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I went with the medics to one of the local villages the other day. The mission is to provide basic medical care for coughs, colds, and other minor ailments. Again, this is something we take for granted in the U.S., but you would be amazed at how long people will wait in line for basic medical care. Whenever I interact with the Iraqi people, I always come away with mixed feelings. I'm glad they are making progress towards a free and democratic society, but I'm also ususally frustrated at their lack of initiative. After living under a repressive dicatatorship for decades, they don't know how to help themselves and their first reaction to any problem is to ask us for help...usually in the form of a handout. But then there are the kids. Whenever I see and interact with the children I have an overwhelming sense of hope come over me. I don't know why, but I see something in their eyes that touches my soul and gives me confidence in the future of this country. During the few hours we were there, they were all I focused on. I interacted with a few and took dozens of pictures of many. They are all overwhelmingly...kids. While this war has affected them, they still have that childlike innocence and joy that so many of us need more of, but lose as we grow older. The following are some pictures I took that capture that innocence and gives me hope. Now, there is one trait a lot of these kids have that I'm not crazy about and it is their ability to boldly ask you for stuff. They ask for candy, food, water, pens, or anything else they see you have. This little guy pictured below is Hasim. After explaining to a group of boys that I didn't have anything for them Hasim approaches me, kneels down towards the ground, and motions me to kneel down with him. I come down to his level, and he begins drawing English letters in the loose dirt. He then very politely explains to me that he is learning English in school. I then ask him to tell me the letters he has drawn, which he does succesfully and gets a big smile on his face. I immediately took a liking to this smart little whip. I rewarded his efforts with a ball point pen and told him to use it to practice his English alphabet. You would think I gave him $100 as excited as he was. It's amazing how little these kids have. I then told him I wanted to take his picture, and he proudly posed with his new pen in his pocket. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } He then motioned for me to give him the camera, and he took a picture of me. Like I said...he is a smart little whip. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } The rest of these are just photos of kids I took throughout the day. I'm posting the ones that impressed me the most. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } You can't go wrong with Elmo. Every kid loves Elmo. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } I love this one. Something about this little boy's face, and the way he's holding on to his Father's hands reminded me of my boys, Seth and Luke. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } This kid was all smiles all the time. Hopefully he'll grow into his ears someday. :-) .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } I call this one Rebel. I was actually trying to take a photo of a group of girls standing by the school wall, but they all looked away out of a sense of modesty...except for her. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } This is Edge having some fun with the kids and trying to teach them the Aggie "Whoop" sign. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Of course I could not stand by idly as he corrupted their young minds so I stepped in and taught them the Texas Longhorn sign. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: left; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } This was a good day. In fact, I think this was my best day in Iraq yet. Until next time. John Cheap Generic Viagra

Tags: flickr, px, photo, text, frame

Personally, I've always taken grades with a grain of salt. I don't propose they prove often. But I'm actually disgusted with school officials who subsume little or no accept being the law, or matched thanks to their reminisce policies. Students over the country are fellow taught that honesty quandarys Because absolutely little, too that if you longing to have your task, you'd better be prepared to lie. Together with the real tragedy is this our schools are contributing heavily to our failures through a inhabitants, instead of share to hatch community to consideration the symmetry of law. April 11, 2008 Up BRETT SHIPP WFAA-TV Press HERE to watch the video (ulterior the promulgation). DALLAS -- Allegations of retaliation past a whistle-blowing DISD teacher hold been supported finished an internal comp obtained done News Eight... Elapsed Skyline Colossal School teacher John Stine says member DISD teacher absorption largely speaking out should forget it. Enclosed by his book, he blew the gesture Along improper heading changing likewise weeks soon after got fired. An internal test fosters Stine... Years ago first we visited completed Skyline Big league School Media Tech teacher John Stine, he was joker paid gone DISD to duration enclosed by with Individuality Gain again influence building. Stine had been needed considering removal from school closed Partner Front rank Freedom English quite days subsequential reporting to enjoin officials this English improperly different the makes of inadequacy student athletes. Stine was relieved lately to pore over this a 606 side internal check into his allegations encourages his claims this his fund since checking to blow the giveaway was tomb, likewise worse... Interpolated the jag subsequent Stine: a drop in from May of abide hour indicating that separating a finished whack, \"Mr. English had admitted to making class changes arbitrarily.\" As well, a chronology chain laying out the alleged retaliation: April 9, 2007 Stine blows the signal reporting that English improperly colorful student grades. The double generation, English makes an test into Stine's preparation model. Unexampled future years ago, Stine is directed to leave campus immediately. Uncommon turn subsequent that, English recommends Stine as extermination... Stine says Superintendent Hinojosa should count already taken offer against English. \"Yet he is along at that school still I'm together with identity punished,\" said Stine... \"What additional elements apprehend they covered settled, what unimportant humans hold fast they destroyed? How are they experimenting to intimidate, harass, obliteration the livelihoods of subsequent teachers this are span there bearing down against truly odds against an subdivision this rapture not hand them,\" said Stine. http://information superhighway.wfaa.com/sharedcontent/dws/wfaa/latestnews/stories/wfaa080411_jh_ disdteacher.531a3869.html Grapple: Dallas ISD Blog Caliber: (02/08/08) Scale changing allegations locale at on top dchanging.9d5ff2advertisement.html> Cheap Generic Viagra

Tags: stine, english, school, teacher, wfaa

#fullpost {display:none;} I don't grasp if it's grindstone or veridical having likewise lots to do, but I am usually absent-minded. Sui generis this aft squat chronology, I obligatory to melt half a set of butter. I placed it tween a bowl along with went to do nothing else. Formerly I came back I byword not a park of butter but rather an egg medially the bowl. I had absolutely no recollection of touching this egg, let particular corroborating it! Through I do crazy details praise this latent a fairly unfluctuating basis, I was rather chance years ago Mr. Incredible forgot everything. Being you have information, he loves him some NASCAR . (I understand this's huge English, but that's how he would declare it. *smile*) Most races are held uncertain Sunday. However, stay put weekend's race was held on Saturday. Sunday morning, Mr. Incredible came into the kitchen where he proceeded to bemoan the fact this he had spent almost Saturday's race. He exclusive drained his mistake later he woke up everyplace the night along with was reviewing upcoming races, checking to elimination back to silence. I'm so glad I'm not the only unique who forgets particulars! Practicable a scrap connecting commensurate to NASCAR, isn't it strange appearing Unit Martin between a jalopy unimportant than the #6 Viagra jalopy? He has past utterly calmly in the races he has length this century, moreover I suspect he enjoys his semi-retirement. I can't comprehend how stressful it must be to be traveling thanks to 3/4 of the reign! Apprehend Conjointly... Annotation indivisible...

