Displaying publications 21 - 40 of 470 in total

  1. Agbo EN, Makhafola TJ, Choong YS, Mphahlele MJ, Ramasami P
    Molecules, 2015 Dec 25;21(1):E28.
    PMID: 26712730 DOI: 10.3390/molecules21010028
    Suzuki-Miyaura cross-coupling of 6-bromo-2-styrylquinazolin-4(3H)-ones with arylboronic acids afforded a series of novel 6-aryl-2-styrylquinazolin-4(3H)-ones. These compounds were evaluated for potential anticancer properties against the human renal (TK-10), melanoma (UACC-62) and breast cancer (MCF-7) cell lines. Their antimicrobial properties were also evaluated against six Gram-positive and four Gram-negative bacteria, as well as two strains of fungi. Molecular docking studies (in silico) were conducted on compounds 5a, b, d and 6a, b, d-f to recognize the hypothetical binding motif of the title compounds within the active site of the dihydrofolate reductase and thymidylate synthase enzymes.
  2. Arumugam N, Almansour AI, Kumar RS, Menéndez JC, Sultan MA, Karama U, et al.
    Molecules, 2015;20(9):16142-53.
    PMID: 26404224 DOI: 10.3390/molecules200916142
    A series of hitherto unreported anthracene-embedded dispirooxindoles has been synthesized via a one-pot three-component 1,3-dipolar cycloaddition reaction of an azomethine ylide, generated in situ from the reaction of isatin and sarcosine to 10-benzylideneanthracen-9(10H)-one as a dipolarophile in 1-butyl-3-methylimidazolium bromide([bmim]Br), an ionic liquid. This reaction proceeded regio- and diastereoselectively, in good to excellent yields.
  3. Goh PS, Ng MH, Choo YM, Amru NB, Chuah CH
    Molecules, 2015;20(11):19936-46.
    PMID: 26556328 DOI: 10.3390/molecules201119666
    Molecules, 2015;20(11):19886-99.
    PMID: 26556323 DOI: 10.3390/molecules201119665
  5. Mawa S, Jantan I, Husain K
    Molecules, 2016 Jan 05;21(1):9.
    PMID: 26742027 DOI: 10.3390/molecules21010009
    Three new triterpenoids; namely 28,28,30-trihydroxylupeol (1); 3,21,21,26-tetrahydroxy-lanostanoic acid (2) and dehydroxybetulinic acid (3) and seven known compounds; i.e., taraxerone (4); taraxerol (5); ethyl palmitate (6); herniarin (7); stigmasterol (8); ursolic acid (9) and acetyl ursolic acid (10) were isolated from the stem of Ficus aurantiaca Griff. The structures of the compounds were established by spectroscopic techniques. The compounds were evaluated for their inhibitory effects on polymorphonuclear leukocyte (PMN) chemotaxis by using the Boyden chamber technique and on human whole blood and neutrophil reactive oxygen species (ROS) production by using a luminol-based chemiluminescence assay. Among the compounds tested, compounds 1-4, 6 and 9 exhibited strong inhibition of PMN migration towards the chemoattractant N-formyl-methionyl-leucyl-phenylalanine (fMLP) with IC50 values of 6.8; 2.8; 2.5; 4.1; 3.7 and 3.6 μM, respectively, comparable to that of the positive control ibuprofen (6.7 μM). Compounds 2-4, 6, 7 and 9 exhibited strong inhibition of ROS production of PMNs with IC50 values of 0.9; 0.9; 1.3; 1.1; 0.5 and 0.8 μM, respectively, which were lower than that of aspirin (9.4 μM). The bioactive compounds might be potential lead molecules for the development of new immunomodulatory agents to modulate the innate immune response of phagocytes.
  6. Al-Majedy YK, Al-Duhaidahawi DL, Al-Azawi KF, Al-Amiery AA, Kadhum AA, Mohamad AB
    Molecules, 2016 Jan 23;21(2):135.
    PMID: 26805811 DOI: 10.3390/molecules21020135
    Syntheses of coumarins, which are a structurally interesting antioxidant activity, was done in this article. The modification of 7-hydroxycoumarin by different reaction steps was done to yield target compounds. Molecular structures were characterized by different spectroscopical techniques (Fourier transformation infrared and nuclear magnetic resonance). Antioxidant activities were performed by using various in vitro spectrophometric assays against 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical and hydrogen peroxide (H2O2). All compounds exhibited high efficiency as antioxidants compared to ascorbic acid. The highest efficiency scavenging activity was found for compound 3 (91.0 ± 5.0), followed by compounds 2 and 4 (88.0 ± 2.00; and 87.0 ± 3.00). Ascorbic acid C was used as a standard drug with a percentage inhibition of 91.00 ± 1.5. The mechanism of the synthesized compounds as antioxidants was also studied. Hartree-Fock-based quantum chemical studies have been carried out with the basis set to 3-21G, in order to obtain information about the three-dimensional (3D) geometries, electronic structure, molecular modeling, and electronic levels, namely HOMO (highest occupied molecular orbital) and LUMO (lowest unoccupied molecular orbital), to understand the antioxidant activity for the synthesized compounds.
  7. Barakat A, Al-Majid AM, Soliman SM, Lotfy G, Ghabbour HA, Fun HK, et al.
    Molecules, 2015;20(11):20642-58.
    PMID: 26610441 DOI: 10.3390/molecules201119710
    The synthesis of the new diethyl ammonium salt of diethylammonium(E)-5-(1,5-bis(4-fluorophenyl)-3-oxopent-4-en-1-yl)-1,3-diethyl-4,6-dioxo-2-thioxohexaydropyrimidin-5-ide 3 via a regioselective Michael addition of N,N-diethylthiobarbituric acid 1 to dienone 2 is described. In 3, the carboanion of the thiobarbituric moiety is stabilized by the strong intramolecular electron delocalization with the adjacent carbonyl groups and so the reaction proceeds without any cyclization. The molecular structure investigations of 3 were determined by single-crystal X-ray diffraction as well as DFT computations. The theoretically calculated (DFT/B3LYP) geometry agrees well with the crystallographic data. The effect of fluorine replacement by chlorine atoms on the molecular structure aspects were investigated using DFT methods. Calculated electronic spectra showed a bathochromic shift of the π-π* transition when fluorine is replaced by chlorine. Charge decomposition analyses were performed to study possible interaction between the different fragments in the studied systems. Molecular docking simulations examining the inhibitory nature of the compound show an anti-diabetic activity with Pa (probability of activity) value of 0.229.
    Molecules, 2015;20(10):18827-46.
    PMID: 26501248 DOI: 10.3390/molecules201018827
  9. Huang D, Guo W, Gao J, Chen J, Olatunji JO
    Molecules, 2015;20(9):17405-28.
    PMID: 26393569 DOI: 10.3390/molecules200917405
    Clinacanthans nutans (Burm. f.) Lindau is a popular medicinal vegetable in Southern Asia, and its extracts have displayed significant anti-proliferative effects on cancer cells in vitro. However, the underlying mechanism for this effect has yet to be established. This study investigated the antitumor and immunomodulatory activity of C. nutans (Burm. f.) Lindau 30% ethanol extract (CN30) in vivo. CN30 was prepared and its main components were identified using high-performance liquid chromatography (HPLC) and mass spectrometry (LC/MS/MS). CN30 had a significant inhibitory effect on tumor volume and weight. Hematoxylin and eosin (H & E) staining and TUNEL assay revealed that hepatoma cells underwent significant apoptosis with CN30 treatment, while expression levels of proliferation markers PCNA and p-AKT were significantly decreased when treated with low or high doses of CN30 treatment. Western blot analysis of PAPR, caspase-3, BAX, and Bcl2 also showed that CN30 induced apoptosis in hepatoma cells. Furthermore, intracellular staining analysis showed that CN30 treatment increased the number of IFN-γ⁺ T cells and decreased the number of IL-4⁺ T cells. Serum IFN-γ and interleukin-2 levels also significantly improved. Our findings indicated that CN30 demonstrated antitumor properties by up-regulating the immune response, and warrants further evaluation as a potential therapeutic agent for the treatment and prevention of cancers.
  10. Gaaz TS, Sulong AB, Akhtar MN, Kadhum AA, Mohamad AB, Al-Amiery AA
    Molecules, 2015;20(12):22833-47.
    PMID: 26703542 DOI: 10.3390/molecules201219884
    The aim of this review was to analyze/investigate the synthesis, properties, and applications of polyvinyl alcohol-halloysite nanotubes (PVA-HNT), and their nanocomposites. Different polymers with versatile properties are attractive because of their introduction and potential uses in many fields. Synthetic polymers, such as PVA, natural polymers like alginate, starch, chitosan, or any material with these components have prominent status as important and degradable materials with biocompatibility properties. These materials have been developed in the 1980s and are remarkable because of their recyclability and consideration of the natural continuation of their physical and chemical properties. The fabrication of PVA-HNT nanocomposites can be a potential way to address some of PVA's limitations. Such nanocomposites have excellent mechanical properties and thermal stability. PVA-HNT nanocomposites have been reported earlier, but without proper HNT individualization and PVA modifications. The properties of PVA-HNT for medicinal and biomedical use are attracting an increasing amount of attention for medical applications, such as wound dressings, drug delivery, targeted-tissue transportation systems, and soft biomaterial implants. The demand for alternative polymeric medical devices has also increased substantially around the world. This paper reviews individualized HNT addition along with crosslinking of PVA for various biomedical applications that have been previously reported in literature, thereby showing the attainability, modification of characteristics, and goals underlying the blending process with PVA.
  11. Lau WK, Goh BH, Kadir HA, Shu-Chien AC, Muhammad TS
    Molecules, 2015;20(12):22301-14.
    PMID: 26703529 DOI: 10.3390/molecules201219847
    Numerous documented ethnopharmacological properties have been associated with Swietenia macrophylla (Meliaceae), with its seed extract reported to display anti-hypoglycemic activities in diabetic rats. In the present study, three compounds isolated from the seeds of S. macrophylla were tested on a modified ELISA binding assay and showed to possess PPARγ ligand activity. They were corresponded to PPARγ-mediated cellular response, stimulated adipocyte differentiation but produced lower amount of fat droplets compared to a conventional anti-diabetic agent, rosiglitazone. The up-regulation of adipocytes was followed by increased adipocyte-related gene expressions such as adiponectin, adipsin, and PPARγ. The S. macrophylla compounds also promoted cellular glucose uptake via the translocation of GLUT4 glucose transporter.
