliable when you can crosscheck your results between different modes of operation.”
Avoiding safety risks
Working with batteries always includes risks. Batteries contain toxic liquids and charging them with high currents will cause them to heat up. Especially the plastic casing of cables leading to the interface can melt or catch fire. In the worst case, batteries will vent, which means that they can suddenly release dangerous gases and liquids when under pressure.
With conventional tools such as thermistors or thermocouples, the user needs to take measurements with the tool contacting the object of research. Thermal imaging cameras offer the Hyped team a way to inspect battery packs and electronics from a safer distance, without making contact.
Variety of applications
Toth also owns a Flir One® thermal imager for smartphones - a tool he says that really taught him to appreciate the power of thermal imaging. “Having worked with electronics for quite some time now, thermal imaging has always come in handy for electronics inspections. That is why I am looking forward to using the Flir tools for even more applications.”
Testing the prototype’s propulsion system and motor control unit are on the Hyped team’s to-do list. The team needs to cool all these systems efficiently, a task that Toth believes can really show the value of thermal imaging.
“Building a prototype during a one-year competition can be stressful at times, but fortunately, tools like thermal imaging cameras and clamp meters, help us to stay on schedule and make reliable measurements.”


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If your family is bright, bold and lively, celebrate the season with this equally unique holiday address label from Jill
Smith Design! The festive pattern will capture your family's personality perfectly.This Merry Grid design from our holiday return address label ...
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Physical Exam Cardiac - murmur, AD Extremity - look for signs of chronic peripheral vascular disease Neurological - sensory and motor loss Vascular - grade peripheral pulses ABPI
Amputations are more common with thrombotic occlusions. Emboli are different - and most often from the heart and comprised of platelets. They can also come from aneurysms - and will be made of atheroma. Vasculitis, iatrogenic, compartment syndrome, aortic dissection are also risk factors.
Upper arm emboli are less common. Thoracic outlset syndrome may masquerade - pressure on the subclavian artery from a cervical rib or abnormal soft tissue band may lead to a dilatation lined with thrombus, predisposing to occlusion or embolisatoin. Popliteal aneurysms are very likely to be dislodged.
PAIN - worse on movement, and relieved by hanging your legs over the edge. Tenderness on examination is often due to muscle death. PALLOR - limbs are often white. Chronically ischaemic limbs may turn sunset pink due to compensatory response. Dry gangrene is black, and a sign of chronic ischaemia for more than two weeks. PARAESTHESIA- PERISHINGLY COLD - compare PULSELESSNESS - use dopplers
Check bloods including a creatinine kinase.
Treatment: Analgesia, Oxygen, 5000 units IV heparin, heparin infusion, IV fluids Unless bleeding, pregnant, CVA/TIA, tumour, previous GI bleed, trauma
As a presentation to ED, I don't think sexual assault is that common, and the brief mention in the curriculum probably supports that. Sexual assault is maybe underrepresented and more common than we think.
Sexual Assault - Examine carefully including in the mouth and treat any injuries - consider liasing with SARC for forensic samples to be taken before irrigating wounds if appropriate. - Advise patient not to wash or bathe, eat or drink - as it will affect samples - Refer to SARC if patient wishes to attend. The investigations may take three hours. DNA can be gathered for up to seven days after vaginal penetration, up to two days in oral penetration and for up to three days in anal/penile penetration irrespective of washing or bathing - Offer emergency contraception - Safeguarding referrals -Accelerated Hep B - one now, one month, two month If high risk Hep B immunoglobulin - Bloods 3 months after exposure - Consider PEPSE - STI prophylaxis - Cefixime 400mg + Azithromycin 1g + Metronidazole 2g as single oral stat (pregnant or breastfeeding women Cefixime 400mg + Azithromycin 1g).
Domestic Violence SAFE Questions S tress/Safety Do you feel safe in your relationship? A fraid/Abused Have you ever been in a relationship where you were threatened, hurt, or afraid? F riend/Family Are your friends aware you have been hurt? E mergency Plan Do you have a safe place to go and the resources you need in an emergency?
Sexually Transmitted Infections Reactive Arthritis aka Wegener's 2-6 weeks following infection (Chlamydia, salmonella, shigella, yersinia, campylobcater) Symmetrical arthritis, knees, ankles, feet and heels Conjunctivitis or uveitis Dactylitis NSAIDs
Gonococcal Arthritis often causes septic arthritis
Other STIs Our curriculum says we need to know the main types. I think that seems sensible...although actually, all we really need to know I think is test test test. And secondary syphilis is making a come back.
