Lenovo Z5 Pro features a 6.39-inch Super AMOLED display by Samsung. The notch-less display supports Full HD+ resolution of 2340 x 1080 pixels. The screen is surrounded by 2.07mm slim bezels. According to Lenovo, the Z5 Pro offers a screen-to-body ratio of 95.06 percent and an aspect ratio of 19.5:9. The HDR 10 compliant AMOLED display is embedded with fifth-generation photo-electric under-display fingerprint sensor.
The slider of the Lenovo Z5 Pro houses multiple sensors such as dual front-facing cameras, infrared sensor, infrared light and proximity sensor. The dual selfie camera setup comprises of an f/2.2 aperture 16-megapixel main sensor and an 8-megapixel infrared camera. The Z5 Pro features AI capabilities for shooting beautified selfie images and it also carries support IR face recognition for accurately unlocking the phone in dim-light.
Do you accept returns if in case it doesn't work in Australia. Coz some forums say it won't install Viber and whatsapp.
Re: Yes, return in a week, but keep new condition(for sale).
Does this phone work in USA and is it released?
Re: It is only available in China now, It works on these bands: 4G FDD-LTE: B1/B3/B4/B5/B7/B8, please check if your SIM cards compatible with this phone.
HOW MUCH WILL IT COST FOR THE EXPRESS EXPEDITED SHIPPING TO KENYA?
Re: The DHL shipping cost is $39.99 to Kenya.
Does this phone work in Australia?
How long does it take for you to ship the device?
Re: Estimate delivery at beginning of December, Lenovo only release a few phones to the market now, we only get a sample so far.
it will work in usa, with 4g lte?
Re: Please check the LTE bands, it only support B1/B3/B4/B5/B7/B8.
Can I install nova launcher and replace it with Lenovo's launcher on it?
Re: I think it's difficult, but you can try.
Re: It will be shipped out in 5-7 days.
Does Lenovo Z5 pro work in India network if yes then I will purchase ?
1 - Are you sure that it have playstore installed?
2 - Are you sure thar it have italian language?
4 - Do you offer warranty?
5 - What about duty taxes?
1. Yes, Google Play store installed before shipping.
3. No microSD card slot.
4. Yes, 2 years warranty.
5. For Italy, about 20% customs importing duty.
Does this phone have google play installed? And where do you ship from?
Re: Yes, with Google Play, from China.
Do you get an EU charger and case for the Lenovo Z5 pro?
And how much cost the shipping to Belgium?
Re: It comes with a EU charger adapter, no case for this phone yet, but we will list it soon. About the shipping cost, it is $12.99 to Belgium.


text:
~closed to lizard~
/ By wingedwolfy120 [+Watch]
Replies: 7879 / 186 days 23 hours 31 minutes 7 seconds
"this is my second trial with the calcium pills..." She said and sighed frustrated. "The first batch I made was too potent and..." She showed him a picture of the poor lab rat covered in painful bone spurs. "The little guy died after a few days of it..."
Midori Uchiha / wingedwolfy120 / 170d 23h 40m 45s
Sasuke studied the mentioned projects and studied the notes with his Sharingan to memorize it. He looked back at Karin and smiled a little as he nodded. "Any trouble so far?" he asked her softly. He wondered if he should let Sakura check the projects as well, knowing she could help a ton as well.
Sasuke Uchiha / TheLizardWizard / 170d 23h 43m 46s
Karin smiked at her old friend and said. "I'm working on a couple of different formulas right now. The aburame clan wanted me to develop this special anti venom for this really rare spider that's starting to populate the forest more...." She stretched slightly and showed him the other one. "This one is supposed to help with calcium production for broken bones.... Help them heal faster."
Sasuke finally arrived at the old lab he took from Orochimaru. He let himself in and soon found Karin. "Hello, Karin. Any new medicines I should know about?" he asked as he looked around the lab.
Sasuke Uchiha / TheLizardWizard / 171d 2m 31s
She watched him leave and got dressed. She ate her takoyaki a little sadly at the table and sighed.
Midori Uchiha / wingedwolfy120 / 171d 4m 25s
Itachi kissed her several times, having trouble leaving her. He kissed her one last time before he grabbed his things and nodded. "I'll be back in a few days, honey," he promised then headed off.
She touched his necklace and listened looking at it. He almost never took it off and so him doing this meant a lot to her. She leaned forward and kissed him gently. "I love you."
Itachi went to her side again and kneeled down. He removed his necklace and put it on her with a smile. "I swear on my Uchiha honor that I'll always come home, Kara. No matter what it takes."
"Itachi...." She called out before he could leave and looked up at him worriedly. "Come home alive...."
Midori Uchiha / wingedwolfy120 / 171d 11m 58s
"Kara, I've never been mad at you," he told her and kissed her lips. "I swear." He got his things together and smiled. "I have to go..."
Sasuke Uchiha / TheLizardWizard / 171d 14m 12s
She blushed feeling a little guilty and looked up at him. "You're not mad?" She asked and took the food.
Itachi practically ran out of the house to find some. When he did, he ordered extra just in case then ran back home. He tried catching his breath as he handed her the food. "E...enjoy," he managed then smiled.
She blinked at him and shook her head. "I genuinely really want some... You don't have to get me any though..."
Itachi froze with his face near her stomach and stared up at her. "....Are...Are you messing with me, Kara?" he asked her softly, eyes wide. "Shisui loved that stuff..."
Sasuke Uchiha / TheLizardWizard / 171d 34m 2s
She blushed at his soft kisses on her stomach and smiled shyly. "I've been soft of craving takoyaki..."
1..445446447448449450451452453454455..526

redpajama_set_name: RedPajamaCommonCrawl


The Washoe County Sheriff's Office is investigating a shooting in the Galena area that happened early Sunday morning, killing one and injuring another.
The Washoe County Sheriff's Office is investigating a shooting in the Galena area that happened early Sunday morning, killing one and injuring another. WCSO is asking for the public's help identifying the suspects.
Just before 3:30 a.m. on June 24, deputies responded to the area of White Cedar Drive and Galena Meadows Road on a report that a shooting had just occurred, according to a press release from the Sheriff's Office.
Deputies located two known victims and found evidence that multiple shots had been fired.
Deputies interviewed multiple witnesses who were attending a party nearby, but they had no information that helped identify the suspect's vehicle.
Anyone with information that could assist with this investigation is asked to contact the Washoe County Sheriff's Office at (775) 785-WCSO or Secret Witness at (775) 322-4900. Refer to case #WC18-2949.
White Cedar Drive and Galena Meadows Drive are expected to be closed for an unknown duration due to this incident.


