text:
Fairest
Levana's Story
Meyer, Marissa
"Queen Levana is a ruler who uses her "glamour" to gain power. But long before she crossed paths with Cinder, Scarlet, and Cress, Levana lived a very different story - a story that has never been told... until now"-- Provided by publisher.
Branch Call Number: / SF MEYER MARISSA
Characteristics: 222 pages ; 22 cm
Alternative Title: Levana's story
Read more reviews of Fairest at iDreamBooks.com
Gwen904 Mar 22, 2019
Haunting and enlightening, Fairest serves to create a spark of empathy with Levana. It's a good story.
white_swan_63 Feb 09, 2019
A good read by more of a bonus in the Luner chronicles.... Definitely for an older audience but helps you see Levana in a different way.
Xxmidnight_shadowxX Nov 24, 2018
WHY LEVANA!!! WHY DO YOU HAVE TO DO THIS!!!! );
JackofAllFandoms3234 Sep 12, 2018
You don't have to read this book.
But everything that Levana does in the Lunar Chronicles will make more sense.
It's a good book.
I recommend it.
Tumby_Corn Jul 09, 2018
Personally, I enjoyed this book, even though I don't think it was as interesting as the four main books in the Lunar Chronicles series. Marissa Meyer did a great job of telling Levana's story, but I was rarely able to sympathize with her. I appreciated reading about some of the important parts of the series' storyline that were hinted at during Cinder, Scarlet, Cress, and Winter, but weren't brought to life until Fairest. If you enjoyed reading the other books in the Lunar Chronicles, this isn't a necessary book to read, but you'll still benefit from it.
sarahbru17 Jul 17, 2017
Characters: 9/10
Plot: 9/10
Writing: 10/10
This book was so good and yet so bad. Obviously, Levana is a horrible person, so you don't like her, but as the protagonist of this book, you have to sympathize with her. Talk about making a relatable, understandable villain! It was a real page-turner; I couldn't put it down, but I was still horrified by everything she did. I really liked learning more about Evret and Channary. My one point of confusion was over Levana's glamour; it describes her as mimicking Solstace, but that's not how I'd pictured her during the rest of the series, so I'm not sure where the mix-up was. I really think it served its function very well within the Lunar Chronicles; it's a great intermediary between Cress and Winter (I ended up reading it after Winter, and suddenly some things made a lot more sense). I might re-read it again in context with the rest of the series, but it's almost more like bonus materials than it is a necessary re-read.
Chapel_Hill_MarthaW Jun 29, 2017
Villain origin stories can be quite interesting, though this wasn't the best-executed example of it. Meyer strikes a good balance between making Levana a bit more sympathetic and showing the factors that led to her becoming the villain she is in the Lunar Chronicles, while also showing that she's always been a bit unhinged. However, I really thought this was too long - it's practically the length of a full-length book, not a novella, and I think a lot of the information could have been conveyed in a short story. Fans of the previous books in the series will still likely want to read this, though, for completion's sake – and it's also nice to read a bit more about the childhood of Princess Winter, before she takes her place at center stage for the series' final installment
GCPL_Teen Jun 23, 2017
Though Levana is not an entirely believable character, this book is characterized by unexpected twists and little references to the other books in the Lunar Chronicles. Best read before Winter.
ArapahoeLesley Nov 10, 2016
Not usually a fan of the novella, I liked this background story on Levanna and history leading up to 'Cinder'. Meyer doesn't try to garner too much sympathy for our psychotic queen but succeeds in making the character less one dimensional.
xinzhuchen Aug 10, 2016
This book was written beautifully, and the characters were realistic. In my opinion, Levana's actions were almost justified in a 'what else can you expect from the offspring of neglectful parents, self-esteem issues and a psycho older sister?' kind of way. I heard that other people call Levana a bad queen for the overproduction she starts (she increased productivity in factories), but I think that's ridiculous. You can find a ton of parallels between artemesian society and victorian britain. An upper class of lazy aristocrats. A lower class of factory workers. When the resources seem to be running out, try to invade other countries and set up colonies. Levana never struck me as particularly bad, since I was comparing her actions to other world leaders (Genghis Khan, Vlad the Impaler, that kind of person). It's either that or I can't help feeling bad for a disfigured woman in a court where appearance is everything. It sounds horrible, but I never stopped to consider the suffering of other characters than Levana- compared to her's, their suffering was inconsequential. Levana is one of my favourite characters. I seem to favour the ones that normally are deemed "unlikable". They strike me as more believable. They're refreshing compared to the mary sues that plague most YA literature.
Did it come to anyone else after reading winter that Levana was actually very, very close to success? If Cinder had really died, and if Channary hadn't stolen her beauty and her confidence, she might've ended up ruling the world.
NikT Jan 25, 2018
NikT thinks this title is suitable for 13 years and over
black_pony_62 Oct 08, 2016
black_pony_62 thinks this title is suitable for 12 years and over
white_panda_575 Jul 19, 2016
white_panda_575 thinks this title is suitable for 9 years and over
mauve_raven_12 Jul 01, 2016
mauve_raven_12 thinks this title is suitable for 12 years and over
Bella_H Mar 09, 2016
Bella_H thinks this title is suitable for 12 years and over
UnbreakableValour Dec 11, 2015
UnbreakableValour thinks this title is suitable for 14 years and over
Julia20030927 Jul 15, 2015
Julia20030927 thinks this title is suitable for between the ages of 10 and 99
mauve_badger_63 Jul 07, 2015
mauve_badger_63 thinks this title is suitable for between the ages of 13 and 18
blue_badger_590 May 26, 2015
blue_badger_590 thinks this title is suitable for 11 years and over
violet_shark_50 Mar 30, 2015
violet_shark_50 thinks this title is suitable for 9 years and over
library_queen May 03, 2018
We all know Queen Levana, the cruel Lunar who used her gift to manipulate others, make herself beautiful, and gain power she has always wanted. Now we dig deeper into her story
3je82rs9 Oct 10, 2017
Pure evil has a name, hides behind a mask of deceit, and uses her "glamour" to gain power. But who is Queen Levana? Long before she crossed paths with Cinder, Scarlet, and Cress in The Lunar Chronicles, Levana lived a very different story–a story that has never been told . . . until now.
sadia1903 Jul 27, 2015
This is a prequel that goes back to when levana was child. his book helps us understand why she is who she is. Don't worry, you will not end up feeling very sorry for her.
gabithereader99 Apr 19, 2015
Very smart little bro ;)
OwenLayton Apr 19, 2015
"Queen Levana is a ruler who uses her "glamour" to gain power. But long before she crossed paths with Cinder, Scarlet, and Cress, Levana lived a very different story - a story that has never been told . . . until now...
Sexual Content: There are definitely some consent issues going on. (Spoilers) Levana basically mind-controls a guy into sleeping with her and "falling in love" with her.
Sexual Content: Not a lot of description, but there is more here than in Cinder, Scarlet, and Cress.
SashaE Feb 22, 2016
Love is a conquest...
Love is a war...
~Levana
kn1226 Jun 25, 2015
But she also knew that fire was dangerous, and illusions were dangerous, and being tricked into believing things that weren't real was often the most dangerous thing of all.
Kings, Queens, Rulers, Etc. — Fiction
Cyborgs — Fiction
Extraterrestrial Beings — Fiction


text:
Liou Chuan-jüan (; * 19. března 1983 Su-čchien) je bývalá čínská zápasnice – judistka.

Sportovní kariéra
S judem začínala ve 14 letech v Nankingu. Připravovala se pod vedením trenéra Liou Ťia-linga. S výškou 196 cm patřila k nejvyšším vrcholovým judistkám své doby. V čínské ženské reprezentaci se pohybovala od roku 2003 v těžké váze nad 78 kg. Kvůli vysoké domácí konkurenci a především kvůli fenomenální krajance Tchung Wen startovala v neolympijské disciplíně bez rozdílu vah. V roce 2004 a 2008 dostaly v nominaci na olympijské hry přednost soupeřky. V disciplíně bez rozdílu vah vybojovala v letech 2006 a 2010 vítězství na Asijských hrách. Sportovní kariéru ukončila po nevydařené kvalifikaci na olympijské hry v Londýně v roce 2012.