  12. Deng E, Nguyen NT, Hild F, Hamilton IE, Dimitrakis G, Kingman SW, et al.
    Molecules, 2015;20(11):20131-45.
    PMID: 26569198 DOI: 10.3390/molecules201119681
    Macromolecules that possess three-dimensional, branched molecular structures are of great interest because they exhibit significantly differentiated application performance compared to conventional linear (straight chain) polymers. This paper reports the synthesis of 3- and 4-arm star branched polymers via ring opening polymerisation (ROP) utilising multi-functional hydroxyl initiators and Sn(Oct)2 as precatalyst. The structures produced include mono-functional hydrophobic and multi-functional amphiphilic core corona stars. The characteristics of the synthetic process were shown to be principally dependent upon the physical/dielectric properties of the initiators used. ROP's using initiators that were more available to become directly involved with the Sn(Oct)₂ in the "in-situ" formation of the true catalytic species were observed to require shorter reaction times. Use of microwave heating (MWH) in homopolymer star synthesis reduced reaction times compared to conventional heating (CH) equivalents, this was attributed to an increased rate of "in-situ" catalyst formation. However, in amphiphilic core corona star formation, the MWH polymerisations exhibited slower propagation rates than CH equivalents. This was attributed to macro-structuring within the reaction medium, which reduced the potential for reaction. It was concluded that CH experiments were less affected by this macro-structuring because it was disrupted by the thermal currents/gradients caused by the conductive/convective heating mechanisms. These gradients are much reduced/absent with MWH because it selectively heats specific species simultaneously throughout the entire volume of the reaction medium. These partitioning problems were overcome by introducing additional quantities of the species that had been determined to selectively heat.
    Molecules, 2015;20(10):18107-27.
    PMID: 26445039 DOI: 10.3390/molecules201018107
  14. Abu Bakar MH, Cheng KK, Sarmidi MR, Yaakob H, Huri HZ
    Molecules, 2015 May 07;20(5):8242-69.
    PMID: 25961164 DOI: 10.3390/molecules20058242
    Mitochondrial dysfunction and inflammation are widely accepted as key hallmarks of obesity-induced skeletal muscle insulin resistance. The aim of the present study was to evaluate the functional roles of an anti-inflammatory compound, celastrol, in mitochondrial dysfunction and insulin resistance induced by antimycin A (AMA) in human skeletal muscle cells. We found that celastrol treatment improved insulin-stimulated glucose uptake activity of AMA-treated cells, apparently via PI3K/Akt pathways, with significant enhancement of mitochondrial activities. Furthermore, celastrol prevented increased levels of cellular oxidative damage where the production of several pro-inflammatory cytokines in cultures cells was greatly reduced. Celastrol significantly increased protein phosphorylation of insulin signaling cascades with amplified expression of AMPK protein and attenuated NF-κB and PKC θ activation in human skeletal muscle treated with AMA. The improvement of insulin signaling pathways by celastrol was also accompanied by augmented GLUT4 protein expression. Taken together, these results suggest that celastrol may be advocated for use as a potential therapeutic molecule to protect against mitochondrial dysfunction-induced insulin resistance in human skeletal muscle cells.
  15. Islam MS, Al-Majid AM, Barakat A, Soliman SM, Ghabbour HA, Quah CK, et al.
    Molecules, 2015 May 07;20(5):8223-41.
    PMID: 25961163 DOI: 10.3390/molecules20058223
    This paper describes an efficient and regioselective method for the synthesis of novel fluorinated spiro-heterocycles in excellent yield by cascade [5+1] double Michael addition reactions. The compounds 7,11-bis(4-fluorophenyl)-2,4-dimethyl- 2,4-diazaspiro[5.5] undecane-1,3,5,9-tetraone (3a) and 2,4-dimethyl-7,11-bis (4-(trifluoromethyl)phenyl)-2,4-diazaspiro[5.5]undecane-1,3,5,9-tetraone (3b) were characterized by single-crystal X-ray diffraction, FT-IR and NMR techniques. The optimized geometrical parameters, infrared vibrational frequencies and NMR chemical shifts of the studied compounds have also been calculated using the density functional theory (DFT) method, using Becke-3-Lee-Yang-Parr functional and the 6-311G(d,p) basis set. There is good agreement between the experimentally determined structural parameters, vibrational frequencies and NMR chemical shifts of the studied compounds and those predicted theoretically. The calculated natural atomic charges using NBO method showed higher polarity of 3a compared to 3b.The calculated electronic spectra are also discussed based on the TD-DFT calculations.
  16. Amid M, Manap MY, Hussin M, Mustafa S
    Molecules, 2015 Jun 17;20(6):11184-201.
    PMID: 26091076 DOI: 10.3390/molecules200611184
    Lipase is one of the more important enzymes used in various industries such as the food, detergent, pharmaceutical, textile, and pulp and paper sectors. A novel aqueous two-phase system composed of surfactant and xylitol was employed for the first time to purify lipase from Cucurbita moschata. The influence of different parameters such as type and concentration of surfactants, and the composition of the surfactant/xylitol mixtures on the partitioning behavior and recovery of lipase was investigated. Moreover, the effect of system pH and crude load on the degree of purification and yield of the purified lipase were studied. The results indicated that the lipase was partitioned into the top surfactant rich phase while the impurities partitioned into the bottom xylitol-rich phase using an aqueous two phase system composed of 24% (w/w) Triton X-100 and 20% (w/w) xylitol, at 56.2% of tie line length (TLL), (TTL is one of the important parameters in this study and it is determined from a bimodal curve in which the tie-line connects two nodes on the bimodal, that represent concentration of phase components in the top and bottom phases) and a crude load of 25% (w/w) at pH 8.0. Recovery and recycling of components was also measured in each successive step process. The enzyme was successfully recovered by the proposed method with a high purification factor of 16.4 and yield of 97.4% while over 97% of the phase components were also recovered and recycled. This study demonstrated that the proposed novel aqueous two phase system method is more efficient and economical than the traditional aqueous two phase system method for the purification and recovery of the valuable enzyme lipase.
    PMID: 26046324 DOI: 10.3390/molecules200610280
  18. Swamy MK, Sinniah UR
    Molecules, 2015 May 12;20(5):8521-47.
    PMID: 25985355 DOI: 10.3390/molecules20058521
    Pogostemon cablin Benth. (patchouli) is an important herb which possesses many therapeutic properties and is widely used in the fragrance industries. In traditional medicinal practices, it is used to treat colds, headaches, fever, nausea, vomiting, diarrhea, abdominal pain, insect and snake bites. In aromatherapy, patchouli oil is used to relieve depression, stress, calm nerves, control appetite and to improve sexual interest. Till now more than 140 compounds, including terpenoids, phytosterols, flavonoids, organic acids, lignins, alkaloids, glycosides, alcohols, aldehydes have been isolated and identified from patchouli. The main phytochemical compounds are patchouli alcohol, α-patchoulene, β-patchoulene, α-bulnesene, seychellene, norpatchoulenol, pogostone, eugenol and pogostol. Modern studies have revealed several biological activities such as antioxidant, analgesic, anti-inflammatory, antiplatelet, antithrombotic, aphrodisiac, antidepressant, antimutagenic, antiemetic, fibrinolytic and cytotoxic activities. However, some of the traditional uses need to be verified and may require standardizing and authenticating the bioactivity of purified compounds through scientific methods. The aim of the present review is to provide comprehensive knowledge on the phytochemistry and pharmacological activities of essential oil and different plant extracts of patchouli based on the available scientific literature. This information will provide a potential guide in exploring the use of main active compounds of patchouli in various medical fields.
  19. Barakat A, Ghabbour HA, Al-Majid AM, Soliman SM, Ali M, Mabkhot YN, et al.
    Molecules, 2015;20(7):13240-63.
    PMID: 26197312 DOI: 10.3390/molecules200713240
    The synthesis of 2,6-bis(hydroxy(phenyl)methyl)cyclohexanone 1 is described. The molecular structure of the title compound 1 was confirmed by NMR, FT-IR, MS, CHN microanalysis, and X-ray crystallography. The molecular structure was also investigated by a set of computational studies and found to be in good agreement with the experimental data obtained from the various spectrophotometric techniques. The antimicrobial activity and molecular docking of the synthesized compound was investigated.
  20. Azeman NH, Yusof NA, Abdullah J, Yunus R, Hamidon MN, Hajian R
    Molecules, 2015;20(7):12328-40.
    PMID: 26198220 DOI: 10.3390/molecules200712328
    In this paper, a comprehensive study has been made on the detection of free fatty acids (FFAs) in palm oil via an optical technique based on enzymatic aminolysis reactions. FFAs in crude palm oil (CPO) were converted into fatty hydroxamic acids (FHAs) in a biphasic lipid/aqueous medium in the presence of immobilized lipase. The colored compound formed after complexation between FHA and vanadium (V) ion solution was proportional to the FFA content in the CPO samples and was analyzed using a spectrophotometric method. In order to develop a rapid detection system, the parameters involved in the aminolysis process were studied. The utilization of immobilized lipase as catalyst during the aminolysis process offers simplicity in the product isolation and the possibility of conducting the process under extreme reaction conditions. A good agreement was found between the developed method using immobilized Thermomyces lanuginose lipase as catalyst for the aminolysis process and the Malaysian Palm Oil Board (MPOB) standard titration method (R2 = 0.9453).
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Calculus with Applications, Global Edition

RM 324.00 RM 326.84

For freshman/sophomore, 2-semester (2-3 quarter) courses covering applied calculus for students in business, economics, social sciences, or life sciences.

