Nasdaq-listed carrier AmTrust has raised $300mn of capital through family members of the company's founders via a private placement.
The news follows troubled months for the carrier, which has included a delay in its 2016 results and an announcement that it would have to restate its financials between 2014 and the first nine months of 2016 and a note from KBW analysts speculating that AmTrust may need to take a nine-digit reserve charge in order to restore investor confidence.
"AmTrust intends to direct the proceeds from the private placement to the company's insurance subsidiaries to support their financial strength, continued organic growth, and writing of business," it added.
The company said it would issue around 24.1 million common shares price at $12.45 a share – equivalent to the closing price of the carrier's stock on 25 May – through a private placement, which subsequently closed on 26 May.
Although the sole purchasers were certain family members of AmTrust chairman and CEO Barry Zyskind and director George Karfunkel, neither Zyskind or Karfunkel acquired any shares themselves.
The carrier also said that the unnamed buyers have agreed not to transfer the stock for at least a year and will not exercise their right to vote their shares of common stock until after the company's 2018 annual shareholders' meeting.
"In addition to enhancing our balance sheet and capital base, this sizeable investment of $300 million should also provide confidence to all of our stakeholders that we are well capitalized to grow and write business. We remain committed to continuing to support growth and maintain confidence in AmTrust," he concluded.
In early May research note, KBW analyst Meyer Shields said that he was "very uncomfortable" with AmTrust's stated reserves, suggesting that the company should take a "meaningful (ie, in the hundreds of millions of dollars) reserve charge" and commit to "much-improved disclosure" to ease investor concerns.


text:
Historical property available in Queensland
A historic fire station in Yeronga is being offered for sale for the first time in 15 years.
The station was built in the 1930s by architecture company Conrad and Gargett, who also designed Old Government House and Customs House in Brisbane.
"This property represents an incredible purchase opportunity for the astute buyer to secure a piece of Brisbane's rich cultural history," said Aron Burtenshaw, one of the Ray White Industrial Milton agents on the property.
"Currently zoned emergency services, the 280-square-metre two-level building on a 1,062-square-metre block could be used as an office or residence, or enhanced with additional development (STCA). An office approval was granted in 2001 but was never finalised," said Mr Burtenshaw.
"We have already had strong interest from a range of buyers including doctors and art businesses seeking a live and work option," he said.
The property includes many original features including fireman pole hole and levered garage doors which open onto an original engine room.
The fire station auction will be held onsite at 11am (AEST) on Wednesday, 7 December 2016.
Last Updated: 29 November 2016 Published: 29 November 2016