Tall trees, mushroom ice-cream, a Buddhist brunch: the possibilities are endless in this rural slice of Northern California.
The week's best bargains around the globe.
The extra legroom comes with written rules, unwritten rules and serious responsibilities.


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Oliver Mayman
An Ann Arbor, Michigan, native and current student at Philadelphia's Temple University, Oliver Mayman is a vibraphonist, pianist, educator, and composer. Beginning as a child on drums and piano, the vibraphone was an inevitable discovery as a teenager -- the instrument essentially fusing the mechanics of drumming with the harmonic capabilities of the piano. By bringing his array of pianist influences such as Thelonious Monk, Bud Powell, Bill Charlap, and McCoy Tyner and applying their concepts to the vibraphone, he truly treats the instrument as a piano, comfortable in every setting from solo to big band. He has performed across Michigan and Pennsylvania, from clubs like Cliff Bell's, the Blue Llama, and Chris' Jazz Cafe to events attracting hundreds of thousands like the Detroit Jazz Festival. He also has extensive teaching experience, teaching privately for vibraphone, piano, and music theory, in addition to being on faculty at vibesworkshop.com.
In 2021, He won the Italy Percussive Arts Society jazz vibraphone competition, the largest vibraphone competition in the world. He has also received a Downbeat Magazine student award for outstanding combo (2019) and outstanding soloist (2020); been awarded second place in the junior open division at the prestigious 2018 M-Prize International Chamber Arts Competition; and been invited to perform at the 2019 Detroit Jazz Festival as part of an all-star youth group composed of high schoolers from across Michigan.
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Using Deadstroking and Staccato Dampening in your Lines Video Upload 01/19/2022 - 12:43
"If I Should Lose You" - Solo Vibes Arrangement Video Embed 01/15/2022 - 16:00
"Dampening Speed" Lesson Video Upload 01/15/2022 - 15:55
"Half-Dampening" Lesson Video Upload 01/15/2022 - 14:20
Skylark - Vibes Trio Video Embed 12/27/2021 - 22:44
Who played vibes on Ella Fitzgerald's "Ella Wishes You a Swinging Christmas?" Blog entry 12/27/2021 - 21:19
All By Myself - Vibes Trio Video Embed 12/14/2021 - 13:35
3 Interesting Chord Voicings that Shouldn't Work but do! Video Upload 12/13/2021 - 00:02
The 2 Methods of Moving Chords Around (AKA "planing") Video Upload 12/12/2021 - 23:58
The 3 Types of Spread Voicings Lesson: Drop 2, Drop 3, and Drop 2+3 Video Upload 12/03/2021 - 14:25
Basic Voicing Construction Lesson Video Upload 12/03/2021 - 13:48
Chord Scales for Minor and Half-Diminished Chords - Dorian, Harmonic Minor, Locrian, etc. Video Upload 11/25/2021 - 12:29
Chord Scales for Major Chords - Ionian, Lydian, Harmonic Major, Double Harmonic Major Video Upload 11/25/2021 - 12:01
The Three Types of Dominant Chords, Part 2: Why does lydian dominant exist? Video Upload 11/17/2021 - 00:15
The Three Types of Dominant Chords (Don't Play Mixolydian over Everything!) Part 1 Video Upload 11/15/2021 - 12:10
Softly, as in a Morning Sunrise - Solo Vibraphone Video Embed 11/08/2021 - 11:59
Partial Deadstroking Lesson Video Upload 11/08/2021 - 11:03
Staccato Dampening and Deadstroking Lesson Video Upload 11/08/2021 - 10:52
Everything Happens to Me - Solo Vibraphone Video Embed 11/03/2021 - 14:06
Augmented Scale Lesson Part 2: Triad pairs and how to use it more musically Video Upload 11/01/2021 - 12:27
Augmented Scale Lesson Part 1: How it's built and what chords to use it on Video Upload 10/30/2021 - 12:34
Inner Voices Dampening: How to create harmonic motion within one chord Video Upload 10/25/2021 - 14:08
How to Pitch Bend Using Dampening: Monk "bent" notes, blues inflection, and chordal pitch bending Video Upload 10/25/2021 - 13:34
Selective Dampening Lesson: Creating chords out of lines Video Upload 10/04/2021 - 14:20
A Sleepin' Bee - Solo Arrangement (with verse) Video Embed 09/27/2021 - 12:02
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this is very cool and…
In reply to: 24/8 — African drums played with Burton grip
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Hmm, it wouldn't play in the…
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Stand Alone I'll Be Seeing You
Roger that. I'll spend some…
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Correct, just going through…
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great with the piano!
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Home — Business Office—Bree Bullingham
Bree Bullingham
Payroll (login required)
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Associate Vice President for Human Resources
bbullingham@mmm.edu
Bree has worked in Human Resources for more than 20 years. She returned to MMC in 2009 after leaving her first role as HR Generalist at MMC in 2004. From 2004-2009, she worked as the HR Director for Cohn and Wolfe, NY, a Public Relations firm, where she was responsible for recruitment, benefits administration, implementing training programs and policy, as well as providing counsel on employee relations issues and performance management. Prior to these roles, Bree was the HR Manager at a boutique PR firm called Lippe Taylor. She started her HR career as a technical recruiter for Merrill Lynch. Bree holds a Bachelor of Arts in Psychology from Skidmore College. After college, she returned to her hometown of NYC where she received a Master's Degree in Industrial and Organizational Psychology from Baruch College.
Carson Hall, Room 305C


