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Compensability for occupational diseases has become commonplace in most, if not all, jurisdictions throughout the country; however, the majority of claims filed allege physical rather than mental disability. The California Workers' Compensation Institute recently published their study of mental stress claims which indicated an increase of 430 percent in the number of claims filed from 1980 to 1986.
The main causes for these claims include job pressures, harassment, and job termination. Other types of discrimination and stressors account for a small percentage of the claims filed.
The age of the worker also appears as a significant variable in determining whether a claim for mental stress is filed. In general, younger workers are more likely to file such claims than older workers. Almost 60% of the claims reported by the National Council on Compensation Insurance were filed by workers under the age of 40. (A complete breakdown is shown in the chart entitled "Mental Stress Claims--Age of Worker." National Council on Compensation Insurance, 1985.) It is possible that the stigma associated with mental or emotional illness has been reduced, thus enabling workers who are experiencing these conditions to file claims; whereas their older counterparts have preferred to keep their emotional problems out of the public eye. Another possible explanation for the increased filing of mental stress claims in general may be the faster-paced world in which we now live and the increased pressures on families where both spouses must work.
For many years, employment situations have led to stressful conditions for employees. An employee may be faced with stress generated by the immediate performance of the task itself or by collateral problems associated with the work environment. The decade of the 1980's has brought with it an increased awareness of and sensitivity to the sociological and environmental aspects of the workplace. New attention has been focused upon such areas as sexual harassment, the dangers of co-workers' smoking in the workplace, and the threat of communicable diseases such as AIDS.
Mental disease has been a challenge to the workers' compensation system since its inception. The complexity of the causal relationship of psychological, emotional, and nervous disorders to a work environment and the subjective analysis of various mental disorders have been a challenge to the objective standards of the workers' compensation system, the underlying basis of which is to provide benefits to disabled workers through social remedial legislation.
Mental stress claims are generally divided into 3 classifications:
Claims in which physical injury results in mental disability;
Claims in which mental stress results in physical disability;
Claims in which mental stress results in mental disability.
Physical Injury-Mental Disability
Disabilities caused by traumatic events which result in mental disability have been afforded compensation under the New Jersey Act. Both psychoneurosis and conversion hysteria flowing from industrial accidents have been deemed compensable. In Watts v. City of Newark, 25 N.J. Misc. 402 (Com.Pl. 1947), the court concluded that a hysteria may be the cause of a disabling condition in the absence of any discernible and anatomical cause.
Indeed, it was the absence of apparent connection between the objective, discernible, tangible event and the neurotic symptoms which caused the condition to be termed "an hysteria." In this case, since even the physicians appearing for the respondent were unwilling to term the claimant a malingerer, the petitioner was awarded 100% total disability as a result of severe psychoneurosis and conversion hysteria.
In another situation, an employee who suffered a serious back injury with permanent physical impairment also suffered mental consequences which resulted in permanent psychiatric disability. Psychiatric experts on both sides independently concluded that the worker was suffering from a state of mind that constituted a mental disorder. Their determination was based upon sound professional medical judgment, thereby constituting objective medical evidence of the employee's psychiatric disability under the Act. Margaritondo v. Stauffer Chemical Company, 217 N.J.Super. 560 (App.Div. 1985), remanded by 104 N.J. 388 (1986), aff'd on rehearing 217 N.J.Super. 565 (App.Div. 1986).
Mental Stress-Physical Disability
In instances where mental stress results in either a traumatic event or disability which is physical in nature, the courts have continued to award compensation benefits. In Hall v. Doremus, 114 N.J.L. 47 (1934), an individual who was employed as a laborer on a farm, who was unloading a wagon containing hay, and who was stunned when he discovered a cow giving birth, suffered a "terrifying ordeal" and was permitted to receive workers' compensation benefits for a fractured skull which he sustained as a result of his fainting and falling to a concrete floor.
In a more recent case, an office worker who was hired as a bookkeeper was permitted to recover compensation benefits for a coronary infarction which was said to have been caused by her failure to balance her books. The court took into consideration her pre-existing hypertension but nevertheless concluded that the incident was a work-related event. The court decided that it was more probable that a person of the employee's age, emotional fears, and pre-existing hypertension would suffer such stress as a result of her concern for her failure to provide a correct accounting and that this would be sufficient to precipitate or accelerate the resulting coronary infarction. Coleman v. Andrew Jergens Company, 65 N.J.Super. 592 (Law Div. 1961).
The courts have recognized that physical stress and strain can result in physical injury; the courts have also concluded that continued emotional stress to which an employee may be subjected may be considered to be a factor in the causation, exacerbation, or acceleration of the progression of physical conditions such as artherosclerotic disease. In interpreting the phrase "substantial condition, event, or happening" as promulgated in N.J.S.A. 34:15-7.2, the court determined that the employee's activities should be measured against the "wear and tear of the claimant's daily living." Therefore, the level of a claimant's emotional stress can also be recognized as a standard against which a particular event can be measured. Hellwig v. J.F. Rast & Company, Inc., 110 N.J. 37 (1988).
Mental Stress-Mental Disability
Jurisdictions throughout the United States have had divergent opinions with regard to the recognition of psychiatric disability flowing from mental disorders. Two major schools of thought exist with regard to this area of law. The Michigan approach is that an injury caused by gradual mental stimuli is considered compensable. An assembly line worker who suffered from paranoid schizophrenia was awarded benefits. In this case, the award was based upon the employee's purely subjective reactions to the work which in turn were based upon his own perception of his inability to maintain the production rate of the assembly line. Carter v. General Motor Corporation, 361 Mich. 577 (Mich. 1960). The ruling was extended to another factual situation in which, as a result of being a compulsive perfectionist, an employee became irritable and nervous about the poor working habits of his co-worker. The perfectionist's abnormal perception of his employment was considered not to have diminished the causal nexus, and compensation was awarded for the resulting psychoneurosis since the disturbance that the individual experienced was not imaginary to him. MacKenzie v. General Motors Corporation, 403 Mich. 1 (Mich. 1978).
On the other end of the spectrum of the jurisdictional split is Wisconsin's so-called "objective" approach, where "out of the ordinary stress is required." The test for compensability for mental disease flowing from mental stress is that there be a situation which would exist which is greater than the dimensions of normal day to day stress and tensions which employees experience. In one particular claim, a schizophrenic suffered a mental breakdown which was alleged to have occurred as a result of pressure caused by seasonal business and harassment by her supervisor. The work stress experienced by the employee was considered by the petitioner's medical expert to be the principal cause and major factor in her mental breakdown, and benefits were awarded. Swiss Colony v. Department of ILHR, 72 Wis.2d 46 (Wis. 1976).
California adopted a more moderate approach in the early 1970's holding compensable those matters where gradual mental stress occurred in the ordinary pursuit of daily employment activity and resulted in mental disability. In Baker v. Workmen's Compensation Appeals Board, 18 Cal.App.3d 852, (Cal. Ct. App. 1971) a full time fire fighter was exposed to fumes and smoke while battling a blaze in 1953. Over the years he continued to be exposed to acrid fumes and smoke, and he continued to complain of physical disability although objective findings were absent. His condition became progressively worse, and in 1968 he was unable to work and was declared to be totally and permanently disabled. Evidence was presented that the claimant was preoccupied with heart disease as a result of stressful experiences and fatigue and some probable lung damage.
The court indicated that the fire fighter suffered from a psychoneurotic syndrome which it described as "cardiac neurosis." It attributed this mental disability to the claimant's work environment and to the cumulative effect of the daily stress and strain of his employment.
In a generally imperfect world which subjects employees to stress and anxiety from many aspects of daily living, California further defined its approach to permit compensability where the employment is merely one of the contributing causes which would be determined to be proximate to the resulting mental disability. A cake baker who had a series of conflicts with her supervisor concerning scheduling of work hours and a temporary layoff and who was said to have had an honest misperception of job harassment was awarded compensation benefits even though she had suffered stress from pre-existing conditions including marriage to a brutal (first) husband and a childhood traumatized by parental divorce. Albertson's Inc. v. Workers' Compensation Appeals Board, 131 Cal.App.3d 308 (Cal. Ct. App. 1982).
New Jersey has followed a consistent middle of the road approach and has permitted the awarding of compensation benefits for mental injuries where no physical disability is evident. A steam engineer who sustained no physical injuries but who suffered from a complete psychoneurotic disability as a result of the explosion of a steampipe in a boiler room was permitted to recover disability benefits. Evidence presented demonstrated that the employee's state of comparative health changed dramatically as a result of the psychic trauma. Simon v. R.H.H. Steel Laundry, Inc., 25 N.J.Super. 50 (1953), aff'd 26 N.J.Super. 598 (N.J. 1953).
New Jersey requires that a disability be established, that the disability arise out of the employment and that the petitioner carry the burden of proof through the use of objective evidence. An individual who was labelled an "idiot" by a co-worker, who suffered a "nervous spell" and who was taken by her father for one visit to a treating physician for a "nervous spell" was denied benefits for her failure to establish disability under the Act. Voss v. Prudential Insurance Company,
14 N.J.Misc. 791 (N.J. Dept. of Labor 1936). Additionally, a New Jersey assembly line worker in a case similar to the factual situation in Carter, supra, was denied benefits for a disability based upon repetitive mental strain. In interpreting the decision based on the law prior to the 1979 amendments to the Workers' Compensation Act, the court recognized the longstanding Ciuba doctrine, which eliminated the need to show unusual strain or exertion, Ciuba v. Irvington Varnish & Insulator Co., 27 N.J. 127 (N.J. 1958), but denied compensability based upon a lack of evidence demonstrating that the mental disability "arose out of the employment." While rejecting the totally subjective course followed by Michigan, the courts in New Jersey appear to have adopted an approach which requires an objective evidential basis demonstrating that a mental disability arose out of an employment and was due in some "realistic sense of material degree to a risk reasonably incident to the employment." The New Jersey system will not rely upon the purely subjective reaction of the employee and his perception of his work demands. The court will not rely solely upon the petitioner's unrealistic perception of the work since it considers such an evaluation to be made by a "diseased mind." The court has indicated that testimony by co-workers with regard to the conditions of the employment as well as testimony by medical experts to support causal relationship will be required to support a claim. Williams v. Western Electric Company, 178 N.J. Super. 571 (N.J.App.Div. 1981).
In summary, the courts in New Jersey permit the awarding of workers' compensation benefits in those instances where psychological disability can be shown to have arisen out of the employment and can be substantiated by objective medical evidence. Where a mental disability can be considered occupational rather than traumatic in origin, the time frame for instituting a claim for benefits would be based upon when the disease is recognized as causally related to the employment, as it would be with any other occupational disease claim. As the condition of mental disability due to employment stress becomes more widely recognized in New Jersey, the number of claims filed will probably follow the trend which was established in California during the 1980's.
By Jon L. Gelman
This article was reprinted by permission by the New Jersey Law Journal, Cite as 123 N.J.L.J. 7 (Feb. 16, 1989)
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Diamonds are fascinating.
They really are…
They carry a lot of mystery and myth with them. No matter how much you know about diamonds, there are some things you probably don’t.
Below are 15 facts you may not know. Some are simple and common sense, others may surprise you.
See for yourself.
15 Things you don’t know about diamonds.
1) Diamonds last forever:
Remember the phrase “Diamonds are forever?“, well, it’s true. Diamonds are forever. Diamonds were born over a billion years ago and they still look brand new today. When they say forever, they mean it.
The only way to harm a diamond is to chip or break it. Otherwise it will be brand new for another billion years.
Which brings us to…
2) Diamonds can be chipped:
Most people are under the impression that you cannot chip or break a diamond. But it happens, and it happens more often than you know.
The vulnerable part of a diamond is around the outer edge (the girdle), where it’s the thinnest and the weakest. One sharp blow at the right angle and pressure could cause your diamond to splinter or shatter.
3) Diamonds are not the hardest substance:
Everyone thinks that diamond is the hardest substance on the face of the Earth. But they are wrong.
Diamond is the hardest ‘natural‘ substance, but, certain man-made substances like nanorods are harder.
4) Diamonds are 100% pure carbon:
Carbon is a funny thing. It’s both strong, yet very weak. Take pencil lead for example. Pencil lead (graphite) is made of carbon. Graphite is very soft, it’s a 1 on the Moh’s Scale of Hardness. But, when mother nature adds heat and pressure to this carbon, it transforms into a diamond (10 on the Moh’s Scale). From one end of the scale to the other, carbon is a crazy thing.
5) Diamond is the #1 inclusion:
The most common type of inclusion found in a diamond is actually diamond. It’s true. Pieces of diamond that never formed properly or crystallized like the rest of the diamond leave inclusions inside the stone. Things like pinpoints, naturals, feathers, and crystals.
Diamond is the #1 inclusion.
6) Diamonds are not identical:
No two diamonds are alike. Every diamond is different. Everything born or made in nature is. Every diamond has its own unique flaws, characteristics, color, inclusions and imperfections that make it one-of-a- kind, just like a fingerprint.
7) Most diamonds are yellow:
Many would think that diamonds are white in color, but the truth of the matter is, most diamonds have a yellow cast or hue to them. Only diamond colors D-E and F are pure white. Everything else is off-white or slightly yellow, not to mention, other fun colors like browns, grays, or fancy colors.
8) Diamonds come in all colors:
Diamonds come in all colors of the rainbow. Once you get into the fancy colors (Z+) on the Diamond Grading Color Chart, you’ll see that Diamonds come in awesome colors like blue (The Hope Diamond), yellow, orange, red (the rarest color), pink, purple, green, brown (champagne and chocolate diamonds), and black diamonds.
9) Diamonds glow in the dark:
Some diamonds have the natural ability to glow in the dark. They have something that is called fluorescence. Fluorescence is a unique trait that allows a diamond to glow under an ultraviolet light. The next time you’re around a black light, check it out. Your diamond may be glowing.
This might sound like a cool feature, but it’s something that I don’t recommend. Read: Diamond fluorescence.
10) Diamonds are not perfect:
Every diamond has something that keeps it from being truly perfect. It can have perfect color (D), and perfect clarity (flawless), but what about a perfect cut? Or a perfect carat weight? There are none. The ideal cut, which many consider perfect, varies in percentages. Is this range really ideal? Carat weights can also vary. There is no perfect weight. Nothing is perfect. Cut and weight are all subjective. The perfect diamond does not exist.
11) There are no diamond chips:
People believe that all small diamonds are just “chips“. This is not true.
The fact is, jewelers don’t use chips in jewelry anymore. In the old days, really old days, before they had machines that could cut such small diamonds, jewelers would use diamonds that were rough, fractured, chipped or broken in jewelry. In other words, “chips” or chunks of the stone were set into mountings. Under a microscope they would look like pieces of broken glass.
Zoom ahead to the modern era and we have now have machines that can cut these small, tiny stones. This cut is usually called the single cut diamond. It’s a cut of diamond that has 16-18 facets on it, unlike the brilliant cut (full cut diamond) that has 58 facets.