redpajama_set_name: RedPajamaCommonCrawl


text:
Physician's sociodemographic profile and distribution across public and private health care: an insight into physicians' dual practice in Brazil
Bruno Alonso Miotto ORCID: orcid.org/0000-0002-6052-09351,
Aline Gil Alves Guilloux1,
Alex Jones Flores Cassenote1,
Giulia Marcelino Mainardi1,
Giuliano Russo2 &
Mário César Scheffer1
The intertwined relation between public and private care in Brazil is reshaping the medical profession, possibly affecting the distribution and profile of the country's medical workforce. Physicians' simultaneous engagement in public and private services is a common and unregulated practice in Brazil, but the influence played by contextual factors and personal characteristics over dual practice engagement are still poorly understood. This study aimed at exploring the sociodemographic profile of Brazilian physicians to shed light on the links between their personal characteristics and their distribution across public and private services.
A nation-wide cross-sectional study using primary data was conducted in 2014. A representative sample size of 2400 physicians was calculated based on the National Council of Medicine database registries; telephone interviews were conducted to explore physicians' sociodemographic characteristics and their engagement with public and private services.
From the 2400 physicians included, 51.45% were currently working in both the public and private services, while 26.95% and 21.58% were working exclusively in the private and public sectors, respectively. Public sector physicians were found to be younger (PR 0.84 [0.68–0.89]; PR 0.47 [0.38–0.56]), less experienced (PR 0.78 [0.73–0.94]; PR 0.44 [0.36–0.53]) and predominantly female (PR 0.79 [0.71–0.88]; PR 0.68 [0.6–0.78]) when compared to dual and private practitioners; their income was substantially lower than those working exclusively for the private (PR 0.58 [0.48–0.69]) and mixed sectors (PR 0.31 [0.25–0.37]). Conversely, physicians from the private sector were found to be typically senior (PR 1.96 [1.58–2.43]), specialized (PR 1.29 [1.17–1.42]) and male (PR 1.35 [1.21–1.51]), often working less than 20 h per week (PR 2.04 [1.4–2.96]). Dual practitioners were mostly middle-aged (PR 1.3 [1.16–1.45]), male specialists with 10 to 30 years of medical practice (PR 1.23 [1.11–1.37]).
The study shows that more than half of Brazilian physicians currently engage with dual practice, while only one fifth dedicate exclusively to public services, highlighting also substantial differences in socio-demographic and work-related characteristics between public, private and dual-practitioners. These results are consistent with the international literature suggesting that physicians' sociodemographic characteristics can help predict dual practice forms and prevalence in a country.
Physicians' concurring engagement in multiple public and private sector clinical activities, a modality of practice often referred as dual practice, has been identified as a widespread phenomenon across different national health systems [1,2,3]. Multiple negative and positive aspects regarding dual practice have been highlighted in the public health and health economics literature [2, 3], and although few studies have pointed out at some positive effects of holding multiple job positions over healthcare provision [4], mostly attributed to savings on public expenditure and the possibility of retaining specialist doctors in the public sector, it is a widespread concern that this practice could potentially reduce the accessibility and quality of care in public health systems in low- and middle-income countries [5, 6]. Previous studies [6, 7] indicate that the comparatively better conditions offered by the private sector, such as higher remuneration and more flexibility of working hours, would promote physician's shirking from public duties to dedicate time to more lucrative private activities, diversion of patients from public to private facilities, and the use of public resources to support privately provided services [8, 9].
Although the evidence base on the effects and motivations of physicians' dual practice is scant, some have highlighted that it is likely to represent a formidable hurdle for the achievement of Universal Health Coverage and Sustainable Development Goals [5]. For such reasons, understanding dual practice has been considered one of the top priorities for human resources for health research in low- and middle-income countries [5, 10]. The extent and forms of such practice across different national health systems seem to depend primarily on how local physicians interact within the public and private spheres, local labour markets, and on how local legislation regulates medical healthcare services [5, 11]. Some studies have shown that physicians' personal characteristics such as age, sex, specialty and years of practice, can predict their engagement in dual practice [12].
The present paper aims at exploring forms and extent of different medical practice modalities in Brazil, including dual practice. Brazil is one of world's most populated countries, operating the largest public health system worldwide, where public and private funds and services are almost inextricably mixed to provide care for the country's very diverse population.
Brazil is a middle-income Federative Republic composed of 26 states and one Federal District, with a population of approximately 206,081,432 inhabitants. The country has a Human Development Index of 0.755 and a gross domestic product (GDP) of US$ 11,067 per capita [13]. It is marked by profound health disparities [14], and despite the major advances achieved towards the decrease of infant mortality rates and infectious diseases control [15], Brazil still struggles to overcome critical distribution inequalities between public and private services [16].
Since 1988, the country has implemented a tax-funded Unified Health System (SUS, from its Portuguese acronym), providing primary health care and some tertiary care services to its population free at the point of delivery. While the majority of the Brazilian population depends exclusively on public healthcare provided by the SUS (approximately 75% of the country's population), private expenditures still represents 54% of total health expenditures, with 39% of out-of pocket payments [17]. Some authors have therefore defined Brazil's health system as a mixed system predominantly funded by private resources [14].
However, no clear-cut distinction exists between private and public sectors in Brazil, as (a) for certain medical acts the public sector can purchase services from both private for-profit and private not-for-profit organizations; (b) public facilities can be used to provide private services; (c) public facilities can be managed by private companies; and (d) public funds may be allocated to both private and public institutions [18, 19].
Similarly to what observed in other high-, middle- and low-income countries [4, 20, 21], the medical profession in Brazil is marked by the coexistence of multiple job affiliations and possibilities of insertion in the health system [22], including working part-time jobs in both public and private services. Previous studies have shown substantial differences in the availability and supply of physicians for private plan customers and those depending exclusively on the SUS, and a increasingly proportion of job positions for the medical workforce has been provided by the private sector [23].
Over the last 30 years, a number of policies have been implemented in Brazil to attenuate physician's regional and public/private distribution disparities. More recently, the Federal Government has implemented the Mais Médicos programme (More Doctors Law; October 22, 2013), in order to promote the retention of health workers in unassisted areas and the opening of several new medical schools and internship programs. The programme also addresses educational policies towards changes in medical school curriculum, which should in theory provide an incentive to new doctors to take up positions in priority primary care services. The Law, however, does not establish any restrictions for holding simultaneous public and private job positions, and there are no current policies to regulate such practice.
Even though dual practice is a common and unrestricted activity in Brazil, the proportion and the sociodemographic profile of Brazilian physicians working as dual practitioners have been conspicuously under-researched. Most available information addressing the profile of the medical workforce in Brazil is currently based on data provided by local medical associations and/or national public access databases; medical registries from these repositories are often incomplete, inaccurate or missing, with conflicting information across different sources. The evaluation of the extent of dual practice and physician's demographic characteristics, such as age, region, gender, income, years of medical practice, public or private education and weekly workload, may help to better understand the impact of physicians' multiple job-holding over healthcare accessibility in Brazil.
The present study presents the findings from the first representative nation-wide survey of the Brazilian medical workforce. Primary data was used to establish linkages between physician's sociodemographic and work-related characteristics to their engagement with public and private services in Brazil, with a specific reference to those engaging in dual practice. The ultimate goal of this work is to contribute to the existing debate on the determinants and consequences of physicians' dual practice in low- and middle-income settings.
Study and sample design
A nation-wide cross-sectional study including 2400 physicians was conducted in 2014. Sample size was calculated based on a total of 399,692 active medical registries from the National Medical Council Medicine database (CFM – Conselho Federal de Medicina), using a 95% confidence level with 5% margin of error and statistical power of 80% [22]. Proportional stratified sampling was drawn according to the population from each Brazilian region (Northern, Northeastern, Southeastern, Southern and Center-western regions), which were considered as statistical stratum (Fig. 1). Within each stratum, the physician's distribution for gender, age, state and local of address (capital or countryside) were preserved.
Proportional stratified sampling according to the population from each Brazilian region; all regions were considered statistical stratum. Source: Miotto et al. 2018
Substitution was carried out exclusively in cases of unsuccessful contact or refusal to participate in our survey; 2,400 physicians were randomly selected and five substitutions were identified for each individual. Substitution sampling followed the same stratification criteria used for the initial sample calculation. We controlled sample replacements for state, region, sex and age, meaning that every physician who refused to participate was replaced by an individual with the same characteristics to avoid selection bias.
Primary data were collected via a telephone survey approach by 14 data collectors, including one field coordinator, 11 experienced interviewers and two professionals responsible for checking missing data. Sample size calculation, sample selection, questionnaire design, substitution control, database assembly and data analysis were performed by the authors. Data collection was carried out by the Datafolha Research Institute under financial support and supervision of the authors' research institution. The interviews consisted of a 30-min oral questionnaire, containing 30 questions ranging from multiple, closed questions to interdependently concatenated and semi-opened questions, as presented in an additional file (see Additional file 1). Three senior researchers from the medical demography field previously piloted and calibrated the questionnaire with 30 interviewees to estimate the reposition rate. Reproducibility was tested by sampling a random sample after the field collection and repeating the interview, resulting in 100% agreement.
The independent variables used were divided into two groups: (1) sociodemographic characteristics and (2) medical employment characteristics. For the purpose of international comparison, the values in Brazilian currency (R$) were converted into US dollars (US$) based on the exchange value of R$2.0742 for US$1 (average exchange rate for 2013). Only income values obtained from activities related to the medical profession were considered. The dependent variable 'mode of practice' was divided into three categories: (a) working exclusively as a public practitioner, (b) working exclusively as a private practitioner and (c) working simultaneously in public and private practices. For the present study, the public sector services were defined as "those services offered free-of-charges by the SUS, funded through general taxation and social contribution". Private services were considered "those offered through private health insurances funded through private and employer's contributions, or out-of-pocket expenditures".