Professor Paul Collier is to be recognized at a special ceremony this week, having been awarded the prestigious 2013 A.SK Social Science Award. The award is bestowed every other year by the WZB Berlin Social Science Center in recognition of work towards political or social reform. This year, the international jury honors Paul Collier for his contributions to understanding global issues of development and social inequality.
Paul Collier is a professor of economics and public policy at the Blavatnik School of Government and director of the Centre for the Study of African Economies at Oxford University. He is also a Professeur invité at Sciences Po, and Paris 1. He is the author of the international best seller The Bottom Billion (2007). His book Wars, Guns and Votes: Democracy in Dangerous Places was published in 2009, followed by The Plundered Planet: How to reconcile prosperity with nature (2010).
Professor Collier took a five-year public service leave, from 1998 to 2003, during which he was director of the World Bank Research Development Department. He is currently advisor to the International Monetary Fund Strategy and Policy Department. He writes a monthly column for The Independent, and also writes for The New York Times and other international papers.
Collier's latest book, "Exodus", was published earlier this month.
The 100,000 Euro A.SK Social Science Award is one of the best-endowed awards in the social sciences. The endowment capital has been donated by the Chinese entrepreneurs Angela and Shu Kai Chan. The award recognizes outstanding contributions to social and political reform. The previous prize-winners have been British economist Sir Anthony Atkinson (2007), the American law and philosophy professor Martha C. Nussbaum (2009) and the non-governmental organization Transparency International (2011).
The award ceremony will be held on October 19, 2013, 1 p.m. at the WZB.


It's all well and good to talk about the awesomeness of our summer dining options, but the fact is most of us get the bulk of what we eat from grocery stores, not restaurants. Restaurants are a convenience and a treat – a splurge, even – while grocery stores supply us with the ingredients we eventually toil over to turn into everyday meals, right? Not any more.
Until recently, the distinction between restaurants and grocery stores was pretty clear, but anyone who has been paying attention has probably noticed that grocery stores increasingly blur that line.
Grocery stores have always provided convenience meals (which are typically frozen and generally gross). But now, depending on the store, the fresh, prepared snacks and meals you can buy are anywhere from pretty decent to really great.
What the mainstream grocery stores have picked up on recently, Community Natural Foods has been doing since 1977. Community focuses on high-quality, local and organic ingredients in the meals and snacks it sells and serves in its in-store caf, which underwent a major renovation in 2011 and has both eat-in and to-go items.
Whether you're heading out for a picnic or home from work and don't have time to cook, remember that grocery stores aren't just for groceries anymore.
Selections vary and may not be available at all locations.


The Italian composer Ennio Morricone is now established as one if the masters in the art of music for films. This excelent arrangement from the film of the same name will be an undoubtedy success at your next concert.
This humourous theatrical arrangement takes a satirical look at the many "spaghetti" Westerns. Ennio Morricone's immortal theme is the basis for a "shoot-out" between "Clint Eastwood" and a "Mexican Bandit", but (un)fortuantely the conductor gets caught in the cross fire! A lot of fun for both band and audience. Ray Farr's arrangement is available scored for brass and wind band.


April | 2014 | Read.Write.Discuss.Repeat.
It's finished! And now onto the next one.
My second short story of the year entitled 'A night like any other', is finally finished. I continued with the third person view point and it seemed to work. When I go back over it and then look for feedback I'm sure I'll find out it doesn't. Or maybe it does. In my head it seemed to work as a way of connecting to two half's of the story.
Both parts have been written from the first person view point so going to the third person, in my head anyway, allowed their stories to link up and conclude. I did consider going from the second person view point but I've only recently tried it. I didn't want to use it until I was completely at ease with the second person view and, I just didn't think it would work. I also ended up putting a twist in at the end which ties up any loose ends. I did consider leaving it to the reader to decide what happened next but I didn't think it would work. Anyway, that story is complete.
So, I then found myself with nothing to do on a Tuesday night. I would usually update this little blog of mine but another run left me feeling tired and unable to concentrate or want to look at a computer screen. Having done that all day I'm sure you can understand. Instead, I wrote out an idea for my next story. The idea is about a world which is split equally into two half's. Each being led by a leader that led their army to victory over a now completely dead third party. Once the dust settled, it was agreed by both leaders second in command, because the two leaders could not function after almost dying in the war, that the world be split equally. But the leaders, now living peacefully, long to fight each other to see who is the better warrior. However, with no fighting of any kind between the two sides, how would this ever happen?
Not sure yet. I have a rough idea but will go over it again soon. Iron out the creases. I could've done that last night but I ended up watching some football (soccer) and then a few episodes of The Walking Dead season 3. I'll do it at some point.
Right, I'm off to do something else.
It doesn't look too bad after all.
Following on from last time, I've started to write the beginning of the end of my short story 'A night like any other'. It's a story of two complete strangers and how they eventually meet and fall for each other over the course of one night out written from the first person perspective of each of the characters alternately.
I like writing using the first person point of view as it makes me think more and more about the emotions people go through day to day. In just writing about something as simple as getting ready and going on a night out I've enjoyed how much detail I need to go into to make it even slightly realistic. And this hasn't meant me going on and on, this has just meant being more concise and to the point to get the reader into the minds of my characters as smoothly and efficiently as possible. I have previously written and almost completed a long story from the first person view point so I might go back to it to keep it fresh in my mind. I'll make that decision when I'm done with this story I think because it is hard work. But the good kind of hard work.
So, I've written 500 words which I've written from the third person view point. So much for liking first person and all that. I said last time that I wasn't sure it would work but I think it has. Bit biased but there you go. As I was writing it, the impression it gave me was of two different paths meeting at the end of each of their respective journeys. Both meeting in a kind of inevitable conclusion. Or is it inevitable and is it the conclusion they both want? Who smeggin knows. I'll come to that part when I'm right RIGHT at the end. Which should be soon and as always I'll let you know.
A couple more words and a fair few distractions.
Since last time I've managed to get another 500 words written for my short story. I've laid out the story using 500 words for the two main characters. First is from the man's point of view, second from woman's point of view and so on. The last 500 I have broken up into 250 word chunks for each character as they are about to meet. I'm thinking of changing the view point from first person to third for the final part of it. Though I'm not entirely sure it will work but I'm going to try it. In my head it will works wonders but usually that thought jumps right out of my brain once it's been written. Fingers crossed and all that.
As for the distractions, having moved out of the flat I shared with my friend all we now have to do is get the deposit back. But will it be, again like it is in my head, all plain sailing? Of course not! This is life! How can something so simple be that way? The estate agents have contacted us and have played a very strange game in order to get as much of OUR deposit into THEIR pockets. My friend has unfortunately had plenty of experience with this kind of thing. He knows what to do but it is all a bit distracting. I was hoping to get the deposit back so I could book my yearly holiday. Hopefully it will all be sorted soon.
And then to my day job. I'm currently loaned over to a team whose department is expanding and will be offering permanent positions doing what I'm doing now. I should be able to apply on Monday so I've been getting my CV in order. Which has taken time as I keep going over and over it. More distractions but if all goes the way I'd like it to, I'll have a new job and lots to look forward to.
All this has stopped me from writing as much as I'd like to so I'm going to use the next week to make up for it. I'll let you know how it goes.
To sign off, The Picture of Dorian Gray is still going strong. I'd recommend it already without even being half way through it.