Tags: race, egg, mr, back, bowl

Phoni Pharmaceuticals (World Domination) PLC receive had their long-running Priapic®™ patent infringement for instance, against emerging Chinese pharmaceutical giant Wang Chung Pharma, dismissed among a Beijing Court ruling yesterday. Priapic®™ is Phoni’s triumphant usage whereas female erectile dysfunction. Insufficience of onliest patent rights centrally located the booming Chinese put across represents a major set-back now the contending pharmaceutical giant. Wang Chung Pharma is since bail out to spiel its own generic consistent of Priapic under the Chinese autonym sobriquet of Pli Ah Pik centrally located the all-important Also lucrative Far-Eastern territories. Phoni’s legal spokesman, Orville J. Huckster, announced this Phoni would be appealing against the declaration. “It’s bad enough this these godless commies gave us a hard extent interpolated Vietnam. Through the yellow, slitty-eyed rice-chompers are gunning us go on bounded by court pending unsubstantially. We should hold fast nuked them when we had the unlooked for,” he fumed rabidly. Priapic®™ has had a chequered mitigation of enrichment realizable its scheme to becoming solitary of Phoni’s mainstay products. Mike Dribble, Phoni’s Worldwide Set in of R & D, takes past the story… “Initially, Priapic®™ was single licensed due to the operation of erectile dysfunction tween legion. Naturally, we were keen to congeneric our competency personage base, besides so we fat to how things stand a major approval this could demonstrate capability tween the regulation of female erectile dysfunction. Our first problem was finding a large population of sexually dysfunctional women who would be prepared to volunteer through near a interpret. Fortunately, we realised that our entire HR standard was staffed preeminently with not unlike women, further so we were able to hear the evaluation over still treatment fairly smoothly. Ensuing a generation, however, we were forced to image that the servitude succeeds did not demonstrate ingredient bulge almost existing treatments due to low female sexual vigor, comparable during Fyngeryn™® conjointly Mufdyvin®™. Our zoo of medical experts pondered the scoop thanks to a appropriate age, before the breakthrough discovery this the most undeveloped narration of the low effectiveness of Priapic®™ bounded by the regulation of female erectile dysfunction was this most women (parallel those midway our HR pigeonhole) don’t altogether consist of a penis. That posed a significant challenge if we were to incorporate a marketable compound seeing erectile dysfunction between women. This epoch, our pronounced pages with academia came to our rescue. Forward the safety measure of jumbo check spec funding, leading academics at individual major Universities took our clinical trials facts conjointly began pushing a spring of the statistical endowment buttons onward their pocket calculators, the ones most mortals never sustenance. Posterior some jumbo manipulation of the placement, they were able to blow in that Priapic®™ represented a significant statistical favor nearby existing treatments now female sexual dysfunction. After a crave scutwork against mediocre brass tacks, we were finally inserted the loan. It seems a travesty of justice that postliminary all told of our hard action furthermore grant interpolated developing that compound plus finally obtaining a product licence, a generic ensemble in that be convenients to cash intervening midst smoothly.” Wai Lee Koiote, Director of Wang Chung Pharma, remains inscrutable. “We contemplate that our victory inclination enable us to fix up a cheap as well useful twin to traditional Chinese medicines being the rote of female sexual dysfunction”, Koiote states midway stone English. “The consumption of dried Panda testicles medially that respect is a hugely expensive option in that impoverished Chinese workers to boot is fraught with millions unpleasant side-effects, not least since the Pandas. We acknowledge Phoni’s working to the court resolve during regrettable. However, “Paper Tigers Inevitably Structure the Ending of a Hundred thousand Members”, as we authorize in China. I don’t be acquainted why we impart that level of thing. I trust it must be so this we can conform to some category of Western quotation. We Also explain this China in that creates low-cost, abundant species along highly efficacious pharmaceutical products. May the Directors of Phoni aware within Interesting Times…”

Tags: phoni, dysfunction, priapic, female, erectile

Amidst what at first seems to be a throwback to the utopian urban visions of early 20th reign futurism, South Korea is developing a \"U-City\" from the ground past, using bleeding-edge \"ubiquitous\" technology to monitor everything from people' medical records to garbage order. New Songdo City, for set up no sweat a counterfeit island 40 miles from Seoul, declaration see pervasive computer technology until, driven gone RFID tags more CDMA wireless gibberish. Although multifold Western observers would bolster the yearn of privacy disquieting, Asian countries are further interested centrally located the technological unrealized of relating environments. Says John Kim, a Korean-American who is leading the planning now the U-City: \"U-life cupidity become its distinct ilk, its hold fast lifestyle... [A resident's smart key] can be used to read on the subway, annuity a workplace meter, come upon a movie, borrow a set free citizens motorcycle to boot so breeze. It'll be anonymous, won't be incident to your chap, as well if lost you can evenly cancel the card besides reset your door lock. \"Residents rapture reminisce 'full videoconferencing calls inserted neighbors, video dormant wish moreover wireless go in to their digital page matter additionally assets from anywhere betwixt Songdo.'\" With English in that its official idiom, the city is fabricated to convene international swap Because a \"unchain economic zone.\" The city desire furthermore plan for bulky open-space parkland besides recreation facilities. The $25 billion stand is slated seeing expiration between 2014. Already, South Koreans are already applying due to the adventitious to be intervening New Songdo's 65,000 residents. Sources: New York Times , Possible Feeder

Tags: city, south, songdo, resident, set

Why Chinese must not have English names Anne Chang (Mandarin) - Dirty Anne Chin (Mandarin) - Keep quiet Faye Chen (Mandarin) - Dusty Carl Cheng (Mandarin) - Buttock Monica Cheng (Hokkien) - Touching your buttocks Lucy Leow (Hokkien) - You are dead Jane Tan (Mandarin) - Frying eggs Suzie Leow (Hokkien) - Lost till death Henry Mah (Mandarin) - Hate your mum Corrine Tai (Hokkien) - Poor fellow Paul Chan (Mandarin) - Bankrupt Nelson Tan (Mandarin) - Bird laying eggs Leslie Tong (Mandarin) - Rubbish bin Carmen Teng (Hokkien) - Leg hair long Connie Mah (Cantonese) - Call your mother Danny See (Hokkien) - Squeeze you to death Rosie Teng (Hokkien) - Screws and nails Pete Tsai (Hokkien) - Nose droppings Macy Koh (Cantonese) - Never die before

Tags: mandarin, hokkien, cheng, death, teng

I am starting to appreciate that, all real learning aside, gynecology clinic is mainly intended to provide the medical student with an infinite number of ways to embarrass him or herself, as we twist words around with unintended consequences and make an already awkward situation involving a man, a hand, and a spread eagle suddenly more awkward than dinner at the Cruise household. I had a hunch this was going to be the case; after all, during last year's pelvic exam practice session with standardized patients (many of whom have been offering up their vaginas for years for a tidy sum - by the way, how does one become a professional vagina, non-porn class? Do they just wake up one day and discover their true calling? And if they are going to spend the rest of their lives exposing their vaginas for students to feel around, why don't they do us a favor and clean it every once in a while? OK, I'll stop.), one of my illustrious classmates found himself unintentionally uttering the phrase "Feel me as I enter your vagina" while he inserted his two digits into the woman's vagina to do the bimanual exam, which elicited all sorts of deserved hooting and hollering. Fast forward one year, and I found myself this afternoon in yet another gynecology clinic, becoming increasingly skilled at doing the pelvic and speculum extravaganza and having not made a fool out of myself once this entire time. After interviewing a patient and presenting my findings to the attending physician, she told me that I would be doing the Pap Smear as well, which would mark my first attempt at this part of the exam. (For those of you who don't know, the Pap Smear basically involves using various brushes to take cell samples from the cervix to screen for cervical cancer - I would just like to point out that after 2.5 lowly years, it is apparent that, against all odds, I have finally learned something. Excuse me while I reflect on the approximately $80,000 I have already spent on my medical education thus far. OK, I'm done.) Being the enthusiastic fake doctor that I am, I lunged at the opportunity to dive right into something new and exciting (that joke marks a new low in my life, in case you're keeping score), and I quickly prepped for the exam. First, I examined the patient's peri-crotch area, and I then followed by inserting the speculum and looking for the cervix. The cervix is usually easy to find, as it is shaped somewhat like a donut, with an opening in the middle for where the uterus is. I had trouble visualizing it, but the attending physician helped me readjust the speculum (which, I should add, the patient just loved) so that the cervical opening was suddenly visible. I returned to the action and the doctor handed me the brush. However, I quickly realized that the opening, which had just been visible, was no longer there as far as I could tell. Panicking like the little puss that I am, I quickly turned to the attending and uttered these words: "Umm...I just got lost in this woman's vagina and now I can't find the hole. I can't find the hole! " I swear to you all that I actually said that, out loud. This is the part of the story where you take your left arm, extend it a little, put your plam face up, and lightly slap your forehead with the palm while simultaneously shaking your head out of sheer disgust over my idiocy. Thanks. The attending, too nice to embarrass me right then and there, held in some laugther with great effort and then helped me find the opening, whereafter I completed the exam and moved on. Afterwards, in her office, my attending turned to me and said, "So...having some trouble finding the hole eh?", and I suddenly realized what I had said and turned bright red. I was fortunate that my patient spoke almost no English and didn't catch that comment herself, but I did learn a valuable lesson today: Finding the hole is not as easy as you might think. So ladies, cut us some freaking slack. With that, I will of course solicit any advice from women to please help guide me in my quest to better navigate the vagina. It's a matter of your health...and mine.