Herpes Zoster Significant exposure - infected people with exposed or disseminated lesions, or those with compromised immunity are more likely to shed the virus. Low risk of contracting the virus from the zozster rash under clothing. - Infectious 48hrs before until crusts. - Closeness and duration of the contact - face to face or contact in the same room for >15minutes.
I wrote a summary of what each common competency involved to make sure I linked properly. Here's my summary:
CC1 - History Taking - Risk Factors, Communication Barriers, Time Management, Questionnaire, conflicting family, assimilate, non-verbal queues, mechanism of injury, no bias in re-attenders, children, interpretor, third parties, notes review
CC2 - Clinical Examination - constraints to overcome them, limitations, targeted, DSH, interpet, mental state, clinical, psychologial, religious, social and cultural factors, adjunctive examinations, ECG, spirometry, ABPI, joints, FAST, echo
CC3 - Therapeutics and safe prescribing Indications, contraindications, SEs, drug interaction, dose of commonly used drugs, adverse drug reactions, complementary meds, tools for patient safety and prescribing including ID, effects of age, body size, organ dysfunction, concurrent illness on drug distribution and metabolism, regulatory agencies, review long term meds, anticipate and avoid interactions, appropriate drug dose, adjustments, monitoring, concordane, explainations, minimise risk, non-medical prescribers, formulary, info sharing, therapeutic alert Methadone Meds from overseas, and translate into UK equivalent, Children, rapid chemical tranq. Empathetic for pain. PGD. Drug prescribing audits. Reviews stock. Introduces new drugs.
CC4 - Time management and decision making Organisation, prioritisation, delegation, techniques for time management, prompt investigation, diagnosis + treatment. Estimate time. Workload. Work to deadline. Calm in stress. Manages multiple patients. Quick disposal decisions, CTR... Staff allocation. Team management. Teaching during low demand. Rota vs patient attendances
CC6 - Patient central focus of case Recall health needs to deal with diverse patient groups - learning disabled, elderly, refugees and non-English speaking. Gives time. Answers questions honestly. Self-management plan. Voice preferences. Acts as advocate. Time off work. GP letters. Gillick-competent adolescent. Assess capacity. Alternative management options. Worried well. DNAR + end of life decisions Complaints Patient survey + local patient groups
CC7 - Patient safety Safe working environment. Hazards of medical equipment. Med side effects. Risk assessment + management. Safe working practice. Local procedures for optimal practice. NHS and regulatory procedures where concern about performance of team. Recognise failure to response. Use medical equipment carefully, report faults. Improve understanding of SEs and CIs. Sensitively cousel a collegue following SE or near miss. Root cause analysis. High risk patients - nonEnglish speaking, agressive, un-cooperative, clinically brittle Supports trainees + nursing staff after SUIs Handover
CC8- Team working _ patient safety Effective collaboration. Roles + responsibilities. Factors adversely affecting a Drs performance. Note keeping. Patient lists. Handover. Leadership and management in education & training, deteriorating performance of collegues (stress fatigue), high quality care, effective handover. Interdisciplinary team meetings. Supervision. Encourage open environment. Second opinion. Induction. Information sharing. Debrief.
CC9 - Quality and Safety Improvement Clinical governance, local and national significant event reporting, EBP, local health + safety protocols (fire and manual handling), risk - biohazards, patient early warning systems, national patient safety initiatives - NPSA, NCEPOD, NICE Surgical checklits. Quality improvement process eg. audit, errors/ discrepancy meetings, critical incident reporting, unit mortality and morbidity, local and national databases. Reflect regulalrly No-blame culture. Audit
CC10 - Infection Control Prevent infection in high risk groups. Notification in UK. HPA / CCDC / LA in infection control. Potential for infecition. Counsel patients on risk. Local infection control procedures. Antibiotics according to local guidelines. Cross - infection. Aseptic technique. Atypical common infections. Not eating on shop floor Blood cultures, sepsis 6
CC11 - Long term conditions + patient self care Natural history of diseases that run a chronic course, rehab and MDT, QoL, medical and social models of disability, social services, carers, information, patient advocate. Feedback on referrals. Patient notes. Self-help groups,
CC12 - Patients + Communication Structure an interview, understand importance of patient's background, rapport, sensitive, manage communication barriers, deliver information compassionately, use and refer to other sources, check understanding, notes, follow up. Language line, anxious patients. Acutely disturbed psych patient. Safe and lawful restraint.