The only way you will ever see a “chip” nowadays, is if you are looking at old, antique pieces. And even then it’s extremely fare.
12) Diamonds are used:
Used diamonds? It’s true. Some diamonds have been used before. Because diamonds look brand new forever, and because people are always trading them in, selling them, exchanging them, and pawning them, you could be purchasing a diamond that someone else has worn before (used) and never even know it.
Don’t be alarmed about this, since diamonds will never show any real signs of wear and tear (unless you break them), they will be officially new forever. Hence, diamonds can always be sold as new.
13) Diamonds are not a good investment:
Just like a car, once you buy a diamond, the value drops. You will never (unless you’re really lucky) get the full price you paid for a diamond if you sold it. You’d be lucky to get half (and normally, it’s more like 20-30%).
The reason being? There isn’t a market for buying diamonds… Only selling them.
So always buy a diamond because you want one, not because you think you could make a profit on it later. It’s not going to happen.
14) Diamonds are not the most expensive gem:
Believe it or not, but some gemstones (like ruby, emerald, sapphire or alexandrite) could bring in higher prices than a diamond can. Of course, it’s all based upon size, clarity, color and rarity, but some gems are more valuable than a diamond is.
15) Jewelers make very little profit on diamonds:
People tend to think that jewelers make big bucks on diamonds. The truth is, jewelers make very little on these transitions. In fact, jewelers make less money selling diamonds than any other item in the store.
There is way too much competition in the industry for diamonds. Price margins are slim. Jewelers will be lucky to make 5-10% profit. And diamonds that are of larger carat weights with great color and clarity, jewelers will probably make even less. There is not a huge market for expensive stones. This keeps the diamond margins down. Demand is not high enough.
So there you go, 15 facts you may not have known about diamonds…
Consider yourself informed.
You May Also Like:
You May Also Like:
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AP Human Geography Practice Exams
There are plenty of great AP Human Geography practice exams available. Our list below shows the very best options to choose from. Start your test prep right now!
ALBERT’s Geography Tests
Hundreds of challenging AP Geography questions that are organized by topic. Mostly free, but full access requires a subscription.
AP Human Geography Practice Test
A great set of free practice tests that cover all 7 topics from the course. These questions are very similar to those found on the AP exams. Detailed explanations are included.
This is a free online AP Human Geography practice test from Barron’s. A complete test that includes a full set of free response questions as well.
REA Practice Test
Another full-length practice test that features multiple choice and free response questions. Detailed explanations are included.
Textbook Self Tests
Multiple-choice quizzes for each of the 14 chapters of Human Geography: People, Place, and Culture by de Blij, Murphy, and Fouberg.
More Chapter Quizzes
At the Student Center for Fellmann’s Human Geography: Landscapes of Human Activities you will find two interactive quizzes for each chapter. Tons of practice questions!
Online quizzes for all 14 units of the course. There are also some cool map quizzes and world capitals quizzes. Be sure to check out this amazing resource!
Quia Practice Test
This is a really cool fill-in-the-blank AP Geo practice test. It was posted on Quia by Mrs. Christine Bell, and features a total of 40 challenging questions.
Practice Test 2010
Here’s another Quiz test to try. this one features 200 AP Geography multiple choice questions. A nice way to prepare for your final exam.
Practice Test 2011
Another 179 questions from Mrs. Bell. This even includes one essay question at the end.
Quizlet Exam Flashcards
Hundreds of amazing flashcards to help with your final exam review. These 929 terms can also be reviewed as a practice test or a matching game.
Check out these 948 free online flashcards. The cool thing about these is that you can choose to review the whole set or just focus on specific topics.
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Findings from a Cornell University study, which appear in the journal Molecular Nutrition and Food Research, found that compared to eggs and beef, eating fish resulted in increased levels of circulating trimethylamine N-oxide (TMAO).
High levels of TMAO are naturally found in fish and in humans the gut bacteria firmicutes, aids in convert the nutrient choline (from eggs) and carnitine (from meat) into TMAO.
It was found that higher levels of firmicutes compared to another bacterial species bacteroidetes in some individuals resulted in greater TMAO production and subsequent levels - a known predictive risk factor for heart disease in cardiac patients.
The results raise a host of questions, one of which asks whether the gut microbiome is playing a role in the disease process rather than the TMAO itself.
"My hypothesis is that diseased individuals - whether it's heart disease, cancer or other chronic diseases - are going to have a different microbiome than non-diseased individuals,” said Dr Marie Caudill, Cornell professor of nutritional sciences and lead author of the study. “The microbiome can be marked by TMAO levels in the blood."
Another question involves the role of TMAO and whether it causes heart disease or is simply a sign of the disease’s progression.
The team employed a randomised, controlled crossover design, where 40 healthy men aged 21–50 years with a BMI of 20–29.9 kg/m2 were recruited. Blood and urine samples were obtained at the start of the study.
Participants then consumed four different study meals. These meals were (1) three eggs, (2) six ounces of beef, (3) six ounces of fish (cod) and (4) a control meal of fruit. Each of these meals was administered in random order in a single day separated by a one-week period.
Following the consumption of the study meal, blood samples were obtained again, this time at 15 and 30 minutes, and one, two, four, and six hours and each participant provided urine samples throughout the six hour study period. These were carried out in order to measure TMAO levels.
At 4.5 hours the men ate a fixed snack of apple sauce and water. Throughout each study session, participants refrained from eating and drinking foods and beverages (other than water) outside those provided by the study.
Results showed that fish produced a higher circulating and urinary TMAO concentration (46–62 times) when compared to eggs, beef, or the fruit control.
Circulating TMAO concentrations were elevated after 15 minutes of fish consumption, indicating that dietary TMAO could be absorbed without processing by gut microbes.
Analysis of the subject’s genes showed that high-TMAO producers (more than a 20% increase in urinary TMAO after eating eggs and beef) had more Firmicutes than Bacteroidetes and less gut microbiota diversity.
"This provides some evidence that the elevation in TMAO may simply be a biomarker of differences in the gut microbiome," said Caudill.
“It is very likely that our diets interact with our gut microbiome to influence disease risk, and that our diet influences our gut microbiome composition,” she added.
Dietary changes needed?
The effects of animal source foods on TMAO generation, absorption, and elimination in healthy adults, however has suffered from a lack of attention.
The study concluded that recent studies proposing TMAO as a causative agent for cardiovascular disease, could give reason for some to advise on the restriction of animal source foods that raise circulating TMAO concentrations. However, Caudill remained cautious.
“Unless it is demonstrated that TMAO is a causative agent in the disease process, eating fish in recommended quantities does not need to be re-examined,” she said. “Likewise, people should not be restricting consumption of foods such as eggs and meat because of their TMAO raising properties.”
“It seems prudent at this time to place the emphasis on a high quality plant based diet that incorporates lean sources of meat (and eggs) to meet nutritional requirements.”
Source: Molecular Nutrition and Food Research
Published online ahead of print, DOI 10.1002/mnfr.201600324
“Trimethylamine-N-oxide (TMAO) response to animal source foods varies among healthy young men and is influenced by their gut microbiota composition: A randomized controlled trial.”
Authors: Marie Caudill et al.
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A character in the play "The widdow Ranter": Semernia, a Native American queen, with two black pageboys. Mezzotint by W. Vincent.
- Vincent, William, active 17th century.
About this work
Identified by Chaloner Smith (loc. cit.) as the actress Anne Bracegirdle in character. She may be playing the role of Semernia, the Native American queen, in Aphra Behn's play "The widdow Ranter" (1688-1689). She wears a headdress of feathers and pearls, earrings, a necklace, and bracelets and a fringed dress. She holds a fan of feathers and is attended by two black boys, of whom one holds her train and the other a parasol over her head. In the background is a landscape with a river and hills, supposed to represent the "sevana" (savannah) of Virginia. She is described in the Dramatis personae as "Indian Queen, call'd Semernia, belov'd by [Nathaniel] Bacon" (edition published in Lon don by James Knapton, 1690). In Act V scene 1 she appears disguised as a male Native American warrior and is killed by Bacon: previously she appears in female dress, as here. Less likely (as there is no suitable scene in the play) is the interpretation of Chaloner Smith (loc. cit.) , who identifies her as the title character in The Indian queen, a play by Sir Robert Howard and John Dryden, which was first performed in 1664: it was set in Mexico "The widdow Ranter, or, The history of Bacon in Virginia was probably written in 1688, first performed in late 1689, and published in 1690. It is a highly fictionalized drama of Bacon's Rebellion of 1676 in Virginia, when Nathaniel Bacon (c.1640-1676), commander of a volunteer force of Indian fighters, succeeded for several months in overthrowing the government of Sir William Berkeley, who had declared Bacon a rebel and refused to countenance or commission his actions against the Indians. Mrs. Behn's play casts Bacon as a classical hero, motivated by "Honour", and in love with an Indian princess. A variety of supporting characters present a less-than-flattering picture of colonial life and mores. The title character, the young and wealthy widow Ranter, puts on mens clothes and fights in several battles. The work ends tragically for Bacon, the Indian princess Semernia, and the Indian king Cavarnio; but comically and happily for everyone else. Its treatments of race, class, gender, rebellion, cross-dressing, sexuality, and miscegenation make it full of interest for a wide range of students of early America"--Paul Royster, Electronic texts in American studies, University of Nebraska-Lincoln, online December 2018
The Indian queen. W. Vincent fe.
[London] : J. Smith ex, [1690?]
1 print : mezzotint
John Chaloner Smith, British mezzotinto portraits, vol. 3, London 1883, pp. 1424-1425, Vincent no. 1
Wellcome Library no. 4001i
Where to find it
You can use this work for any purpose, including commercial uses, without restriction under copyright law. You should also provide attribution to the original work, source and licence.
Creative Commons Attribution (CC BY 4.0) terms and conditions https://creativecommons.org/licenses/by/4.0
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Trip to Jerusalem by Jennifer Tolbert
This is the story of what happened when Mary and Joseph took 12-year-old Jesus to Jerusalem to celebrate Passover.
1. Jesus knew he was God's son from a young age.
2. Jesus was faithful to God and to his parents as he grew up.
3. We can trust God's plan, even when we don't always understand it.
"For God so loved the world, that he gave his only Son, that whoever believes in him should not perish but have eternal life." - John 3:16
Read Your Bible and Pray Every day
Be Still and Know
I Love the Lord Messiah
Said I Wasn't
Shine Jesus Shine
Stand Up and Shout It
Begin Class with Songs, Games, Table Activity, or Sharing Time
Open Class in Prayer
Introducing the Story Ideas
1. Talk About Homes
Ask the children what they like best about their home. Who is in their home? What makes it feel like home? Say: Today, we are talking about a time when Jesus was just a boy. He was supposed to be going home but he felt just as at home in the temple. Why do you think that is?
2. Simple Maze
Give the kids a simple maze. Talk about the idea of finding your way. Today, we are going to talk about Mary and Joseph had to find their way back to Jesus.
3. Lost and Found
Ask the kids about what it feels like to be lost? Have they ever gotten lost before? How did they feel? How did their parents feel?
READ Luke 2:41-52 or tell the story of Jesus lost in Jerusalem as a child.
1. How old was Jesus in the story?
2. How do you think Joseph and Mary felt when they couldn't find Jesus?
3. Where did they find Jesus?
4. What did Jesus say when they found him?
Connect the story back to God and his character. Explain how this story fits into God's plan for salvation.
1. Memory Verse Measuring Tapes by Trueway Kids
Supplies: Template, Colors, Scissors, Glue
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For most of the 19th and 20th centuries, the city of Chicago was one of the most desirable destinations for immigrants. Emerging in the late 19th century as the hub of midwestern development, Chicago had good rail access from eastern ports of entry, and its slaughterhouses and industries provided jobs for unskilled workers. Large numbers of Germans, Irish, Swedes, Norwegians, Canadians, Czechs, Poles, Greeks, and Italians clustered there in the 19th and early 20th centuries. After World War II (1939–45), Bosnian Muslims, Latvians, Lithuanians, Pakistanis, Mexicans, and Hasidic Jews created significant enclaves in Chicago. According to the 2000 U.S. census, Chicago had the third largest Hispanic population in the United States (753,644, behind New York City and Los Angeles) and the seventh largest Asian population (125,974). Its foreign-born population was about 1.1 million.
Chicago began as a small military outpost established in 1816. By 1833, it was incorporated as a village with a population of more than 150. When the government forced a land settlement on the local Indian tribes, removing them west of the Mississippi River, the European population boomed. By 1848, a canal was completed linking Chicago to the Mississippi, and by 1856, it was the hub of 10 railroads. The city continued to grow during and after the Civil War (1861–65), becoming the leading grain, livestock, and lumber market in the world. In 1870, Chicago’s population of almost 300,000 was 17 percent German (52,316) and 13 percent Irish (40,000), with the percentage of foreign born rapidly rising. Unprepared for the rapid influx of inhabitants, the city was host to overcrowding, disease, and degraded living conditions.
In response to the plight of the immigrants, in 1889, Jane Addams opened the Hull-House settlement to provide assistance to the urban poor. The large pool of unskilled labor fueled the city’s economic development but also led to tensions. In May 1886, the deadly Haymarket bombing during a labor rally revived nativist fears of immigrant radicalism. By 1890, Chicago was second only to New York in population and a magnet for numerous immigrant groups. In 1900, Swedes comprised almost 9 percent of Chicago’s population (150,000), making it second only to Stockholm in Swedish population. By 1920, it was the largest Norwegian city in the world besides Oslo, and there was already a Polish population of 400,000. Between 1910 and 1920, at the peak of early 20th-century immigration, about threefourths of Chicago’s population was either first- or secondgeneration immigrant.
Charles Sawer, gateman at Union Station, Chicago, Illinois, 1943. In multiethnic Chicago, a man like Sawer was useful in the train station, where he served as an interpreter in Yiddish, Polish, German, Russian, Slovak, and Spanish. (Photo by Jack Delano/Library of Congress, Prints & Photographs Division)
After World War I (1914–18), most of the immigrant groups, including Czechs, Italians, Poles, and Greeks, began to disperse into new neighborhoods and eventually the suburbs, replaced by African Americans and other southerners moving north for industrial work. A Mexican community was well established by 1920, having moved north to work in steel mills and meatpacking plants. By the 1920s, the children and grandchildren of the “new immigrants” were developing a strong middle-class base (see new immigration). Together with economic ascendancy came greater opportunities for leadership and financial backing, both necessary to begin to influence the political process. A milestone was reached in 1930 when Anton J. Cermak, born in a mining town northwest of Prague, was elected mayor of Chicago. From that point forward, most of the old European immigrant groups rapidly assimilated into the mainstream of Chicago social and political life. Still, Chicago was a city of immigrants. In 1927, almost 30 percent of its population was born in Europe. The Jewish population alone, composed largely of poor eastern Europeans, was 275,000.