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August/2021 vol. 3
CC-BY-NC 4.0
Direct primary care: Family physician perceptions of a growing model
Gayle Brekke 1
Jarron Saint Onge 1
Kim Kimminau 2
Shellie Ellis 1
University of Kansas Medical Center, Kansas City, United States
University of Missouri, Columbia, United States
Gayle Brekke
University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, United States
Popul. Med. 2021;3(August):21
DOI: https://doi.org/10.18332/popmed/140087
References (36) Citations (1)
physician perspectives
alternative models of care delivery
Health Service Coverage
Direct Primary Care (DPC) is a relatively new primary care practice model in which patients receive unlimited access to a defined set of primary care services in exchange for a monthly practice-specific membership fee. DPC is a bottom-up physician-driven approach in contrast to typical top-down insurer-centric healthcare delivery reform efforts. The degree to which physicians are aware of this practice model and whether they believe it addresses two key challenges facing primary care, access and administrative burden, are unclear.
An online survey was distributed in July 2017 to 672 members of a research marketing sample of the American Academy of Family Physicians (n=225; response rate 33%). Based on AAFP definitions, the survey consisted of both open- and close-ended questions that gauged family physicians' awareness of DPC, as well as their perceptions about the model.
Most respondents (85%) had heard of DPC and 8% practised in a DPC model at the time of the survey. In general, respondents reported that DPC can offer positive outcomes through lower administrative burden for physicians, improved doctor–patient relationships, and better access. Respondents also suggested DPC may result in improved patient health outcomes and lower overall healthcare spending. Respondents' concerns included inappropriateness of the model for vulnerable populations and physician shortages. Survey responses differed depending on whether the respondent practised in a DPC model. DPC physicians had a more favorable view of the model and were focused on benefits to patients rather than benefits to physicians.
Any changes to practice models will require a better understanding of clear definitions of practice models. Further education is required about the specific benefits to vulnerable patients and practice standards. As the perceptions of DPC vary by practice experience, DPC physicians appear to be strong potential advocates of the model.
Despite widespread agreement that the availability of robust primary care is critical to the health of patients and the performance of the healthcare system overall1-3, primary care faces several difficult challenges, including lack of adequate access for many patients4-6, and high levels of administrative burden leading to both physician burnout and career dissatisfaction7-12. While alternative models of primary care delivery, such as Direct Primary Care (DPC), offer the potential to mitigate these challenges, less is known about physicians' knowledge and perspectives on the relevance of new approaches to care. Accordingly, this study uses a sample of family physicians to explore their understanding and interest in adopting a DPC approach and how it varies by their current practice model.
DPC is a primary care delivery model characterized by enhanced access to care13; DPC patient panels are roughly one-third to one-fourth the size of typical PCP patient panels and DPC physicians spend a smaller portion of their time on administrative tasks14,15. In a policy statement supporting DPC in December 2017, the American Academy of Family Physicians (AAFP) found DPC to be consistent with the Academy's advocacy to protect and enhance 'the intrinsic power of the relationship between a patient and his/her family physician to improve health outcomes and lower overall healthcare costs'. A body of literature connects various aspects of the doctor–patient relationship and trust with patient health outcomes such as use of preventive services, treatment adherence, reduced ED visits and hospitalizations, and lower expenditures16-19. The DPC model appears to show considerable growth over the past several years; while there is no official registry of DPC practices, an unofficial source showed 125 practices in 2014, 620 in 2017 and over 1500 in 202120,21.
Several articles and commentaries suggest that DPC practices have benefits specific to physicians, as well as to patients. For example, emerging research shows the potential for improved physician satisfaction through patient engagement and shared decision making, increased time to develop personal relationships and improvement in the quality of care22-25. Additionally, DPC models have the potential to reduce administrative burden for physicians. DPC is a decentralized, physician-driven model of primary care delivery compared to other more common delivery reform efforts that tend to be more centralized and bureaucratic. For example, delivery reform efforts such as patient-centered medical homes and accountable care organizations are characterized by guidelines and oversight, which may serve patients, but may also be associated with high administrative burden among physicians due to their numerous documentation and reporting requirements8,9,26. In contrast, there is no national DPC organization to define requirements or practice rules, and there are no documentation or reporting requirements associated with the DPC model, which may reduce physician administrative burden but may also have implications for practice standards.
This study gauges the awareness of DPC among a sample of family physicians. Specifically, the objective is to understand whether physicians are aware of DPC and if they view DPC as a model with potential benefits. We explore physician perceptions of DPC patient care and their understanding of the model. Next, we aim to understand physician perceptions about the model's potential to increase professional satisfaction. Finally, we compare responses by the respondent's practice model (DPC compared to non-DPC) to describe characteristics germane to both groups.
There remains limited visibility of the DPC model and it is unclear how physicians understand or interpret the potential advantages or challenges associated with this approach. Physician perspectives about DPC are important for several reasons. First, physician-level knowledge about the structure and definitions of a DPC model will provide information about whether physicians accurately understand the model. Second, if uptake and/or modifications to the DPC model are to increase, it remains important to understand how family medicine physicians perceive advantages and disadvantages of the model. Questions about whether physicians perceive that DPC might improve career satisfaction or improve patient access to primary care present an opportunity to assess the potential future growth of the DPC model in the US. Third, research consistently shows that administrative burden (leading to physician burnout and career dissatisfaction) and lack of adequate access to primary care for vulnerable patients remain key problems in primary care4-12. Identifying the differences in perceptions among DPC compared to non-DPC physicians will highlight whether those currently in the model exhibit more or less favorable perceptions of a DPC approach.
We developed a survey that was distributed online by the American Academy of Family Physicians (AAFP) during the week of 17 July 2017. Participants were self-selected through their participation in the Member Insight Exchange (MIE), the marketing research online community of the AAFP, which had a total of 672 members. The sampling frame included all MIE members. Results of MIE surveys, while not fully generalizable, provide a snapshot of views and practice patterns of AAFP members27,28. The Institutional Review Board of the University of Kansas Medical Center determined the study is exempt from human subject protection review.
Most survey questions had a small number of fixed responses and respondents had an opportunity to submit written responses to open-ended questions. Items elicited physicians' perceptions about: 1) patients' understanding of DPC, 2) the financial sustainability of DPC practice, 3) patient health outcomes in DPC, and 4) quality of care in DPC. Respondents were first asked whether they have heard of the DPC model and whether they currently practise in this model; they were then asked to choose the best definition of DPC from a short list in which generally accepted definitions of DPC, patient centered medical homes (PCMHs), and other primary care delivery models, were provided as options.
Second, we used an AAFP-endorsed definition to assess knowledge and beliefs about the DPC model. AAFP defines DPC as a model in which physicians do not accept payments from insurance companies or other third-party payers, but rather, patients pay a monthly membership fee ranging from $50 to $150 for a defined set of primary care services for no extra charge, and low-cost prescriptions and other services13. Survey respondents were asked to indicate their agreement on a Likert-type scale with each of several statements about the model: Statement #1 – patient confusion; Statement #2 – not financially sustainable; Statement #3 – increases physician shortage; Statement #4 – only benefits healthy and wealthy; Statement #5 – lack of health improvement; Statement #6 – low quality. Statements were worded negatively with agreement indicating negative perceptions of DPC. See Figure 1 for complete text of the statements.
