Virginia Bar Takes Aim at Avvo

Virginia Bar takes aim at Avvo

This post was written by Megan Zavieh and originally published on on October 31, 2017.

On Friday, October 27, 2017, Virginia Bar’s Standing Committee on Legal Ethics voted to send Legal Ethics Opinion 1885 to the Supreme Court for Adoption. LEO 1885 addresses third-party platforms offering legal services on a flat fee basis. While it could easily be read as “Avvo has been shot down in Virginia,” the opinion highlights a relatively small flaw in the business model and a map toward partial acceptance of those types of services. Still, it blocks those services from operating in Virginia, thwarts a type of legal service that the public has broadly accepted, and forecloses an avenue available to bridge the access-to-justice gap.

Not Avvo-Specific

LEO 1885 does not identify Avvo by name. Avvo is well aware that the model described in the opinion closely resembles a business unit of Avvo, but the opinion is not limited to Avvo nor does it provide an entirely accurate depiction of how Avvo runs its service. Thus, although it is easy to read the opinion and think only of Avvo, this is a more general opinion that has the potential to impact multiple companies offering or considering offering a third-party platform for delivery of legal services.

The opinion describes a business model it calls an “attorney-client matching service” (ACMS), which it describes as a for-profit entity that provides an online platform for matching attorneys and clients. An ACMS gives a client a limited scope fee agreement, and the client pays the full fee to the ACMS. The lawyer does not negotiate the scope of services or the fee, nor does the attorney receive any of the client’s money until the services have been performed. The lawyer agrees to provide flat fee legal services under ACMS’s terms. When the matter has been completed, the attorney receives the full amount of the legal fee paid by the client. Then, ACMS auto-debit’s the attorney’s account for a “marketing fee” which varies based on the amount of the legal fee received.

Related: Fee Agreements for a Small Law Firm: What Lawyers Need to Know

Virginia’s Issues with ACMS Companies

Virginia identified five problems with the ACMS business model:

  1. The lawyer is not properly handling the client’s advanced fee because it is allowing a third-party to hold the funds. Thus, the funds are not being held in an IOLTA account as required.
  2. Since the lawyer has no access to the client’s money until they are paid in full by the platform, they are unable to fulfill their obligation to refund any unearned fees at the conclusion of the matter.
  3. Without being in control of the definition of the scope of legal services or negotiation of the fee, the lawyer may well be understanding representation which violates any number of ethics rules. The services may not be appropriate to the client. The fee may not be commensurate with the value of the services provided. The services may be inadequate for the client’s needs. And so on.
  4. Payment of the marketing fee to ACMS constitutes the sharing of legal fees with a non-lawyer.
  5. Payment of the marketing fee constitutes payment for recommending the lawyer’s services.

Virginia’s Possible (and Partial) Solutions

Virginia laid out its objections to the model while also offering some solutions. On the issue of the lawyer ceding control over the fee and scope of the representation, it stopped short of saying that a lawyer is prohibited from participating in an ACMS. Instead, it concluded that a lawyer could participate so long as, before accepting a matter, the lawyer consults with the client and is satisfied that the services can be performed competently and in compliance with the ethical rules. Also, the lawyer must also exercise independent professional judgment and assure themselves that the fee is reasonable under the rules.

Virginia’s opinion that these issues do not entirely prohibit a lawyer’s participation in an Avvo-like platform provides something of a guide to move forward with delivering legal services in a modern manner. With some tweaks to an ACMS platform, Virginia’s concerns on these issues could be addressed. For example, if the lawyer needs to exercise independent professional judgment over the amount of the fee and also must consult with the client regarding the services needed, an initial phone call between lawyer and client before the client’s payment could resolve these concerns. Avvo’s model could be modified so that before the client can purchase services on the platform, an intake call between lawyer and client must take place.

In fact, the way Virginia identified the issues presupposes the solutions. The lawyer and client must agree on the scope of representation. This can be done within a platform like Avvo. The lawyer must be sure that the description of legal services is complete and accurate. This can also be done. The fees must be reasonable and not excessive compared to the competition. The marketplace will help guard against this problem in the first place, and the lawyer having the obligation not to accept unreasonable fees provides an additional layer of protection.

Ongoing Roadblocks

Though it provided steps forward on the attorney-client relationship front, LEO 1885 does nothing to resolve the ongoing ethical struggle over payment of fees in ACMS platforms. If there is one single issue that holds up the evolution of the legal industry in the modern world, it has to be the handling of client money and legal fees.

Trust Accounting Problems

Trust accounting rules are in place to protect the client, and while it is indeed an essential goal of the profession to prevent the misappropriation of client funds, the rules hold up the evolution of legal services. Virginia concluded multiple problems exist when a client pays a fee to a third-party ACMS at the outset of the matter. First, unearned fees are to remain in trust. As an ACMS is not a law firm, it cannot have an IOLTA or hold client fees in trust. Second, since the fees are not provided to the lawyer, the lawyer cannot hold the funds in trust as required. Third, lawyers have an obligation under the rules to refund unearned fees at the conclusion of the matter. Even in in a flat fee case, it is theoretically possible for fees to remain unearned at the conclusion of the matter, and thus the lawyer would need to return them but has no access to them. Virginia offered no solution to this particular problem. It seems entirely possible that fees could be transferred into the lawyer’s trust account at the outset of a matter, but the fact that they pass through the third-party platform is likely to be a problem on its own. The idea of paying at the conclusion of the matter is not likely to be accepted within the industry of third-party platforms, so some other solution remains needed.

One solution not considered by Virginia in LEO 1885 would be modification to the rules to account for the modern way of doing business and the participation of third-party non-law firm entities.

Fee Splitting

From the advent of third-party platforms like Avvo (including UpCounsel and others), one big issue has been how to pay the service without implicating fee splitting rules. Virginia explicitly held that the substance of the arrangement trumps its form, and a lawyer paying the platform, with that amount having any relation to the amount of the legal fee, constitutes unethical fee sharing.

In Virginia’s hypothetical, the lawyer received the full amount of the legal fee paid by the client, but then the lawyer’s bank account was auto-debited was the “marketing fee.” Virginia stated, “The fact that the ACMS executes a separate electronic debit from the lawyer’s bank account for its ‘marketing fee’ following the firm’s electronic deposit of the full legal fee to the lawyer’s bank account does not change the ethically impermissible fee-sharing character of the transaction.” So, that possible solution to the problem has been ruled out.

Virginia’s key consideration was that the amount of the lawyer’s marketing fee was tied to the amount of the legal fees they earned from the client through the platform, and that correlation makes it fee-splitting. However, the opinion leaves open the possibility that fee splitting can be avoided by tying the lawyer’s fee to the number of clients they receive through the platform or the number of inquiries or clicks on their profile. Here, again, Virginia provided somewhat of a road map to solve this issue.

As innovators work to revamp the legal industry and bring consumers a more modern approach to the delivery of legal services, the most significant hurdle remains the handling of client funds. If the trust accounting piece of this can be addressed within the profession, it would open the door to the industry meeting public demand for better access to legal services. However, this change is going to have to come from a revamp of the rules, not from the ethics committees of the states.

Ultimately, the industry stands in its own way. As Avvo noted in its public comments, application of the ethics rules to preclude operation of a third-party platform is akin to regulating that all Virginia ham be sold with an extra layer of sugar, even if the consumer prefers ham with less sugar. The public is benefited by a service that regulators prohibit in the name of protecting the consumer. At least Virginia began to address some of the roadblocks and offer solutions to them under the current regime. As for the rest of the hurdles, rule changes seem inescapable if we are going to move forward.

The post Virginia Bar Takes Aim at Avvo appeared first on Ethics and California State Bar defense lawyer Megan Zavieh.

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The European Institute of Peace (EIP) hosted 20 young political leaders to participate in a mediation simulation and a spirited debate on democratisation, good governance, inclusion and political transitions.

The delegates from Libya, Algeria, Mauritania, Tunisia and Morocco (including parliamentarians, political party representatives, civil society and business leaders) were invited to Brussels by the European Parliament’s Mediation Support Service to attend seminars and trainings on how to build democracy and sustainable peace.

EIP’s team helped maneuver provocative topics on non-violent solutions to unconstitutional changes of power; election violence; winner-takes-all mentality; and on dealing with inclusion of civil society. In the afternoon, delegates engaged in a mediation simulation exercise in which they had to negotiate a peace deal in a tense political environment in the aftermath of a terrorist attack. In the scenario, mediators from the African Union led complex negotiations between the government and rebel forces while taking into account concerns voiced by civil society actors, businesses and international observers.

EIP’s exercise was designed to get the group thinking about political issues from different levels and perspectives. It also served to expose participants to a snapshot of dialogue and mediation techniques on how to prevent and resolve conflict.

This was the second event of its kind: in April 2015, EIP hosted 12 young political leaders from Sudan to reflect on issues of political pluralism, tolerance of others, peaceful consensus building, reconciliation and conflict resolution. The EIP session focussed on creating a forum for developing a culture of peace and what it could mean for the future of Sudan.


Working With the Works of Women, No.1

Women In Public, by Elaine Kahn

Poetry, for me, is purely a process of interpretation. When reading a new text, I find that certain groups of words resonate with me more than others. Whether this is due to a current understanding of the world, or simply a liking of an author's word choice, I notice that I begin to pick, collect, and compile phrases from poetry.

This process of selecting passages and rearranging them into new formats is a way of understanding art through a self-oriented set of lens. Rearrangement of an already produced work then becomes a way to create and navigate art, written word, in a more intimate manner. With this approach, art can take on a uniqueness represented by a disordering of one's order into newly created patterns.