Vítězství
 2004 – 1x světový pohár (Paříž)
 2009 – 1x světový pohár (Hamburk)
 2010 – 3x světový pohár (Bukurešť, Tallinn, Abú Zabí)

Výsledky

Váhové kategorie

Bez rozdílu vah

Odkazy

Související články
 Sport v Číně

Externí odkazy
 Výsledky a novinky Liou Chuan-jüan na judoinside.com

Čínské judistky
Narození v roce 1983
Žijící lidé
Ženy

redpajama_set_name: RedPajamaWikipedia


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text:
The month that changed the world: Monday, 20 July to Thursday, 23 July 1914
The French delegation, led by President Raymond Poincaré and the premier/foreign minister René Viviani, finally arrived in Russia. They boarded the imperial yacht, the Alexandria, while a Russian band played the 'Marseillaise' – that revolutionary ode to the destruction of royal and aristocratic privilege. The tsar and his foreign minister welcomed the visitors before they travelled to Peterhof where a spectacular banquet awaited them.
While the leaders of republican France and tsarist Russia were proclaiming their mutual admiration for one another, the Habsburg emperor was approving the terms of the ultimatum to be presented to Serbia three days later. No one was to be forewarned, not even their allies: Italy was to be told on Wednesday only that a note would be presented on Thursday; Germany was not to be given the details of the ultimatum until Friday – along with everyone else.
In London, Sir Edward Grey remained in the dark. He was optimistic; he told the German ambassador on Monday that a peaceful solution would be reached. It was obvious that Austria was going to make demands on Serbia, including guarantees for the future, but Grey believed that everything depended on the form of the demands, whether the Austrians would exercise moderation, and whether the accusations of Serb government complicity were convincing. If Austria kept its demands within 'reasonable limits' and if the necessary justification was provided, it ought to be possible to prevent a breach of the peace; 'that any of them should be dragged into a war by Serbia would be detestable'.
Raymond Poincaré, President of France, public domain
On Tuesday the Germans complained that the Austrians were keeping them in the dark. From Berlin, the Austrian ambassador offered Berchtold his 'humble opinion' that the Germans ought to be given the details of the ultimatum immediately. After all, the Kaiser 'and all the others in high offices' had loyally promised their support from the first; to treat Germany in the same manner as all the other powers 'might give offence'. Berchtold agreed to give the German ambassador a copy of the ultimatum that evening; the details should arrive at the Wilhelmstrasse by Wednesday.
That same day the French visitors arrived in St Petersburg, where the mayor offered the president bread and salt – according to an old Slavic custom – and Poincaré laid a wreath on the tomb of Alexander III 'the father' of the Franco-Russian alliance. In the afternoon they travelled to the Winter Palace for a diplomatic levee. Along the route they were greeted by enthusiastic crowds: 'The police had arranged it all. At every street corner a group of poor wretches cheered loudly under the eye of a policeman.' Another spectacular banquet was held that evening, this time at the French embassy.
Perhaps the presence of the French emboldened the Russians. The foreign minister, Sergei Sazonov, warned the German ambassador that he perceived 'powerful and dangerous influences' might plunge Austria into war. He blamed the Austrians for the agitation in Bosnia, which arose from their misgovernment of the province. Now there were those who wanted to take advantage of the assassination to annihilate Serbia. But Russia could not look on indifferently while Serbia was humiliated, and Russia was not alone: they were now taking the situation very seriously in Paris and London.
But stern warnings in St Petersburg were not repeated elsewhere. In Vienna the French ambassador believed as late as Wednesday that Russia would not take an active part in the dispute and would try to localize it. The Russian ambassador there was so confident of a peaceful resolution that he left for his vacation that afternoon. The Russian ambassador in Berlin had already left for vacation and had yet to return; the French ambassador there returned on Thursday. The British ambassador was also absent and Grey saw no need to send him back to Berlin.
In Rome however, San Giuliano had no doubt that Austria was carefully drafting demands that could not be accepted by Serbia. He no longer believed that Franz Joseph would act as a moderating influence. The Austrian government was now determined to crush Serbia and seemed to believe that Russia would stand by and allow Serbia to 'be violated'. Germany, he predicted, 'would make no effort' to restrain Austria.
By Thursday, 23 July, twenty-five days had passed since the assassination. Twenty-five days of rumours, speculations, discussions, half-truths, and hypothetical scenarios. Would the Austrian investigation into the crime prove that the instigators were directed from or supported by the government in Belgrade? Would the Serbian government assist in rooting out any individuals or organizations that may have provided assistance to the conspirators? Would Austria's demands be limited to steps to ensure that the perpetrators would be brought to justice and such outrages be prevented from recurring in the future? Or would the assassination be utilized as a pretext for dismembering, crushing or abolishing the independence of Serbia as a state? Was Germany restraining Austria or goading it to act? Would Russia stand with Serbia in resisting Austrian demands? Would France encourage Russia to respond with restraint or push it forward? Would Italy stick with her alliance partners, stand aside, or join the other side? Could Britain promote a peaceful resolution by refusing to commit to either side in the dispute, or could it hope to counterbalance the Triple Alliance only by acting in partnership with its friends in the entente? At last, at least some of these questions were about to be answered.
At 'the striking of the clock' at 6 p.m. on Thursday evening the Austrian note was presented in Belgrade to the prime minister's deputy, the chain-smoking Lazar Paču, who immediately arranged to see the Russian minister to beg for Russia's help. Even a quick glance at the demands made in the note convinced the Serbian Crown Prince that he could not possibly accept them. The chief of the general staff and his deputy were recalled from their vacations; all divisional commanders were summoned to their posts; railway authorities were alerted that mobilization might be declared; regiments on the northern frontier were instructed to prepare assembly points for an impending mobilization. What would become the most famous diplomatic crisis in history had finally begun.
Gordon Martel is a leading authority on war, empire, and diplomacy in the modern age. His numerous publications include studies of the origins of the first and second world wars, modern imperialism, and the nature of diplomacy. A founding editor of The International History Review, he has taught at a number of Canadian universities, and has been a visiting professor or fellow in England, Ireland and Australia. Editor-in-chief of the five-volume Encyclopedia of War, he is also joint editor of the longstanding Seminar Studies in History series. His new book is The Month That Changed The World: July 1914. Read his previous blog posts.
Image credit: Raymond Poincaré, public domain via Wikimedia Commons