After World War II (1939–45), Chicago continued to attract immigrants. Historically a city populated mainly by Europeans and African Americans, it became one of the most ethnically diverse cities in the world. Mexicans continued to join the “colony” established after 1910, settling mainly in South Chicago. Apart from the largely assimilated Germans and Irish, Mexican Americans formed the largest ethnic group in Chicago by far, with a population of 1,132,147 in 2001 (in the greater Chicago-Gary- Kenosha area). Vietnamese, Laotians, and Cambodians fleeing in the aftermath of the Vietnam War (1964–75) and the Khmer repression came in large numbers during the late 1970s and early 1980s, congregating in the North Side neighborhood of Uptown. By 2000, there were about 25,000 Southeast Asians living in Chicago. Asian Indians were one of the most rapidly growing populations, settling mainly in western and northwestern suburbs. Indian Americans benefited greatly from provisions of the Immigration and Nationality Act of 1965, abolishing racial quotas and favoring skilled workers such as engineers and medical professionals. The act also gave preference to family reunification, which enabled Indians to bring their families to Chicago. Between 1980 and 2000, their numbers grew from about 32,000 to 123,000. There were also large populations of Puerto Ricans (161,655) and Chinese (78,277). In 1990–91, more than 5,000 Soviet Jews were relocated in Chicago, representing more than 9 percent of all Jewish émigrés to the United States. During the 1990s, Chicago was still the fourth most popular destination for immigrants, ranking behind New York City, Los Angeles, and Miami, Florida.
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Organizational culture development the induction or orientation component of a program is distinct from actual job training in induction, employees learn the philosophies, values and culture of the organization. Spemann and mangold’s work with induction and organization in developing embryologists continue to study the spemann-mangold organizer and induction. Induction of employee is the first step towards gaining an employees' commitment, induction is aimed at introducing the job and organization to the recruit and him or her to the organization. New employee orientation is a critical factor in helping a new employee develop a productive, lasting relationship with your organization here are tips. Induction is designed to provide a new employee with the information required to function comfortably and effectively in the organization orientation conveys three types of information – (i) general information about daily routine (ii) a review of the organization’s history (iii) a detailed. Employee induction training: common obstacles and how to overcome them your organization’s employee induction training should serve as the center of your company’s hiring process. Successful inductions and give him the best possible start in the organization conversely, a poor induction program is either too full-on or not thought through.
Deductive and inductive paragraph organization this type of organization gets more crafty, throwing down bits and pieces before coming to a conclusion. Been given proper induction about the organization structure effectiveness h 2: induction programme has positive impact on employees’ intention to stay on the job. Bsbhrm506 manage recruitment selection and induction process this assessment defines the knowledge and skills needed to manage all parts of recruitment, selection and induction processes according to. Why is induction so important published on 3 dec 2012 hr pulse news desk many employers see induction as a waste of valuable time but this is a critical process. Good evening and welcome tonight we celebrate our achievements and the induction of the new officers i look to the future of this great organization which i am honored to lead on its journey to wellness. Induction training is the training immediately received by an employee when he first joins an organization the basic purpose of an induction program is the integration of new employees with the systems and processes in and across the organization.
Advertisements: induction programmes: concept, objectives and phases of induction programme 1 concept of induction: introduction of a new entrant into any existing group of people has been a common feature we come across in. Define induction induction synonyms, induction pronunciation, induction translation, english dictionary definition of induction induction when a magnet is passed through a coil of wire, it produces an electric current. Staff induction is vital in getting staff up to speed, and ensuring they are productive yet most organisations have inadequate or ad-hoc processes in place. Induction of people new to the organization is a continuing training need for businesses small and large much energy and effort is devoted to induction, often without too much effective return either for the individual(s) concerned or for the organization.
introduction in this assignment we will analyse the importance of induction in making a good impression about the company on the employee we will enumerate the various steps in induction at workplace and finally conclude our study. Who recommendations for induction of labour acknowledgements 2 abbreviations 3 executive summary 4 anticipated impact on the organization of.
Induction is known as a conclusion reached through reasoning an inductive statement is derived using facts and instances which lead to the formation of a general. An induction programme is the process used within many businesses to welcome new employees to the company and prepare them for their new role it helps in the effective integration of the employee into the organisation.
This section includes rhl summaries of published systematic reviews on various aspects of pregnancy and childbirth, including preconception care, management of miscarriage, antenatal care, medical problems in pregnancy, disorders that might affect the unborn baby, complications arising during pregnancy, the induction of labour, and. Ing direct: induction training walkgrove developed this course for ing direct as part of their blended induction programit aims to provide an overview of the organization’s vision and key values. World health organization the primary goal of the present guidelines is to improve the quality of care and outcomes for pregnant women undergoing induction of. Changing conception of organizatios n and induction1 jane maienschein and organization emerge gradually and how the best scientific approach to the.
Induction is the process of introducing a new employee to his/her job and organization and giving him all the necessary information required by him/her to start his work. Definition of orientation: and a part of his or her continuous socialization process in an organization induction of em overt discrimin. ♦ instill positive attitudes about the organization the objectives of a successful induction and orientation program should be to. Employee induction in an organization induction is a necessity for future performance of the new employee or even for existing employees. Induction training organizational values and satisfying was induction inducted employees into an organization by. Orientation: an induction programme is commonly used to help new employees understand their job within the organisation research purpose: the main aim of this study was to examine whether or not the programme theory of an induction programme was plausible and would lead to the intended outcomes as described by the.
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Brushing your teeth twice daily is an effective way to clean the visible surfaces of your teeth, but what about the hard-to-reach surfaces in between? This is where flossing comes in. Flossing removes trapped food particles and plaque, a sticky film that forms on your teeth, from the areas between your teeth and around the gumline. According to the American Dental Association (ADA), flossing is an essential part of good dental hygiene and reduces the likelihood of tooth decay and gum disease.
How Often Should You Floss?
The ADA recommends flossing at least once daily. Most people like to fit flossing into their morning routines, while others do so before bed. It’s up to personal preference. Just do it daily when it’s convenient for you, and before long, you’ll have adopted a new oral care habit.
What happens if you never floss?
Flossing helps remove plaque from the hard-to-reach tooth surfaces and prevents it from hardening to tartar, which only a professional dental cleaning can remove. Plaque can produce acids that attack the enamel between your teeth, resulting in tooth decay and cavities. It can also cause bad breath (halitosis) and unsightly tooth staining.
Additionally, plaque can irritate the gums and cause gingivitis (early gum disease), characterized by red, swollen, and bleeding gums. If left untreated, gingivitis can progress to periodontitis, an advanced form of gum disease that can destroy the tissue and bone supporting the teeth, resulting in tooth loss. Additionally, gum disease is linked to heart disease, rheumatoid arthritis, diabetes, premature birth, and many other health conditions.
Different Ways to Floss
Although traditional dental floss is the most common way to maintain your dental health, there are also some alternatives.
- Traditional dental floss: Traditional flossing or manual flossing involves moving sections of waxed or non-waxed string between your teeth and under your gum line to remove bacteria and food debris.
- Waterpik: This is the most popular brand of water flossers. Waterpik uses pressurized streams of water to remove food, bacteria, and plaque between your teeth. You can adjust the pressure setting to your liking, from a gentle to maximum cleanse.
- Interproximal brushes: These brushes specialize in cleaning wide or open spaces between teeth, including the space around and between the premolars and molars. They come in various sizes, ranging from 0.4 mm to 0.8 mm. For the best results, it’s important to choose an interdental brush of the right size.
It’s clear that flossing daily is not only key to a clean mouth but may also serve as good preventive care for complications elsewhere in the body. To maintain your dental health, you should also schedule regular dental exams and cleanings at 4th Street Dental Studio in Columbus OH. Contact us today to schedule appointment.
Robert D. Wood II, DDS
Third-generation dentist and Nashville native Dr. Robert D. Wood II leverages his professional experience to deliver superior dental care at his Columbus-based practice, 4th Street Dental Studio. An advocate for preventative medicine, Dr. Wood combines his patient-centric approach with his talent for transforming dental visits from daunting experiences into positive ones. Beyond his practice, he enjoys exploring Columbus, engaging in outdoor activities, and is an active member of several dental associations and the Kappa Alpha Psi Fraternity, Inc.
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NC Student Standards
DIGITAL LEARNING STANDARDS (effective 2020-2021)
The State Board of Education and the North Carolina Department of Public Instruction are committed to providing personalized, digital-age education that K-12 students need to be successful in college, careers, and as globally engaged, productive citizens. For student standards in the areas of Digital Learning (K-12), NC has adopted the International Society for Technology in Education Standards for Students.
Implementation of the NC Standard Course of Study for Digital Learning Grades K-12 will begin in the 2020-2021 school year. North Carolina’s Digital Learning Standards are designed to be delivered by classroom teachers in all curricular areas and grade levels providing students the equitable opportunity to learn in a digitally enabled classroom. The Digital Learning Standards encompass the following:
- Digital citizenship, data privacy, and cyber safety
- Digital-aged skills that enable students to be college and career ready
- Creation, collaboration, communication, and critical thinking skills
- Inquiry and design thinking learning opportunities
Additional information and resources for the Digital Learning Standards are available from the DTL Google site.
During 2009, Digital Teaching and Learning staff members worked with LEA representatives and other DPI staff to create Information and Technology Essential Standards. These standards were developed using Bloom's Revised Taxonomy and replace the Computer Skills and Information Literacy Standard Courses of Study. The standards were piloted in 2010-2011.
These standards are critical building blocks for the education of our students. ITES represent the "must have" information and technology skills and knowledge that each student must have in order to achieve success at the next level. The standards are designed to be delivered by classroom teachers in all curricular areas and grade levels. As the ITES are taught throughout all classrooms and across all curricular areas, it is essential that classroom teachers collaborate with school library media coordinators and instructional technology facilitators in delivering this instruction. School library media coordinators and instructional technology facilitators should be active participants in grade level and/or curricular area planning groups as these teams analyze student data, identify learning goals, plan and deliver instruction, and assess student progress.
- Sources of Information
- Informational Text
- Technology as a Tool
- Research Process
- Safety and Ethical Use
Supporting documents include learning progressions, standards alignment and clarifying objectives.
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Does MRA neck need contrast?
Contrast. MRA – Brain is done without contrast (gadolinium). Because no contrast is given, it is a good alternative to CT angiography for patients that can’t tolerate CT contrast (iodinated contrast.) MRA – Neck requires gadolinium contrast.
What can an MRA detect in the neck?
MRA uses a magnetic field, radio waves and a computer to create images of soft tissues, bones and internal body structures. MRA of the neck is used to produce two three-dimensional images of the blood vessels. MRA of the neck is primarily used to detect narrowing of the arteries.
Why would a doctor order an MRA of the neck?
Doctors use MRA to: identify abnormalities, such as aneurysms, in the aorta, both in the chest and abdomen, or in other arteries. detect atherosclerotic (plaque) disease in the carotid artery of the neck, which may limit blood flow to the brain and cause a stroke.
What does an MRA of head and neck show?
An MRA of the head is done to look at the blood vessels leading to the brain to check for a bulge (aneurysm), a clot, or a narrowing (stenosis) because of plaque.
What is the difference between MRA with and without contrast?
An MRA uses a machine to generate a magnetic field using pulses of radio wave energy, to build real-time images of blood vessels and blood flow within the body. An MRA can be used with a contrast medium (medical dye) or without. When it is used without dye, it is called a non-contrast MRA.
What happens when you have an MRI with contrast?
An MRI scan with contrast only occurs when your doctor orders and approves it. During the procedure, they’ll inject the gadolinium-based dye into your arm intravenously. The contrast medium enhances the image quality and allows the radiologist more accuracy and confidence in their diagnosis.
How long does an MRA without contrast take?
An MRA takes between 30-60 minutes, depending upon the part of the body being imaged and the information requested by your doctor.
What is the difference between MRA and MRI?
The key difference between MRI and MRA is their intended uses and applications, as the MRA is used for a very specific purpose, while MRIs can be employed in many different settings. Both MRI and MRA studies offer high resolution images with few risks for the patient.
Does MRA use contrast?
An MRA exam may or may not use contrast material. If needed, an injection of a gadolinium-based contrast material may be used. Gadolinium is less likely to cause an allergic reaction than the iodinated contrast material used in CT angiography .
What does MRA stand for In contrast?
Contrast MRA abbreviation meaning defined here. What does MRA stand for in Contrast? Top MRA abbreviation related to Contrast: Magnetic Resonance Angiography
Does MRA of the brain use contrast?
3-dimensional (3D) time-of-flight (TOF) MRA is the most common technique used to assess the arterial blood supply system of brain. 3D TOF provides higher signal-to-noise and shorter imaging times. MRA brain is easy to perform and does not require contrast administration.
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What is blues piano more precisely? Blues piano is a piano style that helps you play other styles much easier once you have mastered it. After you finish reading this article you will know more about playing the blues music on the piano.
In the beginning, you must know 12-bar blues. This is a very common progression if you want to do blues piano playing. To play this particular blues form, most pianists make use of seventh chords. A song is usually broken into 3 sets. Each of the set consists of 4 bars. Start by playing the song on the C key. Use ‘I’ to illustrate the tone (C) in the C key. The IV tone is F and the V tone is G.
The initial set is played as I-I-I-I. The next set is played as IV-IV-I-I. The final set is V-IV-I-I. Use your right hand when playing these three sets on the piano. To come up with a sound that’s just like blues piano, try to master playing 7th chords.
For your left hand, follow the 8-note pattern. The pattern is like this: I-III-V-VI-VIIb-VI-V-III. When playing the C chord with the use of your right hand, the notes played will be C-E-G-A-Bb-A-G-E. While for the chord F, you will be playing F-A-C-D-Eb-D-C-A. For the chord G, you will be playing G-B-D-E-F-E-D-B.
Try to examine the chords and notes played both by the left and right hand. If you already know the different piano chords and notes, learning blues piano can be very easy. Before anything else, you will have to master 12-bar blues in the key C. Once you’ve mastered it, you can try playing it using other keys.
Learning to play the blues is the first step in establishing a good foundation in playing the piano. Many great pianists began playing the blues on the piano for starters then evolved to other music styles that they love. After you develop a strong foundation, all the new songs you will learn will be much easier to play. Your audience will love and praise your performance if you can play different music styles with elegance and grace.
You can master the art of blues piano with the help of a great piano teacher. Find one close to you that can guide and inspire you to be a better pianist. If you like, you can use other methods to learn playing the piano lice CDs or DVDs with piano lessons, online piano lessons and a piano guide book. You are the only one who can determine the learning process. If you are committed and persevere, you will soon learn how to play piano blues the right way.
It takes a lot of time and practice to become a good pianist. Sometimes it takes even years of constant practice and determination.