CC13 -Breaking Bad news Stressful. Honest, factual, realistic, empathetic. Organ donation. Lead resuscitation with relatives present.
CC14: Complaints and Medical error Local complaints procedure. Factors likely to lead to complaints. Deal with disasatisfied patients. Honest. Apologise. Review. Support junior ED staff in responding.
CC15: Communication with collegues + cooperation MDT + team dynamics. Inter-professional collaboration. Communicate accurately, clearly, promptly. Use whole MDT. Hospital at night. Behavioural management skills with collegues. Healthy work / life balance for whole team. Confidentiality. Accept additional duties. Handover. Manages shift to ensure breaks. Respect for nursing staff.
CC16: Health promotion and public health Incidence and prevalence of communication conditions - biological, social, cultural and economic. Lifestyle on health. Screening. Smoking, obseity. Globalisation. Substance misuse, gambling. Ill health and disease. Lifestyle changes. Registered with Dr. Encourages alcohol, drug, smoking. Discourages high risk. Display local information.
CC17: Medical ethics + confidentiality GMC on confidentiality. Data Protection Act + FOI Act. Caldicott Guardian. Caldicott approval. Patient consent - desirable but not required eg. communicable diseases. Consent. Confidentiality following death. Problems by disclosure in public interest. Factors influencing ethical decision making. DNR. MCA. Confidential waste, no password sharing, doesn't take notes home, anonymisation, DNAR
CC18: Valid Consent Consent is a process that may culminate in a consent form. Consider understanding and mental state. Balanced view. Autonoy. Scope of authority. Don't withold information. Seek advance directives. 2nd opinion. STEMI/ stroke thrombolysis Patient advocacy
CC19: Legal framework Best interest of the patient. Legislative framework - death certification and role of coroner/ procurator fiscal. Safeguarding children. Mental health legislation. Advanced directives. Living Wills. Withdrawaing and witholding treatment. Resus decisions. Surrogate decision making - organi donation + retention. Communicable disease notification. Medical risk + driving. Data protection + FOI Act, continuing care. Differences in legislation in 4 countries of UK. Disciplinatry processes. Role of medical practitioner in relation to personal health + substance misue including what to do ?abuse. Report to Coroner.
CC20: Ethical Research Good practice in research. Audit vs research. Understand how guidelines produced. Knowledge of research principles. Formulate research question. Comprehend principal qualitative, quantitative, bio-statistical and epidemiological research methods. Funding. Critical appraisal skills Write scientific paper. Ethical research, literature databases, good verbal + written presentation skills Popuation based assessment + unit-based studies and evaluate outcomes. Complete a BestBET. CTR.
CC21: Evidence and Guidelines Application of statistics in scientific medical practice. Different style methodologies. Critical appraisal. Level of evidence + quality. Advantages and disadvantages of guidelines. NICE and SIGN process. Search medical literature. Address clinical question. Limits of research.
CC22: Audit Data for audit. Role + steps. Local + national. Local / national audit meetings.
CC23: Teaching and training Adult learning principles, identification of learning methods. Educational objectives. Questinoning tecnhiques. Teaching format and stimulus. Literature. Appraisal interview. Bodies in med ed. Appraisal vs assessment. WBPA knowledge. Define learning objectives and outcomes. Failing trainee. Vary teaching format and stimulus. Feedback. Appraisal. Demonstrate effective lecture, presentation, small group + bedside teaching sessions. Career advice. Improve patient education. Departmental teaching programmes, failing trainee. Has discussion. Formal tuition in medical education. Personal development as a role model. PowerPoint. Small group teaching. Simple feedback. Supevision. WBPA.Teaces med students. Supervises things. Medical student programme.
CC24: Personal Behaviour Inappropriate patient and family behaviour. Respect rights of children, elderly, physical, mental, learning or communication difficulties. Eliminate discrimination. Honesty and probity. Honesty and sensitivity. Ethical reasoning. Value-based practice. Royal Colleges, JRCPTB, GMC, Postgraduate Dean, BMA, specialist societies, medical defence organisations Practice with integrity, compassion, altruism, continuous improvement, excellence, respect for cultural and ethnic diversity, equity Rotas. Utilise resources. Specialist support. Press + media. Clinical leadership + management Mentor, educator and role model. Accept mentoring. 360 feedback. Annual departmental stragetic vision.
