an "In My View" article by NIGEL WARD: Is SBC attempting to protect corrupt staff from criminal prosecution?
Now that the Ben MARRIOTT corruption allegations are out in the open, a steady stream of information has been reaching me about exactly who benefited from unauthorised use of Council manpower, materials and equipment. Not all of the sources have been able to provide hard evidence; nevertheless, it is clear from the frequent occurrence of certain names – including names of Councillors (past and present) and members of staff (past and present) – that there has been a long-running and systemic abuse of position by a group of paid and/or elected public servants running well into double figures.
Thus, we are not talking about the odd 'bad apple' – oh, no.
We are talking about organised CORRUPTION – crime in the workplace pursued as a way of life over many years – and a number of promotions.
But it would appear that, with the sole exception of Ben MARRIOTT, not a single individual at SBC – Councillor or Officer – had the integrity, the courage or the common decency to "blow the whistle".
Well, the whistle is blowing now, alright, loud and shrill. Yet SBC Leader Councillor Derek BASTIMAN [Con.] has made it known that he wishes to keep any investigation – and there MUST be one – strictly 'in house'. Still trying to keep a lid on a scandal far more toxic even than the Highpoint Rendel fiasco.
"I wish to advise you there is no information held within North Yorkshire Police to answer your request".
Three years of SBC internal investigation had not produced a single referral to the North Yorkshire Police.
Readers – and Councillors – may wish to contemplate just why SBC refrained from reporting allegations of systemic fraud and corruption to the proper authority – the North Yorkshire Police.
But the big question now is why no-one at SBC responded to an email from a member of the public dated Sunday 7th February 2016, addressed to all fifty SBC Councillors, plus SBC Director of Legal & Democratic Services Lisa DIXON and her counterpart at North Yorkshire County Council (NYCC) Mr Barry KHAN.
[The URL-link at the top of the email leads to the second of my four 'Corruptophenia' articles, also dated 7th February 2016].
Asking around, I soon learned that not all Councillors received this email. Apparently, Borough Solicitor David KITSON's infamous 'filtering system' kept selected Councillors 'out of the loop'.
So it seems that only Councillors John NOCK [Con.], Sandra TURNER [Con.] and Martin SMITH [Con.] (members of the panel who considered – and rejected – Ben MARRIOT's appeal) were provided with any information at all about the endemic corruption – and they were lied to by Officers. On whose orders were they 'misled'?
What we do know is that, as far as most of the remaining Councillors were concerned, the answer to all three of these questions was a resounding NO. I say 'most' because some, of course, did know exactly what was going on.
But what of Lisa DIXON? Why did she not respond to the three questions?
the Council was facing legal action by Ben MARRIOTT.
Lisa DIXON knew full well that the answer to all three questions was a resounding YES. Why did she not respond, if for no better reason than to attempt to elicit further information from the sender that, for all she knew, might contribute to the Council's investigation of Ben MARRIOTT's corruption allegations?
Ah, silly me. The Council was not in the business of diligently investigating Ben MARRIOTT's corruption allegations – as Judge Humphrey FORREST made unequivocally clear in his Judgment.
(Readers of an earlier article in this series will be aware that I wrote to Lisa DIXON three years ago, in August 2013, offering to give her the low-down on the corruption in the Technical Services Department. She never accepted my offer).
But then, on 7th August 2016, two days after the conclusion of the Ben MARRIOTT -v- SBC hearing, North Yorks Enquirer editor Tim THORNE renewed his efforts to elicit information from the North Yorkshire Police. His series of four emails can be reviewed HERE.
"Thank you for your email, I have forwarded it to our serious crime unit".
Unsurprisingly, the NYP Serious Crime Unit has yet to approach Tim THORNE, or me – or Ben MARRIOTT.
It becomes clear that there was, and is, simply no will to investigate the corruption.
How could that possibly be, you may well ask?
Could it be that even a half-hearted investigation would have risked revealing that there were beneficiaries of the corruption at the highest levels within the Council? Were the Chief Officers/Directors themselves beneficiaries? Or leading Councillors? Without a thoroughgoing and impartial external investigation, the public is unlikely ever to find out.
But SBC Leader Councillor Derek BASTIMAN is on record confirming a commitment to an internal investigation. Surely he cannot mean Elaine BLADES and Alison JOHNSON – to whom HHJ Humphrey FORREST gave very short shrift indeed at the hearing; either they were utterly incompetent or extremely adept – at keeping the corruption off the record.
The Scarborough & Whitby Labour Group has issued a Press Release insisting on an external investigation.
The Scarborough News has published Ben MARRIOTT's views under the title "Whistleblower calls for council action".
Public reaction, as expressed on social media, is unanimous in its condemnation of the Council's obsession with secrecy, cover-up and whitewash.
I doubt that SBC CEO Jim DILLON and his fellow Paid Service Officers Lisa DIXON and Nick EDWARDS will be able to brazen it out much longer – though perhaps they should publish photos of their own homes and invoices for any home improvements they have carried out in, say, the past five years.
In Nick EDWARDS case, he may wish to include any improvements he and his wife Deborah have carried out with their property development company Edwards Estates (Scarborough) Ltd.
And now, on the day of publication of this article, there comes 'out of the blue' (as it were) an email from North Yorkshire Police which seems to suggest that a criminal investigation may be underway after all . . .
Had SBC (and the North Yorkshire Police) not been so hell bent on smearing the Enquirer, perhaps Councillors might have given credence to our exposés three years ago – and spared Ben MARRIOTT his heart attacks (and the taxpayers of the Borough a small fortune).
And then there is another huge scandal brewing – just around the corner in the Department closest to Technical Services; Assets, Harbours and Lands – the Portfolio of Councillor Mike COCKERILL [Ind.]; he of the Sicilian connection.


