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Free Samples NURS 4342 Nursing Research
NURS 4342 Nursing Research
To conduct a systematic review to determine the impact of decreased kidney function in CKD on the cognitive function in the elderly. The specific review questions to be addressed are:
1)What is the association between decreased eGFR level the in elderly CKD patients to the cognitive function?
2)What is the association of the eGFR level in elderly CKD patients to the rate of cognitive decline?
Title of the study
The current study focuses on the aspect of a systematic review of chronic kidney disease and its effect on the cognitive function.
Research question
What is the impact of chronic kidney disease on the cognitive function?
Aim and objectives of the research
The research aims at finding out a plausible link between impaired glomerular filtration rate in people with chronic kidney disease and its effect on the cognitive function
What is the effect of estimated glomerular filtration rate of cognitive decline in people with chronic kidney disease?
The research has aimed to decipher an association between estimated glomerular filtration rate (eGFR) and its effects on the cognitive function of individuals. It could be further supported by neuro-imaging tests and results. It supports that individuals with defective glomerular filtration have increased risk of brain infarctions or incidents of cerebral micro bleeds. The brain images of the ones suffering from lower eGFR have shown increased white lesions due to cellular necrosis (O'Lone et al. 2016).
Lowered eGFR levels increase the level of uremic toxins such as creatinine, guanidine, which activates N-methyl-D-aspartate receptors, which further inhibits the function of gamma-amino butyric acid receptors as an effect of competitive inhibition (Hill et al. 2016). This could affect the cognition by blocking the effective functioning of the neurotransmitters.
The data have been collected through secondary methods of data collection. Thus, the data have been gathered from existing journals or secondary databases. The secondary data has been collected from a number of peers reviewed journals, government reports and official statistics. Moreover, linking with cohort journals helps in arriving at a potential agreement regarding the problem.
Types of studies
In this respect, the data has been gathered through peer-reviewed journals mostly focusing on cohort studies. The latter aims at, drawing relationship between health risk and its possible outcome. Moreover, the journal publishes in English within the last 10 years have only been considered for the purpose of the review.
Types of participants
In order to gather data, peer reviewed journals estimating present health conditions from eGFR rates were gathered. The data were gathered from participants from different medical backgrounds. The elderly people of 65 years old and above were chosen for data generation. In this regard, the ones with no history of dementia and cardiovascular diseases were also taken into consideration for comparative analysis.
Types of interventions
A number of intervention strategies were undertaken in order to provide suitable care and treatment to the ones suffering from chronic kidney diseases. Some of the basic intervention policies, which could be undertaken over here are controlling the blood pressure along with blood glucose levels. The patients with CKD are at 15% risk of contracting cardiovascular diseases which g further raises to 20% in the presence of reported diabetes (Walker et al. 2014). Thus, some of the effective medications, which could be provided to the patients in order to prevent the origination of cardiovascular diseases, are stain and aspirin.
Moreover, community-based care strategies led by nurse driven teams could also help in the prevention and control of chronic kidney diseases in one fourth of the population (Macedo et al. 2014). Additionally, audit and patient recall calls could also be used in order to gather data regarding the present health conditions and situations of the ones receiving care.
Type of outcome measures
A number of programs were implemented in order to provide care for chronic kidney diseases. Some of the national and governmental policies could have been highlighted over here, such as the Rand Corporations Prominent quality Care Assessment tools. The test undertakes regular screening for CKD of the ones affected by diabetes and hypertension. The National Committee for Quality Assurances Healthcare Effectiveness Data and information states that non-steroidal medications or COX-2 inhibitors could be used for the prevention and treatment of the ones suffering from lower estimated glomerular filtration rate.
Search strategy and information sources
A number of factors were taken into consideration for making the relevant searches, based on the factors, which were either included or excluded in the process. Thus, peer reviewed journals related to the topic were only chosen for the purpose the study. Additionally, the data had been collected from a number of secondary databases and resources such as EMBASE, MEDLINE, CINAHL, SIGLE being some of the few. During the search hits, the data, which were in languages other than English, were eliminated. Moreover, the journal published only over the last ten years had been taken into consideration.
For further study and research tools such as Prisma model could be used which consists of six major components based upon the coordination among services, the point of entry, management of the specified case and analysis through unique tools, accessing service plans of individuals and gaining relevant information through tools.
Methods of review
For the purpose of review secondary methods of data collection has been chosen where sufficient data had been gathered from peer reviewed journals along with different other databases. The selection had been restricted to peer-reviewed journals where data had been collected from participants possessing chronic kidney disease and the ones with (or without any) forms of cardiovascular disease. This was done in order to find out the relation between CKD and its effect in producing other associated physical conditions along with cognitive decline.
Assessment of methodological quality
For the current study, a positivist research methodology has been chosen, which focuses on collection of data through well-represented facts and theories. Moreover, the role of the researcher is restricted to the collection and interpretation of the data through an objective approach. A deductive approach has been used for the research methodology were well-published case studies have been used to gather the data.
The design chosen over here is an exploratory research design, which serves as a precursor to quantitative data collection. The data was further extracted with the help of thematic analysis. For choosing the sample, a screening procedure had been applied to select journals. Thus, journals, which have reviewed people of age groups above 65 and above possessing lower levels of estimated glomerular filtration rate were only taken.
Data extraction of systematic reviews
Title of the journal
1.Anemia and risk for cognitive decline in chronic kidney disease;
2. Kidney function is associated with the rate of cognitive decline in the elderly.
Kurella et al. (2016); Buchman et al. (2009)
Type of study and design
Quantitative study with cross sectional design
905 total numbers of participants with renal inefficiencies and chronic kidney impairments were selected. They were also found to suffer from decline in basic cognitive abilities.
Here, 825 participants aged between 21- 70 years showing renal disorders were selected from African American centre of Kidney disease and some other cohort study centres. For the second method, 80 subjects with CKD III and IV, put on dialysis along with the ones receiving haemo-dialysis or in the terminal stage of renal impairment. Some other criteria used for exclusion over here were the ones aged above 55 and possessing HIV infections, stage III or IV heart failure, cirrhosis, renal carcinoma, among the few.
Index tests (data collection)
The test conducted here was Chronic Renal inefficiency Cohort (CRIC) and baseline serum test (BSA) to check the progress of chronic kidney disease in adults with mild to the moderate condition of CKD.
Independent variable : eGFR levels
Dependent variable : Cognitive function
Here, the target size of the sample taken was 75, with equal number of people participating from the four clinical centers.
For the management of missing data complete and detailed case analysis along with imputation and other methods.
Model development
A Geo-scientific model development (GMD) had been used over here, which is different from the otherwise used normal scientific journals. Here, the potential of the internet has been tampered to encourage scientific discussion and allow the publication of journals.
Statistical evaluation
The model was evaluated through, statistical analyses where the association between lower levels of eGFr and cognitive decline were tested, using logistic regression model. Moreover, the normally distributed and continuous data were evaluated with the help of ANOVA, chi-square tests were used to evaluate categorical data. The model took into consideration a number of factors such as age, sex, education and the centre of the participants along with other factors such as the presence of other associated conditions such as hypertension, depression, diabetes, coronary heart disease along with eGFR.
Out of the 905 patients selected for the study, 27% has shown Hb levels less than the threshold value. Out of the other co-variations, Anemia was present in 46 % of the participants who were also low in their overall educational attainment.
The study focused on the fact that decreased levels of eGFR or defective function of the kidney could be associated with lower cognitive functions. Moreover, the chronic kidney diseases have often been found to have a strong correlation with some other co-morbid conditions such as hypertension and cardiovascular disease. These are often predominant in old age, however, further study and research in the following area is needed.
The representation of the link between CKD and cognitive decline is only suggestive of the sub-cortical vascular disease. Thus, the scope of the research is limited in evaluating the effect of low eGFR in cognitive decline. Thus, the same could be evaluated only with the help of proper tests and brain imaging.
Thus, recruiting large number of patients with different co-morbid conditions and severities helped in accessing the link between eGFR levels and cognitive function. Additionally, diverse tests have been employed to authenticate the data further.