CC25: Management and NHS Structure GMC management guidelines. Understand local NHS structure. Structure and function of healthcare systems. Understand NHS debates and changes in the NHS. Local demographic data. Clinical coding, EWTD, NSF, health regulatory agencies, NHS structure + relationships, NHS finance and budgeting, consultant contract + contracting process, resource allocation, independent sector. Managerial meetings. Technology.
TIAs Isolated vertigo is rare in posterior circulation TIAs. They may be hard to diagnose.
There is little benefit from further aspirin if patients are already on aspirin. If patients present late, they should be treated as lower risk of stroke.
For risk assessment, RCP guidelines say investigate all urgently without further risk stratification, and all patients need to be seen within 24hours. No imaging unless to exclude haemorrhage - in patients taking an anticoagulant.
TIAs need aspirin (for 2 weeks), clopidogrel, statins, and BP lowering therapy.
Confusion, memory problems, faintless or syncope, generalised weakness or numbness and incontinence are NOT TIA symptoms.
Always assess the carotid as part of your TIA assessment.
Stroke Anatomy Anterior circulation is served by the internal carotids which branch into the MCA, ACA. - weakness or sensory loss affecting the contra-lateral arm, leg or face - mostly leg. Dysphasia or dysarthria. Monocular visual loss. - Middle cerebral - contra-lateral face and arm more than leg. - Internal capsule often affects the face, arm, and leg equally.
Poster circulation: CN palsy + contralateral deficiency or bilateral. 20% dead, 20% dependent, 60% independent Lacunar: pure motor or pure sensory. Dependent 30%, independent 60% TACS: cortical dysfunction and field deficit and contralateral weakness in 2 areas. 60% dead. PACS: 2/3 of TACS.
The posterior circulation is served by the vertebrobasilar arteries - which supply to the posterior 2/5 of the cerebrum, and the basilar arteries.
Anterior and posterior circulations are linked by the posterior communicating arteries, forming the circle of Willis.
Malignant MCA infarcts cause a lot of brain oedema, which may lead to herniation and early death. Young patients are particularly at risk because they don't have any spare brain space. A decompressive hemicraniectomy may be considered if pre-stroke rankin <2, defects indicate MCA, NIHSS >15, not alert, signs on CT of at least 50% of the MCA. Refer to neurosurgery. Likely fatal, and early senior neurosurgical involvement is necessary.
Stroke Assessment Consider a ROSIER score - negative score for LOC/ syncope or seizures, with positive for weakness, speech and visual fields. NIH score Perfusion scan if diagnosis in doubt, or >4 hours including wake up stroke
Stroke Treatment - Very high BP is a contraindication to thrombolysis so stick on a GTN patch on the way
Hypertensive encephalopathy or nephropathy Hypertensive cardiac failure/myocardial infarction Aortic dissection Pre-eclampsia/eclampsia Intracerebral haemorrhage with systolic blood pressure over 200 mmHg. In patients being considered for thrombolysis, a blood pressure target of less than 185/110 mmHg should be achieved
- ASPECT score to see if for thrombolysis - determined from CT findings >7 = thrombolyse. - Alteplase is the preferred option. 19/20 stay the same, 1/20 get worse. - If on NOAC (not dabigatran) no thrombolysis. Consider if clotting normal.
A tear in the vertebral artery, is a common cause of stroke in young people. The tear has a clot and causes a false blockage - causing an ischaemic stroke. It can happen spontaneously or after minor trauma to the neck, including yoga and chiropractice.
A recent respiratory tract infection may also predispose - making vertebral artery dissection seasonal.
There are two types: Infarction - ischaemia of the vertebrobasillar circulation due to arterial narrowing and thromboembolism Haemorrhagic type - presents as a SAH
They may not present with problems, because of the contralateral vessel. Acutely ruptured dissections have a high mortality, and may rebleed (mostly in the month immediately after).
Clinical Symptoms Severe neck pain, followed later by neurological symptoms May get a spinal cord infarction Maybe with a headache and horners syndrome
We think of spondaneous coronary artery dissection as being a cause of peripartum myocardial infarction - but about 90% of cases are not pregnant. It can be precipitated by valsalva type manoeuvres. There is an association with exercise, especially in male users. There are case reports linking SCAD with drugs, and emotional stressors.
