Use of Shared Decision-Making (SDM) and Decision Aids (DAs) has been encouraged but is not regularly implemented in primary care. The Office-Guidelines Applied to Practice (Office-GAP) intervention is an application of a previous model revised to address guidelines based care for low-income populations with diabetes and coronary heart disease (CHD). Objective: To evaluate Office-GAP Program feasibility and preliminary efficacy on medication use, patient satisfaction with physician communication and confidence in decision in low-income population with diabetes and coronary heart disease (CHD) in a Federally Qualified Healthcare Center (FQHC).
Ninety-five patients participated in an Office-GAP program. A quasi-experimental design study, over 6 months with 12-month follow-up. Office-GAP program integrates health literacy, communication skills education for patients and physicians, patient/physician decision support tools and SDM into routine care. Main Measures: 1) Implementation rates of planned program elements 2) Patient satisfaction with communication and confidence in decision, and 3) Medication prescription rates. We used the GEE method for hierarchical logistic models, controlling for confounding.
Feasibility of the Office-GAP program in the FQHC setting was established. We found significant increase in use of Aspirin/Plavix, statin and beta-blocker during follow-up compared to baseline: Aspirin OR 1.5 (95 % CI: 1.1, 2.2) at 3-months, 1.9 (1.3, 2.9) at 6-months, and 1.8 (1.2, 2.8) at 12-months. Statin OR 1.1 (1.0, 1.3) at 3-months and 1.5 (1.1, 2.2) at 12-months; beta-blocker 1.8 (1.1, 2.9) at 6-months and 12-months. Program elements were consistently used (≥ 98 % clinic attendance at training and tool used). Patient satisfaction with communication and confidence in decision increased.
The use of Office-GAP program to teach SDM and use of DAs in real time was demonstrated to be feasible in FQHCs. It has the potential to improve satisfaction with physician communication and confidence in decisions and to improve medication use. The Office-GAP program is a brief, efficient platform for delivering patient and provider education in SDM and could serve as a model for implementing guideline based care for all chronic diseases in outpatient clinical settings. Further evaluation is needed to establish feasibility outside clinical study, reach, effectiveness and cost-effectiveness of this approach.
According to the Chronic Care Model, disease management is best provided through collaboration between the patient and the healthcare team . The Patient Centered Medical Home and Meaningful Use criteria expect patients to be actively involved in the decision making and management of their chronic conditions [2–4]. Patients who become informed and active participants in decision making consistently experience a positive impact on their health outcomes [2–5]. As described by Wagner et al. high quality medical care for chronic illness must accomplish three objectives, : 1) assure the delivery of those interventions that have been shown by rigorous evidence to be effective, 2) empower patients to take responsibility for the management of their condition, and 3) provide information, support, and resources to assist patients in self -management tasks. The collaborative care model described by Wagner remains an ideal but often elusive goal of care systems . The use of Shared Decision Making (SDM) and decision aids (DAs) to accomplish the collaborative model has been encouraged but not regularly implemented in primary care. Shared decision-making has been defined as: "an approach where clinicians and patients share the best available evidence when faced with the task of making decisions, and where patients are supported to consider options, to achieve informed preferences" . At its core, SDM rests on accepting that individual self-determination is a desirable goal and that clinicians need to support patients to achieve this goal, wherever feasible .
Physician and patient interventions designed in tandem to support the therapeutic partnership from both perspectives have been advocated but infrequently implemented . The challenge is how to support patients and providers to develop new behaviors and knowledge about treatment options and communication skills necessary for collaboration and shared decision making (SDM). Only a few studies have simultaneously intervened with both patients and providers and objectively measure intervention effects on health outcomes . Furthermore, some patient-activation interventions designed to improve patient-physician communication have been tested in patients with chronic diseases, but relatively few have used targeted strategies, and focused on ethnic minorities and low socio-economic populations who typically have lower levels of engagement and poorer communication with providers . Cooper et al.  found that interventions that enhance physicians' communication skills and activate patients to participate in their care positively affect patient-centered communication, patient perceptions of engagement in care and may improve systolic blood pressure among urban African-American and low socioeconomic status patients with uncontrolled hypertension. The greatest improvements were seen among patients who received coaching by a community health worker and whose physicians also received patient-centered communication skills training . Stacey et al.  in their Cochrane review of DAs for people facing health treatment or screening decisions found high-quality evidence that DAs compared to usual care improve people's knowledge regarding options, and reduce their decisional conflict related to feeling uninformed and unclear about their personal values. In addition, their study revealed moderately quality evidence that DAs compared to usual care stimulate people to take a more active role in decision making. They however concluded that the effects of DAs on adherence with the chosen option, cost-effectiveness, use with lower literacy populations, and level of detail needed in DAs need further evaluation .
Our study addresses the need for more research on use of SDM and DAs, the translation of evidence-based decision support interventions and the implementation of guidelines based care into practice especially in community outpatient settings that provide care for minority low income populations [12–15].
We previously developed an integrated shared decision making (SDM) intervention  based on our research in communication skills training for both patients and providers [17, 18], and provision of problem-specific decision support tools [19, 20]. Our prior study focused on decisions about exercise stress testing in stable coronary artery disease and was underpowered to evaluate the impact on patient behavior. In the present study, we used our intervention approach to encourage SDM in guidelines-based medication use in coronary heart disease (CHD) among patients with diabetes/CHD receiving care in a Federally Qualified Health Center (FQHC). FQHCs provide care for over 22 million people in 9000 communities in US . They play a vital role in caring for the poor and medically underserved, underinsured, and uninsured Americans, including migrant workers and non-US citizens. Most of these patients are at higher risk of cardiovascular disease and underuse of guidelines based care [22, 23]. We tested the feasibility of the intervention process in the new application and performed a preliminary test of the impact of the intervention on patient satisfaction with communication with their provider and confidence in decision made and on medication use.
We used the approach from our previous work  and provided specific decision support tools to create a simple, parsimonious strategy as a new intervention in primary care we call the Office Guidelines Applied to Practice (Office-GAP) to improve prevention of coronary heart disease (CHD) in outpatient settings.
Our objectives were to evaluate: 1) feasibility of the Office-GAP program among patients with diabetes and CHD in a Federally Qualified Healthcare Center (FQHC); 2) the impact on a) patient satisfaction with physician communication and confidence in decisions; and b) use of guidelines-based medication for CHD prevention.
A one-group, pretest-posttest quasi-experimental design was adopted over 6 months, followed by a 12-month follow-up. The study site was the Ingham County Healthcare Center in Mid-Michigan, a designated FQHC. Patients with diabetes and/or heart disease were recruited through direct provider referrals and on-site recruitment using patient ICD Code. At the visit to the primary practice where diabetes or heart disease, or both is on the problem list, practice staff informed patients about the study and directed interested patients to the research assistant (RA) for more information. The RA briefly described the project to the patient; if patient was interested, he/she was scheduled for a group visit; Consent and Health Insurance Portability and Accountability Act (HIPAA) forms were completed during the group visit. All providers, practice staff and patients signed informed consent documents. The Michigan State University (MSU) Institutional Review Board (IRB) approved the study.
Adults aged 18 or older, who could provide informed consent and who sought care from September 2009 to December 2011. ICD codes were used to identify patients with a diagnosis of 1) Diabetes mellitus. 2) Coronary heart disease. 3) All doctors and nurse practitioners providing care for patients at the study site.
Adults with cognitive impairment, dementia and psychosis as determined by ICD codes. Patient race was self-reported.
Interpreters were used to obtain information from patients who could not speak English. Study participants received 30-dollar reimbursement for transportation and parking fees.
All providers in the clinic and practice staff (Nurses, Medical Assistants, Administrators, Receptionists, and Social Workers) were recruited into the study. An informational meeting was offered at 4 different times to accommodate staff schedules. Two doctors (one internal medicine physician and 1 family medicine physician), 1 nurse-practitioner (NP), 8 staff, and 95 patients with a diagnosis of CAD or diabetes mellitus in one FQCHC participated in this pilot study.
The Office-GAP model (Fig. 1) is based on the Health Literacy Care Model (HLCM)  and the Relational Coordination model . The HLCM is a systems approach to improving patients' engagement in care. Relational coordination refers to the quality of communication that strengthens interpersonal relationships [25, 26]. This is fundamental to collaborative goal setting that both patients and providers will embrace.
Program elements show how Office-GAP operationalizes key constructs in the Relational Coordination model that enhance relational coordination among providers and patients (Table 1). Relational coordination originally referred to the quality of communication among individuals in a work setting, and is understood as a function of the quality of those professionals' interpersonal relationships . We focused on strong provider-patient relationships as described in the HLCM . The HLCM, weaves health literacy strategies into the widely accepted Wagner Care Model . The Care Model represents an evidence-based framework that promotes the delivery of safe, effective, and collaborative care to patients. Measures of relational coordination have been positively correlated with outcomes in health systems  and integrated care in hospitals  and relational coordination has been shown to improve results in primary care and in community settings . Havens et al.  report on the specific features of high-quality communication and provider relationships leading to strong relational coordination. Table 1 below summarizes the way the features of Office-GAP met the criteria discussed by Havens .
SDM and the HLCM both aim to improve productive interactions between informed, activated patients and a prepared, proactive practice team. The purpose is to go beyond informed decision making and paternalistic models, in which communication is one way between clinicians and patients, and to achieve two-way communication and SDM . Our model explicitly identifies two aspects of the model that are often overlooked . One is to directly identify the choices patients are offered (the framing problem). The framing problem in our model is answered by limiting the decision space to choices supported by guidelines. In CHD/diabetes, the clinical cases that provide the preliminary test of the model, choices offered are among known efficacious medical and behavioral treatments. The other aspect of the interaction is to deliberately address how the patient is involved (the nature of reasoning problem). The communication represented in joint decision making (the nature of reasoning) is answered by explicitly describing the pros and cons of identified treatments and encouraging the patient and physician to openly discuss each to reach a shared decision about a treatment plan. The process continues with patient values clarification and shared-decision-making to formulate a treatment plan.
The Office-GAP tools were grounded in the Guidelines of the American Heart Association/American College of Cardiology (AHA/ACC) on secondary prevention of heart disease  and those of the American Diabetes Association (ADA) . The process, developed previously , consisted of three Office-GAP components: 1) Physician and practice staff training; 2) Patient Group Visit; and 3) Use of the Office-GAP checklist tool during follow-up provider visits. The checklist tool  aided SDM and communication between patient and provider. Components were scripted and monitored to maintain study fidelity .
The physician communication intervention was a 90-min training offered at 4 different times to accommodate staff schedules. Training included review of CHD secondary prevention guidelines and communication skills. Discussions on Steps in Patient-Centered Care Method of Communication (PTC) , SDM and goal setting, was led by Dr. Robert Smith, a world renowned expert in teaching PTC. The communication skills training goal was to increase patient engagement, activation, goal setting and empowerment. The intervention focused on strong provider-patient relationships as described in the HLCM and Relational Coordination Model. The research team, providers and practice staff discussed the best strategy for implementing the Office-GAP tools in the practice and their use during patient encounters with their providers. We identified possible opportunities and pitfalls of the study. Role-plays were conducted to model office visit skills. The training section was evaluated by surveying participating physicians and practice staff at the end of the training.
Patients attended one group visit to learn SDM, communication skills and review decision support tools parallel to skills targeted in the physician intervention. Patient pre-visit coaching has been shown to improve patients' communication with their physicians and health outcomes . We define decision support tools to include the Office-GAP checklist tool and two decision aids to support patient decision making about CHD ("Living with CHD" a 35 min DVD and Pamphlet  and ADA/ACP Booklet ("Living with Diabetes" ). How to use the GAP Agreement for Heart Health/Checklist during office visit with their physician was discussed. The Office-GAP checklist was written at the 6th grade reading level. Two follow-up visits at 3 and 6 months were scheduled with patients' primary care physician using the Office-GAP checklist tool described in more details below. The group visits included four to six patients, were scheduled for a 90–120 min/group visit and were conducted by the Research Assistant and PI (AO).
Introduction to CHD and life style changes was presented through viewing the CHD decision aid  that included scientific information and patient interviews about secondary prevention and living with CHD. Purpose and side effects of cardiac medications were discussed by a physician (AO) with a Research Assistant. The ADA/ACP Booklet "Living with Diabetes" was reviewed to set goals. Principles of SDM and how to interact with physicians during office visit were discussed. The program focused on patient communication skills related to engagement, SDM, activation and empowerment consistent to the provider intervention skills [38, 39].
The Office-GAP Checklist (The GAP-Agreement for Heart Health Checklist)  was used to stimulate SDM and aid communication and impact the process of care by providing a systematic list of evidence based medications/ interventions for patient and provider to review together. The use of the checklist during routine office visit was an added reinforcement of the group visit SDM and patient engagement process. The Office-GAP Checklist served as the core SDM reminder tool. It was completed in real time by the physician and patient at two separate office visits (at 3 and 6 months). A SDM process was used to agree on medication use and life-style changes. For each guideline based item in the list, the physician checked, Yes (if patient was on the medication or life style activity), or No or Does Not Apply to me because…. (if the patient was not eligible for the medication, had a contraindication, or was unwilling due to side effect concerns). Physician and patient discussed each item before the physician checked the box. The Office-GAP Checklist also stated the next follow-up details. At the end of the visit the physician and patient signed the checklist form to confirm that both of them has reviewed and discussed all the items. A copy of the checklist went to the medical record and a copy went to the patient to take home.