Level of agreement with statements about direct primary care by practice model
Next, respondents were asked to rank the top three benefits of the model, selecting from a list of five choices. Respondents could select 'Other' and enter a written response. The topics included administrative burden, time with patients, spending on downstream care, and physician responsiveness to patient needs and preferences.
Results were summarized and compared by practice model (DPC or not), using the Mann-Whitney U test. Complete case analysis was performed. Fifteen surveys with missing data on either the outcome or the belief statements were excluded.
There were 225 complete responses to this survey for a response rate of 33%. Respondents were similar to AAFP membership by sex, years since completed residency, and practice ownership model. Table 1 represents distributions of survey respondents, MIE members, and AAFP members, however, variables of interest to this study are not available in the broader data.
Characteristics of survey respondents, member insight exchange and AAFP active members (2017 AAFP data)
AAFP
Member insight exchange
Male 58 50 55
Female 42 50 45
Years since completed residency
≤7 25 32 21
≤22 32 19 37
Ownership model
Sole owner 13 13 11
Partial owner 17 14 12
100% employed 66 69 74
Not applicable/not in clinical practice 3 3 2
Member count 68300 672 225
[i] No variables are significantly different between AAFP members and survey respondents.
Most respondents (85%) were familiar with DPC, with 8% of the sample reporting practising in a DPC model; a majority (79%) selected the AAFP-endorsed definition of DPC, 13% responded 'Don't know' and 8% selected a definition that aligns with PCMH rather than DPC.
Respondents indicated agreement with statements that DPC has benefits for patients. For example, a minority expressed concern about quality in DPC, with 29 (13%) perceiving that DPC practice will result in quality problems such as over-treatment and under-treatment. Similarly, 43 (19%) perceived that DPC patients will not experience improved health outcomes. There was, however, concern about the applicability of DPC to all patients. While the survey did not directly address low-income or vulnerable patients, two respondents expressed this concern in the open-ended responses. One physician stated: 'This model may leave undue burden on patients and it risks losing the primary care safety net for the very poor and underserved'.
For all statements included in Figure 1, agreement was greater among non-DPC than DPC family physicians. For four of the six belief statements, the difference in responses by the physician's current practice model was statistically significant. Compared to non-DPC physicians, DPC physicians were less concerned about the primary care physician shortage (p=0.013), less concerned about the potential for over-treatment and under-treatment in DPC (p=0.039), more certain that DPC benefits more than just healthy and wealthy patients (p=0.038), and more certain that DPC will lead to improved patient health outcomes (p=0.028).
Figure 2 presents the respondent rankings of the topthree most important benefits of DPC. Overall, respondents ranked the most important benefits about DPC as: 1) lower administrative burden, 2) improved patient health outcomes, and 3) lower healthcare expenditures. Forty-eight percent of respondents selected lower administrative burden as the most important benefit and 84% selected it as one of the topthree benefits of DPC.
Ranking of DPC benefits by practice model
Increased time with patients to improve the doctor–patient relationship and to educate the patient and get to the root of problems was selected by 68 respondents (30%) as the most important benefit and by 189 (84%) as one of the top-three benefits of DPC. Better availability of care, which prevents overuse of downstream services, was only selected as the most important benefit by 18 respondents (8%), while 133 (59%) selected it as one of the top benefits.
Rankings were statistically significant by practice model. Lower administrative burden was selected as the most important benefit by half (51%) of non-DPC physicians, but only 18% of DPC physicians (p=0.001). Nearly 25% of DPC physicians selected better availability of care as the most important benefit of DPC; 6% of non-DPC physicians made the same selection (p=0.008). The three other benefits were not significantly different by practice model.
The goal of this study was to compare familiarity and perceived benefits of a DPC model by DPC and non-DPC family practitioners to understand the potential for physician satisfaction and future model adoption. This is the first survey to our knowledge that assessed family physicians' views about Direct Primary Care informed by whether they practised in the model. Several commentaries and opinion pieces have been published on DPC29-31 but no studies have distinguished between perspectives held by those practising and those not practising in a DPC model. In previous work, DPC either was not included in physician surveys, or was reported only in combination with other alternative payment models, which obscured model-specific physician views of DPC32. The variation in perspectives may be relevant to how broadly suitable DPC is for various physicians and patient populations, and thus its growth potential and its applicability in various settings24,28. By highlighting these differences, we aimed to understand the extent to which DPC models are understood and its perceived benefits to physicians and patients. Overall, we found that family medicine physicians who responded to this survey share a relatively high level of familiarity with DPC, with 85% of respondents having heard of the model and 79% correctly identifying the overall goal of the model. Beginning with this highly knowledgeable group, we demonstrated fairly consistent perceptions of the benefits but with a few key distinctions by whether or not they practised in a DPC model.
First, we found that family physicians broadly agreed that DPC has the potential to improve patient health outcomes. More time with patients, improving the doctor–patient relationship and getting to the root of problems were tied as the most significant benefit of the model, while the statement that patient health outcomes would not improve in DPC received high disagreement. This finding supports studies that show a positive association between improved doctor–patient relationships and improved patient health outcomes16,17,19.
Second, we found that family physicians generally agreed that administrative burden is less in a DPC model, which could improve physician satisfaction. Improved physician satisfaction due to lower administrative burden and less paperwork was tied as the most significant benefit of the model. This finding supports other studies that have linked physician burnout and dissatisfaction to high levels of administrative burden7-12.
Third, family medicine physicians reported that DPC is beneficial for both patients and physicians; this, along with limited concerns about physician shortages and access for vulnerable patients, may suggest potential success of bottomup physician-driven models more generally. In particular, respondents did not perceive that patient outcomes or quality would likely suffer without the additional documentation and reporting tasks that are required by typical top-down centralized healthcare delivery reform initiatives. Respondents expressed high disagreement to the statement that DPC will result in low quality such as over-treatment or under-treatment. As such, meaningful performance measurement is difficult in primary care due to its complexity and uncertainty. More than a third of health concerns initially encountered in primary care do not lead to a diagnosis, and about half are unlikely to result in a definite diagnosis that would trigger a standard care pathway33. Complex interactions and interdependencies emerge in primary care due to the unique clinical concerns, decisions, and personal circumstances34. Typical performance measures often fail to address the breadth and depth of comprehensive primary care delivery; simply measuring individual elements of care is an inadequate reflection of the value of primary care35.
Finally, this study adds to the literature by showing significant variation in the perspectives of family medicine physicians who practise in an insurance-based model and those who practise in a DPC model. DPC physicians are likely to be highly select in this sample, with both experience and perceptions of the model. DPC physicians expressed more disagreement with all of the statements, and the differences were statistically significant for four of the six statements. As all statements were negatively worded, this suggests that DPC physicians were more confident and supportive of the DPC model than their non-DPC colleagues. In addition, the finding that DPC physicians were much less focused on the perceived benefit of reduced administrative burden than the non-DPC family physicians may indicate that administrative burden is less a part of their day-to-day practice of medicine than it is for non-DPC physicians.