The differences in sociodemographic/work-related characteristics and prevalence rates (PR) between physicians were established using prevalence ratio and 95% confidence intervals. The selected variables were initially studied with frequency analysis including 95% confidence intervals (95%CI) estimated from 1000 bootstrap samples. Data was stratified according to the nature of the services (public, private or dual practice). Unadjusted (crude) prevalence ratio for dual practitioners [(PR (dual practitioners/ public practitioners)] and private practitioners [(PR (private practitioners/public practitioners)], including confidence intervals (95%CI), were used to evaluate influences of the independent variables over the dependent variables. All statistical analysis was performed in IBM SPSS Statistics version 21.
This study was reviewed and approved by the Medical School Research Ethics Committee from São Paulo University (Protocol Number 79.424), in accordance with Brazilian and international regulations for research with human subjects. All the physicians interviewed gave their informed verbal consent before participating in the study.
Of the 2400 physicians included in the study, 51.45% (n = 1235; 95% CI 49.42–53.42) declared working as dual practitioners, while 26.95% (n = 647; 95% CI 25.17–28.79) and 21.58% (n = 518; 95% CI 19.88–23.33) were working exclusively as private and public practitioners, respectively (Additional files 2 and 3). All the prevalence rates and PR confidence intervals addressing sociodemographic and work-related differences between public, private and dual practitioners described in the text were calculated taking the public practitioners as reference (Figs. 2 and Fig. 3).
Forest plot of PR and PR 95%CI for sociodemographic characteristics of physicians working as dual and private practitioners, taking public practitioners as reference. Source: Miotto et al. 2018
Forest plot of PR and PR 95%CI for work-related characteristics of physicians working as dual and private practitioners, taking public practitioners as reference. * This variable had the private system as comparison basis, as doctors in the public system do not have private practice activities. Source: Miotto et al. 2018
In the study, 57.5% were males and 42.5% were females (95% CI 55.4%–59.6%; 40.4%–44.6%), in agreement to the general distribution of physicians in Brazil. Most physicians working exclusively as private practitioners or as dual practitioners were males (64 and 58.3%, respectively – 95% CI 60.4%–67.4%; 55.5%–61.1%). Prevalence of male physicians working exclusively as private practitioners was 35% higher in comparison to public assistance physicians (PR 95% CI 1.21–1.51). Conversely, female physicians were 46,3 and 26,4% more prevalent among public practitioners rather than private and dual practitioners, respectively (PR 95% CI 0.6–0.78; 0.71–0.88).
Younger physicians (less than 35 years of age) were 114.7% and 19.5% more prevalent among public physicians than private and dual practitioners, respectively (PR 95% CI 0.38–0.56; 0.73–0.95). Physicians with ages ranging from 35 to 60 years were 30% more prevalent in the dual practice category in relation to the public practice category (PR 95% CI 1.16–1.45), while no significant age difference was found in the prevalence rates between public and private physicians. Physicians above 60 years of age were 96% more prevalent among private practitioners than physicians delivering public services (PR 95% CI 1.58–2.43), whereas senior dual practitioners were 54.4% less prevalent as compared to public practitioners (PR 95% CI 0.51–0.83).
Most physicians included in the study were located at the Southeast region (56%; 95% CI 54%–58%) followed by the Northeast (17.3%; 95% CI 15.7%–18.7%), South (14.8%; 95% CI 13.5%–16.2%), Central-western (7.6%; 95% CI 6.6%–8.7%) and North regions (4.3%; 95% CI 3.4%–5.2%), in agreement to the general distribution of physicians in Brazil. Despite the marked inequality of physician's distribution across the country, only two regions showed differences in prevalence rates between public, dual and private practice: the northeast region presented higher prevalence of physicians working as public practitioners (72,8%; PR 95% CI 0.44–0.76) when compared to private practitioners, as opposed to the Central-western region, where dual and private practitioners were respectively 59% and 102% more prevalent than public practitioners (PR 95% CI 1.04–2.45 and 1.29–3.16).
Most physicians (64.1%; 95% CI 62.1%–65.9%) reported working at their city of residence (same city). Only 7% (95% CI 6.1%–8.1%) reported working exclusively in a city that they were not living in (different city), while 28.9% (95% CI 27.1%–30.8%) occupied job positions located both at their cities of residence, but also in another city (both). Physicians working in the same city they live were 29% more prevalent among private practitioners than physicians working in public services (PR 95% CI 1.19–1.39). Conversely, the prevalence of doctors working exclusively in a different city in the public sector was 251.4 and 274.7% higher than among dual and private practitioners, respectively (PR 95% CI 0.21–0.39 and 0.18–0.4). Physicians working in both same and different cities were 67% more prevalent among dual practitioners in comparison to physicians delivering public services (PR 95% CI 1.4–1.99).
Most physicians providing private services (including dual or private practitioners) were working at medical clinics and private hospitals, representing 78.2% (95% CI 74.3%–82.2%) of the interviewees; 31.1% reported working at private clinics/ambulatories (95% CI 29.3%–32.8%), and only 5.3% were currently working at private universities (95% CI 4.3%–5.2%).
Physicians providing public services (including dual practitioners and doctors dedicated exclusively to public practice) were more frequently registered at public hospitals (51.5%; 95% CI 49.5%–53.5%), followed by primary care (23.5%; 95% CI 22%–25.2%), specialized care (4.8%; 95% CI 3.9%–5.7%) and public college/university institutions (4.1%; 95% CI 3.3%–5%). Primary care physicians were 46.2% more prevalent among doctors exclusively working as public practitioners than dual practitioners (PR 95% CI 0.6–0.78).
Most doctors reported not working in on-call services (54.5%; 95% CI 52.5%–56.5%). Public practice physicians that provided on-call services were 212.3% more prevalent as compared to private service physicians (PR 95% CI 0.27–0.38). Prevalence of on-call services was similar between public and dual practice physicians.
In relation to the years of medical practice, doctors with less than 10 years of medical practice represented 29.5% (95% CI 27.5%–31.4%), practically the same proportion of physicians with more than 30 years of practice (29.9%; 95% CI 28%–31.8%). Physicians with less than 10 years of practice were concentrated in public services (28% and 127.9% more prevalent than dual and private practitioners, respectively; PR 95% CI 0.68–0.89; 0.36–0.53). Physicians with 10 to 30 years of practice were 49% more prevalent among dual practitioners as compared to their public sector peers (PR 95% CI 1.29–1.72). Physicians with more than 30 years of practice were concentrated among private practitioners (59% more prevalent than the public service physicians; PR 95% CI 1.35–1.87). Nevertheless, physicians with more than 30 years of practice were 77% more prevalent among public practitioners than dual practitioners (PR 95% CI 0.65–0.92).
Weekly workload ranging from 40 to 60 h was reported by 43,1% of the interviewees (95% CI 41.1%–45%); 32.4% reported working more than 60 h per week (95% CI 30.5%–34.2%). Nearly one fifth (19,4%; 95% CI 18%–20.9%) of physicians reported a weekly workload of 20 to 40 h and only 5.2% reported working less than 20 h per week (95% CI 4.3%–6.2%).
Distribution of physician's workload according to their mode of practice revealed that private practitioners were over-represented in the 20 h per week category (prevalence rate 104% greater than public practitioners; PR 95% CI 1.4–2.96), showing also no dual practitioners in this category. Few dual practitioners dedicate 20 to 40 working hours per week, in contrast to physicians from public services, which are 424.5% more prevalent than doctors dedicated to dual practice when considering this category/interval (PR 95% CI 0.15–0.24). Dual practitioners, however, are more prevalent in the 40 to 60 working hours category (17%; PR 95% CI 1.3–1.32), showing also marked prevalence among physicians working more than 60 h per week as compared to public practitioners (139%; PR 95% CI 1.99–2.86). Besides dual practitioners had presented the most extended weekly workloads, public service physicians working more than 60 h per week were 46.2% more prevalent than private practitioners (PR 95% CI 0.53–0.89).
Of all physicians included in the study, 68% held a specialization (95% CI 66.3%–69.8%). Specialists were more prevalent among dual and private practitioners than physicians delivering public assistance (41 and 29%, respectively; PR 95% CI 1.29–1.54; 1.17–1.42). Physicians holding surgery specialties were 85% and 67% more prevalent among dual and private practitioners as compared to the public practitioners, respectively (PR 95% CI 1.38–2.46; 1.21–2.29). These differences became more evident across the categories when surgery and general clinical specialties were considered (146% and 91% more prevalent among dual and private practitioners rather than public practitioners – PR 95% CI 1.85–3.27%; 1.40–2.61).
More than half of the physicians surveyed (55.5%; 95% CI 51.0%–60.0%) reported wages ranging from US$ 3857.00 to US$8969.00. Lower incomes (below US$ 3857.00) were reported by 20% of the interviewees (95% CI 18.4%–21.7%), whereas the highest income values (more than US$8969.00) were reported by 20.7% of physicians (95% CI 18.3%–23.1%).
Distribution of physician's income across the sectors revealed marked differences between the categories; physicians earning less than US$ 3857.00 were 226,8% (PR 95% CI 0.25–0.37) and 73,6% (PR 95% CI 0.48–0.69) more prevalent among public practitioners in relation to dual and private practice physicians, respectively. Contrastingly, physicians with monthly wages ranging from US$8969.00 to US$10,762.00 were 116 and 108% more prevalent among dual and private practitioners, respectively, as compared to public practice physicians (PR 95% CI 1.35–3.45 and 1.26–3.44). The same distortions were intensified among physicians earning more than US$10,762.00: professionals who fell into this category were 661 and 807% more prevalent among dual and private practitioners, respectively, in relation to physicians providing public medical services (PR 95% CI 3.72–11.73; 4.51–14.44).
This study shows that more than half of Brazilian physicians engage with dual practice, while nearly one fifth are employed exclusively as public practitioners. Dual practitioners are mostly middle-aged male professionals with 10 to 30 years of medical practice, working in medical offices at state capitals of the wealthiest regions of Brazil. Most dual practitioners hold a specialisation and undertake the heaviest workloads, with their income ranging from US$ 3857.00 to US$8969.00. On the other hand, doctors working exclusively in the public sector are predominantly female, younger, not specialized and less experienced physicians, and their income are substantially lower compared to dual and private practitioners. Physicians dedicated exclusively to private services were found to be senior, specialized, male doctors that often work less than 20 h per week, for a substantially higher income.
Interestingly, our results suggest little influence of private or public school training in physicians' choices of practice sector. Previous studies in Brazil have shown that the public sector is responsible for providing specialist titles for a large proportion of the medical workforce, and that most specialists deliver services through private services [24]. Our findings seem to support scholars' opinion that the public education may not necessarily be instrumental for retaining specialists in the public services [25].
Although the cross-sectional model used in this study mapped out the current profile of physicians working in both public and private sectors, it has limited power to predict the trajectory of physician's careers over time; still, some preliminary conclusions can be drawn. It appears that younger and less experienced physicians are concentrated among doctors delivering public services, mostly at primary care units, public hospitals and on-call services; this could be partially explained by the fact that most internship programs are provided by public universities and hospitals, especially at primary care and general practice areas. Public practitioners work mostly 20 to 40 h per week, and often have to commute between job and their residence location. Moreover, these job positions frequently provide lower remuneration when compared to private working positions and are frequently located at poor peripheral areas; such conditions may impact on the residence decisions of more experienced physicians in public services. As doctors become more experienced and specialised, they may start migrating towards those urban areas offering ampler opportunities for private practice, dedicating only part-time jobs to public services [26]. These practitioners have higher income than those physicians dedicated exclusively to the public practice, but are also subjected to longer working hours to keep both job positions. Private practitioners engage exclusively with medical services in private hospital institutions or at their own medical offices, and working exclusively as private practitioner appears to provide access to higher incomes; according to the income-leisure trade-off theory [27, 28] this would allow physicians to effectively reduce their weekly workloads, which would explain the over-representation of such physicians in the 20 h per week category. Obviously, older physicians may be working shorter hours in Brazil because they are no longer able to work full-time, but an alternative explanation could be that they are already established and wealthy enough to dedicate more time to leisure activities.