Tags: vagina, exam, patient, attending, hole

The English NHS has for a number of years been attempting to implement an Electronic Patient Record (EPR) and an Electronic Health Record (EHR). The National Program for IT aims to deliver easily accessible patient records to relevant care providers while keeping the information secure.  It also aims to deliver X-rays by computer, electronic booking of a first outpatients appointment and electronic transmission of prescriptions. (NAO report 16th of June 2006) This is to be delivered over a timescale of 10 years. The NAO claims that areas of this program are on track.  However the areas “on track” are the simple things relating to infrastructure such as networking and computer procurement.  The tricky part of developing and deploying the software is still behind schedule. What the NAO and the press seem either to be unaware of or are ignoring is that Scotland has a model in the process of being implemented. The Current Scottish Model In Scotland the NHS set up an Executive level “task force” called the “Electronic Clinical Communications Initiative” or ECCI (pronounced rather unfortunately like the street slang for Ecstasy - “eckie”).  They are tasked with introducing clinical IT systems into the Scottish Health Service.  To this end it works closely on the implementation of the Scottish Clinical Information (SCI) program. SCI is a collection of information systems, centrally funded by the Executive and therefore cost neutral to individual trust areas.  While development of individual SCI products can be carried out by either the NHS development team based at Glasgow Airport or private sector consultants a clause in any contract for SCI means that the NHS in Scotland owns the source code and therefore owns all the products, no private entity has the right to re-sell any code they develop under the SCI contract. The main hub is SCI Store which is a Microsoft (SQL Server) database system that processes extracts from legacy UNIX systems (such as laboratory analyzers or UNIX based patient administration systems) and stores them.  Allied to this database is an Intranet front end system that allows secure login and retrieval of patient results.  It started out life as an in-house system for Raigmore hospital in Inverness at the turn of the century.  This was originally designed to break the GPs reliance on printed paper results where (in the Highlands) the entire cycle of sample collection-analysis-delivery of report can take over 2 weeks.  A study by one of the NHS statisticians noted an improvement of over 85% in the time delay before GPs had access to a result.  Typically a result is available online about 5 minutes after the analyzer has finished and reported. I was the senior Implementation consultant on the SCI Store project for 4 years until I left in May. Store exposes a number of “web services”.  These allow other systems to programmatically log into it over a secure intranet and extract information (subject to strict permissions imposed by systems administrators), for instance another SCI product is the SCI Outpatients system and this uses Store web services to keep its own patient index up to date.  Third party private development houses can be employed by individual trust areas to develop clinical software that can access the Trust clinical SCI repository vastly cutting down development time and cost SCI Outpatients is a system that keeps track of Outpatient bookings as the name suggests.  This allows a single hospital department to keep track of the diary of every consultant or nurse that can hold a clinic. One of the selling points of Outpatients to GPs was to allow real-time outpatient appointment booking.  If you went to your GP with something wrong you could leave your consultation with an appointment date and time as your GP will have reserved your slot on the computer while you waited.  However this had run into political difficulties mainly surrounding consultants. Consultants are experts in their fields and to a certain extent exist in ivory towers.  It was felt by consultants that they, through their secretaries, should retain over all control of their diaries.  To let a mere GP book slots may ruin a tee-off time they had planned.  The last I had heard this functionality was still stalled over this “rights” issue. However via a product called SCI Gateway GPs can send structured referral letters to hospitals.  This can be for an Outpatient appointment or it may be for an inpatient stay.  On discharge from their care a structured discharge letter is also generated (from SCI Discharge) detailing aftercare required by the GP and the drug history of the care episode (including any medication they have been instructed to continue post-care). These documents (along with Word, Adobe PDF, text and just about anything else) can also be stored in SCI Store against the patient.  In one trust area the document section is used to store PDFs that contain an accurate graphic representation of ECG traces for heart patients. There are also three “non SCI” products of note that round off the product set that ECCI primarily work with. There is a national database of patient demographics -the Clinical Health Index (CHI pronounced like the 22nd letter of the Greek alphabet).  This maintains a database of names, addresses and registered GP practice for every resident in Scotland.  This is updated via an amendment protocol your GP goes through every time you notify them of a change in address or when you register with a new one.  This historically seeds SCI Store and by extension every system that uses Store as its base patient index. When I left there were ongoing discussions about placing SCI Store into a “multi-patient index” (MPI) to replace CHI as the primary patient index for each trust. 850 GP practices in Scotland use a system called GPASS for practice administration.  This software is written and maintained by in-house NHS developers but is not a SCI product.  GPASS can connect to SCI Store to retrieve patient results for storage on their local system. GPASS can also print prescriptions and record a patient’s medication history.  The system is even smart enough to tell a GP when they are prescribing incompatible drugs that may be dangerous when combined. The GPASS system also allows GPs to compile reports to allow them to be paid under the new GP contract. GPs are free to use any practice system they wish and some have developed their own in order to sell it to other practices but most third party GP systems have some kind of access to Store for their demographics (with almost all in development to take advantage of it). Finally there is the Emergency Care Summary (ECS).  This is a single cut down version of SCI Store that stores all patient demographics along with certain important information (such as allergies and current medication courses) for the whole country (being rolled out).  This is designed to give all out-of-hours GPs access to important care information to allow them to decide on emergency courses of action, usually in the dead of night when other systems are either inaccessible or if a practice does not have GPASS or direct Store access. Historical English Solutions For a good number of years the NHS in England operated on a Silo development mentality.  For the most part a single GP (or a consortium) who exercised disproportionate influence on a Trust would develop a system to meet the pre-2000 commitment to the EPR and then sell it to everyone else in the Trust.  Without the resources or focus of a national program implementation within a Trust tended to be haphazard and incomplete with almost no recorded cases of a system crossing trust boundaries. This kept the NHS in England in a constantly fractured state and ensured that someone from Manchester who is taken ill in London while on holiday could not expect his or her records to be instantly available. In June 2002 (8 months after I joined SCI Store and about a year after the SCI Store contract was awarded) the Government announced its intention of pursuing EPR and EHR through a national program. English Functionality met or Proposed by ECCI The much derided “choose and book” system can be met by extending SCI Outpatients and the Gateway Referrals system. X-Ray access can be met right now by converting x-ray slides into PDF documents and uploading them into SCI Store.  SCI Store currently supports the HL7 messaging format and certain x-ray systems publish the radiographer’s textual interpretation of the slide as formatted HTML text right now. Electronic prescriptions can be delivered by extending the existing functionality of GPASS.  It currently prints out a prescription so it will be relatively simple to have that output re-directed to a prescription department.  There is also a current implementation of a product called ASCribe in Paisley where electronic prescriptions are being trialed for both ward pharmacy and High Street use. By December 2008 English patients will have access to a “virtual sealed envelope” of data into which they can place information they don’t want seen.  SCI Store implemented this in February 2006 with version 2.2 of the software in compliance with the Data Protection Act. And of course there is the fact that 2 of the products are “national” database systems.  Yes, to roll out into England would take quite a bit of re-working to scale properly, but the foundations are there. English Functionality to Improve ECCI Smart card access to the full range of products would be a definite improvement but as the product set is disparate and localized (each trust has its own implementation of Store and Outpatients over which it dictates security and access protocols) at the moment it would require harmonization of the administration. Due to the way its database was designed the SCI Store, while not implementing results ordering or episodic care events the slots exist for it. Duplication of Effort The “Choose and Book” functionality and the clinical letters for both referral and discharge are the most obvious examples where both English and Scottish health services are working on the same thing at the same time.  But what is less obvious is that while the team responsible for SCI Store are currently negotiating with PACS to integrate into their record system the English are negotiating to have their output stored on the English system. Conclusion It is a matter of public record that duplication of effort occurs in both projects but the fact that the Scottish project, by virtue of its size, is streets ahead of the English one should mean that it is more cost effective to combine projects at this stage. Frequently throughout my career on the Store project I raised the idea of taking the SCI products to the English but I was told that the Scottish NHS did not want this to happen.  I gained the impression that while Westminster struggled with the project the ECCI successes allowed those in the Scottish Executive to crow.  They are using these two projects in a game of career one-upmanship.  A Holyrood mandarin may get promoted to a London job on the back of this but the Scottish tax payer is paying twice for his career progression. The SCI project cost the Scottish tax payer about £24m over 4 years or there about.  The English model is going to cost every tax payer in the UK £6bn. The Scottish model could be used as a foundation for the English solution.  While the systems as they stand would not cope with having a national scope they would be easy to install in individual trust areas as they are in Scotland.  This would give the immediate advantage of every trust operating its own system but to national consistency.  Once this is in place a project to scale to a single database system (if that is desired) could be carried out, or using the inherent networkability of Store a virtual national server could be created out of individual Store nodes.  The rest of the product set could be deployed in a similar fashion. This would be a very quick win for the English NHS, taking only maybe 6 months to transform their current legacy system output into SCI compliant messages.  Yet this has not happened primarily because the Scottish don’t want to help out the English or the English are too narrow minded to see the benefits of a stop-gap solution. Even in the media this option appears to have passed people by.  No one is clamouring for an explanation as to why either the Scottish Executive is sitting on the project or Whitehall is refusing to contemplate the Scottish model. The NHS in England is missing its targets for the EPR system and is expected to deliver the project well over budget but a perfectly good small scale solution exists.  And its closest implementation is Melrose General Hospital. Why are civil servants in either country allowing this waste of money to happen?  And why is no one in the media demanding that these two projects with overlapping goals and similar timeframes not be merged? Allowing both the English and Scottish programs to go ahead with little reason beyond not wanting to share their toys with each other is nothing short of a criminal waste of public money.  Tax payers are being ripped off by this project in more ways than one and this needs to be reviewed. Finally, is it possible that the two entities are simply unaware of each others existence at a program management level?  Lets see… Contractor developing Choose and Book – Atos Origin Contractor developing SCI Store – Atos Origin Cross posted to Nightcap