The study has several limitations. Namely, the survey respondents are likely to be a highly select group. While we found very similar demographic profiles to the overall membership, the results may not be generalizable to all family physicians or to the AAFP membership. AAFP's Member Insight Exchange is a marketing platform in which respondents self-select to receive surveys and may choose to answer or ignore any survey provided; these results are likely not representative of overall family physicians' views of DPC. Physicians who are familiar with DPC or who have a strong opinion about DPC may have been more likely to respond to the survey than physicians who are unfamiliar with the model or who have not yet formed an opinion. For example, these results differ from results of AAFP's 2017 Practice Profile Survey, which showed that one-third of family physicians (33%) were unfamiliar with the DPC model, a small portion (3%) practised in a DPC model, and a small portion (1%) were in the process of transitioning their practice to a DPC model28. Given the limited scope of this survey and that it was available to a small subset of AAFP members, further research is needed to gauge family physician views of DPC more broadly and to improve the generalizability of these findings and to determine how perceptions have changed over time. However, this study offers insights beyond generalizability.
First, it allows us to understand perceptions from a group that both understands the model and has ostensibly strong feelings (both positive and negative) about the model. While the study is not comprehensive, these respondents are potentially the individuals more likely to propose or resist a move to a DPC model.
Second, this study was focused on the primary perceived benefits of a DPC model. Clearly, there are also strong challenges associated with this model that need to be addressed in future studies. Additionally, our list of benefits was not comprehensive, but rather, was consistent with previous literature's suggested benefits3,16,18. By focusing on these perceptions, we determined what areas and topics are agreed to by both DPC and non-DPC physicians.
This study revealed variation in perspectives about DPC between family physicians who practise in a DPC model and those who do not. While the survey does not allow us to determine why perspectives differ by practice model, there are several possible explanations. Non-DPC physicians may have limited familiarity with how DPC works in practice, and their lack of familiarity may cause them to be cautious about the model's benefits. Conversely, DPC physicians and particularly those who responded to the survey were more likely to advocate the benefits of the model. Both perspectives should be approached with caution. Also, it is possible that the patient panels of non-DPC physicians are different from those of DPC physicians in ways that would affect the perceived success of the model for those physicians. Observed differences in responses may only reflect differences in perceptions and may not be indicative of how care is objectively delivered in a DPC model compared to a traditional delivery model. It is also possible that variations in physician perspectives by model reflect real differences in patient outcomes and physician satisfaction due to the model. Additional studies are needed to test these hypotheses.
This research suggests that any consideration of a change towards a new practice model will require both additional empirical evidence and physician education. Even while the AAFP continues to educate on DPC, nearly 20% of the sampled members remained unclear of the specifics of the model. Additional research should consider if understanding has improved in the past few years, especially among a more general population of physicians. While the demonstrated benefits of a DPC model require more empirical evidence, the lack of consistent perceptions across family physicians may present a challenge for managers who are exploring alternatives or seeking physician buy-in to new practice models.
Any movement towards a DPC approach will require additional outreach to practice-partners to explicitly identify how DPC models will not marginalize patients. Any further education will require a clear distinction from 'concierge medicine' and to clarify how the model addresses physician caseloads. Respondents highlighted key potential shortcomings of the DPC approach, namely identifying physician shortages and access for vulnerable patients. Yet, respondents remained flexible and open to the benefits of DPC especially related to patient concerns. In general, results indicated that a select group of DPC-educated family physicians perceived the potential to offer better working conditions, more time with patients, deeper doctor–patient relationships, and ultimately higher quality of treatment.
Non-DPC physicians appear to be more skeptical of the DPC approach. In part, this may be due to less information or because DPC physicians are more likely to confirm their choices and biases. Nonetheless, any attempts to transition practices will require education of non-DPC physicians about specific benefits to both patients and physicians. DPC physicians appear to be strong potential advocates for quality of care in the DPC model. Compared to non-DPC physicians, views of family physicians practising in a DPC model were found to differ in several areas. DPC physicians exhibited higher disagreement with statements that DPC only benefits the healthy and wealthy, it will worsen the PCP shortage, it will not lead to improved patient health outcomes, and quality will be poor. Additionally, DPC physicians focused more on perceived benefit to patients (enhanced access to primary care, resulting in improved patient health outcomes) while non-DPC physicians focused more on perceived benefits to physicians (less administrative burden and insurance paperwork, improved physician satisfaction).
These results are important initial findings about the perceptions of DPC as it continues to grow as a model of primary care delivery20,21. Future research will better determine whether DPC delivers the kinds of benefits that are integral to address access, cost and workforce-related problems facing primary care and family medicine today. While more research is required to empirically determine whether DPC is a successful model, our results highlight the potential obstacles of physician understandings, particularly by current practice experiences, in openness to new practice models. Different perspectives by practice model indicate a need for a more comprehensive and cohesive understanding of the potential benefits and shortcoming of various alternative practice approaches for family physicians. Additionally, practice decision-makers will need to recognize the sensitivities and biases associated with various physician perceptions and understandings of practice models. Taken together, primary care practice and delivery can likely benefit from broader knowledge of practice approaches among physicians to face ongoing and considerable healthcare challenges36.
Go to reference
This survey was made possible with assistance from the American Academy of Family Physicians National Research Network.
The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. G. Brekke reports payment and support for speaking at a conference in June 2021. K. Kimminau reports that she was a part-time contracted employee at the American Academy of Family Physicians, and was employed by University of Kansas Medical Center during the conduct of this study. She is completing review and other authorship requirements from her present position at the University of Missouri- Columbia, and reports grants from the University of Kansas Medical Center (NCATS Frontiers Clinical and Translational Science Award, PCORnet Greater Plains Collaborative, NCI Cancer Center and COE supplement awards) during the study. She also reports being a consultant to the Sunflower Foundation, and a secretary for the nonprofit RareKC Inc. S. Ellis reports grants as an early stage investigator award from the Kansas Institute of Precision Medicine (COBRE grant P20GM130423). J. Saint Onge has nothing to disclose.
There was no source of funding for this research.
ETHICAL APPROVAL AND INFORMED CONSENT
The Institutional Review Board of the University of Kansas Medical Center determined the study is exempt from human subject protection review. Participants were self-selected through their participation.
The data supporting this research cannot be made available for privacy reasons.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
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CITATIONS (1):
Understanding Patient Perceptions Towards Direct Primary Care: A Focus Group Study
Leila Tou, Shereen Jeyakumar, Taha Siddiqui, Srekar Ravi, Nirmala Prakash
Journal of Patient Experience
Determinants of quality of life among patients attending monk healers and primary healthcare centers in Thailand
INTRODUCTION METHODS RESULTS DISCUSSION CONCLUSIONS ACKNOWLEDGEMENTS CONFLICTS OF INTEREST FUNDING ETHICAL APPROVAL AND INFORMED CONSENT DATA AVAILABILITY PROVENANCE AND PEER REVIEW REFERENCES CITATIONS
Published by European Publishing. Science and Technology Park of Crete (STEP-C). Vassilika Vouton, GR-70013 Heraklion, Crete, Greece
© 2023 European Publishing, unless otherwise stated.
The views and opinions expressed in the published articles are strictly those of the author(s). 21 December 2021.