Top viewed piano sheets!
Bruno Mars - When I Was Your Man
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Les Miserables - On My Own
Macklemore - Thrift Shop (feat. Wanz)
The Beatles - Let It Be
Emeli Sande - Read All About It (Part III)
Queen - Bohemian Rhapsody
Henry Mancini - The Pink Panther Theme Song
Alicia Keys - Girl on Fire
Labrinth - Beneath Your Beautiful
Alladin - A Whole New World
James Bond 007 - James Bond Theme Song
Imagine Dragons - Radioactive
Rihanna - Stay
Sinead O'Connor - Nothing Compares 2 U
Whitney Houston - I Will Always Love You
Les Miserables - Castle on a Cloud
Hear and Play: The Gift of Playing the Piano by Ear Have you ever heard a really nice song that got you so captivated that you just wish you can play it in the piano right away? Playing the piano by ear appears to be a gift, a talent of hearing music once or twice, and then once you have your hands on the keys, the magic begins. As easy as it may sound, hearing the music and playing it at once is not just pure genius. It requires a little background and familiarity with the piano scale and some piano lessons. Some people may not be able to read sheet music but knows the sound of each keys. That is the key to hearing and playing music. But others are born artists of piano. Surely, it would be great that even without music sheets, one can play music beautifully and can share his or her ow...Continue reading Hear and Play: The Gift of Playing the Piano by Ear
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Science Says: Hawaii hurricanes rare, but getting less so
Hurricanes seldom get close to Hawaii and it's even rarer for one of the islands to take a direct hit.
Hurricane Lane is already drenching and pummeling the island chain, even without reaching land.
The last time a major hurricane hit Hawaii was in 1992 when Category 4 Iniki caused billions in damage. On average, the central Pacific hurricane region, which includes Hawaii, sees about four or five storms moving through, but that may be changing with global warming.
A look at the hurricane season in Hawaii:
WIND IS KEY
Usually wind is what keeps storms from threatening Hawaii. Most eastern Pacific hurricanes form in the warm waters off Mexico and head west. But before they get too far, wind currents usually cause them to circle back toward the coast. The storms that stay a bit further south are the rare ones that make it to the central Pacific, said Princeton University climate scientist Gabe Vecchi.
This year, those winds aren't quite steering storms back east. Add to that weaker than normal winds aloft—about where airplanes fly—that usually shred storms. Winds at that level would normally be 23 mph to 29 mph (27 to 47 kph). Now, they are less than half as strong, allowing storms to stay alive, explained Colorado State University hurricane scientist Phil Klotzbach.
That also happened in 2014 and 2015, which were busier than normal years for storms getting close to Hawaii. There were four in 2015 and three in 2014, including Iselle, which hit the Big Island but was a weakened tropical storm.
But the central Pacific is a big area and the islands occupy a small area, so most storms aren't likely to come too close.
Hurricanes are fueled by warm water. The water temperature in the region is about 2 to 3.5 degrees (1 to 2 degrees Celsius) warmer than normal, according to Vecchi. That was also the case in 2014-2015. "We've come to learn that an unusually warm ocean in the subtropical Pacific will tend to increase the number of hurricanes around Hawaii," Vecchi said.
The Pacific has more storms during a strong El Nino, a weather event that warms the water. Meteorologists expect an El Nino to form in the next couple months, but right now El Nino conditions are still more neutral than hot. Vecchi and others attribute the warming to a natural cousin of El Nino, with help from climate change. When it comes to hurricane activity in the central Pacific, warming from that north-south weather pattern is much more connected to causing more storms than east-west El Nino, Vecchi said.
So far this year, the entire eastern Pacific region, which includes the central region, is much more active with more storms, stronger ones and longer lasting ones than normal, Klotzbach calculated . On average, the region gets 15 named storms for the total season. Lane, which formed Aug. 15 far off Mexico, is already the 12th named storm and the second to get close to Hawaii. In contrast, the Atlantic region is running around its average for this point in the season, with stormy conditions slowing down recently. Storms get named when winds reach 39 mph (63 kph).
August is the biggest month far for central Pacific hurricanes, compared to September for the Atlantic. The central Pacific hurricane season runs from June through November, just like the Atlantic. The eastern Pacific runs from May through October.
While climate scientists are reluctant to link individual weather events or even seasons to global warming, they can make the connections with elaborate detailed studies. National Oceanic Atmospheric Administration climate scientist Hiro Murakami, Vecchi and others studied the 2014 hurricane season around Hawaii and found it was "made substantially more likely" by climate change caused by emissions from burning coal, oil and gas, with a natural boost from El Nino.
In a study last year, they also connected global warming to 2015's record number of major storms in the region, including three Category 4 hurricanes in the central and eastern Pacific at the same time. These studies are limited because of weak records of storms in the area before 1970, Vecchi said.
Many climate studies recently predict that as the world warms, the globe overall and the Atlantic region will have fewer named storms but more intense ones. However, the central Pacific bucks that prediction.
Several studies forecast that the central Pacific will become busier with more storms, stronger storms and faster developing ones, Vecchi said. A Murakami study used computer simulations to predict a noticeable increase in storms around the Hawaiian Islands.
It's once again because of winds and water. The water in the region is predicted to warm faster than elsewhere around the globe because of a weakening of trade winds, Vecchi said.
© 2018 The Associated Press. All rights reserved.
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Section 1: Epidemiology and aetiology
Obsessive compulsive disorder (OCD) is a psychiatric disorder characterised by persistent and intrusive thoughts, images and urges (obsessions) and repetitive behaviours (compulsions), as listed in table 1.
The symptoms typically wax and wane, but often follow a chronic course, causing functional impairment and distress.
The estimated prevalence in children and adolescents is 0.25-4%. It was previously considered rare in children. Paediatric OCD is associated with an increased risk of other psychiatric disorders in adulthood. Causation is poorly understood but it can be bio-psychosocial and multifactorial.
- Genetic: OCD is a highly heritable condition. First-degree relatives and monozygotic twin offspring of patients who have OCD have higher rates of OCD and anxiety disorders.
- Neurobiological: Characteristic neuropsychological profiles have been found in children and adults who are diagnosed with OCD.
- Environmental: The role of environmental factors remains unclear, with conflicting evidence regarding environmental triggers such as social isolation and physical abuse.
- Individual: Personality traits, such as perfectionism and rigidity, may be predisposing factors. High personal expectations and low self-esteem are also considered risk factors.
PANDAS (paediatric autoimmune neuropsychiatric disorders associated with streptococcus) is a term for a subgroup of children who have a sudden onset of OCD symptoms after a streptococcal infection.
The mechanism is unknown and the effectiveness of prophylactic antibiotics is inconsistent.1
The ICD-10 diagnostic criteria for OCD in children are similar to those for adults (see box 1).
However, children are less likely to have insight into the obsessions and compulsions, leading to a delay in seeking treatment.
Section 2: Making the diagnosis
Patients who have OCD often go undetected before an accurate diagnosis is made. The nature of these obsessions may often lead to reluctance in discussing them, resulting in a delay in seeking help.
It is important to identify signs early and to undertake steps towards considering appropriate treatment. Most cases should be referred to secondary care.
When making the diagnosis, consider the following:
- Detailed history of obsessive and compulsive behaviour
- Functional impairment, such as time spent doing rituals
- Brief developmental history
- Physical examination (dry skin from excessive washing)
- Other psychiatric illnesses, for example, autism
- Mental state examination
- Assessment of risk of self-harm or suicide
- Family history of psychiatric illness or similar traits
- Medication history
Behavioural indicators of OCD include attempts to conceal symptoms owing to embarrassment. Children are likely to lack insight into the irrationality of their obsessions.
It is important to differentiate true compulsions from normal ritualistic and routine behaviours. The compulsion needs to be distressing and/or impairing.
Avoidance is an integral part of the symptoms, where a patient takes care not to touch toilet seats, door handles or other items used by others.2
Parents of children with OCD may accommodate their symptoms and provide constant reassurances. Children often react aggressively when a family member does not adhere to their compulsions.2
OCD can often be associated with other psychiatric disorders, such as depression, anxiety disorders, eating disorders, body dysmorphic disorder, hoarding disorder and trichotillomania.
The patient's beliefs and fears are best elicited by face-to-face assessment, although parents may be better placed to report ritualistic behaviours.
The short OCD screener (see box 2) provides a framework for screening and onward referral.
Source: NICE CG31
Common differential diagnoses are:
- Autism spectrum disorders (ASD): stereotyped behaviours in OCD are not pleasurable and associated with relief in anxiety. OCD can also be present in children who have ASD
- Complex tic disorders
- Psychosis: the presence of other characteristic symptoms in psychosis, such as hallucinations and delusions1
Section 3: Managing the condition
For a young person with symptoms of OCD with mild functional impairment, guided self-help should initially be offered through primary care or early intervention services. If this is refused or ineffectual, they should be referred to secondary care.
If the young person presents with moderate to severe functional impairment, a secondary care referral should be made. Patients with a previous history of OCD with a relapse in their symptoms or with associated comorbidities should also be referred to secondary care.
A referral letter explaining why a particular route has been chosen should accompany referrals. The letter should include current symptoms, and degree of impairment and interference, as well as other information relevant to risk and comorbidities.
Two treatments have an established evidence base in paediatric OCD, namely CBT, incorporating exposure and response prevention (E/RP), and SSRIs.
Central to any psychological therapy is a thorough case formulation that involves a collaborative understanding of the patient's difficulties.3 CBT includes initial psychoeducation that aids engagement and is necessary for the development of a therapeutic relationship, crucial if change is to be made possible.4
Typically, CBT is a short-term treatment consisting of 12-20 weekly sessions. The main therapeutic strategy is E/RP, which involves the patient confronting their fears in a graded manner, with help from the therapist and family members.
Involving the patient's family is crucial in helping family members to stop accommodating the child's compulsions.5,6
RCTs have shown that CBT can be efficacious in paediatric OCD, associated with a 45-60% reduction in symptoms.7
SSRIs can be prescribed as an adjunct to CBT in cases where the patient has moderate to severe functional impairment, or when an initial 12 sessions of CBT have not been effective.8 RCTs have indicated a 29-44% reduction in symptoms over a range of SSRIs.2
In the UK, currently only sertraline and fluvoxamine are licensed for use in children with OCD, with sertraline as the first choice owing to its favourable side-effect profile. A specialist should initiate these medications.1
In recent years, there has been research into using novel approaches to delivering CBT, for example, by telephone and using the internet. Further validation on these methods is awaited.
Pharmacologically, there has also been an increase in research interest in the use of d-cycloserine to augment CBT. This therapy is mainly delivered in the community and inpatient treatment is rarely required.
Section 4: Prognosis
OCD in young people, with factors such as secretiveness and a lack of desire to change, can negatively affect the likelihood of recognition and engagement in treatment.9
Higher levels of functional impairment, family conflict, parental blame and poor insight have been associated with poorer outcomes.
The presence of comorbid psychiatric disorders, specifically oppositional disorders and/or ADHD, makes compliance with OCD treatment more difficult.
Positive outcomes have been linked to higher treatment expectations and therapeutic alliance.10 A calm, supportive family environment, in which parents and/or caregivers can support the child's coping strategies, can improve outcomes.
CBT should involve relapse prevention strategies and follow-up review appointments can be helpful.
Section 5: Case study
HK is a 10-year-old girl with a two-year history of repetitive activities, involving getting dressed and rewriting words.
Her mother told the GP that HK had to pull every item of clothing on and off 25 times when dressing for school in the morning, making her late for school every day.
Her schoolwork also suffered because she felt the need to rewrite each word up to 25 times. If interrupted, she felt compelled to start counting again from the beginning.
HK's experiences were affecting her family, who were supportive but felt overwhelmed and unconfident about how to help her.
HK had attempted to conceal her difficulties, because she felt revealing them would mark her out as different, strange or mad. She had been unable to hide her distress before an important test at school, which increased her obsessional thoughts and compulsive behaviours.
Her GP elicited information from HK and her mother in a supportive and sensitive manner, with additional focus on other comorbidities. A referral to secondary care was made for a routine assessment.
Following the initial assessment in secondary care, it was concluded that HK's symptoms were consistent with OCD. A detailed assessment letter, with a formulation and management plan, was sent to the GP.
HK was offered 12 sessions of CBT, to include E/RP and family sessions with a clinical psychologist.
In the early stages of treatment, HK and her family reported a decrease in her symptoms of repetitive actions. These improvements had a positive impact on HK's mood.
Her treatment also included using behavioural experiments (E/RP). HK and her family remained engaged in treatment, so her symptoms continued to improve.
Medications were not considered in this case because of the positive effect of CBT.
Following completion of treatment, HK was discharged back to her GP with a summary of her management and relapse prevention plan.
Section 6 Evidence base
- Barrett, P, Farrell L, March J. Cognitive-behavioral family treatment of childhood OCD: a controlled trial. J Am Acad Child Adolesc Psychiatry 2004; 43: 46-62.
Here, CBT was associated with better responses and longer-term benefits, compared with psychoeducation plus relaxation training.
- Watson H, Rees C. Meta-analysis of randomized, controlled treatment trials for pediatric obsessive-compulsive disorder. J Child Psychol Psychiatry 2008; 49(5): 489-98.
This meta-analysis indicated that CBT is shown to reduce symptoms by 40-65% in a paediatric population.
- Torp NC, Dahl K, Skarphedinsson G et al. Effectiveness of cognitive behavior treatment for pediatric obsessive-compulsive disorder: Acute outcomes from the Nordic long-term OCD treatment study (NordLOTS). Behav Res Therapy 2015; 64: 15-23.
This study found that manualised CBT could be applied effectively in community mental health clinics.
- NICE. Obsessive-compulsive disorder: Core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder. CG31. London, NICE, November 2005.
- NICE pathway for suspected OCD. http://pathways.nice.org.uk/pathways/obsessive-compulsive-disorder
- Rutter M, Bishop D, Pine D et al (eds). Rutter’s Child and Adolescent Psychiatry (fifth edition). Oxford, Wiley-Blackwell, 2008.
- OCD Action (for people with OCD) www.ocdaction.org.uk
- OCD UK (national support group) www.ocduk.org
|CPD IMPACT: EARN MORE CREDITS|
|These further action points may allow you to earn more credits by increasing the time spent and the impact achieved.
1. Veale D, Roberts A. Obsessive-compulsive disorder. BMJ 2014; 348: g2183.
2. Krebs G, Heyman I. Obsessive-compulsive disorder in children and adolescents. Arch Dis Child 2015; 100(5): 495-9.
3. Johnstone L, Dallos R. Formulation in Psychology and Psychotherapy: Making Sense of People’s Problems. Hove, Routledge, 2013.
4. Lambert MJ, Barley DE. Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy: Theory, Research, Practice, Training 2001; 38: 357-61.