Also available with MyMathLab

The MyMathLab (R) course for the text provides online homework and additional learning resources for students, such as video tutorials, algebra help, step-by-step examples, and graphing calculator help. The course features many more assignable exercises than the previous edition.


Think differently – and get different results! If we continue to do the same things in the same way, we are likely to get the same results.  Einstein apparently said something along these lines and he was absolutely right.

It’s too easy to stay within our comfort zone and do the same over and over.  There often comes a time when we become frustrated with the status quo but we are so far entrenched in our habits or repetition, of sticking to what we know, we cannot break out of it. This is where we need to think differently.

Think differently – try something new.

Ask yourself what someone else might do, what might your future self do, what might a competitor do?

There are so many possibilities but in the day to day of business and stress, it’s not always easy to identify them,  This is where coaching comes in extremely useful! Getting a view from the outside, and external, non judgmental perspective, can encourage you to think differently, try new ways and start seeing the change you’d like.

Get in touch if you’d like to discuss coaching.

Change your limiting beliefs

Are your limiting beliefs holding you back?

Sound familiar?

Where do they come from?

You can change it.

Notice it: “ My opinions are not worth hearing”.
Challenge: Ask yourself “says who?”

Remember NCS – Notices, challenge, switch

Which limiting belief will you challenge first?

Case study – planning for further, more focused business growth

Coaching for the next steps in business growth

Take an outside view of the business

Marketing plan

How profitable?

Delegation – what gets in the way

What is it about delegation?

Delegation has so many benefits and is a vital part of effective working, so why do we have such trouble doing it?

I guess as humans we generally don’t like change. As your role or business changes, are you slow to adapt what you do? If your business has grown or you have been promoted, your role will become more strategic. You will be looking at planning for the future and working out how you will get there, as opposed to dealing with the day to day. But if you’re entrenched in the day to day, you will have little opportunity to stop and consider the future. The busier you get dealing with managing others and doing the day to day, the more difficult it will become to clearly set your direction. Work life balance goes out the window and it’s likely stress levels will mount. This is not the only disadvantage with failing to delegate. You might find it difficult to focus and productivity could fall.

Few people would think that this is a good way to work, so why do so many of us do it?

Why do we fail to delegate?

From coaching business leaders and senior people in organisations, the root of so many challenges is failure to delegate. But why don’t we delegate when the benefits are so clear?

About asking others to do the things you are no longer doing. You want to be seen doing the day to day tasks so that the team feel you too get stuck in. But hang on, think back to when you had a manager – did you expect your manager to do everything? Or did it frustrate you when they didn’t delegate and insisted on getting involved in everything?

Fear of abandoning the team

“But if I don’t work with them, they will feel I have abandoned them.” So often the reasons why we do things is down to belief.  When I hear a statement like this, I ask if this statement is based on any evidence.  Most of the time, there is no reason to believe this.  If your team feels properly trained and supported, it is unlikely they will feel abandoned.

Fear of losing control

If you delegate, you won’t know exactly what’s going in every area of the business. It’s worth asking yourself  how much control you will have over the bigger picture and strategic aspects of the business if you don’t take time to focus. Which is more important for you to get involved in?

Belief it’s easier to do it yourself

In the short term, perhaps. It takes time to explain, to train, to ensure they’ve understood. But what happens in the longer term? Taking time in the short term to delegate will bring rewards in the longer term.

Lack of trust

Others wont do as good a job or won’t do it “like you do”. Ask yourself if this is true all the time? It is true that no-one else will do it exactly as you do.  But you may not actually be doing it effectively. Others may have better ideas of how to approach a task. Be open to how others work and see that you too can learn from them. It’s also important to ask yourself how it might feel for a team member to have a controlling boss? Will they feel trusted? If not, what sort of impact could this have?

Bad experience in the past

One difficult experience with a team member/ employee shapes all else. Have there been good experiences as well as bad? We tend to hold negative experiences in our minds for longer than good ones.  Try and shift the focus to the good experience. It might be helpful to ask yourself what you can learn from the bad experience and how you can move on.

Fear of not being needed

What will happen when you’ve delegated much of your work? Will you be a spare part? Will you go too far and delegate yourself out of a job? What is the true likelihood of this happening? Or is it more realistic to see that you will take on different responsibilities that are vital for your business or career development (as well as your sanity)?

I was recently coaching the CEO of a charity. He was overwhelmed with work and stress. We started looking at why. He operated an “open door “ policy for staff which meant staff were free to walk into his office whenever they had a query or problem, or just for a chat. He did this because he wanted to be seen to be part of the team and be up for getting stuck in just like them.

I find it impossible to focus on the bigger more strategic tasks as I just don’t have the time and am constantly being interrupted.

He considered how he might reduce the interruptions.

I don’t want to discourage staff from sharing their problems with me, I want them to feel supported.

On further discussion, he came to realise that he feared not knowing every little detail of what was going on. There was a certain amount of fear of losing control.

To cut a long story short, he realised that this way of supporting others and getting so involved was affecting his work. He decided to speak to his staff and explain that he wanted to support them, but that he would make himself available for certain times of the day. He also discussed how some of the more experienced members of the team could be first points of contact if there were problems. He trialled this and found that staff were very happy to discuss problems with other members of the team before coming to him if something couldn’t be resolved (which was rare). The more experienced members of the team were actually pleased with the increased levels of trust he had shown in them. He found he was approached less frequently with queries and could focus on his own work, which reduced the stress levels considerably. He felt like his work was having more impact and this in turn helped him enjoy the work more.

Could you delegate more?

Ask yourself if you could delegate more? If the answer is yes, what can you start doing now that will set you in the right direction?

If you’d like to discuss coaching or delegation, please email me

Building Resilience Skills

 Resilience = the capacity to recover quickly from difficulties

Something for the  resilience toolbox

Reframing – how to do it.

Consider the problem or difficulty that you’re facing.

Now think about what other sort of frame it could have.

Managing people

Strategies for managing people

Or ask about the “Mantra – managing well” course.

Managing others well - management training

What’s the AIM of this?

Cull those tasks that don’t align

Ask yourself…

Why not stop right now and have a think.

Does every item on the agenda align with our aim?

Reduce stress

Your personal aim

Start the “aim project”

Why not start now?

Are you holding yourself back?

Are your beliefs limiting your potential?

Coaching is all about seeing things from another perspective. Most people develop a pattern of behaviours that remains largely unchanged for much of their life. These patterns are usually formed during childhood and early adulthood, where we are learning about the world and people. These patterns also contribute to our beliefs and how we see ourselves and others. Some of these beliefs can be negative and limit our potential to do many things, including being confident, successful and even happy. Read more

Is being emotionally aware wearing you out?

Can being too emotionally aware paralyse decision making?

Networking – are you clear about your message?

What will you say?

Whatever your reason for networking, whether you’re a lawyer looking to make connections for business or referrals, a business owner raising your company profile or a sole trader wanting more customers, it’s essential to be clear about what your will say to others at a networking event. Read more

Coaching – an indulgence or investment?

Have you considered coaching as a tool


Fig and almond cake

Ah, a beautiful, juicy fig… and sunshine. And saltwater hugs. It was so good to be back in South Africa, spending time with family and friends. The kids loved every moment (especially the fact that they could wear shorts most of the time) and I enjoyed the slightly more relaxed pace. On our way from Hermanus to Plettenberg Bay, we stopped at a fig farm and bought a whole box of figs for £3.50! We were all salivating in the car the rest of the journey. We enjoyed them in so many different ways: gobbled up whole, sliced into salads, in smoothies, smashed on buttered toast. And then there was the cake, of course. The first piece eaten very quickly with a dollop of mascarpone. The second piece nibbled a little more slowly, savouring its crumbly texture and delicious flavour.

Figs 2

Figs 3

125g unsalted butter, room temperature
65g (1/2 cup loosely packed) light muscovado sugar
3 medium eggs
160g (roughly 1 cup) whole raw almonds
80g (scant ½ cup) spelt flour or gluten-free flour blend
½ teaspoon baking powder
pinch of salt
zest from 3 large organic lemons
12 figs, stalk removed and quartered

  1. Preheat oven to 180°C. Lightly grease a medium sized ovenproof dish (or cake tin).
  2. Beat the butter until light and fluffy. Add the sugar and beat for another minute or two.
  4. Process the almonds in a food processor until they resemble a coarse meal. Add this, as well as the flour, baking powder and salt to the mixture and stir until just combined. Stir in the lemon zest.
  5. Spoon the mixture into the greased dish, flatten the top with a spatula and press the fig quarters into the batter.
  6. Bake for 25 – 30 minutes or until golden and crunchy-looking, and a toothpick inserted in the centre comes out clean. Do not overbake, as it will dry out.

