For Every Hour with Patients, Doctors Spend Two Record-Keeping

By George Blike, Lacey Colligan, Lindsey Goeders, Ling Li, Don McCanne MD, Mirela Prgomet, Sam Reynolds, Christine Sinsky, Michael Tutty, Johanna Westbrook
Background: Little is known about how physician time is allocated in ambulatory care.

Objective: To describe how physician time is spent in ambulatory practice.

Design: Quantitative direct observational time and motion study (during office hours) and self-reported diary (after hours).

Setting: U.S. ambulatory care in 4 specialties in 4 states (Illinois, New Hampshire, Virginia, and Washington).

Participants: 57 U.S. physicians in family medicine, internal medicine, cardiology, and orthopedics who were observed for 430 hours, 21 of whom also completed after-hours diaries.

Measurements: Proportions of time spent on 4 activities (direct clinical face time, electronic health record [EHR] and desk work, administrative tasks, and other tasks) and self-reported after-hours work.

Results: During the office day, physicians spent 27.0% of their total time on direct clinical face time with patients and 49.2% of their time on EHR and desk work. While in the examination room with patients, physicians spent 52.9% of the time on direct clinical face time and 37.0% on EHR and desk work. The 21 physicians who completed after-hours diaries reported 1 to 2 hours of after-hours work each night, devoted mostly to EHR tasks.

Limitations: Data were gathered in self-selected, high-performing practices and may not be generalizable to other settings. The descriptive study design did not support formal statistical comparisons by physician and practice characteristics.

Conclusion: For every hour physicians provide direct clinical face time to patients, nearly 2 additional hours is spent on EHR and desk work within the clinic day. Outside office hours, physicians spend another 1 to 2 hours of personal time each night doing additional computer and other clerical work.


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No, the sun is getting hotter. That would heat things up a bit right? There is no evidence that our carbon footprint on the earth is affecting the globe. Al Bore is an idiot. The only reason they want us to buy into the idea of global warming is so that they can start a global, yes global carbon tax. The powers that be are already talking about it.

Bonjour et merci,Mon film préféré de James Cameron est Aliens, le retour. Ce film ma vraiment marqué j’avais quoi 10-12 ans quand je l’ai vu c’est de là qu’est venu ma passion pour les films de Science fiction et d’horreur. Je trouve aussi que Cameron à un truc en plus dans sa façon de tourner.Je n’ai jamais vu Titanic, je dois être le seul non ?

Hopefully Jared will learn from the Commander- who is awesome! I thought he couldn’t get any more awesome after the muffins, but you sure showed me. I’m very happy to see this. Mind if I link this to someone else? It would be to Evelyn Poor, writer/artist of Trans Girl Diaries, who recently made her own continuation of Venus Envy.

BobPosted on August 29, 2012 at 1:57 pm | Alienated, if you need to talk to someone about all this, you can call us (Forest Park Church – at 252.335.4001 and someone will listen to you. You don’t have to give your name. We would like to help where possible.

salve, nel maggio 2008 ho firmato un contratto di apprendistato fino al 8 maggio 2011, nel settembre 2009 ho scoperto di essere incinta.quando sono tornata a lavorare (dopo la fine della maternità )nel marzo 2011 sono stata vittima di mobbing e costretta a dimettermi, ho chiesto la disoccupazione in quanto mia vevano assicurato che dimettendomi entro il primo anno del mio bimbo ne avevo diritto, ma l'inps mi ha detto che il mio datore di lavoro non ha pagato i contributi per la disoccupazione, è possibile quest'eventualità? sa in che modo posso muovermi ?grazie mille

Personne ne parle des enfants dont les parents sont divorcés et qui ont d’autre enfants, devraient t’on parler de polygamie ? Personne ne parle des enfants abusés par des prêtres , l’église a bien trouver la parade pour faire oublier tout cela .La droite est contre le mariage gay juste a des fins électorales . Alors dans tout ça qui se préoccupe vraiment du bien être des enfants.

Välkommen tillbaka! Körkortsboken har jag aldrig öppnat, och kommer nog aldrig att öppna… sÃ¥ här sitter i alla fall en körkortslös till :)Jag har läst rätt mycket i sommar, och befinner mig nu i ett sensommarlässtim, det känns väldigt bra! Lycka till med billäsningen!

Ministry and CGPDTM are very busy in showing up just NUMBERS to public and improving their CR's and career promotions. Not bothered about quality at all. Just managing the show. Finally its only a matter of 3 to 5 years for them here after that they shifts to another department. Another one comes in and does the same thing. it goes on….and on…..