5. Salkovskis PM. Obsessional-compulsive problems: a cognitive-behavioural analysis. Behav Res Therapy 1985; 23: 571-83.
6. Wells A, Matthews G. Attention and emotion. A clinical perspective. Hove, Erlbaum, 1994.
7. Torp NC, Dahl K, Skarphedinsson G et al. Effectiveness of cognitive behavior treatment for pediatric obsessive-compulsive disorder: Acute outcomes from the Nordic long-term OCD treatment study
(NordLOTS). Behav Res Therapy 2015; 64: 15-23.
8. NICE. Obsessive-compulsive disorder: Core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder. CG31. London, NICE, November 2005.
9. De Haan E. Effective treatment of OCD? J Am Acad Child Adolesc Psychiatry 2006; 45: 383-501.
10. Fonagy, P, Target M, Cottrell D et al. What Works for Whom? A Critical Review of Treatments for Children and Adolescents. New York, The Guildford Press, 2002.
- Contributed by Dr Eloise Donaghay-Spire, clinical psychologist, and Dr Vibhav Shetty, consultant child & adolescent psychiatrist, South Kent CAMHS, Sussex Partnership NHS Foundation Trust.
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Sociology and Adult Education
Many believe that vessel education and training that that the very foundation of success. A strong educational background can help any individual branch into new opportunities, where individual goals and community goals are intimately intertwined. In addition to traditional education facilities, the United States has a prominent adult education industry which helps bring academic practices and continuous learning to individuals already within a working environment. Essentially, adult education helps empower both the individual and the community through a continual closure to new and useful information that continuously pushes the individual towards more progressive action.
There is a wide variety of types of adult education offers within mainstream American society today. Essentially, what sets adult education apart from traditional educational program is the fact that adults are already within the workforce are returning to an educational civility in order to train on some potentially lucrative element of a future position or to gain knowledge on something that would benefit them within their daily lives, like foreign nationals continuing their studies in English. A number of sources claim that the individual can be considered an adult when that “individual perceives herself or himself to be essentially responsible for her or his own life” (Merriam & Brockett 2007 p 5). Thus adult education focuses on providing learning opportunities for students who are arty which her look or deep been exposed to the workplace. The whole process of adult education within contemporary American society has been an evolving process. It has been incredibly particular “to the adult status of students” and “the notion of the activity being purposeful or planned,” meaning that the educational facility is one which is premeditated and not conducted within the context of everyday experiences (Merriam & Brockett 2007 p 7). Some elements of adult education are known as continuing education. These educational programs often offer literacy, management or other business services, and a wide variety of other genres available for adult the study in order to better their current mission within their employment, or lack thereof. Essentially, the main goal of adult education is to improve the quality-of-life an adult is already experiencing. Further education can only mean further opportunity within one’s current working position, or at a different level or organization. Thus, “adult education is an intervention into the ordinary business of life — an intervention’s immediate goal is change, in knowledge or incompetence” (Merriam & Brockett 2007 p 7). The policies and procedures of most adult education programs aim to empower already working individuals on a time span that works with a full-time occupation. Even more innovative, many adult education facilities have implemented new developments in technology as a way to increase the scope and availability of adult education within the modern social landscape. New technologies are essentially increasing the range and availability of adult education to a wider range of the American public. For example, distance learning has been crucial to the influx of adult learners within the American environment (Hopey 1999). Online applications have allowed the continuous evolution of distance learning within adult education. Today, almost all adult learning facilities have some form of distance learning that is often revolving around online applications. This empowers individuals to continue their learning and academic goals on their own time, and therefore in synergy with their full-time work schedules. Some resistance to adult learning practices. These accommodating elements of contemporary adult education programs that are offered help make the entire process of adult education easier for those individuals trying to better their quality of life and positions within the organizations they work for. Here, the data shows that “individuals appear to meet general pressure for engaging in lifelong learning very different feelings” (Weber 113). Thus, with all the accommodations available within the context of adult education many students are finding new possibilities in continuing their learning and academic experiences as a way to further their individual professional and academic goals.
Empowering individuals is a major element of how adult education is supposed to function within contemporary society. There are two basic theoretical perspectives which understand how adult education empowers the individual. First, there is the concept of functional theory. In this sense, Adult Education helps create a situation where the individual gains tools and insight and therefore increases their own functioning within the larger society. Here, the research states that “Adult Education is believed to foster empowerment by equipping people with the skills needed to obtain higher wage employment, to improve their health, to their children succeed academically, and to perform other functional tasks,” (Prins & Drayton 2010 p 209). However, this functional role of adult education is often limited in terms of its view of power relations and individual roles within a larger society, like gender or ethnic roles. From a psychological perspective, adult education increases self-esteem and confidence, therefore creating a stronger individual who can do more to improve their own lives. Thus, adult education focuses on “giving individuals a voice” which they can use to increase their own capabilities within the society (Prins & Drayton 2010 p 210). These are often the product of education organizing, which focuses on individual goals that meet academic demands and requirements. Adult Education often is shown by the research to increase individual self-esteem and provides a stronger sense of confidence and capacity so that the individual can take greater forces of action within their own lives and in the lives of the community around them. Prins and Drayton (2010) argue that “adult education programs often seek to overcome learners low self-esteem — a common obstacle to empowerment — by building their self-confidence and sense of the possible” (p 216). By strengthening the psychological well-being of the individual, adult education empowers that individual. Easy to access and understand classes and other educational resources are often provided either free or at a low cost to community members and focus on increasing “community organization and civic participation” in order to make the communities voice heard and push them further towards their progressive goals (Prins & Drayton 2010 p 211). Essentially, adult education is the locator for improvement of life and livelihood. The knowledge gained from additional education helps the individual adapt to changing technologies and therefore guarantee a higher rate of employment compared to the individual fails to upgrade his or her knowledge of the profession chosen. According to the research, “The provision of education throughout the whole of the lifespan may help the learner to satisfy a basic human need, especially in a rapidly changing world in which the individual may be posing many questions of meaning” (Jarvis 37). Adult Education helps increase the ability of the individual to adapt to new environments because new training is consistently available through the educational facilities offered. Thus, individuals continue with Adult Education will likely have a better chance of employment in a wide variety of industries and positions compared to those who failed to utilize community efforts to educate individuals. Adult education tends to emphasis self-direction through individualism gained by empowerment through knowledge (Brookfield 1993). A common trend within current adult education has been the empowerment of teaching English to those workers who had previously gone without learning the language of the mainstream culture in the society they live in.
There is a strong influence on providing educational programs to teach literacy and language skills to adults already in the working world looking to increase their potential roles within society. In fact, the research shows that “millions have been taught to read through national literacy campaigns,” even at adult ages (Merriam & Brockett 2007 p 260). Such statistics to prove how successful Adult Education strategies are in terms of providing working adults was additional augmented knowledge of an ever-changing workplace.
Still, adult education often suffers from the same prejudices and disadvantages as traditional education facilities do. Racism and racial stereotypes can be a problem within any American institution. However, they are often prevalent within adult education facilities because there is a connotation that individuals of lower socioeconomic statuses are unable to absorb the same types of information individuals of higher classes would be. Therefore, many minority groups are offered less opportunities in terms of adult education programs and facilities. It is clear that there is discrimination within various forms of adult education has proven to have a detrimental impact on its overall connotations. Racism is seen within the structure of adult education, as it is within almost every American institution. Still, issues of various subgroups within society have begun to gather more support in the adult educational world, therefore allowing for the potential of greater individual and community empowerment. Porting to the research “Multiculturalism, gender, and sexual orientation have begun to receive increasing attention in the field of adult dictation, along with the impact of these factors on the teaching-learning context,” (Sheared et al. 2010 p 100). Thus, the more prevalent adult education is becoming within the contemporary workforce, the more open it is to different members of racial, class, or gender group.
Today, adult education can be a method of empowerment for individuals and groups that reside just outside the majority group’s characteristics. Practices of adult education can help empower members of certain racial groups gather acknowledgment and actively move towards a more progressive stance within the larger community. A lot of efforts to educate adults here in the United States aim to help improve general literacy of particular minority groups that do not speak English as their first language (Prins & Drayton 2010). The power of language is incredible, and when one cannot use that power to progress oneself and one’s community, one will be a clear disadvantage within the larger mainstream culture. Merriam and Brockett (2007) posit the idea that “is there a to ensure that the voices of those people who have traditionally been marginalized due to race, sex, or lifestyle factors are fully engaged in the learning process,” (p 157). Still, there is the need to be racially and ethnically sensitive in program emphasizing adult education (Sheared et al. 2010). No programs of adult education will ever be successful within subgroups of the mainstream culture if those educational programs do not incorporate cultural elements of the subgroups looking to further their knowledge within particular industries or in terms of general knowledge to increase their capabilities as a whole. Socioeconomic status can also see direct measures of improvement through increased education and knowledge as a result of entering into adult education programs. Essentially, education can prove a major benefit to members of various socioeconomic classes. Within the context of lower socioeconomic classes, education can prove lifesaving endeavor that gives rise to the possibility of socioeconomic mobilization.
Moreover, practices within adult education have continued to progress the gap between gender stereotypes. According to the research, “Adult Education can equip women and men to challenge gender hierarchies” (Prins & Drayton 2010 p 210). Adult education provides women with the tools needed to survive within the capitalist environment. Therefore, Adult Education aims to challenge the structural conditions of society that has generated such staunch stereotypes based on gender roles for so long. In our society, “learning is biologically and socially determined and that the brain processes information a unique way, and the interaction of individuals and their environment impact their learning,” (Farer 2010 p 378). Elements of gender stereotypes are learned socially at a very young age, and are prompted in a way that reinforces them. Modern trends in adult education aimed to educate both male and female individuals. This creates a situation where the educational environment equal to both genders. Yet, current strategies in adult education are still fighting against very entrenched gender stereotype. Gender learning begins well before adulthood, with young individuals being exposed to gender stereotypes and encouraged to embody them (Farmer 2010). Gender is essentially a social construction, and we are taught specific gender roles at a very young age. Little girls are taught to play with dolls, while little boys enjoy playing with miniature tanks and fake guns. The stereotypes embody the gender discrimination within Western societies. In the past, “men tended to have more years of education than women and to be from higher income households” (Winkley et al. 1992 p 817). Yet this gender limited environment, current adult education “need to help learners renegotiate their personal and social identities” (Farmer 2010 p 377). Today, programs within larger adult educational facilities are offered to both men and women. This provides an additional level of training that women can use to gain a stronger foothold within the contemporary workplace. Farmer (2010 states that “women now constitute the majority of workers and formal adult education learners in the United States,” (p 377). Ting you’ll devotion of the female working population towards additional educational opportunities will only continue to place women at a greater advantage within the contemporary work environment. This is essentially empowering individual female to take on greater roles within the workplace, and therefore generate greater self-esteem within an environment that was previously dominated by men.
At the same time, Adult Education can work on empowering entire communities as well. Essentially, adult education helps empower individuals and communities to take greater action to improve the quality of life. Thus, the “popular education of the poor collected action,” (Prins & Drayton 2010 p 209). The third and final perspective discussed by Prins and Drayton (2010) examines power structures within the social foundation of today’s contemporary culture. Known as the critical perspective, this theory posits that “empowerment means understanding the causes of injustice and taking action to create more equitable conditions, not only individually but especially in concert with others,” (p 210). Adult education within the community-based perspective can come in the form of either in former or formal teaching as a way to increase the group’s position in terms of balance of social justice and individual representation within politics and legislation. Often times, informal education of adults and still prove a powerful tool in generating groups to move towards progressive change. Here, the research illustrates that “empowerment oriented organizations all use non-formal education as a tool for supporting marginalized groups’ struggle for social justice in their respective communities and society,” (Prins & Drayton 2010 p 211). These educational efforts are most often not to serve personal goals for educational attainment, but rather the education of an entire community in order to help motivated community towards a specific political or social goal. Prins and Drayton (2010) postulate that Adult Education focuses on efforts necessary “to equip citizens to solve community problems” (p 212). A number of minority groups can motivated to act and challenge established social conditions in order to increase the well-being of the individuals within such groups. This reigns true for both minority groups based on ethnicity or race, but also as well as gender minorities. Feminist movements have often focused on grassroots efforts to bring educational resources to a number of women within the community in order to help support women’s rights.
However, issues of race and ethnicity have often been at the forefront of focusing on bringing elements of adult education to communities of minority groups. In this, adult education can be seen as empowering groups of minorities based on either race or socioeconomic statuses to pull their efforts together in order to come together in pursuit of a common and mutually beneficial goal for the entire community at large. Through actively providing education to the community, particular goals and issues gain greater acceptance and power through greater community involvement. Therefore, adult education can be intimately tied to political activism as community politics often relies on the process of educating the public in order to gain further support from the very people that are being educated by the effort. Essentially, empowering the community is also working to empower the individual. Here the research shows that “empowerment occurs through community organizing and development activities whereby citizens begin to exercise more control over decisions that affect them” (Prins & Drayton 2010 p 210).
Yet it is an unfortunate reality to see so many problems with funding in Adult Education programs, especially within a harsh financial environment like today, where budget cuts are an everyday reality. Tight financial times have always been a tough environment for the successful adaptation of effective adult educational practices. As Seekins (1991) showed in a different financial downturn that the current international recession plaguing a number of industries around the world, state budgets often turn to the cutting of adult education programs before any other educational organizations get budget cuts. The contemporary environment is increasingly cut funding for adult education, causing uproar within many academic communities based on the fact that denying a very vulnerable population of workers the necessary information to stay relevant within the modern workplace.
Overall, adult education provides an opportunity for individuals already in the workplace to increase the scope and variety of their skills and therefore maintain relevancy and competitiveness within a contemporary work environment. In this, adult education empowers the individual both psychologically and functionally. Still, adult education also empowers local communities. By educating the adults of the communities, local government or other grassroots initiatives can gain support for political causes and help empower individuals through increased protection of civil liberties.
Brookfield, Stephen. (1993). Self-directed learning, political clarity, and the critical practice of adult education. Adult Education Quarterly, 43(4). Web. http://www.nl.edu/academics/cas/ace/facultypapers/StephenBrookfield_Learning.cfm?RenderForPrint=1
Farmer, Lesley S.J. (2010). Gender impact on adult education. Information Communication Technologies and Adult Education. IGI Global. P 377-394.
Hopey, Christopher. (1999). Technology and adult education: Rising expectations. Adult Education, 10(4), 26-27.
Jarvis, Peter. (2004). Adult Education and Lifelong Learning. 3rd ed. Routledge Falmer.
Merriam, Sharan B. (2007). The Profession and Practice of Adult Education: An Introduction. John Wiley & Sons.
Prins, Esther & Drayton, Brendaly. (2010). Adult education for the empowerment of individuals and communities. Handbook of Adult and Continuing Education. Carol E. Kaswom, Amy D., & Jovita Ross-Gordon (Eds). Sage Publications.