Such patterns are consistent with the existing worldwide literature on this subject [29, 30], and the dual practice prevalence described in this study is not dissimilar from those found in low and middle-income countries, such as Peru [31], Indonesia [32, 33], Thailand [34], Mexico, Egypt and Kenya [35], where the majority of physicians also seemed to engage in multiple job-holding. Despite the peculiarities of its health sector, Brazil's findings appear to confirm that some contextual factors like governance and economic growth play a primary role in dual practice prevalence and forms [12, 36]. Demand for services, opportunities for private sector engagement, and how clearly defined public and private systems are configured seem to be key determinants of the frequency and forms in which physicians take on simultaneous profit generating activities in the two sectors. Perhaps differently from what observed in other contexts, the Brazilian case shows a more marked trend of public sector physicians' engagement with private services, starting with the younger age cohorts.
Some authors highlighted their concern that physicians' dual practice may reduce the accessibility and/or quality of care available to users of the public system [3, 37, 38]. As in Brazil prepaid and private out-of-pocket expenditures represents 54% of the total health spending [17], our findings lend credibility to the hypothesis that physicians' migration to the private sector may pose challenges to population access to medical services. Previous analyses tackling inequalities of the Brazilian health system have identified negative impacts of the private sector over public-based health services, such as the shortage of public services, decreased funding of human resources and the decreased governmental investments on the SUS [17, 39].
The present study has shown that more than 78% of physicians are engaged in private services (including dual practitioners), whereas 73.1% provide healthcare by state-financed healthcare structures (also including dual practitioners). Considering the part-time dedication of dual practitioners, these results reinforces concerns of reduced access to services, once the population dependent solely on public care represents three fold the population of private plan users [40]. Furthermore, other studies [23] compared the number of working positions across the public and private sectors in Brazil over the years 2002, 2005 and 2009, revealing an increased concentration of working positions in private services when compared to working positions of the SUS, despite the continuous growth of the medical population in Brazil. Based on this scenario characterized by the absence of proper dual practice regulation and a growing tendency of physicians to take job positions at private services, the inauguration of new medical schools and medical residence programs predicted by the More Doctors Law may not yield positive effects over the distribution of medical workforce to cover the poorest and under-assisted regions, which are still highly dependent on public health services.
The present study used original primary data to describe the profile of physicians currently working in Brazil, one of world's largest countries, with one of the world's most complex health systems.
Our findings highlight substantial differences in the proportion and socio-demographic/work-related characteristics between physicians engaging in public and private services, with a specific reference to those engaging in dual practice. As the vast majority of Brazilian citizens are highly dependent on public healthcare services, the high proportion of physicians working as dual and private practitioners found in this study may raise doubts for population's access to public services. This scenario demands attention from public health authorities and further exploration of the motivations behind such behaviour in Brazil is needed to support policies addressing the maldistribution of physicians across public and private services.
This study draws from the findings of the country's first medical demography study, and we highlight the need for further analysis to be carried out to evaluate the impact of dual practice on the provision of services. By comparing and contrasting the Brazilian physicians' case with other country experiences, the present study enriches the existing literature and the ongoing debate on this subject.
CFM:
Confidence intervals
Prevalence Ratios
SPSS:
Statistical Package for the Social Sciences
SUS:
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Gragnolati M, Lindelow M, Couttolenc B. Twenty years of health system reform in Brazil: an assessment of the Sistema Único de Saúde. Washington DC: The World Bank; 2013
Piola SF, Servo LMS, de Sa EB, de Paiva AB. Estruturas de financiamento e gasto do sistema público de saúde A saúde no Brasil em 2030 - prospecção estratégica do sistema de saúde brasileiro: estrutura do financiamento e do gasto setorial. Fundação Oswaldo Cruz 2013;4:19–70.
Hipgrave DB, Hort K. Dual practice by doctors working in south and East Asia: a review of its origins, scope and impact, and the options for regulation. Health Policy Plan. 2014;29:703–16.
Gruen R, Anwar R, Begum T, Killingsworth JR, Normand C. Dual job holding practitioners in Bangladesh: an exploration. Soc Sci Med. 2002;54:267–79.
Scheffer M, Biancarelli A, Cassenote A. Demografia médica no Brasil: dados gerais e descrições de desigualdades: Conselho Regional de Medicina do Estado de São Paulo: Conselho Federal de Medicina; 2016. p. 1–285. http://www.usp.br/agen/wp-content/uploads/DemografiaMedica30nov2015.pdf (Accessed 5 Aug 2017)
Scheffer M, Biancarelli A, Cassenote A. Demografia médica no Brasil: dados gerais e descrições de desigualdades: Conselho Regional de Medicina do Estado de São Paulo: Conselho Federal de Medicina; 2011. p. 1–285. http://www.cremesp.org.br/pdfs/demografia_medica_brasil_29112011.pdf (Accessed 5 Aug 2017)
Cremesp. Estado financia Residência, mas regula pouco a oferta de profissionais. 2006;1–21. http://www.cremesp.org.br/library/modulos/centro_de_dados/arquivos/residencia_medica.pdf. (Accessed 5 Aug 2017).
Scheffer MC, Dal Poz MR. The privatization of medical education in Brazil: trends and challenges. Human Resour Health. 2015;13:96.
Russo G, Ferrinho P, de Sousa B, Conceição C. What influences national and foreign physicians' geographic distribution? An analysis of medical doctors' residence location in Portugal. Human Resour Health. 2012;10:12.
Newhouse JP. A model of physician pricing. South Econ J. 1970;37:174.
Moses LN. Income, leisure, and wage pressure. Econ J. 1962;72:320.
Sherr K, Mussa A, Chilundo B, Gimbel S, Pfeiffer J, Hagopian A, et al. Brain drain and health workforce distortions in Mozambique. PLoS One. 2012;7:e35840.
Filc D, Davidovitch N. Rethinking the private-public mix in health care: analysis of health reforms in Israel during the last three decades. J Health Serv Res Policy. 2016;21:249–56.
Jumpa M, Jan S, Mills A. The role of regulation in influencing income-generating activities among public sector doctors in Peru. Human Resour Health. 2007;5:14–8.
Meliala A, Hort K, Trisnantoro L. Addressing the unequal geographic distribution of specialist doctors in Indonesia: the role of the private sector and effectiveness of current regulations. Soc Sci Med. 2013;82:30–4.
Rokx C, Giles J, Satriawan E. New insights into the provision of health services in Indonesia: a health workforce study. Washington DC: The World Bank; 2010.
Prakongsai P, Limwattananon S, Tangcharoensathien V. The equity impact of the universal coverage policy: lessons from Thailand. Adv Health Econ Health Serv Res. 2009;21:57–81.
Berman P, Cuizon D. Multiple public-private jobholding of health care providers in developing countries. An exploration of theory and evidence. Harvard School of Public Health, USA. DFID Health Systems Resource Centre; 2004.
García-Prado A, González P. Whom do physicians work for? An analysis of dual practice in the health sector. J Health Polit Policy Law. 2011;36:265–94.
Ashmore J, Gilson L. Conceptualizing the impacts of dual practice on the retention of public sector specialists - evidence from South Africa. Human Resour Health. 2015;13:3–9.
McPake B, Hanson K. Managing the public–private mix to achieve universal health coverage. Lancet. 2016;388:622–30.
Marten R, McIntyre D, Travassos C, Shishkin S. An assessment of progress towards universal health coverage in Brazil, Russia, India, China, and South Africa (BRICS). Lancet. 2014;384:2164–71.
Malta DC, Stopa SR, Pereira CA, Szwarcwald CL, Oliveira M, Reis ACD. Cobertura de planos de saúde na população brasileira, segundo a Pesquisa Nacional de Saúde, 2013. Ciênc saúde coletiva. 2017;22:179–90.
This study was financially supported by Fundação Faculdade de Medicina (FFM), Conselho Regional de Medicina do Estado de São Paulo (Cremesp) and Conselho Federal de Medicina (CFM), agreement (#0075/2015), which also contributed by making their database fully available. This study was also funded by the UK Medical Research Concil (MRC/R022747/1) and the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP; project number 17/50356-7). Alex Jones Flores Cassenote was given a PhD Student scholarship from FAPESP (proc. 2013/18158–0).
The datasets generated and/or analyzed during the current study are not publicly available due to ethical issues related to participant confidentiality imposed by the Ethics Committee of the medical School of the University of São Paulo. Data from this paper are available upon request to the Ethics Committee of the medical School of the University of São Paulo. Mailing address: 251 Dr. Arnaldo Avenue- Cerqueira César – 01246-000 – São Paulo – SP – Brazil. Phone: + 55 (11) 3893–4401: Dr. Maria Aparecida Azevedo Koike Folgueira.
Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, Doutor Arnaldo Avenue, nº 455, São Paulo, SP, 01246-903, Brazil
Bruno Alonso Miotto, Aline Gil Alves Guilloux, Alex Jones Flores Cassenote, Giulia Marcelino Mainardi & Mário César Scheffer
Centre for Primary Care and Public Health, Queen Mary University of London, 58 Turner Street, London, E1 2AB, UK
Giuliano Russo
Bruno Alonso Miotto
Aline Gil Alves Guilloux
Alex Jones Flores Cassenote
Giulia Marcelino Mainardi
Mário César Scheffer
AJFC and MCS made substantial contributions to conception, design and acquisition of data. Data analysis and interpretation were performed by BAM, GMM, GR and AGAG; BAM was enrolled in drafting the manuscript; GMM and GR were enrolled in revising it critically for important intellectual content. Each author participated sufficiently in the work to take public responsibility for appropriate portions of the content; MSC agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors read and approved the final manuscript.
Correspondence to Bruno Alonso Miotto.
Ethics Statement: The study was based on a telephone inquiry, therefore all the physicians interviewed gave their informed verbal consent before participating. This study was approved by the Ethics in Research Committee of the Medical School of the University of São Paulo (Universidade de São Paulo) (Decision #. Protocol Number 79.424, 09/03/2014).
Questionnaire used to obtain primary data. Additional file 1 shows the full version of the questionnaire used by the interviewers to obtain primary data for this study. (DOCX 79 kb)
Sociodemographic profile of Brazilian physicians according to their public/dual/private modality of practice. Additional file 2 shows all prevalence rates and confidence intervals obtained from the socioeconomic variables included in this study. (DOCX 88 kb)
Medical work characteristics of Brazilian physicians according to their public/dual/private modality of practice. Additional file 3 shows all prevalence rates and confidence intervals obtained from the medical work related variables included in this study. (DOCX 126 kb)
Miotto, B.A., Guilloux, A.G.A., Cassenote, A.J.F. et al. Physician's sociodemographic profile and distribution across public and private health care: an insight into physicians' dual practice in Brazil. BMC Health Serv Res 18, 299 (2018). https://doi.org/10.1186/s12913-018-3076-z
Dual practice
Brazilian healthcare system
Physician behaviour