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Canadian Journal of Emergency Medicine (14)
International Journal of Technology Assessment in Health Care (1)
Canadian Association of Emergency Physicians (CAEP) (14)
Health Technology Assessment International (1)
Cambridge Pocket Clinicians (2)
Rates and predictive factors of return to the emergency department following an initial release by the emergency department for acute heart failure
Pierre-Géraud Claret, Lisa A. Calder, Ian G. Stiell, Justin W. Yan, Catherine M. Clement, Bjug Borgundvaag, Alan J. Forster, Jeffrey J. Perry, Brian H. Rowe
Journal: Canadian Journal of Emergency Medicine / Volume 20 / Issue 2 / March 2018
Following release by emergency department (ED) for acute heart failure (AHF), returns to ED represent important adverse health outcomes. The objective of this study was to document relapse events and factors associated with return to ED in the 14-day period following release by ED for patients with AHF.
The primary outcome was the number of return to ED for patients who were release by ED after the initial visit, for any related medical problem within 14 days of this initial ED visit.
Return visits to the EDs occurred in 166 (20%) patients. Of all patients who returned to ED within the 14-day period, 77 (47%) were secondarily admitted to the hospital. The following factors were associated with return visits to ED: past medical history of percutaneous coronary intervention or coronary artery bypass graft (aOR=1.51; 95% CIs [1.01-2.24]), current use of antiarrhythmics medications (1.96 [1.05-3.55]), heart rate above 80 /min (1.89 [1.28-2.80]), systolic blood pressure below 140 mm Hg (1.67[1.14-2.47]), oxygen saturation (SaO2) above 96% (1.58 [1.08-2.31]), troponin above the upper reference limit of normal (1.68 [1.15-2.45]), and chest X-ray with pleural effusion (1.52 [1.04-2.23]).
Many heart failure patients (i.e. 1 in 5 patients) are released from the ED and then suffer return to ED. Patients with multiple medical comorbidities, and those with abnormal initial vital signs are at increased risk for return to ED and should be identified.
Implementation of an Emergency Department Sepsis Bundle and System Redesign: A Process Improvement Initiative
Tamara McColl, Mathieu Gatien, Lisa Calder, Krishan Yadav, Ryan Tam, Melody Ong, Monica Taljaard, Ian Stiell
In 2008–2009, the Canadian Institute for Health Information reported over 30,000 cases of sepsis hospitalizations in Canada, an increase of almost 4,000 from 2005. Mortality rates from severe sepsis and septic shock continue to remain greater than 30% in Canada and are significantly higher than other critical conditions treated in the emergency department (ED). Our group formed a multidisciplinary sepsis committee, conducted an ED process of care analysis, and developed a quality improvement protocol. The objective of this study was to evaluate the effects of this sepsis management bundle on patient mortality.
This before and after study was conducted in two large Canadian tertiary care EDs and included adult patients with suspected severe infection that met at least two systemic inflammatory response syndrome (SIRS) criteria. We studied the implementation of a sepsis bundle including triage flagging, RN medical directive, education campaign, and a modified sepsis protocol. The primary outcomes were 30-day all-cause mortality and sepsis protocol use.
We included a total of 167 and 185 patients in the pre- and post-intervention analysis, respectively. Compared to the pre-intervention group, mortality was significantly lower in the post-intervention group (30.7% versus 17.3%; absolute difference, 13.4%; 95% CI 9.8–17.0; p=0.006). There was also a higher rate of sepsis protocol use in the post-intervention group (20.3% versus 80.5%, absolute difference 60.2%; 95% CI 55.1–65.3; p<0.001). Additionally, we found shorter time-intervals from triage to MD assessment, fluid resuscitation, and antibiotic administration as well as lower rates of vasopressor requirements and ICU admission.
The implementation of our multidisciplinary ED sepsis bundle, including improved early identification and protocolized medical care, was associated with improved time to achieve key therapeutic interventions and a reduction in 30-day mortality. Similar low-cost initiatives could be implemented in other EDs to potentially improve outcomes for this high-risk group of patients.
Paramedics assessing Elders at Risk for Independence Loss (PERIL): Derivation, Reliability and Comparative Effectiveness of a Clinical Prediction Rule
Jacques S. Lee, P. Richard Verbeek, Michael J. Schull, Lisa Calder, Ian G. Stiell, John Trickett, Laurie J. Morrison, Michael Nolan, Brian H. Rowe, Sunil Sookram, David Ryan, Alex Kiss, Gary Naglie
We conducted a program of research to derive and test the reliability of a clinical prediction rule to identify high-risk older adults using paramedics' observations.
We developed the Paramedics assessing Elders at Risk of Independence Loss (PERIL) checklist of 43 yes or no questions, including the Identifying Seniors at Risk (ISAR) tool items. We trained 1,185 paramedics from three Ontario services to use this checklist, and assessed inter-observer reliability in a convenience sample. The primary outcome, return to the ED, hospitalization, or death within one month was assessed using provincial databases. We derived a prediction rule using multivariable logistic regression.
We enrolled 1,065 subjects, of which 764 (71.7%) had complete data. Inter-observer reliability was good or excellent for 40/43 questions. We derived a four-item rule: 1) "Problems in the home contributing to adverse outcomes?" (OR 1.43); 2) "Called 911 in the last 30 days?" (OR 1.72); 3) male (OR 1.38) and 4) lacks social support (OR 1.4). The PERIL rule performed better than a proxy measure of clinical judgment (AUC 0.62 vs. 0.56, p=0.02) and adherence was better for PERIL than for ISAR.
The four-item PERIL rule has good inter-observer reliability and adherence, and had advantages compared to a proxy measure of clinical judgment. The ISAR is an acceptable alternative, but adherence may be lower. If future research validates the PERIL rule, it could be used by emergency physicians and paramedic services to target preventative interventions for seniors identified as high-risk.
CAEP 2014 Academic Symposium: "How to make research succeed in your department: Promoting excellence in Canadian emergency medicine resident research"
Lisa A. Calder, Riyad B. Abu-Laban, Jennifer D. Artz, Shelley McLeod, Barbara Blackie, Bijon Das, Robert Woods, Jeffrey J. Perry, Christian Vaillancourt, Ian G. Stiell, Jason R. Frank
Journal: Canadian Journal of Emergency Medicine / Volume 17 / Issue 5 / September 2015
To characterize the current state of Canadian emergency medicine (EM) resident research and develop recommendations to promote excellence in this area.
We performed a systematic review of MEDLINE, Embase, and ERIC using search terms relevant to EM resident research. We conducted an online survey of EM residency program directors from the Royal College of Physicians and Surgeons of Canada (RCPSC) and College of Family Physicians of Canada (CFPC). An expert panel reviewed these data, presented recommendations at the Canadian Association of Emergency Physicians 2014 Academic Symposium, and refined them based on feedback received.
Of 654 potentially relevant citations, 35 articles were included. These were categorized into four themes: 1) expectations and requirements, 2) training and assessment, 3) infrastructure and support, and 4) dissemination. We received 31 responses from all 31 RCPSC-EM and CFPC-EM programs. The majority of EM programs reported requiring a resident scholarly project; however, we found wide-ranging expectations for the type of resident research performed and how results were disseminated, as well as the degree of completion expected. Although 93% of RCPSC-EM programs reported providing formal training on how to conduct research, only 53% of CFPC-EM programs reported doing so. Almost all programs (94%) reported having infrastructure in place to support resident research, but the nature of support was highly variable. Finally, there was marked variability regarding the number of resident-published abstracts and manuscripts.
Based on the literature, our national survey, and discussions with stakeholders, we offer 14 recommendations encompassing goals, expectations, training, assessment, infrastructure, and dissemination in order to improve Canadian EM resident research.
CAEP 2014 Academic symposium: "How to make research succeed in your department: How to fund your research program"
Christian Vaillancourt, Brian H. Rowe, Jennifer D. Artz, Robert Green, Marcel Émond, Venkatesh Thiruganasambandamoorthy, Grant Innes, Jeffrey J. Perry, Lisa A. Calder, Ian G. Stiell
Journal: Canadian Journal of Emergency Medicine / Volume 17 / Issue 4 / July 2015
We sought to gather a comprehensive list of funding strategies and opportunities for emergency medicine (EM) centres across Canada, and make recommendations on how to successfully fund all levels of research activity, including research projects, staff salaries, infrastructure, and researcher stipends.
We formed an expert panel consisting of volunteers recognized nationally for their scholarly work in EM. First, we conducted interviews with academic leaders and researchers to obtain a description of their local funding strategies using a standardized open-ended questionnaire. Panelists then identified emerging funding models. Second, we listed funding opportunities and initiatives at the provincial, national, and international levels. Finally, we used an iterative consensus-based approach to derive pragmatic recommendations after incorporating comments and suggestions from participants at an academic symposium.
Our review of funding strategies identified four funding models: 1) investigator dependent model, 2) practice plan, 3) generous benefactor, and 4) mixed funding. Recommendations in this document include approaches for research contributors and producers (seven recommendations), for local academic leaders (five recommendations), and for national organizations, such as the Canadian Association of Emergency Physicians (CAEP) (three recommendations).