Sheared, Vanessa; Johnson-Bailey, Juanita; Colin, Scipio A.J.; Peterson, Elizabeth; Brookfield. Stephen D. (2010). The Handbook of Race and Adult Education: A Resource Dialogue on Racism. John Wiley & Sons.
Seekings, Brenda. (1991). State budget cuts affect adult education programs. Bangor Daily News. Web. http://news.google.com/newspapers?nid=2457&dat=19910814&id=fqJJAAAAIBAJ&sjid=Ww0NAAAAIBAJ&pg=3567,3608363
Weber, Kirsten. (2010). Aggression, recognition, and qualification: On the social psychology of adult education in everyday life. European Journal for Research on the Education and Learning of Adults, 1(2010), 113-129.
Winkley, Marilyn A.; Jatulis, Darius; Frank, Erica; & Fortmann, Stephen P. (1992). Socioeconomic status and health: How education, income, and occupation contribute to risk factors for cardiovascular disease. American Journal of Public Health, 82(6), 816-821.
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What’s next for America’s most important parks program?
Key changes could help the Land and Water Conservation Fund remain effective in the 21st century
Since 1964, the Land and Water Conservation Fund (LWCF) has helped protect critical landscapes within our national parks and increase recreational access to public lands across the country. Congress permanently renewed this key program in a sweeping bipartisan public lands bill this year, but did not provide any promise of funding — leaving the program subject to the whims of Congress each year. Now that LWCF will be around for the foreseeable future, what’s next for America’s most important parks program?
For decades, the Land and Water Conservation Fund has garnered strong support from both parties in Congress, as well as states and local stakeholders across the country. The program receives revenues from offshore drilling, then uses the proceeds to conserve and increase access to our parks and public lands, routinely partnering with cities and states to meet their conservation needs. In many instances, LWCF has been used to purchase islands of private lands, called “inholdings,” within our national parks from willing sellers at fair market value, protecting those critical landscapes from development. An analysis by the Center for Western Priorities found that from 2014 to 2017, the LWCF was used to complete at least 293 projects across 42 states, conserving more than 431,000 acres.
Although the program has been wildly successful, one key fact has remained true since its inception — the Land and Water Conservation Fund has almost never been funded at the full level intended by Congress. Going forward, two critical changes could ensure the LWCF enhances our parks and public lands for generations to come.
Fully fund the Land and Water Conservation Fund — at the level Congress intended
Virtually every year since the program’s inception, Congress has failed to fully fund the LWCF. Remarkably, of the $40 billion that has accrued to the Land and Water Conservation Fund since 1964, only $18.4 billion has actually been appropriated by Congress.
While Congress did not initially set an authorization level for the Land and Water Conservation Fund, it did amend the program several times, eventually settling on a $900 million annual authorization beginning in Fiscal Year 1978. That funding level, adjusted for inflation, would be more than $3.6 billion today. To ensure the program can address critical public lands access projects going forward, Congress should increase the program’s annual authorization and index it to inflation.
Change the structure of the Land and Water Conservation Fund to ensure dedicated funding and revenue from interest
Currently, funds generated by offshore drilling and intended for LWCF are sent to the General Treasury. While there is a Land and Water Conservation Fund within the Treasury, it is not a true trust fund in the traditional sense. As currently structured, Congress must appropriate accrued funds before they can actually be spent, and the remaining balance does not generate interest.
Instead of sitting on a pile of unspent or diverted funds that are not generating interest, Congress should change the structure of the Land and Water Conservation Fund to ensure that most of the funds accrued each year are actually disbursed to federal, state, and local stakeholders in the form of mandatory funding. In establishing a level of mandatory funding, while maintaining a level of discretionary funding that Congress appropriates, Congress could ensure that key conservation projects are addressed while maintaining a role in setting funding direction. Further, Congress should ensure that remaining balances in the LWCF can generate interest, similar to the Leaking Underground Storage Tank (LUST) Trust Fund and other true trust funds.
Boosting our investment in the Land and Water Conservation Fund will pay dividends for Americans across the country — every $1 of LWCF funds invested into the protection of new U.S. public lands generates $4 in economic value. The fund’s successes contribute essential infrastructure for the nation’s growing outdoor recreation economy, providing lifeblood for gateway communities.
It is hard to understate the importance of the sweeping public lands package passed by Congress and signed into law earlier this year. The legislation designated more than 1.3 million acres of wilderness, established new national parks and monuments, and permanently renewed the Land and Water Conservation Fund. However, Congress cannot rest on its laurels if it wants to truly address the challenges that face our parks and public lands in the coming century. Ensuring funding for the Land and Water Conservation Fund keeps pace with inflation and establishing mandatory funding streams to ensure critical projects are completed would be a strong start.
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Two local experts say the ongoing drought could have a negative impact on the vitality of bats migrating north through the Central Valley.
Bats make a positive impact by controlling insect populations, but if the bats – traveling thousands of miles – have fewer bugs to eat, their lives are threatened, said Rachael Long, a farm adviser in the Yolo County Cooperative Extension office in Woodland.
Each year, thousands of bats stop in the Sacramento region for a period of weeks during their migration. Most stop in the Central Valley first.
As many as 250,000 Mexican freetail bats utilize the Yolo Causeway as their home from April through October.
“With the drought, there wouldn’t be the abundance of insects. If there is not enough food where they come to rest, by the time they get here they will be weak,” Long said.
The issue was first brought to the region’s attention by Corky Quark, who runs Northern California Bats, a Davis-based rescue organization. She said she’s seen a spike in the number of bats that have come to her in poor health.
Quark said she’s received 10 dehydrated bats in need of care in the last two weeks. They are fed mealworms until they are strong enough to rejoin the colony.
While that number is not staggering, it’s likely that only a very small percentage of ailing bats are brought to anyone’s attention.
Since most of those bats recover quickly, Quark said, she can almost certainly rule out rabies or other illnesses. Her organization, online at www.norcalbats.org, works to educate the public about bats and rescues bats that are referred for care.
Quark has been involved with the nocturnal creatures for nearly a decade.
“It’s not normal for me to have this many bats this time of year,” she said.
Long and Quark said their conclusions are not based on hard data.
Quark said she was “not alarmed, but concerned” by the number of bats she said need care.
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/**/Skip to main content
Search Tips and Strategies
1. Generate a set of terms related to your topic. These will be the keywords with which you begin searching.
social media online identities community/ies
online self games
virtual Other utopia
2. In order to get search results more specific to your topic, find the appropriate subject heading. To do this, choose a book from your keyword search in the catalog. Next look in the record under "subject." You should find hyperlinked subject headings like those highlighted to the right.
Possible subject headings:
Virtual reality -- Philosophy
Share virtual environments
Ethnology -- Interactive multimedia
Boolean Operators: AND, OR, NOT and Other Symbols for More Effective Searching
hinduism AND (movies OR film)=Using the AND operater narrows your search to only results that mention both keywords. Use the OR operator to search for variants or synonyms of the same keyword.
“virtual reality” AND relig*=Use quotation marks to search for a specific phrase. The asterisk (*) is a wildcard symbol that is used to catch variant endings of a word (religion, religious).
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to shop agates, or scroll to the bottom of the article.
Agate is the ayurvedic birthstone for the month of May and the mystical birthstone for the month of September.
The name is derived from its occurrence at the Achates River in southwestern Sicily and received its name from the Ancient Greek philosopher and naturalist Theophrastus, who found the gemstone on the banks of the Achates River (
Dirillo river), Acate, Ragusa Province, Sicily, Italy.
Agate is a distinctly banded fibrous formation of common semi-precious chalcedony (Formula: SiO2). Agate is the compact, microcrystalline variety of quartz. It is made of fibrous length-fast chalcedony, sometimes with layers of quartzine (length-slow chalcedony) fibers (Michel-Lévy and Munier-Chalmas 1892; Correns and Nagelschmidt, 1933; Bernauer 1927; Braitsch 1957; Frondel, 1978; Flörke et al. 1991; Graetsch 1994).
Most agates form in cavities in ancient lavas or other extrusive igneous rocks. They are characterized for the most part by color bands in a concentric form, and less often by mosslike inclusions (moss agate). Other names often precede the word agate and indicate either its visual characteristics or its place of origin. Fortification agate is a type of banded agate with angularly arranged bands that resemble an aerial view of an ancient fortress. There are several types of fortification agate. Brazilian agate is a fortification agate with banding in angled concentric circles like the fortifications of a castle. Botswana agate from Africa had beautiful dark and light banding. Mexican lace--sometimes called "crazy lace"--is a multicolored fortification agate with highly convoluted layering. Blue lace agate from South Africa--one of the most common kinds for sale today--is a delicate light blue with a fine interlayering of colorless agate. Fire agate has inclusions of reddish to brown hematite that give an internal iridescence to polished stones. There are a number of varieties of chalcedony that are called "agate" that do not match the definition given above. Good examples are "feather agates" and "fire agates". These are listed as varieties of chalcedony, not as varieties of agate. Because the colors and patterns found in agates are so varied and so characteristic for the respective localities, there is a confusingly large number of ever-changing varietal and trade names. Roger Pabian's "Agate Lexicon" at UNL is a good source: Agates Lexicon http://snr.unl.edu/data/geologysoils/agates/agateslexicon.aspx
In thin slices of agate, the fibers are sometimes visible in transmitted light and may cause interesting optical effects (see Iris Agate). The banding in agate is based on periodic changes in the translucency of the agate substance. Layers appear darker when they are more translucent (this may appear reversed in transmitted light). This effect may be accompanied and amplified by changes in the color of neighboring layers, due to other co-precipitated minerals and occur in shades of white, yellow, gray, pale blue, brown, pink, red, or black. Much of the sliced agate offered on the market in particularly bright colors are dyed or stained to enhance the natural color, an easy process because the individual crystallites in the fibers are not tightly interlocked, agate is slightly porous (e.g., Monroe, 1964), and can be dyed easily. In old agates that have been subject to weathering and chemical alteration, the differences in translucency may disappear, and such specimens may turn almost opaque.
Banded agate is produced by a series of processes that take place in cavities in solidified lava. As the lava cools, steam and other gasses form bubbles in the liquid rock that are preserved as the lava hardens, forming cavities. Long after the rock has solidified, silica-bearing water solutions penetrate into a bubble and coagulate to form a layer of silica gel. This sequence is repeated until the hollow is filled (sometimes occurring inside of quartz geodes). Some of the layers will have picked up traces of iron or other soluble material to give the bands remaining undisturbed. Note: Agate is not simply "banded chalcedony." There are other types of chalcedony that are banded that do not match the description above; banded flint, for example. Two characteristic types of banding can be distinguished in agates (e.g. Graetsch 1994):
1. Wall-lining Banding. (The characteristic bands usually follow the outline of the cavity in which the mineral has formed.) The individual bands run perpendicular to the orientation and growth direction of the chalcedony fibers. Since the chalcedony fibers grow from the walls to the interior of a cavity, a concentric, onion-like pattern develops. The changes in translucency reflect periodic changes of crystallite sizes and repetitive nucleation of new fibers at the growth front (Taijing and Sunagawa 1994; Cady et al 1998), as well as chemical composition (Frondel 1978; Heaney and Davis 1995). In addition to the visible bands, there are compositional bands of varying trace element and hydroxyl concentrations on the micrometer scale (Frondel 1978, 1985).
Note that this type of banding is not restricted to walls of geodes: similar-looking patterns of banding will develop around other structures that grew into the cavity, like crystals or moss-like inclusions.
2. Horizontal Banding (also called Uruguay-type banding). This type of banding is less common and usually accompanied by wall-lining banding. The banding consists of fine, irregularly spaced layers of small chalcedony spherulites and sometimes quartz crystals that precipitated in the cavity. Horizontal bands can serve as spirit levels to determine the original orientation of the specimen in the host rock. When the difference in translucency or color between the layers is pronounced, agates with horizontal banding can be used for cutting cameos and engravings.
Agates have been worked since prehistoric times and were among the world's first lapidary materials. Today, it is usually cut as thin slabs, or polished ornaments broaches, or cut as cabochons for pendants. But the decorative uses of this hardstone have origins as far back as the Bronze Age. Remnants of agate crystal have been found in Knossos, Crete, signifying a role in the Minoan culture. Agate stone was also found along the Nahe River in modern-day Germany during the reign of Julius Caesar. Using running water-powered facilities, the Romans cut these agate stones into various shapes for various uses until the resources depleted in the 1800s. Renaissance artisans found many applications for agate, too; collecting bowls made of agate were especially popular.
Metaphysical properties have been attributed to agate for thousands of years. Some believe agate has the ability to dispel dysfunctional or problematic energies and dreams, while others believe it balances one’s physical, emotional, and spiritual auras. Agate is believed to discern truth, accept circumstances, and is a powerful emotional healer. Legend says that Agate helps to prevent insomnia and insure pleasant dreams, to enhance personal courage, and protect one against danger. improves memory and concentration, increases stamina, and encourages honesty. Grey agates were worn by ancient Egyptians to prevent and remedy stiff necks. In Persia and parts of Asia, the gemstone was believed to reduce fevers.
Agate has long been beloved by royalty, as well. In particular, Queen Victoria made Scottish agate a staple in her wardrobe. This fashion choice led to an explosion in the popularity of agate jewelry during her reign. In fact, Victorian-era jewelry with agate is highly sought after by today’s collectors and connoisseurs.
Agate is found worldwide, but Brazil, Botswana, South Africa, Mexico, Egypt, China, and Scotland are prolific sources and produce interesting varieties. Oregon, Washington, Idaho, and Montana are popularly abundant sources in the US.
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A diplomatic mission is a group of people from one country that is sent to another country to represent their government. The main purpose of a diplomatic mission is to promote the interests of the home country in the host country. They do this by maintaining relationships with the government and people of the host country, and by providing information about their home country to the host country. A diplomatic mission is made up of several different people, each with its own role to play.
The head of the mission is the ambassador, who is the official representative of their home country. The ambassador is responsible for all of the activities of the mission, and for representing their home country to the host country. The ambassador is assisted by a staff of diplomats, who are responsible for specific areas of work. For example, there might be a diplomat responsible for economic affairs, or for cultural affairs. The diplomats work together to promote the interests of their home country in the host country.
A diplomatic mission also has a support staff, who are responsible for providing administrative and logistical support to the mission. The support staff includes people like secretaries, drivers, and security guards. A diplomatic mission is an important part of the work of a country’s government. They play a vital role in promoting the interests of their home country, and in maintaining relationships with other countries.
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Considers other pertinent contexts. It is also good for the teacher, because it gives her the ability to justify a score on paper, without having to explain everything in a later conversation.
The topic is not clearly defined. Task-specific rubrics function as "scoring directions" for the person who is grading the work.
To grab a copy of this for your own modification, click here. By Alfie Kohn [This is a slightly expanded version of the published article. General rubrics take longer to learn to apply well.