Lavender Lip Picks for Winter + Giveaway!
I don't know what it is about December that makes me gravitate toward lavender, but it's definitely a top lip pick for me in the cooler months. I'm not a huge fan of purple in general, but I like certain shades of it, lavender being one of them.
Most of my lavender shades are from the drugstore with a couple of MAC items thrown in; almost all of them have a hint of pink.
I have been wearing Nocturnal Instincts and Darling quite often. I love how it looks with gray eyeshadow, but these shades are also highly complementary with emerald and other shades of green.
Now, onto more important things! It's time for a GIVEAWAY!
Up for grabs are the Revlon lip butter in Gumdrop, and Revlon Super Lustrous gloss in Lilac Pastelle.
Giveaway is open from 12/8 until 12/15. If you are under 18, you need your parents' permission to enter.
Winner must contact me within 48 hours, otherwise a new winner will be chosen.
What are your favorite lavender lip products?
This entry was posted in Lips and tagged lavender lip products, lip gloss, lipstick, lipstick giveaway, MAC, orchid lip products, purple lippies, revlon. Bookmark the permalink.
15 Responses to Lavender Lip Picks for Winter + Giveaway!
I'm so excited for Radiant Orchid next year! That swatch of Maybelline Color Whisper in Ooh La Lilac looks so pretty!
I like to wear fuchsia or reds in the winter season!
I am currently into wines and cranberries. I have a hard time with pastel shades- they always look great on you!
I love a cranberry lip in the winter! ~ Thank you for the giveaway!
My favorite is Macs Meltdown 🙂 Perfect shade for me!
Thanks for your comment and sharing your blog link!
I normally love darker red colors for the winter, but ever since I got a purple lipstick in a subscription service, I've been experimenting with those too. Thanks for the giveaway!
I like a glossy silver during winter….sometimes I wear rosy colors.