Figs 1

Chocolate bark with macadamia nuts, dried banana and sea salt

Choc bark blog 1

Chocolate bark with macadamia nuts, dried banana and sea salt

Makes enough for 2 – 4 little bags

150g dark chocolate (minimum 60% cocoa solids)

large pinch of sea salt flakes

30g (1/4 cup) macadamia nuts, toasted for 5 minutes at 180˚C pre-heated

30g dried bananas, finely chopped

5g popped quinoa, optional

20g milk chocolate

  3. Quickly scatter  over all the toppings  evenly.
  4. While the bark is cooling, melt the milk chocolate in the same way as the dark chocolate.  Either drizzle this over the bark with a spoon or use a small sandwich bag (or piping bag) to pipe the melted chocolate onto the bark. Set aside to cool completely.
  5. Peel away the paper and snap into pieces.

Apricot, red currant & butternut cake

I absolutely love cooked apricots, whether in a cake, jam, compote, tart or savoury dish. I find that they offer the perfect balance of flavour, and the vibrant colour is always a treat. This cake has a firm texture and is not very crumbly, so makes for an ideal dessert to take along on a picnic. Use frozen red currants if you can’t find fresh.

apricot cake (2)

Apricot, red currant and butternut squash cake

Makes one 20cm cake

3 medium eggs

150ml (1/2 cup plus 2 tablespoons) macadamia nut or extra virgin olive oil

140g (1 cup) palm sugar or dark muscovado sugar

1 vanilla pod, cut into smaller pieces (or just the seeds if you are not using a high-speed blender)

130g (1 cup) wholemeal spelt or buckwheat flour

1 teaspoon baking soda

1 teaspoon baking powder

pinch of sea salt

165g (1 1/2 cups) grated peeled butternut squash

150g red currants, stripped from the stalks

8 small apricots, halved and stone removed

Toasted macadamias, optional

  1. Pre-heat the oven to 180°C/360°F, and grease a 20cm spring form.
  2. In a blender, whisk together the eggs, oil, sugar and vanilla pod pieces (or vanilla seeds, if not using a strong blender).
  3. Mix together the flour, baking soda, baking powder and salt. Make a well in the centre and add the egg mix. Stir until just combined.
  4. Stir in the butternut and half the red currants, then scrape into prepared tin.
  5. Place the apricot halves, cut sides down, onto the cake batter and scatter the rest of the currants on top. Use the back of a large spoon to gently press the fruit into the batter.
  6. Bake for about 60 minutes or until a toothpick inserted in the centre of the cake comes out clean or with a few dry crumbs.  It may need a little longer, depending on your oven.
  8. Serve with whipped cream and toasted macadamia nuts.

Puffed quinoa squares

A relative unknown a few years ago, South American-born Quinoa has since crept into our hearts and is unlikely to disappear anytime soon. This little pseudo-grain is very nutritious, rich in protein and gluten-free to boot, making it an ideal addition to any meal. It is most often cooked and prepared in the same way as rice, but I love grinding and making a delicious breakfast porridge with it. You can also make puffed quinoa as if you were making popcorn. Heat a large heavy bottomed pot (cast iron ones work best) and add about half a cup of quinoa. Keep shaking the pot until most of the seeds have popped. If your pot is deep enough, you won’t need a lid to keep the little nippers at bay.  Tip them out onto a baking sheet to cool and use in muesli, as a topping on yoghurt or in recipes such as these squares below.

Puffed quinoa squares (1)

Puffed quinoa squares

The squares make an excellent after-school snack, as they are a mini version of a complete meal.

Makes about 40

200g (1 1/2 loosely packed cups) soft, dried prunes

125ml coconut water, at room temperature and preferably raw (i.e. unpasteurised)

150ml (125g or 1/2 cup plus 2 tablespoons) liquid coconut oil

125ml (1/2 cup) raw honey

Pinch of sea salt

5 cups puffed quinoa (home-made or store-bought)

90g (1 cup) toasted desiccated coconut

70g (1/2 cup) shelled hemp seeds

70g (1/2 cup) shelled sunflower seeds

  1. Soak the prunes in the coconut water whilst you get your other ingredients together.
  2. In a powerful blender, blend the prunes, coconut water and enough of the coconut oil to give you a smooth paste. Scrape into a bowl.
  3. Add the rest of the oil, honey, salt, quinoa, desiccated coconut and seeds, and stir until well combined. Your mixture needs to be sticky and hold together when pressed.
  4. Line a 34cm x 26cm (9” x 13”) tin or oven dish with greaseproof paper, then press the mixture into the tin and refrigerate until set (at least a couple of hours).
  5. Turn out onto a chopping board and cut into squares. They will keep a week or so in the fridge, and freeze really well.

Melon and avocado poke

This is refreshing and utterly summery. Unlike the British weather. (Here’s hoping the guys at the met office are right about that heat wave…) Poke (pronounced poke-keh) is a Hawaiian staple and can be found in many different guises, with chunks of tuna marinated in soy being the most popular and ubiquitous. This is a meat- and fish-free version and something I love eating whilst sat on my garden chair with the sun kissing my toes. It serves 4 as a starter, but I often eat the entire bowlful for lunch. Whatever you do, only attempt this if you can get your hands on seriously good melons.

Version 2

Melon & avocado poké with nori crisps

Serves 4 as a starter

Ingredients for the nori crisps

2 sheets nori

white sesame seeds

sesame oil

sea salt

Ingredients for the dressing

15ml (1 tablespoon) extra virgin olive oil

5ml (1 teaspoon) rice wine vinegar

5ml (1 teaspoon) toasted sesame oil

15ml (1 tablespoon) tamari

30ml (2 tablespoons) lemon juice

1/2 – 1 teaspoon raw honey

1 teaspoon each of white and black sesame seeds, plus more for garnish

pinch of dried chilli flakes (or to taste)

1 shallot, very finely chopped

1 large clove garlic, finely chopped

Ingredients for the poké

500g (3 1/2 cups) diced watermelon (or a mixture of melons)

2 ripe avocado, cut into small dice

large handful sugar snap peas, thinly sliced lengthways

1 spring onion, finely sliced

sea salt

  1. For the nori crisps: Preheat the oven to 140°C (275°F). Line a large baking sheet with parchment paper and set aside. Place two sheets of nori, shiny side up, on a chopping board. Using a pastry brush, lightly brush one sheet with water, then press the other one firmly firmly on top to stick the two together.
  2. Now brush the uppermost sheet with sesame oil, sprinkle on some sea salt and sesame seeds, and using scissors or a sharp knife, cut the nori into thin strips.
  3. Arrange the strips in a single layer on the baking sheet and bake for 15 to 20 minutes or until they have turned crispy and dark green. Remove from the oven and allow to cool.
  4. For the dressing: Combine all the ingredients in a jar and give it a good shake. Taste and adjust seasoning.
  5. To serve: Gently toss together the melon and other poké ingredients with the dressing and serve immediately topped with nori crisps.

DSC_3376 Melon Poke 2

Crustless courgette quiche

Crustless Courgette Quiche

Knob of butter or glug of extra virgin olive oil

1 medium onion, finely chopped

200g spinach

9 medium eggs, whisked

125ml (1/2 cup) milk of your choice

1 teaspoon sea salt

1/2 teaspoon cayenne pepper

4 medium courgette (about 550g), trimmed

1/3 red pepper, finely diced

soft goats cheese (optional)

DSC_2147 Slice

Mackerel and romanesco with preserved lemon

Mackerel salad (1)

Mackerel and romanesco with preserved lemon dressing

Serves 4

Ingredients for the salad

3 smoked mackerel fillets, skin discarded and flaked

one large handful of rocket per person

150g large green olives, pitted and halved

45g (a heaped 1/4 cup) organic raisins

Ingredients for the dressing

90g (about 3/4 cup) cooked romanesco

125ml (1/2 cup) extra virgin olive oil

45ml (3 tablespoons) lemon juice

1 – 2 teaspoons Dijon mustard

2 – 3 teaspoons raw honey

2 tablespoons fresh thyme leaves

small bunch of dill

freshly ground black pepper

sea salt to taste

Chewy almond and fig thins

It doesn’t really matter when you make these, but you should! They are rather easy to throw together and definitely hit the spot when you need a little something to cheer up your darling (or yourself!). If you can’t find matcha powder, use a few drops of beetroot juice instead, to colour the chocolate pink.

Chewy almond and fig thins

50g unsalted organic butter (or coconut oil)

50g coconut palm sugar (or you could use demarara sugar)

Pinch of sea salt

65g orange marmalade, very finely chopped

100g soft dried figs, finely chopped

80g flaked blanched almonds

30g shelled hemp seeds (also called hemp hearts)

25g brown rice flour

For the chocolate drizzle

100g organic white chocolate, broken into pieces

matcha powder (roughly 1 teaspoon)

freeze-dried raspberries or additional hemp hearts

  1. Pre-heat the oven to 180°C/350°F and line two baking trays with parchment paper.
  2. Melt the butter and palm sugar in a small pan over a medium heat until the sugar is dissolved. Add the salt, give it a stir and set aside.
  3. Put the rest of the ingredients in a bowl and using a tablespoon, press everything against the sides to mix thoroughly and evenly distribute the flour. Add the butter and sugar mix and repeat the process until you have a lovely dark golden ball of deliciousness.
  4. Place this ball between two large pieces of parchment paper and roll it out until it is quite thin (how thin will depend on your preference, but I have found that 4mm is just about perfect). Slide onto a baking sheet and bake for about 10 minutes before removing from the oven.
  5. Now cut out shapes with a cookie cutter (press any offcuts together and roll them out again) or for a lot less effort, use a large knife to cut the cookie dough into rectangles. Place on the lined baking trays and return to the oven for another 8 – 10 minutes, rotating the trays half-way. Remove from the oven and transfer to a cooling rack to cool completely.
  6. When cool, melt the white chocolate in a double boiler or in a heatproof bowl set over a pan of simmering water (don’t let the bowl touch the water!) and stir every now and then. As soon as the chocolate has melted, add enough matcha powder for a lovely green hue.
  7. Dip each cookie in the melted chocolate half-way and sprinkle with freeze-dried raspberries or additional hemp hearts. return to the cooling racks and store in an air-tight container when set. You could also spread chocolate on the underside of each cookie and let it cool upside down. You will need more than 100g of chocolate, but it is more traditional. And reeeeeally good.