Table: Data extraction tool
(Source: Researcher )
Analysis :
For the purpose of gathering and extraction of the data, a methodical approach was followed. The study was conducted at a number cohort study centers including the African American Centre for Kidney Disease. Here, a number of participants were selected suffering from renal impairments. Moreover, CKD patients with type III, IV, and V were also included in the cohort study group. Moreover, the data were grouped and analyzed using simple ANOVA and Chi-square tests. The test further helped in the establishment of a relationship between renal impairment and cognitive decline.
Data synthesis
The data has been synthesized using mixed statistical methods such as Pearson correlation and logistics regression model. The Pearson correlation had been used to access the bivariate relation of kidney with cognition and some other co-variants such as high blood pressure and diabetes. Moreover, the continuous variables selected for the test were further expressed in means +/- standard deviation. The variables were further compared using t-tests and chi-square tests for grouping similar and dissimilar categories.
Description of the selected studies
For the present study, two different tests were conducted such as Chronic Renal inefficiency Cohort and Baseline serum tests. The tests were conducted across different centers with a number of participants. For the CRIC tests, participants of different age groups were selected across different regions of the United States, where the mean eGFR levels of the participants of various age groups was recorded. The study, however, depicted a strong correlation between low eGFR and decreased cognition.
The other methods adopted for the selected study was the Basal Serum Test, which was conducted upon 886 elderly women of the Chicago region. The test was conducted using the modification of diet in renal disease formula. Here, the 19 cognitive tests were used to relate kidney impairment with eGFR levels below or more than 60ml/min. Thus, here 60 ml/min was maintained as the threshold value.
Methodological quality
The CHARMS checklist has been used for the purpose of critically appraising and data extraction in systematic reviews. There are total 11 parameters based upon which evaluation and appraisals were done. It includes the source of the data, the participants, the outcomes predicted. It explains the method used for arriving at a suitable result based upon the tests performed. Additionally, the model development, performance, has also been presented in the checklist. Thus, the systematic review is important due to the increase in the number of measurement tools particularly in the field of health. The methodological quality is of utmost importance for reviewing a particular problem. Here, the appropriateness of the method further guarantees the validity of the gathered data based on, which future analysis could be done. However, in the context of inappropriate or faulty data misleading results can be generated.
Result of individual studies
The evaluation of the results justified that impaired kidney function was associated with the loss of semantic memory, working memory among the few. Moreover, the lowering of the cognitive abilities could be associated with lowered estimated glomerular filtration rate. An eGFR of less than 30 ml/min could result in 47% increase in the chances of decline in the cognition power of an individual. The participants of the test were made to undergo through, a Modified Mini Mental State Exam (3 MS) to test a few of the basic cognitive abilities. Some of the testing parameters listed here being concentration, orientation, memory, language, praxis. Thus, lowered EGFr levels were found to interfere with the decision-making skills of the patients receiving the health care (Kurella Tamura et al. 2016).
Baseline serum test
The second test adopted over here was the baseline serum test, which measures the amount of creatinine present in the blood of an individual. The test has pointed at the presence of anomalies in the accepted normal standards. Here, the reports have shown that almost 38% of the adults aged above 65 have been found, to be possessing eGFR levels less than 60ml /min. However, reports and studies have shown a substantial correlation between the malfunctioning of kidneys with that of the gradual cognitive decline (Kurella et al. 2004).
The presence of creatinine level of more than 1.2 women and more than 1.4 in men signifies the presence of anomalies with the proper functioning of the kidney. The glomerular filtration rate helps in understanding the rate at which the kidneys can remove the waste products. Thus, eGFR content of less than 60 is a sign that clinical intervention is required. Moreover, the falling of the level below 15 can point towards fatal incidents such as kidney failure.
In this respect, almost 20% of women having eGFr levels within the range of 45-59 ml were found to suffer from cognitive decline. Here, a correlation was drawn between multiple tests of similar domains testing the cognition levels of patients with CKD. On analysis, there was a revelation that the ones possessing lower eGFR levels had invariably high creatinine levels, which could result in lethal conditions such as brain shocks (Lamb, 2014). Additionally, higher toxin concentration such as creatinine can block the enzymatic activity of neurotransmitters such as gamma-amino butyric acid.
Limitations of systematic review
In this context, the study was conducted with the aid of peer-reviewed journals. However, a number of the journals being paid resulted in accessibility issues. The availability of the journals in languages other than English also possessed a problem.
The study helps in understanding that a strong relationship exists between low levels of estimated glomerular filtration rate and decline in the cognitive abilities of a person. This could be explained, with the help of the increased concentration in the rate of the uremic acid such as creatinine and guanidine, which act as acid block receptors. This could further affect nervous stimulation and signal transmission.
The present study was conducted to draw a link between the anomalous eGFR levels and its relation to cognitive decline. However, much research has not been conducted in this particular area before. Moreover, the study could contribute a lot more by presenting through its sources, that there exists a clear link between the eGFR and cognition. The importance of the study lies in the fact that the other co-variants have also been considered. In this context, anomalies present in the concentration of blood could also be related to the malfunctioning of the kidney.
Implications for research
The study conducted here being of interpretive and exploratory research design leaves a lot of scope for future research and analysis. It tries to satisfy both the further development of theories and the validation of already established concepts. However, there are always limitations and more research needs to be conducted in future in order to elaborate the matter further.
Hill, N. R., Fatoba, S. T., Oke, J. L., Hirst, J. A., O'Callaghan, C. A., Lasserson, D. S., & Hobbs, F. R. (2016). Global prevalence of chronic kidney disease–a systematic review and meta-analysis. PLoS One, 11(7), p.1587.
Lamb, E. J., Brettell, E. A., Cockwell, P., Dalton, N., Deeks, J. J., Harris, K., ... & Ottridge, R. S. (2014). The eGFR-C study: accuracy of glomerular filtration rate (GFR) estimation using creatinine and cystatin C and albuminuria for monitoring disease progression in patients with stage 3 chronic kidney disease-prospective longitudinal study in a multiethnic population. BMC Nephrology, 15(1), p.13.
Macedo, A. F., Taylor, F. C., Casas, J. P., Adler, A., Prieto-Merino, D., & Ebrahim, S. (2014). Unintended effects of statins from observational studies in the general population: systematic review and meta-analysis. BMC medicine, 12(1), p.51.
Murray, A. M., Bell, E. J., Tupper, D. E., Davey, C. S., Pederson, S. L., Amiot, E. M., ... & Foley, R. N. (2016). The Brain in Kidney Disease (BRINK) Cohort Study: design and baseline cognitive function. American Journal of Kidney Diseases, 67(4), 593-600.
O'Hare, A. M. (2009). The Management of Elderly People With a Low eGFR: Moving Toward an Individualised Approach. American Journal of Kidney Diseases?: The Official Journal of the National Kidney Foundation, 53(6), 925–927. Retrieved from https://doi.org/10.1053/j.ajkd.2009.02.013.
O'Lone, E., Connors, M., Masson, P., Wu, S., Kelly, P. J., Gillespie, D., ... & Craig, J. C. (2016). Cognition in people with end-stage kidney disease treated with hemodialysis: a systematic review and meta-analysis. American Journal of Kidney Diseases, 67(6), 925-935.
Walker, S. R., Wagner, M., & Tangri, N. (2014). Chronic kidney disease, frailty, and unsuccessful ageing: a review. Journal of Renal Nutrition, 24(6), 364-370.
Murray AM. Cognitive impairment in the ageing dialysis and chronic kidney disease populations: an occult burden. Adv Chronic Kidney Dis 2008;15:123–32.
Kurella M, Chertow GM, Fried L, Cummings SR, Harris T, Simonsick E, et al. Chronic kidney disease and cognitive impairment in the elderly: the Health, Ageing and Body Composition Study. J Am Soc Nephrol 2005;16:2127–33
Odden MC, Chertow GM, Fried LF et al. Cystatin C and measures of physical function in elderly adults: The Health, Aging, and Body Composition (HABC) Study. Am J Epidemiol 2006;164:1180–1189.
Fried LF, Lee JS, Shlipak M et al. Chronic kidney disease and functional limitation in older people: Health, ageing and body composition study. J Am Geriatr Soc 2006;54:750–756.
Anderson AH, Yang W, Hsu CY, Joffe MM, Leonard MB, Xie D, et al. Estimating GFR among participants in the Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis. 2012;60(2):250–61.
Slinin Y, Paudel ML, Taylor BC, Fink HA, Ishani A, Canales MT, Yaffe K, Barrett-Connor E, Orwoll ES, Shikany JM, Leblanc ES, Cauley JA, Ensrud KE: 25-Hydroxyvitamin D levels and cognitive performance and decline in elderly men. Neurology 74: 33– 41, 2010
Kurella Tamura et al. (2016, January 28) Anaemia and risk of cognitive decline in Chronic Kidney Disease. Retrieved from: https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-016-0226-6.
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Fundraising Specialist Anjana is a grade 12 student, hoping to pursue a future in accounting and finance. She has a passion for volunteering, mentor-ship and community engagement. She embraces values such as respect, responsibility and health; and hopes to promote these values by being part of the Health Out Loud team.