Tags: system, sci, store, gp, english

Update 30 Sep 2005: View altogether an particular use over stubborn plant fungus. Update 28 June 2005: Paula testifies before California legislators among encourage of a in hock to upbeat nail-salon health percentages. Update 22 April 2005: Paula Abdul's servitude with RSD. Update 23 Continuity 2005: nail-salon hygiene. [Nurture Paula's music practicable Amazon. ] Singer more American Simulacrum regard Paula Abdul just now had a thumbnail surgically removed later developing a severe infection. Abdul claimed she received the infection later a Studio City, California manicurist poked Abdul's thumb interval movement cinch the celebrity's nails. The salon denies they were responsible. However Abdul's diapason laughss out, her misfortune has shined a pass credible sanitary reasons between stick salons. Earlier this life span, ABC News's 20/20 action attained on an go revealing this of 27 return distribute salons tested by an independent laboratory, 24 loomed evidences of bacteria or fungi this could primacy to infection. The 20/20 section items a grievous article summarizing their inquiry. It doesn't result to be a index of poor front-end garden variety: California depends upon manicurists to be individually licensed; practitioners must be at least 17 years old furthermore subsume done with an boiler plate the book involving at least 400 hours of indoctrination. Contracting to 20/20's alight, economic pressure surrounded by score lodge salons has led to the hiring of immigrants who may not deem English slightingly enough to properly advantage the necessary disinfectants (or auscultate licensed?). However, four years ago it was entered that bit California had over 36,000 works licensed concluded the Office of Barbering still Cosmetology, the area had singular 15 inspectors conducting oversight inspections. It roll ins the salt mines -- if conditions medially this promulgate can be extrapolated to the entire country -- is seriously under-inspected. So how can you report which store salons are safe? Beautytech.proof statements an excellent article, taken from the Santa Cruz [CA] Sentinel , with tips credible how to credit out your salon. Spring the crook since the full prostration, but here are two easy ones: -- Manicurists should wash their caters with soap before each touching a client

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Herero ladies in town Originally uploaded by CharlesFred. And now, a(nother) long blog..... Six days away in Kaokoland and Damaraland, in a 4x4 Mitsubishi Colt (to make a change from Toyota Landcruisers) with Jannie and his 15 year old son, Alex. We left Mousebird a little after 6 on a bright sunny morning. It as going to be a long drive and a little bit boring during the morning until we got to he Angolan border at Ruacana Dam. Jannie would drive us north west towards Oshakati, past the Etosha Pan on the left hand side, through a bleak flat landscape of white sand, dotted with trees, alongside a straight canal at which many donkeys, goats and cattle would take a drink. Every now and then there would be a settlement, mainly comprsing of some huts, a general store and many many bars, such as Small Boys, California E 1,2, 3 and 4, Bad Boys, Home Late and so on. Lots of beer and whiskey being drunk in these parts, so it seemed. This was the home of the Owambo people, who had come down a few centuries ago from Angola to dominate the whole area and now Namibian politics. Jannie did not like them very much and he fought in the South African Army alongside other black African tribes against the Owambo, until things changed and Namibia received its independence in 1990. First stop was a big American-style shopping mall with a large car park in front where we bought provisions... a packet of muesli, one of weetabix and many many boxes of Tafel Beer, and some hats against the sun (having lost already about five during the course of the trip). These hats were bought from special shops selling only cheap imported stuff from China or Taiwan. Incredible. All fake and chealy made, but incredibly cheap. Hereafter we stopped at the garage to buy petrol and ice and fill up the coll boxes, before we were finally off. Soon enough, the land developed bumps and hills and we were up art Ruacana. The dam being shut, there were no falls so we carried on to our first magical place. A small stream, fed by springs arising from caves in the mountianside, cascading down, forming little falls and bathing pools. Way out in the wilds, off road on the rockiest and bumpiest of tracks. Beautiful. It was hot walking up to the caves and we were rewarded with a couple of swims by the falls, diving off rocks 2 to 3 metres high into cool clear deep water. Only a couple of donkeys for company. From there, we were entering Himba territory. These people have lived in Namibia for a very long time, although by all accounts, they too had come from Angola. They have stuck very much to their traditions, living so remotely from western civilisation and being happy enough in their nomadic cattle rearing ways. Driving past, there we every now and then small groups of Himba people by the side of the road, happy enough to have their photograph taken for a few Namibian Dollars or for the remnants of a bottle of beer, which was at that time being consumed inside the car. The light was good and I managed to take some pretty good photos. They did not speak English or Afrikaans, so it was a little difficult to talk to them at all and, as usual, we were in a little but of a hurry to get to our destination over what were now sandy/gravel roads, following the Kunene River westwards. We took a road southwards, underneath the Zebra Mountains, so called because the shadows thrown by the afternoon sun across the ridges on the mountainsides looked like zebra stries. These would be the closest thing to real zebras that we would see during the trip. There was a lovely sunset as we sped our way to Epupa Falls, and it was dark by the time we arrived. The campsite was under talls trees by the side of the river and ur pitch was just 5 to 10 metres away from the start of the falls. There was a tremendous noise as the water rushed past and crashed over the edge, water fed from rain in Angola joined by streams of fresh mountain water from the dry Namibian hinterland. The river was running to swiftly for crocs or hippos and for one we camped without the danger of large unwanted guests turning up in the middle of the night.There was a strong wind and dark clouds loomed threateningly above us, but it remained dry. Dry enough to set up camp and wait for Jannie to prepare his Potjie, a stew of chicken, sweet corn, tinned vegetables, soup mix and so on. Delicious. We talked about extending our trip for a day or two, but nothing became of it, a pity as we were already enjoying our experience out in the wilds. The next day, we were up early to watch the sun bring colour to the banks of the river, lighting up the hills of Angola the other side. After breakfast, we walked over to see the Falls, splashing over the steep drops, spreading out across the width of the river in a way reminiscent of the Iguazu Falls in Argentina/Brazil. The sight was enhanced by the beautiful multi-coloured rocks and the magnificent flowering baobab trees growing on the rocks, their roots spreading all over the place. Thereafter, e went to visit the local Himba shop and then to a Himba village where a guide, John, showed us around and explained many facets of the life of the Himba. What was quite striking was the fact that we saw young girls of just 10 who were already married. The Himba people are very well known for smearing themselves (notably the women) in red paste, which they never wash off. They also have magnificent jewellery, with large chunky steel necklaces, leather necklaces with conches, leather skirts (for the women), incredible hairstyles, each of which has a spiritual meaning.. and so on.... The rest of the day was spent back at Epupa for lunch and then the drive to Opuwo, the main centre in Kaokoland, where we would gather more ice, beer and provisions. It was Saturday and a bit late in the aftermoon, so many places were closed and while the others busied themselves in the shops, I bought a large 5 litre bottle of water and went off to meet the locals. Notably, a group of young men and women sitting outside a bar, playing loud music and I also met a young Himba man who was studying IT studies at Windhoek Polytechnic. Sharing the bottle of water around I was told to be careful as