merlin dentifrices pvt ltd, the proud owner of merlin, a brand with excellence in Indian toothbrush industry is a part of the Targett group of companies. Commemorating a quarter-century in the Indian Toothbrush industry, the foray began in June, 1986 at Baroda, Gujarat. Founded by Prafull Goradia, the group services a third of India's requirement of toothbrushes at 400 million pieces annually. Plastic Toothbrush are manufactured for various brands under exclusive conditions in independent plants. State-of-the-art machine lines are applied to manufacture the product entirely in-house. From Moulding of the toothbrush handles to Bristling them and Packaging the final product. Quality systems comprehensively circuit the operations. Quality with competitiveness and confidentiality comprise our corporate cornerstone.


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Home Local News David A. Lopez Charged With Murder in Troy Road Death
David A. Lopez Charged With Murder in Troy Road Death
Frank L. Cahill
Antonio "Jose" DeJesus
PARSIPPANY — Morris County Acting Prosecutor Robert J. Carroll, Morris County Prosecutor's Office Acting Chief of Investigations Chris Kimker, Morris County Sheriff James M. Gannon, and Parsippany-Troy Hills Police Chief Andrew Miller charged David A. Lopez, 19, of Parsippany, with first-degree Murder, third-degree Possession of a Weapon for Unlawful Purpose, and fourth-degree Unlawful Possession of a Weapon.
Investigators from the Morris County Prosecutors' Office, the Morris County Sheriff's Department, and Parsippany-Troy Hills Police Department on the scene investigating.
It is alleged that at approximately 9:00 a.m. on Sunday, November 22, law enforcement received a 9-1-1 call regarding an injured male outside a home on Troy Road.
Upon arrival at the scene, law enforcement officers located the injured male, later identified as David A. Lopez, outside the residence.
The injuries sustained by Lopez were determined to have been self-inflicted. Officers also located a deceased male, identified as Antonio "Jose" DeJesus, 34, inside the residence.
The cause of death has been ruled homicide by the Morris County Medical Examiner's Office.
The manner of death was determined to be sharp force injury to head, neck, torso, and arms.
As a result of the investigation, the Defendant has been charged with murder, a crime of the first degree, Possession of a Weapon for an Unlawful Purpose, a crime of the third degree, and Unlawful Possession of a Weapon, a crime of the fourth degree.
The Defendant was charged on a warrant-complaint and remains in custody pending a court appearance.
Members of the Parsippany-Troy Hills Police Department, the Morris County Sheriff's Office – Crime Scene Investigation Unit, and the Morris County Prosecutor's Office Major Crimes Unit all participated in the investigation.
If anyone has any information related to this investigation, they are encouraged to call the Major Crimes Unit of the Morris County Prosecutor's Office at (973) 285-6200, or the Parsippany-Troy Hills Police Department at (973) 263-4300.
A GoFundMe account has been set up for Antonio "Jose" DeJesus for click here. Jose was an employee at Parsippany Applebee's for thirteen years, and prior to Applebee's, he worked at Longhorn Restaurant and J.C.s Bakery.
Editor's Note: An arrest or the signing of a criminal complaint is merely an accusation. Despite this accusation, the defendants are presumed innocent unless and until he or she has been proven guilty beyond a reasonable doubt in a court of law.
Previous articleMultiple Individuals at PHHS Tested Positive for COVID-19
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Publisher of Parsippany Focus since 1989 and Morris Focus since January 1, 2019 both covering a wide range of events. Mr. Cahill serves as the Executive Board Member of the Parsippany Area Chamber of Commerce, President of Kiwanis Club of Greater Parsippany Foundation, Vice Chairman of Parsippany-Troy Hills Economic Development Advisory Board and Co-Host of Focus on Business, Cable TV Business Show.
TGI Friday's Liquor License Transferred; Property Will be Sold to Restaurant Group


Here's a cute layout I've just finished. I started it last Sunday after church but was struck down by the flu the next day. The layout was inspired by one made by Krista Fenton on the My Digital Studio website.


June is my month for the BLISS circle of do. Good Stitches and I am really excited to say our theme will be a Rainbow of Bow Ties. I have put together a little tutorial for the block with the measurements I am asking the Bliss girls to use, but I am so happy to share it with you all as well!
NOTE: The inspiration for this quilt came from Angela's Pink Lemonade quilt, which I absolutely adore!
1. The bow tie block is made up of four units. Concentrating on one unit at a time, place your cut pieces as shown in the picture below.
2. Making sure right sides are together, sew from corner to corner on the two "partial snowball blocks," either by marking your fabric or by using the center guides on your sewing machine. Trim middle piece of print fabric to 1/4 " to help eliminate bulk in your block.
3. Using a 1/4" seam allowance, sew the four 3.5" x 3.5" squares together as pictured below. Pressing all seams open.
4. Repeat Steps 1 - 3 for the remaining three units. See below.
5. Using a 1/4" seam allowance, sew the four units together as pictured below. Press seams open. Your finished block should measure 12.5" x 12.5".
Happy Sewing and thanks Bliss ladies!
Also if you like this overall design, Lee from Freshly Pieced has a great tutorial for some yummy placemats.
Great tute Megan! I've added it to GXQ's Block Library.
Thanks for sharing this! I am in love with the bowtie block and have been looking for a good tutorial.
I'm bookmarking this one! So cute!!
Good tutorial! I've never done a bow tie block, and you make it look very approachable. I'm looking forward to getting started on it!
Awesome, looks like fun to me!
Bow Ties are so fun!


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Human Achievement
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The Artificial Intelligence and Cyber Security Alliance
Staff Writer	by Staff Writer 1 May 2019 3 May
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The premise of the 2003 "Terminator 3: Rise of the Machines" movie was that crippling viral infection of the Internet on a global scale demanded a creative solution. So someone suggested plugging the Air Force's experimental AI in to clean things up, and of course that AI became Skynet. Thankfully, we're far from that fictional scenario. But the sad reality is that data breaches and cyber attacks have become so common that they happen every 39 seconds. The question now is not about whether a cyber attack is going to occur, but how much damage the next attack will cost. For example, in 2018, the total cost for cyber crimes committed globally added up to over $1 trillion. With cyber attacks getting more and more sophisticated, an alliance between artificial intelligence and cyber security has become an inevitability.
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Cyber attacks are an inevitability, which means the role of AI in cyber security could be a prominent one.
The Artificial Intelligence and Cyber Security Connection: Neural and Data-Driven
Traditional antivirus technology is finding it difficult to keep up with cybersecurity threats and attacks. The detection rate of anti-virus software is slow, plus the recovery from intrusions is grueling and difficult. But the biggest challenge for cyber security experts rests not on malware intrusions but on non-malware attacks. Intrusions have become more creative and sophisticated. Cybercriminals have devised ways to break into the system through social engineering like baiting, phishing, and vishing.
There are limited resources available that can detect data security breach executed through these exploit tools. These security breaches hide in plain sight by masquerading as a legitimate process. Legacy antivirus technology is not designed to detect such kind of breach. The merging of artificial intelligence and cybersecurity is the missing puzzle.
With algorithms under artificial intelligence and cybersecurity, new technologies are being developed that can process data at rapid speed. Through features that can comb through vast amounts of data, artificial intelligence and cybersecurity can discern and make decisions whether an activity or process is deemed a threat. Additionally, this speed and scale allow the automation of tasks that may be too repetitive or complex for a human to process. By automating most of the tasks, security analysts can tune out false alerts and focus on more pressing security threats.
The union of artificial intelligence and cyber security is born out of necessity.
Capitalizing on AI in Cybersecurity
Set against the evolving landscape of cybersecurity, the use of artificial intelligence in cybersecurity as a preventive infrastructure is promising. While the use of artificial intelligence in cybersecurity is a newly-forged path, experts and industry leaders are beginning to see where the buzz is coming from. The ability of artificial intelligence to process and crunch a large amount of data at lightning speed is particularly useful in cybersecurity. Grouping parallel data, identifying deviation, detecting anomalies and preventing attacks are just some of the ways artificial intelligence and cybersecurity is creating an impact. A number of companies are pursuing this newly-forged path.
LogRythm is a security solution provider based in Boulder, CO. Its strength is in threat detection in the shortest possible time allowing the company's security team to separate false threats and easily investigate security issues.
Jask is a security information and event management software based in San Francisco, CA. Through automated tasks, enhanced visibility and better context of alerts, the SOC analyst can focus and investigate on high-priority alerts.
PerimeterX is a bot-detection solution designed to help companies curb automated attacks such as account take-over, fake account creation, validation of stolen credit cards, and marketing fraud.
Anomali helps organizations through a suite of solutions meant to alert the security team, detect threats inside the network, automate repetitive tasks, enable seamless investigation, and collaborate with other organizations.
DarkTrace and its technology are regarded as the world's leading enterprise-grade AI in cybersecurity by thousands of customers worldwide. The company uses the human immune system as a model
CrowdStrike is a cloud-native endpoint protection software. CrowdStrike works by keeping customer data secure especially during highly-vulnerable times like weekends and holidays.
CyberReason's mantra is Hunt, Detect, and Protect. This Boston-based software solution company helps organizations against advanced security attacks by providing multi-layer protection and analyzing or flagging suspicious data.
Cyclance by Blackberry provides native AI solutions via threat prevention, detection and response capabilities. The solution's predictive advantage can identify and analyze threats as early as 25 months in advance.
The Role of AI in Cyber Security
The role of AI in cyber security will increase with the sophistication of cyber crimes.
Thankfully, businesses and organizations know that to survive the cybersecurity warfare, acquiring cyber resilience is a must. Some organizations learn the hard and costly way. Fortunately, there are businesses that choose a preventive stance. Likewise, investors are placing their bets on startups working on AI-enabled technologies.
Similarly, antivirus technology companies are tapping on the potentials of AI to learn from past cyber security mistakes by shifting from deterministic programming to probabilistic programming approach. With artificial intelligence and cyber security crossing paths, we may have already found some answers.
Posted in Digital Tagged Artificial Intelligence and Cyber Security Digital Role of AI in Cyber Security
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When sewage strikes Orange County properties, home and business owners call us first. Our experts have been tackling sewage and other bio-waste losses since 1976 using the latest equipment and bio-cides available.
Sewage and odor related damage to your Orange County home or business must be cleaned by a professional. A backflow of sewage can cause serious health problems for your family and should be taken very seriously. We can remove these unwelcome problems and bring your work or living environment back to a healthy, worry-free state.