Note: If you are not a fan of white chocolate, feel free to use dark chocolate instead.

DSC_1635 DSC_1642

A winter salad with blood orange and lentils

Lentil and blood orange salad

Serves 2 – 4

Ingredients for the dressing

1 blood orange, 1 slice and the rest juiced

80ml (1/3 cup) extra virgin olive oil

15ml (1 tablespoon) tahini

30ml (2 tablespoons) rice vinegar

15ml (1 tablespoon) naturally fermented shoyu or soy sauce

1 tablespoon maple syrup

squeeze of lemon

pinch of sea salt

shichimi togarashi (Japanese 7-spice blend) to taste

Ingredients for the salad

100g (about 1 cup) cooked puy lentils

2 large handfuls of greens, including baby spinach

1/2 large cucumber, sliced

2 blood oranges, peeled and sliced

1 large carrot, grated or thinly sliced

1/2 medium fennel, grated or thinly sliced

2 spring onions, thinly sliced

Sweet potato loaf with apple butter

Some mornings I just need things to happen a little quicker than usual. Avocado on a slice of rye sourdough will always be a favourite, but for something different try baking this loaf the day before. It was born out of my eternal quest to incorporate more vegetables into our daily eating and the kids love it with raw lightly salted butter. As a special treat (and to keep it dairy-free), slather it with the apple coconut butter below. This gorgeous spread keeps well in the fridge for a week or so and is equally delicious stirred into hot porridge, as a topping on pancakes, or on crunchy toast.

Version 2

Sweet potato loaf

5 medium organic free range eggs, lightly beaten

520g (about 2 cups) mashed cooked sweet potato

1 1/2 teaspoons baking powder

1 teaspoon salt

100g (just over 3/4 cup) coconut flour

1 tablespoon grated fresh ginger

50g (about 1/3 cup) dried cranberries, soaked in juice from 1/2 an orange for at least 2 hours

60g (1/2 cup) pecan nuts, roughly chopped

some coconut sugar to sprinkle over, optional

  1. Preheat the oven to 180°C / 350°F (or 160°C in a fan oven).
  2. Grease a medium sized loaf tin and line with parchment paper, allowing the paper to overhang on the long sides.
  3. Beat together the mashed sweet potato and the eggs until smooth, light and fluffy.
  4. Sift in the baking powder, add the salt, coconut flour and grated ginger, and mix well.
  5. Stir in the soaked and softened cranberries, any remaining orange juice and chopped nuts.
  6. Let the batter sit for 10 minutes to give the coconut flour time to absorb the liquids.
  7. Pour the batter into the prepared tin, sprinkle over a little coconut palm sugar if using, and bake for 50 minutes or until the top begins to brown and a toothpick inserted in the centre of the bread comes out clean.
  8. Remove from the oven and allow to cool completely before slicing. Store covered for a couple of days at room temperature or in the fridge for several days. You could also freeze it. Like most gluten-free breads, it is quite fragile and can’t really be slotted into a toaster, but I do sometimes toast it in a medium hot pan in some butter or coconut oil.

Sweet pot

Apple and coconut butter

This will only really work if you have a high-speed blender, as the coconut butter is quite solid in anything other than very hot weather and you will end up with a lumpy mess. But if you don’t own one, try gently heating the coconut butter and then stirring in the apple sauce. It won’t be as spreadable, but still pretty darn delicious as a topping.

160ml (2/3 cups) home-made or store-bought apple sauce

70g coconut butter (also called coconut manna or creamed coconut) at room temperature

squeeze of lemon juice

  1. Pour the apple sauce into the blender, then cut the coconut butter into small chunks and add. If the fat has separated and formed a layer on top of the more crumbly coconut component, make sure you include some of the fat when adding to the apple sauce.
  2. Blend until smooth. Scrape down the sides once or twice.
  3. Add lemon juice to taste, blending in between additions.


Measles, Politics and the Erosion of Trust

4 March, 2019

(from a news item in the New Yorker, with thanks to Global Health Now)

'Vaccination, writes Masha Gessen, is a basic political issue because its success hinges on community agreement - and vaccine refusal is a politiical act. Most US anti-vaxxers are educated, so why do they flout evidence-based recommendations of the government and health workers? Because they’ve lost trust in the US health system, Gessen argues. “The American health-care system is ill-suited to protect public health, because a profit-driven industry cannot serve as the guardian of public good.” The solution, she says, doesn’t lie in better vaccine messaging - the politics of health care need to be transformed.'

The Quote: “Measles is a quintessential political issue of the late two-thousand-teens, one that turns on the conflict between facts and lies.”

Comment (NPW): Trust in the health system, and public understanding of health and disease, is paramount, as we have seen with Ebola aggression as well as vaccine hesitancy. In the US, lack of trust is associated with deep inequality in access to health care. The same is true in many LMICs, with the added pressure of weak health systems and people's negative perceptions/experiences of health services.

Best wishes, Neil


Home Loans for Low Income Seniors

In today’s economy, there are many senior citizens whose income is considered low. These individuals may need housing loans or refinancing but aren’t sure how they can accomplish this with the amount of money they have. The good news is that there are home loans for low income seniors, available from a variety of different lenders. One source to consider is the U.S. government. They have loan programs for families wanting to purchase land in rural areas and other areas as well. A good first place for senior citizens to start is the Housing and Redevelopment Authority.

There are government backed loans from the FHA, USDA and institutions like Sallie Mae that can help seniors get the loans they need for residential housing and even farming purposes. The first step is to define what kind of loan is needed and for what purpose. For a farm loan where agriculture will take place a USDA loan is recommended as these are meant for low income individuals and families. FHA and Sallie Mae loans can be used for other areas not considered rural and are also geared towards those with moderate to low incomes.

In many cases, senior citizens who have low income may actually have good credit because they have had many years to establish a credit rating. So, the likelihood of approval is higher even if the income is low. Home loans for low income seniors who are already homeowners would actually be classified as home equity loans, mortgage refinancing or a reverse mortgage. These options can help those who don’t want to sell their home but are having trouble making ends meet. Let’s take a look at these options, which are similar but have their differences as well.

When refinancing a home, you are basically trading in your original mortgage for a new one. There are a variety of reasons to refinance. If the housing market rates have dropped, it may be a good time to consider refinancing to get a lower rate and thus lower payments. If your credit has gone up, you may also be able to secure a lower rate than you had previously. There are two different types of mortgages, fixed and adjustable rate. Many people who have an adjustable rate mortgage may decide to switch to a fixed rate mortgage to avoid fluctuations in their payment amounts, especially if fixed rates are low. Refinancing can also change the term of your loan, making it longer or shorter based on your needs. A longer term will lower your monthly payments and may remove some of the financial burden.

A home equity loan can provide a lump sum of money for any purpose, such as a college education for a grandchild, home renovations or even the repayment of debt. Equity is the amount you have paid on your mortgage subtracted from the original mortgage amount. Some who are looking for home loans for low income seniors decide on a reverse mortgage. Rather than getting a large sum of money at once, multiple payments are sent and may span the rest of one’s life. Payments may be sent on a monthly basis or other time frame.

There are plenty of options when it comes to home loans for low income seniors. As previously mentioned, the government can be of assistance but in some cases banks, credit unions and mortgage lenders may be able to help also. A good first step is to learn as much as you can on the subject and speak with a financial and/or mortgage advisor if possible.