Thrombolysis is considered safe and apparently effective but generally avoided, because can cause rupture leading to tamponade. Dual antiplatelet therapy probably indicated - but may cause menorrhagia as is used for women of child bearing age.
Transient ischaemia of the basilar circulation system. Dizziness, vertigo, headaches, vomit, diplopia, blindness, ataxia, imbalance and weakness are all possible symptoms.
Ear symptoms may also cause ischaemia of the inner ear. Posterior circulation imbalance rarely causes only one symptom. Isolated dizziness is rarely VBI. Standard artherosclerotic risk factors. May be associated with facial pain - sharp single stabs or jolts of pain.
Wallenberg Syndrome - lateral medullary syndrome, caused by a vertebral artery stroke. May be facial pain with a contralateral hyperanalgesia.
2. Erysipelas is a superficial cellulitis, with similar risk factors. It looks a lot worse than cellulitis with ruptured bullae and vivid bright red erythema. Almost all erysipelas is caused by group A beta haemolytic strep. It can recur due to persistence of risk factors and lymphatic drainage. Complications can include abscesses, gangrene, chronic leg swelling
Signs and symptoms are normally abrupt, affecting predominantly the lower limb and face. It has a sharp raised border, and is bright red and swollen. The swelling may lead to dimpling, blistering, and even necrosis.
3. Cellulitis Cellulitis is very rarely bilateral. 35-50% of patients will have a leukocytosis, 60-92% will have an elevated ESR, and 75-95% will have an elevated CRP. Blood cultures are unlikely to be helpful. Orals are very bioavailable so most of the time are just as good as IVs.
Often caused by strep and staph. Atypicals are common: Cat bites can have pasteurella, sea water Vibrio vulnificus, fresh water Aeromonas hydrophila, fish farms Streptococcus iniae. These atypicals can cause a rapidly progressive cellulitis.
Class I: No signs of systemic toxicity or co-morbidities. Can be managed on POs. Class II: 2 or more SIRS, but no organ dysfunction, or have a co-morbidity. May need IV outpatient management. Class III: Sepsis and organ dysfunction, or unstable co-morbidities normally require admission. Class IV: Severe life threatening infection.
Later Pregnancy https://www.rcemlearning.co.uk/modules/bleeding-in-pregnancy/
Antepartum Haemorrhage >24 weeks gestation Placenta praevia - stage depends how much of the os is covered by the placenta. Bright red and painless bleeding. Placental abruption - complete or partial separation of the placenta. Causes lots of bleeding which may be concealed. Normally associated with continuous abdominal pain. Vasa praevia - the fetal blood vessels run everywhere, not protected by the placenta. They may run over the cervix. High perinatal mortality - easy to rupture the fetal blood vessels. Can cause painless bleeding. AntiD may be needed after a potentially sensitising event.
Hopefully all of these will be identified by screening, and hopefully these patients will present to the maternity assessment unit, not the ED!
PostPartum Haemorrhage Primary PPH - in first 24hours. Secondary PPH - up to six weeks. Again, hopefully these patients will present to MAU not ED.
In pregnancy, problems are the 4Ts Tone, trauma, tissue, thrombin. Tone: uterine massage, bimanual compression, catheterise, give syntrometrin
Bleeding should slowly stop after a 12 weeks. It's often significantly less after the first few hours, and should change from bright red to brown (lochia). The commonest cause is endometritis. There may be retained products - start IVs, get an USS. If there's no RPOC, there could still be endometritis. The uterus in endometritis will remain palpable after 14days after delivery. Endometritis is a clinical diagnosis. I think bleeding persistently after delivery needs to see O&G. Bleeding that stops and starts again is probably "new" bleeding.
B12 deficiency, cobalamin deficiency or pernicious anaemia is also knon as Biermer's anaemia, Addison's or Addison-Biermer anaemia. It's one of the megaloblastic anaemias.