How can poetry be transferred into fashion? Similarly, to how one can read and rearrange words to create their own “poems” or means of understanding, I take certain phrases and express them through sketches.

An outfit may aim to express the mood of a poem, or it may aim to sew together certain components of a poem.

For Kahn’s “Negative Desire” phrases such as “There is nothing wrong with being sensitive”; “I make myself into a line”; and “The black boxes of my body floating just above the earth” all feed into my design.

This poem is seemingly dark, as we read mention of potential murder, and a wanting to disappear. Nonetheless, these words are written and living in the world. If they were to be transferred through the art of fashion, how could they be represented?

I started by chopping up tracing paper into tiny boxes. The translucent nature of these sheets emphasizes this want to “make [oneself] into a line.” Then through adding color tints and layering sheets, I sketched black marks around a variety of boxes to directly relate to Kahn’s mention of boxes. As the voice of the poem mentions the floating nature of boxes, this dress is likewise lightweight and almost hovering.

At first glance this dress is opposite to Kahn’s poem. It is nowhere near dark, and it in no way causes one to disappear (if we imagine one wearing it). Because this poem has been represented as graceful and elegant, we are led to question is pain beautiful or should it be represented as so?

Is it appropriate to grab inspiration from words and translate their meaning into something else?

My focus with this piece is to cause individuals to ask “how?” and “why?” At first it is obvious to ask: How do these two connect? and Why was this poem represented in this way? But what if we asked “What?”
What is the responsibility of the designer?

It is known that the world is far from utopic. So, what does this mean for fashion designers that draw inspiration from the world around them? If fashion has a responsibility to translate poems, movies, novels, magazines, current events, and even moments between individuals into the art of fabric, then they will indefinitely come across the challenge of relaying a dark message.

I ask you, the reader, the viewer, is it responsible to depict something sad, dreary, yet unavoidably there, as beautiful?

A portion of the poem "Be A Friend" From Elaine Kahn's Women IN Public

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Spain offers to host UN Climate Change Conference

2019-11-01 08:54:15Xinhua Editor : Gu Liping ECNS App Download

Spain has offered to host the United Nations Climate Change Conference (COP 25) in Madrid following the decision from Chile to step down as host for the event due to the ongoing street protests in the South American country.

The acting Spanish government of Pedro Sanchez issued a communique on Thursday indicating Spain would be willing to host the conference respecting the dates the event was due to be held on in Chile, which is Dec. 2-13.

In its communique the Spanish executive explained that "multinational action on the climate is a priority on the agenda of the United Nations and the European Union and demands a major commitment from everyone."

Chile's President Sebastian Pinera welcomed the Spanish offer, saying he hoped the "generous offer from the president of Spain" represented a solution and adding that his government had "shared this information with the leading authorities at the United Nations."

The annual Conference of the Parties (COP) summit is a key event which allows representatives from around 200 nations to monitor and discuss the current situation of the world's warming climate and the event usually attracts thousands of delegates along with journalists and climate activists.

If Spain's offer is accepted, the COP summit would be held just three weeks after the Nov. 10 general election is due to be held in the country.

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Historical Atlas of Modern Europe
by R. Lane Poole

code no.Plate namecommentspixelskilobytesPriceBuy
0036:0001The Roman Empire from Diocletian to the death of Theodosius (285-395 A.D.)4117x303111239$4
0036:0002Europe 395-527 A.D.: The Barbarian Invasions.3859x303110524$4
0036:0003Europe, 527-750 A.D.3890x300010182$4
0036:0004Europe in the time of Charles the Great4086x302110822$4
0036:0005Europe at the time of the restoration of the Empire in the west by Otto the Great, 962.4066x301011345$4
0036:0006Europe at the time of the Third Crusade8201x639045589$8
0036:0007Europe in 13604045x300012022$4
0036:0008Europe at the Accession of the Emperor Charles V8423x642349124$8
0036:0009Europe after the Peace of Westphalia, 1648.4045x300011531$4
0036:0010Europe in the eighteenth century prior to the French Revolution.4024x304111663$4
0036:0011Central Europe from the Peace of Basle to the War of the 2nd Coalition. Central Europe from the Peace of Lunéville to the Decree of the Imperial Diet.7874x571038844$3
0036:0012Central Europe from the Establishment of the French Emp[ire] to the Abolition of the German Emp[ire]. Central Europe from the Peace of Tilsit to the War with Austria.7865x578335821$3
0036:0013Europe, 1814-18634086x296912718$4
0036:0014Central and Eastern Europe, 1863-18978345x633451064$8
0036:0015Roman Britain.3848x30109396$4
0036:0016England and Wales before the Norman Conquest2979x397210487$4
0036:0017England and Wales in 1086. Wales and the Borders about 1185.6337x823843839$8
0036:0018England and Wales under Edward I2979x395210199$4
0036:0019The ecclesiastical geography of England2979x395210488$4
0036:0020England and Wales under the House of Lancaster2979x410710824$4
0036:0021Anglia Monastica2979x392110669$4
0036:0022England and Wales after the accession of the House of Tudor2948x392110653$4
0036:0023Parliamentary representation of England and Wales2948x39219717$4
0036:0024England and Wales shewing the Parliamentary Representation according to the reform Act of 18326406x820143104$8
0036:0026The ecclesiastical organization of Scotland in the Middle Ages2948x392110610$4
0036:0027Scotland, c. 16002948x392111315$4
0036:0028Scotland showing the distribution of the Principal Clans & Families. Scotland showing the Parliamentary Representation before 1832.8211x639143474$8
0036:0029Early Ireland3890x303111003$4
0036:0030Ireland under the Tudors3859x304110661$4
0036:0031Ireland from 1541-16533859x296910594$4
0036:0032The Frankish dominions in Merovingian times (486-768)3890x301011043$4
0036:0033The Frankish dominions in Carolingian times (768-900)3879x303111303$4
0036:0034Germany under the Saxon and Salian dynasties (919-1137)3879x303111580$4
0036:0035Germany under the House of Hohenstaufen, 1138-12543879x303111500$4
0036:0036Germany in the Later Middle Ages (1273-1492)3879x303112611$4
0036:0037Germania Sacra illustrating the ecclesiastical divisions in the Middle Ages3879x303111609$4
0036:0038Germany during the period of the Thirty Years' War [western part]6338x821353460$8
0036:0039Germany during the period of the Thirty Years' War [eastern part]6450x833847705$8
0036:0040Germany at the Peace of Westphalia8028x621951050$8
0036:0041Germany 1648-17958029x620150371$8
0036:0042The Growth of Prussia 1415-18907901x617449029$8
0036:0043The Formation of the Modern German Empire8001x621947143$8
0036:0044The Swiss Confederation.3879x303112078$4
0036:0045Hungary, 997-13823879x303110081$4
0036:0046Hungary, 1382-17393879x303111114$4
0036:0047Poland & Lithuania3879x30319548$4
0036:0048Poland from the Union of Lublin to the third partition, 1569-17953879x30319662$4
0036:0049Russia, 1613-18783021x39319348$4
0036:0050Scandinavia, 13th century6339x816445369$8
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0036:0052The Netherlands2979x393111157$4
0036:0053France, Lotharingia, and Burgundy in the Eleventh and Twelfth Centuries2979x393111048$4
0036:0054Northern France in 10663931x297911357$4
0036:0055France in the Thirteenth Century2979x393111360$4
0036:0056France during the Hundred Years' War3890x301010456$4
0036:0057Gallia Sacra3000x40009926$4
0036:0058France under the Ancien Régime, 1600-17903000x400010023$4
0036:0059The French Empire in 18108028x622944029$8
0036:0060The Spanish Peninsula, 1263-14924000x30009208$4
0036:0061The ecclesiastical organization of the Spanish Peninsula4000x30009551$4
0036:0062The Spanish Kingdoms since 15134200x30009817$4
0036:0063Italy in the Lombard period, A.D. 568-7743000x40008849$4
0036:0064Italy c. 1000-1067. Italy between c. 850 & 1000. Sicily under Saracen Rule.6301x818845352$8
0036:0065Italy c. 1060 - 11676363x825146105$8
0036:0066Italy c. 1167 - 12506276x816444473$8
0036:0067Northern Italy in the fourteenth and fifteenth centuries3000x40009825$4
0036:0068Italy after the Peace of Lodi (1454)2925x39009067$4
0036:0069Italia Sacra illustrating the ecclesiastical divisions in the Middle Ages3000x39009048$4
0036:0070The House of Savoy in Italy3000x40009143$4
0036:0071The Eastern Roman Empire in the tenth century (plate I.)3000x40009863$4
0036:0072The Eastern Roman Empire in the tenth century (plate II.)3000x40009792$4
0036:0073The Eastern Roman Empire from the death of Basil II to its fall (1025-1472)4000x30008759$4
0036:0074South-Eastern Europe and Asia Minor, c. 12104000x30008456$4
0036:0075The Eastern Patriarchates c. 750. Patriarchate of Constantinople 911. SW Asia Minor.7991x619141365$8
0036:0076Syria during the Period of the Crusades, 1096-1291. Kingdom of Cyprus.6351x827640091$8
0036:0077Western Asia under the Abbasid Caliphs (786)3900x30008739$4
0036:0078Western Asia under the Mohammaden Dynasties c. 970 and c. 1070 A.D.4000x30009788$4
0036:0079Western Asia at the time of Saladin, A.D. 11904000x30009834$4
0036:0080Western Asia under the Mongols, A.D. 13304000x300010760$4
0036:0081Western Asia under the Turks & Persians8310x643847461$8
0036:0082The Ottoman Empire in Europe 1356-1897 6276x812644965$8
0036:0083The Kingdom of Delhi, A.D. c 1340. The Moghul Empire at the death of Akbar, A.D. 1605.8074x619242171$8
0036:0084India in 1792. India in 1845. Burma showing British Acquisitions, 1826-1890.8110x624645000$8
0036:0085European explorations and colonies from the fifteenth to the seventeeth century4150x31008615$4
0036:0086European colonies and dependencies after the Peace of Utrecht (1713)4000x30008006$4
0036:0087European colonies and dependencies, 17633993x30008837$4
0036:0089European colonies and dependencies, and states independent of European powers, 1815-18973993x30009730$4
0036:0090South Africa previous to the Suppression of the Boer Republics.8019x620147094$8

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True Blood: The Complete Second Season Overview

Sookie Stackhouse (Anna Paquin) is working in a rural bar and although she seems like a normal young woman, she's actually harboring a big secret—she has the ability to hear the thoughts of others. Things get even more complicated when she meets Bill Compton (Stephen Moyer), a 173-year-old vampire, and the two are instantly drawn to one another.