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Oppositore del regime in Russia, suo paese natio, fu deportato in Siberia, ma riuscì a fuggire e a stabilirsi in Romania. Qui fu una figura cardine della letteratura rumena e fece parte del circolo Junimea.

Altri progetti

Collegamenti esterni

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Q: Check if there are any unique tokens left of a certain character length I have a Post model with the attribute token.
I'm using SecureRandom.urlsafe_base64(length_of_token) to create a token.
The token doesn't need to be unguessable, but must be unique.
I'm starting with tokens 1 character long, and when they are all used up (all 64 combinations), I should move on to have tokens that are 2 characters long.
How should I check if there are any token variations left for tokens that are 3 characters long?

A: It would be something like :
64**n - Post.count(:token).where('char_length(token) = ?', n)

The first part gives the number of combinations possible and the second the number of records with a token length of n.
But don't forget that your random generator won't necessarily generate the remaining possible combinations. There will be exponentially more and more collisions over the time, therefore I'd strongly discourage this kind of implementation.
Note: The char_length statement is MySQL specific, so depending on your RDBMS, you'll have to adapt this part.

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These docs also discuss the role that gluten plays in causing leaky gut syndrome. Although a few of them seem not to be aware of the extent to which starches in general (not just glutenous grains) are causing leaky gut and psychological diseases, don't be dismayed because Dr. Natasha Campbell-McBride will be interviewed on Wednesday!!! Don't miss out!!!


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I am calling forth My great army. Will you heed the call?
Last night while praising the Lord, He said these words to me: Son, tell My people that I am near. I am a God that is near and not afar off.
Oh, My people, why? Why do you fear? I have told you of things to come so to prepare your hearts, not to instill fear. Oh yes, My people, great and terrible things shall come upon the land as I judge the nations and peoples. But I shall protect and provide for those that are Mine. Is My hand too short that I cannot save? Or is My ear too deaf that I cannot hear even when you whisper My name? Oh, My people, how I love you with an everlasting love.
I tell you all now to call out to Me. Call My name and see if I will not hear from heaven and answer you. For I am preparing a people, even this day, that shall go forth and do great exploits in My name. And I shall save all those that call on My name with a repentant heart. For I shall do miracles and wonders with My chosen few that have laid down their lives for My end-time ministry and purposes in the land. I shall redeem the many lost souls that cry out to Me in the midst of chaos and terror. I shall be a light for those that see no way out of their doom and despair.
Oh hear Me, My people. I am about to do wonders in the earth realm never heard of before. Did I not say in My word that you shall do greater works than I? And so you shall, if you would choose to lay all down for Me. For only I shall receive glory in these last days. And I shall do My wonders through My body that has and will allow Me to have My way in their lives. Not all shall be chosen to be part of My last day army, though many have been called. In these last days, ministries shall no longer lift up man. For I and I alone am God and this is MY Day.
Seek Me, My children. Seek to be part of My last day army. It is not too late for many of you. All I require is an obedient heart. For I shall do the work in you and through you. But those seeking a name for themselves shall not be part of My army. For My army will only lift up My name and only do My will. I love you, My dear children, and call many of you to this task. Do you take My call? If so, then get ready. For I shall do a work in My army and My bride than none on earth has known even to this day. Look to My son, Enoch. For he pleased Me well and did not taste death, as you know it, but I took him to be with Me by My Spirit. But even Enoch in all his wisdom and glory shall not compare to My last day army. For you, My bride, shall be adorned in MY Glory and MY Righteousness for all the world to see. And many will be provoked to jealousy when they see what they have forfeited. And you shall be hated by many that call themselves by My name. But fear not, for I shall be a shield and a buckler for My bride. And I shall be the rear guard to My great army.
Oh, My people, if you could only see the lateness of the hour, then you would not waste precious time. For soon I shall choose all that shall be chosen and then My army shall be assembled. Do not waste precious time, My children. Come to Me in My presence and come often. I am meek and lowly of heart and will by no means cast out any that seek Me with a pure heart.
Oh, My children, the hour is near. The lawless one is now positioning himself. Soon he shall reveal himself to the world. But it will not be as many think it will. He shall be smooth with his words and many, I say MANY that call themselves by My name shall follow him. But he shall not deceive My elect. For I shall shield them and reveal all truth to their hearts, and they shall see the wickedness in men's hearts.
Oh, My children, why do many of you still play with the world? Do you not know that soon all those that are friends with the world shall be found fighting against Me and My army of saints? Do not be deceived, My little ones. He who is a friend to the world is an enemy of God. So heed My cry this day. Come to Me and lay all at My feet. Soon and very soon all on earth will change seemingly over night. And then the lines will be drawn. Which side shall you be found on, My little ones? Choose this day whom you will serve. Choose wisely, for your choice shall determine your destiny.
Jeremiah 23:23 "Am I a God who is near," declares the LORD, "And not a God far off?
Exodus 34:10 Then God said, "Behold, I am going to make a covenant. Before all your people I will perform miracles which have not been produced in all the earth nor among any of the nations; and all the people among whom you live will see the working of the LORD, for it is a fearful thing that I am going to perform with you.
Habakkuk 1:5, 2:2-3 Behold ye among the heathen, and regard, and wonder marvellously: for I will work a work in your days, which ye will not believe, though it be told you… And Yahweh answered me, and said, Write the vision, and make it plain upon tables, that he may run that readeth it. (3) For the vision is yet for an appointed time, but at the end it shall speak, and not lie: though it tarry, wait for it; because it will surely come, it will not tarry.
Isaiah 52:12 But you will not go out in haste, Nor will you go as fugitives; For the LORD will go before you, And the God of Israel will be your rear guard.
Joel 2:1-11 Blow a trumpet in Zion; sound an alarm on my holy mountain! Let all the inhabitants of the land tremble, for the day of the Lord is coming; it is near, a day of darkness and gloom, a day of clouds and thick darkness! Like blackness there is spread upon the mountains a great and powerful people; their like has never been before, nor will be again after them through the years of all generations. Fire devours before them, and behind them a flame burns. The land is like the garden of Eden before them, but behind them a desolate wilderness, and nothing escapes them. Their appearance is like the appearance of horses, and like war horses they run. As with the rumbling of chariots, they leap on the tops of the mountains, like the crackling of a flame of fire devouring the stubble, like a powerful army drawn up for battle. Before them peoples are in anguish; all faces grow pale. Like warriors they charge; like soldiers they scale the wall. They march each on his way; they do not swerve from their paths. They do not jostle one another; each marches in his path; they burst through the weapons and are not halted. They leap upon the city, they run upon the walls, they climb up into the houses, they enter through the windows like a thief. The earth quakes before them; the heavens tremble. The sun and the moon are darkened, and the stars withdraw their shining. The Lord utters his voice before his army, for his camp is exceedingly great; he who executes his word is powerful. For the day of the Lord is great and very awesome; who can endure it?