The intervention feasibility was assessed by 1) Physicians' and Office staff attendance at the providers' educational meetings, 2) patient group visits and follow ups' attendance, and 3) Office-GAP tool utilization rate abstracted from the medical record.
The COMRADE survey  assessed the patient's satisfaction with provider communication during the encounter, the information they received and confidence in the decisions made with their provider regarding their care. The previously validated COMRADE survey contains two sub-scales: 1) satisfaction with physician communication, and 2) patient confidence in decision made . The full survey consists of 20 items that was administered at three times: at initial group visit (pre-GAP, 0 months), and at two subsequent post-GAP visits with their physician (3, 6 months)  It states "we would like to talk with you about your discussions with your physician" and it includes questions such as "The doctor made me aware of the different treatments available," "The doctor gave me a chance to be involved in the decisions during the consultation". "I know the advantages of treatment or not having treatment". "My doctor and I agreed about which treatment (or no treatment) was best for me". "I am satisfied with the way in which the decision was made in the consultation". "I can easily discuss my condition again with my doctor". "I feel an informed choice has been made"." Overall, I am satisfied with the information I was given".
At baseline patients were asked to assess their satisfaction with their provider's communication and confidence in decision made with their provider during their last office visit using the COMRADE survey.
All items used a Likert response format (1 = strongly disagreed to 5 = strongly agree). Research Assistants explained the questions and helped only patients with limited literacy to complete the forms at each visit. Rates of using aspirin, beta-blocker, ACEI/ARBs, and cholesterol treatment were obtained at baseline, 3, 6 and 12 months as primary endpoints.
Medication use was assessed by self-report at each visit and confirmed by patients bringing in all active medications, (validated by presence of the prescription in the medical record). This also verified that prescription was filled.
For descriptive statistics we used mean and standard deviation (SD) for continuous variables and frequency and percentage for discrete variables. To test for the effect of the Office-GAP intervention on perceived satisfaction with communication and confidence in decision, we summed raw scores on items 1 to 10 for satisfaction subscale scores and items 11 to 20 for the confidence subscale scores. The resulting scores for both subscales could range from 10 to 50, with high scores indicating more satisfaction and more confidence. We used the generalized estimating equations (GEE) method  to estimate hierarchical linear models to account for the correlations of the subscale scores within the same patient, controlling for patient's age, race, gender, primary insurance and Charlson index. These analyses tested whether the mean subscale scores were higher at each of the post Office-GAP assessment (at 3 and 6 months) than they had been at the pre-Office GAP visit (0 month/baseline).
For medication use data, we used the GEE method  for hierarchical logistic models, controlling for the same covariates as above. Only medication eligible patients were included in the analysis for specific adherence, resulting in different numbers of patients in each model. Medication eligibility criteria was based on guidelines and followed previous studies [42–45] (Appendix 1). "Extending our statistical analysis for medication use, we created a "global" medication adherence measure based on the following algorithm: a variable that equals to the adherence for ACEI if the patient was eligible for ACEI, else equals to the adherence for aspirin if the patient was eligible for aspirin; else equals to the adherence for statin if the patient was eligible for statin; and else equals the adherence for beta-blocker if the patient was eligible for beta-blocker.
Worst-case scenario imputation was carried out for 3 patients with missing data at 12-month follow up.
All analyses were performed using Stata 13 .
One hundred and forty-six patients met the inclusion criteria but only 95 (65 %) patients with CHD and/or diabetes participated in the study (Table 2). Reasons for non-participation included, refusal to participate, some indicated willingness to participate but did not show up for the group visit, some patients could not be contacted for scheduling for group visit because their phone were disconnected. On average the patients were 53.2 (SD 10.3) years of age, with BMI 36.9 (SD 10.2) and Charlson Index 2.6 (SD 1.5) indicating substantial risk of mortality within the next 10 years for a typical patient . The majority of patients were female (53.7 %), white (51.6 %), with Medicare or Medicaid insurance (52.6 %), and 8.4 % were uninsured.
Office-GAP was consistently implemented. All providers and staff attended the 90-min physician training. Among the 95 patients who attended the first 90-min group visits, 77 (81.1 %) completed their first Office-GAP provider visit; 60 (63.2 %) completed their second (final) visit. The Office-GAP tool was found completed in the medical record 98.7 % of the time. The clinic staff made sure that every patient goes into the consulting room with the Office-GAP checklist. We checked that both the provider and patient signed the Office-GAP checklist at the end of each encounter to confirm that both has discussed each item and they are both in agreement with their plan regarding the medication use and appropriate life-style changes. "The one-page Office-Gap checklist was reported to be simple and easy to use by the physicians in the study. The study met all the criteria for the TIDieR checklist (Appendix 2).
Results of the COMRADE analysis show improvement in patient satisfaction with provider communication and confidence in decisions, based on principles of SDM (Table 3). Relative to the baseline, satisfaction with communication increased at the first GAP follow-up by 4.6 points (95 % CI: 2.6, 6.5, P < 0.001) and by 5.0 at the second post-GAP follow-up (3.1, 7.0; p < 0.001). Similarly, confidence in decision increased at the first follow-up by 3.7 points (1.3, 6.1; p < 0.05) and by 5.5 at the second follow-up (3.0, 8.0; p < 0.001). These improvements were in the small to medium effect size range.
There were significant increases in the proportions of patients using Aspirin/Plavix, statin and beta-blocker during follow-up compared to baseline, with ORs for Aspirin 1.5 (95 % CI: 1.1, 2.2; p < 0.05) at 3-month, 1.9 (1.3, 2.9; p < 0.01) at 6-month, and 1.8 (1.2, 2.8; p < 0.01) at 12-month; for Statin 1.1 (1.0, 1.3; p < 0.05) at 3-months and 1.5 (1.1, 2.2; p < 0.05) at 12-month; and for beta-blocker 1.8 (1.1, 2.9; p < 0.05) at 6-month and 12-month (Table 4). The predicted probability for "global" medication adherence over time revealed that compared with baseline, the odds for adherence increased by 52 % at 6-month (OR = 1.52, 95 % CI = 1.01, 2.29; p < 0.05) and by 34 % at 12-month (OR = 1.34, CI = 0.87, 2.06 p = 0.189) (Table 4). Figure 2 depicts the predicted probability and 95 % confidence intervals for global medication adherence over time using the model in the last column in Table 4.
Our results demonstrate the feasibility of the Office-GAP Program and these preliminary efficacy data suggest it leads to improvement in patient satisfaction with communication with their provider and medication use. The medication use in the study was based on ACC/AHA/ADA guidelines based care for secondary prevention of heart disease for patients with diabetes and heart disease. The Office-GAP tool was found to be almost universally used in this study. The simplicity of the tools and the team-based approach which involved patients and providers/practice staff in training and implementation likely accounted for high use of Office-GAP tools. The one-page Office-GAP checklist that enables physicians' to systematically consider evidence based care for every patient during each encounter was reported to be simple and easy to administer by the physicians. The Office-GAP decision support tools provide educational content and structure the clinical encounter.
Beyond establishing program feasibility, we are encouraged that the simultaneous training of physicians and patients in communication skills appeared to boost patients' confidence in their decisions and their evaluation of providers' communication as measured by COMRADE. These are critical aspects of increased trust and strengthening of the provider-patient relationship. Importantly, the improved COMRADE scores show improvement in patients' satisfaction with provider communication and comfort with discussing prevention and treatment, and making treatment decisions with their providers. This, in itself, is an important improvement in the provider-patient relationship. In addition, the Office-GAP pilot study showed increase in medication use in this low-income population. We suggest the improved relationship may contribute to improved medication prescription use. Previous studies have rarely shown an impact of communication skills interventions on patient behavior . Our results, however, are consistent with the findings of Cooper et al.  who showed in their Hypertension Patient-Physician Partnership Study that the greatest improvements in blood pressure control were seen among patients who received coaching by community health workers and among those whose physicians also received patient-centered communication skill training.
A key component of the system is communication skills training for both the patient and physician. A second key is that the use of the Office-GAP checklist brings the specific clinical decisions directly into the patient encounter for systematic discussion and patient-provider decision making. Results show improved physician prescribing behavior and patient follow-through. Sustained improvement in medication and life style, structured and supported by a team-based approach, could lead to improved cardiovascular outcomes .
We studied minority and low-income populations who are unlikely to be able to afford the cost of medications without insurance coverage. Availability of insurance coverage to almost everyone due to health care reform should sustain access to these medications.
Our feasibility study sought to implement and evaluate the proposed main intervention of a broader trial while reducing threats to the validity of the future study . Our results allow estimation of the probable effects of our intervention. These results will likely enable estimation of an adequately powered sample size for a planned randomized controlled trial (RCT).
Several limitations are pertinent. Office-GAP implementation was tested in a FQHC in a small cohort and not in a randomized control trial, limiting generalizability. The educational intervention exposure for physicians was limited to a one-time administration, and may degrade over time; however, Office-GAP tools assisted the follow-up interactions. Since we did not audio or video record the encounters, there was no definitive way to confirm how physicians and patients were actually engaged in the SDM. However, at the end of the clinic visit the physician and patient signed the checklist form to confirm that both of them has reviewed and discussed all the items. In addition, we are unable to disentangle the effects of the providers' training and the patients' training to explain our results. The increase in medication use may reflect more effective physician prescribing and communication practices, as well as more effective patient communication and activation. We did not evaluate implementation cost in this pilot study. Finally, since we did not track which patients formed a group at each visit we could not take into account of the clustering of patients in the analysis. Despite these study limitations, this study has several strengths. We believe that the Office-GAP pilot initiative may provide the foundation for future initiatives and that it is unique in several ways. First the tools remind physicians, nurses and patients of the key goals of therapy in real time and in follow-up office visits. Office-GAP strengthened shared decision making and resulted in improved patient satisfaction and confidence in decision made in an underserved population not characterized by high engagement at baseline. Second, the tools' design was very simple and easy to use at the point of care. Third, all the physicians and practice staff were involved in the training and implementation of the tools and assisted in identifying the barriers to successful implementation, a strategy previously proven to be effective in influencing physician behavior .
The Office-GAP Program is feasible within the outpatient clinical settings. It has the potential to improve shared decision-making, satisfaction with provider communication, and evidence-based medication use for patients with heart disease and/or diabetes. Improved satisfaction with physician communication and confidence in decision may be the key to improving medication use in underserved populations. The Office-GAP Program could serve as a model for implementation of guideline based care for other chronic diseases in outpatient clinical settings. Further evaluation is needed to establish feasibility outside a clinical study, reach, effectiveness and cost-effectiveness of this approach.
CHD, Coronary Heart Disease; F/U, Follow up; NP, Nurse Practitioner; Office-GAP, Office-Guidelines Applied to Practice; PTC, Patient-Centered Method of Communication; RA, Research Assistant; SDM, Shared Decision-Making.
The authors thank Kim Eagle MD, Professor of Medicine, University of Michigan, a consultant to this project, Robert Smith MD, MS, Professor of Medicine, Michigan State University for teaching the Providers and Practice Staff, Patient Centered Interviewing Skills; We thank Dr. Sugandha Lowhim, Dr. Jeffrey Meier and patients and staff of Ingham Community Health Center for their time, and enthusiasm in support of this research. We want to thank the Foundation for Informed Medical Decision Making for supplying decision aids for use in this project. Finally, we thank Esha Kumar and Samanjit Kandola for their assistance with editing the manuscript.
The study was funded by a grant from Blue Cross Blue Shield of Michigan Foundation 1426. RFP.me7. The funding source had no involvement in any aspect of this study.
The datasets for the study are available from the corresponding author on reasonable request.
AO is responsible for the conception, design, implementation, evaluation and drafting of the manuscript; WHD, critical revision and review of the manuscript for important intellectual content; ZL, Statistical analysis and interpretation of the data and critical revision of the manuscript; KKB, critical review of the manuscript for important intellectual content, MHR, design, and critical review of the paper for important intellectual content. All authors read and approved the final manuscript.
Consent and Health Insurance Portability and Accountability Act (HIPAA) forms were completed during the group visit. All providers, practice staff and patients signed informed consent documents. The Michigan State University (MSU) Institutional Review Board (IRB) approved the study.
Diagnosed with (1) coronary artery disease, (2) peripheral vascular disease, or (3) diabetes mellitus combined with one other risk factor (for males' age > 50, or for females' age > 60).
Diagnosed with (1) angina, (2) congestive heart failure paired with left ventricular systolic dysfunction, (3) coronary artery disease, (4) myocardial infarction, or (5) peripheral vascular disease.
Diagnosed with either (1) congestive heart failure paired with an ejection fraction < 40, or (2) diabetes mellitus.
Diagnosed with (1) diabetes mellitus, (2) coronary artery disease, (3) hyperlipidemia, or (4) peripheral vascular disease.
Brief name: Provide the name of a phrase that describes the intervention.
Materials: Describe any physical or informational materials used in the intervention, including those provided to participants or used in intervention delivery or in training of intervention providers. Provide information on where the materials can be accessed (e.g., online appendix, URL).
Procedures: Describe each of the procedures, activities, and/or processes used in the intervention, including any enabling or support activities.
Who Provided: For each category of intervention provider (e.g., psychologist, nursing assistant), describe their expertise, background and any specific training given.
How: Describe the modes of delivery (e.g., face-to-face or by some other mechanism, such as internet or telephone) of the intervention and whether it was provided individually or in a group.
Where: Describe the type(s) of location(s) where the intervention occurred, including any necessary infrastructure or relevant features.
When and How Much: Describe the number of times the intervention was delivered and over what period of time including the number of sessions, their schedule, and their duration, intensity or dose.
Tailoring: If the intervention was planned to be personalized, titrated or adapted, then describe what, why, when, and how.
Modifications: If the intervention was modified during the course of the study, describe the changes (what, why, when, and how).
Planned: If intervention adherence or fidelity was assessed, describe how and by whom, and if any strategies were used to maintain or improve fidelity, describe them.
Actual: If intervention adherence or fidelity was assessed, describe the extent to which the intervention was delivered as planned.
Living With Diabetes, American Diabetes Association. http://www.diabetes.org/living-with-diabetes/. Accessed March 2015.