In Season 2, Sookie and Bill's relationship grows even stronger as a range of other supernatural forces and characters are introduced.


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Uber is going to offer riders a four-digit code to help riders identify and get into the correct car.  This will be available in United States and Canada and the feature will be rolled out by the end of this week.  Uber will send a four-digit code to the rider then before getting into the car the rider tells the driver the code and the driver enters the code into the app.  When both numbers are matched the rider will be notified that the ride is verified. “They can see the confirmation before getting into the vehicle and they don’t have to take the driver’s word for it,” said Rebecca Payne, senior product manager at Uber.


YEAR INDEX  09/04/1995 Clay Pigeon Kart Club

Photos for this event are grouped by class and listed in sequential order. Problems finding your photos on this event? Drop me an email with the event, class and number, and I will try to help.

These samples are the size of the smallest, phone size photos which cost just £2 each, and have no watermarking on! Why bother copying the watermarked thumbnails when you can have an image more than twice the size, better quality and without all the writing for just £2?


Zombie Gunship Survival APK Description

Zombie Gunship Survival apk is a zombie survival game. The whole world is a zombie attack. Your mission is to destroy them and let them live safely. If not, then they can only be eliminated. Players need to protect humans from the sky and build shelters on the ground to escape the undead.


Chairman’s Message

CFA Chicago Annual Dinner: 28th Annual Dinner

CFA Chicago Annual Dinner Keynote: Governor Jon Huntsman, Jr.

CFA Society Chicago celebrated a class of 140 new charterholders during the CFA Chicago 28th Annual Dinner held at the Navy Pier Grand Ballroom. The festivities commenced at 5 p.m. with networking and drinks. Prior to the start of dinner, entertainment was provided by the City Lights Quartet.

CFA Chicago Chairman Christopher Vincent, CFA, opened the proceedings by welcoming the new CFA charterholders and thanking the dinner underwriters. There were 53 corporate sponsors (45 bronze, 2 silver, 8 gold, 4 platinum and two premier sponsors) for this event.  The premier sponsors were Harris Associates and UBS Global Asset Management.  Each new charterholder attended gratis, courtesy of CFA Chicago.  The event greatly benefited from the organizing efforts of Doug Jackman, CFA and Stephen Moy, CFA who lead the Annual Dinner Advisory Group.

The winner of the 2014 Hortense Friedman, CFA, Award for Excellence was Ralph Wanger, CFA.  This award honors a CFA Chicago Founder and prominent institutional investor.  Ralph Wagner began his investing career with Harris Associates in Chicago in 1960.  He is currently Head of Columbia Wagner Asset Management, L.P. and is an Advisor to the Acorn Fund.  In his brief remarks, Wagner reflected on his long career and the people in Chicago he met along the way.

The evening continued with a keynote address by Governor Jon Huntsman, Jr.  Gov. Huntsman has led a life devoted to public service.  He was twice voted Governor of Utah (2005-2009), and was U.S. Ambassador to China (2009-2011).  In 2012 Huntsman ran as a candidate for the Republican Nomination for President.

In an era of increasing ideological paralysis in politics, Gov. Huntsman stressed that bipartisanship is the only way to move forward to solve the problems of the United States.  He now serves as co-chair of No Labels, a citizen’s movement of Democrats, Republicans and others dedicated to promoting a new politics of problem solving.  In his opinion, the major challenges facing the US can be summarized by the following four issues; 1) Entitlements 2) Budget Deficits 3) Energy Security and 4) Jobs Security.

He stressed the importance of the mid-term elections and the fact that 42% of voters are now calling themselves unaffiliated. He predicted that the Republicans would gain control the Senate; however this did not mean that the ideological paralysis would go away.  Dissatisfaction with incumbents has skyrocketed because no viable solutions are being offered.

In the short Q&A following the event, Gov. Huntsman commented on the state of the Republican Party, and the role of China and the US in the global economy.  He fears that the Republican Party has lost its connection to its Lincoln, Eisenhower and Reagan roots.  His opinion is that in the global marketplace it is China who takes the long view, while the US is more focused on short-term results.  His best example of a leader in the world today is Alan Mulalley former CEO of Ford, who led his company through trying economic times.

Following Gov. Huntsman’s keynote address and Q&A, there was more opportunity for networking. Drinks, coffee and cookies were provided to attendees who wished to stay after dinner.

 View Photos from the 2014 CFA Chicago Annual Dinner

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I Need to Stop Misusing Namespaces

At the recent NSBCon one interesting question that came about was how to structure a project. The panel consisting of various speakers had no answer, after all this is dependant upon the project in question. Therefore there is no right or wrong answer.

However one point they were in unison about was splitting the domain and technical implementation of a project apart by the correct use of in namespaces.

This is not the first time I've come across this, but I find myself breaking this principle on a regular basis. For example a typical project I work on looks like the following.

Use namespaces for related domain responsibilities. In turn, group together the objects and types that are used together.

An example of a better solution therefore would be:

While this is the ideal way of structuring our applications it's not always possible. Some coding conventions actually encourage the first example, and depending on the configurability of certain frameworks this may prove difficult. That aside, I'll be making a strong push towards structuring my projects correctly going forwards.


What makes Camp Manitou great?

Camp Manitou is a summer camp and year-round outdoor recreation facility located five minutes outside of Winnipeg. With its forests, large grass playing field, and the Assiniboine River on three sides, this 28 acre oasis provides lots of space in which to enjoy nature. We provide a wide range of activities, challenging educational programming, and the perfect environment to step out of the everyday and connect with nature.

Camp Manitou is proud to be an accredited member of the Manitoba Camping Association. Our camp is committed to meeting industry standards and providing a safe environment for our campers and staff.


Systematic Review Of Survival Rates

Ethical clearance was not required as this is a systematic review of literature, and anonymized data was used. [20] in their study have reported that more stress was observed in the solitary type than in the bar splinting type when the photoelastic stress distribution was assessed in ods with three mandibular implants according to the retention mechanism. The majority of studies (80%) were conducted with patients who had completed treatment. The remaining 34 trials explored interventions aimed at reducing patients' levels of anxiety. By way of illustration, three legal cases are presented in table 1.

Systematic Survival
Systematic Survival

Bmc international health and human rights. [6] in clinical situations involving poor posterior ridge form, reducing posterior mucosal support in this manner may be advantageous as it prevents rotational movements of the prosthesis. Finally, interactions of smoking status with age at diagnosis, menopausal status, body mass index, er/pr status, regional or distal involvement and treatments were assessed. Revealed", i encourage you to go to my website and explore what this book. Meanwhile, the next episode of “. It's also beneficial to begin a healing regimen with a cleanse of the kidneys, liver and colon to remove stored toxins. We also collected data on potential explanatory variables, that is, variables that may explain variance in effect size. This was a turn in history that very few anticipated. Outcome measures assessed were change in weight, length/height, head circumference, body mass index (bmi) and mortality rate.

Systematic Survival
Systematic Survival

We have reviewed systematic survival today and published a research document. There was large fear that iraq would employ weapons of mass destruction, this had been the case a few years earlier during the war between iran and iraq. Also concluded that cps is one of the best predictors of survival and is. Guidelines for treatment planning of mandibular implant overdenture. First, some data were excluded from our analysis, which could cause some bias in our estimates, but was unlikely to change. Patients with intermediate-2 and high-risk myelodysplastic syndrome (mds) have a survival rate of 0. How is the consensus conference organised.

Systematic Survival
Systematic Survival

The systematic review of the literature shows that alteration of the p53 gene in the lung cancer cells is a poor prognostic factor for survival in patients with nsclc. The press who showed up were surprised to find trump hosting a panel of three women who have accused bill clinton of sexual assault or rape – paula jones, kathleen willey, and juanita broaddrick. , an organizer with the brooklyn-based families united for racial and economic justice, told alternet that news of proposed cuts to hud didn’t come as a surprise. In order to benefit from the increased number of implants, the crowns should be splinted together. The whois data for systematic survival is public which is generally the good thing.