redpajama_set_name: RedPajamaCommonCrawl


text:
Permalink Prev Next (2) Return to results list (149 results)
Health Legislation Amendment (Podiatric Surgery and Other Matters) Bill 2004
Bills Digests
Bills Digest Service
PRATT, Angela
RXKC6
Health and Other Services (Compensation) Act 1995
Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003
Online Text: 1080615
Health and Ageing portfolio
Health Insurance Act 1973
Private health funds
Legislative amendments
16p.
no.137 (2003-04)
legislation/billsdgs/RXKC6
I N F O R M A T I O N , A N A L Y S I S A ND A DV ICE FO R T HE PA RL IA MENT
I N F O R M A T I O N A N D R E S E A R C H S E R V I C E S PAR LIAMEN TAR Y L IBR AR Y
Bills Digest No. 137 2003-04
D E P A R T M E N T O F P A R L I A M E N T A R Y S E R V I C E S
 Copyright Commonwealth of Australia 2004
Except to the extent of the uses permitted under the Copyright Act 1968, no part of this publication may be reproduced or transmitted in any form or by any means including information storage and retrieval systems, without the prior written consent of the Parliamentary Library, other than by Senators and Members of the Australian Parliament in the course of their official duties.
This paper has been prepared for general distribution to Senators and Members of the Australian Parliament. While great care is taken to ensure that the paper is accurate and balanced, the paper is written using information publicly available at the time of production. The views expressed are those of the author and should not be attributed to the Information and Research Services (IRS). Advice on legislation or legal policy issues contained in this paper is provided for use in parliamentary debate and for related parliamentary purposes. This paper is not professional legal opinion. Readers are reminded that the paper is not an official parliamentary or Australian government document. IRS staff are available to discuss the paper's contents with Senators and Members and their staff but not with members of the public.
Members, Senators and Parliamentary staff can obtain further information from the Information and Research Services on (02) 6277 2646.
Information and Research Services publications are available on the ParlInfo database. On the Internet the Parliamentary Library can be found at: http://www.aph.gov.au/library/
Published by the Information and Research Services, Parliamentary Library, Department of Parliamentary Services, 2004.
I N F O R M A T I O N A N D R E S E A R C H S E R V I C E S
Bills Digest
No. 137 2003-04
Dr Angela Pratt Social Policy Section 21 May 2004
Purpose....................................................................................................................................... 1
Background ................................................................................................................................ 2
Schedule 1—Part 1—Amendments relating to payment of benefits for hospital treatment associated with podiatric surgery........................................................................ 2
Podiatry and the podiatric workforce in Australia.............................................................. 2
Podiatry and health insurance: current arrangements ......................................................... 3
Position of significant interest groups ................................................................................ 5
Schedule 1—Part 2—Amendments relating to provision of Hospital Casemix Protocol Data ...................................................................................................................... 5
What is Hospital Casemix Protocol Data?.......................................................................... 5
The collection of Hospital Casemix Protocol data ............................................................. 6
Schedule 1—Part 3—Amendments relating to the Pharmaceutical Benefits Scheme ......... 7
Existing provisions for the supply of pharmaceutical benefits following the death of a pharmacist...................................................................................................................... 7
Schedule 1—Part 4—Miscellaneous amendments of other health legislation ..................... 8
Main Provisions ......................................................................................................................... 9
Schedule 1—Part 4—Miscellaneous amendments of other health legislation ................... 10
Concluding Comments............................................................................................................. 10
Endnotes................................................................................................................................... 11
Date Introduced: 1 April 2004
House: House of Representatives
Portfolio: Health and Ageing
Commencement: The different parts of Schedule 1 of the Bill have various commencement dates, as indicated under 'Main provisions', below.
This Bill is an omnibus bill which proposes various, unrelated amendments to legislation within the Health and Ageing portfolio:
• Schedule 1, Part 1 provides for amendments to the Health Insurance Act 1973 to enable private health insurance funds to provide benefits for the hospital treatment costs associated with foot surgery performed on admitted patients by accredited podiatrists
• Schedule 1, Part 2 provides for amendments to paragraphs within the Health Insurance Act 1973 which relate to the provision by private hospitals of Hospital Casemix Protocol data to the Department of Health and Ageing
• Schedule 1, Part 3 provides for amendments to provisions within the National Health Act 1953 which govern the Pharmaceutical Benefits Scheme (PBS), to provide for the continuing supply of pharmaceutical benefits in the event of the death of a PBS- approved pharmacist
• Schedule 1, Part 4 provides for minor amendments to the Health and Other Services (Compensation) Act 1995 and the Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003 to correct drafting errors.
This Digest was prepared for debate. It reflects the legislation as introduced and does not canvass subsequent amendments.
This Digest does not have any official legal status. Other sources should be consulted to determine the subsequent official status of the Bill.
2 Health Legislation Amendment (Podiatric Surgery and Other Matters) Bill 2004
Schedule 1—Part 1—Amendments relating to payment of benefits for hospital treatment associated with podiatric surgery
This part of the Bill proposes amendments to the Health Insurance Act 1973 to enable private health insurance funds to provide benefits from their hospital tables for hospital accommodation and nursing costs associated with foot surgery performed in hospitals by registered podiatric surgeons.
Podiatry and the podiatric workforce in Australia
Podiatry (also known as chiropody) deals 'with the prevention, diagnosis, treatment and rehabilitation of medical and surgical conditions of the feet and lower limbs'.1 Podiatrists treat a range of conditions, including those which result from 'bone and joint disorders such as arthritis and soft-tissue and muscular pathologies, as well as neurological and circulatory disease'.2 Podiatric surgery is a branch of podiatry, specialising in the treatment of feet and lower limb conditions which warrant surgical intervention.3
The majority of work podiatrists do involves older patients experiencing difficulty with mobility as a result of injury, structural problems, or the effects of chronic diseases. Diabetes, for example, if not adequately controlled, can damage nerves and cause problems with blood supply to the feet. Foot conditions often develop with age; subsequently, demand for podiatrists is likely to grow as the Australian population ages.4
According to the Podiatry Labour Force Survey conducted by the Australian Institute of Health and Welfare (AIHW) in 1999, there are over 2200 registered podiatrists in Australia. The podiatry workforce has grown rapidly in recent years: it increased by 42.7 per cent over the 8-year period 1991 to 1999.5 By contrast, there are only a small number of podiatric surgeons—approximately 25—in Australia.6 The majority of podiatrists counted in the AIHW's 1999 survey (74.5 per cent) worked in the private sector.7
The practice of podiatry in Australia is regulated by state and territory legislation.8 To become a podiatrist, a practitioner must complete a recognised undergraduate degree, and be registered to practise with a state or territory registration board.9 Podiatric surgeons are
podiatrists who have undergone additional postgraduate training, and who have successfully completed the requirements for admission to the Australasian College of Podiatric Surgeons (ACPS).10 They are not required to have medical degrees.
Under state and territory legislation, podiatrists are licensed to perform a limited range of foot surgery, including soft tissue procedures such as toe nail removal.11 The vast majority of these kinds of procedures are performed in podiatrists' rooms, community health
centres, and some hospitals (though generally in out-patient facilities). Podiatric surgeons can perform more complex surgical procedures, including deep tissue surgery and some
Health Legislation Amendment (Podiatric Surgery and Other Matters) Bill 2004 3
bone surgery (such as hammer toe corrections).12 Many of these procedures are also performed in podiatrists' rooms, but as they may require the use of general anaesthetic, they tend to be performed in hospitals.
Podiatric surgeons have been performing foot surgery in Australia since the early 1970s. However, podiatrists and podiatric surgeons are not recognised as medical practitioners (they are classified as allied health professionals). Consequently, the number of hospitals—both private and public—in which podiatric surgeons are able to perform surgical operations is very limited.13
As the section below on podiatry and health insurance discusses, podiatrists' and podiatric surgeons' services do not attract Medicare rebates, and are only eligible for private health insurance coverage in some circumstances. Subsequently, much of the foot surgery that could be performed by podiatric surgeons is performed by orthopaedic surgeons instead. However, there is evidence to suggest that the treatment outcomes of foot conditions treated by podiatrists and podiatric surgeons are as good, and in many cases better, than when the same conditions are treated by orthopaedic surgeons and other registered physicians.
Therefore, there seem to be good reasons, from a public health perspective alone, for expanding the availability of podiatric surgeons' services within the Australian health system.14 Such an expansion would bring Australia into line with treatment patterns elsewhere: in the USA, for example, podiatrists perform almost two-thirds of all major (orthopaedic) foot surgery (compared with only 10-15 per cent in Australia). In the UK, podiatric surgeons operate widely within the National Health Service, the UK's public health system (whereas they tend to operate almost exclusively in the private sector in Australia).15
Podiatry and health insurance: current arrangements
Until this year, podiatry and the services of other allied health care professionals have not been eligible for any rebates under the Medicare program—Australia's publicly funded health insurance scheme. According to the Explanatory Memorandum circulated with this Bill:
Extending Medicare benefits coverage to a wider range of allied health care providers (which includes podiatrists) has been considered on other occasions and each time it has been decided that it is not possible to extend these arrangements given the economic climate. This is still the case.16
However, the revised Medicare Plus package negotiated earlier this year between independent senators and the government has resulted in Medicare benefits being made available, in some circumstances, for services provided by allied health care professionals (including podiatrists) for the first time.17 However, because the new benefits will only apply to consultations with allied health professionals for services delivered 'for and on
behalf of a GP', it is unlikely they will extend to surgical procedures performed by podiatric surgeons.
Private health insurance which includes ancillary (or extras) cover provides cover for non-hospital services which are generally not covered by Medicare. Out of hospital services provided by podiatrists and podiatric surgeons (as well as those provided by other allied health professionals such as dentists, chiropractors, home nurses, physiotherapists, and occupational therapists) are covered by most private health insurance policies with ancillary cover.
As mentioned above, foot surgery performed by podiatric surgeons often needs to take place in hospital because of the need for general anaesthetic. However, in-hospital foot surgery performed by podiatric surgeons is not covered by private health insurance. Under the Health Insurance Act, private health insurance benefits for in-hospital treatment are only payable for treatment performed by providers of 'professional attention', which includes medical practitioners, nurses with obstetric qualifications (midwifes), and dental practitioners. Podiatric surgeons are not recognised as medical practitioners, and therefore are not included as providers of 'professional attention' under the Health Insurance Act. In its 2003 assessment of governments' progress in implementing the National Competition Policy and related reforms, the National Competition Council found that this arrangement restricts competition between medical practitioners and 'substitute health care providers', such as podiatrists.18
Patients with ancillary health cover may be eligible for limited benefits towards the cost of podiatric surgery performed in a hospital, but the patient usually has to pay the full cost of hospital accommodation and nursing care. In other words, people who choose to have foot surgery performed by podiatric surgeons in hospital are likely to be liable for all of the out-of-pocket costs associated with the surgery. The amendments proposed by this Bill will make it possible for private health insurance companies to pay benefits towards the cost of hospital accommodation and nursing care for podiatric surgery performed on admitted patients.19
The extension of private health insurance benefits to foot surgery performed by podiatric surgeons raises some issues about public patients' equity of access to equivalent kinds of treatment (since podiatric surgeons practice in only a very small number of public hospitals). However, as noted above, orthopaedic surgeons also perform the kinds of surgery in which podiatric surgeons specialise.20 Public patients therefore have access to the same type of treatment which this Bill will enable private health insurance funds to provide cover for. It is also important to bear in mind that the amendments proposed by this Bill will not alter existing foot surgery practice, and in the short term, are unlikely to significantly alter treatment patterns. That is, the Bill, if passed, will not change the kinds of procedures podiatric surgeons currently are and are not able to perform, or where they are able to perform them. Rather, it will simply allow private health insurance funds to pay benefits for accommodation and nursing costs associated with procedures which are already being performed.
Position of significant interest groups
Both the Australasian Podiatry Council, the peak body representing podiatrists' in Australia, and the Australasian College of Podiatric Surgeons, the body which develops, implements and monitors guidelines for the practice of podiatric surgery in Australia, fully support the amendments proposed by the Bill.
According to the Explanatory Memorandum accompanying the Bill, 'certain medical groups' have expressed concern about the safety and quality of surgical procedures performed by podiatric surgeons, and the level of training podiatric surgeons receive. However, these concerns are rarely expressed publicly. Further, there is little, if any, clinical evidence which supports these concerns. In any case, as noted above, the amendments proposed by this Bill will not alter existing foot surgery practice, but simply make it possible for private health insurance funds to provide some benefits for in hospital foot surgery performed by podiatric surgeons.
Schedule 1—Part 2—Amendments relating to provision of Hospital Casemix Protocol Data
This part of the Bill proposes amendments to provisions within the Health Insurance Act and the National Health Act which govern the collection of data about the activities and outputs of private hospitals in Australia. The proposed amendments will update the existing legislative provisions to reflect current practice for the collection of this data and are likely to be uncontroversial.
What is Hospital Casemix Protocol Data?
Data on Australia's hospitals and the health system is collected and published by a number of agencies.21 Detailed and comprehensive data collection is important for monitoring the effectiveness of Australia's hospitals and health care system, as well as for planning for the future.