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Communication campaign to improve work conditions in the artisanal mining.
A true story about how after spending two months in Nicaragua volunteering in the artisanal mining, I created a communication campaign to bring work safety awareness into the artisanal mining community.
In Nicaragua, where the industrial mining and artisanal mining coexist, the situation is dangerous with extremely safety deficiencies and negative health consequences. The artisanal miners have no responsibility in many different aspects: they drink a lot of alcohol, they don't follow the safety standards, the environment is polluted, the mercury usage without the appropriate materials, etc. causing a lot of economic and family issues.
Through a volunteer experience in 2011, I was aware of the importance of the risks that artisanal miners face every day at work. My solution was to create a "Prevention of Occupational Risks" strategic campaign through to prevent, minimize and eliminate potential risks that cause accidents as well as avoid the dangers of pollution to the environment.
Raise awareness and communicate about the importance of prevention risks in the mining sector.
Artisanal miners have to be conscious about the safety measures and know how to use them in order to work properly and safely, as well as to know how to act effectively to any incident.
Mining Immersion - My lack of domain knowledge in the artisanal mining sector I needed to understand the nature of the lifestyle and work methods thoroughly and quickly during te volunteering project. I approached all aspects of the project collaboratively spending most of my time working on‑site with my co-workers in the artisanal mining work area, in the industrial mining company, and inside the mining.
I conducted ethnographic research and used participatory design methods to understand the life conditions in the community and also to compare the work conditions on both sides (industrial and artisanal mining).
We ran workshops and training about work safety and health and spent a lot of time researching about their lifestyle at work and outside work. This allowed me to quickly understand the day-to-day challenges of the artisanal miners and their families.
My research revealed the great importance in improving working and social conditions at the small-scale mining.
Better quality of life for the artisanal miners to envision a new communication system that would allow the artisanal miners and all the community to understand why they have to use the safety materials at work and how this will change their lifestyle in a better way, always being aware of all these changes and learn from each other.
Better thinking big, starting small - Although my vision was to create a high impact with a lot of applications that they would constantly persist on using the safety elements at work, I understood that it has to be the first change of their mentality to understand why they have to make the change and convince themselves that it would help in their life.
A new brand called 'Mina+Vida' was created to establish an effective channel of communication and generate a sense of self-identification with the project among the miners.
Visual Applications - Various applications and graphic supports were developed and used in different stages of communication such as Presentations, Manual, Flyers, Posters, Warning Signs and a website that would be used as a channel to reach all the people who are involved in Artisanal Mining in Nicaragua and other countries.