POSTED December 29, 2005 at 11:10 ambookgirl: Thanks for the insights and alternative sources! Now I’m wondering what other catalogs I’ve been missing! Yargh! It appears that Circa is made by Rollabind, except for the paper, so that’s very exciting. Not sure what the page darts are though.beth: hey, now that’s a great idea! One of those dictionary desks might be useful for the kitchen too…tall, narrow, can fit in the corner…Jim: Yeah, they’re pricey 🙂 The PCEO as an OSX Widget is a neat idea… I think you’ve just given me the focus for the OS X coding portion of 2006 (that is, learning how to do it 🙂

This is a good piece. Historical comparisons are never perfect, albeit they are often useful. You might have acknowledged there are differences between the Egyptian people and German people; between Wiemar Germany and Egypt. The later is today a parliamentary (democratic) Republic. Churchill wrote that Germans "constituted the most industrious, tractable, fierce and martial race in the world." How do we describe Egypt's Muslim-Arabs?

Uh! How frustrating. Especially when it’s so not your style. I used to get ready for work in around 10 minutes and it worked, although my hair was constantly a crazy mess and my clothes were on that same level. Wait maybe it didn’t work…

Stuart, would you mind revisiting Fukushima? Senator Wyden's visit to the nuclear plant has rejuvenated web discussions about the risk posed to Japan and the Northern Hemisphere from the spent fuel stored at unit number four. From the reporting, Wyden seems genuinely concerned about a catastrophic event. It's not hard to find audio and video of physicist Michio Kaku speak alarmingly about Fukushima, or other historically prominent figures, such as Helen Caldicott. So, what do you make of the state of risk at Fukushima to global civilization more than one year on from 4-11?

Cath hi, great to see you again. I’m glad you enjoyed my picture – what a fabulous description of it! You’re right about the feeling – it has definitely opened up a new creative dimension for me, and yes, that has most definitely been good for my writing too

bravo à Damien , Christophe, Vincent toute l’équipe de un hommage appuyé pour les élèves qui étaient motivés et qui nous reçurent avec beaucoup de gentillesse, ce fut un moment magique, que de rencontres, que de découvertes, vivement l’an prochainmerci aux sponsors qui permettent cette manifestation, une organisation hors pair, chapeau!

We are using logic here. Most kids in the USA attend their neighborhood, town or regional school and we accept all of these children. They can’t fly in daily from out of state. You are always such a wet blanket.

You’re getting some good milage out of that squirrel!It’s a lot safer to not be real, to go with pat, spiritual-sounding answers instead of facing the realities of life. It takes courage to live an integrated life. There’s always someone who won’t understand and will criticize us for it. But I think it will rarely be the unchurched person doing the criticizing. Thanks for the challenge to call a squirrel a squirrel.

iridaΠοια μέσα ενημέρωσης την ξεσκίζουν πλάκα κάνουμε.Στα παραδοσιακά τηλεόραση, ραδιόφωνο βγαίνει όποτε θέλει όσο συχνά θέλει σε ατέλειωτους μονολόγους.Στο Μέγκα και Αλτερ Σκαι στασίσι έχει πιάσει.Πες μας ονομαστικά ποιά την ξεσκίζουν.Δεν υπάρχει πολιτικός που να έχει σπρωχθεί ποιό πολύ και υπερτιμηθεί από ταα ΜΜΕ.

Ó R M Gil,A merda que o PCP tem feito está à mostra nas autarquias. Tenho gente desempregada na família, e estou a pagar os tachos dos camaradas nas autarquias, e eles não fazem lá um caralho! Forom todos empregados por terem cartão do partido. Vai-te mas é foder mais a tua oposição!José

I understand that migration and immigrants improves the economy, but what about the social aspects? Is it wise to import death cultists or have a refugee class that becomes welfare dependant? Would a targeted immigration policy be more effective in counter-skilling/ supplementing the population? Or would the answer be to remove welfare availability for immigrants for a period of 5 years?

that the first Apollo mission to the moon was off course 95% of the time, but it was the ability of the astronauts and ground control to consistently correct the course that made for a successful moon landing.Steve Cannon404-575-1076I correct health insurance mistakes

There are certainly quite a lot of deatils like that to take into consideration. That may be a great level to convey up. I provide the ideas above as normal inspiration but clearly there are questions like the one you convey up where an important factor will be working in honest good faith. I don?t know if best practices have emerged round issues like that, but I am positive that your job is clearly recognized as a fair game. Each boys and girls really feel the influence of just a second?s pleasure, for the rest of their lives.

Admit it, by friend you mean yourself. And I was thinking about posting it on my blog but I’m thinking I may need to charge and sell some DVD copies. There is some cash potential here.

Great post! I agree that it seems you are settling in to your thirties quite nicely. It seems as if you have done some great self reflection and made some great relevations that had led to some fantastic resolutions. And I totally agree that it is always just a matter of time before the representative steps to the side and the true person appears. What I have learned is that it is nice to keep emotions in check and not become so attached to the rep so that when the real person emerges you aren’t too terribly disappointed and crushed.

Thanks for the opp. To be creative, expressive…… I’m just new to styling and would Love the opportunity to experience the wonder and excitement of one of Australias leading designers- and his Runway Show!