Pathophysiology Normally, B12 is absorbed through the ileum with the help of intinsic factor which is secreted by the parietal cells. Various things can stop this happening - antibiodies to parietal cells, like in atrophic gastritis, antibodies to intrinsic factor like in pernicious anaemia, lack of a terminal ileum, or disease of the ileum - like Crohn's disease, and reduced b12 intake. It takes a while for the disease to become apparent as there's 3-5 years worth of reserves in the liver. Lack of B12 means that DNA replication is slow, so cells divide less but grow bigger. This gives you your macrocytic or megaloblastic anaemia. Lack of B12 means the conversion of homocysteine to methionine is reduced, so there are high levels of homocysteine - causing things like atherosclerosis, thromboembolism and osteoporosis. More importantly, B12 is a cofactor in the conversion of methylmalonic acid into succinyl CoA. Without this, the dorsal and lateral spinal columns are demyelinated, through an unknown mechanism, so you get neurological symptoms.
Investigation FBC will show macrocytic anaemia, and maybe neutropaenia and thrombocytopenia. A blood film will show anisocytosis and poikilocytosis. Bilirubin may be increased because of haemolysis. Then you can look for autoantibiodies, and maybe an absorption test like the Schilling test.
Symptoms Symmetrical, legs > arms Ataxia Loss of position sense Loss of vibration sense
Low grade pyrexia, weight loss, diarrhoea, jaundice due to haemolysis, pallor due to anaemia, premature greying of the hair.
Treatment If B12 levels are low, then patients need intramuscular B12 and a haematology referal. If there is neurological involvement, 5 - 6 loading doses of 1000mcg, followed by maintainence of 1000mcg every three months. If B12 levels are borderline, then oral B12 may have a reponse and be diagnostic. Patients often feel better within 24hours of starting treatment. If patients are asymptomatic, there is debate about their treatment- monitoring seems preferred.
B12 is naturally found in animal products - fish, meet, eggs, milk. It's not generally present in plant foods, but is in fortified cereals. It's worth mentioning that pabrinex doesn't contain B12!

domain: medical


text:
The N.C. Division of Motor Vehicles set out to improve customer service a few years ago, but the state auditor's office said this week that the agency doesn't do a good job of measuring how well it is doing.
In a report released Thursday, the Office of State Auditor said DMV lacks specific goals and objectives and in any event doesn't collect the kind of data that would indicate whether it is meeting them.
DMV Commissioner Torre Jessup agrees. In a one-page memo in response to the audit, Jessup said DMV would hire an "outside expert" to help develop a strategic plan for the agency, including specific goals and the measures it will use to determine whether it is meeting them.
"The commissioner is very grateful to the auditor’s office for pointing out areas we need to improve,” said DMV spokeswoman Marge Howell.
Former Gov. Pat McCrory pledged to "fix DMV" both as a candidate and after he took office in 2013. During his administration, DMV took several steps aimed at improving customer service and reducing wait times, such as expanding evening and weekend hours and offering more services online, including routine license renewals.
But the audit, which looked at DMV activities over a year ending last June 30, concluded that the agency falls short in measuring its own performance.
DMV collects nearly 300 different types of data, according to the audit. But nearly all of that data has to do with how much work the agency is doing, and not how well it is doing it.
For example, knowing that DMV issues hundreds of thousands of vehicle registrations a year gives some sense of what the agency does, wrote the audit's author, Dale Roenigk, director of the benchmarking program at the UNC-Chapel Hill School of Government. But it doesn't show how much it costs on average to issue a registration, how long it takes for customers to receive one and how often the registrations contain errors.
"Effective performance measurement should be more than just what can be measured but measuring what is important," Roenigk wrote.
DMV will hire a consultant within 90 days to help determine what's important. It's not clear yet how long it will take DMV to develop its strategic plan and begin measuring its performance, Howell said.
“DMV’s always looking for any way we can find to help us improve our services to our customers and our efficiencies — anything that’s going to make us work better," she said. "And we’re looking forward to getting that kind of information from this study.”

domain: politics


text:
Public comment opens on Klamath dam removal plan
Dam removal on the Klamath River is one step closer to reality. A draft environmental impact statement was released on Friday by the Federal Energy Regulatory Commission. It’s an opportunity to get feedback on the dam removal plan along the Oregon-California border.
The overall Klamath Dam removal project would be the largest dam removal effort in U.S. history. It comprises four aging dams – J.C. Boyle, Copco No. 1, Copco No. 2, and Iron Gate – which are owned by the utility PacifiCorp in Klamath County, Oregon and Siskiyou County, California.
The draft EIS comment period runs until April 18. It will allow the public to correct any errors in the current removal plan, according to Glen Spain with the Pacific Coast Federation of Fisherman’s Associations.