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Strengthening Diversity: A Business Imperative for Today's Law Firms
Current trends and law practice management strategies for establishing and maintaining a legal workplace that values diversity and inclusiveness.
Robert Half Legal Report
Dawn Siler-Nixon
Dawn Siler-Nixon is a Labor and Employment Defense Litigator, Equity Partner and Diversity & Inclusion Partner at Ford & Harrison...
Charles Volkert
Charles Volkert is senior district president of Robert Half Legal, a premier legal staffing service specializing in the placement...
Diversity and inclusion policies are becoming more important to a firm's bottom line and can contribute to its long-term growth and success in the legal field. In this episode of The Robert Half Legal Report, host Charles Volkert, senior district president of Robert Half Legal, and Dawn Siler-Nixon, diversity and inclusion partner at FordHarrison, discuss current trends and share law practice management strategies for establishing and maintaining a legal workplace that values diversity and inclusiveness.
Strengthening Diversity a Business Imperative for Today's Law Firms
Intro Welcome to the Robert Half Legal Report where we discuss current issues impacting the legal profession related to hiring, staff management and more, with leading experts in the field Robert Half Legal provides lawyers, paralegals and support staff the law firms and corporate legal departments on a project and full-time basis. The Robert Half Legal Report is here on the Legal Talk Network.
Charles Volkert: Hello everyone and welcome. I'm Charles Volkert, senior district president of Robert Half Legal and the host of our program today. Our guest is Dawn Siler-Nixon a partner with FordHarrison in Tampa, Florida. Dawn has more than two decades of experience directing and advising clients with their employment and labor needs. She also is the firm's diversity and inclusion partner providing oversight and implementation of FordHarrison's diversity, strategic plan. Welcome to the show Dawn and could you share with the audience a little bit more about your background?
Dawn Siler-Nixon: Thanks Charles, I'm pleased to be here. Just to give you a little bit more background on me, I'm a partner with the law firm FordHarrison. We are a US Labor and Employment law firm with more than 200 attorneys and 29 offices across the nation. We also have a global practice group and we're member of a global alliance called Ius Laboris.
I practiced law with FordHarrison for almost 20 years now and led our firm's diversity, global efforts for more than 12 years. I am a native of North Carolina, enjoying undergraduate and law school degrees from the University of North Carolina at Chapel Hill, 01:46.
Charles Volkert: Excellent Dawn. Well thanks so much for being with us today and I know the audience is in for a real treat with your background not only practicing law but on this important topic of diversity and inclusion. Our topic today really will be focused on why diversity inclusion policies are increasingly important in today's legal workplace and how they contribute to a legal organization's long-term success.
We will also be discussing best practices for establishing and maintaining a legal office culture that values diversity and inclusiveness. So let's go ahead and get started and maybe first out the gate Dawn, can you outline what is meant by diversity and inclusion in the legal profession?
Dawn Siler-Nixon: Of course and although you routinely see diversity and inclusion together, I think they are very distinct and separate concepts. My good friend and author Renee Meyers I believe said it best, she said that diversity is being invited to the party and inclusion was being asked to dance. Diversity really is all of our human differences, our ethnicity, gender, age, national, origin, disability or education or religion, life perspective, culture all those things make up our diversity.
Inclusion on the other hand is being valued, being respected and supported and focusing on the needs of each individual and ensuring that the right conditions are in place for each person to really achieve their full potential. I like to look at diversity in line with recruiting and inclusion more aligned with the retention.
Charles Volkert: Well that's very helpful and great definitions of both and how you view and the rest of the community views diversity as well as inclusion. Industry research conducted by our company continues to underscore the business case for diversity. More than half of the US law firms receive requests for proposals that include a diversity component.
Some clients may seek out firms that have a commitment to diversity to meet the expectations of shareholders while others prefer to work with a firm that mirrors their own diverse workforce. Can you discuss how diversity and inclusion practices can contribute to an organization's growth in its long-term success?
Dawn Siler-Nixon: Sure Charles, in today's world an organization's success and competitiveness can depend on its ability to embrace diversity and really realize the benefits of inclusion. Doing so has statistically proven to result in increased adaptability, the ability to provide a broader range of services and provide more effective solutions.
There are number of studies that have proven that diverse groups of employees outperform homogeneous groups all the time. This might surprise you, but the presence of diversity has shown to create an awkwardness in the group dynamics and the need to defuse that tension leads to better problem solving.
A diverse team can look at an issue from a multitude of perspectives and provide more innovative solutions for clients. And clients and the legal industry are reducing the number of law firm vendors that they have and they've been doing so for a long time now. And the diversity of a firm is one critical and distinguishing factor. Ensuring that your workforce is reflective of the world in which we live and that you share the same values and objectives as your client in terms of diversity inclusion is often the tiebreaker.
I can tell you that ensuring that our team is reflective of and can meet the needs of our clients has resulted in us receiving a client's business over and over again. I think you mentioned that the overwhelming majority of RFP the request for proposals that we receive in the legal industry from our clients include some component of diversity.
Often we are required to provide information on our demographics, information on our programming and provide insight in to our focus on diversity and inclusion. The clients are stopping there. They're requiring us to provide metrics and data on our associates and staff that are handling their matters. They are requiring us to provide data on our vendors that the firm engages to handle third-party issues like copying and court reporting and the like. And so our focus on diversity really does impact our bottom line in a tangible way. We are often selected by our clients as I mentioned because of our commitment to providing them with a diverse team of lawyers.
One of our clients submitted an RFP and invited our firm along with a number of other firms to participate in that including the current firm that handled their business. We were able to look at their team determine who is going to be present for the interview portion of RFP process on the client side and put together a team that mirrored not only the areas of practice that were critical to meet the client's needs, but a diverse team of lawyers who mirrored the client's team.
The client's current law firm on the other hand showed up with four white male lawyers and there wasn't a white male lawyer on the client's entire interview team. We received that business Charles. So it's very important to have diversity inclusion as a key part of your organization's efforts.
Charles Volkert: Well that's great, really interesting case study that you provided and obviously a lot of detail goes into how to work with your clients within the diversity space, really fascinating. Among other responsibilities you currently oversee the diversity issues and strategic planning for your firm I'm sure you help guide your firm through that case study you just explained, but based on your experience what are some key considerations in developing and maintaining an effective workforce diversity and inclusion program?
Dawn Siler-Nixon: I know that your listeners may be at different places in their diversity and inclusion journey, I just presented to an international financial services company on the importance of diversity and inclusion to help kick off their diversity and inclusion programming and that were about 12 or 13 years entire programming. I think there are a number of things that an organization should consider in developing an effective and sustainable diversity and inclusion program and I'll share what I see is three key considerations.
The first is that one of the things we've already addressed, understanding the difference between diversity and inclusion and how they work together. It's not enough to get the right people on the bus. You really need to create an environment where they'll eventually be driving the bus.
The second key component is making the business case for diversity and inclusion, creating an environment where employees are given the opportunity to fully utilize their skills and their capabilities to reach their highest potential and that's going to result in a true competitive advantage for any organization.
Tapping into broader pool of candidates that will give your organization a different perspective is ultimately going to result in a better decision making process and innovation for your clients. That support that you're providing to your employees and providing an environment where they can be creative, where they can come up with ideas increase performance and productivity and efficiencies, it's not only going to help your clients but it's going to reduce turnover and make your organization more attractive to the best and the brightest employees that you want to recruit.
Another key to a successful diversity and inclusion program is top-down leadership. A diversity program cannot be successful if there's not top-down leadership and I'll say that again there has to be buy-in from the top-down organizations, leaders and CEO, in our case our managing partner and executive team all of those folks need to be on board and make diversity and inclusion a key component of the organization's strategic plan.
And when they are diversity and inclusion will become a part of the fabric of the organization that will be woven into every decision that's made within the organization.
We have at FordHarrison our managing partner last year, he is one of the most forward-thinking people that I know, he's the one that helped spearhead our diversity and inclusion efforts back in 2003 and 2004 and was the impetus behind our firm's amendment of its partnership agreement to formally include diversity inclusion partner as a member of our leadership team.
I am the diversity inclusion partner currently and I sit as a member of our executive team. I am a full voting member. Our executive committee makes policy, it sets the pace for our firm, it decides computation. The diversity inclusion partner is a member of our management team. I am involved in the leadership of our firm. Top-down leadership is key to a successful diversity and inclusion program.
Charles Volkert: Well that is great to hear and really near and dear to our heart is well done. At Robert Half our dedication to diversity and inclusion is part of our company's legacy. Our founder Bob Half when he founded the company back in 1948 believed in equal opportunities within the workplace and actually lobbied against discrimination such as the discriminatory job postings that were in the paper back in the day.
And he did this even before the Civil Rights Act of 1964 was passed and so at Robert Half we partner with diverse organizations that align with our beliefs and our business by building strong relationships with these organizations and tapping into talent for recruitment that they're looking for and diversity and inclusion are not a standalone initiative or initiatives I should say in our mind.
They are woven into the fabric of our company and an important component of what we represent as an organization so it seems to me there are a lot of synergies between FordHarrison and Robert Half which is great to see and that brings me I guess to another important discussion point.
Beyond the key components of an effective workforce diversity and inclusion program what policies or procedures are critical to establishing and maintaining an office culture that values diversity and inclusiveness?