Funding for research in EM varies across Canada and is largely insecure. We offer recommendations to help facilitate funding for large and small projects, for salary support, and for local and national leaders to advance EM research. We believe that these recommendations will increase funding for all levels of EM research activity, including research projects, staff salaries, infrastructure, and researcher stipends.
Executive summary of the CAEP 2014 Academic Symposium: How to make research succeed in your department
Ian G. Stiell, Jennifer D. Artz, Jeffrey Perry, Christian Vaillancourt, Lisa Calder
Journal: Canadian Journal of Emergency Medicine / Volume 17 / Issue 3 / May 2015
The vision of the recently created Canadian Association of Emergency Physicians (CAEP) Academic Section is to promote high-quality emergency patient care by conducting world-leading education and research in emergency medicine. The Academic Section plans to achieve this goal by enhancing academic emergency medicine primarily at Canadian medical schools and teaching hospitals. It seeks to foster and develop education, research, and academic leadership amongst Canadian emergency physicians, residents, and students. In this light, the Academic Section began in 2013 to hold the annual Academic Symposia to highlight best practices and recommendations for the three core domains of governance and leadership, education scholarship, and research. Each year, members of three panels are asked to review the literature, survey and interview experts, achieve consensus, and present their recommendations at the Symposium (2013, Education Scholarship; 2014, Research; and 2015, Governance and Funding).
Research is essential to medical advancement. As a relatively young specialty, emergency medicine is rapidly evolving to adapt to new diagnostic tools, the challenges of crowding in emergency departments, and the growing needs of emergency patients. There is significant variability in the infrastructure, support, and productivity of emergency medicine research programs across Canada. All Canadians benefit from an investigation of the means to improve research infrastructure, training programs, and funding opportunities. Such an analysis is essential to identify areas for improvement, which will support the expansion of emergency medicine research. To this end, physician-scientist leaders were gathered from across Canada to develop pragmatic recommendations on the improvement of emergency medicine research through a comprehensive analysis of current best practices, systematic literature reviews, stakeholder surveys, and expert interviews.
CAEP 2014 Academic Symposium: "How to make research succeed in your emergency department: How to develop and train career researchers in emergency medicine"
Jeffrey J. Perry, Carolyn E. Snider, Jennifer D. Artz, Ian G. Stiell, Sedigheh Shaeri, Shelley McLeod, Natalie Le Sage, Corinne Hohl, Lisa A. Calder, Christian Vaillancourt, Brian Holroyd, Judd E. Hollander, Laurie J. Morrison
We sought to 1) identify best practices for training and mentoring clinician researchers, 2) characterize facilitators and barriers for Canadian emergency medicine researchers, and 3) develop pragmatic recommendations to improve and standardize emergency medicine postgraduate research training programs to build research capacity.
We performed a systematic review of MEDLINE and Embase using search terms relevant to emergency medicine research fellowship/graduate training. We conducted an email survey of all Canadian emergency physician researchers. The Society for Academic Emergency Medicine (SAEM) research fellowship program was analysed, and other similar international programs were sought. An expert panel reviewed these data and presented recommendations at the Canadian Association of Emergency Physicians (CAEP) 2014 Academic Symposium. We refined our recommendations based on feedback received.
Of 1,246 potentially relevant citations, we included 10 articles. We identified five key themes: 1) creating training opportunities; 2) ensuring adequate protected time; 3) salary support; 4) infrastructure; and 5) mentorship. Our survey achieved a 72% (67/93) response rate. From these responses, 42 (63%) consider themselves clinical researchers (i.e., spend a significant proportion of their career conducting research). The single largest constraint to conducting research was funding. Factors felt to be positive contributors to a clinical research career included salary support, research training (including an advanced graduate degree), mentorship, and infrastructure. The SAEM research fellowship was the only emergency medicine research fellowship program identified. This 2-year program requires approval of both the teaching centre and each applying fellow. This program requires training in 15 core competencies, manuscript preparation, and submission of a large grant to a national peer-review funding organization.
We recommend that the CAEP Academic Section create a process to endorse research fellowship/graduate training programs. These programs should include two phases: Phase I: Research fellowship/graduate training would include an advanced research university degree and 15 core learning areas. Phase II: research consolidation involves a further 1-3 years with an emphasis on mentorship and scholarship production. It is anticipated that clinician scientists completing Phase I and Phase II training at a CAEP Academic Section-endorsed site(s) will be independent researchers with a higher likelihood of securing external peer-reviewed funding and be able to have a meaningful external impact in emergency medicine research.
Outcome Feedback within Emergency Medicine Training Programs: An Opportunity to Apply the Theory of Deliberate Practice?
Timothy R. Dalseg, Lisa A. Calder, Curtis Lee, Jaymie Walker, Jason R. Frank
Outcome feedback is the process of learning patient outcomes after their care within the emergency department. We conducted a national survey of Canadian Royal College emergency medicine (EM) residents and program directors to determine the extent to which active outcome feedback and follow-up occurred. We also compared the perceived educational value of outcome feedback between residents and program directors.
We distributed surveys to all Royal College-accredited adult and pediatric EM training programs using a modified Dillman method. We analyzed the data using student's t-test for continuous variables and Fisher's exact test for categorical variables.
We received 210 completed surveys from 260 eligible residents (80.8%) and 21 of 24 program directors (87.5%) (overall 81.3%). Mandatory active outcome feedback was not present in any EM training program for admitted or discharged patients (0/21). Follow-up was performed electively by 89.4% of residents for patients admitted to the hospital, and by 44.2% of residents for patients discharged home. A majority of residents (76.9%) believed that patient follow-up should be mandatory compared to 42.9% of program directors (p=0.002). The perceived educational value of outcome feedback was 5.8/7 for residents and 5.1/7 for program directors (difference 0.7; p=0.002) based on a seven-point Likert scale (1=not important; 7=very important).
While Canadian EM training programs do not mandate follow-up, it is performed electively by the majority of residents surveyed. Residents place a significantly greater educational value on outcome feedback than their program directors, and believe that follow-up should be a mandatory component of EM residencies.
Accommodating pregnant emergency physicians
Lisa A. Calder, A. Adam Cwinn
Mesures d'accommodation aux besoins des urgentologues enceintes
Sex differences in clinical presentation, management and outcome in emergency department patients with chest pain
Erik P. Hess, Jeffrey J. Perry, Lisa A. Calder, Venkatesh Thiruganasambandamoorthy, Veronique L. Roger, George A. Wells, Ian G. Stiell
Published online by Cambridge University Press: 21 May 2015, pp. 405-413
We sought to assess sex differences in clinical presentation, management and outcome in emergency department (ED) patients with chest pain, and to measure the association between female sex and coronary angiography within 30 days.
We conducted a prospective cohort study in an urban academic ED between Jul. 1, 2007, and Apr. 1, 2008. We enrolled patients over 24 years of age with chest pain and possible acute coronary syndrome (ACS).
Among the 970 included patients, 386 (39.8%) were female. Compared with men, women had a lower prevalence of known coronary artery disease (21.0% v. 34.2%, p < 0.001) and a lower frequency of typical pain (37.1% v. 45.7%, p = 0.01). Clinicians classified a greater proportion of women as having a low (< 10%) pretest probability for ACS (85.0% v. 76.4%, p = 0.001). Despite similar rates of electrocardiography, troponin T and stress testing between sexes, there was a lower rate of acute myocardial infarction (AMI) (4.7% v. 8.4%, p = 0.03) and positive stress test results (4.4% v. 7.9%, p = 0.03) in women. Women were less frequently referred for coronary angiography (9.3% v. 18.9%, p < 0.001). The adjusted association between female sex and coronary angiography was not significant (odds ratio 0.63, 95% confidence interval 0.37–1.10).
Women had a lower rate of AMI and a lower rate of positive stress test results despite similar rates of testing between sexes. Although women were less frequently referred for coronary angiography, these data suggest that sex differences in management were likely appropriate for the probability of disease.
Adverse events among patients registered in high-acuity areas of the emergency department: a prospective cohort study
Lisa Anne Calder, Alan Forster, Melanie Nelson, Jason Leclair, Jeffrey Perry, Christian Vaillancourt, Guy Hebert, A. Adam Cwinn, George Wells, Ian Stiell
To enhance patient safety, it is important to understand the frequency and causes of adverse events (defined as unintended injuries related to health care management). We performed this study to describe the types and risk of adverse events in high-acuity areas of the emergency department (ED).