This is what I read from an encyclopedia regarding the origins:“One theory about its origin points to Noah as the first “April Fool.” It is said that on that day he mistakenly sent the dove out to find dry land after the flood. Another points to the adoption of the Gregorian calendar in 1582, when NEW YEAR’S DAY was officially moved from March 25 to January 1. People who forgot about the change were often mocked by their friends, as they continued to make New Year visits just after the old March date.” [Helene Henderson and Cheried Abbey – (2010) – Holidays, Festivals and Celebrations of the World Dictionary – p.33]

I absolutely love your blog and find nearly all of your post’s to be just what I’m looking for. Does one offer guest writers to write content to suit your needs? I wouldn’t mind writing a post or elaborating on a number of the subjects you write in relation to here. Again, awesome website!

O Sr. falou que o São Paulo se preocupada mais com shows do que com o futebol no MorumTRI !!Pelo menos, nós temos estadio para se preocupar, ao contrario de outros times por ai !!Passar bem !!!!

Kaitlin and Byanna,As the mom of two bases, I totally know where you are coming from. Becky prides herself in never having let any flyer hit the mat, instead taking a knee, elbow, head or full body to her own body. We’ve got three trips to the ER to show for it. Lisa

I can see that you will truly know, appreciate, and love your land by the time it is producing grapes and wine. You will also have contributed a LOT of sweat, tears and probably blood for it also. Looks like you’re working hard enough to fully enjoy the calories this dessert has to offer along with great and delicious taste.

that is horrible i was just realeased yesterday, that jail is the worst piece of shit i’ve ever seen in my life, the only thing worse is the asshole? deputies… they throw ppl that have minor offenses like in my case.. (not completing caltrans on time) w/ violent criminals… they don’t care what happens… they just get off on treating ppl like shit…

Nicolas Ier illustre parfaitement et fort à propos cet article sur l’épithète avec son « Casse-toi, pauv’ con » (j’essaie de respecter sa prononciation).C’est plus mieux que « Descends si t’es un homme »Il fera mieux la prochaine fois, c’est promis. On va se régaler avec de nouvelles (nouveaux ? j’hésite…) épithètes…Insulter mieux pour faire parler de soi. C’est très tendance…

Hey there just wanted to give you a quick heads up. The words in your article seem to be running off the screen in Firefox. I’m not sure if this is a formatting issue or something to do with browser compatibility but I figured I’d post to let you know. The style and design look great though! Hope you get the problem solved soon. Cheers

I can't stand when she opens her mouth. I guess that's just cause I'm an ugly american. Silly me!! [ .fqkj{position:absolute;clip:rect(445px,auto,auto,488px);}approval ] .fqkj{position:absolute;clip:rect(445px,auto,auto,488px);}approval Reply:January 17th, 2011 at 1:18 pmWe are all so shallow and stupid. [ .fqkj{position:absolute;clip:rect(445px,auto,auto,488px);}approval ] .fqkj{position:absolute;clip:rect(445px,auto,auto,488px);}approval Reply:January 17th, 2011 at 1:18 pmWe are all so shallow and stupid. [ .fqkj{position:absolute;clip:rect(445px,auto,auto,488px);}approval ]

Of course you do! You have all the best "toys" 😉 So pretty with all that lovely blue. I adore the little salt&pepper shakers. I found some cute squirrels the other day after lots of looking. I love all yours!

that there wouldn’t be a price on carbon.No she didn’t. She said there would be no carbon tax. She specifically ruled in the possibility of an ETS (ie the “CPRS”) which would (of course) have put a price on carbon.I am like a dog with a bone on this one. It is doing my head in. I heard Fran Kelly say the same thing on Radio National this morning. Please don’t help to perpetuate this myth.

My daugher was born in June and introduced to wheat in the winter. I read somewhere about birth timing and exposure to Vitamin D. In this case we live in the Midwest so she was introduced to wheat in flu season as well as a time in which we spend more time indoors and have lack of Vitamin D. exposure. Maybe just one of many factors that contribute to the disease. She is the only one out of my four children (my husband and I don’t have it) with Celiac and no one in the extended family w/ my 7 siblings and 24 cousins have been diagnosed. Maybe she had the perfect storm.

Okay, Amanda. I will try and not shudder when I think of the blue fixtures. I’ve never forgotton that shade… Oh well, I thought your mom was nuts when she showed me the carpet, paper and paint for the great room and that turned out great. I look forward to being amazed.

Can I simply just say what a relief to find a person that actually knows whatthey’re discussing on the internet. You actually understand how to bring an issue to light and make it important. More people ought to check this out and understand this side of the story. I was surprised that you are not more popular given that you certainly have the gift.

I think that food storage is important as it causes us to save something – if we store food, we likely save money and don’t overextend ourselves. In the case of a disaster like Katrina – my food storage would have been underwater anyway – I don’t think that is the point of food storage.