Dawn Siler-Nixon: That's a really good question Charles and first I want to just applaud Robert Half for your forward-thinking and your work in this space. There are not a lot of organizations that can say that they have that background. So I'm very impressed with that.
Back to your question in creating a culture where employees feel valued, part of a team, part of the solution for the company or the clients' problems is an integral part of maintaining a healthy and successful organization and ensuring that you have a policy in place and a practice that prohibits bullying, discrimination and harassment for any reason is important. It's more than just what's required by law but really creating an environment where everyone valued equally and no group is belittled simply by virtue of their membership in that group that's critical.
Requiring mandatory annual training in some fashion is important. We had at FordHarrison have a specific focus every two years on some aspect of diversity and inclusion. We focused on the business case, generational diversity, unconscious bias, cultural competence and a number of other issues and each year we have trained all of our lawyers and staff on these issues.
We try to ensure that our FordHarrison team understands how highly we value diversity in that regard. Oftentimes even we've closed our offices for periods of time so that everyone can be trained together. The training can happen virtually. It can be computer based on person but having a mandatory training program is very important.
Another key policy that's critical to establishing and maintaining cultural values, diversity and inclusion is work-life effectiveness or work-life balance as has been called in the past. Ensuring employees have the flexibility to handle their lives and balance that with their work responsibilities has a significant impact on employee morale. Giving employees that flexibility to manage their own workload is ultimately going to allow those employees to achieve greater success.
Our clients have repeatedly told us when they been on panels in our firm and outside of our firm that they don't care where we work. As long as were accessible and responsive to their needs. One client even went so far as to say she didn't care if we were sitting on a beach as long as we picked up the phone and we could handle her problem.
I will offer one final suggestion on this topic Charles is regularly take the pulse of your workforce in terms of what you're doing right and suggestions for change. At FordHarrison we conducted an anonymous survey of our employees, our partners, our associates, our staff and solicit their input on the issues that they believe we should be addressing, concerns that they see that we need to be exploring and the things that are working well.
And after the survey we published the results of the survey and then try to work on changes where changes are necessary and those are key policies that I think are critical to establishing a culture of diversity and inclusion.
Charles Volkert: That's great and that whole openness to communication and feedback is key. It's something we pride ourselves on at Robert Half as well, this openness to ideas and in that diversity and inclusion space really, really important and so I know you were talking a lot about the factors that contribute to successful diversity and inclusion programs, but maybe shifting gears can you share some common challenges, obstacles, I'm sure there's many from time to time that legal managers may face when trying to strengthen diversity and inclusion behaviors within their organizations and any advice on how to overcome those challenges that have been successful for you or your colleagues.
Dawn Siler-Nixon: Sure. With the success we've enjoyed thus far in the legal profession in terms of diversity inclusion you're exactly right, there's also been a number of challenges that we faced in trying to implement successful programs. The first I would say is resistance to change. Close thinking especially at the top, you can develop great programs, you can bring in amazing speakers, you can create employee resource groups or business resource groups but nothing's going to change if key leaders, those individuals in key leadership positions are not on board.
Even if they don't say anything negative, attitude will have a trickle-down effect. They come to a program, leave halfway through, to take a call or come in late or don't come at all, they're looking down at their phone the entire meeting that's a message that's heard louder than shouting it from the mountaintop, Charles. They don't see anything wrong with the way that things have always been and don't see any reason to change.
Giving key leaders to understand the need for a diverse workforce and how this one will enhance and grow their business strategically and make more money is the first step to creating a diversion inclusive environment.
Fear is another common challenge that I've seen Charles. It's a challenge for people to feel comfortable having that open dialogue like you were talking about, about race, gender, religion and other issues. We are in a society where we've been ingrained with the notion that we should be politically correct and so all of this discussion and being open and having safe places to talk about these issues is counter-intuitive.
We are also in a world where there is labor employment laws that protect everyone in our society from discrimination or harassment and so that makes people even less likely to be open and talk about those things. In addition the people who fit into the categories we are talking about are oftentimes afraid of having these conversations because all they're trying to do is fit in Charles not to stand out. So creating a safe place for a dialogue is key to the success of any programming and having an opportunity within your organization to do that, to say that this is a safe room, we're going to talk about these issues and have an open dialogue about them is key.
I do you think that the last thing that I'll share about this topic implicit or unconscious bias is a huge roadblock to the success of diversity and inclusion and when I say implicit or unconscious bias I mean our experiences with other people. Some of them are direct, the real world encounters that we've had over our lives but most of them are vicarious, they relate to us through stories, through books or movies or the media, thought our parents.
Many of the things we've been taught or heard since childhood. They make an impact on us that we don't realize and these are unconscious or implicit biases that impact our decision-making today, they make a stereotype people or they impact our judgment and if we don't understand that we have them and realize that they might be impacting our reaction to certain groups or people in a positive or negative way we can't do anything about it. We really don't know what we don't know. It's really the thought process and it's eye-opening for people to understand how their environment when they were young may be impacting who they choose to be on their team for a specific project today.
We had all of our lawyers at FordHarrison take an implicit bias test and provided each one of the individuals with their results and I can tell you that they were eye-opening where people with biases against their own race or their own gender something that if they had been asked about they would never believe was true and then we were able to spend the better part of a year delving into the reasons underlying those biases and how to interrupt those biases and make different choices today.
So those are three challenges on potential solutions and the diversity inclusion context.
Charles Volkert: I mean really fascinating Dawn, and to think as you walked us through that that some of the laws and some of the barriers that are out there that were put up to actually protect diverse individuals, really prevent that open discussion to help with the inclusion et cetera. So really, really fascinating, earlier we discussed how a culture of diversity and inclusiveness can impact a legal organization's ability to attract and retain clients. How can a law firm demonstrate clients, potential clients and other constituents the value at places on diversity and inclusion?
Dawn Siler-Nixon: Well, there are a number of ways Charles that we can do that. One thing we try to do at FordHarrison is to provide our clients with opportunities to partner with us in what we are doing. We have a biannual publication called 'Moving Forward', that really highlights what our firm is doing in terms of diversity and inclusion and spotlights one of our offices and everybody in that office, including staff and attorneys, and it also spotlights one of our clients and their contributions to diversity and inclusion.
I'll give you one example of our efforts and how we partner with our clients. Several years ago one of my dear friends and a former partner Kay Wolf recommended that their firm build a school in the Prey Veng Province of Cambodia. It sounded like an incredible but an unattainable endeavor for the firm. I can tell you when she first told us about it, you may know that Cambodia has one of the lowest per capita incomes in the world, children and hundreds of rural villages there have no access to education. Kay found a foundation that would match funds raise so that we can help build a five-room primary school building and provide continuing operations for several years for just $15,000. I can tell you that I was amazed at the outpouring of support that our firm had for this effort.
We had competitions between offices to raise more money than other offices and when we shared our initiative with our clients, their reaction and desire to help was overwhelming. We were able to raise not just $15,000 initially that we needed, but $85,000 in our efforts and opened that school in January of 2013 and it's called the FordHarrison School in Cambodia and our clients loved it. Our clients are 22:44 lawyers who they partner with thinking the same way; it really reinforces our commitment in their mind to diversity and inclusion of the world that we live in. And in turn it solidifies our client relationships. So there really is a bridge between our diversity and inclusion efforts and the relationships that we make with our clients.
Charles Volkert: That's really great to hear Dawn, it sort of takes me back to the downturn when I approached Robert Half and encouraged us to get more active in the diversity world in particular as it pertains to the legal world and their full support. As I suggested, we participate in the Lloyd M. Johnson Scholarship with the MCCA and we've been a strong backer of that program ever since, and I mean, just unbelievable, that's just something small, building a school in Cambodia is really outstanding. So it's been a great discussion thus far but now it's time for a quick break.
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Charles Volkert: Welcome back to the Robert Half legal Report. I am Chad Volkert and joining me today is Dawn Siler-Nixon, Diversity and Inclusion Partner at FordHarrison. Before the break we were talking about why strong and effective diversity and inclusion practices have become a business imperative for legal organizations in today's legal world? Earlier, Dawn, you mentioned briefly that diversity and inclusion programs are being used to enhance recruitment and retention of legal professionals.
Can you talk more about that and how legal hiring managers can use their organization's diversity profile to attract top candidates?
Dawn Siler-Nixon: Well, they definitely can Chad; diversity is certainly a selling point to attract the best and the brightest to your firm or your organization. Lawyers and legal professionals expect that you'll not only have a commitment to diversity and inclusion, but that you show affirmatively the effects of your program and your involvement as well as your personal commitment. I'll share a quick story; we participated in a local diversity and inclusion picnic that was hosted by our County Bar Association. A Hispanic male law student came to our table and gathered some information on our farm, he told us that he was considering labor and employment and was interested in our firm. And so, we interviewed him and he later told us that he had been recruited from some of the top firms within the city. He had interview with them and interviewed with us and it was our lawyer's passion for diversity and inclusion that tipped the scales for him.
He said that his decision came down to two firms, one was a national full-service law firm that had a labor and employment component, and the other one was ours, FordHarrison, that's the boutique of labor employment firm. And when he asked the partners at the other firms about their diversity and inclusion programs and their commitment that they listed on their website, they couldn't explain any of the programs or initiatives that they allegedly had in place, instead, they referred him to their HR manager to talk more about that.