This prospective cohort study examined the outcomes of consecutive patients who received treatment at 2 tertiary care EDs. For discharged patients, we conducted a structured telephone interview 14 days after their initial visit; for admitted patients, we reviewed the inpatient charts. Three emergency physicians independently adjudicated flagged outcomes (e.g., death, return visits to the ED) to determine whether an adverse event had occurred.
We enrolled 503 patients; one-half (n = 254) were female and the median age was 57 (range 18–98) years. The majority of patients (n = 369, 73.3%) were discharged home. The most common presenting complaints were chest pain, generalized weakness and abdominal pain. Of the 107 patients with flagged outcomes, 43 (8.5%, 95% confidence interval 8.1%–8.9%) were considered to have had an adverse event through our peer review process, and over half of these (24, 55.8%) were considered preventable. The most common types of adverse events were as follows: management issues (n = 18, 41.9%), procedural complications (n = 13, 30.2%) and diagnostic issues (n = 10, 23.3%). The clinical consequences of these adverse events ranged from minor (urinary tract infection) to serious (delayed diagnosis of aortic dissection).
We detected a higher proportion of preventable adverse events compared with previous inpatient studies and suggest confirmation of these results is warranted among a wider selection of EDs.
Prevalence of information gaps for seniors transferred from nursing homes to the emergency department
Matthew A. Cwinn, Alan J. Forster, A. Adam Cwinn, Guy Hebert, Lisa Calder, Ian G. Stiell
Information gaps, defined as previously collected information that is not available to the treating physician, have implications for patient safety and system efficiency. For patients transferred to an emergency department (ED) from a nursing home or seniors residence, we determined the frequency and type of clinically important information gaps and the impact of a regional transfer form.
During a 6-month period, we studied consecutive patients who were identified through the National Ambulatory Care Reporting System database. Patients were over 60 years of age, lived in a nursing home or seniors residence, and arrived by ambulance to a tertiary care ED. We abstracted data from original transfer and ED records using a structured data collection tool. We measured the frequency of prespecified information gaps, which we defined as the failure to communicate information usually required by an emergency physician (EP). We also determined the use of the standardized patient transfer form that is used in Ontario and its impact on the rate of information gaps that occur in our community.
We studied 457 transfers for 384 patients. Baseline dementia was present in 34.1% of patients. Important information gaps occurred in 85.5% (95% confidence interval [CI] 82.0%–88.0%) of cases. Specific information gaps along with their relative frequency included the following: the reason for transfer (12.9%), the baseline cognitive function and communication ability (36.5%), vital signs (37.6%), advanced directives (46.4%), medication (20.4%), activities of daily living (53.0%) and mobility (47.7%). A standardized transfer form was used in 42.7% of transfers. When the form was used, information gaps were present in 74.9% of transfers compared with 93.5% of the transfers when the form was not used (p < 0.001). Descriptors of the patient's chief complaint were frequently absent (81.0% for head injury [any information about loss of consciousness], 42.4% for abdominal pain and 47.1% for chest pain [any information on location, severity and duration]).
Information gaps occur commonly when elderly patients are transferred from a nursing home or seniors residence to the ED. A standardized transfer form was associated with a limited reduction in the prevalence of information gaps; even when the form was used, a large percentage of the transfers were missing information. We also determined that the lack of descriptive detail regarding the presenting problem was common. We believe this represents a previously unidentified information gap in the literature about nursing home transfers. Future research should focus on the clinical impact of information gaps. System improvements should focus on educational and regulatory interventions, as well as adjustments to the transfer form.
By Jeremy Ackerman, Polly Bijur, Hans Bradshaw, Ciaran J. Browne, John H. Burton, Lisa Calder, David Cline, Rita K. Cydulka, Deborah B. Diercks, James Ducharme, Megan L. Fix, Michel Galinski, Ula Hwang, Jonathan S. Ilgen, Andy Jagoda, Samuel Kim, Robert Knopp, Jason B. Lester, Adam Levine, Todd M. Listwa, Frank LoVecchio, Sharon E. Mace, Alan P. Marco, Catherine A. Marco, Chris McEachin, James R. Miner, Kalani Olmsted, Sohan Parekh, Peter Rosen, Michael S. Runyon, Michael T. Schultz, Adam J. Singer, Robert A. Swor, Joshua H. Tamayo-Sarver, Stephen H. Thomas, Michael Turturro, Michael Walta, Benjamin A. White, Beth Wicklund, Susan R. Wilcox, Nathanael Wood, Dale P. Woolridge, Andrew Worster, Janet Simmons Young, Kelly Young
Edited by Stephen H. Thomas
Book: Emergency Department Analgesia
Print publication: 25 September 2008, pp viii-xii
from Chief complaints and diagnoses
By Lisa Calder
Print publication: 25 September 2008, pp 184-187
Treating the pain of land-based envenomations is an acute care priority, since the discomfort may be both severe and long lasting. In some cases, administration of antivenom (or antivenin) can dramatically relieve pain and other symptoms of envenomation, even after failure of other approaches such as opioids and muscle relaxants. While neurotoxic envenomation should prompt close respiratory monitoring, opioids should be administered if clinically indicated for pain relief. The histamine pathway's contributions to terrestrial envenomation symptoms create a role for antihistamines (e.g. diphenhydramine) in treating land-based bites and stings. NSAIDs have been reported useful in small case series of bites from spiders such as brown recluses and tarantulas. Preliminary evidence from animal models and case reports suggests a role for NSAIDs for scorpion envenomation. Case studies suggest that corticosteroids are occasionally useful for some centipede bites, especially in cases in which Wells' syndrome (eosinophilic cellulitis) develops.
Lack of consensus on corneal abrasion management: results of a national survey
Lisa Calder, Sowmya Balasubramanian, Ian Stiell
Journal: Canadian Journal of Emergency Medicine / Volume 6 / Issue 6 / November 2004
Our objective was to determine the practice patterns of Canadian emergency physicians with respect to the management of traumatic corneal abrasions.
After developing our instrument and pilot testing it on a sample of emergency residents, we randomly surveyed 470 members of the Canadian Association of Emergency Physicians, using a modified Dillman technique. We distributed a pre-notification letter, an 18-item survey, and appropriate follow-up surveys to non-responders. Those members with an email address (n = 400) received a Web-based survey, and those without (n = 70) received a survey by post. The survey focused on the indications and utilization of analgesics (oral and topical), cycloplegics, eye patches and topical antibiotics.
Our response rate was 64% (301/470), and the median age of respondents was 38 years. Most (77.7%) were male, 71.8% were full-time emergency physicians, 76.5% were emergency medicine certified, and 64.4% practised in teaching hospitals. Pain management preferences (offered usually or always) included oral analgesics (82.1%), cycloplegics (65.1%) and topical nonsteroidal anti-inflammatory drugs (NSAIDs) (52.8%). Only 21.6% of respondents performed patching, and most (71.2%) prescribed topical antibiotics, particularly for contact lens wearers and patients with ocular foreign bodies. Two-thirds of the respondents provided tetanus toxoid if a foreign body was present, and 46.2% did so even if a foreign body was not present. Most respondents (88.0%) routinely arranged follow-up.
This national survey of emergency physicians demonstrates a lack of consensus on the management of traumatic corneal abrasions. Further study is indicated to determine the optimal treatment, particularly regarding the use of topical NSAIDs.
A COMPARISON OF CLINICAL PRACTICE GUIDELINE APPRAISAL INSTRUMENTS
Ian D. Graham, Lisa A. Calder, Paul C. Hébert, Anne O. Carter, Jacqueline M. Tetroe
Journal: International Journal of Technology Assessment in Health Care / Volume 16 / Issue 04 / October 2000
Objective: To identify and compare clinical practice guideline appraisal instruments.
Methods: Appraisal instruments, defined as instruments intended to be used for guideline evaluation, were identified by searching MEDLINE (1966–99) using the Medical Subject Heading (MeSH) practice guidelines, reviewing bibliographies of the retrieved articles, and contacting authors of guideline appraisal instruments. Two reviewers independently examined the questions/statements from all the instruments and thematically grouped them. The 44 groupings were collapsed into 10 guideline attributes. Using the items, two reviewers independently undertook a content analysis of the instruments.
Results: Fifteen instruments were identified, and two were excluded because they were not focused on evaluation. All instruments were developed after 1992 and contained 8 to 142 questions/statements. Of the 44 items used for the content analysis, the number of items covered by each instrument ranged from 6 to 34. Only the instrument by Cluzeau and colleagues included at least one item for each of the 10 attributes, and it addressed 28 of the 44 items. This instrument and that of Shaneyfelt et al. are the only instruments that have so far been validated.
Conclusions: A comprehensive, concise, and valid instrument could help users systematically judge the quality and utility of clinical practice guidelines. The current instruments vary widely in length and comprehensiveness. There is insufficient evidence to support the exclusive use of any one instrument, although the Cluzeau instrument has received the greatest evaluation. More research is required on the reliability and validity of existing guideline appraisal instruments before any one instrument can become widely adopted.