Accuracy No mistakes, scholarly and accurate. As a student, you probably come across a rubric for essay almost every time you submit a new essay, sometimes even without knowing. Citations Cites all data obtained from other sources.
Distracting errors, difficult to read.
Andrade, Du, and Mycek replicated these findings with students in 5th, 6th, and 7th grade, except that the rubric group's writing was evaluated as having higher quality on all six criteria. Sources More than 5 current sources, of which at least 3 are peer-review journal articles or scholarly books.
The main point about criteria is that they should be about learning outcomes, not aspects of the task itself. Capstone Project in Design This rubric describes the components and standards of performance from the research phase to the final presentation for a senior capstone project in design Carnegie Mellon.
For the study, the same rubric was used for a required course assignment three years in a row. The short answer was yes. The paper demonstrates that the author, for the most part, understands and has applied concepts learned in the course.
One or Several Judgments. The WSU rubric specifies only the highest and lowest levels of performances, leaving it to faculty adapting it to describe the intervening levels.
Analytic Each criterion dimension, trait is evaluated separately. The practice of using single point rubrics is slowly but surely catching on. The simplicity of these rubrics — with just a single column of criteria, rather than a full menu of performance levels — offers a whole host of benefits: I first talked about this type of rubric in an earlier post (Know.
College-Level Writing Rubric Masterful Skilled Able Developing Novice (Way Off) Focus, Purpose, Thesis (Controlling of the assigned topic. Idea). Grading Student Work. Print Version What Purposes Do Grades Serve?
Sample Rubrics Range of Disciplines and Assignment Types; Suggestions About Making Marginal and End Comments on Student Writing; Maintaining Grading Consistency in Multi-sectioned Courses (for course heads) Communicate your grading policies, standards, and criteria to.
Sharyland FCCLA Members Brings Christmas Spirit To Senior Citizens; FCCLA Students Assist in Distracted Driver Study; Sharyland FCCLA Volunteers at H-E-B Feast of Sharing.
Lets face facts, most students have little or no idea why they get a particular grade. A student may think they worked hard (I stress think!) or they may know they were pretty much correct in an essay or question, but for the most part grading remains a mystery to most students.
1 Using Rubrics to Grade, Assess, and Improve Student Learning Strengthening Our Roots: Quality, Opportunity & Success Professional Development Day Miami-Dade College March 7,Grading rubrics for essays for college
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ColdCaching is an exciting way to explore and learn about the many natural features along the Ice Age Trail. If you are looking for a family-friendly activity that allows you to experience the thrill of a treasure hunt, learn important navigational skills and develop an appreciation for Wisconsin’s fascinating Ice Age history, ColdCaching is for you.
What is ColdCaching?
The concept of Ice Age Trail ColdCaching is based on the popular activities of GeoCaching and EarthCaching.
- GeoCaching is an outdoor treasure-hunting game where participants use a GPS device or other navigational techniques to hide and seek caches that contain a logbook and treasure (usually toys or trinkets).
- EarthCaching is a similar to GeoCaching, except participants seek out natural features instead of human-placed caches.
- ColdCaching is a type of EarthCaching in which participants seek out natural features along the Ice Age Trail.
Finding a ColdCache
As a ColdCaching participant, you can choose from a list of Ice Age Trail landmarks (ColdCaches) to seek out.
The interactive map below shows the location and basic information about the ColdCache sites.
- The dark-blue diamonds represent ColdCache sites.
- The turquoise diamonds represent locations of ColdCache Park Packs.
The Ice Age Trail goes through twelve (12) Wisconsin State Parks or Forests. Forty (40) ColdCache sites are distributed in or near eight (8) of these state properties.
ColdCache Park Packs can be checked out by visitors at these eight (8) locations, (see map – turquoise diamonds- above). The Packs contain the site information and supplies needed to find the sites in or near the properties and learn about the ColdCache program. These packs encourage families or other groups to be active in the outdoors. In the process, Park visitors learn how to use a GPS unit, get fresh air, exercise, and a geologic lesson while enjoying the thrill of finding a treasure and working as a team.
The list of natural features can be found on geocaching.com. On your first visit to the website, you’ll need to create an account with geocaching.com in order to see the full details (including location information) for each ColdCache.
Each ColdCache includes instructions for performing a simple task or answering questions (or both) in order to verify your find.
ColdCaching is consistent with Leave No Trace outdoor ethics in that participants leave only footprints on the landscape as part of their activities.
New sites are added periodically, so check back regularly for new ColdCaches to explore.
Earning an Award
As you find more ColdCaches, you can register for the ColdCache awards program to receive patches recognizing your prowess as a ColdCache hunter. Download the awards program log [PDF], and you’re ready to go.
- Level I: Snowflake. A water crystal that forms in the atmosphere and falls to the earth. Visit and log 3 ColdCache sites representing at least 2 different feature types.
- Level II: Blizzard. A long, severe snowstorm with intensely cold wind and fine snow. Visit and log 7 ColdCache sites representing at least 5 different feature types.
- Level III: Firn. Partially consolidated snow that has passed through one summer melt season, but is not yet glacial ice. Visit and log 12 ColdCache sites representing at least 9 different feature types.
- Level IV: Ice Sheet. A broad, thick sheet of ice covering an extensive area for a long period of time. Visit and log 18 ColdCache sites representing at least 14 different feature types.
- Level V: Glacier. An extended mass of ice, formed from snow falling and accumulating over years, that flows over a land mass. Visit and log 25 ColdCache sites representing at least 20 different feature types.
Please note: the ColdCache awards program is not linked to your account at geocaching.com. That is, even as you register sites as “found” on your geocaching.com account, you’ll need to notify the ColdCache coordinator via the awards program log to quality for ColdCache patches.
Creating a ColdCache
In addition to searching for ColdCaches, you can also play a valuable role by developing new sites for others to find.
If you are interested in helping out, email the ColdCache coordinator at firstname.lastname@example.org. The coordinator will walk you through the process of developing a ColdCache using the proper guidelines and provide important forms.
For questions about the ColdCache program, send an email to the program coordinator at email@example.com.
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In English, many things are named after a particular country – but have you ever wondered what those things are called in those countries?
- No more swung dashes - each compound or derivative, each headword that is repeated in a phrase or example sentence, is given in full.
- Nowadays, however, swung dash is used wrongly in everyday language regardless of writing forms.
- It sounds pretty, but when you're blogging, it's a lot better to use an ellipsis, even if your tone is swinging; strictly speaking, the swung dash is never to be used as a punctuation mark.
- The ‘swung dash’ or ‘approximation’ sign is not quite the same as tilde in typeset material but the ASCII tilde serves for both (compare angle brackets).
- The design is minimalist, with simple structure, little metalanguage and no swung dashes.
English has borrowed many of the following foreign expressions of parting, so you’ve probably encountered some of these ways to say goodbye in other languages.
Many words formed by the addition of the suffix –ster are now obsolete - which ones are due a resurgence?
As their breed names often attest, dogs are a truly international bunch. Let’s take a look at 12 different dog breed names and their backstories.
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This document is one entry in a series of questions and answers originally posted to the Purdue University Department of Horticulture & Landscape Architecture’s Plant Growth Facility Web site [http://www.hort.purdue.edu/hort/facilities/greenhouse/RiceMethod.shtml] regarding best practices for rice plant growth in a greenhouse. Controlled studies were conducted with the goals of optimizing growth and yield; developing standardized methodology using readily available commercial materials; and providing recommendations for large-scale high-throughput production. Digital images showing treatment differences are included. A summary of recommendations; materials and methods description; and a reference list are available in separate documents.
Rice, Oryza, growing methods, greenhouse methods, greenhouse protocols, greenhouse best practices, Purdue methods, calcined clay, Turface
Date of this Version
Eddy, Robert and Hahn, Daniel T., "Optimizing Greenhouse Rice Production: How Can Leaf Yellowing Be Avoided?" (2008). Purdue Methods for Rice Growth. Paper 5.
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Van goph essay
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Portrait of père tanguy, painted by vincent van gogh in 1887, is one of his three paintings of julien tanguy the three works demonstrate a progression in van gogh's. 2017 年 12 月 20 日 grieg solveig s song analysis essays good quotes for essay writing help essay on violence in south african schools essay on importance of computer. You have not saved any essays starry night vincent van gogh's starry night is a marvelous painting in which van gogh paints a picture that is colorful and. Disclaimer: this essay has been submitted by a student this is not an example of the work written by our professional essay writers any opinions, findings.
Van goph essayRated 5/5 based on 30 review
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Right now, amid these unprecedented times of coronavirus pandemic, we all are going through various changes in our lifestyles. This coronavirus has disturbed our lives in a lot of ways hence, it is understandable that your oral health might not be an important consideration as of now. However, if you develop serious toothaches with an abscess, you will certainly regret not caring for your oral health on time.
The current pandemic situation is not in our control however, we can focus on the things that are in our control and it includes taking care of our oral health too. Well, we are here to talk about some important tips that you should keep in mind to take care of your oral health:
A Good Oral Care Routine is Needed
Brushing teeth at least twice a day- just when you wake up in the morning and right before going to your bed at night. This routine is always suggested by dental experts. Along with this, brushing your teeth for at least 2 minutes is recommended as it will ensure that every tooth is cleaned properly.
Additional Tip: You can always choose Electric Brushes over the normal ones as they come with built-in timers that can ease your effort to note the time while brushing. Or else, if you are using a manual brush then you can use your smartphone to keep a tab of the time.
Flossing Is The Most Important
While brushing is very important, flossing is also not a thing to miss. Even after brushing, one-third of your tooth surfaces remain uncleaned. The bacteria between your teeth can destroy the tooth enamel, and it can lead to a cavity. Hence, flossing is important to ensure cleaning between your teeth and removal of the plaque so that it can prevent the chances of tooth decay or gum disease. There are two types of flossers available in the market, both electrical and manual. Hence, you can choose according to your comfort level.
Toothbrush Should Be Replaced Regularly
According to dental experts, toothbrushes should be changed within 2-3 months or even earlier if they are looking worn or old. Brushing with a heavy hand may cause your bristles to wear out before the three-month mark. If a toothbrush is worn out then it will not clean your teeth properly and hence, it can increase the chances of dental problems such as decay. Also, the other reason is, that bacteria and plaque stick to your toothbrush after you brush your teeth. According to some studies, a single toothbrush can contain over 10 million germs and bacteria. If you use the same toothbrush for an extended period of time, it is likely that additional bacteria will accumulate on it. Hence, replacing your toothbrush regularly is very important to avoid dental issues and other gum diseases.
Intake Of Sugar Should Be In Control
Tooth decay has a direct connection to sugar intake. After consuming sugar-containing foods, sugar molecules mix with the bacteria and saliva present in the mouth. As a result of this combination, plaque starts developing on the surface of the teeth. Plaque on teeth can destroy their enamel, and it can result in one of the major dental problems that are cavities. Intake of sugar at a high level also increases the production of acid in the mouth. The enamel of your teeth is directly affected by these acids also, and it gets weak. This can also result in various types of further dental issues and gum diseases. Hence, one should definitely take care of sugar intake to prevent such dental problems.
Staying Hydrated Is A Must
Staying hydrated is so important because the human body needs plenty of water to produce enough saliva. Saliva is the first line of protection in your mouth from various types of dental issues and diseases. It helps in washing away the excess food particles as well as bacteria that are present in the mouth. It makes swallowing easier, and it also includes essential minerals such as calcium, phosphate, and fluoride that helps in strengthening your teeth. A dry mouth might put you at risk for tooth decay if your saliva supply is low in your mouth. Saliva also helps in maintaining the neutral pH of your mouth and as a result, it lowers the risk of other dental issues. Hence, staying hydrated is most important to maintain good oral health.
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NetWellness is a global, community service providing quality, unbiased health information from our partner university faculty. NetWellness is commercial-free and does not accept advertising.
Saturday, September 5, 2015
We often hear the phrase "meet the team" before the start of a sports season. Here, we invite you to meet the research team. Research involves a lot of people who have different roles; much like a sports team has different coaches, players, referees and fans. Both on a sports team and in research each person plays a vital role and like a game, research can only be done with the all team members.
Let's start with the head coach. The Principal Investigator (PI) is like the head coach because he or she is an expert in the topic. They are most responsible for planning the research study and the work of the rest of the team. The head coach, researcher/PI has to follow a playbook. This playbook is called a "protocol". A protocol is a guide researchers must follow during the research study. Like sports, the guide must be in line with the rules of the game. The research study can only begin after the "protocol" has been reviewed by the IRB. The IRB tells the researcher/PI the rules that must be used before the study starts. Following the rules helps keep the volunteer safe during the study.
The research staff is like the assistant coaches. Why? Because the research staff handles most of the day-to-day activities and works closely with the head coach. The research staff is there for you when you or your family and friends have questions about the research study. You can call them if you have any questions or concerns about the study! Just as coaches and assistant coaches must complete special training before they are allowed to coach a game, the PI and research staff must also complete special training to ensure that they understand the rules of research.
Research volunteers are the MOST important members on the research team. Like a game can only be played with players, research can only be done with volunteers. Research studies need all kinds of people to volunteer. (In the same way that you don't have a team without the players, researchers cannot learn about what works and what doesn't without volunteers). For example, for a long time heart disease was thought to be a man's disease and was only studied in men. Because women were not studied, little was known about the symptoms of heart attacks in women or what treatments were effective. Now we know women get heart disease, too, and their symptoms are often different from those that men have.
Research studies need volunteers of all ages, genders, races, and ethnicities. Volunteers can be tall or short, rich or poor, and thin or heavy. They are not always people with an illness. Healthy people can also volunteer to take part in research.
Volunteers from each of these groups are important for different reasons. For example, children volunteers are needed to learn more about childhood diseases such as childhood asthma. Elderly volunteers help researchers learn about concerns and conditions that effect only older people. Volunteers of different races and ethnicities are important to learn more about diseases that are more common among them and because some treatments work differently for different groups of people. For example, type-2 diabetes and asthma are more common in African Americans and Hispanics.
This is why it is so important that people of all ages, genders, races and ethnic groups take part in research studies. It is the only way that researchers can find treatments for all people and that researchers can know the different ways different people respond to different treatments.
Family, friends and personal support
Much like a sports team has fans to observe the game and cheer the team to victory, your family, friends and personal support are people you can talk with about taking part in the study. You may share with them what the study is about. They may have questions about the study. They may also help support you during the study. The final decision though, is yours, as to whether you will take part or not.
Like a sports team, the referees are the people that protect your safety. In research, there are national rule makers or regulators, the Food and Drug Administration (FDA); local, Institutional Review Board (IRB); and institutional, research subject advocates (RSAs). The research rule makers:
Referees help teams follow certain rules. In sports these rules protect the safety of the players and depend on the game. In research, rules also protect the safety of volunteers and are different depending on the type of research.