“The realities don’t change. The dams are not going to be cost-effective. They do an enormous amount of damage to the river. The company doesn’t want them. The company doesn’t need them,” Spain says.
Neither the members of the Klamath County board of commissioners or the Siskiyou County board of supervisors responded to a request for comment.
Decommissioning and removal would open up 400 miles of creeks and tributaries that are important for coho and Chinook salmon and steelhead trout. Stagnant, warm water from the dams has resulted in as many as 90% of the river’s juvenile Chinook salmon to be infected by a lethal parasite called C. shasta in recent years.
“These are very old structures, very far from modern design,” Spain says. “They also were built without fish passage, which is illegal under today’s laws. And they produce only a very small amount of energy.”
Dam removal would be carried out by the Klamath River Renewal Corporation. Spain, who also serves on the group’s board, says they hope to begin drawing down reservoirs in Jan. 2023. The KRRC would then be responsible for removing the dams and associated facilities, restore the land occupied by the dams, and improve fish passage. The initial removal plan is expected to take 20 months, followed by five years of restoration.

domain: geography


In the world of gaming, standing out from the crowd is becoming increasingly problematic. However, the iGaming industry has been able to sustain its sense of individuality through the use of forward-thinking mechanics and consumer-friendly themes. That said, it does pose an interesting question concerning which component is more pivotal to the online casino market. So, let’s see if we can answer that question by analysing both of their respective impacts.
Is it True that Themes Make a Good Game Great?
There’s a widespread belief surrounding all forms of gaming that an effective and well-thought-out theme can enhance the appeal of any given title. Dating back to the 3500 BC, Senet – the oldest known board game to have existed – was designed with an ancient Egyptian theme that was fitting of the era. It’s a testament to the game’s appeal and longevity that it’s still played in 2020, with manufacturers retaining the Egyptian theme by commonly integrating hieroglyphic symbols into modern-day designs.
Regarding online casino games, jackpot bingo at Paddy Power indicates the pivotal nature of themes within the industry. Among the operator’s vast array of different titles, prospective gamers can immerse themselves in numerous games, including Lucho Rumble Jackpot and Temple of Ausar, which adopt Mexican wrestling and Ancient Egypt themes, respectively. With big prizes on offer through various forms of jackpots, such as fixed and progressive options, the attention to detail regarding on-theme aesthetics undoubtedly adds more depth to digital slots, thus enhancing user enjoyment and immersion. Moreover, the platform’s variation is indicative of the fact that subject matters have enabled them to steer clear of creative repetition.
Mechanics Provide the Foundations for a Successful Title
Perhaps one of the biggest debates in the industry concerns the importance of in-game mechanics compared to visuals. Irrespective of the platform, each and every game features mechanics, albeit many of them will differ depending on the sought-after complexity. As per an article at Game Skinny, similarly to themes, the systems that facilitate user actions add more depth to a game, highlighting LIM as an example of how stripped-back games can flourish.
In many ways, parallels can be drawn to online casino developments. Fundamentally, the mechanics of slots are centred around creating a fast-paced experience with consistent replayability. If a lesser focus on themes became common in the industry, the core mechanics would still ensure enjoyment, albeit in the less aesthetically-pleasing fashion.
As touched on above, this debate has long been rife within the gaming community. Interestingly, a report at League of Gamemakers states that themes should take a back seat if their focus detracts from a game having solid mechanics. That said, the iGaming industry has perhaps found the perfect balance between functions and visuals. The use of fewer mechanics than mainstream console titles ensures that the likes of bingo, slots, and traditional casino games don’t dilute the value of in-game features and themes.
Why Choose Between the Two?
Ultimately, game designers don’t need to and shouldn’t have to pick between mechanics and themes. In their own right, both are paramount to the overall success of any given game, particularly at online casinos. The market’s accessibility requires the flowing gameplay that comes with minimalistic functions, while themes aid in creating a storyline that brings to life a title’s interactivity.


text:
I saw Ed today. I’m not really kidding. I was in the bedroom here right after dinner at home with Chris’s parents, and when I came up to get dressed for our after dinner walk along the beach, I saw him from the corner of my eye staring at me from the next door neighbor’s front yard. I looked right at him and he saw me, and then when I looked again, he was gone.
Even though he’s no longer in the same form, I know my Ed is there watching over me. I don’t get to see him or talk to him the way I used to, but I can always feels him around, even all the way across the world and in the Southern Hemisphere. I miss him.