redpajama_set_name: RedPajamaCommonCrawl


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Captain Cork ist eine deutschsprachige Webplattform zu den Themen Wein, Kulinarik und Touristik mit Sitz in Potsdam. Sie wurde im Jahr 2009 von Marcus Johst und Manfred Klimek als Blog gegründet. Manfred Klimek war von 2009 bis 2014 Chefredakteur des Blogs. Nach seinem Ausscheiden wurde die Seite komplett überarbeitet und zur Informationsplattform um- und ausgebaut. Alleiniger Geschäftsführer ist seit 2009 Marcus Johst.

Im Jahr 2013 wurde zusammen mit dem Gräfe-und-Unzer-Verlag ein Weinbuch herausgegeben. Die Hauptautoren des Buchs sind Manfred Klimek und Rainer Balcerowiak.

Ausrichtung und Konzept
Captain Cork richtet sich an Wein- und Kulinarikfreunde, die jünger sind als die Leser herkömmlicher Weinzeitschriften. Die Texte sind unterhaltsam und brechen mit dem bei Weinthemen üblichen Schreibstil. Dazu hat die Redaktion fünf Thesen aufgestellt:
 Gut ist, was schmeckt.
 Viele Weintrinker trauen sich nicht mehr zu sagen, was ihnen schmeckt, da die allgegenwärtigen Tester mit ihren Punkten, Gläsern und Beschreibungen alle eingeschüchtert haben.
 Herkömmliche Weinbeschreibungen sind unlesbar, weil sie in einer Geheimsprache verfasst wurden, die kein normaler Weintrinker versteht.
 Der Weintrinker wagt keinen Widerspruch, da er glaubt, von Wein nichts zu verstehen. Dabei ist es ganz einfach. Man muss Wein bewusst trinken, Fragen stellen und dem eigenen Geschmackssinn vertrauen.
 Es lohnt, sich für Wein zu interessieren, denn guter Wein macht zufrieden. Und das kann man immer öfter brauchen.

Der Tagesspiegel schreibt dazu: "Amüsant und respektlos bespricht das Team von "Captain Cork" Weine. Das typische Weinchinesisch? Gibt es nicht. Den Lesern gefällts." Insbesondere wird häufig hervorgehoben, dass die Weintexte neben erfahrenen Weintrinkern auch Einsteiger ansprechen.

Auf geteilte Meinung in der Weinwelt treffen häufig insbesondere die Beurteilungen von Weinen prominenter Winzer. Dies betrifft zum Beispiel eine überwiegend positive Rezension des Weins von Til Schweiger. Ein weiteres Beispiel, das für Wirbel sorgte, ist die Bewertung des Weins des damaligen Berliner Flughafenchefs Hartmut Mehdorn, den die Redaktion zusammen mit dem Vorsitzenden des Untersuchungsausschusses des Flughafens Berlin Brandenburg Martin Delius (Fraktion der Piratenpartei im Berliner Abgeordnetenhaus) verkostete.

Da es bei den digitalen Erzeugnissen zum Thema Wein in Deutschland keine ivw-geprüften Zahlen gibt, sind offizielle Reichweitenzahlen nicht existent. Laut einer Statistik mit dem Analysetool Alexa Internet gehört Captain Cork jedoch zu den meistbesuchten Seiten zum Thema Wein in Deutschland.

Internationaler Weinwettbewerb
Seit 2019 besitzt Captain Cork das Kleberecht, ist also berechtigt, als einer von 26 deutschen Veranstaltern einen staatlich anerkannten Weinwettbewerb durchzuführen. Dies wurde vom zuständigen Bundesministerium für Landwirtschaft, Regionen und Tourismus am 14. November 2019 in einer Bekanntmachung veröffentlicht.

Stimmen
Das als Marketingeinrichtung der deutschen Weinwirtschaft getragene Deutsche Weininstitut (DWI) spricht u. a. von "einer der führenden Plattformen für Weinfreunde im Internet".

Weblinks
 Website von Captain Cork

Einzelnachweise

Unternehmen (Potsdam)
Blog
Gegründet 2009
Önologie

redpajama_set_name: RedPajamaWikipedia


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The foundation for a transformation
In 2018, A.P. Moller - Maersk completed the process of finding new ownership structures for the majority of the oil and oil-related businesses, which will enable their continued development and growth, while at the same time laying the foundation for the transformation of A.P. Moller - Maersk.
By Jesper Toft Madsen
With new ownership structures in place for three out of four of the oil and oil-related businesses, A.P. Moller - Maersk has reached a milestone in its strategy to become a focused, integrated transport and logistics company.
With the Board of Directors' decision to demerge A.P. Moller - Maersk and list Maersk Drilling as an independent company on Nasdaq Copenhagen, the shareholders of A.P. Moller - Maersk get the opportunity to take part in the future value creation of Maersk Drilling.
First day of trading of the Maersk Drilling share is expected to be 4 April 2019, subject to shareholder approval of the demerger at the A.P. Moller - Maersk Annual General Meeting on 2 April 2019.
"Maersk Drilling is an industry leader in the global offshore drilling market, based on its well-reputed and safe operations and a fleet that is among the youngest and most advanced in the industry," says Claus V. Hemmingsen, Vice CEO of A.P. Moller - Maersk and Chairman of the Maersk Drilling Board of Directors, and continues:
"The demerger will create a listed Danish-based offshore drilling company with a clear investment profile and long-term development prospects. Maersk Drilling is well-positioned to capitalise on the value creation opportunity of a globally leading pure play offshore drilling company to the benefit of both its long-term blue-chip customer base, as well as its investors."
Maersk Drilling is an industry leader in the global offshore drilling market, based on its well-reputed and safe operations and a fleet that is among the youngest and most advanced in the industry.
Claus V. Hemmingsen, Vice CEO of A.P. Moller - Maersk and Chairman of the Maersk Drilling Board of Directors
Transforming an industry
A.P. Moller - Maersk made the historic, strategic decision to move from being a conglomerate to focusing the company on transport and logistics in 2016. A decision that in many ways returns the company to the starting point, but at the same time with the ambition to transform major parts of the transport and logistics industry and become the world's leading global integrator of container logistics
As a consequence, it was decided to find new ownership structures for the four oil and oil-related companies Maersk Oil, Maersk Drilling, Maersk Tankers and Maersk Supply Service. The companies were placed in the Energy division under Vice CEO Claus V. Hemmingsen, along with the responsibility for the separation process and for finding new ownership structures to ensure their continued growth and development outside A.P. Moller - Maersk
"With the listing of Maersk Drilling, we will have almost completed the separation of our oil and oil-related businesses, totalling more than USD 12bn worth of separation transactions and can now focus our efforts fully on becoming the global integrator of container logistics," says Søren Skou, CEO of A.P. Moller - Maersk and continues:
"A warm thank you to all our colleagues in the oil and oil-related businesses who have worked relentlessly to serve our customers and add value to their business units, as well as A.P. Moller – Maersk. I commend them for doing this under challenging circumstances and uncertainties about future owner structures."
With the listing of Maersk Drilling, we will have almost completed the separation of our oil and oil-related businesses, totalling more than USD 12bn worth of separation transactions and can now focus our efforts fully on becoming the global integrator of container logistics.
Søren Skou, CEO of A.P. Moller - Maersk
The demerger and separate listing of Maersk Drilling
- In the demerger of A.P. Moller - Maersk, Maersk Drilling will be separated out and established as a new, independent company. The shares in the new company will then be admitted for trading and official listing on Nasdaq Copenhagen.
- Subject to approval of the demerger at the A.P. Moller - Maersk Annual General Meeting, the shares in Maersk Drilling will be distributed to A.P. Moller - Maersk shareholders, who in addition to their shareholding in A.P. Moller - Maersk will become shareholders in Maersk Drilling.
- Although Maersk Drilling will be separated from A.P. Moller - Maersk, the company will continue to operate under the name Maersk Drilling and use the seven-pointed star as part of its identity. However, the independently listed company will have the legal name 'The Drilling Company of 1972 A/S'.
Finding the structural solutions
Maersk Tankers was sold to APMH Invest, a subsidiary of A.P. Moller - Holding, in October 2017, ensuring a financially solid owner with deep industry insights.
Maersk Oil was sold to oil major Total S.A. in August 2017 and the transaction was completed in March 2018. Total S.A. is a strong owner with an investment interest in the industry. Total S.A. has made Denmark a hub for its North Sea activities, ensuring the best possible foundation for the continued development of Maersk Oil, its employees and the Danish North Sea continental shelf.
Maersk Supply Service progressed on its strategy to diversify its business into new markets in 2018. The company has completed its fleet renewal programme initiated in 2016, with 23 vessels divested and ten new vessels delivered. A structural solution for Maersk Supply Service is pending.
UPDATE 29 MARCH 2019:
A.P. Møller - Mærsk A/S to retain full ownership of Maersk Supply Service
For me and my colleagues in the Energy division, this journey has been both exciting and challenging. We have concluded the vast part of the separation with very satisfactory results. I owe thanks to my colleagues in the oil and oil-related business units for their tireless support and efforts.
CONNECTING AND SIMPLIFYING GLOBAL SUPPLY CHAINS
Making supply chains tick like clockwork
Leveraging technology to grow
Towards a zero-carbon future
The right calls at the right times
Increasing LG's speed to market