And then he said on the other hand our lawyers were able to share their personal experiences with diversity and inclusion training, our mentoring circles, our initiatives. He said that he felt more comfortable knowing that we were really committed to diversity and inclusion and in turn to his success within the firm. He's been with our firm for seven years now Chad, and he is being considered for partner this year. Legal professionals today particularly Millennials like this young man and Gen Z expect a work environment where diversity matters and its value.
Charles Volkert: That's a great, great testimonial and a great example of the importance of diversity within the workplace and having a sound plan on how to communicate that. I can tell you Dawn that in our recruiting world we have many candidates coming to us, looking to make a move and near the top of their priority list many times is, does the organization value diversity and inclusion, what is their plan, how do they communicate that to the world at large, and what are they doing internally with their staff.
Not only lawyers, a lot of times I think we think about it from a lawyer's perspective but also the rest of the staff and how the entire law firm or corporate legal department works effectively with diversity and inclusion. I guess I'd like to turn our discussion now do a related topic, specifically, how can legal organizations measure their diversity profile and track improvements. In your opinion Dawn, should they have a formal metrics driven approach to diversity or can you suggest other effective approaches?
Dawn Siler-Nixon: Well, there's no question Chad but the legal organizations have to track their progress towards creating a diverse environment and the impact of their inclusion efforts. Although not all diversity and inclusion programs can be measured by numbers, but it is what our clients are requesting. So we do have to ensure that we track the categories of people that we have on board, as well as individual hours that are being spent on client's legal matters. The ABA, the American Bar Association recently unveiled new diversity standards and policies and procedures and created a model survey that corporations and law firms are currently using to gather information and consistent diversity data from law firms.
There's a new diversity and inclusion portal on ABA website with tools and resources that our listeners can use and the ABA is working with the new organization that we are a member of called LCLD; it's the Leadership Council on Legal Diversity. They're working with them to develop metrics, specifically quantitative and qualitative measures of diversity and their impact, and LCLD, if you don't know that organization, it's a member organization of almost 300 corporate chief legal officers and law firm managing partners, and they'd come together to work on building a more diverse legal profession. And one of the metrics that they're developing to roll out will allow clients to measure their legal vendors against one another and attract their progress over time, if the vendors are receiving failing marks, these executives have committed to having hard conversations with them.
Sharing best practices from some of their other vendors, and ultimately parting ways Chad; if these vendors are unwilling to reflect their commitment to diversity and inclusion.
The ALA, the Association of Legal Administrators developed a Diversity and Inclusion scorecard that provides best practices for ALA members and measures the progress and eliminating barriers that limit opportunities for the success of all legal professionals.
There are a number of ways that progress can be measured Chad, but it's important that it's measured.
Charles Volkert: Well, it sounds that way and it sounds like that if an organization providing services to law firms, corporate legal departments, et cetera are not in tune with these measurements that they are being measured in their expectations, they're simply not going to be successful working with those firms, those corporate legal departments in business in general, let alone with diversity and inclusion initiatives.
So what advice would you give to a law firm looking to increase diversity in its partnership rank?
Dawn Siler-Nixon: That's a good question. I think that clients are looking at numbers Chad, but I don't think that they can focus primarily on that. We really need to create an environment where lawyers and legal professionals can thrive; putting programs in place that assist individuals with their professional development and help them reach their full potential I think are critical.
One example I'll give you in a program that we have at Ford & Harrison, is called LEAP. LEAP is a program that we developed specifically to focus on moving more women into the equity partnership ranks. What we were seeing was that a number of women were being initially permitted to partner from associate, but they were languishing there. Not as many of them were matriculating through to the higher ranks of equity partnership.
The LEAP program provided both an internal mentor and an external consultant advisor to assist those lawyers with focusing on client development and client development training that really is necessary for the ultimate success for the business generator or a law firm. And we can tangibly see how their books of business have grown exponentially as a result of being a part of that program.
But we need to remember Chad that looking at the numbers doesn't always tell us the full story about an organization of diversity and inclusion efforts. We need to look at the entire structure, their programming, their buy-in and their culture. So I think that firms need to look at all of those things in terms of increasing the number of diverse individuals in their partnership ranks.
Charles Volkert: Those are great points Dawn and sounds similar, your LEAP program to the initiative that Jean Lee has with the MCCA and with NAPABA as well, to really take in-house counsel and be able to grow them, mentor them, bring them along from a leadership standpoint but also in and around diversity and inclusion and maybe before we wrap up that really leads to my last key question for you.
I've read a number of articles about the differences between mentoring and sponsorship within the legal profession. Can you go into some detail and explain the distinction between the two, and also how mentoring and sponsorship each are used to enhance workplace diversity.
Dawn Siler-Nixon: Yeah, so I've read a lot of those same articles as well Chad. Some of them were titled 'Forget Mentor and Find a Sponsor.' I really think that both are essential to being successful in the legal profession.
A mentor, I see a mentor as someone who will provide you with advice and guidance that you might need to navigate through the corporate hierarchy. They can provide you with wisdom and direction.
A sponsor, on the other hand, is someone who will endorse you in closed-door meetings and is a valuable ally in establishing your career. Often mentors can turn into sponsors or champions that we call them. It's building that relationship that takes time.
We have both of those categories at Ford & Harrison, mentors as well as sponsors. Through our initiative, we call our Pipeline Initiative; we developed a mentoring circle for diverse associates. We had one-on-one mentors for some time, and took the concept of it; it takes a village to raise a child and turn that into a program that we have at Ford & Harrison where for the first two years of a diverse individual's time at our firm they have three mentors.
Their office managing partner, myself as a diversity and inclusion partner, and a partner or senior associate outside of their office. All of those individuals are resources to help them with any issue that they might encounter.
Through our Leadership Program, which is another program we had at Ford & Harrison, attorneys are connected with a sponsor or a champion. Somebody who is a power broker or a firm a leader, who can help them launch or catapult their career.
Another thing that we highly recommend is external mentors. No matter how highly we think of ourselves at Ford & Harrison, I think research shows that the majority of legal professionals are not going to spend their entire career at one firm. Although, we do have a number of partners who have been here for 30 years and started as associates.
With that been said, having an external mentor who can provide give you with a 30,000 view of an issue or open doors for potential opportunities to you to generate business or work, it's critical to someone's success. I really like to say that you need to have your own board of directors. People who are not going to just tell you what you want to hear, but they're going to tell you what you need to hear. And building a diverse network can do nothing but serve you well in the future.
Charles Volkert: That's great Dawn. Great advice and it sounds like Ford & Harrison really through your leadership has great programs in place to drive diversity and inclusion, mentor, sponsor individuals and bring them along the path of leadership which you mentioned at the beginning of your comment, is so key to have that leadership buy-in.
Well, unfortunately it looks like we've reached the end of our program today. I can say that that was certainly a great discussion, and I hope all our listeners took a lot of notes and took a lot of value away from your comments today Dawn. And really a big thank you to Dawn Siler-Nixon for joining us today.
Before we close, I'd like to let the audience know how they can contact you and where they can obtain more information about diversity and inclusion practices, within the legal workplace.
Dawn, how can our listeners reach out to you?
Dawn Siler-Nixon: Well, I'm happy to share any of the knowledge or insights that I've obtained along our journey at Ford & Harrison with you and any of your listeners. My email is HYPERLINK "mailto:[email protected]"[email protected]. Our firm website is also fordharrison.com and there's a wealth of information on our diversity and inclusion efforts on the diversity page of our website and I'm happy to share any of the information that I have with any of your listeners.
Charles Volkert: Great. Thank you Dawn. And if our listeners want to reach out to me directly, they certainly can, my email address is HYPERLINK "mailto:[email protected]" [email protected]. And you can visit the Robert Half Legal website for additional information on diversity practices, as well as legal career and management resources including our latest our salary guide for the legal profession at HYPERLINK "http://www.roberthalflegal.com" roberthalflegal.com.
Thanks again Dawn and to our audience for listening today. Join us next time on the Robert Half Legal report, as we discuss important trends impacting the legal field and legal careers.
Outro: The views expressed by the participants of this program are their own, and do not represent the views of, nor are they endorsed by, Legal Talk Network, its officers, directors, employees, agents, representatives, shareholders, and subsidiaries. None of the content should be considered legal advice. As always, consult a lawyer.
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Podcast: Robert Half Legal Report
Category: Diversity , Practice Management
The Robert Half Legal Report covers the latest trends affecting the legal profession.
What Legal Teams Need to Know about the LIBOR Transition
Host Charles Volkert is joined by Doug Wilbert to discuss significant legal implications inherent in the benchmark transition.
Legal Teams and COVID-19: Key Strategies for Adapting to a New Business Environment
Charles Volkert, senior district president of Robert Half Legal, and Billie Moliere, district president with the company, explore key considerations as legal offices re-open.
Understanding Recent Updates to the CCPA and EU-US Privacy Shield
Joel Wuesthoff discusses significant updates relating to data privacy that could directly impact your business and compliance obligations.
Great Expectations: Legal Departments' Changing Requirements for Outside Counsel
Jamy Sullivan discusses the changing expectations of legal departments and the impact on the selection, management and evaluation of outside counsel.
Key Strategies to Attract, Motivate and Retain Gen Z in the Legal Workplace
Jamy Sullivan outlines Gen Z's values, attitudes and career aspirations and offer critical strategies to recruit and motivate this next generation of legal professionals.
Beyond the GDPR and CCPA: Leveraging Data Privacy Strategies to Comply with Multiple Regulatory Mandates
Joel Wuesthoff offers strategies to help companies stay ahead and adjust security and privacy practices to manage the growing volume of data regulations.