The Hospital Casemix Protocol Data Collection—which is managed by the Department of Health and Ageing—was established to monitor the deregulation of the private health industry, following the 1995 Private Health Insurance Reform legislation.22 The Hospital Casemix Protocol refers to the arrangement whereby private hospitals provide the Department of Health and Ageing with a series of patient de-identified casemix data. Patient de-identified data means data which does not identify individual patients. 'Casemix' data refers to data which incorporates both the number and types of patients treated, and the mix of diagnoses, treatments, procedures, and so on provided to patients. Casemix data is a way of measuring, monitoring and comparing hospitals' output and activities.23 Private hospitals are required to supply this data under Section 23EA of the Health Insurance Act:
For the purposes of this Act and the National Health Act 1953, a declared private hospital must provide data specified in the Hospital Casemix Protocol:
(a) in a patient identifiable state, to a registered private health insurance organization which has an applicable benefits agreement with the patient;
(b) in a patient de-identified state to a data bureau established for the purpose of receiving and disseminating such data.
The Department releases the Hospital Casemix Protocol data annually to all private hospitals, registered health funds, and various external stakeholders. The data can be used to analyse trends, compare variations in charges between different hospitals, and examine the effects of clinical and patient demographics.24
The collection of Hospital Casemix Protocol data
The Private Hospitals Data Bureau was established in 1997, following the 1995 amendments to the Health Insurance Act. Between 1997 and 2002, the Department funded an external agency to perform the functions of the Private Hospitals Data Bureau, and to collect Hospital Casemix Protocol data from private hospitals on the Department's behalf. However, during this time, both private hospitals and the Department itself experienced problems with access to the data, and with the completeness of the data collection. Subsequently, since January 2003, the Department has managed the Private Hospitals Data Bureau internally. Since the Department took over the management of the Private Hospitals Data Bureau, it has worked with the private hospital industry to improve the accessibility of the data, the completeness of the data collection, and to streamline the process of collecting the data itself.
The first amendment proposed by this part of the Bill removes the reference in Section 23EA of the Health Insurance Act to the 'data bureau', and replaces it with 'the Department'. This will not change existing practice, but rather reflects the current arrangements.
The second amendment proposed by this part of the Bill inserts a new subsection in the National Health Act, which will require day hospitals—that is, facilities in which the procedures performed do not require an overnight hospital stay—to provide both private health insurance funds and the Department with the same Hospital Casemix Protocol data that private hospitals are obliged to provide under the Health Insurance Act.
This amendment, if passed, may lead to a change in existing practices, in that day hospitals have hitherto not been required to provide health insurance funds or the Department—or the Private Hospitals Data Bureau, when it was in existence—with Hospital Casemix Protocol data (though many day hospitals may already provide this information, even if they are not under any legal obligation to do so). Imposing this requirement on day hospitals will improve the comprehensiveness of the Hospital Casemix
Protocol Data Collection, and therefore the ability of the Department and other stakeholders to monitor day hospitals' output and activity, as well as that of the private hospital sector as a whole.
The Department will be required to observe both the Privacy Act 1988, and the secrecy provisions in section 135A of the National Health Act and section 130 of the Health Insurance Act in using the data collected under the provisions proposed by this part of the Bill.
The Australian Private Hospitals Association, the peak body for private hospitals in Australia, supports both amendments proposed by this part of the Bill. The Australasian Day Surgery Association supports the amendments pertaining to the provision of Hospital Casemix Protocol data by day hospitals.
Schedule 1—Part 3—Amendments relating to the Pharmaceutical Benefits Scheme
This part of the Bill proposes a series of amendments to provisions within the National Health Act 1953 which relate to the continuing supply of pharmaceutical benefits in the event of the death of a pharmacist who was approved to supply pharmaceutical benefits at or from particular premises.
The proposed amendments seek to remove deficiencies in the existing provisions. While the volume of amendments proposed by this part is substantial compared to Parts 1 and 2 of Schedule 1 of the Bill, most of the amendments are technical in nature and do not represent new policy. Therefore, this part of the Bill is likely to be uncontroversial.
Existing provisions for the supply of pharmaceutical benefits following the death of a pharmacist
The Pharmaceutical Benefits Scheme (PBS) is the publicly funded scheme for the subsidisation of medicines which exists under the National Health Act. State and territory legislation regulates the registration of pharmacists and the practice of pharmacy (that is, the actual dispensing and compounding of medicines). Under the National Health Act, however, to supply PBS medicines, a pharmacy must be approved by the Commonwealth Department of Health (on the recommendation of the Australian Community Pharmacy Authority).25
State and territory legislation also provides for legal personal representatives of deceased pharmacists' estates to continue deceased pharmacists' businesses, as long as the actual practice of pharmacy in the business is conducted by a registered pharmacist.26 There are provisions in section 90 of the National Health Act for legal representatives of deceased pharmacists to apply for approval to supply PBS medicines at or from the premises at
which the deceased pharmacist was approved by the Commonwealth to supply pharmaceutical benefits—that is, to continue the deceased pharmacists' business with respect to the supply of PBS medicines. However, according to the Bill's Explanatory Memorandum, this provision has been found to be deficient in a number of respects. For example:
In some cases, the time period involved in obtaining an approval under section 90 is lengthy. This is particularly so if it is only viable for a legal representative to apply for approval after probate or letters of administration are granted.
In some instances, the legal personal representative requests an Act of Grace payment be made to the estate of the deceased approved pharmacist in relation to pharmaceutical benefits supplied during the period following the death of the approved pharmacist and before the granting of a section 90 approval. In some cases the amount claimed is large, and the ongoing viability of a pharmacy has been jeopardised by having to carry this financial burden.27
The proposed amendments are intended to enable a person who is, or is likely to become, an executor or administrator of the estate of a deceased pharmacist, to apply for permission to supply pharmaceutical benefits (for PBS purposes) at or from the particular premises at which the deceased pharmacist was approved. The amendments are also intended to clarify that in cases where a beneficiary of a deceased approved pharmacist is not a pharmacist, s/he 'may only apply under section 90 for approval to supply pharmaceutical benefits in circumstances where he or she has acquired the deceased approved pharmacists' interest in the pharmacy'.28
The amendments do not give legal representatives of deceased approved pharmacists the right to practice pharmacy—as noted above, state and territory legislation regulates the registration of pharmacists and requires that, in the event of the death of a pharmacist, the actual practice of pharmacy must be carried out by a registered pharmacist. Nothing in section 90 of the National Health Act (or the amendments proposed by this part of the Bill) 'authorizes the Secretary [of the Department of Health and Ageing] to grant approval to a pharmacist in respect of premises at which that pharmacist is not permitted, under the law of the State or Territory in which the premises are situated, to carry on business'.29 Rather, the amendments simply seek to improve the process by which a person who acquires a deceased pharmacist's interest in a pharmacy can apply for reimbursement, under the PBS, for PBS medicines dispensed.
Schedule 1—Part 4—Miscellaneous amendments of other health legislation
This part of the Bill proposes minor amendments to other legislation within the health portfolio to correct minor errors. The proposed amendments are discussed under 'Main Provisions', below.
Main Provisions
The following items all relate to the Health Insurance Act 1973.
Item 1 inserts a definition of 'accredited podiatrist' to subsection 3(1) of the Act.
Item 3 expands the Act's definition of 'professional attention' (which currently includes treatment performed by or under the supervision of medical practitioners, nurses with obstetric qualifications and dental practitioners) to include podiatric treatment performed by an accredited podiatrist.
Item 4 inserts two new subsections (3AAA and 3AAB) which provide for the accreditation of podiatrists by the Minister for the purposes of the Act, and for appeal to the Administrative Appeals Tribunal for review of the Minister's decision in this regard.
Schedule 1, Part 1 commences on a date to be fixed by Proclamation, or if this does not occur within 6 months of Royal Assent, on the first day after the end of that period.
Item 5 and Item 6 amend paragraphs of the Health Insurance Act 1973 and the National Health Act 1953 pertaining to the collection of Hospital Casemix Protocol data, for the purposes described in the 'Background' section, above.
Schedule 1, Part 2 commences when the Act receives Royal Assent.
The following items all relate to the National Health Act 1953.
Item 7 and Item 8 repeal existing definitions of 'pharmacist' and 'approved pharmacist' in subsections 4(1) and 84(1) respectively, and replace them with revised definitions.
Item 10 inserts new subsections (90(3AC) and 90(3AD)) defining when an interest in a deceased pharmacists' business has been acquired for the purposes of the Act.
Item 12 prevents beneficiaries of deceased approved pharmacists, who are not pharmacists themselves, from applying for approval to supply pharmaceutical benefits under section 90 unless they have acquired the deceased approved pharmacist's interest in the pharmacy.
10 Health Legislation Amendment (Podiatric Surgery and Other Matters) Bill 2004
Item 13 inserts a new section 91 which sets out the process for granting approval to the executor or administrator of the estate of a deceased approved pharmacist to supply pharmaceutical benefits at or from the premises from which the deceased pharmacist had been approved. Item 14 provides for appeal to the Administrative Appeals Tribunal for review of decisions in this regard.
Items 15 to 18 propose minor amendments to the Health and Other Services (Compensation) Act 1995 and the Health Insurance Amendment (Diagnostic Imaging, Radiation Oncology and Other Measures) Act 2003 to amend typographical and other drafting errors.
The provisions in Schedule 1, Part 4 commence immediately after the time specified for the commencement of the relevant sections and items in the Acts this part of the Bill amends.
None of the proposed amendments contained in this Bill are significant in terms of numbers of persons affected or in terms of government expenditure or savings—the financial impact of the Bill is negligible.
With the possible exception of Schedule 1, Part 1, the proposed amendments do not represent any change to existing policy or practice, but rather, will streamline, improve, and/or codify existing arrangements, and are therefore likely to be uncontroversial. As noted above, the amendments proposed by Schedule 1, Part 1 (pertaining to podiatric surgery) raise some questions about public patients' ability to access the kinds of treatment performed by podiatric surgeons, since orthopaedic surgeons appear to have a monopoly on foot surgery performed in public hospitals at present. However, the issue of whether or not podiatric surgeons' services should be made more widely available in the public hospital system is beyond the scope of this Bill.
Health Legislation Amendment (Podiatric Surgery and Other Matters) Bill 2004 11
1 Australasian Podiatry Council (APODC) website: see: http://www.apodc.com.au/Podiatry%20in%20Australia/scope.htm (accessed 9 May 2004).
3 Australasian College of Podiatric Surgeons (ACPS) website: see: http://www.acps.edu.au/surgery.html (accessed 9 May 2004).
4 Australian Institute of Health and Welfare (AIHW), Podiatry Labour Force 1999, National Health Labour Force Series, Number 23, AIHW, Canberra, 2002, p. 1.
5 ibid., pp. 5-7.
6 Explanatory Memorandum, p. 3.
7 AIHW, op. cit., pp.5-7
8 The Northern Territory, which does not regulate the practice of podiatry, is the exception to this rule.
9 APODC website: see http://www.apodc.com.au/Education/Education.htm (accessed 11 May 2004).
10 ACPS website: see http://www.acps.edu.au/surgery.html (accessed 11 May 2004). The ACPS is the national organisation responsible for the 'development, implementation and monitoring of guidelines for the practice of podiatric surgery in Australia'. The ACPS was established in 1976 and is affiliated with the Australasian Podiatry Council.
11 A podiatrists' license to practice generally includes a license to use local anaesthesia where appropriate. In some states, some podiatrists are also licensed to prescribe and supply S4 (prescription only) drugs.
12 ACPS website: see http://www.acps.edu.au/surgery.html (accessed 11 May 2004).
13 Less than 10 out of approx. 540 private hospitals have granted podiatric surgeons admitting rights—Explanatory Memorandum (p.3). The number of public hospitals in which podiatric surgeons have admitting rights is believed to be even less.
14 It should be pointed out, however, that the Explanatory Memorandum (at p.6) notes that 'some medical groups' have expressed concern about the levels of training podiatric surgeons receive, and whether they are amply qualified to perform non-superficial procedures. Bennett and Patterson note that objections by the medical profession to surgical podiatry have also focused on podiatrists' 'pharmacological knowledge and pre-operative and post-operative care' (Bennett and Patterson 1997, op. cit., p.48). However, as noted above, there is little, if any, clinical evidence which supports these concerns. Orthopaedic surgeons have also expressed concerns 'about encroachment into their own specialty by surgical podiatrists and the resulting economic competition' (Bennett and Patterson 1997, op. cit., p. 48).
15 Bennett and Patterson 1997, op. cit., pp.47-48.
16 Explanatory Memorandum, p. 3.
17 The measures contained in the Medicare Plus package will only apply to services being provided by an allied health provider, 'for and on behalf of a GP', for patients with a chronic condition and complex care needs who are being managed under a multidisciplinary care plan through the Enhanced Primary Care (EPC) program—see the Department of Health and Ageing's Medicare Plus website: http://www.health.gov.au/medicareplus/update_march_04/glance04.htm#section4 (accessed 11 May 2004). Doctors' groups have expressed concern that few doctors will take up the allied health measures contained in Medicare Plus because of burdensome administrative arrangements associated with the measures—see Adam Cresswell and George Liondis, 'Red tape hinders Medicare plan: Concern about allied health/EPC link', Australian Doctor, 19 March 2004, pp. 1-2.
18 National Competition Council, Assessment of governments' progress in implementing the National Competition Policy and related reforms: Volume two - Legislation review and reform, AusInfo, Canberra, 2003, p. 98.
19 The amendments proposed by the Bill will not make it possible for health funds to pay benefits towards the cost of podiatric surgeons' or associated anaesthetists' fees, because podiatric surgery will still not be covered by the Medicare Benefits Schedule (MBS).
20 Though as also noted above, there is some evidence to suggest that the treatment outcomes from procedures performed by podiatric surgeons are as good, and in some cases better, than those performed by orthopaedic surgeons. However, the issue of expanding the availability of podiatric surgeons' services in public hospitals is beyond the scope of this Bill.
21 These include the Department of Health and Ageing, the Australian Institute of Health and Welfare, the Australian Bureau of Statistics, various state and territory health agencies, and various non-government stakeholders and interest groups.
22 Department of Health and Ageing, Australian Hospital Information, Performance Information Program website: see http://www.health.gov.au/casemix/hcp/hcpmain1.htm (accessed 11 May 2004).
23 ibid., see: http://www.health.gov.au/casemix/glossary1.htm (accessed 11 May 2004).
24 ibid., see: http://www.health.gov.au/casemix/hcp/hcpmain1.htm (accessed 11 May 2004).
25 Warwick J. Wilkinson, National Competition Policy Review of Pharmacy—Preliminary Report, Council of Australian Governments, Canberra, 1999, p. ii.
26 Explanatory Memorandum, p. 1, See: for example, the Pharmacy Act 1964 (NSW), sections 27 and 29.
28 ibid., p. 2.
29 National Health Act 1953, section 90(4).