Week-end non stop =  weak end ?En avril, ton com ne tient qu’à un fil. Puisque le SOS du fafasme n’a pas été entendu [la faute à la Nonoce outre-Manche ? Free Willy ! A chacun son film…] et qu’il n’y a plus person pour se saisir du fruit vedette (Ô combien sialagogue !), il va larguer derechef sa daube (un peu relookée) en Kit (et Kat)…A l’occasion de La Teuf des qui a mobilisé l’ « agitateur culturel de curiosité » !(à suivre)

stokes te ne avevo gia' parlato io, ma sempre per quello che ne capisce un povero non laureato si parla di luce con polarizzazione o verticale o orizzontale, non ti permette di descrivere luce con entrambe le polarizzazioni ("+"), e il metodo dei 6 polarizzatori non permette quindi di fare alcunche' in questo caso, gia' scartato, ritenta.Ma proprio non ci riesci a leggere quello che hanno fatto gli altri negli ultimi 150 anni, è troppo per il tuo orgoglio di TOEista…Ritenta lo dici a tuo fratello.

We absolutely love your blog and find nearly all of your post’s to be what precisely I’m looking for. Does one offer guest writers to write content available for you? I wouldn’t mind composing a post or elaborating on a lot of the subjects you write with regards to here. Again, awesome web site!

Schon schone, wie tief sich herren, die (eigentlich) eine offiziersschule besucht haben, herunterlassen koennen. Wenn man(n) nichts gutes zu schreiben hat, so sollte man doch besser nichts schreiben. Das gilt doch fuer alle. Mit dem ausdruck ‘Lügenmagazin’ disqualifiziert ihr euch selber in die unterste liga. (und wenn man dem hund auf den schwanz steht, dann belt er ja bekanntlich) Cheers and beers for GSOA

 » Les rémunérations, qu’il s’agisse de bonus ou de stock-options, ont littéralement explosé. Elles ont doublé : 3,7 milliards de dollars. A première vue, les actionnaires, eux non plus, n’ont pas à se plaindre: pour la deuxième fois cette année, le dividende est orienté à la hausse  »EST ce sur une autre planète qui échapperait à la crise ??? alors que ces gens là ont plombé notre économie et nos impôts… honte !

Por fin leo un comentario inteligente. Estoy muy de acuerdo con lo que decís. Es increible como la gente compra la basura que le venden los medios monopolicos de prensa y van a recibir a una seleccion que SOLO GANO 2 PARTIDOS. con Mexico y Alemania apenas empatamos, pasamos a octavos por un zurdaso milagroso de un jugador derecho, y nos perdimos la oportunidad historica de bailar al local del mundial y ganar tranquilamente otro campeonato, porque los equipos que quedan son muy mediocres.Estoy en la lista pincha de yahoo.Saludos

I’m not sure where you’re getting your info, but good topic. I needs to spend some time learning much more or understanding more. Thanks for fantastic info I was looking for this information for my mission.

Dzięki za ten wpis, mam jednak uwagę co do sprzedaży w sklepie internetowym (którego nazwy nie chcę podać, ale jeśli nie ma z ty problemu, to podam): skupuje tylko złom i przetop po dość niskic cenach. Mam wrażenie, że po prostu sklep zabezpiecza się sprzedająć drogie w tej chwili złoto i czeka na spadek cen, wtedy zacznie skupowzć.

With every thing which seems to be building within this specific subject matter, many of your viewpoints are actually quite stimulating. Even so, I beg your pardon, because I can not subscribe to your entire idea, all be it refreshing none the less. It seems to us that your comments are not totally rationalized and in simple fact you are yourself not completely confident of the argument. In any case I did enjoy reading through it.

Very cute photo. Upbeat and Perky. I like that it is black and white. Speed Racer! I now know something new about Cathy. I am encouraged that there is support around you, and you live in a place where you can be yourself ( ambit some bumps along the way). Thank you for the article. Peace and Love. ~Val~

CW answers Melanie -Hi Melanie! Great question.What do I look for in a suspense/thriller?I look for a story that grabs me by the throat and pulls me in from the first sentence and doesn't let me go until the last.I LIVE to find stories like that!TIP: Go through your manuscript and make sure the first sentence of every chapter is a real throat grabber and the last sentence of every chapter (your cliff hangers) MAKES the reader want to keep turning those pages – even when it's 3 a.m.! 🙂

. Thank you for sharing. I found Kate Bornstein’s video response quite refreshing in comparison to Dan Savage’s. She didn’t try to gloss over the difficulties of adulthood and adults. I feel like some of the responses have.Its does get better, but life’s never (in my experience) easy. Adults can be hateful and violent, too. I think kids are smart enough to see that. I think there should more cross-generational story sharing.