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Box And IBM Ink Wide-Ranging Cloud Partnership
Alex Wilhelm	5 years
IBM is going Levie.
This evening, Box and IBM announced a partnership that will see their technologies integrated, and their cloud products commingled. As part of the arrangement, Box will also offer its customers the ability to store their data on IBM's cloud, which will have — I checked with the firm — 46 data centers around the world by the end of the year.
The deal has a number of facets, including the integration of Box with IBM's content management technology, the application of IBM data tools to information stored by Box, use of IBM security tech by Box, and a set of promised mobile applications building on the tech of both firms.
So what does all that mean. In short, Box just linked up with a company worth around 80 times its own value, that has inroads into enterprise space that, as a far younger firm, Box is still creating. Box also picked up access to technology and data centers that it now doesn't have to build on its own.
For IBM, driving greater usage of its cloud is likely a welcome result, and the larger firm now also has a window into one of the more quickly growing enterprise-facing software companies, the very market that it wants to grow its share in.
IBM isn't Box's first love. The enterprise file storage and sharing company has announced a number of integrations with Microsoft, tying its storage functions into Redmond's Office environment.
I asked Box's CEO Aaron Levie if the partnership will lead to Box increasing its full-year revenue guidance. Unsurprisingly, he demurred.
The deal matters as it represents another Fortune 500 company publicly endorsing Box with their actions. Box has long traded, and fairly, for example, on the chit of its broad deal with General Electric — if GE is investing into Box, surely it's safe for our team, and so forth.
Box has worked to extract its product from its storage roots, even offering a build of its software — Box Developer Edition — that customers can spin up inside their own data center. Combine that with the increasingly important data storage rules in place in various markets, Box at the least has a good shot at snagging


Self Description: Finally I am here and ready to share with you something about me. I'm master of sports in rhythmic gymnastics, positive, bright person, fond of aviation, love to travel, appreciate in people sincerity, kindness, care, so I'm trying to develop it in myself. I am sure you ll be interested to find out more.
Comments: I want to find someone for whom your existence will be everything, but in fact our world needs caring, respect you man, responsible, understanding and support you in any situation, of course, want that feelings were mutual, that each day brings happiness, joy and prosperity, in a cozy house.


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Expansion of scope for patent infringement confirmed
Posted in Patents, united kingdom | Nov 02, 2018
As reported in July 2017 (link), the Supreme Court, the country's highest court, handed down a judgment on patent infringement that delivered the most significant change in the law of patent infringement in the last decade, and probably the biggest change in the career of most patent attorneys.
There was speculation at the time about how wide ranging the change would be, and a recent decision (Icescape v Ice-World in the Court of Appeal) delivered by Lord Kitchin has confirmed that the changes are significant, with the (now Supreme Court) judge explaining that in his view the new test for infringement is "markedly different" from before.
The most important aspect of the 2017 decision (Actavis v Eli Lilly) meant that patents might in future be found to be infringed by actions that would not previously have been considered infringing.
In brief, in the Actavis case, Eli Lilly discovered that when combined with vitamin B12, the side effects of a particular drug (pemetrexed) were largely avoided. Eli Lilly therefore obtained a patent claiming the combination of vitamin B12 and the specific compound of pemetrexed, pemetrexed disodium.
Actavis sought to produce a competing product using vitamin B12 with a different pemetrexed compound, specifically (a) pemetrexed diacid, (b) pemetrexed ditromethamine, or (c) pemetrexed dipotassium.
These compounds all contain the same active ingredient, pemetrexed, and work in exactly the same way, but they lack the "disodium" ion, using chemically equivalent, but different, ions in its place.
The Supreme Court decided that even though under normal interpretation, there would be no infringement, because the allegedly infringing "variant" fell outside the meaning of the words of the claim, the variant nonetheless infringed because it varied from the invention in a way which was immaterial.
In justifying that the difference was immaterial, the Court determined that it was obvious that the variant achieved substantially the same result in substantially the same way and that the reader of the patent would not conclude that the patentee intended that strict compliance with the literal meaning of the relevant claim (i.e. the requirement for the disodium ion) was an essential requirement of the invention.
Whilst this change was noted as a significant departure from the status quo, for many practitioners outside the field of Chemistry, it was unclear how significant an effect it would have. This is in particular because when dealing with mechanical/electrical inventions it is not uncommon in a claim to define a feature by its function and therefore effectively encompass all equivalents to a feature. For example, we might claim a "fixing means" rather than a screw.
The Judgement in Icescape v Ice-World
In Icescape v Ice-World, the invention at issue was not chemical, but mechanical; a system for cooling mobile ice rinks. Although the patent owned by Ice-World was held invalid, the judge ruled that, if valid, it would have been infringed by Icescape, despite the fact that it would not have been held to infringe under the approach taken before last year's Supreme Court decision.
In particular, in this case, the key inventive feature; the "inventive core" of the patent in the words of Lord Kitchin, was considered to be the provision of a joint member which allowed the cooling pipes of the mobile ice rink to be folded up for transportation, without disassembly.
However, the main patent claim, which should define the scope of protection was fairly long and quite specific as to the structure of the cooling member of the mobile ice rink, that included the flexible joints.
In particular the claim included terminology that required two "cooling elements" made up of a feed manifold and a discharge manifold with pipes connected in between, and required, in effect, that the two elements were coupled in series with each other (wherein the feed and discharge manifolds of the two elements are provided with a coupling member (47, 48) to make a fluid-tight connection between the respective feed and discharge manifolds of the first and the second element).
These features (as well as the feature of the "inventive core") were present in the "characterising" part of the patent claim – which is the part of the claim which is considered to distinguish the invention from the most relevant example of known technology considered when the application was examined; the "closest prior art".
In consequence, on initial reading, it could well be considered that all of the features in the characterising portion of the claim combine to form the "inventive core".
In the opinion of the judges, however, these other features of the invention were not part of the inventive core; they were, in the court's view, features of conventional systems.
This conclusion meant that Icescape's "variant" of the invention, which in effect had the two cooling elements coupled in parallel rather than in series, but included the joint member that allowed folding, was considered to achieve substantially the same result in substantially the same way as the invention.
The judges also took the view that it would be obvious to the person skilled in the art, reading the patent and knowing that the variant achieves substantially the same result as the invention, that it does so in substantially the same way as the invention.
And, the judges decided that the skilled reader of the patent would not have concluded that Ice-World intended that strict compliance with the literal meaning of the claim.
Having reached these conclusions, it was decided that the Icescape product would fall within the scope of protection. Fortunately, for Icescape, however, the patent was held invalid, and in fact Ice-World were guilty of making groundless threats of infringement.
This decision may be welcomed by patent owners as it confirms that the scope of protection available in the UK can cover competing products that use the same inventive concept, even if they do not fall within the words used to define the invention. Arguably, it may make patent law easier for non-experts, who might find it easier to identify what the inventive core of a patent is than to determine the scope of a patent claim.
On the other hand, the decision certainly confirms that it is it more difficult to ascertain the scope of protection based only on the patent at issue, which is bound to reduce legal certainty and/or increase the time and cost to provide an opinion on infringement.
It is notable that in both this case and Actavis v Eli Lilly, the judges found it straightforward to identify the "inventive core". Certainly there are patents where the nature of the inventive concept is much more difficult to ascertain. Especially when considering patent applications that have not yet been granted, there may appear to be many "cores" or potentially inventive cores, and the part which seems inventive could change according to the "prior art" located.
We would reiterate our advice to revisit any infringement opinions given before the Actavis v Eli Lilly decision in July 2017 (and perhaps opinions produced shortly afterwards), as it is clear that that decision has wide application regardless of the technology concerned.
In particular, most opinions prior to the Actavis v Eli Lilly decision will only comment on infringement under a "purposive construction", but now, having decided on non-infringement under a purposive construction, it is necessary to consider whether the patent might be infringed by "equivalence".
This will be relevant whether you are concerned about a competitor infringing your patent, or concerned about infringing your competitor's patent.
If you have any questions, do not hesitate to contact one of our patent attorneys.