Systematic Survival
Systematic Survival

A crying and smiling baby. So any apical migration of the gingival margin should be noted and monitored, even though there is no evidence that gingival stability is important for implant survival over the long term. Risk of death, equivalent to an absolute benefit of 5% at 5 years). Lancet, has revealed that cancer survival is increasing across the world, however, some countries are faring better than others. Thus, 50% of infant deaths in ethiopia occur during the first month of life; and almost one in every twenty babies born in ethiopia (46. With family, friends, and coworkers) domains [22, 28]. Much of this variation is thought to be due to differences in environmental risk factors as the incidence rate of colorectal cancer in migrants approaches that of the host country within one or two generations (58). However, although her physical comfort improved with treatment, her overall distress remained.

Systematic Survival
Systematic Survival

This commentary summarizes the levels and trends in child mortality as well as the coverage and quality of key maternal and newborn care from pregnancy through childbirth and the postnatal period as discussed in the unicef report. No specific statements on the views of manual therapy were offered. (15) found that a four-level ordinal definition of diabetes based on an oral glucose tolerance test significantly predicted hospital complication mortality (or 1. Evidence based practice for information professionals. 7 stata (version 10) was used to summarise positive predictive values (ppvs) and to plot forest and likelihood ratio graphs. The only way to make sure you are not eating food that has been genetically modified is to eat organic food or food labeled non-gmo. Unlike incidence or mortality statistics where the total population is included in the denominator, only diagnosed patients are included in the survival calculations. He recognised that what the bullet holes were in fact showing was where a plane could be hit and still survive to make it home. Risk may not be worth the side effects of adjuvant treatment.

Systematic Survival
Systematic Survival

, comorbidities, tumor histology) might exist and bias the analysis results in the study by mazzone et al. Keywords: zirconium oxide,biomaterial,biocompatible,bone implant contact. The gulf monarchies had listened with cynicism to obama’s news conference and to his promise that his plan, once it was ready, would include partner nations. Research: the authors did not state any implications for research. Keywords = "posterior partial edentulism, short dental implant, systematic review",. Neonates whose mothers attended antenatal visits exhibited lower risk of death than those whose mothers did not [26]. The exclusion criteria were as follows: animal study; diagnostic criteria setting; mechanism; genetic change (i. The limited attention given in policy to survivorship and expert assessments of the evolving needs of cancer patients highlight the fact that many policymakers are still unaware of just how many people are living with or beyond cancer, and the extent to which their numbers are swelling every year. A systematic review, published in the. Crc-p is rare, leading to symptoms being overlooked, and diagnosis made at advanced stages.

All but one study, harwood et al. 2 interestingly, a recent study showed that decitabine induces expression of p53-inducible ribonucleotide reductase, an effect that is independent of its hypomethylating activity. The strength of this particular systematic review is that the presentation of the information and data has been done in such a way that it is easy to follow from the beginning to the end. Later prussian and german generals, such as helmuth graf von moltke, were clearly influenced by clausewitz: moltke's widely quoted statement that "no campaign plan survives first contact with the enemy" is a classic reflection of clausewitz's insistence on the roles of chance, friction, "fog," uncertainty, and interactivity in war. Other instructions in blood support elixir turn off blood flow to tumors.

Implant survival rates in partially edentulous patients: a 3-year prospective multicenter study. Cancer that spreads outside the prostate gland to the lymph nodes, bones, or other areas is called metastatic prostate cancer. All causes of child death – globally. However, time to diagnosis ≥90 days was associated with a higher mean number of relapses [23] (level of evidence 4). Where can i get systematic survival. [12] as this systematic review included both prospective and retrospective studies, hawker's criteria were found most suitable to assess the quality of the included studies. The proportion of original cohort members eligible for analysis at ten years in these four studies ranged from 6% to 59% (see table 1).

0%)] and the longest survival time (approximately 3,182 days). Moreover, implants with 10 mm length (10. The health extension workers, females who have completed tenth grade and trained in health extension program modules for one year, provide family planning and immunization services; they promote preparedness for birth and readiness for complications and active management of the third stage of labor among others [40]. 4 doctors face two challenges in prognosticating near the end of life:. The iterative and multifaceted search strategies employed, however, should have minimized the number of unidentified references. Debacker 2008 ij pros rct really bad for 4 unit bridge especially maxilla. The following visualisation shows the child mortality rate for all countries in 1955 and six decades later.

Statin use has been associated with improved survival outcomes in various malignancies. The remaining 18 trials evaluated modifications to aqueous shunts, including 14 trials of ahmed implants. Considering that insomnia symptoms tend to be exacerbated during chemotherapy, berger et al investigated whether sleep could be improved with an individualized sleep-promotion plan including the cbt-i components of stimulus control, sleep restriction, relaxation therapy, and sleep-hygiene counseling in a group of women undergoing chemotherapy for breast cancer. Less likely side effects include nausea, liver problems, and fatigue. A huge crater was made in a road at elephant & castle, london on september 7, 1940, after a night raid on london. (g) mean is more robust to outliers. When comparing the overall long-term (that is, 15 years or more) tooth loss rate with that of implants, the authors observed rates ranging between 3. Systematic survival scam or legit.   many times, as you can see from the meta-analysis below, the long term success rates are the same. Statements as innocuous as, “acupuncture works for many patients like you for this problem,” are backed up by evidence from one of the most respected databases of systematic reviews.

Her article about corporate exploitation of the refugee crisis was honored as a top censored story of 2016 by project censored. Passive defense requires measures that are taken to protect yourself from expected threats. , statistical analysis, biostatistics, computational analysis): m. Finally, the farmer can hire laborers to the harvest the fields at a rate of $5 per hour. Author = "giugliani, {elsa r j} and horta, {bernardo l. This need can be served by meta-analysis.

Chamberlain (2006) - demography in archaeology-cambridge university press (cambridge manuals in archaeology). With another treatment for metastatic melanoma. We included all papers published in english language, having an abstract and describing interventions put in place to reduce neonatal mortality due to neonatal tetanus. Doctors sometimes also recommend that lymph nodes near the area where the breast cancer was removed be included in the area that gets radiation. All patients with grade 3 breast cancer had died. To assess risk of bias across studies, scores were summarized for each of the 12 assessed items. Ms dreier drafted the initial manuscript that was jointly finalized by all authors and is the guarantor of the work. Finally, studies not performed in humans, written in a language other than those listed in table 1, or with fewer than ten participants were excluded. Media interventions are defined as organized and purposive activities that utilize a variety of media channels to inform, persuade, or motivate populations [1]. Orman s, stÃ¶ckl h, busza j, howard lm, zimmerman c.

  actually, you should have a couple. In this situation, immediate therapy resulted in a significant improvement in progression free survival, prostate cancer specific survival, and overall survival. Surviving is almost an art and that is why practice and knowledge is the thing that you need to make sure that you have gotten it all right. Data were extracted from each intervention study about the sex, age, disease, and treatment characteristics of the patient group targeted, the nature of the psychological therapies investigated, the nature of the outcome measures assessed, the length of follow-up, and the study design.   we will have a lecture on the concept here in jacksonville in october of 2016. This is not an opinion; it is a statement of fact that's based on this author's first-hand experience. It doesn’t take a genius to understand that america isn’t as safe as it used to be. To report on any of the following specified outcomes of interest: response rates, progression-free survival, overall survival,.

, recording whether the light was red, green, or yellow at that time. The children were diagnosed at 0 to18 years of age and their mean age at diagnosis ranged from 3. Howard ra, the foundation of decision analysis revisited: advances in decision analysis. Knowledge of their risk, both within or outside screening programmes, may also encourage adoption of more healthy lifestyles which might further improve outcomes: it is estimated that between 30% and 70% of the overall burden of colon cancers in the u. Farber j, weinerman b, kuypers j, behark k. In a publication in the american economic journal the authors report that thailand's 2001 healthcare reform led to significant reductions in child mortality, especially among the poor. Studies on the benefits of breastfeeding have demonstrated substantial benefits for child health [3, 4]. Are there any circumstances that may deny you access to a key avenue of approach or a sustainment node. So first thing’s first, what is a systematic review.

Systematic Survival Battle Plan

(18) reported rates of 30-day mortality in clinical populations with cancer of the gastrointestinal junction or gastrointestinal junction/esophagus, respectively. The us fish and wildlife service 1987 northern rocky mountain wolf recovery plan proposed reintroduction of an “experimental population” of wolves into yellowstone. Prostate cancer review fact sheet. Brca1/2 carriership and breast cancer survival. We found an exponential relation. After using systematic survival battle plan for some ideal time at this point, we have realized that it is one of the best solutions we have ever previously come across. Results of a systematic review including two large trials have confirmed that adding a drug called abiraterone to standard long-term hormone therapy helps men with prostate cancer that has spread to live longer.

Our systematic review demonstrates that, compared to conventional care, treatment with hypomethylating agents and specifically 5-azacitidine, prolongs overall survival and time to aml transformation or death, despite increased treatment-related mortality and lack of difference in early mortality. Neither of the two studies reporting unadjusted estimates from regression models found a significant difference. Therefore, future studies should include careful planning of the timing of obesity measurement to elucidate the causal mechanisms surrounding adverse survival in obese women with ovarian cancer. This review contributes to the evidence base for the generation of an updated world health organization (who) guideline for the clinical management of mdr-tb and xdr-tb. Large and increasing differences are observed in childhood mortality among world regions. Support for the emotional and spiritual needs of the child and the family that are based on differences among family members and on the family's cultural beliefs. A cancer survivor can achieve this in part by becoming proactive through researching alternative options.