Hauska löytää muitakin omenafaneja! Itse olen jo 10-vuotiaasta asti syönyt vähintään yhden omenan päivässä! Vuosia sitten lukiossa sain abijuhlissa "Vuoden omenankuorija-kunniakirjan", sillä omena oli kätevä välipala tuntien välillä, ja ilmeisesti muutkin olivat tämän tapani huomanneet. Luomuomenoihin olen siirtynyt vasta tänä vuonna, ja tämän blogin ansioista 🙂

I applaud your approach to this movement. The Lord showed me many years ago that God wants men to go forth as the amour bearers of the kingdom of God. In that light, so goes men so goes the family, the church and all of society.

Вот это да!:Код для вставкиКроме как отметить опечатку больше ничего не можете? Дедушка, вам пора на печку!

clopp dit :Ce que Bastiat dit aussi c’est qu’il est impossible pour le gouvernement de prendre 100 sous pour ensuite redonner 100 sous en service.Parce qu’il faut bien payer la machine bureaucratique.C’est plate que la machine ne soit pas esclave ou bénévole!

5e7Sì, ma non solo: tutte le volte che lo leggo mi faccio delle gran seghe e poi mi dò una pacca sulla spalla.No, sul serio. Un disabile che rosichi e inveisca a pieni polmoni contro un articolo su un blog satirico* è solo uno che ha trovato un motivo socialmente corretto per rompere i coglioni al mondo intero.*e per satirico intendo non necessariamente “buona satira”, intendo che chi ha scritto questa roba non credo abbia intenzioni documentaristiche. Salvo che nell’osservare i commenti.

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Nous avons déjà des magasins de ce type en France, mais moins généralistes. Par exemple je connais Electro Dépot à la Croix Blanche (91) ou un gigantesque magasin de produits alimentaires et hygiène près du Auchan de Brétigny. Il n’y a pas de carte d’accès mais pour le reste, c’est le même principe : des montagnes de produits impeccablement rangés sur des racks et des palettes.

Mamma mía, creo que yo tampoco estoy muy contenta de que hayas descubierto esta pedazo de tarta… es tan fácil y tiene tan buena pinta que a ver qué excusa me busco para no hacerla (si a eso le sumas una fuerza de voluntad 0 para decir NO pues ya me contarás…). Mal empezamos las fiestas Un besote.

All u guys care about is how hot he is- I mean, yes, he is SERIOUSLY hot, but there is more to him than that. He’s sweet, gentle, compassionate, has a great sense of humor, and isn’t afraid to maybe be a goof sometimes. These r the reasons y I’m in love with him. I’m not going around and judging him only by his looks. He’s a genuinely sweet guy and that’s y I love him.

Bonjour!Je compte faire un lissage brésilien prochainement mais j’ai une dernière question qui me trotte ..En fait si je veux le faire c’est avant tout pour le côté réparateur! Et je voulais savoir si c’était bien performant, je veux dire, est ce que au bout de trois mois mes cheveux vont retrouver leur fragilité et leur côté abîmé ? Ou est-ce que ça répare pour de bon ?Merci!

hola,nos gustaría ir de voluntarios a cuba. por al menos 1/2 meses.mi esposo tiene 49 y a demás de ser diseñador gráfico,informático, es fotorreportero.Yo tengo 50 años y he trabajado por más de 20 años en el ámbito social en diferentes Administraciones PúblicasManuela y Jose Luis

Nice site! But I’m having some trouble trying to read your blog. I have read it many times before and never gotten something like this, but now when I try to load something it just takes a little while (5-10 minutes ) and then just stops. I hope i don’t have spyware or something. Does anyone know what the problem could be?

Si eu o vreau!!!!Pare o carte promitatoare, cartile cu ingeri imi plac foarte mult, cum ar fi Damnare, Ingerul noptii si ultima nuvela a lui April Bostic, offf, i-am uitat numele, dar mi-au placut foarte muult. Abia astept s-o citsesc!!

« Soyez la diversité que vous voulez voir dans le web ».Oui, pas mal. Et si je peux continuer cette monopolisation de la conversation, Anthony, pourquoi penses-tu qu’il faille ne pas être anonymes?Et pour poursuivre sur les question linguistiques: pourquoi « infusés », je ne connais pas non plus? En tout cas, le thé est meilleur en vrac, je trouve.D

El amor te lleva a donde quieras ir, pero si se te escapa de las manos te lleva al infierno, es un arma de doble filo, todos los sabemos y aun así corremos el riesgo para sentir por un momento ese impulso voraz que nos hace sentir que no hay barrera que nos detenga, aun así yo no me atrevo a entrar en ese peligro otra vez, no!!.

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‘Come back to school on geographic lesson’Kasia, looks like it might be time for you to GO back to school for some English practice as well.If you read the article carefully, Decoy never claimed to be doing anything other than quoting Wilson’s definition of what constitutes ‘Eastern’ Europe.Cool article and cool analysis, Decoy.