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Epic of Kings: A Battle Between The Gods – Coming February 18th
Being on the edge of release, we remain curious about Epic of Kings due to its wonderful graphics and epic storyline. Can Dead Mage really make a competitor to Infinity Blade or is it very unlikely? We wanted to share with you the debut trailer for the game so you can have a different outlook into…
February 5, 2016 in 2016 - Q1.
Final Fantasy II – Get It For Free While You Can!
Final Fantasy II was probably not the best of the franchise but is, nevertheless, a title that has contributed in building the Final Fantasy universe. If you are familiar with Final Fantasy Portal App [Free] by Square Enix, then you know that this app provides all the relevant news about Final Fantasy games and offers…


Системи обробки інформації. — 2018. — № 1(152). – С. 16-19.
Annotation: The paper considers the problem of efficiency enhancing of spectral analysis of the signals observed against noise via Root-Min-Norm method with data preprocessing by modification of the SSA method. Simulations results are presented that confirm the enhancement of spectral analysis efficiency by Root-Min-Norm method when using the SSA method and its modification.
Vasilishin, V.І. (2018), Spectral analysis of signals by Root-Min-Norm method, using modified SSA method, Information Processing Systems, Vol. 1(152), pp. 16-19. https://doi.org/10.30748/soi.2018.152.02.


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Home Dispatches Where's the Ground Game to Overcome Voter ID?
Where's the Ground Game to Overcome Voter ID?
by Ruth Conniff
Update 10/09/2014: The Supreme Court issued an emergency ruling on Thursday evening, October 9, blocking Wisconsin's voter ID law and allowing the November election to go forward without the new voter ID requirements.
In the home stretch before election day in November, voting rights groups in Wisconsin are grappling with one of the most restrictive voter ID laws in the nation.
Governor Scott Walker and his opponent Mary Burke have been tied in the polls for months.
In a tight race where the outcome will depend largely on turnout, the effect of the new voter ID law will be crucial.
Yet the state agencies charged with implementing voter ID for the November 4 election say they have no additional money set aside to help voters and state workers comply with the new law, the Wisconsin State Journal reports.
The Government Accountability Board does have detailed information on the specific types of ID that will be accepted for voting in the November election, as well as how to obtain a free state ID on the web site BringIt.Wisconsin.org.
Opponents of voter ID point out that in-person voter fraud is virtually nonexistent, and argue that the voter ID requirement is a transparent attempt by Republicans to win the election by making Democratic voters, including students, the poor, and people of color, ineligible to vote.
The short timeline for implementing voter ID, and the lack of information for voters, is bound to lead to confusion and chaos at the polls.
So where is the ground game to overcome the new restrictions?
"The party is focused on making sure that every eligible voter can cast a ballot," says state Democratic Party communications director Melissa Baldauff.
But the state party itself is not working on getting people who don't have photo ID to the department of motor vehicles to get the new state ID they will need to vote.
"My understanding is that independent community organizations will be working with people," says Baldauff. "We will encourage people to seek out those groups so we can continue to focus on our efforts on voter education and turnout."
On University of Wisconsin campuses, where students need to get an updated ID card (the standard student ID doesn't meet the new law's requirements), plus bring proof of enrollment to the polls, a team of college organizers is getting the word out, and a UW web site gives more details.
Mike Wilder, issue coordinator at Wisconsin Voices, is organizing a get-out-the-vote and voter ID drive in communities around the state.
Wisconsin Voices is an umbrella organization of 70 groups, including the ACLU, League of Women Voters, and the United Council of Students, that are concerned with democracy, voting rights, and civic engagement.
The groups have been going door to door in Milwaukee, Racine, Madison, and Appleton, handing out pledge cards for voters to sign as they make a promise to vote, Wilder says.
The pledge cards have space for voters to sign up to volunteer, and ask whether they need to get voter ID. Wilder's group is giving rides to the DMV to those who need a free state ID card.
"We are taking the next group on Friday afternoon," he said. "That's a good time because it's a slow time for the DMV."
"Our goal was to reach 30,000 voters, and so far we've mailed about 20,000 cards. I think we will get close to the 30,000," Wilder says.
The pledge card campaign was specifically designed to target drop-off voters—those who tend to turn out only in Presidential election years.
"A lot of them will be the same voters that don't have ID," says Wilder.
In April, when District court judge Lynn Adelman issued an injunction against the voter ID law, which was overturned last month, he estimated that 300,000 registered voters across the state lack the IDs they need to vote.
"But we are not seeing that high a number," Wilder said. "A lot of people are confused. They do have an acceptable form of ID but they don't know it—there's a lot of confusion about what's acceptable."
That confusion is exacerbated by the lack of funds for a public information campaign by the Government Accountability Board, the Department of Motor Vehicles, or the Department of Health Services.
To remedy the problem, One Wisconsin Now is urging Wisconsin media to donate air time and ad space for photo ID education.
"This is a great opportunity for the broadcasters that use the public airwaves to step up and do a great public service, helping ensure legal voters are able to cast their vote in November," says One Wisconsin Now Executive Director Scot Ross. "We're calling on Wisconsin's media – TV, radio and newspapers – to donate airtime and ad space to help raise awareness about the requirements of the new photo ID requirement."
The most recent Marquette University Law School Poll found that nearly one in five Wisconsin voters are unaware of the photo ID requirement that will be in place in the November elections.
Ruth Conniff is editor-in-chief of The Progressive.
Dispatches Activism Voting Wisconsin Wire
Ruth Conniff
Editor-at-large for The Progressive magazine.
Read more by Ruth Conniff