The English Civil War was a complicated, intellectual war between the two most powerful forces in England: Parliament and the King. Conflicts between the two powers began when King Charles I dissolved Parliament in 1625 because they would not give him the money he demanded to fund his war against Spain. Parliament, who was lead by John Pym, felt that the King was showing favouritism towards the Roman Catholics, especially since Charles had recently married the Roman Catholic French Princess. Although Charles recalled Parliament in 1626, he proceeded to dissolve the second Parliament mainly because it attempted to impeach him. John Pym, who had been prevented from being elected to the second Parliament, was re-elected into the third Parliament and was looking for revenge on King Charles. He refused to give Charles supplies for his war until certain issues such as forced loans, compulsory billeting and arbitrary imprisonment had been addressed. The King attempted to bargain with Parliament, agreeing that Parliament could no longer be dissolved and that it had to be called regularly. When the Irish rebellion broke out, Pym took the opportunity to blame Charles and his administration for the rebellion. Pym stated that the parties at fault should be dismissed and replaced with people approved by Parliament. Charles attempted to impeach Pym and others, but word of his plans leaked out and the individuals got away. This was the beginning of conflicts between Parliament and the King and although discussions between the two groups went on until March of 1641, war was inevitable. When the war began, it was clear that the King held the upper hand. However, after four years of fighting (1642 – 1646), Parliament emerged victorious, lead by Oliver Cromwell who had obtained leadership after the Marston Moor battle. Although it took more then eighteen years for the results of the civil war to settle, there were no long term effects of the war. While there were minor reforms to the system, the people, the Church and the Monarchy of England went back to living their lives relatively the same as they had before the start of the English Civil War. Violence during the English Civil war effected hundreds of thousands of English civilians. However, while violence killed thousands of people…the impact of the war – as a war – was surprisingly limited. Casualties during the war were high: 190 000 people died in England and 868 000, or 11.6% of the population, perished within the British Isles. This number was only a third of the amount of people who died in England during the great plague of 1570 – 1670. King Charles II was content with putting things aside and starting over again, and it seemed like the people of England were too. Although women and children lost husbands and fathers, their loses were quickly replaced by new husbands or relatives to help out. By the end of the war, most people simply wanted to get on with their lives since there was nothing that they could about the people they lost during the war. Many people forgot their differences and were found even marrying across the barriers which were created during the war. Damaged property was quickly repaired since it created jobs for civilians looking for work. Buildings were destroyed, but since the war was not as explosive as the wars we know today, they were easily rebuilt. Cities were sacked, however most were mended; citizens lost possessions, but they were easily rebought; royalists forced residents of London to cut down trees for fuel by cutting off their coal supply, but the trees grew back. It seemed like civilians were anxious to forget the wars and restore their lives to what it was before the war by returning to life as it were. A more difficult transition for the common folk of England was the re-civilization of the soldiers, but even that did not create many effects. It was a complicated procedure to merge the soldiers into society as every day working people, however since it took place at two different times; once when Cromwell was dissolving the army and once when the new Parliament was attempting to rid themselves of the army completely. Because of this, it affected both sides in different ways at different times. This process limited the wars long-term effects. The city of London literally scratched out its history of cooperating with Cromwell by drawing lines through the appropriate pages of its record books. It was almost as if the people of England erased the memory of the Civil War and started their lives where they left off before the war started. Another aspect of society which was effected during the English Civil War was the Church and religion. In a sense, religion played a role in the suspicion which arose within Parliament. It was because of a suspected favoritism towards Roman Catholics that John Pym turned against King Charles I. And because of the Irish Rebellion in which the Irish rose up against the English Protestants, Parliament felt that there was a conspiracy against English liberty in which Charles was participating. Parliament, who was composed of mainly Puritans, was fighting a war for their freedom in what they believed was a conspiracy against them. In 1645, six days before the execution of Archbishop Land, the Book of Common Prayer was abolished in favour of the Presbyterian directory of worship. This appeared to be the end of an era for the Church of England. During the Civil War, many new religions emerged. Baptists did not believe that children should be baptized, Levellers were far more radical, accepting the sacredness of private property but they demanded new laws that would protect the poor as well as the wealthy. Diggers opposed the private ownership of land and sought the abolition of wage labor. Ranters rejected the idea of Heaven, Hell and sin and thought that true salvation could be found only in drink and sex. Because England was in a state of anarchy during the war, rebels destroyed churches and cathedrals without a trace of guilt. Religious festivals, opposed by the Puritans were practiced by Anglicans in order to raise money for the church. In the 1650s, Oliver Cromwell attempted to unite all Protestants in a single-state church with outside tolerance. This idea failed since the possibility of a single all-embracing state church was impossible even before revolution. From then on, England possessed two Protestant nations as well as a Roman Catholic minority. After the Monarchy was revised and the events of the Civil war were finished, the Church of England regained its title as the established church of the country. Once again, any other religions were not tolerated by it and the church expelled Presbyterian ministers. The Church of England had returned to its state from before the war, almost as if the destruction of alters and cathedrals in rebellion had never happened. The Monarchy of England was severely affected by the Civil War during the actual events of the war, however, it was restored almost back to normal after the occurrences had been resolved. Soon after Parliaments victory, King Charles I was charged on the terms that he had personally started and waged war against Parliament. Oliver Cromwell, the leader of Parliament, took office over England in 1653 with the title Lord Protector. He began dissolving his army soon after Parliaments victory as well as dissolving the Rump Parliament. Cromwells government was beginning to seem familiar to many civilians as it was beginning to be run similar to the monarchy which Cromwell wanted to reform. He was making laws without the advice of Parliament as well as ignoring their authority when it came to setting taxes. Despite his decreasing popularity, Cromwell was offered the throne of England, which he refused. When Cromwell died in 1658, his son Richard Cromwell tried too hard to enforce his fathers policies and the Wallingford house party, lead by Fleetwood, coaxed him down from power. However, the Wallingford house party was forced to recall the Rump Parliament, whos priorities were clearly in restoring the power of the army. Lambert, who was a Parliamentary general during the war, was recalled to help to dissolve Rump Parliament. The Royalists joined with the Presbyterians and Lambert, and together they called for an election of a new Parliament. They won their fight and sent a petition up to the rump wanting a select senate which would speed up the dissolution of parliament and confirm Fleetwood as Commander in Chief and Lambert as second in command. This was the spark which started the conflagration that destroyed the commonwealth. Unfortunately, the restoration of the Monarchy was not that simple. Monck, a general from Scotland who had been one of Cromwells most loyal friends and companions, marched into England and demanded that Rump Parliament be recalled. Fleetwood and Lambert were obligated to follow Moncks orders and restored the Rump Parliament. Almost immediately after it was reintroduced, it turned its forces against Fleetwood and Lambert. Lambert was captured and fearing for his own safety, Fleetwood allowed the Scottish Army to invade England with no resistance. Once Monck had established control over London, he informed the Rump Parliament that the civilians would be satisfied with nothing less than a newly elected parliament. However, the Rump Parliament still refused to give up their position. They could not hold out for that much longer and eventually, they were forced to resign. Once the Rump was dissolved, Monck had a secret meeting with Charles II, who was heir to the English throne, and his advisor. During this meeting, Monck laid out certain rules which he said that the King must oblige by. Charles, who did not agree with the terms that Monck set out, took a letter to the new Parliament explaining what Monck was doing. At the same time, Lambert escaped from his imprisonment and called a reunion of his men to try to overthrow Monck. Monck, who insisted that all regiments of Parliament say that they will obey him without a question and abide by any decision of Parliament. was overthrown on Parliaments decision to offer Charles II the throne of England. Eleven years after his fathers execution, Charles II crossed the English channel to be crowned King of England and to mark the restoration of the English Monarchy that had been abolished during the Civil War. The first task of the reestablished Monarchy was to rid themselves of Oliver Cromwells army. The Monarchy had full Parliamentary support to complete this task. Charles formed the 1st Regiment of foot guards and with Moncks army, the 2nd Regiment of foot guards was made. What was originally Cromwells Regiment of horse was divided into the Duke of Yorks lifeguards and the Royal Horse Guards. This was the beginning of the British Regular Army. Although it was almost impossible to demolish the entire army, King Charles II did the best job that he could. Charles II was compelled to make an Act of Indemnity and Oblivion, which some criticized as indemnity to enemies, oblivion to friends. However, this was simply a reflection of the fact that Parliament won the English Civil War and that restoration of the Monarchy was an act of grace. Because of this, Parliament and the King made some agreements: the King could never take money from citizens without consenting with Parliament first as well as never operating outside the courts of the common law through the Star chamber- a forum for commonfolk to voice their opinions. As well, the King had complete power over military decisions and no one would have powers over the King. Despite all the chaos and disorder within the Monarchy and Parliament, constitution and structure or society and government appeared untouched by the traumatic events. With the exception of the agreements between Parliament and the Monarchy, things were restored back to how they were before the war. The king was once again chronically short of money and depended on Parliament for money. Once again, it seemed as though the events that occurred during the English Civil War had never occurred. While the Civil War was taking place, many issues in society went through reform. The people of England lost a lot of family members who were close to them, the Church of England was cause for a lot of rebellions as religions emerged and formed and the Monarchy was completely dissolved only to be revived again by the winners of the war- Parliament. However, once the dust had settled, there were only a few changes which had occurred in English society. Everything else was like the clocks had been turned back to before the Civil War.: The English Civil War was different then the ones in Scotland or Ireland since there were no major long-term effects. It is believed that this is because the Civil War in England was simply a product of short-term events as well as miscalculations from the king, and not because of long-term effects building up like those in Ireland and Scotland. Although the English Civil War disrupted the entire society of England while it took place, England and its infrastructure was almost identical only a few short years after, as it was before the war began.


Security of processing in Confluence Server and Data Center

Atlassian documents some best practices for securing both your network as well as your Confluence instance. Please review the guidelines on configuring the security of your Confluence, and ensure that they are applied where appropriate.

Security Considerations

Please note that there are some security considerations in Confluence that the administrator will need to be aware of, and implement the appropriate measures to mitigate if necessary:

  1. Confluence does not provide a data encryption feature for data stored in the database, nor data stored in the filesystem.
  2. In Confluence Data Center, the communication between nodes happens over TCP sockets and is unencrypted.
  3. The communication between Confluence and Synchrony clusters happens over HTTP, and is unencrypted.
  4. The communication between the user's browser and Synchrony happens over HTTP, and is unencrypted. The administrator is advised to configure a loadbalancer with SSL termination to provide encryption between browser and Synchrony.

Securing your Infrastructure

Atlassian strongly recommends that customers implement SSL to secure the TCP communication between Confluence and its users or any other system interacting with it. That includes database and LDAP (for external user directory). Please see the documentation about how to Run Confluence Over SSL or HTTPS for details.

Confluence + other Atlassian products

If Confluence is connected to other Atlassian products (i.e. Jira, Bitbucket, Bamboo...), make sure the other products are using HTTPS and that the communication between those systems are secure.