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Q: show results if it matches any of the conditions? This is driving me nuts. I'm checking 3 conditions in my sql query. If any of them match, I want to grab the result campaign_id:
SELECT `campaign_id` FROM `tracking`
WHERE `user` = 'username@domain.net' AND `attempts` > '5'
    AND `clicked` > '0' AND `shared` > '0'

From what I can tell, the way it works now is it has to match ALL the conditions. How can I make it show the results of campaign_id if it matches ANY of the conditions?

A: Change the AND to OR. But only for the parts that you want OR'd, using parentheses
SELECT `campaign_id` FROM `tracking`
WHERE `user` = 'username@domain.net' AND (`attempts` > '5'
    OR `clicked` > '0' OR `shared` > '0')

Basically, you want the specified user AND any of these other filters that are grouped together using internal ORs

A: If you want ANY as opposed to ALL then you need to replace the AND operators with OR operators. If you need to mix ANDs and ORs then make sure you get the precedence right; the easiest way to do this is to wrap relating conditions in parentheses). For example, if you always want to match the user and then any of the other conditions then
SELECT `campaign_id`
FROM `tracking`
WHERE `user` = 'username@domain.net'
  AND (   `attempts` > '5'
       OR `clicked` > '0'
       OR `shared` > '0'
      )

A: If you want to limit either attempts, clicked or shared while just going by that specific user, do something like:
SELECT `campaign_id`
FROM `tracking`
WHERE `user` = 'username@domain.net'
    AND (`attempts` > '5'
    OR `clicked` > '0'
    OR `shared` > '0')

redpajama_set_name: RedPajamaStackExchange


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Man's Nature and Destiny
Smith, Uriah
02 IMMORTAL AND IMMORTALITY
IN turning to the Bible, our only source of information on this question, to learn whether or not man is immortal, the first and most natural step in the inquiry is to ascertain what use the Bible makes of the terms "immortal" and "immortality." How frequently does it use them? To whom does it apply them? Of whom does it make immortality an attribute? Does it affirm it of man or any part of him? MND 13.1
Should we, without opening the Bible, endeavor to form an opinion of its teachings from the current phraseology of modern theology we should conclude it to be full of declarations in the most explicit terms that man is in possession of an immortal soul and deathless spirit; for the popular religious literature of to-day, which claims to be a true reflection of the declarations of God's word, is full of these expressions. Glibly they fall from the lips of the religious teacher. Broadcast they go forth from the religious press. Into orthodox sermons and prayers they enter as essential elements. They are appealed to as the all-prolific source of comfort and consolation in case of those who mourn the loss of friends by death. We are told that they are not dead; for "there is no death; what seems so is transition;" they have only changed to another state of being, only gone before; for the soul is immortal, the spirit never dying; and it cannot for a moment cease its conscious existence. MND 13.2
This is all right provided the Bible warrants such declarations. But it is far from safe to conclude without examination that the Bible does warrant them; for whoever has read church history knows that it is little more than a record of the unceasing attempts of the great enemy of all truth to corrupt the practices of the professors of Christianity, and to pervert and obscure the simple teachings of God's word with the absurdities and mysticisms of heathen mythology. It has been only by the utmost vigilance that any Christian institution has been preserved, or any Christian doctrine saved, free from some of the corruptions of the great systems of false religion which have always held by far the greater portion of our race in their chains of darkness and superstition. And if we arraign the creeds of the multitudinous Protestant sects, as containing many unscriptural dogmas, it is only what every one of them does, in reference to all the others. MND 14.1
To the law, then and to the testimony. What say the Scriptures on the subject of immortality? MND 14.2
FACT ONE. The terms "immortal" and "immortality" are not found in the Old Testament, either in our English version or in the original Hebrew. There is, however, one expression, in Genesis 3:4, which is, perhaps, equivalent in meaning, and was spoken in reference to the human race; namely, "Thou shalt not surely die." But unfortunately for believers in natural immortality, this declaration came from one whom no person would like to acknowledge as the author of his creed. It is what the Devil said to Eve, the terrible deception by means of which he accomplished her fall, and so "brought death into the world and all our woe." But does not the New Testament supply this seemingly unpardonable omission of the Old, by many times affirming that all men have immortality? MND 14.3
Remembering the many times you have heard and read from Biblical expositors that you were in possession of an immortal soul, how many times do you think the New Testament declares that you have such an immortal soul? One hundred times? - No. Ten? - No. Five? - No. Twice? - No! ONCE? - NO!! Does not the New Testament then apply the term immortal to anything? - Yes; and this brings us to - MND 15.1
FACT TWO. The term "immortal" is used but once in the New Testament, in the English version, and is then applied to God. The following is the passage: 1 Timothy 1:17; "Now unto the King eternal, immortal, invisible, the only wise God, be honor and glory forever and ever. Amen." MND 15.2
The original word, however, aphthartos, from which "immortal is here translated, occurs in six other instances in the New Testament, in every one of which it is rendered "incorruptible." The word is defined by Greenfield, "Incorruptible, immortal, imperishable, undying, enduring." The following is a complete list of the texts where it is found:- MND 15.3
APHTHARTOS
Rom. 1:23 the glory of the uncorruptible God.
1 Cor. 9:25 a corruptible crown, but we an incorruptible
15:52 the dead shall be raised incorruptible
1 Tim. 1:17 the King eternal, immortal, invisible,
1 Pet. 1:4 to an inheritance incorruptible.
23 not of corruptible seed, but of incorruptible.
3:4 that which is not corruptible.
According to these references it will be seen that this word is used, first, in Romans 1:23, to describe God: "And changed the glory of the uncorruptible God into an image made like to corruptible man, and to birds, and four-footed beasts, and creeping things." MND 16.1
It is used in 1 Corinthians 9:25 to describe the heavenly crown of the overcomer: "And every man that striveth for the mastery is temperate in all things. Now they do it to obtain a corruptible crown, but we an incorruptible." MND 16.2
It is used in 1 Corinthians 15:52 to describe the immortal bodies of the redeemed: "In a moment, in the twinkling of an eye, at the last, trump; for the trumpet shall sound, and the dead shall be raised incorruptible, and we shall be changed." MND 16.3
It is used in 1 Timothy 1:17 to describe God, as already quoted. MND 16.4
It is used in 1 Peter 1:14 to describe the inheritance reserved in heaven for the overcomer: "To an inheritance incorruptible and undefiled, that fadeth not away, reserved in heaven for you." MND 16.5
It is used in 1 Peter 1:23 to describe the principle by which regeneration is wrought in us: "Being born again, not of corruptible seed, but of incorruptible, by the word of God, which liveth and abideth forever." MND 16.6
It is used in 1 Peter 3:4 to describe the heavenly adorning which we are laboring to secure: "But let it be the hidden man of the heart, in that which is not corruptible, even the ornament of a meek and quiet spirit, which is in the sight of God of great price." MND 16.7
And these are all the instances of its use. In no one of them is it applied to man or any part of him, as a natural possession. But does not the last text affirm that man is in possession of a deathless spirit? The words "incorruptible" and "spirit" both occur, it is true, in the same verse; but they do not stand together, another noun and its adjectives coming in between them; they are not in the same case, "incorruptible" being in the dative, and "spirit" in the genitive; they are not of the same gender, "incorruptible" being masculine or feminine, and "spirit" neuter. What is it which is in the sight of God of great price? - The ornament of a meek and quiet spirit. What is the nature of this ornament? - It is not destructible, like the laurel wreath, the rich apparel, the gold and gems, with which the unsanctified man seeks to adorn himself; but it is incorruptible, a disposition molded by the Spirit of God, some of the fruit of that heavenly tree which God values. Does man by nature possess this incorruptible ornament, this meek and quiet spirit? - No; for we are exhorted to procure and adopt this instead of the other. This, and this only, the text affirms. To say that this text proves that man is in possession of a deathless spirit, is no more consistent nor logical than it would be to say that Paul declares that man has an immortal soul, because in his first epistle to Timothy (1:17) he uses the word "immortal," and in his first epistle to the Thessalonians (5:23) he uses the word "soul." The argument would be the same in both cases. MND 16.8
FACT THREE. The word "immortality" occurs but five times in the New Testament, in our English version. The following are the instances:- MND 17.1
In Romans 2:7 it is set forth as something for which we are to seek by patient continuance in well-doing: "To them who by patient continuance in well-doing seek for glory and honor and immortality, [God will render] eternal life." MND 17.2
In 1 Corinthians 15:53, 54 it is twice used to describe what this mortal must put on before we can inherit the kingdom of God: "For this corruptible must put on incorruption, and this mortal must put on immortality. So when this corruptible shall have put on incorruption, and this mortal shall have put on immortality, then shall be brought to pass the saying that is written, 'Death is swallowed up in victory.'" MND 18.1
In 1 Timothy 6:16 it is applied to God, and the sweeping declaration is made that he alone has it: "Who only hath immortality, dwelling in the light which no man can approach unto; whom no man hath seen, nor can see: to whom be honor and power everlasting. Amen." MND 18.2
In 2 Timothy 1:10 we are told from what source we receive the true light concerning it, which forever cuts off the claim that reason or sciences can demonstrate it, or that the oracles of heathenism can make it known to us: "But now is made manifest by the appearing of our Saviour Jesus Christ, who hath abolished death, and hath brought life and immortality to light through the gospel." MND 18.3
How has Christ brought life and immortality to light? - Answer: By abolishing death. There could have been no life nor immortality without this; for the race was hopelessly doomed to death through sin. Then by what means and for whom has he abolished death? - Answer: He has abolished it by dying for man and rising again, a victor over death; and he has wrought this work only for those who will accept of it through him; for all who reject his proffered aid will meet at last the same fate that would have been the lot of all, had Christ never undertaken the work of redemption in our behalf. Thus through the gospel, - the good news of salvation by his sufferings and death, - he has brought to light the fact, not that all men are by nature in possession of immortality, but that a way is opened whereby we may at last gain possession of this inestimable boon. MND 18.4
As with the word "immortal," so with the word "immortality;" it occurs in the Greek, in a few instances, where it is not translated "immortality" in the English version. There are two words from which the English term is rendered. These are athanasia and aphtharsia. The former, athanasia, is defined by Greenfield and Robinson simply "immortality," and is so translated in every instance. It occurs three times, as follows:- MND 19.1
ATHANASIA
1 Corinthians 15:53 must put on immortality
54 shall have put on immortality
1 Timothy 6:16 who only hath immortality
The latter, aphtharsia, is defined, by the same authorities, "incorruptibility, incorruptness; by implication, immortality." The following is a complete list of the texts where it occurs:- MND 19.2
APHTHARSIA
Romans 2:7 seek for glory, honor, and immortality
1 Corinthians 15:42 it is raised in incorruption
50 neither doth corruption inherit incorruption
53 must put on incorruption
54 shall have put on incorruption
Ephesians 6:24 love our Lord ... in sincerity
2 Timothy 1:10 brought life and immortality to light
Titus 2:7 gravity, sincerity
In addition to remarks already made on Romans 2:7 and 2 Timothy 1:10, where this term is rendered, in our version, "immortality," we may add that in 1 Corinthians 15:42 it refers to the body after the resurrection from the dead; and in verses 50, 53, 54 of the same chapter, it is that incorruption which cannot be inherited by corruption; that is, by our present mortal condition; and it is that which this corruptible must put on before we can enter into the kingdom of God. In Ephesians 6:24 it is used to describe the love we should bear to Christ, and in Titus 2:7 the quality of the doctrine we should hold; both of which instances it is translated "sincerity." MND 19.3
We now have before us all the testimony of the Bible relative to the use of the words "immortal" and "immortality." So far from being applied to man, the terms are used, as in Romans 1:23, to point out the contrast between God and man. God is incorruptible, or immortal. Man is corruptible, or mortal. But if the real man, the essential being, consists of an undecaying soul, a deathless spirit, he too, is, in this respect, incorruptible, and this contrast could not be drawn. Immortality is placed before us as an object of hope for which we are to seek, - a declaration which would be a fraud and deception if we already have it. The word is used to distinguish between heavenly and eternal objects, and those that are earthly and decaying. In view of these facts no candid mind can dissent from the following- MND 20.1
CONCLUSION: So far as its use of the terms "immortal" and "immortality" is concerned, the Bible contains no proof that man is in possession of an undying nature. MND 20.2