redpajama_set_name: RedPajamaCommonCrawl


text:
Officers step up enforcement for holiday
Friday, December 31st 2004, 1:28 pm
OKLAHOMA CITY (AP) Law enforcement agencies stepped up traffic enforcement for the New Year's holiday, with special attention focused on drunken drivers.
``There are so many celebrations and parties that involve alcohol so the prevalence of DUI offenses is greater because of that,'' Oklahoma City police Sgt. Charles Phillips said.
Oklahoma City, Oklahoma County and other local law enforcement agencies were putting extra officers on patrol looking exclusively for drunken drivers. Oklahoma Highway Patrol troopers also were targeting drunken drivers.
In Tulsa, police were planning to focus on places where a number of bars and clubs are located, Tulsa Police Officer Craig Murray said.
``We are just going to have the regular complement of officers working New Year's Eve. We are not going to do sobriety checkpoints, but we will be out enforcing liquor laws,'' Murray said.
Through Dec. 30, 752 traffic fatalities occurred in Oklahoma, compared to 671 last year, OHP Lt. Brandon Kopepasah. He believes that more multiple-fatality crashes have occurred this year.
``The number of crashes has not really spiked, but I believe we are seeing an increase in the multiple-fatalities crashes,'' he said. ``Many of them involve large vehicles and SUVs.''
The 2003 fatality total was a low number compared to previous years, and ``it is hard to get a good comparison with that number,'' Kopepasah said.
Through Dec. 17, 156 of this year's traffic deaths were drug- or alcohol-related.
A 47-year-old Ponca City man was struck by a van and killed Thursday night as he walked on State Highway 177 in Kay County. Jacob Donald Roughface was thrown 150 feet from the point of impact. An odor of alcohol was detected on him, the OHP reported.
News On 6 OKLAHOMA CITY (AP) Law enforcement agencies stepped up traffic enforcement for the New Year's holiday, with special attention focused on drunken drivers.
``There are so many celebrations


Okay, so it spins for anywhere from five to thirty seconds then stops. Nothing prompted this to start. No download, no power outage, no lightning storm. No getting p*ssed off and tossing my computer. At first, every twenty or so times trying to get the thing to work, it would eventually read a disc. Now, it never does.
Any ideas as to what's going on (in as simple of terms as you can put it, I'll understand a lot of what you mean but not everything technical, sorry) and what I can perhaps do to fix this? I'm low on money so buying a new one isn't an immediate option. But I have a feeling I'm going to have to just wait and get a new one.


There are many supplements available on the internet and in stores that contain this crucial component. Be aware that, although an individual looks absolutely fit and fine, they may have an abnormal number of visceral fat, given his medical conditions aren't normal. It is a good option for any man or woman who's interested in trying safflower oil for a weight reduction aid.


As the energy of the new year rolls into our hearts, minds and consciousness, there's a strong desire to change something, anything, in order to ignite new creative insights. Yet, the date on the calendar does not magically make the experiences and emotions of last year disappear, or enable change to spring into motion.
The push and pull between these two distinctly different types of energies is actually happening all the time, despite what the calendar says. The imprint of old ideas and patterns mix with the desire to create something new, fresh and in alignment to keep us evolving and creating new experiences, connections and things.
This is why it's so important to get clear on YOUR basics. It helps you honor the energy of transition and respect its' gifts every day of the year.
When you cut out fluff and get down to the bare essentials that are most meaningful, there's a sense of empowerment that washes over you. Mental clutter, cleared. Emotional baggage, illuminated for healing. Inspiration, unearthed and brought forth to germinate into cool creative awesomeness. Clarity, engaged.
What Are your 4 Grounding Guideposts?
The true expression of simplicity is distilling everything you feel, think and desire down to the kernels of your unique truth; the bare essentials required for you to be the most joyful "you" possible.
Start the new year by clarifying your guideposts before outlining specific detailed goals. Reset, realign and reestablish what's most important based on past lessons and current desires. Take what deeply resonates and build a clear, simple structure for today and each moment forward. Begin to simplify and slowly refocus where you want to go.
As is the case with transition, there will be turbulence along the way that might shake your confidence. Simply come back to your core grounding guideposts when scattered, overwhelmed or feeling creatively depleted. Honor them as the gospel of your heart.
Running an idea or feeling past these basic requirements helps me identify what's a true need vs. external fluff or distracting mental chatter. They serve as truth tellers and beacons at the most elemental level.
Sticking with your own simple core truths as a guide allows you to flow with life and remain grounded. Returning to these unique grounding elements consistently is what refines the discernment process, making it easier to tune into core needs quickly and decipher a clear creative direction, one day at a time.
What are your four pillars for 2016? What can you come back to again and again to simplify, clarify and reset creative energy in order to bring focus back to what matters most and inspire new creative insights?
If you are looking for additional posts about tuning into your unique flow and getting down to basics, check out my past blogs; Opening Awareness to Creative Flow in Daily Life and Honoring the Birth and Death Cycle of Creativity. Want a little more personal clarity to kick-off 2016? Connect with me for an intuitive reading or creativity coaching. For more insights on keeping things simple in life and how powerful it can be, check out Keeping Things Simple for a Healthy, Long Life.


Download e-book for iPad: 2,000 Toxicology Board Review Questions by Richard J. Fruncillo MD PhD DABT,PhD, DABT Richard J.
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text:
define(function () {
  "use strict";

  return 123;
});