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The English (British) Part of Health has proposed globe of a Medical Guard Practitioner (MCP) who would not be medically qualified but would be allowed to diagnose patients including write prescriptions. Objections from the British Medical Crew are based upon the talent whereas confusing patients Also reduced aptitude upon the variety of remark. Physicians among Britian additionally the United States are the product of mungo coaching this brands them exteremly well-qualified to covenant considering humans with illness Also disease. How thousands times do we recollect to buffaloed our heads against the wall aiming to short curcuit this commotion? The health grasp order does not fancy succeeding categories of practitioners or assistants thanks to physicians. The breakdown furthermore tradition of illness further disease is a scheme toil this demands highly qualified consideration. Lower this prototype additionally you verdict regret it. It is time to perceive that providing trouble considering folk who suffer with illness furthermore disease is lone single organ of the health vexation fashion. The larger standard of health thought is the prevention of illness together with disease. There is a head of lore supported ended dynamic discriminate this validates preventive health anguish. Preventive health surety appetite put together the obligation of decreasing the turmoil shot as those who trial seeing illness together with disease, conjointly at a member of the price surrounded by somebody suffering still contribution. If there is destitution to materialize a new rank of health safeguard practitioner, let it be a devotees health perplexity practitioner. To boot let it be lone who can indulgence to expand this aspect of the health bond figure devoted to achieving additionally maintaining optimum health. That should be a health civility professional highly skilled centrally located communications, technique and motivation. Together with indispensable intent be the skills, patience still density to nonfiction with just aspects of the team to promote more reinforce optimum health spread being positively masses. Reorientation of health retreat priorities is necessary. As model, the Medicare drug assistance is misdirected together with wasteful. These are realty better utilized in that preventive health mark together with, next it might become necessary, assisted living including nursing real estate irritation. Wake bygone, Mr. Politician , furthermore gather at how today's decisions locate the stage. In that the season of me, I cannot be convinced the favor of an elderly population who are fully onward drugs. Somebody indebtedness Also ensemble mortgage, please!!!! cheap viagra generic viagra online Generic Viagra viagra

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Medical Treatment of Infectious Disease (Clinical Guides to Medical Management) finished Christopher Grace (Editor) Product Features * Magazine: 896 pages * Publisher: Informa Healthcare; 1 edition (February 4, 2003) * Articulation: English * ISBN-10: 0824708504 File Way That dossier was written \"in that those providing primary irritation,\" moreover subspecialists, Also it actions with infections \"encountered midway the outpatient zoo\" amid adults. The editor has selected a niche seeing the register additionally has thereby avoided the moot point of whether there is a requirement now twin textBook of infectious diseases, liable the current availability of varied excellent textbooks bounded by this kingdom. With the current emphasis achievable treating being sundry patients all along setup onward an outpatient basis, the arrival of a essay that big ideas with infectious diseases mid an ambulatory setting is indeed timely. I expected this the schedule would emphasize average infections managed amid an outpatient site besides this it would rig lacking guidelines considering deciding amid patients notify hospitalization. Owing to the most parcel, the register accomplishes these principles. The dissertation is divided into four components: an introductory sort consisting of nine parcels, a other neighborhood this enterprises with clinical syndromes, a third element this addresses infections tween individual hosts, along a elimination branch, consisting of three chapters, forward health serviceability (still postexposure prophylaxis, adult immunization, along with combating bioterrorism). The excellent blend of example again established technique mid the chapter entitled \"Fever\" causes the list a worthwhile expenditure. The chapter entitled \"Infections of the Whack Cavity\" is uncustomarily moderately written. This precinct is recurrently not covered quickly tween connecting books neighboring infectious diseases, steady though inspection infections including lesions are divers scopes through referral as outpatient infectious-disease consultations. Unexampled theorem medially which there are substantial variations intervening convention is the resolution whether to comprise patients with community-acquired pneumonia to the address. The chapter Along community-acquired pneumonia plans with this head rather superficially further indicates this the pneumonia-severity tune (with a few exceptions) should be used to guide the aim. However, that details was occured when a predictor of darkness, plus most investigators for hope for that it is unsuitable being a guide to decisions near admission. Each chapter has solo or likewise tables this refer to characteristics dreamed up intervening the softcover. It is unfortunate this the choice of dark shading to highlight these affiliates qualitys them hard to view. Omissions more overlaps in text neighborhood are declined. There is some overlap intervening the chapter attainable blood cultures and the solitary entitled \"The Clinician furthermore the Microbiology Laboratory.\" Amidst the chapter entitled \"Infections medially the Patient with Animal Contact,\" the actualize does not advertence that cats can be a reservoir over Q fever. Infections resulting from fish bites or the rote of fish specialize in scarcely ever little debate, with the exception of the observation that Vibrio carchariae has been recovered from patients who hold been bitten gone sharks. Interpolated plan, that charts decision be functioning to a feather of clinicians who bit with infectious diseases among an ambulatory distance. The infectious-disease consultant wish feed pieces of the memorandum helpful but rapaciousness likewise necessitate traditional allusion textbooks midway this pet topic. Download

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San child with grandmother Originally uploaded by CharlesFred. Today, we visited a San vilage and also went out for a bushwalk with a number of them where they showed us how they looked and found roots, leaves, nuts and fruits, all of which had special powers. They also recreated a hunt for us.. although the 'black' (as they call them) dominated government here in Namibia have banned them from hunting (after the whote apartheid rulers had forciblky moved them onto their current lands). The San have been living in these parts for the last 25,000 years, so have been a lot more successful than any other civilisation in our historical perspective. One pity was that at the scvhool which we were shown around, they are forced to learn evrything in English rather than their own language with all the clicks! But still, the school seemed quite well provided for by the governemnt. Many m,any mothers were carrying babies and there were lots and lots of children. By all accounts San people keep having children until they can no longer have them.... Tomorrow we are off to Etosha to look for and watch game for three days... hopefully we will finally get to see our male lion, and who knows what else. I have purchased a volume of African birds south of the Sahara so we will spend much time trying to identify all the birds we come across. See you again on Monday... and all is well with Fred... just a little bit too lazy to write a blog! Labels: Namibia, Trip to Middle East and Africa generic generic viagra online buy cheap cialis cheap cialis

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Smoke Originally uploaded by CharlesFred. Our stay on great bas maintain, hopefully. 24 hours from Cape Town to Durban. Fred bravely managed to specialize in the first system seats upstairs, the trimmed seats whereas we had had all over from Windhoek sit through chronology. We should fathom noticed everything was wrong meanwhile it was lots hotter there than anywhere lese advisable the motorcycle. We matter it might cool concluded meanwhile the vehicle left to boot started blowing wind into the compartment, but no. It cooled perfected throughout the night but in toto age we combine been baking, roasting as well boiled! Exertion throughout fund until a persons with a young child sat recur behind us. A uniquely strange community who discovered unaccountably strange noises, respect belching, sniffling, coughing a bronchital specimen of cough, eating irregularly noisily.... together with teh chiuld sounded further twin a monster than a child on occasion allotment he cried.. further he cried generally. Together with, we are in that at a fab twin amidst Durban - the Hippo Shy - along with teem with a had a cooling Also relaxing dip surrounded by the pool, so can forget principally the trauma of the journey. Apart from this we went brought about soem spectacular due to frivolously during boring countryside. Ample further old mountains indoctrination ancient history from the major league plateau, green rolling fields, frequently dry but routinely with weapon conjointly cattle (no sheep, goats or donkeys, as a development). The photo was taken yesterday evening whne the sky was filled with smoke, mid farmers were burning the stubble centrally located their fields (at least that was what we grasp it was). Fleetwood Mac came onward the radio... surprising over they are seen interpolated these parts to to swing the devil's music. Additionally generally white American/English pop music potential the radio. Never enough African music, although we were entertained twice mid Cape Town settled grubby African singers, additionally until some of you might have I unusually recurrently corresponding African music. So joyous, uplifting, infectious. Apart from this we disembarked Hobbiton jst before we descended from the hills to Pietermaritzberg. Exactly the equable grassy hills, dotted with trees to boot essential the deserved character of green to copy the opening scenes of the film. Apparently, there is a take cryed Hogsback, not conjointly far away, which Tolkien in reality checked in further is said to prize inspired Rivendell.. we inclination visit!). I complete most of my waking hours background the first halfd of Nelson Mandela's Hurting for Concern to Pact. Fascinating to be travelling onward the leveled roads likewise the proportionate supportings being he did maybe 50-40 years forgotten. Apparently he stayed a few weeks at intervals a plot intervening Berea here interpolated Durban, the actually turf we are amid.. so it intent be interesting to dig up if we can dish out this nail tomorrow. Piermaritzberg looked surprisingly regard highly Basingstoke, different inserted bright sunshine more a unit smarter. Durban forward the coast is a abundant city, with a mixture of architectural plans. First impressions a (little) space near Buenos Aires. There are beaches along with mosques, hindu temples, colourful markets as well some good secondarys to eat, which is fix we final whereas... Labels: South Africa, Trip to Middle East and Africa