I have included our personal favourites, the trendiest in Vilnius, or the most popular with locals.
is among our favorites. The moment you step inside you enter an oasis of opulent interior, uplifting Latin music and friendly atmosphere.
can be a fun, cheap night out in Vilnius for a group of friends. It is famous for always being busy and known as one of the most unpretentious Vilnius clubs.
Famous Lithuanian and foreign bands play in the club quite often. This is also a club to get a taste of something close to local party, however, locals have a divided opinion about the club and to find out more….
is a newly opened club in Vilnius. The club is a part of a large network of super clubs around the world. I visited Pacha in London and the glamorous Pacha Ibiza and was very curious about the one in Vilnius.
The stylish colourful interior here is Mediterranean inspired with mosaic walls, sea like colours and flashing lights. With a few halls it's easy to find space on the dance floor, those who would prefer some rest there are a few quieter hideaways.
Music is mainly Ibiza house but other types of music is played in the other hall. Sometimes live shows are taking place and they also present some of the best international DJ's. One of the fancy drinks that is worth trying is the special Pacha cherry mojito. They also offer a variety of snacks. The crowd here is diverse and seem friendly. In my opinion Pacha has got the perfect clubbing formula and is one of the classiest clubs in Vilnius.
is a spacious modern club superbly located in the main area of the Old Town, next to the Town Hall. A few years ago it was considered one of the best clubs in town with both locals and foreigners alike, but now it's getting some big competitors.
Still the sound and lightning systems are very good and the club attracts a trendy crowd. At the weekends Helios offers some live music or fashion shows and other entertainment. You can enjoy an extensive cocktail list and some exotic dishes at their Night Sushi Bar.
Also a good thing is that if you find the place is not to your liking, the Vila Latina club, Eden club and the city Casino are situated next door in the same building.
is one of the oldest Vilnius clubs established in the premises of the ex Soviet bomb shelter. The venue is mainly known for attracting people passionate for the best international dancing music. They feature some of the best Lithuanian and foreign DJ's who arrive to play the hottest tunes from the world's dance-floors. The London-chic interior here is stylish and unique for its combination of colourful lighting, leather and some examples of modern art exhibited in one of the rooms. The entrance to the club, which is a rather long tunnel, adds to the character as well.
The sound and lighting systems, as well as the service are known for their very high quality.
Very conveniently located in the Old Town, close to the Town hall the club attracts a diverse international crowd. To get there you open the door of what looks a bit like a telephone box on the street and then go down the mysterious purple tunnel into a live music and cocktail bar.
The cosy interior inside is flowery and atmospheric, however, the vibe inside is not very romantic; it is lively and bouncy instead. The club is open into the early hours of the morning and you have to be 18 to get in.


Much like there are Friendly Local Gaming Stores (FLGS) within the board gaming world, I want Start Your Meeples to be a Friendly Local Gaming Blog. As such, I practice a policy of trying to be as open as possible. Below is a whole load of information about a whole host of topics to do with the technical "behind the scenes". It's not the most interesting page in the world, but it should hopefully answer a few questions.
The views and opinions expressed on this blog are strictly my own.
The majority of the photos on this blog are taken by me, most on my dining room table, on the floor, a footrest, or a friend's gaming table. The majority of photos thus far have been taken using a Huawei P9 Lite, Huawei P20, iPhone 7 or a Canon 650D. Most in fairly poor lighting (so sorry about the blurriness). They are in context and thus should constitute being used under fair usage, as I am talking about the games I am displaying. If however, for any reason, you want me to remove a photo please just drop me a note. You can do this from the contact page.
Yes, I am a real person. Yes, Luke is my real name. Yes, I write all the content on this blog myself. I try to post every other day, but this may change on occasion.
All views expressed are my own opinion. I am not paid for any reviews, nor am I paid for writing these articles. At the moment this blog does not earn me any money and is not monetised. I never set out to offend with anything I write and just want to share the love of gaming.
This site is managed using the WordPress.com blogging platform and so uses the cookies WordPress.com uses as a default. To find out more about the WordPress.com cookies you can click here.
The Follow Functionality on this site is a WordPress widget. What it does is, if you sign up, it will send you an email asking you to confirm your subscription. You will then receive an email when I post. Please note that I do not do anything with your email address.
To contact me you do need to provide an email address, but this is just so I can respond (the contact goes through a form to avoid crawlers from spamming my email address!). If you email me, I will not sign you up automatically to my mailing list. That just wouldn't be cool.
I'm a pretty approachable guy, so if you have any questions please do not hesitate to contact me.