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It was a wonderful day for our anonymous hero, at least until the moment when he was torn from his loved ones by a viciously sharp grappling hook.
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MIDDLEBURY — About three years after the old Champlain Bridge was closed due to safety concerns, workers will soon begin the final phase of work on the new Lake Champlain Bridge project.
That work will involve upgrades to property on the Vermont side of the span to include construction of a new boat launch, two gravel parking lots and walking paths with interpretive signs.
WEST ADDISON — Around 10,000 people are expected to converge upon the new Lake Champlain Bridge this weekend for a celebration marking the restoration of the vital transportation link between Crown Point, N.Y., and Addison.
A group known as the Lake Champlain Bridge Community (LCBC) has spent many months planning the May 19-20 festivities, which will include a parade, entertainment, vendors and a fireworks display.
WEST ADDISON — A legion of dignitaries and hundreds of residents from both sides of Lake Champlain marked the much-anticipated opening of the new Champlain Bridge on Monday afternoon.
Gov. Peter Shumlin and state Rep. Diane Lanpher, D-Vergennes, were among the Vermont delegates who helped cut the ribbon on the $76 million bridge that was two years in the making. The former Champlain Bridge, build in 1929, was abruptly closed on Oct. 16, 2009, after it was deemed to be unsafe for travel.
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Review: Bret Michaels gets The Paramount all fired up with rock classics Special
By Markos Papadatos Dec 29, 2018 in Music
Huntington - On December 29, global music star Bret Michaels performed a solo concert at The Paramount in Huntington, as part of "The Party Starts Now" Tour.
"Are you ready to party?" Michaels screamed, as he took the stage. "The Party Starts Now," he exclaimed, and he opened his set with "Talk Dirty to Me," where he encouraged everybody to raise their hands up in the air. It was well-received and it earned him and his talented four-piece band a standing ovation.
The veteran rocker went on to perform a classic Poison tune "Ride the Wind," as yellow and purple lights dimmed from the stage, which featured a killer electric guitar intro from Pete Evick.
"It is awesome to see all my good friends tonight. I am happy to be back in New York," Michaels acknowledged, and he wished everybody to have an "unbelievable holiday" and a "Happy New Year."
Michaels treated the audience to "Look What the Cat Dragged In," which was the first song that he ever played in New York back in the day. It was the title track of their breakthrough studio album, which was released in 1986, and he did it justice.
Speaking of New York, he shared that one of the most amazing shows of his career took place at Jones Beach this past summer with Poison. Ironically enough, this journalist felt the same way, as previously stated in his Jones Beach review, of Poison's "Nothin' But a Good Time" headlining show.
He went on to showcase his chops on harmonica on "Your Mama Don't Dance," and the crowd really got into it. He noted that he comes from a family of veterans, and without getting political, he expressed his gratitude to the veterans and the first responders for their service. "Thank you to the men and women in the armed forces for kicking ass and for allowing us to party," he said.
At that moment, he sported his patriotic hat and his acoustic guitar and delivered a poignant rendition of the inspirational "Something to Believe In," as he encouraged the audience to light up the venue with their phones, and they followed his wish, as if it were a command. "You look awesome tonight," he told the crowd.
During this song, Michaels invited several veterans up on stage with him, which was quite moving. He went on to describe these veterans as the "real deal," and rightfully so.
Rjkowal, Courtesy of Wikimedia Commons
He picked up the pace with the mid-tempo "Unskinny Bop." "It is awesome to be here at The Paramount," he said, and he asked everybody to give it up for his drummer, Mike Bailey, who broke into an impressive drum solo.
"Ladies and gentlemen, Mike Bailey on the drums," Michaels said, and subsequently introduced the other three gifted band members, which included the ever-talented Eric Brittingham on bass (from Cinderella), Pete Evick on guitar, and Robbie Jozwiak on keyboards.
"It never gets old playing in New York," he admitted. "You can't beat the energy in New York." He revealed that he recorded a new original song, "Unbroken," which will be released in the new year that features his youngest daughter, Jorja Bleu. "It is about fighting adversity," he hinted.
He introduced his signature ballad "Every Rose Has Its Thorn" as the first No. 1 single for Poison, and once again, he invited everybody to light up the venue with their phones. It was a beautiful sight, as everybody recited the lyrics verbatim.
Equally noteworthy were the vivacious "Nothin' but a Good Time" and his soaring rendition of "Sweet Home Alabama" by Lynynrd Skynyrd, where he left his dedicated fans yearning for more rock music.
Overall, Bret Michaels was able to get The Paramount all fired up with his superb solo performance. His band was comprised of four top-notch musicians, and they all delivered. It was a high-energy show and Michaels' zest and passion for his craft were infectious. He showcased a great deal of heart, with all the work he does to pay homage to our veterans.
Michaels proved yet again that he is worthy of a nomination for the Rock and Roll Hall of Fame, which is long overdue. At every Bret Michaels or Poison show, one thing is always guaranteed, that the fans and listeners will have "nothin' but a good time" to quote his smash single. He is equally comfortable performing in outdoor amphitheaters and indoor theaters alike. His live solo concert at The Paramount tonight earned an A+ rating.
For more information on acclaimed rock singer-songwriter Bret Michaels and his music, check out his official website and Facebook page.
More about Bret michaels, the paramount, Poison, Rock, every rose has its thorn
Bret michaels the paramount Poison Rock every rose has its t...