Public Allies' "Pathways" initiative is a series of trainings, activities, and programmatic interventions that provide our members with the necessary supports and structures to successfully transition to careers, higher education, and continued service.
By 2018, 65% of jobs in the U.S. will require at least some college, yet only 40% of American adults aged 25 to 34 have attained a postsecondary degree. People of color in particular continue to face significant barriers to college access and completion. Similarly, racial and socioeconomic barriers to meaningful and family-sustaining employment perpetuate inequality and limit the life chances of too many promising young people.
Our Education Pathway is an evidence-based initiative that transforms national service into a seamless bridge to college completion. It expands our proven AmeriCorps apprenticeship – comprised of full-time, work-based learning; 200 hours of personal success skills training; and individual support and coaching – by adding structured pathways to and through college.
Our Career Pathway expands the AmeriCorps apprenticeship and accelerates graduates' careers by providing intensive network building, professional skill building, career planning, and advancement supports.


text:
Stonewall é uma cidade  localizada no estado americano de Luisiana, na Paróquia de De Soto.

Demografia
Segundo o censo americano de 2000, a sua população era de 1668 habitantes.
Em 2006, foi estimada uma população de 1894, um aumento de 226 (13.5%).

Geografia
De acordo com o United States Census Bureau tem uma área de
19,3 km², dos quais 19,3 km² cobertos por terra e 0,0 km² cobertos por água. Stonewall localiza-se a aproximadamente 65 m acima do nível do mar.

Localidades na vizinhança
O diagrama seguinte representa as localidades num raio de 24 km ao redor de Stonewall.

Ligações externas

Cidades da Luisiana

redpajama_set_name: RedPajamaWikipedia


text:
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Home » Botched COVID-19 vaccination clinic latest disappointment for high-needs community in Gaithersburg
Posted inCoronavirus, Education & Family, Gaithersburg, Government
Botched COVID-19 vaccination clinic latest disappointment for high-needs community in Gaithersburg
Parents, advocates say MCPS, county need to rebuild trust
by Caitlynn Peetz November 17, 2021 10:00 am November 17, 2021 4:41 pm
A mishap administering the COVID-19 vaccine to students at South Lake Elementary School last week was the latest affront to the community's relationship with the school district and county government, parents and advocates said on Tuesday.
At South Lake Elementary School, more than half of the students are English language learners. It has one of the largest percentages (90%) of students eligible for free or reduced-priced meals, an indicator the district uses to measure poverty.
Last week, the county's Department of Health and Human Services sponsored a vaccination clinic for students at the school, aiming to target a community with people less likely to be able to travel to other clinics.
Five county youths died of overdoses in January, Jawando tells teens
Community advocates organized in the days leading up to the clinic, working to teach families — largely families of color, more likely to be skeptical — about the importance and safety of the vaccine. When the day came, they were pleased with the turnout.
Then, on Monday, county health officials announced that 98 students who got a COVID-19 shot at the school would need to be revaccinated because their doses had been too diluted. Many parents found out through news reports, and were still waiting for a call or email from the health department on Tuesday afternoon.
In a press release on Monday night, the department wrote that the doses were "diluted more than recommended" and affected students are being asked to get the shot again as soon as possible.
The county has said human error was to blame.
"We apologize for the error, and we are offering another opportunity for the children to be revaccinated," James Bridgers, the acting county health officer, said in the press release. "We are confident that this is an isolated situation and staff have already received additional training on reconstituting and administering pediatric doses."
"I feel guilty because I advocated … to get them vaccinated," South Lake parent Adama Moussa Harouna said. "In a community where there's a lot of people who mistrust the vaccine, we did the advocacy … and this is what we get."
Moussa Harouna said her two children, ages 5 and 10, were both vaccinated at the clinic. She said health department leaders need to better explain what went wrong and apologize directly to families.
"We partnered with all of these people for a community that's been ignored for a long time," she said. "We got their trust and … we want to build trust again."
Health officials were expected to hold a meeting with community members on Tuesday night to discuss the mistake and answer questions.
Another clinic will be held at the school on Wednesday, so the affected students can receive an additional dose.
While South Lake parents are frustrated about the vaccination debacle, they say it's the culmination of years of letdowns that's most concerning.
For at least three years, the community has asked police for a crossing guard to help manage traffic around the school at dropoff and pickup times. In the same time frame, three students have been hit by cars trying to walk to or from the school, parent Adoree Betancourt said.
The South Lake community also spent years advocating for a new school. They highlighted persistent rodent infestations, air quality and HVAC malfunctions, and lack of Americans with Disabilities Act (ADA) compliance.
Last year, MCPS leaders acknowledged the problems, calling them "insurmountable" with routine maintenance. The school board, and later the County Council, approved a $5.8 million budget appropriation to fund a rebuild of the school.
The project, scheduled now to be completed in 2023, includes tearing down the existing school, built in 1972, and replacing it with a new building.
Advocates were excited about the project's approval, but disappointed it took years of pressure and watching other schools with what they perceived to have less urgent needs get addressed first.
To many, it represents a pattern of county agencies neglecting some of their highest-needs students.
Asked what it will take to rebuild trust, Betancourt said: "Treat us fairly."
"They talk about equity," she said, "but we don't see any equity at South Lake."
Caitlynn Peetz can be reached at caitlynn.peetz@bethesdamagazine.com
COVID closures hurt disabled kids. Now some can't get MCPS services to catch up, advocates say.
High school student advocates block Rockville street for social housing, tenant protection
Two former educators compete for District 3 Board of Education seat
Planning Board should push transparency, service to public over developers, GOP applicants say
Book Report: New titles by local authors
Two shot Tuesday in Gaithersburg, police say
Montgomery County launches bid to house new ARPA-H federal agency
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redpajama_set_name: RedPajamaCommonCrawl


The ESR and EuroSafe Imaging are proud to announce the publication of the European Guidelines on Diagnostic Reference Levels for Paediatric Imaging in the European Commission's Radiation Protection Series.
Gadolinium @ ECR 2018 – diverse and "disunited"?
The first comprehensive European advice on deep vein thrombosis is published in the current issue of European Heart Journal. The recommendations were produced by the European Society of Cardiology (ESC) Working Group on Aorta and Peripheral Vascular Diseases and Working Group on Pulmonary Circulation and Right Ventricular Function.
With 4,500 accepted abstracts, 600 sessions and 30,000 expected attendees, ESC Congress 2017 is undoubtedly the world's largest cardiovascular event. On healthcare-in-europe.com, Dr Stephan Achenbach, Congress Program Committee Chairperson, gives an overview of issues and events unfolding in Barcelona from August 26-30.


text:
Q: How to add custom title for form fields in Django? I created this simple form:
class FormsProject(forms.Form):
    fullname = forms.CharField(
        widget=forms.TextInput(attrs={'class': 'form-control mb-3', 'placeholder': 'Basir Payenda'}))
    Django = forms.BooleanField(widget=forms.CheckboxInput())
    Flask = forms.BooleanField(widget=forms.CheckboxInput())
    gender = forms.ChoiceField(
        widget=forms.RadioSelect(), choices=SELECT_GENDER)
    comments = forms.CharField(widget=forms.Textarea(attrs={
        'class': 'form-control mb-2',
        'rows': 4,

    }), help_text='Write here your message!')

and it looks like

How do I add a title asking something like "Your favorite frameworks: " before those checkbox, let me illustrate it:

Help me add that title before checkbox, thanks

A: You can rendering fields manually, for example:

    {{ form.fullname.label }}
    {{ form.fullname }}
    {{ form.fullname.errors }}

Your favorite frameworks

    {{ form.Django.label }}
    {{ form.Django }}
    {{ form.Django.errors }}

    {{ form.Flask.label }}
    {{ form.Flask }}
    {{ form.Flask.errors }}

See this docs for more https://docs.djangoproject.com/en/dev/topics/forms/#rendering-fields-manually

redpajama_set_name: RedPajamaStackExchange


Discreetly nestled in the heart of the North Shore's most desired suburbs, Clyde Gardens offers a private retreat with spectacular views, from the bush to the city.
A development unique for its focus on lifestyle. A solid double brick construction.Nestled in a private, leafy cul de sac these apartments feature generous proportions, outdoor terraces or balconies and many with sweeping district views.
Harvie Group became the key selling agent for this development and is the preferred managing agent with most of the investment apartments managed by Harvie Group Real Estate.


text:
// --------------------------------------------------------------------------------------------------------------------
// <copyright file="IPersistedObject.cs" company="James Dibble">
//    Copyright 2012 James Dibble
// </copyright>
// --------------------------------------------------------------------------------------------------------------------
namespace Dibble.Framework.Data
{
    using System.Diagnostics.CodeAnalysis;

    /// <summary>
    /// Implementing classes represent an object to be managed by an <see cref="IPersistenceManager"/>.
    /// </summary>
    [SuppressMessage("Microsoft.Design", "CA1040:AvoidEmptyInterfaces",
        Justification = @"This is a marker interface.
        Because we are trying to keep domain objects clean an attribute is inappropriate.")]
    public interface IPersistedObject
    {
    }
}

redpajama_set_name: RedPajamaGithub


Start your day with our rich breakfast buffet. In our restaurant the chef and his team will prepare a delicious dinnerbuffet.
If our restaurant is closed, you can eat at one of our partner restaurants in Passau.