Confluence + Synchrony

Starting with Confluence 6.0, the Collaborative Editing feature requires Synchrony (which is bundled along with Confluence). When running Confluence Data Center, the administrator needs to run the Synchrony cluster separately from the Confluence cluster. Confluence users will connect directly to the Synchrony cluster, and the Confluence Data Center nodes will also connect directly with the Synchrony cluster. Please refer to the documentation for Administering Collaborative Editing for information on securing the Synchrony Cluster nodes.

Confluence Data Center + Loadbalancer

In Confluence Data Center, a loadbalancer is required spread the load across the cluster nodes. For increased security, we recommend that the administrator secure the communication between the loadbalancer and the Confluence nodes. Please see the Data Center documentation on Load balancer configuration options, specifically the section on SSL termination for details.

On-Premise Cloud

If the Confluence instance is hosted on a cloud service (such as AWS or Microsoft Azure), please be sure to work with the cloud service provider in order to secure the production environment.

Backups and Resilience

Confluence has a feature for backing up the instance, and restoring the backup (documented in Site Backup and Restore). This feature has some size limitations: Confluence instances with a large amount of data or users may not be able to perform the backup or restore, depending on the available memory and CPU on the hardware hosting the instance.

The administrator is advised to make use of the native backup features of their database and operating system, in order to remain resilient against failures. See the documentation on Production Backup Strategies for more details and guidelines on backups.

Atlassian Security & Bug Bounty Program

Atlassian releases regular security advisory reports to inform customers about vulnerabilities. These can be viewed and tracked in the Confluence security overview. Please review these advisories to ensure that the Confluence instance is not vulnerable to known issues.

Moreover, Atlassian offers the community a way to contribute to enhancing the security of our products through the Vulnerability Bug Bounty Program. This program awards contributors who report vulnerabilities to Atlassian, and increases the general security of the product by discovering problems earlier.

Last modified on Jan 2, 2019

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Letter from J.R. Fearing to Captain Timothy Hunter

Date: February 1862 - June 1862 | Identifier: 748.2.f
Letter to Captain Timothy Hunter from J.R. Fearing regarding the Burnside Expedition. Fearing tells Hunter that General Ambrose Burnside's men are close and they are waiting to be attacked near Elizabeth City, N.C. He asks Hunter to take care of his wife if something happens to him. He mentions that a part of General Henry A. Wise's forces are present, but he wishes the whole unit was there. Date approximated. more...


Day 71: Strategy on Indiegogo and Video

Today I kept working on planning out the mid-level and high-level tiers for Eternal Camping as I really want to make sure that people find them valuable enough to donate money to. I also narrowed down my video options of which kind of video to make. It really depends on what kind of video shots I can find in the public domain-especially of scary woods-and if I can find a good voice if I decide to attach a fake trailer to the Indiegogo video. Right now I’m thinking of a simple campaign pitch where I explain the project, explain why I need money, and try to get people excited for Eternal Camping.

If you have any ideas or would like to help in some way, feel free to get in touch with me!


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Political scientists who study disagreement, disagree about the need to formalize their studies.

Accepted submission by JoeMerchant at 2019-04-08 20:58:47 from the Argument for the sake of argument dept.

To Swedish blogger John Nerst, online flame wars reveal a fundamental shift in how people debate public issues. Nerst and a nascent movement of other commentators online believe that the dynamics of today’s debates—especially the misunderstandings and bad-faith arguments that lead to the online flame wars—deserve to be studied on their own terms. “More and less sophisticated arguments and argumenters are mixed and with plenty of idea exchange between them,” Nerst explained in an email. “Add anonymity, and knowing people’s intentions becomes harder, knowing what they mean becomes harder.” Treating other people’s views with charity becomes harder, too, he said.

Inspired by this rapid disruption to the way disagreement used to work, Nerst, who describes himself as a “thirty-something sociotechnical systems engineer with math, philosophy, history, computer science, economics, law, psychology, geography and social science under a shapeless academic belt,” first laid out what he calls “erisology,” or the study of disagreement itself. Here’s how he defines it:

...political scientists who study disagreement, unsurprisingly, disagree. Though Nerst has claimed that “no one needs to be convinced” of the needlessly adversarial quality of online discourse, Syracuse University political scientist Emily Thorson isn’t buying it. “I actually do need to be convinced about this,” she said in an email, “or at least about the larger implication that ‘uncivil online discourse’ is a problem so critical that we need to invent a new discipline to solve it. I’d argue that much of the dysfunction we see in online interactions is just a symptom of much larger and older social problems, including but not limited to racism and misogyny.

So, old political scientists think they've already identified the root cause of "bad behavior" and that online argument isn't a significant factor, or at least that's the argument they put forth in their e-mail vs the younger blogger... Dismissive, much ;-)

Original Submission


So happens for other sorts of large real-world economic decisions? Buying cars, selecting a mortgage or saving for retirement. Do people make good cautious decisions when the stakes get large? Do they attend to the details knowing how much more is on the line?

Our decision making abilities are not that great

You know the answers. The same biases found in the small decisions in the grocery store or laboratory also appear in the biggest decisions of our lives. We don’t have special machinery that we can suddenly turn on when we face a big decision. We’re stuck with the same brain circuits that helped our ancestors forward for food and track down prey but never evolved to compare fixed and adjustable-rate mortgages.

There are two fundamental types limitations on her decision-making. The first involves constraints on our cognitive abilities. Much as we might hate to admit it there are limits on her intellectual capacities. We can’t know everything, remember everything, compute everything. Some people work well with numbers and data, some can do complex calculations in their head. Other people have more difficulty with numbers and they adopt different strategies for making decisions but none of us is a supercomputer.

We don’t process information in absolute terms for example but in relative terms in comparison to a point of reference. Even though a silver medal is objectively better than a bronze medal after they win Olympic bronze medalist tend to be happier than silver medalist. That’s because they adopt different reference points. The bronze medalist think I did well enough to earn a metal while the silver medalist think I didn’t do enough to earn gold. Our brains are set up to use reference points.

We do not have unlimited time to make decisions

That’s a way of simplifying the decision process and using reference point does help in many circumstances as we’ll see in future lectures, but if we adopt the wrong reference point we lose perspective on what really matters. Put yourself in the place of a distant ancestor walking through grassland out of the corner of your eye you see a flash of movement a glint of sunlight and you react you immediately run for safety just eluding a predators clutches.

Each of us exists because some of her ancestors made decisions very rapidly avoiding a predator diffusing a violent situation steering away from a car crash in the road ahead. Real world decision-makers don’t always have the luxury of waiting, waiting until all the information is collected. Time constraints affect her economic decisions as well when deciding whether to purchase a home time is both your friend and enemy.

Acting slowly gives you more time to gain information and deliberate on this largest of all purchases, but acting slowly also carries opportunity costs someone else they put in an offer or interest rates may increase. These two limitations cognitive abilities and time constraints prevent us humans from being the ideal rational decision-makers posited by traditional economics.

The bounded rationality theory

We cannot make optimal decisions that always lead to the best outcome even if we wanted to, but we can recognize these limitations and try to optimize the decision process. The economist psychologist Herbert Simon introduced the idea of bounded rationality or rationality within limits.

Simon contended that the key challenges for real-world decision-making were in acquiring the right information, in simplifying the decision process and in adopting strategies for decision-making. We can’t overcome these challenges by becoming even more analytic and deliberative in our decisions.

Instead we adopt rules called heuristics that allow us to prioritize some information over other that simplify complex decisions into something manageable and that give us strategies that can be implemented quickly and with little effort. Those heuristics help us improve our odds of making a good decision even in the face or limitations.

But, like us, they’re not optimal, they’re just good enough most of the time over the two dozen lectures of this course we will explore many aspects of the decision-making process. Our biases are often surprising an counterintuitive and it is easy to just dismiss them as odd features of human nature, but they are oddities their clues.

Out limitations point to the deeper general principles that govern decision-making that show we aren’t rational decision-makers and you’ll start to recognize the limitations of your own thinking. Knowing your limitations won’t make them just go away they are too deeply rooted in your biology.

It is very difficult to change the basic mechanisms of decision-making, but that shouldn’t be a depressing thought it should be liberating. We are real people with real limitations making your way through a constantly changing world. We don’t need to be perfectly rational we just need to be good enough.


Emma Josefsson-Projects

Emma Josefsson-Projects

Platelet function in cancer progression

The role of platelets in lymphoma and leukaemia

Platelets, important for blood clot formation, are known to have a role in the progression of solid tumours through metastasis. However their role in blood cancer remains obscure. Our group will delineate the role of platelets in lymphoma and leukaemia progression and define potential mechanism(s) of platelet and tumour cell interactions. This is critical in the context of an increasing burden of disease with the growing incidence of lymphoma and an ageing population.


social science
Alternative Titles: NI, neo-institutionalism, new institutionalism

Neoinstitutionalism, also spelled neo-institutionalism, also called new institutionalism, methodological approach in the study of political science, economics, organizational behaviour, and sociology in the United States that explores how institutional structures, rules, norms, and cultures constrain the choices and actions of individuals when they are part of a political institution. Such methodology became prominent in the1980s among scholars of U.S. politics. That so-called new institutionalism combined the interests of traditionalist scholars, who focused on studying formal institutional rules and structures, with behavioralist scholars, who examined the actions of individual political actors.