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Liverpool not haunted by Raheem Sterling and Luis Suárez, and Premier League win shows why
Waking up with Liverpool.com
Dan MorganContent Editor
There are no losers from Sterling's move to City. (Image: (Photo by Shaun Botterill/Getty Images))
A win is a win, as they say.
Within football that stretches beyond the boundaries of the patch of green and three precious points. Football is layered with winning and losing on every level. Marginal gains means you can win at eating breakfast or the mode of transport a team uses to travel to an away game. Yet when it comes to transfers, winning and losing takes on a whole new concept.
It's five years to the day since Raheem Sterling left Liverpool for Manchester City. On Thursday, it will be six years since Luis Suárez departed for Barcelona. Both players "won" in the immediacy of seasons which followed. They collected success and were vindicated in their decision to both themselves and the watching world, while Liverpool wore the capital L of both transfers to an extent it dwarfed the Liver bird upon their chest.
In recent years, the pendulum has swung as Jürgen Klopp fired his team back to the forefront of domestic and European glory. In signing Virgil van Dijk, City and the rest of the league "lost". As did, most notably, Phillipe Coutinho when he followed Suárez' path in 2018. But why the need for such absolution when it comes to these moves? Why can't things just work out or not? Why does it have to be contextualised with our own clubs' constant status?
Liverpool need specific transfer solution to fill imminent squad void, and must plan accordingly
Liverpool rightly have questions over Man City Champions League call, with UEFA's future in balance
In Sterling, there is now the argument that both he and Liverpool have won. He left and has become a world class and hugely successful attacker in City's frontline. Liverpool became league and European champions by climbing the hill their own way and not dwelling on him, Suárez or Coutinho. We're all winners then, right? Not quite.
Regardless of how things occasionally work out for the best all round, we will continue to scrutinise every single decision made by a person essentially moving job. They might not like the weather, where their kids go to school or the commute to training. Forget that, because if they plunder or prosper elsewhere we'll all be there with our beating sticks of I told you so judgement. In the case of Sterling and Liverpool on this day, it's time to finally let sleeping dogs lie.
What I'm reading on Liverpool.com
I wrote about the reaction to City's CAS appeal success twice yesterday. To (try) to put some light on the matter, this second piece about the thing they cannot quantify — being Klopp's impact on Liverpool — might give you an alternative look on the matter. Also, this piece from Andrew Beasley on Roberto Firmino's goalscoring problem is insightful and excellently written.
Bernadine Evaristo's Girl, Woman, Other is the book I've currently got my nose in and I must say, getting used to the relaxed writing style and format took a little getting used to. However, its waves of social consciousness and the burdensome issues pertaining to black, female, youth and minorities comes together so well. A really enthralling read to date.
Barclay's Premier League