While the budget document reportedly suggests that funds for the program “could come from outside the hud budget as part of a separate white house bill,” it is not immediately clear where exactly such dollars would come from and whether they would be guaranteed. They found that the less pain the patient is experiencing the more ptg they report across all three domains. Mesothelioma has no definitive cure and most cases are diagnosed in the latter stages, after tumors have spread — a main reason why survival rates are generally lower compared to other cancers. This was the most powerful non nuclear explosion since the second world war. We determined the accuracy of predictions by examining the absolute difference between cps and as and the extent of agreement between cps and as, measured by the weighted statistic. (d) the methods section provided an explanation of how the date of death was determined.

Systematic survival battle plan – usd56. Bmc cancer, to gain a broader perspective on previous research conducted on the relationship between exercise and cancer-related fatigue. Devastating disasters are on the rise all across the nation. The outcomes assessed were overall survival, time to transformation or death, overall response rate and toxicity. If they were not reported by the authors, they were calculated from the data available in the article and, if this was not possible, they were extrapolated from the survival curves, hence making assumptions on the censoring process. We don't use the chemical chlorine because it's safe, we use it because it is. Predictors of relapse are shown in appendix 9 (available as supplementary data at. 3 years (two studies [35], [36] did not provide specific information on the children's age at diagnosis).

A systematic review was carried out based on the reliable domestic medical databases including: sid, magiran, irandoc and iranmedex as well as reliable foreign databases like pubmed and scopus using “cancer”, “esophagus”, “survival” “neoplasms” and “longevity” as keywords. What is alone and unafraid: patriot defense and survival guide. Inequity of income: income disparities and poverty affect the maternal and child nutritional status in cambodia, as low income affects nutrition and food choices. At 3 years of follow-up, no statistically significant differences were observed for implant survival (. Despite the published information on cranial chordoma, most of the data regarding survival in these patients has come from a single institution. However, the quality of the evidence was generally poor and more evidence is required using valid and reliable outcome measurements. This difference was statistically significant, which means that it was likely due to the difference in treatment and not just because of chance. Backyard or mountain side, nature is just outside your door. Ten studies met the inclusion criteria (figure 1 – prisma statement).

Progression to esrf was documented in 34% of patients [3]. Decision makers willing to introduce earlier hospital discharge need evidence based information about the effect of such policies on neonatal and maternal health outcomes. Reference: strand t-e, rostad h, moller b, norstein j. We screened the title and abstract of each article identified for relevance to this literature review. Though inaccurate, predictions of up to six months in length are nevertheless reliable, as they are highly correlated with actual survival. The authors concluded that extracorporeal liver support systems appeared to improve survival in acute liver failure but no evidence that they improved survival in acute-on-chronic liver failure.

Forest plot summary of ischemic heart disease mortality in 6 studies included in the meta-analysis. This problem becomes, for them, more difficult to solve when doctors fail to recognise the complexity and changeable nature of the desires, emotions, and needs that characterise the doctor-child-parent relationship, especially during end-of-life care. , mobile vans and reduced-cost mammograms) were shown to be most effective, followed by individually directed interventions (e. The criteria for success at the prosthetic level were the occurrence of technical complications/prosthetic maintenance, adequate function, and esthetics during the five-year period. A list with the details of the studies included in the review is shown in appendix 5 (available as supplementary data at.

The most important thing is to provide as many “details” and “guidance” as you can in the opord. Overall the quality of the five reviewed articles are of a medium level. Support groups or spiritual networks, which patients may find beneficial. Often, surgeons will remove the pelvic lymph nodes at the same time. Spend the final three and one-half years living on the run or will face death in christ. Weeks, made prospectively for each patient by a doctor;.

This stage of the review aimed to critically summarize the evidence about the effectiveness of specific psychological intervention strategies in improving the outcomes of cancer patients. Multivariate analysis of the prognostic factors for survival: report of the relative risk with the confidence interval (2 points); results without evaluation of the relative risk and its confidence interval (1 point); not reported or inadequate (0 point). The overall results from tables 4 and 5 suggest that no intervention strategy could be recommended for reduction of patients' hostility levels or for further exploration in relation to any time period. Stone’s email to bannon, dated sept. Dissertations and abstracts were also included. Reports of programmatic changes leading to reductions in treatment delay exist in the literature, but attribution of differences in outcomes specifically to treatment delay is confounded by other contemporaneous changes.

Shorter implants are easier to insert. To this end, the luftwaffe chief, göring, on august 2 issued the “eagle day” directive, laying down a plan of attack in which a few massive blows from the air were to destroy british air power and so open the way for the amphibious invasion, termed operation “sea lion”. However, proximity to health services did appear to have a significant effect on child survival. This review aims to analyze the benefits of systematic survival battle plan. This comparison of the survival rates after 10 years demonstrates that the calculated numbers for the implant-supported scs are very similar to the ones from the conventional fdps and more favorable compared to cantilever fdps. Long-term cpd initiatives accompanied by pedagogical guidance and coaching in reflection groups proved to be effective for enhancing and sustaining the quality of ecec services over long periods of time; evidence of impact on children’s cognitive and social outcomes was also found.

Systematic Review Survival Cancer

Data availability: the authors confirm that all the data used in the analyses underlying this study are freely available and included in the tables, figures, and supplemental information. Margaret anderson developed the search strategy and geraldine macdonald edited the review. Australian institute of health and welfare & national breast and ovarian cancer centre. With a full moon, take a family walk in the dark. Abduction and rape in an idp camp was included in the review. Hard to transport and store. Without addressing these conditions, optimum healing may be delayed or prevented. Over the last decades we have seen a very rapid decline of child mortality globally.

  those who befriended israel during the tribulation. Data extraction: methodologic quality of randomized, controlled trials (literature overview and effectiveness review). National campaigns with strong mass media components have been part of distribution of this message and have been aimed at members of the public and medical practitioners. Two other similar drugs are strontium-89 (metastron) and samarium-153 (quadramet). 14 “patients should be evaluated at regular intervals to monitor their peri-implant status, the condition of the implant supported prostheses, and plaque control. Relation between ckd and cardiovascular death. We found that there was a relative survival benefit associated with metformin treatment compared with treatment with other. We used fleissâ kappa coefficient to calculate agreement between reviewers for full-text screening. The time-specific results from table 5 show that all of the benefits of these strategies were seen immediately after the intervention or in the short-term follow-up; however, it was still not possible to make any tentative recommendations for any of the intervention strategies.

The quality and strength level of the results were considered, and we focused the review on meta-analyses and systemic reviews, large epidemiological studies, well designed control or case cohort studies and randomised control trials. The forest plots of absolute survival differences in fig. In addition, mortality from ischemic heart disease was 24% (95% ci: 0. Perhaps the best-validated clinical rule is the palliative prognosis score (pps). The paper presents both a descriptive analysis and a thematic analysis in order to provide the state-of-art of international literature on child rights, classroom and school management.

The author explains that this could be because of well-controlled physical symptoms due to accessible palliative care over the years in germany, which probably led to less requirement of sedation for refractory physical symptoms and more for psycho-existential issues. Conclusion: this systematic review supports the fact that palliative sedation does not shorten survival in terminally ill cancer patients. Food staples with a long shelf life is next on the list. Study quality was assessed by using a critical appraisal tool produced by the local health authority. The expert panel confirms the need for the new systematic evidence review, issues a call for critical questions from the public, defines the final critical questions, establishes screening and selection criteria, and develops the review protocol. Objectives: this systematic review investigated the effect of palliative sedation on survival time in terminally ill cancer patients. The concept of a hotline was not always understood, or the audience was attempting to use voice technology when texting was required.

Make your own field guide cards. Following removal of duplicates, two-stage screening against inclusion and exclusion criteria was executed independently by two reviewers (jn, am), sifting first by title and abstract, followed by full-text sifting. Summary of "statin use and kidneycancer survival outcomes: a systematic review and meta-analysis. There are various groups of white blood cells that possess an innate intelligence for healing. Tumors/gross lymph nodal enlargement close to or involving the common hepatic duct. What is the potential for new or improved production facilities in the area. Every attempt was made to devise search terms that were sufficiently sensitive to detect all prognostic studies; however, it remains possible that some studies were not identified. 8% of children included in the review). Current guidelines recommend the use of hypomethylating agents (e. (k) mean of standard normal variable, z is 1.

But there are too few articles included in the ever versus never smokers group analysis. Complications or failures were managed and noted by a specialist, and the chart was completed accordingly. Before implementing an early discharge policy, western countries with longer length of hospital stay may benefit from testing shorter length of stay in studies with an appropriate design. The cancer girl whoâs had enough of treatment. Early studies of obesity and breast cancer survival have been summarised in two meta-analyses, but the latest of these only included studies that recruited women diagnosed as recently as 1991. Patient-related factors such as smoking and diabetes also take their toll on survival rates. As for case studies, we summarized them in a table (see additional file 2) listing the studyâs name and country, health topic, type of media used, and characteristics of the media intervention and policy outcome. A recent meta-analysis published as an abstract also supports our results. This concentrates harmful chemicals in the bladder, where they damage cells that can give rise to cancer. Implant overdenture (od) is the common treatment modality for the rehabilitation of complete mandibular edentulism with dental implants.

However, breast and cervical cancer screening rates are consistently low among asian women, both in asian and western countries. A systematic review evaluating the relationship between progression free survival and post progression survival in advanced ovarian cancer. Thus, these recommendations should be considered with appropriate caution and should not be seen as supporting the current wide-scale adoption of these strategies. Studies had to include at least five cases and report on survival rates of teeth and implants. “america will lead a broad coalition to roll back this terrorist threat,” he said in a sept. Risk for all-cause mortality in 42 cohorts according to baseline estimated.