Each property has a key value which results from several factors, which include the size, the area, the amenities and other factors, which may be the height, the overall state and all the equipment housed inside, which the owner would leave in the property. Of course, as you will see, there are tons of ways you can raise the value of your property. Let's show you a few of these sell my home fast tips.
This means, if you can provide with a high quality, possibly brand new , but most importantly great looking, all equipped kitchen with a great countertop space, a squeaky clean bathroom, where taps, sinks and the furniture is either brand new or it looks the part and you can show lots of storage space ( and space in general) you are winning. All these can make you topple your home's original value with great deal of extra without a problem.
If you have any sort of an outdoor space, where you can put a table for two at least, some great looking pots and lush plant, then do it, and make it look as fabulous as possible. Colourful lanterns can serve as a great addition to the overall scene. The same goes for balconies, terraces and backyards too.
Many people, who don't use their garage would use it as an additional storage space. But in fact, it can add value to your home brilliantly as a garage. Make sure you empty it and clean it before you put up a listing. Many people would love to have a garage. So make sure you can show it to them.
From the entryway it should be easy and effortless to get in any other rooms of your property. This is what is called a good flow. Pack, move or drop away everything that makes getting ahead difficult or uneasy.
Living room especially should be light and spacious. Even if you can achieve this by only leaving a sofa, a small table and a lovely lush plant inside, do it. In addition, don't ever enlist your property all empty. Empty rooms look visibly smaller which makes imagination run much more poorly than in the rooms which have a couple of furniture. This is why the job of staging was born.
Make it look as beautiful from the outside as possible. Entryways do count a lot in the eyes of many. Make the effort, bring in some bushes, have it cleaned and you will see that it will pay off.


text:
Q: linux daemon can't run python file I'm using a raspberry pi with Raspbian and I try to do this:
I made a file myservice.sh  in etc/init.d
...
DIR=/var/www/MDH/python
DAEMON=$DIR/myserv.py
DAEMON_NAME=myserv
DAEMON_USER=pi
PIDFILE=/var/run/$DAEMON_NAME.pid
...
do_start () {
echo "Starting system do_start $DAEMON_NAME daemon"
start-stop-daemon --start --background --pidfile $PIDFILE --make-pidfile --user $DAEMON_USER --chuid $DAEMON_USER --startas $DAEMON -- $DAEMON_OPTS
echo "Started $DAEMON"
}
do_stop () {
...
ccase "$1" in

start|stop)
    do_${1}
    ;;

restart|reload|force-reload)
    do_stop
    do_start
    ;;

status)
    status_of_proc "$DAEMON_NAME" "$DAEMON" && exit 0 || exit $?
    ;;

*)
    echo "Usage: /etc/init.d/$DAEMON_NAME {start|stop|restart|status}"
    exit 1
    ;;

esac
exit 0

When i run sudo service /etc/init.d/myservice.sh start the prompt is ok:
Starting system do_start myserv daemon
. ok
Started /var/www/MDH/python/myserv.py

But if I do sudo service /etc/init.d/myservice.sh status my script is not running:
[FAIL] /var/www/MDH/python/myserv.py is not running ... failed!

If I try to run python script with python /var/www/MDH/python/myserv.py and it work OK.
Any idea to implement log or for debug better the script.

A: I have moved the script in python in the user folder:
\home\pi\
execution permission for my script
chmod +e myserv.py
also I add in myservice.sh:
#-------------------------------------------------------------
#! /bin/sh
### BEGIN INIT INFO
# Provides: MDH daemon
# Required-Start: $all
# Required-Stop:
# Default-Start: 2 3 4 5
# Default-Stop: 0 1 6
# Short-Description: daemon MDH 0.1
# Description: bla bla bla... MDH.
### END INIT INFO

now with
service myservice.sh start
the python script work ok and the status,stop and restart are working good.
Why in folder /var/www/MDH/python/myserv.py not work???


text:
Counties Position Themselves to Defy Supreme Court Ruling
It seems that several counties in Tennessee are standing fast to uphold Biblical marriage against the Supreme Court's illegal ruling to redefine it to include sodomites.
The illegal and unconstitutional ruling of the Nazi-like supreme court regarding marriage this past summer was not only illegal, but a complete infringement upon the Constitution and the united States of America, led by none other than the queen of queerifying Harvard, Elena Kagan.
WND reports:
In Johnson County, officials voted "to affirm and go on record that Johnson County is vehemently opposed to the Supreme Court's decision in Obergefell et al v. Hodges and supports the decision of any elected/appointed official challenging that unconstitutional decision."
In Greene County officials adopted a very similar statement that pointed out that "since this country's founding [states] have regulated and defined marriage without interference from the federal government or its courts."
In McMinn County, officials pointed out the text of the Ninth and Tenth Amendments to the U.S. Constitution "reserves all powers not explicitly delegated to the federal government to the people and the states."
The votes weren't close. Johnson County's was approved 15-0. McMinn's was 10-0 and in Greene, it was 17-2.
Other counties are also drawing up similar nullification resolutions, including McMinn County and Blount County. In fact, Blount County Commissioner Karen Miller sponsored a resolution that states, "We adopt this resolution before God that he pass us by in His coming wrath and not destroy our county as He did Sodom and Gomorrah."
The first and most important thing to consider in the marriage issue is that all legislative power in the federal jurisdiction is placed within Congress. However, the issue of marriage is not within their authority to make law on.
Second, the Judicial Branch does not have any authority to rule on the issue of marriage as their enumerated powers do not give them that jurisdiction.
Leading the charge against the illegal ruling of the supreme Court, is the American Principle's Project.
"It cannot … be taken to have settled the law of the United States," said a statement by the American Principles Project.
"We call on all federal and state officeholders: To refuse to accept Obergefell as binding precedent for all but the specific plaintiffs in that case," read the statement. "To recognize the authority of states to define marriage, and the right of federal and state officeholders to act in accordance with those definitions. To pledge full and mutual legal and political assistance to anyone who refuses to follow Obergefell for constitutionally protected reasons. To open forthwith a broad and honest conversation on the means by which Americans may constitutionally resist and overturn the judicial usurpations evidence in Obergefell."
The project cited James Madison, who wrote, "The several departments being perfectly co-ordinate by the terms of their common commission, neither of them, it is evident, can pretend to an exclusive or superior right of settling the boundaries between their respective powers."
They also quoted Abraham Lincoln, who said, "Judicial decisions are of greater or less authority as precedents, according to circumstances. That this should be so, accords both with common sense, and the customary understanding of the legal profession." If a decision "had been made by the unanimous concurrence of the judges, and without any apparent partisan bias, and in accordance with legal public expectation, and with the steady practice of the departments throughout our history, and had been in no part, based on assumed historical facts which are not really true; or, if wanting in some of these, it had been before the court more than once, and had there been affirmed and re-affirmed through a course of years, it then might be, perhaps would be, factious, nay, even revolutionary, to not acquiesce in it as a precedent."
The project then stated:
We stand with James Madison and Abraham Lincoln in recognizing that the Constitution is not whatever a majority of Supreme Court justices say it is.
We remind all officeholders in the United States that they are pledged to uphold the Constitution of the United States, not the will of five members of the Supreme Court.
We call on all federal and state officeholders:
To refuse to accept Obergefell as binding precedent for all but the specific plaintiffs in that case.
To recognize the authority of states to define marriage, and the right of federal and state officeholders to act in accordance with those definitions.
To pledge full and mutual legal and political assistance to anyone who refuses to follow Obergefell for constitutionally protected reasons.
To open forthwith a broad and honest conversation on the means by which Americans may constitutionally resist and overturn the judicial usurpations evident in Obergefell.
While many in our culture are pushing for an Article V convention to stop federal tyranny (something Article V was never designed to do since words do not stop lawbreakers from breaking more laws), including out of control federal courts, nullification and interposition is the method advanced by the founders. It is the power of the states to do so since the DC government is their creature; the states are not the creature of the DC.
Courtesy of Freedom Outpost.
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Atwater Village residents, business owners, city agencies and volunteers came together on this past Saturday, October 1, to make our village sparkle and shine. Friends of Atwater Village (FAV) would like to express our heartfelt thanks to everyone who helped make our community cleaner and greener.
As part of a team effort the Atwater Village Chamber of Commerce and FAV was awarded a $2,500 "Clean and Connected Communities" grant for our "Make 'em Sparkle Make 'em Shine" beautification project. This joint project focused on sprucing up the commercial corridors of Glendale Blvd and Fletcher Dr. "Make 'em Sparkle Make 'em Shine" entailed steam cleaning, repairing and painting of the historic tile trash receptacles; as well as repainting and replanting the plant containers all along Glendale Blvd. Fletcher Dr will soon get its graffiti abatement murals cleaned and touched up – including a fresh application of anti-graffiti coating. And the river rock parkway at the corner of Larga Ave and Fletcher Dr also got weeded and cleaned.
Besides these projects many volunteers helped to remove weeds from around tree wells, curbs and gutters, picked up trash, swept the streets through out the neighborhood and some of the businesses had their sidewalks steam cleaned.
In addition, the Atwater Village Neighborhood Council (AVNC) was also awarded a separate grant and has already started working on improving and beautifying the landscaping of the median down Glendale Blvd. The AVNC has started their planting of drought tolerant plants on the Glendale Blvd median between Glenfeliz Blvd and Larga Ave.
It does take a village to keep our village beautiful. Again, thanks to everyone who worked so hard to make Atwater Village sparkle and shine.