text:
https://www.agein.com/kaley-cuocos-short-hair-the-big-bang-theory-stars-pixie-short-bangs-13208 Kaley Cuoco's Short Hair: How to get The Big Bang Theory Star's Pixie and… Agein Editorial Agein 2016-12-12T13:00:25Z 2016-12-28 10:47:18 Kaley Cuoco short hair Pixie Short bangs The Big Bang Theory star Short hair tutorial Kaley Cuoco hair 2016 Kaley Cuoco bob Big Bang Theory star Kaley Cuoco, known for her hairstyles. Cut your hair into a pixie cut, short bangs. Get the Kaley Cuoco look. Celebrity Hairstyle,News
Kaley Cuoco's Short Hair: How to get The Big Bang Theory Star's Pixie and Short Bangs
By : Agein Editorial
Credit: Jesse Grant / Stringer / Getty
Big Bang Theory star Kaley Cuoco is known for being on the trend radar when it comes to hairstyles. The blonde starlet made waves when she cut her hair into a pixie cut with short bangs a couple of years ago, and fans everywhere still want to copy the look.
The Kaley Cuoco short hair trend started to gain attention when the actress appeared with a short haircut for season 8. However, in the beginning, fans didn't accept the hair transformation of Penny, who Cuoco plays on the show. They took to Twitter to express their dislike for the new short cut, stating that Kaley Cuoco's hair is the worst thing Big Bang Theory has ever done.
As with many things in life, people have a hard time accepting change. The writers thought the haircut would go nicely with the character's change of occupation from struggling actress to pharmaceutical sales representative. Now considered one of the top hairstyles on trend, it seems fans have gotten over the change and embraced the pixie cut, even wanting it for themselves. In several post chop interviews, the actress confessed to loving her new short hair.
Kaley Cuoco Hairstyles & Haircuts; Short, Pixie and Bangs
Getting the pixie look cut of Kaley Cuoco and keeping it styled just right calls for a short hair tutorial. Not everyone's hair is suited for Kaley Cuoco's short crop, and it is more compatible for fine to medium thick hair that is naturally straight or has a soft wave.
Credit: Flickr.com/celebrityabc
Cuoco's pixie was cut with long layered bangs, tapered sides, and graduated layers from the crown to the nape of the neck. This hairstyle does require a trim every 6-8 weeks, so keep in mind if you go for the pixie cut, it will need a little upkeep. Style the cut with a volumizing product to pump up the roots. If your hair is naturally curly and you would like to copy Cuoco's hair, you may need to temporarily straighten it with a brush, blow dryer, and iron.
For the current season of The Big Bang Theory, Kayle Cuoco has a shoulder length bob that is more blonde and reminiscent of Penny in the earlier seasons of the hit show. The Kaley Cuoco bob was created by celebrity hairstylist Faye Woods. She took off several inches from Cuoco's length, creating a soft wave, and also touched up the star's hair color, giving Kayle Cuoco a lighter shade of blonde.
The actress's hair transformation came just a few weeks after the show announced the casting of Katy Sagal, who is currently playing Penny's Mom. It seems for every life change that Penny goes though on the show, her hair also changes! Kalye Cuoco's hair in 2016 has been under the watch of trend hunters, and we are just as excited to see what the starlet will do next with her blonde locks.
Sarah K, "Penny Is Back! See Kaley Cuoco's New Short Cut," People web site, August 17 2016;
http://people.com/style/kaley-cuoco-cuts-hair-lob/
Carrie T, "Kaley Cuoco's Hair HowTo, Hair Boutique" web site, December 17 2014;
http://www.hairboutique.com/tips/articles.php?f=tip999409.htm


The following is a list of Kenyan billionaires. It is based on an annual assessment of wealth and assets compiled and published by New World Wealth report.
4. Chris Kirubi: You can aslo call him DJ CK . He is the owner of Capital Media Group and has a huge stake in Haco Tiger brands. He is the chairman of Centum Investment Group and is estimated to be worth Ksh29 billion.
5. Manu Chandaria: He is an industrialist who has recently become Kenya's top most philanthropists. He chairs Comcraft Group, a company that produces steel and has a presence in more than 40 countries.


text:
10 Years Jail Term for Sex Offender
HomeAYV News10 Years Jail Term for Sex Offender
According to the charge sheet, the offence of Sexual Penetration of a Child negates Section (19) of the Sexual Offences Act No.12 of 2012 of the laws of Sierra Leone.
The evidenced further adduced revealed that the victim's name (withheld) was going to buy some food stuff in the market, when the convict Musa Koroma called and offered her a mobile phone.
The evidence further indicated that the convict later invited the victim in his bedroom, where he penetrated her sex organ. It was also gathered that when the victim returned home, she informed her mother about what had transpired between her and the convict before the matter was reported the matter at a police Station.
The convict was committed to stand trial in the High Court of Sierra Leone for the offence charged, on 15 November 2018, but he initially pleaded not guilty when the charge was put to him.
But In the middle of the trial, the convict Musa Koroma pleaded guilty to the offence of Sexual Penetration of Child and begged for mercy.
Before slamming sentence on the convict, the adjudicating judge, Hon. Justice Sengu Koroma said the offence of Sexual Penetration was ratified by Parliament as a solid and dependable laws, aimed at protecting girl child from potential sex offenders.
He told the court that the punishment for the offence of Sexual Penetration of a Child is a fifteen years jail term, but after taking certain factors into consideration, he would sentence the convict to ten years imprisonment.
The convict Musa Koroma has started serving his jail at the Male Correction Centre on Pademba Road in the west part of Freetown.
The State was represented by Lytton Jones, while the convict, Musa Koroma was defended by Barrister Sonia -Bobanie Brown from the Legal Aid Board.


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text:
Q: Given a real function $f(x)$ which is continuous, how can I show that $|f(x)|$ is continuous? Given a continuous, real function $f : D \rightarrow \mathbb{R}$ (where $D \subseteq \mathbb{R}$), how can I show that $|f(x)|$ is continuous?
This need not be done using a direct $\varepsilon - \delta$ proof, and may be done using sequences $x_n$ and the Algebra of Limits.

A: Hint. Note that, by the triangle inequality,
$$||f(x)|-|f(y)||\leq |f(x)-f(y)|.$$

A: A somewhat different idea: Suppose $|f|$ fails to be continuous at a point $y$. At this point, $f$ cannot be positive, because in a neighborhood of $y$ we would have $f = |f|$ by continuity of $f$. Nor can it negative, because in a neighborhood of $y$ we would have $-f = |f|$. Thus $|f(y)| = 0 = f(y)$. But $f(x_n) \to 0 = f(y)$ is clearly equivalent to $|f(x_n)| \to 0 = |f(y)|$ as $n \to \infty$, for any sequence $\{ x_n \}$ with $x_n \to y$. Thus $f$ is not continuous at $y$. This is a contradiction.


text:
MV Troubridge was a ferry that served the South Australian coastal trade between Port Adelaide, Kingscote on Kangaroo Island and Port Lincoln. It was built by Evans Deakin & Company, of Brisbane, Queensland as a roll on roll off ferry to minimise loading time and maximise time spent at sea.

Operational history
Troubridge was built to replace SS Karatta in serving on the Adelaide - Kingscote - Port Lincoln route. It began services to Kingscote and Port Lincoln in 1961. Services to Port Lincoln were eventually discontinued leaving Troubridge to dedicated Kingscote Services.  It operated until 1 June 1987, when it was replaced by Island Seaway.

Troubridge was sold and went to Malta in 1990 as City of Famagusta. She was then bought by European Seaways and renamed European Glory. Her ownership passed to Poseidon Lines, under the name Sea Wave. In 1995 she was registered in Turkey as Karden. She was re-registered in North Korea in 2003 as Marwa, before being finally scrapped in Turkey in 2004.

References

Kangaroo Island
Ferries of South Australia
Ships of South Australia

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LU (SuanShu 1.3.1 API Documentation)
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                SuanShu, a Java numerical and statistical library

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com.numericalmethod.suanshu.matrix.doubles.factorization.triangle

Class LU

java.lang.Object
  com.numericalmethod.suanshu.matrix.doubles.factorization.triangle.LU

All Implemented Interfaces:
LUDecomposition

public class LU
extends java.lang.Object
implements LUDecomposition

LU decomposition of a matrix.

 It decomposes an n x n matrix A so that

 P %*% A == L %*% U

 where
 P is an n x n permutation matrix,

 L is an n x n lower triangular matrix,

 U is an n x n upper triangular matrix

 That is,

 P.multiply(A) == L.multiply(U)

 This decomposition can be used to

solve a system of linear equations

compute the determinant

See Also:
Wikipedia: LU decomposition

Nested Class Summary

static class
LU.Method

          the methods available to do the LU decomposition

Constructor Summary

LU(Matrix A)

          Construct an instance of the LU decomposition.

LU(Matrix A,
   LU.Method method,
   double epsilon)

          Construct an instance of the LU decomposition that uses Gaussian Elimination.

Method Summary

 LowerTriangularMatrix
L()

          Get a copy of the lower triangular matrix L as in
 P %*% A == L %*% U

 PermutationMatrix
P()

          Get a copy of the permutation matrix P as in
 P %*% A == L %*% U

 UpperTriangularMatrix
U()

          Get a copy of the upper triangular matrix U as in
 P %*% A == L %*% U

Methods inherited from class java.lang.Object

clone, equals, finalize, getClass, hashCode, notify, notifyAll, toString, wait, wait, wait

Constructor Detail

LU

public LU(Matrix A,
          LU.Method method,
          double epsilon)

Construct an instance of the LU decomposition that uses Gaussian Elimination.

Parameters:
A - the matrix to be decomposed such that
P %*% A == L %*% U

method - the algorithm to do the LU decomposition
epsilon - a precision parameter: when a number |x| ≤ ε, it is considered 0

LU

public LU(Matrix A)

Construct an instance of the LU decomposition.

Parameters:
A - a matrix

Method Detail

L

public LowerTriangularMatrix L()

Description copied from interface: LUDecomposition

Get a copy of the lower triangular matrix L as in

P %*% A == L %*% U

Specified by:
L in interface LUDecomposition

Returns:
a copy of L

U

public UpperTriangularMatrix U()

Description copied from interface: LUDecomposition

Get a copy of the upper triangular matrix U as in

P %*% A == L %*% U

Specified by:
U in interface LUDecomposition

Returns:
a copy of U

P

public PermutationMatrix P()

Description copied from interface: LUDecomposition

Get a copy of the permutation matrix P as in

P %*% A == L %*% U

Specified by:
P in interface LUDecomposition

Returns:
a copy of P

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                Copyright © 2011 Numerical Method Inc. Ltd. All Rights Reserved.

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