[45], and universal promotion of iodized salt. Review of claims by insurance companies to determine liability and amount of payment for various services. Dietary agents have gained considerable attention, often receiving much publicity in the media. In patients with advanced melanoma, high cns penetration is imperative because most cases of brain metastases lead directly. The implant introduced by shuurman.

In vivo studies have shown good peri-implant results, enough to suggest good biocompatibility of zirconia implants with surrounding tissues. Results sixteen studies were added to 19 other studies identified in the previous review, resulting in 35 studies. The first paper that group 2 discussed was prepared by rapporteur marjolein vercruyssen and was titled âhow are computer-supported planning and execution integrated in implant therapy: examinations, planning, execution, indications: a narrative reviewâ. You may need to launch your convoy. The review identified 32 relevant publications, most of which were non-randomised and uncontrolled and their results supported that the use of spinal manipulative therapy during pregnancy was associated with reduced back pain. Ovarian cancer is a highly fatal disease, with only about 40% of women with ovarian cancer still alive more than 5 years postdiagnosis (1).

Implant Survival Systematic Review

Its causes and consequences are not clarified. Intermittent and continuous sedation were used in combination in six studies, whereas one study used continuous sedation alone. 0 allowed users of the web to interact and generate content especially through social media [22]. In a more traditional type of vaccine, the patient is injected with a virus that contains psa. In the study of bourgarit.

Her2/neu oncogene new option for which we found one rct. Ev and jn undertook the analysis, developed the analytical model and the theoretical framework. Survival to hospital admission for ohca and 24 hour survival for ihca), survival to hospital discharge, and neurologic outcome, comparing amiodarone to placebo or other antidysrrhythmic drug (lidocaine or nifekalant). The systematic survival guide is a program designed to help you break free from the control of the system. The brutal battle lasted all day and it was here that most of the casualties were incurred - on both sides, until chief crazy horse personally led a charge surrounding the soldiers. The importance of "moral forces" (more than simply "morale") as opposed to quantifiable physical elements. Insomnia severity and all sleep-diary variables (except total sleep time) demonstrated significant improvements at posttreatment, and these gains were maintained at the 3-month follow-up.

The one excluded from final analysis was on iron and folic acid supplementation to the pregnant women to improve chances of neonatal survival by improved immune status. The maxillary canine area had the highest failure rate [9 of 132 implants (6. The discrepancies between these data sources also urge caution in generalizing the scandinavian experience. Our conclusions: this systematic review and meta-analysis demonstrates that while amiodarone significantly increased survival to hospital to admission compared with placebo or other antidysrhythmics for ohca, it does not significantly improve favorable neurological outcome or survival to hospital discharge. 47) and breast cancer specific survival (hr = 1.

Interestingly, in the 6 long-term survivors with pt2 disease,. It is believed that maternal and child undernutrition in cambodia has been impacted by parasitic infections and other infectious diseases. (“arthroplasty, replacement, hip/methods”[majr] or “arthroplasty, replacement, hip/statistics and numerical data”[majr]) and (“revision rates” or “revision rate” or “rates of revision” or “rate of revision” or “prosthesis failure” or “prosthesis survival”). Over time, the number of intervention studies that included both male and female patients increased, whereas the number of studies that only enrolled either patients of one sex or children decreased. For women with metastatic breast cancer (mbc) at diagnosis, median survival is generally 2–4 years [2, 4], although prolonged survival is observed in a small percentage of patients [5]. Nevertheless, esophageal carcinoma is still a malignant tumor with the poor prognosis [9].

All of the other strategies examined, except self-practice, appeared worthy of further investigation in relation to either their short-term or medium-term benefits. Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases. "tooth preservation or implant placement - a systematic review of long-term tooth and implant survival rates" 2013. Thus, a systematic review was performed to identify the risk of colorectal cancer in patients reporting a symptom to primary care. Abstract = "the primary goal of this paper was to determine the survival rate of immediately loaded (il) dental implants based on a systematic review of the literature. Despite improvements in diagnosis and therapy, the overall 5-;yr survival is still 15%. , 2011) found that there was a positive association between bf and being married or cohabiting and living alone, as well as with higher educational qualifications. A major obstacle facing reviewers, which many acknowledge or discuss, is the wide variation in the use of instruments to measure outcomes and in sampling methods used. The conduct of research and recruitment of children with cancer at the terminal stage is acknowledged as being ethically and technically highly challenging.

This period on their survival expertise. The most common method of predicting survival in clinical practice remains simple clinical intuition. Third bowl-rivers and fountains become blood (revelation 16:4). The aim of the present systematic review of implant-supported maxillary overdentures was to assess the survival of implants, survival of maxillary overdentures and the condition of surrounding hard and soft tissues after a mean observation period of at least 1 year. We used multiple linear regression to determine three predictive models for log(as):. The iraqi conflict has often been described as a religious or ethnic conflict. Every acre planted with watermelons requires 50 gallons of water per day and must be prepared for planting with 20 pounds of fertilizer. The comparative lack of immediate- and short-term benefits could suggest that psychological therapies are more likely to offer psychosocial benefits over the longer term. These tumors, like the surface epithelial tumors, can also be benign or malignant. Titanium allergy is barely recognized in mainstream medicine – yet laboratories using the melisa® technology have reported that about 4% of all patients tested to titanium will be allergic to it (valentine-thon e.

With a respective 10-year implant survival rate of 95. Smoking has a significant effect on dental implants placed in patient having bone height less than 4 mm. Where ‘can’t tell’ was used, the study was considered to meet some of the criteria for the question, but not others. What is the experience and knowledge of the doctor. But given the magnitude of the tww policy and pressure it places on a stretched nhs resources, plus the government plans to tighten the referral timeframes even further, it is vital that we explore and have an accurate understanding of its impact on health-related outcomes based on the available literature. Clausewitz was born on 1 june 1780 in burg bei magdeburg in the prussian duchy of magdeburg as the fourth and youngest son of a middle-class family, though it made claims to noble status that carl accepted. The researchers report "deaths due to infectious diseases, such as. Previous reviews of the literature have concluded that psychological therapies may help cancer patients in various ways, ranging from reducing the side effects of cancer treatments to improving patients' immune function and longevity. Brca1/2 carriers compared to ‘non-carriers’ was arbitrarily defined as an absolute survival difference ≥10% or a risk estimate ≤0. Despite strong advances in fighting childhood illnesses, infectious diseases – which are most often diseases of the poor and thus are a marker of equity – remain highly prevalent, particularly in sub-saharan africa and south asia.

Furthermore, most countries currently experiencing or that have recently experienced rapid growth have used huge amounts of asbestos for paving roads, parking areas, school playgrounds, and race courses [17]. Mass media campaigns to reduce delays in prehospital response for heart attacks and other emergency health disorders have been related to increased understanding of symptoms but no sustained lowering of response times or mortality rates. 78 one completed trial, the deworming and vitamin a (devta) trial, seems likely to meet the eligibility criteria and could be included in further updates of this review. , “impact of smoking on patients with stage iii colon cancer: results from cancer and leukemia group b 89803,”. In the present systematic review of literature, most of the parameters have been compared with that of titanium, presently the most commonly used implant material. Zirconia, because of its mechanical strength. Similarly, risk scores including genetic biomarkers require sample collection and processing and some means of feeding back results to individuals. The attachment selection is affected by the implant number, distribution and alignment, bone quality, arch shape, retention, and denture design. The highest rate in the world was 167, in angola.

(ii) at least one will hit the target. Title = "survival of short dental implants for treatment of posterior partial edentulism: a systematic review",. Hazard ratios were calculated from these published summary statistics and then combined to give pooled estimates of treatment efficacy. In addition, interventions involving patients' significant others and self-practice appeared to be worthy of future investigation in relation to their short-term benefits, and relaxation training appeared to be worthy of future investigation for its medium-term benefits. After about 10 years of follow-up, the researchers found there was no difference in overall survival between the nodal radiation group and the control group: about 82% of the women in each group were alive.

Systematic Review Of Survival Rates

The authors did not discuss measurement of, or adjustment for, potential confounders. 78–80 preliminary evidence has shown that mbcr/mbsr participation is also associated with improved sleep outcomes in cancer patients. 6 for an implant in bone of adequate density with a direct bone contact, the greatest magnitude of stress is concentrated in the crestal 5 mm of the bone-implant interface. Owing to the skewed nature of survival data we decided to examine the differences between cps and as after log transformation. Just a few minutes spent in signing up for systematic survival and in waiting for your credentials to be approved would offer you access to the system within no time. Table 7 summarizes the study samples, interventions, and results, by type of outcome, of the four papers that discussed four fair-quality trials that explored interventions aimed at increasing patients' lengths of survival. Papers often reported average time to treatment, but did not disaggregate outcomes by timing of treatment, even with the more relaxed early versus late definition (not requiring a 28 day cut-off). N2 - most data regarding survival in patients with chondrosarcoma are limited to case studies and small series performed at single institutions.

The review showed that people in the lowest educational and income groups had at least a twofold increased risk of developing hanc [2]. The first stage is uncertainty or vigilance, during which patients suspect a condition and attempt to maintain emotional control whilst trying to understand their condition and its severity. It has been frequency enhanced to make the glutathione even more effective. Thus the exploration and explanation of sources of heterogeneity is important here as elsewhere; in these circumstances meta-analyses are better deployed as exploratory tools rather than to establish definitive estimates. Aftercare services for child victims of sex trafficking: a systematic review of policy and practice. High-dose vitamin c (ascorbic acid) therapy in the treatment of patients with advanced cancer.