Tropicana Co-Op - Sales - Windows, Windows and More Windows!!!
Windows, Windows and More Windows!!!
Windows, windows and more windows! If you love the beautiful Florida sunshine and bright blue skies (and who doesn't), then this beautiful home in a 55 plus land lease community is the one for you! This roomy open home boasts a huge kitchen with breakfast bar, separate dining room, spacious master bedroom with walk in closet and vanity area.The evening shaded screen room provides plenty of room for you and all you're new friends to enjoy happy hour. With over 1100 square feet this home won't last long! CALL TODAY for YOUR SHOWING!


text:
Barrington Public Schools
Bay Spring Community Center
Barrington Learning Center
Bristol County Water Authority
Barrington Land Conservation Trust
Preservation Society & Museum
History of Barrington
State of Rhode Island
Charter and Ordinances
See Executive Order 2022-1
See additional information about the Down Payment Assistance Program
Council Agendas, Minutes, etc.
Town Council (with Meeting Videos)
Proposed Ordinances
Government Bids | Job Openings
Public Library - Calendar
Assessor's Database
Receive Town e-News via i-Contact
NEW: Daily Fire Index Rating
For details, see Ordinance and Addendum
Place Your Order for FREE
At-Home COVID-19 Tests
Residential households in the U.S. can order one set of 4 free individual rapid antigen COVID-19 at-home tests (Limit of one order per residential address). Order here: https://special.usps.com/testkits
New Refuse and Recycling Holiday Collection Schedule
All refuse and recycling will be collected the following day during holiday weeks. Monday's scheduled collection becomes a Tuesday collection. Tuesday's scheduled collection becomes a Wednesday collection and ends with a Friday's scheduled collection becoming a Saturday collection. The normal refuse and recycling will continue afterwards.
Barrington Town Manager Responds to Surging COVID-19 Cases Issues with Executive Order Requiring Remote Meetings
Continues Requirement to Wear Face Mask in Municipal Buildings
The Barrington Town Manager issued a new executive order today requiring all public meetings of Town public bodies and departments to be held remotely, with no in-person option.
Executive Order 2022-1, which is effective immediately, also continues the requirement to wear a mask in municipal buildings, regardless of a person's vaccination status.
The action by Town Manager Philip Hervey was issued following Governor McKee's new executive order authorizing public meetings to be held by telephone or audio or video conferencing.
"In person meetings are certainly preferable, but the remote option will help reduce exposure to this wave of infections resulting from the highly infectious Omicron variant," Hervey said.
The Town strongly recommends the use of N95, KN95 or 3-ply surgical masks rather than the less effective cloth coverings.
The Manager's executive order will remain in effect until terminated or superseded by a subsequent order.
Winter Storm Alert
Town Hall, Peck Center for Adult Enrichment and the Barrington Pubic Library are closed today, January 7th.
Rubbish and recycling collection rescheduled
Due to the impending snowstorm, there will be no rubbish or recycling collection on Friday, January 7th. Friday's collection will be Saturday, January 8th.
Parking Ban
There will be a town-wide on-street parking ban starting at 8:00 pm tonight, January 6th until further notice. Barrington's Limited Winter Parking ordinance indicates there is no parking after snowfall of 1" for a 12-hr period after a snowfall. https://ecode360.com/7120823.
Snow and Ice Removal Information
Barrington businesses and residents, let's ensure our sidewalks are shoveled. We can work together to provide a safe route for all citizens and children near our local schools and businesses who utilize the sidewalks this winter season. https://ecode360.com/7120701#7120713
Peck Center for Adult Enrichment
Lunches and programming have been canceled for Friday, January 7th.
All other Town Hall services will continue unless stated otherwise. Please check back for updates.
COVID-19: Barrington Update
Barrington residents,
This update is provided to assist you in staying safe during the holiday season as you gather with relatives and friends.
Governor Dan McKee Announces New Covid-19 Mitigation Measures
Governor McKee announced actions to address the significant increase in COVID-19 cases and pressure on Rhode Island's hospitals. These measures include masking or proof of vaccination at certain indoor venues, including entertainment venues, retail, places of worship, manufacturing, and offices.
Masking is required of employees and patrons inside venues with a capacity of 250 or more regardless of vaccination status.
Masking or proof of vaccination is required of employees and patrons inside venues with a capacity of fewer than 250 persons.
These temporary measures went into effect on Monday, December 20, 2021 and remain in full force and effect through Tuesday, January 18th, 2022 unless renewed, modified, or terminated by a subsequent Executive Order.
The COVID-19 testing site at the former Joseph A. Bank in Barrington Plaza remains open. For more information go to: https://covid.ri.gov/testing.
To understand what you need to do as a member of the public or a business owner, please see the links to resources below or visit the Rhode Department of Health COVID-19 Information Website.
12/15/2021 Press Release and Executive Order
RIDOH's Frequently Asked Questions
RIDOH's Information for Workplaces
Schedule a Vaccination Appointment
Schedule a COVID-19 Test
A reminder that the mask mandate remains in effect for all municipal and school buildings.
Stay Safe and Happy Holidays
Town of Barrington selects new Director of Planning, Building and Resiliency
See Press Release
Teresa Crean to serve as the
new Director of Planning,
Building and Resiliency effective January 10, 2022.
The Town of Barrington is pleased to announce the hiring of Teresa Crean as Barrington's next Director of Planning, Building and Resiliency. Crean has worked as a coastal community planner at the URI Graduate School of Oceanography's Coastal Resources Center and RI Sea Grant for the past 14 years. A resident of North Kingstown, Crean will be joining the Barrington team as of January 10, 2022. She is filling a vacancy created by the appointment of Philip Hervey to serve as Barrington Town Manager starting on January 1st. Crean earned a Master of Landscape Architecture from the State University of New York, College of Environmental Science and Forestry. She has a Bachelor of Science degree in natural resources from the University of Michigan.
Town Council selects new Town Manager
Philip Hervey to serve as the Town Manager effective January 1, 2022.
Mr. Hervey has served as the town's planner for over 15 years. He received his B.A. in Economics from the University of Maryland at College Park. He also received his Master's Degree in City & Regional Planning from UNC - Chapel Hill. Mr. Hervey has overseen various municipal projects for the town, such as Latham Park Phases 1 and 2, Town Beach recreation and water quality improvements, and the LED streetlight conversion project. In addition, he helped to secure approximately 50 grants totaling more than $6.4 million for Barrington. Mr. Hervey has been a recipient of several awards from the Rhode Island Chapter of American Planning Association.
Events, Alerts, Job Openings, Etc.
Email jbellm@barrington.ri.gov to submit requests to list an upcoming event on Community Calendar
Let's Hear from You!
Carmelite Monastery. Click here to submit your ideas on the future use of the Carmelite Monastery property. In the coming months, the Town will be a launching a public planning process to identify the community's goals and objectives that will provide a basis for evaluating developers' proposals to develop the property. In the meantime, the Town wants to hear what you think!
American Rescue Plan funds. Click here to submit your ideas on how to spend $4,700,000 in American Rescue Plan funds the Town will be receiving.
Community Electricity Aggregation Program
Goal is to expand access to clean electricity at competitive rates
Primer: What is Community Electricity Aggregation?
The Town of Barrington, along with the cities of Providence and Central Falls and the Town of South Kingstown, received approval from the Public Utilities Commission (PUC), for the state's first Community Electricity Aggregation (CEA) programs, also known as municipal aggregation. Together these communities represent nearly 20% of all households in Rhode Island.
The program launch will take place in early 2022, to include an extensive public outreach campaign.
Each municipality's plan sets out a vision to provide competitively sourced and cleaner electricity as the new default in their communities. The plans also offer optional products to maximize affordability or environmental benefit. Community Electricity Aggregation, or CEA, allows a municipality to procure electricity in bulk for residents and businesses, with the goal of increasing the renewable content of the electricity used by the entire community while keeping the supply rate stable and affordable.
National Grid Electrical
Distribution Interruptions
Click here for 2015 - 2020 Customer Interruption details for the following Towns: Barrington, Bristol, Middletown, Portsmouth, Tiverton and Warren.
Apply to "Adopt-A-Spot"
The Adopt-A-Spot program was created to meet a need of our community. The program allows volunteers to keep a portion of public areas beautified and properly maintained. Volunteers are allowed to adopt a spot that is important to them, their families, and their community. All public spaces are eligible for adoption such as: traffic islands, medians, and town owned lots, streets, and parks.
Adopt-A-Spot Program Guidelines
Get Application: Word | PDF
Accessing Town Clerk Services During Covid-19
Urging Residents to Use Online and Mail Services. As you know, the Coronavirus (Covid-19) is in RI and diligence must be made to prevent the spread. In that effort, the Town of Barrington is advising residents and businesses to take advantage of its Online, Mail-in services and utilization of the Town's Drop Box located at the left front door of Town Hall. For more information, please visit the Town Clerk's page.
Barrington Village: Neighbors helping neighbors remain in their community as they age.
Visit www.villagecommonri.org, and select Barrington Village in Our Villages tab for details.
Contact us by phone at (401) 400-5599
to speak with a volunteer,
Monday-Friday, 9-5. Or by email at barrington@villagecommonri.org
Eco-Depot - Disposal of Household Hazardous Waste
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text:
Q: JSON Definition inside JSON Object inside Schema not Obeying Enums: Python jsonvalidation I am writing a vcxproj generator for my own personal use. Part of this project is having me learn about JSON schema. Below is the Schema I have defined. (Problem defined after schema).
    self._schema = {
        'definitions': {

            ...