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From California To The New York Island, A New Understanding Of Higher Medicare Spending
By Jordan Rau	 March 8, 2011
Some regions of the country that have been lambasted for high levels of Medicare spending actually are below the national average once the severity of patient sickness and special local expenses are taken into account, according to data from a new government analysis.
Manhattan, Contra Costa County, Calif., and Newark, N.J. – areas suspected as places where doctors and hospitals may be performing too many procedures – actually have Medicare spending below the national average, given their patients' medical needs, according to the new calculations from the federal Centers for Medicare & Medicaid Services, or CMS.
In CMS's analysis, 27 of the country's 306 hospital markets switched from higher than average to lower than average spenders after patient health and geographic cost factors were considered. Conversely, 60 regions that appeared to be low spenders in raw dollars actually were above the national average once the adjustments were made, the data show. Those areas include Ocala, Fla., Mobile, Ala., Tulsa, Okla., and Wichita, Kan.- nearly one out of every five regions.
Table: Medicare Spending Per Beneficiary
The CMS analysis may provide new fodder for an ongoing debate in Congress and health policy circles about altering Medicare payments to reward places that provide good medical care at a reasonable cost. The data were requested by the Institute of Medicine, which is examining geographic variation in health care spending and making recommendations about Medicare to U.S. Secretary of Health and Human Services Kathleen Sebelius. The institute made the data public last week.
Underlying the drive to change reimbursements is the hypothesis that hospitals and other providers in high-spending areas are performing excessive procedures in order to make more money from Medicare's fee-for-service payment model. For decades, some prominent researchers, most notably at the Dartmouth Atlas of Health Care, have argued that needless treatments are the reason that spending is higher in some places than others. The research has been cited as evidence that as much as one third of the $2.7 trillion expected to be spent on health care in the United States this year may be unnecessary.
Providers in many of the high cost areas have disputed this, saying their spending is elevated because they treat sicker patients. They also note that some areas may appear to be spending more on patients when they are getting extra money from Medicare to compensate for the costs of training doctors, treating large numbers of impoverished patients or having to pay higher wages.
The new data gives ammunition to defenders of some high-cost areas even as it confirms the existence of significant variations in Medicare spending levels across the country.
James Reschovsky, a senior researcher at the Center for Studying Health System Change, a Washington think tank, says the CMS analysis shows that the variation among regions is about a third smaller than previous estimates and that much of the differences can be explained by the overall health of the patients in a given area. CMS controlled for such differences by examining the prevalence of 189 different medical diagnoses among patients. CMS revised each region's costs based on the degree that they had to provide more or less expensive treatments than average. CMS also took into account other risk factors, including the overall age of the Medicare patients, whether they lived in a nursing home and whether they had qualified for Medicare because of disability.
"If you look at the data, you're going to see that high cost areas have sicker patients," Reschovsky says. "There's far more variation among physicians and providers within a geographic area than across areas."
Even after CMS adjusted for these factors, however, there remained a significant spread in spending among different regions in 2008. Medicare spent $9,468 for the average beneficiary in Monroe, La., but only $4,959 in Honolulu. (In CMS's calculations, the national average spending per Medicare beneficiary was $7,500 after the special payments were removed and the nature of patient sicknesses taken into account.)
Elliott Fisher, one of the leaders of the Dartmouth Institute for Health Policy & Clinical Practice, which publishes the Dartmouth Atlas, said the CMS analysis supported "the key conclusions of the Dartmouth Atlas: substantial variations in spending remain across U.S. regions that are not explained by differences in prices or underlying illness rates. These differences point to important opportunities to improve the efficiency of U.S. health care."
In the CMS analysis, the majority of the highest spending areas remained so after the adjustments. Miami, where federal prosecutors are intensely prosecuting Medicare fraud, still topped all regions with spending that averaged $10,145, which is 35 percent above the national average. McAllen, Texas, made infamous by a 2009 New Yorker article, dropped from second place to fourth, but still spent $9,370, or 25 percent above the national average. Many low-spending areas, such as Burlington, Vt., Rochester, N.Y., and Tacoma, Wash., also didn't change much.
But in the analysis, spending in 45 percent of regions changed relative to national averages by at least 10 percentage points. The Bronx spent 55 percent above the national average in raw dollars, but only 15 percent above the national average after excluding the extra payments Medicare provides for higher wages and special programs. Furthermore, the CMS data show doctors and hospitals had to treat an above average number of patients with chronic kidney disease, diabetes and heart problems. Bronx Medicare patients were also a little bit older than the average Medicare patient. When all this was taken into account, the Bronx's average per patient spending dropped to $6,719, or 10 percent below the national average.
In Mesa, Ariz., spending was 5 percent below average. But the average Mesa Medicare patient was slightly younger than the national average, and fewer patients than average had diagnoses that were expensive to treat such as heart failure and diabetes. After all the adjustments, average Medicare spending in Mesa became $8,370, which put it 12 percent above average.
CMS provided similar estimates for the states, although most researchers generally consider that less useful data because state boundaries don't conform to specific hospital markets. In the new risk-adjusted analysis, Maryland topped all other states in spending per Medicare beneficiary, although officials cautioned that since Congress uniquely allows Maryland to set its own hospital reimbursement rates, the state can't be fairly compared to payments set by Medicare elsewhere else. Maryland comes out so high in the CMS analysis because it includes extra Medicare payments for physician training and treating the poor that CMS removed from all other states' numbers.
In CMS's list of top spending states and territories for Medicare, Maryland was followed by Louisiana, Florida, Mississippi and Texas. The Virgin Islands was the least expensive, followed by Hawaii and Puerto Rico.
The CMS analysis is the latest in a series of studies reassessing geographic variation in Medicare spending. Last December, the Medicare Payment Advisory Commission, which makes recommendations to Congress, performed its own analysis that adjusted for regional cost differences and the health of patients to compare how some areas perform more services and drive up Medicare spending. That study, which used different methods than CMS did, also found a 30 percent difference between the highest- and lowest-spending areas.
Michael Chernew, a Harvard Medical School health policy professor who has studied geographic variation, warns there's a danger if the discussion is dominated by arguments about which regions are truly high spending.
"It's a much more complicated story than just finding areas and labeling them good or bad," he says. "Even once you do the adjustments, you'd still reach the conclusion there's so much variation in the health care system it's hard to explain that as random chance.
"In health care, we could improve our system if we knew the best and worst ways of practicing" medicine, Chernew says. "The real contribution" of the research, he says, "is to illustrate that there's not one unique practice pattern that's being followed all across the country."
This story was corrected from an earlier version.
jrau@kff.org
Jordan Rau, Kaiser Health News March 8, 2011
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Odds & Ends: Billy Porter to Direct World Premiere Play in Boston & More
by Broadway.com Staff • Mar 27, 2019
(Photo: Caitlin McNaney for Broadway.com)
Here's a quick roundup of stories you might have missed today.
Billy Porter to Direct World Premiere Play in Boston
Billy Porter is spreading his talents around. The Tony-winning Kinky Boots original and Golden Globe-nominated star of Pose has signed on to direct Dan McCabe's world premiere play The Purists as part of Huntington Theatre Company's 2019-2020 season. The Boston production will run from August 30-September 29, 2019. The Purists follows a former rapper, a DJ and a showtune-loving telesales director who have become an unlikely group, hanging out and sparring about music on a stoop in Queens. When an impromptu rap battle erupts between two younger female emcees, everything gets questioned. The Huntington's new season of shows will also include Rosencrantz and Guildenstern Are Dead; Quixote Nuevo; When We All Fall Down; Sweat; Our Daughters, Like Pillars; and The Bluest Eye.
Alan Cumming, Christy Altomare, Erich Bergen & Garrett Clayton to Read New Play Sparkler
A foursome of mega-talents will come together later this week for a reading of the new play Sparkler by Erik Champney. Tony nominee Sheryl Kaller will direct the private industry reading, set for March 29 in New York City. The cast will include Tony winner Alan Cumming ("Daddy"), Christy Altomare (Anastasia), Erich Bergen (Waitress) and Garrett Clayton (Hairspray Live!). Sparkler is set in 1964 Hollywood, where Clayton Boyd (Erich Bergen) is the prototypical icon, movie star, husband and devoted father—as far as the public knows. Behind closed doors, however, Clayton is an impulsive alcoholic and a closeted gay man whose hidden desires are bursting at the seams. The Hollywood moguls have kept his private life out of the public arena—until Jack (Garrett Clayton) arrives. Now Clayton's make-believe marriage is threatened, along with his public image.
Site-Specific Little Shop Extends at Bool's Flower Shop
Good news for the upcoming site-specific staging of Little Shop of Horrors. The highly anticipated production has been extended through May 2 at Bool's Flower Shop in Ithaca, NY. The shop has been repurposed as Mushnik's Skid Row Florists on the fictional Skid Row in New York City for the staging set to begin on April 24. The previously announced production has also announced casting. Leading the company will be Logan Geddes as Seymour, Audrey Fisher as Audrey, Amber Ward as Chiffon, Sushma Saha as Crystal, Courtney Long as Ronnette, Dharon Jones as Orin Scrivello, D.D.S., Kylie Heyman as Audrey II and Jaden Boyd as Mushnik, with Sami Schonberger and Tanner George as understudies. The production team includes producers Jacob Stuckelman and Ben Fleischer, director Alisar Awwad, music director Daniel Mullarney, choreographer Maria Scherer and lighting designer Chris Perrone.
Amanda Jane Cooper's Somewhere Over the Rainbow to Play Encore Performance
Amanda Jane Cooper, the former Broadway.com vlogger who played an acclaimed run as Glinda in Wicked, has added an encore turn to her new show at midtown's Feinstein's/54 Below. Following the sold-out show on April 7 at 9:30pm will now be a performance on June 7 at 9:30pm. Cooper's cabaret, titled Somewhere Over the Rainbow: A Night of Story and Song, will feature songs ranging from musical theater and pop to folk and R&B. Dan Micciche will music-direct.


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Tweets by foodnut1461
Cinzia Caggia
Associate professor, Department of Agriculture, Food and Environment, University of Catania, Italy
Jenzer Helena
Reader & Head, Department of Nutrition and Dietetics, Bern University of Applied Sciences, Switzerland
YongJae Lee
Adjunct Professor, Department of Nutrition and Food Science, Texas A&M University, USA
Nuray Guzeler
Professor, Department of Food Engineering, Çukurova University, Turkey
Sheryl LaCoursiere
Clinical Assistant Professor, University of Massachusetts, Boston, U.S
Zhengqiang Jiang
Professor, Department of Food Science and Nutritional Engineering, China Agriculture University, China
Abdelaziz ED-DRA
Faculty of Sciences, Department of Biology, Moulay Ismail University, Morocco
Doaa Mohamed El Amrousy
Assistant professor, Department of pediatric cardiology, Tanta University Hospitals, Egypt
Iwona Rybakowska
Chief, Department of Biochemistry and Clinical Physiology, Medical University of Gdansk, Poland
Jin Seop Bak
Prof. Dr. Sec.-Gen, United Cultural Convention, IBC, Cambridge, UK
Myoung-Gun Choung
Professor, Department of Herbal Medicine Resource, Kangwon National University, Republic of Korea
Manchala Raghunath
Scientist G& Head, Department of Endocrinology and Metabolism, National Institute of Nutrition, Indian Council of Medical Research, India
Pasquale Russo
Postdoctoral fellow, Department of Agriculture, Food and Environment Sciences, University of Foggia, Italy
Md. Shafiqul Islam Khan
Associate professor and Chair, Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Bangladesh.
Abdul Karim Salim Allaf
Professor	Doctor "Exceptional Class" 2E, Laboratory of	Engineering Science for	Environment (LaSIE-UMR 7356 CNRS), Pole Science and Technology - University of La Rochelle-France
Karina Oliveira Lima
Ph.D., School of Food and Chemistry, Federal University of Rio Grande, Rio Grande RS, Brazil
Masresha Ahmed
Lecturer, nuclear medicine unit, Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Ethiopia


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Obasanjo Not Among Buhari's Advisers – Oshiomhole
The former Governor of Edo State, Adams Oshiomhole, on Friday added his voice to those criticising former President Olusegun Obasanjo over his letter to President Muhammadu Buhari.
Obasanjo, apart from faulting the Buhari's administration, also advised him not to seek re-election in 2019.
But speaking with State House correspondents after meeting with President Buhari, Oshiomhole said Obasanjo is not one of Buhari's advisers.
He recalled that when Obasanjo was the President of the country he declared that he was at liberty to listen or not to listen to his advisers.
Since Obasanjo is not one of Buhari's advisers, Oshiomhole said the ex-President should allow the President to make his own decisions.
The ex- governor said he was in the Villa to reassure Buhari of his absolute and total support for the government and even for 2019 elections.
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The OpenPath project will improve undergraduate computing education by developing a learning pathway through the computing curriculum that will help address key challenges of computing education via student exposure to and participation in Humanitarian Free and Open Source Software (HFOSS) projects. HFOSS is open source software that improves the human condition, addressing needs in areas such as health care, disaster management, education, economic development, and accessibility. Students will be provided with opportunities to positively impact their communities or others, which will engage and motivate traditionally underrepresented minorities and women to pursue careers in computing. As a result, the OpenPath project will improve student learning and content retention, and will help students to develop professional skills and personal attributes.
OpenPath will integrate two existing research initiatives: participation in HFOSS, and Process Oriented Guided Inquiry Learning in Computer Science (CS-POGIL). In CS-POGIL, students work in small self-managed teams using specifically designed materials to construct their own knowledge. In this project CS-POGIL will be used to scaffold early learning and help students develop team and process skills. This early learning will support a transition to more independent learning in HFOSS environments. Working in an HFOSS project provides students with the skills and professional experience needed to ensure a smooth pathway to the computing professions. Multiple types of evaluations will enable the research team to track the progress of the project, to determine the legitimacy of the model created and its mapping to the curriculum, to understand the impact of the faculty and student activities, and to identify the student learning that occurs through participation in an HFOSS project.