At the national level, the Food and Drug Administration (FDA) has an official guide or set of rules that all researchers must follow. These rules are also called the "Common Rules." This means that these rules apply to or are "common" to all studies that involve humans.
Locally, IRBs help researchers follow those rules. IRB is a complex term. The B stands of BOARD. This means that it is a group of people that looks at the research study. R is for REVIEW, meaning that the study is checked closely to see that rules are followed. The I stands for INSTITUTIONAL, meaning that the study follows rules that apply to wherever the research will be done. Research goes on at hospitals, colleges, and other places, and the IRB is the local group that helps to keep volunteers safe by overseeing study activities at these locations.
There are other local referees whose job is to support volunteers more directly. These people are often called "participant advocates" or sometimes "research subject advocates." They are the insiders who can help you while you are in the study. They are there to support you. You can contact them at any time. If you have questions or need help with some aspect of your taking part.
Helpful Research Terms
Clinical research: a type of research that involves a particular person or group of people
Clinical trial: a particular type of clinical research that tests whether a new medicine or device is safe and effective
Consent form: One part of the informed consent process (see “informed consent”). A consent form is a document that describes and explains the parts of the study. Each form has at least 8 parts. The parts will cover what the study is about, who can join, what you will be asked to do, any risks or benefits, any costs, any inconvenience, what your information will be used for, and that your taking part is voluntary. After all questions have been answered and the volunteer agrees, it is signed by the volunteer. By choosing to sign the consent form, a person shows that s/he understands the study and is willing to take part.
Data: the information that researchers get and look at
Device: A piece of equipment made for a particular purpose; especially a mechanical or electrical one. An example would be a pacemaker.
Eligibility: A process of finding out whether a volunteer is a good fit or match for a study.
FDA (Food and Drug Administration): A government agency that monitors and approves drugs and devices before they can be used in the general public; one of the “referees.”
Informed consent: A process that involves talking with a study team about why they’re doing the study, what you will have to do while taking part in a research study, how much time it will take, whether you will be paid , whom to contact if you have questions – everything you need to know about volunteering. Part of the informed consent process includes a consent form (see “consent form”).
Investigator: A professional, usually a doctor, but may also be a nurse, pharmacist or other health care professional; one of the “coaches.”
IRB (Institutional Review Board): A special group of professionals who look over research studies to protect the safety of study participants; one of the “referees.”
Observations: Looking at and learning why things are the way they are.
Participant: A person taking part in a study. Also called a research volunteer or research subject; one of the “players.”
Protocol: The study plan; the “play book.”
Recruitment: Finding and getting people to join a study.
Research Subject: A person taking part in a study. Also called a participant or research volunteer; one of the “players.”
Research Volunteer: A person taking part in a study. Also called a participant or research subject; one of the “players.”
Retention: Refers to the completion of follow-up visits and procedures involved in the study; staying in the study until it is completed.
Sample: A small set of a larger group.
Standard Treatment: The treatment we know works for most people and that usually happens at the doctor’s office or hospital; part of usual care (see “usual care”).
Surveys: The use of written or verbal questions to gather information about people’s thoughts and behaviors.
Usual Care: What you normally get at the doctor’s office; includes preventative health care, routine screenings, and standard treatment (see “standard treatment”).
This article is a NetWellness exclusive.
Last Reviewed: Dec 05, 2013
Nicole M Deming, JD, MA
Assistant Professor of Bioethics
School of Medicine
Case Western Reserve University
Mary Ellen Lawless, MA, RN
School of Medicine
Case Western Reserve University
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Part B2 Heated water services
Introduction to this Part
This Part sets out the requirements for the design, construction, installation, replacement, repair, alteration and maintenance of any part of a heated water service of a property that is connected to the drinking water supply. It covers from the point of connection to the points of discharge.
The Objective of this Part is to—
- safeguard people from illness, injury or loss (including loss of amenity) due to the failure of a heated water installation; and
- ensure that a heated water installation is suitable; and
- conserve water; and
- safeguard the environment; and
- reduce greenhouse gas emissions; and
- safeguard public and private infrastructure; and
- ensure that a heated water installation is designed and is capable of being maintained so that throughout its serviceable life it will continue to satisfy Objectives (a) to (f).
- minimises any adverse impact on building occupants, the Network Utility Operator's infrastructure, property and the environment; and
- facilitates the conservation of water.
To reduce greenhouse gas emissions, to the degree necessary, a heated water service is to—
- be capable of efficiently using energy; and
- obtain its heating energy from—
- a low greenhouse gas intensity energy source; or
- an on-site renewable energy source; or
- another process as reclaimed energy.
The greenhouse gas intensity of energy sources vary. For example, natural gas has a low greenhouse gas intensity compared with electricity generated from coal.
BP2.1 Water supply
BP2.3 Design, construction and installation
A heated water service must ensure the following:
Heated water is provided at appropriate flow rates and temperatures for fixtures and appliances to function.
Access for maintenance of mechanical components and operational controls.
The system, appliances and devices can be isolated for testing and maintenance.
BP2.4 Pressure relief and temperature limitation
Containers used for producing and/or storing heated water must—
relieve excessive pressure; and
limit temperatures to avoid flash steam production in the event of rupture.
BP2.5 Legionella control
Heated water must be stored and delivered under conditions which avoid the likelihood of the growth of Legionella bacteria.
BP2.6 Energy use and source
A heated water service, including any associated distribution system and components, must ensure the efficient use of energy and water.
Excessive 'dead water' draw-off, i.e. where cooled water from the supply pipe is drained off prior to delivery of heated water, can result in water and energy wastage.
To improve the efficiency of heated water systems, the design should consider factors such as the number of outlets, their purpose and expected typical usage, and the distance between the water heater and each of the outlets. The water heatershould be positioned nearest to the most used outlets, or installed to provide consistent coverage of the building. Where this is not viable, the use of multiple water heaters or flow and return pipe loop may need to be considered.
Features in BP2.6(1) must be appropriate to the following:
The heated water service and its usage.
The geographic location of the building.
The location of the heated water service.
The energy or water source.
BP2.6(2) permits the energy source of the heated water service to be considered. This means that the net energy obtained from renewable energy sources such as solar, geothermal, wind, and biofuels may be considered as 'free' energy in calculating the energy consumption. Similarly, heat reclaimed from another 'free' source such as a by-product from co-generation type processes as well as other industrial processes, which could otherwise be rejected from the building, could be considered as 'free' energy in calculating the energy consumption.
A heated water service, including any associated distribution system and components, must obtain heating energy from one, or a combination, of the following:
A source that has a greenhouse gas intensity up to and including 100 g CO2-e/MJ of thermal energy load.
An on-site renewable energy source.
Another process as reclaimed energy.
- The intent of BP2.6(3) is to constrain the use of a high greenhouse gas intensity source of energy. It does not prevent the use of electricity because the greenhouse gas intensity is related to the thermal load rather than the energy consumption which is covered by BP2.6(2).
- For the purposes of BP2.6(3) the renewable energy must be on-site (not GreenPower) and includes, but is not limited to, solar, wind, hydroelectric, wave action, and geothermal.
BV2.1 Greenhouse gas intensity of a water heater
annual amount of energy consumed from that energy source; and
emission factor of—
if the energy source is electricity, 253 g CO2-e/MJ; or
if the energy source is liquefied petroleum gas, 65 g CO2-e/MJ; or
if the energy source is natural gas, 61 g CO2-e/MJ; or
if the energy source is wood or biomass, 4 g CO2-e/MJ.
In BV2.1, the symbol "g CO2-e/MJ" means "grams of Carbon Dioxide equivalent per megajoule/s".
BV2.2 Heated water storage temperature
Compliance with BP2.5 is verified for each heated water storage system when the water heater is designed such that all water is subjected to a temperature-dependent minimum exposure period as specified in Table BV2.2 within 7 days before passing through the water-heating appliance's heated water outlet.
Minimum exposure period
70°C or greater
B2.2 Water heater in a heated water supply system
In a new Class 1 or Class 10 building—
a water heater in a heated water supply system must be—
a solar water heater complying with B2.2(1)(b); or
a heat pump water heater complying with B2.2(1)(b); or
a gas water heater complying with B2.2(1)(c); or
an electric resistance water heater only in the circumstances described in B2.2(1)(d); or
a wood fired thermosiphon water heater or direct fired water heater each complying with AS/NZS 3500.4; and
a solar water heater and a heat pump water heater must have—
for a building with 1 or 2 bedrooms—
at least 14 Small-scale Technology Certificates for the zone where it is being installed; or
an energy saving of not less than 40% in accordance with AS/NZS 4234 for a "small" load system; and
for a building with 3 or 4 bedrooms—
at least 22 Small-scale Technology Certificates for the zone where it is being installed; or
an energy saving of not less than 60% in accordance with AS/NZS 4234 for a "medium" load system; and
for a building with more than 4 bedrooms
at least 28 Small-scale Technology Certificates for the zone where it is being installed; or
an energy saving of not less than 60% in accordance with AS/NZS 4234 for a "large" load system; and
In colder climates the performance of some heat pumps may diminish.
a gas water heater must be rated not less than 5 stars in accordance with AS 4552; and
an electric resistance water heater with no storage or a heated water delivery of not more than 50 litres in accordance with AS 1056.1 may be installed when—
the building has—
not more than 1 bedroom; and
not more than 1 electric resistance water heater installed; or
the greenhouse gas emission intensity of the public electricity supply is low.
B2.3 Layout of taps
B2.4 Maximum flow rates for heated water outlets
The outlet of a shower, basin, kitchen sink, or laundry trough must have a maximum flow rate of not more than 9 litres per minute.
The requirements of B2.4 do not apply to a shower intended to provide rapid drenching of a person for emergency purposes, such as chemical removal.
B2.5 Maximum delivery temperature
The delivery temperature of heated water at the outlet of each sanitary fixture must be—
not more than 45°C in any—
residential part of an aged care building; or
part of an early childhood centre, or primary or secondary school, that is used by children; or
designated accessible facility in a common area of Class 2 building, or in any part of a Class 3, 5, 6, 7, 8, 9a, 9b, 9c or 10 building; or
B2.6 Temperature control devices
The required maximum delivery temperature must be achieved in accordance with AS/NZS 3500.4.
B2.7 Heated water storage
Containers used for producing and/or storing heated water must be provided with temperature and pressure relief devices in accordance with AS/NZS 3500.4.
B2.8 Legionella control
Legionella control for water heaters must be carried out in accordance with AS/NZS 3500.4.
B2.9 General requirements
Explanatory information: Cross-volume considerations
NCC Volume One Class 2 to 9 buildings
NCC Volume Two Class 1 and 10 buildings
Excavations for pipework adjacent to a building and footings
Termite management for attachments to buildings and penetrations through a slab
Penetrations for pipework through a vapour barrier
Pipework in timber bearers and joists of solid timber or engineered wood products
Fittings, fixtures and pipework installations in steel framed construction
Penetrations through a fire-resisting wall or floor
|C3 Protection of openings|
Fixtures or fittings in a wet area
|F1 Damp and weather proofing|
Service pipework external to the building and penetrations through roof cladding in a bushfire prone area
Pipework sound insulation
Central heating pipework
Pool and spa heating and pumping – energy efficiency
Energy consumption monitoring for water heaters
|
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] |
en
| 0.899937
| 2,366
| 2.640625
| 3
|
train
| 7
| 49,993,926
| 1
| 2,100
|
-9,223,068,617,568,384,000
|
Space & Astronomy
New planet-hunting telescope begins search
By T.K. Randall
July 29, 2018 · 6 comments
The hunt for extrasolar planets is now on. Image Credit: NASA
NASA's Transiting Exoplanet Survey Satellite (TESS) is now on the hunt for habitable extrasolar worlds.
Designed to carry on where the Kepler Space Telescope left off, the new satellite launched in to space aboard a Falcon 9 rocket back on April 18th and officially began operations last week.
Scientists hope that TESS will find thousands of previously undiscovered extrasolar planets including many potentially habitable worlds in neighboring solar systems.
The most promising candidates will become targets for the upcoming James Webb Space Telescope.
"I'm thrilled that our planet hunter is ready to start combing the backyard of our solar system for new worlds," said Paul Hertz, director of NASA's Astrophysics division.
"With possibly more planets than stars in our universe, I look forward to the strange, fantastic worlds we're bound to discover."
| Comments (6)
|
[
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en
| 0.887069
| 226
| 2.78125
| 3
|
train
| 2
| 152,792,211
| 1
| 216
|
End of preview. Expand
in Data Studio
YAML Metadata
Warning:
empty or missing yaml metadata in repo card
(https://huggingface.co/docs/hub/datasets-cards)
[WIP]
FineWeb-Edu with Metadata
This repo contains 3 versions of the FineWeb-Edu v1 dataset:
fwedu1-metaonly/
fwedu1-text-content-zstd/
fineweb-edu-1.0.0-meta-and-text/
These are all joinable via the hash column, which is xxhash64 in pyspark, calculated on the text column. This hash is unique for all instances in the dataset. For convenience, this join is done for you in the third table
fwedu1-metaonly is just the metadata of the data exactly as it comes from the FineWeb-Edu v1 subset. This include duplicates! There are XXX records. For instance, identical text content might have been found at several different urls, across many CC dumps. The advantage of storing this data separately is that is is MUCH smaller than the text data and still allows for useful analysis - and you can always join it back!
DataFrame[id: string, dump: string, url: string, file_path: string, language: string, language_score: double, token_count: bigint, score: double, int_score: bigint, hash: bigint]
fwedu1-text-content-zstd/ is the deduplicated data and is a table containing only the text content and the hash. This saves space - we don't need to store redundant copies of the text data.
DataFrame[hash: bigint, rebuilt_count: bigint, first_text: string]
fineweb-edu-1.0.0-meta-and-text/ is the joined data, containing both the text data the metadata. It has the count columns used in our work (to come) and has the varying instance level data (e.g. url) compressed into a struct column.
DataFrame[hash: bigint, text: string, instances: array<struct<dump:string,file_path:string,id:string,url:string>>, language: string, language_score: double, token_count: bigint, score: double, int_score: bigint, split: string, original_doc_count: bigint, position: int, reversed_count: int, tiktoken_size: int]
This lets you easily run a query like this:
from pyspark.sql import functions as F
from pyspark.sql.types import ArrayType, StringType
df = spark.read.parquet("fineweb-1.0.0-meta-and-text")
filtered_df = df.filter(F.size(F.array_distinct(F.transform(F.col("instances"), lambda x: x.url))) > 1)
print(filtered_df.count())
filtered_df.show()
# 57292242 57M documents are found at more than one url - many of these are trivial differences like http vs https, but some reflect more interesting patterns like migrations or rehosts.
Which finds all duplicated text content that appears at distinct urls!
NOTE: This was built on v1 of the FineWeb-Edu dataset, which has been updated since
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