            'project_settings': {
                'required': ['configuration', 'platform'],

                'type': 'object',
                'properties': {
                    'platform': {
                        'enum': ['x86_64', 'Win32']
                    },
                    'connfiguration': {
                        'enum': ['Release', 'Debug']
                    },

                    ...

                }
            }
        },

        # Start of actual requirements
        'type': 'object',
        'properties': {
            'project_configurations': {
                'type': 'array',
                'minItems': 1,
                'items': {
                    'allOf': [{'#ref': 'definitions/project_settings'}]
                }
            }
        },
        'additionalProperties': False,
        'required': ['project_configurations'],
    }

My issue resides in the #definitions/project_settings/configuration and #definitions/project_settings/platform. If I provide the following JSON to be validated by python's jsonschema.validate it is considered valid, when I think the enums should be failing.
{
  "project_configurations": [
    {
      "configuration": "taoshwu",
      "platform": "esostat"
    }
  ]
}

A: The $ref keyword is not correct.
Try:
'$ref':'#/definitions/project_settings'


Lessons and custom fitting are available here at Sleaford Golf Club, so no need to travel miles to be fix your game or to trial that new club you've been wanting. Whether you want to take part in a group coaching session at a cost of £10.00 per person or you'd prefer an individual lesson that costs £18.00 per ½ hour we can accommodate your requirements. We can even offer on course 10 hole playing lessons to aid your course management for £35.00. We also offer Junior Coaching Clinics every Saturday morning from 9.00am for only £3.00 per child with no need to book. For those that want a more in depth and detailed analysis of their game we can also offer a 1 hour Flightscope lesson at £35.00 which includes a performance data report, which can be forwarded on to you for future reference. With the aid of our Flightscope launch monitor we are also able to offer a full custom fitting service for Titleist, Callaway and Ping golf equipment. You will be taken through every step of the process from loft and lie angle, shaft length and flex, right through to grip size. Custom fitting takes around 1 hour and costs £20.00 per session which gets refunded in golf balls should you wish to purchase a club.
All full swing lessons and custom fittings take place on our main practice ground which is only a short walk from the Clubhouse. Whether you want to improve your driving, fairway woods or your long bunker shots, this is the place to come. For pitching and greenside bunker shots we can utilise the 6 hole short course which offers a wealth of different shots and lies that you will encounter on any course. Next to the 1st tee is our practice putting green which we can use to hone your technique for all those delicate chips, along with the most vital part of the game, putting. Also adjacent to the 1st tee are two practice nets which can be used before play to loosen up the swing before that vital game.
We offer a comprehensive custom fitting opportunity thanks to Titleist, Callaway and Ping. We were one of the first golf clubs to have the Flightscope launch monitor in the county. The Flightscope is a 3D Doppler radar that accurately measures the launch and flight of the ball and the path and attack angles of the club. It provides quantitative data about player and equipment performance. Flightscope is able to track speeds extremely accurately and determine ball positions to within single yards. Measurements include: ball and clubhead speeds, launch angles, spin rates, carry distance, total distance, hang time and height. On average people who have been fitted here at Sleaford Golf Club have seen their handicaps reduce by an average of 1.25 strokes and seen their driving distance increase by 11 yards. I'm sure you would like to do the same. Fittings cost £20.00 and take around 1 hour. There is no obligation to buy but if you do you will receive £20.00 worth of golf balls.


text:
Q: Adding The Sum Of Nested List In Scheme I'm using scheme. I'm having no problems in finding the sum of a certain list but I'm quite having trouble in adding the sum when a list has a list in it or AKA Nested List.
(define (my-summation li)
(if (null? li)
  0
  ((if (list? (car li)) (my-summation (car li))
  (+ (car li) (my-summation (cdr li)))))))

This was my input and this was the result of the error. Scheme is my weakness since it involves recursion but I can't seem to find the problem.
> (my-summation '(6 3 -2 5 '(4 2 -3) 4 ))
function call: expected a function after the open parenthesis, but received -3

A: Its in the parentheses, you have an extra set around the if. Also you don't need to quote a list when it is in a quoted list. And the (list? (car li)) case was incorrect, it should sum the element and the rest of the list.
(define (my-summation li)
  (if (null? li)
      0
      (if (list? (car li))
          (+ (my-summation (car li)) (my-summation (cdr li)))
          (+ (car li) (my-summation (cdr li))))))

(my-summation '(6 3 -2 5 (4 2 -3) 4))

Results in a sum of 19.

A: An alternative solution:
(define (sum-list xs)
  (define (loop sum-so-far xs)
    (cond
      [(null? xs)        sum-so-far]                              ; no-more-elements
      [(pair? (car xs))  (loop (+ sum-so-far (sum-list (car xs))) ; the first element is a sublist
                               (cdr xs))]                         ;   so sum-list computes its sum
      [else              (loop (+ sum-so-far (car xs))            ; the first element is a number
                               (cdr xs))]))                        ;  so it is added directly
  (loop 0 xs))

(sum-list '(6 3 -2 5 (4 2 -3) 4)) ; note: no quote in the middle

; ==> 19


text:
require "railsify/version"

module Railsify
  # Your code goes here...
end


text:
Jamie Lee Curtis quotes
Her role as Laurie Strode in 'Halloween' (1978)
Background:A two-time Golden Globe winner for Best Actress (True Lies, 1995 and Anything but Love, 1990,TV) Jamie Lee Curtis established worldwide fame after portraying the funny character of Helen Tasker in True Lies, and Hannah Miller in Anything but Love. The role in True Lies also handed her an American Comedy award for Funniest Actress in a Motion Picture (Leading Role) in 1995. Additionally, Curtis was well remembered for her supporting role as prostitute Ophelia in the 1983 comedy Trading Places. Her spectacular performance won both a BAFTA and a British Academy award in 1984.Perhaps the most remembered role associated with Curtis is that of tormented young Laurie Strode in John Carpenter's horror 1978 classic Halloween. The legacy of twisted psychotic Michael Myers still screams across televisions every Halloween and gave birth to an entire legend of sequels: Halloween II (1981), Halloween III: Season of the Witch (1982), Halloween H20: 20 Years Later (1998), and Halloween: Resurrection (2002).Off screen, Curtis reportedly has bad taste in clothing and trouble with choosing colors, textures and styles, and often misses the mark.She loves renting designer clothes to overcome the problem and rents because she prefers to return them once they are worn because she hates hoarding clothes.Currently, Curtis spends time giving support to a variety of charitable groups. She was a guest at the 11th annual Gala and Fundraiser in 2003 for Women in Recovery, Inc, which is a non-profit organization that offers a live-in, 12-Step program for the rehabilitation of women.Introvert GirlChildhood and Family:Daughter of actor legends Tony Curtis and Janet Leigh, Jamie Lee Curtis was born on November 22, 1958, in Los Angeles, California. Her mom and dad divorced when she was almost three. Due to the separation of her parents, Jamie Lee and sister Kelly Lee were raised by their mother, who remarried stockbroker Robert Brandt soon after the divorce.During her teen years at Beverly Hills High School, Jamie had difficulty making friends because she felt the school was not appropriate for her. She also experienced difficulties living with her stepfather doe to his problems with drugs and alcohol. Jamie Lee eventually moved to Choate Rosemary Hall private school and graduated in 1976. She then continued her studies by attending the University of the Pacific in Stockton, California, but left after one semester to pursue a career in acting.Jamie married actor Christopher Guest (born on February 5, 1948) on December 18, 1984. Shortly after their marriage, the couple established Syzygy Industries and adopted two children, Thomas Haden-Guest (born in 1996) and Annie Guest (born in December 1986).Scream QueenCareer:After appearing in Columbo: The Bye-Bye Sky High I.Q. Murder Case (1977, TV), Jamie Lee Curtis drew attention from the TV sitcom Operation Petticoat (1977-1978, played Lt. Barbara Duran). Her big break came when Curtis, nicknamed the Scream Queen, was cast in several horror movies. She starred in John Carpenter's Halloween (1978, played Laurie Strode) and reprised her role in Halloween II (1981). She followed it up with films like The Fog (1980), Prom Night (1980), and Terror Train (1980).In 1983, Curtis made a big transition to comedian when she received the supporting role of prostitute Ophelia in Trading Places (1983, starred Dan Aykroyd and Eddie Murphy). Curtis attracted Hollywood's attention when she appeared topless and showed off her fantastic body in a scene she often referrers to as the "Freeze Frame." Additionally, her outstanding performance handed her a BAFTA and British Academy award for Best Supporting Actress in 1984. Subsequent roles in Love Letters (1984) and Grandview, U.S.A. (1984) added to her popularity though her performance in the movie Perfect (1985) was a temporary slowdown.A comedy named A Fish Called Wanda (1988) gave Curtis the opportunity to again show off her talent and she received a Golden Globe nomination the following year. Curtis' significant performances in the TV Series Anything But Love (1989, played Hannah Miller), rewarded Jamie with a Golden Globe for Best Actress in a Series (Musical or Comedy) in 1990.At the beginning of the 1990s, Curtis had such wide screen projects as Blue Steel (1990), Queens Logic (1991), My Girl (1991), and Mother's Boys (1994). She also tried her hand in writing children's books and penned: When I Was Little: A Four-Year-Old's Memoir of Her Youth (1993) and Tell Me Again About the Night I Was Born (1996).Curtis played the role of Helen Tasker in 1994's hilarious action hit True Lies (also starring Arnold Schwarzenegger). Due to her spectacular performance in the film, Curtis won her second Golden Globe for Best Performance by an Actress in a Motion Picture - Comedy/Musical in 1995. In the same year, the role also handed her an American Comedy award for Funniest Actress in a Motion Picture (Leading Role). Regarded by some critics as her best work, True Lies boosted Curtis' career. She next played leading roles in the movies Virus (1999), Forever Young (1992, also starred Mel Gibson), My Girl 2 (1994), Fierce Creatures (1997), Halloween H20: 20 Years Later (1998) and Drowning Mona (2000).In 2000, Curtis provided the voice of Clara in the television series Pigs Next Door and appeared as a host at the 5th Annual Prism Awards (2001). She was also seen starring with Oscar-winner Geoffrey Rush and Pierce Brosnan in the film The Tailor of Panama (2001) and had the supporting role of Elaine Bowen in Daddy and Them (2001). That same year, Curtis lent her voice to Queen Camilla in the video Rudolph the Red-Nosed Reindeer & the Island of Misfit Toys. Curtis also had a cameo in Halloween: Resurrection (2002).The following year, Curtis was seen in the family-oriented blockbuster Freaky Friday (2003, with Lindsay Lohan). Although Curtis said she would retire from making movies after Christmas with the Kranks (2004, played Nora Krank), Curtis is scheduled to appear in The Kid & I (2005).Awards: Hasty Pudding Theatricals: Woman of the Year, 2000. American Comedy: Funniest Actress in a Motion Picture (Leading Role), True Lies, 1995. Golden Globe: Best Performance by an Actress in a Motion Picture - Comedy/Musical, True Lies, 1995. Golden Globe: Best Actress in a Series (Musical or Comedy), Anything but Love, 1990. BAFTA: Best Supporting Actress, Trading Places, 1984. British Academy: Best Actress Supporting, Trading Places, 1984. NATO: Star of Tomorrow, 1980.
I was doing a children's book on self-esteem, and I really felt like I wanted to shed the shame I'd been feeling - and maybe make it easier for women my age who had probably felt bad about themselves.More Jamie Lee Curtis quotes [03/29/2018 05:03:36]
Actually, the books were never a planned career path.More Jamie Lee Curtis quotes [03/29/2018 05:03:36]
I recommend it to all people: Get down on the floor and look at the world from where the child looks at it.More Jamie Lee Curtis quotes [03/29/2018 05:03:36]
I've been happily married to Chris for almost 20 years.More Jamie Lee Curtis quotes [03/29/2018 05:03:36]
The same way that mid century modern architecture was in the 50s, I want to be as a human being. New. Different. Challenging the old. Function over frivolity. Clean living. Clean lines.More Jamie Lee Curtis quotes [03/29/2018 05:03:36]