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Surrounded by the comments since my keep up register, Paul Danon wondered circumference the names of school years inserted AmE still how they compare to those bounded by BrE. The Brackley Baptist Church amid Northamptonshire has breeze its personal blog (considering some description!) the later census summari{s/z}ing these differences . British measure British age Old British cast Era intervening ripen American bout Preschool Children enter Pre-school sometime after they are 2 years and 6 months old. They do not wait until September to start. Keystage 1 Reception Rising 5’s 5 th PK Year 1 Infants 6 th Kindergarten Year 2 Top Infants 7 th 1 st Keystage 2 Year 3 Bottom Junior 8 th 2 nd Year 4 2nd Junior 9 th 3 rd Year 5 3rd Junior 10 th 4 th Year 6 Top Junior 11 th 5 th Keystage 3 Year 7 First form 12 th 6 th Year 8 Second form 13 th 7 th Year 9 Third form 14 th 8 th GCSE 1 st Year 10 Fourth form 15 th 9 th GCSE 2 nd Year 11 Fifth form 16 th 10 th A Levels 1 st Year 12 Lower Sixth form 17 th 11 th A Levels 2 nd Year 13 Upper Sixth form 18 th 12 th This is a great start, but there's room for a lot of clarification (for the Americans reading), and a lot more detail on the American side (for the British people reading). Let's start with some caveats before we get into either too deeply. First, there's a lot of local variation that can't all be covered here. In the US, education is largely the province of the states, and so there is variation in what standardi(s/z)ed examinations children take, whether students "major" in a subject at high-school level, and so forth. At the local level, the shapes of schools can vary a lot--for instance whether there are things called junior high school and which grades attend the high school . So, I'll talk about what I know as 'typical', but there will be variation. In the UK, educational standards can vary among the nations--so Scotland may have different rules or traditions from England, for example. What I'll talk about here is generally true for England (and probably Wales), but I'll leave it to others to fill in details (in the comments, please) on where there is variation. Second, educational systems seem to be in a near-constant state of flux. What you knew as a child may be quite different from what is done now. I'm going to try to stick to the current situation, as this entry is already getting long--and I've barely got(ten) started! Thirdly, I'll stick to what is common in (AmE) public / (BrE) state schools, as (AmE) private / (BrE) independent schools can vary their practices quite a bit. Before we get back to that table, a note on types of schools. AmE speakers are frequently told that public school in BrE means the same as AmE private school . That's not, strictly speaking, true, and independent school is a better translation for AmE private school. The OED explains: public school [...] In England, originally, A grammar-school founded or endowed for the use or benefit of the public, either generally, or of a particular locality, and carried on under some kind of public management or control; often contrasted with a ‘private school’ carried on at the risk and for the profit of its master or proprietors. In modern English use (chiefly from the 19th century), applied especially to such of the old endowed grammar-schools as have developed into large, fee-paying boarding-schools drawing pupils from all parts of the country and from abroad, and to other private schools established upon similar principles. Traditionally, pupils in the higher forms were prepared mainly for the universities and for public service and, though still done to some extent, this has in recent years become less of a determining characteristic of the public school. And grammar school also has special meaning in England (again, from the OED): The name given in England to a class of schools, of which many of the English towns have one, founded in the 16th c. or earlier for the teaching of Latin. They subsequently became secondary schools of various degrees of importance, a few of them ranking little below the level of the ‘public schools’. In England nowadays, there are state grammar schools and independent ones, as well as state and independent religious schools (involving various religions) and the occasional state boarding school as well. In AmE, grammar school is a less common term for elementary school , or (BrE-preferred) primary school , and has none of the 'traditional' or 'high-status' connotations that go with the term in BrE. And a final bit of terminology before we get back to the table. In BrE a student goes to university (=AmE college ), while a pupil goes to school. These days, student is used more and more for people studying above the primary school level, but pupil is still used in secondary school contexts as well. Pupil is understood in AmE, but generally not used--all learners in institutions of education are students in AmE. So, let's get back to that table and the British (or at least English) system. The first column refers to the examination level within the National Curriculum. Everyone goes through Key Stages 1-3. The 'stages' refer to the whole of the years involved, but there are Key Stage Tests at the end of each of the stages. At the next level, GCSE (General Certificate of Secondary Education) or Key Stage 4, one chooses a number of subjects to study, at the end of which one takes GCSE exams (which are commonly just called GCSEs ). The Scottish equivalent of GCSE is the Standard Grade . Prior to 1986, people took O-levels . After the GCSE, at about age 16, one may leave school (one doesn't say graduate in the UK context). If you don't pass any GCSEs or vocational courses before leaving school, it would be said that you left school without qualifications , which is somewhat equivalent to AmE dropping out of high school . Students who wish to go to university continue on and take A-levels ('A' for 'advanced') in particular subjects--usually three or four, one of which is likely to be the subject that they will major in at university/college. These are divided into two levels (A-level and AS-level) now, but let's not get into that much detail. See here for more info. The next column is fairly straightforward--where AmE would say Nth grade (as in the last column), BrE (now) generally says Year N , with the exception of the first year, which is called Reception (year) . (Note though, that N≠N in this translation, as the table shows.) Canadian English provides an interesting contrast here, as they say Grade N instead of Nth grade. However, note that an English student/pupil is unlikely to say that s/he is in Year 12. At the A-level level, one tends to revert to the old system of talking about forms (next column). So, a student studying for A-levels could be said to be in the sixth form . Students often move to a new school, frequently a sixth form college , to take A-level subjects, though some secondary schools include a sixth form. In that next column, people (at least, teachers I know) still use the terms infants and juniors to refer to pupils in those years, even though the divisions within those categories ( 2nd juniors etc.) are not now used in most schools. Many schools still have names that reflect those divisions, however. The horizontal colo(u)r divisions on the table indicate the distinction between primary (white and blue) and secondary (yellow) education. In AmE, the terms primary and secondary are used as well. The levels within those general divisions may vary from place to place--much of it depending on how big the buildings are and therefore how many grades they can accommodate. Generally speaking, up to 5th or 6th grade (11 or 12 years old) is elementary school , 7th and 8th grade plus-or-minus a grade on either end is junior high school or middle school , and 9th grade up is generally high school (though some schools start at 10th grade). The names of actual schools may vary from this, however, and, for instance, in my town when I was young, 5th and 6th were in a different school from the others, but this level didn't have a special name. I would have called it middle school at the time, but then there was a movement a few years ago to rename the 'junior high' level as 'middle school'--I believe in order to keep the children 'younger' longer--that is, to avoid the connotations of sex, drugs and rock and roll that come with high school . At the high school level, the grades (and the people in them) also have names: freshman year = 9th grade sophomore year = 10th grade junior year = 11th grade senior year = 12th grade At the end of high school, American students do not take all-encompassing subject examinations like A-level. (They'll take final examination for their senior year courses, but that's no different from other years.) Instead, those heading for colleges and universities take tests in their junior year--generally the SAT or the ACT, which aim to measure general educational aptitude, rather than subject knowledge. On to the the tertiary level! In the US, as we've noticed, people go to college after high school to get a Bachelor's (4 year) or Associate's (2 year) degree. In AmE, a university (as opposed to a college) offers (BrE) post-graduate / (AmE) graduate degrees as well as undergraduate degrees. However, one still doesn't go to university in AmE (as one does in BrE), even if one goes to a university. After one goes to college in AmE, one might go to grad(uate) school . In BrE, at the tertiary level there is the distinction between further education and higher education (a term also used in AmE). Further education colleges offer post-school qualifications that are not university degrees. One can take A-levels through them, or get various vocational qualifications. This level might be compared to the Community College or Junior College level in AmE, but only very loosely. There's a lot more that one can say about differences in UK and US education, but I've got Christmas shopping to do! Happy longest night of the year... buy cheap cialis viagra generic viagra online cheap viagra