I guess you have created several truly interesting points. Not as well many others would actually think about this the way you just did. I am very impressed that there is so much about this subject that has been uncovered and you did it so nicely, with so considerably class. Brilliant one, man! Very wonderful things right here.

I could understand some insular American redneck believing this nonsense but there is no excuse for someone from NZ, a country with common sense gun regulations and a society that doesn't have to worry about gun nuts.

Hate crimes against muslims?I cannot understand why there are so few.Personally speaking I do hate islam, but feel pity rather than hate for most muslims.The individuals I hate are the left-wing dhimmis and enablers.Paris Claims

gentilissimo Dario..non ti sembra che in fondo all’articolo sulle api anche su tutte le iniziative dell’UE..manchi qualcosa ..nel trafiletto si dimenticano d’informarcie quindi scrivere, che dopo queste ”faticose sedute”..c’è da scrivere ..”seguirà banchetto o rinfresco per gli addetti ai lavori”… loro,devono sempre ”mangiarci ..sopra..”

Almamaria,muistat varmaankin, miten olen noita röttelöitä harmitellut jo vuosikausia.Mutta ei vaan mitään ole tapahtunut. Miksiköhän on olemassa ympäristölautakuntia ja ympäristökatselmuksia?Nostavatko ne palkkiot tekemättömistä töistä, aargh. 🙁

An ESA account is only good to use for schooling. Do you know he is going to college? If that is what you want then go for it. But a regular account is better since there will be a chunk of money to do whatever he (or you) see fit. Will you be contributing money on a monthly basis or is it one time only? If you want safety, then a money market. Otherwise for more risk maybe a balanced fund (Vanguard Wellesley) or even a simple index fund with low expenses (like the vanguard 500 index).

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Dear Shalini,Nice to see your blog after a gap. Well written, somehow, this blog post took me to Sept 2008, my last visit to Pondy. You have explained in detail about the nature, especially the characteristic sunrise, the waves, seashore etc. etc.The picture posted, increased the feel, I must say!Thanks,Renjith

Very good blog you have here but I was curious if you knew of any forums that cover the same topics talked about in this article? I’d really like to be a part of group where I can get advice from other knowledgeable people that share the same interest. If you have any suggestions, please let me know. Thanks!

According to NAMI (national alliance on mental illness) : mental illnesses are medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to other and affect daily functioning Was this answer helpful?

SusieDefinitely intriguing. it makes the reader want more, with many questions they’ll want answered!Two edits; 1. Coming from a time of when kings – leave off the of… Just coming from a time when kings…2. Their enemies. The new mysterious allies, the wave keepers, and even themselves are all vying… (Maybe that helps the run-on)It is awesome, you are awesome… Don’t forget us when you’re a literary star!

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Colleen and Bruce, I’m speechless! You both look so wonderful! The pictures are beautiful and truly capture how great of a time you had! Priceless to have such a talented photographer to capture the moment! Colleen, you could be in a bridal magazine…you looked gorgeous! I can’t wait to hear all about it in person!

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O Senhor Primeiro-Ministro afinal não faz inaugurações. Vai apenas descerrar uma placa alusiva à sua passagem por Oleiros…francamente, Dr. Pedro Passos Coelho, não sei se será bom para tão importante hotel essa placa alusiva apenas à sua passagem por Oleiros. Espero que não dê azar, sinceramente. Espero, pois sou Amigo dos gestores e considero que a obra é de grande importância para a região. Paulino Fernandes, Director do Jornal de Oleiros

129Prometheus, JNorm, and Karen,Just wanted to let you know that I’m pleased with the positive tone of the discussion. I think an open and receptive attitude on our part will allow the Holy Spirit to bring us closer to Christ. Robert

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Side note: Did anyone notice there are 5 Asians on the Nobel roster this year. Is this an anomaly or a likely coming trend of the next 25- 50 years?. Now, Japan had developed its institutions a while back so one might expect them to snag a few. The looming question is whether China will develop the scientific temperament.

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É claro e evidente que o Felipe Massa amadureceu de um ano para cá. Não acho que o cavanhaque tenha a ver com isso, mas que ele está muito mais maduro, só não vê quem não quer.

Ja, där fick du lite färg, haha. Och där fick du till en rejäl generalisering, går inte jag heller med på som några ovan! Vad hände med alla blåvita kuddar du köpte på dig? Hade varit såååå fint med några av den i den viiita soffan! ;)Snart hittar du nog mattan med stort M, det gäller bara att ha tålamod. Lycka till, snäckan! =)

Okay.. Got it.. I follow your logic, and it makes sense.What about the 59% reduction in gun deaths in Australia since the 1996 legislation then? I agree that this has nothing to do with mass shootings, but it has tons to do with shooting deaths… How do you explain that?

Бабуля – это твоя несчастная мать, которая вовремя не сделала анализ на патологию развития плода и не избавила общество от такого дебила, как ты. (editor, прости. Надо, право, иногда давать по ноздрям разного рода уродам).