JUST WAIT UNTIL YOU SEE OUR NEW LOOK! Magnolia Court is in the midst of some exciting changes. Some of our new apartment features include ceramic tile, dark simulated wood planking, designer paint, granite countertops and crown molding. And our location, just off 290 and IH-35, is close to several major employers and only minutes from downtown. So come visit us at Magnolia Court, where every resident is treated like a welcome guest.


Check out our next event.... alien flash!! We're giving away a free tattoo or piercing to our best dressed customer! Alien/space themed costume contest entries accepted until 4pm! Break out your galaxy leggings and star shaped glitter to celebrate UFO day at Painted Hand Tattoo!
July 2017 Our piercing of the month.
Two days away.... get ready! These tattoos will be available in a first come, first served style on Wednesday!
Friendly North Oakland Tattoo Studio & Art Gallery Tattoos and piercings by appointment or Walk-ins welcomed. New gallery featured artist each month.
Friendly North Oakland tattoo and piercing shop and gallery.
Come support your local ART!!
Free Face Tattoo First Friday Last Event!
First Friday $25 Finger Tattoos and Piercings!
30 Dolla Valentine's Day FLASH ART tattoos and Piercings!
St. Patrick's Day Sale! LUCKY Flash Art Tattoos and Piercings!
$25 Finger Tattoos and Piercings on First Fridays!
4/20 Flash Tattoos and Piercings Sale!
$25 Finger Tattoos and Piercings Sale on First Friday!
May Flowers flash tattoos and piercings sale!
$25+ Finger Tattoos and Piercings Sale on First Friday!
Phallic Flash Tattoo Fundraiser for Planned Parenthood!
$50+ Summer Themed Tattoos and Piercings Sale!
UFO Day Flash Tattoos and Piercing Sale!
$25+ Finger Tattoos, Piercings, and Henna on First Fridays!
2 for 1 Friendship Tattoos and Piercings!
$25+ Finger Tats and Piercings on First Friday!
Lighthouse Day Flash Tattoo and Piercing Sale!
Celebrate Lighthouse Day with Painted Hand Tattoo!


text:
RFD: A Nobel Peace Prize for Disarming Software Patents
Submitted by Michael Tiemann on Fri, 2007-10-19 10:34
If Al Gore can win the Nobel Peace Prize for bringing the findings of the scientific community to the political forefront, perhaps Richard Stallman should be next in line for his early and tireless advocacy against Software Patents. And the sooner, the better.
Al Gore was not one of the scientists who observed, theorized, modeled, or predicted the catastrophic consequences of rising concentrations of atmospheric CO2. But he paid attention when scientists, including future Nobel Prize winners, formulated and published theories that predict dire consequences for the fate of the human species if all nations on earth do not radically change our economic and environmental behavior. Gore made a personal decision to accept these findings as truth, albeit a very inconvenient truth, and took it upon himself to share the message with all the political leaders, business leaders, educational leaders, and concerned citizens he could reach. It is a disturbing message for those who have gained the most through unsustainable practices (which is most of the people who have gained the most on an absolute basis), and it is a message that has been vigorously challenged by those whose paychecks depend on maintaining the status quo, no matter how unsustainable.
But the Nobel committee did not stop there. By awarding the Nobel Prize for Economics to Leonid Hurwicz, Eric Maskin and Roger Myerson for their work on Mechanism Design Theory, they endorsed the fundamental thinking behind another inconvenient truth. Namely, that software patents may be greater deterrents to innovation than they are incentives, as they summarize in this paper:
...when discoveries are "sequential" (so that each successive invention builds in an essential way on its predecessors) patent protection is not as useful for encouraging innovation as in a static setting. Indeed, society and even inventors themselves may be better off without such protection. Furthermore, an inventor's prospective profit may actually be enhanced by competition and imitation.
Which brings us now to a pressing question about today's legal climate: as the concentration of software patents continues to rise, to the point where these patents now threaten the single most important innovation model known in the software world today--open source software--is it time for us to pay attention and do something about putting caps on these hazardous discharges?
After years of indecision, Sun has finally made a strategic commitment to open source. From their CEO to their engineering ranks, Sun is not only releasing software under OSI-approved licenses, but they are starting to behave like an open source company as well. Bravo Sun! One particularly innovative bit of technology is Sun's ZFS file system. Except that as soon as people start paying attention to ZFS, NetApp decides to sue Sun. Jonathan Schwarz responded, calling them patent trolls. The case has not yet gone to trial and there is much we do not know. Did Sun or NetApp develop any innovative code related to the file systems in question? Was any of that code related to the patents that are being litigated? Are the patents being litigated are valid or enforceable? One thing is sure: when it comes to innovation the Linux community had been there and done that with the tux2 filesystem back in 2000, but fears over patent infringement led to abandonment of the that project in 2002.
What a shame!
The claims made by both companies make it impossible for me to judge which side is using patents more unfairly, but what is perfectly clear in 2007 is that a potentially more innovative file system, tux2, never saw commercial use because of the fundamental dangers of any use of software patents. In this way, Stallman got it exactly right when he likened software patents to land mines--they do harm long after they are put into place, and the harm they cause can be wholly independent of the intent or trustworthiness of the holder. In this context, NetApp and Sun are but two of the too many high-tech companies who have not sworn off the devastating and indiscriminate effects of software patents. They are not agressors against open source per se, but the consequences of their patent stance does us great environmental harm. By contrast, members of the Open Innovation Network have created a safe harbor of innovation, at least for Linux. My employer, Red Hat, has gone farther with a promise not to enforce patents against any GPL-licensed software implementation, as well as several other reciprocal licenses they cite. Open Source needs more companies who are more committed to the open innovation models now explained by Maskin's work. We need more companies willing to dig up and disarm their patent arsenal, unilaterally if need be.
So, if you know anybody on the Nobel Peace Prize committee, please send in your recommendations. The time for debate on the benefits or harm of software patents is winding down. The time has come to take action--promoting the open source model and dismantling a system of software patents that should never have existed. If we don't, we'll suffer climate change of a legal nature, with dire consequences for the subset of the human population who write, support, or use software.
Michael Tiemann's blog


Subtitle of item Should the 'red flag' law be repealed?
Abstract Argument that the current provisions for review may be anachronistic and that the benefits of deregulation might outweigh possible disadvantages. Includes responses by Roxanne Lalonde and Sepideh Taheri.
Notes See also commentaries and author's response, below (both from Baha'i Studies Review 6, 1996).
See also newer letters written by the Baha'i World Centre on this topic, at uhj_publishing_internet, and a compilation, Reviewing: Practice and Functions of Literature Review.
Last edited 2014-12-18 01:48 EDT. See previous versions [archive.org].