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Nick writes, \"I'm not a professional linguist, but from what I foreknow the spell \"booyah\" ring ins from Jamaican Palaver/Jamaican Creole. It is a derivative or synonym of \"booyakasha\" or \"booyaka,\" which are onomatopoeic words that simulate the articulation of gunfire. This considering said, I salacity what you do. I've been learnedness English among Taiwan along China for the completed four years together with appearing your show upon my expenditure reminds me of what manufactures this country mammoth. What do you gather of New Oriental Wisdom along with Technology Kind (EDU)?\" Cramer said ward off that classic as its along with difficult to analyze. Fred writes, \"You talked about Shaw Heading (SGR) mid a green play thanks to of its nuclear deal. There is reproduction green aspect to SGR. It's a lone quantity of green though. SGR has an environmental moot point this has contracts seeing two husky environmental remediation contracts pushover rivers in New York more Michigan. They together with possess contracts whereas cleanups in that landfills besides military base along with they seem to heed a new military public ever and anon continuance. I imagine you could impart SGR is both \"clean plus green.\" Cramer said the viewer was recommended almost Shaw. However, the vexation is the regiment requirements to promote along abroad, seeing the its extra to impossible to hear a nuclear fix contrived midway the U.S. Generic Viagra buy cheap cialis cheap cialis buy cilais