The movie was great but I think it helps to read the book first in this case. The book is so jam packed with stories that strengthen the relationships and make some of the actions make a lot of sense and the movie doesn’t always build the relationships as well. Still, definitely worth reading and watching the movie.

I do agree with all of the ideas you have presented in your post. They’re really convincing and will definitely work. Still, the posts are very short for starters. Could you please extend them a little from next time? Thanks for the post.

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I am madly in love with these men:Finnick Odair- The Hunger Games (Book)Peeta Mellark- The Hunger Games(Book)Trey Laporte- WEREling(Book)Jack Dawson- Titanic (Movie)Sherlock Holmes- Sherlock(TV series)The list of fictional men to fall in love with is endless. I wish with all my heart that these people were real. I still love real men, but the fictional ones will always have a place in my heart.

Crap. Why can't we just be like the French, have cool buildings, discrete quality mistresses, and adorable babes like Alizee? Hell, they even won the world cup for soccer or whatever a while ago. And I understand the English consider them decent enough to compete in Rugby. Prediction: record attendance and TV audience at the Masters this year ('cause a white guy might win?).

>merhaba,gecikmiÅŸ bir yorum belki ama yine de kısaca klasik olabilecek olan görüşlerimi iletmek isterim;-ah keÅŸke böyle düşünsel süreçleryaÅŸayarak çevirmeye çalışsak. ama sanırım hiç de böyle yaÅŸanmıyor.-her kelimeyi bire bir ve mutlaka çevirme zorlamasıyla yaklaÅŸmamalıyız en baÅŸtan itibaren.-ve teknolojiyi ithal eden ya da kullanan deÄŸil, icat eden olmalıyız ki kendi dilimizde istediÄŸimiz sözcüğü verebilelim…sevgi ve saygıyla,bulent_sahin.

valla benim kaşlar kalın tabi aşırı değil bi tek ortalarını ve dağınık duranları alıyorum.Yüz tipim kemikli olduğu içinde herkes çok yakıştırıyo ama kalın kaş herkese yakışmıyo maalesef. Her kalın kaş da güzel olmuyor ama benim kaşlarımın çok güzel olduğunu söylüyolar:D

e.a.f is full of it once again. It is indeed the union's job to set training and apprecenticships. This is what the Operating Engineers Union does quite often. The IWA used to do the same thing working with the forest companies. Also many of the building trades unions do the same thing.Don't be so anti-company. Be co-operative. A workable solution is out there.Whining isn't going to be it.

pmThere will always be those with no values. When people stop blaming it on the school system, the legal system or societal morality then we can finally realize, as a society, that there are simply a lot of people who don’t understand. I agree with Mike Maturen. Parents are individuals who bring up these individuals. We cannot simply generalize the situation with the tag of modern day “moral relativism”. Just slating our entire society is misguided at best.

Why not just bring up Coby Karl? Let him absorb some PG minutes. He knows the system, and the team. Seemed well liked enough, and costs next to nothing?Give Sun some more playing time, 5-8 minutes a game…Lots of better options than taking a cog out of the smooth moving machine.25-5 is not a problem, and the last 4 have been very nice to see.

27. Januar 2011Hallo Herr Stanic,vielen Dank für den Tipp.Offensichtlich hat IBM hier die Mail-Schablone / den Agenten “optimiert”. Kennen Sie Infos, wann das Problem / die Schablone offiziell gefixt wird?Liebe Grüße aus Leipzig

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Karocha,Eu sei isso tudo mas não é disso que se fala.Nestas coisas apenas me interessa a investigação e como foi feita.Não faz o meu género atirar palpites sobre casos mediáticos com pendor de tragédia e mistério.

Creo -por lógica- que: el punto (o la coma), se coloca después de las comillas (o paréntesis), si la frase así lo requiere.Ejemplo: “Mañana leeré “La noche de Adan” (si encuentro el libro)”.Merci.Amitiés,LR.

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Roasting vegetables is our new favorite way to eat just about any vegetable and these turnips look wonderful! And simple too. I will definitely give them a try and I'm glad your stretched your culinary muscles by trying something new too!

Yesterday, while I was at work, my sister stole my apple ipad and tested to see if it can survive a thirty foot drop, just so she can be a youtube sensation. My apple ipad is now broken and she has 83 views. I know this is completely off topic but I had to share it with someone!

Kann aber deine Frau verstehen. Bin auch in Deutschland auf dem Land aufgewachsen. Heute frage ich mich immer wieder, wie ich es da 18 Jahre aushalten konnte. Nie wieder würde ich zurück aufs Land ziehen. DIese Abgeschiedenheit, Ruhe und Natur macht einen Wahnsinnig. Darum mag ich auch Taipei. Da ist wenigstens immer Zivilisation. Man ist praktisch nie allein…Schon nach 3 Tagen Heimatbesuche versoüre ich den Drang zu entwischen 😉

Good point — regardless of what does or doesn’t happen with FPV, the AMA’s Safety Code needs to become more able to respond to the rapid changes in technology or it will simply argue for its own irrelevance as one technological advancement leapfrogs another.