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Factory of the future
Mario Cywinski October 22, 2021
Technology Aerospace Automotive Electronics Food & Beverage Manufacturing canadian manufacturing COVID-19 factory of the future future future of manufacturing Innovation manufacturing Operations Technology
PLANT spoke with Richard Kunst, President and CEO, and Mariela Castaño, Senior Vice-President and COO, at Kunst Solutions, about the factory of the future, focusing on various trends, technologies and automation.
Photo © rybindmitriy / Adobe Stock
As manufacturers continue to recover in the face of COVID-19, they are exploring new ways to innovate and bounce back, changing the future of Canadian manufacturing forever.
Manufacturers are still investing in and adopting advanced technologies to optimize processes, improve operations, and create new products for the marketplace. In this Q&A, Kunst and Castaño give us an insight on what the future of manufacturing might look like.
Kunst has over 45 years of senior leadership experience in manufacturing, operations, retail, and supply chain. He was previously the President of the Canadian Region for the Association for Manufacturing Excellence, and is a regular contributor to PLANT magazine.
Castaño is an industrial engineer by trade. She has over 35 years of experience in operations, manufacturing, and continuous improvement. She is a Six Sigma Black Belt with a passion for "working with less" and a sharp eye for waste reduction.
PLANT: Do you believe that the factory of the future is already here?
Kunst: The answer is yes, and no. The factory of the future is like trying to chase the horizon; you think you're getting close, and all of a sudden, it shifts.
We have grandiose visions that the factory of the future is a gleaming, huge enterprise filled to the brim with automation. However, seeing a bit of divergence, especially through COVID-19, as the technology of communication exponentially improved, not only in the quality, but in acceptance by society. We're seeing a lot of craft businesses that are being competitive. If you look at beer brewing industry, before it was dominated by the large breweries, today, everywhere you have a craft brewer competing with the big breweries, and there's only a fixed market of beer consumption out there.
The factory of the future, I don't think it's been clearly defined. In North America, our factory of the future is primarily there to compete against the intrusion of low-cost country entries. Over time, we have allowed some critical infrastructure businesses to evaporate from our landscape. People are starting to acknowledge that factory of the future is here. As the technology comes, we're going to embrace it and it's going to be increments of continuous improvement.
Photo ©DIgilife / Adobe Stock
Castaño: I will add that the plant of the future has always been in the making. Often, we see projects in the pipeline that have a status and have not moved forward, because they're going too fast. The customers are not ready for it. Maybe their equipment manufacturers don't have the technology that they need to bring this particular strategic move to realization. What been missing in the deployment to that future is the proper supply chain, and having the proper education between those manufacturers and
the customers.
Kunst: As we saw COVID-19 impact our daily lives, we started to see other emerging trends. If you go to the grocery store today, I'm now competing in the aisles with order pickers, and other delivery services where people are doing online ordering. I'm not seeing a lot of warehouses going up, but a lot of organizations are using their existing bricks and mortar as their local regional distribution centre to pick orders.
Society is saying, "I'm not willing to wait 24 hours to get my order, how am I going to get it right now within an hour or two," which is becoming a competitor to Amazon. Amazon's highly automated, very sophisticated, large warehousing operations are competing against the grocery chains, with order pickers walking the aisles, picking orders using their smartphones, to satisfy that customer demand within a couple hours.
Castaño: If you think about communication, for example, if we wanted to talk to people around the world, a conference call was the way to go. However, what if we can meet on site, that's even better. When COVID -19 came along, suddenly, using a video camera and having a video call became easier, and accepted. People who did not want it, are now on board.
What was thought to take 10 years for people to adapt , has taken a month for people to digest, and in the span of about a month and a half, people absorbed what some thought would take 10 years to absorb. COVID-19 has put a huge spin on manufacturing, but also on how people are seeing businesses, and how they are seeing the customer and trying to understand the customer needs.
PLANT: Automation is at or near the top of most trends lists. How do you see it impacting the factory of the future now and going forward?
Kunst: There are different facets of automation that we have to take into consideration. We are in unprecedented times, data mining is at an exceptional high point, which is driving automated algorithms. They are capturing our personal profiles and customizing that solution. Looking at the production of widgets, we're seeing that high degree of automation, increased robotics, end of arm tooling, design and capability. Before, you were using three-axis robots, those are now antiquated. Now, everyone is going to a five-axis robot. We're seeing the evolution of wearable, automated technologies, creating a new specter of opportunity within the organization.
If we look at order entry, with COVID-19 not allowing us to touch anything, there are QR codes when you go to a restaurant, you scan your phone, see the menu and order it online. It's automated directly into the kitchen and the food comes out. Therefore, automation has many layers.
Castaño:With information there is also a lot of complexity and with a lot of data generated, if that complexity is not managed properly at the operational level, it is going to be overwhelming to the organization, and is going to become very expensive to the point that some people will not be able to manage their business efficiently.
There are millions of data points to which a piece of software can make decisions, but the people behind it need to manage those decisions, the people that need to manage behaviour, their organizations sometimes are not keeping up with the pace. You make a big investment in automation, but if you don't have the right systems behind it, that automation is going to fail you. In some instances, it's going way too fast for some organizations, as they have no way of defining that future. What is the future state for every organization? Not everyone can afford those big, very complex technologies, or have the proper systems in place to deal with them.
Photo © rGorodenkoff / Adobe Stock
Kunst: Recently, we had the opportunity to talk to a lead engineer with an automotive company. The brand was always considered a premium brand; with advanced technology that they could put into their vehicles. They said three to four years ago, they typically felt that based on their investment in R&D, they were on average, six to 10 years ahead of their closest competitor from a technical expertise. Today, they are lucky if they are one to two years ahead.
If you start taking a look at motor vehicle production today, quality is no longer a differentiator, no matter what level of automobile you're buying, you're pretty well guaranteed many miles out of the product. When you take a look at the features in the broad spectrum, there's very little differentiator between a high-end vehicle and an entry level vehicle. Therefore, it's interesting to see where that level of automation is going, and how accepting people are of that automation, and how affordable it's becoming.
PLANT: Do you see any other technologies emerging in the near future that we haven't discussed yet?
Kunst: What we're seeing with drone deliveries, at this point, it looks like a toy. However, what starts off as a toy can have merit. I think autonomous vehicles, and the issue of labour shortage is going to impact industry quicker and harder than we anticipate. We have a huge mass of our current working population scheduled to retire. So autonomous vehicles will fill that void out of necessity. Some people although are going to extend their working careers, which is going to dull that transition.
The issue that we have when we talk about people, is the intellectual requirement that we're seeking of our operators and technical capability that our operators have is increasing at such a rapid rate. I don't know how we're going to train people to absorb this technology. What we're seeing is we're complementing it. It's like wearable technology.
One of the areas that we're seeing a huge indent is in wiring. Particularly, in automotive wiring, there are miles of wire in a motor vehicle. Try and memorize how to put a wire harness together, how to thread the wire through the door of a vehicle, or through the engine compartment of a vehicle. I can virtually take an operator, put a wearable face shield on them and just say follow the instructions and the artificial intelligence knows where the operators located, tells them what kind of wire to pick up, how to thread it, etc.
Therefore, I don't have to train that operator. I'm not looking necessarily for a highly skilled operator, yet, if something goes wrong, that operator still has to be very quick to problem solve. We're seeing the same in how we build reliability into a lot of the emerging technology and I think that's going to be a little bit of our impediment.
Just as at the supermarkets, we're seeing people go with carts, you're picking four to eight orders concurrently, as they go through, as the as the picklist is merged. Automation is definitely going to come in almost like a vending machine; you punch it in, I want that particular candy bar, and boom, it'll come in a box and will be shipped to you within minutes.
Castaño: The other technology that I feel is going to have a very strong play is nanotechnology., compacting more in any smaller footprint. If you look at TVs, for example, they are now almost as thin as a piece of paper. Look at the physical space that a TV used to take in a warehouse, versus now, where you can pack like 10 TVs where it used to take the space of one TV. I think that nanotechnology is going to be the future of manufacturing.
Kunst: Along with 3D printing, because I can now send a part electronically to a 3D printer anywhere in the world, so my logistics problem starts to go away. Have I got the durability, capability in a 3D printed product? I think the evolution of the materials used in 3D printing is another frontier that's coming very quickly.
Mario Cywinski is the Editor of PLANT magazine, Machinery and Equipment MRO magazine and Food and Beverage magazine, a member of the Automobile Journalists Association of Canada.
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The acclaimed chef featured in the Emmy-Award winning US PBS series The Mind of a Chef and the Netflix docuseries Chef's Table explores the rich baking tradition of the Nordic region, with 450 tempting recipes for home bakers.
No other book on Nordic baking is as comprehensive and informative. Nilsson travelled extensively throughout the Nordic region – Denmark, the Faroe Islands, Finland, Greenland, Iceland, Norway, and Sweden – collecting recipes and documenting the landscape. The 100 photographs in the book have been shot by Nilsson – now an established photographer, following his successful exhibitions in the US.
From the pubisher of Nilsson's influential and internationally bestselling Fäviken and The Nordic Cookbook.


We've checked our list of distributors of the Debian cd's.
the  Debian DVD's as well. Is this possible to add us to the list then ?
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