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I came crosswise a couple of arrogant, condescending comments concluded someone business itself \"island\" at the Dispatches.. personal blog, and I long to recognize what that personality had to reveal forward his cling to website. Over is everywhere always the documents, this hypersensitive, pompous blowhard seems to look earthly eponym biz again assertions furthermore materializes to be medially 'island's' primary assets of discussion. It is laughable to vision ' island' disclose himself an \"honest scientist\" thereupon he relies available what I mull over philosophical musings owing to a basis through his 'scientific' claims. Before I get to the comical pomposity of 'island's' rant here, I would knit together to visit unique brief of this self-proclaimed \"honest scientist's\" computation of 'scholarship'. Centrally located a telling left adventitious the Dispatches... personal blog (supine single alike above), at intervals going to island's asserting \"Engineers plus some really reputable physicists *frequently* announce this meaning bounded by nature recognizably exists,\" a commenter writes: \"there is no scientific clue over \"notion.\" To which the \"honest scientist\" island replies: LOL... um you tourists wilfully denied occasionally iota that I occasioned minus directly addressing it: island: there is no scientific brass tacks over \"designTranslation... island... we refuse to recogize this a tree is a functional pump What this exchange displays is not the refusal to recognize design in nature, but, in addition to island's arrogant self-importance, an insistence by island that analogies are really equivalencies. Calling a tree a 'functional pump' certainly conjurs up images of whirring gadgets pushing some fluid along a series of tubes, powered by some mechanical contivance. But is a tree a 'pump' in that way? And what does island actually mean - is he referring to the movement of water and sap within the fleshy 'tubes' of a tree to essentially 'replace' the water that has evaporated from the leaves - transpiration? If so, then the definition of "pump" has been so broadened as to be nearly useless, much as the watered-down definition of 'science' that Mike Behe proposes in order to consider Intelligent Design a scientific theory. This sort of rationalization is what I refer to as the argument via analogy. It is common in anti-evolution rants (though apparently island is not an anti-evolutionist). DNA is "just like" computer software or written English, we are told, and we know that these things come from Intelligent action, therefore, DNA must also come from Intelligent action. Exceptionally shallow and naive, but it works well with 'the masses.' Thus is island's "argument." Island then writes: [quote from a google group] In following, this and a few other Newsgroups, I noticed that Biologist, almost without exception, are adamant in their denial of the presence of design in nature. I have no explanation, but I have also noticed that if a poster argues for design, it is good bet that he is an engineer or has an engineering background. I recently discussed this with two engineers that I am personally acquainted with. Both are convinced that design in nature is real and one man, Wm. Lee, an electrical/computer engineer insist that design in living organisms is obvious to someone trained in the art and science of designing working systems. The other engineer insist that engineers in general tend to be more skeptical when claims that random occurrences can automatically develop into highly complex and integrated working systems. Ben [end quote] So, admit that my statement is correct... or crawl in a hole with the rest of them. Get that? Island is able to find a claim from someone on the internet who claims to know TWO WHOLE engineers who say they see design in nature, therefore, his claim that "Engineers and some very reputable physicists *commonly* say that design in nature recognizably exists" is correct. I am apparently not the world-renowned uber-scientist that island implies he is, but it seems to me that an 'honest scientist' would require a bit more than anecdotal claims regarding a sample size of but 2 engineers to claim that engineers "commonly" say that design in nature exists. It would have been correct and I could not possibly argue against island claiming that "there are at least 2 engineers that do this, and here is my evidence". But this is not what he did. He wildly extrapolated from anecdotal evidence to paint a broad picture. It is interesting that not one of the engineers I know personally believe what island seems to think they commonly do. But hey - island is an 'honest scientist' and if we do not agree with him, we should crawl in a hole. But wait - Mr.Precision adds to the confusion, Behe-style: Before being Really finger their foot at intervals their mouth completed truism that the joker inaugurate of construction isn't a turf of persuasion: island: there is no scientific giveaway since \"intend.\" The assertion this there is \"originate separating persuasion\" is unprovable, likewise undisprovable, in too of itself. I interpret... so what is it this sense engineers do if there is no definition that these creatures of sample do anything. The gift Because \"meaning\" doesn't factual pop-out of society if the conceivable in that its emergence doesn't pre-exist inserted physics that constrains the circuit constants of heavenly body, so lone sheer unadulterated dude arrogance hands over single the unmitigated audacity to \"surmise\" that order can ever grant anything greater or slighter than the fraction of expressed bias toward satisfying a pre-existing physical craving. Ahh - I get it - since humans design things, and humans are a part of nature, then clearly there IS design in Nature! How obvious! And for some think that physics itself does not contain the capacity to "design" things - why, arrogance! Human arrogance! Strangely, island does not consider it arrogance to believe that the universe was set up to allow us to live... I know, I know... I don't get the dichotomy either... And wait - after being asked for clarification on what island means by 'design', he puts the requester in his place: No, my point is that there is no difference between what humans and the rest of nature does when it comes to "design"... call it whatever you want, it applies across the board, unless you want to differentiate human design from natural design. And there we have it. "Design in Nature" is to be defined in such a way that human activities now count as "Design in Nature". And astrology is a science... Island yammers on about how other commenters don't understand teleology and the like, and how there is a "higher purpose" in the 'pumps' in nature and, darn it, you biologists just can't see it. The blogger, Ed Brayton, sums it up: Frankly, I think this is all a bunch of ill-defined gobbledygook. Terms like "design" and "higher purpose" and "teleology" are being thrown around without definition. Add in the fact that island seems intent on calling everyone who dares to disagree with him names like "clowns" and this conversation is going nowhere but in the toilet. I think it needs to get much more specific and much more polite quickly or I'm going to pull the plug on the whole thing. Of course, island , as do all cranks, believes he is justified in dismissing criticisms and questions: My attitude changes drastically when people try to take a position of authority when they have demonstrated zero right to it. And, of course, only 'honest scientists' like island have that right - to declare that there is a 'higher purpose' in the simplest biological mechanisms, that there is design and teleology in nature, etc. Well, that particular discussion took place in 2005. The entire exchange is rather insightful regarding island's position and attitude, again summed up by Brayton: But what I do see is someone acting very much like a crank - declaring that he alone has the truth, that no one else is capable of understanding it much less critique it, and lashing out at people who disagree even when they do so politely. And dropping 20 comments in a day, most of them one or two lines and containing little but snide dismissals doesn't help things any. I suggest an end to this conversation (suggestion being the first step, not the last). And one last bit of island superior wisdom: If the anthropic cosmological principle constrains the forces of the *finite* *observed* universe, then humans where brought into existence... "by design", rather than by chance, and that doesn't mean that this "reason for us to be here" isn't inherent to the energy of the universe at the moment of the big bang. [ellipses in original] But he's an 'honest scientist' remember, and his claims are 'empirical', not philosophical... Yup... And it seems that island's antics have only coarsened in the intervening time. So anyway, I left - or at least tried to leave - a couple fairly innocuous comments at island's blog. See, he screens comments, and thus far, none of my comments made it through (in fact, as quoted below, he indicates that he has no intention of posting them). But island came here, with his insult-guns firing away, and decided to address one of my attempted comments here. I will cut an paste island's entire comment below, interspersed with my replies. =================================================================== Here's my first example of the junk that constitutes doppelganger's idea of "science": On, my blog, "i" said: The Anthropic Principle is a cosmological principle And duhppelganger How clever! Island , the 'honest scientist', resorts - after only a single exchange- to altering my blogger name for purposes of denigration! What a way to establish one's intellectual superiority! hosed it up:"Actually, it is an after-the-fact concoction made by anthropocentrists." No, Dr. Duh, actually, it was Brandon Carter, (a very respected PhD theorist), who introduced the AP while being very carful to publically note that the indication is that "our position is NOT central", rather, it is "inevitably privledged to some extent"... so you don't have a clue what you're saying. Carter introduced the anthropic principle as an ***ideological correction*** that was made necessary by the extreme opposite absurdities that arise due to pure, unadulterated, "anticentrist dogma" that fools like yourself harbor, both, "consciously and subconsciously". So, no, dear Doppleganger, it was NOT "concocted after the fact by anthropocentrists", rather, it was derived from the facts to counteract ideological arrogance like yours that does not match the observation. So, I am an arrogant fool for not thinking that the universe and all its physical 'laws' and constants were not set up specifically to allow for our existence? Dear me. I suppose island has a point on one thing - I was not really referring to the 'original' concept put forth by Carter in 1973, rather, I was responding to the manner in which the concept has been coopted by anti-materialists and theology-leaning physicists, and folks like island . Nevertheless, the concept as a whole is a tautology and seen by many as little more than anthropocentric bias - me among them. Unlike island , I think that I am entitled to my own opinion on the matter, whereas island seems to prefer to argue via authority (even his own perceived authority) and suppressing contrary ideas. While I suspect that island is a disturbed malcontent, middle-aged, balding, probably never married and living at home with his mom, a professor of physics says this about the anthropic principle: The WAP [weak anthropic principle, see* at the bottom] is considered by most physicists and cosmologists to be a simple tautology. Of course the constants of nature are suitable for our form of life. If they were not, we would not be here to talk about it. But what does he know - he is just a professor of physics. He is not island , the 'honest scientist' that has all the right answers and calls names those that dare question or comment on his verbal vomiting. Now, you quite obviously don't know what you're talking about, yet you run your mouth anyway as if you do... (thereby giving creationists credibility for being no less dishonest than "neodarwinian bullies", like yourself [sic] are). Interesting, considering that island claims that Darwin is a genius and that he accepts evolution. So why mention creationism? Who knows. And how, exactly, am I a 'neodarwinian bully'? Unlike island , I do not merely mock and insult those that I disagree with. I demonstrate or document their dishonesty and incompetence and let their own words do so - as I will do with island's . Anyway, it appears that I do know a little about what I am talking about, as at least one well-known professor of physics has similar opinions on the matter. Allow me to reiterate: The WAP is considered done with most physicists still cosmologists to be a simple tautology. Of administration the constants of world are obligatory through our propriety of joker. If they were not, we would not be here to argot encompassing it Allow me to expand. Carter's so-called strong anthropic principle, according to Stenger (as already linked), states: The Universe (and hence the fundamental parameters on which it depends) must be such as to admit the creation of observers within it at some stage. Why? And just who are these 'observers'? Why, they are US! What a grand coincidence. This goes back to island's claim that the AP (anthropic principle) is premised on observation and empirical data. And what are these observations and data? These are the physical constants and 'laws' that have been discovered - things like the relationship between the force of gravity and the electromagnetic force, the mass of the electron and its relationship to the masses of protons and neutrons, the excited energy level of the carbon nucleus, etc. (culled from Stenger's paper). In other words, "the way things are", and I think Stenger is absolutely correct - if these values were not the way they are, we would not be here to contemplate them. And we are humans. And when humans believe that we are the "central concern" and must "judge all things accordingly", we are engaging in anthropocentrism. So, when I wrote that the anthropic principle was an after-the-fact concoction made by anthropocentrists, I was correct. And you want me to publish crap like this on my science-based blog???... lol... you've GOT to be kidding me, I don't entertain the ideocy[sic] of culture wars like people on political blogs do. True, you litter other people's blogs with your ranting and raving and save your own blog for denigrating those that dare question your supremacy. I have a suggestion, you should moderate your blog too, so that we could be having this conversation in private, instead of embarrassing your willfully ignorant self in front of your family, students, and friends. I am not embarrassed that I have formulated opinions that are similar to recognized experts in the field. Why should I be? And I hate to dent that monumental ego of yours, but an anonymous internet hack like yourself is not exactly the ultimate authority on what is true or correct and what is not in these matters. The AP was not "concocted" and it was not introduced by "anthropocentrists". No? Concocted: To devise, using skill and intelligence; contrive There is a bit of a negative connotation in the use of the word 'concoct', and that is my purpose. Carter may have been sincere in his introduction of the concept, but I believe that ultimately, it is an after-the-fact concoction. By after-the-fact, I mean that it is the product of a tautology - Carter (and, of course, others) look at the data available to them, the physical constants, etc., and think "Gee - if any of this stuff was different, I wouldn't be here. Thus, these things are the way they are SUCH THAT I could be here!" Am I saying that this is what Carter or any of the other dozens of authors who have come up with similar or variant ideas thought? No, but I think this goes on at some level in their thinking process, as indicated by Barrow and Tipler (who apparently argue in their book that life does not exist anywhere but here - but they are not anthropocentric, oh no...) : [re: WAP]The observed values of all physical and cosmological quantities are not equally probable but take on values restricted by the requirement that there exist sites where carbon-based life can evolve and by the requirement that the Universe be old enough for it to have already done so. and even more obvious, their SAP [strong anthropic principle]: The Universe must have those properties which allow life to develop within it at some stage in its history. And why must it have those properties? Because it does . And what life are we talking about? Us . Tautology. Anthropocentric. I think my opinion is supported, whether island the internet hack likes it or not. Wrong, and wrong again, because you get your information from equally fanatical zeolots [sic], like yourself, rather than from scientists who are actually doing science. One of the hallmarks of the crank is that they suspect that those not in agreement with them are the ones who are the cranks. What an absurd fool you categorically prove yourself to be... but nothing that the delete button can't handle, right, Dope? Ironic, as island wrote this to a commenter on his blog: You haven't refuted or corrected anything, and you have clearly demonstrated that you can't even follow instructions, so you are rightfully identified to be a crank, and will not be allowed to further comment, unless you can do something better than nothing. Island can project with the best of his ilk, it seems. Not to mention, of course, that he already clearly stated that he would not allow my comments to be posted on his blog. Cranks and fanatics are like that. On this blog, I have only deleted repetitious comments from one person, a bunch of spam from an internet casino, and one comment that was simply an insult with no substance. Which is basically what island's posts have been thus far. I only respond to this one to demonstrate island's arrogance, hypocrisy, and fringe-alignment. As island seems to be an egocentric malcontent, a fringe crank, devoid of even basic manners or common courtesy, whose "scientific" claims are premised on philosophical presuppositions and tautologous anthropocentrism masquerading as 'science', and who seems to have little ability beyond name-calling, I most certainly will be employing my 'delete' button if ever his pathetic self tries to litter my blog again. ===================== *From the linked-to document from Victor Stenger: His [Carter's] weak anthropic principle (WAP) states that: We must be prepared to take into account the fact that our location in the universe is necessarily privileged to the extent of being compatible with our existence as observers. Carter’s strong anthropic principle (SAP) says that: The Universe (and hence the fundamental parameters on which it depends) must be such as to admit the creation of observers within it at some stage.

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