When multiple studies using the same study population had been published, the study with the largest number of subjects and longest follow-up time was included. “qatar didn’t want to fly strikes,” he said, but contributed air defense with fighter jets protecting the others. Two studies provided sample size calculations; sufficient recruitment was achieved in these studies. Ridd m, shaw a, lewis g, salisbury c: the patient-doctor relationship: a synthesis of the qualitative literature on patientsâ perspectives. And a private password that gives you full vip access to our “survivors blueprint” members community. The phenomenon of higher cres-tal stresses next to an implant is confirmed in photoelastic and 2-d or 3-d finite element analysis (fea) studies when an implant is placed within a bone simulant and loaded. Protocol, review, plain language summary. The conflict ended with the withdrawal of argentinean forces from the islands, just under 1000 persons died in the conflict. One reason why we do not hear about how global living conditions are improving in the media is that these are the slow processes that never make the headlines: in 1990 7.

This could include referral outside of the healthcare team. Force magnifiers are situations or devices that increase the amount of force applied and include a screw, pulley, incline plane, and a lever. This systematic review addressed the survival and complication rates of implant-supported scs based on clinical studies with a mean observation period of at least 5 years. We also thought that the marginal association of mortality rate with vegetarians might have been due to residual confounding among former smokers or to a recent change in diet in an attempt to alleviate ill health. Patients differed significantly in status (as measured by karnofsky. Additionally, there were differences in importance between the values of parents and oncologists.

These results offer hope of progress and suggest that chemotherapy may have a role in treating this disease. "first, make sure you have treated properly the underlying disease and achieved a disease-free or stable condition. Attempt to identify any articles missed by the electronic search. Population (hypertensive, heart failure, cardiovascular disease, or from the general population); proportion of patients who. However, the ease of administration of hypomethylating agents and the fewer adverse events associated with their use, especially in the elderly, make these drugs more attractive than intensive chemotherapy in many respects. The terminal stage involved the prediction and evaluation of outcomes, which were usually probable rather than certain. In addition, therapist-delivered interventions involving individual therapy, unstructured counseling, relaxation training, and guided imagery warrant further exploration before recommendations for or against their use can be made. Davies, “oesophageal cancer mortality in europe: paradoxical time trend in relation to smoking and drinking,”. , time of day, frequency, and sequencing) for end user receptivity. Details of themes and subthemes are described below.

22 it is assumed that weight of teenage student is normally distributed with mean=140 lbs. If subjective, ensure it is clear whether the rater was aware of the patients' experimental groups. Snow (1961) – the reassessment of the age and sex of the indian knoll skeletal population:  demographic and methodological aspects, american journal of physical anthropology, vol. Inconclusive (unclear) evidence regarding the effectiveness of osteopathic treatment for adhd (not evaluated in the uk evidence report). In addition, the reference lists of relevant articles were manually searched to find any other potentially eligible articles. If you do not have time to conduct a recon, you should at least refer to a map or terrain model. However, to our knowledge, there has not been a systematic literature review of published articles describing tha survival rates from these large national or regional registries. Remember, you're always fully protected by our . This increases costs and administrative burden and dilutes programs’ ability to reduce poverty and increase families’ resiliency through allowing them to spend and invest the transfers as they deem most appropriate for themselves. 77 mbsr is an increasingly popular, evidence-based intervention designed to reduce overall distress in cancer patients.

Thus the entire history of philosophy appears in lenin's writings as a vast struggle between "idealism" and "materialism". All study designs that looked at use of any probiotic product in well-nourished and under-nourished children were included in the review. The thread shape of an implant body may be v-shape, reverse buttress, or square. Conclusions: there is no difference, in terms of implant survival rate, between periodontitis and nonperiodontitis patients. Table 1 summarizes the 10 methodologic quality indicators and the classification criteria that we used for each. ” this is the case, as opposed to various diverse euro-descended peoples who over time came to demarcate themselves as a collective white race through the actual genocide, colonization and enslavement of others.

After the end of the cold war unita would have to finance the war on their own, this was mainly done through the harvesting of diamonds. Based on these findings, they suggested that routine resection of the ehbd is essential in all patients with t2-4 disease. Gray; historian hew strachan (like wilkinson also the chichele professor of military history at oxford university, since 2001) has been an energetic proponent of the. Brca1 mutation carriership appears to decrease both short-term and long-term overall survival rates and short-term but not long-term progression-free survival. A systematic literature search was done in the following databases: medline, embase, psycinfo, the cochrane central register of controlled trials (central), cinahl, and scopus to identify papers that investigated the effect of survival time in terminally ill cancer patients receiving palliative sedation.

( d ) are the events the academic year “ay 11” and the college of education “ed” independent. If excellence of quality is what you are expecting from a product, systematic survival would definitely beat all its competitors.

Child Survival Systematic Review

Kuczewski mg, polansky r: bioethics. Since its establishment the hep has created greater awareness of how to prevent communicable diseases. We reviewed bibliographies of relevant papers and reviews to identify additional studies to be included. Balance physician and patient perspectives in the selection of treatments for metastatic breast cancer. Second, the negatively worded and positively worded items are bipolar statements within the same construct.

[36],[37] studies indicate negative difference for acupuncture comparing with ht. That is, acupuncture treatment is not entirely analogous to most western therapy, wherein one kind of therapy treats one kind of problem. During group 1âs first work session, rapporteur bodil lund presented her paper on âperioperative antibiotics in conjunction with dental implant placement: a systematic reviewâ. Overtime, the scientific research contributed enormously to the improvement of the ceramic’s mechanical strength. These can range from simple skin rashes to muscle pain and fatigue. Experience of the doctor makes a difference; whether the nature of the. Child undernutrition has short and long term consequence for both individuals and society. Generally, for women with four or more positive lymph nodes, radiation to the supraclavicular lymph nodes often is recommended. These threats can cause a significant disruption to operations. Articles were searched through ebsco and manually through the references of the peer reviewed literature.

Whenever possible, measurements should be taken with a periodontal probe from the midaspect of the mesiobuccal, buccal, distobuccal, mesiolingual, lingual and distolingual surfaces of the fixture. This phenomenon, called tumor flare, can cause increased symptoms from the prostate cancer that didn't exist before the patient received the therapy. Because an accurate communicated or formulated prediction of survival is so relevant to the decisions that patients and doctors make, knowing how well clinicians can predict survival and whether modelling prognostic factors can add value to clinicians' predictions is important. Case–control studies were not used in the assessment of ppv because of potential bias associated with this research design. A : alternative cancer treatments at oasis of hope have proven three times better results over conventional treatments from us national averages. In this review the primary author (sh) reviewed and evaluated all the retrieved abstracts and selected papers with twenty percent checks undertaken by co-authors.

The table is organized into the three categories of exploitation employed by this review: 1) early or forced marriage; 2) sexual exploitation of combatants; and 3) sex slavery. Medline, embase, cinahl, and the cochrane database of systematic reviews and trials. Far too many people are reliant on the national grid for their power, not realizing just how dangerous that is. From the other four studies had been available for inclusion, the problem of. Shortly after the withdrawal of british forces from the european continent in the dunkirk evacuation (. Conclusions vitamin a supplementation is associated with large reductions in mortality, morbidity, and vision problems in a range of settings, and these results cannot be explained by bias. Looking at smoking intensity, we found significantly worse survival rates in esophageal squamous-cell cancer patients with a history of heavy tobacco smoking (py of more than 15 or 20).

For example, factors related to growth (. In bosnia-herzegovina the peacekeeping forces haven’t been able to leave the area until this very day. The effect of proximity to health services did not appear to differ by region (africa vs asia) or by vaccine coverage at the country level. Search strategy exists for identifying studies of prognostic factors, the. But the relationship between smoking exposure and the prognosis of patients with esophagus cancer is still not clear. Only the implant reported by schuurman showed large limitations in longevity with the latest design (80% survival at four years).

Tabellverket was founded as early as 1749. Nymsar is a frequency enhanced elixir that supports both the liver and kidneys. Children and adolescents can develop hnc, but due to high relevance of developmental stage, and cognitive maturity they are excluded from the review. 4 ,5 however, there have been few studies that have examined the barriers to accessing health services, such as distance to health facilities in low- and middle-income countries. Two studies used morphine for sedation along with other sedatives. There are many advantages to using short dental implants to support an implant prosthesis. Of these five articles, two were systematic reviews, two were cross sectional studies and one was a review article.

10 this outcome might be an indirect consequence of reductions in adult (eg, parental) smoking attributable to campaigns, which exerts a protective effect on youth uptake. Make sure your subordinate leaders have ample time to complete their planning and preparation. Bmc int health hum rights. 5 air pollution, a meta-analysis showed. The differences were in the targets of the planned media. First, some of the reviewed trials failed to present the data collected for all outcomes. Five-year survival among whites is 7. In order to help reduce the load on the liver, and to enable more toxins to be eliminated when the liver is overloaded -- then the liver detox pathways are not working well, the toxin elimination elixir instructs the body to channel more toxin elimination through the skin. This information will be the “meat and potatoes” of your final opord. Although race does not appear to impact mesothelioma survival rate much initially, race becomes a more telling factor as time passes.