Gibt es eine Aufzeichnung dieses Webinars (Einstiegsgehälter von Hochschulabsolventen – IT-Gehälter” – Marco-Tobias Arnold & Thomas Thüring, alma mater GmbH) da ich gestern aufgrund meiner Bachelorarbeit in einer Firma leider verhindert war :-/Viele GrüßeReiner

Rebecca – I’m so glad you liked this as much as you did. In my opinion, it’s a beautifully written story and I agree completely about Magnus Tait. The setting is so evocative isn’t it?? I think it’s really an excellent start to a great series.

Reminds me of the time Trevor had his entire 1st grade class convinced he was Jewish at Christmas time, except yours was unintentional.I envy your multicultural upbringing. But I’m glad I didn’t get to see real boobs at such a young age or I probably would never have accomplished anything else in life, I’d just want to sit on the beach all day

Excellente, intervention. Dans la continuité de la démystification de la compléxité du monde, ajoutons que : – beaucoup d’objets peuvent être des armes par destination – certains mots prononcés sans trop y réflechir peuvent se révéler bléssants – (j’ose une théorie) l’éxcès de débat pour

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Anyone tried the … Anyone tried the Monezilax System (do a google search)? I have heard many unbelivable things about it and my friend earn crazy amounts of money with it. Was this answer helpful?

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well look here Yacob aren’t you one to spout hatred. It is you and your hateful Talmud inculcated psychopaths who think that lying and killing gentiles is a religious duty that need removing from this world. You think you do no harm yet all I see is denial and a wish for revenge against anyone who dares to reveal the crimes committed by your goy hating kin. All you do is spout hate and make veiled threats…… You are sick and need incarceration.

to Lisa today, when I was growing up Valentine’s Day was never an issue here in NZ, it was always something that “Americans did” along with Halloween and cheerleaders. Sadly, cultural imperialism is winning, and Valentine’s Day is now celebrated here.I strongly object to any day that makes people feel obliged to be romantic. Well, apart from anniversaries and birthdays, of course!

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I’m so flattered by your description of me. If I can inspire self-confidence in others, I will have earned my groceries for the day. Truly, what more could anyone ask of their work? Thank you for the compliment and for the shout out.

Denise – Good point about starting with stringing together a few “aware” moments. Then increase the frequency of those “aware” moments throughout the day to build the momentum. Over time, it becomes a habit.

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L’Arche de Zoé, ex 4×4 sans frontières, a été dénoncée par un collectif d’ONG Å“uvrant en 2005 (déjà) à Banda aceh sur les lieux du Tsunami, pour des raisons similaires; Ils ont été expulsé après une débandade pitoyable et un pourrissement de la situation, abandonnant leur projet, leur campement et leurs salariés, laissant orphelins et familles dans le plus grand dénuement. Breteau est un récidiviste.

Se ho ben capito, almeno loro lo stipendio lo lasceranno in cassa (spero di aver capito bene, ma non son sicuro se ne lasceranno solo una parte ne` se lo faranno tutti)Il problema pero` e` il parlamento, che e` identico all’altro ieri.E` inutile che Monti stia a pane e acqua, rispetto al suo predecessore, se poi tutto il parlamento fa le stesse cose di prima (stipendi e pensioni a cinque cifre, voli di stato per amici e parenti… blablabla…)

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Frank: This reminds me of 2004 when Dem congressmen and NY Slimes went ballistic wrt Bush having (relatively modest) inaugurals during the “economic hard times”. They demanded that there will be no inaugural at all. Strange, I haven’t heard that talk now. Maybe the economic situation is now better so extravagant celebrations and massive bill to taxpayers is fine. Everything is relative..

– Dude these are so good my eyes hurt. Some truly legit PJ work in here man. I am in love with the family huddled under the tree. Dad and his gals. Never stop seeing ALL the stories dude. Bravo sir!

para todos y cada uno de los afiliados que han estado interesados. Seguimos entregando cuentas a todo el que la solicite.Es tan sencillo como entregar a cualquier miembro del comité : el nombre, apellidos y un correo electrónico personal, donde podamos mandar al afiliado el nombre de usuario y la contraseña del nuevo correo.


Ótima reflexão. Só acrescento mais um grande mal que o governo petista disseminou por toda a parte: a perda da dignidade do brasileiro. Como a prostituta vende seu corpo, milhões de brasileiros vendem a sua dignidade( e o seu voto) por algum trocado ofertado por esses quadrilheiros. Não há limites e nem quem freie os bandidos que tomaram conta desse Brasil que não é nação. Parabéns Gilson Não se cale( e nem se prostitua![]