redpajama_set_name: RedPajamaGithub


text:
Danny Dyer is seen for the first time since announcing EastEnders exit
Danny Dyer is seen for the first time since announcing the departure of EastEnders as he returns to Bentley… after bookies lowered the odds of him becoming the next Doctor Who.
By Owen Tonks and Connie Rusk for Mailonline
Published: 4:17 PM EST, January 14, 2022 | Updated: 4:17 PM EST, January 14, 2022
Danny Dyer was seen returning to work on Friday for the first time since announcing he was leaving EastEnders after nine years on the soap.
The 44-year-old actor drove his black Bentley to the set in London as he prepared to film scenes as Mick Carter.
It comes about as Danny was named as one of the frontrunners to take over the Doctor Who role from Jodie Whittaker.
Moving on: Danny Dyer was seen returning to work on Friday for the first time after he was named as one of the frontrunners to take over the Doctor Who role from Jodie Whittaker.
Fans of the show are betting that Jodie, 39, will be replaced by Danny when he leaves the show this fall.
Danny sat behind the wheel of his black motor as it drove to Elstree Studios in Hertfordshire.
The screen star showed a casual figure inside his vehicle wearing a gray jacket while having a serious look on his face.
Next move? Fans of the show are betting that Jodie, 39, will be replaced by Danny, 44, when he leaves the show this fall.
Screen star: While he announced he was leaving his role as Mick Carter on EastEnders after nine years last week, he was back at work when he arrived today to film in his luxurious Bentley.
On a roll: Danny could be seen sitting behind the wheel of his black engine as he drove towards Elstree Studios in Hertfordshire
Following Danny's announcement that he was leaving EastEnders, bookies reduced his odds from 66/1 to 16/1.
On how the odds of the next Doctor Who have changed dramatically since its announcement, a Ladbrokes spokeswoman told The Sun: "Danny may not be the archetypal actor to play the Doctor, but that's why he could be the perfect choice to make. a big change in the program.
He is all the rage with punters and has already said he wants to take on different roles.
"So we could see him swapping The Queen Vic for the Tardis, and we've lowered our odds accordingly."
Departure: Jodie will be leaving Doctor Who later this year and, following Danny's announcement that she is leaving EastEnders, bookmakers have reduced her odds from 66/1 to 16/1.
Earlier this week, Danny admitted he wanted to leave EastEnders "for a while" when he spoke for the first time since announcing his departure from the soap opera.
Speaking on his Sorted With The Dyers podcast, he said: "When you're in a job like a soap opera, your contract gets renewed and every time it does I've been asked to stay on, and I'm very grateful for that." . Because I've seen a lot of people come and go. It is very hard
I'm always debating if I want to re-sign and I've been contemplating for a while if it's time to roll the dice, take the plunge.
Moving on: The actor is stepping down from his role as Mick Carter on the BBC series after nine years and said he now wants to try other things.
'The great news is that I have decided not to renew my contract. That's it. That's not because I've had a fight with someone, I love everyone. That job has been amazing to me. It is an important part of television.
The soap opera star insisted that there is no "big story" behind her departure, other than that she wants to try other things.
It comes after Jodie called in another doctor to take on the role.
She told Radio 1's Vick Hope and Jordan North: "If we had the power to choose, I would pick an actress who I think is really exciting and I think would be phenomenal, an actress called Lydia West." If I had the power!
Lydia is the Coral sportsbook favorite to replace Jodie at odds 3-1, while Fisayo Akinade and Omari Douglas (both 5-1) are the joint second favorites and Olly Alexander is next in the betting with 6-
New: It comes after Jodie called in another doctor to take on the role. She said: 'If we had the power to choose, I would choose an actress named Lydia West'; Lydia in the photo of 2021
Victoria Beckham and her daughter Harper, 10, wear matching gray robes as they enjoy a… Read More »Victoria Beckham enjoys relaxing spa day with daughter Harper, 10, as they sport dressing gowns
Inside Dancing On Ice's Bez's time in prison as he once rioted over trifle
CROCKED Dancing On Ice star Bez has revealed that he once rioted in prison because… Read More »Inside Dancing On Ice's Bez's time in prison as he once rioted over trifle


text:
Skorumpowani – polski film z 2008 roku
 Skorumpowani – francuski film z 1984 roku
 Skorumpowani – polski serial telewizyjny


text:
#include "../system/cmsis/LPC13Uxx.h"
#include "../system/peripheral/usart.h"
#include "usart_handler.h"
#include "FreeRTOS.h"
#include "task.h"
#include "queue.h"

#define USE_QUEUE 0

static xQueueHandle usart_rx_queue = NULL;

static void usart_receive_data(uint8_t data);

/* Priorities at which the tasks are created. */
#define USART_RECEIVE_DATA_TASK_PRIORITY ( tskIDLE_PRIORITY + 2 )

/* The rate at which data is sent to the queue, specified in milliseconds. */
#define USART_RECEIVE_DATA_FREQENCY_MS	( 20 / portTICK_RATE_MS )

static void usart_receive_data_task(void* parameters)
{
	portTickType xNextWakeTime;

	/* Initialise xNextWakeTime - this only needs to be done once. */
	xNextWakeTime = xTaskGetTickCount();
	for (;;)
	{
		vTaskDelayUntil(&xNextWakeTime, USART_RECEIVE_DATA_FREQENCY_MS);

		uint8_t data;
		while (xQueueReceive(usart_rx_queue, &data, 0) == pdTRUE)
		{
			usart_receive_data(data);
		}
	}
}

static inline void write_error(const_string msg, portBASE_TYPE code)
{
	usart_write_string("msg <");
	usart_write_string(msg);
	usart_write_string(", code ");
	usart_write_int32((int) code);
	usart_writeln_string(">");
}

void usart_handler_init(void)
{
#if USE_QUEUE
	usart_rx_queue = xQueueCreate(1024, sizeof(uint8_t));

	if (usart_rx_queue == NULL)
	{
		usart_write_string("msg <can't allocate usart_rx_queue.");
		usart_writeln_string(">");
	}

	portBASE_TYPE result;

	if ((result = xTaskCreate(usart_receive_data_task, "usart_rx_data",
			configMINIMAL_STACK_SIZE, NULL, USART_RECEIVE_DATA_TASK_PRIORITY,
			NULL)) != pdPASS)
	{
		write_error("cannot create \"usart_rx_data\" task.", result);
	}
#endif
}

volatile uint8_t usart_buf_arr[USART_BUFFER_SIZE];
volatile uint8_t* usart_buf_ptr = usart_buf_arr;
volatile uint32_t usart_buf_count = 0;

#define WEAK __attribute__((weak))

WEAK void usart_receive_data_handler(string str, uint32_t str_len);

static void usart_receive_data(uint8_t data)
{
	if (usart_buf_count < USART_BUFFER_SIZE)
	{
		switch (data)
		{
		case 0x05:
			usart_write_char(0x06);
			break;
		case 0x02:
			usart_buf_count = 0;
			break;
		case 0x03:
			usart_buf_arr[usart_buf_count] = '\0';
			usart_receive_data_handler(usart_buf_arr, usart_buf_count);
			break;
		default:
			usart_buf_arr[usart_buf_count++] = data;
		}
	}
	else
	{
		usart_buf_count = 0; // buffer overflow
		usart_write_string("uart buffer overflow.");
	}
}

void USART_IRQHandler(void)
{
	portBASE_TYPE xHigherPriorityTaskWoken = pdFALSE;
	uint8_t IIRValue, LSRValue;
	uint8_t Dummy = Dummy;

	IIRValue = LPC_USART->IIR;
	IIRValue &= ~(USART_IIR_IntStatus_MASK); /* skip pending bit in IIR */
	IIRValue &= USART_IIR_IntId_MASK; /* check bit 1~3, interrupt identification */

	// 1.) Check receiver line status
	if (IIRValue == USART_IIR_IntId_RLS)
	{
		LSRValue = LPC_USART->LSR;
		// Check for errors
		if (LSRValue
				& (USART_LSR_OE | USART_LSR_PE | USART_LSR_FE | USART_LSR_RXFE
						| USART_LSR_BI))
		{
			/* There are errors or break interrupt */
			/* Read LSR will clear the interrupt */
			//uart_pcb.status = LSRValue;
			Dummy = LPC_USART->RBR; /* Dummy read on RX to clear interrupt, then bail out */
			return;
		}
		// No error and receive data is ready
		if (LSRValue & USART_LSR_RDR_DATA)
		{
			/* If no error on RLS, normal ready, save into the data buffer. */
			/* Note: read RBR will clear the interrupt */
			usart_buf_arr[usart_buf_count++] = LPC_USART->RBR;
			if (usart_buf_count == USART_BUFFER_SIZE)
			{
				usart_buf_count = 0; /* buffer overflow */
			}
		}
	}

	// 2.) Check receive data available
	else if (IIRValue == USART_IIR_IntId_RDA)
	{
		// Add incoming text to UART buffer
		uint8_t data = LPC_USART->RBR;

#if USE_QUEUE
		if (usart_rx_queue)
		{
			xQueueSendToBackFromISR(usart_rx_queue, &data,
					&xHigherPriorityTaskWoken);
		}
#else
		usart_receive_data(data);
#endif
	}

	// 3.) Check character timeout indicator
	else if (IIRValue == USART_IIR_IntId_CTI)
	{
		/* Bit 9 as the CTI error */
		//uart_pcb.status |= 0x100;
	}

	// 4.) Check THRE (transmit holding register empty)
	else if (IIRValue == USART_IIR_IntId_THRE)
	{
		/* Check status in the LSR to see if valid data in U0THR or not */
		LSRValue = LPC_USART->LSR;
		if (LSRValue & USART_LSR_THRE)
		{
			//uart_pcb.pending_tx_data = 0;
		}
		else
		{
			//uart_pcb.pending_tx_data = 1;
		}
	}

	portEND_SWITCHING_ISR(xHigherPriorityTaskWoken);
	return;
}