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Monty Python's Flying Circus Season 4
Rating (7436)
Monty Python's Flying Circus is a British sketch comedy series created by the comedy group Monty Python and broadcast by the BBC from 1969 to 1974. The shows were composed of surreality, risqué or innuendo-laden humour, sight gags and observational sketches without punchlines. It also featured animations by Terry Gilliam, often sequenced or merged with live action. The first episode was recorded on 7 September and broadcast on 5 October 1969 on BBC One, with 45 episodes airing over four series from 1969 to 1974, plus two episodes for German TV. The show often targets the idiosyncrasies of British life, especially that of professionals, and is at times politically charged. The members of Monty Python were highly educated. Terry Jones and Michael Palin are Oxford University graduates; Eric Idle, John Cleese, and Graham Chapman attended Cambridge University; and American-born member Terry Gilliam is an Occidental College graduate. Their comedy is often pointedly intellectual, with numerous erudite references to philosophers and literary figures. The series followed and elaborated upon the style used by Spike Milligan in his ground breaking series Q5, rather than the traditional sketch show format. The team intended their humour to be impossible to categorise, and succeeded so completely that the adjective "Pythonesque" was invented to define it and, later, similar material.
Actor: Eric Idle, Connie Booth, Terry Jones, Ian Davidson, Terry Gilliam
Director: Ian MacNaughton, John Howard Davies
Monty Python's Flying Circus Season 4 was a hdmovies of Movies123. The started year is 1974. We can see some actors in detail, such as Eric Idle, Connie Booth, Terry Jones, Ian Davidson, Terry Gilliam and so on. Movie' genres are War, Action. About uploader, PutNuaDi is funny uploader, he is very lovely. Monty Python's Flying Circus Season 4 has high rated, it is 8.2 from www.imdb.com. We have a good movie for streaming. The length of this movie are so long, about 30 minutes. We may check on Monty Python's Flying Circus Season 4 all the day. There is only one word to say for Monty Python's Flying Circus Season 4, I think it should be 'crazy'. And now, what is your thought about Monty Python's Flying Circus Season 4. Do you know what are visitors thinking? Hatake Kakashi is the best. I don't fight my iPhone screen. Watch this movies and then share to your friends or family
Trailer: Monty Python's Flying Circus Season 4
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I am currently living in Anagni, which is an hour out of rome. I am searcing for someone to explore Italy with me on the weekends!
What's the best way to explore the Amalfi coast?
Exploring Italy for the first time.
What are 3 best things to do in Palermo that you won't find in typical tourist guide? And Catania?
What are 3 things to do in Palermo that you won't find in the average tourist guide?


There is nothing worse than having your investment property vacant for an extended period of time. For that matter even one week without a tenant is a week too much, especially if you have a mortgage against it. I am sure that you would have seen properties rented out within the first week it comes on the market. So what should you do as a Property Owner to get your property rented out fast?
In this article, I will provide property owners with 6 important tips to help.
The first and most important step is to get yourself a good property manager who knows the suburb that your property is located. In addition, the property manager should be able to treat your property as if it was the only property that they manage. When selecting a property manager, look out for honesty, professionalism and responsiveness. Timely and effective communication is the key in any relationship and this is certainly no different in property management.
Make sure that you attend to all the maintenance issues which have come to your attention. If you are handy with DIY jobs it would be great. However, make sure that you get the appropriate licenced tradies for plumbing, gas and electrical jobs. While it may be tempting to avoid additional expenditure, it is better to fix issues before they become bigger and more expensive to fix in the future. If there are items of a hazardous nature to be fixed eg exposed wiring, loose steps or railing get them attended to straight away.
Make sure the yard is spruce and tidy. There is nothing worse for a tenant than seeing an untidy garden and giving them the impression that it would be too much work. Outdoor spaces are every much as important as indoor living areas.
Once the property is empty – and I mean really empty of everything – make sure that it is cleaned to a professional standard. There are very good professional house cleaners out there that clean properties to a "bond standard". Do not spare this expense. Properties that are clean and neat rent out extremely fast. In addition your property manager would be able to enforce the same standard throughout the tenancy and when it is vacated.
At the end of the day, it is all about how the property is presented. In this day and age, tenants look for properties firstly on the internet and then they come for an inspection to confirm what they have seen and read. Therefore, it is extremely important that your property manager uses a professional photographer rather than just a smartphone. There is nothing worse than displaying a property with sub- par images. If a few furniture items could be added for the photo shoot it would be an added bonus. Not too must though as we want to emphasise spaciousness.
Make sure that your property management agency provides Premier Marketing on the major rental portals. This is to ensure that your property gets a top spot on the first page for the suburb.
If Property Owners follow these basic guidelines it will certainly go a long way in renting out their investment property out fast!
Realty8 is a premium service Property Management Agency servicing suburbs in Brisbane and the Redlands. Call us today on 07-3343 1591 or 0478 677 044 to find out how we could help you look after your investment property.
Royden is the principal and founder of Realty8. He is a Fellow (FCPA) of the Australian Association of CPA's and hold a Business degree from the Queensland University of Technology. Royden is an avid reader and is a passionate hobby photographer and digital artist. However, his real passion is Real Estate and Property Management in particular.


On September 11, 1777, the American General George Washington in an attempt to protect Philadelphia, engaged the British General Sir William Howe in the largest battle of the American Revolution. That 11-hour Battle encompassed more troops (nearly 30,000) over more land (10 square miles) than any combat fought on American soil until the American Civil War. This is registered pen number Z;ASE18013. I made it from a downed branch of a black walnut tree that is growing in front of the Benjamin Ring House where General George Washington made his headquarters during this battle. This tree is located at 39°52'26.27"N, 75°34'46.07"W.
I highly recommend an excellent, recently published book, "Brandywine by Michael Harris" that is now available. I have some of his author signed books but cannot offer them on Etsy. If you would like a pen-bookmark-book combo please contact me.
This pen has an oval of light gray-beige surrounded by darker brown. At the top this brown turns in to a highly chatoyant burl with a patch of green turquoise in gold acrylic. It is a twist action Ball Point pen that uses a Cross refill available at any stationary in broad, medium and fine points and three colors. The metal finish is a sealed 24kt gold.
Nature gives each of these a unique design which I have the pleasure to reveal. Because of the source, I can only make so many, so they will remain inherently rare. This pen is invested with historical, educational and inspirational value, it will be a piece of history in your hand to use, show, share and perhaps inspire among colleagues, friends and family.
Teachers, students, and enthusiasts of American, English, and French or military history. Pen collectors, and collectors and investors in history objects. Anyone who appreciates the unique, or just simple beauty. And of course, anyone living in the Chadds Ford aria.
Each pen comes on a nice handmade pillow in a box suitable for display and gift giving (gold with a clear top) and a parchment paper pamphlet with a history of this famous battle, along with the documents described below.


This major archaeological site has been classified by the UNESCO as a World Heritage Site.
The Chavin civilisation has developed between 1200 and 400 BC influencing an enormous territory stretching from the Pacific coast to the Amazon.
During the guided tour of the archeological site and the museum you will learn of its historical importance and of its ceremonial customs.
Walking around the two temples discovering the Stela Raimundi and the Cabeza clava Three animals are worshipped here : the Condor, the Felin and the Snake.
Not included : The entrance fees of the site and the museum Museum, lunch.


2015 – Another Year of the Car!
America's love affair with vehicles is reported to have peaked fifty years ago during the 1960's as baby boomers began driving, the US interstate highway system was expanded, and rock and roll both popularized and gave personality to many cars. While our attachment has certainly changed, one only needs visit a classic car show, see a young driver purchase their first new car, or meet a gathering of millennials with modified rice-burners in a grocery parking lot to recognize that Americans still embrace their vehicles. Welcome 2015 – Another Year of the Car! Go auto industry!
Like all great loves, our emotional attachment to our vehicles has evolved with time. It aged, shall we say, with enthralling systems surfacing that are far quieter than healthy cams and the straight exhaust of our teens. Features that enhance safety, customization, and provide tele-connected experiences are coupled with sleek drive-train combinations that provide performance and increased fuel economy.
While car culture may have waned with younger drivers for a short time. The manufacturers have adapted both the vehicles and their marketing strategies to bolster interest even in the millennial market. As for us Baby Boomers, we are now allowed a sophisticated sports or luxury drive that does not insult our growing sense of responsibility for future generations.
Despite the reports that interest in vehicles calmed there are economic indicators and technological developments that tell a different story this year. Vehicle prices and sales are strong, with economic indexes being one of our best gauges of interest. Even classics such as Mustangs, Barracudas and Corvettes continue to gain value and new vehicle sales are stronger than we have seen in years. We look forward towards self-driving vehicles, increased performance, continually improved safety and vehicles that we can feel good and even green about.
Throughout the ages, we continually reinforce the emotional attachment we have with our cars. The changing year brings a time for reflection on the past, for this recent year and for times gone by. As you remember the iconic images we associate with our vehicles like drive-in theaters and roller skating waitresses at drive in hops, be assured that the smiling service station attendants who topped off your fluids, aired your tires and checked your oil are alive and well at the neighborhood garage you have come to trust.
You can trust the ASE Certified Technicians at Beckwith's Car Care.
Give them a call to talk in person, or visit www.beckwiths.com to chat live online.