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governance: The new institutionalism
An institutional approach dominated the study of the state, government, public administration, and politics until about the 1940s. Scholars…

From the 1930s through the 1950s, traditionalist scholars dominated political science as a discipline, especially in the United States. Those scholars were most interested in examining the formal structures and rules that were the foundation of political and governmental institutions such as the executive, legislative, and judicial branches. Traditionalist studies were often descriptive in nature, used mostly qualitative methods, and usually did not use broad theories to ground their observations in a larger theoretical perspective. Often, traditionalist scholars were quite normative in their desire to describe how political institutions ought to function, as opposed to the empirical study of how things actually worked in practice.

Beginning in the 1960s, political scientists began to move away from focusing on political institutions and instead almost exclusively studied the actions of individual political actors. That so-called behavioral or behavioralist revolution strove to make the study of politics more scientific, and quantitative methods came to predominate in political science. Behavioralists would, for example, focus on specific decisions of individual judges or choices made by individual members of Congress rather than on the rules and structures of the courts and the role of Congress in the broader system of government. The hope was that political scientists would develop broad theoretical approaches that would be validated by quantitative empirical methods, thus moving political science away from the disciplines of history, law, and philosophy and instead bringing it closer to the scientific approaches of economics, sociology, and psychology.

By the mid-1980s many political scientists had begun to question whether the discipline should continue to ignore the traditionalist interest in political institutions—but without abandoning what behavioralists had learned in examining the choices of individuals. They also worried that behavioralism could bring the field only so far and that perhaps nothing more could be learned from that approach. Therefore, a “postbehavioralist” movement, neoinstitutionalism, arose, designed in part to bring the study of institutions back into the discipline.

The new institutionalist approach has its roots in the early to mid-1980s. Often considered two of the leading founders of the new institutionalism, American political scientist James G. March and Norwegian political scientist Johan P. Olsen published a very influential piece, “The New Institutionalism: Organizational Factors in Political Life” (1984), followed by a book, Rediscovering Institutions: The Organizational Basis of Politics (1989). They continued to argue for further institutional analysis in Democratic Governance (1995). In each piece, March and Olsen argued that political scientists needed to rediscover institutional analysis in order to better understand the behaviour of individual political actors within political institutions. In other words, according to those authors, studying individual political behaviour without examining institutional constraints on that behaviour was giving scholars a skewed understanding of political reality.

Streams of neoinstitutionalism

One of the reasons that there is no single agreed-on definition of a political institution is that the neoinstitutionalist approach encompasses a wide variety of complementary, but clearly different, methodologies. There are at least three branches of neoinstitutionalism: rational choice institutionalism, sociological institutionalism, and historical institutionalism.

Rational choice institutionalism

Rational choice institutionalism, which has its roots in economics and organizational theory, examines institutions as systems of rules and incentives. Rules are contested so that one group of political actors can gain leverage over another. Political decision making is explained through modeling assumptions and game theory, as challengers and holders of political power pit themselves against one another. Thus, rational choice scholars often focus on a single institution in a specific time frame, although some look at institutions across time.

Sociological institutionalism

This stream, which has its roots in sociology, organizational theory, anthropology, and cultural studies, stresses the idea of institutional cultures. Scholars of this stream view institutional rules, norms, and structures not as inherently rational or dictated by efficiency concerns but instead as culturally constructed. They tend to look at the role of myth and ceremony in creating institutional cultures, as well as the role of symbol systems, cognitive scripts, and moral templates. At times they take on a normative (usual and customary) approach to the study of political institutions, and they tend to blur the line between institutions and culture. Their work often focuses on questions of the social and cultural legitimacy of the organization and its participants.

Historical institutionalism

Historical institutionalism is the hardest of the three streams to define because it includes so many different scholars and so many different methodological approaches. It is based on the assumption that institutional rules, constraints, and the responses to them over the long term guide the behaviour of political actors during the policy-making process. Historical institutionalism mixes the quantitative analysis of the rational choice stream with the idea- and culture-based thought of the sociological stream. It includes an eclectic group of scholars with a wide variety of research agendas.

Despite the differences, there are some common notions in this line of research. Historical institutionalists seek to define and explain specific real-world political outcomes, such as an election, using the historical legacy of institutional structures and feedbacks available to them. They also view politics as a competition over scarce resources and highlight differences in political power between institutions, such as between the courts and the legislature. They consider decision trees and path dependence, terms of art meaning the effects that one decision has to limit the available future choices for any political actor or institution. Historical institutionalists note that institutions do not perform with perfect efficiency (because they were designed in earlier times) and institutional rules (such as the insistence on supermajorities or unanimity in voting) are slow to change, and, thus, those factors must be taken into account in any analysis.

John T. Ishiyama Marijke Breuning The Editors of Encyclopaedia Britannica

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Luxury Pattaya Holidays

Visit an exotic land with a buzzing nightlife, idyllic white beaches and tropical islands topped with emerald forests.

Guide to Luxury Holidays in Pattaya

Nestled on the east coast of the Gulf of Thailand, Pattaya is a city renowned for its white sand, palm-lined beaches and lively neon-hued bar scene, featuring cabaret shows and cocktail lounges. Historic buildings and temples provide cultural insights and unique museums celebrate the local history. Luxury Pattaya holidays offer world class hotels, seaside retreats, and a thrilling nightlife.

A two hour drive from Bangkok, Pattaya is one of the most famous resorts in Thailand. Walk sugary sands lapped by emerald and turquoise waters and delve into the resorts leisure activities, like scuba diving, fishing and golfing. Stop by the five floors of the Central Festival shopping mall at Pattaya Beach and browse over 300 exclusive stores and local boutiques. Be sure to visit the floating market with boat-stores selling handmade goods and Thai produce.

Take a trip to the Gems Gallery Pattaya and shop at a massive jewellery store with endless rows of fine rings and necklaces studded with rare stones. Encounter elephants and tigers at wildlife sanctuaries and spend a day strolling unique attractions like Art in Paradise, an interactive art museum with 3D artworks that put you in the picture. Take a boat tour to one of the beautiful surrounding islands, like Koh Larn Island, and explore more divine beaches.

Head to the north of Pattaya to the Naklua district and find a more traditional Thai atmosphere. This part of the city enjoys a relaxed, laid-back vibe with golden sands shared by local fisherman. It's a great place to get a taste of everyday Thai life. The area's also home to the stunning Sanctuary of Truth, an ornate wooden building made without a single nail.

Pattaya enjoys sunny weather all year round with temperatures averaging 30 degrees Celsius. The most popular time to visit the city is from November to January when there is less humidity and rainfall.

If you love the heat, from February to June is the hot season, when temperatures rise to the high 30s. The wet season is from July to October, and you'll find that during these months the hot weather continues, but with additional short showers, that leave behind blue skies and cool breezes.

As with any holiday, it's a good idea to carry some identification with you and to keep a photocopy of your passport. British passport holders don't need a visa to enter Thailand for stays up to 30 days. Longer stays require a visa. Visit GOV.UK for more travel advice.

Enjoy fine dining at your luxury hotel in Pattaya. Begin your morning with fresh pastries and international breakfast buffets. In the evening, try a gourmet buffet or a la carte menus. Sample traditional Thai cuisine, from chicken green curry to massaman lamb, and Chinese specialities like dim sum.

You'll also get to taste authentic Italian dishes such as carbonara, baked pizza and lasagne. Try lots of different seafood, like lobster, cooked and served to your particular preferences. Relax and watch the sunset with a tropical cocktail in hand.

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Speak to one of our Pattaya experts about planning your dream holiday today

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FOTO Rehab Outcomes Blog

Models Used for Risk Adjustment

The questions are being asked across the pond. It is now a global concern to better understand the accuracy of predictions.

The rehabilitation industry has move ahead to assume more responsibility than just measuring a person's functional ability. Systems are now in place to also predict how much change should occur for a person receiving rehabilitation services. This is the first paper that I am aware of that is asking the next question: How accurate is the prediction? In my opinion, a systematic review proves to be a challenging method to answer questions. When you think about it, systematic reviews typically have quite a bit of heterogeneity which makes it difficult for clinicians to actually apply what is learned into practice. This particular publication that I reviewed did it's best to focus on what we in the United States would term risk adjustment. I was introduced to a new term: case-mix adjustment (which as I read the paper seems to be the same as risk adjustment).

Predictive ability across US study models ranged from 18-42% and in UK models from 23-30%, demonstrating moderate to strong predictive ability across models.

See What FOTO Risk Adjusts

 If we use common sense, a model that only focuses on patient factors will be 100% accurate. A final treatment outcome includes far more than just patient factors. If you think of what rehabilitation looks like, there are other factors that play a role in treatment outcomes: clinician factors, patient-clinician factors and clinic factors. I'd like to think that a clinician's belief system affects an outcome. I'd like to believe that the strength of the therapeutic alliance has a role. I'd also like to think that the way an organization structures patient experience also has a role. In my mind, if a model that only focuses on patient factors is able to accurately predict the outcome 40-50% of the time, the model is very strong.

Because there are now more products on the market that risk adjust, I take the stand that the industry needs to demand the percentage of variation in the product's ability to predict the clinical outcome. The next step then includes defining the power of the product's predictive ability. As an example 0-15% variation explained = poor; 16-25% variation explained = limited; 26-30% variation explained = average; 31-42% variation explained = good; >42% variation explained = excellent. Since I am just thinking out loud with this concept, I would also propose that 26-42% would be defined as the typical industry standard to meet when providing predictive analytics for clinicians. The reason I believe this is important is because outcomes are compared in aggregated data. If the risk adjustment process is not able to adequately capture the important factors to increase the predictive accuracy, then clinicians will be unfairly compared.

The abstract is included below for you to review.

 2018 Nov 9. pii: S0031-9406(18)30292-X. doi: 10.1016/j.physio.2018.10.002. [Epub ahead of print]

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