This systematic review assesses all accessing electronic databases to determine valid estimation of survival rate among patients with esophageal cancer in different regions of iran. There is also disagreement about whether using a combination of hormone therapies or just a single anti-androgen drug works best to treat prostate cancer. Owing to the remarkable success, there have been various researches going on to find out factors responsible for the failure of implants. This is why it is essential to launch broaddrick, willey, jones and others. The possible causes and consequences of frequently-reported complications among all types of implants such as radiolucency/osteolysis, sigmoid notch erosion and radiological instability need further investigation. In the past few years however there has been a concerted effort to include this group in clinical trials. Answer: the corn crop benefits from reactive nitrogen added to the soil by the soybean crop.

All studies were assessed for methodological quality using a modified cochrane review quality assessment form [25]. [38] pragmatic trials yield results that are more useful for the clinician in situations that require different treatment options that can often not be controlled. In these analyses, the level of renal dysfunction in each subgroup was categorized by. It took generations, and a vast amount of coercion, before this became a white country.

Systematic Review Overall Survival

The urine may look darker than usual, brownish, or (rarely) bright red. In the treatment of patients with cancer and concurrent type 2 diabetes. Chronic kidney disease and mortality risk: a systematic review. Primary outcome: mean survival time. On the other hand, female gender and being married were predictive of increased survival or lower mortality. Criteria included randomisation, sequence generation, blinding, sample size calculation and recruitment levels. These complications may be related to an increase in crown height, higher bite forces in the posterior regions, and less bone density. To what extent does this evidence translate into medium and long term improvements in language and literacy outcomes for children.

Systematic survival battle plan 50% – great epcs scam review. Trust was in part a product of clinician behaviour. #6 explode “enteral-nutrition”/all topical subheadings in mime, mjme. These two factors combined with the location of the tumour may impact the development of bf/ptg, and it is for this reason that a systematic review of this cancer site is needed. A guide to the reading of "on war", in the 1976 princeton translation, expressed his interpretations of the prussian's theories and provided students with an influential synopsis of this vital work. Is there a local amateur communication network. They compared the results between smokers and nonsmokers patients in which implants were placed. Individuals may be interested in the both the probability of death from cancer and the probability of death from other causes each estimated in the presence of the other.

Small group discussions with health professionals were not found to be effective in increasing cancer screening among filipino americans in los angeles [62]. Proven, cost-effective interventions can save the lives of millions of children per year. The strengths of this review include the use of different search engines, namely medline, psycinfo, embase, cinahl, cochrane central, and scopus. And in line with survivor numbers, these benefits are growing. [19] as it is clear that the shortcoming of short implant was found to be improved by some means and paucity of data regarding review of ≤7 mm short implant studies, they need to be investigated thoroughly for their use.

Parents with inaccurate perceptions of the prognosis or unrealistic expectations for cure were more likely to choose aggressive therapies, including cancer-directed treatment to overcome disease and promote recovery, than parents with more realistic expectations. Leaders can “move freely” between steps as they create their plan. Second some articles did not give the survival rate by year and just report the five-year survival rate. Methods: an electronic search without date or language restrictions was undertaken in pubmed in march 2012. It is well established that several infections, such as the torch complex (toxoplasmosis, other vertically transmitted infections, rubella, cytomegalovirus, herpes simplex virus 2), have teratogenic effects. As described above, vitamin a supplementation was associated with significant reductions in mortality in both asia and africa. [23] compared marginal bone loss (mbl), survival, and radiographic evidence of success of dental implants between smokers and nonsmokers. [17],[21] also the stress distribution for yttrium-partially stabilized zirconia was similar to that of titanium. See related article by frank l.

These plans “consider the systematic implementation of evidence-based interventions across the whole cancer continuum from prevention to end-of-life care”. (2) patients who accepted acupuncture as the main treatment or an adjunct to other treatment for hfs (if the control group also received the same concomitant treatment as the acupuncture group) were employed. This review indicates that women and girls, and men and boys, in situations of humanitarian crisis are subjected to extreme forms of sexual exploitation. Encouraging photosynthesis as she raises crops burning carbon-based fuels by consuming vegetables grown on her farm all of the choices are correct. In the process of eliminating as much toxic exposure as possible for sake of the chemicals and cancer link, you need to limit exposure from the chemicals in your carpets and walls of your home. In all studies but four both mothers and fathers were included; only mothers were included in one study and parental gender was not reported in three studies. Table 1 shows the relationship between cancer stage and 5-year survival. Feasibility of implementation of each intervention for pakistan has also been reviewed in the light of existing evidence. East asian ethnicity (china, taiwan, japan, and korea).

  basically this comes down to a personal decision and although it seems like a “big” decision, it often doesn’t matter which you choose. A new study published by the concord-3 program on cancer survival on tuesday published in the lancet shows the progress and the gap in five-year cancer survival rates between countries. Flow of the systematic review. The source of drinking water is another determinant that was consistently associated with child survival. An effective assessment must be one that is multi-disciplined and balances security, protection, and survivability. 9 review, shorter implants had at least a 7% higher failure rate when they were less than 10 mm long. Several approaches of active and passive immunotherapy for eoc have been studied. Author links open overlay panelprofmarichardsfrcp.

2, there is no clear improvement in discrimination as increasing numbers of variables are added from self-completed questionnaires to routine data. For the society, the distress is associated with costs due to health care utilization, productivity loss, and sick leave [23]. Along with those, you get the doomsday self-defense tactics course, the heat holocaust survivor course and the systematic survival battle plan video. Quality was assessed by using a critical appraisal tool produced by the local. From the systematic review, it is noted that there have been a lot of strides which have been made towards understanding the various symptoms that relate to lung cancer in adults.

Result from full text review 137 article exclude due to insufficient data. Although the authors mentioned that the 2 groups were similar with regards to biopsychosocial variables, the specifics were not presented, and no mention was made with regards to adjustment for confounders or consideration of effect modification. Overall survival is how long women live, with or without the cancer coming back. The characteristics of included studies are summarized in table 1. For the hazard ratios (hr), pooled estimates were calculated and statistical heterogeneity was assessed using random effect analyses, which is designed to estimate the mean effect size from a range of studies while accounting for heterogeneity across the studies [14]. The elimination of lateral forces during mandibular excursions is especially beneficial to decrease the effects of an increased crown height. âassociation of trauma and ptsd symptoms with openness to reconciliation and feelings of revenge among former ugandan and congolese child soldiers,â. Moreover the five year survival rate in iran is less than many other countries.

Children maltreated previously were approximately six times more likely to experience recurrent maltreatment than children who had not previously been maltreated. In ten of the 18 series, no useful information could be retrieved, whereas eight papers reported osteolysis without frank loosening of the implant components. Associated with metformin treatment [16], whereas most of the studies in our data pool, including the other study performed in lung cancer by tan et al. Further studies are needed to establish the exact role of decitabine compared to 5-azacitidine in these patients. According to other reviews, the systematic survival guide is a very real and workable program.

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Particular to the Dutch legal context is that all UAMs have a guardian from Nidos Foundation, the Dutch guardianship institution for unaccompanied minor refugees, asylum seekers and undocumented migrants, which has been given this responsibility by the Ministry of Justice. Nidos has the lawful assignment of exercising the authority of supervising these young people on their path to adulthood and promoting their interests. The guardian provides long-term continued care and has the responsibility for the mental and physical wellbeing of the child and the development of his or her personality.

As a guardian, Nidos is responsible for accommodating a child in the right form of reception. Vulnerable minors, including all minors under the age of 13, are directly accommodated in foster families (or if necessary, for instance in case of suspicion of trafficking, in protected shelters run by COA). As a result, around 47% of all UAMs in the Netherlands are accommodated with foster families.

In the field of foster care, UAMs form a specific group that requires a specific vision and interpretation of foster care. Because of the different backgrounds of these youngsters, Nidos favours reception in families connected with or close to their own ethnic background. These family connections provide the minors with a secure basis from which they can return to their country of origin or integrate in Dutch society, while preserving their own cultural identity. In many cases, the minors are familiar with the idea of living with next of kin because, in most of the countries of origin, it is customary for family members to receive and educate children whose parents are absent.

A nationwide team dedicated to Reception and Living in Families (RLF team) within Nidos is responsible for recruiting, screening, matching and supporting the foster families in the reception pool developed by Nidos (not linked to the the general Dutch foster care system), which consists of around 400 families, as well as an additional 778 kinship/network families that foster children related to them who are also under Nidos’ guardianship. The major task in support for the families is assigned to the guardians who visit the children and the families monthly. A reception family (both pool families and kinship/network families) receives a daily allowance linked to the age of the unaccompanied minor. For a 16-17 year old this is around 600 euro a month.

The methodology that is used by the RLF team was officially detailed in summer 2010 in a handbook and has been further developed since then, for example in the field of safety. The RLF team has been trained in working with this methodology.

One promising initiative is the new reception facility OWG+ (‘RLF+’) which is currently being executed in a pilot format. It was developed to see whether reception in families can also be a useful option for older minors who are already rather self-dependent but not yet entirely ready to be on their own. In this facility, foster parents take care of a maximum of 4-5 children (varying in age from 15-17 and mainly from similar ethnic backgrounds) in a setting that closely resembles a family situation but with the opportunity for the youngsters to experiment with self-dependency training. This way, continuity in support is much more guaranteed than in a professional setting, especially because of the fact that foster parents recognize the culture and language of the youngsters. This form of reception has similarities with the concept of the extended family as is commonplace in many of the minors’ countries of origin, whereby adults other than the parents also keep an eye on them.

Maliebaan 99, 3581CH Utrecht
Peter van de Pol (RLF team manager)
+31 30 2391208