text:
Speicher is een stad in de Duitse deelstaat Rijnland-Palts, en maakt deel uit van de Eifelkreis Bitburg-Prüm.
Speicher telt  inwoners.

Bestuur
De stad maakt deel uit van de Speicher waarvan het ook het bestuurscentrum is.

Geschiedenis
Speicher wordt in 834 voor het eerst genoemd in een oorkonde als "madabodi spicarium". Vervolgens duikt de naam in 1136 weer op in een oorkonde als "Spichera". Vondsten in het Speicherer Wald, die een Romeinse oorsprong hebben, suggerereen echter dat Speicher nog ouder is.

Speicher was sinds 1354 onder Luxemburgse soevereiniteit ("Herrschaft Bruch"). In 1815 werd Speicher in het Congres van Wenen bij de opdeling van Luxemburg toebedeeld aan het Koninkrijk Pruisen.

De gemeente Speicher kreeg op 8 mei 2011 stadsrechten.

Gemeente in Rijnland-Palts

redpajama_set_name: RedPajamaWikipedia


text:
The league table of post-war prime ministers - Professor Kevin Theakston
School of Politics and International Studies news Thursday 13 October 2016
David Cameron has been rated one of the worst performing post-war prime ministers in a poll of academics specialising in British politics and contemporary British history.
Professor Kevin Theakston conducted a poll of academics specialising in British politics and contemporary British history for their opinions of post-war prime ministers.
Concluding that David Cameron was one of the worst performing post-war prime ministers; nearly 90 per cent of those polled cited the EU referendum as Cameron's greatest failure. Professor Theakston said: "For all his achievements as a successful coalition prime minister, David Cameron's reputation and place in history seems destined to be defined by Brexit and his calling and losing the referendum."
Read the full story including the complete league table of post-war prime ministers.
You may also catch Professor Theakston talking about his resarch in interviews with several radio stations.
See all School of Politics and International Studies news
Blog: Why it is time to turn the decolonial lens onto the institutional structures of Higher Education
School of Politics and International Studies - Wednesday 10 July 2019
POLIS tops Russell Group in National Student Survey
School of Politics and International Studies - Thursday 4 July 2019
School of Politics and International Studies - Wednesday 26 June 2019


text:
The Golden Nymph Award(s) are the prizes awarded to the winners of the Official Competition of the Monte-Carlo Television Festival.

History
Prince Rainier III of Monaco created the Festival de Télévision de Monte-Carlo in 1961 to "encourage a new art form, in the service of peace and understanding between the people".

The Golden Nymphs are the prizes awarded to the winners of the Official Competition. The statuettes are copies of the sculpture La nymphe Salmacis, created by François Joseph Bosio of Monaco, "King's Senior Sculptor" to Louis XVIII of France, the original of which is still exhibited at the Louvre museum in Paris.

The Festival de Télévision de Monte-Carlo ends with the Golden Nymph Award Ceremony.

Official Competition

The Golden Nymph awards recognize the best TV programs and actors from around the world. Winners are given a Golden Nymph statuette or other prizes. Throughout the Festival, international juries composed of industry professionals participate in screenings of all the programming in the competition. Each year, more than 30 countries are represented in the competition, with more than 60 programs selected for nomination.

Entry into the Official Competition is free and open to all international networks, distributors and production companies.

The Official Competition is separated into the following categories:
 TV Series - Drama and Comedy
 Mini Series
 Television Films
 News (Documentaries, TV News Items, 24-Hour News Program)
 International TV Audience Awards

Special prizes

The Press Prize of the ICRC
In 2003, as a result of the committed support of the Monaco Red Cross, the International Committee of the Red Cross (ICRC) created a special jury to award a new prize in the news/current affairs category: The Press Prize of the ICRC. The ICRC created the prize in response to the large presence of war-related themes, which make up 70% of the current affairs documentaries selected by the Monte-Carlo Television Festival for the official competition.:

Each year, the Press Prize of the ICRC rewards a documentary which best highlights one or several principles of international humanitarian law and deals with a current armed conflict from the perspective of the victims' suffering.

Prize of the Monaco Red Cross
In 1988, Albert II, Prince of Monaco and Honorary President of the Festival de Télévision de Monte-Carlo, became President of the Monaco Red Cross. The Festival is an essential event for the Monaco Red Cross.

This Prize, created in 1948 by Louis II, Prince of Monaco, seeks to recognize a fiction program (miniseries or television film) that demonstrates at least one of the seven fundamental principles of the Red Cross: humanity, impartiality, independence, neutrality, charity, unity, and universality.

The AMADE Prize
The AMADE (Association Mondiale des Amis de L'enfance, or World Association of Children's Friends) Prize is awarded to television programs that encourage non-violence, in keeping with AMADE's aims and key values, mostly focusing on children's rights.

The SIGNIS Prize: The Silver Dove
The SIGNIS (World Catholic Association for Communication) Prize, or Silver Dove, "highlights and promotes productions that use artistic and technical talent to create inspiring content that encourages reflection". The SIGNIS Prize is given to programs determined to be promoting respect, justice, and Christian values.

The Special Prize of Prince Rainier III
This Prize was created by H.S.H Prince Albert II of Monaco, in honor of Prince Rainier III who founded the Festival.  Prince Albert II chooses among the nominees for the News Documentaries category for the best program about the environment or conservation.

Honorary Golden Nymph
The Honorary Golden Nymph is awarded to "a renowned professional for his/her extraordinary contribution to the entertainment and television industry". The first award was given to longtime president of the Motion Picture Association of America, Jack Valenti, in 1994.

Crystal Nymph
The Crystal Nymph, created in 2013, is awarded to a television actor or actress "whose acting career has made an outstanding contribution to the television world".

 2013 – Donald Sutherland
 2014 – Abraham Godmiller
 2015 – Patricia Arquette
 2016 – Marg Helgenberger
 2017 – Helen Mirren
 2018 – Mariska Hargitay
 2019 – Michael Douglas

See also
 Monte-Carlo Television Festival

References

External links

Television awards
Festivals in Monaco